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Electrochemistry associated with redox-active compounds enclosed inside thin carbon nanotubes.
Background and Aims We aimed to redefine the preoperative factors that may challenge the airway and safe apnea time (SAT) in the obese. Material and Methods We analyzed 834 patients with body mass index (BMI) >35 kg/m2 for their difficult airway score (DASc). DASc is a consolidation of measures of difficult airway like mask ventilation, difficult intubation, change of device, and number of personnel required. DASc varied from "0" no difficulty to "12" serious difficulty and DASc ≥6 was considered difficult. Preoperative parameters - neck circumference (NC), BMI, STOPBANG score, Mallampati score, obstructive sleep apnea grade, and waist circumference- were assessed. Results Receiver operating characteristic curve was used to identify risk factors for obese patients at DASc ≥6. The Youden index (for the best threshold, with highest sensitivity and specificity) was BMI 45 kg/m2 and NC 44.5 cm. Their absence had an 81% negative predictive value to include a difficult airway, while their presence had a positive predictive value of 55%. This further has sensitivity of 66% and specificity of 73%. The mean SAT (256 ± 6 s) was inversely related to DASc (P less then 0.001). Conclusion This study demonstrates that BMI and NC have a strong association with difficult airway in obese patients and are inversely related to SAT. Nirmatrelvir Amongst these NC is the single most important predictor of difficult airway in obese and should be used as a screening tool. Copyright © 2020 Journal of Anaesthesiology Clinical Pharmacology.Background and Aims Supraglottic airways used in pediatric surgeries are associated with a lesser number of postanesthesia respiratory complications. However, there is limited literature on the use of i-gel for pediatric laparoscopic surgery. The aim of this study is to assess the adequacy of ventilation of i-gel for pediatric laparoscopic surgery and note any associated adverse event. Material and Methods This is a single-centered prospective observational study including 119 children, aged 6 months to 18 years, scheduled for laparoscopic surgery, during a 9-month period, in a tertiary care center. I-gel was used for positive pressure ventilation, and if the post-insertion oropharyngeal seal pressure was less then 25 cm H2O, it was replaced with a tracheal tube. link2 Adequacy of ventilation and adverse events were noted. Results Data from 102 cases were analyzed (17 cases excluded tracheal intubation in 11; missing data in 6 cases). The mean oropharyngeal seal pressure was 34.2 ± 5.2 cm H2O and mean airway pressure was 16.1 ± 2.4 cm H2O. The adverse events included transient cough (10.7%), sore throat (4.9%), and desaturation (3.9%). There was no sign of respiratory distress during the recovery and no intervention was required in any child postoperatively. Conclusion I-gel provided adequate ventilation of the lungs in children undergoing laparoscopic surgery with no major adverse event. Copyright © 2020 Journal of Anaesthesiology Clinical Pharmacology.The World Health Organization (WHO) announced antimicrobial resistance (AMR) as a major threat to public health which requires that new antimicrobials need to be developed faster than ever before. The rapid development of resistance has rendered many promising antibacterials useless in treating critically ill patients. This article discusses new antibacterials, which got Food and Drug Administration (FDA) approval in the last few years, along with their key pharmacokinetic and pharmacodynamic (PK/PD) advantages, added antimicrobial spectrum, indications, strengths and weaknesses of these drugs from an intensivist point of view. A brief mention has been made on antimicrobial peptides (AMPs), bacteriophages and nanoparticles, which are likely to dominate the future of antibacterials. Finally, it must be understood that the battle against AMR can only be won by a combination of innovative therapies, good infection control practices, strong antibiotic stewardship in the hands of informed healthcare workers. Copyright © 2020 Journal of Anaesthesiology Clinical Pharmacology.Ultrasound is gaining increasing popularity among anesthesiologists as it is readily available and provides real-time imaging for various procedures. It is considered as a "visual stethoscope" of the anesthesiologist. After establishing its use in regional blocks and central venous catheter insertion, it is now finding increasing use in anticipation of difficult airway and securing and maintaining it. It has challenged the classical approach of clinical assessment of airway and allows more dynamic bedside assessment. This article attempts to briefly outline the role of ultrasound and its applications for airway management in patients. Copyright © 2020 Journal of Anaesthesiology Clinical Pharmacology.In phenotype prediction the physical characteristics of an organism are predicted from knowledge of its genotype and environment. Such studies, often called genome-wide association studies, are of the highest societal importance, as they are of central importance to medicine, crop-breeding, etc. We investigated three phenotype prediction problems one simple and clean (yeast), and the other two complex and real-world (rice and wheat). We compared standard machine learning methods; elastic net, ridge regression, lasso regression, random forest, gradient boosting machines (GBM), and support vector machines (SVM), with two state-of-the-art classical statistical genetics methods; genomic BLUP and a two-step sequential method based on linear regression. Additionally, using the clean yeast data, we investigated how performance varied with the complexity of the biological mechanism, the amount of observational noise, the number of examples, the amount of missing data, and the use of different data representations. Weal. © The Author(s) 2019.A two to three period analytical chemistry experiment has been developed which allows second year students to explore chemical color tests used to detect adulterated pharmaceuticals. Students prepare several paper analytical devices (PADs) to generate positive and negative controls antibiotics, along with cutting agents such as starch and chalk. These PADs are used to identify the active ingredients and excipients in mystery tablets prepared by their classmates. In the second part of the lab, the students select an individual color test and design an experiment to quantify their mystery pill's active pharmaceutical ingredient (API). Nearly all of the student groups were able to successfully identify adulterants present in their mystery tablets. The quantification of the mystery tablets was also successful with all but one group calculating the correct concentration within 6%. In a postlab assessment, the students identified their largest gains in their ability to analyze data and other information, skill in science writing, and learning of laboratory techniques. Copyright © 2020 American Chemical Society and Division of Chemical Education, Inc.Glaciers have shaped past and present habitats for Pacific salmon (Oncorhynchus spp.) in North America. During the last glacial maximum, approximately 45% of the current North American range of Pacific salmon was covered in ice. Currently, most salmon habitat occurs in watersheds in which glacier ice is present and retreating. This synthesis examines the multiple ways that glacier retreat can influence aquatic ecosystems through the lens of Pacific salmon life cycles. We predict that the coming decades will result in areas in which salmon populations will be challenged by diminished water flows and elevated water temperatures, areas in which salmon productivity will be enhanced as downstream habitat suitability increases, and areas in which new river and lake habitat will be formed that can be colonized by anadromous salmon. Effective conservation and management of salmon habitat and populations should consider the impacts of glacier retreat and other sources of ecosystem change. © The Author(s) 2020. Published by Oxford University Press on behalf of the American Institute of Biological Sciences.Introduction An optimal classroom acoustic environment is essential for children with hearing impairment to achieve academic success. The aim of the present study is to provide an overview of classroom listening conditions in schools for children with hearing impairment in a developing country context. Materials and Methods Noise levels were measured in 37 classrooms from four schools in Chennai, India. Teacher speech levels were measured to obtain classroom speech to noise ratio (SNR) data. The reverberation time was estimated for each classroom. Results The mean noise level and reverberation time in all classrooms exceeded recommended maximum levels. The measured SNRs were not optimal for children with hearing impairment. Observations of the classrooms revealed that acoustical treatments were inadequate. Conclusion The results indicated that Indian schools for children with hearing impairment should take steps to improve classroom listening environments. Possible solutions that may alleviate suboptimal classroom sound environments are discussed.Aim To investigate the association between the single nucleotide polymorphism in the position-889 (C/T) of the promoter region of the IL-1α gene and the susceptibility to tinnitus. Method This was a case-control study with a sample of 108 independent elderly people over 60 years of age. Information on exposure to occupational noise and tinnitus was obtained by interviews. The genetic polymorphism was analyzed by polymerase chain reaction followed by cleavage with restriction enzyme NcoI. Data were analyzed using the Chi-square test, with the significance level set at 5%. For the statistical analysis all individuals with tinnitus on the right ear were eligible. Results Among elderly with tinnitus, 42.9% had a history of exposure to occupational noise. There was statistically significant association between IL-1α gene polymorphism and tinnitus in subjects without a history of exposure to occupational noise (P  = 0.006 and χ2 = 10.39). The elderly with the T allele were less likely to have tinnitus due to occupational noise exposure when compared to those carrying the C allele. Conclusion This study suggests an association between the IL-1α gene polymorphism with susceptibility to tinnitus in individuals without a history of exposure to occupational noise. The present study demonstrated that allele T of IL-1α is a protective factor for presence and severity of tinnitus in the elderly and allele C contributes to the pathogenesis of the inflammatory response. The present observation implied the signaling IL-1α is involved in ear aging.Objective The aim is to investigate whether noise is effective on hearing screening tests of neonates born to mothers exposed to noise during pregnancy. Material and Method Screening results of 2653 infants from the period of January 2013-May 2017 were evaluated. Transient Evoked Otoacoustic Emissions (TEOAE) and Auditory Brainstem Response (ABR) were used. Infants of 65 mothers exposed to noise (LAeq 80-85 dBA/8 hours/day) during pregnancy (Week ± SD; 32.58 ± 2.71) comprised the study group while the control group consisted of infants of 2588 mothers without noise exposure. Results Among the 65 infants, 23 (35.4%) passed screening at the first emission test (OAE1); 34 (52.3%) at the second emission test (OAE2); 7 (10.8%) at the ABR stage, 1 (1.5%) infant was referred to a tertiary center. In the control group, 458 (17.7%) infants passed at OAE1; 1822 (70.4%) at OAE2; 289 (11.2%) at ABR stages, 19 (0.7%) infants were referred to a tertiary center. link3 The rate of infants that passed screening at OAE1 in the study group was high (P = 0.
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