Incidence and characteristics of low-speed vehicle run over events in rural and remote children aged 0–14 years in Queensland: an eleven year (1999–2009) retrospective analysis

Introduction: The main objective of this study is to describe incidence rates of low-speed vehicle run-over (LSVRO) events among children aged 0–14 years residing in Queensland from 1999 to 2009. A second objective was to describe the associated patterns of injury, with respect to gender, age group, severity, characteristics (host, vehicle and environment), and trends over time in relation to geographical remoteness. Final results are hoped to inform prevention policies. Methods: In this statewide, retrospective, population-based study, data were collected on LSVRO events that occurred among children aged 0–14 years in Queensland from 1999 to 2009 from all relevant data sources across the continuum of care, and manually linked to obtain the most comprehensive estimate possible of the magnitude and nature of LSVRO events to date. Crude incidence rates were calculated separately for males and females, for fatal events, non-fatal events (hospital admissions and non-admissions, respectively), and for all LSVRO events, for each area of geographical remoteness (major cities, inner regional, outer regional, remote/very remote). Relative risks and 95% confidence interval were calculated, and trends over time were examined. Data on host, injury and event characteristics were also obtained to investigate whether these characteristics varied between areas of remoteness. Results: Incidence rates were lowest among children (0–14 years) living in major cities (13.8/100000/annum, with the highest recorded incidence in outer regional areas (incidence rate =42.5/100000/annum). Incidence rates were higher for children residing outside major cities for both males and females, for every age group, for each of the 11 years of the study, and consequences of LSVRO events were worse. Young children aged 0–4 years were identified as those most at risk for these events, regardless of geographical location. Differences were observed as a function of remoteness category in relation to injury characteristics (eg injury type), and host characteristics (eg sociodemographic status), but there were no observed differences in environmental characteristics (eg time of day, day of week). Heavy vehicles such as four-wheel drives, utilities, trucks and tractors were more frequently involved in LSVRO events that occurred outside major cities. Conclusion: The results confirmed that children of all ages and genders residing outside of major cities in Queensland are more at risk of being involved in an LSVRO incident, and experience more severe consequences compared to children in major cities. Future research should address the specific risk factors and focus on engaging rural communities to assist in the prevention of LSVRO incidents

Gastroschisis: Ward Reduction Compared With Traditional Reduction Under General Anesthesia

Background/Purpose In gastroschisis it is proposed that gut reduction may be achieved without intubation or general anesthesia (GA) through ward reduction. The authors aimed to determine if ward reduction decreased morbidity and duration of treatment. Methods Infants born from January 1, 1995, to December 31, 2001, with gastroschisis were managed with either reduction under GA in the operating theatre (OT group) - up to September 1999, or ward reduction (when eligible) in the neonatal unit without GA/ventilation (ward reduction [WR] group) - from September 1999. Results Of the 37 infants, 31 were eligible for ward reduction—15 from the OT group, 16 from the WR group. All infants in the OT group had at least 1 episode of ventilation and 1 GA: 62% of infants in the WR group avoided ventilation (P = .0002) and 81% avoided GA (P < .0001). Infants who had ward reduction had significantly shorter durations of ventilation and oxygen therapy. Septicemia occurred in 31% of the WR group and 7% of the OT group (P = .17). Infants who had ward reduction left intensive care 16 days earlier (P = .02) and tended to reach full enteral feeds 8 days sooner (P = .06) and be discharged from hospital 15 days earlier (P = .05). Conclusions Infants who had ward reduction do better in terms of avoiding GA/ventilation, establishing feeds, and going home earlier. A randomized, controlled trial comparing the 2 approaches is feasible, safe, and worthwhile

The C. elegans tailless/Tlx homolog nhr-67 regulates a stage-specific program of linker cell migration in male gonadogenesis

Cell migration is a common event during organogenesis, yet little is known about how migration is temporally coordinated with organ development. We are investigating stage-specific programs of cell migration using the linker cell (LC), a migratory cell crucial for male gonadogenesis of C. elegans. During the L3 and L4 larval stages of wild-type males, the LC undergoes changes in its position along the migratory route, in transcriptional regulation of the unc-5 netrin receptor and zmp-1 zinc matrix metalloprotease, and in cell morphology. We have identified the tailless homolog nhr-67 as a cell-autonomous, stage-specific regulator of timing in LC migration programs. In nhr-67-deficient animals, each of the L3 and L4 stage changes is either severely delayed or never occurs, yet LC development before the early L3 stage or after the mid-L4 stage occurs with normal timing. We propose that there is a basal migration program utilized throughout LC migration that is modified by stage-specific regulators such as nhr-67

Nonclassical Light Generation from III-V and Group-IV Solid-State Cavity Quantum Systems

In this chapter, we present the state-of-the-art in the generation of nonclassical states of light using semiconductor cavity quantum electrodynamics (QED) platforms. Our focus is on the photon blockade effects that enable the generation of indistinguishable photon streams with high purity and efficiency. Starting with the leading platform of InGaAs quantum dots in optical nanocavities, we review the physics of a single quantum emitter strongly coupled to a cavity. Furthermore, we propose a complete model for photon blockade and tunneling in III-V quantum dot cavity QED systems. Turning toward quantum emitters with small inhomogeneous broadening, we propose a direction for novel experiments for nonclassical light generation based on group-IV color-center systems. We present a model of a multi-emitter cavity QED platform, which features richer dressed-states ladder structures, and show how it can offer opportunities for studying new regimes of high-quality photon blockade.Comment: 64 pages, 32 figures, to appear as Chapter 3 in Advances in Atomic Molecular and Optical Physics, Vol. 6

Filtering multiphoton emission from state-of the-art cavity quantum electrodynamics

© 2018 Optical Society of America. Engineering multiphoton states is an outstanding challenge with applications in multiple fields such as quantum metrology, quantum lithography, or even biological sensing. State-of-the-art methods to obtain them rely on post-selection, multi-level systems, or Rydberg atomic ensembles. Recently, it was shown that a strongly driven two-level system interacting with a detuned cavity mode can be engineered to continuously emit n-photon states. In the present work, we show that spectral filtering of its emission relaxes considerably the requirements on the system parameters even to the more accessible bad-cavity situation, opening up the possibility of implementing this protocol in a much wider landscape of different platforms. This improvement is based on a key observation: in the imperfect case where only a certain fraction of emission is composed of n-photon states, these have a well-defined energy separated from the rest of the signal, which allows one to reveal and purify multiphoton emission just by frequency filtering. We demonstrate these results by obtaining analytical expressions for the relevant figures of merit of multiphoton emission, such as the n-photon coupling rate between cavity and emitter, the fraction of light emitted as n-photon states, and n-photon emission rates. This allows us to make a systematic study of such figures of merit as a function of the system parameters and demonstrate the viability of the protocol in several relevant types of cavity quantum electrodynamics setups, where we take into account the impact of their respective experimental limitations.Published versio

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Lysyl hydroxylase 3 localizes to epidermal basement membrane and Is reduced in patients with Recessive Dystrophic Epidermolysis Bullosa

Recessive dystrophic epidermolysis bullosa (RDEB) is caused by mutations in COL7A1 resulting in reduced or absent type VII collagen, aberrant anchoring fibril formation and subsequent dermal-epidermal fragility. Here, we identify a significant decrease in PLOD3 expression and its encoded protein, the collagen modifying enzyme lysyl hydroxylase 3 (LH3), in RDEB. We show abundant LH3 localising to the basement membrane in normal skin which is severely depleted in RDEB patient skin. We demonstrate expression is in-part regulated by endogenous type VII collagen and that, in agreement with previous studies, even small reductions in LH3 expression lead to significantly less secreted LH3 protein. Exogenous type VII collagen did not alter LH3 expression in cultured RDEB keratinocytes and we show that RDEB patients receiving bone marrow transplantation who demonstrate significant increase in type VII collagen do not show increased levels of LH3 at the basement membrane. Our data report a direct link between LH3 and endogenous type VII collagen expression concluding that reduction of LH3 at the basement membrane in patients with RDEB will likely have significant implications for disease progression and therapeutic intervention

Opening a Pandora's Box that can't be salvaged: Health professionals’ perceptions of appearance-related care in an Australian pediatric specialist hospital

© 2019 Elsevier Ltd Many children and young people struggle adjusting to the psychosocial consequences (e.g., body dissatisfaction, social anxiety, and stigmatisation) of visible differences (or disfigurement). As appearance-affecting conditions often require specialist multidisciplinary team care, health professionals are in a unique position to offer psychosocial support and intervention. However, there is a dearth of literature on how appearance-related concerns are managed in pediatric hospital settings. Sixteen Australian specialist health professionals participated in semi-structured qualitative interviews to address this gap. Interviews explored current appearance-related psychosocial service provision, barriers in accessing appearance-related care, and perceptions of online platforms to deliver specialist support and intervention. Thematic analysis demonstrated four themes: We can do it better, Capability versus availability, Online generation, and Putting appearance on the agenda. This research highlighted the potential value of online platforms to increase accessibility to specialist appearance-related care, the need for more psychosocial resources to be integrated into appearance-related specialities, prioritising the development of low to medium appearance-related support and intervention, increasing the appearance-related knowledge of health professionals and families, and the need for more holistic approaches in routine care

Quantum bits with Josephson junctions

Already in the first edition of this book (Barone and Paterno, "Fundamentals and Physics and Applications of the Josephson Effect", Wiley 1982), a great number of interesting and important applications for Josephson junctions were discussed. In the decades that have passed since then, several new applications have emerged. This chapter treats one such new class of applications: quantum optics and quantum information processing (QIP) based on superconducting circuits with Josephson junctions. In this chapter, we aim to explain the basics of superconducting quantum circuits with Josephson junctions and demonstrate how these systems open up new prospects, both for QIP and for the study of quantum optics and atomic physics.Comment: 30 pages, 10 figures. Book chapter for a new edition of Barone and Paterno's "Fundamentals and Physics and Applications of the Josephson Effect". Final versio