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Sample records for preliminary pediatric experience

  1. Resting-state functional magnetic resonance imaging for surgical planning in pediatric patients: a preliminary experience.

    Science.gov (United States)

    Roland, Jarod L; Griffin, Natalie; Hacker, Carl D; Vellimana, Ananth K; Akbari, S Hassan; Shimony, Joshua S; Smyth, Matthew D; Leuthardt, Eric C; Limbrick, David D

    2017-12-01

    -state analysis precludes any need for task cooperation. These features make rs-fMRI an ideal technology for cerebral mapping in pediatric neurosurgical patients. This review of the use of rs-fMRI mapping in an initial pediatric case series demonstrates the feasibility of utilizing this technique in pediatric neurosurgical patients. The preliminary experience presented here is a first step in translating this technique to a broader clinical practice.

  2. Pediatric Endoscopic Pilonidal Sinus Treatment, a Revolutionary Technique to Adopt in Children with Pilonidal Sinus Fistulas: Our Preliminary Experience.

    Science.gov (United States)

    Esposito, Ciro; Izzo, Serena; Turrà, Francesco; Cerulo, Mariapina; Severino, Giovanni; Settimi, Alessandro; Iannazzone, Marta; Masieri, Lorenzo; Cortese, Giuseppe; Escolino, Maria

    2018-03-01

    This study aimed to report our preliminary experience with pediatric endoscopic pilonidal sinus treatment (PEPSiT). We retrospectively reviewed the reports of 15 patients, 6 girls and 9 boys, with an average age of 16 years (range 13-18) with noninfected pilonidal sinus disease who underwent PEPSiT in our institution over an 18-month period. Four cases were redo-procedures, for recurrence of disease after open excision repair. Surgical outcomes of sinus healing, recurrence of disease, postoperative pain, hospital stay, analgesic requirements, and patient satisfaction levels were evaluated and a comparison analysis with classic open repair was performed. All procedures were performed under subarachnoid spinal anesthesia. We always adopted a fistuloscope, an endoscopic forceps, and a monopolar electrode to remove the hairs and to heal the fistula. The average length of surgery was 28.5 minutes (range 26-41). No intraoperative or postoperative complications were reported. The average pain score evaluated using Visual Analogue Scale (VAS) pain scale during the first 48 postoperative hours was 3.2 (range 2-5). The average analgesic requirement was 22 hours (range 16-28). The average hospital stay length was 28 hours (range 22-48). They changed dressing daily, by applying a topical solution of eosin 2% and a silver sulfadiazine spray. At 1 month postoperatively, the external openings were closed in all patients and no recurrence was recorded at a mean follow-up of 6 month. PEPSiT was associated with a significantly shorter, painless, and better outcome compared to open technique. On the basis of our preliminary experience, we believe that PEPSiT is a promising technique for surgical treatment of pilonidal sinus in children. It is technically easy and quick to perform, with a short and painless hospital stay, without recurrences in our series. It allows operated patients an early return to full daily activities without restrictions that happen for the classic treatment.

  3. Preliminary experience on the use of PET/CT in the management of pediatric post-transplant lymphoproliferative disorder.

    Science.gov (United States)

    Guerra-García, Pilar; Hirsch, Steffen; Levine, Daniel S; Taj, Mary M

    2017-12-01

    Post-transplant lymphoproliferative disorder (PTLD) is a well-known complication following prolonged immunosuppression. Contrary to other lymphomas, there is no standardized imaging approach to assess PTLD either at staging or for response to therapy. Positron emission tomography/computed tomography (PET/CT) is an imaging modality that has proven to be useful in lymphoma. However, there is still limited data concerning its use in pediatric PTLD. Our study evaluates the use of PET/CT in pediatric PTLD at our institution. To assess the role of PET/CT in pediatric PTLD, we reviewed the pediatric patients with PTLD who had undergone PET/CT at our institution between 2000 and 2016. Nine patients were identified. Six had PET/CT at diagnosis. All lesions seen on CT were identified with PET/CT. Fourteen PET/CTs were done during treatment. Eight PET/CTs were negative, including three where CT showed areas of uncertain significance. In these cases, PET/CT helped us to stop treatment and the patients remain in remission after a long follow-up (mean 74.3 months; range 12.4-180.9 months). PET/CT revealed additional disease in two cases, therefore treatment was intensified. Six biopsies and close follow-up was done to confirm PET/CT results. In one case, PET/CT did not identify central nervous system involvement demonstrated on magnetic resonance imaging. PET/CT may have an important role in the staging and follow-up of pediatric PTLD. In our cohort, PET/CT was helpful in staging and assessing treatment response and in clarifying equivocal findings on other imaging modalities. © 2017 Wiley Periodicals, Inc.

  4. Pediatric emergence delirium: Canadian Pediatric Anesthesiologists' experience.

    Science.gov (United States)

    Rosen, H David; Mervitz, Deborah; Cravero, Joseph P

    2016-02-01

    Pediatric emergence agitation/delirium (ED) is a cluster of behaviors seen in the early postanesthetic period with negative emotional consequences for families and increased utilization of healthcare resources. Many studies have looked at identifying risk factors for ED and at pharmacologic regimens to prevent ED. There are few published reports on treatment options and efficacy for established ED episodes, and essentially no data concerning current practice in the treatment of ED. We sought to elicit the experience and opinions of Canadian Pediatric Anesthesiologists on the incidence of ED in their practice, definitions and diagnostic criteria, preventative strategies, treatments, and their perceived efficacy. A web-based survey was sent to pediatric anesthesiologists working at academic health science centers across Canada. The participants were selected based on being members of the Canadian Pediatric Anesthesia Society (CPAS), which represents the subspecialty in Canada. All members of CPAS who had e-mail contact information available in the membership database were invited to participate. A total of 209 members out of the total of 211 fulfilled these criteria and were included in the study population. The response rate was 51% (106/209). Of respondents, 42% felt that ED was a significant problem at their institutions, with 45% giving medication before or during anesthesia to prevent the development of ED. Propofol was the most common medication given to prevent ED (68%) and to treat ED (42%). Total intravenous anesthesia (TIVA) was considered by 38% of respondents as a technique used to prevent ED. Medications used for treatment included propofol (42%), midazolam (31%), fentanyl (10%), morphine (7%), and dexmedetomidine (5%), with 87% of respondents rating effectiveness of treatment as 'usually works quickly with one dose'. We present information on current practice patterns with respect to prophylaxis and treatment of ED among a specialized group of pediatric

  5. Pediatric epilepsy: The Indian experience.

    Science.gov (United States)

    Gadgil, Pradnya; Udani, Vrajesh

    2011-10-01

    Epilepsy is a common clinical entity in neurology clinics. The understanding of the genetics of epilepsy has undergone a sea change prompting re-classification by the International league against epilepsy recently. The prevalence rates of epilepsy in India are similar to those of developed nations. However, the large treatment gap is a major challenge to our public health system. Perinatal injuries are a major causative factor in pediatric group. We have discussed a few common etiologies such as neurocysticercosis and newer genetic epilepsy syndromes. We have also briefly touched upon the Indian experience in pediatric epilepsy surgery.

  6. Pediatric Liver Transplantation: Our Experiences.

    Science.gov (United States)

    Basturk, Ahmet; Yılmaz, Aygen; Sayar, Ersin; Dinçhan, Ayhan; Aliosmanoğlu, İbrahim; Erbiş, Halil; Aydınlı, Bülent; Artan, Reha

    2016-10-01

    The aim of our study was to evaluate our liver transplant pediatric patients and to report our experience in the complications and the long-term follow-up results. Patients between the ages of 0 and 18 years, who had liver transplantation in the organ transplantation center of our university hospital between 1997 and 2016, were included in the study. The age, sex, indications for the liver transplantation, complications after the transplantation, and long-term follow-up findings were retrospectively evaluated. The obtained results were analyzed with statistical methods. In our organ transplantation center, 62 pediatric liver transplantations were carried out since 1997. The mean age of our patients was 7.3 years (6.5 months-17 years). The 4 most common reasons for liver transplantation were: Wilson's disease (n=10; 16.3%), biliary atresia (n=9; 14.5%), progressive familial intrahepatic cholestasis (n=8; 12.9%), and cryptogenic cirrhosis (n=7; 11.3%). The mortality rate after transplantation was 19.6% (12 of the total 62 patients). The observed acute and chronic rejection rates were 34% and 4.9%, respectively. Thrombosis (9.6%) was observed in the hepatic artery (4.8%) and portal vein (4.8%). Bile leakage and biliary stricture rates were 31% and 11%, respectively. 1-year and 5-year survival rates of our patients were 87% and 84%, respectively. The morbidity and mortality rates in our organ transplantation center, regarding pediatric liver transplantations, are consistent with the literature.

  7. In vivo diagnostic nuclear medicine. Pediatric experience

    International Nuclear Information System (INIS)

    Goetz, W.A.; Hendee, W.R.; Gilday, D.L.

    1983-01-01

    The use of radiopharmaceuticals for diagnostic tests in children is increasing and interest in these is evidenced by the addition of scientific sessions devoted to pediatric medicine at annual meetings of The Society of Nuclear Medicine and by the increase in the literature on pediatric dosimetry. Data presented in this paper describe the actual pediatric nuclear medicine experience from 26 nationally representative U.S. hospitals and provide an overview of the pediatric procedures being performed the types of radiopharmaceuticals being used, and the activity levels being administered

  8. Preliminary Outcomes from an Integrated Pediatric Mental Health Outpatient Clinic.

    Science.gov (United States)

    Maslow, Gary R; Banny, Adrienne; Pollock, McLean; Stefureac, Kristen; Rosa, Kendra; Walter, Barbara Keith; Hobbs Knutson, Katherine; Lucas, Joseph; Heilbron, Nicole

    2017-10-01

    An estimated 1 in 5 children in the United States meet criteria for a diagnosable mental disorder, yet fewer than 20% receive mental health services. Unmet need for psychiatric treatment may contribute to patterns of increasing use of the emergency department. This article describes an integrated pediatric evaluation center designed to prevent the need for treatment in emergency settings by increasing access to timely and appropriate care for emergent and critical mental health needs. Preliminary results showed that the center provided rapid access to assessment and treatment services for children and adolescents presenting with a wide range of psychiatric concerns. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Versator divertor experiment: preliminary designs

    International Nuclear Information System (INIS)

    Wan, A.S.; Yang, T.F.

    1984-08-01

    The emergence of magnetic divertors as an impurity control and ash removal mechanism for future tokamak reactors bring on the need for further experimental verification of the divertor merits and their ability to operate at reactor relevant conditions, such as with auxiliary heating. This paper presents preliminary designs of a bundle and a poloidal divertor for Versator II, which can operate in conjunction with the existing 150 kW of LHRF heating or LH current drive. The bundle divertor option also features a new divertor configuration which should improve the engineering and physics results of the DITE experiment. Further design optimization in both physics and engineering designs are currently under way

  10. Simultaneous whole body 18F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with 18F-fluorodeoxyglucose positron emission tomography computed tomogra

    Institute of Scientific and Technical Information of China (English)

    Brian S Pugmire; Alexander R Guimaraes; Ruth Lim; Alison M Friedmann; Mary Huang; David Ebb; Howard Weinstein; Onofrio A Catalano; Umar Mahmood; Ciprian Catana; Michael S Gee

    2016-01-01

    AIM: To describe our preliminary experience with simultaneous whole body 18F-fluorodeoxyglucose(18F-FDG)positron emission tomography and magnetic resonance imaging(PET-MRI) in the evaluation of pediatric oncology patients.METHODS: This prospective, observational, singlecenter study was Health Insurance Portability and Accountability Act-compliant, and institutional review board approved. To be eligible, a patient was required to:(1) have a known or suspected cancer diagnosis;(2) be under the care of a pediatric hematologist/oncologist; and(3) be scheduled for clinically indicated 18F-FDG PETCT examination at our institution. Patients underwent PET-CT followed by PET-MRI on the same day. PET-CT examinations were performed using standard department protocols. PET-MRI studies were acquired with an integrated 3 Tesla PET-MRI scanner using whole body T1 Dixon, T2 HASTE, EPI diffusion-weighted imaging(DWI) and STIR sequences. No additional radiotracer was given for the PET-MRI examination. Both PET-CT and PETMRI examinations were reviewed by consensus by two study personnel. Test performance characteristics of PETMRI, for the detection of malignant lesions, including FDG maximum standardized uptake value(SUVmax) and minimum apparent diffusion coefficient(ADCmin), were calculated on a per lesion basis using PET-CT as a reference standard.RESULTS: A total of 10 whole body PET-MRI exams were performed in 7 pediatric oncology patients. The mean patient age was 16.1 years(range 12-19 years) including 6 males and 1 female. A total of 20 malignant and 21 benign lesions were identified on PET-CT. PET-MRI SUVmax had excellent correlation with PET-CT SUVmax for both benign and malignant lesions(R = 0.93). PETMRI SUVmax > 2.5 had 100% accuracy for discriminating benign from malignant lesions using PET-computed tomography(CT) reference. Whole body DWI was also evaluated: the mean ADCmin of malignant lesions(780.2 + 326.6) was significantly

  11. Simultaneous whole body (18)F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with (18)F-fluorodeoxyglucose positron emission tomography computed tomography.

    Science.gov (United States)

    Pugmire, Brian S; Guimaraes, Alexander R; Lim, Ruth; Friedmann, Alison M; Huang, Mary; Ebb, David; Weinstein, Howard; Catalano, Onofrio A; Mahmood, Umar; Catana, Ciprian; Gee, Michael S

    2016-03-28

    To describe our preliminary experience with simultaneous whole body (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography and magnetic resonance imaging (PET-MRI) in the evaluation of pediatric oncology patients. This prospective, observational, single-center study was Health Insurance Portability and Accountability Act-compliant, and institutional review board approved. To be eligible, a patient was required to: (1) have a known or suspected cancer diagnosis; (2) be under the care of a pediatric hematologist/oncologist; and (3) be scheduled for clinically indicated (18)F-FDG positron emission tomography-computed tomography (PET-CT) examination at our institution. Patients underwent PET-CT followed by PET-MRI on the same day. PET-CT examinations were performed using standard department protocols. PET-MRI studies were acquired with an integrated 3 Tesla PET-MRI scanner using whole body T1 Dixon, T2 HASTE, EPI diffusion-weighted imaging (DWI) and STIR sequences. No additional radiotracer was given for the PET-MRI examination. Both PET-CT and PET-MRI examinations were reviewed by consensus by two study personnel. Test performance characteristics of PET-MRI, for the detection of malignant lesions, including FDG maximum standardized uptake value (SUVmax) and minimum apparent diffusion coefficient (ADCmin), were calculated on a per lesion basis using PET-CT as a reference standard. A total of 10 whole body PET-MRI exams were performed in 7 pediatric oncology patients. The mean patient age was 16.1 years (range 12-19 years) including 6 males and 1 female. A total of 20 malignant and 21 benign lesions were identified on PET-CT. PET-MRI SUVmax had excellent correlation with PET-CT SUVmax for both benign and malignant lesions (R = 0.93). PET-MRI SUVmax > 2.5 had 100% accuracy for discriminating benign from malignant lesions using PET-CT reference. Whole body DWI was also evaluated: the mean ADCmin of malignant lesions (780.2 + 326.6) was significantly lower than

  12. Simultaneous whole body 18F-fluorodeoxyglucose positron emission tomography magnetic resonance imaging for evaluation of pediatric cancer: Preliminary experience and comparison with 18F-fluorodeoxyglucose positron emission tomography computed tomography

    Science.gov (United States)

    Pugmire, Brian S; Guimaraes, Alexander R; Lim, Ruth; Friedmann, Alison M; Huang, Mary; Ebb, David; Weinstein, Howard; Catalano, Onofrio A; Mahmood, Umar; Catana, Ciprian; Gee, Michael S

    2016-01-01

    AIM: To describe our preliminary experience with simultaneous whole body 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography and magnetic resonance imaging (PET-MRI) in the evaluation of pediatric oncology patients. METHODS: This prospective, observational, single-center study was Health Insurance Portability and Accountability Act-compliant, and institutional review board approved. To be eligible, a patient was required to: (1) have a known or suspected cancer diagnosis; (2) be under the care of a pediatric hematologist/oncologist; and (3) be scheduled for clinically indicated 18F-FDG positron emission tomography-computed tomography (PET-CT) examination at our institution. Patients underwent PET-CT followed by PET-MRI on the same day. PET-CT examinations were performed using standard department protocols. PET-MRI studies were acquired with an integrated 3 Tesla PET-MRI scanner using whole body T1 Dixon, T2 HASTE, EPI diffusion-weighted imaging (DWI) and STIR sequences. No additional radiotracer was given for the PET-MRI examination. Both PET-CT and PET-MRI examinations were reviewed by consensus by two study personnel. Test performance characteristics of PET-MRI, for the detection of malignant lesions, including FDG maximum standardized uptake value (SUVmax) and minimum apparent diffusion coefficient (ADCmin), were calculated on a per lesion basis using PET-CT as a reference standard. RESULTS: A total of 10 whole body PET-MRI exams were performed in 7 pediatric oncology patients. The mean patient age was 16.1 years (range 12-19 years) including 6 males and 1 female. A total of 20 malignant and 21 benign lesions were identified on PET-CT. PET-MRI SUVmax had excellent correlation with PET-CT SUVmax for both benign and malignant lesions (R = 0.93). PET-MRI SUVmax > 2.5 had 100% accuracy for discriminating benign from malignant lesions using PET-CT reference. Whole body DWI was also evaluated: the mean ADCmin of malignant lesions (780.2 + 326.6) was

  13. Preliminary experiments of electronic duplication

    International Nuclear Information System (INIS)

    Fay, Bernard

    1974-01-01

    Systems of electron sputtering (at the unit scale) use as master mask a photocathode with localized emitting zones. Emitted electrons are accelerated and focussed on a silicon substrate covered with an electrosensitive resin. The very high definition associated with electron masking is obtained whatever the complexity of the master mask is, for a printing duration of the order of the minute. This is a duplication method without any contact that prevents the master mask from any mechanical erosion. Alignment of the successive masks is obtained from an electric signal directly usable through an automatic alignment system. Experiments using the apparatus for reproducing masks through an electronic image or ''electronic duplicator'' developed in Thomson-CSF Laboratory at Corbeville, are presented [fr

  14. Medical home characteristics and the pediatric patient experience.

    Science.gov (United States)

    Burnet, Deborah; Gunter, Kathryn E; Nocon, Robert S; Gao, Yue; Jin, Janel; Fairchild, Paige; Chin, Marshall H

    2014-11-01

    The patient-centered medical home (PCMH) has roots in pediatrics, yet we know little about the experience of pediatric patients in PCMH settings. To examine the association between clinic PCMH characteristics and pediatric patient experience as reported by parents. We assessed the cross-sectional correlation between clinic PCMH characteristics and pediatric patient experience in 24 clinics randomly selected from the Safety Net Medical Home Initiative, a 5-state PCMH demonstration project. PCMH characteristics were measured with surveys of randomly selected providers and staff; surveys generated 0 (worst) to 100 (best) scores for 5 subscales, and a total score. Patient experience was measured through surveying parents of pediatric patients. Questions from the Consumer Assessment of Healthcare Providers and Systems-Clinician and Group instrument produced 4 patient experience measures: timeliness, physician communication, staff helpfulness, and overall rating. To investigate the relationship between PCMH characteristics and patient experience, we used generalized estimating equations with an exchangeable correlation structure. We included 440 parents and 214 providers and staff in the analysis. Total PCMH score was not associated with parents' assessment of patient experience; however, PCMH subscales were associated with patient experience in different directions. In particular, quality improvement activities undertaken by clinics were strongly associated with positive ratings of patient experience, whereas patient care management activities were associated with more negative reports of patient experience. Future work should bolster features of the PCMH that work well for patients while investigating which PCMH features negatively impact patient experience, to yield a better patient experience overall.

  15. Exploring play therapy in pediatric oncology: a preliminary endeavour.

    Science.gov (United States)

    Chari, Uttara; Hirisave, Uma; Appaji, L

    2013-04-01

    To discuss the benefits and feasibility of play therapy in pediatric oncology. This is highlighted through the use of a case report of non-directive play therapy with a 4 y- old girl, diagnosed with Acute Lymphoblastic Leukemia. The outcome of play therapy was examined using a combination of qualitative and quantitative assessments. The benefits of play therapy with this child were manifested in better illness adjustment and general mental well-being, enhanced coping, and normalization. Having illustrated benefits of play therapy in pediatric oncology, this paper discusses its feasibility and proposes avenues for clinical practice and research endeavours.

  16. Preliminary results from film boiling destabilisation experiments

    International Nuclear Information System (INIS)

    Naylor, P.

    1984-05-01

    A series of experiments to investigate the triggered destabilisation of film boiling has been undertaken. Film boiling was established on a polished brass rod immersed in water and the effects of various triggers were investigated. Preliminary results are presented and two thresholds have been observed: an impulse threshold below which triggered destabilisation will not occur and a thermal threshold above which film boiling will re-establish following triggered destabilisation. (author)

  17. A preliminary examination of child well-being of physically abused and neglected children compared to a normative pediatric population.

    Science.gov (United States)

    Lanier, Paul; Kohl, Patricia L; Raghavan, Ramesh; Auslander, Wendy

    2015-02-01

    Federal mandates require state child welfare systems to monitor and improve outcomes for children in three areas: safety, permanency, and well-being. Research across separate domains of child well-being indicates maltreated children may experience lower pediatric health-related quality of life (HRQL). This study assessed well-being in maltreated children using the Pediatric Quality of Life Inventory (PedsQL 4.0), a widely used measure of pediatric HRQL. The PedsQL 4.0 was used to assess well-being in a sample of children (N = 129) receiving child welfare services following reports of alleged physical abuse or neglect. We compared total scores and domain scores for this maltreated sample to those of a published normative sample. Within the maltreated sample, we also compared well-being by child and family demographic characteristics. As compared with a normative pediatric population, maltreated children reported significantly lower total, physical, and psychosocial health. We found no significant differences in total and domain scores based on child and parent demographics within the maltreated sample. This preliminary exploration indicates children receiving child welfare services have significantly lower well-being status than the general child population and have considerable deficits in social and emotional functioning. These findings support continued investment in maltreatment prevention and services to improve the well-being of victims of maltreatment. © The Author(s) 2014.

  18. Pediatric radiology fellows' experience with intussusception reduction

    International Nuclear Information System (INIS)

    Stein-Wexler, Rebecca; Bateni, Cyrus; Wootton-Gorges, Sandra L.; Li, Chin-Shang

    2011-01-01

    Intussusception reduction allows young children to avoid surgery. However, graduating residents have had relatively little training in intussusception reduction and, for the most part, consider themselves ill-prepared to perform this procedure. The goal of this study was to assess the extent of training in intussusception reduction during one year of a pediatric radiology fellowship and to determine whether graduating fellows consider themselves adequately trained in this technique. Pediatric radiology fellows were surveyed during June 2010 and asked to characterize their fellowship, to indicate the number of intussusception reductions performed (both the total number and those performed with faculty oversight but without active faculty involvement), and to assess the adequacy of their training. There were 31 responses, representing almost 1/3 of current fellows. Pediatric radiology fellows perform on average 6.9 reductions, 3.8 of which are with faculty oversight but without active faculty involvement. Ninety percent consider themselves well-trained in the technique, whereas 10% are uncertain (none consider their training inadequate). Almost all pediatric radiology fellows consider their training in intussusception reduction to be adequate. (orig.)

  19. Pediatric acute gastroenteritis: understanding caregivers' experiences and information needs.

    Science.gov (United States)

    Albrecht, Lauren; Hartling, Lisa; Scott, Shannon D

    2017-05-01

    Pediatric acute gastroenteritis (AGE) is a common condition with high health care utilization, persistent practice variation, and substantial family burden. An initial approach to resolve these issues is to understand the patient/caregiver experience of this illness. The objective of this study was to describe caregivers' experiences of pediatric AGE and identify their information needs, preferences, and priorities. A qualitative, descriptive study was conducted. Caregivers of a child with AGE were recruited for this study in the pediatric emergency department (ED) at a tertiary hospital in a major urban centre. Individual interviews were conducted (n=15), and a thematic analysis of interview transcripts was completed using a hybrid inductive/deductive approach. Five major themes were identified and described: 1) caregiver management strategies; 2) reasons for going to the ED; 3) treatment and management of AGE in the ED; 4) caregivers' information needs; and 5) additional factors influencing caregivers' experiences and decision-making. A number of subthemes within each major theme were identified and described. This qualitative descriptive study has identified caregiver information needs, preferences, and priorities regarding pediatric AGE. This study also identified inconsistencies in the treatment and management of pediatric AGE at home and in the ED that influence health care utilization and patient outcomes related to pediatric AGE.

  20. A Pediatric Near-Death Experience: Tunnel Variants.

    Science.gov (United States)

    Serdahely, William J.

    1990-01-01

    Presents case study of boy who had near-death experience (NDE) due to nearly drowning when he was seven years old. Discusses case's variation of tunnel experience not before reported in either adult or pediatric NDE literature: while in the tunnel, the boy was comforted by two of his family's pets who had died prior to his accident. (Author/NB)

  1. Helical tomotherapy in the treatment of pediatric malignancies: a preliminary report of feasibility and acute toxicity

    Directory of Open Access Journals (Sweden)

    Beltrán César

    2011-08-01

    Full Text Available Abstract Background Radiation therapy plays a central role in the management of many childhood malignancies and Helical Tomotherapy (HT provides potential to decrease toxicity by limiting the radiation dose to normal structures. The aim of this article was to report preliminary results of our clinical experience with HT in pediatric malignancies. Methods In this study 66 consecutive patients younger than 14 years old, treated with HT at our center between January 2006 and April 2010, have been included. We performed statistical analyses to assess the relationship between acute toxicity, graded according to the RTOG criteria, and several clinical and treatment characteristics such as a dose and irradiation volume. Results The median age of patients was 5 years. The most common tumor sites were: central nervous system (57%, abdomen (17% and thorax (6%. The most prevalent histological types were: medulloblastoma (16 patients, neuroblastoma (9 patients and rhabdomyosarcoma (7 patients. A total of 52 patients were treated for primary disease and 14 patients were treated for recurrent tumors. The majority of the patients (72% were previously treated with chemotherapy. The median prescribed dose was 51 Gy (range 10-70 Gy. In 81% of cases grade 1 or 2 acute toxicity was observed. There were 11 cases (16,6% of grade 3 hematological toxicity, two cases of grade 3 skin toxicity and one case of grade 3 emesis. Nine patients (13,6% had grade 4 hematological toxicity. There were no cases of grade 4 non-hematological toxicities. On the univariate analysis, total dose and craniospinal irradiation (24 cases were significantly associated with severe toxicity (grade 3 or more, whereas age and chemotherapy were not. On the multivariate analysis, craniospinal irradiation was the only significant independent risk factor for grade 3-4 toxicity. Conclusion HT in pediatric population is feasible and safe treatment modality. It is characterized by an acceptable level of

  2. Helical tomotherapy in the treatment of pediatric malignancies: a preliminary report of feasibility and acute toxicity

    International Nuclear Information System (INIS)

    Mesbah, Latifa; Marsiglia, Hugo; Matute, Raúl; Usychkin, Sergey; Marrone, Immacolata; Puebla, Fernando; Mínguez, Cristina; García, Rafael; García, Graciela; Beltrán, César

    2011-01-01

    Radiation therapy plays a central role in the management of many childhood malignancies and Helical Tomotherapy (HT) provides potential to decrease toxicity by limiting the radiation dose to normal structures. The aim of this article was to report preliminary results of our clinical experience with HT in pediatric malignancies. In this study 66 consecutive patients younger than 14 years old, treated with HT at our center between January 2006 and April 2010, have been included. We performed statistical analyses to assess the relationship between acute toxicity, graded according to the RTOG criteria, and several clinical and treatment characteristics such as a dose and irradiation volume. The median age of patients was 5 years. The most common tumor sites were: central nervous system (57%), abdomen (17%) and thorax (6%). The most prevalent histological types were: medulloblastoma (16 patients), neuroblastoma (9 patients) and rhabdomyosarcoma (7 patients). A total of 52 patients were treated for primary disease and 14 patients were treated for recurrent tumors. The majority of the patients (72%) were previously treated with chemotherapy. The median prescribed dose was 51 Gy (range 10-70 Gy). In 81% of cases grade 1 or 2 acute toxicity was observed. There were 11 cases (16,6%) of grade 3 hematological toxicity, two cases of grade 3 skin toxicity and one case of grade 3 emesis. Nine patients (13,6%) had grade 4 hematological toxicity. There were no cases of grade 4 non-hematological toxicities. On the univariate analysis, total dose and craniospinal irradiation (24 cases) were significantly associated with severe toxicity (grade 3 or more), whereas age and chemotherapy were not. On the multivariate analysis, craniospinal irradiation was the only significant independent risk factor for grade 3-4 toxicity. HT in pediatric population is feasible and safe treatment modality. It is characterized by an acceptable level of acute toxicity that we have seen in this highly

  3. Noise and dose modeling for pediatric CT optimization: preliminary results

    International Nuclear Information System (INIS)

    Miller Clemente, Rafael A.; Perez Diaz, Marlen; Mora Reyes, Yudel; Rodriguez Garlobo, Maikel; Castillo Salazar, Rafael

    2008-01-01

    Full text: A Multiple Linear Regression Model was developed to predict noise and dose in computed tomography pediatric imaging for head and abdominal examinations. Relative values of Noise and Volumetric Computed Tomography Dose Index was used to estimate de model respectively. 54 images of physical phantoms were performed. Independent variables considered included: phantom diameter, tube current and kilovolts, x ray beam collimation, reconstruction diameter and equipment's post processing filters. Predicted values show good agreement with measurements, which were better in noise model (R 2 adjusted =0.953) than the dose model (R 2 adjusted =0.744). Tube current, object diameter, beam collimation and reconstruction filter were identified as the most influencing factors in models. (author)

  4. Mycosis Fungoides: Experience in a Pediatric Hospital.

    Science.gov (United States)

    Cervini, A B; Torres-Huamani, A N; Sanchez-La-Rosa, C; Galluzzo, L; Solernou, V; Digiorge, J; Rubio, P

    Mycosis fungoides (MF), the most common primary cutaneous T-cell lymphoma, is unusual in children. We aimed to describe the epidemiologic, clinical, histopathologic, and immunophenotypic characteristics of MF as well as treatments and course of disease in a pediatric case series. Data for all patients admitted to our pediatric hospital (Hospital Dr. J. P. Garrahan) in Argentina with a clinical and histopathologic diagnosis of MF between August 1988 and July 2014 were included. A total of 14 patients were diagnosed with MF. The ratio of boys to girls was 1:1.33. The mean age at diagnosis was 11.23 years (range, 8-15 years). The mean time between onset and diagnosis was 3.5 years (range, 4 months-7 years). All patients had hypopigmented MF and 42% also presented the features of classic MF. Seven (50%) had the CD8 + immunophenotype exclusively. Seventy-eight percent were in stage IB at presentation. Phototherapy was the treatment of choice. Four patients relapsed at least once and skin lesions progressed in 3 patients. All patients improved. MF is unusual in children. The hypopigmented form is the most common. Diagnosis is delayed because the condition is similar to other hypopigmented diseases seen more often in childhood. Although prognosis is good, the rate of recurrence is high, so long-term follow-up is necessary. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Neuroimaging experience in pediatric Horner syndrome

    International Nuclear Information System (INIS)

    Kadom, Nadja; Rosman, N.P.; Jubouri, Shams; Trofimova, Anna; Egloff, Alexia M.; Zein, Wadih M.

    2015-01-01

    Horner syndrome in children is rare. The frequency and spectrum of malignancy as the cause of Horner syndrome in children remains unclear. Also unclear is whether the imaging work-up should include the entire oculo-sympathetic pathway or should be more targeted. In addition, the value of cross-sectional angiographic imaging in Horner syndrome is uncertain. To review imaging pathology in a cohort of children with Horner syndrome at a major academic pediatric medical center. We reviewed a 22-year period of CT and MR imaging studies in children with a clinical diagnosis of Horner syndrome referred for imaging. We found 38 patients who fulfilled study criteria of Horner syndrome and 6/38 had relevant imaging findings: 2/6 etiologies were neoplastic (congenital neuroblastoma and central astrocytoma), 1/6 had a vascular abnormality (hypoplastic carotid artery), 1/6 had maldevelopment (Chiari I malformation), and 2/6 had inflammatory/traumatic etiology (viral cervical lymphadenopathy, post jugular vein cannulation). There was a similar number of congenital and acquired pathologies. The malignancies were found at any level of the oculosympathetic pathway. There are treatable causes, including malignancies, in children presenting with Horner syndrome, which justify imaging work-up of the entire oculosympathetic pathway, unless the lesion level can be determined clinically. (orig.)

  6. Neuroimaging experience in pediatric Horner syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kadom, Nadja [Boston University School of Medicine, Department of Radiology, Boston University Medical Center, Boston, MA (United States); Rosman, N.P. [Boston Medical Center, Division of Pediatric Neurology, Departments of Pediatrics and Neurology, Boston University School of Medicine, Boston, MA (United States); Jubouri, Shams; Trofimova, Anna; Egloff, Alexia M. [Children' s National Medical Center, Department of Radiology and Diagnostic Imaging, Washington, DC (United States); Zein, Wadih M. [National Eye Institute (NEI), Bethesda, MD (United States)

    2015-09-15

    Horner syndrome in children is rare. The frequency and spectrum of malignancy as the cause of Horner syndrome in children remains unclear. Also unclear is whether the imaging work-up should include the entire oculo-sympathetic pathway or should be more targeted. In addition, the value of cross-sectional angiographic imaging in Horner syndrome is uncertain. To review imaging pathology in a cohort of children with Horner syndrome at a major academic pediatric medical center. We reviewed a 22-year period of CT and MR imaging studies in children with a clinical diagnosis of Horner syndrome referred for imaging. We found 38 patients who fulfilled study criteria of Horner syndrome and 6/38 had relevant imaging findings: 2/6 etiologies were neoplastic (congenital neuroblastoma and central astrocytoma), 1/6 had a vascular abnormality (hypoplastic carotid artery), 1/6 had maldevelopment (Chiari I malformation), and 2/6 had inflammatory/traumatic etiology (viral cervical lymphadenopathy, post jugular vein cannulation). There was a similar number of congenital and acquired pathologies. The malignancies were found at any level of the oculosympathetic pathway. There are treatable causes, including malignancies, in children presenting with Horner syndrome, which justify imaging work-up of the entire oculosympathetic pathway, unless the lesion level can be determined clinically. (orig.)

  7. Mycophenolate mofetil in pediatric renal transplantation: A single center experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2011-05-01

    Raheem OA, Kamel MH, Daly PJ, Mohan P, Little DM, Awan A, Hickey DP. Mycophenolate mofetil in pediatric renal transplantation: A single center experience. Pediatr Transplantation 2011: 15:240-244. © 2009 John Wiley & Sons A\\/S. Abstract:  We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the period from January 1997 till October 2006 (MMF group). A previously reported non-MMF group of 59 pediatric renal transplants was included for comparative analysis (non-MMF group). The MMF group comprised 29 boys and 18 girls, whereas the non-MMF group comprised 34 boys and 25 girls. Mean age was 11.7 and 12 yr in the MMF and non-MMF groups, respectively. The incidence of acute rejection episodes was 11 (23.4%) and 14 (24%) in the MMF and non-MMF group, respectively. Two (3.3%) grafts were lost in the non-MMF group compared with one (2.1%) in the MMF group. Twenty-one (44.68%) patients in the MMF group developed post-transplant infections compared with 12 (20.33%) in the non-MMF group (p < 0.0001). In conclusion, the use of MMF in pediatric renal transplantation was not associated with a lower rejection rate or immunological graft loss. It did, however, result in a significantly higher rate of viral infections.

  8. Mycophenolate mofetil in pediatric renal transplantation: a single center experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2012-02-01

    We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the period from January 1997 till October 2006 (MMF group). A previously reported non-MMF group of 59 pediatric renal transplants was included for comparative analysis (non-MMF group). The MMF group comprised 29 boys and 18 girls, whereas the non-MMF group comprised 34 boys and 25 girls. Mean age was 11.7 and 12 yr in the MMF and non-MMF groups, respectively. The incidence of acute rejection episodes was 11 (23.4%) and 14 (24%) in the MMF and non-MMF group, respectively. Two (3.3%) grafts were lost in the non-MMF group compared with one (2.1%) in the MMF group. Twenty-one (44.68%) patients in the MMF group developed post-transplant infections compared with 12 (20.33%) in the non-MMF group (p < 0.0001). In conclusion, the use of MMF in pediatric renal transplantation was not associated with a lower rejection rate or immunological graft loss. It did, however, result in a significantly higher rate of viral infections.

  9. Our experience with percutaneous nephrolithotomy in pediatric renal stone disease.

    Science.gov (United States)

    Oral, İlknur; Nalbant, İsmail; Öztürk, Ufuk; Can Şener, Nevzat; Yeşil, Süleyman; Göksel Göktuğ, H N; Abdurrahim İmamoğlu, M

    2013-03-01

    In this paper, we present our experience with percutaneous nephrolithotomy (PNL) in a pediatric patient group. From June 2007 to September 2010, we performed PNL on 57 pediatric patients. children with a mean age of 7.56 (1-15) years. Study population consisted of 30 male, and 27 female children with a mean age of 7.56 (1-5) years. Mean stone burden was calculated to be 312.2 (95-1550) mm(2). Percutaneous access was performed under fluoroscopy. Tract dilatation was accomplished with 20 F Amplatz dilators. Pneumatic lithotripsy was used to fragment the renal calculi. Mean operating time was 34 (3-80) minutes. With a single session of PNL, complete stone-free rates were achieved in 55 (96.4%) patients. Residual fragments were remained in 2 (3.5%) patients. Two patients had a febrile episode without signs and symptoms of bacteremia. Subcostal access was used in all of the patients, and none of the patients had any complications. Based on our experience, we conclude that PNL is a safe and effective method in the management of pediatric stone disease.

  10. Pediatric glioblastoma multiforme: A single-institution experience.

    Science.gov (United States)

    Ansari, Mansour; Nasrolahi, Hamid; Kani, Amir-Abbas; Mohammadianpanah, Mohammad; Ahmadloo, Niloofar; Omidvari, Shapour; Mosalaei, Ahmad

    2012-07-01

    Glioblastoma multiforme (GBM) is the most common astrocytoma in adults and has a poor prognosis, with a median survival of about 12 months. But, it is rare in children. We report our experience on the pediatric population (20 years or younger) with GBM. Twenty-three patients with GBM who were treated at our hospital during 1990-2008 were evaluated. The mean age was 15.2 years, and the majority of them (14/23) were male. All had received radiotherapy and some had also received chemotherapy. The mean survival was 16.0 months. Two cases survived more than 5 years. Age, radiation dose and performance status were significantly related to survival. GBM in pediatric patients were not very common in our center, and prognosis was unfavorable.

  11. Preliminary results of the Adone storage ring FEL experiment, LELA

    International Nuclear Information System (INIS)

    Barbini, R.; Vignola, G.; Trillo, S.

    1983-01-01

    A short description of the LELA (Free Electron Laser on Adone) experiment is given. Results on the spontaneous radiation angle and energy spectra and preliminary results on optical gain measurements are also discussed

  12. Preliminary In Vivo Experiments on Adhesion of Geckos

    OpenAIRE

    Lepore, E.; Brianza, S.; Antoniolli, F.; Buono, M.; Carpinteri, A.; Pugno, N.

    2008-01-01

    We performed preliminary experiments on the adhesion of a Tokay gecko on surfaces with different roughness, with or without particles with significant different granulometry, before/after or during the moult. The results were analyzed using the Weibull statistics.

  13. The Lived Experiences of Nurses Caring For Dying Pediatric Patients.

    Science.gov (United States)

    Curcio, Danna L

    2017-01-01

    Nurses and healthcare professionals may have difficulty adjusting to and comprehending their experiences when a patient’s life ends. This has the potential to interfere with patient care. Reflection on past events and actions enables critical discovery of strategies to benefit both nurses and patients. This qualitative phenomenological study explores the lived experiences of nurses caring for dying pediatric patients. The philosophical underpinning of Merleau-Ponty (2008), in combination with the research method of van Manen (1990), was used for this study. The Roy Adaptation Model (RAM) (Roy, 2009; Roy & Andrews, 1991) was the nursing model that guided the study to help understand that nurses are an adaptive system, using censoring as a compensatory adaptive process to help function for a purposeful cause. Nine female nurse participants with one to four years of experience were interviewed. The context of the experiences told by nurses caring for dying pediatric patents uncovered seven essential themes of empathy, feelings of ambivalence, inevitability, inspiration, relationship, self-preservation, and sorrow, and these themes demonstrated a connection formed between the nurse and the patient.

  14. Treatment of Pediatric Condylar Fractures: A 20-Year Experience.

    Science.gov (United States)

    Ghasemzadeh, Ali; Mundinger, Gerhard S; Swanson, Edward W; Utria, Alan F; Dorafshar, Amir H

    2015-12-01

    The purpose of this study was to define patterns of injury and treatment for condylar and subcondylar fractures and evaluate short-term outcomes in the pediatric population. A retrospective chart review was performed on pediatric patients with mandibular condylar fractures who presented between 1990 and 2010. Computed tomographic imaging was reviewed for all patients to assess fracture characteristics. Mandibular fractures were codified using the Strasbourg Osteosynthesis Research Group and Lindahl classification methods. Sixty-four patients with 92 condylar fractures were identified. Of these patients, 29 had isolated condylar fracture and 35 had a condylar fracture associated with an additional mandibular arch fracture. The most common fracture patterns were diacapitular fracture in the Strasbourg Osteosynthesis Research Group system (n = 46) and vertical condylar head fracture in the Lindahl system (n = 14). Condylar fracture with additional mandibular arch fractures were treated with maxillomandibular fixation more often than patients with condylar fracture [n = 40 (74.1 percent) versus n = 14 (25.9 percent); p = 0.004]. No condylar fracture was treated in an open fashion. Forty-three patients returned for follow-up. The median follow-up period was 81 days (interquartile range, 35 to 294 days). Ten patients had complications (23.3 percent). The most common complication was malocclusion (n = 5). Nine of 10 patients with complications had condylar fracture with an additional mandibular arch fracture. Closed treatment of condylar fractures yields satisfactory results in pediatric patients. Pediatric patients with condylar fractures combined with additional arch fractures experience a higher rate of unfavorable outcomes.

  15. Experience with PET FDG - Preliminary analysis

    International Nuclear Information System (INIS)

    Massardo, Teresa; Jofre, Josefina; Canessa, Jose; Gonzalez, Patricio; Humeres, Pamela; Sierralta, Paulina; Galaz, Rodrigo; Miranda, Karina

    2004-01-01

    Full text: The objective of this preliminary communication was to analyse the indications and data in initial group of patients studied with first dedicated PET scanner in the country at Hospital Militar in Santiago Chile. The main application of positron emission tomography (PET) with 18-Fluoro deoxyglucose (FDG) is related with oncological patients management. We studied 136 patients, 131 (97%) with known or suspected malignant disease and remaining 5 for cardiological or neuropsychiatric disease. Ten patients were controlled diabetics (1 insulin dependent). Their mean age was 51.6±18 years ranging from 6 to 84 years and 65% were females. A total of 177 scans were acquired using a dedicated PET (Siemens HR + with 4mm resolution) system. Mean F18-FDG injected dose was 477±107 MBq (12.9±2.9 mCi). Mean blood glucose levels, performed prior the injection, were 94±17mg/dl (range 62-161). F18-FDG was obtained from the cyclotron IBA Cyclone 18/9 installed in the Chilean Agency of Nuclear Energy, distant about 15 miles away from the clinical PET facility. PET studies were analyzed by at least 4 independent observers visually. Standardized uptake value (SUV) was calculated in some cases. Image fusion of FDG images with recent anatomical (CT, MRI) studies was performed where available. Data acquisition protocol consisted in 7-8 beds/study from head to mid-thighs, with 6-7-min/bed acquisitions, 36% transmission with germanium 68 rods. Data was reconstructed with standard OSEM protocol. The main indications included pulmonary lesions in 31%, gastrointestinal cancers in 21%, melanoma in 13% and lymphoma in 9% patients. The remaining were of breast, thyroid, testes, ovary, musculoskeletal (soft tissue and bone), brain tumour etc. Abnormal focal tracer uptake was observed in 83/131 oncological patients, 54% corroborating with clinical diagnosis of primary tumor or recurrence while 46% showed new metastatic localization. FDG scans were normal 36/131 patients. In 9 patients

  16. Experience with PET FDG - Preliminary analysis

    Energy Technology Data Exchange (ETDEWEB)

    Massardo, Teresa; Jofre, Josefina; Canessa, Jose; Gonzalez, Patricio; Humeres, Pamela; Sierralta, Paulina; Galaz, Rodrigo; Miranda, Karina [Centro PET de Imagenes Moleculares, Hospital Militar de Santiago, Santiago (Chile)

    2004-01-01

    Full text: The objective of this preliminary communication was to analyse the indications and data in initial group of patients studied with first dedicated PET scanner in the country at Hospital Militar in Santiago Chile. The main application of positron emission tomography (PET) with 18-Fluoro deoxyglucose (FDG) is related with oncological patients management. We studied 136 patients, 131 (97%) with known or suspected malignant disease and remaining 5 for cardiological or neuropsychiatric disease. Ten patients were controlled diabetics (1 insulin dependent). Their mean age was 51.6{+-}18 years ranging from 6 to 84 years and 65% were females. A total of 177 scans were acquired using a dedicated PET (Siemens HR + with 4mm resolution) system. Mean F18-FDG injected dose was 477{+-}107 MBq (12.9{+-}2.9 mCi). Mean blood glucose levels, performed prior the injection, were 94{+-}17mg/dl (range 62-161). F18-FDG was obtained from the cyclotron IBA Cyclone 18/9 installed in the Chilean Agency of Nuclear Energy, distant about 15 miles away from the clinical PET facility. PET studies were analyzed by at least 4 independent observers visually. Standardized uptake value (SUV) was calculated in some cases. Image fusion of FDG images with recent anatomical (CT, MRI) studies was performed where available. Data acquisition protocol consisted in 7-8 beds/study from head to mid-thighs, with 6-7-min/bed acquisitions, 36% transmission with germanium 68 rods. Data was reconstructed with standard OSEM protocol. The main indications included pulmonary lesions in 31%, gastrointestinal cancers in 21%, melanoma in 13% and lymphoma in 9% patients. The remaining were of breast, thyroid, testes, ovary, musculoskeletal (soft tissue and bone), brain tumour etc. Abnormal focal tracer uptake was observed in 83/131 oncological patients, 54% corroborating with clinical diagnosis of primary tumor or recurrence while 46% showed new metastatic localization. FDG scans were normal 36/131 patients. In 9

  17. Preliminary Validation of a Parent-Child Relational Framework for Teaching Developmental Assessment to Pediatric Residents.

    Science.gov (United States)

    Regalado, Michael; Schneiderman, Janet U; Duan, Lei; Ragusa, Gisele

    A parent-child relational framework was used as a method to train pediatric residents in basic knowledge and observation skills for the assessment of child development. Components of the training framework and its preliminary validation as an alternative to milestone-based approaches are described. Pediatric residents were trained during a 4-week clinical rotation to use a semistructured interview and observe parent-child behavior during health visits using clinical criteria for historical information and observed behavior that reflect developmental change in the parent-child relationship. Clinical impressions of concern versus no concern for developmental delay were derived from parent-child relational criteria and the physical examination. A chart review yielded 330 preterm infants evaluated using this methodology at 4 and 15 months corrected age who also had standardized developmental testing at 6 and 18 months corrected age. Sensitivities and specificities were computed to examine the validity of the clinical assessment compared with standardized testing. A subset of residents who completed 50 or more assessments during the rotation was timed at the end of 4 weeks. Parent-child behavioral markers elicited from the history and/or observed during the health visit correlated highly with standardized developmental assessment. Sensitivities and specificities were 0.72/0.98 and 0.87/0.96 at 4 to 6 and 15 to 18 months, respectively. Residents completed their assessments parent-child relational framework is a potentially efficient and effective approach to training residents in the clinical knowledge and skills of child development assessment. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  18. Magnetic resonance imaging features of the spinal cord in pediatric multiple sclerosis: a preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Verhey, Leonard H. [Hospital for Sick Children, Neuroscience and Mental Health, Toronto, ON (Canada); University of Toronto, Institute of Medical Science, Faculty of Medicine, Toronto, ON (Canada); Branson, Helen M.; Shroff, Manohar [Hospital for Sick Children, Department of Diagnostic Imaging (Neuroradiology), Toronto, ON (Canada); University of Toronto, Department of Medical Imaging, Toronto, ON (Canada); Makhija, Monica [Hospital for Sick Children, Neuroscience and Mental Health, Toronto, ON (Canada); Banwell, Brenda [Hospital for Sick Children, Neuroscience and Mental Health, Toronto, ON (Canada); University of Toronto, Institute of Medical Science, Faculty of Medicine, Toronto, ON (Canada); University of Toronto, Department of Pediatrics (Neurology), Toronto, ON (Canada)

    2010-12-15

    Spinal cord lesions in adults with multiple sclerosis (MS) are thought to contribute to disability. The magnetic resonance imaging (MRI) appearance and clinical correlates of spinal cord lesions in children with MS have not been reported. T1-weighted pre- and post-gadolinium and T2-weighted TSE/FSE spine MR images of 36 children (age, 14.3 {+-} 3.3) with relapsing-remitting MS (annualized relapse rate, 0.7; disease duration, 7.5 {+-} 3.3 years) were analyzed for total lesion count, lesion location and length, intramedullary extent, and gadolinium enhancement. Clinical, demographic, laboratory, and MRI data were correlated. Lesions preferentially involved the cervical region, were predominantly focal, and involved only a portion of the transverse cord diameter. However, ten of 36 patients demonstrated longitudinally extensive lesions. Children with the highest clinical relapse rate also tended to have more spinal cord lesions and were more likely to accrue new lesions on serial spinal scans. These preliminary data suggest that MS lesions of the spinal cord in children are radiographically similar to that of adult-onset MS - supporting a common biology of pediatric- and adult-onset disease. However, children with relapsing-remitting MS can also develop longitudinally extensive lesions, suggesting that such lesions may be less specific for diseases such as neuromyelitis optica in pediatric patients. All patients recovered well from spinal cord attacks, and the presence of spinal cord lesions in the first few years of disease did not correlate with physical disability. Measures of spinal cord atrophy and longer periods of observation are required to determine the impact of spinal cord involvement in pediatric-onset MS. (orig.)

  19. Magnetic resonance imaging features of the spinal cord in pediatric multiple sclerosis: a preliminary study

    International Nuclear Information System (INIS)

    Verhey, Leonard H.; Branson, Helen M.; Shroff, Manohar; Makhija, Monica; Banwell, Brenda

    2010-01-01

    Spinal cord lesions in adults with multiple sclerosis (MS) are thought to contribute to disability. The magnetic resonance imaging (MRI) appearance and clinical correlates of spinal cord lesions in children with MS have not been reported. T1-weighted pre- and post-gadolinium and T2-weighted TSE/FSE spine MR images of 36 children (age, 14.3 ± 3.3) with relapsing-remitting MS (annualized relapse rate, 0.7; disease duration, 7.5 ± 3.3 years) were analyzed for total lesion count, lesion location and length, intramedullary extent, and gadolinium enhancement. Clinical, demographic, laboratory, and MRI data were correlated. Lesions preferentially involved the cervical region, were predominantly focal, and involved only a portion of the transverse cord diameter. However, ten of 36 patients demonstrated longitudinally extensive lesions. Children with the highest clinical relapse rate also tended to have more spinal cord lesions and were more likely to accrue new lesions on serial spinal scans. These preliminary data suggest that MS lesions of the spinal cord in children are radiographically similar to that of adult-onset MS - supporting a common biology of pediatric- and adult-onset disease. However, children with relapsing-remitting MS can also develop longitudinally extensive lesions, suggesting that such lesions may be less specific for diseases such as neuromyelitis optica in pediatric patients. All patients recovered well from spinal cord attacks, and the presence of spinal cord lesions in the first few years of disease did not correlate with physical disability. Measures of spinal cord atrophy and longer periods of observation are required to determine the impact of spinal cord involvement in pediatric-onset MS. (orig.)

  20. Preliminary tests in skull pediatric phantom for dosimetry in computerized tomography

    International Nuclear Information System (INIS)

    Martins, Elaine Wirney; Potiens, Maria da Penha de A.

    2014-01-01

    Computed tomography (CT) is one of the techniques in the field of radiology with striking technological advance in recent years. One reason for this was the increased number of channels associated with the increased power of the X-ray tube. These conditions allowed the equipment high speed in the acquisition of the cuts, reducing the patient exposure time essential characteristic for the increase of its use in pediatric patients. In this context, were developed a new pediatric skull simulator to analyze the results of measurements performed in laboratory and clinic beams with the objective of creation and use of diagnostic reference levels observing risks stochastic effects and assessing the reduction of absorbed doses in patients undergoing growing. Preliminary tests performed in clinical beams showed C w values: 2.525 ± 0.212 mGy for the developed simulator quoted and 3.362 ± 0.282 mGy for a simulator developed by IPEN called standard, both being between uncertainty values of 8.4% and 14.4% suggested by TRS number 457

  1. Warm pre-stressing, preliminary experiments

    International Nuclear Information System (INIS)

    Hedner, G.

    1984-09-01

    The beneficial effect of warm pre-stressing, WPS, on apparent fracture thoughness at low temperature is well established. Tests are usually performed with constant load during the cooling part of the load cycle. In practice load variations may occur during this part. The present paper reports a preliminary study of the influence of superimposed fatigue loads. It is found that if crack propagation occurs during cooling+fatigue loading, then the maximum load during the fatigue load cycle is the preload to be used for WPS consideration. A few tests were preformed to study the effect of preload reversal. Tensile preload was followed by a compressive load and after unloading the specimens were cooled and fractured. It was found that for the high preload level used in the tests, the beneficial effect of the tensile preload could be totally annihilated by the compressive preload. (author)

  2. The mothers' experiences in the pediatrics hemodialysis unit.

    Science.gov (United States)

    Mieto, Fernanda Stella Risseto; Bousso, Regina Szylit

    2014-01-01

    The need for hemodialysis exerts a deep impact on the lives of children and adolescents with end-stage kidney chronic failure and their mothers, who predominantly assume the care related to treatment. The hemodialysis requires that the mother accompanies the child during sessions at least three times a week and, since it is not a healing practice, they also experience the waiting for a kidney transplant, attributing different meanings to this experience. To understand what it means for the mothers to accompany the child in a Pediatric Hemodialysis Unit and to construct a theoretical model representing this experience. The Symbolic Interactionism was adopted as a theoretical model and the Grounded Theory as a methodological framework. Data were collected through interviews with 11 mothers. The comparative analysis of the data enabled the identification of two phenomena that compose the experience: "Seeing the child´s life being sucked by the hemodialysis machine" expresses the experiences of the mothers that generates new demands to comprehend the new health conditions of their children and "Giving new meaning to the dependence of the hemodialysis machine" that represents the strategies employed to endure the experience. The relationship of these phenomena allowed the identification of the main category: "Having the mother's life imprisoned by the hemodialysis machine", from which we propose a new theoretical model. The results of the study allow us to provide a theoretical ground for planning an assistance that meets the real needs of the mothers, identifying aspects that require intervention.

  3. Are drowned donors marginal donors? A single pediatric center experience.

    Science.gov (United States)

    Kumm, Kayla R; Galván, N Thao N; Koohmaraie, Sarah; Rana, Abbas; Kueht, Michael; Baugh, Katherine; Hao, Liu; Yoeli, Dor; Cotton, Ronald; O'Mahony, Christine A; Goss, John A

    2017-09-01

    Drowning, a common cause of death in the pediatric population, is a potentially large donor pool for OLT. Anecdotally, transplant centers have deemed these organs high risk over concerns for infection and graft dysfunction. We theorized drowned donor liver allografts do not portend worse outcomes and therefore should not be excluded from the donation pool. We reviewed our single-center experience of pediatric OLTs between 1988 and 2015 and identified 33 drowned donor recipients. These OLTs were matched 1:2 to head trauma donor OLTs from our center. A chart review assessed postoperative peak AST and ALT, incidence of HAT, graft and recipient survival. Recipient survival at one year between patients with drowned donor vs head trauma donor allografts was not statistically significant (94% vs 97%, P=.63). HAT incidence was 6.1% in the drowned donor group vs 7.6% in the control group (P=.78). Mean postoperative peak AST and ALT was 683 U/L and 450 U/L for drowned donors vs 1119 U/L and 828 U/L in the matched cohort. These results suggest drowned donor liver allografts do not portend worse outcomes in comparison with those procured from head trauma donors. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Preliminary experiments on quantification of skin condition

    Science.gov (United States)

    Kitajima, Kenzo; Iyatomi, Hitoshi

    2014-03-01

    In this study, we investigated a preliminary assessment method for skin conditions such as a moisturizing property and its fineness of the skin with an image analysis only. We captured a facial images from volunteer subjects aged between 30s and 60s by Pocket Micro (R) device (Scalar Co., Japan). This device has two image capturing modes; the normal mode and the non-reflection mode with the aid of the equipped polarization filter. We captured skin images from a total of 68 spots from subjects' face using both modes (i.e. total of 136 skin images). The moisture-retaining property of the skin and subjective evaluation score of the skin fineness in 5-point scale for each case were also obtained in advance as a gold standard (their mean and SD were 35.15 +/- 3.22 (μS) and 3.45 +/- 1.17, respectively). We extracted a total of 107 image features from each image and built linear regression models for estimating abovementioned criteria with a stepwise feature selection. The developed model for estimating the skin moisture achieved the MSE of 1.92 (μS) with 6 selected parameters, while the model for skin fineness achieved that of 0.51 scales with 7 parameters under the leave-one-out cross validation. We confirmed the developed models predicted the moisture-retaining property and fineness of the skin appropriately with only captured image.

  5. A new mini-invasive technique in treating pediatric diaphyseal forearm fractures by bioabsorbable elastic stable intramedullary nailing: a preliminary technical report.

    Science.gov (United States)

    Sinikumpu, J-J; Keränen, J; Haltia, A-M; Serlo, W; Merikanto, J

    2013-01-01

    Operative treatment is often indicated in unstable pediatric diaphyseal forearm fractures. Recently minimally invasive reduction and elastic stable intramedullary nailing have been of increasing interest, instead of open reduction and internal fixation with plates. There are several disadvantages of metallic intramedullary implants, such as soft-tissue irritation and a risk of disturbing later imaging. Thus, they are generally removed in later operations. We aimed to develop a new technique to stabilize pediatric forearm fractures by the bioabsorbable intramedullary nailing. We developed a new, two-stage mini-invasive surgical technique to stabilize the unstable diaphyseal fractures in children. The procedure is bioabsorbable elastic stable intramedullary nailing. Ultra-high-strength bioabsorbable intramedullary nails of poly(lactide-co-glycolide) were manufactured for our purpose. The material has been widely proven to be biocompatible and stable enough for fracture treatment as screws and pins. We have used the new technique in the unstable both-bone diaphyseal forearm fractures in children between the ages of 5 and 15 years. We report the technique and our clinical experience in the series of those three cases that have been followed up for at least 12 months. The present series has been randomized for the procedure instead for titanium elastic stable intramedullary nailing, and the series represents a part of ongoing randomized trial. The reported cases operated by the new technique referred good union in the fractured bones and acceptable alignment in the follow-up. Removal of the implants was not required. No troubles with the procedure or implant per se were noticed, indicating good feasibility. One high-energy refracture occurred half year after the primary trauma. Traditional titanium implants were used to control the refracture. We report our preliminary experience of a new surgical mini-invasive procedure to stabilize the unstable pediatric forearm shaft

  6. Preliminary analysis of ROSAIII experiment, (2)

    International Nuclear Information System (INIS)

    Kitaguchi, Hidemi; Suzuki, Mitsuhiro; Sobajima, Makoto; Adachi, Hiromichi; Shiba, Masayoshi.

    1978-02-01

    Loss-of-coolant accident (LOCA) experiments to be performed in ROSAIII has been examined with computer code RELAP-4J concerning the experimental conditions. From the results (1) to (3), the needs (4) to (6) are there. (1) Initial enthalpy distribution is important for simulation of break flow of an actual BWR. (2) The simulations of lower plenumn flashing and pressure transient in pressure vessel are good except when power is lacking. (3) The simulation of the cladding temperature transient is difficult because of lack of physical properties. (4) The initial pressure distribution in the facility for different core flow rates up to 72 lb/sec must be attained to analyze accurately. (5) Reverse core flow detectors and reverse jet pump flow detectors are necessary to compare flow pattern of recirculation loops between calculation and experiment. (6) Further information is necessary on physical properties of the fuels. (auth.)

  7. Preliminary results on the NPE experiment

    Energy Technology Data Exchange (ETDEWEB)

    Cansi, Y.; Crusem, R.; Masso, J.P. [CEA, Chatel (France)] [and others

    1994-12-31

    Answering to an invitation of the DOE, the Laboratoire de Detection et de Geophysique du Commissariat a I`Energie Atomique (CEA/LDG) participated to the seismic measurements associated with the NPE Experiment organized by the DOE at the Nevada Test Site. Our main motivations were: to evaluate and compare the capabilities of detection and location of the two types of the so-called alpha stations which composed the Experimental International Seismic System (i.e.: the composite stations and the miniarrays) and this in a regional environnement, to calibrate these stations with a chemical blast of known energy within a given propagation structure.

  8. Preliminary In Vivo Experiments on Adhesion of Geckos

    Directory of Open Access Journals (Sweden)

    E. Lepore

    2008-01-01

    Full Text Available We performed preliminary experiments on the adhesion of a Tokay gecko on surfaces with different roughness, with or without particles with significant different granulometry, before/after or during the moult. The results were analyzed using the Weibull statistics.

  9. Medical Audit: A Nigerian Teaching Hospital's Preliminary Experience

    African Journals Online (AJOL)

    The definition, historical background, aims dimensions and the characteristics of medical audit as well as the indices to be measured in a medical audit exercise are highlighted. The preliminary experience of the University of Ilorin Teaching Hospital (UITH) in the planning, implementation and monitoring of a viable medical ...

  10. Pediatric Renal Transplantation in Oman: A Single-center Experience

    Directory of Open Access Journals (Sweden)

    Mohamed S. Al Riyami

    2018-01-01

    Full Text Available Objectives: This study sought to report 22 years experience in pediatric kidney transplantation in Oman. Methods: Electronic charts of all Omani children below 13 years of age who received a kidney transplant from January 1994 to December 2015 were reviewed. Data collected included patient demographics, etiology of end-stage kidney disease, modality and duration of dialysis, donor type, complication of kidney transplantation (including surgical complications, infections, graft rejection graft and patient survival, and duration of follow-up. Results: During the study period transplantation from 27 living related donors (LRDs, 42 living unrelated donors (LURDs, also referred to as commercial transplant, and one deceased donor were performed. The median age at transplantation was nine years for both groups. The most common primary diagnosis was congenital anomalies of the kidney and urinary tract in 32.8% of patients followed by familial nephrotic syndrome in 20.0% and polycystic kidney disease in 18.5%. Almost half the patients were on hemodialysis before transplantation, 35.7% were on peritoneal dialysis, and 14.2% received preemptive renal transplantation. Children who received LURD kidneys had high surgical complications (42.8% compared to the LRDs group (17.8%. Five patients from LURDs group had early graft nephrectomy and four patients developed non-graft function or delayed graft function. In addition, patients in the LURDs group had a higher incidence of hypertension and acute rejection. Graft and patient survival were both better in the LRDs than the LURDs group. Conclusions: Although our pediatric kidney transplant program is a young program it has had successful patient outcomes comparable to international programs. Our study provides evidence that in addition to legal and ethical issues with commercial transplant, it also carries significantly higher morbidity and reduced graft and patient survival.

  11. [Physical therapy in pediatric primary care: a review of experiences].

    Science.gov (United States)

    de Sá, Miriam Ribeiro Calheiros; Thomazinho, Paula de Almeida; Santos, Fabiano Luiz; Cavalcanti, Nicolette Celani; Ribeiro, Carla Trevisan Martins; Negreiros, Maria Fernanda Vieira; Vinhaes, Marcia Regina

    2014-11-01

    To review pediatric physical therapy experiences described in the literature and to analyze the production of knowledge on physical therapy in the context of pediatric primary health care (PPHC). A systematic review was conducted according to the PRISMA criteria. The following databases were searched: MEDLINE, LILACS, SciELO, PubMed, Scopus and Cochrane; Brazilian Ministry of Health's CAPES doctoral dissertations database; and System for Information on Grey Literature in Europe (SIGLE). The following search terms were used: ["primary health care" and ("physical therapy" or "physiotherapy") and ("child" or "infant")] and equivalent terms in Portuguese and Spanish, with no restriction on publication year. Thirteen articles from six countries were analyzed and grouped into three main themes: professional dilemmas (three articles), specific competencies and skills required in a PPHC setting (seven articles), and practice reports (four articles). Professional dilemmas involved expanding the role of physical therapists to encompass community environments and sharing the decision-making process with the family, as well as collaborative work with other health services to identify the needs of children. The competencies and skills mentioned in the literature related to the identification of clinical and sociocultural symptoms that go beyond musculoskeletal conditions, the establishment of early physical therapy diagnoses, prevention of overmedication, and the ability to work as team players. Practice reports addressed stimulation in children with neurological diseases, respiratory treatment, and establishing groups with mothers of children with these conditions. The small number of studies identified in this review suggests that there is little knowledge regarding the roles of physical therapists in PPHC and possibly regarding the professional abilities required in this setting. Therefore, further studies are required to provide data on the field, along with a continuing

  12. Bridging Adult Experience to Pediatrics in Oncology Drug Development.

    Science.gov (United States)

    Leong, Ruby; Zhao, Hong; Reaman, Gregory; Liu, Qi; Wang, Yaning; Stewart, Clinton F; Burckart, Gilbert

    2017-10-01

    Pediatric drug development in the United States has grown under the current regulations made permanent by the Food and Drug Administration Safety and Innovation Act of 2012. Over 1200 pediatric studies have now been submitted to the US FDA, but there is still a high rate of failure to obtain pediatric labeling for the indication pursued. Pediatric oncology represents special problems in that the disease is most often dissimilar to any cancer found in the adult population. Therefore, the development of drug dosing in pediatric oncology patients represents a special challenge. Potential approaches to pediatric dosing in oncology patients include extrapolation of efficacy from adult studies in those few cases where the disease is similar, inclusion of adolescent patients in adult trials when possible, and bridging the adult dose to the pediatric dose. An analysis of the recommended phase 2 dose for 40 molecularly targeted agents in pediatric patients provides some insight into current practices. Increased knowledge of tumor biology and efforts to identify and validate molecular targets and genetic abnormalities that drive childhood cancers can lead to increased opportunities for precision medicine in the treatment of pediatric cancers. © 2017, The American College of Clinical Pharmacology.

  13. Development of Pediatric Neurologic Emergency Life Support Course: A Preliminary Report.

    Science.gov (United States)

    Haque, Anwarul; Arif, Fehmina; Abass, Qalab; Ahmed, Khalid

    2017-11-01

    Acute neurological emergencies (ANEs) in children are common life-threatening illnesses and are associated with high mortality and severe neurological disability in survivors, if not recognized early and treated appropriately. We describe our experience of teaching a short, novel course "Pediatric Neurologic Emergency Life Support" to pediatricians and trainees in a resource-limited country. This course was conducted at 5 academic hospitals from November 2013 to December 2014. It is a hybrid of pediatric advance life support and emergency neurologic life support. This course is designed to increase knowledge and impart practical training on early recognition and timely appropriate treatment in the first hour of children with ANEs. Neuroresuscitation and neuroprotective strategies are key components of this course to prevent and treat secondary injuries. Four cases of ANEs (status epilepticus, nontraumatic coma, raised intracranial pressure, and severe traumatic brain injury) were taught as a case simulation in a stepped-care, protocolized approach based on best clinical practices with emphasis on key points of managements in the first hour. Eleven courses were conducted during the study period. One hundred ninety-six physicians including 19 consultants and 171 residents participated in these courses. The mean (SD) score was 65.15 (13.87%). Seventy percent (132) of participants were passed (passing score > 60%). The overall satisfaction rate was 85%. Pediatric Neurologic Emergency Life Support was the first-time delivered educational tool to improve outcome of children with ANEs with good achievement and high satisfaction rate of participants. Large number courses are required for future validation.

  14. Preliminary experiments with a cusp-field ion source

    International Nuclear Information System (INIS)

    Bickes, R.W. Jr.; O'Hagan, J.B.

    1980-12-01

    Preliminary experiments with a cusp field ion source have been completed. Measurements were made of the total ion current and mass and energy distributions as a function of source operating conditions and cusp field geometry. These experiments have indicated that a cusp field source may be used in the Sandia Neutron Generator for Cancer Therapy and may permit the incorporation of a simplified unpumped accelerator design. Suggestions for future work are briefly outlined

  15. Preliminary experience with frameless stereotactic radiotherapy

    International Nuclear Information System (INIS)

    Buatti, John M.; Bova, Frank J.; Friedman, William A.; Meeks, Sanford L.; Ellis, Thomas L.; Marcus, Robert B.; Zuofeng, Li; Mendenhall, William M.

    1997-01-01

    Purpose/Objective: To report our initial clinical experience using a novel high-precision frameless stereotactic radiotherapy system in 50 patients who have received 1271 treatments. Materials and Methods: Fifty patients ranging in age from 2 to 72 yr were treated with fractionated stereotactic radiotherapy. Thirty-two were treated with stereotactic radiotherapy alone, and 18 had stereotactic radiotherapy interdigitated as a boost in addition to standard irradiation. Pathologies treated included meningioma (13), low grade astrocytoma (10), germinoma (9), craniopharyngioma (4), schwannoma (2), and pituitary adenoma (2). Two additional patients had miscellaneous benign neoplasms and 8 patients had the technique used as a dose escalation strategy for malignant lesions including chordoma, primitive neuroectodermal tumor, sarcoma, and anaplastic oligoastrocytoma. Treatment reproducibility was initially gauged by comparing the bite plate position using infrared light emitting diodes (irleds) with the stereotactic radiosurgery reference system. This test of accuracy consisted of 10 bite plate repositionings for each patient and 100 readings of each of the 6 irleds on the bite plate at each new position. Each of the 1271 patient treatments was monitored for continuous digital position, and a reading was made before treating each arc of radiation. We chose 0.3 mm translation and 0.3 degrees rotation as the maximum tolerated misalignment before treating each arc. Results: With a mean follow-up of 9 mo, no patient had a marginal or distal failure. One patient with a malignant glioma had central disease progression. Acute side effects were minimal. In 3 of 9 low grade astrocytomas, a marked increase in imaging enhancement and edema occurred in the first year after treatment that resolved with steroids. The initial test of accuracy revealed bite plate reproducibility as follows. Translational errors (mm): Anterior-posterior, 0.06 ± 0.06; lateral, 0.03 ± 0.05; axial, 0.07 ± 0

  16. Preliminary experience with frameless stereotactic radiotherapy

    International Nuclear Information System (INIS)

    Buatti, John M.; Bova, Francis J.; Friedman, William A.; Meeks, Sanford L.; Marcus, Robert B.; Mickle, J. Parker; Ellis, Thomas L.; Mendenhall, William M.

    1998-01-01

    Purpose: To report initial clinical experience with a novel high-precision stereotactic radiotherapy system. Methods and Materials: Sixty patients ranging in age from 2 to 82 years received a total of 1426 treatments with the University of Florida frameless stereotactic radiotherapy system. Of the total, 39 (65%) were treated with stereotactic radiotherapy (SRT) alone, and 21 (35%) received SRT as a component of radiotherapy. Pathologic diagnoses included meningiomas (15 patients), low-grade astrocytomas (11 patients), germinomas (9 patients), and craniopharyngiomas (5 patients). The technique was used as means of dose escalation in 11 patients (18%) with aggressive tumors. Treatment reproducibility was measured by comparing bite plate positioning registered by infrared light-emitting diodes (IRLEDs) with the stereotactic radiosurgery reference system, and with measurements from each treatment arc for the 1426 daily treatments (5808 positions). We chose 0.3 mm vector translation error and 0.3 deg. rotation about each axis as the maximum tolerated misalignment before treating each arc. Results: With a mean follow-up of 11 months, 3 patients had recurrence of malignant disease. Acute side effects were minimal. Of 11 patients with low grade astrocytomas, 4 (36%) had cerebral edema and increased enhancement on MR scans in the first year, and 2 required steroids. All had resolution and marked tumor involution on follow-up imaging. Bite plate reproducibility was as follows. Translational errors: anterior-posterior, 0.01 ± 0.10; lateral, 0.02 ± 0.07; axial, 0.01 ± 0.10. Rotational errors (degrees): anterior-posterior, 0.00 ± 0.03; lateral, 0.00 ± 0.06; axial, 0.01 ± 0.04. No patient treatment was delivered beyond the maximum tolerated misalignment. Daily treatment was delivered in approximately 15 min per patient. Conclusion: Our initial experience with stereotactic radiotherapy using the infrared camera guidance system was good. Patient selection and treatment

  17. Pediatrics

    Science.gov (United States)

    Spackman, T. J.

    1978-01-01

    The utilization of the Lixiscope in pediatrics was investigated. The types of images that can presently be obtained are discussed along with the problems encountered. Speculative applications for the Lixiscope are also presented.

  18. Pediatrics

    NARCIS (Netherlands)

    Rasheed, Shabana; Teo, Harvey James Eu Leong; Littooij, Annemieke Simone

    2015-01-01

    Imaging of pediatric patients involves many diverse modalities, including radiography, ultrasound imaging, computed tomography, magnetic resonance imaging, and scintigraphic and angiographic studies. It is therefore important to be aware of potential pitfalls that may be related to these modalities

  19. Safety and feasibility of transcranial direct current stimulation in pediatric hemiparesis: randomized controlled preliminary study.

    Science.gov (United States)

    Gillick, Bernadette T; Feyma, Tim; Menk, Jeremiah; Usset, Michelle; Vaith, Amy; Wood, Teddi Jean; Worthington, Rebecca; Krach, Linda E

    2015-03-01

    Transcranial direct current stimulation (tDCS) is a form of noninvasive brain stimulation that has shown improved adult stroke outcomes. Applying tDCS in children with congenital hemiparesis has not yet been explored. The primary objective of this study was to explore the safety and feasibility of single-session tDCS through an adverse events profile and symptom assessment within a double-blind, randomized placebo-controlled preliminary study in children with congenital hemiparesis. A secondary objective was to assess the stability of hand and cognitive function. A double-blind, randomized placebo-controlled pretest/posttest/follow-up study was conducted. The study was conducted in a university pediatric research laboratory. Thirteen children, ages 7 to 18 years, with congenital hemiparesis participated. Adverse events/safety assessment and hand function were measured. Participants were randomly assigned to either an intervention group or a control group, with safety and functional assessments at pretest, at posttest on the same day, and at a 1-week follow-up session. An intervention of 10 minutes of 0.7 mA tDCS was applied to bilateral primary motor cortices. The tDCS intervention was considered safe if there was no individual decline of 25% or group decline of 2 standard deviations for motor evoked potentials (MEPs) and behavioral data and no report of adverse events. No major adverse events were found, including no seizures. Two participants did not complete the study due to lack of MEP and discomfort. For the 11 participants who completed the study, group differences in MEPs and behavioral data did not exceed 2 standard deviations in those who received the tDCS (n=5) and those in the control group (n=6). The study was completed without the need for stopping per medical monitor and biostatisticial analysis. A limitation of the study was the small sample size, with data available for 11 participants. Based on the results of this study, tDCS appears to be safe

  20. Preliminary analysis of the KAERI RCCS Experiment Using GAMMA+

    Energy Technology Data Exchange (ETDEWEB)

    Khoza, Samukelisiwe; Tak, Nam-il; Lim, Hong-Sik; Lee, Sung-Nam; Cho, Bong-Hyun; Kim, Jong-Hwan [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-05-15

    This paper describes the analysis of the KAERI RCCS experiment. GAMMA+ code was used for analysis of the RCCS 1/4-scale natural cooling experimental facility designed and built at KAERI to verify the performance of the natural circulation phenomenon. The results obtained from the GAMMA+ analysis showing the temperature profiles and flow rates at steady state were compared with the results from the preliminary experiments conducted in this facility. GAMMA+ analysis for the KAERI RCCS experimental setup was carried out to understand its natural circulation behavior. The air flow rate at the chimney exit achieved by experiments was from to be almost same as that of GAMMA+.

  1. Preliminary results of the Spacelab 2 superfluid helium experiment

    International Nuclear Information System (INIS)

    Mason, P.V.; Collins, D.J.; Elleman, D.D.; Jackson, H.W.; Wang, T.

    1986-01-01

    An experiment to investigate the properties of superfluid helium in a microgravity environment flew on the Shuttle on the Spacelab 2 mission in July and August of 1985. This paper summarizes the flight experiment and describes some preliminary results. The experiment comprised an investigation of long-wavelength third-sound waves in micron-thick films, a study of the motions of superfluid helium under milli-g and micro-g accelerations, and measurements of the fluctuations in temperature associated with the small motions of the bulk helium. An additional objective was to qualify and characterize a reflyable, space-compatible cryostat

  2. Preliminary results from the MINERvA experiment

    International Nuclear Information System (INIS)

    Harris, Deborah A.

    2011-01-01

    The MINERvA experiment, operating since 2009 in the NuMI neutrino beam line at Fermilab, has collected neutrino and antineutrino scattering data on a variety of nuclear targets. The detector is designed to identify events originating in plastic scintillator, lead, carbon, iron, water, and liquid helium. The goal of the experiment is to measure inclusive and exclusive cross sections for neutrino and antineutrino with much greater precision than previous experiments. We present preliminary kinematic distributions for charged current quasi-elastic scattering and other processes.

  3. Doses in pediatric patients undergoing chest and abdomen CT examinations. Preliminary results

    International Nuclear Information System (INIS)

    Jornada, Tiago S.; Silva, Teogenes A. da

    2011-01-01

    Computed tomography (CT) is a non-invasive method of image production that imparts significant doses to a patient, it is expected that pediatric CT examinations will increase the risk of induced cancer in children. In this study the effective doses in a five year-old child submitted to chest or abdomen CT scans were assessed for comparison purposes. The CTEXPO computed program was used with data from routine protocols of a 0 to 13 year-old children in two public hospitals in Belo Horizonte. Hospital A used a Siemens Dual-Slice unit with 80 kV, 41 mA and pitch 2 for chest or abdomen; hospital B used a Multislice GE unit with 120 kV, 45 mA and pitch 1 for chest and 120 kV, 55 mA. and pitch 1 for abdomen. Results of effective doses in a five year-old child were 1.7 and 1.0 mSv in hospital A and 9.1 and 7.2 mSv in hospital B, for chest and abdomen, respectively. Results were compared to the reference effective doses of 7.2 and 5.0 mSv for chest and abdomen respectively that were derived from the air kerma length product values given in ICRP publication 87. Results of hospital A showed that low dose exposures also can be achieved in CT scans of children. Results showed that even a hospital with a modern facility (hospital B) can provided doses higher than reference values if protocols are not adjusted for children. Preliminary results suggested that there is a room for optimizing children exposure submitted to CT scans. (author)

  4. Preliminary Study of Neurodevelopmental Outcomes and Parenting Stress in Pediatric Mitochondrial Disease.

    Science.gov (United States)

    Eom, Soyong; Lee, Young-Mock

    2017-06-01

    Little is known regarding the neuropsychological profiles of pediatric patients with mitochondrial diseases or their parents, information that is crucial for improving the quality of life (QOL) for both patients and parents. We aimed to delineate neurodevelopment and psychological comorbidity in children with mitochondrial diseases in the preliminary investigation of adequate intervention methods, better prognoses, and improved QOL for both patients and parents. Seventy children diagnosed with mitochondrial diseases were neuropsychologically evaluated. Neurocognitive (development, intelligence) and psychological (behavior, daily living function, maternal depression, parenting stress) functions were analyzed. Clinical variables, including the first symptom, epileptic classification, organ involvement, lactic acidosis, brain magnetic resonance imaging findings, muscle pathology, biochemical enzyme assay results, and syndromic diagnosis of mitochondrial diseases, were also reviewed. Prediagnostic assessments indicated that cognitive and psychomotor developments were significantly delayed. Group mean full scale intelligence quotient (IQ) scores indicated mild levels of intellectual disability, borderline levels of verbal IQ impairment, and mild levels of intellectual disability on performance IQ. Many children exhibited clinically significant levels of behavioral problems, whereas mothers of children with mitochondrial diseases exhibited significant increases in parenting stress relative to mothers of healthy children. Furthermore, 65% of mothers exhibited significant levels of depression. Early onset of the first symptoms, diffuse brain atrophy, and drug-resistant epilepsy negatively influenced neurodevelopmental and adaptive functions. Better understanding of the functional levels and profiles of neurodevelopment and psychological comorbidity in children with mitochondrial diseases in the prediagnostic period is essential for adequate support and QOL of children with

  5. Preliminary Langmuir probe results on the CTX gun experiment

    International Nuclear Information System (INIS)

    Tuszewski, M.

    1981-12-01

    Preliminary results obtained with a double Langmuir probe in the Compact Toroid experiment facility confirm the existence of a gun plasma of n approx. 5 x 10 14 cm -3 and T approx. 10 eV lasting for approx. 250 to 400 μs, which is consistent with interferometry and Thomson scattering data. The probe current characteristics as a function of voltage suggest non-Maxwellian features of the particles distribution functions

  6. Safe intravenous administration in pediatrics: A 5-year Pediatric Intensive Care Unit experience with smart pumps.

    Science.gov (United States)

    Manrique-Rodríguez, S; Sánchez-Galindo, A C; Fernández-Llamazares, C M; Calvo-Calvo, M M; Carrillo-Álvarez, Á; Sanjurjo-Sáez, M

    2016-10-01

    To estimate the impact of smart pump implementation in a pediatric intensive care unit in terms of number and type of administration errors intercepted. Observational, prospective study carried out from January 2010 to March 2015 with syringe and great volumen infusion pumps available in the hospital. A tertiary level hospital pediatric intensive care unit. Infusions delivered with infusion pumps in all pediatric intensive care unit patients. Design of a drug library with safety limits for all intravenous drugs prescribed. Users' compliance with drug library as well as number and type of errors prevented were analyzed. Two hundred and eighty-three errors were intercepted during 62 months of study. A high risk drug was involved in 58% of prevented errors, such as adrenergic agonists and antagonists, sedatives, analgesics, neuromuscular blockers, opioids, potassium and insulin. Users' average compliance with the safety software was 84%. Smart pumps implementation has proven effective in intercepting high risk drugs programming errors. These results might be exportable to other critical care units, involving pediatric or adult patients. Interdisciplinary colaboration is key to succeed in this process. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  7. Preliminary results of statistical dynamic experiments on a heat exchanger

    International Nuclear Information System (INIS)

    Corran, E.R.; Cummins, J.D.

    1962-10-01

    The inherent noise signals present in a heat exchanger have been recorded and analysed in order to determine some of the statistical dynamic characteristics of the heat exchanger. These preliminary results show that the primary side temperature frequency response may be determined by analysing the inherent noise. The secondary side temperature frequency response and cross coupled temperature frequency responses between primary and secondary are poorly determined because of the presence of a non-stationary noise source in the secondary circuit of this heat exchanger. This may be overcome by correlating the dependent variables with an externally applied noise signal. Some preliminary experiments with an externally applied random telegraph type of signal are reported. (author)

  8. Possession experiences in dissociative identity disorder: a preliminary study.

    Science.gov (United States)

    Ross, Colin A

    2011-01-01

    Dissociative trance disorder, which includes possession experiences, was introduced as a provisional diagnosis requiring further study in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Consideration is now being given to including possession experiences within dissociative identity disorder (DID) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), which is due to be published in 2013. In order to provide empirical data relevant to the relationship between DID and possession states, I analyzed data on the prevalence of trance, possession states, sleepwalking, and paranormal experiences in 3 large samples: patients with DID from North America; psychiatric outpatients from Shanghai, China; and a general population sample from Winnipeg, Canada. Trance, sleepwalking, paranormal, and possession experiences were much more common in the DID patients than in the 2 comparison samples. The study is preliminary and exploratory in nature because the samples were not matched in any way.

  9. Pharmacologic studies in vulnerable populations: Using the pediatric experience.

    Science.gov (United States)

    Zimmerman, Kanecia; Gonzalez, Daniel; Swamy, Geeta K; Cohen-Wolkowiez, Michael

    2015-11-01

    Historically, few data exist to guide dosing in children and pregnant women. Multiple barriers to inclusion of these vulnerable populations in clinical trials have led to this paucity of data. However, federal legislation targeted at pediatric therapeutics, innovative clinical trial design, use of quantitative clinical pharmacology methods, pediatric thought leadership, and collaboration have successfully overcome many existing barriers. This success has resulted in improved knowledge on pharmacokinetics, safety, and efficacy of therapeutics in children. To date, research in pregnant women has not been characterized by similar success. Wide gaps in knowledge remain despite the common use of therapeutics in pregnancy. Given the similar barriers to drug research and development in pediatric and pregnant populations, the route toward success in children may serve as a model for the advancement of drug development and appropriate drug administration in pregnant women. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Preliminary Safety Analysis Report for the Tokamak Physics Experiment

    International Nuclear Information System (INIS)

    Motloch, C.G.; Bonney, R.F.; Levine, J.D.; Masson, L.S.; Commander, J.C.

    1995-04-01

    This Preliminary Safety Analysis Report (PSAR), includes an indication of the magnitude of facility hazards, complexity of facility operations, and the stage of the facility life-cycle. It presents the results of safety analyses, safety assurance programs, identified vulnerabilities, compensatory measures, and, in general, the rationale describing why the Tokamak Physics Experiment (TPX) can be safely operated. It discusses application of the graded approach to the TPX safety analysis, including the basis for using Department of Energy (DOE) Order 5480.23 and DOE-STD-3009-94 in the development of the PSAR

  11. Survey of pediatric MDCT radiation dose from university hospitals in Thailand. A preliminary for national dose survey

    Energy Technology Data Exchange (ETDEWEB)

    Kritsaneepaiboon, Supika [Dept. of Radiology, Faculty of Medicine, Prince of Songkla Univ., Hat Yai (Thailand)], e-mail: supikak@yahoo.com; Trinavarat, Panruethai [Dept. of Radiology, Faculty of Medicine, Chulalongkorn Univ., Bangkok (Thailand); Visrutaratna, Pannee [Dept. of Radiology, Faculty of Medicine, Chiang Mai Univ., Chiang Mai (Thailand)

    2012-09-15

    Background: Increasing pediatric CT usage worldwide needs the optimization of CT protocol examination. Although there are previous published dose reference level (DRL) values, the local DRLs should be established to guide for clinical practice and monitor the CT radiation. Purpose: To determine the multidetector CT (MDCT) radiation dose in children in three university hospitals in Thailand in four age groups using the CT dose index (CTDI) and dose length product (DLP). Material and Methods: A retrospective review of CT dosimetry in pediatric patients (<15 years of age) who had undergone head, chest, and abdominal MDCT in three major university hospitals in Thailand was performed. Volume CTDI (CTDIvol) and DLP were recorded, categorized into four age groups: <1 year, 1- < 5 years, 5- <10 years, and 10- <15 years in each scanner. Range, mean, and third quartile values were compared with the national reference dose levels for CT in pediatric patients from the UK and Switzerland according to International Commission on Radiological Protection (ICRP) recommendation. Results: Per age group, the third quartile values for brain, chest, and abdominal CTs were, respectively, in terms of CTDIvol: 25, 30, 40, and 45 mGy; 4.5, 5.7, 10, and 15.6 mGy; 8.5, 9, 14, and 17 mGy; and in terms of DLP: 400, 570, 610, and 800 mGy cm; 80, 140, 305, and 470 mGy cm; and 190, 275, 560,765 mGy cm. Conclusion: This preliminary national dose survey for pediatric CT in Thailand found that the majority of CTDIvol and DLP values in brain, chest, and abdominal CTs were still below the diagnostic reference levels (DRLs) from the UK and Switzerland regarding to ICRP recommendation.

  12. Anesthesia Experiences During Magnetic Imaging Process on Pediatric Patients

    OpenAIRE

    Öztürk, Ömür; Üstebay, Sefer; Bilge, Ali

    2017-01-01

    We aim to study the quality of sedation and complications ratios during anesthesia applied with sodium thiopental and propofol and the reason of the magnetic imaging requests on pediatric patients retrospectively according to the hospital data. Material and Method: In this study, 109 patients, aged from 3 months to 5 years, that have been applied magnetic imaging process under anesthesia, have been examined retrospectively. Results: Pentotal sodium has been applied to 53 patients and propofol...

  13. Pediatric gastric volvulus--experience with 7 cases.

    OpenAIRE

    Park, W. H.; Choi, S. O.; Suh, S. J.

    1992-01-01

    Gastric volvulus, organoaxial or mesenterioaxial, is a rare condition in infancy and childhood. We experienced 7 cases of pediatric gastric volvulus, consisting of 3 cases of secondary gastric volvulus due to left diaphragmatic eventration or paraesophageal hernia and 4 cases of idiopathic gastric volvulus. Of 7 cases, five were organoaxial in type and two were mesenterioaxial. The main symptoms of secondary gastric volvulus were vomiting and respiratory difficulty whereas those of idiopathic...

  14. Global general pediatric surgery partnership: The UCLA-Mozambique experience.

    Science.gov (United States)

    Amado, Vanda; Martins, Deborah B; Karan, Abraar; Johnson, Brittni; Shekherdimian, Shant; Miller, Lee T; Taela, Atanasio; DeUgarte, Daniel A

    2017-09-01

    There has been increasing recognition of the disparities in surgical care throughout the world. Increasingly, efforts are being made to improve local infrastructure and training of surgeons in low-income settings. The purpose of this study was to review the first 5-years of a global academic pediatric general surgery partnership between UCLA and the Eduardo Mondlane University in Maputo, Mozambique. A mixed-methods approach was utilized to perform an ongoing needs assessment. A retrospective review of admission and operative logbooks was performed. Partnership activities were summarized. The needs assessment identified several challenges including limited operative time, personnel, equipment, and resources. Review of logbooks identified a high frequency of burn admissions and colorectal procedures. Partnership activities focused on providing educational resources, on-site proctoring, training opportunities, and research collaboration. This study highlights the spectrum of disease and operative case volume of a referral center for general pediatric surgery in sub-Saharan Africa, and it provides a context for academic partnership activities to facilitate training and improve the quality of pediatric general surgical care in limited-resource settings. Level IV. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. The first experience of mobile pediatric palliative team in Ukraine

    Directory of Open Access Journals (Sweden)

    O. О. Riga

    2016-12-01

    Full Text Available The aim of the study was to identify needs among young children with life-limiting diseases under 4 years old and their parents living in rural area of Kharkiv region Ukraine during home visiting. Materials and methods. After the creation of the first mobile pediatric palliative team, we reviewed the visits of 31 families at home to define their clinical, and psychological, and social needs. The first mobile pediatric palliative care team has been created for 2015. 31 families who have young children with life –threating diseases were visited to determine their clinical, and psychological, and social needs. Results. All children (31 had severe pathology of the central nervous system: congenital birth defects (29 %; cerebral palsy (35.4 %; genetic disorders (12.9 %. Parental and children’s needs were divided into three categories. Medical needs: orthopedic (93.5 %, vaccination (93.5 %, food (80.6 %, posture (61.3 %, salivation (32.2 %, anticonvulsant therapy (16 %. Psychological problems: communication with siblings (100 %; socialization of children (90.3 %; sensory activity (83.8 %, parental relationships (74.2 %. Social issues: the need for support/social worker or volunteers (58.1 %, poverty (58.1 %, communication with local rehabilitation centers (54.8 %, the need for medical equipment (41.9 %. Along with high medical, social and psychological needs of children with incurable diseases, both they and their families feel the lack of pediatric palliative care, and at present they have no access to it. The authors suggest that pediatric palliative care in Ukraine requires its development, application and inclusion in the general health care at all levels of the health system. The establishment of a national concept of modern educational programs, protocols and standards, dissemination of public information communities is also very necessary due to author’s point of view. Conclusions. Mobile team that performs home visits may be one of the

  16. A phenomenologic investigation of pediatric residents' experiences being parented and giving parenting advice.

    Science.gov (United States)

    Bax, A C; Shawler, P M; Blackmon, D L; DeGrace, E W; Wolraich, M L

    2016-09-01

    Factors surrounding pediatricians' parenting advice and training on parenting during residency have not been well studied. The primary purpose of this study was to examine pediatric residents' self-reported experiences giving parenting advice and explore the relationship between parenting advice given and types of parenting residents received as children. Thirteen OUHSC pediatric residents were individually interviewed to examine experiences being parented and giving parenting advice. Phenomenological methods were used to explicate themes and secondary analyses explored relationships of findings based upon Baumrind's parenting styles (authoritative, authoritarian, permissive). While childhood experiences were not specifically correlated to the parenting advice style of pediatric residents interviewed, virtually all reported relying upon childhood experiences to generate their advice. Those describing authoritative parents reported giving more authoritative advice while others reported more variable advice. Core interview themes related to residents' parenting advice included anxiety about not being a parent, varying advice based on families' needs, and emphasis of positive interactions and consistency. Themes related to how residents were parented included discipline being a learning process for their parents and recalling that their parents always had expectations, yet always loved them. Pediatric residents interviewed reported giving family centered parenting advice with elements of positive interactions and consistency, but interviews highlighted many areas of apprehension residents have around giving parenting advice. Our study suggests that pediatric residents may benefit from more general educational opportunities to develop the content of their parenting advice, including reflecting on any impact from their own upbringing.

  17. Professional carers' experiences of providing a pediatric palliative care service in Ireland.

    Science.gov (United States)

    Clarke, Jean; Quin, Suzanne

    2007-11-01

    In this article the authors present findings on professional carers' experience of providing pediatric palliative care to children with life-limiting conditions. For this qualitative study, part of a national pediatric palliative care needs analysis, the authors engaged in 15 focus group interviews and drew on the responses of open-ended questions to give voice to the experiences of professional carers and to situate the humanity of their caring reality. This humanity is articulated through three themes: clarity of definition and complexity of engagement, seeking to deliver a palliative care service, and the emotional cost of providing palliative care. Further analysis of these themes points to a work-life experience of skilled and emotional engagement with children, and their parents, in complex processes of caregiving and decision making. Pediatric palliative care occurs in an environment where parents shoulder a large burden of the care and professionals find themselves working in underresourced services.

  18. Experiences of four parents with physical therapy and early mobility of their children in a pediatric critical care unit: A case series.

    Science.gov (United States)

    Parisien, Rachel B; Gillanders, Kirstie; Hennessy, Erin K; Herterich, Lisa; Saunders, Kendra; Lati, Jamil; Dos Santos, Stephanie; Hassall, Alison; O'Brien, Kelly K

    2016-05-31

    The aim of this study was to conduct a preliminary investigation into parents' experiences of physical therapy and early mobility (EM) for their children in a pediatric critical care unit (PCCU). We conducted a series of four qualitative case studies using in-depth semi-structured face-to-face interviews. We recruited parents of children who had undergone surgery and received at least one EM physical therapy intervention while intubated. We conducted a thematic analysis of transcribed interviews to illuminate the factors that influenced EM experiences. Four parents participated in the study. We developed an overview of Parental Experiences with Physical Therapy and Early Mobility in a PCCU, which includes four themes that parents believed influenced their experiences: (1) environmental factors; (2) awareness of physical therapist and health care professional (HCP) roles; (3) communication among parents and HCPs; and (4) parental participation in their child's EM, within the overarching parental experiences in the PCCU. This study affords a preliminary understanding of parents' experiences with physical therapy and EM in a PCCU setting. Results provide an important foundation for future research on mobility in the context of pediatric critical care research and practice.

  19. Early Experience with Biodegradable Fixation of Pediatric Mandibular Fractures

    OpenAIRE

    Mazeed, Ahmed Salah; Shoeib, Mohammed Abdel-Raheem; Saied, Samia Mohammed Ahmed; Elsherbiny, Ahmed

    2014-01-01

    This clinical study aims to evaluate the stability and efficiency of biodegradable self-reinforced poly-l/dl-lactide (SR-PLDLA) plates and screws for fixation of pediatric mandibular fractures. The study included 12 patients (3–12 years old) with 14 mandibular fractures. They were treated by open reduction and internal fixation by SR-PLDLA plates and screws. Maxillomandibular fixation was maintained for 1 week postoperatively. Clinical follow-up was performed at 1 week, 6 weeks, 3 months, and...

  20. Preliminary report on a glass burial experiment in granite

    International Nuclear Information System (INIS)

    Clark, D.E.; Zhu, B.F.; Robinson, R.S.; Wicks, G.G.

    1983-01-01

    Preliminary results of a two-year burial experiment in granite are discussed. Three compositions of simulated alkali borosilicate waste glasses were placed in boreholes approximately 350 meters deep. The glass sample configurations include mini-cans (stainless steel rings into which glass has been cast) and pineapple slices (thin sections from cylindrical blocks). Assemblies of these glass samples were prepared by stacking them together with granite, compacted bentonite and metal rings to provide several types of interfaces that are expected to occur in the repository. The assemblies were maintained at either ambient mine temperature (8 to 10 0 C) or 90 0 C. The glasses were analyzed before burial and after one month storage at 90 0 C. The most extensive surface degradation occurred on the glasses interfaced with bentonite. In general, very little attack was observed on glass surfaces in contact with the other materials. The limited field and laboratory data are compared

  1. Early Experience with Biodegradable Fixation of Pediatric Mandibular Fractures.

    Science.gov (United States)

    Mazeed, Ahmed Salah; Shoeib, Mohammed Abdel-Raheem; Saied, Samia Mohammed Ahmed; Elsherbiny, Ahmed

    2015-09-01

    This clinical study aims to evaluate the stability and efficiency of biodegradable self-reinforced poly-l/dl-lactide (SR-PLDLA) plates and screws for fixation of pediatric mandibular fractures. The study included 12 patients (3-12 years old) with 14 mandibular fractures. They were treated by open reduction and internal fixation by SR-PLDLA plates and screws. Maxillomandibular fixation was maintained for 1 week postoperatively. Clinical follow-up was performed at 1 week, 6 weeks, 3 months, and 12 months postoperatively. Radiographs were done at 1 week, 3 months, and 12 months postoperatively to observe any displacement and fracture healing. All fractures healed both clinically and radiologically. No serious complications were reported in the patients. Normal occlusion was achieved in all cases. Biodegradable osteofixation of mandibular fractures offers a valuable clinical solution for pediatric patients getting the benefit of avoiding secondary surgery to remove plates, decreasing the hospital stay, further painful procedures, and psychological impact.

  2. Preliminary Validation of a Screening Tool for Adolescent Panic Disorder in Pediatric Primary Care Clinics

    Science.gov (United States)

    Queen, Alexander H.; Ehrenreich-May, Jill; Hershorin, Eugene R.

    2012-01-01

    This study examines the validity of a brief screening tool for adolescent panic disorder (PD) in a primary care setting. A total of 165 participants (ages 12-17 years) seen in two pediatric primary care clinics completed the Autonomic Nervous System Questionnaire (ANS; Stein et al. in Psychosomatic Med 61:359-364, 40). A subset of those screening…

  3. Preliminary results from initial in-pile debris bed experiments

    International Nuclear Information System (INIS)

    Rivard, J.B.

    1977-01-01

    An accident in a liquid metal fast breeder reactor (LMFBR) in which molten core material is suddenly quenched with subcooled liquid sodium could result in extensive fragmentation and dispersal of fuel as subcritical beds of frozen particulate debris within the reactor vessel. Since this debris will continue to generate power due to decay of retained fission products, containment of the debris is threatened if the generated heat is not removed. Therefore, the initial safety question is the capacity which debris beds may have for transfer of the decay heat to overlying liquid sodium by natural processes--i.e., without the aid of forced circulation of the coolant. Up to the present time, all experiments on debris bed behavior either have used substitute materials (e.g., sand and water) or have employed actual materials, but atypical heating methods. Increased confidence in the applicability of debris bed simulations is afforded if the heat is generated within the fuel component of the appropriate fast reactor materials. The initial series of in-pile tests reported on herein constitutes the first experiments in which the internal heating mode has been produced in particulate oxide fuel immersed in liquid sodium. Fission heating of the fully-enriched UO 2 in the experiment while it is contained within Sandia Laboratories Annular Core Pulse Reactor (ACPR), operating in its steady-state mode, approximates the decay heating of debris. Preliminary results are discussed

  4. The learning experiences of student nurses in pediatric medication management: a qualitative study.

    Science.gov (United States)

    Lin, Fang-Yi; Wu, Wei-Wen; Lin, Hung-Ru; Lee, Tzu-Ying

    2014-05-01

    Traditionally, the 'five rights' (right patient, right route, right drug, right time, and right dose) principle is taught to be practiced during every medication administration process. Nursing educators use this principle to evaluate student performance. However, health care unit factors and education system characteristics that can contribute to student errors should not be underestimated. Students often felt stressed when medicating children during clinical practicum. The voices of these students are rarely represented. To understand students' experiences and perceptions of medication administration during their pediatric clinical practicum. A descriptive qualitative study design was adopted. A university in Northern Taiwan. A total of 34 undergraduate students who had completed a pediatric clinical practicum participated in a one-on-one interview. Each student was interviewed according to a semi-structured interview guide and was encouraged to disclose individual feelings and thoughts toward their experiences in pediatric medication administration. Eight themes emerged. The findings suggest that to decrease students' anxiety and increase their competence, pediatric instructors should improve their teaching strategies to better prepare students for clinical training. Providing self-directed learning activities and resources to improve students' familiarity with medication and medication safety knowledge is necessary. Instructors should provide students with a secure environment to discuss their medication errors. The 'nine rights' should be taught in fundamental nursing courses to enhance students' awareness during the medication administration process, and students should continue to practice the 'nine rights' in later pediatric clinical courses. Equal importance should be given to system failures that impact patient safety. © 2013.

  5. Treatment of pediatric uveitis with adalimumab: the MERSI experience.

    Science.gov (United States)

    Castiblanco, Claudia; Meese, Halea; Foster, C Stephen

    2016-04-01

    To evaluate adalimumab therapy in children with uveitis. The electronic health records of pediatric patients diagnosed with uveitis and treated with adalimumab therapy were reviewed retrospectively. Demographic information, site and degree of intraocular inflammation, visual acuity, underlying systemic disorders, duration of therapy, side effects, and ability to obtain steroid-free remission were recorded. A total of 17 patients were included, 16 patients with anterior uveitis and 1 with panuveitis; 14 patients had bilateral disease. Juvenile idiopathic arthritis had been diagnosed in 14 patients, sarcoidosis in 1 patient, and idiopathic etiology in 2 patients. Of the 17 patients, 13 (about 77%) achieved steroid-free remission, and 4 did not. Six patients flared after discontinuation of adalimumab, with evidence of inflammation noted 3-7 months later. Adalimumab therapy was of 12-64 months' duration (mean, 36 months). At the time of initiation, 14 patients were using other agents concomitantly with adalimumab; 3 patients were on adalimumab monotherapy. At 1 year's follow-up, 12 patients were using combination therapy, and 3 patients were on adalimumab monotherapy: 11 patients had no evidence of inflammation. Side effects included pain at site of injection in 3 patients, anemia in 1 patient, and depression in 1 patient. In our study cohort, adalimumab was effective in inducing steroid-free remission. It was well tolerated, especially in combination with other immunomodulatory agents. The dosing and the interval can be adjusted to further improve inflammation control. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  6. Pediatric colonic volvulus: A single-institution experience and review.

    Science.gov (United States)

    Tannouri, Sami; Hendi, Aditi; Gilje, Elizabeth; Grissom, Leslie; Katz, Douglas

    2017-06-01

    Pediatric colonic volvulus is both rare and underreported. Existing literature consists only of case reports and small series. We present an analysis of cases (n=11) over 15 years at a single institution, focusing on workup and diagnosis. This was an institutional review board approved single-institution retrospective chart review of 11 cases of large bowel volvulus occurring over 15 years (2000-2015). In our series, the most common presenting symptoms were abdominal pain and distention. Afflicted patients often had prior abdominal surgery, a neurodevelopmental disorder or chronic constipation. Of the imaging modalities utilized in the 11 patients studied, colonic volvulus was correctly diagnosed by barium enema in 100% of both cases, CT in 55.6% of cases and by plain radiography of the abdomen in only 22.2%of cases. Colonic volvulus was confirmed by laparotomy in all cases. The cecum (n=5) was the most often affected colonic segment, followed by the sigmoid (n=3). Operative treatment mainly consisted of resection (63.6%) and ostomy creation (36.4%). Colopexy was performed in 18.2% of cases. Plain abdominal radiography may be performed as an initial diagnostic study, however, it should be followed CT or air or contrast enema in children where there is high clinical suspicion and who do not have indications for immediate laparotomy. CT may be the most specific and useful test in diagnosis of colonic volvulus and has the added advantage of detection of complications including bowel ischemia. We demonstrate a range of diagnostic and therapeutic modalities for pediatric colonic volvulus. This underscores the need for further study to draft standard best practices for this life-threatening condition. Prognosis Study: Level IV. Study of a Diagnostic Test: Level III. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Results of preliminary experiments on tritium decontamination by UV irradiation

    International Nuclear Information System (INIS)

    Oya, Yasuhisa; Shu, Wataru; O'hira, Shigeru; Hayashi, Takumi; Nishi, Masataka

    2000-03-01

    In the point of view of protection of workers from the radiation exposure and the limitation of the contamination with radioactive materials, it is important to decontaminate mobile tritium from plasma facing components of a nuclear fusion reactor at the beginning of their maintenance work. It is considered that the heating is the most effective method for decontamination. However, it is important to develop new decontamination method of adsorbed hydro-carbon based substances from the materials that cannot be heated or the inner pipe of double pipes. This report presents results of preliminary experiments performed for the development of the effective tritium decontamination technique pursuing under US/Japan collaborative program on technology for fusion-fuel processing (Annex IV). In the experiments, the effects of Ultra Violet (UV) irradiation on tritium removal from some kinds of materials, such as poly vinyl chloride -(CH 2 CHCl) n - film, polyethylene film and graphite samples coated by C 2 H 2 plasma were examined. As the result of UV irradiation, it was confined that hydrogen and carbon based compounds could be released from the specimen during UV irradiation. It is concluded that UV irradiation is one of the hopeful candidates for effective tritium decontamination. (author)

  8. The experiences of pediatric social workers providing end-of-life care.

    Science.gov (United States)

    Muskat, Barbara; Brownstone, David; Greenblatt, Andrea

    2017-07-01

    Pediatric social workers working in acute care hospital settings may care for children and their families in end-of-life circumstances. This qualitative study is part of a larger study focusing on the experiences of health care providers working with dying children. This study consisted of 9 semi-structured interviews of acute care pediatric social workers who work with dying children and their families. Themes included the role of social work with dying children, the impact of their work and coping strategies. Authors suggest a hospital-worker partnership in supporting staff and promotion of supportive resources.

  9. Experience with endoscopic holmium laser in the pediatric population

    Science.gov (United States)

    Merguerian, Paul A.; Reddy, Pramod P.; Barrieras, Diego; Bagli, Darius J.; McLorie, Gordon A.; Khoury, Antoine E.

    1999-06-01

    Introduction: Due to the unavailability of suitable endoscopic instruments, pediatric patients have not benefited fully from the technological advances in the endoscopic management of the upper urinary tract. This limitation may be overcome with the Holmuim:Yttrium-Aluminum-Garnet(Ho:YAG) laser delivered via small instruments. To date, there is no published report on the use of this modality in children. Purpose: We evaluated the indications, efficacy, and complications of endourological Ho:YAG laser surgery in the treatment of pediatric urolithiasis, posterior urethral valves, ureterocele and ureteropelvic junction obstruction. Methods: The patient population included 10 children with renal, ureteral and bladder calculi, 2 children with posterior urethral valves, 2 children with obstructing ureteroceles, 2 children with ureteropelvic junction obstruction and 1 child with a urethral stricture. Access to the lesions was either antegrade via a percutaneous nephrostomy tract or retrograde via the urethra. A solid state Ho:YAG laser with maximum output of 30 watts (New Star lasers, Auburn, CA) was utilized as the energy source. Results: A total of 10 patients underwent laser lithotripsy. The means age of the patients was 9 yrs (5-13 yrs). The average surface area of the calculi as 425.2 mm2 (92-1645 mm2). 8 of the patients required one procedure to render them stone free, one patient had a staghorn calculus filling every calyx of a solitary kidney requiring multiple treatments and one other patient with a staghorn calculus required 2 treatments. There were no complications related to the laser lithotripsy. Two newborn underwent successful ablation of po sterious urethral valves. Two infants underwent incision of obstructing ureteroceles with decompression of the ureterocele on postoperative ultrasound. Two children underwent endypyelotomy for ureteropelvic junction obstruction. One was successful an done required an open procedure to correct the obstruction. One child

  10. Advanced Practice Nursing in Pediatric Urology: experience report in the Federal District.

    Science.gov (United States)

    Souza, Bruna Marcela Lima de; Salviano, Cristiane Feitosa; Martins, Gisele

    2018-01-01

    To describe the creation and implementation of the extension program Advanced Practice Nursing in Pediatric Urology, developed in the outpatient clinic of a teaching hospital in the Federal District. This is an experience report regarding the implementation of an outpatient service aimed at children and adolescents with symptoms of bladder and bowel dysfunction. Because it is an extension program linked to the university, it follows a different model of care, valuing empowerment, informed and shared decision making, which results in a stronger bond between patients, family and the Pediatric Urology nursing team. It has also become a privileged space for the production and use of scientific knowledge, associated with the principles of evidence-based practice. This project shows a different performance of the nurse-specialist-professor-researcher in Pediatric Urology Nursing, and it has become a reference in the Federal District, mainly for undergraduate and graduate nursing students.

  11. Advanced Practice Nursing in Pediatric Urology: experience report in the Federal District

    Directory of Open Access Journals (Sweden)

    Bruna Marcela Lima de Souza

    Full Text Available ABSTRACT Objective: To describe the creation and implementation of the extension program Advanced Practice Nursing in Pediatric Urology, developed in the outpatient clinic of a teaching hospital in the Federal District. Method: This is an experience report regarding the implementation of an outpatient service aimed at children and adolescents with symptoms of bladder and bowel dysfunction. Results: Because it is an extension program linked to the university, it follows a different model of care, valuing empowerment, informed and shared decision making, which results in a stronger bond between patients, family and the Pediatric Urology nursing team. It has also become a privileged space for the production and use of scientific knowledge, associated with the principles of evidence-based practice. Conclusion: This project shows a different performance of the nurse-specialist-professor-researcher in Pediatric Urology Nursing, and it has become a reference in the Federal District, mainly for undergraduate and graduate nursing students.

  12. Iranian pediatric nurse's experience: The facilitators of the learning of ethical practices

    Directory of Open Access Journals (Sweden)

    Kobra Karami

    2017-01-01

    Full Text Available Background: Ethical care is a core value in nursing. Pediatric nurses are in direct and continuous contact with children and their parents. They manage their lives and health. As part of the pediatric nurses' daily work, ethical issues play an important role in making decisions, are important to make decisions, and this capability is only achieved by ethical practice. This study aimed to explore the factors facilitating the learning of ethical practice among Iranian pediatric nurses. Materials and Methods: This study is a conventional qualitative content analysis based on the Graneheim and Lundman method. It was conducted through semi-structured interviews with two focus groups, incorporating 28 nurses working in pediatric wards. Unstructured observation and field notes were other methods of data collection. Purposive sampling continued until data saturation was ensured. All interviews were tape recorded and transcribed in verbatim. Results: Three main categories and 12 subcategories emerged from this study. The facilitating factors include (1 individual competencies (knowledge, experience, emotional intelligence, and loving children, (2 ethical imprinting (responsibility, reflection, empathy, and ethical beliefs, and (3 an environment that nurtures moral values (organizational, spiritual, family, and cultural environments as facilitating factors. Conclusions: The promotion of nurses' competencies, ethical virtues, and imprinting, as well as improvement of the quality of nursing care must be the top priority of the health team. Undoubtedly, the success of the health care system is not possible without ensuring that pediatric nurses learn ethical practices.

  13. [Thyroid carcinoma:Experience 57 cases. Is there a different bio-development in pediatric age?].

    Science.gov (United States)

    Abad, P; Martínez Ibáñez, V; Galofré, P; Lloret, J; Boix-Ochoa, J

    2003-01-01

    It has been suggested a different biodevelopment in the differentiated thyroid cancer in pediatric age. General and pediatric surgeons from different centres has coincided to operate this kind of pediatric pathology that finally conclude the treatment in the nuclear medicine department from the reference hospital. The objectives of this revision is, to confirm de difference in thyroid cancer in pediatric age and to know few factors implicated. A review of 57 patients with differentiated thyroid cancer, medullary and anaplastic were excluded, treated in the nuclear medicine department during the last 20 years. 28% were 10 years old (41 cases). This 57 young patients were operated in 22 hospitals and 79% by a general surgeon and 21% by pediatric surgeon. The analysis was performed with SPSS MS Windows 6.0 (chi cuadrado, t-Student-Fisher). There are more reinterventions in patients operated by a general surgeon. There aren't differences between the number of total neck dissections between both groups of surgeons, but when is performed, the incidence of complications is significantly high. In patients < 10 years old, there are more metastasis and more surgical complications. In spite of, all patients still alive. Children < 10 years old, the illness is more local aggressive and the recurrence and lung metastasis is high, more surgical complications. We recommend to concentrate this pathology in a few hospitals to achieve more experience and to avoid complications.

  14. Pre-clinical medical student experience in a pediatric pulmonary clinic

    Directory of Open Access Journals (Sweden)

    Thomas G. Saba

    2015-11-01

    Full Text Available Objective: Our objective was to evaluate the educational value of introducing pre-clinical medical students to pediatric patients and their families in a subspecialty clinic setting. Methods: First- and second-year medical students at the University of Michigan seeking clinical experience outside of the classroom attended an outpatient pediatric pulmonary clinic. Evaluation of the experience consisted of pre- and post-clinic student surveys and post-clinic parent surveys with statements employing a four-point Likert scale as well as open-ended questions. Results: Twenty-eight first-year students, 6 second-year students, and 33 parents participated in the study. Post-clinic statement scores significantly increased for statements addressing empathic attitudes, confidence communicating with children and families, comfort in the clinical environment, and social awareness. Scores did not change for statements addressing motivation, a sense of team membership, or confidence with career goals. Students achieved their goals of gaining experience interacting with patients, learning about pulmonary diseases, and observing clinic workflow. Parents felt that they contributed to student education and were not inconvenienced. Conclusions: Students identified several educational benefits of exposure to a single pediatric pulmonary clinic. Patients and families were not inconvenienced by the participation of a student. Additional studies are warranted to further investigate the value of this model of pre-clinical medical student exposure to subspecialty pediatrics.

  15. Safety and feasibility of inpatient exercise training in pediatric heart failure: a preliminary report.

    Science.gov (United States)

    McBride, Michael G; Binder, Tracy Jo; Paridon, Stephen M

    2007-01-01

    To determine the safety and feasibility of an inpatient exercise training program for a group of pediatric heart transplantation candidates on multiple inotropic support. Children with end-stage heart disease often require heart transplantation. Currently, no data exist on the safety and feasibility of an inpatient exercise training program in pediatric patients awaiting heart transplantation while on inotropic support. Twenty ambulatory patients (11 male; age, 13.6 +/- 3.2 years) were admitted, listed, and subsequently enrolled into an exercise training program while awaiting heart transplantation. Patient diagnoses consisted of dilated cardiomyopathy (n = 15), restrictive cardiomyopathy (n = 1), and failing single-ventricle physiology (n = 4). Inotropic support consisted of a combination of dobutamine, dopamine, or milrinone. Exercise sessions were scheduled three times a week lasting from 30 to 60 minutes and consisted of aerobic and musculoskeletal conditioning. Over 6.2 +/- 4.2 months, 1,251 of a possible 1,508 exercise training sessions were conducted, with a total of 615 hours (26.3 +/- 2.7 min/session) dedicated to low-intensity aerobic exercise. Reasons for noncompliance included a change in medical status, staffing, or patient cooperation. Two adverse episodes (seizures) occurred, neither of which resulted in termination from the program. No adverse episodes of hypotension or significant complex arrhythmias occurred. No complication of medication administration or loss of intravenous access occurred. Data from this study indicate that pediatric patients on inotropic support as a result of systemic ventricular or biventricular heart failure can safely participate in exercise training programs with relatively moderate to high compliance.

  16. DNA Methylation in Pediatric Obstructive Sleep Apnea: An Overview of Preliminary Findings.

    Science.gov (United States)

    Perikleous, Evanthia; Steiropoulos, Paschalis; Tzouvelekis, Argyris; Nena, Evangelia; Koffa, Maria; Paraskakis, Emmanouil

    2018-01-01

    Obstructive sleep apnea (OSA) is characterized by phenotypic variations, which can be partly attributed to specific gene polymorphisms. Recent studies have focused on the role of epigenetic mechanisms in order to permit a more precise perception about clinical phenotyping and targeted therapies. The aim of this review was to synthesize the current state of knowledge on the relation between DNA methylation patterns and the development of pediatric OSA, in light of the apparent limited literature in the field. We performed an electronic search in PubMed, EMBASE, and Google Scholar databases, including all types of articles written in English until January 2017. Literature was apparently scarce; only 2 studies on pediatric populations and 3 animal studies were identified. Forkhead Box P3 (FOXP3) DNA methylation levels were associated with inflammatory biomarkers and serum lipids. Hypermethylation of the core promoter region of endothelial Nitric Oxide Synthase (eNOS) gene in OSA children were related with decreased eNOS expression. Additionally, increased expression of genes encoding pro-oxidant enzymes and decreased expression of genes encoding anti-oxidant enzymes suggested that disturbances in oxygen homeostasis throughout neonatal period predetermined increased hypoxic sensing in adulthood. In conclusion, epigenetic modifications may be crucial in pediatric sleep disorders to enable in-depth understanding of genotype-phenotype interactions and lead to risk assessment. Epigenome-wide association studies are urgently needed to validate certain epigenetic alterations as reliable, novel biomarkers for the molecular prognosis and diagnosis of OSA patients with high risk of end-organ morbidity.

  17. DNA Methylation in Pediatric Obstructive Sleep Apnea: An Overview of Preliminary Findings

    Directory of Open Access Journals (Sweden)

    Evanthia Perikleous

    2018-05-01

    Full Text Available Obstructive sleep apnea (OSA is characterized by phenotypic variations, which can be partly attributed to specific gene polymorphisms. Recent studies have focused on the role of epigenetic mechanisms in order to permit a more precise perception about clinical phenotyping and targeted therapies. The aim of this review was to synthesize the current state of knowledge on the relation between DNA methylation patterns and the development of pediatric OSA, in light of the apparent limited literature in the field. We performed an electronic search in PubMed, EMBASE, and Google Scholar databases, including all types of articles written in English until January 2017. Literature was apparently scarce; only 2 studies on pediatric populations and 3 animal studies were identified. Forkhead Box P3 (FOXP3 DNA methylation levels were associated with inflammatory biomarkers and serum lipids. Hypermethylation of the core promoter region of endothelial Nitric Oxide Synthase (eNOS gene in OSA children were related with decreased eNOS expression. Additionally, increased expression of genes encoding pro-oxidant enzymes and decreased expression of genes encoding anti-oxidant enzymes suggested that disturbances in oxygen homeostasis throughout neonatal period predetermined increased hypoxic sensing in adulthood. In conclusion, epigenetic modifications may be crucial in pediatric sleep disorders to enable in-depth understanding of genotype-phenotype interactions and lead to risk assessment. Epigenome-wide association studies are urgently needed to validate certain epigenetic alterations as reliable, novel biomarkers for the molecular prognosis and diagnosis of OSA patients with high risk of end-organ morbidity.

  18. Validation of the Child HCAHPS survey to measure pediatric inpatient experience of care in Flanders.

    Science.gov (United States)

    Bruyneel, Luk; Coeckelberghs, Ellen; Buyse, Gunnar; Casteels, Kristina; Lommers, Barbara; Vandersmissen, Jo; Van Eldere, Johan; Van Geet, Chris; Vanhaecht, Kris

    2017-07-01

    The recently developed Child HCAHPS provides a standard to measure US hospitals' performance on pediatric inpatient experiences of care. We field-tested Child HCAHPS in Belgium to instigate international comparison. In the development stage, forward/backward translation was conducted and patients assessed content validity index as excellent. The draft Flemish Child HCAHPS included 63 items: 38 items for five topics hypothesized to be similar to those proposed in the US (communication with parent, communication with child, attention to safety and comfort, hospital environment, and global rating), 10 screeners, a 14-item demographic and descriptive section, and one open-ended item. A 6-week pilot test was subsequently performed in three pediatric wards (general ward, hematology and oncology ward, infant and toddler ward) at a JCI-accredited university hospital. An overall response rate of 90.99% (303/333) was achieved and was consistent across wards. Confirmatory factor analysis largely confirmed the configuration of the proposed composites. Composite and single-item measures related well to patients' global rating of the hospital. Interpretation of different patient experiences across types of wards merits further investigation. Child HCAHPS provides an opportunity for systematic and cross-national assessment of pediatric inpatient experiences. Sharing and implementing international best practices are the next logical step. What is Known: • Patient experience surveys are increasingly used to reflect on the quality, safety, and centeredness of patient care. • While adult inpatient experience surveys are routinely used across countries around the world, the measurement of pediatric inpatient experiences is a young field of research that is essential to reflect on family-centered care. What is New: • We demonstrate that the US-developed Child HCAHPS provides an opportunity for international benchmarking of pediatric inpatient experiences with care through parents

  19. Contrast-enhanced ultrasound for extrahepatic lesions: preliminary experience

    Energy Technology Data Exchange (ETDEWEB)

    Thorelius, Lars E-mail: lars@thorelius.com

    2004-06-01

    Ultrasound imaging (US) is a convenient, inexpensive and non-invasive investigation. Its use is limited by low sensitivity in the detection of a number of parenchymal lesions, especially those produced by trauma, such as infarctions. Contrast enhancement with SonoVue{sup [reg]} improves the sensitivity of ultrasound in the detection and characterization of focal liver lesions to such an extent, that it may replace computed tomography (CT) and magnetic resonance imaging (MRI). Preliminary experience suggests that SonoVue-enhanced sonography may be useful in the detection of lesions in which blood flow is severely reduced as compared to surrounding parenchyma, such as infarctions, lacerations, hematomas, necrotic tissue and non-vascular cysts, especially in the spleen, kidney and pancreas. This technique can also rule out occlusion of the superior mesenteric, splenic and portal veins, and dilation of the biliary tree. Clinical trials comparing contrast-enhanced sonography with contrast-enhanced computed tomography are warranted to establish the role of this inexpensive and non-invasive technique in the routine work-up of patients with abdominal trauma or presenting with sudden flank pain.

  20. A Preliminary Study of Sex Differences in Emotional Experience.

    Science.gov (United States)

    Reyes-Aguilar, Azalea; Barrios, Fernando A

    2016-04-01

    Evolutionary approaches have proposed that women possess an advantage over men in emotional functioning to promote attachment for child-rearing. Likewise, sex differences have been reported in traits such as personality and empathy, traits that likely modulate emotional processing. In this preliminary study, sex differences in emotional processing were analyzed, including empathy as a social emotion and personality traits, as well as whether there exist relationships between those measures. Young volunteers (N = 105) indicated the emotional valence, activation, and dominance that they experience in situations categorized as emotionally positive, negative, or neutral. The results of comparison between sexes supported the approach that women showed more sensitivity to high activation and dominance for positive emotions and empathy, and men were more sensitive to negative situations. Correlation analysis showed only one positive relationship between scores of Self-transcendence, a subscale of Temperament and Character Inventory, with activation scores of neutral situations, but not with emotionally charged situations, perhaps because emotions are context-dependent processes while personality traits are considered context-independent descriptions of habits. These findings should be replicated to enrich knowledge about problems in emotional processing. © The Author(s) 2016.

  1. [Percutaneous radiofrequency ablation of hepatic metastases. Preliminary experience].

    Science.gov (United States)

    De Baere, T; Elias, D; Ducreux, M; Dromain, C; Kuach, V; Gamal El Din, M; Sobotka, A; Lasser, P; Roche, A

    1999-11-01

    To evaluate the efficiency of percutaneous radiofrequency ablation in the treatment of liver metastases. Eighteen patients with 31 liver metastases, mainly from colorectal cancer, 10 - 35 mm in diameter (m = 23), underwent 26 courses of percutaneous radiofrequency ablation. Fifteen patients had previously undergone hepatectomy, and 3 patients had contra-indications to surgery. Imaging guidance was ultrasound in 21 patients, CT in 4 (tumors not seen with ultrasound), and both in 1. A generator working at 450 KHz with a maximum output power of 150 W was used to treat each lesion for 18 - 20 min. Treatment was monitored with real time ultrasound. Among the 12 patients followed more than 3 months, only one of the 24 treated lesions recurred after a mean follow up of 259 ¿ 109 days. Liver disease was controlled in 8 of the 12 patients after 90 - 509 days (m = 306). Among these 8 patients, 3 were tumor free after 559, 378 and 90 days, respectively; 2 died tumor free of non-tumoral disease (pulmonary embolism, digestive bleeding); 3 developed lung metastases treated with chemotherapy (n = 2) or surgery (n = 1). Three of the 12 patients had widespread hepatic tumor occurrence, and one patient died of these metastases. Six patients experienced mild skin burns, but no major complication was observed. Radiofrequency ablation of hepatic metastases appears safe and promising in this preliminary experience. Further investigation is needed.

  2. Evaluation of undergraduate clinical learning experiences in the subject of pediatric dentistry using critical incident technique

    Directory of Open Access Journals (Sweden)

    S Vyawahare

    2013-01-01

    Full Text Available Introduction: In pediatric dentistry, the experiences of dental students may help dental educators better prepare graduates to treat the children. Research suggests that student′s perceptions should be considered in any discussion of their education, but there has been no systematic examination of India′s undergraduate dental students learning experiences. Aim: This qualitative investigation aimed to gather and analyze information about experiences in pediatric dentistry from the students′ viewpoint using critical incident technique (CIT. Study Design: The sample group for this investigation came from all 240 3 rd and 4 th year dental students from all the four dental colleges in Indore. Using CIT, participants were asked to describe at least one positive and one negative experience in detail. Results: They described 308 positive and 359 negative experiences related to the pediatric dentistry clinic. Analysis of the data resulted in the identification of four key factors related to their experiences: 1 The instructor; 2 the patient; 3 the learning process; and 4 the learning environment. Conclusion: The CIT is a useful data collection and analysis technique that provides rich, useful data and has many potential uses in dental education.

  3. Evaluation of undergraduate clinical learning experiences in the subject of pediatric dentistry using critical incident technique.

    Science.gov (United States)

    Vyawahare, S; Banda, N R; Choubey, S; Parvekar, P; Barodiya, A; Dutta, S

    2013-01-01

    In pediatric dentistry, the experiences of dental students may help dental educators better prepare graduates to treat the children. Research suggests that student's perceptions should be considered in any discussion of their education, but there has been no systematic examination of India's undergraduate dental students learning experiences. This qualitative investigation aimed to gather and analyze information about experiences in pediatric dentistry from the students' viewpoint using critical incident technique (CIT). The sample group for this investigation came from all 240 3rd and 4th year dental students from all the four dental colleges in Indore. Using CIT, participants were asked to describe at least one positive and one negative experience in detail. They described 308 positive and 359 negative experiences related to the pediatric dentistry clinic. Analysis of the data resulted in the identification of four key factors related to their experiences: 1) The instructor; 2) the patient; 3) the learning process; and 4) the learning environment. The CIT is a useful data collection and analysis technique that provides rich, useful data and has many potential uses in dental education.

  4. Preliminary results of the XR2-1 experiment

    International Nuclear Information System (INIS)

    Gauntt, R.O.; Helmick, P.H.; Humphries, L.

    1996-01-01

    The XR2-1 (Ex-Reactor) experiment, investigating metallic core-melt relocation in boiling water reactor geometry, was performed on October 12, 1995, following two previous simpler XR1-series tests in August and November of 1993. The XR2-1 test made use of a highly detailed replication of the lower region of the BWR core, including the control blade and channel box structures, fuel rods, fuel canister nosepieces, control blade velocity limiter, and fuel support pieces, in order to investigate a key core melt progression uncertainty for BWR Station Blackout type accidents. The purpose of this experiment program is to examine the behavior of downward-draining molten metallic core materials in a severe reactor accident in a dry BWR core, and to determine conditions under which the molten materials drain out of the core region, or freeze to form blockages in the lower portion of the core. In the event that the draining metallic materials do not form stable blockages in the lower core region, and instead erode the lower core structures such as the lower core plate, then the subsequent core melt progression processes may proceed quite differently than was observed in the TMI-2 accident, with correspondingly different impact on vessel loading and vessel release behavior. The results of the Ex-Reactor tests are preliminary. All of the tests conducted have shown a significant degree of channel box destruction induced by the draining control blade materials. The XR2-1 test further showed that the draining zircaloy melt causes significant disruption of the fuel rod geometry. All of the tests have shown tendencies to form interim blockages as the melts temporarily freeze, but that these blockages re-melt, assisted by eutectic interactions, resulting in the sudden draining of accumulated metallic melt pools

  5. Preliminary design and definition of field experiments for welded tuff rock mechanics program

    International Nuclear Information System (INIS)

    Zimmerman, R.M.

    1982-06-01

    The preliminary design contains objectives, typical experiment layouts, definitions of equipment and instrumentation, test matrices, preliminary design predictive modeling results for five experiments, and a definition of the G-Tunnel Underground Facility (GTUF) at the Nevada Test Site where the experiments are to be located. Experiments described for investigations in welded tuff are the Small Diameter Heater, Unit Cell-Canister Scale, Heated Block, Rocha Slot, and Miniature Heater

  6. Health Disparities in Pediatric Asthma: Comprehensive Tertiary Care Center Experience.

    Science.gov (United States)

    Holmes, Laurens; Kalle, Fanta; Grinstead, Laura; Jimenez, Maritza; Murphy, Meghan; Oceanic, Pat; Fitzgerald, Diane; Dabney, Kirk

    2015-03-01

    Study conducted at Nemours /Alfred I. duPont Hospital for Children, Wilmington, DE 19803 BACKGROUND: Although the treatment and management of asthma hasimproved over time, incidence and prevalence among children continues to rise in the United States. Asthma prevalence, health services utilization, and mortality rate demonstrate remarkable disparities. The underlying causes of these disparities are not fully understood. We aimed to examine racial/ethnic variances in pediatric asthma prevalence/admission. We retrospectively reviewed data on 1070 patients and applied a cross-sectional design to assess asthma admission between 2010 and 2011. Information was available on race/ethnicity, sex, insurance status, severity of illness (SOI), and length of stay/hospitalization (LOS).Chi-square statistic was used for the association between race and other variables in an attempt to explain the racial/ethnic variance. The proportionate morbidity of asthma was highest amongCaucasians (40.92%) and African Americans (40.54%), intermediate among others (16.57%), and lowest among Asian (0.56%), American Indian/Alaska Native (0.28%), and Hawaiian Native/Pacific Islander (0.28%). Overall there were disparities by sex, with more boys (61.80%) diagnosed with asthma than girls (38.20%), χ2(7)=20.1, p=0.005. Insurance status, and SOI varied by race/ethnicity, but not LOS. Caucasian children were more likely to have private insurance, while African Americans and Hispanics were more likely to have public insurance (p<0.005). Asthma was more severe among non-Hispanic children, χ2(14)=154.6, p<0.001. While the overall readmission proportion was 2.8%, readmission significantly varied by race/ethnicity. Racial/ethnic disparities in asthma admission exist among children in the Delaware Valley. There were racial/ethnic disparities in insurance status, asthma severity, and sex differed by race/ethnicity, but not in length of hospitalization. © 2015 National Medical Association. Published by

  7. Administered activities of 18F-FDG PET clinics in pediatrics patients in Brazil- preliminary study

    International Nuclear Information System (INIS)

    Oliveira, Cassio Miri; Sa, Lidia V. de

    2013-01-01

    A survey was conducted among the Brazilian clinical PET, with the purpose of investigating the activities administered to pediatric oncology patients and assess whether significant differences between the protocols adopted. In addition, this survey can cooperate to the suggestion diagnostic reference levels (DRLs) in nuclear medicine. Although the methodology for delivering doses by most clinics be based on patient's weight, the results showed variations of up to 191, 6% between the activities administered in clinics, even for similar devices. The average value of the distribution of activities reported was 4.46 ± 1,6 MBq /kg. These data demonstrate the need for harmonization and optimization of 18 F-FDG/PET procedures, as well as training for professionals involved in the clinical routine

  8. Treatment of unicameral bone cysts in pediatric patients with an injectable regenerative graft: a preliminary report.

    Science.gov (United States)

    Gentile, John V; Weinert, Carl R; Schlechter, John A

    2013-01-01

    Multiple treatment modalities exist for unicameral bone cysts (UBC), including steroid injection, autologous bone marrow injection, mechanical decompression, intramedullary fixation, curettage, and bone grafting. All have their own potential limitations such as high recurrence rates, cyst persistence, need for multiple procedures, and prolonged immobilization. A minimally invasive regimen consisting of curettage, decompression, and injection of a calcium sulfate-calcium phosphate (CaSO4-CaPO4) composite has been utilized at our institution in an attempt to obtain optimal results for the treatment of UBCs in the pediatric population. We retrospectively evaluated 16 patients with pathologically confirmed UBC who were treated with curettage, decompression, and injection of a calcium sulfate-calcium phosphate composite between April 2006 and August 2010 at a single institution. The average age of the patients at time of surgical intervention was 9.4 years of age (range, 3 to 16 y). Average follow-up was 16 months (range, 6 to 36 mo). Radiographic healing, clinical outcomes, and complications were evaluated. Final follow-up radiographs demonstrated healing in 93.7% (15 of 16) of patients after a single procedure. Complete healing was observed in 14 of 16 patients and partially healed with a defect in 1 of 16 patients. One patient had a persistent cyst but did not wish to receive further treatment. All patients returned to full activities including sports on average at 3.1 months (range, 1 to 6 mo) and were asymptomatic on most recent follow-up. No postoperative complications, including refracture, were observed. Curettage, decompression, and injection of a calcium sulfate-calcium phosphate composite for UBC in the pediatric population demonstrates encouraging results with low recurrence rates and complications compared with conventional methods. Case series, Level of Evidence IV.

  9. Myocardial stress perfusion magnetic resonance: initial experience in a pediatric and young adult population using regadenoson

    International Nuclear Information System (INIS)

    Noel, Cory V.; Krishnamurthy, Ramkumar; Krishnamurthy, Rajesh; Moffett, Brady

    2017-01-01

    Dipyridamole and adenosine are traditional pharmacological stressors for myocardial perfusion. Regadenoson, a selective adenosine A2A agonist, has a lower side effect profile with lower incidence of bronchospasm and bradycardia. There is a growing need for myocardial perfusion assessment within pediatrics. There is no report on the utility of regadenoson as a stress agent in children. To observe the safety and feasibility of regadenoson as a pharmacologic stressor for perfusion cardiac MR in a pilot cohort of pediatric patients weighing more than 40 kg who have congenital heart disease and pediatric acquired heart disease. We reviewed our initial experience with regadenoson stress cardiac MR in 31 pediatric patients 15.8 ± 1.7 years (range 12-22 years) with congenital heart disease and acquired heart disease. Mean patient weight was 60 ± 15 kg (range of 40-93 kg). All patients underwent cardiac MR because of concern for ischemia. The cohort included a heterogeneous group of patients at a pediatric institution with potential risk for ischemia. Subjects' heart rate and blood pressure were monitored and pharmacologic stress was induced by injection of 400 mcg of regadenoson. We evaluated their hemodynamic response and adverse effects using changes in vital signs and onset of symptoms. A pediatric cardiologist and radiologist qualitatively assessed myocardial perfusion and viability images. One child was unable to complete the stress perfusion portion of the examination, but did complete the remaining portion of the CMR. Resting heart rate was 72 ± 14 beats per minute (bpm) and rose to peak of 124 ± 17 bpm (95 ± 50% increase, P < 0.005) with regadenoson. Image quality was considered good or diagnostic in all cases. Three patients had irreversible perfusion defects. Four patients had reversible perfusion defects. Nine of the patients underwent cardiac catheterization with angiography and the findings showed excellent agreement. Regadenoson might be a safe and

  10. Myocardial stress perfusion magnetic resonance: initial experience in a pediatric and young adult population using regadenoson

    Energy Technology Data Exchange (ETDEWEB)

    Noel, Cory V. [Baylor College of Medicine, Department of Pediatric Cardiology, Houston, TX (United States); Texas Children' s Hospital, Department of Pediatric Cardiology, Houston, TX (United States); Krishnamurthy, Ramkumar; Krishnamurthy, Rajesh [Texas Children' s Hospital, Department of Radiology, Houston, TX (United States); Moffett, Brady [Texas Children' s Hospital, Department of Pharmacology, Houston, TX (United States)

    2017-03-15

    Dipyridamole and adenosine are traditional pharmacological stressors for myocardial perfusion. Regadenoson, a selective adenosine A2A agonist, has a lower side effect profile with lower incidence of bronchospasm and bradycardia. There is a growing need for myocardial perfusion assessment within pediatrics. There is no report on the utility of regadenoson as a stress agent in children. To observe the safety and feasibility of regadenoson as a pharmacologic stressor for perfusion cardiac MR in a pilot cohort of pediatric patients weighing more than 40 kg who have congenital heart disease and pediatric acquired heart disease. We reviewed our initial experience with regadenoson stress cardiac MR in 31 pediatric patients 15.8 ± 1.7 years (range 12-22 years) with congenital heart disease and acquired heart disease. Mean patient weight was 60 ± 15 kg (range of 40-93 kg). All patients underwent cardiac MR because of concern for ischemia. The cohort included a heterogeneous group of patients at a pediatric institution with potential risk for ischemia. Subjects' heart rate and blood pressure were monitored and pharmacologic stress was induced by injection of 400 mcg of regadenoson. We evaluated their hemodynamic response and adverse effects using changes in vital signs and onset of symptoms. A pediatric cardiologist and radiologist qualitatively assessed myocardial perfusion and viability images. One child was unable to complete the stress perfusion portion of the examination, but did complete the remaining portion of the CMR. Resting heart rate was 72 ± 14 beats per minute (bpm) and rose to peak of 124 ± 17 bpm (95 ± 50% increase, P < 0.005) with regadenoson. Image quality was considered good or diagnostic in all cases. Three patients had irreversible perfusion defects. Four patients had reversible perfusion defects. Nine of the patients underwent cardiac catheterization with angiography and the findings showed excellent agreement. Regadenoson might be a safe and

  11. Role of laser myringotomy in a pediatric otolaryngology practice: initial experience

    Science.gov (United States)

    Shah, Udayan K.

    2001-05-01

    A new technology (OtoLAM) to fenestrate the tympanic membrane with the carbon dioxide laser (CO2), in the office or the operating room, has been introduced over the last three years. While not new conceptually, this product offers the ability to easily create a precise window into the middle ear using a portable system. Controversy regarding the indications and benefits of this technique, amplified by the costs of the system and the marketing of the technology prior to extensive clinical testing, has plagued the clinical application of this technology. We report our experience over the past year with this system in a busy pediatric otolaryngology practice. Laser fenestration of the tympanic membrane has been useful for the insertion of tympanostomy tubes, and for the minimally invasive evaluation of the middle ear. Our small experience to date reveals that there is a limited role for laser tympanic membrane fenestration in a busy pediatric otolaryngology practice.

  12. Application of the Reina Trust and Betrayal Model to the experience of pediatric critical care clinicians.

    Science.gov (United States)

    Rushton, Cynda Hylton; Reina, Michelle L; Francovich, Christopher; Naumann, Phyllis; Reina, Dennis S

    2010-07-01

    Trust is essential in the workplace, yet no systematic studies of trust among pediatric critical care professionals have been done. To determine the feasibility of measuring trust in a pediatric intensive care unit by using established scales from the corporate world and to determine what behaviors build, break, and rebuild trust. The Reina Trust and Betrayal Model was used to explore contractual, competence, and communication trust. Nurses and physicians in a pediatric intensive care unit completed online surveys to measure organizational, team, and patient trust. Quantitative data from 3 standard survey instruments and qualitative responses to 3 open-ended questions were analyzed and compared. Quantitative data from all 3 instruments indicated moderate to high levels of trust; scores for competence and contractual trust were higher than scores for communication trust. Scores indicated agreement on behaviors that build trust, such as pointing out risky situations to each other, actively striving to build supportive and productive relationships, and giving and receiving constructive feedback. Foremost among trust-breaking behaviors was gossip, which was more troublesome to respondents with longer experience in critical care. Responses to the open-ended questions underscored these themes. The most frequently cited items included encouraging mutually serving intentions, sharing information, and involving and seeking the input of others. The Reina trust scales and open-ended questions are feasible and applicable to pediatric critical care units, and data collected with these instruments are useful in determining what behaviors build, break, and rebuild trust among staff.

  13. [Pain therapy in pediatric oncology: pain experience, drugs and pharmacokinetics].

    Science.gov (United States)

    Mertens, Rolf

    2011-11-01

    Paediatric cancer patients often experience fear and pain from the disease but also in connection with the necessary diagnostic and therapeutic procedures. The treatment of pain is a priority for all patients, especially for critically ill children because of their vulnerability and limited understanding. The experience of pain is always subjective and depends on the age, the pain experience and the environment.In contrast to adults, it is often difficult to detect character of pain, pain intensity and pain localization in very young patients. Diagnostic and therapeutic procedures are performed in analgosedation for a given drug scheme by a pediatrician experienced in intensive care.In addition, a local anesthetic for an access system/lumbar punctures in the form of EMLA® patch is to be carried out. A rapid and effective treatment of pain and appropriate analgesia can prevent patients from being traumatized.For severe pain, malignancy- or chemotherapy-induced (eg. mucositis WHO grade 3 and 4) initial use of strong opiates is recommended instead of climbing the WHO ladder. For strong opiates, there is no maximum dose, as long as a dose increase leads to clinically observable increase in analgesia, without severe side effects. Patient-controlled analgesia with morphine as continuous subcutaneous or intravenous infusions and the possibility of a bolus injection is suited for children aged 6 years. A measurement of O2-saturation is essential during this infusion. Prophylactic approaches also must be used consistently in regard to the acute side effect of opiate treatment. Good experience, we have also made a non-drug therapy, e.g. personnel/physical affection, cuddling, massage, etc.The choice of analgesia depends on the nature and cause of pain. In neuropathic pain or phantom pain coanalgetics should be used to effectively treat pain in young patients. Different analgesic treatment approaches of the appropriate indications and adverse effects are presented. A

  14. Cognitive-behavioral therapy plus motivational interviewing improves outcome for pediatric obsessive-compulsive disorder: A preliminary study

    Science.gov (United States)

    Merlo, Lisa J.; Storch, Eric A.; Lehmkuhl, Heather D.; Jacob, Marni L.; Murphy, Tanya K.; Goodman, Wayne K.; Geffken, Gary R.

    2010-01-01

    Lack of motivation may negatively impact cognitive behavioral therapy (CBT) response for pediatric patients with obsessive-compulsive disorder (OCD). Motivational interviewing is a method for interacting with patients in order to decrease their ambivalence and support their self-efficacy in their efforts at behavior change. This paper presents a preliminary randomized trial (N = 16) to evaluate the effectiveness of adding motivational interviewing (MI) as an adjunct to CBT. Patients aged 6–17 who were participating in intensive family-based CBT for OCD were randomized to receive either CBT plus MI or CBT plus extra psychoeducation sessions. Results indicated that after 4 sessions, the mean CY-BOCS score for the CBT+MI group was significantly lower than for the CBT+psychoeducation group (t(14) = 2.51, p < .03, Cohen’s d = 1.34). In addition, the degree of reduction in CY-BOCS scores was significantly greater (t(14) = 2.14, p = .05, Cohen’s d = 1.02) for the CBT+MI group (mean change = 16.75, SD = 9.66) than for the CBT+psychoeducation group (mean change = 8.13, SD = 6.01). This effect decreased over time, and scores at post-treatment were not significantly different. However, participants in the MI group completed treatment on average three sessions earlier than those in the psychoeducation group, providing support for the utility of MI in facilitating rapid improvement and minimizing the burden of treatment for families. PMID:19675960

  15. A Preliminary Study of D-Cycloserine Augmentation of Cognitive-Behavioral Therapy in Pediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

    Storch, Eric A.; Murphy, Tanya K.; Goodman, Wayne K.; Geffken, Gary R.; Lewin, Adam B.; Henin, Aude; Micco, Jamie A.; Sprich, Susan; Wilhelm, Sabine; Bengtson, Michael; Geller, Daniel A.

    2010-01-01

    Background Research on the neural circuitry underlying fear extinction has led to the examination of d-cycloserine (DCS), a partial agonist at the NMDA receptor in the amygdala, as a method of enhancing exposure therapy outcome. Preliminary results have supported the use of DCS to augment exposure therapy in adult anxiety disorders; however, no data have been reported in any childhood anxiety disorder. Thus, we sought to preliminarily examine if weight-adjusted DCS doses (25 or 50mg) enhanced the overall efficacy of cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD). Method Participants were 30 youth (ages 8–17) with a primary diagnosis of OCD. The study design was a randomized, double-blinded, placebo-controlled augmentation trial examining CBT+DCS versus CBT+Placebo (15 youth per group). All patients received 7 E/RP sessions paired with DCS or placebo taken 1 hour prior to sessions. Results Although not significantly different, compared to the CBT+Placebo group, youth in the CBT+DCS arm showed small-to-moderate treatment effects (d=.31 to .47 on primary outcomes). No adverse events were recorded. Conclusions The present results complement findings in adult OCD and non-OCD anxiety disorders and provide initial support for a more extensive study of DCS augmentation of CBT among youth with OCD. PMID:20817153

  16. Development and Preliminary Face and Content Validation of the "Which Health Approaches and Treatments Are You Using?" (WHAT) Questionnaires Assessing Complementary and Alternative Medicine Use in Pediatric Rheumatology.

    Science.gov (United States)

    Toupin April, Karine; Stinson, Jennifer; Boon, Heather; Duffy, Ciarán M; Huber, Adam M; Gibbon, Michele; Descarreaux, Martin; Spiegel, Lynn; Vohra, Sunita; Tugwell, Peter

    2016-01-01

    Complementary and alternative medicine (CAM) is commonly used by children with juvenile idiopathic arthritis (JIA), yet no validated questionnaires assess that use. The objective of this study was to develop child self- and parent proxy-report questionnaires assessing CAM use and to determine the face and content validity of the "Which Health Approaches and Treatments are you using?" (WHAT) questionnaires in pediatric rheumatology. A sequential phased mixed methods approach was used to develop the questionnaires. A Delphi Survey of 126 experts followed by an interdisciplinary consensus conference of 14 stakeholders in CAM, general pediatrics and pediatric rheumatology was held to develop consensus on the content of the questionnaires using a nominal group technique. To determine face and content validity of the questionnaires, two groups, including (a) a purposive sample of 22 children with JIA 8 to 18 years and their parents from the Children's Hospital of Eastern Ontario and the Hospital for Sick Children, and (b) 21 Canadian pediatric rheumatology experts, participated in interviews. Participants were independently asked about the goal, understandability and comprehensiveness of the WHAT questionnaires, as well as the relevance of items. Consensus was reached on 17 items of the WHAT questionnaires. The domains found to be relevant were child's CAM use, factors associated with CAM use, perceived impact of CAM use, and communication about CAM. A total of 15 items in the parent proxy-report questionnaire and 13 items in the child report questionnaire showed adequate content validity. Consensus was reached by experts on the content of a pediatric CAM questionnaire. Face and content validity testing and modifications made to the WHAT questionnaires have helped ensure adequate preliminary validity for use in pediatric rheumatology. This constitutes the basis for further testing of these questionnaires in pediatric rheumatology and for adaptation to other chronic

  17. Development and Preliminary Face and Content Validation of the "Which Health Approaches and Treatments Are You Using?" (WHAT Questionnaires Assessing Complementary and Alternative Medicine Use in Pediatric Rheumatology.

    Directory of Open Access Journals (Sweden)

    Karine Toupin April

    Full Text Available Complementary and alternative medicine (CAM is commonly used by children with juvenile idiopathic arthritis (JIA, yet no validated questionnaires assess that use. The objective of this study was to develop child self- and parent proxy-report questionnaires assessing CAM use and to determine the face and content validity of the "Which Health Approaches and Treatments are you using?" (WHAT questionnaires in pediatric rheumatology.A sequential phased mixed methods approach was used to develop the questionnaires. A Delphi Survey of 126 experts followed by an interdisciplinary consensus conference of 14 stakeholders in CAM, general pediatrics and pediatric rheumatology was held to develop consensus on the content of the questionnaires using a nominal group technique. To determine face and content validity of the questionnaires, two groups, including (a a purposive sample of 22 children with JIA 8 to 18 years and their parents from the Children's Hospital of Eastern Ontario and the Hospital for Sick Children, and (b 21 Canadian pediatric rheumatology experts, participated in interviews. Participants were independently asked about the goal, understandability and comprehensiveness of the WHAT questionnaires, as well as the relevance of items.Consensus was reached on 17 items of the WHAT questionnaires. The domains found to be relevant were child's CAM use, factors associated with CAM use, perceived impact of CAM use, and communication about CAM. A total of 15 items in the parent proxy-report questionnaire and 13 items in the child report questionnaire showed adequate content validity.Consensus was reached by experts on the content of a pediatric CAM questionnaire. Face and content validity testing and modifications made to the WHAT questionnaires have helped ensure adequate preliminary validity for use in pediatric rheumatology. This constitutes the basis for further testing of these questionnaires in pediatric rheumatology and for adaptation to other

  18. Hemodynamic responses to dexmedetomidine in critically injured intubated pediatric burned patients: a preliminary study.

    Science.gov (United States)

    Shank, Erik S; Sheridan, Robert L; Ryan, Colleen M; Keaney, Timothy J; Martyn, J A Jeevendra

    2013-01-01

    Because of ineffectiveness and tolerance to benzodiazepines and opioids developing with time, drugs acting via other receptor systems (eg, α-2 agonists) have been advocated in burn patients to improve sedation and analgesia. This study in severely burned pediatric subjects examined the hemodynamic consequences of dexmedetomidine (Dex) administration. Eight intubated patients with ≥20 to 79% TBSA burns were studied between 7 and 35 days after injury. After baseline measurements of mean arterial blood pressure and heart rhythm were taken, each patient received a 1.0 µg/kg bolus of Dex followed by an ascending dose infusion protocol (0.7-2.5 µg/kg/hr), with each dose administered for 15 minutes. There was significant hypotension (27±7.5%, average drop in mean arterial pressure [MAP] ± SD), and a decrease in heart rate (HR; 19% ± 7, average drop in HR ± SD). The average HR decreased from 146 beats per minute to 120. No bradycardia (HR patients, the MAP decreased to patients, three patients completed the study receiving the highest infusion dose of Dex (2.5 µg/kg/hr), whereas in 2 patients the infusion part of the study was begun, but the study was stopped due to persistent hypotension (MAP burn patients.

  19. Choices and control: parental experiences in pediatric terminal home care.

    Science.gov (United States)

    Vickers, J L; Carlisle, C

    2000-01-01

    During the past decade, palliative care at home has become an alternative option to hospital care for terminally ill children. This study describes the experience of caring for a dying child at home from a parent's perspective. A qualitative research design was used to conduct and analyze data. Nonstandardized, focused interviews were conducted with 10 families. Thematic content analysis assisted in deriving themes from the transcripts of the interviews. "Choice and control" was the major theme that linked all the other concepts, and it appeared to be fundamental to parental coping strategies. Most parents were willing to take responsibility for the nursing care of their child, including administration of intravenous medication. The patient's home was the overwhelming choice of parents for delivery of terminal care, with most parents perceiving it as their child's choice also.

  20. Do Pediatricians Ask About Adverse Childhood Experiences in Pediatric Primary Care?

    Science.gov (United States)

    Kerker, Bonnie D; Storfer-Isser, Amy; Szilagyi, Moira; Stein, Ruth E K; Garner, Andrew S; O'Connor, Karen G; Hoagwood, Kimberly E; Horwitz, Sarah M

    2016-03-01

    The stress associated with adverse childhood experiences (ACEs) has immediate and long-lasting effects. The objectives of this study were to examine 1) how often pediatricians ask patients' families about ACEs, 2) how familiar pediatricians are with the original ACE study, and 3) physician/practice characteristics, physicians' mental health training, and physicians' attitudes/beliefs that are associated with asking about ACEs. Data were collected from 302 nontrainee pediatricians exclusively practicing general pediatrics who completed the 2013 American Academy of Pediatrics Periodic Survey. Pediatricians indicated whether they usually, sometimes, or never inquired about or screened for 7 ACEs. Sample weights were used to reduce nonresponse bias. Weighted descriptive and logistic regression analyses were conducted. Only 4% of pediatricians usually asked about all 7 ACEs; 32% did not usually ask about any. Less than 11% of pediatricians reported being very or somewhat familiar with the ACE study. Pediatricians who screened/inquired about ACEs usually asked about maternal depression (46%) and parental separation/divorce (42%). Multivariable analyses showed that pediatricians had more than twice the odds of usually asking about ACEs if they disagreed that they have little effect on influencing positive parenting skills, disagreed that screening for social emotional risk factors within the family is beyond the scope of pediatricians, or were very interested in receiving further education on managing/treating mental health problems in children and adolescents. Few pediatricians ask about all ACEs. Pediatric training that emphasizes the importance of social/emotional risk factors may increase the identification of ACEs in pediatric primary care. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  1. Parental perspectives of screening for adverse childhood experiences in pediatric primary care.

    Science.gov (United States)

    Conn, Anne-Marie; Szilagyi, Moira A; Jee, Sandra H; Manly, Jody T; Briggs, Rahil; Szilagyi, Peter G

    2018-03-01

    Pediatricians recognize a need to mitigate the negative impact that adverse childhood experiences (ACEs) can have on health and development. However, ACEs screening and interventions in primary care pediatrics may be inhibited by concerns about parental perceptions. We assessed parent perspectives of screening for ACEs in the pediatric primary care setting, to understand their views on the potential impact of their ACEs on their parenting and to identify opportunities for pediatric anticipatory guidance. We used purposive sampling to recruit parents of children <6 years receiving care at an urban, pediatric clinic. Semistructured questions guided 1:1 interviews that were later coded by multiple researchers to verify reliability. A thematic framework approach guided analysis and identified main themes and subthemes. We reached thematic saturation after 15 parent interviews, which consistently revealed 3 interrelated themes. First, parents strongly supported ACEs screening as a bridge to needed services, and they recommended using a trauma-sensitive, person-centered approach in pediatric practices. Second, parents understood the intergenerational impact of ACEs and expressed a desire to break the cycle of adversity. Finally, parents saw their child's pediatrician as a potential change-agent who could provide support to meet their parenting goals. Parents want to discuss their ACEs and receive help and guidance from pediatricians. Furthermore, they perceive their child's pediatrician as having an important role to play in meeting their parenting goals. It is important to ensure that pediatricians have the training, skills and familiarity with available resources to meet parental expectations. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  2. Preliminary Investigation of Workplace-Provided Compressed Mindfulness-Based Stress Reduction with Pediatric Medical Social Workers.

    Science.gov (United States)

    Trowbridge, Kelly; Mische Lawson, Lisa; Andrews, Stephanie; Pecora, Jodi; Boyd, Sabra

    2017-11-01

    Mindfulness practices, including mindfulness meditation, show promise for decreasing stress among health care providers. This exploratory study investigates the feasibility of a two-day compressed mindfulness-based stress reduction (cMBSR) course provided in the hospital workplace with pediatric health care social workers. The standard course of Jon Kabat-Zinn's MBSR requires a participant commitment to eight weeks of instruction consisting of one 2.5-hour-per-week class, a single day retreat, and 45 minutes of practice for six of seven days each week. Commitments to family, work, caregiving, education, and so on, as well as limitations such as distance, may prevent health care providers from participating in a standard MBSR course. Using t tests, researchers measured the effect of cMBSR on (a) positive and negative experiences in pediatric social work, (b) perceived stress, (c) mindfulness, and (d) caring self-efficacy (as a component of patient- and family-centered care). Results included significant differences between the pre- and post-intervention outcome variables on the Professional Quality of Life Secondary Traumatic Stress subscale, the Mindful Attention and Awareness Scale, and the Caring Efficacy Scale. Findings found adequate evidence for the feasibility of cMBSR design and for a need of a more rigorous study of the effects of the cMBSR intervention. © 2017 National Association of Social Workers.

  3. "Spaghetti Maneuver": A useful tool in pediatric laparoscopy - Our experience

    Directory of Open Access Journals (Sweden)

    Antonio Marte

    2011-01-01

    Full Text Available Aims: The laparoscopic "Spaghetti Maneuver" consists in holding an organ by its extremity with a grasper and rolling it up around the tool to keep the organ stable and facilitate its traction within a small space. We describe our experience with the "Spaghetti Maneuver" in some minimally invasive procedures. Materials and Methods: We successfully adopted this technique in 13 patients (5F : 8M aged between 6 and 14 years (average age, 10 on whom we performed 7 appendectomies, 2 ureteral reimplantation and 4 cholecystectomies. In all cases, after the first steps, the appendix, the gallbladder and the ureter were rolled around the grasper and easily isolated; hemostasis was thus induced and the organ was mobilized until removal during cholecystectomy and appendectomy, and before the reimplantation in case of ureteral reimplantation. Results: We found that this technique facilitated significantly the acts of holding, isolating and removing, when necessary, the structures involved, which remained constantly within the visual field of the operator. This allowed a very ergonomic work setting, overcoming the problem of the "blind" zone, which represents a dangerous and invisible area out of the operator′s control during laparoscopy. Moreover the isolation maneuvers resulted easier and reduced operating time. Conclusion: We think that this technique is easy to perform and very useful, because it facilitates the dissection of these organs, by harmonizing and stabilizing the force of traction exercised.

  4. Multidisciplinary management of the patients with cerebral aneurysm - Preliminary experience

    International Nuclear Information System (INIS)

    Gomez Hoyos, Juan Fernando; Celis Mejia, Jorge Ignacio; Yepez Sanchez, Carlos Jaime; Duque Botero, Julieta

    1998-01-01

    A Actually, complex pathologies are treated according to a decision, which is adopted, by a group of specialists from different fields concerned to the same disease. The intention is to have success that is reflected in a low morbimortality and the most complete recovery to permit patients to return their previous life activities. Depending the status of each patient, type of aneurysm and its location, different techniques are performed to exclude them from circulation. Microneurosurgery, aneurysmatic sac embolization with platinum detachable coils and vessel originating aneurysm balloon occlusion The main objective of this work is to demonstrate that both microneurosurgery, classic technique in the cerebral aneurysms management but in continuing development, and endovascular therapy are not excluded, and their effectiveness depends in a strict selection criteria of patients and a comprehensive medical management before, during and after treatment by a multidisciplinary group. Also, to evaluate both techniques based on different indexes, including the ongoing evolution. In this work the preliminary experience of the Neurovascular Group at the Clinica Cardiovascular Santa Maria in Medellin, during the period of time from December 1996 until May 1998.45 patients with 47 aneurysm were treated 55.3% aneurysmatic lesions were treated by endovascular therapy and the remaining (44.7%) by microneurosurgery. 26 patients and same number of aneurysmatic lesions composed the endovascular group, the age range was between 20 and 70 years. 80.0% were women, 20.0% men. 53.8% complained from subarachnoid hemorrhage signs and symptoms. 36.0% were in a Hunt and Hess score scale of III and 84.7% complete success was achieved. 3 patients died, 2 of them were in IV and V Hunt and Hess score scale, respectively. The surgical group composed by 19 patients with 21 lesions and an age range between 31 and 78 years. 64.8% were women and 71,5% had confirmed diagnosis of subarachnoid hemorrhage

  5. Avoiding steroids in pediatric renal transplantation: long-term experience from a single centre

    DEFF Research Database (Denmark)

    Pedersen, Erik Bo; El-Faramawi, Mohamad; Foged, Nils

    2007-01-01

    We report our experience in pediatric renal transplantation avoiding steroids whenever possible. Immunosuppression consisted of an initial induction with antithymocyte globulin followed by maintenance therapy with a calcineurin inhibitor and MMF. Steroids were only given to selected patients......). Unfortunately PTLD occurred in three patients, but all survived with functioning grafts. Accordingly, our findings indicate that steroid avoidance in pediatric renal transplantation is possible with good results with respect to acute graft rejection as well as long-term graft survival....... because of the primary disease, recurrence, rejection, or PTLD. Thirty-four transplants grafted into 32 recipients between 1995 and 2005 were followed for a median of 3.5 yr (range 1-9.8). All patients survived. Graft rejection occurred in 10 cases during the first year post-transplantation and graft...

  6. Correlation of parenting style and pediatric behavior guidance strategies in the dental setting: preliminary findings.

    Science.gov (United States)

    Aminabadi, Naser Asl; Farahani, Ramin Mostofi Zadeh

    2008-04-01

    The aim of this study was to investigate the influence of parenting style on the choice of proper behavior guidance strategies in pedodontics. Seventy-two children aged between 4 and 6 years (mean 5.12 years) with carious primary mandibular molars were selected. The Primary Caregivers' Practices Report (PCPR) was used to quantify authoritarian, permissive and authoritative aspects of the caregivers' parenting style. After inferior alveolar nerve block, carious lesions were removed and the teeth were restored using amalgam. The children's behavior during operation was assessed according to the sound, eye, and motor (SEM) scale. Communicative guidance, advance behavior guidance, parental separation, and deferred treatment were used for behavior management. The dominant authoritative score was observed in 50% of parents, permissive in 37.5%, and authoritarian in 12.5%. The mean SEM score in children belonging to authoritative parents was significantly lower than in children of permissive and of authoritarian parents (pparenting style. Advanced behavior guidance (protective stabilization) was applied in 16.7% of cases in the authoritative category and in 100% in the permissive and authoritarian categories. The use of restrictive devices (7.4%) and sedation (3.7%) was limited to the permissive category. Parental separation (40.7%) and deferred treatment (3.7%) were performed only in the permissive category. This study provides preliminary evidence that a child's reaction to restorative dental procedures is influenced by the nature of the caregiver's parenting style.

  7. Knowledge and attitudes regarding neonatal pain among nursing staff of pediatric department: an Indian experience.

    Science.gov (United States)

    Nimbalkar, Archana S; Dongara, Ashish R; Phatak, Ajay G; Nimbalkar, Somashekhar M

    2014-03-01

    Neonates receiving care in intensive care units are highly likely to experience pain due to investigations and/or treatments carried out by the health care providers. Neonates are a vulnerable population because they are unable to vocalize their pain. Unaddressed and mismanaged pain can not only affect the child's comfort, but also may alter the development and cognitive abilities of the child in a later part of his/her life. Therefore it is entirely the caregiver's responsibility to accurately assess and manage neonatal pain. We assessed and compared the knowledge and attitudes regarding neonatal pain among the nurses posted in the various units of a pediatric department [pediatric ward, pediatric intensive care unit (PICU) and neonatal intensive care unit (NICU)]. An appropriately modified Knowledge and Attitudes Survey Regarding Pain questionnaire was consensually validated, pretested, and then administered to the nursing staff of the pediatric department at a department at a hospital in Gujarat. Data were entered in Epi-Info and analyzed with the use of SPSS 14.0. The questionnaire was administered to 41 nurses working in the Department of Pediatrics, and the response rate was 97.5%. Mean age of the nurses in the study sample was 25.75 years (SD 5.513). The mean total score of the participants was 8.75 out of 17 (SD 2.549), which was unsatisfactory. The mean correct answer rate was 49.67% among the staff of NICU and 48.67% among the pediatric ward and PICU staff. The attitudes among the nurses were assessed. It was concluded that the nurses lack knowledge and that their attitudes also were hindering pain management. One of the barriers identified by the nurses was that physicians do not prescribe analgesics for managing neonatal pain. So not only the nursing staff, but all of the caregivers involved in neonatal care may be lacking in knowledge and hold perceptions and attitudes that hamper neonatal pain management. Copyright © 2014 American Society for Pain

  8. Experiences with 6-mercaptopurine and azathioprine therapy in pediatric patients with severe ulcerative colitis.

    Science.gov (United States)

    Kader, H A; Mascarenhas, M R; Piccoli, D A; Stouffer, N O; Baldassano, R N

    1999-01-01

    The effectiveness of 6-mercaptopurine combined with azathioprine in treating severe ulcerative colitis has been shown in several adult studies. Reported pediatric experiences are rare. The purpose of this study was to investigate the safety and the potential efficacy of 6-mercaptopurine and azathioprine in the treatment of active ulcerative colitis in a pediatric population. The medical records of patients with active ulcerative colitis who were under observation at The Children's Hospital of Philadelphia and its satellite clinics from January 1984 through December 1997 were retrospectively reviewed. Patients were included who had received a diagnosis of ulcerative colitis, who met no criteria for Crohn's colitis, and who had received treatment with 6-mercaptopurine and azathioprine. They were then analyzed for the development of side effects, the indication to use 6-mercaptopurine and azathioprine, and the ability to discontinue corticosteroid use in those patients taking 5-acetylsalicylic acid products who were corticosteroid-dependent or whose disease was refractory to treatment. Excluded from the corticosteroid analyses were patients who underwent surgery for their disease and patients treated with 5-acetylsalicylic acid only. Statistical analysis was performed by the Kaplan-Meier survival curve and paired Student's t-test. In a review of 200 medical records of patients with active ulcerative colitis, 20 patients met the criteria. The patients' average age at the initiation of treatment with 6-mercaptopurine and azathioprine was 13.8 years. Sixteen patients (80%) were corticosteroid dependent and 3 (15%) had ulcerative colitis refractory to corticosteroid treatment. One patient had severe colitis treated with 5-acetylsalicylic acid only. Discontinuation of corticosteroid was accomplished in 12 (75%) of 16 patients. The median time to discontinuation of corticosteroid after initiation of 6-mercaptopurine and azathioprine therapy was 8.4 months. Eight patients

  9. Accountability and pediatric physician-researchers: are theoretical models compatible with Canadian lived experience?

    Directory of Open Access Journals (Sweden)

    Czoli Christine

    2011-10-01

    Full Text Available Abstract Physician-researchers are bound by professional obligations stemming from both the role of the physician and the role of the researcher. Currently, the dominant models for understanding the relationship between physician-researchers' clinical duties and research duties fit into three categories: the similarity position, the difference position and the middle ground. The law may be said to offer a fourth "model" that is independent from these three categories. These models frame the expectations placed upon physician-researchers by colleagues, regulators, patients and research participants. This paper examines the extent to which the data from semi-structured interviews with 30 physician-researchers at three major pediatric hospitals in Canada reflect these traditional models. It seeks to determine the extent to which existing models align with the described lived experience of the pediatric physician-researchers interviewed. Ultimately, we find that although some physician-researchers make references to something like the weak version of the similarity position, the pediatric-researchers interviewed in this study did not describe their dual roles in a way that tightly mirrors any of the existing theoretical frameworks. We thus conclude that either physician-researchers are in need of better training regarding the nature of the accountability relationships that flow from their dual roles or that models setting out these roles and relationships must be altered to better reflect what we can reasonably expect of physician-researchers in a real-world environment.

  10. Blunt pediatric anterior and posterior urethral trauma: 32-year experience and outcomes.

    Science.gov (United States)

    Voelzke, Bryan B; Breyer, Benjamin N; McAninch, Jack W

    2012-06-01

    To analyze our experience with delayed repair of pediatric urethral trauma. From 1978 to 2007, 26 boys posterior urethral injuries were separately stratified. There were 8 anterior and 18 posterior urethral strictures. All patients presented in a delayed fashion. Mean follow up of the anterior cohort was 2.9 years. All repairs were performed via a ventral onlay buccal graft or anastomotic approach. The mean follow up of the posterior cohort was 1.1 years, and all posterior urethral injuries were repaired via an anastomotic approach. Overall success for anterior stricture disease was 88.9% and for posterior stricture disease was 89.5%. All three urethroplasty failures responded favorably to internal urethrotomy; however, one failed anterior repair and one of the two failed posterior repairs required two internal urethrotomy operations for success. No secondary urethroplasty operations were required and ultimately all patients were voiding per urethra without need for urethral dilation. Delayed, definitive repair of pediatric urethral trauma via open urethroplasty has a high success rate. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  11. STELLA and SPINE data transmission experiments preliminary results and conclusions

    CERN Document Server

    Bartholome, P; Scanlan, J O

    1981-01-01

    Discusses the CERN-based proposal for a single experiment, Satellite Transmission Experiment Linking Laboratories (STELLA) and the ESA experimental programme SPINE (Space Informatics Network Experiments). Both projects are examples of experiments to explore the capability and utility of high speed data transmission by satellite, and used the European OTS. (2 refs).

  12. Then and Now: Examining Memories of Pediatric Experiences and Their Influence on Opinions about Healthcare as an Adult

    Directory of Open Access Journals (Sweden)

    Sherwood Burns-Nader

    2017-03-01

    Full Text Available Children use their memories of healthcare experiences to navigate subsequent visits. The purpose of this exploratory study was to examine young adults’ (N =343 memories of childhood medical experiences, how support from parents and the medical team influenced these memories, and how memories of pediatric experiences influence opinions about healthcare as an adult. The participants remembered having mild anxiety about childhood medical visits, feeling parents and the medical team were helpful with coping, and thinking the medical staff were supportive/friendly. Participants remembered having a relationship with their healthcare providers and the healthcare providers communicating with them as a child. The adults reported their current opinion and healthcare use was influenced by childhood healthcare experiences. These findings highlight the importance of parents and the medical team during pediatric healthcare visits. Also, visits during childhood were found to influence use of healthcare as an adult, highlighting the need for positive pediatric experiences, both at the doctor and dentist.

  13. AGC-1 Experiment and Final Preliminary Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Robert L. Bratton; Tim Burchell

    2006-08-01

    This report details the experimental plan and design as of the preliminary design review for the Advanced Test Reactor Graphite Creep-1 graphite compressive creep capsule. The capsule will contain five graphite grades that will be irradiated in the Advanced Test Reactor at the Idaho National Laboratory to determine the irradiation induced creep constants. Seven other grades of graphite will be irradiated to determine irradiated physical properties. The capsule will have an irradiation temperature of 900 C and a peak irradiation dose of 5.8 x 10{sup 21} n/cm{sup 2} [E > 0.1 MeV], or 4.2 displacements per atom.

  14. Preliminary findings of altered functional connectivity of the default mode network linked to functional outcomes one year after pediatric traumatic brain injury.

    Science.gov (United States)

    Stephens, Jaclyn A; Salorio, Cynthia F; Barber, Anita D; Risen, Sarah R; Mostofsky, Stewart H; Suskauer, Stacy J

    2017-07-10

    This study examined functional connectivity of the default mode network (DMN) and examined brain-behavior relationships in a pilot cohort of children with chronic mild to moderate traumatic brain injury (TBI). Compared to uninjured peers, children with TBI demonstrated less anti-correlated functional connectivity between DMN and right Brodmann Area 40 (BA 40). In children with TBI, more anomalous less anti-correlated) connectivity between DMN and right BA 40 was linked to poorer performance on response inhibition tasks. Collectively, these preliminary findings suggest that functional connectivity between DMN and BA 40 may relate to longterm functional outcomes in chronic pediatric TBI.

  15. Whose Experience Is Measured?: A Pilot Study of Patient Satisfaction Demographics in Pediatric Otolaryngology

    Science.gov (United States)

    Nieman, Carrie L.; Benke, James R.; Ishman, Stacey L.; Smith, David F.; Boss, Emily F.

    2015-01-01

    Objectives/Hypothesis Despite a national emphasis on patient-centered care and cultural competency, minority and low-income children continue to experience disparities in health care quality. Patient satisfaction scores are a core quality indicator. The objective of this study was to evaluate race and insurance-related disparities in parent participation with pediatric otolaryngology satisfaction surveys. Study Design Observational analysis of patient satisfaction survey respondents from a tertiary pediatric otolaryngology division. Methods Demographics of survey respondents (Press Ganey Medical Practice Survey©) between January and July 2012 were compared to a clinic comparison group using t test and chi-square analyses. Multivariate logistic regression analyses were performed to assess likelihood to complete a survey based on race or insurance status. Results A total of 130 survey respondents were compared to 1,251 patients in the comparison group. The mean patient age for which the parent survey was completed was 5.7 years (6.1 years for the comparison group, P =0.18); 59.2% of children were ≤5 years old. Relative to the comparison group, survey respondents were more often white (77.7% vs. 58.1%; P <0.001) and privately insured (84.6% vs. 60.8%; P <0.001). Similarly, after controlling for confounding variables, parents of children who were white (OR 1.8, 95% CI 1.13–2.78, P =0.013) or privately insured (OR 2.9, 95% CI 1.74–4.85, P <0.001) were most likely to complete a survey. Conclusion Methods to evaluate satisfaction did not capture the racial or socioeconomic patient distribution within this pediatric division. These findings challenge the validity of applying patient satisfaction scores, as currently measured, to indicate health care quality. Future efforts to measure and improve patient experience should be inclusive of a culturally diverse population. Level of Evidence 2c. PMID:23853050

  16. The influence of family accommodation on pediatric hospital experience in Canada.

    Science.gov (United States)

    Franck, Linda S; Ferguson, Deron; Fryda, Sarah; Rubin, Nicole

    2017-08-15

    The goals of our study were to describe the types of family accommodation for parents of hospitalized children and to examine their influence on the pediatric hospital experience. This multi-site cohort survey included 10 hospitals in Ontario Province, Canada. Participants were parents of inpatient children (n = 1240). Main outcome measures included ratings of three parent-reported measures of hospital experience: overall hospital experience; willingness to recommend the hospital to family or friends; and how much the accommodation type helped parent stay involved in their child's hospital care. Parents most often stayed in the child's room (74.7%), their own home (12.3%), hotel (4.0%) or a Ronald McDonald House (3.0%). Accommodation varied based on hospital, parent and child factors. Length of stay and the child's health status were significant predictors for overall hospital experience and recommending the hospital to family or friends, but accommodation type was not. Families who stayed at a Ronald McDonald House reported greater involvement in their child's care compared with other accommodation types (odds ratio: 1.54-20.73 for contrasted accommodation types). Use of different overnight accommodations for families of hospitalized pediatric patients in Canada is similar to a previous report of U.S. family hospital accommodations. In contrast to the previous U.S. findings, Canadian hospital experience scores were lower and accommodation type was not a significant predictor of overall hospital experience or willingness to recommend the hospital. In Canada, as in the U.S., families who stayed at a Ronald McDonald House reported that this accommodation type significantly improved their ability to be involved in their child's care.

  17. Zero-gravity cloud physics laboratory: Experiment program definition and preliminary laboratory concept studies

    Science.gov (United States)

    Eaton, L. R.; Greco, E. V.

    1973-01-01

    The experiment program definition and preliminary laboratory concept studies on the zero G cloud physics laboratory are reported. This program involves the definition and development of an atmospheric cloud physics laboratory and the selection and delineations of a set of candidate experiments that must utilize the unique environment of zero gravity or near zero gravity.

  18. Work Experiences of People with Mental Illness in Malaysia: A Preliminary Qualitative Study

    Science.gov (United States)

    Boo, Su-Lyn; Loong, Jaymee; Ng, Wai-Sheng

    2011-01-01

    This is a preliminary qualitative study, using a basic interpretive approach, to investigate the work experiences of people with mental illness in Malaysia. Six females and four males (aged 30-70) from a residential home for the mentally ill participated in semi-structured interviews. Three inter-relating themes emerged, namely the experience of…

  19. SUMS preliminary design and data analysis development. [shuttle upper atmosphere mass spectrometer experiment

    Science.gov (United States)

    Hinson, E. W.

    1981-01-01

    The preliminary analysis and data analysis system development for the shuttle upper atmosphere mass spectrometer (SUMS) experiment are discussed. The SUMS experiment is designed to provide free stream atmospheric density, pressure, temperature, and mean molecular weight for the high altitude, high Mach number region.

  20. Preliminary Experiment on Neutron-Induced Mn Activity in Mn-Cd Solutions

    Energy Technology Data Exchange (ETDEWEB)

    Broda, E.

    1942-07-01

    This report was written by E. Broda, J. Gueron and L. Kowarski at the Cavendish Laboratory (Cambridge) in June 1942 and is about a preliminary experiment on neutron-induced Mn activity in Mn-Cd solutions. The description of the experiment and the results can be found also in this report. (nowak)

  1. Pediatric Palliative Sedation Therapy with Propofol: Recommendations Based on Experience in Children with Terminal Cancer

    Science.gov (United States)

    Hamilton, Hunter; Faughnan, Lane G.; Johnson, Liza-Marie; Baker, Justin N.

    2012-01-01

    Abstract Background The use of propofol for palliative sedation of children is not well documented. Objective Here we describe our experience with the use of propofol palliative sedation therapy (PST) to alleviate intractable end-of-life suffering in three pediatric oncology patients, and propose an algorithm for the selection of such candidates for PST. Patients and Methods We identified inpatients who had received propofol PST within 20 days of death at our institution between 2003 and 2010. Their medical records were reviewed for indicators of pain, suffering, and sedation from 48 hours before PST to the time of death. We also tabulated consumption of opioids and other symptom management medications, pain scores, and adverse events of propofol, and reviewed clinical notes for descriptors of suffering and/or palliation. Results Three of 192 (1.6%) inpatients (aged 6–15 years) received propofol PST at the end of life. Consumption of opioids and other supportive medications decreased during PST in two cases. In the third case, pain scores remained high and sedation was the only effective comfort measure. Clinical notes suggested improved comfort and rest in all patients. Propofol infusions were continued until the time of death. Conclusions Our experience demonstrates that propofol PST is a useful palliative option for pediatric patients experiencing intractable suffering at the end of life. We describe an algorithm that can be used to identify such children who are candidates for PST. PMID:22731512

  2. A new extra-abdominal channel alternative to the mitrofanoff principle: experimental and preliminary clinical experience

    Directory of Open Access Journals (Sweden)

    Antonio Macedo Jr.

    2009-04-01

    Full Text Available INTRODUCTION: The appendix is the gold-standard channel for the Mitrofanoff principle in pediatric urology, but the search for alternatives is justified considering it may not be available or preferably used for colonic stomas (Malone antegrade continence enema. The aim of this study is to report on technical feasibility of a new approach for creating catheterizable channels in a rabbit model and to present our preliminary clinical experience. MATERIAL AND METHODS: We configured a tube from two rectangular skin flaps 1x4 cm opposite each other in the middle line of the lower inferior abdomen. The channel was anastomosed to the bladder dome with embedding sutures to create a valvular mechanism. The experimental study consisted of 12 rabbits, divided in 4 groups according to the sacrifice schedule at 2, 4, 8 and 12 weeks. At 30th postoperative day, an urodynamic evaluation was performed to record continence of the stoma. A histological analysis of the specimens stained with hematoxylin-eosin, Masson trichrome and Picrosirius red was also done in group 2 (sacrifice at 4 weeks postoperatively. We used this method in 3 patients with congenital non-neurogenic bladder disease presenting with massive residual volumes without compliance deficits. RESULT: The technique proved feasible in all animals, 9 of 12 could be easily catheterized and underwent urodynamic study. No stoma leakage was observed in 7 animals at high bladder pressures (> 50 cm H20 and only 2 animals had some leakage at 40 cm H20. Urodynamics performed through the stoma showed urethral leakage at 20 cm H20, therefore demonstrating the efficacy of the valvular mechanism. Histological analysis confirmed good integration between the tube and the bladder. Mean follow-up of the clinical series (3 patients was 7.2 months. Two patients remained continent up to 4 hours, whereas 1 patient had some leakage after 2 hours. CONCLUSION: We were able to confirm feasibility of a new extra

  3. Preliminary results from a crowdsourcing experiment in immunohistochemistry.

    Science.gov (United States)

    Della Mea, Vincenzo; Maddalena, Eddy; Mizzaro, Stefano; Machin, Piernicola; Beltrami, Carlo A

    2014-01-01

    Crowdsourcing, i.e., the outsourcing of tasks typically performed by a few experts to a large crowd as an open call, has been shown to be reasonably effective in many cases, like Wikipedia, the Chess match of Kasparov against the world in 1999, and several others. The aim of the present paper is to describe the setup of an experimentation of crowdsourcing techniques applied to the quantification of immunohistochemistry. Fourteen Images from MIB1-stained breast specimens were first manually counted by a pathologist, then submitted to a crowdsourcing platform through a specifically developed application. 10 positivity evaluations for each image have been collected and summarized using their median. The positivity values have been then compared to the gold standard provided by the pathologist by means of Spearman correlation. Contributors were in total 28, and evaluated 4.64 images each on average. Spearman correlation between gold and crowdsourced positivity percentages is 0.946 (p crowdsourcing for an image analysis task that is currently time-consuming when done by human experts. Crowdsourced work can be used in various ways, in particular statistically agregating data to reduce identification errors. However, in this preliminary experimentation we just considered the most basic indicator, that is the median positivity percentage, which provided overall good results. This method might be more aimed to research than routine: when a large number of images are in need of ad-hoc evaluation, crowdsourcing may represent a quick answer to the need.

  4. Kinetics experiments and bench-scale system: Background, design, and preliminary experiments

    International Nuclear Information System (INIS)

    Rofer, C.K.

    1987-10-01

    The project, Supercritical Water Oxidation of Hazardous Chemical Waste, is a Hazardous Waste Remedial Actions Program (HAZWRAP) Research and Development task being carried out by the Los Alamos National Laboratory. Its objective is to obtain information for use in understanding the basic technology and for scaling up and applying oxidation in supercritical water as a viable process for treating a variety of DOE-DP waste streams. This report gives the background and rationale for kinetics experiments on oxidation in supercritical water being carried out as a part of this HAZWRAP Research and Development task. It discusses supercritical fluid properties and their relevance to applying this process to the destruction of hazardous wastes. An overview is given of the small emerging industry based on applications of supercritical water oxidation. Factors that could lead to additional applications are listed. Modeling studies are described as a basis for the experimental design. The report describes plug flow reactor and batch reactor systems, and presents preliminary results. 28 refs., 4 figs., 5 tabs

  5. Accountability and pediatric physician-researchers: are theoretical models compatible with Canadian lived experience?

    Science.gov (United States)

    Czoli, Christine; Da Silva, Michael; Shaul, Randi Zlotnik; d'Agincourt-Canning, Lori; Simpson, Christy; Boydell, Katherine; Rashkovan, Natalie; Vanin, Sharon

    2011-10-05

    Physician-researchers are bound by professional obligations stemming from both the role of the physician and the role of the researcher. Currently, the dominant models for understanding the relationship between physician-researchers' clinical duties and research duties fit into three categories: the similarity position, the difference position and the middle ground. The law may be said to offer a fourth "model" that is independent from these three categories.These models frame the expectations placed upon physician-researchers by colleagues, regulators, patients and research participants. This paper examines the extent to which the data from semi-structured interviews with 30 physician-researchers at three major pediatric hospitals in Canada reflect these traditional models. It seeks to determine the extent to which existing models align with the described lived experience of the pediatric physician-researchers interviewed.Ultimately, we find that although some physician-researchers make references to something like the weak version of the similarity position, the pediatric-researchers interviewed in this study did not describe their dual roles in a way that tightly mirrors any of the existing theoretical frameworks. We thus conclude that either physician-researchers are in need of better training regarding the nature of the accountability relationships that flow from their dual roles or that models setting out these roles and relationships must be altered to better reflect what we can reasonably expect of physician-researchers in a real-world environment. © 2011 Czoli et al; licensee BioMed Central Ltd.

  6. Private Cord Blood Banking: Experiences And Views Of Pediatric Hematopoietic Cell Transplantation Physicians

    Science.gov (United States)

    Thornley, Ian; Eapen, Mary; Sung, Lillian; Lee, Stephanie J.; Davies, Stella M.; Joffe, Steven

    2011-01-01

    Objective Private cord blood banks are for-profit companies that facilitate storage of umbilical cord blood for personal or family use. Pediatric hematopoietic cell transplantation (HCT) physicians are currently best situated to use cord blood therapeutically. We sought to describe the experiences and views of these physicians regarding private cord blood banking. Participants and Methods Emailed cross-sectional survey of pediatric HCT physicians in the United States and Canada. 93/152 potentially eligible physicians (93/130 confirmed survey recipients) from 57 centers responded. Questions addressed the number of transplants performed using privately banked cord blood, willingness to use banked autologous cord blood in specific clinical settings, and recommendations to parents regarding private cord blood banking. Results Respondents reported having performed 9 autologous and 41 allogeneic transplants using privately banked cord blood. In 36/40 allogeneic cases for which data were available, the cord blood had been collected because of a known indication in the recipient. Few respondents would choose autologous cord blood over alternative stem cell sources for treatment of acute lymphoblastic leukemia in second remission. In contrast, 55% would choose autologous cord blood to treat high-risk neuroblastoma, or to treat severe aplastic anemia in the absence of an available sibling donor. No respondent would recommend private cord blood banking for a newborn with one healthy sibling when both parents were of Northern European descent; 11% would recommend banking when parents were of different minority ethnicities. Conclusions Few transplants have been performed using cord blood stored in the absence of a known indication in the recipient. Willingness to use banked autologous cord blood varies depending on disease and availability of alternative stem cell sources. Few pediatric HCT physicians endorse private cord blood banking in the absence of an identified recipient

  7. Neurally Adjusted Ventilatory Assist After Pediatric Cardiac Surgery: Clinical Experience and Impact on Ventilation Pressures.

    Science.gov (United States)

    Crulli, Benjamin; Khebir, Mariam; Toledano, Baruch; Vobecky, Suzanne; Poirier, Nancy; Emeriaud, Guillaume

    2018-02-01

    After pediatric cardiac surgery, ventilation with high airway pressures can be detrimental to right ventricular function and pulmonary blood flow. Neurally adjusted ventilatory assist (NAVA) improves patient-ventilator interactions, helping maintain spontaneous ventilation. This study reports our experience with the use of NAVA in children after a cardiac surgery. We hypothesize that using NAVA in this population is feasible and allows for lower ventilation pressures. We retrospectively studied all children ventilated with NAVA (invasively or noninvasively) after undergoing cardiac surgery between January 2013 and May 2015 in our pediatric intensive care unit. The number and duration of NAVA episodes were described. For the first period of invasive NAVA in each subject, detailed clinical and ventilator data in the 4 h before and after the start of NAVA were extracted. 33 postoperative courses were included in 28 subjects with a median age of 3 [interquartile range (IQR) 1-12] months. NAVA was used invasively in 27 courses for a total duration of 87 (IQR 15-334) h per course. Peak inspiratory pressures and mean airway pressures decreased significantly after the start of NAVA (mean differences of 5.8 cm H 2 O (95% CI 4.1-7.5) and 2.0 cm H 2 O (95% CI 1.2-2.8), respectively, P < .001 for both). There was no significant difference in vital signs or blood gas values. NAVA was used noninvasively in 14 subjects, over 79 (IQR 25-137) h. NAVA could be used in pediatric subjects after cardiac surgery. The significant decrease in airway pressures observed after transition to NAVA could have a beneficial impact in this specific population, which should be investigated in future interventional studies. Copyright © 2018 by Daedalus Enterprises.

  8. Mothers and Fathers Experience Stress of Congenital Heart Disease Differently: Recommendations for Pediatric Critical Care.

    Science.gov (United States)

    Sood, Erica; Karpyn, Allison; Demianczyk, Abigail C; Ryan, Jennie; Delaplane, Emily A; Neely, Trent; Frazier, Aisha H; Kazak, Anne E

    2018-03-10

    To inform pediatric critical care practice by examining how mothers and fathers experience the stress of caring for a young child with congenital heart disease and use hospital and community supports. Qualitative study of mothers and fathers of young children with congenital heart disease. Tertiary care pediatric hospital in the Mid-Atlantic region of the United States. Thirty-four parents (20 mothers, 14 fathers) from diverse backgrounds whose child previously underwent cardiac surgery during infancy. Subjects participated in semi-structured, individual interviews about their experiences and psychosocial needs at the time of congenital heart disease diagnosis, surgical admission, and discharge to home after surgery. Qualitative interview data were coded, and consistent themes related to emotional states, stressors, and supports were identified. Fathers experience and respond to the stressors and demands of congenital heart disease in unique ways. Fathers often described stress from not being able to protect their child from congenital heart disease and the associated surgeries/pain and from difficulties balancing employment with support for their partner and care of their congenital heart disease child in the hospital. Fathers were more likely than mothers to discuss support from the work environment (coworkers/managers, flexible scheduling, helpful distraction) and were less likely to describe the use of hospital-based resources or congenital heart disease peer-to-peer supports. This study highlights the importance of understanding the paternal experience and tailoring interventions to the unique needs of both mothers and fathers. Opportunities for critical care practice change to promote the mental health of mothers and fathers following a diagnosis of congenital heart disease are discussed.

  9. Preliminary performance and ICF target experiments with Nova

    International Nuclear Information System (INIS)

    Drake, R.P.

    1985-11-01

    In December 1984, the Nova facility fired all ten laser arms, converted the output 1.05 micron energy to 0.35 micron light, and focused the 0.35 micron light through a 4 mm pinhole in the ten-beam target chamber. Since that time, a two-beam target chamber has been added, the performance of the laser evaluated, and preparation has been made for target experiments. This paper summarizes the performance of Nova and describes progress and plans for target experiments

  10. Head-controlled laparoscopy : experiment, prototype, and preliminary results

    NARCIS (Netherlands)

    Voorhorst, F.A.; Meijer, D.W.; Overbeeke, C.J.

    1999-01-01

    Depth perception is closely linked to the ability to explore. Previously described laboratory experiments showed the advantage of linking the motions of the laparoscope directly to the head movements of the surgeon. Additionally, it was found that the laparoscope should be mechanically supported

  11. Preliminary results report: Conasauga near-surface heater experiment

    International Nuclear Information System (INIS)

    Krumhansl, J.L.

    1979-06-01

    From November 1977 to August 1978, two near-surface heater experiments were operated in two somewhat different stratigraphic sequences within the Conasauga formation which consist predominantly of shale. Specific phenomena investigated were the thermal and mechanical responses of the formation to an applied heat load, as well as the mineralogical changes induced by heating. Objective was to provide a minimal integrated field and laboratory study that would supply a data base which could be used in planning more expensive and complex vault-type experiments in other localities. The experiments were operated with heater power levels of between 6 and 8 kW for heater mid-plane temperatures of 385 0 C. The temperature fields within the shale were measured and analysis is in progress. Steady state conditions were achieved within 90 days. Conduction appears to be the principal mechanism of heat transport through the formation. Limited mechanical response measurements consisting of vertical displacement and stress data indicate general agreement with predictions. Posttest data, collection of which await experiment shutdown and cooling of the formation, include the mineralogy of posttest cores, posttest transmissivity measurements and corrosion data on metallurgical samples

  12. Educational Activity: A Preliminary Review and Some International Experiences

    Directory of Open Access Journals (Sweden)

    Salem Ali Al Qahtani

    2017-11-01

    Full Text Available This paper reviews the history of the educational activity which was entered through John Dewey’s Experimental School, founded in 1896, the first school to use the activity curriculum. It sheds the light on the stages that activity has gone through till today. The Islamic view and a number of quotes from a number of Islamic thinkers and educators also were reviewed. The importance of the activity, its basics, functions, types and classifications were also discussed. The research concluded with a number of international experiences which gave great importance to the activity in their curricula and educational plans. The most important recommendations are: 1 Offering advanced training programs for teachers on educational activity; 2 Adding educational activity as an independent material in educational colleges; 3 Expanding the scope of study for international experiences in educational activity; and 4 Making use of technology and employing it in the educational activity.

  13. Preliminary pellet injection experiment in the Gamma 10 tandem mirror

    Energy Technology Data Exchange (ETDEWEB)

    Kawamori, Eiichirou; Tamano, Teruo; Nakashima, Yousuke; Yoshikawa, Masayuki; Kobayashi, Shinji; Cho, Teruji; Ishii, Kameo; Yatsu, Kiyoshi [Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan); Mase, Atsushi [Advanced Sceince and Technology Center for Cooperative Research, Kyushu University, Kasuga, Fukuoka (Japan)

    2000-07-01

    In the GAMMA 10 tandem mirror, pellet injection experiments have been started as a solution for the density limit problem. This is the first pellet injection experiment in open systems. We describe the possibilities of confinement of pellet fueled particles. For that, we measure the number of end loss particles and compare them with pellet fueled ones in various conditions of confining potentials. The deterioration of confining potential with the pellet injection is a fundamental issue. The results show that the ion confining potential recover faster than central electron temperature due to thermal barrier. We also consider the operating space for fueling method. It is demonstrated that the operating space for pellet injection exceeds gas fueled one on hot ion mode plasmas. (author)

  14. Preliminary experiments on wastes degradation by thermal plasma

    International Nuclear Information System (INIS)

    Cota S, G.; Pacheco S, J.; Segovia R, A.; Pena E, R.; Merlo S, L.

    1996-01-01

    This work presents the fundamental aspects involved in the installation and start up of an experimental equipment for the hazardous wastes degradation using the thermal plasma technology. It is mentioned about the form in which the thermal plasma is generated and the characteristics that its make to be an appropriate technology for the hazardous wastes degradation. Just as the installed structures for to realize the experiments and results of the first studies on degradation, using nylon as problem sample. (Author)

  15. Preliminary experiments on energy recovery on a neutral beam injector

    International Nuclear Information System (INIS)

    Fumelli, M.

    1977-06-01

    Energy recovery tests performed on an injector of energetic neutral atoms in which the ion source is operated at the ground potential and the neutralizer is biased at the high energy potential corresponding to the desired neutral beam energy, are presented. The operation of the suppressor grid is studied in two different experiments. These tests underline the problems to be solved for an efficient recovery of the energy of the unneutralized beam fraction

  16. Perceptions of the Pediatric Hospice Experience among English- and Spanish-Speaking Families.

    Science.gov (United States)

    Thienprayoon, Rachel; Marks, Emily; Funes, Maria; Martinez-Puente, Louizza Maria; Winick, Naomi; Lee, Simon Craddock

    2016-01-01

    Many children who die are eligible for hospice enrollment but little is known about parental perceptions of the hospice experience, the benefits, and disappointments. The objective of this study was to explore parental perspectives of the hospice experience in children with cancer, and to explore how race/ethnicity impacts this experience. We held 20 semistructured interviews with 34 caregivers of children who died of cancer and used hospice. Interviews were conducted in the caregivers' primary language: 12 in English and 8 in Spanish. Interviews were recorded, transcribed, and analyzed using accepted qualitative methods. Both English and Spanish speakers described the importance of honest, direct communication by medical providers, and anxieties surrounding the expectation of the moment of death. Five English-speaking families returned to the hospital because of unsatisfactory symptom management and the need for additional supportive services. Alternatively, Spanish speakers commonly stressed the importance of being at home and did not focus on symptom management. Both groups invoked themes of caregiver appraisal, but English-speaking caregivers more commonly discussed themes of financial hardship and fear of insurance loss, while Spanish-speakers focused on difficulties of bedside caregiving and geographic separation from family. The intense grief associated with the loss of a child creates shared experiences, but Spanish- and English-speaking parents describe their hospice experiences in different ways. Additional studies in pediatric hospice care are warranted to improve the care we provide to children at the end of life.

  17. Pediatric MS

    Science.gov (United States)

    ... Pediatric MS Share this page Facebook Twitter Email Pediatric MS Pediatric MS Pediatric MS Support Pediatric Providers ... system through the Pediatric MS Support Group . Treating pediatric MS In 2018 the U.S. Food and Drug ...

  18. Some preliminary considerations on antiproton-nucleus experiments

    International Nuclear Information System (INIS)

    Yavin, A.I.

    1981-05-01

    The antiproton as a probe of the atomic nucleus is discussed in the expectation that fairly intense beams of high quality will be available in 1983 at the Low Energy Antiproton Ring (LEAR) facility at CERN and possibly also in some other laboratories at a later date. Several antiproton-nucleus experiments are proposed, and the possibility of observing antiprotonic nuclei as well as antineutronic nuclei is discussed. It is demonstrated that even for the study of the elementary nucleon-antinucleon systems it could be advantageous to use nuclei rather than protons as target. The possibility of investigating several antiprotonic atomic systems is also briefly discussed [fr

  19. Preliminary results of a neutron-gamma coincidence experiment

    International Nuclear Information System (INIS)

    Piercey, R.B.; Dunnam, F.E.; Muga, M.L.; Rester, A.C.; Ramayya, A.V.; Hamilton, J.H.; Eberth, J.; Zganjar, E.F.

    1984-01-01

    The recently completed neutron multiplicity detector dubbed PANDA (Pentagonal Annular Neutron Detector Array) is fully described later in this report. The new detector was recently used for the first time on-line at the Holifield Heavy Ion Research Facility to measure neutron-gamma coincidence in the 24 Mg( 58 Ni,xαypzn) reaction. The detector configuration for the experiment is shown. The PANDA was situated in the forward direction, coaxial to the beam line with five gamma-ray detectors placed at +/- 90 0 , +/- 135 0 , and 0 0 . 2 figures

  20. THE MORPHOLOGICAL BASIS FOR OLFACTORY PERCEPTION OF STEROIDS DUING AGONISTIC BEHAVIOR IN LOBSTER: PRELIMINARY EXPERIMENTS

    Science.gov (United States)

    The morphological basis for olfactory perception of steroids during agonistic behavior in lobsters: preliminary experiments. Borsay Horowitz, DJ1, Kass-Simon, G2, Coglianese, D2, Martin, L2, Boseman, M2, Cromarty, S3, Randall, K3, Fini, A.3 1US EPA, NHEERL, ORD, Atlantic Ecology...

  1. New pellet compression schemes by indirect irradiation of REB and related preliminary experiments

    International Nuclear Information System (INIS)

    Sato, M.; Tazima, T.; Yonezu, H.

    1986-01-01

    Preliminary experiments on a proposed scheme for pellet compression is carried out with a Point Pinch Diode. A high current density of ion beam is observed, and its value corresponds to 13.5 kA/cm 2 from the anode to the cathode. (author)

  2. Geochemistry of shale groundwaters: Results of preliminary laboratory leaching experiments

    International Nuclear Information System (INIS)

    Von Damm, K.L.; Johnson, K.O.

    1987-09-01

    Twelve shales were reacted with distilled water at 20 0 C and 100 0 C; the composition of the waters and the mineralogy were determined before and after reaction. The experiments were conducted in a batch mode over a period of approximately 40 days. Major changes occurred in the solution chemistry; in most cases sulfate became the dominant anion while either sodium or calcium was the major cation. The high sulfate is most likely a result of the oxidation of pyrite in the samples. In the 100 0 C experiments some of the solutions became quite acidic. Examination of the observed mineralogy and comparison to the mineral assemblage calculated to be in equilibrium with the experimentally determined waters, suggests that the acidic waters are generated when no carbonate minerals remain to buffer the groundwaters to a more neutral pH. The pH of shale waters will be determined by the balance between the oxidation of pyrite and organic matter and the dissolution of carbonate minerals. The experimental data are helping to elucidate the chemical reactions that control the pH of shale groundwaters, a critical parameter in determining other water-rock and waste-water-rock interactions and ultimate solute mobility. An experimental approach also provides a means of obtaining data for shales for which no groundwater data are available as well as data on chemical species which are not usually determined or reported

  3. Geochemistry of shale groundwaters: Results of preliminary laboratory leaching experiments

    Energy Technology Data Exchange (ETDEWEB)

    Von Damm, K.L.; Johnson, K.O.

    1987-09-01

    Twelve shales were reacted with distilled water at 20/sup 0/C and 100/sup 0/C; the composition of the waters and the mineralogy were determined before and after reaction. The experiments were conducted in a batch mode over a period of approximately 40 days. Major changes occurred in the solution chemistry; in most cases sulfate became the dominant anion while either sodium or calcium was the major cation. The high sulfate is most likely a result of the oxidation of pyrite in the samples. In the 100/sup 0/C experiments some of the solutions became quite acidic. Examination of the observed mineralogy and comparison to the mineral assemblage calculated to be in equilibrium with the experimentally determined waters, suggests that the acidic waters are generated when no carbonate minerals remain to buffer the groundwaters to a more neutral pH. The pH of shale waters will be determined by the balance between the oxidation of pyrite and organic matter and the dissolution of carbonate minerals. The experimental data are helping to elucidate the chemical reactions that control the pH of shale groundwaters, a critical parameter in determining other water-rock and waste-water-rock interactions and ultimate solute mobility. An experimental approach also provides a means of obtaining data for shales for which no groundwater data are available as well as data on chemical species which are not usually determined or reported.

  4. Long Term Sequelae of Pediatric Craniopharyngioma – Literature Review and 20 Years of Experience

    Science.gov (United States)

    Cohen, Michal; Guger, Sharon; Hamilton, Jill

    2011-01-01

    Craniopharyngioma are rare histologically benign brain tumors that develop in the pituitary–hypothalamic area. They may invade nearby anatomical structures causing significant rates of neurological, neurocognitive, and endocrinological complications including remarkable hypothalamic damage. Information regarding long term implications of the tumors and treatment in the pediatric population is accumulating, and treatment goals appear to be changing accordingly. In this review we aim to present data regarding long term complications of craniopharyngioma in children and adolescents and our experience from a large tertiary center. Hypothalamic dysfunction was noted to be the most significant complication, adversely affecting quality of life in survivors. Obesity, fatigue, and sleep disorders are the most notable manifestations of this dysfunction, and treatment is extremely difficult. Changes in management in recent years show a potential for improved long term outcomes; we found a trend toward less aggressive surgical management and increasing use of adjuvant treatment, accompanied by a decrease in complication rates. PMID:22645511

  5. Long term sequelae of pediatric craniopharyngioma - literature review and 20 years of experience

    Directory of Open Access Journals (Sweden)

    Michal eCohen

    2011-11-01

    Full Text Available Craniopharyngioma are rare histologically benign brain tumors that develop in the pituitary- hypothalamic area. They may invade nearby anatomical structures causing significant rates of neurological, neurocognitive and endocrinological complications including remarkable hypothalamic damage. Information regarding long term implications of the tumors and treatment in the pediatric population is accumulating, and treatment goals appear to be changing accordingly. In this review we aim to present data regarding long term complications of craniopharyngioma in children and adolescents and our experience from a large tertiary center. Hypothalamic dysfunction was noted to be the most significant complication, adversely affecting quality of life in survivors. Obesity, fatigue and sleep disorders are the most notable manifestations of this dysfunction, and treatment is extremely difficult. Changes in management in recent years show a potential for improved long term outcomes; we found a trend towards less aggressive surgical management and increasing use of adjuvant treatment, accompanied by a decrease in complication rates.

  6. Clinical Experience of Auditory Brainstem Response Testing on Pediatric Patients in the Operating Room

    Directory of Open Access Journals (Sweden)

    Guangwei Zhou

    2012-01-01

    Full Text Available Objectives. To review our experience of conducting auditory brainstem response (ABR test on children in the operating room and discuss the benefits versus limitations of this practice. Methods. Retrospective review study conducted in a pediatric tertiary care facility. A total of 267 patients identified with usable data, including ABR results, medical and surgical notes, and follow-up evaluation. Results. Hearing status successfully determined in all patients based on the ABR results form the operating room. The degrees and the types of hearing loss also documented in most of the cases. In addition, multiple factors that may affect the outcomes of ABR in the operating room identified. Conclusions. Hearing loss in children with complicated medical issues can be accurately evaluated via ABR testing in the operating room. Efforts should be made to eliminate adverse factors to ABR recording, and caution should be taken when interpreting ABR results from the operating room.

  7. Discrete choice experiment to evaluate factors that influence preferences for antibiotic prophylaxis in pediatric oncology.

    Science.gov (United States)

    Regier, Dean A; Diorio, Caroline; Ethier, Marie-Chantal; Alli, Amanda; Alexander, Sarah; Boydell, Katherine M; Gassas, Adam; Taylor, Jonathan; Kellow, Charis; Mills, Denise; Sung, Lillian

    2012-01-01

    Bacterial and fungal infections in pediatric oncology patients cause morbidity and mortality. The clinical utility of antimicrobial prophylaxis in children is uncertain and the personal utility of these agents is disputed. Objectives were to use a discrete choice experiment to: (1) describe the importance of attributes to parents and healthcare providers when deciding between use and non-use of antibacterial and antifungal prophylaxis; and (2) estimate willingness-to-pay for prophylactic strategies. Attributes were chances of infection, death and side effects, route of administration and cost of pharmacotherapy. Respondents were randomized to a discrete choice experiment outlining hypothetical treatment options to prevent antibacterial or antifungal infections. Each respondent was presented 16 choice tasks and was asked to choose between two unlabeled treatment options and an opt-out alternative (no prophylaxis). 102 parents and 60 healthcare providers participated. For the antibacterial discrete choice experiment, frequency of administration was significantly associated with utility for parents but not for healthcare providers. Increasing chances of infection, death, side effects and cost were all significantly associated with decreased utility for parents and healthcare providers in both the antibacterial and antifungal discrete choice experiment. Parental willingness-to-pay was higher than healthcare providers for both strategies. Chances of infection, death, side effects and costs were all significantly associated with utility. Parents have higher willingness-to-pay for these strategies compared with healthcare providers. This knowledge can help to develop prophylaxis programs.

  8. Discrete choice experiment to evaluate factors that influence preferences for antibiotic prophylaxis in pediatric oncology.

    Directory of Open Access Journals (Sweden)

    Dean A Regier

    Full Text Available Bacterial and fungal infections in pediatric oncology patients cause morbidity and mortality. The clinical utility of antimicrobial prophylaxis in children is uncertain and the personal utility of these agents is disputed. Objectives were to use a discrete choice experiment to: (1 describe the importance of attributes to parents and healthcare providers when deciding between use and non-use of antibacterial and antifungal prophylaxis; and (2 estimate willingness-to-pay for prophylactic strategies.Attributes were chances of infection, death and side effects, route of administration and cost of pharmacotherapy. Respondents were randomized to a discrete choice experiment outlining hypothetical treatment options to prevent antibacterial or antifungal infections. Each respondent was presented 16 choice tasks and was asked to choose between two unlabeled treatment options and an opt-out alternative (no prophylaxis.102 parents and 60 healthcare providers participated. For the antibacterial discrete choice experiment, frequency of administration was significantly associated with utility for parents but not for healthcare providers. Increasing chances of infection, death, side effects and cost were all significantly associated with decreased utility for parents and healthcare providers in both the antibacterial and antifungal discrete choice experiment. Parental willingness-to-pay was higher than healthcare providers for both strategies.Chances of infection, death, side effects and costs were all significantly associated with utility. Parents have higher willingness-to-pay for these strategies compared with healthcare providers. This knowledge can help to develop prophylaxis programs.

  9. Experience base for Radioactive Waste Thermal Processing Systems: A preliminary survey

    International Nuclear Information System (INIS)

    Mayberry, J.; Geimer, R.; Gillins, R.; Steverson, E.M.; Dalton, D.; Anderson, G.L.

    1992-04-01

    In the process of considering thermal technologies for potential treatment of the Idaho National Engineering Laboratory mixed transuranic contaminated wastes, a preliminary survey of the experience base available from Radioactive Waste Thermal Processing Systems is reported. A list of known commercial radioactive waste facilities in the United States and some international thermal treatment facilities are provided. Survey focus is upon the US Department of Energy thermal treatment facilities. A brief facility description and a preliminary summary of facility status, and problems experienced is provided for a selected subset of the DOE facilities

  10. Sodium MR imaging of human brain neoplasms. A preliminary experience

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Shu; Yoshikawa, Kohki; Takakura, Kintomo; Iio, Masahiro

    1988-08-01

    We reported the experience of the sodium magnetic resonance imaging of 5 patients with brain tumors (4 astrocytomas and 1 craniopharyngioma), using a Siemens 1.5 Tesla superconductive magnet. We used two-dimensional Fourier imaging with a spin-echo scanning sequence (and with the repetition time of 140 msec and the echo time of 11 - 14 msec). The radiofrequency was maintained at 17 MHz. Sodium MR imaging was achieved with a 64 x 64 data acquisition (30 mm slice thickness) in 19.1 min. On the sodium MRI, all four astrocytomas, along with the eye balls and the cerebrospinal fluid spaces, appeared as high-intensity areas. Peritumoral edema is also visualized as highly intense, so that it is difficult to discriminate tumor extent from the surrounding edema. Our comparative studies with malignant glioma cases using the same equipment are needed to clarify the relationship between sodium signal intensities and the malignancy of gliomas, and to evaluate the potential clinical utility of sodium MRI. A craniopharyngioma than contained a yellowish cystic fluid with a sodium concentration as high as CSF was shown on sodium MRI as a mass with highly intense signals. The ability to differentiate extracellular from intracellular sodium, that has been studied by several investigators, would greatly augment the clinical specificity of MR imaging.

  11. Interventional sialendoscopy for parotid ductal calculi: our preliminary experience.

    Science.gov (United States)

    Singh, P P; Gupta, Neelima; Goyal, Arun; Tomar, Sanjeev

    2012-09-01

    With this article we present our initial experience with interventional sialendoscopy of the parotid duct for the parotid calculi. We carried out a prospective study of patients of parotid calculi in a tertiary referral centre. Diagnostic and interventional sialendoscopy was performed in five cases of parotid calculi. The outcome was classified on the basis of clearance of the lumen of the duct and resolution of symptoms. Diagnostic sialendoscopy was able to diagnose the calculus in all cases. Interventional sialendoscopy was done under general anesthesia in all cases and calculus was successfully removed. The average size of sialolith was 8.2 mm. No complications occurred in any of the cases. Check sialendoscopy was done in all cases after a minimum follow up of 6 months, which showed the duct lumen to be free of stone with no stricture of the duct. Sialendoscopy is an optimal technique for removal of intraductal parotid calculi and avoids removal of the gland. In our series there was no associated morbidity and complication.

  12. Preliminary experiment research of explosively driven opening switch

    International Nuclear Information System (INIS)

    Li Xiaolin; Chen Dongqun; Li Da; Cao Shengguang; Chen Yingcong

    2010-01-01

    In pulse power technology field, many loads require high current pulse with fast risetime, but sometimes, the common high current pulse powers don't satisfy request, thus there need pulse erection switches of sorts to shorten pulse risetime. Explosively driven opening switch (EDOS) is a good choice, it has simple structure and excellent performance, the primary parameters of EDOS are opening time, opening resistance, opening current and dissipation energy, which determine its performance and range for applications. For this, two kinds of EDOS are designed and manufactured, in the later experiments, the power supply is a 200 μF capacitor and the conductor is 0.03 mm copper foil, the results indicate that the two kinds of EDOS have good performance, the opening time is about 1-3 μs, the opening resistance is about 1-2 Ω, the opening current is about 24-31 kA and the average dissipation energy is about 0.125-0.34 kJ per groove, the capability of conduction current is adjusted by the thickness of conductor along with different opening current. (authors)

  13. Smart Ultrasound Remote Guidance Experiment (SURGE) Preliminary Findings

    Science.gov (United States)

    Hurst, Victor; Dulchavsky, Scott; Garcia, Kathleen; Sargsyan, Ashot; Ebert, Doug

    2009-01-01

    To date, diagnostic quality ultrasound images were obtained aboard the International Space Station (ISS) using the ultrasound of the Human Research Facility (HRF) rack in the Laboratory module. Through the Advanced Diagnostic Ultrasound in Microgravity (ADUM) and the Braslet-M Occlusion Cuffs (BRASLET SDTO) studies, non-expert ultrasound operators aboard the ISS have performed cardiac, thoracic, abdominal, vascular, ocular, and musculoskeletal ultrasound assessments using remote guidance from ground-based ultrasound experts. With exploration class missions to the lunar and Martian surfaces on the horizon, crew medical officers will necessarily need to operate with greater autonomy given communication delays (round trip times of up to 5 seconds for the Moon and 90 minutes for Mars) and longer periods of communication blackouts (due to orbital constraints of communication assets). The SURGE project explored the feasibility and training requirements of having non-expert ultrasound operators perform autonomous ultrasound assessments in a simulated exploration mission outpost. The project aimed to identify experience, training, and human factors requirements for crew medical officers to perform autonomous ultrasonography. All of these aims pertained to the following risks from the NASA Bioastronautics Road Map: 1) Risk 18: Major Illness and Trauna; 2) Risk 20) Ambulatory Care; 3) Risk 22: Medical Informatics, Technologies, and Support Systems; and 4) Risk 23: Medical Skill Training and Maintenance.

  14. The preliminary results of steam explosion experiments in TROI

    International Nuclear Information System (INIS)

    Song, J.H.; Park, I.K.; Chang, Y.J.; Min, B.T.; Hong, S.W.; Kim, H.D.

    2001-01-01

    Korea Atomic Energy Research Institute (KAERI) launched an intermediate scale steam explosion experiment named 'Test for Real corium Interaction with water (TROI)' using reactor material to investigate the effect of material composition, multi-dimensional melt-water interaction, and hydrogen generation. The melt-water interaction is confined in a pressure vessel with the multi-dimensional fuel and water pool geometry. The cold crucible technology, where the mixture of oxide powder in a water-cooled cage is heated by high frequency induction, is employed. It minimizes unwanted inclusion of impurities during the melting process. The data acquisition system and instrumentations which measure the static and dynamic pressure, temperatures of melt and water are set up. In the first series of tests using several kg of ZrO 2 , melt water interaction is made in a heated water pool at 95 Celsius degrees without triggering. A steam spike pressure at about 10 bar is observed. The morphology of debris shows that there was a mild local steam explosion. The melt water interaction was monitored by video cameras. The UO 2 tests are scheduled around March of 2001, in parallel with the improvements of the design of test facility. (authors)

  15. Reflooding Experimental On Beta Test Loop : The Characterisation And Preliminary Experiment

    International Nuclear Information System (INIS)

    Khairul, H.; Antariksawan, Anhar R.; Sumamo, Edy; Kiswanta; Giarno; Joko, P.; H, Ismu

    2001-01-01

    The characterisation and preliminary experiment of reflooding had been conducted. The characteristics of main system and component had been identified completely. From these characteristics the experiment condition was set up : heated rod voltage was 20 volt, frequency,of pump was 19 Hz, flow rate was 1 m3/h. The first of experiment did not show the phenomena of rewetting. Possibly because the heated rod temperature was too low. For the second experiment, the voltage of heated rod was increased to 22 Volt and the flow rate was decreased. The result was that the nucleation boiling on the surfaced of heated rod, was observed during the water re flooded the test section

  16. Preliminary experience with biodegradable implants for fracture fixation

    Directory of Open Access Journals (Sweden)

    Dhillon Mandeep

    2008-01-01

    Full Text Available Background: Biodegradable implants were designed to overcome the disadvantages of metal-based internal fixation devices. Although they have been in use for four decades internationally, many surgeons in India continue to be skeptical about the mechanical strength of biodegradable implants, hence this study. Materials and Methods: A prospective study was done to assess the feasibility and surgeon confidence level with biodegradable implants over a 12-month period in an Indian hospital. Fifteen fractures (intra-articular, metaphyseal or small bone fractures were fixed with biodegradable implants. The surgeries were randomly scheduled so that different surgeons with different levels of experience could use the implants for fixation. Results: Three fractures (one humeral condyle, two capitulum, were supplemented by additional K-wires fixation. Trans-articular fixator was applied in two distal radius and two pilon fractures where bio-pins alone were used. All fractures united, but in two cases the fracture displaced partially during the healing phase; one fibula due to early walking, and one radius was deemed unstable even after bio-pin and external fixator. Conclusions: Biodegradable -implants are excellent for carefully selected cases of intra-articular fractures and some small bone fractures. However, limitations for use in long bone fractures persist and no great advantage is gained if a "hybrid" composite is employed. The mechanical properties of biopins and screws in isolation are perceived to be inferior to those of conventional metal implants, leading to low confidence levels regarding the stability of reduced fractures; these implants should be used predominantly in fracture patterns in which internal fixation is subjected to minimal stress.

  17. Biological therapy with TNF-inhibitors in pediatric rheumatology. Review of the litterature and personal experience

    Directory of Open Access Journals (Sweden)

    F. Fantini

    2011-09-01

    Full Text Available The therapeutic approach to JIA is sometimes very troublesome and progression to erosive polyarthritis may occur in all JIA categories. Only Methotrexate has shown efficacy and safety in a large controlled trial. Nevertheless, in many cases, drug resistance or intolerance has led to try other therapeutic options, with still debatable results. Therefore, there has been space, in the last few years, for new therapies as the TNF-inhibitors. This therapeutic approach has shown a dramatic clinical benefit in active polyarticular refractory JIA: the rate and rapidity of response have exceeded those of all other studied DMARDs. Preliminary data show that they are efficacious also for other pediatric rheumatic disease (spondyloarthropathies, autoimmune uveitis, dermatomyositis, Kawasaki syndrome and some auto- inflammatory diseases. TNF-inhibitors in JIA have demonstrated a favourable benefit-to-risk profile. However, as their use has increased worldwide, some unusual, usually not serious, adverse events have emerged. Severe infections, including TB, and deaths have been reported. Long-lasting active disease, systemic disease, concurrent and previous immunosuppressive therapies, all contribute to risk of infection and other serious AEs. Given the evidence that TNF has a primary role in the pathogenesis of JIA, particularly in joint destruction, neutralizing this cytokine early, within the window of opportunity, could halt or delay progression of joint damage and debilitating consequences of the disease. Thus, for JIA patients whose disease is not quickly controlled with MTX, TNF blockers may be considered as first-line treatment, although long-term safety data still need to be established.

  18. Ministernotomy: A preliminary experience in heart valve surgery

    Directory of Open Access Journals (Sweden)

    Kovačević Pavle

    2011-01-01

    Full Text Available Background/Aim. The last decade of the 20th century brought up a significant development in the field of minimally invasive approaches to the valvular heart surgery. Potential benefits of this method are: good esthetic appearance, reduced pain, reduction of postoperative hemorrhage and incidence of surgical site infection, shorter postoperative intensive care units (ICU period and overall in-hospital period. Partial upper median sternotomy currently presents as a state-of-the art method for minimally invasive surgery of cardiac valves. The aim of this study was to report on initial experience in application of this surgical method in the surgery of mitral and aortic valves. Methods. The study was designed and conducted in a prospective manner and included all the patients who underwent minimally invasive cardiac valve surgery through the partial upper median sternotomy during the period November 2008 - August 2009. We analyzed the data on mean age of patients, mean extubation time, mean postoperative drainage, mean duration of hospital stay, as well as on occurance of postoperative complications (postoperative bleeding, surgical site infection and cerebrovascular insult. Results. During the observed period, in the Institute for Cardiovascular Diseases of Vojvodina, Clinic for Cardiovascular Surgery, 17 ministernotomies were performed, with 14 aortic valve replacements (82.35% and 3 mitral valve replacements (17.65%. Mean age of the patients was 60.78 ± 12.99 years (64.71% males, 35.29% females. Mean extubation time was 12.53 ± 8.87 hours with 23.5% of the patients extubated in less than 8 hours. Mean duration of hospital stay was 12.35 ± 10.17 days (in 29.4% of the patients less than 8 days. Mean postoperative drainage was 547.06 ± 335.2 mL. Postoperative complications included: bleeding (5.88% and cerebrovascular insult (5.88%. One patient (5.88% required conversion to full sternotomy. Conclusion. Partial upper median sternotomy represents

  19. [Ministernotomy: a preliminary experience in heart valve surgery].

    Science.gov (United States)

    Kovarević, Pavle; Mihajlović, Bogoljub; Velicki, Lazar; Redzek, Aleksandar; Ivanović, Vladimir; Komazec, Nikola

    2011-05-01

    The last decade of the 20th century brought up a significant development in the field of minimally invasive approaches to the valvular heart surgery. Potential benefits of this method are: good esthetic appearance, reduced pain, reduction of postoperative hemorrhage and incidence of surgical site infection, shorter postoperative intensive care units (ICU) period and overall in-hospital period. Partial upper median stemotomy currently presents as a state-of-the art method for minimally invasive surgery of cardiac valves. The aim of this study was to report on initial experience in application of this surgical method in the surgery of mitral and aortic valves. The study was designed and conducted in a prospective manner and included all the patients who underwent minimally invasive cardiac valve surgery through the partial upper median stemotomy during the period November 2008 - August 2009. We analyzed the data on mean age of patients, mean extubation time, mean postoperative drainage, mean duration of hospital stay, as well as on occurance of postoperative complications (postoperative bleeding, surgical site infection and cerebrovascular insult). During the observed period, in the Institute for Cardiovascular Diseases of Vojvodina, Clinic for Cardiovascular Surgery, 17 ministernotomies were performed, with 14 aortic valve replacements (82.35%) and 3 mitral valve replacements (17.65%). Mean age of the patients was 60.78 +/- 12.99 years (64.71% males, 35.29% females). Mean extubation time was 12.53 +/- 8.87 hours with 23.5% of the patients extubated in less than 8 hours. Mean duration of hospital stay was 12.35 +/- 10.17 days (in 29.4% of the patients less than 8 days). Mean postoperative drainage was 547.06 +/- 335.2 mL. Postoperative complications included: bleeding (5.88%) and cerebrovascular insult (5.88%). One patient (5.88%) required conversion to full stemotomy. Partial upper median sternotomy represents the optimal surgical method for the interventions on the

  20. Nurses' Perceptions of Pediatric Intensive Care Unit Environment and Work Experience After Transition to Single-Patient Rooms.

    Science.gov (United States)

    Kudchadkar, Sapna R; Beers, M Claire; Ascenzi, Judith A; Jastaniah, Ebaa; Punjabi, Naresh M

    2016-09-01

    The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms. A cross-sectional survey of nurses was conducted before and after the move to a new hospital building in which all rooms in the pediatric critical care unit were single-patient rooms. Nurses reported that compared with multipatient rooms, single-patient private rooms were more conducive to patients sleeping well at night and promoted a more normal sleep-wake cycle (P noise in single-patient rooms (33%) than in multipatient rooms (79%; P pediatric intensive care unit environment for promoting patients' sleep and the nurses' own work experience. ©2016 American Association of Critical-Care Nurses.

  1. Opportunities lost and found: experiences of patients with cerebral palsy and their parents transitioning from pediatric to adult healthcare.

    Science.gov (United States)

    DiFazio, Rachel L; Harris, Marie; Vessey, Judith A; Glader, Laurie; Shanske, Susan

    2014-01-01

    To describe and define the experiences of adults with cerebral palsy (CP) and parents of adults with CP who have been involved in a transfer of physiatry care from pediatric to adult healthcare and to explore their experiences more generally in the transition from pediatric to adult services. A qualitative research approach was used. Semi-structured focus group interviews were conducted with adults with CP (n=5) and parents of adults with CP (n=8) to explore the health care transition (HCT) process from pediatric to adult healthcare. Four key content domains were used to facilitate the focus groups; 1) Transition Planning, 2) Accessibility of Services, 3) Experience with Adult Providers, and 4) Recommendations for Improving the Transition Process. Conventional content analysis was used to analyze the data. Four themes emerged from the focus groups; Lost in Transition, Roadmap to Care, List of None, and One Stop Shopping. Participants felt lost in the HCT process, requested a transparent transition plan, expressed concern regarding access to adult healthcare, and made recommendations for improvements. Challenges in transitioning from pediatric to adult health care were identified by all participants and several strategies were recommended for improvement.

  2. Child- And Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: Development and Preliminary Results.

    Science.gov (United States)

    Pavuluri, Mani N.; Graczyk, Patricia A.; Henry, David B.; Carbray, Julie A.; Heidenreich, Jodi; Miklowitz, David J.

    2004-01-01

    Objective: To describe child- and family-focused cognitive-behavioral therapy (CFF-CBT), a new developmentally sensitive psychosocial intervention for pediatric bipolar disorder (PBD) that is intended for use along with medication. CFF-CBT integrates principles of family-focused therapy with those of CBT. The theoretical framework is based on (1)…

  3. Preliminary Predictors of within-Session Adherence to Exposure and Response Prevention in Pediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

    Morgan, Jessica; Caporino, Nicole E.; De Nadai, Alessandro S.; Truax, Tatyana; Lewin, Adam B.; Jung, Leah; Park, Jennifer M.; Khan, Yasmeen Ali; Murphy, Tanya K.; Storch, Eric A.

    2013-01-01

    Background: Cognitive-behavioral therapy with exposure and response prevention (ERP) is an effective treatment for pediatric OCD; however, up to 30 % of children are treatment non-responders and as many as 40% are partial responders. Although poor treatment adherence has been linked to attenuated response in adults with OCD, little research has…

  4. Adolescents growing with HIV/AIDS: experiences of the transition from pediatrics to adult care

    Directory of Open Access Journals (Sweden)

    Daisy Maria Machado

    2016-05-01

    Full Text Available The main objective of this work is to describe the formation of the Transition Adolescent Clinic (TAC and understand the process of transitioning adolescents with HIV/AIDS from pediatric to adult care, from the vantage point of individuals subjected to this process. A qualitative method and an intentional sample selected by criteria were adopted for this investigation, which was conducted in São Paulo, Brazil. An in-depth semi-structured interview was conducted with sixteen HIV-infected adolescents who had been part of a transitioning protocol. Adolescents expressed the need for more time to become adapted in the transition process. Having grown up under the care of a team of health care providers made many participants have reluctance toward transitioning. Concerns in moving away from their pediatricians and feelings of disruption, abandonment, or rejection were mentioned. Participants also expressed confidence in the pediatric team. At the same time they showed interest in the new team and expected to have close relationships with them. They also ask to have previous contacts with the adult health care team before the transition. Their talks suggest that they require slightly more time, not the time measured in days or months, but the time measured by constitutive experiences capable of building an expectation of future. This study examines the way in which the adolescents feel, and help to transform the health care transition model used at a public university. Listening to the adolescents’ voices is crucial to a better understanding of their needs. They are those who can help the professionals reaching alternatives for a smooth and successful health care transition.

  5. Physician and medical student perceptions and expectations of the pediatric clerkship: a Qatar experience

    Directory of Open Access Journals (Sweden)

    Hendaus MA

    2016-05-01

    Full Text Available Mohamed A Hendaus,1,2 Shabina Khan,1 Samar Osman,1 Yasser Alsamman,2 Tushar Khanna,2 Ahmed H Alhammadi1,2 1Department of Pediatrics, General Academic Pediatrics Division, Hamad Medical Corporation, Doha, 2Weill Cornell Medical College-Qatar, Al Rayyan, Qatar Background: The average number of clerkship weeks required for the pediatric core rotation by the US medical schools is significantly lower than those required for internal medicine or general surgery. Objective: The objective behind conducting this survey study was to explore the perceptions and expectations of medical students and pediatric physicians about the third-year pediatric clerkship. Methods: An anonymous survey questionnaire was distributed to all general pediatric physicians at Hamad Medical Corporation and to students from Weill Cornell Medical College-Qatar. Results: Feedback was obtained from seven attending pediatricians (100% response rate, eight academic pediatric fellow physicians (100% response rate, 36 pediatric resident physicians (60% response rate, and 36 medical students (60% response rate. Qualitative and quantitative data values were expressed as frequencies along with percentages and mean ± standard deviation and median and range. A P-value <0.05 from a 2-tailed t-test was considered to be statistically significant. Participants from both sides agreed that medical students receive <4 hours per week of teaching, clinical rounds is the best environment for teaching, adequate bedside is provided, and that there is no adequate time for both groups to get acquainted to each other. On the other hand, respondents disagreed on the following topics: almost two-thirds of medical students perceive postgraduate year 1 and 2 pediatric residents as the best teachers, compared to 29.4% of physicians; 3 weeks of inpatient pediatric clerkship is enough for learning; the inpatient pediatric environment is safe and friendly; adequate feedback is provided by physicians to

  6. Interactions between piscivores, zooplanktivores and zooplankton in submerged macrophytes : Preliminary observations from enclosure and pond experiments

    DEFF Research Database (Denmark)

    Jacobsen, Lene; Perrow, M.R.; Landkildehus, F.

    1997-01-01

    behavioural changes of zooplanktivores has received little attention, even though this may be an important mechanism in enhancing the stability of submerged macrophytes in shallow lakes. Preliminary observations from an unreplicated large-scale field enclosure experiment and a replicated pond experiment...... and the presence of zooplanktivores typically changed the habitat selection of cladoceran zooplankton. In the case of piscivore/zooplanktivore interactions, the risk of predation was enough to generate clear responses even where the losses to predation were low. However, only in the enclosure experiment...

  7. Experience and policy implications of children presenting with dental emergencies to US pediatric dentistry training programs.

    Science.gov (United States)

    Edelstein, Burton; Vargas, Clemencia M; Candelaria, Devanie; Vemuri, Maryen

    2006-01-01

    The purpose of this study was to describe and substantiate the experience of children, their families, and their caregivers with children's dental pain and to explore implications of these experiences for public policy. Data for 301 children presenting to 35 pediatric dentistry training programs during a 1-week period in 2000 for pain relief were collected with a questionnaire asking for: (1) sociodemographic characteristics; (2) oral health status; (3) dental care history; (4) presenting problem; (5) clinical findings; and (6) clinical disposition. Descriptive statistics are presented. Among children presenting to training programs with oral pain, 28% were under age 6, 57% were on Medicaid, and 38% were regarded by their dentists to have "likely or obvious" functional impairment-with 22% reporting the highest pain level. Parents reported that 59% had "poor or fair oral health" and 29% had a prior dental emergency in the previous year. Pain, experienced for several days by 73% of children, was associated with difficulty: (1) eating; (2) sleeping; (3) attending school; and (4) playing. Parent-reported barriers to seeking dental care included: (1) missed work (24%); (2) transportation costs (12%); and (3) arranging child care (10%). In this study of children with dental pain, many suffered significant pain: (1) duration; (2) intensity; (3) recurrence; and (4) consequences. This study demonstrates the ongoing need for public policies that assure timely, comprehensive, and affordable dental care for vulnerable children.

  8. Illness Experience, Self-Determination, and Recreational Activities in Pediatric Asthma.

    Science.gov (United States)

    Bingham, Peter M; Crane, Ian; Manning, Sarah Waterman

    2017-06-01

    Although asthma self-management depends on ongoing and accurate self-assessment by the patient, pediatric asthma patients have weak skills in the area of symptom perception. Before developing an asthma game targeted to improving asthma self-management and improved symptom awareness, we sought to identify gaps in existing games. To clarify the role of relatedness and autonomy in asthma health game design, we investigated symptom awareness, vocabulary, and self-determination through a series of semi-structured interviews with children suffering from asthma. Using self-determination theory as a framework, interviews were oriented to patients' illness experience and vocabulary related to symptomatology, as well as to recreational activities. Formative analysis of the interviews reveals attitudes, perceptions, and motivational factors arising in the context of childhood asthma, and it elucidates the images and vocabulary associated with both illness experience and recreational activities. Qualitative assessment of patient perspectives leads to specific recommendations for game design ideas that will support market entry of a spirometer-controlled game for children with asthma.

  9. Extension of academic pediatric radiology to the community setting: experience in two sites

    International Nuclear Information System (INIS)

    Ecklund, K.; Share, J.C.

    2000-01-01

    Background. Children are better served by radiologists and technical personnel trained in the care of pediatric patients. However, a variety of obstacles may limit the access of children to dedicated pediatric imaging facilities. Objective. We designed and implemented two models for providing community-based imaging by academic pediatric radiologists. Materials and methods. The first site was an outpatient clinic staffed by physicians from the university-affiliated children's hospital. Imaging services included radiography, fluoroscopy, and ultrasound. The second site was a full-service community hospital radiology department staffed by a group practice, with pediatric imaging covered by the children's hospital radiologists. Facility, equipment, and protocol modifications were required to maintain quality standards. Success of these models was determined by volume statistics, referring physician/patient satisfaction surveys, and quality-assurance (QA) programs. Results. The outpatient satellite had a 48 % increase in total examinations from the first year to the second year and 87 % the third year. Pediatric examinations in the community hospital increased over 1000 % the first 7 months. Referring physicians reported increased diagnostic information and patient satisfaction compared to previous service. QA efforts revealed improved image quality when pediatric radiologists were present, but some continuing difficulties off-hours. Conclusion. We successfully implemented pediatric imaging programs in previously underserved communities. This resulted in increased pediatric radiologist supervision and interpretation of examinations performed on children and improved referring physician and patient satisfaction. (orig.)

  10. Extension of academic pediatric radiology to the community setting: experience in two sites

    Energy Technology Data Exchange (ETDEWEB)

    Ecklund, K.; Share, J.C. [Children' s Hospital Medical Center, Boston, MA (United States). Dept. of Radiology

    2000-01-01

    Background. Children are better served by radiologists and technical personnel trained in the care of pediatric patients. However, a variety of obstacles may limit the access of children to dedicated pediatric imaging facilities. Objective. We designed and implemented two models for providing community-based imaging by academic pediatric radiologists. Materials and methods. The first site was an outpatient clinic staffed by physicians from the university-affiliated children's hospital. Imaging services included radiography, fluoroscopy, and ultrasound. The second site was a full-service community hospital radiology department staffed by a group practice, with pediatric imaging covered by the children's hospital radiologists. Facility, equipment, and protocol modifications were required to maintain quality standards. Success of these models was determined by volume statistics, referring physician/patient satisfaction surveys, and quality-assurance (QA) programs. Results. The outpatient satellite had a 48 % increase in total examinations from the first year to the second year and 87 % the third year. Pediatric examinations in the community hospital increased over 1000 % the first 7 months. Referring physicians reported increased diagnostic information and patient satisfaction compared to previous service. QA efforts revealed improved image quality when pediatric radiologists were present, but some continuing difficulties off-hours. Conclusion. We successfully implemented pediatric imaging programs in previously underserved communities. This resulted in increased pediatric radiologist supervision and interpretation of examinations performed on children and improved referring physician and patient satisfaction. (orig.)

  11. Intravenous regional anaesthesia (Bier's block) for pediatric forearm fractures in a pediatric emergency department-Experience from 2003 to 2014.

    Science.gov (United States)

    Chua, Ivan S Y; Chong, S L; Ong, Gene Y K

    2017-12-01

    To evaluate the efficacy (length of stay in the emergency department and failure rate of Bier's block) and safety profile (death and major complications) of Bier's block in its use for manipulation and reduction of paediatric forearm fractures. This is a retrospective cohort study of pediatric patients in KKWomen's and Children's Hospital Children's Emergency Department with forearm fractures between Jan 2003 and Dec 2014 who underwent manipulation and reduction using Bier's block. Demographic data, time from registration to discharge, major complications and success rate were collated in a standardized data collection form. A subanalysis of the Bier's block group from 2009 to 2014 was performed and compared to a corresponding data set of paediatric patients who underwent manipulation and reduction of forearm fractures using ketamine for procedural sedation from 2009 to 2014. 1781 cases of paediatric forearm fractures were analysed. The mean age of patients in the Bier's block group was 12.0 years (range 5.5-17.8 years old). Of all patients undergoing Bier's block, 1471 out of 1781 patients were male (82.7%). The mean length of stay (LOS) in the department was 168±72min, measured from time of registration till departure. From our subanalysis of data from 2009 to 2014, the mean LOS for the Bier's block group was shorter - 170min compared to 238min for the ketamine group (P block which required a repeat procedural sedation using ketamine. 96% of patients who underwent Bier's block were discharged with an outpatient orthopaedic appointment. There were no deaths or major complications identified in our study. Bier's block is a safe technique for reduction of fractures when used in the appropriate population and fracture types, with a low failure rate and no major complications including death. Compared to the ketamine group, it has a shorter length of stay in the emergency department. We recommend the adoption of this practice for manipulation and reduction of

  12. The first preliminary experiments on an 84 GHz gyrotron with a single-stage depressed collector

    International Nuclear Information System (INIS)

    Shimozuma, T.; Sato, M.; Takita, Y.

    1997-10-01

    We fabricated and tested an 84GHz gyrotron with a single-stage depressed collector. The gyrotron has a high-voltage insulating section made of a low loss silicon nitride composite. In this preliminary experiment in the depressed collector configuration, we obtained 591kW, 41% operation with a depression voltage of 22.5kV. Access to the higher efficiency region was inhibited by an increase in anode current. (author)

  13. Preliminary mini experiments on leaching of glass. A report of the situation 1979-03-15

    International Nuclear Information System (INIS)

    Blomqvist, G.

    1979-04-01

    The work performed within a project concerning preliminary mini experiments on the leaching of glass up to 1979-03-15 is summarized. It is shown that steady states are not obtained during one month for the investigated elements (Na, Cs, Sr, B) while the concentration of Ca in the leachate decreases to almost zero. The solubility of glass seems to be dependent on the volume. (E.R.)

  14. Muon-catalyzed fusion experiment target and detector system. Preliminary design report

    International Nuclear Information System (INIS)

    Jones, S.E.; Watts, K.D.; Caffrey, A.J.; Walter, J.B.

    1982-03-01

    We present detailed plans for the target and particle detector systems for the muon-catalyzed fusion experiment. Requirements imposed on the target vessel by experimental conditions and safety considerations are delineated. Preliminary designs for the target vessel capsule and secondary containment vessel have been developed which meet these requirements. In addition, the particle detection system is outlined, including associated fast electronics and on-line data acquisition. Computer programs developed to study the target and detector system designs are described

  15. The RPC-based IFR system at BaBar experiment: preliminary results

    International Nuclear Information System (INIS)

    Piccolo, Davide; Palano, A.; Bagnasco, S.; Buzzo, A.; Contri, R.; Crosetti, G.; Lo Vetere, M.; Macri, M.; Monge, R.; Passaggio, S.; Patrignani, C.; Robutti, E.; Santroni, A.; Anulli, F.; Baldini, R.; Calcaterra, A.; De Sangro, R.; Falciai, D.; Finocchiaro, G.; Patteri, P.; Peruzzi, I.; Piccolo, M.; Yu, Z.; Zallo, A.; Cavallo, N.; De Nardo, G.; Fabozzi, F.; Gatto, C.; Lista, L.; Paolucci, P.; Sciacca, C.; Bionta, R.; Wright, D.; Band, H.; Johnson, J.

    2002-01-01

    The IFR system is a RPC-based detector used to identify muons and neutral hadrons in the BaBar experiment at PEP II machine in SLAC. The RPC system can be used to reconstruct the trajectory of muons, pions and neutral hadrons interacting in the iron of the IFR. The different range and hit pattern allow to discriminate different particles crossing the IFR. An overview of the system design and the preliminary results on the IFR performances are reported

  16. The RPC-based IFR system at BaBar experiment preliminary results

    CERN Document Server

    Piccolo, D; Bagnasco, S; Baldini, R; Band, H R; Bionta, R; Buzzo, A; Calcaterra, A; Cavallo, N; Contri, R; Crosetti, G; De Nardo, Gallieno; De Sangro, R; Fabozzi, F; Falciai, D; Finocchiaro, G; Gatto, C; Johnson, J; Lista, L; Lo Vetere, M; Macri, M; Monge, R; Palano, A; Paolucci, P; Passaggio, S; Patrignani, C; Patteri, P; Peruzzi, I; Piccolo, M; Robutti, E; Santroni, A; Sciacca, C; Wright, D; Yu, Z; Zallo, A

    2002-01-01

    The IFR system is a RPC-based detector used to identify muons and neutral hadrons in the BaBar experiment at PEP II machine in SLAC. The RPC system can be used to reconstruct the trajectory of muons, pions and neutral hadrons interacting in the iron of the IFR. The different range and hit pattern allow to discriminate different particles crossing the IFR. An overview of the system design and the preliminary results on the IFR performances are reported.

  17. Assessment of patient experience with unilateral vocal fold immobility: a preliminary study.

    Science.gov (United States)

    Francis, David O; McKiever, Monique E; Garrett, C Gaelyn; Jacobson, Barbara; Penson, David F

    2014-09-01

    Systematically moving toward patient-centered care for unilateral vocal fold immobility (UVFI) requires comprehensive understanding of the variability of actual patient experiences. This rigorous qualitative study assesses UVFI-related disability and proposes a preliminary taxonomy of UVFI patient experience. (1) Semistructured interviews and (2) taxonomy development. Consecutive UVFI patients presenting July to September, 2012, prospectively underwent open-ended interviews investigating how UVFI affected their quality of life (QOL) and had caused disability. Comments reported by >20% were synthesized into axes based on content similarity. Variables were arranged into a preliminary taxonomy of UVFI patient experience, which was evaluated for four attributes of face validity. The majority of 39 patients had "extensive" baseline voice use (56%) and an iatrogenic etiology (62%). Taxonomy of patient experience included three main axes of symptomatic classification: (1) voice, (2) swallowing, and (3) breathing-all with intrinsic (physical and emotional) and extrinsic (social) subaxes that describe major impacts on QOL. Voice complaints were 100% penetrant, whereas breathing and swallowing symptoms afflicted 76% and 66%, respectively, of interviewees. Of affected patients, solid and liquid dysphagia was experienced by 70% and 63%, respectively. Of dyspneic patients, shortness of breath existed with talking (97%) and exercise (72%). Persistent throat congestion (76%), weakened cough (62%), globus (62%), and dysfunctional valsalva (41%) were frequent. Patient experience with UVFI has been incompletely characterized. This qualitative assessment and preliminary taxonomy highlight several related patient experiences not well documented in the literature or incorporated into currently available metrics. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  18. Blood culture contamination in hospitalized pediatric patients: a single institution experience

    Science.gov (United States)

    Min, Hyewon; Park, Cheong Soo; Kim, Dong Soo

    2014-01-01

    Purpose Blood culture is the most important tool for detecting bacteremia in children with fever. However, blood culture contamination rates range from 0.6% to 6.0% in adults; rates for young children have been considered higher than these, although data are limited, especially in Korea. This study determined the contamination rate and risk factors in pediatric patients visiting the emergency room (ER) or being admitted to the ward. Methods We conducted a retrospective chart review of blood cultures obtained from children who visited Yonsei Severance Hospital, Korea between 2006 and 2010. Positive blood cultures were labeled as true bacteremia or contamination according to Centers for Disease Control and Prevention/National Healthcare Safety Network definitions for laboratory-confirmed bloodstream infection, after exclusion of cultures drawn from preexisting central lines only. Results Among 40,542 blood cultures, 610 were positive, of which 479 were contaminations and 131 were true bacteremia (overall contamination rate, 1.18%). The contamination rate in the ER was significantly higher than in the ward (1.32% vs. 0.66%, P6 years, respectively). Conclusion Overall, contamination rates were higher in younger children than in older children, given the difficulty of performing blood sampling in younger children. The contamination rates from the ER were higher than those from the ward, not accounted for only by overcrowding and lack of experience among personnel collecting samples. Further study to investigate other factors affecting contamination should be required. PMID:24868215

  19. Pediatric cardiology. Clinical and practical experiences with heart diseases of children, juveniles and young adults

    International Nuclear Information System (INIS)

    Haas, Nikolaus A.

    2011-01-01

    The book on pediatric cardiology covers the following chapters: (I) Fundamentals and diagnostics: pediatric cardiologic anamnesis, electrocardiograms, thorax X-radiography, MRT and CT of the heart, nuclear medical diagnostics, exercise tests, heart catheter examination, electrophysiological tests. (II) Leading symptoms: Cyanosis, cardiac murmur, thorax pain, palpitation, syncopes. (III) Disease pictures: congenital heart defects, acquired heart defects, cardiomyopathies, heart rhythm disturbances, heart insufficiency, arterial hypertension, pulmonary hypertension, other heart involving syndromes. (IV) Therapy: Catheter interventional therapy, post-surgical pediatric cardiac therapy, surgery involving the life-support machine, mechanical cardiovascular support systems, initial treatment of newborns with critical heart defects, heart transplantation, vaccination of children with heart diseases, medicinal therapy.

  20. PEDIATRIC HEAD INJURIES, MECHANISM TO MANAGEMENT: EXPERIENCE OF A SINGLE CENTER

    Directory of Open Access Journals (Sweden)

    Pankaj

    2016-01-01

    Full Text Available INTRODUCTION Head injury is very common in modern life. Patients of any age group may have head injury however mechanism of head injury, pathophysiology and outcome of head injury is quite different in adults as compared to children. Road traffic accident is a common mode of head injury in adults while fall from height and household abuse is common mode in children. In Western countries, there is a separate registry system for pediatric head injury but there is no such system exist in india. Our present study is focused on pediatric head injury and evaluation of factors that affect the final outcome in pediatric patients.

  1. Preliminary results from the U.S. participation in the 2000 Beam Park Experiment

    Science.gov (United States)

    Stansbery, Gene

    2001-10-01

    The United States participated in the 2000 Beam Park Experiment (BPE) conducted in late October, 2000 under the auspices of the Inter-Agency Space Debris Coordination Committee (IADC). The U.S. participated using several sensors which have participated in previous campaigns: Haystack, TRADEX, and COBRA DANE radars, and the Liquid Mirror Telescope. New to the BPE experiments this time are the GBR-P radar located at Kwajalein Atoll and the Haystack Auxiliary (HAX) radar located in Massachusetts. This paper will present and discuss preliminary results from each of the participating U.S. sensors.

  2. Fuel-coolant interactions: preliminary experiments on the effect of gases dissolved in the 'coolant'

    International Nuclear Information System (INIS)

    Asher, R.C.; Davies, D.; Jones, P.G.

    1976-12-01

    A simple apparatus has been used to study fuel-coolant interactions under reasonably well controlled conditions. Preliminary experiments have used water as the 'coolant' and molten tin at 800 0 C as the 'fuel' and have investigated how the violence of the interaction is affected by dissolving gases (oxygen, nitrogen, carbon dioxide and nitrous oxide) in the water. It was found that saturating the water with carbon dioxide or nitrous oxide completely suppresses the violent interaction. Experiments in which the concentrations of these gases were varied showed that a certain critical concentration was needed; below this concentration the dissolved gas has no significant effect but above it the suppression is

  3. Experiences During a Psychoeducational Intervention Program Run in a Pediatric Ward: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Paula Magalhães

    2018-05-01

    Full Text Available Hospitalization, despite its duration, is likely to result in emotional, social, and academic costs to school-age children and adolescents. Developing adequate psychoeducational activities and assuring inpatients' own class teachers' collaboration, allows for the enhancement of their personal and emotional competences and the maintenance of a connection with school and academic life. These educational programs have been mainly designed for patients with long stays and/or chronic conditions, in the format of Hospital Schools, and typically in pediatric Hospitals. However, the negative effects of hospitalization can be felt in internments of any duration, and children hospitalized in smaller regional hospitals should have access to actions to maintain the connection with their daily life. Thus, this investigation aims to present a psychoeducational intervention program theoretically grounded within the self-regulated learning (SRL framework, implemented along 1 year in a pediatric ward of a regional hospital to all its school-aged inpatients, regardless of the duration of their stay. The program counts with two facets: the psychoeducational accompaniment and the linkage to school. All the 798 school-aged inpatients (Mage = 11.7; SDage = 3.71; Mhospital stay = 4 days participated in pedagogical, leisure nature, and SRL activities designed to train transversal skills (e.g., goal-setting. Moreover, inpatients completed assigned study tasks resulting from the linkage between the students' own class teachers and the hospital teacher. The experiences reported by parents/caregivers and class teachers of the inpatients enrolling in the intervention allowed the researchers to reflect on the potential advantages of implementing a psychoeducational intervention to hospitalized children and adolescents that is: individually tailored, focused on leisure playful theoretically grounded activities that allow learning to naturally occur, and designed to facilitate

  4. Experiences During a Psychoeducational Intervention Program Run in a Pediatric Ward: A Qualitative Study.

    Science.gov (United States)

    Magalhães, Paula; Mourão, Rosa; Pereira, Raquel; Azevedo, Raquel; Pereira, Almerinda; Lopes, Madalena; Rosário, Pedro

    2018-01-01

    Hospitalization, despite its duration, is likely to result in emotional, social, and academic costs to school-age children and adolescents. Developing adequate psychoeducational activities and assuring inpatients' own class teachers' collaboration, allows for the enhancement of their personal and emotional competences and the maintenance of a connection with school and academic life. These educational programs have been mainly designed for patients with long stays and/or chronic conditions, in the format of Hospital Schools, and typically in pediatric Hospitals. However, the negative effects of hospitalization can be felt in internments of any duration, and children hospitalized in smaller regional hospitals should have access to actions to maintain the connection with their daily life. Thus, this investigation aims to present a psychoeducational intervention program theoretically grounded within the self-regulated learning (SRL) framework, implemented along 1 year in a pediatric ward of a regional hospital to all its school-aged inpatients, regardless of the duration of their stay. The program counts with two facets: the psychoeducational accompaniment and the linkage to school. All the 798 school-aged inpatients ( M age = 11.7; SD age = 3.71; M hospital stay = 4 days) participated in pedagogical, leisure nature, and SRL activities designed to train transversal skills (e.g., goal-setting). Moreover, inpatients completed assigned study tasks resulting from the linkage between the students' own class teachers and the hospital teacher. The experiences reported by parents/caregivers and class teachers of the inpatients enrolling in the intervention allowed the researchers to reflect on the potential advantages of implementing a psychoeducational intervention to hospitalized children and adolescents that is: individually tailored, focused on leisure playful theoretically grounded activities that allow learning to naturally occur, and designed to facilitate school re

  5. Quengel Casting for the Management of Pediatric Knee Flexion Contractures: A 26-Year Single Institution Experience.

    Science.gov (United States)

    Wiley, Marcel R; Riccio, Anthony I; Felton, Kevin; Rodgers, Jennifer A; Wimberly, Robert L; Johnston, Charles E

    Quengel casting was introduced in 1922 for nonsurgical treatment of knee flexion contractures (KFC) associated with hemophilic arthropathy. It consists of an extension-desubluxation hinge fixed to a cast allowing for gradual correction of a flexion deformity while preventing posterior tibial subluxation. The purpose of this study is to report 1 center's experience with this technique for the treatment of pediatric KFC. A retrospective review was conducted over a 26-year period. All patients with KFC treated with Quengel casting were included. Demographic data, associated medical conditions, adjunctive soft tissue releases, complications, and the need for late surgical intervention were recorded. Tibiofemoral angle measurements in maximal extension were recorded at initiation and termination of casting, 1-year follow-up, and final follow-up. Success was defined as no symptomatic recurrence of KFC or need for subsequent surgery. Eighteen patients (26 knees) were treated for KFC with Quengel casting. Average age at initiation of casting was 8.1 years with average follow-up of 59.9 months. Fifteen knees (58%) underwent soft tissue releases before casting. An average of 1.5 casts per knee were applied over an average of 23.9 days. Average KFC before casting was 50.6 degrees (range, 15 to 100 degrees) which improved to 5.96 degrees (0 to 40 degrees) at cast removal (Pcasting before 1 year. Of these, 11 knees (50%) had a successful outcome. Residual KFC of those treated successfully was 6.8 degrees (range, 0 to 30 degrees) at 1 year and 8.2 degrees (range, 0 to 30 degrees) at final follow-up, averaging 71.4 months (P=0.81). Of the 11 knees deemed failures, all had recurrence of deformity within an average of 1 year from cast removal. Surgical release before Quengel casting did not improve the chances for success (P=0.09). Quengel casting can improve pediatric KFC an average of 44.2 degrees with minimal complications. Although 50% of treated patients will demonstrate

  6. [Management of recurrent urethrocutaneous fistula after hypospadias surgery in pediatric patients: initial experience with dermal regeneration sheet Integra].

    Science.gov (United States)

    Casal-Beloy, I; Somoza Argibay, I; García-González, M; García-Novoa, A M; Míguez Fortes, L; Blanco, C; Dargallo Carbonell, T

    2017-10-25

    To present our initial experience using a dermal regeneration sheet as an urethral cover in the repair of recurrent urethrocutaneous fistulae in pediatric patients. Since May 2016 to March a total of 8 fistulaes were repaired using this new technique. We performed the ddissection of the fistulous tract and posterior closure of the urethral defect. A dermal regeneration sheet was used to cover the urethral suture. Finally a rotational flap was performed to avoid overlap sutures. During the follow-up (average 6 months), one patient presented in the immediate postoperative period infection of the surgical wound. This patient presented recurrence of the fistula. 88% of the patients included presented a good evolution with no other complications. In our initial experience the new technique seems easy, safe and effective in the management of the recurrent urethrocutaneous fistulae in pediatric patients. More studies are needed to prove these results.

  7. Care of Pediatric Neurosurgical Patients in Iraq in 2007: Clinical and Ethical Experience of a Field Hospital

    Science.gov (United States)

    2010-09-01

    penetrating spine injury      •      bioethics Abbreviations used in this paper: EMDG = Expeditionary Medical Group; GCS = Glasgow Coma Scale; GOS...select group of high-acuity patients capable of consuming significant medical resources in a deployed environment. This information has the potential to...impact medical planning, logistics, and policy. 25 256 Care of pediatric neurosurgical patients in Iraq in 2007: clinical and ethical experience of

  8. Pediatric - specific Antimicrobial Resistance Patterns of Urinary Tract Infections: A Single - Centre Experience from Turkey

    OpenAIRE

    Kandur, Yasar; Ozden, Sevinc; Buyukkaragoz, Bahar

    2016-01-01

    Objectives: Antimicrobial resistance of the causative microorganisms of pediatric urinary tract infection (UTI) is a growing problem. The aim of this study is to determine the changing pattern of antibiotic susceptibility in UTIs in an outpatient setting. Methods: We retrospectively reviewed the medical records of pediatric patients with UTI who were followed-up in our center between January-2014 and May-2015. Results: One hundred and seventy-one patients (M...

  9. Initial clinical experience with Ahmed Valve implantation in refractory pediatric glaucoma

    OpenAIRE

    Novak-Lauš, Katia; Škunca Herman, Jelena; Šimić Prskalo, Marija; Jurišić, Darija; Mandić, Zdravko

    2016-01-01

    The purpose is to report on the safety and efficacy of Ahmed Glaucoma Valve (AGV, New World Medical, Inc., Rancho Cucamonga, CA, USA) implantation for the management of refractory pediatric glaucoma observed during one-year follow up period. A retrospective chart review was conducted on 10 eyes, all younger than 11 years, with pediatric glaucoma that underwent AGV implantation for medicamentously uncontrolled intraocular pressure (IOP) between 2010 and 2014. Outcome measures were control of I...

  10. Preliminary condensation pool experiments with steam using DN80 and DN100 blowdown pipes

    International Nuclear Information System (INIS)

    Laine, J.; Puustinen, M.

    2004-03-01

    The report summarizes the results of the preliminary steam blowdown experiments. Altogether eight experiment series, each consisting of several steam blows, were carried out in autumn 2003 with a scaled-down condensation pool test rig designed and constructed at Lappeenranta University of Technology. The main purpose of the experiments was to evaluate the capabilities of the test rig and the needs for measurement and visualization devices. The experiments showed that a high-speed video camera is essential for visual observation due to the rapid condensation of steam bubbles. Furthermore, the maximum measurement frequency of the current combination of instrumentation and data acquisition system is inadequate for the actual steam tests in 2004. (au)

  11. Kids in the atrium: comparing architectural intentions and children's experiences in a pediatric hospital lobby.

    Science.gov (United States)

    Adams, Annmarie; Theodore, David; Goldenberg, Ellie; McLaren, Coralee; McKeever, Patricia

    2010-03-01

    The study reported here adopts an interdisciplinary focus to elicit children's views about hospital environments. Based at the Hospital for Sick Children (SickKids), Toronto, the research explores the ways in which designers and patients understand and use the eight-storey lobby, The Atrium, a monumental addition constructed in 1993. It is a public place that never closes; hundreds of children pass through the namesake atrium every day. Combining methodological approaches from architectural history and health sociology, the intentions and uses of central features of the hospital atrium are examined. Data were collected from observations, focused interviews, and textual and visual documents. We locate the contemporary atrium in a historical context of building typologies rarely connected to hospital design, such as shopping malls, hotels and airports. We link the design of these multi-storey, glass-roofed spaces to other urban experiences especially consumption as normalizing forces in the everyday lives of Canadian children. Seeking to uncover children's self-identified, self-articulated place within contemporary pediatric hospitals, we assess how the atrium--by providing important, but difficult-to-measure functions such as comfort, socialization, interface, wayfinding, contact with nature and diurnal rhythms, and respite from adjacent medicalized spaces--contributes to the well-being of young patients. We used theoretical underpinnings from architecture and humanistic geography, and participatory methods advocated by child researchers and theorists. Our findings begin to address the significant gap in understanding about the relationship between the perceptions of children and the settings where their healthcare occurs. The study also underlines children's potential to serve as agents of architectural knowledge, reporting on and recording their observations of hospital architecture with remarkable sophistication. 2009 Elsevier Ltd. All rights reserved.

  12. Competency Testing for Pediatric Cardiology Fellows Learning Transthoracic Echocardiography: Implementation, Fellow Experience, and Lessons Learned.

    Science.gov (United States)

    Levine, Jami C; Geva, Tal; Brown, David W

    2015-12-01

    There is currently great interest in measuring trainee competency at all levels of medical education. In 2007, we implemented a system for assessing cardiology fellows' progress in attaining imaging skills. This paradigm could be adapted for use by other cardiology programs. Evaluation consisted of a two-part exercise performed after years 1 and 2 of pediatric cardiology training. Part 1: a directly observed evaluation of technical skills as fellows imaged a normal subject (year 1) and a patient with complex heart disease (year 2). Part 2: fellows interpreted and wrote reports for two echocardiograms illustrating congenital heart disease. These were graded for accuracy and facility with communicating pertinent data. After 5 years of testing, fellows were surveyed about their experience. In 5 years, 40 fellows were tested at least once. Testing identified four fellows who underperformed on the technical portion and four on the interpretive portion. Surveys were completed by 33 fellows (83 %). Most (67 %) felt that intermittent observation by faculty was inadequate for assessing skills and that procedural volume was a poor surrogate for competency (58 %). Posttest feedback was constructive and valuable for 90, and 70 % felt the process helped them set goals for skill improvement. Overall, fellows felt this testing was fair and should continue. Fellow performance and responses identified programmatic issues that were creating barriers to learning. We describe a practical test to assess competency for cardiology fellows learning echocardiography. This paradigm is feasible, has excellent acceptance among trainees, and identifies trainees who need support. Materials developed could be easily adapted to help track upcoming ACGME-mandated metrics.

  13. Knowledge of and Attitudes Regarding Postoperative Pain among the Pediatric Cardiac Nursing Staff: An Indian Experience.

    Science.gov (United States)

    Dongara, Ashish R; Shah, Shail N; Nimbalkar, Somashekhar M; Phatak, Ajay G; Nimbalkar, Archana S

    2015-06-01

    Pain following cardiac intervention in children is a common, but complex phenomenon. Identifying and reporting pain is the responsibility of the nursing staff, who are the primary caregivers and spend the most time with the patients. Inadequately managed pain in children may lead to multiple short- and long-term adverse effects. The aim of this cross-sectional study was to assess the knowledge and attitudes regarding postoperative pain in children among the nursing staff at B.M. Patel Cardiac Center, Karamsad, Anand, Gujarat, India. The study included 42 of the 45 nurses employed in the cardiac center. The nurses participating in the study were responsible for the care of the pediatric patients. A modified Knowledge and Attitudes Survey Regarding Pain and a sociodemographic questionnaire were administered after obtaining written informed consent. The study was approved by the institutional Human Research Ethics Committee. Mean (SD) experience in years of the nursing staff was 2.32 (1.69) years (range 1 month to 5 years). Of the nurses, 67% were posted in the cardiac surgical intensive care unit (ICU). The mean (SD) score for true/false questions was 11.48 (2.95; range 7,19). The average correct response rate of the true/false questions was 45.9%. Knowledge about pain was only affected by the ward in which the nurse was posted. In first (asymptomatic) and second (symptomatic) case scenarios, 78.6% and 59.5% underestimated pain, respectively. Knowledge and attitudes regarding pain and its management is poor among nurses. Targeted training sessions and repeated reinforcement sessions are essential for holistic patient care. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  14. CBD-enriched medical cannabis for intractable pediatric epilepsy: The current Israeli experience.

    Science.gov (United States)

    Tzadok, Michal; Uliel-Siboni, Shimrit; Linder, Ilan; Kramer, Uri; Epstein, Orna; Menascu, Shay; Nissenkorn, Andrea; Yosef, Omer Bar; Hyman, Eli; Granot, Dorit; Dor, Michael; Lerman-Sagie, Tali; Ben-Zeev, Bruria

    2016-02-01

    To describe the experience of five Israeli pediatric epilepsy clinics treating children and adolescents diagnosed as having intractable epilepsy with a regimen of medical cannabis oil. A retrospective study describing the effect of cannabidiol (CBD)-enriched medical cannabis on children with epilepsy. The cohort included 74 patients (age range 1-18 years) with intractable epilepsy resistant to >7 antiepileptic drugs. Forty-nine (66%) also failed a ketogenic diet, vagal nerve stimulator implantation, or both. They all started medical cannabis oil treatment between 2-11/2014 and were treated for at least 3 months (average 6 months). The selected formula contained CBD and tetrahydrocannabinol at a ratio of 20:1 dissolved in olive oil. The CBD dose ranged from 1 to 20mg/kg/d. Seizure frequency was assessed by parental report during clinical visits. CBD treatment yielded a significant positive effect on seizure load. Most of the children (66/74, 89%) reported reduction in seizure frequency: 13 (18%) reported 75-100% reduction, 25 (34%) reported 50-75% reduction, 9 (12%) reported 25-50% reduction, and 19 (26%) reported CBD withdrawal. In addition, we observed improvement in behavior and alertness, language, communication, motor skills and sleep. Adverse reactions included somnolence, fatigue, gastrointestinal disturbances and irritability leading to withdrawal of cannabis use in 5 patients. The results of this multicenter study on CBD treatment for intractable epilepsy in a population of children and adolescents are highly promising. Further prospective, well-designed clinical trials using enriched CBD medical cannabis are warranted. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  15. Early in vivo experience with the pediatric continuous-flow total artificial heart.

    Science.gov (United States)

    Karimov, Jamshid H; Horvath, David J; Byram, Nicole; Sunagawa, Gengo; Kuban, Barry D; Gao, Shengqiang; Dessoffy, Raymond; Fukamachi, Kiyotaka

    2018-03-30

    Heart transplantation in infants and children is an accepted therapy for end-stage heart failure, but donor organ availability is low and always uncertain. Mechanical circulatory support is another standard option, but there is a lack of intracorporeal devices due to size and functional range. The purpose of this study was to evaluate the in vivo performance of our initial prototype of a pediatric continuous-flow total artificial heart (P-CFTAH), comprising a dual pump with one motor and one rotating assembly, supported by a hydrodynamic bearing. In acute studies, the P-CFTAH was implanted in 4 lambs (average weight: 28.7 ± 2.3 kg) via a median sternotomy under cardiopulmonary bypass. Pulmonary and systemic pump performance parameters were recorded. The experiments showed good anatomical fit and easy implantation, with an average aortic cross-clamp time of 98 ± 18 minutes. Baseline hemodynamics were stable in all 4 animals (pump speed: 3.4 ± 0.2 krpm; pump flow: 2.1 ± 0.9 liters/min; power: 3.0 ± 0.8 W; arterial pressure: 68 ± 10 mm Hg; left and right atrial pressures: 6 ± 1 mm Hg, for both). Any differences between left and right atrial pressures were maintained within the intended limit of ±5 mm Hg over a wide range of ratios of systemic-to-pulmonary vascular resistance (0.7 to 12), with and without pump-speed modulation. Pump-speed modulation was successfully performed to create arterial pulsation. This initial P-CFTAH prototype met the proposed requirements for self-regulation, performance, and pulse modulation. Copyright © 2018 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  16. An evaluation of the Positive Emotional Experiences Scale: A preliminary analysis

    Directory of Open Access Journals (Sweden)

    Rene van Wyk

    2016-11-01

    Full Text Available Orientation: The positive organisational behaviour movement emphasises the advantages of psychological strengths in business. The psychological virtues of positive emotional experiences can potentially promote human strengths to the advantages of business functioning and the management of work conditions. This is supported by Fredrickson’s broaden-and-build theory that emphasises the broadening of reactive thought patterns through experiences of positive emotions. Research purpose: A preliminary psychometric evaluation of a positive measurement of dimensions of emotional experiences in the workplace, by rephrasing the Kiefer and Barclay Toxic Emotional Experiences Scale. Motivation for the study: This quantitative Exploratory Factor Analysis investigates the factorial structure and reliability of the Positive Emotional Experiences Scale, a positive rephrased version of the Toxic Emotional Experiences Scale. Research approach, design and method: This Exploratory Factor Analysis indicates an acceptable three-factor model for the Positive Emotional Experiences Scale. These three factors are: (1 psychological recurrent positive state, (2 social connectedness and (3 physical refreshed energy, with strong Cronbach’s alphas of 0.91, 0.91 and 0.94, respectively. Main findings: The three-factor model of the Positive Emotional Experiences Scale provides a valid measure in support of Fredrickson’s theory of social, physical and psychological endured personal resources that build positive emotions. Practical/Managerial implications: Knowledge gained on positive versus negative emotional experiences could be applied by management to promote endured personal resources that strengthen positive emotional experiences. Contribution/value-add: The contribution of this rephrased Positive Emotional Experiences Scale provides a reliable measure of assessment of the social, physical and endured psychological and personal resources identified in Fredrickson

  17. A combination of preliminary results on gauge boson couplings measured by the LEP Experiments

    CERN Document Server

    CERN. Geneva

    2004-01-01

    This note presents a combination of published and preliminary measurements of triple gauge boson couplings (TGCs) and quartic gauge boson couplings (QGCs) from the four LEP experiments. We give an updated combination of the charged TGCs, g1z, kg and lg in single and multi-parameter fits. Updated results from the QGCs from the ZZgg vertex, ac/Lambda^2 and a0/Lambda^2, are given as well. The combinations of neutral TGCs hiv anf fiv are also presented, including an updated fiv combination.

  18. ROUND-ROBIN ATOM-PROBE EXPERIMENT : PRELIMINARY RESULTS IN JAPAN

    OpenAIRE

    Nakamura , S.

    1986-01-01

    A round-robin experiment were to be carried out by 6 laboratories in Japan (Nishikawa ; Tokyo Inst. Tech., Sakurai and Igata ; Univ. of Tokyo, Ishikawa ; Hitachi, Tanino ; Nippon Steel Corp. and Nakamura ; Osaka Univ.) under the normal operating condition (T < l00 °K,. pulse fraction ~ 15% ~, P < 10-9 torr). Fe-Cr-Al and W-25%Re alloys, which are divided from a single wire were chosen as the specimen materials. A preliminary analysis of the W-Re alloy of the laboratory concerned show the good...

  19. Excitation of rare gases in an electron-beam-controlled discharge: report on preliminary experiments

    International Nuclear Information System (INIS)

    Bingham, F.W.

    1976-05-01

    Data from the preliminary phase of a study of rare-gas-excimer production in an electron-beam-controlled discharge are presented. The results indicate that it is possible to maintain an arc-free discharge in preionized Ar and Xe gas for a period of several microseconds at applied external E/p values up to 5 V/cm/Torr. In these experiments ultraviolet radiation emitted during the discharge signaled the presence of excited rare-gas molecules. Application of the external electric field significantly enhanced the ultraviolet intensity from xenon-gas discharges but produced little enhancement from argon-gas discharges

  20. Preliminary Experiments for the Assessment of VW-Band Links for Space-Earth Communications

    Science.gov (United States)

    Nessel, James A.; Acosta, Roberto J.; Miranda, Felix A.

    2013-01-01

    Since September 2012, NASA Glenn Research Center has deployed a microwave profiling radiometer at White Sands, NM, to estimate atmospheric propagation effects on communications links in the V and W bands (71-86GHz). Estimates of attenuation statistics in the millimeter wave due to gaseous and cloud components of the atmosphere show good agreement with current ITU-R models, but fail to predict link performance in the presence of moderate to heavy rain rates, due to the inherent limitations of passive radiometry. Herein, we discuss the preliminary results of these measurements and describe a design for a terrestrial link experiment to validaterefine existing rain attenuation models in the VW-bands.

  1. Preliminary report on the experiment performed in MARIUS reactor loaded with teledial fuel

    Energy Technology Data Exchange (ETDEWEB)

    Estiot, J C; Morier, F

    1972-06-15

    The experimental work described in this paper is part of a collaborative programme agreed between CEA and the Dragon Project. The aim of the programme is the measurement of the relative conversion ratio in a reactor loaded with Teledial fuel elements. The results will allow us to check our calculational methods and assumptions upon which the calculations are based, in the case of a teledial core, which represents a very complicated geometry, specially, due to the presence of the U238 with its resonance. The programme of experiments described in the paper have been completed. Some preliminary results are presented in the second part of this report (Part 2).

  2. Spinel dissolution via addition of glass forming chemicals. Results of preliminary experiments

    Energy Technology Data Exchange (ETDEWEB)

    Fox, K. M. [Savannah River Site (SRS), Aiken, SC (United States); Johnson, F. C. [Savannah River Site (SRS), Aiken, SC (United States)

    2015-11-01

    Increased loading of high level waste in glass can lead to crystallization within the glass. Some crystalline species, such as spinel, have no practical impact on the chemical durability of the glass, and therefore may be acceptable from both a processing and a product performance standpoint. In order to operate a melter with a controlled amount of crystallization, options must be developed for remediating an unacceptable accumulation of crystals. This report describes preliminary experiments designed to evaluate the ability to dissolve spinel crystals in simulated waste glass melts via the addition of glass forming chemicals (GFCs).

  3. Critical incidents and mortality reporting in pediatric anesthesia: the Australian experience.

    Science.gov (United States)

    Ragg, Philip

    2011-07-01

    Since 1960, the collection and analysis of mortality data for anesthesia in Australia has been of significant benefit to practising anesthetists. These figures include pediatric deaths which fortunately have been rare and often inevitable because of severe underlying disease and patient risk factors. The reporting of critical incidents and serious morbidity, on the other hand, has been far less impressive. Only one state in Australia, Victoria, currently has a committee that collects morbidity data and, as this reporting is voluntary, is likely to under-represent the true numbers of critical events. There is no specific pediatric morbidity database in Australia so much of this discussion will be regarding overall anesthesia critical event reporting which includes pediatrics as a subset. © 2011 Blackwell Publishing Ltd.

  4. High-Fidelity Simulation of Pediatric Emergency Care: An Eye-Opening Experience for Baccalaureate Nursing Students.

    Science.gov (United States)

    Small, Sandra P; Colbourne, Peggy A; Murray, Cynthia L

    2018-01-01

    Background Little attention has been given to in-depth examination of what high-fidelity simulation is like for nursing students within the context of a pediatric emergency, such as a cardiopulmonary arrest. It is possible that such high-fidelity simulation could provoke in nursing students intense psychological reactions. Purpose The purpose of this study was to learn about baccalaureate nursing students' lived experience of high-fidelity simulation of pediatric cardiopulmonary arrest. Method Phenomenological methods were used. Twenty-four interviews were conducted with 12 students and were analyzed for themes. Results The essence of the experience is that it was eye-opening. The students found the simulation to be a surprisingly realistic nursing experience as reflected in their perceiving the manikin as a real patient, thinking that they were saving their patient's life, feeling like a real nurse, and feeling relief after mounting stress. It was a surprisingly valuable learning experience in that the students had an increased awareness of the art and science of nursing and increased understanding of the importance of teamwork and were feeling more prepared for clinical practice and wanting more simulation experiences. Conclusion Educators should capitalize on the benefits of high-fidelity simulation as a pedagogy, while endeavoring to provide psychologically safe learning.

  5. Use and reimbursement of off-label drugs in pediatric anesthesia: the Italian experience.

    Science.gov (United States)

    Salvo, Ida; Landoni, Giovanni; Mucchetti, Marta; Cabrini, Luca; Pani, Luca

    2014-06-01

    Most of the drugs used in anesthesia are off-label in children even if they present solid clinical evidence in adults. This lack of authorization is caused by multiple factors including the difficulty in conducting research in this area (due to the ethical concerns and/or the low number of available participants, the high variability of the outcome measures) and the lack of economic interest of the pharmaceutical companies (due to the limited market). Define a list of medicinal products commonly used off-label in pediatrics anesthesia to be reimbursed by Italian National Health System. We hereby describe the methodological framework used to allow reimbursed use of a list of medicinal products, widely used off-label in pediatric patients, ensuring the best therapeutic results with the lowest possible risk for children. A task force of pediatric anesthesiologists from Italy petitioned the Italian Medicines Agency (AIFA) to allow a number of commonly utilized but off-label drugs for pediatric anesthesia to be reimbursed for specific indications. For each drug, both the supporting literature and expert opinion were used, and the resulting list of drugs allowed to be used/reimbursed officially by AIFA was significantly expanded. This paper documents one approach to the problem of off-label use of drugs for pediatric patients that can be a model for future efforts. Continuous efforts are needed from government institutions and sponsors on drug development and on drug approval process in pediatrics, as research on drug effectiveness and safety is mandatory in children as in adults. At the same time, clinicians must become more familiar with the drug-approval process, participate to sponsored trials, and perform ztrials themselves. © 2014 John Wiley & Sons Ltd.

  6. Hospitalized pediatric antituberculosis drug induced hepatotoxicity: Experience of an Indonesian referral hospital

    Directory of Open Access Journals (Sweden)

    Heda Melinda Nataprawira

    2017-05-01

    Full Text Available Objective: To determine the characteristics and risk factors of pediatric antituberculosis drug induced hepatotoxicity (ADIH in Dr. Hasan Sadikin Hospital, a referral hospital in West Java, Indonesia. Methods: Medical records of hospitalized pediatric ADIH from October 2010 to October 2015 were reviewed retrospectively through computer-based search. Descriptive data were presented as percentage. Analytical case-control study on characteristics of ADIH was conducted using Chi-square and Mann Whitney test. Results: Fifty (3.5% out of 1 424 pediatric TB patients developed ADIH; 20 (40% were boys and 30 (60% girls. More than half were under 5 years old and 33 (66% were malnourished. ADIH occured in 29 (58% cases treated for pulmonary TB, 15 (30% for extrapulmonary TB and 6 (12% for both; 34 cases (68% occured during the intensive phase. We identified hepatic comorbidities including CMV infection [1 (2%] and typhoid [1 (2%], and other diseases treated by hepatotoxic drugs such as chemotherapeutic drugs, antiepileptics, and antiretroviral drugs [9 (18%]. Case-control analysis of 50 ADIH cases and 100 TB controls without ADIH showed that the correlation between gender, age, type of TB, nutritional status and comorbidities to occurence of ADIH was statistically insignificant (P = 0.26, 0.765, 0.495, 0.534 9 and 0.336, respectively. Pediatric ADIH was treated using modified British Thoracic Society guidelines. Conclusions: Pediatric ADIH in our hospital is quite frequent, thus identifying risk factors and development of pediatric guideline is mandatory. Further study is needed to identify other risk factors such as genetic acetylator status.

  7. Development and Preliminary Face and Content Validation of the “Which Health Approaches and Treatments Are You Using?” (WHAT) Questionnaires Assessing Complementary and Alternative Medicine Use in Pediatric Rheumatology

    Science.gov (United States)

    Toupin April, Karine; Stinson, Jennifer; Boon, Heather; Duffy, Ciarán M.; Huber, Adam M.; Gibbon, Michele; Descarreaux, Martin; Spiegel, Lynn; Vohra, Sunita; Tugwell, Peter

    2016-01-01

    Objective Complementary and alternative medicine (CAM) is commonly used by children with juvenile idiopathic arthritis (JIA), yet no validated questionnaires assess that use. The objective of this study was to develop child self- and parent proxy-report questionnaires assessing CAM use and to determine the face and content validity of the “Which Health Approaches and Treatments are you using?” (WHAT) questionnaires in pediatric rheumatology. Methods A sequential phased mixed methods approach was used to develop the questionnaires. A Delphi Survey of 126 experts followed by an interdisciplinary consensus conference of 14 stakeholders in CAM, general pediatrics and pediatric rheumatology was held to develop consensus on the content of the questionnaires using a nominal group technique. To determine face and content validity of the questionnaires, two groups, including (a) a purposive sample of 22 children with JIA 8 to 18 years and their parents from the Children’s Hospital of Eastern Ontario and the Hospital for Sick Children, and (b) 21 Canadian pediatric rheumatology experts, participated in interviews. Participants were independently asked about the goal, understandability and comprehensiveness of the WHAT questionnaires, as well as the relevance of items. Results Consensus was reached on 17 items of the WHAT questionnaires. The domains found to be relevant were child’s CAM use, factors associated with CAM use, perceived impact of CAM use, and communication about CAM. A total of 15 items in the parent proxy-report questionnaire and 13 items in the child report questionnaire showed adequate content validity. Conclusions Consensus was reached by experts on the content of a pediatric CAM questionnaire. Face and content validity testing and modifications made to the WHAT questionnaires have helped ensure adequate preliminary validity for use in pediatric rheumatology. This constitutes the basis for further testing of these questionnaires in pediatric

  8. Adolescents' Observations of Parent Pain Behaviors: Preliminary Measure Validation and Test of Social Learning Theory in Pediatric Chronic Pain.

    Science.gov (United States)

    Stone, Amanda L; Walker, Lynn S

    2017-01-01

    Evaluate psychometric properties of a measure of adolescents’ observations of parental pain behaviors and use this measure to test hypotheses regarding pain-specific social learning. We created a proxy-report of the Patient Reported Outcomes Measurement Information System (PROMIS) Pain Behavior–Short Form (PPB) for adolescents to report on parental pain behaviors, which we labeled the PPB-Proxy. Adolescents (n = 138, mean age = 14.20) with functional abdominal pain completed the PPB-Proxy and a parent completed the PPB. Adolescents and their parents completed measures of pain and disability during the adolescent’s clinic visit for abdominal pain. Adolescents subsequently completed a 7-day pain diary period. The PPB-Proxy moderately correlated with the PPB, evidencing that adolescents observe and can report on parental pain behaviors. Both the PPB-Proxy and PPB significantly correlated with adolescents’ pain-related disability. Parental modeling of pain behaviors could represent an important target for assessment and treatment in pediatric chronic pain patients.

  9. An interactive E-Learning portal in pediatric endocrinology : Practical experience

    NARCIS (Netherlands)

    Kranenburg-van Koppen, L.J.C.; Grijpink-van den Biggelaar, K.; Drop, S.L.S.

    2013-01-01

    Based on educational considerations, the European Society for Paediatric Endocrinology (ESPE) e-learning portal has been developed, providing an interactive learning environment for up-to-date information in pediatric endocrinology. From March 2011 to January 2012, five small-scale pilot studies

  10. Investigation of fracture-matrix interaction: Preliminary experiments in a simple system

    International Nuclear Information System (INIS)

    Foltz, S.D.

    1992-01-01

    Paramount to the modeling of unsaturated flow and transport through fractured porous media is a clear understanding of the processes controlling fracture-matrix interaction. As a first step toward such an understanding, two preliminary experiments have been performed to investigate the influence of matrix imbibition on water percolation through unsaturated fractures in the plane normal to the fracture. Test systems consisted of thin slabs of either tuff or an analog material cut by a single vertical fracture into which a constant fluid flux was introduced. Transient moisture content and solute concentration fields were imaged by means of x-ray absorption. Flow fields associated with the two different media were significantly different owing to differences in material properties relative to the imposed flux. Richards' equation was found to be a valid means of modeling the imbibition of water into the tuff matrix from a saturated fracture for the current experiment

  11. Preparation of a Strong Thin Polonium Source And Preliminary Experiments on the Yield of (α,n) Reactions

    International Nuclear Information System (INIS)

    Broda, E.

    1945-01-01

    This report was written by E. Broda and P. K. Wright at the Cavendish Laboratory (Cambridge) in July 1945 and is about the preparation of a strong thin polonium source and preliminary experiments on the yield of (alpha,n) reactions. This report includes the experiment description, the discussion of the results and consist of 4 parts: (1) the electrode position of polonium under different conditions (2) a standard procedure for preparation of strong thin Po sources (3) a simple method for the recovery of RaD from complex mixtures (4) some preliminary experiments with a Po source. (nowak)

  12. Preparation of a Strong Thin Polonium Source And Preliminary Experiments on the Yield of (α,n) Reactions

    Energy Technology Data Exchange (ETDEWEB)

    Broda, E.

    1945-07-01

    This report was written by E. Broda and P. K. Wright at the Cavendish Laboratory (Cambridge) in July 1945 and is about the preparation of a strong thin polonium source and preliminary experiments on the yield of (alpha,n) reactions. This report includes the experiment description, the discussion of the results and consist of 4 parts: (1) the electrode position of polonium under different conditions (2) a standard procedure for preparation of strong thin Po sources (3) a simple method for the recovery of RaD from complex mixtures (4) some preliminary experiments with a Po source. (nowak)

  13. Pediatric neurocritical care.

    Science.gov (United States)

    Murphy, Sarah

    2012-01-01

    Pediatric neurocritical care is an emerging multidisciplinary field of medicine and a new frontier in pediatric critical care and pediatric neurology. Central to pediatric neurocritical care is the goal of improving outcomes in critically ill pediatric patients with neurological illness or injury and limiting secondary brain injury through optimal critical care delivery and the support of brain function. There is a pressing need for evidence based guidelines in pediatric neurocritical care, notably in pediatric traumatic brain injury and pediatric stroke. These diseases have distinct clinical and pathophysiological features that distinguish them from their adult counterparts and prevent the direct translation of the adult experience to pediatric patients. Increased attention is also being paid to the broader application of neuromonitoring and neuroprotective strategies in the pediatric intensive care unit, in both primary neurological and primary non-neurological disease states. Although much can be learned from the adult experience, there are important differences in the critically ill pediatric population and in the circumstances that surround the emergence of neurocritical care in pediatrics.

  14. Experiment HFR-B1: A preliminary analysis of the water-vapor injection experiments in capsule 3

    International Nuclear Information System (INIS)

    Myers, B.F.

    1993-01-01

    A preliminary analysis of the response of uranium oxycarbide (UCO) fuel to water vapor addition in capsule 3 of experiment HFR-B1 (HFR-B1/3) has been conducted. The analysis provides an early indication of the behavior of fission gas release under a wider range of water-vapor pressures and of temperatures than heretofore studied. A preliminary analysis of selected aspects of the water-vapor injection tests in capsule 3 of experiment HFR-B1 is presented. The release of fission gas stored in bubbles and the diffusive release of fission-gas atoms are distinguished. The dependence of the release of stored fission gas ( 85m Kr) on water-vapor pressure, P(H 2 O), and temperature were established taking into account the contributing mechanisms of gaseous release, the effect of graphite hydrolysis, and the requirement of consistency with experiment HRB-17 in which similar water-vapor injection tests were conducted. The dependence on P(H 2 O) becomes weaker as temperatures increase above 770 degree C; the activation energy for release of stored-fission gas is 393 kJ/mol. Isorelease curves for the pressure-temperature plane were deduced from a derived functional relation. The stored-fission gas releases as a function of P(H 2 O) at a common temperature for experiments HFR-B1 and HRB-17 differ by a factor of 4; this discrepancy could be attributed to the differences in fission-rate density and neutron flux between the two experiments. Diffusive release of fission gas occurred during and after the release of stored gas. The ratio of diffusive release during water-vapor injection to that prior to injection varied in contrast to the results from HRB-17. The variation was attributed to the practice of injecting water vapor into HFR-B1 before sintering of the fuel, hydrolyzed in the previous test, was completed. The derived activation energy for diffusive release is 23.6 kJ/mol

  15. Experiment HFR-B1: A preliminary analysis of the water-vapor injection experiments in capsule 3

    Energy Technology Data Exchange (ETDEWEB)

    Myers, B.F.

    1993-08-01

    A preliminary analysis of the response of uranium oxycarbide (UCO) fuel to water vapor addition in capsule 3 of experiment HFR-B1 (HFR-B1/3) has been conducted. The analysis provides an early indication of the behavior of fission gas release under a wider range of water-vapor pressures and of temperatures than heretofore studied. A preliminary analysis of selected aspects of the water-vapor injection tests in capsule 3 of experiment HFR-B1 is presented. The release of fission gas stored in bubbles and the diffusive release of fission-gas atoms are distinguished. The dependence of the release of stored fission gas ({sup 85m}Kr) on water-vapor pressure, P(H{sub 2}O), and temperature were established taking into account the contributing mechanisms of gaseous release, the effect of graphite hydrolysis, and the requirement of consistency with experiment HRB-17 in which similar water-vapor injection tests were conducted. The dependence on P(H{sub 2}O) becomes weaker as temperatures increase above 770{degree}C; the activation energy for release of stored-fission gas is 393 kJ/mol. Isorelease curves for the pressure-temperature plane were deduced from a derived functional relation. The stored-fission gas releases as a function of P(H{sub 2}O) at a common temperature for experiments HFR-B1 and HRB-17 differ by a factor of 4; this discrepancy could be attributed to the differences in fission-rate density and neutron flux between the two experiments. Diffusive release of fission gas occurred during and after the release of stored gas. The ratio of diffusive release during water-vapor injection to that prior to injection varied in contrast to the results from HRB-17. The variation was attributed to the practice of injecting water vapor into HFR-B1 before sintering of the fuel, hydrolyzed in the previous test, was completed. The derived activation energy for diffusive release is 23.6 kJ/mol.

  16. Phase III clinical evaluation of gadoteridol injection: Experience in pediatric neuro-oncologic MR imaging

    International Nuclear Information System (INIS)

    Debatin, J.F.; Nadel, S.N.; Gray, L.; Trotter, P.; Friedman, H.S.; Hockenberger, B.; Oakes, W.J.

    1992-01-01

    Twenty-two pediatric patients with known CNS neoplasms underwent magnetic resonance (MR) imaging before and after intravenous injection of 0.1 mmol/kg gadoteridol injection as part of a Phase IIIB open label multicenter clinical trial. Intravenous adminstration of this neutral, nonionic contrast agent was found to be safe in children. No clinically relevant changes in vital signs or laboratory values were attributed to the administration of gadoteridol injection. There were no systemic complaints. The imaging characteristics of gadoteridol in pediatric CNS disease appeared similar to those of gadopentetate dimeglumine. The very low toxicity, inherent to this nonionic low osmolal paramagnetic contrast formulation may allow administration of increased doses at increased infusion rates for an increased number of indications with improved sensitivity. (orig.)

  17. An institutional experience in the management of pediatric mandibular fractures: A study of 74 cases.

    Science.gov (United States)

    Andrade, Neelam N; Choradia, Smriti; Sriram S, Ganapathy

    2015-09-01

    In maxillofacial surgery, children represent a special group of patients, as they have significant differences from adults as far as the facial skeleton is concerned. The etiology and epidemiology of pediatric trauma involving the facial skeleton has been reported in a large series of patients. Nevertheless, few of these reports review large numbers of pediatric patients, and little is known about treatment protocols for fractures in children. The aims of this study were to retrospectively analyze the treatment methods and outcomes of pediatric mandibular fractures in children and young adolescents up to the age of 15 years, to discuss the findings, and to propose treatment protocols for maxillofacial fractures in childhood. The present study retrospectively analyzed the treatment methods and outcome of the pediatric mandibular fractures in children and young adolescents' up to the age of 15 years over a period of 5 years. All patients were followed up for an average period of 18 months, with a maximum follow-up of 2 years. A total of 74 patients were treated for mandibular and dentoalveolar fractures in children upto the age of 15 years at the Department of Oral and Maxillofacial Surgery at Nair Hospital Dental College, Mumbai from 2007 to 2012. AND CONCLUSIONS: The treatment methods used at our centre had satisfactory outcomes at the end of a follow-up period of 2 years. Reported complications were minimal. Our results confirm the usefulness of open reduction and plate fixation in older children (>12 years of age) and a conservative approach in younger children (≤12 years of age) in treating mandibular fractures. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  18. The ACGME case log: General surgery resident experience in pediatric surgery

    Science.gov (United States)

    Gow, Kenneth W.; Drake, F. Thurston; Aarabi, Shahram; Waldhausen, John H.

    2014-01-01

    Background General surgery (GS) residents in ACGME programs log cases performed during their residency. We reviewed designated pediatric surgery (PS) cases to assess for changes in performed cases over time. Methods The ACGME case logs for graduating GS residents were reviewed from academic year (AY) 1989–1990 to 2010–2011 for designated pediatric cases. Overall and designated PS cases were analyzed. Data were combined into five blocks: Period I (AY1989–90 to AY1993–94), Period II (AY1994–95 to AY1998–99), Period III (AY1999–00 to AY2002–03), Period IV (AY2003–04 to AY2006–07), and Period V (AY2007–08 to AY2010–11). Periods IV and V were delineated by implementation of duty hour restrictions. Student t-tests compared averages among the time periods with significance at P < .05. Results Overall GS case load remained relatively stable. Of total cases, PS cases accounted for 5.4% in Period I and 3.7% in Period V. Designated pediatric cases declined for each period from an average of 47.7 in Period I to 33.8 in Period V. These changes are due to a decline in hernia repairs, which account for half of cases. All other cases contributed only minimally to the pediatric cases. The only laparoscopic cases in the database were anti-reflux procedures, which increased over time. Conclusions GS residents perform a diminishing number of designated PS cases. This decline occurred before the onset of work-hour restrictions. These changes have implications on the capabilities of the current graduating workforce. However, the case log does not reflect all cases trainees may be exposed to, so revision of this list is recommended. PMID:23932601

  19. Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS): Experience at a Tertiary Referral Center

    OpenAIRE

    Singer, Harvey S.

    2015-01-01

    The entity Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) was initially proposed in 1998 (Swedo, et al. 1998). The formal diagnosis required that the affected individual meet five specific criteria: prepubertal onset, obsessive compulsive disorder (OCD) and/or a tic disorder, the dramatic sudden explosive onset of symptoms, a relapsing and remitting course of symptoms that are temporally associated with Group A beta-hemolytic streptococcal (G...

  20. Preliminary Results from the PrimEx-II experiment at Jefferson Lab

    Energy Technology Data Exchange (ETDEWEB)

    Gasparian, Ashot [NCA& T, Greensboro, NC; Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States)

    2016-06-01

    Properties of the neutral pion, as the lightest hadron in Nature, are most sensitive to the basic symmetries and their partial breaking effects in the theory of the strong interaction (QCD). In particular, the po →gg decay width is primarily defined by the spontaneous chiral symmetry breaking effect (chiral anomaly) in QCD. The next order corrections to the anomaly have been shown to be small and are known to a 1% precision level. The PrimEx Collaboration at JLab has developed and performed two Primakoff type experiments to measure the po →gg decay width with a similar precision. The published result from the PrimEx-I experiment, G(p0 →gg ) = 7.82±0.14 (stat.)±0.17 (syst.) eV, was a factor of two more precise than the average value quoted in PDG-2010 [1]. The second experiment was performed in 2010 with a goal of 1.4% total uncertainty to address the next-to-leading-order theory calculations. The preliminary results from the PrimEx-II experiment are presented and discussed in this note.

  1. Melody pulmonary valve bacterial endocarditis: experience in four pediatric patients and a review of the literature.

    Science.gov (United States)

    Villafañe, Juan; Baker, George Hamilton; Austin, Erle H; Miller, Stephen; Peng, Lynn; Beekman, Robert

    2014-08-01

    The objectives of this manuscript are two-fold: (a) to describe the clinical characteristics and management of four pediatric patients with bacterial endocarditis (BE) after Melody pulmonary valve implantation (MPVI); and (b) to review the literature regarding Melody pulmonary valve endocarditis. There are several reports of BE following MPVI. The clinical course, BE management and outcome remain poorly defined. This is a multi-center report of four pediatric patients with repaired tetralogy of Fallot (TOF) and BE after MPVI. Clinical presentation, echocardiogram findings, infecting organism, BE management, and follow-up assessment are described. We review available literature on Melody pulmonary valve endocarditis and discuss the prognosis and challenges in the management of these patients. Of our four BE patients, two had documented vegetations and three showed worsening pulmonary stenosis. All patients remain asymptomatic after medical treatment (4) and surgical prosthesis replacement (3) at follow-up of 17 to 40 months. Analysis of published data shows that over half of patients undergo bioprosthesis explantation and that there is a 13% overall mortality. The most common BE pathogens are the Staphylococcus and Streptococcus species. Our case series of four pediatric patients with repaired TOF confirms a risk for BE after MPVI. A high index of suspicion for BE should be observed after MPVI. All patients should be advised to follow lifelong BE prophylaxis after MPVI. In case of BE, surgery should be considered for valve dysfunction or no clinical improvement in spite of medical treatment. © 2014 Wiley Periodicals, Inc.

  2. Pain-only complaint about cochlear implant device: A five-patient pediatric experience.

    Science.gov (United States)

    Todd, Norman Wendell; Fainberg, Jolie C; Ukatu, CeIsha Chinwe; Venable, Claudia Y; Segel, Phil

    2015-09-01

    To present the case histories and management of five pediatric patients who experienced pain at the receiver-stimulator site, but no other indication that the device was failing. Patients were from a sole-surgeon pediatric practice (600 + implant surgeries before June 2013; about even proportions of Advanced Bionics, Cochlear Corporation, and MED-EL devices). The University Institutional Review Board-approved review of sole-surgeon pediatric case series. The onset of pain ranged from 2 to 16 years post implantation. Pain, not amenable to conventional medical therapy, was present regardless of whether or not the external appliance was 'on', or even being worn on the head. Four of the five patients were bilaterally implanted, but pain was only at one receiver-stimulator package. Clinical management ultimately included revision surgery in all five cases, with immediate resolution of the pain in four. For those four, the replacement cochlear implant (CI) performed well; the other patient fears pain if her replacement device is used, but continues enjoying her contralateral implant. At analysis by the company, two of five explanted devices exhibited problems: loss of hermeticity; insulation failure. Though infrequently reported, pain-only complaint by a CI user is a challenging dilemma. Pain may be the sole clinical manifestation of cochlear implant device failure. We offer a flowchart for the care of CI patients with pain, encourage a worldwide registry of such cases, and offer ideas to try to understand better the problem.

  3. Initial Clinical Experience with Ahmed Valve Implantation in Refractory Pediatric Glaucoma

    Science.gov (United States)

    Novak-Lauš, Katia; Škunca Herman, Jelena; Šimić Prskalo, Marija; Jurišić, Darija; Mandić, Zdravko

    2016-12-01

    The purpose is to report on the safety and efficacy of Ahmed Glaucoma Valve (AGV, New World Medical, Inc., Rancho Cucamonga, CA, USA) implantation for the management of refractory pediatric glaucoma observed during one-year follow up period. A retrospective chart review was conducted on 10 eyes, all younger than 11 years, with pediatric glaucoma that underwent AGV implantation for medicamentously uncontrolled intraocular pressure (IOP) between 2010 and 2014. Outcome measures were control of IOP below 23 mm Hg (with or without antiglaucoma medications) and changes in visual acuity. Complications were recorded. After AGV implantation, IOP values ranged from 18 mm Hg to 23 mm Hg (except for one eye with postoperative hypotonia due to suprachoroid hemorrhage, where the postoperative IOP value was 4 mm Hg). The number of antiglaucoma medications was reduced, i.e. four patients had two medications, one patient had one medication, and the others did not need antiglaucoma medication on the last follow-up visit. One eye had suprachoroid hemorrhage, one eye had long-term persistent uveitic membrane, and two eyes had tube-cornea touch. In conclusion, AGV implantation appears to be a viable option for the management of refractory pediatric glaucoma and shows success in IOP control. However, there was a relatively high complication rate limiting the overall success rate.

  4. Pediatric Specialists

    Science.gov (United States)

    ... Healthy Children > Family Life > Medical Home > Pediatric Specialists Pediatric Specialists Article Body ​Your pediatrician may refer your child to a pediatric specialist for further evaluation and treatment. Pediatric specialists ...

  5. Understanding Pediatric Dentists' Dental Caries Management Treatment Decisions: A Conjoint Experiment.

    Science.gov (United States)

    Kateeb, E T; Warren, J J; Gaeth, G J; Momany, E T; Damiano, P C

    2016-04-01

    When traditional ranking and rating surveys are used to assess dentists' treatment decisions, the patient's source of payment appears to be of little importance. Therefore, this study used the marketing research tool conjoint analysis to investigate the relative impact of source of payment along with the child's age and cooperativeness on pediatric dentists' willingness to use Atraumatic Restorative Treatment (ART) to restore posterior primary teeth. A conjoint survey was completed by 707 pediatric dentists. Three factors (age of the child, cooperativeness, type of insurance) were varied across 3 levels to create 9 patient scenarios. The relative weights that dentists placed on these factors in the restorative treatment decision process were determined by conjoint analysis. "Cooperativeness" (52%) was the most important factor, "age of the child" (26%) the second-most important factor, followed by "insurance status of the child" (22%). For the third factor, insurance, pediatric dentists were least willing to use ART with publicly insured children (-0.082), and this was significantly different from their willingness to use ART with uninsured children (0.010) but not significantly different than their willingness to use ART for children with private insurance (0.073). Unlike traditional ranking and rating tools, conjoint analysis found that the insurance status of the patient appeared to be an important factor in dentists' decisions about different restorative treatment options. When pediatric dentists were forced to make tradeoffs among different patients' factors, they were most willing to use ART technique with young, uncooperative patients when they had no insurance. Knowledge Transfer Statement : The present study suggests the feasibility of using techniques borrowed from marketing research, such as conjoint analysis, to understand dentists' restorative treatment decisions. Results of this study demonstrate pediatric dentists' willingness to use a particular

  6. Preliminary Analysis of Rapid Condensation Experiment with MARS-KS Code

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jae Ho; Jun, Hwang Yong; Jeong, Hae Yong [Sejong University, Seoul (Korea, Republic of)

    2016-05-15

    In the present study, the rapid condensation experiment performed in MANOTEA facility is analyzed with the MARS-KS code. It is known that there exists some limitation with a system code to predict this kind of a very active condensation due to direct mixing of cold injection flow and steam. Through the analysis we investigated the applicability of MARS-KS code for the design of various passive safety systems in the future. The configuration of the experimental facility MANOTEA, which has been constructed at the University of Maryland - United States Naval Academy, is described and the modeling approach using the MARS-KS code is also provided. The preliminary result shows that the MARS-KS predicts the general trend of pressure and temperature in the condensing part correctly. However, it is also found that there exist some limitations in the simulation such as an unexpected pressure peak or a sudden temperature change.

  7. Preliminary experiment of non-induced plasma current startup on SUNIST spherical tokamak

    International Nuclear Information System (INIS)

    He Yexi; Zhang Liang; Xie Lifeng; Tang Yi; Yang Xuanzong; Fu Hongjun

    2005-01-01

    Non-inductive plasma current startup is an important motivation on the SUNIST spherical tokamak. In this experiment, a 100 kW, 2.45 GHz magnetron microwave system has been applied to the plasma current startup. Besides the toroidal field, a vertical field was applied to generate a preliminary toroidal plasma current without action of the central solenoid. As the evidence of the plasma current startup by the vertical field drift effect, the direction of the plasma current is changed with the changing direction of the vertical field during ECR startup discharge. We have also observed the plasma current maximum by scanning the vertical field in both directions. Additionally, we have used electrode discharge to assist the ECR current startup. (author)

  8. HACCP and water safety plans in Icelandic water supply: preliminary evaluation of experience.

    Science.gov (United States)

    Gunnarsdóttir, María J; Gissurarson, Loftur R

    2008-09-01

    Icelandic waterworks first began implementing hazard analysis and critical control points (HACCP) as a preventive approach for water safety management in 1997. Since then implementation has been ongoing and currently about 68% of the Icelandic population enjoy drinking water from waterworks with a water safety plan based on HACCP. Preliminary evaluation of the success of HACCP implementation was undertaken in association with some of the waterworks that had implemented HACCP. The evaluation revealed that compliance with drinking water quality standards improved considerably following the implementation of HACCP. In response to their findings, waterworks implemented a large number of corrective actions to improve water safety. The study revealed some limitations for some, but not all, waterworks in relation to inadequate external and internal auditing and a lack of oversight by health authorities. Future studies should entail a more comprehensive study of the experience with the use of HACCP with the purpose of developing tools to promote continuing success.

  9. Preliminary optimization experiments of coupled liquid hydrogen moderator for KENS-II

    International Nuclear Information System (INIS)

    Watanabe, N.; Kiyanagi, Y.; Inoue, K.; Furusaka, M.; Ikeda, S.; Arai, M.; Iwasa, H.

    1989-01-01

    As a preliminary optimization experiment on the cold-neutron source for KENS-II, energy and time distributions of cold neutrons emanating from coupled liquid-hydrogen moderators with and without a premoderator in a graphite reflector were measured and compared with those from a decoupled liquid-hydrogen moderator. The results showed that the energy spectra from the coupled liquid-hydrogen moderators are almost the same as those from a decoupled one. Relative gain of the former to the latter is fairly high, more than 5, and further increases with increasing wavelength. The broadening of the neutron pulse width in coupled moderators at the cold-neutron region is not so significant and only 1.5 times compared to the solid methane moderator presently operated at KENS-II. 2 refs., 12 figs., 1 tab

  10. Preliminary experiment of fast neutron imaging with direct-film method

    International Nuclear Information System (INIS)

    Pei Yuyang; Tang Guoyou; Guo Zhiyu; Zhang Guohui

    2005-01-01

    A preliminary experiment is conducted with direct-film method under the condition that fast neutron is generated by the reaction of 9 Be(d, n) on the Beijing University 4.5 MV Van de Graaff, whose energy is lower than 7 MeV. Basic characteristics of direct-film neutron radiography system are investigated with the help of samples in different materials, different thickness and holes of different diameter. The fast neutron converter, which is vital for fast neutron imaging, is produced with the materials made in China. The result indicates that fast neutron converter can meet the requirement of fast neutron imaging; further research of fast neutron imaging can be conducted on the accelerator and neutron-generator in China. (authors)

  11. PROMISE: A preliminary study of a scientific information system for MIPAS satellite experiment

    International Nuclear Information System (INIS)

    Kapetanios, E.

    1993-08-01

    A scientific information system for MIPAS satellite experiment will be presented according to its main hardware and software configuration. It will be considered as a MIPAS data processing and archiving node of the ground segment of the planned satellite mission for the remote sensing of atmospheric parameters, as well as an information system supporting the researchers in their scientific environment. In this preliminary study, the methodology of a more detailed system design has also been specified. The system consists of two logical components, an operational database for the generation, storage and management of vast amounts of MIPAS data received from the satellite, and the research and development database, which must be interfaced to the operational one, providing a more abstract and user-friendly interface for the scientific community enabling experimentation and the extraction of the information needed. (orig.) [de

  12. Preliminary Experiments for the Assessment of V/W-band Links for Space-Earth Communications

    Science.gov (United States)

    Nessel, James A.; Acosta, Roberto J.; Miranda, Felix A.

    2013-01-01

    Since September 2012, NASA Glenn Research Center has deployed a microwave profiling radiometer at White Sands, NM, to estimate atmospheric propagation effects on communications links in the V and W bands (71-86GHz). Estimates of attenuation statistics in the millimeter wave due to gaseous and cloud components of the atmosphere show good agreement with current ITU-R models, but fail to predict link performance in the presence of moderate to heavy rain rates, due to the inherent limitations of passive radiometry. Herein, we discuss the preliminary results of these measurements and describe a design for a terrestrial link experiment to validate/refine existing rain attenuation models in the V/Wbands.

  13. Experiments, conceptual design, preliminary cost estimates and schedules for an underground research facility

    International Nuclear Information System (INIS)

    Korbin, G.; Wollenberg, H.; Wilson, C.; Strisower, B.; Chan, T.; Wedge, D.

    1981-09-01

    Plans for an underground research facility are presented, incorporating techniques to assess the hydrological and thermomechanical response of a rock mass to the introduction and long-term isolation of radioactive waste, and to assess the effects of excavation on the hydrologic integrity of a repository and its subsequent backfill, plugging, and sealing. The project is designed to utilize existing mine or civil works for access to experimental areas and is estimated to last 8 years at a total cost for contruction and operation of $39.0 million (1981 dollars). Performing the same experiments in an existing underground research facility would reduce the duration to 7-1/2 years and cost $27.7 million as a lower-bound estimate. These preliminary plans and estimates should be revised after specific sites are identified which would accommodate the facility

  14. Preliminary experiments on a planar electron beam for an intense free electron maser

    International Nuclear Information System (INIS)

    Kato, Katsumasa; Iwata, Kazuma; Kitamura, Taro; Yamada, Naohisa; Soga, Yukihiro; Kamada, Keiichi; Yoshida, Mitsuhiro; Ginzburg, Naum S.

    2013-01-01

    A planar wiggler magnetic field was used to increase the output power of an intense free electron maser. As a preliminary experiment, a cylindrical electron beam was injected into a planar wiggler field with an axial magnetic field. Without the axial magnetic field, the cylindrical beam could not propagate through the wiggler field with length of 1 m. The microwave with frequency of 40 GHz was observed only when the beam propagates through the wiggler field. The frequency was nearly equal to the expected frequency of the free electron maser interaction. Though a sheet electron beam with nearly the same energy propagated through the planar wiggler field with deformation of its cross section, the microwave with frequency of 40 GHz was not observed. (author)

  15. The Structured Trauma-Related Experiences and Symptoms Screener (STRESS): Development and Preliminary Psychometrics.

    Science.gov (United States)

    Grasso, Damion J; Felton, Julia W; Reid-Quiñones, Kathryn

    2015-08-01

    The Structured Trauma-Related Experiences and Symptoms Screener (STRESS) is a self-report instrument for youth of age 7-18 that inventories 25 adverse childhood experiences and potentially traumatic events and assesses symptoms of post-traumatic stress disorder using the revised criteria published in the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5). The STRESS can be administered by computer such that questions are read aloud and automatic scoring and feedback are provided. Data were collected on a sample of 229 children and adolescents of age 7-17 undergoing a forensic child abuse and neglect evaluation. The purpose of the current study was to examine preliminary psychometric characteristics of the computer-administered STRESS as well as its underlying factor structure in relation to the four-factor DSM-5 model. Results provide initial support for the use of the STRESS in assessing adverse and potentially traumatic experiences and traumatic stress in children and adolescents. © The Author(s) 2015.

  16. Preliminary oscillating fluxes current drive experiment in DIII-D tokamak

    International Nuclear Information System (INIS)

    Yamaguchi, S.; Schaffer, M.; Kondoh, Y.

    1995-01-01

    A preliminary oscillating flux helicity injection experiment was done on DIII-D tokamak. The toroidal flux was modulated by programming the plasma elongation. Instead of programming the surface voltage directly, the plasma current was programmed with a periodic modulation at some phase shift. The theoretical basis of this modulation is discussed in terms of the helicity injection and also introduced by cross-field motion of the modulated plasma. Because the primary winding is well coupled with the plasma current and the power supply is strong, the plasma current behaves as programmed. However, as the plasma shape is not coupled strongly with the shaping and equilibrium coils, the elongation amplitude and phase are affected by the change of plasma current and do not behave as programmed. Because of this, the voltage induced by the helicity injection is low, and the experiment did not test the principle of helicity injection. The injection powers of helicity and energy, and the electric field intensity of the helicity injection model and the cross-field motion of plasma are compared with each other experimentally. The improvement necessary to do the experiment is also proposed. ((orig.))

  17. Screening diagnostics of antivital experiences and propensity toward impulsive, autoagressive behavior in adolescents (preliminary results

    Directory of Open Access Journals (Sweden)

    Bannikov G.S.,

    2014-08-01

    Full Text Available Development of methods for revealing antivital experiences and propensity to autoaggressive behavior in educational institutions is one of the key steps in developing strategies for the primary prevention of suicidal behavior in adolescents. The purpose of this study was to develop an effective screening diagnostic package aimed at identifying antivital experiences and propensity to autoaggressive behavior. The survey methods we used were: Beck Hopelessness Scale, Russell Loneliness Scale, A.G. Shmelev Suicide Risk Questionnaire, PDQ-IV Borderline disorder and Narcissism scales. At the first stage we examined 750 minors aged 12-18 and identified risk group (85 people – 11.4%, which included adolescents with high levels of both individual scales, and their combination. At the second stage we examined 10 adolescents at risk. In 7 of them (70% were identified antivital, suicidal thoughts of passive or compulsive nature, signs of subjective and objective socio- psychological maladjustment. Our preliminary conclusion is that high levels of hopelessness and loneliness in adolescents are stable predictors of mental and emotional distress and psychosocial maladjustment in the period of psychological crises and decompensation of character accentuation of borderline and narcissistic types. These scales can be recommended for primary screening of antivital (depressive experiences and propensity to autoaggressive behavior in adolescents.

  18. Pediatric retinal detachment in the Eastern Province of Saudi Arabia: experience of a tertiary care hospital.

    Science.gov (United States)

    Cheema, Rizwan A; Al-Khars, Wajeeha; Al-Askar, Essam; Amin, Yasir M

    2009-01-01

    Because no previous studies have addressed the issue, we describe clinical characteristics and surgical outcome of patients with rhegmatogenous retinal detachment (RRD) in a pediatric population of the Eastern province of Saudi Arabia. We conducted a retrospective review of all consecutive cases of pediatric RRD (0-18 years) patients presenting at Dhahran Eye Specialist Hospital, a tertiary care hospital, in the Eastern Province of Saudi Arabia over a period of 3 years. Twenty patients were included in the study, accounting for 9.4% of all retinal detachment surgery cases performed over a period of 3 years (January 2006 to December 2008). The median age was 11.0 years, (range, birth to 18 years). Trauma, (45%) myopia/vitreoretinal degeneration (10%) and prior ocular surgery (25%) were significant risk factors for RRD. Proliferative vitreoretinopathy (PVR) more than grade C was present in 14/20 (70%) of cases. Most patients (15/20, 75%) were treated with pars plana vitrectomy and placement of an encircling buckle, while silicone oil or gas was used as tamponade in 13/20 (65%) patients. Surgery was successful in 17/20 (85%) cases in achieving retinal re-attachment. Visual acuity improved significantly following surgery (Mean preop 2.146 LogMAR, Mean postop 1.497 LogMAR) ( P= .014). Longer duration of RRD ( P =.007) and macular involvement ( P =.05) were associated with worse anatomical outcomes following surgery. Pediatric RRD in the Eastern province is often associated with predisposing pathology. Surgery is successful in achieving anatomical reattachment of the retina in a majority of cases with improvement of visual acuity.

  19. A worldview of the professional experiences and training needs of pediatric psycho-oncologists

    Science.gov (United States)

    Oppenheim, Daniel; Breyer, Joanna; Battles, Haven; Zadeh, Sima; Patenaude, Andrea Farkas

    2012-01-01

    BACKGROUND Thirty years after the origin of the field of psycho-oncology, limited data exist about the work practices of professionals providing psychosocial care to children with cancer and their families. METHOD A survey was designed to assess training, work environment, theoretical orientation, services provided, sub-specialty areas or areas of special interest, satisfactions, challenges and continuing education needs of pediatric psycho-oncologists. Members of national and international psycho-oncology organizations were invited to participate in the web-based survey. RESULTS 786 professionals from 63 countries responded. The sample consisted mostly of psychologists (41%), physicians (20%), and social workers (14%). Approximately half of the participants worked in a designated psycho-oncology unit. Psychologists and social workers provided the majority of psychosocial services. Individual sessions with parents were most common (42%), followed by sessions with children (41%), survivors (36%), families (31%) and siblings (25%). Therapies provided include CBT (50%), relaxation (43%), psychodynamic psychotherapy (27%), play therapy (26%), and imagery (23%). Two-thirds report having appropriate supervision; 37% conduct research; only half feel their salary is appropriate. Differences in therapeutic modalities were found by country. Clinicians desire training on clinical interventions, improving communication with medical staff, research and ethics. CONCLUSIONS An international cohort of clinicians providing pediatric psycho-oncology services perform a wide variety of tasks, use a range of therapeutic approaches and report considerable work satisfaction. Problem areas include professional inter-relations, inadequate supervision and needs for additional, specialized training. Opportunity exists for global collaboration in pediatric psycho-oncology research and practices to enhance clinical effectiveness and reduce professional isolation. PMID:22461180

  20. Experience with the Cardiva Boomerang Catalyst system in pediatric cardiac catheterization.

    Science.gov (United States)

    Seltzer, Sharon; Alejos, Juan Carlos; Levi, Daniel S

    2009-09-01

    We studied the safety and efficacy of the Cardiva Boomerang Catalyst vascular closure system in pediatric patients after cardiac catheterization with access in femoral and internal jugular vessels. Recurrent catheterization and advances in pediatric interventions increase the need for easy hemostasis without a residual foreign body that may prevent re-accessing the vessel. The Boomerang can be deployed in sheaths as small as 4Fr without residual foreign body, with minimal orientation needed, and few complications reported. In a two-month period, all patients between 18 months and 21 years old catheterized with 4-8Fr sheaths less than 15 cm long were eligible for Boomerang placement. These were compared retrospectively with control patients with manual hemostasis. Anthropomorphic measurements, procedure type, activated clotting time, and sheath size as well as total times of cases, intubation, hemostasis, and extubation were compared between the two groups. Forty-six Boomerangs were deployed in 31 patients and compared with 40 patients with manual hemostasis. Boomerangs were deployed in femoral vessels and the internal jugular vein. Device success with hemostasis was achieved in 39 patients (85%). There were no significant differences in time to hemostasis or extubation between the two groups. No major complications or operator error occurred, including hematoma, transfusion, retroperitoneal bleed, infection, vessel occlusion, or need for surgery. The Boomerang is a safe and easy means of achieving hemostasis in the pediatric population, in femoral vessels as well as internal jugular veins. Its times to hemostasis and extubation were not significantly different from manual hold. 2009 Wiley-Liss, Inc.

  1. CBT for Pediatric Migraine: A Qualitative Study of Patient and Parent Experience.

    Science.gov (United States)

    Kroon Van Diest, Ashley M; Ernst, Michelle M; Vaughn, Lisa; Slater, Shalonda; Powers, Scott W

    2018-03-08

    The goal of this study was to determine which cognitive behavioral therapy (CBT-HA) treatment components pediatric headache patient stakeholders would report to be most helpful and essential to reducing headache frequency and related disability to develop a streamlined, less burdensome treatment package that would be more accessible to patients and families. Pediatric migraine is a prevalent and disabling condition. CBT-HA has been shown to reduce headache frequency and related disability, but may not be readily available or accepted by many migraine sufferers due to treatment burden entailed. Research is needed to determine systematic ways of reducing barriers to CBT-HA. Qualitative interviews were conducted with 10 patients and 9 of their parents who had undergone CBT-HA. Interviews were analyzed using an inductive thematic analysis approach based upon modified grounded theory. Patients were 13-17.5 years of age (M = 15.4, SD = 1.63) and had undergone CBT-HA ∼1-2 years prior to participating in the study. Overall, patients and their parents reported that CBT-HA was helpful in reducing headache frequency and related disability. Although patients provided mixed reports on the effectiveness of different CBT-HA skills, the majority of patients indicated that the mind and body relaxation skills of CBT-HA (deep breathing, progressive muscle relaxation, and activity pacing in particular) were the most helpful and most frequently used skills. Patients and parents also generally reported that treatment was easy to learn, and noted at least some aspect of treatment was enjoyable. Results from these qualitative interviews indicate that mind and body CBT-HA relaxation skills emerged as popular and effective based on patient and parent report. Future research examining the effectiveness of streamlined pediatric migraine nonpharmacological interventions should include these patient-preferred skills. © 2018 American Headache Society.

  2. A worldview of the professional experiences and training needs of pediatric psycho-oncologists.

    Science.gov (United States)

    Wiener, Lori; Oppenheim, Daniel; Breyer, Joanna; Battles, Haven; Zadeh, Sima; Patenaude, Andrea Farkas

    2012-09-01

    Thirty years after the origin of the field of psycho-oncology, limited data exist about the work practices of professionals providing psychosocial care to children with cancer and their families. A survey was designed to assess training, work environment, theoretical orientation, services provided, subspecialty areas or areas of special interest, satisfactions, challenges, and continuing education needs of pediatric psycho-oncologists. Members of national and international psycho-oncology organizations were invited to participate in the web-based survey. Seven hundred eighty-six professionals from 63 countries responded. The sample consisted mostly of psychologists (41%), physicians (20%), and social workers (14%). Approximately half of the participants worked in a designated psycho-oncology unit. Psychologists and social workers provided the majority of psychosocial services. Individual sessions with parents were most common (42%), followed by sessions with children (41%), survivors (36%), families (31%), and siblings (25%). Therapies provided include cognitive behavioral therapy (50%), relaxation (43%), psychodynamic psychotherapy (27%), play therapy (26%), and imagery (23%). Two-thirds reported having appropriate supervision, 37% were conducting research, and only half felt their salary was appropriate. Differences in therapeutic modalities were found by country. Clinicians desire training on clinical interventions, improving communication with medical staff, research, and ethics. An international cohort of clinicians providing pediatric psycho-oncology services perform a wide variety of tasks, use a range of therapeutic approaches, and report considerable work satisfaction. Problem areas include professional inter-relations, inadequate supervision, and need for additional specialized training. Opportunity exists for global collaboration in pediatric psycho-oncology research and practices to enhance clinical effectiveness and reduce professional isolation

  3. Routine studies of swallowed radionuclide transit in pediatrics: experience with 400 patients

    Energy Technology Data Exchange (ETDEWEB)

    Guillet, J.; Basse-Cathalinat, B.; Christophe, E.; Blanquet, P.; Ducassou, D.; Wynchank, S.

    1984-02-01

    Scintigraphic studies of swallowed 99m Tc-sulphur colloid mixed with a few millilitres of liquid, performed on 400 pediatric patients of all ages, allowed visualisation of foregut function and measurement of oesophageal transit time and gastric emptying proportions. This non-invasive and physiological procedure requires a standard gamma camera with computing facilities and was performed as an outpatient routine. It proved very effective for the detection of gastro-oesophageal reflux and aspiration of refluxed liquid in patients of all ages but especially in neonates. The relevance of these scintigraphic results to oesophagitis, repeated respiratory problems, cyanotic and apnoeic spells and alternative methods of investigation is described.

  4. Long-term experience of steroid-free pediatric renal transplantation

    DEFF Research Database (Denmark)

    Wittenhagen, Per; Thiesson, Helle C; Baudier, François

    2014-01-01

    Increased focus on the potential negative side effects of steroid usage in pediatric transplantation has led to steroid minimization or steroid-free transplantation. In this study, we report results after complete steroid avoidance in renal transplantation in the period 1994-2009. We evaluate...... in the youngest (renal transplantation is safe and protects against steroid-induced obesity and short stature....... the effects of complete steroid avoidance on allograft function, BMI, and linear growth. The majority of transplanted children were induced with antithymocyte globulin and immunosuppressed with a calcineurin inhibitor and mycophenolate mofetil. Steroids were given only when rejection occurred or due...

  5. Sedation and Anesthesia in Pediatric and Congenital Cardiac Catheterization: A Prospective Multicenter Experience.

    Science.gov (United States)

    Lin, C Huie; Desai, Sanyukta; Nicolas, Ramzi; Gauvreau, Kimberlee; Foerster, Susan; Sharma, Anshuman; Armsby, Laurie; Marshall, Audrey C; Odegard, Kirsten; DiNardo, James; Vincent, Julie; El-Said, Howaida; Spaeth, James; Goldstein, Bryan; Holzer, Ralf; Kreutzer, Jackie; Balzer, David; Bergersen, Lisa

    2015-10-01

    Sedation/anesthesia is critical to cardiac catheterization in the pediatric/congenital heart patient. We sought to identify current sedation/anesthesia practices, the serious adverse event rate related to airway, sedation, or anesthesia, and the rate of intra-procedural conversion from procedural sedation to the use of assisted ventilation or an artificial airway. Data from 13,611 patients who underwent catheterization at eight institutions were prospectively collected from 2007 to 2010. Ninety-four (0.69 %) serious sedation/airway-related adverse events occurred; events were more likely to occur in smaller patients (anesthesia, LMA, or tracheostomy, whereas 4232 (31 %) were managed with procedural sedation without an artificial airway, of which 75 (1.77 %) patients were converted to assisted ventilation/general anesthesia. Young age (risk procedure (category 4, OR 10.1, 95 % CI 6.5-15.6, p pediatric/congenital patients was associated with a low rate of serious sedation/airway-related adverse events. Smaller patients with non-cardiac comorbidities or low mixed venous oxygen saturation may be at higher risk. Patients under 1 year of age, undergoing high-risk procedures, or requiring continuous pressor/inotrope support may be at higher risk of requiring conversion from procedural sedation to assisted ventilation/general anesthesia.

  6. Water privatization, water source, and pediatric diarrhea in Bolivia: epidemiologic analysis of a social experiment.

    Science.gov (United States)

    Tornheim, Jeffrey A; Morland, Kimberly B; Landrigan, Philip J; Cifuentes, Enrique

    2009-01-01

    Water and sanitation services are fundamental to the prevention of pediatric diarrhea. To enhance both access to water and investment, some argue for the privatization of municipal water networks. Water networks in multiple Bolivian cities were privatized in the 1990s, but contracts ended following popular protests citing poor access. A population-based retrospective cohort study was conducted in two Bolivian cities. Data were collected on family water utilization and sanitation practices and on the prevalence of diarrhea among 596 children. Drinking from an outdoor water source (OR, 2.08; 95%CI, 1.25-3.44) and shorter in-home water boiling times (OR, 1.99; 95%CI, 1.19-3.34) were associated with prevalence of diarrhea. Increased prevalence was also observed for children from families using private versus public water services, using off-network water from cistern trucks, or not treating their water in-home. Results suggest that water source, water provider, and in-home water treatment are important predictors of pediatric diarrhea.

  7. Fusarium spp infections in a pediatric burn unit: nine years of experience.

    Science.gov (United States)

    Rosanova, María Teresa; Brizuela, Martín; Villasboas, Mabel; Guarracino, Fabian; Alvarez, Veronica; Santos, Patricia; Finquelievich, Jorge

    2016-01-01

    Fusarium spp are ubiquitous fungi recognized as opportunistic agents of human infections, and can produce severe infections in burn patients. The literature on Fusarium spp infections in pediatric burn patients is scarce. To describe the clinical and epidemiological features as well as outcome of Fusarium spp infections in pediatric burn patients. Retrospective, descriptive study of Fusarium spp infections in a specialized intensive care burn unit. In 15 patients Fusarium spp infections were diagnosed. Median age was 48 months. Direct fire injury was observed in ten patients. The median affected burn surface area was 45%. Twelve patients had a full thickness burn. Fourteen patients had a Garces Index ≥3. Fungal infection developed at a median of 11 days after burn injury. Fungi were isolated from burn wound in 14 patients and from the bone in one patient. Amphotericin B was the drug of choice for treatment followed by voriconazole. Median time of treatment completion was 23 days. One patient (7%) died of fungal infection-related causes. In our series Fusarium spp was an uncommon pathogen in severely burnt patients. The burn wound was the most common site of infection and mortality was low. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  8. Impact of radiotherapy for pediatric CNS atypical teratoid/rhabdoid tumor (single institute experience)

    International Nuclear Information System (INIS)

    Chen, Y.-W.; Wong, T.-T.; Ho, Donald Ming-Tak; Huang, P.-I.; Chang, K.-P.; Shiau, C.-Y.; Yen, S.-H.

    2006-01-01

    Purpose: To assess outcomes and prognostic factors in radiotherapy of pediatric central nervous system atypical teratoid/rhabdoid tumor (AT/RT). Methods and Materials: Seventeen patients with central nervous system AT/RT were retrospectively reviewed after curative radiotherapy as primary or adjuvant therapy between January 1990 and December 2003. Overall and failure-free survival rates were calculated using the Kaplan-Meier method. The log-rank method was used to compare the effects of dosage (>50 Gy or ≤50 Gy) and treatment duration (>45 days or ≤45 days). Multivariate analysis was performed for prognostic factors. Results: Median overall survival and failure-free survival were 17 and 11 months, respectively. The 3 longest-surviving patients were older, underwent gross tumor removal, and completed both craniospinal and focal boost irradiation. Multivariate analysis revealed a significant relationship between the following: overall survival and performance status (p = 0.019), failure-free survival and total irradiation dose (p = 0.037), time interval between surgery and radiotherapy initiation (p = 0.031), and time interval between surgery and radiotherapy end point (p = 0.047). Conclusion: Radiotherapy is crucial in the treatment of AT/RT. We recommend initiating radiotherapy immediately postoperatively and before systemic chemotherapy in pediatric patients ≥3 years of age

  9. Experiences with a new film-screen system in pediatric chest radiography

    International Nuclear Information System (INIS)

    Leenen, A.; Brandt, G.A.; Riebel, T.; Marciniak, H.

    1996-01-01

    Purpose: To compare the X-ray images made by the Kodak InSight Pediatric Imaging System (InSight P) with conventional film-screen systems in pediatric chest radiography. Material and methods: The comparison involved chest radiographs made using Quanta-Fast-Detail/Cronex 4 (DuPont), Trimax 16/XDA (3 M) and DuPont UVR/UVL systems. The image quality of critical structures and the physical parameters of quantum interference, contrast and resolution were assessed. The energy path of the system was assessed by preparing density curves. Test conditions were in accordance with the latest guidelines of the Bundesaerztekammer (German Physicians' Association). Results: The mediastinal area, retrocardiac and paravertebral spaces and the peripheral vessels of the lung were all displayed more distinctly using InSight P. The reason for this seems to be a lower degree of quantum interference associated with this system. With tube voltages between 60 and 80 kV, InSight P displayed a relatively low degree of sensitivity. Conclusion: InSight P can be used to produce predominantly high quality chest radiographs on infants between one and five years of age. However, this system has limited sensitivity in the tube voltage range recommended by the German Physicians' Association. (orig.) [de

  10. Early versus late tracheostomy in pediatric intensive care unit: does it matter? A 6-year experience.

    Science.gov (United States)

    Pizza, Alessandro; Picconi, Enzo; Piastra, Marco; Genovese, Orazio; Biasucci, Daniele G; Conti, Giorgio

    2017-08-01

    The aim of this study is to examine the clinical data of children who underwent tracheostomy during their stay in Pediatric Intensive Care Unit (PICU), in order to describe the relationship between the timing of tracheostomy, the length of PICU stay and the occurrence of ventilator-associated pneumonia (VAP). This is a retrospective cohort study that collects all patients undergoing tracheostomy during their PICU stay over a six-year period. Data collection included PICU length of stay, days of intubation, days of mechanical ventilation, primary indication for tracheostomy, information about VAP and decannulations. The early tracheostomy group was defined as patients who had ten or fewer days of continuous ventilation, whereas the late tracheostomy group had more than ten days of continuous ventilation. A significant decrease in the rate of VAP incidence was noticed in the early tracheostomy group vs. late group (P=0.004, OR=0.39, 95% CI: 0.18-0.85). No differences were observed about decannulation, need of long-term ventilation and death rate. Significant decreases of days of mechanical ventilation and PICU stay were found in subgroup of patients who underwent early tracheostomy and were decannulated within 18 months. No standard timing for tracheostomy placement has been established in the pediatric population. Early tracheostomy can shorten the days of ventilation and hospitalization in PICU and reduce the incidence of VAP, but further studies are needed to identify patient categories in which it can be of benefit.

  11. Taiwanese parents' experience of making a "do not resuscitate" decision for their child in pediatric intensive care unit.

    Science.gov (United States)

    Liu, Shu-Mei; Lin, Hung-Ru; Lu, Frank L; Lee, Tzu-Ying

    2014-03-01

    The purpose of this project was to explore the parental experience of making a "do not resuscitate" (DNR) decision for their child who is or was cared for in a pediatric intensive care unit in Taiwan. A descriptive qualitative study was conducted following parental signing of a standard hospital DNR form on behalf of their critically ill child. Sixteen Taiwanese parents of 11 children aged 1 month to 18 years were interviewed. Interviews were recorded, transcribed, analyzed and sorted into themes by the sole interviewer plus other researchers. Three major themes were identified: (a) "convincing points to sign", (b) "feelings immediately after signing", and (c) "post-signing relief or regret". Feelings following signing the DNR form were mixed and included "frustration", "guilt", and "conflicting hope". Parents adjusted their attitudes to thoughts such as "I have done my best," and "the child's life is beyond my control." Some parents whose child had died before the time of the interview expressed among other things "regret not having enough time to be with and talk to my child". Open family visiting hours plus staff sensitivity and communication skills training are needed. To help parents with this difficult signing process, nurses and other professionals in the pediatric intensive care unit need education on initiating the conversation, guiding the parents in expressing their fears, and providing continuing support to parents and children throughout the child's end of life process. Copyright © 2013. Published by Elsevier B.V.

  12. Initial experience with intravenous pentobarbital sedation for children undergoing MRI at a tertiary care pediatric hospital: the learning curve

    International Nuclear Information System (INIS)

    Greenberg, S.B.; Adams, R.C.; Aspinall, C.L.

    2000-01-01

    Objective. Our purpose is to describe the initial experience with intravenous pentobarbital sedation in children undergoing MRI at a tertiary pediatric hospital to identify errors associated with inexperience. Subjects and methods. The study included the first 100 children sedated with intravenous pentobarbital prior to magnetic resonance examination at a tertiary pediatric hospital. The protocol included a maximum dose of 6 mg/kg administered in three divided doses with the total dose not to exceed 200 mg. Flow sheets documenting vital signs, administered drug doses, and adverse reactions were maintained contemporaneous to sedation. Results. Sedation was successful in 92 children. Of the eight children who failed sedation, three were at least 12 years old and three weighed more than 50 kg. χ 2 tests identified significantly greater failure rates in children older than 11 years or weight greater than 50 kg. Two children had prolonged sedation after the maximum suggested dose was exceeded. Conclusions. The success rate was good, but could have been improved by restricting the use of pentobarbital to children less than 12 years of age and weighing less than 50 kg. Radiologists inexperienced with intravenous sedation should strictly observe the maximum suggested dose of pentobarbital to prevent prolonged sedation. (orig.)

  13. Biologism in Psychiatry: A Young Man’s Experience of Being Diagnosed with “Pediatric Bipolar Disorder”

    Directory of Open Access Journals (Sweden)

    Peter Parry

    2014-03-01

    Full Text Available Pediatric bipolar disorder is a diagnosis that arose in the mid 1990s in the USA and has mostly remained confined to that nation. In this article a young American man (under a pseudonym describes his experience of having the diagnosis throughout his adolescent years. His story was conveyed via correspondence and a meeting with the author, an Australian child psychiatrist. The young American’s story reveals several issues that afflict contemporary psychiatry, particularly in the USA, where social and economic factors have contributed to the rise of a dominant biomedical paradigm—or “biologism”. This focus on the “bio” to the relative exclusion of the “psychosocial” in both diagnosis and treatment can have serious consequences as this young man’s story attests. The author explores aspects of his tale to analyze how the pediatric bipolar disorder “epidemic” arose and became emblematic of a dominant biologism. This narrative points to the need, depending on the service and country, to return to or retain/improve a balanced biopsychosocial perspective in child and adolescent mental health. Child psychiatry needs to advocate for health systems that support deeper listening to our patients. Then we can explore with them the full range of contextual factors that contribute to symptoms of individual and family distress.

  14. Augmented Reality Cubes for Cognitive Gaming: Preliminary Usability and Game Experience Testing

    Directory of Open Access Journals (Sweden)

    Costas Boletsis

    2016-03-01

    Full Text Available Early detection is important in dementia care; however, cognitive impairment is still under-recognised and under-diagnosed. Cognitive screening and training are two important preventative treatments, which can lead to early detection of cognitive decline. In this work, the “Cognitive Augmented Reality Cubes” (CogARC system is presented, i.e. a serious game for cognitive training and screening, utilising an interaction technique based on Augmented Reality and the manipulation of tangible, physical objects (cubes. The game is a collection of cognitive mini-games of preventative nature and is, primarily, targeting elderly players (≥60 years old. A preliminary testing was conducted focusing on the game experience that CogARC offers (utilising the In-Game Experience Questionnaire, the usability of the system (using the System Usability Scale, and the specific user observations and remarks, as documented by open, semi-structured interviews.  Overall, CogARC demonstrated satisfying positive responses, however, the negative reactions indicated that there are specific problems with aspects of the interaction technique and a number of mini-games. The open interview shed more light on the specific issues of each mini-game and further interpretation of user interactions. The current study managed to provide interesting insights into the game design elements, integration of Augmented Reality, tangible interaction of the system, and on how elderly players perceive and use those interaction components. 

  15. Preliminary Experience with Small Animal SPECT Imaging on Clinical Gamma Cameras

    Directory of Open Access Journals (Sweden)

    P. Aguiar

    2014-01-01

    Full Text Available The traditional lack of techniques suitable for in vivo imaging has induced a great interest in molecular imaging for preclinical research. Nevertheless, its use spreads slowly due to the difficulties in justifying the high cost of the current dedicated preclinical scanners. An alternative for lowering the costs is to repurpose old clinical gamma cameras to be used for preclinical imaging. In this paper we assess the performance of a portable device, that is, working coupled to a single-head clinical gamma camera, and we present our preliminary experience in several small animal applications. Our findings, based on phantom experiments and animal studies, provided an image quality, in terms of contrast-noise trade-off, comparable to dedicated preclinical pinhole-based scanners. We feel that our portable device offers an opportunity for recycling the widespread availability of clinical gamma cameras in nuclear medicine departments to be used in small animal SPECT imaging and we hope that it can contribute to spreading the use of preclinical imaging within institutions on tight budgets.

  16. Children's (Pediatric) Abdominal Ultrasound Imaging

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Ultrasound - Abdomen Children’s (pediatric) ultrasound imaging of ... 30 minutes. top of page What will my child experience during and after the procedure? Ultrasound examinations ...

  17. Pulmonary tuberculous: Symptoms, diagnosis and treatment. 19-year experience in a third level pediatric hospital.

    Science.gov (United States)

    González Saldaña, Napoleón; Macías Parra, Mercedes; Hernández Porras, Marte; Gutiérrez Castrellón, Pedro; Gómez Toscano, Valeria; Juárez Olguin, Hugo

    2014-07-19

    Pulmonary tuberculosis (PTB) is an infectious disease that involves the lungs and can be lethal in many cases. Tuberculosis (TB) in children represents 5 to 20% of the total TB cases. However, there are few updated information on pediatric TB, reason why the objective of the present study is to know the real situation of PTB in the population of children in terms of its diagnosis and treatment in a third level pediatric hospital. A retrospective study based on a revision of clinical files of patients less than 18 years old diagnosed with PTB from January 1994 to January 2013 at Instituto Nacional de Pediatria, Mexico City was carried out. A probable diagnosis was based on 3 or more of the following: two or more weeks of cough, fever, tuberculin purified protein derivative (PPD) +, previous TB exposure, suggestive chest X-ray, and favorable response to treatment. Definitive diagnosis was based on positive acid-fast bacilli (AFB) or culture. In the 19-year period of revision, 87 children were diagnosed with PTB; 57 (65.5%) had bacteriologic confirmation with ZN staining or culture positive (in fact, 22 were ZN and culture positive), and 30 (34.5%) had a probable diagnosis; 14(16.1%) were diagnosed with concomitant disease, while 69/81 were immunized. Median evolution time was 21 days (5-150). Fever was found in 94.3%, cough in 77%, and weight loss in 55.2%. History of contact with TB was established in 41.9%. Chest X-ray showed consolidation in 48.3% and mediastinal lymph node in 47.1%. PPD was positive in 59.2%, while positive AFB was found in 51.7% cases. Culture was positive in 24/79 patients (30.4%), PCR in 20/27 (74.1%). 39 (44.8%) patients were treated with rifampin, isoniazid, and pyrazinamide while 6 (6.9%) received the former drugs plus streptomycin and 42 (48.3%) the former plus ethambutol. There were three deaths. PTB in pediatric population represents a diagnostic challenge for the fact that clinical manifestations are unspecific and the diagnosis is not

  18. Pediatric vasculitis.

    Science.gov (United States)

    Barut, Kenan; Sahin, Sezgin; Kasapcopur, Ozgur

    2016-01-01

    The aim of this review is to define childhood vasculitis and to highlight new causative factors and treatment modalities under the guidance of recently published studies. Childhood vasculitis is difficult to diagnose because of the wide variation in the symptoms and signs. New nomenclature and classification criteria were proposed for the diagnosis of pediatric vasculitis. Recently, progress has been made toward understanding the genetic susceptibility to pediatric vasculitis as it was in other diseases. Various radiological techniques provide great opportunities in establishing the diagnosis of pediatric vasculitis. Mild central nervous system disease can accompany Henoch-Schonlein purpura and can go unnoticed. Antineutrophilic cytoplasmic antibody-associated vasculitis is rare in children. Increased severity of the disease, subglottic stenosis, and renal disease are described more frequently among children. Biological therapies are used with success in children as in adults. Future studies, whose aims are to evaluate treatment responses, prognosis and to design guidelines for activity, and damage index of vasculitis for children are required. Henoch-Schonlein purpura and Kawasaki disease are the most frequent vasculitides of children. Experience from adult studies for treatment and prognosis are usually used because of low incidence of other vasculitides in children. Multicenter studies of pediatric vasculitis should be conducted to detail treatment responses and prognosis in children.

  19. Preliminary Flight Results of the Microelectronics and Photonics Test Bed: NASA DR1773 Fiber Optic Data Bus Experiment

    Science.gov (United States)

    Jackson, George L.; LaBel, Kenneth A.; Marshall, Cheryl; Barth, Janet; Seidleck, Christina; Marshall, Paul

    1998-01-01

    NASA Goddard Spare Flight Center's (GSFC) Dual Rate 1773 (DR1773) Experiment on the Microelectronic and Photonic Test Bed (MPTB) has provided valuable information on the performance of the AS 1773 fiber optic data bus in the space radiation environment. Correlation of preliminary experiment data to ground based radiation test results show the AS 1773 bus is employable in future spacecraft applications requiring radiation tolerant communication links.

  20. Social pediatrics: weaving horizontal and vertical threads through pediatric residency.

    Science.gov (United States)

    van den Heuvel, Meta; Martimianakis, Maria Athina Tina; Levy, Rebecca; Atkinson, Adelle; Ford-Jones, Elizabeth; Shouldice, Michelle

    2017-01-13

    Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions. Forty-one social pediatric learning objectives were extracted from the RCPSC Objectives of Training for Pediatrics, most were listed in the Medical Expert (51%) and Health Advocate competencies (24%). Almost all RCPSC social pediatric learning objectives were identified in more than one rotation and/or seminar. Adolescent Medicine (29.2%), Pediatric Ambulatory Medicine (26.2%) and Developmental Pediatrics (25%) listed the highest proportion of social pediatric learning objectives. Four (10%) RCPSC social pediatric objectives were not explicitly named within learning objectives of the formal curriculum. The informal curriculum revealed that both teachers and residents viewed social pediatrics as integral to all clinical encounters. Perceived barriers to teaching and learning of social pediatrics included time constraints, particularly in a tertiary care environment, and the value of social pediatrics relative to medical expert knowledge. Despite the lack of an explicit thematic presentation of social pediatric learning objectives by the Royal College and residency training program

  1. Anesthesia Practice in Pediatric Radiation Oncology: Mayo Clinic Arizona's Experience 2014-2016.

    Science.gov (United States)

    Khurmi, Narjeet; Patel, Perene; Koushik, Sarang; Daniels, Thomas; Kraus, Molly

    2018-02-01

    Understanding the goals of targeted radiation therapy in pediatrics is critical to developing high quality and safe anesthetic plans in this patient population. An ideal anesthetic plan includes allaying anxiety and achieving optimal immobilization, while ensuring rapid and efficient recovery. We conducted a retrospective chart review of children receiving anesthesia for radiation oncology procedures from 1/1/2014 to 7/31/2016. No anesthetics were excluded from the analysis. The electronic anesthesia records were analyzed for perianesthetic complications along with efficiency data. To compare our results to past and current data, we identified relevant medical literature covering a period from 1984-2017. A total of 997 anesthetic procedures were delivered in 58 unique patients. The vast majority of anesthetics were single-agent anesthesia with propofol. The average duration of radiation treatment was 13.24 min. The average duration of anesthesia was 37.81 min, and the average duration to meet discharge criteria in the recovery room was 29.50 min. There were seven instances of perianesthetic complications (0.7%) and no complications noted for the 80 CT simulations. Two of the seven complications occurred in patients receiving total body irradiation. The 5-year survival rate for pediatric cancers has improved greatly in part due to more effective and targeted radiation therapy. Providing an anesthetic with minimal complications is critical for successful daily radiation treatment. The results of our data analysis corroborate other contemporary studies showing minimal risk to patients undergoing radiation therapy under general anesthesia with propofol. Our data reveal that single-agent anesthesia with propofol administered by a dedicated anesthesia team is safe and efficient and should be considered for patients requiring multiple radiation treatments under anesthesia.

  2. Improving patient experience in a pediatric ambulatory clinic: a mixed method appraisal of service delivery

    Directory of Open Access Journals (Sweden)

    Soeteman M

    2015-03-01

    Full Text Available Marijn Soeteman,1 Vera Peters,2 Jamiu O Busari1,3 1Department of Pediatrics, Atrium Medical Center, Heerlen, 2Faculty of Health, Medicine and Life Sciences, 3Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, the Netherlands Objective: In 2013, customer satisfaction surveys showed that patients were unhappy with the services provided at our ambulatory clinic. In response, we performed an appraisal of our services, which resulted in the development of a strategy to reduce waiting time and improve quality of service. Infrastructural changes to our clinic’s waiting room, consultation rooms, and back offices were performed, and schedules were redesigned to reduce wait time to 10 minutes and increase consultation time to 20 minutes. Our objective was to identify if this would improve 1 accessibility to caregivers and 2 quality of service and available amenities. Design: We conducted a multi-method survey using 1 a patient flow analysis to analyze the flow of service and understand the impact of our interventions on patient flow and 2 specially designed questionnaires to investigate patients’ perceptions of our wait time and how to improve our services. Results: The results showed that 79% of our respondents were called in to see a doctor within 20 minutes upon arrival. More patients (55% felt that 10–20 minutes was an acceptable wait time. We also observed a perceived increase in satisfaction with wait time (94%. Finally, a large number of patients (97% were satisfied with the quality of service and with the accessibility to caregivers (94%. Conclusion: The majority of our patients were satisfied with the accessibility to our ambulatory clinics and with the quality of services provided. The appraisal of our operational processes using a patient flow analysis also demonstrated how this strategy could effectively be applied to investigate and improve quality of

  3. The Ross Procedure in Patients among the Pediatric Population, Post Ten Years of Experience

    Directory of Open Access Journals (Sweden)

    Andrey A. Ivanov

    2013-09-01

    Full Text Available The aim of the study was to analyze the results of the surgical treatment in pediatric patients who had undergone the Ross procedure.Material and Methods: The study involved 114 patients between 12 days to 18 years in age. The early and late (up to 5 years results of the treatment were studied. The examination included echocardiography, catheterization of the cardiac chambers and angiocardiography. The case distribution of patients based on diagnosis was as follows: isolated aortic valve stenosis (IAVS in 38 (33.3% patients, aortic valve insufficiency (AVI in 33 (28.9%, and combined heart defects in 56 patients (49.1%.Results: The death rate was 6.14% during the early postoperative period and 1.14% in the late postoperative period; the actuarial survival in the long-term was 98.86%. The complication rate was 51.5%. The most frequent complication was pericarditis (25.6%, whereas cardiac and respiratory failure occurred in 7.6% of the cases and cardiac arrhythmias in 6.1% of the cases. The average time spent in the intensive care unit was 3.48 ± 2.90 days; the hospitalization period on average was 24.70±10.87 days. After surgery, there was a tendency of the echocardiographic parameters to move toward normalization. The frequency of reoperation in the late period was 23.7%, the main reason for which being the conduit dysfunction in the position of the pulmonary artery (PA.Conclusion: The clinical efficacy of the Ross procedure in the treatment of aortic valve malformations in the pediatric group was confirmed. However, in some cases, the need to perform repeated operations due to the increase in the ring size and an increase in the neo-aortic insufficiency during the somatic growth process.

  4. [Rapid malnutrition in patient with anorexia nervosa: experience of a general pediatric department].

    Science.gov (United States)

    Cros, G; Sznajder, M; Meuric, S; Mignot, C; Chevallier, B; Stheneur, C

    2010-02-01

    Rapid undernutrition in patients with anorexia nervosa can compromise vital functions, notably due to cardiac complications. The aim of this study was to analyze the clinical parameters of anorexic patients, hospitalized for substantial weight loss, in a general pediatric inpatient unit, in order to determine which parameters should be tested by the medical doctor. We performed a retrospective study on 20 consecutive patients (18 girls), median age of 13.75 (+/-2.3) years, admitted for the first time in our pediatric inpatient unit for anorexia nervosa. Symptoms evolved for a median duration of 11.5 (+/-10.2) months before admittance and was shorter for the youngest patients (r = 0.42, p = 0.067). The mean BMI was 13.3 (+/-0.6) kg/m(2) (-3.0+/-1.2 Z-score) and was inversely correlated with serum creatinine levels (74+/-15 micromol/l) (r = 0.44, p case. Mean serum glucose was 3.5+/-1.2 mmol/l. At admittance, an electrocardiogram, performed for 16 patients, showed sinusal bradycardia without conduction impairment. Enteral nutrition was necessary for 14 patients (70%) for a mean duration of 18.1 days (range, 6-56 days). The mean weight gain was 3.1+/-2 kg and was inversely correlated to the BMI at admittance (r = 0.49, p anorexia nervosa is above all clinical, as hematological and biological parameters remain normal for a long time. The cardiac complications found in our study appeared to be more related to the rapid rate of weight loss than to the amount of weight loss itself. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  5. Percutaneous sclerotherapy of pediatric lymphatic malformations: experience and outcomes according to the agent used.

    Science.gov (United States)

    Gallego Herrero, C; Navarro Cutillas, V

    Analyze statistically the success, number of sessions required and complete duration of treatment of agents used in pediatric percutaneous sclerotherapy of lymphatic malformations, to determine the most suitable. Retrospective study based on outcomes from percutaneous sclerotherapy performed on lymphatic malformations of 56 patients conducted by pediatric interventional radiologist for 14 years. As first approach, the procedure consists of ultrasound-guided introduction of sclerosing agent. Sessions were repeated until clinical resolution. Success, number of sessions and the duration of treatment were recorded and statistical treatment of the data was performed to obtain further conclusions. Lost patients in follow up and other minority agents used were excluded from the data. Eventually, 52 patients treated with OK432 (n=29), Ethibloc (n=5) and combination therapy (n=18) were included. The average number of sessions and duration in months of treatment was respectively 2.38 and 8.6 for OK432, 1.4 and 5.6 for Ethibloc, and 1.83 and 2.30 for dual therapy. The results were statistically significant for the difference in duration between OK432 and dual therapy. Also, 60-80% of patients reached proper results related to success, but the difference was no significant among the agents. Other demographic and anatomical variables were analyzed, not showing any difference, which supports the homogeneity of the sample. Despite of no significant difference in success and number of sessions among agents, longer duration of treatment with OK432 than dual therapy could mean greater health costs and probably greater disturb for patient and family. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Unrelated hematopoietic stem cell transplantation in the pediatric population: single institution experience

    Directory of Open Access Journals (Sweden)

    Daniela Hespanha Marinho

    2015-08-01

    Full Text Available OBJECTIVE: Hematopoietic stem cell transplantation has been successfully used to treat the pediatric population with malignant and non-malignant hematological diseases. This paper reports the results up to 180 days after the procedure of all unrelated hematopoietic stem cell transplantations in pediatric patients that were performed in one institution.METHODS: A retrospective review was performed of all under 18-year-old patients who received unrelated transplantations between 1995 and 2009. Data were analyzed using the log-rank test, Cox stepwise model, Kaplan-Meier method, Fine and Gray model and Fisher's exact test.RESULTS: This study included 118 patients (46.8% who received bone marrow and 134 (53.2% who received umbilical cord blood transplants. Engraftment occurred in 89.47% of the patients that received bone marrow and 65.83% of those that received umbilical cord blood (p-value < 0.001. Both neutrophil and platelet engraftments were faster in the bone marrow group. Acute graft-versus-host disease occurred in 48.6% of the patients without statistically significant differences between the two groups (p-value = 0.653. Chronic graft-versus-host disease occurred in 9.2% of the patients with a higher incidence in the bone marrow group (p-value = 0.007. Relapse occurred in 24% of the 96 patients with malignant disease with 2-year cumulative incidences of 45% in the bone marrow group and 25% in the umbilical cord blood group (p-value = 0.117. Five-year overall survival was 47%, with an average survival time of 1207 days, and no significant differences between the groups (p-value = 0.4666.CONCLUSION: Despite delayed engraftment in the umbilical cord blood group, graft-versus-host disease, relapse and survival were similar in both groups.

  7. Extracorporeal shock wave lithotripsy in the treatment of pediatric urolithiasis: a single institution experience

    Directory of Open Access Journals (Sweden)

    Konstantinos N. Stamatiou

    2010-12-01

    Full Text Available PURPOSE: To compare the efficacy and safety of the electromagnetic lithotripter in the treatment of pediatric lithiasis to that of the earlier electrohydraulic model. MATERIALS AND METHODS: Two groups of children with lithiasis aged between 10 and 180 months who underwent extracorporeal shock wave lithotripsy (ESWL. In the first group (26 children, ESWL was performed by using the electrohydraulic MPL 9000X Dornier lithotripter between 1994 and 2003 while in the second group (19 children the electromagnetic EMSE 220 F-XP Dornier lithotripter was used from April 2003 to May 2006. RESULTS: In the first group, 21/26 children (80.7% were stone free at first ESWL session. Colic pain resolved by administration of an oral analgesic in 6 (23%, brief hematuria (< 24 h resolved with increased fluid intake in 5 (19.2%, while slightly elevated body temperature (< 38°C occurred in 4 (15.3%. Four children (15.3% failed to respond to treatment and were treated with ureteroscopy. In the second group 18/19 children were completely stone free at first ESWL session (94.7%. Complications were infrequent and of minor importance: colic pain treated with oral analgesic occurred in 1 (5.26%, brief hematuria (< 24 h, resolved with increased fluid intake in 4 (21% and slightly elevated body temperature (< 38°C monitored for 48 hours occurred in 6 (31.5%. Statistical analysis showed that electromagnetic lithotripter is more efficacious and safer than the earlier electrohydraulic model. CONCLUSIONS: Technological development not only has increased efficacy and safety of lithotripter devices in treating pediatric lithiasis, but it also provided less painful lithotripsy by eliminating the need for general anesthesia.

  8. Preliminary three-dimensional potential flow simulation of a five-liter flask air injection experiment

    International Nuclear Information System (INIS)

    Davis, J.E.

    1977-01-01

    The preliminary results of an unsteady three-dimensional potential flow analysis of a five-liter flask air injection experiment (small-scale model simulation of a nuclear reactor steam condensation system) are presented. The location and velocity of the free water surface in the flask as a function of time are determined during pipe venting and bubble expansion processes. The analyses were performed using an extended version of the NASA-Ames Three-Dimensional Potential Flow Analysis System (POTFAN), which uses the vortex lattice singularity method of potential flow analysis. The pressure boundary condition at the free water surface and the boundary condition along the free jet boundary near the pipe exit were ignored for the purposes of the present study. The results of the analysis indicate that large time steps can be taken without significantly reducing the accuracy of the solutions and that the assumption of inviscid flow should not have an appreciable effect on the geometry and velocity of the free water surface. In addition, the computation time required for the solutions was well within acceptable limits

  9. Preliminary experiments of a tubular linear actuator in the vertical direction using YBCO bulk

    Energy Technology Data Exchange (ETDEWEB)

    Sugawara, A; Ueda, H; Ishiyama, A [Department of Electrical Engineering and Bioscience, Waseda University, 3-4-1 Ohkubo, Shinjuku-ku, Tokyo 169-8555 (Japan)

    2004-05-01

    We have been developing a new type of active-maglev system composed of field-cooled disc-shaped YBCO bulk and multiple ring-shaped electromagnets, which are vertically piled up. One of the useful features of the active-maglev system is that the levitation height is adjustable by varying the operating current through an electromagnet. Maximum levitation height in stable levitation, however, is restricted by the magnetic field distribution produced by the electromagnet. To enhance the levitation height, we have fabricated and tested an active-maglev system with multiple ring-shaped electromagnets instead of using a larger single electromagnet. Up to now, we have reported the experimental results in a model active-maglev system composed of five electromagnets and showed that the levitation height, as well as stability, can be remarkably improved by adjusting the operating current of each electromagnet individually. In this study, we constructed a model system operated as a tubular linear synchronous actuator in the vertical direction in expectation of it being applied in factory automation upgrading. The primary consists of six ring-shaped copper-winding coils without iron core and is supplied with three-phase sinusoidal excitation. A disc-shaped YBCO bulk, which was magnetized by a field-cooling process, was adopted as a secondary (mover). We carried out preliminary experiments to confirm the feasibility of synchronous operation and also numerically investigated the electromagnetic phenomenon within the bulk superconductor by a developed computer program based on the finite element method.

  10. Preliminary experiments of a tubular linear actuator in the vertical direction using YBCO bulk

    International Nuclear Information System (INIS)

    Sugawara, A; Ueda, H; Ishiyama, A

    2004-01-01

    We have been developing a new type of active-maglev system composed of field-cooled disc-shaped YBCO bulk and multiple ring-shaped electromagnets, which are vertically piled up. One of the useful features of the active-maglev system is that the levitation height is adjustable by varying the operating current through an electromagnet. Maximum levitation height in stable levitation, however, is restricted by the magnetic field distribution produced by the electromagnet. To enhance the levitation height, we have fabricated and tested an active-maglev system with multiple ring-shaped electromagnets instead of using a larger single electromagnet. Up to now, we have reported the experimental results in a model active-maglev system composed of five electromagnets and showed that the levitation height, as well as stability, can be remarkably improved by adjusting the operating current of each electromagnet individually. In this study, we constructed a model system operated as a tubular linear synchronous actuator in the vertical direction in expectation of it being applied in factory automation upgrading. The primary consists of six ring-shaped copper-winding coils without iron core and is supplied with three-phase sinusoidal excitation. A disc-shaped YBCO bulk, which was magnetized by a field-cooling process, was adopted as a secondary (mover). We carried out preliminary experiments to confirm the feasibility of synchronous operation and also numerically investigated the electromagnetic phenomenon within the bulk superconductor by a developed computer program based on the finite element method

  11. Universal newborn hearing screening: preliminary experience at the University Hospital of Cagliari

    Directory of Open Access Journals (Sweden)

    Giulia Pinna

    2012-10-01

    Full Text Available Bilateral congenital or acquired sensorineural hearing loss is a pathological condition affecting 1-2 children per 1,000 live births; it represents a major issue in public health because its late identification can negatively affect speech and language development. The aim of hearing screening is to obtain diagnosis and management of hearing loss as soon as possible; in fact early diagnosis and treatment allow children with congenital hearing impairment to acquire adequate linguistic competence. The present study reports our preliminary experience in newborn hearing screening at Neonatology services of University of Cagliari (Italy. During the first semester of surveillance, between January 2012 and June 2012, hearing screening was performed on a total of 901 babies using two different methods, TEOAEs in healthy neonates and automated ABR in high-risk babies. All infants were screened prior to hospital discharge; in some cases, especially for preterm infants of Neonatal Intensive Care Unit and Puericulture Institute, the screening was performed after discharge, to achieve a possible better global and acoustic maturation; 5 cases of hearing impairment were found. In the present study the Authors confirmed that it is possible to start a universal hearing screening in a relatively short time reaching the percentages suggested by Joint Committee on Infant Hearing.

  12. Single-balloon enteroscopy following videocapsule endoscopy for diagnosis of small bowel tumors: preliminary experiences.

    Science.gov (United States)

    Trifan, A; Singeap, A M; Cojocariu, C; Sfarti, C; Tarcoveanu, E; Georgescu, S

    2010-01-01

    Small bowel tumors (SBTs), either benign or malignant, are rare, accounting for 3-6% of all digestive neoplasms. Videocapsule endoscopy (VCE) and double-balloon enteroscopy (DBE) have revolutionized the diagnosis and management of patients with small bowel diseases, including SBTs. A novel method using the single-balloon enteroscopy (SBE) has recently been developed. The aim of present study was to present our preliminary experience with SBE in patients with suspected SBTs on VCE examination. Patients in whom VCE showed one or more lesions suggesting SBTs underwent SBE. Three patients (2 males, 1 female; mean age 52 +/- 11 years) underwent SBE, and then surgery. There were two gastrointestinal stromal tumors and one adenocarcinoma. Clinically, all patients had iron-deficiency anemia and abdominal pain, and one patient had episodes of nausea/ vomiting. SBE was well tolerated without adverse events. SBE is a safe procedure and overcomes the limitations of VCE. Both procedures are complimentary in patients with suspected SBTs. VCE should be used first for initial diagnosis, followed by SBE for histopathological confrmation of the diagnosis and, if necessary, endoscopic therapy.

  13. Review of preliminary additional heating experiments in JT-60 (Aug. - Nov., 1986)

    International Nuclear Information System (INIS)

    1987-03-01

    This is a prompt report on preliminary additional heating experiments in JT-60 from August to November in 1986. Neutral beam heating power was raised up to 20 MW in about a month. Plasma stored energy is about 2 MJ and energy confinement time is 0.1 ∼ 0.12 sec with the maximum heating power. The energy confinement time shows L-mode like deterioration with power, while it has little dependence on electron density. The maximum ion temperature of ∼ 7 keV and electron temperature of 4.5 keV were obtained at relatively low electron density (n-bar e = 2 - 3 x 10 19 m -3 ). Lower hybrid wave could efficiently drive plasma current up to 1.7 MA with 1.2 MW LH power. The current drive efficiency is 1 ∼ 1.7 in ohmically heated plasmas and 2 ∼ 2.8 in NB heated plasmas. Futhermore the energy confinement was improved when neutral beam was injected into entirely current driven discharges of 1 MA by LH in contrast to inductively driven target plasmas. Similar improvement in energy confinement was observed during combined heating with NB and ion cyclotron wave. (author)

  14. A new Subcutaneously Anchored Device for Securing External Cerebrospinal Fluid Catheters: our Preliminary Experience.

    Science.gov (United States)

    Frassanito, Paolo; Massimi, Luca; Tamburrini, Gianpiero; Pittiruti, Mauro; Doglietto, Francesco; Nucci, Carlotta Ginevra; Caldarelli, Massimo

    2016-09-01

    Accidental dislocation or removal is a well-known complication of external cerebrospinal fluid (CSF) drainage in daily clinical practice. At present, no data about the incidence of such complications are available in the scientific literature. SecurAcath (Interrad Medical, Plymouth, Minnesota, USA) is a subcutaneously anchored device recently adopted for securement of central venous catheters, known to be highly effective (and cost-effective) in reducing the risk of catheter dislodgement and/or accidental removal. We report our preliminary experience with the use of SecurAcath to secure CSF drainage, either ventricular or spinal, to the skin. SecurAcath was used in 29 consecutive patients (age range: 3 weeks-16 years, median age 6.3 years). In particular, the device was used for 25 ventricular catheters (a patient received 2 catheters in the same procedure for bilateral brain abscess) and 5 spinal drainages. Period in place ranged from 1-4 weeks (median 22 days). No complication related to the use of the device was observed, in particular there was no case of dislocation or accidental removal of the catheter. The removal procedure was extremely easy. The device has proven its utility also in 3 cases requiring an adjustment of the length of the catheter. In our experience, SecurAcath is a safe and effective device to secure CSF external catheters to the skin, with several relevant advantages: its placement and maintenance are easy; it may stay in place for the entire duration of the catheter; it allows a more complete antisepsis of the exit site, thus reducing local skin complications; it eliminates the risk of suture-related needlestick injuries. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Preliminary results from the Arecibo Heating Experiment (HEX): HF to GNSS

    Science.gov (United States)

    Jackson-Booth, N.; Penney, R.; Bernhardt, P. A.; Martin, P. L.; Buckland, R.; Morton-Orr, T.; Nossa, E.; Buckland, R.

    2017-12-01

    The ionosphere is subject to many solar and terrestrial influences that can generate disturbances, causing degradation to modern communication and navigational systems. Whilst the disturbances are normally caused by natural phenomena such as hurricanes, earthquakes and solar storms; they can also be generated by artificially modifying the ionosphere. Artificial Ionospheric Modification (AIM) attempts to alter a small region of the ionosphere in order to perturb the RF propagation environment. This can be achieved through injecting the ionosphere with aerosols, chemicals or radio signals. The effects of any such modification can be detected through the deployment of sensors, including ground based high-frequency (HF) sounders and dual-band Global Navigation Satellite System (GNSS) receivers. HF sounders allow measurements of the bottom-side of the ionosphere. GNSS receivers offer a convenient means of obtaining information about the ionosphere, including ionospheric disturbances through changes in the derived total electron content information. The Heating EXperiment (HEX), which took place in March and May 2017, was designed to further our understanding of the phenomena caused by artificially heating a small region of the ionosphere, using the Arecibo facility in Puerto Rico. This was achieved by utilizing a HF measurement experiment spread between Texas and Trinidad and the deployment of a small scale travelling ionospheric disturbance (TID) network near the heater. The TID network comprised three GNSS receivers along baselines of approximately 4 km, located 20 km north of the heater. This paper presents preliminary results from the HEX campaign, including evidence of heating-induced disturbances enhancing propagation between Virginia and Trinidad. The implications of generated irregularities on GNSS will also be discussed.

  16. Wageningen Urban Rainfall Experiment 2014 (WURex14): Experimental setup and preliminary results

    Science.gov (United States)

    van Leth, Thomas C.; Uijlenhoet, Remko; Overeem, Aart; Leijnse, Hidde; Hazenberg, Pieter; Berne, Alexis

    2016-04-01

    Microwave links from cellular communication networks have been shown to be able to provide valuable information concerning the space-time variability of rainfall. In particular over urban areas, where network densities are generally high, they have the potential to complement existing dedicated infrastructure to measure rainfall (gauges, radars). In addition, microwave links provide a great opportunity for ground-based rainfall measurement for those land surface areas of the world where gauges and radars are generally lacking. Such information is not only crucial for water management and agriculture, but also for instance for ground validation of space-borne rainfall estimates such as those provided by the GPM (Global Precipitation Measurement) mission. WURex14 is dedicated to address several errors and uncertainties associated with such quantitative precipitation estimates in detail. The core of the experiment is provided by three co-located microwave links installed between two major buildings on the Wageningen University campus, approximately 2 km apart: a 38 GHz commercial microwave link, provided by T-Mobile NL, and 26 GHz and 38 GHz (dual-polarization) research microwave links from RAL. Transmitting and receiving antennas have been attached to masts installed on the roofs of the two buildings, about 30 m above the ground. This setup has been complemented with a Scintec infrared Large-Aperture Scintillometer, installed over the same path, as well as 5 Parsivel optical disdrometers and an automated rain gauge positioned at several locations along the path. Temporal sampling of the received signals was performed at a rate of 20 Hz. The setup is being monitored by time-lapse cameras to assess the state of the antennas as well as the atmosphere. Finally, data is available from the KNMI weather radars and an automated weather station situated just outside Wageningen. The experiment has been active between August 2014 and December 2015. We give a global overview of

  17. Portal vein thrombosis in children and adolescents: 20 years experience of a pediatric hepatology reference center

    Directory of Open Access Journals (Sweden)

    Priscila Menezes Ferri

    2012-03-01

    Full Text Available CONTEXT: Portal vein thrombosis refers to a total or partial obstruction of the blood flow in this vein due to a thrombus formation. It is an important cause of portal hypertension in the pediatric age group with high morbidity rates due to its main complication - the upper gastrointestinal bleeding. OBJECTIVE: To describe a group of patients with portal vein thrombosis without associated hepatic disease of the Pediatric Hepatology Clinic of the Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil with emphasis on diagnosis, presentation form and clinical complications, and the treatment of portal hypertension. METHODS: This is a descriptive study of a series of children and adolescents cases assisted from January 1990 to December 2010. The portal vein thrombosis diagnosis was established by ultrasound. RESULTS: Of the 55 studied patients, 30 (54.5% were male. In 29 patients (52.7%, none of the risk factors for portal vein thrombosis was observed. The predominant form of presentation was the upper gastrointestinal bleeding (52.7%. In 20 patients (36.4%, the initial manifestation was splenomegaly. During the whole following period of the study, 39 patients (70.9% showed at least one episode of upper gastrointestinal bleeding. The mean age of patients in the first episode was 4.6 ± 3.4 years old. The endoscopic procedure carried out in the urgency or electively for search of esophageal varices showed its presence in 84.9% of the evaluated patients. The prophylactic endoscopic treatment was performed with endoscopic band ligation of varices in 31.3% of patients. Only one died due to refractory bleeding. CONCLUSIONS: The portal vein thrombosis is one of the most important causes of upper gastrointestinal bleeding in children. In all non febrile children with splenomegaly and/or hematemesis and without hepatomegaly and with normal hepatic function tests, it should be suspect of portal vein thrombosis. Thus, an

  18. Pediatric Sinusitis

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Pediatric Sinusitis Pediatric Sinusitis Patient Health Information News media interested in ... sinuses are present at birth. Unlike in adults, pediatric sinusitis is difficult to diagnose because symptoms of ...

  19. Pediatric Asthma

    Science.gov (United States)

    ... Science Education & Training Home Conditions Asthma (Pediatric) Asthma (Pediatric) Make an Appointment Refer a Patient Ask a ... meet the rising demand for asthma care. Our pediatric asthma team brings together physicians, nurses, dietitians, physical ...

  20. Retrospective Review of Pediatric Blunt Renal Trauma: A Single Institution's Five Year Experience

    Science.gov (United States)

    Clark, Margaret E; Sutherland, Ronald S; Woo, Russell K

    2017-01-01

    Children are at higher risk of renal injury from blunt trauma than adults due to a variety of anatomic factors such as decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. Non-operative management is gaining in popularity for even major injuries, although there are no universally accepted guidelines. We present a retrospective review of pediatric major blunt renal injuries (grade 3 or higher) at a children's hospital in Hawai‘i over a 5-year period. Medical records were examined between January 2009 and September 2014 from Kapi‘olani Medical Center for Women and Children in Honolulu, Hawai‘i. Inclusion criteria were a diagnosis of renal trauma, or the diagnosis of blunt abdominal trauma with hematuria. Exclusion criteria were grade I or II renal injury or death due to an additional traumatic injury. Mechanism of injury, clinical characteristics on admission, blood product requirements, surgical interventions performed, and hospital length of stay were retrospectively analyzed. Eleven total patient records were examined, nine of which fit inclusion criteria. Uniquely, 33% of patients sustained their renal injury while surfing. No patients required laparotomy or nephrectomy, though 22% of patients received a blood transfusion and 44% of patients underwent ureteral stent placement. Non-operative management of major renal injuries in children is feasible and allows for preservation of renal tissue. A novel mechanism of surfing as a cause of major renal trauma is seen in the state of Hawai‘i. PMID:28484665

  1. Retrospective Review of Pediatric Blunt Renal Trauma: A Single Institution's Five Year Experience.

    Science.gov (United States)

    Richards, Carly R; Clark, Margaret E; Sutherland, Ronald S; Woo, Russell K

    2017-05-01

    Children are at higher risk of renal injury from blunt trauma than adults due to a variety of anatomic factors such as decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. Non-operative management is gaining in popularity for even major injuries, although there are no universally accepted guidelines. We present a retrospective review of pediatric major blunt renal injuries (grade 3 or higher) at a children's hospital in Hawai'i over a 5-year period. Medical records were examined between January 2009 and September 2014 from Kapi'olani Medical Center for Women and Children in Honolulu, Hawai'i. Inclusion criteria were a diagnosis of renal trauma, or the diagnosis of blunt abdominal trauma with hematuria. Exclusion criteria were grade I or II renal injury or death due to an additional traumatic injury. Mechanism of injury, clinical characteristics on admission, blood product requirements, surgical interventions performed, and hospital length of stay were retrospectively analyzed. Eleven total patient records were examined, nine of which fit inclusion criteria. Uniquely, 33% of patients sustained their renal injury while surfing. No patients required laparotomy or nephrectomy, though 22% of patients received a blood transfusion and 44% of patients underwent ureteral stent placement. Non-operative management of major renal injuries in children is feasible and allows for preservation of renal tissue. A novel mechanism of surfing as a cause of major renal trauma is seen in the state of Hawai'i.

  2. An interactive E-Learning Portal in Pediatric Endocrinology: Practical Experience

    Directory of Open Access Journals (Sweden)

    Stenvert L. S. Drop

    2013-10-01

    Full Text Available Based on educational considerations, the European Society for Paediatric Endocrinology (ESPE e-learning portal has been developed, providing an interactive learning environment for up-to-date information in pediatric endocrinology. From March 2011 to January 2012, five small-scale pilot studies were completed to assess the usefulness of the structure and content by senior experts, fellows, residents and medical students. Altogether, 8 cases and 4 chapters were studied by a total of 71 individuals: 18 senior experts, 21 fellows, 10 medical students, 9 regional pediatricians and 13 residents, resulting in a total of 127 evaluations. Participants considered the portal content interesting and appreciated the way of learning compared to traditional learning from literature and textbooks. Special attention was paid to assess the personalized feedback given by experts to fellows and residents who completed the portal. Feedback from experts included both medical understanding and communication skills demonstrated by fellows and residents. Users highly appreciated the feedback of the medical experts, who brought perspectives from another clinic. This portal also offers educational opportunities for medical students and regional pediatricians and can be used to develop various CanMEDS competencies, e.g., medical expert, health advocate, and scholar.

  3. Injury patterns of child abuse: Experience of two Level 1 pediatric trauma centers.

    Science.gov (United States)

    Yu, Yangyang R; DeMello, Annalyn S; Greeley, Christopher S; Cox, Charles S; Naik-Mathuria, Bindi J; Wesson, David E

    2018-05-01

    This study examines non-accidental trauma (NAT) fatalities as a percentage of all injury fatalities and identifies injury patterns in NAT admissions to two level 1 pediatric trauma centers. We reviewed all children (<5years old) treated for NAT from 2011 to 2015. Patient demographics, injury sites, and survival were obtained from both institutional trauma registries. Of 4623 trauma admissions, 557 (12%) were due to NAT. However, 43 (46%) of 93 overall trauma fatalities were due to NAT. Head injuries were the most common injuries sustained (60%) and led to the greatest increased risk of death (RR 5.1, 95% CI 2.0-12.7). Less common injuries that increased the risk of death were facial injuries (14%, RR 2.9, 95% CI 1.6-5.3), abdominal injuries (8%, RR 2.8, 95% CI 1.4-5.6), and spinal injuries (3%, RR 3.9, 95% CI 1.8-8.8). Although 76% of head injuries occurred in infants <1year, children ages 1-4years old with head injuries had a significantly higher case fatality rate (27% vs. 6%, p<0.001). Child abuse accounts for a large proportion of trauma fatalities in children under 5years of age. Intracranial injuries are common in child abuse and increase the risk of death substantially. Preventing NAT in infants and young children should be a public health priority. Retrospective Review. II. Copyright © 2018. Published by Elsevier Inc.

  4. The Ross Procedure in Pediatric Patients: A 20-Year Experience of Ross Procedure in a Single Institution.

    Science.gov (United States)

    Yoon, Dong Woog; Yang, Ji-Hyuk; Jun, Tae-Gook; Park, Pyo Won

    2017-08-01

    The Ross/Ross-Konno procedure is considered a good option for irreparable aortic valve disease in pediatric patients because of its hemodynamic performance and potential for growth of the pulmonary autograft. This study is a review of the long-term results of our 20-year experience with the Ross and Ross-Konno operations in a single institution. Between June 1995 and January 2016, 16 consecutive patients (mean age, 6.0±5.9 years; range, 16 days to 17.4 years) underwent either a Ross operation (n=9) or a Ross-Konno operation (n=7). The study included 12 males and 4 females, with a median follow-up period of 47 months (range, 6 to 256 months). There were no cases of in-hospital or late mortality. Six reoperations were performed in 5 patients. Four patients underwent right ventricular-pulmonary artery (RV-PA) conduit replacement. Two patients underwent concomitant replacement of the pulmonary autograft and RV-PA conduit 10 years and 8 years after the Ross operation, respectively. The rate of freedom from adverse outcomes of the pulmonary autograft was 88% and 70% at 5 and 10 years, respectively. The rate of freedom from valve-related reoperations was 79% and 63% at 5 and 10 years, respectively. Pulmonary autografts demonstrated good durability with low mortality. The Ross/Ross-Konno procedure is a good option that can be performed safely in pediatric patients with aortic valve disease, even in a small-volume center.

  5. Non-invasive ventilation in complex obstructive sleep apnea--a 15-year experience of a pediatric tertiary center.

    Science.gov (United States)

    Girbal, I C; Gonçalves, C; Nunes, T; Ferreira, R; Pereira, L; Saianda, A; Bandeira, T

    2014-01-01

    Obstructive sleep apnea (OSA) affects approximately 1-3% of pediatric population and is associated with significant morbidity. As adenotonsillar hypertrophy (ATH) is its primary cause in children, elective adenotonsillectomy is the first treatment of choice. Noninvasive ventilation (NIV) has been increasingly considered as an option, mainly for children with complex diseases, ineligible or waiting for surgeries, or after surgery failure. To describe the experience in the management of children with complex OSA, and to evidence the feasibility and advantages of NIV. This was a retrospective cohort study of 68 children on NIV, in whom complex OSA was the main indication for ventilation, in a Pediatric Respiratory Unit at a University Hospital between January 1997 and March 2012. Demographic and clinical data were collected on the underlying diagnosis, therapeutic interventions prior to NIV, NIV related issues and outcome. Forty (59%) children were male, median age at starting NIV was 6 years and 7 months, with interquartile range (IQR) of 15-171 months. Twenty-two (32%) were infants and 25 (37%) adolescents. The most common diagnosis was congenital malformations and genetic disorders in 34 (50%) patients. Nine patients had cerebral palsy, 8 were post treatment for central nervous system tumors and 6 had inborn errors of metabolism. Three children had ATH and three obesity. The majority of patients (76%) had exclusively obstructive OSA and started CPAP. Ten patients had minor complications. Twenty-two patients stopped NIV due to clinical improvement, 8 were non-compliant and 8 patients died. NIV median duration was 21.5 months (IQR: 7-72). NIV is feasible and well tolerated by children with OSA associated with complex disorders, and has been shown to have few complications even in infants and toddlers. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

  6. Parents' experiences of pediatric palliative care and the impact on long-term parental grief.

    Science.gov (United States)

    van der Geest, Ivana M M; Darlington, Anne-Sophie E; Streng, Isabelle C; Michiels, Erna M C; Pieters, Rob; van den Heuvel-Eibrink, Marry M

    2014-06-01

    Approximately 25% of children diagnosed with cancer eventually die. Losing a child puts parents at increased risk for developing psychological problems. To explore parents' perceptions of the interaction with health care professionals (communication, continuity of care, and parental involvement) and symptom management during the pediatric palliative phase, and to investigate the influence on long-term grief in parents who lost a child to cancer. A total of 89 parents of 57 children who died of cancer between 2000 and 2004 participated in this retrospective cross-sectional study by completing a set of questionnaires measuring grief (Inventory of Traumatic Grief), parents' perceptions of the interaction with health care professionals (communication, continuity of care, and parental involvement), and symptom management during the palliative phase. Care was assessed on a five point Likert scale (1=disagree and 5=agree). Parents highly rated communication (4.6±0.6), continuity of care (4.3±0.6), and parental involvement (4.6±0.7) during the palliative phase. Parents' most often reported physical and psychological symptoms of their child during the palliative phase were fatigue (75%), pain (74%), anxiety to be alone (52%), and anger (48%). Higher ratings of parents on communication (β=-9.08, P=0.03) and continuity of care (β=-11.74, P=0.01) were associated with lower levels of long-term parental grief. The severity of the child's dyspnea (β=2.96, P=0.05), anxiety to be alone (β=4.52, Pparental grief. Multivariate models combining the interaction with health care professionals and symptom management showed a significant influence of both aspects on long-term parental grief. Both interaction with health care professionals, especially communication and continuity of care, and symptom management in children dying of cancer are associated with long-term parental grief levels. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights

  7. Retrospective Analysis of Factors Leading to Pediatric Tracheostomy Decannulation Failure. A Single-Institution Experience.

    Science.gov (United States)

    Bandyopadhyay, Anuja; Cristea, A Ioana; Davis, Stephanie D; Ackerman, Veda L; Slaven, James E; Jalou, Hasnaa E; Givan, Deborah C; Daftary, Ameet

    2017-01-01

    There is a lack of evidence regarding factors associated with failure of tracheostomy decannulation. We aimed to identify characteristics of pediatric patients who fail a tracheostomy decannulation challenge Methods: A retrospective review was performed on all patients who had a decannulation challenge at a tertiary care center from June 2006 to October 2013. Tracheostomy decannulation failure was defined as reinsertion of the tracheostomy tube within 6 months of the challenge. Data on demographics, indications for tracheostomy, home mechanical ventilation, and comorbidities were collected. Data were also collected on specific airway endoscopic findings during the predecannulation bronchoscopy and airway surgical procedures before decannulation. We attempted to predict the decannulation outcome by analyzing associations. 147 of 189 (77.8%) patients were successfully decannulated on the first attempt. Tracheostomy performed due to chronic respiratory failure decreased odds for decannulation failure (odds ratio = 0.34, 95% confidence interval = 0.15-0.77). Genetic abnormalities (45%) and feeding dysfunction (93%) were increased in the population of patients failing their first attempt. The presence of one comorbidity increased the odds of failure by 68% (odds ratio = 1.68, 95% confidence interval = 1.23-2.29). Decannulation pursuit based on parental expectation of success, rather than medically determined readiness, was associated with a higher chance of failure (P = 0.01). Our study highlights the role of genetic abnormalities, feeding dysfunction, and multiple comorbidities in patients who fail decannulation. Our findings also demonstrate that the outcome of decannulation may be predicted by the indication for tracheostomy. Patients who had tracheostomy placed for chronic respiratory support had a higher likelihood of success. Absence of a surgically treatable airway obstruction abnormality on the predecannulation bronchoscopy increased the

  8. IVC filter retrieval in adolescents: experience in a tertiary pediatric center.

    Science.gov (United States)

    Guzman, Anthony K; Zahra, Mahmoud; Trerotola, Scott O; Raffini, Leslie J; Itkin, Maxim; Keller, Marc S; Cahill, Anne Marie

    2016-04-01

    Inferior vena cava (IVC) filters are commonly implanted with the intent to prevent life-threatening pulmonary embolism in at-risk patients with contraindications to anticoagulation. Various studies have reported increases in the rate of venous thromboembolism within the pediatric population. The utility and safety of IVC filters in children has not yet been fully defined. To describe the technique and adjunctive maneuvers of IVC filter removal in children, demonstrate its technical success and identify complications. A retrospective 10-year review was performed of 20 children (13 male, 7 female), mean age: 15.1 years (range: 12-19 years), who underwent IVC filter retrieval. Eleven of 20 (55%) were placed in our institution. Electronic medical records were reviewed for filter characteristics, retrieval technique, technical success and complications. The technical success rate was 100%. Placement indications included: deep venous thrombosis with a contraindication to anticoagulation (10/20, 50%), free-floating thrombus (4/20, 20%), post-trauma pulmonary embolism prophylaxis (3/20, 15%) and pre-thrombolysis pulmonary patient (1/20, 5%). The mean implantation period was 63 days (range: 20-270 days). Standard retrieval was performed in 17/20 patients (85%). Adjunctive techniques were performed in 3/20 patients (15%) and included the double-snare technique, balloon assistance and endobronchial forceps retrieval. Median procedure time was 60 min (range: 45-240 min). Pre-retrieval cavogram demonstrated filter tilt in 5/20 patients (25%) with a mean angle of 17° (range: 8-40). Pre-retrieval CT demonstrated strut wall penetration and tip embedment in one patient each. There were two procedure-related complications: IVC mural dissection noted on venography in one patient and snare catheter fracture requiring retrieval in one patient. There were no early or late complications. In children, IVC filter retrieval can be performed safely but may be challenging, especially in

  9. [Experience in molecular diagnostic in hereditary neuropathies in a pediatric tertiary hospital].

    Science.gov (United States)

    Fernández-Ramos, Joaquín A; López-Laso, Eduardo; Camino-León, Rafael; Gascón-Jiménez, Francisco J; Jiménez-González, M Dolores

    2015-12-01

    Charcot-Marie-Tooth (CMT) is the most common hereditary sensory motor neuropathy. Advances in molecular diagnosis have increased the diagnostic possibilities of these patients. Retrospective study of 36 pediatric patients diagnosed with CMT in a tertiary center in 2003-2015. We found 16 patients were diagnosed by a duplication in PMP22; two cases were diagnosed of hereditary neuropathy with liability to pressure palsies, one with a point mutation in PMP22; a male with a mild demyelinating phenotype, without family history, was diagnosed with GJB1 mutation; in a patient with a peripheral hypotonia at birth and axonal pattern in EMG by mutation in MFN2; a gypsy patient, with consanguineous family, CMT4D, was identified by a mutation in the gene NDRG1; a patient with multiplex congenital arthrogryposis and vocal cord paralysis, whose mother had a scapular-peroneal syndrome, had a congenital spinal muscular atrophy with mild distal axonal neuropathy by mutation in gene TRPV4; three girls, from a gypsy consanguineous family, with axonal CMT with neuromyotonic discharges were diagnosed by a mutation in the gene HINT1; twelve patients haven't molecular diagnosis currently. CMT1A predominated in our series (44%), as previous studies. We emphasize the description of a patient with a mutation in TRPV4 recently described as a cause of CMT2C and three cases, of gypsy consanguineous family, with the same mutation in HINT1 gene, recently described as a cause of axonal neuropathy with neuromyotonia, autosomal recessive (AR-CMT2). The proportion of patients without molecular diagnosis is similar to main European series.

  10. Incisional hernia in pediatric surgery - experience at a single UK tertiary centre.

    Science.gov (United States)

    Mullassery, Dhanya; Pedersen, Ami; Robb, Andrew; Smith, Nicola

    2016-11-01

    Incisional hernia (IH) is a recognized complication of open and laparoscopic visceral surgery, with reported rates of 10-50% in adult surgical literature. There is a paucity of data relating to incisional hernias in children. The aim of our study was to analyze the incidence and treatment of IH in children. Retrospective review of all patients admitted for incisional hernia repair at a tertiary pediatric surgical centre in the UK more than a 7-year period was performed. Data collected included age at initial surgery, time to IH repair, and type of IH repair and postoperative complications. Twenty one patients (14 male) underwent IH repair during the study period. The incidence of IH among children who had primary abdominal surgery in our institution less than the age of 6months was 2.3%. Median age at repair was 7.9months (range: 18days-5years). Median time from primary surgery to diagnosis of IH was 2months (range 0day-3years), with 81% (17/21) diagnosed within 1year of the preceding abdominal procedure. The most common pathology necessitating the primary operative procedure was necrotising enterocolitis (n=9) in babies of gestational age less than 30weeks. The highest rates of IH were noted in infants following closure of stoma (7.5%) and pyloromyotomy (2.52%). Primary closure was undertaken in all cases. Two children had recurrence of IH, one of which underwent surgical repair. Incidence of IH in children is low but significant. IH was most commonly diagnosed following closure of stoma for NEC in this study. Copyright © 2016. Published by Elsevier Inc.

  11. Five-year experience with burns from glass fireplace doors in the pediatric population.

    Science.gov (United States)

    Baryza, Mary Jo; Hinson, Michelle; Conway, Jennifer; Ryan, Colleen M

    2013-01-01

    Burns from contact with glass doors of gas fireplaces have been previously reported. The purpose of this study is to examine the incidence and severity of this injury in our population. Patients were identified for inclusion in the retrospective chart review study using the National Trauma Registry of the American College of Surgeons (NTRACS) and our local outpatient database. Criteria for inclusion were burn injuries sustained from contact with fireplace glass doors treated at our pediatric burn center from 2007 through 2011. Fifty children met these criteria, including two children whose burns were caused by electric fireplace glass doors. BSA burned was 1.5 ± 1.5% (mean ± SD), range 0.5 to 10%. Age was 27.2 ± 27.3 months, range 8 months to 13 years. Forty-five children (90%) had hand burns; of these, 18 children had bilateral hand involvement. Facial burns were found in three children (6%), and eight children (16%) had other areas burned. One patient developed cellulitis. Two patients required surgery. Six children (12%) required hospitalization; mean length of stay was 5.8 ± 5 days, range 1 to 5 days. Although the number of inpatient admissions was relatively few, 329 outpatient visits and 309 rehabilitation visits were required for treatment of these children. Nineteen patients (38%) required splints and six patients (12%) required scar treatment with pressure garments. Burns from contact with fireplace glass doors are a recurring problem. Toddlers are most at risk. Directed preventive strategies including parent education, safety warnings, and design modifications such as temperature sensors and barrier screens could be potentially helpful in reducing the incidence of this injury.

  12. Parents' experiences discussing pediatric vaccination with healthcare providers: a survey of Canadian naturopathic patients.

    Science.gov (United States)

    Busse, Jason W; Walji, Rishma; Wilson, Kumanan

    2011-01-01

    Parents who choose to selectively vaccinate or avoid vaccination for their children may do so at risk of compromising relations with their family physician or pediatrician. Groups that are associated with reduced rates of pedicatic vaccination, such as parents who access naturopathic care, may be particularly vulnerable to this issue. In March through September 2010, we administered a 26-item cross-sectional survey to 129 adult patients, all of whom were parents with children ≤ 16 years of age, presenting for naturopathic care in Ontario, Canada. Ninety-five parents completed the survey (response rate 74%), and only 50.5% (48 of 95) reported that their children had received all recommended vaccines. Most parents (50.5%; 48 of 95) reported feeling pressure to vaccinate from their allopathic physician and, of those who discussed vaccination with their physician, 25.9% (21 of 81) were less comfortable continuing care as a result. Five percent (4 of 81) of respondents were advised by their physician that their children would be refused care if they decided against vaccination. In our adjusted generalized linear model, feeling pressure to vaccinate (odds ratio [OR] = 3.07; 95% confidence interval [CI] = 1.14 to 8.26) or endorsing a naturopathic physician as their most trusted source of information regarding vaccination (OR = 3.57; 95% CI = 1.22 to 10.44) were associated with greater odds of having a partially vaccinated or unvaccinated child. The majority (69.6%; 32 of 46) of parent's with partially vaccinated or unvaccinated children reported a willingness to re-consider this decision. Use of naturopathic care should be explored among parents in order to identify this high-risk group and engage them in discussion regarding pediatric vaccination to encourage evidence-based, shared decision making. Physicians should ensure that discussions regarding vaccination are respectful, even if parents are determined not to vaccinate their children.

  13. Parents' experiences discussing pediatric vaccination with healthcare providers: a survey of Canadian naturopathic patients.

    Directory of Open Access Journals (Sweden)

    Jason W Busse

    Full Text Available Parents who choose to selectively vaccinate or avoid vaccination for their children may do so at risk of compromising relations with their family physician or pediatrician. Groups that are associated with reduced rates of pedicatic vaccination, such as parents who access naturopathic care, may be particularly vulnerable to this issue.In March through September 2010, we administered a 26-item cross-sectional survey to 129 adult patients, all of whom were parents with children ≤ 16 years of age, presenting for naturopathic care in Ontario, Canada. Ninety-five parents completed the survey (response rate 74%, and only 50.5% (48 of 95 reported that their children had received all recommended vaccines. Most parents (50.5%; 48 of 95 reported feeling pressure to vaccinate from their allopathic physician and, of those who discussed vaccination with their physician, 25.9% (21 of 81 were less comfortable continuing care as a result. Five percent (4 of 81 of respondents were advised by their physician that their children would be refused care if they decided against vaccination. In our adjusted generalized linear model, feeling pressure to vaccinate (odds ratio [OR] = 3.07; 95% confidence interval [CI] = 1.14 to 8.26 or endorsing a naturopathic physician as their most trusted source of information regarding vaccination (OR = 3.57; 95% CI = 1.22 to 10.44 were associated with greater odds of having a partially vaccinated or unvaccinated child. The majority (69.6%; 32 of 46 of parent's with partially vaccinated or unvaccinated children reported a willingness to re-consider this decision.Use of naturopathic care should be explored among parents in order to identify this high-risk group and engage them in discussion regarding pediatric vaccination to encourage evidence-based, shared decision making. Physicians should ensure that discussions regarding vaccination are respectful, even if parents are determined not to vaccinate their children.

  14. Risk of surgical site infection in paediatric herniotomies without any prophylactic antibiotics: A preliminary experience

    Directory of Open Access Journals (Sweden)

    Dhananjay Vaze

    2014-01-01

    Full Text Available Background: Different studies underline the use of pre-operative antibiotic prophylaxis in clean surgeries like herniotomy and inguinal orchiopexy. But, the meta-analyses do not recommend nor discard the use of prophylactic pre-operative antibiotics. The scarcity of controlled clinical trials in paediatric population further vitiates the matter. This study assessed the difference in the rate of early post-operative wound infection cases in children who received single dose of pre-operative antibiotics and children who did not receive antibiotics after inguinal herniotomy and orchiopexy. Materials and Methods: This randomised prospective study was conducted in Paediatric Surgery department of PGIMER Chandigarh. Out of 251 patients, 112 patients were randomised to the case group and 139 were ascribed to the control group. The patients in control group were given a standard regimen of single dose of intravenous antibiotic at the time of induction followed by 3-4 days of oral antibiotic. Case group patients underwent the surgical procedure in similar manner with no antibiotic either at the time of induction or post-operatively. Results: The incidence of surgical site infection in case group was 3.73 % and that in control group was 2.22%. The observed difference in the incidence of surgical site infection was statistically insignificant (P value = 0.7027. The overall infection rate in case and control group was 2.89%. Conclusions: Our preliminary experience suggests that there is no statistically significant difference in the proportion of early post-operative wound infection between the patients who received single dose of pre-operative antibiotics and the patients who received no antibiotics after inguinal herniotomy and orchiopexy. The risk of surgical site infection in paediatric heriotomies does not increase even if the child′s weight is less than his/her expected weight for age.

  15. Pulmonary Arteriovenous Malformations Embolized Using a Micro Vascular Plug System: Technical Note on a Preliminary Experience

    Energy Technology Data Exchange (ETDEWEB)

    Boatta, Emanuele, E-mail: emanuele.boatta@yahoo.it; Jahn, Christine, E-mail: christine.jahn@chru-strasbourg.fr [Hôpitaux Universitaires de Strasbourg, Service de Imagerie Interventionelle, Nouvel Hôpital Civil (France); Canuet, Matthieu, E-mail: matthieu.canuet@chru-strasbourg.fr [Hôpitaux Universitaires de Strasbourg, Service Service de Pneumologie, Nouvel Hôpital Civil (France); Garnon, Julien, E-mail: juleiengarnon@gmail.com [Hôpitaux Universitaires de Strasbourg, Service de Imagerie Interventionelle, Nouvel Hôpital Civil (France); Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com [Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom); Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Gangi, Afshin, E-mail: gangi@unistra.fr [Hôpitaux Universitaires de Strasbourg, Service de Imagerie Interventionelle, Nouvel Hôpital Civil (France)

    2017-02-15

    AIMTo report our preliminary experience using a Micro Vascular Plug (MVP) deployed through a 2.8Fr micro-catheter for the treatment of pulmonary arteriovenous malformations (PAVMs) in a cohort of patients affected by Hereditary Haemorrhagic Telangiectasia (HHT).Materials and MethodsFour consecutive female patients (mean age 38.0 years; range 25–55 years) with PAVMs diagnosed on echocardiogram/bubble test and contrast-enhanced CT (CECT) underwent MVP embolization. One patient was symptomatic with recent transient ischaemic attack. Follow-up was undertaken at 1-month post-procedure with CECT to assess PAVMs permeability and MVP positioning and at 1-, 6-, and 12-month post-procedure, with echocardiography/bubble test and standard neurological history, to confirm absence of right-to-left shunts and recurrent symptoms.ResultsEight PAVMs were treated in 4 patients over 5 interventional sessions (mean 1.6 PAVMs per session). All PAVMs were simple, with mean feeding artery diameter of 4.25 mm. Eight 6.5 mm MVPs were deployed in total (one per lesion). Technical success was 100%. Mean procedural time and patient dose per session were 70 min (range 40–70 min) and 53418 mGy.cm{sup 2} (range 6113–101628 mGy.cm{sup 2}), respectively. No signs of reperfusion neither of MPV migration were noted at 1-month CECT follow-up. At early follow-up (mean 3.75 months; range 1–12 months), clinical success was 100% with no evidence of recurrent right-to-left shunt, and no neurological symptoms. No immediate or late complications were observed.ConclusionsMVP embolization of PAVMs appears technically feasible, safe, and effective at early follow-up. Further prospective studies are required to confirm long-term safety and efficacy of this promising technique.

  16. Free-field ground motions for the nonproliferation experiment: Preliminary comparisons with nearby nuclear events

    International Nuclear Information System (INIS)

    Olsen, K.H.; Peratt, A.L.

    1994-01-01

    Since 1987, we have installed fixed arrays of tri-axial accelerometers in the fire-field near the shot horizons for low-yield (≤ 20 kt) nuclear events in the N-tunnel complex beneath Rainier Mesa. For the Nonproliferation Experiment (NPE) we augmented the array to achieve 23 free-field stations. Goals are: (a) to examine robustness and stability of various free-field source function estimates -- e.g., reduced displacement potentials (RDP) and spectra; (b) to compare close-in with regional estimates to test whether detailed close-in free-field and/or surface ground motion data can improve predictability of regional-teleseismic source functions; (c) to provide experimental data for checking two-dimensional numerical simulations. We report preliminary comparisons between experimental free-field data for NPE (1993) and three nearby nuclear events (MISTY ECHO, 1988; MINERAL QUARRY, 1990; HUNTERS TROPHY, 1992). All four working points are within 1 km of each other in the same wet tuff bed, thus reducing concerns about possible large differences in material properties between widely separated shots. Initial comparison of acceleration and velocity seismograms for the four events reveals: (1) There is a large departure from the spherical symmetry commonly assumed in analytic treatments of source theory; both vertical and tangential components are surprisingly large. (2) All shots show similar first-peak particle-velocity amplitude decay rates suggesting significant attenuation even in the supposedly purely elastic region. (3) Sharp (>20 Hz) arrivals are not observed at tunnel level from near-surface pP reflections or spall-closure sources -- but broadened peaks are seen that suggest more diffuse reflected energy from the surface and from the Paleozoic limestone basement below tunnel level

  17. Preliminary Results of the NASA Beacon Receiver for Alphasat Aldo Paraboni TDP5 Propagation Experiment

    Science.gov (United States)

    Nessel, James; Morse, Jacquelynne; Zemba, Michael; Riva, Carlo; Luini, Lorenzo

    2014-01-01

    NASA Glenn Research Center (GRC) and the Politecnico di Milano (POLIMI) have initiated a joint propagation campaign within the framework of the Alphasat propagation experiment to characterize rain attenuation, scintillation, and gaseous absorption effects of the atmosphere in the 40 GHz band. NASA GRC has developed and installed a K/Q-band (20/40 GHz) beacon receiver at the POLIMI campus in Milan, Italy, which receives the 20/40 GHz signals broadcast from the Alphasat Aldo Paraboni TDP#5 beacon payload. The primary goal of these measurements is to develop a physical model to improve predictions of communications systems performance within the Q-band. Herein, we describe the design and preliminary performance of the NASA propagation terminal, which has been installed and operating in Milan since May 2014. The receiver is based upon a validated Fast Fourier Transform (FFT) I/Q digital design approach utilized in other operational NASA propagation terminals, but has been modified to employ power measurement via a frequency estimation technique and to coherently track and measure the amplitude of the 20/40 GHz beacon signals. The system consists of a 1.2-m K-band and a 0.6-m Qband Cassegrain reflector employing synchronous open-loop tracking to track the inclined orbit of the Alphasat satellite. An 8 Hz sampling rate is implemented to characterize scintillation effects, with a 1-Hz measurement bandwidth dynamic range of 45 dB. A weather station with an optical disdrometer is also installed to characterize rain drop size distribution for correlation with physical based models.

  18. Non-invasive coronary angiography with multislice computed tomography. Technology, methods, preliminary experience and prospects.

    Science.gov (United States)

    Traversi, Egidio; Bertoli, Giuseppe; Barazzoni, Giancarlo; Baldi, Maurizia; Tramarin, Roberto

    2004-02-01

    The recent technical developments in multislice computed tomography (MSCT), with ECG retro-gated image reconstruction, have elicited great interest in the possibility of accurate non-invasive imaging of the coronary arteries. The latest generation of MSCT systems with 8-16 rows of detectors permits acquisition of the whole cardiac volume during a single 15-20 s breath-hold with a submillimetric definition of the images and an outstanding signal-to-noise ratio. Thus the race which, between MSCT, electron beam computed tomography and cardiac magnetic resonance imaging, can best provide routine and reliable imaging of the coronary arteries in clinical practice has recommenced. Currently available MSCT systems offer different options for both cardiac image acquisition and reconstruction, including multiplanar and curved multiplanar reconstruction, three-dimensional volume rendering, maximum intensity projection, and virtual angioscopy. In our preliminary experience including 176 patients suffering from known or suspected coronary artery disease, MSCT was feasible in 161 (91.5%) and showed a sensitivity of 80.4% and a specificity of 80.3%, with respect to standard coronary angiography, in detecting critical stenosis in coronary arteries and artery or venous bypass grafts. These results correspond to a positive predictive value of 58.6% and a negative predictive value of 92.2%. The true role that MSCT is likely to play in the future in non-invasive coronary imaging is still to be defined. Nevertheless, the huge amount of data obtainable by MSCT along with the rapid technological advances, shorter acquisition times and reconstruction algorithm developments will make the technique stronger, and possible applications are expected not only for non-invasive coronary angiography, but also for cardiac function and myocardial perfusion evaluation, as an all-in-one examination.

  19. Clinical experiences of undergraduate dental students in pediatric dentistry at Cork University Dental School and Hospital, Ireland.

    LENUS (Irish Health Repository)

    Stewart, Christopher J

    2010-03-01

    The objectives of this study were to evaluate the number and range of clinical procedures completed by undergraduate dental students in pediatric dentistry in Cork University Dental School and Hospital, Ireland, and to compare the number of procedures undertaken with the subsequent examination scores. The work comprised a retrospective audit of clinical logbooks for all of the undergraduate dental students in one cohort through their fourth and fifth clinical years between 2004 and 2006. Thirty-four quantitative logbooks were audited. Students had seen a total of 1,031 patients, and each student had completed a full course of dental treatment for an average of twenty-two children. Students completed means of 30.2 restorative procedures for children, fourteen in deciduous dentition (range six to twenty-eight), and seventeen in permanent dentition (range seven to twenty-eight). Continuity of education and care (measured through children having their treatment fully completed by the same student) was 72 percent. A moderate positive correlation between levels of clinical experience and exam score was identified. All students gained experience in management of child patients with students providing care for an average of thirty children and a minimum of nineteen.

  20. PET/MRI: a novel hybrid imaging technique. Major clinical indications and preliminary experience in Brazil.

    Science.gov (United States)

    Vitor, Taise; Martins, Karine Minaif; Ionescu, Tudor Mihai; Cunha, Marcelo Livorsi da; Baroni, Ronaldo Hueb; Garcia, Marcio Ricardo Taveira; Wagner, Jairo; Campos, Guilherme de Carvalho; Nogueira, Solange Amorim; Guerra, Elaine Gonçalves; Amaro, Edson

    2017-01-01

    In recent years, medical imaging with hybrid techniques has widely accepted and employed in clinical routine. PET/MRI offers significant advantages, including excellent contrast and resolution and reduced ionizing radiation, as compared to well-established PET/CT. Therefore, PET/MRI is a promising modality for oncologic imaging of some regions, such as brain, head and neck, liver and pelvis. This article set out to analyze clinical conditions that could benefit from PET/MRI imaging based on our caseload. The potential of PET/MRI to become the imaging modality of choice for assessment of neurologic and oncologic conditions associated with soft tissues is highlighted. Clinical aspects of PET/MRI and its application to clinical cases are illustrated with examples extracted from the authors' preliminary experience. RESUMO Nos últimos anos, imagens médicas com tecnologias híbridas tornaram-se amplamente aceitas e utilizadas na prática clínica. O PET/RM possui vantagens importantes, incluindo excelentes contrastes e resolução, e menor radiação ionizante, em comparação ao PET/TC. Por isto, é uma modalidade promissora para exames de imagem de pacientes oncológicos, para avaliar o cérebro, cabeça e pescoço, o fígado e a pelve. O objetivo deste artigo foi analisar as situações clínicas que se beneficiariam de exames de PET/RM a partir de uma casuística. Destacamos o potencial desta técnica se tornar o método de imagem de escolha para doenças neurológicas e oncológicas que envolvam partes moles. Os aspectos clínicos de PET/RM e sua aplicação aos casos clínicos são ilustrados com exemplos da experiência inicial dos autores.

  1. 2D seismic tomography of Somma- Vesuvius. Description of the experiment and preliminary results.

    Directory of Open Access Journals (Sweden)

    G. Milano

    1996-06-01

    Full Text Available A multidisciplinary project for the investigation of Mt. Vesuvius Structure was started in 1993. The core of the project is represented by a high resolution seismic tomography study by using controlled and natura1 sources. The main research objective is to investigate the feeding system of the vo1cano and to retrieve details of the upper crustal structure in the area. A first 2D using seismic experiment was performed in May 1994, with the aim of studing the feasibility of lIsing tomographic techniques for exploring the vo1cano interiors. Particularly, this experiment was designed to obtain information on the optimal sources-receivers configuration and on the depth extension of the volume sampled by shot-generated seismic waves. 66 three-component seismic stations and 16 single-component analogue instruments were installed by several Italian and French groups to record signals generated by three on-land, underground explosions. Sources and geophones were deployed along a 30-km NW-SE profile passing through the volcano crater. Receivers were placed at an average spacing of 250 m in the middle of the recording line and at 500 m outside. The arrival time data base was complemented by first P and S readings of micro earthquakes which occurred in the recent past within the volcano. The first arrival data set was preliminary used to determine the shallow structure of the volcano by applying Thurber's (1983 tomographic inversion technique. This analysis shows evidence for a high-velocity body which extends vertically from about 400 m below the crater down to at least 3000 m and for a shallow 300-500 m thick low-velocity cover which borders the edifice. Data from the distant shot show evidence for arrivals of deep reflected/converted phases and provide information on the deeper structure under the volcano. The results from the interpretation of 2D data are used for planning a 3D tomographic survey which will be cauied out in 1996.

  2. Barriers to Medical Compassion as a Function of Experience and Specialization: Psychiatry, Pediatrics, Internal Medicine, Surgery, and General Practice.

    Science.gov (United States)

    Fernando, Antonio T; Consedine, Nathan S

    2017-06-01

    Compassion is an expectation of patients, regulatory bodies, and physicians themselves. Most research has, however, studied compassion fatigue rather than compassion itself and has concentrated on the role of the physician. The Transactional Model of Physician Compassion suggests that physician, patient, external environment, and clinical factors are all relevant. Because these factors vary both across different specialities and among physicians with differing degrees of experience, barriers to compassion are also likely to vary. We describe barriers to physician compassion as a function of specialization (psychiatry, general practice, surgery, internal medicine, and pediatrics) and physician experience. We used a cross-sectional study using demographic data, specialization, practice parameters, and the Barriers to Physician Compassion Questionnaire. Nonrandom convenience sampling was used to recruit 580 doctors, of whom 444 belonged to the targeted speciality groups. The sample was characterized before conducting a factorial Multivariate Analysis of Covariance and further post hoc analyses. A 5 (speciality grouping) × 2 (more vs. less physician experience) Multivariate Analysis of Covariance showed that the barriers varied as a function of both speciality and experience. In general, psychiatrists reported lower barriers, whereas general practitioners and internal medicine specialists generally reported greater barriers. Barriers were generally greater among less experienced doctors. Documenting and investigating barriers to compassion in different speciality groups have the potential to broaden current foci beyond the physician and inform interventions aimed at enhancing medical compassion. In addition, certain aspects of the training or practice of psychiatry that enhance compassion may mitigate barriers to compassion in other specialities. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  3. Pediatric radiology

    International Nuclear Information System (INIS)

    Benz-Bohm, G.

    1997-01-01

    Pediatric radiology is an important subsection of diagnostic radiology involving specific difficulties, but unfortunately is quite too often neglected as a subject of further education and training. The book therefore is not intended for specialists in the field, but for radiologists wishing to plunge deeper into the matter of pediatric radiology and to acquire a sound, basic knowledge and information about well-proven modalities, the resulting diagnostic images, and interpretation of results. The book is a compact guide and a helpful source of reference and information required for every-day work, or in special cases. With patients who are babies or children, the challenges are different. The book offers all the information needed, including important experience from pediatric hospital units that may be helpful in diagnostic evaluation, information about specific dissimilarities in anatomy and physiology which affect the imaging results, hints for radiology planning and performance, as well as information about the various techniques and their indication and achievements. The book presents a wide spectrum of informative and annotated images. (orig./CB) [de

  4. Pediatric fibromyalgia

    Directory of Open Access Journals (Sweden)

    J. Ablin

    2012-09-01

    Full Text Available Fibromyalgia (FM is currently defined as chronic widespread pain (CWP with allodynia or hyperalgesia to pressure pain. It is classified as one of the large group of soft-tissue pain syndromes. Pain is the cardinal symptom of FM; however, most patients also experience additional symptoms such as debilitating fatigue, disrupted or non-restorative sleep, functional bowel disturbances, and a variety of neuropsychiatric problems, including cognitive dysfunction, anxiety and depressive symptoms. Its pathogenesis is not entirely understood, although it is currently believed to be the result of a central nervous system (CNS malfunction that increases pain transmission and perception. FMS usually involves females, and in these patients it often makes its first appearance during menopause. But it is often diagnosed both in young as well as elderly individuals. Pediatric FMS is a frustrating condition affecting children and adolescents at a crucial stage of their physical and emotional development. Pediatric FMS is an important differential diagnosis to be considered in the evaluation of children suffering from widespread musculoskeletal pain, and must be differentiated from a spectrum of inflammatory joint disorders such as juvenile idiopathic arthritis (JIA, juvenile ankylosing spondylitis, etc. The management of pediatric FMS is centered on the issues of education, behavioral and cognitive change (with a strong emphasis on physical exercise, and a relatively minor role for pharmacological treatment with medications such as muscle relaxants, analgesics and tricyclic agents.

  5. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

    International Nuclear Information System (INIS)

    Zbojniewicz, Andrew M.; Emery, Kathleen H.; Maeder, Matthew E.; Salisbury, Shelia R.

    2014-01-01

    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  6. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

    Energy Technology Data Exchange (ETDEWEB)

    Zbojniewicz, Andrew M.; Emery, Kathleen H. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Maeder, Matthew E. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Lenox Hill Hospital, Department of Radiology, New York, NY (United States); Salisbury, Shelia R. [University of Cincinnati College of Medicine, Division of Biostatistics and Epidemiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States)

    2014-06-15

    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  7. Initial experience with percutaneous endoscopic gastrostomy with T-fastener fixation in pediatric patients

    Science.gov (United States)

    Kvello, Morten; Knatten, Charlotte Kristensen; Perminow, Gøri; Skari, Hans; Engebretsen, Anders; Schistad, Ole; Emblem, Ragnhild; Bjørnland, Kristin

    2018-01-01

    Background and study aims  Insertion of a percutaneous endoscopic gastrostomy (PEG) with push-through technique and T-fastener fixation (PEG-T) has recently been introduced in pediatric patients. The T-fasteners allow a primary insertion of a balloon gastrostomy. Due to limited data on the results of this technique in children, we have investigated peri- and postoperative outcomes after implementation of PEG-T in our department. Patients and methods  This retrospective chart review included all patients below 18 years who underwent PEG-T placement from 2010 to 2014. Main outcomes were 30-day postoperative complications and late gastrostomy-related complications. Results  In total, 87 patients were included, and median follow-up time was 2.4 years (1 month – 4.9 years). Median age and weight at PEG-T insertion were 1.9 years (9.4 months – 16.4 years) and 10.4 kg (5.4 – 33.0 kg), respectively. Median operation time was 28 minutes (10 – 65 minutes), and 6 surgeons and 3 endoscopists performed the procedures. During the first 30 days, 54 complications occurred in 41 patients (47 %). Most common were peristomal infections treated with either local antibiotics in 11 patients (13 %) or systemic antibiotics in 11 other patients (13 %). 9 patients (10 %) experienced tube dislodgment. Late gastrostomy-related complications occurred in 33 patients (38 %). The T-fasteners caused early and late complications in 9 (10 %) and 11 patients (13 %), respectively. Of these, 4 patients (5 %) had subcutaneously migrated T-fasteners which were removed under general anesthesia. Conclusion  We found a high rate of complications after PEG-T. In particular, problems with the T-fasteners and tube dislodgment occurred frequently after PEG-T insertion. PMID:29399615

  8. Preliminary experiments to estimate the PE.MA.M (PElagic MArine Mesocosm) offshore behaviour

    Science.gov (United States)

    Albani, Marta; Piermattei, Viviana; Stefanì, Chiara; Marcelli, Marco

    2016-04-01

    The phytoplankton community is controlled not only by local environmental conditions but also by physical processes occurring on different temporal and spatial scales. Hydrodynamic local conditions play an important role in marine ecosystems. Several studies have shown that hydrodynamic conditions can influence the phytoplankton settling velocity, vertical and horizontal distribution and formation of cyanobacterial blooms. Mesocosms are useful structures to simulate marine environment at mesoscale resolution; allowing to closely approximate biotic or abiotic parameters of interest directly in nature. In this work an innovative structure named PE.MA.M (PElagic MArine Mesocosm) is presented and tested. Laboratory experiments have been conducted in order to observe seasonal variations of biomass behaviour in two different hydrodynamic conditions: outside as well as whithin the PE.MA.M. We have evaluated whether it is possible to isolate a natural system from external water mass hydrodynamic exchanges and to assume that phytoplankton cells' transition is limited at the net and sea interface. Preliminary experiments test the isolating capacity of the net, to determine the currents' attenuation rate and to estimate the possible PE.MA.M. offshore behaviour. In the first investigation, we monitored the diffusion of phytoplankton cells. The PE.MA.M. exterior and interior were simulated using a plexiglass tank divided into two half-tanks (Aout-Bin) by a septum consisting of a net like a PE.MA.M. The tank was filled up with 10 L of water and only the half-tank Aout was filled up with 10 ml of phytoplankton culture (Clorella sp.). We monitored the chlorophyll concentrations for 24 hours. The two tanks had similar concentrations after 4 hours (2.70322 mg/m³ Aout and 2.37245 mg/m3 Bin) and this constant relationship was maintened until the end of the test. In the second investigation we used clod cards to measure water motions.We conducted two experiments within tank, the first

  9. Lessons learned from early implementation of option B+: the Elizabeth Glaser Pediatric AIDS Foundation experience in 11 African countries.

    Science.gov (United States)

    Kieffer, Mary Pat; Mattingly, Meghan; Giphart, Anja; van de Ven, Roland; Chouraya, Caspian; Walakira, Moses; Boon, Alexandre; Mikusova, Silvia; Simonds, R J

    2014-12-01

    "Option B+" is a World Health Organization-recommended approach to prevent mother-to-child HIV transmission whereby all HIV-positive pregnant and lactating women initiate lifelong antiretroviral therapy (ART). This review of early Option B+ implementation experience is intended to inform Ministries of Health and others involved in implementing Option B+. This implementation science study analyzed data from 11 African countries supported by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) to describe early experience implementing Option B+. Data are from 4 sources: (1) national guidelines for prevention of mother-to-child HIV transmission and Option B+ implementation plans, (2) aggregated service delivery data between January 2013 and March 2014 from EGPAF-supported sites, (3) field visits to Option B+ implementation sites, and (4) relevant EGPAF research, quality improvement, and evaluation studies. Rapid adoption of Option B+ led to large increases in percentage of HIV-positive pregnant women accessing ART in antenatal care. By the end of 2013, most programs reached at least 50% of HIV-positive women in antenatal care with ART, even in countries using a phased approach to implementation. Scaling up Option B+ through integrating ART in maternal and child health settings has required expansion of the workforce, and task shifting to allow nurse-led ART initiation has created staffing pressure on lower-level cadres for counseling and community follow-up. Complex data collection needs may be impairing data quality. Early experiences with Option B+ implementation demonstrate promise. Continued program evaluation is needed, as is specific attention to counseling and support around initiation of lifetime ART in the context of pregnancy and lactation.

  10. Screening for Adverse Childhood Experiences (ACEs) in an Integrated Pediatric Care Model

    Science.gov (United States)

    Purewal, Sukhdip K.; Bucci, Monica; Wang, Lisa Gutiérrez; Koita, Kadiatou; Marques, Sara Silvério; Oh, Debora; Harris, Nadine Burke

    2016-01-01

    Adverse childhood experiences (ACEs) are stressful or traumatic events that place children at risk of negative health, mental health, and behavioral outcomes. The Center for Youth Wellness (CYW), working in partnership with the Bayview Child Health Center (BCHC), pioneered ACE screening for children and adolescents. This article describes the…

  11. Preliminary results from an integrated, multi-parameter, experiment at the Santiaguito lava dome complex, Guatemala

    Science.gov (United States)

    De Angelis, S.; Rietbrock, A.; Lavallée, Y.; Lamb, O. D.; Lamur, A.; Kendrick, J. E.; Hornby, A. J.; von Aulock, F. W.; Chigna, G.

    2016-12-01

    Understanding the complex processes that drive volcanic unrest is crucial to effective risk mitigation. Characterization of these processes, and the mechanisms of volcanic eruptions, is only possible when high-resolution geophysical and geological observations are available over comparatively long periods of time. In November 2014, the Liverpool Earth Observatory, UK, in collaboration with the Instituto Nacional de Sismologia, Meteorologia e Hidrologia (INSIVUMEH), Guatemala, established a multi-parameter geophysical network at Santiaguito, one of the most active volcanoes in Guatemala. Activity at Santiaguito throughout the past decade, until the summer of 2015, was characterized by nearly continuous lava dome extrusion accompanied by frequent and regular small-to-moderate gas or gas-and-ash explosions. Over the past two years our network collected a wealth of seismic, acoustic and deformation data, complemented by campaign visual and thermal infrared measurements, and rock and ash samples. Here we present preliminary results from the analysis of this unique dataset. Using acoustic and thermal data collected during 2014-2015 we were able to assess volume fractions of ash and gas in the eruptive plumes. The small proportion of ash inferred in the plumes confirms estimates from previous, independent, studies, and suggests that these events did not involve significant magma fragmentation in the conduit. The results also agree with the suggestion that sacrificial fragmentation along fault zones in the conduit region, due to shear-induced thermal vesiculation, may be at the origin of such events. Finally, starting in the summer of 2015, our experiment captured the transition to a new phase of activity characterized by vigorous vulcanian-style explosions producing large, ash-rich, plumes and frequent hazardous pyroclastic flows, as well as the formation a large summit crater. We present evidence of this transition in the geophysical and geological data, and discuss its

  12. Shigaraki UAV-Radar Experiment (ShUREX): overview of the campaign with some preliminary results

    Science.gov (United States)

    Kantha, Lakshmi; Lawrence, Dale; Luce, Hubert; Hashiguchi, Hiroyuki; Tsuda, Toshitaka; Wilson, Richard; Mixa, Tyler; Yabuki, Masanori

    2017-12-01

    The Shigaraki unmanned aerial vehicle (UAV)-Radar Experiment (ShUREX) is an international (USA-Japan-France) observational campaign, whose overarching goal is to demonstrate the utility of small, lightweight, inexpensive, autonomous UAVs in probing and monitoring the lower troposphere and to promote synergistic use of UAVs and very high frequency (VHF) radars. The 2-week campaign lasting from June 1 to June 14, 2015, was carried out at the Middle and Upper Atmosphere (MU) Observatory in Shigaraki, Japan. During the campaign, the DataHawk UAV, developed at the University of Colorado, Boulder, and equipped with high-frequency response cold wire and pitot tube sensors (as well as an iMET radiosonde), was flown near and over the VHF-band MU radar. Measurements in the atmospheric column in the immediate vicinity of the radar were obtained. Simultaneous and continuous operation of the radar in range imaging mode enabled fine-scale structures in the atmosphere to be visualized by the radar. It also permitted the UAV to be commanded to sample interesting structures, guided in near real time by the radar images. This overview provides a description of the ShUREX campaign and some interesting but preliminary results of the very first simultaneous and intensive probing of turbulent structures by UAVs and the MU radar. The campaign demonstrated the validity and utility of the radar range imaging technique in obtaining very high vertical resolution ( 20 m) images of echo power in the atmospheric column, which display evolving fine-scale atmospheric structures in unprecedented detail. The campaign also permitted for the very first time the evaluation of the consistency of turbulent kinetic energy dissipation rates in turbulent structures inferred from the spectral broadening of the backscattered radar signal and direct, in situ measurements by the high-frequency response velocity sensor on the UAV. The data also enabled other turbulence parameters such as the temperature

  13. Only fixation for cervical spondylosis: Report of early results with a preliminary experience with 6 cases

    Directory of Open Access Journals (Sweden)

    Atul Goel

    2013-01-01

    Full Text Available Aim: The author reports early post-operative outcome and preliminary experience with an alternative form of treatment of cervical degenerative or spondylotic disease leading to spinal canal stenosis that involves fixation-arthrodesis of the affected spinal segment using one or two (double insurance transarticular screws for each joint. Materials and Methods: During the period of months from March 2013 to July 2013, six patients having cervical spondylotic cord compression were treated with transarticular method of screw fixation of the involved segments. The operation involved section of the spinous process at its base, opening up of the facet joint, denuding of articular cartilage, placement of intraarticular cavity bone graft chips and insertion of either a single or two transarticular screws at each level. The fixation was done in four levels in four patients and at two levels in two patients. Japanese Orthopedic Association score, visual analog scale (neck pain and Odom′s criteria were used to monitor the clinical status of the patients before and after the surgery and at follow-up. Results: Immediate post-operative and a relatively short-term post-operative outcome was remarkably gratifying. During the average period of follow-up of 6 months (range: 3-8 months; there was varying degree of recovery of symptoms. The procedure resulted in firm stabilization and fixation of the spinal segment and provided a ground for arthrodesis. No patient worsened after treatment. During the period of follow-up, all patients showed remarkable and progressive recovery in symptoms. Conclusions: Vertical instability and telescoping, listhesis or overriding of the facets on physical activity seems to be the defining phenomenon in pathogenesis of cervical spondylotic disease. The clinical outcome in our patients suggest that only fixation of the spinal segment can be a rationale form of treatment. Transarticular method of treatment is a simple, safe and

  14. Interdisciplinary development and implementation of communication checklist for postoperative management of pediatric airway patients.

    Science.gov (United States)

    Kim, Sang W; Maturo, Stephen; Dwyer, Danielle; Monash, Bradley; Yager, Phoebe H; Zanger, Kerstin; Hartnick, Christopher J

    2012-01-01

    The authors describe their multidisciplinary experience in applying the Institute of Health Improvement methodology to develop a protocol and checklist to reduce communication error during transfer of care for postoperative pediatric surgical airway patients. Preliminary outcome data following implementation of the protocol and checklist are also presented. Prospective study from July 1, 2009, to February 1, 2011. Tertiary care center. Subjects. One hundred twenty-six pediatric airway patients who required coordinated care between Massachusetts Eye and Ear Infirmary and Massachusetts General Hospital. Two sentinel events involving airway emergencies demonstrated a critical need for a standardized, comprehensive instrument that would ensure safe transfer of care. After development and implementation of the protocol and checklist, an initial pilot period on the first set of 9 pediatric airway patients was reassessed. Subsequent prospective 11-month follow-up data of 93 pediatric airway patients were collected and analyzed. A multidisciplinary pediatric team developed and implemented a formalized, postoperative checklist and transfer protocol. After implementation of the checklist and transfer protocol, prospective analysis showed no adverse events from miscommunication during transfer of care over the subsequent 11-month period involving 93 pediatric airway patients. There has been very little written in the quality and safety patient literature about coordinating effective transfer of care between the pediatric surgical and medical subspecialty realms. After design and implementation of a simple, electronically based transfer-of-care checklist and protocol, the number of postsurgical pediatric airway information transfer and communication errors decreased significantly.

  15. Imaging appearances of soft-tissue tumors of the pediatric foot: review of a 15-year experience at a tertiary pediatric hospital

    Energy Technology Data Exchange (ETDEWEB)

    Caro-Dominguez, Pablo [University of Toronto, Department of Medical Imaging, Toronto, ON (Canada); The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada); Hospital San Juan de Dios, Health Time Group, Department of Diagnostic Imaging, Cordoba, Andalucia (Spain); Navarro, Oscar M. [University of Toronto, Department of Medical Imaging, Toronto, ON (Canada); The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)

    2017-11-15

    Tumors of the foot are rare in children. In this review the authors illustrate radiographic, sonographic and MR imaging findings of foot soft-tissue tumors in children based on all cases presenting at a tertiary pediatric hospital during the 15-year period of 1999-2014. Among these cases there were 155 tumors of the foot - 72 of the bones and 83 of the soft tissues. Vascular malformations, fibromatosis and sarcomas were respectively the most frequent benign, intermediate and malignant soft-tissue tumors. Some tumors showed specific imaging findings. In imaging investigations, ultrasound can be used as the first imaging modality for diagnostic workup of most lesions because it is noninvasive, low-cost and readily available, and can confirm the presence of the mass and evaluate cystic components, especially in young children who would otherwise require sedation for MR imaging. MR imaging is the reference standard technique because of its high tissue contrast, which allows for detection and characterization of soft-tissue and bone abnormalities. MR imaging is useful as the first imaging modality in select cases, including those with high suspicion of malignancy, very large lesions or pre-treatment lesions. Recognition of some typical imaging findings in pediatric soft-tissue foot tumors is helpful to establish diagnosis and facilitate patient management. (orig.)

  16. Experience in Training of Primary Health Care Specialists in the Context of the Integrated Management of Childhood Illness in the Teaching of Pediatrics to Junior Students

    Directory of Open Access Journals (Sweden)

    O.D. Fofanov

    2013-09-01

    Full Text Available The article describes an overview of the basic principles of the integrated management of childhood illness (IMCI strategy, which is designed to improve the quality of care for children up to 5 years at the level of primary health care. The first experience of the implementation of this strategy in the educational process while studying of pediatrics at the junior courses within the curriculum is described. A considerable attention is paid to the method of mastering communication skills by the junior students’ and applying them in the collection of medical history, communicating with parents and relatives of children. According to IMCI recommendations all health care professionals, who work in primary health care, must master the methodology of counseling family about care for healthy and sick children, feeding, providing optimal conditions for the physical and neuropsychological development. Our first experience demonstrates the feasibility of implementing IMCI individual issues in the educational process while studying pediatrics for the junior classes.

  17. Preliminary data for the 20 May 1974, simultaneous evaluation of remote sensors experiment. [water pollution monitoring

    Science.gov (United States)

    Johnson, R. W.; Batten, C. E.; Bowker, D. E.; Bressette, W. E.; Grew, G. W.

    1975-01-01

    Several remote sensors were simultaneously used to collect data over the tidal James River from Hopewell to Norfolk, Virginia. Sensors evaluated included the Multichannel-Ocean Color Sensor, multispectral scanners, and multispectral photography. Ground truth measurements and remotely sensed data are given. Preliminary analysis indicates that suspended sediment and concentrated industrial effluent are observable from all sensors.

  18. Preliminary results from Brookhaven Experiment 802 with 14.5 GeVu 28Si

    International Nuclear Information System (INIS)

    1987-01-01

    Preliminary data on beam calorimetry, charged particle multiplicities, pseudo-rapidity distributions and hadron spectroscopy from 28 Si + Al and Au at 14.5 GeV per nucleon are presented. Comments on nuclear stopping, multiplicity systematics, and Kπ ratios are offered. 5 refs., 6 figs., 1 tab

  19. Away from home: experiences of Mexican American families in pediatric palliative care.

    Science.gov (United States)

    Contro, Nancy; Davies, Betty; Larson, Judith; Sourkes, Barbara

    2010-01-01

    In this study, the authors describe the experiences of Mexican American family members who immigrated to the United States and then experienced the death of a child. Participants described difficulties they encountered crossing the border, leaving the culture of their homeland, and then caring for a seriously ill child. Key themes that characterized their experience of being far from home included a backdrop of poverty, absence of traditional social support, and challenges caring for healthy siblings. Participants made comparisons between health care in Mexico and the United States and assessed the trade-off they made to come to the United States, discussing access to medical care and how they were able to relate to health care providers. Further, participants conveyed how rituals from their home country were important in maintaining connections with the child who died. Based on these themes, clinical implications and strategies that focus on understanding participants' experiences with past traumas, communication and literacy needs, and the challenges of living in poverty--especially with a critically ill child--are needed.

  20. Preliminary condensation pool experiments with steam using DN80 and DN100 blowdown pipes[VIDEO CAMERAS

    Energy Technology Data Exchange (ETDEWEB)

    Laine, J.; Puustinen, M. [Lappeenranta University of Technology (Finland)

    2004-03-01

    The report summarizes the results of the preliminary steam blowdown experiments. Altogether eight experiment series, each consisting of several steam blows, were carried out in autumn 2003 with a scaled-down condensation pool test rig designed and constructed at Lappeenranta University of Technology. The main purpose of the experiments was to evaluate the capabilities of the test rig and the needs for measurement and visualization devices. The experiments showed that a high-speed video camera is essential for visual observation due to the rapid condensation of steam bubbles. Furthermore, the maximum measurement frequency of the current combination of instrumentation and data acquisition system is inadequate for the actual steam tests in 2004. (au)

  1. Worldwide Experience with the Syncardia Total Artificial Heart in the Pediatric Population.

    Science.gov (United States)

    Morales, David L S; Lorts, Angela; Rizwan, Raheel; Zafar, Farhan; Arabia, Francisco A; Villa, Chet R

    Individual centers have documented the use of the Syncardia Total Artificial Heart (TAH) in adolescents with heart failure; however, the number of patients at any given center is small. Herein, we describe the worldwide experience for all patients ≤21 years old supported with the TAH between May 2005 and May 2015 (n = 43). The number of patients experiencing a positive outcome at 60, 90, and 120 days were 30 (70%), 27 (63%), and 25 (58%), respectively. Successful bridge to transplantation varied by diagnosis, but outcomes reported are similar to adults supported with the TAH or biventricular assist devices.

  2. Video-Teleconferencing in Pediatric Neuro-Oncology: Ten Years of Experience

    Directory of Open Access Journals (Sweden)

    Nisreen Amayiri

    2017-04-01

    Full Text Available Purpose: The management of central nervous system tumors is challenging in low- and middle-income countries. Little is known about applicability of twinning initiatives with high-income countries in neuro-oncology. In 2004, a monthly neuro-oncology video-teleconference program was started between King Hussein Cancer Center (Amman, Jordan and the Hospital for Sick Children (Toronto, Ontario, Canada. More than 100 conferences were held and > 400 cases were discussed. The aim of this work was to assess the sustainability of such an initiative and the evolution of the impact over time. Methods: We divided the duration in to three eras according to the initial 2 to 3 years of work of three consecutive oncologists in charge of the neuro-oncology program at King Hussein Cancer Center. We retrospectively reviewed the written minutes and compared the preconference suggested plans with the postconference recommendations. Impact of changes on the patient care was recorded. Results: Thirty-three sets of written minutes (covering 161 cases in the middle era and 32 sets of written minutes (covering 122 cases in the last era were compared with the initial experience (20 meetings, 72 cases. Running costs of these conferences has dropped from $360/h to < $40/h. Important concepts were introduced, such as multidisciplinary teamwork, second-look surgery, and early referral. Suggestions for plan changes have decreased from 44% to 30% and 24% in the respective consecutive eras. Most recommendations involved alternative intervention modalities or pathology review. Most of these recommendations were followed. Conclusion: Video-teleconferencing in neuro-oncology is feasible and sustainable. With time, team experience is built while the percentage and the type of treatment modifications change. Commitment and motivation helped maintain this initiative rather than availability of financial resources. Improvement in patients’ care was achieved, in particular, with the

  3. Linking soil permeability and soil aggregate stability with root development: a pots experiment (preliminary results)

    Science.gov (United States)

    Vergani, Chiara; Graf, Frank; Gerber, Werner

    2015-04-01

    Quantifying and monitoring the contribution of vegetation to the stability of the slopes is a key issue for implementing effective soil bioengineering measures. This topic is being widely investigated both from the hydrological and mechanical point of view. Nevertheless, due to the high variability of the biological components, we are still far from a comprehensive understanding of the role of plants in slope stabilization, especially if the different succession phases and the temporal development of vegetation is considered. Graf et al., 2014, found within the scope of aggregate stability investigations that the root length per soil volume of alder specimen grown for 20 weeks under laboratory conditions is comparable to the one of 20 years old vegetation in the field. This means that already relatively short time scales can provide meaningful information at least for the first stage of colonization of soil bioengineering measures, which is also the most critical. In the present study we analyzed the effect of root growth on two soil properties critical to evaluate the performance of vegetation in restoring and re-stabilizing slopes: permeability and soil aggregate stability. We set up a laboratory experiment in order to work under controlled conditions and limit as much as possible the natural variability. Alnus incana was selected as the study species as it is widely used in restoration projects in the Alps, also because of its capacity to fix nitrogen and its symbiosis with both ecto and arbuscular mycorrhizal fungi. After the first month of growth in germination pots, we planted one specimen each in big quasi cylindrical pots of 34 cm diameter and 35 cm height. The pots were filled with the soil fraction smaller than 10 mm coming from an oven dried moraine collected in a subalpine landslide area (Hexenrübi catchment, central Switzerland). The targeted dry unit weight was 16 kN/m3. The plants have been maintained at a daily temperature of 25°C and relative

  4. Preliminary Study of 20 MWth Experiment Power Reactor based on Pebble Bed Reactor

    Science.gov (United States)

    Irwanto, Dwi; Permana, Sidik; Pramuditya, Syeilendra

    2017-07-01

    In this study, preliminary design calculations for experimental small power reactor (20 MWt) based on Pebble Bed Reactor (PBR) are performed. PBR technology chosen due to its advantages in neutronic and safety aspects. Several important parameters, such as fissile enrichment, number of fuel passes, burnup and effective multiplication factor are taken into account in the calculation to find neutronic characteristics of the present reactor design.

  5. Preliminary results of Resistive Plate Chambers operated with eco-friendly gas mixtures for application in the CMS experiment

    International Nuclear Information System (INIS)

    Abbrescia, M.; Muhammad, S.; Saviano, G.; Auwegem, P. Van; Cauwenbergh, S.; Tytgat, M.; Benussi, L.; Bianco, S.; Passamonti, L.; Pierluigi, D.; Piccolo, D.; Primavera, F.; Russo, A.; Ferrini, M.

    2016-01-01

    The operations of Resistive Plate Chambers in LHC experiments require Fluorine based (F-based) gases for optimal performance. Recent European regulations demand the use of environmentally unfriendly F-based gases to be limited or banned. In view of the CMS experiment upgrade, several tests are ongoing to measure the performance of the detector with these new ecological gas mixtures, in terms of efficiency, streamer probability, induced charge and time resolution. Prototype chambers with readout pads and with the standard CMS electronic setup are under test. In this paper preliminary results on performance of RPCs operated with a potential eco-friendly gas candidate 1,3,3,3-Tetrafluoropropene, commercially known as HFO-1234ze, with CO 2 and CF 3 I based gas mixtures are presented and discussed for the possible application in the CMS experiment.

  6. Preliminary results of Resistive Plate Chambers operated with eco-friendly gas mixtures for application in the CMS experiment

    CERN Document Server

    Abbrescia, Marcello; Benussi, Luigi; Bianco, Stefano; Cauwenbergh, Simon Marc D; Ferrini, Mauro; Muhammad, Saleh; Passamontic, L; Pierluigi, Daniele; Piccolo, Davide; Primavera, Federica; Russo, Alessandro; Savianoc, G; Tytgat, Michael

    2016-01-01

    The operations of Resistive Plate Chambers in LHC experiments require F-based gases for optimal performance. Recent regulations demand the use of environmentally unfriendly F-based gases to be limited or banned. In view of the CMS experiment upgrade several tests are ongoing to measure the performance of the detector in terms of efficiency, streamer probability, induced charge and time resolution. Prototype chambers with readout pads and with the standard cms electronic setup are under test. In this talk preliminary results on performance of RPCs operated with a potential eco-friendly gas candidate 1,3,3,3-Tetrafluoropropene, commercially known as HFO-1234ze and with CO2 based gas mixtures are presented and discussed for the possible application in the CMS experiment.

  7. Preliminary results of Resistive Plate Chambers operated with eco-friendly gas mixtures for application in the CMS experiment

    CERN Document Server

    Abbrescia, M.

    2016-01-01

    The operations of Resistive Plate Chambers in LHC experiments require Fluorine based (F-based) gases for optimal performance. Recent European regulations demand the use of environmentally unfriendly F-based gases to be limited or banned. In view of the CMS experiment upgrade, several tests are ongoing to measure the performance of the detector with these new ecological gas mixtures, in terms of efficiency, streamer probability, induced charge and time resolution. Prototype chambers with readout pads and with the standard CMS electronic setup are under test. In this paper preliminary results on performance of RPCs operated with a potential eco-friendly gas candidate 1,3,3,3-Tetrafluoropropene, commercially known as HFO-1234ze, with CO2 and CF3I based gas mixtures are presented and discussed for the possible application in the CMS experiment.

  8. Pediatric Oncology Palliative Care: Experiences of General Practitioners and Bereaved Parents.

    Science.gov (United States)

    Neilson, Sue J; Gibson, Faith; Greenfield, Sheila M

    2015-03-01

    This qualitative study set in the West Midlands region of the United Kingdom, aimed to examine the role of the general practitioner (GP) in children's oncology palliative care from the perspective of GPs who had cared for a child with cancer receiving palliative care at home and bereaved parents. One-to-one semi-structured interviews were undertaken with 18 GPs and 11 bereaved parents following the death. A grounded theory data analysis was undertaken; identifying generated themes through chronological comparative data analysis. Similarity in GP and parent viewpoints was found, the GPs role seen as one of providing medication and support. Time pressures GPs faced influenced their level of engagement with the family during palliative and bereavement care and their ability to address their identified learning deficits. Lack of familiarity with the family, coupled with an acknowledgment that it was a rare and could be a frightening experience, also influenced their level of interaction. There was no consistency in GP practice nor evidence of practice being guided by local or national policies. Parents lack of clarity of their GPs role resulted in missed opportunities for support. Time pressures influence GP working practices. Enhanced communication and collaboration between the GP and regional childhood cancer centre may help address identified GP challenges, such as learning deficits, and promote more time-efficient working practices through role clarity. Parents need greater awareness of their GP's wide-ranging role; one that transcends palliative care incorporating bereavement support and on-going medical care for family members.

  9. Preliminary experience and near future utilization programmes of the MPR-30 fueled by LEU [low enriched uranium

    International Nuclear Information System (INIS)

    Arbie, B.; Soentono, S.

    1987-01-01

    The MTR type reactor MPR-30 G.A. Siwabessy, located at PUSPIPTEK Serpong has recently reached its first criticality. This multipurpose reactor is supposed to be the first MTR type reactor in the world that is designed and constructed to be fueled by low enriched uranium. Preliminary experience covering the approach to the first criticality and the excess reactivity loading as well as some thermal hydraulics and power ascension tests are briefly presented and discussed. The near future utilization programmes during and after commissioning are also presented. (Author)

  10. Preliminary experiments for the fabrication of clad for a spherical fuel for a research fluidized bed nuclear reactor

    International Nuclear Information System (INIS)

    Almeida, L.A.A.

    1982-01-01

    A preliminary experiments using 1100 aluminum 0,5mm thick hemispheres welded on 10mm diameter steel and ceramic spheres in order to determine a method to clad spherical fuel for a research fluidized bed nuclear reactor were studied. The processes of hot press, T.I.G. and resistance we use for welding. A qualitative compression and metalographic tests of welded pieces are performed. By the analysis of the results of the tests we conclude that the resistance welding was the best. The experimental methods and the results with their analysis are presented in the paper. (Author) [pt

  11. Ethical issues at the interface of clinical care and research practice in pediatric oncology: a narrative review of parents' and physicians' experiences

    Directory of Open Access Journals (Sweden)

    de Vries Martine C

    2011-09-01

    Full Text Available Abstract Background Pediatric oncology has a strong research culture. Most pediatric oncologists are investigators, involved in clinical care as well as research. As a result, a remarkable proportion of children with cancer enrolls in a trial during treatment. This paper discusses the ethical consequences of the unprecedented integration of research and care in pediatric oncology from the perspective of parents and physicians. Methodology An empirical ethical approach, combining (1 a narrative review of (primarily qualitative studies on parents' and physicians' experiences of the pediatric oncology research practice, and (2 comparison of these experiences with existing theoretical ethical concepts about (pediatric research. The use of empirical evidence enriches these concepts by taking into account the peculiarities that ethical challenges pose in practice. Results Analysis of the 22 studies reviewed revealed that the integration of research and care has consequences for the informed consent process, the promotion of the child's best interests, and the role of the physician (doctor vs. scientist. True consent to research is difficult to achieve due to the complexity of research protocols, emotional stress and parents' dependency on their child's physician. Parents' role is to promote their child's best interests, also when they are asked to consider enrolling their child in a trial. Parents are almost never in equipoise on trial participation, which leaves them with the agonizing situation of wanting to do what is best for their child, while being fearful of making the wrong decision. Furthermore, a therapeutic misconception endangers correct assessment of participation, making parents inaccurately attribute therapeutic intent to research procedures. Physicians prefer the perspective of a therapist over a researcher. Consequently they may truly believe that in the research setting they promote the child's best interests, which maintains the

  12. Pediatric Stroke

    Science.gov (United States)

    ... and Patient Resources Home » Patients & Families » About Stroke » Pediatric Stroke » Introduction Introduction What is a Stroke? Ischemic Stroke Intracerebral Hemorrhage Subarachnoid Hemorrhage Pediatric Stroke Introduction Types of Stroke Diagnosis and Treatment ...

  13. Myocarditis - pediatric

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007307.htm Myocarditis - pediatric To use the sharing features on this page, please enable JavaScript. Pediatric myocarditis is inflammation of the heart muscle in ...

  14. Campus-Based, Community-Based, and Philanthropic Contributions to Predoctoral Pediatric Dental Clinical Education: Two Years of Experiences at One Dental College.

    Science.gov (United States)

    Spiritoso, Stephen; Gross, Erin; Bean, Canise Y; Casamassimo, Paul S; Levings, Kevin; Lloyd, Patrick

    2015-08-01

    The aim of this study was to investigate the contribution of a tiered predoctoral pediatric dentistry clinical education model to competency achievement by dental students over a two-year clinical education. Retrospective data were obtained for academic years 2012-13 and 2013-14 from three sources: a campus-based, dental school-housed clinic; division-directed clinics in community-based pediatric and special needs clinics (DDC); and clinics affiliated with the dental college's community-based dental education (CBDE) program, the OHIO Project (OP). A fourth dataset was obtained for the same two-year period from a biannual clinic event held at the college in conjunction with Give Kids a Smile Day (GKAS). Procedures considered essential to the care of children were sorted by 12 dental codes from all services for patients 18 years of age and younger. The dental school clinic provided 11,060 procedures; the DDC, 28,462; the OP, 17,863; and GKAS, 2,028. The two-year total was 59,433 procedures. Numbers of diagnostic and preventive procedures were 19,441, restorative procedures were 13,958, and pulp and surgical procedures were 7,392. Site contribution ranged from 52.2 to 144.9 procedures per attending student, with the DDC yielding the highest per student average for each year (126.4 and 144.9) and the dental school clinic the lowest (52.2 and 53.1). This study found that a combination of school-based, community-based, and philanthropic pediatric dental experiences offered a large number of essential pediatric dentistry experiences for predoctoral dental students, with CBDE opportunities offering the largest contribution.

  15. Frictional sliding in layered rock model: Preliminary experiments. Yucca Mountain Site Characterization Project

    International Nuclear Information System (INIS)

    Perry, K.E. Jr.; Buescher, B.J.; Anderson, D.; Epstein, J.S.

    1995-09-01

    An important aspect of determining the suitability of Yucca Mountain as a possible nuclear waste repository requires understanding the mechanical behavior of jointed rock-masses. To this end we have studied the frictional sliding between simulated rock joints in the laboratory using the technique of phase shifting moire interferometry. The models were made from stacks of Lexan plates and contained a central hole to induce slip between the plates when the models were loaded in compression. These preliminary results confirm the feasibility of the approach and show a clear evolution of slip as function of load

  16. D-shaped configurations in FTU for testing liquid lithium limiter: Preliminary studies and experiments

    Directory of Open Access Journals (Sweden)

    G. Ramogida

    2017-08-01

    A possible alternative connection of the poloidal field coils in FTU is here proposed, with the aim of achieving a true X-point configuration with a magnetic single null well inside the plasma chamber and strike points on the lithium limiter. A preliminary assessment of this design allowed estimating the required power supply upgrade and showed its compatibility with the existing mechanical structure and cooling system, at least for plasmas with current up to 300 kA and flat-top duration up to 4s.

  17. MR imaging of prostate. Preliminary experience with calculated imaging in 28 cases

    International Nuclear Information System (INIS)

    Gevenois, P.A.; Van Regemorter, G.; Ghysels, M.; Delepaut, A.; Van Gansbeke, D.; Struyven, J.

    1988-01-01

    The majority of studies with MR imaging in prostate disease are based on a semiology obtained using images weighted in T1 and T2. A study was carried out to evaluate effects of images calculated in T1 and T2 obtained at 0.5T. This preliminary study concerns 28 prostate examinations with spin-echo acquisition and inversion-recuperation parameters, and provided images calculated in T1, weighted and calculated in T2. Images allowed detection and characterization of prostate lesions. However, although calculated images accentuate discrimination of the method, the weighted images conserve their place because of their improved spatial resolution [fr

  18. Chronicle of pediatric radiology

    International Nuclear Information System (INIS)

    Benz-Bohm, Gabriele; Richter, Ernst

    2012-01-01

    The chronicle of pediatric radiology covers the following issues: Development of pediatric radiology in Germany (BRD, DDR, pediatric radiological accommodations); development of pediatric radiology in the Netherlands (chronology and pediatric radiological accommodations); development of pediatric radiology in Austria (chronology and pediatric radiological accommodations); development of pediatric radiology in Switzerland (chronology and pediatric radiological accommodations).

  19. Percutaneous nephrolithotomy of bilateral staghorn renal calculi in pediatric patients: 12 years experience in a tertiary care centre.

    Science.gov (United States)

    Purkait, Bimalesh; Kumar, Manoj; Sokhal, Ashok Kumar; Bansal, Ankur; Sankhwar, Satya Narayan; Gupta, Ashok Kumar

    2017-08-01

    To assess the outcomes of percutaneous nephrolithotomy (PCNL) in bilateral staghorn calculi in pediatric patients, we have performed a retrospective analysis. Staghorn calculus is defined as stone that fills a greater part of the pelvic-caliceal system. Still, in developing countries, patients may present with staghorn calculus. PCNL is the preferred treatment modality for staghorn calculus both in adult and children. Our study included fifty-one pediatric patients (calculus in children needs expertise. PCNL in B/L staghorn renal calculus in children is safe and effective. B/L staghorn renal calculi with compromised renal function have higher chance of complications including bleeding.

  20. Laparoendoscopic single-site surgery (LESS) for the treatment of different urologic pathologies in pediatrics: single-center single-surgeon experience.

    Science.gov (United States)

    Abdel-Karim, Aly M; Elmissery, Mostafa; Elsalmy, Salah; Moussa, Ahmed; Aboelfotoh, Ahmed

    2015-02-01

    , the Triport access can be inserted through a 12-15-mm single umbilical incision without any additional openings in the abdomen as required with conventional laparoscopy which may increase the risk of internal organ injury and other port-related complications. Our results of five LESS varicocelectomies correlate with reports in the literature; regarding the operative time and hospital stay. LESS pediatric nephrectomy has been reported by many authors and our results correlates with that have been published. Compared with conventional laparoscopic nephrectomy, LESS nephrectomy seems to have shorter operative time and hospital stay. Although both cases of LESS nephrectomy were on the right side, we did not add any extra-ports which could be related to technical modifications during the surgery as well as the experience of the surgeon. To date, few data are available about LESS pyeloplasty in pediatrics. Our study included three patients who had left LESS pyeloplasties. In these patients, no extra-port was added. Despite of the technical difficulty of intracorporeal suturing during LESS, LESS pyeloplasty seems to be feasible with adequate training. Our patients had short hospital stay, low VAS at discharge, received a low dose of NSAID as postoperative analgesic and in all cases there was high wound satisfaction. One of the limitations of the current study could be the selection criteria of the patients, with children younger than 3 years and children who may be more technically difficult, being excluded. Furthermore, the number of patients in some indications is small and more patients are required to give solid conclusions and detect possible complications. Our study demonstrates the technical feasibility and safety of LESS for both ablative and reconstructive pathologies in pediatrics. However, more applications including a larger scale of pediatric patients as well as prospective comparative studies with conventional laparoscopy, are necessary. Copyright © 2014

  1. The role of coarse woody debris in southeastern pine forests; preliminary results from a large-scale experiment.

    Energy Technology Data Exchange (ETDEWEB)

    McCay Timothy, S.; Hanula, James, L.; Loeb, Susan, C.; Lohr, Steven, M.; McMinn, James, W.; Wright-Miley. Bret, D.

    2002-08-01

    McCay, Timothy S., James L. Hanula, Susan C. Loeb, Steven M. Lohr, James W. McMinn, and Bret D. Wright-Miley. 2002. The role of coarse woody debris in southeastern pine forests; preliminary results from a large-scale experiment. 135-144. In: Proceedings of the symposium on the ecology and management of dead wood in western forests. 1999 November 2-4; Reno, NV. Gen. Tech. Rep. PSW-GTR-181. Albany, CA: Pacific Southwest Research Station, Forest Service, U.S. Department of Agriculture 949 p. ABSTRACT: We initiated a long-term experiment involving manipulation of coarse woody debris (CWD) at the Savannah River National Environmental Research Park in the upper Coastal Plain of South Carolina. Each of four 9.3-ha plots in each of four blocks was subject to one of the following treatments: removal of all snags and fallen logs, removal of fallen logs only, felling and girdling to simulate a catastrophic pulse of CWD, and control. Removal treatments were applied in 1996, and the felling or snag-creation treatment will be applied in 2000-2001. Monitoring of invertebrate, herptile, avian, and mammalian assemblages and CWD dynamics began immediately after CWD removal and continues through the present. Removal treatments resulted in a fivefold to tenfold reduction in CWD abundance. To date, significant differences among treatments have only been detected for a few animal taxa. However, preliminary results underscore the benefits of large-scale experiments. This experiment allowed unambiguous tests of hypotheses regarding the effect of CWD abundance on fauna. Coupled with studies of habitat use and trophic interactions, the experimental approach may result in stronger inferences regarding the function of CWD than results obtained through natural history observation or uncontrolled correlative studies.

  2. The impact of language barriers and immigration status on the care experience for Spanish-speaking caregivers of patients with pediatric cancer.

    Science.gov (United States)

    Zamora, Eduardo R; Kaul, Sapna; Kirchhoff, Anne C; Gwilliam, Vannina; Jimenez, Ornella A; Morreall, Deborah K; Montenegro, Roberto E; Kinney, Anita Y; Fluchel, Mark N

    2016-12-01

    An increasing proportion of pediatric cancer patients in the United States are Latino and many have Spanish-speaking immigrant parents with limited English proficiency (LEP). Little is known about how language or undocumented immigration status impacts their care experience. A cross-sectional survey was administered to English (N = 310) and Spanish-speaking LEP (N = 56) caregivers of pediatric cancer patients. To assess differences in healthcare experiences between the language groups, t-tests and chi-square statistics were used. Multivariable logistic regression evaluated associations between primary language and knowledge of clinical trial status. Spanish-speaking caregivers were more likely to report higher rates of quitting or changing jobs as a direct result of their child's cancer, and their children were more likely to experience a delay in education. Although Spanish-speaking caregivers reported higher satisfaction with care, 32% reported feeling that their child would have received better care if English was their primary language. Spanish-speaking caregivers were more likely to incorrectly identify whether their child was on a clinical trial compared with English-speaking caregivers. The majority of Spanish-speaking caregivers reported at least one undocumented caregiver in the household and 11% of them avoided or delayed medical care for their child due to concerns over their undocumented immigration status. Language barriers and undocumented immigration status may negatively impact the quality of informed decision-making and the care experience for Spanish-speaking LEP caregivers of pediatric cancer patients. These families may benefit from culturally appropriate Spanish language resources to improve communication and open a dialogue regarding undocumented immigration status. © 2016 Wiley Periodicals, Inc.

  3. Cigotica programme: pediatric experiences

    Directory of Open Access Journals (Sweden)

    Lešović Snežana

    2011-01-01

    Full Text Available Introduction The alarming spread of obesity epidemic in children and adolsecents, as well as the absence of tested and efficient measures and programmes on obesity preven­tion indicate the necessity for the establishment of the Centre for the prevention, treatment and rehabilitation of obesity in children and adolescents and the 'Cigotica Programme' at the Special Hospital 'Zlatibor'. The advantage of the 'Cigotica' Programme is the multidisciplinary approach to treating obese children, which implies specific education, dietetic interventions with the reduction in the total daily calorie intake, physical activity, medical, educational and psychological support, change of behavior and lifestyle. Objective To define obesity complications, metabolic risk factors and treatment effects on body composition and metabolic parameters in adolescents participating in the 'Cigotica' Programme. Method 1,030 adolescents were examined (498 girls and 532 boys, aged 12 to 18, average age 15.45, diagnosed with primary obesity, hospitalized at the Centre for the prevention, treatment and rehabilitation of obesity in children and adolescents at the Special Hospital 'Zlatibor', in the period from 27/07/2008 to 03/10/2010. Hospitalization lasted 21 days. Obesity criterion was body mass index (BMI > +2 SD . Body The Special Hospital for the Thyroid Gland and Metabolism Zlatibor mass, BMI, % of fat were obtained by means of Tanita scales for determining body composition using the impendence method. Apart from medical examination, blood pressure was also taken. The levels of triglycerides, total HDL and LDL cholesterols, uric acids and glycemia were determined on the second and twenty-first day of hospitalization after a 12-day fasting period. Results After the multidisciplinary treatment, the average reduction in body mass (p< 0.05 in all adolescents was 5.92 ± 2.71 kg, in boys - 6.24 ±3.24 kg, and in girls -5.86±2.4. During the 21-day hospitalization, the average BMI (p< 0.05 was reduced by -2.12 ± 0.31 in all examinees, in boys by -2.33 ± 48 and in girls by -2.04 ± 0.41 kg/m2. The BMI z-score was considerably lower in all examinees upon release and it was (p<0.05-0.26 ±0.08, in girls 0.28 ±0.06 and in boys 0.31 ± 0.08. % of fat was considerably lower (p< 0.05 in all examinees -1.65 ± 0.23, in girls 1.72 ± 0.32 and in boys 1.50% ± 0.20. The waist circumference was reduced by -7.85 ±3.01 in all examinees, in girls -8.20 ± 4.3 and in boys -7.25 ± 2.6. Hypertension was observed in 28% of adolescents. Two factors of metabolic syndrome were present in 27.6%, and metabolic syndrome was present in 18.3% of the examinees. The disorder in sugar transport was observed in 8.9% of the examinees. Conclusion The effects of the 'Cigotica' Programme are very encouraging and they show that the multidisciplinary approach directed towards the reduction in energetic intake, education, change of lifestyle and habits related to nutrition and physical activity, leads to a considerable reduction in body mass, improvement in blood pressure, laboratory analyses, aerobic capacities and self-confidence in obese adolescents. There are obe­sity complications in a large number of adolescents, which indicates that the obesity problem has not been duly detected by parents or medical workers and that more efficient prevention programmes are needed. A great interest of children, parents, doctors and their participation in the 'Cigotica' Programme are going to contribute to raising awareness of obesity risks and the importance of health prevention in ado­lescents in our region.

  4. Taiwanese Parents' Experience of Making a “Do Not Resuscitate” Decision for Their Child in Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Shu-Mei Liu, RN, MN

    2014-03-01

    Conclusion: Open family visiting hours plus staff sensitivity and communication skills training are needed. To help parents with this difficult signing process, nurses and other professionals in the pediatric intensive care unit need education on initiating the conversation, guiding the parents in expressing their fears, and providing continuing support to parents and children throughout the child's end of life process.

  5. Neuroprotective Anesthesia Regimen and Intensive Management for Pediatric Cardiac Surgery with Cardiopulmonary Bypass: a Review and Initial Experience

    Directory of Open Access Journals (Sweden)

    Jyrson Guilherme Klamt

    Full Text Available Abstract This article describes our proposal for routine anesthesia, intraoperative medical management, cerebral and physiological monitoring during pediatric cardiac surgery with cardiopulmonary bypass that intend to provide appropriate anesthesia (analgesia, hypnosis, neuroprotection, adequate cerebral and systemic oxygen supply, and preventing against drugs neurotoxicity. A concise retrospective data is presented.

  6. Pre- and post-processing of TORT data and preliminary experience with TORT version 3

    International Nuclear Information System (INIS)

    Hoogenboom, J.E.; John, T.M.; Hersman, A.; Leege, P.F.A. de

    1997-01-01

    As the cross-section input to the TORT 3-D transport code is very rigid, subroutines have been included in the local version of TORT to process other cross-section libraries. A mixing table routine was added in order to prepare macroscopic cross-sections from microscopic cross-section libraries. Post-processing was added through additional output flux files in the CCCC-format together with the GEODST file describing the geometry. Recently the new TORT version 3 was successfully installed. However, many problems had to be solved to properly extract the source code and documentation from the UNIX script delivered with the code package. Preliminary tests did not show big differences in performance with the older version. (R.P.)

  7. Full-scale and time-scale heating experiments at Stripa: preliminary results

    International Nuclear Information System (INIS)

    Cook, N.G.W.; Hood, Michael; California Univ., Berkeley

    1978-01-01

    Two full-scale heating experiments and a time-scale heating experiment have recently been started in granite 340 meters below surface. The purpose of the full-scale heating experiments is to assess the near-field effects of thermal loading for the design of an underground repository of nuclear wastes. That of the time-scale heating experiments is to obtain field data of the interaction between heaters and its effect on the rock mass during a period of about two years, which corresponds to about twenty years of full-scale operation. Geological features of the rock around each experiment have been mapped carefully, and temperatures, stresses and displacements induced in the rock by heating have been calculated in advance of the experiments. Some 800 different measurements are recorded at frequent intervals by a computer system situated underground. These data can be compared at any time with predictions made earlier on video display units underground

  8. A hand-held imaging probe for radio-guided surgery: physical performance and preliminary clinical experience

    International Nuclear Information System (INIS)

    Pitre, S.; Menard, L.; Charon, Y.; Solal, M.; Garbay, J.R.

    2003-01-01

    Improvements in the specificity of radiopharmaceutical compounds have been paralleled by an upsurge of interest in developing small detectors to assist surgeons in localizing tumour tissue during surgery. This study reports the main technical features and physical characteristics of a new hand-held gamma camera dedicated to accurate and real-time intra-operative imaging. First clinical experience is also reported. The POCI (Per-operative Compact Imager) camera consists of a head module composed of a high-resolution interchangeable lead collimator and a CsI(Na) crystal plate optically coupled to an intensified position-sensitive diode. The current prototype has a 40-mm diameter field of view, an outer diameter of 9.5 cm, a length of 9 cm and a weight of 1.2 kg. Overall detector imaging characteristics were evaluated by technetium-99m phantom measurements. Three patients with breast cancer previously scheduled to undergo sentinel lymph node detection were selected for the preliminary clinical experience. Preoperative images of the lymphatic basin obtained using the POCI camera were compared with conventional transcutaneous explorations using a non-imaging gamma probe. The full-width at half-maximum (FWHM) spatial resolution was investigated in both air and scattering medium; when the phantom was placed in contact with the collimator, the POCI camera exhibited a 3.2 mm FWHM. The corresponding sensitivity was 290 cps/MBq. The preliminary clinical results showed that POCI was able to predict the number and location of all SLNs. In one case, two deep radioactive nodes missed by the gamma probe were detected on the intra-operative images. This very initial experience demonstrates that the physical performance of the POCI camera is adequate for radio-guided surgery. These results are sufficiently encouraging to prompt further evaluation studies designed to determine the specific and optimal clinical role of intra-operative imaging devices

  9. Near-Death Experiences and the "Fantasy-Prone" Personality: Preliminary Findings.

    Science.gov (United States)

    Council, James R.; Greyson, Bruce

    Near-death experiences (NDEs) are subjective experiences at the threshold of death which can include strong positive affect, dissociation from the physical body, and paranormal/transcendental phenomena. Empirical investigation of NDEs has typically relied upon retrospective reports and personality studies of individuals who have come close to…

  10. Results and preliminary analysis of critical experiments with interacting slab solution tanks

    International Nuclear Information System (INIS)

    Gurin, Victor N.; Ryazanov, Boris G.; Sviridov, Victor I.

    2003-01-01

    The paper presents the main results of several sets of critical experiments with two interacting similar slab tanks filled with aqueous solution of uranyl nitrate with uranium of 90% enrichment. These experiments were carried out at the RF-GS facility, Obninsk, Russia. Tanks with the thickness of 15 cm, width of 100 cm and height of 120 cm were used in these experiments. The experiments were conducted with partitions made of concrete, brick, polyethylene, cadmium, borated polyethylene. Consideration was given to the dependence of critical volume in each tank on the distance between the tanks and on the partition thickness. The tanks were filled with solutions of highly enriched uranium with its concentrations of 75 g/L and 250 g/L. Critical experiments were analysed with the MCNP 4A code based on the Monte-Carlo method and with the ENDF/B-V library. (author)

  11. Corrective emotional experience in an integrative affect-focused therapy: Building a preliminary model using task analysis.

    Science.gov (United States)

    Nakamura, Kaori; Iwakabe, Shigeru

    2018-03-01

    The present study constructed a preliminary process model of corrective emotional experience (CEE) in an integrative affect-focused therapy. Task analysis was used to analyse 6 in-session events taken from 6 Japanese clients who worked with an integrative affect-focused therapist. The 6 events included 3 successful CEEs and 3 partially successful CEEs for comparison. A rational-empirical model of CEE was generated, which consisted of two parallel client change processes, intrapersonal change and interpersonal change, and the therapist interventions corresponding to each process. Therapist experiential interventions and therapist affirmation facilitated both intrapersonal and interpersonal change processes, whereas his relational interventions were associated with the interpersonal change process. The partially successful CEEs were differentiated by the absence of the component of core painful emotions or negative beliefs in intrapersonal change process, which seemed crucial for the interpersonal change process to develop. CEE is best represented by a preliminary model that depicts two parallel yet interacting change processes. Intrapersonal change process is similar to the sequence of change described by the emotional processing model (Pascual-Leone & Greenberg, ), whereas interpersonal change process is a unique contribution of this study. Interpersonal change process was facilitated when the therapist's active stance and use of immediacy responses to make their relational process explicit allowed a shared exploration. Therapist affirmation bridged intrapersonal change to interpersonal change by promoting an adaptive sense of self in clients and forging a deeper emotional connection between the two. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Early experience with X-ray magnetic resonance fusion for low-flow vascular malformations in the pediatric interventional radiology suite

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Tiffany J. [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Keck School of Medicine of the University of Southern California, Los Angeles, CA (United States); Girard, Erin [Siemens Corporation, Corporate Technology, Princeton, NJ (United States); Shellikeri, Sphoorti; Vossough, Arastoo; Ho-Fung, Victor; Cahill, Anne Marie [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Setser, Randolph [Siemens Medical Solutions USA, Inc., Hoffman Estates, IL (United States)

    2016-03-15

    This technical innovation describes our experience using an X-ray magnetic resonance fusion (XMRF) software program to overlay 3-D MR images on real-time fluoroscopic images during sclerotherapy procedures for vascular malformations at a large pediatric institution. Five cases have been selected to illustrate the application and various clinical utilities of XMRF during sclerotherapy procedures as well as the technical limitations of this technique. The cases demonstrate how to use XMRF in the interventional suite to derive additional information to improve therapeutic confidence with regards to the extent of lesion filling and to guide clinical management in terms of intraprocedural interventional measures. (orig.)

  13. Preliminary experience with SpineEOS, a new software for 3D planning in AIS surgery.

    Science.gov (United States)

    Ferrero, Emmanuelle; Mazda, Keyvan; Simon, Anne-Laure; Ilharreborde, Brice

    2018-04-24

    Preoperative planning of scoliosis surgery is essential in the effective treatment of spine pathology. Thus, precontoured rods have been recently developed to avoid iatrogenic sagittal misalignment and rod breakage. Some specific issues exist in adolescent idiopathic scoliosis (AIS), such as a less distal lower instrumented level, a great variability in the location of inflection point (transition from lumbar lordosis to thoracic kyphosis), and sagittal correction is limited by both bone-implant interface. Since 2007, stereoradiographic imaging system is used and allows for 3D reconstructions. Therefore, a software was developed to perform preoperative 3D surgical planning and to provide rod's shape and length. The goal of this preliminary study was to assess the feasibility, reliability, and the clinical relevance of this new software. Retrospective study on 47 AIS patients operated with the same surgical technique: posteromedial translation through posterior approach with lumbar screws and thoracic sublaminar bands. Pre- and postoperatively, 3D reconstructions were performed on stereoradiographic images (EOS system, Paris, France) and compared. Then, the software was used to plan the surgical correction and determine rod's shape and length. Simulated spine and rods were compared to postoperative real 3D reconstructions. 3D reconstructions and planning were performed by an independent observer. 3D simulations were performed on the 47 patients. No difference was found between the simulated model and the postoperative 3D reconstructions in terms of sagittal parameters. Postoperatively, 21% of LL were not within reference values. Postoperative SVA was 20 mm anterior in 2/3 of the cases. Postoperative rods were significantly longer than precontoured rods planned with the software (mean 10 mm). Inflection points were different on the rods used and the planned rods (2.3 levels on average). In this preliminary study, the software based on 3D stereoradiography low

  14. Gender and urban infrastructural poverty experience in Africa: A preliminary survey in Ibadan city, Nigeria

    Directory of Open Access Journals (Sweden)

    Raimi. A. Asiyanbola

    2012-12-01

    Full Text Available The paper examines gender differences in the urban infrastructural poverty experience in an African city – Ibadan, Nigeria. The result of the cross-sectional survey of 232 households sampled in Ibadan city shows that there is intra-urban variation in the women and men urban infrastructure experience in Ibadan. The result of the correlation analysis shows that there is significant relationship between women and men urban infrastructure experience and the household income, educational level, household size and the stage in the life cycle; only with the urban infrastructure experience of the women is a significant relationship found with the occupation and the responsibility in the household. The result of the multiple linear regression analysis shows that the impact/effect of the socio-cultural, demographic and economic characteristics are more on women experience of urban infrastructure than on men’s experience. While the relative contributions of the economic characteristics, family characteristics and socio-cultural characteristics in that order are all significant in explaining the variance in women’s experience of urban infrastructure, only economic characteristics and family characteristics in that order are found to be significant in the case of the men. Also, the most important socio-cultural demographic and economic variables as shown by the beta coefficients for women are household income, household size, and responsibility in the household, while for men are the household income and the household size. Policy implications of the findings are highlighted in the paper.

  15. Preliminary experiment design of graphite dust emission measurement under accident conditions for HTGR

    Energy Technology Data Exchange (ETDEWEB)

    Peng, Wei, E-mail: pengwei@tsinghua.edu.cn [Institute of Nuclear and New Energy Technology of Tsinghua University, Advanced Nuclear Energy Technology Cooperation Innovation Center, The Key Laboratory of Advanced Nuclear Engineering and Safety, Ministry of Education, Beijing 100084 (China); Chen, Tao; Sun, Qi; Wang, Jie [Institute of Nuclear and New Energy Technology of Tsinghua University, Advanced Nuclear Energy Technology Cooperation Innovation Center, The Key Laboratory of Advanced Nuclear Engineering and Safety, Ministry of Education, Beijing 100084 (China); Yu, Suyuan, E-mail: suyuan@tsinghua.edu.cn [Center for Combustion Energy, The Key Laboratory for Thermal Science and Power Engineering, Ministry of Education, Tsinghua University, Beijing 100084 (China)

    2017-05-15

    Highlights: • A theoretical analysis is used to predict the total graphite dust release for an AVR LOCA. • Similarity criteria must be satisfied between the experiment and the actual HTGR system. • Model experiments should be conducted to predict the graphite dust resuspension rate. - Abstract: The graphite dust movement behavior is significant for the safety analyses of high-temperature gas cooled reactor (HTGR). The graphite dust release for accident conditions is an important source term for HTGR safety analyses. Depressurization release tests are not practical in HTGR because of a radioactivity release to the environment. Thus, a theoretical analysis and similarity principles were used to design a group of modeling experiments. Modeling experiments for fan start-up and depressurization process and actual experiments of helium circulator start-up in an HTGR were used to predict the rate of graphite dust resuspension and the graphite dust concentration, which can be used to predict the graphite dust release during accidents. The modeling experiments are easy to realize and the helium circulator start-up test does not harm the reactor system or the environment, so this experiment program is easily achieved. The revised Rock’n’Roll model was then used to calculate the AVR reactor release. The calculation results indicate that the total graphite dust releases during a LOCA will be about 0.65 g in AVR.

  16. Viking satellite program - preliminary results from the APL Magnetic Field Experiment

    International Nuclear Information System (INIS)

    Potemra, T.A.; Zanetti, L.J.; Erlandson, R.E.; Gustafsson, G.; Acuna, M.H.; NASA, Goddard Space Flight Center, Greenbelt, MD)

    1986-01-01

    Sweden's Viking satellite, launched in February 1986, has been conducting plasma process observations in the earth magnetosphere and auroral regions; the U.S.-supplied APL Magnetic Field Experiment aboard Viking is used to determine field-aligned Birkeland current characteristics in previously unsampled regions of near-earth space. The Magnetic Field Experiment has an equivalent spatial resolution of 12 m in the auroral ionosphere when making measurements near apogee. The purposes of Viking's other instruments and their relationship to the Magnetic Field Experiment are discussed

  17. The expression and correlation of Hsp 70 and Hsp 27 in serous middle ear effusion fluids of pediatric patients-a preliminary study.

    Science.gov (United States)

    Min, Hyun Jin; Choe, Ji Won; Chang, Moon Young; Kim, Kyung Soo; Lee, Sei Young; Mun, Seog-Kyun

    2017-10-01

    Several cytokines and innate immune-associated molecules are present in middle ear effusions, but damage-associated molecular patterns (DAMPs) in middle ear effusion have not been studied. Therefore, we evaluated the role of heat shock proteins (Hsps) in the development of otitis media with effusion (OME). Serous middle ear effusions from 22 pediatric patients who were diagnosed with OME and underwent ventilation tube insertion from June 2015 to March 2017 were evaluated in our study. The levels of Hsp 90, 70, 27, IL-8, and TNF-α in effusion fluids were evaluated by enzyme-linked immunosorbent assays. The associations between the levels of these molecules and the degree of tympanic membrane inflammation were statistically evaluated. Finally, the relationships among these molecules were also evaluated. Hsp 70 and Hsp 27 were detected in all middle ear effusions, but Hsp 90 was detected in only five effusion fluid samples. IL-8 was also detected in all middle ear effusions, but TNF-α was detected in only four effusion fluid samples. When we compared the degree of tympanic membrane inflammation with the levels of Hsp 70, Hsp 27, and IL-8, which were detected in all effusion fluids, we could not find statistical significance. However, Hsp 70, Hsp 27, and IL-8 were significantly associated with each other (p effusions. Furthermore, the levels of Hsp 70 and Hsp 27 were positively correlated with each other, and were also positively associated with the neutrophil chemoattractant, IL-8. Our findings suggested that Hsp 70 and Hsp 27 might be involved in the pathophysiology of pediatric OME. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Preliminary study of religious, spiritual and mystical experiences. Thematic analysis of Poles adult’s narratives

    Directory of Open Access Journals (Sweden)

    Marta Magdalena Boczkowska

    2016-07-01

    Full Text Available The aim of this study was to examine narratives of the personal religious, spiritual and mystical experiences of adult Poles (N = 74 and their impact on narrative identity. The method for collecting qualitative data about individual understandings and spiritual, religious and mystical experiences was the narrative interview, developed on the basis of the Life Story Interview. During the analysis, the following key topics were identified: awareness of the presence/protection of God, a peak experience, the awareness of oneness with nature and the world, and a sense of closeness/contact with a person who has died. This study provides specific information on the spiritual, religious and mystical experiences of the investigated group of Poles.

  19. Preliminary experiences with sentinel lymph node detection in cases of vulvar malignancy

    International Nuclear Information System (INIS)

    Zambo, Katalin; Schmidt, Erzsebet; Dehghani, Babak; Hartmann, Tamas; Bodis, Jozsef; Kornya, Laszlo; Tinneberg, Hans Rudolf

    2002-01-01

    Lymph node status is the most important prognostic factor in vulvar malignancy. The aim of this pilot study was to explore the clinical significance of radionuclide lymphoscintigraphy in the management of vulvar neoplasms. Eight patients with squamous cell carcinoma and two patients with malignant melanoma of the vulva were studied with 100 MBq technetium-99m nanocolloid (Sentiscint, OSSKI, Budapest) 1 day before surgery. The location of the sentinel lymph node was checked by a single-head gamma camera-computer system (MB 9200, Mediso, Budapest). Vulvectomy with bilateral inguinofemoral lymphadenectomy was performed in each case. At lymphadenectomy, the sentinel lymph node was separately removed and histologically studied. Three of the ten patients had positive sentinel lymph nodes (micrometastasis). Five months later one of them had local recurrence of the vulvar cancer, and another had inguinal recurrence of the tumour 6 months postoperatively; the third patient was operated on only recently. Our preliminary results are impressive and suggest that lymphoscintigraphy is an easy and reliable method for detection of the sentinel lymph node in vulvar malignancy. (orig.)

  20. Mental health nurses' experiences of schizophrenia rehabilitation in China and India: a preliminary study.

    Science.gov (United States)

    Higgins, Louise; Dey-Ghatak, Priya; Davey, Gareth

    2007-02-01

    Nursing methods based on Western models may not be culturally relevant to patients from ethnic minority groups or other countries. In order to meet the needs of all patients, more research is needed to understand the cultural and social factors that influence nursing approaches. This paper reports preliminary open-ended discussions with mental health nurses in China and India in order to gain insights into the cultural and social issues that surround social rehabilitation of patients with schizophrenia. Rehabilitation methods included cognitive behavioural therapy, psychosocial methods, and employment/vocational training. Several cultural and social issues drive the rehabilitation process in both countries, including the use of traditional medicine and healers, emphasis on family involvement, stigma, gender inequality, and lack of resources. Participants in both countries were working hard to tackle some of these issues, but also expressed need for improved resources. The study provides an insight into the cultural and social factors that shape schizophrenia rehabilitation in China and India, and serves as a baseline for further research about nursing across cultures. The study also highlights the marked differences in attitudes, values, and behaviours across cultural groups that need to be considered by nursing professionals to ensure that services are culturally competent.

  1. Biodegradable biliary stent implantation in the treatment of benign bilioplastic-refractory biliary strictures: preliminary experience.

    Science.gov (United States)

    Mauri, Giovanni; Michelozzi, Caterina; Melchiorre, Fabio; Poretti, Dario; Tramarin, Marco; Pedicini, Vittorio; Solbiati, Luigi; Cornalba, Gianpaolo; Sconfienza, Luca Maria

    2013-12-01

    To evaluate feasibility, safety, and outcome of patients treated with biodegradable biliary stents for benign biliary stenosis refractory to other treatments. Between March 2011 and September 2012, ten patients (seven men, three women; age 59 ± 7 years) with recurrent cholangitis due to postsurgical biliary stricture, previous multiple unsuccessful (two to five) bilioplasties, and unsuitability for surgical/endoscopic repair underwent percutaneous implantation of a biodegradable biliary stent. Patients were followed-up clinically and with ultrasound at 1, 3 and 6 months, and then at 6-month intervals. Stent implantation was always feasible. No immediate major or minor complications occurred. In all patients, 48-h cholangiographic control demonstrated optimal stent positioning and stenosis resolution. In a median follow-up time of 16.5 months (25th-75th percentiles = 11-20.25 months) no further invasive treatment was needed. Three patients experienced transient episodes of cholangitis. Neither re-stenosis nor dilatation of the biliary tree was documented during follow-up. No stent was visible at the 6-month follow-up. Percutaneous placement of biodegradable biliary stents represents a new option in treating benign biliary stenoses refractory to treatment with bilioplasty. This technique seems to be feasible, effective and free from major complications. Further investigations are warranted to confirm our preliminary results.

  2. Examining implementation and preliminary performance indicators of veterans treatment courts: The Kentucky experience.

    Science.gov (United States)

    Shannon, Lisa M; Birdwhistell, Shira; Hulbig, Shelia K; Jones, Afton Jackson; Newell, Jennifer; Payne, Connie

    2017-08-01

    Veterans' Treatment Courts (VTCs) are posited as a solution to offer rehabilitation for veterans involved in the criminal justice system. Despite the pervasive implementation of VTCs, there is little research focused specifically on VTC implementation and outcomes, which are based on other problem-solving court models such as drug court. The current study presents qualitative process evaluation data from key stakeholders (n=21) and veteran participants (n=4) to show accomplishments, challenges, and lessons learned during first-year implementation at two VTC sites. Quantitative performance data is also presented on veteran participants (n=19) served during the first year to show: types of services, monitoring, judicial interaction, sanctions/therapeutic responses, and rewards, as well as preliminary data on recidivism. Qualitative data, from both key stakeholders and veteran participants, suggests that offering rehabilitation via various program components, services/referrals, and accountability are critical to the success of the VTC. Data also provides valuable lessons learned for VTC implementation including communication, collaboration, information/protocols, and resources. Performance data shows that a variety of services are utilized and that frequent judicial interaction, drug testing, and sanctions are cornerstones of the VTC. Implications and future directions for research are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. The TETRA-II Experiment to Observe Terrestrial Gamma Flashes at Ground Level - Preliminary Results

    Science.gov (United States)

    Cherry, M. L.; Adams, C.; Al-Nussirat, S.; Bai, S.; Banadaki, Y.; Bitzer, P. M.; Hoffmann, J.; Khosravi, E.; Legault, M.; Orang, M.; Pleshinger, D. J.; Rodriguez, R.; Smith, D.; Trepanier, J. C.; Sunda-Meya, A.; Zimmer, N.

    2017-12-01

    An upgraded version of the TGF and Energetic Thunderstorm Rooftop Array (TETRA-II) consists of an array of BGO scintillators to detect bursts of gamma rays from thunderstorms at ground level in four separate locations: the campus of Louisiana State University in Baton Rouge, Louisiana; the campus of the University of Puerto Rico at Utuado, Puerto Rico; the Centro Nacional de Metrologia de Panama (CENAMEP) in Panama City, Panama; and the Severe Weather Institute and Radar & Lightning Laboratories in Huntsville, Alabama. The original TETRA-I array of NaI scintillators at Louisiana State University detected 37 millisecond-scale bursts of gamma rays at energies 50 keV-2 MeV associated with nearby (brief description of the TETRA-I observations, a description of TETRA-II, and preliminary results of the first events observed by TETRA-II will be presented including frequency and time history of events, spectral information, and correlation with local radar and radio data.

  4. Automated lung module detection at low-dose CT: preliminary experience

    International Nuclear Information System (INIS)

    Goo, Jin-Mo; Lee, Jeong-Won; Lee, Hyun-Ju; Kim, Seung-Wan; Kim, Jong-Hyo; Im, Jung-Gi

    2003-01-01

    To determine the usefulness of a computer-aided diagnosis (CAD) system for the automated detection of lung nodules at low-dose CT. A CAD system developed for detecting lung nodules was used to process the data provided by 50 consecutive low-dose CT scans. The results of an initial report, a second look review by two chest radiologists, and those obtained by the CAD system were compared, and by reviewing all of these, a gold standard was established. By applying the gold standard, a total of 52 nodules were identified (26 with a diameter ≤ 5 mm; 26 with a diameter > 5 mm). Compared to an initial report, four additional nodules were detected by the CAD system. Three of these, identified only at CAD, formed part of the data used to derive the gold standard. For the detection of nodules > 5 mm in diameter, sensitivity was 77% for the initial report, for the second look review, and 88% for the second look review,and 65% for the CAD system. There were 8.0 ± 5.2 false-positive CAD results per CT study. These preliminary results indicate that a CAD system may improve the detection of pulmonary nodules at low-dose CT

  5. Preliminary experiments to simulate glass/electrode interactions within a Joule Ceramic Melter

    International Nuclear Information System (INIS)

    Dalton, J.T.; Paige, E.L.; Sutcliffe, P.W.

    1986-01-01

    Preliminary isothermal corrosion tests have been made on Inconel 690 coupon samples immersed in Harvest II M9 glass with and without excess additions of Li 2 O (1.5%) and RuO 2 (20%) together with TeO 2 (2%) at 1200 0 C for periods up to 100 hours. Inconel 690 corrosion and the products and ruthenium redox conditions within the glass approximate to those observed in the 1/3rd scale Joule Ceramic Melter operations. Corrosion takes place by an oxidation mechanism to form a chromium-rich surface oxide, and dissolution of this surface oxide by the surrounding glass. Additions of excess Li 2 O increase the corrosion rate of Inconel 690, whereas RuO 2 + TeO 2 are neutral. The latter however have a marked effect in lowering the room temperature resistivity by at least 5 orders of magnitude even though relatively small fraction of the RuO 2 precipitates were reduced to ruthenium metal. (author)

  6. Preliminary Clinical Experience with a Combined Automated Breast Ultrasound and Digital Breast Tomosynthesis System.

    Science.gov (United States)

    Larson, Eric D; Lee, Won-Mean; Roubidoux, Marilyn A; Goodsitt, Mitchell M; Lashbrook, Chris; Davis, Cynthia E; Kripfgans, Oliver D; Carson, Paul L

    2018-03-01

    We analyzed the performance of a mammographically configured, automated breast ultrasound (McABUS) scanner combined with a digital breast tomosynthesis (DBT) system. The GE Invenia ultrasound system was modified for integration with GE DBT systems. Ultrasound and DBT imaging were performed in the same mammographic compression. Our small preliminary study included 13 cases, six of whom had contained invasive cancers. From analysis of these cases, current limitations and corresponding potential improvements of the system were determined. A registration analysis was performed to compare the ease of McABUS to DBT registration for this system with that of two systems designed previously. It was observed that in comparison to data from an earlier study, the McABUS-to-DBT registration alignment errors for both this system and a previously built combined system were smaller than those for a previously built standalone McABUS system. Copyright © 2018 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

  7. MDCT assessment of tracheomalacia in symptomatic infants with mediastinal aortic vascular anomalies: preliminary technical experience

    International Nuclear Information System (INIS)

    Lee, Edward Y.; Mason, Keira P.; Zurakowski, David; Waltz, David A.; Ralph, Amy; Riaz, Farhana; Boiselle, Phillip M.

    2008-01-01

    Mediastinal aortic vascular anomalies are relatively common causes of extrinsic central airway narrowing in infants with respiratory symptoms. Surgical correction of mediastinal aortic vascular anomalies alone might not adequately treat airway symptoms if extrinsic narrowing is accompanied by intrinsic tracheomalacia (TM), a condition that escapes detection on routine end-inspiratory imaging. Paired inspiratory-expiratory multidetector CT (MDCT) has the potential to facilitate early diagnosis and timely management of TM in symptomatic infants with mediastinal aortic vascular anomalies. To assess the technical feasibility of paired inspiratory-expiratory MDCT for evaluating TM among symptomatic infants with mediastinal aortic vascular anomalies. The study group consisted of five consecutive symptomatic infants (four male, one female; mean age 4.1 months, age range 2 weeks to 6 months) with mediastinal aortic vascular anomalies who were referred for paired inspiratory-expiratory MDCT during a 22-month period. CT angiography was concurrently performed during the end-inspiration phase of the study. Two pediatric radiologists in consensus reviewed all CT images in a randomized and blinded fashion. The end-inspiration and end-expiration CT images were reviewed for the presence and severity of tracheal narrowing. TM was defined as ≥50% reduction in tracheal cross-sectional luminal area between end-inspiration and end-expiration. The presence of TM was compared to the bronchoscopy results when available (n = 4). Paired inspiratory-expiratory MDCT was technically successful in all five patients. Mediastinal aortic vascular anomalies included a right aortic arch with an aberrant left subclavian artery (n = 2), innominate artery compression (n = 2), and a left aortic arch with an aberrant right subclavian artery (n 1). Three (60%) of the five patients demonstrated focal TM at the level of mediastinal aortic vascular anomalies. The CT results were concordant with the results

  8. Effect of ionizing radiation on radionuclide speciation: Preliminary results from site-specific experiments in a basaltic system

    International Nuclear Information System (INIS)

    Reed, D.T.; Burnell, J.R.

    1986-01-01

    Rockwell Hanford Operations, under contract to the Department of Energy, is investigating the suitability of the Hanford site in the state of Washington as a high level nuclear waste repository. An important consideration in these investigations is the effect of ionizing radiation on the speciation of radionuclides in the groundwater after the high-level-waste container has been breached and there is direct contact between the groundwater and the waste form (controlled released period). The effect of ionizing radiation on radionuclide speciation depends on the radiation environment and site-specific chemistry near the waste container. With respect to these two aspects, the following results will be presented: a definition of the radiation environment during the controlled release period; preliminary site-specific experimental results: (1) basaltic systems spiked with radionuclides; (2) spent fuel-groundwater-basalt experiments

  9. The Thirty Gigahertz Instrument Receiver for the QUIJOTE Experiment: Preliminary Polarization Measurements and Systematic-Error Analysis

    Directory of Open Access Journals (Sweden)

    Francisco J. Casas

    2015-08-01

    Full Text Available This paper presents preliminary polarization measurements and systematic-error characterization of the Thirty Gigahertz Instrument receiver developed for the QUIJOTE experiment. The instrument has been designed to measure the polarization of Cosmic Microwave Background radiation from the sky, obtaining the Q, U, and I Stokes parameters of the incoming signal simultaneously. Two kinds of linearly polarized input signals have been used as excitations in the polarimeter measurement tests in the laboratory; these show consistent results in terms of the Stokes parameters obtained. A measurement-based systematic-error characterization technique has been used in order to determine the possible sources of instrumental errors and to assist in the polarimeter calibration process.

  10. Pediatric Dentistese

    Directory of Open Access Journals (Sweden)

    Sharath Asokan

    2017-01-01

    Full Text Available Successful practice of pediatric dentistry depends on the establishment of a good relationship between the dentist and the child. Such a relationship is possible only through effective communication. Pediatric dentistry includes both an art and a science component. The focus has been mostly on the technical aspects of our science, and the soft skills we need to develop are often forgotten or neglected. This paper throws light on the communication skills we need to imbibe to be a successful pediatric dentist. A new terminology “Pediatric Dentistese” has been coined similar to motherese, parentese, or baby talk. Since baby talk cannot be applied to all age groups of children, pediatric dentistese has been defined as “the proactive development-based individualized communication between the pediatric dentist and the child which helps to build trust, allay fear, and treat the child effectively and efficiently.”

  11. Role of Surgery in Stages II and III Pediatric Abdominal Non-Hodgkin Lymphoma: A 5-Years Experience.

    Science.gov (United States)

    Ali, Amany M; Sayd, Heba A; Hamza, Hesham M; Salem, Mohamed A

    2011-03-29

    Abdominal Non-Hodgkin lymphomas (NHL) are the most common extra nodal presentation of pediatric NHL. Our aim is to assess the role of surgery as a risk factor and to evaluate the impact of risk-adjusted systemic chemotherapy on survival of patients with stages II and III disease. This study included 35 pediatric patients with abdominal NHL treated over five years at South Egypt Cancer Institute (SECI), Assiut University, between January 2005 and January 2010. The data of every patient included: Age, sex, and presentation, staging work up to determine extent of the disease and the type of resection performed, histopathological examination, details of chemotherapy, disease free survival and overall survival. The study included 25 boys and 10 girls with a median age of six years (range: 2.5:15). Thirty patients (86%) presented with abdominal pain, 23 patients (66%) presented with abdominal mass and distention, 13 patients (34%) presented with weight loss, and intestinal obstruction occurred in six patients (17%). The ileo-cecal region and abdominal lymph nodes were the commonest sites (48.5%, 21% respectively). Burkitt's lymphoma was the most common histological type in 29 patients (83%). Ten (28.5%) stage II (group A) and 25 (71.5%) stage III (group B). Complete resections were performed in 10 (28.5%), debulking in 6 (17%) and imaging guided biopsy in 19 (54%). A11 patients received systemic chemotherapy. The median follow up duration was 63 months (range 51-78 months). The parameters that significantly affect the overall survival were stage at presentation complete resection for localized disease. In conclusion, the extent of disease at presentation is the most important prognostic factor in pediatric abdominal NHL. Surgery is restricted to defined situations such as; abdominal emergencies, diagnostic biopsy and total tumor extirpation in localized disease. Chemotherapy is the cornerstone in the management of pediatric abdominal NHL.

  12. Role of Surgery in Stages II and III Pediatric Abdominal Non-Hodgkin Lymphoma: A 5-Years Experience

    Directory of Open Access Journals (Sweden)

    Mohamed A. Salem

    2011-03-01

    Full Text Available Abdominal Non-Hodgkin lymphomas (NHL are the most common extra nodal presentation of pediatric NHL. Our aim is to assess the role of surgery as a risk factor and to evaluate the impact of risk-adjusted systemic chemotherapy on survival of patients with stages II and III disease. This study included 35 pediatric patients with abdominal NHL treated over five years at South Egypt Cancer Institute (SECI, Assiut University, between January 2005 and January 2010. The data of every patient included: Age, sex, and presentation, staging work up to determine extent of the disease and the type of resection performed, histopathological examination, details of chemotherapy, disease free survival and overall survival. The study included 25 boys and 10 girls with a median age of six years (range: 2.5:15. Thirty patients (86% presented with abdominal pain, 23 patients (66% presented with abdominal mass and distention, 13 patients (34% presented with weight loss, and intestinal obstruction occurred in six patients (17%. The ileo-cecal region and abdominal lymph nodes were the commonest sites (48.5%, 21% respectively. Burkitt's lymphoma was the most common histological type in 29 patients (83%. Ten (28.5% stage II (group A and 25 (71.5% stage III (group B. Complete resections were performed in 10 (28.5%, debulking in 6 (17% and imaging guided biopsy in 19 (54%. A11 patients received systemic chemotherapy. The median follow up duration was 63 months (range 51-78 months. The parameters that significantly affect the overall survival were stage at presentation complete resection for localized disease. In conclusion, the extent of disease at presentation is the most important prognostic factor in pediatric abdominal NHL. Surgery is restricted to defined situations such as; abdominal emergencies, diagnostic biopsy and total tumor extirpation in localized disease. Chemotherapy is the cornerstone in the management of pediatric abdominal NHL.

  13. Experiment designs offered for discussion preliminary to an LLNL field scale validation experiment in the Yucca Mountain Exploratory Shaft Facility

    International Nuclear Information System (INIS)

    Lowry, B.; Keller, C.

    1988-01-01

    It has been proposed (''Progress Report on Experiment Rationale for Validation of LLNL Models of Ground Water Behavior Near Nuclear Waste Canisters,'' Keller and Lowry, Dec. 7, 1988) that a heat generating spent fuel canister emplaced in unsaturated tuff, in a ventilated hole, will cause a net flux of water into the borehole during the heating cycle of the spent fuel. Accompanying this mass flux will be the formation of mineral deposits near the borehole wall as the water evaporates and leaves behind its dissolved solids. The net effect of this process upon the containment of radioactive wastes is a function of (1) where and how much solid material is deposited in the tuff matrix and cracks, and (2) the resultant effect on the medium flow characteristics. Experimental concepts described in this report are designed to quantify the magnitude and relative location of solid mineral deposit formation due to a heated and vented borehole environment. The most simple tests address matrix effects only; after the process is understood in the homogeneous matrix, fracture effects would be investigated. Three experiment concepts have been proposed. Each has unique advantages and allows investigation of specific aspects of the precipitate formation process. All could be done in reasonable time (less than a year) and none of them are extremely expensive (the most expensive is probably the structurally loaded block test). The calculational ability exists to analyze the ''real'' situation and each of the experiment designs, and produce a credible series of tests. None of the designs requires the acquisition of material property data beyond current capabilities. The tests could be extended, if our understanding is consistent with the data produced, to analyze fracture effects. 7 figs

  14. Management of pediatric mandibular fractures using bioresorbable plating system - Efficacy, stability, and clinical outcomes: Our experiences and literature review.

    Science.gov (United States)

    Singh, Mahinder; Singh, R K; Passi, Deepak; Aggarwal, Mohit; Kaur, Guneet

    2016-01-01

    The purpose of this study was to determine the efficacy and stability of the biodegradable fixation system for treatment of mandible fractures in pediatric patients by measuring the bite force. Sixty pediatric patients with mandibular fractures (36 males, 24 females) were included in this study. The 2.5-mm resorbable plates were adapted along Champy's line of ideal osteosynthesis and secured with four 2.5 mm diameter monocortical resorbable screws, 8 mm in length. All patients were followed for 10 months. Clinical parameters, such as soft tissue infection, nonunion, malunion, implant exposure, malocclusion, nerve injury, and bite force for stability, were prospectively assessed. Adequate fixation and primary bone healing was achieved in 100% of the cases. Six minor complications (10%) were observed: 2 soft tissue infections (3%), 1 plate dehiscence (2%), 1 malocclusion (2%), and 2 paresthesia (3%). 2.5-mm resorbable plating system along Champy's line of ideal osteosynthesis is a good treatment modality for mandible fractures in pediatric patients.

  15. Management of pediatric mandibular fractures using bioresorbable plating system – Efficacy, stability, and clinical outcomes: Our experiences and literature review

    Science.gov (United States)

    Singh, Mahinder; Singh, R.K.; Passi, Deepak; Aggarwal, Mohit; Kaur, Guneet

    2015-01-01

    Aims The purpose of this study was to determine the efficacy and stability of the biodegradable fixation system for treatment of mandible fractures in pediatric patients by measuring the bite force. Methods Sixty pediatric patients with mandibular fractures (36 males, 24 females) were included in this study. The 2.5-mm resorbable plates were adapted along Champy's line of ideal osteosynthesis and secured with four 2.5 mm diameter monocortical resorbable screws, 8 mm in length. All patients were followed for 10 months. Clinical parameters, such as soft tissue infection, nonunion, malunion, implant exposure, malocclusion, nerve injury, and bite force for stability, were prospectively assessed. Results Adequate fixation and primary bone healing was achieved in 100% of the cases. Six minor complications (10%) were observed: 2 soft tissue infections (3%), 1 plate dehiscence (2%), 1 malocclusion (2%), and 2 paresthesia (3%). Conclusion 2.5-mm resorbable plating system along Champy's line of ideal osteosynthesis is a good treatment modality for mandible fractures in pediatric patients. PMID:27195206

  16. Computer-Aided Diagnosis Based on Convolutional Neural Network System for Colorectal Polyp Classification: Preliminary Experience.

    Science.gov (United States)

    Komeda, Yoriaki; Handa, Hisashi; Watanabe, Tomohiro; Nomura, Takanobu; Kitahashi, Misaki; Sakurai, Toshiharu; Okamoto, Ayana; Minami, Tomohiro; Kono, Masashi; Arizumi, Tadaaki; Takenaka, Mamoru; Hagiwara, Satoru; Matsui, Shigenaga; Nishida, Naoshi; Kashida, Hiroshi; Kudo, Masatoshi

    2017-01-01

    Computer-aided diagnosis (CAD) is becoming a next-generation tool for the diagnosis of human disease. CAD for colon polyps has been suggested as a particularly useful tool for trainee colonoscopists, as the use of a CAD system avoids the complications associated with endoscopic resections. In addition to conventional CAD, a convolutional neural network (CNN) system utilizing artificial intelligence (AI) has been developing rapidly over the past 5 years. We attempted to generate a unique CNN-CAD system with an AI function that studied endoscopic images extracted from movies obtained with colonoscopes used in routine examinations. Here, we report our preliminary results of this novel CNN-CAD system for the diagnosis of colon polyps. A total of 1,200 images from cases of colonoscopy performed between January 2010 and December 2016 at Kindai University Hospital were used. These images were extracted from the video of actual endoscopic examinations. Additional video images from 10 cases of unlearned processes were retrospectively assessed in a pilot study. They were simply diagnosed as either an adenomatous or nonadenomatous polyp. The number of images used by AI to learn to distinguish adenomatous from nonadenomatous was 1,200:600. These images were extracted from the videos of actual endoscopic examinations. The size of each image was adjusted to 256 × 256 pixels. A 10-hold cross-validation was carried out. The accuracy of the 10-hold cross-validation is 0.751, where the accuracy is the ratio of the number of correct answers over the number of all the answers produced by the CNN. The decisions by the CNN were correct in 7 of 10 cases. A CNN-CAD system using routine colonoscopy might be useful for the rapid diagnosis of colorectal polyp classification. Further prospective studies in an in vivo setting are required to confirm the effectiveness of a CNN-CAD system in routine colonoscopy. © 2017 S. Karger AG, Basel.

  17. Endovascular radiofrequency renal denervation in treating refractory arterial hypertension: a preliminary experience.

    Science.gov (United States)

    Simonetti, G; Spinelli, A; Gandini, R; Da Ros, V; Gaspari, E; Coco, I; De Francesco, M; Santucci, D; Di Daniele, N; Lauro, R

    2012-04-01

    This study was done to investigate the efficacy and safety of percutaneous renal denervation with the Symplicity catheter for reducing blood pressure in patients with essential hypertension resistant to medical therapy (systolic blood pressure >160 mmHg despite the use of three or more antihypertensive drugs, including a diuretic). In September 2010, five patients affected by essential hypertension resistant to medical therapy were treated. All patients were studied by computed tomography angiography (CTA) of the renal arteries before the procedure and underwent follow-up at 30 and 60 days with colour Doppler ultrasound (CDUS) with evaluation of resistive index, glomerular filtration rate (GFR), 24-h blood pressure and serum catecholamine concentration. Student's t test was used to assess the effectiveness of the procedure in lowering blood pressure. In treated patients, mean blood pressure at baseline was 171/100 mmHg [standard deviation (SD) ± 8/10]; mean GFR was 91.6 ml/min/1.73 m(2) (SD ± 15). Blood pressure after the procedure was reduced by -18/-5 and -13/-10 mmHg at 30 and 60 days, respectively, with a mean medication reduction of 3.6. No complications occurred during the intra- or periprocedural period or during short-term follow-up. The Symplicity system proved to be efficacious and without serious adverse events in reducing blood pressure and antihypertensive medication use in patients affected by essential hypertension resistant to medical therapy. Although encouraging, our data are preliminary and need to be validated by larger prospective randomised studies.

  18. A pancreas imaging agent-131I-HIPDM: the animal experiment and preliminary clinical application

    International Nuclear Information System (INIS)

    Shao Hesheng

    1988-01-01

    131 I-HIPDM has been used clinically for studying regional cerebral perfusion. The [ 131 I] HIPDM was prepared in a kit. The labelling yields were consistently more than 95%, as analyzed by the TLC-Silica gel. The labelled compound is stable in vitro and in vivo. S D Strain rats (170-220 g) and mice (18-22 g) were used. The pancreatic uptake of [ 131 I] HIPDM is rather slow in mice and rats. At 8 hr after iv, the pancreas activity and the pancreas to liver (P/L) ratio are highest in mice and rats. The effect of carrier loading dose from 0.010 to 6.0 mg/kg on blodistribution in mice has been studied. The liver uptake was increased by adding carrier HIPDM. The result indicates that administration between 0.010 and 0.05 mg/kg carrier dose is most suitable for the pancreas imaging. Gamma camera imaging of dog at 6 hr after iv with 300 μCi [ 131 I] HIPMD, 0.05 mg/kg body weight showed clear pancreas image. The P/L ratio of the dog is 0.40. Preliminary clinical tests were satisfactory. Using 1 to 1.5 mCi of [ 131 I] HIPDM, 0.05 mg/kg, the pancreas imaging was operated in 4 cases of volunteers and pancreas cyst respectively with the good diagnostic quality. The authors are of the opinion that this pancreas imaging agent may have potential value for routine use

  19. Acquisition procedures, processing methodologies and preliminary results of magnetic and ROV data collected during the TOMO-ETNA experiment

    Directory of Open Access Journals (Sweden)

    Danilo Cavallaro

    2016-09-01

    Full Text Available The TOMO-ETNA experiment was devised for the investigation of the continental and oceanic crust beneath Mt. Etna volcano and northeastern Sicily up to the Aeolian Islands, through an active source study. In this experiment, a large amount of geophysical data was collected both inland and in the Ionian and Tyrrhenian Seas for identifying the major geological and structural features offshore Mt. Etna and NE Sicily. One of the oceanographic cruises organized within the TOMO-ETNA experiment was carried out on the hydrographic vessel “Galatea” by Italian Navy. During the cruise a detailed magnetic survey and a set of ROV (remotely operated vehicle dives were performed offshore Mt. Etna. The magnetic survey allowed the compilation of a preliminary magnetic map revealing a clear direct relationship between volcanic structures and high frequency magnetic anomalies. Significant positive magnetic anomalies were identified offshore the Timpa area and along the easternmost portion of the Riposto Ridge and correlated to a primitive volcanic edifice and to shallow volcanic bodies, respectively. On the whole, the magnetic anomaly map highlights a clear SW-NE decreasing trend, where high amplitude positive magnetic anomaly pattern of the SW sector passes, northeastwardly, to a main negative one. ROV dives permitted to directly explore the shallowest sectors of the Riposto Ridge and to collect several videos and seafloor samples, allowing us to identify some locally developed volcanic manifestations.

  20. Preliminary experience in laparoscopic resection of hepatic hydatidectocyst with the Da Vinci Surgical System (DVSS): a case report.

    Science.gov (United States)

    Zou, Haibo; Luo, Lanyun; Xue, Hua; Wang, Guan; Wang, Xiankui; Luo, Le; Yao, Yutong; Xiang, Guangming; Huang, Xiaolun

    2017-09-11

    At present, Da Vinci robotic assisted hepatectomy has been routinely carried out in conditional units. But there is no report concerning the use of Da Vinci robots for hepatic hydatid cystectomy and experience on this aspect is seldom mentioned before. This study was to summarize the preliminary experience in laparoscopic resection of hepatic hydatidectocyst with the Da Vinci Surgical System (DVSS). A 29-year-old female diagnosed as hepatic hydatid in the right anterior lobe of liver was treated with laparoscopic resection by the DVSS under general anesthesia. Appropriate disposal of tumor cell in vascular system and disinfection of surgical field with hypertonic saline were conducted. The hepatic hydatidectocyst was resected completely with an operation time of 130 min, an intraoperative blood loss of 200 ml and a length of hospital stay for five days. The vital signs of patient were stable and no cyst fluid allergy occurred after operation. Our result showed that laparoscopic resection of hepatic hydatidectocyst by using the DVSS is safe and feasible on the basis of hospitals have rich experience in treatment of cystic echinococcosisliver, resection with DVSS and laparoscopic excision.

  1. Preliminary - discrete fracture network modelling of tracer migration experiments at the SCV site

    International Nuclear Information System (INIS)

    Dershowitz, W.S.; Wallmann, P.; Geier, J.E.; Lee, G.

    1991-09-01

    This report describes a numerical modelling study of solute transport within the Site Characterization and Validation (SCV) block at the Stripa site. The study was carried out with the FracMan/MAFIC package, utilizing statistics from stages 3 and 4 of the Stripa phase 3 Site Characterization and Validation project. Simulations were carried out to calibrate fracture solute transport properties against observations in the first stage of saline injection radar experiments. These results were then used to predict the performance of planned tracer experiments, using both particle tracking network solute transport, and pathways analysis approaches. Simulations were also carried out to predict results of the second stage of saline injection radar experiments. (au) (34 refs.)

  2. Preliminary analysis of surface displacement results in the creepdown irradiation experiment HOBBIE-1

    International Nuclear Information System (INIS)

    Hobson, D.O.

    1979-01-01

    This report presents the results of the eddy-current surface displacement measurements of Zircaloy cladding obtained during the HOBBIE-1 irradiation experiment in the HFR at ECN-Petten, the Netherlands. Raw creepdown data from the test were corrected through the use of reference coils incorporated in the eddy-current coil block in the experiment capsule. The corrected displacement results are compared with out-of-reactor results obtained under nominally identical conditions of pressure and temperature. Experiment HOBBIE-1 was run at 371 0 C and 13.1 MPa specimen external pressure for a total time of approximately 950 h. No gross cladding ovalization was obtained. This result differed from the relatively simple ovality found in the out-of-reactor test. Contact with the internal mandrel occurred between 400 and 500 h, compared with 375 h for a comparable out-of-reactor test. Average diameter decreases for both tests were similar. These results are discussed in detail

  3. The effect of high-resolution orography on numerical modelling of atmospheric flow: a preliminary experiment

    International Nuclear Information System (INIS)

    Scarani, C.; Tampieri, F.; Tibaldi, S.

    1983-01-01

    The effect of increasing the resolution of the topography in models of numerical weather prediction is assessed. Different numerical experiments have been performed, referring to a case of cyclogenesis in the lee of the Alps. From the comparison, it appears that the lower atmospheric levels are better described by the model with higherresolution topography; comparable horizontal resolution runs with smoother topography appear to be less satisfactory in this respect. It turns out also that the vertical propagation of the signal due to the front-mountain interaction is faster in the high-resolution experiment

  4. Preliminary findings of the Viking gas exchange experiment and a model for Martian surface chemistry

    International Nuclear Information System (INIS)

    Oyama, V.I.; Berdahl, B.J.; Carle, G.C.

    1977-01-01

    It is stated that O 2 and CO 2 were evolved from humidified Martian soil in the gas exchange experiment on Viking Lander 1. Small changes in N 2 gas were also recorded. A model of the morphology and a hypothesis of the mechanistics of the Martian surface are proposed. (author)

  5. Norwegian fjords as potential sites for CO{sub 2} experiments. A preliminary feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Golmen, Lars G.; Soerensen, Jan; Haugan, Peter; Bakke, Torgeir; Bjerknes, Vilhelm

    1997-12-31

    Large-scale deposition of CO{sub 2} will probably take place deep in the open oceans. But small-scale experiments on plume dynamics and chemical or biological impacts are more conveniently performed in Norwegian fjords. This report describes a feasibility study treating the physical, biological and legal constraints upon such experiments. Several small and large fjord basins with depths exceeding 500 m exist in western Norway. The report gives guidelines to what further steps should be taken to establish an in-situ CO{sub 2} experiment in a fjord. Twenty-six different basins have been identified in terms of maximum depths, municipal adherence etc. Deep water hydrographic conditions vary relatively little from one fjord to another. Data on the dynamical states and on deep water biology are in general lacking and a baseline study on selected fjords should be performed prior to the final selection. User conflicts and legal aspects must be considered and a complete EIA study will probably be required before any CO{sub 2} experiment can be started in a fjord. 60 refs., 13 figs.

  6. Student Satisfaction or Happiness?: A Preliminary Rethink of What Is Important in the Student Experience

    Science.gov (United States)

    Dean, Aftab; Gibbs, Paul

    2015-01-01

    Purpose: This paper aims to investigate the purpose of the complex open system of higher education and to explore this transformative experience as personal flourishing, where students come to terms with a way of being, matching their potentiality with their agency and leading to profound happiness. There is influential, but not uncontested…

  7. Visual Research Methods: A Novel Approach To Understanding The Experiences of Compulsive Hoarders: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Satwant Singh

    2012-04-01

    Conclusion: The study concluded that the experience of hoarding is both psychologically and physically distressing with numerous impacts upon everyday living and relationships. The study also concluded that visual research methods may be particularly helpful when generating qualitative evidence within this specialist field. [JCBPR 2012; 1(1.000: 36-42

  8. Preliminary results from a simulated laboratory experiment or an encounter of cluster satellite probes with a reconnection layer

    Science.gov (United States)

    Yamada, M.; Ren, Y.; Ji, H.; Gerhardt, S.; Darfman, S.

    2006-12-01

    With the recent upgrade of the MRX (Magnetic Reconnection Experiment) device[1], our experimental operation allows us to carry out a jog experiment in which a current sheet can be moved swiftly across an inserted probe assembly. A cluster of probes with variable distances can be inserted into a known desired position in the MRX device. This setup can be similar to the situation in which a cluster of satellites encounters a rapidly moving reconnection layer. If necessary, we can create a neutral sheet where the density of one side is significantly higher than the other, as is the case for the magnetopause. A variable guide field will be applied to study its effect on reconnection. We proposed[2] to document basic patterns of data during a simulated encounter of the MRX reconnection layer with the four-probe mock-up system and compare them with data acquired from past satellites. Relative position of the MMS satellites in the magnetosphere can then be determined. Optimum cluster configuration or distance between the four satellites can be determined for various diagnostics or research missions. The relationship of magnetic fluctuations[3] with the observed out-of- plane quadrupole field, a characteristic signature of the Hall MHD, can be also studied in this series of experiments. In this paper, results from a preliminary experiment will be presented. These experiments utilize effectively the unique MRX ability to accurately know the location of diagnostics with respect to the moving reconnection layer. Supported by DoE, NASA, NSF. [1] M. Yamada et al, Phys. Plasmas 13, 052119 (2006), [2] M.Yamada et al, MMS-IDS proposal (2006), [3] H. Ji et al, Phys. Rev. Letts. 92, 115001 (2004)

  9. Characterize Behaviour of Emerging Pollutants in Artificial Recharge: Column Experiments - Experiment Design and Results of Preliminary Tests

    Science.gov (United States)

    Wang, H.; Carrera, J.; Ayora, C.; Licha, T.

    2012-04-01

    Emerging pollutants (EPs) have been detected in water resources as a result of human activities in recent years. They include pharmaceuticals, personal care products, dioxins, flame retardants, etc. They are a source of concern because many of them are resistant to conventional water treatment, and they are harmful to human health, even in low concentrations. Generally, this study aims to characterize the behaviour of emerging pollutants in reclaimed water in column experiments which simulates artificial recharge. One column set includes three parts: influent, reactive layer column (RLC) and aquifer column (AC). The main influent is decided to be Secondary Effluent (SE) of El Prat Wastewater Treatment Plant, Barcelona. The flow rate of the column experiment is 0.9-1.5 mL/min. the residence time of RLC is designed to be about 1 day and 30-40 days for AC. Both columns are made of stainless steel. Reactive layer column (DI 10cm * L55cm) is named after the filling material which is a mixture of organic substrate, clay and goethite. One purpose of the application of the mixture is to increase dissolve organic carbon (DOC). Leaching test in batchs and columns has been done to select proper organic substrate. As a result, compost was selected due to its long lasting of releasing organic matter (OM). The other purpose of the application of the mixture is to enhance adsorption of EPs. Partition coefficients (Kow) of EPs indicate the ability of adsorption to OM. EPs with logKow>2 could be adsorbed to OM, like Ibuprofen, Bezafibrate and Diclofenac. Moreover, some of EPs are charged in the solution with pH=7, according to its acid dissociation constant (Ka). Positively charged EPs, for example Atenolol, could adsorb to clay. In the opposite, negatively charged EPs, for example Gemfibrozil, could adsorb to goethite. Aquifer column (DI 35cm * L1.5m) is to simulate the processes taking place in aquifer in artificial recharge. The filling of AC has two parts: silica sand and

  10. Zero-gravity cloud physics laboratory: Candidate experiments definition and preliminary concept studies

    Science.gov (United States)

    Eaton, L. R.; Greco, R. V.; Hollinden, A. B.

    1973-01-01

    The candidate definition studies on the zero-g cloud physics laboratory are covered. This laboratory will be an independent self-contained shuttle sortie payload. Several critical technology areas have been identified and studied to assure proper consideration in terms of engineering requirements for the final design. Areas include chambers, gas and particle generators, environmental controls, motion controls, change controls, observational techniques, and composition controls. This unique laboratory will allow studies to be performed without mechanical, aerodynamics, electrical, or other type techniques to support the object under study. This report also covers the candidate experiment definitions, chambers and experiment classes, laboratory concepts and plans, special supporting studies, early flight opportunities and payload planning data for overall shuttle payload requirements assessments.

  11. Preliminary experiments for measuring Kd values for cesium and strontium. To be used in site evaluations

    International Nuclear Information System (INIS)

    Benischek, I.; Hess, V.; Metzker, E.

    1992-03-01

    In an underground dump not only technolgical barriers but also the natural geological formations are efficient in withholding radionuclides. Sites are to be chosen where the rocks have good sorption properties and where transportation due to various chemical interactions should be minimal. Minerals obtained from deep drilling - granodiorite, mylonite and granit gneis - were investigated. The liquid phase (cement leaching water) contained different amounts of cesium 137 and strontium 85. Details of the experiments and results are given

  12. An association study of 13 SNPs from seven candidate genes with pediatric asthma and a preliminary study for genetic testing by multiple variants in Taiwanese population.

    Science.gov (United States)

    Wang, Jiu-Yao; Liou, Ya-Huei; Wu, Ying-Jye; Hsiao, Ya-Hsin; Wu, Lawrence Shih-Hsin

    2009-03-01

    Asthma is one of the most common chronic diseases in children. It is caused by complex interactions between various genetic factors and exposures to environmental allergens and irritants. Because of the heterogeneity of the disease and the genetic and cultural differences among different populations, a proper association study and genetic testing for asthma and susceptibility genes is difficult to perform. We assessed 13 single-nucleotide polymorphisms (SNPs) in seven well-known asthma susceptibility genes and looked for association with pediatric asthma using 449 asthmatic subjects and 512 non-asthma subjects in Taiwanese population. CD14-159 C/T and MS4A2 Glu237Gly were identified to have difference in genotype/allele frequencies between the control group and asthma patients. Moreover, the genotype synergistic analysis showed that the co-contribution of two functional SNPs was riskier or more protective from asthma attack. Our study provided a genotype synergistic method for studying gene-gene interaction on polymorphism basis and genetic testing using multiple polymorphisms.

  13. Application of Cardio-O-Fix occluders for transcatheter closure of patent ductus arteriosus and interatrial communications: Preliminary experience.

    Science.gov (United States)

    Białkowski, Jacek; Szkutnik, Małgorzata; Fiszer, Roland; Głowacki, Jan; Banaszak, Paweł; Zembala, Marian

    2010-01-01

    Transcatheter treatment has become the method of choice for treating many heart defects. Recently, Cardio-O-Fix occluder (COF) - a new, self-expandable nitinol wire-mesh device very similar to the Amplatzer device - has been introduced into clinical practice. To the best of our knowledge, this is the first publication related to its application. Five patients aged from six months to 69 years were included in the study: two with atrial septal defect (ASD), one with patent foramen ovale (PFO) after cryptogenic stroke, and two with patent ductus arteriosus (PDA). These latter two comprised one six month old infant with co-existent hypertrophied cardiomyopathy, and a 53 year-old woman with recanalized PDA after previous ligation. All were treated percutaneously with COF. There was no preliminary patient selection. The only limitation was the size of the devices in our possession (16 and 22 mm ASD COF, 25 PFO COF, 4/6 and 6/8 PDA COF). The implantation technique was the same as previously described for Amplatzer occluders. All procedures were finished successfully with complete closure of the shunt. No complications were observed during a six month follow-up. In the child with PDA, we observed decrease of gradient from 80 to 60 mm Hg in hypertrophied left ventricular outflow tract, although a small protrusion of PDA-COF device was noted in the descending aorta (8 mm Hg gradient in ECHO). In the patient with recanalized PDA, the procedure was performed after arterio-venous loop creation. Mean fluoroscopy time was 4.4 (range from 1.6 to 11) minutes. Our preliminary experience indicates that the application of Cardio-O-Fix devices is safe and effective.

  14. TMOD-05. MOLECULAR CHARACTERIZATION OF ORTHOTOPIC PATIENT-DERIVED XENOGRAFT MODELS OF PEDIATRIC BRAIN TUMORS AND THEIR USE IN PRECLINICAL EXPERIMENTS

    Science.gov (United States)

    Brabetz, Sebastian; Schmidt, Christin; Groebner, Susanne N.; Mack, Norman; Seker-Cin, Huriye; Jones, David T.W.; Chavez, Lukas; Milde, Till; Witt, Olaf; Leary, Sarah E.; Li, Xiao-Nan; Wechsler-Reya, Robert J.; Olson, James M.; Pfister, Stefan M.; Kool, Marcel

    2017-01-01

    Abstract Genomic studies have shown that multiple molecular subtypes of pediatric brain tumors exist that are biologically and clinically highly distinct. These findings ask for novel subtype specific treatments. To develop these we need more and better preclinical models that correctly reflect the proper tumor (sub)type. Orthotopic patient-derived xenograft (PDX) models generated by intracranial injection of primary patient material into the brain of NSG mice offer the unique possibility to test novel substances in primary patient tissue in an in vivo environment. Prior to drug selection and testing, extensive molecular characterizations of PDX and matching primary tumor/blood (DNA methylation, DNA sequencing, and gene expression) are needed to see how the PDX represents the original disease and to learn about targetable oncogenic drivers in each model. In collaboration with several groups around the world we have generated and fully characterized thus far 75 PDX models reflecting 15 distinct subtypes of pediatric brain cancer. PDX models always retain their molecular subtype and in the vast majority of cases also mutations and copy number alterations compared to matching primary tumors. Most aggressive tumors, harboring MYC(N) amplifications, are overrepresented in the cohort, but also subtypes which have not been available for preclinical testing before due to lack of genetically engineered mouse models or suitable cell lines, such as Group 4 medulloblastoma, are included. All models and corresponding molecular data will become available for the community for preclinical research. Examples of such preclinical experiments will be presented. PDX models of pediatric brain tumors are still quite rare. Our repertoire of PDX models and corresponding molecular characterizations allow researchers all over the world to find the right models for their specific scientific questions. It will provide an unprecedented resource to study tumor biology and pave the way for

  15. Presentation, Management, and Outcome of Thyroglossal Duct Cysts in Adult and Pediatric Populations: A 14-Year Single Center Experience

    Directory of Open Access Journals (Sweden)

    Hassan Al-Thani

    2016-07-01

    Full Text Available Objectives: A thyroglossal duct cyst (TDC is a frequent congenital midline anomaly of the neck that usually manifests during the first decade of life. We aimed to describe the presentation, management, and outcome of TDC in pediatric and adult cases. Methods: A retrospective observational analysis was conducted for all patients diagnosed and treated for TDC between 2000 and 2014 in a single center in Qatar. Data included patients’ demographics, presentations, preoperative investigations, anesthesia type, histopathological findings, surgical management, recurrences, and complications. Results: We identified 102 patients, of which 57% were males. The mean age of patients was 20.2±15.6 years. A bimodal distribution of TDC has been observed, which peaked between the ages of 6–13 years and at ≥19 years. The preoperative evaluation mainly includes ultrasonography (66%, thyroid function test (44%, and fine-needle aspiration cytology (10%. The median size of the cyst was 25 (2–60 mm. Patients mainly presented with an asymptomatic midline neck mass at or below the hyoid bone (82%, followed by fistula (9%, infection (2%, and dysphagia (2%. Eighty-nine cases were identified preoperatively as TDC. The histopathological findings confirmed TDC with hyoid bone in 61 cases, and TDC alone in 38 cases. Eighty patients underwent the Sistrunk procedure while excision of TDC alone was observed in 18 cases. Five cases of recurrent disease were also treated. Adults had a greater median cyst size (30 (9–60 vs. 22 (2–55 mm; p = 0.005 and required prolonged operation time (69 (1–169 vs. 32.5 (1–140 mins; p = 0.004 compared to the pediatric group. Conclusion: The occurrence of TDC shows a bimodal age distribution. Preoperative evaluation and time for surgery vary whereas clinical presentations, surgical management, and postoperative outcomes are comparable among adult and pediatric groups. Ultrasonography is the preferred diagnostic modality, and the

  16. Global atmospheric response to specific linear combinations of the main SST modes. Part I: numerical experiments and preliminary results

    Directory of Open Access Journals (Sweden)

    S. Trzaska

    1996-10-01

    Full Text Available This article investigates through numerical experiments the controversial question of the impact of El Niño-Southern Oscillation (ENSO phenomena on climate according to large-scale and regional-scale interhemispheric thermal contrast. Eight experiments (two considering only inversed Atlantic thermal anomalies and six combining ENSO warm phase with large-scale interhemispheric contrast and Atlantic anomaly patterns were performed with the Météo-France atmospheric general circulation model. The definition of boundary conditions from observed composites and principal components is presented and preliminary results concerning the month of August, especially over West Africa and the equatorial Atlantic are discussed. Results are coherent with observations and show that interhemispheric and regional scale sea-surface-temperature anomaly (SST patterns could significantly modulate the impact of ENSO phenomena: the impact of warm-phase ENSO, relative to the atmospheric model intercomparison project (AMIP climatology, seems stronger when embedded in global and regional SSTA patterns representative of the post-1970 conditions [i.e. with temperatures warmer (colder than the long-term mean in the southern hemisphere (northern hemisphere]. Atlantic SSTAs may also play a significant role.

  17. In gas laser ionization and spectroscopy experiments at the Superconducting Separator Spectrometer (S3): Conceptual studies and preliminary design

    International Nuclear Information System (INIS)

    Ferrer, R.; Bastin, B.; Boilley, D.; Creemers, P.; Delahaye, P.; Liénard, E.; Fléchard, X.; Franchoo, S.; Ghys, L.; Huyse, M.; Kudryavtsev, Yu.; Lecesne, N.; Lu, H.; Lutton, F.; Mogilevskiy, E.; Pauwels, D.; Piot, J.; Radulov, D.; Rens, L.; Savajols, H.

    2013-01-01

    Highlights: • A setup to perform In-Gas Laser Ionization and Spectroscopy experiments at the Super Separator Spectrometer is presented. • The reported studies address important aspects necessary to applied the IGLIS technique to short-lived isotopes. • An R and D phase required to reach an enhanced spectral resolution will be carried out at KU Leuven. • High-sensitivity and enhanced-resolution laser spectroscopy studies will be possible with the IGLIS setup at S 3 . -- Abstract: The results of preparatory experiments and the preliminary designs of a new in-gas laser ionization and spectroscopy setup, to be coupled to the Super Separator Spectrometer S 3 of SPIRAL2-GANIL, are reported. Special attention is given to the development and tests to carry out a full implementation of the in-gas jet laser spectroscopy technique. Application of this novel technique to radioactive species will allow high-sensitivity and enhanced-resolution laser spectroscopy studies of ground- and excited-state properties of exotic nuclei

  18. Simple Carotid-Sparing Intensity-Modulated Radiotherapy Technique and Preliminary Experience for T1-2 Glottic Cancer

    International Nuclear Information System (INIS)

    Rosenthal, David I.; Fuller, Clifton D.; Barker, Jerry L.; Mason, Bryan M.S.; Garcia, John A. C.; Lewin, Jan S.; Holsinger, F. Christopher; Stasney, C. Richard; Frank, Steven J.; Schwartz, David L.; Morrison, William H.; Garden, Adam S.; Ang, K. Kian

    2010-01-01

    Purpose: To investigate the dosimetry and feasibility of carotid-sparing intensity-modulated radiotherapy (IMRT) for early glottic cancer and to report preliminary clinical experience. Methods and Materials: Digital Imaging and Communications in Medicine radiotherapy (DICOM-RT) datasets from 6 T1-2 conventionally treated glottic cancer patients were used to create both conventional IMRT plans. We developed a simplified IMRT planning algorithm with three fields and limited segments. Conventional and IMRT plans were compared using generalized equivalent uniform dose and dose-volume parameters for in-field carotid arteries, target volumes, and organs at risk. We have treated 11 patients with this simplified IMRT technique. Results: Intensity-modulated radiotherapy consistently reduced radiation dose to the carotid arteries (p < 0.05) while maintaining the clinical target volume coverage. With conventional planning, median carotid V35, V50, and V63 were 100%, 100%, and 69.0%, respectively. With IMRT planning these decreased to 2%, 0%, and 0%, respectively (p < 0.01). Radiation planning and treatment times were similar for conventional radiotherapy and IMRT. Treatment results have been excellent thus far. Conclusions: Intensity-modulated radiotherapy significantly reduced unnecessary radiation dose to the carotid arteries compared with conventional lateral fields while maintaining clinical target volume coverage. Further experience and longer follow-up will be required to demonstrate outcomes for cancer control and carotid artery effects.

  19. Elevated source SF6-tracer dispersion experiments in the Copenhagen area. Preliminary results II

    International Nuclear Information System (INIS)

    Gryning, S.E.; Lyck, E.

    1980-01-01

    The results from 10 experiments, performed in neutral to unstable meteorological conditions, are reported from an ongoing series of elevated-source, urban-scale tracer dispersion experiments in the Copenhagen area. The tracer is released at a height of 115 m from the TV-tower in GLADSAXE, a suburb of Copenhagen, with tracer sampling units positioned at ground-level in 1 to 3 crosswind series, 2 to 6 km downwind of the tower. The lateral dispersion parameter, sigma(y), was estimated from the measured tracer concentration distribution and compared with values of sigma(y), computed by 1) methods based on wind variance measured during the experiments and 2) methods based on a stability classification of the atmospheric conditions. The wind-variance based methods proved superior in predicting the variation of sigma(y) compared with the stability based methods. Moreover, some of the former methods produced significantly biased estimates of sigma(y). The measured tracer concentration distributions were also crosswind integrated, chi(CWI). Estimates of chi(CWI) were computed using sigma (z) -values derived from the aforementioned computations assuming a Gaussian-type vertical tracer concentration distribution. A comparison is measured and calculated values of chi(CWI) showed no significant differences in the ability of the methods to predict the variation of chi(CWI). Only one method, the EPA, came out with a mean fractional error outside the range +-20% which constitutes the uncertainty in the absolute tracer concentration associated with the calibration of the gas chromatograph for tracer analysis

  20. Silent game as Model for Examining Student Online Creativity - Preliminary Results from an Experiment

    DEFF Research Database (Denmark)

    Sørensen, Jannick Kirk

    2016-01-01

    The ERASMUS+ project “OnCreate” aims at improving online mediated creative collaboration among students. But what are the differences between collaboration online and in a face-to-face setting in terms of creative processes? Theories on media richness and collaborative creativity can provide...... the creative dialogues developed through a very constrained communicative environment. The participants could only communicate their creative ideas by placing standard LEGO bricks on a plate. No talking or any other communication was allowed. The game used in the experiment is an adoption of the so...

  1. Age-related change in emotional experience in a sample of Chinese adults: a preliminary study.

    Science.gov (United States)

    Shi, Zhanbiao; Wang, Li; Li, Huanhuan

    2009-08-01

    Age-related change in emotional experience was explored in a Chinese community sample. 968 healthy adults (483 women, 485 men) ranging in age from 18 to 66 years (M = 37.5, SD = 12.3) took part. The frequency of experiencing negative and positive emotion was self-reported on the general dimension scales of Positive and Negative Affect Scale-Expanded Form (PANAS-X). Regression analyses indicated that the frequency of negative affect decreased with age, and the frequency of positive affect was not significantly associated with age. These findings are similar to those found in Western samples, as discussed in relation to socioemotional selectivity theory.

  2. The AAEC rotamak experiment description and preliminary results at low input power

    International Nuclear Information System (INIS)

    Durance, G.; Hogg, G.R.; Tendys, J.

    1984-12-01

    A description is given of the initial experiments on a rotamak device operating with 10 kW input power at a frequency of 1.85 MHz. The experimental apparatus and the diagnostic systems are also described. The matching of the radiofrequency power sources to the drive coils is discussed and details are given of the results from discharges in hydrogen, deuterium, helium and argon. The plasma/magnetic field configuration appears to be stable although, under certain conditions, fluctuations of the magnetic field structure have been observed

  3. Add-On Therapy with Ertapenem in Infections with Multidrug Resistant Gram-Negative Bacteria: Pediatric Experience

    Directory of Open Access Journals (Sweden)

    Sevgen Tanır Basaranoglu

    2017-01-01

    Full Text Available Optimal therapy for infections with carbapenem resistant GNB is not well established due to the weakness of data. Patients presenting with bloodstream infections caused by multidrug resistant Klebsiella pneumoniae were treated with a combination treatment. Optimal therapy for infections with carbapenem resistant Gram-negative bacteria is a serious problem in pediatric patients. We presented three cases who were successfully treated with addition of ertapenem to the combination treatment for bacteremia with multidrug resistant Klebsiella pneumoniae. Dual carbapenem treatment approach is a new approach for these infections and requires more data in children.

  4. Integrated laboratory scale demonstration experiment of the hybrid sulphur cycle and preliminary scale-up

    International Nuclear Information System (INIS)

    Leybros, J.; Rivalier, P.; Saturnin, A.; Charton, S.

    2010-01-01

    The hybrid sulphur cycle is today one of the most promising processes to produce hydrogen on a massive scale within the scope of high temperature nuclear reactors development. Thus, the Fuel Cycle Technology Department at CEA Marcoule is involved in studying the hybrid sulphur process from a technical and economical performance standpoint. Based on mass and energy balance calculations, a ProsimPlus TM flow sheet and a commercial plant design were prepared. This work includes a study on sizing of the main equipment. The capital cost has been estimated using the major characteristics of main equipment based upon formulae and charts published in literature. A specific approach has been developed for electrolysers. Operational costs are also proposed for a plant producing 1000 mol/s H 2 . Bench scale and pilot experiments must focus on the electrochemical step due to limited experimental data. Thus, a pilot plant with a hydrogen capacity of 100 NL/h was built with the aim of acquiring technical and technological data for electrolysis. This pilot plant was designed to cover a wide range of operating conditions: sulphuric acid concentrations up to 60 wt.%, temperatures up to 100 deg. C and pressures up to 10 bar. New materials and structures recently developed for fuel cells, which are expected to yield significant performance improvements when applied to classical electrochemical processes, will be tested. All experiments will be coupled with phenomenological simulation tools developed jointly with the experimental programme. (authors)

  5. Preliminary study of kaonic deuterium X-rays by the SIDDHARTA experiment at DAΦNE

    Energy Technology Data Exchange (ETDEWEB)

    Bazzi, M. [INFN, Laboratori Nazionali di Frascati, C.P. 13, Via E. Fermi 40, I-00044 Frascati (Roma) (Italy); Beer, G. [Department of Physics and Astronomy, University of Victoria, P.O. Box 3055, Victoria BC V8W3P6 (Canada); Berucci, C. [Stefan-Meyer-Institut für subatomare Physik, Boltzmanngasse 3, 1090 Wien (Austria); INFN, Laboratori Nazionali di Frascati, C.P. 13, Via E. Fermi 40, I-00044 Frascati (Roma) (Italy); Bombelli, L. [Politecnico di Milano, Dipartimento di Elettronica e Informazione, Piazza L. da Vinci 32, I-20133 Milano (Italy); Bragadireanu, A.M. [INFN, Laboratori Nazionali di Frascati, C.P. 13, Via E. Fermi 40, I-00044 Frascati (Roma) (Italy); IFIN-HH, Institutul National pentru Fizica si Inginerie Nucleara Horia Hulubei, Reactorului 30, Magurele (Romania); Cargnelli, M., E-mail: michael.cargnelli@oaaw.ac.at [Stefan-Meyer-Institut für subatomare Physik, Boltzmanngasse 3, 1090 Wien (Austria); Curceanu, C.; D' Uffizi, A. [INFN, Laboratori Nazionali di Frascati, C.P. 13, Via E. Fermi 40, I-00044 Frascati (Roma) (Italy); Fiorini, C.; Frizzi, T. [Politecnico di Milano, Dipartimento di Elettronica e Informazione, Piazza L. da Vinci 32, I-20133 Milano (Italy); Ghio, F. [INFN Sezione di Roma I and Instituto Superiore di Sanita, I-00161 Roma (Italy); Guaraldo, C. [INFN, Laboratori Nazionali di Frascati, C.P. 13, Via E. Fermi 40, I-00044 Frascati (Roma) (Italy); Hayano, R. [University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo (Japan); Iliescu, M. [INFN, Laboratori Nazionali di Frascati, C.P. 13, Via E. Fermi 40, I-00044 Frascati (Roma) (Italy); Ishiwatari, T. [Stefan-Meyer-Institut für subatomare Physik, Boltzmanngasse 3, 1090 Wien (Austria); Iwasaki, M. [RIKEN, Institute of Physical and Chemical Research, 2-1 Hirosawa, Wako, Saitama 351-0198 (Japan); and others

    2013-06-03

    The study of the K{sup ¯}N system at very low energies plays a key role for the understanding of the strong interaction between hadrons in the strangeness sector. At the DAΦNE electron–positron collider of Laboratori Nazionali di Frascati we studied kaonic atoms with Z=1 and Z=2, taking advantage of the low-energy charged kaons from Φ-mesons decaying nearly at rest. The SIDDHARTA experiment used X-ray spectroscopy of the kaonic atoms to determine the transition yields and the strong interaction induced shift and width of the lowest experimentally accessible level (1s for H and D and 2p for He). Shift and width are connected to the real and imaginary part of the scattering length. To disentangle the isospin dependent scattering lengths of the antikaon–nucleon interaction, measurements of K{sup −}p and of K{sup −}d are needed. We report here on an exploratory deuterium measurement, from which a limit for the yield of the K-series transitions was derived: Y(K{sub tot})<0.0143 and Y(K{sub α})<0.0039 (CL 90%). Also, the upcoming SIDDHARTA-2 kaonic deuterium experiment is introduced.

  6. Aespoe Pillar Stability Experiment. Final coupled 3D thermo-mechanical modeling. Preliminary particle mechanical modeling

    International Nuclear Information System (INIS)

    Wanne, Toivo; Johansson, Erik; Potyondy, David

    2004-02-01

    SKB is planning to perform a large-scale pillar stability experiment called APSE (Aespoe Pillar Stability Experiment) at Aespoe HRL. The study is focused on understanding and control of progressive rock failure in hard crystalline rock and damage caused by high stresses. The elastic thermo-mechanical modeling was carried out in three dimensions because of the complex test geometry and in-situ stress tensor by using a finite-difference modeling software FLAC3D. Cracking and damage formation were modeled in the area of interest (pillar between two large scale holes) in two dimensions by using the Particle Flow Code (PFC), which is based on particle mechanics. FLAC and PFC were coupled to minimize the computer resources and the computing time. According to the modeling the initial temperature rises from 15 deg C to about 65 deg C in the pillar area during the heating period of 120 days. The rising temperature due to thermal expansion induces stresses in the pillar area and after 120 days heating the stresses have increased about 33% from the excavation induced maximum stress of 150 MPa to 200 MPa in the end of the heating period. The results from FLAC3D model showed that only regions where the crack initiation stress has exceeded were identified and they extended to about two meters down the hole wall. These could be considered the areas where damage may occur during the in-situ test. When the other hole is pressurized with a 0.8 MPa confining pressure it yields that 5 MPa more stress is needed to damage the rock than without confining pressure. This makes the damaged area in some degree smaller. High compressive stresses in addition to some tensile stresses might induce some AE (acoustic emission) activity in the upper part of the hole from the very beginning of the test and are thus potential areas where AE activities may be detected. Monitoring like acoustic emissions will be measured during the test execution. The 2D coupled PFC-FLAC modeling indicated that

  7. Aespoe Pillar Stability Experiment. Final coupled 3D thermo-mechanical modeling. Preliminary particle mechanical modeling

    Energy Technology Data Exchange (ETDEWEB)

    Wanne, Toivo; Johansson, Erik; Potyondy, David [Saanio and Riekkola Oy, Helsinki (Finland)

    2004-02-01

    SKB is planning to perform a large-scale pillar stability experiment called APSE (Aespoe Pillar Stability Experiment) at Aespoe HRL. The study is focused on understanding and control of progressive rock failure in hard crystalline rock and damage caused by high stresses. The elastic thermo-mechanical modeling was carried out in three dimensions because of the complex test geometry and in-situ stress tensor by using a finite-difference modeling software FLAC3D. Cracking and damage formation were modeled in the area of interest (pillar between two large scale holes) in two dimensions by using the Particle Flow Code (PFC), which is based on particle mechanics. FLAC and PFC were coupled to minimize the computer resources and the computing time. According to the modeling the initial temperature rises from 15 deg C to about 65 deg C in the pillar area during the heating period of 120 days. The rising temperature due to thermal expansion induces stresses in the pillar area and after 120 days heating the stresses have increased about 33% from the excavation induced maximum stress of 150 MPa to 200 MPa in the end of the heating period. The results from FLAC3D model showed that only regions where the crack initiation stress has exceeded were identified and they extended to about two meters down the hole wall. These could be considered the areas where damage may occur during the in-situ test. When the other hole is pressurized with a 0.8 MPa confining pressure it yields that 5 MPa more stress is needed to damage the rock than without confining pressure. This makes the damaged area in some degree smaller. High compressive stresses in addition to some tensile stresses might induce some AE (acoustic emission) activity in the upper part of the hole from the very beginning of the test and are thus potential areas where AE activities may be detected. Monitoring like acoustic emissions will be measured during the test execution. The 2D coupled PFC-FLAC modeling indicated that

  8. Predictive models applied to groundwater level forecasting: a preliminary experience on the alluvial aquifer of the Magra River (Italy).

    Science.gov (United States)

    Brozzo, Gianpiero; Doveri, Marco; Lelli, Matteo; Scozzari, Andrea

    2010-05-01

    Computer-based decision support systems are getting a growing interest for water managing authorities and water distribution companies. This work discusses a preliminary experience in the application of computational intelligence in a hydrological modeling framework, regarding the study area of the alluvial aquifer of the Magra River (Italy). Two sites in the studied area, corresponding to two distinct groups of wells (Battifollo and Fornola) are managed by the local drinkable water distribution company (ACAM Acque), which serves the area of La Spezia, on the Ligurian coast. Battifollo has 9 wells with a total extraction rate of about 240 liters per second, while Fornola has 44 wells with an extraction rate of about 900 liters per second. Objective of this work is to make use of time series coming from long-term monitoring activities in order to assess the trend of the groundwater level with respect to a set of environmental and exploitation parameters; this is accomplished by the experimentation of a suitable model, eligible to be used as a predictor. This activity moves on from the modeling of the system behavior, based on a set of Input/Output data, in order to characterize it without necessarily a prior knowledge of any deterministic mechanism (system identification). In this context, data series collected by continuous hydrological monitoring instrumentation installed in the studied sites, together with meteorological and water extraction data, have been analyzed in order to assess the applicability and performance of a predictive model of the groundwater level. A mixed approach (both data driven and process-based) has been experimented on the whole dataset relating to the last ten years of continuous monitoring activity. The system identification approach presented here is based on the integration of an adaptive technique based on Artificial Neural Networks (ANNs) and a blind deterministic identification approach. According to this concept, the behavior of

  9. Preliminary experiments using light-initiated high explosive for driving thin flyer plates

    International Nuclear Information System (INIS)

    Benham, R.A.

    1980-02-01

    Light-initiated high explosive, silver acelytide - silver-nitrate (SASN), has been used to produce simulated x ray blow-off impulse loading on reentry vehicles to study the system structural response. SASN can be used to accelerate thin flyer plates to high terminal velocities which, in turn, can deliver a pressure pulse that can be tailored to the target material. This process is important for impulse tests where both structural and material response is desired. The theories used to calculate the dynamic state of the flyer plate prior to impact are summarized. Data from several experiments are presented which indicate that thin flyer plates can be properly accelerated and that there are predictive techniques available which are adequate to calculate the motion of the flyer plate. Recommendations are made for future study that must be undertaken to make the SASN flyer plate technique usable

  10. Preliminary analysis of the MER magnetic properties experiment using a computational fluid dynamics model

    DEFF Research Database (Denmark)

    Kinch, K.M.; Merrison, J.P.; Gunnlaugsson, H.P.

    2006-01-01

    Motivated by questions raised by the magnetic properties experiments on the NASA Mars Pathfinder and Mars Exploration Rover (MER) missions, we have studied in detail the capture of airborne magnetic dust by permanent magnets using a computational fluid dynamics (CFD) model supported by laboratory...... simulations. The magnets studied are identical to the capture magnet and filter magnet on MER, though results are more generally applicable. The dust capture process is found to be dependent upon wind speed, dust magnetization, dust grain size and dust grain mass density. Here we develop an understanding...... of how these parameters affect dust capture rates and patterns on the magnets and set bounds for these parameters based on MER data and results from the numerical model. This results in a consistent picture of the dust as containing varying amounts of at least two separate components with different...

  11. Impact into the earth's ocean floor - Preliminary experiments, a planetary model, and possibilities for detection

    Science.gov (United States)

    Mckinnon, W. B.

    1982-01-01

    Impact processes and plate tectonics are invoked in an experimental study of craters larger than 100 km in diameter on the ocean floor. Although the results obtained from 22-caliber (383 m/sec) ammunition experiments using dense, saturated sand as a target medium cannot be directly scaled to large events, the phenomenology exhibited is that expected of actual craters on the ocean floor: steep, mixed ejecta plume, gravitational adjustment of the crater to form a shallow basin, and extensive reworking of the ejecta, rim, and floor materials by violent collapse of the transient water cavity. Excavation into the mantle is predicted, although asthenospheric influence on outer ring formation is not. The clearest geophysical signature of such a crater is not topography; detection should instead be based on gravity and geoid anomalies due to uplift of the Moho, magnetic anomalies, and seismic resolution of the Moho uplift and crater formation fault planes.

  12. Preliminary results of the Artemia salina experiments in biostack on LDEF

    International Nuclear Information System (INIS)

    Graul, E.H.; Ruether, W.; Hiendl, C.O.

    1992-01-01

    The mosaic egg of the brine shrimp, Artemia salina, resting in blastula or gastrula state represents a system that during further development, proceeds without any further development to the larval stage, the free swimming nauplius. Therefore, injury to a single cell of the egg will be manifest in the larvae. In several experiments, it was shown that the passage of a single heavy ion through the shrimp egg damaged a cellular area large enough to disturb either embryogenesis or further development of the larvae, or the integrity of the adult individual. Emergence from the egg shell was heavily disturbed by the heavy ions as was hatching. Additional late effects, due to a hit by a heavy ion, are delayed of growth and of sexual maturity, and reduced fertility. Anomalies in the body and the extremities could be observed more frequently for the nauplii which had developed from eggs hit by heavy ions

  13. Preliminary characterization of materials for a reactive transport model validation experiment

    International Nuclear Information System (INIS)

    Siegel, M.D.; Ward, D.B.; Cheng, W.C.; Bryant, C.; Chocas, C.S.; Reynolds, C.G.

    1993-01-01

    The geochemical properties of a porous sand and several tracers (Ni, Br, and Li) have been characterized for use in a caisson experiment designed to validate sorption models used in models of inactive transport. The surfaces of the sand grains have been examined by a combination of techniques including potentiometric titration, acid leaching, optical microscopy, and scanning electron microscopy with energy-dispersive spectroscopy. The surface studies indicate the presence of small amounts of carbonate, kaolinite and iron-oxyhydroxides. Adsorption of nickel, lithium and bromide by the sand was measured using batch techniques. Bromide was not sorbed by the sand. A linear (K d ) or an isotherm sorption model may adequately describe transport of Li; however, a model describing the changes of pH and the concentrations of other solution species as a function of time and position within the caisson and the concomitant effects on Ni sorption may be required for accurate predictions of nickel transport

  14. Purification, crystallization and preliminary X-ray diffraction experiment of nattokinase from Bacillus subtilis natto.

    Science.gov (United States)

    Yanagisawa, Yasuhide; Chatake, Toshiyuki; Chiba-Kamoshida, Kaori; Naito, Sawa; Ohsugi, Tadanori; Sumi, Hiroyuki; Yasuda, Ichiro; Morimoto, Yukio

    2010-12-01

    Nattokinase is a single polypeptide chain composed of 275 amino acids (molecular weight 27,724) which displays strong fibrinolytic activity. Moreover, it can activate other fibrinolytic enzymes such as pro-urokinase and tissue plasminogen activator. In the present study, native nattokinase from Bacillus subtilis natto was purified using gel-filtration chromatography and crystallized to give needle-like crystals which could be used for X-ray diffraction experiments. The crystals belonged to space group C2, with unit-cell parameters a=74.3, b=49.9, c=56.3 Å, β=95.2°. Diffraction images were processed to a resolution of 1.74 Å with an Rmerge of 5.2% (15.3% in the highest resolution shell) and a completeness of 69.8% (30.0% in the highest resolution shell). This study reports the first X-ray diffraction analysis of nattokinase.

  15. Intracranial pressure monitoring in pediatric and adult patients with hydrocephalus and tentative shunt failure: a single-center experience over 10 years in 146 patients.

    Science.gov (United States)

    Sæhle, Terje; Eide, Per Kristian

    2015-05-01

    OBJECT In patients with hydrocephalus and shunts, lasting symptoms such as headache and dizziness may be indicative of shunt failure, which may necessitate shunt revision. In cases of doubt, the authors monitor intracranial pressure (ICP) to determine the presence of over- or underdrainage of CSF to tailor management. In this study, the authors reviewed their experience of ICP monitoring in shunt failure. The aims of the study were to identify the complications and impact of ICP monitoring, as well as to determine the mean ICP and characteristics of the cardiac-induced ICP waves in pediatric versus adult over- and underdrainage. METHODS The study population included all pediatric and adult patients with hydrocephalus and shunts undergoing diagnostic ICP monitoring for tentative shunt failure during the 10-year period from 2002 to 2011. The patients were allocated into 3 groups depending on how they were managed following ICP monitoring: no drainage failure, overdrainage, or underdrainage. While patients with no drainage failure were managed conservatively without further actions, over- or underdrainage cases were managed with shunt revision or shunt valve adjustment. The ICP and ICP wave scores were determined from the continuous ICP waveforms. RESULTS The study population included 71 pediatric and 75 adult patients. There were no major complications related to ICP monitoring, but 1 patient was treated for a postoperative superficial wound infection and another experienced a minor bleed at the tip of the ICP sensor. Following ICP monitoring, shunt revision was performed in 74 (51%) of 146 patients, while valve adjustment was conducted in 17 (12%) and conservative measures without any actions in 55 (38%). Overdrainage was characterized by a higher percentage of episodes with negative mean ICP less than -5 to -10 mm Hg. The ICP wave scores, in particular the mean ICP wave amplitude (MWA), best differentiated underdrainage. Neither mean ICP nor MWA levels showed any

  16. Hoe Creek II field experiment on underground coal gasification, preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Aiman, W.R.; Thorsness, C.B.; Hill, R.W.; Rozsa, R.B.; Cena, R.; Gregg, D.W.; Stephens, D.R.

    1978-02-27

    A second in-situ coal gasification experiment was performed by Lawrence Livermore Laboratory at Hoe Creek in Wyoming. The Linked Vertical Wells scheme for in-situ coal gasification was used. The experiment took 100 days for air flow testing, reverse combustion linking, forward combustion gasification, and post-burn steam flow. Air was used for gasification except for a 2-day test with oxygen and steam. Reverse combustion linking took 14 days at 1.6 m/day. Air requirements for linking were 0.398 Mgmol per meter of link assuming a single direct link. The coal pyrolysed during linking was 17 m/sup 3/, which corresponds to a single link 1.0 m in diameter. There was, however, strong evidence of at least two linkage paths. The detected links stayed below the 3 m level in the 7.6 coal seam; however, the product flow from the forward-burn gasification probably followed the coal-overburden interface not the reverse burn channels at the 3 m level. A total of 232 Mgmols (194 Mscf) of gas was produced with heating value above 125 kJ/mol (140 Btu/scf) for significant time periods and an average of 96 kJ/mol (108 Btu/scf). During the oxygen-steam test the heating value was above 270 kJ/gmol (300 Btu/scf) twice and averaged 235 kJ/gmol (265 Btu/scf). The coal recovery was 1310 m/sup 3/ (1950 ton). Gasification was terminated because of decreasing product quality not because of burn through. The product quality decreased because of increasing underground heat loss.

  17. Virtual Pediatric Hospital

    Science.gov (United States)

    ... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant™ Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...

  18. [Diet of neutropenic patients in pediatric oncology service; the experience of the university hospital of Strasbourg (HUS)].

    Science.gov (United States)

    Mutel, T; Foeglé, J; Belotti, L; Sery, V; Bourneton, O; Hernandez, C; Lutz, P; Lavigne, T

    2012-12-01

    This article clarifies the choices made by the HUS concerning the ways of preparing food reserved to neutropenic children hospitalized in pediatric oncology service. We will describe the results of microbiological analysis of food realized from 2002 to 2007. A specific team prepares this food which is canned and treated by "appertisation" (autoclaving). Each dish portion produced is provided to the service only if the microbiological results are conform, that is to say free of organisms. Three thousand and seventy-eight dishes were analysed: 82.9% of the analysed packs were conform. The contamination ratio decreased significantly (Pfood which is the most frequently "nonconform" is the dry food with a contamination rate of 37.9%. The identified concentrations remain mainly lower than 50 colony-forming units per millilitre (CFU/mL): 66.2% for the bacteria and 97.2% for the fungi. Considering the lack of consensus on the acceptable microbiological thresholds and on the food protection level, the HUS make it a rule to have a maximal precautionary principle. Currently, this principle appears to us to be a safety option required for the patients hospitalized in pediatric oncology service. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  19. Pediatric Resident Academic Projects While on Global Health Electives: Ten Years of Experience at the University of Minnesota.

    Science.gov (United States)

    Pitt, Michael B; Slusher, Tina M; Howard, Cynthia R; Cole, Valerie B; Gladding, Sophia P

    2017-07-01

    Many residency programs require residents to complete an academic project as part of a global health (GH) elective. However, there has been little description of the range of projects residents have pursued during GH electives or the extent to which these projects are consistent with proposed best practices. The authors conducted a document review of 67 written summaries or copies of presentations of academic projects (hereafter, summaries) completed by pediatric and medicine-pediatric residents at the University of Minnesota while on GH electives from 2005 to 2015. Two authors independently coded each summary for the type of project completed; when the project idea was generated; explicit mention of a mentor from the home institution, host institution, or both; whether a needs assessment was conducted; and whether there were plans for sustainability. Most of the 67 projects were categorized into one of three project types: quality/process improvement (28 [42%]), education (18 [27%]), or clinical research (14 [21%]). Most summaries explicitly mentioned a mentor (45 [67%]), reported conducting a needs assessment (38 [57%]), and indicated sustainability plans (45 [67%]). Of the 42 summaries that indicated the timing of idea generation, 30 (71%) indicated the idea was developed after arriving at the host site. Residents undertook a wide range of academic projects during GH electives, most commonly quality/process improvement and education projects. The projects were largely aligned with best practices, with most summaries indicating the resident worked with a mentor, conducted a needs assessment, and made plans for sustainability.

  20. A prospective survey of chiropractic student experiences with pediatric care and variability of case mix while on clinical placement in Rarotonga.

    Science.gov (United States)

    Todd, Angela J; Carroll, Matthew T; Russell, David G; Mitchell, Eleanor K L

    2017-03-01

    To compare chiropractic students' perceptions of preparedness for practice before and after a clinical placement in Rarotonga and to report demographics from these experiences. The students completed deidentified pre- and postplacement surveys assessing pediatric practice preparedness. Students tallied the patient numbers, age, and chiropractic techniques used per visit for each day of clinic placement. On completion of the program, participating students (27/34, or 79% of the student cohort) did a postplacement survey on their perception of practice preparedness. Data were analyzed with the Spearman rho correlation, the Mann-Whitney U test, and regression analysis. There was an increase in perceived preparedness for pediatric practice, ranging from 24.1% of the student cohort at the start of the study to 82.1% following clinical placement in Rarotonga. The change in student preparedness to practice with children was positively correlated with the total number of children managed (r s = .05, p = .01) and the number of children managed who were under 10 years of age (r s = .60, p = .001). Multiple regression analysis demonstrated a medium positive effect for postprogram preparedness (F [4, 20] = 3.567, p = .024). Clinical outreach to Rarotonga provided a broad case mix of patients and a change in student perceptions of preparedness to practice with children, which was positively affected by the total number of children managed and the number of children managed who were under 10 years of age.

  1. Effects of Palliative Care Training Program on Knowledge, Attitudes, Beliefs and Experiences Among Student Physiotherapists: A Preliminary Quasi-experimental Study

    OpenAIRE

    Kumar, Senthil P; Jim, Anand; Sisodia, Vaishali

    2011-01-01

    Background: Physiotherapists play an inherent role in the multidisciplinary palliative care team. Existing knowledge, attitudes, beliefs and experiences influence their team participation in palliative care. Aims: The objective of this study was to assess the changes in knowledge, attitudes, beliefs and experiences among student physiotherapists who attended a palliative care training program. Settings and Design: Preliminary quasi-experimental study design, conducted at an academic...

  2. Combined videofluoroscopy and manometry in the diagnosis of oropharyngeal dysphagia: examination technique and preliminary experience.

    Science.gov (United States)

    Cappabianca, S; Reginelli, A; Monaco, L; Del Vecchio, L; Di Martino, N; Grassi, R

    2008-09-01

    Dysphagia is a symptom of different pathological conditions characterised by alteration of the swallowing mechanism, which may manifest at different levels. We report our experience in the evaluation of the swallowing mechanism with combined videofluoroscopy and manometric recordings. For the combined study, we used a Dyno Compact computerised system (Menfis Biomedical s.r.l., Bologna, Italy) equipped with: (1) graphics card for the management of ultrasonographic or radiological images; (2) A.VI.U.S. dedicated software package, which enables digital-quality recording (PAL/NTSC, composite video or S-Video) of the videofluoroscopy study in AVI format with 320 x 240 resolution and 25 Hz acquisition frequency. The delay introduced by the process of image digitalisation is in the order of 200 ms, so for analysis purposes, the images can be considered synchronised with the manometric recordings. The videomanometry study was performed with the administration of contrast material either in bolus form or diluted. Data were collected on a specifically designed grid for the evaluation of 46 videofluoroscopic items, of which 34 are derived from the laterolateral view (seven in the oral preparatory phase, 15 in the oral transport phase and 12 in the pharyngeal phase) and 12 in the anteroposterior view (six in the oral preparatory phase and six in the oropharyngeal phase). A positive finding for the individual parameters is expressed in a binary fashion. Manometric evaluation was based on 11 items divided into four major and seven minor criteria. Dynamic videofluoroscopy swallow study combined with concurrent manometry enabled the simultaneous recording of anatomical alterations and the functional data of oropharyngeal pressure, thus providing a picture of the anatomical, biomechanical and physiological conditions of swallowing and the manner of bolus propulsion and transit. An early and effective diagnosis of oropharyngeal dysphagia means being able to effectively implement

  3. Development of a lower extremity wearable exoskeleton with double compact elastic module: preliminary experiments

    Directory of Open Access Journals (Sweden)

    Y. Long

    2017-08-01

    Full Text Available In this paper, a double compact elastic module is designed and implemented in the lower extremity exoskeleton. The double compact elastic module is composed of two parts, i.e., physical human robot interaction (pHRI measurement and the elastic actuation system (EAS, which are called proximal elastic module (PEM and distal elastic module (DEM respectively. The PEM is used as the pHRI information collection device while the DEM is used as the compliance device. A novel compact parallelogram-like structure based torsional spring is designed and developed. An iterative finite element analysis (FEA based optimization process was conducted to find the optimal parameters in the search space. In the PEM, the designed torsional spring has an outer circle with a diameter of 60 mm and an inner hole with a diameter of 12 mm, while in the DEM, the torsional spring has the outer circle with a diameter of 80 mm and the inner circle with a diameter of 16 mm. The torsional spring in the PEM has a thickness of 5 mm and a weight of 60 g, while that in the DEM has a thickness of 10 mm and a weight of 80 g. The double compact elastic module prototype is embedded in the mechanical joint directly. Calibration experiments were conducted on those two elastic modules to obtain the linear torque versus angle characteristic. The calibration experimental results show that this torsional spring in the PEM has a stiffness of 60.2 Nm rad−1, which is capable of withstanding a maximum torque of 4 Nm, while that in the DEM has a stiffness of 80.2 Nm rad−1, which is capable of withstanding a maximum torque of 30 Nm. The experimental results and the simulation data show that the maximum resultant errors are 6 % for the PEM and 4 % for the DEM respectively. In this paper, an assumed regression algorithm is used to learn the human motion intent (HMI based on the pHRI collection. The HMI is defined as the angular position of the human limb joint. A

  4. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... immediately after the exam. A few patients experience side effects from the contrast material, including nausea and local ... Related Articles and Media Catheter Angiography Magnetic Resonance, Functional (fMRI) - Brain Children's (Pediatric) CT (Computed Tomography) Magnetic ...

  5. Preliminary experience with extraperitoneal endoscopic radical prostatectomy through duplication of the open technique

    Directory of Open Access Journals (Sweden)

    M. Tobias-Machado

    2005-06-01

    Full Text Available OBJECTIVE: To describe surgical and functional results with extraperitoneal laparoscopic radical prostatectomy with duplication of the open technique, from the experience obtained in the treatment of 28 initial cases. MATERIALS AND METHODS: In a 36-month period, we prospectively analyzed 28 patients diagnosed with localized prostate cancer undergoing extraperitoneal laparoscopic radical prostatectomy. RESULTS: Mean surgical time was 280 min, with mean blood loss of 320 mL. As intraoperative complications, there were 2 rectal lesions repaired with laparoscopic suture in 2 planes. There was no conversion to open surgery. Median hospital stay was 3 days, with return to oral diet in the first post-operative day in patients. As post-operative complications, there were 3 cases of extraperitoneal urinary fistula. Two of these cases were resolved by maintaining a Foley catheter for 21 days, and the other one by late endoscopic reintervention for repositioning the catheter. Five out of 18 previously potent patients evolved with erectile dysfunction. The diagnosis of prostate cancer was confirmed in all patients, with focal positive margin occurring in 3 cases. During a mean follow-up of 18 months, 2 patients presented increased PSA, with no clinical evidence of disease. CONCLUSION: Laparoscopic radical prostatectomy is a laborious and difficult procedure, with a long learning curve. Extraperitoneal access is feasible, and it is possible to practically duplicate the principles of open surgery. The present technique can possibly offer advantages in terms of decreased blood loss, preservation of erectile function and prevention of positive margins.

  6. Contrast-enhanced ultrasonography for the determination of Crohn’s disease activity – preliminary experience

    Science.gov (United States)

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Kłopocka, Maria; Liebert, Ariel; Lemanowicz, Adam; Serafin, Zbigniew

    2014-01-01

    Summary Background Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn’s disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD. Material/Methods Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR). Results Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation. Conclusions CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn’s disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI. PMID:24723988

  7. Contrast-enhanced ultrasonography for the determination of Crohn's disease activity - preliminary experience.

    Science.gov (United States)

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Kłopocka, Maria; Liebert, Ariel; Lemanowicz, Adam; Serafin, Zbigniew

    2014-01-01

    Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn's disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD. Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR). Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation. CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn's disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI.

  8. Intensity-modulated radiotherapy for pituitary adenomas: The preliminary report of Cleveland Clinic experience

    International Nuclear Information System (INIS)

    Mackley, Heath B.; Reddy, Chandana A. M.S.; Lee, S.-Y.; Harnisch, Gayle A.; Mayberg, Marc R.; Hamrahian, Amir H.; Suh, John H.

    2007-01-01

    Purpose: Intensity-modulated radiotherapy (IMRT) is being increasingly used for the treatment of pituitary adenomas. However, there have been few published data on the short- and long-term outcomes of this treatment. This is the initial report of Cleveland Clinic's experience. Methods and Materials: Between February 1998 and December 2003, 34 patients with pituitary adenomas were treated with IMRT. A retrospective chart review was conducted for data analysis. Results: With a median follow-up of 42.5 months, the treatment has proven to be well tolerated, with performance status remaining stable in 90% of patients. Radiographic local control was 89%, and among patients with secretory tumors, 100% had a biochemical response. Only 1 patient required salvage surgery for progressive disease, giving a clinical progression free survival of 97%. The only patient who received more than 46 Gy experienced optic neuropathy 8 months after radiation. Smaller tumor volume significantly correlated with subjective improvements in nonvisual neurologic complaints (p = 0.03), and larger tumor volume significantly correlated with subjective worsening of visual symptoms (p = 0.05). New hormonal supplementation was required for 40% of patients. Younger patients were significantly more likely to require hormonal supplementation (p 0.03). Conclusions: Intensity-modulated radiation therapy is a safe and effective treatment for pituitary adenomas over the short term. Longer follow-up is necessary to determine if IMRT confers any advantage with respect to either tumor control or toxicity over conventional radiation modalities

  9. Preliminary Study on CHF Enhancement of Cellulose Nano Fiber (CNF) Fluid with Wire Pool Boiling Experiment

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Won Ki; Lee, Yun Seok; Lim, Dong Young; Song, Sub Lee; Lee, Jae Young; Lee, Kwon Yeong [Hanyang Global University, Pohang (Korea, Republic of); Hwang, Dong Soo [POSTECH, Pohang (Korea, Republic of)

    2016-05-15

    Critical heat flux (CHF) is enhancement of a boiling system will make more compact and effective cooling systems, for examples, nuclear reactors, and air conditioning units. For decades, researchers have been trying to develop more efficient working fluid for heat transfer. This is where nano-fluid could play a key role. There have been a lot of researches for CHF enhancements in nucleate boiling by using nano-fluid which are composed of metal such as copper, Al{sub 2}O{sub 3} and ceramic. And a critical factor of the enhancement is deposition of nano-particles on heating surface, although some results of recent studies are contrary. Also, previous nano-fluid are expensive and have a problem in mass production, so they are difficult to apply to practical industries. Therefore we chose a new material, cellulose nano fiber (CNF) as a solution. CNF can be applied to real situation because it has some advantages which are cost-effectiveness, easiness to get and to make it in nano scale. CHF performance of CNF fluid was different from that of distilled water. Compared to CHF of distilled water, CHF of the CNF fluid which had 0.001V%, 0.01V%, and 0.1V% volumetric concentrations were enhanced to 1%, 104%, and 13% respectively. Likewise other nano-fluid, deposition phenomena was observed in this CNF fluid boiling experiment.

  10. Preliminary Study on CHF Enhancement of Cellulose Nano Fiber (CNF) Fluid with Wire Pool Boiling Experiment

    International Nuclear Information System (INIS)

    Hwang, Won Ki; Lee, Yun Seok; Lim, Dong Young; Song, Sub Lee; Lee, Jae Young; Lee, Kwon Yeong; Hwang, Dong Soo

    2016-01-01

    Critical heat flux (CHF) is enhancement of a boiling system will make more compact and effective cooling systems, for examples, nuclear reactors, and air conditioning units. For decades, researchers have been trying to develop more efficient working fluid for heat transfer. This is where nano-fluid could play a key role. There have been a lot of researches for CHF enhancements in nucleate boiling by using nano-fluid which are composed of metal such as copper, Al_2O_3 and ceramic. And a critical factor of the enhancement is deposition of nano-particles on heating surface, although some results of recent studies are contrary. Also, previous nano-fluid are expensive and have a problem in mass production, so they are difficult to apply to practical industries. Therefore we chose a new material, cellulose nano fiber (CNF) as a solution. CNF can be applied to real situation because it has some advantages which are cost-effectiveness, easiness to get and to make it in nano scale. CHF performance of CNF fluid was different from that of distilled water. Compared to CHF of distilled water, CHF of the CNF fluid which had 0.001V%, 0.01V%, and 0.1V% volumetric concentrations were enhanced to 1%, 104%, and 13% respectively. Likewise other nano-fluid, deposition phenomena was observed in this CNF fluid boiling experiment.

  11. Preliminary experience with extraperitoneal endoscopic radical prostatectomy through duplication of the open technique.

    Science.gov (United States)

    Tobias-Machado, M; Lasmar, Marco T C; Medina, Jimmy J A; Forseto, Pedro H; Juliano, Roberto V; Wroclawski, Eric R

    2005-01-01

    To describe surgical and functional results with extraperitoneal laparoscopic radical prostatectomy with duplication of the open technique, from the experience obtained in the treatment of 28 initial cases. In a 36-month period, we prospectively analyzed 28 patients diagnosed with localized prostate cancer undergoing extraperitoneal laparoscopic radical prostatectomy. Mean surgical time was 280 min, with mean blood loss of 320 mL. As intraoperative complications, there were 2 rectal lesions repaired with laparoscopic suture in 2 planes. There was no conversion to open surgery. Median hospital stay was 3 days, with return to oral diet in the first post-operative day in patients. As post-operative complications, there were 3 cases of extraperitoneal urinary fistula. Two of these cases were resolved by maintaining a Foley catheter for 21 days, and the other one by late endoscopic reintervention for repositioning the catheter. Five out of 18 previously potent patients evolved with erectile dysfunction. The diagnosis of prostate cancer was confirmed in all patients, with focal positive margin occurring in 3 cases. During a mean follow-up of 18 months, 2 patients presented increased PSA, with no clinical evidence of disease. Laparoscopic radical prostatectomy is a laborious and difficult procedure, with a long learning curve. Extraperitoneal access is feasible, and it is possible to practically duplicate the principles of open surgery. The present technique can possibly offer advantages in terms of decreased blood loss, preservation of erectile function and prevention of positive margins.

  12. Preliminary research informing policy on remote alcohol monitoring in criminal justice: the Scottish experience.

    Science.gov (United States)

    Goodall, Christine A; Neville, Fergus G; Williams, Damien J; Donnelly, Peter D

    2016-11-01

    To explore the views of Scottish offenders on the impact of alcohol on their experience of offending and their lives in general. Furthermore, to explore their views on the concept of remote alcohol monitoring (RAM) as a way to address alcohol misuse upon liberation from prison. A convenience sample of 12 serving offenders participated in one of three focus groups. Data were analysed using the principles of thematic analysis. Analysis of the data revealed the significant impact of alcohol on the lives of the participants. Key themes included the amount and frequency of alcohol consumption; the association of alcohol with harm; the association of alcohol with offending; the previous attempts to reduce alcohol consumption and possible reasons for failure; and the views of participants on the utility of RAM in relation to crime prevention. Participants had significant issues with alcohol misuse prior to incarceration that had impacted on their offending and resulted in both health and social harms. Participants were generally positive but pragmatic about RAM, recognising that technology alone may not be enough to change deeply ingrained and addictive behaviours.

  13. Contrast-enhanced ultrasonography for the determination of Crohn’s disease activity – preliminary experience

    International Nuclear Information System (INIS)

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Kłopocka, Maria; Liebert, Ariel; Lemanowicz, Adam; Serafin, Zbigniew

    2014-01-01

    Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn’s disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD. Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR). Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation. CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn’s disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI

  14. Purification, crystallization and preliminary X-ray diffraction experiment of nattokinase from Bacillus subtilis natto

    International Nuclear Information System (INIS)

    Yanagisawa, Yasuhide; Chatake, Toshiyuki; Chiba-Kamoshida, Kaori; Naito, Sawa; Ohsugi, Tadanori; Sumi, Hiroyuki; Yasuda, Ichiro; Morimoto, Yukio

    2010-01-01

    Nattokinase, a protein found in high levels in the traditional Japanese food natto, has been reported to have high thrombolytic activity. In the present study, the crystallization of native nattokinase and the collection of X-ray diffraction date from a nattokinase crystal to a resolution of 1.74 Å are reported. Nattokinase is a single polypeptide chain composed of 275 amino acids (molecular weight 27 724) which displays strong fibrinolytic activity. Moreover, it can activate other fibrinolytic enzymes such as pro-urokinase and tissue plasminogen activator. In the present study, native nattokinase from Bacillus subtilis natto was purified using gel-filtration chromatography and crystallized to give needle-like crystals which could be used for X-ray diffraction experiments. The crystals belonged to space group C2, with unit-cell parameters a = 74.3, b = 49.9, c = 56.3 Å, β = 95.2°. Diffraction images were processed to a resolution of 1.74 Å with an R merge of 5.2% (15.3% in the highest resolution shell) and a completeness of 69.8% (30.0% in the highest resolution shell). This study reports the first X-ray diffraction analysis of nattokinase

  15. Purification, crystallization and preliminary X-ray diffraction experiment of nattokinase from Bacillus subtilis natto

    Energy Technology Data Exchange (ETDEWEB)

    Yanagisawa, Yasuhide [Faculty of Pharmaceutical Sciences, Chiba Institute of Science, 15-8 Shiomi-cho, Choshi, Chiba 288-0025 (Japan); Chatake, Toshiyuki [Research Reactor Institute, Kyoto University, Asashironishi 2, Kumatori, Sennan, Osaka 590-0494 (Japan); Chiba-Kamoshida, Kaori [National Institute of Advanced Industrial Science and Technology (AIST), Umezono 1-1-1, Tsukuba, Ibaraki 305-8568 (Japan); Naito, Sawa; Ohsugi, Tadanori; Sumi, Hiroyuki [Kurashiki University of Science and Arts, Nishinoura 2640, Tsurajima-cho, Kurashiki, Okayama 712-8505 (Japan); Yasuda, Ichiro [Faculty of Pharmaceutical Sciences, Chiba Institute of Science, 15-8 Shiomi-cho, Choshi, Chiba 288-0025 (Japan); Morimoto, Yukio [Research Reactor Institute, Kyoto University, Asashironishi 2, Kumatori, Sennan, Osaka 590-0494 (Japan); Faculty of Pharmaceutical Sciences, Chiba Institute of Science, 15-8 Shiomi-cho, Choshi, Chiba 288-0025 (Japan)

    2010-12-01

    Nattokinase, a protein found in high levels in the traditional Japanese food natto, has been reported to have high thrombolytic activity. In the present study, the crystallization of native nattokinase and the collection of X-ray diffraction date from a nattokinase crystal to a resolution of 1.74 Å are reported. Nattokinase is a single polypeptide chain composed of 275 amino acids (molecular weight 27 724) which displays strong fibrinolytic activity. Moreover, it can activate other fibrinolytic enzymes such as pro-urokinase and tissue plasminogen activator. In the present study, native nattokinase from Bacillus subtilis natto was purified using gel-filtration chromatography and crystallized to give needle-like crystals which could be used for X-ray diffraction experiments. The crystals belonged to space group C2, with unit-cell parameters a = 74.3, b = 49.9, c = 56.3 Å, β = 95.2°. Diffraction images were processed to a resolution of 1.74 Å with an R{sub merge} of 5.2% (15.3% in the highest resolution shell) and a completeness of 69.8% (30.0% in the highest resolution shell). This study reports the first X-ray diffraction analysis of nattokinase.

  16. [Home Hemodialysis: Experience and Preliminary Results Of The First Center In Campania].

    Science.gov (United States)

    Brancaccio, Stefania; Capuano, Alfredo; Memoli, Andrea; Sorrentino, Livia Maria; Pirro, Laura; Federico, Stefano

    2015-12-01

    The Home Hemodialysis (HHD) is an uncommon dialytic option that can offer better clinical outcomes and a more satisfactory quality of life. The Health Plan of the Region Campania 2011-2013 states that" the system of home care for regional planning is particularly important". From August 2014 to March 2015 two patients, on standard dialysis (HD) as inpatients at Dialysis Centre of the University "Federico II" of Naples, started Short Daily Home Hemodialysis (SDHD) (4-6 dialysis treatments%week, 2.5 hours per session) using the portable cycler NxStage System One). The data collected showed that the clinical benefits described in the literature were confirmed in patients enrolled in this HHD program. Shorter and more frequent hemodialysis sessions allowed a significant reduction in interdialytic weight gain and greater intradialytic hemodynamic stability. A significant reduction in blood pressure and anti-hypertensive drugs were obtained. The control of phosphorus appeared better and hemoglobin was to target with a lower dose of weekly erythropoetin. The patients reported a greater well-being and a reduction in post-dialytic asthenia. No problem has been reported in using the vascular access (CVC and FAV) by the patient%caregiver. The dialysis adequacy and efficiency were comparable between SDHD and HD. The experience with the HHD is encouraging as the patients achieved an adequate dialysis dose without any complications reporting an improving sense of well-being and a better quality of life. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  17. Pitfalls in pediatric radiology

    International Nuclear Information System (INIS)

    Engelkemier, Dawn R.; Taylor, George A.

    2015-01-01

    This essay depicts some of the diagnostic errors identified in a large academic pediatric imaging department during a 13-year period. Our aim is to illustrate potential situations in which errors are more likely to occur and more likely to cause harm, and to share our difficult cases so other radiologists might learn without having to experience those situations themselves. (orig.)

  18. The experiences of living with a sibling who stutters: a preliminary study.

    Science.gov (United States)

    Beilby, Janet M; Byrnes, Michelle L; Young, Kate N

    2012-06-01

    Stuttering impacts on the child in a variety of ways, notably in terms of communicative impairment and psychosocial impact. In addition, the stuttering disorder has a holistic impact, affecting those with whom the child who stutters lives. Within the family constellation, the closest person to the individual who stutters is often their sibling. This study investigated the experiences of fluent siblings of children who stutter to examine the impact that stuttering may have on their lives. A mixed methods research design incorporated qualitative semi-structured interviews and quantitative questionnaires. The results of the qualitative investigation revealed four aspects of children's lives that were affected by having a sibling who stuttered: the relationship between siblings, the impact on the fluent sibling, the impact on the parent relationship with both children, and the impact on the sibling's relationship with others. Findings revealed that siblings of children who stutter exhibited strongly negative emotions, and differing levels of responsibility associated with their involvement in the actual stuttering management programme. Furthermore, for the fluent sibling, secondary to having a brother or sister who stuttered, communication with and attention from their parents was variable. The results of the quantitative component of the study revealed children who stutter and their siblings demonstrated significantly greater closeness, and concurrently, increased conflict and status disparity than did the control fluent sibling dyads. The parents of the experimental sibling dyads also demonstrated significantly greater partiality towards a child, namely the child who stuttered, than did the parents of the control sibling dyads. The reader will be able to: (1) identify the themes associated with having a sibling who stutters; (2) identify how the quality of the sibling relationship differs between sibling dyads that do and do not consist of a sibling who stutters; and

  19. Catheter-assisted retrieval of adhesive Geunther Tulip filter: preliminary experience

    International Nuclear Information System (INIS)

    Xiao Liang; Tong Jiajie; Xie Shiyang; Shen Jing

    2011-01-01

    Objective: To retrospectively summarize the technical experience in performing catheter-assisted retrieval of adhesive Geunther Tulip filter. Methods: During the period from November 2007 to October 2009, 95 patients with pulmonary embolism and acute deep vein thrombosis of lower limbs were admitted to authors' hospital. As simple snare technique failed to catch the adhesive Geunther Tulip filter previously implanted in inferior vena cava (IVC) in 6 patients (four males and two females with a mean age of 43.7 years), catheter-assisted retrieval of adhesive Geunther Tulip filter had to be carried out. The specific procedure was as follows. After phlebography of IVC confirmed that the filter's retrieval hook had adhered to IVC wall, the adhesion was separated with the help of catheter as well as goose-neck capturing device, then, the Geunther Tulip filter was retrieved. After the procedure, both anticoagulation and antibiotic medication were employed for 3-5 days. All the patients were followed up for 4-12 months. Vascular ultrasonography and pulmonary 3D CTA were re-examined in 6 months after primary operation. Results: All 6 adhesive Geunther Tulip filters were successfully removed with a success rate of 100%. The manipulation used in the procedure included catheter-twisting technique (n=1), catheter-looping technique (n=1) and catheter-snare looping technique (n=4). The mean operation time was 40.5 minutes (in the range of 17-78 minutes). The average filter-dwelling time was 46.7 days (ranging from 14 to 80 days). No thrombus formation in deep veins of lower extremity or pulmonary embolism occurred during the follow-up period. Conclusion: The catheter-assisted retrieval technique carries high retrieval rate for adhesive Geunther Tulip filter in IVC, it can markedly improve the retrieval success rate of Tulip IVC filter. (authors)

  20. Simulation in pediatric anesthesiology.

    Science.gov (United States)

    Fehr, James J; Honkanen, Anita; Murray, David J

    2012-10-01

    Simulation-based training, research and quality initiatives are expanding in pediatric anesthesiology just as in other medical specialties. Various modalities are available, from task trainers to standardized patients, and from computer-based simulations to mannequins. Computer-controlled mannequins can simulate pediatric vital signs with reasonable reliability; however the fidelity of skin temperature and color change, airway reflexes and breath and heart sounds remains rudimentary. Current pediatric mannequins are utilized in simulation centers, throughout hospitals in-situ, at national meetings for continuing medical education and in research into individual and team performance. Ongoing efforts by pediatric anesthesiologists dedicated to using simulation to improve patient care and educational delivery will result in further dissemination of this technology. Health care professionals who provide complex, subspecialty care to children require a curriculum supported by an active learning environment where skills directly relevant to pediatric care can be developed. The approach is not only the most effective method to educate adult learners, but meets calls for education reform and offers the potential to guide efforts toward evaluating competence. Simulation addresses patient safety imperatives by providing a method for trainees to develop skills and experience in various management strategies, without risk to the health and life of a child. A curriculum that provides pediatric anesthesiologists with the range of skills required in clinical practice settings must include a relatively broad range of task-training devises and electromechanical mannequins. Challenges remain in defining the best integration of this modality into training and clinical practice to meet the needs of pediatric patients. © 2012 Blackwell Publishing Ltd.

  1. Biventricular assist using a portable driver in combination with implanted devices: preliminary experience.

    Science.gov (United States)

    von Segesser, L K; Tkebuchava, T; Leskosek, B; Marty, B; Pei, Y C; Turina, M

    1997-01-01

    Left ventricular assist systems with portable drive units are increasingly used in the clinical setting. However, such systems usually are not suitable for right ventricular support, and therefore, in the case of biventricular heart failure, they must be combined with other support devices that require additional drive consoles. As a result, most of the benefits of the wearable drive units (early mobilization and outpatient care) are lost. This present study was performed to evaluate biventricular support with implanted assist devices and a portable DC/battery-powered driver (Thoratec TLC-II). Electronic control by nonvolatile RAM accessible via RS232 interface, internal backup emergency battery, and optional manual activation are additional features of this 6 kg biventricular drive unit. In 3 bovine experiments (body weight 70 +/- 5 kg) partial cardiopulmonary bypass (CPB) was established, and two ventricular assist devices were implanted into a preperitoneal pocket on each side after connection to the right atrium and the pulmonary artery and to the left atrium and aorta, respectively. After weaning the patient from CPB, activated coagulation time (ACT) was kept at greater than 180 s, and biventricular support with the portable driver was activated. After 10 min, mean device flow stabilized at 3.5 +/- 0 L/min and remained at that level throughout the ensuing 6 h (3.5 +/- 0.3 L/min; NS). The heart rate moved from 130 +/- 13 beats per minute (bpm) at the end of CPB to 116 +/- 13 bpm after 10 min of assist (p < 0.05). Right atrial pressure moved from 11 +/- 2 mm Hg at the end of CPB to 13 +/- 3 mm Hg after 10 min of assist (not significant [NS]). Mean pulmonary artery pressure was 18 +/- mm Hg at the end of CPB and 17 +/- 5 mm Hg after 10 min of assist (NS). Left atrial pressure was 10 +/- 1 mm Hg at the end of CPB and 13 +/- 3 mm Hg after 10 min of assist (NS). Mean aortic pressure was 73 +/- 11 mm Hg at the end of CPB and 77 +/- 3 mm Hg after 10 min of assist (NS

  2. Individualized computer-aided education in mammography based on user modeling: concept and preliminary experiments.

    Science.gov (United States)

    Mazurowski, Maciej A; Baker, Jay A; Barnhart, Huiman X; Tourassi, Georgia D

    2010-03-01

    The authors propose the framework for an individualized adaptive computer-aided educational system in mammography that is based on user modeling. The underlying hypothesis is that user models can be developed to capture the individual error making patterns of radiologists-in-training. In this pilot study, the authors test the above hypothesis for the task of breast cancer diagnosis in mammograms. The concept of a user model was formalized as the function that relates image features to the likelihood/extent of the diagnostic error made by a radiologist-in-training and therefore to the level of difficulty that a case will pose to the radiologist-in-training (or "user"). Then, machine learning algorithms were implemented to build such user models. Specifically, the authors explored k-nearest neighbor, artificial neural networks, and multiple regression for the task of building the model using observer data collected from ten Radiology residents at Duke University Medical Center for the problem of breast mass diagnosis in mammograms. For each resident, a user-specific model was constructed that predicts the user's expected level of difficulty for each presented case based on two BI-RADS image features. In the experiments, leave-one-out data handling scheme was applied to assign each case to a low-predicted-difficulty or a high-predicted-difficulty group for each resident based on each of the three user models. To evaluate whether the user model is useful in predicting difficulty, the authors performed statistical tests using the generalized estimating equations approach to determine whether the mean actual error is the same or not between the low-predicted-difficulty group and the high-predicted-difficulty group. When the results for all observers were pulled together, the actual errors made by residents were statistically significantly higher for cases in the high-predicted-difficulty group than for cases in the low-predicted-difficulty group for all modeling

  3. Direct measurement of tritium production rate in LiPb with removed parasitic activities: Preliminary experiments

    Energy Technology Data Exchange (ETDEWEB)

    Kuc, Tadeusz, E-mail: kuc@agh.edu.pl; Pohorecki, Władysław; Ostachowicz, Beata

    2014-10-15

    Liquid scintillation (LS) technique applied to direct measurement of tritium activity produced in LiPb eutectic in Frascati HCLL TBM mock-up neutronic experiment has been tested so far in the case of LS measurement after long period since irradiation. LiPb samples irradiated in neutron filed show, except of tritium, meaningful activity of other radioisotopes (parasitic). Parasitic activity, mainly from isotopes of lead ({sup 209}Pb, {sup 204m}Pb, {sup 203}Pb) calculated with the use of FISPACT, exceeds ca 5 times tritium activity 1.4 h after irradiation. We propose to remove disturbing radioisotopes in a chemical way to avoid long “cooling” of the irradiated samples before tritium measurement. Samples (1 g of LiPb) irradiated in reactor fast neutron flux were diluted and metallic cations removed by chemical precipitation. For this purpose we used: potassium iodide (KJ), strontium chloride (SrCl{sub 2}), APDC (C{sub 5}H{sub 8}NS{sub 2}·NH{sub 4}), NaDDTC (C{sub 5}H{sub 10}NNaS{sub 2}·3H{sub 2}O), and PAN (C{sub 15}H{sub 11}N{sub 3}O). Precipitation procedure in each case lasted ca 5–25 min, and the following filtration next 10–20 min. In each filtrate (ca 120 ml) we measured Pb concentration in total reflection X-ray fluorescence (TXRF) analyzer and parasitic activity (left after 21-day “cooling”) applying HPGe gamma spectrometer. Pb cations precipitated by SrCl{sub 2} and than by PAN lowered activity of Pb isotopes to less than 1% of the initial tritium activity. Another combination of reagents: NaDDTC followed by SrCl{sub 2} in a single and double step filtration reduced Pb concentration 10{sup 2} and 10{sup 4} times, respectively. Reduction of this order allows tritium radiometric measurement ca 3 h after irradiation with acceptable accuracy. This time can be shortened by applying correction for decay of known parasitic activity. Input of {sup 76}As and other less abundant radioisotopes can be eliminated using high purity LiPb. Tritium activity of

  4. Designing assisted living technologies ‘in the wild’: preliminary experiences with cultural probe methodology

    Directory of Open Access Journals (Sweden)

    Wherton Joseph

    2012-12-01

    , limited emotional or psychological resources, life events, and acute illness. Discussions between researchers and participants about the materials collected (and sometimes about what had prevented them completing the tasks helped elicit further information relevant to assisted living technology design. The probe materials were particularly helpful when having conversations with non-English speaking participants through an interpreter. Conclusions Cultural probe methods can help build a rich picture of the lives and experiences of older people to facilitate the co-production of assisted living technologies. But their application may be constrained by the participant’s physical, mental and emotional capacity. They are most effective when used as a tool to facilitate communication and development of a deeper understanding of older people’s needs.

  5. GPS water vapour tomography: preliminary results from the ESCOMPTE field experiment

    Science.gov (United States)

    Champollion, C.; Masson, F.; Bouin, M.-N.; Walpersdorf, A.; Doerflinger, E.; Bock, O.; Van Baelen, J.

    2005-03-01

    Water vapour plays a major role in atmospheric processes but remains difficult to quantify due to its high variability in time and space and the sparse set of available measurements. The GPS has proved its capacity to measure the integrated water vapour at zenith with the same accuracy as other methods. Recent studies show that it is possible to quantify the integrated water vapour in the line of sight of the GPS satellite. These observations can be used to study the 3D heterogeneity of the troposphere using tomographic techniques. We develop three-dimensional tomographic software to model the three-dimensional distribution of the tropospheric water vapour from GPS data. First, the tomographic software is validated by simulations based on the realistic ESCOMPTE GPS network configuration. Without a priori information, the absolute value of water vapour is less resolved as opposed to relative horizontal variations. During the ESCOMPTE field experiment, a dense network of 17 dual frequency GPS receivers was operated for 2 weeks within a 20×20-km area around Marseille (southern France). The network extends from sea level to the top of the Etoile chain (˜700 m high). Optimal results have been obtained with time windows of 30-min intervals and input data evaluation every 15 min. The optimal grid for the ESCOMTE geometrical configuration has a horizontal step size of 0.05°×0.05° and 500 m vertical step size. Second, we have compared the results of real data inversions with independent observations. Three inversions have been compared to three successive radiosonde launches and shown to be consistent. A good resolution compared to the a priori information is obtained up to heights of 3000 m. A humidity spike at 4000-m altitude remains unresolved. The reason is probably that the signal is spread homogeneously over the whole network and that such a feature is not resolvable by tomographic techniques. The results of our pure GPS inversion show a correlation with

  6. Preliminary experiments on surface flow visualization in the cryogenic wind tunnel by use of condensing or freezing gases

    Science.gov (United States)

    Goodyer, M. J.

    1988-01-01

    Cryogenic wind tunnel users must have available surface flow visualization techniques to satisfy a variety of needs. While the ideal from an aerodynamic stand would be non-intrusive, until an economical technique is developed there will be occasions when the user will be prepared to resort to an intrusive method. One such method is proposed, followed by preliminary evaluation experiments carried out in environments representative of the cryogenic nitrogen tunnel. The technique uses substances which are gases at normal temperature and pressure but liquid or solid at cryogenic temperatures. These are deposited on the model in localized regions, the patterns of the deposits and their subsequent melting or evaporation revealing details of the surface flow. The gases were chosen because of the likelihood that they will not permanently contaminate the model or tunnel. Twenty-four gases were identified as possibly suitable and four of these were tested from which it was concluded that surface flow direction can be shown by the method. Other flow details might also be detectable. The cryogenic wind tunnel used was insulated on the outside and did not show signs of contamination.

  7. Review of management and morbidity of pediatric craniopharyngioma patients in a low-middle-income country: a 12-year experience.

    Science.gov (United States)

    Amayiri, Nisreen; Swaidan, Maisa; Yousef, Yocoub; Halalsheh, Hadeel; Abu-Hijlih, Ramiz; Kalaldeh, Sima; Barbar, Maha; Elayyan, Maher; Faqih, Nesreen; Al-Hussaini, Maysa; Mehyar, Mustafa; Bartels, Ute; Drake, James; Musharbash, Awni; Bouffet, Eric

    2017-06-01

    Management of craniopharyngioma in children is challenging, and their quality of life can be significantly affected. Series describing this from low-middle income countries (LMIC) are few. The study provides a retrospective chart review of pediatric patients craniopharyngioma between 2003 and 2014, and treated at King Hussein Cancer Center, Jordan. Twenty-four patients (12 males) were identified. Median age at diagnosis was 7.4 years (0.9-16.4 years). Commonest symptoms were visual impairment and headache (71%). Review of seventeen preoperative MRIs showed hypothalamic involvement in 88% and hydrocephalus in 76%. Thirteen patients (54%) had multiple surgical interventions. Five patients (21%) had initial gross total resection. Eleven patients (46%) received radiotherapy and six (25%) intra-cystic interferon. Five years' survival was 87 ± 7% with a median follow-up of 4.5 years (0.3-12.3 years). Four patients (17%) died; one after post-operative cerebral infarction and three secondary to hypothalamic damage. At their last evaluation, all but one patient required multiple hormonal supplements. Ten patients (42%) had best eye visual acuity (VA) >20/40, and four (16%) were legally blind. Eleven patients (46%) were overweight/obese; one had gastric bypass surgery. Seven patients had hyperlipidemia, and eight developed fatty liver infiltration. Eleven patients (65%) were attending schools and one at college. Nine of the living patients (53%) expressed difficulty to engage in the community. Management of pediatric craniopharyngioma is particularly complex and demanding in LMIC. Multidisciplinary care is integral to optimize the care and minimize the morbidities. A management outline for LMIC is proposed.

  8. Implantable cardioverter defibrillator therapy in pediatric and congenital heart disease patients: a single tertiary center experience in Korea

    Directory of Open Access Journals (Sweden)

    Bo Kyung Jin

    2013-03-01

    Full Text Available Purpose: The use of implantable cardioverter defibrillators (ICDs to prevent sudden cardiac death is increasing in children and adolescents. This study investigated the use of ICDs in children with congenital heart disease. Methods: This retrospective study was conducted on the clinical characteristics and effectiveness of ICD implantation at the department of pediatrics of a single tertiary center between 2007 and 2011. Results: Fifteen patients underwent ICD implantation. Their mean age at the time of implantation was 14.5±5.4 years (range, 2 to 22 years. The follow-up duration was 28.9±20.4 months. The cause of ICD implantation was cardiac arrest in 7, sustained ventricular tachycardia in 6, and syncope in 2 patients. The underlying disorders were as follows: ionic channelopathy in 6 patients (long QT type 3 in 4, catecholaminergic polymorphic ventricular tachycardia [CPVT] in 1, and J wave syndrome in 1, cardiomyopathy in 5 patients, and postoperative congenital heart disease in 4 patients. ICD coils were implanted in the pericardial space in 2 children (ages 2 and 6 years. Five patients received appropriate ICD shock therapy, and 2 patients received inappropriate shocks due to supraventricular tachycardia.During follow-up, 2 patients required lead dysfunction-related revision. One patient with CPVT suffered from an ICD storm that was resolved using sympathetic denervation surgery. Conclusion: The overall ICD outcome was acceptable in most pediatric patients. Early diagnosis and timely ICD implantation are recommended for preventing sudden death in high-risk children and patients with congenital heart disease.

  9. Clinical hyperthermia of prostate cancer using magnetic nanoparticles - preliminary experience with a new interstitial technique

    International Nuclear Information System (INIS)

    Johannsen, M.; Gneveckow, U.; Eckelt, L.; Feussner, A.; Waldoefner, N.; Scholz, R.; Deger, S.; Wust, P.; Loening, S.A.; Jordan, A.

    2005-01-01

    .5, 42.3, 41.5 and 40.7 o C, whereas minimal temperatures were 40.5, 39.8, 39.7 and 39.4 o C, respectively. Mean temperatures measured in the urethra and the rectum did not exceed 42 o C. Using the AMIRA software, a non-invasive estimation of temperature values in the prostate, based on intratumoral distribution of magnetic nanoparticles, could be performed and correlated with invasively measured temperatures. Hyperthermia using magnetic nanoparticles is feasible and well tolerated in locally recurrent prostate carcinoma. Maximum intraprostatic temperatures achieved are in the thermoablative range. Interstitial deposition of nanoparticles in the prostate is stable for at least 6 weeks, allowing for sequential hyperthermia treatments without the need for repeated application of magnetic fluid. These first clinical experiences prompted us to initiate a phase I study to evaluate this technique in patients with local recurrence of prostate cancer following radiotherapy with curative intent. Further improvements will focus on optimization of intraprostatic application and distribution of nanoparticles as well as non-invasive temperature measurements. (author)

  10. Pediatric Terminology

    Science.gov (United States)

    The National Institute of Child Health and Human Development (NICHD) works with NCI Enterprise Vocabulary Services (EVS) to provide standardized terminology for coding pediatric clinical trials and other research activities.

  11. Pediatric MRI

    Data.gov (United States)

    U.S. Department of Health & Human Services — The NIH Study of Normal Brain Development is a longitudinal study using anatomical MRI, diffusion tensor imaging (DTI), and MR spectroscopy (MRS) to map pediatric...

  12. Using Distributed Fiber Optic Sensing to Monitor Large Scale Permafrost Transitions: Preliminary Results from a Controlled Thaw Experiment

    Science.gov (United States)

    Ajo Franklin, J. B.; Wagner, A. M.; Lindsey, N.; Dou, S.; Bjella, K.; Daley, T. M.; Freifeld, B. M.; Ulrich, C.; Gelvin, A.; Morales, A.; James, S. R.; Saari, S.; Ekblaw, I.; Wood, T.; Robertson, M.; Martin, E. R.

    2016-12-01

    In a warming world, permafrost landscapes are being rapidly transformed by thaw, yielding surface subsidence and groundwater flow alteration. The same transformations pose a threat to arctic infrastructure and can induce catastrophic failure of the roads, runways, and pipelines on which human habitation depends. Scalable solutions to monitoring permafrost thaw dynamics are required to both quantitatively understand biogeochemical feedbacks as well as to protect built infrastructure from damage. Unfortunately, permafrost alteration happens over the time scale of climate change, years to decades, a decided challenge for testing new sensing technologies in a limited context. One solution is to engineer systems capable of rapidly thawing large permafrost units to allow short duration experiments targeting next-generation sensing approaches. We present preliminary results from a large-scale controlled permafrost thaw experiment designed to evaluate the utility of different geophysical approaches for tracking the cause, precursors, and early phases of thaw subsidence. We focus on the use of distributed fiber optic sensing for this challenge and deployed distributed temperature (DTS), strain (DSS), and acoustic (DAS) sensing systems in a 2D array to detect thaw signatures. A 10 x 15 x 1 m section of subsurface permafrost was heated using an array of 120 downhole heaters (60 w) at an experimental site near Fairbanks, AK. Ambient noise analysis of DAS datasets collected at the plot, coupled to shear wave inversion, was utilized to evaluate changes in shear wave velocity associated with heating and thaw. These measurements were confirmed by seismic surveys collected using a semi-permanent orbital seismic source activated on a daily basis. Fiber optic measurements were complemented by subsurface thermistor and thermocouple arrays, timelapse total station surveys, LIDAR, secondary seismic measurements (geophone and broadband recordings), timelapse ERT, borehole NMR, soil

  13. Preliminary experiments on dynamic biology of micro-organisms to avoid any specific full-blown syndrome on humans

    Science.gov (United States)

    Meer, Sneer

    2002-06-01

    The aim of this paper is to apply an efficient system to detect, identify and quicken suppression of any dangerous micro-organism which threatens the health of the human body in any form. It is well known that some specimens of this kind of possess a specific energy related to their speed of division, toxin emissions and high-powered interaction with human and animal cells which have the capacity to provide certain deadly full-blown syndromes. Many problems relating to the above-mentioned properties have not been clarified to date, and it is vital to find a rapid and valid reply as soon as possible. Inter-disciplinary sciences directed us to start some experiments to solve such problems, considering that the human body is dotted with a multiple interactive system of energy release, a fact which can explain the source of the micro-organism's energy also, for their necessity to manifest their deadly pathology. From practical preliminary experiments with some micro-mechanical systems using light-microscopy, connected to video TV Recorder System, one obtains optical enlarged TV images of certain processes which indicated the right way towards our crucial target; ie: the preparation of safe vaccines and safe medicines. This will constitute a basic system to a void deadly manifestations of dangerous micro-organisms and/or even regular infections on earth and in space, a system which will probably be applied at the ISS Space Station and other future actions in space in long and very long flights. We look forward to applying this system of dynamic biology towards preparation of a real and valid vaccine(s) against HIV virus on AIDS diseases.

  14. CT-guided thin needles percutaneous cryoablation (PCA) in patients with primary and secondary lung tumors: A preliminary experience

    Energy Technology Data Exchange (ETDEWEB)

    Pusceddu, Claudio, E-mail: clapusceddu@gmail.com [Division of Interventional Radiology, Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncologic Diseases, Cagliari, Zip code 09100 (Italy); Sotgia, Barbara, E-mail: barbara.sotgia@gmail.com [Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncological Diseases, Cagliari, Zip code 09100 (Italy); Fele, Rosa Maria, E-mail: rosellafele@tiscali.it [Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncological Diseases, Cagliari, Zip code 09100 (Italy); Melis, Luca, E-mail: doclucamelis@tiscali.it [Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncological Diseases, Cagliari, Zip code 09100 (Italy)

    2013-05-15

    Purpose: To report the data of our initial experience with CT-guided thin cryoprobes for percutaneous cryoablation (PCA) in patients with primary and secondary pulmonary tumors. Material and methods: CT-guided thin needles PCA was performed on 34 lung masses (11 NSCLC = 32%; 23 secondary lung malignancies = 68%) in 32 consecutive patients (24 men and 8 women; mean age 67 ± 10 years) not suitable for surgical resection. Lung masses were treated using two types of cryoprobes: IceRod and IceSeed able to obtain different size of iceball. The number of probes used ranged from 1 to 5 depending on the size of the tumor. After insertion of the cryoprobes into the lesion, the PCA were performed with two 2 (91%) or 3 (9%) cycles each of 12 min of freezing followed by a 4 min active thawing phase and a 4 min passive thawing phase for each one for all treatments. Results: All cryoablation sessions were successfully completed. All primary and metastatic lung tumors were ablated. No procedure-related deaths occurred. Morbidity consisted of 21% (7 of 34) pneumothorax and 3% (1 of 34) cases asymptomatic small pulmonary hemorrhage, respectively, all of CTCAE grade 1 (Common Terminology Criteria for Adverse Events). Low density of entire lesion, central necrosis and solid mass appearance were identify in 21 (62%), 7 (21%) and 6 (17%) of cryoablated tumors, respectively. No lymphadenopathy developed in the region of treated lesions. Technical success (complete lack of enhancement) was achieved in 82%, 97% and 91% of treated lesions at 1-, 3- and 6-months CT follow-up scan, respectively (p < .000). Comparing the tumor longest diameter between the baseline and at 6 month CT images, technical success was revealed in 92% cases (p < .000). Conclusion: Our preliminary experience suggests that PCA is a feasible treatment option. Well-designed clinical trials with a larger patient population are necessary to further investigate the long-term results and prognostic factors.

  15. Detailed characterization and preliminary adsorption model for materials for an intermediate-scale reactive-transport experiment

    International Nuclear Information System (INIS)

    Ward, D.B.; Bryan, C.R.

    1994-01-01

    An experiment involving migration of fluid and tracers (Li, Br, Ni) through a 6-m-high x 3-m-dia caisson Wedron 510 sand, is being carried out for Yucca Mountain Site Characterization Project. Sand's surface chemistry of the sand was studied and a preliminary surface-complexation model of Ni adsorption formulated for transport calculations. XPS and leaching suggest that surface of the quartz sand is partially covered by thin layers of Fe-oxyhydroxide and Ca-Mg carbonate and by flakes of kaolinite. Ni adsorption by the sand is strongly pH-dependent, showing no adsorption at pH 5 and near-total adsorption at pH 7. Location of adsorption edge is independent o