Bronchopulmonary dysplasia and neurodevelopmental outcome in extremely preterm neonates

We tested the hypothesis that the use of supplemental oxygen (sO(2)) at discharge from the NICU in extremely preterm neonates is associated with a greater risk of neurodevelopmental impairment (NDI) at 18 months corrected gestational age (CGA) than the risk of NDI of those neonates discharged in room air. Four hundred twenty-four charts were retrospectively reviewed from infants born at <27 weeks and transferred to Nationwide Children’s Hospital from December 1, 2004 to June 14, 2010. Use of sO(2) was evaluated on day of life (dol) 28, at 36 weeks post-menstrual age (PMA), and at discharge. Logistic regression was used to identify postnatal risk factors associated with sO(2) at discharge and NDI. At dol 28, 96 % of surviving patients received sO(2), and therefore had bronchopulmonary dysplasia (BPD) by definition from a National Institutes of Child Health and Human Development workshop. At 36 weeks PMA, 89 % continued on sO(2) (moderate/severe BPD), and at discharge, 74 % continued on sO(2). When factors associated with NDI were examined, the need for mechanical ventilation ≥28 days (adjOR = 3.21, p = 0.01), grade III–IV intraventricular hemorrhage (IVH) (adjOR = 4.61, p < 0.01), and discharge at >43 weeks PMA (adjOR = 2.12, p = 0.04) were the strongest predictors of NDI at 18 months CGA. There was no difference in Bayley Scales of Infant Development, third edition composite scores between patients with no/mild BPD and patients with moderate/severe BPD (cognitive p = 0.60, communication p = 0.53, motor p = 0.19) or those scores between patients on and off oxygen at discharge (cognitive p = 0.58, communication p = 0.70, motor p = 0.62). Conclusions: The need for sO(2) at discharge is not associated with an increased risk of NDI in these patients. The strongest predictors of poor neurodevelopmental outcome in this population were prolonged positive pressure support, grade III–IV IVH, and discharge at >43 weeks PMA

Anisotropic eddy-viscosity concept for strongly detached unsteady flows

The accurate prediction of the flow physics around bodies at high Reynolds number is a challenge in aerodynamics nowadays. In the context of turbulent flow modeling, recent advances like large eddy simulation (LES) and hybrid methods [detached eddy simulation (DES)] have considerably improved the physical relevance of the numerical simulation. However, the LES approach is still limited to the low-Reynolds-number range concerning wall flows. The unsteady Reynolds-averaged Navier–Stokes (URANS) approach remains a widespread and robust methodology for complex flow computation, especially in the near-wall region. Complex statistical models like second-order closure schemes [differential Reynolds stress modeling (DRSM)] improve the prediction of these properties and can provide an efficient simulationofturbulent stresses. Fromacomputational pointofview, the main drawbacks of such approaches are a higher cost, especially in unsteady 3-D flows and above all, numerical instabilities

Floquet analysis of secondary instability of boundary layers distorted by Klebanoff streaks and Tollmien-Schlichting waves

Previous studies of the interaction between boundary layer streaks and Tollmien-Schlichting (TS) waves have shown puzzling effects. Streaks were shown to reduce the growth rate of primary TS waves and, thereby, to delay transition; however, they can also promote transition by inducing a secondary instability. The outcome of the interaction depends on the spanwise wavelength and intensity of the streaks as well as on the amplitude of the TS waves. A Floquet analysis of secondary instability is able to explain many of these features. The base state is periodic in two directions: it is an Ansatz composed of a saturated TS wave (periodic in x) and steady streaks (periodic in z). Secondary instability analysis is extended to account for the doubly periodic base flow. Growth rate computations show that, indeed, the streak can either enhance or diminish the overall stability of the boundary layer. The stabilizing effect is a reduction in the growth rate of the primary two-dimensional TS wave; the destabilizing effect is a secondary instability. Secondary instability falls into two categories, depending on the spanwise spacing of the streaks. The response of one category to perturbations is dominated by fundamental and subharmonic instability; the response of the other is a detuned instability

Intergenerational correlations in size at birth and the contribution of environmental factors: The Uppsala Birth Cohort Multigenerational Study, Sweden, 1915-2002.

Sizes at birth of parents and their children are known to be correlated, reflecting in part the influence of fetal and maternal genes. Sociodemographic factors, regarded as aspects of the shared environment across generations, would also be expected to contribute, but evidence is limited. In the present study, the authors aimed to quantify the role of the shared environment in explaining intergenerational correlations in birth weight and length by using data across 3 consecutive generations from the Uppsala Birth Cohort Multigenerational Study in Uppsala, Sweden. That study included birth and sociodemographic data on 7,657 singletons born in Uppsala in 1915-1929 (generation 1) and their grandchildren (generation 3). Standard regression and biometric models were used to study the correlations in size at birth of generation 1-generation 3 pairs. The data showed stronger correlations in maternal pairs than in paternal pairs for birth weight (0.125 vs. 0.096, P = 0.02) but not for birth length (0.097 vs. 0.093, P = 0.77). These correlations were not reduced by adjustment for sociodemographic factors in regression models. In contrast, significant shared-environment contributions to the intergenerational correlations were identified in biometric models, averaging 14% for both birth measures. These models assumed a common latent factor for the sociodemographic variables. The present results show that the shared environment moderately but significantly contributes to intergenerational correlations

Maternal Pregnancy Levels of trans-Nonachlor and Oxychlordane and Prevalence of Cryptorchidism and Hypospadias in Boys

Background: The etiologies of the male urogenital anomalies—cryptorchidism and hypospadias—are poorly understood. Given positive associations between chlordane isomers and testicular germ cell tumors, it is reasonable to assume that chlordanes might also be associated with other testicular dysgenesis syndrome disorders, namely cryptorchidism and hypospadias

Maternal Body Mass Index and Daughters’ Age at Menarche

The role of inter-generational influences on age at menarche has not been explored far beyond the association between mothers’ and daughters’ menarcheal ages. Small size at birth and childhood obesity have been associated with younger age at menarche, but the influence of maternal overweight or obesity on daughters’ age at menarche has not been thoroughly examined