Publications by authors named "Strunk T"

Introduction: Compromised neonatal intensive care unit neonates are at risk of acquiring late-onset infections (late-onset sepsis [LOS]). Neonates born with congenital anomalies (CAs) could have an additional LOS risk.

Methods: Utilising the population-based Australian and New Zealand Neonatal Network data from 2007 to 2017, bacterial LOS rates were determined in very preterm (VPT, <32 week), moderately preterm (MPT, 32-36 weeks), and term (FT, 37-41 weeks) neonates with or without CA.

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Background: Early-life antibiotic exposure is disproportionately high compared to the burden of culture-proven early-onset sepsis (CP-EOS). We assessed the contribution of culture-negative cases to the overall antibiotic exposure in the first postnatal week.

Methods: We conducted a retrospective analysis across eleven countries in Europe, North America, and Australia.

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  • * The study examined how factors like scaffold layering, cross-linking time, and freeze-drying impact the stability and properties of these nanofibers, finding that cross-linking with formaldehyde vapor offers optimal stability.
  • * Results show that different cross-linking times alter mechanical properties without changing hydration, and the nanofibers have a higher susceptibility to enzyme degradation compared to planar forms, highlighting their potential in soft tissue applications.
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  • There is a significant need for clinical trials that include infants, children, and adolescents to ensure evidence-based care; this communication discusses three different trial design strategies to address this issue.
  • The three strategies include sequential, parallel, and unified adult-pediatric Bayesian adaptive designs, which allow for better integration of pediatric populations into clinical research.
  • The unified design, exemplified by the SNAP trial, utilizes Bayesian hierarchical models to share data across age groups, enhancing accuracy in assessing treatment safety and efficacy for both children and adults.
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Neonatal sepsis remains one of the key challenges of neonatal medicine, and together with preterm birth, causes almost 50% of all deaths globally for children younger than 5 years. Compared with advances achieved for other serious neonatal and early childhood conditions globally, progress in reducing neonatal sepsis has been much slower, especially in low-resource settings that have the highest burden of neonatal sepsis morbidity and mortality. By contrast to sepsis in older patients, there is no universally accepted neonatal sepsis definition.

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  • - Neonatal sepsis is a serious condition leading to high mortality and morbidity, particularly affecting low and middle-income countries, while late-onset sepsis (LOS) still impacts a notable percentage of infants in high-income countries.
  • - A study at King Edward Memorial Hospital analyzed data from over 23,000 newborns, finding 370 sepsis episodes; predominant causes for early-onset sepsis were Streptococcus agalactiae and Escherichia coli, whereas coagulase-negative staphylococci and E. coli were the main culprits for LOS, which decreased in incidence over the study period.
  • - Infants with sepsis faced significantly worse health outcomes, including higher mortality rates, longer hospital stays, and
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  • This study looked at how different people, like parents and doctors, feel about the effects of treatments for neonatal sepsis, which is a serious infection in newborns.
  • The researchers found 19 important outcomes that matter to these people, like how the treatment affects parents and their babies' organs.
  • They concluded that it's important to include these personal views in future research to get a full picture of what's important in treating neonatal sepsis, since the views shared were different from what doctors usually report in clinical trials.
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Neonatal sepsis is a major cause of childhood mortality. Limited diagnostic tools and mechanistic insights have hampered our abilities to develop prophylactic or therapeutic interventions. Biomarkers in human neonatal sepsis have been repeatedly identified as associated with dysregulation of angiopoietin signaling and altered arachidonic acid metabolism.

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Purpose: To investigate the physicochemical compatibility of caffeine citrate and caffeine base injections with 43 secondary intravenous (IV) drugs used in Neonatal Intensive Care Unit (NICU) settings.

Methods: Caffeine citrate (20 mg/mL or 10 mg/mL) or caffeine base injection (10 mg/mL) were mixed in a volume ratio of 1:1 with the secondary drug solution to simulate Y-site co-administration procedures in NICUs. Physical compatibility was evaluated based on visual observation for 2 h, against a black and white background and under polarised light, for changes in colour, precipitation, haze and evolution of gas.

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Sildenafil is used to treat pulmonary hypertension in neonatal intensive care unit (NICU) settings. As multiple intravenous (IV) medications are co-administered in NICU settings, we sought to investigate the physicochemical compatibility of sildenafil with a range of IV drugs. Sildenafil 600 mcg/mL or 60 mcg/mL was mixed 1:1 with the secondary drug solution to simulate Y-site co-administration procedures.

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Adult stem cells are important for tissue turnover and regeneration. However, in most adult systems it remains elusive how stem cells assume different functional states and support spatially patterned tissue architecture. Here, we dissected the diversity of neural stem cells in the adult zebrafish brain, an organ that is characterized by pronounced zonation and high regenerative capacity.

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Our objective was to establish and test a machine learning-based screening process that would be applicable to systematic reviews in pharmaceutical sciences. We used the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) model, a broad search strategy, and a machine learning tool (Research Screener) to identify relevant references related to y-site compatibility of 95 intravenous drugs used in neonatal intensive care settings. Two independent reviewers conducted pilot studies, including manual screening and evaluation of Research Screener, and used the kappa-coefficient for inter-reviewer reliability.

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The structure and function of infant skin is not fully developed until 34 weeks of gestation, and this immaturity is associated with risk of late-onset sepsis (LOS). Topical coconut oil improves preterm-infant skin integrity and may reduce LOS. However, data on early-life skin-microbiome succession and potential effects of emollient skin care in preterm infants are scarce.

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Article Synopsis
  • Neonatal sepsis is a serious illness in newborns, and different studies measure its effects in different ways, making it hard to compare results.
  • Researchers want to create a Core Outcome Set (COS) to standardize what outcomes should be measured for treatments of neonatal sepsis, using input from parents, healthcare workers, and researchers.
  • By getting everyone to agree on what to measure through online surveys and meetings, this project hopes to make research on neonatal sepsis clearer and more useful.
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Objective: The purpose of this study was to investigate the physical compatibility of intravenous lipid emulsions with parenteral medications used in neonatal intensive care.

Methods: Lipid emulsion and drug solutions were combined 1:1 in glass vials, inspected for physical incompatibility at 0, 1 and 2 hours, and assessed on the basis of lipid droplet size at 0 and 2 hours after mixing. Intravenous fluid controls (Water for Injection, sodium chloride 0.

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Background: Overuse of empirical intravenous antibiotics in neonates in high-income countries (HICs) is well documented. The Kaiser Permanente neonatal early-onset sepsis (EOS) calculator is an evidence-based sepsis risk assessment tool that has demonstrated potential to reduce antibiotic usage in this population. The incidence of early-onset sepsis in most HICs is 0.

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  • Advances in neonatal care have not eliminated the long-term respiratory infection issues faced by infants discharged from NICUs; this study focuses on the incidence of respiratory infections in a cohort in Western Australia from 2002-2013.
  • The research analyzed data from over 23,000 infants and found a high hospitalization rate for acute respiratory infections (ARIs), particularly among infants aged 0-5 months, highlighting a specific vulnerability in very young patients.
  • Extremely preterm infants and those with chronic lung disease faced significantly higher risks of hospitalization for ARIs, indicating the need for targeted post-NICU care for these high-risk groups.
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Machine learning (ML) algorithms are powerful tools that are increasingly being used for sepsis biomarker discovery in RNA-Seq data. RNA-Seq datasets contain multiple sources and types of noise (operator, technical and non-systematic) that may bias ML classification. Normalisation and independent gene filtering approaches described in RNA-Seq workflows account for some of this variability and are typically only targeted at differential expression analysis rather than ML applications.

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  • - Antibiotic use during infancy can disrupt the microbiome and contribute to higher antimicrobial resistance, which may lead to chronic health issues later on in life.
  • - The main reason for excessive antibiotic treatment in newborns is the concern about potentially missing cases of neonatal sepsis.
  • - The authors call for a more balanced approach that weighs the risks of overtreatment against the actual risks of disease, advocating for better management of antibiotics and sepsis care.
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  • - The study investigates how placental inflammation, particularly maternal chorioamnionitis, is linked to the severity of retinopathy of prematurity (ROP) in infants born prematurely.
  • - An analysis of 878 infants revealed that maternal chorioamnionitis might decrease the odds of severe ROP, while conditions like oxygen supplementation, postnatal steroids, and platelet transfusions are strongly associated with an increased risk of severe ROP.
  • - The findings suggest that while maternal inflammation might have a protective effect against severe ROP, certain medical interventions in premature infants could heighten the risk of developing the disease.
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Conductivity doping has emerged as an indispensable method to overcome the inherently low conductivity of amorphous organic semiconductors, which presents a great challenge in organic electronics applications. While tuning ionization potential and electron affinity of dopant and matrix is a common approach to control the doping efficiency, many other effects also play an important role. Here, we show that the quadrupole moment of the dopant anion in conjunction with the mutual near-field host-dopant orientation have a crucial impact on the conductivity.

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