bluuebunny/crossref_metadata_2025 huggingface dataset:
Pneumatosis coli: A benign form of necrotizing enterocolitis
Authors: Cordero Leandro , Giannone Peter J. , Valentine Christina J. , Coley Brian D. , Nankervis Craig A.
Published: December 2019

Background: Recently, we observed an increase in the number of late preterm neonates with pneumatosis coli (Pcoli) an infrequently reported benign form of necrotizing enterocolitis (NEC).

Objective: To review our experience (2000–09) with infants who presented with visible blood in the stools (VBS) and pneumatosis intestinalis (PI).

Methods: Retrospective cohort study. There were 65~infants who had VBS and PI. Thirty-two who constituted the pneumatosis coli (Pcoli) group were compared with 33 infants with VBS and PI who were designated as classic NEC.

Results: 75% of Pcoli cases occurred during 2008–09. Demographics and obstetrical risk factors (except for preterm labor and antepartum steroid use) for the mothers of both groups were similar. Ninety-one percent of Pcoli were $\geq $ 34w while 82% of classic NEC cases were ⩽ 33w GA. At the time of diagnosis 70% of infants in the Pcoli group and 30% of those in the classic NEC group were < 7d old. In the Pcoli group prior to VBS, 78% of these infants were taking formula and 22% formula and breast milk. VBS was the only clinical sign which prompted radiographic evaluation. Thirty of these 32 infants had blood cultures (all negative), 20% received antibiotics, 50% continued with feedings, no patients had surgery and all survived. In the classic NEC group prior to VBS 47% were taking formula, 47% formula and breast milk and 6% breast milk. Seventy-four percent of these infants had abdominal distention, emesis or apnea, 48% had abnormal WBC-diff, and 6 infants had positive blood cultures. Ten infants had surgery and 3 of them expired. Among Pcoli infants, PI was limited to the colon in 94% of the cases. In the classic NEC group 35% of infants had difuse PI, 65% had focal PI and 27% had portal venous gas.

Conclusion: Pcoli is a benign form of NEC that affects mainly late preterm or term infants, who once diagnosed, in contrast to classic NEC patients, require less intensive care. Further studies are needed to elucidate etiology (including the role of feeding practices) and to explore preventive or therapeutic measures.
Sucrose as an analgesic in relieving procedural pain in neonates
Authors: Basnet Srijana , Shrestha Laxman , Shrestha Prakash Sundar
Published: December 2019

Objective: This study was undertaken to study physiological and behavioral pain responses of neonates and to assess the analgesic effect of orally administered sucrose as assessed by the behavioral pain rating scale [DAN (Douleur Aiguë du Nouveau-né) score] during venepuncture in neonates.

Method: In 50 healthy neonates requiring bilirubin estimation, blood sugar was randomly assigned to receive 2ml of 30% sucrose two minutes before the venepuncture (intervention) in comparison to a group not receiving sucrose (control). During the procedure, pain was assessed by behavioral pain rating scale [Douleur Aiguë Nouveau-né (DAN) scale]. The heart rate, oxygen saturation before, during and after procedure as well as crying time was noted.

Results: There was significantly lower pain (DAN) score in the intervention group compared to control group. Median (inter-quartile) DAN score in the group receiving sucrose was 3 (1.5–5.5) compared to 7 (5–9.5) in control group. The difference in median DAN score between two groups was statistically significant (p=0.0001). There was a significant increase in heart rate in the control group whereas in group receiving sucrose, no significant change in heart rate was observed. Similarly, oxygen saturation was also significantly reduced in control group when compared to intervention group.

Conclusion: The analgesic effect of 30% sucrose was large enough to be clinically significant and can thus be detected by behavioral rating scale for acute pain (DAN). Sucrose reduces the physiological alteration occurring during venipuncture.
Interrupted inferior vena cava and persistent left superior vena	cava without heterotaxia in a fetus
Authors: Hartas Georgios A. , Gupta-Malhotra Monesha
Published: December 2019

Presence of systemic venous anomalies including a persistent left superior vena cava to a dilated coronary and interrupted inferior vena cava with azygous continuation are extremely rare in absence of heterotaxia or cardiosplenic syndrome. For this reason, the diagnosis of extracardiac venous anomalies can often be missed in absence of a heterotaxia as was the case in our patient whose prior fetal echocardiogram and the first postnatal echocardiogram read by other pediatric cardiologists failed to detect these anomalies. We report these systemic venous anomalies in a fetus in the absence of heterotaxia and further describe the echocardiographic findings helpful in their detection in-utero.
Protein C concentration in newborn infants with sepsis-like illness
Authors: Pishva N. , Afrasiabi A. , Shahbazi M. , Haghpanah S. , Karimi M.
Published: December 2019

Background: Neonatal sepsis is frequently associated with multiple hematologic abnormalities, including depletion of protein C. The status of protein C is not known in infants who clinically present with a sepsis-like picture without a culture-proven sepsis. The objectives of this study were to determine whether sepsis-like illness is associated with a reduction in protein C. Methods: In this case-control, cross-sectional study, 49 full-term neonates admitted to the neonatal intensive care unit (NICU) with the clinical manifestation of sepsis that was not proven by cultures. Fifty healthy full-term newborns were also randomly selected as a control group. Protein C concentrations were compared between both groups. Results: There was no difference between the case and control groups regarding sex and gestational age. Protein C concentration did not differ between groups (p > 0.05); mean protein C concentration was 29.4% of the normal adult level in cases with clinical sepsis and 32% in the control group. Conclusion: Protein C deficiency was not related to clinical manifestations in sepsis-like illness. Further studies examining other predictors of sepsis-like illness are recommended.
A study on eleven cases of neonatal tetanus in Sabah, North Borneo, Malaysia
Authors: Moy F.S. , Juin W.K.
Published: December 2019

Aim: To describe the demographic data, clinical presentation, and outcome of babies admitted to hospital with neonatal tetanus in Sabah. Methods: Retrospective review of babies with neonatal tetanus admitted to tertiary neonatal unit. Results: Eleven babies were admitted with neonatal tetanus between January 2007 and April 2009. All babies had non-immunized mothers and were home-delivered. The mean incubation period of neonatal tetanus was 6.8 (SD 2.2) days and the mean age of admission was 7.6 (SD 1.9) days. All had severe generalized tetanus on admission but were well upon discharge. Survival was 100% in this series. There was no follow-up. Conclusions: Neonatal tetanus still exists and should be considered in the differential diseases of sick infants. The presence of qualified neonatal units were crucial for the survival of neonates with tetanus.
Red blood cells and plasma harvested from cord blood of preterm and term infants: Sterility and indicators of quality for early retransfusion
Authors: Hentschel R. , Mohr T. , Pelz K. , Zahradnik H.P. , Beck K.H.
Published: December 2019

Objective: Even though red blood cells from cord blood (CB) have been investigated for many years for the purpose of autologous retransfusion to newborns this technique is still far from clinical routine. In severely ill neonates fresh frozen plasma from donors is frequently transfused for volume expansion or as a source of coagulation factors but autologous plasma transfusion has not been described. Methods: We investigated 35 CB preparations of preterm and term newborns for sterility and fast provision of either red blood cell concentrate (RBC) or plasma with respect to quality of both components and time needed for bacterial testing. CBs and 34 control RBCs from regular blood donors were collected in citrate-phosphate-dextrose solution (CPD). RBCs and plasma were prepared in sodium-adenine-glucose-mannitol (SAGM). Swabs were taken from the placenta for cultivation of bacteria. Quality of stored blood was assessed in RBCs on day 0, 3, 8, 14 and 42, respectively, and tests for activated coagulation were done in thawed plasma. Results: CB harvesting started within 30 minutes after umbilical cord clamping. A mean CB volume of 50.6 mL (range 19.6 mL to 90.6 mL) was collected. None of the bacteria detected in the placenta smear could be detected in the collected CBs. Mean Hct in the RBC was 53 ± 7%. Glucose, pH, ATP and 2,3-DPG decreased over time, while lactate, potassium, hematocrit and hemolysis increased. Sterility of CBs was verified within 72 hours. Prothrombin fragment 1 + 2 (F1 + 2; n = 34) was elevated (3.9 ± 2.5 nmol/L), and high levels of thrombin-antithrombin complexes (TAT) were detected also in the majority of newborns' plasma (>61 μg/L; n = 31). Discussion: Suitability of RBCs from CB must be restricted to 14 days, mainly because of a decreasing pH. Probably, by adding CPD solution at an amount appropriate for the actual volume of CB it will be possible to extend the storage time. However, retransfusion of plasma harvested from CB seems imposssible, due to the activated coagulation process.
The use of high frequency jet ventilation to treat suspected pulmonary hypoplasia
Authors: Swenson A.W. , Becker M.A. , Donn S.M. , Attar M.A.
Published: December 2019

We report two cases of term male infants with suspected pulmonary hypoplasia, who could not be managed successfully with conventional mechanical ventilation. Both responded to rescue support with high frequency jet ventilation (HFJV) using an optimal positive end expiratory pressure strategy. One infant had the oligohydramnios sequence secondary to posterior urethral valves. The second infant was diagnosed prenatally with a severe right-sided congenital diaphragmatic hernia. We summarize the literature on the use of HFJV to support infants with severe pulmonary dysfunction. Unique air flow dynamics of HFJV may enable better gas exchange with less barotrauma, less volutrauma and ventilation at lower mean airway pressure. Our experience and the available literature suggest that HFJV appears to offer a unique advantage over conventional ventilation in such infants.
Serum activin A as a predictor of intraventricular hemorrhage in preterm neonates
Authors: Wahed M.A. Abdel , Khafagy S.M. , Abdel-Al H. , El-Sayed R.F.
Published: December 2019

Background: Intraventricular hemorrhage (IVH) is the most common neurological injury in preterm infants; it is a significant cause of morbidity and mortality in these neonates. Serum activin A is a growth factor that has been shown to be expressed in the brain, among other places; it is produced by the placenta. Increased concentrations in the umbilical cord are characteristic of certain pregnancy disorders. Objective: To evaluate the use of serum activin A concentration, measured on the first day of life, as a predictor for the development of intraventricular hemorrhage in preterm neonates. Methods: This study was conducted on 44 preterm infants with gestational ages less than 34 weeks. A transcranial ultrasound was performed for each preterm within the first 48 hours and at one week of life. Neonates who developed IVH were considered the case group and those who did not develop IVH were considered the control group. Serum activin A (μg/L) was assessed for all preterm infants within the first 24 hours of life. Results: Cases had greater serum activin A concentration (median = 2.8, I.Q = 2.55–3.57) compared to control group (median = 0.8, I.Q = 0.5–1.27) (p < 0.001). There was a positive correlation between serum activin A concentration and IVH grading (r = 0.08, p < 0.001). There was no significant correlation between serum activin A concentration and gestational age or birth weight. Serum activin A cutoff value 2 μg/L could differentiate preterm with IVH from preterm without IVH. Conclusion: Serum activin A concentration could be a useful predictor for intraventricular hemorrhage in preterm infants.
Case presentation: Tuberculosis in a newborn infant
Authors: Phattraprayoon N. , Tam B. , Pavlova Z. , Ramanathan R. , Paquette L.
Published: December 2019

We present a case of a neonate born in the United States who developed hypoxemic respiratory failure, significant hepatomegaly, pancytopenia, and conjugated hyperbilirubinemia. It was suspected that she had hemophagocytic lymphohistiocytosis (HLH). However, she had disseminated tuberculosis. It is imperative that tuberculosis is considered in the differential diagnosis of neonatal respiratory failure, abnormal blood cell counts, elevated bilirubin, and/or hepatomegaly of unknown etiology.
Smoking cessation counseling and pneumococcal vaccine administration to parents of infants admitted to neonatal intensive care unit: A life-changing opportunity
Authors: Shah S.
Published: December 2019

Second-hand smoke exposure is a significant health risk to newborn infants, particularly preterm infants with underlying respiratory disorders. Smoking cessation counseling during all phases of pregnancy and 23-valent pneumococcal polysaccharide vaccine (PPSV23) administration to adult smokers is advocated by multiple healthcare organizations but faces barriers to implementation. The neonatal intensive care unit is an ideal arena for providing smoking cessation counseling to parents because advice from pediatric caregivers is well received. High parental immunization rates for PPSV23 may also be achieved with NICU-bedside vaccination.
Amino acid profiles and serial blood urea nitrogen levels in infants less than 1250 g receiving early parenteral nutrition
Authors: Gravari E. , Radmacher P.G. , Adamkin D.H. , Myers S.R.
Published: December 2019

Objective: To analyze amino acid profiles and serial blood urea nitrogen values (BUN) in infants <1250 g receiving early amino acid infusion within hours of birth and compare them to previously published values. Design/methods: A retrospective study was conducted on infants <1250 g admitted to the NICU between July 2009 to July 2010. Plasma amino acid (AA) profiles were analyzed by high-performance liquid chromatography and values were compared to previously established reference values. Demographic data, treatment with indomethacin or neoprofen and laboratory results were also collected. Results: A total of 40 neonates were studied. Thirty infants had a single plasma sample and 10 infants were followed with serial samples. AA profiles were consistent with previously published reference values. Serial samples showed little change over 3 days of infusion. Increased BUN did not correlate with abnormal AA profiles or concentration of AA infused in the infants studied. Conclusions: AA profiles on infants <1250 g on exclusive total parenteral nutrition on DOL1-3 demonstrated no evidence of hyperaminoacidemia with the exception of asparagines, threonine and lysine that were below reference levels. A small subset of infants with elevated BUN, demonstrated similar aminograms to those with lower BUN value even when being treated for a symptomatic PDA. Early TPN appears to be well tolerated by extremely preterm infants.
Apgar score of zero at one minute: Perinatal factors and early neonatal outcomes
Authors: Madi J.M. , Cachafeiro R.H. , de Araújo B.F. , Rombaldi R.L. , Madi S.R.C. , Zatti H. , Viecceli C. , Barazzetti D.O. , Pavan G.
Published: December 2019

Aims: To assess the perinatal results of newborns with a zero Apgar score at the first minute of life. Methods: Case-control study conducted over a period of 10 years. We assessed maternal, fetal, and neonatal variables. Data were analyzed using SPSS 19.0. Results: Of the 15,616 births occurring during the study period, 29 (0.2%) had a zero Apgar score at the first minute of life (Group I). A control group comprised three newborns with Apgar scores greater than zero for each case (Group II). Comparing cases (Group I) and controls (Group II) showed a higher rate of cesarean deliveries (69% vs. 46.7%; p < 0.05), younger gestational age (34.8 ± 5.5 years vs. 38.5 ± 2.5 years; p < 0.0001), higher incidence of hemorrhagic amniotic fluid (27.6% vs. 17.2%; p < 0.0001), lower fetal weight (2,307 ± 958 g vs. 3,069 ± 609 g; p < 0.0001), lower fifth-minute Apgar score (2.5 ± 2.0 vs. 8.9 ± 0.7; p < 0.0001), lower pH of the umbilical artery (7.01 ± 0.21 vs. 7.21 ± 0.08; p < 0.0001), need for neonatal intensive care unit (100% vs. 20.7%; p < 0.0001), and early neonatal mortality rate (n = 12, 41.4% vs. n = 0). Conclusion: The perinatal assessment of newborns with zero Apgar score in the first minute of life showed a higher rate of operative deliveries and preterm fetuses with low birth weight than in control infants. The higher need for neonatal intensive care therapy is associated with more significant fetal acidosis and apparent death.
The value of blood eosinophils count in infants with feeding intolerance in the neonatal intensive care setting
Authors: Lutfi S.A. , Mahmah M.A. , AlBuraki W. , Salama H. , Rahman S.U.
Published: December 2019

Objectives: We aimed to assess the relationship between feeding intolerance or necrotizing enterocolitis (NEC), and neonatal blood eosinophilc counts >700 cells/mm3 (eosinophilia) in the first 28 days of life. Methods: In this prospective observational cohort study, the highest and the average absolute eosinophil counts were recorded for each infant. Date of onset at first enteral feed, type of milk, time taken to reach full oral feeding, and incidence of feeding intolerance were also noted. Results: A total of 486 infants admitted to the neonatal intensive care unit with 1171 complete blood cell count samples drawn were observed. Eosinophilia (count >700/mm3) was noted in 106 infants (22%). When compared to infants without eosinophilia (n = 380) infants with eosinophilia had significantly younger gestational age. Fourteen percent of infants with eosinophilia compared with 6% of the controls developed feeding intolerance (OR 2.86, 95% CL 1.40–5.68). Moreover, infants with eosinophilia were less likely to achieve full feeds in one week (OR 0.48, 95% CL 0.30–0.76) or two weeks (OR 0.37, 95% CL 0.21–0.65) as compared to their controls respectively. However, after gestational age adjustment only exclusive formula feeding was found to have a significant association with eosinophilia (OR 1.76, 95% CL 1.07–2.89). Of other secondary factors evaluated only antenatal antibiotics (OR 2.29, 95% CL 1.23–4.25) and total parenteral nutrition (TPN) (OR 2.99, 95% CL 1.32–6.77) continued to maintain statistical significance after gestational age adjustment. Conclusions: Eosinophilia is more likely in infants who are premature, receiving TPN, exclusively formula-fed, and whose mothers received antenatal antibiotics. Eosinophilia does not independently correlate with either feeding intolerance or NEC.
Perinatal dengue infection: Two new cases
Authors: Shah S.S. , Bhide P. , Mankare P.
Published: December 2019

Dengue infection is commonly observed in tropical countries, but its transmission from mother to baby has not been frequently described. We report two cases with neonatal dengue infection due to perinatal transmission. The first signs of dengue appeared on day 4 of life in both the infants. Initially a bacterial infection was suspected. Clinical diagnosis of dengue fever was confirmed by appropriate laboratory testing. In areas where dengue is endemic, the diagnosis of dengue should be considered in a neonate with signs of sepsis. When dengue is suspected in a parturient woman, laboratory investigation and extended observation of the newborn are advised.
Plastic bronchitis: An unusual cause of airway obstruction in the neonatal intensive care unit
Authors: Abdelhamid A.E.
Published: December 2019

Plastic bronchitis (PB) is a rare condition known to be associated with many pulmonary, cardiac, and systemic diseases. It is characterized by the formation and expectoration of peculiar long branching casts of the bronchial tree with rubber-like consistency causing airway obstruction. PB does not present as early as the neonatal or immediate post-neonatal period [1]. However, the condition is probably underestimated, as the casts with their specific ramifications are sometimes difficult to recognize. PB has been increasingly reported in relation to some cardiosurgical procedures, notably those bypassing the right ventricle via connecting the systemic venous vessels to the pulmonary artery (e.g., Fontan and Glenn) [2]. Being mainly composed of laminated mucin, little fibrin, but usually no inflammatory cells, the bronchial casts associated with cardiosurgical procedures are classified as type-II (acellular) casts, while type-I (inflammatory) casts, mostly made of fibrin, a small amount of mucin and dense eosinophilic infiltrate, usually complicate pulmonary disorders [3]. Although inflammatory mechanisms have not been considered for cases of congenital heart disease, small numbers of infiltrating cells, including eosinophils usually exist in the casts. We report on a preterm baby with pulmonary atresia and intact interventricular septum, that was not detected antenatally, who presented with cyanosis after iatrogenic induction of duct closure by a non-steroidal anti-inflammatory drug, ibuprofen. Prostaglandin E1 infusion commences to reverse duct closure and keep its patency. A series of cardiosurgical procedures undertaken to improve oxygenation were complicated by an unusual cause of airway obstruction, PB with inflammatory cellular-type casts.
Factors associated with survival of <27 week infants in an all-referral neonatal intensive care unit
Authors: Moorehead P.A. , Martin E.M. , Shepherd E.G. , Parikh N.A. , Reagan P.B. , Gardner W. , Yeates K.O. , Nelin L.D.
Published: December 2019

Objective: Transport of infants born at the threshold of viability (<27 weeks) may negatively impact outcomes. Our neonatal intensive care unit (NICU) is an all-referral unit, and therefore all patients have been transported. This study examined survival rates and the factors that influenced survival in this specific population of extremely premature infants. Study design: The study setting was at an all-referral tertiary care NICU within a children's hospital. Data were collected from December 2004 to August 2008, and included 227 patients. Results: Overall, the survival-to-discharge rate for these infants was 78%. The primary causes of death were sepsis (41%), necrotizing enterocolitis (NEC) (27%), respiratory failure (18%), and severe intraventricular hemorrhage (IVH) (10%). By logistic discrete time hazard analyses, patients receiving dopamine (p < 0.01) or insulin (p < 0.01), with NEC (p < 0.05), or of gestational age 22, 23 or 24 weeks (p < 0.01) were more likely to die; while those born in the same county as the NICU (p < 0.01), receiving patent ductus arteriosis (PDA) treatment (p < 0.01) or peripheral intravenous central catheters (p < 0.01) were more likely to survive. Within the group of survivors the rate of cerebral palsy was 9% and the mean scores on the Bayley-III at 18 months corrected age were 95 ± 13, 90 ± 15, and 92 ± 14 in the cognitive, communication, and motor scales respectively. Conclusion: Infection, NEC, and respiratory failure were the primary causes of death among extremely premature infants in an all-referral NICU. New approaches to preventing infection, NEC, and bronchopulmonary dysplasia are needed for this population.
Increased N-terminal pro-brain type natriuretic peptide secretion in infants of diabetic mothers
Authors: El-Ganzoury M.M. , El-Farrash R.A. , Ahmed H.A. , Mohamed R.A.
Published: December 2019

Background: Diabetes is recognized as a particular threat to pregnant women and their neonates. B-type natriuretic peptide (BNP) and N-terminal-proBNP play an important role in the regulation of extracellular fluid volume and blood pressure. BNP inhibits myocardial fibrosis and hypertrophy. Aim: To test the hypothesis that cord blood NT-proBNP would be increased in infants of diabetic mothers (IDMs) and linking its concentration to the degree of maternal glycemic control. Subjects and methods: This case control study was conducted on 85 full term neonates born at the Obstetrics and Gynecology department at Ain-Shams University Hospitals. The studied neonates were classified into 3 groups; Group I (n = 30) included IDMs with good maternal glycemic control (HbA1c <6%), group II (n = 25) included IDMs with suboptimal maternal glycemic control (HbA1c ≥6%) and healthy control group (n = 30). The included mothers/infants dyads were subjected to detailed history taking, thorough clinical examination and laboratory investigations which included maternal HbA1c and cord blood NT-proBNP. Results: Cord blood NT-proBNP levels were higher in IDMs with suboptimal maternal glycemic control than those born to healthy mothers, while NT-proBNP levels were comparable between neonates with good maternal glycemic control and healthy controls. NT-proBNP levels were higher in IDMs with suboptimal maternal glycemic control than those born to mothers with good glycemic control. NT-proBNP showed significant correlations with maternal HbA1c and one minute Apgar score. Conclusions: Neonatal NT-BNP concentrations are related to maternal glycemic control and perinatal hypoxia. In infants born to mothers with suboptimally controlled diabetes, NT-proBNP increases.
Is ethnicity a risk factor for maternal complications in operative vaginal delivery?
Authors: Gimovsky A.C. , Macri C.J. , Bathgate S. , Mohamed M.A. , Larsen Jr J.W.
Published: December 2019

Objective: To evaluate ethnic-based differences in maternal complications following operative vaginal deliveries. Study design: Retrospective, case-controlled analysis of obstetric deliveries over a fourteen year period in a single urban hospital, enrolled in a computerized database. Results: Of 18285 deliveries, 8948 (49.0%) occurred in non-Hispanic (WNH) women, and 7611 (41.6%) occurred in non-Hispanic (BNH) women. Operative vaginal deliveries included vacuum, outlet forceps, low forceps and mid-forceps. Maternal outcomes included incidence of third and fourth degree lacerations and calculated blood loss. The WNH population had 1349 (15%) operative vaginal deliveries and 277 (20.5%) had third and fourth degree lacerations, while in the BNH population there were 807 (10.6%) operative vaginal deliveries and 114 (14%) third and fourth degree lacerations (p ≤ 0.001). In the WNH group, calculated blood loss in operative vaginal deliveries was 1057 ml for midforceps and 907 ml for low forceps deliveries; the BNH group had 828 ml blood loss in midforceps and 660cc in low forceps group (p < 0.001 for midforceps and p < 0.001 for low forceps). Conclusion: WNH women had more operative vaginal deliveries, maternal morbidity, third and fourth degree lacerations and greater blood loss compared to the BNH women.
Recovery of injured cingulum in a patient with brain injury: Diffusion tensor tractography study
Authors: Seo Jeong Pyo , Jang Sung Ho
Published: December 2019

Objectives:

Little is known about neural recovery of an injured cingulum following brain injury. We report on a patient with brain injury who showed apparent neural recovery of an injured cingulum on follow up diffusion tensor tractography (DTT).

Methods:

A 53-year-old female patient had suffered hypoxic ischemic brain injury for a period of approximately nine hours following spontaneous subarachnoid hemorrhage and intraventricular hemorrhage, and underwent coiling of a left ruptured aneurysm of the posterior communicating artery. She showed severe cognitive impairment, so that she could not be evaluated on the Mini-Mental State Examination, however, her cognition showed improvement to 21 at five months after onset and 24 at 14 months after onset on the Mini-Mental State Examination.

Results:

On seven-day DTT for the fornix in the patient, we observed a discontinuation in the left crus and thinning of the right crus. However, on 14-month DTT, the thinned right fornical crus had disappeared. Regarding the cingulum, on seven-day DTTs, discontinuations of both cingulums anterior to the genu of the corpus callosum were observed. However, on 14-month follow up DTT, the right cingulum was elongated to the right basal forebrain and no change in the discontinuation of the left cingulum was observed.

Conclusions:

These changes observed on DTT in both cingulums appeared to indicate recovery of the injured cingulum in this patient. The results of this study may suggest a mechanism for recovery of injured cingulum following brain injury.
Cardiac autonomic status is associated with spasticity in post-stroke patients
Authors: Hung Chi-Yao , Tseng Sung-Hui , Chen Shih-Ching , Chiu Hou-Chang , Lai Chien-Hung , Kang Jiunn-Horng
Published: December 2019

Background:

Whether post-stroke spasticity is associated with autonomic status is unclear. The purpose of our study was to determine whether spasticity in post-stroke patients is associated with heart rate variability (HRV), an indicator of sympathetic and parasympathetic regulation.

Objective:

To determine whether HRV is associated with spasticity in post-stroke patients.

Methods:

Our cross-sectional observational study included 21 post-stroke patients with varying degrees of knee spasticity. We measured patients' heart rate variability (HRV) during the morning and afternoon of the same day using the modified Ashworth assessment and the pendulum test. The relationship between HRV and the spasticity parameters was evaluated based on the Pearson correlation coefficient (r).

Results:

The data for the morning measurements showed that the relaxation index negatively correlated with the high frequency (HF) power of HRV (r = −0.47, P < 0.05), and positively correlated with the low frequency (LF) power of HRV (r = 0.47, P < 0.05) and the LF/HF power ratio (r = 0.55, P < 0.05). Similar correlations were observed between the diurnal differences of HRV and the relaxation index. No correlation was observed among the data for the afternoon measurements.

Conclusions:

Higher parasympathetic tone and lower sympathetic tone are associated with a higher degree of knee spasticity in post-stroke patients. Further studies are warranted to confirm our findings and investigate the pathological mechanisms involved.
Language outcomes following neurosurgery for brain tumours: A systematic review
Authors: Finch Emma , Copland David A.
Published: December 2019

Background:

Language function is susceptible to the effects of brain tumours during both the tumour growth phase and during neurosurgical resection.

Aim:

This paper aimed to systematically review existing literature to determine the current status of knowledge about language outcomes following neurosurgery.

Methods:

A systematic review was conducted involving a detailed literature search using online databases, quality assessment of relevant articles and data extraction.

Results:

Of the 1449 articles retrieved, nine articles satisfied the study criteria. Overall, these studies reported variable patterns of language function post-surgery, however, there was a trend towards an early post-surgical decline in language function that greatly improved by 3 months. The likelihood of developing post-surgical communication impairments was influenced by a number of factors including pre-operative aphasia and the identification of sub-cortical language tracts inside the tumour margin, however, further research is required to fully elucidate pertinent predictors.

Conclusion:

These findings have implications for rehabilitation programs following brain tumour surgery and suggest that there are a number of key gaps warranting further investigation.
Improvement in strength following resistance training in MS patients despite varied disability levels
Authors: Filipi Mary L. , Kucera Daryl L. , Filipi Eric O. , Ridpath Alanson C. , Leuschen M. Patricia
Published: December 2019

Strength and endurance data from 67 participants with multiple sclerosis (MS) were compared before, during and after a 6-month program of standardized resistance training. The hypothesis was that a standardized, structured resistance training exercise program improves strength in MS patients with different levels of disability. The range of EDSS scores was 1–8: (40% – EDSS of 1–4.5), (35% – EDSS of 5–7) (25% – EDSS of 7.5 or higher). This unique study evaluated patients with differing levels of disability for a change in strength and endurance following a 6-month training program. Data were analyzed by repeat measures and analysis of variables using Proc GLM in SAS to account for variability between subjects, and within subjects, due to repeated measures at 3 time points. Each treatment was blocked by disability class. Every within-treatment analysis was significant. Each exercise showed significant improvement in strength for participants, despite disability levels. Increases in strength followed parallel improvement pathways, at all disability levels. All but one treatment displayed highly significant improvement (p-value < 0.0001). The results demonstrated that all individuals with MS, despite disability levels, show parallel improvement in strength and endurance. This study supports the use of exercise, including resistance programs, for all MS patients.
Neural connection between injured cingulum and pedunculopontine nucleus in a patient with traumatic brain injury
Authors: Yeo Sang Seok , Chang Min Cheol , Kim Seong Ho , Son Su Min , Jang Sung Ho
Published: December 2019

We report on a patient with traumatic brain injury who showed neural connection between injured cingulum and pedunculopontine nucleus on diffusion tensor tractography (DTT). A 74-year-old male who had suffered a traffic accident underwent conservative management for subarachnoid haemorrhage. Brain MRI which was performed 6 months after onset showed no specific lesions. On 6-month DTTs for cingulum of the patient, we observed discontinuations of both cingulums above the genu of corpus callosum. However, the left cingulum was connected to the left PPN via a neural tract that passed through the anterior corona radiata and thalamus. The neural connection between the injured cingulum and PPN seems to be a compensatory phenomenon for the destruction of cholinergic pathways from basal forebrain. We believe that this result might suggest one of recovery mechanisms of injured cingulum following brain injury.
The impact of RF technologies and EPC standard on the fresh vegetables supply chain
Authors: Mainetti Luca , Mele Francesca , Patrono Luigi , Simone Francesco , Stefanizzi Maria Laura , Vergallo Roberto
Published: December 2019

This paper evaluates the impact of the EPCglobal international standard and some emerging Radio Frequency (RF) technologies, such as Radio Frequency IDentification (RFID) and Near Field Communication (NFC), on the main processes of the fresh vegetables supply chain. Particular attention was focused on the first steps of the supply chain, which include cultivation in greenhouses and manufacturing of packaged vegetables, known as IV gamma products (i.e., goods ready to be consumed), because they represent crucial points of the considered supply chain. A qualitative and quantitative analysis of the current business processes was performed exploiting the experience of a big Italian company, with several locations and different brands. This analysis highlighted some critical aspects in the management of the whole supply chain, from the land to the table of the end-consumer, and allowed us to perform an efficient re-engineering of the main business processes. The re-engineered model was designed by exploiting the potentialities derived from the combined use of innovative technologies, including EPCglobal, RFID, NFC, and DataMatrix. Moreover, this work has led to the definition of important guidelines able to substantially improve both the culture techniques and the vegetables transformation procedures, based on strategic concepts such as precision agriculture, item-level traceability, and integration of heterogeneous Information Systems (IS). The proposed tracing and tracking system, based on EPCglobal standard, is able to guarantee to end-consumer the ability to know the entire history of the purchased product. Moreover, in order to evaluate the potential benefits of the re-engineered processes in a real supply chain, some metrics able to compare the current (AS IS) and reengineered (TO BE) models were considered. In particular, the Key Performance Indicator (KPI) method has been chosen to carry out this analysis on the pilot project implemented in the chosen company. Experimental results allowed us to derive a realistic estimate of the selected performance indicators for the re-engineered model.
Item-level RFID in retailing: What can B&M retailers learn from online retailers?
Authors: Bureau Sylvain , Zhou Wei , Piramuthu Selwyn
Published: December 2019

When online retailing became prevalent more than a decade ago, there was a natural tendency for these retailers to mimic as many essential characteristics of the B&M (Brick & Mortar) retail stores as possible to facilitate smooth transfer of customer experience from B&M to the online shopping environment. Online stores have evolved over the years and have diverged enough from their B&M counterparts to lay claim to their own idiosyncratic characteristics. Given that enough online retailers have been successful, it may now be the B&M retailers' turn to learn from their online counterparts. With finer-granular experience from several decades of customer online retail store shopping behavior and the fact that B&M stores are here to stay at least for the very near future, B&M retailers stand to benefit from transfer of appropriate knowledge from online stores. We provide an overview of this dynamic with the availability of RFID-generated item-level information in B&M stores.
An experimental analysis of packet reception rate in RFID localization network
Authors: Li Junhuai , Jia Jinpeng , Liu Hailing , Yu Lei , Wang Zhixiao
Published: December 2019

Indoor localization systems based on received signal strength indication (RSSI) techniques are usually used in office buildings. However, RSSI is susceptible to environmental influences, which may make localization performances unstable. Packet reception rate (PRR) is a good indicator which can reflect the changes in signal intensity with distance changing. This paper establishes a relationship between PRR and RSSI according to the classic radio propagation model in localization field, and theoretically analyzes the normal probability distribution of PRR. Based on communication experiments between Radio Frequency Identification (RFID) readers and tags, this paper discusses how PRR changes with respect to power and distances. Moreover, the distribution of received packets (RP) is described by performing curve fitting on frequency histogram. Its normality and other parameters (e.g. expectation, variation, kurtosis, and skewness) are also analyzed. The results show that this model is valid and proper for the description of relationship between PRR and RSSI. This research provides a novel perspective and theoretical support for the further study and application of RFID indoor localization.
System design by simulation – A case study for sensor tags embedded in tyres
Authors: Deicke Frank , Grätz Hagen , Fischer Wolf-Joachim
Published: December 2019

The implementation of ID functions and sensors in a tyre has been discussed intensively for some time past. Such an intelligent tyre is necessary to identify the manufacturer and the type of the tyre. Additionally, physical parameters of the tyre can be measured during use to warn the driver against possible damages or to test different tyres in a lab. The RFID technique is one possibility to realise such an application. During system design, there is a big challenge to answer at least two important questions. The first one is if the system would work with the selected antenna shapes, sizes and positions. And the second one is, which antenna design is more advantageous than others depending on power consumption of the tag, rim shape, size and material as well as using a steel cord in the tyre or not. Answering those questions in a correct way, within an appropriate amount of time and without doing a lot of prototyping is very difficult, because there are relations between electrical and electromagnetic models that must be considered carefully. This paper will focus on these challenges. It will show a way to analyse an inductively coupled transponder system that can be used for such an application. And it presents an approach for modelling and analysing the transmission channel as well as the electrical system behaviour including the influence of a metal rim and the steel cord. Additionally, a discussion is done concerning business value of such a design flow considering different RFID applications with other application specific requirements but finally the some challenges on system design.
Correlating distributed RFID-based event data for logistics process monitoring
Authors: Werner Kerstin , Schill Alexander , Scheibe Jan
Published: December 2019

Decreasing sizes and a static decline in production costs are fostering the use of RFID tags and sensors in cross-company logistics networks. The EPCIS specification comprises interface standards for capturing and querying RFID based event data and its exchange in a standardized data format. Additionally, modern technologies for event processing enable novel event based applications whose potentials have not been precisely examined in this context so far. Our contribution covers this issue by exploring the utilization of the given technologies for the monitoring of complex inter-organizational logistics processes. The monitoring should detect contract violations, product shrinkage and counterfeiting. We introduce requirements for the monitoring of individual quality objectives and process constraints using distributed event data. In consideration of these, we propose a monitoring system architecture and argue that it can nearly seamlessly be integrated into existing EPCglobal compliant RFID infrastructures. Furthermore, we estimate the value of event processing technologies in addressing the given requirements and identify challenges in application design.
RFID technology for an intelligent public transport network management
Authors: Gnoni Maria Grazia , Elia Valerio , Rollo Alessandra
Published: December 2019

The concept of ubiquitous computing is widespread in several fields; mobility of persons and goods currently represents an interesting field of application of these ideas. One promising technology is the Radio Frequency Identification (RFID) technology: its application is quite well applied in logistics activities. Few applications are developed for urban mobility, where RFID technology could support an effective tracing system of both vehicles and persons in Public Transport Networks (PTNs). Tools applied for currently managing PTNs are not integrated as several different applications have been developed. The present paper proposes a research project aiming to define an Integrated Mobility Platform (IMP) based on intensive application of RFID as an enabling technology: the IMP applies RFID for tracing people and vehicles in the whole life cycle characterizing an intermodal PTN. A pilot project has been developed in order to validate the proposed IMP.
Analysis of the requirements of RFID tags for efficient fashion supply chain management
Authors: Bertolini Massimo , Bottani Eleonora , Ferretti Gino , Montanari Roberto , Volpi Andrea
Published: December 2019

This paper investigates the requirements of RFID solutions that should be used in the fashion industry supply chain. Specifically, this study attempts to fill the gap between the technical features of commercial RFID solutions currently available on the market and the characteristics required to RFID technology for its successful application in the fashion context. The analysis is grounded on two primary sources of information. First, 5 RFID technical providers are examined with the purpose of identifying the available RFID solutions designed for application in the fashion industry, and to assess their performance. Second, 6 end-users of RFID technology, operating as distributors or manufacturers of fashion items, were asked to provide their opinions related to the technical features of RFID tags required for their successful application in the fashion industry supply chain. By comparing the findings obtained from those sources of data, it is found that RFID solutions currently available do not fully meet the requirements expressed by the fashion end-users; hence, the successful design of RFID tags for the fashion supply chain requires further efforts, and a close collaboration between end-users and technical solutions developers. Results of this study provide an exhaustive overview of the commercial RFID solutions designed for the fashion industry; moreover, our findings can be used as guidelines by practitioners, for the design of more efficient RFID solutions.
The role of the internet of things in enabling sustainable agriculture in Europe
Authors: Kidd P.T.
Published: December 2019

Considered is the application of the Internet of Things (IoT) as an enabler for sustainable agriculture. Rather than using the IoT in support of precision agriculture, which it is argued is a technology of the past that grew out of a system of industrial scale intensive agriculture, it is proposed that the IoT in agriculture should be used to better understand and support the management of biodiversity, as well as the management of other natural resources such as water used for irrigation. In this context, things are defined by zones, fields, farms, landscapes, and key parameters within these things. Through Internet enabled systems, a platform could be built for managing farm activities within the context of preserving and enhancing biodiversity (which is severely threatened by industrial scale intensive agriculture) as well as reducing water use. Such an IoT application will provide the basis for future sustainable intensification of agriculture to meet the projected growth in the demand for food, but in a way that respects natural constraints, and which delivers system-level benefits in terms of biodiversity at different levels (field, farm, and landscape). Such a system could also enable land-use management which could facilitate decisions to be made about where to intensify production and where to de-intensify, as it would provide data with extended timescales appropriate to that of ecological systems. Such data could be used in the medium to long term to establish exactly what effect agricultural practices and technologies are having upon factors such as biodiversity, helping to identify complex interrelationships. Such a system would then provide a basis to support farmers in adjusting their agronomy practices to satisfy local biodiversity requirements and natural resource limitations.