Validation of the cognitive recovery assessments with the Postoperative Quality of Recovery Scale in patients with low-baseline cognition

Patients with pre-surgery cognitive impairment cannot currently be assessed for cognitive recovery after surgery using the Postoperative Quality of Recovery Scale (PostopQRS),as they would mathematically be scored as recovered. The group nonetheless represent a frail cohort at high risk of recovering poorly. We aimed to validate a novel method to score cognitive recovery in patients with low baseline cognition, using the number of low-score tests rather than their numerical values. Face validity was demonstrated in 86 participants in whom both PostopQRS and an 11-item neuropsychological battery were performed. The PostopQRS agreed with neuropsychological categorization of low versus normal cognition 74% of the time, with all but 5 incorrectly coded participants deviating by only 1 neurocognitive test. Cognitive recovery over time was comparable for groups with differing baseline cognitive function, irrespective of whether PostopQRS or neuropsychological methods were used. Discriminant validation was demonstrated in a post hoc analysis of the Steroids in Cardiac Surgery (SIRS) substudy by allocating groups to normal (n=246) or low baseline cognition (n=231) stratified by cognitive recovery on day 1. Recovery was similar for participants with low and normal baseline cognition. Postoperative length of stay was longer in patients with failed cognitive recovery whether they had normal (10.4±10.0 vs. 8.0±5.9 days, P=0.02) or low baseline cognition (12.0±11.1 vs. 8.2±4.7 days, P<0.01). Overall quality of recovery, as well as cognitive, emotive, and physiological recovery in those who recovered was independent of baseline cognition. The modified scoring method for the PostopQRS cognitive domain therefore demonstrates acceptable face and discriminant validity

EC88-2305 Six Steps to Mushroom Farming

Extension circular 88-2305 is six steps to mushroom farming

Lignin Biodegradation of Nitrogen Supplemented Red Oak (Quercus Rubra) Wood Chips with Two Strains of Phanerochaete Chrysosporium

Red oak (Quercus rubra L.) wood chips were treated at two levels of nitrogen content (0.95% and 2.87% N level based on oven-dry wood chips) with either anhydrous liquid ammonia or ammonium nitrate in attempts to enhance the lignin degradation rate of a wild and mutant strain of Phanerochaete chrysosporium. As growth time increased, significant changes in weight loss, alkali solubility, alcohol/benzene extractive content, holocellulose content, and klason lignin content were observed.Experimental results showed that lignin biodegradation rate of both a wild and a mutant strain of P. chrysosporium was increased by pretreating the wood chips with either liquid ammonia at low levels (0.95% N) or by treating wood chips with additions of ammonium nitrate at the 0.95% N and 2.87% N level. Treating red oak chips with liquid ammonia at the 2.87% N level not only caused a reduction in holocellulose content of red oak wood chips, but also inhibited the growth of both strains of P. chrysosporium during incubation. When ammonium nitrate was added to the red oak wood chips at the 2.97% N level, biodegradation capabilities of the wild strain were suppressed. However, the red oak wood chips treated to the 2.87% N level with ammonium nitrate did not affect the growth of the mutant strain of P. chrysosporium. An increase in lignolytic activity was found to occur using the mutant strain of fungus.Significant differences in lignin and carbohydrate content of fungus-degraded wood were observed. The wild strain appeared to attack the lignin and carbohydrate constituents of wood simultaneously, resulting in a loss in both components as incubation time increased from 0 to 30 days. However, the mutant strain appeared to attack the lignin constituents while leaving the carbohydrate components largely intact. Comparison between the two strains (30 days of incubation) showed the red oak wood chips degraded by the mutant strain had a higher holocellulose content than did the wood chips degraded by the wild strain. These results suggest that the mutant strain may be the preferred fungus to use in manufacturing biomechanical pulps and the biodegradation rate may be slightly increased with the addition of nitrogen to the substrate

Verifying a quasi-classical spin model of perturbed quantum rewinding in a Fermi gas

We systematically test a quasi-classical spin model of a large spin-lattice in energy space, with a tunable, reversible Hamiltonian and effective long-range interactions. The system is simulated by a weakly interacting Fermi gas undergoing perturbed quantum rewinding using radio-frequency(RF) pulses. The model reported here is found to be in a quantitative agreement with measurements of the ensemble-averaged energy-resolved spin density. This work elucidates the effects of RF detunings on the system and measurements, pointing the way to new correlation measurement methods.Comment: 13 pages 8 figure

A human volunteer study to identify variability in performance in the cognitive domain of the postoperative quality of recovery scale

Background: The Postoperative Quality of Recovery Scale found lower than anticipated recovery in the cognitive domain. The definition of cognitive recovery did not allow for performance variability, and may have been too sensitive. This study aimed to examine variability in cognitive performance in volunteers. Methods: One hundred forty-three volunteers completed the cognitive domain questions at baseline, after 15 min and 40 min, and on days 1 and 3. Delivery via face-to-face interview was conducted for the first three measurements,and then randomized for day 1 and 3 measurements (faceto-face only, telephone only, telephone then face-to-face, face-to-face then telephone)

The application of componentised modelling techniques to catastrophe model generation

In this paper we show that integrated environmental modelling (IEM) techniques can be used to generate a catastrophe model for groundwater flooding. Catastrophe models are probabilistic models based upon sets of events representing the hazard and weights their likelihood with the impact of such an event happening which is then used to estimate future financial losses. These probabilistic loss estimates often underpin re-insurance transactions. Modelled loss estimates can vary significantly, because of the assumptions used within the models. A rudimentary insurance-style catastrophe model for groundwater flooding has been created by linking seven individual components together. Each component is linked to the next using an open modelling framework (i.e. an implementation of OpenMI). Finally, we discuss how a flexible model integration methodology, such as described in this paper, facilitates a better understanding of the assumptions used within the catastrophe model by enabling the interchange of model components created using different, yet appropriate, assumptions

An Annotated Bibliography Of Chickpea Diseases 1915-1976

The purpose of this bibliography, on which work began in 1975, is to provide a working file of the literature concerned wi th chickpea (Cicer arietinum L.) diseases that wi l l assist in the identification of fungal and bacterial microorganisms associated wi th chickpea seeds. Chickpea is one of the more important pulse crops of the Eastern Hemisphere, where it has been cultivated for centuries. The primary function of this bibliography is to make the chickpea disease literature available to agricultural workers throughout the wor ld, especially in countries where such reference material is difficult to obtain

3D modelling of geological and anthropogenic deposits at the World Heritage Site of Bryggen in Bergen, Norway

The landscape of many historic cities and the character of their shallow subsurface environments are defined by a legacy of interaction between anthropogenic and geological processes. Anthropogenic deposits and excavations result from processes ranging from archaeological activities to modern urban development. Hence, in heritage cities, any geological investigation should acknowledge the role of past and ongoing human activities, while any archaeological investigation should be conducted with geological processes in mind. In this paper it is shown that 3D geological and anthropogenic models at different scales can provide a holistic system for the management of the subsurface. It provides a framework for the integration of other spatial and processmodels to help assess the preservationpotential for buried heritage. Such an integrated framework model is thus contributing to a decision support system for sustainable urban (re)development and regeneration in cities, while preserving cultural heritage. A collaborative approach is proposed to enhance research and implementation of combined geological and archaeological modelling for sustainable land use planning and heritage preservation, using York and Bryggen as prime examples. This paper presents the status of 3D framework modelling at Bryggen in Norway as an example

Predictors of patient satisfaction with anaesthesia and surgery care: a cohort study using the Postoperative Quality of Recovery Scale

Context Previous research has shown that most patients are satisfied with their anaesthetic care. For those who are not the causes may be multifactorial including dissatisfaction with surgical outcomes. Objectives We aimed to identify whether quality of recovery after anaesthesia and surgery measured in multiple domains affects patient satisfaction. Design Sub-group analysis of previously published observational cohort study of quality of recovery after surgery (using the Postoperative Quality of Recovery Scale) was used to identify predictors of incomplete satisfaction 3 days after surgery. Setting Multicentre perioperative surgery. Patients Patients !6 years old, undergoing a variety of operation types and all receiving general anaesthesia. Observations Of 701 patients, 573 completed the satisfaction question on day 3. Satisfaction was rated by a single fivepoint rating question. Patients were divided into two groups: 477 (83%) were completely satisfied and 96 (17%) were not completely satisfied. Multivariable logistic regression analysis was performed on preoperative and patient characteristics and recovery in five domains as follows: physiological, nociceptive (pain and nausea), emotive (anxiety and depression), activities of daily living and cognition. Recovery was defined as return to baseline values or better for all questions within each domain. Results Incomplete satisfaction was predicted by persistent pain or nausea at day 3 [OR 8.2 (95% CI 2.5 to 27), P &lt; 0.01] and incomplete satisfaction at day 1 [OR 28 (95% CI 10 to 77), P &lt; 0.01]. Paradoxically, incomplete satisfaction was less likely to occur if pain or nausea was present 15 min after surgery [OR 0.34 (95% CI 0.11 to 0.99), P &lt; 0.05] or at day 1 [OR 0.30 (95% CI 0.10 to 0.91), P ¼ 0.03]. Incomplete recovery in the other domains did not influence satisfaction. Conclusion Of the recovery domains measured using the Postoperative Quality of Recovery Scale, only nociception (pain or nausea) contributed to incomplete satisfaction. Eur J Anaesthesiol 2012; 29:000-00