Journal of surgery and research最新文献

IBM and the University Hospital Zurich have developed an online tool for predicting outcomes of a patient with polytrauma, the IBM WATSON Trauma Pathway Explorer^® . The three predicted outcomes are Systemic Inflammatory Response Syndrome (SIRS) and sepsis within 21 days as well as early death within 72 hours since the admission of the patient. The validated Trauma Pathway Explorer^® offers insights into the most common laboratory parameters, such as procalcitonin (PCT). Sepsis is one of the most important complications after polytrauma, which is why it is crucial to detect it early. This study aimed to examine the time-dependent relationship between PCT values and sepsis, based on the WATSON technology. A total of 3653 patients were included, and ongoing admissions are incorporated continuously. Patients were split into two groups (sepsis and non-sepsis), and the PCT value was assessed for 21 days (1, 2, 3, 4, 6, 8, 12, 24, 48 hours, and 3, 4, 5, 7, 10, 14 and 21 days). The Mann-Whitney U-Test was used to evaluate the difference between the two groups. Binary logistic regression was utilized to examine the dependency of prediction. The Closest Top-left Threshold Method provided time-specific thresholds at which the PCT level is predictive for sepsis. At p <0.05, the data were declared significant. R was used to conduct all statistical analyses. The Mann-Whitney U-test showed a significant difference in PCT values in sepsis and non-sepsis patients between 12 and 24 hours, including post-hoc analysis (p <0.05). Likewise, the p-value started to be significant between 12 and 24 hours in the binary logistic regression (p <0.05). The threshold value of PCT to predict sepsis at 24 hours is 0.7μg/l, and at 48 hours 0.5μg/l. The presented time course of PCT levels in polytrauma patients shows the PCT as a separate predictor for sepsis relatively early. Even later, during the 21-day observation period, time-dependent PCT values may be utilized as a benchmark for the early and preemptive detection of sepsis, which may reduce death from septic shock and other deadly infectious episodes.

Background: Few studies have examined which National Institutes of Health (NIH) Institutes or Centers (ICs) provide most of the funding to surgeons, nor examined the specifics of their research focus areas. A better understanding of both the goals of ICs and research focus areas for surgeons may facilitate further alignment of the two.

Methods: A previously created database of NIH-funded surgeons was queried. To understand trends in funding, total grant cost was calculated for each IC in 2010 and 2020, and distribution of IC funds to each principal investigator (PI) category (surgeons, other physicians, and PhDs without a medical degree) was compared. Finally, total cost for Research Condition and Disease Categorization (RCDC) areas funded to surgeons compared to all of NIH was calculated. Statistical analyses were performed; a two-tailed p value of < 0.05 was considered significant.

Results: The National Cancer Institute (NCI) awarded the largest percentage of all 2020 surgeon funding, 34.3% ($298.9M). Compared to the other ICs, surgeons held the largest percentage of the National Eye Institute's (NEI) total funding in 2010 and 2020 at 8.7% and 9.0%, respectively. The RCDC super category comprising the most funding for surgeons was health disparities with 14.5% of all surgeon funding, followed by neurology (13.8%) and cancer (11.4%). Surgeons were awarded 10.8% of NIH's transplant-related research, 7.0% of ophthalmology-related research, and 3.4% of cancer-related research in 2020.

Conclusions: Our study shows surgeons have positioned themselves to examine new and myriad research topics while maintaining a focus on health disparities and cancer-related research.