Interrater agreement in the interpretation of neonatal electroencephalography in hypoxic‐ischemic encephalopathy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136482/1/epi13661_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136482/2/epi13661.pd

Neuromonitoring in neonatal critical care part II: extremely premature infants and critically ill neonates

Abstract: Neonatal intensive care has expanded from cardiorespiratory care to a holistic approach emphasizing brain health. To best understand and monitor brain function and physiology in the neonatal intensive care unit (NICU), the most commonly used tools are amplitude-integrated EEG, full multichannel continuous EEG, and near-infrared spectroscopy. Each of these modalities has unique characteristics and functions. While some of these tools have been the subject of expert consensus statements or guidelines, there is no overarching agreement on the optimal approach to neuromonitoring in the NICU. This work reviews current evidence to assist decision making for the best utilization of these neuromonitoring tools to promote neuroprotective care in extremely premature infants and in critically ill neonates. Neuromonitoring approaches in neonatal encephalopathy and neonates with possible seizures are discussed separately in the companion paper. Impact: For extremely premature infants, NIRS monitoring has a potential role in individualized brain-oriented care, and selective use of aEEG and cEEG can assist in seizure detection and prognostication.For critically ill neonates, NIRS can monitor cerebral perfusion, oxygen delivery, and extraction associated with disease processes as well as respiratory and hypodynamic management. Selective use of aEEG and cEEG is important in those with a high risk of seizures and brain injury.Continuous multimodal monitoring as well as monitoring of sleep, sleep–wake cycling, and autonomic nervous system have a promising role in neonatal neurocritical care

Has HERA reached a new QCD regime?

These notes are a summary of our efforts to answer the question in the title. Our answer is in the affirmative as: (i) HERA data indicate a large value of the gluon structure function; (ii) no contradictions with the asymptotic predictions of high density QCD have been observed; and (iii) the numerical estimates of our model give a natural description of the size of deviation from the routine DGLAP explanation. We discuss the alternative approaches and possible new experiments.Comment: 29 pages, 37 figures in eps file

Non-linear QCD dynamics and exclusive production in epep collisions

The exclusive processes in electron-proton ($ep$) interactions are an important tool to investigate the QCD dynamics at high energies as they are in general driven by the gluon content of proton which is strongly subject to parton saturation effects. In this paper we compute the cross sections for the exclusive vector meson production as well as the deeply virtual Compton scattering (DVCS) relying on the color dipole approach and considering the numerical solution of the Balitsky-Kovchegov equation including running coupling corrections. We show that the small-$x$ evolution given by this evolution equation is able to describe the DESY-HERA data and is relevant for the physics of the exclusive observables in future electron-proton colliders and in photoproduction processes to be measured in coherent interactions at the LHC.Comment: 6 pages, 4 figure

Neuroprotective therapies in the NICU in term infants: present and future

Outcomes of neonatal encephalopathy (NE) have improved since the widespread implementation of therapeutic hypothermia (TH) in high-resource settings. While TH for NE in term and near-term infants has proven beneficial, 30–50% of infants with moderate-to-severe NE treated with TH still suffer death or significant impairments. There is therefore a critical need to find additional pharmacological and non-pharmacological interventions that improve the outcomes for these children. There are many potential candidates; however, it is unclear whether these interventions have additional benefits when used with TH. Although primary and delayed (secondary) brain injury starting in the latent phase after HI are major contributors to neurodisability, the very late evolving effects of tertiary brain injury likely require different interventions targeting neurorestoration. Clinical trials of seizure management and neuroprotection bundles are needed, in addition to current trials combining erythropoietin, stem cells, and melatonin with TH

Coherent QCD phenomena in the Coherent Pion-Nucleon and Pion-Nucleus Production of Two Jets at High Relative Momenta

We use QCD to compute the cross section for coherent production of a di-jet (treated as a $q\bar q$ moving at high relative transverse momentum,$\kappa_t$). In the target rest frame,the space-time evolution of this reaction is dominated by the process in which the high $\kappa_t$ $q\bar q$ component of the pion wave function is formed before reaching the target. It then interacts through two gluon exchange. In the approximation of keeping the leading order in powers of $\alpha_s$ and all orders in $\alpha_{s}\ln(\kappa_{t}^2/k_{0}^2),$ the amplitudes for other processes are shown to be smaller at least by a power of $\alpha_{s}$. The resulting dominant amplitude is proportional to $z(1-z) \kappa_t^{-4}$ ($z$ is the fraction light-cone(+)momentum carried by the quark in the final state) times the skewed gluon distribution of the target. For the pion scattering by a nuclear target, this means that at fixed $x_{N}= 2\kappa_{t}^2/s$ (but $\kappa_{t}^2\to \infty$) the nuclear process in which there is only a single interaction is the most important one to contribute to the reaction. Thus in this limit color transparency phenomena should occur.These findings are in accord with E971 experiment at FNAL. We also re-examine a potentially important nuclear multiple scattering correction which is positive and $\propto A^{1/3}/\kappa_t^4$. The meaning of the signal obtained from the experimental measurement of pion diffraction into two jets is also critically examined and significant corrections are identified.We show also that for values of $\kappa_t$ achieved at fixed target energies, di-jet production by the e.m. field of the nucleus leads to an insignificant correction which gets more important as $\kappa_t$ increases.Comment: 23 pages, 9 figure

The impact of hypsarrhythmia on infantile spasms treatment response: Observational cohort study from the National Infantile Spasms Consortium

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141801/1/epi13937_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141801/2/epi13937.pd

A cross-sectional study of patients with and without substance use disorders in Community Mental Health Centres

<p>Abstract</p> <p>Background</p> <p>Epidemiological studies have consistently established high comorbidity between psychiatric disorders and substance use disorders (SUD). This comorbidity is even more prominent when psychiatric populations are studied. Previous studies have focused on inpatient populations dominated by psychotic disorders, whereas this paper presents findings on patients in Community Mental Health Centres (CMHCs) where affective and anxiety disorders are most prominent. The purpose of this study is to compare patients in CMHCs with and without SUD in regard to differences in socio-demographic characteristics, level of morbidity, prevalence of different diagnostic categories, health services provided and the level of improvement in psychiatric symptoms.</p> <p>Methods</p> <p>As part of the evaluation of the National Plan for Mental Health, all patients seen in eight CMHCs during a 4-week period in 2007 were studied (n = 2154). The CMHCs were located in rural and urban areas of Norway. The patients were diagnosed according to the ICD-10 diagnoses and assessed with the Health of the Nation Outcome Scales, the Alcohol Use Scale and the Drug Use Scale.</p> <p>Results</p> <p>Patients with SUD in CMHCs are more frequently male, single and living alone, have more severe morbidity, less anxiety and mood disorders, less outpatient treatment and less improvement in regard to recovery from psychological symptoms compared to patients with no SUD.</p> <p>Conclusion</p> <p>CMHCs need to implement systematic screening and diagnostic procedures in order to detect the special needs of these patients and improve their treatment.</p

Cloud computing and RESERVOIR project

The support for complex services delivery is becoming a key point in current internet technology. Current trends in internet applications are characterized by on demand delivery of ever growing amounts of content. The future internet of services will have to deliver content intensive applications to users with quality of service and security guarantees. This paper describes the RESERVOIR project and the challenge of a reliable and effective delivery of services as utilities in a commercial scenario. It starts by analyzing the needs of a future infrastructure provider and introducing the key concept of a service oriented architecture that combines virtualisation-aware grid with grid-aware virtualisation, while being driven by business service management. This article will then focus on the benefits and the innovations derived from the RESERVOIR approach. Eventually, a high level view of RESERVOIR general architecture is illustrated