Maternal undernutrition or overnutrition during pregnancy alters organ structure, impairs prenatal and neonatal growth and development, and reduces feed efficiency for lean tissue gains in pigs. These adverse effects ...Maternal undernutrition or overnutrition during pregnancy alters organ structure, impairs prenatal and neonatal growth and development, and reduces feed efficiency for lean tissue gains in pigs. These adverse effects may be carried over to the next generation or beyond. This phenomenon of the transgenerational impacts is known as fetal programming, which is mediated by stable and heritable alterations of gene expression through covalent modifications of DNA and histones without changes in DNA sequences(namely, epigenetics). The mechanisms responsible for the epigenetic regulation of protein expression and functions include chromatin remodeling; DNA methylation(occurring at the 5′-position of cytosine residues within CpG dinucleotides); and histone modifications(acetylation, methylation, phosphorylation, and ubiquitination). Like maternal malnutrition, undernutrition during the neonatal period also reduces growth performance and feed efficiency(weight gain:feed intake; also known as weightgain efficiency) in postweaning pigs by 5–10%, thereby increasing the days necessary to reach the market bodyweight. Supplementing functional amino acids(e.g., arginine and glutamine) and vitamins(e.g., folate) play a key role in activating the mammalian target of rapamycin signaling and regulating the provision of methyl donors for DNA and protein methylation. Therefore, these nutrients are beneficial for the dietary treatment of metabolic disorders in offspring with intrauterine growth restriction or neonatal malnutrition. The mechanism-based strategies hold great promise for the improvement of the efficiency of pork production and the sustainability of the global swine industry.展开更多
Alongside clinical achievements,experiments conducted on animal models (including primate or non-primate) have been effective in the understanding of various pathophysiological aspects of perinatal hypoxic/ ischemic e...Alongside clinical achievements,experiments conducted on animal models (including primate or non-primate) have been effective in the understanding of various pathophysiological aspects of perinatal hypoxic/ ischemic encephalopathy (HIE).Due to the reasonably fair degree of flexibility with experiments,most of the research around HIE in the literature has been largely concerned with the neurodevelopmental outcome or how the frequency and duration of HI seizures could relate to the severity of perinatal brain injury,following HI insult.This survey concentrates on how EEG experimental studies using asphyxiated animal models (in rodents,piglets,sheep and non-human primate monkeys) provide a unique opportunity to examine from the exact time of HI event to help gain insights into HIE where human studies become difficult.展开更多
<strong>Introduction: </strong><span style="font-family:""><span style="font-family:Verdana;">Fetal heart rate monitoring during labor is used to study fetal well-being...<strong>Introduction: </strong><span style="font-family:""><span style="font-family:Verdana;">Fetal heart rate monitoring during labor is used to study fetal well-being and predict neonatal acidosis of newborn. Fetal heart rate monitoring is analyzed by the obstetrical team and categorized according to the FIGO guidelines. An important limitation of this diagnostic tool is an inter- and intra-observer variability, leading to subjective cardiotocography interpretation and classification. Our objective was to study the association between the categories of fetal heart rate analysis (according to FIGO classification) and neonatal acidosis of full-term newborns. </span><b><span style="font-family:Verdana;">Study design:</span></b><span style="font-family:Verdana;"> This is a multicenter retrospective cohort study conducted between 2014 and 2018 in the Grand-Est region. We searched and included retrospectively children hospitalized in a pediatric intensive care unit in one of the participating hospitals with an ICD-10 coding type “P91.6” corresponding to “Hypoxic Ischemic Encephalopathy”. Maternal, pregnancy, delivery, and newborn characteristics were collected and compared by univariate logistic regression with multiple imputation. Odds Ratio and 95% confidence intervals (CI) were calculated using the model and presented. Multiple imputation with m = 100 imputations was tested, using Rubin rules to combine the results. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">55 patients were included in the study. Fetal heart rate tracings classified in Category 3 as “pathological” according to FIGO guidelines were significantly associated with an increased risk of severe neonatal acidosis. Late decelerations and bradycardia during labor were associated with severe neonatal acidosis. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Severe neonatal acidosis may be suspected by interpretation of fetal heart rate during labor. Fetal bradycardia and late decelerations are predictive of the severity of neonatal acidosis. This study emphasizes the need to screen severe neonatal acidosis and allows the identification of populations most at risk. Repeated team training and upgrading of fetal heart rate study would further reduce the incidence of neonatal acidosis.</span></span>展开更多
Neonatal hypoxic-ischemic encephalopathy(HIE)is a significant cause of disability in children.Improving brain function and accelerating neurological recovery may require a combination of neuroprotective and pro-regene...Neonatal hypoxic-ischemic encephalopathy(HIE)is a significant cause of disability in children.Improving brain function and accelerating neurological recovery may require a combination of neuroprotective and pro-regenerative treatments at different stages of HIE.While the first hours after the neonatal insult are the most critical period for neuroprotection,the existence of secondary and tertiary mechanisms of brain injury offers the possibility of preventing delayed neurodegeneration in the subsequent days,weeks,or months(Levison et al.,2022).展开更多
BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’...BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’s condition and the uncertainty and high medical costs of possible sequelae,which frequently cause anxiety,depression,and other adverse emotions.AIM To investigate the anxiety and depression status of mothers of children in the NICU and its related factors.METHODS A convenient sampling method is adopted.The research objects included the mothers of 191 children in the NICU of Suzhou Ninth Hospital Affiliated with Suzhou University from January 2023 to July 2024.The general information questionnaire,personal control scale,self-rating anxiety scale,and self-rating depression scale were utilized for investigation.Anxiety and depression status in mothers of children in the NICU and its related factors were analyzed.RESULTS The incidences of maternal anxiety and depression among 191 hospitalized children in the NICU were 32.98%(63/191)and 23.56%(45/191),respectively.Single-factor analysis reveals that family monthly income,individual sense of control,gestational age of the child,and the number of diseases in the child are associated with the anxiety and depression experienced by the mother of the child in the NICU(P<0.05).Multivariate logistic regression analysis revealed that family monthly income of<5000 yuan(RMB),poor individual control,gestational age of<32 weeks,and the number of diseases of≥3 kinds are all related factors for anxiety and depression in mothers of children admitted to the NICU(P<0.05).CONCLUSION Mothers of children admitted to the NICU demonstrated high anxiety and depression incidences.The nursing staff in the neonatal department established intervention measures for each related factor,strengthened communication and communication with the mother of the child,and did a good job in psychological counseling.展开更多
Moderate to severe perinatal hypoxic-ischemic encephalopathy occurs in~1 to 3/1000 live births in high-income countries and is associated with a significant risk of death or neurodevelopmental disability.Detailed asse...Moderate to severe perinatal hypoxic-ischemic encephalopathy occurs in~1 to 3/1000 live births in high-income countries and is associated with a significant risk of death or neurodevelopmental disability.Detailed assessment is important to help identify highrisk infants,to help families,and to support appropriate interventions.A wide range of monitoring tools is available to assess changes over time,including urine and blood biomarkers,neurological examination,and electroencephalography.At present,magnetic resonance imaging is unique as although it is expensive and not suited to monitoring the early evolution of hypoxic-ischemic encephalopathy by a week of life it can provide direct insight into the anatomical changes in the brain after hypoxic-ischemic encephalopathy and so offers strong prognostic information on the long-term outcome after hypoxic-ischemic encephalopathy.This review investigated the temporal dynamics of neonatal hypoxic-ischemic encephalopathy injuries,with a particular emphasis on exploring the correlation between the prognostic implications of magnetic resonance imaging scans in the first week of life and their relationship to long-term outcome prediction,particularly for infants treated with therapeutic hypothermia.A comprehensive literature search,from 2016 to 2024,identified 20 pertinent articles.This review highlights that while the optimal timing of magnetic resonance imaging scans is not clear,overall,it suggests that magnetic resonance imaging within the first week of life provides strong prognostic accuracy.Many challenges limit the timing consistency,particularly the need for intensive care and clinical monitoring.Conversely,although most reports examined the prognostic value of scans taken between 4 and 10 days after birth,there is evidence from small numbers of cases that,at times,brain injury may continue to evolve for weeks after birth.This suggests that in the future it will be important to explore a wider range of times after hypoxic-ischemic encephalopathy to fully understand the optimal timing for predicting long-term outcomes.展开更多
Background: Birth weight has been identified as one of the most significant predictors of a child’s physical growth, development, and survival in later life. A quest to provide an answer on the impact of maternal ant...Background: Birth weight has been identified as one of the most significant predictors of a child’s physical growth, development, and survival in later life. A quest to provide an answer on the impact of maternal anthropometry on neonatal birth weight necessitated this study. Materials and methods: It is a cross-sectional descriptive hospital based study that involved 130 participants selected using a systematic sampling method, utilizing a semi-structured, pre-tested interviewer administered questionnaire. Data were collected using a standard procedure and were summarized using proportions, and the Chi square test was used to explore the association between categorical variables. Predictors of birth weight were determined using logistic regression. The level of statistical significance was set at p Results: Participants had a mean age of 28.6 ± 5.1 years, mean weight of 72.2 ± 11.2 kg and mean height of 1.63 ± 0.07m while the mean fetal birth weight was 3.10 ± 0.56 kg. There was a significant association between maternal delivery body mass index and neonatal birth weight (p Conclusion: The prevalence of low birth weight and macrosomia in this study population was high. The focus should be geared towards balanced nutrition support for all mothers at booking so as to mitigate the risks associated with these extremes of birth weight.展开更多
Objective: In the Healthy Child Action Enhancement Program (2021-2025), it is proposed to ensure the safety and health of newborns and to promote high-quality development of health. Our department established risk ass...Objective: In the Healthy Child Action Enhancement Program (2021-2025), it is proposed to ensure the safety and health of newborns and to promote high-quality development of health. Our department established risk assessment criteria for medical adhesives in neonates by applying the best evidence in the management program for the reduction of medical adhesive-associated skin injuries in neonates, in terms of the use and removal of adhesives. Methods: A systematic search and quality assessment of topics related to medical adhesive-related skin injury in neonates was conducted to summarize the best evidence and to conduct a quality review in the neonatal unit. Results: After 2 rounds of review, medical and nursing staff in the neonatal unit had a 98% compliance rate for the knowledge of neonatal medical adhesive-related skin injury and a satisfactory compliance rate for the other 9 indicators;after the application of the evidence, the incidence of neonatal medical adhesive-related skin injury was significantly lower than that before the application of the evidence, and the differences were statistically significant (P Conclusion: The application of the best evidence-based management program in neonatal medical adhesive-associated skin injury can reduce the incidence of neonatal medical adhesive-associated skin injury, reduce neonatal infections, and improve the integrity of the protective skin barrier in neonates.展开更多
Objective:Neonatal sepsis is a critical pathology that particularly affects neonates,especially preterm and low birth weight neonates,with varying incidence according to the onset(early or late)of the disease.Although...Objective:Neonatal sepsis is a critical pathology that particularly affects neonates,especially preterm and low birth weight neonates,with varying incidence according to the onset(early or late)of the disease.Although preterm neonatal mortality related to sepsis is high in Ethiopia and in the study area,limited studies have been conducted on the time-to-death and predictors of mortality among preterm neonates diagnosed with neonatal sepsis.Therefore,this study aimed to determine the time-to-death and predictors of mortality among preterm neonates with neonatal sepsis admitted to government hospitals in Southwest Ethiopia in 2022.Methods:A prospective cohort study was conducted at the Southwest government hospitals between March 2021 and January 30,2022.The data were entered into Epi-data version 4.4.2.1 and exported to Stata version 14 for editing,cleaning,and analysis.The Cox proportional hazards(CPH)model was used to identify the predictors of mortality.Results:In this study,out of 354 preterm neonates diagnosed with neonatal sepsis,121(34.18%)had died with an incidence rate of 59.8%(95%confidence interval[CI]:50-71.5)deaths per 1000 person-day-observations.The median survival time of preterm neonates diagnosed with neonatal sepsis was 15 days.The following factors were the predictors of mortality among preterm neonates diagnosed with neonatal sepsis:(1)the neonate’s mother did not have antenatal care(ANC)follow-up(adjusted hazard ratio[AHR]2.5[95%CI:1.3-4.84]);(2)the neonates had an APGAR score<7(5th-minute activity,pulse,grimace,appearance,and respiration)(AHR 1.5[95%CI:1.29-3.46]);(3)and they had comorbidities such as respiratory distress syndrome(RDS)(AHR 1.50[95%CI:1.13-2.31])and jaundice(AHR 1.89[95%CI:1.26-2.84]).Conclusions:In this study,preterm neonates diagnosed with neonatal sepsis showed a higher incidence of mortality compared with other national and local studies.The median survival time of neonates was 15 days.Born from mothers who did not have ANC follow-up,5th-minute APGAR score<7,and comorbidities such as RDS and jaundice were independent predictors of mortality among preterm neonates diagnosed with neonatal sepsis.Therefore,healthcare providers and other stakeholders should consider prompt and timely diagnosis and therapeutic interventions to preterm neonates with neonatal sepsis.展开更多
BACKGROUND Neonatal screening(NS)is a public health policy to identify genetic pathologies such as cystic fibrosis(CF),sickle cell disease,and other diseases.Sickle cell disea-se is the comprehensive term for a group ...BACKGROUND Neonatal screening(NS)is a public health policy to identify genetic pathologies such as cystic fibrosis(CF),sickle cell disease,and other diseases.Sickle cell disea-se is the comprehensive term for a group of hemoglobinopathies characterized by the presence of hemoglobin S.CF is an autosomal recessive multisystemic disease with pathophysiology involving deleterious mutations in the transmembrane re-gulatory gene that encodes a protein that regulates the activity of chloride and sodium channels in the cell surface epithelium.NS is crucial for early diagnosis and management,which ensures a better quality of life.AIM To report a case of the coexistence of sickle cell anemia(SCA)and CF and perform an integrative literature review.METHODS This is an observational study and a review of the literature focusing on two rare genetic pathologies identified simultaneously in NS from the perspective of a clinical case.The authors identified only 5 cases of SCA associated with CF.No clinical trials or review articles were identified considering the rarity of the coexistence of these two pathologies.RESULTS Herein,the authors reported the case of a girl who after undergoing NS on day 8 of life was diagnosed with SCA with an alteration in the dosage of immunoreactive trypsin.The diagnosis of CF was confirmed by the Coulometry Sweat Test.The rarity of the co-occurrence of these two severe genetic pathologies(CF and SCA)is a challenge for medical science.CONCLUSION This study adds to the few case reports present in the literature that highlight the identification of two severe diseases via NS.展开更多
Neonatal and pediatric sepsis remains a major global health concern,contributing significantly to morbidity and mortality among children under 5 years of age.The clinical and microbiological characteristics of sepsis ...Neonatal and pediatric sepsis remains a major global health concern,contributing significantly to morbidity and mortality among children under 5 years of age.The clinical and microbiological characteristics of sepsis differ markedly in neonates and children,necessitating tailored diagnostic and treatment approaches.This mini-review explores the evolving microbiological landscape,recent advancements in diagnostic methodologies,and challenges posed by antimicrobial resistance(AMR)in managing neonatal and pediatric sepsis.Emerging pathogens,including multidrug-resistant Gram-negative bacilli and fungal organisms,are reshaping the epidemiology of sepsis.Innovations in molecular diagnostics,including polymerase chain reaction-based platforms,next-generation sequencing,and artificial intelligence-integrated tools,are revolutionizing early pathogen detection and resistance profiling.However,implementation gaps persist,particularly in low-and middle-income countries.Therapeutic challenges are compounded by limited pediatric data on newer antimicrobials and rising AMR rates.Infection prevention strategies,especially in intensive care units,are crucial to outbreak containment.An integrated approach combining microbiological surveillance,rapid diagnostics,and antimicrobial stewardship is critical for improving sepsis outcomes.Future research should focus on context-specific implementation of diagnostic tools and optimizing treatment strategies for resource-limited settings.展开更多
Kinetics of thymocyte development in vivo during embryogenesis was pursued. The early development of thymocytes in the fetal and neonatal BALB/c mice was discontinuous, with four waves of cell proliferation occurring ...Kinetics of thymocyte development in vivo during embryogenesis was pursued. The early development of thymocytes in the fetal and neonatal BALB/c mice was discontinuous, with four waves of cell proliferation occurring at fetal day (Fd) 14 to 17, Fd 18 to day (D) 1 after birth, D 2 to D 5 and D6 thereafter. The first three proliferation waves coincided with the generation of CD4/'CD8/' (DP), TCR+CD4/hiCD8-/lo (CD4 SP), and TCR+CD4-/loCD8int/hi (CD8 SP) thymocytes, respectively. The transition from DN to DP cells was further investigated and it was found out that there were two differential pathways via immature single positive (ISP) cells in the BALB/c mice, each functioning at different fetal ages. One is via TCR-CD4-CD8+ cells, occurring between Fd 15 and Fd 17 and the other is via TCR-CD4+CD8- cells, occurring from Fd 17 until birth. In contrast, the TCR-CD4-CD8+ pathway dominated overwhelmingly in the C57BL/6 mice. These findings shed new light on the hypothesis that the differential pathway preference varies with mouse strains. With respect to the shift in the intensity of CD4 and CD8 expression on thymocytes from fetal to adult mice, the TCR+CD4/hiCD8-/lo, and TCR+CD4-/loCD8int/hi subsets might be equivalent to the medullary type TCR+CD4/CD8 SP cells.展开更多
Objective:To assess knowledge and practice among nurses toward neonatal resuscitation in hospitals in Hebron.Methods:A cross-sectional study design was conducted among 151 nurses from Hebron.Data were collected using ...Objective:To assess knowledge and practice among nurses toward neonatal resuscitation in hospitals in Hebron.Methods:A cross-sectional study design was conducted among 151 nurses from Hebron.Data were collected using a self-administered questionnaire.Multiple logistic regression was conducted to test the associated factors with the dependent variables.Results:Only 9.3%of participants had a standardized level of knowledge,while 68.9%reported adequate skills for neonatal resuscitation.Factors associated with a standardized level of knowledge were age(p=0.001)and supportive supervision(p=0.007).Factors associated with the standardized practice level were the presence of hospital guidelines(p=0.028),previous training of nurses(p=0.011),and the presence of supportive supervision(p<0.001).Conclusions:The majority of emergency nurses in Hebron hospitals demonstrated a substandard level of knowledge of neonatal resuscitation.However,most of those nurses surprisingly reported a standardized practice level.The presence of hospital guidelines,training programs,or direct supervision for nurses are factors that can be considered to improve both knowledge and practice toward neonatal resuscitation among emergency nurses in Hebron.展开更多
Objective: Obstetricians, Neonatologists, and Pathologists have studied gross histological analysis of human placentas in search of specific alterations in placental functions that can be correlated with neonatal outc...Objective: Obstetricians, Neonatologists, and Pathologists have studied gross histological analysis of human placentas in search of specific alterations in placental functions that can be correlated with neonatal outcomes. Our study assessed the prevalence of abnormal placental findings associated with non-reassuring fetal monitoring in labor requiring emergent instrumental or cesarean delivery, followed by an excellent neonatal outcome. Study Design: One hundred consecutive emergency deliveries, instrumental or cesarean, performed due to non-reassuring fetal monitoring while in labor were retrospectively evaluated. All patients were low-risk for obstetric complications, and had a singleton, term pregnancy. They had a normal antenatal routine testing and a normal anatomy ultrasound scan at 20 to 22 weeks gestation. Results: There were 35 placentas (35%) with gross placental anomalies at the delivery triage. Additionally 7 placentas (7%) were reported to be abnormal at the pathology examination. Conclusion: The prevalence of abnormal placental findings in our studied population was 42%.展开更多
This study explores the clinical efficacy of budesonide combined with ambroxol inhalation therapy for neonatal pneumonia.A total of 68 neonatal pneumonia patients treated at Li County Hospital from January 2023 to Dec...This study explores the clinical efficacy of budesonide combined with ambroxol inhalation therapy for neonatal pneumonia.A total of 68 neonatal pneumonia patients treated at Li County Hospital from January 2023 to December 2024 were randomly divided into a monotherapy group and a combination group,with 34 patients in each.The monotherapy group received ambroxol inhalation therapy,while the combination group received budesonide inhalation therapy in addition to ambroxol.The recovery progress,blood gas analysis indicators,inflammatory response improvement,and overall clinical efficacy were compared between the two groups.Results showed that the combination group experienced a significantly shorter time for body temperature normalization(3.36±0.58 days vs.4.59±0.45 days),oxygen inhalation duration(4.89±0.57min vs.6.96±0.79min),disappearance of shortness of breath and cough(4.56±0.29 days vs.6.63±0.75 days),and resolution of lung wet rales(5.62±1.46 days vs.7.92±1.28 days)compared to the monotherapy group(P<0.05).Additionally,the total effective rate was significantly higher in the combination group(97.06%)than in the monotherapy group(73.52%)(P<0.05).Post-treatment,the combination group exhibited significantly better blood gas analysis and inflammatory response indicators(P<0.05).These findings suggest that budesonide combined with ambroxol inhalation therapy can effectively improve blood oxygen saturation,reduce inflammation,promote faster recovery,and enhance overall clinical efficacy,making it a reliable treatment option for neonatal pneumonia.展开更多
Neonatal hypoxic-ischemic encephalopathy(HIE)refers to neonatal brain damage caused by various factors during the perinatal period that lead to hypoxia and reduced cerebral blood flow[1].Globally,0.2%to 2.26%of newbor...Neonatal hypoxic-ischemic encephalopathy(HIE)refers to neonatal brain damage caused by various factors during the perinatal period that lead to hypoxia and reduced cerebral blood flow[1].Globally,0.2%to 2.26%of newborns develop HIE,with approximately 20%resulting in neonatal death and about 25%of survivors suffering from neurological impairment[2].Currently,there is a lack of highly sensitive and specific diagnostic tools for HIE,posing significant challenges to reducing HIE mortality and neurological abnormalities[3].The development of high-throughput proteomics technology based on mass spectrometry(MS)has significantly enhanced the potential to discover biomarkers in biological fluids such as plasma,cerebrospinal fluid,saliva,and urine[4].Proteomics technology has become an engine for exploring novel markers of HIE[5].This article systematically reviews the progress of proteomics technology in the study of biomarkers for the early diagnosis of HIE,elucidating its potential application value.展开更多
The number of newborns born with diseases is increasing recently.Thyroid hormones(THs)are closely related to the growth and development of the newborn in the mother's womb and to the carriage of related diseases a...The number of newborns born with diseases is increasing recently.Thyroid hormones(THs)are closely related to the growth and development of the newborn in the mother's womb and to the carriage of related diseases after birth.Environmental endocrine-disrupting compounds(EDCs)have been proven to harm THs in newborns.Phthalates(PAEs),a typical class of EDCs,are commonly used in toys,childcare materials,and food contact materials,which have been closely connected with neonatal thyroid dysfunction and thyroid-related diseases.As restrictions on PAEs becomemore stringent in neonatal field,numerous PAE alternatives are emerging.Associations between exposure to PAEs and their alternatives and dysfunctions in THs have been explored.Hence,we summarized the body burdens and regional characteristics of PAEs and their alternatives in neonatal urine,cord blood,and meconium.Subsequently,the influences of PAEs and their alternatives on thyroid dysfunction,prematurity,low birth weight,fetal growth restriction,respiratory dysfunction,immune disorders,neurological disorders,and reproductive disorders in newborns were evaluated.Furthermore,we scrutinized the effects of PAEs and their alternatives on the neonatal thyroid from signaling,substance transport,and hormone production to explore the underlying mechanisms of action on neonatal thyroid and thyroid-related disorders.As the declining global trends of healthy newborns and the potential impacts of PAEs and their alternatives on thyroid function,a more comprehensive study is needed to discuss their effects on newborns and their underlying mechanisms.This review facilitates attention to the effects of PAEs and their alternatives on thyroid and thyroid-related disorders in newborns.展开更多
BACKGROUND Neonatal sepsis is a serious health problem,with high morbidity and mortality during the first 28 days of life.Clinical diagnosis at presentation is challenging due to the nonspecific signs and symptoms.Alt...BACKGROUND Neonatal sepsis is a serious health problem,with high morbidity and mortality during the first 28 days of life.Clinical diagnosis at presentation is challenging due to the nonspecific signs and symptoms.Although blood culture is the gold standard for diagnosis,it is not always positive.AIM To evaluate the diagnostic and prognostic utility of D-dimer and heparin-binding protein(HBP)in neonatal sepsis.METHODS This prospective case-control study included 90 neonates in two groups:A sepsis group(n=45)and a control group(n=45)without sepsis.Sepsis group was further subdivided based on blood culture results into proven sepsis(n=28 culturepositive sepsis)and suspected sepsis(n=17 culture-negative sepsis).All neonates underwent complete history taking,thorough clinical examination and investigations[complete blood count,C-reactive protein(CRP),liver and kidney function tests,plasma D-dimer and HBP].RESULTS Levels of CRP,D-dimer and HBP were significantly higher in the sepsis group compared to the controls.At a cutoff value above 517.9 ng/mL,D-dimer outperformed CRP and HBP in distinguishing sepsis group from controls with 95.6%sensitivity and 97.8%specificity.D-dimer was also a better prognostic marker than the neonatal sequential organ failure assessment(nSOFA)for predicting mortality,with 100%sensitivity and 92.5%specificity vs 80%sensitivity and 82.5%specificity.There was a significant positive correlation between CRP,D-dimer and HBP.CONCLUSION D-dimer demonstrated superior diagnostic accuracy compared to CRP and HBP in predicting sepsis,and demonstrated superior prognostic accuracy compared to nSOFA in predicting the outcome of neonatal sepsis.展开更多
Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth reco...Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth record data from the Ghana Demographic and Health Surveys(2008,2014,and 2022)were used to analyse trends and determinants in neonatal mortality and preterm birth aligned with World Health Organization antenatal care(ANC)guidelines using Pearson’s Chi-square test and multivariate logistic regression with statistical significance at P<0.05 and 95%confidence intervals(CI).Results:Preterm birth rate and neonatal mortality rate decreased from 13.0%to 9.1%and 27.6 to 23.7 per 1000 live births from 2008 to 2022 respectively.Lack of iron supplementation(odds ratio[OR]1.127,95%CI:1.047 to 1.967)a nutritional intervention maternal assessments(moderate/severe anaemia(OR 1.423,95%CI:1.178 to 2.051),preventive measures(Untreated malaria(OR 1.449,95%CI:1.104 to 2.411)or deworming(OR 1.267,95%CI:0.970 to 1.645)were associated with increased preterm birth risk.Attending<8 ANC visits raised the odds of preterm birth(OR 1.24,95%CI:1.03 to 1.257)and neonatal mortality(OR 1.583,95%CI:1.120 to 2.480).Conclusion:Despite reductions in preterm birth and neonatal mortality rates,substantial gaps in antenatal care remain.Strengthening the implementation of World Health Organization ANC guidelines is critical to reducing preterm birth and neonatal mortality in Ghana.展开更多
Jaundice,common condition in newborns,is characterized by yellowing of the skin and eyes due to elevated levels of bilirubin in the blood.Timely detection and management of jaundice are crucial to prevent potential co...Jaundice,common condition in newborns,is characterized by yellowing of the skin and eyes due to elevated levels of bilirubin in the blood.Timely detection and management of jaundice are crucial to prevent potential complications.Traditional jaundice assessment methods rely on visual inspection or invasive blood tests that are subjective and painful for infants,respectively.Although several automated methods for jaundice detection have been developed during the past few years,a limited number of reviews consolidating these developments have been presented till date,making it essential to systematically evaluate and present the existing advancements.This paper fills this gap by providing a thorough survey of automated methods for jaundice detection in neonates.The primary focus of the survey is to review the existing methodologies,techniques,and technologies used for neonatal jaundice detection.The key findings from the review indicate that image-based bilirubinometers and transcutaneous bilirubinometers are promising non-invasive alternatives,and provide a good trade-off between accuracy and ease of use.However,their effectiveness varies with factors like skin pigmentation,gestational age,and measurement site.Spectroscopic and biosensor-based techniques show high sensitivity but need further clinical validation.Despite advancements,several challenges including device calibration,large-scale validation,and regulatory barriers still haunt the researchers.Standardization,regulatory compliances,and seamless integration into healthcare workflows are the key hurdles to be addressed.By consolidating the current knowledge and discussing the challenges and opportunities in this field,this survey aims to contribute to the advancement of automatic jaundice detection and ultimately improve neonatal care.展开更多
基金supported by the National Basic Research Program of China(2013CB127302)the National Natural Science Foundation of China(31272450 and 31572412)+2 种基金Competitive Grants from the Animal Reproduction Program(no.2014-67015-21770)Animal Growth & Nutrient Utilization Programs(no.2015-67015-23276)of the USDA National Institute of Food and AgricultureTexas A&M AgriL ife Research(H-8200)
文摘Maternal undernutrition or overnutrition during pregnancy alters organ structure, impairs prenatal and neonatal growth and development, and reduces feed efficiency for lean tissue gains in pigs. These adverse effects may be carried over to the next generation or beyond. This phenomenon of the transgenerational impacts is known as fetal programming, which is mediated by stable and heritable alterations of gene expression through covalent modifications of DNA and histones without changes in DNA sequences(namely, epigenetics). The mechanisms responsible for the epigenetic regulation of protein expression and functions include chromatin remodeling; DNA methylation(occurring at the 5′-position of cytosine residues within CpG dinucleotides); and histone modifications(acetylation, methylation, phosphorylation, and ubiquitination). Like maternal malnutrition, undernutrition during the neonatal period also reduces growth performance and feed efficiency(weight gain:feed intake; also known as weightgain efficiency) in postweaning pigs by 5–10%, thereby increasing the days necessary to reach the market bodyweight. Supplementing functional amino acids(e.g., arginine and glutamine) and vitamins(e.g., folate) play a key role in activating the mammalian target of rapamycin signaling and regulating the provision of methyl donors for DNA and protein methylation. Therefore, these nutrients are beneficial for the dietary treatment of metabolic disorders in offspring with intrauterine growth restriction or neonatal malnutrition. The mechanism-based strategies hold great promise for the improvement of the efficiency of pork production and the sustainability of the global swine industry.
基金supported by the Auckland Medical Research Foundation,No.1117017(to CPU)
文摘Alongside clinical achievements,experiments conducted on animal models (including primate or non-primate) have been effective in the understanding of various pathophysiological aspects of perinatal hypoxic/ ischemic encephalopathy (HIE).Due to the reasonably fair degree of flexibility with experiments,most of the research around HIE in the literature has been largely concerned with the neurodevelopmental outcome or how the frequency and duration of HI seizures could relate to the severity of perinatal brain injury,following HI insult.This survey concentrates on how EEG experimental studies using asphyxiated animal models (in rodents,piglets,sheep and non-human primate monkeys) provide a unique opportunity to examine from the exact time of HI event to help gain insights into HIE where human studies become difficult.
文摘<strong>Introduction: </strong><span style="font-family:""><span style="font-family:Verdana;">Fetal heart rate monitoring during labor is used to study fetal well-being and predict neonatal acidosis of newborn. Fetal heart rate monitoring is analyzed by the obstetrical team and categorized according to the FIGO guidelines. An important limitation of this diagnostic tool is an inter- and intra-observer variability, leading to subjective cardiotocography interpretation and classification. Our objective was to study the association between the categories of fetal heart rate analysis (according to FIGO classification) and neonatal acidosis of full-term newborns. </span><b><span style="font-family:Verdana;">Study design:</span></b><span style="font-family:Verdana;"> This is a multicenter retrospective cohort study conducted between 2014 and 2018 in the Grand-Est region. We searched and included retrospectively children hospitalized in a pediatric intensive care unit in one of the participating hospitals with an ICD-10 coding type “P91.6” corresponding to “Hypoxic Ischemic Encephalopathy”. Maternal, pregnancy, delivery, and newborn characteristics were collected and compared by univariate logistic regression with multiple imputation. Odds Ratio and 95% confidence intervals (CI) were calculated using the model and presented. Multiple imputation with m = 100 imputations was tested, using Rubin rules to combine the results. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">55 patients were included in the study. Fetal heart rate tracings classified in Category 3 as “pathological” according to FIGO guidelines were significantly associated with an increased risk of severe neonatal acidosis. Late decelerations and bradycardia during labor were associated with severe neonatal acidosis. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Severe neonatal acidosis may be suspected by interpretation of fetal heart rate during labor. Fetal bradycardia and late decelerations are predictive of the severity of neonatal acidosis. This study emphasizes the need to screen severe neonatal acidosis and allows the identification of populations most at risk. Repeated team training and upgrading of fetal heart rate study would further reduce the incidence of neonatal acidosis.</span></span>
基金supported by Fundação de AmparoàPesquisa do Estado do Rio de Janeiro(FAPERJ,E-26/010.002160/2019,E-26/203.227/2017,E-260003/001177/2020,and E-26/201.279/2021)Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq,313757/2020-8,311188/2023-0)(to PMPC).
文摘Neonatal hypoxic-ischemic encephalopathy(HIE)is a significant cause of disability in children.Improving brain function and accelerating neurological recovery may require a combination of neuroprotective and pro-regenerative treatments at different stages of HIE.While the first hours after the neonatal insult are the most critical period for neuroprotection,the existence of secondary and tertiary mechanisms of brain injury offers the possibility of preventing delayed neurodegeneration in the subsequent days,weeks,or months(Levison et al.,2022).
文摘BACKGROUND Newborns are immediately admitted to the neonatal intensive care unit(NICU)after birth,and thus mothers suffer from the pain of mother-infant separation.Some mothers worry about alterations in their child’s condition and the uncertainty and high medical costs of possible sequelae,which frequently cause anxiety,depression,and other adverse emotions.AIM To investigate the anxiety and depression status of mothers of children in the NICU and its related factors.METHODS A convenient sampling method is adopted.The research objects included the mothers of 191 children in the NICU of Suzhou Ninth Hospital Affiliated with Suzhou University from January 2023 to July 2024.The general information questionnaire,personal control scale,self-rating anxiety scale,and self-rating depression scale were utilized for investigation.Anxiety and depression status in mothers of children in the NICU and its related factors were analyzed.RESULTS The incidences of maternal anxiety and depression among 191 hospitalized children in the NICU were 32.98%(63/191)and 23.56%(45/191),respectively.Single-factor analysis reveals that family monthly income,individual sense of control,gestational age of the child,and the number of diseases in the child are associated with the anxiety and depression experienced by the mother of the child in the NICU(P<0.05).Multivariate logistic regression analysis revealed that family monthly income of<5000 yuan(RMB),poor individual control,gestational age of<32 weeks,and the number of diseases of≥3 kinds are all related factors for anxiety and depression in mothers of children admitted to the NICU(P<0.05).CONCLUSION Mothers of children admitted to the NICU demonstrated high anxiety and depression incidences.The nursing staff in the neonatal department established intervention measures for each related factor,strengthened communication and communication with the mother of the child,and did a good job in psychological counseling.
基金supported by a grant from the Health Research New Zealand(HRC)22/559(to AJG and LB)。
文摘Moderate to severe perinatal hypoxic-ischemic encephalopathy occurs in~1 to 3/1000 live births in high-income countries and is associated with a significant risk of death or neurodevelopmental disability.Detailed assessment is important to help identify highrisk infants,to help families,and to support appropriate interventions.A wide range of monitoring tools is available to assess changes over time,including urine and blood biomarkers,neurological examination,and electroencephalography.At present,magnetic resonance imaging is unique as although it is expensive and not suited to monitoring the early evolution of hypoxic-ischemic encephalopathy by a week of life it can provide direct insight into the anatomical changes in the brain after hypoxic-ischemic encephalopathy and so offers strong prognostic information on the long-term outcome after hypoxic-ischemic encephalopathy.This review investigated the temporal dynamics of neonatal hypoxic-ischemic encephalopathy injuries,with a particular emphasis on exploring the correlation between the prognostic implications of magnetic resonance imaging scans in the first week of life and their relationship to long-term outcome prediction,particularly for infants treated with therapeutic hypothermia.A comprehensive literature search,from 2016 to 2024,identified 20 pertinent articles.This review highlights that while the optimal timing of magnetic resonance imaging scans is not clear,overall,it suggests that magnetic resonance imaging within the first week of life provides strong prognostic accuracy.Many challenges limit the timing consistency,particularly the need for intensive care and clinical monitoring.Conversely,although most reports examined the prognostic value of scans taken between 4 and 10 days after birth,there is evidence from small numbers of cases that,at times,brain injury may continue to evolve for weeks after birth.This suggests that in the future it will be important to explore a wider range of times after hypoxic-ischemic encephalopathy to fully understand the optimal timing for predicting long-term outcomes.
文摘Background: Birth weight has been identified as one of the most significant predictors of a child’s physical growth, development, and survival in later life. A quest to provide an answer on the impact of maternal anthropometry on neonatal birth weight necessitated this study. Materials and methods: It is a cross-sectional descriptive hospital based study that involved 130 participants selected using a systematic sampling method, utilizing a semi-structured, pre-tested interviewer administered questionnaire. Data were collected using a standard procedure and were summarized using proportions, and the Chi square test was used to explore the association between categorical variables. Predictors of birth weight were determined using logistic regression. The level of statistical significance was set at p Results: Participants had a mean age of 28.6 ± 5.1 years, mean weight of 72.2 ± 11.2 kg and mean height of 1.63 ± 0.07m while the mean fetal birth weight was 3.10 ± 0.56 kg. There was a significant association between maternal delivery body mass index and neonatal birth weight (p Conclusion: The prevalence of low birth weight and macrosomia in this study population was high. The focus should be geared towards balanced nutrition support for all mothers at booking so as to mitigate the risks associated with these extremes of birth weight.
文摘Objective: In the Healthy Child Action Enhancement Program (2021-2025), it is proposed to ensure the safety and health of newborns and to promote high-quality development of health. Our department established risk assessment criteria for medical adhesives in neonates by applying the best evidence in the management program for the reduction of medical adhesive-associated skin injuries in neonates, in terms of the use and removal of adhesives. Methods: A systematic search and quality assessment of topics related to medical adhesive-related skin injury in neonates was conducted to summarize the best evidence and to conduct a quality review in the neonatal unit. Results: After 2 rounds of review, medical and nursing staff in the neonatal unit had a 98% compliance rate for the knowledge of neonatal medical adhesive-related skin injury and a satisfactory compliance rate for the other 9 indicators;after the application of the evidence, the incidence of neonatal medical adhesive-related skin injury was significantly lower than that before the application of the evidence, and the differences were statistically significant (P Conclusion: The application of the best evidence-based management program in neonatal medical adhesive-associated skin injury can reduce the incidence of neonatal medical adhesive-associated skin injury, reduce neonatal infections, and improve the integrity of the protective skin barrier in neonates.
文摘Objective:Neonatal sepsis is a critical pathology that particularly affects neonates,especially preterm and low birth weight neonates,with varying incidence according to the onset(early or late)of the disease.Although preterm neonatal mortality related to sepsis is high in Ethiopia and in the study area,limited studies have been conducted on the time-to-death and predictors of mortality among preterm neonates diagnosed with neonatal sepsis.Therefore,this study aimed to determine the time-to-death and predictors of mortality among preterm neonates with neonatal sepsis admitted to government hospitals in Southwest Ethiopia in 2022.Methods:A prospective cohort study was conducted at the Southwest government hospitals between March 2021 and January 30,2022.The data were entered into Epi-data version 4.4.2.1 and exported to Stata version 14 for editing,cleaning,and analysis.The Cox proportional hazards(CPH)model was used to identify the predictors of mortality.Results:In this study,out of 354 preterm neonates diagnosed with neonatal sepsis,121(34.18%)had died with an incidence rate of 59.8%(95%confidence interval[CI]:50-71.5)deaths per 1000 person-day-observations.The median survival time of preterm neonates diagnosed with neonatal sepsis was 15 days.The following factors were the predictors of mortality among preterm neonates diagnosed with neonatal sepsis:(1)the neonate’s mother did not have antenatal care(ANC)follow-up(adjusted hazard ratio[AHR]2.5[95%CI:1.3-4.84]);(2)the neonates had an APGAR score<7(5th-minute activity,pulse,grimace,appearance,and respiration)(AHR 1.5[95%CI:1.29-3.46]);(3)and they had comorbidities such as respiratory distress syndrome(RDS)(AHR 1.50[95%CI:1.13-2.31])and jaundice(AHR 1.89[95%CI:1.26-2.84]).Conclusions:In this study,preterm neonates diagnosed with neonatal sepsis showed a higher incidence of mortality compared with other national and local studies.The median survival time of neonates was 15 days.Born from mothers who did not have ANC follow-up,5th-minute APGAR score<7,and comorbidities such as RDS and jaundice were independent predictors of mortality among preterm neonates diagnosed with neonatal sepsis.Therefore,healthcare providers and other stakeholders should consider prompt and timely diagnosis and therapeutic interventions to preterm neonates with neonatal sepsis.
文摘BACKGROUND Neonatal screening(NS)is a public health policy to identify genetic pathologies such as cystic fibrosis(CF),sickle cell disease,and other diseases.Sickle cell disea-se is the comprehensive term for a group of hemoglobinopathies characterized by the presence of hemoglobin S.CF is an autosomal recessive multisystemic disease with pathophysiology involving deleterious mutations in the transmembrane re-gulatory gene that encodes a protein that regulates the activity of chloride and sodium channels in the cell surface epithelium.NS is crucial for early diagnosis and management,which ensures a better quality of life.AIM To report a case of the coexistence of sickle cell anemia(SCA)and CF and perform an integrative literature review.METHODS This is an observational study and a review of the literature focusing on two rare genetic pathologies identified simultaneously in NS from the perspective of a clinical case.The authors identified only 5 cases of SCA associated with CF.No clinical trials or review articles were identified considering the rarity of the coexistence of these two pathologies.RESULTS Herein,the authors reported the case of a girl who after undergoing NS on day 8 of life was diagnosed with SCA with an alteration in the dosage of immunoreactive trypsin.The diagnosis of CF was confirmed by the Coulometry Sweat Test.The rarity of the co-occurrence of these two severe genetic pathologies(CF and SCA)is a challenge for medical science.CONCLUSION This study adds to the few case reports present in the literature that highlight the identification of two severe diseases via NS.
文摘Neonatal and pediatric sepsis remains a major global health concern,contributing significantly to morbidity and mortality among children under 5 years of age.The clinical and microbiological characteristics of sepsis differ markedly in neonates and children,necessitating tailored diagnostic and treatment approaches.This mini-review explores the evolving microbiological landscape,recent advancements in diagnostic methodologies,and challenges posed by antimicrobial resistance(AMR)in managing neonatal and pediatric sepsis.Emerging pathogens,including multidrug-resistant Gram-negative bacilli and fungal organisms,are reshaping the epidemiology of sepsis.Innovations in molecular diagnostics,including polymerase chain reaction-based platforms,next-generation sequencing,and artificial intelligence-integrated tools,are revolutionizing early pathogen detection and resistance profiling.However,implementation gaps persist,particularly in low-and middle-income countries.Therapeutic challenges are compounded by limited pediatric data on newer antimicrobials and rising AMR rates.Infection prevention strategies,especially in intensive care units,are crucial to outbreak containment.An integrated approach combining microbiological surveillance,rapid diagnostics,and antimicrobial stewardship is critical for improving sepsis outcomes.Future research should focus on context-specific implementation of diagnostic tools and optimizing treatment strategies for resource-limited settings.
基金supported by grants from National 973 Program in China(No.G1999053904)National Natural Sciences Foundation of China(No.39730410)
文摘Kinetics of thymocyte development in vivo during embryogenesis was pursued. The early development of thymocytes in the fetal and neonatal BALB/c mice was discontinuous, with four waves of cell proliferation occurring at fetal day (Fd) 14 to 17, Fd 18 to day (D) 1 after birth, D 2 to D 5 and D6 thereafter. The first three proliferation waves coincided with the generation of CD4/'CD8/' (DP), TCR+CD4/hiCD8-/lo (CD4 SP), and TCR+CD4-/loCD8int/hi (CD8 SP) thymocytes, respectively. The transition from DN to DP cells was further investigated and it was found out that there were two differential pathways via immature single positive (ISP) cells in the BALB/c mice, each functioning at different fetal ages. One is via TCR-CD4-CD8+ cells, occurring between Fd 15 and Fd 17 and the other is via TCR-CD4+CD8- cells, occurring from Fd 17 until birth. In contrast, the TCR-CD4-CD8+ pathway dominated overwhelmingly in the C57BL/6 mice. These findings shed new light on the hypothesis that the differential pathway preference varies with mouse strains. With respect to the shift in the intensity of CD4 and CD8 expression on thymocytes from fetal to adult mice, the TCR+CD4/hiCD8-/lo, and TCR+CD4-/loCD8int/hi subsets might be equivalent to the medullary type TCR+CD4/CD8 SP cells.
文摘Objective:To assess knowledge and practice among nurses toward neonatal resuscitation in hospitals in Hebron.Methods:A cross-sectional study design was conducted among 151 nurses from Hebron.Data were collected using a self-administered questionnaire.Multiple logistic regression was conducted to test the associated factors with the dependent variables.Results:Only 9.3%of participants had a standardized level of knowledge,while 68.9%reported adequate skills for neonatal resuscitation.Factors associated with a standardized level of knowledge were age(p=0.001)and supportive supervision(p=0.007).Factors associated with the standardized practice level were the presence of hospital guidelines(p=0.028),previous training of nurses(p=0.011),and the presence of supportive supervision(p<0.001).Conclusions:The majority of emergency nurses in Hebron hospitals demonstrated a substandard level of knowledge of neonatal resuscitation.However,most of those nurses surprisingly reported a standardized practice level.The presence of hospital guidelines,training programs,or direct supervision for nurses are factors that can be considered to improve both knowledge and practice toward neonatal resuscitation among emergency nurses in Hebron.
文摘Objective: Obstetricians, Neonatologists, and Pathologists have studied gross histological analysis of human placentas in search of specific alterations in placental functions that can be correlated with neonatal outcomes. Our study assessed the prevalence of abnormal placental findings associated with non-reassuring fetal monitoring in labor requiring emergent instrumental or cesarean delivery, followed by an excellent neonatal outcome. Study Design: One hundred consecutive emergency deliveries, instrumental or cesarean, performed due to non-reassuring fetal monitoring while in labor were retrospectively evaluated. All patients were low-risk for obstetric complications, and had a singleton, term pregnancy. They had a normal antenatal routine testing and a normal anatomy ultrasound scan at 20 to 22 weeks gestation. Results: There were 35 placentas (35%) with gross placental anomalies at the delivery triage. Additionally 7 placentas (7%) were reported to be abnormal at the pathology examination. Conclusion: The prevalence of abnormal placental findings in our studied population was 42%.
文摘This study explores the clinical efficacy of budesonide combined with ambroxol inhalation therapy for neonatal pneumonia.A total of 68 neonatal pneumonia patients treated at Li County Hospital from January 2023 to December 2024 were randomly divided into a monotherapy group and a combination group,with 34 patients in each.The monotherapy group received ambroxol inhalation therapy,while the combination group received budesonide inhalation therapy in addition to ambroxol.The recovery progress,blood gas analysis indicators,inflammatory response improvement,and overall clinical efficacy were compared between the two groups.Results showed that the combination group experienced a significantly shorter time for body temperature normalization(3.36±0.58 days vs.4.59±0.45 days),oxygen inhalation duration(4.89±0.57min vs.6.96±0.79min),disappearance of shortness of breath and cough(4.56±0.29 days vs.6.63±0.75 days),and resolution of lung wet rales(5.62±1.46 days vs.7.92±1.28 days)compared to the monotherapy group(P<0.05).Additionally,the total effective rate was significantly higher in the combination group(97.06%)than in the monotherapy group(73.52%)(P<0.05).Post-treatment,the combination group exhibited significantly better blood gas analysis and inflammatory response indicators(P<0.05).These findings suggest that budesonide combined with ambroxol inhalation therapy can effectively improve blood oxygen saturation,reduce inflammation,promote faster recovery,and enhance overall clinical efficacy,making it a reliable treatment option for neonatal pneumonia.
文摘Neonatal hypoxic-ischemic encephalopathy(HIE)refers to neonatal brain damage caused by various factors during the perinatal period that lead to hypoxia and reduced cerebral blood flow[1].Globally,0.2%to 2.26%of newborns develop HIE,with approximately 20%resulting in neonatal death and about 25%of survivors suffering from neurological impairment[2].Currently,there is a lack of highly sensitive and specific diagnostic tools for HIE,posing significant challenges to reducing HIE mortality and neurological abnormalities[3].The development of high-throughput proteomics technology based on mass spectrometry(MS)has significantly enhanced the potential to discover biomarkers in biological fluids such as plasma,cerebrospinal fluid,saliva,and urine[4].Proteomics technology has become an engine for exploring novel markers of HIE[5].This article systematically reviews the progress of proteomics technology in the study of biomarkers for the early diagnosis of HIE,elucidating its potential application value.
基金supported by the National Natural Science Foundation of China(No.22225605)the National Key Research and Development Program of China(No.2023YFC3706600)the Strategic Priority Research Program of the Chinese Academy of Sciences(No.XDB0750200).
文摘The number of newborns born with diseases is increasing recently.Thyroid hormones(THs)are closely related to the growth and development of the newborn in the mother's womb and to the carriage of related diseases after birth.Environmental endocrine-disrupting compounds(EDCs)have been proven to harm THs in newborns.Phthalates(PAEs),a typical class of EDCs,are commonly used in toys,childcare materials,and food contact materials,which have been closely connected with neonatal thyroid dysfunction and thyroid-related diseases.As restrictions on PAEs becomemore stringent in neonatal field,numerous PAE alternatives are emerging.Associations between exposure to PAEs and their alternatives and dysfunctions in THs have been explored.Hence,we summarized the body burdens and regional characteristics of PAEs and their alternatives in neonatal urine,cord blood,and meconium.Subsequently,the influences of PAEs and their alternatives on thyroid dysfunction,prematurity,low birth weight,fetal growth restriction,respiratory dysfunction,immune disorders,neurological disorders,and reproductive disorders in newborns were evaluated.Furthermore,we scrutinized the effects of PAEs and their alternatives on the neonatal thyroid from signaling,substance transport,and hormone production to explore the underlying mechanisms of action on neonatal thyroid and thyroid-related disorders.As the declining global trends of healthy newborns and the potential impacts of PAEs and their alternatives on thyroid function,a more comprehensive study is needed to discuss their effects on newborns and their underlying mechanisms.This review facilitates attention to the effects of PAEs and their alternatives on thyroid and thyroid-related disorders in newborns.
基金Supported by National Liver Institute,Menoufia University,and Damietta General Hospital,Damietta,Egypt.
文摘BACKGROUND Neonatal sepsis is a serious health problem,with high morbidity and mortality during the first 28 days of life.Clinical diagnosis at presentation is challenging due to the nonspecific signs and symptoms.Although blood culture is the gold standard for diagnosis,it is not always positive.AIM To evaluate the diagnostic and prognostic utility of D-dimer and heparin-binding protein(HBP)in neonatal sepsis.METHODS This prospective case-control study included 90 neonates in two groups:A sepsis group(n=45)and a control group(n=45)without sepsis.Sepsis group was further subdivided based on blood culture results into proven sepsis(n=28 culturepositive sepsis)and suspected sepsis(n=17 culture-negative sepsis).All neonates underwent complete history taking,thorough clinical examination and investigations[complete blood count,C-reactive protein(CRP),liver and kidney function tests,plasma D-dimer and HBP].RESULTS Levels of CRP,D-dimer and HBP were significantly higher in the sepsis group compared to the controls.At a cutoff value above 517.9 ng/mL,D-dimer outperformed CRP and HBP in distinguishing sepsis group from controls with 95.6%sensitivity and 97.8%specificity.D-dimer was also a better prognostic marker than the neonatal sequential organ failure assessment(nSOFA)for predicting mortality,with 100%sensitivity and 92.5%specificity vs 80%sensitivity and 82.5%specificity.There was a significant positive correlation between CRP,D-dimer and HBP.CONCLUSION D-dimer demonstrated superior diagnostic accuracy compared to CRP and HBP in predicting sepsis,and demonstrated superior prognostic accuracy compared to nSOFA in predicting the outcome of neonatal sepsis.
文摘Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth record data from the Ghana Demographic and Health Surveys(2008,2014,and 2022)were used to analyse trends and determinants in neonatal mortality and preterm birth aligned with World Health Organization antenatal care(ANC)guidelines using Pearson’s Chi-square test and multivariate logistic regression with statistical significance at P<0.05 and 95%confidence intervals(CI).Results:Preterm birth rate and neonatal mortality rate decreased from 13.0%to 9.1%and 27.6 to 23.7 per 1000 live births from 2008 to 2022 respectively.Lack of iron supplementation(odds ratio[OR]1.127,95%CI:1.047 to 1.967)a nutritional intervention maternal assessments(moderate/severe anaemia(OR 1.423,95%CI:1.178 to 2.051),preventive measures(Untreated malaria(OR 1.449,95%CI:1.104 to 2.411)or deworming(OR 1.267,95%CI:0.970 to 1.645)were associated with increased preterm birth risk.Attending<8 ANC visits raised the odds of preterm birth(OR 1.24,95%CI:1.03 to 1.257)and neonatal mortality(OR 1.583,95%CI:1.120 to 2.480).Conclusion:Despite reductions in preterm birth and neonatal mortality rates,substantial gaps in antenatal care remain.Strengthening the implementation of World Health Organization ANC guidelines is critical to reducing preterm birth and neonatal mortality in Ghana.
基金funded by the Indian Council of Medical Research(ICMR),New Delhi,Government of India under Grant No.EM/SG/Dev.Res/124/0812-2023.
文摘Jaundice,common condition in newborns,is characterized by yellowing of the skin and eyes due to elevated levels of bilirubin in the blood.Timely detection and management of jaundice are crucial to prevent potential complications.Traditional jaundice assessment methods rely on visual inspection or invasive blood tests that are subjective and painful for infants,respectively.Although several automated methods for jaundice detection have been developed during the past few years,a limited number of reviews consolidating these developments have been presented till date,making it essential to systematically evaluate and present the existing advancements.This paper fills this gap by providing a thorough survey of automated methods for jaundice detection in neonates.The primary focus of the survey is to review the existing methodologies,techniques,and technologies used for neonatal jaundice detection.The key findings from the review indicate that image-based bilirubinometers and transcutaneous bilirubinometers are promising non-invasive alternatives,and provide a good trade-off between accuracy and ease of use.However,their effectiveness varies with factors like skin pigmentation,gestational age,and measurement site.Spectroscopic and biosensor-based techniques show high sensitivity but need further clinical validation.Despite advancements,several challenges including device calibration,large-scale validation,and regulatory barriers still haunt the researchers.Standardization,regulatory compliances,and seamless integration into healthcare workflows are the key hurdles to be addressed.By consolidating the current knowledge and discussing the challenges and opportunities in this field,this survey aims to contribute to the advancement of automatic jaundice detection and ultimately improve neonatal care.
