Prevalence of Errors in Anaphylaxis in Kids (PEAK): A Multicenter Simulation-Based Study

Background Multi-institutional, international practice variation of pediatric anaphylaxis management by health care providers has not been reported. Objective To characterize variability in epinephrine administration for pediatric anaphylaxis across institutions, including frequency and types of medication errors. Methods A prospective, observational, study using a standardized in situ simulated anaphylaxis scenario was performed across 28 health care institutions in 6 countries. The on-duty health care team was called for a child (patient simulator) in anaphylaxis. Real medications and supplies were obtained from their actual locations. Demographic data about team members, institutional protocols for anaphylaxis, timing of epinephrine delivery, medication errors, and systems safety issues discovered during the simulation were collected. Results Thirty-seven in situ simulations were performed. Anaphylaxis guidelines existed in 41% (15 of 37) of institutions. Teams used a cognitive aid for medication dosing 41% (15 of 37) of the time and 32% (12 of 37) for preparation. Epinephrine autoinjectors were not available in 54% (20 of 37) of institutions and were used in only 14% (5 of 37) of simulations. Median time to epinephrine administration was 95 seconds (interquartile range, 77-252) for epinephrine autoinjector and 263 seconds (interquartile range, 146-407.5) for manually prepared epinephrine (P = .12). At least 1 medication error occurred in 68% (25 of 37) of simulations. Nursing experience with epinephrine administration for anaphylaxis was associated with fewer preparation (P = .04) and administration (P = .01) errors. Latent safety threats were reported by 30% (11 of 37) of institutions, and more than half of these (6 of 11) involved a cognitive aid. Conclusions A multicenter, international study of simulated pediatric anaphylaxis reveals (1) variation in management between institutions in the use of protocols, cognitive aids, and medication formularies, (2) frequent errors involving epinephrine, and (3) latent safety threats related to cognitive aids among multiple sites

Expected Performance of the ATLAS Experiment - Detector, Trigger and Physics

A detailed study is presented of the expected performance of the ATLAS detector. The reconstruction of tracks, leptons, photons, missing energy and jets is investigated, together with the performance of b-tagging and the trigger. The physics potential for a variety of interesting physics processes, within the Standard Model and beyond, is examined. The study comprises a series of notes based on simulations of the detector and physics processes, with particular emphasis given to the data expected from the first years of operation of the LHC at CERN

Drons col·laboratius

La robòtica col·laborativa és senzillament robots dissenyats per dur a terme treballs de col·laboració amb els humans. Els robots col·laboratius o cobots són cada cop més utilitzats a les indústries. La robòtica col·laborativa és un dels àmbits d'actualitat en aquests moments. Però també és un dels més interessants en més d'un sentit. Com es comuniquen dos drons autònoms que col·laboren per fer una tasca? Com són aquests missatges que s'envien? Que poden fer que no podrien fer sols? Aquestes són algunes de les preguntes que ens volem respondre en aquest projecte. En aquest treball es presenta un disseny i implementació de dos drons terrestres que es comuniquen per col·laborar entre ells per resoldre una tasca.Collaborative robotics is simply robots designed to perform collaborative work with humans. Collaborative robots or cobots are increasingly used in industries. Collaborative robotics is one of the current topics now. But it is also one of the most interesting in more ways than one. How do two autonomous drones that collaborate to perform a task communicate? How are these messages sent? What can they do that they could not do alone? These are some of the questions we want to answer in this project. This work presents a design and implementation of two ground drones that communicate to collaborate with each other to solve a task.La robótica colaborativa es sencillamente robots diseñados para llevar a cabo trabajos de colaboración con los humanos. Los robots colaborativos o cobots son cada vez más utilizados en las industrias. La robótica colaborativa es uno de los ámbitos de actualidad. Pero también es uno de los más interesantes en más de un sentido. ¿Cómo se comunican drones autónomos que colaboran para hacer una tarea? ¿Cómo son estos mensajes que es envían? ¿Qué pueden hacer que no lo podrían hacer solos? Estas son algunas de las preguntas que queremos responder con este proyecto. En este trabajo se presenta un diseño e implementación de dos drones terrestres que se comunican para colaborar entre ellos para resolver una tarea

Short and long arm cast and pain after discharge in children who underwent reduction of distal forearm fracture in the Emergency Department: A study protocol for a randomized comparative effectiveness study

Distal forearm fracture is the most common fracture in childhood. Patients with this type of injury suffer from meaningful pain after Emergency Department (ED) discharge. Previous studies demonstrated that short arm (below-the-elbow) casts perform as well as long arm (above-the-elbow) casts for maintaining the reduction of distal forearm fractures, with a similar rate of complications. Consequently, short casts are the commonly used method of immobilization after closed reduction of a distal forearm fractures in children older than 4 years. However, short casts carry a potential disadvantage; since they cannot prevent supination in a wrist that is held in pronation, and vice versa, their use might be associated with pain.We initiated this study to examine the effect of the type of casting on post discharge pain. We will conduct an open-label randomized, controlled trial comparing short cast immobilization with long cast immobilization in children who had a reduction of distal forearm fracture in the ED. Our hypothesis is that children with distal forearm fractures who are treated with a long cast, experience less pain during the first 48 h after ED discharge than children who are treated with a short cast. Keywords: Pain, Children, Fracture, Cas

The influence of an accredited pediatric emergency medicine program on the management of pediatric pain and anxiety

Abstract Background The emergency department (ED) setting is an environment where children may experience intense physical pain and emotional stress. This study sought to determine the availability of pain and anxiety management practices in all Israeli emergency departments which accept children, specifically looking for differences between accredited pediatric emergency medicine departments and others. Methods A cross-sectional survey of all Israeli emergency departments that accept children was performed. One person at each institution was approached to complete the survey. Data were collected between May and June 2016 using an electronic survey tool. Results Responses were collected from 21 of 22 hospitals (95% response rate). Commonly available in all types of emergency departments were nurse ordered analgesia, medical clowns (in 95% of the hospitals), topical analgesia and oral sucrose solution. The accredited pediatric emergency medicine departments showed a tendency for more frequent use of all pharmacologic methods for pain and anxiety relief, specifically oxycodone and ketamine. Conclusions Overall, Israeli emergency departments have similar access to pharmacologic and non-pharmacologic pain and anxiety management strategies in children, but gaps still exist, especially where not all attending physicians are pediatric emergency medicine trained. We suggest that certified pediatric emergency medicine physicians should advise all emergency departments that accept children to promote the use of the various methods of pain and anxiety reduction

Prevalence of Errors in Anaphylaxis in Kids (PEAK): A Multicenter Simulation-Based Study

Multi-institutional, international practice variation of pediatric anaphylaxis management by health care providers has not been reported. To characterize variability in epinephrine administration for pediatric anaphylaxis across institutions, including frequency and types of medication errors. A prospective, observational, study using a standardized in situ simulated anaphylaxis scenario was performed across 28 health care institutions in 6 countries. The on-duty health care team was called for a child (patient simulator) in anaphylaxis. Real medications and supplies were obtained from their actual locations. Demographic data about team members, institutional protocols for anaphylaxis, timing of epinephrine delivery, medication errors, and systems safety issues discovered during the simulation were collected. Thirty-seven in situ simulations were performed. Anaphylaxis guidelines existed in 41% (15 of 37) of institutions. Teams used a cognitive aid for medication dosing 41% (15 of 37) of the time and 32% (12 of 37) for preparation. Epinephrine autoinjectors were not available in 54% (20 of 37) of institutions and were used in only 14% (5 of 37) of simulations. Median time to epinephrine administration was 95 seconds (interquartile range, 77-252) for epinephrine autoinjector and 263 seconds (interquartile range, 146-407.5) for manually prepared epinephrine (P = .12). At least 1 medication error occurred in 68% (25 of 37) of simulations. Nursing experience with epinephrine administration for anaphylaxis was associated with fewer preparation (P = .04) and administration (P = .01) errors. Latent safety threats were reported by 30% (11 of 37) of institutions, and more than half of these (6 of 11) involved a cognitive aid. A multicenter, international study of simulated pediatric anaphylaxis reveals (1) variation in management between institutions in the use of protocols, cognitive aids, and medication formularies, (2) frequent errors involving epinephrine, and (3) latent safety threats related to cognitive aids among multiple sites

Expected Performance of the ATLAS Experiment - Detector, Trigger and Physics

A detailed study is presented of the expected performance of the ATLAS detector. The reconstruction of tracks, leptons, photons, missing energy and jets is investigated, together with the performance of b-tagging and the trigger. The physics potential for a variety of interesting physics processes, within the Standard Model and beyond, is examined. The study comprises a series of notes based on simulations of the detector and physics processes, with particular emphasis given to the data expected from the first years of operation of the LHC at CERN

Κορώνη -- Μοσχάτον

A joint measurement is presented of the branching fractions $B^0_s\to\mu^+\mu^-$ and $B^0\to\mu^+\mu^-$ in proton-proton collisions at the LHC by the CMS and LHCb experiments. The data samples were collected in 2011 at a centre-of-mass energy of 7 TeV, and in 2012 at 8 TeV. The combined analysis produces the first observation of the $B^0_s\to\mu^+\mu^-$ decay, with a statistical significance exceeding six standard deviations, and the best measurement of its branching fraction so far, and three standard deviation evidence for the $B^0\to\mu^+\mu^-$ decay. The measurements are statistically compatible with SM predictions and impose stringent constraints on several theories beyond the SM