Several guidelines exist on urinary tract infection (UTI) in children. The objectives of this study were to (1) implement an evidence-based diagnostic guideline on UTI and evaluate determinants of ...successful implementation, and (2) determine compliance to and impact of the guideline in febrile, non-toilet trained children at the emergency department (ED). We performed a prospective cross-sectional observational study, with observations before and after implementation. Children aged 1 month to 2 years, presenting at the ED with unexplained fever (temperature above 38.5 °C), were included. We excluded children with a chronic underlying disease. Primary outcome measure was compliance to the standardized diagnostic strategy and determinants influencing compliance. Secondary outcome parameters included the following: number of used dipsticks, contaminated cultures, number of genuine UTI, frequency of prescribed antibiotic treatment, and hospitalization. The pre-intervention group {169 children (male 60.4 %, median age 1.0 range 0.1–2.0)} was compared with the post-intervention group {150 children (male 54.7 %, median age 1.0 range 0.1–1.9)}. In 42 patients (24.9 %), there was compliance to local guidelines before implementation, compared with 70 (46.7 %) after implementation (
p
-value < 0.001). Improvement in compliance after implementation was higher in patients 3–24 months and outside the office hours (
p
< 0.001).
Conclusion
: Implementation of a guideline for diagnosing UTI in febrile children at the ED has led to a significantly better compliance, especially in children aged 3–24 months. However, this study also underlines the need for a well-defined implementation strategy after launching an (inter)national guideline, taking determinants influencing implementation into account.
ContextFollow-up strategies after emergency department (ED) discharge, alias safety netting, is often based on the gut feeling of the attending physician.ObjectiveTo systematically identify evaluated ...safety-netting strategies after ED discharge and to describe determinants of paediatric ED revisits.Data sourcesMEDLINE, Embase, CINAHL, Cochrane central, OvidSP, Web of Science, Google Scholar, PubMed.Study selectionStudies of any design reporting on safety netting/follow-up after ED discharge and/or determinants of ED revisits for the total paediatric population or specifically for children with fever, dyspnoea and/or gastroenteritis. Outcomes included complicated course of disease after initial ED visit (eg, revisits, hospitalisation).Data extractionTwo reviewers independently assessed studies for eligibility and study quality. As meta-analysis was not possible due to heterogeneity of studies, we performed a narrative synthesis of study results. A best-evidence synthesis was used to identify the level of evidence.ResultsWe summarised 58 studies, 36% (21/58) were assessed as having low risk of bias. Limited evidence was observed for different strategies of safety netting, with educational interventions being mostly studied. Young children, a relevant medical history, infectious/respiratory symptoms or seizures and progression/persistence of symptoms were strongly associated with ED revisits. Gender, emergency crowding, physicians’ characteristics and diagnostic tests and/or therapeutic interventions at the index visit were not associated with revisits.ConclusionsWithin the heterogeneous available evidence, we identified a set of strong determinants of revisits that identify high-risk groups in need for safety netting in paediatric emergency care being related to age and clinical symptoms. Gaps remain on intervention studies concerning specific application of a uniform safety-netting strategy and its included time frame.
We report the timing and spatial resolution from the Muon Telescope Detector (MTD) installed in the STAR experiment at RHIC. Cosmic ray muons traversing the STAR detector have an average transverse ...momentum of 6GeV/c. Due to their very small multiple scattering, these cosmic muons provide an ideal tool to calibrate the detectors and measure their timing and spatial resolution. The values obtained were ~100ps and ~1–2cm. These values are comparable to those obtained from cosmic-ray bench tests and test beams.
The granular layer of the cerebellar cortex consists of densely packed neuronal cells, classified into granule cells and large interneurons. In this study, we provide a comparative survey of large ...granular layer interneurons in the adult rat cerebellum based on both morphological and neurochemical criteria. To this end, double immunofluorescence histochemistry was performed by combining antibodies against the cytoplasmic antigen Rat-303, calretinin, the metabotropic glutamate receptor mGluR2 and somatostatin. Based on Rat-303/calretinin double immunohistochemistry, three distinct populations of large granular layer interneurons could be discerned: cells immunopositive for Rat-303, calretinin or both. Rat-303 or calretinin single-labeled cells represented Golgi cells and unipolar brush cells, respectively. Rat-303/calretinin double-labeled cells located just underneath the Purkinje cell layer represented Lugaro cells. Morphometrical analysis distinguished two populations of Rat-303-positive Golgi cells according to their location: vermis versus hemisphere. Immunostaining for the metabotropic glutamate receptor mGluR2 combined with Rat-303 or calretinin revealed that the majority of Golgi cells (about 90%) appeared to be mGluR2 positive. Lugaro cells were mGluR2 negative. In addition, a limited population of large polymorphous interneurons in the depth of the granular layer with morphological features resembling Golgi cells also displayed Rat-303/calretinin immunoreactivity and were mGluR2 negative. Double immunohistochemistry for Rat-303 and somatostatin revealed three populations of labeled cells in the depth of the granular layer. Besides double-labeled Golgi cells, Rat-303 or somatostatin single-labeled cells were present. Based on mGluR2/somatostatin and calretinin/somatostatin double immunostainings, Rat-303 single-labeled cells were found to correspond to Rat-303/calretinin-positive, mGluR2-negative Golgi-like cells, while the identity of somatostatin single-labeled cells remained unclear.
The data presented in this article elaborate previous reports on the morphological and neurochemical differentiation of large interneurons in the rat cerebellar granular layer. In addition, they indicate that the current classification of these cells into Golgi cells, Lugaro cells and unipolar brush cells does not describe the observed neurochemical heterogeneity.
The TOFp/pVPD time-of-flight system for STAR Llope, W.J; Geurts, F; Mitchell, J.W ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
04/2004, Letnik:
522, Številka:
3
Journal Article
Recenzirano
Odprti dostop
A time-of-flight system was constructed for the STAR Experiment for the direct identification of hadrons produced in
197Au+
197Au collisions at RHIC. The system consists of two separate detector ...subsystems, one called the Pseudo Vertex Position Detector (pVPD, the “start” detector) and the other called the Time of Flight Patch (TOFp, the “stop” detector). Each detector is based on conventional scintillator/phototube technology and includes custom high-performance front-end electronics and a common CAMAC-based digitization and read-out. The design of the system and its performance during the 2001 RHIC run will be described. The start resolution attained by the pVPD was 24
ps, implying a pVPD single-detector resolution of 58
ps. The total time resolution of the system averaged over all detector channels was 87
ps, allowing direct
π/
K/
p discrimination for momenta up to ∼1.8
GeV/
c, and direct (
π+
K)/
p discrimination up to ∼3
GeV/
c.
Performance of the prototype MRPC detector for STAR Geurts, F.; Shao, M.; Bonner, B. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
11/2004, Letnik:
533, Številka:
1-2
Journal Article
Recenzirano
A prototype 168-channel multi-gap resistive plate chamber (MRPC) time-of-flight system for the STAR experiment at RHIC was completed in February 2002, tested for 10 weeks at the AGS at BNL, and ...installed in the STAR detector for the 2002–2003 physics run. At the AGS, the MRPC detectors were operated on a number of different gas mixtures, high voltages, and threshold voltages. The results for detection efficiency, time resolution, streamer probability, and noise rates are presented.
A
bstract
A search is presented for additional neutral Higgs bosons in the
τ τ
final state in proton-proton collisions at the LHC. The search is performed in the context of the minimal supersymmetric ...extension of the standard model (MSSM), using the data collected with the CMS detector in 2016 at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 35.9 fb
−1
. To enhance the sensitivity to neutral MSSM Higgs bosons, the search includes production of the Higgs boson in association with b quarks. No significant deviation above the expected background is observed. Model-independent limits at 95% confidence level (CL) are set on the product of the branching fraction for the decay into τ leptons and the cross section for the production via gluon fusion or in association with b quarks. These limits range from 18 pb at 90 GeV to 3.5 fb at 3.2 TeV for gluon fusion and from 15 pb (at 90 GeV) to 2.5 fb (at 3.2 TeV) for production in association with b quarks, assuming a narrow width resonance. In the
m
h
hod +
scenario these limits translate into a 95% CL exclusion of tan
β >
6 for neutral Higgs boson masses below 250 GeV, where tan
β
is the ratio of the vacuum expectation values of the neutral components of the two Higgs doublets. The 95% CL exclusion contour reaches 1.6 TeV for tan
β
= 60.
A search for leptoquarks produced singly and in pairs in proton-proton collisions is presented. We consider the leptoquark (LQ) to be a scalar particle of charge −1/3e coupling to a top quark plus a ...tau lepton (tτ) or a bottom quark plus a neutrino (bν), or a vector particle of charge +2/3e, coupling to tν or bτ. These choices are motivated by models that can explain a series of anomalies observed in the measurement of B meson decays. In this analysis the signatures tτνb and tτν are probed, using data recorded by the CMS experiment at the CERN LHC at s=13 TeV and that correspond to an integrated luminosity of 137 fb−1. These signatures have not been previously explored in a dedicated search. The data are found to be in agreement with the standard model prediction. Lower limits at 95% confidence level are set on the LQ mass in the range 0.98–1.73 TeV, depending on the LQ spin and its coupling λ to a lepton and a quark, and assuming equal couplings for the two LQ decay modes considered. These are the most stringent constraints to date on the existence of leptoquarks in this scenario.
Measurements of differential top quark pair tt¯\ \mathrm{t}\overline{\mathrm{t}} \ cross sections using events produced in proton-proton collisions at a centre-of-mass energy of 13 TeV containing two ...oppositely charged leptons are presented. The data were recorded by the CMS experiment at the CERN LHC in 2016 and correspond to an integrated luminosity of 35.9 fb−1. The differential cross sections are presented as functions of kinematic observables of the top quarks and their decay products, the tt¯\ \mathrm{t}\overline{\mathrm{t}} \ system, and the total number of jets in the event. The differential cross sections are defined both with particle-level objects in a fiducial phase space close to that of the detector acceptance and with parton-level top quarks in the full phase space. All results are compared with standard model predictions from Monte Carlo simulations with next-to-leading-order (NLO) accuracy in quantum chromodynamics (QCD) at matrix-element level interfaced to parton-shower simulations. Where possible, parton-level results are compared to calculations with beyond-NLO precision in QCD. Significant disagreement is observed between data and all predictions for several observables. The measurements are used to constrain the top quark chromomagnetic dipole moment in an effective field theory framework at NLO in QCD and to extract tt¯\ \mathrm{t}\overline{\mathrm{t}} \ and leptonic charge asymmetries.
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