Exposure to electromagnetic radiation can have a profound impact on human health. Ultraviolet (UV) radiation from the sun causes skin cancer. Blue light affects the body’s circadian melatonin rhythm. At the same time, electromagnetic radiation in controlled quantities has beneficial use. UV light treats various inflammatory skin conditions, and blue light phototherapy is the standard of care for neonatal jaundice. Although quantitative measurements of exposure in these contexts are important, current systems have limited applicability outside of laboratories because of an unfavorable set of factors in bulk, weight, cost, and accuracy. We present optical metrology approaches, optoelectronic designs, and wireless modes of operation that serve as the basis for miniature, low-cost, and battery-free devices for precise dosimetry at multiple wavelengths. These platforms use a system on a chip with near-field communication functionality, a radio frequency antenna, photodiodes, supercapacitors, and a transistor to exploit a continuous accumulation mechanism for measurement. Experimental and computational studies of the individual components, the collective systems, and the performance parameters highlight the operating principles and design considerations. Evaluations on human participants monitored solar UV exposure during outdoor activities, captured instantaneous and cumulative exposure during blue light phototherapy in neonatal intensive care units, and tracked light illumination for seasonal affective disorder phototherapy. Versatile applications of this dosimetry platform provide means for consumers and medical providers to modulate light exposure across the electromagnetic spectrum in a way that can both reduce risks in the context of excessive exposure and optimize benefits in the context of phototherapy.

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Congenital chylothorax, an uncommon cause of respiratory distress in the neonate, is diagnosed initially by prenatal ultrasound or postnatal x-ray and definitively by evaluation of the fluid in the pleural space. The etiology is not well understood, and reaccumulation of fluid can occur. Thoracentesis and chest tube placement may be required to support respiratory status. Conservative treatment, which may be tried for up to five weeks, includes diet and should be attempted before surgical intervention. Nutritional status, along with fluids and electrolytes, needs to be monitored closely.

Objectives The gut microbiota of preterm infants (PTI) differs from that of term infants, with higher abundances of pathogenic bacteria and late acquisition of beneficial bacteria. This dysbiosis is affected by different types of milk and milk fortifiers fed to PTI, exposure to antibiotics after birth, and long hospitalization periods. Different enterotypes have been proposed to classify the gut bacteria ecosystems in adults, but little data exits regarding the PTI gut microbiota. Thus, the objective herein was to investigate gut microbial enterotypes of PTI infants. Methods PTI were followed from birth until NICU discharge. Data including daily feeding information and medications were obtained from the medical records. Freshly voided stool samples were collected, bacterial DNA was extracted and the V3-V4 regions of the 16S rRNA were sequenced. Enterotypes were determined using the partitioning around medoids clustering algorithm and the Jensen-Shannon divergence method using RStudio. Results A total of 551 stool samples were collected from 97 PTI. At genus level, two enterotypes were obtained; enterotype A (EA) was characterized by a high abundance (62%) of Escherichia-Shigella and Staphylococcus, whereas Enterobacteriaceae, Clostridium sensu stricto 1 and Klebsiella accounted 55% of relative abundance for Enterotype B (EB). Alpha diversity (Shannon index) was higher (P < 0.0001) in EB. In the earliest sample collected after birth (2.2 ± 1.1 weeks of life), the majority of PTI (64%) belonged to EB, but 37% of PTI switched enterotypes during their hospital stay, most of these changed from EA to EB. The change on enterotypes occurred at 4.6 ± 2.7 weeks of life. Bovine milk-based fortifier (BMF) and abundance of Escherichia-Shigella were positively associated in EA, whereas, this correlation was negative for EB. Similarly, Enterobacteriaceae abundance was positively correlated with the use of antibiotics in EA, but was negatively correlated in EB. Conclusions The gut microbiota of PTI was more likely to belong to a more diverse enterotype. There were opposite effects between both enterotypes to exposure to BMF and antibiotics. This suggests that responses to dietary and clinical factors could be dependent upon the characteristics of the gut microbiota of PTI. Funding Sources Seed grant Carle Foundation Hospital and University of Illinois. CONACyT Graduate Fellowship.

Objectives Preterm infants (PTI) are at risk for many complications including growth retardation, and co-morbidities, such as necrotizing enterocolitis. Microbiome composition is influenced by diet and other environmental factors or medical treatments. The use of mother's own milk (MOM) or donor human milk (DHM) is recommended over preterm formula (PF). However, when there is insufficient human milk (HM), PF is used. The objective of this study was to evaluate how each type of feed (MOM, DHM and PF) affects PTI gut microbiota composition during the infant's Neonatal Intensive Care Unit (NICU) stay. Methods This cohort study followed PTI from birth until discharge from the NICU. Medical records, weekly weight and daily feed volume were recorded. Stool samples (n = 551) were collected from the infant's diaper. Total DNA was extracted to assess microbiome composition, V3-V4 regions of 16S rRNA gene were amplified and sequenced using Illumina HiSeq and data were analyzed in Qiime2. Results PTI (n = 97; 63% female) were enrolled with mean gestational age (GA) of 29 ± 2.45 weeks, birth weight of 1.27 ± 0.43 kg, and 78% delivered by C-section. Infants were discharged at 37 ± 2.06 weeks corrected GA (cGA) weighing 2.69 ± 0.57 kg. At birth, PTI from black mothers (27%) had higher (P < 0.05) microbiota diversity (observed OTUs) than other ethnicities. No differences in microbiota were found for sex or mode of delivery in the first 14d postpartum. PF was not fed prior to 34 weeks cGA. Over time, microbiota beta diversity differentiated by cGA and type of feeding. In HM-fed PTI, when > 50% MOM was consumed, the abundance of Clostridium, Enterococcus, and Staphylococcus was higher (P < 0.05) than DHM. When > 50% DHM was fed, Bifidobacteium, Paeniclostridium, Staphylococcus and Veillonela increased (P < 0.05) compared to > 50% MOM. In PTI fed both HM and PF, in those consuming > 33% PF, the abundance of Clostridium difficile was higher and Staphylococcuslower than either MOM or DHM (P < 0.05). Conclusions The development of fecal microbiota of PTI was modulated by cGA, such that abundance and diversity increased over time. The fecal microbiota was differently modified by consumption of human milk, either MOM or DHM, versus PF. Ongoing studies are investigating the effect of milk fortifiers and other NICU environmental factors on the gut microbiota. Funding Sources Supported by a seed grant from Carle Foundation Hospital and University of Illinois and a CONACyT Graduate Fellowship.