The Correspondence of Jeremy Bentham, Volume 13 contains authoritative and fully annotated texts of all known and publishable letters sent both to and from Bentham between 1 July 1828 and his death ...on 6 June 1832. In addition to 474 letters, the volume contains three memorandums concerning Bentham’s health shortly before his death, his Last Will and Testament, and extracts from both the Autobiography and the manuscript diaries of Bentham’s nephew George. Of the letters that have been previously published, most are drawn from the edition of The Works of Jeremy Bentham, prepared under the superintendence of Bentham’s literary executor John Bowring. A small number of letters have been reproduced from newspapers and periodicals. This volume publishes for the first time all the extant correspondence between Bentham and Daniel O’Connell, the Irish Liberator. Other new acquaintances included Charles Sinclair Cullen, barrister and law reformer, and John Tyrrell, the Real Property Commissioner. Throughout the period, Bentham maintained regular contact with old friends and connections, but he also entered into sporadic correspondence with such leading figures in government as the Duke of Wellington, Robert Peel and Henry Brougham. Further afield, Bentham corresponded, amongst others, with the Marquis de La Fayette in France, Edward Livingston in the United States of America and José del Valle in Guatemala.
The Duke Activity Status Index (DASI) questionnaire might help incorporate self-reported functional capacity into preoperative risk assessment. Nonetheless, prognostically important thresholds in ...DASI scores remain unclear. We conducted a nested cohort analysis of the Measurement of Exercise Tolerance before Surgery (METS) study to characterise the association of preoperative DASI scores with postoperative death or complications.
The analysis included 1546 participants (≥40 yr of age) at an elevated cardiac risk who had inpatient noncardiac surgery. The primary outcome was 30-day death or myocardial injury. The secondary outcomes were 30-day death or myocardial infarction, in-hospital moderate-to-severe complications, and 1 yr death or new disability. Multivariable logistic regression modelling was used to characterise the adjusted association of preoperative DASI scores with outcomes.
The DASI score had non-linear associations with outcomes. Self-reported functional capacity better than a DASI score of 34 was associated with reduced odds of 30-day death or myocardial injury (odds ratio: 0.97 per 1 point increase above 34; 95% confidence interval CI: 0.96–0.99) and 1 yr death or new disability (odds ratio: 0.96 per 1 point increase above 34; 95% CI: 0.92–0.99). Self-reported functional capacity worse than a DASI score of 34 was associated with increased odds of 30-day death or myocardial infarction (odds ratio: 1.05 per 1 point decrease below 34; 95% CI: 1.00–1.09), and moderate-to-severe complications (odds ratio: 1.03 per 1 point decrease below 34; 95% CI: 1.01–1.05).
A DASI score of 34 represents a threshold for identifying patients at risk for myocardial injury, myocardial infarction, moderate-to-severe complications, and new disability.
This study investigates the use of serum DUPAN-2 in predicting the PC progression in CA19-9 nonsecretors.
Although we previously reported that serum CA19-9 >500U/ mL is a poor prognostic factor and ...an indication for enhanced neoadjuvant treatment, there is not a biomarker surrogate that equivalently predicts prognosis for CA19-9 nonsecretors.
We evaluated consecutive PC patients who underwent pancreatectomy from 2005 to 2019. All patients were categorized as either nonsecretor or secretor (CA19-9 ≤ or >2.0U/mL).
Of the 984 resected PC patients, 94 (9.6%) were nonsecretors and 890 (90.4%) were secretors. The baseline characteristics were not statistically different between the 2 groups except for the level of DUPAN-2 (720 vs. 100U/mL, P < 0.001). Survival curves after resection were similar between the 2 groups (29.4 months vs. 31.3 months, P = 0.900). Survival curves of patients with DUPAN-2 >2000U/mL in the nonsecretors and patients with CA19-9 >500U/mL in the secretors were nearly equivalent as well (hazard ratio 2.08 vs. 1.89). In the multivariate analysis, DUPAN-2 >2000U/mL (hazard ratio 2.53, P = 0.010) was identified as independent prognostic factor after resection.
DUPAN-2 >2000U/mL in CA19-9 nonsecretors can be an unfavorable factor that corresponds to CA19-9 >500U/mL in CA19-9 secretors which is an indicator for enhanced neoadjuvant treatment. The current results shed light on the subset of nonsecretors with poor prognosis that were traditionally categorized in a group with a more favorable prognosis group.
Abstract
Background
The 2023 Duke–International Society for Cardiovascular Diseases (ISCVID) criteria for infective endocarditis (IE) were proposed as an updated diagnostic classification of IE. ...Using an open prospective multicenter cohort of patients treated for IE, we compared the performance of these new criteria to that of the 2000 Modified Duke and 2015 European Society of Cardiology (ESC) criteria.
Methods
Cases of patients treated for IE between January 2017 and October 2022 were adjudicated as certain IE or not. Each case was also categorized as either definite or possible/rejected within each classification. Sensitivity, specificity, and accuracy were estimated with 95% confidence intervals.
Results
Of the 1194 patients analyzed (mean age, 66.1 years; 71.2% males), 414 (34.7%) had a prosthetic valve and 284 (23.8%) had a cardiac implanted electronic device (CIED); 946 (79.2%) were adjudicated as certain IE; 978 (81.9%), 997 (83.5%), and 1057 (88.5%) were classified as definite IE in the 2000 modified Duke, 2015 ESC, and 2023 Duke–ISCVID criteria, respectively. The sensitivity of each set of criteria was 93.2% (95% confidence interval CI, 91.6–94.8), 95.0% (95% CI, 93.7–96.4), and 97.6% (95% CI, 96.6–98.6), respectively (P < .001 for all 2-by-2 comparisons). Corresponding specificity rates were 61.3% (95% CI, 55.2–67.4), 60.5% (95% CI, 54.4–66.6), and 46.0% (95% CI, 39.8–52.2), respectively. In patients without CIED, sensitivity rates were 94.8% (95% CI, 93.2–96.4), 96.5% (95% CI, 95.1–97.8), and 97.7% (95% CI, 96.6–98.8); specificity rates were 59.0% (95% CI, 51.6–66.3), 56.6% (95% CI, 49.3–64.0), and 53.8% (95% CI, 46.3–61.2), respectively.
Conclusions
Overall, the 2023 Duke–ISCVID criteria had a significantly higher sensitivity but a significantly lower specificity compared with older criteria. This decreased specificity was mainly attributable to patients with CIED.
The 2023 Duke–International Society for Cardiovascular Diseases criteria had a significantly higher sensitivity but a significantly lower specificity than older criteria. Decreased specificity was mainly attributable to patients with cardiac implantable electronic devices.
Graphical abstract
Graphical Abstract
This graphical abstract is also available at Tidbit: https://tidbitapp.io/tidbits/compared-performance-of-the-2023-duke-international-society-for-cardiovascular-infectious-diseases-the-2000-modified-duke-and-the-2015-esc-criteria-for-the-diagnosis-of-infective-endocarditis-in-a-french-multicenter-prospective-cohort/update
Abstract
Background
The 2023 Duke-ISCVID (International Society of Cardiovascular Infectious Diseases) classification is a new diagnostic tool for infective endocarditis, updating the 2000 modified ...Duke and the 2015 European Society for Cardiology (ESC) classifications. In comparison, its sensitivity is higher; however, its specificity remains to be evaluated and compared to that of the 2 other classifications in endocarditis suspected patients.
Methods
We retrospectively collected the characteristics of patients hospitalized in Bichat University’s Hospital, Paris, in 2021, who had been evaluated for clinical suspicion of endocarditis, have had at least a transthoracic echocardiography, 2 pairs of blood cultures, 3-month follow-up and in whom endocarditis diagnosis was finally rejected. All patients were classified by 2000 modified Duke, 2015 ESC and 2023 Duke-ISCVID, as though the endocarditis diagnosis had not been rejected.
Results
In total, 130 patients’ charts were analyzed. Mean age was 62 years, 84 (64.6%) were male, 39 (30.0%) had prosthetic cardiac valve or valve repair, 21 (16.2%) cardiac implanted electronic device, and 30 (23.1%) other cardiac conditions. Overall, 5, 2, and 5 patients were falsely classified as definite endocarditis with the 2000 modified Duke, 2015 ESC, and 2023 Duke-ISCVID classifications, respectively. The corresponding specificities were 96.2% (95% confidence interval CI 90.8%, 98.6%), 98.5% (95% CI 93.9%, 99.7%), and 96.2% (95% CI 90.8%, 98.6%). The rates of possible endocarditis were of 38%, 35%, and 35% in the 3 classifications, respectively.
Conclusions
The 2023 Duke-ISCVID classification is highly specific for ruling out the diagnosis of definite infective endocarditis in patients who had been evaluated for IE.
In a population of patients suspected of EI for whom the diagnosis was finally rejected, the 2023 Duke-ISCVID (International Society of Cardiovascular Infectious Diseases) classification presents with an excellent specificity.
Na ulomku luka oltarne ograde iz crkve sv. Martina u Lepurima kod Benkovca prepoznaje se ime hrvatskog kneza Branimira (879‒892). Iako tekstovno manjkavo, ime kneza grafijski vjerno reproducira ime s ...natpisa istog kneza iz Gornjeg Muća, datiranog 888. Otprije je utvrđeno da je oba reljefa izradila tzv. Benediktinska klesarska radionica iz vremena kneza Branimira, što osnažuje ovdje izneseni prijedlog čitanja. Branimirovom vladavinom datiran je gradbeni natpis opata Teodeberta iz iste crkve u Lepurima, objavljen prije desetak godina. Čitanje kneževa imena na još jednom natpisu iz Lepura dodatno precizira vrijeme izrade jednog od ansambla liturgijskih instalacija te crkve, ujedno otvarajući mogućnost da je ista klesarska radionica na obama lokalitetima izvela ne samo reljefe nego i natpisni tekst. To je osmi po redu epigrafički spomen kneza Branimira.
•Characteristics of patients with infective endocarditis (IE) have changed over time.•Modified Duke criteria provide excellent diagnostic value in suspected IE.•Transesophageal echocardiography as a ...single diagnostic test, best detects IE.•Immunosuppression or cancer are not linked with increased IE probability.
To determine whether relevant comorbidities stratify patients with and without IE and whether these may improve the diagnostic accuracy, in addition to the modified Duke criteria.
261 consecutive patients (aged 60.1 ± 16.1 years, 62.8% male) with suspected IE were prospectively included in this single-center observational trial. Modified Duke criteria and relevant comorbidities as well as clinical characteristics, were assessed. Forty-seven patients had IE, as confirmed by a clinical event committee. Patients with IE had a higher frequency of positive blood cultures (70.2% vs. 36.9%, p < 0.0001), embolic diseases (36.2% vs. 10.8%, p < 0.0001), heart murmurs (27.7% vs. 11.7%, p = 0.01), and intensive care therapy (74.5% vs. 58.4%, p = 0.04). In receiver operating characteristics, the combination of modified Duke criteria without transesophageal echocardiography led to an area under the curve of 0.783 (0.715–0.851). The predictive value was only marginally improved by the addition of heart murmur and intensive care therapy (0.794 0.724–0.863). In contrast, transesophageal echocardiography alone achieved an area under the curve of 0.956 (0.937–0.977) and was further improved when adding modified Duke criteria, heart murmur, and intensive care therapy (0.999 0.998–1.000).
Modified Duke criteria provide excellent diagnostic value for evaluating suspected IE, mainly driven by transesophageal echocardiography.
NCT03365193.
Abstract
In this retrospective/prospective study, we assessed the role of fundoscopy in 711 episodes with suspected infective endocarditis (IE); 238 (33%) had IE. Ocular embolic events (retinal ...emboli or chorioretinitis/endophthalmitis) and Roth spots were found in 37 (5%) and 34 (5%) episodes, respectively, but had no impact on IE diagnosis.
Fundoscopy among patients with suspected infective endocarditis detected ocular embolic events and Roth spots in 5% of episodes each but failed to substantially reclassify patients according to Duke criteria, suggesting that universal fundoscopy for diagnostic purposes is not justified.
Graphical Abstract
Graphical Abstract
This graphical abstract is also available at Tidbit: https://tidbitapp.io/tidbits/eyes-wide-shut-a-cohort-study-questioning-the-role-of-fundoscopy-in-infective-endocarditis-diagnosis
Palais Rihour in Lille, built for Philip the Good, duke of Burgundy, was an ambitious and influential architectural project that redefined princely magnificence in the 15th century. Despite its ...significance for court architecture in Northern Europe and Spain, the building has only recently garnered scholarly attention. Its destruction has hindered a comprehensive understanding of its interior. This article presents a meticulous analysis of the great hall and ‘sallette’ in the north-west wing of Rihour based on new empirical data. By combining detailed building specifications, archival data, and visual sources, a reliable reconstruction of the original design has been achieved. Close examination of drawings depicting later modifications and restorations has been crucial in establishing the connection between the great hall and the overall structure. Utilizing these sources, a Critical Digital Model of the north- west wing has been developed, enhancing the visual impact and spatial organization. However, the aim is not to create an attractive but undocumented reconstruction; instead, the model’s accuracy is authenticated and the interpretation traceable through comprehensive documentation of all sources and design choices in a metafile (linked at the end).
This book tells the story of the bitter feud between the Duchess of Kingston and the actor, Samuel Foote, which resulted in a pair of scandalous trials in London in the revolutionary year of 1776.
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