Using 17 α-hydroxyprogesterone caproate to impact rates of recurrent preterm delivery in clinical practice

Extended Solution Gate OFET-based Biosensor for Label-free Glial Fibrillary Acidic Protein Detection with Polyethylene Glycol-Containing Bioreceptor Layer

A novel organic field effect transistor (OFET) -based biosensor is described for label-free glial fibrillary acidic protein (GFAP) detection. We report the first use of an extended solution gate structure where the sensing area and the organic semiconductor are separated, and a reference electrode is not needed. Different molecular weight polyethylene glycols (PEGs) are mixed into the bio-receptor layer to help extend the Debye screening length. The drain current change was significantly increased with the help of higher molecular weight PEGs, as they are known to reduce the dielectric constant. We also investigated the sensing performance under different gate voltage (V_g). The sensitivity increased after we decreased V_g from -5 V to -2 V, because the lower V_g is much closer to the OFET threshold voltage and the influence of attached negatively charged proteins become more apparent. Finally, the selectivity experiments toward different interferents were performed. The stability and selectivity are promising for clinical applications.

The Impact of Special Health Care Needs on Academic Achievement in Children Born Prematurely

BACKGROUND

Preterm, low-birth-weight (LBW) children are at increased risk for poor academic achievement and special health care needs (SHCN) compared to term-born peers. It is not known how having SHCN during childhood modifies the relationship between LBW and achievement over time.

METHODS

We used data from the Infant Health and Development Program, a multisite randomized trial of an intervention for preterm, LBW infants with longitudinal follow-up. Primary outcome measures were Woodcock-Johnson Tests of Academic Achievement math and reading scores at age 8 and 18 years. Primary predictor was having a SHCN, defined by prescription medication and medical services use, receipt of special therapies, or any functional limitation. We used repeated measures multivariate analysis of covariance to test the effect of SHCN on achievement at 8 and 18 years and effect modification by IQ.

RESULTS

The 576 participants had a mean body weight of 1798.1 ± 455.0 g and a median gestational age of 33 weeks (range, 26-37 weeks). Mean achievement scores were as follows: math (age 8) 97.5 ± 21.6, math (age 18) 90.1 ± 18.3, reading (age 8) 99.0 ± 20.1, and reading (age 18) 96.8 ± 23.5. Mean full scale IQ at age 8 was 92.3 ± 18.2. Eighty percent had a SHCN. Mean achievement scores were significantly different between those with and without SHCN in both math and reading. There was no evidence of effect modification by IQ.

CONCLUSIONS

SHCNs are associated with poor academic achievement. Targeted interventions for improving performance outcomes by reducing the burden of chronic health problems may be accomplished through prevention strategies or efforts to limit the frequency and severity of symptoms.

The prediction of recurrent preterm birth in patients on 17-alpha-hydroxyprogesterone caproate using serial fetal fibronectin and cervical length

OBJECTIVE

The objective of the study was to estimate the predictive value of cervical length (CL) and fetal fibronectin (fFN) in patients being treated with 17-alpha-hydroxyprogesterone caproate (17P).

METHODS

This was a retrospective cohort of 176 patients with a prior spontaneous preterm birth being treated with weekly injections of 17P who underwent serial CL and fFN screening.

RESULTS

A short CL (≤25 mm) was significantly associated with an earlier gestational age at delivery and with recurrent preterm birth at less than 37, less than 35, less than 34, and less than 32 weeks. A positive fFN was not significantly associated with recurrent preterm birth. As a screening test for recurrent preterm birth, the positive and negative likelihood ratios for CL were 2.04 and 0.35, respectively, whereas for fFN they were 1.22 and 0.98, respectively, indicating that fFN did not offer any additional predictive value.

CONCLUSION

In patients being treated with 17P, cervical length at 22-32 weeks is predictive of recurrent preterm birth, but fetal fibronectin is not.