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Abbas TO, Khalil IA, Hatem M, Boyko A, Zorkin S. Plate Objective Scoring Tool (POST) in distal hypospadias: Correlation with post-repair complications. J Pediatr Urol 2024; 20:238.e1-238.e6. [PMID: 38071112 DOI: 10.1016/j.jpurol.2023.11.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 11/10/2023] [Accepted: 11/20/2023] [Indexed: 04/22/2024]
Abstract
OBJECTIVES The Plate Objective Scoring Tool (POST) accurately reflects configuration of the urethral plate in distal hypospadias. Here we assessed whether POST score also correlates with patient risk of complications after surgical repair. METHODS Data were obtained prospectively from pre-pubertal boys who underwent primary hypospadias repair between January 2020 and February 2023. Both POST and Glans-Urethral Meatus-Shaft (GMS) scores were determined in triplicate by three independent reviewers before evaluating correlation with complications after surgery. RESULTS POST ratios were strongly correlated with incidence of post-repair complications in n = 121 patients. Mean POST score was 1.10 (range 0.5-1.62) and average GMS value was 5.29 ± 1.36 (median G = 2, M = 2, S = 1). Bivariate correlation analysis indicated that POST score can accurately predict risk of complications after surgery (Pearson correlation coefficient r = 0.821 [0.724-0.918], 95 % CI). A POST threshold of 1.2 provided the highest specificity for risk of post-operative complications, which occurred in 4.4 % of patients with POST score ≥1.2 (2/45 cases), compared with 25 % among patients with POST score <1.2 (19/76 cases). CONCLUSIONS This study confirms that POST index can be used as a surrogate marker of urethral plate quality and accurately predicts the outcome of distal hypospadias repair. Objective scoring of POST revealed that low ratios were significantly associated with high risk of postoperative complications. In future, this approach could be used to stratify patients and better identify cases that require close follow-up care.
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Affiliation(s)
- Tariq O Abbas
- Urology Devision, Department of Surgery, Sidra Medicine, Doha, Qatar; College of Medicine, Qatar University, Doha, Qatar; Weill Cornell Medicine - Qatar, Doha, Qatar.
| | | | - Mohamed Hatem
- Urology Department, Hamad Medical Corporation, Doha, Qatar
| | - Andrey Boyko
- Pediatric Municipal Clinical Hospital, Barnaul, Russia
| | - Sergei Zorkin
- National Medical Research Center for Children's Health, Moscow, Russia
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Clemente N, Yagnik VD, James KCW. A new scoring system on the horizon to assess fecal incontinence: Garg Incontinence Scores (GIS). Updates Surg 2024; 76:723-724. [PMID: 38150156 DOI: 10.1007/s13304-023-01742-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 12/19/2023] [Indexed: 12/28/2023]
Affiliation(s)
- Nicola Clemente
- U.O. ChirugiaOspedale di Montebelluna (TV), AULSS 2 Marca Tevigiana, Treviso, Italy
| | - Vipul D Yagnik
- Department of Surgery, Banas Medical College and Research Institute, Palanpur, Gujarat, 385001, India
| | - Khaw C W James
- Department of Colorectal Surgery, Penang General Hospital, Penang, Malaysia.
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Bruyninckx L, Jennes S, Pirnay JP, de Schoutheete JC. Burn or trauma scoring: experience of the burn unit of the Queen Astrid Military Hospital during the terror attacks on 22 March 2016. Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02486-y. [PMID: 38509185 DOI: 10.1007/s00068-024-02486-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/22/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE On 22 March 2016, the burn unit (BU) of Queen Astrid Military Hospital assessed a surge in severely injured victims from terror attacks at the national airport and Maalbeek subway station according to the damage control resuscitation (DCR) and damage control surgery (DCS) principles. This study delves into its approach to identify a suitable triage scoring system and to determine if a BU can serve as buffer capacity for mass casualty incidents (MCIs). METHODS The study reviewed retrospectively the origin of explosion, demographic data, sustained injuries, performed surgery, and length of stay of all admitted patients. Trauma scores (Injury Severity Score (ISS) and New Injury Severity Score (NISS)) and triage scores (Revised Trauma Score (RTS), New Trauma Score (NTS), and Trauma Score Injury Severity Score (TRISS)), were compared to burn mortality scores (Osler updated Baux Score and Tobiasen's Abbreviated Burn Severity Index (ABSI)). RESULTS Of the 23 casualties admitted to the BU, the scores calculated on average 3.5 indications for a level 1 trauma center (ISS 4, NISS 6, RTS 0, T-NTS 4). Nevertheless, no deaths occurred during admission or the 1-year follow-up. CONCLUSION MCIs create chaos and a high demand for care. Avoiding bottlenecks and adhering to the DCR/DCS principles are necessary to deliver the best care to the largest number of people. This study indicates that a BU can serve as buffer capacity for MCIs. Nevertheless, its integration into the medical resilience plan depends on accurate scoring, comprehensive care availability, and understanding of the DCR/DCS concept. NTS for triage seems the best fit for scoring polytrauma referrals to a BU during MCIs.
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Affiliation(s)
| | - Serge Jennes
- Burn Unit, Queen Astrid Military Hospital, Brussels, Belgium
| | - Jean-Paul Pirnay
- Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital, Brussels, Belgium
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Ikuma S, Akatsuka J, Takeda H, Endo Y, Kiriyama T, Hamasaki T, Kimura G, Kondo Y. Determining the clinicopathological significance of the VI-RADS ≧4 group: a retrospective study. BMC Urol 2024; 24:63. [PMID: 38509503 PMCID: PMC10953073 DOI: 10.1186/s12894-024-01452-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 03/11/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The Vesical Imaging Reporting and Data System (VI-RADS) is widely used for predicting muscle-invasive bladder cancer (MIBC). This study aimed to determine the clinicopathological significance of the VI-RADS ≧4 (VI≧4) group. METHODS Patients who underwent transurethral resections of bladder tumors during the study period and preoperative magnetic resonance imaging were considered. The patients were pathologically diagnosed with urothelial carcinoma (UC). We first compared the results of patients with VI-RADS scores of 3 and 4 to determine the cut-off score for MIBC; thereafter, the patients were divided into the VI≧4 and VI-RADS ≦3 (VI≦3) groups using VI-RADS. The clinicopathological significance of the VI≧4 group was examined retrospectively by comparing the characteristics of each group. RESULTS In total, 121 cases were examined, of which 28 were pathologically diagnosed with MIBC. Of the 28 MIBC cases, three (10.7%) had a VI-RADS score of ≦3, and 25 (89.3%) had a VI-RADS score of ≧4. Of the 93 NMIBC cases, 86 (92.5%) had a VI-RADS score of ≦3, and seven (7.5%) had a VI-RADS score of ≧4. The diagnostic performance of the VI-RADS with a cut-off score of 4 was 89.3% for sensitivity, 92.5% for specificity, and an area under the curve (AUC) of 0.91. Contrastingly, for a cut-off score of 3, the sensitivity was 89.3%, specificity was 62.0%, and AUC was 0.72. A VI-RADS score of ≥ 4 could predict MIBC. In the VI≧4 group, 30 of 32 (93.8%) patients had high-grade tumors. The VI≧4 group had significantly more high-grade bladder cancers than the VI≦3 group (p < 0.001 OR = 31.77 95%CI:8.47-1119.07). In addition, the VI≧4 group had more tumor necrosis (VI≧4 vs VI≦3, p < 0.001 OR = 7.46 95%CI:2.61-21.34) and more UC variant cases (VI≧4 vs VI≦3, p = 0.034 OR = 3.28 95%CI:1.05-10.25) than the VI≦3 group. CONCLUSIONS This study suggests that VI-RADS has a high diagnostic performance in predicting MIBC and that VI-RADS could diagnose high-grade tumors, necrosis, and UC variants.
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Affiliation(s)
- Shunsuke Ikuma
- Department of Urology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan
| | - Jun Akatsuka
- Department of Urology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan
| | - Hayato Takeda
- Department of Urology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan
| | - Yuki Endo
- Department of Urology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan
| | - Tomonari Kiriyama
- Department of Radiology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan
| | - Tsutomu Hamasaki
- Department of Urology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan
| | - Go Kimura
- Department of Urology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan
| | - Yukihiro Kondo
- Department of Urology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
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Huang S, Chung S, Cai L. A random item effects generalized partial credit model with a multiple imputation-based scoring procedure. Qual Life Res 2024; 33:637-651. [PMID: 37950818 DOI: 10.1007/s11136-023-03551-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 11/13/2023]
Abstract
PURPOSE Random item effects item response theory (IRT) models have received much attention for more than a decade. However, more research is needed on random item effects IRT models for polytomous data. Additionally, to improve the utility of this new class of IRT models, the scoring issue must be addressed. METHODS We proposed a new random item effects generalized partial credit model (GPCM), which considers both random person and random item and category-specific effects. In addition, we introduced a multiple imputation (MI)-based scoring procedure that applies to various random item effects IRT models. To evaluate the proposed model and scoring procedure, we analyzed data from a Quality of Life (QoL) scale for the Chronically Mentally III and conducted a preliminary simulation study. RESULTS In the empirical data analysis, we found that patient scores generated based on the proposed model and scoring procedure were almost identical to those obtained through the conventional GPCM and scoring method. However, the standard errors (SEs) associated with the scores were slightly larger when the proposed approach was utilized. In the simulation study, we observed adequate recovery of the model parameters and patient scores. CONCLUSION The proposed model and MI-based scoring procedure contribute to the literature. The proposed model substantially reduces the number of free parameters in comparison to a conventional GPCM, which can be desired when sample sizes are small, e.g., special populations. In addition, the MI-based scoring procedure addresses the scoring issue and can be easily extended for scoring with other random item effects IRT models.
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Affiliation(s)
- Sijia Huang
- Indiana University Bloomington, Bloomington, USA.
| | | | - Li Cai
- University of California, Los Angeles, USA
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Koester SW, Rhodenhiser EG, Dabrowski SJ, Scherschinski L, Hartke JN, Naik A, Karahalios K, Nico E, Hackett AM, Ciobanu-Caraus O, Lopez Lopez LB, Winkler EA, Catapano JS, Lawton MT. Optimal PHASES Scoring for Risk Stratification of Surgically Treated Unruptured Aneurysms. World Neurosurg 2024; 183:e447-e453. [PMID: 38154687 DOI: 10.1016/j.wneu.2023.12.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE The PHASES (Population, Hypertension, Age, Size, Earlier subarachnoid hemorrhage, Site) score was developed to facilitate risk stratification for management of unruptured intracranial aneurysms (UIAs). This study aimed to identify the optimal PHASES score cutoff for predicting neurologic outcomes in patients with surgically treated aneurysms. METHODS All patients who underwent microneurosurgical treatment for UIA at a large quaternary center from January 1, 2014, to December 31, 2020, were retrospectively reviewed. Inclusion criteria included a modified Rankin Scale (mRS) score of ≤2 at admission. The primary outcome was 1-year mRS score, with a "poor" neurologic outcome defined as an mRS score >2. RESULTS In total, 375 patients were included in the analysis. The mean (SD) PHASES score for the entire study population was 4.47 (2.67). Of 375 patients, 116 (31%) had a PHASES score ≥6, which was found to maximize prediction of poor neurologic outcome. Patients with PHASES scores ≥6 had significantly higher rates of poor neurologic outcome than patients with PHASES scores <6 at discharge (58 [50%] vs. 90 [35%], P = 0.005) and follow-up (20 [17%] vs. 18 [6.9%], P = 0.002). After adjusting for age, Charlson Comorbidity Index score, nonsaccular aneurysm, and aneurysm size, PHASES score ≥6 remained a significant predictor of poor neurologic outcome at follow-up (odds ratio, 2.75; 95% confidence interval, 1.42-5.36, P = 0.003). CONCLUSIONS In this retrospective analysis, a PHASES score ≥6 was associated with significantly greater proportions of poor outcome, suggesting that awareness of this threshold in PHASES scoring could be useful in risk stratification and UIA management.
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Affiliation(s)
- Stefan W Koester
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Emmajane G Rhodenhiser
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Stephen J Dabrowski
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Lea Scherschinski
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Joelle N Hartke
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Anant Naik
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Katherine Karahalios
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Elsa Nico
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Ashia M Hackett
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Olga Ciobanu-Caraus
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Laura Beatriz Lopez Lopez
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Ethan A Winkler
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Joshua S Catapano
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Michael T Lawton
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
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Zhang Z, Yang LZ, Vékony T, Wang C, Li H. Split-half reliability estimates of an online card sorting task in a community sample of young and elderly adults. Behav Res Methods 2024; 56:1039-1051. [PMID: 36944861 PMCID: PMC10030079 DOI: 10.3758/s13428-023-02104-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 03/23/2023]
Abstract
Executive function is vital for normal social, cognitive, and motor functions. Executive function decline due to aging increases the risk of disability and falls in older adults, which has become an urgent public health issue. Fast and convenient neuropsychological tools are thus needed to identify high-risk groups as early as possible to conduct a timely intervention. Card sorting tasks, such as Wisconsin Card Sorting Task (WCST) and its variants, are popular tools for measuring executive function. This study investigated the reliability of an open-source, self-administered, online, short-version card sorting task with a sample of young (n = 107, 65 females, age: M = 30.1 years, SD = 5.5 years) and elderly Chinese (n = 113, 53 females, age: M = 64.0 years, SD = 6.7 years). We developed an automated scoring and visualization procedure following the recent recommendations on scoring perseverative responses to make the results comparable to the standardized WCST. Reliability estimates of commonly used measures were calculated using the split-half method. All task indices' reliabilities were reasonably good in both old and young groups except for "failure-to-maintain-set." Elderly Chinese adults showed compromised task performance on all measures compared with the young Chinese adults at the group level. The R script of automated scoring and estimation of reliability is publicly available.
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Affiliation(s)
- Zhengkang Zhang
- School of Biomedical Engineering, Anhui Medical University, Hefei, 230032, China
| | - Li-Zhuang Yang
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China.
| | - Teodóra Vékony
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, 95 Boulevard Pinel, 69500, Bron, France
| | - Changqing Wang
- School of Biomedical Engineering, Anhui Medical University, Hefei, 230032, China.
| | - Hai Li
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China.
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Nagashima K, Yasuno N, Watanabe M. Creating and evaluating the score to assess overdose: the OD score. BMC Emerg Med 2024; 24:5. [PMID: 38185623 PMCID: PMC10773033 DOI: 10.1186/s12873-023-00923-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND During disasters (including epidemics such as coronavirus disease 2019), the capacity of emergency departments is exceeded, thereby hindering the administration of appropriate lifesaving measures. Furthermore, the number of overdose patients increases because of the stress overload during emergency situation. The fact that overdose patients are forced to be transported to medical facilities that do not typically treat them is becoming worrisome. Moreover, there is no definitive score for overdose. This study aimed to create a patient-specific scoring system to assess overdose. METHODS This was a retrospective single-center study. The evidence-based OD score was evaluated on a scale of 0-15. Further, logistic analysis and receiver operating characteristic (ROC) curve analysis were performed to evaluate the score. RESULTS Overall, 262 patients (including 118 overdose patients) receiving care at the intensive care unit of Japan's Teikyo University Hospital in 2021 were targeted. Regarding the total OD score, ROC analysis revealed a cutoff of 8 (area under the curve [AUC]: 0.99, 95% confidence interval [CI]: 0.980-0.997, sensitivity: 0.95, specificity: 0.95, p < 0.05), which was considered to indicate an overdose. Of the items evaluated in the OD score, the scenario at the location of the patient's discovery (adjusted odds ratio [AOR]: 16.8, 95% CI: 5.0-255.9, p = 0.002) and recent experience of mental anxiety (AOR: 55.7, 95% CI: 2.8-5399.5, p = 0.03) significantly predicted an overdose in multivariable logistic regression analysis. External validation revealed that the OD score could also identify overdose in patients treated in a cohort from 2022 (average cutoff: 8.6, average AUC: 1.0, p < 0.0001). CONCLUSIONS The OD score could accurately assess overdose patients. Medical facilities that do not frequently address overdose patients will benefit from the use of this score.
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Affiliation(s)
- Kazuki Nagashima
- Laboratory of Practical Pharmacy, Graduate School and Faculty of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8675, Japan.
- Laboratory of Clinical Pharmaceutics, Faculty of Pharma-Science, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
| | - Nobuhiro Yasuno
- Laboratory of Hospital Pharmacy, Faculty of Pharma-Science, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Machiko Watanabe
- Laboratory of Clinical Pharmaceutics, Faculty of Pharma-Science, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
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Musto JA, Lucey MR. Prognostic models in alcohol-related liver disease and alcohol-related hepatitis. Best Pract Res Clin Gastroenterol 2023; 67:101867. [PMID: 38103931 DOI: 10.1016/j.bpg.2023.101867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 08/18/2023] [Indexed: 12/19/2023]
Abstract
Alcohol-associated liver disease (ALD) and alcohol-associated hepatitis (AH) are dynamic disorders whose prognosis can be challenging to determine. A number of prognostic models have been developed to determine likelihood of death, when to refer for liver transplant (LT) and the role for glucocorticoids. Often these models were created with a specific application in mind but were found to have additional applications with further study. Those prognostic models that have stood the test of time are easy to use, have clear interpretations and employ objective parameters. These parameters most often include total bilirubin, INR and creatinine among other data points. Ideally, these models could be utilized at all phases of disease but in most, it is important for clinicians to consider drinking history and how it might alter the determined scores. Herein we provide a brief review of prognostic models in ALD and AH and provide practical tips and considerations to successfully make use of these tools in a clinical setting.
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Affiliation(s)
- Jessica Ann Musto
- Department of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
| | - Michael Ronan Lucey
- Department of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Haubruck P, Heller R, Blaker CL, Clarke EC, Smith SM, Burkhardt D, Liu Y, Stoner S, Zaki S, Shu CC, Little CB. Streamlining quantitative joint-wide medial femoro-tibial histopathological scoring of mouse post-traumatic knee osteoarthritis models. Osteoarthritis Cartilage 2023; 31:1602-1611. [PMID: 37716405 DOI: 10.1016/j.joca.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 07/03/2023] [Accepted: 07/26/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVES Histological scoring remains the gold-standard for quantifying post-traumatic osteoarthritis (ptOA) in animal models, allowing concurrent evaluation of numerous joint tissues. Available systems require scoring multiple sections/joint making analysis laborious and expensive. We investigated if a single section allowed equivalent quantitation of pathology in different joint tissues and disease stages, in three ptOA models. METHOD Male 10-12-week-old C57BL/6 mice underwent surgical medial-meniscal-destabilization, anterior-cruciate-ligament (ACL) transection, non-invasive-ACL-rupture, or served as sham-surgical, non-invasive-ACL-strain, or naïve/non-operated controls. Mice (n = 12/group) were harvested 1-, 4-, 8-, and 16-week post-intervention. Serial sagittal toluidine-blue/fast-green stained sections of the medial-femoro-tibial joint (n = 7/joint, 84 µm apart) underwent blinded scoring of 40 histology-outcomes. We evaluated agreement between single-slide versus entire slide-set maximum or median scores (weighted-kappa), and sensitivity/specificity of single-slide versus median/maximum to detect OA pathology. RESULTS A single optimal mid-sagittal section showed excellent agreement with median (weighted-kappa 0.960) and maximum (weighted-kappa 0.926) scores. Agreement for individual histology-outcomes was high with only 19/240 median and 15/240 maximum scores having a weighted-kappa ≤0.4, the majority of these (16/19 and 11/15) in control groups. Statistically-significant histology-outcome differences between ptOA models and their controls detected with the entire slide-set were reliably reproduced using a single slide (sensitivity >93.15%, specificity >93.10%). The majority of false-negatives with single-slide scoring were meniscal and subchondral bone histology-outcomes (89%) and occurred in weeks 1-4 post-injury (84%). CONCLUSION A single mid-sagittal slide reduced the time needed to score diverse histopathological changes by 87% without compromising the sensitivity or specificity of the analysis, across a variety of ptOA models and time-points.
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Affiliation(s)
- Patrick Haubruck
- Centre for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, Heidelberg University Hospital, D-69118 Heidelberg, Germany; Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Institute of Bone and Joint Research, Faculty of Medicine and Health University of Sydney, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia
| | - Raban Heller
- Centre for Orthopaedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, Heidelberg University Hospital, D-69118 Heidelberg, Germany; Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt Universität zu Berlin, Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany; Bundeswehr Hospital Berlin, Clinic of Traumatology and Orthopaedics, D-10115 Berlin, Germany
| | - Carina L Blaker
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Institute of Bone and Joint Research, Faculty of Medicine and Health University of Sydney, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia; Murray Maxwell Biomechanics Laboratory, Kolling Institute, Institute of Bone and Joint Research, Faculty of Medicine and Health University of Sydney, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia
| | - Elizabeth C Clarke
- Murray Maxwell Biomechanics Laboratory, Kolling Institute, Institute of Bone and Joint Research, Faculty of Medicine and Health University of Sydney, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia
| | - Susan M Smith
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Institute of Bone and Joint Research, Faculty of Medicine and Health University of Sydney, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia
| | - Daniel Burkhardt
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Institute of Bone and Joint Research, Faculty of Medicine and Health University of Sydney, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia
| | - Yolanda Liu
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Institute of Bone and Joint Research, Faculty of Medicine and Health University of Sydney, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia
| | - Shihani Stoner
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Institute of Bone and Joint Research, Faculty of Medicine and Health University of Sydney, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia
| | - Sanaa Zaki
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Institute of Bone and Joint Research, Faculty of Medicine and Health University of Sydney, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia; Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Australia
| | - Cindy C Shu
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Institute of Bone and Joint Research, Faculty of Medicine and Health University of Sydney, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia
| | - Christopher B Little
- Raymond Purves Bone and Joint Research Laboratory, Kolling Institute, Institute of Bone and Joint Research, Faculty of Medicine and Health University of Sydney, Royal North Shore Hospital, St. Leonards, New South Wales 2065, Australia.
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11
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Marballi Basavaraju D, Mishra S, Chhabra G, Chougule S. Comparison of flowcytometry-based scoring system for the diagnosis of early T precursor-acute lymphoblastic leukemia. Cytometry B Clin Cytom 2023; 104:453-459. [PMID: 36892134 DOI: 10.1002/cyto.b.22119] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/15/2023] [Accepted: 02/28/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Early T cell precursor-acute lymphoblastic leukemia (ETP-ALL) is a hematolymphoid malignancy where the blasts demonstrate T cell differentiation markers along with stem cell and myeloid antigen expression. The differential diagnosis of ETP-ALL from non-ETP ALL and mixed phenotype acute leukemia is often challenging due to its overlapping immunophenotypic picture with co-expression of myeloid antigens. In this study, we endeavored to describe the immune-phenotype profile of ETP-ALL in our patients and compared the utility of four different scoring systems for better discrimination of these entities. METHODS This retrospective analysis included 31 ETP-ALL out of 860 acute leukemia cases consecutively diagnosed at the two tertiary care centers. Flowcytometry-based immunophenotype was reviewed for all the cases, and the utility of four flow-based objective scorings was assessed for the diagnosis of ETP-ALL. Receiver operating curves were drawn to compare the different flow-based scoring systems. RESULTS The prevalence of ETP-ALL was 40% (n = 31/77 T-ALL) in our study group, comprised mainly of adults with a median age of 20 years. The five-marker scoring system had the maximum area under the curve, followed by the seven-marker scoring system. A cut-off of ≥2.5 was more specific (sensitivity: 91%; specificity: 100%), while a score of ≥1.5 was more sensitive but slightly less specific (sensitivity: 94%, specificity: 96%). CONCLUSION The WHO criteria for the diagnosis of ETP-ALL should be followed across all laboratories to avoid confusion and for better treatment stratification. Flow-based scoring systems can be objectively employed for better detection of cases.
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Affiliation(s)
| | - Shruti Mishra
- Bone Marrow Transplantation and Stem Cell Research Centre, IMS, BHU, Varanasi, India
| | - Gaurav Chhabra
- Department of Pathology and Laboratory Medicine, AIIMS, Bhubaneswar, India
| | - Sudarshan Chougule
- Department of Laboratory Hematology, Narayana Hrudayalaya, Bangalore, India
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12
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Liedel C, Rieckmann K, Baums CG. A critical review on experimental Streptococcus suis infection in pigs with a focus on clinical monitoring and refinement strategies. BMC Vet Res 2023; 19:188. [PMID: 37798634 PMCID: PMC10552360 DOI: 10.1186/s12917-023-03735-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 09/14/2023] [Indexed: 10/07/2023] Open
Abstract
Streptococcus suis (S. suis) is a major pig pathogen worldwide with zoonotic potential. Though different research groups have contributed to a better understanding of the pathogenesis of S. suis infections in recent years, there are still numerous neglected research topics requiring animal infection trials. Of note, animal experiments are crucial to develop a cross-protective vaccine which is highly needed in the field. Due to the severe clinical signs associated with S. suis pathologies such as meningitis and arthritis, implementation of refinement is very important to reduce pain and distress of experimentally infected pigs. This review highlights the great diversity of clinical signs and courses of disease after experimental S. suis pig infections. We review clinical read out parameters and refinement strategies in experimental S. suis pig infections published between 2000 and 2021. Currently, substantial differences exist in describing clinical monitoring and humane endpoints. Most of the reviewed studies set the body temperature threshold of fever as high as 40.5°C. Monitoring intervals vary mainly between daily, twice a day and three times a day. Only a few studies apply scoring systems. Published scoring systems are inconsistent in their inclusion of parameters such as body temperature, feeding behavior, and respiratory signs. Locomotion and central nervous system signs are more common clinical scoring parameters in different studies by various research groups. As the heterogenicity in clinical monitoring limits the comparability between studies we hope to initiate a discussion with this review leading to an agreement on clinical read out parameters and monitoring intervals among S. suis research groups.
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Affiliation(s)
- Carolin Liedel
- Institute of Bacteriology and Mycology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 29, Leipzig, 04103, Germany
| | - Karoline Rieckmann
- Institute of Bacteriology and Mycology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 29, Leipzig, 04103, Germany
| | - Christoph G Baums
- Institute of Bacteriology and Mycology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 29, Leipzig, 04103, Germany.
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13
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Edjtemaei R, Nili F, Jahanzad I, Ameli F, Ghasemi D. HER-2 overexpression in female genital tract clear cell carcinomas: Evaluation of different scoring guidelines, clinicopathological features and prognostic impact. Ann Diagn Pathol 2023; 66:152184. [PMID: 37543027 DOI: 10.1016/j.anndiagpath.2023.152184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Clear cell carcinoma (CCC) is a rare high-grade adenocarcinoma associated with poor response to platinum-based chemotherapy agents in the female genital tract. Human epidermal growth factor receptor 2 (HER2) overexpression is routinely used as a biomarker for targeted therapy in breast and gastric carcinomas, but its role in CCC remains unclear. METHODS In this study, HER2 overexpression was evaluated by immunohistochemistry (IHC) using College of American Pathologists (CAP) HER2 scoring guidelines for breast and endometrial serous carcinoma (ESC) on tissue microarray blocks. In equivocal and positive cases, fluorescence in situ hybridization (FISH) was performed. IHC score 3, and all amplified cases on FISH test were considered positive. RESULTS Thirty-six cases of ovarian (OCCC), 36 endometrial (ECCC), and 2 cervical CCC were included. According to ESC and breast scoring guidelines, 20 % and 15.1 % of ECCC and 14.7 % and 6 % of OCCC were HER2 positive, respectively. Both cases of cervical CCC were negative. Scoring based on breast carcinoma guideline showed higher concordance (100 %) with gene amplification results, in comparison with ESC guideline (82.7 %). On multivariate survival analysis, HER2 positive ECCC and OCCC (based on ESC scoring methods) had significantly lower overall and disease-free survivals (OS, DFS) (P < 0.05). CONCLUSION HER2 immunoscoring based on ESC guideline can yield a higher sensitivity with relevant clinical and prognostic features in OCCC and ECCC. HER2 can be considered a potential biomarker for targeted therapy and future clinical trials.
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Affiliation(s)
- Ramtin Edjtemaei
- Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Nili
- Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
| | - Issa Jahanzad
- Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Ameli
- Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Dorsa Ghasemi
- Department of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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14
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Park JY, Seo EH, Yoon HJ, Won S, Lee KH. Automating Rey Complex Figure Test scoring using a deep learning-based approach: a potential large-scale screening tool for cognitive decline. Alzheimers Res Ther 2023; 15:145. [PMID: 37649070 PMCID: PMC10466875 DOI: 10.1186/s13195-023-01283-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 07/31/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND The Rey Complex Figure Test (RCFT) has been widely used to evaluate the neurocognitive functions in various clinical groups with a broad range of ages. However, despite its usefulness, the scoring method is as complex as the figure. Such a complicated scoring system can lead to the risk of reducing the extent of agreement among raters. Although several attempts have been made to use RCFT in clinical settings in a digitalized format, little attention has been given to develop direct automatic scoring that is comparable to experienced psychologists. Therefore, we aimed to develop an artificial intelligence (AI) scoring system for RCFT using a deep learning (DL) algorithm and confirmed its validity. METHODS A total of 6680 subjects were enrolled in the Gwangju Alzheimer's and Related Dementia cohort registry, Korea, from January 2015 to June 2021. We obtained 20,040 scanned images using three images per subject (copy, immediate recall, and delayed recall) and scores rated by 32 experienced psychologists. We trained the automated scoring system using the DenseNet architecture. To increase the model performance, we improved the quality of training data by re-examining some images with poor results (mean absolute error (MAE) [Formula: see text] 5 [points]) and re-trained our model. Finally, we conducted an external validation with 150 images scored by five experienced psychologists. RESULTS For fivefold cross-validation, our first model obtained MAE = 1.24 [points] and R-squared ([Formula: see text]) = 0.977. However, after evaluating and updating the model, the performance of the final model was improved (MAE = 0.95 [points], [Formula: see text] = 0.986). Predicted scores among cognitively normal, mild cognitive impairment, and dementia were significantly different. For the 150 independent test sets, the MAE and [Formula: see text] between AI and average scores by five human experts were 0.64 [points] and 0.994, respectively. CONCLUSION We concluded that there was no fundamental difference between the rating scores of experienced psychologists and those of our AI scoring system. We expect that our AI psychologist will be able to contribute to screen the early stages of Alzheimer's disease pathology in medical checkup centers or large-scale community-based research institutes in a faster and cost-effective way.
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Affiliation(s)
- Jun Young Park
- Gwangju Alzheimer's & Related Dementia Cohort Research Center, Chosun University, Gwangju, 61452, South Korea
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, South Korea
- Neurozen Inc., Seoul, 06168, South Korea
| | - Eun Hyun Seo
- Gwangju Alzheimer's & Related Dementia Cohort Research Center, Chosun University, Gwangju, 61452, South Korea
- Premedical Science, College of Medicine, Chosun University, Gwangju, South Korea
| | - Hyung-Jun Yoon
- Department of Neuropsychiatry, College of Medicine, Chosun University, Gwangju, South Korea
| | - Sungho Won
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, South Korea.
- Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, South Korea.
- Institute of Health and Environment, Seoul National University, Seoul, South Korea.
- RexSoft Inc., Seoul, 08826, South Korea.
| | - Kun Ho Lee
- Gwangju Alzheimer's & Related Dementia Cohort Research Center, Chosun University, Gwangju, 61452, South Korea.
- Department of Biomedical Science, Chosun University, Gwangju, South Korea.
- Korea Brain Research Institute, Daegu, 41062, South Korea.
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15
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Parikh SR, Boudewyns A, Friedman NR, Schwartz SR, Baldassari CM, Benedek P, Carr MM, Chan DK, Chan KC, Cheng AT, Couloigner V, Diala OR, DeRowe A, El-Hakim H, Fayoux P, Hsu WC, Ishman S, Kirkham EM, Mitchell RB, Thevasagayam R, Lam D. International Pediatric Otolaryngology Group (IPOG) consensus on scoring of pediatric Drug Induced Sleep Endoscopy (DISE). Int J Pediatr Otorhinolaryngol 2023; 171:111627. [PMID: 37441992 DOI: 10.1016/j.ijporl.2023.111627] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/10/2023] [Accepted: 06/05/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVES To develop consensus statements for the scoring of pediatric drug induced sleep endoscopy in the diagnosis and management of pediatric obstructive sleep apnea. METHODS The leadership group identified experts based on defined criteria and invited 18 panelists to participate in the consensus statement development group. A modified Delphi process was used to formally quantify consensus from opinion. A modified Delphi priori process was established, which included a literature review, submission of statements by panelists, and an iterative process of voting to determine consensus. Voting was based on a 9-point Likert scale. Statements achieving a mean score greater than 7 with one or fewer outliers were defined as reaching consensus. Statements achieving a mean score greater than 6.5 with two or fewer outliers were defined as near consensus. Statements with lower scores or more outliers were defined as no consensus. RESULTS A total of 78 consensus statements were evaluated by the panelists at the first survey - 49 achieved consensus, 18 achieved near consensus, and 11 did not achieve consensus. In the second survey, 16 statements reached consensus and 5 reached near consensus. Regarding scoring, consensus was achieved on the utilization of a 3-point Likert scale for each anatomic site for maximal observed obstructions of <50% (Score 0, no-obstruction), ≥ 50% but <90% (Score 2, partial obstruction), and ≥ 90% (Score 3, complete obstruction). Anatomic sites to be scored during DISE that reached consensus or near-consensus were the nasal passages, adenoid pad, velum, lateral pharyngeal walls, tonsils (if present), tongue base, epiglottis, and arytenoids. CONCLUSION This study developed consensus statements on the scoring of DISE in pediatric otolaryngology using a modified Delphi process. The use of a priori process, literature review, and iterative voting method allowed for the formal quantification of consensus from expert opinion. The results of this study may provide guidance for standardizing scoring of DISE in pediatric patients.
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Affiliation(s)
- Sanjay R Parikh
- Department of Otolaryngology, University of Washington, Seattle Children's Hospital, USA.
| | - An Boudewyns
- Department of Otolaryngology, Antwerp University Hospital, University of Antwerp, Belgium
| | - Norman R Friedman
- Department of Otolaryngology, University of Colorado, Children's Hospital Colorado, USA
| | - Seth Roslow Schwartz
- Department of Otolaryngology, University of Washington, Virginia Mason Hospital, Seattle, USA
| | - Cristina M Baldassari
- Department of Otolaryngology, Eastern Virginia Medical School, Children's Hospital of The King's Daughters, USA
| | - Palma Benedek
- Department of Otolaryngology, Heim Pal National Pediatric Institute, Hungary
| | - Michele M Carr
- Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, USA
| | - Dylan K Chan
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, USA
| | - Kate C Chan
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Alan T Cheng
- Department of Otolaryngology, The University of Sydney, The Children's Hospital at Westmead, Australia
| | - Vincent Couloigner
- Department of Otolaryngology, Hôpital Necker-Enfants Malades, Université Paris Cité, France
| | - Obinna R Diala
- Department of Otolaryngology, University of Colorado, Children's Hospital Colorado, USA
| | - Ari DeRowe
- Department of Otolaryngology Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Dana-Dwek Children's Hospital, Israel
| | - Hamdy El-Hakim
- Department of Otolaryngology, University of Alberta, Stollery Children's Hospital, Canada
| | - Pierre Fayoux
- Pediatric Otolaryngology - Head Neck Surgery, Jeanne de Flandre Hospital, CHU Lille, France
| | - Wei-Chung Hsu
- Department of Otolaryngology, National Taiwan University Hospital and Children's Hospital, Taiwan
| | - Stacey Ishman
- Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, USA
| | - Erin M Kirkham
- Department of Otolaryngology, University of Michigan, Mott Children's Hospital, USA
| | - Ron B Mitchell
- Department of Otolaryngology, University of Texas, Southwestern Medical Center, Children's Medical Center Dallas, USA
| | - Ravi Thevasagayam
- Department of Otolaryngology, Sheffield Children's Hospital, United Kingdom
| | - Derek Lam
- Department of Otolaryngology, Oregon Health and Science University, USA
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16
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Wang Y, Chow D, Indrakanti SS, Palmer EL, Scott JA. Schrodinger's cat and Deauville 5 point scoring. Clin Imaging 2023; 101:180-182. [PMID: 37385118 DOI: 10.1016/j.clinimag.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 06/08/2023] [Accepted: 06/22/2023] [Indexed: 07/01/2023]
Affiliation(s)
- Yingbing Wang
- Massachusetts General Hospital, Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, 55 Fruit Street, White 4-427, Boston, MA 02114, United States of America.
| | - David Chow
- Massachusetts General Hospital, Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, 55 Fruit Street, White 4-427, Boston, MA 02114, United States of America
| | - Shalini Santoshi Indrakanti
- Massachusetts General Hospital, Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, 55 Fruit Street, White 4-427, Boston, MA 02114, United States of America
| | - Edwin Lincoln Palmer
- Massachusetts General Hospital, Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, 55 Fruit Street, White 4-427, Boston, MA 02114, United States of America
| | - James Arthur Scott
- Massachusetts General Hospital, Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, 55 Fruit Street, White 4-427, Boston, MA 02114, United States of America
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17
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Atia O, Hazan E, Rotem R, Armon S, Yagel S, Grisaru-Granovsky S, Sela HY, Rottenstreich M. A Scoring System Developed by a Machine Learning Algorithm to Better Predict Adnexal Torsion. J Minim Invasive Gynecol 2023; 30:486-493. [PMID: 36775053 DOI: 10.1016/j.jmig.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 01/18/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
STUDY OBJECTIVE To establish a clinically relevant prediction score for the diagnosis of adnexal torsion (AT) in women who were operated on for suspected AT. DESIGN A retrospective cohort study conducted between 2014 and 2021. SETTING A large tertiary teaching medical center. PATIENTS Women who underwent urgent laparoscopy for suspected AT. INTERVENTIONS Analyses included univariate and multivariate models combined with the machine learning (ML) Random Forest model, which included all information available about the women and reported the accuracy of the model and the importance of each variable. Based on this model, we created a predictive score and evaluated its accuracy by receiver operating characteristic (ROC) curve. MEASUREMENTS AND MAIN RESULTS A total of 503 women were included in our study, 244 (49%) of whom were diagnosed with AT during the surgery, and 44 (8.8%) cases of necrotic ovary were found. Based on the Random Forrest and multivariate models, the most important preoperative clinical predictive variables for AT were vomiting, left-side complaints, and concurrent pregnancy; cervical tenderness and urinary symptoms decreased the likelihood of surgically confirmed AT. The most important sonographic findings that predicted increased risk of surgically confirmed AT were ovarian edema and decreased vascular flow; in contrast, hemorrhagic corpus luteum decreased the likelihood of surgically confirmed AT. The accuracy of the Random Forest model was 71% for the training set and 68% for the testing set, and the area under the curve for the multivariate model was 0.75 (95% confidence interval [CI] 0.69-0.80). Based on these models, we created a predictive score with a total score that ranges from 4 to 12. The area under the curve for this score was 0.72 (95% CI 0.67-0.76), and the best cutoff for the final score was >5, with a sensitivity, specificity, positive predictive value, and negative predictive value of 64%, 73%, 70%, and 67%, respectively. CONCLUSION Clinical characteristics and ultrasound findings may be incorporated into the emergency room workup of women with suspected AT. ML in this setting has no diagnostic/predictive advantage over the performance of logistic regression methods. Additional prospective studies are needed to confirm the accuracy of this model.
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Affiliation(s)
- Ohad Atia
- Department of Pediatrics, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine (Dr. Atia), Jerusalem, Israel
| | - Ella Hazan
- Faculty of Medicine, Hadassah-Hebrew University Medical Center (Hazan), Jerusalem, Israel
| | - Reut Rotem
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine (Drs. Rotem, Armon, Grisaru-Granovsky, Sela, Rottenstreich), Jerusalem, Israel.
| | - Shunit Armon
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine (Drs. Rotem, Armon, Grisaru-Granovsky, Sela, Rottenstreich), Jerusalem, Israel
| | - Simcha Yagel
- Department of Nursing, Jerusalem College of Technology (Dr. Yagel), Jerusalem, Israel
| | - Sorina Grisaru-Granovsky
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine (Drs. Rotem, Armon, Grisaru-Granovsky, Sela, Rottenstreich), Jerusalem, Israel
| | - Hen Y Sela
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine (Drs. Rotem, Armon, Grisaru-Granovsky, Sela, Rottenstreich), Jerusalem, Israel
| | - Misgav Rottenstreich
- Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine (Drs. Rotem, Armon, Grisaru-Granovsky, Sela, Rottenstreich), Jerusalem, Israel; Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center (Dr. Rottenstreich), Jerusalem, Israel
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18
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Raman G, Ashraf B, Demir YK, Kershaw CD, Cheruku S, Atis M, Atis A, Atar M, Chen W, Ibrahim I, Bat T, Mete M. Machine learning prediction for COVID-19 disease severity at hospital admission. BMC Med Inform Decis Mak 2023; 23:46. [PMID: 36882829 PMCID: PMC9990559 DOI: 10.1186/s12911-023-02132-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/06/2023] [Indexed: 03/09/2023] Open
Abstract
IMPORTANCE Early prognostication of patients hospitalized with COVID-19 who may require mechanical ventilation and have worse outcomes within 30 days of admission is useful for delivering appropriate clinical care and optimizing resource allocation. OBJECTIVE To develop machine learning models to predict COVID-19 severity at the time of the hospital admission based on a single institution data. DESIGN, SETTING, AND PARTICIPANTS We established a retrospective cohort of patients with COVID-19 from University of Texas Southwestern Medical Center from May 2020 to March 2022. Easily accessible objective markers including basic laboratory variables and initial respiratory status were assessed using Random Forest's feature importance score to create a predictive risk score. Twenty-five significant variables were identified to be used in classification models. The best predictive models were selected with repeated tenfold cross-validation methods. MAIN OUTCOMES AND MEASURES Among patients with COVID-19 admitted to the hospital, severity was defined by 30-day mortality (30DM) rates and need for mechanical ventilation. RESULTS This was a large, single institution COVID-19 cohort including total of 1795 patients. The average age was 59.7 years old with diverse heterogeneity. 236 (13%) required mechanical ventilation and 156 patients (8.6%) died within 30 days of hospitalization. Predictive accuracy of each predictive model was validated with the 10-CV method. Random Forest classifier for 30DM model had 192 sub-trees, and obtained 0.72 sensitivity and 0.78 specificity, and 0.82 AUC. The model used to predict MV has 64 sub-trees and returned obtained 0.75 sensitivity and 0.75 specificity, and 0.81 AUC. Our scoring tool can be accessed at https://faculty.tamuc.edu/mmete/covid-risk.html . CONCLUSIONS AND RELEVANCE In this study, we developed a risk score based on objective variables of COVID-19 patients within six hours of admission to the hospital, therefore helping predict a patient's risk of developing critical illness secondary to COVID-19.
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Affiliation(s)
- Ganesh Raman
- grid.267313.20000 0000 9482 7121Departments of Internal Medicine and Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Bilal Ashraf
- grid.267313.20000 0000 9482 7121Departments of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Yusuf Kemal Demir
- grid.266859.60000 0000 8598 2218School of Data Science, University of North Carolina at Charlotte, Charlotte, NC USA
| | - Corey D. Kershaw
- grid.267313.20000 0000 9482 7121Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Sreekanth Cheruku
- grid.267313.20000 0000 9482 7121Department of Anesthesiology and Pain Management, Divisions of Cardiothoracic Anesthesiology and Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Murat Atis
- grid.267313.20000 0000 9482 7121Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Ahsen Atis
- grid.267313.20000 0000 9482 7121Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Mustafa Atar
- grid.239578.20000 0001 0675 4725Cleveland Clinic, Cleveland, OH 44195 USA
| | - Weina Chen
- grid.267313.20000 0000 9482 7121Department of Pathology, Hematopathology Section, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Ibrahim Ibrahim
- grid.267313.20000 0000 9482 7121Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Taha Bat
- grid.267313.20000 0000 9482 7121Department of Internal Medicine, Division of Hematology and Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - Mutlu Mete
- grid.264758.a0000 0004 1937 0087Department of Computer Science and Information Systems, Texas A&M University – Commerce, Commerce, TX 75429-3011 USA
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Balasundaram N, Chandra I, Sunilkumar VT, Kanake S, Bath J, Vogel TR. Frailty Index (mFI-5) Predicts Resource Utilization after Nonruptured Endovascular Aneurysm Repair. J Surg Res 2023; 283:507-513. [PMID: 36436287 DOI: 10.1016/j.jss.2022.10.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/14/2022] [Accepted: 10/16/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The 5- factor frailty index (mFI-5) has reliably predicted outcomes after vascular surgeries. The purpose of this study was to determine the performance of this index in aortic endovascular surgery ( endovascular aneurysm repair [EVAR]) MATERIALS AND METHODS: The American College of Surgeons' National Surgical Quality Improvement Program Database (NSQIP) was retrospectively analyzed for patients undergoing nonruptured EVAR between 2015 and 2019. Outcomes were assessed using bivariate analysis (Mann Whitney U test, chi-squared test, and t-test) and multivariate logistic regression analysis. RESULTS 10,450 patients were identified with a mean age of 73.59 (SD 8.93) y. 8222 (78.7%) were performed for large diameter with the remaining indications including dissection, symptomatic, and embolization/thrombosis. 30-d mortality was 1.3%. Univariate analysis showed that mFI-5≥0.6 was associated with higher rates of prolonged hospital stay (18.8% versus 5.7%, P < 0.001, reference mFI-5 = 0), readmission (12.3% versus 5.9%, P < 0.001), mortality (3.6 % versus 1.2%, P = 0.01), intensive care unit (ICU) length of stay more than 3 d (7.2% versus 2.7%, P < 0.001). Female gender higher age, indication for surgery, and mFI-5 were all associated with increased mortality. Multivariate logistic regression showed that mFI-5 remained as a significant predictor with mFI-5≥0.6 predicting a close to 3 times higher odds for 30-d mortality (odds ratio OR 2.83, P = 0.003), ICU length of stay >3 d (OR 2.48, P < 0.001), >7 d hospital stay (OR 3.94, P < 0.001), readmission (OR 2.16, P < 0.001), and pneumonia (OR 4.2, P < 0.001) CONCLUSIONS: The modified frailty index (mFI-5) is a good predictor for postoperative complications and hospital resource utilization after nonruptured EVAR.
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Affiliation(s)
- Naveen Balasundaram
- Division of Vascular Surgery, Department of Surgery, University of Missouri, Columbia, Missouri 65212.
| | - Isaiah Chandra
- School of Medicine, University of Missouri, Columbia, Missouri 65212
| | | | - Shubham Kanake
- School of Medicine, University of Missouri, Columbia, Missouri 65212
| | - Jonathan Bath
- Division of Vascular Surgery, Department of Surgery, University of Missouri, Columbia, Missouri 65212
| | - Todd R Vogel
- Division of Vascular Surgery, Department of Surgery, University of Missouri, Columbia, Missouri 65212
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20
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Balasundaram N, Ramji S, Burgon RD, Assefa M, Chandra I, Vogel TR. Performance of the Emergency Surgery Score in Nonelective Lower-Extremity Endovascular Procedures. J Surg Res 2023; 283:619-625. [PMID: 36446249 DOI: 10.1016/j.jss.2022.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 10/29/2022] [Accepted: 11/06/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Multiple studies have validated the Emergency Surgery Score (ESS) as a tool which reliably predicts outcomes after emergency general surgery. The purpose of this study was to assess the performance of the ESS for lower-extremity endovascular procedures in nonelective setting (neLEE). METHODS The American College of Surgeons' National Surgical Quality Improvement Program database was retrospectively analyzed for patients undergoing neLEE between 2015 and 2019. The performance of the ESS in predicting mortality in each procedure was assessed using receiver operating characteristic analyses. RESULTS Four thousand five hundred and eighty three patients underwent neLEE with median age 68 (±12.3 SD), with 1802 females (39.3%). The ESS correlated with 30-day mortality (area under the curve [AUC] was 0.729), discharge to rehab (AUC 0.638), renal failure (AUC 0.667), postintervention ventilation requirement (AUC 0.680), and stroke (AUC 0.656). The predictive ability of the ESS decreased with increasing age, with the ESS performing best for patients between 60 and 69 y in age (AUC 0.735) and worst for patients above 80 y (AUC 0.650). A Cochran-Armitage test showed linear trend towards increased 30-day mortality among the quartiles with increasing ESS (P < 0.001), with patients with ESS ≥10 having 10 times odds of increased 30-day mortality compared to reference quartile of patients with ESS ≤4 on multivariate analysis. CONCLUSIONS The ESS score is associated with 30-day mortality and other complications after neLEE procedures. It can potentially be used as a predictive tool for preoperative risk stratification and can also be used for equitably evaluating standards and outcomes after lower extremity endovascular procedures.
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Affiliation(s)
- Naveen Balasundaram
- Division of Vascular Surgery, Department of Surgery, University of Missouri, Columbia, Missouri.
| | - Sadhvika Ramji
- Division of Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Riley D Burgon
- Division of Vascular Surgery, Department of Surgery, University of Missouri, Columbia, Missouri
| | - Mahilet Assefa
- School of Medicine, University of Missouri, Columbia, Missouri
| | - Isaiah Chandra
- School of Medicine, University of Missouri, Columbia, Missouri
| | - Todd R Vogel
- Division of Vascular Surgery, Department of Surgery, University of Missouri, Columbia, Missouri
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21
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Fana V, Terslev L. Lacrimal and salivary gland ultrasound - how and when to use in patients with primary Sjögren's syndrome. Best Pract Res Clin Rheumatol 2023; 37:101837. [PMID: 37258318 DOI: 10.1016/j.berh.2023.101837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 04/27/2023] [Indexed: 06/02/2023]
Abstract
This paper addresses how to perform an ultrasound assessment of the salivary and lacrimal glands, how to identify pathological changes, and how to score disease activity, focusing on the use for primary Sjögren's syndrome (pSS). It addresses the role of salivary gland ultrasound for diagnosing and management of patients with pSS and touches upon the use for differential diagnosis, including how and when to perform ultrasound-guided biopsies and injections.
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Affiliation(s)
- Viktoria Fana
- Center for Rheumatology and Spine Diseases, Copenhagen Center for Arthritis Research, Rigshospitalet, Copenhagen, Denmark.
| | - Lene Terslev
- Center for Rheumatology and Spine Diseases, Copenhagen Center for Arthritis Research, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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22
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Sajeed SM, De Dios MP, Dan OWJ, Punyadasa AC. Defining a clinical prediction rule to diagnose bacterial gastroenteritis requiring empirical antibiotics in an emergency department setting: A retrospective review. Indian J Gastroenterol 2023; 42:79-87. [PMID: 36753039 PMCID: PMC10038946 DOI: 10.1007/s12664-022-01304-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/23/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND Gastroenteritis (GE) is a non-specific term for various pathologic states of the gastrointestinal tract. Infectious agents usually cause acute GE. At present, there are no robust decision-making rules that predict bacterial GE and dictate when to start antibiotics for patients suffering from acute GE to the emergency department (ED). We aim to define a clinical prediction rule to aid in the diagnosis of bacterial GE, requiring empirical antibiotics in adult patients presenting to the emergency department with acute GE. METHODS A two-year retrospective case review was performed on all cases from July 2015 to June 2017 that included patients with acute GE symptoms referred to the ED, after which their stool cultures were performed. The clinical parameters analyzed included patient with comorbid conditions, physical examination findings, historical markers, point-of-care and radiographic tests and other laboratory work. We then used multi-variate logistic regression analysis on each group (bacterial culture-positive GE and bacterial culture-negative GE) to elucidate clinical criteria with the highest yield for predicting bacterial gastroenteritis (BGE). RESULTS A total of 756 patients with a mean age of 52 years, 52% female and 48% male, respectively, were included in the study. On the basis of the data of these patients, we suggested using a scoring system to delineate the need for empirical antibiotics in patients with suspected bacterial GE based on six clinical and laboratory variables. We termed this the BGE score. A score 0 - 2 points suggests low risk (0.9%) of bacterial GE. A score of 3 - 4 points confers an intermediate risk of 12.0% and a score of 5 - 8 points confers a high risk of 85.7%. A cut-off of ≥ 5 points may be used to predict culture-positive BGE with a 75% sensitivity and 75% specificity. The area under the receiver operating characteristic (AUROC) for the scoring system (range 0 - 8) was 0.812 (95% CI: 0.780-0.843) p-value < 0.001. CONCLUSION We suggest using the BGE scoring system (cut-off ≥ 5 points) to delineate the need for empirical antibiotics in patients diagnosed with gastroenteritis. While this is a pilot study, which will require further validation with a larger sample size, our proposed decision-making rule will potentially serve to improve the diagnosis of BGE and thus reduce unnecessary prescription of antibiotics, which will in turn reduce antibiotic-associated adverse events and save on costs worldwide.
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Affiliation(s)
- Shanaz Matthew Sajeed
- Department of Intensive Care Medicine, Ng Teng Fong General Hospital, Singapore, Singapore.
- Department of Emergency Medicine, Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore, 609606, Singapore.
| | - Michael P De Dios
- Department of Emergency Medicine, Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore, 609606, Singapore
| | - Ong Wei Jun Dan
- Department of Respiratory Therapy, Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore, 609606, Singapore
| | - Amila Clarence Punyadasa
- Department of Emergency Medicine, Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore, 609606, Singapore
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Dakhale BJ, Sharma M, Arif M, Asthana K, Bhurane AA, Kothari AG, Rajendra Acharya U. An automatic sleep- scoring system in elderly women with osteoporosis fractures using frequency localized finite orthogonal quadrature Fejer Korovkin kernels. Med Eng Phys 2023; 112:103956. [PMID: 36842776 DOI: 10.1016/j.medengphy.2023.103956] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/04/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023]
Abstract
Healthy sleep signifies a good physical and mental state of the body. However, factors such as inappropriate work schedules, medical complications, and others can make it difficult to get enough sleep, leading to various sleep disorders. The identification of these disorders requires sleep stage classification. Visual evaluation of sleep stages is time intensive, placing a significant strain on sleep experts and prone to human errors. As a result, it is crucial to develop machine learning algorithms to score sleep stages to acquire an accurate diagnosis. Hence, a new methodology for automated sleep stage classification is suggested using machine learning and filtering electroencephalogram (EEG) signals. The national sleep research resource's (NSRR) study of osteoporotic fractures (SOF) dataset comprising 453 subjects' polysomnograph (PSG) data is used in this study. Only two unipolar EEG derivations C4-A1 and C3-A2 are employed individually and jointly in this work. The EEG signals are decomposed into sub-bands using a frequency-localized finite orthogonal quadrature Fejer Korovkin wavelet filter bank. The wavelet-based entropy features are extracted from sub-bands. Subsequently, extracted features are classified using machine learning techniques. Our developed model obtained the highest classification accuracy of 81.3%, using an ensembled bagged trees classifier with a 10-fold cross-validation method and Cohen's Kappa coefficient of 0.72. The proposed model is accurate, dependable, and easy to implement and can be employed as an alternative to a PSG-based system at home with minimal resources. It is also ready to be tested on other EEG data to evaluate the sleep stages of healthy and unhealthy subjects.
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Affiliation(s)
- Bharti Jogi Dakhale
- Department of Electonics and Communication, Indian Institute of Information Technology Nagpur, Maharashtra, India.
| | - Manish Sharma
- Department of Electrical and Computer Science Engineering, Institute of Infrastructure, Technology, Research and Management (IITRAM), Ahmedabad, India.
| | - Mohammad Arif
- Department of Electrical and Computer Science Engineering, Institute of Infrastructure, Technology, Research and Management (IITRAM), Ahmedabad, India.
| | - Kushagra Asthana
- Department of Electrical and Computer Science Engineering, Institute of Infrastructure, Technology, Research and Management (IITRAM), Ahmedabad, India.
| | - Ankit A Bhurane
- Department of Electronics and Communication, Visvesvaraya National Institute of Technology Nagpur, Maharashtra, India.
| | - Ashwin G Kothari
- Department of Electronics and Communication, Visvesvaraya National Institute of Technology Nagpur, Maharashtra, India.
| | - U Rajendra Acharya
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore 639798, Singapore; Department of Bioinformatics and Medical Engineering, Asia University, Taichung 41354, Taiwan; Department of Biomedical Engineering, School of Science and Technology, Singapore 639798, Singapore.
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24
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Misaki K, Kamide T, Uno T, Tsutsui T, Nambu I, Nakada M. Evaluation of a scoring system to assess proficiency in cerebral angiography for neuroendovascular surgery education. Heliyon 2023; 9:e13249. [PMID: 36755597 PMCID: PMC9900261 DOI: 10.1016/j.heliyon.2023.e13249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/26/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Objective Cerebral angiography is indispensable for endovascular neurosurgeons. However, there is no established system to evaluate the competency of trainees. We established a scoring system and statistically analyzed its characteristics. Methods Endovascular neurosurgeons scored the operators of 177 cerebral angiography based on ten evaluation items. Preoperative explanation, device selection, and device assembly were classified as "preparation," communication with the patient, radiation protection and angiography system as "attention," and catheter operation, blood loss, procedure completion, and sheath insertion as "skill". The sum of the scores were compared using the Mann-Whitney test according to the status of the operator (trainee (TR), neurosurgeon (NS), or endovascular neurosurgeon (EVNS)). Results The highest average for each item was 0.89 for communication, and the lowest was 0.68 for catheter operation. The mean ± standard deviation of the total score was 7.82 ± 2.02, and scores by status were 7.08 ± 2.12 for TR, 8.32 ± 1.35 for NS, and 9.33 ± 1.20 for EVNS with significant differences among each status (p < 0.05). The sum scores of the preparation, attention, and skill sections also showed significant differences between each status except between NS and EVNS in the preparation section and TR and NS in the skill section (p < 0.05). Conclusions There were significant differences in the total score between statuses, suggesting that the scoring system may be an indicator of proficiency in cerebral angiography. It was suggested that dividing each item into preparation, attention, and skill sections may indicate the characteristics of proficiency.
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Affiliation(s)
- Kouichi Misaki
- Corresponding author. Department of Neurosurgery, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan.
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Puligheddu M, Figorilli M, Congiu P, Lecca R, Casaglia E, Tamburrino L, Orrù R, Meloni F, Ferri R. Quantification of REM sleep without atonia: A review of study methods and meta-analysis of their performance for the diagnosis of RBD. Sleep Med Rev 2023; 68:101745. [PMID: 36640617 DOI: 10.1016/j.smrv.2023.101745] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/23/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023]
Abstract
The present review focuses on REM sleep without atonia (RSWA) scoring methods. In consideration of the numerous papers published in the last decade, that used different methods for the quantification of RSWA, their systematic revision is an emerging need. We made a search using the PubMed, Embase, Scopus and Web of Science Databases, from 2010 until December 2021, combining the search term "RSWA" with "scoring methods", "IRBD", "alfasyn disease", and "neurodegenerative disease", and with each of the specific sleep disorders, diagnosed according to current criteria, with the identification of the references of interest for the topic. Furthermore, a Meta-analysis of the diagnostic performance of RSWA scoring methods, in terms of sensitivity and specificity, was carried out. The comparison of the hierarchical summary receiver-operating characteristic curves obtained for visual methods and that obtained for the automated REM sleep atonia index (RAI), shows substantially similar prediction areas indicating a comparable performance. This systematic review and meta-analysis support the validity of a series of visual methods and of the automated RAI in the quantification of RSWA with the purpose to guide clinicians in the interpretation of their results and their correct and efficient use within the diagnostic work-up for REM sleep behavior disorder.
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26
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Bösherz MS, Samarska IV, Gaisa NT. Scoring Systems for Immunohistochemistry in Urothelial Carcinoma. Methods Mol Biol 2023; 2684:3-25. [PMID: 37410225 DOI: 10.1007/978-1-0716-3291-8_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Immunohistochemistry is widely used in diagnostic and scientific analysis of urothelial carcinoma. Objective interpretation of staining results is mandatory for accuracy and comparability in diagnostic and therapeutic patient care as well as research.Herein we summarize and explain standardized microscopic evaluation and scoring approaches for immunohistochemical stainings. We focus on commonly used and generally feasible approaches for different cellular compartments and comment on their utility in diagnostics and research practice.
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Affiliation(s)
| | - Iryna V Samarska
- Department of Pathology, GROW - School for Oncology and Reproduction, Maastricht University, Medical Centre+, Maastricht, The Netherlands
| | - Nadine T Gaisa
- Institute of Pathology, University Hospital, RWTH Aachen University, Aachen, Germany
- German Study Group of Bladder Cancer (DFBK e.V.), Munich, Germany
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27
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Liedel C, Mayer L, Einspanier A, Völker I, Ulrich R, Rieckmann K, Baums CG. A new S. suis serotype 3 infection model in pigs: lack of effect of buprenorphine treatment to reduce distress. BMC Vet Res 2022; 18:435. [PMID: 36510249 PMCID: PMC9743652 DOI: 10.1186/s12917-022-03532-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Streptoccocus suis (S. suis) is a major porcine pathogen causing meningitis, septicemia, arthritis and endocarditis. These diseases severely impair welfare of pigs. Experimental studies in pigs are important to better understand the pathogenesis and to identify protective antigens, as so far there is no vaccine available protecting against various serotypes (cps). Due to the severity of disease, application of appropriate refinement strategies in experimental S. suis infections is essential to reduce distress imposed on the piglets without jeopardizing the scientific output. The objectives of this study were to evaluate buprenorphine treatment as a refinement measure and serum cortisol levels as a distress read out parameter in a new S. suis cps3 infection model in pigs. RESULTS Intravenous application of 2 × 108 CFU of S. suis cps3 (sly+, mrp+) to 6-week-old piglets led to severe morbidity in approximately 50% of the animals. Main pathological findings included suppurative meningoencephalitis and arthritis as well as fibrinosuppurative endocarditis. Buprenorphine treatment (0.05 mg/kg every 8 h) did not prevent signs of severe pain, high clinical scores, moderate to severe pathologies or high levels of serum cortisol in single severely affected piglets. Significant differences in the course of leukocytosis, induction of specific antibodies and bactericidal immunity were not recorded between groups with or w/o buprenorphine treatment. Of note, clinically unobtrusive piglets showed serum cortisol levels at 2 and 5 days post infectionem (dpi) comparable to the levels prior to infection with cps3. Cortisol levels in serum were significantly increased in piglets euthanized due to severe disease in comparison to clinically unobtrusive pigs. CONCLUSIONS Different clinical courses and pathologies are induced after intravenous challenge of piglets with 2 × 108 CFU of this S. suis cps3 strain. The chosen protocol of buprenorphine application does not prevent severe distress in this infection model. Important parameters of the humoral immune response, such as the level of IgM binding to S. suis cps3, do not appear to be affected by buprenorphine treatment. Serum cortisol is a meaningful parameter to measure distress in piglets experimentally infected with S. suis and to evaluate refinement strategies. In this intravenous model, which includes close clinical monitoring and different humane endpoints, clinics and cortisol levels suggest convalescence in surviving piglets within 5 days following experimental infection.
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Affiliation(s)
- Carolin Liedel
- grid.9647.c0000 0004 7669 9786Institute of Bacteriology and Mycology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 29, 04103 Leipzig, Germany
| | - Leonie Mayer
- grid.9647.c0000 0004 7669 9786Institute of Bacteriology and Mycology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 29, 04103 Leipzig, Germany
| | - Almuth Einspanier
- grid.9647.c0000 0004 7669 9786Institute of Physiological Chemistry, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 1, 04103 Leipzig, Germany
| | - Iris Völker
- grid.9647.c0000 0004 7669 9786Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 33, 04103 Leipzig, Germany
| | - Reiner Ulrich
- grid.9647.c0000 0004 7669 9786Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 33, 04103 Leipzig, Germany
| | - Karoline Rieckmann
- grid.9647.c0000 0004 7669 9786Institute of Bacteriology and Mycology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 29, 04103 Leipzig, Germany
| | - Christoph G. Baums
- grid.9647.c0000 0004 7669 9786Institute of Bacteriology and Mycology, Centre for Infectious Diseases, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 29, 04103 Leipzig, Germany
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Menashe SJ, Iyer RS, Ngo AV, Rosenwasser NL, Zhao Y, Maloney E. Whole-body MRI at initial presentation of pediatric chronic recurrent multifocal osteomyelitis and correlation with clinical assessment. Pediatr Radiol 2022; 52:2377-2387. [PMID: 35670843 DOI: 10.1007/s00247-022-05388-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/11/2022] [Accepted: 04/22/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Chronic recurrent multifocal osteomyelitis (CRMO) is a diagnosis of exclusion, relying heavily on whole-body magnetic resonance imaging (WB-MRI) for diagnosing and evaluating response to therapy. Information with respect to disease distribution and imaging correlation with clinical disease severity at initial presentation is lacking. OBJECTIVE To retrospectively characterize distribution of disease on WB-MRI and to correlate imaging findings with disease severity at initial rheumatology presentation. MATERIALS AND METHODS Using a modified version of a recently devised imaging-based scoring system, we evaluated disease distribution and correlation between findings on WB-MRI and clinical disease severity in 54 patients presenting for initial evaluation of CRMO. Symptomatic lesion sites were extracted from chart review and physician global assessment was determined by the consensus of two rheumatologists. RESULTS Sites of CRMO involvement evident on imaging at initial presentation had a strong predilection for the pelvis and lower extremities. There was significant correlation between the number of lesions detected on WB-MRI and total clinical severity score at initial rheumatology presentation (P<0.01). However, no other imaging parameter correlated with disease severity. CONCLUSION While the overall number of lesions identified on MRI correlates with clinical severity scores at initial imaging, other MR parameters of CRMO lesions may not be reliable indicators of disease severity at initial presentation. Further research is needed to assess whether these parameters are implicated in longitudinal disease severity or overall response to therapy.
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Affiliation(s)
- Sarah J Menashe
- Pediatric Radiology Department, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way N.E, Seattle, WA, 98105, USA.
| | - Ramesh S Iyer
- Pediatric Radiology Department, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way N.E, Seattle, WA, 98105, USA
| | - Anh-Vu Ngo
- Pediatric Radiology Department, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way N.E, Seattle, WA, 98105, USA
| | - Natalie L Rosenwasser
- Pediatric Rheumatology Department, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Yongdong Zhao
- Pediatric Rheumatology Department, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA.,Center of Clinical and Translational Research, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Ezekiel Maloney
- Pediatric Radiology Department, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way N.E, Seattle, WA, 98105, USA
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Gonthier C. An easy way to improve scoring of memory span tasks: The edit distance, beyond "correct recall in the correct serial position". Behav Res Methods 2022. [PMID: 35794418 DOI: 10.3758/s13428-022-01908-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2022] [Indexed: 11/08/2022]
Abstract
For researchers and psychologists interested in estimating a subject's memory capacity, the current standard for scoring memory span tasks is the partial-credit method: subjects are credited with the number of stimuli that they manage to recall correctly in the correct serial position. A critical issue with this method, however, is that intrusions and omissions can radically change the scores depending on where they occur. For example, when recalling the sequence ABCDE, "ABCD" is worth 4 points but "BCDE" is worth 0 points. This paper presents an improved scoring method based on the edit distance, meaning the number of changes required to edit the recalled sequence into the target. Edit-distance scoring gives results close to partial-credit scoring, but without the corresponding vulnerability to positional shifts. A reanalysis of memory performance in two large datasets (N = 1093 and N = 758) confirms that in addition to being more logically consistent, edit-distance scoring demonstrates similar or better psychometric properties than partial-credit, with comparable validity, a small increase in reliability, and a substantial increase of test information (measurement precision in the context of item response theory). Test information was especially improved for harder items and for subjects with ability in the lower range, whose scores tend to be severely underestimated by partial-credit scoring. Code to compute edit-distance scores with various software is made available at https://osf.io/wdb83/ .
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Gutenkunst SL, Bell ML. Managing missing items in the Fagerström Test for Nicotine Dependence: a simulation study. BMC Med Res Methodol 2022; 22:145. [PMID: 35596136 PMCID: PMC9121580 DOI: 10.1186/s12874-022-01637-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/11/2022] [Indexed: 11/12/2022] Open
Abstract
Background The Fagerström Test for Nicotine Dependence (FTND) is frequently used to assess the level of smokers’ nicotine dependence; however, it is unclear how to manage missing items. The aim of this study was to investigate different methods for managing missing items in the FTND. Methods We performed a simulation study using data from the Arizona Smokers’ Helpline. We randomly sampled with replacement from the complete data to simulate 1000 datasets for each parameter combination of sample size, proportion of missing data, and type of missing data (missing at random and missing not at random). Then for six methods for managing missing items on the FTND (two involving no imputation and four involving single imputation), we assessed the accuracy (via bias) and precision (via bias of standard error) of the total FTND score itself and of the regression coefficient for the total FTND score regressed on a covariate. Results When using the total FTND score as a descriptive statistic or in analysis for both types of missing data and for all levels of missing data, proration performed the best in terms of accuracy and precision. Proration’s accuracy decreased with the amount of missing data; for example, at 9% missing data proration’s maximum bias for the mean FTND was only − 0.3%, but at 35% missing data its maximum bias for the mean FTND increased to − 6%. Conclusions For managing missing items on the FTND, we recommend proration, because it was found to be accurate and precise, and it is easy to implement. However, because proration becomes less accurate with more missing data, if more than ~ 10% of data are missing, we recommend performing a sensitivity analysis with a different method of managing missing data. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01637-2.
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Affiliation(s)
- Shannon L Gutenkunst
- University of Arizona, Statistics Graduate Interdisciplinary Program, Tucson, AZ, USA. .,University of Arizona, Statistics Consulting Lab, Health Sciences & Bio5 Institute, Tucson, AZ, USA.
| | - Melanie L Bell
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Heath, University of Arizona, Tucson, AZ, USA
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Lior Y, Yatzkan N, Brami I, Yogev Y, Riff R, Hekselman I, Fremder M, Freixo-Lima G, Be'er M, Amirav I, Lavie M. Fractional exhaled Nitric Oxide (FeNO) level as a predictor of COVID-19 disease severity. Nitric Oxide 2022; 124:68-73. [PMID: 35597408 PMCID: PMC9116042 DOI: 10.1016/j.niox.2022.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 05/03/2022] [Accepted: 05/13/2022] [Indexed: 11/12/2022]
Abstract
Objective To assess the feasibility of Fractional exhaled Nitric Oxide (FeNO) as a simple, non-invasive, cost-effective and portable biomarker and decision support tool for risk stratification of COVID-19 patients. Methods We conducted a single-center prospective cohort study of COVID-19 patients whose FeNO levels were measured upon ward admission by the Vivatmo-me handheld device. Demographics, COVID-19 symptoms, and relevant hospitalization details were retrieved from the hospital databases. The patients were divided into those discharged to recover at home and those who died during hospitalization or required admission to an intensive care unit, internal medicine ward, or dedicated facility (severe outcomes group). Results Fifty-six patients were enrolled. The only significant demographic difference between the severe outcomes patients (n = 14) and the home discharge patients (n = 42) was age (64.21 ± 13.97 vs. 53.98 ± 15.57 years, respectively, P = .04). The admission FeNO measurement was significantly lower in the former group compared with the latter group (15.86 ± 14.74 vs. 25.77 ± 13.79, parts per billion [PPB], respectively, P = .008). Time to severe outcome among patients with FeNO measurements ≤11.8 PPB was significantly shorter compared with patients whose FeNO measured >11.8 PPB (19.25 ± 2.96 vs. 24.41 ± 1.09 days, respectively, 95% confidence interval [CI] 1.06 to 4.25). An admission FeNO ≤11.8 PPB was a significant risk factor for severe outcomes (odds ratio = 12.8, 95% CI: 2.78 to 58.88, P = .001), with a receiver operating characteristics curve of 0.752. Conclusions FeNO measurements by the Vivatmo-me handheld device can serve as a biomarker and COVID-19 support tool for medical teams. These easy-to-use, portable, and noninvasive devices may serve as valuable ED bedside tools during a pandemic.
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Affiliation(s)
- Yotam Lior
- Division of Anesthesia, Intensive Care, and Pain Medicine, Tel Aviv Medical Center, Tel Aviv, Israel Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Noga Yatzkan
- Division of Anesthesia, Intensive Care, and Pain Medicine, Tel Aviv Medical Center, Tel Aviv, Israel Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ido Brami
- Faculty of Health Sciences. Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Yuval Yogev
- Faculty of Health Sciences. Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Reut Riff
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - Idan Hekselman
- Faculty of Health Sciences. Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Moran Fremder
- Faculty of Health Sciences. Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | | | - Moria Be'er
- Pediatric Pulmonology Unit, Dana-Dwek Children's Hospital, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Israel Amirav
- Pediatric Pulmonology Unit, Dana-Dwek Children's Hospital, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moran Lavie
- Pediatric Pulmonology Unit, Dana-Dwek Children's Hospital, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Fertitta L, Bergqvist C, Armand ML, Moryousef S, Ferkal S, Jannic A, Ravaud P, Tran VT, Ezzedine K, Wolkenstein P. Quality of life in neurofibromatosis 1: development and validation of a tool dedicated to cutaneous neurofibromas in adults. J Eur Acad Dermatol Venereol 2022; 36:1359-1366. [PMID: 35412677 DOI: 10.1111/jdv.18140] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/10/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cutaneous neurofibromas (cNF), present in 95% of individuals with neurofibromatosis 1 (NF1), are considered as one of the greatest medical burden because of physical disfigurement. No specific score evaluates their impact on quality of life (QoL). OBJECTIVE To develop a specific score assessing cNF-related QoL. METHODS Through a multidisciplinary workshop including 10 patients, 3 expert-in-NF1 physicians, 3 health care workers (nurses and psychologist) and 1 methodologist, the French version of the Skindex-16 was modified by adding 3 items. The new cNF-Skindex was validated among patients with NF1 recruited in the ComPaRe online cohort, in France (N=284). Construct validity was assessed by comparing it with the EQ-5D-5L, its visual analog scale and the MYMOP2 and by assessing its association with patients' characteristics. Reliability was assessed by a test-retest. An English version of the tool was developed using a back forward translation. RESULTS A total of 228 individuals with NF1, with cNF answered the 19-item questionnaire. These items fitted into 3 domains: emotions, symptoms, functioning. One was dropped during analysis because >90% responders were not concerned. The cNF-Skindex significantly correlated with the EQ-5D-5L (N=193) and MYMOP2 (N=210) indicating good external validity: rs 0.38 (p<0.001), and 0.58 (p<0.001) respectively. Having >50 cNF was the only independent variable associated with the total score cNF-Skindex (β=15.88, 95%CI 6.96 - 24.81, p=0.001), and with the 3 sub-scores: "functioning" (β=2.65, 95%CI 0.71 - 4.59, p=0.008), "emotions" (β=17.03, 95%CI 4.11 - 29.96, p=0.010) and "symptoms" (β=3.90, 95%CI 1.95 - 5.85, p<0.001). Test-retest reliability (N=133) found an ICC at 0.96 demonstrating good reproducibility. CONCLUSION The cNF-Skindex demonstrated excellent psychometric properties. The global and sub-scores were increased with higher number of cNF arguing for its use in further trials aiming to reduce their number or prevent their development. Cross-cultural validation and evaluation of its responsiveness are the next steps.
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Affiliation(s)
- L Fertitta
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France
| | - C Bergqvist
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France
| | - M L Armand
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France
| | - S Moryousef
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France
| | - S Ferkal
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France.,INSERM, Centre d'Investigation Clinique 1430, National Referral Center for Neurofibromatoses, Henri-Mondor Hospital, Assistance Publique-Hôpitaux Paris (AP-HP), 94010, Créteil, France
| | - A Jannic
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France
| | - P Ravaud
- Center for Clinical Epidemiology, Hôtel-Dieu Hospital (AP-HP), Paris, France.,Université de Paris, CRESS, INSERM, INRA, F-75004, Paris, France
| | - V T Tran
- Center for Clinical Epidemiology, Hôtel-Dieu Hospital (AP-HP), Paris, France.,Université de Paris, CRESS, INSERM, INRA, F-75004, Paris, France
| | - K Ezzedine
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France.,Université Paris-Est Créteil (UPEC), 94010, Créteil, France
| | - P Wolkenstein
- Dept. of Dermatology, National Referral Center for Neurofibromatoses, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), 94010, Créteil, France.,Université Paris-Est Créteil (UPEC), 94010, Créteil, France.,INSERM U955, 94010, Créteil, France
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Nicoll K, Lucocq J, Khalil T, Khalil M, Watson H, Patil P. Follow-up after emergency laparotomy suggests high one- and five-year mortality with risk stratified by ASA. Ann R Coll Surg Engl 2022; 104:202-209. [PMID: 34519559 PMCID: PMC9773906 DOI: 10.1308/rcsann.2021.0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION We investigated all-cause mortality following emergency laparotomy at 1 and 5 years. We aimed to establish a basis from which to advise patients and relatives on long-term mortality. METHODS Local data from a historical audit of emergency laparotomies from 2010 to 2012 were combined with National Emergency Laparotomy Audit (NELA) data from 2017 to 2020. Covariates collected included deprivation status, preoperative blood work, baseline renal function, age, American Society of Anesthesiologists (ASA) grade, operative time, anaesthetic time and gender. Associations between covariates and survival were determined using multivariate logistic regression and Kaplan-Meier analysis. We used patients undergoing laparoscopic cholecystectomy between 2015 and 2020 as controls. RESULTS ASA grade was the best discriminator of long-term outcome following laparotomy (n=894) but was not a predictor of survival following cholecystectomy (n=1,834), with mortality being significantly greater in the laparotomy group. Following cholecystectomy, 95% confidence intervals for survival at 5 years were 98-99%. Following laparotomy these intervals were: ASA grade 1, 79-96%; ASA grade 2, 69-82%; ASA grade 3, 44-58%; ASA grade 4, 33-48%; and ASA grade 5, 4-51%. The majority of deaths occurred after 30 days. CONCLUSIONS Emergency laparotomy is associated with a significantly increased risk of death in the following 5 years. The risk is strongly correlated to ASA grade. Thirty-day mortality estimation is not a good basis on which to advise patients and carers on long-term outcomes. ASA grade can be used to predict long-term outcomes and to guide patient counsel.
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Chan Y, Selvaratnam V, Manickavasagar T, Shetty V, Sahni V. Liverpool carpal tunnel scoring system to predict nerve conduction study results: A prospective correlation study. World J Orthop 2022; 13:171-177. [PMID: 35317399 PMCID: PMC8891662 DOI: 10.5312/wjo.v13.i2.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/30/2021] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Carpal tunnel syndrome (CTS) is one of the most common peripheral nerve compressive neuropathies. The clinical symptoms and physical examinations of CTS are widely recognised, however, there is still debate around what is the best approach for assessment of CTS. Clinical assessment is still considered the gold standard, however, controversies do exist regarding the need for investigations such nerve conduction studies (NCS) to aid with management decisions.
AIM To correlate the severity of NCS results to a scoring system which included symptoms, signs and risk factors.
METHODS This was a prospective correlation study. We scored patients’ signs and symptoms using our CTS scoring system. This was then correlated with the findings of the NCS. The scoring system included - four symptoms (2 Katz hand diagrams – one for tingling and one for numbness; nocturnal paresthesia and bilateral symptoms) and four clinical signs (weak thumb abduction test; Tinel’s sign; Phalen sign and hypoalgesia in median nerve territory) and two risk factors (age more than 40 years and female sex). We classified the NCS results to normal, mild, moderate and severe.
RESULTS There were 61 scores in 59 patients. The mean scores for the categories were as follows: 6.75 for normal NCS; 5.50 for mild NCS; 9.17 for moderate NCS and 9 for severe NCS. All scores of 8 or more matched with NCS results of moderate and severe intensity apart from three scores which were greater than seven that had normal NCS. Eta score was 0.822 for the CTS score being the dependent value and the NCS category being the independent variable showing a strong association between the scoring system and the NCS group.
CONCLUSION We feel that this simple scoring system can be used to predict and correlate the severity of NCS in patients with CTS.
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Affiliation(s)
- Yuen Chan
- Department of Trauma and Orthopaedics, Mersey Deanery, Prescot L35 5DR, Merseyside, United Kingdom
| | - Veenesh Selvaratnam
- Department of Trauma and Orthopaedics, Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, United Kingdom
| | - Tharjan Manickavasagar
- Department of Trauma and Orthopaedics, Southport and Ormskirk NHS Trust, Southport L39 2AZ, United Kingdom
| | - Vishwanath Shetty
- Department of Trauma and Orthopaedics, Southport and Ormskirk NHS Trust, Southport L39 2AZ, United Kingdom
| | - Vishal Sahni
- Department of Trauma and Orthopaedics, Southport and Ormskirk NHS Trust, Southport L39 2AZ, United Kingdom
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Gupta P, Dutta U, Rana P, Singhal M, Gulati A, Kalra N, Soundararajan R, Kalage D, Chhabra M, Sharma V, Gupta V, Yadav TD, Kaman L, Irrinki S, Singh H, Sakaray Y, Das CK, Saikia U, Nada R, Srinivasan R, Sandhu MS, Sharma R, Shetty N, Eapen A, Kaur H, Kambadakone A, de Haas R, Kapoor VK, Barreto SG, Sharma AK, Patel A, Garg P, Pal SK, Goel M, Patkar S, Behari A, Agarwal AK, Sirohi B, Javle M, Garcea G, Nervi F, Adsay V, Roa JC, Han HS. Gallbladder reporting and data system (GB-RADS) for risk stratification of gallbladder wall thickening on ultrasonography: an international expert consensus. Abdom Radiol (NY) 2022; 47:554-565. [PMID: 34851429 DOI: 10.1007/s00261-021-03360-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 02/07/2023]
Abstract
The Gallbladder Reporting and Data System (GB-RADS) ultrasound (US) risk stratification is proposed to improve consistency in US interpretations, reporting, and assessment of risk of malignancy in gallbladder wall thickening in non-acute setting. It was developed based on a systematic review of the literature and the consensus of an international multidisciplinary committee comprising expert radiologists, gastroenterologists, gastrointestinal surgeons, surgical oncologists, medical oncologists, and pathologists using modified Delphi method. For risk stratification, the GB-RADS system recommends six categories (GB-RADS 0-5) of gallbladder wall thickening with gradually increasing risk of malignancy. GB-RADS is based on gallbladder wall features on US including symmetry and extent (focal vs. circumferential) of involvement, layered appearance, intramural features (including intramural cysts and echogenic foci), and interface with the liver. GB-RADS represents the first collaborative effort at risk stratifying the gallbladder wall thickening. This concept is in line with the other US-based risk stratification systems which have been shown to increase the accuracy of detection of malignant lesions and improve management.
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Affiliation(s)
- Pankaj Gupta
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - Usha Dutta
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pratyaksha Rana
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manphool Singhal
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Gulati
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naveen Kalra
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Raghuraman Soundararajan
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Daneshwari Kalage
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manika Chhabra
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vishal Sharma
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vikas Gupta
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Thakur Deen Yadav
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Lileshwar Kaman
- Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Santosh Irrinki
- Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Harjeet Singh
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Yashwant Sakaray
- Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Chandan Krishuna Das
- Haematology and Medical Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma Saikia
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritambhara Nada
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Srinivasan
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manavjit Singh Sandhu
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Raju Sharma
- Department of Radiology, All India Institute of Medical Education and Research, New Delhi, India
| | - Nitin Shetty
- Department of Interventional Radiology, Tata Memorial Hospital, Mumbai, India
| | - Anu Eapen
- Department of Radiodiagnosis, Christian Medical College, Vellore, India
| | - Harmeet Kaur
- Division of Diagnostic Imaging, Department of Abdominal Imaging, MD Anderson Cancer Centre, Houston, TX, USA
| | - Avinash Kambadakone
- Abdominal Imaging, Harvard Medical School, Medical Director, Martha's Vineyard Hospital Imaging, Massachusetts General Hospital, Boston, USA
| | - Robbert de Haas
- Radiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Vinay K Kapoor
- HPB Surgery, Mahatma Gandhi Medical College & Hospital, Jaipur, India
| | - Savio George Barreto
- Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Atul K Sharma
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Amol Patel
- Indian Naval Hospital Ship, Asvini, Mumbai, India
| | - Pramod Garg
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Sujoy K Pal
- Surgical Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
| | - Mahesh Goel
- Gastrointestinal and HPB Surgery, Tata Memorial Hospital, Mumbai, India
| | - Shraddha Patkar
- Gastrointestinal and HPB Surgery, Tata Memorial Hospital, Mumbai, India
| | - Anu Behari
- HPB Surgery, Mahatma Gandhi Medical College & Hospital, Jaipur, India
| | - Anil K Agarwal
- GI Surgery and Liver Transplant, GB Pant Institute of Medical Education and Research and MAM College, New Delhi, India
| | - Bhawna Sirohi
- Medical Oncology, Apollo Proton Cancer Centre, Chennai, India
| | - Milind Javle
- Department of Gastrointestinal Medical Oncology, MD Anderson Cancer Centre, Houston, USA
| | | | - Flavio Nervi
- Department of Gastroenterology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Volkan Adsay
- Department of Pathology, Koc University Hospitals, Istanbul, Turkey
| | - Juan Carlos Roa
- Department of Pathology, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Ho-Seong Han
- Department of Surgery, College of Medicine, Seoul National University Bundang Hospital Seoul National University, Seongnam-si, South Korea
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Abstract
Corn head smut fungus Sporisorium reilianum f. sp. zeae is a biotrophic pathogen belonging to the class of basidiomycetes. Under field conditions, it infects maize (Zea mays L.) still in the soil at early stages of development. Later, the infection spreads systemically to all aerial parts of the plant with mild symptoms of anthocyanin accumulation until the development of inflorescences, where it causes a replacement of maize inflorescences with spore-filled sori or leaf-like structures. Recently, Sporisorium reilianum (S. reilianum) is being established as a model organism to study fungal-plant interactions and corresponding virulence factors. Here, we describe a detailed protocol for a method that has been described and employed previously (Ghareeb H, Zhao Y, Schirawski J, Molecular plant pathology 20:124-136, 2019) to test the virulence of S. reilianum in maize under controlled laboratory conditions.
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Affiliation(s)
- Mamoona Khan
- Department of Plant Pathology, Institute of Crop Science and Resource Conservation (INRES), University of Bonn, Bonn, Germany.
| | - Armin Djamei
- Department of Plant Pathology, Institute of Crop Science and Resource Conservation (INRES), University of Bonn, Bonn, Germany
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Pihan E, Kotev M, Rabal O, Beato C, Diaz Gonzalez C. Fine tuning for success in structure-based virtual screening. J Comput Aided Mol Des 2021; 35:1195-1206. [PMID: 34799816 DOI: 10.1007/s10822-021-00431-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/08/2021] [Indexed: 11/30/2022]
Abstract
Structure-based virtual screening plays a significant role in drug-discovery. The method virtually docks millions of compounds from corporate or public libraries into a binding site of a disease-related protein structure, allowing for the selection of a small list of potential ligands for experimental testing. Many algorithms are available for docking and assessing the affinity of compounds for a targeted protein site. The performance of affinity estimation calculations is highly dependent on the size and nature of the site, therefore a rationale for selecting the best protocol is required. To address this issue, we have developed an automated calibration process, implemented in a Knime workflow. It consists of four steps: preparation of a protein test set with structures and models of the target, preparation of a compound test set with target-related ligands and decoys, automatic test of 24 scoring/rescoring protocols for each target structure and model, and graphical display of results. The automation of the process combined with execution on high performance computing resources greatly reduces the duration of the calibration phase, and the test of many combinations of algorithms on various target conformations results in a rational and optimal choice of the best protocol. Here, we present this tool and exemplify its application in setting-up an optimal protocol for SBVS against Retinoid X Receptor alpha.
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Affiliation(s)
- Emilie Pihan
- Computational Drug Discovery, Evotec (France) SAS, Campus Curie, 195 Route d'Espagne, 31036, Toulouse, France.
| | - Martin Kotev
- Computational Drug Discovery, Evotec (France) SAS, Campus Curie, 195 Route d'Espagne, 31036, Toulouse, France
| | - Obdulia Rabal
- Computational Drug Discovery, Evotec (France) SAS, Campus Curie, 195 Route d'Espagne, 31036, Toulouse, France
| | - Claudia Beato
- Aptuit (Verona) Srl, an Evotec Company, Via Alessandro Fleming, 4, 37135, Verona, Italy
| | - Constantino Diaz Gonzalez
- Computational Drug Discovery, Evotec (France) SAS, Campus Curie, 195 Route d'Espagne, 31036, Toulouse, France
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Fan C, Wang Z, Sun Y, Sun J, Liu X, Kang L, Xu Y, Yang M, Dai W, Song L, Wei X, Xiang J, Huang H, Zhou M, Zeng F, Huang L, Xu Z, Peng Z. AutoCNV: a semiautomatic CNV interpretation system based on the 2019 ACMG/ClinGen Technical Standards for CNVs. BMC Genomics 2021; 22:721. [PMID: 34615484 PMCID: PMC8496072 DOI: 10.1186/s12864-021-08011-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/08/2021] [Indexed: 11/24/2022] Open
Abstract
Background The American College of Medical Genetics and Genomics (ACMG) and the Clinical Genome Resource (ClinGen) presented technical standards for interpretation and reporting of constitutional copy-number variants in 2019 (the standards). Although ClinGen developed a web-based CNV classification calculator based on scoring metrics, it can only track and tally points that have been assigned based on observed evidence. Here, we developed AutoCNV (a semiautomatic automated CNV interpretation system) based on the standards, which can automatically generate predictions on 18 and 16 criteria for copy number loss and gain, respectively. Results We assessed the performance of AutoCNV using 72 CNVs evaluated by external independent reviewers and 20 illustrative case examples. Using AutoCNV, it showed that 100 % (72/72) and 95 % (19/20) of CNVs were consistent with the reviewers’ and ClinGen-verified classifications, respectively. AutoCNV only required an average of less than 5 milliseconds to obtain the result for one CNV with automated scoring. We also applied AutoCNV for the interpretation of CNVs from the ClinVar database and the dbVar database. We also developed a web-based version of AutoCNV (wAutoCNV). Conclusions AutoCNV may serve to assist users in conducting in-depth CNV interpretation, to accelerate and facilitate the interpretation process of CNVs and to improve the consistency and reliability of CNV interpretation. Supplementary Information The online version contains supplementary material available at 10.1186/s12864-021-08011-4.
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Affiliation(s)
- Chunna Fan
- College of Life Sciences, University of Chinese Academy of Sciences, 100049, Beijing, China.,Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China.,Binhai Genomics Institute, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China
| | - Zhonghua Wang
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China.,Binhai Genomics Institute, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China
| | - Yan Sun
- BGI Genomics, BGI-Shenzhen, 518083, Shenzhen, China
| | - Jun Sun
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China.,Binhai Genomics Institute, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China
| | - Xi Liu
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China.,Binhai Genomics Institute, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China
| | - Licheng Kang
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China.,Binhai Genomics Institute, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China
| | - Yingshuo Xu
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China.,Binhai Genomics Institute, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China
| | - Manqiu Yang
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China.,Binhai Genomics Institute, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China
| | - Wentao Dai
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China.,Binhai Genomics Institute, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China
| | - Lijie Song
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China.,Binhai Genomics Institute, BGI-Tianjin, BGI-Shenzhen, 300308, Tianjin, China
| | - Xiaoming Wei
- BGI-Wuhan Clinical Laboratories, BGI-Shenzhen, 490079, Wuhan, China
| | - Jiale Xiang
- BGI Genomics, BGI-Shenzhen, 518083, Shenzhen, China
| | - Hui Huang
- BGI Genomics, BGI-Shenzhen, 518083, Shenzhen, China
| | - Meizhen Zhou
- BGI Genomics, BGI-Shenzhen, 518083, Shenzhen, China
| | - Fanwei Zeng
- BGI Genomics, BGI-Shenzhen, 518083, Shenzhen, China.,Department of Biology, Faculty of Science, University of Copenhagen, DK-2200, Copenhagen, Denmark
| | - Lin Huang
- BGI Genomics, BGI-Shenzhen, 518083, Shenzhen, China
| | - Zhengfeng Xu
- State Key Laboratory of Reproductive Medicine, Department of Prenatal Diagnosis, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 210004, Nanjing, China.
| | - Zhiyu Peng
- BGI Genomics, BGI-Shenzhen, 518083, Shenzhen, China.
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Crampon K, Giorkallos A, Deldossi M, Baud S, Steffenel LA. Machine-learning methods for ligand-protein molecular docking. Drug Discov Today 2021; 27:151-164. [PMID: 34560276 DOI: 10.1016/j.drudis.2021.09.007] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/14/2021] [Accepted: 09/15/2021] [Indexed: 12/22/2022]
Abstract
Artificial intelligence (AI) is often presented as a new Industrial Revolution. Many domains use AI, including molecular simulation for drug discovery. In this review, we provide an overview of ligand-protein molecular docking and how machine learning (ML), especially deep learning (DL), a subset of ML, is transforming the field by tackling the associated challenges.
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Affiliation(s)
- Kevin Crampon
- Université de Reims Champagne Ardenne, CNRS, MEDyC UMR 7369, 51097 Reims, France; Université de Reims Champagne Ardenne, LICIIS - LRC CEA DIGIT, 51100 Reims, France; Atos SE, Center of Excellence in Advanced Computing, 38130 Echirolles, France
| | - Alexis Giorkallos
- Atos SE, Center of Excellence in Advanced Computing, 38130 Echirolles, France
| | - Myrtille Deldossi
- Atos SE, Center of Excellence in Advanced Computing, 38130 Echirolles, France
| | - Stéphanie Baud
- Université de Reims Champagne Ardenne, CNRS, MEDyC UMR 7369, 51097 Reims, France
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40
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Hatmal MM, Abuyaman O, Taha M. Docking-generated multiple ligand poses for bootstrapping bioactivity classifying Machine Learning: Repurposing covalent inhibitors for COVID-19-related TMPRSS2 as case study. Comput Struct Biotechnol J 2021; 19:4790-4824. [PMID: 34426763 PMCID: PMC8373588 DOI: 10.1016/j.csbj.2021.08.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/03/2021] [Accepted: 08/16/2021] [Indexed: 01/10/2023] Open
Abstract
In the present work we introduce the use of multiple docked poses for bootstrapping machine learning-based QSAR modelling. Ligand-receptor contact fingerprints are implemented as descriptor variables. We implemented this method for the discovery of potential inhibitors of the serine protease enzyme TMPRSS2 involved the infectivity of coronaviruses. Several machine learners were scanned, however, Xgboost, support vector machines (SVM) and random forests (RF) were the best with testing set accuracies reaching 90%. Three potential hits were identified upon using the method to scan known untested FDA approved drugs against TMPRSS2. Subsequent molecular dynamics simulation and covalent docking supported the results of the new computational approach.
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Affiliation(s)
- Ma'mon M. Hatmal
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, PO Box 330127, Zarqa 13133, Jordan
| | - Omar Abuyaman
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, PO Box 330127, Zarqa 13133, Jordan
| | - Mutasem Taha
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, University of Jordan, Amman 11942, Jordan
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Ougier E, Ganzleben C, Lecoq P, Bessems J, David M, Schoeters G, Lange R, Meslin M, Uhl M, Kolossa-Gehring M, Rousselle C, Vicente JL. Chemical prioritisation strategy in the European Human Biomonitoring Initiative (HBM4EU) - Development and results. Int J Hyg Environ Health 2021; 236:113778. [PMID: 34089975 DOI: 10.1016/j.ijheh.2021.113778] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023]
Abstract
The European Human Biomonitoring Initiative (HBM4EU1) has established a European Union-wide human biomonitoring (HBM) programme to generate knowledge on human internal exposure to chemical pollutants and their potential health impacts in Europe, in order to support policy makers' efforts to ensure chemical safety and improve health in Europe. A prioritisation strategy was necessary to determine and meet the most important needs of both policy makers and risk assessors, as well as common national needs of participating countries and a broad range of stakeholders. This strategy consisted of three mains steps: 1) mapping of knowledge gaps identified by policy makers, 2) prioritisation of substances using a scoring system, and 3) generation of a list of priority substances reflective of the scoring, as well as of public policy priorities and available resources. For the first step, relevant ministries and agencies at EU and national levels, as well as members of the Stakeholder Forum each nominated up to 5 substances/substance groups of concern for policy-makers. These nominations were collated into a preliminary list of 48 substances/substance groups, which was subsequently shortened to a list of 23 after considering the total number of nominations each substance/substance group received and the nature of the nominating entities. For the second step, a panel of 11 experts in epidemiology, toxicology, exposure sciences, and occupational and environmental health scored each of the substances/substance groups using prioritisation criteria including hazardous properties, exposure characteristics, and societal concern. The scores were used to rank the 23 substances/substance groups. In addition, substances were categorised according to the level of current knowledge about their hazards, extent of human exposure (through the availability of HBM data), regulatory status and availability of analytical methods for biomarker measurement. Finally, in addition to the ranking and categorisation of the substances, the resources available for the project and the alignment with the policy priorities at European level were considered to produce a final priority list of 9 substances/substance groups for research activities and surveys within the framework of the HBM4EU project.
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Affiliation(s)
- Eva Ougier
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), 14 rue Pierre et Marie Curie, 94701, Maisons-Alfort, France.
| | - Catherine Ganzleben
- European Environment Agency (EEA), Kongens Nytorv 6, 1050, Copenhagen, Denmark
| | - Pierre Lecoq
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), 14 rue Pierre et Marie Curie, 94701, Maisons-Alfort, France
| | - Jos Bessems
- Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - Madlen David
- German Environment Agency (UBA), Corrensplatz 1, 14195, Berlin, Germany
| | - Greet Schoeters
- Flemish Institute for Technological Research (VITO), Boeretang 200, 2400, Mol, Belgium
| | - Rosa Lange
- German Environment Agency (UBA), Corrensplatz 1, 14195, Berlin, Germany
| | - Matthieu Meslin
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), 14 rue Pierre et Marie Curie, 94701, Maisons-Alfort, France
| | - Maria Uhl
- Environment Agency Austria (EAA), Spittelauer Lände 5, 1090, Vienna, Austria
| | | | - Christophe Rousselle
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), 14 rue Pierre et Marie Curie, 94701, Maisons-Alfort, France
| | - Joana Lobo Vicente
- European Environment Agency (EEA), Kongens Nytorv 6, 1050, Copenhagen, Denmark
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Apprich S, Nia A, Schreiner MM, Friedrich K, Windhager R, Trattnig S. The Vienna morphological Achilles tendon score-VIMATS : Description, reproducibility and initial clinical results. Wien Klin Wochenschr 2021; 133:560-567. [PMID: 34081188 PMCID: PMC8195882 DOI: 10.1007/s00508-021-01863-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 03/22/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose was to introduce the Vienna morphological Achilles tendon score (VIMATS), to evaluate its reproducibility and to assess its clinical application. METHODS In 38 patients a total number of 40 painful ATs and 20 volunteers were examined on a 3T magnetic resonance imaging (MRI) scanner using a standard MRI protocol. In 20 patients clinical scoring according to the Achilles tendon rupture score was available. Two observers independently assessed the thickness, continuity, signal intensity, and associated pathologies of the Achilles tendon (AT) according to the newly created VIMATS. Intraobserver and interobserver agreements were calculated and the clinical application of the VIMATS regarding its potential to differentiate between patients and volunteers was tested. RESULTS An analysis of the Intraclass correlation coefficient (ICC) yielded an excellent intraobserver (ICC 0.925) and interobserver agreement (ICC 0.946) for the total VIMAT score. A significant difference in total VIMATS was found between patients (47.6 ± StD 21.1 points) and volunteers (91.5 ± SD 10.9 points; p < 0.01) as well as a moderate correlation between morphological and clinical scoring (Pearson correlation 0.644). CONCLUSION The VIMAT score is the first MRI score for the semiquantitative morphological evaluation of AT injuries and was shown to be an easy, fast and reproducible tool for assessing injuries of the AT.
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Affiliation(s)
- Sebastian Apprich
- Department of Orthopaedic Surgery, Medical University of Vienna, Währinger Straße 18-20, 1090, Vienna, Austria.
| | - Arastoo Nia
- Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | - Markus M Schreiner
- Department of Orthopaedic Surgery, Medical University of Vienna, Währinger Straße 18-20, 1090, Vienna, Austria
| | - Klaus Friedrich
- Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopaedic Surgery, Medical University of Vienna, Währinger Straße 18-20, 1090, Vienna, Austria
| | - Siegfried Trattnig
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
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43
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Mullen JT, Cassidy DJ. Let's Not Throw the Baby Out with the Bath Water - Keep the ABSITE a Numerically Scored Exam. J Surg Educ 2021; 78:714-716. [PMID: 32958423 DOI: 10.1016/j.jsurg.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/05/2020] [Indexed: 06/11/2023]
Abstract
The American Board of Surgery In-Training Examination (ABSITE) is a low-stakes, validated, objective measure of the medical knowledge of our surgical residents and is an important predictor of ABS Qualifying Exam (QE) passage. It was never intended to serve as a global assessment of resident performance or aptitude, to assess any competency other than medical knowledge, or to serve as the sole criterion by which to judge resident promotion to the next PGY level. Though the scoring of the ABSITE and the use of the exam by some PDs and fellowship directors may be imperfect, let's not throw the baby out with the bath water and destroy the utility of the ABSITE by changing its grading to pass/fail. Rather, let's set rigorous, high standards for our residents in preparation for the ABSITE, as well as for PDs and fellowship directors in the proper interpretation of the ABSITE as a formative assessment of resident knowledge progression as opposed to a high-stakes summative exam.
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Affiliation(s)
- John T Mullen
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Douglas J Cassidy
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
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44
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Fischer L, Kolb G, Segendorf C, Huber B, Watrinet K, Horoba L, Huck B, Schultze D. [Which patient needs controls of laboratory values after elective laparoscopic cholecystectomy?-Can a score help?]. Chirurg 2021; 92:369-373. [PMID: 32757046 DOI: 10.1007/s00104-020-01258-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Laparoscopic cholecystectomy is nearly exclusively carried out as an inpatient operation in Germany. The aim of the study was to evaluate for which patients postoperative laboratory control values are necessary. METHODS This retrospective analysis included 100 patients who underwent elective laparoscopic cholecystectomy. A scoring and data collection sheet was developed, which enables a risk stratification. Using the scoring system patients can achieve between 3 and 15 points. RESULTS In total 100 patients were included in the study. Of the patients 64 (group 1) had between 3 and 8 points, 29 patients (group 2) between 9 and 11 points and 7 patients (group 3) between 12 and 15 points. In comparison to group 1 the C‑reactive protein values as well as the duration of hospital stay were significantly increased in group 2 and group 3 (p > 0.05). In group1 a total of 60 patients (93.7%) were discharged regularly on postoperative days 1-3. In group 2 there were 17 patients (58.6%) who could be discharged with unremarkable blood values and in group 3 there were 3 patients (42.8%). In the total collective hospital discharge without a laboratory control of blood values would have been justified in 80% of the patients. CONCLUSION A postoperative control of laboratory blood values is not routinely necessary for patients after elective laparoscopic cholecystectomy with a score <9 points.
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Affiliation(s)
- L Fischer
- Abteilung für Allgemein‑, Viszeral- und Thoraxchirurgie, Klinikum Mittelbaden, Balger-Straße 50, 76532, Baden-Baden, Deutschland.
| | - G Kolb
- Abteilung für Allgemein‑, Viszeral- und Thoraxchirurgie, Klinikum Mittelbaden, Balger-Straße 50, 76532, Baden-Baden, Deutschland
| | - C Segendorf
- Abteilung für Allgemein‑, Viszeral- und Thoraxchirurgie, Klinikum Mittelbaden, Balger-Straße 50, 76532, Baden-Baden, Deutschland
| | - B Huber
- Abteilung für Allgemein‑, Viszeral- und Thoraxchirurgie, Klinikum Mittelbaden, Balger-Straße 50, 76532, Baden-Baden, Deutschland
| | - K Watrinet
- Abteilung für Allgemein‑, Viszeral- und Thoraxchirurgie, Klinikum Mittelbaden, Balger-Straße 50, 76532, Baden-Baden, Deutschland
| | - L Horoba
- Abteilung für Allgemein‑, Viszeral- und Thoraxchirurgie, Klinikum Mittelbaden, Balger-Straße 50, 76532, Baden-Baden, Deutschland
| | - B Huck
- Abteilung für Allgemein‑, Viszeral- und Thoraxchirurgie, Klinikum Mittelbaden, Balger-Straße 50, 76532, Baden-Baden, Deutschland
| | - D Schultze
- Abteilung für Allgemein‑, Viszeral- und Thoraxchirurgie, Klinikum Mittelbaden, Balger-Straße 50, 76532, Baden-Baden, Deutschland
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Abstract
Quantifying how accurate epidemiological models of COVID-19 forecast the number of future cases and deaths can help frame how to incorporate mathematical models to inform public health decisions. Here we analyze and score the predictive ability of publicly available COVID-19 epidemiological models on the COVID-19 Forecast Hub. Our score uses the posted forecast cumulative distributions to compute the log-likelihood for held-out COVID-19 positive cases and deaths. Scores are updated continuously as new data become available, and model performance is tracked over time. We use model scores to construct ensemble models based on past performance. Our publicly available quantitative framework may aid in improving modeling frameworks, and assist policy makers in selecting modeling paradigms to balance the delicate trade-offs between the economy and public health.
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Affiliation(s)
- Osman N Yogurtcu
- Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, US FDA, 10903 New Hampshire Ave, Silver Spring, 20993, Maryland, USA
| | - Marisabel Rodriguez Messan
- Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, US FDA, 10903 New Hampshire Ave, Silver Spring, 20993, Maryland, USA
| | - Richard C Gerkin
- School of Life Sciences, Arizona State University, Tempe, 85287, Arizona, USA
| | - Artur A Belov
- Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, US FDA, 10903 New Hampshire Ave, Silver Spring, 20993, Maryland, USA
| | - Hong Yang
- Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, US FDA, 10903 New Hampshire Ave, Silver Spring, 20993, Maryland, USA
| | - Richard A Forshee
- Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, US FDA, 10903 New Hampshire Ave, Silver Spring, 20993, Maryland, USA
| | - Carson C Chow
- Mathematical Biology Section, NIDDK/LBM, NIH, Bethesda, 20892, Maryland, USA
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Abstract
Brain arteriovenous malformations (AVMs) classification has been the subject of extensive discussion. The aim of our work was to review the main classification schemes proposed in the literature, which can be summarized in four main groups: (a) traditional schemes oriented to evaluate the operability of AVMs have been joined by (b) specific classifications that evaluate the outcome and the predictability of obliteration of other treatment modalities and (c) others that evaluate the outcome of intracerebral hemorrhages in ruptured AVMs. Eventually, (d) topographical classifications that categorize the subtypes of AVMs located in specific anatomical regions have been drawn. For each classification, we discuss the implications on surgical management.
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47
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Lacour JP. Les scores d’évaluation de la dermatite atopique. Ann Dermatol Venereol 2020; 147:11S12-11S18. [PMID: 33250133 DOI: 10.1016/s0151-9638(20)31083-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Scores evaluating the severity of atopic dermatitis are less well known and less used in daily practice of dermatologists than those for psoriasis, but things are changing. Indeed, the numerous trials and therapeutic advances in the field of eczema have also imposed the use of scales to objectively assess the severity of the disease and its improvement with treatment. The scores were initially numerous and poorly validated, but there is currently a trends towards simplification and standardization, with the work in particular of the Harmonizing Outcome Measures for Eczema (HOME) group. Scores for objective clinical signs, patient-reported symptoms, quality of life, and long-term disease control are now considered to be the core outcome set. The most used scores are detailed in this article. © 2020 Elsevier Masson SAS. All rights reserved.
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Affiliation(s)
- J-P Lacour
- Service de dermatologie, Hôpital Archet 2, CHU de Nice, CS 23079 06202, Nice, Cedex 3, France.
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Lindenmann J, Fink-Neuboeck N, Porubsky C, Fediuk M, Anegg U, Kornprat P, Smolle M, Maier A, Smolle J, Smolle-Juettner FM. A nomogram illustrating the probability of anastomotic leakage following cervical esophagogastrostomy. Surg Endosc 2020; 35:6123-6131. [PMID: 33106886 PMCID: PMC8523496 DOI: 10.1007/s00464-020-08107-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 10/16/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Early diagnosis of anastomotic dehiscence following cervical esophagogastrostomy may become difficult. Estimation of an individual probability could help to establish preventive and diagnostic measures. The predictive impact of epidemiological, surgery-related data and laboratory parameters on the development of anastomotic dehiscence was investigated in the immediate perioperative period. METHODS Retrospective study in 412 patients with cervical esophagogastrostomy following esophagectomy. Epidemiological data, risk factors, underlying disease, pre-treatment- and surgery-related data, C-reactive protein and albumin levels pre-and post-operatively were evaluated. We applied univariable and multivariable logistic regression analysis and developed a nomogram for individual risk assessment. RESULTS There were 345 male, 67 female patients, mean aged 61.5 years; 284 had orthotopic, 128 retrosternal gastric pull-up; 331 patients had carcinoma, 81 non-malignant disease. Mean duration of operation was 184 min; 235 patients had manual, 113 mechanical and 64 semi-mechanical suturing; 76 patients (18.5%) developed anastomotic dehiscence clinically evident at mean 11.4 days after surgery. In univariable testing young age, retrosternal conduit transposition, manual suturing, high body mass index, high ASA and high postoperative levels of C-reactive protein were predictors for anastomotic leakage. These six parameters which had yielded a p < 0.1 in the univariable analysis, were entered into a multivariable analysis and a nomogram allowing the determination of the patient's individual risk was created. CONCLUSION By using the nomogram as a supportive measure in the perioperative management, the patient's individual probability of developing an anastomotic leak could be quantified which may help to take preventive measures improving the outcome.
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Affiliation(s)
- Joerg Lindenmann
- Division of Thoracic Surgery and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/3, 8036, Graz, Austria.
| | - Nicole Fink-Neuboeck
- Division of Thoracic Surgery and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/3, 8036, Graz, Austria
| | - Christian Porubsky
- Division of Thoracic Surgery and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/3, 8036, Graz, Austria
| | - Melanie Fediuk
- Division of Thoracic Surgery and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/3, 8036, Graz, Austria
| | - Udo Anegg
- Division of Thoracic Surgery and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/3, 8036, Graz, Austria
| | - Peter Kornprat
- Department of General Surgery, Medical University of Graz, Graz, Austria
| | - Maria Smolle
- Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria
| | - Alfred Maier
- Division of Thoracic Surgery and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/3, 8036, Graz, Austria
| | - Josef Smolle
- Institute of Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Freyja Maria Smolle-Juettner
- Division of Thoracic Surgery and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/3, 8036, Graz, Austria
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Abstract
CLINICAL ISSUE Patients with cystic fibrosis (CF) require regular follow-up examinations, usually from birth onwards, using imaging techniques. METHODS The conventional chest x‑ray examination is the only technique recommended by the guidelines at this age. The examination can be performed at every age and is well standardized. The radiation dose to the patient is small and does not require any sedation. RADIOLOGICAL FINDINGS AND CLASSIFICATION The typical structural changes of the bronchi and the lung parenchyma can be depicted. Typical findings are air-trapping, bronchiectasis, peribronchial cuffing, bronchial wall thickening, mucus plugging, nodular opacities, atelectasis and/or consolidations and hilar lymphadenopathy. Different scoring systems have been developed to allow for a relatively easy but reproducible assessment of the severity of the disease. The most important ones for daily clinical practice are the Chrispin-Norman score, Brasfield score, and the Wisconsin score. All of them show a good correlation with pulmonary function parameters and the clinical picture of the patients. PRACTICAL RECOMMENDATIONS It is recommended to take an annual X‑ray for patients with CF, and in addition in individual cases with clinical deterioration. Computed tomography (CT) can be performed if relevant information for treatment is expected to gained.
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Egglestone R, Sparkes D, Dushianthan A. Prediction of mortality in critically-ill elderly trauma patients: a single centre retrospective observational study and comparison of the performance of trauma scores. Scand J Trauma Resusc Emerg Med 2020; 28:95. [PMID: 32967736 PMCID: PMC7510154 DOI: 10.1186/s13049-020-00788-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 09/10/2020] [Indexed: 11/27/2022] Open
Abstract
Background Trauma in the elderly (≥ 65 years) population is increasing. This study compares the performance of trauma scoring systems in predicting 30-day mortality among the traumatised elderly patients admitted to the intensive care unit in a major trauma centre. Methods We collected retrospective data for all elderly trauma patients admitted to our intensive care units between January 2012 and December 2017. We assessed Injury Severity Score (ISS), Geriatric Trauma Outcome Score (GTOS) and the Trauma Audit and Research Network’s (TARN) Probability of Survival (Ps17) between survivors and non-survivors. Receiver operator characteristic (ROC) curves were used to assess the performance of these scoring systems. Results There were 255 elderly trauma patients with overall 30-day survival of 76%. There was a statistically significant difference in ISS, GTOS and Ps17 scores between survivors and non-survivors (p < 0.001). The area under the ROC curve (AUROC) was statistically significant for all 3, with AUROC of 0.66 (95% CI 0.59–0.74) for the ISS, 0.68 (95% CI 0.61–0.76) for the GTOS and 0.79 (95% CI 0.72–0.85) for the Ps17. The optimal cut-off points were ≥ 28, ≥ 142, ≤ 76.73 for ISS, GTOS and Ps17, respectively. Conclusion Both ISS and GTOS scoring systems preformed equally in predicting 30-day mortality in traumatised elderly patients admitted to the intensive care unit, however neither were robust enough to utilise in clinical practise. The Ps17 performed more robustly, although was not developed for prognosticating on individual patients. Larger prospective studies are needed to validate these scoring systems in critically-ill elderly traumatised patients, which may help to facilitate early prognostication.
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Affiliation(s)
- Rebecca Egglestone
- General Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK.
| | - David Sparkes
- General Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Ahilanandan Dushianthan
- General Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK.,Acute Perioperative and Critical Care Group, Southampton NIHR Biomedical Research Centre, University Hospital Southampton/ University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
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