Susquehanna Health

Infections related to neuromodulation devices such as spinal cord stimulators (SCS) and intrathecal pumps (ITPs) present complex challenges due to potential complications such as localized infections, deep infections, sepsis, and neurological injury. Prompt diagnosis requires patients and providers to be educated on wound management and sepsis symptoms for immediate medical attention. Antibiotic therapy and duration vary based on infection severity, with deep infections often requiring device removal despite recent improvements in salvage rates with aggressive initial intervention. Deep infections necessitate timely diagnosis through imaging modalities such as magnetic resonance imaging (MRI) or computed tomography (CT), followed by device removal and culture-guided antibiotic therapy, often in collaboration with infectious disease specialists and spine surgeons. ITP infections pose similar challenges along with the risk of meningitis and may require careful management of medication withdrawal symptoms during emergent pump removal. Lab monitoring may aid treatment assessment, although negative cultures can occur due to post-antibiotic exposure. Postoperative recommendations stress standardized guidelines, patient education, and vigilant surveillance, with close follow-up crucial for early infection detection and intervention. Managing device-related infections demands a multi-specialty approach to minimize complications and optimize outcomes. This paper outlines best practices for diagnosing, managing, and treating neuromodulation device infections, focusing on guiding clinical decision-making from the onset of infection through treatment and potential reimplantation.

Women giving birth in in-patient maternity units are required to complete certain education. The aim of this study was to investigate the effects of prompting on post-partum women's education engagement (time from assignment to completion) while testing the feasibility of staff nurses assisting in research. A quasi-experimental design was used with 141 women allocated by admission date to one of three groups (usual care and two intervention) between September 2014 and December 2015. Intervention group I women were quickest to engage in their education and had the shortest length of stay. Significance was found for academic attainment (df = 1, F = 6.218, p = .014), partial eta squared = 0.053 and R2 = 0.124. Women who had attended college engaged more quickly in all groups than those who had not. This statistically significant finding indicates how nurses can identify patients needing more assistance. Nurses reported no adverse effects on care.

A daily quality assurance program is needed for blood gas analyzers. While newer, more technologically advanced analyzers will calibrate automatically and detect errors, older-generation analyzers tend to require more maintenance, manual use of electrodes, and waste management related to the various solutions used.

Most hospital librarians are rather busy people. Many work in smaller libraries with little or no staff support. Many are required to take on additional responsibilities such as staff development, ...

Pneumatosis cystoides intestinalis (PCI) is the rare clinical finding of gas accumulation within the gastrointestinal wall. It can be secondary to a variety of disease processes including Crohn’s disease and systemic sclerosis. The present case describes PCI associated with pneumoperitoneum and ascites as the initial presentation of systemic sclerosis in a 64-year-old female with a history of Crohn’s disease. The diagnosis of systemic sclerosis was delayed as PCI was initially attributed Crohn’s disease. This report reviews the pathogenesis, clinical presentation, and management of PCI in relation to both diseases.

Future large-scale particle accelerators, for example, the Future Circular Collider (FCC), the Compact Linear Collider (CLIC) and the International Linear Collider (ILC), will require significant RF drive power on the order of 100 MW. Thus, an RF source with high efficiency is preferable to minimise the overall power required. Klystrons represent an attractive RF source, with the current state of the art operating at efficiencies of up to 70%. Such devices feature monotonic bunching, where at the output cavity, a number of electrons will not be in the main bunch, and instead will be present in the anti-bunch, and therefore not contributing to the output power. Therefore, novel bunching methods, such as the Core Oscillation Method (COM), are worthy of investigation. By allowing the core of the electron beam to bunch and de-bunch between successive cavities, the number of electrons contained in the final bunch can increase, and therefore improve the efficiency of the device. Numerical simulation of klystrons featuring COM will be presented, with efficiencies of up to 85% being predicted thus far.

The abstract, table of contents, and first twenty-five pages are published with permission from the Cornell University Press. For ordering information, please visit the Cornell University Press at http://www.cornellpress.cornell.edu/.

This book is not a how-to manual. Rather, it is a series of discussions on the changes in library technology either now evolving or likely to develop in the near future. In the introduction, editor...