Cricoid Pressure Controversies

2017 ◽  
Vol 126 (4) ◽  
pp. 738-752 ◽  
Author(s):  
M. Ramez Salem ◽  
Arjang Khorasani ◽  
Ahed Zeidan ◽  
George J. Crystal
Keyword(s):  
Cricoid Pressure ◽  
Current Status ◽  
Controversial Issues ◽  
Manual Ventilation ◽  
Gastric Tubes ◽  
Esophageal Sphincter ◽  
Effective Use ◽  
Available Information ◽  
Training Of Personnel ◽  
Regular Training

Abstract Since cricoid pressure was introduced into clinical practice, controversial issues have arisen, including necessity, effectiveness in preventing aspiration, quantifying the cricoid force, and its reliability in certain clinical entities and in the presence of gastric tubes. Cricoid pressure–associated complications have also been alleged, such as airway obstruction leading to interference with manual ventilation, laryngeal visualization, tracheal intubation, placement of supraglottic devices, and relaxation of the lower esophageal sphincter. This review synthesizes available information to identify, address, and attempt to resolve the controversies related to cricoid pressure. The effective use of cricoid pressure requires that the applied force is sufficient to occlude the esophageal entrance while avoiding airway-related complications. Most of these complications are caused by excessive or inadequate force or by misapplication of cricoid pressure. Because a simple-to-use and reliable cricoid pressure device is not commercially available, regular training of personnel, using technology-enhanced cricoid pressure simulation, is required. The current status of cricoid pressure and objectives for future cricoid pressure–related research are also discussed.

scholarly journals OVERVIEW OF RESEARCH OF MUSHROOMS IN SRI LANKA

2017 ◽  
Vol 40 (4) ◽  
pp. 399-403
Author(s):  
Samantha C. Karunarathna ◽  
Peter E. Mortimer ◽  
Jianchu Xu ◽  
Kevin D. Hyde
Keyword(s):  
Sri Lanka ◽  
Future Development ◽  
Native Species ◽  
Ornamental Plants ◽  
Current Status ◽  
Sri Lankan ◽  
Mycological Research ◽  
The Future ◽  
Available Information

According to recent estimates the mycota of Sri Lanka is highly diverse, yet it has been relatively little studied and remains poorly understood. Sri Lanka may contain up to 25,000 species of fungi, of which only a little more than 2000 are presently known, and this estimate does not take into account the large number of exotics introduced along with food, plantation, and ornamental plants. Mycological research in Sri Lanka has been limited to certain parts of the country, and the available information is widely dispersed, difficult to access, and plagued by synonymy. Commercially cultivable mushrooms were first introduced to Sri Lanka in 1985, and today both endemic and non-native species are cultivated. This paper addresses the current status of Sri Lankan mushroom research, and suggests measures which are needed to support the future development of Sri Lankan mycology.

The Effective Use of Laboratories in Undergraduate Courses

1995 ◽  
Vol 23 (2) ◽  
pp. 95-101 ◽  
Author(s):  
A. D. Grant
Keyword(s):  
Engineering Education ◽  
Laboratory Work ◽  
Current Status ◽  
Effective Use

The current status of laboratory-based teaching is reviewed, and found to be in decline. It is argued that in educational terms, this trend is undesirable and threatens the quality of engineering courses. The effectiveness of laboratory work can be assured by adopting an appropriate methodology, and an attempt has been made to identify its key elements. A class currently operating at Strathclyde is described as a case study. It is concluded that laboratories are at present under-used and under-valued but, if exploited imaginatively, they can make a major contribution to engineering education.

scholarly journals Resistance to insecticides in Heliothine Lepidoptera: a global view

1998 ◽  
Vol 353 (1376) ◽  
pp. 1735-1750 ◽  
Author(s):  
A. R. McCaffery
Keyword(s):  
Helicoverpa Zea ◽  
Resistance Management ◽  
Corn Earworm ◽  
Tobacco Budworm ◽  
Current Status ◽  
Controversial Issues ◽  
Mechanisms Of Resistance ◽  
Pyrethroid Insecticides ◽  
Global View ◽  
The Status

The status of resistance to organophosphate, carbamate, cyclodiene and pyrethroid insecticides in the heliothine Lepidoptera is reviewed. In particular, resistance in the tobacco budworm, Heliothis virescens , and the corn earworm, Helicoverpa zea , from the New World, and the cotton bollworm, Helicoverpa armigera , from the Old World, are considered in detail. Particular emphasis has been placed on resistance to the most widely used of these insecticide groups, the pyrethroids. In each case, the incidence and current status of resistance are considered before a detailed view of the mechanisms of resistance is given. Controversial issues regarding the nature of mechanisms of resistance to pyrethroid insecticides are discussed. The implications for resistance management are considered.

Effective Use of Integrated Decision Making: An Advanced Technology Model for Evaluating Fraud in Service-Based Computer and Technology Firms

2007 ◽  
Vol 4 (1) ◽  
pp. 123-137 ◽  
Author(s):  
Mary Jane Lenard ◽  
Ann L. Watkins ◽  
Pervaiz Alam
Keyword(s):  
Financial Reporting ◽  
Private Information ◽  
Manufacturing Industries ◽  
Advanced Technology ◽  
Nonfinancial Information ◽  
Technology Firms ◽  
Integrated Decision Making ◽  
Percent Accuracy ◽  
Effective Use ◽  
Available Information

Most fraud-detection models developed to date require the use of private information and focus on companies primarily in retail and manufacturing industries. In the wake of recent corporate failures, a broad spectrum of interested parties now uses publicly available information to monitor their investments. The central issue we raise in this paper is the ability of external parties to detect financial reporting fraud in service-based computer and technology organizations by using publicly available information. Utilizing both financial and nonfinancial information, we develop a model that employs logical reasoning through the use of Excel® and fuzzy logic. We predict fraud in these firms with 76.7 percent accuracy.

scholarly journals A human model of restricted upper esophageal sphincter opening and its pharyngeal and UES deglutitive pressure phenomena

2016 ◽  
Vol 311 (1) ◽  
pp. G84-G90 ◽  
Author(s):  
Hongmei Jiao ◽  
Ling Mei ◽  
Tarun Sharma ◽  
Mark Kern ◽  
Patrick Sanvanson ◽  
...  
Keyword(s):  
Contractile Function ◽  
Cricoid Pressure ◽  
Cricoid Cartilage ◽  
Oropharyngeal Dysphagia ◽  
Upper Esophageal Sphincter ◽  
The Other ◽  
Human Model ◽  
Esophageal Sphincter ◽  
Ues Opening ◽  
High Pressure Zone

Oropharyngeal dysphagia due to upper esophageal sphincter (UES) dysfunction is commonly encountered in the clinical setting. Selective experimental perturbation of various components of the deglutitive apparatus can provide an opportunity to improve our understanding of the swallowing physiology and pathophysiology. The aim is to characterize the pharyngeal and UES deglutitive pressure phenomena in an experimentally induced restriction of UES opening in humans. We studied 14 volunteers without any dysphagic symptoms (7 men, 66 ± 11 yr) but with various supraesophageal reflux symptoms. To induce UES restriction, we used a handmade device that with adjustment could selectively apply 0, 20, 30, or 40 mmHg pressure perpendicularly to the cricoid cartilage. Deglutitive pharyngeal and UES pressure phenomena were determined during dry and 5- and 10-ml water swallows × 3 for each of the UES perturbations. External cricoid pressure against the UES resulted in a significant increase in hypopharyngeal intrabolus pressure and UES nadir deglutitive relaxation pressure for all tested swallowed volumes ( P < 0.05). Application of external cricoid pressure increased the length of the UES high pressure zone from 2.5 ± 0.2 to 3.1 ± 0.2, 3.5 ± 0.1, and 3.7 ± 0.1 cm for 20, 30, and 40 mmHg cricoid pressure, respectively ( P < 0.05). External cricoid pressure had no significant effect on pharyngeal peristalsis. On the other hand, irrespective of external cricoid pressure deglutitive velopharyngeal contractile integral progressively increased with increased swallowed volumes ( P < 0.05). In conclusion, acute experimental restriction of UES opening by external cricoid pressure manifests the pressure characteristics of increased resistance to UES transsphincteric flow observed clinically without affecting the pharyngeal peristaltic contractile function.

Manipulating a synchronous or separatist group orientation to improve performance on a hidden profile task

2016 ◽  
Vol 21 (1) ◽  
pp. 57-72 ◽  
Author(s):  
Miranda R. Kolb ◽  
Lyn M. van Swol
Keyword(s):  
Value Similarity ◽  
Group Orientation ◽  
Minority Member ◽  
Or Groups ◽  
Shared Information ◽  
Group Members ◽  
Hidden Profile ◽  
Effective Use ◽  
Available Information ◽  
Selection Of

Effective use of available information is a problem that plagues group decision-making tasks. Groups heavily favor shared information, or information that is known to all group members, which can lead to incorrect decisions and selection of inferior alternatives. However, groups may be less prone to overlooking unshared information if they are focused to value uniqueness and novel input from group members. The present research demonstrates that groups that value uniqueness, or a separatist orientation, correctly solved a hidden profile task more often than groups with a synchronous orientation, or groups that value similarity. Separatist groups repeated more unshared information than synchronous overall. Separatists also repeated more shared information than synchronous groups. Further, groups with a correct minority member also repeated more unshared information than groups with either a majority correct or no correct members. Results are discussed in terms of group focus and biases that affect the discussion of information.

Current status and controversial issues concerning endocrine therapy for patients with recurrent breast cancer in Japan

Breast Cancer ◽  
1999 ◽  
Vol 6 (4) ◽  
pp. 344-350 ◽  
Author(s):  
Hiroshi Sonoo ◽  
Junichi Kurebayashi ◽  
Yuichi Lino ◽  
Hideo Inaji ◽  
Toru Watanabe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Recurrent Breast Cancer ◽  
Current Status ◽  
Controversial Issues ◽  
Recurrent Breast

scholarly journals The State-based Financial Control in Ukraine: Status and Directions for Improvement

2021 ◽  
Vol 10 (525) ◽  
pp. 336-340
Author(s):  
I. V. Yahodenko ◽  
◽  
O. D. Hordei ◽  
Keyword(s):  
The State ◽  
Current Status ◽  
Financial Control ◽  
Theoretical Understanding ◽  
Regulatory Authorities ◽  
Control Functions ◽  
Role Of The State ◽  
Definition Of ◽  
Effective Use

The article is aimed at disclosing the economic essence of the concept of «the State-based financial control», defining and analyzing the current status of the State-based financial control in Ukraine. The article analyzes the opinions of scholars on the definition of the conceptual apparatus of the research topic and derives a theoretical understanding of the State-based financial control. The issue of building an effective unified system of the State-based financial control is researched. The analysis of legislation norms on the implementation of the State-based financial control is carried out. The opinions of leading scholars who study the problems of control over the effective use of both the State and the local budgets together with reforms in this area are taken into account. The current status of the State-based financial control in the country is analyzed, a number of problems within the system are outlined. The characteristic shortcomings of functioning of the elements of the State-based control system are outlined (absence of a unified concept for the development of the State-based financial control, deepening of the powers of regulatory authorities, presence of a large number of normative legal acts, their outdatedness and inconsistency), the inadmissibility of duplication of control functions is emphasized. The role of the State-based audit in the formation of the successful State-based financial control in the country is determined. The risks that influence the formation of the State-based financial control are analyzed. It is concluded that the system of the State-based financial control in Ukraine does not have sufficient legal, informational, organizational, communicative, institutional and methodological provision that would meet the modern challenges of the country’s economy. Solving the problems of organization and functioning of the State-based financial control is possible by systematically improving the activities of financial control bodies, increasing the level of audit and continuous improvement of the management system within the organizations of regulatory authorities.

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