Morin Hoppe (iriswhale59)

BACKGROUND Current guidelines recommend laparoscopic cholecystectomy be offered for patients with acute cholecystitis except those deemed as high risk. Few studies have examined the impact of frailty on outcomes for patients undergoing laparoscopic cholecystectomy. Therefore, the aim of this study was to determine the association of frailty with postoperative morbidity and mortality in patients undergoing laparoscopic cholecystectomy for acute cholecystitis. METHODS Patients undergoing laparoscopic cholecystectomy for acute cholecystectomy were identified from 2005 to 2010 in the American College of Surgeons National Surgical Quality Improvement Project (NSQIP). The Modified Frailty Index (mFI) was used a surrogate for frailty, and patients were stratified as non-frail (mFI 0), low frailty (mFI 1-2), intermediate frailty (mFI 3-4) and high frailty (mFI ≥ 5). Univariable and multivariable analyses were performed. Receiver operator curves (ROC) and an area under the curve (AUC) were generated to determine accuracy of mFI in predicting postoperative morbidity and mortality. RESULTS Of the 6898 patients undergoing laparoscopic cholecystectomy, 3245 (47%) patients were non-frail. There were 2913 (42%) patients with low-frailty, 649 (9%) patients with intermediate frailty, and 91 (2%) with high frailty. Clavien IV complications were higher for intermediate frail patients (OR 1.81, 95% CI 1.00-3.28, p = 0.050) and high-frail patients (OR 4.59, 95% CI 1.98-10.7, p less then 0.001). Additionally, mortality was higher for patients with intermediate frailty (OR 4.69, 95% CI 1.37-16.0, p = 0.014) and high frailty (OR 12.2, 95% CI 2.67-55.5, p = 0.001). The mFI had excellent accuracy for mortality (AUC = 0.83) and Clavien IV complications (AUC = 0.73). CONCLUSION Frailty is associated with postoperative morbidity and mortality in patients undergoing laparoscopic cholecystectomy for acute cholecystitis.The increasing employment of eye-tracking technology in different application areas and in vision research has led to an increased need to measure fast eye-movement events. Whereas the cost of commercial high-speed eye trackers (above 300 Hz) is usually in the tens of thousands of EUR, to date, only a small number of studies have proposed low-cost solutions. Existing low-cost solutions however, focus solely on lower frame rates (up to 120 Hz) that might suffice for basic eye tracking, leaving a gap when it comes to the investigation of high-speed saccadic eye movements. In this paper, we present and evaluate a system designed to track such high-speed eye movements, achieving operating frequencies well beyond 500 Hz. This includes methods to effectively and robustly detect and track glints and pupils in the context of high-speed remote eye tracking, which, paired with a geometric eye model, achieved an average gaze estimation error below 1 degree and average precision of 0.38 degrees. Moreover, average undetection rate was only 0.33%. At a total investment of less than 600 EUR, the proposed system represents a competitive and suitable alternative to commercial systems at a tiny fraction of the cost, with the additional advantage that it can be freely tuned by investigators to fit their requirements independent of eye-tracker vendors.We describe a novel method of Bayesian inference for hierarchical or non-hierarchical equal variance normal signal detection theory models with one or more criteria. The method is implemented as an open-source R package that uses the state-of-the-art Stan platform for sampling from posterior distributions. Our method can accommodate binary responses as well as additional ratings and an arbitrary number of nested or crossed random grouping factors. The SDT parameters can be regressed on additional predictors within the same model via intermediate unconstrained parameters, and the model can be extended by using automatically generated human-readable Stan code as a template. In the paper, we explain how our method