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Applications of Solid Freeform Fabrication at the Naval Research Laboratory
Solid Freeform Fabrication (SFF) and related techniques are used at the Naval Research
Laboratory (NRL) for a variety of materials related investigations. Research and applications
conducted over the past few years are described including: Helisys Laminated Object
Manufacturing System (LOMS) fabrication of: ceramic piezoelectric actuators, tooling for
multifunctional materials, and anatomical prototypes for surgical visualization; fabrication of
mesoscale electronic and sensor components using a laser forward transfer direct write
technique; and visualization of complex, 3-D microstructures using a Stratasys Fused-Deposition
Modeler. The paper closes with a brief overview of future SFF related work at the NRL.Support for this work from DARPA, Office of Naval Research, and the Naval Research
Laboratory Core Research Program is gratefully acknowledged.Mechanical Engineerin
The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications
Background:
The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications.
Methods:
ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery.
Results:
The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784.
Conclusions:
This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance.
© 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran