Does experience influence the forces exerted on maxillary incisors during laryngoscopy? A manikin study using the Macintosh laryngoscope

The influence of the level of experience of the laryngoscopist on the duration of laryngoscopy, the forces exerted on the tongue and on the maxillary incisors during laryngoscopy, were investigated. Five groups (anaesthetists, residents in anaesthesia, nurse anaesthetists, surgeons and medical students), each consisting of 15 individuals, participated in the study. An intubation manikin was used with a laryngoscope modified so that the forces applied during laryngoscopy could be measured. The mean duration of laryngoscopy in these groups was 23.4 sec, 17.6 sec, 27.1 sec, 26.8 sec and 42.7 sec, respectively. The maximally applied forces on the tongue were 71.7 N, 60.5 N, 65.9 N, 74.2 N and 69.7 N, respectively. The maximally applied forces on the maxillary incisors were 49.9 N, 36.3 N, 41.1 N, 58.3 N and 53.9 N, respectively. These results indicate the level of experience has a significant influence on the duration of laryngoscopy but seems to have little influence on the forces applied to the tongue and the maxillary incisors

D & D screening risk evaluation guidance

The Screening Risk Evaluation (SRE) guidance document is a set of guidelines provided for the uniform implementation of SREs performed on decontamination and decommissioning (D&D) facilities. Although this method has been developed for D&D facilities, it can be used for transition (EM-60) facilities as well. The SRE guidance produces screening risk scores reflecting levels of risk through the use of risk ranking indices. Five types of possible risk are calculated from the SRE: current releases, worker exposures, future releases, physical hazards, and criticality. The Current Release Index (CRI) calculates the current risk to human health and the environment, exterior to the building, from ongoing or probable releases within a one-year time period. The Worker Exposure Index (WEI) calculates the current risk to workers, occupants and visitors inside contaminated D&D facilities due to contaminant exposure. The Future Release Index (FRI) calculates the hypothetical risk of future releases of contaminants, after one year, to human health and the environment. The Physical Hazards Index (PHI) calculates the risks to human health due to factors other than that of contaminants. Criticality is approached as a modifying factor to the entire SRE, due to the fact that criticality issues are strictly regulated under DOE. Screening risk results will be tabulated in matrix form, and Total Risk will be calculated (weighted equation) to produce a score on which to base early action recommendations. Other recommendations from the screening risk scores will be made based either on individual index scores or from reweighted Total Risk calculations. All recommendations based on the SRE will be made based on a combination of screening risk scores, decision drivers, and other considerations, as determined on a project-by-project basis

Forces acting on the maxillary incisor teeth during laryngoscopy using the Macintosh laryngoscope

We determined the forces on the maxillary incisors during routine laryngoscopy in 65 adult patients. The forces were measured by a strain gauge based sensor positioned between the handle and the blade of the laryngoscope. The mean maximal force acting on the maxillary incisors was 49 N. In patients without maxillary incisors, the force acting on the gums was significantly lower at 21N (p < 0.001). These results suggest that, despite traditional advice to the contrary, a levering movement of the laryngoscope, using the maxillary incisors (or gums) as a fulcrum, is common practice. Biomechanical analysis revealed that, although levering is not the preferred movement, it is an efficient way of bringing the glottis into view. These results may have implications for future laryngoscope design

Family caregiving tips: Creating a care team

The Oklahoma Cooperative Extension Service periodically issues revisions to its publications. The most current edition is made available. For access to an earlier edition, if available for this title, please contact the Oklahoma State University Library Archives by email at [email protected] or by phone at 405-744-6311

Development of Cell Permeable NanoBRET Probes for the Measurement of PLK1 Target Engagement in Live Cells

PLK1 is a protein kinase that regulates mitosis and is both an important oncology drug target and a potential antitarget of drugs for the DNA damage response pathway or anti-infective host kinases. To expand the range of live cell NanoBRET target engagement assays to include PLK1, we developed an energy transfer probe based on the anilino-tetrahydropteridine chemotype found in several selective PLK inhibitors. Probe 11 was used to configure NanoBRET target engagement assays for PLK1, PLK2, and PLK3 and measure the potency of several known PLK inhibitors. In-cell target engagement for PLK1 was in good agreement with the reported cellular potency for the inhibition of cell proliferation. Probe 11 enabled the investigation of the promiscuity of adavosertib, which had been described as a dual PLK1/WEE1 inhibitor in biochemical assays. Live cell target engagement analysis of adavosertib via NanoBRET demonstrated PLK activity at micromolar concentrations but only selective engagement of WEE1 at clinically relevant doses

Application of BRET to monitor ligand binding to GPCRs

Bioluminescence resonance energy transfer (BRET) is a well-established method for investigating protein-protein interactions. Here we present a BRET approach to monitor ligand binding to G protein–coupled receptors (GPCRs) on the surface of living cells made possible by the use of fluorescent ligands in combination with a bioluminescent protein (NanoLuc) that can be readily expressed on the N terminus of GPCRs

D and D alternatives risk assessment for Building 3515 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

This report presents the results of the Level 3 Decontamination and Decommissioning (D and D) Alternatives Risk Assessment (DARA) performed on Building 3515 located at the Oak Ridge National Laboratory (ORNL). The goal of the risk evaluation process is to provide risk information necessary to assist decision making for Environmental Restoration (ER) Program D and D facilities. This risk information is developed in the baseline risk assessment (BRA) and in the DARA. The BRA provides risk information necessary for determining whether or not a facility represents an unacceptable risk and requires remediation. In addition, the BRA also provides an estimation of the risks associated with the no-action alternative for use in the DARA. The objective of this Level 3 DARA is to evaluate and document the potential risks to human health, human safety, and the environment associated with the proposed remedial action at Building 3515. A Level 3 assessment is the least rigorous type of DARA. The decision to conduct a Level 3 DARA was based on the fact that characterization data from the facility are limited, and currently only one remedial alternative (complete dismantlement) is being evaluated in addition to the no-action alternative. The results of the DARA along with cost and engineering information may be used by project managers in making decisions regarding the final disposition of Building 3515. This Level 3 assessment meets the requirements of the streamlined risk assessment necessary for an Engineering Evaluation/Cost Analysis (EE/CA)