Wall Mount Research Articles

A Randomized Control Trial Comparing the Yield of Bronchoalveolar Lavage Using Three Different Techniques in Patients Undergoing Flexible Bronchoscopy (BAL-3T).

Three techniques have been described for aspirating the bronchoalveolar lavage (BAL) fluid, namely the wall mount suction (WMS), manual suction (MS), and manual suction with tubing (MST). However, there is no direct comparison among the 3 methods. We randomized patients undergoing flexible bronchoscopy and BAL in a 1:1:1 ratio to one of the 3 arms. The primary outcome was to compare the optimal yield, defined as at least 30% return of volume instilled and <5% bronchial cells. The key secondary outcomes were the percentage of volume and total amount (in millimeters) return of BAL, as well as complications (hypoxemia, airway bleeding, and others). We randomized 942 patients [MST (n = 314), MS (n = 314), WMS (n = 314)]. The mean age of the study population [58.7% (n = 553) males] was 46.9 years. The most common indication for BAL was suspected pulmonary infection. Right upper lobes and middle lobes were the commonest sampled lobes. The optimal yield was similar in all the groups [MST (35.6%) vs MS (42.2%) vs WMS (36.5%); P = 0.27]. A significantly higher proportion of patients had BALF return >30% (P = 0.005) in the WMS (54.2%) and MS (54%) than in the MST arm (42.9%). The absolute and the percentage volume of BALF was also higher in WMS and MS than in the MST arm. There was no difference in the complication rate or other secondary outcomes across the groups. We found no difference in the optimal yield of BAL or complications using any one of the 3 methods for BAL fluid retrieval.

Reliability of cervicocephalic sense of force

Cervicocephalic proprioception (CCP) is an important assessment item for people with a range of clinical conditions, where reduced CCP is associated with neck pain and imbalance. Reliability has been established for a range of positional and movements tests, but there is limited data regarding sense of force, particularly across three planes of movement. The current test–retest study assessed reliability when evaluating sense of force in healthy adults (8 males, 6 females, mean age 31.50 years [SD 10.14]) over two sessions, 4–7 days apart. A force matching protocol was used to evaluate reliability of absolute error (AE), constant error (CE), and variable error (VE) for 10 % and 25 % maximal voluntary contraction (MVC) target forces for flexion, extension, lateral flexion, and rotation. Participants were strapped to a chair to limit trunk movement and data was captured using a compressive force transducer fixed to an adjustable wall mount. Six trials were performed for each contraction-type, totaling 72 submaximal MVCs per session. ICC estimates for AE (0.15–0.77), CE (0.01–0.85), and VE (0.00–0.83) were varied and confidence intervals were mostly wide. Considering lower limits of confidence intervals, CE had best reliability values generally, but more specifically the most reliable contraction type and movement was 25 % MVC flexion (ICC 0.85, confidence interval 0.54–0.95). This study found that reliability for sense of force testing was dependent upon contraction, type of error, and target force utilized. Further reliability analysis should be performed when applying this test to measure validity outcomes in clinical populations.

Parametric Investigation of Mechanical Aspect for TV Wall Mount Bracket via Finite Element Analysis

Nowadays, most flat screen television (TV) come with a feature that allows users to mount the TV and it takes some effort on the user's part to attach the mount to the wall and the TV to the mount. Various TV wall mount designs available on the market with different dimensions, thicknesses, and materials may cause mechanical problems. This study aims to analyze the effect of the design parameters on the wall mounting bracket and evaluate the best design parameters for minimal mechanical defects. The validated 3D model is simulated using SolidWorks software. Different wall mount lengths, widths, thicknesses, and TV wall mount bracket designs are selected as factors in this study. Meanwhile, stress, displacement, and strain are selected as responses in this study. Statistical regression analysis analyzes the correlations between design parameters and mechanical defects. The analysis shows that 6 mm thickness, 430 mm length, and 160 mm width have the lowest stress, strain, and displacement. Design 3 is the best wall plate design to minimize stress and strain. To conclude, the results of this study could make the TV wall mount bracket a universal mounting for various weights of TVs.

Impact of hamstring flexibility on functional performance of collegiate football players

Introduction: Football is the most popular high-intensity intermittent team sport that requires speed, strength, agility, and endurance. During official matches, elite football players perform 150–250 short-lasting, energy-demanding intense actions interspersed with periods of low-intensity jogging or running. Collegiate football programs place great importance on controlling player's body weight, body composition, muscle strength, and length. Of all the muscle strains associated with competitive sport, hamstring strains are the most common and problematic. Objectives: To determine the correlation between hamstring flexibility and functional performance of collegiate football players.Methods: 100 subjects who met the inclusion criteria were enrolled in the study. Once the baseline data was collected the subject's hamstring flexibility was assessed by the Active knee extension test (AKE) and limb length was measured. Subjects were then asked to perform Illinois Agility Test, 30m Sprint Test and Wall Mount test, and Star Excursion Balance Test (SEBT). Three trials of each test were performed, and the mean was taken for statistical evaluation. Result: There exists weak correlation between sprint, agility, SEBT, and hamstrings length; however, results indicate a moderate correlation between posterolateral reach distance and hamstring flexibility and a statistically significant relationship between hamstring length and vertical height of jump with p< 0.05.Conclusion: Hamstring flexibility has a weak correlation with functional performance of collegiate football players. However, it has positive correlation with vertical jump height and posterolateral reach distance of SEBT.

Uncommon concern during MRI of conjoined twins under general anesthesia.

Dear Editor, Anesthesia management for magnetic resonance imaging (MRI) of conjoined twins poses challenges to deal with two infants simultaneously, unfamiliar environment, limited space and personnel.[1] Providing anesthesia for MRI to conjoined twins is a rare opportunity that requires two MRI compatible anesthesia workstations. We report a peculiar problem due to different terminal wall-mount outlets in MRI complex. Six-month-old pyopagus conjoined twins were scheduled for MRI. We have three MRI suites in one complex and all are equipped with MRI compatible anesthesia workstations. Two separate anesthesia teams, two sets of MRI compatible workstations, monitors, equipment, drugs, infusion pumps and suction were arranged. We planned to shift a second workstation from one of the other suites. MRI compatible full oxygen (O2) cylinders were ensured for both workstations. MRI suite-I had two pipeline sources of O2, and one each for nitrous oxide, air and suction units. We planned O2, nitrous oxide, isoflurane for maintenance of anesthesia for twin-1 and O2, air, isoflurane for twin-2. We noticed that the anesthesia workstation of MRI suite-II did not have compatible gas pipeline connection to be fitted in suite-I. There was no separate compatible tubing to connect the workstation to wall gas outlets. We had two options; first, to use 100% O2 from cylinder without any air or nitrous oxide due to unavailability of MRI compatible nitrous oxide and air cylinder. Second, to use workstation from suite-III. We decided to use the workstation from the suite-III which had compatible tubing. Case was done uneventfully. We observed presence of different terminal wallmounts in two adjacent MRI suites. MRI suites, I and III had quick connect probes with Geometric Index Safety System and MRI suite-II had quick connect probes with indexing collars for oxygen, nitrous oxide and air [Figure 1a and b].[2,3] Recovery room had probes with pin index safety system in the terminal wall-mount outlet [Figure 1c]. We noticed that MRI suites were built by different companies and all the equipment needed in the suite including anesthesia machine, monitor, wall mount assembly for gases etc., were provided by that particular company. Breakdown of anesthesia workstation requiring repair or replacement is not uncommon. Anesthesia for conjoined twins requires utilization of 2 anesthesia workstations in a single room. All workstations in a hospital complex should have same terminal wall mount assemblies and same hose pipe connectors for ease of exchange of workstation in any given scenario. We did not find any guidelines regarding types of wall mount assembly and pipeline connectors in one unit/complex. This may have led to installation of wall-mounts in non-uniform way.Figure 1: Different types of terminal wall mount gas outlets at MRI complex. (1a). Quick connect with geometric index safety system. (1b). Quick connect with indexing collars safety system. (1c). Quick connect with pin index safety systemWe suggest that there should be a central committee in every hospital which must include at least one anesthesiologist along with other technical experts who can contribute in planning and designing of all areas requiring anesthesia services including operation theatre complex, recovery room, radio-diagnostics, radio-therapeutics, Cath-lab, Intensive Care unit, emergency room and similar areas. This team should make sure that there is uniformity in terminal wall mount all across the hospital to avoid such issues. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Wall-mounted Versus Handheld Syringe Suction for Pediatric Bronchoalveolar Lavage: A Randomized Controlled Trial.

Bronchoalveolar lavage (BAL) via flexible bronchoscopy is a valuable diagnostic technique in children. The quality of BAL is directly related to the volume of the fluid recovered. Continuous wall suctioning and handheld syringe suctioning are the 2 commonly used methods, but they are rarely compared in children. We aimed to compare the above 2 suctioning techniques for BAL in the pediatric age group. This randomized controlled study enrolled children from 1 month to 18 years of age undergoing flexible bronchoscopy and BAL. We compared continuous wall suctioning and the handheld syringe suctioning technique. The primary outcome was the percentage of BAL fluid recovery in 2 different suctioning techniques. Secondary outcomes included technical acceptable BAL and yield of various diagnostic tests in BAL. The study included 73 children (48 boys) with a median (interquartile range) age of 30 (8, 108) months. There were 37 children in the wall mount group and 36 children in the syringe suction group. Baseline characteristics of the groups were similar. The wall mount suction had more recovery of BAL fluid compared with the syringe method (43.6±8.4% vs. 37.8±8.5%, P=0.004). The proportion of BAL having a fluid recovery of ≥40% was also high in the wall mount suction [31 (83.8%) vs. 17 (47.2%); P=0.001]. There was no difference in diagnostic yield between the groups. Wall mount suction had better BAL fluid recovery compared with handheld syringe suction in children undergoing flexible bronchoscopy. The diagnostic yield was similar in both groups.

Portable, consumer-grade pulse oximeters are accurate for home and medical use: Implications for use in the COVID-19 pandemic and other resource-limited environments.

ObjectiveTo determine the correlation between 3 lightweight portable pulse oximeter devices compared to a standard wall mount pulse oximetry device.MethodsWe performed a single‐center, prospective, observational study of 4 pulse oximetry devices, 3 of which are commercially available to the public. A convenience sample of 200 emergency department (ED) patients with chief complaints of cardiopulmonary origin or a peripheral capillary oxygen saturation ≤ 94 percent were enrolled. Analysis of variance was performed to compare SpO2s and test characteristics of the 3 devices compared to control.ResultsAlthough differences in measured SpO2s were observed (P < 0.001) across groups, the differences were small (mean differences ranged from 1.00% to 1.87%). The correlation between test devices and the control were high (r range 0.70–0.79). Although the test characteristics were not perfect, the devices did have good sensitivity using a cutoff value of 94% (sensitivity ranging from 90% to 92%), which improved with lower SpO2 cutoff values to 92% (sensitivity ranging from 96% to 97%).ConclusionThe 3 commercially available devices were accurate enough to be clinically useful when compared to a hospital bedside monitor pulse oximeter. Consumer‐grade portable pulse oximeters may be useful if overwhelming numbers of patients require oxygen saturation monitoring, such as during the COVID‐19 pandemic.

An Assessment Of The AFL Mask® And LUNA Wallmount, The New Developments In The AirPurifier Industry For Preventing The Airborne Pathogens

The current unprecedented situation with the COVID-19 (Coronavirus Disease 2019) poses a great challenge to the scientific world, demanding immediate development of technologies to fight with and prevent transmission of pathogens, especially in regards to airborne pathogens and surface contaminants. It also urges us to reevaluate designs of advanced Personal Protective Equipment (PPE). We have been working on the development and assessment of the AFL-Photo Catalytic Oxidation (AFLPCO®) Nanotechnology to combat with airborne pathogens and different forms of impurities and pollutants present in the indoor air. Various types of facemasks are available in the world market and have become the most important personal protective equipment for healthcare workers and the public. Depending upon their filters, they can provide protection against dreaded contagious diseases and several types of pollution. With the current 2 spread of the COVID-19 Pandemic, facemasks and powerful air purification equipment are considered as lifesaving apparatus necessary for survival and living a healthy life. The facemasks filter fine airborne particles from reaching the respiratory system and prevent infection. We have designed a new type of facemask, AFL Mask® and LUNA Wall Mount Sanifier® air purification unit to combat with the airborne pathogen and increased air pollution. The AFL Mask® has proven to prevent the entry of the PM2.5 and airborne pathogen up to 99% and provide internal air, reducing the chances of building up moisture on the face. This newly designed AFL Mask® and LUNA Wall Mount Sanifier® can be used to prevent the pathogens and particulate matters significantly. We also tested the LUNA Wall Mount Sanifier® (LNT2-6000 Model), AFL Car Sanifier® and AFL Mask® for Ozone emission. All the equipment tested were proven safe to international standards in terms of Ozone emission. &nbsp;

Modified Barrier Enclosure for Noninvasive Respiratory Support in COVID-19 Outbreak.

AimTo develop a device that can reduce the exposure of aerosols to healthcare workers (HCWs) who are working in coronavirus disease-2019 (COVID-19) critical units.BackgroundBarrier enclosure has recently been proposed for use during intubations where the risk of aerosolization is high. In COVID-19 outbreak, use of noninvasive respiratory support is increasing. But at the same time, it is associated with high risk of aerosol generation, leading to infections among HCWs. We have made a modification in the intubation box and hence expanded its use with an aim to reduce COVID-19 exposure.TechniqueVacuum suction tubing was attached to wall mount, and the other end of tubing was fixed, using adhesive surgical tapes, to the inside of the roof of barrier enclosure. Keeping the vacuum suction switched-on inside the box created a negative pressure while overall air flow is into the box from outside. This led us to believe that aerosols if generated are not contaminating patient's vicinity. Currently, we are using barrier enclosure boxes on all patients who are on noninvasive support (noninvasive ventilation or high-flow oxygen therapy).Conclusion and clinical significanceWe believe that adding barrier enclosure with the above-mentioned negative-pressure modification will provide an opportunity to use noninvasive support widely, while at the same time, HCW's exposure to aerosols will be reduced.How to cite this articleKumar P, Chaudhry D, Lalwani LK, Singh PK. Modified Barrier Enclosure for Noninvasive Respiratory Support in COVID-19 Outbreak. Indian J Crit Care Med 2020;24(9):835–837.

Ambulatory Clinic Exam Room Design with respect to Computing Devices: A Laboratory Simulation Study

OCCUPATIONAL APPLICATIONS When comparing a typical exam room layout to the Department of Veterans Affairs (VA's) new exam room design, with respect to the exam room computing, primary care providers experienced significantly less mental workload and greater situation awareness when using the new exam room design. Further, providers rated the new exam room layout significantly higher in terms of being integrated with their clinical workflow and spent significantly more time in screen sharing activities with the patient. A more thoughtful design of the exam room layout with respect to the placement and physical design of the computing set-up may reduce provider cognitive effort and enhance aspects of patient centeredness by viewing the computer and electronic health record (EHR) it displays as an important mediator between provider and patient. This was achieved by using an all-in-one computer attached to a wall mount that moves the monitor along three axes, allowing for optimal screen positioning and adjustable depending upon the scenario.TECHNICAL ABSTRACT Background: Challenges persist regarding how to integrate computing effectively into the exam room, while maintaining patient-centered care. Purpose: Our objective was to evaluate a new exam room design with respect to the computing layout, which included a wall-mounted monitor for ease of (re)-positioning. Methods: In a lab-based experiment, 28 providers used prototypes of the new and older “legacy” outpatient exam room layouts in a within-subject comparison using simulated patient encounters. We measured efficiency, errors, workload, patient-centeredness (proportion of time the provider was focused on the patient), amount of screen sharing with the patient, workflow integration, and provider situation awareness. Results: There were no statistically significant differences between the exam room layouts for efficiency, errors, or time spent focused on the patient. However, when using the new layout providers spent 75% more time in screen sharing activities with the patient, had 31% lower workload, and gave higher ratings for situation awareness (14%) and workflow integration (17%). Conclusions: Providers seemed to be unwilling to compromise their focus on the patient when the computer was in a fixed position in the corner of the room and, as a result, experienced greater workload, lower situation awareness, and poorer workflow integration when using the old “legacy” layout. A thoughtful design of the exam room with respect to the computing may positively impact providers' workload, situation awareness, time spent in screen sharing activities, and workflow integration.

A Methodology for Evaluating Accuracy of Capacitive Touch Sensing Grid Patterns

In recent years, there has been significant increase in research conducted in the field of capacitive touch technology. Capacitive touch screen technology, both in consumer electronics (for example, smartphones, MP3 players, etc.) and in wall mount displays (for example, ATM kiosks) seem to be omnipresent in the future. This paper discusses the physical design of the self-capacitive grid patterns used in current smartphones and the interpolation algorithms used to determine the position of the touch. The main aim of this paper is to simulate and test different touch screen patterns other than the widely used diamond shaped grid design and to provide a methodology for the accuracy comparison of sensor patterns. The paper deals with self-capacitance and presents results based on simulations for various sensor patterns.

Implementation of a galvanically isolated low-noise power supply board for multi-channel headstage preamplifiers

Custom made multi-channel headstage preamplifiers are traditionally powered by battery. By the use of an isolated unregulated DC/DC converter integrated circuit (DCP010512B from Texas Instruments Inc., TX, USA), here we describe the implementation of a galvanically isolated low-noise power supply board for multi-channel headstage preamplifiers. The implemented galvanically isolated power supply board provides the same quality noise free recording as the battery power supply. The non-isolated part of the power supply board is powered by standard 230 V AC/6 V DC wall mount adapter or USB cable. The described galvanically isolated power supply board can replace the batteries in preamplifier power supplies without any deterioration of the quality of recordings.

A pheromone-baited trap for monitoring the Indian meal moth, Plodia interpunctella (Hübner) (Lepidoptera: Pyralidae)

A pheromone-baited trap was developed to monitor the Indian meal moth in grocery stores and similar areas where visible traps are not desirable. The trap can be used under shelves and against walls. As a shelf mount, the trap is in close proximity to the food packages and may capture emerging insects before they mate. The trap can also be used as a hanging trap similar to the Pherocon II. When used as a shelf or wall mount, it was as effective as the Pherocon II, but when used as a hanging trap significantly fewer insects were captured.

Xeroradiography in dentistry

Extensive review of the literature reveals that the diagnostic benefits of xeroradiography in medicine are rapidly being recognized. It is viewed with particular interest by clinicians managing neoplasms of the laryngopharyngeal, mammary, and joint regions. Xeroradiography is a definite aid in cephalometric analysis. Examples of use have been presented. The main disadvantage of xeroradiography in dentistry is that of slow-speed developing in comparison with that of our current silver halide films. This becomes significant when dealing with intraoral films. However, the only disadvantage that we have experienced with xerocephalometrics is that of head orientation. Because our radiology department is not equipped with a wall mount for proper alignment along the horizontal and vertical planes, the head position must be estimated with a plumb line. Very often, therefore, the head may be tipped in one direction or another. This, however, is not difficult to correct. I have noted several definite advantages that include: --Sharp, clear-cut contrast (because of the edge effect), which enhances image quality. --Simplified viewing (no need for view boxes). --Less radiation than that required for conventional radiographs. Because of the benefit of multiple-tissue diagnosis on one radiograph, there is no need to take multiple radiographs to record tissues of different densities, with the possible exceptional of special situations in tomography. --Dry, automatic processing, therefore, eliminating the need for mixed chemicals and darkroom. --Less cost to produce a xeroradiograph than a conventional radiograph because of the lower cost of materials and equipment (for example, no darkroom requirement). The Russian investigators reported an eightfold reduction in cost. Xeroradiography (from Greek word xeros meaning dry) is a radiographic process in which the quality is critically dependent on the potential of the surface charge on the plate, the amount of radiation exposure, and the conditions of development, all of which must be carefully controlled. This technique is gaining general acceptance. Special courses are being offered to teach technicians this process. I believe we have come on a new horizon in diagnostic radiography. Only through further investigation and research will we be better able to delineate the exact role of xeroradiography in dentistry.