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The observational evidence for kinematic substructure in Local Group dSphs is reviewed. The properties of these substructures are consistent with their being disrupted star clusters. The persistence of cold substructure argues strongly against the presence of dark matter cusps in the haloes of dSphs. A formation scenario for dSphs is described involving the merger of star clusters in the potential well of a low-mass dark matter halo.
To determine the effectiveness of a prototype esophageal detection device (EDD) during use in the prehospital setting.
Prospective convenience sample in a prehospital setting.
Intubated adult patients.
The study device was used to determine esophageal or endotracheal placement of endotracheal tubes in intubated patients. Clinical means were used to confirm tube location. A data sheet was completed for each patient.
Of 105 uses of the device, 17 of 17 esophageal tubes were identified correctly (100% sensitivity). Sixty-five of 88 tracheal tubes were correctly identified (78% specificity). There was intermediate reinflation of the device on 13 of the 65 tracheal tubes. Five tests were indeterminate. There were no false negatives (negative predictive value 100%), but 18 false positives (positive predictive value 48%).
This prototype EDD adequately identifies esophageally placed endotracheal tubes. Correct identification of endotracheally placed tubes was less sensitive. Much work needs to be done regarding the use of negative aspiration devices to identify placement of endotracheal tubes.
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