Development and Utility of Quality Metrics for Ambulatory Pediatric Cardiology in Kawasaki Disease.

The Adult Congenital and Pediatric Cardiology (ACPC) Section of the American College of Cardiology sought to develop quality indicators/metrics for ambulatory pediatric cardiology practice. The objective of this study was to report the creation of metrics for patients with Kawasaki disease. Over a period of 5 months, 12 pediatric cardiologists developed 24 quality metrics based on the most relevant statements, guidelines, and research studies pertaining to Kawasaki disease. Of the 24 metrics, the 8 metrics deemed the most important, feasible, and valid were sent on to the ACPC for consideration. Seven of the 8 metrics were approved using the RAND method by an expert panel. All 7 metrics approved by the ACPC council were accepted by ACPC membership after an "open comments" process. They have been disseminated to the pediatric cardiology community for implementation by the ACPC Quality Network

The role of aortic compliance in determination of coarctation severity: Lumped parameter modeling, in vitro study and clinical evaluation

Early detection and accurate estimation of the extent of coarctation of the aorta (COA) is critical to long-term outcome. Peak-to-peak trans-coarctation pressure gradient (PKdP) higher than 20 mmHg is an indication for interventional/surgical repair. Patients with COA have reduced proximal and distal aortic compliances. A comprehensive study investigating the effects of variations of proximal COA and systemic compliances on PKdP, and consequently on the COA severity evaluation has never been done. This study evaluates the effect of aortic compliance on diagnostic accuracy of PKdP. Lumped parameter modeling and in vitro experiments were performed for COA severities of 50%, 75% and 90% by area. Modeling and in vitro results were validated against retrospective clinical data of PKdP, measured in 54 patients with COA. Modeling and in vitro. PKdP increases with reduced proximal COA compliance (+36%, +38% and +53% for COA severities of 50%, 75% and 90%, respectively; p<0.05), but decreases with reduced systemic compliance (−62%, −41% and −36% for COA severities of 50%, 75% and 90%, respectively; p<0.01). Clinical study. PKdP has a modest correlation with COA severity (R=0.29). The main determinants of PKdP are COA severity, stroke volume index and systemic compliance. Systemic compliance was found to be as influential as COA severity in PKdP determination (R=0.30 vs. R =0.34). In conclusion, PKdP is highly influenced by both stroke volume index and arterial compliance. Low values of PKdP cannot be used to exclude the severe COA presence since COA severity may be masked by reduced systemic compliance and/or low flow conditions

Conversion électro-optique du signal et découplage actif d'un capteur IRM endoluminal à liaison optique

International audienceUne boucle endoluminale radiofréquence (RF) située à proximité de la zone à examiner permet d'avoir localement un rapport signal sur bruit élevé qui peut être mis à profit pour augmenter la résolution spatiale des images de RM. Ce type de capteur permet en particulier d'analyser la paroi de l'intestin qui permettrait d'améliorer le bilan d'extension tumorale [1]. Malheureusement, les câbles coaxiaux, couramment utilisés pour transmettre le signal RMN et le courant nécessaire au découplage actif du capteur de réception, peuvent induire des échauffements des tissus compromettant l'utilisation clinique d'un tel capteur. En effet, le champ électrique E z accompagnant le champ magnétique RF B 1 , induit des courants RF le long du câble et augmente ainsi le taux d'absorption spécifique (TAS) local [2]. Afin d'assurer la sécurité du patient, l'utilisation d'une connexion optique est une solution alternative élégante pour supprimer ces risques d'échauffements. La conversion électro-optique (EO) des signaux [3] et le découplage optique [4] sont démontrés sur la base d'un capteur endoluminal

Conversion électro-optique du signal et découplage actif d'un capteur IRM endoluminal à liaison optique

International audienceUne boucle endoluminale radiofréquence (RF) située à proximité de la zone à examiner permet d'avoir localement un rapport signal sur bruit élevé qui peut être mis à profit pour augmenter la résolution spatiale des images de RM. Ce type de capteur permet en particulier d'analyser la paroi de l'intestin qui permettrait d'améliorer le bilan d'extension tumorale [1]. Malheureusement, les câbles coaxiaux, couramment utilisés pour transmettre le signal RMN et le courant nécessaire au découplage actif du capteur de réception, peuvent induire des échauffements des tissus compromettant l'utilisation clinique d'un tel capteur. En effet, le champ électrique E z accompagnant le champ magnétique RF B 1 , induit des courants RF le long du câble et augmente ainsi le taux d'absorption spécifique (TAS) local [2]. Afin d'assurer la sécurité du patient, l'utilisation d'une connexion optique est une solution alternative élégante pour supprimer ces risques d'échauffements. La conversion électro-optique (EO) des signaux [3] et le découplage optique [4] sont démontrés sur la base d'un capteur endoluminal

Optical characterization of ultra-short Bragg grating on lithium niobate ridge waveguide

International audienceIn this Letter, we report a technique to etch giant aspect ratio nanostructures in lithium niobate. An 8 μm long Bragg grating on a Ti:LiNbO3 ridge waveguide was fabricated by combining optical-grade dicing and focused ion beam milling. The reflectivity was evaluated using an optical coherence tomography system: it is measured to be 53% for the TM wave and 47% for the TE wave. We study by 2D-FDTD the modeled behavior of the electromagnetic field when an angle exists between two consecutive sidewalls of the grating in order to understand the difference between ideal Bragg grating and experimental samples. These simulations allow us to optimize the parameters in order to increase the reflection of the grating up to 80%

Treatment Intensification in Patients With Kawasaki Disease and Coronary Aneurysm at Diagnosis.

BackgroundCoronary artery aneurysms (CAA) are a serious complication of Kawasaki disease. Treatment with intravenous immunoglobulin (IVIg) within 10 days of fever onset reduces the risk of CAA from 25% to &lt;5%. Corticosteroids and infliximab are often used in high-risk patients or those with CAA at diagnosis, but there are no data on their longer-term impact on CAA.MethodsRetrospective multicenter study including children who had CAA with a z score ≥2.5 and &lt;10 at time of diagnosis and who received primary therapy with IVIg alone or in combination with either corticosteroids or infliximab within 10 days of onset of fever.ResultsOf 121 children, with a median age of 2.8 (range 0.1-15.5) years, 30 (25%) received primary therapy with corticosteroids and IVIg, 58 (48%) received primary therapy with infliximab and IVIg, and 33 (27%) received primary therapy with IVIg only. Median coronary z scores at the time of diagnosis did not differ among treatment groups (P = .39). Primary treatment intensification with either corticosteroids or infliximab were independent protective factors against progression of coronary size on follow-up (coefficient: -1.31 [95% confidence interval: -2.33 to -0.29]; coefficient: -1.07 [95% confidence interval: -1.95 to -0.19], respectively).ConclusionsAmong a high-risk group of patients with Kawasaki disease with CAA on baseline echocardiography, those treated with corticosteroids or infliximab in addition to IVIg had less progression in CAA size compared with those treated with IVIg alone. Prospective randomized trials are needed to determine the best adjunctive treatment of patients who present with CAA

El Imperio Retórico: Auge y Caída

This article is the product of a bibliographic review whose objective is to show evidence of the classical foundations of political communication. The method of analysis was applied, with a qualitative approach, non-experimental design, under a transversal documentary-bibliographic level. After the documentary review it was found that the debate on rhetoric, in ancient times, constituted the very essence of citizen participation in community affairs. Although it has usually been seen with description, the rhetoric was the subject of important reflections in classical Greece and Rome. It is concluded that the art of persuading audiences through the use of the word has managed to build a conceptual machinery, whose contributions will be necessary in this analysis. The distinction that is often made in politics between words and deeds, between "do not see what the president says, but what he does this", is questioned in the rhetorical perspective: saying is also a way of doing.How to reference this article: Dahdah-Antar, S. (2019). El império retórico: Auge y Caida. Revista Políticas, Globalidad y Ciudadanía, 5(9), 46-63. Recuperado de http://revpoliticas.uanl.mx/index.php/RPGyC/article/view/111El presente artículo es producto de una revisión bibliográfica cuyo objetivo consistió en mostrar evidencia de los fundamentos clásicos de la comunicación política. Se aplicó el método de análisis, con un enfoque cualitativo, diseño no experimental, bajo un nivel documental-bibliográfico transversal. Tras la revisión documental se encontró que el debate sobre la retórica, en la antigüedad, constituía la esencia misma de la participación de los ciudadanos en los asuntos de la comunidad. Si bien ha sido vista usualmente con descrédito, la retórica fue objeto de importantes reflexiones en la Grecia y Roma clásicas. Se concluye que el arte de persuadir públicos mediante el uso de la palabra ha logrado construir una maquinaria conceptual, cuyos aportes serán descritos en este análisis.  La distinción que con frecuencia se hace en política entre las palabras y los hechos, entre el “no veas lo que dice el presidente, sino lo que éste hace”, se cuestiona en la perspectiva retórica: el decir es también una manera de hacer.Cómo referenciar este artículo: Dahdah-Antar, S. (2019). El império retórico: Auge y Caida. Revista Políticas, Globalidad y Ciudadanía, 5(9), 46-63. Recuperado de http://revpoliticas.uanl.mx/index.php/RPGyC/article/view/11

Parametric amplification and phase preserving amplitude regeneration of a 640 Gbit/s RZ-DPSK signal

We report the first experimental demonstration of parametric amplification and all-optical phase-preserving amplitude regeneration for a 640 Gbit/s return-to-zero (RZ) differential phase-shift keying (DPSK) optical time division multiplexed (OTDM) signal. In the designed gain-flattened singlepump fiber optical parametric amplifier (FOPA), 620 fs short optical pulses are successfully amplified with 15 dB gain with error-free performance and less than 1 dB power penalty. Phase-preserving amplitude regeneration based on gain saturation in the FOPA is carried out for optical signals with degraded optical signal-to-noise ratio. An improvement of 2.2 dB in receiver sensitivity at a bit-error-ratio of 10-9 has been successfully achieved after regeneration, together with 13.3 dB net gain.</p

PEMANFAATAN SEKAM PADI MENJADI BRIKET SEBAGAI ENERGI ALTERNATIF STUDI KASUS DESA WOTANSARI – BALONG PANGGANG

Pengabdian telah dilaksanakan di Desa Wotansari, Kecamatan Balong Panggang, Kabupaten Gresik. Pelaksanaan pengabdian selama 13 minggu dari bulan&nbsp; 26 Juli 2019 sampai&nbsp; 27 Oktober 2019. Tujuan dari pengabdian yaitu memanfaatkan limbah sisa penggilingan padi menjadi Briket sebagai enegi alternatif. Agar limbah Sekam padi hasil panen pertanian masyarakat di Desa Wotansari bisa di manfaatkan. Hasil dari kegiatan pengabdian ini dapat membantu pemanfaatan limbah yang ada di sekitar kawasan desa Wotansari . Pemanfaatan ini menggunakan metode ceramah dan pengenalan hasil jadi briket secara langsung. Dimana yang pertama dilakukan adalah penyuluhan dengan metode ceramah yang berisikan penyampaian materi dan fungsi mengenai briket itu sendiri. Untuk metode pengenalan hasil jadi briket secara langsung yaitu berupa penjelasan &nbsp;briket yang sudah jadi dari sekam padi ke masyarakat