Development of a Core Outcome Set and Minimum Reporting Set for intervention studies in growth restriction in the NEwbOrN (COSNEON): study protocol for a Delphi study.

BACKGROUND: Growth restriction in the newborn (GRN) can predispose to severe complications including hypoglycemia, sepsis, and necrotizing enterocolitis. Different interventions and treatments, such as feeding strategies, for GRN have specific benefits and risks. Comparing results from studies investigating intervention studies in GRN is challenging due to the use of different baseline and study characteristics and differences in reported study outcomes. In order to be able to compare study results and to allow pooling of data, uniform reporting of study characteristics (minimum reporting set [MRS]) and outcomes (core outcome set [COS]) are needed. We aim to develop both an MRS and a COS for interventional and treatment studies in GRN. METHODS/DESIGN: The MRS and COS will be developed according to Delphi methodology. First, a scoping literature search will be performed to identify study characteristics and outcomes in research focused on interventions/treatments in the GRN. An international group of stakeholders, including experts (clinicians working with GRN, and researchers who focus on GRN) and lay experts ([future] parents of babies with GRN), will be questioned to rate the importance of the study characteristics and outcomes in three rounds. After three rounds there will be two consensus meetings: a face-to-face meeting and an electronic meeting. During the consensus meetings multiple representatives of stakeholder groups will reach agreement upon which study characteristics and outcomes will be included into the COS and MRS. The second electronic consensus meeting will be used to test if an electronic meeting is as effective as a face-to-face meeting. DISCUSSION: In our opinion a COS alone is not sufficient to compare and aggregate trial data. Hence, to ensure optimum comparison we also will develop an MRS. Interventions in GRN infants are often complicated by coexisting preterm birth. A COS already has been developed for preterm birth. The majority of GRN infants are born at term, however, and we therefore chose to develop a separate COS for interventions in GRN, which can be combined (with expected overlap) in intervention studies enrolling preterm GRN babies. TRIAL REGISTRATION: Not applicable. This study is registered in the Core Outcome Measures for Effectiveness ( COMET ) database. Registered on 30 June 2017

Dynamic Effects of Turbulent Crosswind on the Serviceability State of Vibrations of a Slender Arch Bridge Including Wind-Vehicle-Bridge Interaction

The use of high-performance materials in bridges is leading to structures that are more susceptible to wind- and traffic-induced vibrations due to the reduction in the weight and the increment of the slenderness in the deck. Bridges can experience considerable vibration due to both moving vehicles and wind actions that affect the comfort of the bridge users and the driving safety. This work explored the driving safety and comfort in a very slender arch bridge under turbulent wind and vehicle actions, as well as the comfort of pedestrians. A fully coupled wind–vehicle–bridge interaction model based on the direct integration of the system of dynamics was developed. In this model, the turbulent crosswind is represented by means of aerodynamic forces acting on the vehicle and the bridge. The vehicle is modeled as a multibody system that interacts with the bridge by means of moving contacts that also simulate road-surface irregularities. A user element is presented with generality and implemented using a general-purpose finite-element software package to incorporate the aeroelastic components of the wind forces, which allows modeling and solving of the wind–vehicle–bridge interaction in the time domain without the need for using the modal superposition technique. An extensive computational analysis program is performed on the basis of a wide range of turbulent crosswind speeds. The results show that bridge vibration is significantly affected by the crosswind in terms of peak acceleration and frequency content when the crosswind intensity is significant. The crosswind has more effect on the ride comfort of the vehicle in the lateral direction and, consequently, on its safety in terms of overturning accidents

‘Friends call me racist’: Experiences of repercussions from writing comments on newspaper websites

acceptedVersio

Seasonal forecasts of the 20th century

New seasonal retrospective forecasts for 1901-2010 show that skill for predicting ENSO, NAO and PNA is reduced during mid-century periods compared to earlier and more recent high-skill decades. Forecasts of seasonal climate anomalies using physically-based global circulation models are routinely made at operational meteorological centers around the world. A crucial component of any seasonal forecast system is the set of retrospective forecasts, or hindcasts, from past years which are used to estimate skill and to calibrate the forecasts. Hindcasts are usually produced over a period of around 20-30 years. However, recent studies have demonstrated that seasonal forecast skill can undergo pronounced multi-decadal variations. These results imply that relatively short hindcasts are not adequate for reliably testing seasonal forecasts and that small hindcast sample sizes can potentially lead to skill estimates that are not robust. Here we present new and unprecedented 110-year-long coupled hindcasts of the next season over the period 1901 to 2010. Their performance for the recent period is in good agreement with those of operational forecast models. While skill for ENSO is very high during recent decades, it is markedly reduced during the 1930s to 1950s. Skill at the beginning of the 20th Century is, however, as high as for recent high-skill periods. Consistent with findings in atmosphere-only hindcasts, a mid-century drop in forecast skill is found for a range of atmospheric fields including large-scale indices such as the NAO and the PNA patterns. As with ENSO, skill scores for these indices recover in the early 20th Century suggesting that the mid-century drop in skill is not due to lack of good observational data. A public dissemination platform for our hindcast data is available and we invite the scientific community to explore them.</p

Supplementary Material for: Improved Visual Perception in Very Low Birth Weight Infants on Enhanced Nutrient Supply

<b><i>Background:</i></b> Optimal nutrient supply to very low birth weight (VLBW: BW <1,500 g) infants is important for growth and neurodevelopment. Growth restriction is common among these infants and may be associated with neurocognitive impairments. <b><i>Objectives:</i></b> To compare an enhanced nutrient supply to a routine supply given to VLBW infants and to evaluate the effects on visual perception of global form and motion measured by visual event-related potentials (VERP). <b><i>Methods:</i></b> A total of 50 VLBW infants were randomized to an intervention group that received an increased supply of energy, protein, fat, essential fatty acids, and vitamin A or a control group that received standard nutritional care. At 5 months' corrected age the infants were examined using VERP to investigate the responses to global form and motion. VERP were analysed at the first (f1) and third (f3) harmonics of the stimulus frequency. <b><i>Results:</i></b> Data from 31 subjects were eligible for analysis. The motion VERP responses for the f1 and f3 components were stronger in the area near the posterior midline region in the intervention group compared to the controls in the group analyses (p = 0.02 and p = 0.001, respectively). <b><i>Conclusion:</i></b> The results showed a more consistent response to global motion among infants receiving enhanced nutrition. The intervention may have improved visual perception of global motion