Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

NSC219902

This chapter is based on a paper given at Electronic Visualisation and the Arts (EVA) London, 5-7 July 2010, British Computer Society, London. It was one of 22 papers chosen for this volume of the best of EVA London 2009-2012 (approximately 160 full papers). This chapter is historical in two respects. Its first purpose is to enquire how visual representations of historical time can be used to bring out patterns in cultural collections. Such a visual analytics approach raises questions about the proper representation of time and of objects and events within it. It is argued that such chronographics can support both an externalised, objectivising point of view from ‘outside’ time and one which is immersive and gives a sense of the historic moment. These modes are set in their own historical context through original historical research, highlighting the shift to an Enlightenment view of time as a uniform container for events. This in turn prompts new ways of thinking about chronological visualisation, in particular the separation of the ‘ideal’ image of time from contingent, temporary rendered views

Под знаменем Ленина. 1970. № 123

It is a characteristic feature of our mental make-up that the same perceptual input situation can simultaneously elicit conflicting mental perspectives. This ability pervades our perceptual and cognitive domains. Striking examples are the dual character of pictures in picture perception, pretend play, or the ability to employ metaphors and allegories. I argue that traditional approaches, beyond being inadequate on principle grounds, are theoretically ill equipped to deal with these achievements. I then outline a theoretical perspective that has emerged from a theoretical convergence of perceptual psychology, ethology, linguistics, and developmental research. On the basis of this framework, I argue that corresponding achievements are brought forth by a specific type of functional architecture whose core features are as follows: (1) a perceptual system that is biologically furnished with a rich system of conceptual forms, (2) a triggering relation between the sensory input and conceptual forms by which the same sensory input can be exploited by different types or systems of conceptual forms, and (3) computational principles for handling semantically underspecified conceptual forms. Characteristic features of the proposed theoretical framework are pointed out using the Heider–Simmel phenomenon as an example