Early Term Research Articles

Preterm birth and the risk of multimorbidity in adolescence: a multiregister-based cohort study

Multimorbidity affects people of all ages, but the risk factors of multimorbidity in adolescence are unclear. The aim of this study was to examine preterm birth (<37 weeks) as a shared risk factor for multiple health outcomes and the role of gestational age (degree of prematurity) in the development of increasingly complex multimorbidity (two, three, or four health outcomes) in adolescence (age 10-18 years). We used population-wide data from Finland (1 187 610 adolescents born 1987-2006) and Norway (555 431 adolescents born 1998-2007). Gestational age at birth was ascertained from medical birth registers and categorised as 23-27 weeks (extremely preterm), 28-31 weeks (very preterm), 32-33 weeks (moderately preterm), 34-36 weeks (late preterm), 37-38 weeks (early term), 39-41 weeks (term, reference category) and 42-44 weeks (post-term). Children who died or emigrated before their 10th birthday, and those with missing or implausible data on gestational age, birthweight, or covariates, were excluded. Health outcomes at age 10-18 years were ascertained from specialised health care and mortality registers. We calculated hazard ratios (HRs) and population attributable fractions (PAFs) with 95% CIs for multiple health outcomes during adolescence. Individuals were followed up from age 10 to 18 years (mean follow-up: 6 years, SD: 3 years). Preterm birth was associated with increased risks of 20 hospital-treated malignant, cardiovascular, endocrinological, neuropsychiatric, respiratory, genitourinary, and congenital health outcomes, after correcting for multiple testing and ignoring small effects (HR <1·2). Confounder-adjusted HRs comparing preterm with term-born adolescents were 2·29 (95% CI 2·19-2·39) for two health outcomes (PAF 9·0%; 8·3-9·6), and 4·22 (3·66-4·87) for four health outcomes (PAF 22·7%; 19·4-25·8) in the Finnish data. Results in the Norwegian data showed a similar pattern. We observed a consistent dose-response relationship between an earlier gestational age and elevated risks of increasingly complex multimorbidity in both datasets. Preterm birth is associated with increased risks of diverse multimorbidity patterns at age 10-18 years. Adolescents with a preterm-born background could benefit from diagnostic vigilance directed at multimorbidity and a multidisciplinary approach to health care. European Union Horizon 2020, Academy of Finland, Foundation for Pediatric Research, Sigrid Jusélius Foundation, Signe and Ane Gyllenberg Foundation.

Sentiment analysis of Indonesian tweets on COVID-19 and COVID-19 vaccinations

Background: Sentiments and opinions regarding COVID-19 and the COVID-19 vaccination on Indonesian-language Twitter are scarcely reported in one comprehensive study, and thus were aimed at our study. We also analyzed fake news and facts, and Twitter engagement to understand people’s perceptions and beliefs that determine public health literacy. Methods: We collected 3,489,367 tweets data from January 2020 to August 2021. We analyzed factual and fake news using the string comparison method. The difflib library was used to measure similarity. The user's engagement was analyzed by averaging the engagement metrics of tweets, retweets, favorites, replies, and posts shared with sentiments and opinions regarding COVID-19 and COVID-19 vaccination. Result: Positive sentiments on COVID-19 and COVID-19 vaccination dominated, however, the negative sentiments increased during the beginning of the implementation of restrictions on community activities (PPKM). The tweets were dominated by the importance of health protocols (washing hands, keeping distance, and wearing masks). Several types of vaccines were on top of the word count in the vaccine subtopic. Acceptance of the vaccination increased during the studied period, and the fake news was overweighed by the facts. The tweets were dynamic and showed that the engaged topics were changed from the nature of COVID-19 to the vaccination and virus mutation which peaked in the early and middle terms of 2021. The public sentiment and engagement were shifted from hesitancy to anxiety towards the safety and effectiveness of the vaccines, whilst changed again into wariness on an uprising of the delta variant. Conclusion: Understanding public sentiment and opinion can help policymakers to plan the best strategy to cope with the pandemic. Positive sentiments and fact-based opinions on COVID-19, and COVID-19 vaccination had been shown predominantly. However, sufficient health literacy levels could yet be predicted and sought for further study.

Immunopharmacological aspects of studying immunotropic properties of a novel biocompound

The article presents an experimental study of immunotropic activity of a new compound, a metabiotic, based on metabolites (biologically active substances) produced by a of saprophytic Bacillus subtilis B-9909 strain, being safe for health and standardized at Russian National Collection of Industrial Microorganisms (RNCIM). The aim of our study was to experimentally evaluate the immunotropic effects of metabolites produced by the probiotic Bacillus subtilis B-9909 upon the parameters of cellular immunity tested in the animal model of induced toxic liver damage. The metabolites were isolated from the cultural liquid of Bacillus subtilis culture (RNCIM strain B-9909) during its deep cultivation in a medium containing hydrochloric acid hydrolyzate of soy flour, or pancreatic hydrolyzate of casein. At 16-18 hours of cultivation, the cells were in the exponential growth phase. The indices of cellular status were studied in experimental groups of animals, when assessing therapeutic efficacy of an experimental metabiotic sample, as compared to a group of laboratory animals treated with the reference drug (ursosan). We assessed the quantitative indicators of blood as follows: determination of phagocytic activity (FA) of peripheral blood neutrophils; measurement of metabolic activity in peripheral blood neutrophils by means of NBT-test; quantitative determination of T and B lymphocytes; the number of antibody-forming cells (AFC). Liver damage was studied in a model of acute toxic hepatitis in albino rats. Experimental toxic hepatitis was induced by 40% solution of CCl4 in vaseline oil injected intragastrically for 2 weeks at the dose of 0.2 g/kg. The results of experimental studies showed activation of phagocytic activity by peripheral blood neutrophils at the early terms of experiment, being also confirmed by the results of NBT-testing. Moreover, at the early observation terms, a significantly increased representation of T and B lymphocyte populations as well as AFC numbers, were revealed thus suggesting activation of all components of cellular immunity in response to the carbon tetrachloride toxicity. Thus, the reported studies on the cellular status of laboratory animals treated with metabolites produced by probiotic microorganisms of the genus Bacillus subtilis (B-9909) on laboratory animals with toxic liver damage allow us to conclude that the test sample of this metabiotic preparation exerts a significant immunomodulatory effect, when compared with ursosan. This evidence allows us to consider this compound a promising candidate drug for a new hepatoprotector with immunotropic effect.

One for all, all for one: an analysis towards the speed of internationalization in clustered and non-clustered family firms

PurposeThis article aims to explore how cluster affiliation moderates the relationship between family involvement and speed of internationalization in family firms. The speed of internationalization is examined in terms of earliness and post-internationalization speed.Design/methodology/approachThe research is based on a sample of 639 Portuguese family businesses (FBs) created and internationalized between 2010 and 2018 that was retrieved from the Iberian Balance Analysis System – SABI database. The partial least squares structural equation modeling (PLS-SEM) was used to assess the measurement and construct the model.FindingsThe results suggest that higher levels of family involvement in ownership and management make family firms enter on international markets in later stages of their development but, after the first international market entry, the firms are able to exhibit a higher post-internationalization speed. When considering the effect of cluster affiliation, the authors found that clustered FBs are more likely to engage in early internationalization and to accelerate the post-internationalization process than non-clustered FBs.Originality/valueThe study's findings are explained by the existence of socially proximate relationships with other cluster members, based on similarity, trust, knowledge exchange and sense of belonging, which push family firms to internationalize and increase their level of international commitment over time. The empirical evidence, therefore, highlights the primary role of industrial clusters in moderating the relationship between family involvement, earliness of internationalization and post-internationalization speed.

Paternal and maternal psychiatric history and risk of preterm and early term birth: A nationwide study using Swedish registers.

Women with psychiatric diagnoses are at increased risk of preterm birth (PTB), with potential life-long impact on offspring health. Less is known about the risk of PTB in offspring of fathers with psychiatric diagnoses, and for couples where both parents were diagnosed. In a nationwide birth cohort, we examined the association between psychiatric history in fathers, mothers, and both parents and gestational age. We included all infants live-born to Nordic parents in 1997 to 2016 in Sweden. Psychiatric diagnoses were obtained from the National Patient Register. Data on gestational age were retrieved from the Medical Birth Register. Associations between parental psychiatric history and PTB were quantified by relative risk (RR) and two-sided 95% confidence intervals (CIs) from log-binomial regressions, by psychiatric disorders overall and by diagnostic categories. We extended the analysis beyond PTB by calculating risks over the whole distribution of gestational age, including "early term" (37 to 38 weeks). Among the 1,488,920 infants born throughout the study period, 1,268,507 were born to parents without a psychiatric diagnosis, of whom 73,094 (5.8%) were born preterm. 4,597 of 73,500 (6.3%) infants were born preterm to fathers with a psychiatric diagnosis, 8,917 of 122,611 (7.3%) infants were born preterm to mothers with a pscyhiatric diagnosis, and 2,026 of 24,302 (8.3%) infants were born preterm to both parents with a pscyhiatric diagnosis. We observed a shift towards earlier gestational age in offspring of parents with psychiatric history. The risks of PTB associated with paternal and maternal psychiatric diagnoses were similar for different psychiatric disorders. The risks for PTB were estimated at RR 1.12 (95% CI [1.08, 1.15] p < 0.001) for paternal diagnoses, at RR 1.31 (95% CI [1.28, 1.34] p < 0.001) for maternal diagnoses, and at RR 1.52 (95% CI [1.46, 1.59] p < 0.001) when both parents were diagnosed with any psychiatric disorder, compared to when neither parent had a psychiatric diagnosis. Stress-related disorders were associated with the highest risks of PTB with corresponding RRs estimated at 1.23 (95% CI [1.16, 1.31] p < 0.001) for a psychiatry history in fathers, at 1.47 (95% CI [1.42, 1.53] p < 0.001) for mothers, and at 1.90 (95% CI [1.64, 2.20] p < 0.001) for both parents. The risks for early term were similar to PTB. Co-occurring diagnoses from different diagnostic categories increased risk; for fathers: RR 1.10 (95% CI [1.07, 1.13] p < 0.001), 1.15 (95% CI [1.09, 1.21] p < 0.001), and 1.33 (95% CI [1.23, 1.43] p < 0.001), for diagnoses in 1, 2, and ≥3 categories; for mothers: RR 1.25 (95% CI [1.22, 1.28] p < 0.001), 1.39 (95% CI [1.34, 1.44] p < 0.001) and 1.65 (95% CI [1.56, 1.74] p < 0.001). Despite the large sample size, statistical precision was limited in subgroups, mainly where both parents had specific psychiatric subtypes. Pathophysiology and genetics underlying different psychiatric diagnoses can be heterogeneous. Paternal and maternal psychiatric history were associated with a shift to earlier gestational age and increased risk of births before full term. The risk consistently increased when fathers had a positive history of different psychiatric disorders, increased further when mothers were diagnosed and was highest when both parents were diagnosed.

Light source spectrum influences long-term flowering cycles and visual appearance in African violet (Saintpaulia ionantha Wendl.)

Light-emitting diodes (LEDs) offer the potential for physiological control of flowering and vegetative growth of ornamental potted plants such as African violet ( Saintpaulia ionantha Wendl.). In this experiment, we investigated the flowering and vegetative traits of African violet under 6 months of artificial illumination of four different spectra: monochromatic red, monochromatic blue, mixed red 75% plus blue 25%, and fluorescent light under 118 μmol m−2 s−1 ± 6 μmol m−2 s−1 photon flux for 12 h per day. Results showed that the number of days to the open flower stage was significantly influenced by irradiance. Although the blue-illuminated plants appeared to be significantly smaller and compact, they were superior in their most flowering qualities as they induced a pronounced effect on the flowering in terms of earliness, uniformity, consistency, the number of flowers, and the percentage of canopy covered with the flowers. We concluded that LEDs can be used as an effective tool to manipulate plant visual qualities without any further need for the application of conventional plant regulator chemicals, which are mostly identified as hazardous substances.

When should contralateral testicular fixation be performed in postpubertal patients with testicular torsion: A comparative study

ObjectiveIn this study, we aimed to describe the timing of contralateral testicular fixation with our ten year results in postpubertal patients with testicular torsion with a patient-based approach. MethodsPostpubertal patients diagnosed with testicular torsion in a tertiary hospital between January-2012 and September-2022 were divided into 2 groups according to the "patient-based approach" criteria we adopted in our clinic. Group 1 in whom the contralateral teste was fixed in the same surgical act and group 2 in whom the fixation was deferred. Both groups, were retrospectively examined, statistically analyzed and compared. ResultsA total of 41 patients were included in the study. Among those, 19 (46.3%) were fixed in the same act, and 22 (53.7%) underwent postponed elective contralateral testicular fixation. Early term wound dehiscence was observed in one patient in each group (4.5% Group 1 vs. 5.3% Group 2). In the postoperative period, no contralateral testicular atrophy or torsion was detected in the study groups during 1-year follow-up. ConclusionThere is no algorithm for when contralateral testicular fixation should be performed in postpubertal patients with testicular torsion. Patient-based approaches, in which the clinical characteristics of the patient are prioritized in determining the timing of contralateral testicular fixation, can produce more effective and safe results.

Role of gestational age and maternal biological factors in early term neonatal morbidity.

The morbidity of early-term newborns (ETNBs) is associated with the immaturity of their organs and maternal biological factors (MBF). In this study, we determined the relationship between MBF and early-term birth. In addition, we assessed the role of gestational age (GA) and MBF in the morbidity of ETNBs compared with full-term newborns (FTNBs). This retrospective cohort included ETNBs and FTNBs. The frequency of morbidities was compared between groups stratified by GA with the X2 test or Fisher's exact test. The association of MBF with GA and morbidity was calculated using binomial regression models between the variables that correlated with the morbidity of the ETNBs using Spearman's correlation. A significance level of 5% was estimated for all analyses. The probability of morbidity at birth for ETNBs was 1.9-fold higher than for FTNBs (37.5% vs. 19.9%), as they required more admission to the neonatal unit and more days of hospitalization; the most frequent pathology was jaundice. The MBF associated with early term birth were hypertensive disorders of pregnancy (aRR = 1.4, 95% confidence interval (CI): 1.3-1.6), intrauterine growth restriction (aRR = 1.5, 95% CI: 1.3-1.6), and chronic hypertension (aRR = 1.6, 95% CI: 1.4-1.8). No association was found between MBF and morbidity at 37 and 38 weeks. The morbidity among ETNBs is related to physiological immaturity. The adverse MBF favor a hostile intrauterine environment, which affects fetal and neonatal well-being.

Dynasty and Alchemy or a Brief Foray into the Evolution of the Cello

The beginnings of scientific research in this field date back to the 16th century, when the first treatise on the subject was published. At the beginning of said century, the ancestor of string instruments - the fiddle - was gradually replaced by the lyre, an instrument developed in the first and kept in use until the middle of the following century. The Italian schools of luthiers, through members of the famous Amati, Guarneri and Stradivarius families, made an essential contribution to the present form of string instruments. The cello is considered to be the lowest sounding instrument of the violin family, its Italian name “violoncello” including both the superlative suffix“-one”, and the diminutive “ello” – “a big little violin” in translation. The term “violoncello” was used more often in publications of the late 17th century, although the earlier term “violone” persisted until the end of the following century. The basic, Stradivarius-standardized form of the cello was very little changed in the 19th century. Cello manufacture continued to be based on Italian models, particularly Stradivarius Type B. The question “Quo vadis the performance and composition dedicated to it?” is a recurring one in this century, marked by the rapid pace at wich all aspects of social, cultural and artistic life evolve. It is with joy, pride and hope that we can answer that the future of the cello and of violin performance is in good hands, both nationally and internationally, as long as musical art endures...

Breeding bulbous and bulbotuberiferous flower crops at the Subtropical Scientific Centre of RAS

Bulbous and bulbotuberiferous plants are the most popular flower crops among amateur flower growers, florists, landscape designers, introducers and breeders. These crops collected by the Federal Research Centre the Subtropical Scientific Centre of the Russian Academy of Sciences include both foreign and domestic cultivars. Breeding work within these collections has been carried out for more than 50 years, for many – for the first time in the country. The obtained cultivars are not inferior in decorative qualities to foreign ones, and they are superior in resistance. Currently, due to the limited import of foreign planting material, the demand for domestic products has significantly increased. This paper presents the results of research conducted over the last 15 years. During this period, researchers have created more than 90 cultivars of freesia, hippeastrum and tulip; an extensive hybrid fund has been collected; sources of economically valuable traits have been allocated. Currently, xiphium and crocus are included in the breeding process. In the course of the research, bulbous and bulbotuberiferous flower crops collected by FRC SSC of RAS have been replenished with 26 domestic highly decorative cultivar samples, productive and resistant to abiotic and biotic factors, including 22 freesias, 2 hippeastrums and tulips. New cultivars are different in flowering terms: 7 of them have an early flowering term, 11 – with an average, 8 – with a late one. There are six groups according to the main colour of the perianth lobes: white – 4 cultivars, yellow – 5, red – 3, medium blue – 4, pink-purple – 8, black – 2.

Independent predictors of preeclampsia and their impact on the complication in Bulgarian study group of pregnant women.

One of the major obstetrical complications, affecting 2%-8% of all pregnancies, is preeclampsia. To predict the onset of preeclampsia, several methods have recently been put forth. The Fetal Medicine Foundation has developed combined screening that can identify the vast majority of women who will develop preeclampsia using a combination of maternal factors, obstetrical history, biochemical, and biophysical factors.

Ecological and evolutionary aspects of the nesting life of black-headed gulls &lt;i&gt;Larus ridibundus&lt;/i&gt;) as a colonial breeding species

This article analyzes the ecological and evolutionary aspects of the nesting life of the black-headed gull (Larus ridibundus), which leads a synanthropic lifestyle and forms colonies during the breeding season. The number of individuals belonging to this species began to increase rapidly at the end of the 19th century, which is a manifestation of one of the criteria for biological progress. This direction of evolution is associated with an increase in the level of adaptability of descendants in comparison with their ancestors. The progressive nature of the development of the species affects the stages of the annual life cycle, which includes the pre-breeding and nesting periods. During the pre-nesting period, birds arrive in the nesting area and select a site for the colonial settlement. Arrival dates are determined by temperature, the state of aquatic ecosystems and the physiological characteristics of birds. The nesting period includes the construction of a nest in a certain part of the territory on which the colony is being built. The process of colony formation occurs in stages: single nests, microcolonies, biological center. After the formation of the biological center, nests are built on the periphery. The formation of this part of the colony according to the same stages as the biological center. The biological center deals with the birds that arrive first on the territory of the colony. This area within the colony differs from the periphery in early terms of formation and high density of nests. In the formed colony, the biological center and periphery are distinguished. The colony as a supraorganismal structure is built under the influence of environmental factors that provide a sufficient level of adaptability of this group of individuals to the environment. The obtained materials will make it possible to study monospecific and polyspecific colonies as groups of individuals that exist on the basis of the manifestation of biocoenotic relationships.

Comparison of the efficacy between controlled-release dinoprostone delivery system (PROPESS) and Cook's double balloon catheter plus oxytocin: A retrospective single-center study in Japan.

To compare the efficacy of the controlled-release dinoprostone delivery system (PROPESS) and Cook's double balloon catheter (DBC) plus oxytocin as induction treatment. A total of 197 term pregnant women with unfavorable cervix were admitted for scheduled induction and enrolled retrospectively (PROPESS, 113; Cook's DBC plus oxytocin, 84). The main birth outcomes were cervical ripening at the treatment-end and 24 h after the treatment-start, and rate of vaginal birth. Logistic regression and propensity score matching analyses were performed to evaluate the association between the outcomes and clinical characteristics including which treatment was selected. The choice of PROPESS was associated with the success of cervical ripening at 24 h after (adjusted odds ratio (OR) 2.17, 95% confidence interval (CI) 1.11-4.26, p = 0.024) and increased the rate of vaginal birth (adjusted OR 2.03, 95% CI 1.04-3.98, p = 0.039). Similar trends in the association between PROPESS and birth outcomes were maintained after adjusting for propensity scores (p = 0.072 and p = 0.163, respectively). However, some of the women with gestational age of early 39 weeks and low Bishop scores could achieve cervical ripening at 24 h after using Cook's DBC plus oxytocin, and none by PROPESS. Our findings suggest the possibility of slight advantages of PROPESS for scheduled induction of labor. In women with early term and extremely low Bishop scores, Cook's DBC plus oxytocin may be a superior or alternative treatment to PROPESS. Therefore, the optimal choice of induction treatment should be managed on an individual basis.

Risk of stillbirth in United States patients with diagnosed intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy is associated with a 4- to 10-fold increase in the risk of stillbirth in the absence of intervention, leading to recommendations for antenatal assessment, ursodiol use, and often preterm or early term delivery. This study aimed to determine whether current management strategies for intrahepatic cholestasis of pregnancy mitigate the elevated risk of stillbirth at a population level. This was a retrospective cohort study using the 2015-2020 National Readmissions Database, an administrative database developed by the United States Agency for Healthcare Research and Quality. Our study identified delivery hospitalizations, gestational age at delivery, occurrence of intrahepatic cholestasis of pregnancy and stillbirth, and comorbid conditions using the International Classification of Diseases diagnosis and procedure codes. Moreover, this study compared the timing of delivery and stillbirth rates of pregnant patients with intrahepatic cholestasis of pregnancy vs those without intrahepatic cholestasis of pregnancy at the time of delivery hospitalization. This study identified a cohort of 9,987,705 delivery hospitalizations in the National Readmissions Database, corresponding to a weighted national estimate of 18,609,207 births. Of these births, 152,040 (0.8%) were noted to have an intrahepatic cholestasis of pregnancy diagnosis. Patients with an intrahepatic cholestasis of pregnancy diagnosis were older, with small differences in comorbidities, such as a higher rate of gestational diabetes mellitus, than patients without an intrahepatic cholestasis of pregnancy diagnosis at delivery hospitalization. The overall rates of stillbirth were lower among those with intrahepatic cholestasis of pregnancy than among those without intrahepatic cholestasis of pregnancy (252 vs 386 per 100,000 deliveries; risk difference, 133 fewer per 100,000 deliveries; 95% confidence interval, 98-170), a finding that persisted after adjustment for insurance status, socioeconomic factors, and comorbid conditions (risk difference, 160 fewer stillbirths per 100,000 deliveries; 95% confidence interval, 127-194). Furthermore, although patients with intrahepatic cholestasis of pregnancy were more likely to deliver before term than those without intrahepatic cholestasis of pregnancy (30.1% vs 9.3%; P<.001), increased rates of stillbirth were not noted at any point after stratification of the cohort by gestational age at delivery. Patients with intrahepatic cholestasis of pregnancy diagnosis codes delivered earlier than those without intrahepatic cholestasis of pregnancy diagnosis codes, but the percentage of births affected by stillbirth was lower, even when stratifying for gestational age at birth. These results may provide reassurance to patients receiving an intrahepatic cholestasis of pregnancy diagnosis that current management does mitigate stillbirth risk in intrahepatic cholestasis of pregnancy.

¿Cuándo se debe realizar la fijación testicular contralateral en pacientes pospuberales con torsión testicular? Estudio comparativo

ObjectiveIn this study, we aimed to describe the timing of contralateral testicular fixation with our ten year results in postpubertal patients with testicular torsion with a patient-based approach. MethodsPostpubertal patients diagnosed with testicular torsion in a tertiary hospital between January-2012 and September-2022 were divided into two groups according to the «patient-based approach» criteria we adopted in our clinic. Group1 in whom the contralateral teste was fixed in the same surgical act and group2 in whom the fixation was deferred. Both groups, were retrospectively examined, statistically analyzed and compared. ResultsA total of 41 patients were included in the study. Among those, 19 (46.3%) were fixed in the same act, and 22 (53.7%) underwent postponed elective contralateral testicular fixation. Early term wound dehiscence was observed in one patient in each group (4.5% group1 vs. 5.3% group2). In the postoperative period, no contralateral testicular atrophy or torsion was detected in the study groups during 1-year follow-up. ConclusionThere is no algorithm for when contralateral testicular fixation should be performed in postpubertal patients with testicular torsion. Patient-based approaches, in which the clinical characteristics of the patient are prioritized in determining the timing of contralateral testicular fixation, can produce more effective and safe results.

Effect of delivery mode on admission to neonatal intensive care unit in healthy singleton pregnancies.

The aim of this study was to evaluate the short-term results of perinatal health in vaginal and cesarean deliveries and the indications for admission to the neonatal intensive care unit (NICU) in terms of healthy singleton pregnancies. In this study, 300 pregnant women who gave birth in our tertiary hospital was included. The records of newborns admitted to the NICU of these pregnant women were reviewed between January 1, 2019 and January 1, 2021. Durations of newborn hospitalizations and problems encountered during admission were recorded. The results were statistically evaluated. There was no significant difference between vaginal delivery and cesarean section groups in terms of the indications for admission to the NICU of term low-risk pregnant women (p=0.91, p=0.17). A higher admission in the NICU was found in the early term group. The early term group required more respiratory support compared to the full term group (p=0.02). When the groups were compared in terms of IV fluid treatment support, hypoglycemia or feeding difficulty, and jaundice requiring phototherapy, no significant difference was found. Withlimited data available for admission indications to the NICU of newborns born from term pregnancies, we found that the mode of delivery affects hospitalization indications of newborns, need for support, and Apgar scores. Early term delivery is associated with higher rates of neonatal morbidity and admission to the NICU. Better maternal care and prevention of factors that may lead to preterm birth will provide the prevention and management of these problems.

Early dark energy with power-law F(R) gravity

We study a power-law F(R) gravity with an early dark energy term, that can describe both the early-time and the late-time acceleration of the Universe. We confront this scenario with recent observational data including the Pantheon Type Ia supernovae, measurements of the Hubble parameter H(z) (Cosmic Chronometers), data from Baryon Acoustic Oscillations and standard rulers data from the Cosmic Microwave Background (CMB) radiation. The model demonstrates some achievements in confronting with these observations and can be compared with the Λ-Cold-Dark-Matter model. In particular, in both models we obtain very close estimates for the Hubble constant H0, but it is not true for Ωm0. The early dark energy term supports viability of the considered F(R) gravity model.

CLINICOETIOLOGICAL PROFILE, MANAGEMENT AND OUTCOME OF NEONATAL SHOCK PRESENTING WITHIN FIRST 72 HOURS OF LIFE

Objective: To study the ethology, presentation, response to treatment and outcome of neonatal shock which is one of the most common causes of morbidity and mortality in neonates while at the same time being amongst the less studied topics in pediatrics, with data from children and adult being extrapolated to the neonates. Study Design: This was a cross sectional observational study done in a government hospital of north India from 1 January 2023 to 30 April 2023.All the neonates aged 0 – 72 hours who presented to the neonatal intensive care unit (NICU) of the pediatric department of the hospital as a case of shock were included in the study. Shock was defined as decreased perfusion, altered mental status, diminished or bounding pulses, cool extremities or decreased urine output. Results: Our study included 71 patients (54.9% males and 45.1% females) out of which 77.5 % participants presented within 24 hours of birth. 54.9% babies had normal weight and 47.9% were early term. Babies born via LSCS were more likely to develop and present earlier with shock. 43.7% cases were attributed to respiratory distress syndrome, 32.4% cases to perinatal asphyxia and 27.1% to sepsis. Sepsis and Meconium aspiration were more likely to present earlier. 25.4% required triple inotropic support and 7% had catecholamine refractory shock. Mortality was 18.3% with maximum mortality seen in patients on triple inotropic support, all of whom presented with shock at less than 24 hours of age.

Retrospective analysis of 102 neonatal cases hospitalized with diagnosis of the ongoing phenomenon of neonatal period: hypernatremic dehydration

Aim: The aim of this study was to examine the prevalence of hypernatremic dehydration (HD) among term neonates admitted to a tertiary care unit over a three-year period and to identify mother and neonate related risk factors associated with HD.&#x0D; Material and Method: Medical records of 102 term babies and their mothers were analyzed retrospectively. The gender, weight at birth, type of birth, postnatal day of diagnosis, weight and weight loss percentage at diagnosis, season and presenting complaint upon admission, feeding with human milk/formula/mixed, laboratory findings, usage of antibiotics as well as maternal age, parity, residence, level of education and presence of smoking were recorded. Serum sodium (Na) levels, severity of dehydration, age on admission, and length of stay in the neonatal intensive care unit (NICU) were recorded along with any significant effect of maternal demographic properties, residence, season, gender, and type of birth.&#x0D; Results: The average Na levels were found to be 152.1±4.2 mEq/L (max:166 mEq/L). Mild, moderate and severe hypernatremia were found in 34 (33%), 62 (61%) and 6 (6%) patients, respectively. More weight loss was observed in neonates born via cesarean section vs. vaginal delivery (12.8±3.0% vs. 11.6±3.5%, p=0.01). Higher serum Na levels (153.9±4.86 mEq/L vs. 151±2.34 mEq/L, p=0.008) and a greater median age at admission (4.5 [IQR4-6]) days vs. 3 [IQR3-4]) days, p=0.03) were reported for neonates born to mothers residing in rural/suburban vs. urban areas. Serum Na levels were not different based on the mother's level of education or parity (p=0.96 and p=0.29, respectively). There was no difference in serum Na levels (p=0.05) but the percentage of weight loss was higher when the mother smoked (14.3±3.8% vs. 11.7±3.1%, p=0.003). Serum Na and glucose levels were lower, antibiotics usage rates, and prevalence of mixed feedings were higher in early term infants (p=0.01, p=0.002, p=0.04 and p=0.04, respectively). Males had higher creatinine levels (0.89±0.27 mg/dl vs. 0.78±0.28 mg/dl, p=0.005), but there was no difference between the sexes in terms of day of admission, percentage of weight loss, or length of stay in NICU.&#x0D; Conclusion: Hypernatremic dehydration is a significant and increasingly prevalent problem of neonatal period. Serum Na levels and severity of dehydration in neonates may be affected by the type of birth, mother's smoking status, residence and early term birth. Counseling on breastfeeding, education of health professionals and caregivers on the signs and symptoms of dehydration, and monitoring of body weight are essential for the prevention, diagnosis, and treatment of HD.

Newborn metabolomic signatures of maternal per- and polyfluoroalkyl substance exposure and reduced length of gestation

Marginalized populations experience disproportionate rates of preterm birth and early term birth. Exposure to per- and polyfluoroalkyl substances (PFAS) has been reported to reduce length of gestation, but the underlying mechanisms are unknown. In the present study, we characterized the molecular signatures of prenatal PFAS exposure and gestational age at birth outcomes in the newborn dried blood spot metabolome among 267 African American dyads in Atlanta, Georgia between 2016 and 2020. Pregnant people with higher serum perfluorooctanoic acid and perfluorohexane sulfonic acid concentrations had increased odds of an early birth. After false discovery rate correction, the effect of prenatal PFAS exposure on reduced length of gestation was associated with 8 metabolomic pathways and 52 metabolites in newborn dried blood spots, which suggested perturbed tissue neogenesis, neuroendocrine function, and redox homeostasis. These mechanisms explain how prenatal PFAS exposure gives rise to the leading cause of infant death in the United States.