Paediatrics & Child Healthhttps://hdl.handle.net/10468/6252024-03-28T09:57:00Z2024-03-28T09:57:00Z1831A core outcome set for studies of gestational diabetes mellitus prevention and treatmentEgan, Aoife M.Bogdanet, DeliaGriffin, Tomás P.Kgosidialwa, O.Cervar-Zivkovic, MilaDempsey, Eugene M.Allotey, JohnAlvarado, FernandaClarson, CherilCooray, Shamil D.de Valk, Harold W.Galjaard, SanderLoeken, Mary R.Maresh, MichaelNapoli, AngelaO'Shea, Paula M.Wender-Ozegowska, Ewavan Poppel, Mireille N. M.Thangaratinam, ShakilaCrowther, CarolineBiesty, Linda M.Devane, DeclanDunne, Fidelma P.https://hdl.handle.net/10468/132922023-04-05T06:57:48Z2020-03-01T00:00:00Zdc.title: A core outcome set for studies of gestational diabetes mellitus prevention and treatment
dc.contributor.author: Egan, Aoife M.; Bogdanet, Delia; Griffin, Tomás P.; Kgosidialwa, O.; Cervar-Zivkovic, Mila; Dempsey, Eugene M.; Allotey, John; Alvarado, Fernanda; Clarson, Cheril; Cooray, Shamil D.; de Valk, Harold W.; Galjaard, Sander; Loeken, Mary R.; Maresh, Michael; Napoli, Angela; O'Shea, Paula M.; Wender-Ozegowska, Ewa; van Poppel, Mireille N. M.; Thangaratinam, Shakila; Crowther, Caroline; Biesty, Linda M.; Devane, Declan; Dunne, Fidelma P.
dc.description.abstract: Aims/hypothesis: The aim of this systematic review was to develop core outcome sets (COSs) for trials evaluating interventions for the prevention or treatment of gestational diabetes mellitus (GDM). Methods: We identified previously reported outcomes through a systematic review of the literature. These outcomes were presented to key stakeholders (including patient representatives, researchers and clinicians) for prioritisation using a three-round, e-Delphi study. A priori consensus criteria informed which outcomes were brought forward for discussion at a face-to-face consensus meeting where the COS was finalised. Results: Our review identified 74 GDM prevention and 116 GDM treatment outcomes, which were presented to stakeholders in round 1 of the e-Delphi study. Round 1 was completed by 173 stakeholders, 70% (121/173) of whom went on to complete round 2; 84% (102/121) of round 2 responders completed round 3. Twenty-two GDM prevention outcomes and 30 GDM treatment outcomes were discussed at the consensus meeting. Owing to significant overlap between included prevention and treatment outcomes, consensus meeting stakeholders agreed to develop a single prevention/treatment COS. Fourteen outcomes were included in the final COS. These consisted of six maternal outcomes (GDM diagnosis, adherence to the intervention, hypertensive disorders of pregnancy, requirement and type of pharmacological therapy for hyperglycaemia, gestational weight gain and mode of birth) and eight neonatal outcomes (birthweight, large for gestational age, small for gestational age, gestational age at birth, preterm birth, neonatal hypoglycaemia, neonatal death and stillbirth). Conclusions/interpretation: This COS will enable future GDM prevention and treatment trials to measure similar outcomes that matter to stakeholders and facilitate comparison and combination of these studies.
2020-03-01T00:00:00ZA detailed exploration of early infant milk feeding in a prospective birth cohort study in Ireland: combination feeding of breast milk and infant formula and early breast-feeding cessationHemmingway, AndreaFisher, DawnBerkery, TeresaDempsey, Eugene M.Murray, Deirdre M.Kiely, Mairead E.https://hdl.handle.net/10468/103092023-04-05T06:57:41Z2020-04-14T00:00:00Zdc.title: A detailed exploration of early infant milk feeding in a prospective birth cohort study in Ireland: combination feeding of breast milk and infant formula and early breast-feeding cessation
dc.contributor.author: Hemmingway, Andrea; Fisher, Dawn; Berkery, Teresa; Dempsey, Eugene M.; Murray, Deirdre M.; Kiely, Mairead E.
dc.description.abstract: Breast-feeding initiation and continuation rates in the UK and Ireland are low relative to many European countries. As a core outcome of the prospective Cork Nutrition and Development Maternal-Infant Cohort (COMBINE) study (Cork, Ireland), we aimed to describe infant milk feeding practices in detail and examine the prevalence and impact of combination feeding of breast milk and infant formula on breast-feeding duration. COMBINE recruited 456 nulliparous mothers (2015â 2017) for maternalâ infant follow-up via interview at hospital discharge (median 3 (interquartile range (IQR) 2, 4) d (n 453)), 1 (n 418), 2 (n 392), 4 (n 366), 6 (n 362) and 9 (n 345) months of age. Median maternal age was 32 (IQR 29, 34) years, 97 % of mothers were of white ethnicity, 79 % were Irish-born and 75 % were college-educated. Overall, 75 % breastfed to any extent at discharge and 44 % breastfed solely. At 1, 2, 4, 6 and 9 months, respectively, 40, 36, 33, 24 and 19 % breastfed solely. Combination feeding of breast milk and infant formula was common at discharge (31 %) and 1 month (20 %). Reasons for combination feeding at 1 month included perceived/actual hunger (30 %), healthcare professional advice (31 %) and breast-feeding difficulties (13 %). Of mothers who breastfed to any extent at discharge, 45 % stopped within 4 months. Mothers who combination fed were more likely to cease breast-feeding than those who breastfed solely (relative risk 2·3 by 1 month and 12·0 by 2 months). These granular data provide valuable insight to early milk feeding practices and indicate that supporting early breast-feeding without formula use may be key to the successful continuation of breast-feeding.
2020-04-14T00:00:00ZA good start in life is important-perinatal factors dictate early microbiota development and longer term maturationWang, ShaopuEgan, MuireannRyan, Anthony C.Boyaval, PatrickDempsey, Eugene M.Ross, R. PaulStanton, Catherinehttps://hdl.handle.net/10468/132912023-04-05T06:58:31Z2020-11-01T00:00:00Zdc.title: A good start in life is important-perinatal factors dictate early microbiota development and longer term maturation
dc.contributor.author: Wang, Shaopu; Egan, Muireann; Ryan, Anthony C.; Boyaval, Patrick; Dempsey, Eugene M.; Ross, R. Paul; Stanton, Catherine
dc.description.abstract: Maternal health status is vital for the development of the offspring of humans, including physiological health and psychological functions. The complex and diverse microbial ecosystem residing within humans contributes critically to these intergenerational impacts. Perinatal factors, including maternal nutrition, antibiotic use and maternal stress, alter the maternal gut microbiota during pregnancy, which can be transmitted to the offspring. In addition, gestational age at birth and mode of delivery are indicated frequently to modulate the acquisition and development of gut microbiota in early life. The early-life gut microbiota engages in a range of host biological processes, particularly immunity, cognitive neurodevelopment and metabolism. The perturbed early-life gut microbiota increases the risk for disease in early and later life, highlighting the importance of understanding relationships of perinatal factors with early-life microbial composition and functions. In this review, we present an overview of the crucial perinatal factors and summarise updated knowledge of early-life microbiota, as well as how the perinatal factors shape gut microbiota in short and long terms. We further discuss the clinical consequences of perturbations of early-life gut microbiota and potential therapeutic interventions with probiotics/live biotherapeutics.
2020-11-01T00:00:00ZA longitudinal study of hymenoptera stings in preschool childrenClifford, DanielleNí Chaoimh, Carol E.Stanley, EveHourihane, Jonathan O'B.https://hdl.handle.net/10468/72632023-04-05T06:57:24Z2018-10-08T00:00:00Zdc.title: A longitudinal study of hymenoptera stings in preschool children
dc.contributor.author: Clifford, Danielle; Ní Chaoimh, Carol E.; Stanley, Eve; Hourihane, Jonathan O'B.
dc.description.abstract: Background: Insect venom is the second most common cause of anaphylaxis outside of medical encounters. Stings cause over 20% of all anaphylactic deaths and 7% of anaphylaxis in children. To date, there have been no longitudinal studies of insect sting events or allergy in preschool children. Methods: A prospective longitudinal nested observational study in the BASELINE Birth Cohort Study (n = 2137). Sting‐related questions were asked at 6 and 12 months and 2 and 5 years. Skin prick testing (SPT) was performed at 2 and 5 years. SpIgE testing was performed on selected cases at 2 years. Results: Seventy‐seven children (6.8%) were stung by the age of 2. Of these, 25 (32.5%) reported adverse reactions (four systemic). Eleven (0.9%) had positive SPT at 2 years (eight bee, two wasp, one both). Four stung children had positive SPT. Two (one stung, one never stung) had positive spIgE to a venom component at 2 years. A total of 268 children (21.9%) were stung by 5 years, 144 (52.1%) reporting local reactions and none systemic. Four children (0.4%) had positive SPT at 5 years: one bee and three wasp. Of the 11 SPT‐positive children at 2 years, none were still positive at 5 years. Conclusion: This is the first longitudinal study of the natural history of hymenoptera stings and allergy in preschool children. Hymenoptera venom allergy is less common in this cohort than in adults. Systemic reactions were not medically documented in this population, in keeping with previous literature. This study confirms the poor correlation of IgE sensitization to venom with sting allergy and does not support the common parental request to screen children for sting allergy.
2018-10-08T00:00:00ZA machine-learning algorithm for neonatal seizure recognition: a multicentre, randomised, controlled trialPavel, AndreeaRennie, Janet M.de Vries, Linda S.Blennow, MatsForan, AdrienneShah, Divyen K.Pressler, RonitKapellou, OlgaDempsey, Eugene M.Mathieson, Sean R.Pavlidis, Elenavan Huffelen, Alexander C.Livingstone, VickiToet, Mona C.Weeke, Lauren C.Finder, MikaelMitra, SubhabrataMurray, Deirdre M.Marnane, William P.Boylan, Geraldine B.https://hdl.handle.net/10468/131222023-04-05T06:58:36Z2020-10-01T00:00:00Zdc.title: A machine-learning algorithm for neonatal seizure recognition: a multicentre, randomised, controlled trial
dc.contributor.author: Pavel, Andreea; Rennie, Janet M.; de Vries, Linda S.; Blennow, Mats; Foran, Adrienne; Shah, Divyen K.; Pressler, Ronit; Kapellou, Olga; Dempsey, Eugene M.; Mathieson, Sean R.; Pavlidis, Elena; van Huffelen, Alexander C.; Livingstone, Vicki; Toet, Mona C.; Weeke, Lauren C.; Finder, Mikael; Mitra, Subhabrata; Murray, Deirdre M.; Marnane, William P.; Boylan, Geraldine B.
dc.description.abstract: Background: Despite the availability of continuous conventional electroencephalography (cEEG), accurate diagnosis of neonatal seizures is challenging in clinical practice. Algorithms for decision support in the recognition of neonatal seizures could improve detection. We aimed to assess the diagnostic accuracy of an automated seizure detection algorithm called Algorithm for Neonatal Seizure Recognition (ANSeR).Methods: This multicentre, randomised, two-arm, parallel, controlled trial was done in eight neonatal centres across Ireland, the Netherlands, Sweden, and the UK. Neonates with a corrected gestational age between 36 and 44 weeks with, or at significant risk of, seizures requiring EEG monitoring, received cEEG plus ANSeR linked to the EEG monitor displaying a seizure probability trend in real time (algorithm group) or cEEG monitoring alone (non algorithm group). The primary outcome was diagnostic accuracy (sensitivity, specificity, and false detection rate) of health-care professionals to identify neonates with electrographic seizures and seizure hours with and without the support of the ANSeR algorithm. Neonates with data on the outcome of interest were included in the analysis. This study is registered with ClinicalTrials.gov, NCT02431780.Findings: Between Feb 13, 2015, and Feb 7, 2017, 132 neonates were randomly assigned to the algorithm group and 132 to the non-algorithm group. Six neonates were excluded (four from the algorithm group and two from the non-algorithm group). Electrographic seizures were present in 32 (25.0%) of 128 neonates in the algorithm group and 38 (29.2%) of 130 neonates in the non-algorithm group. For recognition of neonates with electrographic seizures, sensitivity was 81.3% (95% CI 66.7-93.3) in the algorithm group and 89.5% (78.4-97.5) in the non-algorithm group; specificity was 84.4% (95% CI 76.9-91.0) in the algorithm group and 89.1% (82.5-94.7) in the non-algorithm group; and the false detection rate was 36.6% (95% CI 22.7-52.1) in the algorithm group and 22.7% (11.6-35.9) in the non-algorithm group. We identified 659 h in which seizures occurred (seizure hours): 268 h in the algorithm versus 391 h in the non algorithm group. The percentage of seizure hours correctly identified was higher in the algorithm group than in the non-algorithm group (177 [66.0%; 95% CI 53.8-77.3] of 268 h vs 177 [45.3%; 34.5-58.3] of 391 h; difference 20.8% [3.6-37.1]). No significant differences were seen in the percentage of neonates with seizures given at least one inappropriate antiseizure medication (37.5% [95% CI 25.0 to 56.3] vs 31.6% [21.1 to 47.4]; difference 5.9% [-14.0 to 26.3]).Interpretation ANSeR, a machine-learning algorithm, is safe and able to accurately detect neonatal seizures. Although the algorithm did not enhance identification of individual neonates with seizures beyond conventional EEG, recognition of seizure hours was improved with use of ANSeR. The benefit might be greater in less experienced centres, but further study is required.
2020-10-01T00:00:00ZA multi-disciplinary approach to the diagnosis and management of allergic diseases: An EAACI Task ForceVassilopoulou, EmiliaSkypala, IsabelFeketea, GavrielaGawlik, RadoslawDunn Galvin, AudreyMeyer, RosanPitsios, ConstantinosPop, Raluca MariaRyan, DermotSaid, MariaSchiere, SophieVlieg-Broestra, BerberKull, Ingerhttps://hdl.handle.net/10468/139042023-04-04T12:08:24Z2021-12-31T00:00:00Zdc.title: A multi-disciplinary approach to the diagnosis and management of allergic diseases: An EAACI Task Force
dc.contributor.author: Vassilopoulou, Emilia; Skypala, Isabel; Feketea, Gavriela; Gawlik, Radoslaw; Dunn Galvin, Audrey; Meyer, Rosan; Pitsios, Constantinos; Pop, Raluca Maria; Ryan, Dermot; Said, Maria; Schiere, Sophie; Vlieg-Broestra, Berber; Kull, Inger
dc.description.abstract: Background: Guidelines for management of patients with allergic conditions are available, but the added value of nurses, allied healthcare professionals (AHPs), and general practitioners (GPs), in the management of allergic disease, has not been fully clarified. The European Academy of Allergy and Clinical Immunology (EAACI) appointed a task force to explore this issue. Aim To investigate the added value of nurses, AHPs, and GPs in management of allergic diseases, in an integrated model of care. Methods: A search was made of peer-reviewed literature published between 2010 and December 2020 (Cochrane Library, PubMed, and CINAHL) on the involvement of the various specific healthcare providers (HCPs) in the management of allergic diseases. Results: Facilitative models of care for patients with allergies can be achieved if HCP collaborates in the diagnosis and management. Working in multi-disciplinary teams (MDT) can increase patients' understanding of the disease, adherence to treatment, self-care capabilities, and ultimately improve quality of life. The MDT competencies and procedures can be improved and enhanced in a climate of mutual respect and shared values, and with inclusion of patients in the planning of care. Patient-centered communication among HCPs and emphasis on the added value of each profession can create an effective integrated model of care for patients with allergic diseases. Conclusion: Nurses, AHPs, and GPs, both individually and in collaboration, can contribute to the improvement of the management of patients with allergic disease. The interaction between the HCPs and the patients themselves can ensure maximum support for people with allergies.
2021-12-31T00:00:00ZA nonlinear model of newborn EEG with nonstationary inputsStevenson, Nathan J.Mesbah, MostefaBoylan, Geraldine B.Colditz, Paul B.Boashash, Boualemhttps://hdl.handle.net/10468/6292023-04-05T06:59:14Z2010-09-01T00:00:00Zdc.title: A nonlinear model of newborn EEG with nonstationary inputs
dc.contributor.author: Stevenson, Nathan J.; Mesbah, Mostefa; Boylan, Geraldine B.; Colditz, Paul B.; Boashash, Boualem
dc.contributor.editor: McIntire, Larry V.
dc.description.abstract: Newborn EEG is a complex multiple channel signal that displays nonstationary and nonlinear characteristics. Recent studies have focussed on characterizing the manifestation of seizure on the EEG for the purpose of automated seizure detection. This paper describes a novel model of newborn EEG that can be used to improve seizure detection algorithms. The new model is based on a nonlinear dynamic system; the Duffing oscillator. The Duffing oscillator is driven by a nonstationary impulse train to simulate newborn EEG seizure and white Gaussian noise to simulate newborn EEG background. The use of a nonlinear dynamic system reduces the number of parameters required in the model and produces more realistic, life-like EEG compared with existing models. This model was shown to account for 54% of the linear variation in the time domain, for seizure, and 85% of the linear variation in the frequency domain, for background. This constitutes an improvement in combined performance of 6%, with a reduction from 48 to 4 model parameters, compared to an optimized implementation of the best performing existing model.
2010-09-01T00:00:00ZA nonparametric feature for neonatal EEG seizure detection based on a representation of pseudo-periodicityStevenson, Nathan J.O'Toole, John M.Rankine, Luke J.Boylan, Geraldine B.Boashash, Boualemhttps://hdl.handle.net/10468/8362023-04-05T06:58:12Z2012-05-01T00:00:00Zdc.title: A nonparametric feature for neonatal EEG seizure detection based on a representation of pseudo-periodicity
dc.contributor.author: Stevenson, Nathan J.; O'Toole, John M.; Rankine, Luke J.; Boylan, Geraldine B.; Boashash, Boualem
dc.description.abstract: Automated methods of neonatal EEG seizure detection attempt to highlight the evolving, stereotypical,
pseudo-periodic, nature of EEG seizure while rejecting the nonstationary, modulated, coloured stochastic
background in the presence of various EEG artefacts. An important aspect of neonatal seizure detection is,
therefore, the accurate representation and detection of pseudo-periodicity in the neonatal EEG. This paper
describes a method of detecting pseudo-periodic components associated with neonatal EEG seizure based on a novel signal representation; the nonstationary frequency marginal (NFM). The NFM can be considered as an alternative time-frequency distribution (TFD) frequency marginal. This method integrates the TFD along data-dependent, time-frequency paths that are automatically extracted from the TFD using an edge linking procedure and has the advantage of reducing the dimension of a TFD. The reduction in dimension simplifies the process of estimating a decision statistic designed for the detection of the pseudo-periodicity associated with neonatal EEG seizure. The use of the NFM resulted in a significant detection improvement
compared to existing stationary and nonstationary methods. The decision statistic estimated using the NFM
was then combined with a measurement of EEG amplitude and nominal pre- and post-processing stages to form a seizure detection algorithm. This algorithm was tested on a neonatal EEG database of 18 neonates, 826 hrs in length with 1389 seizures, and achieved comparable performance to existing second generation algorithms (a median receiver operating characteristic area of 0.902; IQR 0.835-0.943 across 18 neonates).
2012-05-01T00:00:00ZA phase II randomized clinical trial on cerebral near-infrared spectroscopy plus a treatment guideline versus treatment as usual for extremely preterm infants during the first three days of life (SafeBoosC): study protocol for a randomized controlled trialHyttel-Sorensen, SimonAustin, Topunvan Bel, FrankBenders, ManonClaris, OlivierDempsey, Eugene M.Fumagalli, MonicaGreisen, GormGrevstad, BeritHagmann, CorneliaHellström-Westas, LenaLemmers, PetraLindschou, JaneNaulaers, Gunnarvan Oeveren, WimPellicer, AdelinaPichler, GerhardRoll, ClaudiaSkoog, MariaWinkel, PerWolf, MartinGluud, Christianhttps://hdl.handle.net/10468/46072023-04-05T06:58:32Z2013-05-01T00:00:00Zdc.title: A phase II randomized clinical trial on cerebral near-infrared spectroscopy plus a treatment guideline versus treatment as usual for extremely preterm infants during the first three days of life (SafeBoosC): study protocol for a randomized controlled trial
dc.contributor.author: Hyttel-Sorensen, Simon; Austin, Topun; van Bel, Frank; Benders, Manon; Claris, Olivier; Dempsey, Eugene M.; Fumagalli, Monica; Greisen, Gorm; Grevstad, Berit; Hagmann, Cornelia; Hellström-Westas, Lena; Lemmers, Petra; Lindschou, Jane; Naulaers, Gunnar; van Oeveren, Wim; Pellicer, Adelina; Pichler, Gerhard; Roll, Claudia; Skoog, Maria; Winkel, Per; Wolf, Martin; Gluud, Christian
dc.description.abstract: Background: Every year in Europe about 25,000 infants are born extremely preterm. These infants have a 20% mortality rate, and 25% of survivors have severe long-term cerebral impairment. Preventative measures are key to reduce mortality and morbidity in an extremely preterm population. The primary objective of the SafeBoosC phase II trial is to examine if it is possible to stabilize the cerebral oxygenation of extremely preterm infants during the first 72 hours of life through the application of cerebral near-infrared spectroscopy (NIRS) oximetry and implementation of an clinical treatment guideline based on intervention thresholds of cerebral regional tissue saturation rStO2. Methods/Design: SafeBoosC is a randomized, blinded, multinational, phase II clinical trial. The inclusion criteria are: neonates born more than 12 weeks preterm; decision to conduct full life support; parental informed consent; and possibility to place the cerebral NIRS oximeter within 3 hours after birth. The infants will be randomized into one of two groups. Both groups will have a cerebral oximeter monitoring device placed within three hours of birth. In the experimental group, the cerebral oxygenation reading will supplement the standard treatment using a predefined treatment guideline. In the control group, the cerebral oxygenation reading will not be visible and the infant will be treated according to the local standards. The primary outcome is the multiplication of the duration and magnitude of rStO2 values outside the target ranges of 55% to 85%, that is, the ‘burden of hypoxia and hyperoxia’ expressed in ‘%hours’. To detect a 50% difference between the experimental and control group in %hours, 166 infants in total must be randomized. Secondary outcomes are mortality at term date, cerebral ultrasound score, and interburst intervals on an amplitude-integrated electroencephalogram at 64 hours of life and explorative outcomes include neurodevelopmental outcome at 2 years corrected age, magnetic resonance imaging at term, blood biomarkers at 6 and 64 hours after birth, and adverse events. Discussion: Cerebral oximetry guided interventions have the potential to improve neurodevelopmental outcome in extremely preterm infants. It is a logical first step to test if it is possible to reduce the burden of hypoxia and hyperoxia. Trial registration: ClinicalTrial.gov, NCT01590316
2013-05-01T00:00:00ZA review of important electroencephalogram features for the assessment of brain maturation in premature infantsPavlidis, ElenaLloyd, Rhodri O.Mathieson, SeanBoylan, Geraldine B.https://hdl.handle.net/10468/46352023-04-05T06:58:18Z2017-08-17T00:00:00Zdc.title: A review of important electroencephalogram features for the assessment of brain maturation in premature infants
dc.contributor.author: Pavlidis, Elena; Lloyd, Rhodri O.; Mathieson, Sean; Boylan, Geraldine B.
dc.description.abstract: This review describes the maturational features of the baseline electroencephalogram (EEG) in the neurologically healthy preterm infant. Features such as continuity, sleep state, synchrony and transient waveforms are described, even from extremely preterm infants and includes abundant illustrated examples. The physiological significance of these EEG features and their relationship to neurodevelopment are highlighted where known. This review also demonstrates the importance of multichannel conventional EEG monitoring for preterm infants as many of the features described are not apparent if limited channel EEG monitors are used. Conclusion: This review aims to provide healthcare professionals in the neonatal intensive care unit with guidance on the more common normal maturational features seen in the EEG of preterm infants.
2017-08-17T00:00:00Z