General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multicentre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients’ (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16–22) and failed intubation in 1 in 312 (95%CI 1 in 169–667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

Production and growth of coniferous tree seedings in different compost substrates in a modern Tunisian forest nursery

Within the framework of the modernization of Tunisian forest nurseries, the substitution of forest or diversetextured agricultural soil-based substrates by compost produced from locally available forest biomass is one of the principal areas of research aimed at improving the quality of forest plants produced for reforestation programs. To develop a standard growing medium that could be used in these modern nurseries, and taking into account the availability of the diverse constituents, five compost-based growing media (S1, S2, S3, S4, and S5) mixed with different support and aeration materials were compared to a control substrate made of peat and vermiculite for the production of seedlings of three different forest species: Pinus pinea, Pinus halepensis and Cupressus sempervirens. Although the physical and chemical properties of the different growing media studied varied in their composition, by the end of the growing season these substrates had produced plants that complied with the quality standards required for Tunisian reforestation programs. Growth of the three species seedlings raised under nursery conditions in these substrates was significantly affected by the nature of the substrate used. Growth of plants produced using compost-based substrates was significantly lower than that achieved with other substrates. Our results clearly demonstrate that we are able to meet plant quality standards relating to growth while using substrates made up of local materials with no need to resort to the importation of peat and vermiculite. The adaptation and generalization of this approach in other countries with similar constraints offer promising prospects.Dans le cadre de la modernisation des pépinières forestières en Tunisie, la substitution des substrats à base de terreau forestier ou de sols agricoles par un compost produit à partir de la biomasse forestière localement disponible figure parmi les principaux axes de recherche en matière d’amélioration de la qualité des plants forestiers pour satisfaire les programmes de reboisement. Pour la mise au point d’un substrat standard utilisable dans ces pépinières, et tenant compte de la disponibilité des divers constituants, cinq substrats à base de compost mélangé à divers matériaux ont été comparés à un substrat témoin, constitué d’un mélange de tourbe et de vermiculite, pour la production de plants de trois essences forestières : Pinus pinea, Pinus halepensis et Cupressus sempervirens. Bien que les propriétés physico-chimiques des différents substrats étudiés aient varié selon leur composition, ces substrats ont permis de produire à la fin de la saison de croissance des plants qui respectent les normes de qualité requises pour les programmes de reboisement en Tunisie. La croissance des plants des trois essences produits en pépinière dans ces substrats a été affectée de façon significative par la nature du substrat utilisé. La croissance des plants produits dans les substrats à base de compost a été significativement inférieure à celle mesurée dans les autres substrats. Nos résultats démontrent que nous pourrons atteindre les normes de qualité des plants en matière de croissance tout en utilisant des substrats à base de matériaux locaux et sans recourir aux importations de tourbe et de vermiculite. L’adaptation et la généralisation de cette approche restent très prometteuses pour les régions aux contraintes similaires

Intelligent classification of stingless bee honey using Enose

Honey is an essential product produced by both honey bees and stingless bees. It is one of the most powerful natural products used for wound healing also known as natural sweetener that is widely available across the entire world. One of the problems required to sustain the bee honey by measuring and quantifying the quality. One of the methods to detect bee honey via odor signature. However, the difficulties in identifying the odour profile feature are common by using human or animal nose. The second challenge is to find efficient and accurate artificial intelligence methods to identify the odours. The objective of this research is to identify the stingless bee honey (SBH) using odour-profile feature. SBH is one of a bee species, yet different in size, it produces a honey that is clearer in colour as compared to natural honey bee. However, study on SBH grade is not yet extensively explored. Other than that, this research is done to measure the odour-profile by using E-nose which comprises of sensor array has been used to measure the samples of dataset from a few different types of SBH. Hence, this research aim is to classify stingless bee honey based on smell pattern recognition. The final step is the measured data were normalised and analysed using case-based reasoning (CBR) method. Interestingly, CBR classification had shown significant findings whereby it could achieved 100% rate of accuracy, specificity and sensitivity. In conclusion, classification of SBH odor-profile using CBR is feasible