Safer Ambu-Bag Manual Ventilation through Addition of a Second High Efficiency Particulate Air (HEPA) Filter

Experts from the Thomas Jefferson University Health Design Lab met with Emergency Medicine and Anesthesia physicians and local engineers A design was envisioned in which 3-D printed connectors could be created to add an additional HEPA Filter as shown in Figure 1 STL Files for the adapters were created based on standard HEPA filter diameters and 3-D printed The second HEPA filter was easily assembled by novice users using the adapters Ventilation adequacy using the double HEPA filter ambu-bag was similar to single HEPA filtered ambu-bag ventilation based on observed inflation of a test lun

A Strategy for Deploying Large-Scale Volunteer Continuous Bag Valve Tube (BVT) Ventilation

Part 1: Hospital Guide The hospital guide outlines steps and considerations for the healthcare system to successfully implement a manual ventilation strategy Part 2: Online BVT Training Module We created an online articulate evidence based training module for safe and effective Bag-Valve-Tube (BVT) ventilation for medical and nonmedical providers

Repairing a Damaged Powered Air-Purifying Respirator (PAPR) Battery Component Component with 3-D Printing

A team from the Thomas Jefferson University Health Design Lab worked with local engineers at FKB to create a 3-D replacement model for the faulty component A new component was designed to function with existing battery components The new component was created using a desktop fused deposition modeling (FDM) 3-D printer with polylactic acid (PLA) filamen

Maintaining Powered Air-Purifying Respirator (PAPR) Supply through Repair of Damaged Hose Units by 3D Printing

What’s the Problem? Powered air-purifying respirators (PAPRs) are a type of Personal Protective Equipment (PPE) that serves an essential line of defense against the spread of COVID-19 and other airborne pathogens. Demand for PAPRs are at a premium during a time where supply chains have been disrupted. The hose component of the 3M™ Air-Mate™ PAPR has a fragile interface with the hood, leading to damage and rendering the PAPR unit unsafe for continued use. PAPR units are on backorder, as are their components. Given the acute need for functional PAPRs other approaches for repair were explored

A Web-Based Application to Simulate Manual Bag-Valve-Tube Ventilation

What’s the Problem? The COVID-19 pandemic has threatened ventilator capacity in many locations which has led to alternative solutions to meet surge ventilator capacity including a strategy for deploying large-scale volunteer continuous bag-valve-tube (BVT) ventilation While an online training module may teach the manual ventilation volunteer force requisite knowledge, evidence suggests technology enhanced simulation training in health professions training is associated with improved outcomes for desired knowledge, skills and behavior

Skeletal trade-offs in coralline algae in response to ocean acidification

Ocean acidification is changing the marine environment, with potentially serious consequences for many organisms. Much of our understanding of ocean acidification effects comes from laboratory experiments, which demonstrate physiological responses over relatively short timescales. Observational studies and, more recently, experimental studies in natural systems suggest that ocean acidification will alter the structure of seaweed communities. Here, we provide a mechanistic understanding of altered competitive dynamics among a group of seaweeds, the crustose coralline algae (CCA). We compare CCA from historical experiments (1981-1997) with specimens from recent, identical experiments (2012) to describe morphological changes over this time period, which coincides with acidification of seawater in the Northeastern Pacific. Traditionally thick species decreased in thickness by a factor of 2.0-2.3, but did not experience a change in internal skeletal metrics. In contrast, traditionally thin species remained approximately the same thickness but reduced their total carbonate tissue by making thinner inter-filament cell walls. These changes represent alternative mechanisms for the reduction of calcium carbonate production in CCA and suggest energetic trade-offs related to the cost of building and maintaining a calcium carbonate skeleton as pH declines. Our classification of stress response by morphological type may be generalizable to CCA at other sites, as well as to other calcifying organisms with species-specific differences in morphological types

Tibial tubercle osteotomy for access during revision knee arthroplasty: Ethibond suture repair technique

<p>Abstract</p> <p>Background</p> <p>Tibial Tubercle Osteotomy has shown much promise in revision total knee replacement. Methods of repair previously described include screw and wire fixation. Both methods have significant complications.</p> <p>Methods</p> <p>This article describes suture fixation of the osteotomy using Ethibond sutures placed medially with a lateral periosteal hinge.</p> <p>Results</p> <p>This method of fixation relies upon an adequate osteotomy segment including the entire insertion of the patella tendon. The lateral periosteal hinge is maintained and adds to the stability of the construct. A minimum of two number 5 Ethibond sutures are passed medially through drill holes to secure the osteotomy segment. No post-operative immobilisation is required.</p> <p>Conclusion</p> <p>Ethibond sutures provide adequate fixation of the tibial tubercle osteotomy segment in revision knee arthroplasty with reduced risk of complication as compared to conventional fixation methods.</p

Seagrass can mitigate negative ocean acidification effects on calcifying algae

The ultimate effect that ocean acidification (OA) and warming will have on the physiology of calcifying algae is still largely uncertain. Responses depend on the complex interactions between seawater chemistry, global/local stressors and species-specific physiologies. There is a significant gap regarding the effect that metabolic interactions between coexisting species may have on local seawater chemistry and the concurrent effect of OA. Here, we manipulated CO2 and temperature to evaluate the physiological responses of two common photoautotrophs from shallow tropical marine coastal ecosystems in Brazil: the calcifying alga Halimeda cuneata, and the seagrass Halodule wrightii. We tested whether or not seagrass presence can influence the calcification rate of a widespread and abundant species of Halimeda under OA and warming. Our results demonstrate that under elevated CO2, the high photosynthetic rates of H. wrightii contribute to raise H. cuneata calcification more than two-fold and thus we suggest that H. cuneata populations coexisting with H. wrightii may have a higher resilience to OA conditions. This conclusion supports the more general hypothesis that, in coastal and shallow reef environments, the metabolic interactions between calcifying and non-calcifying organisms are instrumental in providing refuge against OA effects and increasing the resilience of the more OA-susceptible species.E.B. would like to thank the Coordenação de Aperfeiçoamento de Pessoas de Nível Superior (CAPES) for Masters funding. Funding for this project came from the Synergism grant (CNPq 407365/2013-3). We extend our thanks to the Brazil-based Projeto Coral Vivo and its sponsor PetroBras Ambiental for providing the Marine Mesocosm structure and experimental assistance.info:eu-repo/semantics/publishedVersio