Jelli KA

Dear 99 NICU community I just completed Ethics of AI Course Diploma with the University of Michigan with Prof.H.V. Jagadish This prompt to write a case study as applied to neonates. At the end ( sources ) you'll find the last article on the use of deep learning to predict outcomes In the last decade, many different projects around the globe have attempted to use artificial intelligence to improve outcomess of premmies, estimate age, and predict the possible complications in the NICU stay. Several ethical issues and how the neonatal community is trying to use it for the good. Each premature infant generates a huge amount of data. This is where AI comes in bringing insight, but with an ethical implication beyond data privacy with many ramifications, extending data breaches to threaten health disparities due to population sample usesd to train AI models. Thus, This Health data mining has a huge potential for harm. In past, there have been many attempts by tech companies to monetize this data. In the early 2000 with the advent of genomics legislators tried to protect the user by passing laws such as Gattaca, to prevent discrimination. This was not enough as tech usually is ahead of legislation. Starting with the bad. Here is an example that struck me the most as explained by the “ website. A recent ethical misconduct case illustrated by David Marco is Google’s “project Nightingale”, where they were able to access personal health records to develop their AI. In doing so, violating several ethical principles starting with consent without asking for consent from the patient and without notifying medical professionals.Secondary violations in terms of data privacy and transparency about the objective of the project. The company claimed they respect the HIPAA legislation business clauses. In my opinion, clearly not enough and not acceptable. In addition, breaking Dr. Jagadish's first rule - do not be surprised. When I heard the episode “Harnessing the Power of AI for Better Neonatal Outcomes (ft NeoMIND-AI founders Drs. Barry and McAdams)” I was intrigued but skeptical due to data privacy issues, discrimination and equity ramifications. After listening to the @nicupodcast episode It hits a lot of good points about how tech can bring better care to the NICU, in terms of insights and capabilities augmented for clinicians. Yet it still feels it needs care and consciousness. Here there are data privacy concerns, so we need to take care with parental consent. In addition, Algorithms need to be tweaked to prevent discrimination against minorities. The doctor also explains that data sharing is tricky in terms of ethics. https://podcasts.apple.com/es/podcast/the-incubator/id1566031191?i=1000655297640 To conclude that AI needs to be used with consciousness, transparency, solid data validation and engaging the stakeholders such as parents and clinicians. Sources / Data Ethics: Master Responsible Data Use: https://www.ewsolutions.com/understanding-data-ethics/ The ethics of data mining in healthcare: challenges, frameworks, and future directions - PMC AI can predict preemies’ path, Stanford Medicine-led study shows

Latest article I discovered relating to Japanese care neonatal of the tiniest babies 22-25. Good 🌟 news on the positive outcome. It is worth a 📖. It is an open access article published by Tokyo University researchers in nature September 2024 #FOAM #neonatal #beyondlimits #periviability #neonatalethics https://www.nature.com/articles/s41372-024-02093-0

Great iniciative

Had a chance to attend #TEIBIO - Transference (of knowledge Entrepreneurship ) & Innovation in Biotech . inspirational talk on rare diseases awareness day and topics were bringing hope to paediatrics #nicu: by address solutions to Neonatal Congenital Heart #CHD ❤️and better tolerance heart transplant. - 💡Crazy scienceco-founder Dr. Beatriz Salvador shows us how her team have found a non-invasive treatment for Congenital Diaphragmatic Hernia. They were able the hole in CDH by regulating the immune system. Have had 75%success rate and animal models have shown low toxicity. Currently recognized as an orphan drug EU - finalize animal model trial in a non-rodent model. Hopes to begin clinical trials in 2025 with the esteem collaboration of Dra. Mayte Vallejo, del Instituto para la Investigación Biomédica del Hospital Universitario La Paz de Madrid (IDIPAZ) y paciente advocacy association «La vida con Hernia Diafragmática Congénita» located in Mérida, Spain. Crazy Science & Business S.L. https://crazyscience.es Rafael C. Rocha THYTECH founded a start-up to find a solution to avoid rejection in❤️ transplant in babies. Here the team are using an infant's timus cell to avoid rejection. https://es.linkedin.com/company/thytech Thanks to Carlos Cosculluela Chocarro for the shout-out. @FundacionDRO AsBioMad

Hi Philip, I recently read this article about locally designed designed made in Cameroon by autor Leocadia Bongben. http://nigeriahealthwatch.com/made-in-cameroon-the-locally-fabricated-incubator-designed-to-give-pre-term-babies-a-fighting-chance/?amp=1 In addition,as mentioned by @Gustaf Lernfelt mom-Incubator are designed for such setting. It is feature in an episode @TheIncubatorPodcast Check out #091 - - mOm Incubators: James Roberts. The Incubator Podcast #TechTuesday featurin mOm-Incubator.

Sound great..past meeting having been a treat. Great learning done.😀

hey there here are organizations 🟡Medikamente für die Kleinsten – Deutsche Stiftung Kranke Neugeborene (DSKN) https://www.betterplace.org/de/projects/106791-medikamente-fuer-die-kleinste DSKN organizer of Dresden Symposium with ESPR raising funds for medication and medical supplies fo NICUs in Ukraine 🇺🇦 . Below a few words about the project. “A few years ago I visited some neonatal institutions in Kyiv. On site, we supported our colleagues in improving the care of premature and sick newborns. Now the call for help has reached us that the medical care of the little patients can no longer be guaranteed. Vital medicines for the newborns are urgently needed. The German Foundation for Sick Newborns would like to send the urgently needed medicines to the Ukraine and thus help their colleagues”- Prof. Mario Rüdiger ( translated to English ) 🔵 Tantaka is an organization that collaborates with the Spanish Red Cross and Caritas to fund medicines, food and logistical cost in the UK Vía la Universidad de Navarra.

Dear All, Another organization helping Ukraine is UN World Food Program via their app Share a Meal. They have created a dedicated space - just clink on the link below x more #ShareTheMeal App donate online or download the app on Apple or Android. @piatkat. @Stefan Johansson

That’s great will have to try that.

I haven’t heard about cool cuddle in Spain. I feel it is doable in NICU with care. I see as a way humanize care and allow parents to bond with their babies.

Fantastic put together webinar by neonatal transport Seneo work neonatal transport group. Here are some favorite suggestions. 🔷Ear Muffs 🔷Air mattress 🔷Blanky with mum swell 🔷Fuzzy toy. 🔷Thank the Drivers : Be aware of G force driver have take with sudden break. 🔹Consider 🚑 design allow all to have a better transport experience. From my perspective it was Interesting the neonatal transport Landscape is diverse from the pioneering region Catalonia that NICU/PICU in 1995(🟢) to other regions that don’t. For example, Galicia have a private providers. Madrid & Valencia have dedicated Neonatal teams ( light 🔵). Some team's like the Balear region team have available helicopters/planes. Below is map showing the situation.Regions in 🛑 done by regional Emergency Teams. Benchmarking there work in a effort to improve the quality, provide constructive feedback and find ways to better ways to collaborate. Benchmarking and humanize care are interlinked with each other. They also underlined that need to keep in constant communication between the transport teams and the coordination hub.

Nice feature easy to do.🙂

Hi all, I am relaying a message from one PhD Twitter Xavi Jimenez ( PhD student , Neonatal nurse at VallHebron, Barcelona) he reply to my re-tweet of the survey by saying the following In the Delivery room they don’t use humidified air, they mostly central air conditioning. They use the humidified air in the NICU as an extra during the Summer month. Cheers, Jelli

So many to recommend , vital topics . Agree it a good idea to start with RCT TOBY trial/ Cool Cap Here the latest I viewed. Human umbilical cord mesenchymal stromal cells as an adjunct therapy with therapeutic hypothermia in a piglet model of perinatal asphyxia - ScienceDirect https://www.sciencedirect.com/science/article/pii/S1465324920309300 by one Dr.Nicola Robertson et al who working on this field + 10 yrs.

Today I sharing ‘tis post from HUGES a great. Organization dedicated to humanizing care in intensive care settings and emergency services. I particularly by this webinar on humanize. Management starting with leading with empathy, simply things that can be hard to achieve, but make us think Speakers suggests a few things to start with : J. Carlos March - Profesor EASP {Escuela Salud Publica- Public Health Institute of Andalucia} Director of School of patient. @joancmarch Focus aligning Humility, vision and Values. Suggests Emphasizing clear communication so that it flows with the team. Those we should aim to think in we . Leading can choose the words we say to br Proactive with self care and link up with stake holder in the community. Be awareness t ok to question , as when we question we can find ways to things better and learn. Chelo Nurse , Nursing Director ( Poniente Region) gives a glimpse Difference humanizing project going on. @cheloArtero Support each other and encourage the team to mindfully disconnect. For example Dosify info in this time of corovirus,so it not in a constant loop Have a dynamic & shared metrology to features to perinatal programs Cuidado co mimo in NICU : NICU care beyond family centered. Siempre en mi Mi. Supporting mums in perinatal death.

Thanks for a such an well crafted seminar it really helped me get a fuller inderstanding of delayed cord clamping. Agree on we to have better collaboration.From my experience, as someone who part of job was to find beds for In-utero transfers. I have learned from my seniors and experience that It is essential that there a good communication flow between obs team as and the neonatal team yet it can be a tricky task .

A article that most struck lately: This article by Dr. G.Moore et al researchers at the University of Ottawa, accessible #FOAM, give a good thoughtful analysis to whether chest compression & epinephrine cause more harm than good to V.preterm infants using 'principals' as an ethical framework aka the Spanish /French say does 'Encarnecimiento Terapeutico' a concept complex. As I understand, away to explain it what happens when you go beyond overtreatment? When continuing treatment is medically futile, but you keep going it starts to cause more harm than it yields benefits. Here the author explain with explain with examples why chest compression and justified in cases of need - concludes with a maybe.

Thanks for the article. It very interesting to see help manage the spread antibiotic resistance . Lots to learn.

After watching a documentary in ARTE about bacteriophages it made me think about how else is antibiotic resistance in NICU.? It available french / German Here the story phages was told. First discovered use by Felix Derrel to combat infections in the pre-antibiotics era and was later discredited and forget about in the western world Historically they worked rather well, so there is an attempt to bring them back in the light of increasing antibiotics resistance. This rediscovery started with lab study that showed that the phages were effective at clearing infection in rats population sample. Phagoburn Recently, a French team took it to human and show it feasible despite the many challenges. This study was a RCT which a specific process approval and protocols were established. The aim in *Phagoburn*was to see if phages could be useful using to fight infection in burn victims. It was lead by Dr. Patrick Jault and large team .Jerôme Gabbard head Start up tells Pherecydes provided the synthesis of phages. control got standard treatment {silver salts +antiobiotics} and othe got phages.This got published in nature. The was a reduction in the infection rate in phage group, a loading dosing issue among other practical things. Researchers in france say that there a scaling issue to produce larger amounts, as well a regulatory framework. From bioethical point of view it is possible, a more detail informed consent will be necessary.These days research still going a la Croix de Lion Hospital, France. University Hospital ~CHU Lyon~. ( initial used - discovered @pasteur Institute) https://www.arte.tv/fr/videos/078693-000-A/l-incroyable-histoire-des-tueurs-de-bacteries/ Thus what do think any future of phage in NICU?

This September I had the opportunity to go to BAPM-EBNEO to kept Learning a out Neonatology and hopefully network with the EBNEO, so glad I see lots of you face to face. This kept motivated to finish my PhD as I re-embark in find a new supervisor _only 1.5 yrs to go. I was real hard to let of the clinician in me as , this is my comfort zone. As a budding academic learn I get explore ideas and ways to implement them as bioethicists , as well finding ways to humanize the NIcU via processes. Last year, I took a small detour as jr.posdoc and spent time studying system thinking, process and how to improve health using design thinking. An important fact , I beat my fear of being back in UK .I had mild anxious feeling about going to bapm but Northerners are such lovely folks. At the end of the day it you team of people will fluctuate for good & bad. ----------- Product Reviews: Review BAPM. Probiotics Pro-prems finally available in individual sachets pre-dose sachets that in my opinion provide a higher security and is more practical. Only maltodextrin . Need mixing with 3 ml in H20. This has more of a track record as it collaboration with a company who been working bio culture for a long time pharmaceuticals grade certified. Vegan alternative for well babies is Labinic drop available liquid bottle comes in 5mls flask_recommended dose 0.2ml( a syringe is needed). Ideally given with maternal milk ( EBM ). * free off dairy, soya, sweetener, presevatives. Good for neonates with intolerances. Both have different formula of microbiota but have a 1 bifidobacterium probiotic in common. Amount of bacteria are specified in the ingredientes list of of proprems on the box. Nëo from ant neuro aEEG The most distinctive item to provide EEG monitoring to Neonate at the bed side. It features a user friendly screen, allowing NICU professionals easy access to interpret resulting brain waves. Electrode are applied through a cap, as I understand help to give a clearer signal. Bliss finally got to nicu mile stone card which are such lovely way to involve parents and make progress. Favorite is parent centered care poster. Bili bluelight . Compared to the standard it is small portable and easily stored . complement comes with a stand.Practical and can carried around, easily stored in the unit. Li-lac As one who had to deal a lot of of documentation I found Li-lac EBM labeling, sorting and tracking useful from quality & safety point of view. I found quite easy to use and track on a smartphone,and it builds an audit trail.Not sure how easy the set up is . Especial mention to SHED/S/upport & H/elp for E/very D/ad : providing specific support for dad whose babies are admitted to NICU. Disclaimer: I have no ties to any of companies. Review Health devices enthusiasts academic. Permission for all pics .

Go through the equipment check . I start checking incubator follow the step but their a mal function. Instead of declare a failure have a second look it, they usually can a fresh look. When I worked for transport we simulate equipment check to at night to avoid equipment failure when tired and hungry. Here have a novice go through the new protocol steps , this way you can find bumps and pit falls. Hope it helps.

Hola , Some time ago I read this really good article by Petra Hüppi who performed an RCT on use EPO in sinergie with HiE. Also Dr.Nicola Roberston who quite a bit of work on this area.

Having read this article has many good ideas in my experience. The design rethink many good idea . 👌 for the safety of the neonates. I'd like to highlight 2 features. 1) ambulance tv screen/camera allows connexion the hospital site, such as when a tertiary center is necessary. Here a neonatologist can lead the team to provide optimum care of the neonate on transfer. It can use for example the zoom© software enabling remote telehealth service. Alternatively , the ambulance designed by the generalitat de catalunia is powered 4G-5G comm .Its communication system is has a direct to the hospital site , where a clinical is there to provide supportany time. 2), I feel solar roof can provide some autonomy on transport. It also a sustainable option , make it a bit more green.