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8. The role of porous structure on airfoil turbulence interaction noise reduction.

Author

Bowen, L., Celik, A., Westin, M. F., and Azarpeyvand, M.

Subjects
*NOISE control, *AEROFOILS, *TURBULENT flow, *TURBULENCE, *MINIMAL surfaces, *FLOW separation
Abstract

Experiments are performed to investigate the effect of porous treatment structure used at the leading edge on the aerodynamic and aeroacoustic characteristics of a National Advisory Committee for Aeronautics (NACA) 0012 airfoil. Three different triply periodic minimal surface porous structures of constant porosity are studied to explore their effect on the flow field and the relationship between airfoil response and far-field noise. The results show that the ratio between the porous structure pore size and the length scale of the turbulent flow plays an important role in the noise reduction capability of a porous leading edge. Changes to the turbulent flow properties in the vicinity of the airfoil are assessed to characterize the contributing physical behavior responsible for far-field noise manipulation. Velocity field analysis in front of the leading edge demonstrates a pronounced difference among porous structures. Furthermore, close to the airfoil surface and off from the stagnation line, all porous leading edges demonstrate a marked reduction in the low-frequency content of the velocity fluctuations. These results demonstrate the importance of the airfoil leading edge region and not just the stagnation line. The strong link evident in pressure–velocity coherence analysis of the solid airfoil is broken by the introduction of the porous leading edge. Furthermore, the porous leading edges reduce the near-field to far-field pressure coherence in both magnitude and frequency range. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Cost‐effectiveness of emergency versus delayed laparoscopic cholecystectomy for acute gallbladder pathology

Author

Sutton, A. J., Vohra, R. S., Hollyman, M., Marriott, P. J., Buja, A., Alderson, D., Pasquali, S., Griffiths, E. A., Vohra, R. S., Spreadborough, P., Hollyman, M., Marriott, P. J., Kirkham, A., Pasquali, S., Alderson, D., Griffiths, E. A., Fenwick, S., Elmasry, M., Nunes, Q. M., Kennedy, D., Khan, R. B., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., Saunders, M., Jamel, S., Ul Haque, S., Zafar, S., Shiwani, M. H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R. S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P. B., Lee, K., Joji, N., Heath, J., Teasdale, R. L., Weerasinghe, C., Needham, P. J., Welbourn, H., Forster, L., Finch, D., Blazeby, J. M., Robb, W., McNair, A. G. K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C.‐B., Jayanthi, N. V. G., Noor, N., Dobbins, B., Cockbain, A. J., Nilsen‐Nunn, A., de Siqueira, J., Pellen, M., Cowley, J. B., Ho, W.‐M., Miu, V., White, T. J., Hodgkins, K. A., Kinghorn, A., Tutton, M. G., Al‐Abed, Y. A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L. J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S. J., McCallum, I. J. D., Jones, M. J., Elsayed, M., Tuck, E., Wayman, J., Carney, K., Aroori, S., Hosie, K. B., Kimble, A., Bunting, D.M., Fawole, A. S., Basheer, M., Dave, R. V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M. P., Gough, M., Wallace, T., Singh, S., Downing, J., Mockford, K. A., Issa, E., Shah, N., Chauhan, N., Wilson, T. R., Forouzanfar, A., Wild, J. R. L., Nofal, E., Bunnell, C., Madbak, K., Rao, S. T. V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J. C., Gould, L., Chambers, A., Rodriguez, D. U., Sen, G., Robinson, S., Carney, K., Bartlett, F., Rae, D. M., Stevenson, T. E. J., Sarvananthan, K., Dwerryhouse, S. J., Higgs, S. M., Old, O. J., Hardy, T. J., Shah, R., Hornby, S. T., Keogh, K., Frank, L., Al‐Akash, M., Upchurch, E. A., Frame, R. J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T. O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W. S., Fleming, K., Bajwa, D. S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M. A., Bellini, M. I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Iqbal, L. G. N., Watson, N. F., Aggarwal, S. K., Orchard, P., Villatoro, E., Willson, P. D., Mok, J., Woodman, T., Deguara, J., Garcea, G., Babu, B. I., Dennison, A. R., Malde, D., Lloyd, D., Satheesan, S., Al‐Taan, O., Boddy, A., Slavin, J. P., Jones, R. P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M. M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S. R., Sampat, K., Oʼshea, K. M., Manu, M., Asprou, F. M., Malik, N. S., Chang, J., Johnstone, M., Lewis, M., Roberts, G. P., Karavadra, B., Photi, E., Hewes, J., Gould, L., Chambers, A., Rodriguez, D., OʼReilly, D. A., Rate, A. J., Sekhar, H., Henderson, L. T., Starmer, B. Z., Coe, P. O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A. E. J., Borowski, D. W., Hornsby, J., Courtney, M. J., Virupaksha, S., Seymour, K., Robinson, S., Hawkins, H., Bawa, S., Gallagher, P. V., Reid, A., Wood, P., Finch, J. G., Parmar, J., Stirland, E., Gardner‐Thorpe, J., Al‐Muhktar, A., Peterson, M., Majeed, A., Bajwa, F. M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D. R., Al‐Khyatt, W., Taylor, C., Bhandari, S., Chambers, A., Subramanium, D., Toh, S. K. C., Carter, N. C., Tate, S., Pearce, B., Wainwright, D., Mercer, S. J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., Khan, S., El‐Hasani, S. S., Hussain, A. A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M. N., Chishti, I. A., Fordham, I. J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A. K., Basu, S., Mohan, A. C., Harilingam, M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S. F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M. I., Ball, W. R., Wood, C. P. J., Pinho‐Gomes, A. C., Kausar, A., Obeidallah, M. R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S. Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond‐Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M. R., Goh, Y. L., Turner, P., Shetty, V., Riera, M., Macano, C. A.W., Sukha, A., Preston, S. R., Hoban, J. R., Puntis, D. J., Williams, S. V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G. H., Smith, S. R., Hall, C., Carty, N., Ahmed, J., Panteleimonitis, S., Gunasekera, R. T., Sheel, A. R. G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., McGlone, E. R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D. A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C. R., Yeldham, G., Read, E., Gossage, J. A., Rolph, R. C., Ebied, H., Phull, M., Khan, M. A., Popplewell, M., Kyriakidis, D., Hussain, A., Henley, N., Packer, J. R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N. A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson‐Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A. R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J. P., Pearson, K. L., Delisle, T. G., Davies, J., Tomlinson, M. A., Johnpulle, M. A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B. S., Zafrani, Z., Brett, D., Francombe, J., Spreadborough, P., Barnes, J., Cheung, M., Al‐Bahrani, A. Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P. A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R. C., Hebbar, M., Farag, S. F., Spearman, J., Hamdan, M. F., DʼCosta, C., Blane, C., Giles, M., Peter, M. B., Hirst, N. A., Hossain, T., Pannu, A., El‐Dhuwaib, Y., Morrison, T. E. M., Taylor, G. W., Thompson, R. L. E., McCune, K., Loughlin, P., Lawther, R., Byrnes, C. K., Simpson, D. J., Mawhinney, A., Warren, C., McKay, D., McIlmunn, C., Martin, S., MacArtney, M., Diamond, T., Davey, P., Jones, C., Clements, J.M., Digney, R., Chan, W. M., McCain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., McAree, B., Ghareeb, E., Thomas, G., Connelly, M., McKenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A. D. K., Cassidy, J. T., Boland, M., Burke, P., Nally, D. M., Hill, A. D. K., Khogali, E., Shabo, W., Iskandar, E., McEntee, G. P., OʼNeill, M. A., Peirce, C., Lyons, E. M., OʼSullivan, A. W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D. C., Kelly, M. E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J. G., McDermott, F., Martin, S. T., Cross, K. S., Cooke, F., Zeeshan, S., Murphy, J. O., Mealy, K., Mohan, H. M., Nedujchelyn, Y., Ullah, M. F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A. M., Vaughan, E. M., Ramage, M. I., Aldridge, R. C., Gibson, S., Nicholson, G. A., Vass, D. G., Grant, A. J., Holroyd, D. J., Jones, M. A., Sutton, C. M. L. R., OʼDwyer, P., Nilsson, F., Weber, B., Williamson, T. K., Lalla, K., Bryant, A., Carter, C. R., Forrest, C. R., Hunter, D. I., Nassar, A. H., Orizu, M. N., Knight, K., Qandeel, H., Suttie, S., Belding, R., McClarey, A., Boyd, A. T., Guthrie, G. J. K., Lim, P. J., Luhmann, A., Watson, A. J. M., Richards, C. H., Nicol, L., Madurska, M., Harrison, E., Boyce, K. M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M. S. J., Dalgaty, F., Fothergill, L., Driscoll, P. J., Mozolowski, K. L., Banwell, V., Bennett, S. P., Rogers, P. N., Skelly, B. L., Rutherford, C. L., Mirza, A. K., Lazim, T., Lim, H. C. C., Duke, D., Ahmed, T., Beasley, W. D., Wilkinson, M. D., Maharaj, G., Malcolm, C., Brown, T. H., Shingler, G. M., Mowbray, N., Radwan, R., Morcous, P., Wood, S., Kadhim, A., Stewart, D. J., Baker, A. L., Tanner, N., Shenoy, H., Hafiz, S., De Marchi, J. A., Singh‐Ranger, D., Hisham, E., Ainley, P., OʼNeill, S., Terrace, J., Napetti, S., Hopwood, B., Rhys, T., Downing, J., Kanavati, O., Coats, M., Aleksandrov, D., Kallaway, C., Yahya, S., Weber, B., Templeton, A., Trotter, M., Lo, C., Dhillon, A., Heywood, N., Aawsaj, Y., Hamdan, A., Reece‐Bolton, O., McGuigan, A., Shahin, Y., Ali, A., Luther, A., Nicholson, J. A., Rajendran, I., Boal, M., and Ritchie, J.

Published
2017
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32. Predicting the difficult laparoscopic cholecystectomy: development and validation of a pre-operative risk score using an objective operative difficulty grading system

Author

Nassar, A. H. M., Hodson, J., H. J., Ng, Vohra, R. S., Katbeh, T., Zino, S., Griffiths, E. A., Kirkham, A. J., Pasquali, S., Marriott, P., Johnstone, M., Spreadborough, P., Alderson, D., Fenwick, S., Elmasry, M., Nunes, Q. M., Kennedy, D., Khan, R. B., Khan, M. A. S., Magee, C. J., Jones, S. M., Mason, D., Parappally, C. P., Mathur, P., Saunders, M., Jamel, S., Haque, S. U., Zafar, S., Shiwani, M. H., Samuel, N., Dar, F., Jackson, A., Lovett, B., Dindyal, S., Winter, H., Fletcher, T., Rahman, S., Wheatley, K., Nieto, T., Ayaani, S., Youssef, H., Nijjar, R. S., Watkin, H., Naumann, D., Emesih, S., Sarmah, P. B., Lee, K., Joji, N., Lambert, J., Heath, J., Teasdale, R. L., Weerasinghe, C., Needham, P. J., Welbourn, H., Forster, L., Finch, D., Blazeby, J. M., Robb, W., Mcnair, A. G. K., Hrycaiczuk, A., Charalabopoulos, A., Kadirkamanathan, S., Tang, C. -B., Jayanthi, N. V. G., Noor, N., Dobbins, B., Cockbain, A. J., Nilsen-Nunn, A., de Siqueira, J., Pellen, M., Cowley, J. B., W. -M., Ho, Miu, V., White, T. J., Hodgkins, K. A., Kinghorn, A., Tutton, M. G., Al-Abed, Y. A., Menzies, D., Ahmad, A., Reed, J., Khan, S., Monk, D., Vitone, L. J., Murtaza, G., Joel, A., Brennan, S., Shier, D., Zhang, C., Yoganathan, T., Robinson, S. J., Mccallum, I. J. D., Jones, M. J., Elsayed, M., Tuck, L., Wayman, J., Carney, K., Aroori, S., Hosie, K. B., Kimble, A., Bunting, D. M., Fawole, A. S., Basheer, M., Dave, R. V., Sarveswaran, J., Jones, E., Kendal, C., Tilston, M. P., Gough, M., Wallace, T., Singh, S., Mockford, J. D. K. A., Issa, E., Shah, N., Chauhan, N., Wilson, T. R., Forouzanfar, A., Wild, J. R. L., Nofal, E., Bunnell, C., Madbak, K., Rao, S. T. V., Devoto, L., Siddiqi, N., Khawaja, Z., Hewes, J. C., Gould, L., Chambers, A., Rodriguez, D. U., Sen, G., Robinson, S., Bartlett, F., Rae, D. M., Stevenson, T. E. J., Sarvananthan, K., Dwerryhouse, S. J., Higgs, S. M., Old, O. J., Hardy, T. J., Shah, R., Hornby, S. T., Keogh, K., Frank, L., Al-Akash, M., Upchurch, E. A., Frame, R. J., Hughes, M., Jelley, C., Weaver, S., Roy, S., Sillo, T. O., Galanopoulos, G., Cuming, T., Cunha, P., Tayeh, S., Kaptanis, S., Heshaishi, M., Eisawi, A., Abayomi, M., Ngu, W. S., Fleming, K., Bajwa, D. S., Chitre, V., Aryal, K., Ferris, P., Silva, M., Lammy, S., Mohamed, S., Khawaja, A., Hussain, A., Ghazanfar, M. A., Bellini, M. I., Ebdewi, H., Elshaer, M., Gravante, G., Drake, B., Ogedegbe, A., Mukherjee, D., Arhi, C., Giwa, L., Iqbal, N., Watson, N. F., Aggarwal, S. K., Orchard, P., Villatoro, E., Willson, P. D., Mok, K. W. J., Woodman, T., Deguara, J., Garcea, G., Babu, B. I., Dennison, A. R., Malde, D., Lloyd, D., Satheesan, S., Al-Taan, O., Boddy, A., Slavin, J. P., Jones, R. P., Ballance, L., Gerakopoulos, S., Jambulingam, P., Mansour, S., Sakai, N., Acharya, V., Sadat, M. M., Karim, L., Larkin, D., Amin, K., Khan, A., Law, J., Jamdar, S., Smith, S. R., Sampat, K., O'Shea, K. M., Manu, M., Asprou, F. M., Malik, N. S., Chang, J., Lewis, M., Roberts, G. P., Karavadra, B., Photi, E., Hewes, J., Rodriguez, D., O'Reilly, D. A., Rate, A. J., Sekhar, H., Henderson, L. T., Starmer, B. Z., Coe, P. O., Tolofari, S., Barrie, J., Bashir, G., Sloane, J., Madanipour, S., Halkias, C., Trevatt, A. E. J., Borowski, D. W., Hornsby, J., Courtney, M. J., Virupaksha, S., Seymour, K., Hawkins, H., Bawa, S., Gallagher, P. V., Reid, A., Wood, P., Finch, J. G., Guy Finch, J., Parmar, J., Stirland, E., Gardner-Thorpe, J., Al-Muhktar, A., Peterson, M., Majeed, A., Bajwa, F. M., Martin, J., Choy, A., Tsang, A., Pore, N., Andrew, D. R., Al-Khyatt, W., Taylor, C., Bhandari, S., Subramanium, D., Toh, S. K. C., Carter, N. C., Tate, S., Pearce, B., Wainwright, D., Mercer, S. J., Knight, B., Vijay, V., Alagaratnam, S., Sinha, S., El-Hasani, S. S., Hussain, A. A., Bhattacharya, V., Kansal, N., Fasih, T., Jackson, C., Siddiqui, M. N., Chishti, I. A., Fordham, I. J., Siddiqui, Z., Bausbacher, H., Geogloma, I., Gurung, K., Tsavellas, G., Basynat, P., Shrestha, A. K., Basu, S., Chhabra, A., Harilingam, M., Rabie, M., Akhtar, M., Kumar, P., Jafferbhoy, S. F., Hussain, N., Raza, S., Haque, M., Alam, I., Aseem, R., Patel, S., Asad, M., Booth, M. I., Ball, W. R., Wood, C. P. J., Pinho-Gomes, A. C., Kausar, A., Obeidallah, M. R., Varghase, J., Lodhia, J., Bradley, D., Rengifo, C., Lindsay, D., Gopalswamy, S., Finlay, I., Wardle, S., Bullen, N., Iftikhar, S. Y., Awan, A., Ahmed, J., Leeder, P., Fusai, G., Bond-Smith, G., Psica, A., Puri, Y., Hou, D., Noble, F., Szentpali, K., Broadhurst, J., Date, R., Hossack, M. R., Goh, Y. L., Turner, P., Shetty, V., Riera, M., Macano, C. A. W., Sukha, A., Preston, S. R., Hoban, J. R., Puntis, D. J., Williams, S. V., Krysztopik, R., Kynaston, J., Batt, J., Doe, M., Goscimski, A., Jones, G. H., Hall, C., Carty, N., Panteleimonitis, S., Gunasekera, R. T., Sheel, A. R. G., Lennon, H., Hindley, C., Reddy, M., Kenny, R., Elkheir, N., Mcglone, E. R., Rajaganeshan, R., Hancorn, K., Hargreaves, A., Prasad, R., Longbotham, D. A., Vijayanand, D., Wijetunga, I., Ziprin, P., Nicolay, C. R., Yeldham, G., Read, E., Gossage, J. A., Rolph, R. C., Ebied, H., Phull, M., Khan, M. A., Popplewell, M., Kyriakidis, D., Henley, N., Packer, J. R., Derbyshire, L., Porter, J., Appleton, S., Farouk, M., Basra, M., Jennings, N. A., Ali, S., Kanakala, V., Ali, H., Lane, R., Dickson-Lowe, R., Zarsadias, P., Mirza, D., Puig, S., Al Amari, K., Vijayan, D., Sutcliffe, R., Marudanayagam, R., Hamady, Z., Prasad, A. R., Patel, A., Durkin, D., Kaur, P., Bowen, L., Byrne, J. P., Pearson, K. L., Delisle, T. G., Davies, J., Tomlinson, M. A., Johnpulle, M. A., Slawinski, C., Macdonald, A., Nicholson, J., Newton, K., Mbuvi, J., Farooq, A., Mothe, B. S., Zafrani, Z., Brett, D., Francombe, J., Barnes, J., Cheung, M., Al-Bahrani, A. Z., Preziosi, G., Urbonas, T., Alberts, J., Mallik, M., Patel, K., Segaran, A., Doulias, T., Sufi, P. A., Yao, C., Pollock, S., Manzelli, A., Wajed, S., Kourkulos, M., Pezzuto, R., Wadley, M., Hamilton, E., Jaunoo, S., Padwick, R., Sayegh, M., Newton, R. C., Hebbar, M., Farag, S. F., Spearman, J., Hamdan, M. F., D'Costa, C., Blane, C., Giles, M., Peter, M. B., Hirst, N. A., Hossain, T., Pannu, A., El-Dhuwaib, Y., Morrison, T. E. M., Taylor, G. W., Thompson, R. L. E., Mccune, K., Loughlin, P., Lawther, R., Byrnes, C. K., Simpson, D. J., Mawhinney, A., Warren, C., Mckay, D., Mcilmunn, C., Martin, S., Macartney, M., Diamond, T., Davey, P., Jones, C., Clements, J. M., Digney, R., Chan, W. M., Mccain, S., Gull, S., Janeczko, A., Dorrian, E., Harris, A., Dawson, S., Johnston, D., Mcaree, B., Ghareeb, E., Thomas, G., Connelly, M., Mckenzie, S., Cieplucha, K., Spence, G., Campbell, W., Hooks, G., Bradley, N., Hill, A. D. K., Cassidy, J. T., Boland, M., Burke, P., Nally, D. M., Khogali, E., Shabo, W., Iskandar, E., Mcentee, G. P., O'Neill, M. A., Peirce, C., Lyons, E. M., O'Sullivan, A. W., Thakkar, R., Carroll, P., Ivanovski, I., Balfe, P., Lee, M., Winter, D. C., Kelly, M. E., Hoti, E., Maguire, D., Karunakaran, P., Geoghegan, J. G., Mcdermott, F., Martin, S. T., Cross, K. S., Cooke, F., Zeeshan, S., Murphy, J. O., Mealy, K., Mohan, H. M., Nedujchelyn, Y., Ullah, M. F., Ahmed, I., Giovinazzo, F., Milburn, J., Prince, S., Brooke, E., Buchan, J., Khalil, A. M., Vaughan, E. M., Ramage, M. I., Aldridge, R. C., Gibson, S., Nicholson, G. A., Vass, D. G., Grant, A. J., Holroyd, D. J., Jones, M. A., Sutton, C. M. L. R., O'Dwyer, P., Nilsson, F., Weber, B., Williamson, T. K., Lalla, K., Bryant, A., Carter, C. R., Forrest, C. R., Hunter, D. I., Nassar, A. H., Orizu, M. N., Knight, K., Qandeel, H., Suttie, S., Belding, R., Mcclarey, A., Boyd, A. T., Guthrie, G. J. K., Lim, P. J., Luhmann, A., Watson, A. J. M., Richards, C. H., Nicol, L., Madurska, M., Harrison, E., Boyce, K. M., Roebuck, A., Ferguson, G., Pati, P., Wilson, M. S. J., Dalgaty, F., Fothergill, L., Driscoll, P. 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Subjects
Adult, Male, operative difficulty, medicine.medical_specialty, medicine.medical_treatment, Difficulty grading, difficult cholecystectomy, predictive score, surgery, laparoscopic, cholecystectomy, Surgical planning, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Preoperative Care, Humans, Medicine, Laparoscopic cholecystectomy, Framingham Risk Score, business.industry, General surgery, Reproducibility of Results, Middle Aged, medicine.disease, Pre operative, Single surgeon, Cholecystectomy, Laparoscopic, ROC Curve, 030220 oncology & carcinogenesis, Multivariate Analysis, Cholecystitis, Female, 030211 gastroenterology & hepatology, Surgery, Cholecystectomy, business, Abdominal surgery
Abstract

The prediction of a difficult cholecystectomy has traditionally been based on certain pre-operative clinical and imaging factors. Most of the previous literature reported small patient cohorts and have not used an objective measure of operative difficulty. The aim of this study was to develop a pre-operative score to predict difficult cholecystectomy, as defined by a validated intra-operative difficulty grading scale. Two cohorts from prospectively maintained databases of patients who underwent laparoscopic cholecystectomy were analysed: the CholeS Study (8755 patients) and a single surgeon series (4089 patients). Factors potentially predictive of difficulty were correlated to the Nassar intra-operative difficulty scale. A multivariable binary logistic regression analysis was then used to identify factors that were independently associated with difficult laparoscopic cholecystectomy, defined as operative difficulty grades 3 to 5. The resulting model was then converted to a risk score, and validated on both internal and external datasets. Increasing age and ASA classification, male gender, diagnosis of CBD stone or cholecystitis, thick-walled gallbladders, CBD dilation, use of pre-operative ERCP and non-elective operations were found to be significant independent predictors of difficult cases. A risk score based on these factors returned an area under the ROC curve of 0.789 (95% CI 0.773–0.806, p

Published
2019
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34. Association analysis of 31 common polymorphisms with type 2 diabetes and its related traits in Indian sib pairs

Author

Gupta, V., Vinay, D. G., Rafiq, S., Kranthikumar, M. V., Janipalli, C. S., Giambartolomei, C., Evans, D. M., Mani, K. R., Sandeep, M. N., Taylor, A. E., Kinra, S., Sullivan, R. M., Bowen, L., Timpson, N. J., Smith, G. D., Dudbridge, F., Prabhakaran, D., Ben-Shlomo, Y., Reddy, K. S., Ebrahim, S., Chandak, G. R., and for the Indian Migration Study Group

Published
2012
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35. Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Author

Kirmeier, E, Eriksson, L, Lewald, H, Jonsson Fagerlund, M, Hoeft, A, Hollmann, M, Meistelman, C, Hunter, J, Ulm, K, Blobner, M, Abad Gurumeta, A, Abernethy, C, Abigail, P, Achaibar, K, Adam, E, Afshari, A, Agudelo Montoya, M, Akgun, F, Aletti, G, Alkis, N, Allan, K, Allan, A, Allaouchiche, B, Allcock, C, Almasy, E, Amey, I, Amigoni, M, Andersen, E, Andersson, P, Anipchenko, N, Antunes, P, Armstrong, E, Aslam, T, Aslin, B, Assuncao, J, Ausserer, J, Avvai, M, Awad, N, Ayas Montero, B, Ayuso, M, Azevedo, P, Badarau, V, Badescu, R, Baiardo Redaelli, M, Baird, C, Baird, Y, Baker, T, Balaji, P, Balan, C, Balandin, A, Balescu-Arion, C, Baliuliene, V, Baltasar Isabel, J, Baluch, S, Bandrabur, D, Bankewitz, C, Barber, K, Barbera, F, Barcraft-Barnes, H, Barletti, V, Barnett, G, Baron, K, Barros, A, Barsan, V, Bartlett, P, Batistaki, C, Baumgarten, G, Baytas, V, Beauchamp, N, Becerra Cayetano, I, Bell, S, Bellandi, M, Belletti, A, Belmonte Cuenca, J, Benitez-Cano, A, Beretta, L, Berger, M, 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A., Bell S., Bellandi M., Belletti A., Belmonte Cuenca J., Benitez-Cano A., Beretta L., Berger M., Bergmann N., Bergmark K., Bermudez Lopez M., Bernotaite M., Beurskens C., Bidd H., Bifulco F., Bignami E., Bilic A., Bilskiene D., Bischoff P., Bishop L., Bjonness T., Blaylock H., Blethyn K., Blincoe T., Blokhin I., Blunt N., Boer C., Bois G., Bonicolini E., Booth J., Borecka-Kedzierska M., Borstnar K., Borys M., Boselli E., Bouvet L., Bouwman A., Bowen L., Bowrey S., Boxall L., Bozic T., Bradley T., Branco T., Brazzi L., Brazzoni M., Brear T., Brogly N., Brohi F., Broms J., Bubliauskas A., Bucolo G. E., Buerkle H., Buggy D., Buhre W., Bukauskas T., Butturini F., Byttner A., Cabrera Diaz I., Calderon A., Calhau R., Callejo A., Cammu G., Campesato M., Can O. S., Candeias M., Cantor A., Carise E., Carmona C., Carreteiro J., Carrieri C., Carter A., Casal M., Casanova I., Cascella M., Casero L. M., Casiraghi G. M., Castelo-Branco L., Castro Arranz C., Cernea D. D., Cervantes J., Chandler B., Charnock R., Chatzimicali A., Chinery E., Chishti A., Chondhury P., Christie E., Christodoudiles G., Ciardo S., Cimpeanu L., Cindea I., Cinnella G., Clark S., Clayton M., Cocu S., Collyer T., Colvin C., Cope S., Copeta F., Copotoiu S. -M., Correia de Barros F., Corso R. M., Cortegiani A., Costa G., Cowton A., Cox N., Craig J., Cricca V., Cronin J., Cunha M., Cuomo A., Curley K., Czuczwar M., Dabrowska D., Damster S., Danguy des Deserts M., Daniliuc A., Danninger T., Darwish I., Dascalu C., Davies K., Davies S., De Boer H., De Flaviis A., De Selincourt G., Deana C., Debaene B., Debreceni G., Dedhia J., Delgado Garcia I., Della Rocca G., Delroy-Buelles L., Desai T., Dhillon P., Di Giacinto I., Di Mauro P., Diaz Gomez T. V., Dimitrovski A., Dinic V., Dirzu D. -S., Divander M. B., Dolinar J., Domingues S., Doolan J., Downes C., Dragoescu N. A., Droc G., Dum E., Dumitrescu A., Duncan L., Dzurnakova P., Eberl S., Edwards J., Edwards M., Ekelund K., Ekengren P., Elghouty E., Ellerkmann R., Ellis H., Elme A., Ernst T., Errando C. L., Estenes S., Ewaldsson C., Farid N., Featherstone J., Febres D., Fedorov S., Feggeler J., Feijten P., Fellmann T., Fernandez Candil J., Fernandez Castineira A., Fernandez Castineira J., Fernando A., Ferrando C., Ferreira L., Ferreira P., Feyling A., Filipescu D., Fleischer A., Floris L., Foerster U., Fox B., Franke U., Frasca D., Frey C., Frost V., Fullin G., Fumagalli J., Furneval J., Fusari M., Gallacher S., Galushka S., Gambale G., Gambino I., Garcia-Perez M. L., Garg S., Garlak J., Gavranovic Z., Gavrilov R., Gaynor L., Gecaj Gashi A., Georghiou M., Gerjevic B., Gferer G., Giarratano A., Gibson A., Gievski V., Giles J., Gillberg L., Gilowska K., Gilsanz Rodriguez F., Gioia A., Giovannoni C., Girotra V., Gkinas D., Gkiokas G., Godoroja D., Goebel U., Goel V., Gonzalez M., Goranovic T., Gornik-Wlaszczuk E., Gosavi S., Gottfridsson P., Gottschalk A., Granell M., Granstrom A., Grassetto A., Greenwood A., Grigoras I., Grintescu I., Gritsan A., Gritsan G., Grynyuk A., Guadagnin G. M., Guarnieri M., Guclu C., Guerrero Diez M., Gunenc F., Gunther U., Gupta P., Guttenthaler V., Hack Y., Hafisayena A., Hagau N., Haldar J., Hales D., Hanci V., Hanna-Jumma S., Harazim H., Harlet P., Harper D., Harris B., Harvey O., Hashimi M., Hawkins L., Hayes C., Heaton J., Heier T., Helliwell L., Hemmes S., Henderson K., Hermanides J., Hermanns H., Herrera Hueso B., Hestenes S., Hettiarachchi R., Highgate J., Hodgson K., Hoelbling D., Holland J., Horhota L., Hormis A., Hribar R., Hua A., Humphreys S., Humphries R., Humplikova S., Hunt J., Husnain A., Hussein A., Hyams B., Iannuccelli F., Ilette K., Ilyas C., Inan T., India I., Ionitav V., Irwin F., Jain V., Janez B., Jankovic R., Jenkins S., Jenko M., Jimenez R., Jimenez Gomez B., Joachim S., Joelsson-Alm E., John J., Jonikaite L., Jovic M., Jungwirth B., Junke E., Kabakov B., Kadaoui S. -D., Kanski A., Karadag S., Karbonskiene A., Karjagin J., Kasnik D., Katanolli F., Katsika E., Kaufmann K., Keane H., Kelly M., Kent M., Keraitiene G., Khudhur A., Khuenl-Brady K., Kidd L., King S., Kirchgassner K., Klancir T., Klucniks A., Knotzer J., Knowlden P., Koers L., Kompan J., Koneti K. K., Kooij F., Koolen E., Koopman - van Gemert A. W. M. M., Kopp K., Korfiotis D., Korolkov O., Kosinova M., Kostenberger M., Kotzinger O., Kovacevic M., Kranke P., Kranke E., Kraus C., Kraus S., Kubitzek C., Kucharski R., Kucukguclu S., Kudrashou A., Kumar V., Kummen L., Kunit C., Kushakovsky V., Kuvaki B., Kuzmanovska B., Kyttari A., Landoni G., Lau G., Lazarev K., Legett S., Legrottaglie A. M., Leonardi S., Leong M., Lercher H., Leuvrey M., Leva B., Levstek M., Limb J., Lindholm E., Linton F., Liperi C., Lipski F., Lirk P., Lisi A., Liskova K., Lluch Oltra A., Loganathan V., Lombardi S., Lopez E., Lopez Rodriguez M., Lorenzini L., Lowicka M., Lugovoy A., Luippold M., Lumb A., Macas A., Macgregor M., Machado H., Maciariello M., Madeira I., Maitan S., Majewski J., Maldini B., Malewski G., Manfredini L., Manner O., Marchand B., Marcu A., Margalef J., Margarson M., Marinheiro L., Markic A., Markovic Bozic J., Marrazzo F., Martin J., Martin Ayuso M., Martinez E., Martino E. A., Martinson V., Marusic-Gaser K., Mascarenhas C., Mathis C., Matsota P., Mavrommati E., Mazul Sunko B., McCourt K., McGill N., McKee R., Meco B. C., Meier S., Melbourne S., Melbybrathen G., Meli A., Melia A., Melotti R. M., Menga M. R., Mercer P., Merotra S., Mescolini S., Metterlein T., Michalov M., Michlig S., Midgley S., Milic M., Milojevic M., Minana A., Minto G., Mirabella L., Mirea L., Mittelstadt L., Moeglen A., Moise A., Mokini Z., Molin A., Molto L., Monea M. C., Montalto F., Montgomery J., Montgomery C., Montillo G., Moore S., Moore F., Moreira Z., Moreno T., Moreno R., Moret E., Moreton S., Morgan M., Moro Velasco C., Morri D., Moull A., Moura F., Mraz P., Mrozek K., Mukhtar K., Muniyappa S., Murray H., Murthy B. V., Mushambi M., Nadolski M., Nardelli P., Nardin G., Navarro Perez R., Naveiro A., Negri M., Nesek Adam V., Neskovic V., Neuwersch S., Neves M., Nguyen B., Ni Eochagain A., Nicholas C., Nightingale J., Norrie K., Novak-Jankovic V., Novakova A., Novillo M., Numan S., Oduro-Dominah L., Oldner A., Oliveira I., Ologoiu D., Oloktsidou I., O'Reilly R., Orlando A., Ovezov A., Ozbilgin S., Paal P., Padin Barreiro L., Palugniok R., Papaioannou A., Papapostolou K., Paranthaman P., Pardey Bracho G., Parente S., Parfeni A., Pasin L., Passey S., Pastor E., Patch S., Patil A., Paunescu M. -A., Pehboeck D., Pereira M., Pereira C., Perez Caballero P., Perez Garcia A., Perez Soto A., Perez Tejero G., Perez-Cerda F., Pesenti A., Petta R., Philippe S., Pickering D., Pico Veloso J., Pina P., Pinho-Oliveira V., Pinol S., Pinto R., Pistidda L., Pitterle M., Piwowarczyk P., Plotnikova O., Pohl H., Poldermann J., Polkovicova L., Pompei L., Popescu M., Popovic R., Pota V., Potocnik M., Potrec B., Potter A., Pramod N., Prchalova M., Preckel B., Pugh R., Pulletz M., Radoeshki A., Rafi A., Ragazzi R., Raineri Santi M., Rajamanickam T., Rajput Z., Ramachandran R., Ramasamy R., Ramessur S., Rao R., Rasmussen A., Rato A., Razaque U., Real Navacerrada M. I., Reavley C., Reid J., Reschreiter H., Rial E., Ribas Carrasco P., Ribeiro S., Rich N., Richardson L., Rimaitis K., Rimaitis M., Ringvold E. -M., Ripke F., Ristescu I., Ritchie K., Rodenas F., Rodrigues P., Rogers E., Rogerson D., Romagnoli S., Romero E., Rondovic G., Rose B. O., Roth W., Rotter M. -T., Rousseau G., Rudjord A., Rueffert H., Rundgren M., Rupprecht K., Rushton A., Russotto V., Rypulak E., Ryszka M., Sa J., Sa Couto P., Saby S., Sagic J., Saleh O., Sales G., Sanchez Sanchez Y., Sanghera S., Sanli Karip C., Santiveri Papiol F. J., Santos S., Sarno S., Saul D., Saunders D., Savic N., Scalco L., Scanlon D., Schaller S., Schax C., Scheffer G. J., Schening A., Schiavone V., Schmidt-Ehrenberg F., Schmidt-Mutter C., Schonberg C., Schopflin C., Schreiber J. -U., Schultz M., Schurig M., Scott C., Sebestian S., Sehgal S., Sem V., Semenas E., Serafini E., Serchan P., Shields M., Shobha R., Shosholcheva M., Siamansour T., Siddaiah N., Siddiqi K., Sinclair R., Singh P., Singh R., Sinha A., Skinner A., Smee E., Smekalova O., Smith N., Smith T., Smitz C., Smole D., Sojcic N., Soler Pedrola M., Somanath S., Sonksen J., Sorella M. C., Sormus A., Soro M., Soto C., Spada A., Spadaro S., Spaeth J., Sparr H., Spielmann A., Spindler-Vesel A., Stamelos M., Stancombe L L., Stanculescu A., Standl T., Standley T., Stanek O., Stanisavljevic S., Starczewska M., Stauble C., Steen J., Stefan O. M., Stell E., Stera C., Stevens M., Stoerckel M., Stosic B., Stourac P., Stroumpoulis K., Struck R., Suarez de la Rica A., Sultanpori A., Sundara Rajan R., Suying O., Svensen C., Swan L., Syrogianni P., Sysiak J., Szederjesi J., Taddei S., Tan Hao E., Tanou V., Tarabova K., Tardaguila Sancho P., Tarroso M., Tartaglione M., Taylor E., Tbaily L., Telford R., Terenzoni M., Theodoraki K., Thornley H., Tiganiuc L., Toim H., Tomescu D., Tommasino C., Toni J., Toninelli A., Toretti I., Townley S., Trepenaitis D., Trethowan B., Tsaousi G., Tsiftsi A., Tudor A., Turan G., Turhan S. C., Unic-Stojanovic D., Unterbuchner C., Unzueta C., Uranjek J., Ursic T., Vaida S., Valldeperas Ferrer S., Valldeperas Hernandez M. I., Valsamidis D., Van Beek R., Van dasselaer N., Van Der Beek T., Van Duivenvoorde Y., van Klei W. A., Van Poorter F., Van Zaane B., Van Zundert T., Van Zyl R., Vargas Munoz A. M., Varsani N., Vasconcelos P., Vassilakis G., Vecchiatini T., Vecera L., Vercauteren M., Verdouw B., Verheyen V., Verri M., Vicari Sottosanti L. G., Vico M., Vidal Mitjans P., Vilardi A., Vissicchio D., Vitale G., Vitkovic B., Vizcaychipi M. P., Voicu A., Voje M., Volfova I., Volta C. A., Von Lutterotti T., von Tiesenhausen A., Vrecic-Slabe S., Vukcevic D., Vukovic R., Vullo P. A., Wade A., Wallberg H., Wallden J., Wallner J., Walther Sturesson L., Watson D., Weber S., Wegiel Leskiewiq A., Weller D., Wensing C., Werkmann M., Westberg H., Wikstrom E., Williams B., Wilson R., Wirth S., Wittmann M., Wood L., Wright S., Zachoval C., Zambon M., Zampieri S., Zampone S., Zangrillo A., Zani G., Zavackiene A., Zieglerder R., Zonneveldt H., Zsisku L., Zucker T. -P., Zukowski M., Zuleika M., Zupaneie D., Kirmeier, E, Eriksson, L, Lewald, H, Jonsson Fagerlund, M, Hoeft, A, Hollmann, M, Meistelman, C, Hunter, J, Ulm, K, Blobner, M, Abad Gurumeta, A, Abernethy, C, Abigail, P, Achaibar, K, Adam, E, Afshari, A, Agudelo Montoya, M, Akgun, F, Aletti, G, Alkis, N, Allan, K, Allan, A, Allaouchiche, B, Allcock, C, Almasy, E, Amey, I, Amigoni, M, Andersen, E, Andersson, P, Anipchenko, N, Antunes, P, Armstrong, E, Aslam, T, Aslin, B, Assuncao, J, Ausserer, J, Avvai, M, Awad, N, Ayas Montero, B, Ayuso, M, Azevedo, P, Badarau, V, Badescu, R, Baiardo Redaelli, M, Baird, C, Baird, Y, Baker, T, Balaji, P, Balan, C, Balandin, A, Balescu-Arion, C, Baliuliene, V, Baltasar Isabel, J, Baluch, S, Bandrabur, D, Bankewitz, C, Barber, K, Barbera, F, Barcraft-Barnes, H, Barletti, V, Barnett, G, Baron, K, Barros, A, Barsan, V, Bartlett, P, Batistaki, C, Baumgarten, G, Baytas, V, Beauchamp, N, Becerra Cayetano, I, Bell, S, Bellandi, M, Belletti, A, Belmonte Cuenca, J, Benitez-Cano, A, Beretta, L, Berger, M, Bergmann, N, Bergmark, K, Bermudez Lopez, M, Bernotaite, M, Beurskens, C, Bidd, H, Bifulco, F, Bignami, E, Bilic, A, Bilskiene, D, Bischoff, P, Bishop, L, Bjonness, T, Blaylock, H, Blethyn, K, Blincoe, T, Blokhin, I, Blunt, N, Boer, C, Bois, G, Bonicolini, E, Booth, J, Borecka-Kedzierska, M, Borstnar, K, Borys, M, Boselli, E, Bouvet, L, Bouwman, A, Bowen, L, Bowrey, S, Boxall, L, Bozic, T, Bradley, T, Branco, T, Brazzi, L, Brazzoni, M, Brear, T, Brogly, N, Brohi, F, Broms, J, Bubliauskas, A, Bucolo, G, Buerkle, H, Buggy, D, Buhre, W, Bukauskas, T, Butturini, F, Byttner, A, Cabrera Diaz, I, Calderon, A, Calhau, R, Callejo, A, Cammu, G, Campesato, M, Can, O, Candeias, M, Cantor, A, Carise, E, Carmona, C, Carreteiro, J, Carrieri, C, Carter, A, Casal, M, Casanova, I, Cascella, M, Casero, L, Casiraghi, G, Castelo-Branco, L, Castro Arranz, C, Cernea, D, Cervantes, J, Chandler, B, Charnock, R, Chatzimicali, A, Chinery, E, Chishti, A, Chondhury, P, Christie, E, Christodoudiles, G, Ciardo, S, Cimpeanu, L, Cindea, I, Cinnella, G, Clark, S, Clayton, M, Cocu, S, Collyer, T, Colvin, C, Cope, S, Copeta, F, Copotoiu, S, Correia de Barros, F, Corso, R, Cortegiani, A, Costa, G, Cowton, A, Cox, N, Craig, J, Cricca, V, Cronin, J, Cunha, M, Cuomo, A, Curley, K, Czuczwar, M, Dabrowska, D, Damster, S, Danguy des Deserts, M, Daniliuc, A, Danninger, T, Darwish, I, Dascalu, C, Davies, K, Davies, S, De Boer, H, De Flaviis, A, De Selincourt, G, Deana, C, Debaene, B, Debreceni, G, Dedhia, J, Delgado Garcia, I, Della Rocca, G, Delroy-Buelles, L, Desai, T, Dhillon, P, Di Giacinto, I, 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M., Varsani N., Vasconcelos P., Vassilakis G., Vecchiatini T., Vecera L., Vercauteren M., Verdouw B., Verheyen V., Verri M., Vicari Sottosanti L. G., Vico M., Vidal Mitjans P., Vilardi A., Vissicchio D., Vitale G., Vitkovic B., Vizcaychipi M. P., Voicu A., Voje M., Volfova I., Volta C. A., Von Lutterotti T., von Tiesenhausen A., Vrecic-Slabe S., Vukcevic D., Vukovic R., Vullo P. A., Wade A., Wallberg H., Wallden J., Wallner J., Walther Sturesson L., Watson D., Weber S., Wegiel Leskiewiq A., Weller D., Wensing C., Werkmann M., Westberg H., Wikstrom E., Williams B., Wilson R., Wirth S., Wittmann M., Wood L., Wright S., Zachoval C., Zambon M., Zampieri S., Zampone S., Zangrillo A., Zani G., Zavackiene A., Zieglerder R., Zonneveldt H., Zsisku L., Zucker T. -P., Zukowski M., Zuleika M., and Zupaneie D.

Abstract

Background: Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods: We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients' preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings: Between June 16, 2014, and April 29, 2015, data from 22 803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21 694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj −4·4%, 95% CI −5·5 to −3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj −2·6%, 95% CI −3·9 to −1·4) and the administration of reversal agents (1·23, 1·07–1·41; −1·9%, −3·2 to −0·7) were not associated with a decreased risk of postoperative pulmonary

Published
2019

37. The butterflies of North America

Author

Edwards, William H. 1822-1909, Bowen, L., Peart, Mary, T. Sinclair & Son, Smithsonian Libraries, Edwards, William H. 1822-1909, Bowen, L., Peart, Mary, and T. Sinclair & Son

Subjects
Butterflies, Lepidoptera, North America, Pictorial works
Published
1879

42. Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Author

Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, Fonseca F, Nicolau J, Koenig W, Anker SD, Kastelein JJP, Cornel JH, Pais P, Pella D, Genest J, Cifkova R, Lorenzatti A, Forster T, Kobalava Z, Vida-Simiti L, Flather M, Shimokawa H, Ogawa H, Dellborg M, Rossi PRF, Troquay RPT, Libby P, Glynn RJ, Novo S, Krum H, Varigos J, Siostrzonek P, Sinnaeve P, Gotcheva N, Yong H, Urina-Triana M, Milicic D, Vettus R, Manolis AJ, Wyss F, Sigurdsson A, Fucili A, Veze I, Petrauskiene B, Salvador L, Klemsdal TO, Medina F, Budaj A, Otasevic P, Lainscak M, Seung KB, Commerford P, Donath M, Hwang JJ, Kultursay H, Bilazarian S, East C, Forgosh L, Harris B, Ligueros M, Bohula E, Charmarthi B, Cheng S, Chou S, Danik J, McMahon G, Maron B, Ning M, Olenchock B, Pande R, Perlstein T, Pradhan A, Rost N, Singhal A, Taqueti V, Wei N, Burris H, Cioffi A, Dalseg AM, Ghosh N, Gralow J, Mayer T, Rugo H, Fowler V, Limaye AP, Cosgrove S, Levine D, Lopes R, Scott J, Hilkert R, Tamesby G, Mickel C, 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Hodnett P, Hoffman M, Hogan C, Holmes Z, Rees DH, Hotchkiss D, Huang P, Humbert J, Hutchens E, Iachini K, Ibarra M, Igbokidi O, Ilahi T, Imbrognio M, Ipp E, Iteld B, Jacques G, Jafri A, Jafry B, Jardula M, Jefferson D, Jenkins R, Johnson E, Johnson J, Jones S, Kawahara M, Kelehan S, Kelly R, Kendall T, Kereiakes D, Khan M, Khan S, Kick J, Kimmel M, King T, King A, Kirkland S, Kissel S, Kitchens D, Klein P, Klugherz B, Korban E, Koren M, Korte M, Kostis J, Kotek L, Kozak M, Kreutter F, Kusnick B, Labovitz R, Lail J, Lamance J, Lamas G, Lambert J, Lambert C, Landzberg J, Langdon J, Lavoie W, Ledger G, Lee T, Lee K, Lehman R, Leimbach W, Lennard M, Lepor N, Lester F, Levin P, Levinson L, Lewis D, Lillo J, Link L, Long C, Longaker R, Lorch G, Lucksinger G, Lynd S, Rhudy JM, Madder R, Magness K, Maheshwari A, Alan A, Malek M, Maletz L, Malhotra V, Malhotra S, Mandviwala M, Mani CK, Manuel J, Marchelletta N, Marshall L, Marsters M, Martin L, Martinez E, Mavromatis K, Maynard R, Mays M, Mays 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Subjects
0301 basic medicine, 030204 cardiovascular system & hematology, law.invention, 0302 clinical medicine, c-reactive protein, Randomized controlled trial, law, Cardiovascular Disease, middle aged, double-blind method, antibodies, Myocardial infarction, humans, Stroke, interleukin-1beta, biology, Antibodies, Monoclonal, drug, General Medicine, Lipid, Aged, anti-inflammatory agents, monoclonal, humanized, atherosclerosis, cardiovascular diseases, dose-response relationship, female, incidence, infections, lipids, male, myocardial infarction, neutropenia, secondary prevention, stroke, Anti-Inflammatory Agent, aged, Editorial, Atherosclerosi, Monoclonal, Human, medicine.drug, medicine.medical_specialty, Neutropenia, Antibodies, Monoclonal, Humanized, Infections, Placebo, antibodies, monoclonal, dose-response relationship, drug, infection, medicine (all), 03 medical and health sciences, Internal medicine, medicine, Dose-Response Relationship, Drug, business.industry, Antiinflammatory Therapy, Canakinumab, for Atherosclerotic Disease, C-reactive protein, medicine.disease, Surgery, Canakinumab, 030104 developmental biology, biology.protein, business
Abstract

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.)

Published
2017
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43. Assessment of US Paramedic Professionalism: A Psychometric Appraisal

Author

Bowen, L Michael and Williams, Brett

Subjects
Advances in Medical Education and Practice, allied health personnel, paramedic, professionalism, Original Research
Abstract

L Michael Bowen, Brett Williams Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, AustraliaCorrespondence: Brett WilliamsDepartment of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, AustraliaEmail brett.williams@monash.eduIntroduction: Professionalism is an essential behavior for paramedic students to demonstrate. In the United States, paramedic accreditation standards require educators to evaluate and document summative affective evaluation on each paramedic student before graduation. The 2009 Emergency Medical Services Education Standards identified the affective behaviors as one of the three learning domains and published a grading tool to help educators recognize professional behaviors. However, little attention was given to the validity or reliability of this tool. Therefore, the aim of this study was to evaluate the psychometric properties of the 5-point Paramedic Affective Domain Tool.Methods: This was a retrospective study with educators that completed evaluations on paramedic students from May 2013 to January 2017. A total of 707 cases met inclusion criteria and 131 unique evaluators from 27 different paramedic programs. A Rasch Partial Credit Model was used to analyze the data.Results: Almost 97% of the paramedic students received passing scores and 28.1% (n=199) received perfect scores. Only 3.5% (n=25) failed the evaluation. Scores ranged from 11 to 55 (M = 46, SD = 9.02) and α = 0.97. Evidence suggests that the tool is not valid and the clustering of scores suggests minimal information can be gleaned from the results.Conclusion: Serious consideration should be made in the continued use of this tool and future research should focus on developing a new tool that is both valid and reliable.Keywords: allied health personnel, paramedic, professionalism

Published
2020

44. The nature, origin and significance of luminescent layers in the Bazhenov Shale Formation of West Siberia, Russia

Author

Shaldybin, MV, Wilson, MJ, Wilson, L, Lopushnyak, YM, Brydson, R, Krupskaya, VV, Kondrashova Deeva, ES, Glotov, AV, Goncharov, IV, Samoilenko, VV, Arbuzov, SI, Bether, OV, Fraser, AR, Bowen, L, White, D, and Dorofeeva, NV

Abstract

Argillites that strongly luminesce under UV radiation were detected in the Bazhenov Shale Formation (BSF) of the West Siberian Basin during routine core examination and found to be persistent over a wide lateral area. The mineralogy and fabric of these luminescent layers were characterized by optical and fluorescence microscopy, SEM, TEM, XRD and IR methods. Optical and fluorescence microscopy showed that the luminescent layers were to a large extent derived from volcanic ash falls and could be described as meta-tuffites, although normal detrital sedimentation continued at the same time. The layers have a thickness of several mm to a maximum of 3–4 cm and can be defined as a clay-rich regional horizons extending for over 500 km. XRD showed that two principal clay minerals were predominant, namely a kaolinite group minerals, (kaolinite-rich) and a mixed-layer illite-smectite (I/S) similar to that found in K-bentonite. Total organic matter in the luminescent layers is much lower than that in the enclosing BSF clayey-silty siliceous sediments above and below as shown by pyrolytic analyses. Evidence is presented that the luminescent characteristic of the argillites is related to their clay mineralogy, specifically to their content of kaolin minerals, although a contribution from nitrogenous organic matter cannot be entirely discounted. In some ways the luminescent argillites can be compared with bentonites associated with ash transformations or with tonsteins in coal beds, which are also derived from volcanic ash falls and contain highly crystalline kaolinite. However, tonsteins originate at or near land surface whereas the argillites were apparently formed in the deep ocean. But just as tonsteins can be used for detailed stratigraphic studies and are valuable in the context of coal exploration, so may the luminescent argillites prove to be significant both stratigraphically and in the search for economic hydrocarbon deposits, bearing in mind that their clay mineralogy may be sensitive to temperature and depth of burial and related to their placement in the oil and gas window.

Published
2019

49. Assessment of US Paramedic Professionalism: A Psychometric Appraisal

Author

Bowen,L Michael, Williams,Brett, Bowen,L Michael, and Williams,Brett

Abstract

L Michael Bowen, Brett Williams Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, AustraliaCorrespondence: Brett WilliamsDepartment of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, AustraliaEmail brett.williams@monash.eduIntroduction: Professionalism is an essential behavior for paramedic students to demonstrate. In the United States, paramedic accreditation standards require educators to evaluate and document summative affective evaluation on each paramedic student before graduation. The 2009 Emergency Medical Services Education Standards identified the affective behaviors as one of the three learning domains and published a grading tool to help educators recognize professional behaviors. However, little attention was given to the validity or reliability of this tool. Therefore, the aim of this study was to evaluate the psychometric properties of the 5-point Paramedic Affective Domain Tool.Methods: This was a retrospective study with educators that completed evaluations on paramedic students from May 2013 to January 2017. A total of 707 cases met inclusion criteria and 131 unique evaluators from 27 different paramedic programs. A Rasch Partial Credit Model was used to analyze the data.Results: Almost 97% of the paramedic students received passing scores and 28.1% (n=199) received perfect scores. Only 3.5% (n=25) failed the evaluation. Scores ranged from 11 to 55 (M = 46, SD = 9.02) and α = 0.97. Evidence suggests that the tool is not valid and the clustering of scores suggests minimal information can be gleaned from the results.Conclusion: Serious consideration should be made in the continued use of this tool and future research should focus on developing a new tool that is both valid and reliable.Keywords: allied health personnel, paramedic, professionalism

Published
2020

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