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PURPOSE In neuroblastoma (NB), the ALK receptor tyrosine kinase can be constitutively activated through activating point mutations or genomic amplification. We studied ALK genetic alterations in high-risk (HR) patients on the HR-NBL1/SIOPEN trial to determine their frequency, correlation with clinical parameters, and prognostic impact. MATERIALS AND METHODS Diagnostic tumor samples were available from 1,092 HR-NBL1/SIOPEN patients to determine ALK amplification status (n 5 330), ALK mutational profile (n 5 191), or both (n 5 571). RESULTS Genomic ALK amplification (ALKa) was detected in 4.5% of cases (41 out of 901), all except one with MYCN amplification (MNA). ALKa was associated with a significantly poorer overall survival (OS) (5-year OS: ALKa [n 5 41] 28% [95% CI, 15 to 42]; no-ALKa [n 5 860] 51% [95% CI, 47 to 54], [P , .001]), particularly in cases with metastatic disease. ALK mutations (ALKm) were detected at a clonal level (. 20% mutated allele fraction) in 10% of cases (76 out of 762) and at a subclonal level (mutated allele fraction 0.1%-20%) in 3.9% of patients (30 out of 762), with a strong correlation between the presence of ALKm and MNA (P , .001). Among 571 cases with known ALKa and ALKm status, a statistically significant difference in OS was observed between cases with ALKa or clonal ALKm versus subclonal ALKm or no ALK alterations (5-year OS: ALKa [n 5 19], 26% [95% CI, 10 to 47], clonal ALKm[n565] 33% [95% CI, 21 to 44], subclonal ALKm(n522) 48% [95% CI, 26 to 67], and no alteration [n 5 465], 51% [95% CI, 46 to 55], respectively; P 5 .001). Importantly, in a multivariate model, involvement of more than one metastatic compartment (hazard ratio [HR], 2.87; P , .001), ALKa (HR, 2.38; P 5 .004), and clonal ALKm (HR, 1.77; P 5 .001) were independent predictors of poor outcome. CONCLUSION Genetic alterations of ALK (clonal mutations and amplifications) in HR-NB are independent predictors of poorer survival. These data provide a rationale for integr

PURPOSE In neuroblastoma (NB), the ALK receptor tyrosine kinase can be constitutively activated through activating point mutations or genomic amplification. We studied ALK genetic alterations in high-risk (HR) patients on the HR-NBL1/SIOPEN trial to determine their frequency, correlation with clinical parameters, and prognostic impact. MATERIALS AND METHODS Diagnostic tumor samples were available from 1,092 HR-NBL1/SIOPEN patients to determine ALK amplification status (n 5 330), ALK mutational profile (n 5 191), or both (n 5 571). RESULTS Genomic ALK amplification (ALKa) was detected in 4.5% of cases (41 out of 901), all except one with MYCN amplification (MNA). ALKa was associated with a significantly poorer overall survival (OS) (5-year OS: ALKa [n 5 41] 28% [95% CI, 15 to 42]; no-ALKa [n 5 860] 51% [95% CI, 47 to 54], [P , .001]), particularly in cases with metastatic disease. ALK mutations (ALKm) were detected at a clonal level (. 20% mutated allele fraction) in 10% of cases (76 out of 762) and at a subclonal level (mutated allele fraction 0.1%-20%) in 3.9% of patients (30 out of 762), with a strong correlation between the presence of ALKm and MNA (P , .001). Among 571 cases with known ALKa and ALKm status, a statistically significant difference in OS was observed between cases with ALKa or clonal ALKm versus subclonal ALKm or no ALK alterations (5-year OS: ALKa [n 5 19], 26% [95% CI, 10 to 47], clonal ALKm[n565] 33% [95% CI, 21 to 44], subclonal ALKm(n522) 48% [95% CI, 26 to 67], and no alteration [n 5 465], 51% [95% CI, 46 to 55], respectively; P 5 .001). Importantly, in a multivariate model, involvement of more than one metastatic compartment (hazard ratio [HR], 2.87; P , .001), ALKa (HR, 2.38; P 5 .004), and clonal ALKm (HR, 1.77; P 5 .001) were independent predictors of poor outcome. CONCLUSION Genetic alterations of ALK (clonal mutations and amplifications) in HR-NB are independent predictors of poorer survival. These data provide a rationale for integr

Comparative international data on patterns of inequality in child welfare interventions, for example, the proportion of children about whom there are substantiated child protection concerns or who are in out-of-home care, are far less developed than data about inequalities in health. Few countries collect reliable, comprehensive information and definitions, methods of data collection and analysis are rarely consistent. The four UK countries (England, Northern Ireland, Scotland and Wales) provide a potential ‘natural experiment’ for comparing intervention patterns. This study reports on a large quantitative, descriptive study focusing on children in contact with children’s services on a single date in 2015. It found that children’s chances of receiving a child protection intervention were related to family socio-economic circumstances, measured by neighbourhood deprivation, within all four countries. There was a strong social gradient which was significantly steeper in some countries than others. Ethnicity was another important factor underlying inequalities. While inequalities in patterns of intervention between the four countries were considerable, they did not mirror relative levels of deprivation in the child population. Inequalities in intervention rates result from a combination of demand and supply factors. The level and extent of inequity raise profound ethical, economic and practical challenges to those involved in child protection, the wider society and the state.

Comparative international data on patterns of inequality in child welfare interventions, for example, the proportion of children about whom there are substantiated child protection concerns or who are in out-of-home care, are far less developed than data about inequalities in health. Few countries collect reliable, comprehensive information and definitions, methods of data collection and analysis are rarely consistent. The four UK countries (England, Northern Ireland, Scotland and Wales) provide a potential ‘natural experiment’ for comparing intervention patterns. This study reports on a large quantitative, descriptive study focusing on children in contact with children’s services on a single date in 2015. It found that children’s chances of receiving a child protection intervention were related to family socio-economic circumstances, measured by neighbourhood deprivation, within all four countries. There was a strong social gradient which was significantly steeper in some countries than others. Ethnicity was another important factor underlying inequalities. While inequalities in patterns of intervention between the four countries were considerable, they did not mirror relative levels of deprivation in the child population. Inequalities in intervention rates result from a combination of demand and supply factors. The level and extent of inequity raise profound ethical, economic and practical challenges to those involved in child protection, the wider society and the state.

Thesis: M. Arch., Massachusetts Institute of Technology, Department of Architecture, 2018., Cataloged from PDF version of thesis., Leaks, demolitions, vacancy and ruins. Our City, What Ruins is a double entendre we use to describe the conditions of urban life at the peak time of our practice. On the one hand, one third of the land lay vacant, transforming into blight, and targeted for demolition. The city was the world's flagship destination for wonders of the modern day ruin. We declared the largest federal bankruptcy in the nation's history, and our democratically elected officials were on their way to prison. It was clear the ruin landscape was an allegory for a failing system from the top down. On the other hand, Our City, What Ruins willfully drops the connotations associated with the ruins and the blight that surrounds them, and the bodies who still call the neighborhoods home. Our practice was born out of a necessity we saw to fill a void in society; a collectively led spatial justice practice that was willing to work both nefariously and legally, on the psyche and on the land, on damaged histories and invented futures. We advocate for an expanded agency of the architect; especially in landscapes of divestment and subtraction. This thesis explores spatial and socio economic tactics relating to rebranding of the body, community wealth building and emancipatory infrastructures in the form of drawings, models, slides, legal documents, literature, animation, collage and various other materials and documentation from the time of our practice. All of this presented in the very bureaus we discovered and rescued from a school tainted for demolition. Just as our practice worked to unravel the failed bureaucracy that helped produce Our City, we dive into our bureaus to question What Ruins?, by Martin Joshua Holmblade Elliott., M. Arch.

Thesis: M. Arch., Massachusetts Institute of Technology, Department of Architecture, 2018., Cataloged from PDF version of thesis., Leaks, demolitions, vacancy and ruins. Our City, What Ruins is a double entendre we use to describe the conditions of urban life at the peak time of our practice. On the one hand, one third of the land lay vacant, transforming into blight, and targeted for demolition. The city was the world's flagship destination for wonders of the modern day ruin. We declared the largest federal bankruptcy in the nation's history, and our democratically elected officials were on their way to prison. It was clear the ruin landscape was an allegory for a failing system from the top down. On the other hand, Our City, What Ruins willfully drops the connotations associated with the ruins and the blight that surrounds them, and the bodies who still call the neighborhoods home. Our practice was born out of a necessity we saw to fill a void in society; a collectively led spatial justice practice that was willing to work both nefariously and legally, on the psyche and on the land, on damaged histories and invented futures. We advocate for an expanded agency of the architect; especially in landscapes of divestment and subtraction. This thesis explores spatial and socio economic tactics relating to rebranding of the body, community wealth building and emancipatory infrastructures in the form of drawings, models, slides, legal documents, literature, animation, collage and various other materials and documentation from the time of our practice. All of this presented in the very bureaus we discovered and rescued from a school tainted for demolition. Just as our practice worked to unravel the failed bureaucracy that helped produce Our City, we dive into our bureaus to question What Ruins?, by Martin Joshua Holmblade Elliott., M. Arch.

The practice of extended family and friends helping to care for children when their parents are unable to is an enduring tradition in many cultures. Kinship care provides the largest proportion of out of home care in Western society but many of these carers experience poverty and deprivation, and do not receive comparable levels of support, financial or professional, to other placement types. This study provides UK evidence for the relationship between kinship care and deprivation and examines how the welfare state frames kinship care in policy and practice.

The practice of extended family and friends helping to care for children when their parents are unable to is an enduring tradition in many cultures. Kinship care provides the largest proportion of out of home care in Western society but many of these carers experience poverty and deprivation, and do not receive comparable levels of support, financial or professional, to other placement types. This study provides UK evidence for the relationship between kinship care and deprivation and examines how the welfare state frames kinship care in policy and practice.

IN 1999 AND EARLY 2000, THE ASSOCIATION FOR European Paediatric Cardiology published the European Paediatric Cardiac Code as independent but linked Short and Long Lists, containing 650 and 3876 primary terms respectively. The historical background and rationale for development of this coding system has been previously detailed, but essentially it followed a series of meeting of the coding committee of the Association between 1997-1999, during which a pre-existing Long List was adopted and then used to create the condensed Short List. The system was published as the recommended standard coding system for use across Europe, covering the diagnosis and therapy of children with congenital and acquired cardiac disease. The scope of the lists was to encompass the needs of all those involved with such patients, from the fetal cardiologist through to the specialist in adult congenital heart disease; and from the general paediatric cardiologist and cardiac surgeon, to those specialising in transcatheter interventions, paediatric electrophysiology, and paediatric echocardiographers. In addition, the code was crossmapped to the 9th and 10th revisions of the International Classification of Diseases ("ICD-9” and "ICD-10”) provided by the World Health Organisation in order to facilitate returns to central government, a requirement in most countries. In so doing, it was hoped to address the concerns of many centres that such information submitted by professional coding staff was often inaccurate due to the complex nature of congenital cardiac disease, together with the limited scope and vague terminology of the International listings

Objectives: One-stage repair of transposition of great arteries (TGA) and aortic arch obstruction (AAO) is currently advocated, but carries formidable surgical challenges. This report presents our experience and re-interventions for residual lesions over the last 10 years. Methods: Twenty-two patients (19.5±42.4 days; range 2-206; median 10 days, 3.5±0.6kg) diagnosed with TGA (nine patients) or double outlet right ventricle (DORV) (13 patients) and AAO underwent one-stage repair. Of the nine TGA patients (two with intact ventricular septum), AAO were: two patients hypoplastic arch, one patient discrete coarctation, four patients hypoplastic arch with coarctation and two patients interrupted aortic arch. The 13 DORV patients were all of Taussig-Bing type and one showed multiple ventricular septal defects (VSDs). The degree of AAO ranged from hypoplastic arch in five patients, coarctation two patients, combined four patients and interrupted aortic arch (IAA) two patients. Arterial switch with Lecomte±VSD repair was performed during cooling, and aortic arch repair was performed under deep hypothermic circulatory arrest (DHCA) (35±14min at 16.9±0.7°C). Our preference was to use homograft patch-plasty for arch and direct end-to-side anastomosis for coarctation repair. Aortic-cross-clamp time was 124±24min and cardiopulmonary bypass (CPB) time 215±84min. Results: Early survival was 19/22 (86%) up to 30 days without mortality in the second half of our series. Three patients required extracorporeal membrane oxygenation (ECMO) support and renal support was needed in three and preferred permanent pace maker (PPM) implantation in two. Length of stay was 21.9±22.1 days. There was one late death and overall survival was 18/22 (82%) for the follow-up period of 4.8 years (0.2-9.8 years). Eight patients (44%) required re-intervention for re-coarctation. Four patients required right ventricular outflow tract (RVOT)/pulmonary artery re-interventions. At follow-up, there was no requir

The channel width-to-length ratio is an important transistor parameter for integrated circuit design. Contact diffusion into the channel during fabrication or operation alters the channel width and this important parameter. A novel methodology combining atomic force microscopy and scanning Kelvin probe microscopy (SKPM) with self-consistent modeling is developed for the nondestructive detection of contact diffusion on active devices. Scans of the surface potential are modeled using physically based Technology Computer Aided Design (TCAD) simulations when the transistor terminals are grounded and under biased conditions. The simulations also incorporate the tip geometry to investigate its effect on the measurements due to electrostatic tip-sample interactions. The method is particularly useful for semiconductor- and metal-semiconductor interfaces where the potential contrast resulting from dopant diffusion is below that usually detectable with scanning probe microscopy.

The electron transfer properties of proteins are normally measured as molecularly averaged ensembles. Through these and related measurements, proteins are widely regarded as macroscopically insulating materials. Using scanning tunnelling microscopy (STM), we present new measurements of the conductance through single-molecules of the electron transfer protein cytochrome b562 in its native conformation, under pseudo-physiological conditions. This is achieved by thiol (SH) linker pairs at opposite ends of the molecule through protein engineering, resulting in defined covalent contact between a gold surface and a platinum–iridium STM tip. Two different orientations of the linkers were examined: a long-axis configuration (SH-LA) and a short-axis configuration (SH-SA). In each case, the molecular conductance could be ‘gated’ through electrochemical control of the heme redox state. Reproducible and remarkably high conductance was observed in this relatively complex electron transfer system, with single-molecule conductance values peaking around 18 nS and 12 nS for the SH-SA and SH-LA cytochrome b562 molecules near zero electrochemical overpotential. This strongly points to the important role of the heme co-factor bound to the natively structured protein. We suggest that the two-step model of protein electron transfer in the STM geometry requires a multi-electron transfer to explain such a high conductance. The model also yields a low value for the reorganisation energy, implying that solvent reorganisation is largely absent.

The biologically and nanotechnologically important heme protein cytochrome b562 was reconstructed with zinc and copper porphyrins, leading to significant changes in the spectral, redox and electron transfer properties. The Cu form shifts the redox potential by +300 mV and exhibits high electron transfer, while the Zn form is redox inert.

The electron transfer properties of proteins are normally measured as molecularly averaged ensembles. Through these and related measurements, proteins are widely regarded as macroscopically insulating materials. Using scanning tunnelling microscopy (STM), we present new measurements of the conductance through single-molecules of the electron transfer protein cytochrome b562 in its native conformation, under pseudo-physiological conditions. This is achieved by thiol (SH) linker pairs at opposite ends of the molecule through protein engineering, resulting in defined covalent contact between a gold surface and a platinum–iridium STM tip. Two different orientations of the linkers were examined: a long-axis configuration (SH-LA) and a short-axis configuration (SH-SA). In each case, the molecular conductance could be ‘gated’ through electrochemical control of the heme redox state. Reproducible and remarkably high conductance was observed in this relatively complex electron transfer system, with single-molecule conductance values peaking around 18 nS and 12 nS for the SH-SA and SH-LA cytochrome b562 molecules near zero electrochemical overpotential. This strongly points to the important role of the heme co-factor bound to the natively structured protein. We suggest that the two-step model of protein electron transfer in the STM geometry requires a multi-electron transfer to explain such a high conductance. The model also yields a low value for the reorganisation energy, implying that solvent reorganisation is largely absent.

The biologically and nanotechnologically important heme protein cytochrome b562 was reconstructed with zinc and copper porphyrins, leading to significant changes in the spectral, redox and electron transfer properties. The Cu form shifts the redox potential by +300 mV and exhibits high electron transfer, while the Zn form is redox inert.

The electron transfer properties of proteins are normally measured as molecularly averaged ensembles. Through these and related measurements, proteins are widely regarded as macroscopically insulating materials. Using scanning tunnelling microscopy (STM), we present new measurements of the conductance through single-molecules of the electron transfer protein cytochrome b562 in its native conformation, under pseudo-physiological conditions. This is achieved by thiol (SH) linker pairs at opposite ends of the molecule through protein engineering, resulting in defined covalent contact between a gold surface and a platinum–iridium STM tip. Two different orientations of the linkers were examined: a long-axis configuration (SH-LA) and a short-axis configuration (SH-SA). In each case, the molecular conductance could be ‘gated’ through electrochemical control of the heme redox state. Reproducible and remarkably high conductance was observed in this relatively complex electron transfer system, with single-molecule conductance values peaking around 18 nS and 12 nS for the SH-SA and SH-LA cytochrome b562 molecules near zero electrochemical overpotential. This strongly points to the important role of the heme co-factor bound to the natively structured protein. We suggest that the two-step model of protein electron transfer in the STM geometry requires a multi-electron transfer to explain such a high conductance. The model also yields a low value for the reorganisation energy, implying that solvent reorganisation is largely absent.

The biologically and nanotechnologically important heme protein cytochrome b562 was reconstructed with zinc and copper porphyrins, leading to significant changes in the spectral, redox and electron transfer properties. The Cu form shifts the redox potential by +300 mV and exhibits high electron transfer, while the Zn form is redox inert.

Short chains of porphyrin molecules can mediate electron transport over distances as long as 5-10 nm with low attenuation. This means that porphyrin-based molecular wires could be useful in nanoelectronic and photovoltaic devices, but the mechanisms responsible for charge transport in single oligo-porphyrin wires have not yet been established. Here, based on electrical measurements of single-molecule junctions, we show that the conductance of the oligo-porphyrin wires has a strong dependence on temperature, and a weak dependence on the length of the wire. Although it is widely accepted that such behaviour is a signature of a thermally assisted incoherent ( hopping) mechanism, density functional theory calculations and an accompanying analytical model strongly suggest that the observed temperature and length dependence is consistent with phase-coherent tunnelling through the whole molecular junction.

Cytochrome b562 was engineered to introduce a cysteine residue at a surface-exposed position to facilitate direct self-assembly on a Au(111) surface. The confined protein exhibited reversible and fast electron exchange with a gold substrate over a distance of 20 Å between the heme redox center and the gold surface, a clear indication that a long-range electron-transfer pathway is established. Electrochemical scanning tunneling microscopy was used to map electron transport features of the protein at the single-molecule level. Tunneling resonance was directly imaged and apparent molecular conductance was measured, which both show strong redox-gated effects. This study has addressed the first case of heme proteins and offered new perspectives in single-molecule bioelectronics.

The Smithsonian Kite Festival is a spectacular event that is traditionally part of the National Cherry Blossom Festival on the National Mall in Washington, DC. Kite flyers attend from the U.S. and all over the world, filling the skies around the Washington Monument with color and beauty. Classroom students will be witnesses to the pageantry as they create their own kites, learning about math and science concepts along the way. A particular emphasis will be on the power of wind and weather. This EFT is specifically geared toward younger students, suitable for grades K-5., An electronic field trip broadcasted from the National Mall in Washington, DC., This archival material has been provided for educational purposes. Ball State University Libraries recognizes that some historic items may include offensive content. Our statement regarding objectionable content is available at: https://dmr.bsu.edu/digital/about

Background. Surgery for congenital heart disease (CHD) has changed considerably during the last three decades. The results of primary repair have steadily improved, to allow treating almost all patients within the pediatric age; nonetheless an increasing population of adult patients requires surgical treatment. The objective of this study is to present the early surgical results of patients who require surgery for CHD in the adult population within a multicentered European study population. Methods. Data relative to the hospital course of 2,012 adult patients (age >= 18 years) who required surgical treatment for CHD from January 1, 1997 through December 31, 2004 were reviewed. Nineteen cardiothoracic centers from 13 European countries contributed to the data collection. Results. Mean age at surgery was 34.4 +/- 14.53 years. Most of the operations were corrective procedures (1,509 patients, 75%), followed by reoperations ( 464 patients, 23.1%) and palliative procedures (39 patients, 1.9%). Six hundred forty-nine patients (32.2%) required surgical closure of an isolated ostium secundum atrial septal defect. Overall hospital mortality was 2%. Preoperative cyanosis, arrhythmias, and NYHA class III-IV, proved significant risk factors for hospital mortality. Follow-up data were available in 1,342 of 1,972 patients (68%) who were discharged home. Late deaths occurred in 6 patients (0.5%). Overall survival probability was 97% at 60 months, which is higher for corrective procedures (98.2%) if compared with reoperations (94.1%) and palliations (86.1%). Conclusions. Surgical treatment of CHD in adult patients, in specialized cardiac units, proved quite safe, beneficial, and low-risk.

Background There has been a sharp increase in mental health problems experienced by children and young people. Prior to the pandemic, one in eight 5-19 year olds in England had a probable mental disorder. In 2020, amongst 5-16 year olds this figure had risen to one in six. Amongst those with a mental health difficulty, almost half of older teenagers and a quarter of 11-16 year olds report having self-harmed or attempted suicide. In this context, services for young people in crisis are a UK priority, and provision is expanding. However, very little research into crisis services for young people has been undertaken. Aims This project is answering the question, ‘How are mental health crisis responses for children and young people up to the age of 25 sustained, experienced and integrated within their local systems of services’? Methods In work package (WP) 1, survey methods are being used to gather data on NHS, local authority, education and third sector approaches to the implementation and organisation of crisis care for children and young people across England and Wales. In WP2, qualitative methods underpinned by commitments to the use of normalisation process theory are being used to generate data on how services are organised, sustained, experienced and integrated in eight contrasting case studies. In WP3, findings from each case study will be compared and contrasted, and then synthesised to inform actionable lessons for policy and services. Results Our WP1 survey opened at the end of January 2023, with approaching 100 responses received from individual services by the middle of May 2023. WP2 fieldwork is scheduled to commence in summer 2023. This concurrent session opens with an introduction to our project, and summarises progress and findings to date. Further, comprehensive, findings will be presented at future MHNR conferences as the larger project progresses. Discussions/conclusions This project is funded by the National Institute for Health Research (NIHR) unde

Background There has been a sharp increase in mental health problems experienced by children and young people. Prior to the pandemic, one in eight 5-19 year olds in England had a probable mental disorder. In 2020, amongst 5-16 year olds this figure had risen to one in six. Amongst those with a mental health difficulty, almost half of older teenagers and a quarter of 11-16 year olds report having self-harmed or attempted suicide. In this context, services for young people in crisis are a UK priority, and provision is expanding. However, very little research into crisis services for young people has been undertaken. Aims This project is answering the question, ‘How are mental health crisis responses for children and young people up to the age of 25 sustained, experienced and integrated within their local systems of services’? Methods In work package (WP) 1, survey methods are being used to gather data on NHS, local authority, education and third sector approaches to the implementation and organisation of crisis care for children and young people across England and Wales. In WP2, qualitative methods underpinned by commitments to the use of normalisation process theory are being used to generate data on how services are organised, sustained, experienced and integrated in eight contrasting case studies. In WP3, findings from each case study will be compared and contrasted, and then synthesised to inform actionable lessons for policy and services. Results Our WP1 survey opened at the end of January 2023, with approaching 100 responses received from individual services by the middle of May 2023. WP2 fieldwork is scheduled to commence in summer 2023. This concurrent session opens with an introduction to our project, and summarises progress and findings to date. Further, comprehensive, findings will be presented at future MHNR conferences as the larger project progresses. Discussions/conclusions This project is funded by the National Institute for Health Research (NIHR) unde

Background There has been a sharp increase in mental health problems experienced by children and young people. Prior to the pandemic, one in eight 5-19 year olds in England had a probable mental disorder. In 2020, amongst 5-16 year olds this figure had risen to one in six. Amongst those with a mental health difficulty, almost half of older teenagers and a quarter of 11-16 year olds report having self-harmed or attempted suicide. In this context, services for young people in crisis are a UK priority, and provision is expanding. However, very little research into crisis services for young people has been undertaken. Aims This project is answering the question, ‘How are mental health crisis responses for children and young people up to the age of 25 sustained, experienced and integrated within their local systems of services’? Methods In work package (WP) 1, survey methods are being used to gather data on NHS, local authority, education and third sector approaches to the implementation and organisation of crisis care for children and young people across England and Wales. In WP2, qualitative methods underpinned by commitments to the use of normalisation process theory are being used to generate data on how services are organised, sustained, experienced and integrated in eight contrasting case studies. In WP3, findings from each case study will be compared and contrasted, and then synthesised to inform actionable lessons for policy and services. Results Our WP1 survey opened at the end of January 2023, with approaching 100 responses received from individual services by the middle of May 2023. WP2 fieldwork is scheduled to commence in summer 2023. This concurrent session opens with an introduction to our project, and summarises progress and findings to date. Further, comprehensive, findings will be presented at future MHNR conferences as the larger project progresses. Discussions/conclusions This project is funded by the National Institute for Health Research (NIHR) unde

This study seeks to address a number of important questions with regard to children in public care, commonly referred to in the UK as ‘looked-after’ children. Firstly, the study aims to identify whether there are child or placement characteristics that explain the observable variations in rates of children ‘looked-after’ between local authority areas. Secondly, it seeks to investigate the impact of poverty and social inequality on the likelihood of children becoming ‘looked-after’. Using a social inequalities lens the study seeks to identify whether there is a ‘social gradient’ in the rates at which children enter public care. Finally, the research aims to identify factors that predict a child who has experienced a period of being ‘looked-after’ re-entering care. Using six years of administrative data on children ‘looked after’ in Wales the study was undertaken using quantitative analyses of secondary data relating to approximately 15,000 ‘looked-after’ children. The research was undertaken using descriptive statistics, linear regression and binary logistic regression. The study identifies a relationship between neighbourhood level deprivation and the likelihood of children becoming ‘looked-after’. There is clear evidence of a ‘social gradient’ in the numbers of children entering care, with a corresponding increase in rates of children ‘looked-after’ for each step increase in neighbourhood level deprivation. Whilst both age and predominant category of need of children entering care are statistically correlated to a local authority’s overall rate of children ‘looked-after’, there are a number of differences not related to overall rates, which suggest differences in local social work practice. Logistic regression analysis results show that the length of a child’s initial period in care (stays of <90 days) and their age group (11-15 years) were associated with an increased likelihood of returning to care. The implications for child welfare policy and practice are consi

We describe the performance of a direct detector that uses the high mobility 2D electron gas (2DEG) formed at the AlGaAs/GaAs interface as a frequency selective absorber. The 2DEG mesa-structure is etched to form a planar periodic structure with resonant absorption properties in the submm - THz region. Electrons in the 2DEG are heated by incoming radiation above the lattice temperature and the temperature of the hot electrons is measured by Superconducting - 2DEG - Superconducting (S-2DEG-S) tunnel junctions. The estimated noise equivalent power for such a detector at 100 mK is in order of 10-18 W/Hz1/2. In this paper we present the spectral measurements and simulated results of absorption properties at 4.2 K for a resonant mesa geometry. The thermal conductance and time constant of 2D electrons are studied at 450 mK-4.2 K. We measure an electron-phonon conductance on the order of 10-17 W/K per electron at 450 mK which gives a low value of heat conductance 2DEG relative to normal metal absorbers due to the low 2DEG electron density. These devices have a combination of sensitivity and speed which makes them possible candidates for the components in future astrophysical THz instruments.

We describe a new type of Terahertz (THz) detector using a two-dimensional electron gas (2DEG) hot electron bolometer where the temperature of the electrons read out using superconducting tunnel junctions connected to the 2DEG (similar to a SINIS detector). We present measurements of the electron-phonon thermal conductivity in a high-mobility GaAs/AlGaAs 2DEG sample at 4.2 K as a function of electron temperature and magnetic field. From these measurements we estimate the sensitivity of an element in a filled array of S-2DEG-S detectors at 4.2 K to be approximately 10-14 W/[square root]Hz with a response time of 1 ns. Using measured parameters for the normal resistance of the S-2DEG-S contacts, we calculate the effect of using a voltage bias to cool the electrons in the absorber significantly from a 300 mK base temperature. In this configuration, these detectors can achieve sufficient sensitivity to detect individual THz photons.

This study seeks to address a number of important questions with regard to children in public care, commonly referred to in the UK as ‘looked-after’ children. Firstly, the study aims to identify whether there are child or placement characteristics that explain the observable variations in rates of children ‘looked-after’ between local authority areas. Secondly, it seeks to investigate the impact of poverty and social inequality on the likelihood of children becoming ‘looked-after’. Using a social inequalities lens the study seeks to identify whether there is a ‘social gradient’ in the rates at which children enter public care. Finally, the research aims to identify factors that predict a child who has experienced a period of being ‘looked-after’ re-entering care. Using six years of administrative data on children ‘looked after’ in Wales the study was undertaken using quantitative analyses of secondary data relating to approximately 15,000 ‘looked-after’ children. The research was undertaken using descriptive statistics, linear regression and binary logistic regression. The study identifies a relationship between neighbourhood level deprivation and the likelihood of children becoming ‘looked-after’. There is clear evidence of a ‘social gradient’ in the numbers of children entering care, with a corresponding increase in rates of children ‘looked-after’ for each step increase in neighbourhood level deprivation. Whilst both age and predominant category of need of children entering care are statistically correlated to a local authority’s overall rate of children ‘looked-after’, there are a number of differences not related to overall rates, which suggest differences in local social work practice. Logistic regression analysis results show that the length of a child’s initial period in care (stays of <90 days) and their age group (11-15 years) were associated with an increased likelihood of returning to care. The implications for child welfare policy and practice are consi

IN 1999 AND EARLY 2000, THE ASSOCIATION FOR European Paediatric Cardiology published the European Paediatric Cardiac Code as independent but linked Short and Long Lists, containing 650 and 3876 primary terms respectively. The historical background and rationale for development of this coding system has been previously detailed, but essentially it followed a series of meeting of the coding committee of the Association between 1997-1999, during which a pre-existing Long List was adopted and then used to create the condensed Short List. The system was published as the recommended standard coding system for use across Europe, covering the diagnosis and therapy of children with congenital and acquired cardiac disease. The scope of the lists was to encompass the needs of all those involved with such patients, from the fetal cardiologist through to the specialist in adult congenital heart disease; and from the general paediatric cardiologist and cardiac surgeon, to those specialising in transcatheter interventions, paediatric electrophysiology, and paediatric echocardiographers. In addition, the code was crossmapped to the 9th and 10th revisions of the International Classification of Diseases ("ICD-9” and "ICD-10”) provided by the World Health Organisation in order to facilitate returns to central government, a requirement in most countries. In so doing, it was hoped to address the concerns of many centres that such information submitted by professional coding staff was often inaccurate due to the complex nature of congenital cardiac disease, together with the limited scope and vague terminology of the International listings

Objectives: One-stage repair of transposition of great arteries (TGA) and aortic arch obstruction (AAO) is currently advocated, but carries formidable surgical challenges. This report presents our experience and re-interventions for residual lesions over the last 10 years. Methods: Twenty-two patients (19.5±42.4 days; range 2-206; median 10 days, 3.5±0.6kg) diagnosed with TGA (nine patients) or double outlet right ventricle (DORV) (13 patients) and AAO underwent one-stage repair. Of the nine TGA patients (two with intact ventricular septum), AAO were: two patients hypoplastic arch, one patient discrete coarctation, four patients hypoplastic arch with coarctation and two patients interrupted aortic arch. The 13 DORV patients were all of Taussig-Bing type and one showed multiple ventricular septal defects (VSDs). The degree of AAO ranged from hypoplastic arch in five patients, coarctation two patients, combined four patients and interrupted aortic arch (IAA) two patients. Arterial switch with Lecomte±VSD repair was performed during cooling, and aortic arch repair was performed under deep hypothermic circulatory arrest (DHCA) (35±14min at 16.9±0.7°C). Our preference was to use homograft patch-plasty for arch and direct end-to-side anastomosis for coarctation repair. Aortic-cross-clamp time was 124±24min and cardiopulmonary bypass (CPB) time 215±84min. Results: Early survival was 19/22 (86%) up to 30 days without mortality in the second half of our series. Three patients required extracorporeal membrane oxygenation (ECMO) support and renal support was needed in three and preferred permanent pace maker (PPM) implantation in two. Length of stay was 21.9±22.1 days. There was one late death and overall survival was 18/22 (82%) for the follow-up period of 4.8 years (0.2-9.8 years). Eight patients (44%) required re-intervention for re-coarctation. Four patients required right ventricular outflow tract (RVOT)/pulmonary artery re-interventions. At follow-up, there was no requir

United States. Bureau of mines. Report of investigations, 3867. Includes recommendations and bibliography.