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Shields LBE, Edelen A, Daniels MW, Flanders K. Decline in Physical Restraint Use Following Implementation of Institutional Guidelines. J Nurs Adm 2021; 51:318-323. [PMID: 34006803 DOI: 10.1097/nna.0000000000001020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the strategies implemented at our institution to reduce medical restraint use. BACKGROUND Restraints have been utilized to prevent agitation, self-extubations, and falls, although they are often associated with negative repercussions for nurses and patients. METHODS The restraint data at our institution were compared with the National Database of Nursing Quality Indicators (NDNQI) benchmark. We also described the measures taken to improve restraint documentation. RESULTS The number of patients in medical restraints, medical restraint hours, medical restraints/patient-days, and deaths in restraints at our institution all significantly decreased (P < 0.00001). There were 27 self-extubations of restrained patients compared with 11 self-extubations of nonrestrained patients. The percentage of inpatients with restraints in critical care and step-down areas declined and remained below the NDNQI benchmark. CONCLUSIONS This study reports the processes implemented to reduce restraint use through enhanced communication and increased documentation. Further exploration into factors that may attain a restraint-free environment is warranted.
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Affiliation(s)
- Lisa B E Shields
- Author Affiliations: Medical Research Associate, Norton Neuroscience Institute (Dr Shields), and Manager of Quality and Regulation, Quality Research Management (Ms Edelen), Norton Healthcare; Biostatistician (Mr Daniels), Department of Bioinformatics & Biostatistics, University of Louisville; Vice President of Patient Care Services and Chief Nursing Officer (Dr Flanders), Practice Administration, Norton Healthcare, Louisville, Kentucky
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Taguchi H, Tanaka T, Nishiofuku H, Fukuoka Y, Minamiguchi K, Taiji R, Takayama K, Takeda M, Hatakeyama K, Inoue T, Ohbayashi C, Kichikawa K. A Rat Model of Frozen Shoulder Demonstrating the Effect of Transcatheter Arterial Embolization on Angiography, Histopathology, and Physical Activity. J Vasc Interv Radiol 2021; 32:376-383. [PMID: 33309281 DOI: 10.1016/j.jvir.2020.10.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/28/2020] [Accepted: 10/18/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To assess the angiographic findings and the effects of transcatheter arterial embolization on physical activity and histopathology using a frozen shoulder rat model. MATERIALS AND METHODS First, the angiographic and histopathologic findings of rats in which the shoulder was immobilized with molding plaster for 6 weeks (n = 4) were compared to control rats with normal non-immobilized shoulders (n = 4). Next, a total of 16 frozen shoulder rats were divided into 2 groups. In the transcatheter arterial embolization group (n = 8), imipenem/cilastatin was injected into the left thoracoacromial artery. The changes of physical activity before and after procedures were evaluated and compared with a saline-injected control group (n = 8). Histopathologic findings were also compared between the 2 groups. RESULTS Angiography revealed abnormal shoulder staining in all of the rats with a frozen shoulder. On histopathology, the numbers of microvessels and mononuclear inflammatory cells in the synovial membrane of the joint capsule were significantly higher compared with the control rats (both P = .03). In the transcatheter arterial embolization group, the running distance and speed were improved (P = .03 and P = .01, respectively), whereas there were no significant differences in the control group. The number of microvessels and mononuclear inflammatory cells in the transcatheter arterial embolization group were significantly lower than the control group (P = .002 and P = .001, respectively). CONCLUSIONS The rat frozen shoulder model revealed the development of neovascularization. Transcatheter arterial embolization decreased the number of blood vessels and inflammatory changes in the frozen shoulder and increased the moving distance and speed of the rats.
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Affiliation(s)
- Hidehiko Taguchi
- Department of Radiology, IVR center, Nara Medical University, Kashihara, Japan
| | - Toshihiro Tanaka
- Department of Radiology, IVR center, Nara Medical University, Kashihara, Japan.
| | - Hideyuki Nishiofuku
- Department of Radiology, IVR center, Nara Medical University, Kashihara, Japan
| | - Yasushi Fukuoka
- Department of Radiology, IVR center, Nara Medical University, Kashihara, Japan
| | | | - Ryosuke Taiji
- Department of Radiology, IVR center, Nara Medical University, Kashihara, Japan
| | - Katsutoshi Takayama
- Department of Interventional Neuroradiology and Radiology, Koseikai Takai Hospital, Tenri, Japan
| | - Maiko Takeda
- Diagnostic Pathology, Nara Medical University, Kashihara, Japan
| | - Kinta Hatakeyama
- Diagnostic Pathology, Nara Medical University, Kashihara, Japan; Department of Pathology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takashi Inoue
- Clinical Research Center, Nara Medical University, Kashihara, Japan
| | - Chiho Ohbayashi
- Diagnostic Pathology, Nara Medical University, Kashihara, Japan
| | - Kimihiko Kichikawa
- Department of Radiology, IVR center, Nara Medical University, Kashihara, Japan
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3
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Howard E. Case of neurotoxic snakebite in a soldier. BMJ Mil Health 2020; 166:283. [PMID: 32723782 DOI: 10.1136/jramc-2019-001331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 11/03/2022]
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Patalak JP, Harper MG, Stitzel JD. Implications of head and neck restraint test repeatability for specification improvement. Traffic Inj Prev 2019; 20:588-594. [PMID: 31329480 DOI: 10.1080/15389588.2019.1633467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 06/13/2019] [Accepted: 06/13/2019] [Indexed: 06/10/2023]
Abstract
Objective: Since 2005, National Association for Stock Car Auto Racing, Incorporated (NASCAR) drivers have been required to use a head and neck restraint system (HNR) that complies with SFI Foundation, Inc. (SFI) 38.1. The primary purpose of the HNR is to control and limit injurious neck loads and head kinematics during frontal and frontal oblique impacts. The SFI 38.1 performance specification was implemented to establish a uniform test procedure and minimum standard for the evaluation of HNRs using dynamic sled testing. The purpose of this study was to evaluate the repeatability of the current SFI 38.1 test setup and explore the effects of a polyester seat belt restraint system. Method: Eight sled tests were conducted using the SFI 38.1 sled test protocol with additional test setup constraints. Four 0° frontal tests and 4 30° right frontal (RF) oblique tests were conducted. The first 3 tests of each principal direction of force (PDOF) used nylon SFI 16.1 seat belt restraint assemblies. The fourth test of each PDOF used polyester SFI 16.6 seat belt restraint assemblies. A secondary data set (Lab B Data) was also supplied by the HNR manufacturer for further comparisons. The International Organization for Standardization (ISO) 18571 objective comparison method was used to quantify the repeatability of the anthropomorphic test device (ATD) resultant head, chest, and pelvis acceleration and upper neck axial force and flexion extension bending moment time histories across multiple tests. Results: Two data sets generated using the SFI 38.1 test protocol exhibited large variations in mean ISO scores of ATD channels. The 8 tests conducted with additional setup constraints had significantly lower mean ISO score coefficients of variation (CVs). The Lab B tests conducted within the current specification but without the additional test setup constraints had larger mean ISO score standard deviation and CV for all comparisons. Specifically, tests with the additional setup constraints had average CVs of 3.3 and 2.9% for the 0° and 30° RF orientations, respectively. Lab B tests had average CVs of 22.9 and 24.5%, respectively. Polyester seat belt comparisons had CVs of 5.3 and 6.2% for the 0° and 30° RF orientations, respectively. Conclusion: With the addition of common test setup constraints, which do not violate the specification, the SFI 38.1 test protocol produced a repeatable test process for determining performance capabilities of HNRs within a single sled lab. A limited study using polyester webbing seat belt assemblies versus the nylon material called for in SFI 38.1 indicates that the material likely has less effects on ATD upper neck axial force and flexion extension bending moment time histories than the test setup freedom currently available within the specification. The additional test setup constraints are discussed and were shown to improve ATD response repeatability for a given HNR.
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Affiliation(s)
- John P Patalak
- a Wake Forest University School of Medicine , Winston-Salem , North Carolina
- b Virginia Tech, Wake Forest University School of Biomedical Engineering and Sciences , Winston-Salem , North Carolina
- c National Association for Stock Car Auto Racing, Incorporated , Daytona Beach , Florida
| | - Matthew G Harper
- c National Association for Stock Car Auto Racing, Incorporated , Daytona Beach , Florida
| | - Joel D Stitzel
- a Wake Forest University School of Medicine , Winston-Salem , North Carolina
- b Virginia Tech, Wake Forest University School of Biomedical Engineering and Sciences , Winston-Salem , North Carolina
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Koppel S, Jiménez Octavio J, Bohman K, Logan D, Raphael W, Quintana Jimenez L, Lopez-Valdes F. Seating configuration and position preferences in fully automated vehicles. Traffic Inj Prev 2019; 20:S103-S109. [PMID: 31246512 DOI: 10.1080/15389588.2019.1625336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/27/2019] [Accepted: 05/27/2019] [Indexed: 06/09/2023]
Abstract
Objective: This study aimed to understand seating configuration and position preferences in a fully automated vehicle (FAV) across 7 hypothetical traveling scenarios.Methods: Participants completed an online survey in which they were asked to imagine traveling in an FAV across 7 hypothetical traveling scenarios and asked to select 1 of 5 seating configurations and 1 of 4 seating positions for themselves and for any additional occupants. Furthermore, participants were asked to indicate any activities that they and any additional occupants would engage in and whether they would be willing to wear a different seat belt in an FAV while seated in a non-forward-facing mode or while reclined.Results: Five hundred and fifty-two participants (male = 50.5%; mean = 36.6 years, SD = 14.0 years) completed the online survey. Most participants resided in Australia (40.9%), Spain (16.5%), Sweden (15.6%), or Lebanon (19.4%). Most participants drove on a daily basis (60.0%), had driven between 5,000 and 15,000 km in the previous year (33.2%), and reported that they always or almost always wear a seat belt while traveling in a motor vehicle (98.2%). Across all scenarios, participants were most likely to prefer a conventional seating configuration (i.e., all seats facing forward; between 40.0 and 76.3%). In terms of seating position preferences, participants preferred seating position A (i.e., the conventional driver's seat; between 54.6 and 68.3%), regardless of with whom they were traveling. The most common activity while traveling alone was reading (25.0%). However, when traveling with other occupants, talking was the most common activity (41.0-63.0%), even with someone they did not know (31.0%). Most participants predicted that they would always or almost always wear a seat belt when traveling in an FAV (95.9%). Most participants also reported that they would be very willing or willing to wear a different seat belt configuration in an FAV while seated in a non-forward-facing mode or while reclined (73.8 and 80.7%, respectively).Conclusions: This study has provided valuable insight regarding seating configuration and position preferences in an FAV, as well as predicted activities and restraint use. Future research will use this information to simulate likely injury outcomes of these preferences in the event of a motor vehicle crash and provide a basis for the design of occupant protection systems for FAVs.
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Affiliation(s)
- Sjaan Koppel
- Monash University Accident Research Centre, Monash University, Victoria, Australia
| | - Jesús Jiménez Octavio
- Instituto de Investigación Tecnológica (IIT), Pontifical University Comillas, Madrid, Spain
| | | | - David Logan
- Monash University Accident Research Centre, Monash University, Victoria, Australia
| | - Wassim Raphael
- Department of Doctoral Studies, Saint-Joseph University of Beirut, Beirut, Lebanon
| | | | - Francisco Lopez-Valdes
- Instituto de Investigación Tecnológica (IIT), Pontifical University Comillas, Madrid, Spain
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Rasal Carnicer M, Juguera Rodríguez L, Vela de Oro N, García Pérez AB, Pérez Alonso N, Pardo Ríos M. Differences in lung function after the use of 2 extrication systems: a randomized crossover trial. Emergencias 2019; 30:115-118. [PMID: 29547234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The main purpose of this study in healthy volunteers was to compare the lung function effects of 2 extrication devices that use spinal vests: the Kendrick Extrication Device (KED) and the Ferno KED-XT board. MATERIAL AND METHODS Randomized crossover trial in 50 healthy adult volunteers. The subjects were placed in the KED and KED-XT devices for 5 minutes each and rested for 10 minutes between devices. Assignment to the first device was randomized. Each subject underwent spirometry at baseline and after placement of each device. The subjects were seated for all tests. The main outcome measures were the mean absolute differences between baseline and other measurements of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and the FVC/FEV1 ratio. RESULTS Use of the devices led to statistically significant mean decreases from baseline FVC (KED-XT, -0.48 L; 95% CI, -0.16 to -0.81 L [P=.016] and KED, -0.79 L; 95% CI, -0.44 to -1.13 L [P<.001]) and from baseline FEV1 (KED-XT, -0.35 L/s; 95% CI, -0.14 to -0.56 L/s [P=.002] and KED, -0.52 L/s; 95% CI, -0.31 to -0.72 L/s [P<.001]). The decrease in FVC was greater after use of the KED device (mean difference, KED vs KED-XT, -0.30 L; 95% CI, -0.08 to -0.69 L [P<.016]). CONCLUSION The use of spinal vests leads to decreases in lung function variables. The KED vest causes a greater decrease in FVC than the new KED-XT board, possibly because the crossed straps on the board compress the abdomen less.
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Affiliation(s)
- Marta Rasal Carnicer
- Programa de Doctorado en Ciencias de la Salud. Universidad Católica de Murcia (UCAM), Murcia, España
| | | | - Nuria Vela de Oro
- Facultad de Enfermería de la Universidad Católica de Murcia (UCAM), Murcia, España
| | - Ana Belén García Pérez
- Programa de Doctorado en Ciencias de la Salud. Universidad Católica de Murcia (UCAM), Murcia, España
| | - Nuria Pérez Alonso
- Facultad de Enfermería de la Universidad Católica de Murcia (UCAM), Murcia, España
| | - Manuel Pardo Ríos
- Gerencia de Urgencias y Emergencias 061 de la Región de Murcia. Universidad Católica de Murcia (UCAM). Murcia, España
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7
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Hontoria Hernández MI, Gordillo Martín R, Serrano Martínez FJ, Alonso Ibáñez L, Carazo Díaz C, Prieto Merino D, Sánchez-Arévalo Morato S, Dixon M, Pardo Ríos M, Juguera Rodríguez L. Self-extraction with and without a cervical collar: a biomechanical simulation study. Emergencias 2019; 31:36-38. [PMID: 30656871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To compare self-extraction with and without a cervical collar in subjects at low risk of cervical spine injuries. MATERIAL AND METHODS Simulation study analyzing biomechanical data from inertial sensors to detect misalignment of the cervical spine during self-extraction with and without a cervical collar. RESULTS Misalignment was a mean (SD) 3.12 (34.62) degrees greater during self-extraction with a Stiffneck collar in place (95% CI, -15.33 to 21.57 degrees; P=.7234) than during extraction without a collar. Misalignment was also greater, by 5.95 (31.76) degrees, with an X-collar in place (95% CI, -10.98 to 22.87; P=.4654) than without a collar. The between-collar comparison of differences showed that misalignment was 2.83 (12.10) degrees greater with the X-collar (95% CI, -3.62 to 9.27 degrees; P=.3650). CONCLUSION Misalignment of the cervical spinal column is similar during self-extraction with or without a cervical collar in place.
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Affiliation(s)
| | | | | | | | - Carmen Carazo Díaz
- Applied Statistical Methods in Medical Research Group, UCAM, Murcia, España
| | - David Prieto Merino
- Applied Statistical Methods in Medical Research Group, UCAM, Murcia, España. Faculty of Epidemiology and Population Health, London School of Hygiene Tropical Medicine, Londres, Reino Unido
| | - Silvia Sánchez-Arévalo Morato
- Servicio de Especialidades Quirúrgicas, Hospital Severo Ochoa, Leganés, Madrid. Autora del Blog Creative Nurse, España
| | - Mark Dixon
- Senior Lecturer, Course Director Paramedic Studies. Graduate Entry Medical School, University of Limerick, Irlanda
| | - Manuel Pardo Ríos
- Gerencia de Urgencias y Emergencias 061 de la Región de Murcia, España. Análisis Tridimensional de Reconocimiento Corporal, España
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8
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Power JD, Silver BM, Silverman MR, Ajodan EL, Bos DJ, Jones RM. Customized head molds reduce motion during resting state fMRI scans. Neuroimage 2019; 189:141-149. [PMID: 30639840 DOI: 10.1016/j.neuroimage.2019.01.016] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/13/2018] [Accepted: 01/07/2019] [Indexed: 01/13/2023] Open
Abstract
Head motion causes artifacts in functional magnetic resonance imaging (fMRI) scans, a problem especially relevant for task-free resting state paradigms and for developmental, aging, and clinical populations. In a cohort spanning 7-28 years old (mean age 15) we produced customized head-anatomy-specific Styrofoam molds for each subject that inserted into an MRI head coil. We scanned these subjects under two conditions: using our standard procedure of packing the head coil with foam padding about the head to reduce head motion, and using the customized molds to reduce head motion. In 12 of 13 subjects, the molds reduced head motion throughout the scan and reduced the fraction of a scan with substantial motion (i.e., volumes with motion notably above baseline levels of motion). Motion was reduced in all 6 head position estimates, especially in rotational, left-right, and superior-inferior directions. Motion was reduced throughout the full age range studied, including children, adolescents, and young adults. In terms of the fMRI data itself, quality indices improved with the head mold on, scrubbing analyses detected less distance-dependent artifact in scans with the head mold on, and distant-dependent artifact was less evident in both the entire scan and also during only low-motion volumes. Subjects found the molds comfortable. Head molds are thus effective tools for reducing head motion, and motion artifacts, during fMRI scans.
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Affiliation(s)
- Jonathan D Power
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, 1300 York Avenue, Box 140, New York, NY, 10065, USA.
| | - Benjamin M Silver
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, 1300 York Avenue, Box 140, New York, NY, 10065, USA.
| | - Melanie R Silverman
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, 1300 York Avenue, Box 140, New York, NY, 10065, USA.
| | - Eliana L Ajodan
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, 1300 York Avenue, Box 140, New York, NY, 10065, USA.
| | - Dienke J Bos
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, 1300 York Avenue, Box 140, New York, NY, 10065, USA.
| | - Rebecca M Jones
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, 1300 York Avenue, Box 140, New York, NY, 10065, USA.
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Abstract
BACKGROUND The halo vest is widely used throughout the world to manage craniovertebral and cervical instabilities. It can be used for postoperative immobilization or as an alternative to surgical fixation. METHOD In this paper we present some cases of severe complications from our own practice and review the literature on halo complications. RESULTS Like any therapeutic manoeuvre, halo placement may be followed by various complications. In the meantime, modern techniques of fixation offer safe and immediate stabilization. CONCLUSION The halo vest remains a formidable method for cervical immobilization. However, it should not be used a priori instead of surgery.
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Affiliation(s)
- Giuseppe Talamonti
- Department of Neurosurgery, AO Niguarda Ca'Granda Hospital, Milan, Italy.
- Institute of Neurosurgery, Catholic University, Rome, Italy.
| | - Alberto Debernardi
- Department of Neurosurgery, AO Niguarda Ca'Granda Hospital, Milan, Italy
- Institute of Neurosurgery, Catholic University, Rome, Italy
| | - Massimiliano Visocchi
- Department of Neurosurgery, AO Niguarda Ca'Granda Hospital, Milan, Italy
- Institute of Neurosurgery, Catholic University, Rome, Italy
| | - Fabio Villa
- Department of Neurosurgery, AO Niguarda Ca'Granda Hospital, Milan, Italy
- Institute of Neurosurgery, Catholic University, Rome, Italy
| | - Giuseppe D'Aliberti
- Department of Neurosurgery, AO Niguarda Ca'Granda Hospital, Milan, Italy
- Institute of Neurosurgery, Catholic University, Rome, Italy
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10
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Williams B, Speed A, Haider B. A novel device for real-time measurement and manipulation of licking behavior in head-fixed mice. J Neurophysiol 2018; 120:2975-2987. [PMID: 30256741 PMCID: PMC6442917 DOI: 10.1152/jn.00500.2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/13/2018] [Accepted: 09/24/2018] [Indexed: 01/12/2023] Open
Abstract
The mouse has become an influential model system for investigating the mammalian nervous system. Technologies in mice enable recording and manipulation of neural circuits during tasks where they respond to sensory stimuli by licking for liquid rewards. Precise monitoring of licking during these tasks provides an accessible metric of sensory-motor processing, particularly when combined with simultaneous neural recordings. There are several challenges in designing and implementing lick detectors during head-fixed neurophysiological experiments in mice. First, mice are small, and licking behaviors are easily perturbed or biased by large sensors. Second, neural recordings during licking are highly sensitive to electrical contact artifacts. Third, submillisecond lick detection latencies are required to generate control signals that manipulate neural activity at appropriate time scales. Here we designed, characterized, and implemented a contactless dual-port device that precisely measures directional licking in head-fixed mice performing visual behavior. We first determined the optimal characteristics of our detector through design iteration and then quantified device performance under ideal conditions. We then tested performance during head-fixed mouse behavior with simultaneous neural recordings in vivo. We finally demonstrate our device's ability to detect directional licks and generate appropriate control signals in real time to rapidly suppress licking behavior via closed-loop inhibition of neural activity. Our dual-port detector is cost effective and easily replicable, and it should enable a wide variety of applications probing the neural circuit basis of sensory perception, motor action, and learning in normal and transgenic mouse models. NEW & NOTEWORTHY Mice readily learn tasks in which they respond to sensory cues by licking for liquid rewards; tasks that involve multiple licking responses allow study of neural circuits underlying decision making and sensory-motor integration. Here we design, characterize, and implement a novel dual-port lick detector that precisely measures directional licking in head-fixed mice performing visual behavior, enabling simultaneous neural recording and closed-loop manipulation of licking.
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Affiliation(s)
- Brice Williams
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University , Atlanta, Georgia
| | - Anderson Speed
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University , Atlanta, Georgia
| | - Bilal Haider
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University , Atlanta, Georgia
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Goltstein PM, Reinert S, Glas A, Bonhoeffer T, Hübener M. Food and water restriction lead to differential learning behaviors in a head-fixed two-choice visual discrimination task for mice. PLoS One 2018; 13:e0204066. [PMID: 30212542 PMCID: PMC6136814 DOI: 10.1371/journal.pone.0204066] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 08/31/2018] [Indexed: 12/11/2022] Open
Abstract
Head-fixed behavioral tasks can provide important insights into cognitive processes in rodents. Despite the widespread use of this experimental approach, there is only limited knowledge of how differences in task parameters, such as motivational incentives, affect overall task performance. Here, we provide a detailed methodological description of the setup and procedures for training mice efficiently on a two-choice lick left/lick right visual discrimination task. We characterize the effects of two distinct restriction regimens, i.e. food and water restriction, on animal wellbeing, activity patterns, task acquisition, and performance. While we observed reduced behavioral activity during the period of food and water restriction, the average animal discomfort scores remained in the 'sub-threshold' and 'mild' categories throughout the experiment, irrespective of the restriction regimen. We found that the type of restriction significantly influenced specific aspects of task acquisition and engagement, i.e. the number of sessions until the learning criterion was reached and the number of trials performed per session, but it did not affect maximum learning curve performance. These results indicate that the choice of restriction paradigm does not strongly affect animal wellbeing, but it can have a significant effect on how mice perform in a task.
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Affiliation(s)
- Pieter M. Goltstein
- Max Planck Institute of Neurobiology, Martinsried, Germany
- * E-mail: (PG); (MH)
| | - Sandra Reinert
- Max Planck Institute of Neurobiology, Martinsried, Germany
- Graduate School of Systemic Neurosciences, Martinsried, Germany
| | - Annet Glas
- Max Planck Institute of Neurobiology, Martinsried, Germany
- Graduate School of Systemic Neurosciences, Martinsried, Germany
| | | | - Mark Hübener
- Max Planck Institute of Neurobiology, Martinsried, Germany
- * E-mail: (PG); (MH)
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12
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Misasi A, Ward JG, Dong F, Ablah E, Maurer C, Haan JM. Prehospital Extrication Techniques: Neurological Outcomes Associated with the Rapid Extrication Method and the Kendrick Extrication Device. Am Surg 2018; 84:248-253. [PMID: 29580354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Most emergency medical service personnel rely on one of two techniques to extricate motor vehicle crash victims; the Rapid Extrication Maneuver (REM) or the Kendrick Extrication Device (KED). The purpose of this study was to compare pre- and postextrication neurological outcomes between these two techniques. A retrospective review was conducted of all adult patients with a vertebral column injury resulting from motor vehicle collision and admitted to a Level I trauma center between January 1, 2003 and December 31, 2010. Standardized pre- and postextrication neurological examinations were reviewed for all patients. More than half of patients (N = 81) were extricated using the KED (53.1%, n = 43) and 46.9 per cent (n = 38) were extricated with the REM. Except for the thoracic Abbreviated Injury Score, no differences between groups emerged related to the Glasgow Coma Scale score, Injury Severity Score or Abbreviated Injury Score. There were no pre- and postextrication changes for motor to all extremities and sensation to all extremities using either method. The results of this study suggest that the REM and the KED are equivalent in protecting the patient from neurologic injury after motor vehicle collision.
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Chen PC, Shoa KH, Jao JC, Hsiao CC. Dynamic magnetic resonance imaging of carbogen challenge on awake rabbit brain at 1.5T. J Xray Sci Technol 2018; 26:997-1009. [PMID: 30223421 DOI: 10.3233/xst-180395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Anesthesia may alter the cellular components contributing to the magnetic resonance imaging (MRI) signal intensities. Developing awake animal models to evaluate cerebral function has grown in importance. OBJECTIVE To investigate a noninvasive strategy for dynamic MRI (dMRI) of awake rabbits during carbogen challenge. METHODS A nonmetallic assistive device with a self-adhering wrap secure procedure was developed for the head fixation of awake rabbits. Multi-shot gradient echo echo-planar imaging sequence was applied for the dMRI on a 1.5 T clinical MRI scanner with a quadrature head coil. The carbogen challenge pattern was applied in a sequence of air - carbogen - air - carbogen - air. Twelve scans were performed for each block of carbogen challenge. T2-weighted fast-spin echo and T1-weighted gradient echo sequences were performed before and after dMRI to evaluate the head position shifts. The whole dMRI scan time was about 30 minutes. RESULTS The position shift of 8 rabbits in the x-and y-direction was less than 3%. The average MRI signal intensities (SI) from the 8 rabbits during carbogen challenge was fitted well using exponential growth and decay functions. The average MRI SI increase due to carbogen inhaling was 1.51%. CONCLUSIONS The proposed strategy for head dMRI on an awake rabbit during carbogen challenge is feasible.
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Affiliation(s)
- Po-Chou Chen
- Department of Biomedical Engineering, I-Shou University, Kaohsiung City, Taiwan, ROC
| | - Kuan-Hsiung Shoa
- Department of Radiology, Jhong Jheng Orthopedic Hospital, Kaohsiung City, Taiwan, ROC
| | - Jo-Chi Jao
- Department of Medical Imaging and Radiological Sciences, College of Health Sciences, Kaohsiung Medical University, Kaohsiung City, Taiwan, ROC
| | - Chia-Chi Hsiao
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan, ROC
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Durkes A, Sivasankar MP. A Method to Administer Agents to the Larynx in an Awake Large Animal. J Speech Lang Hear Res 2017; 60:3171-3176. [PMID: 29098280 PMCID: PMC5945077 DOI: 10.1044/2017_jslhr-s-17-0040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/12/2017] [Accepted: 04/17/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE This research note describes an adapted experimental methodology to administer an exogenous agent to the larynx and upper airway of awake animals. The exogenous agent could be a perturbation. In the current study, the agent was isotonic saline. Isotonic saline was selected because it is safe, of similar composition to extracellular fluid, and used in voice studies. The described approach allowed large animals such as pigs to be comfortably restrained without chemical sedation or anesthesia for extended periods while receiving the agent. METHOD Six Sinclair pigs were successfully trained with positive reinforcement to voluntarily enter and then be restrained in a Panepinto Sling. Once restrained, the pigs accepted a nose cone that delivered nebulized isotonic saline. This procedure was repeated 3 times per day for 20 days. At the end of the study, the larynx and airway tissues were excised and examined using histology and transmission electron microscopy. RESULTS Pathology related to the procedure (i.e., nebulized inhaled isotonic saline or stress) was not identified in any examined tissues. CONCLUSIONS This methodology allowed for repeated application of exogenous agents to awake, unstressed animals. This method can be used repeatedly in the laboratory to test various therapeutics for safety, toxicity, and dosage. Future studies will specifically manipulate the type of agent to further our understanding of laryngeal pathobiology.
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Affiliation(s)
- Abigail Durkes
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN
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Cheng P, Hollingsworth B, Scarberry D, Shen DH, Powell K, Smart SC, Beech J, Sheng X, Kirschner LS, Menq CH, Jhiang SM. Automated MicroSPECT/MicroCT Image Analysis of the Mouse Thyroid Gland. Thyroid 2017; 27:1433-1440. [PMID: 28920557 PMCID: PMC5672640 DOI: 10.1089/thy.2017.0264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The ability of thyroid follicular cells to take up iodine enables the use of radioactive iodine (RAI) for imaging and targeted killing of RAI-avid thyroid cancer following thyroidectomy. To facilitate identifying novel strategies to improve 131I therapeutic efficacy for patients with RAI refractory disease, it is desired to optimize image acquisition and analysis for preclinical mouse models of thyroid cancer. METHODS A customized mouse cradle was designed and used for microSPECT/CT image acquisition at 1 hour (t1) and 24 hours (t24) post injection of 123I, which mainly reflect RAI influx/efflux equilibrium and RAI retention in the thyroid, respectively. FVB/N mice with normal thyroid glands and TgBRAFV600E mice with thyroid tumors were imaged. In-house CTViewer software was developed to streamline image analysis with new capabilities, along with display of 3D voxel-based 123I gamma photon intensity in MATLAB. RESULTS The customized mouse cradle facilitates consistent tissue configuration among image acquisitions such that rigid body registration can be applied to align serial images of the same mouse via the in-house CTViewer software. CTViewer is designed specifically to streamline SPECT/CT image analysis with functions tailored to quantify thyroid radioiodine uptake. Automatic segmentation of thyroid volumes of interest (VOI) from adjacent salivary glands in t1 images is enabled by superimposing the thyroid VOI from the t24 image onto the corresponding aligned t1 image. The extent of heterogeneity in 123I accumulation within thyroid VOIs can be visualized by 3D display of voxel-based 123I gamma photon intensity. CONCLUSIONS MicroSPECT/CT image acquisition and analysis for thyroidal RAI uptake is greatly improved by the cradle and the CTViewer software, respectively. Furthermore, the approach of superimposing thyroid VOIs from t24 images to select thyroid VOIs on corresponding aligned t1 images can be applied to studies in which the target tissue has differential radiotracer retention from surrounding tissues.
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Affiliation(s)
- Peng Cheng
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio
| | - Brynn Hollingsworth
- Department of Physiology and Cell Biology, The Ohio State University, Columbus, Ohio
| | - Daniel Scarberry
- Department of Physiology and Cell Biology, The Ohio State University, Columbus, Ohio
| | - Daniel H. Shen
- PET Center and Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kimerly Powell
- Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio
| | - Sean C. Smart
- Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - John Beech
- Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Xiaochao Sheng
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio
| | | | - Chia-Hsiang Menq
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio
| | - Sissy M. Jhiang
- Department of Physiology and Cell Biology, The Ohio State University, Columbus, Ohio
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Colpitts ME, Phillion RC, Malinowski M, Coleman RA, Mitchell LA, Malone AB, Eberhart LL, Sanders RA, Langholz DE. Feasibility of transthoracic echocardiographic imaging in non-sedated ovine subjects using a commercial restraint device. Lab Anim 2017; 52:196-199. [PMID: 29058999 DOI: 10.1177/0023677217736553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Transthoracic echocardiography (TTE) is a valuable non-invasive imaging research technique. In ovine models of cardiac disease, restraint for TTE often involves sedation even with currently available restraint equipment; our goal was to determine the feasibility of using a commercial restraint device, commonly known as the sheep chair, in minimizing animal stress and the need for sedation while achieving a complete TTE examination. A total of 10 healthy adult Dorset sheep were restrained in a sheep chair for TTE and observed for signs of stress. No animals displayed overt evidence of stress and none required sedation. While individual anatomic variation existed, image quality was sufficient to determine cardiac function. These observations suggest that a sheep chair is a useful aid in minimizing the need for sedation to acquire a full TTE study in ovine subjects.
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Affiliation(s)
- Michelle E Colpitts
- 1 Division of Cardiovascular Medicine, Spectrum Health, Grand Rapids, MI, USA
| | - Rachel C Phillion
- 1 Division of Cardiovascular Medicine, Spectrum Health, Grand Rapids, MI, USA
| | - Marcin Malinowski
- 2 Division of Cardiothoracic Surgery, Spectrum Health, Grand Rapids, MI, USA
- 3 Medical University of Silesia, School of Medicine in Katowice, Department of Cardiac Surgery, Katowice, Poland
| | - Rhonda A Coleman
- 1 Division of Cardiovascular Medicine, Spectrum Health, Grand Rapids, MI, USA
| | - Lou A Mitchell
- 1 Division of Cardiovascular Medicine, Spectrum Health, Grand Rapids, MI, USA
| | - Angela B Malone
- 1 Division of Cardiovascular Medicine, Spectrum Health, Grand Rapids, MI, USA
| | - Lenora L Eberhart
- 1 Division of Cardiovascular Medicine, Spectrum Health, Grand Rapids, MI, USA
| | - Robert A Sanders
- 4 70726 Michigan State University, College of Veterinary Medicine , Small Animal Clinical Sciences, East Lansing, MI, USA
| | - David E Langholz
- 1 Division of Cardiovascular Medicine, Spectrum Health, Grand Rapids, MI, USA
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McMillan JL, Bloomsmith MA, Prescott MJ. An International Survey of Approaches to Chair Restraint of Nonhuman Primates. Comp Med 2017; 67:442-451. [PMID: 28935007 PMCID: PMC5621573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 01/25/2017] [Accepted: 02/23/2017] [Indexed: 06/07/2023]
Abstract
Specifically designed restraint chairs are the preferred method of restraint for research studies that require NHP to sit in place for sustained periods of time. In light of increasing emphasis on refinement of restraint to improve animal wellbeing, it is important to have a better understanding of this potentially stressful procedure. Although chair restraint is used internationally, very little published information is available on this subject. We developed a survey to obtain an overview of equipment, procedures, and plans for improvement regarding chair restraint. We received 101 responses from people working in academic, government, contract research, and pharmaceutical laboratories within the Americas, Europe and Asia. Findings indicate that the majority of laboratories using restraint chairs work with macaque species. Restraint chairs are used for a wide range of procedures, including cognitive testing, recording neuronal activity, functional MRI, intravenous infusion, and blood sampling. Approximately 2/3 of laboratories use an enclosed 'box chair,' which the animal is trained to enter and then to extend its head through an opening on the top of the chair; the remaining one third of laboratories use an 'open chair' design, in which manual handling or the pole-and-collar system is used to transfer and secure the animal into the chair. Respondents reported that when selecting the type of chair to use, they considered comfort for the animal, ease of use, and the ability to adjust fit between animals of different sizes. Various training methods and timeframes are used to prepare macaques for restraint chair procedures. Several laboratories are incorporating greater use of positive reinforcement training. The community that uses these restraint procedures needs to work together to define best practice; our survey results can help in that effort.
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Affiliation(s)
- Jennifer L McMillan
- Division of Animal Resources, Yerkes National Primate Research Center, Atlanta, Georgia
| | - Mollie A Bloomsmith
- Division of Animal Resources, Yerkes National Primate Research Center, Atlanta, Georgia
| | - Mark J Prescott
- National Centre for Replacement, Refinement, and Reduction of Animals in Research (NC3Rs), London;,
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18
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Protective Stabilization for Pediatric Dental Patients. Pediatr Dent 2017; 39:260-5. [PMID: 29179366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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19
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Guideline on Protective Stabilization for Pediatric Dental Patients. Pediatr Dent 2016; 38:199-203. [PMID: 27931460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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20
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Schultz-Darken NJ, Pape RM, Tannenbaum PL, Saltzman W, Abbott DH. Novel restraint system for neuroendocrine studies of socially living common marmoset monkeys. Lab Anim 2016; 38:393-405. [PMID: 15479554 DOI: 10.1258/0023677041958918] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We describe a novel soft jacket and sling-harness restraint that permits species-typical postures for small-bodied primates, such as the common marmoset ( Callithrix jacchus), during long-term (>6 h), continuous restraint. The restraint system is straightforward to use and manipulate, it is easily repaired, and the materials used are readily available. The soft jacket allows for increased versatility and longevity, and the sling-harness provides for greater movement and much longer duration of continuous restraint (up to 3 days) compared to a previously described, more conventional chair restraint for small-bodied primates. The new restraint system prevents the normal diurnal decrease in plasma cortisol levels across the daylight hours; however, it does not disrupt ovulatory cycles. Unlike the previously available techniques, therefore, this new restraint system is applicable to many neurobiological and neuroendocrine studies involving small-bodied, non-human primates and is especially suited to investigations requiring the maintenance of relationships within social groups.
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Affiliation(s)
- N J Schultz-Darken
- National Primate Research Center, University of Wisconsin, Madison, Wisconsin 53715, USA.
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22
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Baker SE, Sharp TM, Macdonald DW. Assessing Animal Welfare Impacts in the Management of European Rabbits (Oryctolagus cuniculus), European Moles (Talpa europaea) and Carrion Crows (Corvus corone). PLoS One 2016; 11:e0146298. [PMID: 26726808 PMCID: PMC4699632 DOI: 10.1371/journal.pone.0146298] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 12/15/2015] [Indexed: 11/18/2022] Open
Abstract
Human-wildlife conflict is a global issue. Attempts to manage this conflict impact upon wild animal welfare, an issue receiving little attention until relatively recently. Where human activities harm animal welfare these effects should be minimised where possible. However, little is known about the welfare impacts of different wildlife management interventions, and opinions on impacts vary widely. Welfare impacts therefore need to be assessed objectively. Our objectives were to: 1) establish whether an existing welfare assessment model could differentiate and rank the impacts of different wildlife management interventions (for decision-making purposes); 2) identify and evaluate any additional benefits of making formal welfare assessments; and 3) illustrate issues raised by application of the model. We applied the welfare assessment model to interventions commonly used with rabbits (Oryctolagus cuniculus), moles (Talpa europaea) and crows (Corvus corone) in the UK. The model ranked interventions for rabbits (least impact first: fencing, head shot, chest shot) and crows (shooting, scaring, live trapping with cervical dislocation). For moles, managing molehills and tunnels scored least impact. Both spring trapping, and live trapping followed by translocation, scored greater impacts, but these could not be compared directly as they scored on different axes of the model. Some rankings appeared counter-intuitive, highlighting the need for objective formal welfare assessments. As well as ranking the humaneness of interventions, the model highlighted future research needs and how Standard Operating Procedures might be improved. The model is a milestone in assessing wildlife management welfare impacts, but our research revealed some limitations of the model and we discuss likely challenges in resolving these. In future, the model might be developed to improve its utility, e.g. by refining the time-scales. It might also be used to reach consensus among stakeholders about relative welfare impacts or to identify ways of improving wildlife management practice in the field.
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Affiliation(s)
- Sandra E. Baker
- Wildlife Conservation Research Unit, Department of Zoology, University of Oxford, Oxford, Oxfordshire, United Kingdom
- * E-mail:
| | - Trudy M. Sharp
- Fowlers Gap Arid Zone Research Station, Centre of Ecosystem Science, School of Biological, Earth and Environmental Sciences, University of New South Wales, Kensington, NSW 2052, Australia
| | - David W. Macdonald
- Wildlife Conservation Research Unit, Department of Zoology, University of Oxford, Oxford, Oxfordshire, United Kingdom
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Gagnon KB, Caine S, Samadi N, Martinson M, van der Loop M, Alcorn J, Chapman LD, Belev G, Nichol H. Design of a mouse restraint for synchrotron-based computed tomography imaging. J Synchrotron Radiat 2015; 22:1297-1300. [PMID: 26289283 DOI: 10.1107/s160057751501036x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 05/29/2015] [Indexed: 06/04/2023]
Abstract
High-resolution computed tomography (CT) imaging of a live animal within a lead-lined synchrotron light hutch presents several unique challenges. In order to confirm that the animal is under a stable plane of anaesthesia, several physiological parameters (e.g. heart rate, arterial oxygen saturation, core body temperature and respiratory rate) must be remotely monitored from outside the imaging hutch. In addition, to properly scan the thoracic region using CT, the animal needs to be held in a vertical position perpendicular to the fixed angle of the X-ray beam and free to rotate 180°-360°. A new X-ray transparent mouse restraint designed and fabricated using computer-aided design software and three-dimensional rapid prototype printing has been successfully tested at the Biomedical Imaging and Therapy bending-magnet (BMIT-BM) beamline at the Canadian Light Source.
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Affiliation(s)
- Kenneth B Gagnon
- Anatomy and Cell Biology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Sally Caine
- Anatomy and Cell Biology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nazanin Samadi
- Biomedical Engineering, University of Saskatchewan, Saskatoon, SK, Canada
| | - Mercedes Martinson
- Physics and Engineering Physics, University of Saskatchewan, Saskatoon, SK, Canada
| | - Melanie van der Loop
- Research Services and Ethics Office, University of Saskatchewan, Saskatoon, SK, Canada
| | - Jane Alcorn
- Research Services and Ethics Office, University of Saskatchewan, Saskatoon, SK, Canada
| | - L Dean Chapman
- Anatomy and Cell Biology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - George Belev
- Biomedical Imaging and Therapy Beamlines, Canadian Light Source, Saskatoon, SK, Canada
| | - Helen Nichol
- Anatomy and Cell Biology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Huang G, Ma M, Zhang B. [The application of new type of medical glove restraint appliance in the prevention of non planned extubation in patients with severe strengthening treatment]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2015; 27:700-701. [PMID: 26255023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Guomin Huang
- Department of Critical Care Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan 528000, Guangdong, China. Corresponding author: Huang Guomin,
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Manabe N, Shimizu T, Tanouchi T, Fueki K, Ino M, Toda N, Itoh K, Shirakura K. A novel skull clamp positioning system and technique for posterior cervical surgery: clinical impact on cervical sagittal alignment. Medicine (Baltimore) 2015; 94:e695. [PMID: 25929898 PMCID: PMC4603043 DOI: 10.1097/md.0000000000000695] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
A prospective radiographic study.The purpose of this study was to analyze whether a novel skull clamp positioning system and technique is useful for obtaining good, quantitative cervical sagittal alignment during posterior cervical surgery.Different surgical procedures depend on cervical spine positioning. However, maneuver of the device and cervical position depends on the skill of the operator.This study included 21 male and 10 female patients with cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament of the cervical spine, undergoing posterior cervical surgery using the novel skull clamp positioning system. The average patient age was 68.6 years (range: 56-87 years). The novel system has a scale to adjust the neck position and to enable intended cervical sagittal alignment. First, the patient was placed on the operating table in the prone position with preplanned head-neck sagittal alignment (neutral position in general). The head was rotated sagittally, and the head was positioned in the military tuck position with the novel device that was used to widen the interlaminar space. After completing the decompression procedure, the head was rotated again back to the initial preplanned position. During this position change, the scale equipped with the device was useful in determining accurate positions. The C0-C1, C0-C2, C1-C2, C2-C7, and C0-C7 angles were measured on lateral radiographs taken pre-, intra-, and postoperatively.This novel system allowed us to obtain adequate, quantitative cervical sagittal alignment during posterior cervical surgery. There were no clinically significant differences observed between the pre- and postoperative angles for C1-C2 and C2-C7.Sagittal neck position was quantitatively changed during posterior cervical surgery using a novel skull clamp positioning system, enabling adequate final cervical sagittal alignment identical to the preplanned neck position.
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Affiliation(s)
- Nodoka Manabe
- From the Department of Orthopaedic Surgery (NM, TS, TT, KF, MI, NT, KI), Gunma Spine Center (Harunaso Hospital), Kamitoyooka, Takasaki; and Department of Rehabilitation Medicine (KS), Gunma University Graduate School of Medicine, Showa-machi, Maebashi, Gunma, Japan
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Moore JD, Deschênes M, Kleinfeld D. Juxtacellular Monitoring and Localization of Single Neurons within Sub-cortical Brain Structures of Alert, Head-restrained Rats. J Vis Exp 2015:51453. [PMID: 25938559 PMCID: PMC4541592 DOI: 10.3791/51453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
There are a variety of techniques to monitor extracellular activity of single neuronal units. However, monitoring this activity from deep brain structures in behaving animals remains a technical challenge, especially if the structures must be targeted stereotaxically. This protocol describes convenient surgical and electrophysiological techniques that maintain the animal's head in the stereotaxic plane and unambiguously isolate the spiking activity of single neurons. The protocol combines head restraint of alert rodents, juxtacellular monitoring with micropipette electrodes, and iontophoretic dye injection to identify the neuron location in post-hoc histology. While each of these techniques is in itself well-established, the protocol focuses on the specifics of their combined use in a single experiment. These neurophysiological and neuroanatomical techniques are combined with behavioral monitoring. In the present example, the combined techniques are used to determine how self-generated vibrissa movements are encoded in the activity of neurons within the somatosensory thalamus. More generally, it is straightforward to adapt this protocol to monitor neuronal activity in conjunction with a variety of behavioral tasks in rats, mice, and other animals. Critically, the combination of these methods allows the experimenter to directly relate anatomically-identified neurophysiological signals to behavior.
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Affiliation(s)
- Jeffrey D Moore
- Department of Physics 0374, University of California, San Diego;
| | - Martin Deschênes
- Department of Psychiatry and Neuroscience, Centre de Recherche de l'Université Laval Robert-Giffard
| | - David Kleinfeld
- Department of Physics 0374, University of California, San Diego
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Zharkova N, Gibbon FE, Hardcastle WJ. Quantifying lingual coarticulation using ultrasound imaging data collected with and without head stabilisation. Clin Linguist Phon 2015; 29:249-265. [PMID: 25651199 DOI: 10.3109/02699206.2015.1007528] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Previous studies reporting the use of ultrasound tongue imaging with clinical populations have generally provided qualitative information on tongue movement. Meaningful quantitative measures for use in the clinic typically require the speaker's head to be stabilised in relation to a transducer, which may be uncomfortable, and unsuitable for young children. The objective of this study was to explore the applicability of quantitative measurements of stabilisation-free tongue movement data, by comparing ultrasound data collected from 10 adolescents, with and without head stabilisation. Several measures of tongue shape were used to quantify coarticulatory influence from two contrasting vowels on four different consonants. Only one of the measures was completely unaffected by the stabilisation condition for all the consonants. The study also reported cross-consonant differences in vowel-related coarticulatory effects. The implications of the findings for the theory of coarticulation and for potential applications of stabilisation-free tongue curve measurements in clinical studies are discussed.
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Affiliation(s)
- Natalia Zharkova
- Clinical Audiology, Speech and Language Research Centre, Queen Margaret University , Edinburgh , UK and
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Abstract
The purpose of this article is to present the Kinesio taping method used to improve the upper extremity function in the adult with hemiplegia. The article discusses various therapeutic methods used in the treatment of stroke patients to achieve a functional upper extremity. The only taping technique for various upper extremity conditions that has been described in the literature is the athletic taping technique. In this article, some interpretation is offered on proper assessment of the nonfunctional upper extremity, including the emphasis on postural alignment, trunk control, and scapula alignment. The Kinesio taping method in conjunction with other therapeutic interventions may facilitate or inhibit muscle function, support joint structure, reduce pain, and provide proprioceptive feedback to achieve and maintain preferred body alignment. Restoring trunk and scapula alignment after the stroke is critical in an effective treatment program for the upper extremity in hemiplegia.
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Affiliation(s)
- Ewa Jaraczewska
- Orthopedic Program, Rehabilitation Institute of Chicago, Illinois, USA
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Abstract
OBJECTIVE dimensional guidelines for bedrails have been developed to minimise the risk of patient entrapment within the bed. We examined whether bedrails in a large Irish teaching hospital complied with these standards. DESIGN AND SETTING survey of 60 accessible beds in six hospital wards. METHODS a specialised cone and cylinder tool that mimics the size and weight of a small adult neck and head was used to determine gaps in the four zones most associated with entrapment. RESULTS the number of failures for each zone was 15 beds for zone 1 (any space between the perimeters of the rail); 42 beds for zone 2 (the space under the rail); 41 beds for zone 3 (the space between the inside surface of the bedrail and the mattress) and 13 beds for zone 4 (the space between the mattress and rail at the end of the rail). Failures were more common with hydraulic adjusted than with electric profiling beds. Mattresses that were the wrong size (usually too narrow) or too soft and bedrails that were loose or were poorly maintained accounted for many failures. CONCLUSION many beds used in our hospital did not comply with dimensional standards to minimise entrapment risks. This emphasises the need for careful selection of patients for whom bedrails are to be used as well as the need for monitoring and maintenance of bed systems.
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Affiliation(s)
- Jennifer Haugh
- Department of Geriatric Medicine, Galway University Hospitals, Galway, Ireland
| | - Tomás O Flatharta
- Department of Geriatric Medicine, Galway University Hospitals, Galway, Ireland
| | - Tomás P Griffin
- Department of Geriatric Medicine, Galway University Hospitals, Galway, Ireland
| | - Shaun T O'Keeffe
- Department of Geriatric Medicine, Merlin Park Regional Hospital, Unit 4 Merlin Park Hospital, Galway, Ireland
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Abstract
OBJECTIVE to determine the prevalence and predictors of bedrail use in an acute hospital. DESIGN AND SETTING overnight survey in a University teaching hospital. SUBJECTS Three-hundred and twenty-seven beds and patients in 14 wards. METHODS data were collected on bedrail use and on the bed system, ward and patient characteristics. Medical, nursing and physical therapy notes were examined and the night and day nurses and, if necessary, the doctors and therapists caring for the patient interviewed to determine patients' diagnoses, functional and cognitive status. RESULTS there were 133 (40.7%) beds with one or more raised rails. Independent predictors of bedrail use were use of electric profiling beds, confusion, reduced alertness and any difficulty with transferring from bed. The most common reported indication for bedrail use was 'to prevent rolling out of bed' (59%); 'to prevent getting out of bed' was recorded in 11% of cases. Use of bedrails was judged inappropriate in 27/133 (20.3%) patients and in 14/43 (32.6%) patients with abnormal mental status; misuse was particularly common in those with confusion or agitation [13/34 (38.2%)]. Failure to use bedrails was potentially inappropriate in 32/194 (16.5%) of those without bedrails. CONCLUSION this study using individual patient data shows that the use of electric profiling beds, abnormal mental states and difficulty transferring from bed are the main predictors of bedrail use in acute hospitals. Inappropriate use of bedrails is common in those with cognitive impairment or with agitation.
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Affiliation(s)
| | - Jennifer Haugh
- Geriatric Medicine, Galway University Hospitals, Galway, Ireland
| | | | - Shaun T O'Keeffe
- Geriatric Medicine, Galway University Hospitals, Galway, Ireland
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Sultanov DV, Khugaeva VK. [Method in vivo study of the microcirculation in rat lung using a modified technique]. Patol Fiziol Eksp Ter 2014:102-104. [PMID: 25536799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A modifed technique that allows in vivo study microcirculation in the rat lungs using a special camera. Feature of the method is stable fixation of lung tissue, which prevents its displacement during the study. Imaged surface of the lung tissue (alveoli with surrounding them on all sides capillaries).
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Hansen CR, Christiansen RL, Nielsen TB, Bertelsen AS, Johansen J, Brink C. Comparison of three immobilisation systems for radiation therapy in head and neck cancer. Acta Oncol 2014; 53:423-7. [PMID: 24063295 DOI: 10.3109/0284186x.2013.813966] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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White CC, Domeier RM, Millin MG. EMS spinal precautions and the use of the long backboard - resource document to the position statement of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma. PREHOSP EMERG CARE 2014; 18:306-14. [PMID: 24559236 DOI: 10.3109/10903127.2014.884197] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Field spinal immobilization using a backboard and cervical collar has been standard practice for patients with suspected spine injury since the 1960s. The backboard has been a component of field spinal immobilization despite lack of efficacy evidence. While the backboard is a useful spinal protection tool during extrication, use of backboards is not without risk, as they have been shown to cause respiratory compromise, pain, and pressure sores. Backboards also alter a patient's physical exam, resulting in unnecessary radiographs. Because backboards present known risks, and their value in protecting the spinal cord of an injured patient remains unsubstantiated, they should only be used judiciously. The following provides a discussion of the elements of the National Association of EMS Physicians (NAEMSP) and American College of Surgeons Committee on Trauma (ACS-COT) position statement on EMS spinal precautions and the use of the long backboard. This discussion includes items where there is supporting literature and items where additional science is needed.
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Du S, Wu H, Xu X, Meng Y, Xia F, Zhai H, Lu Y. Tracing fasting glucose fluxes with unstressed catheter approach in streptozotocin induced diabetic rats. J Diabetes Res 2014; 2014:743798. [PMID: 24772449 PMCID: PMC3977083 DOI: 10.1155/2014/743798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 02/09/2014] [Accepted: 02/09/2014] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Blood glucose concentrations of type 1 diabetic rats are vulnerable, especially to stress and trauma. The present study aimed to investigate the fasting endogenous glucose production and skeletal muscle glucose uptake of Streptozotocin induced type 1 diabetic rats using an unstressed vein and artery implantation of catheters at the tails of the rats as a platform. RESEARCH DESIGN AND METHODS Streptozotocin (65 mg·kg⁻¹) was administered to induce type 1 diabetic state. The unstressed approach of catheters of vein and artery at the tails of the rats was established before the isotope tracer injection. Dynamic measurement of fasting endogenous glucose production was assessed by continuously infusing stable isotope [6, 6-²H₂] glucose, while skeletal muscle glucose uptake by bolus injecting radioactively labeled [1-¹⁴C]-2-deoxy-glucose. RESULTS Streptozotocin induced type 1 diabetic rats displayed polydipsia, polyphagia, and polyuria along with overt hyperglycemia and hypoinsulinemia. They also had enhanced fasting endogenous glucose production and reduced glucose uptake in skeletal muscle compared to nondiabetic rats. CONCLUSIONS The dual catheters implantation at the tails of the rats together with isotope tracers injection is a save time, unstressed, and feasible approach to explore the glucose metabolism in animal models in vivo.
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Affiliation(s)
- Shichun Du
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Hui Wu
- Department of Endocrinology, Zhejiang Province People's Hospital, Hangzhou 310014, China
| | - Xiao Xu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Ying Meng
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Hualing Zhai
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- *Yingli Lu:
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Dick T. 'Stirrup' old ideas: power cots mandate different restraint strategies. JEMS 2013; 38:63. [PMID: 24592571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Ho JD, Dawes DM, Chang RJ, Nelson RS, Miner JR. Physiologic effects of a new-generation conducted electrical weapon on human volunteers. J Emerg Med 2013; 46:428-35. [PMID: 24238599 DOI: 10.1016/j.jemermed.2013.08.069] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Revised: 05/16/2013] [Accepted: 08/15/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Conducted electrical weapons (CEWs) are used by law enforcement to restrain or repel potentially violent persons. The TASER X2 CEW is a next-generation device with new technology, including new electrical waveform and output specifications. It has not previously been studied in humans. OBJECTIVE The objective of this study was to evaluate the human physiologic effect of a new-generation CEW. METHODS This was a prospective, observational human study. Volunteers received a 10-s exposure via deployed probes from an X2 CEW in the abdomen and upper thigh. Measured data included vital signs; 12-lead electrocardiograms; and blood serum biomarkers before, immediately after, and 24 h post exposure. Biomarkers measured included pH, lactate, potassium, creatine kinase (CK), and troponin-I. Real-time spirometry and echocardiography were performed before, during, and after the exposure. RESULTS Ten volunteers completed the study. There were no important changes in vital signs or potassium. Median increase in lactate as a consequence of the exposure was 1.2 mg/dL (range 0.6-2.8 mg/dL). Median change in pH was -0.031 (range -0.011 to -0.067). No subject had a positive troponin. Median change in CK at 24 h was 313 ng/mL (range -40 to 3418 ng/mL). There was no evidence of respiratory impairment. Baseline median minute ventilation was 14.2 L/min, increased to 21.6 L/min intra-exposure (p = 0.05), and remained elevated at 21.6 L/min post exposure (p = 0.01). CONCLUSIONS There was no evidence of dangerous physiology found in the measured parameters. The physiologic effects of the X2 CEW are similar to older-generation CEWs. We encourage further study to validate these results.
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Affiliation(s)
- Jeffrey D Ho
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota; Meeker County Sheriff's Office, Litchfield, Minnesota
| | - Donald M Dawes
- Department of Emergency Medicine, Lompoc Valley Medical Center, Lompoc, California; Santa Barbara Police Department, Santa Barbara, California
| | - Richard J Chang
- Department of Emergency Medicine, Providence Regional Medical Center, Everett, Washington
| | - Rebecca S Nelson
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota
| | - James R Miner
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota
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Hadj-Bouziane F, Monfardini E, Guedj C, Gardechaux G, Hynaux C, Farnè A, Meunier M. The helmet head restraint system: a viable solution for resting state fMRI in awake monkeys. Neuroimage 2013; 86:536-43. [PMID: 24121168 DOI: 10.1016/j.neuroimage.2013.09.068] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 09/23/2013] [Accepted: 09/25/2013] [Indexed: 11/18/2022] Open
Abstract
In monkey neuroimaging, head restraint is currently achieved via surgical implants. Eradicating such invasive head restraint from otherwise non-invasive monkey studies could represent a substantial progress in terms of Reduction and Refinement. Two non-invasive helmet-based methods are available but they are used exclusively by the pioneering research groups who designed them. In the absence of independent replication, they have had little impact in replacing the surgical implants. Here, we built a modified version of the helmet system proposed by Srihasam et al. (2010 NeuroImage, 51(1), 267-73) and tested it for resting state fMRI in awake monkeys. Extremely vulnerable to motion artifacts, resting state fMRI represents a decisive test for non-invasive head restraint systems. We compared two monkeys restrained with the helmet to one monkey with a surgically implanted head post using both a seed-based approach and an independent component analysis. Technically, the helmet system proved relatively easy to develop. Scientifically, although it allowed more extensive movements than the head post system, the helmet proved viable for resting state fMRI, in particular when combined with the independent component analysis that deals more effectively with movement-related noise than the seed-based approach. We also discuss the pros and cons of such device in light of the European Union new 2013 regulation on non-human primate research and its firm Reduction and Refinement requests.
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Affiliation(s)
- Fadila Hadj-Bouziane
- INSERM, U1028, CNRS UMR5292, Lyon Neuroscience Research Center, ImpAct Team, Lyon F-69000, France; University UCBL Lyon 1, F-69000, France.
| | - Elisabetta Monfardini
- INSERM, U1028, CNRS UMR5292, Lyon Neuroscience Research Center, ImpAct Team, Lyon F-69000, France; University UCBL Lyon 1, F-69000, France; Institut de Médecine Environnementale, Paris F-75007, France
| | - Carole Guedj
- INSERM, U1028, CNRS UMR5292, Lyon Neuroscience Research Center, ImpAct Team, Lyon F-69000, France; University UCBL Lyon 1, F-69000, France
| | - Gislène Gardechaux
- INSERM, U1028, CNRS UMR5292, Lyon Neuroscience Research Center, ImpAct Team, Lyon F-69000, France; University UCBL Lyon 1, F-69000, France
| | - Clément Hynaux
- INSERM, U1028, CNRS UMR5292, Lyon Neuroscience Research Center, ImpAct Team, Lyon F-69000, France; University UCBL Lyon 1, F-69000, France
| | - Alessandro Farnè
- INSERM, U1028, CNRS UMR5292, Lyon Neuroscience Research Center, ImpAct Team, Lyon F-69000, France; University UCBL Lyon 1, F-69000, France
| | - Martine Meunier
- INSERM, U1028, CNRS UMR5292, Lyon Neuroscience Research Center, ImpAct Team, Lyon F-69000, France; University UCBL Lyon 1, F-69000, France
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Bledsoe BE. The evidence against backboards. Backboards often don't help and may hurt--why do they persist? EMS World 2013; 42:42-45. [PMID: 24073508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Rodríguez Delgado J. [Mechanical restraints in the elderly: technical proposals and recommendations for use in the social environment]. Rev Esp Geriatr Gerontol 2013; 48:185-189. [PMID: 23743357 DOI: 10.1016/j.regg.2013.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 02/08/2013] [Accepted: 03/11/2013] [Indexed: 06/02/2023]
Abstract
There is some confusion in the national gerontological literature in the use of terms that refer to mechanical restraints. There is a lack of dialogue as regards ethical conflicts that suggest their use, as well as a significant generalization of the claims against, and the absence of positive references despite its high prevalence as shown by some authors. This paper presents some technical proposals on the definition, the use of terms, and the use of mechanical restraints in the social environment, such as putting the ethical dialogue to arguments based on the prevalence, define them in terms of their intent, agree on a classification of the different restraint methods, identify the types and levels of risk, and intervene specifically in accordance with these proposals. Finally, recommendations are added with regards to risks, the decision process, prescription and the withdrawal process.
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Affiliation(s)
- Joan Rodríguez Delgado
- Centre Gerontològic Montsacopa, Olot, Girona, España; Departamento de Salud y Acción Social, Facultad de Ciencias de Salud y Bienestar, Universitat de Vic, Vic, Barcelona, España.
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Ohata H, Iida Y, Kito K, Kawamura M, Yamashita M, Ohta S, Ueda N, Iida H. [A case of transient postoperative median nerve palsy due to the use of the wrist holder to stabilize an intra-arterial catheter]. Masui 2013; 62:733-736. [PMID: 23815005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We experienced a case of right median nerve palsy at the distal forearm following abdominal surgery. We postulate that the cause of the median nerve palsy is overextension of the wrist by the inappropriate fixation with a holder. The patient was a 46-year-old man with habit of smoking receiving low-anterior resection of the rectum under general and epidural anesthesia in lithotomy position. During surgery his upper limbs were placed on padded arm board abducted about 80 degrees and affixed with soft cotton. His forearms were slightly supinated, whereas his elbows were not over-extended. A 22 G cannula was inserted in the right radial artery and the right wrist was fixed with plastic-holder with soft pad. This position was maintained throughout the operation approximetly for 250 minutes. During anesthesia any special events regarding hemodynamic variables were not observed. He complained of numbness in the palmar side of the digits 1-3 on his right hand without motor disturbance 4 hours after the operation. Examination by the anesthesiologist revealed median nerve palsy. Fortunately, this symptom gradually but completely resolved over the next few days. The possible causes of this neuropathy include the overextension of the wrist or the unexpected extension of the elbow beyond the acceptable range by the supination of forearm, which was induced by the attachment used to stabilize an intra-arterial catheter. Therefore, in the current case we should have returned the wrists promptly to the neutral position following arterial catheter placement to prevent the median nerve palsy. This case suggests the importance of holding the proper position of the arm during surgery.
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Affiliation(s)
- Hiroto Ohata
- Department of Anesthesiology, Gifu Municipal Hospital, Gifu 500-8513
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Schültke E, Nanko N, Pinsker M, Katzev M, Sebastian A, Feige B, Nikkhah G. Improving MRT image quality in patients with movement disorders. Acta Neurochir Suppl 2013; 117:13-17. [PMID: 23652651 DOI: 10.1007/978-3-7091-1482-7_3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE In order to improve image quality in a simultaneous fMRI-EEG study with patients suffering from the involuntary movements typical for Huntington's disease, the aim was to develop a technique for immobilizing the heads of our patients inside an MRI head coil. METHODS We modified a mask technique previously used for reliable repositioning in temporally fractionated radiotherapy. The mask was tested in three patients with Huntington's disease, acquiring structural and functional MR images with simultaneous EEG with and without the mask. RESULTS Image as well as EEG signal quality were significantly improved in patients wearing the mask. However, the image quality with mask was comparable to acquisitions from patients without movement disorders only in patients with light to moderate dyskinesia. Although image quality was also significantly improved in a patient suffering from severe dyskinesia with quasi-continuous involuntary movements, the quality of both the MR images as well as the EEG signal was lower than what would be expected in a healthy control person. CONCLUSION We have succeeded in developing a mask that fits into the MRI head coil, does not disturb the MRI signal, and significantly improves both fMRI and EEG signal quality.
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Affiliation(s)
- Elisabeth Schültke
- Division of Stereotactic and Functional Neurosurgery, Department of General Neurosurgery, University Medical Center Freiburg, Breisacher Straße 64, Freiburg, D-79106, Germany,
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Koppel S, Charlton JL, Rudin-Brown CM. The impact of new legislation on child restraint system (CRS) misuse and inappropriate use in Australia. Traffic Inj Prev 2013; 14:387-396. [PMID: 23531262 DOI: 10.1080/15389588.2012.700746] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The current study aimed to investigate the incidence of child restraint system (CRS) misuse and/or inappropriate use of CRS through an Australian CRS inspection program conducted by CRS fitting specialists between October 2004 and October 2011 and to determine whether CRS misuse and/or inappropriate use of CRS changed following new Australian legislation regarding CRS and motor vehicle restraint use for children aged 7 years and under. METHODS Participants were recruited through an advertisement for free CRS inspections displayed at childcare centers, kindergartens, community centers, hospitals, and child expos. At each inspection, a CRS fitting specialist inspected each child in their CRS while in their vehicle and reported to the owner of the CRS on the installation of the child restraint(s) and/or system(s) and any fitting faults and/or concerns with the fitting and/or use of the child restraint(s) and or system(s). RESULTS Results are based on the inspection of 2674 CRS. Of all of the CRS inspected, the majority (79%) were reported as having at least one instance of misuse and/or inappropriate use. The most common forms of CRS misuse and/or inappropriate use observed were harness strap errors (twisted, poorly adjusted, and/or incorrectly positioned, 41%), seat belt errors (incorrectly routed, twisted, and/or incorrectly adjusted, 32%), and a missing or incorrect fitting of the gated buckle/locking clip (24%). Significant differences were found across the proportion of CRS misuse and/or inappropriate use across restraint types (infant restraint/forward-facing CRS/convertible [birth to 18 kg] CRS/convertible [8-26 kg] CRS/boosters [booster seat/cushion/booster with harness combination]), χ(2)(4) = 147.852, P < .001. CRS misuse and/or inappropriate use were most prevalent among convertible CRS (birth to 18 kg; 87%), forward-facing CRS (85%), and convertible CRS (8-26 kg; 81%), compared to infant restraints (73%) and booster seats (booster seats/cushions/boosters with H-harness combination; 65%). There was no significant difference in the proportion of CRS with misuse and/or inappropriate use across the pre- and post-legislation period (80% vs. 77%), χ(2)(1) = 1.545, P > .5. CONCLUSIONS Based on the findings of the current study, it was concluded that, despite the introduction of new, definitive CRS legislation, CRS misuse and/or inappropriate use remains widespread in Australia. The findings highlight the need for CRS education and legislation that include information on correct CRS use, as well as information on appropriate CRS use, in order to provide specialized protection for child vehicle occupants in the event of a motor vehicle crash.
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Affiliation(s)
- S Koppel
- Monash University Accident Research Centre, Monash University, Melbourne, Victoria 3800, Australia.
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Wroe AJ, Ghebremedhin A, Gordon IR, Schulte RW, Slater JD. Water Equivalent Thickness Analysis of Immobilization Devices for Clinical Implementation in Proton Therapy. TCRT Express 2013; 13:415-20. [PMID: 24000987 PMCID: PMC4527428 DOI: 10.7785/tcrtexpress.2013.600260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Immobilization devices can impact not only the inter- and intra-fraction motion of the patient, but also the range uncertainty of the treatment beam in proton therapy. In order to limit additional range uncertainty, the water equivalent thickness (WET) of the immobilization device needs to be well known and accurately reflected in the calculations by the treatment planning system (TPS). The method presented here focusses on the use of a nozzle-mounted variable range shifter and precision-machined polystyrene blocks of known WET to evaluate commercial immobilization devices prior to clinical implementation. CT studies were also completed to evaluate the internal uniformity of the immobilization devices under study. Multiple inserts of the kVue platform (Qfix Systems, Avondale, PA) were evaluated as part of this study. The results indicate that the inserts are largely interchangeable across a given design type and that the measured WET values agree with those generated by the TPS with a maximum difference less than 1 mm. The WET of the devices, as determined by the TPS, was not impacted by CT beam hardening normally experienced during clinical use. The reproducibility of the WET method was also determined to be better than ±0.02 mm. In conclusion, the testing of immobilization prior to implementation in proton therapy is essential in order to ascertain their impact on the proton treatment and the methodology described here can also be applied to other immobilization systems.
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Affiliation(s)
- A J Wroe
- Department of Radiation Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA 92354.
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Association of Women's Health, Obstetric and Neonatal Nurses. Shackling incarcerated pregnant women. Nurs Womens Health 2011; 15:549-50. [PMID: 22900699 DOI: 10.1111/j.1751-486X.2011.01691.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cordovil R, Vieira F, Barreiros J. Crossing safety barriers: influence of children's morphological and functional variables. Appl Ergon 2012; 43:515-520. [PMID: 21871604 DOI: 10.1016/j.apergo.2011.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Revised: 07/25/2011] [Accepted: 08/05/2011] [Indexed: 05/31/2023]
Abstract
Thirty-three children between 3 and 6 years of age were asked to climb four different types of safety barriers. Morphological and functional variables of the children, which were expected to influence climbing or passing through skills, were collected. The influence of those variables on children's success rate and time to cross was tested. No barrier offered a total restraining efficacy. The horizontal bars barrier was crossed by 97% of the children. In the group of children that succeeded in crossing the four barriers, mean time to cross the most difficult barrier was 15 s. Age was the best predictor for success in crossing most barriers but morphology and strength were important predictors of time to cross. The influence of anthropometric variables in time to cross was dependent upon the characteristics of the barrier. A good design of safety barriers should consider children's age, morphology and strength.
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Affiliation(s)
- Rita Cordovil
- Faculty of Human Kinetics - Technical University of Lisbon, Department of Health and Sport Sciences, Estrada da Costa, 1495-688 Cruz Quebrada, Portugal.
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Garrett FG, Hawkins JL, Overmyer AE, Hayden JB, Durham PL. Validation of a novel rat-holding device for studying heat- and mechanical-evoked trigeminal nocifensive behavioral responses. J Orofac Pain 2012; 26:337-344. [PMID: 23110274 PMCID: PMC5894827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIMS To test the reliability and validity of a novel rat-holding device designed to be used in conjunction with the plantar test apparatus for studying nocifensive behavioral responses in an established model of temporomandibular joint (TMJ) pathology. METHODS Thirty-five young adult male Sprague-Dawley rats were used. Withdrawal latencies in response to infrared 40 heat stimulation of the submandibular region in naïve animals (n = 4) and animals injected with saline or complete Freund's adjuvant (CFA) in the TMJ (n > 9) were measured over a 2-week time period. Nocifensive responses to mechanical stimulation of the cutaneous tissue directly over the TMJ with von Frey filaments were investigated in animals injected with CFA in the TMJ (n = 6). The effect on nocifensive responses to heat and mechanical stimulation of subcutaneous administration of buprenorphine (0.05 mg/kg) into the hindquarter was assessed in CFA and cotreated animals (n = 6). Statistical analysis was performed using a nonparametric Mann-Whitney U test. RESULTS Under basal conditions, withdrawal latencies to heat stimulation of the orofacial region remained consistently around 15 seconds over 14 days. Unilateral CFA injection in the TMJ significantly decreased heat-withdrawal latencies on days 1, 2, 7, and 14 in the ipsilateral side (P < .05), but not contralateral side, when compared with basal values. CFA also significantly decreased the nocifensive threshold to mechanical stimulation on days 1, 2, and 7 postinjection (P < .05). CFA-mediated changes in heat withdrawal and mechanical thresholds in the orofacial region were significantly suppressed by subcutaneous administration of buprenorphine into the hindquarter (P < .05). CONCLUSION Findings from this study provide evidence to validate the use of this holding device for studying nocifensive behaviors in the orofacial region of rats in response to heat or mechanical orofacial stimulation.
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Affiliation(s)
- Filip G Garrett
- Center for Biomedical and Life Sciences, Missouri State University, Springfield, MO 65806, USA
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47
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Affiliation(s)
- Louis Catalano
- C.V. Starr Hand Surgery Center, St. Luke's-Roosevelt Hospital, New York, NY 10019, USA.
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Golan A, Marco R, Raz H, Shany E. Imaging in the newborn: infant immobilizer obviates the need for anesthesia. Isr Med Assoc J 2011; 13:663-665. [PMID: 22279698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Neonatal cerebral imaging is a sensitive technique for evaluating brain injury in the neonatal period. When performing computed tomography or magnetic resonance imaging, sedation is needed to prevent motion artifacts. However, general anesthesia in neonates carries significant risks and requires a complex logistic approach that often limits the use of these modalities. The development of infant immobilizers now enables imaging without general anesthesia and significantly increases clinical and research investigational opportunities. OBJECTIVES To assess the efficacy of the infant immobilizer instead of general anesthesia for infants undergoing imaging. METHODS The study group comprised all infants born over a 1 year period at Soroka University Medical Center who required imaging such as MRI, CT or bone scans. A MedVac Vacuum Splint infant immobilizer was used in all infants to prevent motion during imaging. The success rate of a single scan and the need for general anesthesia were assessed. RESULTS Forty infants were examined during 1 year. The studies included 15 CT scans, 25 MRIs and 1 bone scan. The infants' gestational age at birth was 27-40 weeks and the examinations were performed at ages ranging from delivery to 6 months old. All imaging was successful and none of the infants required general anesthesia. CONCLUSIONS An infant immobilizer should be used for imaging of newborns. Since this method carries a low risk and has a high success rate, general anesthesia in newborns is justified only when this non-invasive procedure fails.
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Affiliation(s)
- Agneta Golan
- Department of Neonatology, Soroka University Medical Center and Faculty of Health Sciences, Beer Sheva, Israel.
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Keeping kids still during exams. Radiol Technol 2011; 82:491-2. [PMID: 21572073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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