Preterm Infant Feeding and Cardiorespiratory Stability

Purpose: The primary purpose of this study was to investigate the effect of two different bottle feeding positions on a preterm infant's cardiorespiratory stability while feeding. Other factors associated with feeding success such as feeding duration, volume of consumption, gestational age, and day of life were also examined with respect to the feeding positions used. The long term objective for this line of investigation was to develop a neonatal intensive care unit feeding position protocol in order to decrease length of stay, improve oral feeding success, reduce health care costs, and prevent future feeding problems.Background: Of all live births in the United States, approximately 12% are to premature infants and of those born prematurely 90% will require admission to a neonatal intensive care unit (NICU). Although technological advances have improved preterm infant survival rates, they have failed to decrease medical costs and length of hospital stay. This is due mostly to the preterm infant's failure to oral feed successfully. As a result, research efforts tend to focus on oral feeding skills, the transition period from nasogastric to oral feeding, oral feeding readiness, and oral feeding advancement. However, little attention has been given to bottle feeding positions used and the preterm infant's cardiorespiratory stability.Methods: The study used a randomized, two-period, cross-over design to test Upright (45 degree head up) and Cradle (15 degree head up) feeding positions on cardiorespiratory stability. Feeding positions were administered by a NICU nurse on 12 medically stable, bottle feeding infants who were < 35 weeks gestational age.Results: Subject demographics were similar between each order grouping. Findings indicated that neither the Cradle nor the Upright feeding positions had a statistically significant effect on the preterm infant's cardiorespiratory stability. No significant relationships were found between feeding positions, volume of consumption, gestational age, and day of life as well. However, results suggested that preterm infants experienced a somewhat slower heart rate (p = .005), higher oxygen saturation level (p = .02), and although non-significant, a slightly shorter feeding duration (p = .27) when held in an Upright position as compared to the Cradle position

Effect of left atrial and ventricular abnormalities on renal transplant recipient outcome—a single-center study

Background: Premature cardiovascular (CV) death is the commonest cause of death in renal transplant recipients. Abnormalities of left ventricular (LV) structure (collectively termed uremic cardiomyopathy) and left atrial (LA) dilation, a marker of fluid status and diastolic function, are risk factors for reduced survival in patients with end stage renal disease (ESRD). In the present analysis, we studied the impact of pre-transplant LA and LV abnormalities on survival after successful renal transplantation (RT).&lt;p&gt;&lt;/p&gt; Methods: One hundred nineteen renal transplant recipients (first transplant, deceased donors) underwent cardiovascular MRI (CMR) as part of CV screening prior to inclusion on the waiting list. Data regarding transplant function and patient survival after transplantation were collected.&lt;p&gt;&lt;/p&gt; Results: Median post-transplant follow-up was 4.3 years (interquartile range (IQR) 1.9, 6.2). During the post-transplant period, 13 patients returned to dialysis after graft failure and 23 patients died with a functioning graft. Survival analyses, censoring for patients returning to dialysis, showed that pre-transplant LV hypertrophy and elevated LA volume were significantly associated with reduced survival after transplantation. Multivariate Cox regression analyses demonstrated that longer waiting time, poorer transplant function, presence of LV hypertrophy and higher LA volume on screening CMR and female sex were independent predictors of death in patients with a functioning transplant.&lt;p&gt;&lt;/p&gt; Conclusions: Presence of LVH and higher LA volume are significant, independent predictors of death in patients who are wait-listed and proceed with renal transplantation.&lt;p&gt;&lt;/p&gt; METHODS: One hundred nineteen renal transplant recipients (first transplant, deceased donors) underwent cardiovascular MRI (CMR) as part of CV screening prior to inclusion on the waiting list. Data regarding transplant function and patient survival after transplantation were collected.&lt;p&gt;&lt;/p&gt; RESULTS: Median post-transplant follow-up was 4.3 years (interquartile range (IQR) 1.9, 6.2). During the post-transplant period, 13 patients returned to dialysis after graft failure and 23 patients died with a functioning graft. Survival analyses, censoring for patients returning to dialysis, showed that pre-transplant LV hypertrophy and elevated LA volume were significantly associated with reduced survival after transplantation. Multivariate Cox regression analyses demonstrated that longer waiting time, poorer transplant function, presence of LV hypertrophy and higher LA volume on screening CMR and female sex were independent predictors of death in patients with a functioning transplant.&lt;p&gt;&lt;/p&gt; CONCLUSIONS: Presence of LVH and higher LA volume are significant, independent predictors of death in patients who are wait-listed and proceed with renal transplantation

Multiple Input Phoneme Therapy: An Approach to Severe Apraxia and Expressive Aphasia

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Hypoxia-mimicking bioactive glass/collagen glycosaminoglycan composite scaffolds to enhance angiogenesis and bone repair.

One of the biggest challenges in regenerative medicine is promoting sufficient vascularisation of tissue-engineered constructs. One approach to overcome this challenge is to target the cellular hypoxia inducible factor (HIF-1α) pathway, which responds to low oxygen concentration (hypoxia) and results in the activation of numerous pro-angiogenic genes including vascular endothelial growth factor (VEGF). Cobalt ions are known to mimic hypoxia by artificially stabilising the HIF-1α transcription factor. Here, resorbable bioactive glass particles (38 μm and 100 μm) with cobalt ions incorporated into the glass network were used to create bioactive glass/collagen-glycosaminoglycan scaffolds optimised for bone tissue engineering. Inclusion of the bioactive glass improved the compressive modulus of the resulting composite scaffolds while maintaining high degrees of porosity (\u3e97%). Moreover, in vitro analysis demonstrated that the incorporation of cobalt bioactive glass with a mean particle size of 100 μm significantly enhanced the production and expression of VEGF in endothelial cells, and cobalt bioactive glass/collagen-glycosaminoglycan scaffold conditioned media also promoted enhanced tubule formation. Furthermore, our results prove the ability of these scaffolds to support osteoblast cell proliferation and osteogenesis in all bioactive glass/collagen-glycosaminoglycan scaffolds irrespective of the particle size. In summary, we have developed a hypoxia-mimicking tissue-engineered scaffold with pro-angiogenic and pro-osteogenic capabilities that may encourage bone tissue regeneration and overcome the problem of inadequate vascularisation of grafts commonly seen in the field of tissue engineering

Supporting information for National, regional, and worldwide estimates of low birthweight rates in 2015, with trends from 2000: a systematic analysis

Data produced by the World Health Organization, UNICEF, LSHTM and Johns Hopkins University to estimate national low birthweight (LBW) and numbers for 195 countries. LBW data was collated through a systematic review of national routine/registration systems, nationally representative surveys, and other data sources, and subsequently modelled using restricted maximum likelihood estimation with country-level random effects. Data includes a list of 1447 rate data points used as an input to the modelled estimates, yearly national-level covariates for each of the 195 countries studied from 2000 to 2015, and information on estimated low birthweight rates from 2000 to 2015 for 148 countries with data. Stata code used to generate these estimates is provided

St. Pauls Inlet: a biological re-assessment of zooplankton and fish populations within an estuarine system in Western Newfoundland

St. Pauls Inlet is a fjord-type estuary on the western coast of insular Newfoundland. It has been classified as a marine area of interest by the Canadian Parks and Wildlife Society (Rao et al. 2009). The inlet can be defined as an estuarine system in that it is a semi-enclosed coastal body of water with a free connection to the sea and within which the sea water is measurably diluted with fresh water (Pritchard 1967). The area is also characteristic of fjordal landscapes as a result of the glacial sculpting which occurred in western Newfoundland approximately 12, 000 years ago (Rogerson 1983)