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Background: Small bowel obstruction is a common surgical emergency, and is associated with high levels of morbidity and mortality across the world. The literature provides little information on the conservatively managed group. The aim of this study was to describe the burden of small bowel obstruction in the UK. Methods: This prospective cohort study was conducted in 131 acute hospitals in the UK between January and April 2017, delivered by trainee research collaboratives. Adult patients with a diagnosis of mechanical small bowel obstruction were included. The primary outcome was in‐hospital mortality. Secondary outcomes included complications, unplanned intensive care admission and readmission within 30 days of discharge. Practice measures, including use of radiological investigations, water soluble contrast, operative and nutritional interventions, were collected. Results: Of 2341 patients identified, 693 (29·6 per cent) underwent immediate surgery (within 24 h of admission), 500 (21·4 per cent) had delayed surgery after initial conservative management, and 1148 (49·0 per cent) were managed non‐operatively. The mortality rate was 6·6 per cent (6·4 per cent for non‐operative management, 6·8 per cent for immediate surgery, 6·8 per cent for delayed surgery; P = 0·911). The major complication rate was 14·4 per cent overall, affecting 19·0 per cent in the immediate surgery, 23·6 per cent in the delayed surgery and 7·7 per cent in the non‐operative management groups (P < 0·001). Cox regression found hernia or malignant aetiology and malnutrition to be associated with higher rates of death. Malignant aetiology, operative intervention, acute kidney injury and malnutrition were associated with increased risk of major complication. Conclusion: Small bowel obstruction represents a significant healthcare burden. Patient‐level factors such as timing of surgery, acute kidney injury and nutritional status are factors that might be modified to improve outcomes. [ABSTRACT FROM AUTHOR]

Ecological studies about marine benthic communities received a major leap from the application of a variety of non-destructive sampling and mapping techniques based on underwater image and video recording. The well-established scientific diving practice consists in the acquisition of single path or 'round-trip' over elongated transects, with the imaging device oriented in a nadir looking direction. As it may be expected, the application of automatic image processing procedures to data not specifically acquired for 3D modelling can be risky, especially if proper tools for assessing the quality of the produced results are not employed. This paper, born from an international cooperation, focuses on this topic, which is of great interest for ecological and monitoring benthic studies in Antarctica. Several video footages recorded from different scientific teams in different years are processed with an automatic photogrammetric procedure and salient statistical features are reported to critically analyse the derived results. As expected, the inclusion of oblique images from additional lateral strips may improve the expected accuracy in the object space, without altering too much the current video recording practices. [ABSTRACT FROM AUTHOR]

Background The optimal timing of cholecystectomy for patients admitted with acute gallbladder pathology is unclear. Some studies have shown that emergency cholecystectomy during the index admission can reduce length of hospital stay with similar rates of conversion to open surgery, complications and mortality compared with a 'delayed' operation following discharge. Others have reported that cholecystectomy during the index acute admission results in higher morbidity, extended length of stay and increased costs. This study examined the cost-effectiveness of emergency versus delayed cholecystectomy for acute benign gallbladder disease. Methods Using data from a prospective population-based cohort study examining the outcomes of cholecystectomy in the UK and Ireland, a model-based cost-utility analysis was conducted from the perspective of the UK National Health Service, with a 1-year time horizon for costs and outcomes. Probabilistic sensitivity analysis was used to investigate the impact of parameter uncertainty on the results obtained from the model. Results Emergency cholecystectomy was found to be less costly (£4570 versus £4720; €5484 versus €5664) and more effective (0·8868 versus 0·8662 QALYs) than delayed cholecystectomy. Probabilistic sensitivity analysis showed that the emergency strategy is more than 60 per cent likely to be cost-effective across willingness-to-pay values for the QALY from £0 to £100 000 (€0-120 000). Conclusion Emergency cholecystectomy is less costly and more effective than delayed cholecystectomy. This approach is likely to be beneficial to patients in terms of improved health outcomes and to the healthcare provider owing to the reduced costs. [ABSTRACT FROM AUTHOR]

B Correction: World J Surg (2019) 43:1928-1934 b https://doi.org/10.1007/s00268-019-04981-5 Since the publication of this work, S. Kanavati has changed their name from O. Kanavati. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. [Extracted from the article]

Background The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals. Methods Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy 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 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals. Conclusion Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Measurement of contamination of marine and naval diesel fuels (arising from product mixing or adulteration) with biodiesel or fatty acid methyl esters can be problematic, especially at very low levels. A suitable solution for this task for trace amounts of individual fatty acid methyl esters with resolution and quantification can be achieved by using a multidimensional gas chromatographic approach with electron and chemical ionization mass spectrometric detection. A unique column set comprising a 100mmethyl-siloxane nonpolar first dimension column and high-temperature ionic liquid column in the second dimension enabled identification of individual fatty acid methyl esters at below the lowest concentrations required to be reported in a diesel fuel matrix. Detection limits for individual fatty acid methyl esters compounds ranged from 0.5 to 5.0 mg/L, with excellent linearity up to 5000 mg/L and repeatability of the method from 1.3 to 3.2%. The method was applied to the analysis of diesel fuel samples with suspected biodiesel contamination. Contamination at 568 mg/L was calculated for an unknown sample and interpretation of the results permitted the determination of a likely source of the contamination. [ABSTRACT FROM AUTHOR]

Recent progress using geometry in the design of efficient Markov chain Monte Carlo (MCMC) algorithms have shown the effectiveness of the Fisher Riemannian structure. Furthermore, the theory of the underlying geometry of spaces of statistical models has made an important breakthrough by extending the classical theory on exponential families to their closures, the so-called extended exponential families. This paper looks at the underlying geometry of the Fisher information, in particular its limiting behaviour near boundaries, which illuminates the excellent behaviour of the corresponding geometric MCMC algorithms. Further, the paper shows how Fisher geodesics in extended exponential families smoothly attach the boundaries of extended exponential families to their relative interior. We conjecture that this behaviour could be exploited for trans-dimensional MCMC algorithms. [ABSTRACT FROM AUTHOR]

A green sampling approach by direct injection of ionic liquid (IL) solvent containing a variety of analytes using programmable temperature vaporisation (PTV) injection with gas chromatography (GC) is presented. The method was developed using test mixtures of n-alkanes, n-alcohols and polyaromatic compounds, whilst back extraction of isolated compounds from the IL with organic solvent is not required. In the final method, 2 μL of IL, 1-butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)amide containing analytes, was diluted to different volumes (ranging from 10 to 70%) with solvent then injected into the system. Several PTV injector parameters were investigated to ensure analyte volatilisation and transfer into the GC column. Concentration calibration curves (10-150 μg mL-1 and 10-100 μg mL-1 for n-alkanes and n-alcohols, respectively) were constructed, and showed addition of IL increased the peak area of each analyte, with good precision, and acceptable linearity with correlation coefficient, r² > 0.93. This method was successfully applied in analysis of a polynuclear aromatic hydrocarbons (PAHs) mixture, with addition of IL in the mixture and suitable operation of the PTV injector. The method was also applied to eucalyptus leaf essential oil compounds as a test sample in a single drop microextraction experiment. [ABSTRACT FROM AUTHOR]

Purpose: Incisional hernia is a common long-term complication after laparotomy. This study investigated whether prophylactic mesh reinforcement of laparotomy reduced the rate of incisional hernia, with emphasis on trial design and quality. Methods: A systematic review of published literature was performed for studies comparing incisional hernia presence following conventional closure or prophylactic mesh reinforcement. Studies were assessed using the Cochrane Risk of Bias Tool, the Jadad score and the Newcastle Ottawa Scale (NOS). The primary endpoint was incisional hernia, assessed by meta-analysis. Results: Seven studies [four randomised controlled trials (RCTs) and three prospective trials] included 588 patients; 262 received mesh reinforcement. All studies included elective patients at high risk of incisional hernia. Six incorporated a polypropylene mesh and one a biologic mesh. Four studies were judged high quality by NOS and two of four RCTs were at low risk of bias, although overall outcome assessment from all studies was either poor or mediocre. Mesh significantly reduced the rate of incisional hernia [odds ratio (OR) 0.15, p < 0.001]; the same effect was seen in RCTs only (OR 0.17, p < 0.001). A borderline increase of seroma seen with a fixed effect model (OR 1.82, p = 0.050) was not seen with a random effect model (OR 1.86, p = 0.210, I = 45 %). Conclusion: Mesh reinforcement of laparotomy significantly reduced the rate of incisional hernia in high-risk patients. However, poor assessment of secondary outcomes limits applicability; routine placement in all patients cannot yet be recommended. More evidence regarding the rates of adverse events, cost-benefits and quality of life are needed. [ABSTRACT FROM AUTHOR]

Mammography challenged [ABSTRACT FROM AUTHOR]

Age validation of bluenose Hyperoglyphe antarctica was sought using the independent bomb chronometer procedure. Radiocarbon (C) levels were measured in core micro-samples from 12 otoliths that had been aged using a zone count method. The core C measurement for each fish was compared with the value on a surface water reference curve for the calculated birth year of the fish. There was good agreement, indicating that the line-count ageing method described here is not substantially biased. A second micro-sample was also taken near the edge of nine of the otolith cross-sections to help define a bomb-carbon curve for waters deeper than 200-300 m. There appears to be a 10 to 15 year lag in the time it takes the C to reach the waters where adult H. antarctica are concentrated. The maximum estimated age of this species was 76 years, and females grow significantly larger than males. Von Bertalanffy growth curves were estimated, and although they fit the available data reasonably well, the lack of aged juvenile fish results in the K and t parameters being biologically meaningless. Consequently, curves that are likely to better represent population growth were estimated by forcing t to be −0·5. [ABSTRACT FROM AUTHOR]

A new class of local mixture models called local scale mixture models is introduced. This class is particularly suitable for the analysis of mixtures of the exponential distribution. The affine structure revealed by specific asymptotic expansions is the motivation for the construction of these models. They are shown to have very nice statistical properties which are exploited to make inferences in a straightforward way. The effect on inference of a new type of boundaries, called soft boundaries, is analyzed. A simple simulation study shows the applicability of this type of models. [ABSTRACT FROM AUTHOR]

Comprehensive multidimensional gas chromatography (GC×GC) is a powerful separation technique. One of the features of this technique is that it offers separations with more apparent structure than that offered by conventional one-dimensional GC (1-D GC). While some previous studies have alluded to this structure, and used structured retention patterns for some simple classifications, the topic of structured retention in GC×GC has not been studied in any great detail. Using the separation of fatty acid methyl esters (FAME) on both nonpolar/polar and polar/nonpolar column sets, the interaction between the separation dimensions and the sample dimensions is explored here. The GC×GC separation of a series of compounds is presented as a projection of the sample from sample space, a p-dimensional space with dimensions defined by the dimensionality of the sample, into separation space: for GC×GC, a two-dimensional plane passing through the sample space in an orientation defined by the separation conditions. Using this conceptual model and some a priori knowledge of the sample, it is shown how the image of the sample in the separation space can be used to construct an image of the sample in alternate dimensions, such as second dimension retention factor (2k) vs. chain length in the case of FAME. These projections into alternate dimensions should facilitate the interpretation of the complex patterns found within the GC×GC chromatogram for the identification and classification of compounds. [ABSTRACT FROM AUTHOR]

Rutherford backscattering spectrometry (RBS) and related techniques have long been used to determine the elemental depth profiles in films a few nanometres to a few microns thick. However, although obtaining spectra is very easy, solving the inverse problem of extracting the depth profiles from the spectra is not possible analytically except for special cases. It is because these special cases include important classes of samples, and because skilled analysts are adept at extracting useful qualitative information from the data, that ion beam analysis is still an important technique. We have recently solved this inverse problem using the simulated annealing algorithm. We have implemented the solution in the `IBA DataFurnace' code, which has been developed into a very versatile and general new software tool that analysts can now use to rapidly extract quantitative accurate depth profiles from real samples on an industrial scale. We review the features, applicability and validation of this new code together with other approaches to handling IBA (ion beam analysis) data, with particular attention being given to determining both the absolute accuracy of the depth profiles and statistically accurate error estimates. We include examples of analyses using RBS, non-Rutherford elastic scattering, elastic recoil detection and non-resonant nuclear reactions. High depth resolution and the use of multiple techniques simultaneously are both discussed. There is usually systematic ambiguity in IBA data and Butler's example of ambiguity (1990 Nucl. Instrum. Methods B 45 160–5) is reanalysed. Analyses are shown: of evaporated, sputtered, oxidized, ion implanted, ion beam mixed and annealed materials; of semiconductors, optical and magnetic multilayers, superconductors, tribological films and metals; and of oxides on Si, mixed metal silicides, boron nitride, GaN, SiC, mixed metal oxides, YBCO and polymers. [ABSTRACT FROM AUTHOR]

Vancouver is located in a temperate rain forest surrounded by mountains and water. Indigenous communities, including the Nations whose homelands the city occupies, have recognized that the abundance of this place can build healthy communities for many generations. But contemporary Vancouver is not a healthy city for all. Since 2014, Vancouver has adopted a Healthy City Strategy, a master social sustainability plan to address inequities in the social determinants of health at a population scale. This includes a number of population health targets and indicators. However, implementation has been slow, with substantive integration of health into policy not yet achieved. With support from the Partnership for Healthy Cities, we have translated the Healthy City Strategy’s indicators into an online dashboard, including disaggregated local data. In addition to public accountability, this tool enables data to be a platform for aligning city policy, action and investment toward common health outcomes. In parallel, we are also piloting more community-generated approaches to health data and indicators, with a focus on co-creating health indicators with Indigenous communities. Preliminary results have shown improvement in collaboration across city departments, leading to increased focus on upstream, preventive work. The dashboard is enabling frameworks for funding and working with the social service sector toward common health goals. Engagement efforts have shown the continued importance of a holistic strategy for health that is co-created with community knowledge and priorities. These interventions must be sustained and integrated into ongoing work. The technical work of developing the dashboard contributes to city-wide efforts toward data monitoring and reporting. Data has shown to be an important tool for beginning conversations, but sharing data about health inequities experienced by communities must be matched with an ongoing commitment to engagement and co-creation. Key messages: Population health data can be leveraged through interactive tools to better integrate and align city policies, plans and investments to address the social determinants of health. Engaging and co-creating policy with communities supports upstream, preventive action on health inequities. [ABSTRACT FROM AUTHOR]

The synthesis of DNA, as measured by the incorporation of [3H]- thymidine into the nuclei of cells of cultured explants of rabbit spleen, has been studied and correlated with estimation of DNA content of these nuclei using Feulgen densitometry, with and without colcemid arrest. Observations of the proportion of nuclei labelled with [3H] thymidine and their DNA content indicated that many cells were incorporating this precursor for DNA synthesis without the concomitant increases in DNA expected of cells in division cycle. Colcemid arrest failed to produce the changes in DNA content expected of a cell population as rapidly dividing as the labelling kinetics suggested. The results indicated that [3H] thymidine-labelled material, possibly DNA, was being transferred between cells and this accounted for the increased labelling index seen after pulsing with [3H] thymidine. The suppression of [3H] thymidine uptake by hydroxyurea indicated that this was not repair synthesis of damaged DNA.

The study discusses the photodegradation and photochemistry of the organophosphorus pesticide parathion. It states that unpurified parathion and paraoxon were observed to better understand its photoreactions and the environmental effects of pesticides. It states that the concentration spectrum of parathion in methanol indicated a impregnable but structureless band.

A patient with a 14 year history of sarcoidosis developed a progressive left cerebral hemisphere lesion. The clinical diagnosis of progressive multifocal leucoencephalopathy was confirmed by brain biopsy and remission occurred after treatment with cytosine arabinoside. [ABSTRACT FROM AUTHOR]

Clomipramine was used to treat 14 patients with panic attacks. Diagnosis was made according Lo DSM-III criteria for agoraphobia with panic attacks or panic disorder uncomplicated. An open evaluation of the drug over an 8-week treatment period was conducted. A total of 10 patients completed the study. Clomipramine was effective in reducing the mean number of panic attacks, the greatest response being observed in the first 2 weeks of treatment. Findings on all outcome measures showed that clomipramine was also effective in alleviating depression secondary to panic attacks, non-specific aspects of anxiety and improving phobic avoidance. There was a suggestion that responders to treatment received tower doses of clomipramine than non-responders. Further studies are required to evaluate this issue and the role of clomipramine in the treatment or panic disorders. [ABSTRACT FROM AUTHOR]

GC×GC is a novel technique, rapidly gaining importance for the analysis of complex samples. Here we evaluate the potential of GC×GC for the analysis of the FA-profile of milk from dairy cows fed either a control diet or the control diet supplemented with marine algae. FA methyl esters were separated using a BPX80-column (30m×0.25mm×0.25μm) coupled to a BPX35 (0.25m×0.10mm×0.10μm). Modulation (6s) was performed using a LMCS II with liquid CO2 as the cryogen. This modulator traps compounds eluting from the first dimension (1D) column by means of a cold spot. By moving the modulator to a position upstream of the cold spot, the solutes are exposed to the oven temperature and are re-injected on the second dimension (2D) column resulting in sharp peaks and higher sensitivity. The trap then returns to its original position and the process repeats throughout the analysis. Due to the difference in separation mechanism of the two columns, GC×GC results in an improved separation compared with analysis on the same column set without the use of the modulator (1-D GC). Thus whereas branched-chain C17-FA normally co-elute with C16:1-isomers using 1-D GC, GC×GC resulted in separation of these FA on the 2D column. Similarly, C18:1-isomers and conjugated linoleic acids were well resolved from C19:0 and C20:1-isomers, respectively. Displaying the peaks in a 2-D contour plot showed a well-ordered structure of FA according to their chemical properties, facilitating identification. 2D retention times provided information on the number of double bonds whereas retention in the 1D column was closely related with double bond position (n-3 vs. n-6). In conclusion, this experiment suggests GC×GC to be a powerful technique for the analysis of FA. Nevertheless, further research is needed to achieve improved separation of trans and cis C18:1-isomers, which may require a longer 1D column. [ABSTRACT FROM AUTHOR]

In the analysis of fatty acids, one of the most commonly used tools is a GC separation of the fatty acid methyl esters (FAME). Many researchers perform this separation using a non-polar phase such the ubiquitous 5% phenyl / 95% methyl capillary columns found in most every chromatography laboratory. Numerous laboratories have also turned recently to polar phases such as 70% cyanopropyl columns, as this type of chemistry provides increased selectivity for unsaturated compounds, and thus improved separation of cis/trans and ω3/ ω6 FAME isomers. Here, a series of columns nominally having 60, 70, 80, and 90% bis-cyanopropyl content have been tested for the separation of FAME isomers. Trends in retention and the influence of increasing phase polarity on effective and fractional chain lengths are highlighted to provide the FAME chromatographer with insight into which of these novel stationary phases might be best suited to their particular application. In addition, the elution temperatures ( Te) of the FAME and linear alkane standards are presented, as this information will be of value to comprehensive two-dimensional multidimensional GC (GC × GC) users who wish to use these columns in the primary dimension separation. [ABSTRACT FROM AUTHOR]

Trans-resveratrol, found in wine, grapes, peanuts, soy and tea, is one constituent of the polyphenol class which is reported to be beneficial to animal health. The analysis of trans-resveratrol may be accomplished by use of solid-phase microextraction (SPME), with on-fibre derivatization in order to improve the subsequent GC analysis (to increase the volatility and recovery) of the extracted solute. An 85 μm polyacrylate SPME fibre was selected for this study, and the SPME method incorporated a modification to the procedure to remove moisture and permit the use of water sensitive derivatizing reagents. Both BSTFA and acetic anhydride reagents were tested. Comprehensive two-dimensional gas chromatography (GC×GC) with a cryogenic modulation system was employed for the final chromatographic separation step. It was found that successful separation of resveratrol derivatives from potential interferences, that cause peak overlap in single column GC analysis of complex red wine samples, could be achieved. This increased separation power allows more accurate quantitative results for extracted trans-resveratrol Reproducible positioning of the trans-resveratrol peak in the 2D separation space was found in the SPME-GC×GC experiment, consistent with other studies on GC×GC retention reproducibility. Calibration curves for peak area were prepared for SPME extracted resveratrol, for both derivatising reagents, and good linearity (R2 ca. 0.998) was achieved. The trans-resveratrol content of five Australian red wine samples was determined by using the acetic anhydride derivatizing reagents, and optimum conditions for the analysis were established. [ABSTRACT FROM AUTHOR]

Explores the influence of home computer use on the use and attitude towards higher education information and communication technologies in Great Britain. Main constructs of 'computer attitude'; Advantages of the access to a home computer by students; Frequency of home computer-using students' use of information technology in universities.