The euroSCORE is a widely applied scoring system to estimate perioperative risk in patients undergoing cardiac surgery. It acknowledges an increased risk in women but does not apply a gender-specific weighing of individual risk indicators. We separately investigated the performance of the euroSCORE for men and women. Cardiac surgical patients operated in 2002 and 2003 (n = 1930) served as training group. Patients operated in 2004 served as validation group (n = 870). Using binary regression analysis, we developed a gender-specific model on the basis of the original euroSCORE risk indicators. The individual risk indicators were assigned gender-specific correlation coefficients. Applying ROC analysis to the validation group, the original euroSCORE performed well, with an area under curve (AUC) of 0.758, for men but poor, with an AUC 0.676, for women. After gender-specific re-weighing, ROC analysis revealed considerably improved predictive values of the modified euroSCORE. AUC for women increased to 0.755, AUC for men further increased to 0.772. The original euroSCORE failed to accurately predict perioperative mortality in women. A binary regression model, assigning a gender-specific weight to each of the risk indicators of the original euroSCORE, considerably improved the predictive power of the modified euroSCORE.
Until today, iron gall ink is classified as an exceptional underdrawing material for paintings. Its study and definite identification is usually based on invasive analysis. This article presents a new non-destructive approach using micro-X-ray fluorescence scanning (MA-XRF), LED-excited IRR (LEDE-IRR) based on a narrow wavelength-range of infrared radiation (IR) for illumination and stereomicroscopy for studying and visualising iron gall ink underdrawings. To assess possibilities and limits of these analytical techniques, the approach was tested on panel paintings by Hans Holbein the Elder and Giovanni Battista Cima da Conegliano. Results are compared to invasive examinations on cross-sections using scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDX). The holistic setup could successfully visualise iron gall ink underdrawings, allowing to harness the formerly invisible underdrawing lines for interdisciplinary studies.
Until today, iron gall ink is classified as an exceptional underdrawing material for paintings. A certain identification is always based on invasive analysis. This article presents a new non-destructive analysis approach using micro-X-ray fluorescence scanning (MA-XRF), LED-excited IRR (LEDE-IRR) using a narrow wavelength-range of infrared radiation (IR) and stereomicroscopy for visualising and identifying iron gall ink underdrawings. To assess possibilities and limits of this non-invasive approach, results were compared to invasive examinations on cross-sections using scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDX). The approach is tested on panel paintings of Hans Holbein the Elder and Giovanni Battista Cima da Conegliano. The holistic setup could successfully visualise underdrawing lines made with iron gall inks, which formerly remained invisible by means of conventional IRR. For the first time, a direct access to a formerly invisible type of underdrawing is created, allowing to harness the whole iron gall ink underdrawing for interdisciplinary studies.
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