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In the PDA-TOLERATE trial, persistent (even for several weeks) moderate to large patent ductus arteriosus (PDA) was not associated with an increased risk of BPD when the infant required

The PDA: TO LEave it alone or Respond And Treat Early trial compared the effects of 2 strategies for treatment of patent ductus arteriosus (PDA) in infants

ObjectiveTo evaluate the effectiveness of drugs used to constrict patent ductus arteriosus (PDA) in newborns

ObjectiveTo compare early routine pharmacologic treatment of moderate-to-large patent ductus arteriosus (PDA) at the end of week 1 with a conservative approach that requires prespecified respiratory and hemodynamic criteria before treatment can be given.Study designA total of 202 neonates of

ObjectiveTo test the hypothesis that infants who are just being introduced to enteral feedings will advance to full enteral nutrition at a faster rate if they receive "trophic" (15 mL/kg/d) enteral feedings while receiving indomethacin or ibuprofen treatment for patent ductus arteriosus.Study designInfants were eligible for the study if they were 23(1/7)-30(6/7) weeks' gestation, weighed 401-1250 g at birth, received maximum enteral volumes ≤60 mL/kg/d, and were about to be treated with indomethacin or ibuprofen. A standardized "feeding advance regimen" and guidelines for managing feeding intolerance were followed at each site (N = 13).ResultsInfants (N = 177, 26.3 ± 1.9 weeks' mean ± SD gestation) were randomized at 6.5 ± 3.9 days to receive "trophic" feeds ("feeding" group, n = 81: indomethacin 80%, ibuprofen 20%) or no feeds ("fasting [nil per os]" group, n = 96: indomethacin 75%, ibuprofen 25%) during the drug administration period. Maximum daily enteral volumes before study entry were 14 ± 15 mL/kg/d. After drug treatment, infants randomized to the "feeding" arm required fewer days to reach the study's feeding volume end point (120 mL/kg/d). Although the enteral feeding end point was reached at an earlier postnatal age, the age at which central venous lines were removed did not differ between the 2 groups. There were no differences between the 2 groups in the incidence of infection, necrotizing enterocolitis, spontaneous intestinal perforation, or other neonatal morbidities.ConclusionInfants required less time to reach the feeding volume end point if they were given "trophic" enteral feedings when they received indomethacin or ibuprofen treatments.

In the last decade there has been significant growth in the interest and application of using EEG (electroencephalography) outside of laboratory as well as in medical and clinical settings, for more ecological and mobile applications. However, for now such applications have mainly included military, educational, cognitive enhancement, and consumer-based games. Given the monetary and ecological advantages, consumer-grade EEG devices such as the Emotiv EPOC have emerged, however consumer-grade devices make certain compromises of data quality in order to become affordable and easy to use. The goal of this study was to investigate the reliability and accuracy of EPOC as compared to a research-grade device, Brainvision. To this end, we collected data from participants using both devices during three distinct cognitive tasks designed to elicit changes in arousal, valence, and cognitive load: namely, Affective Norms for English Words, International Affective Picture System, and the n-Back task. Our design and analytical strategies followed an ideographic person-level approach (electrode-wise analysis of vincentized repeated measures). We aimed to assess how well the Emotiv could differentiate between mental states using an Event-Related Band Power approach and EEG features such as amplitude and power, as compared to Brainvision. The Emotiv device was able to differentiate mental states during these tasks to some degree, however it was generally poorer than Brainvision, with smaller effect sizes. The Emotiv may be used with reasonable reliability and accuracy in ecological settings and in some clinical contexts (for example, for training professionals), however Brainvision or other, equivalent research-grade devices are still recommended for laboratory or medical based applications.

(1) Background: Mild traumatic brain injury produces significant changes in neurotransmission including brain oscillations. We investigated potential quantitative electroencephalography biomarkers in 57 patients with post-concussive syndrome and chronic pain following motor vehicle collision, and 54 healthy nearly age- and sex-matched controls. (2) Methods: Electroencephalography processing was completed in MATLAB, statistical modeling in SPSS, and machine learning modeling in Rapid Miner. Group differences were calculated using current-source density estimation, yielding whole-brain topographical distributions of absolute power, relative power and phase-locking functional connectivity. Groups were compared using independent sample Mann–Whitney U tests. Effect sizes and Pearson correlations were also computed. Machine learning analysis leveraged a post hoc supervised learning support vector non-probabilistic binary linear kernel classification to generate predictive models from the derived EEG signatures. (3) Results: Patients displayed significantly elevated and slowed power compared to controls: delta (p = 0.000000, r = 0.6) and theta power (p < 0.0001, r = 0.4), and relative delta power (p < 0.00001) and decreased relative alpha power (p < 0.001). Absolute delta and theta power together yielded the strongest machine learning classification accuracy (87.6%). Changes in absolute power were moderately correlated with duration and persistence of symptoms in the slow wave frequency spectrum (

Grossberg's adaptive resonance theory (ART) provides a framework for understanding possible interactions between mental imagery and visual perception. Our purpose was to integrate, within ART, the phenomenological notion of mental image vividness and thus investigate the possible biasing effects of individual differences on visual processing. Using a Vernier acuity task, we tested whether indirect estimation of relative V1 size (small, medium, large) and self-reported vividness, in three subgroups of 53 observers, could predict significant effects of priming, interference, or more extreme Perky effects (negative and positive), which could be induced by imagery, impacting acuity performance. The results showed that small V1 was correlated with priming and/or negative Perky effects independently of vividness; medium V1 was related to interference at low vividness but priming at high vividness; and large V1 was related to positive Perky effects at high vividness but negative Perky effects at low vividness. Our interpretation of ART and related modeling based on ARTSCAN contributes to expanding Grossberg's comprehensive understanding of how and why individually experienced vividness may drive the differential use of the dorsal and ventral complementary visual processing pathways, resulting in the observed effects of imagery on concurrent perception. [ABSTRACT FROM AUTHOR]

Background: Transcranial direct current stimulation (tDCS) is a safe, tolerable, and acceptable technique in adults. However, there is limited evidence for its safety in youth. Although limited, there are a handful of important empirical articles that have evaluated safety and tolerability outcomes in youth. However, a synthesis of pediatric safety studies is not currently available. Objective: To synthesize objective evidence regarding the safety and tolerability of pediatric tDCS based on the current state of the literature. Methods: Our search and report used PRISMA guidelines. Our method systematically examined investigations purposefully designed to evaluate the safety, tolerability, and acceptability of tDCS in healthy and atypical youth that were submitted to three databases, from the beginning of the database to November 2019. Safety considerations were evaluated by studies utilizing neuroimaging, physiological changes, performance on tasks, and by analyzing reported and objective side effects; tolerability via rate of adverse events; and acceptability via rate of dropouts. Results: We report on 203 sham sessions, 864 active sessions up to 2 mA, and 303 active hours of stimulation in 156 children. A total of 4.4% of the active sessions were in neurotypical controls, with the other 95.6% in clinical subjects. Conclusion: In spite of the fact that the current evidence is sporadic and scarce, the presently reviewed literature provides support for the safety, tolerability, and acceptability, of tDCS in youth for 1–20 sessions of 20 min up to 2 mA. Future pediatric tDCS research is encouraged.

The interest in using non-invasive brain stimulation (NIBS) for the treatment of major depression (MD), including treatment resistant depression, is growing rapidly. The paper by Bennabi and Haffen (Brain Sci. 2018, 8) was an important step towards the formal acceptance of transcranial direct current stimulation (tDCS) as a possible form of therapy. Their review demonstrated favourable support for the beneficial effects of tDCS for MD, coupled with necessary practical considerations, such as its relatively low cost, portability/ease of use in clinical settings, non-invasiveness, and good tolerability. Here, we provide a follow-up to their review and sketch a current update. Means for optimizing tDCS efficacy and potential limitations of current studies are discussed.

Key Points: Question: For preterm infants with respiratory distress syndrome supported with continuous positive airway pressure (CPAP), does administration of surfactant via a thin catheter improve survival without moderate to severe neurodevelopmental disability (NDD) at 2 years of age compared with sham treatment? Findings: In this follow-up of a randomized clinical trial of 486 infants at 25 to 28 weeks' gestation, the composite outcome of death or NDD at 2 years of age occurred in 36.3% receiving minimally invasive surfactant therapy compared with 36.1% receiving sham treatment. Meaning: In preterm infants supported with CPAP, minimally invasive surfactant therapy did not lead to a reduction in the composite outcome of death or neurodevelopmental disability at 2 years of age. Importance: The long-term effects of surfactant administration via a thin catheter (minimally invasive surfactant therapy [MIST]) in preterm infants with respiratory distress syndrome remain to be definitively clarified. Objective: To examine the effect of MIST on death or neurodevelopmental disability (NDD) at 2 years' corrected age. Design, Setting, and Participants: Follow-up study of a randomized clinical trial with blinding of clinicians and outcome assessors conducted in 33 tertiary-level neonatal intensive care units in 11 countries. The trial included 486 infants with a gestational age of 25 to 28 weeks supported with continuous positive airway pressure (CPAP). Collection of follow-up data at 2 years' corrected age was completed on December 9, 2022. Interventions: Infants assigned to MIST (n = 242) received exogenous surfactant (200 mg/kg poractant alfa) via a thin catheter; those assigned to the control group (n = 244) received sham treatment. Main Outcomes and Measures: The key secondary outcome of death or moderate to severe NDD was assessed at 2 years' corrected age. Other secondary outcomes included components of this composite outcome, as well as hospitalizations for respiratory illness and parent-reported wheezing or breathing difficulty in the first 2 years. Results: Among the 486 infants randomized, 453 had follow-up data available (median gestation, 27.3 weeks; 228 females [50.3%]); data on the key secondary outcome were available in 434 infants. Death or NDD occurred in 78 infants (36.3%) in the MIST group and 79 (36.1%) in the control group (risk difference, 0% [95% CI, −7.6% to 7.7%]; relative risk [RR], 1.0 [95% CI, 0.81-1.24]); components of this outcome did not differ significantly between groups. Secondary respiratory outcomes favored the MIST group. Hospitalization with respiratory illness occurred in 49 infants (25.1%) in the MIST group vs 78 (38.2%) in the control group (RR, 0.66 [95% CI, 0.54-0.81]) and parent-reported wheezing or breathing difficulty in 73 (40.6%) vs 104 (53.6%), respectively (RR, 0.76 [95% CI, 0.63-0.90]). Conclusions and Relevance: In this follow-up study of a randomized clinical trial of preterm infants with respiratory distress syndrome supported with CPAP, MIST compared with sham treatment did not reduce the incidence of death or NDD by 2 years of age. However, infants who received MIST had lower rates of adverse respiratory outcomes during their first 2 years of life. Trial Registration: anzctr.org.au Identifier: ACTRN12611000916943 This follow-up study of a randomized clinical trial examines the effect of minimally invasive surfactant therapy, surfactant administration via a thin catheter, on death or neurodevelopmental disability at 2 years' corrected age. [ABSTRACT FROM AUTHOR]

In the last decade there has been significant growth in the interest and application of using EEG (electroencephalography) outside of laboratory as well as in medical and clinical settings, for more ecological and mobile applications. However, for now such applications have mainly included military, educational, cognitive enhancement, and consumer-based games. Given the monetary and ecological advantages, consumer-grade EEG devices such as the Emotiv EPOC have emerged, however consumer-grade devices make certain compromises of data quality in order to become affordable and easy to use. The goal of this study was to investigate the reliability and accuracy of EPOC as compared to a research-grade device, Brainvision. To this end, we collected data from participants using both devices during three distinct cognitive tasks designed to elicit changes in arousal, valence, and cognitive load: namely, Affective Norms for English Words, International Affective Picture System, and the n-Back task. Our design and analytical strategies followed an ideographic person-level approach (electrode-wise analysis of vincentized repeated measures). We aimed to assess how well the Emotiv could differentiate between mental states using an Event-Related Band Power approach and EEG features such as amplitude and power, as compared to Brainvision. The Emotiv device was able to differentiate mental states during these tasks to some degree, however it was generally poorer than Brainvision, with smaller effect sizes. The Emotiv may be used with reasonable reliability and accuracy in ecological settings and in some clinical contexts (for example, for training professionals), however Brainvision or other, equivalent research-grade devices are still recommended for laboratory or medical based applications. [ABSTRACT FROM AUTHOR]