PRONATION POSITION OF OXYGEN SATURATION, RESPIRATORY AND PULSE FREQUENCY IN LOW BIRTH WEIGHT BABIES

Introduction: Data from WHO 2018 shows the prevalence of LBW is estimated at 21% globally with a limit of 4.5%-40%. LBW babies often have complications in the form of Respiratory Distress Syndrome and an increase in pulse rate. One way to prevent complications is to place the baby in a prone position. Based on scientific article searches, this literature review aims to determine the effect of pronation position on oxygen saturation, pulse rate, and respiratory rate in LBW infants. Method: The type of research was a Literature Review with meta-analysis. Journal searches are carried out on the electronic basis of Google Scholar, Garuda Portal, One Search, and Pubmed, totaling 30 articles. The literature used is literature published from 2016 - 2021. Results: The study results of 30 articles found that the average oxygen saturation before and after being given a pronation position was in the range of 90.27% - 98.1%. The average pulse frequency before and after being given a pronation position was in the range of 144.87 x/minute -140.90 x/minute. The average breathing frequency before and after being given a pronation position was in the range of 69.50 x/minute – 44.18 x/minute. All articles have the effect of pronation position on oxygen saturation in infants (LBW). There is an effect of pronation position on oxygen saturation, respiratory, and pulse with p-value <0,05. Conclusion: It was concluded that the pronation position affected the oxygen saturation, pulse rate, and respiratory frequency in LBW infants. It is expected for nursing services to make the provision of a pronation position as one of the nursing interventions and become a standard operating procedure in the management of LBW infants.

Bright single photon emitters with enhanced quantum efficiency in a two-dimensional semiconductor coupled with dielectric nano-antennas

Single photon emitters in atomically-thin semiconductors can be deterministically positioned using strain induced by underlying nano-structures. Here, we couple monolayer WSe2 to high-refractive-index gallium phosphide dielectric nano-antennas providing both optical enhancement and monolayer deformation. For single photon emitters formed on such nano-antennas, we find very low (femto-Joule) saturation pulse energies and up to 104 times brighter photoluminescence than in WSe2 placed on low-refractive-index SiO2 pillars. We show that the key to these observations is the increase on average by a factor of 5 of the quantum efficiency of the emitters coupled to the nano-antennas. This further allows us to gain new insights into their photoluminescence dynamics, revealing the roles of the dark exciton reservoir and Auger processes. We also find that the coherence time of such emitters is limited by intrinsic dephasing processes. Our work establishes dielectric nano-antennas as a platform for high-efficiency quantum light generation in monolayer semiconductors.

Developing Medical Technologies for Low-Resource Settings: Lessons From a Wireless Wearable Vital Signs Monitor–neoGuard

The neoGuard™ technology is a wireless wearable vital signs monitor attached to a patient's forehead to continuously measure oxygen saturation, pulse rate, respiratory rate and temperature. Developed with feedback from more than 400 health workers, primarily in East Africa, the product has been designed to meet the unique constraints of low-resource settings. This perspective piece by the innovators of neoGuard™ and some of their key partners examines the complicated journey of taking a medical technology from concept through clinical validation and finally to market. By shedding light on some of the most critical steps and common challenges encountered along the pathway to commercialization, the authors hope that their experiences will provide some valuable insights to other aspiring innovators in this space.

Altered saturation pulse with a high flip angle for venous saturation on 7 T time-of-flight magnetic resonance angiography

This study aimed to apply minimum-time variable-rate selective excitation (MinVER) to a presaturation pulse (PSP) with a high flip angle on 7 T time-of-flight magnetic resonance angiography (7T TOF-MRA), to attain a superior vessel-to-tissue contrast (VTCR), short acquisition time, and minor off-resonance effect. An altered PSP modified by using the 90° flip angle (FA)-MinVER was implemented in the 7 T TOF-MRA, and its performance was evaluated with a signal profile and vessel-tissue contrast ratios and compared to the conventional PSP and 45 FA-TOF. The 90 FA-MinVER showed a similar signal profile to that of the conventional PSP and improved the vessel-tissue contrast ratios (0.313 ± 0.80) compared to all conventional types (45 FA-TOF: 0.088 ± 0.84, 90 FA-TOF: 0.203 ± 0.72). Moreover, this noteworthy approach achieved substantially reduced total acquisition time (5 min and 55 s) with a short repeat-to-time (28 ms), indicating that at the 7 T TOF-MRA, the 90 FA-MinVER could be applied by default to suppress the venous signals regardless of individual human status and the specific absorption ratio constraint and with rapid imaging. Ultimately, its application could also help to observe subtle microvascular changes in the early stages and serve as key biomarkers in various vascular diseases.

Covid SeveriTy Score PREDICTOR 50: A novel scoring system to assess prognosis in COVID 19 illness

Background: The first case of COVID 19 illness was detected on 31st December 2019 and the disease has progressed globally causing significant morbidity and mortality. The disease initially thought to be a respiratory virus soon showed manifestations involving other systems and diagnosis and treatment of the disease became more complicated. Aims and Objective: This study aims to derive a scoring system based on health records of patients suffering from COVID 19, to help in early triaging of the illness and therefore allowing for early institution of treatment. To establish a scoring system inclusive of clinical, laboratory and radiological parameters to assist in the prognosis of patients afflicted with COVID 19 illness. Materials and Methods: Health records of 138 COVID patients has been included in the study. The scoring system comprises of parameters including Age, Co-morbidities, Shortness of breath, Saturation, Pulse Rate, Respiratory rate, temperature, D dimer, Neutrophil Lymphocyte ratio, Troponin I, Organ involvement, Radiology. The cumulative scoring ranges from 0-16. The mortality rate among the subjects included was 25.4%. Results: All parameters involved were found to be independent risk factors for mortality. Patients were effectively categorizedbased on the scoring system and mortality found to be associated with increasing scores. This model displayed good discrimination (AUC =0.875) and the sensitivity and specificity of the model was found to be 0.857 and 0.767 respectively. Conclusion: This scoring system has been designed to categorize based on the systemic involvement of the disease and thus would serve as a reliable indicator for prognostic assessment in patients.

Examination of Physiological Changes Seen in Workers Using Breathing Masks During COVID-19 Pandemic

Background: There are very few studies in the literature evaluating the effects of mask use on physiological parameters. Objectives: This study aims to examine physiological changes due to masks in healthcare workers who use respiratory masks for long hours in the emergency room during the pandemic process. Methods: Cross-sectional and prospective study was carried out with healthcare professionals with an FFP2 type valve mask. The participants’ transcutaneous oxygen saturation, pulse, and respiratory rate were measured before wearing the respirator mask and at 30 and 60 minutes after wearing the mask. Results: SPO2 values of the participants decreased gradually at 0th, 30th, and 60th minutes and respiratory rate increased gradually at 0th, 30th, and 60th minutes. The statistically significant difference arises from the 0 and 60 minutes values. Higher SPO2 values were found at 0 and 30 minutes in non-smokers. SPO2 value gradually decreased in non-smokers at 0, 30, and 60 minutes, but no significant decrease was observed in non-smokers. Pulse rate was found to be higher at 60th minute compared to 0th minute in non-smokers. No significant difference was found between smokers and non-smokers. The respiratory rate gradually increased in smokers at 0th, 30th, and 60th minutes. SPO2 values were lower at the 60th minute compared to the 0th minute in both women and men. There was no significant difference in pulse rates. Respiratory rate was found to be higher at 60th minute in men than at 0th minute. Conclusion: It is recommended to follow the physiological parameters and to regulate the working conditions when necessary.

Saturation-Pulse Prepared Heart-Rate Independent Inversion-REcovery (SAPPHIRE) Biventricular T1 Mapping: Inter-Field Strength, Head-To-Head Comparison of Diastolic, Systolic And Dark-Blood Measurements

Purpose To assess the feasibility of SAPPHIRE T1 mapping in vivo across field strengths and compare results to those obtained by conventional Modified Look-Locker inversion recovery (MOLLI). Methods 10 healthy volunteers underwent same-day non-contrast cardiovascular magnetic resonance at 1.5 Tesla (T) and 3T. Left and right ventricular (LV, RV) T1 mapping was performed in the basal, mid and apical short axis using MOLLI and 4-variants of SAPPHIRE: diastolic, systolic, 0th and 2nd order motion-sensitized dark blood (DB). Results LV myocardial T1 times differed significantly between MOLLI and each of the SAPPHIRE variants (all p<0.005). LV global myocardial T1 (1.5T then 3T results) was significantly longer by diastolic SAPPHIRE (1283±11|1600±17ms) than any of the other SAPPHIRE variants: systolic (1239±9|1595±13ms), 0th order DB (1241±10|1596±12) and 2nd order DB (1251±11|1560±20ms, all p<0.05). In the mid septum MOLLI and diastolic SAPPHIRE exhibited significant T1 signal contamination (longer T1) at the blood-myocardial interface not seen with the other 3 SAPPHIRE variants (all p<0.025). Additionally, systolic, 0th order and 2nd order DB SAPPHIRE showed narrower dispersion of myocardial T1 times across the mid septum when compared to diastolic SAPPHIRE (interquartile ranges respectively: 25ms, 71ms, 73ms vs 143ms, all p<0.05). RV T1 mapping was achievable using systolic, 0th and 2nd order DB SAPPHIRE but not with MOLLI or diastolic SAPPHIRE. All 4 SAPPHIRE variants showed excellent re-read reproducibility (intraclass correlation coefficients 0.953 to 0.996). Conclusion These preliminary data suggest that systolic and DB SAPPHIRE approaches can reduce myocardial T1 signal contamination by the adjacent bright blood pool at the blood-myocardial interface.

Structure Solution of Nano-Crystalline Small Molecules Using MicroED and Solid-State NMR Dipolar-Based Experiments

Three-dimensional electron diffraction crystallography (microED) can solve structures of sub-micrometer crystals, which are too small for single crystal X-ray crystallography. However, R factors for the microED-based structures are generally high because of dynamic scattering. That means R factor may not be reliable provided that kinetic analysis is used. Consequently, there remains ambiguity to locate hydrogens and to assign nuclei with close atomic numbers, like carbon, nitrogen, and oxygen. Herein, we employed microED and ssNMR dipolar-based experiments together with spin dynamics numerical simulations. The NMR dipolar-based experiments were 1H-14N phase-modulated rotational-echo saturation-pulse double-resonance (PM-S-RESPDOR) and 1H-1H selective recoupling of proton (SERP) experiments. The former examined the dephasing effect of a specific 1H resonance under multiple 1H-14N dipolar couplings. The latter examined the selective polarization transfer between a 1H-1H pair. The structure was solved by microED and then validated by evaluating the agreement between experimental and calculated dipolar-based NMR results. As the measurements were performed on 1H and 14N, the method can be employed for natural abundance samples. Furthermore, the whole validation procedure was conducted at 293 K unlike widely used chemical shift calculation at 0 K using the GIPAW method. This combined method was demonstrated on monoclinic l-histidine.

Fick versus flow: a real-time invasive cardiovascular magnetic resonance (iCMR) reproducibility study

Background Cardiac catheterization and cardiovascular magnetic resonance (CMR) imaging have distinct diagnostic roles in the congenital heart disease (CHD) population. Invasive CMR (iCMR) allows for a more thorough assessment of cardiac hemodynamics at the same time under the same conditions. It is assumed but not proven that iCMR gives an incremental value by providing more accurate flow quantification. Methods Subjects with CHD underwent real-time 1.5 T iCMR using a passive catheter tracking technique with partial saturation pulse of 40° to visualize the gadolinium-filled balloon, CMR-conditional guidewire, and cardiac structures simultaneously to aid in completion of right (RHC) and left heart catheterization (LHC). Repeat iCMR and catheterization measurements were performed to compare reliability by the Pearson (PCC) and concordance correlation coefficients (CCC). Results Thirty CHD (20 single ventricle and 10 bi-ventricular) subjects with a median age and weight of 8.3 years (2–33) and 27.7 kg (9.2–80), respectively, successfully underwent iCMR RHC and LHC. No catheter related complications were encountered. Time taken for first pass RHC and LHC/aortic pull back was 5.1, and 2.9 min, respectively. Total success rate to obtain required data points to complete Fick principle calculations for all patients was 321/328 (98%). One patient with multiple shunts was an outlier and excluded from further analysis. The PCC for catheter-derived pulmonary blood flow (Qp) (0.89, p < 0.001) is slightly lower than iCMR-derived Qp (0.96, p < 0.001), whereas catheter-derived systemic blood flow (Qs) (0.62, p = < 0.001) was considerably lower than iCMR-derived Qs (0.94, p < 0.001). CCC agreement for Qp at baseline (C1-CCC = 0.65, 95% CI 0.41–0.81) and retested conditions (C2-CCC = 0.78, 95% CI 0.58–0.89) were better than for Qs at baseline (C1-CCC = 0.22, 95% CI − 0.15–0.53) and retested conditions (C2-CCC = 0.52, 95% CI 0.17–0.76). Conclusion This study further validates hemodynamic measurements obtained via iCMR. iCMR-derived flows have considerably higher test–retest reliability for Qs. iCMR evaluations allow for more reproducible hemodynamic assessments in the CHD population.

Post-coronavirus disease 2019 children in Sarajevo-Lessons learnt?

Introduction: A new disease coronavirus disease 2019 (COVID-19) is with insufficiently known epidemiological characteristics and spectrum of clinical expression in childhood. Children have a lower incidence of this disease with a predominance of mild forms but severe clinical forms, such as among others, acute respiratory distress syndrome, and multisystem inflammatory syndrome may occur, according to current findings. In children with atypical symptomatology and positive or suspicious epidemiological survey, practitioners should consider the possibility of COVID-19.Methods: This study formed the group of 70 children previously healthy or with no pre-existing heart disease from Sarajevo with positive post-COVID history. Following the history of disease and epidemiological data, establishing the 1st day of disease or contact, a detailed cardiovascular examination was performed, including parameters of body weight, height, oxygen saturation, pulse, blood pressure, 12 leads electrocardiogram (ECG) done on Schiller machine, values of polymerase chain reaction (PCR), or serological test on corona: Immunoglobulin (Ig) G and IgM. Echocardiographic examination was done using M, B mode, color, continuous wave, and pulse wave Doppler in standard views. Laboratory blood tests included: Full blood count, creatinine phosphokinase myofibril, creatinine phosphokinase, lactate dehydrogenase; liver enzymes, D dimer, C reactive protein, and urine.Results: Majority of children (64.3%) were asymptomatic. ECG was normal in relation to patients’ age except in eight patients (intermittent palpitations on exertion) who had short PR interval 0.120–0.140 ms, with no delta wave, with heart rate within the normal range according to age, so 24 h ECG Holter was performed without any significant arrhythmias, incomplete right branch block has been documented in 12%, monofocal ventricular ectopic extrasistoly in 15%. Mean IgG, as a marker of infection, showed a statistical significance when compared between age Groups I and II (<5) and older groups: III, IV, and V (>5) (p < 0.05; p = 0.043). PCR test was negative in 9 (70 children), although they showed symptoms, COVID-19 infection clinical data, and positive laboratory findings. Echocardiogram was normal in all patients with normal ejection fraction of the left ventricle.Conclusion: The possibility of COVID-19 in children with atypical symptomatology and positive or suspicious epidemiological survey should be in the focus of every pediatrician at primary care institutions nowadays. Cardiovascular assessment should always be an option in post-COVID patients. Immunological assessment is necessary in post-COVID patients in order to gain a further understanding of PTS status. With more serological testing for severe acute respiratory syndrome coronavirus 2 physicians would be able to make a diagnosis of COVID-19 timely and more accurately, as well as to evaluate the role of asymptomatic children in disease transmission and to assess the importance of protective antibodies and the distribution of COVID-19.