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

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Sex-related differences in oncologic outcomes, operative complications and health-related quality of life after curative-intent oesophageal cancer treatment: multicentre retrospective analysis

Background: Oesophageal cancer, in particular adenocarcinoma, has a strong male predominance. However, the impact of patient sex on operative and oncologic outcomes and recovery of health-related quality of life is poorly documented, and was the focus of this large multicentre cohort study. Methods: All consecutive patients who underwent oncological oesophagectomy from 2009 to 2015 in the 20 European iNvestigation of SUrveillance after Resection for Esophageal cancer study group centres were assessed. Clinicopathologic variables, therapeutic approach, postoperative complications, survival and health-related quality of life data were compared between male and female patients. Multivariable analyses adjusted for age, sex, tumour histology, treatment protocol and major complications. Specific subgroup analyses comparing adenocarcinoma versus squamous cell cancer for all key outcomes were performed. Results: Overall, 3974 patients were analysed, 3083 (77.6%) male and 891 (22.4%) female; adenocarcinoma was predominant in both groups, while squamous cell cancer was observed more commonly in female patients (39.8% versus 15.1%, P < 0.001). Multivariable analysis demonstrated improved outcomes in female patients for overall survival (HRmales 1.24, 95% c.i. 1.07 to 1.44) and disease-free survival (HRmales 1.22, 95% c.i. 1.05 to 1.43), which was caused by the adenocarcinoma subgroup, whereas this difference was not confirmed in squamous cell cancer. Male patients presented higher health-related quality of life functional scores but also a higher risk of financial problems, while female patients had lower overall summary scores and more persistent gastrointestinal symptoms. Conclusion: This study reveals uniquely that female sex is associated with more favourable long-term survival after curative treatment for oesophageal cancer, especially adenocarcinoma, although long-term overall and gastrointestinal health-related quality of life are poorer in women

A cell biological analysis of the lox-1 scavenger receptor

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Social media buzz created by #nanotechnology: insights from Twitter analytics

The word “nanotechnology” has been exaggerated not only by media but also by scientist groups who have overstated the unforeseen benefits of nanotechnology to validate research funding. Even ecologists, who normally remain indulged in doom-and-gloom divinations, use this word to fuel their own motives. Such outcomes lead to widespread misinformation and an unaware public. This research work is a staunch effort to filter the Twitter-based public opinions related to this word. Our results clearly indicate more of positive sentiments attached to the subject of nanotechnology, as trust, anticipation and joy overweigh by many folds the anger, mistrust and anger related to nanotechnology

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Not AvailableThe DNA methylation events mark a major epigenetic change in the genome, reflecting non-genetic disease developments and varied phenotypes. The water buffalo is a dairy production animal with wide agro-climatic distribution in India. Breed-wise the coat color of water buffalo varies from ash-gray to jet black. A typical pigmentation pattern is found in one of the breeds of North India, Nili Ravi, with variedly distributed white patches. The DNA methylation pattern could potentially reveal the epigenetic factors responsible for the pigmentation patterns. To address this question, the DNA isolated from the skin tissues of Nili Ravi with varied white pigmentation and black Murrah buffaloes was subjected to reduced representation bisulfite sequencing. DNA methylation analysis revealed, 68.44%, 63.39%, and 47.94% of the promoter regions were hypermethylated in Nili Ravi over-white versus Murrah, Nili Ravi under-white versus Murrah, and Nili Ravi under-white versus Nili Ravi over-white, respectively. Major genes identified to be differentially methylated among over-white and under-white skin tissues in Nili Ravi included TBX2, SNAI2, HERC2, and CITED1. Overall the results have indicated differential methylation patterns to be potentially involved in hyper or hypopigmentation in Nili Ravi and Murrah buffaloes.Not Availabl

Glacier changes in the Garhwal Himalaya, India, from 1968 to 2006 based on remote sensing

Glacier outlines are mapped for the upper Bhagirathi and Saraswati/Alaknanda basins of the Garhwal Himalaya using Corona and Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) satellite images acquired in 1968 and 2006, respectively. A subset of glaciers was also mapped using Landsat TM images acquired in 1990. Glacier area decreased from 599.9 ± 15.6 km2 (1968) to 572.5 ± 18.0 km2 (2006), a loss of 4.6 ± 2.8%. Glaciers in the Saraswati/Alaknanda basin and upper Bhagirathi basin lost 18.4 ± 9.0km2 (5.7±2.7%) and 9.0 ± 7.7km2 (3.3±2.8%), respectively, from 1968 to 2006. Garhwal Himalayan glacier retreat rates are lower than previously reported. More recently (1990–2006), recession rates have increased. The number of glaciers in the study region increased from 82 in 1968 to 88 in 2006 due to fragmentation of glaciers. Smaller glaciers (50 km2) which lost 2.8 ± 2.7% (0.074 ± 0.071% a–1). From 1968 to 2006, the debris-covered glacier area increased by 17.8 ± 3.1% (0.46 ± 0.08% a–1) in the Saraswati/Alaknanda basin and 11.8 ± 3.0% (0.31 ± 0.08% a–1) in the upper Bhagirathi basin. Climate records from Mukhim (∼1900 m a.s.l.) and Bhojbasa (∼3780 m a.s.l.) meteorological stations were used to analyze climate conditions and trends, but the data are too limited to make firm conclusions regarding glacier–climate interactions