A Systematic Review of Microsurgical Pedicle Lengthening in Free Tissue Transfer.

Introduction: Traumatic injuries that require free tissue flaps for reconstruction may require vascular pedicle extension between the flap and recipient vessels to form a clear anastomosis. Currently, a variety of techniques are used, each with their own potential benefits and harms. In addition, reports in the literature conflict on the reliability of pedicle extensions of vessels in free flap (FF) surgery.

Sedation and Analgesia for Reduction of Pediatric Ileocolic Intussusception.

Importance: Ileocolic intussusception is an important cause of intestinal obstruction in children. Reduction of ileocolic intussusception using air or fluid enema is the standard of care. This likely distressing procedure is usually performed without sedation or analgesia, but practice variation exists.

Automated 'lights-out' searching of all recovered fingerprints: Review of the current workflow for latent fingerprint processing in Queensland, Australia.

The process of linking an offender to a crime scene via their fingerprints has historically required significant human effort to compare latent fingerprints recovered from the scene with known fingerprints of a suspect. Increasing the speed of such comparisons, whilst maintaining accuracy and reliability and minimising error, is crucial for providing rapid intelligence to police investigators. One major opportunity for streamlining fingerprint examination is the adaptation of 'lights-out' technology to the comparison and matching of latent fingerprints.

Neonatal Outcomes Following Delivery in Water: Evaluation of Safety in a District General Hospital.

Introduction Giving birth in water has increased in popularity over recent years, with potential benefits in terms of maternal comfort and decreased rates of instrumental delivery. Some concerns have been raised about possible adverse neonatal outcomes, including hypothermia and respiratory distress. There is not currently, however, a clear consensus in the literature.

Variation in the management of SSRI-exposed babies across England.

Background: Depression in pregnancy is commonly treated using selective serotonin reuptake inhibitors (SSRIs). A possible withdrawal syndrome following in utero exposure has been reported, but there is currently no UK guidance on the management of these neonates.

Methods: All 160 neonatal units in England were asked for information regarding their management of SSRI-exposed babies.

Throat swabs have no influence on the management of patients with sore throats.

Background: Throat swabs are neither specific nor sensitive for micro-bacteria causing sore throat symptoms; however, current guidelines suggest they are still useful in some cases.

Method: Retrospective and prospective analyses were conducted of throat swabs requested within the months of January 2016 and August 2016, respectively.

Results: The study comprised 247 patients.

Resuscitation of the Newborn: Simulating for Confidence.

Introduction: Non-pediatric trainees working in pediatrics in the UK are expected to attend newborn deliveries and provide initial newborn life support if needed. In Swindon, new junior doctors receive a 90-minute teaching session at the start of their pediatrics rotation, but the content has not previously been standardized, and it may be several weeks before a doctor attends a newborn delivery. Thus, the confidence and competence in newborn resuscitation of doctors attending deliveries can vastly vary.

Early school attainment in late-preterm infants.

Aim: To investigate whether infants born late-preterm have poorer school attainment compared to those born at term.

Methods: This study used data from the Avon Longitudinal Study of Parents and Children. Key stage one (KS1) school assessment results were obtained from local education authorities.

Childhood diet and behavioural problems: results from the ALSPAC cohort.

Objective: To investigate whether a 'junk food' diet at 81 months of age is associated with the development of behavioural problems over the following 16 months.

Subjects/methods: The study used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) and 12,942 children were included. The main outcome measure was behavioural problems, measured using the Strengths and Difficulties Questionnaire (SDQ).

Serum ionized magnesium and calcium levels in adult patients with seizures.

Objective: Prior studies have been equivocal about whether or not serum levels of the divalent ions calcium and magnesium are altered during different types of seizures. Magnesium is a potential modulator of seizure activity because of its ability to antagonize the excitatory calcium influx through the N-methyl-D-aspartate (NMDA) receptor. We hypothesize that serum ionized levels of calcium (Ca(2+)) and magnesium (Mg(2+)) would be altered significantly during certain types of seizures.

Emergency call work-load, deprivation and population density: an investigation into ambulance services across England.

Demand for emergency ambulance services has risen steeply over the recent years. This study examined differences in work-load of ambulance services across England and investigated factors linked to high demand. The number of emergency calls received by each ambulance service in 1997 and 2002 and population and area data were used to calculate call rates and population density for each of 27 service areas.

Changes in the emergency workload of the London Ambulance Service between 1989 and 1999.

Objectives: To examine changes in the emergency workload of the London Ambulance Service (LAS) between 1989 and 1999.

Methods: All emergency responses by the LAS during week 16 in each of 1989, 1996, and 1999 were studied. For each week, 999 call responses were analysed by time and day of call, and age/sex of the patient.

Computerized physician order entry and online decision support.

Computerized physician order entry (CPOE) and decision support systems (DSS) can reduce certain types of error but often slow clinicians and may increase other types of error. The net effect of these systems on an emergency department (ED) is unknown. The consensus participants combined published evidence with expert opinion to outline recommendations for success.

Bonding, energies, and band offsets of Si-ZrO2 and HfO2 gate oxide interfaces.

New oxides with high dielectric constant are required for gate oxides. ZrO2 is a typical example with ionic bonding. We give the rules for bonding at interfaces between Si and ionic oxides, to satisfy valence requirements and give an insulating interface.

New polyazaporphine chemistry for the origin of life.

Molecular orbital spectral predictions suggest that 2,5,7,10,12,15,17,20-octaaza-21H, 23H-porphine has a visible spectral range closely matching that of chlorophyll-a. Since the octaazaporphine is, in its core, a simple derivative of an (HCN)12 oligomer, this fact, together with its spectral properties, would suggest that it occupies a high rank as a primordial porphinic solar energy transducer for photochemistry essential to life's formation. The demonstration that the mass 324 hexahydrooctaazaporphine is formed in protic media by the cyclotetramerization of imidazol-4-aminohydroxonium ion or the derived nitrenium ion, and that a mass 318 species consonant with that of the Huckel aromatic octaazaporphine is observed in the course of these studies, strongly supports the proposed octaazaporphine synthesis in a prebiotic hydrocyanic acid milieu.

What is gross hematuria? Correlation of subjective and objective assessment.

Background: Gross hematuria is a screening test used to help determine the need for radiographic evaluation in patients with blunt trauma. This subjective assessment has not been compared with objective measures, nor has interrater reliability been described.

Methods: We performed a prospective, randomized, controlled study to determine the ability of clinicians to assess gross hematuria.

Diagnosis of grass sickness by ileal biopsy.

Ileal biopsies were obtained from 18 horses with grass sickness, 15 horses with other alimentary disease and three horses without gastrointestinal disease. Samples of small intestine were also obtained from nine cases of obstruction due to small intestinal strangulation. Histological examination revealed that severe enteric neuropathy in the absence of other significant morphological changes was confined to the horses with grass sickness.