Accuracy of Intravenous and Enteral Preparations Involving Small Volumes for Paediatric Use: A Review

Background: Children often need to be administered very small volumes of medicines that are authorised for use in adults. Neonatal drug delivery is particularly challenging and doses are often immeasurable with the equipment currently available. Aim: To summarise research to date on the accuracy of intravenous and enteral medicine preparation requiring small volumes (<0.1mL), with a focus on paediatric use and to identify areas for further work. Method: Twenty-three publications were identified for the narrative review via: Web of Science (1950-2016), Cumulative Index to Nursing and Allied Health Literature (1976-2016), Excerpta Medica Database (1974-2016) and International Pharmaceutical Abstracts (1970-2016) searches. Nine additional papers were identified through backward citation tracking and a further 17 were included from the personal knowledge of the review team. Results: Measurement of volumes (<0.1mL), for enteral and intravenous dosing, account for 25% of medicine manipulations within paediatric hospitals. Inaccuracies are described throughout the literature with dose administration errors attributed to technique, calculation, dilution and problems associated with equipment. Whilst standardised concentrations for intravenous infusion and drug concentrations which avoid measurement of small volumes would ameliorate problems, further work is needed to establish accurate methods for handling small volumes during the administration of medicines to children and risk minimisation strategies to support staff involved are also necessary. Conclusion: This review has revealed a paucity of information on the clinical outcomes from problems in measuring small volumes for children and highlighted the need for further work to eliminate this source of inaccurate dosing and potential for medication error

Studies of the Decay B+- -> D_CP K+-

We report studies of the decay B+- -> D_CP K+-, where D_CP denotes neutral D mesons that decay to CP eigenstates. The analysis is based on a 29.1/fb data sample of collected at the \Upsilon(4S) resonance with the Belle detector at the KEKB asymmetric e+ e- storage ring. Ratios of branching fractions of Cabibbo-suppressed to Cabibbo-favored processes involving D_CP are determined to be B(B- -> D_1 K-)/B(B- -> D_1 pi-)=0.125 +- 0.036 +- 0.010 and B(B- -> D_2 K-)/B(B- -> D_2 pi-)=0.119 +- 0.028 +- 0.006, where indices 1 and 2 represent the CP=+1 and CP=-1 eigenstates of the D0 - anti D0 system, respectively. We also extract the partial rate asymmetries for B+- -> D_CP K+-, finding A_1 = 0.29 +- 0.26 +- 0.05 and A_2 = -0.22 +- 0.24 +- 0.04.Comment: 10 pages, 2 figures, submitted to Physical Review Letter

Measurements of the branching fraction and polarization in B+->rho K-+(*0) decays

We present the results of a study of the charmless vector-vector decay B+->rho K-+(*0), based on 253 fb(-1) of data collected with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. We obtain the branching fraction B(B+->rho K-+(*0))=[8.9 +/- 1.7(stat)+/- 1.2(syst)]x10(-6). We also perform a helicity analysis of the rho and K-* vector mesons, and obtain the longitudinal polarization fraction f(L)(B+->rho K-+(*0))=0.43 +/- 0.11(stat)(-0.02)(+0.05)(syst)

Measurements of B decays to two kaons

We report measurements of B meson decays to two kaons using 253 fb(-1) of data collected with the Belle detector at the KEKB energy-asymmetric e(+)e(-) collider. We find evidence for signals in B+->(K) over bar K-0(+) and B-0-> K-0(K) over bar (0) with significances of 3.0 sigma and 3.5 sigma, respectively. (Charge-conjugate modes are included.) The corresponding branching fractions are measured to be B(B+->(K) over bar K-0(+))=(1.0 +/- 0.4 +/- 0.1)x10(-6) and B(B-0-> K-0(K) over bar (0))=(0.8 +/- 0.3 +/- 0.1)x10(-6). These decay modes are examples of hadronic b -> d transitions. No signal is observed in the decay B-0-> K+K-, and we set an upper limit of 3.7x10(-7) at 90% confidence level

Measurement of polarization and triple-product correlations in B -> phi K-* decays

We present measurements of decay amplitudes and triple-product correlations in B ->phi K-* decays based on 253 fb(-1) of data recorded at the Upsilon(4S) resonance with the Belle detector at the KEKB e(+)e(-) storage ring. The decay amplitudes for the three different helicity states are determined from the angular distributions of final-state particles. The longitudinal polarization amplitudes are found to be 0.45 +/- 0.05 +/- 0.02 for B-0->phi K-*0 and 0.52 +/- 0.08 +/- 0.03 for B+->phi K*+ decays. CP- and T-odd CP-violating triple-product asymmetries are measured to be consistent with zero

Evidence for direct CP violation in B-0 -> K+pi(-) decays

We report evidence for direct CP violation in the decay B-0-->K(+)pi(-) with 253 fb(-1) of data collected with the Belle detector at the KEKB e(+)e(-) collider. Using 275x10(6) B(B) over bar pairs we observe a B-->K(+/-)pi(-/+) signal with 2140+/-53 events. The measured CP violating asymmetry is A(CP)(K(+)pi(-))=-0.101+/-0.025(stat)+/-0.005(syst), corresponding to a significance of 3.9sigma including systematics. We also search for CP violation in the decays B+-->K(+)pi(0) and B+-->pi(+)pi(0). The measured CP violating asymmetries are A(CP)(K(+)pi(0))=0.04+/-0.05(stat)+/-0.02(syst) and A(CP)(pi(+)pi(0))=-0.02+/-0.10(stat)+/-0.01(syst), corresponding to the intervals -0.05< A(CP)(K(+)pi(0))<0.13 and -0.18< A(CP)(pi(+)pi(0))<0.14 at 90% confidence level

Measurement of the B-0-(B)over-bar(0) mixing parameter Delta m(d) using semileptonic B-0 decays

We present a measurement of the B-0-(B-0) over bar mixing parameter Deltam(d) using neutral B meson pairs in a 29.1 fb(-1) data sample collected at the Y(4S) resonance with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. We exclusively reconstruct one neutral B meson in the semileptonic B-0-->D*-.(+)nu decay mode and identify the flavor of the accompanying B meson from its decay products. From the distribution of the time intervals between the two flavor-tagged B meson decay points, we obtain Deltam(d)=(0.494+/-0.012+/-0.015) ps(-1), where the first error is statistical and the second error is systematic

Observation of B-+/-->omega K-+/- decay

We report the first observation of the charmless two-body mode B+/- --> omegaK(+/-) decay, and a new measurement of the branching fraction for the B+/- --> omegapi(+/-) decay. The measured branching fractions are B(B+/- --> omegaK(+/-)) = (9.2(-2.3)(+2.6) +/-1.0) x 10(-6) and B(B+/- --> omegapi(+/-)) = (4.2(-1.8)(+2.0) +/- 0.5) x 10(-6). We also measure the partial rate asymmetry of B+/- --> omegaK(+/-) decays and obtain A(CP) = -0.21 +/- 0.28 +/- 0.03. The results are based on a data sample of 29.4 fb(-1) collected on the Y(4S) resonance by the Belle detector at the KEKB e(+)e(-) collider

Evidence for B+->omega l(+)nu

We have searched for the decay B+-->omegal(+)nu (l=e or mu) in 78 fb(-1) of Y(4S) data (85x10(6)B (B) over bar events) accumulated with the Belle detector. The final state is fully reconstructed using the omega decay into pi(+)pi(-)pi(0), combined with detector hermeticity to estimate the neutrino momentum. A signal of 414+/-125 events is found in the data, corresponding to a branching fraction of (1.3+/-0.4+/-0.2+/-0.3)x10(-4), where the first two errors are statistical and systematic, respectively. The third error reflects the estimated form-factor uncertainty

Observation of a charmoniumlike state produced in association with a J/psi in e(+)e(-) annihilation at root s approximate to 10.6 GeV

We report the first observation of a charmoniumlike state recoiling from the J/psi in the inclusive process e(+)e(-)-> J/psi+anything at a mass of (3.943 +/- 0.006 +/- 0.006) GeV/c(2). We also observe the decay of this state into (DD)-D-* and determine its intrinsic width to be less than 52 MeV/c(2) at the 90% C.L. These results are obtained from a 357 fb(-1) data sample collected with the Belle detector near the Upsilon(4S) resonance, at the KEKB asymmetric-energy e(+)e(-) collider