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Until recently, movement analysis of children with motor disabilities has mainly relied on in-lab measurements using optoelectronic systems. The development of new tools is mainly inspired from mainstream devices, such as video cameras associated with artificial intelligence or inertial sensors. These tools have extended the assessment of movement in these children beyond traditional movement analysis laboratories, to take an interest in their movements in everyday life. Through the complementarity of these measurements (and associated tools), which the use of is becoming mainstream, a more exhaustive understanding of children's motor disorders and their impacts will allow clinicians to optimize their therapeutic management.At Geneva University Hospitals (HUG), occupational therapists and physiotherapists are recognized as inseparable partners in pediatric neurorehabilitation. They help the child and his family from early management to hospital discharge. Early treatment helps promote cerebral plasticity. The discharge from the hospital is prepared thanks to the anticipation of the needs (home adaptation and adaptive equipment/assistive devices) as well as an effective discharge plan in collaboration with outpatient service which results in optimal conditions for a safe return home.Digestive and nutritional problems of children with cerebral palsy put them at risk of malnutrition. Identification of these problems through measurements of weight, height, and body composition is essential. Feeding difficulties may be caused by a combination of oral and digestive problems, such as swallowing difficulties, gastroesophageal reflux, and constipation. If oral feeding is difficult or unsafe, a nasogastric tube or gastrostomy may be necessary. Once the feeding regimen has been established, energy needs must be assessed on an individual basis. This nutritional management involves a multidisciplinary team of health care professionals, the child, and the family.Respiratory problems have a significant impact on morbidity and mortality in children with severe neurological impairment. In particular, impaired airway clearance, recurrent respiratory infections, bronchial hyper reactivity can lead to acute decompensation and, with time, to chronic respiratory failure. Multiple coexisting and interacting factors that influence the respiratory status of these children should be recognized and effectively addressed to reduce respiratory morbidity and mortality. An accurate assessment involving a multidisciplinary approach and relatively simple interventions can lead to significant improvements in the quality of life of children as well as their parents and carers.Children with encephalopathy are at increased risk of swallowing disorders with aspirations, food blockages, difficulties, and stress during meals. Serious consequences may result, such as recurrent lung infections and failure to thrive. The ENT or phoniatric examination includes the evaluation of food bolus management, possible drooling, and swallowing safety. This article explains the role of the ENT in the management of these children, with a description of the examinations to be carried out for a global evaluation of swallowing and aspirations and the treatments proposed for a better management of food intake by mouth and chronic drooling.Children with profound intellectual and multiple disabilities are highly vulnerable. It is related to their numerous medical issues, their reliance on complex care as well as support for daily living activities. They also have frequent reason to visit emergent care. The number of caregivers involved is usually understandably high. This combination of numerous medical issues and multiple procedure required, as benevolent as they are meant to be, will expose these children to potential pain. This article will summarize how to recognize and treat the pain in children with multiple disabilities.The International Classification of Functioning, Disability and Health (ICF) serves as a useful tool to describe the numerous challenges that pediatricians face when dealing with disabled children. In this review article, we will first discuss the issues of diagnosis announcement and communication modalities. In a second part, we will expose the challenges posed by newly available therapies for rare disorders, and innovative technologies in the field of disability, which are at the crossroads of medicine, engineering and education. Finally, we will address the question of schooling of disabled children and advocate for a close and early cooperation between health care professionals and educational stakeholders.Stanford type A acute aortic dissection is an inherently lethal condition that is regarded as a surgical emergency. The Bentall procedure is considered the gold standard for patients requiring aortic root replacement. However, this method can be technically difficult for less-experienced surgeons. Complications encountered after composite graft replacement include distortion of the proximal part of the coronary artery, bleeding from the conduit implant site, and reattached coronary artery origins caused in general by a consumption coagulopathy. In cases for which aortic valve preservation is not applicable and the root is not dissected or dilated, surgeons often opt for less complicated techniques like aortic valve and supracoronary ascending aortic replacement. Nevertheless, these patients carry a high risk of late aortic root dilatation and subsequent reoperation. The goal of aortic root reinforcement by the Florida sleeve technique is to encase the aortic root to prevent any further dilatation and perioperative bleeding.Enucleation of an esophageal leiomyoma is the treatment of choice in symptomatic patients. Several open or minimally invasive approaches have been shown to be safe and effective. Robotic approaches allow for delicate and precise dissection with improved three-dimensional visualization. The robotic operative technique for enucleation has not been well described. In this context, we present the case of a 53-year-old obese man struggling with dysphagia and odynophagia due to a mid-esophageal leiomyoma. In the case presentation, we review the preoperative workup with high-quality images, robotic port placement, equipment needed, intraoperative conduct, and postoperative course. We provide a step-by-step video tutorial encompassing the preoperative workup, operative steps, tips and tricks, and postoperative course using a totally robotic enucleation of a 7-cm mid-esophageal leiomyoma. This case presentation can serve as a comprehensive teaching case for trainees and a high-quality example of the conduct of the operation for practicing surgeons, including some tips and tricks for optimal results. We also highlight that an assistant port is not required.Truncus arteriosus is a rare cardiac anomaly, accounting for less than 4% of all congenital lesions. It is the result of failed aorticopulmonary septation during the fifth week of gestation leading to a single arterial trunk overriding the interventricular septum, a single semilunar valve, and typically a large conotruncal ventricular septal defect. Several classifications exist, and it typically requires surgical repair in the neonatal period. We present a 5-day old female neonate who was diagnosed postnatally with type I truncus arteriosus in which the pulmonary arteries arose from a discrete pulmonary trunk that originated from the posterolateral aspect of the common arterial trunk. A successful repair was undertaken using a variant of the Barbero-Marcial technique.Extracorporeal life support is a well-known therapy for acute respiratory failure. Its use has increased exponentially in recent years, even more since the beginning of the SARS-CoV-2 pandemic. Patients with COVID-19 may need long-term extracorporeal life support runs. They also suffer coagulation derangements that cause a prothrombotic state. Both situations may increase the need for exchanges of extracorporeal life support circuits. Extracorporeal life support circuit exchange should be performed as quickly and as safely as possible because patients may be completely dependent on it.Robotic-assisted thoracoscopy is a procedure that allows certain improvements over the traditionally used thoracoscopic procedures but still has disadvantages. Its association with dissection techniques such as the tunnel technique allows an approach to lungs with incomplete or fused fissures. We present the case of a 65-year-old female smoker with a 33-mm mass with a 13.7 SUVmax on positron emission tomography-computed tomography scans accompanied by biopsies that confirmed the diagnosis of small-cell lung cancer. After confirming that it was stage N0 and M0, surgical treatment was chosen. We performed a left upper lobectomy and thoracoscopic lymphadenectomy with robotic assistance; due to the presence of incomplete fissures, we used the fissure tunneling technique. This procedure ensured a safe dissection technique with the correct identification of the vascular and bronchial structures and reduced the risk of air leakage.

Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is the second most frequent recessive ataxia and commonly features reduced upper limb coordination. Sensitive outcome measures of upper limb coordination are essential to track disease progression and the effect of interventions. However, available clinical assessments are insufficient to capture behavioral variability and detailed aspects of motor control. While digital health metrics extracted from technology-aided assessments promise more fine-grained outcome measures, these have not been validated in ARSACS. Thus, the aim was to document the metrological properties of metrics from a technology-aided assessment of arm and hand function in ARSACS.

We relied on the Virtual Peg Insertion Test (VPIT) and used a previously established core set of 10 digital health metrics describing upper limb movement and grip force patterns during a pick-and-place task. We evaluated reliability, measurement error, and learning effects in 23 participants wiights into upper limb sensorimotor control.With the rapid evolution of microelectronics and nanofabrication technologies, the feature sizes of large-scale integrated circuits continue to move toward the nanoscale. There is a strong need to improve the quality and efficiency of integrated circuit inspection, but it remains a great challenge to provide both rapid imaging and circuit node-level high-resolution images simultaneously using a conventional microscope. This paper proposes a nondestructive, high-throughput, multiscale correlation imaging method that combines atomic force microscopy (AFM) with microlens-based scanning optical microscopy. In this method, a microlens is coupled to the end of the AFM cantilever and the sample-facing side of the microlens contains a focused ion beam deposited tip which serves as the AFM scanning probe. The introduction of a microlens improves the imaging resolution of the AFM optical system, providing a 3-4× increase in optical imaging magnification while the scanning imaging throughput is improved ≈8×. selleck inhibitor The proposed method bridges the resolution gap between traditional optical imaging and AFM, achieves cross-scale rapid imaging with micrometer to nanometer resolution, and improves the efficiency of AFM-based large-scale imaging and detection.