Smartphone apps hold promise for neonatal emergency care in low-resource settings.

AIM: Many countries risk failing the Sustainable Development Goal to reduce neonatal mortality to 12 in 1000 live births before 2030, necessitating intervention. This scoping review assesses available evidence from studies implementing smartphone application-based education and clinical decision support in neonatal emergency care in low- and middle-income countries and describes applied assessment tools to highlight gaps in the current literature. METHODS: A systematic search on 28 March 2024 of PubMed, Web of Science, and EMBASE identified original research papers published in peer-reviewed journals after 2014 in English. The evaluation was based on Kirkpatrick's framework. RESULTS: In total, 20 studies assessing eight different smartphone applications were included. Participants found applications acceptable and feasible in 11 of 14 studies. Knowledge and/or skills were improved in 11 of 12 studies. Behaviour was assessed in 10 studies by tracking app usage. Patient outcome was assessed in four studies, focusing on perinatal mortality, Basic Newborn Care outcomes and correct assessment of newborns. CONCLUSION: Data from included studies further strengthens hope that smartphone applications can improve neonatal mortality rates in low- and middle-income countries. However, further research into the effectiveness of these applications is warranted. This review highlights gaps in the current literature and provides guidance for future trials.

Simulation-based training in paediatric emergency medicine.

Managing critically ill children is a rare and challenging event requiring training to ensure adequate and timely quality of care. Thus, health professionals train for pediatric emergencies in a simulated setting. Virtual reality (VR) is a promising modality for simulation, and current evidence highlights the potential of VR for simulating pediatric emergencies. However, more studies are needed to determine the aspects of VR design and implementation that support transfer of learning.

Efficacy, tolerability, and safety of erenumab for the preventive treatment of persistent post-traumatic headache attributed to mild traumatic brain injury: an open-label study.

BACKGROUND: Calcitonin gene-related peptide (CGRP) has recently been implicated in the pathogenesis of post-traumatic headache (PTH), which raises the prospect for therapeutic use of monoclonal antibodies targeting CGRP or its receptor. Therefore, we decided to assess the efficacy, tolerability, and safety of erenumab for prevention of persistent PTH attributed to mild traumatic brain injury. METHODS: A single-center, non-randomized, single-arm, open-label study of erenumab for adults aged 18-65 years with persistent PTH. Patients were assigned to receive 140-mg erenumab monthly by two subcutaneous 1-mL injections, given every 4 weeks for 12 weeks. The primary outcome measure was the mean change in number of monthly headache days of moderate to severe intensity from baseline (4-week pretreatment period) to week 9 through 12. Tolerability and safety endpoints were adverse events (i.e. number and type). RESULTS: Eighty-nine of 100 patients completed the open-label trial. At baseline, the mean monthly number of headache days of moderate to severe intensity was 15.7. By week 9 through 12, the number was reduced by 2.8 days. The most common adverse events were constipation (n = 30) and injection-site reactions (n = 15). Of 100 patients who received at least one dose of erenumab, two patients discontinued the treatment regimen due to adverse events. CONCLUSIONS: Among patients with persistent PTH, erenumab resulted in a lower frequency of moderate to severe headache days in this 12-week open-label trial. In addition, erenumab was well-tolerated as discontinuations due to adverse events were low. Placebo-controlled randomized clinical trials are needed to adequately evaluate the efficacy and safety of erenumab in patients with persistent PTH. TRIAL REGISTRATION: ClinicalTrials.Gov, NCT03974360. Registered on April 17, 2019 - Retrospectively registered.

[Inattentional blindness in the diagnostic process].

When engaged in a demanding task of visual perception we tend to become blind to stimuli, which are not part of our primary task - a bias known as inattentional blindness. This article studies inattentional blindness in radiologists' interpretation of scans. Furthermore, it is discussed, how attention - being a limited resource - is distributed in the diagnostic process. Does focus on one diagnosis make us blind to findings supporting a differential diagnosis? Does focus on typing patient data into electronic health records draw attention away from the general clinical view of the patient?