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To assess the validity of multivariable models for predicting risk of surgical site infection (SSI) after colorectal surgery based on routinely collected data in national surveillance networks.
Retrospective analysis performed on 3 validation cohorts.
Colorectal surgery patients in Switzerland, France, and England, 2007–2017.
We determined calibration and discrimination (ie, area under the curve, AUC) of the COLA (contamination class, obesity, laparoscopy, American Society of Anesthesiologists [ASA]) multivariable risk model and the National Healthcare Safety Network (NHSN) multivariable risk model in each cohort. A new score was constructed based on multivariable analysis of the Swiss cohort following colorectal surgery, then based on colon and rectal surgery separately.
We included 40,813 patients who had undergone elective or emergency colorectal surgery to validate the COLA score, 45,216 patients to validate the NHSN colon and rectal surgery risk models, and 46,320 patients in the construction of a new predictive model. The COLA score’s predictive ability was poor, with AUC values of 0.64 (95% confidence interval [CI], 0.63–0.65), 0.62 (95% CI, 0.58–0.67), 0.60 (95% CI, 0.58–0.61) in the Swiss, French, and English cohorts, respectively. The NHSN colon-specific model (AUC, 0.61; 95% CI, 0.61–0.62) and the rectal surgery–specific model (AUC, 0.57; 95% CI, 0.53–0.61) showed limited predictive ability. The new predictive score showed poor predictive accuracy for colorectal surgery overall (AUC, 0.65; 95% CI, 0.64–0.66), for colon surgery (AUC, 0.65; 95% CI, 0.65–0.66), and for rectal surgery (AUC, 0.63; 95% CI, 0.60–0.66).
Models based on routinely collected data in SSI surveillance networks poorly predict individual risk of SSI following colorectal surgery. Further models that include other more predictive variables could be developed and validated.
Light-absorbing impurities (LAI) can darken snow and ice surfaces, reduce snow/ice albedo and accelerate melt. Efforts to allocate the relative contribution of different LAI to snow/ice albedo reductions have been limited by uncertainties in the optical properties of LAI. We developed a new method to measure LAI spectral reflectance at the submicron scale by modifying a Hyperspectral Imaging Microscope Spectrometer (HIMS). We present the instrument's internal calibration, and the overall small influence of a particle's orientation on its measured reflectance spectrum. We validated this new method through the comparison with a field spectroradiometer by measuring different standard materials. Measurements with HIMS at the submicron scale and the bulk measurements of the same standard materials with the field spectroradiometer are in good agreement with an average deviation between the spectra of 3.2% for the 400–1000 nm wavelength range. The new method was used (1) to identify BC (black carbon), mineral dust including hematite and the humic substances present in an environmental sample from Plaine Morte glacier and (2) to collect the individual reflectance spectra of each of these types of impurity. The results indicate that this method is applicable to heterogeneous samples such as the LAI found in snow and ice.
Latin America is a region of sharp ethnic inequalities. Uruguay has usually been considered an exception to this pattern, although no data were available to confirm this assumption until recently. This article uses the Household Survey of 2006 to analyze the wage gap between Afro-descendants and whites through OLS equations, decompositions, and quantile regressions. The analysis finds that discrimination explains approximately 50 percent of the racial wage gap for men and 20 percent for women. Discrimination operates partly through occupational segregation. Differences in schooling are the most important explanatory factor for the rest of the gap. Quantile regressions show that discrimination declines across percentiles for men.
OBJECTIVES/SPECIFIC AIMS: Thionamides are anti-thyroid drugs (ATD) that are commonly used to treat autonomous thyrotoxicosis. Although efficacious, these medications carry a risk of neutropenia or agranulocytosis in a small but finite proportion of the patients who receive them. Some risk factors for thionamide-induced neutropenia have been identified, including body mass index (BMI) and dose, but the role of race and ethnicity in the pathogenesis of this potentially life-threatening side effect is not known. We hypothesize that there will be no effect of race or ethnicity on the change in absolute neutrophil count (ANC) following initiation of thionamide therapy among adult patients with thyrotoxicosis. METHODS/STUDY POPULATION: Data from the electronic medical record at UNM HSC were obtained using a standard database query for the years 2000–2016. Inclusion criteria were the prescription of an ATD, an ANC recorded within 30 days of initiating ATD therapy (pre-ATD), and an ANC recorded between 75 and 365 days after starting an ANC (post-ATD). Patients taking other agents known to cause neutropenia and agranulocytosis, such as clozapine, allopurinol, or chemotherapy, were excluded. Patients were assigned to racial and ethnic groups as follows: Hispanic, non-Hispanic Caucasian (NHC), native American, Black, and Asian. The post-ATD ANC was defined as the nadir ANC observed after the ATD was started. “Delta ANC” was defined as [(post-ATD ANC)−(pre-ATD ANC)]. ANOVA analysis with Bonferroni-adjusted post-hoc testing was performed to examine differences in the mean changes of ANC across ethnic groups. RESULTS/ANTICIPATED RESULTS: In total, 123 adult patients met inclusion and exclusion criteria and were included in the analysis. No significant difference was found between any of the racial groups with regard to age, sex, BMI, pre-ATD ANC, or the pre-ATD to post-ATD ANC interval. The native American group showed a significantly greater post-ATD ANC (not shown) and Delta-ANC as compared with the other groups. Delta ANC Hispanic=−1.4±3.3, Caucasian=−0.6±3.3, Black=−0.9±4.1, Asian=−3.8±4.8, native American=3.6±5.1 (all units per mm3; p<0.001). DISCUSSION/SIGNIFICANCE OF IMPACT: In this cohort of New Mexicans with thyrotoxicosis, native American race was protective against thionamide-induced neutropenia.
En décembre 1977, le pianiste argentin Miguel Angel Estrella est arrêté à Montevideo dans le cadre de l'opération Cóndor. Accusé d'appartenir à la guérilla péroniste Montoneros, il est torturé et maintenu au secret avant d’être transféré dans la prison de Libertad où sont rassemblés tous les prisonniers politiques de l'Uruguay. Au terme d'une intense campagne de solidarité internationale – lancée par ses amis parisiens et menée par des personnalités du monde de la musique, des diplomates et des militants des droits de l'homme, mais aussi par de nombreux mélomanes anonymes –, il est libéré et expulsé vers la France en février 1980. Fondé sur les archives du comité de soutien d'Estrella, des sources diplomatiques et une série d'entretiens, ainsi que sur les fonds récemment déclassifiés de la justice militaire uruguayenne, cet article décrit les ressorts d'une cause exceptionnelle, éclairant d'un jour nouveau les liens entre musique et diplomatie au temps de la guerre froide. Il interroge aussi l'expérience vécue par le musicien en prison, où la pénible reproduction d’œuvres de Beethoven sur un piano muet fait écho à l'assimilation, dans les médias, de sa figure à un héros beethovénien, sorte de Florestan moderne. Ainsi, l'article se penche sur les liens entre éthique et esthétique, et analyse la façon dont l’émotion s'articule au politique dans les mobilisations internationales.
Why did the United States subsidize American multinationals' entry into countries treated as informal colonies? We study a classic case of American imperialism, the 1903 U.S. support of Panama's secession from Colombia and subsequent U.S. payment of the 1921 reparations that opened Colombia's oil fields to Standard Oil. We test Noel Maurer's (2013) empire trap hypothesis quantitatively. Archival and econometric evidence documents Colombia's threat to Standard Oil's sunk investment, which induced the multinational to build a supermajority coalition in the U.S. Senate to back a reparations treaty. Results support the empire trap hypothesis but point out important qualifications.
Mozart's bawdy canons and use of scatalogical parlance in his letters have been described as indicative of a personality given to crass expression. Moreover, his association with Emanuel Schikaneder's supposedly dissolute Theater auf der Wieden, a boisterous venue for German stage works, has been taken as further evidence of his profligate tendencies. A review of the original source materials reveals that these views are apocryphal, originating after Mozart's death and embellished in nineteenth-century commentary and scholarship. Examples of even raunchier canons, composed by musicians with connections to Mozart, Schikaneder and the Theater auf der Wieden, provide new insight into the genre. An examination of surviving bawdy Viennese canons in their social context, together with a reconsideration of the Mozart family letters and attitudes toward vulgarity in Viennese popular theatre, reveals that lewd expressions on the stage were relatively uncommon in this period, that Mozart's use of scatalogical language was relatively mild for the time and that accounts of the composer's debauchery in his last years have little evidentiary basis.
This paper describes strategies to search for, detect, and identify organic material on the surface and subsurface of Mars. The strategies described include those applied by landed missions in the past and those that will be applied in the future. The value and role of ESA's ExoMars rover and of her key science instrument Mars Organic Molecule Analyzer (MOMA) are critically assessed.
Computational modeling is discussed of some interstellar surface processes. The surface of interstellar grains is envisaged as covered by at least several layers of weakly bonded molecular material. Simulated amorphous ice particles were used to model interaction of such surfaces with gas, including sticking of H and D atoms, and adsorption of H2. A possibility of microporosity of interstellar ice mantles is discussed.
The field of Molecular Astrophysics or “Astrochemistry” has grown considerably since its inception in the late 1930’s. Molecules have been observed in astronomical environments as diverse as comets in the solar system and galaxies at the highest redshifts. The common thread in these studies is that molecules are excellent probes of the physical structure and dynamics of such regions, owing to the complexity of their energy level structure and the resulting emission and absorption spectra. In addition, the chemical characteristics provide a powerful tool to study the evolution of astrophysical regions. Molecules also play an active role in the energy balance of clouds. Interstellar space is a unique laboratory in which chemical processes can occur that are not normally found on Earth. Indeed, astrochemistry is a highly interdisciplinary subject, linking the macrocosm (galaxies, stars, planets) with the microcosm (basic chemical processes and spectroscopy). The increased potential of ground- and space-based observational facilities over the full wavelength range provides a wealth of information about the physical environments in which molecules occur and makes it possible to study the development of molecular complexity throughout the Universe.
To assess the relative validity and reproducibility of the semi-quantitative FFQ (SFFQ) applied in the evaluation of a community intervention study, SoL-Bornholm, for estimating food intakes.
The reference measure was a 4 d estimated food record. The SFFQ was completed two times separated by a 1-month period in order to test reproducibility.
The Capital Region and the Regional Municipality of Bornholm, Denmark.
A total of fifty-four children aged 3–9 years were enrolled in the study.
In terms of validity, the SFFQ generally overestimated intakes compared with the food records, especially for vegetables. For most intakes, the mean difference increased with increasing intake. Gross misclassification was on average higher for energy and nutrients (17 %) than for foods (8 %). Spearman correlation coefficients were significant for twelve out of fourteen intakes, ranging from 0·29 to 0·63 for foods and from 0·12 to 0·48 for energy and nutrients. Comparing the repeated SFFQ administrations, the intakes of the first SFFQ were slightly higher than those of the second SFFQ. Gross misclassification was low for most intakes; on average 6 % for foods and 8 % for energy and nutrients. Intra-class correlations were significant for all intakes, ranging from 0·30 to 0·82 for foods and from 0·46 to 0·81 for energy and nutrients.
The results indicate that the SFFQ gives reproducible estimates. The relative validity of the SFFQ was low to moderate for most intakes but comparable to other studies among children.
We present a fast object recognition system coding shape by viewpoint invariant geometric relations and appearance information. In our advanced industrial work-cell, the system can observe the work space of the robot by three pairs of Kinect and stereo cameras allowing for reliable and complete object information. From these sensors, we derive global viewpoint invariant shape features and robust color features making use of color normalization techniques.
We show that in such a set-up, our system can achieve high performance already with a very low number of training samples, which is crucial for user acceptance and that the use of multiple views is crucial for performance. This indicates that our approach can be used in controlled but realistic industrial contexts that require—besides high reliability—fast processing and an intuitive and easy use at the end-user side.
This paper compares the corporate network strategies between multinational corporations of two different origins (United States and Spain), business groups, and state-owned enterprises in the public utility sector of a developing country going through economic and political transitions. The transitions we consider are from an import substitution industrialization model to an open market economy and from a democratic regime to a dictatorial one and back to democracy. We analyze the Chilean telecommunications sector between 1958 and 2005 and find that during a democratic regime all firms sought to build more networks with each other, while incentives decrease under an authoritarian regime. In the protectionist era, US investors built links with Chile’s corporate elite, while in times of an open economy, Spanish investors built these links with the government. State-owned corporations did not attempt to build links with other actors at any time, and business groups sought to build most networks among members of the group. Our findings challenge two commonly held assumptions: first, that open economies decrease incentives for domestic actors to build links with each other and, second, that close political regimes increase incentives to build networks among economic actors.