Search

Background: There is limited evidence on benefits of SMOF lipids (mixed fatty acid emulsion of 30% soybean oil, 30% medium chain triglycerides, 25% olive oil, and 15% fish oil) in reducing parenteral nutrition–associated cholestasis in extremely low birth weight infants, compared with soybean oil–based Intralipid. Aim: To compare incidence of parenteral nutrition–associated cholestasis in preterm infants who received Intralipid vs SMOF lipid. Methods: We conducted a retrospective study on infants with birth weight <1000 g, admitted between January 2013 to December 2022, who received parenteral nutrition for >14 days and divided them into two groups based on lipid emulsion received (Intralipid, n = 187, SMOF, n = 127). Primary outcome was incidence of parenteral nutrition–associated cholestasis, defined as direct bilirubin ≥2 mg/dl. Results: Baseline characteristics did not differ between the two groups. No significant difference was noted in parenteral nutrition–associated cholestasis between the two groups on logistic regression, (adjusted odds ratio: 0.71, 95% confidence interval 0.35–1.42, P value 0.33) after adjusting for gestational age, parenteral nutrition days, lipid days, and late‐onset sepsis. Conclusion: There was no difference in the rates of parenteral nutrition–associated cholestasis between preterm infants administered SMOF lipids and those given Intralipid. [ABSTRACT FROM AUTHOR]

To evaluate the association, if any, between closure modality (surgical ligation SL vs. catheter CC) of a hemodynamically significant patent ductus arteriosus (PDA), after failure of or contraindication to medical therapy, and immediate procedural complications, and post-procedure physiologic status in preterm (gestational age < 32 weeks) infants. In this single-center retrospective cohort study, data were accessed on infants < 32 weeks gestation, who underwent SL or CC of PDA, born from 2019–2021. The choice of modality was determined by parents, after they were provided information on both procedures. Our cohort (n = 112) included 36 (32.1%) infants who underwent SL while 76 (67.9%) underwent CC. The SL group of infants were significantly more immature at birth, younger on admission to the level IV NICU and received more mean (SD) surfactant doses than the CC group. Higher proportions of infants in the SL group had 5-min Apgar scores ≤ 5, seizures, severe intracranial hemorrhage and had received medical therapy for PDA. Both procedures were highly efficacious, with 1 unsuccessful device placement attempt and had low associated adverse events. Two (2.6%) infants had device migration 24 h after CC. SL was associated with a higher rate of immediate postoperative hypothermia whereas, in the CC group, mean airway pressure was significantly lower 48 h after, compared to before the procedure. SL and CC are comparable in short-term efficacy and safety for PDA closure. Long-term outcomes data are needed following both procedures. [ABSTRACT FROM AUTHOR]

Objective The aim of the study is to explore the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on preterm birth at different gestational ages and fetal death in the state of Michigan. Study Design Data on live births and fetal deaths in the state of Michigan from March to November in the years 2017 through 2020 were obtained from Michigan Department of Health and Human Services (MDHHS). Preterm birth rate, fetal death rate (per 1,000 live births) overall and stratified by race and maternal comorbidities during the period of pandemic (March–November 2020) were compared with the same period (March–November) in the prepandemic years (2017–2019). Results Of 328,879 live births and 1,470 fetal deaths during the study period, 77,983 live births and 242 fetal deaths were reported in 2020. Compared with prepandemic years, fetal death rate per 1,000 live births was significantly lower in 2020 (3.1 vs. 4.7 [2017], 5.2 [2018], 4.4 [2019], p -value <0.001). The adjusted risk for fetal death in 2020 was decreased (odds ratio [OR] = 0.64 [95% confidence interval (CI): 0.56–0.74], p <0.0001), compared with prepandemic years. Fetal death was significantly associated with African-American race, pregnancy hypertension and prepregnancy diabetes. No significant difference in the proportion of preterm births (<37 weeks' gestation) was noted between pandemic and prepandemic years (9.9 vs. 10.0%, p = 0.50). There was no significant difference in the risk of preterm birth across gestational age strata (<28, 28–31 6/7 , 32–36 6/7 , 37–41 6/7 , and >42 weeks) between pandemic and prepandemic years on multinomial analysis. Significant associations with preterm birth across all years included African American race, lower level of maternal education, pregnancy-induced hypertension, chronic hypertension, prepregnancy diabetes, congenital anomalies, previous preterm birth, and prolonged rupture of membranes >12 hours. Conclusion Fetal death rate was significantly lower whereas preterm births remained unchanged during pandemic in comparison with prepandemic years in the state of Michigan. Key Points A decrease in fetal death rate was noted during SARS CoV-2 pandemic in the State of Michigan. Overall state-wide rates of preterm birth did not change in 2020, compared to previous years. Significant risk factors associated with preterm birth and fetal deaths did not differ between prepandemic and pandemic years. [ABSTRACT FROM AUTHOR]

The article focuses on the case presentation of a term female newborn admitted to the neonatal intensive care unit (NICU) with respiratory distress after birth, with a diagnosis of Joubert Syndrome (JS) confirmed by MRI findings and molecular genetic testing, along with a description of the hospital course and additional medical evaluations conducted.

Peptides are short linear molecules consisting of amino acids that play an essential role in most biological processes. They can treat diseases by working as a vaccine or antimicrobial agent and serves as a cancer molecule to deliver the drug to the target site for the treatment of cancer. They have the potential to solve the drawbacks of current medications and can be industrially produced in large quantities at low cost. However, poor chemical and physical stability, short circulating plasma half-life, and solubility are some issues that need solutions before they can be used as therapeutics. PepAnalyzer tool is a user-friendly tool that predicts 15 different properties such as binding potential, half-life, transmembrane patterns, test tube stability, charge, isoelectric point, molecular weights, and molar extinction coefficients only using the sequence. The tool is designed using BioPython utility and has even results with standard tools, such as Expasy, EBI, Genecorner, and Geneinfinity. The tool assists students, researchers, and the pharmaceutical sector. The PepAnalyzer tool's online platform is accessible at the link: http://www.iksmbrlabdu.in/peptool. [ABSTRACT FROM AUTHOR]

Today, the emergence of social media is helpful for the healthcare system where everyone is closely connected. Large numbers of people can be reached by using seed nodes to provide medical advice, facilities, new changes in the treatment, and any health ministry guidelines. As today's world is dealing with COVID-19, the main objective is to provide healthcare services to many people irrespective of time and locality. As people suffering from corona are dealing with mental health issues, in order to deal with it, a seed pick framework using machine learning for the influence maximization technique is proposed, which will be helpful to provide pervasive healthcare. For pervasive healthcare, an effectual seed pick framework is required focusing on influence maximization using machine learning. The proposed algorithm Fuzzy-VIKOR is helpful to identify the targeted node to spread information at a high rate. Consequently, the proposed structure effectively addresses different issues related to a large number of patients, and thus, increased influence maximization using seed nodes is helpful for pervasive healthcare. The experiments show that the proposed framework has high precision, accuracy, F1-score, and recall compared to other existing algorithms employed to find influence maximization seeds. [ABSTRACT FROM AUTHOR]

Big Data and artificial intelligence are used to transform businesses. Social networking sites have given a new dimension to online data. Social media platforms help gather massive amounts of data to reach a wide variety of customers using influence maximization technique for innovative ideas, products and services. This paper aims to develop a deep learning method that can identify the influential users in a network. This method combines the various aspects of a user into a single graph. In a social network, the most influential user is the most trusted user. These significant users are used for viral marketing as the seeds to influence other users in the network. The proposed method combines both topical and topological aspects of a user in the network using collaborative filtering. The proposed method is DeepWalk based Influence Maximization (DWIM). The proposed method was able to find k influential nodes with computable time using the algorithm. The experiments are performed to assess the proposed algorithm, and centrality measures are used to compare the results. The results reveal its performance that the proposed method can find k influential nodes in computable time. DWIM can identify influential users, which helps viral marketing, outlier detection, and recommendations for different products and services. After applying the proposed methodology, the set of seed nodes gives maximum influence measured with respect to different centrality measures in an increased computable time. [ABSTRACT FROM AUTHOR]

Coronavirus Disease 2019 (COVID-19) is spreading across the world, and vaccinations are running parallel. Coronavirus has mutated into a triple-mutated virus, rendering it deadlier than before. It spreads quickly from person to person by contact and nasal or pharyngeal droplets. The COVID-19 database 'Our World in Data' was analyzed from February 24, 2020, to September 26, 2021, and predictions on the COVID positives and their mortality rate were made. Factors such as Vaccine data for the First and Second Dose vaccinated individuals and COVID positives that influence the fluctuations in the COVID-19 death ratio were investigated and linear regression analysis was performed. Based on vaccination doses (partial or complete vaccinated), models are created to estimate the number of patients who die from COVID infection. The estimation of variance in the datasets was investigated using Karl Pearson's coefficient. For COVID-19 cases and vaccination doses, a quartic polynomial regression model was also created. This predictor model helps to predict the number of deaths due to COVID-19 and determine the susceptibility to COVID-19 infection based on the number of vaccine doses received. SVM was used to analyze the efficacy of models generated. [ABSTRACT FROM AUTHOR]

Objective: To evaluate genetic disease among children referred to a community paediatric clinic.Design: Retrospective cohort study.Setting: Community paediatric clinic, Tower Hamlets, London.Patients: All patients seen for first time in the Child Development Team (CDT) clinic between 1999 and 2013.Interventions: Clinical notes were reviewed. Genetic test results were obtained. Exploratory Excel analysis was performed. Patients without an identified genetic disorder were labelled 'more likely genetic cause' if they had at least two out of three risk factors: developmental delay, congenital abnormality or parental consanguinity, and 'unlikely genetic cause' if they had one or no risk factors, or an obvious alternative cause.Main Outcome Measures: Prevalence of genetic diagnoses and parental consanguinity, undertaking of genetic tests, predicted likelihood of a genetic cause among unsolved patients.Results: 749 patients were included. 404 (53.9%) had undergone genetic testing and 158 of those tested (39.1%) had a confirmed genetic diagnosis. Parental relatedness was documented in 461 patients, of which 128 (27.8%) had first-cousin parents. The number of patients undergoing genetic testing increased over time. Aneuploidies and syndromic/Mendelian disorders were most common. Of the 591 patients without a genetic diagnosis, 29.9% were classified 'more likely genetic cause'. Patients with consanguineous parents were significantly more likely to have a diagnosed genetic disorder than those with non-consanguineous parents (43/128 vs 72/333), particularly an autosomal recessive condition (27/43 vs 6/72).Conclusions: Genetic disease was common and genetic testing is important in evaluating children in this clinic. Consanguinity increases the likelihood of autosomal recessive disease. [ABSTRACT FROM AUTHOR]

Imaging has many uses, but in cases of suspected child abuse, radiographs and CT scans are vital in identifying fractures and head injury that may not be clinically obvious. There are growing concerns about the small but potential adverse effects of radiation, including cancer, in the paediatric population as a result of imaging. The vast majority of general paediatricians undertaking child abuse assessments request skeletal surveys and CT scans, subjecting children to significant amounts of radiation. Informed consent must be taken from parents for these procedures and therefore this paper aims to look at evidence of the dangers of radiation in children and raise awareness among paediatricians. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the change in physiologic stability of very low-birth-weight (VLBW) infants following transport using TRIPS (transport risk index of physiologic stability) score as a measure of physiologic stability and compare changes in TRIPS score in groups of VLBW infants who underwent shorter versus longer transport. Study Design Retrospective chart review. Results Our cohort of 106 infants, 44 (41%) of whom were females, had a mean birth weight of 777 g (standard deviation [SD] 159) and median gestational age of 26 weeks (range 23 to 32 weeks). Mean weight at transfer was 1,610 g (SD 924) and mean postnatal age at transfer was 56 days (SD45). Median time on transport was 15 minutes (range 10 to 85 minutes). All 106 transports were ground transports. Of the 106 infants, 57 (54%) had deterioration, 20 (19%) had improvement, and 29 (27%) had no change in their physiologic status during transport. Comparison of the two transport duration groups based on median transport time as a cutoff point (i.e., ≤ 15 minutes and > 15 minutes) revealed a higher proportion of infants with deterioration in their physiologic status in the prolonged transport (>15 minutes) group (65% versus 45%; p = 0.03). Temperature change, either alone or in combination with other indices, was responsible for change in TRIPS score (deterioration or improvement) in 79% of these infants. Conclusions Interhospital transport of VLBW infants may cause deterioration in their physiologic status, the likelihood of which is increased with longer duration of transport. Better temperature regulation during interhospital transport may decrease the chances of deterioration in physiologic status of VLBW infants. [ABSTRACT FROM AUTHOR]

Objective: To reduce the incidence of hypothermia (admission temperatures <36°C) in extremely low birth weight (ELBW) neonates using a multi-intervention quality improvement (QI) initiative. Study design: We conducted a multi-intervention QI initiative to reduce hypothermia (admission temperatures <36°C) among preterm ELBW (≤1000 g birth weight) neonates born at Hutzel Women's Hospital. The QI project was conducted in three periods: period 1, traditional thermal care of drying and wrapping in towel; period 2, wrapping in plastic wTap without first drying; and period 3, periodic staff education, additional use of chemical warming mattress, and increase in operating room temperature from 20°C to 21°C. Statistical analysis included ANOVA, χ², and logistic regression as appropriate. Results: In our cohort of 209 patients, baseline characteristics were comparable in the three periods except for a reduction in the need for surfactant doses in the 3rd period. Temperature on admission to the neonatal intensive care unit was significantly higher, with a reduction in hypothermia in the 3rd period. There was no patient with a temperature of >37.5 C. On logistic regression, with gestational age, 5-min Apgar score, and mode of delivery as covariates, time period 3 was significantly associated with a reduction in the incidence of hypothermia (P=0.02). Conclusion: A concerted QI approach improved admission temperature in ELBW neonates, with more neonates in the euthermic range, without increasing the risk for hyperthermia. Such an approach could be associated with improved outcomes in this population. [ABSTRACT FROM AUTHOR]

Key Practitioner Messages Common childhood illnesses should always be considered/ruled out in all cases of suspected abuse., When faced with clinical presentations commonly found in cases of child abuse, all doctors should keep an open mind and formulate a differential diagnosis with abuse being one of the possibilities., When requesting an opinion from paediatricians, it is the duty of the referring clinician to be open with parents and inform them that abuse is one of the differential diagnoses. [ABSTRACT FROM AUTHOR]

Key Practitioner Messages Common childhood illnesses should always be considered/ruled out in all cases of suspected abuse., When faced with clinical presentations commonly found in cases of child abuse, all doctors should keep an open mind and formulate a differential diagnosis with abuse being one of the possibilities., When requesting an opinion from paediatricians, it is the duty of the referring clinician to be open with parents and inform them that abuse is one of the differential diagnoses. [ABSTRACT FROM AUTHOR]

Periodontitis is an inflammatory disease which manifests clinically as loss of supporting periodontal tissues including periodontal ligament, cementum, and alveolar bone, and periodontal therapy is aimed at achieving complete regeneration of these structures. To date, this goal has been tried to accomplish using various bone grafts, growth factors, and barrier membranes. Stem cells are the most fascinating area of biology today and have been used clinically in the field of medicine to treat many incurable diseases. Various human and animal studies have confirmed the presence of stem cells in dental tissues including periodontal ligament. This has opened new avenues aiming toward complete periodontal regeneration using cell-based therapies. This review provides an overview of various types of stem cells in medicine and dentistry and their potential uses especially pertaining to periodontal regeneration. [ABSTRACT FROM AUTHOR]

Factors that affect quantitative ultrasound (QUS) bone measurements have not been clearly defined for all clinical populations. To determine some technical and clinical aspects that may affect QUS bone measurement in the neonate–maternal dyad. Speed of sound (SOS) was measured at the radius and tibia using a commercial multisite axial transmission QUS instrument and three manufacturer-provided probes (CS, CR and CM). The study included 183 singleton neonates and 159 mothers. The type of probe, weight and edema significantly affected SOS measurements. In infants, the CS and CR probes measured SOS consistently at the tibia but not the radius. Gestational age was predictive of SOS from the CS probe and remained significant when race, gender, and birth weight were included. None of these parameters predicted SOS when using the CR probe. Maternal SOS at the radius and tibia was correlated with the CM probe. Maternal SOS was predicted by age but not by gravid status, number of living children, or race. There was no consistent correlation between maternal–infant dyad SOS measurements. Axial transmission SOS of bone varies with probe and site and is affected by technical and clinical factors. Valid data depend on documentation of the probes used and the clinical population studied. [ABSTRACT FROM AUTHOR]

The article discusses the role of a 'children's liason and discharge coordinator,' a child protection professional who is responsible for follow-up, training and coordination when a child is discharged from the care system. The role was introduced at Peterborough District Hospital in England after an audit of the "concern sheet" revealed dissatisfactory follow-up and reporting. The article describes the coordinator's role and duties and how they were performed. The article concludes that the introduction of the coordinator position has helped to raise awareness among the hospital staff. Documentation and follow-up, two measures whose neglect has been implicated in child deaths, have also been improved.

Shoots originating from nodal stem explants of Salix babylonica showed maximum proliferation through axillary branching on a modified Murashige-Skoog medium supplemented with 1 mg/l of benzylaminopurine. Incorporation of naphthaleneacetic acid or gibberellic acid did not enhance shoot proliferation in the presence of benzylaminopurine. Shoots were grown to a suitable length on a medium with low concentration of benzylaminopurine. Subsequently they were excised and allowed to root on a basal medium, with or without a short pre-treatment with naphthaleneacetic acid. Rooted plantlets were transferred to pots and maintained under high humidity conditions to prevent their desiccation. The high humidity conditions were gradually withdrawn and the plantlets established as independently growing saplings. [ABSTRACT FROM AUTHOR]

A letter to the editor by Dr Monika Bajaj and colleagues on an interesting caseimperforate hymen is presented.