Re-living First Year -the first weeks

Abstract Using data from a survey and interviews with Firs

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 Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra 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 p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 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 p < 0.001). 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

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics

Genomic reconstruction of the SARS-CoV-2 epidemic in England.

The evolution of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus leads to new variants that warrant timely epidemiological characterization. Here we use the dense genomic surveillance data generated by the COVID-19 Genomics UK Consortium to reconstruct the dynamics of 71 different lineages in each of 315 English local authorities between September 2020 and June 2021. This analysis reveals a series of subepidemics that peaked in early autumn 2020, followed by a jump in transmissibility of the B.1.1.7/Alpha lineage. The Alpha variant grew when other lineages declined during the second national lockdown and regionally tiered restrictions between November and December 2020. A third more stringent national lockdown suppressed the Alpha variant and eliminated nearly all other lineages in early 2021. Yet a series of variants (most of which contained the spike E484K mutation) defied these trends and persisted at moderately increasing proportions. However, by accounting for sustained introductions, we found that the transmissibility of these variants is unlikely to have exceeded the transmissibility of the Alpha variant. Finally, B.1.617.2/Delta was repeatedly introduced in England and grew rapidly in early summer 2021, constituting approximately 98% of sampled SARS-CoV-2 genomes on 26 June 2021

Drons col·laboratius

La robòtica col·laborativa és senzillament robots dissenyats per dur a terme treballs de col·laboració amb els humans. Els robots col·laboratius o cobots són cada cop més utilitzats a les indústries. La robòtica col·laborativa és un dels àmbits d'actualitat en aquests moments. Però també és un dels més interessants en més d'un sentit. Com es comuniquen dos drons autònoms que col·laboren per fer una tasca? Com són aquests missatges que s'envien? Que poden fer que no podrien fer sols? Aquestes són algunes de les preguntes que ens volem respondre en aquest projecte. En aquest treball es presenta un disseny i implementació de dos drons terrestres que es comuniquen per col·laborar entre ells per resoldre una tasca.Collaborative robotics is simply robots designed to perform collaborative work with humans. Collaborative robots or cobots are increasingly used in industries. Collaborative robotics is one of the current topics now. But it is also one of the most interesting in more ways than one. How do two autonomous drones that collaborate to perform a task communicate? How are these messages sent? What can they do that they could not do alone? These are some of the questions we want to answer in this project. This work presents a design and implementation of two ground drones that communicate to collaborate with each other to solve a task.La robótica colaborativa es sencillamente robots diseñados para llevar a cabo trabajos de colaboración con los humanos. Los robots colaborativos o cobots son cada vez más utilizados en las industrias. La robótica colaborativa es uno de los ámbitos de actualidad. Pero también es uno de los más interesantes en más de un sentido. ¿Cómo se comunican drones autónomos que colaboran para hacer una tarea? ¿Cómo son estos mensajes que es envían? ¿Qué pueden hacer que no lo podrían hacer solos? Estas son algunas de las preguntas que queremos responder con este proyecto. En este trabajo se presenta un diseño e implementación de dos drones terrestres que se comunican para colaborar entre ellos para resolver una tarea

Analysis of receptor localization in the central nervous system using in vitro and in vivo receptor autoradiography

Quantitative receptor autoradiography methods have been widely used over the last three decades to study the distribution and physiological role of a receptor in various tissues. This review provides an overview of in vivo and in vitro receptor autoradiography methods and their advantages as well as disadvantages in the study of receptors in the central nervous system. Comparison with immunohistochemical and in situ hybridization methods is also highlighted in relation to the study of a given receptor in the nervous sytem