The Right WAYS to Repair the Mitral Valve Gillinov, Marc; Burns, Daniel J.P.; Wierup, Per
The Annals of thoracic surgery,
12/2021, Letnik:
112, Številka:
6
Journal Article
Using a large national database, we sought to better define the relationship between obesity measures and early clinical outcomes following mitral valve surgery for degenerative disease.
For the ...outcomes of in-hospital mortality, postoperative cerebrovascular event (CVA), and deep sternal wound infection (DSWI), a retrospective cohort study was performed using data acquired from the United Kingdom National Adult Cardiac Surgery Audit. Multivariable Cox proportional hazard regression modeling was used to investigate associations with individual measures of obesity. Progressively adjusted body mass index (BMI)-specific hazard ratios (HRs) were plotted against mean BMI values in each World Health Organization category using floated variances to investigate specific shapes of association.
Multivariable Cox proportional hazard modeling failed to demonstrate an association between mortality and an increase in BMI of 5 points (HR, 0.93, 95% confidence interval CI, 0.81-1.07), a BMI quintile increase (HR, 0.98; 95% CI, 0.90-1.07), or being classed “obese” by World Health Organization standards (HR, 1.03; 95% CI, 0.74-1.42). A 5-point BMI increase was associated with an increased hazard of DSWI (HR, 1.38; 95% CI, 1.08-1.77) but was not associated with perioperative CVA (HR, 1.05; 95% CI, 0.91-1.21). The shape of association between BMI and mortality appeared approximately U-shaped. DSWI appeared linear, whereas CVA demonstrated an inverted U, or a possible hourglass.
Although individual measures of obesity were not associated with an increased mortality risk on regression modeling, the U-shaped relationship between mortality and increasing BMI demonstrates lower mortality risks in lower obesity classes. Increasing BMI was associated with an increased hazard for DSWI.
Rings and Things in Mitral Valve Repair Gillinov, Marc; Burns, Daniel J.P.; Wierup, Per
The Annals of thoracic surgery,
09/2021, Letnik:
112, Številka:
3
Journal Article
Anticoagulation After Mitral Valve Repair Gillinov, A. Marc; Hodges, Kevin; Burns, Daniel J.P.
The Annals of thoracic surgery,
April 2023, 2023-04-00, 20230401, Letnik:
115, Številka:
4
Journal Article
We develop a frame-covariant formulation of inflation in the slow-roll approximation by generalizing the inflationary attractor solution for scalar-curvature theories. Our formulation gives rise to ...new generalized forms for the potential slow-roll parameters, which enable us to examine the effect of conformal transformations and inflaton reparameterizations in scalar-curvature theories. We find that cosmological observables, such as the power spectrum, the spectral indices and their runnings, can be expressed in a concise manner in terms of the generalized potential slow-roll parameters which depend on the scalar-curvature coupling function, the inflaton wavefunction, and the inflaton potential. We show how the cosmological observables of inflation are frame-invariant in this generalized potential slow-roll formalism, as long as the end-of-inflation condition is appropriately extended to become frame-invariant as well. We then apply our formalism to specific scenarios, such as the induced gravity inflation, Higgs inflation and F(R) models of inflation, and obtain more accurate results, without making additional approximations to the potential. Our results are shown to be consistent to lowest order with those presented in the literature. Finally, we outline how our frame-covariant formalism can be naturally extended beyond the tree-level approximation, within the framework of the Vilkovisky–DeWitt effective action.
Reply: No secrets with the anterior mitral leaflet Gillinov, Marc; Burns, Daniel J.P.; Wierup, Per
The Journal of thoracic and cardiovascular surgery,
01/2021, Letnik:
161, Številka:
1
Journal Article
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