We hypothesized that the distinct maturational processes take place across different cortical areas from middle fetal stage to normal time of birth and these maturational processes are altered in late third trimester. Fractional anisotropies (FA) from diffusion tensor imaging (DTI) infer the microstructures of the early developing cortical plate. High-resolution DTI of 11 fetal brain specimens at postmenstrual age of 20 weeks (or simplified as 20 weeks), 19 in vivo brains at 35 weeks, and 17 in vivo brains at normal time of birth at term (40 weeks) were acquired. Population-averaged age-specific DTI templates were established with large deformation diffeomorphic metric mapping for subject groups at 20, 35, and 40 weeks. To alleviate partial volume effects, skeletonized FA values were used for mapping averaged cortical FA to the cortical surface and measuring FA at 12 functionally distinctive cortical regions. Significant and heterogeneous FA decreases take place in distinct cortical areas from 20 to 35 weeks and from 35 to 40 weeks, suggesting differentiated cortical development patterns. Temporally nonuniform FA decrease patterns during 35-40 weeks compared with those during 20-35 weeks were observed in higher-order association cortex. Measured skeletonized FA suggested dissociated changes between cerebral cortex and white matter during 35-40 weeks.

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Objective: To evaluate point-of-care (POC) measurement of total serum bilirubin (TSB) in the management of neonatal jaundice.Study design: TSB was measured by a POC direct spectrophotometric bilirubin method (Unistatt (U/TSB)) and a standard diazo clinical laboratory method (Olympus AU640E analyzer (diazo/TSB)). Agreement between U/TSB and diazo/TSB was assessed by correlation coefficient and Bland-Altman analysis. Transcutaneous bilirubin (TcB) was measured using JM-103t (JM).Results: Correlation between U/TSB and diazo/TSB was 0.99 (n ¼ 120). Maximum difference (U/TSB minus diazo/TSB) was À2.9 mg/dl, and 79% were ±1 mg/dl; the average difference was À0.37±0.70 mg/dl and the average absolute difference was 0.60±0.52 mg/dl. Median time to determine U/TSB was 5 min. Correlation between U/TSB and JM was 0.92 (n ¼ 113). Maximum difference (U/TSB minus JM) was 6.3 mg/dl, and 45% were ±1 mg/dl; the average difference was 0.7±1.8 mg/dl and the average absolute difference was 1.4±1.2 mg/dl.Conclusion: Measurement of TSB using Unistatt provides excellent agreement with diazo/TSB and rapid turnaround time. This technique may provide reliable POC confirmation of TcB results that are above a screening cutoff value.

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