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Pruebas predictoras de vía aérea difícil y clasificación cormack-lehane en adultos. ¿mito o realidad?
No full textAirway management is of concern for the anesthesiologist and it is their duty to anticipate difficulties in performing intubation. There are multiple tests to predict the difficult airway. Objective: To describe the results between the Mallampati scale, interincisor distance, sternomental distance and neck circumference and the Cormack- Lehane scale to anticipate a difficult airway. Patients and Methods: Quantitative, descriptive, cross-sectional study; The data was obtained through the application of a questionnaire at the Doctor Mario Catarino Rivas National Hospital. A total of 50 patients over 18 years of age. Results: On the Mallampati scale, 4 (44%) they were difficult intubation according to the results of Cormack-Lehane scale. In the opening greater than 3 cm, 32 (94%) were easy intubation. Of the patients with sternomental distance greater than 13 cm, 41 (89.1%) underwent easy intubation.In neck thickness less than or equal to 36 cm, 32 (94%) were easy intubation. Conclusion: When comparing the results of predictive tests for difficult airway and the Cormack-Lehane classification, it was found that the scales of Mallampati and mouth opening were similar with the Cormack-Lehane classification.El manejo de la vía aérea es de preocupación del anestesiólogo y es su deber anticipar las dificultades al realizar una intubación. Existen múltiples pruebas para predecir la vía aérea difícil. Objetivo: Describir los resultados de las escalas de Mallampati, distancia interincisivos, distancia esternomentoniana y circunferencia de cuello y la clasificación de Cormack-Lehane en pacientes adultos sometidos a cirugía electiva bajo anestesia general. Pacientes y Métodos: Estudio cuantitativo, descriptivo, de corte transversal; método de recolección de datos fue: cuestionario; en el Hospital Nacional Doctor Mario Catarino Rivas. Un total de 50 pacientes mayores de 18 años. Resultados: En la escala de Mallampati 4 (44%) de los pacientes fueron intubación difícil coincidiendo conlos resultados de la escala de Cormack-Lehane. En la apertura mayor de 3 cm el 32 (94%) fueron intubación fácil. De los pacientes con distancia esternomentoniana mayor de 13 cm el 41 (89.1%) fueron intubación fácil. En el grosor del cuello menor o igual a 36 cm, 32 (94%) fueron intubación fácil. Conclusión: Al comparar los resultados de pruebas predictoras de via aérea difícil y la clasificación de Cormack-Lehane se encontró que la clasificación de Mallampati y apertura bucal fueron similares a la clasificación Cormack-Lehane
Dysidea teawanui Mc Cormack & Kelly & Battershill 2020, sp. nov.
No full textDysidea teawanui sp. nov. Figs 1, 6–8 urn:lsid:zoobank.org:act: 6476B247-9085-46A4-B7DE-7D8F97BEFBCA Material examined. Tauranga Harbour, Bay of Plenty: Holotype— NIWA 113650, 37.681° S, 176.171° E, 8 m, 27 Nov 2018. Paratypes— Pilot Bay, Tauranga Harbour , Bay of Plenty: NIWA 113651–113655, 37.681° S, 176.171° E, 12 m, 09 Dec 2018, SCUBA dive. Distribution. Tauranga Harbour, Bay of Plenty, New Zealand, 8– 12 m. Description. Massive, spherical to hemispherical, multilobed cushions, frequently conjoined, forming broad matts covering up to 2.5 m 2 (Fig. 6 A–E), typically 10–50 cm long, 6–50 cm wide, 7.5–10 cm high; immature specimens spherical with low surface mounds (Fig. 6C), often 3–4 cm long, 1.5–3 cm wide, 1.5–2.5 cm high. Larger specimens frequently only alive in the top 4–5 cm of the sponge; when torn, the base is usually dead with only the ladder-like primary fibres visible (Fig. 7A). Surface with regularly spaced conules, 1–3 mm in height (Fig. 6 C–E), granular to the touch. Cobwebs of fibrillar collagen in the surface membrane are clearly visible, stretching between the tips of primary fibres, joining adjacent conules (Fig. 6E). Oscules are relatively large, up to 5 mm diameter, scattered over the surface, with raised translucent collars (Fig. 6C, E). Texture in life, soft, slightly elastic, compressible. In life, the sponge is covered in sediment, appearing as rock substrate. Colour in life beneath surface sediment, powder blue-grey externally (Fig. 6 C–E; 7A), cream to tan, sometimes orange-tinged in the non-illuminated base, cream in ethanol. Dermal membrane translucent. Skeleton. Large, thick, primary fibres, 483 (300–800) µm diameter, relatively uniform in their thickness, dominate the skeleton (Fig. 7A), forming an irregular, laddered reticulation (Fig. 7B) with thin secondary fibres 113 (80– 160) µm diameter, flanged where they join the primary fibres (Fig. 8A, B). Thin, clear, auxiliary secondary fibres are visible in places; about 15 µm thick (Fig. 7B). All secondary fibres are solidly cored, spongin along the edges of the fibres is not visible. The secondary fibres directly link the primary fibres or may form a reticulation between the primary fibres (Fig. 8A, B). Primary fibres diverge from the base of the sponge (Fig. 7A), forming meshes about 814–2567 µm long and 800–1500 µm wide. All fibres heavily cored with sand and foreign spicule fragments. Ectosome cavernous, mesohyl shrinking between the fibres in the preserved specimen (Fig. 7A). Canals filled with detritus and sediment, possibly resultant from worm activity in the aquiferous canals. Ectosome about 108 (105–140) µm deep, reinforced by a thin layer of fibrillar collagen (Fig. 8C), strands of which stretch between the apex of the primary fibres (Fig. 6E). A translucent dermal membrane is raised by large primary fibres, rarely with any inclusions of detritus; unarmoured (Fig. 8C). Choanocyte chambers are obscured by the abundant detritus in the mesohyl. Substrate, depth range and ecology. Found on sheltered rocky reef substrate, covering rocks and boulders to a depth of 10 cm, and on wharf pilings, 5–8 m deep. The clown nudibranch, Ceratosoma amoenum (Cheeseman, 1886) predates on this species, and fan worms are often integrated into the matrix of the sponge. Etymology. Named for Tauranga Moana, Te Awanui, a spiritual symbol of identity for all whanau, hapu and iwi living in the harbour catchment area (Te Awanui, Tauranga Moana; te reo Māori). This species name was accepted and approved by local Tauranga Moana iwi, Ngāti Ranginui, Ngāi Te Rangi and Ngāti Pūkenga. Remarks. Dysidea teawanui sp. nov. has a highly characteristic morphology and colouration that separates it clearly, in the field, from D. tuapokere sp. nov. in the same location; D. teawanui sp. nov. forms massive, pale blue-grey, multi-lobed cushions or spheres while D. tuapokere sp. nov. forms a cavernous lilac mass of lobed branches. Only two species noted from New Zealand waters, Dysidea sp. ‘b’ of Brøndsted (1924) and D. elegans (Nardo, 1847) sensu Brøndsted (1927) (Table 1), vaguely resemble the characteristic cushion-shape of D. teawanui sp. nov. Dysidea sp. ‘b’ Brøndsted, 1924, from a “sandy mud” seabed, at 46 m in Carnley Harbour on the Auckland Islands (see Brøndsted 1924: 165), provides a reasonable description of a sponge attached to shell, with a variable shape, but generally “oblong, lump-shaped”. The “greatest extent” was about 50 mm, the colour in life was “pale grey to greyish yellow” and the surface was conulose, conules being 1 mm high and 4 mm apart. The primary fibres formed an irregular network, generally running perpendicular to the surface and were about 160 µm thick. The thinner spongin fibres were “almost devoid of foreign particles”, and the primary fibres cored with sand grains and broken spicules. While the general form and colour in life are reminiscent of D. teawanui sp. nov., the fibres are much thinner than in the latter. Furthermore, as for D. tuapokere sp. nov., the possibility of conspecificity of D. teawanui sp. nov. with a Subantarctic New Zealand sponge, is low. Finally, with relatively clear secondary fibres, the sponge may be more closely comparable to several Chatham Rise species described by Bergquist (1961b) as Leiosella levis (Lendenfeld, 1886), Polyfibrospongia australis (Lendenfeld, 1888) [now considered to be Fasciospongia turgida (Lamarck, 1814) (Van Soest et al. 2018a)], or Euryspongia arenaria Bergquist, 1961b. Dysidea laxa (Lendenfeld, 1889: 671), from 30–40 m in Port Philip Bay, Australia, is the only other Southwest Pacific species of Dysidea that has a massive, lobose morphology with a light bluish-violet colour in life. However, unlike for D. teawanui sp. nov., the surface is tuberculate, sand-armoured and the oscules are arranged in a longitudinal series along the sides of the lobes. The fibres of D. laxa are quite large (200–500 mm thick) but they form a highly irregular, angular network in which the primary fibres are not clearly pronounced, differentiating it further from D. teawanui sp. nov., which has a highly regular ladder-like architecture. While all fibres in D. laxa are charged with small, abundant sand grains, these are more irregularly scattered in the slender fibres (after Lendenfeld 1889).Published as part of Mc Cormack, Samuel P., Kelly, Michelle & Battershill, Christopher N., 2020, Description of two new species of Dysidea (Porifera, Demospongiae, Dictyoceratida Dysideidae) from Tauranga Harbour, Bay of Plenty, New Zealand, pp. 523-542 in Zootaxa 4780 (3) on pages 534-537, DOI: 10.11646/zootaxa.4780.3.5, http://zenodo.org/record/385533
The politics and economics of regulatory impact assessment
No full textThis is the author accepted manuscript. The final version is available from the publisher via the link in this record
Dysidea tuapokere Mc Cormack & Kelly & Battershill 2020, sp. nov.
No full textDysidea tuapokere sp. nov. Figs 1–4 urn:lsid:zoobank.org:act: F79D832D-AD90-44CE-A18C-83DB4E29306C Material examined. Pilot Bay, Tauranga Harbour, Bay of Plenty: Holotype— NIWA 92974, 37.380° S, 176.102° E, 5–12 m, 27 Sep 2017. Paratypes— NIWA 113646–113649, 37.380° S, 176.102° E, 13 m, 05 Feb 2019. Type location & distribution. Pilot Bay, Tauranga Harbour, Bay of Plenty, New Zealand, 12–13 m. Description. Sponge forms a cavernous mass of interconnected lobate digits, sprawling across the substrate, up to 4–23 cm long, 14–15 cm wide, 2–4 cm high, in general dimensions, digits about 1–3 cm thick (Fig. 2A). Surface conulose in life, conules predominantly clustered on the tips of the lobes (Fig. 2B), but scattered irregularly on the surface, about 0.5–1.0 mm high; conule apices resemble hairs in the preserved specimen (Fig. 2C). Dermal membrane thin and translucent in life and after preservation. Cobwebs of fibrillar collagen in the surface membrane are visible, stretching between the tips of primary fibres, between which are set membranous oscules, about 2 mm diameter (Fig. 2A, B). Conules accentuated in the shrunken, preserved condition (Fig. 2C). Texture soft, compressible, slightly elastic and fragile due to the incorporation of large amounts of detritus in the fibres. Colour in life, translucent lilac under natural lighting in situ (Fig. 2A, C), and tan in shaded sections (Fig. 2C). Cream to tan in preservative. Skeleton. Primary fibres heavily cored with sand and foreign spicule fragments, about 308 (200–500) µm thick (Fig. 3A), frequently bifurcating or divaricating further below the surface (Fig. 3B). Secondary fibres are variable in thickness, often flanged where they join the primary fibre, and generally only partially cored, in which case the laminated golden spongin is visible surrounding the inclusions in histological sections (Fig. 4A, B); 69 (50–100) µm thick. The secondary fibres are supported by cored auxiliary fibres that link the secondary and primary fibres; 10–15 µm thick (Fig. 3B). The overall architecture is extremely irregular and mesh size difficult to provide meaningful dimensions for but range from about 0.5–3 mm wide. The irregularity of the overall skeleton is evident in Figs 2A and B which show the surface conules clustered in groups on the tips of the branches, being evidence of extensive divarication below the surface [compare to the regularity of the surface in D. cf. cristagalli (Fig. 5) and D. teawanui sp. nov. (Fig. 6D)]. The ectosome consists of a dense band of pigmented collagen fibrils (Fig. 4C) and appears cavernous in sections; about 30–100 µm deep, strands of which stretch between the apex of the primary fibres. A translucent dermal membrane is raised by large primary fibres, rarely with any inclusions of detritus; unarmoured (Fig. 4C). The choanocyte chambers are eurypylous, 30–50 µm diameter, and clearly visible in the choanosome (see Fig. 3A, 4A, B). Detritus is scattered lightly through the choanosome and ectosome. Substrate, depth range and ecology. Found predominantly on rocky reefs within a relatively sheltered location. Associated with kelp forests or sponge gardens. Depth range is 5– 12 m. Etymology. Named for the beautiful, translucent, pale lilac colouration of this species in life (tuapokere, violet; te reo Māori). This species name was accepted and approved by local Tauranga Moana iwi, Ngāti Ranginui, Ngāi Te Rangi and Ngāti Pūkenga. Remarks. Dysidea tuapokere sp. nov. is a shallow-water harbour species, with a cavernous lobo-digitate morphology, similar to several species described or noted from New Zealand waters. Most of these species are, however, inadequately described and figured, so only a limited comparison can be made in most cases. The most recently described species, D. cristagalli Bergquist, 1961a, was collected from the intertidal zone on Rangitoto Island in the North Island’s Waitemata Harbour, and the Noises Islands in the inner Hauraki Gulf (Table 1). Dysidea cristagalli differs morphologically from D. tuapokere sp. nov. in being, “erect, tubular in shape, with several tubes coalescing to give a tubula-flabellate condition” (Bergquist 1961a: Fig. 1b). The oscules were “apical, giving access to deep cloacae”, a completely different morphology to the cavernous lobo-digitate form of D. tuapokere sp. nov. which has small, flush oscules scattered across the sponge. Additional key differences are the colouration in life (D. cristagalli: “ash-grey”; D. tuapokere sp. nov.: translucent lilac) and skeletal architecture: Bergquist (1961a) stated that she could not distinguish between the primary and secondary fibres, which ranged in diameter from 20–200 µm, whereas in D. tuapokere sp. nov. the secondary fibres are much smaller than the primaries which can be up to 500 µm thick. Bergquist (1961a) also noted that the fibres of D. cristagalli are exclusively packed with broken sponge spicules. Several specimens have been attributed to D. cristagalli with hesitation, including one by Kelly in McNamara et al. (2005). That sponge (NIWA 101432) was described as forming a “spherical mass of meandering ridges and interconnected short blunt branches”, with oscules situated on the ends of branches and along the tops of ridges (Fig. 5). While this arrangement is superficially similar to the “tubula-flabellate” condition of Bergquist’s D. cristagalli, the oscules in NIWA 101432 do not lead to deep cloacae (Fig. 5). Although the colour of NIWA 101432 was cited as “greyish white”, the in -situ image was taken in natural lighting and is misleading with red light absorption at depth. The skeleton of NIWA 101432 is comprised of a loose reticulation of large sand-grains cemented into fibres with spongin clearly visible, connected to each other by numerous fibres containing predominantly spicule debris, features not noted by Bergquist (1961a). With the benefit of hindsight, the sponge NIWA 101432 is almost certainly not Dysidea cristagalli, most likely representing a new species. Dysidea tuapokere sp. nov. is distinct from NIWA 101432 in the sandy surface texture of the latter (implying a dermal membrane charged with detritus), and in the extremely regular disposition of the surface conules, compared to that in D. tuapokere sp. nov. (compare Fig. 2A, B). Dysidea spiculivora (Dendy, 1924) was described as “irregularly massive, sub-digitate, 54 mm long, 20 mm diameter, probably repent,” with a “coarsely sub-conulose surface with conuli low and far apart”. The interior was cavernous and no oscules were seen. The colour in life was described as “white, with a curiously translucent appearance”. Dendy described the skeleton as an irregular jumble of spicules and a dermal skeleton was not noted by Dendy (Table 1). Two specimens closely comparable to this, NIWA 52374 and NIWA 52390, have been collected since this first description: the defining characteristics are the translucent white colouration in life, the cavernous interior and broadly sub-conulose surface. Dysidea sp. ‘a’ Brøndsted, 1924, from the Auckland Islands (Table 1), is closely comparable to D. tuapokere sp. nov. in morphology, composed of “densely anastomosing, evenly thick branches” about 40–50 mm long, with a regular, abundantly conulose surface and small oscules, a “thin, pellucid dermal membrane”, a soft consistency and the colour of flesh. However, no skeletal description was attempted as Brøndsted admitted to unfamiliarity with the genus; a direct comparison is not possible in this work. The likelihood of conspecificity of D. tuapokere sp. nov. with this ill-defined, almost unrecognisable Auckland Island specimen, is low: there are only a few precedents of well-characterised, deep subtidal species, existing off both the North Island and Subantarctic New Zealand (see Sim-Smith & Kelly 2019).Published as part of Mc Cormack, Samuel P., Kelly, Michelle & Battershill, Christopher N., 2020, Description of two new species of Dysidea (Porifera, Demospongiae, Dictyoceratida Dysideidae) from Tauranga Harbour, Bay of Plenty, New Zealand, pp. 523-542 in Zootaxa 4780 (3) on pages 528-532, DOI: 10.11646/zootaxa.4780.3.5, http://zenodo.org/record/385533
The measurement of the output spectrum of a cobalt 60 teletherapy unit
No full textThe output spectrum of radiation emerging from a Coteletherapy unit contains a certain amount of low energy radiation in addition to the primary Co60 -rays with energies of 1.17 and 1.33 Mev. Since the beam strength is approximately 2 x 109 photons/cm2/sec at 80 cm from the source, direct measurement of this spectrum was not practicable. The spectral distribution of single scattered radiation from this beam, at each of a number of scattering angles, was therefore measured. This scattered spectrum was then converted to the output spectrum by the application of the appropriate scattering equations.
The measured spectrum was corrected for crystal and photomultiplier tube distortions by means of a correction matrix. This matrix was formulated from information contained in a paper by Berger and Doggett on the response function of NaI(Tl) crystals, and was constructed such that its intervals were proportional to the square root of the photon energy. This provided more detail in the low energy region of the matrix.
The curves of the output spectrum obtained from various scattering angles were essentially the same, and the mean spectral curve compared favorably with the theoretical data derived by Cormack and Johns
Determinants of Cormack–Lehane grading for glottic exposure in microlaryngeal surgery in Middle Delta Egyptian patients
No full textAbstract Background Laryngoscopy is a diagnostic procedure utilized in critical care to examine and visualize the larynx through the diversion of upper airway structures. Its primary functions are airway management and tracheal intubation. The objective of this study was to detect the predictors of laryngeal exposure during microlaryngeal surgery (MLS). Methods An analytical cross-sectional study was conducted on a consecutive sample of 100 patients presenting laryngeal lesions that were trans-orally microsurgeries to treat various glottic diseases (biopsies revealed 68% benign lesions such as vocal fold polyps, cysts, and nodules, and 32% glottic masses) and prepared for MLS. Results This study included 100 patients presenting laryngeal lesions from both sexes with the age of 47.0 ± 14.7 years, in multivariate logistic regression analysis, all these parameters were significant predictors for Cormack–Lehane and Italian Grading (P 35, with more protruded mandible (class C), higher Mallampati Index (class III) and shorter mento-sternal distance (≤ 12.5 cm). Conclusions During microlaryngeal surgery, BMI, mandibular protrusion test, Mallampati Index, mento sternal and AOJ extension were significant predictors of Cormack–Lehane and Italian Grading which makes it easier for laryngeal exposure
Phase Distribution Efficiency of cm-Scale Ultrasonically Powered Receivers
No full textIn the domain of ultrasonically powered biomedical implants, there is an increasing interest in cm-scale ultrasonic receivers (RX). However, when a single-element transducer is used as the RX transducer, an uneven phase distribution across the RX area can significantly reduce the harvestable power. In this paper, we investigate the impact of lateral and angular misalignment on the acoustic field phase distribution across the RX surface. We show that, for a single-element RX transducer, lateral misalignment has minimal effect on the harvestable power, whereas even small angular misalignments can cause a considerable reduction, especially for larger RX sizes. We present a potential solution that consists of subdividing a large RX transducer (e.g. 20 × 20mm2) into smaller elements, which significantly improves power transfer efficiency by taking advantage of the smaller phase variation across the surface of each element. The trade-offs between achieving a minimum acceptable power transfer efficiency and managing the increased complexity in packaging and matching circuitry are also discussed.Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Electronic Components, Technology and MaterialsBio-Electronic
Highly efficient laser-driven Compton gamma-ray source
No full textThe recent advancement of high-intensity lasers has made all-optical Compton scattering become a promising way to produce ultrashort brilliant gamma-rays in an ultra-compact system. However, so far achieved Compton gamma-ray sources are limited by low conversion efficiency and spectral intensity. Here we present a highly efficient gamma photon emitter obtained by irradiating a high-intensity laser pulse on a miniature plasma device consisting of a plasma lens and a plasma mirror. This concept exploits strong spatiotemporal laser-shaping process and high-charge electron acceleration process in the plasma lens, as well as an efficient nonlinear Compton scattering process enabled by the plasma mirror. Our full three-dimensional particle-in-cell simulations demonstrate that in this novel scheme, brilliant gamma-rays with very high conversion efficiency (higher than 10(-2)) and spectral intensity (similar to 10(9) photons/0.1%BW) can be achieved by employing currently available petawatt-class lasers with intensity of 10(21) W cm(-2). Such efficient and intense gamma-ray sources would find applications in wide-ranging areas. ©2019 The Author(s)
CM Periods, CM Regulators, and Hypergeometric Functions, I
No full textWe prove the Gross-Deligne conjecture on CM periods for motives associated with H-2 of certain surfaces fibered over the projective line. Then we prove for the same motives a formula which expresses the K-1-regulators in terms of hypergeometric functions F-3(2), and obtain a new example of non-trivial regulators
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