The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Differences in COVID Related Anxiety Between Those with and without Type 2 Diabetes

As a result of the COVID-19 pandemic, individuals with diabetes may be at higher risk for experiencing negative behavioral, psychosocial, and disease-related outcomes. The purpose of the present study was to compare COVID-19-related anxiety between adults with and without type 2 diabetes. Two separate samples were recruited for this study from web-based panels of adults: 372 adults with type 2 diabetes and 259 adults without type 2 diabetes. COVID-19-related anxiety was assessed using the Fear of COVID-19 Scale (FCV-19S)This scale includes 7 items scored on a 5-point Likert scale. Scores are summed to generate a total score with higher scores indicating greater anxiety. Bivariate comparisons were used to compare the sociodemographic and medical characteristics of the samples. An independent samples t-test was used to compare the means of FCVS-19 between the two samples. A multivariable linear regression model was used to examine the relationship between diabetes status and the COVID-19 anxiety scale, controlling for age, race, sex, level of education, income, having a primary care provider, and health insurance status. There was a significant difference in the COVID-19 anxiety scores between those with Type 2 diabetes (M = 20.34, SD = 6.93) and those without Type 2 diabetes (M = 18.37, SD = 7.07; t = 3.48, df = 548.50, p \u3c.001). The multivariable regression model accounted for 16.1% of the variance in COVID-19 anxiety (F [8, 622] = 14.92, p \u3c.001). Diabetes status was a significant predictor of COVID-19 anxiety (B = 2.20, SE = 0.56, p \u3c .001). Age was also significantly associated with lower COVID anxiety (B = -0.17, SE = 0.02, p \u3c.001). However, race, sex, level of education, income, having a primary care provider, and health insurance status were not significantly associated with COVID-19 anxiety. Adults with type 2 diabetes are significantly more likely to experience COVID-19 anxiety than participants without type 2 diabetes – even when controlling for potentially important sociodemographic and healthcare variables. Additional research is needed to determine whether COVID-related anxiety is adaptive or maladaptive among adults with type 2 diabetes. If maladaptive, additional work is needed to evaluate the effectiveness of evidence-based approaches for the treatment of COVID-related anxiety in medical populations with risk factors for severe COVID-related outcomes

The repertoire and intentionality of gestural communication in wild chimpanzees

A growing body of evidence suggests that human language may have emerged primarily in the gestural rather than vocal domain, and that studying gestural communication in great apes is crucial to understanding language evolution. Although manual and bodily gestures are considered distinct at a neural level, there has been very limited consideration of potential differences at a behavioural level. In this study, we conducted naturalistic observations of adult wild East African chimpanzees (Pan troglodytes schweinfurthii) in order to establish a repertoire of gestures, and examine gesture use and comprehension, comparing across manual and bodily gestures. At the population level, 120 distinct gesture types were identified, consisting of 65 manual gestures and 55 bodily gestures. Both bodily and manual gestures were used intentionally and effectively to attain specific goals, by signallers who are sensitive to recipient attention. However, manual gestures differed from bodily gestures in terms of communicative persistence, indicating a qualitatively different form of behavioural flexibility in achieving goals. Both repertoire size and frequency of manual gesturing were more affiliative than bodily gestures, while bodily gestures were more antagonistic. These results indicate that manual gestures may have played a significant role in the emergence of increased flexibility in great ape communication and social bonding

Cultura e inteligência: reflexões antropológicas sobre aspectos não físicos da evolução em chimpanzés e humanos Culture and intelligence: anthropological reflections on non-physical aspects of evolution in chimpanzees and humans

Trata da história recente dos estudos sobre o comportamento de chimpanzés, enfatizando os resultados das pesquisas, as proposições acerca da existência de 'culturas de chimpanzés' e sua validade. O trabalho problematiza a ideia a partir dos mecanismos de transmissão e aprendizado social bem como de concepções antropológicas e paleoantropológicas de cultura que associam tal fenômeno, entre humanos modernos, às suas capacidades simbólicas e cognitivas.<br>The scope of this work is the recent history of studies on the behavior of chimpanzees, emphasizing research results, propositions about the existence of 'chimpanzee cultures' and their validity. The work discusses the idea based on transmission mechanisms and social learning as well as anthropological and paleoanthropological concepts of culture that associate such phenomena, among modern humans, to their symbolic and cognitive abilities

Deep Underground Neutrino Experiment (DUNE) Near Detector Conceptual Design Report

International audienceThe Deep Underground Neutrino Experiment (DUNE) is an international, world-class experiment aimed at exploring fundamental questions about the universe that are at the forefront of astrophysics and particle physics research. DUNE will study questions pertaining to the preponderance of matter over antimatter in the early universe, the dynamics of supernovae, the subtleties of neutrino interaction physics, and a number of beyond the Standard Model topics accessible in a powerful neutrino beam. A critical component of the DUNE physics program involves the study of changes in a powerful beam of neutrinos, i.e., neutrino oscillations, as the neutrinos propagate a long distance. The experiment consists of a near detector, sited close to the source of the beam, and a far detector, sited along the beam at a large distance. This document, the DUNE Near Detector Conceptual Design Report (CDR), describes the design of the DUNE near detector and the science program that drives the design and technology choices. The goals and requirements underlying the design, along with projected performance are given. It serves as a starting point for a more detailed design that will be described in future documents