Umbilical Cord Oxygen Content and Neonatal Morbidity at Term

2017 ◽  
Vol 35 (04) ◽  
pp. 331-335 ◽  
Author(s):  
Lorene Temming ◽  
Molly Stout ◽  
George Macones ◽  
Alison Cahill ◽  
Methodius Tuuli ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Secondary Analysis ◽  
Area Under The Curve ◽  
Predictive Ability ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Receiver Operating Characteristic Curves ◽  
The Relationship ◽  
Primary Composite Outcome ◽  
Ischemic Encephalopathy

Objective The objective of this study was to investigate the relationship between umbilical cord partial pressure of oxygen (pO2) at delivery and neonatal morbidity. Study Design This is a secondary analysis of a prospective cohort study of term deliveries with universal cord gas collection between 2010 and 2014. The primary composite outcome of neonatal morbidity included neonatal death, meconium aspiration syndrome, intubation, mechanical ventilation, hypoxic-ischemic encephalopathy, and hypothermia treatment. Umbilical artery (UA), vein (UV), UV minus UA (Δ) pO2, and hypoxemia (pO2 ≤ fifth percentile) were compared between patients with and without neonatal morbidity. Areas under the receiver-operating characteristic curves were used to assess the predictive ability of pO2. Results Of 7,789 patients with paired umbilical cord pO2, 106 (1.4%) had the composite neonatal morbidity. UA pO2 was significantly lower in patients with neonatal morbidity compared with those without (median [interquartile range]: 16 (12, 21) vs. 19 (15, 24) mm Hg, p < 0.001). There was no difference in median UV pO2 or ΔpO2 between the groups. UA and UV hypoxemia were significantly more common in patients with neonatal morbidity. UA pO2 had limited predictive ability for neonatal morbidity (area under the curve: 0.61, 95% confidence interval: 0.6–0.7). Conclusion Although UA pO2 is significantly lower in patients with neonatal morbidity, it is a poor predictor of neonatal morbidity at term.

Mild Neonatal Acidemia is Associated with Neonatal Morbidity at Term

2020 ◽  
Author(s):  
Erin J. Bailey ◽  
Antonina I. Frolova ◽  
Julia D. López ◽  
Nandini Raghuraman ◽  
George A. Macones ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Umbilical Artery ◽  
Secondary Analysis ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Term Neonates ◽  
Increased Risk ◽  
Ph Range ◽  
Morbidity Index ◽  
Ischemic Encephalopathy

Objective The aim of this study is to determine the association between mild acidemia (umbilical artery [UA] pH: 7.11–7.19) and neonatal morbidity in neonates at term. Study Design This is a secondary analysis of a prospective cohort of women admitted for labor at ≥37 weeks of gestation within a single institution from 2010 to 2015. Universal umbilical cord blood gas assessment was performed and validated. A composite neonatal morbidity index was created including respiratory distress, mechanical ventilation, meconium aspiration syndrome, suspected or confirmed sepsis, hypoxic-ischemic encephalopathy, need for therapeutic hypothermia, seizures and death. The cohort was stratified by UA pH into normal (≥7.20), mild acidemia (7.11–7.19), acidemia (7.00–7.10), and severe acidemia (≤7.00). A subanalysis was also performed where neonates with UA pH between 7.11 and 7.19 were further stratified into two groups (7.11–7.14 and 7.15–7.19) to determine if mildly acidotic infants at the lower end of the pH range were at increased risk of morbidity. Multivariable logistic regression was used to estimate the association between UA pH and neonatal morbidity. Results Among 6,341 participants, 614 (9.7%) had mild acidemia. These infants were more likely to experience morbidity compared with those with normal UA pH (adjusted odds ratio [aOR]: 2.14; [1.68–2.73]). Among neonates with mild acidemia, UA pH 7.11 to 7.14 was associated with increased risk of composite neonatal morbidity (aOR: 3.02; [1.89–4.82]), as well as respiratory distress and suspected or confirmed sepsis when compared with UA pH 7.15 to 7.19. Conclusion These data demonstrate that term neonates with mild acidemia at birth are at higher odds for short-term morbidity compared with neonates with normal UA pH. Furthermore, among neonates with mild acidemia, those with lower UA pH had worse neonatal outcomes than those with higher UA pH. This suggests that closer evaluation of neonates with UA pH higher than traditionally used could allow for earlier detection of morbidity and possible intervention.

Risk of Neonatal Neurologic Morbidity in Advancing Term Gestations

2017 ◽  
Vol 35 (07) ◽  
pp. 599-604 ◽  
Author(s):  
Molly Stout ◽  
Methodius Tuuli ◽  
Julia López ◽  
George Macones ◽  
Alison Cahill ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Secondary Analysis ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Delivery Mode ◽  
Single Institution ◽  
Term Infants ◽  
Increased Risk ◽  
Adverse Neonatal Outcomes ◽  
Ischemic Encephalopathy

Objective Placental insufficiency is associated with neonatal neurologic morbidity and late-term gestations (410/7–416/7 weeks). Whether late-term infants are at increased risk of neurologic morbidity compared with term infants (390/7–406/7 weeks) remains unclear. We aim to compare risk of neurologic morbidity among late-term and term infants. Study Design This secondary analysis of a single-institution prospective cohort study included all liveborn, nonanomalous singleton term and late-term infants, with data on adverse neonatal outcomes up until 28 days of life. The primary outcome was a neonatal neurologic morbidity composite, defined by having one of these conditions: neonatal seizures, intraventricular hemorrhage, hypoxic-ischemic encephalopathy, and neonatal hypothermic therapy. Secondary outcomes were the composite's individual components and nonneurologic neonatal morbidity. Multivariable logistic regression adjusted for delivery mode, nulliparity, and labor type. Results Of 5,529 infants included, 747 were late term and 4,782 were term. The risk of composite neurologic morbidity was not significantly different among late-term or term infants (0.5 vs. 0.6%; adjusted odds ratio: 0.59, 95% confidence interval: 0.21–1.71). Overall neonatal morbidity was not significantly different in the two groups, though late-term infants had a nonsignificantly higher prevalence of respiratory distress syndrome (5.5 vs. 3.3%) and meconium aspiration syndrome (0.7 vs. 0.2%). Conclusion Neonatal neurologic morbidity is uncommon after 39 weeks. Risk does not increase after 41 weeks.

scholarly journals The Relationship Between Tactical Positioning and the Race Outcome in 800-M Running at the 2016 Olympic Games and 2017 IAAF World Championship

2020 ◽  
Vol 71 (1) ◽  
pp. 299-305
Author(s):  
Fernando González-Mohíno ◽  
Jesús Santos del Cerro ◽  
Andrew Renfree ◽  
Inmaculada Yustres ◽  
José Mª González-Ravé
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Olympic Games ◽  
Area Under The Curve ◽  
Predictive Ability ◽  
Significance Test ◽  
Final Position ◽  
The Difference ◽  
The Relationship

AbstractThe purpose of this analysis was to quantify the probability of achieving a top-3 finishing position during 800-m races at a global championship, based on dispersion of the runners during the first and second laps and the difference in split times between laps. Overall race times, intermediate and finishing positions and 400 m split times were obtained for 43 races over 800 m (21 men’s and 22 women’s) comprising 334 individual performances, 128 of which resulted in higher positions (top-3) and 206 the remaining positions. Intermediate and final positions along with times, the dispersion of the runners during the intermediate and final splits (SS1 and SS2), as well as differences between the two split times (Dsplits) were calculated. A logistic regression model was created to determine the influence of these factors in achieving a top-3 position. The final position was most strongly associated with SS2, but also with SS1 and Dsplits. The Global Significance Test showed that the model was significant (p < 0.001) with a predictive ability of 91.08% and an area under the curve coefficient of 0.9598. The values of sensitivity and specificity were 96.8% and 82.5%, respectively. The model demonstrated that SS1, SS2 and Dplits explained the finishing position in the 800-m event in global championships.

scholarly journals Association of N-Terminal Pro-brain Natriuretic Peptide With Volume Status and Cardiac Function in Hemodialysis Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Yaqiong Wang ◽  
Xuesen Cao ◽  
Jinbo Yu ◽  
Yongmei Zhang ◽  
Xianzhe Li ◽  
...  
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Area Under The Curve ◽  
Volume Overload ◽  
Hemodialysis Patients ◽  
Receiver Operating Characteristic Curves ◽  
Confounding Variables ◽  
Structure Disorder ◽  
The Relationship ◽  
Hemodialysis Duration

Introduction: N-terminal-pro-brain natriuretic peptide (NT-pro BNP) is secreted by cardiomyocytes in cases of cardiac structure disorder and volume overload. However, the relationship between NT-pro BNP level and body fluid status in dialysis patients with reduced cardiac ejection function (EF) is uncertain. Therefore, we aimed to investigate this relationship.Methods: We enrolled patients who had been receiving hemodialysis for &gt;3 months. Blood sample, transthoracic echocardiographic, and bioimpedance spectroscopy measurements were performed during a midweek non-dialysis day. The predictive value of NT-pro BNP in hemodialysis patients with volume overload was analyzed.Results: A total of 129 hemodialysis patients (74 men and 55 women; mean age: 59.4 ± 13.0 years) were recruited. The average hemodialysis duration was 55.5 (23.9–93.4) months, the NT-pro BNP level was 4992 (2,033–15,807) pg/mL, and the value of overhydration was 2.68 ± 0.19 (−1.9 to 12.2) L. The NT-pro BNP level was independently correlated with overhydration in both the LVEF ≥ 60% (β = 0.236, P = 0.044) and LVEF &lt;60% (β = 0.516, P = 0.032) groups, even after adjustments for potentially confounding variables. In receiver operating characteristic curves of NT-pro BNP for predicting volume overload, the area under the curve was 0.783 [95% CI (0.688–0.879), P &lt; 0.001) and 0.788 [95% CI (0.586–0.989), P &lt; 0.001] in the LVEF ≥ 60% and LVEF &lt; 60% groups, respectively.Conclusions: NT-pro BNP is a predictive factor for volume overload in hemodialysis patients with or without EF declines.

scholarly journals Elevation of serum alpha-1-acid glycoprotein in children with bronchial pneumonia caused by Mycoplasma pneumoniae infection

2020 ◽  
Author(s):  
Huanying Fang ◽  
Aiping Zhou ◽  
shusheng yang
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Area Under The Curve ◽  
Related Factor ◽  
Related Factors ◽  
Receiver Operating Characteristic Curves ◽  
Acid Glycoprotein ◽  
Inflammatory Conditions ◽  
Laboratory Examinations ◽  
Logistic Regressions ◽  
The Relationship

Abstract Background:Alpha-1-acid glycoprotein(AGP) is an acute phase protein which can be elevated under inflammatory conditions. Few studies have explored the use of monitoring serum AGP in Mycoplasma pneumoniae pneumonia(MPP). Methods:We aimed to evaluate the relationship between serum AGP and other convention inflammation bio-markers,in order to explore its clinical significance in children with MPP. Pediatric inpatients with bronchopneumonia from January to December 2018 were enrolled and divided into two groups -children with MPP and children without MPP severed as controls. Serum AGP, procalcitonin (PCT) ,and other laboratory examinations were compared and multiple logistic regressions analysis was used to select the main related factors, then receiver-operating characteristic curves were used to evaluate the value of the selected markers used to identify MPP from bronchopneumonia. Results: Two hundred and sixty-eight children were enrolled in this study.Among them, 87 (32.46%) cases were diagnosed as MPP and 181 gender-matched children were without MPP. Children with MPP were slightly older than those without MPP and had lower levels of serum PCT (P<0.05). In addition, serum AGP was significantly higher in patients with MPP than control participants (136.06±46.37 vs. 122.29±44.21,respectively;P=0.020). Multiple logistic regressions analysis adjusted for age showed that only AGP was the main related factor ,which could perhaps be used to identify MPP from common bronchopneumonia and its area under the curve (AUC) was 0.703(95% CI: 0.634-0.772;P=0.000).Combination with AGP and PCT could slightly improve the AUC(95 % CI) to 0.732 (95% CI: 0.666-0.797, P=0.000). Conclusion: AGP is perhaps a potential bio-marker to distinguish MPP from other bronchopneumonia in children and assist early diagnosis and treatment as soon as possible for it is relatively convenient and fast to be carried out.

scholarly journals Intratumoral Susceptibility Signals Reflect Biomarker Status in Gliomas

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ling-Wei Kong ◽  
Jin Chen ◽  
Heng Zhao ◽  
Kun Yao ◽  
Sheng-Yu Fang ◽  
...  
Keyword(s):  
Molecular Markers ◽  
Dna Methyltransferase ◽  
Area Under The Curve ◽  
Predictive Ability ◽  
Low Grade ◽  
Isocitrate Dehydrogenase 1 ◽  
Methylguanine Dna Methyltransferase ◽  
Non Invasive ◽  
Marker Status ◽  
The Relationship

AbstractSusceptibility-weighted imaging (SWI) can be a useful tool to depict vascular structures in brain tumors as well as micro-bleedings, which represent tumor invasion to blood vessels and could also be representative of tumoral angiogenesis. In this study, we investigated the relationship between SWI features and glioma grades, and the expression of key molecular markers isocitrate dehydrogenase 1 (IDH1), O-6-methylguanine-DNA methyltransferase (MGMT), and 1p19q. The gliomas were graded according to the intratumoral susceptibility signals (ITSS). We used the Mann-Whitney test to analyze the relationship between ITSS grades and the pathological level and status of these markers. Additionally, the area under the curve (AUC) was used to determine the predictive value of glioma SWI characteristics for the molecular marker status. In these cases, the ITSS grades of low-grade gliomas (LGG) were significantly lower than those of high-grade gliomas (HGG). Similarly, the ITSS grades of gliomas with IDH1 mutations and MGMT methylation were significantly lower than those of gliomas with Wild-type IDH1 and unmethylated MGMT. However, ITSS grades showed no relationship with 1p19q deletion status, while they did show significant predictive ability for glioma grade, IDH1 mutation, and MGMT methylation. These findings indicate an association between some molecular markers and cerebral microbleeds in gliomas, providing a new avenue for non-invasive prediction of molecular genetics in gliomas and an important basis for preoperative personalized surgical treatment based on molecular pathology.

scholarly journals Usefulness of Hamilton rating scale for depression subset scales and full versions for electroconvulsive therapy

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259861
Author(s):  
Caoimhe Fenton ◽  
Declan M. McLoughlin
Keyword(s):  
Predictive Value ◽  
Rating Scales ◽  
Rating Scale ◽  
Secondary Analysis ◽  
Predictive Ability ◽  
Early Improvement ◽  
Receiver Operating Characteristic Curves ◽  
Predictors Of Response ◽  
Therapeutic Outcomes ◽  
Hamilton Rating Scale

Objectives We investigated the predictive value of subset scales and full versions of the Hamilton Rating Scale for Depression (HAMD) for therapeutic outcomes in ECT. Methods This secondary analysis of patients with major depression (N = 136; 63% female; age = 56.7 [SD = 14.8]) from the EFFECT-Dep trial (NCT01907217) examined the predictive value of Evans-6, Toronto-7, Gibbons-8 and Maier-Philip 6 HAMD subset scales and three ‘full’ versions (HAMD-17, HAMD-21 and HAMD-24) on therapeutic outcomes. We also examined early improvement on subset scales and full versions as predictors of response and remission and explored predictive abilities of individual HAMD-24 items. Results The subset scales and full scales lacked sufficient predictive ability for response and remission. Receiver operating characteristic curves identified a lack of discriminative capacity of HAMD subset scales and full versions at baseline to predict response and remission. Only the Maier-Philip-6 was significantly associated with percentage reduction in HAMD-24 scores from baseline to end of ECT course. Early improvement on most of the subset scales and full versions was a sensitive and specific predictor of response and remission. Four of the HAMD-24 items were significantly associated with response and one with remission. Conclusions Limited utility of the HAMD subset scales and full versions in this context highlight a need for more tailored depression rating scales for ECT.

scholarly journals Sex- and Age-Specific Optimal Anthropometric Indices as Screening Tools for Metabolic Syndrome in Chinese Adults

2018 ◽  
Vol 2018 ◽  
pp. 1-16 ◽  
Author(s):  
Jia Zhang ◽  
Wenhua Zhu ◽  
Lifeng Qiu ◽  
Lijuan Huang ◽  
Lizheng Fang
Keyword(s):  
Metabolic Syndrome ◽  
Area Under The Curve ◽  
Predictive Ability ◽  
Shape Index ◽  
Screening Tools ◽  
Youden Index ◽  
Chinese Adults ◽  
Anthropometric Indices ◽  
Receiver Operating Characteristic Curves ◽  
Cardiometabolic Risks

Objectives. To compare the predictive ability of six anthropometric indices for identification of metabolic syndrome (MetS) and to determine their optimal cut-off points among Chinese adults. Methods. A total of 59,029 participants were enrolled. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), and conicity index (CI) were measured. Receiver-operating characteristic curves analyses were performed to determine the discriminatory power of these indices for the identification of cardiometabolic risks and diagnosis of MetS. The differences in the area under the curve (AUC) values among the indices were evaluated. The Youden index was used to determine the optimal cut-off points. Results. WHtR and BRI exhibited the highest AUC values for identifying MetS and most cardiometabolic risk factors in both sexes, whereas ABSI showed the lowest AUC value. The general optimal cut-off points in women were 23.03 kg/m2 for BMI, 77.25 cm for WC, 0.490 for WHtR, and 3.179 for BRI; those in men were 24.64 kg/m2 for BMI, 87.25 cm for WC, 0.510 for WHtR, and 3.547 for BRI. The AUC values and cut-off points of the indices were also analyzed in each age and BMI category. Conclusions. In Chinese adults, WHtR and BRI showed a superior predictive power for MetS in both sexes, which can be used as simple and effective screening tools for cardiometabolic risks and MetS in clinical practice.

Ascertaining an efficient eligibility cut-off for extended Medicare items for eating disorders

2021 ◽  
pp. 103985622110286
Author(s):  
Tracey Wade ◽  
Jamie-Lee Pennesi ◽  
Yuan Zhou
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
False Positive Rate ◽  
Area Under The Curve ◽  
Rate Sensitivity ◽  
True Positive Rate ◽  
Eating Disorder Examination Questionnaire ◽  
Eating Disorder Examination ◽  
Positive Rate ◽  
The Relationship

Objective: Currently eligibility for expanded Medicare items for eating disorders (excluding anorexia nervosa) require a score ⩾ 3 on the 22-item Eating Disorder Examination-Questionnaire (EDE-Q). We compared these EDE-Q “cases” with continuous scores on a validated 7-item version of the EDE-Q (EDE-Q7) to identify an EDE-Q7 cut-off commensurate to 3 on the EDE-Q. Methods: We utilised EDE-Q scores of female university students ( N = 337) at risk of developing an eating disorder. We used a receiver operating characteristic (ROC) curve to assess the relationship between the true-positive rate (sensitivity) and the false-positive rate (1-specificity) of cases ⩾ 3. Results: The area under the curve showed outstanding discrimination of 0.94 (95% CI: .92–.97). We examined two specific cut-off points on the EDE-Q7, which included 100% and 87% of true cases, respectively. Conclusion: Given the EDE-Q cut-off for Medicare is used in conjunction with other criteria, we suggest using the more permissive EDE-Q7 cut-off (⩾2.5) to replace use of the EDE-Q cut-off (⩾3) in eligibility assessments.

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