Another method to maintain positive-pressure ventilation through the Montgomery® T tube

We describe airway management in a patient who had a Montgomery® T tube in situ. The main concern pertaining to these patients is the inadequate depth of anaesthesia and ventilation, in view of loss of volume of air and gases, as well as dilution through the proximal end of the Montgomery®  T tube. To circumvent these problems, we describe another method of providing ventilation, through the extraluminal horizontal limb of the Montgomery®  T tube by introducing an uncuffed endotracheal tube and minimising the loss of carrier gases to the larynx, together with a review of literature for the same.Keywords: Montgomery® T tube, positive-pressure ventilationSouth Afr J Anaesth Analg 2013;19(5):274-27

A survey on Routing Protocols in Wireless Sensor Networks

In ad-hoc WSN is a collection of mobile nodes that are dynamically and randomly located in such a manner that the interconnections between nodes are changing on a continual basis. The dynamic nature of these networks demands new set of network routing strategy protocols to be implemented in order to provide efficient end-to end communication. Moreover, such issues are very critical due to severe resource constraints like efficient energy utilization, lifetime of network, and drastic environmental conditions in WSNs. Neither hop-by-hop nor neither direct reach ability is possible in case of WSNs. In order to facilitate communication within the network, a routing protocol is used. In this paper we have carried out an extensive survey on WSN protocols based on structure of network, routing protocol of network & clustering techniques of routing protocols

Smoking Behaviors and Arterial Stiffness Measured by Pulse Wave Velocity in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study

Though smoking is strongly associated with peripheral vascular disease and arteriosclerosis, smoking’s association with arterial stiffness has been inconsistent and mostly limited to a single arterial segment. We examined the relationship between smoking behaviors with arterial stiffness in multiple arterial segments among community dwelling older adults

Executive summary of AAPM Report Task Group 113: Guidance for the physics aspects of clinical trials

The charge of AAPM Task Group 113 is to provide guidance for the physics aspects of clinical trials to minimize variability in planning and dose delivery for external beam trials involving photons and electrons. Several studies have demonstrated the importance of protocol compliance on patient outcome. Minimizing variability for treatments at different centers improves the quality and efficiency of clinical trials. Attention is focused on areas where variability can be minimized through standardization of protocols and processes through all aspects of clinical trials. Recommendations are presented for clinical trial designers, physicists supporting clinical trials at their individual clinics, quality assurance centers, and manufacturers.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146453/1/acm212384_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146453/2/acm212384.pd

Depression and Oxidative Stress: Results From a Meta-Analysis of Observational Studies

To perform a systematic review and meta-analysis that quantitatively tests and summarizes the hypothesis that depression results in elevated oxidative stress and lower antioxidant levels

Report of AAPM Therapy Physics Committee Task Group 74: Inâ air output ratio, Sc, for megavoltage photon beams

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134830/1/mp7367.pd

IMRT commissioning: multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119.

AAPM Task Group 119 has produced quantitative confidence limits as baseline expectation values for IMRT commissioning. A set of test cases was developed to assess the overall accuracy of planning and delivery of IMRT treatments. Each test uses contours of targets and avoidance structures drawn within rectangular phantoms. These tests were planned, delivered, measured, and analyzed by nine facilities using a variety of IMRT planning and delivery systems. Each facility had passed the Radiological Physics Center credentialing tests for IMRT. The agreement between the planned and measured doses was determined using ion chamber dosimetry in high and low dose regions, film dosimetry on coronal planes in the phantom with all fields delivered, and planar dosimetry for each field measured perpendicular to the central axis. The planar dose distributions were assessed using gamma criteria of 3%/3 mm. The mean values and standard deviations were used to develop confidence limits for the test results using the concept confidence limit = /mean/ + 1.96sigma. Other facilities can use the test protocol and results as a basis for comparison to this group. Locally derived confidence limits that substantially exceed these baseline values may indicate the need for improved IMRT commissioning

The association of sport and exercise activities with cardiovascular disease risk: The Atherosclerosis risk in Communities (ARIC) study

Background: This study assessed the independent associations between participation in self-reported sport and exercise activities and incident cardiovascular disease (CVD). Methods: Data were from 13,204 participants in the Atherosclerosis Risk in Communities Study cohort (1987–2015). Baseline sport and exercise activities were assessed via the modified Baecke questionnaire. Incident CVD included coronary heart disease, heart failure, or stroke. Multivariable-adjusted Cox proportional hazard models assessed the association of participation in specific sport and exercise activities at enrollment with risk of CVD. Results: During a median follow-up time of 25.2 years, 30% of the analytic sample (n = 3966) was diagnosed with incident CVD. In fully adjusted models, participation in racquet sports (hazard ratio [HR] 0.75; 95% confidence interval [CI], 0.61–0.93), aerobics (HR 0.75; 95% CI, 0.63–0.88), running (HR 0.68; 95% CI, 0.54–0.85), and walking (HR 0.89; 95% CI, 0.83–0.95) was significantly associated with a lower risk of CVD. There were no significant associations for bicycling, softball/baseball, gymnastics, swimming, basketball, calisthenics exercises, golfing with cart, golfing with walking, bowling, or weight training. Conclusions: Participation in specific sport and exercises may substantially reduce the risk for CVD

Monitor unit calculations for external photon and electron beams: Report of the AAPM Therapy Physics Committee Task Group No. 71

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134882/1/mp4244.pd

Validation of the severity index by cardiac catheterization and Doppler echocardiography in patients with aortic sclerosis and stenosis

The severity index is a new echocardiographic measure that is thought to be an accurate indicator of aortic leaflet pathology in patients with AS. However, it has not been validated against cardiac catheterization or Doppler echocardiographic measures of AS severity nor has it been applied to patients with aortic sclerosis. The purposes of this study were to compare the severity index to invasive hemodynamics and Doppler echocardiography across the spectrum of calcific aortic valve disease, including aortic sclerosis and AS. 48 patients with aortic sclerosis and AS undergoing echocardiography and cardiac catheterization comprised the study population. The aortic valve leaflets were assessed for mobility (scale 1 to 6) and calcification (scale 1 to 4) and the severity index was calculated as the sum of the mobility and calcification scores according to the methods of Bahler et al. The severity index increased with increasing severity of aortic valve disease; the severity indices for patients with aortic sclerosis, mild to moderate AS and severe AS were 3.38 ± 1.06, 6.45 ± 2.16 and 8.38 ± 1.41, respectively. The aortic jet velocity by echocardiography and the square root of the maximum aortic valve gradient by cardiac catheterization correlated well with the severity index (r = 0.84, p < 0.0001; r = 0.84, p < 0.0001, respectively). These results confirm that the severity index correlates with hemodynamic severity of aortic valve disease and may prove to be a useful measure in patients with aortic sclerosis and AS