Thrombolysis in myocardial infarction risk score in an observation unit setting.

OBJECTIVE: The Thrombolysis in Myocardial Infarction (TIMI) score is a validated tool for risk stratification of acute coronary syndrome. We hypothesized that the TIMI risk score would be able to risk stratify patients in observation unit for acute coronary syndrome. METHODS: STUDY DESIGN: Retrospective cohort study of consecutive adult patients placed in an urban academic hospital emergency department observation unit with an average annual census of 65,000 between 2004 and 2007. Exclusion criteria included elevated initial cardiac biomarkers, ST segment changes on ECG, unstable vital signs, or unstable arrhythmias. A composite of significant coronary artery disease (CAD) indicators, including diagnosis of myocardial infarction, percutaneous coronary intervention, coronary artery bypass surgery, or death within 30 days and 1 year, were abstracted via chart review and financial record query. The entire cohort was stratified by TIMI risk scores (0-7) and composite event rates with 95% confidence interval were calculated. RESULTS: In total 2228 patients were analyzed. Average age was 54.5 years, 42.0% were male. The overall median TIMI risk score was 1. Eighty (3.6%) patients had 30-day and 119 (5.3%) had 1-year CAD indicators. There was a trend toward increasing rate of composite CAD indicators at 30 days and 1 year with increasing TIMI score, ranging from a 1.2% event rate at 30 days and 1.9% at 1 year for TIMI score of 0 and 12.5% at 30 days and 21.4% at 1 year for TIMI ≥ 4. CONCLUSIONS: In an observation unit cohort, the TIMI risk score is able to risk stratify patients into low-, moderate-, and high-risk groups.

Predicting 10-year risk of fatal cardiovascular disease in Germany: an update based on the SCORE-Deutschland Risk Charts

Estimation of absolute risk of cardiovascular disease (CVD), preferably with population-specific risk charts, has become a cornerstone of CVD primary prevention. Regular recalibration of risk charts may be necessary due to decreasing CVD rates and CVD risk factor levels. The SCORE risk charts for fatal CVD risk assessment were first calibrated for Germany with 1998 risk factor level data and 1999 mortality statistics. We present an update of these risk charts based on the SCORE methodology including estimates of relative risks from SCORE, risk factor levels from the German Health Interview and Examination Survey for Adults 2008-11 (DEGS1) and official mortality statistics from 2012. Competing risks methods were applied and estimates were independently validated. Updated risk charts were calculated based on cholesterol, smoking, systolic blood pressure risk factor levels, sex and 5-year age-groups. The absolute 10-year risk estimates of fatal CVD were lower according to the updated risk charts compared to the first calibration for Germany. In a nationwide sample of 3062 adults aged 40-65 years free of major CVD from DEGS1, the mean 10-year risk of fatal CVD estimated by the updated charts was lower by 29% and the estimated proportion of high risk people (10-year risk > = 5%) by 50% compared to the older risk charts. This recalibration shows a need for regular updates of risk charts according to changes in mortality and risk factor levels in order to sustain the identification of people with a high CVD risk.

L'Analgoscore : score objectif de la douleur intra opératoire et développement d'un système de monitorage intégré en anesthésie

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Project SCORE! Coaches’ Perceptions of an Online Tool to Promote Positive Youth Development in Sport

Research points to the potential of youth sport as an avenue to support the growth of particular assets and outcomes. A recurring theme in this line of research is the need to train coaches to deliberately deliver themes relating to positive youth development (PYD) consistently in youth sport programs. The purpose of the study was to design and deliver a technology-based PYD program. Project SCORE! (www.projectscore.ca) is a series of 10 lessons to help coaches integrate PYD into sport. Four youth sport coaches completed the program in this first phase of this research and were interviewed. The goal of this study was to gain some insights from coaches as they completed the program. Positive comments about the program (i.e. ease of use, success of particular lessons, coach’s personal growth) and challenges regarding teaching positive skills to youth are discussed. These results helped to shape the program and make necessary changes so that it may be used for a larger research study. Other implications and future research directions are discussed.

The ENCARA system for face detection and normalization

[EN]Facial image processing is becoming widespread in human-computer applications, despite its complexity. High-level processes such as face recognition or gender determination rely on low-level routines that must e ectively detect and normalize the faces that appear in the input image. In this paper, a face detection and normalization system is described. The approach taken is based on a cascade of fast, weak classi ers that together try to determine whether a frontal face is present in the image.

Multi-scale score level fusion of local descriptors for gender classification in the wild

The 2015 FRVT gender classification (GC) report evidences the problems that current approaches tackle in situations with large variations in pose, illumination, background and facial expression. The report suggests that both commercial and research solutions are hardly able to reach an accuracy over 90% for The Images of Groups dataset, a proven scenario exhibiting unrestricted or in the wild conditions. In this paper, we focus on this challenging dataset, stepping forward in GC performance by observing: 1) recent literature results combining multiple local descriptors, and 2) the psychophysics evidences of the greater importance of the ocular and mouth areas to solve this task...

External Validation of the ProACS Score for Risk Stratification of Patients with Acute Coronary Syndromes

INTRODUCTION: The ProACS risk score is an early and simple risk stratification score developed for all-cause in-hospital mortality in acute coronary syndromes (ACS) from a Portuguese nationwide ACS registry. Our center only recently participated in the registry and was not included in the cohort used for developing the score. Our objective was to perform an external validation of this risk score for short- and long-term follow-up. METHODS: Consecutive patients admitted to our center with ACS were included. Demographic and admission characteristics, as well as treatment and outcome data were collected. The ProACS risk score variables are age (≥72 years), systolic blood pressure (≤116 mmHg), Killip class (2/3 or 4) and ST-segment elevation. We calculated ProACS, Global Registry of Acute Coronary Events (GRACE) and Canada Acute Coronary Syndrome risk score (C-ACS) risk scores for each patient. RESULTS: A total of 3170 patients were included, with a mean age of 64±13 years, 62% with ST-segment elevation myocardial infarction. All-cause in-hospital mortality was 5.7% and 10.3% at one-year follow-up. The ProACS risk score showed good discriminative ability for all considered outcomes (area under the receiver operating characteristic curve >0.75) and a good fit, similar to C-ACS, but lower than the GRACE risk score and slightly lower than in the original development cohort. The ProACS risk score provided good differentiation between patients at low, intermediate and high mortality risk in both short- and long-term follow-up (p<0.001 for all comparisons). CONCLUSIONS: The ProACS score is valid in external cohorts for risk stratification for ACS. It can be applied very early, at the first medical contact, but should subsequently be complemented by the GRACE risk score.

Warning Against Faking: Boon or Bane? Effects on Test Score Validity

Previous research found personality test scores to be inflated on average among individuals who were motivated to present themselves in a desirable fashion in high stakes situations, such as during the employee selection process. One apparently effective way to reduce the undesirable test score inflation in such situations was to warn participants against faking. This research set out to investigate whether warning against faking would indeed affect personality test scores in the theoretically expected fashion. Contrary to expectations, the results did not support the hypothesized causal chain. Results across three studies show that while a warning may lower test scores in participants motivated to respond desirably (i.e., to fake), the effect of warning on test scores was not fully mediated by: a reduction in motivation to do well and self-reports of exaggerated responses in the personality test. Theoretical and practical implications are discussed.

Determinación de la eficacia del score diagnóstico de apendicitis en el departamento de emergencia del Hospital Vicente Corral Moscoso de Cuenca en el período febrero - julio 2007

Se realizó un estudio trasversal en una población de 306 pacientes con diagnóstico de abdomen agudo no traumático, validación de la prueba diagnóstica y factores asociados en 129 con diagnóstico de apendicitis aguda; el grupo de estudio estuvo conformado por pacientes de edad comprendida entre los 16 y 75 años. Los datos fueron recolectados, por los autores, en un formulario estructurado y analizados con el software SPSS. Resultados: la prevalencia de apendicitis aguda, en la población de 306 pacientes, fue del 42(IC 9533.5-50.5). En los 129 con diagnóstico de apendicitis aguda, el Score dio positivo en el 92.2de los casos comparado con el resultado de anatomía patológica. La asociación entre apendicitis aguda con el sexo dio una razón de prevalencia (PR) de 0.98 IC 950.89-1.08), p=1.00; con el antecedente familiar de apendicitis una RP 0.94 (IC 950.78-1.14) p=0.36 y con alimentación de frutas con semilla RP 1.088 (IC 951.03-1.15) p=1.000 (test exacto de Fisher). La sensibilidad para la prueba diagnóstica, score para apendicitis, fue del 94.96, la especificidad del 60, el valor predictivo positivo del 96.6, el valor predictivo negativo del 50y el índice de Kappa del 0.5 con una p=0.000. Conclusiones: la prevalencia de apendicitis fue del 42; se encontró asociación significativa con alimentación con frutas con semilla. La sensibilidad del score para apendicitis fue del 94.96y la especificidad del 60

Comparison between CDC and WHO BMI z-score and their relation with metabolic risk markers in Northern Portuguese obese adolescents

Growth-curves are an important tool for evaluating the anthropometric development in pediatrics. The different growth-curves available are based in different populations, what leads to different cut-offs. Pediatric obesity tracks into adulthood and is associated with increased cardiovascular risk. The accurate assessment of a child nutritional status using growth-curves can indicate individuals that are either obese or in risk of becoming obese, allowing an early intervention. Moreover, the association between the data obtained from growth-curves with specific metabolic risk factors further highlights the importance of these charts. This study aimed to evaluate the associations between body mass index z-score (BMIzsc), determined using the growth-curves from the Centre for Disease Control and Prevention (CDC) and from the World Health Organization (WHO), with cardiovascular risk factors, represented here by metabolic syndrome (MS) and insulin resistance (IR) related parameters. The study involved 246 obese adolescents (10-18 years, 122 females). MS was defined according to the International Diabetes Federation. IR was considered for HOMA-IR greater than 2.5.

Comparison of five popular normalization methods using a spike-in proteomics data set

Mass spectrometry (MS)-based proteomics has seen significant technical advances during the past two decades and mass spectrometry has become a central tool in many biosciences. Despite the popularity of MS-based methods, the handling of the systematic non-biological variation in the data remains a common problem. This biasing variation can result from several sources ranging from sample handling to differences caused by the instrumentation. Normalization is the procedure which aims to account for this biasing variation and make samples comparable. Many normalization methods commonly used in proteomics have been adapted from the DNA-microarray world. Studies comparing normalization methods with proteomics data sets using some variability measures exist. However, a more thorough comparison looking at the quantitative and qualitative differences of the performance of the different normalization methods and at their ability in preserving the true differential expression signal of proteins, is lacking. In this thesis, several popular and widely used normalization methods (the Linear regression normalization, Local regression normalization, Variance stabilizing normalization, Quantile-normalization, Median central tendency normalization and also variants of some of the forementioned methods), representing different strategies in normalization are being compared and evaluated with a benchmark spike-in proteomics data set. The normalization methods are evaluated in several ways. The performance of the normalization methods is evaluated qualitatively and quantitatively on a global scale and in pairwise comparisons of sample groups. In addition, it is investigated, whether performing the normalization globally on the whole data or pairwise for the comparison pairs examined, affects the performance of the normalization method in normalizing the data and preserving the true differential expression signal. In this thesis, both major and minor differences in the performance of the different normalization methods were found. Also, the way in which the normalization was performed (global normalization of the whole data or pairwise normalization of the comparison pair) affected the performance of some of the methods in pairwise comparisons. Differences among variants of the same methods were also observed.