Bifurcation sets of families of reflections on surfaces in R-3

We introduce a new affinely invariant structure on smooth surfaces in ℝ3 by defining a family of reflections in all points of the surface. We show that the bifurcation set of this family has a special structure at ‘ points’, which are not detected by the flat geometry of the surface. These points (without an associated structure on the surface) have also arisen in the study of the centre symmetry set; using our technique we are able to explain how the points are created and annihilated in a generic family of surfaces. We also present the bifurcation set in a global setting.</jats:p

Generic singularities of symplectic and quasi-symplectic immersions

For any k<2n we construct a complete system of invariants in the problem of classifying singularities of immersed k-dimensional submanifolds of a symplectic 2n-manifold at a generic double point.Comment: 12 page

Singularities of equidistants and global centre symmetry sets of Lagrangian submanifolds

We define the Global Centre Symmetry set (GCS) of a smooth closed m-dimensional submanifold M of R^n, $n \leq 2m$, which is an affinely invariant generalization of the centre of a k-sphere in R^{k+1}. The GCS includes both the centre symmetry set defined by Janeczko and the Wigner caustic defined by Berry. We develop a new method for studying generic singularities of the GCS which is suited to the case when M is lagrangian in R^{2m} with canonical symplectic form. The definition of the GCS, which slightly generalizes one by Giblin and Zakalyukin, is based on the notion of affine equidistants, so, we first study singularities of affine equidistants of Lagrangian submanifolds, classifying all the stable ones. Then, we classify the affine-Lagrangian stable singularities of the GCS of Lagrangian submanifolds and show that, already for smooth closed convex curves in R^2, many singularities of the GCS which are affine stable are not affine-Lagrangian stable.Comment: 26 pages, 2 figure

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Fourier descriptors and handwritten digit recognition

This paper presents the results of a comparative study of various Fourier descriptor representations and their use in recognition of unconstrained handwritten digits. Certain characteristics of five distinct Fourier descriptor representations of handwritten digits are discussed, and illustrations of ambiguous digit classes introduced by use of these Fourier descriptor representations are presented. It is concluded that Fourier descriptors are practically effective only within the framework of an intelligent system, capable of reasoning about digit hypotheses. We describe a hypothesisgenerating algorithm based on Fourier descriptors which allows a classifier to associate more than one digit class with each input. Such hypothesis-generating schemes can be very effective in systems employing multiple classifiers. We compare the performance of the five Fourier descriptor representations based on experiment results produced by a particular hypothesis-generating classifier for a test set of 14000 handwritten digits. It is found that some Fourier descriptor formulations are more successful than others for handwritten digit recognition.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46057/1/138_2005_Article_BF01212429.pd

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics