Kernel Flow:a high channel count scalable time-domain functional near-infrared spectroscopy system

Significance: Time-domain functional near-infrared spectroscopy (TD-fNIRS) has been considered as the gold standard of noninvasive optical brain imaging devices. However, due to the high cost, complexity, and large form factor, it has not been as widely adopted as continuous wave NIRS systems. Aim: Kernel Flow is a TD-fNIRS system that has been designed to break through these limitations by maintaining the performance of a research grade TD-fNIRS system while integrating all of the components into a small modular device. Approach: The Kernel Flow modules are built around miniaturized laser drivers, custom integrated circuits, and specialized detectors. The modules can be assembled into a system with dense channel coverage over the entire head. Results: We show performance similar to benchtop systems with our miniaturized device as characterized by standardized tissue and optical phantom protocols for TD-fNIRS and human neuroscience results. Conclusions: The miniaturized design of the Kernel Flow system allows for broader applications of TD-fNIRS.</p

Relationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICU: a prospective cohort study.

BACKGROUND: The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. METHODS: We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient's age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. RESULTS: The median age in the sample of 7487 consecutive patients was 84 years (IQR 81-87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01). CONCLUSION: Knowledge about a patient's frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided. Trial registration NCT03134807 (VIP1), NCT03370692 (VIP2)

Ocorrência dos indicadores de risco para a deficiência auditiva infantil no decorrer de quatro anos em um programa de triagem auditiva neonatal de um hospital público Occurence of risk indicators for hearing loss over four years in a neonatal hearing screening program of a public hospital

OBJETIVO: Comparar a ocorrência dos indicadores de risco para a deficiência auditiva infantil ao longo de quatro anos, em um Programa de Triagem Auditiva Neonatal. MÉTODOS: Foram pesquisados os prontuários de 382 recém nascidos prematuros nascidos no Hospital São Paulo, de 2000 a 2004. RESULTADOS: Em 2000, encontramos 5,9% de casos de antecedentes familiares/consangüinidade, a qual aumentou de forma estatisticamente significante para 13,6% em 2003. A ventilação mecânica aumentou de forma estatisticamente significante de 24,6% casos em 2000, para 40,2% em 2004. O número de convulsões em RN foi de 4,2% em 2000 para 9,8% em 2004, aumento estatisticamente significante. Encontramos 11,0% de casos de infecção congênita em 2000, o que caiu para 4,3% em 2003. No ano de 2002, houve apenas um caso de sífilis, sendo que a ocorrência destas doenças diminuiu nos últimos anos. O HPIV foi de 15,3% no ano 2000 para 5% em 2003, com redução estatisticamente significante. Os casos de malformação caíram de 3,4% no ano 2000 para 0,7% em 2003. Os casos de ototoxicidade diminuíram de forma estatisticamente significante de 43,2% em 2000 para 30,0% em 2003. CONCLUSÃO: A análise estatística revelou aumento significante da ocorrência dos antecedentes familiares para a deficiência auditiva, do uso de ventilação mecânica e das convulsões neonatais. Os casos de infecção congênita e hemorragia periintraventricular diminuíram estatisticamente do ano 2000 para 2004. Os casos de malformação, baixo peso e ototoxicidade variaram de forma aleatória entre os anos estudados. E alguns indicadores de risco se mantiveram sem alterações estatisticamente significantes.<br>PURPOSE: To compare the occurrence of risk indicators for hearing loss in children over a period of four years, in a Neonatal Hearing Screening Program. METHODS: Three hundred and eighty-two files of preterm infants born at Hospital São Paulo in the period from 2000 to 2004 were researched. RESULTS: In 2000, 5.9% of the cases showed familiar antecedents and/or consanguinities, while in 2003 this indicator was present in 13.6% of the population. Mechanical ventilation showed significant increase from 24.6% in 2000 to 40.2% of the cases in 2004. The cases of neonatal seizures increased significantly from 4.2% in 2000 to 9.8% in 2004. Congenital infections showed significant decrease from 11.0% in 2000 to 4.3% in 2003. In 2002, only one case of syphilis was observed, demonstrating decrease in the occurrence of such diseases. The occurrence of peri-intraventricular hemorrhage significantly decreased from 15.3% in 2000 to 5% in 2003. Malformation cases decreased from 3.4% in 2000 to 0.7% in 2003. Ototoxicity cases showed significant decrease from 43.2% in 2000 to 30.0% in 2003. CONCLUSION: Statistical analysis revealed significant increase of familiar antecedents for hearing loss, use of mechanical ventilation and neonatal seizures during the period considered. Registers of congenital infections and peri-intraventricular hemorrhage showed significant decrease during the same period. Malformation, low birth weight and ototoxicity cases varied randomly, and some risk indicators didn't present any statistically significant variations

Kernel Flow:A high channel count scalable TD-fNIRS system

Time-Domain Near-Infrared Spectroscopy (TD-NIRS) has been considered as the gold standard of non-invasive optical brain imaging devices. However, due to the high cost, complexity, and large form-factor, it has not been as widely adopted as Continuous Wave (CW) NIRS systems. Kernel Flow is a TD-NIRS system that has been designed to break through these limitations by maintaining the performance of a research grade TD-NIRS system while integrating all of the components into a small modular device. The Kernel Flow modules are built around miniaturized laser drivers, custom integrated circuits, and specialized detectors. The modules can be assembled into a system with dense channel coverage over the entire head. We show performance similar to benchtop systems with our miniaturized device.</p