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Delivery room

Emily Cerier, Eliza W Beal, Jeffery Chakedis, Qinyu Chen, Anghela Paredes, Steven Sun, Jordan M Cloyd, Timothy M Pawlik
BACKGROUND: The patient-provider relationship (PPR) is an important element of health care delivery and may influence patient outcomes. The objective of the present study was to identify clinical predictors of PPR among patients with hepatopancreatobiliary (HPB) diseases and assess the association of PPR and health care utilization. MATERIALS AND METHODS: The Medical Expenditure Panel Survey database from 2008-2014 was used to identify adult patients with HPB diagnoses...
August 2018: Journal of Surgical Research
Thomas Fransson, Ruchira Chatterjee, Franklin D Fuller, Sheraz Gul, Clemens Weninger, Dimosthenis Sokaras, Thomas Kroll, Roberto Alonso Mori, Uwe Bergmann, Jan Kern, Vittal K Yachandra, Junko Yano
Serial femtosecond crystallography (SFX) using the ultra-short X-ray pulses from a X-ray free-electron laser (XFEL) provides a new way of collecting structural data at room temperature, which also allows for following the reaction in real time after initiating the reaction with a trigger. XFEL experiments are conducted in a shot-by-shot mode as the sample is destroyed and replenished after each X-ray pulse, and therefore monitoring and controlling the data quality by using in situ diagnostic tools is especially important...
June 15, 2018: Biochemistry
Brian M Ilfeld, Rodney A Gabriel, Engy T Said, Amanda M Monahan, Jacklynn F Sztain, Wendy B Abramson, Bahareh Khatibi, John J Finneran, Pia T Jaeger, Alexandra K Schwartz, Sonya S Ahmed
BACKGROUND AND OBJECTIVES: Percutaneous peripheral nerve stimulation (PNS) is an analgesic modality involving the insertion of a lead through an introducing needle followed by the delivery of electric current. This modality has been reported to treat chronic pain as well as postoperative pain the day following knee surgery. However, it remains unknown if this analgesic technique may be used in ambulatory subjects following foot procedures beginning within the recovery room immediately following surgery, and with only short series of patients reported to date, the only available data are derived from strictly observational studies...
June 13, 2018: Regional Anesthesia and Pain Medicine
Trixie A Katz, Danielle D Weinberg, Claire E Fishman, Vinay Nadkarni, Patrice Tremoulet, Arjan B Te Pas, Aleksandra Sarcevic, Elizabeth E Foglia
OBJECTIVE: A respiratory function monitor (RFM) may improve positive pressure ventilation (PPV) technique, but many providers do not use RFM data appropriately during delivery room resuscitation. We sought to use eye-tracking technology to identify RFM parameters that neonatal providers view most commonly during simulated PPV. DESIGN: Mixed methods study. Neonatal providers performed RFM-guided PPV on a neonatal manikin while wearing eye-tracking glasses to quantify visual attention on displayed RFM parameters (ie, exhaled tidal volume, flow, leak)...
June 14, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
Daniel M Koehler, Ramji Balakrishnan, Ericka A Lawler, Apurva S Shah
PURPOSE: In order to effectively improve value in health care delivery, providers must thoroughly understand cost drivers. Time-driven activity-based costing (TDABC) is a novel accounting technique that may allow for precise characterization of procedural costs. The purpose of the present study was to use TDABC to characterize costs in a high-volume, low-complexity ambulatory procedure (endoscopic vs open carpal tunnel release [CTR]), identify cost drivers, and inform opportunities for clinical improvement...
June 11, 2018: Journal of Hand Surgery
Anthony Lathrop, Carrie F Bonsack, David M Haas
BACKGROUND: Water birth has become an increasingly popular childbirth option, but has also come under scrutiny because of its possible risks and benefits. The primary objective of this study was to explore potential benefits of water birth by comparing the experiences of women who gave birth in water versus conventionally. We also compared maternal and newborn outcomes. METHODS: We performed a prospective study of 66 women who had water births and 132 who had conventional births...
June 13, 2018: Birth
M P Nikitin, A V Orlov, I L Sokolov, A A Minakov, P I Nikitin, J Ding, S D Bader, E A Rozhkova, V Novosad
Geometrically confined magnetic particles due to their unique response to external magnetic fields find a variety of applications, including magnetic guidance, heat and drug delivery, magneto-mechanical actuation, and contrast enhancement. Highly sensitive detection and imaging techniques based on the nonlinear properties of nanomagnets were recently proposed as innovative strong-translational potential methods applicable in complex, often opaque, biological systems. Here we report on the significant enhancement of the detection capability using optical-lithography-defined, ferromagnetic iron-nickel alloy disk-shaped particles...
June 13, 2018: Nanoscale
Sparsh Patel, Po-Yin Cheung, Anne Lee Solevåg, Keith J Barrington, C Omar Farouk Kamlin, Peter G Davis, Georg M Schmölzer
BACKGROUND: The 2015 neonatal resuscitation guidelines added ECG as a recommended method of assessment of an infant's heart rate (HR) when determining the need for resuscitation at birth. However, a recent case report raised concerns about this technique in the delivery room. OBJECTIVES: To compare accuracy of ECG with auscultation to assess asystole in asphyxiated piglets. METHODS: Neonatal piglets had the right common carotid artery exposed and enclosed with a real-time ultrasonic flow probe and HR was continuously measured and recorded using ECG...
June 12, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
Adrien Hertault, Robert Rhee, George A Antoniou, Donald Adam, Hisashi Tonda, Hervé Rousseau, Aurélia Bianchini, Stéphan Haulon
OBJECTIVE: To evaluate radiation exposure in standard endovascular aneurysm repair (EVAR) using intra-operative guidance with pre-operative computed tomographic angiography (CTA) fusion and strict ALARA guidelines in a modern hybrid room. MATERIAL AND METHODS: Between February and November 2016, consecutive patients with AAA undergoing EVAR with a bifurcated device in a hybrid room under fusion imaging guidance were prospectively enrolled in six aortic centres from the United States (n = 1), Europe (n = 4), and Japan (n = 1)...
June 9, 2018: European Journal of Vascular and Endovascular Surgery
B Sivaranjini, R Mangaiyarkarasi, V Ganesh, S Umadevi
A simple and effective approach for vertical alignment of liquid crystals (LCs) over a functionalized transparent flexible substrate is described. Surface characterization of this commercially available plastic substrate through X-ray photoelectron spectroscopy (XPS) and attenuated total reflection infrared spectroscopy (ATR-IR) indicated that cellulose acetate is main component of the transparent substrate. This substrate was chemically functionalized with a suitable LC compound. A trimethoxysilane terminated new rod-shaped mesogen is synthesized and covalently attached to the pre-treated film through silane condensation reaction...
June 11, 2018: Scientific Reports
Hui Wu, Xiaojian Chen, Xin Yang, Yalan Tao, Yunfei Xia, Xiaowu Deng, Cheng Zheng, Jared Robbins, Christopher Schultz, X Allen Li
PURPOSE: To investigate radiation-induced changes of computed tomography (CT) textures in parotid glands (PG) to predict acute xerostomia during radiotherapy (RT) for head and neck cancer (HNC). METHODS AND MATERIALS: Daily or fraction kilovoltage CTs acquired using diagnostic CT scanners (eg, in-room CTs) during intensity-modulated RT for 59 HNC patients at 3 institutions were analyzed. The PG contours were generated on selected daily/fraction CTs. A series of histogram-based texture features, including the mean CT number (MCTN) in Hounsfield units, volume, standard deviation, skewness, kurtosis, and entropy for PGs were calculated for each fraction...
May 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Wei Zou, Brendan Burgdorf, Ning J Yue, Lingshu Yin, Miao Zhang, Atif Khan, Salma K Jabbour, James McDonough, Lei Dong, Boon-Keng Kevin Teo
PURPOSE: Passive scattering proton radiotherapy utilizes beam-specific compensators to shape the dose to the distal end of the tumor target. These compensators typically require therapists to enter the treatment room to mount between beams. This study investigates a novel approach that utilizes a single patient-specific bolus to accomplish the role of multi-field compensators to improve the efficiency of the treatment delivery. METHODS: Ray-tracing from the proton virtual source was used to convert the beam-specific compensators (mounted on the gantry nozzle) into an equivalent bolus thickness on the patient surface...
June 2018: Physica Medica: PM
Philipp Franck, Jaime L Bernstein, Leslie E Cohen, Roger Härtl, Ali A Baaj, Jason A Spector
OBJECTIVES: Patients with neoplastic disease involving the spine either from primary or metastatic disease present a unique challenge given these patients' frequent poor nutritional status at the time of surgery, the delivery of early post-operative chemotherapy or radiation, and placement of large amounts of hardware and avascular bone graft into a wound bed that is atrophic, previously operated or irradiated. As a result, wound morbidity has traditionally been high in this cohort of patients...
May 29, 2018: Clinical Neurology and Neurosurgery
Shireen Parsai, Sheen Cherian, Ryan K Berglund, Byron Lee, Matthew Kolar, Nancy Nagle-Hernan, Allan Wilkinson, Jay Ciezki
OBJECTIVES: To allow for organ preservation, high dose rate brachytherapy may be used in the treatment of localized penile cancer. Penile cancer is a rare malignancy, accounting for less than one percent of cancers in men in the United States. The standard treatment for localized disease is partial amputation of the penis. However, patients with T1b or T2 disease, less than 4 cm in maximum dimension and confined to the glans penis may be treated with brachytherapy as an organ-sparing approach...
June 8, 2018: Practical Radiation Oncology
Shilpi Chabra
BACKGROUND: The approach to intrapartum and postnatal management of an infant born through meconium-stained amniotic fluid (MSAF) in the delivery room (DR) has changed several times over the last few decades, leading to confusion and anxiety among health care providers (nurses, nurse practitioners, respiratory therapists, midwives, and physicians). This article provides state-of-the-art insight into the evidence or lack thereof for the changes in guidelines. PURPOSE: To discuss the evidence for evolution of DR management of vigorous and nonvigorous infants born through any type of MSAF...
June 8, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Amy C Yan, Matthew Levy
Targeting cells with aptamers for the delivery of therapeutic cargoes, in particular oligonucleotides, represents one of the most exciting applications of the aptamer field. Perhaps nowhere has there been more excitement in the field than around the targeted delivery of siRNA or miRNA. However, when industry leaders in the field of siRNA delivery have tried to recapitulate aptamer-siRNA delivery results, they have failed. This problem stems from more than just the age-old problem of delivery to the cytoplasm, a challenge that has stymied the targeted delivery of therapeutic oligonucleotides since its inception...
June 2018: Nucleic Acid Therapeutics
Bethany R Raiff, Nicholas Fortugno, Daniel R Scherlis, Darion Rapoza
BACKGROUND: Cigarette smoking results in an estimated seven million deaths annually. Almost half of all smokers attempt to quit each year, yet only approximately 6% are successful. Although there are multiple effective interventions that can increase these odds, substantial room remains for improvement. One effective approach to helping smokers quit is contingency management, where quitting is incentivized with the delivery of monetary rewards in exchange for objective evidence (eg, exhaled carbon monoxide levels) of abstinence...
June 7, 2018: JMIR Serious Games
O V Angelsky, A Ya Bekshaev, P P Maksimyak, A P Maksimyak, S G Hanson
A method is described for the generation of micrometer-sized vapor-gas bubbles in a water suspension containing absorptive pigment nanoparticles. The diluted suspension (mean interparticle distance 20 μm) absorbs the continuous laser radiation (wavelength 808 nm), and each particle in the best illuminated volume (~10 × 10 × 200 μm3 ) serves as a bubble-nucleation center. The suspension heating is inessential (several degrees above the room temperature) and the bubbles are formed mainly of the air gases dissolved in water...
May 28, 2018: Optics Express
Mahboubeh Rezazadeh, Maryam Parandeh, Vajihe Akbari, Zahra Ebrahimi, Azade Taheri
Rosuvastatin (RSV) has been shown to have significant impact on the simulation of bone regeneration after local injection. The current study aimed to develop a localized controlled delivery system from RSV by incorporating RSV-loaded chitosan/chondroitin sulfate (CTS/CS) nanoparticles into thermosensitive Pluronic F127/hyaluronic acid (PF127/HA) hydrogel. RSV-loaded CTS/CS nanoparticles were prepared by ionic gelation and the impact of various formulation variables was assessed using the Box-Behnken design...
June 4, 2018: Pharmaceutical Development and Technology
Krithika Lingappan, Jennifer L Arnold, Caraciolo J Fernandes, Mohan Pammi
BACKGROUND: Establishment of a secure airway is a critical part of neonatal resuscitation in the delivery room and the neonatal unit. Videolaryngoscopy has the potential to facilitate successful endotracheal intubation and decrease adverse consequences of delay in airway stabilization. Videolaryngoscopy may enhance visualization of the glottis and intubation success in neonates. OBJECTIVES: To determine the efficacy and safety of videolaryngoscopy compared to direct laryngoscopy in decreasing the time and attempts required for endotracheal intubation and increasing the success rate at first intubation in neonates...
June 4, 2018: Cochrane Database of Systematic Reviews
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