The Predictive Role of QEEG in the Post-Operative Delirium and Prognosis of Cardiac Surgery Patients

Abstract Objective To determine whether qEEG has the capable of predicting the onset of post-operative delirium (POD) and prognosis of cardiac surgery patients. Methods We prospectively studied a cohort of cardiac surgery patients undergoing EEG for evaluation of altered mental status. Patients were assessed for delirium with the CAM-ICU or CAM. EEG were interpreted clinically by clinician, and reports were reviewed to identify features such as aEEG，alpha，beta，theta or delta relative band energy, alpha variability and spectral entropy. Generalized linear models were used to quantify associations among EEG findings, delirium, and clinical outcomes, including length of stay and mortality. Results 60 patients were evaluated and 29 (48.33%) met delirium criteria. The EEG finding most strongly associated with delirium presence was aEEG, whether the peak value or valley value less than lower quartile or greater than upper quartile. Conclusions The peak or valley value of aEEG in F3-P3/F4-P4 derivation is a good predictor of post-operative delirium in cardiac surgery patients.Trial registration: Clinical Trials.gov Identifier, NCT03351985. Registered 1 December 201

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Relationship between Cycling Infrastructure and Transportation Cycling in a Small Urban Area

Future Transportation ◽

10.3390/futuretransp1010007 ◽

2021 ◽

Vol 1 (1) ◽

pp. 99-112

Author(s):

Richard Larouche ◽

Nimesh Patel ◽

Jennifer L. Copeland

Keyword(s):

Generalized Linear Models ◽

Qualitative Data ◽

Linear Models ◽

The Other ◽

Small City ◽

The Road ◽

The Past ◽

Low Prevalence ◽

The Relationship

The role of infrastructure in encouraging transportation cycling in smaller cities with a low prevalence of cycling remains unclear. To investigate the relationship between the presence of infrastructure and transportation cycling in a small city (Lethbridge, AB, Canada), we interviewed 246 adults along a recently-constructed bicycle boulevard and two comparison streets with no recent changes in cycling infrastructure. One comparison street had a separate multi-use path and the other had no cycling infrastructure. Questions addressed time spent cycling in the past week and 2 years prior and potential socio-demographic and psychosocial correlates of cycling, including safety concerns. Finally, we asked participants what could be done to make cycling safer and more attractive. We examined predictors of cycling using gender-stratified generalized linear models. Women interviewed along the street with a separate path reported cycling more than women on the other streets. A more favorable attitude towards cycling and greater habit strength were associated with more cycling in both men and women. Qualitative data revealed generally positive views about the bicycle boulevard, a need for education about sharing the road and for better cycling infrastructure in general. Our results suggest that, even in smaller cities, cycling infrastructure may encourage cycling, especially among women.

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83 The predictive role of neutrophil-to-lymphocyte ratio in post-operative cardiopulmonary bypass surgery

European Heart Journal Supplements ◽

10.1093/eurheartj/suab133.007 ◽

2021 ◽

Vol 23 (Supplement_G) ◽

Author(s):

Valentina Bucciarelli ◽

Francesco Bianco ◽

Annaclara Blasi ◽

Martina Primavera ◽

Baldinelli Alessandra ◽

...

Keyword(s):

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Pediatric Patients ◽

Septal Defect ◽

Left Ventricular ◽

Conduction System ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Predictive Role

Abstract Aims Postoperative arrhythmias (POA) are a common complication after cardiac surgical repairs for congenital heart disease (CHD), representing a substantial source of morbidity, mortality, and prolonged total in-hospital stay, with an incidence of 7.5–48% in postoperative pediatric cardiac patients. The etiology is multifactorial, and it has been related to the direct surgical manipulation of the cardiac conduction system, to the local tissue inflammation in the myocardium adjacent to the conduction system and to the arrhythmogenic effects of cardiopulmonary bypass (CPB), inotropes, and electrolyte disturbances. Recently, the prognostic role of neutrophil-to-lymphocyte ratio (NLR), a novel inflammation marker, has been evaluated in pediatric patients after CPB surgery. To evaluate the predictive role of NLR in POA in a population of pediatric CHD patients after CPB. Methods and results We retrospectively collected perioperative clinical and laboratory data of 146 patients (age 8.27 ± 10.79 years; male gender: 60.8%) consecutively admitted to the cardiac surgery intensive care unit (ICU) of our institute after elective cardiac surgery with CPB in 2018. We grouped and analyzed our population over NLR tertiles evaluated at 24 h from CPB and types of POA: supraventricular (SVT) and junctional (JET). The prognostic value of NLR and its association with POA was analyzed. Diagnoses of 146 patients included atrial septal defect (n = 36), ventricular septal defect (n = 20), pulmonary atresia/stenosis (n = 10), tetralogy of Fallot (n = 20), endocardial cushion defect (n = 8), left ventricular outflow tract obstruction (n = 14), anomalous origin of coronary artery (n = 6), complex CHD (n = 13), interrupted/hypoplastic aortic arch (n = 12), anomalous pulmonary venous return (n = 3). The mean CPB time was 121.6 ± 84.6 min. The median ICU hospitalization was 48 h [Q1, Q3: 24, 96]. Twelve patients experienced POA: 6 SVT and 6 JET. The frequency of POA incremented over NLR-tertiles (P-Trend 0.017), while SVT onset was associated with higher values of NLR and C-reactive protein (P = 0.034 and P = 0.011, respectively). Patients in the second and third tertiles of NLR had a prolonged hospitalization (log-rank, P = 0.029), especially when associated with POA (log-rank, P = 0.012). At the multivariable analysis, higher age and NLR values were independently associated with SVT [OR per year 1.22; 95% CI (1.02, 1.25), P = 0.043 and OR per point 1.91; 95% CI (1.29, 2.82), P = 0.012, respectively], but not with JET. Conclusions 24-h post-CPB NLR can predict postoperative SVT in a population of pediatric CHD patients. Our data suggest that the NLR could be a useful, easy-to-obtain marker for postoperative outcome in pediatric patients who had undergone elective CPB.

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Preparation burning may not improve short-term seed survival in an Amazonian savanna

Experimental Results ◽

10.1017/exp.2021.2 ◽

2021 ◽

Vol 2 ◽

Author(s):

Victor J. U. R Rodriguez Chuma ◽

Darren Norris ◽

Taires P. da Silva ◽

Jéssica A. da Silva ◽

Keison S. Cavalcante ◽

...

Keyword(s):

Generalized Linear Models ◽

Linear Models ◽

Brazilian Amazon ◽

Seed Removal ◽

Euterpe Oleracea ◽

Seed Type ◽

Short Term ◽

Tropical Regions ◽

Seed Infestation

Abstract The role of fire in the management of degraded areas remains strongly debated. Here we experimentally compare removal and infestation of popcorn kernels (Zea mays L. – Poaceae) and açaí fruits (Euterpe oleracea Mart. – Arecaceae) in one burned and two unburned savanna habitats in the eastern Brazilian Amazon. In each habitat, a total of ten experimental units (five per seed type) were installed, each with three treatments: (1) open access, (2) vertebrate access, and (3) invertebrate access. Generalized linear models showed significant differences in both seed removal (P < 0.0001) and infestation (P < 0.0001) among seed type, habitats and access treatments. Burned savanna had the highest overall seed infestation rate (24.3%) and invertebrate access increased açaí seed infestation levels to 100% in the burned savanna. Increased levels of invertebrate seed infestation in burned savanna suggest that preparation burning may be of limited use for the management and restoration of such habitats in tropical regions.

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