scholarly journals Association between cognitive quotient test score and hippocampal volume: a novel, rapid application-based screening tool

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Wataru Kasai ◽  
Tadahiro Goto ◽  
Yuki Aoyama ◽  
Kenji Sato

Abstract We aimed to develop a brief, preclinical test to screen the reduced hippocampal volume that is a marker of early dementia [Cognitive Quotient (CQ) test]. We performed an observational study of adult subjects who underwent brain MRI in seven institutions from February 2018 to May 2019. The CQ test consists of five components: (1) digits forward, (2) digits backward, (3) Stroop test, (4) simple calculation, and (5) mental rotation. The primary outcome measure was hippocampal volume. We separated the data into derivation (n = 322) and validation cohorts (n = 96). In the derivation cohort, we built two scoring systems using the results of CQ test (model 1 and 2). In the validation cohort, we validated the correlation of the scoring systems with hippocampal volume. In the derivation cohort, there was a moderate correlation between the scoring systems and hippocampal volume [e.g., correlation coefficient = 0.62 in model 1 (95% CI 0.44–0.75)]. Likewise, in the validation cohort, there was a moderate correlation between the scoring systems and hippocampal volume [e.g., correlation coefficient = 0.54 in model 2 (95% CI 0.38–0.67)]. In this analysis of 418 participants, the score of newly developed CQ test was correlated with hippocampal volume.

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H.-Y Kim ◽  
J.-H Choi ◽  
J.-H Doh ◽  
H.-S Lim ◽  
E.-S Shin ◽  
...  

Abstract Aims The burden of coronary artery disease has been assessed by various semi-quantitative angiographic scores, which are frequently different each other. A non-invasive and quantitative modality may substitute angiographic sores for prognostic implication and decision of revascularization strategy. We compared fractional myocardial mass (FMM) with angiographic scores for predicting myocardial ischemia. Methods In this multicenter registry, 411 patients who underwent coronary computed tomography angiography (CCTA) were followed by invasive coronary angiography and FFR measurement. CCTA–derived %FMM with diameter stenosis ≥70% (%FMM-70) or ≥50% (%FMM-50) were compared with 9 angiographic scores (APPROACH, Duke Jeopardy, BARI, CASS, SYNTAX, Jenkins, BCIS-1, Leaman, Modified Duke) and were tested regarding their performance for predicting FFR ≤0.80. Predictive performance of %FMM or angiographic scores for FFR ≤0.80 established in derivation cohort (N=250) and tested in validation cohort (N=161). Results The performance of %FMM-70 and %FMM-50 were similar to most angiographic scores (%FMM-70, c-statistics=0.76; %FMM-50, 0.71; angiographic scores, 0.68–0.79). The frequency of FFR ≤0.80 increased consistently according to %FMM-70, %FMM-50, and all angiographic scores (p<0.001, all). The optimal cutoff of %FMM-50 and %FMM-70 for FFR ≤0.80 were ≥34.5% and ≥9.8%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of %FMM-50 were 83%, 56%, 73%, 70%, 72%, and of %FMM-70 were 72%, 78%, 75%, 75%, and 75% using these cutoffs. Validation cohort showed consistent results. Conclusion %FMM correlated well with angiographic scores and had a potential to be used as a non-invasive alternative to the angiographic scores. The integration of the severity of stenosis and the amount of subtended myocardium may improve the detection of clinically significant coronary artery stenosis.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joseph Miller ◽  
Yiyang Wu ◽  
Rawan Safa ◽  
Georgiana Marusca ◽  
Sandeep Bhatti ◽  
...  

Abstract Background Existing scoring systems to predict mortality in acute pancreatitis may not be directly applicable to the emergency department (ED). The objective of this study was to derive and validate the ED-SAS, a simple scoring score using variables readily available in the ED to predict mortality in patients with acute pancreatitis. Methods This retrospective observational study was performed based on patient data collected from electronic health records across 2 independent health systems; 1 was used for the derivation cohort and the other for the validation cohort. Adult patients who were eligible presented to the ED, required hospital admission, and had a confirmed diagnosis of acute pancreatitis. Patients with chronic or recurrent episodes of pancreatitis were excluded. The primary outcome was 30-day mortality. Analyses tested and derived candidate variables to establish a prediction score, which was subsequently applied to the validation cohort to assess odds ratios for the primary and secondary outcomes. Results The derivation cohort included 599 patients, and the validation cohort 2011 patients. Thirty-day mortality was 4.2 and 3.9%, respectively. From the derivation cohort, 3 variables were established for use in the predictive scoring score: ≥2 systemic inflammatory response syndrome (SIRS) criteria, age > 60 years, and SpO2 < 96%. Summing the presence or absence of each variable yielded an ED-SAS score ranging from 0 to 3. In the validation cohort, the odds of 30-day mortality increased with each subsequent ED-SAS point: 4.4 (95% CI 1.8–10.8) for 1 point, 12.0 (95% CI 4.9–29.4) for 2 points, and 41.7 (95% CI 15.8–110.1) for 3 points (c-statistic = 0.77). Conclusion An ED-SAS score that incorporates SpO2, age, and SIRS measurements, all of which are available in the ED, provides a rapid method for predicting 30-day mortality in acute pancreatitis.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254580
Author(s):  
Nasheena Jiwa ◽  
Rahul Mutneja ◽  
Lucie Henry ◽  
Garrett Fiscus ◽  
Richard Zu Wallack

Patients hospitalized with COVID-19 infection are at a high general risk for in-hospital mortality. A simple and easy-to-use model for predicting mortality based on data readily available to clinicians in the first 24 hours of hospital admission might be useful in directing scarce medical and personnel resources toward those patients at greater risk of dying. With this goal in mind, we evaluated factors predictive of in-hospital mortality in a random sample of 100 patients (derivation cohort) hospitalized for COVID-19 at our institution in April and May, 2020 and created potential models to test in a second random sample of 148 patients (validation cohort) hospitalized for the same disease over the same time period in the same institution. Two models (Model A: two variables, presence of pneumonia and ischemia); (Model B: three variables, age > 65 years, supplemental oxygen ≥ 4 L/min, and C-reactive protein (CRP) > 10 mg/L) were selected and tested in the validation cohort. Model B appeared the better of the two, with an AUC in receiver operating characteristic curve analysis of 0.74 versus 0.65 in Model A, but the AUC differences were not significant (p = 0.24. Model B also appeared to have a more robust separation of mortality between the lowest (none of the three variables present) and highest (all three variables present) scores at 0% and 71%, respectively. These brief scoring systems may prove to be useful to clinicians in assigning mortality risk in hospitalized patients.


2020 ◽  
Author(s):  
Joseph Miller ◽  
Yiyang Wu ◽  
Rawan Safa ◽  
Georgiana Marusca ◽  
Sandeep Bhatti ◽  
...  

Abstract Background: Existing scoring systems to predict mortality in acute pancreatitis may not be directly applicable to the emergency department (ED). The objective of this study was to derive and validate the ED-SAS, a simple scoring score using variables readily available in the ED to predict mortality in patients with acute pancreatitis. Methods: This retrospective observational study was performed based on patient level data collected from electronic health records across 2 independent health systems, one used for the derivation cohort and one for the validation cohort. Adult patients who were eligible presented to the ED, required hospital admission, and had a confirmed diagnosis of acute pancreatitis. Patients with chronic or recurrent episodes of pancreatitis were excluded. The primary outcome was 30-day mortality. Analyses tested and derived candidate variables to establish a prediction score and that was subsequently applied to the validation cohort to assess odds ratio for the primary and secondary outcomes. Results: The derivation cohort included 599 patients, and the validation cohort 2011 patients. Thirty-day mortality was 4.2% and 3.9% respectively. From the derivation cohort, 3 variables were established for use in the predictive scoring score: ≥2 systemic inflammatory response syndrome (SIRS) criteria, age >60 years, and SpO2 <96%. Summing the presence or absence of each variable yielded an ED-SAS score ranging from 0 to 3. In the validation cohort, the odds of 30-day mortality increased with each subsequent ED-SAS point: 4.4 (95% CI 1.8 – 10.8) for 1 point, 12.0 (95% CI 4.9 – 29.4) for 2 points, and 41.7 (95% CI 15.8 – 110.1) for 3 points (c-statistic = 0.77).Conclusion: An ED-SAS score that incorporates SpO2, age, and SIRS measurements provides a rapid method for predicting 30-day mortality in acute pancreatitis.


2020 ◽  
Author(s):  
Joseph Miller ◽  
MD ◽  
Rawan Safa ◽  
Georgiana Marusca ◽  
BS Sandeep Bhatti ◽  
...  

Abstract Background: Existing scoring systems to predict mortality in acute pancreatitis may not be directly applicable to the emergency department (ED). The objective of this study was to derive and validate the ED-SAS, a simple scoring score using variables readily available in the ED to predict mortality in patients with acute pancreatitis.Methods: This retrospective observational study was performed based on patient level data collected from electronic health records across 2 independent health systems, one used for the derivation cohort and one for the validation cohort. Adult patients who were eligible presented to the ED, required hospital admission, and had a confirmed diagnosis of acute pancreatitis. Patients with chronic or recurrent episodes of pancreatitis were excluded. The primary outcome was 30-day mortality. Analyses tested and derived candidate variables to establish a prediction score and that was subsequently applied to the validation cohort to assess odds ratio for the primary and secondary outcomes. Results: The derivation cohort included 599 patients, and the validation cohort 2011 patients. Thirty-day mortality was 4.2% and 3.9% respectively. From the derivation cohort, 3 variables were established for use in the predictive scoring score: ≥2 systemic inflammatory response syndrome (SIRS) criteria, age >60 years, and SpO2 <96%. Summing the presence or absence of each variable yielded an ED-SAS score ranging from 0 to 3. In the validation cohort, the odds of 30-day mortality increased with each subsequent ED-SAS point: 4.4 (95% CI 1.8 – 10.8) for 1 point, 12.0 (95% CI 4.9 – 29.4) for 2 points, and 41.7 (95% CI 15.8 – 110.1) for 3 points (c-statistic = 0.77).Conclusion: An ED-SAS score that incorporates SpO2, age, and SIRS measurements provides a rapid method for predicting 30-day mortality in acute pancreatitis.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
H Y Kim ◽  
J H Choi ◽  
K H Kim ◽  
S M Kim

Abstract Aims The burden of coronary artery disease has been assessed by various semi-quantitative angiographic scores, which are frequently different each other. A non-invasive and quantitative modality may substitute angiographic sores for prognostic implication and decision of revascularization strategy. We compared fractional myocardial mass (FMM) with angiographic scores for predicting myocardial ischemia. Methods In this multicenter registry, 411 patients who underwent coronary computed tomography angiography (CCTA) were followed by invasive coronary angiography and FFR measurement. CCTA–derived %FMM with diameter stenosis ≥70% (%FMM-70) or ≥50% (%FMM-50) were compared with 9 angiographic scores (APPROACH, Duke Jeopardy, BARI, CASS, SYNTAX, Jenkins, BCIS-1, Leaman, Modified Duke) and were tested regarding their performance for predicting FFR ≤ 0.80. Predictive performance of %FMM or angiographic scores for FFR ≤ 0.80 established in derivation cohort (N = 250) and tested in validation cohort (N = 161). Results The performance of %FMM-70 and %FMM-50 were similar to most angiographic scores (%FMM-70, c-statistics = 0.76; %FMM-50, 0.71; angiographic scores, 0.68 – 0.79). The frequency of FFR ≤ 0.80 increased consistently according to %FMM-70, %FMM-50, and all angiographic scores (p &lt; 0.001, all). The optimal cutoff of %FMM-50 and %FMM-70 for FFR ≤ 0.80 were ≥34.5% and ≥9.8%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of %FMM-50 were 83%, 56%, 73%, 70%, 72%, and of %FMM-70 were 72%, 78%, 75%, 75%, and 75% using these cutoffs. Validation cohort showed consistent results. Conclusion %FMM correlated well with angiographic scores and had a potential to be used as a non-invasive alternative to the angiographic scores. The integration of the severity of stenosis and the amount of subtended myocardium may improve the detection of clinically significant coronary artery stenosis. Abstract 1175 Figure. FMM vs angiographic score


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bongjin Lee ◽  
Kyunghoon Kim ◽  
Hyejin Hwang ◽  
You Sun Kim ◽  
Eun Hee Chung ◽  
...  

AbstractThe aim of this study was to develop a predictive model of pediatric mortality in the early stages of intensive care unit (ICU) admission using machine learning. Patients less than 18 years old who were admitted to ICUs at four tertiary referral hospitals were enrolled. Three hospitals were designated as the derivation cohort for machine learning model development and internal validation, and the other hospital was designated as the validation cohort for external validation. We developed a random forest (RF) model that predicts pediatric mortality within 72 h of ICU admission, evaluated its performance, and compared it with the Pediatric Index of Mortality 3 (PIM 3). The area under the receiver operating characteristic curve (AUROC) of RF model was 0.942 (95% confidence interval [CI] = 0.912–0.972) in the derivation cohort and 0.906 (95% CI = 0.900–0.912) in the validation cohort. In contrast, the AUROC of PIM 3 was 0.892 (95% CI = 0.878–0.906) in the derivation cohort and 0.845 (95% CI = 0.817–0.873) in the validation cohort. The RF model in our study showed improved predictive performance in terms of both internal and external validation and was superior even when compared to PIM 3.


Sports ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 66
Author(s):  
Arne Sørensen ◽  
Vidar Sørensen ◽  
Terje Dalen

The purpose of this study was to evaluate the correlation between soccer players’ performance of receptions of passes in tests of both isolated technical skills and more match-realistic situations in small-sided games (SSGs). In addition, this study investigated whether the involvement in SSGs (number of receptions) correlated with the quality of receptions in the respective SSGs. The participants were 13 male outfield youth soccer players from teams in the first division of the regional U18 league. The quality of receptions was scored by educated coaches according to set criteria of performance. Statistical analyses of correlations were determined using Spearman’s rank-order correlation coefficient (rs). The main results were (1) a significant correlation in the quality of ball reception between 4vs1 SSGs and 5vs5 SSGs (rs = −0.61, p < 0.01) and (2) a trend towards moderate correlation between the quality of ball reception using a ball projection machine and 5vs5 SSGs (rs = −0.48, p = 0.10). (3) A significant correlation was found between the number of receptions in 5vs5 SSGs and the quality score of receptions in 5vs5 SSGs (rs = −0.70, p < 0.01). The trend towards moderate correlations between 5vs5 SSGs and the isolated technical reception test could imply the importance of training in the technical aspects of ball reception. Moreover, it seems as though the players with the best reception performance are the players who are most involved in SSGs, that is, having the most receptions.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.M Leerink ◽  
H.J.H Van Der Pal ◽  
E.A.M Feijen ◽  
P.G Meregalli ◽  
M.S Pourier ◽  
...  

Abstract Background Childhood cancer survivors (CCS) treated with anthracyclines and/or chest-directed radiotherapy receive life-long echocardiographic surveillance to detect cardiomyopathy early. Current risk stratification and surveillance frequency recommendations are based on anthracycline- and chest-directed radiotherapy dose. We assessed the added prognostic value of an initial left ventricular ejection fraction (EF) measurement at &gt;5 years after cancer diagnosis. Patients and methods Echocardiographic follow-up was performed in asymptomatic CCS from the Emma Children's Hospital (derivation; n=299; median time after diagnosis, 16.7 years [inter quartile range (IQR) 11.8–23.15]) and from the Radboud University Medical Center (validation; n=218, median time after diagnosis, 17.0 years [IQR 13.0–21.7]) in the Netherlands. CCS with cardiomyopathy at baseline were excluded (n=16). The endpoint was cardiomyopathy, defined as a clinically significant decreased EF (EF&lt;40%). The predictive value of the initial EF at &gt;5 years after cancer diagnosis was analyzed with multivariable Cox regression models in the derivation cohort and the model was validated in the validation cohort. Results The median follow-up after the initial EF was 10.9 years and 8.9 years in the derivation and validation cohort, respectively, with cardiomyopathy developing in 11/299 (3.7%) and 7/218 (3.2%), respectively. Addition of the initial EF on top of anthracycline and chest radiotherapy dose increased the C-index from 0.75 to 0.85 in the derivation cohort and from 0.71 to 0.92 in the validation cohort (p&lt;0.01). The model was well calibrated at 10-year predicted probabilities up to 5%. An initial EF between 40–49% was associated with a hazard ratio of 6.8 (95% CI 1.8–25) for development of cardiomyopathy during follow-up. For those with a predicted 10-year cardiomyopathy probability &lt;3% (76.9% of the derivation cohort and 74.3% of validation cohort) the negative predictive value was &gt;99% in both cohorts. Conclusion The addition of the initial EF &gt;5 years after cancer diagnosis to anthracycline- and chest-directed radiotherapy dose improves the 10-year cardiomyopathy prediction in CCS. Our validated prediction model identifies low-risk survivors in whom the surveillance frequency may be reduced to every 10 years. Calibration in both cohorts Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Dutch Heart Foundation


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hongseok Yoo ◽  
Yunjoo Im ◽  
Ryoung-Eun Ko ◽  
Jin Young Lee ◽  
Junseon Park ◽  
...  

AbstractThe role of high-mobility group box-1 (HMGB1) in outcome prediction in sepsis is controversial. Furthermore, its association with necroptosis, a programmed cell necrosis mechanism, is still unclear. The purpose of this study is to identify the association between the plasma levels of HMGB1 and the severity and clinical outcomes of sepsis, and to examine the correlation between HMGB1 and key executors of necroptosis including receptor-interacting kinase 3 (RIPK3) and mixed lineage kinase domain-like- (MLKL) proteins. Plasma HMGB1, RIPK3, and MLKL levels were measured with the enzyme-linked immunosorbent assay from the derivation cohort of 188 prospectively enrolled, critically-ill patients between April 2014 and December 2016, and from the validation cohort of 77 patients with sepsis between January 2017 and January 2019. In the derivation cohort, the plasma HMGB1 levels of the control (n = 46, 24.5%), sepsis (n = 58, 30.9%), and septic shock (n = 84, 44.7%) groups were significantly increased (P < 0.001). A difference in mortality between high (≥ 5.9 ng/mL) and low (< 5.9 ng/mL) HMGB1 levels was observed up to 90 days (Log-rank test, P = 0.009). There were positive linear correlations of plasma HMGB1 with RIPK3 (R2 = 0.61, P < 0.001) and MLKL (R2 = 0.7890, P < 0.001). The difference in mortality and correlation of HMGB1 levels with RIPK3 and MLKL were confirmed in the validation cohort. Plasma levels of HMGB1 were associated with the severity and mortality attributed to sepsis. They were correlated with RIPK3 and MLKL, thus suggesting an association of HMGB1 with necroptosis.


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