scholarly journals The usefulness of a trauma probability of survival model for forensic life-threatening danger assessments

2021 ◽  
Author(s):  
Lykke Schrøder Jakobsen ◽  
Niels Lynnerup ◽  
Jacob Steinmetz ◽  
Jytte Banner
Keyword(s):  
Roc Curve ◽  
Area Under The Curve ◽  
Chi Square ◽  
Probability Of Survival ◽  
Forensic Practice ◽  
Significant Difference ◽  
Chi Square Test ◽  
Life Threatening ◽  
Trauma Score ◽  
Medical Examinations

AbstractClinical forensic medical examinations constitute an increasing proportion of our institution’s tasks, and, concomitantly, the authorities are now requesting forensic life-threatening danger assessments based on our examinations. The aim of this retrospective study was to assess if a probability of survival (PS) trauma score could be useful for these forensic life-threatening danger assessments and to identify a cut-off PS score as a supporting tool for the forensic practice of assessing life-threatening danger. We compared a forensic database and a trauma database and identified 161 individuals (aged 15 years or older) who had both a forensic life-threatening danger assessment and a PS score. The life-threatening danger assessments comprised the following statements: was not in life-threatening danger (NLD); could have been in life-threatening danger (CLD); or was in life-threatening danger (LD). The inclusion period was 2012–2016. A statistically significant difference was found in the PS scores between NLD, CLD and LD (chi-square test: p < 0.0001). The usefulness of the PS score for categorizing life-threatening danger assessments was determined by a receiver-operator characteristic (ROC) curve. The area under the curve was 0.76 (95% CI, 0.69 to 0.84) and the ROC curve revealed that a cut-off PS score of 95.8 would appropriately identify LD. Therefore, a PS score below 95.8 would indicate life-threatening danger. We propose a further exploration of how the evidence-based PS score, including a cut-off value, might be implemented in clinical forensic medical statements to add to the scientific strength of these statements.

scholarly journals Life-threatening danger assessments of penetrating injuries in Eastern Danish clinical forensic medicine

2021 ◽  
Author(s):  
Lykke Schrøder Jakobsen ◽  
Marie Toftdahl Christensen ◽  
Sissel Banner Lundemose ◽  
Julie Munkholm ◽  
Anne Birgitte Dyhre Bugge ◽  
...  
Keyword(s):  
Clinical Forensic Medicine ◽  
Chi Square ◽  
Perfect Agreement ◽  
Moderate Severity ◽  
Protocol Implementation ◽  
Forensic Practice ◽  
Before And After ◽  
Chi Square Test ◽  
Life Threatening ◽  
Strong Agreement

AbstractClinical forensic assessments of injuries’ life-threatening danger may have an impact on the legal aftermath following a violent assault. The pursuit of evidence-based guidelines should ensure a user-independent and reproducible forensic practice. However, does it? The aim of this study was to evaluate the forensic life-threatening danger assessments after a protocol implementation in 2016. The evaluation concerned usability and reproducibility of the protocol, and its influence on assessment severity. We analyzed the level of inter- and intra-rater agreement using 169 blinded, prior-protocol cases that were reassessed by two forensic specialists. We compared assessment made the year before and after protocol implementation (n = 262), and the forensic specialists’ reassessments with the prior-protocol cases’ original assessments (n = 169). Whether to make an assessment, the levels of agreement varied between weak agreement (inter-rater, Κ = 0.43; assessor 1, Κ = 0.57) and strong agreement (assessor 2, Κ = 0.90). Regarding severity, the levels of agreement varied between strong agreement (inter-rater, Κ = 0.87; assessor 1: Κ = 0.90) and almost perfect agreement (assessor 2: Κ = 0.94). The assessments were statistically significant redistributed after the implementation (chi-square test: p < 0.0001). The proportion of cases assessed as having not been in life-threatening danger increased from 9 to 43%, and moderate severity assessments decreased from 55 to 23%. Of the moderate severity assessments, 55% were reassessed as having not been in life-threatening danger. The protocol ensured independent and reproducible assessments when the forensic specialists agreed on making one. The protocol resulted in less severe assessments. Future studies should examine the reliability of the protocol and its consequences for legal aftermaths.

Sperm-Associated Antigen 9 Assumes Signifying Capacity in Hepatocellular Carcinoma Diagnosis

2020 ◽  
Author(s):  
Zhong Dai ◽  
Ke-Qing Yao ◽  
Xing-Sheng Hu ◽  
Yi-Qun Li ◽  
Yu-Tao Liu ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Clinical Characteristics ◽  
Mrna Level ◽  
Area Under The Curve ◽  
Enzyme Linked Immunosorbent Assay ◽  
Clinical Value ◽  
Chi Square ◽  
Protein Levels ◽  
Chi Square Test

Abstract Background: Sperm-associated antigen 9 (SPAG9) has been proposed as a novel biomarker for early diagnosis of human tumors. This study was aimed to assess the clinical value of serum SPAG9 for HCC diagnosis.Methods: Serum SPAG9 was measured by quantitative real-time ploymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA). Chi-square test was applied to evaluate the association between serum SPAG9 mRNA level and clinical characteristics. The diagnostic accuracy of the serum SPAG9 mRNA was assessed using receiver operating characteristic (ROC) curve.Results: Serum SPAG9 level was significantly higher in HCC patients than that in healthy controls at both mRNA and protein levels (P<0.01 for all). Furthermore, serum SPAG9 mRNA level was positively correlated with TNM stage (P=0.047), tumor size (P=0.044), and lymph node metastasis (P=0.014). The area under the curve (AUC) of the ROC curve was 0.794, with a sensitivity of 71.4%, a specificity of 80.4%, suggesting the high diagnostic accuracy of serum SPAG9 mRNA for HCC. The cutoff value was 1.030.Conclusions: Serum SPAG9 is significantly increased in HCC, and positively correlated with aggressive clinical characteristics. SPAG9 may serve as a diagnostic biomarker for HCC.

scholarly journals Comparison of EuroSCORE II with EuroSCORE in Cardiac Surgical Patients in a Tertiary Level Teaching Hospital in Nepal

2020 ◽  
Vol 42 (2) ◽  
pp. 5-9
Author(s):  
Bishwas Pradhan ◽  
Priska Bastola ◽  
Madindra B Basnet ◽  
Bibhush Shrestha ◽  
Shailendra Sigdel ◽  
...  
Keyword(s):  
Roc Curve ◽  
Additive Model ◽  
Area Under The Curve ◽  
Surgical Patients ◽  
Operating Characteristics ◽  
Chi Square ◽  
Discrimination Power ◽  
Standard Tool ◽  
Chi Square Test ◽  
Cardiac Operative Risk Evaluation

Introduction European System for Cardiac Operative Risk Evaluation (EuroSCORE) is the standard tool for risk stratification of patients undergoing cardiac surgery. Its relevance has been validated in European, Asian countries and also in Nepal. Its limitations led to development of EuroSCORE II. This study was carried out to compare EuroSCORE II with EuroSCORE in Nepalese cardiac surgical patients. MethodsA retrospective analytical cohort study of 3 years duration in 972 adult cardiac surgeries was conducted. Scores obtained from EuroSCORE (Logistic and Additive) and EuroSCORE II was compared with the observed mortality. Calibration was calculated by Hosmer- Lemeshow (H-L) test (Chi Square test) and discrimination by calculating the area under the curve (AUC) of receiver operating characteristics (ROC) curve. ResultsObserved mortality was 4.11%. EuroSCORE additive, logistic and EuroSCORE II predicted mortality were 4.32%, 4.55% and 2.13% respectively. H-L chi square calculation for EuroSCORE additive model could not hold as all observed and expected frequencies match exactly. Hence it can be considered as a good fit. EuroSCORE logistic model (H-L, Chi-square 7.743, p<0.001) and EuroSCORE II (H-L, Chi-square 11.631, p = 0.168) also showed good fit i.e. both can predict mortality satisfactorily. AUC of ROC curve of EuroSCORE additive, logistic and EuroSCORE II were 0.632, 0.636 and 0.616 respectively, which showed fair discrimination power. ConclusionMortality prediction of adult cardiac surgical patients by EuroSCORE (additive and logistic) and EuroSCORE II was satisfactory.

scholarly journals Per1 has the capacity to serve as a diagnostic biomarker for cholangiocarcinoma patient

2020 ◽  
Author(s):  
Ning Wang ◽  
Yanni Li ◽  
Yanfang Zheng ◽  
Huoming Chen ◽  
Xiaolong Wen ◽  
...  
Keyword(s):  
Roc Curve ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Diagnostic Value ◽  
Positive Lymph Node ◽  
Early Screening ◽  
Chi Square ◽  
Potential Biomarker ◽  
Tumorigenesis And Progression ◽  
Chi Square Test

Abstract Background Period 1 (Per1) had been reported to be involved in the tumorigenesis and progression of human cancers. However, the clinical significance of Per1 in cholangiocarcinoma (CCA) was unclear. The purpose of this study was to explore the diagnostic value of serum Per1 in CCA patients. Methods Serum levels of Per1 in CCA patients and healthy individuals were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Chi-square test was used to evaluate the relationship between Per1 expression and clinical characteristics of patients. The diagnostic value of Per1 in CCA was estimated by establishing a receiver operating characteristic (ROC) curve. Results Serum Per1 level was significantly down-regulated in CCA patients compared to that in healthy controls (P < 0.001). Moreover, the decreased expression of Per1 was closely associated with poor histological differentiation (P = 0.040), advanced TNM stage (P = 0.035) and positive lymph node metastasis (P = 0.007). ROC curve indicated that the area under the curve (AUC) was 0.863 with a sensitivity of 88.1% and a specificity of 72.1%, revealing the high diagnostic value of serum Per1 in CCA. Conclusions Per1 is down-regulated in CCA and negatively correlated with tumor progression. Serum Per1 may be a potential biomarker for early screening of CCA.

scholarly journals A Lower Dose of Magnesium Sulphate for Control of Convulsion in Eclamptic Women of Bangladesh

2013 ◽  
Vol 25 (2) ◽  
pp. 71-76
Author(s):  
N Sultana ◽  
K Begum ◽  
A Begum ◽  
U Akhter
Keyword(s):  
Magnesium Sulphate ◽  
Control Group ◽  
Loading Dose ◽  
Chi Square ◽  
College Hospital ◽  
Medical College ◽  
Significant Difference ◽  
Chi Square Test ◽  
Life Threatening ◽  
One Year

Eclampsia, a life threatening complication of pregnancy. It is one of the important cause of  maternal mortality of Bangladesh. Eclamptic seizure can effectively controlled by use of  magnesium sulphate. A prospective randomized case control study was conducted at eclampsia ward of Dhaka Medical College Hospital for one year from June 2007 to May 2008.Objective: To find out whether only 8gm of magnesium sulphate heptahydrate (Nalepsin) as a  single loading dose is sufficient to control eclamptic convulsion and also to compare the efficacy between 8gm & 10gm of MgSo4 used to control convulsion.Methodology: A random selection was done by lottery of those antepartum and intrapartum  cases who fulfill the selection criteria. Hundred patient were selected and grouped them into  case & control. 8gm Nalepsion (Magnesium sulphate heptahydrate) as a single I.V dose was  selected for case and 10gm MgSo4 (4gm I.V + 3gm I.M in each buttock) was for control  group. Different variables were compaired and results were analyzed by unpaired ‘t’ test and chi-square test (X2) by SPSS programme. Result: Statistically there was no significant difference of any finding between two groups after comparing all variables individually.Conclusion: 8gm Nalepsin intravenously as a single loading dose is sufficient to control  eclamptic convulsion and prevention of its recurrence.DOI: http://dx.doi.org/10.3329/bjog.v25i2.13743 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(2) : 71-76  

The Influence of Age and Gender on Mandibular Indices among the Libyan Population

2019 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Negative Correlation ◽  
Bone Mineralization ◽  
Age Groups ◽  
T Test ◽  
Chi Square ◽  
Age And Gender ◽  
Significant Difference ◽  
Chi Square Test ◽  
And Gender ◽  
Libyan Population

Radiographic Mandibular Indices serve as easy and relatively cheap tools for evaluating bone mineralization. Objectives: To examine the effect of age and gender on three mandibular indices: the panoramic mandibular index (PMI), the mandibular ratio (MR) and the mandibular cortical index (MCI), among Libyan population. Methods: The three indices were measured on 317 digital (OPGs) of adult humans (155 males, 162 females). The sample was divided into six age groups (from 18-25 years through 56-65 years). The measurements were analyzed for interactions with age and sex, using SPSS (Statistical Package for Social Studies) software version no. 22. The tests employed were two way ANOVA, the unpaired T-test and chi-square test. Results: The mean PMI fluctuated between 0.37 s.d. 0.012 and 0.38 s.d. 0.012. among the sixth age groups. One-way ANOVA statistical test revealed no significant of age on PMI. On the other hand gender variation has effect on PMI, since independent sample t-test disclosed that the difference between the male and female PMI means statistically significant. ANOVA test showed that the means of MR among age groups showed a negative correlation i.e. MR mean declined from 3.01 in 18-25 age groups to 2.7 in 55-65 age groups. In contrary, the gender showed no effect on MR according two sample t-test at p> 0.05. In regards with MCI, statistical analysis showed that it affected by age that is C1 was decreasing by age while C2 and C3 were increased by age. Using chi square test the result indicated that there is a significant difference among the different age group and the two genders in MCI readings. Conclusion: PMI was influenced significantly by age but minimally by the gender. MR is not affected by gender but has a negative correlation with age. MCI is affected by both age and gender

scholarly journals Prognostic significance of peritoneal cytology in low-risk endometrial cancer: comparison of laparoscopic surgery and laparotomy

2021 ◽  
Author(s):  
Satoe Fujiwara ◽  
Ruri Nishie ◽  
Shoko Ueda ◽  
Syunsuke Miyamoto ◽  
Shinichi Terada ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Laparoscopic Surgery ◽  
Retrospective Study ◽  
Prognostic Significance ◽  
Low Risk ◽  
Peritoneal Cytology ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test ◽  
Positive Peritoneal Cytology

Abstract Background There is uncertainty surrounding the prognostic value of peritoneal cytology in low-risk endometrial cancer, especially in laparoscopic surgery. The objective of this retrospective study is to determine the prognostic significance of positive peritoneal cytology among patients with low-risk endometrial cancer and to compare it between laparoscopic surgery and conventional laparotomy. Methods From August 2008 to December 2019, all cases of pathologically confirmed stage IA grade 1 or 2 endometrial cancer were reviewed at Osaka Medical College. Statistical analyses used the Chi-square test and the Kaplan–Meier log rank. Results A total of 478 patients were identified: 438 with negative peritoneal cytology (232 who underwent laparotomy and 206 who undertook laparoscopic surgery) and 40 with positive peritoneal cytology (20 who underwent laparotomy and 20 who received laparoscopic surgery). Survival was significantly worse among patients with positive peritoneal cytology compared to patients with negative peritoneal cytology. However, there was no significant difference among patients with negative or positive peritoneal cytology between laparoscopic surgery and laparotomy. Conclusion This retrospective study suggests that, while peritoneal cytology is an independent risk factor in patients with low-risk endometrial cancer, laparoscopic surgery does not influence the survival outcome when compared to laparotomy.

scholarly journals Effect of corneal refractive surgery on accommodative and binocular dysfunctions among civilian pilots in Southwest China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ye Wu ◽  
Zhen Zhang ◽  
Meng Liao ◽  
Qi Li ◽  
Xue Lin Tang ◽  
...  
Keyword(s):  
Binocular Vision ◽  
Refractive Surgery ◽  
Visual Symptom ◽  
Chi Square ◽  
Visual Symptoms ◽  
Significant Difference ◽  
Symptom Scores ◽  
Chi Square Test ◽  
Corneal Refractive Surgery ◽  
Normal Binocular Vision

Abstract Background To analyze whether corneal refractive surgery (CRS) is associated with the distribution of different accommodative dysfunctions (ADs) and binocular dysfunctions (BDs) in civilian pilots. A further aim was to analyze the percentages and visual symptoms associated with ADs and/or BDs in this population. Methods One hundred and eight civilian pilots who underwent CRS from January 2001 to July 2012 (age: 30.33 ± 4.60 years) were enrolled, the mean preoperative SE was − 1.51 ± 1.15 D (range: − 1.00- − 5.00 D). Ninety-nine emmetropic civilian pilots (age: 29.64 ± 3.77 years) who were age- and sex-matched to the CRS group were also enrolled. Refractive status, accommodative and binocular tests of each subject were performed. Visually related symptoms were quantified using the 19-item College of Optometrists in Vision Development Quality of Life (COVD-QOL) questionnaire. The 19 items were summed to obtain visual symptom scores that might indicate visual dysfunctions. The chi-square test was used to analyze differences in percentages of ADs and/or BDs between the CRS and emmetropic groups. The Mann-Whitney U test was used to compare visual symptom scores between pilots with ADs and/or BDs and pilots with normal binocular vision. Results No significant difference was observed between the CRS and emmetropic groups in the overall prevalence of ADs and BDs (15.7% and 15.2% in the CRS and emmetropic groups, respectively; P = 0.185). ADs were present in 4.63% and 3.03% of the CRS and emmetropic group, respectively. BDs were observed in 11.1% and 12.1% of the CRS and emmetropic group, respectively, yielding no significant differences between the groups in the prevalence of ADs or BDs (AD: P = 0.094; BD: P = 0.105). Pilots with ADs and/or BDs had significantly more visual symptoms than pilots with normal binocular vision (p < 0.001). Conclusions CRS for civilian pilots with low-moderate myopia might not impact binocular functions. ADs and/or BDs commonly occur in both emmetropia pilots and pilots who undergo CRS, and pilots with ADs and/or BDs are associated with increased symptoms. This study confirms the importance of a full assessment of binocular visual functions in detecting and remedying these dysfunctions in this specific population.

scholarly journals Antimicrobial Efficacy of Propolis in Comparison to Chlorhexidine against Enterococcus faecalis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (8) ◽  
pp. 3469
Author(s):  
Khalid H. Almadi ◽  
Muhammad Adeel Ahmed ◽  
Tuba Ghazal ◽  
Rizwan Jouhar ◽  
Mazen F. Alkahtany ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Meta Analysis ◽  
Mean Difference ◽  
Permanent Teeth ◽  
Antibacterial Efficacy ◽  
Chi Square ◽  
Reporting Standard ◽  
Standard Mean Difference ◽  
Significant Difference ◽  
Chi Square Test

Propolis is proposed to possess antibacterial and anti-inflammatory properties, which can be used in endodontic applications. However, evidence on its efficacy in comparison to chlorhexidine against Enterococcus faecalis (E. faecalis) is controversial. The aim of the current study was to compare the antibacterial efficacy of Propolis and chlorhexidine as an intracanal medicament against E. faecalis in extracted human permanent teeth. The focused question was, “Does Propolis show better antibacterial efficacy than Chlorhexidine (CHX) as an intracanal medicament against E. faecalis in extracted human permanent teeth?”. Databases including PubMed/Medline, Scopus, EMBASE, ISI-Web of Science were searched from 1990 to August 2020 using different combinations of the following keywords: “Propolis”, “Intracanal medicament”, “E. faecalis”, “Antibacterial activity” and “Chlorhexidine”. Ten studies fulfilling inclusion criteria were considered for qualitative analysis, followed by quantitative analysis of eight studies. Heterogeneity was calculated for colony forming units (CFU) of E. Faecalis using the Chi-square test and I2 statistics. Forest plots were computed reporting standard mean difference (SMD) of outcomes and 95% confidence intervals. The overall mean difference for CFU of E. faecalis showed a statistically significant difference between the antibacterial efficacy of Propolis and CHX (SMD = 3.20 [1.70, 4.69] Z = 4.20; p < 0.001). CHX showed superior antibacterial efficacy against E. faecalis compared to Propolis.

scholarly journals Rheumatologist perspective of the Brazilian consensus for detection of auto antibodies in HEp-2 CELLS

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Isadora Carvalho Medeiros Francescantonio ◽  
Leandro Augusto Rodrigues dos Santos ◽  
Paulo Luiz Carvalho Francescantonio ◽  
Luiz Eduardo Coelho Andrade ◽  
Wilson de Melo Cruvinel
Keyword(s):  
Clinical Practice ◽  
Immunofluorescence Assay ◽  
Chi Square ◽  
Dichotomous Data ◽  
Level Of Satisfaction ◽  
Significant Difference ◽  
Chi Square Test ◽  
Geographic Regions ◽  
Relevant Pattern ◽  
Structured Questionnaire

Abstract Objective To evaluate the perception of rheumatologists regarding the recommendations of the Brazilian Consensus for detection of Autoantibodies (BCA) on HEp-2 Cells by Indirect Immunofluorescence assay (IFA) and how BCA recommendations help in clinical practice. Methodology A structured questionnaire regarding the BCA recommendations for detection and interpretations of autoantibodies in HEp-2 cells was applied to randomly selected rheumatologists. The results were tabulated using the Microsoft® Excel program, expressed as a simple percentage and the dichotomous data were analyzed using the Chi-square test and the Epi Info® program. Results Four hundred fuorteen rheumatologists participated in the study: 70% of them considered their knowledge of the HEp-2 IFA test satisfactory or excellent, and 43% said they knew the BCA recommendations in general, without distinguishing the edition of the BCA to which they refer. The Revista Brasileira de Rheumatologia/Advances in Rheumatology was the means of dissemination most consulted by specialists (50%). According to the rheumatologists’ opinion, the most relevant pattern was the homogeneous nuclear (78%) and 65% stated they were satisfied with the BCA recommendations at a level of satisfaction greater than or equal to 80%. There was no significant difference in the perception of rheumatologists from the several Brazilian geographic regions. Conclusion Brazilian rheumatologists are aware of the BCA guidelines and most are satisfied with the content published, considering that the BCA recommendations assist positively in the clinical practice. Most rheumatologists recognize the patterns associated with rheumatic autoimmune diseases and have used BCA recommendations to interpret the results of the HEp-2 IFA test.

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