External Manipulation Research Articles

Strong circular dichroism absorbers using chiral metamaterials with circular polarization

We designed and characterized a chiral metamaterial circularly polarized strong circular dichroism absorber with dynamic tuning capabilities using graphene. The synergistic combination of strong circular dichroism and perfect absorption, coupled with the tunability afforded by graphene, positions this absorber as a promising candidate for advanced electromagnetic applications. Employing a frequency-domain solver in electromagnetic simulation software, the impact of parameters such as the thickness of a metal U-ring, a silica dielectric layer, and the polarization angle of incident light on circular dichroism is systematically analyzed. Strong circular dichroism can be achieved by adjusting the misalignment angle of the metal U-ring, reaching a value as high as 0.91. At an incident angle of 60°, left-circularly polarized (LCP) light demonstrates outstanding wide-angle absorption performance, absorbing over 80% in the x-z plane and more than 70% in the y-z plane. Transitioning from circular to linear polarization and changing the tilt angle of the metal U-ring also achieves a 99.99% absorption peak at 1.33 THz. Moreover, in comparison to conventional absorbers, the structure presented in this study offers enhanced controllability of absorption performance through external voltage manipulation. This research not only refines the existing concepts but also introduces novel ideas for the development of tunable chiral optical devices.

Psychometric properties of the Chinese version of the Gudjonsson compliance scale: scale validation and associations with mental health

BackgroundTrait compliance involves people reacting favorably to demands made by others across different situations. This may lead to susceptibility to external pressures, exploitation, and manipulation. Moreover, trait compliance was found to correlate with various mental health outcomes, such as depression and anxiety. The Gudjonsson Compliance Scale (GCS) is an efficient tool for assessing trait compliance in Western contexts. To date, no study has validated the psychometric properties of the GCS in Chinese populations.MethodsTwo college student samples from China were recruited. The first sample (N = 4,276) was used to conduct exploratory factor analysis. The second (N = 4,356) was used to perform a confirmatory factor analysis. The reliability, measurement invariance, and correlational tests were conducted on the two combined samples.ResultsThe Chinese GCS showed a 3-factor structure, with two items deleted. Reliability was supported by moderate-to-good internal consistency of the three-factor scales and good internal consistency on the full scale. Strong measurement invariance across sex, ethnicity, and group recruitment was supported. Scores of the total scale and factor scales were found to significantly associated with several mental health problems.ConclusionsThe Chinese version of the GCS appears to be a valid and reliable instrument for measuring trait compliance and could promote both the assessment and research on compliance in Chinese population.

A circular hydrostatic shallow recess thrust bearing integrating a micro-range tilting axis

This article investigates the integration of a micro-range (± 10 µrad) tilting axis into a shallow recess hydrostatic thrust bearing. The working principle relies on pressure taps machined into the bearing geometry, enabling the external manipulation of the local pressure distribution, causing a change in film geometry to restore equilibrium. To estimate the possibilities and limitations, the article presents a theoretical approach to calculate the properties of the integrated tilting axis and the influence on the inherent tilting stiffness of the bearing. Furthermore, performed measurements at 10 µm film height and 10 MPa supply pressure validate the proposed theory. This technology enables the extension of a conventional hydrostatic bearing by a robust, highly sensitive, and low-cost micro-range tilting axis.

Atomic-Scale Visualization of Multiferroicity in Monolayer NiI2.

Progress in layered van der Waals materials has resulted in the discovery of ferromagnetic and ferroelectric materials down to the monolayer limit. Recently, evidence of the first purely 2D multiferroic material wasreported in monolayer NiI2. However, probing multiferroicity with scattering-based and optical bulk techniques is challenging on 2D materials, and experiments on the atomic scale are needed to fully characterize the multiferroic order at the monolayer limit. Here, scanning tunneling microscopy (STM) supported by density functional theory (DFT) calculations is used to probe and characterize the multiferroic order in monolayer NiI2. It is demonstrated that the type-II multiferroic order displayed by NiI2, arising from the combination of a magnetic spin spiral order and a strong spin-orbit coupling, allows probing the multiferroic order in the STM experiments. Moreover, the magnetoelectric coupling of NiI2 is directly probed by external electric field manipulation of the multiferroic domains. The findings establish a novel point of view to analyze magnetoelectric effects at the microscopic level, paving the way toward engineering new multiferroic orders in van der Waals materials and theirheterostructures.

Tailoring compatibility and mechanical properties of cold-mixed epoxy asphalt via external epoxy group content manipulation

The compatibility of cold-mixed epoxy asphalt (CEA) significantly influences its mechanical properties, primarily mediated by the epoxy group content within CEA. However, the feasibility and mechanisms for regulating the external epoxy group content to achieve optimal performance have yet to be explored thoroughly. Herein, soybean oil, epoxidized soybean oil, and epoxy-terminated hyperbranched epoxy resin (EHER) were used to construct CEA with different external epoxy group contents, and their effects and mechanisms on the compatibility and mechanical properties of CEA were investigated based on experiments and molecular dynamics simulation. Our findings suggest that maintaining an external epoxy group content between 8.4%∼11.4% in the CEA blend and below 12.17% in the cured CEA is crucial. These criteria can be met by adding no more than 5 wt% EHER. CEA with 3 wt% EHER exhibited the most balanced compatibility and mechanical properties, characterized by a pot life of 91 min, a tensile strength of 5.02 MPa, an elongation at break of 61.3%, and a tensile toughness of 1.58 MJ/m3. The presence of external epoxy groups increased the cohesive energy density and the solubility parameter difference between epoxy resin and asphalt prior to curing, forming a "sea-island" structure with varying particle sizes, primarily comprising small-sized particles. This structure was preserved post-curing, establishing a stable system with minor energy alterations. Simultaneously, EHER enhanced the molecular rigidity and uniformity of CEA, thereby improving its mechanical properties. It is recommended to relate epoxy group content in CEA blends with indicators of compatibility and mechanical properties, enabling better prediction.

Comparison of McCoy, Macintosh, and Truview laryngoscope for bougie-aided naso-tracheal intubation: A randomized controlled study.

Video laryngoscopes are commonly used along with Macintosh and McCoy laryngoscopes for Nasotracheal intubation (NTI). The purpose of this study was to evaluate the performance of McCoy, Macintosh, and Truview laryngoscopes during bougie-aided NTI with respect to intubation time, success rate, and hemodynamic changes during the procedure. Forty-five American Society of Anesthesiologists (ASA) I-II adult patients, with Mallampati grade 1-4, requiring NTI, were enrolled after taking written informed consent. ASA III/IV, restricted mouth opening, and body mass index >30 were excluded from the study. Patients were randomly allocated to intubate with one of the three laryngoscopes (McCoy, Macintosh, and Truview) and the anesthesiologists were well experienced with all of them. The primary outcome was intubation time and secondary outcomes included first attempt success rate, external laryngeal manipulation, Cormack-Lehane (CL) grade, and hemodynamic responses. The intubation time of McCoy, Macintosh, and Truview, was 86.87 ± 15.92, 82.87 ± 16.46, and 79.93 ± 14.53 (mean ± standard deviation) seconds, respectively, which is comparable with Truview being the shortest. CL grade 1 was obtained more in the Truview group (53.3%) compared to the other two groups, while CL grade 3 was obtained in 20% each in McCoy and Macintosh groups. McCoy, Macintosh, and Truview laryngoscopes were comparable in performance during bougie-aided NTI, with Truview having the shortest intubation time and better visualization.

Anisotropic half-metallicity in zigzag edge SiP3 nanoribbons.

We investigate magnetic and spin-transport properties of the zigzag-edge nanoribbon structures of two-dimensional (2D) SiP3 system within first-principle calculations. Based on the edge terminations, the nanoribbons can be categorized in three subclasses, two of them with even number of silicon (Si) atoms and one of them with odd number of Si atoms in the one-dimensional unitcell with antiferromagnetic bulk spin-ordering, analogous to their 2D counterpart. All the ribbons exhibit indirect band-gap semiconducting behavior and the gap decreases with increase in width of the ribbons. The nanoribbon with only phosphorus (P) atoms at least along one of the edges show half-metallic behavior over a small bias window, when probed with cross-ribbon external electric field. Especially, the nanoribbon with odd number of Si atoms stabilizes in a ground state with net non-zero magnetization and exhibits half-metallicity only under forward bias. Such anisotropic half-metallicity along with the precise control of the electronic properties in terms of edge and external bias manipulation hold immense potential for spintronic and switching device applications.

Modular Drug-Loaded Nanocapsules with Metal Dome Layers as a Platform for Obtaining Synergistic Therapeutic Biological Activities.

Multifunctional drug-loaded polymer-metal nanocapsules have attracted increasing attention in drug delivery due to their multifunctional potential endowed by drug activity and response to physicochemical stimuli. Current chemical synthesis methods of polymer/metal capsules require specific optimization of the different components to produce particles with precise properties, being particularly complex for Janus structures combining polymers and ferromagnetic and highly reactive metals. With the aim to generate tunable synergistic nanotherapeutic actuation with enhanced drug effects, here we demonstrate a versatile hybrid chemical/physical fabrication strategy to incorporate different functional metals with tailored magnetic, optical, or chemical properties on solid drug-loaded polymer nanoparticles. As archetypical examples, we present poly(lactic-co-glycolic acid) (PLGA) nanoparticles (diameters 100-150 nm) loaded with paclitaxel, indocyanine green, or erythromycin that are half-capped by either Fe, Au, or Cu layers, respectively, with application in three biomedical models. The Fe coating on paclitaxel-loaded nanocapsules permitted efficient magnetic enhancement of the cancer spheroid assembly, with 40% reduction of the cross-section area after 24 h, as well as a higher paclitaxel effect. In addition, the Fe-PLGA nanocapsules enabled external contactless manipulation of multicellular cancer spheroids with a speed of 150 μm/s. The Au-coated and indocyanine green-loaded nanocapsules demonstrated theranostic potential and enhanced anticancer activity in vitro and in vivo due to noninvasive fluorescence imaging with long penetration near-infrared (NIR) light and simultaneous photothermal-photodynamic actuation, showing a 3.5-fold reduction in the tumor volume growth with only 5 min of NIR illumination. Finally, the Cu-coated erythromycin-loaded nanocapsules exhibited enhanced antibacterial activity with a 2.5-fold reduction in the MIC50 concentration with respect to the free or encapsulated drug. Altogether, this technology can extend a nearly unlimited combination of metals, polymers, and drugs, thus enabling the integration of magnetic, optical, and electrochemical properties in drug-loaded nanoparticles to externally control and improve a wide range of biomedical applications.

Efficacy of Siddha Therapeutics on Mantha Sanni (Autism Spectrum Disorder) Among Pediatric Patients: An Interventional Non-randomized Open-Label Clinical Trial.

Autism Spectrum Disorder (ASD) refers to a collection of neurodevelopmental disorders that affect brain development and can lead to various psychological imbalances in caregivers of affected children. Siddha formulations have been shown to have a role beyond the physical body and play a significant role in managing Mantha sannior ASD. The objective of this study was to examine the impacts of Amukkara chooranam and Yegamooli thylam in the pediatric population diagnosed with ASD. This was a prospective, interventional, non-randomized, open clinical trial involving 30 patients who met the inclusion and exclusion criteria. Patients received Amukkara chooranamat a dose of 300 mg for ages 3-4 years, 500 mg for ages 5-7 years, and 1 gm for ages 8-12 years, twice a day with honey for 90 days, and Yegamooli thylam was administered using the Thuvalai external manipulation technique once a day for 90 days. Scoring by the Indian Scale for Assessment of Autism (ISAA) was documented at the end of the 0th day, 45th day, and 90th day. The scores were compared at each follow-up, and a statistically significant difference was found at the end of the 90th day of treatment with Amukkara chooranam and Yegamooli thylam (P < 0.05). The statistical analysis included calculating the mean and standard deviation of the clinical assessment, parameters both before and after the treatment were 37.66667 ±13.82485. The treatment with Amukkara chooranam and Yegamooli thylam resulted in a clinically significant improvement in clinical assessment parameters in children with ASD.

Comparative analysis of [formula omitted] and [formula omitted] hybrid ferro-nanofluids flow under magnetic dipole effect over a slip stretching sheet

The available external manipulation of ferrofluids through magnetic fields leads to applications in magnetically controlled actuation and drug targeting. This study investigates the behavior of magnetic hybrid ferro-nanofluids flowing over a stretched sheet with the inclusion of velocity slip and a magnetic dipole. The thermal characteristic of two different hybrid ferro-nanofluids, which are ferrite-cobalt ferrite (Fe3O4/CoFe2O4) and nickel zinc ferrite-manganese zinc ferrite (NiZnFe2O4/MnZnFe2O4) dispersed into a water-ethylene glycol, are theoretically analyzed and compared. The governing equations are developed using the Tiwari and Das model. The simplified equations are solved using the Keller box method. Results show that increased ferrohydrodynamic interaction and slip velocity contribute to higher velocity profiles. A stronger magnetic field intensity, by increasing the distance of the magnetic dipole, significantly improves the velocity profile but leads to a rapid decline in the temperature field. It is found that as the dimensionless distance increases, the temperature profile drops 0.15 % from Fe3O4/CoFe2O4 to NiZnFe2O4/MnZnFe2O4. There is an immediate 0.45 % drop in the velocity profile for Fe3O4/CoFe2O4 as velocity slip enhances, compared to NiZnFe2O4/MnZnFe2O4. The thermal field rises by 1.93 % as the magnetic field distance approaches the plate, influenced by the hybrid nanoparticles' volume fraction.

Semi-Autonomous In Vivo Computation in Internet of Bio-Nano Things

Magnetically assembled bioresorbable nanoswimmers can be used to highlight small tumors, thereby increasing the diagnostic capability of existing medical imaging techniques. Built upon our earlier work, this paper proposes a novel in vivo computational framework for early cancer detection. Engineered nanoswimmers experience a change in their physical properties under the influence of tumor-induced biological gradients. The biologically sensed data by such bio-nano things (nanoswimmers) can either trigger an autonomous target-directed motion or be assisted through external manipulation for steering the swarm towards the target. Previously developed externally manipulable in vivo computation requires constant monitoring of nanoswimmers, introducing positioning and steering errors along with a limit on the swarm size. A parallel approach called autonomous in vivo computation helps to resolve the above drawbacks, but the tumor homing is slow contributing to a higher percentage of pre-detection loss of nanoswimmers. We propose the spot sampling strategy for an autonomous swarm which considers the whole swarm as a single entity for the purpose of its tracking and steering. We show through computational experiments (1) that the proposed semi-autonomous in vivo framework can achieve faster tumor sensitization in complex environments having static and mobile obstacles, and (2) that the spot sampling provides sufficiently precise data to steer the swarm towards the target, saving around 90% of the monitoring resource. Our proposed framework also helps to achieve a large swarm size (number of nanoswimmers) which in return can achieve higher deposition of nanoswimmers on malignant tumors.

Lab‐in‐a‐Bead: Magnetic Janus Bead Probe for the Detection of Biomarkers in Blood

AbstractRemotely handled miniaturized colorimetric sensor platforms with multiple functionalities are able to mimic conventional laboratory operations with reduced assets. The integration of a magnetic phase in a miniaturized hydrogel sensor system allows the manipulation of the sensor, under a magnetic field, in a programmable manner. However, dark color interferences from conventional magnetic phases (Fe3O4, Fe2O3, and Fe micro/nanoparticles) affect the signal readout, hindering the colorimetric response. Therefore, a novel Janus bead configuration is introduced and tested by the localized incorporation of ferromagnetic iron microparticles into a TiO2 nanotubes/alginate hydrogel bead biosystem, under an applied magnetic field. The so‐called hydrogel Janus bead shows both, magnetic translocation and biosensing properties in the same bead. These beads are used for the direct colorimetric analysis of biomarkers in blood. The surface of the Janus bead prevents the biofouling of red blood cells, keeping the sensor surface clean for accurate optical colorimetric analysis. Moreover, the external magnetic manipulation of the bead permits precise control of the time and position of the bead in the sample. Therefore, multiple functionalities are presented by a single magnetic TiO2 nanotubes/alginate Janus bead such as actuation, low biofouling, and sensing, positioning this technology as a truly Lab‐in‐a‐Bead System.

Pregnancy by Oocyte Donation: Reviewing Fetal-Maternal Risks and Complications.

Oocyte donation (OD) has greatly improved over the last three decades, becoming a preferred practice of assisted reproductive technology (ART) for infertile women wishing for motherhood. Through OD, indeed, it has become possible to overcome the physiological limitation due to the ovarian reserve (OR) exhaustion as well as the poor gamete reliability which parallels the increasing age of women. However, despite the great scientific contribution related to the success of OD in the field of infertility, this practice seems to be associated with a higher rate of major risky events during pregnancy as recurrent miscarriage, infections and placental diseases including gestational hypertension, pre-eclampsia and post-partum hemorrhage, as well as several maternal-fetal complications due to gametes manipulation and immune system interaction. Here, we will revisit this questioned topic since a number of studies in the medical literature focus on the successful aspects of the OD procedure in terms of pregnancy rate without, however, neglecting the risks and complications potentially linked to external manipulation or heterologous implantation.

Manipulating Quantum Interference between σ and π Orbitals in Single-Molecule Junctions via Chemical Substitution and Environmental Control.

Understanding and manipulating quantum interference (QI) effects in single molecule junction conductance can enable the design of molecular-scale devices. Here we demonstrate QI between σ and π molecular orbitals in an ∼4 Å molecule, pyrazine, bridging source and drain electrodes. Using single molecule conductance measurements, first-principles analysis, and electronic transport calculations, we show that this phenomenon leads to distinct patterns of electron transport in nanoscale junctions, such as destructive interference through the para position of a six-membered ring. These QI effects can be tuned to allow conductance switching using environmental pH control. Our work lays out a conceptual framework for engineering QI features in short molecular systems through synthetic and external manipulation that tunes the energies and symmetries of the σ and π channels.

Kinetic Models of Wealth Distribution with Extreme Inequality: Numerical Study of Their Stability against Random Exchanges.

In view of some recent reports on global wealth inequality, where a small number (often a handful) of people own more wealth than 50% of the world's population, we explored if kinetic exchange models of markets could ever capture features where a significant fraction of wealth can concentrate in the hands of a few as the market size N approaches infinity. One existing example of such a kinetic exchange model is the Chakraborti or Yard-Sale model; in the absence of tax redistribution, etc., all wealth ultimately condenses into the hands of a single individual (for any value of N), and the market dynamics stop. With tax redistribution, etc., steady-state dynamics are shown to have remarkable applicability in many cases in our extremely unequal world. We show that another kinetic exchange model (called the Banerjee model) has intriguing intrinsic dynamics, where only ten rich traders or agents possess about 99.98% of the total wealth in the steady state (without any tax, etc., like external manipulation) for any large N value. We will discuss the statistical features of this model using Monte Carlo simulations. We will also demonstrate that if each trader has a non-zero probability f of engaging in random exchanges, then these condensations of wealth (e.g., 100% in the hand of one agent in the Chakraborti model, or about 99.98% in the hands of ten agents in the Banerjee model) disappear in the large N limit. Moreover, due to the built-in possibility of random exchange dynamics in the earlier proposed Goswami-Sen model, where the exchange probability decreases with the inverse power of the wealth difference between trading pairs, one does not see any wealth condensation phenomena. In this paper, we explore these aspects of statistics of these intriguing models.

Phosphate ions detection by using an electrochemical sensor based on laser-scribed graphene oxide on paper

In this work, electrodes based on laser-scribed reduced graphene oxide were fabricated using filter paper as the substrate. To fabricate the electrodes, a water suspension of graphene oxide was filtered to produce a continuous and uniform film of graphene oxide on the filter paper surface. Subsequently, a CO2 laser was used to “write” the working, counter and reference eelctroes by reducing graphene oxide in specific areas to define complete sensors. Referecnce electrodes were then coated with a commercial Ag/AgCl conductive paste to produce a quasi Ag/AgCl reference. As fabricated devices were employed as electrochemical sensors for detection of phosphate ions in water by employing the molybdenum blue method. This method exploits the reaction between molybdate and phosphate ions in acidic media leading to a Keggin-type complex (PMo12O403−) which, being electrochemically active, enables the indiret detection of phosphate ions. Sensors exhibited high selectivity and sensitive detection of phosphate ions in a wide linear range, from 1 to 20 µM; with a limit of detection of 0.4 µM. To demonstrate that sensors could be utilized for in-situ phosphate ion detection, paper substrate was first pre-loaded with sulphuric acid and molybdate ions. During analysis, these chemicals were then desorbed directly into the test sample eliminating the need for any kind of external manipulation or reagent addition. Thus, this paper presents the fabrication of a portable, easy-to-use, biodegradable and fast phosphate ions sensor for in situ and real-time monitoring of water quality.

Comparison of C-MACTM Videolaryngoscope with Macintosh Laryngoscope in Anticipated Difficult Airway

Background: Failure to intubate is one of the dreaded outcomes of airway management. Videolaryngoscopes have the potential to increase intubation success by overcoming the shortcomings of direct laryngoscopy. This study aimed to compare the first-attempt intubation success rate of the C-MACTM videolaryngoscope and Macintosh laryngoscope in patients with anticipated difficult airways. Methods: Eighty adult patients with multiple predictors of difficult airway scheduled for surgery under general anaesthesia were randomised either into Group C (first using the C-MACTM videolaryngoscope) or Group D (first using the Macintosh laryngoscope). Laryngoscopy was done sequentially with both laryngoscopes in a patient based on the randomisation. The primary outcome was the first-attempt intubation success rate. Intubation time, Cormack–Lehane view, use of airway adjuncts and the need for external laryngeal manipulations constituted the secondary outcomes. Results: The first-attempt intubation success rate was 100% in both groups with the P value 1.0 and the intubation time was 26 s in Group C and 24.4 s in Group D with P = 0.17. The C-MACTM videolaryngoscope provided better grades of laryngoscopic view than direct laryngoscopy (P = 0.02). Tracheal tube introducer-assisted intubation (P = 0.01) and requirement of laryngeal manipulation to aid intubation (P = 0.01) were higher with the Macintosh laryngoscope. Conclusion: The Macintosh laryngoscope was comparable to the C-MACTM videolaryngoscope in terms of intubation success, intubation time and complications. However, an increased requirement for external laryngeal manipulation, lifting force and the use of an introducer for intubation were noted in the Macintosh group.

Floating Immunomagnetic Microspheres for Highly Efficient Circulating Tumor Cell Isolation under Facile Magnetic Manipulation.

Among circulating tumor cell enrichment strategies, immunomagnetic beads (IMBs) have received great attention due to their excellent performance. However, traditional strategies using IMBs normally require an additional mechanical stirring device to fully mix the IMBs and specimens, and this step may cause mechanical cellular damage. In this study, by changing the architecture and motion trajectory control strategy of the IMBs, floating immunomagnetic microspheres (FIMMs) and their matching rotary magnetic manipulation device were proposed to achieve highly efficient CTC capture under a cell-friendly condition. Generally, the FIMMs were prepared through layer-by-layer assembly of the individual functional components, and their stress state governed by either buoyancy or magnetic force was tuned by the rotary magnetic manipulation device. Consequently, recognition of FIMMs and target cells as well as CTC recovery can be simply realized through external magnetic manipulation. Accordingly, satisfactory enrichment efficiencies for CTCs with varied epithelial expression levels were obtained as 92.93 ± 3.23% for MCF-7, 79.93 ± 3.31% for A549, and 92.57 ± 5.22% for HepG2. Besides, an extremely low detection limitation of 5 cells mL-1 can be achieved from complex sample conditions, even the whole blood. In addition, FIMMs successfully enriched 23-56 CTCs from 1.5 mL of blood samples from cancer patients.

COMPARISON BETWEEN C-MAC VIDEOLARYNGOSCOPE V/S MACINTOSH LARYNGOSCOPE FOR INTUBATION IN EMERGENCY ICU

Introduction: The incidence of difcult endotracheal intubation is high in the ICU because of various factors. Most commonly used method for endotracheal intubation is direct laryngoscopy. Video Laryngoscopes are also helpful aids which provide a better laryngeal view in comparison to Direct Laryngoscope. We should aim at minimizing the time required to achieve a secure airway for ventilation in patients presenting to the Emergency Department/ICU. This was a prospective randomized study in Emer Methods : gency ICU in a tertiary care hospital. A total of 90 patients requiring endotracheal intubation in Emergency ICU were included in the study and were randomly divided into two groups. Group A included patients intubated with the help of C-MAC Videolaryngoscope and Group B included patients intubated with Macintosh Laryngoscope. The primary outcome was to determine overall successful intubation rates. Secondary outcome was to measure rst attempt successful intubation rates, time to intubation, requirement of External Laryngeal Manipulation, requirement of any intubating aids. Patients in Group A and Results : Group B showed an overall similar intubation success rate (p=0.213). Rate of rst attempt intubation in Group A and Group B was similar (p=0.120). Average time to intubation with Group A and Group B was also similar (p=0.0647). Requirement of ELM was lesser with Group A as compared to Group B (p=0.038). The requirement of use of intubating aids was lesser in Group A vs Group B (p=0.003). The use of C- Conclusion : MAC video laryngoscope provided better glottis visualization but resulted in similar rst attempt intubation rates, almost similar time to intubation. C-MAC group required lesser overall requirement of ELM and use of intubating aids when compared to the Macintosh Laryngoscope. Thus, C-MAC® Videolaryngoscopy seems to be a useful technique as the initial approach for endotracheal intubation in the ICU.

Using Neural Networks to Learn the Jet Stream Forced Response from Natural Variability

Abstract Two distinct features of anthropogenic climate change, warming in the tropical upper troposphere and warming at the Arctic surface, have competing effects on the midlatitude jet stream’s latitudinal position, often referred to as a “tug-of-war.” Studies that investigate the jet’s response to these thermal forcings show that it is sensitive to model type, season, initial atmospheric conditions, and the shape and magnitude of the forcing. Much of this past work focuses on studying a simulation’s response to external manipulation. In contrast, we explore the potential to train a convolutional neural network (CNN) on internal variability alone and then use it to examine possible nonlinear responses of the jet to tropospheric thermal forcing that more closely resemble anthropogenic climate change. Our approach leverages the idea behind the fluctuation–dissipation theorem, which relates the internal variability of a system to its forced response but so far has been only used to quantify linear responses. We train a CNN on data from a long control run of the CESM dry dynamical core and show that it is able to skillfully predict the nonlinear response of the jet to sustained external forcing. The trained CNN provides a quick method for exploring the jet stream sensitivity to a wide range of tropospheric temperature tendencies and, considering that this method can likely be applied to any model with a long control run, could be useful for early-stage experiment design.