Apnea, bradycardia and desaturation spells in premature infants: impact of a protocol for the duration of 'spell-free' observation on interprovider variability and readmission rates.

ObjectiveTo study the impact of implementing a protocol to standardize the duration of observation in preterm infants with apnea/bradycardia/desaturation spells before hospital discharge on length of stay (LOS) and readmission rates.Study designA protocol to standardize the duration of in-hospital observation for preterm infants with apnea, bradycardia and desaturation spells who were otherwise ready for discharge was implemented in December 2013. We evaluated the impact of this protocol on the LOS and readmission rates of very low birth weight infants (VLBW). Data on readmission for apnea and an apparent life-threatening event (ALTE) within 30 days of discharge were collected. The pre-implementation epoch (2011 to 2013) was compared to the post-implementation period (2014 to 2016).ResultsThere were 426 and 368 VLBW discharges before and after initiation of the protocol during 2011 to 2013 and 2014 to 2016, respectively. The LOS did not change with protocol implementation (66±42 vs 64±42 days before and after implementation of the protocol, respectively). Interprovider variability on the duration of observation for apneic spells (F-8.8, P=0.04) and bradycardia spells (F-17.4, P<0.001) decreased after implementation of the protocol. The readmission rate for apnea/ALTE after the protocol decreased from 12.1 to 3.4% (P=0.01).ConclusionImplementing an institutional protocol for VLBW infants to determine the duration of apnea/bradycardia/ desaturation spell-free observation period as recommended by the American Academy of Pediatrics clinical report did not prolong the LOS but effectively reduced interprovider variability and readmission rates

Type Iax Supernovae

Type Iax supernovae (SN Iax), also called SN 2002cx-like supernovae, are the largest class of peculiar white dwarf (thermonuclear) supernovae, with over fifty members known. SN Iax have lower ejecta velocity and lower luminosities, and these parameters span a much wider range, than normal type Ia supernovae (SN Ia). SN Iax are spectroscopically similar to some SN Ia near maximum light, but are unique among all supernovae in their late-time spectra, which never become fully nebular. SN Iax overwhelmingly occur in late-type host galaxies, implying a relatively young population. The SN Iax 2012Z is the only white dwarf supernova for which a pre-explosion progenitor system has been detected. A variety of models have been proposed, but one leading scenario has emerged: a type Iax supernova may be a pure-deflagration explosion of a carbon-oxygen (or hybrid carbon-oxygen-neon) white dwarf, triggered by helium accretion to the Chandrasekhar mass, that does not necessarily fully disrupt the star.Comment: Author version of a chapter in the 'Handbook of Supernovae', edited by A. Alsabti and P. Murdin, Springer. 31 pages, 6 figure

Electron imaging of dielectrics under simultaneous electron-ion irradiation

We demonstrate that if charging caused by electron irradiation of an insulator is controlled by a defocused flux of soft-landing positive ions, secondary electron (SE) images can contain contrast due to lateral variations in (i) changes in the SE yield caused by subsurface trapped charge and (ii) the SE-ion recombination rate. Both contrast mechanisms can provide information on microscopic variations in dielectric properties. We present a model of SE contrast formation that accounts for localized charging and the effects of gas ions on the SE emission process, emitted electrons above the sample surface, and subsurface trapped charge. The model explains the ion flux dependence of charge-induced SE contrast, an increase in the sensitivity to surface contrast observed in SE images of charged dielectrics, and yields procedures for identification of contrast produced by localized sample charging. © 2002 American Institute of Physics. © 2002 American Institute of Physics

Electric fields produced by electron irradiation of insulators in a low vacuum environment

We report on the properties of electric fields generated as a result of electron irradiation of dielectrics in a low vacuum scanning electron microscope. Individual field components produced by (i) ionized gas molecules located outside the sample surface and (ii) subsurface trapped charge were detected by measurements of changes in (i) primary electron landing energy and (ii) secondary electron (SE) emission current, respectively. The results provide experimental evidence for a recently proposed model of field-enhanced SE emission from electron irradiated insulators in a low vacuum environment [Toth et al., J. Appl. Phys. 91, 4479 (2002)]. Errors introduced into x-ray microanalysis by the electric fields generated by ionized gas molecules can be alleviated by minimizing the steady state ion concentration by the provision of efficient ion neutralization routes. It is demonstrated how this can be achieved using simple sample-electrode geometries. © 2002 American Institute of Physics. © 2002 American Institute of Physics

An alternative approach to water regulations for public health protection at bathing beaches

This is the final version of the article. Available from Hindawi Publishing Corporation via the DOI in this record.New approaches should be considered as the US Environmental Protection Agency (EPA) moves rapidly to develop new beach monitoring guidelines by the end of 2012, as these guidelines serve as the basis by which states and territories with coasts along the oceans and Great Lakes can then develop and implement monitoring programs for recreational waters. We describe and illustrate one possible approach to beach regulation termed as the "Comprehensive Toolbox within an Approval Process (CTBAP)." The CTBAP consists of three components. The first is a "toolbox" consisting of an inventory of guidelines on monitoring targets, a series of measurement techniques, and guidance to improve water quality through source identification and prevention methods. The second two components are principles of implementation. These include first, "flexibility" to encourage and develop an individualized beach management plan tailored to local conditions and second, "consistency" of this management plan to ensure a consistent national level of public health protection. The results of this approach are illustrated through a case study at a well-studied South Florida recreational marine beach. This case study explores different monitoring targets based on two different health endpoints (skin versus gastrointestinal illness) and recommends a beach regulation program for the study beach that focuses predominately on source prevention.This study was funded in part by the National Science Foundation (NSF) and the National Institute of Environmental Health Sciences (NIEHS) Oceans and Human Health Center at the University of Miami Rosenstiel School (NSF 0CE0432368/0911373) and (NIEHS P50 ES12736); an NSF REU in Oceans and Human Health; and ESF and ERDF Convergence funding to the European Centre for Environment and Human Health (University of Exeter)

Exploiting zinc oxide re-emission to fabricate periodic arrays

The synthesis of hexagonal ring-shaped structures of zinc oxide using nanosphere lithography and metal/metal oxide sputtering is demonstrated. This synthesis exploits the surface re-emission of zinc oxide to deposit material in regions lying out of the line-of-sight of the sputtering source. These rings can nucleate the hydrothermal growth of zinc oxide crystals. Control over the growth could be exercised by varying growth solution concentration or temperature or by applying an external potential. © 2010 American Chemical Society

The Extremes of Thermonuclear Supernovae

The majority of thermonuclear explosions in the Universe seem to proceed in a rather standardised way, as explosions of carbon-oxygen (CO) white dwarfs in binary systems, leading to 'normal' Type Ia supernovae (SNe Ia). However, over the years a number of objects have been found which deviate from normal SNe Ia in their observational properties, and which require different and not seldom more extreme progenitor systems. While the 'traditional' classes of peculiar SNe Ia - luminous '91T-like' and faint '91bg-like' objects - have been known since the early 1990s, other classes of even more unusual transients have only been established 20 years later, fostered by the advent of new wide-field SN surveys such as the Palomar Transient Factory. These include the faint but slowly declining '02es-like' SNe, 'Ca-rich' transients residing in the luminosity gap between classical novae and supernovae, extremely short-lived, fast-declining transients, and the very luminous so-called 'super-Chandrasekhar' SNe Ia. Not all of them are necessarily thermonuclear explosions, but there are good arguments in favour of a thermonuclear origin for most of them. The aim of this chapter is to provide an overview of the zoo of potentially thermonuclear transients, reviewing their observational characteristics and discussing possible explosion scenarios.Comment: Author version of a chapter for the 'Handbook of Supernovae', edited by A. Alsabti and P. Murdin, Springer. 50 pages, 7 figure

Role of the mesoamygdaloid dopamine projection in emotional learning

Amygdala dopamine is crucially involved in the acquisition of Pavlovian associations, as measured via conditioned approach to the location of the unconditioned stimulus (US). However, learning begins before skeletomotor output, so this study assessed whether amygdala dopamine is also involved in earlier 'emotional' learning. A variant of the conditioned reinforcement (CR) procedure was validated where training was restricted to curtail the development of selective conditioned approach to the US location, and effects of amygdala dopamine manipulations before training or later CR testing assessed. Experiment 1a presented a light paired (CS+ group) or unpaired (CS- group) with a US. There were 1, 2 or 10 sessions, 4 trials per session. Then, the US was removed, and two novel levers presented. One lever (CR+) presented the light, and lever pressing was recorded. Experiment 1b also included a tone stimulus. Experiment 2 applied intra-amygdala R(+) 7-OH-DPAT (10 nmol/1.0 A mu l/side) before two training sessions (Experiment 2a) or a CR session (Experiment 2b). For Experiments 1a and 1b, the CS+ group preferred the CR+ lever across all sessions. Conditioned alcove approach during 1 or 2 training sessions or associated CR tests was low and nonspecific. In Experiment 2a, R(+) 7-OH-DPAT before training greatly diminished lever pressing during a subsequent CR test, preferentially on the CR+ lever. For Experiment 2b, R(+) 7-OH-DPAT infusions before the CR test also reduced lever pressing. Manipulations of amygdala dopamine impact the earliest stage of learning in which emotional reactions may be most prevalent