Robotic Ureteral Reconstruction in the Pediatric Population

Robot-assisted laparoscopic (RAL) surgery is a safe, minimally invasive technique that has become more widely used in pediatric urology over recent decades. With several advantages over standard laparoscopy, robotic surgery is particularly well-suited to reconstructive surgery involving delicate structures like the ureter. A robotic approach provides excellent access to and visualization of the ureter at all levels. Common applications include upper ureteral reconstruction (e.g., pyeloplasty, ureteropelvic junction polypectomy, ureterocalicostomy, and high uretero-ureterostomy in duplex systems), mid-ureteral reconstruction (e.g., mid uretero-ureterostomy for stricture or polyp), and lower ureteral reconstruction (e.g., ureteral reimplantation and lower ureter-ureterostomy in duplex systems). Herein, we describe each of these robotic procedures in detail

Endoscopic Treatment of Vesicoureteral Reflux with Dextranomer/Hyaluronic Acid in Children

Purpose. The goal of this review is to present current indications, injectable agents, techniques, success rates, complications, and potential future applications of endoscopic treatment for vesicoureteral reflux (VUR) in children. Materials and Methods. The endoscopic method currently achieving one of the highest success rates is the double hydrodistention-implantation technique (HIT). This method employs dextranomer/hyaluronic acid copolymer, which has been used in pediatric urology for over 10 years and may be at present the first choice injectable agent due to its safety and efficacy. Results. While most contemporary series report cure rates of greater than 85% for primary VUR, success rates of complicated cases of VUR may be, depending on the case, significantly lower. Endoscopic treatment offers major advantages to patients while avoiding potentially complicated open surgery. As the HIT method continues to be applied to complex cases of VUR and more outcome data become available, the indication for endoscopic treatment may exceed the scope of primary VUR. Conclusions. Endoscopic injection is emerging as the treatment of choice for VUR in children

Evaluation of the Legal Cannabis Industry in the United States

This dissertation examines aspects of the legal cannabis industry in the United States. This includes welfare implications of legalized cannabis in Colorado as well as motivations for legalization across the United States. The goal of this dissertation is to provide insight into a newly deregulated industry for which there is relatively little prior research.My first chapter investigates the welfare implications of taxation for the recreational cannabis industry in Colorado. Welfare implications of tax policy on cannabis can be significant. I estimate the sales tax rate which maximizes tax revenue using sales data on cannabis edibles from 2014-2016. Estimation is conducted using a random coefficient logit model. Varying sales tax rates are simulated to determine consumer surplus, producer surplus, and tax revenue. Results suggest revenue from sales taxes is maximized at a rate of 47.6%.My second chapter measures the determinants of cannabis legalization throughout the United States. I account for heterogeneous characteristics of cannabis laws which have been implemented since the 1990’s. I construct a panel of state-year correlates which may be strong determinants of legalization. This includes information on population demographics, education, health, crime, and political variables. An event history analysis is conducted using a logit model. I find political and religious ideology as well as private interests in alcohol and cigarettes to be strong determinants of cannabis policy. My third chapter explores the impact of available legal supply of cannabis on fatal traffic accidents in Colorado counties. Cannabis impaired driving is a major concern surrounding legalization. I measure legal supply of cannabis at the county and month level using cannabis dispensary licensing data from the Colorado Department of Revenue. Fatal accidents follow a count process with non-negative integer values. I utilize a Poisson fixed effects model to explore this impact. I find available legal supply of cannabis has no significant impact on the frequency of fatal accidents in Colorado Counties

Sharing and visualizing environmental data using Virtual Globes

Virtual globe technology holds many exciting possibilities for environmental science. These easy-to-use, intuitive systems provide means for simultaneously visualizing four-dimensional environmental data from many different sources, enabling the generation of new hypotheses and driving greater understanding of the Earth system. Through the use of simple markup languages, scientists can publish and consume data in interoperable formats without the need for technical assistance. In this paper we give, with examples from our own work, a number of scientific uses for virtual globes, demonstrating their particular advantages. We explain how we have used Web Services to connect virtual globes with diverse data sources and enable more sophisticated usage such as data analysis and collaborative visualization. We also discuss the current limitations of the technology, with particular regard to the visualization of subsurface data and vertical sections

Radiation belt slot-region filling events: sustained energetic precipitation into the mesosphere

Precipitation of energetic electrons to the atmosphere is both a loss mechanism for radiation belt particles and a means by which the geospace environment influences the Earth's atmosphere; thus it is important to fully understand the extent of this precipitation. A set of polar orbiting satellites have been used to identify periods when energetic charged particles fill the slot region between the inner and outer radiation belts. These suggest that electrons with energies >30 keV penetrate this region, even under levels of modest geomagnetic activity. Those events with sufficient fluxes of particles produce enough ionization to be detected by a ground‐based radar in Antarctica; this precipitation lasts for ~10 days on average. Analysis of these data reveal that the average precipitation penetrates to the stratopause (~55 km altitude). For some (if not all) of these events, the likely cause of the most energetic precipitation is an interaction between (relativistic) electrons and plasmaspheric hiss leading to little, if no, local time variation in precipitation. This does not preclude a longitudinal effect given that all radar measurements are fixed in longitude. During winter months the radar is under the stable southern polar atmospheric vortex. This transports atmospheric species to lower altitudes including the ozone destroying chemicals that are produced by energetic precipitation. Thus the precipitation from the slot region in the southern hemisphere will likely contribute to the destruction of ozone and changes to atmospheric heat balance and chemistry; more work is required to determine the true impact of these events

Computer-Enhanced Visual Learning Method to Teach Endoscopic Correction of Vesicoureteral Reflux: An Invitation to Residency Training Programs to Utilize the CEVL Method

Herein we describe a standardized approach to teach endoscopic injection therapy to repair vesicoureteral reflux utilizing the CEVL method, an internet-accessed platform. The content was developed through collaboration of the authors' clinical and computer expertises. This application provides personnel training, examination, and procedure skill documentation through the use of online text with narration, pictures, and video. There is also included feedback and remediation of skill performance and teaching “games.” We propose that such standardized teaching and procedure performance will ultimate in improved surgical results. The electronic nature of communication in this journal is ideal to rapidly disseminate this information and to develop a structure for collaborative research

The effectiveness of web-based interventions designed to decrease alcohol consumption – a systematic review

OBJECTIVE To review the published literature on the effectiveness of web-based interventions designed to decrease consumption of alcohol and/or prevent alcohol abuse. METHOD Relevant articles published up to, and including, May 2006 were identified through electronic searches of Medline, PsycInfo, Embase, Cochrane Library, ASSIA, Web of Science and Science Direct. Reference lists of all articles identified for inclusion were checked for articles of relevance. An article was included if its stated or implied purpose was to evaluate a web-based intervention designed to decrease consumption of alcohol and/or to prevent alcohol abuse. Studies were reliably selected and quality-assessed, and data were independently extracted and interpreted by two authors. RESULTS Initial searches identified 191 articles of which 10 were eligible for inclusion. Of these, five provided a process evaluation only, with the remaining five providing some pre-to post-intervention measure of effectiveness. In general the percentage quality criteria met was relatively low and only one of the 10 articles selected was a randomized control trial. CONCLUSION The current review provides inconsistent evidence on the effectiveness of eIectronic screening and brief intervention (eSBI) for alcohol use. Process research suggests that web-based interventions are generally well received. However further controlled trials are needed to fully investigate their efficacy, to determine which elements are keys to outcome and to understand if different elements are required in order to engage low- and high-risk drinkers

Analysis of Proposed Hotel and Conference Center in Downtown Fredrick, MD

Final project for BUMO758K: Management Consulting (Fall 2014). Robert H. Smith School of Business. University of Maryland, College Park.The City of Frederick has joined with PALS and the University of Maryland Smith School of Business to assess a proposed hotel and conference center planned for downtown Frederick. They are particularly interested in assessing the demand for the meeting space planned, and better understanding the likely economic impacts of businesses and nonprofit organizations making use of the conference center. An analysis of the trade show and events industry was conducted to provide additional background as the City and its private partners continue to develop their plans and goals for the project. Two conference centers in similar cities were analyzed to assess likely economic impacts and best practices for marketing strategies. Finally, the regional competitive landscape for conferences and private event venues was analyzed, and opportunities for business development were identified.The City of Frederic

Cognitive facilitation following intentional odor exposure

This paper reviews evidence that, in addition to incidental olfactory pollutants, intentional odor delivery can impact cognitive operations both positively and negatively. Evidence for cognitive facilitation/interference is reviewed alongside four potential explanations for odor-induced effects. It is concluded that the pharmacological properties of odors can induce changes in cognition. However, these effects can be accentuated/attenuated by the shift in mood following odor exposure, expectancy of cognitive effects, and cues to behavior via the contextual association with the odor. It is proposed that greater consideration is required in the intentional utilization of odors within both industrial and private locations, since differential effects are observed for odors with positive hedonic qualities