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

Electrospray from an ionic liquid ferrofluid utilizing the rosensweig instability

© 2013, American Institute of Aeronautics and Astronautics Inc. All rights reserved. A new type of electrospray technology that could be used for space propulsion was developed at Michigan Technological University. This thruster utilized an ionic liquid ferrofluid that was synthesized by suspending magnetic nanoparticles in an ionic liquid carrier solution so that the resulting fluid is superparamagnetic. The magnetic properties of the fluid were exploited to create self-assembling static arrays of surface peaks which were then amplified with an applied electric field until ion current was emitted from the array. The current and voltage profile of the emitting array was measured and its ability to self-heal after a damaging event was observed

Epitranscriptomic Addition of m5C to HIV-1 Transcripts Regulates Viral Gene Expression

How the covalent modification of mRNA ribonucleotides, termed epitranscriptomic modifications, alters mRNA function remains unclear. One issue has been the difficulty of quantifying these modifications. Using purified HIV-1 genomic RNA, we show that this RNA bears more epitranscriptomic modifications than the average cellular mRNA, with 5-methylcytosine (m5C) and 2′O-methyl modifications being particularly prevalent. The methyltransferase NSUN2 serves as the primary writer for m5C on HIV-1 RNAs. NSUN2 inactivation inhibits not only m5C addition to HIV-1 transcripts but also viral replication. This inhibition results from reduced HIV-1 protein, but not mRNA, expression, which in turn correlates with reduced ribosome binding to viral mRNAs. In addition, loss of m5C dysregulates the alternative splicing of viral RNAs. These data identify m5C as a post-transcriptional regulator of both splicing and function of HIV-1 mRNA, thereby affecting directly viral gene expression. Courtney et al. report that HIV-1 transcripts are modified by the addition of 5-methylcytosine (m5C) residues. The nuclear methyltransferase NSUN2 is the primary m5C writer and is required for appropriate HIV-1 translation. NSUN2 deficiency and concomitant loss of m5C residues inhibits ribosomal recruitment to and alternative splicing of HIV-1 mRNAs. © 2019 Elsevier Inc