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1. Preliminary reduction of chromium ore using Si sludge generated in silicon wafer manufacturing process

Author

Jung W.-G., Back G.-S., Johra F.T., Kim J.-H., Chang Y.-C., and Yoo S.-J.

Subjects
chromium ore, silicon sludge, silicon carbide, silicon, pre-reduction, ferrochrome, Mining engineering. Metallurgy, TN1-997
Abstract

In order to promote the recycling of by-product from Si wafer manufacturing process and to develop environment-friend and low cost process for ferrochrome alloy production, a basic study was performed on the preliminary reduction reaction between chromium ore and the Si sludge, comprised of SiC and Si particles, which is recovered from the Si wafer manufacturing process for the semiconductor and solar cell industries. Pellets were first made by mixing chromium ore, Si sludge, and some binders in the designed mixing ratios and were then treated at different temperatures in the 1116°C–1388°C range in an ambient atmosphere. Cordierite and SiO2 were confirmed to be formed in the products after the reduction. Additionally, metal particles were observed in the product with Fe, Cr, and Si components. It is found that temperatures above 1300°C are necessary for the reduction of the chromium ore by the Si sludge. The reduction ratio for Fe was evaluated quantitatively for our experimental conditions, and the proper mixing ratio was suggested for the pre-reduction of the chromium ore by the Si sludge. This study provides basic information for the production of ferrochrome alloys on the pre-reduction of chromium ore using Si sludge.

Published
2018
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2. A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study

Author

Wallace, S., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Ismail, H., Riedel, B., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Au, S., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Day, L., Pazmino-Canizares, J., Oh, P., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, J.K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Lum, M., Martin, D., S James, S., Filipe, H., Pinto, M., Kynaston, S., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Levett, D., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Stephens, R.C.M., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., R Lifford, R., Melo, M., Mamdani, M., Hillis, G., Wijeysundera, H.C., Riedel, Bernhard, Li, Michael H-G., Lee, C.H. Angus, Ismail, Hilmy, Cuthbertson, Brian H., Wijeysundera, Duminda N., and Ho, Kwok M.

Published
2021
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3. Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study

Author

Cuthbertson, B.H., Wijeysundera, D.N., Pearse, R.M., Myles, P.S., Abbott, T.E.F., Shulman, M.A., Torres, E., Ambosta, A., Melo, M., Mamdani, M., Thorpe, K.E., Wallace, S., Farrington, C., Croal, B.L., Grocott, M.P.W., Granton, J.T., Oh, P., Thompson, B., Levett, D., Hillis, G., Beattie, W.S., Wijeysundera, H.C., Wijeysundera, Duminda N., Beattie, W. Scott, Hillis, Graham S., Abbott, Tom E.F., Shulman, Mark A., Ackland, Gareth L., Mazer, C. David, Myles, Paul S., Pearse, Rupert M., Cuthbertson, Brian H., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Ismail, H., Riedel, B., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Day, L., Pazmino-Canizares, J., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Lum, M., Martin, D., James, S., Filipe, H., Pinto, M., Kynaston, S., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Stephens, R.C.M., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., and Lifford, R.

Published
2020
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4. Association of preoperative anaemia with cardiopulmonary exercise capacity and postoperative outcomes in noncardiac surgery: a substudy of the Measurement of Exercise Tolerance before Surgery (METS) Study

Author

Myles, P.S., Shulman, M.A., Wallace, S., Farrington, C., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Ismail, H., Riedel, B., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Wijeysundera, D.N., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Granton, J.T., Day, L., Pazmino-Canizares, J., Oh, P., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Croal, B.L., Lum, M., Martin, D., James, S., Filipe, H., Pinto, M., Kynaston, S., Pearse, R.M., Abbott, T.E.F., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Levett, D., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., Lifford, R., Cuthbertson, B.H., Torres, E., Ambosta, A., Melo, M., Mamdani, M., Thorpe, K.E., Grocott, M.P.W., Hillis, G., Wijeysundera, H.C., Bartoszko, J., and Laupacis, A.

Published
2019
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5. Using the 6-minute walk test to predict disability-free survival after major surgery

Author

Wallace, S., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Ismail, H., Riedel, B., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., MacCormick, A., Leslie, K., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Granton, J.T., Day, L., Pazmino-Canizares, J., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Melo, M., Mamdani, M., Hillis, G., Wijeysundera, H.C., Shulman, M.A., Cuthbertson, B.H., Wijeysundera, D.N., Pearse, R.M., Torres, E., Ambosta, A., Farrington, C., and Myles, P.S.

Published
2019
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6. A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study

Author

Riedel, Bernhard, primary, Li, Michael H-G., additional, Lee, C.H. Angus, additional, Ismail, Hilmy, additional, Cuthbertson, Brian H., additional, Wijeysundera, Duminda N., additional, Ho, Kwok M., additional, Wallace, S., additional, Thompson, B., additional, Ellis, M., additional, Borg, B., additional, Kerridge, R.K., additional, Douglas, J., additional, Brannan, J., additional, Pretto, J., additional, Godsall, M.G., additional, Beauchamp, N., additional, Allen, S., additional, Kennedy, A., additional, Wright, E., additional, Malherbe, J., additional, Ismail, H., additional, Riedel, B., additional, Melville, A., additional, Sivakumar, H., additional, Murmane, A., additional, Kenchington, K., additional, Kirabiyik, Y., additional, Gurunathan, U., additional, Stonell, C., additional, Brunello, K., additional, Steele, K., additional, Tronstad, O., additional, Masel, P., additional, Dent, A., additional, Smith, E., additional, Bodger, A., additional, Abolfathi, M., additional, Sivalingam, P., additional, Hall, A., additional, Painter, T.W., additional, Macklin, S., additional, Elliott, A., additional, Carrera, A.M., additional, Terblanche, N.C.S., additional, Pitt, S., additional, Samuels, J., additional, Wilde, C., additional, Leslie, K., additional, MacCormick, A., additional, Bramley, D., additional, Southcott, A.M., additional, Grant, J., additional, Taylor, H., additional, Bates, S., additional, Towns, M., additional, Tippett, A., additional, Marshall, F., additional, Mazer, C.D., additional, Kunasingam, J., additional, Yagnik, A., additional, Crescini, C., additional, Yagnik, S., additional, McCartney, C.J.L., additional, Choi, S., additional, Somascanthan, P., additional, Flores, K., additional, Au, S., additional, Beattie, W.S., additional, Karkouti, K., additional, Clarke, H.A., additional, Jerath, A., additional, McCluskey, S.A., additional, Wasowicz, M., additional, Day, L., additional, Pazmino-Canizares, J., additional, Oh, P., additional, Belliard, R., additional, Lee, L., additional, Dobson, K., additional, Chan, V., additional, Brull, R., additional, Ami, N., additional, Stanbrook, M., additional, Hagen, K., additional, Campbell, D., additional, Short, T., additional, Van Der Westhuizen, J., additional, Higgie, J.K., additional, Lindsay, H., additional, Jang, R., additional, Wong, C., additional, Mcallister, D., additional, Ali, M., additional, Kumar, J., additional, Waymouth, E., additional, Kim, C., additional, Dimech, J., additional, Lorimer, M., additional, Tai, J., additional, Miller, R., additional, Sara, R., additional, Collingwood, A., additional, Olliff, S., additional, Gabriel, S., additional, Houston, H., additional, Dalley, P., additional, Hurford, S., additional, Hunt, A., additional, Andrews, L., additional, Navarra, L., additional, Jason-Smith, A., additional, Thompson, H., additional, McMillan, N., additional, Back, G., additional, Lum, M., additional, Martin, D., additional, S James, S., additional, Filipe, H., additional, Pinto, M., additional, Kynaston, S., additional, Phull, M., additional, Beilstein, C., additional, Bodger, P., additional, Everingham, K., additional, Hu, Y., additional, Niebrzegowska, E., additional, Corriea, C., additional, Creary, T., additional, Januszewska, M., additional, Ahmad, T., additional, Whalley, J., additional, Haslop, R., additional, McNeil, J., additional, Brown, A., additional, MacDonald, N., additional, Pakats, M., additional, Greaves, K., additional, Jhanji, S., additional, Raobaikady, R., additional, Black, E., additional, Rooms, M., additional, Lawrence, H., additional, Koutra, M., additional, Pirie, K., additional, Gertsman, M., additional, Jack, S., additional, Celinski, M., additional, Levett, D., additional, Edwards, M., additional, Salmon, K., additional, Bolger, C., additional, Loughney, L., additional, Seaward, L., additional, Collins, H., additional, Tyrell, B., additional, Tantony, N., additional, Golder, K., additional, Ackland, G.L., additional, Stephens, R.C.M., additional, Gallego-Paredes, L., additional, Reyes, A., additional, Gutierrez del Arroyo, A., additional, Raj, A., additional, R Lifford, R., additional, Melo, M., additional, Mamdani, M., additional, Hillis, G., additional, and Wijeysundera, H.C., additional

Published
2021
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8. The changing basis of state support for housing associations : a theoretical and empirical analysis

Author

Back, G. P.

Subjects
363.5, Housing association activity
Abstract

In contrast to theories which explain social reforms in terms of the power of individuals, structuralism focuses upon the role of the state in capitalist society. The state is seen as purposive-rational, acting economically, to ensure the continued accumulation of capital, and/or politically, to ensure the hegemony of the bourgeiosie. According to this view all power resides within social structures, outside of the influence of working people, even as a class. Thus state intervention in housing is presented as a deliberate strategy to incorporate and thereby defuse working class pressure, with the intention of cementing existing economic relations. Recent modifications to this radical perspective have suggested that classes do have power, and that political and ideological struggle can be constituted relatively autonomously from economic relations. The recent growth of state support for housing associations provides an opportunity to reevaluate these differing views of state intervention. Is state support for housing associations best explained in economic, political or ideological terms? The economic basis of housing association provision is not substantially different from local authority provision. Provision through association is not cheaper than provision through local authorities, and both rely upon the private sector for house building. In addition, there has been no discernable working class commencement of the municipal programme. Rather, an analysis of political debates on legislation relevant to housing associations demonstrates that support is dependent upon the ideological attitudes of central government towards the relative desirability of private or public sector provision. This has led to sharp party political differences in the tasks that associations have been encourage to perform. These policy shifts have encourage the association movement to develop a wide diversity of organisational forms which renders central government control of the movement problematical, and leads to wide variations in the relationship between local authorities and housing associations. The association movement thus has no clearly defined role, which leads it to house people who are, on many social indicators, mid-way between owners and public tenants. These findings suggest than an economically functionalist view of state intervention is incapable of explaining recent support for the housing association movement. Rather, the policy seems more consistent with a relative autonomy view of state intervention in which policies can pursue political and ideological strategies. Until government policies are related to crucial issues of housing production and consumption, and are as purposive-rational as radical writers would have us believe, associations are likely to suffer considerable uncertainty as a result of as hoc policy formation which leaves them in search of a distinctive role.

Published
1984
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9. Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study

Author

Wijeysundera, DN, Beattie, WS, Hillis, GS, Abbott, TEF, Shulman, MA, Ackland, GL, Mazer, CD, Myles, PS, Pearse, RM, Cuthbertson, BH, Measurement of Exercise Tolerance before Surgery Study Investiga, Wallace, S, Farrington, C, Thompson, B, Ellis, M, Borg, B, Kerridge, RK, Douglas, J, Brannan, J, Pretto, J, Godsall, MG, Beauchamp, N, Allen, S, Kennedy, A, Wright, E, Malherbe, J, Ismail, H, Riedel, B, Melville, A, Sivakumar, H, Murmane, A, Kenchington, K, Kirabiyik, Y, Gurunathan, U, Stonell, C, Brunello, K, Steele, K, Tronstad, O, Masel, P, Dent, A, Smith, E, Bodger, A, Abolfathi, M, Sivalingam, P, Hall, A, Painter, TW, Macklin, S, Elliott, A, Carrera, AM, Terblanche, NCS, Pitt, S, Samuels, J, Wilde, C, Leslie, K, MacCormick, A, Bramley, D, Southcott, AM, Grant, J, Taylor, H, Bates, S, Towns, M, Tippett, A, Marshall, F, Kunasingam, J, Yagnik, A, Crescini, C, Yagnik, S, McCartney, CJL, Choi, S, Somascanthan, P, Flores, K, Karkouti, K, Clarke, HA, Jerath, A, McCluskey, SA, Wasowicz, M, Granton, JT, Day, L, Pazmino-Canizares, J, Oh, P, Belliard, R, Lee, L, Dobson, K, Chan, V, Brull, R, Ami, N, Stanbrook, M, Hagen, K, Campbell, D, Short, T, Van Der Westhuizen, J, Higgie, K, Lindsay, H, Jang, R, Wong, C, Mcallister, D, Ali, M, Kumar, J, Waymouth, E, Kim, C, Dimech, J, Lorimer, M, Tai, J, Miller, R, Sara, R, Collingwood, A, Olliff, S, Gabriel, S, Houston, H, Dalley, P, Hurford, S, Hunt, A, Andrews, L, Navarra, L, Jason-Smith, A, Thompson, H, McMillan, N, Back, G, Croal, BL, Lum, M, Martin, D, James, S, Filipe, H, Pinto, M, Kynaston, S, Phull, M, Beilstein, C, Bodger, P, Everingham, K, Hu, Y, Niebrzegowska, E, Corriea, C, Creary, T, Januszewska, M, Ahmad, T, Whalley, J, Haslop, R, McNeil, J, Brown, A, MacDonald, N, Pakats, M, Greaves, K, Jhanji, S, Raobaikady, R, Black, E, Rooms, M, Lawrence, H, Koutra, M, Pirie, K, Gertsman, M, Jack, S, Celinski, M, Levett, D, Edwards, M, Salmon, K, Bolger, C, Loughney, L, Seaward, L, Collins, H, Tyrell, B, Tantony, N, Golder, K, Stephens, RCM, Gallego-Paredes, L, Reyes, A, Gutierrez Del Arroyo, A, Raj, A, Lifford, R, International and National Coordinators, Central Project Office Operations Committee, CPET Methods Committee, Outcome Adjudication Committee, and International Steering Committee

Abstract

BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.

Published
2020

12. A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: A secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study

Author

Riedel, B., Li, M.H-G, Lee, C.H.A., Ismail, H., Cuthbertson, B.H., Wijeysundera, D.N., Ho, K.M., Wallace, S., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Au, S., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Day, L., Pazmino-Canizares, J., Oh, P., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, J.K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Lum, M., Martin, D., S James, S., Filipe, H., Pinto, M., Kynaston, S., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Levett, D., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Stephens, R.C.M., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., Lifford, R., Melo, M., Mamdani, M., Hillis, G., Wijeysundera, H.C., Riedel, B., Li, M.H-G, Lee, C.H.A., Ismail, H., Cuthbertson, B.H., Wijeysundera, D.N., Ho, K.M., Wallace, S., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Au, S., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Day, L., Pazmino-Canizares, J., Oh, P., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, J.K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Lum, M., Martin, D., S James, S., Filipe, H., Pinto, M., Kynaston, S., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Levett, D., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Stephens, R.C.M., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., Lifford, R., Melo, M., Mamdani, M., Hillis, G., and Wijeysundera, H.C.

Abstract

Background Accurate assessment of functional capacity, a predictor of postoperative morbidity and mortality, is essential to improving surgical planning and outcomes. We assessed if all 12 items of the Duke Activity Status Index (DASI) were equally important in reflecting exercise capacity. Methods In this secondary cross-sectional analysis of the international, multicentre Measurement of Exercise Tolerance before Surgery (METS) study, we assessed cardiopulmonary exercise testing and DASI data from 1455 participants. Multivariable regression analyses were used to revise the DASI model in predicting an anaerobic threshold (AT) >11 ml kg −1 min −1 and peak oxygen consumption (VO 2 peak) >16 ml kg −1 min −1, cut-points that represent a reduced risk of postoperative complications. Results Five questions were identified to have dominance in predicting AT>11 ml kg −1 min −1 and VO 2 peak>16 ml.kg −1min −1. These items were included in the M-DASI-5Q and retained utility in predicting AT>11 ml.kg −1.min −1 (area under the receiver-operating-characteristic [AUROC]-AT: M-DASI-5Q=0.67 vs original 12-question DASI=0.66) and VO 2 peak (AUROC-VO2 peak: M-DASI-5Q 0.73 vs original 12-question DASI 0.71). Conversely, in a sensitivity analysis we removed one potentially sensitive question related to the ability to have sexual relations, and the ability of the remaining four questions (M-DASI-4Q) to predict an adequate functional threshold remained no worse than the original 12-question DASI model. Adding a dynamic component to the M-DASI-4Q by assessing the chronotropic response to exercise improved its ability to discriminate between those with VO 2 peak>16 ml.kg −1.min −1 and VO 2 peak<16 ml.kg −1.min −1. Conclusions The M-DASI provides a simple screening tool for further preoperative evaluation, including with cardiopulmonary exercise testing, to guide perioperative management.

Published
2020

17. Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study

Author

Wijeysundera, Duminda N., primary, Beattie, W. Scott, additional, Hillis, Graham S., additional, Abbott, Tom E.F., additional, Shulman, Mark A., additional, Ackland, Gareth L., additional, Mazer, C. David, additional, Myles, Paul S., additional, Pearse, Rupert M., additional, Cuthbertson, Brian H., additional, Myles, P.S., additional, Shulman, M.A., additional, Wallace, S., additional, Farrington, C., additional, Thompson, B., additional, Ellis, M., additional, Borg, B., additional, Kerridge, R.K., additional, Douglas, J., additional, Brannan, J., additional, Pretto, J., additional, Godsall, M.G., additional, Beauchamp, N., additional, Allen, S., additional, Kennedy, A., additional, Wright, E., additional, Malherbe, J., additional, Ismail, H., additional, Riedel, B., additional, Melville, A., additional, Sivakumar, H., additional, Murmane, A., additional, Kenchington, K., additional, Kirabiyik, Y., additional, Gurunathan, U., additional, Stonell, C., additional, Brunello, K., additional, Steele, K., additional, Tronstad, O., additional, Masel, P., additional, Dent, A., additional, Smith, E., additional, Bodger, A., additional, Abolfathi, M., additional, Sivalingam, P., additional, Hall, A., additional, Painter, T.W., additional, Macklin, S., additional, Elliott, A., additional, Carrera, A.M., additional, Terblanche, N.C.S., additional, Pitt, S., additional, Samuels, J., additional, Wilde, C., additional, Leslie, K., additional, MacCormick, A., additional, Bramley, D., additional, Southcott, A.M., additional, Grant, J., additional, Taylor, H., additional, Bates, S., additional, Towns, M., additional, Tippett, A., additional, Marshall, F., additional, Mazer, C.D., additional, Kunasingam, J., additional, Yagnik, A., additional, Crescini, C., additional, Yagnik, S., additional, McCartney, C.J.L., additional, Choi, S., additional, Somascanthan, P., additional, Flores, K., additional, Wijeysundera, D.N., additional, Beattie, W.S., additional, Karkouti, K., additional, Clarke, H.A., additional, Jerath, A., additional, McCluskey, S.A., additional, Wasowicz, M., additional, Granton, J.T., additional, Day, L., additional, Pazmino-Canizares, J., additional, Oh, P., additional, Belliard, R., additional, Lee, L., additional, Dobson, K., additional, Chan, V., additional, Brull, R., additional, Ami, N., additional, Stanbrook, M., additional, Hagen, K., additional, Campbell, D., additional, Short, T., additional, Van Der Westhuizen, J., additional, Higgie, K., additional, Lindsay, H., additional, Jang, R., additional, Wong, C., additional, Mcallister, D., additional, Ali, M., additional, Kumar, J., additional, Waymouth, E., additional, Kim, C., additional, Dimech, J., additional, Lorimer, M., additional, Tai, J., additional, Miller, R., additional, Sara, R., additional, Collingwood, A., additional, Olliff, S., additional, Gabriel, S., additional, Houston, H., additional, Dalley, P., additional, Hurford, S., additional, Hunt, A., additional, Andrews, L., additional, Navarra, L., additional, Jason-Smith, A., additional, Thompson, H., additional, McMillan, N., additional, Back, G., additional, Croal, B.L., additional, Lum, M., additional, Martin, D., additional, James, S., additional, Filipe, H., additional, Pinto, M., additional, Kynaston, S., additional, Pearse, R.M., additional, Abbott, T.E.F., additional, Phull, M., additional, Beilstein, C., additional, Bodger, P., additional, Everingham, K., additional, Hu, Y., additional, Niebrzegowska, E., additional, Corriea, C., additional, Creary, T., additional, Januszewska, M., additional, Ahmad, T., additional, Whalley, J., additional, Haslop, R., additional, McNeil, J., additional, Brown, A., additional, MacDonald, N., additional, Pakats, M., additional, Greaves, K., additional, Jhanji, S., additional, Raobaikady, R., additional, Black, E., additional, Rooms, M., additional, Lawrence, H., additional, Koutra, M., additional, Pirie, K., additional, Gertsman, M., additional, Jack, S., additional, Celinski, M., additional, Levett, D., additional, Edwards, M., additional, Salmon, K., additional, Bolger, C., additional, Loughney, L., additional, Seaward, L., additional, Collins, H., additional, Tyrell, B., additional, Tantony, N., additional, Golder, K., additional, Ackland, G.L., additional, Stephens, R.C.M., additional, Gallego-Paredes, L., additional, Reyes, A., additional, Gutierrez del Arroyo, A., additional, Raj, A., additional, Lifford, R., additional, Cuthbertson, B.H., additional, Torres, E., additional, Ambosta, A., additional, Melo, M., additional, Mamdani, M., additional, Thorpe, K.E., additional, Grocott, M.P.W., additional, Hillis, G., additional, and Wijeysundera, H.C., additional

Published
2020
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18. Association of preoperative anaemia with cardiopulmonary exercise capacity and postoperative outcomes in noncardiac surgery: a substudy of the Measurement of Exercise Tolerance before Surgery (METS) Study

Author

Bartoszko, J., primary, Thorpe, K.E., additional, Laupacis, A., additional, Wijeysundera, D.N., additional, Myles, P.S., additional, Shulman, M.A., additional, Wallace, S., additional, Farrington, C., additional, Thompson, B., additional, Ellis, M., additional, Borg, B., additional, Kerridge, R.K., additional, Douglas, J., additional, Brannan, J., additional, Pretto, J., additional, Godsall, M.G., additional, Beauchamp, N., additional, Allen, S., additional, Kennedy, A., additional, Wright, E., additional, Malherbe, J., additional, Ismail, H., additional, Riedel, B., additional, Melville, A., additional, Sivakumar, H., additional, Murmane, A., additional, Kenchington, K., additional, Kirabiyik, Y., additional, Gurunathan, U., additional, Stonell, C., additional, Brunello, K., additional, Steele, K., additional, Tronstad, O., additional, Masel, P., additional, Dent, A., additional, Smith, E., additional, Bodger, A., additional, Abolfathi, M., additional, Sivalingam, P., additional, Hall, A., additional, Painter, T.W., additional, Macklin, S., additional, Elliott, A., additional, Carrera, A.M., additional, Terblanche, N.C.S., additional, Pitt, S., additional, Samuels, J., additional, Wilde, C., additional, Leslie, K., additional, MacCormick, A., additional, Bramley, D., additional, Southcott, A.M., additional, Grant, J., additional, Taylor, H., additional, Bates, S., additional, Towns, M., additional, Tippett, A., additional, Marshall, F., additional, Mazer, C.D., additional, Kunasingam, J., additional, Yagnik, A., additional, Crescini, C., additional, Yagnik, S., additional, McCartney, C.J.L., additional, Choi, S., additional, Somascanthan, P., additional, Flores, K., additional, Beattie, W.S., additional, Karkouti, K., additional, Clarke, H.A., additional, Jerath, A., additional, McCluskey, S.A., additional, Wasowicz, M., additional, Granton, J.T., additional, Day, L., additional, Pazmino-Canizares, J., additional, Oh, P., additional, Belliard, R., additional, Lee, L., additional, Dobson, K., additional, Chan, V., additional, Brull, R., additional, Ami, N., additional, Stanbrook, M., additional, Hagen, K., additional, Campbell, D., additional, Short, T., additional, Van Der Westhuizen, J., additional, Higgie, K., additional, Lindsay, H., additional, Jang, R., additional, Wong, C., additional, Mcallister, D., additional, Ali, M., additional, Kumar, J., additional, Waymouth, E., additional, Kim, C., additional, Dimech, J., additional, Lorimer, M., additional, Tai, J., additional, Miller, R., additional, Sara, R., additional, Collingwood, A., additional, Olliff, S., additional, Gabriel, S., additional, Houston, H., additional, Dalley, P., additional, Hurford, S., additional, Hunt, A., additional, Andrews, L., additional, Navarra, L., additional, Jason-Smith, A., additional, Thompson, H., additional, McMillan, N., additional, Back, G., additional, Croal, B.L., additional, Lum, M., additional, Martin, D., additional, James, S., additional, Filipe, H., additional, Pinto, M., additional, Kynaston, S., additional, Pearse, R.M., additional, Abbott, T.E.F., additional, Phull, M., additional, Beilstein, C., additional, Bodger, P., additional, Everingham, K., additional, Hu, Y., additional, Niebrzegowska, E., additional, Corriea, C., additional, Creary, T., additional, Januszewska, M., additional, Ahmad, T., additional, Whalley, J., additional, Haslop, R., additional, McNeil, J., additional, Brown, A., additional, MacDonald, N., additional, Pakats, M., additional, Greaves, K., additional, Jhanji, S., additional, Raobaikady, R., additional, Black, E., additional, Rooms, M., additional, Lawrence, H., additional, Koutra, M., additional, Pirie, K., additional, Gertsman, M., additional, Jack, S., additional, Celinski, M., additional, Levett, D., additional, Edwards, M., additional, Salmon, K., additional, Bolger, C., additional, Loughney, L., additional, Seaward, L., additional, Collins, H., additional, Tyrell, B., additional, Tantony, N., additional, Golder, K., additional, Ackland, G.L., additional, Gallego-Paredes, L., additional, Reyes, A., additional, Gutierrez del Arroyo, A., additional, Raj, A., additional, Lifford, R., additional, Cuthbertson, B.H., additional, Torres, E., additional, Ambosta, A., additional, Melo, M., additional, Mamdani, M., additional, Grocott, M.P.W., additional, Hillis, G., additional, and Wijeysundera, H.C., additional

Published
2019
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20. Heart rate recovery and morbidity after noncardiac surgery: Planned secondary analysis of two prospective, multi-centre, blinded observational studies

Author

Bianchi, C, Ackland, GL, Abbott, TEF, Minto, G, Clark, M, Owen, T, Prabhu, P, May, SM, Reynolds, JA, Cuthbertson, BH, Wijesundera, D, Pearse, RM, Myles, PS, Shulman, MA, Wallace, S, Farrington, C, Thompson, B, Ellis, M, Borg, B, Kerridge, RK, Douglas, J, Brannan, J, Pretto, J, Godsall, MG, Beauchamp, N, Allen, S, Kennedy, A, Wright, E, Malherbe, J, Ismail, H, Riedel, B, Melville, A, Sivakumar, H, Murmane, A, Kenchington, K, Kirabiyik, Y, Gurunathan, U, Stonell, C, Brunello, K, Steele, K, Tronstad, O, Masel, P, Dent, A, Smith, E, Bodger, A, Abolfathi, M, Sivalingam, P, Hall, A, Painter, TW, Macklin, S, Elliott, A, Carrera, AM, Terblanche, NCS, Pitt, S, Samuels, J, Wilde, C, Leslie, K, MacCormick, A, Bramley, D, Southcott, AM, Grant, J, Taylor, H, Bates, S, Towns, M, Tippett, A, Marshall, F, Mazer, CD, Kunasingam, J, Yagnik, A, Crescini, C, Yagnik, S, McCartney, CJL, Choi, S, Somascanthan, P, Flores, K, Wijeysundera, DN, Beattie, WS, Karkouti, K, Clarke, HA, Jerath, A, McCluskey, SA, Wasowicz, M, Granton, JT, Day, L, Pazmino-Canizares, J, Oh, P, Belliard, R, Lee, L, Dobson, K, Chan, V, Brull, R, Ami, N, Stanbrook, M, Hagen, K, Campbell, D, Short, T, Van Der Westhuizen, J, Higgie, K, Lindsay, H, Jang, R, Wong, C, Mcallister, D, Ali, M, Kumar, J, Waymouth, E, Kim, C, Dimech, J, Lorimer, M, Tai, J, Miller, R, Sara, R, Collingwood, A, Olliff, S, Gabriel, S, Houston, H, Dalley, P, Hurford, S, Hunt, A, Andrews, L, Navarra, L, Jason-Smith, A, Thompson, H, McMillan, N, Back, G, Croal, BL, Lum, M, Martin, D, James, S, Filipe, H, Pinto, M, Kynaston, S, Phull, M, Beilstein, C, Bodger, P, Everingham, K, Hu, Y, Niebrzegowska, E, Corriea, C, Creary, T, Januszewska, M, Ahmad, T, Whalley, J, Haslop, R, McNeil, J, Brown, A, MacDonald, N, Pakats, M, Greaves, K, Jhanji, S, Raobaikady, R, Black, E, Rooms, M, Lawrence, H, Koutra, M, Pirie, K, Gertsman, M, Jack, S, Celinski, M, Levett, D, Edwards, M, Salmon, K, Bolger, C, Loughney, L, Seaward, L, Collins, H, Tyrell, B, Tantony, N, Golder, K, Stephens, RCM, Gallego-Paredes, L, Reyes, A, del Arroyo, AG, Raj, A, Lifford, R, King, A, Pollak, C, Williams, C, Patrick, A, West, C, Vickers, E, Green, R, Jones, A, Otto, J, Lach, A, Whittle, J, Paredes, LG, Toner, A, Williams, A, Pradhu, P, Hull, D, Montague, L, Bianchi, C, Ackland, GL, Abbott, TEF, Minto, G, Clark, M, Owen, T, Prabhu, P, May, SM, Reynolds, JA, Cuthbertson, BH, Wijesundera, D, Pearse, RM, Myles, PS, Shulman, MA, Wallace, S, Farrington, C, Thompson, B, Ellis, M, Borg, B, Kerridge, RK, Douglas, J, Brannan, J, Pretto, J, Godsall, MG, Beauchamp, N, Allen, S, Kennedy, A, Wright, E, Malherbe, J, Ismail, H, Riedel, B, Melville, A, Sivakumar, H, Murmane, A, Kenchington, K, Kirabiyik, Y, Gurunathan, U, Stonell, C, Brunello, K, Steele, K, Tronstad, O, Masel, P, Dent, A, Smith, E, Bodger, A, Abolfathi, M, Sivalingam, P, Hall, A, Painter, TW, Macklin, S, Elliott, A, Carrera, AM, Terblanche, NCS, Pitt, S, Samuels, J, Wilde, C, Leslie, K, MacCormick, A, Bramley, D, Southcott, AM, Grant, J, Taylor, H, Bates, S, Towns, M, Tippett, A, Marshall, F, Mazer, CD, Kunasingam, J, Yagnik, A, Crescini, C, Yagnik, S, McCartney, CJL, Choi, S, Somascanthan, P, Flores, K, Wijeysundera, DN, Beattie, WS, Karkouti, K, Clarke, HA, Jerath, A, McCluskey, SA, Wasowicz, M, Granton, JT, Day, L, Pazmino-Canizares, J, Oh, P, Belliard, R, Lee, L, Dobson, K, Chan, V, Brull, R, Ami, N, Stanbrook, M, Hagen, K, Campbell, D, Short, T, Van Der Westhuizen, J, Higgie, K, Lindsay, H, Jang, R, Wong, C, Mcallister, D, Ali, M, Kumar, J, Waymouth, E, Kim, C, Dimech, J, Lorimer, M, Tai, J, Miller, R, Sara, R, Collingwood, A, Olliff, S, Gabriel, S, Houston, H, Dalley, P, Hurford, S, Hunt, A, Andrews, L, Navarra, L, Jason-Smith, A, Thompson, H, McMillan, N, Back, G, Croal, BL, Lum, M, Martin, D, James, S, Filipe, H, Pinto, M, Kynaston, S, Phull, M, Beilstein, C, Bodger, P, Everingham, K, Hu, Y, Niebrzegowska, E, Corriea, C, Creary, T, Januszewska, M, Ahmad, T, Whalley, J, Haslop, R, McNeil, J, Brown, A, MacDonald, N, Pakats, M, Greaves, K, Jhanji, S, Raobaikady, R, Black, E, Rooms, M, Lawrence, H, Koutra, M, Pirie, K, Gertsman, M, Jack, S, Celinski, M, Levett, D, Edwards, M, Salmon, K, Bolger, C, Loughney, L, Seaward, L, Collins, H, Tyrell, B, Tantony, N, Golder, K, Stephens, RCM, Gallego-Paredes, L, Reyes, A, del Arroyo, AG, Raj, A, Lifford, R, King, A, Pollak, C, Williams, C, Patrick, A, West, C, Vickers, E, Green, R, Jones, A, Otto, J, Lach, A, Whittle, J, Paredes, LG, Toner, A, Williams, A, Pradhu, P, Hull, D, and Montague, L

Abstract

BACKGROUND: Impaired cardiac vagal function, quantified preoperatively as slower heart rate recovery (HRR) after exercise, is independently associated with perioperative myocardial injury. Parasympathetic (vagal) dysfunction may also promote (extra-cardiac) multi-organ dysfunction, although perioperative data are lacking. Assuming that cardiac vagal activity, and therefore heart rate recovery response, is a marker of brainstem parasympathetic dysfunction, we hypothesized that impaired HRR would be associated with a higher incidence of morbidity after noncardiac surgery. METHODS: In two prospective, blinded, observational cohort studies, we established the definition of impaired vagal function in terms of the HRR threshold that is associated with perioperative myocardial injury (HRR ≤ 12 beats min-1 (bpm), 60 seconds after cessation of cardiopulmonary exercise testing. The primary outcome of this secondary analysis was all-cause morbidity three and five days after surgery, defined using the Post-Operative Morbidity Survey. Secondary outcomes of this analysis were type of morbidity and time to become morbidity-free. Logistic regression and Cox regression tested for the association between HRR and morbidity. Results are presented as odds/hazard ratios [OR or HR; (95% confidence intervals). RESULTS: 882/1941 (45.4%) patients had HRR≤12bpm. All-cause morbidity within 5 days of surgery was more common in 585/822 (71.2%) patients with HRR≤12bpm, compared to 718/1119 (64.2%) patients with HRR>12bpm (OR:1.38 (1.14-1.67); p = 0.001). HRR≤12bpm was associated with more frequent episodes of pulmonary (OR:1.31 (1.05-1.62);p = 0.02)), infective (OR:1.38 (1.10-1.72); p = 0.006), renal (OR:1.91 (1.30-2.79); p = 0.02)), cardiovascular (OR:1.39 (1.15-1.69); p<0.001)), neurological (OR:1.73 (1.11-2.70); p = 0.02)) and pain morbidity (OR:1.38 (1.14-1.68); p = 0.001) within 5 days of surgery. CONCLUSIONS: Multi-organ dysfunction is more common in surgical patients with cardiac vagal dys

Published
2019

21. Using the 6-minute walk test to predict disability-free survival after major surgery

Author

Shulman, M.A., primary, Cuthbertson, B.H., additional, Wijeysundera, D.N., additional, Pearse, R.M., additional, Thompson, B., additional, Torres, E., additional, Ambosta, A., additional, Wallace, S., additional, Farrington, C., additional, Myles, P.S., additional, Ellis, M., additional, Borg, B., additional, Kerridge, R.K., additional, Douglas, J., additional, Brannan, J., additional, Pretto, J., additional, Godsall, M.G., additional, Beauchamp, N., additional, Allen, S., additional, Kennedy, A., additional, Wright, E., additional, Malherbe, J., additional, Ismail, H., additional, Riedel, B., additional, Melville, A., additional, Sivakumar, H., additional, Murmane, A., additional, Kenchington, K., additional, Gurunathan, U., additional, Stonell, C., additional, Brunello, K., additional, Steele, K., additional, Tronstad, O., additional, Masel, P., additional, Dent, A., additional, Smith, E., additional, Bodger, A., additional, Abolfathi, M., additional, Sivalingam, P., additional, Hall, A., additional, Painter, T., additional, Macklin, S., additional, Elliott, A., additional, Carrera, A.M., additional, Terblanche, N.C.S., additional, Pitt, S., additional, Samuels, J., additional, Wilde, C., additional, MacCormick, A., additional, Leslie, K., additional, Bramley, D., additional, Southcott, A.M., additional, Grant, J., additional, Taylor, H., additional, Bates, S., additional, Towns, M., additional, Tippett, A., additional, Marshall, F., additional, McCartney, C.J.L., additional, Choi, S., additional, Somascanthan, P., additional, Flores, K., additional, Beattie, W.S., additional, Karkouti, K., additional, Clarke, H.A., additional, Jerath, A., additional, McCluskey, S.A., additional, Wasowicz, M., additional, Granton, J.T., additional, Day, L., additional, Pazmino-Canizares, J., additional, Hagen, K., additional, Campbell, D., additional, Short, T., additional, Van Der Westhuizen, J., additional, Higgie, K., additional, Lindsay, H., additional, Jang, R., additional, Wong, C., additional, Mcallister, D., additional, Ali, M., additional, Kumar, J., additional, Waymouth, E., additional, Kim, C., additional, Dimech, J., additional, Lorimer, M., additional, Tai, J., additional, Miller, R., additional, Sara, R., additional, Collingwood, A., additional, Olliff, S., additional, Gabriel, S., additional, Houston, H., additional, Dalley, P., additional, Hurford, S., additional, Hunt, A., additional, Andrews, L., additional, Navarra, L., additional, Jason-Smith, A., additional, Thompson, H., additional, McMillan, N., additional, Back, G., additional, Melo, M., additional, Mamdani, M., additional, Hillis, G., additional, and Wijeysundera, H.C., additional

Published
2019
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24. Artificial Insemination

Author

Duff, Keith, Primrose, Edward J. R., Back, G. A., and Ford, Leslie

Published
1944

26. Foretaste Of Control?

Author

Foxell, Humphrey, Harris, Wilfred, Mercier, C. Jerome, and Back, G. A.

Published
1947

33. Solid AFFF Technology Investigation

Author

COAST GUARD NEW LONDON CT RESEARCH AND DEVELOPMENT CENTER, Back, G G, Scheffey, J L, Alvord, S J, Beene, Jr, D E, COAST GUARD NEW LONDON CT RESEARCH AND DEVELOPMENT CENTER, Back, G G, Scheffey, J L, Alvord, S J, and Beene, Jr, D E

Abstract

The objective of this fire test program was to quantify the firefighting capabilities of commercially available solid Aqueous Film Forming Foam (AFFF) through a side-by-side comparison with the currently used liquid MIL-SPEC AFFF. By eliminating the water in the concentrate, a substantial space and weight savings is potentially available. The 2.6 m2 (28 ft2) fire test in MIL-F-24385F was used as a screening method to determine the viability of the concept. It was determined during this program that the commercially available AFFF stick could not extinguish the MIL-SPEC fire and therefore should not be adopted for use on U.S. Coast Guard ships. However, tests conducted with 25-year old solid AFFF pellets demonstrated that the technology is viable. The Coast Guard should encourage the development and testing of solid AFFF technology which achieves performance equal to or similar to that required by the MIL-SPEC., Prepared in collaboration with SAIC, Mystic, CT and Hughes Associates Inc., Baltimore, MD. The original document contains color images.

Published
2010

35. An Evaluation of Pre-Engineered Fire Extinguishing Systems for Machinery Space Applications

Author

HUGHES ASSOCIATES INC BALTIMORE MD, Forssell, E., Boosinger, M., Back, G., Weaver, E., Nash, L., Beene, D., HUGHES ASSOCIATES INC BALTIMORE MD, Forssell, E., Boosinger, M., Back, G., Weaver, E., Nash, L., and Beene, D.

Abstract

A full-scale fire performance evaluation was conducted to assist the USCG in developing a position on using pre-engineered fire extinguishing systems (PFESs) in larger compartments. Specifically the tests evaluated (1) the reliability of PFESs in irregular- shaped compartments with volumes up to 150 cubic m (5,297 cubic ft); (2) the ability of the systems to distribute the agent in larger/irregular spaces; (3) the effects of ventilation on the extinguishing capability of the pre-engineered systems, and (4) the effect of the agents on diesel engine operations during the discharge of a fire extinguishing agent. This test series was broken down into two parts. The initial set of tests assessed the capabilities of two type approved PFESs over a range of potential compartment configurations (a sensitivity analysis of application parameters). This assessment was performed in an enclosure(s) with a volume equivalent to the maximum allowed by the type approval. The second set of tests assessed the ability to protect larger volumes/spaces with similar types of systems. The results of these tests suggest that the approved systems have good actuation and fire extinguishing capabilities for their approved volumes; however, the results of these tests suggest that the current technology(s) need to be modified (e.g. increased agent design concentration) when applied to larger spaces in order to provide the same level of protection as that provided in the smaller volumes. Testing of the agents on an operating diesel engine showed the engine shut down immediately upon exposure to the agent without any sign of a run-away, and the diesel engine was successfully restarted after the test., Prepared in collaboration with Science Applications International Corp. (SAIC), Mistic, CT. The original document contains color images.

Published
2008

36. An Evaluation of the Potential Failure Modes for Gaseous Agent Fire Extinguishing Systems Installed within the Protected Space

Author

COAST GUARD RESEARCH AND DEVELOPMENT CENTER GROTON CT, Back, G., Forssell, E., Boosinger, M., Beene, D., Nash, L., Weaver, E., COAST GUARD RESEARCH AND DEVELOPMENT CENTER GROTON CT, Back, G., Forssell, E., Boosinger, M., Beene, D., Nash, L., and Weaver, E.

Abstract

A full-scale fire performance evaluation was conducted to assist the USCG in developing a position on the practice of installing gaseous agent fire extinguishing system components (i.e., agent cylinders and control valves) within the space they are protecting (i.e., machinery spaces). Testing was carried out to identify the potential failure modes of the system and its components. The evaluation assessed the survivability of a number of halocarbon and inert gas fire suppression system components against a range of exposures/conditions. The results suggest that a component containing plastic or rubber parts is likely to fail if the exposure exceeds 15 kW/m2 and the energy dosage exceeds 9 MJ/m2. An analytical assessment of agent storage cylinders (various extinguishing agents and cylinder sizes) conducted during this investigation suggests that the pressure relief valves in the cylinders would vent the extinguishing agent with approximately the same exposures/conditions that caused failures of plastic or rubber parts. In addition, one test was conducted to determine if the loss of an agent cylinder in the space (implied in SOLAS as an acceptable consequence) would prevent the system from extinguishing the fire. The results show that the loss of an agent cylinder will render the system ineffective (not able to extinguish the fire). As a result, the system needs to be designed and installed in a manner to ensure that the design concentration of agent (1.3 times the minimum extinguishing concentration) is available at the time the system is activated.

Published
2007

37. An Evaluation of Total Flooding High Expansion Foam Fire Suppression Systems for Machinery Space Applications

Author

HUGHES ASSOCIATES INC BALTIMORE MD, Back, G., Forssell, E., Wakelin, A., Beene, D., Nash, L., HUGHES ASSOCIATES INC BALTIMORE MD, Back, G., Forssell, E., Wakelin, A., Beene, D., and Nash, L.

Abstract

Full-scale fire tests were conducted to identify the fire extinguishing capabilities and limitations of High Expansion Foam Fire Suppression Systems (HEFFSS) in shipboard machinery space applications. A total of 35 tests were conducted in this evaluation utilizing the equipment and foam concentrates from three manufacturers: Ansul, Buckeye and Chemguard. All three systems easily extinguished the pan fires included in this evaluation independent of the type of fuel (heptane or diesel). The differences in the systems' capabilities were observed during the extinguishment of the heptane spray fires that presented a major challenge to the HEFFSS. The difficulty observed in extinguishing spray fires and, conversely, the ease in extinguishing the pan fires, demonstrates that the current high expansion foam test protocol (MSC/Circ. 670) is inadequate for approving HEFFSS for machinery space applications. As a result, it is recommended that HEFFSS be approved using a modified version of the gaseous agent test protocol MSC/Circ. 848, rather than MSC/Circ. 670. Recommendations on how to modify the protocol to account for the differences between high expansion foam and gaseous agent technologies are provided in the report as well as issues requiring further research., Prepared in collaboration with the U.S. Coast Guard, Research and Development Center, Groton, CT. Performing organization rept. no. R&DC-632. The original document contains color images.

Published
2004

38. Lessons Learned From the CG-19 Weapons Effects Test on Mitigating the Effects of a Missile Induced Conflagration

Author

NAVAL RESEARCH LAB WASHINGTON DC, Back, G. G., III, Darwin, R. L., Sheffey, J. L., Williams, F. W., Satterfield, D. B., NAVAL RESEARCH LAB WASHINGTON DC, Back, G. G., III, Darwin, R. L., Sheffey, J. L., Williams, F. W., and Satterfield, D. B.

Abstract

Techniques are recommended for reducing the severity of a missile induced conflagration. Evaluate various "fuel load minimization concepts" (reductions in total fuel loading and"or techniques that prevent burnable material from coming in contact with air). Evaluate techniques for reducing the likelihood of fire spread through intact boundaries. Evaluate possible installation techniques for enhancing the survivability of systems (sprinkler, water delivery, and vital systems). Develop/evaluate systems to cool the PDA and cool the PDA boundaries. Develop a network of sensors designed to increase the overall situational awareness and refine the Doctrine for fighting missile induced fires., Errata added 15 Apr 04, dated 12 Feb 04.

Published
2004

45. Effects of Water Sprinklers on the Performance of Low Level AFFF Aircraft Hangar Fire Suppression Systems

Author

NAVY TECHNOLOGY CENTER FOR SAFETY AND SURVIVABILITY WASHINGTON DC, Back, G. G., Parker, A. J., Scheffey, J. L., Williams, F. W., Gott, J. E., NAVY TECHNOLOGY CENTER FOR SAFETY AND SURVIVABILITY WASHINGTON DC, Back, G. G., Parker, A. J., Scheffey, J. L., Williams, F. W., and Gott, J. E.

Abstract

A series of full-scale fire tests was conducted to evaluate the effect that overhead water-only sprinklers have on the effectiveness of a low level AFFF fire suppression system. The combined overhead water-only sprinkler and low level AFFF system is being considered as a new protection scheme for U.S. Navy aircraft hangars. The results show that the operation of overhead water sprinklers up to 10.2 Lpm/sq m (0.25 gpm/sq ft) does not degrade the performance of a low level system during AFFF discharge (4.0 Lpm/sq m (0.1 gpm/sq ft)). Based on the results of these tests, the design criteria for Navy hangar protection may be revised to incorporate AFFF application from only the low level system, combined with overhead closed-head guide response water sprinklers., Prepared in collaboration with Hughes Associates, Inc., Baltimore, MD.

Published
2000

46. Systems and protocols of geological information management at Telfer gold mine, Western Australia.

Author

Carlson R.D., Fourth international mining geology conference Coolum, Queensland 14-May-0017-May-00, Back G., Howard G.R., Carlson R.D., Fourth international mining geology conference Coolum, Queensland 14-May-0017-May-00, Back G., and Howard G.R.

Abstract

Databases at Telfer include data from drillhole planning, forecasting, drill control, drillholes, geological logging, sampling and assaying, quality assurance, geological rehabilitation, invoice reconciliation and occupational health and safety. The established Quality Assurance Quality Control system has a well-defined role in attempting to reduce the risks associated with resource and reserve estimation by ensuring that analytical data are within specifications. Two examples of loss control were the recognition of a sulphur bias in a number of batches from a commercial laboratory, which was found to result from the use of a particular de-flocculant, and the detection of a laboratory sample handling error when the multi-element signatures of standards were found to be incorrect., Databases at Telfer include data from drillhole planning, forecasting, drill control, drillholes, geological logging, sampling and assaying, quality assurance, geological rehabilitation, invoice reconciliation and occupational health and safety. The established Quality Assurance Quality Control system has a well-defined role in attempting to reduce the risks associated with resource and reserve estimation by ensuring that analytical data are within specifications. Two examples of loss control were the recognition of a sulphur bias in a number of batches from a commercial laboratory, which was found to result from the use of a particular de-flocculant, and the detection of a laboratory sample handling error when the multi-element signatures of standards were found to be incorrect.

Published
2000

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