Small sample deep learning for newborn gestational age estimation

A baby’s gestational age determines whether or not they are preterm, which helps clinicians decide on suitable post-natal treatment. The most accurate dating methods use Ultrasound Scan (USS) machines, but these machines are expensive, require trained personnel and cannot always be deployed to remote areas. In the absence of USS, the Ballard Score can be used, which is a manual postnatal dating method. However, this method is highly subjective and results can vary widely depending on the experience of the rater. In this paper, we present an automatic system for postnatal gestational age estimation aimed to be deployed on mobile phones, using small sets of images of a newborn’s face, foot and ear. We present a novel two-stage approach that makes the most out of Convolutional Neural Networks trained on small sets of images to predict broad classes of gestational age, and then fuse the outputs of these discrete classes with a baby’s weight to make fine-grained predictions of gestational age. On a purpose- collected dataset of 88 babies, experiments show that our approach attains an expected error of 6 days and is three times more accurate than the manual postnatal method (Ballard). Making use of images improves predictions by 30% compared to using weight only. This indicates that even with a very small set of data, our method is a viable candidate for postnatal gestational age estimation in areas were USS is not available

The Alice Springs Hospital Readmission Prevention Project (ASHRAPP): a randomised control trial

Background: Hospitals are frequently faced with high levels of emergency department presentations and demand for inpatient care. An important contributing factor is the subset of patients with complex chronic diseases who have frequent and preventable exacerbations of their chronic diseases. Evidence suggests that some of these hospital readmissions can be prevented with appropriate transitional care. Whilst there is a growing body of evidence for transitional care processes in urban, non-indigenous settings, there is a paucity of information regarding rural and remote settings and, specifically, the indigenous context. Methods: This randomised control trial compares a tailored, multidimensional transitional care package to usual care. The objective is to evaluate the efficacy of the transitional care package for Indigenous and non-Indigenous Australian patients with chronic diseases at risk of recurrent readmission with the aim of reducing readmission rates and improving transition to primary care in a remote setting. Patients will be recruited from medical and surgical admissions to Alice Springs Hospital and will be followed for 12 months. The primary outcome measure will be number of admissions to hospital with secondary outcomes including number of emergency department presentations, number of ICU admissions, days alive and out of hospital, time to primary care review post discharge and cost-effectiveness. Discussion: Successful transition from hospital to home is important for patients with complex chronic diseases. Evidence suggests that a coordinated transitional care plan can result in a reduction in length of hospital stay and readmission rates for adults with complex medical needs. This will be the first study to evaluate a tailored multidimensional transitional care intervention to prevent readmission in Indigenous and non-Indigenous Australian residents of remote Australia who are frequently admitted to hospital. If demonstrated to be effective it will have implications for the care and management of Indigenous Australians throughout regional and remote Australia and in other remote, culturally and linguistically diverse populations and settings

Accurate neonatal heart rate monitoring using a new wireless, cap mounted device

© 2020 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica Aim: A device for newborn heart rate (HR) monitoring at birth that is compatible with delayed cord clamping and minimises hypothermia risk could have advantages over current approaches. We evaluated a wireless, cap mounted device (fhPPG) for monitoring neonatal HR. Methods: A total of 52 infants on the neonatal intensive care unit (NICU) and immediately following birth by elective caesarean section (ECS) were recruited. HR was monitored by electrocardiogram (ECG), pulse oximetry (PO) and the fhPPG device. Success rate, accuracy and time to output HR were compared with ECG as the gold standard. Standardised simulated data assessed the fhPPG algorithm accuracy. Results: Compared to ECG HR, the median bias (and 95% limits of agreement) for the NICU was fhPPG −0.6 (−5.6, 4.9) vs PO −0.3 (−6.3, 6.2) bpm, and ECS phase fhPPG −0.5 (−8.7, 7.7) vs PO −0.1 (−7.6, 7.1) bpm. In both settings, fhPPG and PO correlated with paired ECG HRs (both R2=0.89). The fhPPG HR algorithm during simulations demonstrated a near-linear correlation (n=1266, R2=0.99). Conclusion: Monitoring infants in the NICU and following ECS using a wireless, cap mounted device provides accurate HR measurements. This alternative approach could confer advantages compared with current methods of HR assessment and warrants further evaluation at birth

Postnatal gestational age estimation of newborns using Small Sample Deep Learning

© 2018 A baby's gestational age determines whether or not they are premature, which helps clinicians decide on suitable post-natal treatment. The most accurate dating methods use Ultrasound Scan (USS) machines, but these are expensive, require trained personnel and cannot always be deployed to remote areas. In the absence of USS, the Ballard Score, a postnatal clinical examination, can be used. However, this method is highly subjective and results vary widely depending on the experience of the examiner. Our main contribution is a novel system for automatic postnatal gestational age estimation using small sets of images of a newborn's face, foot and ear. Our two-stage architecture makes the most out of Convolutional Neural Networks trained on small sets of images to predict broad classes of gestational age, and then fuses the outputs of these discrete classes with a baby's weight to make fine-grained predictions of gestational age using Support Vector Regression. On a purpose-collected dataset of 130 babies, experiments show that our approach surpasses current automatic state-of-the-art postnatal methods and attains an expected error of 6 days. It is three times more accurate than the Ballard method. Making use of images improves predictions by 33% compared to using weight only. This indicates that even with a very small set of data, our method is a viable candidate for postnatal gestational age estimation in areas were USS is not available

Comparison of prestellar core elongations and large-scale molecular cloud structures in the Lupus 1 region

Turbulence and magnetic fields are expected to be important for regulating molecular cloud formation and evolution. However, their effects on sub-parsec to 100 parsec scales, leading to the formation of starless cores, are not well understood. We investigate the prestellar core structure morphologies obtained from analysis of the Herschel-SPIRE 350 mum maps of the Lupus I cloud. This distribution is first compared on a statistical basis to the large-scale shape of the main filament. We find the distribution of the elongation position angle of the cores to be consistent with a random distribution, which means no specific orientation of the morphology of the cores is observed with respect to the mean orientation of the large-scale filament in Lupus I, nor relative to a large-scale bent filament model. This distribution is also compared to the mean orientation of the large-scale magnetic fields probed at 350 mum with the Balloon-borne Large Aperture Telescope for Polarimetry during its 2010 campaign. Here again we do not find any correlation between the core morphology distribution and the average orientation of the magnetic fields on parsec scales. Our main conclusion is that the local filament dynamics---including secondary filaments that often run orthogonally to the primary filament---and possibly small-scale variations in the local magnetic field direction, could be the dominant factors for explaining the final orientation of each core

The balloon-borne large-aperture submillimeter telescope for polarimetry: BLAST-Pol

The Balloon-borne Large Aperture Submillimeter Telescope for Polarimetry (BLAST-Pol) is a suborbital mapping experiment designed to study the role played by magnetic fields in the star formation process. BLAST-Pol is the reconstructed BLAST telescope, with the addition of linear polarization capability. Using a 1.8 m Cassegrain telescope, BLAST-Pol images the sky onto a focal plane that consists of 280 bolometric detectors in three arrays, observing simultaneously at 250, 350, and 500 um. The diffraction-limited optical system provides a resolution of 30'' at 250 um. The polarimeter consists of photolithographic polarizing grids mounted in front of each bolometer/detector array. A rotating 4 K achromatic half-wave plate provides additional polarization modulation. With its unprecedented mapping speed and resolution, BLAST-Pol will produce three-color polarization maps for a large number of molecular clouds. The instrument provides a much needed bridge in spatial coverage between larger-scale, coarse resolution surveys and narrow field of view, and high resolution observations of substructure within molecular cloud cores. The first science flight will be from McMurdo Station, Antarctica in December 2010.Comment: 14 pages, 9 figures Submitted to SPIE Astronomical Telescopes and Instrumentation Conference 201

Marked variation in newborn resuscitation practice: a national survey in the UK

Abstract Background Although international newborn resuscitation guidance has been in force for some time, there are no UK data on current newborn resuscitation practices. Objective Establish delivery room (DR) resuscitation practices in the UK, and identify any differences between neonatal intensive care units (NICU), and other local neonatal services. Methods We conducted a structured two-stage survey of DR management, among UK neonatal units during 2009–2010 (n = 192). Differences between NICU services (tertiary level) and other local neonatal services (non-tertiary) were analysed using Fisher's exact and Student's t-tests. Results There was an 89% response rate (n = 171). More tertiary NICUs institute DR CPAP than non-tertiary units (43% vs. 16%, P = 0.0001) though there was no significant difference in frequency of elective intubation and surfactant administration for preterm babies. More tertiary units commence DR resuscitation in air (62% vs. 29%, P < 0.0001) and fewer in 100% oxygen (11% vs. 41%, P < 0.0001). Resuscitation of preterm babies in particular, commences with air in 56% of tertiary units. Significantly more tertiary units use DR pulse oximeters (58% vs. 29%, P < 0.01) and titrate oxygen based on saturations. Almost all services use occlusive wrapping to maintain temperature for preterm infants. Conclusions In the UK, there are many areas of good evidence based DR practice. However, there is marked variation in management, including between units of different designation, suggesting a need to review practice to fulfil new resuscitation guidance, which will have training and resource implications

BLAST: The Mass Function, Lifetimes, and Properties of Intermediate Mass Cores from a 50 Square Degree Submillimeter Galactic Survey in Vela (l = ~265)

We present first results from an unbiased 50 deg^2 submillimeter Galactic survey at 250, 350, and 500 micron from the 2006 flight of the Balloon-borne Large Aperture Submillimeter Telescope (BLAST). The map has resolution ranging from 36 arcsec to 60 arcsec in the three submillimeter bands spanning the thermal emission peak of cold starless cores. We determine the temperature, luminosity, and mass of more than one thousand compact sources in a range of evolutionary stages and an unbiased statistical characterization of the population. From comparison with C^(18)O data, we find the dust opacity per gas mass, kappa r = 0.16 cm^2 g^(-1) at 250 micron, for cold clumps. We find that 2% of the mass of the molecular gas over this diverse region is in cores colder than 14 K, and that the mass function for these cold cores is consistent with a power law with index alpha = -3.22 +/- 0.14 over the mass range 14 M_sun < M < 80 M_sun. Additionally, we infer a mass-dependent cold core lifetime of t_c(M) = 4E6 (M/20 M_sun)^(-0.9) years - longer than what has been found in previous surveys of either low or high mass cores, and significantly longer than free fall or likely turbulent decay times. This implies some form of non-thermal support for cold cores during this early stage of star formation.Comment: Accepted for publication in the Astrophysical Journal. Maps available at http://blastexperiment.info