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

Effervescence in champagne and sparkling wines: From bubble bursting to droplet evaporation

International audienceWhen a bubble reaches an air-liquid interface, it ruptures, projecting a multitude of tiny droplets in the air. Across the oceans, an estimated 1018 to 1020 bubbles burst every second, and form the so called sea spray, a major player in earth's climate system. At a smaller scale, in a glass of champagne about a million bubbles nucleate on the wall, rise towards the surface and burst, giving birth to a particular aerosol that holds a concentrate of wine aromas. Based on the model experiment of a single bubble bursting in simple liquids, we depict each step of this effervescence, from bubble bursting to drop evaporation. In particular, we propose simple scaling laws for the jet velocity and the top drop size. We unravel experimentally the intricate roles of bubble shape, capillary waves, gravity, and liquid properties in the jet dynamics and the drop detachment. We demonstrate how damping action of viscosity produces faster and smaller droplets and more generally how liquid properties enable to control the bubble bursting aerosol characteristics. In this context, the particular case of Champagne wine aerosol is studied in details and the key features of this aerosol are identified. We demonstrate that compared to a still wine, champagne fizz drastically enhances the transfer of liquid into the atmosphere. Conditions on bubble radius and wine viscosity that optimize aerosol evaporation are provided. These results pave the way towards the fine tuning of aerosol characteristics and flavor release during sparkling wine tasting, a major issue of the sparkling wine industry

The physics behind the fizz in champagne and sparkling wines

Bubbles in a glass of champagne may seem like the acme of frivolity to most of people, but in fact they may rather be considered as a fantastic playground for any physicist. Actually, the so-called effervescence process, which enlivens champagne and sparkling wines tasting, is the result of the fine interplay between CO2 dissolved gas molecules, tiny air pockets trapped within microscopic particles during the pouring process, and some both glass and liquid properties. Results obtained concerning the various steps where the CO2 molecule plays a role (from its ingestion in the liquid phase during the fermentation process to its progressive release in the headspace above the tasting glass as bubbles collapse) are gathered and synthesized to propose a self-consistent and global overview of how gaseous and dissolved CO2 impact champagne and sparkling wine science. Physicochemical processes behind the nucleation, rise, and burst of gaseous CO2 bubbles found in glasses poured with champagne and sparkling wines are depicted. Those phenomena observed in close-up through high-speed photography are often visually appealing. I hope that your enjoyment of champagne will be enhanced after reading this fully illustrated review dedicated to the science hidden right under your nose each time you enjoy a glass of champagne. Gérard Liger-Belair: He received his PhD in physical sciences in 2001 from the University of Reims, in France. He received an associate professor position at the University of Reims in 2002, and a full professor position, in 2007, in the same University. He has been researching the physics and chemistry behind the bubbling properties of champagne and sparkling wines for several years. His current interests include the science of bubbles, foams and thin films, and their broad interdisciplinary applications. He is the author of several academic and popular science books. His first book, Uncorked: the science of champagne, published by Princeton University Press, won the 2004 award for the Best Professional/Scholarly Book in Physics from the Association of American Publishers