Frequency of Complications Following Spinal Fusion in Children with Cerebral Palsy

Background: Neuromuscular Scoliosis is a frequent complication of Cerebral Palsy that requires surgical management including spinal fusion. The objective of this observational study was to describe differences in the frequency of postoperative complications in children with Cerebral Palsy following spinal fusion surgery compared to children with Idiopathic Scoliosis. Methods: The 2016 Kids’ Inpatient Database was queried to identify pediatric patients (old) with concurrent diagnoses of Cerebral Palsy and Neuromuscular Scoliosis undergoing spinal fusion surgery. Cases were compared to children without Cerebral Palsy and with a diagnosis of Idiopathic Scoliosis undergoing the same procedure. Fitted Poisson regression analysis with robust variance was performed to estimate relative risks in the frequency of various clinical complications while adjusting for several potentially confounding variables of importance. Results: A total of 660 cases and 5,244 comparators were identified. Compared to children with Idiopathic Scoliosis, children with Cerebral Palsy were younger (13.6 vs. 14.3 years), more likely to be male (54% vs. 23%), and more likely to have had governmental insurance (52% vs. 32%). They also had longer hospital lengths of stay (8 days vs. 4 days). After adjusting for a number of potentially confounding sociodemographic and clinical variables, children with Cerebral Palsy were more likely to have postoperative pulmonary, gastrointestinal, and surgical complications, receive blood transfusions, and be admitted to the ICU. Conclusions: Children with Cerebral Palsy have an increased risk of complications following spinal fusion surgery leading to longer hospital stays. These results further inform surgical decision-making and anticipatory guidance for these children and their caregivers

In situ nanoindentation: probing nanoscale multifunctionality

Nanoindentation is the leading technique for evaluating nanoscale mechanical properties of materials. Consistent developments in instrumentation and their capabilities are transforming nanoindentation into a powerful tool for characterization of multifunctionality at the nanoscale. This review outlines the integration of nanoindentation with real-time electron imaging, high temperature measurements, electrical characterization, and a combination of these. In situ nanoindentation measurements have enabled the real-time study of the interplay between mechanical, thermal, and electrical effects at the nanoscale. This review identifies previous reviews in this area, traces developments and pinpoints significant recent advances (post-2007), with emphasis on the applications of in situ nanoindentation techniques to materials systems, and highlighting the new insights gained from these in situ techniques. Based on this review, future directions and applications of in situ nanoindentation are identified, which highlight the potential of this suite of techniques for materials scientists from all disciplines

The genetics of colored sequence synesthesia: Evidence of linkage to chromosome 16q and genetic heterogeneity for the condition

Synesthesia is a perceptual condition in which normal sensory stimulation can trigger anomalous sensory experiences. For example, synesthetes may experience colors in response to sounds, tastes in response to words, or smells in response to touch. We here focus on colored sequence synesthesia, in which color experiences are triggered by learned ordinal sequences such as letters, numbers, weekdays and months. Although synesthesia has been noted in the scientific literature for over a century, it is understood only at the level of the phenomenology, and not at the molecular and neural levels. We have performed a linkage analysis to identify the first genetic loci responsible for the increased neural crosstalk underlying colored sequence synesthesia. Our analysis has identified a 23 MB region on chromosome 16 as a putative locus for the trait. Our data provide the first step in understanding neural crosstalk from its molecular basis to its behavioral consequences, opening a new inroad into the understanding of the multisensory brain

Causal role of a neural system for separating and selecting multidimensional social cognitive information

People are multi-faceted, typically good at some things but bad at others, and a critical aspect of social judgement is the ability to focus on those traits relevant for the task at hand. However, it remains unknown how the brain supports such context-dependent social judgement. Here, we examine how people represent multidimensional individuals, and how the brain extracts relevant information and filters out irrelevant information when comparing individuals within a specific dimension. Using human fMRI, we identify distinct neural representations in dorsomedial prefrontal cortex (dmPFC) and anterior insula (AI) supporting separation and selection of information for context-dependent social judgement. Causal evaluation using non-invasive brain stimulation shows that AI disruption alters the impact of relevant information on social comparison, whereas dmPFC disruption only affects the impact of irrelevant information. This neural circuit is distinct from the one supporting integration across, as opposed to separation of, different features of a multidimensional cognitive space

Transition metal oxides - Thermoelectric properties

Transition metal oxides (TMOs) are a fascinating class of materials due to their wide ranging electronic, chemical and mechanical properties. Additionally, they are gaining increasing attention for their thermoelectric (TE) properties due to their high temperature stability, tunable electronic and phonon transport properties and well established synthesis techniques. In this article, we review TE TMOs at cryogenic, ambient and high temperatures. An overview of strategies used for morphological, compositing and stoichiometric tuning of their key TE parameters is presented. This article also provides an outlook on the current and future prospects of implementing TMOs for a wide range of TE applications

Alkali ratio control for lead-free piezoelectric thin films utilizing elemental diffusivities in RF plasma

High performance piezoelectric thin films are generally lead-based, and find applications in sensing, actuation and transduction in the realms of biology, nanometrology, acoustics and energy harvesting. Potassium sodium niobate (KNN) is considered to be the most promising lead-free alternative, but it is hindered by the inability to control and attain perfect stoichiometry materials in the thin film form while using practical large area deposition techniques. In this work, we identify the contribution of the elemental diffusivities in the radio frequency (RF) plasma in determining the alkali loss in the KNN thin films. We have also examined the effect of the substrate temperature during the RF magnetron sputtering deposition on the crystal structure of the substrate and KNN thin films, as well as the effect of the postannealing treatments. These results indicate the need for well-designed source materials and the potential to use the deposition partial pressure to alter the dopant concentrations

Clinician Perspectives on the Need for Training and Caring for Pregnant Women with Intellectual and Developmental Disabilities [poster]

Background: Women with intellectual and developmental disabilities (IDD) experience disparities in obstetric care access and quality, in addition to communication gaps with healthcare providers. Many obstetric providers are untrained and uneducated about critical aspects of providing care to persons with IDD. Objectives: The present study was conducted (1) to describe obstetric clinicians’ training experiences related to providing obstetric care to women with IDD, (2) to assess obstetric clinicians’ perceived need for formalized training, and (3) to identify recommendations for training content and dissemination. Methods: This study involved qualitative individual interviews (n=9) and one focus group (n=8) with obstetric clinicians who self-reported experience caring for women with IDD during pregnancy. Descriptive coding and content analysis techniques were used to develop an iterative codebook related to education and training; codes were applied to the data. Coded data were analyzed for larger themes and relationships. Results: Analysis revealed three main themes: 1. Need for obstetric training and education: No participant reported receiving any training in caring for pregnant women with IDD. Participants expressed a need for formal education. 2. Recommendations for formal training: Participants noted a dearth of clinical practice guidelines, the need for pregnancy-specific training during residency and beyond, and all healthcare staff should be included in training opportunities. 3. Training outcomes should increase knowledge, enhance attitudes, and develop practical skills related to communication and care for pregnant women with IDD. Conclusion: Study results indicate a need for and interest in systematic training efforts regarding obstetric care for women with IDD. Improved training and education may decrease health inequities and improve the quality of obstetric care, and thus pregnancy outcomes, for women with IDD

Transparent functional oxide stretchable electronics: micro-tectonics enabled high strain electrodes

Fully transparent and flexible electronic substrates that incorporate functional materials are the precursors to realising nextgeneration devices with sensing, self-powering and portable functionalities. Here, we demonstrate a universal process for transferring planar, transparent functional oxide thin films on to elastomeric polydimethylsiloxane (PDMS) substrates. This process overcomes the challenge of incorporating high-temperature-processed crystalline oxide materials with low-temperature organic substrates. The functionality of the process is demonstrated using indium tin oxide (ITO) thin films to realise fully transparent and flexible resistors. The ITO thin films on PDMS are shown to withstand uniaxial strains of 15%, enabled by microstructure tectonics. Furthermore, zinc oxide was transferred to display the versatility of this transfer process. Such a ubiquitous process for the transfer of functional thin films to elastomeric substrates will pave the way for touch sensing and energy harvesting for displays and electronics with flexible and transparent characteristics