40 research outputs found
METABOLOMIC PATTERNS OF PRETERM NEWBORNS WITH AND WITHOUT GROWTH RESTRICTION: MARKERS OF NUTRITIONAL AND CLINICAL STATUS
No full textBackground: the first thousand days of life are a critical period of time. The impact of growth restriction and nutritional issues in such early age could affect neurodevelopment and contribute to the onset of chronic adult diseases. This is especially true for preterm infants who experienced intrauterine growth restriction (IUGR) and for preterm infants who fail to thrive during the first weeks of life and develop extrauterine growth restriction (EUGR). These groups of premature babies are interesting populations to investigate with a metabolomic approach to optimize nutritional intakes.
Aims of the study: to identify clinical, biochemical and nutritional parameters associated with the IUGR condition and looking for risk factors related to extra-uterine growth retardation; to analyse and compare the urinary metabolomic pattern at birth of preterm infants with and without growth restriction at 36 weeks of postmenstrual age or at discharge, searching for potential predictive biomarkers of growth failure in the very low birth weight infants (VLBWI); to compare the urinary metabolomic profile at birth of preterm infants who develop retinopathy of prematurity (ROP, a disease related also to suboptimal nutrition) compared to preterm infants who do not develop it.
Materials and Methods: we enrolled preterm infants between 23 and 32 weeks of gestational age (GA) and/or with a birth weight <1500 g admitted to the Neonatal Intensive Care Unit (NICU) of the Department of Woman’s and Child’s Health of Padova University Hospital with early initiation of parenteral nutrition (PN). We collected clinical, biochemical and nutritional parameters from birth to 36 weeks of gestational age or discharge. Of a subgroup of patients with and without EUGR and with and without ROP we collected urinary samples within 48 hours of life and performed metabolomic analysis.
Results: from 354 newborns enrolled, 75 IUGRs were paired with 75 non-IUGRs. IUGR infants had lower anthropometric parameters at birth and during hospitalisation, they continued parenteral nutrition longer and reached full enteral feeding later. They showed reduced phosphoremia and almost all of them had EUGR at 36 weeks of GA or at discharge. We found as risk factors of EUGR also in general population lower phosphoremia levels, poor energy and protein intake, prolonged parenteral nutrition and a delay in achieving full enteral feeding. For the metabolomic analysis 16 EUGR infants were selected and matched with 16 controls: they showed a different urinary metabolomic profile at birth, characterised especially by lower levels of anti-inflammatory and anti-oxidant metabolites. Furthermore 6 ROP infants were selected and matched with 6 controls: we found a different urinary metabolomic profile with lower level of L-histidine and L-homoserine in the ROP group, suggesting a pro-inflammatory state and an altered synthesis of the sphingolipids.
Conclusions: growth restriction remains a serious problem in extremely preterm newborns, despite significant advancements in the nutritional care. EUGR is a complex and multifactorial condition but metabolomic analysis suggests a basal predisposition, which identification could be useful to tailor nutritional strategies. Similarly, ROP disease seems to be characterised by specific features in the metabolome at birth
Macronutrients and Micronutrients in Parenteral Nutrition
No full textAppropriate nutrition is of paramount importance during infancy and childhood, and Parenteral Nutrition (PN), which is the intravenous infusion of nutrients in the elementary form, may be necessary as a supplement or a full replacement for enteral nutrition [...
Around the Metadata Wall. Some Functions and Effects of Paratext in Fan Fiction
No full textThe essay tackles some of the specific functions and effects of paratext in fan fiction. Taking as a reference corpus the Pride and Prejudice fandom in the website FanFiction.net, the essay especially focuses on the peritext (everything that is located within the borders of the fan fiction website), considered in terms of a “metadata wall”, that is, a set of thresholds, made up of paratextual signals working as classifying, identifying and especially searching categories in the net of derivative texts that constitute the fan fiction archive. The analysis goes into the detail of such paratextual signals in order to emphasize the huge amount of information the reader acquires prior to any reading of the story itself, and the resulting singular dialectics between suspense and predictability which is typical of fan fiction. Bringing the argument one step further, the essay then proposes a hierarchization of the paratextual signals, discussing the importance (and the complexity) of genre issues, rating, and pairing within the fan environment, drawing on works by Anne Kustritz, Catherine Driscoll, and Elizabeth Woledge. Finally, the analysis shifts to two other major paratextual elements, Author/ Notes and readers’ comments, connecting them to, on the one hand, the serialized character of fan fiction, the problem of gaining reader attention and keeping it over time, and, on the other, again to the dialectics between uncertainty and foreknowledge. On the whole, everything points to the capital though multifaceted role played by paratext in the writing/reading experience of fan fiction
"I have everything to unlearn": Henry James, cultural studies and mass culture
No full textHenry James has always been considered the elitist and aloof writer par excellence. This essay investigates the impact of culturally oriented critical perspectives on the study of James, lowering him into the conflicts and imbalances that lacerate the field of cultural production and his own position as an author writing within that field, exposed to all the tensions that pass through it.
The last decades of the nineteenth century and the beginning of the twentieth are a crucial moment, in which the status of literature and of the literary writer undergo dramatic changes: as Frederic Jameson has put it, “two literary and cultural structures, dialectically interrelated [...] find themselves positioned in the distinct and generally incompatible spaces of the institutions of high literature and what the Frankfurt School conveniently called the «culture industry», that is, the apparatuses for the production of «popular» or mass culture”. Literature becomes more and more a commodity, which is bought, sold, which can (or cannot) produce money, which is judged for its marketplace value. James is a writer that experienced first hand this epochal phase: a novelist, but also a critic, a reviewer, simultaneously protagonist of and witness to the literary scene of his era. And if he is certainly the high priest of form, the “difficult”, opaque, and for some even unreadable writer, he is also – at the same time – he who exploited expedients and topoi of the melodramatic imagination, who accepted publishing in magazines and in installments, who came to terms with the illustration of his texts, who did not hesitate seeking new editorial markets such as popular low-cost periodicals. He has dramatized these issues in his “tales of the literary life”, a series of brief texts, most written between 1888 and the first years of the twentieth century, characterized by a multilayered chiastic structure which testifies to James’s ambivalence and contradictions. This essay proposes to consider these tales as a “multiple otherbiography” of the “high brow” writer in the late modernity, negotiating with his demonic or fascinating other(s): popular literature, the image, the growing power of the press, magazines, best sellers, advertising, and the dream of writing for as large an audience as possible
Early Optimal Parenteral Nutrition During NICU Stay and Neurodevelopmental Outcomes in Very Preterm Infants: State of the Art
No full textBackground: Preterm infants (PIs) are more susceptible to neurodevelopmental
impairment compared with term newborns. Adequate postnatal growth has been associ
ated with improved neurocognitive outcomes; therefore, optimization of nutrition may
positively impact the neurodevelopment of PIs. Objective: This study focused on macro
nutrient parenteral nutrition (PN) intake during the Neonatal Intensive Care Unit stay
and their associations with neurodevelopmental outcomes in PIs in the first two years of
life. Methods: The Embase, MEDLINE, and Cochrane Library databases were searched
using the following subject headings and terms (MeSH): “premature infants”, “parenteral
nutrition”, “growth”, “brain”, “neurodevelopment”, and “central nervous system dis
eases.” All relevant papers’ reference lists were manually searched. PN and neurodevel
opment studies concerning the first two years of life were collected and analyzed. Results:
275 potential studies were retrieved, 64 were selected for full-text reading, and 22 were
included (12 randomized controlled trials). While glucose intakes should be immediately
provided and strictly monitored avoiding hyperglycemia, the long-term outcomes of ag
gressive PN caloric intakes are uncertain. Early amino acid (AA) supplementation is man
datory and improves short-term growth, though it is questionable whether increased AA
and better neurodevelopment are directly related. Lipid infusion should be initiated right
after birth, and further investigation will enable us to ascertain the potential impacts of
lipid emulsions, particularly fish oil, on PI neurodevelopment. Conclusions: An aggres
sive PN and its possible metabolic complication could not favor neurodevelopment; the
way forward could be a customized approach, depending on the patient’s clinical state
and tolerance. Long-term follow-up studies and the search for specific markers of toler
ance are warranted
Metabolomic Patterns at Birth of Preterm Newborns with Extrauterine Growth Restriction: Towards Putative Markers of Nutritional Status
No full textBackground: Nutrition is of paramount importance during early development, since suboptimal growth in this period of life is linked to adverse long- and mid-term outcomes. This is particularly relevant for preterm infants, who fail to thrive during the first weeks of life and develop extrauterine growth restriction (EUGR). This group of premature babies represents an interesting population to investigate using a metabolomic approach to optimize nutritional intake. Aims: To analyse and compare the urinary metabolomic pattern at birth of preterm infants with and without growth restriction at 36 weeks of postmenstrual age or at discharge, searching for putative markers of growth failure. Methods: We enrolled preterm infants between 23 and 32 weeks of gestational age (GA) and/or with a birth weight Results: Sixteen EUGR infants were matched with sixteen non-EUGR controls. The EUGR group showed lower levels of L-cystathionine, kynurenic acid, L-carnosine, N-acetylglutamine, xanthurenic acid, aspartylglucosamine, DL5-hydroxylysine-hydrocloride, homocitrulline, and L-aminoadipic acid, suggesting a lower anti-inflammatory and antioxidant status with respect to the non-EUGR group. Conclusions: Metabolomic analysis suggests a basal predisposition to growth restriction, the identification of which could be useful for tailoring nutritional approaches
Spectral parameters for scattering amplitudes in N=4 super Yang-Mills theory
No full textPlanar N= 4 Super Yang-Mills theory appears to be a quantum integrable four-dimensional conformal theory. This has been used to find equations believed to describe its exact spectrum of anomalous dimensions. Integrability seemingly also extends to the planar space-time scattering amplitudes of the N= 4 model, which show strong signs of Yangian invariance. However, in contradistinction to the spectral problem, this has not yet led to equations determining the exact amplitudes. We propose that the missing element is the spectral parameter, ubiquitous in integrable models. We show that it may indeed be included into recent on-shell approaches to scattering amplitude integrands, providing a natural deformation of the latter. Under some constraints, Yangian symmetry is preserved. Finally we speculate that the spectral parameter might also be the regulator of choice for controlling the infrared divergences appearing when integrating the integrands in exactly four dimensions. © 2014 The Author(s)
Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes
No full textNecrotizing enterocolitis (NEC) is the main gastrointestinal emergency of preterm infants for whom bowel rest and parenteral nutrition (PN) is essential. Despite the improvements in neonatal care, the incidence of NEC remains high (11% in preterm newborns with a birth weight <1500 g) and up to 20–50% of cases still require surgery. In this narrative review, we report how to optimize PN in severe NEC requiring surgery. PN should begin as soon as possible in the acute phase: close fluid monitoring is advocated to maintain volemia, however fluid overload and electrolytes abnormalities should be prevented. Macronutrients intake (protein, glucose, and lipids) should be adequately guaranteed and is essential in each phase of the disease. Composite lipid emulsion should be the first choice to reduce the risk of parenteral nutrition associated liver disease (PNALD). Vitamin and trace elements deficiency or overload are frequent in long-term PN, therefore careful monitoring should be planned starting from the recovery phase to adjust their parenteral intake. Neonatologists must be aware of the role of nutrition especially in patients requiring long-term PN to sustain growth, limiting possible adverse effects and long-term deficiencies
Complementary feeding in infants born preterm: Aspects needing improvement
No full textObjective: The aim of our study was to collect data on complementary feeding
(CF) in preterm infants (PIs).
Methods: We enrolled PI≤34 weeks of gestational age discharged from the
neonatal intensive care unit (NICU) of the University Hospital of Padova. At 12
months of corrected age (CA), CF was investigated with questionnaires to the
parents and a 24‐h dietary recall. In a subgroup of newborns, we also
evaluated bone status at a CA of 12 months using quantitative ultrasound.
Results: We studied 167 ex PI at 1 year of CA. CF was introduced in 67.1% of
them between 5 and 8 months of chronological age, with fruit as the first food
(81%, n=136). Sweet drinks were consumed by 17.4% of our sample, and salt
was added in 33.5% of cases. PIs, at 1 year CA, introduced extra energy
compared to the theoretical requirement (121±31kcal/kg/day) and higher
protein intake than recommended (39±11g/day), while the intake of both total
lipids and carbohydrates was slightly lower. Vitamins and minerals were
adequate, except vitamin D. Regarding bone status, we found a correlation
between vitamin D intakes from the diet and bone parameters (metacarpus
bone transmission time: r=0.36, p=0.01) at 1 year of CA.
Conclusions: Our population of PIs started CF in agreement with current
suggestions though with a notable heterogeneity and with some mistakes.
Vitamin D intake was correlated with bone status at 1 year of C
