Effects of user experience and method in the inflation of endotracheal tube pilot balloon on cuff pressure

Context: Endotracheal tube cuff pressure (ETCP) is recommended to be maintained between 20.30 cmH2O limits. While insufficient inflation of ETC may cause aspirations, over.inflation of it may lead to damage in tracheal epithelium.Aims: We planned to investigate the effects of user experience and cuff pressure inflation method differences following endotracheal tube cuff pressure and complaints about it.Patients and Methods: Two hundred and fifty patients planned for general anaesthesia were included in this study. ETC was inflated by users with different experience according to leakage or pilot balloon palpation techniques. ETCPs were measured by manometer at three periods (5 and 60 minutes after endotracheal intubation, and before extubation). Complaints about it were recorded in post anaesthetic care unit and 24 hours postoperatively.Results: Though we found experience of user had significant effect on the ETCP regulations, we observed inflation methods did not have any effect. However we found ETCP was higher than normal range with experienced users. A correlation was observed between cuff pressure and anaesthesia duration with postoperative complaints.Conclusions: Our study concluded that the methods used do not have any significant advantage over one another. While ETC inflated at normal pressure increases as userfs experience increases, experience alone is not enough in adjusting ETCP. A manometer should be used in routine inflation of ETC instead of conventional methods. CP and anaesthesia duration have correlations with some postoperative complaints.Key words: Endotracheal tube cuff pressure, experience of user, inflation method

Clinical Evaluation of Small Diameter Straumann Implants in Partially Edentulous Patients: A 5-Year Retrospective Study

Objective: The aim of the present study was to retrospectively evaluate small-diameter (3.3 mm) Straumann® dental implants placed in the maxilla or the mandible over a period of 5 years in function.Materials and Methods: Twenty- eight partially edentulous patients received a total of 48 implants over a 5-year period. After the standard healing period (3 to 6 months), the implants were restored with single-tooth prostheses or fixed partial dentures. All patients were followed according to a strict maintenance program with regular recalls. The cumulative survival rates of implants were analyzed and prosthetic complications were assessed.Results: After 5 years of function, one single 10-mm-long implant in the maxillary premolar region was lost because of recurrent peri-implant infection in a female patient. Two single 10-mm-long maxillary implants placed in the posterior region were lost due to body fracture. The cumulative 5-year survival rate of the implants was 93.75 %. The most common prosthetic complication was loosening of the occlusal screw.Conclusion: Within the limited observation period and the number of patients included in this study, it may be concluded that the use of small-diameter implants appears to be predictable if clinical guidelines are followed and appropriate prosthetic restorations are provided. However, it should be noted that fatigue fracture may occur

Highly stable defective TiO2-x with tuned exposed facets induced by fluorine: Impact of surface and bulk properties on selective UV/visible alcohol photo-oxidation

Titanium dioxide samples were prepared in the presence of different amounts of fluorine via hydrothermal method. It has been found that the presence of fluoride influenced the physico-chemical properties of TiO2 in various ways as polymorphic form stability, surface hydroxylation, generation of hydroxyl radicals under irradiation and formation of Ti3+ centers and oxygen vacancies. The generation rate of [rad]OH radicals was investigated by the photoluminescence technique in the presence of terephthalic acid. X-ray diffractometry indicated that fluorine stabilized the anatase TiO2. X-Ray photoelectron spectroscopy (XPS) revealed the presence of fluorine on the surface and the shift of the valence band edge towards less negative potentials, electron paramagnetic resonance (EPR) confirmed the formation of Ti3+ in the bulk of the photocatalysts, UV–vis spectra showed the extension of the TiO2 photo-response in the visible light region. 2-Propanol degradation and 4-methoxybenzyl alcohol partial oxidation were studied as probe reactions by using the home prepared powders as photocatalysts. Surprisingly, the photocatalytic activity resulted to be mainly affected by [rad]OH radicals formation ability under irradiation, rather than by the presence of {0 0 1} facets, although it cannot be excluded that the latter could influence the ability to form radicals under irradiation

Geometrical Constraints on the Cosmological Constant

The cosmological constant problem is examined under the assumption that the extrinsic curvature of the space-time contributes to the vacuum. A compensation mechanism based on a variable cosmological term is proposed. Under a suitable hypothesis on the behavior of the extrinsic curvature, we find that an initially large $\Lambda(t)$ rolls down rapidly to zero during the early stages of the universe. Using perturbation analysis, it is shown that such vacuum behaves essentially as a spin-2 field which is independent of the metric.Comment: [email protected], 17 pages, Latex, 2 figures obtained by reques

Extraction of primary and secondary frequency control from active power generation data of power plants

Frequency control is a vital component of a secure and robust power grid and it ought to be closely monitored. Frequency control consists of two main components; primary and secondary control and their contributions are usually aggregated in the active power generation data of a plant, which is acquired via Supervisory Control And Data Acquisition. In many cases, such as in Turkey, they are demanded to be evaluated separately due to different impacts on power system or different financial policies. However, this is not usually a straightforward process since primary and secondary response cannot be obtained distinctly. In this work, Extraction of Primary and Secondary Control (EPSCon) algorithm is introduced to extract primary and secondary response over active power generation data. Based on time and frequency domain characteristics of primary and secondary response, EPSCon is developed on a Expectation-Maximization type recursive scheme employing Generalized Cross Correlation and ℓ1 Trend Filtering techniques. Favorably, EPSCon uses a simple plant model built upon basic governor and plant load controller technical characteristics as an initial estimate of primary and secondary response. © 2015 Elsevier Ltd. All rights reserved

Black Hole Formation with an Interacting Vacuum Energy Density

We discuss the gravitational collapse of a spherically symmetric massive core of a star in which the fluid component is interacting with a growing vacuum energy density. The influence of the variable vacuum in the collapsing core is quantified by a phenomenological \beta-parameter as predicted by dimensional arguments and the renormalization group approach. For all reasonable values of this free parameter, we find that the vacuum energy density increases the collapsing time but it cannot prevent the formation of a singular point. However, the nature of the singularity depends on the values of \beta. In the radiation case, a trapped surface is formed for \beta<1/2 whereas for \beta>1/2, a naked singularity is developed. In general, the critical value is \beta=1-2/3(1+\omega), where the \omega-parameter describes the equation of state of the fluid component.Comment: 9 pages, 8 figure

Species diversity and distribution of ruderal flora on landfills in Maradi city, Niger

Waste management continues to be a critical environmental issue in cities. It impacts on the well being of the population, the environment and the biodiversity. In the city of Maradi, in Niger, more interest is given to the problem in order to understand the whole waste management system. It is in this context that this study is carried out to investigate on the role of ruderal flora on the municipal solid wastes dumpsites and landfill sites in Maradi city. The specific objectives are to determine the floristic diversity and distribution of ruderal flora on the municipal solid waste disposal sites, and to identify potential species that can play an important role in the phytoremediation of these sites. In total, 65 species belonging to 52 genera and 24 families were recorded. These species can be categorised into two groups containing anthropic and nitrophilic species according to the ascending Hierarchical Classification (AHC) at 25% similarity. Characteristic species of the first group G1 are Amaranthus viridis and Cucurbita pepo, and Datura innoxia and Cucumis melo for the second group G2. Other ruderal species, namely Amaranthus spinosus L., Amaranthus viridis L., Celosia trygina L., Datura innoxia Mill., and an introduced woody species, Cuphea hyssopifolia Kunth., found are not included in the Maradi city list of species. Datura innoxia, Amaranthus viridis and Amaranthus spinosus are species known to tolerate different degrees of pollution and their ecology should be further study to better understand how they can be used for phytoremediation on this kind of sites