Recurring staphylococcal scalded skin syndrome in a very low birth weight infant: A case report

Introduction. Staphylococcal scalded skin syndrome is an extensive desquamative erythematous condition caused by exfoliative toxins of Staphylococcus aureus. This disease usually affects neonates and generally responds rapidly to antibiotic therapy. Case presentation. We describe the case of a premature baby boy, weighing 1030 g, born after 26 6/7 weeks gestation, who developed two episodes of Staphylococcal scalded skin syndrome on days 19 and 48 of life. Cultures obtained during the first period did not reveal Staphylococcus aureus, but diagnosis was based on typical clinical grounds. Although the initial diagnosis was irritation by the fixation material of a nasal continuous positive airway pressure tube, the infant showed rapidly progressing skin blistering and exfoliation, characteristic of Staphylococcal scalded skin syndrome. After administration of antibiotic treatment, complete recovery was seen. In the second period, diagnosis of Staphylococcal scalded skin syndrome was made clinically and confirmed by results of microbiologic investigations. Staphylococcus aureus was cultured from the nose, skin lesions and the pharynx. The strain appeared to produce exfoliative toxin A. The clinical response to similar antibiotic treatment was identical to the first period of Staphylococcal scalded skin syndrome. Conclusion. This case report discusses an unusual presentation of recurring Staphylococcal scalded skin syndrome in a baby with a very low birth weight

Prognostic model for predicting survival in very preterm infants:an external validation study

Objective: To perform a temporal and geographical validation of a prognostic model, considered of highest methodological quality in a recently published systematic review, for predicting survival in very preterm infants admitted to the neonatal intensive care unit. The original model was developed in the UK and included gestational age, birthweight and gender. Design: External validation study in a population-based cohort. Setting: Dutch neonatal wards. Population or sample: All admitted white, singleton infants born between 23+0 and 32+6 weeks of gestation between 1 January 2015 and 31 December 2019. Additionally, the model’s performance was assessed in four populations of admitted infants born between 24+0 and 31+6 weeks of gestation: white singletons, non-white singletons, all singletons and all multiples. Methods: The original model was applied in all five validation sets. Model performance was assessed in terms of calibration and discrimination and, if indicated, it was updated. Main outcome measures: Calibration (calibration-in-the-large and calibration slope) and discrimination (c statistic). Results: Out of 6092 infants, 5659 (92.9%) survived. The model showed good external validity as indicated by good discrimination (c statistic 0.82, 95% CI 0.79–0.84) and calibration (calibration-in-the-large 0.003, calibration slope 0.92, 95% CI 0.84–1.00). The model also showed good external validity in the other singleton populations, but required a small intercept update in the multiples population. Conclusions: A high-quality prognostic model predicting survival in very preterm infants had good external validity in an independent, nationwide cohort. The accurate performance of the model indicates that after impact assessment, implementation of the model in clinical practice in the neonatal intensive care unit could be considered. Tweetable abstract: A high-quality model predicting survival in very preterm infants is externally valid in an independent cohort.</p

Calculation of The Band Gap Energy and Study of Cross Luminescence in Alkaline-Earth Dihalide Crystals

The band gap energy as well as the possibility of cross luminescence processes in alkaline-earth dihalide crystals have been calculated using the ab initio Perturbed-Ion (PI) model. The gap is calculated in several ways: as a difference between one-electron energy eigenvalues and as a difference between total energies of appropriate electronic states of the crystal, both at the HF level and with inclusion of Coulomb correlation effects. In order to study the possibility of ocurrence of cross luminescence in these materials, the energy difference between the valence band and the upmost core band for some representative crystals has been calculated. Both calculated band gap energies and cross luminescence predictions compare very well with the available experimental results.Comment: LaTeX file containing 8 pages plus 1 postscript figure. Final version accepted for publication in The Journal of the Physical Society of Japan. It contains a more complete list of references, as well as a more detailed comparison with previous theoretical investigations on the subjec

Sri Lankan tsunami refugees: a cross sectional study of the relationships between housing conditions and self-reported health

BACKGROUND: On the 26th December 2004 the Asian tsunami devastated the Sri Lankan coastline. More than two years later, over 14,500 families were still living in transitional shelters. This study compares the health of the internally displaced people (IDP), living in transitional camps with those in permanent housing projects provided by government and non-government organisations in Sri Lanka. METHODS: This study was conducted in seven transitional camps and five permanent housing projects in the south west of Sri Lanka. Using an interviewer-led questionnaire, data on the IDPs' self-reported health and housing conditions were collected from 154 participants from transitional camps and 147 participants from permanent housing projects. Simple tabulation with non-parametric tests and logistic regression were used to identify and analyse relationships between housing conditions and the reported prevalence of specific symptoms. RESULTS: Analysis showed that living conditions were significantly worse in transitional camps than in permanent housing projects for all factors investigated, except 'having a leaking roof'. Transitional camp participants scored significantly lower on self-perceived overall health scores than those living in housing projects. After controlling for gender, age and marital status, living in a transitional camp compared to a housing project was found to be a significant risk factor for the following symptoms; coughs OR: 3.53 (CI: 2.11-5.89), stomach ache 4.82 (2.19-10.82), headache 5.20 (3.09-8.76), general aches and pains 6.44 (3.67-11.33) and feeling generally unwell 2.28 (2.51-7.29). Within transitional camp data, the only condition shown to be a significant risk factor for any symptom was household population density, which increased the risk of stomach aches 1.40 (1.09-1.79) and headaches 1.33 (1.01-1.77). CONCLUSION: Internally displaced people living in transitional camps are a vulnerable population and specific interventions need to be targeted at this population to address the health inequalities that they report to be experiencing. Further studies need to be conducted to establish which aspects of their housing environment predispose them to poorer health

Diagnosing collaboration in practice-based learning: Equality and intra-individual variability of physical interactivity

Collaborative problem solving (CPS), as a teaching and learning approach, is considered to have the potential to improve some of the most important skills to prepare students for their future. CPS often differs in its nature, practice, and learning outcomes from other kinds of peer learning approaches, including peer tutoring and cooperation; and it is important to establish what identifies collaboration in problem-solving situations. The identification of indicators of collaboration is a challenging task. However, students physical interactivity can hold clues of such indicators. In this paper, we investigate two non-verbal indexes of student physical interactivity to interpret collaboration in practice-based learning environments: equality and intra-individual variability. Our data was generated from twelve groups of three Engineering students working on open-ended tasks using a learning analytics system. The results show that high collaboration groups have member students who present high and equal amounts of physical interactivity and low and equal amounts of intra-individual variability

Efficacy of feed forward and feedback signaling for inflations and chest compression pressure during cardiopulmonary resuscitation in a newborn mannequin

Background: The objective of the study was to evaluate a device that supports professionals during neonatal cardiopulmonary resuscitation (CPR). The device features a box that generates an audio-prompted rate guidance (feed forward) for inflations and compressions, and a transparent foil that is placed over the chest with marks for inter nipple line and sternum with LED’s incorporated in the foil indicating the exerted force (feedback). Methods: Ten pairs (nurse/doctor) performed CPR on a newborn resuscitation mannequin. All pairs initially performed two sessions. Thereafter two sessions were performed in similar way, after randomization in 5 pairs that used the device and 5 pairs that performed CPR without the device (controls). A rhythm score was calculated based on the number of CPR cycles that were performed correctly. Results: The rhythm score with the device improved from 85 ± 14 to 99 ± 2% (P &lt;0.05). In the control group no differences were observed. The recorded pressures with the device increased from 3.1 ± 1.6 to 4.9 ± 0.8 arbitrary units (P &lt;0.05). The second performance of the teams showed significant better results for the group with the CPR device compared to the controls. Conclusion: Feed forward and feedback signaling leads to a more constant rhythm and chest compression pressure during CPR

Lattice Distortions Around a Tl+ Impurity in NaI:Tl+ and CsI:Tl+ Scintillators. An Ab Initio Study Involving Large Active Clusters

Ab initio Perturbed Ion cluster-in-the-lattice calculations of the impurity centers NaI:Tl+ and CsI:Tl+ are pressented. We study several active clusters of increasing complexity and show that the lattice relaxation around the Tl+ impurity implies the concerted movement of several shells of neighbors. The results also reveal the importance of considering a set of ions that can respond to the geometrical displacements of the inner shells by adapting selfconsistently their wave functions. Comparison with other calculations involving comparatively small active clusters serves to assert the significance of our conclusions. Contact with experiment is made by calculating absorption energies. These are in excellent agreement with the experimental data for the most realistic active clusters considered.Comment: 7 pages plus 6 postscript figures, LaTeX. Submmited to Phys, Rev.

New constrains on the thickness of the Semail Ophiolite in the Northern Emirates

Near-critical angle and refraction studies were performed at IFP as piggyback studies during a wider programme of crustal imagery operated by WesternGeco on behalf of the Ministry of Energy of the United Arab Emirates. The main objective is to illuminate the base of the Semail Ophiolite along part of a regional transect (D1) crossing the Northern Emirates from the Gulf of Oman in the east up to the Arabian Gulf in the west. Results confirm that the sole thrust of the ophiolite has been folded during the Miocene stacking of the underlying Arabian Platform. The thickness of the ophiolite grades from zero in the core of the Masafi tectonic window, up to a maximum of 1.7 km below the axial part of a successor basin which has been preserved on top of the serpentinite west of the current exposure of the main ultramafic bodies. Apatite grains extracted from plagiogranites of the Semail ophiolite also provide evidences for an early unroofing of the gabbros and plagiogranites during the Late Cretaceous, with cooling ages of 72-76 Ma at the top of the ophiolite in the east (not far from the Fujairah coast line), which are coeval and also consistent with the occurrence of Late Cretaceous paleo-soils, rudists and paleo-reef deposits on top of serpentinized ultramafics in the west. Younger cooling ages of 20 Ma have been also found at the base of the ophiolite near Masafi, in the core of the nappe anticline, thus providing a Neogene age for the refolding of the allochthon and stacking of underlying parautochthonous platform carbonate units. These results, together with the occurrence of a thick sedimentary pile illuminated below the metamorphic sole along the north-trending, strike-profile D2 running parallel to the axis of the Masafi window, should stimulate a renewal of the exploration in the central part of the Emirate foothills, where the ophiolite thickness is currently limited, and was already drastically reduced by the end of its Late Cretaceous obduction. © 2010 Saudi Society for Geosciences

Failed resuscitation of a newborn due to congenital tracheal agenesis: a case report

Tracheal agenesis is a rare congenital condition. It usually presents as an unexpected emergency during resuscitation of a newborn in the delivery room. The condition is almost always fatal in the resuscitation phase, but also when the neonate survives the long term prognosis remains poor. We present a case of tracheal agenesis, discuss its presenting symptoms and possibilities for antenatal diagnosis and review the therapeutic options