Background: The pathophysiology of intraventricular hemorrhage (IVH) is multifactorial. This study attempts to identify genetic and clinical factors contributing to IVH in newborns with a focus on those born ≤28 weeks of gestation. Methods: This was a prospective study of 382 consecutive newborns admitted to the neonatal intensive care unit. DNA purification was conducted using standard methods. TaqMan SNP assays were conducted for functional polymorphisms in VEGF (RS699947, RS2010963, RS3025039, and RS1570360) and MMP2 (RS243685 and RS2285053) genes. An RFLP assay was done for a polymorphism in MMP9 (RS3918242). Results: The GG genotype in VEGF RS1570360 (p = 0.013) and the CC genotype in VEGF RS699947 (p = 0.036) were associated with a lower incidence of IVH amongst newborns ≤28 weeks of gestation. Chorioamnionitis, Caucasian race, and patent ductus arteriosus were associated with a higher incidence of IVH. A binary logistic regression analysis of clinical and SNP data that was significant from bivariate analysis demonstrated that VEGF RS1570360 was significantly associated with IVH (p = 0.017). Conclusion: This study demonstrated that the GA/AA genotype in VEGF RS1570360 and the AA/AC genotype in VEGF RS699947 were associated with higher incidence rates of IVH in newborns ≤28 weeks of gestation. A future study is warranted to comprehensively examine VEGF polymorphisms in association with IVH.

Parachute mitral valve (PMV) is a rare congenital cardiac valvular anomaly often associated with other congenital cardiac defects, particularly Shone's complex, but may infrequently occur in isolation. PMV and its variants are predominantly associated with mitral stenosis (MS) or rarely mitral regurgitation (MR). We present the case of a middle-aged female who was evaluated for a syncopal episode and found to have an atypical variant PMV with disproportionately long anterior mitral leaflet, bileaflet mitral valve prolapse, and mitral annular disjunction, without associated MS or MR.

No abstract

<p>The growing adoption of iPaaS (Integration Platform as a Service) solutions in organisations has led to an increased need for efficient and tailored middleware systems to manage the various data types, including various use cases of artificial intelligence and automation. While many iPaaS solutions offer similar core utilities, the differences in configuration options, the availability of connectors, range of features and the ease-of-use can greatly impact their efficacy while handling specific types of data. Most iPaaS solutions try to fit the one-size-fits-all model so that all kinds of data can be manipulated through a single iPaaS medium. Differences in data types poses a limitation to such a model. This paper aims to explore the challenges faced during best practices of the current middleware systems focussing on HR (Human Resources) data, as well as potential AI applications in the design of the iPaaS. The study also highlights the importance of considering factors such as data security, data governance, and user friendliness when selecting an iPaaS solution for HR data management and possible AI-driven strategies.</p>

<p>The growing adoption of iPaaS (Integration Platform as a Service) solutions in organisations has led to an increased need for efficient and tailored middleware systems to manage the various data types, including various use cases of artificial intelligence and automation. While many iPaaS solutions offer similar core utilities, the differences in configuration options, the availability of connectors, range of features and the ease-of-use can greatly impact their efficacy while handling specific types of data. Most iPaaS solutions try to fit the one-size-fits-all model so that all kinds of data can be manipulated through a single iPaaS medium. Differences in data types poses a limitation to such a model. This paper aims to explore the challenges faced during best practices of the current middleware systems focussing on HR (Human Resources) data, as well as potential AI applications in the design of the iPaaS. The study also highlights the importance of considering factors such as data security, data governance, and user friendliness when selecting an iPaaS solution for HR data management and possible AI-driven strategies.</p>

<p>The growing adoption of iPaaS (Integration Platform as a Service) solutions in organisations has led to an increased need for efficient and tailored middleware systems to manage the various data types, including various use cases of artificial intelligence and automation. While many iPaaS solutions offer similar core utilities, the differences in configuration options, the availability of connectors, range of features and the ease-of-use can greatly impact their efficacy while handling specific types of data. Most iPaaS solutions try to fit the one-size-fits-all model so that all kinds of data can be manipulated through a single iPaaS medium. Differences in data types poses a limitation to such a model. This paper aims to explore the challenges faced during best practices of the current middleware systems focussing on HR (Human Resources) data, as well as potential AI applications in the design of the iPaaS. The study also highlights the importance of considering factors such as data security, data governance, and user friendliness when selecting an iPaaS solution for HR data management and possible AI-driven strategies.</p>

No abstract

A term, male neonate presents with pulmonary atresia, discontinuous branch pulmonary arteries (PA) arising from independent ducti arteriosus, and dextrocardia presents a challenging treatment plan. The right pulmonary artery (RPA) arose from the ascending aorta while the left pulmonary artery (LPA) arose from the left subclavian artery, with the proximal segments of each spaced about 1 cm apart, making primary unifocalization suboptimal. The cardiac anatomy included: dextrocardia with situs inversus, double outlet right ventricle (DORV) with malposed great arteries and pulmonary atresia, left sided inferior and superior venae cava, and a right aortic arch with mirror image branching. The neonate underwent cardiac catheterization on day of life 12 wherein the bilateral patent ducti arteriosus (PDA) were stented as an alternative to high-risk surgery. In addition, the pulsatile flow via the stents provided a stimulus for PA growth, facilitating transcatheter rehabilitation of distal PA hypoplasia, and optimizing later PA reconstruction. The patient underwent surgery at 13 months of age, with autologous tube creation to unifocalize the Pas and enable the Glenn procedure. Postoperative autograft stenosis was later managed via cardiac catheterization. This report describes the clinical management and utility of staged percutaneous intervention for complex anatomy.