2,081 research outputs found
The utility of B-type natriuretic peptide in predicting postoperative cardiac events and mortality in patients undergoing major emergency non-cardiac surgery
B-type natriuretic peptide (BNP) levels predict cardiovascular risk in several settings. We hypothesized that they would identify individuals at increased risk of complications and mortality following major emergency non-cardiac surgery.Forty patients were studied with a primary end-point of a new post-operative cardiac event, and/or development of significant ECG changes, and/or cardiac death. The main secondary outcome was all cause mortality at 6 months. Preoperative BNP levels were higher in 11 patients who suffered a new postoperative cardiac event (p=0.001) and predicted this outcome with an area under the receiver operating characteristic curve of 0.85 (CI=0.72-0.98,p=0.001). A pre-operative BNP value >170pg.ml-1 has a sensitivity of 82% and a specificity of 79% for the primary end-point. In this small study, pre-operative BNP levels identify patients undergoing major emergency non-cardiac surgery who are at increased risk of early post-operative cardiac events. Larger studies are required to confirm these data.Peer reviewedPreprin
Polarization correlations in the two--photon decay of hydrogen--like ions
Polarization properties of the photons emitted in the two-photon decay of
hydrogen-like ions are studied within the framework of the density matrix and
second-order perturbation theory. In particular, we derive the polarization
correlation function that gives the probability of the (two-photon) coincidence
measurement performed by polarization-sensitive detectors. Detailed
calculations of this function are performed for the
transition in neutral hydrogen as well as Xe and U ions. The
obtained results allow us to understand the influence of relativistic and
non-dipole effects on the polarization correlations in the bound-bound
two-photon transitions in heavy ions
Performance optimization of a leagility inspired supply chain model: a CFGTSA algorithm based approach
Lean and agile principles have attracted considerable interest in the past few decades. Industrial sectors throughout the world are upgrading to these principles to enhance their performance, since they have been proven to be efficient in handling supply chains. However, the present market trend demands a more robust strategy incorporating the salient features of both lean and agile principles. Inspired by these, the leagility principle has emerged, encapsulating both lean and agile features. The present work proposes a leagile supply chain based model for manufacturing industries. The paper emphasizes the various aspects of leagile supply chain modeling and implementation and proposes a new Hybrid Chaos-based Fast Genetic Tabu Simulated Annealing (CFGTSA) algorithm to solve the complex scheduling problem prevailing in the leagile environment. The proposed CFGTSA algorithm is compared with the GA, SA, TS and Hybrid Tabu SA algorithms to demonstrate its efficacy in handling complex scheduling problems
Does the revised cardiac risk index predict cardiac complications following elective lung resection?
Background:
Revised Cardiac Risk Index (RCRI) score and Thoracic Revised Cardiac Risk Index (ThRCRI) score were developed to predict the risks of postoperative major cardiac complications in generic surgical population and thoracic surgery respectively. This study aims to determine the accuracy of these scores in predicting the risk of developing cardiac complications including atrial arrhythmias after lung resection surgery in adults.
Methods:
We studied 703 patients undergoing lung resection surgery in a tertiary thoracic surgery centre. Observed outcome measures of postoperative cardiac morbidity and mortality were compared against those predicted by risk.
Results:
Postoperative major cardiac complications and supraventricular arrhythmias occurred in 4.8% of patients. Both index scores had poor discriminative ability for predicting postoperative cardiac complications with an area under receiver operating characteristic (ROC) curve of 0.59 (95% CI 0.51-0.67) for the RCRI score and 0.57 (95% CI 0.49-0.66) for the ThRCRI score.
Conclusions:
In our cohort, RCRI and ThRCRI scores failed to accurately predict the risk of cardiac complications in patients undergoing elective resection of lung cancer. The British Thoracic Society (BTS) recommendation to seek a cardiology referral for all asymptomatic pre-operative lung resection patients with > 3 RCRI risk factors is thus unlikely to be of clinical benefit
Segond's fracture: a biomechanical cadaveric study using navigation
Background Segond’s fracture is a well-recognised radiological
sign of an anterior cruciate ligament (ACL) tear.
While previous studies evaluated the role of the anterolateral
ligament (ALL) and complex injuries on rotational
stability of the knee, there are no studies on the biomechanical
effect of Segond’s fracture in an ACL deficient
knee. The aim of this study was to evaluate the effect of a
Segond’s fracture on knee rotation stability as evaluated by
a navigation system in an ACL deficient knee.
Materials and methods Three different conditions were
tested on seven knee specimens: intact knee, ACL deficient
knee and ACL deficient knee with Segond’s fracture. Static
and dynamic measurements of anterior tibial translation
(ATT) and axial tibial rotation (ATR) were recorded by the
navigation system (2.2 OrthoPilot ACL navigation system
B. Braun Aesculap, Tuttlingen, Germany).
Results Static measurements at 30 showed that the mean
ATT at 30 of knee flexion was 5.1 ± 2.7 mm in the ACL
intact condition, 14.3 ± 3.1 mm after ACL cut
(P = 0.005), and 15.2 ± 3.6 mm after Segond’s fracture
(P = 0.08). The mean ATR at 30 of knee flexion was
20.7 ± 4.8 in the ACL intact condition, 26.9 ± 4.1 in
the ACL deficient knee (P[0.05) and 30.9 ± 3.8 after
Segond’s fracture (P = 0.005). Dynamic measurements
during the pivot-shift showed that the mean ATT was
7.2 ± 2.7 mm in the intact knee, 9.1 ± 3.3 mm in the
ACL deficient knee(P = 0.04) and 9.7 ± 4.3 mm in the
ACL deficient knee with Segond’s fracture (P = 0.07).
The mean ATR was 9.6 ± 1.8 in the intact knee,
12.3 ± 2.3 in the ACL deficient knee (P[0.05) and
19.1 ± 3.1 in the ACL deficient knee with Segond’s
lesion (P = 0.016).
Conclusion An isolated lesion of the ACL only affects
ATT during static and dynamic measurements, while the
addition of Segond’s fracture has a significant effect on
ATR in both static and dynamic execution of the pivot-shift
test, as evaluated with the aid of navigation
Computational and Mathematical Modelling of the EGF Receptor System
This chapter gives an overview of computational and mathematical modelling of the EGF receptor system. It begins with a survey of motivations for producing such models, then describes the main approaches that are taken to carrying out such modelling, viz. differential equations and individual-based modelling. Finally, a number of projects that applying modelling and simulation techniques to various aspects of the EGF receptor system are described
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