Background: Aerosol generating medical procedures (AGMPs) present risks to health care workers (HCW) due to airborne transmission of pathogens. During the COVID-19 pandemic, it is essential for HCWs to recognize which procedures are potentially aerosolizing so that appropriate infection prevention precautions can be taken. The aim of this literature review was to identify potential AGMPs in Otolaryngology -Head and Neck Surgery and provide evidence-based recommendations.Methods: A literature search was performed on Medline, Embase and Cochrane Review databases up to April 3, 2020. All titles and abstracts of retrieved studies were evaluated and all studies mentioning potential AGMPs were included for formal review. Full text of included studies were assessed by two reviewers and the quality of the studies was evaluated. Ten categories of potential AGMPs were developed and recommendations were provided for each category.Results: Direct evidence indicates that CO2 laser ablation, the use of high-speed rotating devices, electrocautery and endotracheal suctioning are AGMPs. Indirect evidence indicates that tracheostomy should be considered as potential AGMPs. Nasal endoscopy and nasal packing/epistaxis management can result in droplet transmission, but it is unknown if these procedures also carry the risk of airborne transmission. Conclusions: During the COVID-19 pandemic, special care should be taken when CO2 lasers, electrocautery and high-speed rotating devices are used in potentially infected tissue. Tracheal procedures like tracheostomy and endotracheal suctioning can also result in airborne transmission via small virus containing aerosols.
We introduce Digital microfluidic Isolation of Single Cells for -Omics (DISCO), a platform that allows users to select particular cells of interest from a limited initial sample size and connects single-cell sequencing data to their immunofluorescence-based phenotypes. Specifically, DISCO combines digital microfluidics, laser cell lysis, and artificial intelligence-driven image processing to collect the contents of single cells from heterogeneous populations, followed by analysis of single-cell genomes and transcriptomes by next-generation sequencing, and proteomes by nanoflow liquid chromatography and tandem mass spectrometry. The results described herein confirm the utility of DISCO for sequencing at levels that are equivalent to or enhanced relative to the state of the art, capable of identifying features at the level of single nucleotide variations. The unique levels of selectivity, context, and accountability of DISCO suggest potential utility for deep analysis of any rare cell population with contextual dependencies.
Vestibular rehabilitation therapy is an established treatment for patients with vestibular dysfunction. Virtual reality (VR) and augmented reality (AR) can be utilised in vestibular rehabilitation. Evidence of the efficacy of VR and AR delivered rehabilitation in patients with peripheral vestibular disorders is reviewed. MEDLINE, EMBASE, CENTRAL, CINAHL, PsychInfo, PsychBITE, OTSeeker, Ei Compendex, IEE, Clinical trials.gov and WebofScience databases were searched. Reduction in vestibular dysfunction symptoms 0–3 months post-intervention was the primary outcome. Secondary outcomes included long-term symptom improvement and side effects. Risk of bias assessment and meta analyses were planned. Five studies meeting eligibility criteria were included. Dizziness Handicap Inventory (DHI) scores 0–3 months post-intervention were reported by four studies. Meta-analysis identified a 1.13 (95% CI, − 1.74, − 0.52) standardized mean difference reduction in DHI in VR and AR treated patients compared to controls. Side effects reported by two studies were reduced by week four of VR intervention. Bias assessment identified DHI scores and side effects to be at high risk or of some concern. Adjunct VR interventions reduced patient DHI significantly more than vestibular rehabilitation alone 0–3 months post-intervention in adult patients diagnosed with unilateral vestibular disease. High quality studies are needed.
Failed experiments are a common occurrence in research, yet many undergraduate science laboratories rely on established protocols to ensure students are able to obtain results. While it is logistically challenging to facilitate students’ conducting their own experiments in the laboratory, allowing students to “fail” in a safe environment could help with the development of problem-solving skills. To allow students a safe place to fail and encourage them to think through a laboratory protocol, online decision trees were created to lead students through protocols and give them timely feedback. The online decision trees present students with a scenario, then students execute a protocol by selecting options that will lead them down different paths and result in various realistic results from their experiments. They receive feedback and instructional tutorials throughout the simulation that are dependent on their choices. The significance of this new resource for student learning is that it allows students to practice their problem-solving skills and gain theoretical knowledge about the purpose of various experimental steps. The purpose of this research study was to evaluate whether online decision trees affected students’ self-efficacy, metacognition, and motivation for completing a wet laboratory. A mixed-methods approach was used; three surveys were administered throughout the academic term. For survey 1, students completed the decision tree and survey before the wet laboratory. For survey 2, students completed the survey before the wet laboratory but completed the decision tree after the wet laboratory. Students’ reported self-efficacy and intrinsic motivation were increased with the administration of the online decision trees before the wet laboratory, but their extrinsic motivation and metacognitive scores were unchanged. For survey 3, students provided written feedback about the impact of the online decision trees, and their responses highlighted the importance of the visual components of the approach.
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