Comparison between the standard method and the 30° curved tongue depressor-aided technique for insertion of a laryngeal mask airway: a randomized controlled trial.

BACKGROUND: Laryngeal mask airway (LMA) has been increasingly used for airway management; however, LMA insertion can be difficult and cause adverse effects. Therefore, the rapid, safe, and effective insertion of LMA is necessary. This study aimed to compare the efficacy of the standard method with that of the 30° curved tongue depressor-aided technique for LMA insertion to determine the superior technique. METHODS: This study included 154 patients aged 18-70 years (American Society of Anesthesiologists class I or II) scheduled for general anesthesia. The patients were randomly assigned to the standard LMA insertion group (Group C, n = 77) or the 30° curved tongue depressor-aided LMA insertion group (Group T, n = 77). The primary outcome evaluated was the first-attempt success rate. The secondary outcomes were the second-attempt success rate, insertion time, fiberoptic position grade, oropharyngeal leak pressure (OPLP), and adverse events. RESULTS: The first-attempt success rate was significantly higher in Group T than in Group C (97.40% vs. 88.31%, P = 0.029). The second-attempt success rate (P = 0.209), insertion time (P = 0.340), fiberoptic position grade (P = 0.872), and OPLP (P = 0.203) were slightly improved in Group T; however, there was no statistical significance. Bleeding events were reduced in Group T than in Group C (6.49% vs. 14.29%); however, there was no statistical significance. The incidence of sore throat symptoms was significantly reduced in Group T than in Group C (5.19% vs. 15.58%, P = 0.035). CONCLUSIONS: The curved tongue depressor-aided technique significantly improved the first-attempt success rate of LMA insertion and reduced the incidence of sore throat symptoms. TRIAL REGISTRATION: KCT0004964; Registered at https://cris.nih.go.kr on April 27, 2020.

Comparison of the clinical performance of the Ambu®AuraGain™ laryngeal mask in children undergoing surgery in the supine and prone position - A prospective, non-inferiority clinical trial.

STUDY OBJECTIVE: Reports are limited regarding supraglottic airway (SGA) usage in children in the prone position. This study aimed to compare the clinical performance of the Ambu®AuraGain™, a 2nd generation SGA, in children undergoing surgery in the prone and supine positions. We hypothesized that oropharyngeal leak pressure (OLP) in the prone position would not be inferior to that in the supine position. DESIGN: Single-center, prospective, non-randomized controlled study. SETTING: Operating room. PATIENTS: One hundred and twenty-six children, American Society of Anesthesiologists (ASA) physical status I-III, aged 2-12 years, undergoing elective surgery for 2 h or less in the supine or prone position. INTERVENTIONS: After induction of general anesthesia and insertion of the AuraGain, patients were positioned either supine or prone, according to type of surgery. MEASUREMENTS: OLP immediately after surgical positioning was measured as the primary outcome. The anatomical position of the AuraGain was evaluated using a flexible fiberoptic bronchoscope (Olympus LF-DP Tracheal Intubation Fiberscope, Melville, New York, USA). Airway maneuvers performed during placement and maintenance of the AuraGain and airway-related adverse events were recorded. MAIN FINDINGS: The mean difference in OLP immediately after positioning was 0.048 cmH2O (95 % confidence interval: -1.521 to 1.616), and the non-inferiority hypothesis was accepted (P < 0.001 for non-inferiority). There was no significant difference in the anatomical position of the SGA and adverse events. Airway maneuvers were significantly more commonly performed during placement in the Prone group compared to the Supine group (51 (81.0 %) vs. 3 (4.8 %), respectively; P < 0.001). CONCLUSION: OLP when using AuraGain in the prone position in children was not inferior to that in the supine position. This suggests that the AuraGain may be an effective option for children undergoing short surgical procedures in the prone position.

Assessment of microplastic exposure in nasal lavage fluid and the influence of face masks.

Microplastics (MPs) can enter the human body through respiration and pose a hazard to human health. Wearing masks has become a routine behavior during the COVID-19 pandemic. The level of respirational exposure and the influence of wearing masks are currently unknown. We recruited 113 college students and divided them into natural exposure (NE), surgical mask (SM), and cotton mask (CM) groups. Nasal lavage fluid (NLF) was collected and MPs characteristics were analyzed using polarized light microscopy and laser direct infrared system. We found a relatively high abundance of MPs in NLF in the SM group (41.24 ± 1.73 particles/g). The particle size distribution and fibrous MP percentage significantly differed among the three groups. The main components in the NE, SM, and CM groups were polypropylene (58.70 %)，polycarbonate (PC, 49.49 %)，and PC (54.29 %). Components such as polyamide, polyethylene and polyethylene terephthalate were also detected. Wearing surgical masks increased the MP abundance in NLF (ß = 0.36, P < 0.01). As the wear time increased, the abundance of MPs also rose (ß = 0.28, P < 0.05). However, those who used bedding containing synthetic fibers had lower MP abundance in their NLF. This study highlights the use of NLF to evaluate MP exposure, which is associated with potential health risks.

Assessment of usage, reuse and disposal of thermoplastic masks among radiotherapy technologists in India: A nationwide perspective.

Purpose: Radiotherapy (RT) relies on devices like thermoplastic masks (TMs), that are made up of specialized thermoplastic polymers, and used as an immobilization tool. The study aims to assess the practice of usage and reuse of TMs among radiation therapy technologists (RTTs) in India and explore their awareness of environmental impact during disposal. Materials and Methods: A cross-sectional survey was conducted among RTTs working in different healthcare settings. A structured questionnaire designed by a team of RTTs and radiation oncologists was used to collect responses. Questionnaire encompassed data pertaining to demographics, existing patient load, daily utilisation and reuse practice of TMs, preferred method of disposal and awareness of RTTs regarding environmental consequences associated with TM disposal. Results: A total of 430 RTTs participated in the study, with a median age of 31 years and a median professional experience of 8 years. Among the participants, 213 (49.6 %) reported daily TM utilization in more than 50 patients. TM reuse was reported by 350 (81.1 %) RTTs, with 257 (60 %) reusing TMs in both curative and palliative treatments. Reuse of TMs was observed more commonly in RTTs working in government facilities (81.2 %).Regarding disposal preferences, 381 (88.6%) participants preferred discarding used TMs in biomedical waste and 64.8% of these ultimately ended up as discarded scrap. Awareness regarding adverse environmental impact associated with TM disposal was reported by 320 (74.4%) participant RTTs. Conclusion: The study highlights the prevalent practice of reuse of TMs, especially in curative treatments, government-run facilities and busy treatment settings. Additionally, it emphasises the imperative for enhanced bio-medical waste management practices to facilitate more effective handling and disposal of used TMs.

Effect of Combined Oxygen Therapy and Use of a Surgical Mask or N95 Mask on Inspired Oxygen Fraction and Expired Carbon Dioxide Fraction.

Combined use of a surgical mask and oxygen mask might decrease the inspired oxygen concentration and increase the risk of hypercapnia. We investigated the fraction of inspired oxygen (FiO2) and end-tidal carbon dioxide (ETCO2) under different combinations of masks and oxygen flows. Five healthy volunteers were administered oxygen using the following methods: oxygen mask alone (O group), oxygen mask over a surgical mask (S group), and oxygen mask over an N95 mask (N group). FiO2 and ETCO2 were measured at oxygen flow rates of 0, 5, and 8 L/min under each mask condition. At oxygen flow rates of 5 and 8 L/min, FiO2 was lower in the order of N group (0.32 at 5 L/min, 0.36 at 8 L/min), S group (0.45 at 5 L/min, 0.52 at 8 L/min), and O group (0.61 at 5 L/min, 0.73 at 8 L/min). ETCO2 was higher in the order of N, S, and O groups. In conclusion, wearing the oxygen mask over the surgical mask or N95 mask reduces FiO2 and increases ETCO2 in healthy volunteers. Since patients who have emerged from general anaesthesia are more likely to have worse respiratory conditions, they need close observation to avoid hypoxemia and hypercapnia.

Upper airway resistance during use of a laryngeal mask airway is flow-dependent and dominated by the laryngeal resistance.

During use of a laryngeal mask airway, resistance of the device and larynx contribute to the upper airway resistance. Detailed understanding of this combined resistance is crucial to support spontaneously breathing patients appropriately or to take the right measures during respiratory problems. However, their resistive behavior and which of these components determine the upper airway resistance predominantly, has not been characterized systematically. Pressure-flow-relationships of different sizes of a laryngeal mask airway, of a laryngeal model with vocal cord angles between 10° and 60° and of the combination of a laryngeal mask airway size 4 and the laryngeal model were measured. Results were fitted to the expanded Rohrer's equation and resistances were calculated. The laryngeal mask airway and the laryngeal model showed a nonlinear flow-dependent resistive behavior. Decreasing size of the laryngeal mask airway, decreasing vocal cord angles, and increasing flow rates resulted in increased resistances (all p < 0.001). Resistance of the laryngeal mask and the laryngeal model added up to the combined resistance in a summative way, where the vocal cord angle determines 59-98% of the combined resistance in adults. The upper airway resistance during the use of a laryngeal mask airway is a summative resistance with a flow-dependent, nonlinear behavior. Upper airway resistance in adults is primarily determined by the vocal cord angle during use of a laryngeal mask.

Comparison of the ED50 of Ciprofol Combined With or Without Fentanyl for Laryngeal Mask Airway Insertion in Children: A Prospective, Randomized, Open-Label, Dose-Response Trial.

Purpose: This study aimed to estimate the effect of different doses of fentanyl on the median effective dose (ED50) of ciprofol for attenuating the airway and motor response to laryngeal mask airway (LMA) insertion response in healthy children. Patients and Methods: 90 healthy preschool patients undergoing inguinal hernia repair surgery were randomly assigned to one of three groups: C0 (ciprofol+saline), C1 (ciprofol + fentanyl 1µg/kg), C2 (ciprofol + fentanyl 2µg/kg). Anesthesia was induced with either prepared fentanyl or saline, followed by ciprofol. The dose of ciprofol for each patient was determined using the up-and-down sequential study design. The primary outcome was the ED50 of ciprofol required for smooth LMA insertion in the three groups. Additionally, the time to loss of consciousness and any perioperative adverse events were recorded. Results: Compared with the C0 group, the ED50 (95% confidence interval) of ciprofol in the C1 and C2 groups were significantly lower (1.81 [1.73-1.90]mg/kg versus 0.67 [0.64-0.71]mg/kg and 0.48 [0.42-0.54] mg/kg, respectively; P<0.05). Additionally, the ED50 of ciprofol in the C2 group was lower than that in the C1 group (0.42 [0.42-0.54] mg/kg vs 0.67 [0.64-0.71]mg/kg; P<0.05). Furthermore, the time to loss of consciousness in the C1 and C2 groups decreased by 60% and 53%, respectively, compared to the C0 group. There were no significant differences in the incidence of drug-related hypotension after anesthesia induction among the three groups. No adverse events of hypoxia, bradycardia, or injection pain were observed in any groups. Conclusion: In healthy, non-obese Chinese children undergoing elective inguinal hernia repair surgery, fentanyl 1 µg/kg and 2 µg/kg before ciprofol injection significantly reduced the ED50 of ciprofol for attenuating LMA response, with minimal occurrence of severe side effects.

Comparing the Efficiency of Laryngeal Mask Airway and Endotracheal Tube Insertion in Airway Management in Patients Planning for Elective Orthopedic Surgery under General Anesthesia: A Randomized Clinical Trial.

Objectives: The present study compared respiratory parameters between the two methods of airway establishment, ETT and LMA, for patients scheduled for orthopedic surgery with general anesthesia. Methods: This randomized double-blinded clinical trial was conducted on patients scheduled for elective orthopedic surgery under general anesthesia, in Bandar Abbas, Iran, from January 2021 to December 2021. Using a random allocation table, the study participants were randomly divided into two groups, to employ either ETT (n=48) or LMA insertion (n=48). The study's ultimate goal was to assess the respiratory parameters in 1, 3, 5, 10, and 15 minutes following intubation. Results: At all-time points, the average of peak airway pressure (P peak) and P plateau parameters in the ETT group was much higher than the EMA group (p<0.001 in all comparisons). The value of dynamic lung compliance in the LMA group was significantly higher than the ETT group in all considered time periods (p<0.001 in all comparisons). The upward trend in the value of this index was significant only in the LMA group (p=0.030). There were no significant differences in arterial oxygen saturation and end-tidal carbon dioxide levels between the two groups (p>0.05). Conclusion: In terms of arterial oxygen saturation stability and at the same time providing respiratory dynamic compliance, the LMA device outperformed the ETT.

The Effectiveness of the Gnana Laryngeal Mask Airway II (GLA-II) With Novel Suction Tubing in Gastrointestinal (GI) Cases.

INTRODUCTION: The Gnana laryngeal mask airway II (GLA-II) is a supraglottic airway device similar to the classic laryngeal mask airway, except it has an additional suction port. This suction port allows for the removal of secretions and saliva. A previous version of the Gnana laryngeal airway 4 was made of silicone, while this newer version is made of polyvinyl chloride (PVC), which is more affordable. This study aimed to demonstrate the effectiveness and tolerability of this PVC-designed GLA-II and evaluate its ability to suction secretions. METHODS: The prospective cohort study included 100 gastrointestinal (GI) cases to determine the effectiveness and toleration of the GLA-II. The American Society of Anesthesiologists (ASA) class 1-3 patients were evaluated with a Mallampati airway score for GI-related procedures. After anesthesia induction with propofol, the GLA-II was inserted, and the time for successful insertion was recorded. All cases were completed within 62 minutes. During this time, the secretion volumes were also measured. RESULTS: One hundred patients were included in the study: 52% were males and 48% were females. Thirty-four patients were scored as ASA class 1 or 2, while 66 were scored as ASA class 3. The GLA-II insertion was successful on the first attempt in 92 patients, and a second attempt was necessary for six patients. It was unsuccessful in two patients. The average time for successful insertion was 28.3 ± 4.3 seconds. The average amount of saliva suctioned was 9.3 ± 2.6 mL. There were no intraoperative or postoperative complications during these cases. CONCLUSION: The PVC GLA-II device is distinguished by its ability to allow suctioning during placement. With an adequate epiglottic seal, it can be safely and successfully inserted in a short period of time. More research should be conducted to explore the use of GLA-II devices in other settings, such as emergencies and life-saving scenarios.

Effect of operation table height on ease of mask ventilation, laryngeal view, and endotracheal intubation success.

Background and Aims: Optimal patient positioning and operating table height are essential for an ergonomic posture of an anesthesiologist in which there is minimal or no strain on thewrist during mask ventilation. It also avoids flexion of the neck, lower back, and knee bending at the time of laryngoscopy and intubation. Material and Methods: One hundred eighty patients were randomly allocated to three groups based on different table heights. The height of the table is kept at the mid-sternum level of an anesthesiologist in group 1, at the xiphoid process in group 2, and at the level of umbilicus in group 3. Laryngoscopic view with or without postural changes (exertion at wrist joint, flexion of the neck, lower back, or knee bending) was graded as per Cormack Lehane's (CL) grading. The degree of discomfort experienced by the anesthesiologist during mask ventilation or tracheal intubation was graded subjectively (1 = no discomfort, 2 = mild discomfort, 3 = moderate discomfort, and 4 = severe discomfort) at different table heights. Postural changes required to obtain the best glottic view and quality of endotracheal (ET) intubation (intubation time and attempts required) were also noted. For analysis, quantitative variables were expressed as mean ± SD and compared using unpaired t or analysis of variance test. Qualitative variables were expressed as frequencies/percentages and compared using the Chi-square test. Results with P value <0.05 were considered significant statistically. Results: Moderate discomfort (strain at wrist joint) during bag-mask ventilation was experienced by the anesthesiologist in a maximum number of patients in group 1 (81.7%). Significant improvement was seen in CL grade after the use of postural modifications in groups 1 and 2 (P value ≤0.05). Greater postural modifications were required during ET intubation at lower table heights (group 3). Conclusions: It is advisable to adopt higher table positioning in relation to anesthesiologist performing the laryngoscopy for smooth and single-attempt ET intubation since the best laryngoscopic view and intubation with minimal postural modifications was seen at higher table heights (at the mid-sternum level of an anesthesiologist).

Rapid detection of ingested acetaminophen on face mask by ambient ionization tandem mass spectrometry.

BACKGROUND: A regular face mask is comprised of three layers for resisting moisture, filtration, and absorbing oral fluid, respectively. Since the polymers with different polarities are used to make the layers, a face mask can be used as a sampling tool to retain polar or non-polar chemical and biochemical substances in the exhaled breath. In this study, thermal desorption-electrospray ionization tandem mass spectrometry (TD-ESI/MS/MS), an ambient ionization mass spectrometric technique, was used to detect trace acetaminophen that were exhaled and retained on the surface of different layers in a face mask. RESULTS: With probe sampling combined with TD-ESI/MS/MS, the acetaminophen ion signal can be detected at the mouth/nostril region of the face mask after taking the acetaminophen tablet. The experimental results were similar to previous studies for the detection of acetaminophen in blood over time using LC/MS/MS. In addition, the intensities of acetaminophen on different layers of the face mask could reveal the differing distributions of exhaled acetaminophen on each layer. To explore the distribution of acetaminophen on the face mask surface, multiple probes were used to collect samples from different locations of the face mask for analysis. The molecular mapping of acetaminophen on the face mask was rendered by scaling the analyte ion signal intensity based on a temperature color gradient. The cartography showed a higher acetaminophen ion signal distribution on the mouth and nostril regions than in other areas of the face mask. SIGNIFICANCE: Owing to the advantages of a simple, sensitive, and non-invasive sampling approach, drug monitoring could be potentially performed to provide useful information for anti-drug of precision medicine in the future.

Melt-blown polypropylene nonwoven as an efficient and eco-economic sorbent for pipette tip micro-solid phase extraction for the determination of tyrosine kinase inhibitors.

BACKGROUND: The detection of tyrosine kinase inhibitors (TKIs) in biological fluids is essential due to their critical role in cancer therapy and the variability in individual drug metabolism, which necessitates precise dosing. Traditional methods for analyzing TKIs in biological fluids, such as blood plasma, typically involve complex sample preparation techniques that can be resource-intensive, environmentally burdensome, and not sufficiently sensitive for low-concentration analytes. There is a pressing need for more efficient, economical, and environmentally friendly methods that can enhance sensitivity and throughput without compromising accuracy. RESULTS: This study explores the use of melt-blown polypropylene nonwoven (MBPP), commonly found in face masks, as a novel sorbent for pipette-tip micro-solid phase extraction (PT-µSPE). MBPP demonstrated excellent hydrophobicity and significant mesoporous adsorption capacity. An extraction device was fashioned by inserting a segment of MBPP (15 mg) into a 200 µL disposable plastic pipette tip, which was then attached to a 2.5 mL disposable plastic syringe. The MBPP's fabric form removes the need for a frit, allowing the extraction process to be completed in just 3 min through simple plunger manipulation. The method achieved extraction recoveries ranging from 60.5 % to nearly 100 %. Subsequent method validation using liquid chromatography-tandem mass spectrometry (LC-MS/MS) showed satisfactory linearity (coefficient of determination R2 > 0.993), accuracy (relative recoveries: 86.3%-114.8 %), and precision (relative standard deviation: 3.4%-11.3 %), with detection limits between 0.022 and 0.135 ng mL-1. SIGNIFICANCE: The introduction of MBPP for PT-µSPE represents a significant advancement in the bioanalytical detection of TKIs, offering a highly efficient, cost-effective, and environmentally sustainable method. It compares favorably with existing techniques, offering advantages in terms of cost, environmental impact, and ease of use. This approach has the potential to be widely adopted for routine monitoring of TKIs in clinical settings.

A case of arytenoid dislocation after ProSeal laryngeal mask airway insertion: A case report.

INTRODUCTION AND IMPORTANCE: Arytenoid dislocation, typically manifested as hoarseness and coughing when drinking, is a rare perioperative scenario, with an incidence rate of 0.009 %-0.097 % and endotracheal intubation under general anesthesia being the most common cause. However, arytenoid dislocation caused by a laryngeal mask airway (LMA) is extremely rare. CASE DESCRIPTION: Herein, a 53-year-old female patient was admitted for a "right breast lump" and scheduled for "unilateral mastectomy with ipsilateral axillary sentinel lymph node biopsy" under general anesthesia. During the surgery, the patient was noted to snore mildly, and rocuronium (15 mg) was immediately administered intravenously. The snoring ceased after adjusting the position of the LMA. Postoperatively, the patient was diagnosed with arytenoid dislocation by flexible nasal endoscopy after presenting with a sore throat accompanied by hoarseness and coughing when drinking. Thereafter, the patient underwent two cricoarytenoid joint reductions with a video laryngoscope under intravenous anesthesia, along with anti-inflammatory medication and voice therapy. The voice of the patient returned to normal after 1 month. CLINICAL DISCUSSION: Despite being a supraglottic airway device, the LMA can still cause arytenoid dislocation in clinical practice. Hence, anesthesiologists should analyze the potential causes and understand the diagnosis and treatment of arytenoid dislocation. Although closed reduction surgery typically requires two or three attempts, with a shorter disease duration leading to better outcomes, it can also aid in voice recovery for a longer disease course. In the presented case, the patient achieved a good prognosis after two closed reduction surgeries. CONCLUSION: Anesthesiologists should be vigilant for arytenoid dislocation in patients who present with persistent hoarseness and coughing while drinking after the insertion of the LMA, necessitating prompt treatment after diagnoses to achieve the best results.

Improving microvascular sensitivity of color doppler using phase mask based flow recycling algorithm.

OBJECTIVE: Blood flow sensitivity is a crucial metric for appraising the effectiveness of color Doppler flow imaging (CDFI). Color Doppler velocity maps based on classic autocorrelation techniques are widely used in clinical practice. However, these techniques often produce twinkling artifacts in noisy regions due to the inherent randomness of noise phases. To mitigate artifacts and improve image quality, Power Mask (PoM) technology becomes imperative. Nevertheless, PoM technology unintentionally filters out small flow signals that have similar power and frequency characteristics to noise signals, thereby reducing the imaging system's sensitivity to flow. Approach: To address this issue, a novel Flow Recycling Algorithm (FRA) based on phase anomaly is introduced in this study. This algorithm, excavating small flow signals from noise, aims to enhance the small flow signals with low-velocity by the phase characteristics of the color Doppler flow information. Main results: Experiments in multi-organ imaging have shown that the FRA-CDFI approach is more effective in suppressing twinkling artifacts in noisy regions, preserving intricate small flow signals, and markedly improving small blood flow sensitivity. This novel approach provides adequate technical support for clinical ultrasound imaging of organs with dense small blood vessels, such as the brain, kidneys, liver, and more. Significance: As a novel post-processing method, FRA-CDFI holds significant potential for future deployment in clinical high-frame-rate ultrasound imaging devices.

Practical Way to Use Supraglottic Airway Device.

We read a review of case reports published on Current Pediatric Reviews 2024 about the use of I-gel® in neonatal complicated intubation, and we decided to write a commentary on the benefits and limitations of using supraglottic airways in neonatal age, with a specific focus on Igel [1]. The use of supraglottic airway devices in neonatal ages is limited to particular conditions, but further research is showing the utility of these devices as the first choice in neonatal resuscitation or airway stabilization. Our commentary highlights the broader practical applications of I-gel and reinforces its role as a valuable tool in neonatal resuscitation.

[Effect of non-pharmacological preventive measures on the incidence of respiratory and gastrointestinal pathologies]. / Efecto de las medidas preventivas no farmacológicas en la incidencia de patología respiratoria y gastrointestinal.

OBJECTIVE: The use of non-pharmacological preventive measures during the COVID-19 pandemic has helped to reduce the incidence of multiple airborne or contact diseases. The objective of this paper was to evaluate the impact that all preventive measures have had on the transmission of different microorganisms, both by respiratory and contact transmission. METHODS: We compared the incidence of different infectious episodes coded with the CIAP-2 code (International Classification of Primary Care second edition of the WONCA International Classification Committee) collected from the computerized history of primary care, both with respiratory tract and digestive tract involvement, in the period from March 2018 to February 2020 (pre-pandemic period) and from March 2020 to February 2022 (pandemic period). The data corresponded to the entire region, with an estimated average population for the four years of 650,000 people. The statistical treatment of the data consisted of a descriptive analysis with the calculation of absolute values and percentages. Rates were calculated and compared using data provided by the National Institute of Statistics as a denominator. The P was obtained by statistical comparison by the exact method. A comparison of rates was made. RESULTS: The incidence in the number of CIAP-2 episodes studied, both corresponding to respiratory and gastrointestinal pathologies, comparing the period March 2018-February 2020 with the period March 2020-February 2022 decreased by 65.81%, from 534,439 cases to 182,707. CONCLUSIONS: The preventive measures applied during the pandemic produce a significant decrease in pathology involving the respiratory or the digestive tract.

OBJETIVO: El uso de medidas preventivas no farmacológicas durante la pandemia de la COVID-19 ayudó a reducir la incidencia de múltiples enfermedades de transmisión aérea o por contacto. El objetivo de este trabajo fue evaluar el impacto que habían tenido todas las medidas preventivas en la transmisión de diferentes microorganismos, tanto por transmisión respiratoria como por contacto. METODOS: Comparamos la incidencia de diferentes episodios infecciosos codificados con el código CIAP-2 (Clasificación Internacional de Atención Primaria, segunda edición, del Comité de Clasificación Internacional WONCA-World Organization of Family Doctors) recogidos de la historia informatizada de Atención Primaria, tanto con afectación del tracto respiratorio como del tracto digestivo, en el período de marzo de 2018 a febrero de 2020 (período prepandemia) y de marzo de 2020 a febrero de 2022 (período de pandemia). Los datos correspondieron a toda la región, con una población media estimada para los cuatro años de 650.000 personas. El tratamiento estadístico de los datos consistió en un análisis descriptivo con el cálculo de valores absolutos y porcentajes. Se calcularon y compararon tasas tomando como denominador los datos proporcionados por el Instituto Nacional de Estadística. La P fue obtenida mediante comparación estadística por el método exacto. Se realizó una comparación de tasas. RESULTADOS: La incidencia en el número de episodios CIAP-2 estudiados, tanto correspondientes a patología respiratoria como gastrointestinal, comparando el periodo de marzo de 2018-febrero de 2020 con el periodo marzo de 2020-febrero de 2022, disminuyó en un 65,81%, pasando de 534.439 casos a 182.707. CONCLUSIONES: Las medidas preventivas aplicadas durante la pandemia producen una disminución significativa de la patología del tracto respiratorio o digestivo.

Oxygen Delivery Devices in Postoperative Patients: Proper Selection of Patients Matters!

How to cite this article: Bhattacharya D, Esquinas AM, Mandal M. Oxygen Delivery Devices in Postoperative Patients: Proper Selection of Patients Matters! Indian J Crit Care Med 2024;28(8):802.

Epidemiological impact of revoking mask-wearing recommendation on COVID-19 transmission in Tokyo, Japan.

Despite the global implementation of COVID-19 mitigation measures, the disease continues to maintain transmission. Although mask wearing became one of the key measures for preventing the transmission of COVID-19 early in the pandemic period, many countries have relaxed the mandatory or recommended wearing of masks. The objective of the present study was to estimate the epidemiological impact of removing the mask-wearing recommendation in Japan. We developed a model to assess the consequences of declining mask-wearing coverage after the government revoked its recommendation in February 2023. The declining mask-wearing coverage was estimated using serial cross-sectional data, and a mathematical model was devised to determine the age-specific incidence of COVID-19 using the observed case count in Tokyo from week of October 3, 2022 to October 30, 2023. We explored model-based counterfactual scenarios to measure hypothetical situations in which the mask-wearing coverage decreases or increases relative to the observed coverage. The results show that mask-wearing coverage declined from 97% to 69% by the week of October 30, 2023, and that if the mask-wearing recommendation had continued, 427 lives could have been saved in Tokyo. If the mask-wearing coverage had declined to 25% of the observed level, the model suggests there might have been 1587 additional deaths. Thus, revoking the mask-wearing recommendation had a substantial epidemiological impact. In future pandemics, our proposed approach could provide a real-time quantification of the effects of relaxing countermeasures.

A virtual visualization method for improving the manufacturing accuracy based VPP 3D printers.

Compared to traditional vat photopolymerization 3D printing methods, pixel blending technique provides greater freedom in terms of user-defined lighting sources. Based on this technology, scientists have conducted research on 3D printing manufacturing for elastic materials, biologically inert materials, and materials with high transparency, making significant contributions to the fields of portable healthcare and specialty material processing. However, there has been a lack of a universal and simple algorithm to facilitate low-cost printing experiments for researchers not in the 3D printing industry. Here, we propose a mathematical approach based on morphology to simulate the light dose distribution and virtual visualization of parts produced using grayscale mask vat photopolymerization 3D printing technology. Based on this simulation, we develop an auto-correction method inspired by circle packing to modify the grayscale values of projection images, thereby improving the dimensional accuracy of printed devices. This method can significantly improve printing accuracy with just a single parameter adjustment. We conducted experimental validation of this method on a vat photopolymerization printer using common commercial resins, demonstrating its feasibility for printing high precision structures. The parameters utilized in this method are comparatively simpler to acquire compared to conventional techniques for obtaining optical parameters. For researchers in non-vat photopolymerization 3D printing industry, it is relatively user-friendly.