Current Issue : April-June Volume : 2026 Issue Number : 2 Articles : 5 Articles
Background: β3 adrenergic receptors (β3-ARs) have recently gained scientific attention due to their widespread body expression and their heterogeneous span of tissue-related functions. Recent research has hypothesized their involvement in the pathogenesis of some of the most common complications in preterm infants. The aim of the present systematic review is to examine the published scientific literature on the topic. Methods: PubMED/Medline and Cochrane databases were searched for studies reporting an association between β3-ARs, fetal development, and preterm newborns’ diseases. Results: Of 1596 articles found, 16 studies were selected for the review. Data currently available in the literature show that β3-ARs are upregulated in a hypoxic environment in several tissues and that their activation triggers a downstream cascade that promotes pro-angiogenic, anti-inflammatory, and immunoregulating effects, as well as metabolic adaptative processes and chemoresistance to xenobiotics. These characteristics seem to be central in the development of the fetus. Conclusions: Available preclinical data suggest the possible role of β3-ARs in the pathogenesis of a large number of premature newborn pathologies. Since fetal growth takes place in a low oxygenated environment, preterm delivery exposes newborns to a relatively hyperoxic setting while their development is not fully completed. Given the β3-ARs upregulation in a hypoxic environment, premature exposure to higher oxygen concentration levels affects their expression and their activity, probably derailing fetal normal development and injuring several organs. β3-ARs might therefore represent a central element in the pathogenesis of some of the main pathologies that preterm babies often develop....
Background/Objectives: Neonatal Intensive Care Units (NICUs) constitute a highly complex clinical environment characterized by patient fragility and frequent ethically sensitive decisions. To date, systematic studies investigating how Italian NICUs address these challenges and what forms of ethics support are eectively available are lacking. The aim of this study is therefore to assess how ethical issues are managed in Italian NICUs, with particular aention to the availability, use, and perceived usefulness of clinical ethics support in everyday practice. Methods: A 25-item questionnaire was developed by adapting an existing tool for investigating clinical ethics activities to the neonatal context. Following expert review by the GIBCE (Gruppo Interdisciplinare di Bioetica Clinica e Consulenza Etica in ambito sanitario), the nal instrument covered four areas (general data, experience with ethical dilemmas, tools and procedures, opinions and training needs). A manual web search identied all Italian NICUs and their clinical directors, who were asked to disseminate the survey among sta. Participation was voluntary and anonymous. Data collection was conducted via Google Forms and analyzed through qualitative thematic analysis. Results: A total of 217 questionnaires were collected. The most frequent ethical dilemmas concern quality of life with anticipated multiple or severe disabilities (72.4%) and decisions to withdraw or withhold life-sustaining treatments (64.5%). Major challenges include fear of medico-legal repercussions (57.6%) and communication divergences between physicians and nurses (49,8%). More than half of respondents (52.1%) reported no formal training in clinical ethics, and 68.7% had never developed a Shared Care Plan (Shared Document for healthcare ethics planning) as dened by the Italian Law 219/2017. Conclusions: Findings highlight marked fragmentation in ethical practices across Italian NICUs. On this basis, establishing structured and accessible CEC services could help promote consistency, reinforce shared ethical standards, and support transparent and equitable decision-making in critical neonatal care....
Background/Objectives: Respiratory syncytial virus (RSV) causes severe infection in neonates and infants. However, a suitable RSV vaccine for children is yet to be approved. The development of KD-409 is focused on creating an effective and safe RSV vaccine for newborns and children. The safety and efficacy of the RSV FG chimeric protein KD-409 were evaluated in several rodent models. Methods/Results: The effect of vaccine-induced antibody transfer was verified in a guinea pig model. Next, the exacerbation of infection was evaluated in a BALB/c mouse model of passive immunity designed to mimic the vaccination of pregnant women. KD-409 did not exacerbate infection when administered with alum, unlike pre-F with alum. Our active immunization model of BALB/c mice, which involved stimulating vaccination with a pediatric vaccine, suggested that KD-409 with alum was less likely to exacerbate inflammation than FI-RSV or pre-F with alum. The efficacy was evaluated in a cotton rat model, in which KD-409 demonstrated greater protection against infection than pre-F without adjuvant, the only currently approved formulation for immunizing pregnant women. Conclusions: KD-409 eliminated concerns about vaccineenhanced disease in pediatric vaccination and demonstrated superior efficacy to current vaccines in rodent models. The safety in mice during passive and active immunization, and efficacy in cotton rats demonstrate the high potential of KD-409 as a safe and effective next-generation RSV vaccine candidate that can cover the neonatal-to-pediatric age range....
Background/Objectives: In Ontario, approximately 8% (11,000) of infants are born preterm (22–<37 weeks gestation) each year. Many of these infants are cared for in a Level II Neonatal Intensive Care Unit (NICU). Family Integrated Care (FICare), an innovative model of care, aims to facilitate the involvement of parents in the care of their infants in NICUs. The aim of this study was to gain a better understanding of the general and specific needs of Level II NICUs in Ontario prior to implementation of FICare. Methods: Using a cross-sectional study design, two surveys (leadership and site resources) were developed using the Consolidated Framework for Implementation Science Research’s innovation, inner setting, and outer setting constructs and distributed to Level II NICUs medical and nursing leaders. Results: The surveys were sent to 44 Level II NICUs in Ontario, of which 24 hospitals (55%) responded. Key facilitators to implementation of FICare in Level II hospitals in Ontario were leadership interest, availability of staff and parent volunteers, and existing policies to support implementation. The identified barriers were lack of financial resources for new initiatives, skepticism in FICare’s ability to save costs, need for tailored implementation due to variability in NICU characteristics, and the lack of environmental support for prolonged parental presence. Conclusions: This study has confirmed the interest of many Ontario level II NICUs in implementing FICare and variability in their readiness for implementation based on the identified facilitators and barriers....
Objective: To explore the effect of dual-cycle teaching model integrating in-class and extracurricular activities in Maternal and Newborn Health Nursing. Methods: A quasi-experimental design was adopted. 38 undergraduate nursing students from the class of 2022 were assigned to the intervention group and underwent teaching reforms implementing the “dual-cycle teaching model integrating in-class and extracurricular activities”, while the control group consisted of 41 students from the Class of 2021, received traditional teaching. Results: Students in the intervention group achieved a significantly higher course score (91.74 ± 6.542) compared with the control group (85.78 ± 5.470), with a statistically significant difference (t = 4.402, P < 0.001). Meanwhile, students in the intervention group showed improvement in self-directed learning competence and clinical communication competence. 94.74% of the students in the intervention group held a positive attitude toward the teaching reform. Conclusions: The application of the “dual-cycle teaching model integrating in-class and extracurricular activities” in maternal and newborn health nursing serves to enhance knowledge application, self-directed learning and clinical communication competencies among nursing undergraduates, thereby improving overall teaching outcomes....
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