395 research outputs found
Bostonia: The Boston University Alumni Magazine. Volume 10
Founded in 1900, Bostonia magazine is Boston University's main alumni publication, which covers alumni and student life, as well as university activities, events, and programs
Francisella tularensis in the United States
Subpopulations A.I and A.II. of Francisella tularensis subsp. tularensis are associated with unique biotic and abiotic factors that maintain disease foci
Epidemiologic and Molecular Analysis of Human Tularemia, United States, 1964â2004
Distinct subpopulations of F. tularensis differ in their clinical manifestations, geographic distribution, and likely modes of transmission
Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy
Background
A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets.
Methods
Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendallâs tau for dichotomous variables, or JonckheereâTerpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis.
Results
A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both pâ<â0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROCâ=â0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all pâ<â0.001).
Conclusion
We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty
The role of adsorbed ions during electrocatalysis in ionic liquids
The effects of electrodeâadsorbate interactions on electrocatalysis at Pt in ionic liquids are described. The ionic liquids are diethylmethylammonium trifluoromethanesulfonate, [dema][TfO], dimethylethylammonium trifluoromethanesulfonate, [dmea][TfO], and diethylmethylammonium bis(trifluoromethanesulfonyl)imide, [dema][Tf2N]. Electrochemical analysis indicates that a monolayer of hydrogen adsorbs onto Pt during potential cycling in [dema][[TfO] and [dmea][TfO]. In addition, a prepeak is observed at lower potentials than that of the main oxidation peak during CO oxidation in the [TfO]â-based liquids. In contrast, hydrogen does not adsorb onto Pt during potential cycling in [dema][Tf2N] and no prepeak is observed during CO oxidation. By displacing adsorbed ions on Pt surfaces with CO at a range of potentials, and measuring the charge passed during ion displacement, the potentials of zero total charge of Pt in [dema][TfO] and [dmea][TfO] were measured as 271 ± 9 and 289 ± 10 mV vs RHE, respectively. CO displacement experiments also indicate that the [Tf2N]â ion is bound to the Pt surface at potentials above â0.2 V and the implications of ion adsorption on electrocatalysis of the CO oxidation reaction and O2 reduction reaction in the protic ionic liquids are discussed
Ionic liquids at electrified interfaces
Until recently, âroom-temperatureâ (<100â150 °C) liquid-state electrochemistry was mostly electrochemistry of diluted electrolytes(1)â(4) where dissolved salt ions were surrounded by a considerable amount of solvent molecules. Highly concentrated liquid electrolytes were mostly considered in the narrow (albeit important) niche of high-temperature electrochemistry of molten inorganic salts(5-9) and in the even narrower niche of âfirst-generationâ room temperature ionic liquids, RTILs (such as chloro-aluminates and alkylammonium nitrates).(10-14) The situation has changed dramatically in the 2000s after the discovery of new moisture- and temperature-stable RTILs.(15, 16) These days, the âlater generationâ RTILs attracted wide attention within the electrochemical community.(17-31) Indeed, RTILs, as a class of compounds, possess a unique combination of properties (high charge density, electrochemical stability, low/negligible volatility, tunable polarity, etc.) that make them very attractive substances from fundamental and application points of view.(32-38) Most importantly, they can mix with each other in âcocktailsâ of oneâs choice to acquire the desired properties (e.g., wider temperature range of the liquid phase(39, 40)) and can serve as almost âuniversalâ solvents.(37, 41, 42) It is worth noting here one of the advantages of RTILs as compared to their high-temperature molten salt (HTMS)(43) âsister-systemsâ.(44) In RTILs the dissolved molecules are not imbedded in a harsh high temperature environment which could be destructive for many classes of fragile (organic) molecules
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