Shaw N.J.,SteelHouse |
Mughal M.Z.,Royal Manchester Childrens Hospital
Archives of Disease in Childhood | Year: 2013
The first part of this review focused on the skeletal aspects of vitamin D. This second part reviews some of the available evidence that vitamin D may have a physiological extraskeletal role beyond its traditional effect on the skeleton. This aspect has influenced the definition of vitamin D deficiency and what level of vitamin D should be regarded as optimal. The recognition of the prevalence of vitamin D deficiency and insufficiency has led to debate as to whether and how we should be treating asymptomatic individuals. This review discusses the potential extraskeletal effects of vitamin D, the definition of vitamin D deficiency and our thoughts on indications for measurement and treatment.
News Article | February 15, 2017
UC Berkeley junior Ray Chen took a look around at dozens of other student projects. He scratched his head and let out a revelation of dejection. “We seem to have underplayed a bit here,” Chen said. UC Berkeley was among 30 universities and one high school that spent more than a year designing and developing railcars for a hyperloop — a high-tech transportation system popularized by billionaire entrepreneur Elon Musk. The idea is to transport people or goods at high speeds by shooting levitating pods through low-pressure tubes. Over the weekend, students had their first chance to zip their creations through a nearly mile-long test tube Musk had erected on a closed traffic lane outside SpaceX headquarters in Hawthorne. The UC Berkeley team’s creation didn’t rely on electronics as much as other schools. Its levitation system uses the natural opposition of two magnets rather than electrification to keep the pod suspended. Teams of 15 to 45 members worked through winter break to put together their pods, many of which featured aluminum chassis, an array of batteries, electronics and motors and a carbon fiber shell. They arrived in Los Angeles early last week, working around the clock on the finishing touches. In a parking lot at SpaceX, they hurdled through what many called a daunting 101-item checklist. They also went through judging by SpaceX employees. The competition is just one of a series of events expected as Musk seeks to support his idea. But neither he nor SpaceX has publicly backed the private companies trying to bring the hyperloop concept to life. SpaceX’s gigantic office complex offered a good backdrop for the hyperloop testing. Cars whirring by the test tube, helicopters and planes taking off from Hawthorne Airport and an old-school rail line beside the tube all marked the forms of transportation the hyperloop aims to best. Some put hammers and chisels to work at the last moments; others turned to WD-40, power saws and computers. Delft University of Technology from the Netherlands got its pod here by plane, but its self-made batteries weren’t allowed in air cargo, so the team went with a backup option — electrical bicycle batteries. Northeastern University shipped its pod by truck. Its project received $150,000 in funding, and included free parts, said Ben Lippolis, a senior and the team’s business lead. The University of Washington had one of the cheapest projects, coming in at $35,000, a student said. The team made many parts by hand, though it relied on batteries taken from a Honda Fit car. Lehigh University had the biggest design, coming in at 3,300 pounds — an estimated three times more than anyone else’s, according to sophomore Emma Isaacs. The pod sported batteries from Tesla and other cars and an air compressor that allowed it to levitate for 45 minutes. Isaacs described Lehigh’s as the closest of the entrants to a commercially viable design. Despite that, her team plans to take a new approach in the coming months. The hope is that it will get another crack at the SpaceX tube later this year and perform better. The accusations against Culver City start-up SteelHouse “were vicious,” said its founder and Chief Executive Mark Douglas. But an investor in the online ad software company attempted to set Douglas straight about the allegations made by French rival Criteo in a lawsuit last summer. “‘If we’re getting attacked, we must be doing something right,’” Douglas recalled the investor telling him. The way he saw it, Criteo had to have been scared about losing business to SteelHouse and wanted a way to slow it down. Morale slumped at SteelHouse as the companies argued back and forth in court for several months. The allegations seemed to add further evidence to growing questions about the integrity of the online advertising ecosystem. An estimated billions of dollars are lost each year to ads that never end up in front of people’s eyes, and here again another company had been caught in numbers controversy. SteelHouse’s software enables about 500 customers to analyze website visitors, decide what kinds of people to advertise to, design the ad and set pricing conditions and goals. SteelHouse handles the rest, including buying the ad. It charges a $1 fee for every 1,000 ads shown. Many clients stopped working with SteelHouse, swinging the company to a slight loss last year. It declined to disclose other financial details. “No customer wanted to be a part of this, and both companies lost some customers and that’s unfortunate,” Douglas said. The lawsuit came to a surprising conclusion in the fall, though. The two companies reached an undisclosed settlement, releasing a statement saying that the battle led to greater appreciation of each other’s businesses. “I think I can say very emphatically, we were very pleased with the outcome,” said Peter Lee, an investor at SteelHouse shareholder Baroda Ventures. “How quickly it was resolved and that outcome given that they came after us, it was a thrill.” Issues addressed in the lawsuit were ameliorated but SteelHouse didn’t overhaul its policies or procedures as a result, Douglas said. “I don’t believe in swinging the pendulum out of fear,” he said. Douglas also insists that the lawsuit had no effect on the results customers received. Though some former customers mentioned in the lawsuit have continued to stay away, employees have largely stuck around. Some were able to cash out their shares last year. They also benefit from a three-day weekend once a month and a long list of perks, including a dog run and creekside view at one of the company’s two Culver City offices. SteelHouse employs about 250 people, with plans to hire 100 this year. The kind of online ads SteelHouse helps spread across the Web remain a target of criticism from consumers and privacy advocates. But Douglas says the world loves free content, giving him optimism that SteelHouse’s role won’t be diminished anytime soon. He says website owners just need to acknowledge some of the ads they display are counterproductive and sacrifice the short-term gains they bring. Elsewhere in the Los Angeles advertising technology world, Rubicon Project is gauging its next steps as it struggles to keep pace with competitors.
Current Opinion in Clinical Nutrition and Metabolic Care | Year: 2012
Purpose of Review: Since the 1970s, it has been known that the supplementation of trace elements with parenteral nutrition is required in order to avoid the clinical manifestations of their deficiencies. However, the correct level of requirements of these trace elements, particularly in paediatrics, has provided some debate. The recent developments might help revise some of the current recommendations, particularly in short-term parenteral nutrition provision. Recent Findings: Parenterally fed preterm neonates require routine addition of zinc. Provision of chromium and manganese in parenteral nutrition should be limited, particularly for short-term patients. Newer parenteral iron preparations provide the opportunity for a safer and larger dose of administration. Summary: Clinicians should prescribe according to the individual requirements and revise the routine practice of providing 'all in one' parenteral trace elements preparations, as these products do not reflect or allow tailored provision in paediatrics and may increase the risk of toxicity. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Early Human Development | Year: 2010
Parenteral nutrition liver disease (PNLD) develops in 40-60% of infants who require long-term PN for intestinal failure. The clinical spectrum includes hepatic steatosis, cholestasis, cholelithiasis, and hepatic fibrosis. Progression to biliary cirrhosis and the development of portal hypertension and liver failure occurs in a minority who require combined liver and intestinal transplantation.The pathogenesis is multifactorial and is related to prematurity, low birth weight, duration of PN, short bowel syndrome requiring multiple laparotomies and recurrent sepsis. Other important mechanisms include lack of enteral feeding which leads to reduced gut hormone secretion, reduction of bile flow and biliary stasis which leads to the development of cholestasis, biliary sludge and gallstones, which exacerbate hepatic dysfunction, especially in premature neonates with immature hepatic function.The use of lipid emulsions, particularly soy bean emulsions have been associated with hepatic cholestasis in children, although there are little data now to support toxicity from other PN components.Management strategies for the prevention of parenteral nutrition liver disease include consideration of early enteral feeding, a multidisciplinary approach to the management of parenteral nutrition with a specialized nutritional care team and aseptic catheter techniques to reduce sepsis. The use of specialized lipid emulsions such as fish oil emulsions and or SMOF (Soy bean/Medium Chain Triglyceride/Olive Oil/Fish oil) improves established cholestasis and may prevent the onset.Oral administration of ursodeoxycholic acid may improve bile flow and reduce gall bladder stasis, although there is little data to suggest that prophylactic use prevents the onset of PNLD.Survival following either isolated small bowel or combined liver and small bowel transplantation is approximately 50% at 5. years making this an acceptable therapeutic option in children with irreversible liver and intestinal failure. © 2010.
Early Human Development | Year: 2010
Retinoblastoma is the commonest primary ocular malignancy of childhood. There are two forms - heritable and non heritable. Heritable retinoblastoma is a cancer susceptibility syndrome. Presentation is in the first few years of life, sometimes in the neonatal period. Early detection and prompt treatment can give cure rates up to 95% for intraocular tumours, but extraocular disease carries a very high mortality. The diagnosis is essentially clinical and biopsy is contraindicated due to the risk of extraocular spread. Treatment requires significant multidisciplinary input, with local ophthalmic treatment, systemic chemotherapy and external beam or plaque radiotherapy, or surgery to remove the affected eye. Screening of family members is essential for early detection. Lifelong surveillance of mutation carriers is needed due to the risk of second cancers. Newer treatment modalities including intra-arterial chemotherapy have been added to the therapeutic armamentarium in recent years. © 2010 Elsevier Ireland Ltd.
Pediatric Transplantation | Year: 2011
Pediatric liver transplantation is now so successful that we expect more than 80% of children to survive into adolescence and adulthood. As the focus of care shifts toward long-term patient management, immunosuppressive regimens should, in addition to preventing acute and chronic rejection, promote good quality of life and be free of significant long-term side effects. Historically, the most effective immunosuppressive regimens have been based on induction with a combination of calcineurin inhibitors (cyclosporin or tacrolimus) and steroids. Usually, maintenance is monotherapy with cyclosporin or tacrolimus or dual therapy with low-dose alternate-day steroids to encourage growth. A number of studies, including long-term follow-up, have shown significantly lower incidences of rejection, hypertension, hyperlipidemia and cosmetic side effects in patients treated initially with tacrolimus compared with cyclosporin. The use of anti-interleukin-2 inhibitors as induction therapy, with low-dose tacrolimus or in combination with mycophenolate mofetil, has a key role in preventing significant renal dysfunction and reducing infection and rejection. Steroid-free immunosuppression is also proving to be an effective option for the management of pediatric liver recipients. The main challenges now facing pediatricians include ensuring long-term quality of life, optimizing immunosuppression while preventing associated adverse events, and managing a smooth transition from childhood to adolescence and adulthood. © 2010 John Wiley & Sons A/S.
British Journal of Haematology | Year: 2010
Thrombosis in children may result in vascular occlusion and a potential loss of viability in skin, limbs or organs, or lead to the development of post thrombotic syndrome. Thrombolysis may prevent such complications, and the use of thrombolytics in children has increased in the last three decades. Despite this, optimum paediatric treatment regimens for these drugs remain uncertain, and accurate efficacy and safety profiles for thrombolytics are limited by the lack of controlled, prospective studies in well-defined patient populations. Restoration of vessel patency has often been achieved but the risk of intracranial and other major haemorrhage secondary to thrombolysis continues to be a significant concern for the clinician deciding on such treatment. This review summarises the use of thrombolytic treatment in children and describes outcome data and adverse events following treatment, as well as the limitations of published studies on paediatric thrombolysis. © 2009 Blackwell Publishing Ltd.
BJU International | Year: 2011
Primary vesico-ureteric reflux is a common condition in childhood associated with bladder dysfunction and an increased risk of urinary tract infection. Recent evidence indicates a lower tract functional abnormality in its pathogenesis. Whilst spontaneous resolution will occur in many, some patients will go on to develop complications in adulthood including reflux nephropathy, hypertension, urinary tract infection, bladder dysfunction and complications of pregnancy. An evolving understanding of the natural history has seen radical changes in management. Evidence for management of the child with primary vesico-ureteric reflux is reviewed with a focus on the implications on long-term outcomes in adulthood. © 2011 BJU INTERNATIONAL.
Paediatric Anaesthesia | Year: 2012
The pediatric epidural is an accepted method of advanced analgesia in children. Newer techniques have now superseded pediatric epidural analgesia (PEA), being as effective and safer, especially with the advances in ultrasonography. PEA is, however, still an important technique to master and employ, and it may be that the indications for this mode of analgesia have now become more defined. © 2011 Blackwell Publishing Ltd.
News Article | December 6, 2016
LOS ANGELES--(BUSINESS WIRE)--Marketing technology is earning a bigger and more critical role within the advertising ecosystem, but with that comes many challenges. Today’s marketers are deploying an average of five technology solutions to buy digital media, according to a recent study jointly conducted by Forrester Consulting and SteelHouse, an advertising software company. SteelHouse commissioned Forrester to survey 153 marketing decision-makers in the US. The majority of survey respondents pointed to a lack of transparency from vendors – including a lack of information sharing on the pricing of media buys – as the greatest challenge they face when managing digital advertising. “We’re committed to not only understanding the challenges marketers face, but also providing the transparency this industry needs to allow buyers and sellers to efficiently and effectively drive ads to consumers,” said Mark Douglas, SteelHouse President and CEO. The survey revealed a number of areas marketers are facing, including: Further, the study finds that a single platform approach with the right pricing model can help. Eighty-six percent of respondents said a single platform would have a high impact on the ability to measure marketing’s impact on business as a whole. Additionally, marketers who preferred cost-per-impression (CPM) pricing said they were more likely to report increased performance. To view the related infographic and to download the full study, click here. In this study, Forrester Consulting conducted an online survey of 153 marketing decision-makers with a title of manager or higher to evaluate from companies in US businesses with 500 or more team members. SteelHouse provides software for brands, agencies, and direct marketers. The SteelHouse Advertising Suite gives premium brands worldwide everything they need to run acquisition and retention campaigns through display, mobile, and social. With the SteelHouse Creative Suite anyone can create beautiful ads using the content around them.