Reinforced oxide throat insert development

Wire reinforced zirconium oxide rocket nozzle insert

Congenital diaphragmatic hernia in the preterm infant.

BACKGROUND: Congenital diaphragmatic hernia (CDH) remains a significant cause of death in newborns. With advances in neonatal critical care and ventilation strategies, survival in the term infant now exceeds 80% in some centers. Although prematurity is a significant risk factor for morbidity and mortality in most neonatal diseases, its associated risk with infants with CDH has been described poorly. We sought to determine the impact of prematurity on survival using data from the Congenital Diaphragmatic Hernia Registry (CDHR). METHODS: Prospectively collected data from live-born infants with CDH were analyzed from the CDHR from January 1995 to July 2009. Preterm infants were defined as \u3c37 weeks estimated gestational age at birth. Univariate and multivariate logistic regression analysis were\u3eperformed. RESULTS: During the study period, 5,069 infants with CDH were entered in the registry. Of the 5,022 infants with gestational age data, there were 3,895 term infants (77.6%) and 1,127 preterm infants (22.4%). Overall survival was 68.7%. A higher percentage of term infants were treated with extracorporeal membrane oxygenation (ECMO) (33% term vs 25.6% preterm). Preterm infants had a greater percentage of chromosomal abnormalities (4% term vs 8.1% preterm) and major cardiac anomalies (6.1% term vs 11.8% preterm). Also, a significantly higher percentage of term infants had repair of the hernia (86.3% term vs 69.4% preterm). Survival for infants that underwent repair was high in both groups (84.6% term vs 77.2% preterm). Survival decreased with decreasing gestational age (73.1% term vs 53.5% preterm). The odds ratio (OR) for death among preterm infants adjusted for patch repair, ECMO, chromosomal abnormalities, and major cardiac anomalies was OR 1.68 (95% confidence interval [CI], 1.34-2.11). CONCLUSION: Although outcomes for preterm infants are clearly worse than in the term infant, more than 50% of preterm infants still survived. Preterm infants with CDH remain a high-risk group. Although ECMO may be of limited value in the extremely premature infant with CDH, most preterm infants that live to undergo repair will survive. Prematurity should not be an independent factor in the treatment strategies of infants with CDH

Exploration of Occupational Therapy Practice for Children with Autism Spectrum Disorders in the Dominican Republic

Background: To better understand the current practice trends of ASD treatment globally and promote practitioner collaboration, it is important to complete studies in countries where little is known about the diagnosis and treatment of ASD through an occupational lens. The aim of this study was to gain an insight into how occupational therapists in the Dominican Republic evaluate and treat children diagnosed with ASD. Method: This qualitative descriptive study explored the perception of occupational therapists (n = 6) and caregivers of children with ASD (n = 28) through a questionnaire and focus group. Interview transcripts and questionnaire text were analyzed using thematic analysis. Trustworthiness was established through member checking, an audit trail, triangulation, reflexivity, and a thick description. Results: Three themes emerged: caregiver ability to access quality services, importance of caregiver involvement in the treatment process, and value of client-centered care. Conclusion: Promoting cultural humility, which focuses on continuous critical self-reflection and lifelong learning, can lead to improved outcomes for this population from initial diagnosis to the overall treatment process

Suction force-suction distance relation during aspiration thrombectomy for ischemic stroke: A computational fluid dynamics study

Acute Ischemic Stroke (AIS) is the major type of stroke occurring in patients. Aspiration thrombectomy, which uses suction to remove the thrombosis, is a promising technique in the clinical treatment of AIS patients. In this research a computational fluid dynamics (CFD) analysis was conducted to model the blood flow dynamics in a simplified cerebral model during an aspiration thrombectomy procedure. The flow system being analysed was a typical in vitro cerebral flow model, and the system parameters were set based on the clinical and in vitro data reported in open literature. The simulated flow field features showed good correlation with the in vitro response as reported in literature. The CFD study provides detailed technical data including the peak velocity occurring at the catheter tip and the suction force-suction distance relation during the aspiration thrombectomy procedure, which are useful new knowledge and have the potential to influence future catheter design as well as clinical operational protocols used during thrombectomy intervention

GAUGING THE QUALITY OF MANAGERIAL DECISIONS REGARDING INFORMATION TECHNOLOGY DEPLOYMENT

This paper presents a new approach for evaluating the quality of managerial choices in information technology (IT) deployment. The approach involves measuring the extent to which deployment sites perform in accordance with the firm's objectives, given the constraints of their competitive environment. Our method is to model environmental descriptors as inputs to a production process that yields business outputs. This production process is then evaluated via standard productivity assessment methods to obtain "competitive efficiencyâ scores. Interpreting why different deployment sites exhibit different levels of competitive efficiency involves estimating regression models in which competitive efficiency scores are the dependent variables and management's IT design choices are the independent variables. Such measurement and interpretative methods provide managers with new tools to improve their IT location and design decisions. Our framework is illustrated in the context of automatic teller machine (ATM) deployment.Information Systems Working Papers Serie

Bone mineral content in Hawaiian, Asian, and Filipino children.

Os calcis bone mineral content (BMC) was measured by single photon absorptiometry in 86 children, ages 6 to 13 years from Hawaiian, Oriental, Caucasian, and Filipino ethnic groups. Pearson correlations indicated significant positive correlations between BMC and age, height, and weight. However, there were no significant differences in age, height or weight between ethnic groups. ANOVA revealed a significant effect of ethnic group on BMC with the Hawaiian group having a significantly higher BMC than the Asian or Caucasian groups. When age, height and weight were controlled for, ANCOVA still showed a significant effect of ethnicity on BMC. The current findings suggest that ethnic differences can develop early in life

Bundling Payment Initiatives for Total Hip and Knee Arthroplasties: Perspectives of Health Care Professionals

Background: A broad qualitative research study explored the perceptions of rehabilitation health care professionals and administrative leadership on coordination of care for rehabilitation patients who received hip or knee arthroplasties under the bundling initiative. Method: Data was collected through the conduction of a focus group, email communication, and individual phone interviews. Researchers analyzed data collected from five administrative personnel and eight rehabilitation health care professionals who work in a facility that participates in a bundling initiative payment model. Results: Four major themes were identified: importance of care coordination, increased efficiency and effectiveness, establishing protocols, and challenges of bundling payment. Conclusion: These findings indicate the significance of interprofessional collaboration and communication, establishment of patient autonomy, and adherence to rehabilitation protocols with hip or knee arthroplasties

Fluorescence Efficiency and Visible Re-emission Spectrum of Tetraphenyl Butadiene Films at Extreme Ultraviolet Wavelengths

A large number of current and future experiments in neutrino and dark matter detection use the scintillation light from noble elements as a mechanism for measuring energy deposition. The scintillation light from these elements is produced in the extreme ultraviolet (EUV) range, from 60 - 200 nm. Currently, the most practical technique for observing light at these wavelengths is to surround the scintillation volume with a thin film of Tetraphenyl Butadiene (TPB) to act as a fluor. The TPB film absorbs EUV photons and reemits visible photons, detectable with a variety of commercial photosensors. Here we present a measurement of the re-emission spectrum of TPB films when illuminated with 128, 160, 175, and 250 nm light. We also measure the fluorescence efficiency as a function of incident wavelength from 120 to 250 nm.Comment: 15 pages, 9 figures, Submitted to Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipmen