RESUMEN
The United States (US) Food and Drug Administration (FDA) has issued multiple statements and guidelines since 2015 on the topic of thyroid function testing in babies and children through 3 years old after receiving iodinated contrast media for medical imaging exams. In April 2023, the FDA adjusted this recommendation to target babies and young children younger than 4 years of age who have a history of prematurity, very low birth weight, or underlying conditions which affect thyroid gland function, largely in response to solid arguments from expert statements from the American College of Radiology (ACR) which is endorsed by the Society for Pediatric Radiology (SPR), Pediatric Endocrinology Society (PES), and the Society for Cardiovascular Angiography & Intervention (SCAI). Herein we describe our approach and development of a clinical care guideline along with the steps necessary for implementation of the plan including alterations in ordering exams requiring iodinated contrast media, automatic triggering of lab orders, reporting, and follow-up, to address the 2022 FDA guidance statement to monitor thyroid function in children after receiving iodinated contrast media. The newly implemented clinical care guideline at Ann and Robert H. Lurie Children's Hospital of Chicago remains applicable following the 2023 updated recommendation from the FDA. We will track patients less than 3 months of age who undergo thyroid function testing following computed tomography (CT), interventional radiology, and cardiac catheterization exams for which an iodinated contrast media is administered as a clinical care quality initiative.
Asunto(s)
Planificación Hospitalaria , Yodo , Lactante , Niño , Estados Unidos , Humanos , Preescolar , Glándula Tiroides/diagnóstico por imagen , Medios de Contraste/efectos adversos , United States Food and Drug Administration , Angiografía , Yodo/efectos adversosRESUMEN
The iron arsenide CaFe(4)As(3) features a three-dimensional network derived from intergrown Fe(2)As(2) layers and Ca ions in channels. Complex magnetic interactions between Fe atoms give rise to unexpected transitions and novel direction-dependent magnetic behavior.
RESUMEN
Gervais & Norenzayan (2012) reported in Science a series of 4 experiments in which manipulations intended to foster analytic thinking decreased religious belief. We conducted a precise, large, multi-site pre-registered replication of one of these experiments. We observed little to no effect of the experimental manipulation on religious belief (d = 0.07 in the wrong direction, 95% CI[-0.12, 0.25], N = 941). The original finding does not seem to provide reliable or valid evidence that analytic thinking causes a decrease in religious belief.
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Cognición , Religión , Pensamiento , Adulto , Femenino , Humanos , Masculino , Pruebas PsicológicasRESUMEN
We determine the spatial pattern of Aedes aegypti and the containers in which they develop in two neighborhoods of the Amazonian city of Iquitos, Peru. Four variables were examined: adult Ae. aegypti, pupae, containers positive for larvae or pupae, and all water-holding containers. Adults clustered strongly within houses and weakly to a distance of 30 meters beyond the household; clustering was not detected beyond 10 meters for positive containers or pupae. Over short periods of time restricted flight range and frequent blood-feeding behavior of Ae. aegypti appear to be underlying factors in the clustering patterns of human dengue infections. Permanent, consistently infested containers (key premises) were not major producers of Ae. aegypti, indicating that larvaciding strategies by themselves may be less effective than reduction of mosquito development sites by source reduction and education campaigns. We conclude that entomologic risk of human dengue infection should be assessed at the household level at frequent time intervals.
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Aedes/fisiología , Dengue/epidemiología , Dengue/etiología , Aedes/virología , Animales , Dengue/parasitología , Dengue/prevención & control , Vivienda , Humanos , Insectos Vectores/fisiología , Insectos Vectores/virología , Control de Mosquitos , Perú/epidemiología , Densidad de PoblaciónRESUMEN
Large-scale longitudinal cohort studies are necessary to characterize temporal and geographic variation in Aedes aegypti (L.) (Diptera: Culicidae) production patterns and to develop targeted dengue control strategies that will reduce disease. We carried out pupal/demographic surveys in a circuit of approximately 6,000 houses, 10 separate times, between January 1999 and August 2002 in the Amazonian city of Iquitos, Peru. We quantified the number of containers positive for Ae. aegypti larvae and/or pupae, containers holding pupae, and the absolute number of pupae by 4-mo sampling circuits and spatially by geographic area by using a geographic information system developed for the city. A total of 289,941 water-holding containers were characterized, of which 7.3% were positive for Ae. aegypti. Temporal and geographic variations were detected for all variables examined, and the relative importance of different container types for production of Ae. aegypti was calculated. Ae. aegypti larvae and pupae were detected in 64 types of containers. Consistent production patterns were observed for the lid status (lids: 32% wet containers, 2% pupal production), container location (outdoor: 43% wet containers, 85% pupal production), and method by which the container was filled with water (rain filled: 15% wet containers, 88.3% pupal production); these patterns were consistent temporally and geographically. We describe a new container category (nontraditional) that includes transient puddles, which were rare but capable of producing large numbers of pupae. Because of high variable pupal counts, four container categories (large tank, medium storage, miscellaneous, and nontraditional) should be targeted in addition to outdoor rain-filled containers that are not covered by a lid. The utility of targeted Ae. aegypti control is discussed, as well as the ability to achieve control objectives based on published but untested threshold values.
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Aedes/crecimiento & desarrollo , Animales , Demografía , Geografía , Humanos , Larva , Perú , Densidad de Población , Pupa , Factores de Tiempo , Salud UrbanaAsunto(s)
Adenocarcinoma/diagnóstico , Regulación Neoplásica de la Expresión Génica , Neoplasias Mamarias Animales/diagnóstico , Receptores del Factor de Necrosis Tumoral/genética , Adenocarcinoma/genética , Adenocarcinoma/metabolismo , Animales , Antígenos Transformadores de Poliomavirus/metabolismo , Biomarcadores de Tumor/metabolismo , Modelos Animales de Enfermedad , Resultado Fatal , Femenino , Inmunohistoquímica , Neoplasias Mamarias Animales/genética , Neoplasias Mamarias Animales/metabolismo , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Receptores del Factor de Necrosis Tumoral/metabolismo , Miembro 25 de Receptores de Factores de Necrosis TumoralRESUMEN
Daily vacuuming of floors and flat-shelf racks is a standard procedure in our rodent housing rooms. To determine whether the noise produced by this activity is a potential stressor to animals used for transgenic and knockout mouse production, we measured the sound levels in our genetically engineered mouse facility under ambient conditions and at the in-cage and room levels during vacuuming. Spectral analysis showed that vacuuming produces a multitonal, low-frequency noise that is not attenuated by microisolation caging with bedding material. Comparison of cage-level spectral analysis results with age-specific audiograms of C57Bl/6 and CD1 mice showed that vacuuming produces frequencies audible to C57Bl/6 mice at 3 and 6 mo of age and to CD1 mice at 1 mo of age. These findings suggest that vacuuming in animal rooms could be a source of stress to animals with these genetic backgrounds.