Intubation of a neonate with glossopalatine ankylosis using a paraglossal approach and a laryngoscope with a straight blade

Glossopalatine ankylosis presents a challenge to the anaesthesiologist because of its intraoral attachment which obstructs the view of the oral cavity. When preoperative assessment by direct laryngoscopy is possible, a paraglossal approach using a straight blade can be used in such cases. We share our anaesthesia experience of a neonate with glossopalatine ankylosis.Keywords: glossopalatine ankylosis, paraglossal straight blade laryngoscopy, glossopalatine bands, direct laryngoscopy, endotracheal intubatio

Ultrafast Time-Resolved Structural Changes of Thin-Film Ferromagnetic Metal Heated With Femtosecond Optical Pulses

As a classic ferromagnetic material, nickel has been an important research candidate used to study dynamics and interactions of electron, spin, and lattice degrees of freedom. In this study, we specifically chose a thick, 150 nm ferromagnetic nickel (111) single crystal rather than 10–20 nm thin crystals that are typically used in ultrafast studies, and we revealed both the ultrafast heating within the skin depth and the heat transfer from the surface (skin) layer to the bulk of the crystal. The lattice deformation after femtosecond laser excitation was investigated by means of 8.04 keV subpicosecond x-ray pulses, generated from a table-top laser-plasma based source. The temperature evolution of the electron, spin, and lattice was determined using a three temperature model. In addition to coherent phonon oscillations, the blast force and sonic waves, induced by the hot electron temperature gradient, were also observed by monitoring the lattice contractions during the first couple of picoseconds after laser irradiation. This study further revealed the tens of picoseconds time required for heating the hundred nanometer bulk of the Ni (111) single crystals

A One Health Framework for the Evaluation of Rabies Control Programmes: A Case Study from Colombo City, Sri Lanka

<div><p>Background</p><p>One Health addresses complex challenges to promote the health of all species and the environment by integrating relevant sciences at systems level. Its application to zoonotic diseases is recommended, but few coherent frameworks exist that combine approaches from multiple disciplines. Rabies requires an interdisciplinary approach for effective and efficient management.</p><p>Methodology/Principal Findings</p><p>A framework is proposed to assess the value of rabies interventions holistically. The economic assessment compares additional monetary and non-monetary costs and benefits of an intervention taking into account epidemiological, animal welfare, societal impact and cost data. It is complemented by an ethical assessment. The framework is applied to Colombo City, Sri Lanka, where modified dog rabies intervention measures were implemented in 2007. The two options included for analysis were the control measures in place until 2006 (“baseline scenario”) and the new comprehensive intervention measures (“intervention”) for a four-year duration. Differences in control cost; monetary human health costs after exposure; Disability-Adjusted Life Years (DALYs) lost due to human rabies deaths and the psychological burden following a bite; negative impact on animal welfare; epidemiological indicators; social acceptance of dogs; and ethical considerations were estimated using a mixed method approach including primary and secondary data. Over the four years analysed, the intervention cost US $1.03 million more than the baseline scenario in 2011 prices (adjusted for inflation) and caused a reduction in dog rabies cases; 738 DALYs averted; an increase in acceptability among non-dog owners; a perception of positive changes in society including a decrease in the number of roaming dogs; and a net reduction in the impact on animal welfare from intermediate-high to low-intermediate.</p><p>Conclusions</p><p>The findings illustrate the multiple outcomes relevant to stakeholders and allow greater understanding of the value of the implemented rabies control measures, thereby providing a solid foundation for informed decision-making and sustainable control.</p></div

Medical Malpractice : How Legal Liability Affects Medical Decisions

In health care, overuse and underuse of medical treatments represent equally dangerous deviations from an optimal use equilibrium and arouses concerns about possible implications for patients\u2019 health, and for the healthcare system in terms of both costs and access to medical care. Medical liability plays a dominant role among the elements that can affect these deviations. Therefore, a remarkable economic literature studies how medical decisions are influenced by different levels of liability. In particular, identifying the relation between liability and treatments selection, as well as disentangling the effect of liability from other incentives that might be in place, is a task for sound empirical research. Several studies have already tried to tackle this issue, but much more needs to be done. In the present chapter, we offer an overview of the state of the art in the study of the relation between liability and treatments selection. First, we reason on the theoretical mechanisms underpinning the relationship under investigation by presenting the main empirical predictions of the related literature. Second, we provide a comprehensive summary of the existing empirical evidence and its main weaknesses. Finally, we conclude by offering guidelines for further research

Ultrafast spectra and kinetics of human green-cone visual pigment at room temperature

Rhodopsin is the pigment that enables night vision, whereas cone opsins are the pigments responsible for color vision in bright-light conditions. Despite their importance for vision, cone opsins are poorly characterized at the molecular level compared to rhodopsin. Spectra and kinetics of the intermediate states of human green-cone visual pigment (mid-wavelength sensitive, or MWS opsin) were measured and compared with the intermediates and kinetics of bovine rhodopsin. All the major intermediates of the MWS opsin were recorded in the picosecond to millisecond time range. Several intermediates in MWS opsin appear to have characteristics similar to the intermediates of bovine rhodopsin; however, there are some marked differences. One of the most striking differences is in their kinetics, where the kinetics of the MWS opsin intermediates are slower compared to those of the bovine rhodopsin intermediates