Psychometric properties of the generalised version of the Screener for Substance and Behavioural Addictions (SSBA-G): A comprehensive screening tool for substance-related and behavioural addictions.

Assessing addictive behaviours comprehensively and efficiently is a challenge in both research and clinical practice. Consequently, we tested the psychometric properties of the Generalized Screener for Substance and Behavioural Addictions (SSBA-G), a novel, brief screening tool measuring functional impairment resulting from both substance and behavioural addictions. The SSBA-G was developed from the Screener for Substance and Behavioural Addictions (Schluter et al., 2018) and tested in four samples including university students in Canada (n = 481) and the US (n = 164) as well as community adults in Canada (n = 301), and Hungary (n = 79). Confirmatory factor analysis supported the hypothesized bifactor model of the SSBA-G. Receiver-operation characteristic analyses revealed high differentiation accuracy (AUC=0.86-.95), as well as identical ideal cut points across the Substance Addiction (SSBA-G-S) and Behavioural Addiction (SSBA-G-B) Subscales. Results indicated good-to-excellent sensitivity and moderate-to-good specificity. The SSBA-G demonstrated excellent internal consistency and test-retest reliability as well as promising concurrent validity in relation to the original SSBA and additional questions regarding addiction-related impairment. The SSBA-G also showed good convergent and divergent validity with indicators of general mental health. These results indicate that the SSBA-G is a psychometrically sound and efficient measure of addiction-related impairment across substances and excessive behaviours.

Mid-Infrared Imaging Characterization to Differentiate Lung Cancer Subtypes.

Introduction: Lung cancer is the most common malignancy worldwide. Squamous cell carcinoma (SQ) and adenocarcinoma (LUAD) are the two most frequent histological subtypes. Small cell carcinoma (SCLC) subtype has the worst prognosis. Differential diagnosis is essential for proper oncological treatment. Life science associated mid- and near-infrared based microscopic techniques have been developed exponentially, especially in the past decade. Vibrational spectroscopy is a potential non-destructive approach to investigate malignancies. Aims: Our goal was to differentiate lung cancer subtypes by their label-free mid-infrared spectra using supervised multivariate analyses. Material and Methods: Formalin-fixed paraffin-embedded (FFPE) samples were selected from the archives. Three subtypes were selected for each group: 10-10 cases SQ, LUAD and SCLC. 2 µm thick sections were cut and laid on aluminium coated glass slides. Transflection optical setup was applied on Perkin-Elmer infrared microscope. 250 × 600 µm areas were imaged and the so-called mid-infrared fingerprint region (1800-648cm-1) was further analysed with linear discriminant analysis (LDA) and support vector machine (SVM) methods. Results: Both "patient-based" and "pixel-based" approaches were examined. Patient-based analysis by using 3 LDA models and 2 SVM models resulted in different separations. The higher the cut-off value the lower is the accuracy. The linear C-support vector classification (C-SVC) SVM resulted in the best (100%) accuracy for the three subtypes using a 50% cut-off value. The pixel-based analysis gave, similarly, the linear C-SVC SVM model to be the most efficient in the statistical indicators (SQ sensitivity 81.65%, LUAD sensitivity 82.89% and SCLC sensitivity 88.89%). The spectra cut-off, the kernel function and the algorithm function influence the accuracy. Conclusion: Mid-Infrared imaging could be used to differentiate FFPE lung cancer subtypes. Supervised multivariate tools are promising to accurately separate lung tumor subtypes. The long-term perspective is to develop a spectroscopy-based diagnostic tool, revolutionizing medical differential diagnostics, especially cancer identification.

Mid-Infrared Imaging Is Able to Characterize and Separate Cancer Cell Lines.

Malignancies are still responsible for a large share of lethalities. Macroscopical evaluation of the surgical resection margins is uncertain. Big data based imaging approaches have emerged in the recent decade (mass spectrometry, two-photon microscopy, infrared and Raman spectroscopy). Indocianine green labelled MS is the most common approach, however, label free mid-infrared imaging is more promising for future practical application. We aimed to identify and separate different transformed (A-375, HT-29) and non-transformed (CCD986SK) cell lines by a label-free infrared spectroscopy method. Our approach applied a novel set-up for label-free mid-infrared range classification method. Transflection spectroscopy was used on aluminium coated glass slides. Both whole range spectra (4000-648 cm-1) and hypersensitive fingerprint regions (1800-648 cm-1) were tested on the imaged areas of cell lines fixed in ethanol. Non-cell spectra were possible to be excluded based on mean transmission values being above 90%. Feasibility of a mean transmission based spectra filtering method with principal component analysis and linear discriminant analysis was shown to separate cell lines representing different tissue types. Fingerprint region resulted the best separation of cell lines spectra with accuracy of 99.84% at 70-75 mean transmittance range. Our approach in vitro was able to separate unique cell lines representing different tissues of origin. Proper data handling and spectra processing are key steps to achieve the adaptation of this dye-free technique for intraoperative surgery. Further studies are urgently needed to test this novel, marker-free approach.

'True Day Case' Laparoscopic Cholecystectomy in a High-Volume Specialist Unit and Review of Factors Contributing to Unexpected Overnight Stay.

INTRODUCTION: Laparoscopic cholecystectomy (LC) is the gold standard treatment for gallstones. British Association of Day Case Surgery recommends at least 60% of LCs be performed as day cases. The aim of this study was to assess our rate of true day case LCs and review factors preventing same-day discharge. METHODS: We prospectively collected data of all elective LCs performed in a district general hospital over 32 months. RESULTS: 500 patients underwent LC during this period; 438 (88.2%) patients were planned day cases and 59 patients (11.8%) planned overnight stays. Of the planned day cases, 75.8% (n=332) were discharged on the same day and 106 (24.2%) had unexpected overnight stay (UOS). Most patients with BMI >35 and ASA3 planned day case patients were successfully discharged. Drain insertion, longer operations, and late recovery departure were the main reasons for UOS. There were more complications in this group compared to day cases. CONCLUSIONS: This unit has a high 'true day case' rate of 75.8%. High BMI and ASA3 should not be absolute contraindications to day case surgery. The majority of unexpected overnight stays are unavoidable but may be reduced by patient selection, stringent preoperative assessment, operation scheduling, and reduction in unnecessary drain insertion.

Elective "True Day Case" Laparoscopic Inguinal Hernia Repair in a District General Hospital: Lessons Learned from 1000 Consecutive Cases.

INTRODUCTION: Laparoscopic inguinal hernia repair (LIHR) is ideal for day case surgery. It is recommended that at least 70% should be day cases as a measure of cost-effectiveness. The aims of this study were to (i) assess the rate of true day case (TDC) surgery and (ii) identify predictors associated with unexpected overnight stay (UOS). METHODS: Data was collected prospectively on 1000 consecutive elective LIHR performed in a District General Hospital (DGH) over a 7-year period. Data was collected on baseline patient demographics, ASA grade, and intraoperative details. A multivariate analysis was performed in order to identify predictors of UOS. RESULTS: 1000 patients (927 males) underwent elective LIHR. Mean age was 57.3±15.2 years. 915 patients were planned as day case procedures. 822/915 day cases (89.8%) were discharged on the same day and 93 (10.2%) stayed overnight unexpectedly. Patient age, duration of procedure, and patient slot in the operating list were found to be independent predictors (p<0.05) of UOS. CONCLUSION: Our results demonstrate that LIHR is a "true" day case procedure in a DGH. Although some factors associated with UOS cannot be altered, careful patient selection and operating list planning are of paramount importance in order to minimise the burden on healthcare resources.

Influence of cooking on benzo(a)pyrene content in smoked sausages.

The changes in benzo(a)pyrene (BaP) content of smoked sausages were monitored during 1 h cooking. During this time, the BaP content decreased from 4·80 to 1·87 µg/kg. The maximum drop in BaP content was reached in the first 20 min of cooking. Two factors affected the course of BaP changes, viz. water-holding capacity and the fat content. After excluding these factors, there was a high correlation coefficient of 0·996 between time of cooking and BaP content, which confirmed an inverse relationship between the decrease in BaP content and time of cooking. The BaP decrease was directly proportional to the decrease of fat content during cooking, when the relatively high BaP content of 7·71 µg/kg was found in the cooked-out fat.

Determination of myocardial depolarization and repolarization times using the unipolar ventricular evoked potential: contrasting effects of stimulus interval and isoprenaline in the isolated perfused rabbit heart.

The effects of changes in stimulus interval and the infusion of isoprenaline upon myocardial depolarization and repolarization times have been determined using the unipolar ventricular evoked potential. An isolated perfused rabbit heart was the experimental vehicle and the stimulus-to-R wave (St-R) and R wave-to-end (R-E) of complex time intervals were used as measures of depolarization and repolarization times, respectively. Variation in the stimulus interval was shown to have highly statistically significant effects upon both of the parameters of the unipolar paced evoked potential that were investigated. Myocardial repolarization time is increased at longer intervals, while activation time is reduced. Isoprenaline was found to reduce the duration of the R-E interval of the unipolar ventricular evoked potential when infused at a constant rate at a fixed stimulus interval. At the maximum concentration of the drug, when stimulus interval was just shorter than the intrinsic RR interval, it was estimated that one third of the total change in the R-E interval was due purely to the effects of decreased stimulus interval. It proved impossible to identify any effect of isoprenaline infusion upon the St-R interval. The absence of any effect of isoprenaline on the St-R interval of the evoked potential suggests that it may serve as a monitor of purely stimulus interval dependent variations of the signal.

The ventricular intracardiac unipolar paced-evoked potential in an isolated animal heart.

The endocardial unipolar paced evoked response has excited a great deal of interest due to its possible use in the measurement of the metabolic state of the body and other pacer-related areas. Although rate-responsive pacing utilizing this signal has been clinically evaluated, little is known regarding the behavior of the components of this waveform under normal physiological conditions. We have developed an electronic circuit which allows the recording of the evoked response within a few milliseconds of a pacing stimulus of 5 V and 0.5 ms duration being applied using a single unipolar, smooth platinum electrode of 14 mm2 surface area. The paced evoked response was measured using a total of 20 isolated rabbit heart preparations. Five were run for 8 hours and the remaining fifteen were run for 5 hours. Our results indicate that the waveform components of the evoked response remain stable while the preparation is viable, but that two of the time-related measurements change with loss of viability. A significant lengthening of the stimulus-R interval was seen together with a dramatic shortening of the R-T period. The net result of these changes was an overall reduction of 17% in the complex duration. In addition, we found the R-T shortening to be a sensitive measure of myocardial integrity. We conclude that the combination of our interface charge elimination circuit and the isolated heart preparation has proved a useful system for the investigation of the paced evoked potential. Furthermore, the loss of myocardial viability has a complex action on this response.

Platinum pacemaker electrodes: origins and effects of the electrode-tissue interface impedance.

Investigation of the unipolar properties of the paced-evoked response requires special measures to eliminate the post-stimulus potential, and this in turn requires a knowledge of the properties of the electrode-tissue interface which is not supplied by any single source in the literature. We have therefore drawn together published information and some of our own experimental results. The behavior of a particular type of pacemaker electrode was investigated in vitro under a range of conditions. The application of DC potentials revealed an extremely nonlinear voltage-current characteristic with conduction thresholds at about +1 V and -1 V. Small signal AC response to applied voltages well within these values (20 mV pk-pk) was found to be linear when a nonpolarizable counterelectrode was used. Nonlinearities were introduced by the use of a stainless steel counterelectrode. The response of an in vitro model of a paced patient to voltage pulses (amplitude 5 V, duration 0.5 ms) was also investigated. We have made extensive use of previously published work to demonstrate the mechanisms underlying these results and also their relationship to each other. We have concluded with some theoretical comments upon the design requirements for a device to eliminate the post-stimulus afterpotential in order to detect the paced-evoked response.

A BSc level option in biomedical electronics.

1. The application of electronic instruments in medical diagnosis and therapy is well established. 2. There is a demand for electronic engineers both in industry and in the Health Service at all ranges of educational attainment. 3. It is possible to identify a set of objectives for a first degree course in Biomedical Electronics. An important element of this course should be the provision of practical experience in industry and in hospitals. 4. Such courses are available both in Europe and in the United States. Although the postgraduate course provision was satisfactory in the UK in the early seventies, only one full time undergraduate course was in operation. 5. A sandwich course can be designed in Biomedical Electronics as a major option of an existing BSc course in Electrical and Electronic Engineering. Provision can be made for entering and leaving the option. The option can be arranged to follow the guidelines laid down by the IEE for exemption from its educational requirements. 6. The option described started at the Lanchester Polytechnic in Coventry in September 1977.

A microprocessor controlled multi-channel evoked potential data acquisition system.

A stored program control system is described for the acquisition of evoked potential (EP) data. It is a small, portable and flexible system with a variety of input and output possibilities. The system presents a low cost solution to the problem of acquisition of evoked potential data. A novel method of converting and reducing sixteen channels of EEG analogue data to their digital equivalent is shown. It is adaptable for the inter active control of experiments and is sophisticated enough to deal with the complexities of experimental control as well as data manipulation. One of the major advantages of the system is that both the sequencing of the functions and their detailed make-up can be readily altered by programming to meet the individual requirements of any given situation.

Delayed signal EEG trigger.

Long EEG recordings are often necessary to capture the signals in the short period just before an epileptic attack. This procedure has many disadvantages. The equipment described below enables only the signals of interest to be recorded. It is designed to operate in conjunction with a commercial electroencephalograph and consists of a signal store with a programmable series of logic gates for sensing the onset of an epileptic discharge and activating the chart recorder. The particular system described has a signal bandwidth of d.c. to 25 Hz in all 16 channels, and, because of their particular clinical diagnostic importance, all signals for the 20 seconds immediately preceding the discharge are recorded. The recording can take place for up to one hour after the attack and, if a second attack should occur, it can also be recorded similarly to the first one.