Trauma Early Mortality Prediction Tool (TEMPT) for assessing 28-day mortality.

Background:Prior mortality prediction models have incorporated severity of anatomic injury quantified by Abbreviated Injury Severity Score (AIS). Using a prospective cohort, a new score independent of AIS was developed using clinical and laboratory markers present on emergency department presentation to predict 28-day mortality. Methods:All patients (n=1427) enrolled in an ongoing prospective cohort study were included. Demographic, laboratory, and clinical data were recorded on admission. True random number generator technique divided the cohort into derivation (n=707) and validation groups (n=720). Using Youden indices, threshold values were selected for each potential predictor in the derivation cohort. Logistic regression was used to identify independent predictors. Significant variables were equally weighted to create a new mortality prediction score, the Trauma Early Mortality Prediction Tool (TEMPT) score. Area under the curve (AUC) was tested in the validation group. Pairwise comparison of Trauma Injury Severity Score (TRISS), Revised Trauma Score, Glasgow Coma Scale, and Injury Severity Score were tested against the TEMPT score. Results:There was no difference between baseline characteristics between derivation and validation groups. In multiple logistic regression, a model with presence of traumatic brain injury, increased age, elevated systolic blood pressure, decreased base excess, prolonged partial thromboplastin time, increased international normalized ratio (INR), and decreased temperature accurately predicted mortality at 28 days (AUC 0.93, 95% CI 0.90 to 0.96, P<0.001). In the validation cohort, this score, termed TEMPT, predicted 28-day mortality with an AUC 0.94 (95% CI 0.92 to 0.97). The TEMPT score preformed similarly to the revised TRISS score for severely injured patients and was highly predictive in those having mild to moderate injury. Discussion:TEMPT is a simple AIS-independent mortality prediction tool applicable very early following injury. TEMPT provides an AIS-independent score that could be used for early identification of those at risk of doing poorly following even minor injury. Level of evidence:Level II

An Automatic Finite-Sample Robustness Metric: When Can Dropping a Little Data Make a Big Difference?

We propose a method to assess the sensitivity of econometric analyses to the removal of a small fraction of the data. Manually checking the influence of all possible small subsets is computationally infeasible, so we provide an approximation to find the most influential subset. Our metric, the "Approximate Maximum Influence Perturbation," is automatically computable for common methods including (but not limited to) OLS, IV, MLE, GMM, and variational Bayes. We provide finite-sample error bounds on approximation performance. At minimal extra cost, we provide an exact finite-sample lower bound on sensitivity. We find that sensitivity is driven by a signal-to-noise ratio in the inference problem, is not reflected in standard errors, does not disappear asymptotically, and is not due to misspecification. While some empirical applications are robust, results of several economics papers can be overturned by removing less than 1% of the sample.Comment: 47 pages. Submitted to Econometric

Distal Femur Osteotomy in Collegiate Field Hockey Goalie

In volume 4, Issue 1 of the JSMAHS you will find Professional Research Abstracts, as well as Bachelor Student Research Abstracts and Case Reports. Thank you for viewing this 4th Annual OATA Special Editio

Gaining insights from Candida biofilm heterogeneity: one size does not fit all

Despite their clinical significance and substantial human health burden, fungal infections remain relatively under-appreciated. The widespread overuse of antibiotics and the increasing requirement for indwelling medical devices provides an opportunistic potential for the overgrowth and colonization of pathogenic Candida species on both biological and inert substrates. Indeed, it is now widely recognized that biofilms are a highly important part of their virulence repertoire. Candida albicans is regarded as the primary fungal biofilm forming species, yet there is also increasing interest and growing body of evidence for non-Candida albicans species (NCAS) biofilms, and interkingdom biofilm interactions. C. albicans biofilms are heterogeneous structures by definition, existing as three-dimensional populations of yeast, pseudo-hyphae, and hyphae, embedded within a self-produced extracellular matrix. Classical molecular approaches, driven by extensive studies of laboratory strains and mutants, have enhanced our knowledge and understanding of how these complex communities develop, thrive, and cause host-mediated damage. Yet our clinical observations tell a different story, with differential patient responses potentially due to inherent biological heterogeneity from specific clinical isolates associated with their infections. This review explores some of the recent advances made in an attempt to explore the importance of working with clinical isolates, and what this has taught us

Final targeting strategy for the sloan digital sky survey IV Apache Point Observatory galactic evolution experiment 2 North Survey

Artículo escrito por más de 60 autores.The Apache Point Observatory Galactic Evolution Experiment 2 (APOGEE-2) is a dual-hemisphere, near-infrared (NIR), spectroscopic survey with the goal of producing a chemodynamical mapping of the Milky Way. The targeting for APOGEE-2 is complex and has evolved with time. In this paper, we present the updates and additions to the initial targeting strategy for APOGEE-2N presented in Zasowski et al. (2017). These modifications come in two implementation modes: (i) “Ancillary Science Programs” competitively awarded to Sloan Digital Sky Survey IV PIs through proposal calls in 2015 and 2017 for the pursuit of new scientific avenues outside the main survey, and (ii) an effective 1.5 yr expansion of the survey, known as the Bright Time Extension (BTX), made posible through accrued efficiency gains over the first years of the APOGEE-2N project. For the 23 distinct ancillary programs, we provide descriptions of the scientific aims, target selection, and how to identify these targets within the APOGEE-2 sample. The BTX permitted changes to the main survey strategy, the inclusion of new programs in response to scientific discoveries or to exploit major new data sets not available at the outset of the survey design, and expansions of existing programs to enhance their scientific success and reach. After describing the motivations, implementation, and assessment of these programs, we also leave a summary of lessons learned from nearly a decade of APOGEE-1 and APOGEE-2 survey operations. A companion paper, F. Santana et al. (submitted; AAS29036), provides a complementary presentation of targeting modifications relevant to APOGEE-2 operations in the Southern Hemisphere

The medicinal plant Tabebuia impetiginosa potently reduces pro-inflammatory cytokine responses in primary human lymphocytes

Bark from the Handroanthus impetiginosus (Mart. ex DC.) Mattos (Bignoniaceae) tree has long been used in traditional South American healing practises to treat inflammation. However, its anti-inflammatory activity has not been closely examined. Here we use chemical extraction, qualitative phytochemical examination, toxicity testing and quantitative examination of anti-inflammatory activity on human cells ex vivo. All extracts were found to be nontoxic. We found different extracts exhibited unique cytokine profiles with some extracts outperforming a positive control used in the clinic. These results verify the immunomodulatory activity of Handroanthus impetiginosus (Mart. ex DC.) Mattos (Bignoniaceae) tree bark-derived compounds. Collectively, combining a lack of toxicity and potency in human immune cells supports further fractionation and research