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
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
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 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
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
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
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
Gestational diabetes mellitus(GDM)is the most common metabolic abnormality of pregnancy and is associated with early and late adverse outcomes for both mothers and fetuses.Conventionally,GDM is diagnosed between 24 an...Gestational diabetes mellitus(GDM)is the most common metabolic abnormality of pregnancy and is associated with early and late adverse outcomes for both mothers and fetuses.Conventionally,GDM is diagnosed between 24 and 28 gestational weeks(GW)(late-onset GDM).With the increasing prevalence of prediabetes among women of reproductive age,GDM is increasingly being diagnosed before 24 GW in high-risk populations(early-onset GDM).Compared with late-onset GDM pregnancies,early-onset GDM pregnancies are at greater risk for neonatal adverse events,such as perinatal mortality,neonatal hypoglycemia,neonatal respiratory distress syndrome,and macrosomia.The TOBOGM study revealed that the initiation of treatment before 20 GW can modestly reduce composite neonatal outcomes,mainly due to a reduction in the rate of neonatal respiratory distress syndrome.The benefit was greater when treatment was initiated before 14 GW.The probable mechanisms for early-onset hyper-glycemiainduced neonatal adverse events are decidual and placental defects,interference with fetal lung development,and fetal glucose steal.There is no international consensus on the GDM screening strategy in early pregnancy,and its cost-effectiveness is questioned by several professional bodies.Further prospective randomized controlled studies are strongly recommended to alleviate confusion in clinical practice regarding the management of mild hyperglycemia in early pregnancy.展开更多
This article first outlines the fundamental definitions of Mycoplasma pneumoniae and the basic principles of antibiotics. It then analyzes and discusses the progress in antibiotic application and time-eff ect studies ...This article first outlines the fundamental definitions of Mycoplasma pneumoniae and the basic principles of antibiotics. It then analyzes and discusses the progress in antibiotic application and time-eff ect studies for neonatal pneumonia treatment, specifically comparing conventional antibiotic therapy with stepwise treatment regimens, and contrasting monotherapy with penicillin, monotherapy with cephalosporins, and combination therapy. Finally, it offers a prospective outlook on antibiotic application and time-effect research in neonatal pneumonia treatment, aiming to provide valuable reference for further scholarly investigations.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 Parental presence in neonatal units(NUs)is essential for infant development and family well-being.A deeper understanding of the factors influencing parental presence is vital and will contribute to the deve...BACKGROUND Parental presence in neonatal units(NUs)is essential for infant development and family well-being.A deeper understanding of the factors influencing parental presence is vital and will contribute to the development of targeted interventions and policies that enhance parental engagement in neonatal care,thereby improving outcomes for infants and their families.AIM To identify and analyze primary factors influencing parental involvement in their child’s care in a neonatal intensive care unit(NICU).METHODS A literature search was conducted using the PubMed,MEDLINE,and Cochrane Library for systematic reviews databases,with the following search terms:“parental presence neonatology”,“couplet care”,“zero separation neonatal care”,“family integrated care”,“couplet care intervention”,“mother-child separation”,“parents newborn togetherness”,“mother-baby care”,“closeness and separation NICU”,“mother-infant interaction NICU”,“kangaroo care”,“dyad mother-infant”,and“newborn integrated care”.The database search for this literature review began on December 10,2024,with the final search conducted on April 10,2025.RESULTS The literature search yielded 281 articles,out of which 23 were selected for a detailed review.The factors associated with parental presence in NUs were grouped into five main categories:Parents’socio-demographic and cultural traits;the physical layout and care model of the NUs;the quality of parents’relationships with the healthcare staff;their active involvement in neonatal care;and the newborn’s health status.CONCLUSION The identification of factors that affect parental presence in NUs is critical for developing effective strategies aimed at encouraging increased parental involvement and ultimately improving neonatal and family outcomes.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
Acute Bilirubin Encephalopathy(ABE)is a significant threat to neonates and it leads to disability and high mortality rates.Detecting and treating ABE promptly is important to prevent further complications and long-ter...Acute Bilirubin Encephalopathy(ABE)is a significant threat to neonates and it leads to disability and high mortality rates.Detecting and treating ABE promptly is important to prevent further complications and long-term issues.Recent studies have explored ABE diagnosis.However,they often face limitations in classification due to reliance on a single modality of Magnetic Resonance Imaging(MRI).To tackle this problem,the authors propose a Tri-M2MT model for precise ABE detection by using tri-modality MRI scans.The scans include T1-weighted imaging(T1WI),T2-weighted imaging(T2WI),and apparent diffusion coefficient maps to get indepth information.Initially,the tri-modality MRI scans are collected and preprocessesed by using an Advanced Gaussian Filter for noise reduction and Z-score normalisation for data standardisation.An Advanced Capsule Network was utilised to extract relevant features by using Snake Optimization Algorithm to select optimal features based on feature correlation with the aim of minimising complexity and enhancing detection accuracy.Furthermore,a multi-transformer approach was used for feature fusion and identify feature correlations effectively.Finally,accurate ABE diagnosis is achieved through the utilisation of a SoftMax layer.The performance of the proposed Tri-M2MT model is evaluated across various metrics,including accuracy,specificity,sensitivity,F1-score,and ROC curve analysis,and the proposed methodology provides better performance compared to existing methodologies.展开更多
Infants exhibit diminished susceptibility to external infections,a phenomenon closely linked to the pervasive presence of the bifidobacterial community within their intestinal tract.Nonetheless,a significant knowledge...Infants exhibit diminished susceptibility to external infections,a phenomenon closely linked to the pervasive presence of the bifidobacterial community within their intestinal tract.Nonetheless,a significant knowledge gap remains concerning the distinct species of bifidobacteria initiating anti-infection immune responses during the early developmental stages.In this study,the impact of early intervention with Bifidobacterium bifidum,Bifidobacterium breve,and Bifidobacterium longum on neonatal rats infected with Salmonella enterica serovar Typhimurium SL1344 were compared.The study encompasses various immunity levels,including gut immunity,central immunity(thymus),peripheral immunity(spleen),and brain immunity.Following Salmonella infection,significant alterations in neonatal rats were observed in growth and developmental levels,immune markers,cytokine levels,balance of T lymphocyte subpopulations,intestinal barrier function,and blood-brain barrier integrity.Compared with B.breve and B.longum,B.bifidum demonstrated more pronounced efficacy in regulating these physiological processes.By conducting multi-level analyses of gut microbiota,bifidobacterial community,colonic content metabolomics,and serum metabolomics,the significance of B.bifidum’s role is underscored,and the immune-enhancing function of messenger metabolites is unveiled.Among these metabolites,γ-L-glutamyl-L-glutamic acid and orotic acid were found to be shared by all 3 species,while hippuric acid and 1a,1b-dihomo prostaglandin F2αwere unique to B.bifidum,and DL-arginine was specific to B.longum.Overall,this study has provided novel insights into the intervention and immunomodulation by Bifidobacterium in early-life infections,emphasizing the significant role of B.bifidum.展开更多
Irritable bowel syndrome-diarrhea(IBS-D)is a prevalent functional bowel disease severely impairs the quality of life of patients.Visceral hypersensitivity(VH)is the main symptom of IBS-D.Probiotics have been found to ...Irritable bowel syndrome-diarrhea(IBS-D)is a prevalent functional bowel disease severely impairs the quality of life of patients.Visceral hypersensitivity(VH)is the main symptom of IBS-D.Probiotics have been found to effectively alleviate VH.In this study,neonatal maternal separation(NMS)was used to induce VH in 72 rats and investigated the effects of daily gavage of 3×10^(9) CFU of Lactobacillus and Bifidobacterium on alleviating the symptoms of IBS-D and behavioral interventions,as well as exploring potential mechanisms.The results demonstrated that L.acidophilus and B.breve could alleviate the symptoms of IBS-D such as VH and increased frequency of bowel movements,as well as improving non-spatial memory in NMS rats.These effects were achieved by modulating the composition of gut microbiota and metabolites(including short-chain fatty acids,deoxycholic acid and adenosine),and by regulating the expression of genes and proteins associated with the NGF/TrkA signaling pathway,tryptophan metabolism,and inflammatory factors in the hippocampus.This finding suggests that L.acidophilus and B.breve have promising potential for the alleviation of IBS.展开更多
Objective Great obstetrical syndrome(GOS)represents a group of pregnancy-related diseases that result in inadequate placentation.Most GOS cases end in preterm,either spontaneously or indicatively,and the use of antena...Objective Great obstetrical syndrome(GOS)represents a group of pregnancy-related diseases that result in inadequate placentation.Most GOS cases end in preterm,either spontaneously or indicatively,and the use of antenatal corticosteroids(ACS)is inevitably discussed.The placenta is an important,transient fetal-derived organ and is the embodiment of maternal or fetal well-being.However,few studies provide histological evidence of the placenta in GOS.This study aims to address these issues.Methods A total of 831 pregnant women were prospectively recruited.Placenta tissue was collected immediately and fixed with 4%paraformaldehyde solution for future H&E analysis.A novel checklist was devised to evaluate maternal vascular malperfusion sections on the basis of the commonly accepted Amsterdam placental workshop group consensus statement.Results A total of 131 patients were classified as having GOS.Comparisons between those with and without GOS revealed significant differences,including higher levels of distal villous hypoplasia,increased syncytial knots,accelerated villous maturation,and higher total scores in GOS.We found significant negative associations between GOS and neonatal weight,neonatal height,head circumference,placental surface area,placental volume,and placenta gross examination score.GOS neonates were 1.25 times more likely to have hyperbilirubinemia.Regarding the effect of ACS,a significant reduction in birthweight,height,and head circumference was observed,along with an increased risk of hyperbilirubinemia.Conclusion This study provides histological evidence of the GOS that supports the defective deep placentation hypothesis.Our research also contributes to benefit-risk consultation in the GOS,such as in cases of PE and FGR,where a balance between fetal lung maturation and short-term neonatal outcomes is crucial.展开更多
Neonatal hypoxic-ischemic encephalopathy(HIE),resulting from perinatal asphyxia-induced hypoxic-ischemic brain damage(HIBD),is a severe neurological disorder that impairs neurodevelopment,and no definitive therapies a...Neonatal hypoxic-ischemic encephalopathy(HIE),resulting from perinatal asphyxia-induced hypoxic-ischemic brain damage(HIBD),is a severe neurological disorder that impairs neurodevelopment,and no definitive therapies are available.The polyphenolic natural compound salvianolic acid C(SAC)exhibits antioxidant,anti-inflammatory,and antiapoptotic properties.In this study,we evaluated the efficacy of SAC in treating HIE via animal and human brain organoid experiments.Human brain organoids served as a translational platform for assessing natural product efficacy and clinical effect prediction.Rat brain tissues were harvested at two time points(24 h and 7 d after HIBD and SAC administration)for single-nucleus RNA sequencing.In vitro and in vivo experiments,including microarrays and gene silencing,were employed to confirm the sequencing findings.Our findings demonstrated that during the acute phase of HIBD,SAC suppressed signal transducer and activator of transcription 3+(Stat3+)astrocyte-driven acute neuroinflammation,decreased inflammatory factor release,and maintained glial-immune homeostasis.During the subacute phase,SAC promoted oligodendrocyte differentiation and facilitated crosstalk between anti-inflammatory microglia and myelinating oligodendrocytes,establishing a regenerative microenvironment and enhancing neuregulin 3(NRG3)-receptor tyrosine-protein kinase erbB-4(ErbB4)signaling axis activity.These coordinated mechanisms highlight the dual capacity of SAC in mitigating early injury and driving structural repair in the later stages.This study revealed the pathophysiology of HIE and the multitarget neuroprotective effects of SAC against this disorder at single-cell resolution,advancing the mechanistic foundations for SAC-based therapies in neonatal brain injury.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
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.
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.
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 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Gestational diabetes mellitus(GDM)is the most common metabolic abnormality of pregnancy and is associated with early and late adverse outcomes for both mothers and fetuses.Conventionally,GDM is diagnosed between 24 and 28 gestational weeks(GW)(late-onset GDM).With the increasing prevalence of prediabetes among women of reproductive age,GDM is increasingly being diagnosed before 24 GW in high-risk populations(early-onset GDM).Compared with late-onset GDM pregnancies,early-onset GDM pregnancies are at greater risk for neonatal adverse events,such as perinatal mortality,neonatal hypoglycemia,neonatal respiratory distress syndrome,and macrosomia.The TOBOGM study revealed that the initiation of treatment before 20 GW can modestly reduce composite neonatal outcomes,mainly due to a reduction in the rate of neonatal respiratory distress syndrome.The benefit was greater when treatment was initiated before 14 GW.The probable mechanisms for early-onset hyper-glycemiainduced neonatal adverse events are decidual and placental defects,interference with fetal lung development,and fetal glucose steal.There is no international consensus on the GDM screening strategy in early pregnancy,and its cost-effectiveness is questioned by several professional bodies.Further prospective randomized controlled studies are strongly recommended to alleviate confusion in clinical practice regarding the management of mild hyperglycemia in early pregnancy.
文摘This article first outlines the fundamental definitions of Mycoplasma pneumoniae and the basic principles of antibiotics. It then analyzes and discusses the progress in antibiotic application and time-eff ect studies for neonatal pneumonia treatment, specifically comparing conventional antibiotic therapy with stepwise treatment regimens, and contrasting monotherapy with penicillin, monotherapy with cephalosporins, and combination therapy. Finally, it offers a prospective outlook on antibiotic application and time-effect research in neonatal pneumonia treatment, aiming to provide valuable reference for further scholarly investigations.
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.
文摘BACKGROUND Parental presence in neonatal units(NUs)is essential for infant development and family well-being.A deeper understanding of the factors influencing parental presence is vital and will contribute to the development of targeted interventions and policies that enhance parental engagement in neonatal care,thereby improving outcomes for infants and their families.AIM To identify and analyze primary factors influencing parental involvement in their child’s care in a neonatal intensive care unit(NICU).METHODS A literature search was conducted using the PubMed,MEDLINE,and Cochrane Library for systematic reviews databases,with the following search terms:“parental presence neonatology”,“couplet care”,“zero separation neonatal care”,“family integrated care”,“couplet care intervention”,“mother-child separation”,“parents newborn togetherness”,“mother-baby care”,“closeness and separation NICU”,“mother-infant interaction NICU”,“kangaroo care”,“dyad mother-infant”,and“newborn integrated care”.The database search for this literature review began on December 10,2024,with the final search conducted on April 10,2025.RESULTS The literature search yielded 281 articles,out of which 23 were selected for a detailed review.The factors associated with parental presence in NUs were grouped into five main categories:Parents’socio-demographic and cultural traits;the physical layout and care model of the NUs;the quality of parents’relationships with the healthcare staff;their active involvement in neonatal care;and the newborn’s health status.CONCLUSION The identification of factors that affect parental presence in NUs is critical for developing effective strategies aimed at encouraging increased parental involvement and ultimately improving neonatal and family outcomes.
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.
文摘Acute Bilirubin Encephalopathy(ABE)is a significant threat to neonates and it leads to disability and high mortality rates.Detecting and treating ABE promptly is important to prevent further complications and long-term issues.Recent studies have explored ABE diagnosis.However,they often face limitations in classification due to reliance on a single modality of Magnetic Resonance Imaging(MRI).To tackle this problem,the authors propose a Tri-M2MT model for precise ABE detection by using tri-modality MRI scans.The scans include T1-weighted imaging(T1WI),T2-weighted imaging(T2WI),and apparent diffusion coefficient maps to get indepth information.Initially,the tri-modality MRI scans are collected and preprocessesed by using an Advanced Gaussian Filter for noise reduction and Z-score normalisation for data standardisation.An Advanced Capsule Network was utilised to extract relevant features by using Snake Optimization Algorithm to select optimal features based on feature correlation with the aim of minimising complexity and enhancing detection accuracy.Furthermore,a multi-transformer approach was used for feature fusion and identify feature correlations effectively.Finally,accurate ABE diagnosis is achieved through the utilisation of a SoftMax layer.The performance of the proposed Tri-M2MT model is evaluated across various metrics,including accuracy,specificity,sensitivity,F1-score,and ROC curve analysis,and the proposed methodology provides better performance compared to existing methodologies.
基金supported by the National Natural Science Foundation of China(32272332,31972052,32021005,31820103010)the Fundamental Research Funds for the Central Universities(JUSRP622020,JUSRP22006,JUSRP51501)the Program of Collaborative Innovation Centre of Food Safety and Quality Control in Jiangsu Province,Postgraduate Research&Practice Innovation Program of Jiangsu Province(KYCX22_2391).
文摘Infants exhibit diminished susceptibility to external infections,a phenomenon closely linked to the pervasive presence of the bifidobacterial community within their intestinal tract.Nonetheless,a significant knowledge gap remains concerning the distinct species of bifidobacteria initiating anti-infection immune responses during the early developmental stages.In this study,the impact of early intervention with Bifidobacterium bifidum,Bifidobacterium breve,and Bifidobacterium longum on neonatal rats infected with Salmonella enterica serovar Typhimurium SL1344 were compared.The study encompasses various immunity levels,including gut immunity,central immunity(thymus),peripheral immunity(spleen),and brain immunity.Following Salmonella infection,significant alterations in neonatal rats were observed in growth and developmental levels,immune markers,cytokine levels,balance of T lymphocyte subpopulations,intestinal barrier function,and blood-brain barrier integrity.Compared with B.breve and B.longum,B.bifidum demonstrated more pronounced efficacy in regulating these physiological processes.By conducting multi-level analyses of gut microbiota,bifidobacterial community,colonic content metabolomics,and serum metabolomics,the significance of B.bifidum’s role is underscored,and the immune-enhancing function of messenger metabolites is unveiled.Among these metabolites,γ-L-glutamyl-L-glutamic acid and orotic acid were found to be shared by all 3 species,while hippuric acid and 1a,1b-dihomo prostaglandin F2αwere unique to B.bifidum,and DL-arginine was specific to B.longum.Overall,this study has provided novel insights into the intervention and immunomodulation by Bifidobacterium in early-life infections,emphasizing the significant role of B.bifidum.
基金supported by the National Key Research and Development Program of China(2021YFD2100700)the National Natural Science Foundation of China(32021005)+1 种基金the 111 project(BP0719028)the Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province.
文摘Irritable bowel syndrome-diarrhea(IBS-D)is a prevalent functional bowel disease severely impairs the quality of life of patients.Visceral hypersensitivity(VH)is the main symptom of IBS-D.Probiotics have been found to effectively alleviate VH.In this study,neonatal maternal separation(NMS)was used to induce VH in 72 rats and investigated the effects of daily gavage of 3×10^(9) CFU of Lactobacillus and Bifidobacterium on alleviating the symptoms of IBS-D and behavioral interventions,as well as exploring potential mechanisms.The results demonstrated that L.acidophilus and B.breve could alleviate the symptoms of IBS-D such as VH and increased frequency of bowel movements,as well as improving non-spatial memory in NMS rats.These effects were achieved by modulating the composition of gut microbiota and metabolites(including short-chain fatty acids,deoxycholic acid and adenosine),and by regulating the expression of genes and proteins associated with the NGF/TrkA signaling pathway,tryptophan metabolism,and inflammatory factors in the hippocampus.This finding suggests that L.acidophilus and B.breve have promising potential for the alleviation of IBS.
基金supported by the National Science Foundation of China(No.81873843)the National Science and Technology Pillar Program of China during the Twelfth Five-Year Plan Period(No.2014BA105B05)the Fundamental Research Funds for the Central Universities(No.2017 KFYXJJ102 and No.2019 KFYXKJC053).
文摘Objective Great obstetrical syndrome(GOS)represents a group of pregnancy-related diseases that result in inadequate placentation.Most GOS cases end in preterm,either spontaneously or indicatively,and the use of antenatal corticosteroids(ACS)is inevitably discussed.The placenta is an important,transient fetal-derived organ and is the embodiment of maternal or fetal well-being.However,few studies provide histological evidence of the placenta in GOS.This study aims to address these issues.Methods A total of 831 pregnant women were prospectively recruited.Placenta tissue was collected immediately and fixed with 4%paraformaldehyde solution for future H&E analysis.A novel checklist was devised to evaluate maternal vascular malperfusion sections on the basis of the commonly accepted Amsterdam placental workshop group consensus statement.Results A total of 131 patients were classified as having GOS.Comparisons between those with and without GOS revealed significant differences,including higher levels of distal villous hypoplasia,increased syncytial knots,accelerated villous maturation,and higher total scores in GOS.We found significant negative associations between GOS and neonatal weight,neonatal height,head circumference,placental surface area,placental volume,and placenta gross examination score.GOS neonates were 1.25 times more likely to have hyperbilirubinemia.Regarding the effect of ACS,a significant reduction in birthweight,height,and head circumference was observed,along with an increased risk of hyperbilirubinemia.Conclusion This study provides histological evidence of the GOS that supports the defective deep placentation hypothesis.Our research also contributes to benefit-risk consultation in the GOS,such as in cases of PE and FGR,where a balance between fetal lung maturation and short-term neonatal outcomes is crucial.
基金supported by the Zhejiang Province Traditional Chinese Medicine Science and Technology Project(GZY-ZJKJ-24076)the High-level Talents Special Support Program of Zhejiang Province(2024-KYY-GXJS-0026)+3 种基金the‘Pioneer’Research and Development Program of Zhejiang(2023C03004)the Transverse Research Project of Zhejiang University(2023-KYY-A070350007)the Theme-base Research Scheme,Research Grants Committee(T13-602/21-N)the Starlit South Lake Leading Elite Program(2023A303005).
文摘Neonatal hypoxic-ischemic encephalopathy(HIE),resulting from perinatal asphyxia-induced hypoxic-ischemic brain damage(HIBD),is a severe neurological disorder that impairs neurodevelopment,and no definitive therapies are available.The polyphenolic natural compound salvianolic acid C(SAC)exhibits antioxidant,anti-inflammatory,and antiapoptotic properties.In this study,we evaluated the efficacy of SAC in treating HIE via animal and human brain organoid experiments.Human brain organoids served as a translational platform for assessing natural product efficacy and clinical effect prediction.Rat brain tissues were harvested at two time points(24 h and 7 d after HIBD and SAC administration)for single-nucleus RNA sequencing.In vitro and in vivo experiments,including microarrays and gene silencing,were employed to confirm the sequencing findings.Our findings demonstrated that during the acute phase of HIBD,SAC suppressed signal transducer and activator of transcription 3+(Stat3+)astrocyte-driven acute neuroinflammation,decreased inflammatory factor release,and maintained glial-immune homeostasis.During the subacute phase,SAC promoted oligodendrocyte differentiation and facilitated crosstalk between anti-inflammatory microglia and myelinating oligodendrocytes,establishing a regenerative microenvironment and enhancing neuregulin 3(NRG3)-receptor tyrosine-protein kinase erbB-4(ErbB4)signaling axis activity.These coordinated mechanisms highlight the dual capacity of SAC in mitigating early injury and driving structural repair in the later stages.This study revealed the pathophysiology of HIE and the multitarget neuroprotective effects of SAC against this disorder at single-cell resolution,advancing the mechanistic foundations for SAC-based therapies in neonatal brain injury.
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.
