Feasibility of Achieving Nutritional Adequacy in Critically Ill Children with Critical Neurological Illnesses (CNIs)?-A Quaternary Hospital Experience.

The literature on the nutritional needs and outcomes of critically ill children is scarce, especially on those with critical neurological illnesses (CNIs). Current evidence shows a lower mortality in patients who achieve two-thirds of their nutritional needs during the first week of pediatric intensive care unit (PICU) admission. We hypothesized that achieving 60% of the recommended dietary intake during the first week of a PICU stay is not feasible in patients with CNI.

An In-Depth Look at Nutrition Support and Adequacy for Critically Ill Children with Organ Dysfunction.

Patients admitted to a pediatric intensive care unit (PICU) need individualized nutrition support that is tailored to their particular disease severity, nutritional status, and therapeutic interventions. We aim to evaluate how calories and proteins are provided during the first seven days of hospitalization for children in critical condition with organ dysfunction (OD). A single-center retrospective cohort study of children aged 2-18 years, mechanically ventilated > 48 h, and admitted > 7 days to a PICU from 2016 to 2017 was carried out.

A Systematic Review of Immunization Administration Training for African Pharmacists and Student Pharmacists.

Objectives: Recent calls to action have encouraged African pharmacists to become trained to administer immunizations with the goals of developing a strong pharmacy vaccination workforce, addressing a shortage of vaccinators, and improving vaccination access. However limited availability of training programs for pharmacists and student pharmacists to learn to administer immunizations may restrict the ability of African pharmacists and student pharmacists to meet these goals. This work sought to systematically identify literature published regarding immunization administration training for pharmacists and student pharmacists in Africa.

Postoperative outcomes of acute-on-chronic liver failure in infants and children with biliary atresia.

Introduction: Acute-on-chronic liver failure (ACLF) is associated with increased mortality and morbidity in patients with biliary atresia (BA). Data on impact of ACLF on postoperative outcomes, however, are sparse.

Method: We performed a retrospective analysis of patients with BA aged <18 years who underwent LT between 2011 and 2021 at our institution.

Reliability and validity of the medial standing overhead arm reach (SOAR) test as a measure of functional hip adduction motion.

Objective: The Posterior Standing Overhead Arm Reach (SOAR) test has been previously reported as a reliable clinical measure of closed chain hip extension motion. The proposed Medial SOAR test expands on that testing approach to provide a similar measure of functional hip adduction motion. This was a preliminary intrarater and interrater reliability and validity study of the Medial SOAR test as a measure of functional hip adduction.

Estimating risk of prolonged mechanical ventilation after liver transplantation in children: PROVE-ALT score.

Background: Children at high risk for prolonged mechanical ventilation (PMV) after liver transplantation (LT) need to be identified early to optimize pulmonary support, allocate resources, and improve surgical outcomes. We aimed to develop and validate a metric that can estimate risk for Prolonged Ventilation After LT (PROVE-ALT).

Methods: We identified preoperative risk factors for PMV by univariable analysis in a retrospective cohort of pediatric LT recipients between 2011 and 2017 (n = 205; derivation cohort).

A quantum engine in the BEC-BCS crossover.

Heat engines convert thermal energy into mechanical work both in the classical and quantum regimes. However, quantum theory offers genuine non-classical forms of energy, different from heat, which so far have not been exploited in cyclic engines. Here we experimentally realize a quantum many-body engine fuelled by the energy difference between fermionic and bosonic ensembles of ultracold particles that follows from the Pauli exclusion principle.

Sinus Arrest Related to Dexmedetomidine Infusion in an Infant; a Case Report and Review of Current Literature.

Dexmedetomidine, an alpha 2 agonist, has emerged as a desirable sedative agent in the pediatric intensive care unit due to its minimal effect on respiratory status and reduction in delirium. Bradycardia and hypotension are common side effects, however there are emerging reports of more serious cardiovascular events, including sinus arrest and asystole. These case reports have been attributed to high vagal tone or underlying cardiac conduction dysfunction.

Management of Extensive Central Nervous System Cladophialophora bantiana Infection in a 9-Year-Old Child.

Background: Pediatric central nervous system (CNS) phaeohyphomycosis is a rare invasive fungal infection associated with high mortality.

Methods: We describe a child with progressive neurologic symptoms whose ultimate diagnosis was Cladophialophora bantiana -associated CNS phaeohyphomycosis. We discuss her clinical presentation, medical and surgical management and review the current literature.

Randomised controlled trial on the effect of simethicone bowel preparation on rectal variability during image-guided radiation therapy for prostate cancer (SPoRT study).

Introduction: The purpose of this study was to assess whether simethicone reduces the rectal volume (RV) and gas volume (GV), to increase treatment accuracy and to decrease toxicity of prostate radiation therapy.

Methods: 30 patients were randomised to simethicone or no intervention. Cone-beam computed tomography (CBCT) scans were performed on Days 1-3 and weekly until completion of radiation.

Connecting Scrambling and Work Statistics for Short-Range Interactions in the Harmonic Oscillator.

We investigate the relationship between information scrambling and work statistics after a quench for the paradigmatic example of short-range interacting particles in a one-dimensional harmonic trap, considering up to five particles numerically. In particular, we find that scrambling requires finite interactions, in the presence of which the long-time average of the squared commutator for the individual canonical operators is directly proportional to the variance of the work probability distribution. In addition to the numerical results, we outline the mathematical structure of the N-body system which leads to this outcome.

Self-Pinning Transition of a Tonks-Girardeau Gas in a Bose-Einstein Condensate.

We show that a Tonks-Girardeau (TG) gas that is immersed in a Bose-Einstein condensate can undergo a transition to a crystal-like Mott state with regular spacing between the atoms without any externally imposed lattice potential. We characterize this phase transition as a function of the interspecies interaction and temperature of the TG gas, and show how it can be measured via accessible observables in cold atom experiments. We also develop an effective model that accurately describes the system in the pinned insulator state and which allows us to derive the critical temperature of the transition.

Hemodynamic instability during connection to continuous kidney replacement therapy in critically ill pediatric patients.

Background: Emerging data suggest evidence of organ hypoperfusion during continuous kidney replacement therapy (CKRT). To facilitate kidney and global recovery, we must understand the hemodynamic risks associated with CKRT. We aimed to investigate frequency of hemodynamic instability and association with patient outcomes in pediatric CKRT.

Patterns of the use of advanced radiation therapy techniques for the management of bone metastases and the associated factors in Victoria.

Introduction: To describe the pattern of the use of advanced radiation therapy (RT) techniques, including intensity-modulated RT (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic body RT (SBRT) for the management of bone metastases (BM), and the associated factors in Victoria.

Methods: We used a population-based cohort of patients from the state-wide Victorian Radiotherapy Minimum Data Set (VRMDS) who received RT for BM between 2012 and 2017. The primary outcome was proportion of RT courses using advanced RT techniques.

Advancing a global pharmacy support workforce through a global strategic platform.

The pharmacy support workforce (PSW) is the mid-level cadre of the global pharmacy profession, referring to pharmacy technicians, assistants and other cadres that assist in the delivery of pharmaceutical services in a variety of practice contexts. The PSW undertake technical tasks delegated under the supervision of a pharmacist or performed collaboratively. The PSW are not intended to replace pharmacists, but rather work side-by-side with the pharmacist to achieve a shared goal.

The use of tracheostomy to support critically ill children receiving orthotopic liver transplantation: a single-center experience.

Background: Children with end-stage liver disease and multi-organ failure, previously considered as poor surgical candidates, can now benefit from liver transplantation (LT). They often need prolonged mechanical ventilation (MV) post-LT and may need tracheostomy to advance care. Data on tracheostomy after pediatric LT are lacking.

In Situ Thermometry of a Cold Fermi Gas via Dephasing Impurities.

The precise measurement of low temperatures is a challenging, important, and fundamental task for quantum science. In particular, in situ thermometry is highly desirable for cold atomic systems due to their potential for quantum simulation. Here, we demonstrate that the temperature of a noninteracting Fermi gas can be accurately inferred from the nonequilibrium dynamics of impurities immersed within it, using an interferometric protocol and established experimental methods.

Different models of pharmaceutical services and care in primary healthcare clinics in the Eastern Cape, South Africa: Challenges and opportunities for pharmacy practice.

Background: Primary health care (PHC) re-engineering forms a crucial part of South Africa's National Health Insurance (NHI), with pharmaceutical services and care being crucial to treatment outcomes. However, owing to a shortage of pharmacists within PHC clinics, task-shifting of the dispensing process to pharmacist's assistants and nurses is common practice. The implications of this task-shifting process on the provision of pharmaceutical services and care remains largely unstudied.

Orthogonality Catastrophe as a Consequence of the Quantum Speed Limit.

A remarkable feature of quantum many-body systems is the orthogonality catastrophe that describes their extensively growing sensitivity to local perturbations and plays an important role in condensed matter physics. Here we show that the dynamics of the orthogonality catastrophe can be fully characterized by the quantum speed limit and, more specifically, that any quenched quantum many-body system, whose variance in ground state energy scales with the system size, exhibits the orthogonality catastrophe. Our rigorous findings are demonstrated by two paradigmatic classes of many-body systems-the trapped Fermi gas and the long-range interacting Lipkin-Meshkov-Glick spin model.

Noninvasive stereotactic radioablation for the treatment of atrial fibrillation: First-in-man experience.

Purpose: Catheter ablation is an effective therapy for atrial fibrillation (AF). However, risks remain, and improved efficacy is desired. Stereotactic body radiotherapy (SBRT) is a well-established therapy used to noninvasively treat malignancies and functional disorders with precision.

Stereotactic radiosurgery for intracranial IgG4-related disease.

We report the case of a 20-year-old woman with intracranial IgG4-related disease, initially misdiagnosed as a meningioma on biopsy and treated with radiosurgery as it was in an eloquent location and not resectable. Her intracranial IgG4 disease had a near-complete response to radiosurgery and is still controlled six years later, so this case represents what we believe to be the first reported use of radiotherapy in the treatment of intracranial IgG4-related disease.

A pilot study of venous flow augmentation using a novel mechanical graded intermittent sequential compression device for venous insufficiency.

Background: Guidelines as well as multiple RTCs support the use of intermittent pneumatic compression (IPC) for the treatment of venous leg ulcers when conservative measures fail. Unfortunately, the clinical usefulness of IPC is significantly limited by the physical limitations of pneumatic motors, which leads to bulky devices with slow inflation cycles, uncomfortable sleeves, lack of patient mobility, and ultimately poor patient compliance with therapy. A novel mechanical device for lower leg graded intermittent sequential compression was designed to address these limitations of IPC therapy for venous leg ulcer treatment by providing rapid compression cycles in a truly wearable device that offers the additional benefit of monitoring compression dose and patient compliance.

Safety and efficacy of stereotactic radioablation targeting pulmonary vein tissues in an experimental model.

Background: Stereotactic radioablation (SR), a commonly used therapy to treat malignant tumors, has been used to treat refractory ventricular tachycardia, but the feasibility of treating atrial fibrillation with SR is unknown.

Objective: We evaluated the safety and efficacy of SR targeting pulmonary vein (PV) antral tissues as a potential therapy for atrial fibrillation.

Methods: Seventeen adult canines and 2 adult swine underwent surgical fiducial marker placement, 3-dimensional anatomic rendering computed tomography angiogram of the left atrium, and creation of a treatment plan targeting the right superior PVs.