MATERIALS AND METHODS: Two hundred and ten students completed a validated questionnaire on SOC and SDLR. The percentage of marks obtained by these students in their year-end examination was used as their academic performance. The SOC scores were further divided into three hierarchical clusters using cluster analysis. The data were analyzed to determine the difference in the SDLR scores and academic performance among the three clusters. Furthermore, the relationship between SOC scores, SDLR scores, and academic performance was assessed.
RESULTS: The SDLR scores significantly increased from the low SOC cluster to the high SOC cluster (P = 0.026). However, there was no significant change in academic performance. A positive relationship was found between the SOC and the academic performance (R = +0.025; P > 0.05). The SDLR had a significant positive relationship with both SOC and academic performance (R = +0.27; P < 0.001).
CONCLUSION: Although SOC may not have a direct influence on academic performance, SDLR can play an intermediary role. Early identification and timely intervention in students with a weak SOC and low SDLR can have a beneficial influence on their academic life.
METHODS: In this international, prospective cohort study of 15,065 patients aged 45 yr or older who underwent in-patient noncardiac surgery, troponin T was measured during the first 3 postoperative days. Patients with a troponin T level of 0.04 ng/ml or greater (elevated "abnormal" laboratory threshold) were assessed for ischemic features (i.e., ischemic symptoms and electrocardiography findings). Patients adjudicated as having a nonischemic troponin elevation (e.g., sepsis) were excluded. To establish diagnostic criteria for MINS, the authors used Cox regression analyses in which the dependent variable was 30-day mortality (260 deaths) and independent variables included preoperative variables, perioperative complications, and potential MINS diagnostic criteria.
RESULTS: An elevated troponin after noncardiac surgery, irrespective of the presence of an ischemic feature, independently predicted 30-day mortality. Therefore, the authors' diagnostic criterion for MINS was a peak troponin T level of 0.03 ng/ml or greater judged due to myocardial ischemia. MINS was an independent predictor of 30-day mortality (adjusted hazard ratio, 3.87; 95% CI, 2.96-5.08) and had the highest population-attributable risk (34.0%, 95% CI, 26.6-41.5) of the perioperative complications. Twelve hundred patients (8.0%) suffered MINS, and 58.2% of these patients would not have fulfilled the universal definition of myocardial infarction. Only 15.8% of patients with MINS experienced an ischemic symptom.
CONCLUSION: Among adults undergoing noncardiac surgery, MINS is common and associated with substantial mortality.