ERDS: Emerging Risks Detection Support : 2007 project report

Rapport over het detecteren van risico's met de veiligheid van voeding. Aan de hand van het melamineschandaal wordt gekeken hoe in een vroegtijdig stadium risico's onderkend kunnen worde

Experts aan het stuur - modelleren met ROC

De agrifood sector heeft te maken met een sterk concurrerende wereldmarkt. Innovatie is hierbij van levensbelang. Optimaal gebruikmaken van beschikbare kennis is een basisvoorwaarde voor innovatie. Kennis over de eigen business en kennis uit externe bronnen moeten in kaart worden gebracht en worden ontsloten. Binnen het Food Informatics project is onderzocht hoe Semantic Web technologie hiervoor gebruikt kan worden. Een belangrijke conclusie is dat relevante kennismodellen onmisbaar zijn om de aanwezige informatie te ontsluiten. Om het kostenefficiënt bouwen van kennismodellen mogelijk te maken is de ROC-methode ontwikkeld. ROC staat voor Rapid Ontology Construction en is een methode die speciaal ontworpen is om het kennismodelleringsproces efficiënter te make

Modelling and optimisation of the operation of a radiant warmer

This paper presents numerical calculations of the temperature field obtained for the case of a neonate placed under a radiant warmer. The results of the simulations show a very non-uniform temperature distribution on the skin of the neonate, which may cause increased evaporation leading to severe dehydration. For this reason, we propose some modifications on the geometry and operation of the radiant warmer, in order to make the temperature distribution more uniform and prevent the high temperature gradients observed on the surface of the neonate. It is concluded that placing a high conductivity blanket over the neonate and introducing additional screens along the side of the mattress, thus recovering the radiation heat escaping through the side boundaries, helped providing more uniform temperature fields.The European Union for the Marie Curie Fellowship grant awarded to the Centre for CFD, University of Leeds

Cardiopulmonary Exercise Testing in Pediatrics

Aerobic fitness is an important determinant of overall health. Higher aerobic fitness has been associated with many health benefits. Because myocardial ischemia is rare in children, indications for exercise testing differ in children compared to adults. Pediatric exercise testing is imperative to unravel the physiological mechanisms of a reduced aerobic fitness and to evaluate intervention effects in children and adolescents with a chronic disease or disability. Cardiopulmonary exercise testing includes the measurement of respiratory gas exchange and is the gold standard for determining aerobic fitness, as well as for examining the integrated physiological responses to exercise in pediatric medicine. As the physiological responses to exercise change during growth and development, appropriate pediatric reference values are essential for an adequate interpretation of the cardiopulmonary exercise test

Irradiance footprint of phototherapy devices:a comparative study

Background Phototherapy (PT) is the standard treatment of neonatal unconjugated hyperbilirubinemia. The irradiance footprint, i.e., the illuminated area by the PT device with sufficient spectral irradiance, is essential for PT to be effective. Irradiance footprint measurements are not performed in current clinical practice. We describe a user-friendly method to systematically evaluate the high spectral irradiance (HSI) footprint (illuminated area with spectral irradiance of >= 30 mu W cm(-2) nm(-1)) of PT devices in clinical practice. Materials and methods Six commercially available LED-based overhead PT devices were evaluated in overhead configuration with an incubator. Spectral irradiance (mu W cm(-2) nm(-1)) and HSI footprint were measured with a radiospectrometer (BiliBlanket Meter II). Results The average measured spectral irradiance ranged between 27 and 52 mu W cm(-2) nm(-1) and HSI footprint ranged between 67 and 1465 cm(2), respectively. Three, two, and one PT devices out of six covered the average BSA of an infant born at 22, 26-32, and 40 weeks of gestation, respectively. Conclusion Spectral irradiance of LED-based overhead PT devices is often lower than manufacturer's specifications, and HSI footprints not always cover the average BSA of a newborn infant. The proposed measurement method will contribute to awareness of the importance of irradiance level as well as footprint measurements in the management of neonatal jaundice. Impact While a sufficient spectral irradiance footprint is essential for PT to be effective, some PT devices have spectral irradiance footprints that are too small to cover the entire body surface area (BSA) of a newborn infant. This study introduces a user-friendly, accessible method to systematically evaluate the spectral irradiance level and footprint of PT devices. This study supports awareness on the role of the spectral irradiance footprint in the efficacy of PT devices. Irradiance footprint can be easily measured during phototherapy with the proposed method

Neonatal donation:are newborns too young to be recognized?

Neonatal organ and tissue donation is not common practice in the Netherlands. At the same time, there is a transplant waiting list for small size-matched organs and tissues. Multiple factors may contribute to low neonatal donation rates, including a lack of awareness of this option. This study provides insight into potential neonatal organ and tissue donors and reports on how many donors were actually reported to the procurement organization. We performed a retrospective analysis of the mortality database and medical records of two largest neonatal intensive care units (NICUs) in the Netherlands. This study reviewed records of neonates with a gestational age >37 weeks and weight >3000g who died in the period from January 1, 2005 through December 31, 2016. During the study period, 259 term-born neonates died in the two NICUs. In total, 132 neonates with general contraindications for donation were excluded. The medical records of 127 neonates were examined for donation suitability. We identified five neonates with documented brain death who were not recognized as potential organ and/or tissue donors. Of the remaining neonates, 27 were found suitable for tissue donation. One potential tissue donor had been reported to the procurement organization. In three cases, the possibility of donation was brought up by parents. Conclusion: A low proportion (2%) of neonates who died in the NICUs were found suitable for organ donation, and a higher proportion (12%) were found suitable for tissue donation. We suggest that increased awareness concerning the possibility of neonatal donation would likely increase the identification of potential neonatal donors

Corrigendum to "The knowledge of Indonesian pediatric residents on hyperbilirubinemia management" [Heliyon 7 (4) (2021) e06661]

[This corrects the article DOI: 10.1016/j.heliyon.2021.e06661.]

The knowledge of Indonesian pediatric residents on hyperbilirubinemia management

Hyperbilirubinemia in the newborn occurs more frequently in Indonesia. Therefore, it is important that pediatric residents in Indonesia acquire adequate knowledge of hyperbilirubinemia management. This study aims to determine the pediatric residents' knowledge on hyperbilirubinemia management, whether they follow recommended guidelines, and whether differences exist between five large Indonesian teaching hospitals. We handed out a 25-question questionnaire on hyperbilirubinemia management to pediatric residents at five teaching hospitals. A total of 250 questionnaires were filled in completely, ranging from 14 to 113 respondents per hospital. Approximately 76% of the respondents used the Kramer score to recognize neonatal jaundice. Twenty-four percent correctly plotted the total serum bilirubin levels (TSB) on the phototherapy (PT) nomograms provided by the American Academy of Pediatrics (AAP) and the National Institute for Health and Care Excellence (NICE) for full-term and nearly full-term infants. Regarding preterm infants <35 weeks' gestational age, 66% of the respondents plotted TSB levels on the AAP nomogram, although this nomogram doesn't apply to this category of infants. Seventy percent of residents knew when to perform an exchange transfusion whereas 27% used a fixed bilirubin cut-off value of 20 mg/dL. Besides PT, 25% reported using additional pharmaceutical treatments, included albumin, phenobarbitone, ursodeoxycholic acid and immunoglobulins, while 47% of the respondents used sunlight therapy, as alternative treatment. The limited knowledge of the pediatric residents could be one factor for the higher incidence of severe hyperbilirubinemia and its sequelae. The limited knowledge of the residents raises doubts about the knowledge of the supervisors and the training of the residents since pediatric residents receive training from their supervisors

Severe neonatal hyperbilirubinaemia:lessons learnt from a national perinatal audit

OBJECTIVES: To describe characteristics of neonates with severe neonatal hyperbilirubinaemia (SNH) and to gain more insight in improvable factors that may have contributed to the development of SNH. DESIGN AND SETTING: Descriptive study, based on national Dutch perinatal audit data on SNH from 2017 to 2019. PATIENTS: Neonates, born ≥35 weeks of gestation and without antenatally known severe blood group incompatibility, who developed hyperbilirubinaemia above the exchange transfusion threshold. MAIN OUTCOME MEASURES: Characteristics of neonates having SNH and corresponding improvable factors. RESULTS: During the 3-year period, 109 neonates met the eligibility criteria. ABO antagonism was the most frequent cause (43%). All neonates received intensive phototherapy and 30 neonates (28%) received an exchange transfusion. Improvable factors were mainly related to lack of knowledge, poor adherence to the national hyperbilirubinaemia guideline, and to incomplete documentation and insufficient communication of the a priori hyperbilirubinaemia risk assessment among healthcare providers. A priori risk assessment, a key recommendation in the national hyperbilirubinaemia guideline, was documented in only six neonates (6%). CONCLUSIONS: SNH remains a serious threat to neonatal health in the Netherlands. ABO antagonism frequently underlies SNH. Lack of compliance to the national guideline including insufficient a priori hyperbilirubinaemia risk assessment, and communication among healthcare providers are important improvable factors. Implementation of universal bilirubin screening and better documentation of the risk of hyperbilirubinaemia may enhance early recognition of potentially dangerous neonatal jaundice