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This article discusses the findings of three studies related to neonatal neuroprotection. The first study explores the potential use of haptoglobin as a treatment for cerebral intraventricular hemorrhage in preterm infants. The second study examines the impact of anakinra on immune function in infants with neonatal encephalopathy. The third study explores the therapeutic potential of human mesenchymal stem cells in encephalopathy of prematurity. These studies provide insights into potential treatments for neurodevelopmental impairments in preterm infants. Another study evaluates the impact of telemedicine consults on the time it takes to assess neonatal encephalopathy in a rural state, finding that the program significantly reduced assessment time and improved collaboration and communication. A study on infants with hypoxic-ischemic encephalopathy investigates the levels of immune regulatory cells and suggests their potential use as an adjuvant strategy to reduce inflammation. Lastly, a study compares the use of morphine in neonates undergoing therapeutic hypothermia for hypoxic-ischemic encephalopathy using two different cooling devices, finding no significant difference in morphine use between the groups. These studies highlight the need for further research and interventions to improve outcomes for infants with neonatal encephalopathy and hypoxic-ischemic encephalopathy. [Extracted from the article]

Postoperative cognitive dysfunction (POCD) is a neurological disorder characterized by the emergence of cognitive impairment after surgery. A growing body of literature suggests that the onset of POCD is closely tied to circadian rhythm disruption (CRD). Circadian rhythms are patterns of behavioral and physiological change that repeat themselves at approximately, but not exactly, every 24 h. They are entrained to the 24 h day by the daily light--dark cycle. Postoperative CRD affects cognitive function likely by disrupting sleep architecture, which in turn provokes a host of pathological processes including neuroinflammation, blood--brain barrier disturbances, and glymphatic pathway dysfunction. Therefore, to address the pathogenesis of POCD it is first necessary to correct the dysregulated circadian rhythms that often occur in surgical patients. This narrative review summarizes the evidence for CRD as a key contributor to POCD and concludes with a brief discussion of how circadian-effective hospital lighting can be employed to re-entrain stable and robust circadian rhythms in surgical patients. [ABSTRACT FROM AUTHOR]

There is a need to develop therapies for neonatal encephalopathy (NE) in low‐ and middle‐income countries (LMICs) where the burden of disease is greatest and therapeutic hypothermia (HT) is not effective. We aimed to assess the efficacy of melatonin following inflammation‐amplified hypoxia–ischaemia (IA‐HI) in the newborn piglet. The IA‐HI model accounts for the contribution of infection/inflammation in this setting and HT is not cytoprotective. We hypothesised that intravenous melatonin (5% ethanol, at 20 mg/kg over 2 h at 1 h after HI + 10 mg/kg/12 h between 24 and 60 h) is safe and associated with: (i) reduction in magnetic resonance spectroscopy lactate/N‐acetylaspartate (MRS Lac/sNAA); (ii) preservation of phosphorus MRS phosphocreatine/phosphate exchange pool (PCr/Epp); (iii) improved aEEG/EEG recovery and (iv) cytoprotection on immunohistochemistry. Male and female piglets underwent IA‐HI by carotid artery occlusion and reduction in FiO2 to 6% at 4 h into Escherichia coli lipopolysaccharide sensitisation (2 μg/kg bolus + 1 μg/kg/h over 12 h). At 1 h after IA‐HI, piglets were randomised to HI‐saline (n = 12) or melatonin (n = 11). There were no differences in insult severity between groups. Target melatonin levels (15–30 mg/L) were achieved within 3 h and blood ethanol levels were <0.25 g/L. At 60 h, compared to HI‐saline, melatonin was associated with a reduction of 0.197 log10 units (95% CrI [−0.366, −0.028], Pr(sup) 98.8%) in basal‐ganglia and thalamic Lac/NAA, and 0.257 (95% CrI [−0.676, 0.164], Pr(sup) 89.3%) in white matter Lac/NAA. PCr/Epp was higher in melatonin versus HI‐saline (Pr(sup) 97.6%). Melatonin was associated with earlier aEEG/EEG recovery from 19 to 24 h (Pr(sup) 95.4%). Compared to HI‐saline, melatonin was associated with increased NeuN+ cell density (Pr(sup) 99.3%) across five of eight regions and reduction in TUNEL‐positive cell death (Pr(sup) 89.7%). This study supports the translation of melatonin to early‐phase clinical trials. Melatonin is protective following IA‐HI where HT is not effective. These data guide the design of future dose‐escalation studies in the next phase of the translational pipeline. [ABSTRACT FROM AUTHOR]

Postoperative cognitive dysfunction (POCD) is a neurological disorder characterized by the emergence of cognitive impairment after surgery. A growing body of literature suggests that the onset of POCD is closely tied to circadian rhythm disruption (CRD). Circadian rhythms are patterns of behavioral and physiological change that repeat themselves at approximately, but not exactly, every 24h. They are entrained to the 24h day by the daily light-dark cycle. Postoperative CRD affects cognitive function likely by disrupting sleep architecture, which in turn provokes a host of pathological processes including neuroinflammation, blood-brain barrier disturbances, and glymphatic pathway dysfunction. Therefore, to address the pathogenesis of POCD it is first necessary to correct the dysregulated circadian rhythms that often occur in surgical patients. This narrative review summarizes the evidence for CRD as a key contributor to POCD and concludes with a brief discussion of how circadianeffective hospital lighting can be employed to re-entrain stable and robust circadian rhythms in surgical patients. [ABSTRACT FROM AUTHOR]

Neonatal seizures are commonly associated with acute perinatal brain injury, while understanding regarding the downstream molecular pathways related to seizures remains unclear. Furthermore, effective treatment and reliable biomarkers are still lacking. Post-translational modifications can contribute to changes in protein function, and post-translational citrullination, which is caused by modification of arginine to citrulline via the calcium-mediated activation of the peptidylarginine deiminase (PAD) enzyme family, is being increasingly linked to neurological injury. Extracellular vesicles (EVs) are lipid-bilayer structures released from cells; they can be isolated from most body fluids and act as potential liquid biomarkers for disease conditions and response to treatment. As EVs carry a range of genetic and protein cargo that can be characteristic of pathological processes, the current study assessed modified citrullinated protein cargo in EVs isolated from plasma and CSF in a piglet neonatal seizure model, also following phenobarbitone treatment. Our findings provide novel insights into roles for PAD-mediated changes on EV signatures in neonatal seizures and highlight the potential of plasma- and CSF-EVs to monitor responses to treatment. [ABSTRACT FROM AUTHOR]

On the Books: Jim Crow and Algorithms of Existence is a text-mining project undertaken by University of North Carolina–Chapel Hill libraries to identify racially based laws passed in the state between 1865 and 1967. In the fall 2022, I used the On the Books project to teach a module in my Advanced Legal Research class on critical legal research and artificial intelligence and legal analytics. This article examines the benefits of those modules for teaching critical thinking about legal research structures and legacies of racism in the American legal system. [ABSTRACT FROM AUTHOR]

B MATERIALS AND METHODOLOGY: b 21 healthy newborn piglets were divided into 3 cohorts to either receive normal saline vehicles (control group A, n=6), bicuculine 4mg/kg IV (seizure group B, n= 7) to induce seizures or bicuculine 4mg/kg IV followed by phenobarbitone loading dose 20mg/kg after 10 min of continuous electrical seizures (treated seizure group C, n=8) over two time points 3h apart. Electrographic seizures were identified in 296 (33.9%) newborns, in which 26 (10.6%) had status epilepticus, 170 (69.7%) repetitive seizures and 48 (19.7%) single seizure. A comparison of treatment pathways for seizures in newborns across rural and non-rural level... B Dickman J b SP 1 sp , Carrasco McCaul M SP 1 sp I SP 1 sp University Of Wisconsin School Of Medicine And Public Health, Madison, United States i B BACKGROUND: b Seizures are more common during the neonatal period than at any other age, occurring at a rate of 1.10-5.5 per 1,000 live births. Amplitude integrated electroencephalography combined with raw electroencephalography and video imaging (video aEEG/EEG) provides real-time screening for seizure detection. The survey collected information regarding the evaluation of neonatal seizures, anti-seizure medication availability, electroencephalogram (EEG) monitoring methods, and if and how an official treatment pathway for neonatal seizure patients was established at their institution. [Extracted from the article]