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ObjectiveRegarding the use of lung ultrasound (LU) in neonatal intensive care units (NICUs) across Europe, to assess how widely it is used, for what indications and how its implementation might be improved.Design and interventionInternational online survey.ResultsReplies were received from 560 NICUs in 24 countries between January and May 2023. LU uptake varied considerably (20%–98% of NICUs) between countries. In 428 units (76%), LU was used for clinical indications, while 34 units (6%) only used it for research purposes. One-third of units had <2 years of experience, and only 71 units (13%) had >5 years of experience. LU was mainly performed by neonatologists. LU was most frequently used to diagnose respiratory diseases (68%), to evaluate an infant experiencing acute clinical deterioration (53%) and to guide surfactant treatment (39%). The main pathologies diagnosed by LU were pleural effusion, pneumothorax, transient tachypnoea of the newborn and respiratory distress syndrome. The main barriers for implementation were lack of experience with technical aspects and/or image interpretation. Most units indicated that specific courses and an international guideline on neonatal LU could promote uptake of this technique.ConclusionsAlthough LU has been adopted in neonatal care in most European countries, the uptake is highly variable. The main indications are diagnosis of lung disease, evaluation of acute clinical deterioration and guidance of surfactant. Implementation may be improved by developing courses and publishing an international guideline.

ABSTRACTFollowing the killing of George Floyd on 25 May 2020, a wave of ‘Black Lives Matter’ (BLM) protests swept the globe, including most European countries. In this article, we provide a detailed comparative empirical account of the transnational diffusion of BLM protests from the USA to Italy and Germany. Shedding light on BLM mobilisations outside the USA, we complement theoretical reflections on protest diffusion by inquiring how the interplay of previously existing structural and contingent conditions influence such processes. The main theoretical contribution is hence singling out how some specific characteristics in the receiving context affect the diffusion process. Drawing from quantitative and qualitative data on the protest wave in the two countries, this research points at how, during episodes of cross-national diffusion of contentious politics, the triggering event reshaped existing social movement families in similar directions in different contexts. At the same time, however, it also points at differences in the ways in which existing actors adapt ideas coming from outside, through a mechanism of recontextualisation and adaptation. While the construction of similarities is crucial in distant contexts and cases of thin diffusion, specific national characteristics continue to play a prominent role in shaping diffusion processes.

ABSTRACTThis Special Issue investigates the European Black Lives Matter (BLM) protests that followed the protests in the USA against police brutality in the aftermath of George Floyd’s killing in May 2020. It takes an interdisciplinary theoretical perspective, interested in cultural and political contexts and the mechanism of how street protests and social movements influence public debates. It shows in various dimensions how the BLM mobilisation transformed existing anti-racist struggles within and across countries, bringing forward new debates, narratives, actors, and forms of resistance and organising in the social and cultural landscape of European countries.

Objective: To evaluate COVID-19 pandemic preparedness, available resources, and guidelines for neonatal care delivery among neonatal health care providers in low- and middle-income countries (LMICs) across all continents. Study design: Cross-sectional, web-based survey administered between May and June, 2020. Results: Of 189 invited participants in 69 LMICs, we received 145 (77%) responses from 58 (84%) countries. The pandemic provides significant challenges to neonatal care, particularly in low-income countries. Respondents noted exacerbations of preexisting shortages in staffing, equipment, and isolation capabilities. In Sub-Saharan Africa, 9/35 (26%) respondents noted increased mortality in non-COVID-19-infected infants. Clinical practices on cord clamping, isolation, and breastfeeding varied widely, often not in line with World Health Organization guidelines. Most respondents noted family access restrictions, and limited shared decision-making. Conclusions: Many LMICs face an exacerbation of preexisting resource challenges for neonatal care during the pandemic. Variable approaches to care delivery and deviations from guidelines provide opportunities for international collaborative improvement.

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Objective:Nasal high-flow therapy (nHFT) is commonly used for noninvasive respiratory support in the neonatal intensive care unit. Our objective was to determine which aspects of neonatal nHFT have achieved adequate evidence base to support consensus among experienced clinical investigators, and to document areas lacking consensus to promote future investigations.Study Design:Prospective, modified Delphi collation of tabular queries related to specific aspects of neonatal nHFT. Seven international nHFT clinical researchers were queried regarding approaches to initiation, escalation, weaning and discontinuing nHFT. Completed tables were reviewed independently by each investigator, results clarified and discussed and areas of consensus determined.Results:Consensus agreement was reached for many aspects of nHFT including: need for adequate heating and humidification, need to prevent nares occlusion, maximum flow rate of 8 l min−1, assessment of fraction of inspired oxygen (FiO2) and work of breathing for either flow escalation or weaning, equivalence of nHFT to nasal continuous positive airway pressure (nCPAP) for noninvasive support of infants of ⩾28 weeks with resolving respiratory distress and use of nHFT for noninvasive support of stable infants on nCPAP. There was general agreement for initial gas flow rates in the range of 4 to 6 l min−1and for nHFT as primary therapy for mild respiratory distress. There was no consensus on the approach to discontinuing nHFT.Conclusions:Among an experienced group of nHFT clinical researchers, there was general consensus in the approach to neonatal nHFT. Additional randomized studies are indicated to provide better evidence related to several aspects of nHFT, as well as to identify other clinical conditions where nHFT may provide safe, effective noninvasive support.

CMOS image sensors can suffer from background noise in absence of any light. In order to suppress this it is important to keep this noise, referred to as dark-current low. This implies that the internal generation current should be very low. Trace metal impurities have been reported to increase the generation current. In this study the trap-assisted generation current contributions due to 7 different metal impurities have been calculated. It was concluded that Cu and Mn impurities yield the highest generation current contribution.

We report for the first time complete data on 200mm wafer to wafer aligned copper oxide direct bonding of wafers with five metal levels each with through-silicon-vias (TSVs) as backside connection. Both surface acoustic microscope (SAM) and cross-section scanning electron microscope (X-SEM) images taken across the bonded wafer pairs evidence the good bonding quality of the resulting interface. Kelvin structures and daisy chains with up to 2500 copper to copper bonded pads are shown to be connected successfully and its resistance value to match a target value.

Background:Aerosolization of exogenous surfactant remains a challenge. This study is aimed to evaluate the efficacy of atomized poractant alfa (Curosurf) administered with a novel atomizer in preterm lambs with respiratory distress syndrome.Methods:Twenty anaesthetized lambs, 127?±?1 d gestational age, (mean ± SD) were instrumented before birth and randomized to receive either (i) positive pressure ventilation without surfactant (Control group), (ii) 200?mg/kg of bolus instilled surfactant (Bolus group) at 10?min of life or (iii) 200?mg/kg of atomized surfactant (Atomizer group) over 60?min from 10?min of life. All lambs were ventilated for 180?min with a standardized protocol. Lung mechanics, regional lung compliance (electrical impedance tomography), and carotid blood flow (CBF) were measured with arterial blood gas analysis.Results:Dynamic compliance and oxygenation responses were similar in the Bolus and Atomizer groups, and both better than Control by 180?min (all P < 0.05; two-way ANOVA). Both surfactant groups demonstrated more homogeneous regional lung compliance throughout the study period. There were no differences in CBFConclusion:In a preterm lamb model, atomized surfactant resulted in similar gas exchange and mechanics as bolus administration. This study suggests evaluation of supraglottic atomization with this system when noninvasive support is warranted.

Background:To describe the interrelationship between antenatal steroids, exogenous surfactant, and two approaches to lung recruitment at birth on oxygenation and respiratory system compliance (Cdyn) in preterm lambs.Methods:Lambs (n = 63; gestational age 127?±?1 d) received either surfactant at 10-min life (Surfactant), antenatal corticosteroids (Steroid), or neither (Control). Within each epoch lambs were randomly assigned to a 30-s 40 cmH2O sustained inflation (SI) or an initial stepwise positive end-expiratory pressure (PEEP) open lung ventilation (OLV) maneuver at birth. All lambs then received the same management for 60-min with alveolar–arterial oxygen difference (AaDO2) and Cdynmeasured at regular time points.Results:Overall, the OLV strategy improved Cdynand AaDO2(all epochs except Surfactant) compared to SI (all P < 0.05; two-way ANOVA). Irrespective of strategy, Cdynwas better in the Steroid group in the first 10?min (all P < 0.05). Thereafter, Cdynwas similar to Steroid epoch in the OLV + Surfactant, but not SI + Surfactant group. OLV influenced the effect of steroid and surfactant (P = 0.005) on AaDO2more than SI (P = 0.235).Conclusions:The antenatal state of the lung influences the type and impact of a recruitment maneuver at birth. The effectiveness of surfactant maybe enhanced using PEEP-based time-dependent recruitment strategies rather than approaches solely aimed at initial lung liquid clearance.

A total of 364 bacterial isolates, obtained from spinach leaves, were assayed in a decarboxylase broth containing histidine, lysine, and ornithine to check their ability to produce biogenic amines, and then quantified by high-performance liquid chromatography. Among these isolates, 240 formed cadaverine, 208 formed putrescine, and 196 formed histamine, in widely varying amounts. They frequently produced more than one biogenic amine. Klebsiella pneumoniaesubsp. pneumoniaeand Morganella morganiiwere the main histamine producers, with mean values of 1,600 and 2,440 mg/liter, respectively, followed by Pantoeaspp. 3 (1,710 mg/liter) and Hafnia alvei(2,500 mg/liter). Enterobacter amnigenusand Enterobacter cloacaeproduced particularly high amounts of putrescine, with mean values of 2,340 and 2,890 mg/liter, respectively. The strongest cadaverine formation was shown by Serratia liquefaciens(3,300 mg/liter), Serratia marcescens(3,280 mg/liter), and Stenotrophomonas maltophilia(1,000 mg/liter).

In a double-blind placebo-controlled prospective clinical trial we studied the efficacy and safety of the benzodiazepine antagonist, flumazenil. In 23 patients admitted to the Intensive Care Unit with coma due to overdose with benzodiazepines or other sedatives, flumazenil i.v. (up to 2mg or placebo) was given. In 13 patients given flumazenil the Glasgow Coma Scale (GCS) increased significantly from 4.9 to 7.8 (p<0.05). Six of these 13 patients, including mainly benzodiazepine mono-intoxications, needed only one series of injections (up to 1.0 mg flumazenil); the GCS increased thereby from 4.5 to 10.7 within a maximum of 5 min (p<0.01). In the remaining 7 patients, needing two series of injections of flumazenil (up to 2.0 mg), GCS did not rise significantly and coma was related to intoxications with nonbenzodiazepine sedatives, flunitrazepam and in one patient, encephalitis. In the 10 patients receiving placebo, the GCS did not change. A significant increase in the GCS from 5.5 to 10.8 (p<0.001) was, however, observed when flumazenil (up to 1.0 mg) was given after placebo. In patients with EEG monitoring the changes in waveform pattern paralleled the clinical response. Effects could be detected within 1–2min after flumazenil injection and lasted up to 45min. There were no adverse reactions or benzodiazepine withdrawal symptoms. We conclude that flumazenil is an effective and safe drug in the treatment of benzodiazepine overdose. The use of flumazenil is of diagnostic value in mixed-drug intoxications or coma of unknown origin and is of therapeutic importance for reversal of benzodiazepine intoxications.

• The accuracy of computed tomography, electroencephalography, and clinical features in the differential diagnosis of senile dementia was studied prospectively. Out of 50 demented patients, autopsy revealed 32 cases with either senile dementia of the Alzheimer's type (SDAT), multi-infarct dementia (MID), or a combination of both. Eighteen patients had dementia caused by other diseases. Based on a combination of computed tomography, electroencephalography, and clinical features, senile dementia of the Alzheimer's type was differentiated from all 50 patients, with a specificity of 83% and a sensitivity of 80%. Focusing on senile dementia of the Alzheimer's type, multi-infarct dementia, or a combination of both, specificity decreased to 65% and sensitivity to 47%. Comparing the different methods, multi-infarct processes were diagnosed with a higher sensitivity by the clinical features (73%) than by computed tomography (18%) or electroencephalography (18%). None of the methods validly differentiated multi-infarct dementia from a combination of multi-infarct dementia and senile dementia of the Alzheimer's type.

The article focuses on the art of the thanka painting, a form of Tibetan religious paintings on fabric. It provides a background about the thanka painting techniques, their role in religious celebrations as well as their important role in the everyday lives of Tibetans. It mentions that thankas are created under religious vows and meditation as dictated by tradition. It also mentions that thankas originated from Tibetan artists in Nepal but other ethnic groups who became involved in thanka painting include the Newars, Buddhist Gurung and Tamang. It suggests that the thankas are usually painted on undyed cotton but may be painted on tanned leather, silk or linen also.

The article presents information on various trends in scientific journals and books publishing and their impacts on legal discussions and licensing. It is stated that various factors elections, energy crises across the world are likely to be reflected in the scholarly publishing industry. It is stated that with the evolution scholarly content deliveries, new legal matters that are to be considered are evolving.

We report for the first time complete data on 200mm wafer to wafer aligned copper oxide direct bonding of wafers with five metal levels each with through-silicon-vias (TSVs) as backside connection. Both surface acoustic microscope (SAM) and cross-section scanning electron microscope (X-SEM) images taken across the bonded wafer pairs evidence the good bonding quality of the resulting interface. Kelvin structures and daisy chains with up to 2500 copper to copper bonded pads are shown to be connected successfully and its resistance value to match a target value.

• Thirteen patients with benzodiazepine overdosage received the specific benzodiazepine antagonist Ro 15-1788. Intravenous administration of 1.5 to 10 mg reversed the central nervous system depression induced by different benzodiazepine compounds within one to two minutes of injection. These case reports indicate that Ro 15-1788 may be an effective tool in the primary management of self-poisoning.(Arch Intern Med 1985;145:663-664)

The article discusses the challenges over the revival of books and journals that predate the Internet. It reflects to the case of the Author's Guild in the U.S., along with author representatives from Australia, and Canada, which field the partnership of five universities engaged in a so-called Orphan Works Project. Justified within the case is the author's absolute right to deny a work in digital format.