Approaches to understanding and interpreting the risks of red blood cell transfusion in neonates

In this review, we explore how to assess potential harm related to neonatal transfusion practice. We consider different sources of information, including passive or active surveillance systems such as registries, observational studies, randomised trials and systematic reviews. Future research directions are discussed.     

Evaluating the Cost-Effectiveness of Hydrogel Rectal Spacer in Prostate Cancer Radiation Therapy

Purpose

A hydrogel rectal spacer (HRS) is a medical device that is approved by the U.S. Food and Drug Administration to increase the separation between the prostate and rectum. We conducted a cost-effectiveness analysis of HRS use for reduction in radiation therapy (RT) toxicities in patients with prostate cancer (PC) undergoing external beam RT (EBRT).

African-American Adolescents’ Weight Loss Skills Utilization: Effects on Weight Change in a Sequential Multiple Assignment Randomized Trial

Objective

Successful weight loss interventions for African-Americans adolescents are lacking. Cognitive-behavioral interventions seek to develop weight loss skills (e.g., counting calories, goal setting, managing one's environment). Little is known about how well adolescents implement such skills in their daily lives. Study aims were to (1) examine weight loss skills utilization at midpoint and end of a 6-month cognitive-behavioral/motivational interviewing weight loss sequential multiple assignment randomized trial (SMART), and (2) determine if greater skill utilization predicted weight loss at treatment end and 3 months post-treatment.

Non-linear Wave Propagation and Safety Standards for Diagnostic Ultrasound Devices

Safety standards for clinical diagnostic ultrasonic devices were developed for use in relatively low-frequency systems (1–10 MHz), under the assumption that non-linear effects would be negligible. This article reviews ways in which neglecting non-linear wave propagation affects the measurements and calculations required to comply with safety standards and U.S. Food and Drug Administration guidance that recognizes these standards. An attempt is made to evaluate whether ignoring non-linear effects could result in significant error in the exposure quantities defined in these standards at either low or high frequencies, based on published literature. This article maintains that although non-linear effects have been considered in some parts of safety standards related to hydrophone requirements, the coverage is inadequate, especially for modern equipment with high working frequencies. A new approach is required to assess the magnitude of thermal heating for recently developed high-frequency systems to incorporate non-linear effects. In contrast, the current approach for evaluating the risk of cavitation can be used after appropriate modifications.     

Suboptimal performance of rotavirus testing in a vaccinated community population should prompt laboratories to review their rotavirus testing algorithms in response to changes in disease prevalence

Rotavirus vaccine has reduced disease prevalence in many countries. Consequently, we aimed to assess the reliability of a rotavirus immunoassay in the community population of Auckland and Northland, New Zealand. Between 22 October 2015 and 31 December 2016, 2873 fecal samples were tested by enzyme immunoassay (EIA, Rotascreen II, Microgen, UK) from 2748 patients (median age 8?years, range 0–101?years). Eighty-nine (3.1%) samples were reactive; 86 samples were tested by a second method. Rotavirus was confirmed in 49/86 (57%). Positive rotavirus EIAs were more likely to be confirmed in samples from cases ≥1?year of age (positive predictive value [PPV] 61%, 95% confidence interval [CI] 50–72%, P?=?0.049) and in spring/summer (PPV 67%, 95% CI 55–78%, P?=?0.003). Reactive rotavirus tests required confirmatory testing regardless of demographic, vaccine, or seasonal factors; a review of rotavirus testing algorithms may be necessary in other vaccinated community populations.