Association between Neuron-Specific Enolase, Memory Function, and Postoperative Delirium after Transfemoral Aortic Valve Replacement.

Introduction: Although transfemoral aortic valve replacement (TAVR) is a safe treatment for elderly patients with severe aortic valve stenosis, postoperative microembolism has been described. In this secondary endpoint analysis of the POST-TAVR trial, we aimed to investigate whether changes in neuron-specific enolase (NSE)-a biomarker of neuronal damage-are associated with changes in memory function or postoperative delirium (POD).

Materials And Methods: This was a prospective single-center study enrolling patients undergoing elective TAVR.

NT-proBNP/urine hepcidin-25 ratio and cardiorenal syndrome type 1 in patients with severe symptomatic aortic stenosis.

This study aimed to determine whether novel and conventional cardiorenal biomarkers in patients before transcatheter aortic valve implantation may be associated with cardiorenal syndrome (CRS) type 1. Serum NT-proBNP and urine biomarkers (hepcidin-25, NGAL, IL-6) were measured before and 24 h after transcatheter aortic valve implantation. 16/95 patients had CRS type 1.

Weight a minute: The smaller and more immature, the more predictable the autonomic regulation?

Aim: To investigate the relation between autonomic regulation, measured using heart rate variability (HRV), body weight and degree of prematurity in infants. Further to assess utility to include body weight in a machine learning-based sepsis prediction algorithm.

Methods: Longitudinal cohort study including 378 infants hospitalised in two neonatal intensive care units.

Vital sign-based detection of sepsis in neonates using machine learning.

Aim: Sepsis is a leading cause of morbidity and mortality in neonates. Early diagnosis is key but difficult due to non-specific signs. We investigate the predictive value of machine learning-assisted analysis of non-invasive, high frequency monitoring data and demographic factors to detect neonatal sepsis.

The cerebrospinal fluid proteome of preterm infants predicts neurodevelopmental outcome.

Background: Survival rate increases for preterm infants, but long-term neurodevelopmental outcome predictors are lacking. Our primary aim was to determine whether a specific proteomic profile in cerebrospinal fluid (CSF) of preterm infants differs from that of term infants and to identify novel biomarkers of neurodevelopmental outcome in preterm infants.

Methods: Twenty-seven preterm infants with median gestational age 27 w + 4 d and ten full-term infants were enrolled prospectively.

Electrophysiological correlates of proportion congruency manipulation in a temporal flanker task.

Response conflict evoked by a distractor stimulus object in interference tasks is associated with longer reaction times and a pronounced ERP component referred to as the fronto-central N2. Increasing the proportion congruency (PC, i.e.

Multichannel esophageal signals to monitor respiratory rate in preterm infants.

Background: Apnea of prematurity cannot be reliably measured with current monitoring techniques. Instead, indirect parameters such as oxygen desaturation or bradycardia are captured. We propose a Kalman filter-based detection of respiration activity and hence apnea using multichannel esophageal signals in neonatal intensive care unit patients.

Neonatal sepsis prediction through clinical decision support algorithms: A systematic review.

Aim: To systematically summarise the current evidence of employing clinical decision support algorithms (CDSAs) using non-invasive parameters for sepsis prediction in neonates.

Methods: A comprehensive search in PubMed, CENTRAL and EMBASE was conducted. Screening, data extraction and risk of bias were performed by two authors.

The rhythm of a preterm neonate's life: ultradian oscillations of heart rate, body temperature and sleep cycles.

The objectives are to characterize oscillations of physiological functions such as heart rate and body temperature, as well as the sleep cycle from behavioral states in generally stable preterm neonates during the first 5 days of life. Heart rate, body temperature as well as behavioral states were collected during a daily 3-h observation interval in 65 preterm neonates within the first 5 days of life. Participants were born before 32 weeks of gestational age or had a birth weight below 1500 g; neonates with asphyxia, proven sepsis or malformation were excluded.

Multichannel Esophageal Heart Rate Monitoring of Preterm Infants.

Objective: Autonomic dysregulation in preterm infants requires continuous monitoring of vital signs such as heart rate over days to months. Unfortunately, common surface electrodes are prone to electrocardiography (ECG) signal artifacts and cause serious skin irritations during long-term use. In contrast, esophageal ECG is known to be very sensitive due to the proximity of electrodes and heart and insensitive to external influences.

Caffeine preserves quiet sleep in preterm neonates.

Caffeine is widely used in preterm neonates suffering from apnea of prematurity (AOP), and it has become one of the most frequently prescribed medications in neonatal intensive care units. Goal of this study is to investigate how caffeine citrate treatment affects sleep-wake behavior in preterm neonates. The observational study consists of 64 preterm neonates during their first 5 days of life with gestational age (GA) <32 weeks or very low birthweight of < 1500 g.

Heart rate fluctuation after birth predicts subsequent cardiorespiratory stability in preterm infants.

Background: Cardiorespiratory stability of preterm infants is a prerequisite for discharge from the neonatal intensive care unit (NICU) but very difficult to predict. We aimed to assess whether characterizing heart rate fluctuation (HRF) within the first days of life has prognostic utility.

Methods: We conducted a prospective cohort study in 90 preterm infants using a previously validated surface diaphragmatic electromyography (sEMG) method to derive interbeat intervals.

The time course of distractor-based response activation with predictable and unpredictable target onset.

Electrophysiological recording in a temporal flanker task (i.e., distractors preceding the targets) has demonstrated that distractor processing is adjusted to the overall utility of the distractors.

Beta-blockers for prevention and treatment of retinopathy of prematurity in preterm infants.

Background: Retinopathy of prematurity (ROP) is a vision-threatening disease of preterm neonates. The use of beta-adrenergic blocking agents (beta-blockers), which modulate the vasoproliferative retinal process, may reduce the progression of ROP or even reverse established ROP.

Objectives: To determine the effect of beta-blockers on short-term structural outcomes, long-term functional outcomes, and the need for additional treatment, when used either as prophylaxis in preterm infants without ROP, stage 1 ROP (zone I), or stage 2 ROP (zone II) without plus disease or as treatment in preterm infants with at least prethreshold ROP.

Leaks during multiple-breath washout: characterisation and influence on outcomes.

Nitrogen multiple-breath washout (NMBW) is increasingly used in patients with cystic fibrosis. The current European Respiratory Society/American Thoracic Society consensus statement for MBW recommends the rejection of measurements with leaks. However, it is unclear whether this is necessary for all types of leaks.

Caffeine Citrate Dosing Adjustments to Assure Stable Caffeine Concentrations in Preterm Neonates.

Objective: To identify dosing strategies that will assure stable caffeine concentrations in preterm neonates despite changing caffeine clearance during the first 8 weeks of life.

Methods: A 3-step simulation approach was used to compute caffeine doses that would achieve stable caffeine concentrations in the first 8 weeks after birth: (1) a mathematical weight change model was developed based on published weight distribution data; (2) a pharmacokinetic model was developed based on published models that accounts for individual body weight, postnatal, and gestational age on caffeine clearance and volume of distribution; and (3) caffeine concentrations were simulated for different dosing regimens.

Results: A standard dosing regimen of caffeine citrate (using a 20 mg/kg loading dose and 5 mg/kg/day maintenance dose) is associated with a maximal trough caffeine concentration of 15 mg/L after 1 week of treatment.

Surface electromyography for analysis of heart rate variability in preterm infants.

Objective: Characterizing heart rate variability (HRV) in neonates has gained increased attention and is helpful in quantifying maturation and risk of sepsis in preterm infants. Raw data used to derive HRV in a clinical setting commonly contain noise from motion artifacts. Thoracic surface electromyography (sEMG) potentially allows for pre-emptive removal of motion artifacts and subsequent detection of interbeat interval (IBI) of heart rate to calculate HRV.

Task Dominance Determines Backward Inhibition in Task Switching.

Switching between tasks is assumed to be accompanied by inhibiting currently irrelevant, but competing tasks. A dominant task that strongly interferes with performing a weaker task may receive especially strong inhibition. We tested this prediction by letting participants switch among three tasks that differ in dominance: a location discrimination task with strong stimulus-response bindings (responding with left-hand and right-hand button presses to stimuli presented left or right to the fixation cross) was combined with a color/pattern and a shape discrimination task, for which stimulus-response mappings were arbitrary (e.

Dynamics and complexity of body temperature in preterm infants nursed in incubators.

Background: Poor control of body temperature is associated with mortality and major morbidity in preterm infants. We aimed to quantify its dynamics and complexity to evaluate whether indices from fluctuation analyses of temperature time series obtained within the first five days of life are associated with gestational age (GA) and body size at birth, and presence and severity of typical comorbidities of preterm birth.

Methods: We recorded 3h-time series of body temperature using a skin electrode in incubator-nursed preterm infants.

Strategic control over extent and timing of distractor-based response activation.

In choice reaction time (RT) tasks, performance is often influenced by the presence of nominally irrelevant stimuli, referred to as distractors. Recent research provided evidence that distractor processing can be adjusted to the utility of the distractors: Distractors predictive of the upcoming target/response were more attended to and also elicited stronger motor responses. In an event-related potential (ERP) study, we investigated whether not only the extent of distractor processing (as suggested by these previous results), but also the timing of distractor-based response activation is subject to strategic control.

Early selection versus late correction: Age-related differences in controlling working memory contents.

We examined whether a reduced ability to ignore irrelevant information is responsible for the age-related decline of working memory (WM) functions. By means of event-related brain potentials, we will show that filtering is not out of service in older adults but shifted to a later processing stage. Participants performed a visual short-term memory task (change-detection task) in which targets were presented along with distractors.

Lung clearance index and moment ratios at different cut-off values in infant multiple-breath washout measurements.

Background: Multiple-breath washout (MBW) is increasingly used for infant lung function testing. Current guidelines recommend calculating lung clearance index (LCI) and functional residual capacity (FRC) at 2.5% of normalized tracer gas concentration, without clear recommendation for moment ratios (MR).

Immediate effects of phototherapy on sleep in very preterm neonates: an observational study.

Process C (internal clock) and Process S (sleep-wake homeostasis) are the basis of sleep-wake regulation. In the last trimester of pregnancy, foetal heart rate is synchronized with the maternal circadian rhythm. At birth, this interaction fails and an ultradian rhythm appears.