| 1 | Genetic mapping of complex discrete human diseases by discriminant analysis显示文摘The objective of the present study is to propose and evaluate a novel multivariate approach for genetic mapping of complex categorical diseases. This approach results from an application of standard stepwise discriminant analysis to detect linkage based on the differential marker identity-by-descent (IBD) distributions among the different groups of sib pairs. Two major advantages of this method are that it allows for simultaneously testing all markers, together with other genetic and environmental factors in a single multivariate setting and it avoids explicitly modeling the complex relationship between the affection status of sib pairs and the underlying genetic determinants. The efficiency and properties of the method are demonstrated via simulations. The proposed multivariate approach has successfully located the true position(s) under various genetic scenarios. The more important finding is that using highly densely spaced markers (1~2 cM) leads to only a marginal loss of statistical efficiency of the proposed methods in terms of gene localization and statistical power. These results have well established its utility and advantages as a fine-mapping tool. A unique property of the proposed method is the ability to map multiple linked trait loci to their precise positions due to its sequential nature, as demonstrated via simulations. | Kathy L.MOSER Robert C.ELSTON Jane M.OLSON | 2002 | Progress in Natural Science:Materials International2002，12，6： | 3 |
| 5 | Impact of initial fluid resuscitation volume on clinical outcomes in patientswith heart failure and septic shock显示文摘Background:Fluid resuscitation is a key treatment for sepsis,but limited data exists in patients with existing heartfailure(HF)and septic shock.The objective of this study was to determine the impact of initial fluid resuscitationvolume on outcomes in HF patients with reduced or mildly reduced left ventricular ejection fraction(LVEF)withseptic shock.Methods:This multicenter,retrospective,cohort study included patients with known HF(LVEF≤50%)presentingwith septic shock.Patients were divided into two groups based on the volume of fluid resuscitation in the first 6 h;<30 mL/kg or≥30 mL/kg.The primary outcome was a composite of in-hospital mortality or renal replacementtherapy(RRT)within 7 days.Secondary outcomes included acute kidney injury(AKI),initiation of mechanicalventilation,and length of stay(LOS).All related data were collected and compared between the two groups.A generalized logistic mixed model was used to assess the association between fluid groups and the primaryoutcome while adjusting for baseline LVEF,Acute Physiology and Chronic Health Evaluation(APACHE)II score,inappropriate empiric antibiotics,and receipt of corticosteroids.Results:One hundred and fifty-four patients were included(93 patients in<30 mL/kg group and 61 patientsin≥30 mL/kg group).The median weight-based volume in the first 6 h was 17.7(12.2–23.0)mL/kg in the<30 mL/kg group vs.40.5(34.2–53.1)mL/kg in the≥30 mL/kg group(P<0.01).No statistical difference was detected in the composite of in-hospital mortality or RRT between the<30 mL/kg group compared to the≥30 mL/kggroup(55.9%vs.45.9%,P=0.25),respectively.The<30 mL/kg group had a higher incidence of AKI,mechanicalventilation,and longer hospital LOS.Conclusions:In patients with known reduced or mildly reduced LVEF presenting with septic shock,no differencewas detected for in-hospital mortality or RRT in patients who received≥30 mL/kg of resuscitation fluid comparedto less fluid,although this study was underpowered to detect a difference.Importantly,≥30 mL/kg fluid did notresult in a higher need for mechanical ventilation. | Adam L.Wiss Bruce A.Doepker Brittany Hoyte Logan M.Olson Kathryn A.Disney Eric M.McLaughlin Vincent Esguerra Jessica L.Elefritz | 2023 | Journal of Intensive Medicine2023，3，3： | 0 |
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