Intraoperative management of ETT and LMA cuff pressures: a survey of anaesthetists’ knowledge, attitude and current practice

Background: Endotracheal tubes and laryngeal mask airway devices are routinely used during anaesthesia. Inappropriate inflation of cuffs has been shown to cause postoperative airway morbidity, and limiting the pressure decreases the incidence of pharyngo-laryngeal complications. Subjective measurements of cuff pressures correlate poorly to actual pressures, yet the use of objective cuff manometry is not routinely practised. The aim of this study was to determine current clinical practice of cuff inflation as well as the knowledge and attitude of anaesthetists in the University of KwaZulu-Natal (UKZN) Discipline of Anaesthesiology and Critical Care.Methods: This was a descriptive, observational study and data were collected using an anonymous self-administered questionnaire from practising anaesthetists in the UKZN Discipline of Anaesthesiology and Critical Care.Results: A total of 160 anaesthetists participated. The minimal occlusive volume test (38.8%) and the pilot balloon palpation technique (36.3%) were most commonly used. Most participants felt it was important to accurately measure ETT (84.8%) and LMA (56.1%) cuff pressures and that using a cuff manometer should be mandatory (76%). Reasons for not using it routinely included manometers not being readily available. Gaps in knowledge and education were also identified.Conclusion: There is increasing importance placed on quality assurance. Clinical practice varies widely among practitioners with the only consistency being the omission of cuff manometers during routine intraoperative management, despite their proven benefit and efficacy. The authors propose recommendations to facilitate the routine intraoperative use of cuff manometers.Keywords: anaesthesia, cuff manometer, endotracheal, intracuff pressure, intubation, laryngeal mask airway, sore throat, tracheo-laryngeal complication

The Role of a Federally Qualified Health Center in Identification and Management of an Occupational COVID-19 Outbreak: Lessons for Future Infection Surveillance and Response

Federally Qualified Health Centers (FQHCs) have been essential in response to COVID-19 outbreaks among vulnerable populations. Our rural FQHC had a primary role in early detection of and response to a poultry plant-related outbreak at the outset of the pandemic that disproportionately and gravely affected the local Hispanic community. The health center activated a rapid local response that included the community's first mass testing event and first acute respiratory treatment clinic, both of which were central to abatement. Lessons learned from this experience provide important guidance for the potential role of FQHCs in infection outbreak preparedness in marginalized communities

Sistema modular para superfícies ajardinadas-produzido com geopolímeros e aglomerado negro de cortiça

O aglomerado negro de cortiça expandida foi fornecido pela ISOCOR/SOFALCA.A integração de superfícies ajardinadas em edifícios, como coberturas e paredes verdes, pode constituir uma estratégia passiva de poupança de energia, entre outros benefícios, como se discute neste trabalho. Em primeiro lugar é apresentada uma síntese dos principais benefícios da integração das superfícies ajardinadas em edifícios. Em seguida, são analisadas as principais características das coberturas e paredes verdes. Por fim, é apresentada uma descrição detalhada da concepção do sistema modular GEOGREEN e as suas características inovadoras relevantes.Fundação Portuguesa para a Ciência e Tecnologia, FCT

Corrections to the statistical entropy of five dimensional black holes

We compute the statistical entropy of the three charge (D1-D5-p) five dimensional black hole to sub-leading order in a large charge expansion. We find an agreement with the macroscopic calculation of the Wald entropy in R^2 corrected supergravity theory. The two calculations have a overlapping regime of validity which is not the Cardy regime. We use this result to clarify the 4d-5d lift for black holes on Taub-NUT space. In particular, we compute sub-leading corrections to the formula S^{4d} = S^{5d}. In the microscopic analysis, this correction arises from excitations bound to the Taub-NUT space. In the macroscopic picture, the difference is accounted by a mechanism present in a higher derivative theory wherein the geometry of the Taub-NUT space absorbes some of the electric charge.Comment: 25 pages. Few changes and improvements. To be published in JHE

Logarithmic Corrections to Rotating Extremal Black Hole Entropy in Four and Five Dimensions

We compute logarithmic corrections to the entropy of rotating extremal black holes using quantum entropy function i.e. Euclidean quantum gravity approach. Our analysis includes five dimensional supersymmetric BMPV black holes in type IIB string theory on T^5 and K3 x S^1 as well as in the five dimensional CHL models, and also non-supersymmetric extremal Kerr black hole and slowly rotating extremal Kerr-Newmann black holes in four dimensions. For BMPV black holes our results are in perfect agreement with the microscopic results derived from string theory. In particular we reproduce correctly the dependence of the logarithmic corrections on the number of U(1) gauge fields in the theory, and on the angular momentum carried by the black hole in different scaling limits. We also explain the shortcomings of the Cardy limit in explaining the logarithmic corrections in the limit in which the (super)gravity description of these black holes becomes a valid approximation. For non-supersymmetric extremal black holes, e.g. for the extremal Kerr black hole in four dimensions, our result provides a stringent testing ground for any microscopic explanation of the black hole entropy, e.g. Kerr/CFT correspondence.Comment: LaTeX file, 50 pages; v2: added extensive discussion on the relation between boundary condition and choice of ensemble, modified analysis for slowly rotating black holes, all results remain unchanged, typos corrected; v3: minor additions and correction

Global consortium for the classification of fungi and fungus-like taxa

The Global Consortium for the Classification of Fungi and fungus-like taxa is an international initiative of more than 550 mycologists to develop an electronic structure for the classification of these organisms. The members of the Consortium originate from 55 countries/regions worldwide, from a wide range of disciplines, and include senior, mid-career and early-career mycologists and plant pathologists. The Consortium will publish a biannual update of the Outline of Fungi and fungus like taxa, to act as an international scheme for other scientists. Notes on all newly published taxa at or above the level of species will be prepared and published online on the Outline of Fungi website (https://www.outlineoffungi.org/), and these will be finally published in the biannual edition of the Outline of Fungi and fungus-like taxa. Comments on recent important taxonomic opinions on controversial topics will be included in the biannual outline. For example, ‘to promote a more stable taxonomy in Fusarium given the divergences over its generic delimitation’, or ‘are there too many genera in the Boletales?’ and even more importantly, ‘what should be done with the tremendously diverse ‘dark fungal taxa?’ There are undeniable differences in mycologists’ perceptions and opinions regarding species classification as well as the establishment of new species. Given the pluralistic nature of fungal taxonomy and its implications for species concepts and the nature of species, this consortium aims to provide a platform to better refine and stabilise fungal classification, taking into consideration views from different parties. In the future, a confidential voting system will be set up to gauge the opinions of all mycologists in the Consortium on important topics. The results of such surveys will be presented to the International Commission on the Taxonomy of Fungi (ICTF) and the Nomenclature Committee for Fungi (NCF) with opinions and percentages of votes for and against. Criticisms based on scientific evidence with regards to nomenclature, classifications, and taxonomic concepts will be welcomed, and any recommendations on specific taxonomic issues will also be encouraged; however, we will encourage professionally and ethically responsible criticisms of others’ work. This biannual ongoing project will provide an outlet for advances in various topics of fungal classification, nomenclature, and taxonomic concepts and lead to a community-agreed classification scheme for the fungi and fungus-like taxa. Interested parties should contact the lead author if they would like to be involved in future outlines

Study of Tau-pair Production in Photon-Photon Collisions at LEP and Limits on the Anomalous Electromagnetic Moments of the Tau Lepton

Tau-pair production in the process e+e- -> e+e-tau+tau- was studied using data collected by the DELPHI experiment at LEP2 during the years 1997 - 2000. The corresponding integrated luminosity is 650 pb^{-1}. The values of the cross-section obtained are found to be in agreement with QED predictions. Limits on the anomalous magnetic and electric dipole moments of the tau lepton are deduced.Comment: 20 pages, 9 figures, Accepted by Eur. Phys. J.

Evidence for an Excess of Soft Photons in Hadronic Decays of Z^0

Soft photons inside hadronic jets converted in front of the DELPHI main tracker (TPC) in events of qqbar disintegrations of the Z^0 were studied in the kinematic range 0.2 < E_gamma < 1 GeV and transverse momentum with respect to the closest jet direction p_T < 80 MeV/c. A clear excess of photons in the experimental data as compared to the Monte Carlo predictions is observed. This excess (uncorrected for the photon detection efficiency) is (1.17 +/- 0.06 +/- 0.27) x 10^{-3} gamma/jet in the specified kinematic region, while the expected level of the inner hadronic bremsstrahlung (which is not included in the Monte Carlo) is (0.340 +/- 0.001 +/- 0.038) x 10^{-3} gamma/jet. The ratio of the excess to the predicted bremsstrahlung rate is then (3.4 +/- 0.2 +/- 0.8), which is similar in strength to the anomalous soft photon signal observed in fixed target experiments with hadronic beams.Comment: 37 pages, 9 figures, Accepted by Eur. Phys. J.

Study of Inclusive J/psi Production in Two-Photon Collisions at LEP II with the DELPHI Detector

Inclusive J/psi production in photon-photon collisions has been observed at LEP II beam energies. A clear signal from the reaction gamma gamma -> J/psi+X is seen. The number of observed N(J/psi -> mu+mu-) events is 36 +/- 7 for an integrated luminosity of 617 pb^{-1}, yielding a cross-section of sigma(J/psi+X) = 45 +/- 9 (stat) +/- 17 (syst) pb. Based on a study of the event shapes of different types of gamma gamma processes in the PYTHIA program, we conclude that (74 +/- 22)% of the observed J/psi events are due to `resolved' photons, the dominant contribution of which is most probably due to the gluon content of the photon.Comment: 13 pages, 8 figures, Accepted by Phys. Lett.