Acoustic Breathiness Index for the Japanese-Speaking Population: Validation Study and Exploration of Affecting Factors

Objectives The purposes of this study were to validate the Acoustic Breathiness Index (ABI) for the Japanese-speaking population and to determine whether it is independent of factors such as sex, age, and perceptual ratings of roughness. Method First, the concurrent validity of the ABI for perceptual breathiness was evaluated on the concatenations of continuous speech and sustained vowels from 288 patients with varying degrees of dysphonia. The diagnostic accuracy was examined on 343 samples with 55 additional normophonic speakers. Second, the validity related to responsiveness-to-change was estimated on 222 samples obtained before and after interventions for 111 voice-disordered patients. Third, the relationships between the ABI and other variables (i.e., perceptual hoarseness/breathiness/roughness, sex, and age) were explored using bivariate and multivariate analyses for the 288 patients. Results First, the concurrent validity and the responsiveness-to-change validity were confirmed by strong correlation coefficients of .890 and .878, respectively. Second, the receiver operating characteristic analysis showed the area under the curve to be 0.939, indicating excellent accuracy. The ABI of 3.44 exhibited a sensitivity of 76.3% and a specificity of 94.1%. Third, although bivariate analyses revealed a weak relationship between ABI and roughness and an ABI difference by age, multiple regression analyses showed a strong relation between only ABI and breathiness, without a meaningful contribution from roughness, sex, and age factors. Conclusion The study confirmed that the ABI is an accurate and specific tool to estimate breathiness levels in the Japanese-speaking population and neither roughness, sex, nor age significantly affects the ABI.

Download Full-text

Measuring the palpable pulsatility length as a physical examination test in defining the severity of inflow stenosis for hemodialysis fistulas

BMC Nephrology ◽

10.1186/s12882-019-1536-2 ◽

2019 ◽

Vol 20 (1) ◽

Author(s):

Matt Chiung-Yu Chen ◽

Mei-Jui Weng ◽

Misoso Yi-Wen Wu ◽

Yi-Chun Liu ◽

Wen-Che Chi

Keyword(s):

Operating Characteristic ◽

Area Under The Curve ◽

High Sensitivity ◽

Characteristic Analysis ◽

Main Trunk ◽

Arteriovenous Fistulas ◽

Cannulation Site ◽

Before And After ◽

Physical Examinations ◽

Hemodialysis Fistulas

Abstract Background Pulsatility is an important property of hemodialysis arteriovenous fistulas (AVF) and can be perceived by the fingers as a gradual decrease in strength downstream from the anastomosis along the main trunk of the fistula. The distance from the point at which the pulse becomes imperceptible to the anastomosis is termed the palpable pulsatility length (PPL); we considered this length may play a role in assessing the severity of inflow stenosis for hemodialysis fistulas. Methods This study was performed by retrospective analysis of routinely collected data. Physical examinations and fistula measurements were performed in a selected population of 76 hemodialysis patients with mature fistulas during half a year. Fistula measurements included the PPL before and after treatment and the distance between the anastomosis and the arterial cannulation site (aPump length). The aPump index (API) was calculated by dividing the PPL by the aPump length. Angiograms were reviewed to determine the location and severity of stenosis. PPL and API were used to detect the critical inflow stenosis, which indicates severe inflow stenosis of an AVF. Results Receiver operating characteristic analysis showed that the area under the curve was 0.895 for API and 0.878 for PPL. A cutoff value of API < 1.29 and PPL < 11.0 cm were selected to detect the critical inflow stenosis. The sensitivity was 96.0% versus 80.0% and specificity was 84.31% versus 84.31% for API and PPL, respectively. Conclusions PPL and API are useful tools in defining the severity of pure inflow stenosis for mature AVFs in the hands of trained examiners with high sensitivity and specificity.

Download Full-text

Identification of an optimal prolactin threshold to determine prolactinoma size using receiver operating characteristic analysis

Scientific Reports ◽

10.1038/s41598-021-89256-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Bianca M. Leca ◽

Maria Mytilinaiou ◽

Marina Tsoli ◽

Andreea Epure ◽

Simon J. B. Aylwin ◽

...

Keyword(s):

Receiver Operating Characteristic ◽

Operating Characteristic ◽

Tumour Size ◽

Area Under The Curve ◽

Serum Prolactin ◽

Pituitary Neoplasms ◽

Characteristic Analysis ◽

Roc Curve Analysis ◽

Baseline Serum ◽

Receiver Operating

AbstractProlactinomas represent the most common type of secretory pituitary neoplasms, with a therapeutic management that varies considerably based on tumour size and degree of hyperprolactinemia. The aim of the current study was to evaluate the relationship between serum prolactin (PRL) concentrations and prolactinoma size, and to determine a cut-off PRL value that could differentiate micro- from macro-prolactinomas. A retrospective cohort study of 114 patients diagnosed with prolactinomas between 2007 and 2017 was conducted. All patients underwent gadolinium enhanced pituitary MRI and receiver operating characteristic (ROC) analyses were performed. 51.8% of patients in this study were men, with a mean age at the time of diagnosis of 42.32 ± 15.04 years. 48.2% of the total cohort were found to have microadenomas. Baseline serum PRL concentrations were strongly correlated to tumour dimension (r = 0.750, p = 0.001). When performing the ROC curve analysis, the area under the curve was 0.976, indicating an excellent accuracy of the diagnostic method. For a value of 204 μg/L (4338 mU/L), sensitivity and specificity were calculated at 0.932 and 0.891, respectively. When a cut off value of 204 μg/L (4338 mU/L) was used, specificity was 93.2%, and sensitivity 89.1%, acceptable to reliably differentiate between micro- and macro- adenomas.

Download Full-text

Which Inotropic Drug, Dobutamine or Milrinone, Is Clinically More Effective in the Treatment of Postligation Cardiac Syndrome in Preterm Infants?

American Journal of Perinatology ◽

10.1055/s-0040-1715118 ◽

2020 ◽

Author(s):

Levent Korkmaz ◽

Ahmet Ozdemir ◽

Özge Pamukçu ◽

Tamer Güneş ◽

Mehmet Adnan Ozturk

Keyword(s):

Blood Pressure ◽

Operating Characteristic ◽

Ductus Arteriosus ◽

Area Under The Curve ◽

Therapeutic Effects ◽

Study Group ◽

Cardiac Syndrome ◽

Before And After ◽

The Difference

Objective This study aimed to detect which of the two main medicines suggested in the treatment of postligation cardiac syndrome (PLCS)—dobutamine or mirinone—possesses a more therapeutic effect. While doing this, clinicians are provided with a broader perspective on the treatment and follow-up of cases. The desire was to increase the treatability and monitor ability of the cases in question and hence their survivability. Study Design A retrospective review of a cohort of infants with PLCS was conducted between March 2012 and December 2018. In the treatment of infants with PLCS, dobutamine (dobutamine study group-DSG) or milrinone (milrinone study group-MSG) was used. The respiration, cardiac, echocardiography, and perfusion parameters of the cases were assessed both before and after ligation. Based on the data obtained, both the effects of the medicines on PLCS and the difference between their therapeutic effects were studied. The accuracy of prognostication was assessed with receiver operating characteristic analyses. Results PLCS was detected in 29 (34.1%) of 85 patent ductus arteriosus ligation cases in total. Of all the PLCS cases, 13 (44.8%) were treated with dobutamine and 16 (55.2%) with milrinone. It was observed that the effects of the medicines on the respiratory system and cardiovascular system manifested in the third and 6th hour, respectively. It was detected that both medicines had more effect on the systolic blood pressure (SBP) (area under the curve [AUC]: 0.997/0.996, p = 0.001/0.002) than on the diastolic blood pressure (AUC: 0.911/0.843, p = 0.032/0.046). Conclusion Dobutamine and milrinone, two primary medicines that can be used in the treatment of cases with PLCS, possess similar therapeutic effects on this pathology. In addition, their postoperative therapeutic effects on the SBP are more in the foreground.

Download Full-text

EGFR detection by liquid biopsy: ripe for clinical usage

Future Oncology ◽

10.2217/fon-2021-0620 ◽

2021 ◽

Author(s):

Ullas Batra ◽

Shrinidhi Nathany ◽

Mansi Sharma ◽

Parveen Jain ◽

Surender Dhanda ◽

...

Keyword(s):

Lung Cancer ◽

Liquid Biopsy ◽

Operating Characteristic ◽

International Association ◽

Area Under The Curve ◽

Characteristic Analysis ◽

New Era ◽

Appropriate Treatment ◽

Polymerase Chain ◽

Digital Polymerase Chain Reaction

Introduction: With the International Association for the Study of Lung Cancer (IASLC) recommendations promoting liquid biopsy as a primary detection tool, a new era of research has begun. The authors aimed to study the concordance of plasma genotyping platforms against the tissue gold standard. Methods: 184 patients with non-small cell lung cancer underwent EGFR genotyping using Cobas, droplet digital polymerase chain reaction (ddPCR) and Therascreen assays from 2019–2020. Results: Of 184 cases, 70 were positive by Cobas, 51 by ddPCR and 69 by Therascreen. The sensitivity of Cobas was 97.1% and the sensitivity of ddPCR was 71%. Receiver operating characteristic analysis showed an area under the curve of 0.977 for Cobas and 0.846 for ddPCR. Conclusion: In line with the FLAURA trial of osimertinib making its way to first-line and given the IASLC recommendations, it is important to understand the attributes of these tests to initiate appropriate treatment.

Download Full-text

The Optimal Cut-off of BIPSS in Differential Diagnosis of ACTH-dependent Cushing’s Syndrome: Is Stimulation Necessary?

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgz194 ◽

2019 ◽

Vol 105 (4) ◽

pp. e1673-e1685

Author(s):

Shi Chen ◽

Kang Chen ◽

Shirui Wang ◽

Huijuan Zhu ◽

Lin Lu ◽

...

Keyword(s):

Operating Characteristic ◽

Receiver Operating Characteristic Analysis ◽

Meta Analysis ◽

Correct Diagnosis ◽

Inferior Petrosal Sinus ◽

Resonance Imaging ◽

Characteristic Analysis ◽

Optimal Cutoff ◽

Before And After ◽

Pituitary Lesion

Abstract Contexts Bilateral inferior petrosal sinus sampling (BIPSS) can differentiate Cushing’s disease (CD) and ectopic adrenocorticotropin (ACTH) syndrome (EAS). The traditional cutoff of inferior petrosal sinus to peripheral (IPS:P) ACTH gradient was 2 before stimulation and 3 after stimulation, which yielded unsatisfactory sensitivity in some studies. Objectives To determine the optimal cutoff in BIPSS before or after desmopressin stimulation and to evaluate the necessity of stimulation. Design and Setting Single-center retrospective study (2011–2018) along with meta-analysis. Patients 226 CD and 24 EAS patients with confirmed diagnosis who underwent BIPSS with desmopressin stimulation. Results In the meta-analysis of 25 studies with 1249 CD and 152 EAS patients, the traditional cutoff yielded sensitivity of 86% and 97% and specificity of 98% and 100% before and after stimulation, respectively. We then analyzed the data from our center. With the traditional cutoff, the sensitivity was 87.2% (197/226) and 96.5% (218/226) before and after stimulation, and specificity was both 100% (25/25), which were close to the results of meta-analysis. Receiver operating characteristic analysis revealed that the optimal cutoff was 1.4 before stimulation and 2.8 after stimulation. With the new cutoff, the sensitivity was 94.7% (214/226) and 97.8% (221/226) while the specificity remained 100% (25/25) before and after stimulation. Among the 7 CD patients (7/226; 3.1%) for whom stimulation was necessary to get correct diagnosis, none has a pituitary lesion >6 mm by magnetic resonance imaging, and their sampling lateralization rate (P = .007) and peak ACTH level at dominant inferior petrosal sinus (P = .011) were lower than those among CD patients with IPS:P >1.4 before stimulation. Conclusions The optimal cutoff for IPS:P in BIPSS is different from the commonly-used one. The optimal cutoff value can yield satisfactory accuracy even without stimulation, and stimulation may be unnecessary for those with pituitary adenoma >6 mm.

Download Full-text

Investigating the clinico-anatomical dissociation in the behavioral variant of Alzheimer disease

Alzheimer s Research & Therapy ◽

10.1186/s13195-020-00717-z ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Ellen H. Singleton ◽

Yolande A. L. Pijnenburg ◽

Carole H. Sudre ◽

Colin Groot ◽

Elena Kochova ◽

...

Keyword(s):

Operating Characteristic ◽

Receiver Operating Characteristic Analysis ◽

Area Under The Curve ◽

Posterior Cingulate Cortex ◽

White Matter Hyperintensity ◽

Salience Network ◽

Characteristic Analysis ◽

Cognitively Normal ◽

Metabolic Connectivity ◽

Subcortical Volume

Abstract Background We previously found temporoparietal-predominant atrophy patterns in the behavioral variant of Alzheimer’s disease (bvAD), with relative sparing of frontal regions. Here, we aimed to understand the clinico-anatomical dissociation in bvAD based on alternative neuroimaging markers. Methods We retrospectively included 150 participants, including 29 bvAD, 28 “typical” amnestic-predominant AD (tAD), 28 behavioral variant of frontotemporal dementia (bvFTD), and 65 cognitively normal participants. Patients with bvAD were compared with other diagnostic groups on glucose metabolism and metabolic connectivity measured by [18F]FDG-PET, and on subcortical gray matter and white matter hyperintensity (WMH) volumes measured by MRI. A receiver-operating-characteristic-analysis was performed to determine the neuroimaging measures with highest diagnostic accuracy. Results bvAD and tAD showed predominant temporoparietal hypometabolism compared to controls, and did not differ in direct contrasts. However, overlaying statistical maps from contrasts between patients and controls revealed broader frontoinsular hypometabolism in bvAD than tAD, partially overlapping with bvFTD. bvAD showed greater anterior default mode network (DMN) involvement than tAD, mimicking bvFTD, and reduced connectivity of the posterior cingulate cortex with prefrontal regions. Analyses of WMH and subcortical volume showed closer resemblance of bvAD to tAD than to bvFTD, and larger amygdalar volumes in bvAD than tAD respectively. The top-3 discriminators for bvAD vs. bvFTD were FDG posterior-DMN-ratios (bvAD<bvFTD), MRI posterior-DMN-ratios (bvAD<bvFTD), MRI salience-network-ratios (bvAD>bvFTD, area under the curve [AUC] range 0.85–0.91, all p < 0.001). The top-3 for bvAD vs. tAD were amygdalar volume (bvAD>tAD), MRI anterior-DMN-ratios (bvAD<tAD), FDG anterior-DMN-ratios (bvAD<tAD, AUC range 0.71–0.84, all p < 0.05). Conclusions Subtle frontoinsular hypometabolism and anterior DMN involvement may underlie the prominent behavioral phenotype in bvAD.

Download Full-text

The ability of free to total prostate-specific antigen and prostate-specific antigen density to detect clinically significant prostate cancer in men undergoing transperineal template biopsy

Journal of Clinical Urology ◽

10.1177/2051415817730494 ◽

2017 ◽

Vol 10 (6) ◽

pp. 529-534 ◽

Cited By ~ 1

Author(s):

Surayne V Segaran ◽

Amr M Emara ◽

Tharani Mahesan ◽

Joshua Silverman ◽

Hashim U Ahmed ◽

...

Keyword(s):

Prostate Cancer ◽

Prostate Specific Antigen ◽

Operating Characteristic ◽

Receiver Operating Characteristic Analysis ◽

Specific Antigen ◽

Area Under The Curve ◽

Characteristic Analysis ◽

Total Prostate Specific Antigen ◽

Prostate Specific Antigen Density ◽

Clinically Significant

Objective: The purpose of this study was to determine the ability of the ratio of free to total prostate-specific antigen and prostate-specific antigen density to predict the presence of clinically significant prostate cancer on template biopsies. The value of these tests may be underestimated as they were previously validated against sextant transrectal biopsy of the prostate, which has been proved to miss a large proportion of significant prostate cancers. The ability of these tests to specifically detect clinically significant cancers has not previously been studied. Patients and methods: A retrospective analysis was performed of patients undergoing transperineal template biopsy who also had free to total prostate-specific antigen and prostate-specific antigen density. Receiver-operating characteristic analysis was performed to determine the comparative utility of each test in the detection of all cancers as well as clinically significant cancers, by means of the area under the curve. Results: Data from 293 patients were analysed. Prostate cancer was detected in 72% of patients, of which 62% of this group had clinically significant disease. Receiver-operating characteristic analysis demonstrated the superiority of prostate-specific antigen density and free to total prostate-specific antigen over standard prostate-specific antigen in the overall detection of cancer (area under the curve 0.662 and 0.674 vs 0.534, p=0.003 and 0.02 respectively). Both tests were even more effective in the detection of clinically significant cancers (area under the curve 0.755 and 0.715 vs 0.572, p<0.0001 and 0.009 respectively). Conclusion: The free to total prostate-specific antigen and prostate-specific antigen density both appear to perform well at detecting clinically significant prostate cancer in our population of men undergoing template biopsy. The potential role of these inexpensive tests should not be overlooked as they may be of value when deciding which patients require biopsy following an initial magnetic resonance imaging scan and also for those on surveillance protocols.

Download Full-text

Salivary IL-8 as a putative predictive biomarker of radiotherapy response in head and neck cancer patients

Clinical Oral Investigations ◽

10.1007/s00784-021-04017-0 ◽

2021 ◽

Author(s):

Sara Principe ◽

Enrique Zapater-Latorre ◽

Leo Arribas ◽

Enrique Garcia-Miragall ◽

Jose Bagan

Keyword(s):

Operating Characteristic ◽

Area Under The Curve ◽

Predictive Biomarker ◽

Good Clinical Response ◽

Receiver Operating Characteristic Curves ◽

Irradiation Treatment ◽

Tnf Α ◽

Irradiation Therapy ◽

Before And After ◽

Radiotherapy Treatment

Abstract Objectives Ionizing radiation increases the expression of a number of salivary proteins involved in immunoregulatory networks related to infection, injury, inflammation, and cancer. Our main objective was to analyze whether there are significant differences in salivary cytokines before and after radiotherapy and whether any of them are associated to better outcomes after radiotherapy serving as a potential predictive biomarker of response to the treatment. Materials and methods We analyzed a panel of eight salivary markers (IL-4, IL-6, IL-8, and IL-10; MCP-1; TNF-α; VEGF; and EGF) in a group of HNC patients (N = 30), before and after irradiation treatment pre- and post-RT. We also compared these results with a group of healthy controls (N = 37). In both groups, we used stimulated saliva and we performed immunoassays based on multi-analyte profiling technology (Luminex xMAP). Results In our group of 30 HNC patients, 24 of them showed a good clinical response after radiotherapy treatment while 6 cases did not respond to radiotherapy. The data revealed a post-treatment increase in multiple cytokines in the stimulated saliva of HNC patients; the increases in IL-8 and MCP-1 were statistically significant (p ≤ 0.001 and p ≤ 0.0001, respectively). Analysis of receiver operating characteristic curves indicated the strong potential of IL-8 as a predictive biomarker of RT good outcomes (area under the curve = 0.84; p = 0.018). Conclusions After analyzing the panel of salivary cytokines, IL-8 showed the best association to the response to radiotherapy; in this sense, low IL-8 levels in the saliva of HNC patients before receiving irradiation therapy are associated with positive RT outcomes. Clinical relevance Salivary IL-8 expression in HNC patients undergoing RT may serve as a potential predictive biomarker of response to the treatment.

Download Full-text

Training, Performance, and Physiological Predictors of a Successful Elite Senior Career in Junior Competitive Road Cyclists

International Journal of Sports Physiology and Performance ◽

10.1123/ijspp.2017-0824 ◽

2018 ◽

Vol 13 (10) ◽

pp. 1287-1292 ◽

Cited By ~ 3

Author(s):

Ida S. Svendsen ◽

Espen Tønnesen ◽

Leif Inge Tjelta ◽

Stein Ørn

Keyword(s):

Operating Characteristic ◽

Good Accuracy ◽

Area Under The Curve ◽

Characteristic Analysis ◽

Training Performance ◽

Physiological Variables ◽

Road Cyclists ◽

High Level ◽

National Road ◽

Race Performance

Purpose: To determine whether training, performance, or physiological variables at age 18 can predict which athletes become World Tour (WT) riders at senior level. Methods: Based on performance level at age 23, 80 competitive male cyclists were retrospectively categorized into 4 groups: retired (n = 21), club (n = 26), continental (n = 24), or WT (n = 9). Data collected at age 18 were analyzed to determine whether training, performance, or physiological variables differed significantly between groups. Results: At age 23, 9 riders (11%) were WT level. These riders competed significantly more at age 18 than athletes who were club level (91.5 [19.1] h vs 62.8 [21.8] h, P = .032) or retired by age 23 (61.8 [23.4] h, P = .014). WT athletes placed significantly better in national road championships at age 18 than did continental, club, and retired athletes (all P < .01). Receiver-operating-characteristic analysis showed that placing at national championships at age 18 had good accuracy in predicting whether the athlete would later reach WT level (area under the curve = 0.882). WT athletes had significantly higher maximal aerobic power at age 18 than athletes who did not reach WT level (533 [23] vs 451 [41] W and 6.9 [0.4] vs 6.2 [0.4] W/kg, P < .05). Conclusion: Already at junior level, there were performance and physiological differences distinguishing those who later became WT riders. The findings emphasize the need for high volumes of training and competition, as well as a high level of race performance already at junior level, to become a successful elite road cyclist.

Download Full-text

Clinical Significance of Serum HE4, CA125, CA724, and CA19-9 in Patients With Endometrial Cancer

Technology in Cancer Research & Treatment ◽

10.1177/1533034616666644 ◽

2016 ◽

Vol 16 (4) ◽

pp. 435-439 ◽

Cited By ~ 14

Author(s):

Jing Bian ◽

Xiaoxu Sun ◽

Bo Li ◽

Liang Ming

Keyword(s):

Endometrial Cancer ◽

Receiver Operating Characteristic ◽

Predictive Value ◽

Operating Characteristic ◽

Area Under The Curve ◽

International Federation ◽

Characteristic Analysis ◽

Predictive Values ◽

Gynecology And Obstetrics ◽

Receiver Operating

Purpose: Serum markers with increased sensitivity and specificity for endometrial cancer are required. To date, no good marker has met this standard. The aims of our study were to evaluate the utility of tumor markers HE4, CA125, CA724, and CA19-9 as potential markers in patients diagnosed with endometrial cancer. Methods: Blood samples from 105 patients with endometrial cancer and 87 healthy women were analyzed by Roche electrochemiluminescent immunoassay, and serum values were measured for the following biomarkers: HE4, CA125, CA724, and CA19-9. Results: Serum HE4, CA125, CA724, and CA19-9 concentrations were significantly higher in patients with endometrial cancer, compared with controls ( P < .001). In the receiver operating characteristic analysis, the area under the curve value for combination of HE4, CA125, CA724, and CA19-9 was 82.1% (95% confidence interval: 75.3%-86.2%), the maximum area of the test groups. For all stages of patients with endometrial cancer, HE4 had higher sensitivity (58%), positive predictive value (60%), and negative predictive value (67%) than any other single tumor marker, and in the combination of HE4, CA125, CA724, and CA19-9, the sensitivity and positive predictive values reached 59.1% and 88%, respectively. Meanwhile, the receiver operating characteristic area under the curve of the combination of the 4 markers was significantly increased than any other group, either in stage I or in stage II to IV cases. HE4 and CA125 both correlate with advanced age; in addition, HE4 was related to pathology subtypes and positive adnexal involvement, CA125 was related to International Federation of Gynecology and Obstetrics stage, CA19-9 was related to International Federation of Gynecology and Obstetrics stage, and CA724 was correlated with positive lymph node. Conclusion: Combination of HE4, CA125, CA724, and CA19-9 has the highest value in diagnosing endometrial cancer, and they can be a useful tissue immune marker for patients with endometrial cancer.

Download Full-text