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  • Conference paper
    Chalak LF, Prempunpong C, Garfinkle J, Rollins N, Nguyen K-A, Pappas A, Montaldo P, Thayyil S, Sanchez PJ, Shankaran S, Laptook AR, Sant'Anna Get al., 2017,


    , XXV Biennial Meeting of the International Perinatal Collegium, Publisher: WILEY, Pages: 9-9, ISSN: 0803-5253
  • Journal article
    Chandrasekaran M, Chaban B, Montaldo P, Thayyil Set al., 2017,

    Predictive value of amplitude-integrated EEG (aEEG) after rescue hypothermic neuroprotection for hypoxic ischemic encephalopathy: a meta-analysis

    , Journal of Perinatology, Vol: 37, Pages: 684-689, ISSN: 0743-8346

    Objective:Amplitude-integrated electroencephalography (aEEG) is a useful bedside tool in predicting the neurodevelopmental outcome after neonatal encephalopathy; however, the prognostic accuracy may be altered by rescue hypothermic neuroprotection. The objective of this study is to examine the prognostic accuracy of aEEG for predicting long-term neurodevelopmental outcomes in term newborn infants undergoing therapeutic hypothermia for neonatal encephalopathy.Study Design:We examined all studies (Medline, Cumulative Index to Nursing and Allied Health Literature and the Cochrane Library; 2000 to 2014) comparing aEEG (6, 24, 48 or 72 h) in term encephalopathic babies undergoing therapeutic hypothermia, with neurodevelopmental outcome at 1 year or more. We extracted individual patient data from the eligible studies to calculate prognostic indices with exact confidence intervals (CIs). We considered continuous normal voltage as normal aEEG pattern and discontinuous normal voltage, burst suppression, flat trace and persistently low voltage as abnormal, and defined adverse outcome as death or moderate/severe disability at 1 year.Results:We reviewed a total of 70 articles, 17 of which met the inclusion criteria. Eight studies were excluded and 9 studies (N=520) were included in the meta-analysis. The pooled sensitivity and specificity for an abnormal trace at 6 h of age to predict adverse outcome were 96% (95% CI 91 to 98%) and 39% (95% CI 32 to 46%). The diagnostic odds ratio of an abnormal trace was highest at 48 h (66.9 (95% CI 19.7, 227.2)).Conclusions:A persistantly abnormal aEEG at 48 h or more is associated with an adverse neurodevelopmal outcome. The positive prognostic value of 6 h aEEG is poor and good outcome may occur despite abnormal aEEG. Conversely, a normal 6 h aEEG has a good negative predictive value although do not exclude adverse outcomes.

  • Journal article
    Ahmed MU, Chanwimalueang T, Thayyil S, Mandic DPet al., 2016,

    A multivariate multiscale fuzzy entropy algorithm with application to uterine EMG complexity analysis

    , Entropy, Vol: 19, ISSN: 1099-4300

    The recently introduced multivariate multiscale entropy (MMSE) has been successfully used to quantify structural complexity in terms of nonlinear within- and cross-channel correlations as well as to reveal complex dynamical couplings and various degrees of synchronization over multiple scales in real-world multichannel data. However, the applicability of MMSE is limited by the coarse-graining process which defines scales, as it successively reduces the data length for each scale and thus yields inaccurate and undefined entropy estimates at higher scales and for short length data. To that cause, we propose the multivariate multiscale fuzzy entropy (MMFE) algorithm and demonstrate its superiority over the MMSE on both synthetic as well as real-world uterine electromyography (EMG) short duration signals. Based on MMFE features, an improvement in the classification accuracy of term-preterm deliveries was achieved, with a maximum area under the curve (AUC) value of 0.99.

  • Journal article
    Cawley P, Few K, Greenwood R, Malcolm P, Johnson G, Lally P, Thayyil S, Clarke Pet al., 2016,

    Does magnetic resonance brain scanning at 3.0 Tesla pose a hyperthermic challenge to term neonates?

    , The Journal of Pediatrics, Vol: 175, Pages: 228-230.e1, ISSN: 0022-3476

    Next-generation 3-Tesla magnetic resonance (MR) scanners offer improved neonatal neuroimaging, but the greater associated radiofrequency radiation may increase the risk of hyperthermia. Safety data for neonatal 3-T MR scanning are lacking. We measured rectal temperatures continuously in 25 neonates undergoing 3-T brain MR imaging and observed no significant hyperthermic threat.

  • Journal article
    Montaldo P, Oliveira V, Lally PJ, Chaban B, Atreja G, Kirmi O, Thayyil Set al., 2016,

    Therapeutic hypothermia in neonatal cervical spine injury

    , Archives of Disease in Childhood: Fetal & Neonatal Edition, Vol: 101, Pages: F468-F468, ISSN: 1468-2052
  • Journal article
    Montaldo P, Addison S, Oliveira V, Lally PJ, Taylor AM, Sebire NJ, Thayyil S, Arthurs OJet al., 2016,

    Quantification of Maceration Changes using Post Mortem MRI in Fetuses

    , BMC MEDICAL IMAGING, Vol: 16, ISSN: 1471-2342

    BackgroundPost mortem imaging is playing an increasingly important role in perinatal autopsy, andcorrect interpretation of imaging changes is paramount. This is particularly importantfollowing intra-uterine fetal death, where there may be fetal maceration. The aim of thisstudy was to investigate whether any changes seen on a whole body fetal post mortemmagnetic resonance imaging (PMMR) correspond to maceration at conventionalautopsy.Methods: We performed pre-autopsy PMMR in 75 fetuses using a 1.5 Tesla SiemensAvanto MR scanner (Erlangen, Germany). PMMR images were reported blinded to theclinical history and autopsy data using a numerical severity scale (0 = no macerationchanges to 2 = severe maceration changes) for 6 different visceral organs (total 12).The degree of maceration at autopsy was categorized according to severity on anumerical scale (1 = no maceration to 4 = severe maceration). We also generatedquantitative maps to measure the liver and lung T2.Results: The mean PMMR maceration score correlated well with the autopsymaceration score (R2=0.93). A PMMR score of ≥ 4.5 had a sensitivity of 91%,specificity of 64%, for detecting moderate or severe maceration at autopsy. Liver andlung T2 were increased in fetuses with maceration scores of 3-4 in comparison tothose with 1-2 (liver p=0.03, lung p=0.02).Conclusions: There was a good correlation between PMMR maceration score and theextent of maceration seen at conventional autopsy. This score may be useful ininterpretation of fetal PMMR.

  • Journal article
    Arthurs OJ, Guy A, Thayyil S, Wade A, Jones R, Norman W, Scott R, Robertson NJ, Jacques TS, Chong W, Gunny R, Saunders D, Olsen OE, Owens CM, Offiah AC, Chitty LS, Taylor AM, Sebire NJet al., 2015,

    Comparison of diagnostic performance for perinatal and paediatric post-mortem imaging: CT versus MRI

    , European Radiology, Vol: 26, Pages: 2327-2336, ISSN: 1432-1084
  • Journal article
    Lally P, PAULIAH S, MONTALDO P, CHABAN B, Oliveira V, Bainbridge A, Soe A, Pattnayak S, Clarke P, Satodia P, Harigopal S, Abernethy LJ, Turner MA, Huertas Ceballos A, Shankaran S, THAYYIL Set al., 2015,

    Magnetic Resonance Biomarkers in Neonatal Encephalopathy (MARBLE): A Prospective Multi-Country Study

    , BMJ Open, Vol: 5, ISSN: 2044-6055

    Despite cooling adverse outcomes are seen in upto half of the surviving infants after neonatal encephalopathy. A number of novel adjunct drug therapies with cooling have been shown to be highly neuroprotective in animal studies, and are currently awaiting clinical translation. Riggorous evaluation of these therapies in phase II trials using surrogate magnetic resonance biomarkers may speed up thier bench to bedside translation. A recent systematic review of single centres studies have suggested that Magnetic resonance spectroscopy biomarkers offers the best promise, however the prognostic accuracy of these biomarkers in cooled encephalopathic babies in a multicentre setting using different MR scan makes is not known.

  • Journal article
    Ibrahim T, Few K, Greenwood R, Smith C, Malcolm P, Johnson G, Lally P, Thayyil S, Clarke Pet al., 2015,

    'Feed and wrap' or sedate and immobilise for neonatal brain MRI?

  • Journal article
    Soo A, Taha S, Lally P, Kirmi O, Jones B, Thayyil Set al., 2015,

    Assessment of optic nerve development using post-mortem Magnetic Resonance Imaging (MRI) in fetuses and newborns

    , Prenatal Diagnosis, Vol: 35, Pages: 1262-1264, ISSN: 0197-3851

    What's already known about this topic?Biometric studies of fetal orbit and lens development have been shown to correlate with gestational age.No available data on optic nerve measurements in fetuses/neonates.What does this study add?Normal fetal/neonatal optic nerve diameter measurements for gestational age as measured on post‐mortem MRI scans.

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