20 research outputs found
The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set
Background
Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables.
Methods
Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set.
Results
Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001).
Conclusions
The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy
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Design and Fabrication of Functionally Graded Components by Selective Laser Melting
The control of structure formation of additive manufacturing simplifies the fabrication of functionally
graded components (FGC), which changes in the physical properties can be achieved via structural design. In
this research, selective laser melting (SLM) technology was used to fabricate structures with gradient lattice
designs. The structure was varied in strut thickness continuously and linearly in single direction for cubic and
honeycomb unit cells. Results showed that the complex design was successfully built and achieved nearly full-dense strut. Compression test results showed that the stress-strain curves of both cubic and honeycomb lattice
structures oscillate with multiple peak loads, suggesting ductile characteristics. However, lattice structures with
graded thickness tend to oscillate upward as the strut diameter increases.Mechanical Engineerin
Zinc oxide nanowires doped with Pd nanoparticles for selective hydrogenation of acetylene alcohols
Abstract only
CVD deposited Pd/ZnO nanowires for selective hydrogenation of acetylene alcohols
Pd/ZnO nanowire catalysts were made by chemical vapour deposition onto a ZnO seed layer deposited onto a Si substrate followed by impregnation. The catalysts showed alkene selectivity of up to 95% at the alkyne conversion of 99.5% in the hydrogenation of 2-methyl-3-butyn-2-ol at 323-343 K and a pressure of 5 bar
CVD deposited Pd/ZnO nanowires for selective hydrogenation of acetylene alcohols
Pd/ZnO nanowire catalysts were made by chemical vapour deposition onto a ZnO seed layer deposited onto a Si substrate followed by impregnation. The catalysts showed alkene selectivity of up to 95% at the alkyne conversion of 99.5% in the hydrogenation of 2-methyl-3-butyn-2-ol at 323-343 K and a pressure of 5 bar