Access Technique Research Articles

Nanopore Sequencing Assessment of Bacterial Pathogens and Associated Antibiotic Resistance Genes in Environmental Samples.

As seen in earlier and present pandemics, monitoring pathogens in the environment can offer multiple insights on their spread, evolution, and even future outbreaks. The present paper assesses the opportunity to detect microbial pathogens and associated antibiotic resistance genes, in relation to specific pathogen sources, by using nanopore sequencing in municipal waters and wastewaters in Romania. The main results indicated that waters collecting effluents from a meat processing facility exhibit altered communities' diversity and abundance, with reduced values (101-108 and 0.86-0.91) of Chao1 and, respectively, Simpson diversity indices and Campylobacterales as main order, compared with other types of municipal waters where the same diversity index had much higher values of 172-214 and 0.97-0.98, and Burkholderiaceae and Pseudomonadaceae were the most abundant families. Moreover, the incidence and type of antibiotic resistance genes were significantly influenced by the proximity of antibiotic sources, with either tetracycline (up to 45% of total reads) or neomycin, streptomycin and tobramycin (up to 3.8% total reads) resistance incidence being shaped by the sampling site. As such, nanopore sequencing proves to be an easy-to-use, accessible molecular technique for environmental pathogen surveillance and associated antibiotic resistance genes.

Minimally Anterior Medial Maxillary Approach (MAMMA): a novel technique for a wide access to the maxillary sinus.

To describe a novel endoscopic technique to approach the maxillary sinus (MS), the Modified Anterior Medial Maxillary Approach (MAMMA), preserving the inferior turbinate (IT) and the nasolacrimal duct (NLD). To perform radiological measurements and describe a case series to study the feasibility and limits of MAMMA. Computed tomography (CT) scans (n = 150 nasal cavities) were used to calculate areas of the MAMMA to define surgical limits and extensions. Measurement of distances to critical anatomy landmarks and total area for the MAMMA were calculated. An instructional case illustrating the surgical technique and outcome was also included. Radiological analysis showed a mean distance from the Piriform Aperture (PA) to the anterior limit of the NLD of 1.03 ± 0.18cm (range 0.59-1.48) and a mean distance from de PA to the posterior limit of the NLD of 1.57 ± 0.22cm (range 1.02-2.11). The mean distance from the nasal floor to the Hasner's valve was 1.61 ± 0.27cm (range 1.06-2.52) and the distance from the nasal floor to the insertion of the IT was 2.20 ± 0.36cm (range 1.70-3.69). Finally, the mean total area for the MAMMA was 4.04 ± 0.52 cm2 (range 3.17-5.53). No complications or recurrence of the pathology were observed in operated patients. The MAMMA provides a wide surgical field of the MS walls comparable to more aggressive techniques, with preservation of the sinonasal and lacrimal function. MAMMA is an effective alternative to treat different MS pathologies including benign recurrent maxillary sinus tumors.

Cooperative Relaying in a Three User Downlink NOMA System Using Dynamic Power Allocation

Non-orthogonal multiple access (NOMA) represents the latest addition to the array of multiple access techniques, enabling simultaneous servicing of multiple users within a singular resource block in terms of time, frequency, and code. A typical NOMA configuration comprises a base station along with proximate and distant users. The proximity users experience more favorable channel conditions in contrast to distant users, resulting in a compromised performance for the latter due to the less favorable channel conditions. When cooperative communication is integrated with NOMA, the overall system performance, including spectral efficiency and capacity, is further elevated. This study introduces a cooperative NOMA setup in the downlink, involving three users, and employs dynamic power allocation (DPA). Within this framework, User 2 acts as a relay, functioning under the decode-and-forward protocol, forwarding signals to both User 1 and User 3. This arrangement aims to bolster the performance of the user positioned farthest from the base station, who is adversely affected by weaker channel conditions. Theoretical and simulation outcomes reveal enhancements within the system’s performance.

EXAMINING THE SCIENTIFIC FOUNDATION OF MINDFULNESS AND ALTERNATIVE APPROACHES FOR IMPROVING MENTAL WELL-BEING

Mindfulness has become a proven method for improving mental health and overall well-being. This comprehensive review provides an overview of the current research on mindfulness and its impact on clinical outcomes such as anxiety, depression, stress, and quality of life. Studies using neuroimaging techniques have shown that practicing mindfulness leads to functional and structural changes in specific areas of the brain involved in executive control, emotion regulation, and self-awareness. Meta-analyses have indicated that mindfulness-based interventions have a significant positive effect on mood and anxiety disorders. The proposed psychological mechanisms behind these effects include increased metacognitive awareness, self-compassion, and the ability to distance oneself from negative thoughts. Research-based recommendations are given to utilize mindfulness for enhancing mental well-being. These suggestions include mindfulness apps, online resources, daily routines, and professional therapies based on mindfulness. Although more research is needed, the evidence strongly backs up mindfulness as an effective and accessible therapeutic technique for promoting positive mental health by bringing our awareness to the present moment. This analysis combines the most recent findings on how mindfulness can improve psychological functioning and resilience.

Introducing N-Sulfinylamines into Visible-Light-Induced Carbene Chemistry for the Synthesis of Diverse Amides and α-Iminoesters.

A rare example of visible-light-mediated diverse reactivity of N-sulfinylamines with different types of carbene precursors has been disclosed. Acylsilanes and aryldiazoacetates have been utilized as nucleophilic and electrophilic carbene precursors into the N═S═O linchpin, to achieve valuable amides and α-iminoesters, respectively. Interestingly, diazocarbonyls can also participate in the amidation reaction with N-sulfinylamines via in situ generated ketenes. This operationally simple modular method offers a mild, transition-metal-free, and coupling-reagent-free protocol to fabricate structurally diverse amides and a promptly accessible technique to achieve α-iminoesters, where visible light remains as a key promoter.

Surgical access in treatment of kidney cancer complicated by tumor thrombosis of the inferior vena cava and right atrium

This article discusses the choice of surgical access in renal cancer complicated by tumor thrombus with invasion into the inferior vena cava and the right atrium. This clinical scenario poses a major challenge to the surgeons, as tumor thrombus can obstruct access to the surgical area and increase the risk of complications. This article discusses various surgical access techniques that can be used in treatment of kidney cancer complicated by tumor thrombus of the inferior vena cava and right atrium, including open surgery, robotic surgery, and minimally invasive techniques. An analysis of factors to consider in selection of the optimal surgical access was perfomed.

Blockchain Technology for Access and Authorization Management in the Internet of Things

The Internet of Things (IoT) continues to suffer from security issues, even after 20 years of technological evolution and continuing efforts. While the decentralization of the IoT seems to be a solution for improved resource management and scalability, most of the services remain centralized, exposing IoT systems to malicious attacks. As a result, this leads to functionality failures and endangers user and data integrity. Identity and Access Management (IAM) has the ability to provide defense against a great number of security threats. Additionally, blockchain is a technology which can natively support decentralization, as well as access and authorization management techniques, using the corresponding programmable logic and leveraging cryptographic mechanisms for privacy and security. Using standardized frameworks (e.g., Decentralized Identifiers and Verifiable Credentials), a blockchain-based access and authorization solution can present the basis for a uniform decentralized IAM framework for the IoT. To this end, this paper presents a proof-of-concept design and implementation of an IAM solution based on Solidity smart contracts, targeting two areas: firstly, supporting the fact that blockchain can seamlessly provide the basis for a decentralized IAM framework, while secondly (and most importantly) exploring the challenge of integrating within existing IoT systems, avoiding redesigning and redeveloping on behalf of IoT manufacturers.

Minimally Invasive Approach to Access Vessels for Microvascular Anastomosis in Head and Neck Reconstruction.

To describe our technique, review indications, and evaluate the outcomes of the minimal access approach for recipient vessel identification in microvascular tissue transfer. Retrospective chart review of all patients who underwent microvascular reconstruction using the minimal access technique between 2015 and 2021. We report 236 cases, comprising 214 patients with a mean age of 60.2 years (3-88). The most common primary defect sites were the mandible (22.6%), cranium (14%), maxilla (13.2%), skull base (12.8%), and nose/nasal cavity (10.6%). Indications for free flap reconstruction included head and neck cancer extirpation (32.2%), osteoradionecrosis (29.7%), acquired deformity (14.0%), chronic wound (11.9%) and oral motor dysfunction (7.2%). Free flap donor sites used were the anterolateral thigh (84.3%), fibula (7.2%), and radial forearm (6.4%). Vessels utilized include superficial temporal (49.8%), facial (38.3%), angular (11.1%), and transverse cervical (0.4%). The overall complication rate was 14% (n = 33), with surgical complications at the recipient site accounting for 67.6% (n = 25). Flap failure occurred in 3.4% of procedures. Prior head and neck surgery and free flaps were associated with an increased risk of major recipient site complications (n = 20, p = 0.0257 and n = 14, p = 0.0117, respectively). Minimal access techniques allow consistent recipient vessel identification for microvascular-free tissue transfer. These approaches may be utilized in reconstructing a broad range of head and neck defects, are low morbidity, and contribute to an overall shorter length of stay. 2 Laryngoscope, 134:2177-2181, 2024.

Towards a smart healthy city: A generalised flow-based 2SFCA method for incorporating actual mobility data in healthcare accessibility evaluation

Worldwide efforts have been made to prioritise equal access to hospitals, given its importance to health equality and the necessity of building healthy cities in the post-pandemic society. As the most used spatial accessibility technique to identify the under-served areas, however, the two-step floating catchment area (2SFCA) method was criticised for adopting presumed parameters that might lead to biased and misleading results. With the increasing availability of urban mobility data, it is now possible to incorporate people's actual service-seeking behaviour into the methodological framework of the classic 2SFCA. In this regard, this study proposes a Generalised Flow-based 2SFCA (GF2SFCA) method, which builds upon the demand-driven characteristic of healthcare facilities and utilises underlying patterns in geographical flow data to adaptively measure hospitals' influential range, distance-decay effect, and attractiveness. Specifically, two new indicators, namely, the global popularity index and local preference index, are proposed to synthetically evaluate hospital attraction from the perspective of actual healthcare demand, taking into account visitation counts, travel distance, and the collective preference of communities associated with a hospital. While alleviating certain subjectivity caused by parameters pre-selection, the GF2SFCA framework helps evaluate healthcare accessibility precisely. The experimental results, using Wuhan, China as a case study, confirmed the effectiveness of the proposed framework in producing realistic estimations and demonstrated its robustness to the potential uncertainty in mobility data. The data-driven property of GF2SFCA also allows for practical implementation in various contexts, which would benefit the survey of regional healthcare equality and its dynamics.

Co-operative non-orthogonal multiple access networks: a survey

Purpose The purpose of this paper is to present an up-to-date survey on the non-orthogonal multiple access (NOMA) technique with co-operative strategy, a fast-evolving fifth-generation (5 G) technology. NOMA is used for serving many mobile users, both in power and code domains. This paper considers the power-domain NOMA, which is now discussed as NOMA. Design/methodology/approach The first part of the paper discusses NOMA-based cooperative relay systems using different relay strategies over different channel models. In various research works, the analytical expressions of many performance metrics were derived, measured and simulated for better performance of the NOMA systems. In the second part, a brief introduction to diversity techniques is discussed. The multiple input and multiple output system merged with cooperative NOMA technology, and its future challenges were also presented in this part. In the third part, the paper surveys some new conceptions such as cognitive radio, index modulation multiple access, space-shift keying and reconfigurable intelligent surface that can be combined with NOMA systems for better performance. Findings The paper presents a brief survey of diverse research projects being carried out in the field of NOMA. The paper also surveyed two different relaying strategies that were implemented in cooperative NOMA over different channels and compared several performance parameters that were evaluated and derived in these implementations. Originality/value The paper provides a scope for recognizable future work and presents a brief idea of the new techniques that can be united with NOMA for better performance in wireless systems.

Multiple Mini Incision Technique for Sural Nerve Harvest: When to Add a Fibular Incision Based on a New Surgical Classification

Sural nerve is the most common nerve used as a source for nerve grafting. Open harvest with longitudinal incisions produces unsightly scars, and this have led to development of less invasive techniques using endoscopes, nerve stripper, and mini-incisions. Several anatomical classifications have also been proposed due to the variations in the anatomy of the sural nerve. A simple and practical surgicoanatomical classification of the sural nerve based on which we have refined our minimal access technique, the multiple mini-incision technique for sural nerve harvest is proposed. In this technique, the incisions required for harvest of the sural nerve are standardized and predictable. A fibular incision is required when the sural nerve has major contribution from the common peroneal nerve. We have found this a simpler and reliable technique of harvest of sural nerve in nerve reconstructive surgery.

User pairing impact on the performance of hybrid beamforming NOMA system

This paper proposes a new user pairing technique for a power domain nonorthogonal multiple access (NOMA) deploying fully connected and subconnected hybrid beamforming (HBF) structures for a typical urban microcell downlink of line-of-sight (LOS) and non-line-of-sight (NLOS) surroundings. NOMA system’s configurations are set up for two (multiple input single output) users per cluster down- linking base station equipped with 128 antennas. HBF processing adopts phased zero forcing (P-ZF) for both fully connected (HBFNOMA) structure (FCS) and sub-connected (HBF-NOMA) structure (SCS) precoders’ optimization, and successive interference cancellation zero forcing (SIC-ZF) schemes to optimize the SCS-HBF-NOMA precoder exploiting dynamic power allocation. The new users’ pairing exploits users’ distance to the base station, namely near and far clusters different from the benchmark angle of arrival- based users’ pairing. The proposed users’ pairing and the precoding schemes’ impact are investigated for finite-resolution HBF structures operating in LOS and NLOS surroundings. The execution under New York University (NYU) mmW channel model is explored for two users in a cluster with different angles of arrival. Results show that the users’ pairing based on AoA performs better than the newly proposed users’ pairing. However, the proposed users’ pairing scheme performs better than their corresponding OMA counterparts, which still make them beneficial for multiple access technique and a scenario, where one of the far cluster users need to access the base station for high data rate service and vice versa. Finally, the modified Liang processing scheme for quantizing SCS-HBF-NOMA precoder is capable of mitigating the quantization error arising from the NLOS environment and the nature of sub-connected (HBF) structure under a low SNR regime.

Comparative Evaluation of Vestibular Incision Subperiosteal Tunnel Access (VISTA) Technique With and Without Advanced Platelet Rich Fibrin for Treatment of Maxillary Anterior Gingival Recessions.

Gingival recession is an apical shift of the gingival margin with exposure of the root surface to the oral cavity which creates an aesthetic problem. The present study was attempted to compare Vestibular incision subperiosteal tunnel access (VISTA) with and without Advanced platelet rich fibrin(A-PRF) in the treatment of Miller's class I gingival recessions. 24 patients were assigned randomly either to test (VISTA with A-PRF) or control (VISTA alone) group. Clinical parameters like recession depth (RD), recession width (RW), clinical attachment loss (CAL), width of keratinized gingiva (WKG), gingival thickness (GT) and probing depth (PD) were recorded at baseline,3 and 6 months post operatively. Inter group comparison of mean RC in mm, %RC, ΔWKG and CAG revealed no statistically significant difference (p>0.05). Change in GT showed statistically significant improvement in test group. Within the limitations of this study, both treatment options (VISTA with A-PRF and VISTA alone) have resulted in predictable and comparable root coverage with increased gingival thickness in the test group.

Single femoral artery access is safe and feasible during transcatheter aortic valve replacement: a propensity score matched analysis.

Transcatheter aortic valve replacement (TAVR) potentially may be significantly simplified by using the single artery access (SA) technique, which does not require a secondary artery access. Nevertheless, the safety and efficacy of this technique remains unclear. Our goal was to determine if single artery access TAVR (without upgrading the sheath size) is a feasible, minimally invasive procedure. Patients with symptomatic severe aortic stenosis who underwent TAVR via the femoral artery were consecutively enrolled in this study. Eligible individuals were divided into 2 groups: the SA group and the dual artery access (DA) group. The primary end point was device success (defined by the valve academic research consortium 3, VARC 3). A 6-month follow-up and propensity score matching analyses were performed. After propensity score matching analysis, a total of 130 patients were included: 65 in the SA group and 65 in the DA group. The SA procedure achieved similar device success (95.4% vs. 87.7%; P = 0.115) compared with the DA procedure. The SA procedure shortened the operating time (102 min vs. 125 min; P = 0.001) but did not increase the x-ray time or dose. Both a 20 Fr and a 22 Fr sheath (without upgrading the sheath size) could be used for the SA procedure. There was no major vascular complication occurred in both groups. The incidence of minor main vascular and access complications in the SA group was comparable to those of the DA procedure (0.0% vs. 3.1%; P = 0.156). The SA access procedure is a promising minimally invasive TAVR technique with a low incidence of vascular complications and a high incidence of device success. It is safe and possibly applicable in all TAVR procedures.

A New Method for Common Femoral Arterial Access Using a Mixed Reality-Assisted Technique on a Phantom Model.

The purpose of this study was to investigate the technical feasibility and usability of a mixed reality (MiR)-assisted common femoral arterial (CFA) access technique using a sonography-assisted registration method. A total of 60 CFA punctures were performed on a phantom model by 2 observers. Thirty punctures were performed using MiR (MiR group) and 30 punctures were performed using a conventional sonography-guided access procedure (control group). In the MiR group, a virtual object was created based on a computed tomography (CT) angiography scan of the model and registered to the physical patient in an MiR environment utilizing a software prototype that allowed registration based on a sonography scan. Positional error assessment encompassed 4 measurements using cone beam CT scans: (1) distance of the needle tip to the centerline, (2) distance of the needle entry site from the mid-level of the ostium of the profound femoral artery, (3) angle of entry of the needle in coronal, and (4) sagittal planes. Technical success rates as well as positional errors were compared between both groups. In addition, the usability of the system was assessed according to the system usability scale (SUS). Technical success was 96.7% and 100% in the MiR and control groups, respectively. The median distance between the needle tip and the centerline was 3.0 (interquartile range [IQR]: 2.0-4.6) in the MiR group and 3.2 mm (IQR: 2.3-3.9) (p=0.63) in the control group. Similarly, the median distance from the needle entry site to the mid-level of the ostium of the profound femoral artery was 3.0 mm (IQR: 2.0-5.0) in the MiR group and 4.5 mm (IQR: 2.0-7.8) (p=0.18) in the control group. The median coronal angles of needle entry were 7.5° (IQR: 6-11) and 6° (IQR: 2-12) (p=0.13), and the median sagittal angles were 50° (IQR: 47-51) and 51° (IQR: 50-55) (p<0.01) in the MiR and control groups, respectively. The mean SUS score provided by both observers was 51.3. The feasibility of an MiR-assisted CFA access technique could be demonstrated on a phantom model. Further studies are needed to investigate the technique beyond phantom model experiments and in different anatomical settings. This study demonstrates the technical feasibility of a Mixed-Reality-assisted common femoral arterial access procedure on a phantom model. The positional accuracy was comparable to a conventional sonography-guided technique. However, there are several limitations that need to be resolved prior to potential implementation into clinical practice. Further studies are needed to investigate its performance beyond phantom model experiments and the prototypical application requires further technical refinement to increase its usability.

Doing what matters in times of stress: No-nonsense meditation and occupational well-being in COVID-19.

While the COVID-19 pandemic challenged the general public's health and well-being, it exacerbated the pre-existing well-being issues in the educational sector in many countries. Mindfulness-based interventions are often applied to protect and promote occupational well-being. To investigate how the well-being benefits of these interventions arise, we selected one accessible technique that is used in most of them: focused attention meditation. In the middle of the COVID-19 pandemic, 199 teachers voluntarily practiced five to ten minutes of meditation together with their pupils, every morning for six months. We employed a three-wave longitudinal design to follow any changes in the meditating teachers' well-being and compared these changes to a waitlist control condition of 42 teachers. Three dimensions of well-being were measured at baseline, half-time, and post-intervention: emotional, cognitive, and physical well-being. Latent growth curve models revealed that the meditation technique not only improves well-being but also prevents the development of well-being problems. The practice of focused attention meditation resulted in improvements in emotional and physical well-being and prevented the development of cognitive well-being problems that were observed within the control condition. The effects were strongest for emotional and cognitive well-being and followed a linear trend. This paper shows that the well-being effects of mindfulness-based interventions are at least in part due to the focused attention meditation that is practiced in them. Occupational groups that experience emotional, cognitive, or physical well-being issues can benefit from a few minutes of focused attention meditation per day.

Abstract 059: The Tenzing‐Dotter Technique for Endovascular Management of Atherosclerotic Cervical ICA Tandem Large Vessel Occlusions

Introduction The endovascular treatment of acute ischemic stroke due to atherosclerotic occlusion/near‐occlusion of the cervical internal carotid artery (ICA) and a concurrent intracranial large vessel occlusion (LVO) remains challenging, and the optimal approach remains unclear. Options include initial angioplasty and/or stenting of the cervical lesion followed by intracranial thrombectomy versus Dotter navigation of catheters through the cervical lesion to first target the intracranial LVO. We describe a novel Tenzing‐Dotter technique which utilizes a Tenzing device for the Dotter delivery of large bore (0.070”) and super‐large bore (0.088”) catheters through cervical atherosclerotic lesions to gain access to the intracranial circulation in tandem LVO patients. Methods We performed a retrospective review our single center experience of atherosclerotic tandem occlusion patients in which the Route 92 Medical Tenzing ® 7 (T7®) and Tenzing ® 8 (T8®) delivery catheters were used to Dotter‐deliver large bore or super‐large bore catheters, respectively, through the cervical ICA lesion to gain access to the intracranial circulation. We reviewed clinical, radiographic and procedural data to describe the safety and efficacy of this approach. Results Twenty patients were identified that that atherosclerotic occlusion/near‐occlusion of the cervical ICA and a single symptomatic intracranial LVO. The mean age was 65 (44 – 89), and 40% were female. The mean NIHSS was 14 (7‐25) and 40% were treated initially with intravenous thrombolytics. The ipsilateral cervical ICA was occluded in 11 of 20 patients (55%) and nearly‐occluded (degree of stenosis 90‐99%) in 9 of 20 patients (45%). The intracranial occlusions were carotid terminus (5), M1 middle cerebral artery (14) and M2 middle cerebral artery (1). Seven patients were treated with Tenzing 7 paired with a large bore catheter (6 with Medtronic React 71 and 1 with Route 92 Medical Hipoint 70), while 13 were treated with Tenzing 8 paired with a super‐large bore catheter (11 with Route 92 Medical Hipoint 88 catheter and 2 with Route 92 Medical Freeclimb 88 catheter). In all cases, successful navigation of the paired catheter through the cervical lesion was achieved in 100% of patient using the Tenzing‐Dotter delivery technique. The mean time from groin puncture to successful Tenzing‐Dotter delivery was 11 minutes, and the mean time from groin puncture to device delivery to the intracranial occlusion was 15 minutes. TICI 2B or greater reperfusion (self‐adjudicated) as achieved in 100% of patients, with a mean time to best TICI of 21 minutes. The degree of cervical ICA stenosis following thrombectomy improved from 96.5% to 67.4%. No symptomatic intracranial hemorrhage or cervical arterial dissections were noted. Conclusion The Tenzing‐Dotter technique, in which a Route 92 Medical Tenzing ® delivery catheter is utilized to Dotter navigate a large or super‐large bore catheter through an occluded or nearly‐occluded cervical atherosclertotic lesion, may be a promising technique for safe and fast access to the intracranial circulation in patients presenting with tandem large vessel occlusion acute ischemic strokes.

Power Optimization in a Multicell D2D Communication for Smart City in an mm-Wave Cellular Network: An mIoT Perspective

Device-to-device (D2D) communication ushers the realization of massive Internet of Things (mIoT) network for smart cities through long term evolution-advanced (LTE-A). In a multi-cell mm-Wave environment, acute interference from adjacent cells degrades the signal quality. Thus, our work focuses on the minimization of interference from the neighboring cells through optimal resource allocation and power optimization. Rate splitting multiple access (RSMA) technique is employed where the message to be transmitted is divided into two parts. Two modes for resource allocation are formulated which aims to maximize the throughput under certain interference constraints. Radius of coverage expression is derived for switching of modes to take place. Successive interference cancellation (SIC) is introduced as a power constraint which enhances the overall performance of the network. Subsequently, Lagrange’s dual optimization method is utilized for optimizing the D2D transmit power and also lowering the computational complexity of the overall network. Simulation results depict the overall performance efficiency in terms of transmission rate and signal strength. The results show that with the increase in difference of transmit power allocated to the common and private message, overall transmission rate also increases significantly. Finally, comparison with existing scheme validates the efficiency of the proposed work.

SilicH2O: a graphical user interface for processing silicate glass Raman spectra and quantifying H2O

H2O contents of magmas strongly impact the explosivity of volcanic eruptions, as well as their rheological properties and crystallisation behaviour. Accurate analyses of H2O in magmatic liquids are therefore vital for our understanding of the dynamics of magmatic processes and eruptions. Raman spectroscopy provides an accessible, affordable and high spatial resolution technique for estimating H2O contents of magmas that have been quenched to a glass during eruption. However, calculating H2O concentrations from Raman spectra involves manual data processing and results are therefore sensitive to the specific treatment used. SilicH2O is an open-source software program that uniformises and streamlines this process by providing an interactive graphical user-interface. It can be used to: (a) process Raman spectra of silicate glasses, (b) remove any unwanted peaks through interpolation and unmixing, (c) set up H2O calibrations with reference materials and (d) quantify H2O contents of unknown samples.

Short-axis versus long-axis approach for ultrasound-guided vascular access: An updated systematic review and meta-analysis of randomised controlled trials.

There are two approaches for ultrasound (US)-guided vessel cannulation: the short axis (SA) approach and the long axis (LA) approach. However, it remains to be seen which approach is better. Therefore, we performed the present updated systematic review and meta-analysis to assess the effectiveness and safety of US-guided vascular cannulation between the SA and LA techniques. We performed a comprehensive electronic database search in PubMed, Embase, Cochrane Library and Web of Science for the relevant studies from inception to June 2022. Randomised controlled trials comparing the SA approach and the LA approach for US-guided vascular access were incorporated in this updated meta-analysis. The first-attempt success rate was the primary outcome. The secondary outcomes were the overall success rate, cannulation time, number of attempts and the incidence of complications. The statistical analysis was conducted using RevMan software (version 5.4; the Nordic Cochrane Centre, the Cochrane Collaboration, Copenhagen, Denmark). The Cochrane risk of bias tool was used to evaluate each study's potential risk for bias. In total, 16 studies consisting of 1885 participants were incorporated in this updated meta-analysis. No statistically significant difference was found between the SA and LA vascular access techniques for first-pass success rate (risk ratio = 1.07, 95% confidence interval: 0.94-1.22). The overall cannulation success rate, complication rate, average cannulation time and average number of attempts were not significantly different between the SA and LA groups. This updated meta-analysis demonstrated that the SA and LA approaches of US-guided vessel cannulation are similar regarding first-pass success, overall cannulation success rate, total complication rate, cannulation time and the number of attempts.