Abstract
Background
Bile duct injury (BDI) is a severe complication following cholecystectomy. Early recognition and treatment of BDI has been shown to reduce costs and improve patients’ quality of ...life. The aim of this study was to assess the effect and cost-effectiveness of routine versus selective intraoperative cholangiography (IOC) in cholecystectomy.
Methods
A systematic review and meta-analysis, combined with a health economic model analysis in the Swedish setting, was performed. Costs per quality-adjusted life-year (QALY) for routine versus selective IOC during cholecystectomy for different scenarios were calculated.
Results
In this meta-analysis, eight studies with more than 2 million patients subjected to cholecystectomy and 9000 BDIs were included. The rate of BDI was estimated to 0.36 per cent when IOC was performed routinely, compared with to 0.53 per cent when used selectively, indicating an increased risk for BDI of 43 per cent when IOC was used selectively (odds ratio 1.43, 95 per cent c.i. 1.22 to 1.67). The model analysis estimated that seven injuries were avoided annually by routine IOC in Sweden, a population of 10 million. Over a 10-year period, 33 QALYs would be gained at an approximate net cost of €808 000 , at a cost per QALY of about €24 900.
Conclusion
Routine IOC during cholecystectomy reduces the risk of BDI compared with the selective strategy and is a potentially cost-effective intervention.
This review and meta-analysis confirmed that the use of routine intraoperative cholangiography (IOC) prevents bile duct injury at cholecystectomy. The health economic model showed that routine IOC is a potentially cost-effective intervention compared with the selective strategy of IOC on demand.
Routine intraoperative cholangiography is a potentially cost-effective intervention
Purpose:
To examine the effects of Treatment Foster Care on youth with serious behavior problems.
Method:
Included studies are controlled trials with high or medium quality, published between 1990 ...and September 2017. The control group consists of youth with serious behavior problems in group care, and the follow-up time was at least 12 months. The review also examines ethical and economic aspects.
Results:
A total of eight controlled studies were included, consisting of 633 young people and 55 effect sizes. All studies examined the same model, Treatment Foster Care Oregon (TFCO). There is moderate certainty of evidence that TFCO reduces the risk of future criminal behavior and the number of days in locked settings. Furthermore, there is low certainty of evidence that TFCO reduces the risk of delinquent peer associations, drug use, and depression.
Discussion:
TFCO is to be preferred to group care for youth with serious behavior problems. Ethical and economic implications are discussed.
A precision measurement of the mass of the h_{c}(1P1) state of charmonium has been made using a sample of 24.5x10;{6} psi(2S) events produced in e;{+}e;{-} annihilation at the Cornell Electron ...Storage Ring (CESR). The reaction used was psi(2S)-->pi;{0}h_{c}, pi;{0}-->gammagamma, h_{c}-->gammaeta_{c}, and the reaction products were detected in the CLEO-c detector. Data have been analyzed both for the inclusive reaction and for the exclusive reactions in which eta_{c} decays are reconstructed in 15 hadronic decay channels. Consistent results are obtained in the two analyses. The averaged results of the present measurements are M(h_{c})=3525.28+/-0.19(stat.)+/-0.12(syst.) MeV, and B(psi(2S)-->pi;{0}h_{c})xB(h_{c}-->gammaeta_{c})=(4.19+/-0.32+/-0.45)x10;{-4}. Using the ;{3}P_{J} centroid mass, DeltaM_{hf}(1P) identical withM(chi_{cJ})-M(h_{c})=+0.02+/-0.19+/-0.13 MeV.
We search for a non-SM-like CP-odd Higgs boson (a(1)(0)) decaying to tau(+)tau(-) or mu(+)mu(-) in radiative decays of the Upsilon(1S). No significant signal is found, and upper limits on the product ...branching ratios are set. Our tau(+)tau(-) results are almost 2 orders of magnitude more stringent than previous upper limits. Our data provide no evidence for a Higgs state with a mass of 214 MeV decaying to mu(+)mu(-), previously proposed as an explanation for 3 Sigma(+)-->pmu(+)mu(-) events observed by the HyperCP experiment. Our results constrain NMSSM models.
Using 2.45x10;{7} psi(2S) decays collected with the CLEO-c detector at the Cornell Electron Storage Ring we present the most precise measurements of magnetic dipole transitions in the charmonium ...system. We measure B(psi(2S)-->gammaeta_{c})=(4.32+/-0.16+/-0.60)x10;{-3}, B(J/psi-->gammaeta_{c})/B(psi(2S)-->gammaeta_{c})=4.59+/-0.23+/-0.64, and B(J/psi-->gammaeta_{c})=(1.98+/-0.09+/-0.30)%. We observe a distortion in the eta_{c} line shape due to the photon-energy dependence of the magnetic dipole transition rate. We find that measurements of the eta_{c} mass are sensitive to the line shape, suggesting an explanation for the discrepancy between measurements of the eta_{c} mass in radiative transitions and other production mechanisms.
Hydrazoic acid (HN3) is formed during the synthesis of tributyltin azide and in the following cycloaddition to prepare a tetrazole ring compound. The formation of this substance is inherent to many ...azide processes because small amounts of protic components cannot be avoided. Hydrazoic acid is a very toxic volatile compound, which has highly explosive properties. Under certain conditions (presence of impurities in the reaction mixture), the gas concentration can come close to the decomposition limit. Therefore, online monitoring of this gas concentration is essential to ensure the process safety. FT-IR and FT-NIR experiments were performed in the laboratory scale to calibrate the spectrometers. Due to the possibility of using quartz light fiber cables, a FT-NIR spectrometer was installed to monitor the hydrazoic acid concentration in the industrial scale.
The branching fractions of D(s)(+/-) meson decays serve to normalize many measurements of processes involving charm quarks. Using 298 pb(-1) of e(+)e(-) collisions recorded at a center of mass energy ...of 4.17 GeV, we determine absolute branching fractions for eight D(s)(+/-) decays with a double tag technique. In particular we determine the branching fraction B(D(s)(+)-->K(-)K(+}pi(+))=(5.50+/-0.23+/-0.16)%, where the uncertainties are statistical and systematic, respectively. We also provide partial branching fractions for kinematic subsets of the K(-)K(+)pi(+) decay mode.
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