Anticounterfeiting and Fraud Mitigation Solutions for High-value Food Products.

Globalization and the increasing complexity of supply chains have allowed food fraud to expand to a great extent. Some of the most serious effects of these deceitful activities are damage to a brand's reputation and trust, economic losses, and public health risks. The usual victims of food fraud are dairy, meat, fish, and seafood products, as well as fats/oils and alcoholic drinks. The purpose of this review paper is to present an updated analysis of the currently available anticounterfeit technologies and their application to the four most fraud-affected food supply chains. An assessment that was conducted to determine when the adoption of a combination of technologies could enhance food safety and brand protection is also provided. The obtained results indicate that electronic and data-driven technologies (RFID devices and digital traceability systems) are still in their infancy in the food sectors that are subjected the most to fraudulent activities. Research is necessary to develop innovative digital and physical technologies to "outsmart" such fraudsters and to prevent their illicit actions in the food sector.

UAV-spray application in vineyards: Flight modes and spray system adjustment effects on canopy deposit, coverage, and off-target losses.

Improvements in the spray application of plant protection products enhance agricultural sustainability by reducing environmental contamination, but by increasing food quality and human safety. Currently, Unmanned Aerial Vehicles (UAVs) are raising interest in spray applications in 3D crops. However, operational configurations of UAV-spray systems need further investigation to maximise the deposition in the canopy and minimise the off-target losses. Our experimental research focused on investigating the effects on the canopy spray deposition and coverage due to different UAV-spray system configurations. Twelve configurations were tested under field conditions in an experimental vineyard (cv. Barbera), derived from the combination of different UAV flight modes (band and broadcast spray applications), nozzle types (conventional and air inclusion), and UAV cruise speeds (1 and 3 m s-1). Also, the best treatment, among those tested, by using the UAV-spray system and a traditional airblast sprayer were compared. The data was analysed by testing the effects of the three operational parameters and their two- and three-way interactions by means of linear mixed models. The results indicated that the flight mode deeply affects spray application efficiency. Compared to the broadcast spray modes, the band spray mode was able to increase the average canopy deposition from 0.052 to 0.161 µL cm-2 (+ 309 %) and reduce the average ground losses from 0.544 to 0.246 µL cm-2 (- 54 %). The conventional airblast sprayer, operated at a low spray application rate, showed higher canopy coverage and lower ground losses in comparison to the best UAV-spray system configuration.

[Silica causes difficulties]. / La silice cause des difficultés.

Silicosis and sarcoidosis are two very distinct entities in the literature. All the additional non-invasive examinations, including the chest CT scan, often do not differentiate them. The history, including occupational exposure to identified silica particles, is a discriminating factor. However, due to the pathogenic power of silica, it would be possible to have the simultaneous development of these two pathologies in the same patient. To illustrate this situation, here is the case of a 62-year-old patient, who presented initially with a picture of dyspnea and productive cough. The chest CT showed micronodular peribronchovascular infiltrates and mediastinal lymphadenopathy. The other additional examinations did not find anything specific. In the diagnostic process, the patient had multiple endoscopic samples which did not make it possible to be conclusive on one or the other of these pathologies. He therefore underwent a surgical lung biopsy which revealed histological lesions compatible with the two pathologies. Recent studies suggest that inhaled particles, especially silica, could be responsible for the pattern of sarcoidosis. However, it is difficult to say whether, in this case, silica was responsible for the development of sarcoidosis.

An algorithm for the reconstruction of high-energy neutrino-induced particle showers and its application to the ANTARES neutrino telescope.

A novel algorithm to reconstruct neutrino-induced particle showers within the ANTARES neutrino telescope is presented. The method achieves a median angular resolution of [Formula: see text] for shower energies below 100 TeV. Applying this algorithm to 6 years of data taken with the ANTARES detector, 8 events with reconstructed shower energies above 10 TeV are observed. This is consistent with the expectation of about 5 events from atmospheric backgrounds, but also compatible with diffuse astrophysical flux measurements by the IceCube collaboration, from which 2-4 additional events are expected. A [Formula: see text] C.L. upper limit on the diffuse astrophysical neutrino flux with a value per neutrino flavour of [Formula: see text] is set, applicable to the energy range from 23 TeV to 7.8 PeV, assuming an unbroken [Formula: see text] spectrum and neutrino flavour equipartition at Earth.

Cooperative Clinical Conferences: Nursing Student Pediatric Clinical Innovation.

BACKGROUND: A gap exists between nursing student classrooms (i.e., clinical training) and newly graduated RNs' real-world nursing experiences. The Cooperative Clinical Conference (CCC) was piloted for prelicensure nursing clinical groups as a vehicle to allow students to reflect on their learning and physiology and disease, as it relates to the pediatric patient in the context of the entire plan of care for pediatric patients. METHOD: Participating nursing student clinical groups were allotted 15 to 20 minutes to give group case presentations of de-identified patient scenarios, representative of the patient population on the assigned clinical unit. RESULTS: The CCC as a learning opportunity in the clinical area was rated highly on evaluations by faculty and student participants in terms of their achievement of both learning objectives and satisfaction. CONCLUSION: The CCC represented a feasible and acceptable method of enhanced learning and professional development with and for undergraduate nursing students in the pediatric clinical environment. [J Nurs Educ. 2016; 55(7):416-419.].

Incidence of Severe Infections and Infection-Related Mortality During the Course of Giant Cell Arteritis: A Multicenter, Prospective, Double-Cohort Study.

OBJECTIVE: To assess the incidence of infections leading to hospitalization, the mortality rate related to infections, and the determinants of these factors in patients with giant cell arteritis (GCA). METHODS: In total, 486 patients with GCA (75% women) were enrolled at the time of diagnosis. All patients fulfilled the American College of Rheumatology criteria for GCA. As controls, age- and sex-matched subjects were randomly selected from the general population and matched to patients at the time of diagnosis of GCA. Both groups were prospectively followed up over a 5-year period. RESULTS: Severe infections were more frequent among patients with GCA during the first year after diagnosis, compared to general population controls (incidence rate ratio 2.1, 95% confidence interval [95% CI] 1.2-3.4; incidence rate 11.1/100 patient-years [95% CI 8.3-14.6] in patients with GCA versus 5.9/100 patient-years [95% CI 4-8.4] in controls). Specifically, septic shock and infectious colitis were more frequent among the patients with GCA. Mortality caused by infections was higher in patients with GCA compared to controls (P < 0.0001 by log rank test). In analyses adjusted for age, among patients with GCA, a diagnosis of diabetes (hazard ratio [HR] 3.3, 95% CI 1.4-7.7) and a corticosteroid dosage that was >10 mg/day after 12 months of treatment (HR 4.61, 95% CI 1.38-15.36) were associated with death attributed to severe infection. The observed overall incidence of mortality was increased in patients with GCA during the early period of enrollment in the study (before 1997) (P = 0.0001 by log rank test), but thereafter was the same as that in the general population controls. CONCLUSION: Frequencies of severe infections and rates of infection-related mortality are increased during the first year after the diagnosis of GCA. The risk of infection increases in GCA patients with older age or in the presence of diabetes, or is greater when the dosage of corticosteroids has been increased to >10 mg/day after 12 months of treatment.

Evaluation of the Aspergillus Western blot IgG kit for diagnosis of chronic aspergillosis.

Immunoprecipitin detection (IPD) is the current reference confirmatory technique for anti-Aspergillus antibody detection; however, the lack of standardization is a critical drawback of this assay. In this study, we evaluated the performance of the Aspergillus Western blot (Asp-WB) IgG kit (LDBio Diagnostics, Lyon, France), a recently commercialized immunoblot assay for the diagnosis of various clinical presentations of chronic aspergillosis. Three hundred eight serum samples from 158 patients with aspergillosis sensu lato (s.l.) were analyzed. More specifically, 267 serum samples were derived from patients with Aspergillus disease, including 89 cases of chronic pulmonary aspergillosis, 10 of aspergilloma, and 32 of allergic bronchopulmonary aspergillosis, while 41 samples were from patients with Aspergillus colonization, including 15 cystic fibrosis (CF) and 12 non-CF patients. For blood donor controls, the Asp-WB specificity was 94%, while the kit displayed a sensitivity for the aspergillosis s.l. diagnosis of 88.6%, with a diagnostic odds ratio (DOR) of 119 (95% confidence interval [CI], 57 to 251). The DOR values were 185.22 (95% CI,78.79 to 435.45) and 43.74 (95% CI, 15.65 to 122.20) for the diagnosis of Aspergillus disease and Aspergillus colonization, respectively. Among the patients, the sensitivities of the Asp-WB in the diagnosis of Aspergillus colonization were 100% and 41.7% in CF and non-CF patients, respectively. The Asp-WB yielded fewer false-negative results than did IPD. In conclusion, the Asp-WB kit performed well for the diagnosis of various clinical presentations of aspergillosis in nonimmunocompromised patients, with an enhanced standardization and a higher sensitivity than with IPD, which is the current reference method.

Meta-analysis of the association between obstructive sleep apnoea and postoperative outcome.

BACKGROUND: Obstructive sleep apnoea (OSA) is often undiagnosed before elective surgery and may predispose patients to perioperative complications. METHODS: A literature search of PubMed-Medline, Web of Science, Scopus, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials up to November 2010 was conducted. Our search was restricted to cohort or case-control studies in adults diagnosed with OSA by screening questionnaire, oximetry, or polysomnography. Studies without controls, involving upper airway surgery, and with OSA diagnosed by ICD-9 codes alone were excluded. The primary postoperative outcomes were desaturation, acute respiratory failure (ARF), reintubation, myocardial infarction/ischaemia, arrhythmias, cardiac arrest, intensive care unit (ICU) transfer, and length of stay. RESULTS: Thirteen studies were included in the final analysis (n=3942). OSA was associated with significantly higher odds of any postoperative cardiac events [45/1195 (3.76%) vs 24/1420 (1.69%); odds ratio (OR) 2.07; 95% confidence interval (CI) 1.23-3.50, P=0.007] and ARF [33/1680 (1.96%) vs 24/3421 (0.70%); OR 2.43, 95% CI 1.34-4.39, P=0.003]. Effects were not heterogeneous for these outcomes (I(2)=0-15%, P>0.3). OSA was also significantly associated with higher odds of desaturation [189/1764 (10.71%) vs 105/1881 (5.58%); OR 2.27, 95% CI 1.20-4.26, P=0.01] and ICU transfer [105/2062 (5.09%) vs 58/3681 (1.57%), respectively; OR 2.81, 95% CI 1.46-5.43, P=0.002]. Both outcomes showed a significant degree of heterogeneity of the effect among studies (I(2)=57-68%, P<0.02). Subgroup analyses had similar conclusions as main analyses. CONCLUSIONS: The incidence of postoperative desaturation, respiratory failure, postoperative cardiac events, and ICU transfers was higher in patients with OSA.

Nosocomial transmission of NDM-1-producing Escherichia coli within a non-endemic area in France.

Two patients with no travel history and sharing the same room were colonized by the same strain of New Delhi metallo-ß-lactamase 1 (NDM-1)-producing Escherichia coli within a geographical area not endemic for this highly multidrug-resistant bacterium. It was documented an absence of an epidemiological and bacteriological link with a third patient returning from India after surgery and found to be infected by an NDM-1-producing Citrobacter strain during the same period. Despite extensive investigation, the source of contamination of the two former patients was not elucidated. This case report illustrates the need of investigating rapidly the emergence of highly multidrug-resistant Enterobacteriaceae, to stop their dissemination in a nosocomial setting.

Most probable number methodology for quantifying dilute concentrations and fluxes of Escherichia coli O157:H7 in surface waters.

AIMS: To better understand the transport and enumeration of dilute densities of Escherichia coli O157:H7 in agricultural watersheds, we developed a culture-based, five tube-multiple dilution most probable number (MPN) method. METHODS AND RESULTS: The MPN method combined a filtration technique for large volumes of surface water with standard selective media, biochemical and immunological tests, and a TaqMan confirmation step. This method determined E. coli O157:H7 concentrations as low as 0.1 MPN per litre, with a 95% confidence level of 0.01-0.7 MPN per litre. Escherichia coli O157:H7 densities ranged from not detectable to 9 MPN per litre for pond inflow, from not detectable to 0.9 MPN per litre for pond outflow and from not detectable to 8.3 MPN per litre for within pond. The MPN methodology was extended to mass flux determinations. Fluxes of E. coli O157:H7 ranged from <27 to >10(4) MPN per hour. CONCLUSION: This culture-based method can detect small numbers of viable/culturable E. coli O157:H7 in surface waters of watersheds containing animal agriculture and wildlife. SIGNIFICANCE AND IMPACT OF THE STUDY: This MPN method will improve our understanding of the transport and fate of E. coli O157:H7 in agricultural watersheds, and can be the basis of collections of environmental E. coli O157:H7.

First Report of Leaf Smut on Fescue (Festuca rubra) Caused by Urocystis agropyri in Interior Alaska.

In June and early July of 2003 and July of 2007, a smut disease was found on fescue (Festuca rubra L.) at the Fairbanks Golf and Country Club and vicinities, Interior Alaska. Diseased plants were pale green-to-slightly yellow and stunted. The lesions were long, narrow, yellowish green streaks parallel to the veins of leaves and sheaths. At a later stage, sori developed under the epidermis and the leaves and sheaths turned silvery gray. Rupture of the epidermis resulted in the release of masses of black spores that covered the leaves, especially along and within infected sheaths. Microscopic observation showed spore balls consisting of one-to-four, dark reddish brown teliospores surrounded by small, hyaline-to-light brown sterile cells. The spore balls were globose to elongate and 16 to 32 × 18 to 38 µm. The teliospores were globose, dark reddish brown, and 7.5 to 20 µm in diameter. Urocystis agropyri is recognized by R. W. Smiley et al. (2) and J. D. Smith et al. (3) as occurring on turf grasses; K. Vánky (4) restricts this species to Elymus spp. and recognizes U. ulei as the valid species infecting Festuca spp, including F. rubra. On the basis of host symptoms and morphology of spores, the smut found on F. rubra in Alaska fits better with published descriptions of U. agropyri (Preuss) Schrot (2,3), however, it likely is not conspecific with flag smut of wheat. For molecular verification of this identification, DNA was isolated from teliospores with a DNeasy Plant Mini Kit (Qiagen, Valencia, CA). Primers were designed for amplification of the large subunit ribosomal gene based on the only two published sequences of U. ranunculi (Lib.) Moesz (GenBank Accession No. AF009879) and U. colchici (Schltdl.) Rabenh (GenBank Accession No. AF009878) (1). A 400-bp PCR product was amplified by the forward primer 3'-GCATTGTAAACTCAGAAGTGTTATCCG-5' and reverse primer 5'-TTCCCTAAACCTATATCCGGCG-3'. Nucleotide sequence of the PCR product (GenBank Accession No. AY547283) shared 97.7% homology with U. ranunculi and 98.2% with U. colchici. Comparison of nucleotide sequences will be more meaningful in the identification of species of Urocystis when additional sequences are published. To our knowledge, this is the first report of U. agropyri from turfgrass in Alaska. References: (1) D. Begerow et al. Can. J. Bot. 75:2045, 1997. (2) R. W. Smiley et al. Compendium of Turfgrass Diseases. 3rd ed. The American Phytopathological Society, St Paul, MN, 2005. (3) J. D. Smith et al. Page 189 in: Fungal Diseases of Amenity Turf Grassess. E. & F. N. Spon, London, 1989. (4) K. Vánky. Page 308 in: European Smut Fungi. Gustav Fischer Verlag, NY. 1994.

Control of sigma virus multiplication by the ref(2)P gene of Drosophila melanogaster: an in vivo study of the PB1 domain of Ref(2)P.

Ref(2)P has been described as one of the Drosophila proteins that interacts with the sigma virus cycle. We generated alleles to identify critical residues involved in the restrictive (inhibiting viral multiplication) or permissive (allowing viral multiplication) character of Ref(2)P. We demonstrate that permissive alleles increase the ability of the sigma virus to infect Drosophila when compared to null alleles and we confirm that restrictive alleles decrease this capacity. Moreover, we have created alleles unfunctional in viral cycling while functional for Ref(2)P fly functions. This type of allele had never been observed before and shows that fly- and virus-related activities of Ref(2)P are separable. The viral status of Ref(2)P variants is determined by the amino-terminal PB1 domain polymorphism. In addition, an isolated PB1 domain mimics virus-related functions even if it is similar to a loss of function toward fly-related activities. The evolutionary tree of the Ref(2)P PB1 domain that we could build on the basis of the natural allele sequences is in agreement with an evolution of PB1 domain due to successive transient selection waves.

Nutrient transport in a restored riparian wetland.

We determined the water quality effect of a restored forested riparian wetland adjacent to a manure application area and a heavily fertilized pasture in the Georgia Coastal Plain. The buffer system was managed based on USDA recommendations and averaged 38 m in width. Water quality and hydrology data were collected from 1991-1999. A nitrate plume in shallow ground water with concentrations exceeding 10 mg NO3-N L(-1) moved into the restored forested riparian wetland. Along most of the plume front, concentrations were less than 4 mg NO3-N L(-1) within 25 m. Two preferential flow paths associated with past hydrologic modifications to the site allowed the nitrate plume to progress further into the restored forested riparian wetland. Surface runoff total N, dissolved reactive phosphorus (DRP), and total P concentrations averaged 8.63 mg N L(-1), 1.37 mg P L(-1), and 1.48 mg P L(-1), respectively, at the field edge and were reduced to 4.18 mg N L(-1), 0.31 mg P L(-1), and 0.36 mg P L(-1), respectively, at the restored forested riparian wetland outlet. Water and nutrient mass balance showed that retention and removal rates for nitrogen species ranged from a high of 78% for nitrate to a low of 52% for ammonium. Retention rates for both DRP and total P were 66%. Most of the N retention and removal was accounted for by denitrification. Mean annual concentrations of total N and total P leaving the restored forested riparian wetland were 1.98 mg N L(-1) and 0.24 mg P L(-1), respectively.

Practising evidence-based medicine: the design and implementation of a multidisciplinary team-driven extubation protocol.

BACKGROUND: Evidence from recent literature shows that protocol-directed extubation is a useful approach to liberate patients from mechanical ventilation (MV). However, research evidence does not necessarily provide guidance on how to implement changes in individual intensive care units (ICUs). We conducted the present study to determine whether such an evidence-based strategy can be implemented safely and effectively using a multidisciplinary team (MDT) approach. METHOD: We designed a MDT-driven extubation protocol. Multiple meetings were held to encourage constructive criticism of the design by attending physicians, nurses and respiratory care practitioners (RCPs), in order to define a protocol that was evidence based and acceptable to all clinical staff involved in the process of extubation. It was subsequently implemented and evaluated in our medical/ surgical ICU. Outcomes included response of the MDT to the initiative, duration of MV and stay in the ICU, as well as reintubation rate. RESULTS: The MDT responded favourably to the design and implementation of this MDT-driven extubation protocol, because it provided greater autonomy to the staff. Outcomes reported in the literature and in the historical control group were compared with those in the protocol group, and indicated similar durations of MV and ICU stay, as well as reintubation rates. No adverse events were documented. CONCLUSION: An MDT approach to protocol-directed extubation can be implemented safely and effectively in a multidisciplinary ICU. Such an effort is viewed favourably by the entire team and is useful in enhancing team building.

Noninvasive proportional assist ventilation for acute respiratory insufficiency. Comparison with pressure support ventilation.

Noninvasive positive pressure ventilation (NPPV) is usually applied using pressure support ventilation (PSV). Proportional assist ventilation (PAV) is a newer mode that delivers assisted ventilation in proportion to patient effort. We hypothesized that PAV for NPPV would support gas exchange and avoid intubation as well as PSV and be more comfortable and tolerable for patients. Adult patients with acute respiratory insufficiency were randomized to receive NPPV with PAV delivered using the Respironics Vision ventilator or PSV using a Puritan-Bennett 7200ae critical care ventilator. Each mode was adjusted to relieve dyspnea and improve gas exchange until patients met weaning or intubation criteria, died, or refused to continue. Twenty-one and 23 patients were entered into the PAV and PSV groups, respectively, and had similar diagnoses and baseline characteristics, although pH was slightly lower in the PAV group (7.30 versus 7.35, p = 0.02). Mortality and intubation rates were similar, but refusal rate was lower, reduction in respiratory rate was more rapid, and there were fewer complications in the PAV group. We conclude that use of the PAV mode is feasible for noninvasive therapy of acute respiratory insufficiency. Compared with PSV delivered with the Puritan-Bennett 7200ae, PAV is associated with more rapid improvements in some physiologic variables and is better tolerated.

Postoperative complications in patients with obstructive sleep apnea syndrome undergoing hip or knee replacement: a case-control study.

OBJECTIVE: To identify and assess the impact of postoperative complications in patients with unrecognized or known obstructive sleep apnea syndrome (OSAS) undergoing hip replacement or knee replacement compared with control patients undergoing similar operations. Although OSAS is a risk factor for perioperative morbidity, data quantifying the magnitude of the problem in patients undergoing non-upper airway operations are limited. PATIENTS AND METHODS: This retrospective, case-control study from a single academic medical institution included patients diagnosed as having OSAS between January 1995 and December 1998 and undergoing hip or knee replacement within 3 years before or anytime after their OSAS diagnosis. Patients with OSAS were subcategorized as having the diagnosis either before or after the surgery and also, regardless of time of diagnosis, by whether they were using continuous positive airway pressure (CPAP) prior to hospitalization. Matched controls were patients without OSAS undergoing the same operation. Interventions were defined specifically as administration of a particular treatment in the context of each complication, eg, supplemental oxygen, implementation of additional monitoring such as oximetry for hypoxemia, or transfer to the intensive care unit (ICU) for cardiac ischemia concerns. Postoperative complications were assessed for all patients in the different categories and included respiratory events such as hypoxemia, acute hypercapnia, and episodes of delirium. Serious complications were noted separately, including unplanned ICU days, reintubations, and cardiac events. The length of hospital stay was also tabulated. RESULTS: There were 101 patients with the diagnosis of OSAS in this study and 101 matched controls. Thirty-six patients had their joint replacement before OSAS was diagnosed, and 65 had surgery after OSAS was diagnosed. Of the latter 65 patients, only 33 were using CPAP at home preoperatively. Complications were noted in 39 patients (39%) in the OSAS group and 18 patients (18%) in the control group (P=.001). Serious complications occurred in 24 patients (24%) in the OSAS group compared with 9 patients (9%) in the control group (P=.004). Hospital stay was significantly longer for the OSAS patients at a mean +/- SD of 6.8 +/- 2.8 days compared with 5.1 +/- 4.1 days for the control patients (P<.007). CONCLUSION: Adverse postoperative outcomes occurred at a higher rate in patients with a diagnosis of OSAS undergoing hip or knee replacement compared with a group of matched control patients.

Genetic and molecular features of Su(P), a gene that interacts with ref(2)P in male fertility of Drosophila melanogaster.

The ref(2)P gene is involved in the control of sigma rhabdovirus multiplication in Drosophila melanogaster. ref(2)P activity is also necessary for male fertility. However, in one-third of laboratory strains tested, males that lacked ref(2)P activity were fertile. In all such strains studied, the male sterility phenotype was abolished due to the presence of a particular allele at the Su(P) locus, at 73B1-2. These spontaneous suppressor alleles were dominant. We were able to induce dominant suppressor alleles at the Su(P) locus by X-ray mutagenesis and hybrid dysgenesis, suggesting that null alleles of Su(P) confer the dominant suppressor phenotype. The Su(P) gene was cloned by P element tagging. The P element-tagged alleles identified a Su(P) transcript as a 1.4-kb mRNA produced in the soma of both males and females, which is also abundant in ovaries.

A review of neuromuscular blockade in the critically ill patient.

The continuous administration of neuromuscular blocking agents is thought to be associated with a number of adverse effects and complications, including post-paralytic syndrome (characterized by persistent paralysis), muscle weakness, and the inability to wean from the ventilator despite discontinuation of the therapy. Consequently, clinical objectives emphasize administering only the dose necessary to optimize the effect of the drug and for the shortest possible time. This article provides an overview of the administration of neuromuscular blocking agents, from the perspective of a critical care pharmacist and critical care nurses. The complexities associated with pharmacological paralysis in critically ill patients warrants the comprehensive approach to care that multidisciplinary team members can provide.

The use of high-frequency oscillatory ventilation in adult ARDS patients.

Current ventilatory objectives for adults with ARDS include maximizing gas exchange while minimizing lung injury. To this end, high-frequency oscillatory ventilation (HFOV), a mechanical ventilation strategy that simultaneously avoids end-inspiratory alveolar overdistension and end-expiratory alveolar collapse, has been recommended. HFOV meets these criteria from a theoretical perspective, however, is without the benefit of a prospective randomized clinical trial of CMV versus HFOV to demonstrate that effect. This article provides an overview of high-frequency oscillation, followed by an illustration of how it was applied in the case of a 43-year-old patient who developed respiratory failure 24 hours post-Caesarean section.