A Brief History of Quality Improvement in Health Care and Spinal Surgery.

While medical and technological advances continue to shape and advance health care, there has been growing emphasis on translating these advances into improvement in overall health care quality outcomes in the United States. Innovators such as Abraham Flexner and Ernest Codman engaged in rigorous reviews of systems and patient outcomes igniting wider spread interest in quality improvement in health care. Codman\u27s efforts even contributed to the founding of the American College of Surgeons. This society catalyzed a quality improvement initiative across the United States and the formation of the Joint Commission on Accreditation of Hospitals. Since that time, those such as Avedis Donabedian and the Institute of Medicine have worked to structure the process of improving both the quality and delivery of health care. Significant advances include the defining of minimum standards for hospital accreditation, 7 pillars of quality in medicine, and the process by which quality in medicine is evaluated. All of these factors have affected current practice more each day. In a field such as spinal surgery, cost and quality measures are continually emphasized and led to large outcome databases to better evaluate outcomes in complex, heterogeneous populations. Going forward, these databases will be instrumental in developing practice patterns and improving spinal surgery outcomes

Epilepsy Networks and Their Surgical Relevance

Surgical epilepsy is a rapidly evolved field. As the understanding and concepts of epilepsy shift towards a network disorder, surgical outcomes may shed light on numerous components of these systems. This review documents the evolution of the understanding of epilepsy networks and examines the data generated by resective, ablative, neuromodulation, and invasive monitoring surgeries in epilepsy patients. As these network tools are better integrated into epilepsy practice, they may eventually inform surgical decisions and improve clinical outcomes

Low-light Environment Neural Surveillance

We design and implement an end-to-end system for real-time crime detection in low-light environments. Unlike Closed-Circuit Television, which performs reactively, the Low-Light Environment Neural Surveillance provides real time crime alerts. The system uses a low-light video feed processed in real-time by an optical-flow network, spatial and temporal networks, and a Support Vector Machine to identify shootings, assaults, and thefts. We create a low-light action-recognition dataset, LENS-4, which will be publicly available. An IoT infrastructure set up via Amazon Web Services interprets messages from the local board hosting the camera for action recognition and parses the results in the cloud to relay messages. The system achieves 71.5% accuracy at 20 FPS. The user interface is a mobile app which allows local authorities to receive notifications and to view a video of the crime scene. Citizens have a public app which enables law enforcement to push crime alerts based on user proximity.Comment: Pre-print, accepted to IEEE International Workshop on Machine Learning for Signal Processing 2020 Conference Proceedings. Code and dataset are available at https://github.com/mcgridles

The ISOSAT Small Satellite: A Design in Isogrid Technology

ISOSAT, a small hexagonal shaped satellite structure, was designed and constructed in the Industrial Technology Department at Utah State University as a senior research project using automated manufacturing techniques and incorporating the Isogrid structure concept. Isogrid applications can be found in projects such as Skylab, most cylindrical structural elements of the Delta rocket and in the engine shrouds of Boeing\u27s new 777 commercial airliners. The basis of the Isogrid is the repeating pattern of equilateral triangles which make up the structure. This pattern, machined into solid aluminum plates, results in a substantial weight savings with an acceptable reduction in structural strength. The intersections of adjacent triangles are referred to as nodes. These nodes serve as uniformly distributed attachment points for the mounting of instrumentation and other hardware

The differences between sex offenders who victimise older women and sex offenders who offend against children

Objectives: Within the literature on sex offending, much attention is paid to the distinction between those sex offenders who offend against adults and those who offend against children. In contrast, there is a paucity of research into sex offenders who offend specifically against elderly or older victims. Method: A detailed interview and psychometric tests were conducted with a sample of 28 sex offenders who had been convicted of a sexually motivated offence against an older female. These data were compared to a sample of 23 child sex offenders. Results: Results indicate that amongst other significant differences between these sub-groups, men who offend against older women are generally younger, are more violent, and are more likely to use a weapon and cause injury and death compared to child sex offenders. The men who offended against children were more likely to think about and plan their offending, spend more time with the victim pre and post offence, admit sexual arousal during the offence, and admit to a sexual motivation for the offence. Conclusions: This study suggests that men who sexually offend against older women and men who sexually offend against children are distinct groups. Treatment and risk management strategies should take this into account. Further exploration of this sub-group of offenders is recommended to help inform treatment and risk management strategies for sex offenders who offend against older people

Pediatric anaphylaxis

La anafilaxia es una reacción de hipersensibilidad sistémica de inicio rápido, que en caso de no tratarse adecuadamente puede llegar a ser mortal. Es la respuesta a la liberación de mediadores de inflamación por mecanismos tanto inmunológicos como no inmunológicos, y pueden suceder posterior a una única exposición al alergeno o tras la reexposición en un paciente sensibilizado. Los desencadenantes más comunes son las comidas, los fármacos y el veneno de insectos, siendo los alimentos los causantes principales en niños. Sin embargo, en 20% de los casos no se identifica el desencadenante. El diagnóstico de la anafilaxia es clínico, sin embargo, cabe destacar que esta se puede presentar con una gran variedad de síntomas, de ahí lo complejo de su identificación. Las manifestaciones más comunes son síntomas cutáneos como urticaria, angioedema, eritema y prurito. La ausencia de estos no descarta la anafilaxia y no debe de retrasar el tratamiento. El tratamiento de elección va a ser la epinefrina, esta debe administrarse inmediatamente en los casos que se sospeche anafilaxia, incluso si el diagnóstico es incierto debido a que realmente no existe una contraindicación para su uso, mientras que en caso de colocarse tardíamente puede tener consecuencias fatales. Este articulo aborda la fisiopatología, epidemiologia, diagnóstico y tratamiento de la anafilaxia con un enfoque en la población pediátrica ya que es una población en la que esta patología suele ser infradiagnosticada.  Anaphylaxis is a rapid-onset systemic hypersensitivity reaction that can be fatal if it is not treated properly. Anaphylaxis is the response to the release of inflammatory mediators by both immunological and non-immunological mechanisms, and can occur after a single exposure to the allergen or after re-exposure in a sensitized patient. The most common triggers are food, drugs, and insect venom, with food being the main triggers in children. However, in 20% of cases the trigger is not identified. The diagnosis of anaphylaxis is clinical; however, it should be noted that it can present with a great variety of symptoms, hence the complexity of its identification. The most common manifestations are skin symptoms such as urticaria, angioedema, erythema, and itching. The absence of these does not rule out anaphylaxis and should not delay treatment. The treatment of choice will be epinephrine, this should be administered immediately in cases where anaphylaxis is suspected, even if the diagnosis is uncertain, because there is no contraindication for its use, and if its use is delayed it can cause fatal outcomes. This article addresses the pathophysiology, epidemiology, diagnosis, and treatment of anaphylaxis, focused on pediatric patients, since this is a population in which this pathology is often underdiagnosed. &nbsp

Assessing Preemptive Argumentation in Students’ Persuasive Speech Outlines

The purpose of the present study was to determine if critical thinking skills, a key component of basic communication course pedagogy, can be assessed through students’ use of preemptive argumentation. Persuasive speech outlines were coded to determine if preemptive argumentation was present in students’ speeches and to determine the quality of preemptive argumentation. The results indicated that the majority of outlines contained preemptive argumentation. However, of those speeches containing preemptive argumentation, the majority of outlines employed low-quality preemptive argumentation. Finally, the findings revealed that the quality of preemptive argumentation employed in the persuasive speech outlines did not predict the students’ persuasive speech grades. Implications for instructor training programs and pedagogy in the basic course are discussed

Evidence for production of paralytic shellfish toxins by bacteria associated with Alexandrium spp. (Dinophyta) in culture

A substantial proportion of bacteria from five Alexandrium cultures originally isolated from various countries produced sodium channel blocking (SCB) toxins, as ascertained by mouse neuroblastoma assay. The quantities of SCB toxins produced by bacteria and dinoflagellates were noted, and the limitations in comparing the toxicities of these two organisms are discussed. The chemical nature of the SCB toxins in selected bacterial isolates was determined as paralytic shellfish toxins by pre- and postcolumn high-performance liquid chromatography, capillary electrophoresis-mass spectrometry, and enzyme immunoassay.Versión del editor3,829

Fetal Testosterone Predicts Sexually Differentiated Childhood Behavior in Girls and in Boys

ABSTRACT—Mammals, including humans, show sex differences in juvenile play behavior. In rodents and nonhuman primates, these behavioral sex differences result, in part, from sex differences in androgens during early development. Girls exposed to high levels of androgen prenatally, because of the genetic disorder congenital adrenal hyperplasia, show increased male-typical play, suggesting similar hormonal influences on human development, at least in females. Here, we report that fetal testosterone measured from amniotic fluid relates positively to male-typical scores on a standardized questionnaire measure of sextypical play in both boys and girls. These results show, for the first time, a link between fetal testosterone and the development of sex-typical play in children from the general population, and are the first data linking high levels of prenatal testosterone to increased male-typical play behavior in boys. Sexual differentiation of the mammalian brain occurs under the control of gonadal hormones, particularly androgens, during early development (De Vries & Simerly, 2002; Ehrhardt &amp