scholarly journals The Association Between the Baseline and the Change in Neutrophil-to-Lymphocyte Ratio and Short-Term Mortality in Patients With Acute Respiratory Distress Syndrome

2021 ◽  
Vol 8 ◽  
Author(s):  
Wei Zhang ◽  
Yadan Wang ◽  
Weijie Li ◽  
Guizuo Wang
Keyword(s):  
Mixed Model ◽  
Distress Syndrome ◽  
Multivariable Logistic Regression Analysis ◽  
Short Term ◽  
Survival Group ◽  
Generalized Additive Mixed Model ◽  
Short Term Mortality ◽  
The Difference ◽  
The Relationship ◽  
Over Time

Background: Two previous studies have shown that increased neutrophil to lymphocyte ratio (NLR) is associated with short-term prognosis in patients with acute respiratory distress syndrome (ARDS), but it is usually assessed as a single threshold value at baseline. We investigated the relationship between the baseline and the early change in NLR and 30-day mortality in patients with ARDS to evaluate the prognostic value of NLR baseline and NLR changes during the first 7 days after ICU admission.Methods: This is a retrospective cohort study, with all ARDS patients diagnosed according to the Berlin definition from the Medical Information Mart for Intensive Care III (MIMIC-III) database. We calculated the NLR by dividing the neutrophil count by the lymphocyte count. The multivariable logistic regression analysis was used to investigate the relationship between the baseline NLR and short-term mortality. Then the generalized additive mixed model was used to compare trends in NLR over time among survivors and non-survivors after adjusting for potential confounders.Results: A total of 1164 patients were enrolled in our study. Multivariable logistic regression analysis showed that after adjusting for confounders, elevated baseline NLR was a significant risk factor predicting 30-day mortality (OR 1.02, 95%CI 1.01, 1.03, P = 0.0046) and hospital mortality (OR 1.02, 95%CI 1.01, 1.03, P = 0.0003). The result of the generalized additive mixed model showed that the NLR decreased in the survival group and increased in the non-survival group gradually within 7 days after ICU admission. The difference between the two groups showed a trend of increase gradually and the difference increased by an average of 0.67 daily after adjusting for confounders.Conclusions: We confirmed that there was a positive correlation between baseline NLR and short-term mortality, and we found significant differences in NLR changes over time between the non-survival group and the survival group. The early increase in NLR was associated with short-term mortality in ARDS patients.

Clinical Utility of Surgical Lung Biopsy for Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Respiration ◽  
2021 ◽  
pp. 1-11
Author(s):  
Hiroyuki Hashimoto ◽  
Shota Yamamoto ◽  
Hiroaki Nakagawa ◽  
Yoshihiro Suido ◽  
Shintaro Sato ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Likelihood Ratio ◽  
Lung Biopsy ◽  
Clinical Utility ◽  
Distress Syndrome ◽  
Short Term ◽  
Surgical Lung Biopsy ◽  
Short Term Mortality

<b><i>Background:</i></b> Surgical lung biopsy (SLB) is performed in patients with acute respiratory distress syndrome (ARDS); however, its clinical utility remains unclear. <b><i>Objectives:</i></b> We categorized the pathological diagnoses and investigated the predictive value for short-term mortality. <b><i>Method:</i></b> Three electronic databases (MEDLINE, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov) were searched for the included studies. The QUADAS-2 was used to evaluate the risk of bias and its applicability. The types and populations of pathological diagnoses were investigated. The pooled sensitivity, positive likelihood ratio (LR+), negative likelihood ratio (LR−), and diagnostic odds ratio (DOR) were estimated at a fixed specificity. Hierarchical summary receiver operating characteristic curves were drawn. <b><i>Results:</i></b> A total of 16 studies that enrolled 758 patients were included. The pathological diagnoses were as follows: diffuse alveolar damage (DAD) 29.9%; infection 24.7%; interstitial lung disease 17.2%; malignancy 3.6%; cardiovascular disease 3.6%; drug toxicity 2.3%; connective tissue disease 2.2%; allergic disease 1.1%; and nonspecific diagnosis 15.4%. To predict short-term mortality, 13 studies that enrolled 613 patients used DAD as an index test and recorded a mortality rate of 56.9% (349 of 613 patients). A total of 3 studies that used index tests other than DAD were excluded. The pooled sensitivity, fixed specificity, LR+, LR−, and DOR were 0.46 (95% confidence interval [CI]: 0.29–0.56), 0.69, 1.48 (95% CI: 0.92–1.81), 0.78 (95% CI: 0.63–1.03), and 1.90 (95% CI: 0.89–2.86), respectively. <b><i>Conclusions:</i></b> SLB is unlikely to provide a specific diagnosis and should not be recommended for confirming DAD or predicting ARDS prognosis.

scholarly journals Concentration of Banking Sector and Loan Markups in Short Term: An Example from Poland

2014 ◽  
Vol 5 (2) ◽  
pp. 26-44
Author(s):  
Krysztof Drachal
Keyword(s):  
Monetary Policy ◽  
Banking Sector ◽  
Mortgage Market ◽  
Future Research ◽  
Simple Linear Regression ◽  
Short Term ◽  
Monthly Data ◽  
Regression Techniques ◽  
The Difference ◽  
The Relationship

The aim of this paper is to present an analysis of the relationship between concentration of the banking sector and banks' markups on offered loans. The markup is understood as the difference between the rate offered by banks and the reference rate fixed by the Monetary Policy Council. The period between 2009 and 2013 was analyzed. Monthly data from the Polish banking sector were considered. This paper also consists of the literature review, which focuses on the mortgage market. The methodology used for the analysis is based mainly on simple linear regression techniques. It is found that such methods are not sufficient to give conclusive answers. Therefore additional future research is proposed.

scholarly journals Evaluation of the Relationship between Early Troponin Clearance and Short-Term Mortality in Patients with Chronic Renal Failure

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ahmet Ozbek ◽  
Abdullah Algın ◽  
Gokhan Tas ◽  
Mehmet Ozgur Erdogan
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Survival Rates ◽  
Structural Heart Disease ◽  
Lactate Clearance ◽  
Acute Injury ◽  
Short Term ◽  
Survival Group ◽  
Parametric Data ◽  
Short Term Mortality

Objective. In patients with CKD, cTn concentrations may be elevated in the absence of AMI, which is a predicted finding caused by chronic structural heart disease rather than acute injury. The increase in troponin level observed in noncardiac conditions provides conflicting results when predicting mortality. Low lactate clearance was associated with increased mortality. Lactate clearance is calculated as follows: (early lactate − late lactate/early lactate) ∗ 100. We aimed to investigate whether troponin clearance calculated according to this formula had an effect on short-term mortality. Methods. The study included 300 patients with chronic renal failure who had a sepsis-related organ failure assessment (SOFA) score ≥3. By taking the baseline troponin at the time of emergency presentation as reference and comparing them with the fourth-hour troponin values, troponin clearance was investigated in the evaluation of mortality among hospitalized patients with CKD within the first month after discharge. The data obtained were analyzed using the SPSS data analysis software version 20.0. Student’s t-test was used for the parametric data, and the Chi-squared test for the nonparametric data. Results. Of the 300 patients evaluated, 189 patients survived (mean age 66.20 ± 14.597 years), and 111 died (mean age 74.81 ± 12.916 years). Troponin clearance was detected in 40 of the 111 patients in the mortality group and 119 of the 189 patients in the survival group. Troponin clearance was significantly more frequent in surviving patients (P=0.0000083). Conclusion. Troponin clearance can be considered as a valuable leading indicator of survival, but higher levels of troponin clearance did not lead to higher survival rates.

scholarly journals Optimal duration of prone positioning in patients with acute respiratory distress syndrome: a protocol for a systematic review and meta-regression analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021408 ◽  
Author(s):  
Tetsuro Kamo ◽  
Yoshitaka Aoki ◽  
Tatsuma Fukuda ◽  
Kiyoyasu Kurahashi ◽  
Hideto Yasuda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Prone Positioning ◽  
Short Term ◽  
Optimal Duration ◽  
Short Term Mortality ◽  
Meta Regression ◽  
Meta Regression Analysis

IntroductionSeveral systematic reviews and meta-analyses have demonstrated that prolonged (≥16 hours) prone positioning can reduce the mortality associated with acute respiratory distress syndrome (ARDS). However, the effectiveness and optimal duration of prone positioning was not fully evaluated. To fill these gaps, we will first investigate the effectiveness of prone positioning compared with the conventional management of patients with ARDS, regarding outcomes using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Second, if statistical heterogeneity in effectiveness with regard to short-term mortality (intensive care unit death or ≤30-day mortality) is shown, we will conduct a meta-regression analysis to explore the association between duration and effectiveness, and determine the optimal duration of prone positioning.Method and analysisRelevant studies are collected using PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials and the WHO International Clinical Trials Platform Search Portal. Randomised controlled trials comparing prone and supine positioning in adults with ARDS will be included in the meta-analysis. Two independent investigators will screen trials obtained by search eligibility and extract data from selected studies to standardised data recording forms. For each selected trial, the risk of bias and quality of evidence will be evaluated using the GRADE system. Meta-regression analyses will be performed to identify the most important factors associated with short-term mortality, and subgroup analysis will be used to analyse the following: duration of mechanical ventilation in the prone position per day, patient severity, tidal volume and cause of ARDS. If heterogeneity or inconsistency among the studies is detected, subgroup analysis will be conducted on factors that may cause heterogeneity.Ethics and disseminationThis study requires no ethical approval. The results obtained from this systematic review and meta-analysis will be disseminated through international conference presentations and publication in a peer-reviewed journal.PROSPERO registration numberCRD42017078340.

scholarly journals D-dimer daily continuous tendency predicts the short-term prognosis for COVID-19 independently: A retrospective study from Northeast China

2021 ◽  
pp. 1-9
Author(s):  
Yinting Xing ◽  
Wei Yang ◽  
Yingyu Jin ◽  
Chao Wang ◽  
Xiuru Guan
Keyword(s):  
Cox Regression ◽  
Short Term ◽  
Cox Regression Analysis ◽  
Prognosis Group ◽  
The Difference ◽  
Group B ◽  
The Relationship ◽  
Worse Prognosis ◽  
D Dimer

BACKGROUND AND OBJECTIVE: To study whether D-dimer daily continuous tendency could predict the short-term prognosis of COVID-19. PATIENTS AND METHODES: According to the short-term prognosis, 81 COVID-19 patients were divided into two groups, one of worse prognosis (Group W) and the other of better prognosis (Group B). The slope of D-dimer linear regression during hospitalization (SLOPE) was calculated as an indicator of D-dimer daily continuous tendency. The SLOPE difference between Group W and Group B was compared. The difference between the discharge results and the 3-month follow-up results was also compared. COX regression analysis was used to analyze the relationship between SLOPE and short-term prognosis of COVID-19. RESULTS: There were 16 patients in Group W and 65 patients in Group B. Group W had more critical proportion (p <  0.0001), indicating that the symptoms of its patients were more severe during hospitalization. ARDS, the most visible cause of worse prognosis, accounted for up to 68.75%, and many symptoms merged and resulted in worse prognosis. The D-dimer levels of Group W not only were significantly higher (p <  0.0001), but also showed an increasing trend. In addition, the D-dimer levels at discharge were significantly higher than those at follow-up (p = 0.0261), and the mean difference was as high as 0.7474. SLOPE significantly correlated with the short-term prognosis of COVID-19 independently (RR: 1.687, 95% CI: 1.345–2.116, P <  0.0001). The worst prognosis occurred most likely during the first month after COVID-19 diagnosis. CONCLUSION: Our study found that D-dimer daily continuous tendency independently correlates with worse prognosis and can be used as an independent predictor of the short-term prognosis for COVID-19.

scholarly journals No fingers, no SNARC? Spatial-Numerical Associations and temporal stability of finger counting

2021 ◽  
Author(s):  
Krzysztof Cipora ◽  
Kinga Woloszyn ◽  
Mateusz Hohol
Keyword(s):  
Individual Differences ◽  
Temporal Stability ◽  
Snarc Effect ◽  
Large Magnitude ◽  
Finger Counting ◽  
Weak Evidence ◽  
Left And Right ◽  
The Difference ◽  
The Relationship ◽  
Over Time

The Spatial-Numerical Association of Response Codes (SNARC) effect (i.e., faster left/right side responses to small/large magnitude numbers, respectively) is considered as strong evidence for the link between numbers and space. The studies have shown considerable variation in this effect. Among the factors determining individual differences in the SNARC effect is the hand an individual uses to start the finger counting sequence. Left-starters show a stronger and less variable SNARC effect than right-starters. This observation has been used as an argument for the embodied nature of the SNARC effect. For this to be the case, one must assume that the finger counting sequence (especially the starting hand) is stable over time. Subsequent studies challenged the view that the SNARC differs depending on the finger counting starting hand. At the same time, it has been pointed out that the temporal stability of finger counting starting hand should not be taken for granted. Thus, in this preregistered study, we aimed to replicate the difference in the SNARC between left- and right-starters and explore the relationship between the temporal stability of finger counting starting hand and the SNARC effect. We expected that higher stability should be associated with a stronger SNARC effect. Results of the preregistered analysis did not show the difference between left- and right-starters. However, further exploratory analysis provided weak evidence that this might be the case. Lastly, we found no evidence for the relationship between finger counting starting hand stability and the SNARC effect. Overall, these results challenge the view on the embodied nature of the SNARC effect.

scholarly journals Dynamic Analysis of Retailers’ Paid Membership Strategy

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Lina Xu ◽  
Zhiqing Meng
Keyword(s):  
Customer Loyalty ◽  
Default Risk ◽  
Evolutionary Game ◽  
Service Level ◽  
Adjustment Factor ◽  
Short Term ◽  
Consumption Data ◽  
The Difference ◽  
Fierce Competition ◽  
The Relationship

Paid membership system has attracted more and more attention from retailers because of its advantages in improving customer loyalty, increasing repeat purchases and corporate cash flow in the short term, and collecting consumption data conveniently. In the fierce competition environment, it is an interesting topic whether the paid membership card can be accepted by the customers as soon as possible. Based on the theory of evolutionary game, this paper discusses the strategies of retailers to implement the paid membership in the case of two different consumer groups. The results show that only when the relationship between the parameters meets certain conditions can the paid membership card be accepted smoothly. In order to satisfy the condition, retailers should take such measures: making the difference between service level and membership card price bigger and reducing consumers’ estimated default risk and retailers’ service adjustment factor. The results of this study provide a useful reference for retailers to successfully implement the paid membership system.

P2626Outcome of patients in cardiogenic shock supported with a micro-axial blood pump providing 5 l/min blood flow

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Nersesian ◽  
F Spillmann ◽  
T Gromann ◽  
C Tschoepe ◽  
F Schoenrath ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Axillary Artery ◽  
Acute Myocarditis ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Multivariable Logistic Regression Analysis ◽  
Short Term ◽  
Full Support ◽  
Mortality Effect ◽  
Short Term Mortality

Abstract Introduction Percutaneous mechanical circulatory support devices are increasingly used in acute cardiogenic shock (CS), despite limited evidence for their effectiveness. The aim of this study was to evaluate outcomes associated with use of the full support Impella 5 and 5.5 as a short- term left ventricular device (LVAD) and to identify preoperative predictors of short -term mortality. Methods Data of patients in CS (n=51) treated with the Impella 5 (n=48) and 5.5 (n=3) devices at our institution were collected retrospectively. The primary endpoint was 30-day all-cause mortality. Clinical follow up including adverse events was analyzed. Results Mean age was 58.2±12.1 years; 80.4% were male. 13 patients had BMI >30 kg/m2. CS was caused by acute myocardial infarction (n=14), decompensated chronic heart failure (n=29), postcardiotomy syndrom and acute myocarditis (n=4 each). Before implantation, median Intermacs profile was 1 (range 1–3) and 31 patients (61%) were on respiratory support. In 49 patients the axillary artery was used for vascular access (n=4 left and n=45 right) employing a 10mm dacron graft tunneled through the skin, in one patient left femoral artery and ascending aorta, respectively. Median support time was 14 days. In 12 cases the pump was removed for myocardial recovery. In 15 patients a continuous flow permanent LVAD was implanted. Bleeding (n=9), thromboembolic event (n=5), pump dislodgement (n=7) requiring revision occurred during support. Seven patients developed ventricular arrhythmia requiring flow reduction. In 5 cases the pump was explanted for hemolysis, in 2 other patients pump exchange was performed. The overall 30-day survival was 53% (95% CI: 38.8–67.1%). Penalized multivariable logistic regression analysis identified preoperative elevated lactate (p=0.027) and CK-MB (p=0.022) as predictors for 30- day mortality. On the basis of these data, a nomogram to estimate 30d-mortality after Impella implantation was created. Conclusion Stabilization of patients suffering from CS employing temporary full support Impella LVAD is feasible and results in acceptable survival. Preoperative degree of shock and myocardial damage predict the short-term mortality. Effect of full support Impella LVAD in earlier stages of shock may prevent irreversible end organ damage.

A Star Is Born: The Relationship Between Performance and Achieving Status Through Certification Contests in the Context of Equity Analysts

2022 ◽  
Author(s):  
Eugene Taeha Paik ◽  
Timothy G. Pollock ◽  
Steven Boivie ◽  
Donald Lange ◽  
Peggy M. Lee
Keyword(s):  
High Status ◽  
Short Term ◽  
Equity Analysts ◽  
Subsequent Performance ◽  
The Social ◽  
And Performance ◽  
The Relationship ◽  
Status Position ◽  
Over Time

We investigate how the relationship between status and performance decouples over time by addressing two questions: (1) how performance affects the likelihood that an actor achieves high status and (2) how achieving high status affects the actor’s subsequent performance. In doing so, we focus on the role repeated certification contests play, where evaluators assess actors’ performance along particular dimensions and confer high status on the contest winners. Using the context of sell-side (brokerage) equity analysts and the “All-Star” list from Institutional Investor magazine, we first investigate whether analysts who make the All-Star list are more likely to produce accurate and/or independent forecasts. Then, we investigate analyst performance after recent and multiple wins. Our results demonstrate the decoupling of status and performance over time and the roles played by both the high-status actor and the social evaluators conferring their status. Whereas analyst performance increases the likelihood of being designated an All-Star, recent and multiple All-Star designations differentially affect both how subsequent performance is assessed, and how the All-Star analysts subsequently perform. In the short term, achieving high status can increase performance and solidify an analyst’s status position; however, in the long term, it can lead to lower performance and eventually result in status loss, which further erodes performance.

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