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Objective We aimed to investigate the feasibility of evaluating overall preterm brain growth using a gathered set of measurements of brain structures in standard cranial ultrasound planes. We called this method of assessment Brain Growth Evaluation Assessed with Transfontanellar ultrasound (B-GREAT). Study design In this prospective observational cohort study, cranial ultrasound was regularly performed (on day 1, 2, 3, and 7 of life, and then weekly until discharge, and at term) in preterm infants born with gestational age (GA) less than 32 weeks. We evaluated corpus callosum length, corpus callosum–fastigium length, anterior horn width, frontal white matter height, total brain surface, deep grey matter height, hemisphere height, transverse cerebellar diameter in the axial view, and transverse cerebellar diameter coronal view. Measurements obtained were used to develop growth charts for B-GREAT markers as a function of postmenstrual age. Reproducibility of B-GREAT markers was studied. Results A total of 528 cranial ultrasounds were performed in 80 neonates (median birth GA: 28 +5 weeks and interquartile range: 27 +3 –30 +5). The intraclass correlation coefficients for intra-observer and inter-observer analyses showed substantial agreement for all B-GREAT markers. Growth curves for B-GREAT markers were developed. Conclusion B-GREAT is a feasible and reproducible method for bedside monitoring of the growth of the main brain structures in preterm neonates. Key Points Overall neonatal brain growth is not routinely monitored using ultrasound. Old and new markers were used to build a standardized and non-invasive tool to monitor brain growth. All B-GREAT measurements had a good intra-observer and inter-observer agreement. [ABSTRACT FROM AUTHOR]

An agrivoltaic (APV) plant is a complex system, where photovoltaic (PV) energy generation is concomitant with agricultural production. These activities can be antagonistic as the presence of PV installation might reduce the favorable conditions for agriculture and vice versa. In this context, vertical bifacial PV (AbPV) farms represent a fascinating perspective to optimize the land's dual‐use request. This means finding geometrical configurations for the AbPV plant to produce the same energy as ground‐mounted PV farms, not hinder agricultural activities, and limit the photosynthetically active radiation deficit. This study evaluates the performances of a vertical bifacial APV plant, located in Sicily, as a function of the PV modules' plan allocation. The analyses developed through two software tools, SAM and PVsyst, compare the relative capabilities of monofacial and vertical bifacial farms in terms of acceptable PAR debit, and energy yield as a function of the array density. The land equivalent ratios of vertical AbPVs from a maximum value of 1.93 (p/h = 2.5) and a minimum of 1.56 (p/h = 5.0) for crops which have low sensitive response to the drop of solar radiation, while from 1.71 and 1.42 for crops which have higher sensitive response to the drop of solar radiation. [ABSTRACT FROM AUTHOR]

Idiopathic thrombocytopenic purpura (ITP) is the most common cause of acquired thrombocytopenia in children. In 20% of cases, this condition is classified as chronic when the thrombocytopenia is persistent 6 months after diagnosis. The aim of the present study is to identify the potential factors correlating with a favorable outcome in patients with chronic ITP. Some 71 patients affected by ITP were retrospectively analyzed. Results show a higher rate of spontaneous recovery that is statistically significant for patients with platelet count at diagnosis <20,000/µL. These observations suggest the possibility to delay or avoid aggressive surgical treatment for these patients. [ABSTRACT FROM AUTHOR]

Children with malignancy present an important alteration of the immune system functionality caused by the illness itself and by the therapy they undergo. Therefore, they are at high risk of contracting vaccine-preventable diseases and of developing important complications. Vaccinations represent valid devices against these infections but this condition involves two main problems: are vaccines safe in these patients? Are vaccines effective in these patients? The aim of this review is to discuss the principles of vaccination management in children with cancer. [ABSTRACT FROM AUTHOR]

Cranial ultrasound reliably diagnoses many neonatal brain disorders. Adding Doppler imaging expands the spectrum by providing information on the status of the vasculature and haemodynamics that may guide further diagnostic and clinical management. Doppler imaging may identify neonates with congenital or acquired vascular abnormalities such as perinatal stroke, sinuvenous thrombosis, vein of Galen malformation, dural sinus malformation, sinus pericranii, and developmental venous anomaly. These entities may need further investigation with complementary imaging modalities such as magnetic resonance imaging and magnetic resonance angiography, or conventional angiography.This review aims to help clinicians to improve their Doppler sonography knowledge and skills in order to use this helpful tool in neonates with neurological symptoms or suspected cerebral vascular abnormalities admitted to the neonatal intensive care unit. [ABSTRACT FROM AUTHOR]

Chronic Kidney Disease (CKD) is a clinical condition characterized by the progressive loss of kidney function. 10% of the world's population is affected by this condition, which represents the fifth leading cause of death globally. Furthermore, CKD is associated with increased risk of fatal and non-fatal cardiovascular events, and progression to end-stage renal disease. Over the last twenty years, an exponential growth in its prevalence and incidence has been observed. For this reason, various drugs have been developed and implemented in clinical practice, with various mechanisms, with the aim of reducing and minimizing this dramatic "cardio-renal" risk. These include SGLT2 inhibitors, mineralocorticoid receptor antagonists, and endothelin receptor antagonists. However, a large proportion of CKD patients do not respond sufficiently to these treatments. GLP-1 receptor agonists represent a class of antidiabetic and nephroprotective drugs that are very promising in improving the prognosis of patients with CKD, especially if associated with one of the above-mentioned classes. In this article, we discuss the direct and indirect mechanisms through which one of the GLP-1 agonists, semaglutide, ensures nephro- and cardioprotection in patients with CKD and type 2 diabetes., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)

The thalamic nuclei develop before a viable preterm age. GABAergic neuronal migration is especially active in the third trimester. Thalamic axons meet cortical axons during subplate activation and create the definitive cortical plate in the second and third trimesters. Default higher-order cortical driver connections to the thalamus are then replaced by the maturing sensory networks, in a process that is driven by first-order thalamic neurons. Surface electroencephalographic activity, generated first in the subplate and later in the cortical plate, gradually show oscillations based on the interaction of the cortex with thalamus, which is controlled by the thalamic reticular nucleus. In viable newborn infants, in addition to sensorimotor networks, the thalamus already contributes to visual, auditory, and pain processing, and to arousal and sleep. Isolated thalamic lesions may present as clinical seizures. In addition to asphyxia and stroke, infection and network injury are also common. Cranial ultrasound can be used to classify neonatal thalamic injuries based on functional parcelling of the mature thalamus. We provide ample illustration and a detailed description of the impact of neonatal focal thalamic injury on neurological development, and discuss the potential for neuroprotection based on thalamocortical plasticity., (© 2024 Mac Keith Press.)