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J. M. Nolde M. P. Schlaich D. I. Sessler A. Mian T. B. Corcoran C. K. Chow M. T. V. Chan F. K. Borges M. H. McGillion P. S. Myles N. L. Mills P. J. Devereaux G. S. Hillis 《Anaesthesia》2023,78(7):853-860
Myocardial injury due to ischaemia within 30 days of non-cardiac surgery is prognostically relevant. We aimed to determine the discrimination, calibration, accuracy, sensitivity and specificity of single-layer and multiple-layer neural networks for myocardial injury and death within 30 postoperative days. We analysed data from 24,589 participants in the Vascular Events in Non-cardiac Surgery Patients Cohort Evaluation study. Validation was performed on a randomly selected subset of the study population. Discrimination for myocardial injury by single-layer vs. multiple-layer models generated areas (95%CI) under the receiver operating characteristic curve of: 0.70 (0.69–0.72) vs. 0.71 (0.70–0.73) with variables available before surgical referral, p < 0.001; 0.73 (0.72–0.75) vs. 0.75 (0.74–0.76) with additional variables available on admission, but before surgery, p < 0.001; and 0.76 (0.75–0.77) vs. 0.77 (0.76–0.78) with the addition of subsequent variables, p < 0.001. Discrimination for death by single-layer vs. multiple-layer models generated areas (95%CI) under the receiver operating characteristic curve of: 0.71 (0.66–0.76) vs. 0.74 (0.71–0.77) with variables available before surgical referral, p = 0.04; 0.78 (0.73–0.82) vs. 0.83 (0.79–0.86) with additional variables available on admission but before surgery, p = 0.01; and 0.87 (0.83–0.89) vs. 0.87 (0.85–0.90) with the addition of subsequent variables, p = 0.52. The accuracy of the multiple-layer model for myocardial injury and death with all variables was 70% and 89%, respectively. 相似文献
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Alyssa N. Ball Jennifer N. Phillips C. Wayne McIlwraith Christopher E. Kawcak Richard J. Samulski Laurie R. Goodrich 《Journal of orthopaedic research》2019,37(6):1310-1317
Optimizing the environment of complex bone healing and improving treatment of catastrophic bone fractures and segmental bone defects remains an unmet clinical need both human and equine veterinary medical orthopaedics. The objective of this study was to determine whether scAAV‐equine‐BMP‐2 transduced cells would induce osteogenesis in equine bone marrow derived mesenchymal stem cells (BMDMSCs) in vitro, and if these cells could be cryopreserved in an effort to osteogenically prime them as an “off‐the‐shelf” gene therapeutic approach for fracture repair. Our study found that transgene expression is altered by cell expansion, as would be expected by a transduction resulting in episomal transgene expression, and that osteoinductive levels could still be achieved 5 days after recovery, and protein expression would continue up to 14 days after transduction. This is the first evidence that cryopreservation of genetically modified BMDMSCs would not alter the osteoinductive potential or clinical use of allogeneic donor cells in cases of equine fracture repair. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1310–1317, 2019. 相似文献
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A. Sankar W.S. Beattie G. Tait D.N. Wijeysundera 《British journal of anaesthesia》2019,122(2):255-262
Background
The STOP-BANG questionnaire screens for obstructive sleep apnoea (OSA) in surgical patients. In prior research, the association of STOP-BANG scores with comorbidities and outcomes was inconsistent. The objective of this study was to evaluate the validity of the STOP-BANG score.Methods
We conducted a retrospective cohort study of patients undergoing major elective noncardiac surgery at the University Health Network (Toronto, ON, Canada) between 2011 and 2015. Cross-sectional construct validity was evaluated based on proportions with diagnosed OSA across STOP-BANG strata. Concurrent construct validity was assessed based on the correlation of STOP-BANG with ASA Physical Status (ASA-PS), the Revised Cardiac Risk Index, and the Charlson Comorbidity Index. Predictive validity was assessed based on the adjusted associations of STOP-BANG risk with 30-day mortality (logistic regression), cardiac complications (logistic regression), and length-of-stay (negative binomial regression).Results
Of 26 068 patients in the cohort, 58% were in the low-risk STOP-BANG stratum, 23% in the intermediate-risk stratum, and 19% in the high-risk stratum. The proportion with previously diagnosed OSA was 4% (n=615) in the low-risk stratum, 12% (n=740) in the intermediate-risk stratum, and 44% (n=2142) in the high-risk stratum. The correlations of STOP-BANG with ASA-PS (Spearman ρ=0.28), Revised Cardiac Risk Index (ρ=0.24), and Charlson Comorbidity Index (ρ=0.10) were weak, albeit statistically significant (P<0.001). After risk-adjustment, STOP-BANG risk strata were not associated with 30-day mortality, cardiac complications, or length-of-stay.Conclusions
The STOP-BANG questionnaire has modest construct validity but did not predict postoperative mortality, hospital length-of-stay, or cardiac complications. 相似文献69.
Background: Advances in social technologies offer new tools for large scale data collection and analysis of peer influence and social networks on substance use attitudes and behaviors. Objective: The objective of this study was to determine if text message content can predict alcohol and marijuana use attitudes and behaviors. Methods: Text messages from 91 males ages 18–25 were monitored over a period of 6 months and examined for content related to alcohol and marijuana. Self-report data indicating alcohol and marijuana use attitudes and behaviors were used to determine relationships between text message content, social network structure, and substance use attitudes and behaviors. Results: In total, 23,173 text messages were analyzed with 166 text messages including alcohol related terms and 195 text messages including drug related terms. Individuals who sent text messages related to alcohol use were more likely to have problem alcohol use and positive attitudes toward alcohol use, and individuals who sent text messages related to marijuana use reported higher frequency of marijuana use and more positive attitudes toward marijuana use. Individuals with multiple daily marijuana use were in positions that had less control over network structure. Conclusions: The results of this study indicate that monitoring text message content and social network structure among emerging adult males can potentially predict alcohol and marijuana use attitudes and behaviors. Text message content analysis is a novel technique increasing our understanding of the role of peer influence and social network on substance use attitudes and behaviors. 相似文献
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