scholarly journals Development and validation of a sequential two-step algorithm for the screening of individuals with potential polycythaemia vera

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Miguel Piris-Villaespesa ◽  
Alberto Álvarez-Larrán ◽  
Adolfo Saez-Marín ◽  
Claudia Nuñez-Torrón ◽  
Gloria Muñoz-Martin ◽  
...  
Keyword(s):  
Mutation Screening ◽  
Roc Curves ◽  
Polycythaemia Vera ◽  
Normal Ranges ◽  
Screening Algorithm ◽  
Number Of Patients ◽  
Step Algorithm ◽  
Development And Validation ◽  
Diagnostic Criterion ◽  
Selection Of

AbstractIn 2016, the WHO included haemoglobin values within normal ranges as a diagnostic criterion for Polycythaemia Vera (PV). Since then, concerns have arisen that a large number of patients are undergoing unnecessary screening for PV. To address this issue, we estimated the prevalence of JAK2 p.V617F in individuals with elevated haemoglobin or haematocrit and developed and validated a screening algorithm for PV. A total of 15,366 blood counts performed in seven non-consecutive days were reviewed, of which 1001 were selected for subsequent JAK2 p.V617F mutation screening. Eight (0.8%) new JAK2 p.V617F-mutated cases were detected. From ROC curves, a two-step algorithm was developed based on the optimal cut-off for the detection of the JAK2 p.V617F mutation. The algorithm was prospectively validated in an independent cohort of 15,298 blood counts. A total of 1595 (10.4%) cases met the criterion for haemoglobin or haematocrit, of whom 581 passed to step 2 (3.8% of the total). The JAK2 p.V617F mutation was detected in 7 of the 501 patients tested, which accounts for 0.04% of the total cohort and 0.4% of patients with erythrocytosis. In conclusion, this data show that our two-step algorithm improves the selection of candidates for JAK2 p.V617F testing.

57Co-Bleomycin Scintigraphy in Staging of Carcinoma of the Cervix

1985 ◽  
Vol 24 (01) ◽  
pp. 48-51 ◽  
Author(s):  
K. Dursk ◽  
T. Pertyński
Keyword(s):  
Cervical Cancer ◽  
Roc Curves ◽  
Selection Of

Summary65 patients with cervical cancer at various stages of the disease were studied scintigraphically after 57Co-bleomycin administration, active urine being flushed out from the bladder continuously. The patients were submitted to other auxiliary tests and the interpretation of scintigraphic images could thus be verified. Scintigraphic data were classified semiquantitatively by scoring in the range from zero to 5. Results were evaluated in terms of ROC-curves. This method of analysis permitted selection of cut-off levels for binary decisions that yielded satisfactory sensitivity and acceptable specificity of the test.

PP159 Telemedicine In Paraguay: Contributions Of The Institute Of Health Sciences Research, National University Of Asunción

2020 ◽  
Vol 36 (S1) ◽  
pp. 18-18
Author(s):  
Ronald Rivas ◽  
Pedro Galván
Keyword(s):  
Public Health ◽  
Biomedical Engineering ◽  
List Type ◽  
Telemedicine System ◽  
Cellular Telephony ◽  
Imaging Department ◽  
Number Of Patients ◽  
Computed Tomography Scans ◽  
National University ◽  
Development And Validation

IntroductionThe modalities of telemedicine that have been developed and applied so far by the Department of Biomedical Engineering and Imaging at the National University of Asunción (IICS-UNA) are as follows: (i) telediagnosis: the remote sending of data, signals, and images for diagnostic purposes; (ii) general telediagnostic imaging; (iii) telemonitoring (including telemetry): remote monitoring of vital parameters to provide automatic or semi-automatic surveillance or alarm services in emergencies, epidemiology, or tele-public health; and (iv) tele-education: the use of telematic networks to provide virtual platforms for educating and training health professionals.MethodsWe conducted a comprehensive review of the scientific works developed by the IICS-UNA in order to evaluate the systematic implementation of Telemedicine in Paraguay. Documents, pilot projects (satellite telegraphy), telediagnostic research, telematics, tele-education, published articles, and statistical data (number of patients attending or studies performed, etcetera) relating to the implementation of the National Telemedicine System by the Ministry of Public Health and Social Welfare since 1999 were reviewed.ResultsImplementation of the telemedicine system has meant that 472,038 patients have attended referral centers nationwide, with 297,999 electrocardiographs, 165,323 computed tomography scans, and 8,697 electroencephalograms being conducted. Projects developed within the framework of the Telemedicine Research Line have included the following: (i)Development and validation of a clinical telemicroscopy system based on cellular telephony;(ii)Implementation of a telemetry system for temperature monitoring of the collection of biological samples from a biomedical research center; and(iii)Production and development of a virtual campus at the National University of Asunción.ConclusionsGiven the current healthcare environment, developing a line of research based on telemedicine is a proactive step, since telemedicine provides an alternative solution to the problem of access to the health system. That is why the IICS-UNA Biomedical Engineering and Imaging Department has developed telemedicine as one of its main lines of research.

Development of a Performance-Related Framework for Asphalt Mixture Design for the Illinois Tollway

2021 ◽  
pp. 036119812110148
Author(s):  
Behnam Jahangiri ◽  
Punyaslok Rath ◽  
Hamed Majidifard ◽  
William G. Buttlar
Keyword(s):  
Asphalt Mixture ◽  
Field Performance ◽  
Compact Tension ◽  
T Test ◽  
Novel Approach ◽  
Final Adjustment ◽  
Development And Validation ◽  
High Degree ◽  
Selection Of

Various agencies have begun to research and introduce performance-related specifications (PRS) for the design of modern asphalt paving mixtures. The focus of most recent studies has been directed toward simplified cracking test development and evaluation. In some cases, development and validation of PRS has been performed, building on these new tests, often by comparison of test values to accelerated pavement test studies and/or to limited field data. This study describes the findings of a comprehensive research project conducted at Illinois Tollway, leading to a PRS for the design of mainline and shoulder asphalt mixtures. A novel approach was developed, involving the systematic establishment of specification requirements based on: 1) selection of baseline values based on minimally acceptable field performance thresholds; 2) elevation of thresholds to account for differences between short-term lab aging and expected long-term field aging; 3) further elevation of thresholds to account for variability in lab testing, plus variability in the testing of field cores; and 4) final adjustment and rounding of thresholds based on a consensus process. After a thorough evaluation of different candidate cracking tests in the course of the project, the Disk-shaped Compact Tension—DC(T)—test was chosen to be retained in the Illinois Tollway PRS and to be presented in this study for the design of crack-resistant mixtures. The DC(T) test was selected because of its high degree of correlation with field results and its excellent repeatability. Tailored Hamburg rut depth and stripping inflection point thresholds were also established for mainline and shoulder mixes.

scholarly journals Characterization of Resistance to the Nonnucleoside NS5B Inhibitor Filibuvir in Hepatitis C Virus-Infected Patients

2011 ◽  
Vol 56 (3) ◽  
pp. 1331-1341 ◽  
Author(s):  
Philip J. F. Troke ◽  
Marilyn Lewis ◽  
Paul Simpson ◽  
Katrina Gore ◽  
Jennifer Hammond ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Amino Acid ◽  
Site Directed Mutagenesis ◽  
Phenotypic Resistance ◽  
Number Of Patients ◽  
Chronic Hcv ◽  
Selection Of

ABSTRACTFilibuvir (PF-00868554) is an investigational nonnucleoside inhibitor of the hepatitis C virus (HCV) nonstructural 5B (NS5B) RNA-dependent RNA polymerase currently in development for treating chronic HCV infection. The aim of this study was to characterize the selection of filibuvir-resistant variants in HCV-infected individuals receiving filibuvir as short (3- to 10-day) monotherapy. We identified amino acid M423 as the primary site of mutation arising upon filibuvir dosing. Through bulk cloning of clinical NS5B sequences into a transient-replicon system, and supported by site-directed mutagenesis of the Con1 replicon, we confirmed that mutations M423I/T/V mediate phenotypic resistance. Selection in patients of an NS5B mutation at M423 was associated with a reduced replicative capacityin vitrorelative to the pretherapy sequence; consistent with this, reversion to wild-type M423 was observed in the majority of patients following therapy cessation. Mutations at NS5B residues R422 and M426 were detected in a small number of patients at baseline or the end of therapy and also mediate reductions in filibuvir susceptibility, suggesting these are rare but clinically relevant alternative resistance pathways. Amino acid variants at position M423 in HCV NS5B polymerase are the preferred pathway for selection of viral resistance to filibuvirin vivo.

scholarly journals Cytotoxic Activity of Antineoplastic Agents on Fertility: A Systematic Review

2020 ◽  
Vol 42 (11) ◽  
pp. 759-768
Author(s):  
Gabriel Acácio de Moura ◽  
Paula Bruno Monteiro
Keyword(s):  
Antineoplastic Agents ◽  
Site Effect ◽  
Cytotoxic Action ◽  
Long Term Effects ◽  
Treatment Type ◽  
Number Of Patients ◽  
Serum Hormone ◽  
Hormonal Modulation ◽  
Selection Of

Abstract Objective To analyze the long-term effects of antineoplastic treatments on patient fertility. Selection of Studies The studies were selected through the New PubMed, Scielo and Lilacs databases along with references used for the creation of the present work. For the selection of studies, articles published between the periods from January 1, 2015 to April 6, 2020 in the English, Portuguese and Spanish languages were used. As inclusion criteria: cohort studies and studies conducted in vitro. As exclusion criteria: review articles, reported cases, studies that do not address thematic reproduction, studies that do not address the cancer theme, articles that used animals, articles that address the preservation of fertility and articles in duplicate in the bases. Data Collection The collected data included: age of the patient at the beginning of treatment, type of neoplasm, type of antineoplastic treatment, chemotherapy used, radiotherapy dosage, radiotherapy site, effect of antineoplastic agents on fertility and number of patients in the study. Data Synthesis Thirty studies were evaluated, antineoplastic chemotherapy agents and radiotherapy modulate serum hormone levels, reduces germ cell quantities and correlated with an increase in sterility rates. The effects mentioned occur in patients in the prepubertal and postpubertal age. Conclusion Antineoplastic treatments have cytotoxic effects on the germ cells leading to hormonal modulation, and pubertal status does not interfere with the cytotoxic action of therapies.

scholarly journals Enriching CBT by Neuroscience: Novel Avenues to Achieve Personalized Treatments

2020 ◽  
Author(s):  
Kristoffer N T Månsson ◽  
Ulrike Lueken ◽  
Andreas Frick
Keyword(s):  
Mental Disorders ◽  
Common Mental Disorders ◽  
Behavioral Therapy ◽  
Therapy Outcomes ◽  
Efficient Treatment ◽  
Related Research ◽  
Number Of Patients ◽  
Key Topics ◽  
Selection Of ◽  
The Way

Abstract Although cognitive behavioral therapy (CBT) is an established and efficient treatment for a variety of common mental disorders, a considerable number of patients do not respond to treatment or relapse after successful CBT. Recent findings and approaches from neuroscience could pave the way for clinical developments to enhance the outcome of CBT. Herein, we will present how neuroscience can offer novel perspectives to better understand (a) the biological underpinnings of CBT, (b) how we can enrich CBT with neuroscience-informed techniques (augmentation of CBT), and (c) why some patients may respond better to CBT than others (predictors of therapy outcomes), thus paving the way for more personalized and effective treatments. We will introduce some key topics and describe a selection of findings from CBT-related research using tools from neuroscience, with the hope that this will provide clinicians and clinical researchers with a brief and comprehensible overview of the field.

scholarly journals Appropriate selection of patients with lumbar spinal stenosis for interspinous process decompression with the X STOP device

2007 ◽  
Vol 22 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Carl Lauryssen
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Neurogenic Intermittent Claudication ◽  
Anatomical Structures ◽  
Conservative Care ◽  
Number Of Patients ◽  
Spinous Processes ◽  
Lumbar Spinal ◽  
Selection Of Patients ◽  
Selection Of

✓With the aging of the population, the number of patients suffering from progressive lumbar spinal stenosis with symptomatic neurogenic intermittent claudication is projected to increase. Unfortunately, these patients are limited to a choice between nonsurgical conservative care and more invasive decompressive surgical procedures such as laminectomy with or without fusion. The X STOP interspinous process decompression system is a commercially available device that provides a minimally invasive alternative treatment, an intermediate option within the continuum of care for these patients. The X STOP is appropriate for patients with moderately severe functional impairment whose symptoms are exacerbated in extension and relieved in flexion. Implanted between the spinous processes without disrupting the normal anatomical structures, the X STOP limits narrowing of the spinal canal and neural foramina by reducing extension at the symptomatic level(s). In this report the author details the approved indications for use of the X STOP and discusses several illustrative cases.

scholarly journals A Scripture-Specific Religious Orientation Scale: Development and Validation

2020 ◽  
Vol 4 (4) ◽  
pp. 01-13
Author(s):  
Ebrahim Khodadady
Keyword(s):  
University Students ◽  
Religious Orientation ◽  
Principal Axis ◽  
Scale Development And Validation ◽  
Religious Orientation Scale ◽  
Orientation Scale ◽  
Principal Axis Factoring ◽  
Specific Species ◽  
Development And Validation ◽  
Selection Of

Objectives: to develop a novel religious orientation scale based on the Quran and validate it with pre-university students of secondary education Method: All the Quranic ayat which addressed its believers directly regarding their religious orientation were scrutinized in terms of pre-university students’ characteristics, resulting in the selection of 57 upon which a 60-item Quranic Orientation Scale (QOS) was developed. The scale was administered to 1123 students and their responses were subjected to Principal Axis Factoring and Promax with Kaiser Normalization (PKN). Results: Out of 60 items comprising the QOS, 48 loaded acceptably and exclusively on seven rotated factors called believing in holy scriptures,, remembering and seeking Allah, fulfilling Quranic obligations, following Allah confidently, following Quranic instructions, not befriending disbelievers, and informed Quranic struggle. Both the scale and its underlying factors had internal consistency and correlated significantly with each other. Conclusion: The Quran teaches the domain of religious orientation directly to its readers as a hierarchically and culturally independent schema consisting of specific species and genera. Pre-university student, however, not only reduce the domain as regards the number of its constituting species and genera but also develop their own religious families. Going through this process consciously they render their religious orientation a hierarchically and culturally organized schema.

POSITIVE: Perfusion imaging selection of ischemic stroke patients for endovascular therapy

2021 ◽  
pp. neurintsurg-2021-017315
Author(s):  
J Mocco ◽  
Adnan H Siddiqui ◽  
David Fiorella ◽  
Michael J Alexander ◽  
Adam S Arthur ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Endovascular Therapy ◽  
Perfusion Imaging ◽  
Medical Management ◽  
Primary Outcome ◽  
Functional Improvement ◽  
Positive Trial ◽  
Stroke Patients ◽  
Number Of Patients ◽  
Selection Of

BackgroundThe PerfusiOn imaging Selection of Ischemic sTroke patIents for endoVascular thErapy (POSITIVE) trial was designed to evaluate functional outcome in patients with emergent large vessel occlusion (ELVO) presenting within 0–12 hours with pre-specified bifurcated arms of early and late window presentation, who were selected for endovascular thrombectomy with non-vendor specific commercially available perfusion imaging software. Recent trials demonstrating the benefit of thrombectomy up to 16–24 hours following ELVO removed equipoise to randomize late window ELVO patients and therefore the trial was halted.MethodsUp to 200 patients were to be enrolled in this FDA-cleared, prospective, randomized, multicenter international trial to compare thrombectomy and best medical management in patients with ELVO ineligible for or refractory to treatment with IV tissue plasminogen activator (IV-tPA) selected with perfusion imaging and presenting within 0–12 hours of last seen normal. The primary outcome was 90-day clinical outcome as measured by the raw modified Rankin Scale (mRS) with scores 5 and 6 collapsed (mRS shift analysis).ResultsThe POSITIVE trial suspended enrollment with the release of results from the DAWN trial and was stopped after the release of the DEFUSE 3 trial results. Thirty-three patients were enrolled (21 for medical management and 12 for thrombectomy). Twelve of the 33 patients were enrolled in the 6–12 hour cohort. Despite the early cessation, the primary outcome demonstrated statistically significant superior clinical outcomes for patients treated with thrombectomy (P=0.0060). The overall proportion of patients achieving an mRS score of 0–2 was 75% in the thrombectomy cohort and 43% in the medical management cohort (OR 4.00, 95% CI 0.84 to 19.2).ConclusionPOSITIVE supports the already established practice of delayed thrombectomy for appropriately selected patients presenting within 0–12 hours selected by perfusion imaging from any vendor. The results of the POSITIVE trial are consistent with other thrombectomy trials. The statistically significant effect on functional improvement, despite the small number of patients, reinforces the robust benefits of thrombectomy.Clinical trial registrationNCT01852201

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