Fresnel scatter revisited-comparison of 50 MHz radar and radiosondes in the Arctic, the Tropics and Antarctica

High-resolution radiosondes and calibrated radars operating close to 50 MHz, are used to examine the relationship between the strength of radar scatter and refractive index gradient. Three radars are used, in Kiruna in Arctic Sweden, at Gadanki in southern India and at the Swedish/Finnish base Wasa/Aboa in Queen Maud Land, Antarctica. Calibration is accomplished using the daily variation of galactic noise measured at each site. Proportionality between radar scatter strength and the square of the mean gradient of potential refractive index, M2, is found in the upper troposphere and lower stratosphere at all three sites, confirming previously reported results from many VHF radars. If the radar scatter is interpreted as Fresnel scatter, the constant of proportionality between radar scatter and M2 is found to be the same, within the calibration uncertainties, for all three radars. The radiosondes show evidence of distinct layering with sharp gradients, extending over 10s of kilometers horizontally, but the scatter is found to be two orders of magnitude weaker than would be expected from true Fresnel scatter from such layers. Using radar reflectivities resolved to a few 100 ms, we show that this is due to strong temporal variability in the scattering conditions, possibly due to undulations of the scattering layers. The constancy of the radar scatter – M2 relationship between the different sites suggests an unexpected uniformity in these perturbations between very different regions of the globe

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

Lidar Observations of aerosol layers just below the tropopause level during IFP-INDOEX

A lidar system has been used at Gadanki (13.5º, 79.2ºE) to study the characteristics of aerosol layer (cloud) occurring just below the tropical tropopause. The preliminary results of the lidar observations indicate that the cloud occurs ~ 2 km below the tropopause. The top and bottom edges of the cloud have propensity for ice crystal presence with liquid droplets/ vapours in-between. The clouds show temporal fluctuations (in their backscattering ratio) with temporal scales of the order of 30–90 min

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

Peer reviewe

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

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 &gt;5 (p &lt; 0.001). Conclusions: The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Zero bird-strike rate - an achievable target, not a pipedream

This paper explains how zero bird-strike rate can be achieved by any aerodrome by constant efforts and perseverance of a dedicated team as evidenced from the author’s experience on about 30 aerodromes in India. This paper stresses the importance of conducting survey of problem aerodromes every five years by an expert (Satheesan 1996c), necessity for employing an Ornithologist at every aerodrome, need for regular national-level training for bird-controllers (Satheesan, in press - b) and urgency for setting up Bird-strike Prevention Committees at national (interministerial) and airport levels. Bird strike rates were brought down to zero at the Trivandrum International Airport in 1992 and 1993 and to a low level at the Bangalore Airport in 1993 as a result of implementation of recommendations given by a study team including the author in 1989 and by the author alone afterwards (Satheesan 1996c). Another result of this was that vulture-hits to aircraft have been drastically reduced at Delhi, Bangalore and several other airports. Awareness programmes to educate the public can help reduce bird-strikes (Satheesan 1994a, 1994b). Step by step evaluation of and changes in policies and strategies followed by the Government as well as methods and gadgets employed by airport authorities and replication of successful experiments at problem airports hold the key to translating the dream, zero bird-strike rate, into reality

Neonatal encephalopathic cerebral injury in south india assessed by perinatal magnetic resonance biomarkers and early childhood neurodevelopmental outcome

Although brain injury after neonatal encephalopathy has been characterised well in high-income countries, little is known about such injury in low- and middle-income countries. Such injury accounts for an estimated 1 million neonatal deaths per year. We used magnetic resonance (MR) biomarkers to characterise perinatal brain injury, and examined early childhood outcomes in South India. Methods We recruited consecutive term or near term infants with evidence of perinatal asphyxia and a Thompson encephalopathy score ≥6 within 6 h of birth, over 6 months. We performed conventional MR imaging, diffusion tensor MR imaging and thalamic proton MR spectroscopy within 3 weeks of birth. We computed group-wise differences in white matter fractional anisotropy (FA) using tract based spatial statistics. We allocated Sarnat encephalopathy stage aged 3 days, and evaluated neurodevelopmental outcomes aged 3½ years using Bayley III. Results Of the 54 neonates recruited, Sarnat staging was mild in 30 (56%); moderate in 15 (28%) and severe in 6 (11%), with no encephalopathy in 3 (6%). Six infants died. Of the 48 survivors, 44 had images available for analysis. In these infants, imaging indicated perinatal rather than established antenatal origins to injury. Abnormalities were frequently observed in white matter (n = 40, 91%) and cortex (n = 31, 70%) while only 12 (27%) had abnormal basal ganglia/thalami. Reduced white matter FA was associated with Sarnat stage, deep grey nuclear injury, and MR spectroscopy N-acetylaspartate/choline, but not early Thompson scores. Outcome data were obtained in 44 infants (81%) with 38 (79%) survivors examined aged 3½ years; of these, 16 (42%) had adverse neurodevelopmental outcomes. Conclusions No infants had evidence for established brain lesions, suggesting potentially treatable perinatal origins. White matter injury was more common than deep brain nuclei injury. Our results support the need for rigorous evaluation of the efficacy of rescue hypothermic neuroprotection in low- and middle-income countries