Risk factors and machine learning prediction models for bronchopulmonary dysplasia severity in the Chinese population

Background Bronchopulmonary dysplasia(BPD)is a common chronic lung disease in extremely preterm neonates.The outcome and clinical burden vary dramatically according to severity.Although some prediction tools for BPD exist,they seldom pay attention to disease severity and are based on populations in developed countries.This study aimed to develop machine learning prediction models for BPD severity based on selected clinical factors in a Chinese population.Methods In this retrospective,single-center study,we included patients with a gestational age<32 weeks who were diagnosed with BPD in our neonatal intensive care unit from 2016 to 2020.We collected their clinical information during the maternal,birth and early postnatal periods.Risk factors were selected through univariable and ordinal logistic regression analyses.Prediction models based on logistic regression(LR),gradient boosting decision tree,XGBoost(XGB)and random forest(RF)models were implemented and assessed by the area under the receiver operating characteristic curve(AUC).Results We ultimately included 471 patients(279 mild,147 moderate,and 45 severe cases).On ordinal logistic regression,gestational diabetes mellitus,initial fraction of inspiration O_(2) value,invasive ventilation,acidosis,hypochloremia,C-reactive protein level,patent ductus arteriosus and Gram-negative respiratory culture were independent risk factors for BPD severity.All the XGB,LR and RF models(AUC=0.85,0.86 and 0.84,respectively)all had good performance.Conclusions We found risk factors for BPD severity in our population and developed machine learning models based on them.The models have good performance and can be used to aid in predicting BPD severity in the Chinese population.

Newborn emergency transport based on the fifth-generation wireless networks and blockchain

Neonatal care is of great significance to health capabil-ity.Since neonatal intensive care units(NICUs)started to be established in the late 1980s in China,neonatal mortal-ity has decreased each year to reach 3.4‰in 2020[1,2].However,the improvement for neonatal care is still on the way.More than three-fifths of deaths included critically ill neonates occur in their first 28 days[3].Critically ill neo-nates usually have lower gestational age and body weight,leading to high mortality or requiring specific treatment and monitoring[4].It is a common practice to transfer a critically ill newborn patient to a tertiary children's hospi-tal with an excellent NICU.Therefore,it is crucial to pro-mote patients'safety by improving the neonatal transport network services[5].Owing to the complexity and rapid changes in neonatal conditions,especially for those requir-ing multi-disciplinary treatment,there is a high reliance on a specialized newborn transport team[6,7].

Cryptorchid testicular torsion in children characteristics and treatment outcomes

This study aimed to review and compare the characteristics and treatment outcomes of cryptorchid testicular torsion in pre-and postpubertal children.We reviewed the clinical data of 22 patients with testicular torsion complicated by cryptorchidism who were treated between January 2010 and December 2019.Patients were categorized into prepubertal(1 month to 9 years;n=12)and postpubertal groups(10-16 years;n=10).The age at presentation,clinical presentations,physical examination,and operation outcomes were assessed.The common clinical presentations in both groups were inguinal pain and a tender inguinal mass.Patients in the prepubertal group were significantly more likely to present with restlessness(33.3%)than those in the postpubertal group(0%;P-0.044).After detorsion,testicular blood flow recovered during surgery in 25.0%of the prepubertal and 80.0%of the postpubertal patients(P=0.010).Orchiectomy was required in 50.0%of the prepubertal and 20.0%of the postpubertal patients(P=0.145).Of the 22 patients with follow-up data,the rates of testicular salvage were significantly different,at 16.7%in the prepubertal patients and 60.0%in the postpubertal patients(P=0.035).Cryptorchid testicular torsion has various manifestations.Although an empty hemiscrotum and a painful groin mass were common in both groups,restlessness was more prevalent in the prepubertal patients during early testicular torsion onset than that in the postpubertal patients.Notably,the testicular salvage rate was significantly lower in the prepubertal patients than that in the postpubertal patients.