The impact of early tracheostomy on neurodevelopmental outcomes of infants with severe bronchopulmonary dysplasia exposed to postnatal corticosteroids.

OBJECTIVE: To compare the cognitive, language and motor scores of infants with severe BPD exposed to postnatal corticosteroids (PCS) and had early (ET), late (LT) or no tracheostomy (NT). METHODS: Retrospective study was designed to compare the developmental outcomes of 71 infants born between 2010 and 2017 with severe BPD exposed to PCS and had ET (≤122 days), LT (>122 days), or NT. RESULTS: Cognitive scores were lower in LT versus NT and ET (p = 0.050); motor scores were worse in LT versus NT and ET (p = 0.004). Dexamethasone use was higher in LT versus NT and ET (p = 0.040). Adjusted for PCS, odds for major cognitive impairment were 90% less in ET versus LT. Trend for improved language and motor outcomes was seen in ET versus LT. CONCLUSION: Infants with severe BPD exposed to PCS and had ET had significantly better cognitive, and trend toward improved language and motor outcomes.

Sanctions and economic growth: Do sanction diversity and level of development matter?

The application of economic and political sanctions becomes a vital tool of international politics to facilitate peaceful coexistence among the nations. However, the issue of the effectiveness of sanctions in creating adequate disutility to ensure compliance remains contentious. Therefore, this study assesses the effect of sanctions on the economic growth of the target states. It captures the diversity of sanctions using system Generalized Method of Moments (GMM) with extensive dataset for the period 1970-2018. The findings reveal that extensive, multilateral sanctions, and export restriction are the only sanction categories that are effective in creating disutility and reducing the real income per capita growth when targeted at the developed countries. On the other hand, limited sanctions (partial embargo) - sanctions that are targeted at specific sectors, groups, and issues such as withdrawal of foreign aid, as well as import restrictions can effectively reduce income per capita growth when imposed on developing countries while all other categories of sanctions have a positive effect on income growth in targeted developing economy. Therefore, we, conclude that the sanctions diversity, development level of the target country and sender identity play vital roles concerning the sanctions-economic growth nexus. These attributes should be considered in the application and analyses of sanctions to ensure their effectiveness. The study provided several interesting policy insights.

Prospective assessment of inter-rater reliability of a neonatal adverse event severity scale.

Introduction: To ensure the quality of clinical trial safety data, universal data standards are required. In 2019 the International Neonatal Consortium (INC) published a neonatal adverse event severity scale (NAESS) to standardize the reporting of adverse event (AE) severity. In this study the reliability of AE severity grading with INC NAESS was prospectively assessed in a real-world setting. Methods: Severity of AEs was assessed by two independent observers at each of four centers across the world. In each center two series of 30 neonatal adverse events were assessed by both observers: in a first phase with a generic (Common Terminology Criteria for Adverse Events, CTCAE) severity scale not specific to neonates, and in a second phase with INC NAESS (after a structured training). Intraclass correlation coefficients (ICC) were calculated to express inter-rater agreement in both phases, and bootstrap sampling was used to compare them. Results: 120 AEs were included in each of both phases. The ICC with the use of INC NAESS in phase 2 was 0.69. This represents a significant but modest improvement in comparison to the initial ICC of 0.66 in phase 1 (confidence interval of ratio of ICC in phase 2 to phase 1 = 1.005-1.146; excludes 1). The ICC was higher for those AEs for which a diagnosis specific AE severity table was available in INC NAESS (ICC 0.80). Discussion: Good inter-rater reliability of the INC NAESS was demonstrated in four neonatal intensive care units (NICUs) across the globe. The ICC is comparable to what is reported for scales with similar purposes in different populations. There is a modest, but significant, improvement in inter-rater agreement in comparison to the naïve phase without INC NAESS. The better performance when reviewers use AE-specific NAESS tables highlights the need to expand the number of AEs that are covered by specific criteria in the current version of INC NAESS.

Toward a sustainable growth path in Arab economies: an extension of classical growth model.

Background/Objectives: Many economies are on the trajectory of alternative growth drivers other than conventional capital and labor. Access to credit facilities is a pertinent indicator of economic growth. In line with the United Nations Sustainable Development Goals (UNSDGs-8) agenda, the national goal for sustainable development for most economies and Arab economies is no exception. Therefore, the current study adopts a traditional growth model by exploring the relationship between gross domestic product (GDP) per capita, credit for private sectors, ratio of exports, real GDP, and per labor force participants for selected Arab economies annually from 2001 to 2020. Research design: This study leverages the Fourier Kwiatkowski-Phillips-Schmidt-Shin (KPSS) unit root test and second-generation panel econometrics as estimation techniques, such as Westerlund and Edgerton panel cointegration test, and the use of two estimators, namely the augmented mean group (AMG) and common correlated error mean group (CCEMG), to obtain robust results. Findings: Empirical findings from Westerlund and Edgerton panel cointegration tests validate the long-run equilibrium relationship among the outlined variables. Further empirical results indicate that the share of exports is negatively significant with economic growth in countries such as Kuwait, Lebanon, Tunisia, and Jordan. Additionally, savings and labor force participation have a positive relationship with economic growth in individual countries such as Algeria and Bahrain. As per the panel, there is no significant relationship between labor force participation and economic growth. This indicates that the skilled labor force enhanced economic growth. Conclusions: These findings come with inherent far-reaching policy suggestions for economies and panels. Further details on country-specific policy actions are presented in the concluding section.

Bivalirudin and thrombolytic therapy: a novel successful treatment of severe aortic arch thrombosis in a term neonate.

An early-term infant with uncomplicated perinatal history was found to have a large thrombus in the aortic arch after he failed regular newborn critical congenital heart defect screen. He responded well to bivalirudin thrombolytic and tissue-plasminogen activator (tPA) combination therapy, with a significant resolution of the thrombus. The infant tolerated hospital admission well with no significant complications. He was discharged home on daily aspirin at 2 weeks of life. To our knowledge, the combination therapy approach with bivalirudin and tPA is the first one reported in the literature in the neonatal age group.