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“Flipped learning” has become increasingly popular in medical education as a means of developing independent learning skills in students. The article by Zheng at al. (2020) highlights the potential utility of this approach in disaster triage training. However, the article also highlights to us some concerns regarding how “flipped learning” may favor certain learners over others in the provision of disaster triage education. Specifically, the article demonstrates the necessity for increased preclassroom preparation when a “flipped classroom” model is used, which inevitably privileges those with a higher ability to engage with self-directed learning. Although such a skill is important to develop in medical education, we fear it may lead to polarized student attainment rather than ensuring a maximum number of students achieve the requisite standard required. More research is consequently needed to inform the most efficacious means of facilitating disaster triage training that supports all students sufficiently, while also helping to nurture their independent learning skills.
We report a rare case of successful surgical management of tubercular tracheal stenosis. There was no history of tracheostomy except for trauma management.
Case report:
A 24-year-old man presented with breathing difficulty. He had previously sustained blunt chest injury, a fractured mandible and minor head injury in a traffic accident. Despite successful mandibular fracture fixation, he subsequently developed progressive breathing difficulty with stridor. The patient was treated successfully with surgical resection and bronchoplastic reconstruction. Post-operatively, endotracheal tuberculosis was diagnosed.
Conclusion:
Endotracheal tuberculosis is rare despite the high incidence of pulmonary tuberculosis in India. Early diagnosis and prompt treatment are necessary to prevent tuberculous tracheobronchial stenosis, an extremely rare but serious clinical problem which can cause obstructive pneumonia and exertional dyspnoea. Surgical resection and bronchoplastic reconstruction is the established treatment for such stenosis. Patients with active tuberculosis usually respond to conventional antitubercular treatment.
The investigation of dioxin formation mechanisms demonstrated that most part of PCDD/F
formation occurs in the sinter mix during the sintering operation. This result has a
direct impact on abatement strategies of PCDD/F: use ot inhibitors added in the sinter
feed and study of the impact of raw materials. Trials carried out on the IRSID pilot pot
and on the Charleroi sinter strand have shown that urea addition could be a promising
method to reduce pollutant emissions at the sinter strand main stack: PCDD/Fs
(about - 50%) and SO2.
Irsid and DCPR from Nancy present an investigation on the generation and the abatement of
organic molecules in the flue gas of an electric arc furnace. Investigated in detail are the
environmental cleanliness of scrap, the mixed pyrolysis and combustion that generates these
molecules, the solution to destroy them completely that a perfect post-combustion offers, as
demonstrated in the laboratory and as extrapolated for industrial scale, and the condensation of
dioxines in the flue gas collection system.