Closure Duration Research Articles

A survey on drowsiness detection system with advanced face tracking

To address the increasing dangers associated with driver and worker fatigue, this project introduces an advanced Drowsiness Detection System featuring state-of-the-art face-tracking capabilities. The pressing need for fatigue detection is evident in the alarming figures of 800 annual fatalities and 50,000 injuries resulting from drowsy driving incidents. This research expands the application of the technology to industrial workplaces, where the consequences of drowsiness are equally severe. Our comprehensive approach involves real-time monitoring of facial features, with a focus on eye movements and eyelid patterns. This system goes beyond traditional boundaries, covering drivers and industrial workers operating heavy machinery. By incorporating facial landmarks and introducing the innovative Eyes Aspect Ratio parameter, our technology offers a precise assessment of weariness in individuals within the current frame. This approach enhances safety measures in smart transportation systems and industrial settings. Integrating facial landmarks allows for a nuanced understanding of fatigue, recognizing subtle changes in facial expressions and movements indicative of drowsiness. The Eyes Aspect Ratio parameter, a novel addition, improves weariness assessment precision by considering factors such as eye closure duration, blink frequency, and gaze direction. These outcomes signify a significant contribution to road safety and broader workplace security. By mitigating inherent risks associated with drowsiness among industrial workers, our technology aims to reduce accidents, prevent injuries, and save lives across various occupational settings. The potential impact extends beyond individuals, influencing organizational safety protocols and contributing to the overall well-being of workers in high-risk environments.

Knotless suture in revision total joint arthroplasty: a prospective randomized controlled trial.

The use of barbed sutures for wound closure in primary total joint arthroplasty (TJA) has been shown to be effective and safe. However, their effectiveness and safety in revision TJA procedures has not been thoroughly studied. This study aims to evaluate the efficacy and safety of using barbed suture closure in revision TJA setting. A total of 80 patients undergoing revision TJA between September 2020 and November 2022 were included in this randomized controlled trial study. Following informed consent, patients were computer-randomized to the treatment arm (barbed suture wound closure) or to the control arm (conventional wound closure). Closure duration, closure rate, number of sutures used and wound related outcomes including complication rates and Patient and Observer Scar Assessment Scale (POSAS) score were compared between groups. The use of barbed sutures decreased closure time by 6min (30.1 vs. 36.1min, P = 0.008) with a higher wound closure rate (6.5 vs. 5.5mm/minute, P = 0.013). Additionally, the number of sutures used for wound closure in the barbed group was significantly lower than in the control group (6.2 vs. 10.1, respectively, P < 0.001). There were no significant differences in the rate of postoperative wound complications (P = 0.556) or patient and observer POSAS scores (P = 0.211, P = 297, respectively) between the two groups at 3-month follow-up. Closure of revision TJA surgical wound utilizing barbed sutures reduced closure time and the number of needles handled by operative staff, with no significant increase in intra- or post-operative complications rate when compared to traditional closure technique. I.

Correlation between lesion location and dysphagia characteristics in post-stroke patients

ObjectiveTo assess the correlation between lesion location and swallowing function characteristics in post-stroke dysphagia (PSD) patients. Materials and methodsWe enrolled 133 PSD. The patients were divided into supratentorial and infratentorial stroke groups. We compared the measurements in the videofluoroscopic swallowing study (VFSS) with 3ml and 5 ml of diluted and thickened barium liquid data between supratentorial and brainstem stroke groups. We further compared the difference of VFSS measurements between patients with left hemispheric or right hemispheric lesions (further divided into unilateral hemispheric cortical and subcortical subgroups) and brianstem leison stroke group.To explore the lesion location's effect on different bolus volume, the VFSS measurements of 3ml and 5ml in each subgroups were compared respectively. The measurements of VFSS included the oral transit time, soft palate elevation duration, hyoid bone movement duration (HMD), UES opening duration, pharyngeal transit duration (PTD), stage of ansition duration, and laryngeal closure duration (LCD), the upper esophageal sphincter opening (UESO), hyoid bone superior horizontal displacement, and hyoid bone anterior horizontal displacement. General swallowing function was assessed using the Penetration Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS). We performed the paired t-test, Spearman's correlation, and Kruskal–Wallis test analysis to characterize the parameters among the groups. ResultsFifty-eight patients were assessed in the final analysis. The HMD (p = 0.019), PTD (p = 0.048) and LCD (p = 0.013) were significantly different between the supratentorial and brainstem lesion groups in 5ml volume. The HMD was significantly different (p = 0.045) between the left cortical and brainstem lesion groups. Significant differences in the HMD (p = 0.037) and LCD (p = 0.032) between the left subcortical and brainstem lesion groups were found in 5ml volume bolus. There was no group different when taking the 3ml volume bolus. Regarding the relationship between food bolus volume and swallowing functions, only the UESO demonstrated a significant difference in the subcortical lesion of the right hemisphere (p = 0.0032) compared the 3 ml and 5 ml volume bolus. The PTD demonstrated a moderate correlation with the PAS scores (r = 0.38, p = 0.0044). The HMD (r = 0.32, p = 0.018) and LCD (r = 0.29, p = 0.039) demonstrated weak correlations with the PAS scores. We did not identify any correlation between the VFSS parameters and FOIS scores in each subgroup level. ConclusionThe PSD with brainstem lesion shows more sever dysfunction in the pharyngeal phases. The left hemisphere was engaged in both the oral and pharyngeal phases. Lesions in the bilateral cortical, subcortical, and brainstem regions may impair sensory input.

Small bites versus large bites during fascial closure of midline laparotomies: a systematic review and meta-analysis.

Incisional ventral hernias (IVH) are common after laparotomies, with up to 20% incidence in 12months, increasing up to 60% at 3-5years. Although Small Bites (SB) is the standard technique for fascial closure in laparotomies, its adoption in the United States is limited, and Large Bites (LB) is still commonly performed. We aim to assess the effectiveness of SB regarding IVH. We searched for RCTs and observational studies on Cochrane, EMBASE, and PubMed from inception to May 2023. We selected patients ≥ 18years old, undergoing midline laparotomies, comparing SB and LB for IVH, surgical site infections (SSI), fascial dehiscence, hospital stay, and closure duration. We used RevMan 5.4. and RStudio for statistics. Heterogeneity was assessed with I2 statistics, and random effect was used if I2 > 25%. 1687 studies were screened, 45 reviewed, and 6 studies selected, including 3 RCTs and 3351 patients (49% received SB and 51% LB). SB showed fewer IVH (RR 0.54; 95% CI 0.39-0.74; P < 0.001) and SSI (RR 0.68; 95% CI 0.53-0.86; P = 0.002), shorter hospital stay (MD -1.36days; 95% CI -2.35, -0.38; P = 0.007), and longer closure duration (MD 4.78min; 95% CI 3.21-6.35; P < 0.001). No differences were seen regarding fascial dehiscence. SB technique has lower incidence of IVH at 1-year follow-up, less SSI, shorter hospital stay, and longer fascial closure duration when compared to the LB. SB should be the technique of choice during midline laparotomies.

Influence of Surgeon's Expertise on the Duration of Approach and Closure during Osteosynthesis of Distal Radius Fractures

Abstract Background The aim of this study was to determine whether the duration of the approach (PII) and closure (PV) phases for minimally invasive plate osteosynthesis (MIPO) of distal radius fractures varied according to the surgeon's level of expertise. The main hypothesis was that the PII or PV duration was inversely proportional to the level of expertise. Methods The method measured the duration of PII and PV for 50 videos of MIPO operated by one surgeon with level 3E expertise, three with level 4E, and one with level 5E. The videos were viewed to identify any technical errors. Results The average PII duration was 3 minutes 8 seconds for level 5E, 4 minutes 7 seconds for 4E, and 6 minutes 19 seconds for 3E. Average PV duration was 2 minutes 12 seconds for level 5E, 2 minutes 36 seconds for 4E, and 2 minutes 41 seconds for 3E. The average duration of PII + PV was 5 minutes 20 seconds for level 5E, 6 minutes 37 seconds for 4E, and 9 minutes for 3E. These findings indicate that both PII and PV duration was the longest in the level 3E surgeons' practice. Six technical errors were identified for levels 3E and 4E during PII (hemostasis control, multiple incisions, instrument handling, improper use of the fluoroscope, time-outs) and PV (intradermal reattachment). Clinical Relevance The main hypothesis was verified since the duration of PII or PV was inversely proportional to the surgeon's level of expertise. This study identified technical errors in hand surgery practices of new surgeons. By early identification and correcting these minor errors, it would be possible to speed up the learning curve. We recommend surgical videos to be systematically recorded and analyzed to improve hand surgery practices. Type of Study/Level of Evidence Therapeutic/Level IIIa.

(021) Eight-Dot Extended Corporotomy versus Conventional Corporotomy for Malleable Penile Prosthesis Implantation

Abstract Introduction To date, malleable type penile prosthesis implantation (MPPI) remains the more popular in developing countries, owing to its relative economic cost. Despite the simplicity of the procedure, there still may be areas of improvement and refinement to optimize procedure efficiency and accuracy subsequently improving postoperative outcomes while reducing complication risk. Objective We aimed to compare the eight-dot extended corporotomy and the conventional corporotomy techniques for MPPI with regard to operative time and postoperative complications. Methods We conducted a prospective randomized interventional clinical study on 51 subjects. Patients were randomized into 2 groups: the eight-dot group (n=27) and the conventional group (n=24). The eight-dot group underwent MPPI using the eight-dot extended corporotomy as previously described (VJPU - Eight-dot Extended Corporotomy: A More Secure, Aesthetic and Time Efficient Technique for Semirigid Penile Prosthesis Implantation, n.d.). The conventional group underwent MPPI using conventional limited corporotomies that were closed via continuous running sutures. We compared both groups in terms of corporotomy opening to closure time, overall procedure time, and perioperative complications. The follow-up period was 3 months. Results Upon timing in seconds (s), a significant time difference between the 2 groups was demonstrated for suture placement, corporotomy incision and implant placement, corporotomy closure, and total procedure duration. Although patients in the eight-dot group required a longer time for suture placement vs the conventional group (486 vs 201 s, respectively, p &amp;lt; 0.001), the durations for the remaining implantation steps, as well as the whole procedure, were significantly shorter for the former group. Corporotomy opening followed by implant placement took significantly less time for the eight-dot group (1090 s) vs the conventional group (1313 s), p &amp;lt;0.001. Moreover, insertion of implant rods was subjectively easier with no need for aggressive bending owing to the extended corporotomy length. Similarly, corporotomy closure using the 8-dot technique was 10.13 minutes swifter than the conventional group (220 s vs. 828 s, respectively, p &amp;lt; 0.001). The total procedure length was over 8 minutes shorter for the eight-dot group as opposed to the conventional group (2527 vs 3027 s, respectively, p &amp;lt; 0.001). In terms of postoperative complications in the form of pain, swelling, hematoma, and infection, there were no significant differences between both groups. Conclusions The eight-dot extended corporotomy technique is a safe and time-saving approach compared to the conventional limited corporotomy technique, making the MPPI procedure more efficient. A swifter procedure decreases both patient exposure to anesthesia and device exposure to air which in turn lowers the risk for potential postoperative complications. Disclosure No.

Closure duration versus f0 perturbation as a cue to underlying stops for the American English intervocalic flap

Researchers found that there are five main cues for distinguishing the voicing of these intervocalic plosives, preceding vowel duration, following vowel duration, closure duration, semantic context, and f0 perturbation, also known as consonant intrinsic f0. In American English, when /t/ and /d/ occur intervocalically, they are realized as a voiced alveolar flap [ɾ] (e.g., [ɹa͡ɪɾɪŋ] writing/riding, [liɾɚ] liter/leader). The presence of these cues indicates incomplete neutralization of these forms. To address a current gap in the literature, the present study focused on American English native speakers’ perception and use of CF0 and closure duration as independent and combined informative cues for deciding voicing contrast of /t/ and /d/ when neutralized by the flap. Participants engaged in a self-administered online forced-judgement task of a pseudoword in 30 combinations of CF0 and flap closure duration to indicate the underlying representation (/hɑtɑ/ or /hɑdɑ/) of the surface production [hɑɾɑ] they perceived. This study observed that participants are more likely to select /hɑtɑ/ when the CF0 is higher and / hɑdɑ/ elsewhere. These modest findings suggest that CF0 is a useful cue for voicing distinction. The results suggest that models of spoken word recognition and speech perception ought to include CF0 as a cue.

Phonetics characteristics of seoul korean tense stops

This study investigates Seoul Korean tense stops, asking whether underlying intervocalic tense stops in /at*a ap*a ak*a/ share phonetic characteristics with those derived from a sequence of two lax stops by applying the post-obstruent tensing rule /at.ta ap.pa ak.ka/ → [at*a ap*a ak*a]. To examine whether the tense stops show articulatory fortition compared to lax stops, and if so, whether the underlying and derived tense stops differ from each other, tongue configuration and closure duration of tense stops in [at*a ap*a ak*a] that are underlyingly either /at*a ap*a ak*a/ or /at.ta ap.pa ak.ka/ are compared with those of lax stops in [ata apa aka]. Ultrasound tongue imaging data from six native speakers of Seoul Korean reveal indistinguishable tongue configurations among underlying tense stops, tense stops derived from underlying lax sequences, and lax stops. Both derived and underlying tense stops have longer closure duration than lax stops, but the two surface tense stops did not significantly differ in their closure duration. Taking the articulatory and acoustic evidence together, underlying and derived tense stops in Seoul Korean are phonetically indistinguishable from each other although both have longer closure durations than singleton lax stops. The findings further suggest that Seoul Korean may not use tongue configuration as an articulatory strategy for fortition for either underlying or derived tense stops.

Respiratory laryngeal coordination during vowel-plosive-vowel transition in shouted speech

This study investigates differences in respiratory-laryngeal coordination between normal and shouted speech in the production of a vowel-plosive-vowel utterance, with the goal toward synthesis of such utterances in loud speech. The results showed that compared to normal condition, shouted speech produced higher intraoral pressure during vocal tract closure, higher airflow at the release of vocal tract closure, increased fundamental frequency and increased duration of glottal closure during the following vowel, and increased respiratory activities. For unvoiced plosives, shouted speech also produced increased voice onset time of the following vowel, but its importance to the perception of shouted speech was small. Computational simulations further showed that such increased voice onset time is likely due to increased maximum vocal fold abduction and/or delayed initiation of vocal fold adduction, which are necessary to avoid voice onset immediately after the release of vocal tract closure in conditions of high subglottal pressure.

Comparison of different suture techniques for laparoscopic vaginal cuff closure

Laparoscopic hysterectomy is a commonly performed procedure. However, one high-risk complication is vaginal cuff dehiscence. Currently, there is no standardization regarding thread material or suturing technique for vaginal cuff closure. Therefore, this study aimed to compare extracorporeal and intracorporeal suturing techniques for vaginal cuff closure using a pelvic trainer model. Eighteen experts in laparoscopic surgery performed vaginal cuff closures with interrupted sutures using intracorporeal knotting, extracorporeal knotting and continuous, unidirectional barbed sutures. While using an artificial tissue suturing pad in a pelvic trainer, experts performed vaginal cuff closure using each technique according to block randomization. Task completion time, tension resistance, and the number of errors were recorded. After completing the exercises, participants answered a questionnaire concerning the suturing techniques and their performance. Experts completed suturing more quickly (p < 0.001, p < 0.001, respectively) and with improved tension resistance (p < 0.001, p < 0.001) when using barbed suturing compared to intracorporeal and extracorporeal knotting. Furthermore, the intracorporeal knotting technique was performed faster (p = 0.04) and achieved greater tension resistance (p = 0.023) compared to extracorporeal knotting. The number of laparoscopic surgeries performed per year was positively correlated with vaginal cuff closure duration (p = 0.007). Barbed suturing was a time-saving technique with improved tension resistance for vaginal cuff closure.

Arch First and Beam Later Technology: An Accelerated and Safe Construction for Tied Arch Bridges

The Taidong River Bridge, a 115 m tied arch bridge, was opened in 2021 over the Taidong River in Jiangsu, China. Due to the significant role of the Taidong River as a crucial navigation channel for local transportation, construction activities aimed to reduce the duration of river closure. The bridge construction employed the pioneering technique of arch first and beam later without support mechanisms in the river course. This method entailed the integral hoisting of arch ribs via a floating crane, and the tied-arch bridge's longitudinal deformation was temporarily consolidated with tension during construction phases. The investigation analyzes the hoisting point layouts, arch rib limiting devices, structural system transformations implemented, as displacement, and horizontal thrust of the arch foot during the temporarily consolidated tensioning construction stage of the bridge. The research results showed that the arch first and beam later method without support construction adopted in this project demonstrated impressive compliance with the navigation standards stipulated for the Taidong River. In addition, this study proposes a method that combines mechanical calculation formulas with the Midas model to determine the position of the arch rib suspension point and provide theoretical values for temporary consolidation forces during the construction stage. The findings of this study offer valuable practical guidance that can be applied to comparable bridge projects.

(386) Eight-Dot Extended Corporotomy Versus Conventional Corporotomy for Malleable Penile Prosthesis Implantation

Abstract Introduction To date, malleable type penile prosthesis implantation (MPPI) remains the more popular in developing countries, owing to its relative economic cost. Despite the simplicity of the procedure, there still may be areas of improvement and refinement to optimize procedure efficiency and accuracy subsequently improving postoperative outcomes while reducing complication risk. Objective We aimed to compare between the eight-dot extended corporotomy technique and the conventional corporotomy techniques for MPPI with regards to operative time and postoperative complications. Methods We conducted a prospective randomized interventional clinical study on 51 subjects. Patients were randomized into 2 groups: eight-dot group (n=27) and conventional group (n=24). The eight-dot group underwent MPPI using the eight-dot extended corporotomy as previously described (VJPU - Eight-dot Extended Corporotomy: A More Secure, Aesthetic and Time Efficient Technique for Semirigid Penile Prosthesis Implantation, n.d.). The conventional group underwent MPPI using conventional limited corporotomies that were closed via continuous running sutures. We compared between both groups in terms of corporotomy opening to closure time, overall procedure time and perioperative complications. The follow up period was 3 months. Results Upon timing in seconds (s), a significant time difference between the 2 groups was demonstrated for suture placement, corporotomy incision and implant placement, corporotomy closure, and total procedure duration. Although patients in the eight-dot group required longer time for suture placement vs the conventional group (486 vs 201 s, respectively, p &amp;lt; 0.001), the durations for the remaining implantation steps as well as the whole procedure were significantly shorter for the former group. Corporotomy opening followed by implant placement took significantly less time for the eight-dot group (1090 s) vs the conventional group (1313 s), p &amp;lt;0.001. Moreover, insertion of implant rods were subjectively easier with no need for aggressive bending owing to the extended corporotomy length. Similarly, corporotomy closure using the 8-dot technique was 10.13 minutes swifter than the conventional group (220 s vs. 828 s, respectively, p &amp;lt; 0.001). The total procedure length was over 8 minutes shorter for the eight-dot group opposed to the conventional group (2527 vs 3027 s, respectively, p &amp;lt; 0.001). In terms of postoperative complications in the form of pain, swelling, hematoma, and infection, there were no significant differences between both groups. Conclusions The eight-dot extended corporotomy technique is a safe and time-saving approach compared to the conventional limited corporotomy technique, making the MPPI procedure more efficient. A swifter procedure decreases both patient exposure to anesthesia and device exposure to air which in turn lowers the risk for potential postoperative complications. Disclosure No.

Optimal valve closing law for improved water hammer control: a case from a water supply pipeline in Guelma, Algeria

Abstract Finding the most suitable closing law is essential to decrease the shock wave pressure caused by transient flow and minimize the potential damage to equipment. The closure of a valve can occur instantly, rapidly, or gradually, and the appropriate law can be convex, linear, or concave, depending on various factors. These factors include the pipe's characteristics (type, diameter, roughness, and length), the conveyed fluid (nature and temperature), and operating conditions (pressure and flow rate). Other factors that receive less attention, such as the duration of slow closure and the impact of soil load on the pipe, are also considered in this study. The main focus of this article is to investigate how the optimal law evolves based on the time it takes for a valve to gradually close, specifically in the case of a valve located at the end of an underground gravity supply pipe. The findings reveal that when the slow closure time (t) exceeds 0.50 times the return period (t4), the exponent of the optimal law becomes a damped periodic function. Each closure time corresponds to a unique optimal law, and as the valve closure time increases, the range of optimal laws becomes narrower.

Cost effectiveness of preemptive school closures to mitigate pandemic influenza outbreaks of differing severity in the United States

BackgroundNonpharmaceutical interventions (NPIs) may be considered as part of national pandemic preparedness as a first line defense against influenza pandemics. Preemptive school closures (PSCs) are an NPI reserved for severe pandemics and are highly effective in slowing influenza spread but have unintended consequences.MethodsWe used results of simulated PSC impacts for a 1957-like pandemic (i.e., an influenza pandemic with a high case fatality rate) to estimate population health impacts and quantify PSC costs at the national level using three geographical scales, four closure durations, and three dismissal decision criteria (i.e., the number of cases detected to trigger closures). At the Chicago regional level, we also used results from simulated 1957-like, 1968-like, and 2009-like pandemics. Our net estimated economic impacts resulted from educational productivity costs plus loss of income associated with providing childcare during closures after netting out productivity gains from averted influenza illness based on the number of cases and deaths for each mitigation strategy.ResultsFor the 1957-like, national-level model, estimated net PSC costs and averted cases ranged from $7.5 billion (2016 USD) averting 14.5 million cases for two-week, community-level closures to $97 billion averting 47 million cases for 12-week, county-level closures. We found that 2-week school-by-school PSCs had the lowest cost per discounted life-year gained compared to county-wide or school district–wide closures for both the national and Chicago regional-level analyses of all pandemics. The feasibility of spatiotemporally precise triggering is questionable for most locales. Theoretically, this would be an attractive early option to allow more time to assess transmissibility and severity of a novel influenza virus. However, we also found that county-wide PSCs of longer durations (8 to 12 weeks) could avert the most cases (31–47 million) and deaths (105,000–156,000); however, the net cost would be considerably greater ($88-$103 billion net of averted illness costs) for the national-level, 1957-like analysis.ConclusionsWe found that the net costs per death averted ($180,000-$4.2 million) for the national-level, 1957-like scenarios were generally less than the range of values recommended for regulatory impact analyses ($4.6 to 15.0 million). This suggests that the economic benefits of national-level PSC strategies could exceed the costs of these interventions during future pandemics with highly transmissible strains with high case fatality rates. In contrast, the PSC outcomes for regional models of the 1968-like and 2009-like pandemics were less likely to be cost effective; more targeted and shorter duration closures would be recommended for these pandemics.

The effects of 3D/Full HD and 2D/Ultra HD imaging systems on suturing skills during total laparoscopic hysterectomy: a prospective cohort study.

2D/Ultra HD and 3D/Full HD imaging systems can provide surgeons with more accurate and detailed views of the surgical site. We aimed to compare the effects of 2D/Ultra HD and 3D/Full HD laparoscopy systems on laparoscopic suturing skills during total laparoscopic hysterectomy. In this prospective cohort study, patients were recruited from a tertiary hospital, and demographic data and surgical data were recorded. The primary outcome measures were the durations of the total operation and vaginal cuff closure. Secondary outcome measures were colpotomy duration, total number of sutures placed, duration of first, second, third and fourth sutures, mean suturing duration, total operation duration, the surgeon's perception of difficulty during the vaginal cuff suturing and complications. The 3D/Full HD (n = 39) and 2D/Ultra HD (n = 42) groups were compared in terms of age, BMI, number of previous abdominal surgeries, number of previous cesarean sections, and type of delivery were examined. Both groups were considered homogeneous. The 3D/Full HD group was found to be superior in terms of colpotomy duration, duration of the first, second, and third suture, mean suturing duration, vaginal cuff closure duration, and difficulty of use compared to 2D/Ultra HD group (p < 0.05 for all). In conclusion, the use of 3D/Full HD laparoscopy systems can lead to improved surgical outcomes in terms of colpotomy duration, duration of the first, second, and third suture, mean suturing duration, vaginal cuff closure duration, and difficulty of use compared to 2D/Ultra HD systems.

VIDEOFLUOROSCOPIC EVALUATION OF THE IMPACT OF CAPSULE SIZE AND SUBJECT'S AGE AND GENDER ON CAPSULE SWALLOWING.

People recurrently have difficulties swallowing solid medications, which can be associated with the size of the medication and the age and gender of individuals. To evaluate the impact of capsule size and adults' age and gender on oral and pharyngeal capsule transit during capsule swallows. Videofluoroscopy was used to measure capsule oral and pharyngeal transit during swallows in 49 healthy individuals (17 men and 32 women), with a mean age of 46 years (ranging from 23 to 88 years). Smaller capsules were filled with 0.50 mL of barium sulfate, and larger capsules were filled with 0.95 mL of barium sulfate; the volume of liquid ingested with the capsules was also quantified in each ingestion. The measurements included the oral preparation time, oral transit time, swallowing reaction time, time to laryngeal vestibule closure, laryngeal vestibule closure duration, pharyngeal transit time, and upper esophageal sphincter opening duration. The capsule size did not influence either the oral or pharyngeal transit time. Increased liquid volume was ingested with larger capsules and by people older than 40 years. The oral transit time was shorter in older adults (60-88 years), and the time to laryngeal vestibule closure was longer in women. The size of large capsules did not make a difference in oral or pharyngeal transit when compared with smaller capsules. The capsule size and the participant's age influenced the volume of liquid ingested - larger capsules and older individuals required a larger volume. The capsule oral transit was faster in individuals older than 60 years. •Swallowing is influenced by the characteristics of what is being swallowed. •There was no difference in swallowing capsules containing 0.50 mL or 0.95 mL. •Larger capsules need more liquid ingestion to make swallowing easier. •Individuals older than 40 years need a greater volume of liquid to swallow capsules than younger adults.

The Effect of Bidirectional Barbed Sutures on the Duration of Common Enterotomy Closure in Intracorporeal Anastomosis.

The adoption of intracorporeal anastomosis in minimally invasive surgery for colon cancer has gradually expanded owing to its many advantages. However, intracorporeal anastomosis has the disadvantage of a longer operative time than extracorporeal anastomosis. One reason that intracorporeal anastomosis takes longer to perform is the closure of the common enterotomy. The present study evaluated the effect of bidirectional barbed sutures on the duration of common enterotomy closure in intracorporeal anastomosis for minimally invasive colectomy. The time required for common enterotomy closure was measured with a simulator using an intestinal model. A two-layer suture with continuous full-thickness suture followed by a continuous serosal-muscular suture was adopted. The time required to close the common enterotomy using two unidirectional barbed sutures and one bidirectional barbed suture was measured five times each. The duration of common enterotomy closure using bidirectional barbed suture was significantly shorter than that using two conventional barbed sutures. Bidirectional barbed sutures are useful for closing the common enterotomy in intracorporeal anastomosis for minimally invasive colectomy.

Analyzing Multi-Mode Fatigue Information from Speech and Gaze Data from Air Traffic Controllers

In order to determine the fatigue state of air traffic controllers from air talk, an algorithm is proposed for discriminating the fatigue state of controllers based on applying multi-speech feature fusion to voice data using a Fuzzy Support Vector Machine (FSVM). To supplement the basis for discrimination, we also extracted eye-fatigue-state discrimination features based on Percentage of Eyelid Closure Duration (PERCLOS) eye data. To merge the two classes of discrimination results, a new controller fatigue-state evaluation index based on the entropy weight method is proposed, based on a decision-level fusion of fatigue discrimination results for speech and the eyes. The experimental results show that the fatigue-state recognition accuracy rate was 86.0% for the fatigue state evaluation index, which was 3.5% and 2.2%higher than those for speech and eye assessments, respectively. The comprehensive fatigue evaluation index provides important reference values for controller scheduling and mental-state evaluations.

The outcomes of diode laser transscleral cyclophotocoagulation in refractory primary angle-closure glaucoma in a South Indian population.

The surgical intervention of refractory primary angle-closure glaucomas (PACGs) is a big challenge to any ophthalmologist since the efficacy of lens extraction in eyes with a long duration of angle closure is limited. Also, trabeculectomy in such eyes is not without vision-threatening complications. To evaluate the efficacy and safety of diode laser transscleral cyclophotocoagulation (CPC) in eyes with refractory PACG. A retrospective study analyzing all patients who underwent CPC for refractory PACG in the year 2019 was conducted. Out of the 68 patients recruited, 56 PACG patients fulfilled the study criteria. The mean age of the participants was 58.5 years. The mean (standard deviation [SD]) intraocular pressure (IOP) at baseline was 38.91 (14.86) mmHg, and it ranged from 21 to 74 mmHg. Participants' mean (SD) follow-up duration was 11.87 (7.83) months. Almost 90.9% of eyes showed IOP reduction from baseline during the follow-up period. There was also a reduction in the mean antiglaucoma medications (AGM) to 2.67 (1.29) in the final follow-up visit compared to the baseline of 3.30 (0.81). Chronic hypotony was noted in four eyes, out of which phthisis bulbi occurred in one eye. Six eyes underwent additional incisional surgical procedures. The outcomes from our study support the role of transscleral diode laser CPC in the interim optimization of IOP in PACG eyes refractory to other modalities. This is emerging as a primary treatment option to optimize IOP to safer limits before any planned incisional procedure. Though complications like chronic hypotony occur as anticipated, vision-threatening complications are rare.

Impact of the Toxic Dinoflagellate Alexandrium catenella on the Valve Movement of Mytilus edulis: A Comparison between Two Populations with Contrasting Histories Exposure

Shellfish aquaculture farms, due to their coastal position, face the threat of exposure to harmful algal blooms. Such blooms can release, among others, paralytic shellfish toxins (PST) produced by the dinoflagellate Alexandrium catenella and are known to cause the restriction of bivalve harvesting sites. Shellfish can accumulate PSTs in levels that are poisonous for humans, therefore making them unfit for consumption. Thus, the ability to detect PSTs before they reach the critical threshold is crucial for minimizing losses in the industry. Previous studies have demonstrated that toxic algae detection is possible with the use of an early warning system based on the valve-gaping behaviour of blue mussel Mytilus edulis. However, some studies observed the presence of toxin resistance in other species of bivalves when they are regularly exposed to PSTs. If no resistance is observed whatever the past history of the populations would be with regard to PST exposure, this species could be appropriate as a sentinel candidate. In this study, we compare the valve-gaping behaviour of two blue mussel populations with contrasting long-term histories of PSTs events (i.e., regularly vs. not previously exposed to the PSTs producer) were compared using experimental exposure of A. catenella to M. edulis. It was found that mussels from both populations exhibited similar gaping behaviour patterns when exposed to A. catenella. For both populations, the number of valve closures and closure duration tended to increase in the presence of A. catenella, which suggested an avoidance response to the toxic dinoflagellate. In conclusion, our results support the use of M. edulis without origin discrimination