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Objective: Successful endotracheal intubation is a key step in advanced airway management. The gold standard confirmation for successful endotracheal intubation is end-tidal carbon dioxide (etCO2) monitoring, although recent studies suggest that ultrasound can also be used. In this study, we explored the time-sensitive early recognition of successful endotracheal intubation by comparing ultrasound and etCO2 monitoring. Methods: The study included 104 patients who were posted for elective surgery under general anaesthesia requiring endotracheal intubation. The time from removal of the face mask to ultrasound visualization of flutter in the trachea was compared with that of the appearance of six consecutive capnography waveforms following endotracheal intubation. Results: Ultrasound was a faster tool for recognizing successful endotracheal intubation [(21.63±7.38) seconds] compared with capnography [(40.62±7.93) seconds]. Conclusion: eCO2 requires more time for 6 continuous waveforms to confirm successful intubation and has a false positive rate. Supplementing the gold standard etCO2 with ultrasound is faster and reliable in patients with low pulmonary blood flow without needing positive pressure ventilation, such as during cardiopulmonary resuscitation, in high-risk emergency intubations, such as in trauma, or in difficult airways where intubation can be confirmed in real time. Ultrasound is a reliable and faster tool for the early identification of successful endotracheal intubation than end-tidal carbon dioxide.

The adverse effects of waste generation on the environment and public health have raised global concerns. The utilization of waste as a raw material to develop products with enhanced value has opened up novel prospects for promoting environmental sustainability. Biosurfactants obtained from agro-industrial waste are noteworthy due to their sustainability and environmental friendliness. Microorganisms have been employed to generate biosurfactants as secondary metabolites by making use of waste streams. The utilization of garbage as a substrate significantly reduces the expenses associated with the process. Furthermore, apart from reducing waste and offering alternatives to artificial surfactants, they are extensively employed in bioremediation, food processing, agriculture, and various other industrial pursuits. Bioremediation of heavy metals and other metallic pollutants mitigated through the use of bacteria that produce biosurfactants which has been the more recent research area with the aim of improving its quality and environmental safety. Moreover, the production of biosurfactants utilizing agricultural waste as a raw material aligns with the principles of waste minimization, environmental sustainability, and the circular economy. This review primarily focuses on the production process and various types of biosurfactants obtained from waste biomass and feedstocks. The subsequent discourse entails the production of biosurfactants derived from various waste streams, specifically agro-industrial waste.

Objective: Successful endotracheal intubation is a key step in advanced airway management. The gold standard confirmation for successful endotracheal intubation is end-tidal carbon dioxide (etCO2) monitoring, although recent studies suggest that ultrasound can also be used. In this study, we explored the time-sensitive early recognition of successful endotracheal intubation by comparing ultrasound and etCO2 monitoring. Methods: The study included 104 patients who were posted for elective surgery under general anaesthesia requiring endotracheal intubation. The time from removal of the face mask to ultrasound visualization of flutter in the trachea was compared with that of the appearance of six consecutive capnography waveforms following endotracheal intubation. Results: Ultrasound was a faster tool for recognizing successful endotracheal intubation [(21.63±7.38) seconds] compared with capnography [(40.62±7.93) seconds]. Conclusion: eCO2 requires more time for 6 continuous waveforms to confirm successful intubation and has a false positive rate. Supplementing the gold standard etCO2 with ultrasound is faster and reliable in patients with low pulmonary blood flow without needing positive pressure ventilation, such as during cardiopulmonary resuscitation, in high-risk emergency intubations, such as in trauma, or in difficult airways where intubation can be confirmed in real time. Ultrasound is a reliable and faster tool for the early identification of successful endotracheal intubation than end-tidal carbon dioxide. [ABSTRACT FROM AUTHOR]

Evolving and conflicting information about pathophysiology, clinical course and impact of corona virus disease (COVID-19) on perioperative outcome of patients has brought in new challenges while restarting elective surgeries. A roadmap to resume elective surgeries should detail timings for reopening elective surgeries, COVID-19 testing facilities, adequate PPE supplies, conservation policies for PPE and case prioritization and scheduling. We suggest a six-pronged strategy of minimizing chances of exposure, adherence to standard protocols, perioperative patient care, precautions while performing aerosol generating procedures, limiting movement of personnel within operating room and monitoring and managing health care professionals while scheduling elective surgeries to overcome the challenges this COVID-19 pandemic has brought in.

In most Internet of Things (IoT) systems, Quality of service (QoS) must be confirmed with respect to the requirement of implementation domain. The dynamic nature of the IoT surroundings shapes it to complicate the fulfilment of these commitments. A wide range of unpredictable events endanger the quality of service. While execution the self-adaptive schemes handle with system's unpredictable. In IoT-based Wireless Sensor Networks (WSNs), the significant self-management objectives are self-configuration (SC) and self-healing (SH). In this paper, Self-Configuration and Self-healing Framework using an extreme gradient boosting (XGBoost) Classifier are proposed. In this framework, the IoT traffic classes are categorized as several types under XGBoost classifier. In SC phase, the IoT devices are self-configured by allocating various transmission slots, contention access period (CAPs) on the basis of its categories with priorities. In SH phase, the source node cardinally establishes a confined route retrieval method if the residual power in-between node is truncated or the node has displaced far away. The proposed framework is executed in NS-2 and the results exhibit that the proposed framework has higher packet delivery ratio with reduced packet drops and computational cost. Therefore, the proposed approach has attained 24.7%, 28.9%, 12.75% higher PDR, and 16.8%, 19.87%, and 13.7% higher residual energy than the existing methods like Self-Healing and Seamless Connectivity using Kalman Filter among IoT Networks (SH-SC-KF-IoT), Provenance aware run-time verification mechanism for self-healing IoT (PA-RVM-SH-IoT), and Fully Anonymous Routing Protocol and Self-healing Capacity in Unbalanced Sensor Networks (FARP-SC-USN) methods, respectively. [ABSTRACT FROM AUTHOR]

Objective: Dexmedetomidine is an alpha 2-adrenergic agonist that prolongs analgesia as an adjuvant when added in neuraxial and peripheral nerve blocks. The aim of the present study was to evaluate the efficacy of dexmedetomidine as an adjuvant to bupivacaine in ultrasound (USG)- guided transverse abdominis plane (TAP) block for postoperative analgesia in laparoscopic appendicectomy. Methods: A total of 60 American Society of Anesthesiologists I and II adult patients aged between 16 and 60 years planned for laparoscopic appendicectomy were randomised into two groups (A and B). Group A patients received 20 mL of 0.125% bupivacaine+1 µg kg-1 dexmedetomidine, whereas group B patients received 20 mL of 0.125% bupivacaine alone on both sides at the time of USG-guided TAP block. Haemodynamic variables, pain scores, sedation scores, time to first dose of rescue analgesic and side effects, if any, were assessed and compared between the groups. Results: Demographic and operative characteristics were comparable in both groups. The mean duration of analgesia was more in group A (7.33 h) than in group B (4.8 h). The requirement of rescue analgesics was more in group B (80%) than in group A (56.7%). The sedation and pain scores at 2, 4 and 6 h were better in group A than in group B (p<0.05). The heart rate, systolic blood pressure and diastolic blood pressure were lower in group A during the postoperative period than in group B. Conclusion: The addition of dexmedetomidine as an adjuvant to bupivacaine in TAP block provides prolonged postoperative analgesia and better pain control with reduced need for rescue analgesics than bupivacaine alone in patients undergoing laparoscopic appendicectomy. [ABSTRACT FROM AUTHOR]

The objective of this paper is to model high strain rate and temperature-dependent response of an epoxy resin (DER 353 and bis(p -aminocyclohexyl) methane (PACM-20)) undergoing large inelastic strains under uniaxial compression. The model is decomposed into two regimes defined by the rate and temperature-dependent yield stress. Prior to yield, the model accounts for viscoelastic behavior. Post yield inelastic response incorporates the effects of strain rate and temperature including thermal softening caused by internal heat generation. The yield stress is dependent on both temperature and strain rate and is described by the Ree–Erying equation. Key experiments over the strain rate range of 0.001–12,000/s are conducted using an Instron testing machine and a split Hopkinson pressure bar. The effects of temperature (25–120 ℃) on yield stress are studied at low strain rates (0.001–0.1/s). Stress-relaxation tests are also carried out under various applied strain rates and temperatures to obtain characteristic relaxation time and equilibrium stress. The model is in excellent agreement over a wide range of strain rates and temperatures including temperature in the range of the glass transition. Case studies for a wide range of monotonic and varying strain rates and large strains are included to illustrate the capabilities of the model. [ABSTRACT FROM AUTHOR]

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Punch shear in unidirectional composites is induced by transverse shear loading that progressively perforates the laminate within a narrow shear annulus. At lower micromechanical length scales, punch shear loading creates unique micromechanical damage mechanisms dominated by transverse fiber shear failure, fiber–matrix interphase debonding and large inelastic deformation and cracking of the matrix. A new punch shear experimental method has been developed to test unidirectional S glass/DER353 epoxy composite ribbons at sub-millimeter length scale. The experimental data consist of a statistical measurement of the continuum response (load-deformation and punch shear strength) and the characterization of micromechanical damage modes. A simplified 2D micromechanical finite element model incorporating Weibull fiber strength distribution has been developed and correlated with the experimental data. The 2D micromechanical finite element model can simulate the punch shear failure of the ribbon incorporating mixed mode fiber fracture, and fiber–matrix debonding mechanisms using zero thickness cohesive elements. Results from stochastic simulations of punch shear experiments show that an equivalent 2D micromechanical finite element model can predict the micromechanical damage mechanisms and the statistical distribution of punch shear strength of the continuum with favorable correlation with the experiments. This paper presents a combined experimental and computational approach in simulating the stochastic non-linear progressive punch shear behavior of unidirectional composites for the first time in the literature. [ABSTRACT FROM AUTHOR]

Punch shear in unidirectional composites is induced by transverse shear loading that progressively perforates the laminate within a narrow shear annulus. At lower micromechanical length scales, punch shear loading creates unique micromechanical damage mechanisms dominated by transverse fiber shear failure, fiber–matrix interphase debonding and large inelastic deformation and cracking of the matrix. A new punch shear experimental method has been developed to test unidirectional S glass/DER353 epoxy composite ribbons at sub-millimeter length scale. The experimental data consist of a statistical measurement of the continuum response (load-deformation and punch shear strength) and the characterization of micromechanical damage modes. A simplified 2D micromechanical finite element model incorporating Weibull fiber strength distribution has been developed and correlated with the experimental data. The 2D micromechanical finite element model can simulate the punch shear failure of the ribbon incorporating mixed mode fiber fracture, and fiber–matrix debonding mechanisms using zero thickness cohesive elements. Results from stochastic simulations of punch shear experiments show that an equivalent 2D micromechanical finite element model can predict the micromechanical damage mechanisms and the statistical distribution of punch shear strength of the continuum with favorable correlation with the experiments. This paper presents a combined experimental and computational approach in simulating the stochastic non-linear progressive punch shear behavior of unidirectional composites for the first time in the literature. [ABSTRACT FROM AUTHOR]