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Background Abdominal compartment syndrome (ACS) is a pathological increase of the intra-abdominal pressure (IAP) with dysfunction of one or more organs. There is lack of clarity in neonates regarding what intravesical pressure (IVP) value, a surrogate marker for IAP, indicates the need for intervention for ACS. Methods The medical records at a Children's Hospital NICU were reviewed to identify all neonates that had IVP/s monitored over a 10-year period (2008–2017). Demographic parameters, IVPs, and important clinical outcomes were obtained. Associations between IVP monitoring and clinical outcomes were explored. Results Forty-six neonates had IVP monitoring, with 4 (8%) being diagnosed with ACS requiring further operative intervention. There was no significant correlation between IVP and need for surgery. There was a significant positive correlation between the maximum IVP and the need for total parenteral nutrition (rs = 0.350, p = 0.017), ventilator support (rs = 0.321, p = 0.034) and length of stay (rs = 0.362, p = 0.016) and between a diagnosis of ACS and neonatal mortality (rs = 0.299, p = 0.044). Conclusions IVP monitoring and raised IVP did not correlate with the need for surgical intervention. Raised IVP was associated with neonatal morbidity and maybe neonatal mortality. A large, prospective, observational study is required to evaluate the role of IVP monitoring in ACS and its associated outcomes. Level of Evidence III. more...

Journal of astronomical telescopes, instruments, and systems 8(01), 014007-1 (2022). doi:10.1117/1.JATIS.8.1.014007, The prototype Schwarzschild-Couder Telescope (pSCT) is a candidate for a medium-sized telescope in the Cherenkov Telescope Array. The pSCT is based on a novel dual mirror optics design which reduces the plate scale and allows for the use of silicon photomultipliers as photodetectors. The prototype pSCT camera currently has only the central sector instrumented with 25 camera modules (1600 pixels), providing a 2.68$^{\circ}$ field of view (FoV). The camera electronics are based on custom TARGET (TeV array readout with GSa/s sampling and event trigger) application specific integrated circuits. Field programmable gate arrays sample incoming signals at a gigasample per second. A single backplane provides camera-wide triggers. An upgrade of the pSCT camera is in progress, which will fully populate the focal plane. This will increase the number of pixels to 11,328, the number of backplanes to 9, and the FoV to 8.04$^{\circ}$. Here we give a detailed description of the pSCT camera, including the basic concept, mechanical design, detectors, electronics, current status and first light., Published by SPIE, [Bellingham, Wash.] more...

Background/aims Previous work assessing early developmental outcomes of infants at one year of age following surgery for esophageal atresia (OA) and/or tracheoesophageal fistula (TOF) found a significantly lower score in expressive language compared with control infants. The purpose of this study was to determine whether these differences were still evident at three years of age. Methods Between August 2006 and July 2008, infants who required surgical correction of OA/TOF were prospectively enrolled as part of a large study which examined developmental outcomes following surgery. Patients were reassessed using the Bayley Scales of Infant and Toddler Development Version III. Cognition, expressive and receptive language, fine motor and gross motor skills scores were compared with both the standardized norms and also with contemporaneous control infants. Results 24 of the 31 infants (77%) assessed at one year were reassessed at three years of age. There was no significant difference between the Bayley scores of the infants with OA/TOF and the standardized norms of the tests in four of the subsets: cognition, expressive language, fine and gross motor skills. Infants with OA scored higher than normative values for the receptive language subscale (P=0.001). When compared with the controls, there were no significant differences in any of the subscales. Conclusion Compared with the outcomes at one year, infants with OA/TOF have improved and were scoring within the normal range for the assessment at three years. This may in part be because of the early intervention services which many of these children were provided. more...

Betty Potter's Dip, an unmarked roadside location at Boxted in Essex, is named after Elizabeth Potter, an eighteenth-century suicide who was buried there. Folklore has since assumed that she was a witch. This paper examines the events surrounding Elizabeth Potter's death and burial in relation to the practice of burying suicides by the roadside, and discusses why some roadside burials may have been associated with witches. more...

Aim To compare the developmental outcome of infants with oesophageal atresia with or without trachea-oesophageal fistula (OA/TOF) who underwent surgery in early infancy with healthy control infants in New South Wales, Australia. Methods Infants diagnosed with OA/TOF requiring surgical intervention were enrolled prospectively between 1 August 2006 and the 31 December 2008. Healthy control infants were enrolled in the same time period. The children underwent a developmental assessment at 1 year of age (corrected) using the Bayley Scales of Infant and Toddler Development (Version III). Results Of 34 infants with OA/TOF that were enrolled, 31 had developmental assessments. The majority (75%) were term infants (≥37 weeks gestation) with a mean birth weight of 2717 g. Fourteen infants (44%) had an associated birth defect and one infant with multiple associated anomalies subsequently died. Developmental assessments were also performed on 62 control infants matched for gestational age. Infants with OA/TOF had a mean score significantly lower on the expressive language subscale (P more...

Early detection of neurodevelopmental delay and appropriate intervention has been associated with improved academic and social outcomes. Identifying those who are at high risk and might benefit is not straightforward. Approximately 2% of infants are admitted to a neonatal intensive care unit after birth and these babies are known to be at high risk of developmental impairment. While it is well recognised that the extreme preterm infant is at high risk of developmental impairment, there is increasing evidence of a risk in late preterm infants as well as those undergoing major cardiac and non-cardiac surgery. Not all infants are enrolled in multidisciplinary follow-up clinics with easy access to early intervention. These clinics are expensive to run with both limited and conflicting data on their long-term value. This review will concentrate on identifying which infants are at risk, reviewing the aetiology of the risk factors and the efficacy of follow-up clinics. more...

While folklorists and social historians have assumed that the roadside burial of suicides was a widespread custom in England, there have been few efforts to research or locate specific examples. This study traces documented cases of the practice, and known (or suspected) roadside graves from one area of England in an attempt to establish how common this was. more...

Aim: To describe cardiac surgery, survival and outcomes for low-birthweight (≤2500 g) infants undergoing surgery for congenital heart disease. Methods: Using data from a prospectively collected population-based database of admissions to neonatal intensive care units in New South Wales and the Australian Capital Territory, we identified all low-birthweight infants undergoing cardiac surgery between 1992 and 2001. Infants with only a persistent ductus arteriosus were excluded. Two-year cardiac and neurodevelopmental outcome data were sought from hospital medical records. Results: A total of 121 low-birthweight infants underwent cardiac surgery, of whom 34% had a congenital syndrome or non-cardiac birth defect. Most (81%) underwent a palliative surgical procedure in the neonatal period. There were 19 early (15.7%) and 19 late deaths giving a 2-year mortality of 31%. Factors associated with mortality included birthweight below 1500 g (P = 0.006), low weight at surgery (P = 0.028) and Apgar score at 1 min (P = 0.019). No single factor predicted 30-day mortality. By 2 years of age, 27 (33% of survivors) were known to have neurodevelopmental delay. Although 22 children are known to be developing normally, the neurodevelopmental status of 34 children was not known. Conclusions: These surgical data were comparable to previous single-institution studies. This group had a high risk of disability due to prematurity, low birthweight and associated conditions. There is a need to prospectively assess and manage neurodevelopmental outcomes in this group. more...

The gift of life argument, the claim that suicide is immoral because our lives are not ours to dispose of as we are their guardians or stewards, is a persistent theme in debates about the morality of suicide, assisted-suicide, and euthanasia. I argue that this argument suffers from a fatal internal incoherence. The gift can either be interpreted literally or analogically. If it is interpreted literally there are serious problems in understanding who receives the gift. If it is understood analogically the question arises whether the gift is understood to be a finite or everlasting existence. If it is finite then it is hard to see how one can be punished for bringing that existence to an end for one will not be around to be punished. If the existence is infinite it is impossible to see how one can be punished for ending one’s life because one cannot end it. However, there is still ethical mileage to be gained from the description of life as a gift and in the concluding section I indicate one way in ... more...

We report on transient hyperinsulinism (HI), presenting as severe congenital HI, in two neonates born without intrauterine growth restriction, maternal diabetes, perinatal asphyxia or Rhesus/platelet isoimmunisation. The neonates developed early ( more...

Aim: The aim of the study was to review timing and substrate of initial enteral feeding in the management of infants with gastroschisis (GS) with analysis of their relationship to nutritional outcomes and length of Neonatal Intensive Care Unit (NICU) admission. Methods: A retrospective review was conducted of consecutive admissions of infants with GS to a quaternary NICU between 2010 and 2016. Demographic, clinical data and data on nutritional status and growth were collected. Relationships between time to initiate enteral feeding and length of NICU admission, duration of parenteral nutrition (PN), and time taken to regain birth weight were assessed, as well as effect of exclusive human milk on length of NICU admission and duration of PN. Results and Conclusions: Survival in this cohort was 100%. Significant positive correlations were found between time taken to initiate enteral feeding after abdominal closure and each of the primary outcomes: length of NICU stay, duration of PN, and time taken to regain birth weight. There was no effect of exclusive human milk feeding on either duration of PN or length of NICU stay. A higher rate of exclusive human milk feeding was observed than in published literature. more...

Early detection of neurodevelopmental delay and appropriate intervention has been associated with improved academic and social outcomes. Identifying those who are at high risk and might benefit is not straightforward. Approximately 2% of infants are admitted to a neonatal intensive care unit after birth and these babies are known to be at high risk of developmental impairment. While it is well recognised that the extreme preterm infant is at high risk of developmental impairment, there is increasing evidence of a risk in late preterm infants as well as those undergoing major cardiac and non-cardiac surgery. Not all infants are enrolled in multidisciplinary follow-up clinics with easy access to early intervention. These clinics are expensive to run with both limited and conflicting data on their long-term value. This review will concentrate on identifying which infants are at risk, reviewing the aetiology of the risk factors and the efficacy of follow-up clinics. more...

Purpose The study aimed to compare the developmental outcome of infants with infantile hypertrophic pyloric stenosis (IHPS) who underwent pyloromyotomy with healthy control infants in New South Wales (NSW), Australia. Methods Infants diagnosed with IHPS requiring surgical intervention were enrolled prospectively between August 1, 2006, and July 31, 2008. Healthy control infants were enrolled in the same period. The children underwent a developmental assessment at 1 year of age (corrected) using the Bayley Scales of Infant and Toddler Development (Version III). Results Of 52 infants with IHPS who were enrolled, 43 had developmental assessments. Most (90.6%) were term infants (>36 weeks gestation) with a median birth weight of 3237.8 g. Two infants (8%) had an associated birth defect, and survival was 100%. Developmental assessments were also performed on 211 control infants. Infants with IHPS scored significantly lower on the cognitive, receptive language, fine motor, and gross motor subscales compared to the control infants. Conclusions This unique study found lower than expected developmental scores for infants after surgery for IHPS than for healthy control infants. These findings raise concerns over the potential impact of IHPS and its surgical treatment. Further studies, including continuing developmental review to determine whether these differences persist and their functional importance, should be performed. more...

To ascertain developmental differences between term infants after major noncardiac surgery and cardiac surgery compared with healthy control infants in New South Wales, Australia.This prospective population-based cohort study enrolled infants between August 1, 2006, and December 31, 2008, who required major noncardiac surgery within the first 90 days of life. Developmental outcomes were compared in these children, cohorts of term infants requiring cardiac surgery, and healthy controls. Infants were assessed at 1 year of age using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III).Of the 784 infants enrolled, 688 (90.2%) of infants alive at 1 year were assessed. Of these, 539 infants were term and were included in the present analysis. Compared with controls, the infants who underwent cardiac surgery had significantly lower (P.001) mean scores in all 5 BSID-III subscales, and the infants who underwent noncardiac surgery had significantly lower (P.05) mean scores in 4 of the 5 BSID-III subscales. The greatest difference was in the incidence of gross motor delay in both the cardiac surgery group (OR, 0.25; 95% CI, 0.16-0.41) and the noncardiac surgery group (OR, 0.41; 95% CI, 0.26-0.63).This unique population-based prospective study compared the developmental outcomes of infants who underwent major noncardiac surgery and cardiac surgery. Major surgery in infants was found to be significantly associated with developmental delay at 1 year of age compared with control infants. These data have important implications for interventions and clinical review in the first year of life. more...