scholarly journals Neonatal Hypoglycaemia: A Never-Ending Story?

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Nestor E. Vain ◽  
Florencia Chiarelli
Keyword(s):  
At Risk ◽  
Neonatal Period ◽  
Newborn Infants ◽  
Neonatal Hypoglycaemia ◽  
Rational Decision Making ◽  
Weak Evidence ◽  
Universal Approach ◽  
Definition Of ◽  
Therapeutic Alternatives ◽  
Current Guidelines

Neonatal hypoglycaemia is a common metabolic disorder presenting in the first days of life and one potentially preventable cause of brain injury. However, a universal approach to diagnosis and management is still lacking. The rapid decrease in blood glucose (BG) after birth triggers homeostatic mechanisms. Most episodes of hypoglycaemia are asymptomatic, and symptoms, when they occur, are nonspecific. Therefore, neonatologists are presented with the challenge of identifying infants at risk who might benefit from a rapid and effective therapy while sparing others unnecessary sampling and overtreatment. There is much controversy regarding the definition of hypoglycaemia, and one level does not fit all infants since postnatal age and clinical situations trigger different accepted thresholds for therapy. The concentration and duration of BG which cause neurological damage are unclear. Recognizing which newborn infants are at risk of hypoglycaemia and establishing protocols for treatment are essential to avoid possible deleterious effects on neurodevelopment. Early breastfeeding may reduce the risk of hypoglycaemia, but in some cases, the amount of breast milk available immediately after birth is insufficient or non-existent. In these situations, other therapeutic alternatives such as oral dextrose gel may lower the risk for NICU admissions. Current guidelines continue to be based on expert opinion and weak evidence. However, malpractice litigation related to neurodevelopmental disorders is frequent in children who suffered hypoglycaemia in the neonatal period even if they had other important factors contributing to the poor outcome. This review is aimed to help the practicing paediatricians and neonatologists to comprehend neonatal hypoglycaemia from physiology to therapy, hoping it will result in a rational decision-making process in an area not sufficiently supported by evidence.

THE CONCEPT OF CONSTITUTIONAL AND LEGAL GUARANTEES OF ELECTORAL RIGHTS

2020 ◽  
Vol 10 (4) ◽  
pp. 85-90
Author(s):  
VLADIMIR TROYAN ◽  
Keyword(s):  
Scientific Research ◽  
Formal Aspect ◽  
Universal Approach ◽  
Right To Vote ◽  
Definition Of ◽  
The Right

The relevance of the interpretation of constitutional and legal guarantees of the right to vote is mediated by isolated scientific research in this area, as well as the lack of a universal approach to legal guarantees. In this regard, the purpose of the article is to argue and disclose the author’s definitive aspect of the claimed guarantees. In the work, the author named and characterized the normative (based exclusively on legal means) with the perspective of a branch of legal and technical; regulatory and institutional (combines the formal aspect with the activities of authorized entities) and associated legal (including a set of legal and other aspects) approaches to the definition of legal guarantees. Based on the second approach, as well as combining the guarantees of the right to vote directly guarantees of the subjective right itself and guarantees of its implementation, the author offers a definition of constitutional and legal guarantees of the right to vote.

scholarly journals Definitions and Concepts for Quantitative Rockfall Hazard and Risk Analysis

Geosciences ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 158
Author(s):  
Didier Hantz ◽  
Jordi Corominas ◽  
Giovanni B. Crosta ◽  
Michel Jaboyedoff
Keyword(s):  
Risk Assessment ◽  
At Risk ◽  
Failure Probability ◽  
Rockfall Hazard ◽  
Process Failure ◽  
Failure Propagation ◽  
Element At Risk ◽  
Hazard And Risk ◽  
Hazard And Risk Assessment ◽  
Definition Of

There is an increasing need for quantitative rockfall hazard and risk assessment that requires a precise definition of the terms and concepts used for this particular type of landslide. This paper suggests using terms that appear to be the most logic and explicit as possible and describes methods to derive some of the main hazards and risk descriptors. The terms and concepts presented concern the rockfall process (failure, propagation, fragmentation, modelling) and the hazard and risk descriptors, distinguishing the cases of localized and diffuse hazards. For a localized hazard, the failure probability of the considered rock compartment in a given period of time has to be assessed, and the probability for a given element at risk to be impacted with a given energy must be derived combining the failure probability, the reach probability, and the exposure of the element. For a diffuse hazard that is characterized by a failure frequency, the number of rockfalls reaching the element at risk per unit of time and with a given energy (passage frequency) can be derived. This frequency is relevant for risk assessment when the element at risk can be damaged several times. If it is not replaced, the probability that it is impacted by at least one rockfall is more relevant.

scholarly journals Towards approval of autonomous ship systems by their operational envelope

2021 ◽  
Author(s):  
Ørnulf Jan Rødseth ◽  
Lars Andreas Lien Wennersberg ◽  
Håvard Nordahl
Keyword(s):  
Geographic Area ◽  
System Modelling ◽  
Modelling Language ◽  
Human Control ◽  
Operational Design ◽  
Autonomous Ship ◽  
Definition Of ◽  
Operational Envelope ◽  
Concrete Operations ◽  
Current Guidelines

AbstractCurrent guidelines for approval of autonomous ship systems are focused on the ships’ concrete operations and their geographic area. This is a natural consequence of the link between geography and the navigational complexity, but moving the ship to a new area or changing owners may require a costly re-approval. The automotive industry has introduced the Operational Design Domain (ODD) that can be used as a basis for approval. However, the ODD does not include the human control responsibilities, while most autonomous ship systems are expected to be dependent on sharing control responsibilities between humans and automation. We propose the definition of an operational envelope for autonomous ship systems that include the sharing of responsibilities between human and automation, and that is general enough to allow approval of autonomous ship systems in all geographic areas and operations that falls within the envelope. We also show how the operational envelope can be defined using a system modelling language, such as the unified modelling language (UML).

Salivary Immunoglobulins: Absence of γA in Saliva Following Exchange Transfusions in Neonatal Period

PEDIATRICS ◽  
1967 ◽  
Vol 40 (3) ◽  
pp. 452-454
Author(s):  
JOHN C. SELNER ◽  
DEBORAH A. MERRILL ◽  
HENRY N. CLAMAN
Keyword(s):  
Neonatal Period ◽  
Newborn Infants ◽  
Newborn Period ◽  
Data Support ◽  
Serial Samples

The possible transport of serum γA into saliva was studied in the newborn period. Five infants with erythroblastosis fetalis and undetectable γA in serum or saliva had two-volume exchange transfusions. Serum γA rose to "adult" levels after transfusion, but no detectable γA appeared in serial samples of saliva, as measured by electroimmunodiffusion (EID). The data support the thesis that salivary γA is not transported from the serum and tends to confirm the findings of Haworth and Dilling who previously described the absence of salivary γA following exchange transfusions in newborn infants.

ACTIVITY OF GLUTAMIC-OXALOACETIC TRANSAMINASE IN THE SERUM IN THE NEONATAL PERIOD

PEDIATRICS ◽  
1957 ◽  
Vol 20 (4) ◽  
pp. 584-589
Author(s):  
Simon Kove ◽  
Stanley Goldstein ◽  
Felix Wróblewski
Keyword(s):  
Neonatal Period ◽  
Newborn Infants ◽  
Normal Range ◽  
Glutamic Oxaloacetic Transaminase ◽  
Newborn Period ◽  
Method Of Determination ◽  
Normal Term ◽  
Pathologic State ◽  
Normal Adults

The activity of glutamic oxaloacetic transaminase (GOT) in the serum was determined by the spectrophotometric method in 63 normal term newborn infants, varying from birth to 11 days of age. The normal range of activity in the newborn period varied from 13 to 105 units (with the exception of one infant in whom the level was 160 units). This is a considerably wider range than that of 5 to 45 units found in normal adults. Allowing for an error of about ±10% inherent in the method of determination of GOT, activity as great as approximately 120 units, which in adults would be indicative of some pathologic state, must be considered physiologic in the newborn infant. The activity of GOT was not related to the age of the infant within the neonatal period studied, and varied widely in different infants for each day of age, without any distinctive pattern. Variations of the activity of GOT in specimens of cord blood studied ranged below 59 units, which was lower than for any other day of the neonatal period adequately investigated. No infants were studied repeatedly. No relation was found between the concentration of bilirubin and the activity of GOT in the serum.

scholarly journals Low Body Mass Index Can Identify Majority of Osteoporotic Inflammatory Bowel Disease Patients Missed by Current Guidelines

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Ashish Atreja ◽  
Ashish Aggarwal ◽  
Angelo A. Licata ◽  
Bret A. Lashner
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
At Risk ◽  
Risk Factor ◽  
Risk Group ◽  
Low Bmi ◽  
Inflammatory Bowel ◽  
Provider Adherence ◽  
Not At Risk ◽  
Current Guidelines

Background. Patients with inflammatory bowel disease (IBD) are at high risk of developing osteoporosis. Our objective was to determine the usefulness of IBD guidelines in identifying patients at risk for developing osteoporosis.Methods. We utilized institutional repository to identify patients seen in IBD center and extracted data on demographics, disease history, conventional, and nonconventional risk factors for osteoporosis and Dual Energy X-ray Absorptiometry (DXA) findings.Results. 59% of patients (1004/1703) in our IBD cohort had at least one risk factor for osteoporosis screening. DXA was documented in 263 patients with indication of screening (provider adherence, 26.2%), and of these, 196 patients had DXA completed (“at-risk” group). Ninety-five patients not meeting guidelines-based risk factors also had DXA completed (“not at-risk” group). 139 (70.9%) patients in “at-risk” group had low BMD, while 51 (53.7%) of “not-at-risk” patients had low BMD. Majority of the patients with osteoporosis (83.3%) missed by the current guidelines had low BMI. Multivariate logistic regression analysis showed that low BMI was the strongest risk factor for osteoporosis (OR 3.07; 95% CI, 1.47–6.42;P=0.003).Conclusions. Provider adherence to current guidelines is suboptimal. Low BMI can identify majority of the patients with osteoporosis that are missed by current guidelines.

Williamson on Defining Knowledge

Episteme ◽  
2020 ◽  
pp. 1-17
Author(s):  
Manuel Pérez Otero
Keyword(s):  
At Risk ◽  
Mental States ◽  
Definition Of

Abstract In his outstanding book Knowledge and its Limits (2000), Williamson (a) claims that we have inductive evidence for some negative theses concerning the prospects of defining knowledge, like this: knowing cannot be defined in accordance with a determinate traditional conjunctive scheme; (b) defends a theory of mental states, mental concepts and the relations between the two, from which we would obtain additional, not merely inductive, evidence for this negative thesis; and (c) presents an alternative (non-traditional-conjunctive) definition of knowledge. Here I consider these issues and extract two relevant conclusions: (i) Williamson's theory of states and concepts only supports the negative thesis because this theory would explain too much, since it imposes implausible necessary limitations on possible uses of concepts and linguistic expressions. So, there is no appropriate non-inductive evidence for the negative thesis. (ii) Williamson's own definition of knowledge is at risk.

scholarly journals ISMAR-study presentation: in-hospital epidemiology and clinical management of respiratory and cardiac comorbidities in cardiac and respiratory disease units

2014 ◽  
Vol 9 ◽  
Author(s):  
Roberto Tramarin ◽  
Mario Polverino ◽  
Maurizio Volterrani ◽  
Bruna Girardi ◽  
Claudio Chimini ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Management ◽  
Real Life ◽  
Length Of Hospital Stay ◽  
Relevant Information ◽  
Hospital Epidemiology ◽  
Discharge Data ◽  
Definition Of ◽  
Current Guidelines

Background: Cardiovascular and respiratory diseases are leading causes of morbidity and their co-occurrence has important implications in mortality and other outcomes. Even the most recent guidelines do not reliably address clinical, prognostic, and therapeutic concerns due to the overlap of respiratory and cardiac diseases. Study objectives and design: In order to evaluate in the reality of clinical practice the epidemiology and the reciprocal impact of cardio-pulmonary comorbidity on the clinical management, diagnostic workup and treatment, 1,500 cardiac and 1,500 respiratory inpatients, admitted in acute and rehabilitation units, will be enrolled in a multicenter, nationwide, prospective observational study. For this purpose, each center will enroll at least 50 consecutive patients. At discharge, data analysis will be aimed at the definition of cardiac and pulmonary inpatient comorbidity prevalence, demographic characteristics, length of hospital stay, and risk factors, taking into account also procedures, pharmacological and non-pharmacological treatment, and follow up in patients with cardio-respiratory comorbidity. Conclusions: The purely observational design of the study aims to give new relevant information on the assessment and management of overlapping patients in real life clinical practice, and new insight for improvement and implementation of current guidelines on the management of individual diseases.

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