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Stefan Johansson

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Blog Entries posted by Stefan Johansson

  1. Stefan Johansson
    I like projects outside my clinical and academic work. 99nicu was the first big project that came out in public from my "Department of Brilliant Ideas".
    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)
  2. Stefan Johansson
    The professional communication during the Covid-19 pandemic really shows the potential to share expertise and experience through web-based channels.
    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!
  3. Stefan Johansson
    The new buzz word in health care is “innovation”. Which is a good thing! 
    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
  4. Stefan Johansson
    If you are to read one paper on neonatal ethics this year, I'd argue that this is the one.
    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
    and that
    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)
  5. Stefan Johansson
    While at the #99nicuMeetup, I and @Francesco Cardona were filmed by Miris (one of our exhibiting partners).
    It was a one-time shot without rehearsal, so we spoke from the heart
  6. Stefan Johansson
    I must admit that it is a bit exciting to think about that 99nicu.org went live 12 years ago, at a time when Facebook and other “social media” web sites was yet to be invented.
    (@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
  7. Stefan Johansson
    I just realized that the 99nicu community has grown to >7000 members.
    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.
  8. Stefan Johansson
    We are on important missions in the NICU. From time to time, we all sense the strong rewarding feeling that our work mattered a lot.
    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.
  9. Stefan Johansson
    Register for the 99nicu Meetup!
    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

  10. Stefan Johansson
    I would just like to share a new document by the World Health Organization, WHO.
    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.

  11. Stefan Johansson
    My colleague Ewa Henckel defended her thesis at Karolinska Institutet on "Cellular consequences of preterm birth : telomere biology, immune development and oxidative stress" last week, including four projects on 
    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.

  12. Stefan Johansson
    Since the October issue of Neonatology Today, I and @Francesco Cardona will alternate in writing a column where we will share bits and pieces from the 99nicu community, mixed with more general reflections. This column is the start of a extended partnership between 99nicu and Neonatology Today. 
    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.
  13. Stefan Johansson
    We now have 13 confirmed speakers for the Copenhagen Meetup 7-10 April next year!
    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)
  14. Stefan Johansson
    I just want to share some brief news about our next Meetup, 7-10 April 2019 at Rigshospitalet in Copenhagen/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!
  15. Stefan Johansson
    As you know, our conference the Future of Neonatal care in Vienna is approaching!
    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

  16. Stefan Johansson
    The Society for Evidence-Based Neonatology (EBNEO) had its 4th International Conference in Hyderabad, India, last November. Although being baised, as the chairman of EBNEO, the conference was a huge success, thanks to that the EBNEO was held in association with Indian Association of Pediatrics Neonatology Chapter. Without the IAP/NEOCON committee led by Dr Srinivas Murki, we would not have managed to set this conference up, that counted many hundreds of national delegates from all regions of India.
    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
  17. Stefan Johansson
    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.

  18. Stefan Johansson
    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).

  19. Stefan Johansson
    I subscribe to the small Youtube channel Science Showcase curated by Andrew Maynard, a very enthusiastic researcher!
    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.
  20. Stefan Johansson
    First of all, my sincere thanks to everyone involved in the 99nicu Meetup, delegates for attending, speakers for giving great lectures, and partners for support!
    Despite a lower number of delegates than we had planned for (we did not pick the perfect dates for the Meetup...), I think we managed very well. We needed to downsize and slimline a lot, including changing the venue. But, content was king thanks to great lectures, and all interactions and networking.
    Given the great feedback we had from delegates, we are committed to continue with this IRL forum for the 99nicu members. Stay tuned for information about the next Meetup, preliminary scheduled for April 2018 in Vienna.
    Almost all lectures were videorecorded and they will be added over the summer on the Meetup page here: https://99nicu.org/meetup2017/ 
    Right now you can see David Sweet lecturing about RDS management and Rebeccah Slater lecturing about pain in preterm infants.
    The only downside was the financial results, not yet definite but estimated to be a loss of ~5000 USD. Despite "the pain to open the purse" and our original plan to raise funds for IT work for this web site, I believe we shall regard this first meeting as an investment for future Meetups.
    We will also be trying to crowd-fund to cover some of the deficit. Those who value the videos as a learning experience are able to make a small donation.
    That was all my reflections for now. Until we meet in Vienna, see you here on 99nicu.org  

  21. Stefan Johansson
    There is now only 24 hours until until the 99nicu Meetup starts. The roll-up arrived in time
    Today, I and @Francesco Cardona are printing and packing delegate folders, preparing USB-sticks and getting snacks for the welcome reception tomorrow night. 
    We are very excited to meet some of you tomorrow IRL, it will be a great meeting!
    Now back to our work here in the HQ's!

  22. Stefan Johansson
    There's a lot going in at the 99nicu Headquarters right now, as we prepare for the 99nicu Meetup starting on Monday 12/6.
    USB-sticks and lanyards in preparation
    Really looking forward to the meeting.
    Depending on how things run, we may twitter semi-live, and we will also video-record as many lectures as our memory cards allow. It won't be pro-quality but good enough to view and learn.
    Ciao for now! Stefan

  23. Stefan Johansson
    During final preparations for the 99nicu Meetup (yes, there are still empty seats, so you can still register ), we have discussed how to think out-of-the-box for future Meetups.
    Is it really the best idea for us to run by the classic conference format and setup? Given the experience for this years Meetup, maybe not. Especially since regular meetings are connected to larger financial risks, and 99nicu is still an project that runs on philanthropic fuels.
    One idea is that the 2018 Meetup would be a more crowd-sourced event, and much much cheaper, like #FOAMed but IRL. In addition to one or two high-profiled keynote speakers, the program would include lectures by attending delegates, who volunteer to give talks on a subject they suggest themselves. I have heard so many great lectures by fellows and young consultants and believe we should get a fantastic program with a great variety of topics.
    However, as you know there is no free lunches, a small fee to cover lunches  would still be needed. But without any real budget work, I think a full three day CME-accredited meeting should be possible to run for ~150 euros/USD. Delegates contributing with a lecture should of course be coming free of charge. And naturally, all delegates would need to cover and arrange their own travels and accommodation.
    Just some thoughts from the 99nicu HQs! Please share feedback below.
  24. Stefan Johansson
    For the 99nicu Meetup, not only the venue but also the budget is down-sized  So, there won't be funding for the kind of web cast we originally planned. 
    Instead we plan to use Periscope, the live streaming service that (I think) is a Twitter-owned service.
    It seems from the Periscope test run below, that the image quality from using a smartphone is not superb (despite having the latest model!) but if you plan coming to the 99nicu Meetup and are experienced with Periscope Producer, please drop me a PM or an email.
    PS. The video is cropped... go to here https://www.periscope.tv/w/1ynJOWYbnaWJR to view it with the full width
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