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Background and Objectives: The high rate of neonatal mortality is a major problem in health care systems all around the world. The accurate estimation of neonatal mortality is a prerequisite for the development of future health strategies that leads to the improvements in neonatal health. Providing a predictive model is, therefore, essential to reduce the neonatal mortality rate and reducing health care costs. The purpose of this study was to produce a model based on the data mining techniques to increase the accuracy of the prediction of the outcome of the neonatal mortality using a bagging neural network model in Rapidminer software. Material and Methods: This study was conducted on 8053 births (including 1605 cases and 6448 controls) across the country in 1394. The study variables including maternal diseases, mother age, gestational age, child gender, birth weight, birth order, abnormalities were selected as predictive factors for bagging neural network method. We compared bagging neural network with neural network, decision tree and nearest neighbor. Some criteria including the area under ROC curve, precision, accuracy and classification error rate were considered in comparing with other data mining models. Results: The comparison of bagging neural network with other data mining models showed that the bagging neural network gives better results compared to other models: precision (99.21), accuracy (99.17), classification error rate (0.83) and AUC value (0.992). Conclusion: We conclude that the bagging neural network may help to reduce the cost of health care system, and to improve the community health by preventing the mortality and adverse outcomes in neonates. [ABSTRACT FROM AUTHOR]

Background: Regarding improvements in preterm infants' survival rates, it is necessary the improvement of Neonatal Intensive Care Unit (NICUs) status in order to provide comprehensive care. The aim of this study was to assess the aspects of staffing-oriented neonatal care in NICUs affiliated to Universities of Medical Sciences in Iran.Methods: This survey is a cross-sectional study which was conducted in 23 NICUs of nine type-1 Universities of Medical Sciences across country. The study checklist contained 39 items in four domains, including "Composition, Philosophy, Training, and Support", "Management", "Resources", and "Transition Systems". Data were gathered through observation and analyzed using Stata software, version 13.Results: In this study, the mean score of staffing-oriented care was 43.5 of 100. In none of the studied domains, the mean score obtained was not above 50. Among the four domains studied, the highest score was related to "Management", (the mean score of 50 of 100) and the lowest score related to "Resources" (the mean score of 35 of 100).Conclusions: Considering the importance of the role of health professionals in the neonatal comprehensive care, and also the low mean score of staffing-oriented care (43.51 out of 100) and also its items in NICUs in this study, it is concluded that more attention is needed for staff-oriented care as well as the strengthening of this dimension of developmental care along with other dimensions, through designing of appropriate interventions to improve the health outcomes of preterm infants. [ABSTRACT FROM AUTHOR]

Background: Growth charts have been used to record and evaluate an infant's growth condition at birth and during infancy. The current study was undertaken to explore the anthropometric indices of growth in Iranian newborn infants to draw growth charts and compare them with charts in use. Methods: Data of singleton births was extracted from the Iranian national data centre ministry of health database between March 2014 and 2015. Newborns with ill conditions, stillbirth, congenital anomalies such as neural tube defects (NTDs), and multiple births were excluded. Our study included 1277169 singleton live births. Growth curves were created for boys (51.7%) and girls (48.2%) for birth weight, length, and head circumference. Smoothening of the curves was accomplished by using gamlss package under R.3.0.1 software. Results: The average GA was 38.5 ± 1 weeks. The average birth weight was 3242 ± 422 gram and 3125 ± 422 gram for boys and girls respectively. Length of body at birth was 50 ± 2.2 cm in boys and 49.5 ± 1.2 cm in girls and as for head circumference, the average was 35 ± 1.4 cm and 34.2 ± 2.3 cm respectively for studied boys and girls. Female newborns had lower weight, length and head circumference in comparison to male newborns. Conclusions: we observed differences between age-gender specific growth chart in Iranian newborn infants with Fenton growth chart that maybe attributed to ethnicity, regional and socioeconomic factors, mother-fetus health and nutrition status during pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: Developmental care program is a comprehensive program to reduce secondary effects of NICU and special care on brain development in premature infants. This study aimed to assess neonatal care situation in Iranian NICUs based on developmental approach to design and provide clinical guidelines for daily care for the caregivers and the infant's family.Methods: This was a cross-sectional study conducted in NICUS in Iran. A total of 23 NICUs of 9 Universities of Medical Sciences were investigated. The checklist contains 30 items in 6 domains. Data were analyzed using STATA software, version 13.Results: The total mean score obtained from all six domains was 31.29 of 100, and in all domains, the mean scores calculated were not above 50. In "supporting infant," "developmental caregiving activities," "supporting the infants' state organization," "providing neonatal pain management," "developmental care approaches in documentation," and "developmental care approaches in NICU staffing," the total mean scores were 34.76, 21.6, 20, 30.18, 31.30, and 50, respectively.Conclusion: The low mean score of infant-centered developmental care implies health staff's focus on neonatal care with at least the quality of care and its impact on development in preterm infants, and inadequate attention to the infant as an active member in care. [ABSTRACT FROM AUTHOR]

The September 2017 Chiapas (Mexico) normal-faulting intraplate earthquake (Mw 8.1) occurred within the Tehuantepec seismic gap offshore Mexico. We constrained the finite-fault slip model of this great earthquake using teleseismic and tsunami observations. First, teleseismic body-wave inversions were conducted for both steep (NP-1) and low-angle (NP-2) nodal planes for rupture velocities (Vr) of 1.5-4.0 km/s. Teleseismic inversion guided us to NP-1 as the actual fault plane, but was not conclusive about the best Vr. Tsunami simulations also confirmed that NP-1 is favored over NP-2 and guided the Vr = 2.5 km/s as the best source model. Our model has a maximum and average slips of 13.1 and 3.7 m, respectively, over a 130 km × 80 km fault plane. Coulomb stress transfer analysis revealed that the probability for the occurrence of a future large thrust interplate earthquake at offshore of the Tehuantepec seismic gap had been increased following the 2017 Chiapas normal-faulting intraplate earthquake. [ABSTRACT FROM AUTHOR]

Background: Despite scientific advances on pain measurement and intervention, pain management for infants has remained a challenge for health teams. This is because infants are not able to talk and defend themselves when they are in pain. Prevention of pain is important, not only because it is an ethical expectation, but also because repeated painful exposures can have harmful consequences. The aim of this study was to explore factors influencing neonatal pain management from the perspectives of nurses and physicians in a neonatal intensive care unit (NICU). Methods: A qualitative content analysis study was carried out. The participants were the nurses and physicians working in the NICU of Alavi medical training center in Ardabil, Iran. Twenty-five nurses took part in focus group discussions and five physicians attended private interviews. Four focus group discussions and five interviews were carried out until data saturation was ensured. Data analysis was performed using conventional content analysis. All the participants were provided with information about the purpose and the nature of the study, and provided informed consent. Results: Data analyses indicated two effective themes about barriers of implementation of infant pain management, namely "Individual Factors" and "Organizational Factors". The first theme consisted of the categories "knowledge of the personnel" and "commitment of the personnel". The second theme included three categories namely "pain control policy", "work environment condition" and "management issues". Conclusions: Our findings indicated that lack of educational courses, absence of an infant pain management policy, and management issues were the main obstacles in the way of implementation of infant pain management by nurses and physicians at the NICU. Therefore, strategies are required to reduce or remove these barriers. [ABSTRACT FROM AUTHOR]

The Wharton Basin, off southwest Sumatra, ruptured to a large intraplate left-lateral strike-slip Mw 7.8 earthquake on 2016 March 2. The epicentre was located ∼800 km to the south of another similar-mechanism intraplate Mw 8.6 earthquake in the same basin on 2012 April 11. Small tsunamis from these strike-slip earthquakes were registered with maximum amplitudes of 0.5-1.5 cm on DARTs and 1-19 cm on tide gauges for the 2016 event, and the respective values of 0.5-6 and 6-40 cm for the 2012 event. By using both teleseismic body waves and tsunami observations of the 2016 event, we obtained optimum slip models with rupture velocity (Vr ) in the range of 2.8-3.6 kms-1 belonging to both EW and NS faults. While the EW fault plane cannot be fully ruled out, we chose the best model as the NS fault plane with a Vr of 3.6 km s-1, a maximum slip of 7.7 m and source duration of 33 s. The tsunami energy period bands were 4-15 and 7-24 min for the 2016 and 2012 tsunamis, respectively, reflecting the difference in source sizes. Seismicity in the Wharton Basin is dominated by large strike-slip events including the 2012 (Mw 8.6 and 8.2) and 2016 (Mw 7.8) events, indicating that these events are possible tsunami sources in theWharton Basin. Cumulative number and cumulative seismic-moment curves revealed that most earthquakes are of strike-slip mechanisms and the largest seismic-moment is provided by the strike-slip earthquakes in this basin. [ABSTRACT FROM AUTHOR]

Background: Globally, it is estimated that approximately 13 million neonates are born prematurely each year. The development of the central nervous system in premature neonates continues outside of the uterus and in the environment of neonatal intensive care unit (NICU). This study aimed to evaluate the physical environment of hospital and nursery in Iran's tertiary care centers. Methods: This cross-sectional study was conducted on a total of 23 NICUs of nine Universities of Medical Sciences, where students are trained in the neonatal fellowship course, from seven provinces of Iran, 20th July to 21th September 2015. Data analysis was performed using SPSS software, version 16, and descriptive statistics. Results: In this study, four dimensions of physical environment of hospitals and NICUs including the accessibility of NICU, the physical environment of NICU, infants' bed space, and the sensory elements of bed spaces were evaluated. The obtained scores for each item was 41.17, 39.95, 38.83, and 39.28 out of 100, respectively. The highest mean score was 71.30 that was related to NICU temperature and ventilation considerations. The lowest mean score was 20, which was related to controlling over the movements around the infants' beds. The total mean score of the physical environment of hospital and NICU was 39.77. Conclusion: According to the results, it is recommended to take appropriate action to develop physical space and infrastructures for neonatal care regarding developmental care along with other dimensions. [ABSTRACT FROM AUTHOR]

Background: High-risk infant follow-up (HRIF) program is necessary for early detection, timely intervention, and promotion of health outcomes in vulnerable infants, ethically. The present study was carried out to assess the clinical outcomes of the HRIF Program in Alzahra hospital as a tertiary care centre, in Iran. Materials and Methods: In this cohort study, 5840 neonates were born at Alzahra hospital, from June 1, 2011 to 30th February 2012. Among those who were admitted to neonatal intensive care unit (NICU), 253 infants were recruited by census according to HRIs criteria. After doing necessary measurements and family education, information was recorded in HRI health certificate and then entered in the access database for analysis. Results: From 253 eligible HRIs registered, 241 (95%) infants attended the follow-up clinic after discharge. A total of180 cases were recalled for further visits, 110 of which attended the clinic. Anthropometric indices had an increasing trend in the first 6 months of life. There was no significant relation between ages and stages questionnaire (ASQ) results and infant birth weight, height, and head circumference. The ratios of intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP) were 8.7% and 3.1%, respectively. The incidence of congenital hypothyroidism was 2:341 in HRIs. Conclusions: Although some outcomes, such as ROP, improved in our study compared to similar studies, the findings indicate an impairment of the current follow-up processes and highlight the necessity to modify the current HRIF program. Ethically, we insist on integrating HRIF program in child health services to promote early childhood development. [ABSTRACT FROM AUTHOR]

Background: Hospitalization of infants in the neonatal intensive care unit (NICU) may disrupt the proper interaction with infants and lead to anxiety and depression, while adversely affecting the role of families. Therefore, it is necessary for healthcare teams to be familiar with the principles of parental mental health in the NICU. The present study aimed to codify the principles of parental mental health in the NICU. Methods: This study was conducted with a triangulation methodology in two steps. In the first step, the principles of mental health care for parents in the NICU were compiled and translated. In the second step, the principles were edited using the Delphi method based on the opinion of experts (physicians, faculty members, and health policymakers). Final principles of parental mental health in the NICU were codified. Results: In total, four general principles of holistic care, relationship with parents in the NICU, special care for establishing communication with families in the NICU, and principles of infants and family care were obtained. Conclusion: Since healthcare teams may not be familiar with the principles of parental mental health in the NICU, the results of the present study could lay the groundwork for promoting the knowledge of healthcare team members in interaction with parents. [ABSTRACT FROM AUTHOR]

A complicated earthquake ( M 7.8) in terms of rupture mechanism occurred in the NE coast of South Island, New Zealand, on 13 November 2016 (UTC) in a complex tectonic setting comprising a transition strike-slip zone between two subduction zones. The earthquake generated a moderate tsunami with zero-to-crest amplitude of 257 cm at the near-field tide gauge station of Kaikoura. Spectral analysis of the tsunami observations showed dual peaks at 3.6-5.7 and 5.7-56 min, which we attribute to the potential landslide and earthquake sources of the tsunami, respectively. Tsunami simulations showed that a source model with slip on an offshore plate-interface fault reproduces the near-field tsunami observation in terms of amplitude, but fails in terms of tsunami period. On the other hand, a source model without offshore slip fails to reproduce the first peak, but the later phases are reproduced well in terms of both amplitude and period. It can be inferred that an offshore source is necessary to be involved, but it needs to be smaller in size than the plate interface slip, which most likely points to a confined submarine landslide source, consistent with the dual-peak tsunami spectrum. We estimated the dimension of the potential submarine landslide at 8-10 km. [ABSTRACT FROM AUTHOR]

Background: Neonatal survival is one of the most important challenges today. Over 99% of neonatal mortalities occur in the developing countries, and epidemiologic studies emphasize on this issue in the developed countries, as well. In this study, we attempted to investigate the causes of neonatal mortality in Taleghani Hospital, Tabriz, Iran. Methods: In this cross-sectional study, we studied causes of neonatal mortality in neonatal intensive care unit (NICU) of Taleghani Hospital, Tabriz, Iran, during 2013-2014. Data collection was performed by the head nurse and treating physician using a pre-designed questionnaire. Most of the data were extracted from the neonatal records. Information regarding maternal underlying diseases and health care during pregnancy was extracted from mothers' records. Results: A total of 891 neonates were admitted to NICU of Taleghani Hospital of Tabriz, Iran, during 2013-2014, 68 (7.5%) of whom died. Among these cases, 37 (%54.4) were male, 29 (29.4%) were extremely low birth weight, and 16 (23.5%) weighed more than 2.5 kg. The main causes of mortality were congenital anomalies (35.3%), prematurity (26.5%), and sepsis (10.3%), respectively. Conclusion: Congenital anomaly is the most common cause of mortality, and the pattern of death is changing from preventable diseases to unavoidable mortalities. [ABSTRACT FROM AUTHOR]

Objective: Asphyxia is a major cause of disabilities in term-born infants. Here we have explored the value in HIE (hypoxic-ischemic-encephalopathy) of using a combination of serum pro-oxidant/antioxidant balance (PAB) assay for predicting the prognosis of asphyxia.Method: Ninety term neonates with asphyxia were enrolled and followed up for two years. Serum PAB, demographic/biochemical characteristics of mothers, and their neonates were determined. The Denver II test was used to assess outcomes.Results: Of the 90 asphyxiated neonates, 47 (52.2%) had a normal outcome and 43 babies (47.8%) had abnormal outcome. Serum PAB levels in neonates with normal and abnormal outcomes were 17.1 ± 9.23 and 48.27 ± 41.30 HK, respectively. A combination of HIE intensity and PAB, compared to other indicators, had a higher predictive-value (95.2%) for outcomes in asphyxiated babies.Conclusion: We demonstrate that PAB in combination with HIE grade may have a better predictive value for the prognosis of asphyxiated babies and predicting future neurologic problems in asphyxiated term infants. [ABSTRACT FROM AUTHOR]

The tsunami of 27 November 1945 from an Mw 8.1 earthquake in the Makran subduction zone is the only instrumentally recorded and deadly tsunami in the northwest Indian Ocean; offshore Iran, Pakistan, Oman, and India. Despite the fact that some source models have been proposed based on seismic or far-field tsunami data, none of them was able to reproduce one important observation: near-field runup of 10-12 m. Here, we applied numerical modeling and examined three possible secondary sources: (1) splay faulting, (2) delayed rupture of the earthquake source, and (3) submarine landslides. These secondary sources were added to the existing state-of-the-art earthquake source for this tsunami. Results of simulations revealed that only a submarine landslide with dimensions of 15 km (length) × 15 km (width), a thickness of 600 m, a volume of ~40 km3, and located at 63.0° E, 24.8° N is capable of reproducing the near-field tsunami observation. Such a combined earthquake-landslide source is consistent with all available observations including far-field tsunami waveforms in Karachi (Pakistan) and Mumbai (India), with near-field runup height of 10-12 m, coastal coseismic deformation data in Pasni (subsidence) and Ormara (uplift ~1-3 m), and earthquake magnitude (M 8.0-8.3). [ABSTRACT FROM AUTHOR]

Background: The survival rate of preterm and low-birth-weight (LBW) infants depends on various factors such as birth weight, gestational age, and quality of care. The present study aimed at evaluating the survival rate of preterm and LBW infants, predictive factors, and the risk of mortality in three training hospitals of Mashhad and Tabriz cities. Methods: This prospective, cohort study was conducted during six months from 2013 to 2014. Infants with birth weight ≤1500 g or gestational age ≤32 weeks were enrolled. Their information was gathered by using data collection forms and clinical risk index for infants (CRIB II) was calculated for each participant. Infants were followed up until discharge from the hospital and their outcomes were determined. Kaplan-Meier and Log rock tests were used for survival analysis. Cox regression was also applied in order to find out the factors associated with infants' survival. Results: Among the 338 followed up infants, 97 (28.7%) died and 241 (71.3%) remained alive. The median of preterm and LBW infants' overall survival rate was 76 days (CI: 60.4-91.5). Multivariate Cox regression analysis indicated that three factors of birth weight, base excess, and fifth minute Apgar score had a significant relationship with the survival rate of infants (P<0.05). Conclusion: The survival rate of preterm and low-weight infants was acceptable in this study (71%). Birth weight, fifth minute Apgar score, and base excess were important items that affected infants' survival and could be considered in predicting it in neonatal intensive care units. [ABSTRACT FROM AUTHOR]

The 16 September 2015 Illapel, Chile, earthquake and associated tsunami have been studied by many researchers from various aspects. This paper reviews studies on the source model of the earthquake and examines tsunami data. The Illapel earthquake occurred in the source region of previous earthquakes in 1943 and 1880. The earthquake source was studied using various geophysical data, such as near-field seismograms, teleseismic waveform and backprojection, GPS and InSAR data, and tsunami waveforms. Most seismological analyses show a duration of ~100 s with a peak at ~50 s. The spatial distribution has some variety, but they all have the largest slip varying from 5 to 16 m located at 31°S, 72°W, which is ~70 km NW of the epicenter. The shallow slip seems to be extended to the trench axis. A deeper slip patch was proposed from high-frequency seismic data. A tsunami earthquake model with a total duration of 250 s and a third asperity south of the epicenter is also proposed, but we show that the tsunami data do not support this model. [ABSTRACT FROM AUTHOR]

Several complications during childhood is associated with nutritional status of infants at birth. Therefore, nutritional status of newborns must be evaluated properly after birth. Assessment of the nutritional status of neonates based on anthropometric and physical indices is simple and inexpensive without the need for advanced medical equipment. However, no previous studies have focused on the assessment methods of the nutritional status of infants via anthropometric and physical indices. This study aimed to review some of the key methods used to determine the nutritional status of neonates using anthropometric and physical indices. To date, most studies have focused on the diagnosis of fetal malnutrition (FM) and growth monitoring. In order to diagnose FM, researchers have used growth charts and Ponderal index (PI) based on anthropometric indices, as well as Clinical Assessment of Nutritional (CAN) Score based on physical features. Moreover, in order to assess the growth status of infants, growth charts were used. According to the findings of this study, standard intrauterine growth curves and the PI are common measurement tools in the diagnosis of FM. Furthermore, CAN score is widely used in the evaluation of the nutritional status of neonates. Given the differences in the physical features of term and preterm infants, this index should be adjusted for preterm neonates. Longitudinal growth charts are one of the most prominent methods used for monitoring of the growth patterns of infants. [ABSTRACT FROM AUTHOR]