Computer Simulation to Assess Emergency Department Length of Stay in Pediatric Traumatic Brain Injury.

Objectives: Our study aimed to identify how emergency department (ED) arrival rate, process of care, and physical layout can impact ED length of stay (LOS) in pediatric traumatic brain injury care.

Methods: Process flows and value stream maps were developed for 3 level I pediatric trauma centers. Computer simulation models were also used to examine "what if" scenarios based on ED arrival rates.

Long-term storage does not affect the infectivity of entomopathogenic nematodes on insect hosts.

Entomopathogenic nematodes (EPNs) are effective biopesticides used in insect control. There are several formulations of entomopathogenic nematodes which are commercially available, but their popularity is low because the requirement of periodic release of stored entomopathogenic nematodes in field has reduced infectivity and is a constraint in large-scale repeated application of entomopathogenic nematodes in field. So, in order to overcome this impediment, the current study focuses on storage of entomopathogenic nematodes for a longer period of time using encapsulating beads.

Biosynthesis and characterization of silver nanoparticles from symbiotic bacteria Xenorhabdus nematophila and testing its insecticidal efficacy on Spodoptera litura larvae.

Spodoptera litura, one of the polyphagous pests, causes huge economical lose and use of chemical pesticide causes impact to the environmental. The present study deals with the use of cell- free supernatant of bacteria Xenorhabdus nematophila NP-1 strain for synthesizing silver nanoparticles and analyzing its larvicidal ability against Spodoptera litura. Color change from yellow to dark brown specifies the synthesis of AgNPs.

Biogenic synthesis of ZnO nanoparticles mediated from Borassus flabellifer (Linn): antioxidant, antimicrobial activity against clinical pathogens, and photocatalytic degradation activity with molecular modeling.

Borassus flabellifer leaf extract has been used for rapid biogenic synthesis of zinc oxide nanoparticles (ZnO-NPs) due to rich source of bioactive compounds. The synthesized ZnO-NPs were preliminarily confirmed by UV-visible spectroscopy adsorption peak range at 365 nm. The XRD (X-ray diffraction) confirms purity of ZnO-NPs that were crystalline in nature.

Prehospital Factors Associated with Discharge Outcomes: Baseline Data from the Andhra Pradesh Traumatic Brain Injury Project.

Objective: Strategies to improve traumatic brain injury (TBI) outcomes in India are ill defined. The objective of this study was to examine baseline prehospital (PH) factors associated with outcomes from the Andhra Pradesh Traumatic Brain Injury Project.

Methods: We conducted a prospective observational cohort study of adult patients with TBI admitted to the primary referral hospital.

Patients Who Benefit from Intracranial Pressure Monitoring without Cerebrospinal Fluid Drainage After Severe Traumatic Brain Injury.

Background: India has a high traumatic brain injury (TBI) burden and intracranial pressure monitoring (ICP) remains controversial but some patients may benefit.

Objective: To examine the association between ICP monitor placement and outcomes, and identify Indian patients with severe TBI who benefit from ICP monitoring.

Methods: We conducted a secondary analysis of a prospective cohort study at a level 1 Indian trauma center.

Simulation of the Emergency Department Care Process for Pediatric Traumatic Brain Injury.

The treatment of patients in the emergency department (ED) with severe pediatric traumatic brain injury (TBI) is challenging, and treatment process strategies that facilitate good outcomes are not well documented. The overall objective of this study was to identify factors that can affect the care process associated with pediatric TBI. This objective was achieved using a discrete-event simulation model of patients with TBI as they progress through the ED treatment process of a Level I trauma center.

Frequency of and factors associated with emergency department intracranial pressure monitor placement in severe paediatric traumatic brain injury.

Objective: To examine the frequency of and factors associated with emergency department (ED) intracranial pressure (ICP) monitor placement in severe paediatric traumatic brain injury (TBI).

Methods: Retrospective, multicentre cohort study of children <18 years admitted to the ED with severe TBI and intubated for >48 hours from 2007 to 2011.

Results: Two hundred and twenty-four children had severe TBI and 75% underwent either ED, operating room (OR) or paediatric intensive care unit (PICU) ICP monitor placement.

Examining Emergency Department Treatment Processes in Severe Pediatric Traumatic Brain Injury.

Background: In the treatment of pediatric traumatic brain injury (TBI), timely treatment of patients can affect the outcome. Our objectives were to examine the treatment process of acute pediatric TBI and the impact of non-value-added time (NVAT) on patient outcomes.

Methods: Data for 136 pediatric trauma patients (age < 18 years) with severe TBI from 2 trauma centers in the United States were collected.

Timely Hemodynamic Resuscitation and Outcomes in Severe Pediatric Traumatic Brain Injury: Preliminary Findings.

Objectives: Early resuscitation may improve outcomes in pediatric traumatic brain injury (TBI). We examined the association between timely treatment of hypotension and hypoxia during early care (prehospital or emergency department locations) and discharge outcomes in children with severe TBI.

Methods: Hypotension was defined as systolic blood pressure less than 70 + 2 (age in years), and hypoxia was defined as PaO2 less than 60 mm Hg or oxygen saturation less than 90% in accordance with the 2003 Brain Trauma Foundation guidelines.

Variation in seizure prophylaxis in severe pediatric traumatic brain injury.

OBJECTIVE Posttraumatic seizure is a major complication following traumatic brain injury (TBI). The aim of this study was to determine the variation in seizure prophylaxis in select pediatric trauma centers. The authors hypothesized that there would be wide variation in seizure prophylaxis selection and use, within and between pediatric trauma centers.

Guideline Adherence and Hospital Costs in Pediatric Severe Traumatic Brain Injury.

Objectives: Adherence to pediatric traumatic brain injury guidelines has been associated with improved survival and better functional outcome. However, the relationship between guideline adherence and hospitalization costs has not been examined. To evaluate the relationship between adherence to pediatric severe traumatic brain injury guidelines, measured by acute care clinical indicators, and the total costs of hospitalization associated with severe traumatic brain injury.

Guideline Adherence and Outcomes in Severe Adult Traumatic Brain Injury for the CHIRAG (Collaborative Head Injury and Guidelines) Study.

We examined the effect of early intensive care unit (ICU) adherence to 2007 Brain Trauma Foundation Guideline indicators after traumatic brain injury (TBI) on inpatient mortality at a level 1 trauma center in India (Jay Prakash Narayan Apex Trauma Center [JPNATC]) and Harborview Medical Center (HMC) in U.S. among adults older than 18 years with severe TBI.

Acute care clinical indicators associated with discharge outcomes in children with severe traumatic brain injury.

Objective: The effect of the 2003 severe pediatric traumatic brain injury (TBI) guidelines on outcomes has not been examined. We aimed to develop a set of acute care guideline-influenced clinical indicators of adherence and tested the relationship between these indicators during the first 72 hours after hospital admission and discharge outcomes.

Design: Retrospective multicenter cohort study.

Pediatric neurotrauma.

Traumatic brain injury (TBI) is the leading cause of death and disability in children over 1 year of age. Knowledge about the age-specific types of injury and how to manage children with neurotrauma is essential to understanding and recognizing the extent and degree of injury and to optimize outcomes. In this article, we review the epidemiology, pathophysiology, and clinical management of pediatric neurotrauma.

Triage of children with moderate and severe traumatic brain injury to trauma centers.

Outcomes after pediatric traumatic brain injury (TBI) are related to pre-treatment factors including age, injury severity, and mechanism of injury, and may be positively affected by treatment at trauma centers relative to non-trauma centers. This study estimated the proportion of children with moderate to severe TBI who receive care at trauma centers, and examined factors associated with receipt of care at adult (ATC), pediatric (PTC), and adult/pediatric trauma centers (APTC), compared with care at non-trauma centers (NTC) using a nationally representative database. The Kids' Inpatient Database was used to identify hospitalizations for moderate to severe pediatric TBI.