Children's vomiting following posterior fossa surgery: A retrospective study

<p>Abstract</p> <p>Background</p> <p>Nausea and vomiting is a problem for children after neurosurgery and those requiring posterior fossa procedures appear to have a high incidence. This clinical observation has not been quantified nor have risk factors unique to this group of children been elucidated.</p> <p>Methods</p> <p>A six year retrospective chart audit at two Canadian children's hospitals was conducted. The incidence of nausea and vomiting was extracted. Hierarchical multivariable logistic regression was used to quantify risk and protective factors at 120 hours after surgery and early vs. late vomiting.</p> <p>Results</p> <p>The incidence of vomiting over a ten day postoperative period was 76.7%. Documented vomiting ranged from single events to greater than 20 over the same period. In the final multivariable model: adolescents (age 12 to <17) were less likely to vomit by 120 hours after surgery than other age groups; those who received desflurane, when compared to all other volatile anesthetics, were more likely to vomit, yet the use of ondansetron with desflurane decre kelihood. Children who had intraoperative ondansetron were more likely to vomit in the final multivariable model (perhaps because of its use, in the clinical judgment of the anesthesiologist, for children considered at risk). Children who started vomiting in the first 24 hours were more likely to be school age (groups 4 to <7 and 7 to <12) and receive desflurane. Nausea was not well documented and was therefore not analyzed.</p> <p>Conclusion</p> <p>The incidence of vomiting in children after posterior fossa surgery is sufficient to consider all children requiring these procedures to be at high risk for POV. Nausea requires better assessment and documentation.</p

MICE: The muon ionization cooling experiment. Step I: First measurement of emittance with particle physics detectors

Copyright @ 2011 APSThe Muon Ionization Cooling Experiment (MICE) is a strategic R&D project intended to demonstrate the only practical solution to providing high brilliance beams necessary for a neutrino factory or muon collider. MICE is under development at the Rutherford Appleton Laboratory (RAL) in the United Kingdom. It comprises a dedicated beamline to generate a range of input muon emittances and momenta, with time-of-flight and Cherenkov detectors to ensure a pure muon beam. The emittance of the incoming beam will be measured in the upstream magnetic spectrometer with a scintillating fiber tracker. A cooling cell will then follow, alternating energy loss in Liquid Hydrogen (LH2) absorbers to RF cavity acceleration. A second spectrometer, identical to the first, and a second muon identification system will measure the outgoing emittance. In the 2010 run at RAL the muon beamline and most detectors were fully commissioned and a first measurement of the emittance of the muon beam with particle physics (time-of-flight) detectors was performed. The analysis of these data was recently completed and is discussed in this paper. Future steps for MICE, where beam emittance and emittance reduction (cooling) are to be measured with greater accuracy, are also presented.This work was supported by NSF grant PHY-0842798

Human well‐being and climate change mitigation

Climate change mitigation research is fundamentally motivated by the preservation of human lives and the environmental conditions which enable them. However, the field has to date rather superficial in its appreciation of theoretical claims in well‐being thought, with deep implications for the framing of mitigation priorities, policies, and research. Major strands of well‐being thought are hedonic well‐being—typically referred to as happiness or subjective well‐being—and eudaimonic well‐being, which includes theories of human needs, capabilities, and multidimensional poverty. Aspects of each can be found in political and procedural accounts such as the Sustainable Development Goals. Situating these concepts within the challenges of addressing climate change, the choice of approach is highly consequential for: (1) understanding inter‐ and intra‐generational equity; (2) defining appropriate mitigation strategies; and (3) conceptualizing the socio‐technical provisioning systems that convert biophysical resources into well‐being outcomes. Eudaimonic approaches emphasize the importance of consumption thresholds, beyond which dimensions of well‐being become satiated. Related strands of well‐being and mitigation research suggest constraining consumption to within minimum and maximum consumption levels, inviting normative discussions on the social benefits, climate impacts, and political challenges associated with a given form of provisioning. The question of how current socio‐technical provisioning systems can be shifted towards low‐carbon, well‐being enhancing forms constitutes a new frontier in mitigation research, involving not just technological change and economic incentives, but wide‐ranging social, institutional, and cultural shifts

Mental Imagery and Visual Working Memory

Visual working memory provides an essential link between past and future events. Despite recent efforts, capacity limits, their genesis and the underlying neural structures of visual working memory remain unclear. Here we show that performance in visual working memory - but not iconic visual memory - can be predicted by the strength of mental imagery as assessed with binocular rivalry in a given individual. In addition, for individuals with strong imagery, modulating the background luminance diminished performance on visual working memory and imagery tasks, but not working memory for number strings. This suggests that luminance signals were disrupting sensory-based imagery mechanisms and not a general working memory system. Individuals with poor imagery still performed above chance in the visual working memory task, but their performance was not affected by the background luminance, suggesting a dichotomy in strategies for visual working memory: individuals with strong mental imagery rely on sensory-based imagery to support mnemonic performance, while those with poor imagery rely on different strategies. These findings could help reconcile current controversy regarding the mechanism and location of visual mnemonic storage

Individual Assessment of Arteriosclerosis by Empiric Clinical Profiling

BACKGROUND: Arteriosclerosis is a common cause of chronic morbidity and mortality. Myocardial infarction, stroke or other cardiovascular events identify vulnerable patients who suffer from symptomatic arteriosclerosis. Biomarkers to identify vulnerable patients before cardiovascular events occur are warranted to improve care for affected individuals. We tested how accurately basic clinical data can describe and assess the activity of arteriosclerosis in the individual patient. METHODOLOGY/PRINCIPAL FINDINGS: 269 in-patients who were treated for various conditions at the department of general medicine of an academic tertiary care center were included in a cross-sectional study. Personal history and clinical examination were obtained. When paraclinical tests were performed, the results were added to the dataset. The numerical variables in the clinical examination were statistically compared between patients with proven symptomatic arteriosclerosis (n = 100) and patients who had never experienced cardiovascular events in the past (n = 110). 25 variables were different between these two patient groups and contributed to the disease activity score. The percentile distribution of these variables defined the empiric clinical profile. Anthropometric data, signs of arterial, cardiac and renal disease, systemic inflammation and health economics formed the major categories of the empiric clinical profile that described an individual patient's disease activity. The area under the curve of the receiver operating curve for symptomatic arteriosclerosis was 0.891 (95% CI 0.799-0.983) for the novel disease activity score compared to 0.684 (95% CI 0.600-0.769) for the 10-year risk calculated according to the Framingham score. In patients suffering from symptomatic arteriosclerosis, the disease activity score deteriorated more rapidly after two years of follow-up (from 1.25 to 1.48, P = 0.005) compared to age- and sex-matched individuals free of cardiovascular events (from 1.09 to 1.19, P = 0.125). CONCLUSIONS/SIGNIFICANCE: Empiric clinical profiling and the disease activity score that are based on accessible, available and affordable clinical data are valid markers for symptomatic arteriosclerosis

Neutrinos from Stored Muons nuSTORM: Expression of Interest

The nuSTORM facility has been designed to deliver beams of electron and muon neutrinos from the decay of a stored muon beam with a central momentum of 3.8 GeV/c and a momentum spread of 10%. The facility is unique in that it will: serve the future long- and short-baseline neutrino-oscillation programmes by providing definitive measurements of electron-neutrino- and muon-neutrino-nucleus cross sections with percent-level precision; allow searches for sterile neutrinos of exquisite sensitivity to be carried out; and constitute the essential first step in the incremental development of muon accelerators as a powerful new technique for particle physics. Of the world's proton-accelerator laboratories, only CERN and FNAL have the infrastructure required to mount nuSTORM. Since no siting decision has yet been taken, the purpose of this Expression of Interest (EoI) is to request the resources required to: investigate in detail how nuSTORM could be implemented at CERN; and develop options for decisive European contributions to the nuSTORM facility and experimental programme wherever the facility is sited. The EoI defines a two-year programme culminating in the delivery of a Technical Design Report

Light sterile neutrino sensitivity at the nuSTORM facility

A facility that can deliver beams of electron and muon neutrinos from the decay of a stored muon beam has the potential to unambiguously resolve the issue of the evidence for light sterile neutrinos that arises in short-baseline neutrino oscillation experiments and from estimates of the effective number of neutrino flavors from fits to cosmological data. In this paper, we show that the nuSTORM facility, with stored muons of 3.8 GeV/c ± 10%, will be able to carry out a conclusive muon neutrino appearance search for sterile neutrinos and test the LSND and MiniBooNE experimental signals with 10σ sensitivity, even assuming conservative estimates for the systematic uncertainties. This experiment would add greatly to our knowledge of the contribution of light sterile neutrinos to the number of effective neutrino flavors from the abundance of primordial helium production and from constraints on neutrino energy density from the cosmic microwave background. The appearance search is complemented by a simultaneous muon neutrino disappearance analysis that will facilitate tests of various sterile neutrino models

Immune mechanisms in malaria: new insights in vaccine development.

Early data emerging from the first phase 3 trial of a malaria vaccine are raising hopes that a licensed vaccine will soon be available for use in endemic countries, but given the relatively low efficacy of the vaccine, this needs to be seen as a major step forward on the road to a malaria vaccine rather than as arrival at the final destination. The focus for vaccine developers now moves to the next generation of malaria vaccines, but it is not yet clear what characteristics these new vaccines should have or how they can be evaluated. Here we briefly review the epidemiological and immunological requirements for malaria vaccines and the recent history of malaria vaccine development and then put forward a manifesto for future research in this area. We argue that rational design of more effective malaria vaccines will be accelerated by a better understanding of the immune effector mechanisms involved in parasite regulation, control and elimination