Cerebral Autoregulation in Sick Infants:Current Insights

Cerebrovascular autoregulation is the ability to maintain stable cerebral blood flow within a range of cerebral perfusion pressures. When cerebral perfusion pressure is outside the limits of effective autoregulation, the brain is subjected to hypoperfusion or hyperperfusion, which may cause vascular injury, hemorrhage, and/or hypoxic white matter injury. Infants born preterm, after fetal growth restriction, with congenital heart disease, or with hypoxic-ischemic encephalopathy are susceptible to a failure of cerebral autoregulation. Bedside assessment of cerebrovascular autoregulation would offer the opportunity to prevent brain injury. Clinicians need to know which patient populations and circumstances are associated with impaired/absent cerebral autoregulation

IF impedance and mixer gain of NbN hot electron bolometers

The intermediate frequency (IF) characteristics, the frequency dependent IF impedance, and the mixer conversion gain of a small area hot electron bolometer (HEB) have been measured and modeled. The device used is a twin slot antenna coupled NbN HEB mixer with a bridge area of 1×0.15 µm^2, and a critical temperature of 8.3 K. In the experiment the local oscillator frequency was 1.300 THz, and the (IF) 0.05–10 GHz. We find that the measured data can be described in a self-consistent manner with a thin film model presented by Nebosis et al. [Proceedings of the Seventh International Symposium on Space Terahertz Technology, Charlottesville, VA, 1996 (unpublished), pp. 601–613], that is based on the two temperature electron-phonon heat balance equations of Perrin-Vanneste [J. Phys. (Paris) 48, 1311 (1987)]. From these results the thermal time constant, governing the gain bandwidth of HEB mixers, is observed to be a function of the electron-phonon scattering time, phonon escape time, and the electron temperature. From the developed theory the maximum predicted gain bandwidth for a NbN HEB is found to be 5.5–6 GHz. In contrast, the gain bandwidth of the device under discussion was measured to be ~2.3 GHz which, consistent with the outlined theory, is attributed to a somewhat low critical temperature and nonoptimal film thickness (6 nm)

Full characterization and analysis of a terahertz heterodyne receiver based on a NbN hot electron bolometer

We present a complete experimental characterization of a quasioptical twin-slot antenna coupled small area (1.0×0.15 µm^2) NbN hot electron bolometer (HEB) mixer compatible with currently available solid state tunable local oscillator (LO) sources. The required LO power absorbed in the HEB is analyzed in detail and equals only 25 nW. Due to the small HEB volume and wide antenna bandwidth, an unwanted direct detection effect is observed which decreases the apparent sensitivity. Correcting for this effect results in a receiver noise temperature of 700 K at 1.46 THz. The intermediate frequency (IF) gain bandwidth is 2.3 GHz and the IF noise bandwidth is 4 GHz. The single channel receiver stability is limited to 0.2–0.3 s in a 50 MHz bandwidth

Switching Casimir forces with Phase Change Materials

We demonstrate here a controllable variation in the Casimir force. Changes in the force of up to 20% at separations of ~100 nm between Au and AgInSbTe (AIST) surfaces were achieved upon crystallization of an amorphous sample of AIST. This material is well known for its structural transformation, which produces a significant change in the optical properties and is exploited in optical data storage systems. The finding paves the way to the control of forces in nanosystems, such as micro- or nanoswitches by stimulating the phase change transition via localized heat sources.Comment: 7 pages, 3 figures The AFM images for the inset in Fig.2 were replaced with new ones as obtained with tips having high aspect rati

Clinical usefulness of splanchnic oxygenation in predicting necrotizing enterocolitis in extremely preterm infants:a cohort study

Background: Impaired intestinal microcirculation seems to play an important role in the pathogenesis of necrotizing enterocolitis (NEC). A previous study showed that a SrSO2 &lt; 30% is associated with an increased risk of developing of NEC. We aimed to determine the clinical usefulness of the cut off &lt; 30% for SrSO2 in predicting NEC in extremely preterm neonates.Methods: This is a combined cohort observational study. We added a second cohort from another university hospital to the previous cohort of extremely preterm infants. SrSO2 was measured for 1–2 h at days 2–6 after birth. To determine clinical usefulness we assessed sensitivity, specificity, positive and negative predictive values for mean SrSO2 &lt; 30. Odds ratio to develop NEC was assessed with generalized linear model analysis, adjusting for center.Results: We included 86 extremely preterm infants, median gestational age 26.3 weeks (range 23.0-27.9). Seventeen infants developed NEC. A mean SrSO2 &lt; 30% was found in 70.5% of infants who developed NEC compared to 33.3% of those who did not (p = 0.01). Positive and negative predictive values were 0.33 CI (0.24–0.44) and 0.90 CI (0.83–0.96), respectively. The odds of developing NEC were 4.5 (95% CI 1.4–14.3) times higher in infants with SrSO2 &lt; 30% compared to those with SrSO2 ≥ 30%.Conclusions: A mean SrSO2 cut off ≥ 30% in extremely preterm infants between days 2–6 after birth may be useful in identifying infants who will not develop NEC.</p

Terahertz hot electron bolometer waveguide mixers for GREAT

Supplementing the publications based on the first-light observations with the German Receiver for Astronomy at Terahertz frequencies (GREAT) on SOFIA, we present background information on the underlying heterodyne detector technology. We describe the superconducting hot electron bolometer (HEB) detectors that are used as frequency mixers in the L1 (1400 GHz), L2 (1900 GHz), and M (2500 GHz) channels of GREAT. Measured performance of the detectors is presented and background information on their operation in GREAT is given. Our mixer units are waveguide-based and couple to free-space radiation via a feedhorn antenna. The HEB mixers are designed, fabricated, characterized, and flight-qualified in-house. We are able to use the full intermediate frequency bandwidth of the mixers using silicon-germanium multi-octave cryogenic low-noise amplifiers with very low input return loss. Superconducting HEB mixers have proven to be practical and sensitive detectors for high-resolution THz frequency spectroscopy on SOFIA. We show that our niobium-titanium-nitride (NbTiN) material HEBs on silicon nitride (SiN) membrane substrates have an intermediate frequency (IF) noise roll-off frequency above 2.8 GHz, which does not limit the current receiver IF bandwidth. Our mixer technology development efforts culminate in the first successful operation of a waveguide-based HEB mixer at 2.5 THz and deployment for radioastronomy. A significant contribution to the success of GREAT is made by technological development, thorough characterization and performance optimization of the mixer and its IF interface for receiver operation on SOFIA. In particular, the development of an optimized mixer IF interface contributes to the low passband ripple and excellent stability, which GREAT demonstrated during its initial successful astronomical observation runs.Comment: Accepted for publication in A&A (SOFIA/GREAT special issue

Antenatal Magnesium Sulfate and Preeclampsia Differentially Affect Neonatal Cerebral Oxygenation

Introduction: Magnesium sulfate (MgSO4) is frequently administered for maternal and fetal neuroprotection in preeclampsia (PE) and imminent preterm birth, respectively. Objective: To assess whether MgSO4 affects neonatal cerebral oxygenation, blood flow, and cerebral autoregulation (CAR) during the first postnatal days independently from PE. Methods: 148 neonates 0.5) was determined. Linear mixed models were applied. Results: MgSO4 exposure was recorded in 77 neonates. Twenty-nine neonates were born following PE. MgSO4 independently lowered cFTOE (B: -0.026, 95% CI: -0.050 to 0.002, p < 0.05) but did not affect PSV and RI. PE was associated with a lower cFTOE (B: -0.041, 95% CI: -0.067 to -0.015, p < 0.05) and a tendency towards both lower PSV (B: -4.285, 95% CI: -9.067 to 0.497, p < 0.1) and more impaired CAR (B: 4.042, 95% CI: -0.028 to 8.112, p < 0.1), which seemed to be strongly mediated by fetal brain sparing. MgSO4 did not alter CAR. Conclusions: In contrast to fetal brain sparing in PE, MgSO4 seems to lower cFTOE by lowering cerebral oxygen demands in preterm neonates without affecting the cerebrovasculature

Time to full enteral feeding after necrotizing enterocolitis in preterm-born children is related to neurodevelopment at 2-3 years of age

BACKGROUND: Necrotizing enterocolitis (NEC) is associated with poorer neurodevelopment. It is, however, unclear which factors besides surgery affect neurodevelopment in preterm-born children surviving NEC. AIMS: We determined whether time to full enteral feeding (FEFt) and post-NEC complications after NEC were associated with neurodevelopment. STUDY DESIGN: Prospective observational cohort study. SUBJECTS: Two to three year old preterm-born children who survived NEC (Bells stage ≥ 2). We categorized children in two groups, one group shorter and equal and one group longer than the group's median FEFt. Post-NEC complications included recurrent NEC and/or post-NEC stricture. OUTCOME MEASURES: Bayley Scales of Infants and Toddler Development III (Bayley-III) and Child Behavior Checklist (CBCL). Associations between Bayley-III and CBCL scores with FEFt and Post-NEC complications were determined using linear regression analyses, adjusted for severity of illness and potential confounders. RESULTS: We included 44 children, median gestational age of 27.9 [IQR: 26.7-29.3] weeks, birth weight 1148 [IQR: 810-1461] grams. Median FEFt after NEC was 20 [IQR: 16-30] days. Median follow-up age was 25.7 [IQR: 24.8-33.5] months. FEFt > 20 days was associated with lower cognitive and lower motor composite scores of the Bayley-III (B: -8.6, 95% CI -16.7 to -0.4, and B: -9.0, 95% CI, -16.7 to -1.4). FEFt was not associated with CBCL scores. Post-NEC complications (n = 11) were not associated with Bayley-III scores nor with CBCL scores. CONCLUSIONS: Prolonged FEFt after NEC in preterm-born children surviving NEC is associated with lower cognitive and lower motor composite scores at the age of 2-3 years. These results show the importance of limiting the duration of the nil per mouth regimen if and when possible

Maturation of Intestinal Oxygenation:A Review of Mechanisms and Clinical Implications for Preterm Neonates

Nutrient requirements of preterm neonates may be substantial, to support growth and maturation processes in the presence of challenging post-natal circumstances. This may be accompanied by substantial intestinal oxygen requirements. Preterm neonates may not be able to meet these oxygen requirements, due to a developmental delay in intestinal oxygenation regulation mechanisms. This review summarizes the available literature on post-natal maturation of intestinal oxygenation mechanisms and translates these changes into clinical observations and potential implications for preterm neonates. The different mechanisms that may be involved in regulation of intestinal oxygenation, regardless of post-natal age, are first discussed. The contribution of these mechanisms to intestinal oxygenation regulation is then evaluated in newborn and mature intestine. Finally, the course of clinical observations is used to translate these findings to potential implications for preterm neonates

Ultrafast Ge-Te bond dynamics in a phase-change superlattice

A long-standing question for avant-garde data storage technology concerns the nature of the ultrafast photoinduced phase transformations in the wide class of chalcogenide phase-change materials (PCMs). Overall, a comprehensive understanding of the microstructural evolution and the relevant kinetics mechanisms accompanying the out-of-equilibrium phases is still missing. Here, after overheating a phase-change chalcogenide superlattice by an ultrafast laser pulse, we indirectly track the lattice relaxation by time resolved x-ray absorption spectroscopy (tr-XAS) with a sub-ns time resolution. The approach to the tr-XAS experimental results reported in this work provides an atomistic insight of the mechanism that takes place during the cooling process; meanwhile a first-principles model mimicking the microscopic distortions accounts for a straightforward representation of the observed dynamics. Finally, we envisage that our approach can be applied in future studies addressing the role of dynamical structural strain in PCMs.M.M. acknowledges the support of the BACH beamline staff during the synchrotron experiments and Roberta Ciprian for insightful discussions. This work was supported by EU within FP7 project PASTRY [GA 317764]