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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A simple decay-spectroscopy station at CRIS-ISOLDE

A new decay-spectroscopy station (DSS2.0) has been designed by the CRIS collaboration for use at the radioactive ion beam facility, ISOLDE. With the design optimised for both charged-particle and γ -ray detection, the DDS2.0 allows high-efficiency decay spectroscopy to be performed. The DSS2.0 complements the existing decay-spectroscopy system at the CRIS experiment, and together provide the ability to perform laser-assisted nuclear decay spectroscopy on both ground state and long-lived isomeric species. This paper describes the new decay-spectroscopy station and presents the characterisation studies that have recently been performed

Half-life determination of 215^{215}At and 221^{221}Ra with high-purity radioactive ion beams

International audienceAt CERN-ISOLDE, high-purity radioactive ion beams of $^{219}$Fr and $^{221}$RaF were investigated with $\alpha$-decay spectroscopy at the CRIS and ASET experiments in the course of three different experimental campaigns. The half-life of $^{215}$At, $\alpha$-decay daughter of $^{219}$Fr, is measured to be 36.3(3)[9]μs, and that of $^{221}$Ra was determined to be 26.2(1)[6]s, both of which are well in line with the trends in this region of the nuclear landscape but at odds with some of the reported literature

Data from: You are where you live: parasitic nematode mitochondrial genome size is associated with the thermal environment generated by hosts

There exists remarkable interspecific variation in mitochondrial sequence evolution rates and in mitochondrial genome sizes. A number of hypotheses based on the forces of mutation and selection have been proposed to explain this variation. Among such hypotheses, we test three: 1) the ‘longevity-dependent selection’, 2) the ‘functional constraints’ and 3) the ‘race for replication’ hypotheses, using published mtDNA genomic sequences of 47 Nematoda species. We did not find any relationship between body size (used as a proxy for longevity) and genome size or the substitution rate of protein sequences, providing little evidence for the first hypothesis. Parasitic species from different thermal habitats, as determined by their definitive host type (ectothermal vs. endothermal), did not differ in their rates of protein evolution. Therefore, little support was obtained for the second hypothesis. However, we revealed that mitogenomes of parasites of endotherms were significantly smaller than those of parasites of ectotherms, supporting the race for replication hypothesis. As mitochondrial genomes of endothermal animals are usually more compact than those of ectothermal animals, intriguingly, nematode parasites of endotherms and ectotherms exhibit similar patterns of mtDNA length variation to their hosts

Probing the 31Ga_{31}\mathrm{Ga} ground-state properties in the region near Z=28Z=28 with high-resolution laser spectroscopy

International audienceMagnetic-dipole and electric-quadrupole moments for $^{65,67,69,75,79–82}\mathrm{Ga}$ are reported using the Collinear Resonance Ionization Spectroscopy (CRIS) technique at the ISOLDE facility, CERN. The moments of $^{65}\mathrm{Ga}$ have been measured for the first time: $\mu =+1.775(3)\mu_N$ and $Q_s=+21.0(15)e\mathrm{fm}2$. These results are compared to shell-model calculations using the GXPF1 and JUN45 interactions and the trends of the moments approaching the region of the doubly magic $^{56}\mathrm{Ni}$ are discussed. Additionally, new values for the change in mean-square charge radii for $^{65}\mathrm{Ga}$ and $^{67}\mathrm{Ga}$ allow investigation into the odd-even staggering in the region below $N=40$

Precision measurements of the charge radii of potassium isotopes

International audiencePrecision nuclear charge radii measurements in the light-mass region are essential for understanding the evolution of nuclear structure, but their measurement represents a great challenge for experimental techniques. At the Collinear Resonance Ionization Spectroscopy (CRIS) setup at ISOLDE-CERN, a laser frequency calibration and monitoring system was installed and commissioned through the hyperfine spectra measurement of $^{38–47}$K. It allowed for the extraction of the hyperfine parameters and isotope shifts with better than 1 MHz precision. These results are in excellent agreement with available literature values and they demonstrate the suitability of the CRIS technique for the study of nuclear observables in light atomic systems. In addition, the spectral line shapes obtained under different conditions were systematically investigated, highlighting the importance of finding optimal conditions, under which the extracted nuclear properties remain unaffected by laser-atom interactions

Resonance ionization schemes for high resolution and high efficiency studies of exotic nuclei at the CRIS experiment

This paper presents an overview of recent resonance ionization schemes used at the Collinear Resonance Ionization Spectroscopy (CRIS) setup located at ISOLDE, CERN. The developments needed to reach high spectral resolution and efficiency will be discussed. Besides laser ionization efficiency and high resolving power, experiments on rare isotopes also require low-background conditions. Ongoing developments that aim to deal with beam-related sources of background are presented

Quadrupole moment of 203^{203}Fr

International audienceThe spectroscopic electric quadrupole moment of the neutron-deficient francium isotope 203 Fr was measured by using high-resolution collinear resonance ionization spectroscopy (CRIS) at the CERN Isotope Separation On-Line Device (ISOLDE) facility. A remeasurement of the 207 Fr quadrupole moment was also performed, resulting in a departure from the established literature value. A sudden increase in magnitude of the 203 Fr quadrupole moment, with respect to the general trend in the region, points to an onset of static deformation at N = 116 in the 87 Fr isotopic chain. Calculation of the static and total deformation parameters show that the increase in static deformation only cannot account for the observed departure of its relative charge radius from the 82 Pb chain

High-resolution laser spectroscopy with the Collinear Resonance Ionisation Spectroscopy (CRIS) experiment at CERN-ISOLDE

International audienceThe Collinear Resonance Ionisation Spectroscopy (CRIS) experiment at CERN has achieved high-resolution resonance ionisation laser spectroscopy with a full width at half maximum linewidth of 20(1) MHz for 219,221219,221Fr, and has measured isotopes as short lived as 5 ms with 214214Fr. This development allows for greater precision in the study of hyperfine structures and isotope shifts, as well as a higher selectivity of single-isotope, even single-isomer, beams. These achievements are linked with the development of a new laser laboratory and new data-acquisition systems