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

Frequency doubling and Fourier domain shaping the output of a femtosecond optical parametric amplifier: easy access to tuneable femtosecond pulse shapes in the deep ultraviolet

Tuneable, shaped, ultraviolet (UV) femtosecond laser pulses are produced by shaping and frequency doubling the output of a commercial optical parametric amplifier (OPA). A reflective mode, folded, pulse shaping assembly employing a spatial light modulator (SLM) shapes femtosecond pulses in the visible region of the spectrum. The shaped visible light pulses are frequency doubled to generate phase- and amplitude-shaped, ultrashort light pulses in the deep ultraviolet. This approach benefits from a simple experimental setup and the potential for tuning the central frequency of the shaped ultraviolet waveform. A number of pulse shapes have been synthesised and characterised using cross-correlation frequency resolved optical gating (XFROG). This pulse shaping method can be employed for coherent control experiments in the ultraviolet region of the spectrum where many organic molecules have strong absorption bands

The role of magnets in the management of unerupted teeth in children and adolescents

This case report describes the use of magnets in the management of teeth that fail to erupt. Eight children aged between 10 and 15 years were treated. Magnetic traction was applied to two premolars and six molars. Seven teeth (one premolar and six molars) erupted successfully (mean treatment time with magnetic traction: 7·5 months). One premolar failed to erupt; serial radiographic assessment over a 9-month period revealed no evidence of movement and so the magnetic fixture was removed. Histological evaluation of tissue samples taken from around the fixture revealed no evidence of abnormal pathology

Uranium-series constraints on radionuclide transport and groundwater flow at the Nopal I uranium deposit, Sierra Pena Blanca, Mexico

Uranium-series data for groundwater samples from the Nopal I uranium ore deposit were obtained to place constraints on radionuclide transport and hydrologic processes for a nuclear waste repository located in fractured, unsaturated volcanic tuff. Decreasing uranium concentrations for wells drilled in 2003 are consistent with a simple physical mixing model that indicates that groundwater velocities are low ({approx}10 m/y). Uranium isotopic constraints, well productivities, and radon systematics also suggest limited groundwater mixing and slow flow in the saturated zone. Uranium isotopic systematics for seepage water collected in the mine adit show a spatial dependence which is consistent with longer water-rock interaction times and higher uranium dissolution inputs at the front adit where the deposit is located. Uranium-series disequilibria measurements for mostly unsaturated zone samples indicate that {sup 230}Th/{sup 238}U activity ratios range from 0.005-0.48 and {sup 226}Ra/{sup 238}U activity ratios range from 0.006-113. {sup 239}Pu/{sup 238}U mass ratios for the saturated zone are &lt;2 x 10{sup -14}, and Pu mobility in the saturated zone is &gt;1000 times lower than the U mobility. Saturated zone mobility decreases in the order {sup 238}U{approx}{sup 226}Ra &gt; {sup 230}Th{approx}{sup 239}Pu. Radium and thorium appear to have higher mobility in the unsaturated zone based on U-series data from fractures and seepage water near the deposit

Sea-Level Rise by 2100

ISI Document Delivery No.: 274ZI Times Cited: 0 Cited Reference Count: 0 Church, John A. Clark, Peter U. Cazenave, Anny Gregory, Jonathan M. Jevrejeva, Svetlana Levermann, Anders Merrifield, Mark A. Milne, Glenn A. Nerem, R. Steven Nunn, Patrick D. Payne, Antony J. Pfeffer, W. Tad Stammer, Detlef Unnikrishnan, Alakkat S. payne, antony/A-8916-2008; Church, John/A-1541-2012 payne, antony/0000-0001-8825-8425; Church, John/0000-0002-7037-8194 0 AMER ASSOC ADVANCEMENT SCIENCE WASHINGTON SCIENC