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BackgroundDuring endotracheal intubation training, only providing verbal guidance to students may result in inadequate recognition of the inner larynx and cause delays in mastering endotracheal intubation. Therefore, we introduced a deliberate practice approach to the education of residents in endotracheal intubation. For this purpose, a video laryngoscope was used to give the residents detailed feedback of the anesthesiology faculty. We hypothesized that if the anesthesiology faculty could provide sufficient and precise feedback of the larynx through the video monitor, the residents’ intubation skills would be retained for a more extended period.MethodsThis cluster randomized controlled study enrolled first-year residents who completed a two-month rotation at our department. Each rotation group (2–4 residents) was assigned to the Macintosh laryngoscope (ML) group or the McGRATH MAC video laryngoscope (MML) group. Endotracheal intubation skills were evaluated on a simulated mannequin immediately after the rotation, three months later, and six months later. The primary endpoint was the time required for intubation. The secondary endpoint was the percentage of glottic opening (POGO) score.ResultsForty-six residents participated in this study and were assigned to the ML group (n = 23) or the MML group (n = 23). The time required for intubation was significantly shorter in the MML group than in the ML group. The POGO score did not show any significant differences between the two groups; however, the POGO score of the MML group had a relatively narrower confidence interval than the ML group.ConclusionsWhen comparing endotracheal intubation training using the Macintosh laryngoscope and video laryngoscope, the McGRATH MAC video laryngoscope shortened the intubation procedure and facilitated long-term skill retention.Trial registrationClinical registry and trial number, URL: https://www.umin.ac.jp, UMIN000036643 date of registration: 2019/05/03, This study was retrospectively registered.

Ticks are blood-sucking arthropods that transmit many pathogens, including arboviruses. Arboviruses transmitted by ticks are generally referred to as tick-borne viruses (TBVs). TBVs are known to cause diseases in humans, pets, and livestock. There is, however, very limited information on the occurrence and distribution of TBVs in sub-Saharan Africa. This study was designed to determine the presence and distribution of ticks infesting dogs and cattle in Ghana, as well as to identify the tick-borne or tick-associated viruses they harbour. A more diverse population of ticks was found to infest cattle (three genera) relative to those infesting dogs (one genus). Six phleboviruses and an orthonairovirus were detected in tick pools screened by RT-PCR. Subsequent sequence analysis revealed two distinct phleboviruses and the previously reported Odaw virus in ticks collected from dogs and a virus (16GH-T27) most closely related to four unclassified phleboviruses in ticks collected from cattle. The virus 16GH-T27 was considered a strain of Balambala tick virus (BTV) and named BTV strain 16GH-T27. Next-generation sequencing analysis of the BTV-positive tick pool detected only the L and S segments. Phylogenetic analysis revealed that BTV clustered with viruses previously defined as M-segment-deficient phleboviruses. The orthonairovirus detected in ticks collected from cattle was confirmed to be the medically important Dugbe virus. Furthermore, we discuss the importance of understanding the presence and distribution of ticks and TBVs in disease prevention and mitigation and the implications for public health. Our findings contribute to the knowledge pool on TBVs and tick-associated viruses.

We investigated the non-inferiority of continuous rectus sheath block to continuous epidural anesthesia for postoperative analgesia of gynecological cancer patients. One hundred ASA-PS 1–2 patients via a median incision up to 5 cm above the navel were randomized into a continuous epidural anesthesia (CEA) group and a continuous rectus sheath block (CRSB) group. Following surgery, they have controlled with intravenous patient-controlled analgesia (IV-PCA) as basal postoperative analgesia. For patients in the CEA group were administered 0.25% levobupivacaine at 5 mg/h. Patients in the CRSB group, catheters were inserted on both sides of the posterior rectus sheath after surgery. They received 0.25% levobupivacaine on both sides at 7.5 mg/h. To determine whether CRSB is non-inferior to CEA in postoperative treatment, pain at rest and movement was assessed using the Numerical Rating Scale (NRS). The non-inferiority margin of NRS difference between CRSB and CEA was set at 1.3 difference in means. The primary outcome was non-inferiority comparisons of NRS at rest/at movement after surgery, while the secondary outcome included the frequency of requesting IV-PCA and rescue drugs. NRS at rest in the CRSB group was not inferior to that in the CEA group. On the other hand, the NRS at movement at 4, 6, 8, 12 h following surgery in the CRSB group was inferior to CEA. There was no difference in the frequency of requesting IV-PCA and rescue drugs. CRSB showed the non-inferiority to CEA for postoperative analgesia at rest, while CRSB was not non-inferior to CEA at movement in gynecological cancer patients. CRSB would be a substitute when CEA is contraindicated as a component of postoperative multimodal analgesia.

Entomological surveillance is one of the tools used in monitoring and controlling vector-borne diseases. However, the use of entomological surveillance for arboviral infection vector control is often dependent on finding infected individuals. Although this method may suffice in highly endemic areas, it is not as effective in controlling the spread of diseases in low endemic and non-endemic areas. In this study, we examined the efficiency of using entomological markers to assess the status and risk of arbovirus infection in Ghana, which is considered a non-endemic country, by combining mosquito surveillance with virus isolation and detection. This study reports the presence of cryptic species of mosquitoes in Ghana, demonstrating the need to combine morphological identification and molecular techniques in mosquito surveillance. Furthermore, although no medically important viruses were detected, the importance of insect-specific viruses in understanding virus evolution and arbovirus transmission is discussed. This study reports the first mutualistic relationship between dengue virus and the double-stranded RNA Aedes aegypti totivirus. Finally, this study discusses the complexity of the virome of Aedes and Culex mosquitoes and its implication for arbovirus transmission.

The silver-modified Pd (Ag/Pd) electrode was prepared by underpotential deposition of Cu adatoms, followed by galvanic displacement with Ag atoms to investigate the effect of silver modification on the catalysis and mechanism for glycerol oxidation reaction (GOR) of Pd. Cyclic voltammograms in alkaline glycerol solution exhibited that the Ag/Pd electrode had ca. 100 mV less positive onset potential of the GOR current density and higher peak current density than the Pd electrode, indicating that the GOR activity of Pd was enhanced by surface modification with Ag atoms. In potentiostatic electrolysis at −0.1 V vs. Hg/HgO, GOR mainly began with the oxidation of a terminal OH group for both electrodes, and glycerate and glycolate were major products. The glycolate production was more active for the Ag/Pd electrode. The in situ infrared reflectance-absorption spectra (IRAS) exhibited that GOR products with one or two carbons were detected at lower potentials for the Ag/Pd electrode, indicating that the C C bond cleavage was facilitated by the Ag modification.

Coulometric detection of an analyte in a solution at nanoliter scale was conducted by having redox reactions proceed simultaneously on a platinum electrode. The analyte was oxidized on a part of the electrode in one flow channel and silver was deposited on an array of circular microelectrodes formed in another flow channel at a mixed potential. Coulometric determination of the deposited silver showed a steep change in the generated charge as a result of the complete oxidation of silver. The short measurement time after the start of the coulometry suppressed the increase in background charge, resulting in significant lowering of the detection limit. The lower detection limit for H2O2 was 30 nM (3σ). To improve selectivity and minimize the influence of coexisting interferents, the shifting of the mixed potential, application of a permselective membrane, and electrochemical elimination of the interferents were effective modifications.

A simple evaluation method has been developed for a metal thin layer on a sphere-like plastic microstructure, based on its light-scattering property since, according to our results, the light-scattering intensity of silver-coated microbeads depends significantly on the silver coverage. Our attempt was carried out by using a dark-field microscopy coupled with a spectrometer.

Endothelial dysfunction is associated with increased cardiovascular mortality and morbidity; however, this dysfunction may be ameliorated by several therapies. For example, it has been reported that heat‐induced increases in blood flow and shear stress enhance endothelium‐mediated vasodilator function. Under these backgrounds, we expect that carbon dioxide (CO 2)‐rich water‐induced increase in skin blood flow improves endothelium‐mediated vasodilation with less heat stress. To test our hypothesis, we measured flow‐mediated dilation (FMD) before and after acute immersion of the lower legs and feet in mild warm (38°C) normal or CO 2‐rich tap water (1000 ppm) for 20 min in 12 subjects. Acute immersion of the lower legs and feet in mild warm CO 2‐rich water increased FMD (P

In this paper, we propose a novel method to measure the free spectral range (FSR) of a Fabry-Perot cavity (FPC) using single-frequency modulation (FM) with one electric optical modulator (EOM) and the null method. A laser beam modulated by the EOM, to which a cosine-wave signal is supplied from a radio frequency (RF) oscillator, is incident on the FPC. The transmission light from the FPC is observed and converted to an RF signal by a highspeed photodetector, and the RF signal is synchronously demodulated with a lock-in amplifier (LIA) by referring to the oscillator. We theoretically and experimentally demonstrate that the LIA signal become null with a steep slope, when the modulation frequency equals the FSR under the condition that the carrier frequency is slightly detuned from the resonance of the FPC. The experimental results show that the proposed method has the capability to determine the FSR by the null method with a small measurement uncertainty.

An 81-year-old man presented with poor visual acuity of the left eye, swelling of the left eyelid, and elevation of the left intraocular pressure after contusion of the left palpebral portion. CT revealed left ocular proptosis and left intraorbital hematoma. Traumatic optic neuropathy was suspected, and emergent optic nerve decompression was performed through extradural anterior clinoidectomy followed by optic canal release. Postoperatively, his left visual acuity was markedly improved and the elevated intraocular pressure decreased. Postoperative CT demonstrated improvement of the left ocular proptosis and decompression of the optic nerve. Emergent optic canal release has been recommended in patients who have suffered visual dysfunction caused by optic canal fracture or intraorbital hematoma. The advantages of extradural anterior clinoidectomy followed by optic canal release include a shorter surgical route and easy identification of the optic nerve, resulting in fewer surgical complications. In addition, this procedure can achieve intraorbital decompression. We recommend extradural anterior clinoidectomy followed by optic canal release as a safe and reliable procedure for optic nerve decompression in patients with traumatic optic neuropathy.

Determination of the activity of an enzyme in a solution of nL order was conducted using an electrochemical device with a plug-based microfluidic processing function. β-galactosidase (β-Gal) and adenosine triphosphatase (ATPase) were used as analyte enzymes. β-Gal is often used to be conjugated with antibodies, whereas the latter plays critical roles in cell functions. The activity of the enzymes was determined by measuring the concentration of one of the final products, p-aminophenol (PAP) or hydrogen peroxide (H 2 O 2 ) by coulometry. Preparation of plugs of solutions of predetermined volumes and mixing of solutions was carried out using a T-junction on the device. A partially shallow flow channel structure was designed in the sensing area to improve collection efficiency. The observed output charge was correlated well with the amount of PAP or H 2 O 2 , which served as an indicator of the enzyme activity.

Subclinical mastitis is a common infectious disease of dairy cows. To develop an early diagnostic device for mastitis, we focused our attention to the increase in the number of neutrophils in raw milk of mastitic cows. Since neutrophils secrete superoxide anion (O 2 −), it can be a good indicator to estimate the number of neutrophils. Neutrophils were separated from fat globules using the difference in specific gravity and specific adhesion of neutrophils to P-selectin. Neutrophils trapped in a microchannel were subsequently concentrated in an array of micropillars of a working electrode modified with P-selectin and superoxide dismutase (SOD). The O 2 − secreted from the trapped neutrophils was electrochemically detected. A distinct difference was observed between milk samples containing neutrophils and normal milk samples.

Subclinical mastitis is a common infectious disease affecting dairy cows. To develop an early diagnostic device for this disease, we focused on measuring an increase in the number of neutrophils in raw milk of mastitic cows. Superoxide anions (O(2)(-)), secreted by neutrophils, can be a good indicator of neutrophil concentration, and therefore, the seriousness of the mastitis. In this study, neutrophils in raw milk samples were separated from fat globules in a flow channel using differences in specific gravity and specific adhesion of neutrophils to P-selectin. Neutrophils trapped in the flow channel were subsequently concentrated in an array of micropillars of a working electrode modified with P-selectin and superoxide dismutase. The O(2)(-) secreted from the trapped neutrophils was electrochemically detected. A difference in the detection current was observed between normal and mastitic milk samples. A clear linear relationship between the electric current and cell density was observed.

In this paper, we discuss a method to measure the free spectral range (FSR) of a Fabry–Perot cavity (FP-cavity) using frequency modulation with one electric optical modulator (EOM) and the null method. A laser beam modulated by the EOM, to which a sine wave signal is supplied from a radio frequency (RF) oscillator, is incident on the FP-cavity. The transmitted or reflected light from the FP-cavity is observed and converted to an RF signal by a high-speed photodetector, and the RF signal is synchronously demodulated with a lock-in amplifier by referring to a cosine wave signal from the oscillator. We theoretically and experimentally demonstrate that the lock-in amplifier signal for the transmitted or reflected light becomes null with a steep slope when the modulation frequency is equal to the FSR under the condition that the carrier frequency of the laser is slightly detuned from the resonance of the FP-cavity. To reduce the measurement uncertainty for the FSR, we also discuss a selection method for laser power, a modulation index and the detuning shift of the carrier frequency, respectively.

In this paper, we propose a measurement method for spindle radial, axial and angular motions using concentric circle grating interferometers. In this method, the grating is installed on top of the spindle. Three optical sensors, which consist of two interferometers, are fixed over the grating. One interferometer detects an interference signal between reflection lights from a fixed mirror and the grating for vertical displacement measurement. The other interferometer detects an interference signal between ±first diffraction lights from the grating for lateral displacement measurement. Using three optical sensors, radial, axial and angular motions of the spindle, can be measured concurrently.