Appraisal of Low-Cost Pushbroom Hyper-Spectral Sensor Systems for Material Classification in Reflectance.

Near infrared (NIR) remote sensing has applications in vegetation analysis as well as geological investigations. For extra-terrestrial applications, this is particularly relevant to Moon, Mars and asteroid exploration, where minerals exhibiting spectral phenomenology between 600 and 800 nm have been identified. Recent progress in the availability of processors and sensors has created the possibility of development of low-cost instruments able to return useful scientific results. In this work, two Raspberry Pi camera types and a panchromatic astronomy camera were trialed within a pushbroom sensor to determine their utility in measuring and processing the spectrum in reflectance. Algorithmic classification of all 15 test materials exhibiting spectral phenomenology between 600 and 800 nm was easily performed. Calibration against a spectrometer considers the effects of the sensor, inherent image processing pipeline and compression. It was found that even the color Raspberry Pi cameras that are popular with STEM applications were able to record and distinguish between most minerals and, contrary to expectations, exploited the infra-red secondary transmissions in the Bayer filter to gain a wider spectral range. Such a camera without a Bayer filter can markedly improve spectral sensitivity but may not be necessary.

Are Adolescent Climbers Aware of the Most Common Youth Climbing Injury and Safe Training Practices?

Finger growth plate injuries are the most common youth climbing injuries. The purpose of our study was to understand youth awareness of the most common youth climbing injury and safe training practices. We surveyed climbers, ages eight to 18 years old, at the 2017 USA Climbing Sport and Speed Youth National Championships. A total of 267 climbers completed the survey (mean age = 14 ± 2.7 years; 52% male). The A2 pulley injury was reported as the most common youth climbing injury by the largest portion of participants, 36%. The second most commonly identified injury was at the growth plate of the finger, 15% of participants, which was reported as significantly less than the A2 pulley injury, p < 0.001. Six percent of climbers reported the correct safe age to start double dyno campus board training. Roughly 18% of athletes identified growth plate injuries exclusively as a stress fracture, whereas 29.2% of those climbers self-reported as informed about finger growth plate injuries, but only 7.4% of climbers who self-reported as uninformed answered this question correctly. Misperceptions about skeletally-immature climbing injuries are prevalent amongst youth climbers. Education on the prevalence of finger growth plate injuries and the scarcity of A2 pulley injuries in youth climbers can increase diagnostic accuracy, improve care, and reduce long-term complications.

The Impact of Preventative Multimodal Analgesia on Postoperative Opioid Requirement and Pain Control in Patients Undergoing Lumbar Fusions.

STUDY DESIGN: A prospective observational study with a historical reference group. OBJECTIVES: The main objectives of this study were to determine the impact of preventative multimodal analgesia (PMA) on postoperative opioid requirements and analgesic effectiveness in patients undergoing lumbar fusion surgery. SUMMARY OF BACKGROUND DATA: PMA addresses the multiple pathways of acute and chronic pain by interfering with peripheral and central sensitization and should provide a way to achieve safer and more effective pain management with reduced opioid medication use. MATERIALS AND METHODS: This study compared postoperative opioid requirement and analgesic effect in a total of 101 patients undergoing elective, 1-level or 2-level transforaminal lumbar interbody fusion surgeries for symptomatic lumbar degenerative disk disease. The PMA patient group included 51 consecutive patients who received 1000 mg of acetaminophen, 300-900 mg of gabapentin, and 200-400 mg of celecoxib 1 hour before their index procedure. The reference group included 50 patients who received 15 mg of morphine-equivalent dose (MED) preoperatively.Multiple linear regression was used to evaluate the effect of PMA on postoperative pain and MED over 4 postoperative days, while controlling for all variables likely to influence these outcomes, including age, sex, baseline opioid use, duration of surgery, postoperative intrathecal morphine use and the administration of muscle relaxants and anticonvulsants. RESULTS: The differences in opioid requirement and postoperative pain scores were statistically significant on all 4 postoperative days. The effect size varied from -0.54 to -0.99 (34.8%-54.2% MED reduction) for the postoperative opioid requirement and from -0.59 to -1.16 (28.9%-37.3% visual analog scale reduction) for postoperative pain indicating that these measures were reduced by about ½ to 1 SD in the PMA patient group. CONCLUSIONS: PMA is a highly effective and safe method for postoperative pain management in patients undergoing elective lumbar fusion surgeries by improving pain control and reducing opioid requirement. LEVEL OF EVIDENCE: Level III.

Prospective randomized feasibility study comparing manual vs. automatic position-adaptive spinal cord stimulation with surgical leads.

BACKGROUND: The majority of patients experience uncomfortable stimulation associated with posture changes, especially when lying down. The spinal cord moves within the intrathecal space in response to positional changes affecting the size of the stimulated area accordingly and causing overstimulation or understimulation. To accommodate for positional changes, patients have to manually adjust the stimulation parameters; therefore, an automatic position-adaptive SCS was designed to address these issues. The primary objective of this study was to establish the extent of position-related variations in SCS stimulation parameters experienced by chronic pain patients implanted with surgical, laminectomy-type leads under both automatic and manual SCS conditions. METHODS: A total of 18 patients completed a single-center, prospective, non-blinded, randomized (1:1), feasibility clinical study with a two-arm crossover design. All patients undergoing SCS treatment for chronic refractory back and or leg pain associated with failed back surgery, post-laminectomy, or radicular pain syndromes that were refractory to conservative and surgical interventions were eligible for enrollment. After the manual stimulation mode, the patients were randomized to one of two study arms: manual or automatic position-adaptive stimulation and then crossed over to a different arm. All patients were followed for a total of 5 months (± 2 weeks). RESULTS: Analysis indicated statistically significant differences between therapeutic and threshold stimulation intensity for the supine position compared with all other body positions when using either automatic position-adaptive stimulation or manual stimulation, except for threshold amplitudes in the prone position for automatic stimulation. CONCLUSION: Similar variations were reported for manual and automatic stimulation intensity in response to positional changes.

Malposition of a Central Venous Catheter in Trauma: Confirmation of Placement Prevents Complications.

This case study presents the inadvertent catheterization of a traumatic hemopneumothorax. A 22-year-old man sustained multiple stab wounds, including the left chest with a resultant hemopneumothorax. Upon arrival at a Level 1 trauma center, an ipsilateral subclavian central catheter was placed, blood was freely aspirated, and because of the patient's critical status, immediately utilized for resuscitation prior to line verification by radiography. A short time later, the catheter was felt to be malpositioned, most likely in the left intrathoracic space, and removed. The patient subsequently recovered and was discharged home 3 days later.

Measuring nurses' computer competency: an analysis of published instruments.

The rapid expansion of computer-driven technologies into multiple aspects of modern healthcare suggests that many of the important competencies of the 21st century nurse will encompass mastery of computer technology. This is a comprehensive review of the published measures of computer competence during the past 12 years. Essential knowledge, attitudes, and skills were identified and classified. Multiple competency assessment instruments of varying quality were examined. Little agreement was found regarding specific computer-focused competencies necessary for nurses. Taken as a whole, however, there is consensus that the computer-competent nurse possesses a general knowledge and understanding of computer technology, coupled with a positive attitude toward computers and software. In addition, such a nurse is skillful in computer hardware and software use and able to grasp how such technology benefits nursing and the overall healthcare environment.