Comparison of the epidemiology and co-morbidities of heart failure in the pediatric and adult populations: a retrospective, cross-sectional study

BACKGROUND: Heart failure is a clinical syndrome that is associated with a significant number of interventional procedures and has received a large amount of scrutiny in the adult literature; however, the epidemiology in children is less well described. METHODS: We analyzed two large, commercially available inpatient datasets collected in 1997 by the Agency for Healthcare Research and Quality: the Kids' Inpatient Database and the National Inpatient Study, accounting for 50% of the U.S. pediatric discharges and 20% of the U.S. adult discharges in 1997. RESULTS: The database contained 5,610 children and 732,752 adults with a diagnosis of HF. When compared with the adult sample, the pediatric sample showed a higher proportion with cardiac procedures (61.4% vs. 0.28%, p < 0.01), a higher prevalence of congenital heart disease (61% versus 0.3%, p < 0.01), a higher percentage of male patients (50% pediatric vs. 44% adult, p < 0.01), and a lower percentage of white patients (40.9% vs. 65.6%, p < 0.01). Children had a significantly different spectrum of co-morbidities compared with adults. There was no difference in mortality rate between children and adults (7.5% vs. 7.9%, p = NS). CONCLUSION: There are significant differences in the epidemiological profile of children and adults with heart failure. Children suffer from different types of co-morbidities and require different procedures in the hospital setting. As such, children with heart failure who are hospitalized may require significantly different facilities, management and therapeutic intervention than adults with similar symptoms

Toward Improving Interventions Against Toxoplasmosis by Identifying Routes of Transmission Using Sporozoite- specific Serological Tools

Background. Horizontal transmission of Toxoplasma gondii occurs primarily via ingestion of environmental oocysts or con- sumption of undercooked/raw meat containing cyst-stage bradyzoites. The relative importance of these 2 transmission routes remains unclear. Oocyst infection can be distinguished from bradyzoite infection by identification of immunoglobulin G (IgG) antibodies against T. gondii embryogenesis-related protein (TgERP). These antibodies are, however, thought to persist for only 6–8 months in human sera, limiting the use of TgERP serology to only those patients recently exposed to T. gondii. Yet recent sero- logical survey data indicate a more sustained persistence of anti-TgERP antibodies. Elucidating the duration of anti-TgERP IgG will help to determine whether TgERP serology has epidemiological utility for quantifying the relative importance of different routes of T. gondii transmission. Methods. We developed a serocatalytic mathematical model to capture the change in seroprevalence of non-stage-specific IgG and anti-TgERP IgG antibodies with human age. The model was fitted to published datasets collected in an endemic region of Brazil to estimate the duration of anti-TgERP IgG antibodies, accounting for variable age–force of infection profiles and uncertainty in the diagnostic performance of TgERP serology. Results. We found that anti-TgERP IgG persists for substantially longer than previously recognized, with estimates ranging from 8.3 to 41.1 years. The Brazilian datasets were consistent with oocysts being the predominant transmission route in these settings. Conclusions. The longer than previously recognized duration of anti-TgERP antibodies indicates that anti-TgERP serology could be a useful tool for delineating T. gondii transmission routes in human populations. TgERP serology may therefore be an important epidemiological tool for informing the design of tailored, setting-specific public health information campaigns and interventions

Reducing Costs of Managing Medication Inventory in Automated Dispensing System in Hospital Units

Hospital pharmacies utilize automated dispensing systems (ADS) to store and dispense medication in hospital wards. We propose an algorithm to minimize the inventory management costs incurred in holding and refilling the medications stored in an ADS. The algorithm is a linear integer programming formulation to compute how to configure an ADS, and how to allocate medications into capacity-constrained containers. Using a numerical example with real hospital data we demonstrate significant percentage savings relative to the status quo

Determination of Active Pharmaceutical Ingredients by Heteroatom Selective Detection Using Inductively Coupled Plasma Mass Spectrometry with Ultrasonic Nebuilization and Membrane Desolvation Sample Introduction

The combination of ultrasonic nebulization with membrane desolvation (USN-MD) is utilized to determine active pharmaceutical ingredients (API) by heteroatom inductively coupled mass spectroscopy (ICP-MS) detection. Ultrasonic nebulization provides efficient sampling while use of the membrane desolvator acts to reduce solvent-based interferences. This approach reduces interferences sufficiently so that a standard argon ICPquadrupole MS can be utilized. Examined APIs and associated heteroatoms included: phosphomycin (P), amoxicillin (S), chlorpropamide (Cl), and ofloxacin (F). The optimum plasma r.f. powers for P, S, and Cl were in the 1000 to 1200 watts range. The high ionization energy of F required that the plasma be operated at 1500W. The 16O2 þ interference at mass 32 precluded determinations using the sulfur-32. The sulfur-34 (4.2% natural isotopic abundance), however, was relatively free of isobaric interferences. Interferences were relatively small at the mass 35 isotope of Cl, but increased with higher ICP r.f. powers. Overlaps were significant at the masses of monoisotopic species, fluorine-19 and phosphorus-31. Detection limits for P, S, Cl, and F of 2, 3, 90, and 3000 ng/mL, respectively, were generally lower than those produced with other quadrupole systems and comparable to or better than values published utilizing high-resolution instruments

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Feasibility of a Readiness Exam for Predicting Radiography Program Success: A Pilot Study

ABSTRACT Background: Research investigating predictors of academic success in rigorous health science education is valuable for curricular intervention for identified at-risk students. Various predictors of success have been investigated, but the literature is insufficient when examining anatomy and physiology readiness scores as they correlate to radiography curricular success. This pilot study assessed the correlation between readiness exam scores and programmatic course GPA to determine if the scores could be used as a metric for identifying academic success resources for incoming students. Cohorts of the radiography program at a midwestern health sciences center demonstrated a longitudinal trend of difficulty with anatomy and physiology programmatic coursework. Therefore, researchers set out to investigate whether or not readiness exam scores, in addition to the metrics they were already utilizing, could be used as a tool for early academic remediation. Objective: The objective of this study was to determine if the anatomy and physiology readiness exam scores would be reliable indicators of programmatic success in anatomy and physiology program coursework. Design: This investigation occurred in two phases: a retrospective correlational phase and a quasi-experimental phase. Methods: Retrospective data from cohorts that matriculated between 2013 and 2017 (n=91) was collected and de-identified. Data included prerequisite grade point average (GPA) and grades from anatomy and physiology course taken during the program. During the quasi-experimental phase, a sample of students (n=18) completed a readiness examination. The scores from this examination were correlated with prerequisite GPA and program anatomy and physiology GPA. Results: Data analysis revealed prerequisite GPA and the anatomy and physiology section of the readiness examination to be strong and moderate predictors of programmatic anatomy and physiology course grades, respectively. Conclusion: Predictors of curricular success in a radiography program’s anatomy and physiology coursework are essential factors to consider in relation to admissions practices, curricular prerequisite standards, and on-boarding of new students, especially those identified as at-risk

NASA advanced aeronautics design solar powered remotely piloted vehicle

Environmental problems such as the depletion of the ozone layer and air pollution demand a change in traditional means of propulsion that is sensitive to the ecology. Solar powered propulsion is a favorable alternative that is both ecologically harmless as well as cost effective. Integration of solar energy into designs ranging from futuristic vehicles to heating is beneficial to society. The design and construction of a Multi-Purpose Remotely Piloted Vehicle (MPRPV) seeks to verify the feasibility of utilizing solar propulsion as a primary fuel source. This task has been a year long effort by a group of ten students, divided into five teams, each dealing with different aspects of the design. The aircraft was designed to take-off, climb to the design altitude, fly in a sustained figure-eight flight path, and cruise for approximately one hour. This mission requires flight at Reynolds numbers between 150,000 and 200,000 and demands special considerations in the aerodynamic design in order to achieve flight in this regime. Optimal performance requires a light weight configuration with both structural integrity and maximum power availability. The structure design and choice of solar cells for the propulsion was governed by the weight, efficiency, and cost considerations. The final design is a MPRPV weighting 35 N which cruises 7 m/s at the design altitude of 50 m. The configuration includes a wing composed of balsa and foam NACA 6409 airfoil sections and carbon fiber spars, a tail of similar construction, and a truss structure fuselage. The propulsion system consists of 98 10 percent efficient solar cells donated by Mobil Solar, a NiCad battery for energy storage, and a folding propeller regulated by a lightweight and efficient control system. The airfoils and propeller chosen for the design were research and tested during the design process

Role of rain as perception aid in assessing wind speeds and associated personal risks

Extreme event perception drives personal risks and, consequently, dictates household decision-making before, during, and after extreme events. Given this, increasing the extreme event perception accuracy of the public is important to improving decision-making in extreme event scenarios; however, limited research has been done on this subject. Results of a laboratory experiment, in which 76 human participants were exposed to hurricane-strength weather conditions, and asked to estimate their intensities and associated personal risks, is presented in this article. Participants were exposed to a range of identical wind speeds (20, 40, 60 mph) with (8 in/hr) and without rain. They then provided estimates of the perceived wind and rain (when present) speeds, and associated personal risks on a nominal scale of 0 to 10. Improvements in the accuracy of wind-speed perception at higher speeds were observed when rain was present in the wind field (41.5 and 69.1 mph) than when it was not (45.2 and 75.8 mph) for 40 and 60 mph wind speed exposures respectively. In contrast, risk perceptions were similar for both rain and non-rain conditions. This is particularly interesting because participants failed to estimate rain intensities (both horizontal and wind-driven rain) by a significant margin. We discuss the possible implications of rain as a perception aid to wind and the viability of using perception aids to better convey extreme weather risks. The article is concluded with revisiting discussions about the implications of past hurricane experience on wind intensity perception, personal risk assessment, and future directions in extreme weather risk perception research