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Preoperative mechanical ventilation is associated with morbidity and mortality following CHD surgery, but prior studies lack a comprehensive analysis of how preoperative respiratory support mode and timing affects outcomes.
We retrospectively collected data on children <18 years of age undergoing cardiac surgery at an academic tertiary care medical centre. Using multivariable regression, we examined the association between modes of preoperative respiratory support (nasal cannula, high-flow nasal cannula/noninvasive ventilation, or invasive mechanical ventilation), escalation of preoperative respiratory support, and invasive mechanical ventilation on the day of surgery for three outcomes: operative mortality, postoperative length of stay, and postoperative complications. We repeated our analysis in a subcohort of neonates.
A total of 701 children underwent 800 surgical procedures, and 40% received preoperative respiratory support. Among neonates, 243 patients underwent 253 surgical procedures, and 79% received preoperative respiratory support. In multivariable analysis, all modes of preoperative respiratory support, escalation in preoperative respiratory support, and invasive mechanical ventilation on the day of surgery were associated with increased odds of prolonged length of stay in children and neonates. Children (odds ratio = 3.69, 95% CI 1.2–11.4) and neonates (odds ratio = 8.97, 95% CI 1.31–61.14) on high-flow nasal cannula/noninvasive ventilation had increased odds of operative mortality compared to those on room air.
Preoperative respiratory support is associated with prolonged length of stay and mortality following CHD surgery. Knowing how preoperative respiratory support affects outcomes may help guide surgical timing, inform prognostic conversations, and improve risk stratification models.
The purpose of the present study was to determine the dietary predictors of visceral adipose tissue (VAT) area in overweight young adults. A total of 109 young adults (fifty males and fifty-nine females) ate ad libitum in a university cafeteria for 14 d. All food and beverages consumed in the cafeteria were measured using observer-recorded weighed plate waste. Food consumption outside the cafeteria (i.e. snacks) was assessed by multiple-pass 24 h recall procedures. VAT was determined using computed tomography. Stepwise regression demonstrated that the best predictor of visceral adiposity in women was total dietary fat (P ≤ 0·05). In men, the model for predicting visceral adiposity included Ca and total dietary fat. We concluded that total dietary fat is the best predictor of VAT area in both men and women. While this relationship was independent in women, in men there was a synergistic relationship between dietary fat consumption and Ca consumption in predicting VAT.
Reasonably sized crystals of aluminum and gallium nitrides can be grown in supercritical ammonia using chloride and amide as the mineralizer. Best growth was achieved at 380°C in ammonia at 40,000 psi (270 MPa). Under these conditions crystals as large as 0.4 mm could be grown over several days. Attempts to optimize the identity and concentration of the mineralizer, and the acidity of the solution, led to several new products including A1F3(NH3)2.
The study was designed to investigate 2-month-old infant preferential attention to a feature found to be characteristic of mothers' speech to their infants. A modified infant-control auditory preference paradigm was employed to assess infants' differential attention to synthetically generated and naturally produced rising and falling intonation contours. Analysis of these data revealed that the infants attended more to the rising naturally produced intonation contour. A reverse pattern of greater attention to the falling contour was found with the synthetically generated stimuli. In addition, inspection of the results permitted the conclusion that the infant-control preference paradigm was a viable method for assessing the 2-month-old infant's preferential attention to auditory stimuli. The results are discussed in terms of their relevance to the study of the infant's developing language reception abilities.
A commutant property of ternary algebras, defined as linear subspaces of ℬ(ℋ) (bounded operators on some Hubert space ℋ) closed under three-fold multiplication, is demonstrated through the recovery of an operator from its non- orthogonal restrictions.
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