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Stefan Johansson

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Blog Entries posted by Stefan Johansson

  1. Next in the series "Link to like" is a fantastic web resource by Mary A Rutherford, a pediatric neurologist with 20 years of experience of MRI.
    She has made her book "MRI of the neonatal brain" available as a free e-book on the web.
    Sometimes there is a free lunch
    Link to like: www.mrineonatalbrain.com

  2. Happy holidays!

    · Stefan Johansson · 12/26/2013 05:45 PM

    I just want to say Happy Holidays to everyone, on behalf of the whole 99nicu Team!
    We don't share any New Year's promises for 2014, but there are exciting news in the pipeline.
    Besides polishing corners off the new software, we have plans for at least one educational activity...
     
    Sincere thanks to everyone contributing with questions, expertise and experience in the forums!
     
    Best wishes for the New Year!

  3. As Internet is everywhere (sort of), 99nicu.org has become a truly global network!
     
    From Google analytics we could see that people browsing 99nicu the past month (May 9 - June 8) comes from all over the world.
     
    The final goal for our outreach is Greenland and countries in Central Africa.
  4. Do we not read and talk about research findings more often than we critically discuss methods that led to the findings we discuss?

    Trained in clinical epidemiology, I often believe we should discuss methods more, especially before we move into processes of changing clinical protocols on treatments and diagnostic methods. EBM!

    Nature published a very nice article about how to interpret research claims. The idea was rather to aim the article towards non-scientists but I think their advice is worth to high-light for a medical audience. ( and read the article in full text here)

    The 20 tips are...
    Chance cause variation (results can be due to chance)
    No measurement is exact (as we didn't know)
    Bias is rife (it certainly is)
    Bigger is usually better for sample size (yes!)
    Correlation does not imply causation (we all know this, but we tend to forget that)
    Regression to the mean can mislead (it does)
    Extrapolating beyond the data is risky (and set patients at risk)
    Beware the base-rate fallacy (it is hard to diagnose uncommon conditions)
    Controls are important (or rather, they are essential, and it is essential to select controls right)
    Randomization avoids bias (or at least reduces bias)
    Seek replication, not pseudoreplication (research needs to replicated)
    Scientists are human (and therefore im-perfect)
    Significance is significant (but confidence intervals are more important than p-values)
    Separate no effect from non-significance (abscence of evidence is not evidence of abscence)
    Effect size matters (but remember that effects tend to decrease with study size, i.e. the world is not as good as it seems to be in small trials)
    Study relevance limits generalizations (i.e. don't generalize findings among 33-weekers to 23-weekers)
    Feelings influence risk perception (and that's why we tend to be more afraid in a plane than in a car, despite the higher death risk to drive)
    Dependencies change the risks (some factors or events are related, in additive or multiplicative ways)
    Data can be dredged or cherry picked (see #12)
    Extreme measurements may mislead (and usually do not have a single cause)
  5. Take a moment and visit www.neoknowledge.org, a freshly new web site with neonatology content.

    On of the 99nicu members, associate professor Gautham Suresh, working at Dartmouth Hitchcock Medical Center in Lebanon/NH, USA, started this e-resource. It has only been online for a few months but already contains lots of useful information.

    The web site is principally a portal. One of the great features it the collection of educational videos. The video clip on endotracheal intubation of newborns is among others very useful for doctors in training.
    http://www.neoknowledge.org/endotracheal-intubation/

    We wish the best of luck with this project!


  6. I am on the way to the 2nd EBNEO conference, waiting in the airport to board.

    As you probably know, the 2nd EBNEO conference was scheduled in Cairo/Egypt. Due to current circumstances, the conference was moved in the last minute to Istanbul/Turkey.

    I am very glad and grateful towards the conference president Hesham Abdel-Hady (aka hehady here at 99nicu). It is really a major achievement to make EBNEO happen a 2nd time!

    There will be no webcast this time, but you will be able to follow the symposias on Twitter
    @pubneo or @EbNeo or the hash-tag #ebneo2013


    PS. BTW, the 3rd EBNEO is taking form too. Unless we meet in Istanbul over the next coming days, let's hope that we meet 14-15 September 2015 in.... Philadelphia/USA.
  7. I have a week off clinical duties for research. After the weather forecast yesterday, I brought my laptop and dataset home, as I realized it could be difficult to get to work.

    So, now I sit here analysing the effect of maternal BMI on infant health (more to be read in journals near you in 2013...), with a great snow storm outside our house.

    It's winter, and a very good one !
    Almost as good as the exciting odds ratios coming up on my laptop screen!


  8. I am just reading the yet unofficial and near-final programme for the 2nd EBNEO-conference, scheduled 13-16 March 2013 in Egypt.

    Topics will (probably) include:



    Mode of delivery and morbidity in the preterm infant?

    Developing a cheap surfactant for the third world – planning stages of a large RCT
    Survival without disability to age 5 years after neonatal caffeine therapy for apnea of prematurity
    Resuscitation of the preterm infant
    Implementation of evidence based neonatology - the EPICE project
    Economic outcomes of prematurity
    Follow up of high-risk infants


    Stay tuned

    the conference web site (where you can also register): www.ebneo2013.com
  11. @24weekers started to follow our twitter account @99nicu - which draw my attention to "24weekers" - a film project by the journalist/film producer Alan Entwistle who became the father of a baby born at 24 weeks gestation. A film that "affirms the value of life".

    The project seeks crowd-sourced funding through Kickstarter (here!).

    Moved by the trailer, I really hope that enough people will contribute. This movie would be important document, for the public, for health care professionals, for politicians and not the least for the many-many thousands of those who became parents far too early to the tiny ones, cared for in NICUs around the world.

    Click here to read more about what Alan Entwistle and his team want to achieve.



  12. Sweden is a good country for parents and when it comes to becoming a father, I think our society is becoming more and more "inclusive".
    Illustrated by the welcoming photo outside the maternity ward, an infant - with the father in the background.

    In our Karolinska NICUs we are "rooming-in" parents in family rooms, where the baby is taken care of by the parents as much as possible.
    We promote the presence of both parents. When only one parent is staying over, it is not uncommon that the father is the one doing that.

    Still, we, i.e. fathers in Sweden, have more to work on, before we can say that we equally share all family commitments and responsibilities for our children.


  14. Believe it or not, but I am sitting on 11000 meters in a jumbo-jet, on my way to Dubai.
    I fly Lufthansa - mit Internetz, to my surprise! 1 hour for 10 euros, I simply could not resist to try it

    It's not a superfast connection but enough to do some 99nicu house-keeping (i.e. validating a handful of new members), taking care of the latest emails and checking the news.

    Looking forward to this trip, planned since long. But, I nearly missed the plane in Stockholm, I jumped on the airport express at the same time a major power supply problem shut down all train and underground traffic in Stockholm. For two hours it turned out.

    I was lucky enough to make an early decision to leave the train. I and an Italian pasta producer shared a taxi (nice conversation, we were both against Low Carb High Fat-diets ) and I managed to check in super-fast just before the closed the desk.

    Greetings from... heaven!
  15. I will go on tour to the Arabian Peninsula, and lecture about PDA diagnosis and treatment, 25-29/5. My ambition is to share news and views on ductal problems, from my dual perspective as neonatologist and clinical epidemiologist.

    It will be my first visit to the region, and I am looking forward to it very much, not only for my wish to go on a guided tour of the Desert .

    First of all, I hope to meet many of you, as I know that many neonatal staff in the Arabic countries are active members here. And, secondly, I will be able to meet the "99nicu co-driver" Habib, aka JACK, for the first time IRL. I am more than grateful to him for joining in 2007 and helping me to "resuscitate" 99nicu.org in 2008.

    I will give lectures in Dubai, Saudi Arabia and Kuwait, and I will post details on times and venues as soon as I get them.

    UPDATE - TIMES AND VENUES:
    Dubai: Practical Pediatric Workshop at Taj Palace Hotel, 26/5, 15:30-16:15
    KSA: Marriott hotel in Riyadh, 27/5, 19:00 (07:00 PM)
    Kuwait:Mövenpick Hotel & Resort Al Bida’a, 28/5, 20:00 (08:00 PM)
  17. During the last few days you might have noticed that 99nicu has been offline sometimes, due to technical maintenance.
    I needed to upgrade the software that 99nicu.org is based upon (vBulletin), and also need to compile new versions of the iOS and Android app.

    Since we started, I have done software installations and upgrades (auto-didactic with computers) but the more complex these softwares become, the more I sweat before I do this technical maintenance. And, I also feel kind of responsible for the hundreds of people browsing 99nicu every day.
    If things go wrong, I'd be like a man in a dark forest with the torch just stopped working. I.e. completely lost... and offline.

    Keep fingers crossed that we manage to get funding in the future to out-source the whole technical backend of 99nicu.
  18. The conference Evidence-based Neonatology (EBNEO) in Stockholm 2011 was much about the 99nicu community going IRL. I am very happy that we managed to launch the event. And, as you may know already, there will be a 2nd EBNEO conference, 13-16 March 2013, in Egypt.

    But today I'd just like to tell everyone that review articles of topics presented at the 1st EBNEO in Stockholm are now available on-line, published in a digital supplement in Acta Paediatrica.

    All articles are available in free full-text format.

    Click here to read the supplement.

    If you want to stay tuned about future EBNEO announcements and news, visit www.ebneo.org and www.ebneo2013.com
  19. The 99nicu iPhone app has just been approved by Apple and is now available on iTunes store.
    Free of charge and free from ads, of course.

    One nice feature is that posts from the app is marked "Posted from iPhone app"

    Here's the link to iTunes. On your iPhone, search in iTunes store for "99nicu" and you'll find it.


  20. I should make this announcement later but cannot refrain from telling you half the story now

    There is now a 99nicu app, at least for telephones running Android.
    Click here to download it from Android market.

    One nice feature is... when you post from the app, your posts get marked "Posted from Android app". Please try!


    (you may wonder about the second half of the story... yes, we have an iphone app in pipeline... But the process to have it approved by Apple (Almighty) is more complicated. So, iphone user, you need some patience.)

  21. Happy Holidays!

    · Stefan Johansson · 12/24/2011 01:46 PM


    I'd just like to wish everyone Happy Holidays and a Happy New Year!

    And, also thank all the many people sharing their expertise in the forums, both as questions and as comments.

    During 2011, we had some very positive emails from members telling how discussions here changed practise (and probably outcomes too).
    Which makes me believe even stronger in this kind of crowdsourcing.

    For next year, we will announce some new and cool features, making 99nicu even more useful... stay connected
  22. Welcome to the 99nicu Blogs!
    Given the possibilities to share experiences, thoughts and opinions through a blog, we could not resist to add the latest feature of the software (vBulletin) used for the 99nicu forums.

    As a 99nicu member, you can start your own neonatal blog here! And write comments in blogs written by other members.

    Read the announcement in the News forum, download the blog manual and... get started!


    PS. If you are unfamiliar with blogging, take a look at blogbasics.com and Wikipedia for more information!

  25. Work with me!

    · Stefan Johansson · 11/30/2011 11:09 AM

    I work at a Karolinska unit located at Danderyd Hospital, with 10.000 deliveries per year, the largest delivery unit in Sweden.

    In fact, almost 10% of ALL Swedish babies are born here (110.000 Swedes are born/year)!

    We have several vacant positions for qualified neonatologists.

    Work with me!

    Applicants must speak Swedish or other Scandinavian languages. PM me for more info or email the head of the unit bjorn.westrup@karolinska.se

    Click here for more info in Swedish, and here for more info in English.

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