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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.


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.

Companies should begin the scaling-up process by considering whether the required integration is even possible or feasible. If the application depends on special technology that is difficult to source, for example, that will limit scale-up. Make sure your business process owners discuss scaling considerations with the IT organization before or during the pilot phase: An end run around IT is unlikely to be successful, even for relatively simple technologies like RPA.

The health insurer Anthem, for example, is taking on the development of cognitive technologies as part of a major modernization of its existing systems. Rather than bolting new cognitive apps onto legacy technology, Anthem is using a holistic approach that maximizes the value being generated by the cognitive applications, reduces the overall cost of development and integration, and creates a halo effect on legacy systems. The company is also redesigning processes at the same time to, as CIO Tom Miller puts it, “use cognitive to move us to the next level.”

In scaling up, companies may face substantial change-management challenges. At one U.S. apparel retail chain, for example, the pilot project at a small subset of stores used machine learning for online product recommendations, predictions for optimal inventory and rapid replenishment models, and—most difficult of all—merchandising. Buyers, used to ordering product on the basis of their intuition, felt threatened and made comments like “If you’re going to trust this, what do you need me for?” After the pilot, the buyers went as a group to the chief merchandising officer and requested that the program be killed. The executive pointed out that the results were positive and warranted expanding the project. He assured the buyers that, freed of certain merchandising tasks, they could take on more high-value work that humans can still do better than machines, such as understanding younger customers’ desires and determining apparel manufacturers’ future plans. At the same time, he acknowledged that the merchandisers needed to be educated about a new way of working.

“Big Idea: The Business of Artificial Intelligence” by Erik Brynjolfsson and Andrew McAfee

“Inside Facebook’s AI Workshop” by Scott Berinato

“AI Can Be a Troublesome Teammate” by Kurt Gray

Read more

If scale-up is to achieve the desired results, firms must also focus on improving productivity. Many, for example, plan to grow their way into productivity—adding customers and transactions without adding staff. Companies that cite head count reduction as the primary justification for the AI investment should ideally plan to realize that goal over time through attrition or from the elimination of outsourcing.

In contrast to the large amount of information available on the effect of hypoinsulinemia on P450 expression, few studies have investigated the P450 expression in animals with a type 2 diabetes-like syndrome, and these studies have reported, in part, contradictory results ( Cheng and Morgan, 2001 ). Barnett and coworkers (1993) found that type 2 diabetes had no effect on the microsomal activity of CYP1, CYP2B, CYP2E, CYP3, and CYP4A in the obese-hyperglycemic ( ob / ob ) mouse. In contrast, Enriquez and coworkers (1999) reported a decrease in CYP2E1 activity and an up-regulation in Cyp4a11 and Cyp4a14 mRNA in the same mouse model.

It seems reasonable to assume that these seemingly conflicting results are due to a varying expression of the enzymes at different stages of the development of insulin resistance and diabetes. Thus, we felt that a comprehensive comparison of the P450 and GST expression in mouse populations with different, well-defined metabolic abnormalities of glucose homeostasis was necessary. The objective of this study, therefore, was to compare hepatic P450 and GST expression in the three groups of NSZO mice that are normoglycemic/normolinsulinemic, hyperinsulinemic, or hyperglycemic/hypoinsulinemic. In addition, comparisons in expression were made between male and female NSZO mice in an attempt to find associations between gender-specific gene expression and the development of the type 2 diabetes-like syndrome.

The research was approved by the Animal Experimentation Ethics Committee at the Regierungspräsidium Cologne, Germany. SJL and NZO mice were obtained from Bomholtgard (Ry, Denmark). Housing and generation of F1 hybrids (SJL × NZO) and back-crosses (NZO × F1) were as described previously by this group ( Ortlepp et al., 2000 ; Plum et al., 2000 ). In brief, after weaning (3 weeks of age), mice were maintained on either a standard rodent food (1314) or a fat-enriched diet (C1057; Altromin, Lage, Germany). The high-fat diet contained 16% fat, 46.8% carbohydrates, 17.1% protein, and 15.4 kJ/g digestible energy. The standard diet contained 5% fat, 48% carbohydrates, 22.5% protein, and 12.5 kJ/g digestible energy. Mice were killed at the age of 22 weeks in isoflurane anesthesia by exsanguination. Blood was then collected, and livers were immediately excised and snap frozen in liquid nitrogen. Samples were stored at −70°C until required.

Blood glucose, serum cholesterol, and serum triglycerides were measured by AutoAnalyzer (Johnson Johnson, Neckargemünd, Germany). Plasma insulin was determined in duplicate by radioimmunoassay (Amersham Biosciences, Freiburg, Germany) with anti-rat insulin antiserum and 125 I-labeled rat insulin as tracer. Free and bound radioactivity were separated with an anti-IgG antibody and samples were measured for activity using gamma scintillation counting. Plasma free fatty acid (FFA) content was measured using a FFA determination kit (Roche Diagnostics, Mannheim, Germany) (Table 1 ).

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KidsHealth / For Parents / Teaching Your Child Tolerance
en español Cómo enseñar tolerancia a sus hijos

America is the great "melting pot," a rich blend of cultural traditions from all over the world. Many American families can trace their histories to immigrant ancestors who traveled great distances, enduring risk and hardship, to make a home where they would be guaranteed basic freedoms. And for many American families these freedoms came with a struggle. Their parents and grandparents were denied the basic rights we value.

American society was founded on freedom from religious persecution and on tolerance of differences in beliefs and cultural heritage. The differences (or diversity) that come from people from all over the world enrich our culture, bringing new ideas and energy.

Today, more than ever, kids interact with people of differing ethnicities, religions, and cultures. Classrooms are increasingly diverse, reflecting the communities where families live and work.

A World of Difference

Some parents welcome the fact that we live in an increasingly diverse society. Others may feel more hesitant, especially if they haven't had much exposure to people different from themselves. Many kids are way ahead of their parents regarding exposure to cultural differences. Their circle of friends, their schoolmates, and their athletic teams are much more varied than those of even a generation ago.

Still, parents should help their kids prepare to live, learn, and work in communities that will become even more diverse. Teaching tolerance is important not just because it is part of our American heritage, but because the person who learns to be open to differences will have more opportunities in education, business, and many other aspects of life.

In short, your child's success depends on it. Success in today's world — and tomorrow's — depends on being able to understand, appreciate, and work with others.

Tolerance refers to an attitude of openness and respect for the differences that exist among people. Although originally used to refer to ethnic and religious differences, the concepts of diversity and tolerance can also be applied to gender, people with physical and intellectual disabilities, and other differences, too.

Tolerance means respecting and learning from others, valuing differences, bridging cultural gaps, rejecting unfair stereotypes, discovering common ground, and creating new bonds. Tolerance, in many ways, is the opposite of prejudice.

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