Long-Term Complications of Tracheal Intubation

Endotracheal intubation is an intervention frequently performed in the hospital setting in order to protect the central airway and provide mechanical support of ventilation. Many health care providers are expected to be able to intubate the patients for different indications. As the case in any medical intervention, endotracheal intubation can cause complications. These complications are categorized as early or late according to the time of onset of the presenting symptoms. This chapter will discuss the long term complications of endotracheal intubation that might be encountered by the treating physicians. The chapter will stress on the predisposing factors for these complications and the available methods to avoid and treat them

Therapeutic bronchoscopy for central airway diseases

Over the past century rigid bronchoscopy has been established as the main therapeutic means for central airway diseases of both benign and malignant aetiology. Its use requires general anaesthesia and mechanical ventilation usually in the form of manual or high-frequency jet ventilation. Techniques applied to regain patency of the central airways include mechanical debulking, thermal ablation (laser, electrocautery and argon plasma coagulation) and cryo-surgery. Each of these techniques have their advantages and limitations and best results can be attained by combining different modalities according to the type, location and extent of the airway blockage. If needed, deployment of airway endoprostheses (stents), as either fixed-diameter silicone or self-expandable metal stents, may preserve the airways patency often at the cost of several complications. Newer generation of customised stents either three-dimensional printed or drug-eluting stents constitute a promise for improved safety and efficacy results in the near future. Treating central disease of benign or malignant aetiology, foreign body aspiration or massive bleeding in the airways requires a structured approach with combined techniques, a dedicated team of professionals and experience to treat eventual complications. Specific training and fellowships in interventional pulmonology should therefore be offered to those who wish to specialise in this field. Therapeutic bronchoscopy modalities may effectively treat difficult central airway problems in both malignant and benign diseases. This also involves responsibility for treating related complications. Training in interventional pulmonology is warranted

Rapid identification of foodborne pathogens in limited resources settings using a handheld Raman spectroscopy device

Rapid and precise methods to detect pathogens are paramount in ensuring food safetyand selecting appropriate disinfection treatments. Raman spectrometry is a promising technologybeing investigated for detecting pathogens and achieving rapid, culture-free, and label-free methods.Nonetheless, previous Raman techniques require additional steps, including the preparation ofslides that could introduce significant variability. In this study, we investigated the capability of aRaman handheld device for rapid identification of monocultures of Listeria monocytogenes, SalmonellaTyphimurium, Escherichia coli O157:H7, and Staphylococcus aureus, and the combination of co-culturesin BHI broth suspension by utilising principal component analysis (PCA) and support vector machine(SVM) classification of Raman spectra. The detection method accurately identified monocultures(0.93 ± 0.20), achieving good discrimination after 24 h of bacterial growth. However, the PCA–SVMsystem was less accurate for classifying co-cultures (0.67 ± 0.35). These results show that thismethod requires an isolation step followed by biomass enrichment (>8 log10 CFU/mL) for accurateidentification. The advantage of this technology is its simplicity and low-cost preparation, achievinghigh accuracy in monocultures in a shorter time than conventional culture-dependent methods

Survival and quality of life benefit after endoscopic management of malignant central airway obstruction

Although interventional management of malignant central airway obstruction (mCAO) is well established, its impact on survival and quality of life (QoL) has not been extensively studied.We prospectively assessed survival, QoL and dyspnea (using validated EORTC questionnaire) in patients with mCAO 1 day before interventional bronchoscopy, 1 week after and every following month, in comparison to patients who declined this approach. Material/Patients/Methods: 36 patients underwent extensive interventional bronchoscopic management as indicated, whereas 12 declined. All patients received full chemotherapy and radiotherapy as indicated. Patients of the 2 groups were matched for age, comorbidities, type of malignancy and level of obstruction. Follow up time was 8.0±8.7 (range 1-38) months.Mean survival for intervention and control group was 10±9 and 4±3 months respectively (p=0.04). QoL improved significantly in intervention group patients up to the 6(th) month (p<0.05) not deteriorating for those surviving up to 12 months. Dyspnea decreased in patients of the intervention group 1 month post procedure remaining reduced for survivors over the 12th month. Patients of the control group had worse QoL and dyspnea in all time points.Interventional management of patients with mCAO, may achieve prolonged survival with sustained significant improvement of QoL and dyspnea

A MULTI-SCALE CURVE MATCHING TECHNIQUE FOR THE ASSESSMENT OF ROAD ALIGNMENTS USING GPS/INS DATA

ABSTRACT: In this paper a methodology and an algorithm is presented for the automated extraction of road alignments using GPS/INS navigational data. Centerline geometry assessment is derived in the form of traditional design elements. The core of the proposed algorithm relies on the use of multi-scale correlation analysis (similarity and affinity transformations) and fundamental curve matching techniques that were suitably adapted to adhere the nature of road alignment data. A mobile mapping vehicle comprising a high accuracy multi-sensor navigational system was used to verify the correctness and level of automation of the algorithm as well as the feasibility of the associated software

Geraniol and Linalool Loaded Nanoemulsions and Their Antimicrobial Activity

Geraniol and linalool have been found to be effective against foodborne microorganisms in vitro. However, due to their hydrophobic nature, it is difficult to achieve an even dispersion in foods with high water content resulting in dramatic loss of activity. The aim of the study was to fabricate geraniol or linalool nanoemulsions and investigate their effect against Escherichia coli K12, Listeria innocua and Pseudomonas lundensis in a meat simulation medium. The agar diffusion assay revealed that both geraniol and linalool had a potent antimicrobial activity against all bacteria. Dynamic light scattering showed that geraniol and linalool nanoemulsions had a mean diameter of 68.22±2.46 and 173.59±4.15 nm, respectively. Killing assay results showed that both nanoemulsions were able to significantly reduce E. coli and L. innocua counts by approx. 3 log CFU/ml. Ps. lundensis proved to be more resistant to both nanoemulsions showing a reduction of approx. 1.2 log CFU/ml,. Overall, this study showed that nanoemulsions loaded with geraniol or linalool represent a promising antimicrobial system to improve food preservation and food safety

Development of a long-life vacuum-packaged ready-to-eat meat product based on a traditional Portuguese seasoned meat

Carne do alguidar is a Portuguese traditional pork fried meat, usually manufactured for self-consumption purposes. This study developed a ready-to-eat (RTE) meat product, to meet today's consumers’ convenience, manufactured at the industrial scale evaluating its quality and shelf-life, assessing the effect of vacuum packaging and the use of an antioxidant (50 ppm BHT) to enhance oxidative stability. Physicochemical and microbiological parameters were assessed and a sensory analysis was performed. Interestingly, no significant differences were recorded between control (non-BHT) and antioxidant (BHT) samples. Microbiological counts remained at low levels throughout the storage period, ensuring the product’s required microbiological quality. At later storage stages, higher values of thiobarbituric acid reactive substances arose and off flavours and aromas were perceived. Still, overall appreciation was not affected until 12 months storage and a significant depreciation was perceived only after 15 months. Fibrousness and rising of off flavours were negatively correlated with overall appreciation

An explorative study on the antimicrobial effects and mechanical properties of 3D printed PLA and TPU surfaces loaded with Ag and Cu against nosocomial and foodborne pathogens

Antimicrobial 3D printed surfaces made of PLA and TPU polymers loaded with copper (Cu), and silver (Ag) nanoparticles (NPs) were developed via fused deposition modeling (FDM). The potential antimicrobial effect of the 3D printed surfaces against Escherichia coli, Listeria monocytogenes, Salmonella Typhimurium, and Staphylococcus aureus was evaluated. Furthermore, the mechanical characteristics, including surface topology and morphology, tensile test of specimens manufactured in three different orientations (XY, XZ, and ZX), water absorption capacity, and surface wettability were also assessed. The results showed that both Cu and Ag-loaded 3D printed surfaces displayed a higher inhibitory effect against S. aureus and L. monocytogenes biofilms compared to S. Typhimurium and E. coli biofilms. The results of SEM analysis revealed a low void fraction for the TPU and no voids for the PLA samples achieved through optimization and the small height (0.1 mm) of the printed layers. The best performing specimen in terms of its tensile was XY, followed by ZX and XZ orientation, while it indicated that Cu and Ag-loaded material had a slightly stiffer response than plain PLA. Additionally, Cu and Ag-loaded 3D printed surfaces revealed the highest hydrophobicity compared to the plain polymers making them excellent candidates for biomedical and food production settings to prevent initial bacterial colonization. The approach taken in the current study offers new insights for developing antimicrobial 3D printed surfaces and equipment to enable their application towards the inhibition of the most common nosocomial and foodborne pathogens and reduce the risk of cross-contamination and disease outbreaks

The effect of 3D printing speed and temperature on transferability of Staphylococcus aureus and Escherichia coli during 3D food printing

The current study aimed to determine if the 3D-printing speed and temperature would impact the transferability of foodborne pathogens from the stainless-steel (SS) food cartridge to the 3D-printed food ink. Staphylococcus aureus and Escherichia coli were inoculated onto the interior surface of the SS food cartridges. Subsequently, a model food ink was extruded with a recommended macronutrient contribution of 55.8, 23.7, and 20.5% of carbohydrates, proteins, and fat, respectively. The impact of 3D-printing temperatures and speeds on transfer rates was analysed using a Two-Way ANOVA. S. aureus was transferred more from the cartridge to the food ink with a population of 3.39, 2.98, and 3.09 log CFU/g compared to 2.03, 2.06, and 2.00 log CFU/g for E. coli at 2000, 3000, and 4000 mm/s printing speed, respectively, at 25 °C. A Kruskal-Wallis Test was employed to investigate the effect of different speeds and temperatures on the transferability of S. aureus and E. coli. Speed was the main factor affecting S. aureus transferability, while temperature (25 and 50 °C) had the greatest impact on E. coli transferability. This research seeks to advance the understanding of 3D-printing parameters in pathogen transferability and help the food industry move towards this technology's quick and safe adoption