Malignant Hyperthermia

Malignant hyperthermia (MH) is a hypermetabolic response to succinylcholine or inhaled volatile gases administered during anesthesia and is caused by an autosomal dominant mutation of RYR1 or CACNA1S genes which affect how calcium channels function. The uncontrolled, unopposed calcium release and excitation-contraction coupling results in sustained skeletal muscle contraction resulting in muscle rigidity, hyperthermia, hypercapnia, hypertension, and tachycardia among other less common clinical features. The sequelae of an MH crisis include renal failure, rhabdomyolysis, hyperkalemia, metabolic disturbance and left untreated will result in mortality. All clinicians involved in peri-operative care both in-hospital and out of hospital must be cognizant of this potentially lethal complication and respond rapidly with effective, evidence-based care to reduce the likelihood of death. This poster serves to educate healthcare providers, especially anesthesia providers and students, of the pathophysiology, signs and symptoms, and implications on nursing related to malignant hyperthermia

Routine Evaluation with Gastric Ultrasound to Reduce Gastric Aspiration (REGURGA)

When a patient undergoes anesthesia, there are inherent risks that the providers should protect the patient from. Despite adherence to fasting guidelines established by the American Society of Anesthesiologists (ASA), patients undergoing anesthesia continue to experience intrapulmonary aspiration of gastric contents. There are several factors that delay gastric emptying, including coexisting disease, trauma, pain, and opioid use. Gastric ultrasound assessment of the gastric antrum is a relatively new technology in anesthesia and can be used to assess the gastric antrum and provide information to anesthesia providers regarding the risk of aspiration in the perioperative period. The primary aim of this project was to develop evidence-based practice (EBP) guidelines for using point-of-care ultrasound (POCUS) of the stomach as a preoperative aspiration risk stratification tool. In addition to the primary aim, secondary objectives included developing a comprehensive plan to implement the guidelines as established, a comprehensive plan to monitor and measure the guidelines\u27 effect, and a comprehensive plan to adjust the guidelines if the outcomes are less than desirable. A literature search, review, and synthesis were conducted to establish the background of gastric ultrasound in anesthesia and to determine if the measurements were accurate. Guidelines were developed for theoretical implementation at a level-one trauma center in the midwestern United States. Following the implementation of the guidelines, a retrospective review will be conducted with measurement and analysis of outcomes, and adjustments will be made, if necessary, as described by the comprehensive adjustment plan. By using POCUS preoperatively, the risk of perioperative aspiration is reduced

Custom beef processing: Expected yields

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

Guidance, Navigation, and Control System Design in a Mass Reduction Exercise

Early Orion GN&C system designs optimized for robustness, simplicity, and utilization of commercially available components. During the System Definition Review (SDR), all subsystems on Orion were asked to re-optimize with component mass and steady state power as primary design metrics. The objective was to create a mass reserve in the Orion point of departure vehicle design prior to beginning the PDR analysis cycle. The Orion GN&C subsystem team transitioned from a philosophy of absolute 2 fault tolerance for crew safety and 1 fault tolerance for mission success to an approach of 1 fault tolerance for crew safety and risk based redundancy to meet probability allocations of loss of mission and loss of crew. This paper will discuss the analyses, rationale, and end results of this activity regarding Orion navigation sensor hardware, control effectors, and trajectory design

Development and Reliability of a 7×15m Repeated On-Ice Sprint Test for Female Ice Hockey Players

International Journal of Exercise Science 14(6): 666-676, 2021. The purpose of this investigation was to design and examine the reliability of a 7×15m repeated on-ice skating sprint test for female ice hockey players. Seventeen women ( ± SD age, height and body mass = 21 ± 2 years, 166.2 ± 6.4 cm and 61.9 ± 7.7 kg, respectively) completed 7 consecutive on-ice sprints of 15m repeated every 15s. Two trials of the test were performed on the same day and then repeated on a different day approximately 1 week later for a total of 4 trials. The fastest 15m time, mean time for 7 sprints and total sprint time collapsed across all 4 trials was 2.96 ± 0.12s, 3.05 ± 0.13s and 21.35 ± 0.89s, respectively. There were no significant differences between trials for any variable. Typical error (TE), coefficient of variation (%CV) and intra-class coefficients (ICC) for the fastest 15m time, mean of 7 sprints, and total time were ICC = 0.77, TE = 0.06s and %CV = 2.1; ICC = 0.91; TE = 0.04s and %CV = 1.4; and, ICC = 0.91; TE = 0.29 and %CV = 1.4 for all 4 trials, respectively. Players in the forward position had a faster mean 15m time and lower total time compared to those in the defensive position (p \u3c 0.05). These findings show that a 7×15m repeated on-ice sprint test for varsity women ice hockey players was reliable. It was also found that forwards had a better mean of 7 sprint time and faster total time compared to players in the defensive position

Effects of Total Customer Solutions Strategic Positioning on Organizational Performance in Telecommunication Industry, in Kenya

The purpose of this study was to examine the effect of total customer strategic positioning as envisaged in the Delta Model on Organizational performance. The target population consists of 6,149 front office employees of the four major telecommunication firms in Kenya namely Safaricom, Airtel, Orange and Equitel. The study covered five major cities and towns in Kenya namely Nairobi, Mombasa, Kisumu, Nakuru and Eldoret. Data was collected from 144 respondents drawn from a cross-section of employees specifically those in front office as they are directly involved in the day to day customer service. The response rate of the total questionnaires issued was 83%. A descriptive survey research design was used in this study. Questionnaires were used to collect the data. Analysis of the survey responses was done by means of Statistical Package for Social Sciences (SPSS). Pearson Correlation along with multiple regressions were used in data analysis and the testing of hypotheses. Pearson correlation was used to establish the association between the strategic position and organizational performance. The findings of the study revealed that total customer solution strategic option had a significant coefficient ( =0.295, p value= 0.000). This implies that total customer solutions strategic option had a positive significant effect on organization performance. The findings of the research revealed that a change in the government regulations had a positive and very significant effect on the performance of the telecommunication companies in Kenya. This is revealed by the results which shows that there is a weak, positive correlation which is significant (R = 0.358; p- value <0.05) government regulations and organizational performance of telecommunication firms in Kenya.  The study concluded that the total customer solution strategic positioning had not only a positive correlation but also significant effect on the organizational performance of the telecommunication companies in Kenya. The study also concluded that with appropriate government regulations the strategic positions studied will enhance organizational performance in the telecommunication industry in Kenya. The study recommends that managers need to focus on the use total customer strategic position in order to achieve a great organizational performance in their respective organizations. To policy makers the study recommends formulations of good and effective government regulations which in turn will enhance organizational performance. Keywords: Total Customer Solution, Strategic positioning, Organizational performance DOI: 10.7176/EJBM/11-6-1

S4_4 Roberto Carlos' 'Impossible' Free Kick

In the Tournoi de France 1997, Roberto Carlos scored a free kick in a 1-1 draw between France and Brazil. This goal would go on to make headlines and feature in highlight reels for many years to come. Our calculations show the force applied to the football by Carlos to be 320.2 N at an angle of 9.84 degrees from the initial direction of the ball

S4_5 If You Liked It, You Should Have Put A Ring On It

In this paper, we explore the potential energy to be harnessed by constructing a Dyson Ring, and produce a ball-park figure of the associated costs. We find that there is the possibility to collect approximately 6 ×1010 Watts of power, and that an initial investment of £50 billion could suffice to install such a structure.

S4_6 Fallout: Put Another Quarter In The Nuke-Box

In Fallout 4, Mini Nukes can be slung at enemies. We found a nuke to have 2.99 times the explosive energy of a standard issue US Military grenade, and thus determined the mass of Plutonium-239 require to achieve this energy to be 1.06×10−8 kg.