Cerebral Palsy and Motor Impairment After Extreme Prematurity: Prediction of Diagnoses at Ages 2 and 10 Years.

OBJECTIVE: To identify perinatal factors in children born extremely preterm (EP) that were associated with motor impairment (MI) at 2 and 10 years of age and develop a predictive algorithm to estimate the risk of MI during childhood. STUDY DESIGN: Participants of the Extremely Low Gestational Age Newborns Study (ELGANS) were classified as: no MI, MI only at 2 years, MI only at 10 years, and MI at both 2 and 10 years, based on a standardized neurological examination at 2 and the Gross Motor Function Classification System (GMFCS) at 10 years of age. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to develop the final predictive model. RESULTS: Of the 849 study participants, 64 (7.5%) had a diagnosis of MI at both 2 and 10 years and 63 (7.4%) had a diagnosis of MI at 1 visit but not the other. Of 22 total risk factors queried, 4 variables most reliably and accurately predicted MI: gestational age, weight z-score growth trajectory during neonatal intensive care unit (NICU) stay, ventriculomegaly, and cerebral echolucency on head ultrasound. By selecting probability thresholds of 3.5% and 7.0% at ages 2 and 10, respectively, likelihood of developing MI can be predicted with a sensitivity and specificity of 71.2%/72.1% at age 2 and 70.7%/70.7% at age 10. CONCLUSION: In our cohort, the diagnosis of MI at 2 years did not always predict a diagnosis of MI at 10 years. Specific risk factors are predictive of MI and can estimate an individual infant's risk at NICU discharge of MI at age 10 years.

Association of Growth During Infancy with Neurodevelopment and Obesity in Children Born Very Preterm: The Environmental Influences on Child Health Outcomes Cohort.

OBJECTIVE: To evaluate associations between change in weight z score after neonatal intensive care unit (NICU) discharge and neurodevelopmental outcomes and obesity at 12-48 months of age among individuals born very preterm. STUDY DESIGN: This secondary analysis used data from infants born very preterm participating in the Environmental influences on Child Health Outcomes cohort (n = 1400). Growth during infancy was calculated as change in weight z score between NICU discharge and follow-up at a mean of 27 months of age. Very low weight gain was defined as a change in weight z score <-1.67; very high weight gain was a change in weight z score >1.67. Neurodevelopmental outcomes included the Bayley Scales of Infant and Toddler Development, Child Behavior Checklist 1.5-5 years, and Modified Checklist for Autism in Toddlers. Multivariable linear regression was used to estimate associations between increase in weight z score and neurodevelopmental outcomes. RESULTS: Very low weight gain between NICU discharge and follow-up (experienced by 6.4% of participants) was associated with lower scores on cognitive (adjusted mean difference: -4.26; 95% CI: -8.55, -0.04) and language (adjusted mean difference: -4.80; 95% CI: -9.70, -0.11) assessments. Very high weight gain (experienced by 13.6% of participants) was associated with an increased obesity risk (adjusted relative risk: 6.20; 95% CI: 3.99, 9.66) but not with neurodevelopmental outcomes. CONCLUSIONS: Very high weight gain in the first 12-48 months after NICU discharge was associated with a higher risk of obesity at follow-up; very low weight gain was associated with lower scores on cognitive and language assessments.

Neonatal inflammation and its association with asthma and obesity in late childhood among individuals born extremely preterm.

BACKGROUND: Asthma and obesity are frequent outcomes among individuals born extremely preterm and are associated with decreased lifespan. Neonatal inflammation is associated with chronic neurodevelopmental disorders; however, it is less studied in association with other later childhood chronic disorders in this population. METHODS: Fourteen hospitals in 5 U.S. states enrolled 1506 infants born before 28 weeks of gestation in the Extremely Low Gestational Age Newborn cohort in 2004-2014. Neonatal blood spots were collected on postnatal days 1, 7, 14, 21, and 28, and used to measure 14 inflammation-related proteins. Associations were evaluated between high (top quartile) levels of proteins and two chronic health disorders at ages 10 and 15 years: physician-diagnosed asthma and obesity (body mass index ≥95th percentile). RESULTS: Few associations were found between high levels of 14 inflammation-related proteins, either on a single day or on multiple days, and either asthma or obesity. Similarly, few associations were found in analyses stratified by sex or presence/absence of prenatal inflammation. CONCLUSIONS: In extremely preterm newborns, systemic elevations of inflammation-related proteins during the neonatal period were not associated with childhood asthma and obesity outcomes at 10 or 15 years of age. IMPACT: In the large multi-center Extremely Low Gestational Age Newborn (ELGAN) cohort, sustained elevation of neonatal levels of inflammation-related proteins was not consistently associated with asthma or obesity outcomes at 10 or 15 years of age. This finding contrasts with reported associations of perinatal inflammation with obesity at 2 years and neurodevelopmental disorders at 2-15 years in the ELGANs, suggesting that unlike neurodevelopment, peripubertal obesity and asthma may be driven by later childhood exposures. Future research on perinatal mechanisms of childhood asthma and obesity should account for both fetal and later exposures and pathways in addition to inflammation at birth.

Clinical Characteristics of Necrotizing Enterocolitis Diagnosed by Independent Adjudication of Abdominal Radiographs, Laparotomy, or Autopsy in Preterm Infants in the "Connection Trial".

OBJECTIVE: Necrotizing enterocolitis (NEC) classically is diagnosed by radiographic demonstration of pneumatosis intestinalis/portal venous gas (PI/PVG). This study examines clinical characteristics of NEC confirmed by independent evaluation of abdominal radiographs, taken for clinical signs of NEC, or by pathologic findings at laparotomy or autopsy (confirmed NEC [cNEC]). STUDY DESIGN: The investigated cohort included 1,382 extremely low birth weight (BW) infants (BW range: 500-1,000 g) with median 27 weeks (range: 23-32) gestational age (GA) at birth. They were randomized into the placebo-controlled "Connection Trial" of the new biological drug candidate IBP-9414 with cNEC as one primary endpoint. RESULTS: Total 119 infants (8.6%) had cNEC diagnosed at median 14 days of age by confirming PI/PVG at X-ray adjudication (n = 111) and/or by surgery/autopsy (n = 21). Sixteen percent of cNEC cases died. Adverse events of NEC were reported in 8.5% of infants and 4.1% had NEC diagnosed by radiology and surgery/autopsy at the participating centers. Regression analyses showed that the risk of cNEC decreased by 11 to 30% for every 100-g increment in BW and single-week increment in GA and associated cNEC with odds ratios (ORs) > 2.0 for gastrointestinal (GI) perforation and obstruction, hypotension, hypokalemia, hypophosphatemia, and death. Comparing risks of cNEC in infants below and above 750-g BW showed higher ORs (2.7-4.3) for GI perforation, hypotension, hypokalemia, and renal complications in the smaller infants, whereas the bigger infants had higher ORs (1.9-3.2) for serious non-GI events, late-onset sepsis (LOS), and death. Predictors of cNEC (hazard ratio, HR > 1.5) included serious non-GI events (mainly infections), hyponatremia, and hyperglycemia, whereas the HR was 0.52 for intravenous antibiotics. After cNEC diagnosis, there were higher rates of GI perforation and obstruction, hypotension, hypokalemia, and LOS. CONCLUSION: Independent adjudication of abdominal radiographs increased radiological recognition of NEC and proved to be feasible in a multicenter study setting as well as able to diagnose clinically relevant NEC. KEY POINTS: · Independent adjudication of abdominal radiographs in ELBW infants increased NEC recognition.. · Risk of NEC decreased by 11 to 30% with every 100-g increment in BW and GA week.. · In infants with BW 750 to 1,000 g, the risk of death from NEC was almost twice that in infants with BW 500 to 749 g. · Infants with NEC received antibiotics during one-third and parenteral nutrition during half of the first 7 postnatal weeks..

Growth During Infancy After Extremely Preterm Birth: Associations with Later Neurodevelopmental and Health Outcomes.

OBJECTIVE: To evaluate associations between changes in weight, length, and weight/length ratio during infancy and outcomes later in life among individuals born extremely preterm. STUDY DESIGN: Among participants in the Extremely Low Gestational Age Newborn (ELGAN) study, we measured weight and length at discharge from the neonatal intensive care unit (NICU) and at age 2 years and evaluated neurocognitive, psychiatric, and health outcomes at age 10 years and 15 years. Using multivariable logistic regression, we estimated associations between gains in weight, length, and weight/length ratio z-scores between discharge and 2 years and outcomes at 10 and 15 years. High gain was defined as the top quintile of change; low gain, as the bottom quintile of change. RESULTS: High gains in weight and weight/length were associated with greater odds of obesity at 10 years, but not at 15 years. These associations were found only for females. High gain in length z-score was associated with lower odds of obesity at 15 years. The only association found between high gains in growth measures and more favorable neurocognitive or psychiatric outcomes was between high gain in weight/length and lower odds of cognitive impairment at age 10 years. CONCLUSIONS: During the 2 years after NICU discharge, females born extremely preterm with high gains in weight/length or weight have greater odds of obesity at 10 years, but not at 15 years. Infants with high growth gains in the 2 years after NICU discharge have neurocognitive and psychiatric outcomes in middle childhood and adolescence similar to those of infants with lower gains in weight and weight/length.

Polygenic risk scores and the need for pharmacotherapy in neonatal abstinence syndrome.

BACKGROUND: The aim of this study was to identify genetic variants associated with NAS through a genome-wide association study (GWAS) and estimate a Polygenic Risk Score (PRS) model for NAS. METHODS: A prospective case-control study included 476 in utero opioid-exposed term neonates. A GWAS of 1000 genomes-imputed genotypes was performed to identify variants associated with need for pharmacotherapy for NAS. PRS models for estimating genetic predisposition were generated via a nested cross-validation approach using 382 neonates of European ancestry. PRS predictive ability, discrimination, and calibration were assessed. RESULTS: Cross-ancestry GWAS identified one intergenic locus on chromosome 7 downstream of SNX13 exhibiting genome-wide association with need for pharmacotherapy. PRS models derived from the GWAS for a subset of the European ancestry neonates reliably discriminated between need for pharmacotherapy using cis variant effect sizes within validation sets of European and African American ancestry neonates. PRS were less effective when applying variant effect sizes across datasets and in calibration analyses. CONCLUSIONS: GWAS has the potential to identify genetic loci associated with need for pharmacotherapy for NAS and enable development of clinically predictive PRS models. Larger GWAS with additional ancestries are needed to confirm the observed SNX13 association and the accuracy of PRS in NAS risk prediction models. IMPACT: Genetic associations appear to be important in neonatal abstinence syndrome. This is the first genome-wide association in neonates with neonatal abstinence syndrome. Polygenic risk scores can be developed examining single-nucleotide polymorphisms across the entire genome. Polygenic risk scores were higher in neonates receiving pharmacotherapy for treatment of their neonatal abstinence syndrome. Future studies with larger cohorts are needed to better delineate these genetic associations.

Cypermethrin toxicity in the environment: analytical insight into detection methods and microbial degradation pathways.

The unrestricted utilization of xenobiotic compounds has sparked widespread concern by the world's growing population. A synthetic pyrethroid called cypermethrin (CP) is commonly utilized as an insecticide in horticulture, agriculture, and pest control. The high toxicity levels of accumulated CP have prompted environmental concerns; it damages soil fertility, and an ecosystem of essential bacteria, and causes allergic reactions and tremors in humans by affecting their nervous systems. The damage caused by CP to groundwater, food, and health makes it imperative that new effective and sustainable alternatives are investigated. Microbial degradation has been established as a reliable technique for mineralizing CP into less toxic chemicals. Among the many enzymes produced by bacteria, carboxylesterase enzymes are determined to be the most efficient in the CP breakdown process. High-performance liquid chromatography (HPLC) and gas chromatography-mass spectrometry (GC-MS) have been reported as the best methods for determining CP and its metabolized products, with detection limits as low as ppb from diverse environmental samples. The current study describes the ecotoxicological impact of CP and innovative analytical techniques for their detection. The newly isolated CP-degrading bacterial strains have been evaluated in order to develop an efficient bioremediation strategy. The proposed pathways and the associated critical enzymes in the bacterial mineralization of CP have also been highlighted. Additionally, the strategic action to control CP toxicity has been discussed.

Ultrasonication expedited As(III) adsorption onto chitosan impregnated Ni-Fe layered double hydroxide biosorbent: Optimization studies and artificial intelligence modelling.

Chitosan intercalated Ni-Fe layered double hydroxide (Ni-Fe LDH/Ch), prepared by co-precipitation was examined for adsorptive elimination of arsenic (III). Energy Dispersive X-ray analysis, X-ray diffraction, Fourier Transform Infrared spectroscopy, Scanning Electron Microscopy, and Dynamic Light Scattering validated the successful synthesis of the composite with enhanced adsorption sites. Maximal As(III) removal was obtained at adsorbent dose 1 gL-1, pH 7, ultrasonication time 30 min, temperature 298 K, and initial arsenic concentration 50 mgL-1. The experimentally obtained values fit the Langmuir isotherm and pseudo-second-order dynamics well (R2 > 0.98), while thermodynamic evaluation confirmed exothermic and spontaneous reaction (ΔG = -8.13 kJ mol-1). Further, adaptive neuro-fuzzy inference system and artificial neural network successfully predicted As(III) removal percentage with a high correlation coefficient (R2 > 0.94) and low statistical errors (MSE< 0.002, AARE< 0.063). The prepared material successfully brought down arsenic level by 62% in a natural water sample and showed good reusability up to 5 consecutive treatment cycles. The results recommended that Ni-Fe LDH/Ch has ample potential for arsenic remediation, and further investigations can be carried out for large-scale applications.

Accurate data prediction by fuzzy inference model for adsorption of hazardous azo dyes by novel algal doped magnetic chitosan bionanocomposite.

A bionanocomposite comprising of magnetic chitosan doped with algae isolated from native habitat was fabricated and utilized as an efficient adsorbent for the removal of hazardous azo dyes, namely, Direct Red 31 (DR31) and Direct Red 28 (DR28). The algal doped magnetic chitosan (Alg@mCS) was comprehensively characterized by Scanning Electron Microscopy (SEM), Energy Dispersive X-Ray Analysis (EDAX), Fourier Transform Infrared Spectroscopy (FTIR), X-ray diffraction analysis (XRD), and Brunauer-Emmett-Teller (BET). On the sorption of dyes, the influence of various process variables such as pH, adsorbent dosage, contact time, temperature, and initial dyes concentration were addressed. The adsorbent demonstrated maximal removal of DR31 and DR28 at pH 5 and 3, respectively. The maximum adsorption capacity of DR31 and DR28 was observed at Alg@mCS dose of 0.6 g L-1 and 7 g L-1 in 10 and 20 min, respectively. The Redlich Peterson isotherm model was shown to be appropriate for dye adsorption, indicating monolayer coverage of the dyes on the adsorbent surface (R2 > 0.99). The adsorption process followed pseudo-second-order kinetics (R2 > 0.99). Based on 320 experimental datasets from batch studies and interpolated data, adaptive neuro-fuzzy inference system (ANFIS) models were utilized to estimate dye elimination (percent). A number of parameters were calculated to validate the model's applicability. The Alg@mCS was proven to be a useful adsorbent for eliminating toxic and harmful azo dyes from aqueous solutions.

Myco-degradation of microplastics: an account of identified pathways and analytical methods for their determination.

Microplastics (MPs) have sparked widespread concern due to their non-degradable and persistent nature in ecosystems. Long-term exposure to microplastics can cause chronic toxicity, including impaired reproduction and malnutrition, threatening biota and humans. Microplastics can also cause ingestion, choking, and entanglement in aquatic populations. Thus, it is crucial to establish remarkably effective approaches to diminish MPs from the environment. In this regard, using fungi for microplastic degradation is beneficial owing to its diverse nature and effective enzymatic system. Extracellular and intracellular enzymes in fungi degrade the plastic polymers into monomers and produce carbon dioxide and water under aerobic conditions whereas methane under anaerobic conditions. Further, fungi also secrete hydrophobins (surface proteins) which serve as a crucial aid in the bioremediation process by promoting substrate mobility and bioavailability. Therefore, the present review provides insight into the mechanism and general pathway of fungal-mediated microplastic degradation. Additionally, analytical techniques for the monitoring of MPs degradation along with the roadblocks and future perspectives have also been discussed. However, more research is required to fully perceive the underlying process of microplastic biodegradation in the environment using fungus, to establish an effective and sustainable practice for its management.

Differential regulation of drought stress by biological membrane transporters and channels.

Stress arising due to abiotic factors affects the plant's growth and productivity. Among several existing abiotic stressors like cold, drought, heat, salinity, heavy metal, etc., drought condition tends to affect the plant's growth by inducing two-point effect, i.e., it disturbs the water balance as well as induces toxicity by disturbing the ion homeostasis, thus hindering the growth and productivity of plants, and to survive under this condition, plants have evolved several transportation systems that are involved in regulating the drought stress. The role of membrane transporters has gained interest since genetic engineering came into existence, and they were found to be the important modulators for tolerance, avoidance, ion movements, stomatal movements, etc. Here in this comprehensive review, we have discussed the role of transporters (ABA, protein, carbohydrates, etc.) and channels that aids in withstanding the drought stress as well as the regulatory role of transporters involved in osmotic adjustments arising due to drought stress. This review also provides a gist of hydraulic conductivity by roots that are involved in regulating the drought stress.

Adsorptive decontamination of paper mill effluent by nano fly ash: response surface methodology, adsorption isotherm and reusability studies.

In the present study, adsorption of colour and other pollutants from agro-based paper mill effluent onto fabricated coal fly ash nanoparticles (CFA-N) have been investigated. Response surface methodology was applied to evaluate the operational conditions for maximum ouster of colour from effluent by nano structured CFA-N. Maximum reduction in colour (92.45%) and other pollutants were obtained at optimum conditions: 60 min interaction time, 60 g/L adsorbent dosage and 80 rpm agitation rate. The regression coefficient values (adjusted R2 = 0.7169; predicted R2 = 0.7539) established harmony between predicted and the experimental data. The adsorption equilibrium results matched perfectly with both Langmuir and Freundlich isotherms with maximum adsorption capacity of 250 platinum-cobalt/g. Additionally, the efficacy of CFA-N was also assessed in a continuous column mode. Furthermore, the feasibility of treated effluent for irrigation purpose was checked by growing the plant Solanum lycopersicum. Overall, the findings demonstrated the outstanding role of inexpensive and abundantly available CFA-N in treatment of paper mill effluent to the required compliance levels.

Rapid Electrochemical Monitoring of Bacterial Respiration for Gram-Positive and Gram-Negative Microbes: Potential Application in Antimicrobial Susceptibility Testing.

Antimicrobial resistance is a grave threat to human life. Currently used time-consuming antibiotic susceptibility test (AST) methods limit physicians in selecting proper antibiotics. Hence, we developed a rapid AST using electroanalysis with a 15 min assay time, called EAST, which is live-monitored by time-lapse microscopy video. The present work reports systematical electrochemical analysis and standardization of protocol for EAST measurement. The proposed EAST is successfully applied for Gram-positive Bacillus subtilis and Gram-negative Escherichia coli as model organisms to monitor bacterial concentration, decay kinetics in the presence of various antibiotics (ciprofloxacin, cefixime, and amoxycillin), drug efficacy, and IC50. Bacterial decay kinetics in the presence of antibiotics were validated by the colony counting method, field emission scanning electron microscopy, and atomic force microscopy image analysis. The EAST predicts the antibiotic susceptibility of bacteria within 15 min, which is a significant advantage over existing techniques that consume hours to days. The EAST was explored further by using bacteria-friendly l-lysine-functionalized cerium oxide nanoparticle coated indium tin oxide as a working electrode to observe the enhanced electron-transfer rate in the EAST. The results are very significant for future miniaturization and automation. The proposed EAST has huge potential in the development of a rapid AST device for applications in the clinical and pharmaceutical industries.

Racial and Ethnic Disparities in Maternal and Infant Outcomes Among Opioid-Exposed Mother-Infant Dyads in Massachusetts (2017-2019).

Objectives. To examine the extent to which differences in medication for opioid use disorder (MOUD) in pregnancy and infant neonatal opioid withdrawal syndrome (NOWS) outcomes are associated with maternal race/ethnicity.Methods. We performed a secondary analysis of a statewide quality improvement database of opioid-exposed deliveries from January 2017 to April 2019 from 24 hospitals in Massachusetts. We used multivariable mixed-effects logistic regression to model the association between maternal race/ethnicity (non-Hispanic White, non-Hispanic Black, or Hispanic) and prenatal receipt of MOUD, NOWS severity, early intervention referral, and biological parental custody at discharge.Results. Among 1710 deliveries to women with opioid use disorder, 89.3% (n = 1527) were non-Hispanic White. In adjusted models, non-Hispanic Black women (AOR = 0.34; 95% confidence interval [CI] = 0.18, 0.66) and Hispanic women (AOR = 0.43; 95% CI = 0.27, 0.68) were less likely to receive MOUD during pregnancy compared with non-Hispanic White women. We found no statistically significant associations between maternal race/ethnicity and infant outcomes.Conclusions. We identified significant racial/ethnic differences in MOUD prenatal receipt that persisted in adjusted models. Research should focus on the perspectives and treatment experiences of non-Hispanic Black and Hispanic women to ensure equitable care for all mother-infant dyads.

PediTools Electronic Growth Chart Calculators: Applications in Clinical Care, Research, and Quality Improvement.

BACKGROUND: Parameterization of pediatric growth charts allows precise quantitation of growth metrics that would be difficult or impossible with traditional paper charts. However, limited availability of growth chart calculators for use by clinicians and clinical researchers currently restricts broader application. OBJECTIVE: The aim of this study was to assess the deployment of electronic calculators for growth charts using the lambda-mu-sigma (LMS) parameterization method, with examples of their utilization for patient care delivery, clinical research, and quality improvement projects. METHODS: The publicly accessible PediTools website of clinical calculators was developed to allow LMS-based calculations on anthropometric measurements of individual patients. Similar calculations were applied in a retrospective study of a population of patients from 7 Massachusetts neonatal intensive care units (NICUs) to compare interhospital growth outcomes (change in weight Z-score from birth to discharge [∆Z weight]) and their association with gestational age at birth. At 1 hospital, a bundle of quality improvement interventions targeting improved growth was implemented, and the outcomes were assessed prospectively via monitoring of ∆Z weight pre- and postintervention. RESULTS: The PediTools website was launched in January 2012, and as of June 2019, it received over 500,000 page views per month, with users from over 21 countries. A retrospective analysis of 7975 patients at 7 Massachusetts NICUs, born between 2006 and 2011, at 23 to 34 completed weeks gestation identified an overall ∆Z weight from birth to discharge of -0.81 (P<.001). However, the degree of ∆Z weight differed significantly by hospital, ranging from -0.56 to -1.05 (P<.001). Also identified was the association between inferior growth outcomes and lower gestational age at birth, as well as that the degree of association between ∆Z weight and gestation at birth also differed by hospital. At 1 hospital, implementing a bundle of interventions targeting growth resulted in a significant and sustained reduction in loss of weight Z-score from birth to discharge. CONCLUSIONS: LMS-based anthropometric measurement calculation tools on a public website have been widely utilized. Application in a retrospective clinical study on a large dataset demonstrated inferior growth at lower gestational age and interhospital variation in growth outcomes. Change in weight Z-score has potential utility as an outcome measure for monitoring clinical quality improvement. We also announce the release of open-source computer code written in R to allow other clinicians and clinical researchers to easily perform similar analyses.

In vitro toxicological evaluation of domestic effluent treated by formulated synthetic autochthonous bacterial consortium.

Supplementation of consortium comprising of aboriginal bacterial species with high degradation capacity can significantly enhance the biodegradation process of the domestic wastewater. The present study examined the bioremediation of domestic wastewater using a novel bacterial consortium comprising of five autochthonous bacterial strains with high potential for reduction in BOD, COD and protein content to 89%, 55% and 86%, respectively after 24 h of incubation. HPLC and GC-MS analyses revealed that the chosen consortium had successfully degraded wide-ranging complex organic compounds, which is crucial in the decontamination of wastewater. Phytotoxicity assay of the effluent exhibited that the seeds of Vigna radiata showed better growth and germination when subjected to wastewater treated by novel bacterial consortium as compared to the seeds exposed to untreated wastewater. Further, raw and treated wastewater were assessed for their genotoxicity with comet assay which displayed the intensity of DNA damage in the Allium cepa root tip cells before and after exposure to treated effluent. It is evident from the demonstrated results that the formulated bacterial consortium can be used successfully in a small-scale wastewater treatment plant.

Simultaneous exposure of sulphur and calcium hinder As toxicity: Up-regulation of growth, mineral nutrients uptake and antioxidants system.

The current study was carried out to investigate the role of exogenous sulphur (K2SO4: S; 60 mg S kg-1 sand) and calcium (CaCl2: Ca; 250 mg Ca kg-1 sand) individually as well as in combination (S + Ca) in ameliorating the inhibitory effect of As (Na2HAsO4·7H2O: As1; 15 mg As kg-1 sand and As2; 30 mg As kg-1 sand) by analyzing biomass accumulation, mineral nutrients uptake, photosynthetic pigments content, redox status of the cell, enzymatic and non-enzymatic defense system in Brassica juncea L. seedlings. Biomass accumulation, uptake of mineral nutrients, photosynthetic pigments (chlorophyll a, b and carotenoids) content and the activity of proline dehydrogenase (ProDH) declined with increasing accumulation of As in root as well as leaves in As dose dependent manner. Contrary to this, exogenous application of S, Ca and S + Ca, markedly reduced the negative impact of As on above captioned traits except ProDH activity. On the other hand, ROS and their biomarkers (superoxide radical; O2˙-, hydrogen peroxide; H2O2, malondialdehyde; MDA equivalents content and membrane damage; electrolyte leakage), activities of enzymatic (superoxide dismutase; SOD, peroxidase; POD, catalase; CAT and glutathione-S-transferase; GST) and non-enzymatic antioxidant i.e. proline (Pro) content and its enzyme pyrroline-5-carboxylate synthetase; P5CS activity were increased in root and leaves under As stress. While, exogenous application of S, Ca and S + Ca, further enhanced the activities of above mentioned enzymes and Pro content thereby causing considerable reduction in O2˙-, H2O2, MDA equivalents content and electrolyte leakage. This study suggests that exogenous application of S and/or Ca efficiently (particularly S + Ca) lowered the negative impact of As on biomass accumulation in Brassica seedlings by improving the uptake of essential mineral nutrients', content of photosynthetic pigments, activities of enzymatic and content of non-enzymatic antioxidants.

Can One Predict Resolution of Neonatal Hyperthyrotropinemia?

OBJECTIVE: To identify predictors of transience vs permanence of neonatal hyperthyrotropinemia. We hypothesized that infants with greater severity of perinatal stress are more likely to have transient thyrotropin elevations. STUDY DESIGN: We retrospectively studied infants diagnosed with hyperthyrotropinemia between 2002 and 2014, following them for up to 12 years after diagnosis. Patients were divided into 3 groups: transient hyperthyrotropinemia (treatment was never prescribed), transient congenital hypothyroidism (treatment started but discontinued), and permanent congenital hypothyroidism (withdrawal unsuccessful or not attempted). We performed univariate and multiple logistic regression analyses, including and excluding infants with maternal thyroid disease. RESULTS: We included 76 infants, gestational age mean (±SD) 34.2 (±5.7) weeks, evaluated for hyperthyrotropinemia. Thirty-five (46%) were never treated, and 41 (54%) received levothyroxine. Of the treated patients, 16 successfully discontinued levothyroxine, and for 25 withdrawal either failed or was not attempted. We found that male patients were almost 5 times more likely than female patients to have transient neonatal hyperthyrotropinemia (OR 4.85; 95% CI 1.53-15.37). We documented greater maternal age (31.5 ± 5.48 years vs 26 ± 6.76 years, mean ± SD, P = .02), greater rate of cesarean delivery (86.7% vs 54.2%; P = .036), and retinopathy of prematurity (37.5% vs 8%; P = .02) in the group with transient congenital hypothyroidism vs the group with permanent congenital hypothyroidism. CONCLUSION: The results show transience of neonatal thyrotropin elevations in a majority of patients and suggest a possible association of hyperthyrotropinemia with maternal and perinatal risk factors.