Tracheal agenesis as a rare cause of difficult intubation in a newborn with respiratory distress: a case report

<p>Abstract</p> <p>Introduction</p> <p>Tracheal agenesis is a very rare congenital airway anomaly. It may pose a great challenge to the first attending physician both in diagnosis and in establishing the airway during the first day of life.</p> <p>Case presentation</p> <p>We report a newborn Malay baby boy with trachea agenesis (type III by Floyd's classification) who presented with severe respiratory distress immediately after birth. Clinical diagnosis in this case was not straightforward, as it started with difficulty in intubation followed by an unsuccessful emergency tracheostomy in the neonatal intensive care unit. Urgent surgical neck exploration with endoscopic examination in the general operating theatre revealed the final diagnosis. The authors present a short description of the embryopathology and diagnostic criteria of the abnormality.</p> <p>Conclusion</p> <p>We hope this case presentation will be valuable in increasing the awareness of physicians about this rare cause of tracheal obstruction or difficult intubation.</p

EAOA: Energy-Aware Grid-Based 3D-Obstacle Avoidance in Coverage Path Planning for UAVs

The presence of obstacles like a tree, buildings, or birds along the path of a drone has the ability to endanger and harm the UAV&rsquo;s flight mission. Avoiding obstacles is one of the critical challenging keys to successfully achieve a UAV&rsquo;s mission. The path planning needs to be adapted to make intelligent and accurate avoidance online and in time. In this paper, we propose an energy-aware grid based solution for obstacle avoidance (EAOA). Our work is based on two phases: in the first one, a trajectory path is generated offline using the area top-view. The second phase depends on the path obtained in the first phase. A camera captures a frontal view of the scene that contains the obstacle, then the algorithm determines the new position where the drone has to move to, in order to bypass the obstacle. In this paper, the obstacles are static. The results show a gain in energy and completion time using 3D scene information compared to 2D scene information

PPS: Energy-Aware Grid-Based Coverage Path Planning for UAVs Using Area Partitioning in the Presence of NFZs

Area monitoring and surveillance are some of the main applications for Unmanned Aerial Vehicle (UAV) networks. The scientific problem that arises from this application concerns the way the area must be covered to fulfill the mission requirements. One of the main challenges is to determine the paths for the UAVs that optimize the usage of resources while minimizing the mission time. Different approaches rely on area partitioning strategies. Depending on the size and complexity of the area to monitor, it is possible to decompose it exactly or approximately. This paper proposes a partitioning method called Parallel Partitioning along a Side (PPS). In the proposed method, grid-mapping and grid-subdivision of the area, as well as area partitioning are performed to plan the UAVs path. An extra challenge, also tackled in this work, is the presence of non-flying zones (NFZs). These zones are areas that UAVs must not cover or pass over it. The proposal is extensively evaluated, in comparison with existing approaches, to show that it enables UAVs to plan paths with minimum energy consumption, number of turns and completion time while at the same time increases the quality of coverage

Rivaroxaban with or without aspirin in stable cardiovascular disease

BACKGROUND: We evaluated whether rivaroxaban alone or in combination with aspirin would be more effective than aspirin alone for secondary cardiovascular prevention. METHODS: In this double-blind trial, we randomly assigned 27,395 participants with stable atherosclerotic vascular disease to receive rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg once daily). The primary outcome was a composite of cardiovascular death, stroke, or myocardial infarction. The study was stopped for superiority of the rivaroxaban-plus-aspirin group after a mean follow-up of 23 months. RESULTS: The primary outcome occurred in fewer patients in the rivaroxaban-plus-aspirin group than in the aspirin-alone group (379 patients [4.1%] vs. 496 patients [5.4%]; hazard ratio, 0.76; 95% confidence interval [CI], 0.66 to 0.86; P<0.001; z=−4.126), but major bleeding events occurred in more patients in the rivaroxaban-plus-aspirin group (288 patients [3.1%] vs. 170 patients [1.9%]; hazard ratio, 1.70; 95% CI, 1.40 to 2.05; P<0.001). There was no significant difference in intracranial or fatal bleeding between these two groups. There were 313 deaths (3.4%) in the rivaroxaban-plus-aspirin group as compared with 378 (4.1%) in the aspirin-alone group (hazard ratio, 0.82; 95% CI, 0.71 to 0.96; P=0.01; threshold P value for significance, 0.0025). The primary outcome did not occur in significantly fewer patients in the rivaroxaban-alone group than in the aspirin-alone group, but major bleeding events occurred in more patients in the rivaroxaban-alone group. CONCLUSIONS: Among patients with stable atherosclerotic vascular disease, those assigned to rivaroxaban (2.5 mg twice daily) plus aspirin had better cardiovascular outcomes and more major bleeding events than those assigned to aspirin alone. Rivaroxaban (5 mg twice daily) alone did not result in better cardiovascular outcomes than aspirin alone and resulted in more major bleeding events