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The sanitation of concrete structures through dismantling of nuclear buildings is complicated by the radiological threat associated with the airborne release of fine dust. This is the reason why the aerosol release fraction (ARF) associated with mechanical removal of concrete structure containing radioactivity needs to be accurately evaluated to implement efficient radiological survey and containment techniques. We characterize experimentally the ARF resulting from milling operations on a standard non-radioactive concrete slab in a confined experimental chamber using an industrial scarifying machine. Our results reveal a significant production of fine aerosol particles with a mass median aerodynamic diameter close to 4 μm and which mineralogical composition is dominated by calcium and silica compounds. The ARF measured when a vacuum suction device is used to confine the dust production close to the source is on the order of 5 × 10 -4 ; the maximum ARF estimated when no suction device is used is on the order of 0.5. As the study is focused on non-radioactive concrete, transposition of aerosol characteristics investigated in this study to assess radioactive airborne release is only relevant for in-depth neutron activation on elemental compounds of concrete., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Severe acute respiratory syndrome coronavirus 2 is a novel coronavirus first diagnosed in U.S. hospitals in January 2020. Typical presenting symptoms include fever, dry cough, dyspnea, and hypoxia. However, several other symptoms have been reported, including fatigue, weakness, diarrhea, and abdominal pain. We have identified a series of patients with diabetic ketoacidosis (DKA) likely precipitated by coronavirus disease 2019 (COVID-19)., Case Series: We describe 5 patients with previously known type 2 diabetes and no history of DKA, who presented to the emergency department with new-onset DKA and COVID-19. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Diabetes mellitus is a known risk factor for poor outcomes in viral respiratory illnesses, including COVID-19. Infection may precipitate DKA in patients with type 2 diabetes. Aggressive management of these patients is recommended; however, management guidelines have not yet been put forth for this unique subset of patients., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Study Objective: To determine whether having preoperative airway photographs will change the preanesthetic airway plan., Design: Questionnaire., Setting: American academic medical center (Brigham and Women's Hospital, Boston MA)., Subjects: Twenty-five test subjects (American Society of Anesthesiologists 1-4) were enrolled to have their preoperative airway photographs taken as well as to have a customary preoperative history and physical examination. In addition, 15 anesthetists were enrolled to review the subjects' preoperative history, physical examination, and preoperative airway photographs., Measurements: All 15 anesthetists were asked to fill out a survey for airway management for each test subject., Main Results: All 15 anesthetists completed the survey. Across all providers, plans were changed a median of 24% (95% confidence interval [CI], 12.7-38.6). Among attending anesthesiologists, airway management plans were changed 30% of the time (95% CI, 12.4-40.0), whereas among nonattending level providers, plans changed 24% of the time (95% CI, 12.0-38.8). χ 2 Tests found no difference between the percent change of airway plans between attending and nonattending level providers (P=.306)., Conclusions: Our findings suggest that the addition of dynamic airway photographs to preoperative airway reports affects airway management plans among a variety of anesthesia care providers. In general, dynamic airway photographs can aid preoperative airway management planning., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: ICU telemedicine improves access to high-quality critical care, has substantial costs, and can change financial outcomes. Detailed information about financial outcomes and their trends over time following ICU telemedicine implementation and after the addition of logistic center function has not been published to our knowledge., Methods: Primary data were collected for consecutive adult patients of a single academic medical center. We compared clinical and financial outcomes across three groups that differed regarding telemedicine support: a group without ICU telemedicine support (pre-ICU intervention group), a group with ICU telemedicine support (ICU telemedicine group), and an ICU telemedicine group with added logistic center functions and support for quality-care standardization (logistic center group). The primary outcome was annual direct contribution margin defined as aggregated annual case revenue minus annual case direct costs (including operating costs of ICU telemedicine and its related programs). All monetary values were adjusted to 2015 US dollars using Producer Price Index for Health-Care Facilities., Results: Annual case volume increased from 4,752 (pre-ICU telemedicine) to 5,735 (ICU telemedicine) and 6,581 (logistic center). The annual direct contribution margin improved from $7,921,584 (pre-ICU telemedicine) to $37,668,512 (ICU telemedicine) to $60,586,397 (logistic center) due to increased case volume, higher case revenue relative to direct costs, and shorter length of stay., Conclusions: The ability of properly modified ICU telemedicine programs to increase case volume and access to high-quality critical care with improved annual direct contribution margins suggests that there is a financial argument to encourage the wider adoption of ICU telemedicine., (Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)

This work investigates the aerosols emitted during combustion of aircraft and naval structural composite materials (epoxy resin/carbon fibers and vinyl ester/glass fibers and carbon nanotubes). Combustion tests were performed at lab-scale using a modified cone calorimeter. The aerosols emitted have been characterized using various metrological devices devoted to the analysis of aerosols. The influence of the nature of polymer matrices, the incorporation of fibers and carbon nanotubes as well as glass reinforcements on the number concentration and the size distribution of airborne particles produced, was studied in the 5 nm-10 μm range. Incorporation of carbon fibers into epoxy resin significantly reduced the total particle number concentration. In addition, the interlaced orientation of carbon fibers limited the particles production compared to the composites with unidirectional one. The carbon nanotubes loading in vinyl ester resin composites influenced the total particles production during the flaming combustion with changes during kinetics emission. Predominant populations of airborne particles generated during combustion of all tested composites were characterized by a PN50 following by PN(100-500)., (Copyright © 2015 Elsevier B.V. All rights reserved.)