Quantum Backaction on kg-Scale Mirrors: Observation of Radiation Pressure Noise in the Advanced Virgo Detector.

The quantum radiation pressure and the quantum shot noise in laser-interferometric gravitational wave detectors constitute a macroscopic manifestation of the Heisenberg inequality. If quantum shot noise can be easily observed, the observation of quantum radiation pressure noise has been elusive, so far, due to the technical noise competing with quantum effects. Here, we discuss the evidence of quantum radiation pressure noise in the Advanced Virgo gravitational wave detector. In our experiment, we inject squeezed vacuum states of light into the interferometer in order to manipulate the quantum backaction on the 42 kg mirrors and observe the corresponding quantum noise driven displacement at frequencies between 30 and 70 Hz. The experimental data, obtained in various interferometer configurations, is tested against the Advanced Virgo detector quantum noise model which confirmed the measured magnitude of quantum radiation pressure noise.

Increasing the Astrophysical Reach of the Advanced Virgo Detector via the Application of Squeezed Vacuum States of Light.

Current interferometric gravitational-wave detectors are limited by quantum noise over a wide range of their measurement bandwidth. One method to overcome the quantum limit is the injection of squeezed vacuum states of light into the interferometer's dark port. Here, we report on the successful application of this quantum technology to improve the shot noise limited sensitivity of the Advanced Virgo gravitational-wave detector. A sensitivity enhancement of up to 3.2±0.1 dB beyond the shot noise limit is achieved. This nonclassical improvement corresponds to a 5%-8% increase of the binary neutron star horizon. The squeezing injection was fully automated and over the first 5 months of the third joint LIGO-Virgo observation run O3 squeezing was applied for more than 99% of the science time. During this period several gravitational-wave candidates have been recorded.

Spinal anesthesia in children: most pediatric urologists are not on board.

OBJECTIVE: In 2016, the Food and Drug Administration issued a warning on general anesthetic medications used for lengthy procedures (>3 h) in children younger than 3 years. Spinal anesthesia can be a safe alternative to general anesthesia for many pediatric urology procedures. It can shorten total operating room (OR) time, provide excellent pain control, and allow parents to reunite with their child immediately after surgery. However, use of spinal anesthesia can also directly affect the operating surgeon (awake patient, time constraints of spinal, and prolonged preoperative time). Members of the Societies for Pediatric Urology (SPU) and European Society of Pediatric Urology (ESPU) were surveyed to get their opinions on the use of spinal anesthesia for routine pediatric urology procedures. It was hypothesized that half of pediatric urologists would favor spinal anesthesia and that SPU members would be more likely to favor spinal anesthesia than their European colleagues. MATERIALS AND METHODS: A short survey with five clinical scenarios was created. Scenarios assessed physicians' recommendations regarding timing and the type of anesthesia (general or spinal) for common pediatric urology procedures: undescended testicle, inguinal hernia, hypospadias, phimosis, and phimosis with penoscrotal webbing. Surveys were emailed to members of the SPU and ESPU. Responses and demographic information were collected and analyzed. RESULTS: The survey was completed by 113 SPU members (46% response rate for members who opened the invitation) and 109 ESPU members. For all clinical scenarios, < 20% of pediatric urologists from the SPU and <25% from the ESPU favor doing any procedure with spinal anesthesia. The majority of respondents practice in children's hospitals with pediatric anesthesiologists, but roughly half of the responders (54% SPU and 43% ESPU) do not think their anesthesia colleagues would be comfortable performing spinal anesthesia. Furthermore, only 51% of SPU and 36% of ESPU members discuss the possible neurodevelopmental side-effects of anesthesia with parents; similarly, less than half of all respondents think their anesthesia colleagues address these potential side-effects when obtaining consent. The only significant difference between SPU and ESPU responses was that ESPU members tended to delay penile surgery more than SPU respondents. CONCLUSION: Whether general anesthesia has any effect on the developing brain of children undergoing routine pediatric urology procedures is unclear. Yet, few pediatric urologists, independent of their region of practice, prefer spinal to general anesthesia. Collaboration in the OR is the key to success, and it is important that pediatric urologists and pediatric anesthesiologists work together to balance the benefits and risks of general and spinal anesthesia.

Vesicoureteric reflux (VUR) in children: where are we now?

In 1960 Hodson and Edwards published their landmark paper about the association between chronic pyelonefritis and vesicoureteric reflux (VUR). Since then, the approach for VUR became more important (1). In the last 30 years there have been multiple publications on vesicoureteric reflux (VUR) and discussions at Pediatric Urology meetings with the purpose to give answers to the questions what the best treatment is for VUR, at what age the treatment is advocated, does it prevent for febrile urinary tract infections (UTI's) and does it stop of decreases the risk for reflux nefropathy and renal scars Well known are the International Reflux Study (1981) with a European and an American arm in which the researchers compared medical approaches with surgical approaches to reflux, and the Birmingham Reflux study (1987) which was a prospective trial of operative versus non-operative treatment of severe vesicoureteric reflux in children with five years observation (2). In 2009 the group from John Hopkins (Baltimore, USA) published their interim results from a randomized placebo-controlled study of children with VUR (the RIVUR Study) (3). The most recent randomized controlled trial (RCT) is the Swedish Reflux Trial published in the Journal of Urology 2010, July. This was set up as a RCT to compare 3 treatment alternatives, including antibiotic prophylaxis, endoscopic therapy and surveillance as the control group, in regard to recurrent febrile UTIs, renal damage and VUR status after 2 years (4). Since these new data are available, we want to give an update in this specific and interesting field in Pediatric Urology.

Reflujo vesicoureteral (RVU) en niños: ¿dónde estamos actualmente? / Vesicoureteric reflux (VUR) in children: where are we now?

En 1960 Hodson y Edwards publicaron su memorable trabajo sobre la asociación entre la pielonefritis crónica y el reflujo vesicoureteral (RVU). Desde entonces, el abordaje del RVU se ha vuelto cada vez más importante (1). En los últimos 30 años ha habido múltiples publicaciones sobre el reflujo vesicoureteral (RVU) y discusiones en reuniones de Urología Pediátrica con el propósito de dar respuesta a las preguntas ¿cuál es el mejor tratamiento para el RVU?, ¿a qué edad se aconseja el tratamiento?, ¿previene las infecciones febriles del tracto urinario?, y si el tratamiento consigue detener o disminuir el riesgo de nefropatía por reflujo y de cicatriz renal. Son bien conocidos el Estudio Internacional del Reflujo (1981) con una rama europea y otra estadounidense en el cual se compararon el tratamiento médico y el abordaje quirúrgico del reflujo, y el estudio Birmingham del año (1987) que era un ensayo prospectivo con 5 años de seguimiento, comparando tratamiento quirúrgico y no quirúrgico del reflujo vesicoureteral severo en niños (2). En 2009, el grupo del John Hopkins (Baltimore, USA) publicó sus resultados provisionales de un estudio aleatorizado controlado con placebo en niños con RVU (Estudio RIVUR) (3). El ensayo aleatorizado controlado más reciente es el estudio Sueco sobre Reflujo publicado en Journal of Urology en Julio del 2010. Este fue elaborado como un estudio aleatorizado para comparar 3 alternativas terapéuticas que incluían profilaxis antibiótica, tratamiento endoscópico y vigilancia como grupo control, comparando los resultados de infecciones del tracto urinario (ITUs) recurrentes, daño renal y el estado del RVU después de 2 años de seguimiento (4). En vista de que estos nuevos datos están disponibles, queremos hacer una actualización sobre este campo específico e interesante de la urología pediátrica(AU)

In 1960 Hodson and Edwards published their landmark paper about the association between chronic pyelonefritis and vesicoureteric reflux (VUR). Since then, the approach for VUR became more important (1). In the last 30 years there have been multiple publications on vesicoureteric reflux (VUR) and discussions at Pediatric Urology meetings with the purpose to give answers to the questions what the best treatment is for VUR, at what age the treatment is advocated, does it prevent for febrile urinary tract infections (UTI’s) and does it stop of decreases the risk for reflux nefropathy and renal scars. Well known are the International Reflux Study (1981) with a European and an American arm in which the researchers compared medical approaches with surgical approaches to reflux, and the Birmingham Reflux study (1987) which was a prospective trial of operative versus non-operative treatment of severe vesicoureteric reflux in children with five years observation (2). In 2009 the group from John Hopkins (Baltimore, USA) published their interim results from a randomized placebo-controlled study of children with VUR (the RIVUR Study) (3). The most recent randomized controlled trial (RCT) is the Swedish Reflux Trial published in the Journal of Urology 2010, July. This was set up as a RCT to compare 3 treatment alternatives, including antibiotic prophylaxis, endoscopic therapy and surveillance as the control group, in regard to recurrent febrile UTIs, renal damage and VUR status after 2 years (4). Since these new data are available, we want to give an update in this specific and interesting field in Pediatric Urology(AU)

Testicular torsion after pediatric kidney transplantation.

Kidney transplantation has become the treatment of choice for children with end-stage renal disease and offers recipients an excellent quality of life. Following kidney transplantation several types of medical and surgical complications can arise. In this report, a testicular torsion occurring on the sixth day after pediatric kidney transplantation is described. It remains unclear whether this unusual complication should be regarded as coincidental or as a direct consequence of the transplantation.

Measurement of the cosmic ray e+ +e- spectrum from 20 GeV to 1 TeV with the Fermi Large Area Telescope.

Designed as a high-sensitivity gamma-ray observatory, the Fermi Large Area Telescope is also an electron detector with a large acceptance exceeding 2 m;{2} sr at 300 GeV. Building on the gamma-ray analysis, we have developed an efficient electron detection strategy which provides sufficient background rejection for measurement of the steeply falling electron spectrum up to 1 TeV. Our high precision data show that the electron spectrum falls with energy as E-3.0 and does not exhibit prominent spectral features. Interpretations in terms of a conventional diffusive model as well as a potential local extra component are briefly discussed.

Fermi observations of high-energy gamma-ray emission from GRB 080916C.

Gamma-ray bursts (GRBs) are highly energetic explosions signaling the death of massive stars in distant galaxies. The Gamma-ray Burst Monitor and Large Area Telescope onboard the Fermi Observatory together record GRBs over a broad energy range spanning about 7 decades of gammaray energy. In September 2008, Fermi observed the exceptionally luminous GRB 080916C, with the largest apparent energy release yet measured. The high-energy gamma rays are observed to start later and persist longer than the lower energy photons. A simple spectral form fits the entire GRB spectrum, providing strong constraints on emission models. The known distance of the burst enables placing lower limits on the bulk Lorentz factor of the outflow and on the quantum gravity mass.

High-resolution perineal ultrasound of a paraurethral cyst in a neonate (2008: 8b).

We present high-resolution ultrasonography of a paraurethral cyst, a rare cause of an interlabial mass in a newborn. Although not always performed in these cases, ultrasonographic evaluation is an easily performed examination in assessment of the final diagnosis and therapeutic decisions.

The Fermi Gamma-Ray Space Telescope discovers the pulsar in the young galactic supernova remnant CTA 1.

Energetic young pulsars and expanding blast waves [supernova remnants (SNRs)] are the most visible remains after massive stars, ending their lives, explode in core-collapse supernovae. The Fermi Gamma-Ray Space Telescope has unveiled a radio quiet pulsar located near the center of the compact synchrotron nebula inside the supernova remnant CTA 1. The pulsar, discovered through its gamma-ray pulsations, has a period of 316.86 milliseconds and a period derivative of 3.614 x 10(-13) seconds per second. Its characteristic age of 10(4) years is comparable to that estimated for the SNR. We speculate that most unidentified Galactic gamma-ray sources associated with star-forming regions and SNRs are such young pulsars.

Long-term efficacy and predictive factors of full spectrum therapy for nocturnal enuresis.

PURPOSE: We determine the effect and predictive factors of relapse 1 year after combination therapy of an enuresis alarm, bladder training, motivational therapy and retention control training for nocturnal enuresis. MATERIALS AND METHODS: In 68 of 77 children the relapse rate 1 year after full spectrum therapy for nocturnal enuresis was investigated. Gender, age, sleep arousal, family history, monosymptomatic, bladder capacity, overactive bladder, nighttime polyuria, duration of treatment, over learning and psychosocial factors were investigated. RESULTS: The relapse rate during the whole year was 50%, with 33.8% of subjects being dry and 16.2% sometimes wet. The relapse rate after 1 year was 16%. Nine patients could not be reached and, thus, were considered dropouts. Only overactive bladder and psychosocial problems were significantly related to relapse. CONCLUSIONS: The relapse rate during the year was high while the relapse rate after 1 year was low. Psychosocial problems and overactive bladder were the only 2 predictive factors for relapse.

High initial efficacy of full-spectrum therapy for nocturnal enuresis in children and adolescents.

OBJECTIVE: To investigate the initial efficacy and predictive factors of full-spectrum therapy in the treatment of children and young adolescents with nocturnal enuresis (NE). PATIENTS AND METHODS: Combined therapy for NE comprises an enuresis alarm, bladder training, motivational therapy and pelvic floor muscle training, and is more effective than each of the components alone or than medical intervention. A total of 60 children and adolescents (aged 4-20 years) with NE were treated once a week with full-spectrum therapy for a maximum of 6 months. RESULTS: Overall the therapy was successful (14 consecutive dry nights) in 52 of 60 patients. At 30 days the cure rate was 33%, after 60 days 72% and after 98 days, 87%. The remaining 13% did not achieve 14 consecutive dry nights; seven patients improved, having fewer dry nights/week. One patient discontinued the treatment because of lack of motivation. In children with an initial maximum bladder capacity less than normal for age, the capacity increased from 53% of the normal maximum bladder capacity in week 1 to 88% at the end of treatment. Neither age, gender, sleep arousal, bladder capacity, family history and pathophysiological profile had any association with the success rate. CONCLUSION: The short-term success rate of full-spectrum therapy for NE is high. Age, gender, sleep arousal, bladder capacity, family history and pathophysiological profile of enuresis are unrelated to the success of the intervention.

Low-energy measurement of the 7Be(p,gamma)8B cross section.

We have measured the cross section of the 7Be(p,gamma)8B reaction for E(c.m.) = 185.8, 134.7, and 111.7 keV using a radioactive 7Be target (132 mCi). Single and coincidence spectra of beta+ and alpha particles from 8B and 8Be* decay, respectively, were measured using a large acceptance spectrometer. The zero energy S factor inferred from these data is 18.5+/-2.4 eV b and a weighted mean value of 18.8+/-1.7 eV b (theoretical uncertainty included) is deduced when combining this value with our previous results at higher energies.

Postoperative retroperitoneal hemorrhage due to a bleeding ureteric artery: treatment by transcatheter embolization.

We report a case of a postoperative retroperitoneal haemorrhage due to an iatrogenic perioperative injury of an ureteric artery. Transcatheter embolization using microparticles stopped the bleeding and the patient stabilized immediately. Ureteric artery injury is a very rare condition but can be managed successfully by percutaneous interventional techniques.

Reference values for the five electrophoretic serum protein fractions in Caucasian children by capillary zone electrophoresis.

We report age-related reference intervals for capillary zone electrophoresis for children between 1 and 14 years of age.

[Preliminary experiences with the use of the Holmium-YAG laser in the treatment of soft tissues and of cystine calculi in children]. / Premières expériences avec l'utilisation du laser Holmium-YAG dans le traitement des tissus mous et des calculs de cystine chez l'enfant.

INTRODUCTION: Experience of the use of the Holmium: Yttrium-Aluminium-Garnet (Ho:YAG) laser in children has been limited. However, the Ho:YAG laser has been in clinical use in urology for several years but has mainly been used for the treatment of renal stones and benign prostatic hyperplasia. Due to its unique combination of vaporization and coagulation, the Ho:YAG laser allows a precise cutting action. The depth of penetration in water and tissue is limited to < 0.5 mm and therefore provides a safety margin. The Ho:YAG laser can be used in children, as the energy can be delivered via fibers that range from 200 to 1000 mu in diameter. MATERIALS AND METHODS: We used the Ho:YAG laser in 5 children (2-15 years): one child (2 years) with bladder exstrophy had a urethral stricture after bladder neck reconstruction, two children (6 years and 14 years) had ureteropelvic junction (UPJ) stenosis and refused open surgery and two children (5 years and 15 years) suffered from cystine stones (ESWL failed). The urethral stricture was incised in a retrograde fashion. We performed an antegrade incision of the UPJ with the Ho:YAG laser in the 6-year-old child and a retrograde incision in the 14-year-old child. We removed the stones in antegrade fashion in the 5-year-old child and in retrograde fashion in the 15-year-old child. RESULTS: All children now have more than 12 month's follow-up. There were no immediate or late complications. The boy with urethral stricture remained free of recurrence, the boy with UPJ stenosis obtained improved drainage on the excretory renogram and the two children with cystine stones remained stonefree. CONCLUSION: We have shown that the safety and efficacy of the Ho:YAG laser is also reproducible in urologic pathology in children. In addition, due to its vaporizing quality, the Ho:YAG laser is more effective in the treatment of cystine stones and allows minimaly invasive treatment in children.

Bilateral Legg-Calvé-Perthes disease: different from unilateral disease?

Twenty-five patients or 50 hips with bilateral Legg-Calvé-Perthes disease were reviewed at skeletal maturity in the orthopaedic departments of Leuven, Belgium, and Montpellier, France. The two groups were very similar as to age at onset of the disease, severity of involvement, and classification at skeletal maturity. The results seem to indicate that bilateral disease runs a more severe course as compared with unilateral Legg-Calvé-Perthes disease. Eighty percent presented with a Catterall group III and IV and Herring classification B and C. Forty-eight percent rated as Stulberg 4 and 5 at skeletal maturity.