Early Discontinuation of Levothyroxine Treatment Is Safe and Feasible in Extremely Low Birth Weight Infants with Delayed Hyperthyrotropinemia.

BACKGROUND: While recent pieces of evidence suggest that discontinuation of levothyroxine replacement therapy (LRT) earlier than the current guidelines of 3 years is possible, the optimal duration of LRT for delayed hyperthyrotropinemia in extremely low birth weight infants (ELBWIs) remains unknown. OBJECTIVE: This study aimed to investigate the feasibility of early discontinuation of LRT for delayed hyperthyrotropinemia in ELBWIs. METHODS: The medical records of 92 ELBWIs who had shown delayed hyperthyrotropinemia, defined as a delayed rise in thyroid-stimulating hormone (TSH) levels to >20 µIU/mL after initial normal TSH level, were retrospectively reviewed to determine whether the duration of LRT affects the short-term outcomes at discharge from neonatal intensive care unit (NICU) and the long-term outcomes at the corrected age (CA) of 2 years. The infants were grouped into: no LRT required group (n = 21), short-term LRT given until the time of NICU discharge - 90 ± 64 (13-211) days group (n = 36), and long-term LRT given - 749 ± 333 (339-1,967) days group (n = 35). RESULTS: While mortality in the no LRT required group was significantly higher than that in the long-term LRT group, no significant differences were observed in short-term outcomes at discharge from NICU and long-term growth and neurodevelopmental outcomes at CA of 2 years between the short- and long-term LRT groups. CONCLUSIONS: Termination of LRT at around the time of discharge from NICU in well, clinically stable ELBWIs who have delayed hyperthyrotropinemia appears to be safe and feasible and avoids the risk of overtreatment.

Mesenchymal-Stem-Cell-Derived Extracellular Vesicles Attenuate Brain Injury in Escherichia coli Meningitis in Newborn Rats.

We recently reported that transplantation of mesenchymal stem cells (MSCs) significantly reduced bacterial growth and brain injury in neonatal meningitis induced by Escherichia coli (E. coli) infection in newborn rats. As a next step, to verify whether the MSCs protect against brain injury in a paracrine manner, this study was designed to estimate the efficacy of MSC-derived extracellular vesicles (MSC-EVs) in E. coli meningitis in newborn rats. E. coli meningitis was induced without concomitant bacteremia by the intra-cerebroventricular injection of 5 × 102 colony-forming units of K1 (-) E. coli in rats, at postnatal day 11. MSC-EVs were intra-cerebroventricularly transplanted 6 h after the induction of meningitis, and antibiotics were administered for three consecutive days starting at 24 h after the induction of meningitis. The increase in bacterial growth in the cerebrospinal fluid measured at 24 h after the meningitis induction was not significantly reduced following MSC-EV transplantation. However, an increase in brain cell death, reactive gliosis, and inflammation following meningitis were significantly attenuated after MSC-EV transplantation. Taken together, our results indicate that MSCs show anti-apoptotic, anti-gliosis, and anti-inflammatory, but not antibacterial effects, in an EV-mediated paracrine manner in E. coli-induced neonatal meningitis.

Early pulmonary hypertension is a risk factor for bronchopulmonary dysplasia-associated late pulmonary hypertension in extremely preterm infants.

This study evaluated whether early pulmonary hypertension (PH) in extremely preterm infants (EPIs) at 22-27 weeks of gestation detected clinically with echocardiography at 4-7 postnatal days (PND) is a risk factor for death before 36 weeks post-menstrual age (PMA) or late PH in moderate or severe (m/s) bronchopulmonary dysplasia (BPD) (BPD-PH). We analyzed risk factors for death before 36 weeks PMA or BPD-PH. Among 247 EPIs enrolled, 74 (30.0%) had early PH. Twenty-one (28.4%) infants with early PH and 18 (10.4%) without early PH died before 36 weeks PMA; 14 (18.9%) infants with early PH and 9 (5.2%) without early PH had BPD-PH at 36-38 weeks PMA. Multivariate analysis revealed that early PH (adjusted odds ratio, 6.55; 95% confidence interval, 3.10-13.82, P < 0.05), clinical chorioamnionitis (2.50; 1.18-5.31), intraventricular hemorrhage (grade 3-4) (3.43; 1.26-9.37), and late sepsis (6.76; 3.20-14.28) independently increased the risk of development of death before 36 weeks PMA or BPD-PH. Subgroup analysis among m/s BPD patients revealed that early PH (4.50; 1.61-12.58) and prolonged invasive ventilator care (> 28 days) (4.91; 1.02-23.68) increased the risk for late PH independently. In conclusion, EPIs with early PH at 4-7 PND should be monitored for BPD-associated late PH development.

Fabrication of diffraction gratings by top-down and bottom-up approaches based on scanning probe lithography.

Generation of diffraction gratings by top-down and bottom-up approaches based on scanning probe lithography is demonstrated. With regard to top-down fabrication, silicon nanostructured diffraction gratings are fabricated through one-dimensional (1D) dip-pen-nanolithography (DPN). Nanodot arrays (two-dimensional simple cubic lattice) of alkanethiol self-assembled monolayers (SAMs) are printed by 1D DPN on an Au-film-coated silicon substrate with lattice distances of 700, 1000, and 1200 nm. Silicon nanocircular pillars of length hundreds of nanometers are generated by sequential Au etching and reactive ion etching (RIE) of the 1D DPN printed sample. The performance of the silicon diffraction gratings as a microspectrometer is demonstrated through red, green, and blue color diffraction with white light incident at 45°. Moreover, arrays of zirconia nanoparticles (NPs) with an average diameter of visible wavelength (φ ≈ 470 nm) on an Au substrate are generated via bottom-up fabrication of the diffraction gratings. Microarrays of hydrophilic alkanethiol SAMs are obtained by polymer pen lithography (PPL). Self-assembly of zirconia NPs occurs after the passivation of hydrophobic alkanethiol SAMs of the PPL-printed sample. Fraunhofer diffraction with a square aperture is observed for the zirconia NP diffraction grating fabricated by the bottom-up approach.

Single-Crystal-like Perovskite for High-Performance Solar Cells Using the Effective Merged Annealing Method.

We report a simple, low cost, and quite effective method for achieving single-crystal-like CH3NH3PbI3 perovskite leading to a significant enhancement in the performance and stability of inverted planar perovskite solar cells (IPSCs). By employing a merged annealing method during the fabrication of an IPSC for preparing the perovskite CH3NH3PbI3 film, we remarkably increase the crystallinity of the CH3NH3PbI3 film and enhance the device performance and stability. An IPSC with the indium tin oxide/poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate)/CH3NH3PbI3 (active layer)/[6,6]-phenyl-C61-butyric acid methyl ester/Al structure was fabricated using the merged annealing method and exhibited significantly enhanced performance with a high power conversion efficiency of 18.27% and a fill factor of 81.34%. Moreover, since two separate annealing processes are merged in the proposed annealing method, the fabrication step becomes much simpler and easier, leading to a reduction in fabrication costs.