Anatomic Dead Space Cannot Be Predicted by Body Weight

Anatomic, airway, or tracheal, dead space is the part of the tidal volume that does not participate in gas exchange. Knowledge of the size of the dead space is important for proper mechanical ventilation, especially if small tidal volumes are used. Respiratory and medical textbooks state that anatomic dead space can be estimated from the patient’s body weight. Specifically, these references suggest dead space can be predicted using a relationship of one milliliter per pound of body weight. Using a volumetric capnography monitor that incorporates on-airway flow and CO2 monitoring (NICO2, Respironics, Wallingford CT), anatomic dead space can be automatically and directly measured using Fowler’s method in which dead space equals the exhaled volume up to the point when CO2 rises above a threshold [4]. We retrospectively analyzed data collected in 58 (43 male, 15 female) patients to assess the accuracy of weight-based estimation of anatomic dead space. It appears that the average anatomic dead space roughly corresponds to the average body weight for the overall population; however, the poor correlation between individual patient weight and dead space contradicts the suggestion that dead space can be estimated from body weight

Associating Mathematics to its History: Connecting the Mathematics we Teach to its Past

Across the USA and around the world now, globalization has taken a strong hold. The purpose of this paper is to explore the historical considerations that can be incorporated in the teaching of mathematics. The paper will also provide suggestions for teaching math by interweaving historical elements into the mathematics instruction. Teachers should strive to bridge the cultural and historical gap among all students by incorporating innovative ideas as well as historical and cultural connections into their teaching so to foster understanding, appreciation, and tolerance for the richness inherent in diversity and a sound understanding of mathematics and appreciation for other cultures and their contributions to the field of mathematics. It is often believed that no other subject besides math dissociates itself from its history. This paper makes an attempt to give teachers ideas to incorporate more history in the teaching of mathematics by showing what was going on at the time that may have influenced the development of such mathematics that we now teach in our classrooms of today

Validation of the Vaccination Confidence Scale: A Brief Measure to Identify Parents at Risk for Refusing Adolescent Vaccines

Objective To validate a brief measure of vaccination confidence using a large, nationally representative sample of parents. Methods We analyzed weighted data from 9018 parents who completed the 2010 National Immunization Survey–Teen, an annual, population-based telephone survey. Parents reported on the immunization history of a 13- to 17-year-old child in their households for vaccines including tetanus, diphtheria, and acellular pertussis (Tdap), meningococcal, and human papillomavirus vaccines. For each vaccine, separate logistic regression models assessed associations between parents\u27 mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status. We repeated analyses for the scale\u27s 4-item short form. Results One quarter of parents (24%) reported refusal of any vaccine, with refusal of specific vaccines ranging from 21% for human papillomavirus to 2% for Tdap. Using the full 8-item scale, vaccination confidence was negatively associated with measures of vaccine refusal and positively associated with measures of vaccination status. For example, refusal of any vaccine was more common among parents whose scale scores were medium (odds ratio, 2.08; 95% confidence interval, 1.75–2.47) or low (odds ratio, 4.61; 95% confidence interval, 3.51–6.05) versus high. For the 4-item short form, scores were also consistently associated with vaccine refusal and vaccination status. Vaccination confidence was inconsistently associated with vaccine delay. Conclusions The Vaccination Confidence Scale shows promise as a tool for identifying parents at risk for refusing adolescent vaccines. The scale\u27s short form appears to offer comparable performance

Penning traps with unitary architecture for storage of highly charged ions

Penning traps are made extremely compact by embedding rare-earth permanent magnets in the electrode structure. Axially-oriented NdFeB magnets are used in unitary architectures that couple the electric and magnetic components into an integrated structure. We have constructed a two- magnet Penning trap with radial access to enable the use of laser or atomic beams, as well as the collection of light. An experimental apparatus equipped with ion optics is installed at the NIST electron beam ion trap (EBIT) facility, constrained to fit within 1 meter at the end of a horizontal beamline for transporting highly charged ions. Highly charged ions of neon and argon, extracted with initial energies up to 4000 eV per unit charge, are captured and stored to study the confinement properties of a one-magnet trap and a two-magnet trap. Design considerations and some test results are discussed

Rebreathing Used for Cardiac Output Monitoring Does Not Increase Heart Rate

The partial rebreathing method for cardiac output determination produces short periods of elevated arterial CO2 content. Because previous work had shown that elevated etCO2 levels increased cardiac output, mostly due to heart rate increases, a concern was raised that the rebreathing periods could be inducing an elevated heart rate. This could also raise the cardiac output (CO), since CO = (Heart Rate) X (Stroke Volume). We studied 93 patients in the OR and the ICU who had undergone a total of 5142 partial rebreathing measurements by the NICO2 monitor (Novametrix Medical Systems) to determine whether the heart rate was raised, even if transiently, during the monitored period. Our conclusion was that the rebreathing periods caused no detectable change in the heart rate

Comparisons of Medical Student Knowledge Regarding Life-Threatening CT Images Before and After Clinical Experience

Introduction. Currently, no national standard exists for educatingmedical students regarding radiography or formal research indicatingthe level of improvement regarding computed tomography(CT) interpretation of medical students during clinical rotations. Methods. Students were evaluated based on their response totwenty-two open-ended questions regarding diagnosis and treatmentof eleven de-identified CT images of life-threatening injuries.The number of incorrect answers was compared withcorrect or partially correct answers between students startingthird-year clinical rotations and those starting their fourth year. Results. Survey results were collected from 65 of 65 (100%) beginningthird-year students and 9 of 60 (15%) beginning fourthyearstudents. Students in their fourth-year had less incorrectanswers compared to third-year students, with five questionsreflecting a statistically significant reduction in incorrect responses.The image with the least incorrect for both groups wasepidural hemorrhage, 33.9% and 18.5% incorrect for third-yearstudents for diagnosis and treatment, respectively, and 11.1%and 0% incorrect for fourth-year students. Outside of this image,the range of incorrect answers for third-year students was75.4% to 100% and 44.4% to 100% for fourth-year students. Conclusion. Baseline CT knowledge of medical students,regardless of clinical experience, indicated a strong deficit,as more students were incorrect than correct for themajority of CT images. KS J Med 2017;10(3):55-58