Prediction of movement difficulties at age five from parent report at age two in children born extremely preterm

Aim:To assess the predictive validity of parent reported gross motor impairment (GMI) at age twoyears to detect significant movement difficulties (MD) at age five in children born extremely preterm.Method:  Data come from 556 children born <28 weeks’ gestation in 2011-12 in 10 Europeancountries. Parent report of moderate/severe GMI was defined as walking unsteadily or unable towalk unassisted at two years corrected age. Examiners assessed significant MD (score ≤5th percentileon the Movement Assessment Battery for Children, 2nd Edition) and diagnoses of cerebral palsy (CP)were collected via parent report at five years chronological age. Results:At two years, 66 (11.9%) children had moderate/severe GMI. At five years, 212 (38.1%) hadsignificant MD. Parent reports of GMI at age two accurately classified CP at age five in 91.0-93.2% ofchildren. Classification of moderate/severe GMI at age two had high specificity (96.2%; 95% CI 93.6%,98.0%) and positive predictive value (80.3%; 68.7%, 89.1%) for significant MD at age five. However,74.5% of children with significant MD at five years were not identified with moderate/severe GMI atage two, resulting in low sensitivity (25.1%; 19.4%, 31.5%). Interpretation: This questionnaire may be used to identify extremely preterm children at age twowho have a diagnosis of CP or MD that are likely to have a significant impact on their functionaloutcomes at age five. </p

Datasheet1_Detection of volatile organic compounds in headspace of Klebsiella pneumoniae and Klebsiella oxytoca colonies.docx

IntroductionEarly diagnosis of infections and sepsis is essential as adequate therapy improves the outcome. Unfortunately, current diagnostics are invasive and time-consuming, making diagnosis difficult, especially in neonatology. Novel non-invasive analytical methods might be suitable to detect an infection at an early stage and might even allow identification of the pathogen. Our aim is to identify specific profiles of volatile organic compounds (VOCs) of bacterial species.MethodsUsing multicapillary column-coupled ion mobility spectrometry (MCC/IMS), we performed headspace measurements of bacterial cultures from skin and anal swabs of premature infants obtained during weekly screening for bacterial colonization according to KRINKO. We analyzed 25 Klebsiella pneumoniae (KP) cultures on MacConkey (MC) agar plates, 25 Klebsiella oxytoca (KO) cultures on MC agar and 25 bare MC agar plates as a control group.ResultsUsing MCC/IMS, we identified a total of 159 VOC peaks. 85 peaks allowed discriminating KP and bare MC agar plates, and 51 peaks comparing KO and bare MC agar plates and 6 peaks between KP and KO (significance level of p DiscussionWe developed a method for the analysis of VOC profiles of bacteria. Using MCC/IMS, we demonstrated that VOCs derived from bacteria are clearly distinguishable from a bare agar plate. Characteristic peaks obtained by MCC/IMS are particularly suitable for the species-specific identification and differentiation of KP and KO. Thus, MCC/IMS might be a useful tool for in vitro diagnostics. Future studies must clarify whether similar patterns of VOCs can be detected in vivo in patients that are colonized or infected with KP or KO to enable rapid and accurate diagnosis of bacterial colonization.</p

The early educational environment at five years of age in a European cohort of children born very preterm: challenges and opportunities for research

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Motor-related health care among five-year-old extremely preterm children with movement difficulties: results from a European cohort

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Demographic characteristics of the infants.

<p>Demographic characteristics of the infants.</p

ASM and albumin TA concentrations in infants treated with iNO compared to placebo-treated controls.

<p>Serial TA samples were obtained from PD2 to PD14. Data are displayed as the mean of TA levels and SD on a logarithmic scale <b>A:</b> ASM TA levels were significantly elevated on PD14 in iNO-treated infants (⋆, p<0.05) and increased with advancing postnatal age from PD2 to PD14 in both groups (###, p<0.001). <b>B:</b> Albumin TA levels were not altered by iNO treatment and increased with advancing postnatal age from PD2 to PD14 in both groups (##, p<0.01). PD: postnatal day.</p

Cytokine TA concentrations in infants treated with iNO compared to placebo-treated controls.

<p>Serial TA samples were obtained from PD2 to PD14. Data are displayed as the mean of TA levels and SD on a logarithmic scale. <b>A:</b> TGF-β₁ TA levels were overall decreased by iNO treatment (⋆, p<0.05) and specifically decreased on PD2 (⋆, p<0.05) in iNO-treated infants. <b>B:</b> IL-1β TA levels were not significantly affected in iNO-treated infants and increased with advancing postnatal age from PD2 to PD14 in both groups (###, p<0.001). <b>C:</b> IL-6 TA levels were not altered by iNO treatment and increased with advancing postnatal age from PD2 to PD14 in both groups (#, p<0.05). <b>D:</b> NPY TA levels were not altered by iNO treatment or postnatal age. PD: postnatal day.</p

Human B cells generated in NOD-<i>scid</i>-<i>IL2Rγ^null</i> mice produce a globally diverse V_L immunoglobulin repertoire that is highly similar to normal human peripheral blood B cells.

<p>Engrafted HuMs cells use the full range of IGHK and IGHL families and with a pattern of utilization similar to control HuPBC samples. Frequencies of IGHK and IGHL family member use by B cells arising in HuPBC, HuMs, and HuMs-ImmB are comparable between any two samples examined across all gene families: <i>r_s≥</i>0.86 for <i>IGKV</i> (A); <i>r_s≥</i>0.7 for IGKJ (B); <i>r_s≥</i>0.85 for IGLV (C); <i>r_s≥</i>0.75 for IGLJ (D). Although highly similar overall, an overrepresentation of the IGKV4 family occurred among HuMs-ImmB sequences when compared to HuPBC-2 or any other sample (***<i>P</i><0.0001; χ²).</p

Somatic mutation in IgM primary repertoires.

<p>The ratio of replacement mutations in CDR-H1 and CDR-H2 (<i>R</i>_CDR) to the total number of mutations (<i>M</i>_v) is plotted on the <i>y</i>-axis versus <i>M</i>_v on the <i>x</i>-axis. The 95% confidence limit for the probability of random mutations is shaded in gray. Data points falling outside this limit represent IgM sequences with a significant occurrence of replacement mutations in the CDRs and are considered indicative of antigen selection. Data points are numbered according to their observed frequency. The overall paucity of somatic mutation in the V_H gene among humanized B cells is visually apparent. Replacement mutations in CDR-H1 or CDR-H2 are rare. Whereas this result is expected for humanized samples HuMs-1 and HuMs-2 (naïve CD19⁺IgD⁺CD27^– splenic B cells), and expected for HuMs-ImmB (newly formed, immature bone marrow B cells), HuMs-3 was prepared from bulk spleen and could conceivably have captured a subpopulation of somatically mutated human IgM⁺ memory cells. Whereas greater than 99% of humanized HuMs B cells show no evidence for antigen selection (nonrandom mutation), HuPBC cells show an approximately ten-fold (4.83%) to twenty-fold (7.65%) greater proportion of antigen-selected sequences.</p

Summary of sequence reads generated for each humanized mouse (HuMs), pooled humanized mouse immature B cells (HuMs-ImmB), and human peripheral blood B cell samples (HuPBC).

<p>Summary of sequence reads generated for each humanized mouse (HuMs), pooled humanized mouse immature B cells (HuMs-ImmB), and human peripheral blood B cell samples (HuPBC).</p