Insertion Depth Research Articles

A new formula to predict the size and insertion depth of cuffed nasotracheal tube in children receiving dental surgery: a retrospective study

This retrospective study aimed to develop a new formula for selecting the appropriate size and determining the depth of the cuffed nasotracheal intubation (NTI) for a cuffed endotracheal tube (cETT) in pediatric patients undergoing dental surgery. In addition, the clinical data on cETT (i.e., the size and depth of insertion) was compared with those calculated with age-based formulas to evaluate their correlation. A total number of 684 patients who received NTI were enrolled (healthy group, n = 607; special-need group, n = 77). The ETT size used in real-world scenarios was smaller (i.e., about 0.5 and 0.94 mm) than the age-based formula, while the ETT depth was greater (i.e., about 1.5 cm) than the age-based formula in both groups. In the healthy group, age, gender, and body weight were identified as predictors of ETT size and depth through multiple linear regression analysis, while only age and body weight were predictors in the special-needs group. New formulas were developed based on these findings, with ETT size = 3.98 + 0.052 × age + 0.048 × gender (male = 1, female = 0) + 0.023 × body weight (kg) and ETT depth = 15.1 + 0.43 × age + 0.300 × gender (male = 1, female = 0) + 0.007 × body weight (kg). The new formula could be useful for both healthy and special-need pediatric populations undergoing dental procedures.

Accuracy of Preoperative Cochlear Duct Length Estimation and Angular Insertion Depth Prediction.

In cochlear implantation with flexible lateral wall electrodes, a cochlear coverage of 70% to 80% is assumed to yield an optimal speech perception. Therefore, fitting the cochlear implant (CI) to the patient's individual anatomy has gained importance in recent years. For these reasons, the optimal angular insertion depth (AID) has to be calculated before cochlear implantation. One CI manufacturer offers a software that allows to visualize the AID of different electrode arrays. Here, it is hypothesized that these preoperative AID models overestimate the postoperatively measured insertion angle. This study aims to investigate the agreement between preoperatively estimated and postoperatively measured AID. Retrospective cross-sectional study. Single-center tertiary referral center. Patients undergoing cochlear implantation. Preoperative and postoperative high-resolution computed tomography (HRCT). The cochlear duct length was estimated by determining cochlear parameters ( A value and B value), and the AID for the chosen electrode was (i) estimated by elliptic circular approximation by the software and (ii) measured manually postoperatively by detecting the electrode contacts after insertion. A total of 80 HRCT imaging data sets from 69 patients were analyzed. The mean preoperative AID estimation was 662.0° (standard deviation [SD], 61.5°), and the mean postoperatively measured AID was 583.9° (SD, 73.6°). In all cases (100%), preoperative AID estimation significantly overestimated the postoperative determined insertion angle (mean difference, 38.1°). A correcting factor of 5% on preoperative AID estimation dissolves these differences. The use of an electrode visualization tool may lead to shorter electrode array choices because of an overestimation of the insertion angle. Applying a correction factor of 0.95 on preoperative AID estimation is recommended.

Nasal steroid spray simulations using measured spray characteristics in healthy and rhinitic nasal passages

Intranasal corticosteroid sprays (ICSs) are frequently prescribed for allergic rhinitis (AR), which is the fifth most common chronic disease in the United States. This study aimed to investigate how the intranasal distribution of ICSs is affected by spray characteristics, patient use factors, and anatomical variation. Three-dimensional reconstructions of the nasal cavity were created from computed tomography (CT) scans of one healthy subject and one AR patient. A virtual spray nozzle was positioned in the nasal vestibule according to package insert instructions and subtracted from the nasal airspace. Hybrid tetrahedral-prism meshes were created and spray simulations were conducted in ANSYS Fluent™ with inspiratory airflow present and spray characteristics from in vitro experiments. Changes in regional corticosteroid deposition with variations in spray product, actuation force, inhalation rate, spray cone angle, nozzle insertion depth, nozzle position, and nasal side were assessed. The simulation results demonstrated that, in both models, target site deposition was mostly affected by changes in nozzle position and anatomy (left vs. right nostril). In the healthy subject, target site deposition increased with a higher actuation force, higher inhalation rate, and smaller nozzle depth, but was not significantly affected by changes in the spray cone angle. In the AR patient, target site deposition was not significantly different for changes in actuation force, inhalation rate, nozzle depth, or cone angle. The findings of this numerical study suggest that the intranasal distribution of ICSs is influenced mostly by nozzle position and nasal anatomy.

A Randomized Clinical Trial to Compare Three Different Methods for Estimating Orogastric Tube Insertion Length in Newborns: A Single-Center Experience in China.

Background: Orogastric (OG) and nasogastric (NG) tubes are frequently used in the NICU. Obtaining a relatively accurate estimated length before insertion could significantly reduce complications. While previous studies have mainly focused on the NG tube, OG tubes are more commonly used in China. Purpose: The objective was to determine whether there were differences in the rate of accurate placement among the adapted nose-ear-xiphoid (NEX) method, nose-ear-midway to the umbilicus (NEMU) method, and weight-based (WB) equation in estimating the OG tube insertion distance. Methods: A randomized, controlled, open-label clinical trial to compare the three methods was conducted in a single center. After enrollment, newborns were randomly assigned into three groups. By radiological assessment, the anatomical region for OG tube placement was analyzed. The primary metric was the tip within the gastric body, and the second metric was strictly accurate placement defined as the tube was not looped back within the stomach and the end was located more than 2 cm but less than 5 cm into the stomach, referred to as T10. Results: This study recruited 156 newborns with the majority being preterm infants (n = 96; 61.5 percent), with an average birth weight of 2,200.8 ± 757.8 g. For the WB equation, 96.2 percent (50 cases) of the OG tubes were placed within the stomach, and the rates were 78.8 percent (41 cases) in the adapted NEX and NEMU methods. The strictly accurate placement rates were highest for the WB equation at 80.8 percent (42/52), followed by the adapted NEX method at 65.4 percent (34/52), and the NEMU method at 57.7 percent (30/52). Conclusion: The WB equation for estimating the insertion depth of the OG tube in newborn infants resulted in more precise placement compared to the adapted NEX and NEMU methods.

Computational modeling of the effect of skin pinch and stretch on subcutaneous injection of monoclonal antibodies using autoinjector devices.

Subcutaneous injection of monoclonal antibodies (mAbs) has experienced unprecedented growth in the pharmaceutical industry due to its benefits in patient compliance and cost-effectiveness. However, the impact of different injection techniques and autoinjector devices on the drug's transport and uptake is poorly understood. Here, we develop a biphasic large-deformation chemomechanical model that accounts for the components of the extracellular matrix that govern solid deformation and fluid flow within the subcutaneous tissue: interstitial fluid, collagen fibers and negatively charged proteoglycan aggregates. We use this model to build a high-fidelity representation of a virtual patient performing a subcutaneous injection of mAbs. We analyze the impact of the pinch and stretch methods on the injection dynamics and the use of different handheld autoinjector devices. The results suggest that autoinjector base plates with a larger device-skin contact area cause significantly lower tissue mechanical stress, fluid pressure and fluid velocity during the injection process. Our simulations indicate that the stretch technique presents a higher risk of intramuscular injection for autoinjectors with a relatively long needle insertion depth.

Removing knotted or stuck epidural catheters: a systematic review of case reports.

The knotting or in vivo entrapment of epidural catheters is an uncommon but challenging issue for anesthesiologists. This study aimed to identify the possible causes behind entrapped epidural catheters and the effective methods for their removal. A systematic review of relevant case reports and series was conducted using the patient/population, intervention, comparison and outcome framework and keywords such as "epidural," "catheter," "knotting," "stuck," "entrapped," and "entrapment." The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed, and the review protocol was registered with International Prospective Register for Systematic Reviews (CRD42021291266). The analysis included 59 cases with a mean depth of catheter insertion from the skin of 11.825 cm and an average duration of 8.17 h for the detection of non-functioning catheters. In 27 cases (45.8%), a radiological knot was found, with an average length of 2.59 cm from the tip. The chi-squared test revealed a significant difference between the initial and final positions of catheter insertion (P = 0.049). Deep insertion was the primary cause of epidural catheter entrapment. To remove the entrapped catheters, the lateral decubitus position should be attempted first, followed by the position used during insertion. Based on these findings, recommendations for the prevention and removal of entrapped catheters have been formulated.

Design and evaluation of shape memory alloy-actuated active needle using finite element analysis and deflection tracking control in soft tissues.

Conventional needles lack active mechanisms for large tip deflection to bypass obstacles or guide through a desired trajectory in needle-based procedures, compromising accuracy and effectiveness. An active needle with a shape memory alloy (SMA) actuator was designed and evaluated by demonstrating deflections in tissue-mimicking gels. Finite element simulation and real-time needle tip deflection tracking in tissue-mimicking gels were performed. The active needle deflected 50 and 39mm at 150mm insertion depth in the liver and prostate mimicking gels, respectively. Reasonable simulation errors of 16.42% and 12.62% in needle deflections and small root mean squared errors of 1.42 and 1.47mm in deflection tracking were obtained. The proposed needle produced desirable large tip deflections capable of bypassing obstacles in the insertion path and tracked a preplanned trajectory with minor errors. The finite element study would help optimise needle designs and predict deflections in soft tissues.

Development of a Base-Actuated Three-Rhombus Configured Remote Center of Motion Mechanism for Lumbar Puncture

Abstract Owing to the advantages of safety and reproducibility, remote center of motion (RCM) mechanisms are widely adopted in lumbar puncture (LP) procedures to guide the insertion angle and depth of the end effector. However, the proximal-actuated pattern in existing RCM mechanisms occupies a large space near the end effector, which obstructs the visual field and increases the system inertia. In this work, a base-actuated three-rhombus configured RCM mechanism for LP operation is first proposed, where the symmetric three-rhombus scheme is designed for motion transmission. As a result, the rotational and translational motions of the needle are respectively realized through the homodromous and heterodromous actuation of the two base-mounted motors. Kinematic models are established to analyze the manipulability, singularity, and workspace of the RCM mechanism theoretically. The parameter optimization procedure is provided to minimize the footprint of the RCM mechanism. Experimental results show that the mechanism reaches an insertion angle from −29.2 deg to 29.2 deg, a maximum insertion depth of 60.02 mm, and a footprint of 4.98 × 104 mm2. The relative error of the RCM point is 1.1 mm.

A Randomized, Controlled Trial, comparing the Total Enteroscopy Rate and Diagnostic Efficacy of Novel Motorized Spiral Enteroscopy and Single Balloon Enteroscopy in patients with Small-Bowel Disorders - THE MOTOR TRIAL (NCT 05548140).

Device-assisted enteroscopy (DAE) has revolutionized the management of Small Bowel Disorders (SBD). No study to date has compared both Novel Motorized Spiral Enteroscopy (NMSE) and Single Balloon Enteroscopy (SBE) as a randomized controlled trial. Hence, this study was planned to include patients having SBD with the primary aim to compare the Total Enteroscopy Rate (TER). This study was conducted at the Asian Institute of Gastroenterology (AIG Hospitals), Hyderabad, India from 20th September 2022 to 15th December 2022. All consecutive patients, aged more than 18 years with suspected SBD, and planned for Total Enteroscopy (TE) were screened for inclusion. The primary outcome was to compare the TER and secondary outcomes were to compare the technical success, time taken to reach the Depth of Maximal Insertion (DMI), withdrawal time, total procedure time, diagnostic yield, therapeutic success, and adverse events. Seventy-two patients out of the 110 patients screened, were randomized in either of NMSE (n=35) or SBE (n=37) group. The most common indication for the procedures was obscure GI bleed (48%), others being unexplained abdominal pain with indeterminate radiologic findings (32%) and chronic diarrhea (20%). In NMSE group the TER was 71.4%; while in the SBE group, it was 10.8%, (p<0.0001). The total procedure time (min) was much lesser with NMSE (58.17±21.5 min) versus SBE (114.2±33.5 min), (p<0.0001). The diagnostic yield of NMSE (80%) was comparatively higher than SBE (62.1%), (p = 0.096). Minor adverse events (Grade I) were observed in both the groups: NMSE (3/35, 8.5%) and SBE (2/37, 5.4%). This RCT shows that with NMSE higher TER can be achieved in shorter duration with minimal adverse events, compared to SBE.

Simulation of the NuScale SMR and Investigation of the Effect of Load-Following on Component Lifetimes

The NuScale small modular reactor (SMR) has been modeled using the Virtual Environment for Reactor Applications multiphysics environment and the results compared with the publicly reported data in the Design Certification Application. The results show an excellent agreement for the compared axial and radial power distributions, temperature coefficients of reactivity, boron and control rod worths, and fast neutron flux. This NuScale model is then used to investigate the effect of different operational modes on reactor components to determine how the flexible load-following operation may affect control rod and reactor pressure vessel (RPV) lifetimes. The control rod degradation is confirmed to primarily affect the silver-indium-cadmium rod tip. The degradation rate is observed to follow a nonlinear function of core power level where the increase in degradation decreases with insertion depth. For the variation in core power levels expected with current load-following schemes, the total control rod degradation is found to be mild, at 5% to 10% of usable life per cycle for a reactor operating at <80% power. Nonetheless, this enables load-following strategies to be confirmed and/or modified to ensure that control rods do not need to be replaced during the 60+ year life of the reactor. The RPV degradation was found to be almost directly proportional to the core power level and was not overly sensitive to flux shape perturbations. Future work is planned using these damage functions to optimize operation over multiple NuScale SMR units and to develop strategies for prognostics and health management.

Using Anatomy-Based Fitting to Reduce Frequency-to-Place Mismatch in Experienced Bilateral Cochlear Implant Users: A Promising Concept.

Fitting cochlear implant (CI) users can be challenging. Anatomy-based fitting (ABF) maps may have the potential to lead to better objective and subjective outcomes than conventional clinically based fitting (CBF) methods. ABF maps were created via information derived from exact electrode contact positions, which were determined via post-operative high-resolution flat panel volume computer tomography and clinical fitting software. The outcome measures were speech understanding in quiet and noise and self-perceived sound quality with the CBF map and with the ABF map. Participants were 10 experienced bilateral CI users. The ABF map provided better speech understanding in quiet and noisy environments compared to the CBF map. Additionally, two approaches of reducing the frequency-to-place mismatch revealed that participants are more likely to accept the ABF map if their electrode array is inserted deep enough to stimulate the apical region of their cochlea. This suggests an Angular Insertion Depth of the most apical contact of around 720°-620°. Participants had better speech understanding in quiet and noise with the ABF map. The maps' self-perceived sound quality was similar. ABF mapping may be an effective tool for compensating the frequency-to-place mismatch in experienced bilateral CI users.

Exploring Learning Curves in Acupuncture Education Using Vision-Based Needle Tracking

Measuring learning curves allows for the inspection of the rate of learning and competency threshold for each individual, training lesson, or training method. In this work, we investigated learning curves in acupuncture needle manipulation training with continuous performance measurement using a vision-based needle training system. We tracked the needle insertion depth of 10 students to investigate their learning curves. The results show that the group-level learning curve was fitted with the Thurstone curve, indicating that students were able to improve their needle insertion skills after repeated practice. Additionally, the analysis of individual learning curves revealed valuable insights into the learning experiences of each participant, highlighting the importance of considering individual differences in learning styles and abilities when designing training programs.

Experimental and numerical studies on the mechanical properties and behaviors of a novel wood dowel reinforced dovetail joint

To improve the mechanical strength of dovetail joints, resisting and postponing the crack propagation, a novel method of enhancing the mechanical strength of the dovetail joint using a dowel-reinforced method was proposed. The connection technical parameters of the dowel-reinforced dovetail joint (DRDJ) were investigated and optimized based on experimental and numerical methods. The results showed that there were three typical mechanical behaviors of the DRDJ characterized, and each of them can be separated into three regions, i.e., elastic region, crack propagation region, and failure region, by the defined crack initiation point and critical fracture point. The effects of dowel inserting distance and depth on mechanical properties of the DRDJ was significant. The proposed method was validated experimentally to be an efficient approach to improving the crack initiation load, critical fracture load, and elastic stiffness, and delay crack propagation. The connection technical parameters of the DRDJ were analyzed based on response surface method and experimentally validated to be the distance of 18.56 mm and depth of 32.19 mm. Tensile strength of the DRDJ was seriously influenced by wood dowel species and dowel fit, and increased with the increase of dowel fit and mechanical strength of wood dowel based on numerical analysis. In conclusion, the dowel-reinforced method is capable of improving the mechanical strength of dovetail joints, resisting and postponing the crack propagation, and has an advantage on the risk of pre-warning of wood structure failure.

Comparison of Landmark Versus ECG-Guided Technique for Correct Insertion of Central Venous Catheter in Paediatric Patients Undergoing Cardiothoracic Surgery

Background: Central venous catheters are inserted in internal jugular vein during cardiac surgeries in all patients. However, the length of the catheter should be correctly estimated and the tip of the CVC should be correctly placed to avoid various complications. &#x0D; The primary objective of this study is to compare anatomical landmark technique versus using ECG-guided technique for the correct insertion length of the Central Venous Catheter.&#x0D; Methods: Prospective, randomized, interventional study was conducted on 72 patients of &lt;12 years age. Patients were randomly allotted to two groups of 36 patients each (landmark and ECG). After induction, CVC cannulation was performed using either of the techniques in right IJV in all patients. Correct position of CVC was checked by obtaining post operative chest X rays in all patients. CVC tip position within 0.5cm above/below or at carina was considered as correct position. Using student t-tests and Chi square-tests analyses were performed.&#x0D; Results: In landmark group, CVC was positioned correctly in 22(61.11%) out of 36 patients as compared to 33 (91.67%) in the ECG group, (P = 0.006). The mean depth of CVC insertion was 9.05±1.66 and 8.26±1.41 in the landmark and ECG group respectively (P= 0.032). The landmark group had 12 (33.33%) patients with complications during the procedure, as compared to 3(8.33%) in the ECG-guided group, (P = 0.020).&#x0D; Conclusion: ECG-guided CVC insertion, a simple bedside technique was found more accurate with lesser complications for CVC tip placement than the landmark technique. ECG-guided CVC placement is therefore relatively more accurate, efficient, and safe.

A Constant Output Capacitive Wireless Power Transfer System Based on Parity-Time Symmetric

In existing capacitive wireless power transfer (CPT) systems, the coupling capacitance of the traditional couplers is usually small, which will lead to a significant decrease in the power transfer capability when the transfer distance increases. Thus, it is a big challenge to achieve stable output power and constant transfer efficiency under different coupling capacitance. In this work, the circuit model of the CPT system with double-side LC compensation network is established firstly. Then, based on the parity-time (PT) symmetric theory, a primary-side control strategy is presented to achieve stable output power and constant high transfer efficiency when the coupling capacitance changes. Finally, the experimental results show that when the insertion depth of the stack array coupler changes from 60 to 180 mm, the output power of the proposed CPT prototype is almost stable at 25W, and the transfer efficiency is kept at around 88%, which verifies the feasibility and effectiveness of the proposed design.

Evaluation of a novel platform for placement confirmation of enteral feeding tubes in adults

ObjectiveThe aim of this study was to validate the ability of a novel, impedance-based platform for nasogastric feeding tube (FT) insertion to correctly predict intragastric FT placement in healthy individuals with and without acid suppression medication. MethodsTen patients underwent successive placement of 8, 10, and 12 French FTs with the final intragastric position predicted using an impedance-based algorithm and verified with an abdominal x-ray. Study procedures were repeated after patients received a proton pump inhibitor (PPI) for 3 d. ResultsNasogastric FTs with embedded electrodes spaced along the distal 31 cm of the tubes were placed with the final insertion depth determined by an algorithm integrating impedance and other physiologic parameters. Sixty FT (30 pre-PPI and 30 post-PPI) insertions were performed. The algorithm-predicted location was confirmed as intragastric in all insertions by post-placement abdominal x-ray. For all tube sizes and those with and without PPIs, the impedance at electrodes within the esophagus was significantly higher than at electrodes in the stomach (P < 0.01). As a secondary objective to assess the use of gastric aspirate pH to determine location, gastric aspirate could only be obtained in 30% of insertions. The mean gastric pH was 6.9 (SD 0.6) in patients taking PPIs. ConclusionsA novel platform for real-time assistance with nasogastric FT placement confirmation correctly determined intragastric FT location as confirmed by abdominal x-ray (standard of care) in all 60 insertions. Gastric pH measurements were difficult to obtain and unreliable for intragastric FT placement confirmation in patients taking acid suppression medication.

Laboratory Analysis of Causative Factors for the Final Incision Size due to Intraocular Lens Injector Insertion

In intraocular lens (IOL) implantation, insertion of the IOL injector enlarges the clear corneal incision. A larger incision size (IS) is associated with a higher risk for surgically induced astigmatism and endophthalmitis. The goal of this study was to determine which parameters most influence the final IS. Experimental study. A total of 126 cadaver porcine eyes were included in this study. We analyzed 409 clear corneal incisions made with 126 injectors from 13 injector models. We noted the vertical diameter and the tip angulation for every model. The corneal thickness of each incision location was measured using Scheimpflug tomography. The IS was measured before and after injector insertion and described as preoperative and final ISs, respectively. During surgery, the insertion depth and incision length were documented. A mixed effects model was applied to analyze the influence of the parameters on the final IS. Influence on the final IS. Increases in the vertical diameter of the injector tip, the preoperative IS and the insertion depth, and a reduction of incision length were all significantly associated with increased final IS (P<0.05). The conditional Pseudo-R2-Measure was 0.92. The preoperative IS had the largest standardized estimated effect on the final IS, followed by the vertical diameter of the injector tip, insertion depth, and lastly, incision length. Neither corneal thickness nor the tip angle of the injector had a significant effect on the final IS (P>0.05). The IOL injector's vertical diameter should be as small as possible to ensure a minimal final IS. The injector's insertion depth may be minimized, and the incision length should be long enough to reduce the final IS. Further studies are needed to confirm the findings in human autopsy eyes and in clinical practice. Proprietary or commercial disclosure may be found after the references in the Footnotes and Disclosures at the end of this article..

Effectiveness and safety of novel motorized spiral enteroscopy: a systematic review and meta-analysis.

Motorized spiral enteroscopy (MSE) is a novel advance in small bowel examination that is characterized as fast with a deep insertion. The aim of this study was to elucidate the effectiveness and safety of MSE. Relevant articles that were published before November 1, 2022 were identified by searching PubMed, EMBASE, Cochrane, and the Web of Science. The technical success rate (TSR), total (pan)-enteroscopy rate (TER), depth of maximum insertion (DMI), diagnostic yield, and adverse events were extracted and analyzed. Forest plots were graphed based on random effects models. A total of 876 patients from 8 studies were eligible for analysis. The pooled results of the TSR were 95.0% [95% confidence interval (CI) 91.0-98.0%, I2 = 78%, p < 0.01] and the pooled outcome of the TER was 43.1% (95% CI 24.7-62.5%, I2 = 95%, p < 0.01). The pooled results of the diagnostic and therapeutic yields were 77.2% (95% CI 69.0-84.5%, I2 = 84%, p < 0.01) and 49.0% (95% CI 38.0-60.1%, I2 = 89%, p < 0.01), respectively. The pooled estimates of adverse and severe adverse events were 17.2% (95% CI 11.9-23.2%, I2 = 75%, p < 0.01) and 0.7% (95% CI 0.0-2.1%, I2 = 37%, p = 0.13), respectively. MSE is a novel alternative approach for small bowel examination that can achieve high TER and diagnostic and therapeutic yields, and relatively low rates of severe adverse events. Head-to-head studies comparing MSE and other device-assisted enteroscopies are warranted.

Intrarectal Foley catheter-assisted high-intensity focused ultrasound ablation for benign uterine diseases beyond the treatment region

Objective To evaluate the feasibility of using an intrarectal Foley catheter during ultrasound-guided high-intensity focused ultrasound (US-HIFU) in patients with benign uterine diseases of the posterior wall beyond the HIFU therapeutic range. Methods Patients were treated with US-HIFU and lesion changes were monitored using contrast-enhanced MRI from June 2020 to September 2021. A Foley catheter was inserted into the rectum to facilitate a successful US-HIFU ablation. Complications and lesion responses were recorded during the treatment and follow-up. Results Thirteen patients with 14 lesions beyond the device’s treatable area were enrolled. The average placement time and insertion depth of the intrarectal Foley catheter was 7.6 ± 2.7 min and 23.2 ± 7.6 cm, respectively. A median of 50 mL degassed water was injected into the Foley catheter balloon. All 14 lesions were successfully pushed into a treatable area and subjected to HIFU. The average treatment time, irradiation time, and total therapeutic energy of HIFU were 44.2 ± 17.3 min, 394.4 ± 295.7 s, and 73.3 ± 46.6 kJ, respectively. The mean non-perfusion volume (NPV) in all treated lesions was 23.2 ± 19.2 cm3, and the mean NPV ratio was 57.8 ± 16.9%. Major complications were not observed. Conclusion Intrarectal Foley catheter-assisted US-HIFU is effective and safe. Its clinical application could benefit patients with benign uterine diseases outside the HIFU therapeutic range.

Recommendations for endotracheal tube insertion depths in children

BackgroundEndotracheal tube (ETT) malposition is frequent in paediatric intubation. The current recommendations for ETT insertion depths are based on formulae that hold various limitations. This study aimed to develop age-based,...