Altered functional connectivity in preterm neonates with intraventricular hemorrhage assessed using functional near-infrared spectroscopy.

Intraventricular hemorrhage (IVH) is a common neurological injury following very preterm birth. Resting-state functional connectivity (RSFC) using functional magnetic resonance imaging (fMRI) is associated with injury severity; yet, fMRI is impractical for use in intensive care settings. Functional near-infrared spectroscopy (fNIRS) measures RSFC through cerebral hemodynamics and has greater bedside accessibility than fMRI. We evaluated RSFC in preterm neonates with IVH using fNIRS and fMRI at term-equivalent age, and compared fNIRS connectivity between healthy newborns and those with IVH. Sixteen very preterm born neonates were scanned with fMRI and fNIRS. Additionally, fifteen healthy newborns were scanned with fNIRS. In preterms with IVH, fNIRS and fMRI connectivity maps were compared using Euclidean and Jaccard distances. The severity of IVH in relation to fNIRS-RSFC strength was examined using generalized linear models. fNIRS and fMRI RSFC maps showed good correspondence. Connectivity strength was significantly lower in healthy newborns (p-value = 0.023) and preterm infants with mild IVH (p-value = 0.026) compared to infants with moderate/severe IVH. fNIRS has potential to be a new bedside tool for assessing brain injury and monitoring cerebral hemodynamics, as well as a promising biomarker for IVH severity in very preterm born infants.

Altered resting-state functional connectivity in newborns with hypoxic ischemic encephalopathy assessed using high-density functional near-infrared spectroscopy.

Hypoxic-ischemic encephalopathy (HIE) results from a lack of oxygen to the brain during the perinatal period. HIE can lead to mortality and various acute and long-term morbidities. Improved bedside monitoring methods are needed to identify biomarkers of brain health. Functional near-infrared spectroscopy (fNIRS) can assess resting-state functional connectivity (RSFC) at the bedside. We acquired resting-state fNIRS data from 21 neonates with HIE (postmenstrual age [PMA] = 39.96), in 19 neonates the scans were acquired post-therapeutic hypothermia (TH), and from 20 term-born healthy newborns (PMA = 39.93). Twelve HIE neonates also underwent resting-state functional magnetic resonance imaging (fMRI) post-TH. RSFC was calculated as correlation coefficients amongst the time courses for fNIRS and fMRI data, respectively. The fNIRS and fMRI RSFC maps were comparable. RSFC patterns were then measured with graph theory metrics and compared between HIE infants and healthy controls. HIE newborns showed significantly increased clustering coefficients, network efficiency and modularity compared to controls. Using a support vector machine algorithm, RSFC features demonstrated good performance in classifying the HIE and healthy newborns in separate groups. Our results indicate the utility of fNIRS-connectivity patterns as potential biomarkers for HIE and fNIRS as a new bedside tool for newborns with HIE.

Point-of-care ultrasound aided diagnosis and management of peritoneal parenteral nutrition extravasation in a preterm baby: A case report.

POCUS could identify some of UVC complications at the bedside. It complements the clinical picture and helps narrowing the deferential diagnosis when there is a clinical deterioration.

Anaerobic co-digestion of the marine microalga Nannochloropsis salina with energy crops.

Anaerobic co-digestion of corn silage with the marine microalga Nannochloropsis salina was investigated under batch and semi-continuous conditions. Under batch conditions process stability and biogas yields significantly increased by microalgae addition. During semi-continuous long-term experiments anaerobic digestion was stable in corn silage mono- and co-digestion with the algal biomass for more than 200 days. At higher organic loading rates (4.7 kg volatile solids m(-3)d(-1)) inhibition and finally process failure occurred in corn silage mono-digestion, whereas acid and methane formation remained balanced in co-digestion. The positive influences in co-digestion can be attributed to an adjusted carbon to nitrogen ratio, enhanced alkalinity, essential trace elements and a balanced nutrient composition. The results suggest that N. salina biomass is a suitable feedstock for anaerobic co-digestion of energy crops, especially for regions with manure scarcity. Enhanced process stability may result in higher organic loading rates or lower digester volumes.