Effects of skin-to-skin care on electrical activity of the diaphragm in preterm infants during neurally adjusted ventilatory assist.

BACKGROUND: Skin-to-skin care (SSC) reduces neonatal mortality and morbidity and is widely implemented in the neonatal intensive care unit. However, changes in respiratory effort during SSC in ventilated preterm infants remain unclear. AIMS: To evaluate the effect of SSC on electrical activity of the diaphragm (Edi) and vital signs in premature infants who are intubated and under neurally adjusted ventilatory assist ventilation. STUDY DESIGN: We performed an observational cross-over study. Data were measured in three periods: before (pre-SSC period), during (SSC period), and after (post-SSC period) SSC. Stable 30-min data in each period were extracted. SUBJECTS: Thirty-four SSC procedures were performed in 14 preterm infants with a median gestational age of 25.3 weeks (interquartile range, 24, 26.4) and a birth weight of 659 g (566, 694). The median postnatal age was 41 days (31, 53) at the study with a median postmenstrual age of 31.3 weeks (30.4, 32.5). OUTCOME MEASURES: Median values of Edi peak, Edi minimum, respiratory rate, SpO2, and heart rate were measured in each condition. The Kruskal-Wallis test with Bonferroni multiple comparisons was used to compare each parameter in each period. RESULTS: Median Edi peak and Edi minimum values were significantly lower during SSC compared with pre- and post-SSC, without any change in respiratory rate, SpO2, or heart rate. CONCLUSIONS: Respiratory efforts as evaluated by Edi are significantly reduced during SSC in ventilated preterm infants.

Electronic structure of CeO studied by a four-component relativistic configuration interaction method.

We studied the ground and excited states of CeO using the restricted active space CI method in the energy range below 25,000 cm(-1). Energy levels are computed to within errors of 2700 cm(-1). Electron correlation effects arising from the ionic core composed of Ce5s, 5p, 4f(*), 5d(*), and O2s, 2p spinors play crucial role to CeO spectra, as well as correlation effects of electrons distributed in the valence Ce 4f, 5d, 6s, and 6p spinors. Here, 4f(*) and 5d(*) denote spinors expanded to describe electron polarization between Ce and O. A bonding mechanism is proposed for CeO. As the two separate atoms in their ground states, Ce(4f(1)5d(1)6s(2))(1)G4 and O(2s(2)2p(4))(3)P2, approach each other, a CeO(2+) core is formed by two-electron transfer from Ce5d, 6s to O2p. Inside this ellipsoidal ion, a valence bond between Ce5p and O2s and an ionic bond between O2p and Ce5p are formed with back-donation through Ce 4f(*) and 5d(*).

Electronic structure of LaO based on frozen-core four-component relativistic multiconfigurational quasidegenerate perturbation theory.

The electronic structure of the LaO molecule is studied using frozen-core four-component multiconfigurational quasidegenerate perturbation theory. The ground state and nine experimentally observed excited states are examined. The ground state is (2)Sigma(1/2)(+) and its gross atomic orbital population is La(5p(5.76)6s(0.83)6p(0.14)p(*(0.21) )d(*(1.17) )f(*(0.26) )) O(2p(4.63)), where p*, d*, and f* are the polarization functions of La that form molecular spinors with O 2ps. We found that it is not necessary to consider the excitation from the O 2p electrons when analyzing the experimental spectra. This validates the foundation of the ligand field theory on diatomic molecules, including the La atom where only one electron is considered. The spectroscopic constants R(e), omega(e), and T(0) calculated for the ground state and low-lying excited states A'((2)Delta(3/2)), A'((2)Delta(5/2)) A((2)Pi(1/2)), and A((2)Pi(3/2)) are in good agreement with the experimental values.

Electronic structure of LaF+ and LaF from frozen-core four-component relativistic multiconfigurational quasidegenerate perturbation theory.

The electronic structure of the molecules LaF+ and LaF was studied using frozen-core four-component multiconfigurational quasidegenerate perturbation theory. To obtain proper excitation energies for LaF+, it was essential to include electronic correlations between the outermost valence electrons (4f, 5d, and 6s) and ionic core electrons composed of (4s, 4p, 4d, 5s, and 5p). The lowest-lying 16 excited states were examined for LaF+, and the lowest 30 states were examined for LaF. The excitation energies calculated for LaF+ agree with the available experimental values, as well as with values from ligand field theory. Errors are within 0.4 eV; for example, the highest observed state 2Pi is 3.77 eV above the ground state, and the present value is 4.09 eV. For LaF, agreement between the experimental and theoretical state assignments and between the experimental and calculated excitation energies was generally good, except for the electron configurations of certain states. Errors are within 0.4 eV except for a single anomaly; for example, the highest observed excited-state discussed in this work is 2.80 eV above the ground state, and the present value is 2.42 eV. We discuss the characteristics of the bonding in LaF+ and LaF.

Evaluation of the Use of PenNeedle(®) 32G Taper in Children being Treated with Growth Hormone.

Pain resulting from needle injection is a serious problem for patients that self-administer medication at home. We studied impressions of needle use by comparing PenNeedle® 32G Taper (NovoFine® 32G Tip), developed to reduce the sense of fear and pain of injection, with a conventional needle, in children self-injecting GH. A total of 34 patients self-injected themselves with needles coupled with Norditropin® NordiFlex® pre-filled recombinant human GH, and impressions of use were evaluated by a series of questionnaires. Compared to the conventional needle, PenNeedle 32G Taper was slightly less painful at time of insertion according to patient responses, though the difference was not statistically significant (P=0.06). PenNeedle 32G Taper has the same inner diameter as the conventional needle, thus there was no difference in the pain felt at time of injection between these two needles. Large differences in pain perception between the two needles were not seen probably due to their similar shape and appearance and as the subjects of this study were young. Nevertheless, based on the results of post-study questionnaires, significantly more patients (68%, P=0.02) expressed a desire to use PenNeedle 32G Taper for daily injections of GH. PenNeedle 32G Taper thus appears to be a superior needle which reduces insertion-associated pain in children receiving recombinant GH and improves patient QOL.

A study of the ground state of manganese dimer using quasidegenerate perturbation theory.

We study the electronic structure of the ground state of the manganese dimer using the state-averaged complete active space self-consistent field method, followed by second-order quasidegenerate perturbation theory. Overall potential energy curves are calculated for the 1Sigmag+, 11Sigmau+, and 11Piu states, which are candidates for the ground state. Of these states, the 1Sigmag+ state has the lowest energy and we therefore identify it as the ground state. We find values of 3.29 A, 0.14 eV, and 53.46 cm(-1) for the bond length, dissociation energy, and vibrational frequency, in good agreement with the observed values of 3.4 A, 0.1 eV, and 68.1 cm(-1) in rare-gas matrices. These values show that the manganese dimer is a van der Waals molecule with antiferromagnetic coupling.