Computational methodology to support functional vision assessment in premature infants: A viability study.

BACKGROUND: Premature newborns have a higher risk of abnormal visual development and visual impairment. OBJECTIVE: To develop a computational methodology to help assess functional vision in premature infants by tracking iris distances. METHODS: This experimental study was carried out with children up to two years old. A pattern of image capture with the visual stimulus was proposed to evaluate visual functions of vertical and horizontal visual tracking, visual field, vestibulo-ocular reflex, and fixation. The participants' visual responses were filmed to compose a dataset and develop a detection algorithm using the OpenCV library allied with FaceMesh for the detection and selection of the face, detection of specific facial points and tracking of the iris positions is done. A feasibility study was also conducted from the videos processed by the software. RESULTS: Forty-one children of different ages and diagnoses participated in the experimental study, forming a robust dataset. The software resulted in the tracking of iris positions during visual function evaluation stimuli. Furthermore, in the feasibility study, 8 children participated, divided into Pre-term and Term groups. There was no statistical difference in any visual variable analyzed in the comparison between groups. CONCLUSION: The computational methodology developed was able to track the distances traveled by the iris, and thus can be used to help assess visual function in children.

The effects of multisensory stimulation on the length of hospital stay and weight gain in hospitalized preterm infants: A systematic review with meta-analysis.

BACKGROUND: Multisensory interventions, such as auditory-tactile-visual-vestibular intervention (ATVV), tactile-kinesthesic stimulation (TKS), and the kangaroo mother care (KMC), have been commonly applied in hospitalized preterm infants. OBJECTIVE: To investigate the effectiveness of the ATVV, the TKS, and the KMC combined to standard care compared to standard care in the length of hospital stay and weight gain of hospitalized preterm infants. METHODS: PubMed, Scopus, Web of Science, Embase, SciELO Citation Index, CINAHL, Cochrane, and LILACS databases were searched from the inception to May 06, 2022 without language restrictions. We included randomized controlled trials. Two independent reviewers selected studies and extracted information about participants, interventions, outcomes, and the risk of bias. The body of evidence was synthesized through GRADE. Data were pooled using a random-effects model. RESULTS: Sixty-three randomized clinical trials included a range of 20-488 preterm infants (gestational age=25 to <37 weeks). Evidence was low to very low due to risk of bias, inconsistency, and imprecision. Most studies presented some concerns about methodological quality. The ATVV and the KMC increased weight gain. The TKS reduced the number of days at the hospital and increased the daily weight gain and the total weight gain. CONCLUSIONS: Adding ATVV, TKS, or KMC to standard care was more effective than standard care alone to improve weight gain. Only the TKS combined with standard care was more effective than standard care alone to reduce the length of hospital stay.

Respiratory Therapeutic Strategies in Children and Adolescents with COVID-19: A Critical Review.

Evidence on the treatment strategies for the child population with critical conditions due to COVID-19 is scarce and lacks consensus. Thus, this study aimed to critically review non-pharmacological respiratory strategies for this population. Original studies were searched in six databases considering predefined inclusion criteria. Other studies and recommendations were also included after a manual search. Oxygen therapy, invasive (IMV) and non-invasive (NIV) ventilation were the most frequently addressed interventions. In general, the original studies have cited these strategies, but detailed information on the parameters used was not provided. The recommendations provided more detailed data, mainly based on experiences with other acute respiratory syndromes in childhood. In the context of oxygen therapy, the nasal catheter was the most recommended strategy for hypoxemia, followed by the high-flow nasal cannula (HFNC). However, the risks of contamination due to the dispersion of aerosols in the case of the HFNC were pointed out. Lung protective IMV with the use of bacteriological or viral filters was recommended in most documents, and there was great variation in PEEP titration. Alveolar recruitment maneuvers were mentioned in a few recommendations. NIV was not consensual among studies, and when selected, several precautions must be taken to avoid contamination. Airway suctioning with a closed-circuit was recommended to reduce aerosol spread. Information on prone positioning and physiotherapy was even more scarce. In conclusion, oxygen therapy seems to be essential in the treatment of hypoxemia. If necessary, IMV should not be delayed, and protective strategies are encouraged for adequate pulmonary ventilation. Information about techniques that are adjuvant to ventilatory support is superficial and requires further investigation.

Atuação e intervenção multiprofissional em recém-nascidos de baixo risco internados no alojamento conjunto: revisão integrativa da literatura / Multiprofessional performance and intervention in low risk newborns interned in maternity: integrative literature review

Introdução: O alojamento conjunto é definido como um espaço onde mãe e o recém-nascido saudáveis permanecem juntos após o nascimento até a alta hospitalar. Durante a sua internação, os profissionais de saúde são de extrema importância para uma assistência adequada e humanizada. Objetivo: Identificar quais profissionais e intervenções multiprofissionais são realizadas em recém-nascidos de baixo risco internados no alojamento conjunto. Procedimentos Métodológicos: Revisão sistemática integrativa da literatura com protocolo registrado na PROSPERO (ID134707). A busca foi realizada entre maio de 2018 a outubro de 2019, nas bases de dados MEDLINE, Pubmed, LILACS, SCIELO, PEDro, Scopus, Cochrane, Embase e Cinahl. Foram utilizados os termos medical subject heading (MeSH) Infant, Newborn, "Mother-childrelations", Hospital, Maternity, "Health CareLevels", "Rooming-in Care", e "Physical Therapy Modalities", nos idiomas inglês, português e espanhol. Para avaliação da qualidade utilizou-se Newcastle ­ ottawa quality assessment scale case control studies. Texto da Pesquisa: Somente dois estudos atenderam aos critérios de elegibilidade, demonstrando que os profissionais enfermeiros, fonoaudiólogos e médicos atuam no alojamento conjunto. Uma intervenção foi relacionada ao aleitamento materno, com a avaliação do posicionamento, pega, sucção, aspecto da mama e interação mãe-bebê, e a outra sobre o contato pele a pele e berço aquecido no controle da temperatura corporal do recém-nascido logo após o nascimento. Conclusão: Em razão da escassez de estudos, tornam-se necessárias mais pesquisas com boa qualidade metodológica sobre a atuação de outros profissionais na população de recém-nascidos de baixo risco internados no alojamento conjunto.

Introduction: Maternity is defined as a space where a healthy mother and newborn remain together after birth until hospital discharge. During hospitalization, health professionals are extremely important for adequate and humanized care. Aims: To identify which professionals and multiprofessional interventions are carried out on low-risk newborns admitted to the maternity. Methodological Procedures: Systematic integrative literature review with a protocol registered with PROSPERO (ID134707). The search was conducted between May 2018 - October 2019, in the databases MEDLINE, Pubmed, LILACS, SCIELO, PEDro, Scopus, Cochrane, Embase and Cinahl. The terms medical subject heading (MeSH) Infant, Newborn, "Mother-childrelations", Hospital, Maternity, "Health Care Levels", "Rooming-in Care", and "Physical Therapy Modalities" were used in English, Portuguese and Spanish. The Newcastle - ottawa quality assessment scale case control studies was used to assess quality. Research Text: Only two studies met the eligibility criteria, demonstrating that professional nurses, speech therapists and doctors work in the maternity. One intervention was related to breastfeeding, with the assessment of positioning, holding, sucking, breast aspect and mother-baby interaction, and the other on skin-to-skin contact and a heated cradle to control the newborn's body temperature soon after the birth. Conclusion: Due to the scarcity of studies, more research with good methodological quality on the performance of other professionals in the population of low-risk newborns admitted to the maternity is necessary.