Aim: To describe early cerebral oxygenation (cSO 2 ) and fractional tissue oxygen extraction (FTOE) values and their evolution over the first days of life in infants with all grades of hypoxic-ischaemic encephalopathy (HIE) and to determine whether cSO 2 and FTOE measured early (6 and 12 h) can predict short-term outcome.Methods: Prospective, observational study of cerebral near-infrared spectroscopy (NIRS) in infants >36 weeks' gestation with HIE. Ten one-hour epochs of cSO 2 and FTOE were extracted for each infant over the first 84 h. Infants with moderate and severe HIE received therapeutic hypothermia (TH). Abnormal outcome was defined as abnormal magnetic resonance imaging (MRI) and/or death.Results: Fifty-eight infants were included (28 mild, 24 moderate, 6 severe). Median gestational age was 39.9 weeks (IQR 38.1-40.7) and birthweight was 3.35 kgs . cSO 2 increased and FTOE decreased over the first 24 h in all grades of HIE. Compared to the moderate group, infants with mild HIE had significantly higher cSO 2 at 6 h (p = 0.003), 9 h (p = 0.009) and 12 h (p = 0.032) and lower FTOE at 6 h (p = 0.016) and 9 h (0.029). cSO 2 and FTOE at 6 and 12 h did not predict abnormal outcome. Conclusion:Infants with mild HIE have higher cSO 2 and lower FTOE than those with moderate or severe HIE in the first 12 h of life. cSO 2 increased in all grades of HIE over the first 24 h regardless of TH status.

IMPORTANCEResults of several small randomized clinical trials have suggested that supplements of marine ω-3 fatty acids may be beneficial in treating signs and symptoms of dry eye disease (DED). However, randomized clinical trial data to examine whether ω-3 fatty acid supplements can prevent DED are lacking.OBJECTIVE To evaluate whether long-term daily supplementation with marine ω-3 fatty acids prevents the development of DED. DESIGN, SETTING, AND PARTICIPANTSThis was a prespecified ancillary study of the Vitamin D and Omega-3 Trial (VITAL), a nationwide randomized double-blind placebo-controlled 2 × 2 factorial trial of vitamin D and marine ω-3 fatty acids in the primary prevention of cancer and cardiovascular disease. Participants in this ancillary study were 23 523 US adults (men 50 years and older and women 55 years and older) who at study entry were free of a previous diagnosis of DED and were not experiencing severe dry eye symptoms.

Sleep spindles are associated with normal brain development, memory consolidation and infant sleep-dependent brain plasticity and can be used by clinicians in the assessment of brain development in infants. Sleep spindles can be detected in EEG, however, identifying sleep spindles in EEG recordings manually is very time-consuming and typically requires highly trained experts. Research on the automatic detection of sleep spindles in infant EEGs has been limited to-date. In this study, we present a novel supervised machine learning-based algorithm to detect sleep spindles in infant EEG recordings. EEGs collected from 141 ex-term born infants and 6 ex-preterm born infants, recorded at 4 months of age (adjusted), were used to train and test the algorithm. Sleep spindles were annotated by experienced clinical physiologists as the gold standard. The dataset was split into training (81 ex-term), validation (30 exterm), and testing (30 ex-term + 6 ex-preterm) set. 15 features were selected for input into a random forest algorithm. Sleep spindles were detected in the ex-term infant EEG test set with 92.1% sensitivity and 95.2% specificity. For ex-preterm born infants, the sensitivity and specificity were 80.3% and 91.8% respectively. The proposed algorithm has the potential to assist researchers and clinicians in the automated analysis of sleep spindles in infant EEG.