11 research outputs found

    Predicting Intraoperative Difficulty of Open Liver Resections The DIFF-scOR Study, An Analysis of 1393 Consecutive Hepatectomies From a French Multicenter Cohort

    No full text
    International audienceObjective: The aim of this study was to build a predictive model of operative difficulty in open liver resections (LRs). Summary Background Data: Recent attempts at classifying open-LR have been focused on postoperative outcomes and were based on predefined anatomical schemes without taking into account other anatomical/technical factors. Methods: Four intraoperative variables were perceived by the authors as to reflect operative difficulty: operation and transection times, blood loss, and number of Pringle maneuvers. A hierarchical ascendant classification (HAC) was used to identify homogeneous groups of operative difficulty, based on these variables. Predefined technical/anatomical factors were then selected to build a multivariable logistic regression model (DIFF-scOR), to predict the probability of pertaining to the highest difficulty group. Its discrimination/calibration was assessed. Missing data were handled using multiple imputation. Results: HAC identified 2 clusters of operative difficulty. In the ``Difficult LR'' group (20.8% of the procedures), operation time (401 min vs 243 min), transection time (150 vs.63 minute), blood loss (900 vs 400 mL), and number of Pringle maneuvers (3 vs 1) were higher than in the ``Standard LR'' group. Determinants of operative difficulty were body weight, number and size of nodules, biliary drainage, anatomical or combined LR, transection planes between segments 2 and 4, 4, and 8 or 7 and 8, nonanatomical resections in segments 2, 7, or 8, caval resection, bilioentric anastomosis and number of specimens. The c-statistic of the DIFF-scOR was 0.822. By contrast, the discrimination of the DIFF-scOR to predict 90-day mortality and severe morbidity was poor (c-statistic: 0.616 and 0.634, respectively). Conclusion: The DIFF-scOR accurately predicts open-LR difficulty and may be used for various purposes in clinical practice and research

    AMBITION - comet nucleus cryogenic sample return

    No full text
    We describe the AMBITION project, a mission to return the first-ever cryogenically-stored sample of a cometary nucleus, that has been proposed for the ESA Science Programme Voyage 2050. Comets are the leftover building blocks of giant planet cores and other planetary bodies, and fingerprints of Solar System's formation processes. We summarise some of the most important questions still open in cometary science and Solar System formation after the successful Rosetta mission. We show that many of these scientific questions require sample analysis using techniques that are only possible in laboratories on Earth. We summarize measurements, instrumentation and mission scenarios that can address these questions. We emphasize the need for returning a sample collected at depth or, still more challenging, at cryogenic temperatures while preserving the stratigraphy of the comet nucleus surface layers. We provide requirements for the next generation of landers, for cryogenic sample acquisition and storage during the return to Earth. Rendezvous missions to the main belt comets and Centaurs, expanding our knowledge by exploring new classes of comets, are also discussed. The AMBITION project is discussed in the international context of comet and asteroid space exploration.ISSN:0922-6435ISSN:1572-950

    AMBITION -- Comet Nucleus Cryogenic Sample Return (White paper for ESA's Voyage 2050 programme)

    No full text
    8 figures, 26 pagesThis white paper proposes that AMBITION, a Comet Nucleus Sample Return mission, be a cornerstone of ESA's Voyage 2050 programme. We summarise some of the most important questions still open in cometary science after the successes of the Rosetta mission, many of which require sample analysis using techniques that are only possible in laboratories on Earth. We then summarise measurements, instrumentation and mission scenarios that can address these questions, with a recommendation that ESA select an ambitious cryogenic sample return mission. Rendezvous missions to Main Belt comets and Centaurs are compelling cases for M-class missions, expanding our knowledge by exploring new classes of comets. AMBITION would engage a wide community, drawing expertise from a vast range of disciplines within planetary science and astrophysics. With AMBITION, Europe will continue its leadership in the exploration of the most primitive Solar System bodies

    AMBITION – comet nucleus cryogenic sample return

    No full text
    International audienceWe describe the AMBITION project, a mission to return the first-ever cryogenically- stored sample of a cometary nucleus, that has been proposed for the ESA Science Programme Voyage 2050. Comets are the leftover building blocks of giant planet cores and other planetary bodies, and fingerprints of Solar System’s formation pro- cesses. We summarise some of the most important questions still open in cometary science and Solar System formation after the successful Rosetta mission. We show that many of these scientific questions require sample analysis using techniques that are only possible in laboratories on Earth. We summarize measurements, instrumen- tation and mission scenarios that can address these questions. We emphasize the need for returning a sample collected at depth or, still more challenging, at cryogenic tem- peratures while preserving the stratigraphy of the comet nucleus surface layers. We provide requirements for the next generation of landers, for cryogenic sample acqui- sition and storage during the return to Earth. Rendezvous missions to the main belt comets and Centaurs, expanding our knowledge by exploring new classes of comets, are also discussed. The AMBITION project is discussed in the international context of comet and asteroid space exploration

    AMBITION – comet nucleus cryogenic sample return

    Get PDF
    International audienceWe describe the AMBITION project, a mission to return the first-ever cryogenically- stored sample of a cometary nucleus, that has been proposed for the ESA Science Programme Voyage 2050. Comets are the leftover building blocks of giant planet cores and other planetary bodies, and fingerprints of Solar System’s formation pro- cesses. We summarise some of the most important questions still open in cometary science and Solar System formation after the successful Rosetta mission. We show that many of these scientific questions require sample analysis using techniques that are only possible in laboratories on Earth. We summarize measurements, instrumen- tation and mission scenarios that can address these questions. We emphasize the need for returning a sample collected at depth or, still more challenging, at cryogenic tem- peratures while preserving the stratigraphy of the comet nucleus surface layers. We provide requirements for the next generation of landers, for cryogenic sample acqui- sition and storage during the return to Earth. Rendezvous missions to the main belt comets and Centaurs, expanding our knowledge by exploring new classes of comets, are also discussed. The AMBITION project is discussed in the international context of comet and asteroid space exploration

    Sample return of primitive matter from the outer Solar System

    No full text
    The last thirty years of cosmochemistry and planetary science have shown that one major Solar System reservoir is vastly undersampled in the available suite of extra-terrestrial materials, namely small bodies that formed in the outer Solar System (>10 AU). Because various dynamical evolutionary processes have modified their initial orbits (e.g., giant planet migration, resonances), these objects can be found today across the entire Solar System as P/D near-Earth and main-belt asteroids, Jupiter and Neptune Trojans, comets, Centaurs, and small (diameter < 200 km) trans-Neptunian objects. This reservoir is of tremendous interest, as it is recognized as the least processed since the dawn of the Solar System and thus the closest to the starting materials from which the Solar System formed. Some of the next major breakthroughs in planetary science will come from studying outer Solar System samples (volatiles and refractory constituents) in the laboratory. Yet, this can only be achieved by an L-class mission that directly collects and returns to Earth materials from this reservoir. It is thus not surprising that two White Papers advocating a sample return mission of a primitive Solar System small body (ideally a comet) were submitted to ESA in response to its Voyage 2050 call for ideas for future L-class missions in the 2035-2050 time frame. One of these two White Papers is presented in this article.ISSN:0922-6435ISSN:1572-950
    corecore