Diuretics use in the management of bronchopulmonary dysplasia in preterm infants: A systematic review.

AIM: Bronchopulmonary dysplasia (BPD), a respiratory complication associated with neonatal prematurity, presents opportunities for pharmacological intervention due to its contributing risk factors. Despite diuretics' controversial usage in BPD treatment and varying institutional practices, this review aims to consolidate evidence from clinical trials regarding diuretic use in BPD. METHODS: We conducted a systematic review following PRISMA guidelines, searching EMBASE, Medline, Web of Science and CINAHL databases (PROSPERO 2022: CRD42022328292). Covidence facilitated screening and data extraction, followed by analysis and formatting in Microsoft Excel. RESULTS: Among 430 screened records, 13 were included for analysis. Three studies assessed spironolactone and chlorothiazide combinations, two studied spironolactone and hydrochlorothiazide, while eight examined furosemide. All studies evaluated drug effects on dynamic pulmonary compliance and pulmonary resistance, serving as comparative measures in our review. CONCLUSION: Diuretics' effectiveness in treating bronchopulmonary dysplasia remains uncertain. The limited number of identified randomised controlled trials (RCTs) hampers high-level evidence-based conclusions when applying the Population, Intervention, Comparison, Outcome (PICO) approach. Conducting large prospective studies of good quality could provide more definitive insights, but the rarity of outcomes and eligible patients poses challenges. Further research, primarily focusing on RCTs assessing diuretics' safety and efficacy in this population, is warranted.

The lived experience of being an undergraduate midwifery student in the neonatal unit.

OBJECTIVE: The objective of this study is to examine the experience of undergraduate student midwives in the neonatal unit. BACKGROUND: Clinical experience is an essential component of education for the development of competent midwives. Literature has highlighted the pivotal effects of precepting and how it contributes to student experience. Although there is a plethora of research examining undergraduate student midwives' experience, to our knowledge this is the first study exploring their experience in the neonatal unit. DESIGN: Based in phenomenology, eight semi-structured interviews were conducted producing rich data. METHODS: Following informed consent and ethical approval, post transcription, the data were coded using Colaizzi's (1978) framework. RESULTS: Significant themes and sub-themes emerged such as course design, environmental experience, sources of stress and preceptor experience. The student experience very much depends on the preceptor, how busy the environment is and if appropriately staffed. CONCLUSIONS: Based on these findings there are suggested recommendations including adjusting the timing and length of the placement and how to improve the environment based on the preceptor-student relationship. Also, suggestions on how consistency and communication can be improved are proposed.

The Brazilian drought monitoring in a multi-annual perspective.

Droughts, which consist of natural and transient water deficits, endanger the water, food, and energy security of ecosystems. An effective drought preparedness strategy must focus on mitigating socioeconomic vulnerabilities to the phenomenon. In this context, the article aims to analyze the multi-annual characteristic of droughts in the Northeast region of Brazil. The study identifies each pixel under a spatial-temporal perspective of the phenomenon's severity, based on data from the Drought Monitor, providing a multi-annual and cumulative view of the extreme event. The approach aggregates a series of spatial-temporal drought severity data in a single product with clusters of monthly data referring to 5 years of outputs from the Drought Monitor. The results reveal that from July 2014 to June 2019, over 75% of the Northeast region of Brazil (NEB) area registers exceptional drought for, at least, 1 month along the 5 years. This result means impacts on water supply and crops that correspond respectively to the water dams collapsing volumes and widespread agricultural losses. Despite the natural recurrence and constancy of drought phenomena in the region, water management policies have often based the building of disproportionate and costly water infrastructure works. Cumulative multi-annual analysis of the outputs of drought monitoring can be an early warning system for water basins, regions, or municipalities, notably those who usually live with recurrent highly severe droughts, and remain neglected upon a remarkable vulnerability. This approach also supports proactive and preventive drought management instead of the usual emergency crisis management model.

Normative values of the Rey Word Recognition Test in college athletes.

Improved detection of sport-related concussions can be enhanced by performance validity tests, such as the Rey Word Recognition Test (WRT). The WRT is brief and in the public domain but no norms exist for healthy college-athletes. The present study identified such normative values in a large college-athlete sample. Participants included 1,147 college-athletes, and four measures were collected: total words correct, words correct of the first 8, total number of intrusions, and combination score. The WRT was administered individually during baseline evaluations. Means and standard deviations were as follows: total correct words recognized, 10.47 (SD = 2.12); number of correct words out of the first eight words presented, 6.01 (SD = 1.41); number of intrusions, 0.89 (SD = 1.09); combination score, 15.59 (SD = 3.55). Females scored significantly higher than males in total words correct, number correct of the first eight, and combination score, and significantly lower in intrusions. The WRT proved to be a quick, easily administer test in the baseline testing setting. Only 22 athletes recognized all 15 words, and close to a normal distribution of scores was obtained, suggesting that an expectation of optimum performance by college-athletes as an inference of effortful performance would be misplaced.

Improve ground-level PM2.5 concentration mapping using a random forests-based geostatistical approach.

Accurate measurements of ground-level PM2.5 (particulate matter with aerodynamic diameters equal to or less than 2.5 µm) concentrations are critically important to human and environmental health studies. In this regard, satellite-derived gridded PM2.5 datasets, particularly those datasets derived from chemical transport models (CTM), have demonstrated unique attractiveness in terms of their geographic and temporal coverage. The CTM-based approaches, however, often yield results with a coarse spatial resolution (typically at 0.1° of spatial resolution) and tend to ignore or simplify the impact of geographic and socioeconomic factors on PM2.5 concentrations. In this study, with a focus on the long-term PM2.5 distribution in the contiguous United States, we adopt a random forests-based geostatistical (regression kriging) approach to improve one of the most commonly used satellite-derived, gridded PM2.5 datasets with a refined spatial resolution (0.01°) and enhanced accuracy. By combining the random forests machine learning method and the kriging family of methods, the geostatistical approach effectively integrates ground-based PM2.5 measurements and related geographic variables while accounting for the non-linear interactions and the complex spatial dependence. The accuracy and advantages of the proposed approach are demonstrated by comparing the results with existing PM2.5 datasets. This manuscript also highlights the effectiveness of the geographical variables in long-term PM2.5 mapping, including brightness of nighttime lights, normalized difference vegetation index and elevation, and discusses the contribution of each of these variables to the spatial distribution of PM2.5 concentrations.

An evaluation of oral health-related quality of life in orthodontic patients treated with fixed and twin blocks appliances.

OBJECTIVE: To study the impact of orthodontic treatment on the quality of life in two patient groups, one treated with the twin block appliance and the other with fixed appliances. MATERIALS AND METHODS: Ninety-eight patients, aged between 10 and 16 years, were recruited in the fixed (20 males and 29 females) or functional (29 males and 20 females) treatment groups. The oral health-related quality of life (OHRQoL) was measured before treatment and followed up at the end of the treatment. The instrument used to measure OHRQoL was a modified self-administered short version of the English Oral Health Impact profile (OHIP-16[E]) questionnaire. RESULTS: OHRQoL worsened at the initial stages of the treatment. The overall score of OHRQoL reduced significantly at the end of the treatment in both groups. Both groups showed comparable improvements in OHRQoL as the treatment progressed (analysis of variance test P = 0.05). CONCLUSIONS: The OHRQoL patterns, during the treatment with fixed and twin block appliances, were very similar. This suggests that the functional appliance's impact on the QoL may be overestimates by clinicians. OHRQoL improved significantly with both fixed and functional appliances by the end of the treatment. The OHRQoL trends observed during the study can be communicated to patients and used to increase patients' compliance since they are made aware of the whole treatment process.

Updating the Rey Dot Counting Test for Use in Collegiate Baseline Concussion Testing.

Athletes occasionally attempt to lower their baseline scores to mask the effects of a concussion during post-trauma assessment, a phenomenon known as sandbagging. In order to help prevent this from occurring, the Rey Dot Counting Test (DCT) was examined as a potential measure to be added to a Division II university screening battery. Investigators utilized samples of athletes at baseline and non-athlete students instructed to provide honest effort or suppressed effort, either naïvely or coached. The results support the use of the DCT as a valid measure of suboptimal performance when using modified norms established from collegiate populations.