Shock wave physics and detonation physics – a stimulus for the emergence of numerous new branches in science and engineering

In the period of the Cold War (1945−1991), Shock Wave Physics and Detonation Physics (SWP&DP) – until the beginning of WWII mostly confined to gas dynamics, high-speed aerodynamics, and military technology (such as aero- and terminal ballistics, armor construction, chemical explosions, supersonic gun, and other firearms developments) – quickly developed into a large interdisciplinary field by its own. This rapid expansion was driven by an enormous financial support and two efficient feedbacks: the Terminal Ballistic Cycle and the Research & Development Cycle. Basic knowledge in SWP&DP, initially gained in the Classic Period (from 1808) and further extended in the Post-Classic Period (from the 1930s to present), is now increasingly used also in other branches of Science and Engineering (S&E). However, also independent S&E branches developed, based upon the fundamentals of SWP&DP, many of those developments will be addressed (see Tab. 2). Thus, shock wave and detonation phenomena are now studied within an enormous range of dimensions, covering microscopic, macroscopic, and cosmic dimensions as well as enormous time spans ranging from nano-/picosecond shock durations (such as produced by ultra-short laser pulses) to shock durations that continue for centuries (such as blast waves emitted from ancient supernova explosions). This paper reviews these developments from a historical perspective

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien\u2013Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9\ub72 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4\u20137) and 7 (6\u20138) days respectively (P < 0\ub7001). There were no significant differences in rates of readmission between these groups (6\ub76 versus 8\ub70 per cent; P = 0\ub7499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0\ub790, 95 per cent c.i. 0\ub755 to 1\ub746; P = 0\ub7659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34\ub77 versus 39\ub75 per cent; major 3\ub73 versus 3\ub74 per cent; P = 0\ub7110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients