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

Arginine methylation and citrullination of splicing factor proline- and glutamine-rich (SFPQ/PSF) regulates its association with mRNA

Splicing factor proline- and glutamine-rich (SFPQ) also commonly known as polypyrimidine tract-binding protein-associated-splicing factor (PSF) and its binding partner non-POU domain-containing octamer-binding protein (NONO/p54nrb), are highly abundant, multifunctional nuclear proteins. However, the exact role of this complex is yet to be determined. Following purification of the endogeneous SFPQ/NONO complex, mass spectrometry analysis identified a wide range of interacting proteins, including those involved in RNA processing, RNA splicing, and transcriptional regulation, consistent with a multifunctional role for SFPQ/NONO. In addition, we have identified several sites of arginine methylation in SFPQ/PSF using mass spectrometry and found that several arginines in the N-terminal domain of SFPQ/PSF are asymmetrically dimethylated. Furthermore, we find that the protein arginine N-methyltransferase, PRMT1, catalyzes this methylation in vitro and that this is antagonized by citrullination of SFPQ. Arginine methylation and citrullination of SFPQ/PSF does not affect complex formation with NONO. However, arginine methylation was shown to increase the association with mRNA in mRNP complexes in mammalian cells. Finally we show that the biochemical properties of the endogenous complex from cell lysates are significantly influenced by the ionic strength during purification. At low ionic strength, the SFPQ/NONO complex forms large heterogeneous protein assemblies or aggregates, preventing the purification of the SFPQ/NONO complex. The ability of the SFPQ/NONO complex to form varying protein assemblies, in conjunction with the effect of post-translational modifications of SFPQ modulating mRNA binding, suggests key roles affecting mRNP dynamics within the cell

Language and identity among British South Asians: a theoretical review.

Given the pervasiveness of language in social life and the implications that language use can have for one’s individual and collective identities, attempts were made to explore the theoretical and empirical advantages in connecting social psychological theories of identity and sociological/sociolinguistic approaches to language use and language choices in order to make sense of language and identity among second-generation British Asians. The current theoretical essay features a brief overview of the sociology of British Asians in the United Kingdom and a detailed consideration of dominant theories of identity in social psychology, namely, Social Identity Theory Tajfel (1982), Self-Aspects Model of Identity (Simon 2004) and Identity Process Theory (Breakwell 1986). It is considered that the latter two theories lend themselves readily to the study of language and identity. The present essay considers the substantive literature on language and identity and deconstructs notions such as ‘mother tongue’ in an attempt to demonstrate the constructedness of such terminology. It is argued that a social psychological approach to questions of language and identity among British South Asians is a valid one and that a qualitative methodological approach is particularly well-suited to the area under investigation

Man to man violence: how masculinity may work as a dynamic risk factor

This article presents masculinity as a dynamic risk factor in offences of violence between men. It argues that existing interventions into such violence, in prison, hospital and community settings may be enhanced by incorporating masculinity as a dynamic risk factor alongside other dynamic risk factors such as difficulties in anger management, social skills deficits or problems in moral reasoning. Masculinity is defined as a common denominator of men, as men, across social divisions, as opposed to existing approaches to men's identity, as men, which employ the concept of different 'masculinities' being produced by men in different social positions. The latter approach, while useful in terms of discovering men's personal identity, may be less useful in terms of explaining commonality between men, across other axes of social identity, and consequent broad patterns of violence between men. The development of masculinity as a dynamic risk factor depends on isolating masculinity from other axes of men's identity. It is argued that the individual man may demonstrate his masculinity by two categories of violence to other men: violence which includes victims in the category 'man' as worthy rivals and violence which excludes victims from the category 'man' as unworthy of being there. Masculinity as a dynamic risk factor in man to man violence is developed with particular reference to racism and homophobia