Perinatal factors and high-sensitive C-reactive protein levels during adolescence

Objective: To examine whether perinatal factors are associated with low-grade inflammation measured by high-sensitivity C-reactive protein levels during adolescence. Methods: Nested case-control study of 125 teenagers who were born by Cesarean delivery and had high-sensitivity C-reactive protein levels determined at 15-17 years. Data on obstetric and perinatal factors were recorded prospectively at the time of their birth. Results: Median values of high-sensitivity C-reactive protein were significantly higher in teenagers, who were born as large for gestational age or with maternal diabetes compared to others (2.54 vs 0.34 mg/L; p < 0.024), and born during spring or summer compared to those born during winter or autumn (0.48 vs 0.27 mg/L; p < 0.023). No other perinatal associations were detected (for ex. such as electivity of operation, onset of labor, rupture of fetal membranes, cervical dilatation at delivery, gestational age, Apgar scores at 5 min, umbilical blood pH value, administration of neonatal antibiotics or need of neonatal intensive care treatment) in CRP levels. Further, teenagers with current body mass index in the highest tertile, regular medication for chronic disease and girls using oral contraceptives had significantly higher high-sensitivity C-reactive protein levels than others. Conclusion: Prenatal exposures such as maternal metabolic environment and seasonality may have longterm effects on the low-grade inflammation and later cardiometabolic risks. Seasonality might be partly explained by maternal vitamin D levels during pregnancy, and thus future efforts are warranted to ensure sufficient vitamin D availability during pregnancy. Surprisingly, no other significant associations were detected between perinatal characteristics and high-sensitivity C-reactive protein levels.Peer reviewe

Lung Injury After Neonatal Congenital Cardiac Surgery Is Mild and Modifiable by Corticosteroids

Objectives: The present study was performed to determine whether lung injury manifests as lung edema in neonates after congenital cardiac surgery and whether a stress-dose corticosteroid (SDC) regimen attenuates postoperative lung injury in neonates after congenital cardiac surgery. Design: A supplementary report of a randomized, double-blinded, placebo-controlled clinical trial. Setting: A pediatric tertiary university hospital. Participants: Forty neonates (age Measurements and Main Results: The chest radiography lung edema score was lower in the SDC than in the placebo group on the first postoperative day (POD one) (p = 0.03) and on PODs two and three (p = 0.03). Furthermore, a modest increase in the edema score of 0.9 was noted in the placebo group, whereas the edema score remained at the preoperative level in the SDC group. Postoperative dynamic respiratory system compliance was higher in the SDC group until POD three (p < 0.01). However, postoperative oxygenation; length of mechanical ventilation; and tracheal aspirate biomarkers of inflammation and oxidative stress, namely interleukin-6, interleukin-8, resistin, and 8-isoprostane, showed no differences between the groups. Conclusions: The SDC regimen reduced the development of mild and likely clinically insignificant radiographic lung edema and improved postoperative dynamic respiratory system compliance without adverse events, but it failed to improve postoperative oxygenation and length of mechanical ventilation. (C) 2021 The Authors. Published by Elsevier Inc.Peer reviewe

Levosimendan versus Milrinone for Inotropic Support in Pediatric Cardiac Surgery: Results from a Randomized Trial

Objective : We aimed to determine the differential effects of intra-operative administration of milrinone versus levosimendan on myocardial function after pediatric cardiac surgery. Transthoracic echocardiography was employed for myocardial function evaluation, utilizing biventricular longitudinal strain with two-dimensional speckle tracking echocardiography in addition to conventional echocardiographic variables. Design : A secondary analysis of a randomized, prospective, double-blinded clinical drug trial Setting : Two pediatric tertiary university hospitals Participants : Infants between 1-12 months of age diagnosed with ventricular septal defect, complete atrioventricular septal defect, or tetralogy of Fallot who were scheduled for corrective surgery with cardiopulmonary bypass. Interventions : The patients were randomized to receive an infusion of milrinone or levosimendan at the start of cardiopulmonary bypass and for 26 consecutive hours. Measurements and main results : Biventricular longitudinal strain and conventional echocardiographic variables were measured preoperatively, on the first postoperative morning and prior to hospital discharge. The association between perioperative parameters and postoperative myocardial function was also investigated. Images were analyzed for left ventricular (n=67) and right ventricular (n=44) function. The day after surgery, left ventricular longitudinal strain was deteriorated in both the milrinone and levosimendan groups; 33% and 39%, respectively. The difference was not significant. The corresponding deterioration in right ventricular longitudinal strain was 42% and 50% (non-significant difference). For both groups, biventricular longitudinal strain approached their preoperative values at hospital discharge. Preoperative N-terminal pro-brain natriuretic peptide could predict the left ventricular strain on postoperative day one (p=0.014). Conclusions : Levosimendan was comparable to milrinone for left and right ventricular inotropic support in pediatric cardiac surgery.Peer reviewe

The dynamic course of peripartum depression across pregnancy and childbirth

Objective Peripartum depression (PPD) pertaining to depression in pregnancy and postpartum is one of the most common complications around childbirth with enduring adverse effects on mother and child health. Although psychiatric symptoms may improve or worsen over time, relatively little is known about the course of PPD symptoms and possible fluctuations Methods We applied a person-centered approach to examine PPD symptom patterns across pregnancy and childbirth. 824 women were assessed at three time points: first trimester (T1), third trimester (T2), and again at eight weeks (T3) postpartum. We assessed PPD symptoms, maternal mental health history, and childbirth variables Results Growth mixture modeling (GMM) analysis revealed four discrete PPD symptom trajectory classes including chronic PPD (1.1%), delayed (10.2%), recovered (7.2%), and resilient (81.5%). Delivery complications were associated with chronic PPD but also with the recovered PPD trajectory class. History of mental health disorders was associated with chronic PPD and the delayed PPD class Conclusion The findings underscore that significant changes in a woman’s depression level can occur across pregnancy and childbirth. While a minority of women experience chronic PDD, for others depression symptoms appear to significantly alleviate over time, suggesting a form of recovery. Our findings support a personalized medicine approach based on the woman’s symptom trajectory. Future research is warranted to identify the mechanisms underlying modifications in PPD symptoms severity and those implicated in recovery.Peer reviewe

Carbon-supported shape-controlled Pt nanoparticle electrocatalysts for direct alcohol fuel cells

The demand for power sources alternative to fossil fuels makes urgent the development of more efficient electrocatalysts for fuel cells applications and the maximization of the performances of the existent ones. This work reports, for the first time, the use of carbon-supported shape-controlled Pt nanoparticles as anode catalysts in direct ethanol fuel cells. By using cubic Pt nanoparticles, on which (100) surface sites are predominant, the performance of the fuel cell can be increased from 14 to 24 mW per mg of Pt when compared with cuboctahedral nanoparticles. Moreover, the open circuit potential shifts about 50 mV toward more positive potentials. In comparison with commercially available Pt catalysts, the performance for the (100) preferentially oriented nanoparticles is about three times higher. The reported results evidence that, from an applied point of view, the effect of the surface structure/shape of the electrocatalysts can be also considered to improve the performance of real fuel cell systems.The financial support from Aalto University is acknowledged

Kuopio birth cohort - design of a Finnish joint research effort for identification of environmental and lifestyle risk factors for the wellbeing of the mother and the newborn child

Background: A Finnish joint research effort Kuopio Birth Cohort (KuBiCo) seeks to evaluate the effects of genetics, epigenetics and different risk factors (medication, nutrition, lifestyle factors and environmental aspects) during pregnancy on the somatic and psychological health status of the mother and the child. Methods: KuBiCo will ultimately include information on 10,000 mother-child pairs who have given their informed consent to participate in this cohort. Identification of foetal health risk factors that can potentially later manifest as disease requires a repository of relevant biological samples and a flexible open up-to-date data handling system to register, store and analyse biological, clinical and questionnaire-based data. KuBiCo includes coded questionnaire-based maternal background data gathered before, during and after the pregnancy and bio-banking of maternal and foetal samples that will be stored in deep freezers. Data from the questionnaires and biological samples will be collected into one electronic database. KuBiCo consists of several work packages which are complementary to each other: Maternal, foetal and placental metabolism and omits; Paediatrics; Mental wellbeing; Prenatal period and delivery; Analgesics and anaesthetics during peripartum period; Environmental effects; Nutrition; and Research ethics. Discussion: This report describes the set-up of the KuBiCo and descriptive analysis from 3532 parturients on response frequencies and feedback to KuBiCo questionnaires gathered from June 2012 to April 2016. Additionally, we describe basic demographic data of the participants (n = 1172). Based on the comparison of demographic data between official national statistics and our descriptive analysis, KuBiCo represents a cross-section of Finnish pregnant women.Peer reviewe

Molecular layer deposition of "magnesicone", a magnesium-based hybrid material

Molecular layer deposition (MLD) offers the deposition of ultrathin and conformal organic or hybrid films which have a wide range of applications. However, some critical potential applications require a very specific set of properties. For application as desiccant layers in water barrier films, for example, the films need to exhibit water uptake and swelling and be overcoatable. For application as a backbone for a solid composite electrolyte for lithium ions on the other hand, the films need to be stable against lithium and need to be transformable from a hybrid MLD film to a porous metal oxide film. Magnesium-based MLD films, called "magnesicone", are promising on both these aspects, and thus, an MLD process is developed using Mg(MeCp)(2) as a metal source and ethylene glycol (EG) or glycerol (GL) as organic reactants. Saturated growth could be achieved at 2 to 3 angstrom/cycle in a wide temperature window from 100 to 250 degrees C. The resulting magnesicone films react with ambient air and exhibit water uptake, which is in the case of the GL-based films associated with swelling (up to 10%) and in the case of EG-based magnesicone with Mg(CO)(3) formation, and are overcoatable with an ALD of Al2O3. Furthermore, by carefully tuning the annealing rate, the EG-grown films can be made porous at 350 degrees C. Hence, these functional tests demonstrate the potential of magnesicone films as reactive barrier layers and as the porous backbone of lithium ion composite solid electrolytes, making it a promising material for future applications

Rapid Tooling Method for Soft Customized Removable Oral Appliances

Traditionally oral appliances i.e. removable orthodontic appliances, bite splints and snoring / sleep apnea appliances are made with alginate impressions and wax registrations. Our aim was to describe the process of manufacturing customized oral appliances with a new technique i.e. rapid tooling method. The appliance should ideally be custom made to match the teeth. An orthodontic patient, scheduled for conventional orthodontic treatment, served as a study subject. After a precise clinical and radiographic examination, the approach was to digitize the patient’s dental arches and then to correct them virtually by computer. Additive manufacturing was then used to fabricate a mould for a soft customized appliance. The mould was manufactured using stereolithography from Somos ProtoGen O-XT 18420 material. Casting material for the mould to obtain the final appliance was silicone. As a result we managed to create a customized soft orthodontic appliance. Also, the accuracy of the method was found to be adequate. Two versions of the described device were manufactured: one with small and one with moderate orthodontic force. The study person also gave information on the subjective patient adaptation aspects of the oral appliance