Noise, Distractions, and Hazards in the Operating Room.

Anesthesiologists are perioperative leaders of patient and health care team safety. The anesthesiologist needs to remain vigilant in the perioperative setting and while caring for patients. The ability to navigate increased noise levels, distractions, and hazards is crucial for maintaining a safe environment.

Newborn Screening for Spinal Muscular Atrophy: Variations in Practice and Early Management of Infants with Spinal Muscular Atrophy in the United States.

In the United States (U.S.), newborn screening (NBS) for spinal muscular atrophy (SMA) is implemented by individual states.

Simultaneous implementation of unrelated tumour sites on the MR Linac: A review of the commissioning process from a radiographer perspective and lessons learned.

Introduction: This work reports on a systematic approach to select MRI sequences, quantify inter-observer image registration variation and determine patient positioning for the clinical implementation of MR-guided adaptive radiotherapy (MRgRT) in patients with oropharyngeal (H&N) and lung cancer.

Methods: A total of 30 participants (N=10 H&N and N=10 lung cancer patients and N=10 healthy participants) were scanned on the Elekta Unity Magnetic Resonance Linear Accelerator (MRL). Participant experience questionnaires were used to determine the most appropriate positioning device for lung treatments and tolerability of H&N immobilization devices within the confined MR Linac environment.

Zinc Orthophosphate Can Reduce Nitrate-Induced Corrosion of Lead Solder.

Nitrate-induced spallation of lead-bearing solder particles into drinking water is not sufficiently controlled by phosphate-based inhibitors, although adding zinc can improve their performance. Studies using copper coupons coated with new lead-tin solder in water with up to 12 mg/L nitrate demonstrated that zinc orthophosphate reduced lead release by more than 90% and outperformed orthophosphate alone. Lead release and spallation from harvested pipes with decades-old lead-tin solder in a high nitrate water were improved but not eliminated with zinc orthophosphate over a period of months.

Severe mental illness and the perimenopause.

Hormonal fluctuations in the perimenopause are associated with an array of physical and psychological symptoms. Those with pre-existing mental disorders may experience changes to their symptoms and response to treatment during the perimenopausal and postmenopausal periods and may also be at risk of poorer longer-term physical health outcomes in menopause. The transition towards menopause may be compounded by the oestradiol-suppressing effect of many psychotropics on the hypothalamopituitary-gonadal axis.

A pulmonary vein atlas for radiotherapy planning.

Background And Purpose: Cardiac arrhythmia is a recognised potential complication of thoracic radiotherapy, but the responsible cardiac substructures for arrhythmogenesis have not been identified. Arrhythmogenic tissue is commonly located in the pulmonary veins (PVs) of cardiology patients with arrhythmia, however these structures are not currently considered organs-at-risk during radiotherapy planning. A standardised approach to their delineation was developed and evaluated.

Experience With the Routine Use of Electronic Patient-Reported Outcome Measures for Patients With Lung Cancer.

Purpose: The Christie NHS Foundation Trust launched their electronic patient-reported outcome measures (ePROMs) service in January 2019 in the routine clinical setting. The lung cancer questionnaires consist of 14 symptom items, adapted from the Common Terminology Criteria for Adverse Events (version 5.0) and the EuroQol EQ-5D-5L quality-of-life (QoL) tool.

Seasonal Fluctuations in Nitrate Levels Can Trigger Lead Solder Corrosion Problems in Drinking Water.

After a utility switched its source water from ground to surface water in 2017, first draw water lead levels spiked due to increased lead solder corrosion that could not be explained by existing knowledge. When lead release was not adequately reduced with a 90:10 orthophosphate/polyphosphate corrosion inhibitor blend or even high levels of 100% orthophosphate, an in-depth investigation of possible causes revealed a strong correlation between 90th percentile lead and seasonal fluctuations in surface water nitrate levels. Complementary bench-scale studies that tested new copper coupons with lead solder and harvested pipes from a worst case home verified a strong relationship between nitrate and elevated lead.

Pathogen and Antibody Identification in Children with Encephalitis in Myanmar.

Objective: Prospective studies of encephalitis are rare in regions where encephalitis is prevalent, such as low middle-income Southeast Asian countries. We compared the diagnostic yield of local and advanced tests in cases of pediatric encephalitis in Myanmar.

Methods: Children with suspected subacute or acute encephalitis at Yangon Children's Hospital, Yangon, Myanmar, were prospectively recruited from 2016-2018.

The emergence noise reduction quality improvement initiative to enhance patient safety and quality of care.

Background: Operating room noise levels may hinder staff communication and cause distractions for providers, endangering patient safety. Owing to concerns of unacceptable noise levels during emergence from general anesthesia, our institution developed a quality improvement project. The SMART aim of this initiative was to decrease the average decibel noise level measured during emergence from general anesthesia in our operating rooms from 65.