56 research outputs found
Pedogenic weathering and relative age dating of Quaternary alluvial sediments in the Pindus Mountains of northwest Greece
The "Older Fill" of the Voidomatis Valley Northwest Greece and its relationship to the Palaeolithic Archaeology and Glacial History of the Region
Sediment fingerprinting as a tool for interpreting long-term river activity: The Voidomatis basin, Northwest Greece
The Holocene fluvial sedimentary record and alluvial geoarchaeology in the Nile Valley of northern Sudan
A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: A secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study
Background
Accurate assessment of functional capacity, a predictor of postoperative morbidity and mortality, is essential to improving surgical planning and outcomes. We assessed if all 12 items of the Duke Activity Status Index (DASI) were equally important in reflecting exercise capacity.
Methods
In this secondary cross-sectional analysis of the international, multicentre Measurement of Exercise Tolerance before Surgery (METS) study, we assessed cardiopulmonary exercise testing and DASI data from 1455 participants. Multivariable regression analyses were used to revise the DASI model in predicting an anaerobic threshold (AT) >11 ml kg β1 min β1 and peak oxygen consumption (VO 2 peak) >16 ml kg β1 min β1, cut-points that represent a reduced risk of postoperative complications.
Results
Five questions were identified to have dominance in predicting AT>11 ml kg β1 min β1 and VO 2 peak>16 ml.kg β1min β1. These items were included in the M-DASI-5Q and retained utility in predicting AT>11 ml.kg β1.min β1 (area under the receiver-operating-characteristic [AUROC]-AT: M-DASI-5Q=0.67 vs original 12-question DASI=0.66) and VO 2 peak (AUROC-VO2 peak: M-DASI-5Q 0.73 vs original 12-question DASI 0.71). Conversely, in a sensitivity analysis we removed one potentially sensitive question related to the ability to have sexual relations, and the ability of the remaining four questions (M-DASI-4Q) to predict an adequate functional threshold remained no worse than the original 12-question DASI model. Adding a dynamic component to the M-DASI-4Q by assessing the chronotropic response to exercise improved its ability to discriminate between those with VO 2 peak>16 ml.kg β1.min β1 and VO 2 peak<16 ml.kg β1.min β1.
Conclusions
The M-DASI provides a simple screening tool for further preoperative evaluation, including with cardiopulmonary exercise testing, to guide perioperative management
Holocene alluvial history and the palaeochannels of the River Nile in the Northern Dongola Reach
Holocene alluvial history in the Northern Dongola Reach of the Nile: The 1996/1997 field season
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