Predicting Acute Renal Failure after Cardiac Surgery: Validation and Re‐definition of a Risk‐Stratification Algorithm

Background:  Acute renal failure (ARF) after cardiac surgery is associated with significant morbidity and mortality, irrespective of the need for dialysis. Previous studies have attempted to identify predictors of ARF and develop risk stratification algorithms. This study aims to validate the algorithm in an independent cohort of patients that includes a significant proportion of female and black patients and compares two different definitions of renal outcome.
Methods:  A large single center cardiac surgery database was examined (n, 24,660; 1993–2000) which included 29.9% females and 3.7% black patients. Post‐operative ARF was defined as: a) ARF requiring dialysis, b) > 50% reduction in creatinine clearance relative to baseline or requiring dialysis. Clinical variables related to baseline renal function and cardiovascular disease were used in recursive partitioning analysis for both outcome definitions. Chi‐square goodness of fit analysis was performed to validate the algorithm.
Results:  The frequency of post‐operative ARF requiring dialysis ranged between 0.5 and 15.5% based on the risk categories with the area under the receiver operating characteristic (ROC) curve of 0.78. Using the more inclusive definition of ARF, the frequency was significantly higher ranging from 2.6 to 25%(P < 0.001) with an area under ROC curve of 0.65.
Conclusions:  The renal risk stratification algorithm is valid in predicting post‐operative ARF in an independent cohort of patients, well represented by differences in gender and race. Since the need for dialysis remains subjective, a more objective and inclusive definition of ARF may help in identifying a larger number of patients 'at‐risk'.     

Time and cost securing in complex large-scale projects

Meeting time and cost objectives in complex projects involves specific problems and risks. An attempt is made to analyse the components of total cost increase of a project caused by time delay. An outline is given as to how these considerations can be used to estimate cost increases in investors' decision situations as well as to ascertain fair contractual penalties and claims for compensation and for the evaluation of justified project acceleration costs.     

国外尾矿坝安全与环境研究综述

安全与环境一直是国外尾矿坝研究的重点。笔者综述了自1990年以来国外涉及尾矿坝安全与环境方面有代表性的文献 ,内容包括尾矿坝溃坝、溃坝理论研究、安全管理、环境污染、污染监测、污染治理、污染理论研究及生态复垦 ,这些对提高我国尾矿坝管理、工程技术水平都有较好的参考价值     

Youth gambling behaviors: An examination of the role of resilience.

The study of resilient children has overturned many deficit-focused models concerning the ontogenesis of children raised in adversity. This study explored the relationship between risk and protective factors, resilience, and youth gambling behavior. More specifically, this study examined the relative contribution of various risk and protective domains in relation to problem gambling behavior and examined whether youth identified as resilient (high risk exposure- high internalized protection) were as likely as those identified as vulnerable (high risk exposure-low internalized protection) to engage in excessive gambling behavior. The sample consisted of 1,273 students ages 12 to 19. The findings demonstrated that risk and protective factors each provide a unique contribution to the prediction model of gambling problems. Resilient and vulnerable youth differed significantly in their self-reported gambling severity. As well, resilient youth were not statistically distinguishable from low-risk exposure groups in terms of their gambling severity. Findings are interpreted with respect to resilience and prevention research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

对单位工程竣工验收资料核查要点的探讨

针对竣工资料核查工作中遇到的一些常见和普遍存在的问题进行了分析、探讨，指出单位工程竣工资料的核查应以核查基建程序资料、综合管理资料及质量保证资料为重点。     

论当前家庭装修的几个误区

分析了当前家装存在的破坏结构，一味追求奢华，施工质量差等种种误区，提出了搞好家庭装修的关键环节，对促进家装行业健康发展有积极的意义。     

新丰江大坝监测自动化系统的成功实施与现场维护

本文介绍了新丰江大坝监测自动化系统从失败走向成功的实施过程，强调了良好的工作环境以及精心的现场维护在大坝监测自动化应用中的重要性。     

关于重力坝坝内细部构造设计的几个问题

重力坝常采用横，纵缝将坝体分为柱状体施工。为此，横缝须设置止水，纵缝则待坝体冷却后灌浆，将柱状坝块连成整体。此外坝体内部还须设置坝面排水管以消除坝内渗透压力。关于坝内这些细部构造，设计规范仅有原则性要求，一般专业书列举不多，目前有些工程往往参照已建工程的设计图采用，常由于施工详图不祥易发生施工质量问题。根据丹江口重力坝设计经验，对接缝灌浆中的键槽，止浆片，灌浆管道，出浆盒，排气槽及排气管，基岩陡坡     

The TDCPR Management Mode of Engineering Equipment

The Three Gorges Project is a very large project,and its structure is very complex.Interna-tional advanced engineering equipment is broadly used.The state of equipment running directly influ-ences project building qualities and limited time.According to the factud conditions of the Three Gor-ges Project,the characteristics of engineering equipment are analyzed.At the same time ,some theories about equipment management are induced ,and the TDCPR management mode of engineering equip-ment of the Three Gorges Project is put forwared in order to gain the aim of managing and using equip-ment well and speeding up the project construction.     

随机徐变应力影响下重力坝时变可靠度初探

由于重力坝的随机温度场以及随机徐变应力场均为非平稳随机过程，由此所涉及的结构可靠度是非平稳向量随机过程非线性组合的时变可靠度．本文计入重力坝徐变应力场和混凝土强度随机性的影响，将时变可靠度的数值解法与随机有限元法相结合，模拟施工过程，对一典型重力坝的时变可靠度进行了计算，得出了一些有益的结论．