scholarly journals Is BMI a Valid Indicator of Overweight and Obesity for Adolescents?

2020 ◽  
Vol 17 (13) ◽  
pp. 4815 ◽  
Author(s):  
Viktoryia Karchynskaya ◽  
Jaroslava Kopcakova ◽  
Daniel Klein ◽  
Aleš Gába ◽  
Andrea Madarasova-Geckova ◽  
...  
Keyword(s):  
Area Under The Curve ◽  
High Specificity ◽  
Roc Curves ◽  
Overweight And Obesity ◽  
The Body ◽  
Composition Analysis ◽  
Operating Characteristics ◽  
School Aged Children ◽  
Hbsc Study ◽  
Low Sensitivity

Background: Overweight and obesity are mostly monitored via the Body Mass Index (BMI), based on self-reported or measured height and weight. Previous studies have shown that BMI as a measure of obesity can introduce important misclassification problems. The aim of this study was to assess the validity of overweight and obesity classification based on self-reported and on measured height and weight versus the proportion of body fat as the criterion. Methods: We used data on 782 adolescents (mean age = 13.5, 55.8% boys) from the Health Behaviour in School-Aged Children (HBSC) study conducted in 2018 in Slovakia. We obtained self-reported (height and weight) and objective measures (height, weight) and the proportion of fat (as the criterion measure) measured via bioimpedance body composition analysis (BIA) with an InBody 230 from the adolescents. Results: Both measured and self-reported BMI indicated overweight and obesity with relatively low sensitivity (66–82%), but high specificity (90–92%). The superior accuracy of measured BMI in comparison to self-reported BMI was confirmed by the area under the curve (AUC) based on the receiver operating characteristics (ROC) curves (AUC measured/self-reported: 0.94/0.89; p < 0.001). The misclassification of overweight and obesity was significantly higher when using self-reported BMI than when using measured BMI. Conclusion: Both self-reported and measured BMI as indicators of overweight and obesity underestimate the prevalence of adolescents with overweight and obesity.

scholarly journals MicroRNAs Which Can Prognosticate Aggressiveness of Bladder Cancer

Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1551 ◽  
Author(s):  
Edyta Marta Borkowska ◽  
Tomasz Konecki ◽  
Michał Pietrusiński ◽  
Maciej Borowiec ◽  
Zbigniew Jabłonowski
Keyword(s):  
Bladder Cancer ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Control Group ◽  
Low Grade ◽  
Operating Characteristics ◽  
High Death Rate ◽  
Biological Potential ◽  
High Death ◽  
Muscle Invasive

Bladder cancer (BC) is still characterized by a very high death rate in patients with this disease. One of the reasons for this is the lack of adequate markers which could help determine the biological potential of the tumor to develop into its invasive stage. It has been found that some microRNAs (miRNAs) correlate with disease progression. The purpose of this study was to identify which miRNAs can accurately predict the presence of BC and can differentiate low grade (LG) tumors from high grade (HG) tumors. The study included 55 patients with diagnosed bladder cancer and 30 persons belonging to the control group. The expression of seven selected miRNAs was estimated with the real-time PCR technique according to miR-103-5p (for the normalization of the results). Receiver operating characteristics (ROC) curves and the area under the curve (AUC) were used to evaluate the feasibility of using selected markers as biomarkers for detecting BC and discriminating non-muscle invasive BC (NMIBC) from muscle invasive BC (MIBC). For HG tumors, the relevant classifiers are miR-205-5p and miR-20a-5p, whereas miR-205-5p and miR-182-5p are for LG (AUC = 0.964 and AUC = 0.992, respectively). NMIBC patients with LG disease are characterized by significantly higher miR-130b-3p expression values compared to patients in HG tumors.

Serum sFlt-1/PlGF ratio has better diagnostic ability in early- compared to late-onset pre-eclampsia

2018 ◽  
Vol 47 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Theng Theng Chuah ◽  
Wan Shi Tey ◽  
Mor Jack Ng ◽  
Edward T.H. Tan ◽  
Bernard Chern ◽  
...  
Keyword(s):  
Diagnostic Tool ◽  
Late Onset ◽  
Asian Population ◽  
High Sensitivity ◽  
High Specificity ◽  
Roc Curves ◽  
Youden Index ◽  
Operating Characteristics ◽  
Gestation Age ◽  
Plgf Ratio

Abstract Background To establish gestational specific cutoffs for the soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) ratio as a diagnostic tool for pre-eclampsia (PE) in an Asian population. Methods 82 subjects (48 PE patients and 34 controls) were recruited. sFlt-1 and PlGF were analysed on the Roche Cobas e411 analyzer and their ratio was calculated. Diagnostic performance was evaluated using receiver-operating characteristics (ROC) curves. Optimal cutoffs for sFlt-1/PlGF ratio were determined for different gestation phases. Results The most optimal cut-off for the study group is 32 with a sensitivity and specificity of 85.1% and 100% and Youden Index (J) of 0.85. Applying this cutoff for early-onset PE (EO-PE), sensitivity increased to 95.8% while specificity remains at 100% (J=0.96). However, for late onset PE (LO-PE), sensitivity decreases to 73.9% while specificity remains at 100% (J=0.74). Two cutoffs were further determined for EO-PE and LO-PE – the first focusing on high sensitivity; the second focusing on high specificity. For EO-PE, cutoff <17 yielded sensitivity of 100% and specificity of 94.4% (J=0.94) while cutoff ≥32 yielded sensitivity of 95.8% and specificity of 100% (J=0.95). For LO-PE, cutoff <22 has a sensitivity of 82.6% and a specificity of 91.7% (J=0.74) while cutoff ≥32 yielded sensitivity of 73.9% and specificity of 100% (J=0.74). Conclusion While our study found an overall cutoff at 32 regardless of gestation age, it has limited diagnostic accuracy for LO-PE in our study. Multiple cutoffs focusing on either high sensitivity or high specificity enhance the performance of the sFlt-1/PlGF ratio as a diagnostic tool for PE and contribute to the identification of women at risk of PE in our Asian region.

scholarly journals Utility of Inferior Lead Q-waveforms in diagnosing Ventricular Tachycardia

2020 ◽  
Vol 14 ◽  
pp. 117954682095341
Author(s):  
Swathi Subramany ◽  
Ajoe John Kattoor ◽  
Swathi Kovelamudi ◽  
Subodh Devabhaktuni ◽  
Jawahar L Mehta ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Clinical Diagnosis ◽  
Roc Analysis ◽  
Area Under The Curve ◽  
Diagnostic Algorithm ◽  
High Specificity ◽  
Wave Pattern ◽  
Wide Complex Tachycardia ◽  
Low Sensitivity ◽  
Electrocardiogram Ecg

Background: Electrocardiogram (ECG) differentiation of wide complex tachycardia (WCT) into ventricular tachycardia (VT) and supraventricular tachycardia with aberration (SVT-A) is often challenging. Objective: To determine if the presence of Q-waveforms (QS, Qr, QRs) in the inferior leads (II, III, aVF) can differentiate VT from SVT-A in a WCT compared to Brugada algorithm. We studied 2 inferior lead criteria namely QWC-A where all the inferior leads had a similar Q wave pattern and QWC-B where only lead aVF had a Q-waveform. Methods: A total of 181 consecutive cases of WCT were identified, digitally separated into precordial leads and inferior leads and independently reviewed by 2 electrophysiologists. An electrocardiographic diagnosis of VT or SVT-A was assigned based on Brugada and inferior lead algorithms. Results were compared to the final clinical diagnosis. Results: VT was the final clinical diagnosis in 24.9% of ECG cohort (45/181); 75.1% (136/181) were SVT-A. QWC-A and QWC-B had a high specificity (93.3% and 82.8%) and accuracy (78.2% and 71.0%), but low sensitivity (33.3% and 35.6%) in differentiating VT from SVT-A. The Brugada algorithm yielded a sensitivity of 82.2% and specificity of 68.4%. Area under the curve in ROC analysis was highest with Brugada algorithm (0.75, 95% CI 0.69-0.81) followed by QWC-A (0.63, 95% CI 0.56-0.70) and QWC-B (0.59, 95% CI 0.52-0.67). Conclusion: QWC-A and QWC-B criteria had poor sensitivity but high specificity in diagnosing VT in patients presenting with WCT. Further research combining this simple criterion with other newer diagnostic algorithms can potentially improve the accuracy of the overall diagnostic algorithm.

Deep-learning for predicting C-shaped canals in mandibular second molars on panoramic radiographs

2021 ◽  
pp. 20200513
Author(s):  
Su-Jin Jeon ◽  
Jong-Pil Yun ◽  
Han-Gyeol Yeom ◽  
Woo-Sang Shin ◽  
Jong-Hyun Lee ◽  
...  
Keyword(s):  
Deep Learning ◽  
Cone Beam Ct ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Learning System ◽  
Operating Characteristics ◽  
Panoramic Radiographs ◽  
Test Sets ◽  
Sensitivity Specificity ◽  
Deep Learning Model

Objective: The aim of this study was to evaluate the use of a convolutional neural network (CNN) system for predicting C-shaped canals in mandibular second molars on panoramic radiographs. Methods: Panoramic and cone beam CT (CBCT) images obtained from June 2018 to May 2020 were screened and 1020 patients were selected. Our dataset of 2040 sound mandibular second molars comprised 887 C-shaped canals and 1153 non-C-shaped canals. To confirm the presence of a C-shaped canal, CBCT images were analyzed by a radiologist and set as the gold standard. A CNN-based deep-learning model for predicting C-shaped canals was built using Xception. The training and test sets were set to 80 to 20%, respectively. Diagnostic performance was evaluated using accuracy, sensitivity, specificity, and precision. Receiver-operating characteristics (ROC) curves were drawn, and the area under the curve (AUC) values were calculated. Further, gradient-weighted class activation maps (Grad-CAM) were generated to localize the anatomy that contributed to the predictions. Results: The accuracy, sensitivity, specificity, and precision of the CNN model were 95.1, 92.7, 97.0, and 95.9%, respectively. Grad-CAM analysis showed that the CNN model mainly identified root canal shapes converging into the apex to predict the C-shaped canals, while the root furcation was predominantly used for predicting the non-C-shaped canals. Conclusions: The deep-learning system had significant accuracy in predicting C-shaped canals of mandibular second molars on panoramic radiographs.

scholarly journals The role and place of bioimpedance analysis assessment of body composition of children and adolescents with different body mass

2018 ◽  
Vol 17 (2) ◽  
pp. 121-132 ◽  
Author(s):  
Ya. V. Girsh ◽  
O. A. Gerasimchik
Keyword(s):  
Body Composition ◽  
Body Weight ◽  
Children And Adolescents ◽  
Body Mass ◽  
Clinical Medicine ◽  
Cell Mass ◽  
Overweight And Obesity ◽  
The Body ◽  
Composition Analysis ◽  
Bioimpedance Analysis

The steady rise of obesity in children and adolescents emphasizes the need for new, integrated approaches to its diagnosis and therapy. When diagnosing obesity and choosing methods for its correction, it is fundamentally important to use reliable methods of estimating the amount of adipose tissue. Using the body mass index is not always sufficient, since it does not provide complete information on quantitative content in the body weight of the patient’s body. For these purposes in clinical medicine use of bioimpedance analysis to assess the indicators, which characterize the basal metabolism, active cell mass, fat and basirova mass and total water content in the body. However, the holding of bioimpedance body composition analysis is currently limited mainly to dietetics and sports medicine, and adult patients. Quite interesting is the use of the bioimpedance method in the pediatric age group for accurate evaluation of body composition of children of various ages and body weight that will allow for dynamic control of all types of metabolism to evaluate the effectiveness of the observation and treatment of patients with overweight and obesity.

scholarly journals Neck circumference as a discriminator of obesity in older women enrolled in a physical activity program

2017 ◽  
Vol 19 (6) ◽  
pp. 710-719
Author(s):  
Daniel Rogério Petreça ◽  
Enaiane Cristina Menezes ◽  
Paula Fabricio Sandreschi ◽  
Felipe Fank ◽  
Giovana Zarpellon Mazo
Keyword(s):  
Physical Activity ◽  
Older Women ◽  
Roc Curve ◽  
Roc Curves ◽  
Overweight And Obesity ◽  
Neck Circumference ◽  
The Body ◽  
Anthropometric Measures ◽  
Anthropometric Parameter ◽  
Physically Active

The aim of this study was to evaluate neck circumference (NC) as a discriminator of overweight and obesity and to establish cut-off points for physically active older women. The sample consisted of 170 older women (69.5 ± 6.8 years) practicing physical activity. Anthropometric measures (body weight, height, waist circumference – WC, and NC) were obtained and the body mass index (BMI) was calculated. Correlation analysis was performed and ROC curves were constructed. NC was significantly correlated with BMI (rho = 0.656; p<0.0001) and WC (r = 0.561; p<0.0001). Correlating BMI with NC, areas under the ROC curve of 0.819 (p=0.0001) for overweight and of 0.902 (p=0.0001) for obesity were obtained, with suggested cut-off points of 33.07 and 34.05 cm, respectively. Correlating WC with NC, areas under the ROC curve of 0.711 (p=0.0014) for moderate risk (WC) and of 0.864 (p=0.0001) for high risk were obtained, with suggested cut-off points of 32.15 and 34.15 cm, respectively. NC was associated with BMI and WC. An NC ≥ 34 cm was a risk factor for obesity and abnormal body fat distribution in the older women studied. This anthropometric parameter is an alternative to discriminate overweight and obesity in physically active older women.

scholarly journals Overweight and Obesity Among School-aged Children and Maternal Preventive Practices against Childhood Obesity in Select Local Government Areas of Lagos, Southwest, Nigeria

2019 ◽  
Vol 8 (1) ◽  
pp. 70-83
Author(s):  
Oluwafunmilayo Funke Adeniyi ◽  
Gabriel T. Fagbenro ◽  
Foluke A. Olatona
Keyword(s):  
Childhood Obesity ◽  
Local Government ◽  
Overweight And Obesity ◽  
The Body ◽  
World Health ◽  
School Age Children ◽  
Categorical Variables ◽  
School Aged Children ◽  
Preventive Practices ◽  
Southwest Nigeria

Background: Childhood obesity is an emerging epidemic in the developing countries, particularly in the urban settings. This study examines the prevalence of overweight and obesity among school-aged children and the maternal preventive practices against childhood obesity. Methods: This is a cross-sectional study of school-aged children aged 6-13 years and mothers from two Local Government Areas of Lagos State, Southwest Nigeria. Multi-stage sampling technique was used to select study areas and participants, while data were collected using an interviewer administered questionnaire. The Body Mass Index (BMI) of children were determined using the World Health Organisation (WHO) 2007 reference charts. Chi-square test was used to analyze categorical variables and logistic regression analyses were conducted to determine the factors associated with the nutritional status and maternal childhood obesity preventive practices. All analyses were conducted using the Statistical Package for Social Sciences (SPSS) 21. Results: In all, 440 children comprising of 232 boys (52.7%) and 208 girls (42.3%) were studied. Of these, 29 of the participants (6.6%) were overweight, while 39 of them (8.9%) were obese. Most of the children (71.2%) consumed root/tubers and processed cereals while 9 (0.02%) and (17) 0.04% consumed fruits and vegetables. BMI was only significantly related to child age and sex. In all, 243 mothers (55.2%) had good practices against childhood obesity. Levels of maternal preventive practices were not significantly associated with child BMI. Conclusions and Global Health Implications: Overweight/obesity among school-aged children in Lagos is high. Only half of the mothers were involved in preventive practices against childhood obesity. There is need for continuous education and advocacy concerning healthy diet and other preventive strategies against childhood obesity in Lagos, and potentially other parts of the developing world. Key words: • Overweight • Obesity • School-age children • Childhood Maternal preventive practices • Lagos • Nigeria   Copyright © 2019 Adeniyi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Serum Glutamate Is a Predictor for the Diagnosis of Multiple Sclerosis

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Gheyath Al Gawwam ◽  
Inas K. Sharquie
Keyword(s):  
Multiple Sclerosis ◽  
Area Under The Curve ◽  
The Body ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Operating Characteristics ◽  
Serum Samples ◽  
Elisa Technique ◽  
Autoimmune Demyelination ◽  
Serum Glutamate

One neurotransmitter, glutamate, has been implicated in the autoimmune demyelination seen in multiple sclerosis (MS). Glutamate is present in many tissues in the body, so consideration should be given to whether the serum level of glutamate is likely well correlated with the activity of the disease. This research aimed to compare the serum glutamate levels from patients diagnosed with MS with those from an age-matched control population. A review of this data could shed light upon whether the serum testing of glutamate using Enzyme-Linked Immunosorbent Assay (ELISA) is a reliable indicator of MS activity. Serum samples were obtained from 55 patients with different patterns of MS and from 25 healthy adults as a control group. The ELISA technique was used to determine the glutamate levels in the serum samples. The mean serum glutamate level for patients with MS was1.318±0.543 nmol/ml and that of the controls was0.873±0.341 nmol/ml. The serum glutamate levels showed an area under the curve via the receiver operating characteristics (ROC) of 0.738, which was significant (pvalue = 0.001). The present study is the first to establish a strong connection between the serum glutamate levels and MS patients, where there was statistically significant elevation of serum glutamate in MS patients; hence this elevation might be used as a monitor to help in the diagnosis of MS patients.

scholarly journals Non Type-1 Brugada pattern, diagnostic yield of 5 ECG criteria in a young adult cohort

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Carrington ◽  
A Creta ◽  
W Young ◽  
J Pais ◽  
A.R Rocha ◽  
...  
Keyword(s):  
Drug Testing ◽  
Diagnostic Yield ◽  
High Specificity ◽  
Cross Sectional Study ◽  
Operating Characteristics ◽  
Cross Sectional ◽  
Arrhythmic Death ◽  
Low Sensitivity ◽  
Brugada Pattern

Abstract Introduction Distinguishing between non-Type 1 Brugada pattern (non-T1BrP) and an athlete's ECG remains challenging and may have important prognostic implications. We aimed to study prevalence and the diagnostic yield of experts and non-experts for the electrocardiographic non-T1BrP criteria in the young adults from the Sudden Cardiac Death-Screening Of risk factorS (SCD-SOS) cohort. Methods We performed a cross-sectional study in which we reviewed 14662 ECGs of SCD-SOS survey participants and selected 2494 that presented a rSr'-pattern in V1-V2. Among these, 98 were classified by experts in hereditary arrhythmic syndromes for the presence of non-T1BrP and by non-experts who performed manual measurements of the diagnostic criteria based on triangle formed by r'-wave. We estimated intra and interobserver concordance for each criterion, and used logistic regression and receiver operating characteristics (ROC) analysis and C-statistics for diagnostic accuracy and definition of the most appropriate cut-off values. Results We detected a rSr'-pattern in V1-V2 in 17% of the individuals and found that it was associated with higher PQ and QTc intervals, male gender and lower BMI. The manual measurements of non-T1BrP criteria were reproducible: we had high intraobserver concordance coefficients (CC) ranging from 0.90 to 0.94 (except for d(B) that had 0.66), but interobserver CC were lower (0.45–0.68). The measurements performed were highly correlated with non-T1BrP diagnosis and the criteria with higher discriminatory capacity were the distance d(B) (AUC 0.77; 95% CI0.69–0.84) and the degree of ST-ascent (AUC 0.79; 95% CI 0.72–0.86). The cut-offs defined by other authors had very low sensitivity (8–12%), despite high specificity (98%), so we defined new cut-offs: d(A) ≥2mm, d(B) ≥1.25mm, d(B)/h ≥0.38, β-angle ≥19° and ST-ascent ≥1mm. The addition of the degree of ST-ascent to a model with these 4 parameters presented an increase in C-statistics from 0.77 (95% CI: 0.68–0.86) to 0.83 (95% CI: 0.75–0.91) for the diagnosis of non-T1BrP by an expert in Sudden Arrhythmic Death and Channelopathies. Conclusion A rSr'-pattern in precordial leads V1-V2 is a frequent finding and the detection of non-T1BrP by using the aforementioned 5 measurements is reproducible and accurate. In this study, we describe new cut-off values that may help untrained clinicians to identify young individuals who should be referred for provocative drug testing for Brugada Syndrome. Accuracy of non-T1 BrP criteria Funding Acknowledgement Type of funding source: None

scholarly journals Clinical prediction rules for childhood UTIs: a cross-sectional study in ambulatory care

BJGP Open ◽  
2022 ◽  
pp. BJGPO.2021.0171
Author(s):  
Hanne Ann Boon ◽  
Jan Y Verbakel ◽  
Tine De Burghgraeve ◽  
Ann Van den Bruel
Keyword(s):  
Area Under The Curve ◽  
High Specificity ◽  
Cross Sectional Study ◽  
Clinical Prediction ◽  
Sectional Study ◽  
Clinical Prediction Rules ◽  
Cross Sectional ◽  
Prediction Rules ◽  
Low Sensitivity ◽  
Tract Infections

BackgroundDiagnosing childhood urinary tract infections (UTI) is challenging.AimValidate clinical prediction rules (UTIcalc, DUTY, Gorelick) for paediatric UTIs in primary care.Design & settingPost-hoc analysis of a cross-sectional study in 39 general practices and 2 emergency departments (Belgium, March 2019 to March 2020).MethodPhysicians recruited acutely ill children ≤18 years and sampled urine systematically for culture. Per rule, we performed an apparent validation; calculated sensitivities and specificities with 95%CI per threshold in the target group. For the DUTY coefficient-based algorithm, we performed a logistic calibration and calculated the Area Under the Curve with 95%CI.ResultsOf 834 children ≤18 years recruited, there were 297 children <5 years. The UTIcalc and Gorelick score had high to moderate sensitivity and low specificity (UTIcalc ≥2%) 75%; and 16% respectively; Gorelick (≥2 variables) 91%; and 8%. In contrast, the DUTY score ≥5 points had low sensitivity (8%), but high specificity (99%). Urine samples would be obtained in 72% vs 38% (UTIcalc), 92% vs 38% (Gorelick) or 1% vs 32% (DUTY) of children, compared to routine care. The number of missed infections per score was 1/4 (UTIcalc), 2/23 (Gorelick) and 24/26 (DUTY). The UTIcalc+ dipstick model had high sensitivity and specificity (100%; and 91%); resulting in no missed cases and 59% (95%CI 49%–68%) of antibiotics prescribed inappropriately.ConclusionIn this study, the UTIcalc and Gorelick score were useful for ruling out UTI but resulted in high urine sampling rates. The DUTY score had low sensitivity, meaning that 92% of UTIs would be missed.

Sign in / Sign up

Export Citation Format

Share Document