scholarly journals Development and validation of a preoperative “difficulty score” for laparoscopic transabdominal adrenalectomy: a multicenter retrospective study

2021 ◽  
Author(s):  
Laura Alberici ◽  
Alessandro M. Paganini ◽  
Claudio Ricci ◽  
Andrea Balla ◽  
Zeno Ballarini ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Risk Model ◽  
Area Under The Curve ◽  
Training Group ◽  
Lesion Size ◽  
Reporting Odds Ratio ◽  
Postoperative Course ◽  
Difficulty Score ◽  
Model C ◽  
Development And Validation

Abstract Background A difficulty score for laparoscopic adrenalectomy (LA) is lacking in the literature. A retrospective cohort study was designed to develop a preoperative “difficulty score” for LA. Methods A multicenter study was conducted involving four Italian tertiary centers for adrenal disease. The population was randomly divided into two subsets: training group and validation one. A multicenter study was undertaken, including 964 patients. Patient, adrenal lesion, surgeon’s characteristics, and the type of procedure were studied as potential predictors of target events. The operative time (pOT), conversion rate (cLA), or both were used as indicators of the difficulty in three multivariate models. All models were developed in a training cohort (70% of the sample) and validated using 30% of patients. For all models, the ability to predict complicated postoperative course was reported describing the area under the curve (AUCs). Logistic regression, reporting odds ratio (OR) with p-value, was used. Results In model A, gender (OR 2.04, p = 0.001), BMI (OR 1.07, p = 0.002), previous surgery (OR 1.29, p = 0.048), site (OR 21.8, p < 0.001) and size of the lesion (OR 1.16, p = 0.002), cumulative sum of procedures (OR 0.99, p < 0.001), extended (OR 26.72, p < 0.001) or associated procedures (OR 4.32, p = 0.015) increased the pOT. In model B, ASA (OR 2.86, p = 0.001), lesion size (OR 1.20, p = 0.005), and extended resection (OR 8.85, p = 0.007) increased the cLA risk. Model C had similar results to model A. All scores obtained predicted the target events in validation cohort (OR 1.99, p < 0.001; OR 1.37, p = 0.007; OR 1.70, p < 0.001, score A, B, and C, respectively). The AUCs in predicting complications were 0.740, 0.686, and 0.763 for model A, B, and C, respectively. Conclusion A difficulty score based on both pOT and cLA (Model C) was developed using 70% of the sample. The score was validated using a second cohort. Finally, the score was tested, and its results are able to predict a complicated postoperative course.

Development and validation of novel diagnostic nomogram for tuberculous pleurisy based on TB-IGRA results

2020 ◽  
Vol 24 (11) ◽  
pp. 1178-1185
Author(s):  
R. Zhang ◽  
P. Tian ◽  
S. Zhao ◽  
W. Li
Keyword(s):  
Differential Diagnosis ◽  
Peripheral Blood ◽  
Area Under The Curve ◽  
Training Group ◽  
Validation Group ◽  
Igra Test ◽  
Interferon Gamma Release Assays ◽  
Tuberculous Pleurisy ◽  
Blood Characteristics ◽  
Development And Validation

OBJECTIVE: To establish the diagnostic nomogram for tuberculous pleurisy (TP) based on TB-interferon-gamma release assays (TB-IGRA), as well as clinical and peripheral blood characteristics.MATERIAL AND METHODS: Patients who underwent TB-IGRA tests during hospitalisation and were finally diagnosed, were retrospectively and continuously enrolled. TP was divided into confirmed TP (cTP) and presumptive TP (pTP), and corresponding diagnostic nomograms were established.RESULTS: A total of 1283 patients were enrolled (median age 49 years, range 14–96; males: 63.1%). The area under the curve (AUC) of TB-IGRA was 0.81 (95%CI 0.77–0.84) for cTP (n = 272) and 0.74 (95%CI 0.71–0.78) for pTP (n = 644). The false-positive and negative rates of TB-IGRA among non-TP and cTP were respectively 32.4% and 16.8%. Based on LASSO analysis, we then selected respectively 12 and 10 predictors from clinical and peripheral blood characteristics to establish cTP and pTP nomograms (TB-IGRA was selected). The cTP and pTP nomograms had an AUC of 0.93 (95%CI 0.90–0.95) and 0.92 (95%CI 0.90–0.94) in the training group, and 0.91 (95%CI 0.87–0.96) and 0.93 (95%CI 0.89–0.96) in the validation group, respectively, which were superior to TB-IGRA test alone.CONCLUSION: Novel predictive nomograms with less invasiveness were provided based on TB-IGRA test to assist differential diagnosis of TP and non-TP patients.

Development and Validation of Spectrophotometric and Liquid Chromatographic Methods for Estimation of Tigecycline in Injections

2020 ◽  
Vol 13 (5) ◽  
pp. 5148-5154
Author(s):  
Sagar Suman Panda ◽  
Ravi Kumar B.V.V.
Keyword(s):  
Area Under The Curve ◽  
Reversed Phase ◽  
Equal Concentration ◽  
Pharmaceutical Dosage Form ◽  
Liquid Chromatographic Method ◽  
Array Detection ◽  
The Difference ◽  
The One ◽  
Development And Validation ◽  
Liquid Chromatographic

Three new analytical methods were optimized and validated for the estimation of tigecycline (TGN) in its injection formulation. A difference UV spectroscopic, an area under the curve (AUC), and an ultrafast liquid chromatographic (UFLC) method were optimized for this purpose. The difference spectrophotometric method relied on the measurement of amplitude when equal concentration solutions of TGN in HCl are scanned against TGN in NaOH as reference. The measurements were done at 340 nm (maxima) and 410nm (minima). Further, the AUC under both the maxima and minima were measured at 335-345nm and 405-415nm, respectively. The liquid chromatographic method utilized a reversed-phase column (150mm×4.6mm, 5µm) with a mobile phase of methanol: 0.01M KH2PO4 buffer pH 3.5 (using orthophosphoric acid) in the ratio 80:20 %, v/v. The flow rate was 1.0ml/min, and diode array detection was done at 349nm. TGN eluted at 1.656min. All the methods were validated for linearity, precision, accuracy, stability, and robustness. The developed methods produced validation results within the satisfactory limits of ICH guidance. Further, these methods were applied to estimate the amount of TGN present in commercial lyophilized injection formulations, and the results were compared using the One-Way ANOVA test. Overall, the methods are rapid, simple, and reliable for routine quality control of TGN in the bulk and pharmaceutical dosage form. 

scholarly journals Prognostic Value of Plasma hPG80 (Circulating Progastrin) in Metastatic Renal Cell Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 375
Author(s):  
Manish Kohli ◽  
Winston Tan ◽  
Bérengère Vire ◽  
Pierre Liaud ◽  
Mélina Blairvacq ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Prognostic Value ◽  
Risk Model ◽  
Predictive Accuracy ◽  
Area Under The Curve ◽  
Risk Groups ◽  
Prognostic Impact ◽  
Significant Difference

Precise management of kidney cancer requires the identification of prognostic factors. hPG80 (circulating progastrin) is a tumor promoting peptide present in the blood of patients with various cancers, including renal cell carcinoma (RCC). In this study, we evaluated the prognostic value of plasma hPG80 in 143 prospectively collected patients with metastatic RCC (mRCC). The prognostic impact of hPG80 levels on overall survival (OS) in mRCC patients after controlling for hPG80 levels in non-cancer age matched controls was determined and compared to the International Metastatic Database Consortium (IMDC) risk model (good, intermediate, poor). ROC curves were used to evaluate the diagnostic accuracy of hPG80 using the area under the curve (AUC). Our results showed that plasma hPG80 was detected in 94% of mRCC patients. hPG80 levels displayed high predictive accuracy with an AUC of 0.93 and 0.84 when compared to 18–25 year old controls and 50–80 year old controls, respectively. mRCC patients with high hPG80 levels (>4.5 pM) had significantly lower OS compared to patients with low hPG80 levels (<4.5 pM) (12 versus 31.2 months, respectively; p = 0.0031). Adding hPG80 levels (score of 1 for patients having hPG80 levels > 4.5 pM) to the six variables of the IMDC risk model showed a greater and significant difference in OS between the newly defined good-, intermediate- and poor-risk groups (p = 0.0003 compared to p = 0.0076). Finally, when patients with IMDC intermediate-risk group were further divided into two groups based on hPG80 levels within these subgroups, increased OS were observed in patients with low hPG80 levels (<4.5 pM). In conclusion, our data suggest that hPG80 could be used for prognosticating survival in mRCC alone or integrated to the IMDC score (by adding a variable to the IMDC score or by substratifying the IMDC risk groups), be a prognostic biomarker in mRCC patients.

scholarly journals Predicting drowning from sea and weather forecasts: development and validation of a model on surf beaches of southwestern France

2021 ◽  
pp. injuryprev-2020-044092
Author(s):  
Éric Tellier ◽  
Bruno Simonnet ◽  
Cédric Gil-Jardiné ◽  
Marion Lerouge-Bailhache ◽  
Bruno Castelle ◽  
...  
Keyword(s):  
Regression Models ◽  
Area Under The Curve ◽  
Temperature Wave ◽  
Medical Emergency ◽  
Emergency Center ◽  
Logistic Regression Models ◽  
Weather Forecasts ◽  
Step Model ◽  
Daily Risk ◽  
Development And Validation

ObjectiveTo predict the coast-wide risk of drowning along the surf beaches of Gironde, southwestern France.MethodsData on rescues and drownings were collected from the Medical Emergency Center of Gironde (SAMU 33). Seasonality, holidays, weekends, weather and metocean conditions were considered potentially predictive. Logistic regression models were fitted with data from 2011 to 2013 and used to predict 2015–2017 events employing weather and ocean forecasts.ResultsAir temperature, wave parameters, seasonality and holidays were associated with drownings. Prospective validation was performed on 617 days, covering 232 events (rescues and drownings) reported on 104 different days. The area under the curve (AUC) of the daily risk prediction model (combined with 3-day forecasts) was 0.82 (95% CI 0.79 to 0.86). The AUC of the 3-hour step model was 0.85 (95% CI 0.81 to 0.88).ConclusionsDrowning events along the Gironde surf coast can be anticipated up to 3 days in advance. Preventative messages and rescue preparations could be increased as the forecast risk increased, especially during the off-peak season, when the number of available rescuers is low.

Performance of Abbreviated Protocols Versus Unenhanced MRI in Detecting Occult Breast Lesions of Mammography in Patients with Dense Breasts

2021 ◽  
Author(s):  
Suhong Zhao ◽  
Peipei Chen ◽  
Guangrui Shao ◽  
Baijie Li ◽  
Huikun Zhang ◽  
...  
Keyword(s):  
Reading Time ◽  
Area Under The Curve ◽  
Lesion Size ◽  
Lower Sensitivity ◽  
Chi Square ◽  
Dense Breast Tissue ◽  
Negative Findings ◽  
Chi Square Test ◽  
The Difference ◽  
Sensitivity Specificity

Abstract Objective: To assess the diagnostic ability of abbreviated protocols of MRI (AP-MRI) compared with unenhanced MRI (UE-MRI) in mammographically occult cancers in patients with dense breast tissue.Materials and Methods: The retrospective analysis consisted of 102 patients without positive findings on mammography who received preoperative MRI full diagnostic protocols (FDP) between January 2015 and December 2018. Two breast radiologists read the UE, AP, and FDP. The interpretation times were recorded. The comparisons of the sensitivity, specificity and area under the curve of each MRI protocol, and the sensitivity of these protocols in each subgroup of different size tumors used the Chi-square test. The paired sample t-test was used for evaluating the difference of reading time of the three protocols.Results: Among 102 women, there were 68 cancers and two benign lesions in 64 patients and 38 patients had benign or negative findings. Both readers found the sensitivity and specificity of AP and UE-MRI were similar (p>0.05), whereas compared with FDP, UE had lower sensitivity (Reader 1/Reader 2: p=0.023, 0.004). For different lesion size groups, one of the readers found that AP and FDP had higher sensitivities than UE-MRI for detecting the lesions ≤10 mm in diameter (p=0.041, p=0.023). Compared with FDP, the average reading time of UE-MRI and AP was remarkably reduced (p < 0.001).Conclusion: AP-MRI had more advantages than UE-MRI to detect mammographically occult cancers, especially for breast tumors ≤10 mm in diameter.

scholarly journals Prognostic model and immune-infiltrating cell landscape based on differentially expressed autophagy-related genes in TP53-mutated multiple myeloma

2021 ◽  
Author(s):  
Yan-Hua Zheng ◽  
Hong-Yuan Shen ◽  
Xiang Chen ◽  
Juan Feng ◽  
Guang-Xun Gao
Keyword(s):  
Multiple Myeloma ◽  
Prognostic Model ◽  
Risk Model ◽  
Predictive Accuracy ◽  
Area Under The Curve ◽  
Threshold Value ◽  
Differentially Expressed ◽  
Term Survival ◽  
Tp53 Mutations ◽  
Infiltrating Cells

IntroductionAutophagy functions as a prosurvival mechanism in multiple myeloma (MM).The objective of this research was to establish an autophagy-related gene (ARG) signature for predicting the survival outcomes of MM patients with TP53 mutations.Material and methodsInformation about MM patients with TP53 mutations was downloaded from Gene Expression Omnibus (GEO) database. Cox proportional hazard regression was employed to determine the independent prognostic ARG and construct a risk signature. Time-dependent receiver-operating characteristic (t ROC) curve was used to explore the predictive accuracy of the prognostic model. A nomogram was constructed to give a more precise prediction of the probability of 5-year, 8-year and 10-year overall survival (OS). In addition, we utilized the CIBERSORT algorithm to explore the distribution difference of 22 immune-infiltrating cells.ResultsThree differentially expressed ARGs (CASP8, MAPK8, RB1CC1) were finally incorporated to construct the risk model. Area under the curve (AUC) of corresponding tROC curve for 5-year,8-year and 10-year OS were 0.735, 0.686 and 0.662, respectively. MM patients were categorized into high and low-risk group in accordance with the median threshold value (-1.724549). ARG-based risk score model was an independent prognostic element correlated with OS, giving an hazard ratio (HR) of 3.29 (95%CI 2.35-4.60, P<0.001). 13 immune infiltrating cells were found to have distribution differences between the two groups.ConclusionsWe established a three-ARGs risk signature which manifested an independent prognostic factor. The nomogram was testified to perform well in forecasting the long-term survival of TP53-mutated MM patients.

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