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Author(s): G. Weiner [sup.1] Author Affiliations: (1) Assumption College, 0000 0001 2164 2633, grid.418148.0, , 500 Salisbury Street, 01609, Worcester, MA, USA In the whole of the Burkean corpus, there [...]

Fiber-reinforced soils have been increasingly used in geotechnical engineering. Over the years, research has sought to understand and investigate the influences of fibers as reinforcement in soil–fiber mixtures. This study assessed the behavior of clayey soil in the city of Curitiba (Paraná, Brazil), adding rice husk fiber (RHF), an industrial waste from Cooperativa Agroindustrial in Alegrete (Rio Grande do Sul, Brazil). To evaluate the effect of the presence of natural RHF on the mechanical behavior of compacted soil, aspects such as the influence of fiber content and the drained and undrained behaviors of the soil were evaluated through unconfined triaxial compression tests. The following tests were realized: soil granulometry, specific mass of solids and Atterberg limits. Specimens were produced in quadruplicate for the soil and mixtures using the RHF contents of 0.5%, 0.75%, 1% and 1.5% to determine the unconfined compressive strength (UCS). Triaxial tests were realized on a pure soil specimen and the specimens with 1% RHF under confining pressures of 50 kPa, 100 kPa, 200 kPa and 400 kPa. The interactions at the interface between husk surface and soil were analyzed using scanning electron microscopy (SEM). In UCS tests, specimens with RHF percentages of 1% and 1.5% presented the highest results, with an increment of 36% compared to the soil without RHF. The results of the consolidated drained triaxial compression tests show that in terms of effective stress, there was a small difference in the strength of the compacted pure soil and soil with the addition of RHF. For the undrained tests, the strength increased with the inclusion of husk, with a reduction of 50% in cohesion and an increment of 22% in friction angle for specimens containing RHF compared to the soil without RHF additions.

Non-timber forest products are sources of income for rural populations. This is the case in Burundi for bamboo and until a few years ago for rattan. The latter is threatened by clearing of its habitats for agricultural purposes. This study presents an overview of rattan in Burundi. A mapping of the sites still hosting rattan and hosted it some six to thirty years ago was carried out and the areas covered were measured. In total, rattan covered, in 2015, an area of 1.04 ha on various sites in southern Burundi and mainly in the Kigwena Forest Natural Reserve. The analysis of the anatomical features of rattan stems from this forest confirmed that the species present in Burundi is Eremospatha haullevilleana De Wild. [ABSTRACT FROM AUTHOR]

Presents abstract of a paper entitled 'Quantifying the effect of analgesia on swallowing after tonsillectomy: an objective test,' by G.M. Weiner, G. Banheygi and G. Owen, which was featured at the April 1998 meeting of the Otorhinolaryngology Research Society in Leicester, England. Significant increase in swallowing velocity; Differences between analgesic regimens.

The present study evaluated the influence of the hydraulic gradient on soil conductivity changes using data from permeability tests performed in a column percolation test system, in order to represent geoenvironmental engineering applications. A mature residual soil from gneiss, pedologically classified as Red-Yellow Latosol, with 67% of clay, 10% of silt, 23% of sand, 82% of liquid limit and 46% of plastic limit was used in the study. Soil specimens were compacted at the optimum compaction parameters determined at the Standard Proctor effort, i.e., wopt =31.37% and gdmax =13.54 kN m-3. After compaction, it was determined the permeability of specimens under the hydraulic gradients of 15, 66, 85 and 140. The results obtained support that: (i) at the 5% level, there is statistical significant variation in the permeability coefficient according to the hydraulic gradient used in the tests; (ii) from a geotechnical perspective, there is a slight tendency of increasing the permeability coefficient when increasing the hydraulic gradient, but of no significance for geotechnical practical applications.

Objective. To determine the evidence for a relationship between vascular loops in contact with the vestibulocochlear nerve (CN VIII) and otological symptoms. Method. A systematic review and meta-analysis. Comprehensive search strategy using MEDLINE, EMBASE, CINAHL, Cochrane Library, Clinical Evidence, and Cochrane Central Register of Trials. Reference lists cross-referenced and authors contacted for missing data. No language restrictions. Included studies: (1) compared symptoms in subjects with vascular loops contacting CN VIII to subjects without; or (2) compared the prevalence vascular loops in contact with CN VIII in symptomatic ears to contra-lateral asymptomatic ears. Study quality systematically appraised. Results. Five studies met the inclusion criteria. A statistically significant association was demonstrated for the prevalence of vascular loops in contact with CN VIII, in subjects with unilateral sensorineural hearing loss: pooled odds ratio (OR) 2.0 (95% confidence interval [CI]:1.5, 2.6). No significant association was demonstrated for non-pulsatile tinnitus. A highly significant increase in prevalence of contacting vascular loops in contact with CN VIII was demonstrated in subjects having pulsatile tinnitus, with pooled OR: 78.8 (95% CI: 10.9, 821.8). Conclusions. Vascular loops in contact with CN VIII are a normal variant. Subjects with unilateral hearing loss were twice as likely to have these vascular loops in the symptomatic ear than the asymptomatic ear. Subjects with pulsatile tinnitus were 80 times more likely to have a contacting vascular loop than patients with non-pulsatile tinnitus. This suggests in some cases a causal relationship exists for pulsatile tinnitus, and surgical intervention may be occasionally indicated. [ABSTRACT FROM AUTHOR]

ABSTRACT Morphology studies assume significant importance in analysis of phenomena of granular systems packaging, in particular with a view to the use of the technique of soil stabilization named particle size correction in forest roads. In this context, this study aimed to develop and operationalize a Sand Grain Image Capture System and, hereby, determine the morphological indices of the sand fractions of two sandy soils called João Pinheiro (JP) and Cachoeira da Prata (CP). Soil samples, air-dried, were sieved (2.0 mm nominal mesh size) for removal of gravels. The materials that passed through the sieve were subjected to dispersion, washing in 0.053 mm nominal mesh size sieve, removal of organic matter and iron oxides to obtain the clean sand fractions. Subsequently, each soil sample was sieved for separation into twelve classes, between the diameters of 0.149 mm and 1.190 mm, using a Rotap shaker. Next, tests were carried out to characterize the morphometric attributes of the twelve classes of sand fractions of the soils studied. For validation of the performance of the Sand Grain Image Capture System, the results were compared to those obtained using a standard procedure for image analysis. The analysis of the results led to the following conclusions: (i) the sand fraction of the JP soil presented higher values for the morphometric indices roundness, elongation and compactness compared to sand fraction of the CP soil; and (ii) the Sand Grain Image Capture System worked properly, with practicality.

ABSTRACT This paper addresses the topic soil stabilization for forest roads applications and analyzes the influence of the hydrated lime in structuring the sand fraction of an artificial soil composed of the sand fractions of two natural soils, simulating natural process of cementation of sands and using binary packing systems. The study included the following topics: (i) characterization of the mechanical strength and hydraulic conductivity of binary systems of the artificial soil; and (ii) effect of hydrated lime in structuring binary packing systems of the artificial soil. Soil samples were submitted to chemical pre-treatment, to obtain clean sand fractions from the two sandy soils with particle diameters ranging from 0.053 to 2 mm, following sieving and separation of them in twenty-two classes with maximum (D)/minimum (d) ratios varying from 5.7 to 13.4. Sequentially, binary packing specimens of the artificial soil were prepared and then stabilized with 2% of a commercial hydrated lime. Next, the specimens were submitted to permeability and quasi-static cone penetration tests, in order to determine their hydraulic conductivity and cone tip resistance. Based on the obtained results, it was concluded that: (i) in the artificial soil, an increase of D/d ratio led to an increase of cone tip resistance and decrease of hydraulic conductivity; and (ii) cementation with hydrated lime reduced the hydraulic conductivity and increased the cone tip resistance.

Background: Training with high-technology manikins improves cardio-pulmonary resuscitation (CPR) skill retention, but a checklist to assess both technical and non-technical skills is lacking. This study aimed to develop a standardized checklist to evaluate healthcare's performance during simulated Neonatal Resuscitation Program (NRP) scenarios., Materials and Methods: Twenty-two international neonatal resuscitation experts participated in a two-step modified Delphi process, rating each checklist item on a scale of 1-5 and providing feedback. Items with a mean rating below 4 or receiving comments were reviewed. Inter-rater reliability (IRR) of the final tool was assessed using video-recordings of simulated scenarios., Results: The final checklist, validated by 15 experts, includes 33 items. Mean expert rating of all items was 4.35. The checklist showed moderate inter-rater reliability (ICC = 0.67) overall, with excellent reliability (ICC = 0.8) for technical skills., Conclusion: The tool effectively evaluates technical skills but requires further refinement for non-technical skills assessment., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Nature America, Inc.)

This is the eighth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recent published resuscitation evidence reviewed by the International Liaison Committee on Resuscitation task force science experts. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research.

Objective: To assess the impact of NRP virtual simulations (eSim™), video or no refresher training, on simulation performance, six months after a provider course; and to evaluate eSim™ acceptability., Study Design: In this multi-site randomized controlled trial, NRP providers from four U.S. institutions were randomized to receive refreshers every two months with NRP eSim™, NRP resuscitation video, or no refresher (control). Simulation performance was assessed immediately after an NRP course and six months later., Result: 248 participants completed the baseline simulation and 148 completed the six-month follow-up simulation. The majority (71%) of subjects had a decline in resuscitation skills at 6 months. There were no differences in performance between the study groups, but participants who reported using either the video or eSim™ had less decline in performance at the 6-month follow-up (p < 0.05)., Conclusion: NRP refreshers with either eSim™ or NRP video may mitigate the decline in resuscitation skills after training., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Objective: To characterise applied force on the face and head during simulated mask ventilation with varying mask, device and expertise level., Design: Randomised cross-over simulation study., Setting: A quiet, empty room in the children's hospital., Participants: Neonatal healthcare providers, categorised as novices and experts in positive pressure ventilation (PPV)., Interventions: PPV for 2 min each in a 2×2 within-subjects design with two masks (round and anatomic) and two ventilation devices (T-piece and self-inflating bag (SIB))., Main Outcome Measures: Applied force (Newton (N)) measured under the head and at four locations on the manikin's face (nasal bridge, mentum, left and right zygomatic arches) and symmetry of force applied around the mask rim., Results: For the 51 participants, force applied to the head was greater with the SIB than the T-piece (mean (SD): 16.03 (6.96) N vs 14.31 (5.16) N) and greater with the anatomic mask than the round mask (mean (SD): 16.07 (6.80) N vs 14.26 (5.35) N). Underhead force decreased over the duration of PPV for all conditions. Force measured on the face was greatest at the left zygomatic arch (median (IQR): 0.97 (0.70-1.43) N) and least at the mentum (median (IQR): 0.44 (0.28-0.61) N). Overall, experts applied more equal force around the mask rim compared with novices (median (IQR): 0.46 (0.26-0.79) N vs 0.65 (0.24-1.18) N, p<0.001)., Conclusion: We characterised an initial dataset of applied forces on the face and head during simulated PPV and described differences in force when considering mask type, device type and expertise., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Aim: Compare heart rate assessment methods in the delivery room on newborn clinical outcomes., Methods: A search of Medline, SCOPUS, CINAHL and Cochrane was conducted between January 1, 1946, to until August 16, 2023. (CRD 42021283438) Study Selection was based on predetermined criteria. Reviewers independently extracted data, appraised risk of bias and assessed certainty of evidence., Results: Two randomized controlled trials involving 91 newborns and 1 nonrandomized study involving 632 newborns comparing electrocardiogram (ECG) to auscultation plus pulse oximetry were included. No studies were found that compared any other heart rate measurement methods and reported clinical outcomes. There was no difference between the ECG and control group for duration of positive pressure ventilation, time to heart rate ≥ 100 beats per minute, epinephrine use or death before discharge. In the randomized studies, there was no difference in rate of tracheal intubation [RR 1.34, 95% CI (0.69-2.59)]. No participants received chest compressions. In the nonrandomized study, fewer infants were intubated in the ECG group [RR 0.75, 95% CI (0.62-0.90)]; however, for chest compressions, benefit or harm could not be excluded. [RR 2.14, 95% (CI 0.98-4.70)]., Conclusion: There is insufficient evidence to ascertain clinical benefits or harms associated with the use of ECG versus pulse oximetry plus auscultation for heart rate assessment in newborns in the delivery room., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Aim: To examine speed and accuracy of newborn heart rate measurement by various assessment methods employed at birth., Methods: A search of Medline, SCOPUS, CINAHL and Cochrane was conducted between January 1, 1946, to until August 16, 2023. (CRD 42021283364) Study selection was based on predetermined criteria. Reviewers independently extracted data, appraised risk of bias and assessed certainty of evidence., Results: Pulse oximetry is slower and less precise than ECG for heart rate assessment. Both auscultation and palpation are imprecise for heart rate assessment. Other devices such as digital stethoscope, Doppler ultrasound, an ECG device using dry electrodes incorporated in a belt, photoplethysmography and electromyography are studied in small numbers of newborns and data are not available for extremely preterm or bradycardic newborns receiving resuscitation. Digital stethoscope is fast and accurate. Doppler ultrasound and dry electrode ECG in a belt are fast, accurate and precise when compared to conventional ECG with gel adhesive electrodes., Limitations: Certainty of evidence was low or very low for most comparisons., Conclusion: If resources permit, ECG should be used for fast and accurate heart rate assessment at birth. Pulse oximetry and auscultation may be reasonable alternatives but have limitations. Digital stethoscope, doppler ultrasound and dry electrode ECG show promise but need further study., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘Dr. Kapadia is a co-author of one of the studies included in this review. Drs. Liley and Rabi are editorial board members for the Resuscitation Plus journal. The other authors have no conflicts to disclose.’., (© 2024 The Author(s).)

Objective: In this observational study, we aimed to describe the rounding structure in a high acuity neonatal intensive care unit (NICU) to identify potential barriers to efficient multidisciplinary rounds., Study Design: We observed daily medical rounds (January-December 2018) on the resident teaching service in a 46-bed academic level IV NICU. Daily census, duration of rounds, and causes for rounding delays were recorded. During a subset of the study period, additional data were collected describing the time spent on specific activities and the room-to-room pathway followed by the rounding team. Descriptive statistics were used to summarize the census, total rounding time, time spent on each activity, and rounding time by day of the week and by attending., Results: A total of 208 rounding days were observed. During the study period, the teaching service mean daily census was 17 patients and total rounding time (mean ± standard deviation) was 136 ± 31 minutes. Mean rounding time and time/patient varied between the nine attendings (total time range 109 minutes to 169 minutes, time/patient range 6.4 minutes/patient to 10.0 minutes/patient). In total, 91% of rounding time focused on patient care, teaching, and discussions with parents, while 9% of the time was spent deciding which patient to see next, moving between rooms, and waiting for members of the team to be ready to start rounds., Conclusion: On average, the medical team spent over 2 hours per day making multisciplinary rounds in the NICU with substantial variation between attending providers. While most time was spent on patient care, teaching, and talking with parents, we identified opportunities to improve rounding efficiency., Key Points: · The structure of rounds in a NICU was observed to identify the potential barriers to efficiency.. · There are limited data on MDR processes in the NICU.. · In total, 9% of time was spent on patient care activities during daily rounds.., Competing Interests: None declared., (Thieme. All rights reserved.)

Objective: Measuring exhaled carbon dioxide (ECO 2 ) during non-invasive ventilation at birth may provide information about lung aeration. However, the International Liaison Committee on Resuscitation (ILCOR) only recommends ECO 2 detection for confirming endotracheal tube placement. ILCOR has therefore prioritised a research question that needs to be urgently evaluated: 'In newborn infants receiving intermittent positive pressure ventilation by any non-invasive interface at birth, does the use of an ECO 2 monitor in addition to clinical assessment, pulse oximetry and/or ECG, compared with clinical assessment, pulse oximetry and/or ECG only, decrease endotracheal intubation in the delivery room, improve response to resuscitation, improve survival or reduce morbidity?'., Design: Systematic review of randomised and non-randomised studies identified by Ovid MEDLINE, Embase and Cochrane CENTRAL search until 1 August 2022., Setting: Delivery room., Patients: Newborn infants receiving non-invasive ventilation at birth., Intervention: ECO 2 measurement plus routine assessment compared with routine assessment alone., Main Outcome Measures: Endotracheal intubation in the delivery room, response to resuscitation, survival and morbidity., Results: Among 2370 articles, 23 were included; however, none had a relevant control group. Although studies indicated that the absence of ECO 2 may signify airway obstruction and ECO 2 detection may precede a heart rate increase in adequately ventilated infants, they did not directly address the research question., Conclusions: Evidence to support the use of an ECO 2 monitor to guide non-invasive positive pressure ventilation at birth is lacking. More research on the effectiveness of ECO 2 measurement in addition to routine assessment during non-invasive ventilation of newborn infants at birth is needed., Prospero Registration Number: CRD42022344849., Competing Interests: Competing interests: TI has been helping the company Nihon Koden to develop a respiratory function monitoring device for neonatal resuscitation. The respiratory function monitor does not have a CO2 detector. The other authors have no relevant competing interests., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Aim: To evaluate delivery room (DR) interventions to prevent hypothermia and improve outcomes in preterm newborn infants <34 weeks' gestation., Methods: Medline, Embase, CINAHL and CENTRAL were searched till 22nd July 2022. Randomized controlled trials (RCTs), non-RCTs and quality improvement studies were considered. A random effects meta-analysis was performed, and the certainty of evidence was evaluated using GRADE guidelines., Results: DR temperature of ≥23 °C compared to standard care improved temperature outcomes without an increased risk of hyperthermia (low certainty), whereas radiant warmer in servo mode compared to manual mode decreased mean body temperature (MBT) (moderate certainty). Use of a plastic bag or wrap (PBW) improved normothermia (low certainty), but with an increased risk of hyperthermia (moderate certainty). Plastic cap improved normothermia (moderate certainty) and when combined with PBW improved MBT (low certainty). Use of a cloth cap decreased moderate hypothermia (low certainty). Though thermal mattress (TM) improved MBT, it increased risk of hyperthermia (low certainty). Heated-humidified gases (HHG) for resuscitation decreased the risk of moderate hypothermia and severe intraventricular hemorrhage (very low to low certainty). None of the interventions was shown to improve survival, but sample sizes were insufficient., Conclusions: DR temperature of ≥23 °C, radiant warmer in manual mode, use of a PBW and a head covering is suggested for preterm newborn infants <34 weeks' gestation. HHG and TM could be considered in addition to PBW provided resources allow, in settings where hypothermia incidence is high. Careful monitoring to avoid hyperthermia is needed., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)