Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the Interstage

Congenital heart disease is identified as the most common birth defect with single ventricle physiology carrying the highest mortality. Staged surgical palliation is required for treatment, with mortality historically as high as 22% in the four- to six-month period from the first- to second-stage surgical palliation, known as the interstage. A standardized postoperative feeding approach was implemented through an evidence-based protocol, parent engagement, and interprofessional team rounds. Five infants with single ventricle physiology preprotocol were compared with five infants who received the standardized feeding approach. Mann- Whitney tests were conducted to evaluate the hypotheses that infants in the intervention condition would consume more calories and have a positive change inweight-to-age -score (WAZ) and shorter length of stay (LOS) following the first and second surgeries compared to infants in the control condition. After the protocol, the change inWAZ during the interstage increased by virtually one standard deviation from 0.05 to 0.91.Median LOS dropped 32% after the first surgery and 43% after the second surgery. Since firstand second-stage palliative surgeries occur within the same year of life, this represents savings of $500,000 to$800,000 per year in a 10-infant model.The standardized feeding approach improved growth in single ventricle infants while concurrently lowering hospital costs

Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the Interstage

Congenital heart disease is identified as the most common birth defect with single ventricle physiology carrying the highest mortality. Staged surgical palliation is required for treatment, with mortality historically as high as 22% in the four- to six-month period from the first- to second-stage surgical palliation, known as the interstage. A standardized postoperative feeding approach was implemented through an evidence-based protocol, parent engagement, and interprofessional team rounds. Five infants with single ventricle physiology preprotocol were compared with five infants who received the standardized feeding approach. Mann- Whitney tests were conducted to evaluate the hypotheses that infants in the intervention condition would consume more calories and have a positive change inweight-to-age -score (WAZ) and shorter length of stay (LOS) following the first and second surgeries compared to infants in the control condition. After the protocol, the change inWAZ during the interstage increased by virtually one standard deviation from 0.05 to 0.91.Median LOS dropped 32% after the first surgery and 43% after the second surgery. Since firstand second-stage palliative surgeries occur within the same year of life, this represents savings of $500,000 to$800,000 per year in a 10-infant model.The standardized feeding approach improved growth in single ventricle infants while concurrently lowering hospital costs

Improving Outcomes for Infants with Single Ventricle Physiology through Standardized Feeding during the Interstage

Congenital heart disease is identified as the most common birth defect with single ventricle physiology carrying the highest mortality. Staged surgical palliation is required for treatment, with mortality historically as high as 22% in the four- to six-month period from the first- to second-stage surgical palliation, known as the interstage. A standardized postoperative feeding approach was implemented through an evidence-based protocol, parent engagement, and interprofessional team rounds. Five infants with single ventricle physiology preprotocol were compared with five infants who received the standardized feeding approach. Mann-Whitney U tests were conducted to evaluate the hypotheses that infants in the intervention condition would consume more calories and have a positive change in weight-to-age z-score (WAZ) and shorter length of stay (LOS) following the first and second surgeries compared to infants in the control condition. After the protocol, the change in WAZ during the interstage increased by virtually one standard deviation from 0.05 to 0.91. Median LOS dropped 32% after the first surgery and 43% after the second surgery. Since first- and second-stage palliative surgeries occur within the same year of life, this represents savings of $500,000 to$800,000 per year in a 10-infant model. The standardized feeding approach improved growth in single ventricle infants while concurrently lowering hospital costs

Titan’s surface at 2.18-cm wavelength imaged by the Cassini RADAR radiometer: Results and interpretations through the first ten years of observation

International audienceA comprehensive calibration and mapping of the thermal microwave emission from Titan’s surface is reported based on radiometric data obtained at 2.18-cm wavelength by the passive radiometer included in the Cassini RADAR instrument. Compared to previous work, the present results incorporate the much larger data set obtained in the approximately ten years following Saturn Orbit Insertion. Brightness temperature data including polarization were accumulated by segments in Titan passes from Ta (October 2004) through T98 (February 2014). The observational segments were analyzed to produce a mosaic of effective dielectric constant based on the measurement of thermal polarization covering 76% of the surface, and brightness temperature at normal incidence covering Titan’s entire surface. As part of the mosaicking process we also solved for the seasonal variation of physical temperature with latitude, which we found to be smaller by a factor of 0.87 ± 0.05 in relative amplitude compared to that reported in the thermal infrared by Cassini’s Composite Infrared Spectrometer (CIRS). We used the equatorial temperature obtained by the Huygens probe and the seasonal dependence with latitude from CIRS to convert the brightness mosaic to absolute emissivity, from which we could infer global thermophysical properties of the surface in combination with the dielectric mosaic. We see strong evidence for subsurface (volume) scattering as a dominant cause of the radar reflectivity in bright regions, and elsewhere a surface composition consistent with the slow deposition and processing of organic compounds from the atmosphere. The presence of water ice in the near subsurface is strongly indicated by the high degree of volume scattering observed in radar-bright regions (e.g., Hummocky/mountainous terrains) constituting ∼ 10% of Titan’s surface. A thermal analysis allowed us to infer a mean 2.18-cm emission depth in the range 40 to 100 cm for the dominant radar-dark terrains (the remainder of Titan’s surface) at all latitudes of Titan, consistent with the deposition and possible processing and redistribution of tholin-like atmospheric photochemical products

Nearinfrared spectral mapping of Titan's mountains and channels

Cassini studies of the surface of Titan are beginning to reveal its nature. In addition to hills, channels, and cobbles seen by the Huygens probe, the Visual and Infrared Mapping Spectrometer (VIMS) and RADAR instruments onboard the orbiter have seen sand dunes , channels , mountains [5, 6], and cryovolcanic candidates. Recently the RADAR team announced the discovery of possible lakes near Titan’s north pole

New Frontiers Titan Orbiter

International audienceAs one of two planetary objects (other than Earth) that have solid surfaces, thick atmospheres, and astrobiological significance, Titan, like Mars, merits ongoing study with multiple spacecraft. We propose that a Titan orbiter dedicated to geophysics, geology, and atmospheric science be added to the New Frontiers menu for the coming decade

Mission, Organization, and Future Direction of the Serological Sciences Network for COVID-19 (SeroNet) Epidemiologic Cohort Studies.

BackgroundGlobal efforts are needed to elucidate the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the underlying cause of coronavirus disease 2019 (COVID-19), including seroprevalence, risk factors, and long-term sequelae, as well as immune responses after vaccination across populations and the social dimensions of prevention and treatment strategies.MethodsIn the United States, the National Cancer Institute in partnership with the National Institute of Allergy and Infectious Diseases, established the SARS-CoV-2 Serological Sciences Network (SeroNet) as the nation's largest coordinated effort to study coronavirus disease 2019. The network comprises multidisciplinary researchers bridging gaps and fostering collaborations among immunologists, epidemiologists, virologists, clinicians and clinical laboratories, social and behavioral scientists, policymakers, data scientists, and community members. In total, 49 institutions form the SeroNet consortium to study individuals with cancer, autoimmune disease, inflammatory bowel diseases, cardiovascular diseases, human immunodeficiency virus, transplant recipients, as well as otherwise healthy pregnant women, children, college students, and high-risk occupational workers (including healthcare workers and first responders).ResultsSeveral studies focus on underrepresented populations, including ethnic minorities and rural communities. To support integrative data analyses across SeroNet studies, efforts are underway to define common data elements for standardized serology measurements, cellular and molecular assays, self-reported data, treatment, and clinical outcomes.ConclusionsIn this paper, we discuss the overarching framework for SeroNet epidemiology studies, critical research questions under investigation, and data accessibility for the worldwide scientific community. Lessons learned will help inform preparedness and responsiveness to future emerging diseases