Actigraphic recordings of activity-rest rhythms of neonates born by different delivery modes

Activity-rest behavior of 20 neonates born vaginally, 18 neonates born by medically planned Cesarean section (C-section), and 19 neonates born by medically required C-section after labor onset (all born in the thirty-seventh to forty-second week of gestation) was monitored for six successive days starting in the first week of life. Actigraphy was used to record and show time patterns of activity and rest in neonates by using small wristwatch-like Actiwatch® actometers. Nursing/feeding times were recorded by using the actometers' integrated event marker button. Recordings in both C-section groups were performed in the hospital; for neonates born vaginally and for some born by C-section, recordings were carried out in the hospital and in their homes. In addition to the actigraphic recordings, a standardized diary was kept regularly. To assess periodic characteristics, frequency components of activity-rest behavior were analyzed using fast Fourier transformation. Amount of sleep time during daytime, nighttime, and 24 h, as well as sleep bouts during the daytime and nighttime, were compared. The majority of vaginally born neonates showed a distinct circadian frequency in their spectra. In contrast, both groups of neonates born by C-section showed significantly less distinct circadian frequencies in their spectra. All three groups showed a significant difference in amount of nighttime sleep vs. daytime sleep, with more sleep at nighttime. There were no differences in the amount of nighttime sleep, daytime sleep, and sleep time during 24 h between the groups born by different delivery modes.     

Toxoplasma gondii: Effect of maternal infection in the development of lymphoid organs of BALB/c neonates

Toxoplasmosis is one of the worldwide parasitic zoonoses. Alterations in the lymphopoietic system are still poorly studied. We analyzed lymphoid organs of BALB/c mice neonates from Toxoplasma gondii-intraperitoneally-infected mothers on 19th day of gestation, with 30 tachyzoites of strain RH. Normal non-infected pregnant females were used as controls. At 7 days after birth, animals were classified as neonates from infected (NIM) and neonates from non-infected mothers (NNIM). Weight of the thymus and number of thymic cells in NIM were decreased, percentage of apoptosis was significantly increased. Decrease in lymphocytes and monocytes and an increase of plasma cells were observed in bone marrow of NIM. Peripheral blood of NIM showed an increase of monocytes and neutrophils and a decrease in lymphocytes. Infection of the mother during the last day of gestation provokes in the neonates changes in the lymphoid organs that could explain survival of 75% of them.     

机械通气新生儿撤机失败的危险因素分析及预防对策探讨

摘要 目的：分析机械通气新生儿撤机失败的危险因素,并探讨预防对策。方法：回顾性选取2018年4月~2021年3月在我院接受机械通气治疗的256例新生儿的临床资料。根据是否发生撤机失败将患儿分为撤机成功组与撤机失败组。撤机失败的影响因素采用单因素及多因素Logistic回归分析,并探讨预防对策。结果：256例接受机械通气的新生儿中,有29例发生撤机失败,撤机失败率为11.33%。单因素分析结果显示：撤机成功组与撤机失败组在胎龄、出生体重、Apgar评分、产伤情况、呼吸机相关性肺炎、多脏器功能损害、肺部感染、败血症、营养支持、撤机时血氧分压（PO₂）、撤机时心率、撤机时二氧化碳分压（PCO₂）方面对比差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示：撤机时PO₂偏低、撤机时心率较高、撤机时PCO₂较高、多脏器功能损害、无营养支持、伴有肺部感染、发生呼吸机相关性肺炎、胎龄＜37周是导致机械通气新生儿撤机失败的危险因素（P<0.05）。结论：导致机械通气新生儿撤机失败的危险因素较多,临床应针对危险因素进行干预,并在撤机前进行充分评估以减少撤机失败率。     

Fast Evaluation of Unhealthy and Healthy Neonates Using Hyperspectral Features on 700-850 Nm Wavelengths,ROI Extraction,and 3D-CNN

ObjectivesHyperspectral imaging (HSI) has great potential in detecting the health conditions of neonates as it provides diagnostic information about the tissue by avoiding tissue biopsy. HSI gives more features than thermal imaging, which can obtain images in a single wavelength, as it can obtain images in a large number of wavelengths. The data obtained with hyperspectral sensors are 3-dimensional data called hypercube including first two-dimensional spatial information and third-dimensional spectral information.Material and methodsIn this study, hyperspectral data were obtained from 19 different neonates in the Neonatal Intensive Care Unit (NICU) of Selcuk University, Medical Faculty. There are 16 hypercubes from 16 unhealthy neonates, 16 hypercubes from 3 healthy neonates in a period of three months, and 32 hypercubes in total are available. For the training of 3D-CNN model, data augmentation methods, such as rotation, height shifting, width shifting, and shearing were applied to hyperspectral data. A number of 32 hypercubes taken from neonates in NICU were augmented to 160 hypercubes. Spectral signatures were examined and 51 bands in the range of 700-850 nm with distinctive features were used for the classification. The spectral dimension was reduced by applying Principal Component Analysis (PCA) to all hypercubes. In addition, it is aimed to obtain both spectral and spatial features with the 3D-CNN. For increasing the classification efficiency, ROI extraction was made and four datasets were created in different spatial dimensions. These datasets contain 160, 640, 1440, and 5760 hypercubes, respectively.ResultsThe best result was achieved by using 5760 hypercubes of 25x25x51. As a result of the classification of the hypercubes, accuracy 98.00%, sensitivity 97.22%, and specificity 98.78% were obtained. It was determined how many PCs used to achieve the best result. Further, the proposed 3D-CNN model is compared to 2D-CNN model to evaluate the performance of the study.ConclusionIt was aimed to evaluate the health status of neonates fastly by using HSI and 3D-CNN for the first time. The obtained results are an indication that HSI and 3D-CNN are very effective for the evaluation of unhealthy and healthy neonates.     

Candida parapsilosis fungemia in neonates: genotyping results suggest healthcare workers hands as source, and review of published studies

An outbreak of Candida parapsilosis fungemia involving 17 neonatal intensive care unit (NICU) patients was studied. There were 14 blood culture and nine colonizing isolates from other sites available. The hands of NICU healthcare workers (HCW) yielded eight isolates. Screening of the isolates by random amplified polymorphic DNA (RAPD) method showed only three profiles. Typing by restriction fragment length polymorphism (RFLP) revealed all blood isolates were RFLP subtype VII-1. Among the nine infant colonizing isolates, there were four different RFLP subtypes; four of the isolates were subtype VII-1. Seven of the eight isolates from HCW were RFLP subtype VII-1. The majority of infant colonizers were not found in the blood, suggesting a possible direct spread of the epidemic subtype VII-1 strain from HCW hands to infant blood. The source of the infant colonizing strains is unclear, but non-VII-1 strains may be largely of maternal origin and VII-1 strains from HCW. These findings reinforce prior studies that have implicated HCW hands as the source of nosocomial, including neonatal, fungemia.     

高龄孕妇分娩新生儿出生体重及出院转归的影响因素分析

摘要 目的：探讨高龄孕妇分娩新生儿出生体重及出院转归的影响因素。方法：选择2021年01月到2022年01月与我院就诊的198例产妇作为研究对象,根据孕妇分娩时的年龄分为观察组和对照组,分娩时年龄满35周岁为高龄产妇组（98例）,分娩时年龄为20~34周岁为适龄组（100例）。比较适龄孕妇和高龄孕妇新生儿出生体重情况和新生儿住院时间,对高龄孕妇新生儿体重和新生儿出院转归影响因素进行Logistic单因素分析和多因素分析。结果：与适龄孕妇相比,高龄孕妇新生儿低出生体重儿、巨大儿发生率更高（P<0.05）,新生儿住院时间明显更长（P<0.05）。对高龄孕妇新生儿体重进行单因素分析结果显示,妊娠糖尿病、产检检查、分娩方式、是否使用催产素、分娩时麻醉方式和脐带情况与高龄孕妇新生儿体重无关（P>0.05）,孕妇年龄、孕前BMI、孕期体重增加情况、妊娠高血压、合并其他疾病状况、孕次、产次、羊水情况与高龄孕妇新生儿体重相关（P<0.05）。进行Logistic多因素回归分析结果显示,孕妇年龄、孕前BMI、孕期体重增加情况、孕次、产次、羊水情况是影响高龄孕妇新生儿出生体重的独立危险因素（P<0.05）。对新生儿出院转归情况进行单因素分析结果显示,胎次、开奶时间、喂养方式和有无接受治疗与新生儿出院转归无相关性（P>0.05）,胎龄、出生体重、Apgar评分、出生窒息史、有无伴发疾病与新生儿转归相关（P<0.05）。进行Logistic多因素分析结果显示,胎龄、出生体重、Apgar评分、出生窒息史、有无伴发病是影响新生儿出院转归的独立危险因素（P<0.05）。结论：孕妇年龄、孕前BMI、孕期体重增加情况、孕次、产次、羊水情况是影响高龄孕妇新生儿出生体重的独立危险因素。新生儿出院转归受到胎龄、出生体重、Apgar评分、出生窒息史、有无伴发病影响。     

Health status of young Alaska Steller sea lion pups (Eumetopias jubatus) as indicated by blood chemistry and hematology

Blood chemistry and hematology were examined in 238 Steller sea lion pups (Eumetopias jubatus) to assess the health status of pups <1 month of age. Failure of juvenile recruitment (possibly due to nutritionally or physiologically compromised pups) into breeding populations has been proposed as a cause of recent declines of this endangered species in Alaska. To identify potential correlations with areas of high population decline, blood chemistry data were considered for three areas: eastern Aleutian Islands (low rates of population decline to stable populations), Gulf of Alaska (high rates of decline), and Southeast Alaska (stable to increasing population). Southeast Alaska pups showed elevated ketone body concentrations (beta-hydroxybutyrate,(beta-HBA)) and depressed glucose levels than pups in the Gulf of Alaska. Over 40% of the pups from Southeast Alaska had elevated beta-HBA concentrations suggesting they underwent longer periods of fasting than seen in pups from other areas. Hematocrit (Hct), hemoglobin concentration (Hb) and water content of the blood exhibited typical mammalian relationships. In summary, blood chemistry and hematology data showed no indication that Steller sea lion pups <1 month old from areas of population decline were nutritionally compromised.     

Effect of Candida albicans dsDNA in Gastrointestinal Candida Infection

Neonates are highly sensitive to infections because they are biased to develop Th2 immune responses. When exposed to certain agents, such as DNA vaccines or CpG DNA motifs, neonates are capable to mount adult-like Th1 protective responses. This study investigates the capacity of Candida albicans (C. albicans) dsDNA to induce host resistance in newborn mice against gastrointestinal C. albicans infection. The protective properties of dsDNA are related to an increased number of spleen CD4+ T cells secreting IFN-γ. In infected DNA-treated mice, an enhanced production of IFN-γ by Peyer’s patch cells was observed together with reduced colonization and histopathological changes in the stomach. Our results indicated that C. albicans dsDNA administration in neonates elicited the protective immune response against gastrointestinal Candida infection.     

不同益生菌对抗生素相关性腹泻肺炎 新生儿肠道菌群及促炎因子的影响

目的研究不同益生菌对发生抗生素相关性腹泻的肺炎新生儿肠道菌群及促炎因子的影响。方法选取2014年3月至2017年3月在我院新生儿科治疗的新生儿肺炎合并抗生素相关性腹泻患儿90例,随机分为对照组和观察组各45例。对照组患儿口服布拉酵母进行治疗,观察组患儿选用酪酸梭菌二联活菌散进行治疗。观察两组患儿临床疗效、住院时间、停止腹泻时间、粪便益生菌含量、IL2、IL6、TNF-α水平及不良反应情况。结果治疗后,观察组患儿总有效率(84.44%)明显高于对照组(68.89%)。观察组患儿住院时间、停止腹泻时间、IL2、IL6、TNF-α水平均明显低于对照组(均P0.05),粪便益生菌含量明显高于对照组(均P0.05)。两组患儿均未发现明显不良反应。结论多联益生菌制剂对抗生素相关腹泻患儿肠道菌群的重建具有积极的作用,能降低患儿炎性反应,缩短住院时间和腹泻时间,安全性较高,值得推广。