In this paper, we combine inertial sensing and sensor network technology to create a pedestrian dead reckoning system. The core of the system is a lightweight sensor-and-wireless-embedded device called NavMote that is carried by a pedestrian. The NavMote gathers information about pedestrian motion from an integrated magnetic compass and accelerometers. When the NavMote comes within range of a sensor network (composed of NetMotes), it downloads the compressed data to the network. The network relays the data via a RelayMote to an information center where the data are processed into an estimate of the pedestrian trajectory based on a dead reckoning algorithm. System details including the NavMote hardware/software, sensor network middleware services, and the dead reckoning algorithm are provided. In particular, simple but effective step detection and step length estimation methods are implemented in order to reduce computation, memory, and communication requirements on the Motes. Static and dynamic calibrations of the compass data are crucial to compensate the heading errors. The dead reckoning performance is further enhanced by wireless telemetry and map matching. Extensive testing results show that satisfactory tracking performance with relatively long operational time is achieved. The paper also serves as a brief survey on pedestrian navigation systems, sensors, and techniques.
This state-of-the-art review article aims to highlight the most recent evidence about the therapeutic options of surgical necrotizing enterocolitis, focusing on the molecular basis of the gut-brain axis in relevance to the neurodevelopmental outcomes of primary peritoneal drainage and primary laparotomy. Current evidence favors primary laparotomy over primary peritoneal drainage as regards neurodevelopment in the surgical treatment of necrotizing enterocolitis. The added exposure to inhalational anesthesia in infants undergoing primary laparotomy is an additional confounding variable but requires further study. The concept of the gut-brain axis suggests that bowel injury initiates systemic inflammation potentially affecting the developing central nervous system. Signals about microbes in the gut are transduced to the brain and the limbic system via the enteric nervous system, autonomic nervous system, and hypothalamic-pituitary axis. Preterm infants with necrotizing enterocolitis have significant differences in the diversity of the microbiome compared with preterm controls. The gut bacterial flora changes remarkably prior to the onset of necrotizing enterocolitis with a predominance of pathogenic organisms. The type of initial surgical approach correlates with the length of functional gut and microbiome equilibrium influencing brain development and function through the gut-brain axis. Existing data favor patients who were treated with primary laparotomy over those who underwent primary peritoneal drainage in terms of neurodevelopmental outcomes. We propose that this is due to the sustained injurious effect of the remaining diseased and necrotic bowel on the developing newborn brain, in patients treated with primary peritoneal drainage, through the gut-brain axis and probably not due to the procedure itself.
1 October 2011 in Obstetrical & Gynecological Survey
Atopic dermatitis (AD) is the most common pregnancy dermatosis. This evidence-based review article provides an evaluation of AD in gestation. Our literature search revealed 4 epidemiologic studies on AD in pregnancy, and a total of 55 articles that provide the basis for this review. The limitations of epidemiologic studies included herein are critically reviewed. The management of AD in gestation is reviewed with an emphasis on drug safety. Further studies are required to determine whether it is the intrinsic ("nonallergic" or "atopiform dermatitis") and/or extrinsic (IgE-associated) AD that is affected by pregnancy, and to establish the postpartum prognosis of "new atopic dermatitis" (AD presenting for the first time in pregnancy). A revision of the diagnostic criteria will allow a more accurate confirmation of the prevalence of AD, and especially "new atopic dermatitis," in pregnancy as well as differentiation of AD from specific dermatoses of pregnancy, such as prurigo and pruritic folliculitis. Addressing the above issues and unraveling the etiopathogenesis of AD in pregnancy will help clarify a suggested overlap with the above specific dermatoses.
Background. Atopic dermatitis prevalence has increased in the developed world in recent decades, and effective management is vital to improve patients’ quality of life. Methods. A prospective, randomized, case-control study with a purposive sample of 28 children, aged 6 months to 10 years, diagnosed with atopic dermatitis. Participants received bathing instructions to be followed either daily or twice a week, with a follow-up duration of 2 weeks. Improvement of symptoms over time was measured using the SCORAD (SCORing Atopic Dermatitis) tool. Results. Overall symptoms decreased significantly at follow-up compared with baseline (difference = 5.0938, confidence interval = 0.2116 to 9.9759) but the differences in scores before and after interventions were not statistically significant between the groups (difference = −1.0937, confidence interval = −5.9759 to 3.7884). Conclusions. The frequency of bathing did not seem to play an important role in the management of atopic dermatitis. Clinicians should focus on the need for adequate skin hydration.
Childhood obesity is a nationwide epidemic with an estimated 16% to 18% of children and adolescents qualifying as obese and another 21% to 24% considered overweight. Obesity has been linked to an increased risk of developing serious infections. Healthcare Cost and Utilization Project–Kids’ Inpatient Database 2009 was queried to analyze national trends in patient encounters, specifically those listing patients as comorbid obese and then identified those with urinary tract infection (UTI) as primary or secondary diagnosis. Propensity matching was used to calculate risk for UTI in the inpatient obese pediatric population. A total of 86 638 pediatric hospital admissions were enrolled in the study of which 41 819 included the diagnosis of obesity, and a UTI was diagnosed in 2445 of the cases. In a propensity-matched sample, matched for age, sex, race, and diabetes mellitus, the risk of UTI was increased by 45% in obese females. Obese males did not have a significantly increased risk for UTI.