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Ubenwa: Cry-based Diagnosis of Birth Asphyxia [article]

Charles C Onu, Innocent Udeogu, Eyenimi Ndiomu, Urbain Kengni, Doina Precup, Guilherme M Sant'anna, Edward Alikor, Peace Opara
2017 arXiv   pre-print
Every year, 3 million newborns die within the first month of life. Birth asphyxia and other breathing-related conditions are a leading cause of mortality during the neonatal phase. Current diagnostic methods are too sophisticated in terms of equipment, required expertise, and general logistics. Consequently, early detection of asphyxia in newborns is very difficult in many parts of the world, especially in resource-poor settings. We are developing a machine learning system, dubbed Ubenwa, which
more » ... enables diagnosis of asphyxia through automated analysis of the infant cry. Deployed via smartphone and wearable technology, Ubenwa will drastically reduce the time, cost and skill required to make accurate and potentially life-saving diagnoses.
arXiv:1711.06405v1 fatcat:uobadnpcxvbypfuntdagzsq75i

Predicting Extubation Readiness in Extreme Preterm Infants based on Patterns of Breathing [article]

Charles C. Onu, Lara J. Kanbar, Wissam Shalish, Karen A. Brown, Guilherme M. Sant'Anna, Robert E. Kearney, Doina Precup
2018 arXiv   pre-print
Extremely preterm infants commonly require intubation and invasive mechanical ventilation after birth. While the duration of mechanical ventilation should be minimized in order to avoid complications, extubation failure is associated with increases in morbidities and mortality. As part of a prospective observational study aimed at developing an accurate predictor of extubation readiness, Markov and semi-Markov chain models were applied to gain insight into the respiratory patterns of these
more » ... ts, with more robust time-series modeling using semi-Markov models. This model revealed interesting similarities and differences between newborns who succeeded extubation and those who failed. The parameters of the model were further applied to predict extubation readiness via generative (joint likelihood) and discriminative (support vector machine) approaches. Results showed that up to 84\% of infants who failed extubation could have been accurately identified prior to extubation.
arXiv:1808.07991v1 fatcat:zwzpjbdqq5cedcwivgzlc6aumi

Bronchopulmonary dysplasia prediction model for 7-day-old infants

Carlos A. Bhering, Christieny C. Mochdece, Maria E. L. Moreira, José R. Rocco, Guilherme M. Sant'Anna
2007 Jornal de Pediatria  
Resumo Objetivo: Desenvolver um modelo preditivo capaz de identificar, ao final da primeira semana de vida, os recém-nascidos prematuros com maior probabilidade de evoluir para displasia broncopulmonar (DBP). Métodos : Os dados foram coletados retrospectivamente entre janeiro de 1998 e julho de 2001, e prospectivamente de agosto de 2001 a julho de 2003. Foram incluídas todas as crianças nascidas na Instituição, com idade gestacional < 34 semanas e peso de nascimento < 1.500 g. Os principais
more » ... res de risco foram submetidos inicialmente a uma análise univariada, seguida de regressão logística. As variáveis significativas foram utilizadas na montagem da fórmula para cálculo da probabilidade de ocorrência de DBP. O modelo foi calibrado, e a discriminação avaliada pela curva ROC. De agosto de 2003 a julho de 2005, o modelo foi aplicado em outra população para validação. Resultados: Foram incluídas 247 crianças, das quais 68 evoluíram para DBP, sendo divididas da seguinte maneira: leve = 35 (51,4%), moderada = 20 (29,4%) e grave = oito (11,7 %). Quatro variáveis mantiveram significância em relação à DBP: idade gestacional ≤ 30 semanas, persistência do canal arterial, ventilação mecânica > 2 dias e perda de > 15% do peso de nascimento no sétimo dia de vida. Nos pacientes com todas as variáveis presentes, o modelo permitiu uma probabilidade de acerto de 93,7%. Valores semelhantes foram obtidos com as 61 crianças utilizadas na validação do modelo. Conclusões: O modelo preditivo desenvolvido em nossa população foi capaz de identificar com elevado grau de sensibilidade, ao final da primeira semana de vida, os recém-nascidos sob maior risco de evoluir para DBP. J Pediatr (Rio J). 2007;83(2):163-170: Displasia broncopulmonar, modelo preditivo, doença pulmonar crônica do recém-nascido, ventilação mecânica, prematuridade. Abstract Objective: To develop a predictive model capable of identifying which premature infants have the greatest probability of presenting bronchopulmonary dysplasia (BPD), based on assessment at the end of their first week of life. born at the institution with gestational age < 34 weeks and birth weight < 1,500 g were included. The principal risk factors for BPD were subjected to univariate analysis followed by logistic regression. Significant variables were used to construct a formula to calculate the probability of BPD. The model was calibrated and its discriminative power assessed using receiver operating characteristic (ROC) curves. Between August 2003 and July 2005 the model was then applied to a different population for validation. Results: The sample comprised 247 children, of whom 68 developed BPD, classified as follows: mild = 35 (51.4%), moderate = 20 (29.4%) and severe = 8 (11.7 %). Four variables maintained significance with relation to BPD: gestational age ≤ 30 weeks, persistent ductus arteriosus, mechanical ventilation > 2 days and loss of > 15% of birth weight on the 7th day of life. Where patients exhibited all of these variables, the model had a 93.7% probability of being correct. The model was further validated when using another sample of 61 newborns; similar figures were obtained. Conclusions: At the end of the first week of life, the predictive model developed from our population was capable of identifying newborn infants at increased risk of developing BPD with a high degree of sensitivity. J Pediatr (Rio J). 2007;83(2):163-170: Bronchopulmonary dysplasia, predictive model, chronic neonatal lung disease, mechanical ventilation, prematurity.
doi:10.2223/jped.1599 fatcat:lg3y2xlqurhu3g7eiq75z5ckbe

COVID-19 and Neonatal Respiratory Care: Current Evidence and Practical Approach

Wissam Shalish, Satyanarayana Lakshminrusimha, Paolo Manzoni, Martin Keszler, Guilherme M. Sant'Anna
2020 American Journal of Perinatology  
In another experiment in adults, exposure to exhaled air occurred within a 1-m region (0.3-0.85 m) when using three different types of interfaces and VT of 300 mL (16-20 times the VT of a 3-kg infant).  ...  hospitals with good infection control measures (proper room air exchange rate and adequate PPE). 54,57, 58 Simonds et al evaluated air dispersion during NIPPV and found generation of droplets of >10 μm  ... 
doi:10.1055/s-0040-1710522 pmid:32359226 pmcid:PMC7356086 fatcat:eyqbfqdzhfepbpgsma4wsdw2wi

Incidence and main risk factors associated with extubation failure in newborns with birth weight < 1,250 grams

Fernanda Hermeto, Bianca M. R. Martins, José R. M. Ramos, Carlos A. Bhering, Guilherme M. Sant'Anna
2009 Jornal de Pediatria  
Como citar este artigo: Hermeto F, Martins BM, Ramos JR, Bhering CA, Sant'Anna GM. Incidence and main risk factors associated with extubation failure in newborns with birth weight < 1,250 grams.  ... 
doi:10.2223/jped.1922 fatcat:gixsycge35blnankthyjcb3dqy

A Semi-Markov Chain Approach to Modeling Respiratory Patterns Prior to Extubation in Preterm Infants [article]

Charles C. Onu, Lara J. Kanbar, Wissam Shalish, Karen A. Brown, Guilherme M. Sant'Anna, Robert E. Kearney, Doina Precup
2018 arXiv   pre-print
M. Sant'Anna are with the department of Neonatology, McGill University, Montreal, QC H3A 2B4, Canada. 4 K.  ... 
arXiv:1808.07989v1 fatcat:jtgcqjlg5bh2dlydpdezrhua6m

Modelo preditivo para displasia broncopulmonar ao final da primeira semana de vida

Carlos A. Bhering, Christieny C. Mochdece, Maria E. L. Moreira, José R. Rocco, Guilherme M. Sant'Anna
2007 Jornal de Pediatria  
Objective: To develop a predictive model capable of identifying which premature infants have the greatest probability of presenting bronchopulmonary dysplasia (BPD), based on assessment at the end of their first week of life. . All children born at the institution with gestational age < 34 weeks and birth weight < 1,500 g were included. The principal risk factors for BPD were subjected to univariate analysis followed by logistic regression. Significant variables were used to construct a formula
more » ... to calculate the probability of BPD. The model was calibrated and its discriminative power assessed using receiver operating characteristic ( ROC) curves. Between August 2003 and July 2005 the model was then applied to a different population for validation. Results: The sample comprised 247 children, of whom 68 developed BPD, classified as follows: mild = 35 (51.4%), moderate = 20 (29.4%) and severe = 8 (11.7 %). Four variables maintained significance with relation to BPD: gestational age ≤ 30 weeks, persistent ductus arteriosus, mechanical ventilation > 2 days and loss of > 15% of birth weight on the seventh day of life. Where patients exhibited all of these variables, the model had a 93.7% probability of being correct. The model was further validated when using another sample of 61 newborns; similar figures were obtained. Conclusions: At the end of the first week of life, the predictive model developed from our population was capable of identifying newborn infants at increased risk of developing BPD with a high degree of sensitivity. J Pediatr (Rio J). 2007;83(2):163-170: Bronchopulmonary dysplasia, predictive model, chronic neonatal lung disease, mechanical ventilation, prematurity.
doi:10.1590/s0021-75572007000200011 pmid:17380230 fatcat:fqtk3apoqzczxlqp5tf5m4smee

Incidência e principais fatores associados à falha de extubação em recém-nascidos com peso de nascimento < 1.250 gramas

Fernanda Hermeto, Bianca M. R. Martins, José R. M. Ramos, Carlos A. Bhering, Guilherme M. Sant'Anna
2009 Jornal de Pediatria  
Objectives: To determine the incidence of extubation failure in preterm newborns with birth weight < 1,250 g extubated to nasal continuous positive airway pressure and to identify the main risk factors associated with the need for reintubation in this population. Methods: A retrospective review of eligible infants admitted and mechanically ventilated between July 2002 and June 2004 was performed. Extubation failure was defined as the need for reintubation within 7 days after the first
more » ... attempt. Results: Of the 52 patients included in the study, 13 died before the first extubation attempt. Of the remaining 39 patients, only nine failed extubation (23.1%) Comparing the two groups (failure vs. successful), there was a statistically significant difference regarding birth weight, gestational age and 5-minute Apgar score. After logistic regression, only gestational age was significant. Other secondary outcomes showed significant difference between the groups: intracranial hemorrhage grade III and/or IV, patent ductus arteriosus and death. Conclusions: The incidence of extubation failure in our population was similar to the rate reported in the literature. The main risk factor for extubation failure was prematurity (≤ 28 weeks). In this population of extreme preterm infants, implementation of strategies for early extubation, use of methylxanthines, prevention of patent ductus arteriosus, and use of different modes of assisted ventilation after extubation may improve the outcomes. J Pediatr (Rio J). 2009;85(5):397-402: Prematurity, mechanical ventilation, extubation failure, bronchopulmonary dysplasia.
doi:10.1590/s0021-75572009000500005 fatcat:73hqy4xydbftnhmhqfrggtw45i

Implementation of a Multidisciplinary Team Approach and Fish Oil Emulsion Administration in the Management of Infants with Short Bowel Syndrome and Parenteral Nutrition-Associated Liver Disease

Ana MGA Sant'Anna, Eyad Altamimi, Rose-Frances Clause, Joanne Saab, Heather Mileski, Brian Cameron, Peter Fitzgerald, Guilherme M Sant'Anna
2012 Canadian Journal of Gastroenterology  
Dr A Sant'Anna and GM Sant'Anna were supported by internal research funds received from the McMaster Children's Hospital.  ... 
doi:10.1155/2012/571829 pmid:22590701 pmcid:PMC3352843 fatcat:uopbbwotrnafraz2i356qharfu

Assessment of Extubation Readiness Using Spontaneous Breathing Trials in Extremely Preterm Neonates

Wissam Shalish, Lara Kanbar, Lajos Kovacs, Sanjay Chawla, Martin Keszler, Smita Rao, Samantha Latremouille, Doina Precup, Karen Brown, Robert E. Kearney, Guilherme M. Sant'Anna
2019 JAMA pediatrics  
Author Contributions: Drs Shalish and Sant'Anna had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.  ... 
doi:10.1001/jamapediatrics.2019.4868 pmid:31860014 pmcid:PMC6990705 fatcat:p247psayzndplhvx7jgimjnlay

Kinetics and mechanism of chlorate-chloride reaction

Rafaela T. P. Sant'Anna, Cristina M. P. Santos, Guilherme P. Silva, Ricardo J. R. Ferreira, André P. Oliveira, Carlos E. S. Côrtes, Roberto B. Faria
2012 Journal of the Brazilian Chemical Society  
Figure 1 . 1 Evolution of the chorate-chloride reaction: (a) excess of chlorate: [NaClO 3 ] 0 = 1.25 mol L -1 , [NaCl] 0 = 0.0250 mol L -1 and [ H C l O 4 ] 0 = 2 . 0 0 m o l L -1 , a n d ( b ) ex c e  ... 
doi:10.1590/s0103-50532012005000017 fatcat:tngvqxgr2zbsra43ssyqfkveqq

Patterns of reintubation in extremely preterm infants: a longitudinal cohort study

Wissam Shalish, Lara Kanbar, Martin Keszler, Sanjay Chawla, Lajos Kovacs, Smita Rao, Bogdan A Panaitescu, Alyse Laliberte, Doina Precup, Karen Brown, Robert E Kearney, Guilherme M Sant'Anna
2018 Pediatric Research  
BACKGROUND: The optimal approach for reporting reintubation rates in extremely preterm infants is unknown. This study aims to longitudinally describe patterns of reintubation in this population over a broad range of observation windows following extubation. METHODS: Timing and reasons for reintubation following a first planned extubation were collected from infants with birth weight ≤ 1,250 g. An algorithm was generated to discriminate between reintubations attributable to respiratory and
more » ... piratory causes. Frequency and cumulative distribution curves were constructed for each category using 24 h intervals. The ability of observation windows to capture respiratory-related reintubations while limiting non-respiratory reasons was assessed using a receiver operating characteristic curve. RESULTS: Out of 194 infants, 91 (47%) were reintubated during hospitalization; 68% for respiratory and 32% for nonrespiratory reasons. Respiratory-related reintubation rates steadily increased from 0 to 14 days post-extubation before reaching a plateau. In contrast, non-respiratory reintubations were negligible in the first post-extubation week, but became predominant after 14 days. An observation window of 7 days captured 77% of respiratory-related reintubations while only including 14% of non-respiratory cases. CONCLUSION: Reintubation patterns are highly variable and affected by the reasons for reintubation and observation window used. Ideally, reintubation rates should be reported using a cumulative distribution curve over time.
doi:10.1038/pr.2017.330 pmid:29389921 fatcat:54p76fvmszh53gstcvzlrgxhiu

Heart Rate Variability in Extremely Preterm Infants Receiving Nasal CPAP and Non-Synchronized Noninvasive Ventilation Immediately After Extubation

Samantha Latremouille, Ali Al-Jabri, Philippe Lamer, Lara Kanbar, Wissam Shalish, Robert E Kearney, Guilherme M Sant'Anna
2017 Respiratory care  
INTRODUCTION: There is a paucity of studies comparing the physiological effects of nasal CPAP or non-synchronized noninvasive ventilation (ns-NIV) during the postextubation phase in preterm infants. Heart rate variability (HRV) can identify system instability before clinical or laboratory signs of deterioration. Thus, we sought to investigate any differences in HRV between those modes. METHODS: 15 preterm infants with birthweight <1,250 g and undergoing their first extubation attempt were
more » ... d immediately after disconnection from mechanical ventilation. Electrocardiogram (ECG) recordings were obtained while on nasal CPAP and ns-NIV in a random order (30 -60 min on each). Time and frequency domain analyses were used to calculate HRV from 5-min segments of ECG. RESULTS: 12 of 15 infants were analyzed (3 were excluded for low ECG quality): 7 successes and 5 failures. HRV parameters were higher during ns-NIV when compared to nasal CPAP, but differences were not statistically different. However, absolute and relative differences in HRV values (all time domain parameters) were significantly higher in infants who failed extubation during ns-NIV. CONCLUSIONS: Nasal CPAP or ns-NIV provided immediately postextubation did not affect HRV. Interestingly, in an exploratory analysis, changes in HRV did occur during ns-NIV in the subgroup of infants who failed extubation. Hence, changes in HRV as early as 2 h after extubation should be further explored in larger studies as a potential predictor of postextubation respiratory failure.
doi:10.4187/respcare.05672 pmid:29066587 fatcat:2vi3mik4zfdlxjr24k4ogtem7e

Undersampling and Bagging of Decision Trees in the Analysis of Cardiorespiratory Behavior for the Prediction of Extubation Readiness in Extremely Preterm Infants [article]

Lara J. Kanbar, Charles C. Onu, Wissam Shalish, Karen A. Brown, Guilherme M. Sant'Anna, Robert E. Kearney, Doina Precup
2018 arXiv   pre-print
Extremely preterm infants often require endotracheal intubation and mechanical ventilation during the first days of life. Due to the detrimental effects of prolonged invasive mechanical ventilation (IMV), clinicians aim to extubate infants as soon as they deem them ready. Unfortunately, existing strategies for prediction of extubation readiness vary across clinicians and institutions, and lead to high reintubation rates. We present an approach using Random Forest classifiers for the analysis of
more » ... cardiorespiratory variability to predict extubation readiness. We address the issue of data imbalance by employing random undersampling of examples from the majority class before training each Decision Tree in a bag. By incorporating clinical domain knowledge, we further demonstrate that our classifier could have identified 71% of infants who failed extubation, while maintaining a success detection rate of 78%.
arXiv:1808.07992v1 fatcat:sgcka7ywfndedcv5brybvheqe4

Factors that can influence the survival rates of coral snakes (Micrurus corallinus) for antivenom production

Guilherme F Mendes, Daniel R Stuginski, Selene M C Loibel, Karen de Morais-Zani, Marisa Maria T da Rocha, Wilson Fernandes, Sávio S Sant'Anna, Kathleen F Grego
2018 Journal of Animal Science  
Though more than 30 species of Brazilian coral snakes exist, the specific antivenom serum produced with the venom of two species, Micrurus corallinus and M. frontalis, is able to neutralize the accidents  ...  The objective of this study was to verify the factors influencing the survival rates of coral snakes in captivity through data generated from 289 M. corallinus from the LH snake facility in the last 10  ...  Contrary to M. corallinus, some species such as M. surinamensis, M. lemniscatus, and M. spixii have a higher plasticity regarding their diet, also feeding on eel-shaped fishes (Olamendi-Portugal et al  ... 
doi:10.1093/jas/sky467 pmid:30541079 pmcid:PMC6358253 fatcat:3r7gcizaq5ch7arakuhyqg2hf4
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