Spring times are soon getting here, to my home turf in rural Sweden.

This open landscape (and framing forests) is where my brilliant ideas are rooted, and thrive. The feeling of opportunity and freedom.

https://maps.app.goo.gl/eDaP3zTRCqfAhDox5?g_st=ac

In the beginning, we had a pretty basic Internet. It offered the opportunity to search for information unilaterally and connecting people over electronic mail.

Later came the embryo of the social web, taking the communication beyond emails. The first multi-lateral gatherings happened on so-called Bulletin Boards, often geeky/niched online spaces where like-minded people found freedom and space to “share and care”, as the saying went back then. The 99nicu Discussion Forum was started in 2006 with such an intention, to build a dedicated online community for NICU staff.

The social web, as we know it today, was/is built on scale. I believe the initiatives that developed into the large global platforms had sound intentions, but the magnitude of fast growth required business models and venture capital to sustain. As we all know, there is no such thing as a free lunch.

Through massive user bases and algorithms, the typical social media feed selectively promotes content aligning with your own posts. In the early days of Twitter, this worked wonderfully well. I was an early Twitter user and truly enjoyed an engaging and active feed. Back then, Twitter was my primary space for finding and discussing new research publications. However, when the open athmosphere got lost, I decided to log out for good.

Large social media platforms will, sooner or later, need to capitalise on you, using your data/content for promotion of advertising content. Furthermore, the social web offers anonymity and automation, enabling less nice accounts to ruin your good feeling about your freedom of speech. “Enshittification”…

Coming back to jENS and social media...

There are a larger set of social webs now. In addition to “the old” X, Facebook, and LinkedIn, we now have Threads, BlueSky, and Instagram. I checked in myself on all mentioned platforms, browsing the conference hash tags #jENScongress and #jENS2025. The results were indeed disappointing. With the exception of companies advertising their presence, very few posts popped up with professional reflections, questions, and comments about sessions and workshops. Back in the days, it was possible to follow news and views shared as conference "live-feeds" on Twitter, as if almost being there in person. The social media coverage of jENS was nothing but a disappointment.

Why this?

This variety of social webs has led to fragmentation. Today, there is no natural single space for online instant sharing/discussion. People are spread out, there is no critical mass of niched content / people.

What now?

As a believer of independent initiatives driven by Greater Good Goals beyond business models, I think there is indeed room for our older and slower 99nicu Discussion Forums. But I would love to have an instant feed like Twitter with focused neonatology content, like my old Twitter feed. A large number of NICU staff has joined BlueSky, but despite my attempt to curate a focused feed, it gets cluttered by pets, politics, and all problems in today’s complicated world. I have nothing against pets, politics, or world problems (the other way around!), but I prefer to get such content through other channels (like regular news media).

Some time ago, 99nicu opened “the NICUVERSE”, i.e an own Mastodon server. Mastodon is a self-hosted social media platform that gives full control to you as a user (and to us hosting it). There is a slightly higher threshold to get into how it all works. And, the technical platform is also a work in progress (being open source). But we are all smart people and learn by doing! There are several principal advantages with Mastodon: there are no adverts, no one sells your data, you control your integrity and privacy. I do believe Mastodon to be the platform for a community feed with uncluttered neonatal care content.

If you are curious to try this out, register for the NICUVERSE here! I will do my best to contribute with content 😀

I’ve done it, the last night shift.
What in many ways defines us, devoted to neonatal care, is no longer part of my working life.

One of my gifts in life has been endurance and grit, allowing a good amount of workload. It has enabled my long journey from the countryside where I grew up to an intellectually affluent position with many hats: one clinical, one academic, one for greater-good projects (like 99nicu!), and one as a startup entrepreneur.

But with time and age usually come limitations, even for me. Approaching my 60s, and accepting that our family’s cardiovascular phenotype is also my trajectory, I decided to follow the advice to stop working shifts. There’s no drama or anything like that (no need to send flowers!), but I want to stay in good shape until the finishing line.

Still, quitting night shifts is a big step for me, one I’ve been hesitant about. While there are many upsides, including a sense of relief, I also feel a certain fear of missing out.

I think many of you reading this can relate to how shift work becomes part of your DNA when you dedicate your professional life to neonatal care. Babies are born seven days a week, and they don’t care if delivery happens at 2 a.m. on Midsummer’s Eve.* As NICU staff, we know this. Our setup is planned accordingly, and most of us would admit that we actually like this lifestyle, being able and willing to open our large toolbox of small things, at any time.

During my many shifts over the years, I’ve been privileged to meet countless families and their newborns under challenging circumstances. In most (though unfortunately not all) cases, these situations have brought relief and reward, especially when later meeting families and NICU graduates at our follow-up clinics.

So, what now? Honestly, I’m not entirely sure. My daytime clinical role won’t change much, but the bigger shift is in my overall “business model” for work.

In Sweden, on-duty hours can be compensated with time off instead of pay. For example, if you work a weekend, you can get a full week off with salary instead of “grabbing the money.” For me, time has its own precious value, and our model of compensating shift work with time have allowed me to engage in many fulfilling but unfunded projects still connected to neonatal care. Such as research, 99nicu and EBNEO, and starting Neobiomics from scratch.

Now, without the opportunity to “earn time” from night shifts, I’ll need to rethink how to fit my life into a tighter schedule. That’s not entirely a bad thing, but it will require new, creative ways to keep working for the bigger picture.

⸻

*Maybe this isn’t the best example — at 2 a.m. on Midsummer’s Eve in Sweden, many Swedes are still awake, enjoying the early morning sun. But you get my point.

In the next version (v5) there will be a major overhaul of the user interface, allowing for an even better way of presenting and browsing content here.

You can get a sneak preview in the video below (a bit techy, but still )

Painful it is, but I wanted to share that I have decided to close my Twitter/X account. I will miss you tweeps. But... see you soon elsewhere!

I started to build a network on Twitter in 2009, exploring this new channel for communication about research and medicine. Twitter was different then, compared to what X has become. In the earlier years, Twitter impersonated open, high-level and cross-professional discussions. Despite different opinions shared, the feed was a friendly gathering. If you posted something seemingly controversial (or something not at all controversial about Covid-19, liberal democracy values, suffering among immigrants, or aggressive warfare), people commented in a respectful manner. You did not get a load of automated bot replies (from "verified accounts" with like ~10 followers) telling you were a moron and should XYZ!

Importantly, #NeoTwitter, #NeoEBM and #foamneo all grew into valuable resources. I am so grateful for connecting with you and other wonderful people there. It has indeed enriched my professional life, and often made me think twice.

With X and the new leadership by Musk et al (btw, is there even an “al”?), I have simply taken the consequence of not compromising with my values. That’s why I will delete my X account soon, after saying good bye to comrades there. The principal reason is that I don’t want to contribute to a communication platform where hate speech, conspiracy theories, and fake news is given this much space. The world of today is complicated enough as it is.

Although my own feed is still pretty OK, I feel that sharing a communication platform with the “dark side” (and don’t underestimate the force of it), implies that my presence there, as a person and as a professional, legitimate the bad stuff. In fact, this might even be an intentional business strategy of the X management team.

There is certainly some “alternative cost” to rebuild a neonatal network on a new platform. But I am fine with that. For myself, this is a step worth taking to get rid off the feeling that I am also, to some symbolic extent, feeding the trolls on X.

For the time being, I will stick to LinkedIn, while hoping to rebuild a network feed on our NICUVERSE Mastodon-server and/or on Bluesky. So, might see you there

And of course, maybe the future holds a renaissance for 99nicu.org with its older-school web site-based discussions.

Please note that this is a personal decision and about my own Tw/X account. However, within the 99nicu Team, we are also discussing an X-it strategy, but we need to make sure we have the organization's best interest in mind. And, with our upcoming conference, we may choose to keep the 99nicu account up and running to for sharing the word about our conference plans. After all, #NeoTwitter is still a great place for reaching out.

Thanks to the Verge for making the graphics illustrating this post

Since several years, I have devoted a lot of work for a project that eventually led to the startup Neobiomics, since 2019 under the wings of the Karolinska Innovations AB. Neobiomics provides ProPrems®, a high-quality multi-strain food supplement.

Entering the startup universe has been like embarking a rollercoaster journey. In many ways a personally rewarding experience, but it has also been walking a challenging path with many obstacles to overcome along the way.

Regardless of the ups and downs, bringing an idea into a startup context will make you work. A lot. (And for most of the first few hundred/thousand hours, without renumeration.)

I recently saw a TED-talk by Darria Long (see it below), on how systematic strategies in emergency medicine can be used to cope with high work loads in general. And it struck me that we, as health care professionals, are well fitted as startup founders.

Not anyone make the choice to work in health care. IMHO, we are a selection of people sharing a special compassion for what we do. And, through long education and training, the importance of know-how and experience is incorporated in our DNA.

How does all this make health care professionals fit for startups?

• we build and work through trustful relations
• we like to meet the unknown
• we work hard for a clear objective, even if the outcome may be uncertain
• despite limited resources, we manage things first
• thanks to limited resources, we can prioritize
• our work is problem-based, not solution-based
• our work has structure, even in a seemingly chaotic  situation
• the detective work in medicine makes us good lateral thinkers

Naturally, the startup universe requires its own specific skills (finance, legal, development, communication etc-etc). And the trajectory for becoming a startup founder is similar to becoming a health care professional - one needs to learn, practise and connect with others to make something out a brilliant idea.

You have an idea? Make it happen!

(this post is dedicated to KI Innovations AB)

Journals, societies, regular news media, social media platforms etc-etc play an important role for us to keep updated, and many web sites have also opened up their content free of charge.

We will learn many things from facing and tackling this pandemic, but one major change will certainly be our communication channels. Many are discovering the web-based possibilities to learn and discuss.

We will do our best to facilitate professional communication within the neonatal community.

And, finally it seems that the company providing our software (IPB) will finally roll out a smartphone app. Which means that 99nicu will literally become available in your pocket through a "99nicu App".

The screen shots below comes from the beta-version of the app now used by the company providing our software.

And yes, there will be light-mode and dark-mode  

Stay tuned!

I have been in the ecosystem of innovation since 2016 with the startup company Neobiomics and the ProPrems® product, in the Innovation Incubator at Karolinska Institutet (KI DRIVE). There we meet with other startup companies, and we share several of the challenges of operating in the interface between innovation and “traditional” health care.

Here's a few thoughts.

Innovation can only benefit patients through implementation

For innovations to reach out and bring value, implementation is key. No matter how brilliant an idea, it needs to be brought to life in an open-minded culture, where learning and change are core values. Health care can be conservative and resistive to change, and that may slow down, discourage or even hinder implementation.

Eminence-based medicine vs evidence-based medicine

I am a strong advocate of evidence-based medicine myself, but health care is still influenced a fair bit by “eminence-based medicine”. High-profile people may tell how they “feel” or “believe”. While feelings and beliefs are essential parts of the human nature, they are (IMHO) insufficient arguments in discussions about evidence. Innovations backed by evidence may not “feel right” if they change current practice. But we need to trust data, or else there is little point of doing research.

(Too?) many stakeholders

Health care is a complex structure, with a lot of stakeholders. While patients are more empowered now than ever before, there are a lot of “layers” between an innovation and a patient. Implementation involves staff, informal leaders, heads of departments, pharmacies, management teams, professional bodies, policymakers etc. As a consequence, implementation takes time. It can take more time than patients should need to tolerate.

What to do?

• To take words to action, health care needs to embrace a culture of learning and change, or else “innovation” will be no more than a buzz word
• Research data is a valid starting point for change
• Innovators travel with light luggage, and need a complementary decision-making process in health care, not to delay the benefits and value that innovation bring patients

With best regards from the Department of Brilliant Ideas

Late last year, John Lantos, pediatrician and a leading medical ethicist, published a review in NEJM on the ethics around decision-making in the NICU. The paper is not open-access... but you can surely get it from within your hospital intranet or your university/hospital library.

We have a fantastic toolbox in the NICU. We can provide live-saving treatments and support. Most newborns in the NICU survive to good long-term health.

However, we also operate in a high-risk environment where some infant may suffer, some infants will die, and some infants will survive with difficult sequele. Which raises the question, by staff and by parents, what is the "right" thing to do in complex situations. When withholding and withdrawing life-sustaining therapies becomes a option to decide upon.

How could we navigate in this landscape? IMHO, the review by Lantos is a good starting point on how to form a local practise.

Lantos shares his reasoning about we cannot "solve" these discussion with "information" as such. Despite how hard we try,  data alone does not lead the whole way. Outcomes is hard to measure, they change over time and we all percieve risks differently. Therefore, information is difficult to standardize. Furthermore, those of us sharing the information will filter our presentation through our subjective selves, coping with opinions, experiences and our expertise in different ways. 

The better alternative around ethical questions is shared decision-making. Two central quotes of the review is that

Quote

How can doctors help parents make authentic choices? The first step is the hardest. Doctors must become aware of their own beliefs and unconscious biases. These may relate to disability; to the allocation of scarce resources; to parental ethnic background, educational level, sexual orientation, and socioeconomic status; or to other factors. Such beliefs and biases could cloud physicians’ perceptions of what parents want and need. The second step in helping parents is to learn to ask them open-ended questions about their hopes, fears, goals, and values and then listen carefully for key elements of the answers.

and that

Quote

A focus on the microethics of shared decision making may give the impression that any decision is ethically defensible. Such is not the case. The zone of parental discretion is delineated by society’s complex legal, political, economic, and cultural crosscurrents.

Certainly, the future of neonatal care will bring more ethical questions to us. Refined prenatal diagnostics, the down-shifting boundary of viability and new treatment technologies in the future (like the artificial placenta) will impact how we think about fetal life and postnatal life, what is the "periviable grey zone" and what our fantastic toolbox can do.

While improving our skills, from a medical/technical viewpoint, we also need to improve how we cope with the ethics around decision-making processes.

Besides reading the review by John Lantos, I can recommend you to see this lecture from theh #99nicuMeetup in Copenhagen 2019, by Eduard Verhagen.

(Feature Photo : Cropped photo by Liane Metzler on Unsplash)

It was a one-time shot without rehearsal, so we spoke from the heart

In the virtual 99nicu Headquarters, we are now very busy with all preparations for our upcoming Meetup, AKA the Future of Neonatal Care conference. This third conference will take place in Copenhagen, 7-10 April, and we are already thrilled about what to come.

Our vision for the 99nicu Community is to offer an Internet platform where neonatal staff from all over the world can share questions, experiences and expertise. Therefore, we are grateful to see, as previous years, that our conference “footprints” our global outreach and attracts a truly international group of delegates. There are currently 130 delegates coming from 30 countries, from East to West, from North to South. Naturally, we have room for You as well!

What makes the Future of Neonatal Care conference different from other meetings?

First of all, our principal idea is the one of postgraduate learning. To provide evidence-based neonatal care, we all need to refresh and refine our knowledge base. That is pretty obvious, as our work as neonatology professionals gravitates around know-how. IMHO, we can all improve here.

Secondly, we believe conferences should be a place to exchange expertise and experience, and give anyone a chance to ask questions. Every 45 minute session typically includes a 30 minute lecture, to give sufficient time for discussion. Participants at our previous conferences especially enjoyed “very good discussions” and “plenty of time for questions”. We use the smartphone app sli.do (https://www.sli.do/) to allow immediate feedback from participants. Through polls and multiple-choice-questions during lectures, delegates learn from each other. Most importantly, lecturers also get an opportunity to comment directly on aspects popping up.

Thirdly, we aim to place topics in a forward-facing context, how neonatology will develop in the future. Why do we need to know about cord clamping? How should we support breathing of preterm infants? What inotropes shall we use when? Shall discharge MRIs be standard of care for preterm infants? Why do we need to rehearse simulated scenarios?

Great program!

We are honored to welcome a great set of Faculty members to Copenhagen. To share a few examples:

• Barbara Schmidt and Haresh Kirpalani lead a workshop on when evidence should change the standard of care, and how to interpret non-inferiority trials
• Mortein Breindahl will lecture and lead a workshop on neonatal transports, together with Christian Heiring
• Victoria Payne will share her expertise on prevention of CLABSI
• David Edwards will challenge our minds about MRIs in preterm infants
• Liisa Lethonen and Sari Ahlqvist-Björkroth will, for the third time, run their highly appreciated workshop on Family-based care
• Brett Manley will tell us if/how to “Go with (high) flow”
• Gorm Greisen, Ulrika Ådén and Eduard Verhagen will engage in several lectures and a debate on practices and ethics around the border of viability, and parent-participation in decision-making.

As you can see, we have lots to look forward to! Join us at the Future of Neonatal Care in Copenhagen 7-10 April!

And yes, we will share take-home messages from the Future of Neonatal Care from our Twitter account @99nicu. As previous years, the hashtag will be #99nicuMeetup

In a report that come out the other week, WHO present its key findings from an upcoming publication "Survive and thrive: transforming care for every small and sick newborn."

While we commonly think about neonatal care and preterm infants in high-resource settings, there is really a lot of public health work to be done when it comes to improve neonatal care in low-/mid-resource contexts. In fact, the world will not achieve the global target to achieve health for all unless it transforms care for every newborn.

What I specifically like is that this documents really acknowledge the power of family-based care.

To save newborns, the report recommends:

• Providing round-the-clock inpatient care for newborns
• Training nurses to provide hands-on care 
• Harnessing the power of parents and families
• Providing good quality of care
• Counting and tracking every small and sick newborn

Naturally, countries need to allocate the necessary resources. While we (in the rich world) may think that a LOT of money is needed, WHO estimates that an additional investment of US$ 0.20 cents per person can save 2 of every 3 newborns in low- and middle-income countries. IMHO, that's a small investment for the best of benefit.

Click here to find the report on the WHO web site.

And click here to find "Social media tiles" illustrating the key findings, which I also share below.

• telomere length, inflammation and lung function
• viral respiratory infections and cellular aging 
• immune system development and environmental exposures
• hyperoxia-induced lung damage and the capacity to counter-act surfactant inactivation with a novel antioxidant

A great thesis, available for download here: https://openarchive.ki.se/xmlui/handle/10616/46531

For the table seating at the dissertation party, her husband had made clever and funny personal drawings for all guests. I translate mine for you below, it is on the spot 

Best regards from Mr Conference Organiser

PS. BTW, hope to meet up with you at the next "Future of Neonatal Care" conference in Copenhagen. Click here to find out more.

Quote

NEONATAL CONFERENCE

- So, welcome to this year's conference. Would the first speaker like to crawl on stage and babble?"

In case you don't know, Neonatology Today is a peer-reviewed monthly newsletter that is available free of charge, and has a mission to provide timely news and information the care of newborns and the diagnosis and treatment of premature and/or sick infants. Subscribe here!

Maybe you have already read my first column in (here on page 46-47), but I also want to share my text here, on why 99nicu has a great future despite that there is "an app for everything"  

- - - - - - - - - - - - - - - - - - - - 

"As a starting point, I would like to share some background for those who are not familiar with 99nicu. The online community 99nicu.org started off with a few colleagues in my kitchen in late 2005. This was a time before the social web was on everyone’s fingertip. Instead, Internet-savvy people gathered on so-called Bulletin Boards or Discussion Forums, often niched to specific topics or interests and managed by enthusiasts. Being an active member of a computer forum, I got the idea to bring neonatal staff together online. After plenty of hours, fiddling with software and web stuff, we opened the 99nicu web site on May 11, 2006. But what did the “99” stand for? That people would gather to discuss 99% of neonatology, and 1% of everything else

Since the launch in 2006, I think we have reached the main purpose: to create an international neonatal community for sharing experience and expertise, not restricted by geographical boundaries. We now count more than 7.000 registered members. Although the majority are doctors, members represent all neonatal staff categories. Moreover, our server gets a lot of traffic! During the latest 3-month period, there were 42.000 pageviews, from all over the world (Fig 1.)

What’s the future of online forums, when there’s an app for everything? Will 99nicu be out-competed by the big players of the social web? Services like WhatsApp and Twitter do offer great tools for discussions in closed and open groups. But still, I believe that niched forums will outlive social media platforms when it comes to professional content. For two principal reasons. First, I assume that professionals will want to keep out of the business model of the social media companies, where free-of-charge turns users into data-for-sale (“if it is free online, you are the product”). Second, social media companies, despite smart algorithms, will not bring enough focus to your feeds. If you are primarily interested in neonatal medicine, your content will still be diluted with images of pets and food plates. On the contrary, “old-school” communities are comprehensible and focused. You know why you are there, you know why other people are there, and you know what content to expect.

While 99nicu gravitates around the website, we have also realized the potential in meeting up IRL. Getting to know each other online is fantastic, but personal meetings will always be very powerful for networking and sharing. That is why we are now preparing our third conference “Future of Neonatal Care.” At our previous conference in Vienna, we had 150 delegates from 33 countries. When we meet up in Copenhagen, 7-10 April 2019, we hope to bring more than 250 people together, from an even larger number of countries.

Interested in joining us in Copenhagen? Keep updated on 99nicu.org!

Figure 1 The geographical distribution of 42.000 pageviews on 99nicu.org during 1 July – 30 Sept 2018. The color coding represent the number of pageviews.

Generally, we'll stick to the successful format we have had at the previous meetings: 45 min slots split into a 30 min lecture and a 15 min discussion. We'll continue to use the sli.do smartphone app to facilitate the discussion and allow every delegate to share questions and comments.

In addition to the lecture program 7-9 April, we are also planning workhops and mini-symposia on the 10th of April. We'll share more info about those soonish, but if you want ONE cliff-hanger... we plan one symposium about the infant microbiome etc-etc  

Confirmed topics and speakers

• Neonatal transports - safe and easy, Morten Breindahl (Sweden)
• Treating pain in neonates, Karel Allegaert (Belgium)
• How to improve quality on the NICU, Joseph Kaempf (US)
• Hyperglycemia - how to manage and why, Kathryn Beardsal (UK)
• Why we should rehearse simulated scenarios, Ruth Gottstein (UK)
• Go with the (high) flow, Brett Manley (Australia)
• News in the updated ESPGHAN guidelines, Nadja Haiden ( Austria)
• Prevention of BPD, Christian Poets (Germany)
• The many inotropes - what to use when, Yogen Singh (UK)
• Cord Clamping, 1.0 and 2.0, Ola Andersson (Sweden)
• When NEC rates persist , despite everything done “Right”, Ravi Patel (US)
• Outcomes in infants surviving at the limit of viability, Ulrika Ådén (Sweden)
• Ethical decision making around the limit of viability, Gorm Greisen (Denmark)

We (i.e myself, @Francesco Cardona @RasmusR @Christian Heiring , Gorm Greisen and Morten Breindahl) are currently working on the program lectures and workshops.

I just want to share the first five confirmed speakers and their topics:

• Morten Breindahl: Neonatal transports – how to do them safe and easy
• Ola Andersson: Cord Clamping, 1.0 and 2.0
• Ravi Patel: How to explain when NEC rates persist – even when a NICU does everything “Right”
• Ulrika Ådén: Infants surviving at the limit of viability, what are the outcomes? What shall we do?
• Gorm Greisen: Ethical decision making around the limit of viability- lessons from Scandinavia

I'll update you all with more names and topics as they are confirmed

Looking forward to meet up in Copenhagen!

An amazing number for an independent grass-rotish project, that aims to create a virtual space for neonatal staff around the world.

Naturally, there are members that registered more than 10 years ago who have completely forgotten about 99nicu. But still, we know that our newsletter is recieved by ~6200 members.

Regardless of the exact number,  we have engaged a lot of people over the years, who have been connecting and sharing questions and expertise.

And, in my dreams, I see 99nicu reaching its real potential. Let's hope that dream will come true.

I love the hands-on work in the NICU, but I also believe strongly in pursuing work at the meta-level of things. That we can change care and improve outcomes through research, quality improvement, and taking our professionalism outside the box. And to the web! Naturally, the 99nicu “global village” is one of those meta-level journeys for me.

I have shared small bits of information previously about a new project with a really big scope, Neobiomics, an academic startup company founded in 2016, that will provide a super-high quality bifidobacterial product, “from the community, to the community”. Launch is planned in Europe mid-2019.

Although the product itself is much requested, I personally think that this project has a much wider potential. With access to a highly advanced machinery (literally!) at the production facility, it should be possible to make other compositions (other sets of bacteria, other bacterial numbers, +/- other compounds etc) for some really cool comparative trials.

We are still working mainly behind the scenes in the Neobiomics HQs, but relatively soon, we will step on stage and start creating buzz

Stay tuned  

PS. The project above has nothing and everything to do with the talk below. Creativity is the Power to Act.

(@Zuckerberg, no offense here. Obviously, you created something far greater than 99nicu, still a grass rot project. BTW – could we apply for funding from you Foundation?)

When starting 99nicu.org in 2006, we nourished an idea that experiences and expertise should not be hindered by geographical boundaries. In some sense, this was a statement, that we as medical professionals could help each other through other channels than journals and conferences, with inclusive and open mindsets, and new technologies.

Back then we knew little about the powerful potential of the Internet. Neither could we foresee how the Internet would change our private and professional lives. We were just a group of young staff in Sweden, wanting to create a web based platform for discussions within a global group of neonatal pro’s.

When I read this blog post by @AllThingsNeonatal (on his web site allthingsneonatal.com) where he reflects on how sharing and caring in social media has created a global village, I am struck by the thought - a global village was what we envisioned back in 2006. Coming from a small village myself, I think that also 99nicu.org parallells the village symbolism: a setting with small communication gaps (everyone knows everything about everyone, so we don't need formalities to get in touch and speak out), and where giving and taking advice is a bilateral process that may ultimately lead to “the best solution”. Or simply, that we find out that there are several good solutions for a given problem.

Has 99nicu become as global village for neonatal staff on the Internet? Although biased, I’d say YES . Data also supports that. During January through April,  the web site had 18.000 visitors from all over the globe, making 45.200 pageviews. From the Google Analytics dashboard we can all see that 99nicu reaches almost every corner of the world!

Our principal idea has always been that the virtual space is where we operate. It is the Internet that creates the possibility to connect and exchange experience as expertise from where we are. However, meeting up IRL is also a powerful way to maintain sustainable networks and that idea is the driving force behind the “99nicu Meetups”.

For the 1st and 2nd Meetup conferences in Stockholm and Vienna (in June 2017 and in April 2018), delegates came from 17 and 33 countries, respectively. Let’s hope we can have even a larger geographical representation at our IRL Meetup next year. Stay tuned for dates and location

When we went through the registrations yesterday, it struck us that delegates will come from all corners of the world. There are already delegates coming from 21 countries!

Just to visualize, we marked the countries on the map below.

It will be great to meet up with all of you coming! And, although we will represent many different context, I also believe it is a very good example of how a great diversity of people are sharing common questions and problems. My personal reflection is that not only infants are similar around the globe, neonatal staff also share a passion of doing great things for the tiny ones.

And yes, we still have vacant chairs in the lecture hall. Be mostly welcome to register for the meeting, regardless if you already have colleagues from your country attending

A set of lectures by Barbara Schmidt, Ashok Deorari, Sourabh Dutta, Courtney Wusthoff, Roger Soll and many others, are now available on Youtube. 

You can also view my lecture on Fetal Programming

Enjoy!

Our every-day job is to meet parents and their preterm infants. We have our professionalism, skills and family-centered care strategies. But how do we understand the large gap those families need to bridge, and how parenthood evolves when a child arrives too early?

For myself, music has always been important (even essential!) in my own reflections about wider scopes. When it comes to parenthood, I can strongly recommend the record Mother Tongue by Rebekka Karijord, a Norwegian composer and singer.

Mother Tongue is a beautifully strong and moving record about parenthood complicated by a preterm delivery, about experiencing a cesarean section far too early ("...this is a riot of blood and steel/bending me open, violently..."), and how a tiny infant still could "weigh more than...the universe, to me". The lyrics, as I interpret, is also about parenthood in a deeper sense. The music itself is so delicate and precise, and yet powerful at the same time.

This is a record we should listen to. Get it on CD. Or on vinyl if you still play such records, like I do . And bring it to your next staff meeting. And of course, Mother Tongue is also available on Spotify.

The photographer Johan Bävman is touring around the world with a photo exhibition about "Swedish Dads". The exhibition shows fathers on parental leave.

 Swedish newspapers recently wrote about the reactions in Sydney, Australia (see exhibition before 26/9).  A (female) columnist in Sydney Morning Herald referred to the exhibition like "porn for stressed moms". I wouldn't agree on that headline but the column itself is interesting, and the reasoning about how the society could/should become more equal.

The photos are nothing but fantastic! See some below and visit Bävmans web site to see them all here.

I touched upon this topic long ago, in a short blog post here in 2012, that "it's not all about motherhood in the maternity wards and NICUs". Our family-centered neonatal care includes all parents, i.e. expect the father to be as present and care-giving as the mother.

For myself, being a "Swedish Dad", I never considered NOT taking parental leave when we had our children. When our son was born in 1996, it was more easy as I was a pediatric fellow. But even in 2011 when our daughter was born, going off work during ~6 months was a natural thing to do for me despite being a consultant neonatologist. We work such a lot during our life-time, and we don't have too much ice-cream with our little ones (but it's great when we do )  

I am well aware that many countries have less generous systems for parental leave (especially regarding the amount of time funded but welfare systems). But, I strongly recommend all father to take leave with children, and manage the household while the mother is going back to work. It is an investment for life.

Have a look at the video about the photo project below and enjoy some of the photos, embedded with permission from Johan Bävman.

If you visit Stockholm later this year, the "Swedish Dads" exhibition comes to Galleri Kontrast in Stockholm (30/9 - 29/10).

Science Showcase collect video clips with scientific content aimed for a broader (public) audience. There is a contest going on and the best video will win 2000 USD.

Just wanted share two interesting clips that are sort of relevant for neonatal staff. The first video is about epidemiology and its basic concepts. As you know, there are tons of clinical studies in neonatal medicine based on observational data, many of which suffer from major limitations as researchers did not really grasp some basic concepts how to handle their data... In the first video, there is one mistake though - the illustration of confounding is not entirely correct, instead the video illustrates mediation which is different thing. Small mistake though, as the error in the video is rather that the arrow is flipped 180 degrees. See and find out what I mean  

The second video is about Big Data, a coming major thing in neonatal research as we get access and collect more and more data. The video is about genetic data, but the same principal idea ("so much data you don't know how to handle it") applies to health register data, and the richness of data that could be tanked down from from our monitors, ventilators etc.

Enjoy!