Collar Size Research Articles

Factors Influencing Radiation Sound Fields in Logging While Drilling Using an Acoustic Dipole Source

With the increasing number of complex well types in the development stage of oil and gas fields, it is becoming increasingly urgent to use remote detection logging while drilling (LWD) to explore the geological structures in a formation. In this paper, the feasibility and reliability of the dipole remote detection of logging while drilling are demonstrated theoretically. For this purpose, we use an asymptotic solution of elastic wave far-field displacement to derive the calculation formula for the radiation pattern and energy flux of an LWD dipole source. The effects of influencing factors, including the source frequency, formation property, drill collar size, and mud parameter, on the radiation pattern and energy flux are analyzed. The results show that the horizontally polarized shear wave (SH-wave) has a greater advantage in imaging the reflector compared with the cases of the compressive wave (P-wave) and vertically polarized shear wave (SV-wave), which indicates the dominance of the SH-wave in dipole remote detection while drilling. The optimal source excitation frequency of 2.5 kHz and inner and outer radii of the drill collar of 0.02 and 0.1 m, respectively, should be considered in the design of an LWD dipole shear wave reflection tool. However, the heavy drilling mud is not conducive to remote detection during logging while drilling. In addition, the reflection of the SH-wave for the LWD condition is simulated. Under the conditions of optimal source frequency, drill collar size, and mud parameters, the reflection of the SH-wave signal is still detected under the fast formation.

Numerical Study on Local Scour Reduction around Two Cylindrical Piers Arranged in Tandem Using Collars

Local scour occurring near bridge piers has become a major problem all over the world, which has caused countless bridge damage events. Explorations regarding local scour reduction measurements have become a research hotspot in the field. Much effective research has been conducted on scour reduction for single piers. However, studies on local scour reduction around multiple piers that are arranged in tandem have rarely been reported. Therefore, the effect of the span and the local scour reduction measurement (collar) on the characteristics of the local scouring behavior around two piers arranged in tandem are explored in this research, with numerical simulations in clear-water conditions. The results show that the local scour depth of the downstream pier increases gradually with an increase in the pier spacing, due to the weakened sheltering effect of the upstream pier. The local scouring of both the upstream and downstream piers can be reduced if the upstream pier is protected by a collar. The local scour reduction efficiency of the upstream pier can reach 52~55%. The local scour reduction efficiency of the downstream pier decreases rapidly from 84.3% to 8.3% with an increase in the pier spacing. If the pier spacing, G, is greater than 4.0D (D is the diameter of the pier), the local scour depth around the downstream pier is larger than that around the upstream pier. Therefore, if the local scour depth of the upstream pier is considered safe and acceptable, it is used as the reduction target of the downstream local scour depth. A collar must be adapted for use around the downstream pier when G/D > 4.0. If both the piers are protected by collars of the same size (W = 3.0D), the local scour reduction efficiency of the downstream pier is about 15% more than that of the upstream pier. The local scour depth around the downstream pier is 64.5% of that around the upstream pier. Therefore, the size of the collar around the downstream pier can be decreased to save costs. The local scour reduction efficiency for the downstream pier reduces from 66.7% to 39.8% when the downstream collar size (W) decreases from 3.0D to 2.0D. To ensure that the local scour depth around the downstream pier is no greater than that of the upstream pier, the downstream collar should be larger than 2.25D. These results can serve as a reference for the local scour reduction of two piers arranged in tandem.

0442 Progress in the SUPRA Trial for the Treatment of CPAP-intolerant OSA patients: AHI and Safety

Abstract Introduction An external collar with ~30cmH2O vacuum applied to the anterior neck can expand the oro- and naso-pharynx and improve Pcrit (Kato et al 2015- PMID: 25614595. The hypothesis of SUPRA (Study Using Negative Pressure to Reduce Apnea - NCT04861038) is that the self-contained vacuum device (aerSleep® II) can treat obstructive sleep apnea (OSA) in those unable to use CPAP. Methods Conducted at 15 sleep centers in the United States, CPAP–intolerant subjects meeting eligibility (age >18 yrs, BMI < 42, and an untreated AHI4% by Nox T3 HSAT of 15-50/hr) were fitted to one of three collar sizes. After a 7-day acclimatization trial, those that showed a >50% reduction in AHI4% to less than 20/hr (“Responders”) and accepted therapy agreed to 6 months of supervised treatment, with final assessments at 6 months. 7-day and 6-month end-points reported here are AHI and safety. Results Of screened subjects, 50.2% were excluded, most frequently due to baseline AHI being too high or, mostly, too low (72%). 110 subjects (59±SD11 years, 43% Female, 84% Caucasian) met study criteria. Following device acclimation, 28 (50%) did not meet 7-day pre-selected on-treatment AHI criteria. In 23 subjects (41%), AHI reduced from 26.6±8.5 to 8.1±5.6 (p=0.001), and these Responders differed from non-responders (AHI from 32.7±13.1 to 26.7±9.4, p=0.06) in regard to reductions in apneas and hypopneas and ODI; non-responders had converted to hypopneas. During the 6-month phase, 7 withdrew consent. In all, local irritation occurred in 29 instances in 28 participants, resolving with 1-3 days of discontinuation, and therapy resumed. Eight have completed 6 months without safety issues, and 7 continued to exceed AHI efficacy endpoints. Conclusion We conclude that the aerSleep II device, with current collar sizes and pressure, can reduce the AHI burden at 7 days and continues for 3-6 months without major safety concerns. Support (if any) Presented for the SUPRA Study Group, supported by Sommetrics Inc, San Diego CA

Patterns of change in prehospital spinal motion restriction: A retrospective database review.

Acute management of trauma patients with potential spine injuries has evolved from uniform spinal immobilization (SI) to spinal motion restriction (SMR). Little research exists describing how these changes have been implemented. This study aims to describe and analyze the practice of SMR in one emergency medical services (EMS) agency over the time frame of SMR adoption. This was a retrospective database review of electronic patient care reports from 2009 to 2020. The effects of key practice changes (revised documentation and a collar-only treatment option) were analyzed in an interrupted time series using the rate of SI/SMR as the primary outcome. Secondary outcomes included patient age, sex, acuity, mechanism of injury, treatment provided, cervical collar size, and positioning. These were assessed for changes from year to year by Poisson regression. Associations between patient and treatment characteristics were investigated with binomial logistic regression. There were 25,747 instances of SI/SMR included. Among all patients, the median age was 40 (interquartile range 24-56), 58% (14,970) were male, and 20% (5062) were high-acuity. The rate of SI/SMR declined from 31.2 to 12.7 treatments per 100 trauma calls per month. The proportion of high-acuity patients increased by 9.6% per year on average (95% CI 8.7%-10.0%). When first available, collar-only treatment was provided to 47% of patients, rising by 6.3% per year (95% CI 3.2%-9.5%) to 60% in 2020. Collar-only treatment (compared to board-and-collar) was more likely to be applied to low-acuity patients (as compared to high): odds ratio 3.01 (95% CI 2.64-3.43). This study shows decreasing SI/SMR treatment and changing patient and practice characteristics. These patterns of care cannot be attributed solely to formal protocol changes. Similar patterns and their possible explanations should be investigated elsewhere.

Xerophytic hardwood retention promotes competition over facilitation in longleaf pine woodlands in the absence of fire

Recent reports of xerophytic hardwood facilitation of longleaf pine seedlings challenge the traditional paradigm that co-occurring hardwood tree species constrain longleaf pine (Pinus palustris Mill.) regeneration. To better understand this dynamic, we established an experiment examining the effects of hardwood retention duration (no retention, one-year retention, four-year retention), overstory basal area (2-to-41 m2 ha−1), and understory vegetation cover on microclimatic conditions and longleaf pine seedling survival, development, physiological performance, and brownspot needle blight (Mycosphaerella dearnessii) infection in the Sandhills Ecoregion of North Carolina, USA. Light availability (μmol m−2 s−1) at the forest floor (∼20 cm) was reduced by 27% in the four-year retention treatment which significantly exceeded reductions found in the one-year (<1%) and no retention (<1%) treatments, respectively, post midstory removal. However, midstory treatment had little effect on soil moisture and temperature at 15 and 30 cm depth. Longleaf pine seedling survival (85%), aboveground biomass (7.51 g dry weight), and root collar size (1.53 cm) were significantly highest in the no retention treatment compared to the four-year retention treatment. Between treatments with midstory retention (one-year vs. four-year retention), longleaf pine seedlings were statistically larger in the one-year retention treatment (5.37 g dry weight) compared to the four-year retention treatment (4.84 g dry weight). Seedling brownspot infection did not statistically vary among midstory retention treatments. Across all midstory treatments, overstory basal area had a stronger negative effect on longleaf pine seedling aboveground biomass development, root collar development and brownspot infection compared to midstory hardwood stem density or understory vegetation cover. Moreover, for most measured metrics, overstory basal area had a stronger negative effect on longleaf pine physiological performance compared to midstory hardwood stem density. Collectively, these results indicate that hardwood retention did not facilitate longleaf pine survival and development in the grass stage and that asymmetric competition from the overstory represents a stronger impediment to longleaf pine sapling recruitment than midstory hardwoods.

Associations between neck circumference and markers of dysglycemia, non-alcoholic fatty liver disease, and dysmetabolism independent of Body Mass Index in an Emirati population.

AimNeck circumference (NC) is quick and easy to measure and may be a useful surrogate marker for body composition. We investigated NC as a potential marker of dysglycemia, MetS, and NAFLD.Methods674 individuals were recruited at the Imperial College London Diabetes Centre in a study of sleep apnea prevalence. Of these, 547 (Age 46 ± 11.4 years, Body Mass Index (BMI) 31 ± 6 kg/m2, 279 (51%) female, 113 normal glucose tolerance (NGT), 108 Prediabetes, 326 Type 2 diabetes (T2DM)) met all inclusion criteria for analysis. NC was measured at the thyroid cartilage, and collar size was recorded. Analysis was performed using univariate and multivariate linear regression.ResultsAdjusted for BMI, sex, and age, NC was 0.65 ± 0.3 cm greater in prediabetes (p = 0.0331), and 1.07 ± 0.28 cm greater in T2DM, compared with NGT (p = 0.0002). Adjusting for BMI, sex, and glycemic status, 1-cm increase in NC was associated with a 1.04 ± 1.01 U/L (p <0.0001) increase in ALT and, additionally, correcting for statin use, a 0.03 ± 0.01 mmol/L reduction in HDL (p <0.0001) and a 0.1 ± 0.02 increase in TC : HDL. A 1 cm increase in NC was associated with a 1.15 ± 1.02% (p <0.0001) increase in 10-year AHA cardiovascular risk in individuals over 40 years old and a 0.16 ± 0.02 (p <0.0001) increase in NAFLD fibrosis score. The neck circumference was associated with the hazard of new onset of deranged ALT adjusted for age, sex, glycemic status, and BMI (hazard ratio 1.076 (95% CI 1.015–1.14, p = 0.0131) and with the incidence of Fatty Liver Index associated with high probability of NAFLD (hazard ratio 1.153 (95% CI 1.019–1.304), p = 0.0239).ConclusionNC is associated with dysglycemia, components of the MetS, and factors predictive of NAFLD, but does not appear to independently predict subsequent progression to high risk of liver fibrosis in this predominantly diabetic population.

Countermeasures for local scour at offshore wind turbine monopile foundations: A review

Local scour at monopile foundations of offshore wind turbines is one of the most critical structural stability issues. This article reviews the contemporary methods of scour countermeasures at monopile foundations. These methods include armouring countermeasures (e.g., riprap protection) to enhance the anti-scour ability of the bed materials and flow-altering countermeasures (e.g., collars and sacrificial piles) to reduce downflow or change flow patterns around the monopiles. Stability number and size-selection equations for riprap armour layers are summarised and compared. Moreover, other alternative methods to riprap are briefly introduced and presented. A typical graph of the scour depth reduction with different collar sizes and elevations under specific test conditions is summarised and compared with a plot for a pile founded on a caisson. Reduction rates for different flow-altering countermeasures, including the collar, are listed and compared. A newly developed soil improvement method, namely microbially induced calcite precipitation (MICP), is also reviewed and introduced as a scour protection method. As a popular bio-soil treatment method, MICP has a good potential as a scour countermeasure method. Bio-soil treatment methods and traditional armouring methods are defined as active and passive soil enhancement scour countermeasures, respectively.

Variable negative external pressure-an alternative to continuous positive airway pressure for the treatment of obstructive sleep apnea: a pilot study.

To assess variable negative external pressure (vNEP) therapy using a range of pressures and varying collar sizes and shapes to identify combinations that improve the efficacy and comfort of this emerging therapy for obstructive sleep apnea (OSA). This prospective, open-label pilot study included 28 eligible patients (71% men) having documented moderate OSA (apnea-hypopnea index [AHI] 15 events/h ≤ AHI ≤ 30 events/h) at 1 sleep clinic for an overnight, in-lab sleep trial. Each participant tested at least 2 of 6 available vNEP devices during sleep periods ≥ 2 hours. During the assessment of AHI by polysomnography, negative pressures of -20 cm H2O to -35 cm H2O were adjusted to improve each patient's response. Participants' therapeutic preferences were assessed by a questionnaire and interviews. Twenty (71%) of the participants responded to vNEP therapy: excellent response (AHI ≤ 5 events/h) was observed in 14 (50%); 6 (21%) achieved a partial response (AHI ≤ 50% baseline). For the 20 responders, the therapy reduced the fraction of total sleep time when peripheral oxygen saturation < 90% and improved minimum pulse oximetry oxygen saturation. Six patients experienced a minor, self-limited adverse event. Twenty-six participants (93%) stated that they would use vNEP nightly. In this pilot study, vNEP therapy markedly improved AHI and oxygenation in most patients with moderate OSA. The majority of participants found vNEP comfortable and preferable to prevailing OSA therapies. Further development and studies of vNEP are warranted. Registry: ClinicalTrials.gov; Name: Study of Variable Negative External Pressure (vNEP) in Reducing Respiratory Event in Individuals With OSA; URL: https://clinicaltrials.gov/ct2/show/NCT04718142; Identifier: NCT04718142. Kram JA, Pelayo R. Variable negative external pressure-An alternative to continuous positive airway pressure for the treatment of obstructive sleep apnea: A pilot study. J Clin Sleep Med. 2022;18(1):305-314.

A systematic review of the perforated duodenal diverticula: lessons learned from the last decade

BackgroundThe perforated duodenal diverticulum remains a rare clinical entity, the optimal management of which has not been well established. Historically, primary surgery has been the preferred treatment modality. This was called into question during the last decade, with the successful application of non-operative therapy in selected patients. The aim of this systematic review is to identify cases of perforated duodenal diverticula published over the past decade and to assess any subsequent evolution in treatment.MethodsA systematic review of English and non-English articles reporting on perforated duodenal diverticula using MEDLINE (2008–2020) was performed. Only cases of perforated duodenal diverticula in adults (> 18 years) that reported on diagnosis and treatment were included.ResultsSome 328 studies were identified, of which 31 articles met the inclusion criteria. These studies included a total of 47 patients with perforated duodenal diverticula. This series suggests a trend towards conservative management with 34% (16/47) of patients managed non-operatively. In 31% (5/16) patients initially managed conservatively, a step-up approach to surgical intervention was required.ConclusionConservative treatment of perforated duodenal diverticula appears to be an acceptable and safe treatment strategy in stable patients without signs of peritonitis under careful observation. For patients who fail to respond to conservative treatment, a step-up approach to percutaneous drainage or surgery can be applied. If surgery is required, competence in techniques ranging from simple diverticulectomy to Roux-en-Y gastric diversion or even Whipple’s procedure may be required depending on tissue friability and diverticular collar size.

CHROMOSOMAL PATHOLOGY MARKERS IN FETUS AT THE AGE OF 10-13 WEEKS + 6 DAYS

The most complete information about chromosomal pathology presence in fetuses of thefirst trimester of pregnancy is provided by the use of complex markers: PAPP-A (plasmaprotein-A associated with pregnancy) + free β-hCG (human β chorionic gonadotropin)ultrasound (CP - collar space + nasal bone) for the 10-14th week of development.Purpose of the work – determination of the risk of chromosomal pathology in fetuses inthe first trimester of pregnancy based on markers: biochemical testing of PAPP + freeβ-hCG from the 10-14th week of pregnancy; Ultrasound investigation (US): measurementof the collar space and nasal bone presence.Material and methods: 258 pregnant women with a high risk of chromosomalabnormalities in the first trimester were examined by means of markers: biochemicaltesting of PAPP + free β-hCG and measurements of the collar space. The values ofthe measured markers are expressed as a constituent of the expected median for thecorresponding gestational term. Medians, the 5th and 95th percentiles, percentage outsidethe expected 5th and 95th percentiles, as well as percentage outside the expected 5th /95th percentiles to establish fetal pathology. The study was performed on an ultrasoundscanner Voluson Expert 8 using a transducer with 3-4D transabdominal RAB 4-8D, RAB6-D, and transvaginal RIC 5-9D. Medical Center "EKHOMED" is engaged in expertultrasound envestigations, as well as invasive examinations, which are required for verification of fetal pathology, is the base of Danylo Halytsky Lviv Medical University,DPGE, Department of Radiation Diagnostics.Results. The analysis was carried out in 258 pregnant women with a high risk ofchromosomal abnormalities in the first trimester using markers: biochemical testing ofPAPP + free β-hCG from 10-14 weeks of pregnancy; measurement of the collar spacethickness and visualization or absence of the nasal bone. The pathology is increasedexponentially with the collar space from 0.2% for those fetuses whose thickness isbetween the 5th and 95th centiles, up to 65% for a thickness of 6.5 mm or more. Inthe group of fetuses with chromosomal abnormalities, about 50% have trisomies 21,25% have trisomies 18 or trisomies 13, 10% have Turner syndrome, 5% have triploidy,and 10% have other chromosomal abnormalities. The combination of collar size andPAPP-A and free ß-hCG testing results in a sensitivity of over 90% and a specificity ofover 95%. The rate of false positives is reduced from 3.0% to 2.5%.Conclusions. The thickness of the collar space in chromosomal abnormalities growsexponentially with the thickness of the collar space from 0.2% for those fetuses whosethickness is between the 5th and 95th centile, up to 65% with a collar space thicknessof 6.5 mm or more. In the group of fetuses with chromosomal abnormalities, about 50%have trisomies 21, 25% have trisomies 18 or 13, 10% have Turner's syndrome, 5% havetriploidy, and 10% have other chromosomal abnormalities. The combination of the sizeof the collar space and PAPP-A and free ß-hCG determinations showed a sensitivity ofmore than 90% and a specificity over 95%.

Selection of suitable knitting parameters for 1 x 1 rib collar manufacturing in V-bed knitting machine

The main components of a polo shirt are the body and collar. For different body measurements, different collar sizes are needed. It is very crucial to select the perfect collar size according to body size; otherwise, collar size will be larger or smaller than the required size. However, producing and maintaining perfect collar size concerning body size is very tough as the collar is tiny. If the finished collar size is larger or smaller than the appropriate size, the manufacturer is supposed attach the incorrectly measured collar to the body, placing the customer at risk of a vital quality argument. Otherwise, the manufacturer would have to remake the collar, wasting both time and money. Sometimes, the knitting industry has to deal with purchase order cancellations due to a lack of lead time for replication. To avoid the complexities described earlier, quantitative equations for collar production based on the number of ply, stitch duration, and needle count were established in this study. The precision of this exploration work is approximately 100 percent for matching exact collar size with body size. As a result, the evolved technique can be used in the textile knitting industry to ensure that accurate specifications are met the first time.

Post-traumatic pseudoaneurysm of the external carotid artery

Our case is about a 24-year-old male who consults in an emergency for a left cervical swelling with a history of a penetrating cervical trauma occurred 15 days before. Computed Tomography (CT) was performed who shows a hypo dense left cervical collection well limited surmounted by a spontaneously hyper dense hematoma (A, B), with intense enhancement on post contrast at arterial time with individualization of communication with a branch of the external carotid artery (C,D) characteristic of the pseudo aneurysm (PA). The PA or false aneurysm is defined by a rupture of the continuity of the arterial wall with creation of an aneurysmal sac thanks to a pseudo-wall formed by the adjacent structures while maintaining continuity with the nourishing artery, PA carotid arteries are often post-traumatic sometimes other cause are involved (vasculitis, local infection, iatrogenic). The interval between trauma and symptoms is very variable, it results in a pulsating and pulsating cervical swelling on palpation with an audible noise on auscultation, ultrasound shows a cystic mass with a turbulence in the blood flow making the yin-yong sign on doppler examination and to-and-fro waveforms on the pulsed Doppler examination. Computed Tomography generally targets a hypo-dense collection with an intense vascular type enhancement in arterial time and a smooth wall which communicates with a nourishing artery. Magnetic resonance imaging (MRI) allows more characterization (morphology, size of collar, study of collaterality). Conventional angiography is an invasive examination which generally presents a therapeutic interest (stenting, embolization) while the surgical indication is reserved for specific cases.

Best practice for collar deployment of tri-axial accelerometers on a terrestrial quadruped to provide accurate measurement of body acceleration

BackgroundTri-axial accelerometers are frequently deployed on terrestrial quadrupedal mammals using collars, because they are easy to fit and are thought to have minimal impact on the subject. Collar-attached devices are not fixed to the body and can move independently of the body. This may result in inaccurate measures of acceleration, reducing the accuracy of measured body movement. We determined the effect of collar size and collar weight on acceleration measured by a collar-mounted accelerometer on a quadruped mammal. The aim was to suggest best practice for sizes and weights of collars on which to deploy tri-axial accelerometers. Using pygmy goats, Capra aegagrus hircus, which were trained to walk at different speeds (0.8–3.0 km/h) on a treadmill, we measured body acceleration using a collar-mounted tri-axial accelerometer, with different collar sizes (individual neck circumference + 1 cm to + 9 cm) and collar weight (0.4% to 1.2% of individual weight).ResultsThere was a significant effect of collar size, collar weight and walking speed on measured acceleration. Measured acceleration was less accurate and more variable when collars were looser and heavier. To measure body acceleration more accurately, we found that collar size should be within 5 cm or 16% of an individual’s neck circumference when it was heavy (up to 1.2% of animal’s body weight) or within 7 cm (33%) of neck circumference if the collar was light (up to 0.6% of animal body weight).ConclusionWe suggest that not only reporting collar size and weight for welfare purposes, but it is also important to consider these aspects for scientific rigour, to ensure data are collected as accurately as possible. We provide guidelines for researchers fitting collar-attached devices to ensure a higher degree of accuracy of recorded body acceleration.

0559 Treatment of Obstructive Sleep Apnea with Continuous Negative External Pressure

cNEP is a novel treatment for OSA that involves external application of negative pressure over the upper airway via a silicone collar with an integral vacuum source. Previous studies indicate that cNEP reduces apnea-hypopnea index (AHI) during single night polysomnography (PSG). The current study assessed cNEP during 3 weeks of home use. This was a prospective, open label, single arm study in subjects with baseline AHI between 10 and 50/hr (>80% obstructive apneas). The primary efficacy endpoint was an AHI during an observed PSG after 3 weeks of home use (PSG2), where AHI was <15/hr and < 50% of baseline. To qualify, subjects were required to fit one of the two available cNEP collar sizes and to have a successful cNEP titration as defined by an AHI < 15 and < 50% baseline during an in lab PSG (PSG1) where response to two pressures (-25 and -30 cmw) was assessed. Results: 71 subjects (46 males) were enrolled. 23 (36.5%) were treatment naïve. Demographic characteristics included (mean ± S.D.) age 54.6 ± 11; BMI 28.3 ± 4.1; baseline AHI 27.5 ± 11.7. 59 subjects completed PSG1. 27 subjects (46%) exhibited an initial response at PSG1. 16 subjects (64%) exhibited a sustained response at PSG2. An additional 5 subjects had a reduction in AHI, which did not reach the primary endpoint. Compared to baseline, mean AHI was reduced in responders at both PSG1 (6.6 v. 26.7) and PSG2 (7.6 v. 26.7) (p<0.001). Nightly usage of cNEP averaged 4.34 hours. Most subjects and their bed partners preferred cNEP to other OSA treatments. Adverse events consisted mainly of transient local irritation at the collar site. In four subjects, AHI increased from baseline during PSG1 and changed the OSA severity classification in three. Conclusions: cNEP is a safe, effective and well-tolerated intervention during 3 weeks of home use in subjects with moderate and severe OSA. Support: Sommetrics, Inc.

Self-reported sleepiness in the context of fitness-to-drive

BackgroundExcessive daytime sleepiness (EDS) is a contributing factor to road traffic accidents. It is commonly assessed using self-administered questionnaires. These assessments are important information when discussing with the Driver and Vehicle Licensing Agency (DVLA) about fitness-to-drive. We hypothesised that patients may be confounded in their assessments after being informed about these potential implications.Patients and methodsThis was a prospective single-centre study. Patients attending clinics for sleep-disordered breathing were asked to fill in the Epworth Sleepiness Scale (ESS) and the Stanford Sleepiness Scale (SSS). Following their consultation, patients were informed about EDS in the context of driving and that the DVLA might request information based on their self-assessed sleepiness. They were then asked to complete the same questionnaires again. Parameters recorded included age, gender, body mass index (BMI), driving licence holder, and collar size. An ESS score above 10 points was defined as EDS.ResultsOne hundred twenty-two subjects were studied (age 59.4 years (15.2); 72 males; BMI 32.1 kg/m2 (8.3), driving licence held for 25.2 years (20.6) (n = 94); collar size 42.7 cm (5.0)). There was no difference in the ESS [8 (8) vs 8 (8) points; p = 0.289] or the SSS [2 (2) vs 2 (2) points; p = 0.320] between the two occasions, although seven patients (5.7%) changed their scores from “sleepy” to “non-sleepy” and four patients (3.3%) from “non-sleepy” to “sleepy”.ConclusionProviding patients with information about the risk of driving in the context of sleepiness does not significantly change how they score their symptoms using self-administered questionnaires; only about 9.0% of the patients had inconsistent results.

First Record of Echinoparyphium recurvatum (Trematoda, Echinostomatidae) in Pakistan with New Avian Definitive Host, Vanellus leucurus

Parasitological examinations of White-tailed Lapwing Vanellus leucurus (Charadriiformes: Charadriidae) collected from Dadu district (Sindh Province, Southern Pakistan) were carried out at the Department of Zoology, University of Sindh, Jamshoro. A total of 64 trematodes belonging to the genus Echinoparyphium [1], were collected from the small intestine of two individual hosts. On the basis of the number and varying size of collar spines, number and size of ventral spines, body shape, arrangement of genital organs, distribution of vitellaria and other diagnostic characters, these trematodes were identified as Echinoparyphium recurvatum [2]. Our study provides the first Pakistan record of the trematode E. recurvatum with also the first record of V. leucurus as avian definitive host.

Predictability of airway evaluation indices in diabetic and nondiabetic patients requiring general anesthesia with endotracheal intubation

Introduction: Difficult airway management (intubation and/or ventilation) results in significant morbidity and mortality. In the present study, we evaluated various clinical parameters of airway assessment and their ability to predict difficult laryngoscopy and intubation in patients with diabetes mellitus (DM) compared to nondiabetic individuals. Methods: In this prospective comparative study, we enrolled an equal number of 110 patients in DM group and non-DM group. Patients were examined for body mass index (BMI), Modified Mallampati class (MMC), mouth opening, neck extension (NE), mobility of mandible by upper lip bite test, thyromental distance (TMD), collar size, palm print sign, and prayer sign. Primary outcome measure was Cormack and Lehane's grading on direct laryngoscopy. The comparison of quantitative and qualitative variables between the groups was done using unpaired Student's “t”-test and Chi-square test, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value of each test were done. Results: In DM patients, sensitivity was highest for MMC followed by prayer sign, whereas specificity was highest for palm print, followed by TMD, BMI, prayer sign, and other predictors. In non-DM individuals, sensitivity was highest for MMC whereas specificity was highest for prayer sign, followed by TMD, palm print and NE, and other predictors. Conclusions: In DM patients, sensitivity and specificity was highest for MMC and palm print, respectively. In non-DM individuals, sensitivity was highest for MMC whereas specificity was highest for prayer sign. A combination of tests may predict difficult laryngoscopy.

Effects of cell morphology and attachment to a surface on the hydrodynamic performance of unicellular choanoflagellates.

Choanoflagellates, eukaryotes that are important predators on bacteria in aquatic ecosystems, are closely related to animals and are used as a model system to study the evolution of animals from protozoan ancestors. The choanoflagellate Salpingoeca rosetta has a complex life cycle with different morphotypes, some unicellular and some multicellular. Here we use computational fluid dynamics to study the hydrodynamics of swimming and feeding by different unicellular stages of S. rosetta: a swimming cell with a collar of prey-capturing microvilli surrounding a single flagellum, a thecate cell attached to a surface and a dispersal-stage cell with a slender body, long flagellum and short collar. We show that a longer flagellum increases swimming speed, longer microvilli reduce speed and cell shape only affects speed when the collar is very short. The flux of prey-carrying water into the collar capture zone is greater for swimming than sessile cells, but this advantage decreases with collar size. Stalk length has little effect on flux for sessile cells. We show that ignoring the collar, as earlier models have done, overestimates flux and greatly overestimates the benefit to feeding performance of swimming versus being attached, and of a longer stalk for attached cells.

Effects of collar size and buried depth on the measurement of soil respiration in a typical steppe

Effects of collar size and buried depth on the measurement of soil respiration in a typical steppe

Validation of a Simple Overlay Device to Assess Radial Head Implant Length.

A simple overlay device (SOD) was developed to measure radial head implant length. The purpose of this study was to determine the accuracy and reliability of this device for measuring experimental radial head implant length. Five fresh frozen cadavers were implanted with sequentially longer implants, adjusted by neck length (0, 2, 4, and 8 mm). Fluoroscopic images were obtained in 4 forearm positions: anteroposterior in supination in full extension, anteroposterior in pronation in full extension, supinated in 45° of flexion, and neutral in 45° of flexion. The SOD measurements (made by 2 observers) were compared with the native original radial head (control) to assess implant length. In addition, gapping of the ulnohumeral joint space was measured for comparison purposes. The measured radial head and neck lengths for the specimens were 33, 39, 31, 34, and 42 mm. The difference between the actual radial head and neck lengths and those measured with the SOD template averaged less than 2 mm for all 4 collar sizes, except in 1 measurement in which the bicipital tuberosity could not be visualized. The median intraclass correlation coefficients for observer 1 compared with the SOD were 0.94 to 0.99. The median intraclass correlation coefficients between observers were 0.88 to 0.95. For both observers, elbow position, collar height, and the 2 variables combined did not significantly affect the SOD values. The other method that was evaluated, that of measurement of the ulnohumeral joint space, had higher interobserver variability versus the SOD, and allowed detection of lengthening of over 4 mm. The SOD is a reliable method for simply assessing radial head length with radiographs and can accurately detect 2 mm or more of proximal radial lengthening. The SOD is a simple and accurate method that can help to optimize radial head sizing.