Search

Background: Peripherally inserted central catheter (PICC) are a necessary procedure for preterm newborns care. Despite the use of analgesic treatments, its insertion can be painful. Our objective was to study the effect of maternal voice on pain during PICC insertion., Method: We conducted a pre post study for 2 years. Pain was compared between the two groups (with/without maternal presence) using a neonatal pain scale (FANS). Infection rate, procedure time, number of failures, mothers' anxiety and caregivers'anxiety were compared between the two groups., Results: Ninety neonates were eligible. Finally, 63 neonates were included. Thirty-four placements were realized without maternal voice (first period) and 29 with maternal voice (second period). Mean FANS during PICC placement was lower in the maternal voice group than in the control group (1.15 ± 1.27 vs. 1.41 ± 1.49, p  = 0.033). The FANS was also lower in the maternal voice group during the time of the first cutaneous effraction ( p  = 0.032). There was no significant difference between the two groups concerning the other outcomes., Conclusion: Maternal voice added to conventional care decreased acute pain during PICC insertion without increasing infection rate, number of failures or procedure time., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Flours, Mons, Bedu, Lauvray, Blanquart, Woillard, Mowendabeka, Guigonis and Ponthier.) more...

Background: Early-onset neonatal sepsis represents a diagnostic challenge, as it is a cause of neonatal mortality and morbidity. Guidelines for the prevention of group B streptococcus (GBS) infection recommend that all pregnant women must be screened for GBS carriage at the end of pregnancy, with intrapartum antibiotic prophylaxis being provided for GBS carriers. If vaginal culture is not available, GBS polymerase chain reaction (GBS-PCR) is an alternative option for this type of screening. In our unit, GBS-PCR is performed when pregnant women present to the delivery room with ongoing labor and with no results of culture GBS screening available. The main objective of this study was to evaluate the impact of the results of GBS-PCR on monitoring modifications in newborns of mothers with unknown GBS status. The secondary objectives were to confirm the feasibility of a GBS-PCR-based screening method in everyday practice and to evaluate the impact of GBS-PCR results on the modification of intrapartum antibiotic therapy in pregnant women., Method: A retrospective, single-center, observational study was conducted for 1 year. For dyads with GBS-PCR performed, changes concerning intrapartum antibiotic therapy and the newborn's monitoring were recorded. The feasibility of the method was evaluated by the delay between the GBS-PCR realization and the availability of the result; in addition, the number of GBS-PCR tests that could not be realized were collected., Results: Overall, 60 GBS-PCR samples were tested for 60 pregnant women. Results were obtained for all samples, and the median duration to obtaining the GBS-PCR results was 70 min (60.8-87.2). These results were positive for 11 (18.3 %) women and led to monitoring modifications for two infants. In total, 27 pregnant women (45 %) had modifications in their antibiotic therapy due to the GBS-PCR results., Conclusion: GBS-PCR was quickly available and the results led to changes in maternal antibiotic prophylaxis and in the monitoring level of the newborns., Competing Interests: Conflict of interest None., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.) more...

Background: Urine protein assessment is important when glomerular disease or injury is suspected. Normal values of proteinuria already published for preterm newborns suffer from limitation, with small cohorts of patients. This prospective study was conducted to update the urine total protein- and albumin-to-creatinine ratio values., Methods: Urine samples were collected from 231 preterm newborns within the first 48 h (D0-1) and/or between 72-120 h of life (D3-4). Total protein, albumin, and creatinine were measured, their distribution and upper-limit values determined., Results: At D0-1 and D3-4, respectively, the median for the total protein-to-creatinine ratio were 80 and 107 mg/mmol (upper-limit values 223 and 289 mg/mmol) in the whole studied population, 149 and 214 mg/mmol in children born before 29 weeks of gestational age, 108 and 130 mg/mmol in those born between 29 and 33 weeks, and 61 and 93 mg/mmol in those born after 33 weeks. For the albumin-to-creatinine ratio, the median were 12 and 17 mg/mmol (upper-limit values 65 and 62 mg/mmol) in the whole studied population, 22 and 50 mg/mmol in children born before 29 weeks, 21 mg/mmol in those born between 29 and 33 weeks, and 8 and 12 mg/mmol in those born after 33 weeks. The use of nephrotoxic drugs and mechanical ventilation seems to influence proteinuria and albuminuria values., Conclusions: We report distribution of proteinuria- and albuminuria-to-creatinine in preterm newborns, including the upper-limit values. These values should be taken into account in the detection and diagnosis of glomerular disease and/or injury in daily clinical practice. Graphical abstract. more...

Aim: The families of hospitalised preterm infants risk depression and post-traumatic stress and the preterm infants risk re-hospitalisation. The French neonatal society's aim was to review the literature on how the transition from hospital to home could limit these risks and to produce a position paper., Methods: A systematic literature review was performed covering 1 January 2000 to 1 January 2018, and multidisciplinary experts examined the scientific evidence., Results: We identified 939 English and French papers and 169 are quoted in the position paper. Most studies stressed the importance of early, personalised and progressive involvement of the family. Healthcare staff and families should assess discharge preparations jointly. This evaluation should assess the capacities of the newborn infant, with regard to its physiological maturity. It should also assess the family's ability to supply the medical, psychological and social assistance required before and after discharge. There should be a structured follow-up process that includes effective communication, various tools, interventions, networks, health and social professionals., Conclusion: Discharge preparations may improve the transition from hospital to home and the outcomes for the parents and newborn preterm infant. This early family-centred approach should be structured, coordinated and based on individual needs and circumstances., (© 2019 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.) more...

Copyright of Cuadernos.info is the property of Pontificia Universidad Catolica de Chile, Facultad de Comunicaciones and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Importance: Up-to-date estimates of the health outcomes of preterm children are needed for assessing perinatal care, informing parents, making decisions about care, and providing evidence for clinical guidelines., Objectives: To determine survival and neonatal morbidity of infants born from 22 through 34 completed weeks' gestation in France in 2011 and compare these outcomes with a comparable cohort in 1997., Design, Setting, and Participants: The EPIPAGE-2 study is a national, prospective, population-based cohort study conducted in all maternity and neonatal units in France in 2011. A total of 2205 births (stillbirths and live births) and terminations of pregnancy at 22 through 26 weeks' gestation, 3257 at 27 through 31 weeks, and 1234 at 32 through 34 weeks were studied. Cohort data were collected from January 1 through December 31, 1997, and from March 28 through December 31, 2011. Analyses for 1997 were run for the entire year and then separately for April to December; the rates for survival and morbidities did not differ. Data are therefore presented for the whole year in 1997 and the 8-month and 6-month periods in 2011., Main Outcomes and Measures: Survival to discharge and survival without any of the following adverse outcomes: grade III or IV intraventricular hemorrhage, cystic periventricular leukomalacia, severe bronchopulmonary dysplasia, retinopathy of prematurity (stage 3 or higher), or necrotizing enterocolitis (stages 2-3)., Results: A total of 0.7% of infants born before 24 weeks' gestation survived to discharge: 31.2% of those born at 24 weeks, 59.1% at 25 weeks, and 75.3% at 26 weeks. Survival rates were 93.6% at 27 through 31 weeks and 98.9% at 32 through 34 weeks. Infants discharged home without severe neonatal morbidity represented 0% at 23 weeks, 11.6% at 24 weeks, 30.0% at 25 weeks, 47.5% at 26 weeks, 81.3% at 27 through 31 weeks, and 96.8% at 32 through 34 weeks. Compared with 1997, the proportion of infants surviving without severe morbidity in 2011 increased by 14.4% (P < .001) at 25 through 29 weeks and 6% (P < .001) at 30 through 31 weeks but did not change appreciably for those born at less than 25 weeks. The rates of antenatal corticosteroid use, induced preterm deliveries, cesarean deliveries, and surfactant use increased significantly in all gestational-age groups, except at 22 through 23 weeks., Conclusions and Relevance: The substantial improvement in survival in France for newborns born at 25 through 31 weeks' gestation was accompanied by an important reduction in severe morbidity, but survival remained rare before 25 weeks. Although improvement in survival at extremely low gestational age may be possible, its effect on long-term outcomes requires further studies. The long-term results of the EPIPAGE-2 study will be informative in this regard. more...

In this work, several plausible intra- and intermolecular photoinduced processes of the Watson–Crick base pairs of adenine with uracil (A–U) or thymine (A–T) according to the results of spin component scaling variant of algebraic diagrammatic construction up to the second order [SCS-ADC(2)] calculations are discussed. Although widely explored, these systems lack complete characterization of possible intramolecular relaxation channels perturbed by intermolecular interactions. In particular, we address the still open debate on photodeactivation via purine-ring puckering at the C2 or C6-atom position of adenine. We also show that the presence of low-lying, long-lived 1nπ* states can be a significant factor in hindering relaxation via an electron-driven proton transfer process, as the population of these states can lead to an efficient intersystem crossing to a triplet manifold, the estimated rate of which is 1.6 × 1010 s−1 which exceeds the corresponding internal conversion to the ground state by an order of magnitude. Additionally, the SCS variant of the ADC(2) method is shown to provide a more balanced description of valence and charge-transfer excited states. [ABSTRACT FROM AUTHOR] more...

Background/Objectives: Parents of premature infants experience depression, anxiety, post-traumatic stress disorder, and increased stress, which can negatively impact parent–infant relationships and infant development. To reduce negative consequences and optimally support families, we developed the Transition to Home model (TtH). In this randomized controlled pilot trial (RCT), the feasibility of performing an experimental study to analyse the effects of TtH on parental mental health over time was evaluated. Methods: The following domains were assessed: recruitment, follow-up and study burden, outcome measures used and parental mental health outcomes. We included n = 22 parent couples with their preterm infants in the control group and n = 23 in the intervention group. Depression, anxiety and post-traumatic stress disorders, parenting stress, and parental self-efficacy were assessed at five timepoints. The study burden was evaluated once at the end of the study. Results: The control and intervention groups had similar socio-demographic characteristics. The groups showed no differences in the mental health outcomes except for depression in mothers at T2 (p = 0.042) and T5 (p = 0.027) and state anxiety in fathers at T2 (p = 0.016). Conclusions: This pilot RCT established a framework for the evaluation of the TtH model of care and demonstrated the viability of the evaluation scheme. The results confirm the suitability of the RCT's structure and the feasibility of the methods and instruments used. Minor adjustments are recommended to include a more diverse sample in future studies. [ABSTRACT FROM AUTHOR] more...

Multiscale methods are powerful tools to describe large and complex systems. They are based on a hierarchical partitioning of the degrees of freedom (d.o.f.) of the system, allowing one to treat each set of d.o.f. in the most computationally efficient way. In the context of coupled nuclear and electronic dynamics, a multiscale approach would offer the opportunity to overcome the computational limits that, at present, do not allow one to treat a complex system (such as a biological macromolecule in explicit solvent) fully at the quantum mechanical level. Based on the pioneering work of Kapral and Ciccotti [R. Kapral and G. Ciccotti, J. Chem. Phys.110, 8919 (1999)], this work is intended to present a nonadiabatic theory that describes the evolution of electronic populations coupled with the dynamics of the nuclei of a molecule in a dissipative environment (condensed phases). The two elements of novelty that are here introduced are (i) the casting of the theory in the natural, internal coordinates, that are bond lengths, bond angles, and dihedral angles; (ii) the projection of those nuclear d.o.f. that can be considered at the level of a thermal bath, therefore leading to a quantum-stochastic Liouville equation. Using natural coordinates allows the description of structure and dynamics in the way chemists are used to describe molecular geometry and its changes. The projection of bath coordinates provides an important reduction of complexity and allows us to formulate the approach that can be used directly in the statistical thermodynamics description of chemical systems. [ABSTRACT FROM AUTHOR] more...

Time-resolved photoionization measurements were performed on o-nitrophenol pumped with UV laser pulses at a central wavelength of 255 nm (4.9 eV) and probed with vacuum ultraviolet (VUV) pulses at 153 nm (8.1 eV). The photoelectron spectrum and time of flight mass spectrum for ions were recorded at each pump–probe delay. The measurements are interpreted with the aid of electronic structure calculations for both the neutral and ionic states. Evidence is found for the formation of a bicyclic intermediate followed by NO dissociation through a process of internal conversion and intersystem crossing. The combination of photoelectron and photoion spectroscopy, together with computational results, provides strong evidence of intersystem crossing that is difficult to establish with only a single technique. [ABSTRACT FROM AUTHOR] more...

Copyright of Cuadernos.info is the property of Pontificia Universidad Catolica de Chile, Facultad de Comunicaciones and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Copyright of Mediterranean Journal of Communication / Revista Mediterránea de Comunicación is the property of Revista Mediterranea de Comunicacion / Mediterranean Journal of Communication and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Time-resolved photoelectron spectroscopy using an extreme-ultraviolet (XUV) probe pulse was used to investigate the UV photoinduced dynamics of adenine (Ade), adenosine (Ado), and adenosine-5-monophosphate (AMP) in a liquid water jet. In contrast to previous studies using UV probe pulses, the XUV pulse at 21.7 eV can photoionize all excited states of a molecule, allowing for full relaxation pathways to be addressed after excitation at 4.66 eV. This work was carried out using a gas-dynamic flat liquid jet, resulting in considerably enhanced signal compared to a cylindrical jet. All three species decay on multiple time scales that are assigned based on their decay associated spectra; the fastest decay of B100 fs is assigned to pp* decay to the ground state, while a smaller component with a lifetime of B500 fs is attributed to the np* state. An additional slower channel in Ade is assigned to the 7H Ade conformer, as seen previously. This work demonstrates the capability of XUV-TRPES to disentangle nonadiabatic dynamics in an aqueous solution in a state-specific manner and represents the first identification of the np* state in the relaxation dynamics of adenine and its derivatives. [ABSTRACT FROM AUTHOR] more...

Background: The use of diuretics is extremely common in infants cared for in neonatal wards, despite the lack of proven efficacy for many conditions. The main objective of this study was to assess the rate of diuretics exposure in a multicenter French cohort. The secondary objectives were to describe the evolution of this exposure over time, the indications, the prescription practices, and the exposure rates among centers. Methods: An observational study was conducted in 40 Level 3 French neonatal intensive care units using the same computerized order-entry system. Neonates hospitalized between January 2017 to December 2021 with a corrected age between 24 and 44 weeks of gestation at admission were eligible. Results: A total of 86,032 patients were included. The exposure rate was 8.5%, more specifically 29.4% for children born at < 32 weeks of gestation and 3.7% for neonates born at term. There was no significant variation over the study period, but the exposure ranged from 2.4% to 26.5% depending on the center. The main drugs prescribed were furosemide, spironolactone and dopamine with a diuretic purpose. The main indications were "fluid retention," and to a lesser extent "bronchopulmonary dysplasia" and "post-transfusion." For furosemide, the first exposure occurred in mean at 16.5 (±17.8) days of life, mean duration of exposure was 6.2 (±9.5) days, and the cumulative dose was in mean 10.7 (23.9) mg/kg. Conclusion: Diuretic prescription practices vary between centers. The administration of these drugs is often non-evidence based, doses and duration of treatment easily exceed toxic thresholds. [ABSTRACT FROM AUTHOR] more...

The ultrafast decay dynamics of pyridine-N-oxide upon excitation in the near-ultraviolet range of 340.2–217.6 nm is investigated using the femtosecond time-resolved photoelectron imaging technique. The time-resolved photoelectron spectra and photoelectron angular distributions at all pump wavelengths are carefully analyzed and the following view is derived: at the longest pump wavelengths (340.2 and 325.6 nm), pyridine-N-oxide is excited to the S1(1ππ*) state with different vibrational levels. The depopulation rate of the S1 state shows a marked dependence on vibrational energy and mode, and the lifetime is in the range of 1.4–160 ps. At 289.8 and 280.5 nm, both the second 1ππ* state and the S1 state are initially prepared. The former has an extremely short lifetime of ∼60 fs, which indicates that the ultrafast deactivation pathway such as a rapid internal conversion to one close-lying state is its dominant decay channel, while the latter is at high levels of vibrational excitation and decays within the range of 380–520 fs. At the shortest pump wavelengths (227.3 and 217.6 nm), another excited state of Rydberg character is mostly excited. We assign this state to the 3s Rydberg state which has a lifetime of 0.55–2.2 ps. This study provides a comprehensive picture of the ultrafast excited-state decay dynamics of the photoexcited pyridine-N-oxide molecule. [ABSTRACT FROM AUTHOR] more...

Purpose: The TRAK1 gene is mapped to chromosome 3p22.1 and encodes trafficking protein kinesin binding 1. The aim of this study was to investigate the genotype--phenotype of TRAK1-associated epilepsy. Methods: Trio-based whole-exome sequencing was performed on a cohort of 98 patients with epilepsy of unknown etiologies. Protein modeling and the VarCards database were used to predict the damaging effects of the variants. Detailed neurological phenotypes of all patients with epilepsy having TRAK1 variants were analyzed to assess the genotype--phenotype correlations. Results: A novel TRAK1 compound heterozygous variant comprising variant c.835C > T, p.Arg279Cys and variant c.2560A > C, p.Lys854Gln was identified in one pediatric patient. Protein modeling and VarCards database analyses revealed that the variants were damaging. The patient received a diagnosis of early infantile epileptic spasms with a developmental disorder; he became seizurefree through valproate and adrenocorticotropic hormone treatment. Further results for six variants in 12 patients with epilepsy indicated that biallelic TRAK1 variants (including homozygous or compound heterozygous variants) were associated with epilepsy with developmental disorders. Among these patients, eight (67%) had epileptic spasms and seven (58%) were intractable to anti-seizure medicines. Moreover, eight patients experienced refractory status epilepticus, of which seven (88%) died in early life. To our knowledge, this is the first reported case of epilepsy caused by TRAK1 compound heterozygous variants. Conclusion: Biallelic TRAK1 variants can cause epilepsy and developmental disorders. In these patients, seizures progress to status epilepticus, suggesting a high risk for poor outcomes and the requirement of early treatment. [ABSTRACT FROM AUTHOR] more...

The irradiation of water solution of cytidine with UVC light showed that the compound participates in a tautomerism following the kinetics of a first‐order reaction. The PIDA mechanism showed that the proton detachments in the tautomers of cytidine occur through the repulsive 1πσ* excited states and lead to conical intersections S0/S1, whose structures were optimized. More probable is the IRC mechanism, which proceeds along 1nπ* excited state reaction paths. This mechanism includes a water molecule as a catalyst, which assists the phototransformation of amino‐oxo tautomer of cytidine into imino‐hydroxy one. [ABSTRACT FROM AUTHOR] more...