AimsThe aim of this study was to estimate the proportion of neonates with Down syndrome that are admitted to a neonatal unit, and compare their management and outcomes with other neonatal admissions.MethodsThe number of Down syndrome live births recorded in the National Down Syndrome Cytogenetic Register was compared with the number of admissions of neonates with Down syndrome in 122 neonatal units born from 2009–2011 in the National Neonatal Research Database. For each neonate with Down syndrome identified in the NNRD, three control neonates of similar gestational age at birth (to nearest completed week), neonatal unit of admission, and month of admission were identified. Admission to a neonatal unit, length of stay, level of neonatal care, mortality and requirement for home oxygen were analysed using appropriate paired statistics.Results46% of neonates with Down syndrome were admitted to a neonatal unit. Boys were more likely to be admitted than girls (OR = 1.7; 95% CI: 1.4–2.0). Neonates with Down syndrome required more intensive or high dependency care compared with unaffected neonates (37% vs 27%. p < 0.01) and stayed in neonatal units for longer (11 days versus 5 days, p < 0.01). 31% of neonates with Down syndrome required respiratory support compared with 22% (p < 0.001) of unaffected neonates, and 11% were discharged requiring oxygen supplementation compared with 3% (p < 0.001) of unaffected neonates. 3% of neonates with Down syndrome died in a neonatal unit compared with 1% (p = 0.01) of unaffected neonates.ConclusionNeonates with Down syndrome are more likely than unaffected neonates to be admitted to a neonatal unit, have a prolonged stay and be discharged home on supplemental oxygen.
The classical drug development pipeline necessitates studies using animal models of human disease to gauge future efficacy in humans, however, there is a comparatively low conversion rate from success in animals to in humans. Non-alcoholic fatty liver disease (NAFLD) is a complex chronic disease without any licensed therapies and hence a major field of animal research. We performed a meta-analysis of 414 interventional rodent studies (6,575 animals) in NAFLD to assess the mean difference in hepatic triglyceride content. 20 of 21 studied drug classes had similar efficacy with a mean difference of −30% hepatic triglyceride. However, when publication bias was accounted for, this reduced to −16% difference. Study characteristics were only able to account for a minority of variability on meta-regression, and we replicated previous findings of high risk of bias across 82% of cohorts. These findings build on previous work in preclinical neuroscience and help to explain the challenge of reproducibility and translation within the field of metabolism.
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