Create a competency-based assessment tool for pediatric esophagoscopy with foreign body removal.
Blinded modified Delphi consensus process.
Tertiary care center.
A list of 25 potential items was sent via the Research Electronic Data Capture database to 66 expert surgeons who perform pediatric esophagoscopy. In the first round, items were rated as \"keep\" or \"remove\" and comments were incorporated. In the second round, experts rated the importance of each item on a seven-point Likert scale. Consensus was determined with a goal of 7 to 25 final items.
The response rate was 38/64 (59.4%) in the first round and returned questionnaires were 100% complete. Experts wanted to \"keep\" all items and 172 comments were incorporated. Twenty-four task-specific and 7 previously-validated global rating items were distributed in the second round, and the response rate was 53/64 (82.8%) with questionnaires returned 97.5% complete. Of the task-specific items, 9 reached consensus, 7 were near consensus, and 8 did not achieve consensus. For global rating items that were previously validated, 6 reached consensus and 1 was near consensus.
It is possible to reach consensus about the important steps involved in rigid esophagoscopy with foreign body removal using a modified Delphi consensus technique. These items can now be considered when evaluating trainees during this procedure. This tool may allow trainees to focus on important steps of the procedure and help training programs standardize how trainees are evaluated.
5. Laryngoscope, 131:1168-1174, 2021.

As one of the most notorious atmospheric pollutants, NOx not only promotes the formation of ozone but also has adverse health effects on humans. It is therefore of great importance to study the sources of NOx and its effects on human health. The Comprehensive Air Quality Model (CAMx) modeling system and ozone source apportionment technology (OSAT) were used to study the contribution of NOx from different emission sources over southern China. The results indicate that heavy duty diesel vehicles (HDDVs) and industrial point sources are the two major local NOx sources, accounting for 30.8% and 18.5% of local NOx sources, respectively. In Hong Kong, marine emissions contributed around 43.4% of local NOx in 2011. Regional transport is another important source of this pollutant, especially in February and November, and it can contribute over 30% of ambient NOx on average. Power plant point emission is an significant regional source in Zhuhai, Zhongshan and Foshan. The total emission sources are estimated to cause 2119 (0-4405) respiratory deaths and 991 (0-2281) lung cancer deaths due to long-term exposure to NOx in the Pearl River Delta region. Our results suggest that local governments should combine their efforts and vigorously promote further reduction of NOx emissions, especially for those sources that make a substantial contribution to NOx emissions and affect human health: HDDV, LDGV, industrial point sources and marine sources.