Watersgentry2216

Recent advancements in microfluidics and lab-on-a-chip technologies enabled miniaturization and automation of many downstream nucleic acid analysis steps such as PCR. However, DNA extraction/isolation protocol remains a stand-alone sample preparation step. For a quick sample-to-result solution, downstream protocols and sample preparation protocols need to be seamlessly integrated into a single lab-on-a-chip platform. As a step toward such integration, this paper introduces microfluidic DNA isolation using the liquid-liquid extraction (LLE) method in the drop-to-drop (DTD) format. The electrowetting-on-dielectric digital microfluidic platform is capable of handling a two-phase liquid system easily, which enables DTD LLE. In this study, the extraction of plasmid DNA (pDNA) from an aqueous sample to an ionic liquid is demonstrated. Prior to pDNA extraction study, the DTD LLE protocol was developed and optimized using organic dyes as solutes. The selective extraction of pDNA in the presence of proteins as interfering molecules is also demonstrated. This work implies that DTD LLE can substitute for magnetic beads steps in standard DNA isolation protocols.[This corrects the article DOI 10.1155/2019/1648919.].Reduction of intravenous line placement pain is one of the most important nursing priorities in the pediatric wards. The present study was aimed at comparing the effect of Hugo's point massage and play on the severity of IV-line placement pain in hospitalized children aged 3-6 years in the pediatric ward. 72 children were selected and assigned randomly to three groups, i.e., control, play, and Hugo point massage. In the massage group, the middle angle between the first and second bones of the palm of the opposite hand was massaged, and the playgroup encouraged bubble-making play. The one-way analysis of variance (ANOVA) did not show a statistically significant difference between the mean IV-line placement pain in play, Hugo's point, and control groups before interventions (p=0.838; p > 0.05). However, the ANOVA test revealed a significant difference between the mean IV-line placement pain in play, Hugo's point, and control groups after the interventions (p=0.006; p less then 0.05). Prostaglandin E2 cost The result of the post hoc Scheffe test also showed a statistically significant difference between the mean intensity of IV-line placement pain in both play therapy and Hugo's point massage groups (p=0.028; p less then 0.05). Moreover, this test showed that the playgroup children felt less pain than Hugo's point and control group children. This study showed that, in comparison with Hugo's point massage, the play was a more effective way for reducing pain caused by IV-line placement in children, and pediatric nurses can play a significant role in reducing and managing children's pain by using it.

Even though the guidelines on the management of preschool asthma recommend early use of corticosteroids for acute moderate-to-severe exacerbations, considerable variation exists with regard to type and dose of steroids.

To compare the clinical outcomes and side effect profile between 1 mg/kg/day and 2 mg/kg/day of oral prednisolone when administered for 3 days in preschool children with acute moderate asthma exacerbations.

Randomized double-blind noninferiority trial was done in the paediatric emergency of a teaching hospital.

A total of 128 children aged 1 to 5 years who presented to the paediatric emergency with acute moderate exacerbation of asthma were enrolled. They were randomized into two groups. One group received 1 mg/kg/day and the other 2 mg/kg/day of oral prednisolone for 3 days. Severity of asthma exacerbation was measured by Pediatric Respiratory Assessment Measure (PRAM) score. The PRAM scores, wheeze recurrence, and side effect profile were compared and analyzed between the two groups.

The difference in the PRAM scores at 1, 2, 3, and 4 hours after intervention between the two groups was statistically insignificant. Need for escalation of therapy, salbutamol nebulization, time for resolution of symptoms, and recurrence of wheeze were similar between the two groups. Vomiting was significantly less frequent in low-dose group with a relative risk of 0.19 to 0.99 compared to high-dose prednisolone.

Prednisolone at a dose of 1 mg/kg/day was not inferior to 2 mg/kg/day in terms of clinical improvement and recurrence of wheeze within 1 week and has less frequent vomiting compared to higher dose.

Prednisolone at a dose of 1 mg/kg/day was not inferior to 2 mg/kg/day in terms of clinical improvement and recurrence of wheeze within 1 week and has less frequent vomiting compared to higher dose.

Aminopenicillins are recommended empiric therapy for community-acquired pneumonia (CAP). The aim of the study was to assess treatment over a 5-year period after CAP guideline publication and introduction of an antimicrobial stewardship program (ASP).

Using ICD-10 discharge codes for pneumonia, children less than 18 years admitted to the Children's Hospital of Eastern Ontario January 1, 2012 and December 31, 2016 were identified. Children ≥ 2 months with consolidation were included. One day of therapy (DOT) was one or more doses of an antimicrobial given for 1 day.

Of 1,707 patients identified, 713 met inclusion criteria. Eighteen (2.5%) had bacteria identified by culture and 79 of 265 (29.8%) had

detected. Mean DOT/1,000 patient days of aminopenicillins/penicillin (AAP) increased by 18.1% per year (95% confidence interval [CI] -0.2, 39.9%) and decreased by 37.6% per year (95% CI -56.1, -11.3%) for second- and third-generation cephalosporins in the post-ASP period. The duration of discharge antimicrobbroad-spectrum antimicrobials.While cannabis use among adolescents is frequent in Canada, youth do recognize the potential harms, and increasingly expect knowledgeable health care providers to discuss substance use in everyday practice. This practice point provides sound, evidence-based tools to help health professionals address nonmedical (recreational) cannabis use and its related risks. After highlighting how to make the clinical setting a safe space for youth to talk about psychoactive substances, specific strategies for approaching cannabis use in effective, developmentally appropriate ways are described. Consistent with current literature, screening questionnaires to help structure discussion and identify adolescents who may benefit from more specialized interventions are recommended. Because one in six adolescents who experiments with cannabis goes on to misuse it, appraising their willingness to change risky behaviours is a key aspect of care, along with supportive goal-setting and helping families. Recommended resources for practitioners and parents are included.In the XXI century obesity has become one of the most demanding epidemiological threats worldwide. At the same time, bariatric surgery has established itself as an effective treatment for morbidly obese patients, with laparoscopic sleeve gastrectomy (LSG) emerging as the most popular bariatric procedure. This paper reviews the role of imaging studies of patients after LSG. Computed tomography is widely considered as the method of choice in detection of complications in early postoperative period. The dynamic character of upper gastrointestinal examination allows for the assessment of passage through the gastric remnant. The paper also discusses evaluation of the shape and volume of the gastric remnant assessed by imaging studies.

Morton's neuroma-bursal complex (MNBC) is a common cause of metatarsalgia which is usually investigated with ultrasound. Patients presenting with metatarsalgia may also have computed tomography (CT) as part of their investigation to look for alternative causes such as stress fracture. Although CT is considered to be of most use in assessing the bones in this scenario, the soft tissues can also be reviewed. This study analyses whether MNBC can reliably be detected on CT in patients presenting with metatarsalgia.

43 cases were identified on the Radiology Information System where both CT and ultrasound had been undertaken to assess for metatarsalgia. Two blinded consultant musculoskeletal radiologists retrospectively reviewed the CTs to determine the presence or absence of MNBC and this was compared to the ultrasound reports.

There was a mean sensitivity of 45.5% and mean specificity of 62.5%. Mean accuracy was 52.3% and Youden's index was 0.080. There was fair agreement between the two reviewers with Cohen's κ of 0.62.

Sensitivity and specificity of CT for MNBC are poor. CT should not be used as an isolated modality to make a definite diagnosis regarding the presence or absence of a MNBC.

Sensitivity and specificity of CT for MNBC are poor. CT should not be used as an isolated modality to make a definite diagnosis regarding the presence or absence of a MNBC.

To assess differentiating features between bacterial,

, and

skull base osteomyelitis (SBO) with regard to clinical presentation and imaging appearances.

A literature search was performed in April 2020 for studies on SBO with a minimum sample size of 10 patients. Studies that reported presenting symptoms, cross-sectional imaging findings, complications, and mortality were included in the analysis. The quality of included articles was tested using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. A data extraction form was used to retrieve relevant parameters from each of the articles.

Thirteen articles were included in the final analysis. Diabetes mellitus was the most common predisposing factor (12.5-91.0%). Presenting complaints in all bacterial SBO studies were otogenic, while fungal SBO patients had nasal/ocular complaints. Rates of mortality and surgical intervention in the fungal group were 50-100% and 50%, respectively, as compared to the bacterial group - 7-87% and 10%, respectively. On imaging, the site of initial infection in bacterial SBO was the external auditory canal, while in fungal SBO it was the paranasal sinus. The incidence of orbital extension was < 5% in bacterial and 44-70% in fungal SBO, among which

had rates of 65-70%. Bone erosion was less extensive in bacterial SBO, and the patterns differed. The highest incidence of vascular involvement and non-enhancing lesions (23-36%) was seen in

showed highest sino-cranial extension (52-55%) and homogenous bright enhancement.

Systematic analysis of the clinico-radiological parameters in each of the studies revealed differences in presentation, clinical course, extension, bone erosion, and enhancement.

Systematic analysis of the clinico-radiological parameters in each of the studies revealed differences in presentation, clinical course, extension, bone erosion, and enhancement.

To investigate the predictors of intraductal papillary mucinous neoplasms of the pancreas (IPMNs) with high-grade dysplasia, using 2-dimensional (2D) analysis and 3-dimensional (3D) volume-of-interest-based apparent diffusion coefficient (ADC) histogram analysis.

The data of 45 patients with histopathologically confirmed IPMNs with high-grade or low-grade dysplasia were retrospectively assessed. The 2D analysis included lesion-to-spinal cord signal intensity ratio (LSR), minimum ADC value (ADC

), and mean ADC value (ADC

). The 3D analysis included the overall mean (ADC

), mean of the bottom 10

percentile (ADC

), mean of the bottom 10-25

percentile (ADC

), mean of the bottom 25-50

percentile (ADC

), skewness (ADC

), kurtosis (ADC

), and entropy (ADC

). Diagnostic performance was compared by analysing the area under the receiver operating characteristic curve (AUC). Inter-rater reliability was assessed by blinded evaluation using the intraclass correlation coefficient.

There were 16 and 29 IPMNs with high- and low-grade dysplasia, respectively.