Breast milk offers essential nutrients crucial for the development of the preterm immune system, thus reducing the incidence of infection and mortality often associated with prematurity. In the absence of breast milk,...Breast milk offers essential nutrients crucial for the development of the preterm immune system, thus reducing the incidence of infection and mortality often associated with prematurity. In the absence of breast milk, the preferred option is donated breast milk, the best alternative for hospitalized neonates whose mothers have insufficient breast milk or are unavailable. In Zambia, donor breast milk is unavailable. Instead, the protocol recommends the administration of formula milk. However, the use of formula milk in preterm babies is associated with an increased risk of necrotizing enterocolitis and sepsis. Zambia needs to establish a donor milk bank, hence the need to understand the perception of mothers towards donated breast milk. A qualitative descriptive case study utilized 10 focus group discussions with in-depth interviews, purposively selected using a variation strategy. Data was thematically analysed. Participants demonstrated potential acceptance to donor breast milk utilization, as more nutritional compared to formula despite lack of awareness. Concerns related to safety, quality, fear of disease transmission and discomfort feeding from a different bloodline were identified as hinderance to possible utilisation. These perceptions underscore the importance of educational initiatives aimed at dispelling myths and misconceptions surrounding donor breast milk and establishing donor breast milk programs. Therefore, the study recommends educational initiatives tailored to raise awareness to mothers about donor breast milk.展开更多
Background: Kangaroo Mother Care is a simple safe method used to care for low-birth-weight babies. Low-birth-weight is a global public health issue that pose significant challenge to perinatal care systems. Globally, ...Background: Kangaroo Mother Care is a simple safe method used to care for low-birth-weight babies. Low-birth-weight is a global public health issue that pose significant challenge to perinatal care systems. Globally, complications due to low-birth-weight are the leading cause of neonatal mortality, resulting in an estimated 1 million deaths annually. Kangaroo Mother Care (KMC) is a low-cost method of care for low-birth-weight infants in areas with inadequate incubators and power outages with positive outcomes. Objectives: To assess factors influencing acceptability of Kangaroo Mother Care (KMC) in NICU at Arthur Davison Children’s Hospital in Ndola, Zambia. Methodology: A cross sectional quantitative analytical study design was used. The study was conducted at Arthur Davison Children’s Hospital (ADCH) in Ndola, Zambia. The purposive sampling method was used to select the study participants and a total of 129 mothers with Low Weight Babies A were selected to participate structured closed ended questionnaire was used to collect data from the participants using an interview. Data was analyzed using a Statistical Package for Social Scientists (SPSS) software version 26. Cross tabulations were done to determine association of variables using a Chi square (x<sup>2</sup>) test at 95% confidence interval and were assumptions where not met, fishers exact test was used. Multivariate binary logistic regression analysis was used to quantify the relationship between the dependent and independent variables. Results: Most of the respondents had male babies 77%, 69% of the babies weighed 1000 g - 1400 g, majority 79% had normal delivery, 71% of the respondents were multigravida and most of the respondents 79% were married. The study reviewed that 85% of those who attained secondary education accepted KMC, 74% of the respondents without monthly income accepted KMC, 80% of the respondents had positive attitude and accepted KMC. 82% of the respondents who had positive perception accepted KMC. Conclusion: Acceptance of Kangaroo Mother Care (KMC) among 75% of the mothers underscores its widespread favourability as a beneficial method for infant care.展开更多
Background:Studies on animals have demonstrated that maternal iron deficiency anaemia(IDA)could result in decreased cochlear sensory hair cells and reduced amplitudes of distortion-product otoacoustic emissions(DPOAEs...Background:Studies on animals have demonstrated that maternal iron deficiency anaemia(IDA)could result in decreased cochlear sensory hair cells and reduced amplitudes of distortion-product otoacoustic emissions(DPOAEs)of young guinea pigs.Thus,it is essential to study the functioning of cochlear hair cells using DPOAEs in human newborn babies with maternal IDA.The current study explores maternal IDA’s effect on DPOAEs in newborn babies.Method:A total of 110 newborn babies with gestational age≥34 weeks were considered and a‘betweensubjects’design was used.The participants were divided into 3 groups-“Normal”(61 babies without maternal IDA),“Mild”(28 babies with mild maternal IDA)and“Moderate”(21 babies with moderate maternal IDA).The cord blood was collected and the DPOAEs were recorded for each baby for a range of frequencies(1 k 8 kHz)and a range of intensities(7040 dB SPL in 10 dB steps).Results:The analysis of both DP-gram and DP input-output(I/O)function showed that there was no significant difference(p>0.05)across the normal,mild,and moderate groups in the overall presence of DPOAEs as well as the amplitude across frequencies or intensities(7040 dB SPL).Also,the overall correlation of RBC indices with DPOAE amplitude across frequencies as well as the slope of the I/O function showed no relationship.Conclusion:The current study concludes that there is no effect of late-term maternal IDA on the DPOAEs of newborn babies.展开更多
Many premature babies, especially those with a low birth weight are given multiple transfusions during their first few weeks of life. The major serious complications of prematurity include bronchopulmonary dysplasia, ...Many premature babies, especially those with a low birth weight are given multiple transfusions during their first few weeks of life. The major serious complications of prematurity include bronchopulmonary dysplasia, with lesser incidences of retinopathy of prematurity, intraventricular haemorrhage, and necrotising enterocolitis. Many studies have shown correlations between the receipt of blood transfusions and the development of these conditions, but little is known of the underlying pathophysiology of this relationship. Recent studies are beginning to provide some answers. This review examines recent findings with regard to the influence of preparation and storage of paediatric packed red blood cell units on heme, iron, and oxidative status of the units and relates these to the ability of the premature baby to deal with these changes following the receipt of blood transfusions. Paediatric packed red blood cell units are a potential source of heme, redox active iron and free radicals, and this increases with storage age. Haemolysis of transfused red blood cells may add further iron and cell free haemoglobin to the recipient baby. Premature babies, particularly those with low birth weight and gestational age appear to have littlereserve to cope with any additional iron, heme and/or oxidative load. The consequences of these events are discussed with regard to their contribution to the major complications of prematurity and a novel hypothesis regarding transfusion-related morbidity in premature babies is presented. The review concludes with a discussion of potential means of limiting transfusion related iron/heme and oxidative load through the preparation and storage of packed red blood cell units and through modifications in clinical practice.展开更多
Background: About 15% of world’s population lives with some disability. Zimbabwe’s prevalence of disability was at 7% in 2013. ARSS is a paper-based system to monitor and detect neuro-developmental conditions and ch...Background: About 15% of world’s population lives with some disability. Zimbabwe’s prevalence of disability was at 7% in 2013. ARSS is a paper-based system to monitor and detect neuro-developmental conditions and childhood disability early. Indicators for registering a baby into ARSS include: low Apgar score, low birth weight and birth asphyxia. Active case finding in Rushinga District in July 2015 identified nine cerebral palsy cases that were missed by the system out of 14 randomly chosen babies delivered at Chimhanda District Hospital. We evaluated the performance of the ARSS in Rushinga District. Methods: We evaluated the system using CDC guidelines for surveillance systems evaluation. All 12 health facilities in Rushinga were included. Health workers involved in ARSS were purposively recruited. Interviewer administered questionnaire, key informant interview guide, checklists and records review were used for data collection. Knowledge of participants on the system was assessed using five-point Likert scale. Data were analyzed using Epi Info 7. Results: Fifty-one participants were recruited for the study. Median years in service for all participants was 7 (Q1 = 6;Q3 = 12). Average knowledge score was 3. Majority participants (82.4%) were not trained on ARSS and cited lack of: knowledge, reporting guidelines, induction and focal persons as reasons for missing AR cases. Currently, ARSS is able to detect only 12.5% of cases. Prevalence of AR babies in Rushinga for period November 2014 to November 2015 was 21.1%. Monthly cost of detecting and registering a case was USD$52.46. Conclusions: ARSS was found to be useful, simple, acceptable and affordable, however was found to be unstable and not sensitive. Training of health workers particularly village health workers and integrating ARSS with the DHIS2 could improve system performance. As a result of the evidence from this evaluation, it has been agreed to include ARSS data on the monthly return form (T5) beginning June 2016.展开更多
Prevention and control measures of spontaneous combustion of coal and gas accumulation in a goaf require an accurate description of its gas flow state.However,the commonly used fluid dynamics in porous media is not su...Prevention and control measures of spontaneous combustion of coal and gas accumulation in a goaf require an accurate description of its gas flow state.However,the commonly used fluid dynamics in porous media is not suitable for the new-born goaf with fracture cavity combination,multi-scale,and large blocks.In this study,we propose a cavity flow algorithm to accurately describe the gas flow state in the new-born goaf.The genetic algorithm(GA)is used to randomly generate the binary matrix of a goaf caving shape.The difference between the gas flow state calculated by the lattice Boltzmann method(LBM)and the measured data at the boundary or internal measuring points of the real goaf is taken as the GA fitness value,and the real goaf caving shape and the gas flow state are quickly addressed by GA.The experimental model of new-born goaf is established,and the laser Doppler anemometry(LDA)experiment is carried out.The results show that the Jaccard similarity coefficient between the reconstructed caving shape and the real caving shape is 0.7473,the mean square error between the calculated wind speed and the LDA-measured value is 0.0244,and the R2 coefficient is 0.8986,which verify the feasibility of the algorithm.展开更多
Background: Preterm birth is a primary cause of neonatal morbidity and mortality especially in low-income countries. Although understanding the preventable factors of neonatal deaths in preterm infants is required for...Background: Preterm birth is a primary cause of neonatal morbidity and mortality especially in low-income countries. Although understanding the preventable factors of neonatal deaths in preterm infants is required for timely interventions, data on those factors is lacking in Kenya. We attempted to determine mortality and its associated factors in preterm babies in Kenya. Methods and Materials: A hospital-based, prospective study was implemented from July 2019 to October 2019 involving 163 preterm neonates and their mothers admitted at Kenyatta National Hospital. A systematic random sampling method was used to recruit the study participants. Data on mortality and the associated factors in preterm neonates were collected using a pretested questionnaire for mothers and neonatal medical records. Data was analyzed using descriptive and inferential statistics. Results: The mortality rate was 18.4%. Of the neonates who died, respiratory distress syndrome (63.3%) and neonatal sepsis (20.0%) were documented as the primary causes. Neonates born of single mother (AOR = 8.006, 95% CI 2.267 to 28.272, p = 0.001), unemployed (6.960, 1.059 - 45.757, p = 0.043), self-employed (4.040, 1.067 - 15.302, p = 0.040), anemic (7.465, 2.530 - 22.023, p < 0.001) and with history of bleeding during pregnancy were more likely to have died. The neonates born before 28 weeks of gestation (126.188, 14.554 - 1094.060, p < 0.001), those who did not cry immediately at birth (54.271, 5.970 - 493.395, p < 0.001) and the resuscitated at birth (54.406, 6.807 - 434.851, p < 0.001) were likely to die. Conclusion: High mortality rates of preterm neonates are attributed to both maternal and neonatal factors. Focused antenatal care should aim at early identification of high-risk mothers for early management of bleeding during pregnancy, close monitoring of nutritional status for mothers and health education.展开更多
Background: Some researchers have suggested that when Naegle’s rule (NR) and Dubowitz score (DS) are combined, it could out-perform obstetric ultrasound scan (USS). Others still believe that obstetric USS alone is st...Background: Some researchers have suggested that when Naegle’s rule (NR) and Dubowitz score (DS) are combined, it could out-perform obstetric ultrasound scan (USS). Others still believe that obstetric USS alone is still effective relative to the combination of NR rule and DS in assessing the gestational age (GA) of babies. Objectives: To determine and compare the GA of babies using obstetric USS, NR and DS;and to provide relevant public health information on obstetric USS in the 21st century. Methods: Subjects were selected using systematic random sampling and the GA of babies was determined using obstetric USS, NR, and DS. Statistical package for social science (SPSS) statistical software version 16, Illinois, Chicago USA was used for all data analysis. Results: Eightyfive mother-baby pairs were studied. Forty-four babies (52%) were males and 41 (48%) females. Sixty four (75%) were term with a mean (SD) BW of 3.02 (0.59) at 95%CI (2.89 -?3.14) kg. The overall mean GA of the babies was 38.49 (2.89) at 95%CI (38.14 -?38.85) weeks. The mean GA using obstetric USS, NR and DS were 38.52 (1.98) at 95%CI (38.14 -?38.99), 38.09 (4.13) at 95%CI (37.20-?38.99) and 38.82 (2.02) at 95%CI (38.39 -?39.26), but comparison of these means was not significant (p = 0.256). Combined mean GA by NR and DS was 38.46 (3.26) at 95%CI (37.96 -?38.95). Comparing this mean with mean GA obtained by obstetric USS was also not significant (p = 0.885). Conclusion: The GA assessments by Obstetric USS, NR and DS were all reliable, and Obstetric USS performed effectively relative to combined NR and DS.展开更多
Diagnosing a baby’s feelings poses a challenge for both doctors and parents because babies cannot explain their feelings through expression or speech.Understanding the emotions of babies and their associated expressi...Diagnosing a baby’s feelings poses a challenge for both doctors and parents because babies cannot explain their feelings through expression or speech.Understanding the emotions of babies and their associated expressions during different sensations such as hunger,pain,etc.,is a complicated task.In infancy,all communication and feelings are propagated through cryspeech,which is a natural phenomenon.Several clinical methods can be used to diagnose a baby’s diseases,but nonclinical methods of diagnosing a baby’s feelings are lacking.As such,in this study,we aimed to identify babies’feelings and emotions through their cry using a nonclinical method.Changes in the cry sound can be identified using our method and used to assess the baby’s feelings.We considered the frequency of the cries from the energy of the sound.The feelings represented by the infant’s cry are judged to represent certain sensations expressed by the child using the optimal frequency of the recognition of a real-world audio sound.We used machine learning and artificial intelligence to distinguish cry tones in real time through feature analysis.The experimental group consisted of 50%each male and female babies,and we determined the relevancy of the results against different parameters.This application produced real-time results after recognizing a child’s cry sounds.The novelty of our work is that we,for the first time,successfully derived the feelings of young children through the cry-speech of the child,showing promise for end-user applications.展开更多
Under the guidance of Systemic-Functional Grammar(SFG),cohesion is applied to analyze the selected context.Cohesion plays a great role in organizing a whole context and it can be further divided into grammatical cohes...Under the guidance of Systemic-Functional Grammar(SFG),cohesion is applied to analyze the selected context.Cohesion plays a great role in organizing a whole context and it can be further divided into grammatical cohesion and lexical cohesion.Main ideas of cohesion are illustrated and made it for application,which employs British children's literature-The Water Babies as the object.The research method adopted here is mainly quantitative.Through analyzing selected sections,it is obvious that cohesion helps readers understand the contexts better.Besides,the use of cohesion makes the context more precise and compact.For context,the role of cohesion is irreplaceable.展开更多
目的分析不同胎龄早产儿凝血功能及颅内出血影响因素。方法选择500例早产儿纳入早产儿组,根据胎龄分为早期早产儿组和晚期早产儿组;根据是否颅内出血分为出血组和未出血组。同期选择足月健康新生儿250例为对照组。比较各组血浆凝血酶原...目的分析不同胎龄早产儿凝血功能及颅内出血影响因素。方法选择500例早产儿纳入早产儿组,根据胎龄分为早期早产儿组和晚期早产儿组;根据是否颅内出血分为出血组和未出血组。同期选择足月健康新生儿250例为对照组。比较各组血浆凝血酶原时间(PT)、血浆纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、D-二聚体(DD)、颅内出血发生率。采用多因素Logistic回归分析早产儿出现颅内出血的影响因素。结果早期早产儿组、晚期早产儿组PT、APTT、DD、颅内出血发生率高于对照组,FIB低于对照组,且早期早产儿组较晚期早产儿组更为显著(P<0.05)。出血组早产儿5 min Apgar评分、胎龄、出生体质量、FIB低于未出血组,胎内窘迫、PS治疗、机械通气占比、PT、APTT高于未出血组(P<0.05)。胎内窘迫、PS治疗、机械通气占比、PT、APTT、5 min Apgar评分、胎龄、出生体质量、FIB均为颅内出血影响因素(P<0.05)。结论早产儿多出现凝血功能紊乱,其颅内出血的影响因素较多,早期干预有助于降低早产儿颅内出血发生率。展开更多
文摘Breast milk offers essential nutrients crucial for the development of the preterm immune system, thus reducing the incidence of infection and mortality often associated with prematurity. In the absence of breast milk, the preferred option is donated breast milk, the best alternative for hospitalized neonates whose mothers have insufficient breast milk or are unavailable. In Zambia, donor breast milk is unavailable. Instead, the protocol recommends the administration of formula milk. However, the use of formula milk in preterm babies is associated with an increased risk of necrotizing enterocolitis and sepsis. Zambia needs to establish a donor milk bank, hence the need to understand the perception of mothers towards donated breast milk. A qualitative descriptive case study utilized 10 focus group discussions with in-depth interviews, purposively selected using a variation strategy. Data was thematically analysed. Participants demonstrated potential acceptance to donor breast milk utilization, as more nutritional compared to formula despite lack of awareness. Concerns related to safety, quality, fear of disease transmission and discomfort feeding from a different bloodline were identified as hinderance to possible utilisation. These perceptions underscore the importance of educational initiatives aimed at dispelling myths and misconceptions surrounding donor breast milk and establishing donor breast milk programs. Therefore, the study recommends educational initiatives tailored to raise awareness to mothers about donor breast milk.
文摘Background: Kangaroo Mother Care is a simple safe method used to care for low-birth-weight babies. Low-birth-weight is a global public health issue that pose significant challenge to perinatal care systems. Globally, complications due to low-birth-weight are the leading cause of neonatal mortality, resulting in an estimated 1 million deaths annually. Kangaroo Mother Care (KMC) is a low-cost method of care for low-birth-weight infants in areas with inadequate incubators and power outages with positive outcomes. Objectives: To assess factors influencing acceptability of Kangaroo Mother Care (KMC) in NICU at Arthur Davison Children’s Hospital in Ndola, Zambia. Methodology: A cross sectional quantitative analytical study design was used. The study was conducted at Arthur Davison Children’s Hospital (ADCH) in Ndola, Zambia. The purposive sampling method was used to select the study participants and a total of 129 mothers with Low Weight Babies A were selected to participate structured closed ended questionnaire was used to collect data from the participants using an interview. Data was analyzed using a Statistical Package for Social Scientists (SPSS) software version 26. Cross tabulations were done to determine association of variables using a Chi square (x<sup>2</sup>) test at 95% confidence interval and were assumptions where not met, fishers exact test was used. Multivariate binary logistic regression analysis was used to quantify the relationship between the dependent and independent variables. Results: Most of the respondents had male babies 77%, 69% of the babies weighed 1000 g - 1400 g, majority 79% had normal delivery, 71% of the respondents were multigravida and most of the respondents 79% were married. The study reviewed that 85% of those who attained secondary education accepted KMC, 74% of the respondents without monthly income accepted KMC, 80% of the respondents had positive attitude and accepted KMC. 82% of the respondents who had positive perception accepted KMC. Conclusion: Acceptance of Kangaroo Mother Care (KMC) among 75% of the mothers underscores its widespread favourability as a beneficial method for infant care.
文摘Background:Studies on animals have demonstrated that maternal iron deficiency anaemia(IDA)could result in decreased cochlear sensory hair cells and reduced amplitudes of distortion-product otoacoustic emissions(DPOAEs)of young guinea pigs.Thus,it is essential to study the functioning of cochlear hair cells using DPOAEs in human newborn babies with maternal IDA.The current study explores maternal IDA’s effect on DPOAEs in newborn babies.Method:A total of 110 newborn babies with gestational age≥34 weeks were considered and a‘betweensubjects’design was used.The participants were divided into 3 groups-“Normal”(61 babies without maternal IDA),“Mild”(28 babies with mild maternal IDA)and“Moderate”(21 babies with moderate maternal IDA).The cord blood was collected and the DPOAEs were recorded for each baby for a range of frequencies(1 k 8 kHz)and a range of intensities(7040 dB SPL in 10 dB steps).Results:The analysis of both DP-gram and DP input-output(I/O)function showed that there was no significant difference(p>0.05)across the normal,mild,and moderate groups in the overall presence of DPOAEs as well as the amplitude across frequencies or intensities(7040 dB SPL).Also,the overall correlation of RBC indices with DPOAE amplitude across frequencies as well as the slope of the I/O function showed no relationship.Conclusion:The current study concludes that there is no effect of late-term maternal IDA on the DPOAEs of newborn babies.
基金Supported by The Northcott Devon Medical FoundationThe NHS SW Researchand Development Fund
文摘Many premature babies, especially those with a low birth weight are given multiple transfusions during their first few weeks of life. The major serious complications of prematurity include bronchopulmonary dysplasia, with lesser incidences of retinopathy of prematurity, intraventricular haemorrhage, and necrotising enterocolitis. Many studies have shown correlations between the receipt of blood transfusions and the development of these conditions, but little is known of the underlying pathophysiology of this relationship. Recent studies are beginning to provide some answers. This review examines recent findings with regard to the influence of preparation and storage of paediatric packed red blood cell units on heme, iron, and oxidative status of the units and relates these to the ability of the premature baby to deal with these changes following the receipt of blood transfusions. Paediatric packed red blood cell units are a potential source of heme, redox active iron and free radicals, and this increases with storage age. Haemolysis of transfused red blood cells may add further iron and cell free haemoglobin to the recipient baby. Premature babies, particularly those with low birth weight and gestational age appear to have littlereserve to cope with any additional iron, heme and/or oxidative load. The consequences of these events are discussed with regard to their contribution to the major complications of prematurity and a novel hypothesis regarding transfusion-related morbidity in premature babies is presented. The review concludes with a discussion of potential means of limiting transfusion related iron/heme and oxidative load through the preparation and storage of packed red blood cell units and through modifications in clinical practice.
文摘Background: About 15% of world’s population lives with some disability. Zimbabwe’s prevalence of disability was at 7% in 2013. ARSS is a paper-based system to monitor and detect neuro-developmental conditions and childhood disability early. Indicators for registering a baby into ARSS include: low Apgar score, low birth weight and birth asphyxia. Active case finding in Rushinga District in July 2015 identified nine cerebral palsy cases that were missed by the system out of 14 randomly chosen babies delivered at Chimhanda District Hospital. We evaluated the performance of the ARSS in Rushinga District. Methods: We evaluated the system using CDC guidelines for surveillance systems evaluation. All 12 health facilities in Rushinga were included. Health workers involved in ARSS were purposively recruited. Interviewer administered questionnaire, key informant interview guide, checklists and records review were used for data collection. Knowledge of participants on the system was assessed using five-point Likert scale. Data were analyzed using Epi Info 7. Results: Fifty-one participants were recruited for the study. Median years in service for all participants was 7 (Q1 = 6;Q3 = 12). Average knowledge score was 3. Majority participants (82.4%) were not trained on ARSS and cited lack of: knowledge, reporting guidelines, induction and focal persons as reasons for missing AR cases. Currently, ARSS is able to detect only 12.5% of cases. Prevalence of AR babies in Rushinga for period November 2014 to November 2015 was 21.1%. Monthly cost of detecting and registering a case was USD$52.46. Conclusions: ARSS was found to be useful, simple, acceptable and affordable, however was found to be unstable and not sensitive. Training of health workers particularly village health workers and integrating ARSS with the DHIS2 could improve system performance. As a result of the evidence from this evaluation, it has been agreed to include ARSS data on the monthly return form (T5) beginning June 2016.
基金This work was supported by the Natural Science Foundation of China(Nos.51774169 and 51574142)the National Key Research and Development Program of China(No.2017YFC0804401).
文摘Prevention and control measures of spontaneous combustion of coal and gas accumulation in a goaf require an accurate description of its gas flow state.However,the commonly used fluid dynamics in porous media is not suitable for the new-born goaf with fracture cavity combination,multi-scale,and large blocks.In this study,we propose a cavity flow algorithm to accurately describe the gas flow state in the new-born goaf.The genetic algorithm(GA)is used to randomly generate the binary matrix of a goaf caving shape.The difference between the gas flow state calculated by the lattice Boltzmann method(LBM)and the measured data at the boundary or internal measuring points of the real goaf is taken as the GA fitness value,and the real goaf caving shape and the gas flow state are quickly addressed by GA.The experimental model of new-born goaf is established,and the laser Doppler anemometry(LDA)experiment is carried out.The results show that the Jaccard similarity coefficient between the reconstructed caving shape and the real caving shape is 0.7473,the mean square error between the calculated wind speed and the LDA-measured value is 0.0244,and the R2 coefficient is 0.8986,which verify the feasibility of the algorithm.
文摘Background: Preterm birth is a primary cause of neonatal morbidity and mortality especially in low-income countries. Although understanding the preventable factors of neonatal deaths in preterm infants is required for timely interventions, data on those factors is lacking in Kenya. We attempted to determine mortality and its associated factors in preterm babies in Kenya. Methods and Materials: A hospital-based, prospective study was implemented from July 2019 to October 2019 involving 163 preterm neonates and their mothers admitted at Kenyatta National Hospital. A systematic random sampling method was used to recruit the study participants. Data on mortality and the associated factors in preterm neonates were collected using a pretested questionnaire for mothers and neonatal medical records. Data was analyzed using descriptive and inferential statistics. Results: The mortality rate was 18.4%. Of the neonates who died, respiratory distress syndrome (63.3%) and neonatal sepsis (20.0%) were documented as the primary causes. Neonates born of single mother (AOR = 8.006, 95% CI 2.267 to 28.272, p = 0.001), unemployed (6.960, 1.059 - 45.757, p = 0.043), self-employed (4.040, 1.067 - 15.302, p = 0.040), anemic (7.465, 2.530 - 22.023, p < 0.001) and with history of bleeding during pregnancy were more likely to have died. The neonates born before 28 weeks of gestation (126.188, 14.554 - 1094.060, p < 0.001), those who did not cry immediately at birth (54.271, 5.970 - 493.395, p < 0.001) and the resuscitated at birth (54.406, 6.807 - 434.851, p < 0.001) were likely to die. Conclusion: High mortality rates of preterm neonates are attributed to both maternal and neonatal factors. Focused antenatal care should aim at early identification of high-risk mothers for early management of bleeding during pregnancy, close monitoring of nutritional status for mothers and health education.
文摘Background: Some researchers have suggested that when Naegle’s rule (NR) and Dubowitz score (DS) are combined, it could out-perform obstetric ultrasound scan (USS). Others still believe that obstetric USS alone is still effective relative to the combination of NR rule and DS in assessing the gestational age (GA) of babies. Objectives: To determine and compare the GA of babies using obstetric USS, NR and DS;and to provide relevant public health information on obstetric USS in the 21st century. Methods: Subjects were selected using systematic random sampling and the GA of babies was determined using obstetric USS, NR, and DS. Statistical package for social science (SPSS) statistical software version 16, Illinois, Chicago USA was used for all data analysis. Results: Eightyfive mother-baby pairs were studied. Forty-four babies (52%) were males and 41 (48%) females. Sixty four (75%) were term with a mean (SD) BW of 3.02 (0.59) at 95%CI (2.89 -?3.14) kg. The overall mean GA of the babies was 38.49 (2.89) at 95%CI (38.14 -?38.85) weeks. The mean GA using obstetric USS, NR and DS were 38.52 (1.98) at 95%CI (38.14 -?38.99), 38.09 (4.13) at 95%CI (37.20-?38.99) and 38.82 (2.02) at 95%CI (38.39 -?39.26), but comparison of these means was not significant (p = 0.256). Combined mean GA by NR and DS was 38.46 (3.26) at 95%CI (37.96 -?38.95). Comparing this mean with mean GA obtained by obstetric USS was also not significant (p = 0.885). Conclusion: The GA assessments by Obstetric USS, NR and DS were all reliable, and Obstetric USS performed effectively relative to combined NR and DS.
基金This research was funded by the Deanship of Scientific Research,Najran University,Kingdom of Saudi Arabia,grant number NU/RC/SERC/11/5.
文摘Diagnosing a baby’s feelings poses a challenge for both doctors and parents because babies cannot explain their feelings through expression or speech.Understanding the emotions of babies and their associated expressions during different sensations such as hunger,pain,etc.,is a complicated task.In infancy,all communication and feelings are propagated through cryspeech,which is a natural phenomenon.Several clinical methods can be used to diagnose a baby’s diseases,but nonclinical methods of diagnosing a baby’s feelings are lacking.As such,in this study,we aimed to identify babies’feelings and emotions through their cry using a nonclinical method.Changes in the cry sound can be identified using our method and used to assess the baby’s feelings.We considered the frequency of the cries from the energy of the sound.The feelings represented by the infant’s cry are judged to represent certain sensations expressed by the child using the optimal frequency of the recognition of a real-world audio sound.We used machine learning and artificial intelligence to distinguish cry tones in real time through feature analysis.The experimental group consisted of 50%each male and female babies,and we determined the relevancy of the results against different parameters.This application produced real-time results after recognizing a child’s cry sounds.The novelty of our work is that we,for the first time,successfully derived the feelings of young children through the cry-speech of the child,showing promise for end-user applications.
文摘Under the guidance of Systemic-Functional Grammar(SFG),cohesion is applied to analyze the selected context.Cohesion plays a great role in organizing a whole context and it can be further divided into grammatical cohesion and lexical cohesion.Main ideas of cohesion are illustrated and made it for application,which employs British children's literature-The Water Babies as the object.The research method adopted here is mainly quantitative.Through analyzing selected sections,it is obvious that cohesion helps readers understand the contexts better.Besides,the use of cohesion makes the context more precise and compact.For context,the role of cohesion is irreplaceable.
文摘目的分析不同胎龄早产儿凝血功能及颅内出血影响因素。方法选择500例早产儿纳入早产儿组,根据胎龄分为早期早产儿组和晚期早产儿组;根据是否颅内出血分为出血组和未出血组。同期选择足月健康新生儿250例为对照组。比较各组血浆凝血酶原时间(PT)、血浆纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、D-二聚体(DD)、颅内出血发生率。采用多因素Logistic回归分析早产儿出现颅内出血的影响因素。结果早期早产儿组、晚期早产儿组PT、APTT、DD、颅内出血发生率高于对照组,FIB低于对照组,且早期早产儿组较晚期早产儿组更为显著(P<0.05)。出血组早产儿5 min Apgar评分、胎龄、出生体质量、FIB低于未出血组,胎内窘迫、PS治疗、机械通气占比、PT、APTT高于未出血组(P<0.05)。胎内窘迫、PS治疗、机械通气占比、PT、APTT、5 min Apgar评分、胎龄、出生体质量、FIB均为颅内出血影响因素(P<0.05)。结论早产儿多出现凝血功能紊乱,其颅内出血的影响因素较多,早期干预有助于降低早产儿颅内出血发生率。
