1,720,960 research outputs found
Could Exogenous Surfactant Administration Be Neuroprotective? A NIRS Study of the Efficacy and Short- and Long-Term Cerebrovascular Effects of Fractionated Surfactant Administration in Preterm Infants
No full textBackground: Thirty years ago, Saliba and colleagues first attempted to mitigate the negative effects (hypercarbia) of exogenous surfactant (ES) by slowing its administration. Sixteen years later, Kribs and colleagues introduced the first less invasive surfactant administration (LISA) technique. Since then, numerous studies have aimed to reduce the invasiveness of ES and subsequent cerebral blood flow perturbations using near-infrared spectroscopy (NIRS). This study addresses this medical challenge by exploring a less problematic ES administration method, delivering multiple aliquots instead of a single dose. The aim was to test the hypothesis that administering ES in multiple aliquots could be a safe alternative, warranting further investigation.
Methods: Patients between 23 + 0 and 34 + 0 weeks of gestational age (GA) requiring ES administration were enrolled (January 2023-July 2024). Differently fractioned doses (2 to 6 aliquots) were administered as determined by the attending neonatologist, with continuous NIRS and transcutaneous CO2 (tCO2) monitoring. The effectiveness of ES was assessed by the reduction in the Oxygen Saturation Index (OSI) post-administration. Adverse effects, including persistent desaturation, bradycardia, and airway obstruction, were monitored to evaluate safety, alongside variability in NIRS-rSO2 values and tCO2. All infants underwent brain ultrasound before and within six hours after treatment. Infants with a birth weight <1500 g also underwent brain MRI at term-corrected age, with the TMS score calculated for each.
Results: Fifty-eight infants were enrolled, with a median GA of 29.5 weeks and a birth weight of 1230 g. The population was divided into two groups based on the number of surfactant aliquots: more than 3 aliquots versus 3 or fewer. No differences were observed between the groups in gestational age at birth, birth weight, or common complications of prematurity. Monitoring began before the procedure and continued for 60 minutes after the last ES aliquot. The group receiving 3 or fewer aliquots showed significantly higher variability in NIRS-SpO2 values (p = 0.03), increased NIRS-rSO2 values (p < 0.01), and elevated tCO2 levels (p < 0.01). TMS scores did not show significant statistical differences
Conclusion: Our data support the hypothesis that administering surfactant in multiple smaller aliquots is safer and results in less variability in cerebral oxygen extraction and carbon dioxide levels compared to fewer, larger aliquots. The combination of reduced NIRS variability and lower tCO2 maximum levels indicates more stable cerebral blood flow during the challenging period of ES administration. This lays the foundation for more comprehensive studies, involving a greater number of patients and multiple centers
Pediatric Dehydration Assessment at Triage: Prospective Study on Refilling Time
No full textPurpose: Dehydration is a paediatric medical emergency but there is no single standard parameter to evaluate it at the emergency department. Our aim was to evaluate the reliability and validity of capillary refilling time as a triage parameter to assess dehydration in children.Methods: This was a prospective pilot cohort study of children who presented to two paediatric emergency departments in Italy, with symptoms of dehydration. Reliability was assessed by comparing the triage nurse's measurements with those obtained by the physician. Validity was demonstrated by using 6 parameters suggestive of dehydration. Comparison between refilling time (RT) and a validated Clinical Dehydration Score (CDS) was also considered. The scale's discriminative ability was evaluated for the outcome of starting intravenous rehydration therapy by using a receiver operating characteristic (ROC) curve.Results: Participants were 242 children. All nurses found easy to elicit the RT after being trained. Interobserver reliability was fair, with a Cohen's kappa of 0.56 (95% confidence interval [CI], 0.41 to 0.70). There was a significant correlation between RT and weight loss percentage (r-squared=-0.27; 95% CI, -0.47 to -0.04). The scale's discriminative ability yielded an area under the ROC curve (AUC) of 0.65 (95% CI, 0.57 to 0.73). We found a similarity between RT AUC and CDS-scale AUC matching the two ROC curves.Conclusion: The study showed that RT represents a fast and handy tool to recognize dehydrated children who need a prompt rehydration and may be introduced in the triage line-up
Validation of the postnatal growth and retinopathy of prematurity screening criteria: A retrospective Italian analysis
No full textPurpose: Retinopathy of prematurity (ROP) is the leading cause of childhood blindness. The aim of our study is to validate the new screening criteria elaborated by the Postnatal Growth and Retinopathy of Prematurity (G-ROP) study group in a monocentric cohort of Italian preterm infants. Methods: We retrospectively applied the G-ROP screening criteria to a cohort of preterm infants born between May 2015 and July 2020 with known birth weight, gestational age, serial weight measurement, and known ROP outcome. Primary outcomes were sensitivity and specificity of ROP detection, especially of treatment requiring ROP. Secondary outcomes were reduction of ophthalmologic examinations and of infants requiring screening. Results: We retrospectively evaluated 595 children and 475 were included in our study. Of them, 119 developed any type ROP, 39 developed type 1 ROP, and 28 underwent treatment. G-ROP criteria predicted 39 of 39 cases of type 1 ROP (100% sensitivity and specificity). Sensitivity and specificity for detection of treated ROP were 100%. Considering any type ROP detection, sensitivity was 87.4% and specificity was 100%. Our analysis showed that screening could be avoided in 50% of patients, resulting in a 29% reduction of the number of examinations. Conclusions: Our study validates the new G-ROP screening protocol in a monocentric cohort of premature infants. We demonstrate that all Type 1 ROP and requiring treatment ROP could be found even with a reduction of eye examinations
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Optimizing haemoglobin measurements in VLBW newborns: Insights from a comparative retrospective study
No full textIntroduction: Haemoglobin levels assessment is a crucial part of neonatal intensive care practice, the painful experience of repeated heel pricks and venepunctures blood sampling may negatively affect neonatal clinical course. To date the reliability of haemoglobin levels obtained by point-of-care testing (POCT) analysis if compared to standard blood cell count remains controversial. Materials and methods: Retrospective study conducted on all inborn premature infants (gestational age < 32 weeks) admitted to NICU of the IRCCS Giannina Gaslini Institute during the period May 2021-April 2023. We considered blood samplings occurred within the first 28 days of life recording the laboratory haemoglobin levels (Hblab) (reference method), the point-of-care haemoglobin levels (HbPOCT) (alternative method) and the type of puncture (arterial, venous and capillary). A Bland-Altman analysis was performed to evaluate the Hb agreement, it determines the bias (mean difference between the reference and alternative methods) and limits of agreement (LOA; lower, l-LOA; upper, u-LOA) of measures. An acceptable limit of agreement was 1 g/dl according to the existing literature. Results: We considered 845 blood samplings from 189 enrolled patients. The comparison between the reference and the alternative method showed a good agreement for the capillary sampling technique with l-LOA of -0.717 (-0.776; -0.659) and u-LOA of 0.549 (0.490; 0.607), these results were not achievable with the other techniques, with LOAs over +/- 1 g/dl threshold (venou
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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