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Can standard deviation of overnight pulse oximetry be used to screen childhood obstructive sleep apnea
摘要： Objectives: Pulse oximetry (PO) has been frequently used as an alternative test to polysomnography (PSG) in children. We conducted this study to determine which statistical parameters obtained from overnight PO monitoring would be most suitable and to evaluate its diagnostic performance. Methods: We prospectively recruited children with snoring referred for PSG. Subjects were monitored with PO while performing PSG. Eight statistical parameters of SpO2 data were analyzed to identify which had the best diagnostic performance as assessed by the area under the receiver-operating characteristic curve (AUC). To validate this parameter (which was found to be the standard deviation, SD) in a larger population, we retrospectively extracted raw data of SpO2 from our previous PSG records, calculated the SD of each patient, and assessed its AUC. Results: A total of 166 children were recruited in the first phase. SD of SpO2 was found to have the largest AUC. In the second phase, raw data of 457 patients were extracted. SD of SpO2 correlated well with the apnea/hypopnea index (AHI) (r=0.6, P<0.001). For diagnosis of moderate to severe obstructive sleep apnea (OSA) (AHI ≥5 events/h), AUC was 0.74. SD of SpO2 ≥1.06 representing mean + 2SD of normal to mild OSA (AHI <5) provided 97% specificity and 92% positive predictive value. The positive likelihood ratio was 11. Conclusion: Calculating the SD of SpO2, which quantifies the amount of dispersion of SpO2 values, is a useful initial investigation in childhood OSA. An SD ≥1.06 can predict moderate to severe OSA with confidence. This parameter is simple, practical, and readily accessible.
关键词： Adenotonsillectomy,Screening test,Children,Obstructive sleep apnea,Polysomnography
更新于2025-09-23 15:22:29
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Deep sedation for laser treatment of cutaneous vascular anomalies in children
摘要： Pulse laser treatment is useful for aesthetic improvement in children with capillary vascular malformation and residual superficial haemangiomas. However, pulse laser treatment is painful, and repeated procedures are usually required to achieve a satisfactory clinical result. Evidence shows that analgesia in children undergoing pulse laser treatment may vary from general anaesthesia to no treatment at all. This report describes our institutional experience with deep sedation in children with capillary vascular malformation, undergoing laser pulse treatment.
关键词： Procedural sedation,Pulse laser treatment,Children,Analgesia
更新于2025-09-23 15:21:01
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Efficacy of propranolol and pingyangmycin, respectively, combined with pulsed dye laser on children with hemangioma
摘要： Clinical efficacy of propranolol and pingyangmycin, respectively, combined with pulsed dye laser in the treatment of children with hemangioma was analyzed, to provide a new therapeutic idea for their clinical treatment. A total of 120 children with hemangioma were selected into the study. Children treated with propranolol combined with pulsed dye laser were in group A, those treated with pingyangmycin combined with pulsed dye laser were in group B, and 60 healthy children were selected as control group (group C). Blood samples of children were taken before and after treatment for miR?4295 detection. The expression of miR?4295 was observed after treatment, and the total clinical remission rate and adverse reactions after treatment were compared between the two groups. The tumor volume of the two groups was significantly reduced after treatment, with statistically significant difference (P<0.05); miR?4295 expression was reduced in the two groups (P<0.05); adverse reactions in propranolol group were less than pingyangmycin group during treatment (P<0.05). Propranolol and pingyangmycin, respectively, combined with pulsed dye laser had ideal efficacy on hemangioma in children. Moreover, miR?4295 was highly expressed in children with hemangioma, and the expression level reduced after two methods of treatment. However, adverse reactions in propranolol group were less and its safety was higher.
关键词： pingyangmycin,miR?4295,children with hemangioma,pulsed dye laser
更新于2025-09-23 15:21:01
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Development of a Pediatric Visual Field Test
摘要： Purpose: We describe a pediatric visual field (VF) test based on a computer game where software and hardware combine to provide an enjoyable test experience. Methods: The test software consists of a platform-based computer game presented to the central VF. A storyline was created around the game as was a structure surrounding the computer monitor to enhance patients’ experience. The patient is asked to help the central character collect magic coins (stimuli). To collect these coins a series of obstacles need to be overcome. The test was presented on a Sony PVM-2541A monitor calibrated from a central midpoint with a Minolta CS-100 photometer placed at 50 cm. Measurements were performed at 15 locations on the screen and the contrast calculated. Retinal sensitivity was determined by modulating stimulus in size. To test the feasibility of the novel approach 20 patients (4–16 years old) with no history of VF defects were recruited. Results: For the 14 subjects completing the study, 31 6 15 data points were collected on 1 eye of each patient. Mean background luminance and stimulus contrast were 9.9 6 0.3 cd/m2 and 27.9 6 0.1 dB, respectively. Sensitivity values obtained were similar to an adult population but variability was considerably higher – 8.3 6 9.0 dB. Conclusions: Preliminary data show the feasibility of a game-based VF test for pediatric use. Although the test was well accepted by the target population, test variability remained very high. Translational Relevance: Traditional VF tests are not well tolerated by children. This study describes a child-friendly approach to test visual fields in the targeted population.
关键词： glaucoma,visual field,children’s vision,perimetry,psychophysics
更新于2025-09-23 15:21:01
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Optimal settings for the Holmium: YAG laser in pediatric endourology: tips and tricks
摘要： To the best of our knowledge, no pediatric paper has been published regarding specifically how to set the Holmium:YAG laser for multiple urologic applications. Objective: To provide insight into the laser parameters for pediatric applications Study design: We describe the principle and the settings of the laser Results: The Holmium:YAG laser can produce four different biological effects: (1) fragmentation of stones in small fragments that can be retrieved with grasping instruments, thereby increasing the immediate stone-free outcome. For fragmentation lithotripsy, the laser has to be set with a high energy, low frequency and short pulse duration; (2) dusting which produces fine dust that can spontaneously evacuate, avoiding the use of basket retrieval. The dusting setting requires low energy, high frequency and long pulse duration; (3) incision of posterior urethral valves or ureterocele when all settings are maximized: high energy, high frequency and long pulse duration; (4) coagulation of urothelial tumors using high frequency, long pulse duration and slightly lower energy than required for incision. Discussion: Both dusting by painting and fragmentation with retrieval for ureteroscopic laser lithotripsy are effective. Although dusting tends to be associated with shorter operative times and a lower risk of ureteral trauma, this approach has a potential risk of recurrent stone formation from dust failing to pass. In contrast, fragmentation with extraction may provide for a more immediate postoperative stone-free result. Altering the pulse energy, frequency, width and modulation can help to optimize lithotripsy efficiency. Lower pulse energy settings result in smaller fragments, less retropulsion and reduce fiber tip degradation. A shallow depth of penetration in water and tissue allows precise energy application and provides a margin of safety. Conclusion: An understanding of Ho-YAG laser settings will permit the pediatric surgeon to make a better use of the device for different urological applications.
关键词： children,dusting,fragmentation,section,laser Holmium-YAG
更新于2025-09-23 15:19:57
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Bio-Based Polycationic Polyurethane as an Ion-Selective Membrane for Nitrate Tapered Optical Fiber Sensors
摘要： There has been long-standing controversy, both among scientists and in the public, about whether children absorb more radio frequency (RF) energy in their heads than adults when using a mobile telephone. This review summarizes the current understanding of this issue, and some of the complexities in comparing the absorption of RF energy in different individuals from use of mobile phones. The discussion is limited to dosimetric issues, i.e., possible age-related differences in absorption of RF energy in the heads of mobile phone users. For most metrics of exposure, in particular those relevant to assessing the compliance of handsets with regulatory limits, there is no clear evidence for age-related differences in exposure. For two metrics of exposure, there is a clear evidence that age can play a factor: 1) the local specific absorption rate (SAR), in particular anatomically defined locations within the brain, will vary with head size and hence with age and 2) the SAR, in particular tissues, (e.g., bone marrow in the skull) can vary with age due to age-related differences in the dielectric properties of tissue. However, these differences involve SAR levels that are below the 1-g or 10-g peak spatial SAR (psSAR averaged over 1 or 10 g of tissue) and have no significance for compliance assessment. Age-related differences observed in worst case simulations such as presently considered are difficult to generalize to human populations under real-world exposure conditions due to many variables that determine SAR during realistic usages.
关键词： radiofrequency,specific absorption rate,exposure,children,Mobile phone
更新于2025-09-23 15:19:57
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[IEEE 2019 Compound Semiconductor Week (CSW) - Nara, Japan (2019.5.19-2019.5.23)] 2019 Compound Semiconductor Week (CSW) - Effect of introducing optical blanking to GaN epitaxy by using pulsed laser deposition technology
摘要： Our reports of published research in several of the peer-reviewed journal articles in 1996, 2002, and 2004 have generated a lot of controversy over the last two decades, including the most recent publication by Foster and Chou. In this paper, we present arguments based on physics that the main reason for higher exposure of children (also women and men with smaller heads and likely thinner pinnae) to radiofrequency energy from mobile phones is the closer placement of the cell phone radiation source by several millimeters to the tissues of the head, e.g., the brain. Using heterogeneous anatomically derived shaped models of the head, we have previously reported that the exposure increases by a compounding rate of 10%–15% for every single millimeter of closer location of the radiating antenna. This is similar to the report of ～20% increase for every millimeter in the Foster and Chou’s paper from their (1) even though their simplistic (1) is valid only for a homogenous tissue slab of in?nite size and the radiation source that is a wire dipole rather than a mobile telephone. Both of their assumptions for (1) are obviously not applicable for human exposures to mobile telephones. Actually, the physical reason for such a rapid drop off of coupled energy is that the radiofrequency electromagnetic ?elds close to a radiating source in the so-called near-?eld region reduce in strength very rapidly with every millimeter of distance, even faster than in the far-?eld region, where the electromagnetic ?elds reduce inversely with the square of the distance from the source.
关键词： antennas and radiation,EM compatibility,Mobile telephones,exposure of children
更新于2025-09-23 15:19:57
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Application of infrared thermography in diagnosing peripherally inserted central venous catheter infections in children with cancer
摘要： Children affected by oncological diseases are often fitted with central venous catheters. Catheter infection is a frequent complication, sometimes accompanied by thrombosis. It is designed a case/control-type pilot study of children with oncological diseases fitted with a central venous catheter. The objective of this preliminary study is to use infrared thermography to discern whether there is an infection in patients with a central venous catheter and if so, to undertake a close follow-up of its evolution, after administering a therapy. It is measured Thermal Asymmetry by mean and maximum temperatures (Temperature affected ROI – Temperature contralateral ROI). In all cases with catheter infection, Thermal Asymmetry values were higher than in controls without infection, allowing us to assess improvement after starting the treatment. These preliminary results are satisfactory because they reflect the advantages of using infrared thermography on oncological child patients, as it is a harmless, non-contact, accessible and quick technique, allowing us to reduce the use of ionizing radiation and quantify the clinical signs of inflammation, which are otherwise only qualitatively detectable in the clinical examination. By doing so, it may be possible to anticipate infection and provide early treatment, and, moreover, to observe whether there is any complication after starting a treatment. More studies need to be undertaken with an extensive paediatric population to establish reference values.
关键词： infrared thermography,central venous catheter infection,cancer,children
更新于2025-09-19 17:15:36
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Micropulse laser for glaucoma in children
摘要： The optokinetic nystagmus (OKN) response (induction/suppression) correlates with subjective visual acuity (VA) in adults but has not been studied extensively in school-aged children. We investigated the correlation between subjective and objective VA as elicited with a new computerized OKN suppression test ("SpeedWheel") in adults and school-aged children. Fifteen children (6-12 years) and 27 adults with refractive errors, amblyopia, cataract, age-related macular degeneration and thyroid associated orbitopathy underwent testing of subjective VA with E- and Landolt C-symbols (Freiburg Acuity and Contrast Test [FrACT]) and objective VA (SpeedWheel) on a LCD screen. Statistical analysis: linear regression, Spearman correlation and Bland-Altman plots. Mean difference against the mean was 0.01 when SpeedWheel was compared to Landolt C, but 0.15 when compared to E-symbols. Overall, SpeedWheel correlated very strongly to FrACT ('E': r = 0.85; P < 0.001; Landolt C: r = 0.81; P < 0.001). This also held true in children ('E': r = 0.74; P < 0.003; Landolt C: r = 0.69; P < 0.005). In ocular disease, SpeedWheel appears to underestimate subjective VA. In 2 patients with loss of vision of unknown origin, subjective VA was lower than SpeedWheel VA. This is in agreement with the findings of Fukai et al. and could indicate aggravation or malingering. C? etinkaya et al found no correlation between OKN induction and subjective VA in 52 children. Thus OKN suppression rather than induction may be a better objective acuity test. SpeedWheel can assess visual acuity in in adults as well as in school aged children.
关键词： adults,SpeedWheel,visual acuity,optokinetic nystagmus,children
更新于2025-09-12 10:27:22
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Evaluation of the effectiveness of infrared light-emitting diode photobiomodulation in children with sleep bruxism
摘要： Background: Sleep bruxism is a masticatory muscle activity characterized as rhythmic (phasic) or nonrhythmic (tonic). In children and adolescents, etiological factors, such as breathing pattern and sleep quality, have recently been addressed in studies investigating sleep bruxism. New therapies for adults, such as botulinum toxin, have been investigated, but such techniques are not applicable for individuals in the growth and development phase. Methods: The participants will be 76 children, which will be randomly allocated to a control group, that is group 1, absence of bruxism; group 2, children with bruxism treated with infrared light-emitting diode (LED); and group 3, bruxism treated with occlusal splint. All participants will be submitted to a clinical evaluation to evaluate muscle activity and salivary biomarkers, before and after treatments. Muscle activity will be veri?ed by electromyography of muscles mastication, masseter and temporal, and salivary biomarkers observed will be cortisol and dopamine levels. Discussion: Photobiomodulation therapy has piqued the interest of researchers, as this noninvasive method has demonstrated positive results in problems related to muscle tissues. This document describes the protocol for a proposed study to evaluate morphological and psychosocial aspects in children and adolescents with awake bruxism and their responses to photo-biomodulation therapy with infrared LED.
关键词： LED,electromyography,children,sleep bruxism,salivary biomarkers
更新于2025-09-12 10:27:22