Stable isotope signatures reveal small-scale spatial separation in populations of European sea bass

Scientific information about European sea bass (Dicentrarchus labrax) stocks in NE Atlantic is limited and a more accurate definition of the stock boundaries in the area is required to improve assessment and management advice. Here we study the connectivity and movement patterns of European sea bass in Wales (UK) using the stable isotope (δ13C and δ15N) composition of their scales. Analysis of fish scale δ13C and δ15N values in the last growing season was performed on 189 adult sea bass caught at nine coastal feeding grounds. Fish >50 cm total length (TL) caught in estuaries had very low δ13C and this is characteristic of fresh water (organic/soil) input, indicating the primary use of estuaries as feeding areas. A random forest classification model was used to test if there was a difference in δ15N and δ13C values between north, mid and south Wales and whether it was possible to correctly assign the fish to the area where it was caught. This analysis was restricted to fish of a similar size range (40-50 cm TL) caught in open coastal areas (n=156). The random forest classification model showed that about 75% of the fish could be correctly assigned to their collection region based on their isotope composition. The majority of the misclassifications of fish were fish from north Wales classifying to mid Wales and vice versa, while the majority of fish from south Wales were correctly assigned (80%). Our findings suggest that two sub-populations of sea bass in Welsh waters use separate feeding grounds (south vs. mid/north Wales), and may need separate management

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

Pos(T): Analyzing Dependencies in Typed Logic Programs

. Dependencies play a major role in the analysis of program properties. The analysis of groundness dependencies for logic programs using the class of positive Boolean functions is a main applications area. Work has been done to improve its precision through the integration of either pattern information or type information. This paper develops another approach where type information is exploited. Different from previous work, a separate simple analysis is done for each subtype of the types. Also, a technique is developed that reuses the results of a polymorphic predicate for the type instances under which it is called.