Medicina
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This study purposed to validate the accuracy of an artificial neural network (ANN) model for predicting the mortality after hip fracture surgery during the study period, and to compare performance indices between the ANN model and a Cox regression model. A total of 10,534 hip fracture surgery patients during 1996-2010 were recruited in the study. Three datasets were used: a training dataset (n = 7,374) was used for model development, a testing dataset (n = 1,580) was used for internal validation, and a validation dataset (1580) was used for external validation. ⋯ Global sensitivity analysis of the ANN model showed that the referral to lower-level medical institutions was the most important variable affecting mortality, followed by surgeon volume, hospital volume, and CCI score. Compared with the Cox regression model, the ANN model was more accurate in predicting postoperative mortality after a hip fracture. The forecasting predictors associated with postoperative mortality identified in this study can also bae used to educate candidates for hip fracture surgery with respect to the course of recovery and health outcomes.
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Background and Objectives: The aim of this study was to assess and compare the drag and energy cost of three cyclists assessed by computational fluid dynamics (CFD) and analytical procedures. Materials and methods: A transradial (Tr) and transtibial (Tt) were compared to a full-body cyclist at different speeds. An elite male cyclist with 65 kg of mass and 1.72 m of height volunteered for this research with his competition cloths, helmet and bicycle with 5 kg of mass. ⋯ Linear regression presented a very high adjustment for absolute drag values between able-bodied and Tr (R2 = 1.000; Ra2 = 1.000; SEE = 0.200) and Tt (R2 = 1.00; Ra2 = 1.000; SEE = 0.160). The linear regression for energy cost presented a very high adjustment for absolute values between able-bodied and Tr (R2 = 1.000; Ra2 = 1.000; SEE = 0.570) and Tt (R2 = 1.00; Ra2 = 1.00; SEE = 0.778). Conclusions: This study suggests that drag and energy cost was lower in the able-bodied, followed by the Tr and Tt cyclists.
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Sepsis is a potentially life-threatening condition caused by a systemic dysregulated host response to infection. The brain is particularly susceptible to the effects of sepsis with clinical manifestations ranging from mild confusion to a deep comatose state. Sepsis-associated delirium (SAD) is a cerebral manifestation commonly occurring in patients with sepsis and is thought to occur due to a combination of neuroinflammation and disturbances in cerebral perfusion, the blood brain barrier (BBB) and neurotransmission. ⋯ Through the regular use of validated screening tools for delirium, cases of SAD can be identified early; this allows potentially aggravating factors to be addressed promptly. The usefulness of biomarkers, neuroimaging and electroencephalopathy (EEG) in the diagnosis of SAD remains controversial. The Society of Critical Care Medicine (SCCM) guidelines advise against the use of medications to treat delirium unless distressing symptoms are present or it is hindering the patient's ability to wean from organ support.
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Background and Objectives: Despite the growing number of new research publications, normative references for children's optical coherence tomography (OCT) parameters are still not completed. We chose to explore this topic because of the lack of normative parameters that is due to an improvement in different technologies and instruments. Our aim was to determine referential rates of retinal nerve fiber layer (RNFL) thickness and flow deficits (FD%) in the macular choriocapillaris (CC) in normal eyes of ophthalmologically healthy children. ⋯ FD% values in the C1, C2.5, and R1.5 sectors were similar between the 3 × 3-mm and 6 × 6-mm scans. The negative moderate correlations between AxL and FD% were found in all C1, C2.5, C5, R1.5, and R2.5 sectors of the 6 × 6-mm scans. Further prospective studies are needed to determine more accurate normative references for children's OCT parameters.
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Background and objectives: Alterations in mitochondrial DNA (mtDNA) have been observed and studied in various diseases. However, the clinical value of the mtDNA copy number (mtDNA-CN) alterations in osteonecrosis of the femoral head (ONFH) is poorly understood. In the present study, we investigated whether alterations in mtDNA-CNs are associated with clinicopathological parameters in ONFH. ⋯ The mtDNA-CN was positively associated with age (27.7% vs. 45.9%, p = 0.018) and negatively associated with the erythrocyte sedimentation rate (ESR) (11.8% vs. 39.7%, p = 0.024) in all of the samples. The study also found further associations with age (22.2% vs. 68.8%, p = 0.014), gender (30.0% vs. 64.3%, p = 0.048), and ESR (0% vs. 57.7%, p = 0.043) in ONFH. Conclusions: in this study, we demonstrated that mtDNA-CN might be a significant marker for predicting clinical characteristics in ONFH.