scholarly journals Aerosol box for intubation of patients with suspected COVID-19: simulation study

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Saúl Álvarez Robles ◽  
Claudia Consuelo Torres Contreras ◽  
Raquel Rivera Carvajal ◽  
Víctor Manuel Lucigniani Ariza ◽  
Sonia Margarita Vivas García
Keyword(s):  
Multivariate Regression ◽  
Macintosh Laryngoscope ◽  
Orotracheal Intubation ◽  
Protective Equipment ◽  
Multivariate Regression Model ◽  
Intubation Difficulty ◽  
Hazard Ratios ◽  
High Level ◽  
First Time ◽  
Anesthesia Residents

Introduction. Endotracheal intubation is a procedure associated with a high level of exposure to the COVID-19 virus. This has led to the search of alternatives to reduce the risk of contamination, including the so-called aerosol box. Objective: To compare time and difficulty of orotracheal intubation when using the aerosol box in a simulated setting. Methodology: Observational study conducted with the participation of 33 anesthetist physicians and anesthesia residents; groups were compared in terms of time and intubation difficulty using a conventional Macintosh laryngoscope and the McGRATH™ MAC (Medtronic) videolaryngoscope with or without aerosol box. In order to determine performance with the intubation maneuver, crude hazard ratios were estimated, and a Cox multivariate regression model was built, adjusted by anesthetist years of experience and difficulties during the procedure. Results: On average, the aerosol box increased intubation time by 7.57 seconds (SD 8.33) when the videolaryngoscope was used, and by 6.62 (SD 5.74) with the Macintosh. Overall, 132 intubations were performed, with 121 successful and 6 failed first-time attempts (4 with the use of the aerosol box); 16 participants (48.48%) reported difficulty handling the box. With the use of the Macintosh, intubation was found to be faster than with the videolaryngoscope (cHR: 1.36 [95% CI 0.64-2.88]; adjusted HR: 2.20 [95% CI 0.73-6.62]). Conclusions: The use of the aerosol box and personal protective equipment in a simulation setting hinders the intubation maneuver and may result in protracted execution time.

scholarly journals Comparison of McGrath Videolaryngoscope and Macintosh Laryngoscope in Children with Torticollis: Randomized Controlled Trial

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1171
Author(s):  
Min Hur ◽  
Jong Yeop Kim ◽  
Sang Kee Min ◽  
Kyuheok Lee ◽  
Young Ju Won ◽  
...  
Keyword(s):  
Success Rate ◽  
Controlled Trial ◽  
Macintosh Laryngoscope ◽  
Orotracheal Intubation ◽  
Difficulty Level ◽  
Intubation Time ◽  
Intubation Difficulty ◽  
Lifting Force ◽  
Lehane Grade ◽  
Difficulty Scale

We investigated the efficacy of the McGrath videolaryngoscope compared with the Macintosh laryngoscope in children with torticollis. Thirty children aged 1–10 years who underwent surgical release of torticollis were randomly assigned into the McGrath and Macintosh groups. Orotracheal intubation was performed by a skilled anesthesiologist. The primary outcome was the intubation time. The Cormack–Lehane grade, lifting force, intubation difficulty scale (IDS), difficulty level, and intubation failure rate were also assessed. The intubation time was significantly longer in the McGrath group than in the Macintosh group (31.4 ± 6.7 s vs. 26.1 ± 5.4 s, p = 0.025). Additionally, the Cormack–Lehane grades were comparable between the groups (p = 0.101). The lifting force and IDS were significantly lower in the McGrath group than in the Macintosh group (p < 0.001 and p = 0.022, respectively). No significant differences were observed with respect to endotracheal intubation difficulty and intubation success rate. Intubation-related complications were also not observed. In conclusion, compared with the Macintosh laryngoscope, the McGrath videolaryngoscope extended the intubation time and did not improve glottic visualization in children with torticollis, despite having a lesser lifting force, lower intubation difficulty scale, and similar success rate.

scholarly journals Mutations within embCAB Are Associated with Variable Level of Ethambutol Resistance in Mycobacterium tuberculosis Isolates from China

2017 ◽  
Vol 62 (1) ◽  
Author(s):  
Qing Sun ◽  
Tong-yang Xiao ◽  
Hai-can Liu ◽  
Xiu-qin Zhao ◽  
Zhi-guang Liu ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Multivariate Regression ◽  
Upstream Region ◽  
Multivariate Regression Model ◽  
Resistance Level ◽  
Content Type ◽  
Variable Level ◽  
High Level ◽  
Different Levels

ABSTRACT The EmbCAB proteins have been considered a target for ethambutol (EMB). Mutations in embCAB are known to confer most EMB resistance. However, the knowledge about the effects of embCAB mutations on the EMB resistance level and about the role of mutation-mutation interactions is limited in China. Here, we sequenced embCAB among 125 Mycobacterium tuberculosis isolates from China and quantified their EMB MICs by testing growth at 10 concentrations. Furthermore, a multivariate regression model was established to assess the effects of both individual mutations and multiple mutations. Our results revealed that in China, 82.6% of EMB-resistant isolates (71/86 isolates) harbored at least one mutation within embCAB. Most of the mutations were located in the embB and embA upstream region. Several individual mutations and multiple mutations within this region contributed to the different levels of EMB resistance. Their effects were statistically significant. Additionally, there was an association between high-level EMB resistance and multiple mutations.

A Confrontation between Two Doctrines: The Birth of Struggle for Hegemony in Hebrew Children's Literature during the 1930s and 1940s

2008 ◽  
Vol 1 (2) ◽  
pp. 139-155 ◽  
Author(s):  
YAEL DARR
Keyword(s):  
Children's Literature ◽  
Educational System ◽  
Single Channel ◽  
Children’S Literature ◽  
The Political ◽  
Literary Creation ◽  
History Of ◽  
High Level ◽  
First Time ◽  
Literary Quality

This article describes a crucial and fundamental stage in the transformation of Hebrew children's literature, during the late 1930s and 1940s, from a single channel of expression to a multi-layered polyphony of models and voices. It claims that for the first time in the history of Hebrew children's literature there took place a doctrinal confrontation between two groups of taste-makers. The article outlines the pedagogical and ideological designs of traditionalist Zionist educators, and suggests how these were challenged by a group of prominent writers of adult poetry, members of the Modernist movement. These writers, it is argued, advocated autonomous literary creation, and insisted on a high level of literary quality. Their intervention not only dramatically changed the repertoire of Hebrew children's literature, but also the rules of literary discourse. The article suggests that, through the Modernists’ polemical efforts, Hebrew children's literature was able to free itself from its position as an apparatus controlled by the political-educational system and to become a dynamic and multi-layered field.

scholarly journals Evaluation of the Circularity of Recycled PLA Filaments for 3D Printers

2020 ◽  
Vol 10 (24) ◽  
pp. 8967
Author(s):  
Victor Gil Muñoz ◽  
Luisa M. Muneta ◽  
Ruth Carrasco-Gallego ◽  
Juan de Juanes Marquez ◽  
David Hidalgo-Carvajal
Keyword(s):  
Circular Economy ◽  
Protective Equipment ◽  
Fused Filament Fabrication ◽  
Circular Loop ◽  
Material Supply ◽  
3D Printers ◽  
3D Printed ◽  
Circular Economics ◽  
High Level ◽  
Additional Value

The circular economy model offers great opportunities to companies, as it not only allows them to capture additional value from their products and materials, but also reduce the fluctuations of price-related risks and material supply. These risks are present in all kind of businesses not based on the circular economy. The circular economy also enables economic growth without the need for more resources. This is because each unit has a higher value as a result of recycling and reuse of products and materials after use. Following this circular economics framework, the Polytechnic University of Madrid (Universidad Politécnica de Madrid, UPM) has adopted strategies aimed at improving the circularity of products. In particular, this article provides the result of obtaining recycled PLA filament from waste originating from university 3D FFF (fused filament fabrication) printers and waste generated by “Coronamakers” in the production of visors and parts for PPEs (Personal Protective Equipment) during the lockdown period of COVID-19 in Spain. This filament is used in the production of 3D printed parts that university students use in their classes, so the circular loop is closed. The obtained score of Material Circularity Indicator (MCI) of this material has been calculated, indicating its high level of circularity.

scholarly journals Aberrant Expression of TLR2, TLR7, TLR9, Splicing Variants of TLR4 and MYD88 in Chronic Lymphocytic Leukemia Patients

2021 ◽  
Vol 10 (4) ◽  
pp. 867
Author(s):  
Katarzyna Skorka ◽  
Paulina Wlasiuk ◽  
Agnieszka Karczmarczyk ◽  
Krzysztof Giannopoulos
Keyword(s):  
Bone Marrow ◽  
Chronic Lymphocytic Leukemia ◽  
Cytotoxic T Cells ◽  
Lymphocytic Leukemia ◽  
Aberrant Expression ◽  
Downstream Signaling ◽  
Splicing Variants ◽  
High Level ◽  
Time To First Treatment ◽  
First Time

Functional toll-like receptors (TLRs) could modulate anti-tumor effects by activating inflammatory cytokines and the cytotoxic T-cells response. However, excessive TLR expression could promote tumor progression, since TLR-induced inflammation might stimulate cancer cells expansion into the microenvironment. Myd88 is involved in activation NF-κB through TLRs downstream signaling, hence in the current study we provided, for the first time, a complex characterization of expression of TLR2, TLR4, TLR7, TLR9, and MYD88 as well as their splicing forms in two distinct compartments of the microenvironment of chronic lymphocytic leukemia (CLL): peripheral blood and bone marrow. We found correlations between MYD88 and TLRs expressions in both compartments, indicating their relevant cooperation in CLL. The MYD88 expression was higher in CLL patients compared to healthy volunteers (HVs) (0.1780 vs. 0.128, p < 0.0001). The TLRs expression was aberrant in CLL compared to HVs. Analysis of survival curves revealed a shorter time to first treatment in the group of patients with low level of TLR4(3) expression compared to high level of TLR4(3) expression in bone marrow (13 months vs. 48 months, p = 0.0207). We suggest that TLRs expression is differentially regulated in CLL but is similarly shared between two distinct compartments of the microenvironment.

scholarly journals Revealing the constituents of Egypt’s oldest beer using infrared and mass spectrometry

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Mohamed A. Farag ◽  
Moamen M. Elmassry ◽  
Masahiro Baba ◽  
Renée Friedman
Keyword(s):  
Large Scale ◽  
Beer Brewing ◽  
Chemical Signatures ◽  
Chemical Determination ◽  
Materials Used ◽  
High Level ◽  
Beer Production ◽  
First Time ◽  
Detailed Chemical

Abstract Previous studies have shown that the Ancient Egyptians used malted wheat and barley as the main ingredients in beer brewing, but the chemical determination of the exact recipe is still lacking. To investigate the constituents of ancient beer, we conducted a detailed IR and GC-MS based metabolite analyses targeting volatile and non-volatile metabolites on the residues recovered from the interior of vats in what is currently the world’s oldest (c. 3600 BCE) installation for large-scale beer production located at the major pre-pharaonic political center at Hierakonpolis, Egypt. In addition to distinguishing the chemical signatures of various flavoring agents, such as dates, a significant result of our analysis is the finding, for the first time, of phosphoric acid in high level probably used as a preservative much like in modern beverages. This suggests that the early brewers had acquired the knowledge needed to efficiently produce and preserve large quantities of beer. This study provides the most detailed chemical profile of an ancient beer using modern spectrometric techniques and providing evidence for the likely starting materials used in beer brewing.

scholarly journals L2,1-norm regularized multivariate regression model with applications to genomic prediction

2021 ◽  
Author(s):  
Alain J Mbebi ◽  
Hao Tong ◽  
Zoran Nikoloski
Keyword(s):  
Variable Selection ◽  
Regression Model ◽  
Multivariate Regression ◽  
Statistical Testing ◽  
Supplementary Information ◽  
Nucleotide Polymorphisms ◽  
Multiple Traits ◽  
Multivariate Regression Model ◽  
Proposed Model ◽  
Iterative Optimization Algorithm

AbstractMotivationGenomic selection (GS) is currently deemed the most effective approach to speed up breeding of agricultural varieties. It has been recognized that consideration of multiple traits in GS can improve accuracy of prediction for traits of low heritability. However, since GS forgoes statistical testing with the idea of improving predictions, it does not facilitate mechanistic understanding of the contribution of particular single nucleotide polymorphisms (SNP).ResultsHere, we propose a L2,1-norm regularized multivariate regression model and devise a fast and efficient iterative optimization algorithm, called L2,1-joint, applicable in multi-trait GS. The usage of the L2,1-norm facilitates variable selection in a penalized multivariate regression that considers the relation between individuals, when the number of SNPs is much larger than the number of individuals. The capacity for variable selection allows us to define master regulators that can be used in a multi-trait GS setting to dissect the genetic architecture of the analyzed traits. Our comparative analyses demonstrate that the proposed model is a favorable candidate compared to existing state-of-the-art approaches. Prediction and variable selection with datasets from Brassica napus, wheat and Arabidopsis thaliana diversity panels are conducted to further showcase the performance of the proposed model.Availability and implementation: The model is implemented using R programming language and the code is freely available from https://github.com/alainmbebi/L21-norm-GS.Supplementary informationSupplementary data are available at Bioinformatics online.

scholarly journals Rectal Staphylococcus aureus Carriage and Recurrence After Endoscopic Sinus Surgery for Chronic Rhinosinusitis With Nasal Polyps: A Prospective Cohort Study

2021 ◽  
pp. 014556132110197
Author(s):  
Yue Peng ◽  
Zhao Liu ◽  
Zhijian Yu ◽  
Aiwu Lu ◽  
Tao Zhang
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Regression Model ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Prospective Cohort ◽  
Multivariate Regression ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Multivariate Regression Model

Objective: Chronic rhinosinusitis with nasal polyps (CRSwNPs) remains a major challenge due to its high recurrence rate after endoscopic sinus surgery (ESS). We aimed to investigate the risk factors of recurrence among patients who underwent ESS for Chronic rhinosinusitis (CRS). Methods: Prospective cohort study including 391 cases in a single institution receiving ESS were included for analysis from 2014 and 2017. Baseline characteristics including rectal Staphylococcus aureus ( S aureus) carriage in patients receiving ESS for CRSwNPs. The primary outcome was the recurrence of CRSwNPs. Multivariate regression model was established to identify independently predictive factors for recurrence. Results: Overall, 142 (36.3%) cases with recurrence within 2 years after ESS were observed in this study. After variable selection, multivariate regression model consisted of 4 variables including asthma (odds ratio [OR] = 3.41; P < .001), nonsteroidal anti-inflammatory drug allergy (OR = 2.27; P = .005), previous ESS (OR = 3.64; P < .001), and preoperative carriage of S aureus in rectum (OR = 2.34; P = .001). Conclusions: Based on our results, surgeons could predict certain groups of patients who are at high risk for recurrence after ESS. Rectal carriage of S aureus is more statistically related to the recurrence of CRSwNP after ESS compared with skin and nasal carriage.

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