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Necrotizing enterocolitis (NEC) is the most common and serious intestinal disease among preemies. It happens when tissue in the small or large intestine is injured or begins to die off. This causes the intestine to become inflamed or, in rare cases, develop a hole.

When this happens, the intestine can no longer hold waste, so bacteria and other waste products pass into a baby's bloodstream or abdominal cavity. This can make a baby very sick, possibly causing a life-threatening infection.

NEC typically affects babies born before 32 weeks gestation, but can happen in full-term infants who have health problems, like a heart defect . Babies with NEC usually develop it within the first 2 to 4 weeks of life. Treatment may involve stopping normal feedings and giving babies intravenous (IV) nutrition, draining the stomach and intestines, and/or giving antibiotics. Sometimes surgery is needed to remove a diseased portion of the intestines.

Most infants who develop NEC recover fully and do not have further feeding problems.

The ductus arteriosus is a blood vessel that is an essential part of fetal blood circulation, allowing blood to bypass the lungs, because oxygen for the blood comes from the mother and not from breathing air.

ductus arteriosus

In full-term babies, the ductus arteriosus closes shortly after birth, but often stays open in premature babies. When this happens, excess blood flows into the lungs and can cause breathing problems and sometimes heart failure.

Patent ductus arteriosus (PDA) is often treated with medicine, which is successful in closing the ductus arteriosus in more than 80% of infants. If medical therapy fails, surgery may be required to clamp the ductus.

Many preemies have breathing problems. Different things can cause them, butthe most common is respiratory distress syndrome (RDS).

In RDS, the baby's immature lungs don't make enough of an important substance called surfactant . Surfactant allows the inner surface of the lungs to expand properly when the infant goes from the womb to breathing air after birth. Fortunately, RDS is treatable and many infants do quite well.

surfactant

When premature delivery can't be stopped, most pregnant women can be given medication just before delivery to hasten the production of surfactant in the infant's lungs and help prevent RDS. Then, immediately after birth and several times later, surfactant can be given to the baby if needed.

Most preemies who lack surfactant will need a breathing machine (or ventilator) for a while, but the use of surfactant has greatly decreased the amount of time they spend on the ventilator.

A preemie's eyes are especially vulnerable to injury after birth. A serious complication is retinopathy of prematurity (ROP) , which is abnormal growth of the blood vessels in an infant's eye.

The Principal Community Scholars Program is a collaboration between Principal and Campus Compact that supports the leadership development of undergraduate students seeking a business or business-related degree. The curriculum and project help students develop critical skills for their careers. Students are selected through a competitive process to receive a $1,000 scholarship, participate in a civic leadership learning community and complete a community-based experiential learning project.

Make a Nomination

The process for 2018-2019 academic year scholars is now open! See below for more information and the nomination form, due September 28, 2018.

Current Scholars

In the 2017-2018 academic year, 27 students from across the Midwest were selected for this program and are completing their projects now. Giuseppe Zanotti Lucia slippers BOmviExP5

Previous Results

Last year, 20 students were selected and reported improved student leadership skills, confidence, and efficacy to help them to see themselves as community leaders.

Selected students also accomplished successful projects to address a community priority, including STEM research, establishing a food pantry, social entrepreneurship ventures, and sustainability initiatives among other things. We were delighted by the projects students completed and invite you to view reflection videos they created .

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November 9-10, 2018

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Scholar nominations will be reviewed by based on the following criteria:

Expectations

Scholar Expectations

The Principal Community Scholars Program is administered by Iowa Campus Compact and funded by Principal. It offers students the opportunity to collaborate with peers and receive support for leading a community-engaged project on their campus. Students participate in a virtual retreat, lead a project, and are eligible for a $1,000 scholarship. In order to receive the scholarship, each scholar must complete the following expectations:

Advisor Expectations

Scholar nominations will only be considered if the come from a faculty or staff member who is willing to serve in an advisor role on the students’ community engagement project. Advisors will be included on all communications about the program to help them effectively support the student.

Advising also includes:

Advisors are not expected to complete any paperwork or attend any of the meetings of the cohort and are invited to seek support from Iowa Campus Compact staff as needed.

Attend and fully participate in thePrincipal site visit and Iowa Civic Action Academy on November 9 and 10, 2018.
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Figure 1.

(A) One-compartment model of creatinine kinetics. (B) Two-compartment model of creatinine kinetics.

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Figure 2.

The rise and fall of SCr after severe AKI and recovery. In this simulation, creatinine clearance dropped acutely by 90% at 8 h and then recovered acutely to baseline levels 7 d later. Results from one- and two-compartment models of creatinine kinetics are shown.

The rise in SCr after severe AKI, defined as a 90% reduction in CrCl from baseline, is shown in Figure 3 (two-compartment model), according to baseline kidney function (no CKD and stages 2, 3, and 4 CKD). At 24 h after severe AKI, the absolute increase in SCr is nearly identical (1.8 to 2.0 mg/dl) irrespective of whether CKD is present. By contrast, the percentage increases over baseline are 246% (no CKD), 173% (stage 2), 92% (stage 3), and 47% (stage 4). The results are similar for less severe AKI, defined as a 50% reduction in CrCl from baseline ( Figure 4 ). After 24 h, the absolute increase in SCr ranges from 0.6 mg/dl (no CKD) to 0.9 mg/dl (stage 4), whereas the percentage increase in SCr ranges from 23% (stage 4) to 78% (no CKD). For both severe and less severe AKI, the time necessary to reach a 50% percent increase in SCr increases markedly with increasing stages of CKD, whereas the time necessary to reach an absolute 0.5-mg/dl increase remains relatively constant ( Figures 3 and 4 ). Table 2 illustrates the application of the RIFLE criteria to AKI in patients with and without CKD and how different AKI stages are reached despite an identical reduction in CrCl.

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Figure 3.

SCr concentrations after an abrupt 90% reduction in CrCl, superimposed on four different levels of baseline kidney function (no CKD and stages 2 through 4 CKD). Solid squares show the point at which a 100% increase in SCr has occurred; open triangles show the point at which a 1.0-mg/dl increase in SCr has occurred.

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Figure 4.

SCr concentrations after an abrupt 50% reduction in CrCl, superimposed on four different levels of baseline kidney function (no CKD and stages 2 through 4 CKD). Solid squares show the point at which a 100% increase in SCr has occurred; open triangles show the point at which a 1.0-mg/dl increase in SCr has occurred.

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Table 2.

Classification of AKI as proposed by the RIFLE criteria after severe (90% reduction in CrCl) and moderate (50% reduction in CrCl) AKI, according to baseline level of kidney function LINTERVALLE CORBIN Trainers holographic wUsesNg1UZ

The trajectory of the SCr increase differs according to the severity of AKI and baseline kidney function, as seen in Figures 3 and 4 . The time to reach within 0.1 mg/dl of predicted steady-state SCr concentrations is shown in Table 3 , according to baseline kidney function and percentage reduction in CrCl. At any given level of baseline kidney function, the more severe the AKI, the longer it takes to approach steady-state SCr concentrations. Similarly, at any given percentage reduction in CrCl, the higher the baseline SCr ( i.e. , higher CKD stage), the longer it takes to approach steady-state SCr concentrations. Simple calculations from a single-compartment model also illustrate this point. A 100% increase in SCr from 2.0 to 4.0 mg/dl requires retention of 2.0 mg/dl creatinine throughout the volume of distribution (420 dl), or 840 mg of creatinine. By contrast, the same percentage increase from 1.0 to 2.0 mg/dl requires retention of 420 mg of creatinine. At a constant creatinine generation rate of 60 mg/h and complete cessation of CrCl, the time required to reach a 100% increase is 14 h, when baseline SCr is 2.0, and 7 h, when baseline SCr is 1.0 mg/dl.

Table 1. Baseline characteristics of the study population, stratified by sex.

https://doi.org/10.1371/journal.pone.0189042.t001

With respect to anthropometric parameters women had lower BMI, waist-circumference, waist-to-hip-ratio, and visceral adipose tissue, but higher subcutaneous adipose tissue compared to men.

Regarding laboratory measures women had lower TT, ASD, and DHEAS, but higher estrone, estradiol, SHBG, and leptin. Results of the multivariable linear regression analyses are presented in Table 2 and Fig 3 .

Table 2. Association between sex hormones and anthropometry in men and women.

https://doi.org/10.1371/journal.pone.0189042.t002

Fig 3. Associations of sex hormones with leptin.

Analysis of testosterone, estrone, androstendione, and dehydroepiandrosterone-sulfate (DHEAS) with body-mass-index (BMI) and leptin among men (upper part) and women (lower part). Linear regression adjusted for age, sex, smoking, physical activity, type 2 diabetes mellitus, hypertension, and cholesterol.

https://doi.org/10.1371/journal.pone.0189042.g003

In men inverse associations between all considered anthropometric parameters with TT were found: BMI (β-coefficient, standard error (SE): -0.159, 0.037), waist-circumference (β-coefficient, SE: -0.892, 0.292), waist-to-hip-ratio (β-coefficient, SE: -9.11E -04 , 2.59E -04 ), subcutaneous adipose tissue (β-coefficient, SE: -0.156, 0.023), visceral adipose tissue (β-coefficient, SE: -0.145, 0.022), and leptin (β-coefficient, SE: -0.046, 0.009). Similarly, ASD was inversely associated with BMI (β-coefficient, SE: -0.294, 0.112), waist-circumference (β-coefficient, SE: -0.892, 0.292), subcutaneous adipose tissue (β-coefficient, SE: -0.260, 0.065), and leptin (β-coefficient, SE: -0.090, 0.018) in men. Furthermore, DHEAS was inversely associated with BMI (β-coefficient, SE: -0.680, 0.197), waist-circumference (β-coefficient, SE: -1.460, 0.696), and leptin (β-coefficient, SE: -0.085, 0.027) in men. Additionally, SHBG was inversely associated with BMI (β-coefficient, SE: -0.075, 0.013), waist-circumference (β-coefficient, SE: -0.184, 0.035), subcutaneous adipose tissue (β-coefficient, SE: -0.054, 0.010), visceral adipose tissue (β-coefficient, SE: -0.145, 0.022), and leptin (β-coefficient, SE: -0.046, 0.009) in men. No significant association between estrone and anthropometric parameters were found in men. In women, TT was positively associated with BMI (β-coefficient, SE: 1.356, 0.615). Estrone was positively associated with BMI (β-coefficient, SE: 0.014, 0.005), subcutaneous adipose tissue (β-coefficient, SE: 9.80E -03 , 4.36E -03 ), and leptin (β-coefficient, SE: 2.25E -03 , 8.45E -04 ) in women. SHBG was inversely associated with BMI (β-coefficient, SE: -0.132, 0.031), waist-circumference (β-coefficient, SE: -0.333, 0.074), waist-to-hip-ratio (β-coefficient, SE: 1.30E -03 , 3.64E -04 ), subcutaneous adipose tissue (β-coefficient, SE: -0.121, 0.023), visceral adipose tissue (β-coefficient, SE: -0.064, 0.010), and leptin (β-coefficient, SE: -0.016, 0.004) in women. Similarly, we observed these results in ANOVA ( Fig 4 ): In men, TT, ASD, and DHEAS were inversely associated with BMI and leptin, whereas estrone was positively associated with BMI and leptin. In women, all sex hormones were positively associated with BMI and leptin in ANOVA ( Fig 4 ).

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