BACKGROUND AND OBJECTIVE: Consensus guidelines have recommended newborn pulse oximetry screening for critical congenital heart disease (CCHD). Given that newborn oxygen saturations are generally lower at higher altitudes, the American Academy of Pediatrics and others recommend additional evaluation of the screening algorithm at altitude. Our objective was to evaluate the feasibility of newborn pulse-oximetry CCHD screening at moderate altitude (Aurora, CO; 1694 m). We hypothesized the overall failure rate would be significantly higher compared with published controls. METHODS: We enrolled 1003 consecutive infants at ≥35 weeks’ gestation in a prospective observational study. The nationally recommended protocol for CCHD screening was adhered to with the exceptions of no reflex echocardiograms being performed and providers being informed of results only if saturations were less than predefined critical values. RESULTS: There were 1003 infants enrolled, and 988 completed the screen. The overall failure rate for completed screenings was 1.1% (95% confidence interval: 0.6%–2.0%). The first 500 infants had 1.6% fail, and the last 503 infants had 0.6% fail. Among infants who failed screening, 73% failed secondary to saturations <90%, whereas saturations between 90% and 94%, persistently >3% difference, and multiple criteria were each responsible for 9% of failures. Overall, 1.6% of all infants had incomplete screening and had not passed at the time the test was stopped. CONCLUSIONS: Pulse oximetry screening failure rates at moderate altitude are significantly higher than at sea level. Larger studies with alternative algorithms are warranted at moderate altitudes.

Octreotide treatment of chylothorax in combination with dietary modifications in pediatric patients following cardiothoracic surgery resulted in a reduction of peak effusion drainage and eventual resolution in the majority of cases with few and transient side effects.

We present a new mechanism for spin-wave excitation using a pinned domain wall which is forced to oscillate at its eigenfrequency and radiates spin waves. The domain wall acts as a frequency doubler, as the excited spin waves have twice the frequency of the domain wall oscillation. The investigations have been carried out using micromagnetic simulations and enable the determination of the main characteristics of the excited spin-waves such as frequency, wavelength, and velocity. This behavior is understood by the oscillation in the perpendicular magnetization which shows two anti-nodes oscillating out of phase with respect to each other. PACS numbers:The dynamic properties of ferromagnetic thin films have attracted much attention recently. In particular, the possibility to create logic circuits harvesting magnetic features such as domain walls [1] and spin waves [2,3,4,5] is in the focus of research activities. Thus, the excitation and propagation of spin waves and their interaction with domain walls is relevant to this research interest.In this letter a new mechanism for the excitation and manipulation of spin waves is presented. In case when a pinned domain wall is excited by an external field with its eigenfrequency, a "steady-state" oscillation forms with this eigenfrequency and a distinct amplitude which is determined by the balance between energy dissipation processes due to damping and the external triggering by the applied field. The energy pumped into the system by the external field leads not only to the compensation of the damped oscillation, but also to the radiation of spin waves. It will be shown that the domain wall itself oscillates with the frequency of the externally applied field whereas the spin waves of twice that frequency are allowed to propagate.To demonstrate the principle of a spin-wave frequency doubler, micromagnetic simulations using the LLG-code [6] were performed. The used material is Ni 81 Fe 19 and standard values for this material (saturation magnetization M s =800 G, exchange constant A ex =1.05 µerg/cm 3 ) were used. The sample geometry is presented in Fig.

Pericardial effusions can be insidious, variable in presentation, and may result from a wide variety of causes. We report here a rare case of pericardial effusion in a pediatric patient secondary to infection with Mycoplasma pneumoniae that progressed to cardiac tamponade and constrictive pericarditis. The differential diagnosis of pericardial effusion is reviewed as well as current treatments for pericardial effusions and constrictive pericarditis.