Improving Patient Safety Through A Postoperative Debriefing Initiative

Aims for Improvement Effective and clear communication in the operating room is a necessary aspect of any surgery. Every member of the operative team is integral in fostering an environment focused on patient safety. As such, the institution of a postoperative debrief session may allow for feedback from every member of the team that will ultimately aid in improving a patient’s experience

Case Series of Synthetic Cannabinoid Intoxication from One Toxicology Center.

Synthetic cannabinoid use has risen at alarming rates. This case series describes 11 patients exposed to the synthetic cannabinoid, MAB-CHMINACA who presented to an emergency department with life-threatening toxicity including obtundation, severe agitation, seizures and death. All patients required sedatives for agitation, nine required endotracheal intubation, three experienced seizures, and one developed hyperthermia. One developed anoxic brain injury, rhabdomyolysis and died. A significant number were pediatric patients. The mainstay of treatment was aggressive sedation and respiratory support. Synthetic cannabinoids pose a major public health risk. Emergency physicians must be aware of their clinical presentation, diagnosis and treatment

Women's subsistence strategies predict fertility across cultures, but context matters

Data, Materials, and Software Availability. Anonymized CSV file data have been deposited in OSF (https://osf.io/8d9n2/?view_only=9e07c25 e06414f7a8d041e80e8539e5c) (49).Supporting Information is available online at: https://www.pnas.org/doi/suppl/10.1073/pnas.2318181121/suppl_file/pnas.2318181121.sapp.pdf .While it is commonly assumed that farmers have higher, and foragers lower, fertility compared to populations practicing other forms of subsistence, robust supportive evidence is lacking. We tested whether subsistence activities—incorporating market integration—are associated with fertility in 10,250 women from 27 small-scale societies and found considerable variation in fertility. This variation did not align with group-level subsistence typologies. Societies labeled as “farmers” did not have higher fertility than others, while “foragers” did not have lower fertility. However, at the individual level, we found strong evidence that fertility was positively associated with farming and moderate evidence of a negative relationship between foraging and fertility. Markers of market integration were strongly negatively correlated with fertility. Despite strong cross-cultural evidence, these relationships were not consistent in all populations, highlighting the importance of the socioecological context, which likely influences the diverse mechanisms driving the relationship between fertility and subsistence.A.E.P. received funding from the Medical Research Council MRC (grant no. MR/P014216/1). J.S. acknowledges Institute for Advanced Study in Toulouse funding from the French National Research Agency (ANR) under the Investments for the Future (Investissements d’Avenir) program, grant ANR-17-EURE-0010. This material is based upon work supported while S.M. served at the National Science Foundation (NSF)

ICAR: endoscopic skull‐base surgery

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3D CT scan study of fetal cranial base : interests of occipital bone measurements in age estimation

International audienceOBJECTIVES:Cranial base development during fetal life is of major interest for many research purposes. In this study, we focused on fetal age estimations which are extremely important in forensic contexts. Nevertheless, there have been very few studies using occipital measurements to determine fetal age.OBJECTIVES:To evaluate change in the sagittal length/maximum width ratio of the basilar part of the occipital bone and to propose a simple and reliable method for fetal age determination.METHODS:A sample of 30 male and 7 female fetuses aged 24 to 41 weeks amenorrhea underwent CT scan. Occipital bones were reconstructed (Amira 4.0) and measurements were carried out on each part.RESULTS:A multivariate analysis (ANOVA) gave an age formula using right exoccipital measurements and a linear regression supplied the age of reversion of the sagittal length/maximum width ratio.CONCLUSION:This preliminary study clearly highlighted the promises of 3D CT-Scan studies of fetal cranial base and gave interesting results and the method deserves to be tested on a larger sample

Validation of biometric study of fetal mandibles by 3D tomodensitometric images

We carried out a biometric study of the mandible during the last two trimesters of fetal life using three-dimensional tomodensitometric images. We first validated the method of fetal mandible measurement from three-dimensional reconstructions, and then compared these measurements with direct measurements on dissected mandibles. Thanks to the biometric technique on three-dimensional images, dissection of mandibles is no longer necessary, allowing the material to be conserved for later studies. Tomodensitometric images of the whole fetal skull can be obtained in 10 minutes, a much shorter time than that required for dissection of the fetal mandible. Another major advantage is the possibility of computerized image storage, which allows subsequent studies on the same material, its observation and manipulation as well as exchange of findings with the research community, with no risk of damage to the original material