A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: A secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study

Background Accurate assessment of functional capacity, a predictor of postoperative morbidity and mortality, is essential to improving surgical planning and outcomes. We assessed if all 12 items of the Duke Activity Status Index (DASI) were equally important in reflecting exercise capacity. Methods In this secondary cross-sectional analysis of the international, multicentre Measurement of Exercise Tolerance before Surgery (METS) study, we assessed cardiopulmonary exercise testing and DASI data from 1455 participants. Multivariable regression analyses were used to revise the DASI model in predicting an anaerobic threshold (AT) >11 ml kg −1 min −1 and peak oxygen consumption (VO 2 peak) >16 ml kg −1 min −1, cut-points that represent a reduced risk of postoperative complications. Results Five questions were identified to have dominance in predicting AT>11 ml kg −1 min −1 and VO 2 peak>16 ml.kg −1min −1. These items were included in the M-DASI-5Q and retained utility in predicting AT>11 ml.kg −1.min −1 (area under the receiver-operating-characteristic [AUROC]-AT: M-DASI-5Q=0.67 vs original 12-question DASI=0.66) and VO 2 peak (AUROC-VO2 peak: M-DASI-5Q 0.73 vs original 12-question DASI 0.71). Conversely, in a sensitivity analysis we removed one potentially sensitive question related to the ability to have sexual relations, and the ability of the remaining four questions (M-DASI-4Q) to predict an adequate functional threshold remained no worse than the original 12-question DASI model. Adding a dynamic component to the M-DASI-4Q by assessing the chronotropic response to exercise improved its ability to discriminate between those with VO 2 peak>16 ml.kg −1.min −1 and VO 2 peak<16 ml.kg −1.min −1. Conclusions The M-DASI provides a simple screening tool for further preoperative evaluation, including with cardiopulmonary exercise testing, to guide perioperative management

Spore dispersal gradients and disease development

Non peer reviewe

Spore dispersal in relation to epidemic models

Non peer reviewe

Wind Tunnel Comparison of the Collection Efficiency of Three Hirst-Type Volumetric Sampler Drum Coatings

A large number of sites worldwide measure airborne pollen and fungal spore concentrations using a Hirst-type volumetric impaction sampler. In Europe anumber of adhesive drum coatings are routinely used. The drum coating routinely used in the UK, V/P,consisting of 90% petroleum Jelly (Vaseline)/10%paraffin wax, has not previously been compared with other coatings, for fungal spores or pollens. The collection efficiency of different coatings was compared in a wind tunnel, at IACR-Rothamsted. Spores of different species were released and trapped in identical miniature suction traps which reproduce the aerodynamic features of a full size Hirst-type spore trap. The trapping surfaces were coated in one of three commonly used drum coatings: (1) V/P; (2) SiliconeFluid; (3) Glycerol Jelly. These are all used in Europe and both V/P and Glycerol Jelly are used the UK. Four spore types, Lycopodium clavatum (moss);Alternaria alternata; Botrytis cinerea;and Calvatia excipuliformis, which represent the size range of spores most frequently found in the air, were used. With the exception of B cinerea, the numbers of spores collected on Glycerol Jelly were significantly smaller than on the other two coatings. For all spore types, the numbers caught on the V/P andSilicone Fluid were not significantly different

The incorporation of pathogen spores into rain splash droplets : a modelling approach

International audienc