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Introduction: The EuroSCORE II was updated from the EuroSCORE I and validated this year as a predictor for inhospital mortality after cardiac surgery. The EuroSCORE I was previously shown in multiple studies to be a good predictor of delayed extubation in patients undergoing coronary artery bypass graft (CABG) surgery. In contrast, very few studies have been conducted on predictors of delayed extubation in patients undergoing valvular surgery. Identifying risk factors and predictors of prolonged intubation in patients undergoing valvular surgery will allow clinicians to address any modifiable risk factors, and optimize a high-risk patient's chances of a favorable outcome. The aim of this study is to evaluate the newly developed EuroSCORE II as an indicator for prolonged extubation following valvular surgery. The most common causes of delayed extubation in patients undergoing valvular surgery were also tabulated and analyzed. Methods: We conducted a retrospective chart review on all patients in Queens Medical Center (QMC) from 1/1/2011 to 12/31/2011 who underwent any form of valvular surgery, either as a single procedure or in combination with another cardiothoracic procedure. The factors for patients who were intubated post surgery for 6 hours or more were identified and analyzed. Statistical analysis of the EUROscore as a predictor for the duration of intubation was performed. Results: A total of 186 patients with a median age of 65, (39.8% females) were found to have had valvular surgery during the time period specified for our study. Forty-two (22.6%) patients were extubated within 6 hours, which is the definition of early extubation, in most studies. Strictly valve procedures comprised 66% with the rest being combinations (including CABG and aortic dissection repair). Procedures involving the aortic valve comprised 59%, involving the mitral valve, 46%; involving the tricuspid valve, 10% involving the pulmonary valve, 2%. Minimally invasive procedures were 7%. The most common causes of delayed extubations were hypoxia and bleeding. Statistical analysis of the EuroSCORE II showed that it correlated well with extubation times (P < .01). Conclusion: The majority of the patients undergoing valvular surgery in QMC are not extubated within the recommended time frame. The EuroSCORE II is a good predictor for prolonged extubation in patients following valvular surgery and may be useful in identifying patients at high risk for prolonged extubations, allowing clinicians to mitigate any modifiable risk factors in this group of patients. [ABSTRACT FROM AUTHOR]

The article discusses the contents of "Gender Equity in Higher Education: 2006," published by the American Council on Education. This report took a detailed look at the educational achievement of men and women in the U.S., disaggregating key indicators which include race/ethnicity, age and income. The purpose of this publication was to aid campus leaders in analyzing and responding to the gender equity issue.

The 2020/2021 epidemic in Europe of highly pathogenic avian influenza virus (HPAIV) of subtype H5 surpassed all previously recorded European outbreaks in size, genotype constellations and reassortment frequency and continued into 2022 and 2023. The causative 2.3.4.4b viral lineage proved to be highly proficient with respect to reassortment with cocirculating low pathogenic avian influenza viruses and seems to establish an endemic status in northern Europe. A specific HPAIV reassortant of the subtype H5N3 was detected almost exclusively in red knots ( Calidris canutus islandica ) in December 2020. It caused systemic and rapidly fatal disease leading to a singular and self-limiting mass mortality affecting about 3500 birds in the German Wadden Sea, roughly 1 % of the entire flyway population of islandica red knots. Phylogenetic analyses revealed that the H5N3 reassortant very likely had formed in red knots and remained confined to this species. While mechanisms of virus circulation in potential reservoir species, dynamics of spill-over and reassortment events and the roles of environmental virus sources remain to be identified, the year-round infection pressure poses severe threats to endangered avian species and prompts adaptation of habitat and species conservation practices.