Trial application of the envelope method to the potential ambiguity problem

The optical potential ambiguity is a long-standing problem in the analysis of elastic scattering data.For a specific collid-ing system,ambiguous potential families can lead to different behaviors in the nearside and farside scattering components.By contrast,the envelope method can decompose the experimental data into two components with negative and positive deflection angles,respectively.Hence,a question arises as to whether the comparison between the calculated nearside(or farside)component and the derived positive-deflection-angle(or negative-deflection-angle)component can help analyze the potential ambiguity problem.In this study,we conducted a trial application of the envelope method to the potential ambiguity problem.The envelope method was improved by including uncertainties in the experimental data.The colliding systems of 16O+28Si at 215.2 MeV and 12C+12C at 1016 MeV were considered in the analyses.For each colliding system,the angular distribution experimental data were described nearly equally well by two potential sets,one of which is“surface transpar-ent”and the other is refractive.The calculated angular distributions were decomposed into nearside and farside scattering components.Using the improved envelope method,the experimental data were decomposed into the positive-deflection-angle and negative-deflection-angle components,which were then compared with the calculated nearside and farside components.The capability of the envelope method to analyze the potential ambiguities was also discussed.

Brain development in newborns and infants after ECMO

Background Extracorporeal membrane oxygenation(ECMO)not only significantly improves survival rates in severely ill neonates but also is associated with long-term neurodevelopmental issues.To systematically review the available literature on the neurodevelopmental outcomes of neonates and infants who have undergone ECMO treatment,with a focus on motor deficits,cognitive impairments,sensory impairments,and developmental delays.This review aims to understand the incidence,prevalence,and risk factors for these problems and to explore current nursing care and management strategies.Data sources A comprehensive literature search was performed across PubMed,EMBASE,and Web of Science using a wide array of keywords and phrases pertaining to ECMO,neonates,infants,and various facets of neurodevelopment.The initial screening involved reviewing titles and abstracts to exclude irrelevant articles,followed by a full-text assessment of potentially relevant literature.The quality of each study was evaluated based on its research methodology and statistical analysis.Moreover,citation searches were conducted to identify potentially overlooked studies.Although the focus was primarily on neonatal ECMO,studies involving children and adults were also included due to the limited availability of neonate-specific literature.Results About 50%of neonates post-ECMO treatment exhibit varying degrees of brain injury,particularly in the frontal and temporoparietal white matter regions,often accompanied by neurological complications.Seizures occur in 18%–23%of neonates within the first 24 hours,and bleeding events occur in 27%–60%of ECMO procedures,with up to 33%potentially experiencing ischemic strokes.Although some studies suggest that ECMO may negatively impact hearing and visual development,other studies have found no significant differences;hence,the influence of ECMO remains unclear.In terms of cognitive,language,and intellectual development,ECMO treatment may be associated with potential developmental delays,including lower composite scores in cognitive and motor functions,as well as potential language and learning difficulties.These studies emphasize the importance of early detection and intervention of potential developmental issues in ECMO survivors,possibly necessitating the implementation of a multidisciplinary follow-up plan that includes regular neuromotor and psychological evaluations.Overall,further multicenter,large-sample,long-term follow-up studies are needed to determine the impact of ECMO on these developmental aspects.Conclusions The impact of ECMO on an infant’s nervous system still requires further investigation with larger sample sizes for validation.Fine-tuned management,comprehensive nursing care,appropriate patient selection,proactive monitoring,nutritional support,and early rehabilitation may potentially contribute to improving the long-term outcomes for these infants.

Risk stratification of hemodynamically significant patent ductus arteriosus by clinical and genetic factors

Background Hemodynamically significant patent ductus arteriosus(hsPDA)is associated with increased comorbidities in neonates.Early evaluation of hsPDA risk is critical to implement individualized intervention.The aim of the study was to provide a powerful reference for the early identification of high-risk hsPDA population and early treatment decisions.Methods We enrolled infants who were diagnosed with PDA and performed exome sequencing.The collapsing analyses were used to find the risk gene set(RGS)of hsPDA for model construction.The credibility of RGS was proven by RNA sequencing.Multivariate logistic regression was performed to establish models combining clinical and genetic features.The models were evaluated by area under the receiver operating curve(AUC)and decision curve analysis(DCA).Results In this retrospective cohort study of 2199 PDA patients,549(25.0%)infants were diagnosed with hsPDA.The model[all clinical characteristics selected by least absolute shrinkage and selection operator regression(all CCs)]based on six clinical variables was acquired within three days of life,including gestational age(GA),respiratory distress syndrome(RDS),the lowest platelet count,invasive mechanical ventilation,and positive inotropic and vasoactive drugs.It has an AUC of 0.790[95%confidence interval(CI)=0.749–0.832],while the simplified model(basic clinical characteristic model)including GA and RDS has an AUC of 0.753(95%CI=0.706–0.799).There was a certain consistency between RGS and differentially expressed genes of the ductus arteriosus in mice.The AUC of the models was improved by RGS,and the improvement was significant(all CCs vs.all CCs+RGS:0.790 vs.0.817,P<0.001).DCA demonstrated that all models were clinically useful.Conclusions Models based on clinical factors were developed to accurately stratify the risk of hsPDA in the first three days of life.Genetic features might further improve the model performance.

Characteristics of home oxygen therapy for preterm infants with bronchopulmonary dysplasia in China:results of a multicenter cohort

Background Home oxygen therapy(HOT)is indicated upon discharge in some preterm infants with severe bronchopulmonary dysplasia(BPD).There is a lack of evidence-based consensus on the indication for HOT among these infants.Because wide variation in the institutional use of HOT exists,little is known about the role of regional social-economic level in the wide variation of HOT.Methods This was a secondary analysis of Chinese Neonatal Network(CHNN)data from January 1,2019 to December 31,2019.Infants at gestational ages<32 weeks,with a birth weight<1500 g,and with moderate or severe BPD who survived to discharge from tertiary hospitals located in 25 provinces were included in this study.Infants with major congenital anomalies and those who were discharged against medical advice were excluded.Results Of 1768 preterm infants with BPD,474 infants(26.8%)were discharged to home with oxygen.The proportion of HOT use in participating member hospitals varied from 0 to 89%,with five of 52 hospitals’observing proportions of HOT use that were significantly greater than expected,with 14 hospitals with observing proportions significantly less than expected,and with 33 hospitals with appropriate proportions.We noted a negative correlation between different performance groups of HOT and median GDP per capita(P=0.04).Conclusions The use of HOT varied across China and was negatively correlated with the levels of provincial economic levels.A local HOT guideline is needed to address the wide variation in HOT use with respect to different regional economic levels in countries like China.

Monkeypox and the perinatal period:what does maternal-fetal medicine need to know?

Background After the global elimination of smallpox,monkeypox has become the most threatening orthopoxvirus to human health.Very few studies have been reported on pregnant women and newborns.In the case of monkeypox infection,the virus can cause serious adverse pregnancy events in women,which can lead to fetal or neonatal death.Data sources We made a comprehensive review after an extensive literature search in the PubMed/Medline database and websites concerning smallpox and monkeypox.Results Two case reports reported a total of nine pregnant women,six of whom had fetal deaths.In the autopsy of a stillbirth,researchers found that the placenta was infected with monkeypox virus,but the mechanism of infection remains unclear.Smallpox vaccine should be administered to acutely exposed pregnant women and newborns.Several novel recombinant vac-cinia immunogloblin(rVIG)and human-specific monoclonal antibodies are being developed for the prevention and treatment of monkeypox virus infection.After the fetus was delivered,the newborn should take a bath as soon as possible to remove the amniotic fluid and dirt from the body.The appropriate isolation protocol for the newborn should be selected according to the infection status of the mother.It is not known whether monkeypox virus is present in breast milk,and pasteurized breast milk can be given to newborns when breastfeeding is considered.Conclusion This review presents an overview of monkeypox in the perinatal period and guides the future research direction.