Predictive Value
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Qian Chen ◽  
Junjun Zou ◽  
Beilei Zhang ◽  
Feifei Cui ◽  
Meifen Shen ◽  

IntroductionReducing the extubation failure is vital to the early recovery of patients with mechanical ventilation(MV). We aimed to explore the predictive value of the change of intra-abdominal pressure(ΔIAP) before extubation on the extubation failure in MV patients.Material and methodsPatients undergone MV for more than 24 hours were selected. We used a urodynamic monitor to measure ΔIAP 30 minutes before extubation. The characteristics and prognosis of MV patients were analyzed. Receiver operating characteristic(ROC) curve was drawn to analyze the predictive value of ΔIAP for extubation failure.ResultsA total of 173 MV patients were included. The risks of extubation failure increased with the decrease of ΔIAP. The risk of extubation failure in ΔIAP≤21mmHg group was 5.7 times that of the ΔIAP≥38mmHg group (OR 5.7, 95%CI 1.5-22.0), the risk of extubation failure in ΔIAP 22~37 mmHg group was 3.8 times that of the ΔIAP≥38mmHg group (OR 3.8, 95%CI 1.0-15.3). The area under the curve (AUC) predicted by ΔIAP for extubation failure was 0.721, the cutoff value was 31mmHg with 82.8% sensitivity and 48.6% specificity. There were no significant differences in the duration of MV, length of ICU stay, and death in ICU of the three groups of patients (all P>0.05).ConclusionsThe ΔIAP has good reference value for predicting extubation failure, which is negatively correlated with the risk of extubation failure in patients with MV. For MV patients with ΔIAP≤31mmHg, they may have higher risk of extubation failure, early alert and interventions are highlighted for those patients.

2021 ◽  
Vol 16 (1) ◽  
Sina Vakili ◽  
Mohammad Samare-Najaf ◽  
Amirreza Dehghanian ◽  
Amir Tajbakhsh ◽  
Hassan Askari ◽  

AbstractBrucellosis is considered as the most common bacterial zoonosis in the world. Although the laboratory findings are the most reliable diagnosis today, the current laboratory methods have many limitations. This research aimed to design and evaluate the performance of a novel technique based on the localized surface plasmon resonance (LSPR) to eliminate or reduce existing shortcomings. For this purpose, smooth lipopolysaccharides were extracted from Brucella melitensis and Brucella abortus and fixed on the surface of the gold nanoparticles through covalent interactions. After some optimizing processes, dynamic light scattering was used to characterize the probe. The detection of captured anti-Brucella antibody was performed by measuring the redshift on LSPR peak followed by the determination of cutoff value, which indicated a significant difference between controls and true positive patients (P value < 0.01). Furthermore, 40 sera from true negative samples and positive patients were used to evaluate the performance of this method by comparing its outcomes with the gold standard (culture), standard tube agglutination test, and anti-brucellosis IgM and IgG levels (ELISA). The sensitivity, specificity, positive predictive value, and negative predictive value showed an appropriate performance of the LSPR-based method (85%, 100%, 100%, and 86%, respectively). The current research results provide a promising fast, convenient, and inexpensive method for detecting the anti-Brucella antibodies in human sera, which can be widely used in medical laboratories to diagnose brucellosis quickly and effectively.

2021 ◽  
pp. jclinpath-2020-207275
Sona J Appukutty ◽  
Anna Paterson ◽  
Nishant S Patel ◽  
Adam Duckworth ◽  
James Chan ◽  

AimsTo determine the proportion of thyroid fine needle aspiration (FNA) and core needle biopsy (CNB) cases reported at a single institute into each UK Royal College of Pathologists (RCPath) Thy1-5 and local T category, respectively. Where subsequent histology was available, malignancy rates, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were compared for both procedures.Methods1591 FNAs (2010–2018) and 514 CNBs (2013–2018) cases were identified, together with paired histology excision specimens.ResultsThe FNA samples were classified as: Thy1: 45.3%, Thy2/Thy2c: 22.1%, Thy3a/Thy3f: 28%, Thy4: 1.6% and Thy5: 3%; while the CNB were classified as: T1: 7.2%, T2: 22.4%, T3 59.3%, T4: 1% and T5: 10.1%. Comparison of FNA and CNB classified as Thy5/T5 showed a 100% risk of malignancy (ROM), sensitivity (98% vs 100%), specificity (14.1% vs 12.1%), PPV (29.4% vs 29.4%), NPV (94.9% vs 100%) and accuracy (36.5% vs 35.6%), respectively, for a diagnosis of malignancy. ROMs for other categories were: Thy1/T1 (9% vs 6.7%), Thy2/T2 (5.1% vs 0%), Thy3/T3 (17.5% vs 18.4%) and Thy4/T4 (73.3% vs 100%).ConclusionsThe proportion of cases in each RCPath Thy category has remained relatively stable during the 9-year study period, with the exception of the Thy3a category, which has increased over time. This finding is in line with other more recent reports in the literature and the proportion of T3 cases in the CNB group. The proportion of Thy2/Thy2c cases has also reduced over time, reflecting a local change in the triaging protocol for probable benign lesions. Both FNA and CNB showed comparable performance in our study.

2021 ◽  
Frédéric Fitoussi ◽  
Serge Tonen-Wolyec ◽  
Natalio Awaida ◽  
Raphaël Dupont ◽  
Laurent Belec

Abstract Background: The accuracy and reliability of rapid diagnostic tests are critical for monitoring and diagnosing SARS-CoV-2 infection in the general population. This study aimed to evaluate the analytical performance of the BIOSYNEX COVID-19 Ag BSS (Biosynex Swiss SA, Fribourg, Switzerland) antigen rapid diagnostic test (Ag-RDT), which targets the SARS-CoV-2 N-nucleocapsid protein for the diagnosis of COVID-19. The Ag-RDT was compared with a real-time RT-PCR (rtRT-PCR) gold standard for performance measurement.Methods: Two nasopharyngeal flocked swabs were prospectively collected simultaneously in March and April 2021 from 967 individuals aged ≥18 years tested for SARS-CoV-2 in two private laboratories, Paris, France.Results: Overall, the Ag-RDT demonstrated high sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 81.8%, 99.6%, 96.6%, and 97.5%, respectively, as well as high or near-perfect agreement (97.0%), reliability was assessed using Cohen’s κ-coefficient (0.87), and accuracy was evaluated using Youden index (J) (81.6%) in detecting SARS-CoV-2. The analytical performance of the Ag-RDT remained high when there was significant viral shedding (i.e., N gene Ct values ≤ 33 on reference RT-PCR). The sensitivity was only 55.2% in case of low or very low viral excretion (Ct> 33).Conclusions: The BIOSYNEX COVID-19 Ag BSS Ag-RDT is a promising, potentially simple diagnostic tool, especially in symptomatic COVID -19 or proven infectiousness.

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257328
Hindum Lanyero ◽  
Moses Ocan ◽  
Celestino Obua ◽  
Cecilia Stålsby Lundborg ◽  
Katureebe Agaba ◽  

Introduction Given the frequent initiation of antibacterial treatment at home by caregivers of children under five years in low-income countries, there is a need to find out whether caregivers’ reports of prior antibacterial intake by their children before being brought to the healthcare facility are accurate. The aim of this study was to describe and validate caregivers’ reported use of antibacterials by their children prior to seeking care at the healthcare facility. Methods A cross sectional study was conducted among children under five years seeking care at healthcare facilities in Gulu district, northern Uganda. Using a researcher administered questionnaire, data were obtained from caregivers regarding reported prior antibacterial intake in their children. These reports were validated by comparing them to common antibacterial agents detected in blood and urine samples from the children using liquid chromatography with tandem mass spectrometry (LC-MS/MS) methods. Results A total of 355 study participants had a complete set of data on prior antibacterial use collected using both self-report and LC-MS/MS. Of the caregivers, 14.4% (51/355, CI: 10.9–18.5%) reported giving children antibacterials prior to visiting the healthcare facility. However, LC-MS/MS detected antibacterials in blood and urine samples in 63.7% (226/355, CI: 58.4–68.7%) of the children. The most common antibacterials detected from the laboratory analysis were cotrimoxazole (29%, 103/355), ciprofloxacin (13%, 46/355), and metronidazole (9.9%, 35/355). The sensitivity, specificity, positive predictive value (PPV), negative predictive value and agreement of self-reported antibacterial intake prior to healthcare facility visit were 17.3% (12.6–22.8), 90.7% (84.3–95.1), 76.5% (62.5–87.2), 38.5% (33.0–44.2) and 43.9% (k 0.06) respectively. Conclusion There is low validity of caregivers’ reports on prior intake of antibacterials by these children. There is need for further research to understand the factors associated with under reporting of prior antibacterial use.

2021 ◽  
Vol 09 (10) ◽  
pp. E1497-E1503
Ramon-Michel Schreuder ◽  
Qurine E.W. van der Zander ◽  
Roger Fonollà ◽  
Lennard P.L. Gilissen ◽  
Arnold Stronkhorst ◽  

Abstract Background and study aims Colonoscopy is considered the gold standard for decreasing colorectal cancer incidence and mortality. Optical diagnosis of colorectal polyps (CRPs) is an ongoing challenge in clinical colonoscopy and its accuracy among endoscopists varies widely. Computer-aided diagnosis (CAD) for CRP characterization may help to improve this accuracy. In this study, we investigated the diagnostic accuracy of a novel algorithm for polyp malignancy classification by exploiting the complementary information revealed by three specific modalities. Methods We developed a CAD algorithm for CRP characterization based on high-definition, non-magnified white light (HDWL), Blue light imaging (BLI) and linked color imaging (LCI) still images from routine exams. All CRPs were collected prospectively and classified into benign or premalignant using histopathology as gold standard. Images and data were used to train the CAD algorithm using triplet network architecture. Our training dataset was validated using a threefold cross validation. Results In total 609 colonoscopy images of 203 CRPs of 154 consecutive patients were collected. A total of 174 CRPs were found to be premalignant and 29 were benign. Combining the triplet network features with all three image enhancement modalities resulted in an accuracy of 90.6 %, 89.7 % sensitivity, 96.6 % specificity, a positive predictive value of 99.4 %, and a negative predictive value of 60.9 % for CRP malignancy classification. The classification time for our CAD algorithm was approximately 90 ms per image. Conclusions Our novel approach and algorithm for CRP classification differentiates accurately between benign and premalignant polyps in non-magnified endoscopic images. This is the first algorithm combining three optical modalities (HDWL/BLI/LCI) exploiting the triplet network approach.

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0249762
Michael Christian Leitner ◽  
Dirk Christoph Guetlin ◽  
Stefan Hawelka

Objective “Visual Restitution Therapies” (VRT) claim to ameliorate visual field defects of neurological patients by repeated visual light stimulation, leading to training-related neuroplasticity and resulting in reconnection of lesioned neurons in early cortical areas. Because existing systems are stationary, uncomfortable, and unreliable, we developed a training instrument based on virtual reality goggles. The goal of the “Salzburg Visual Field Trainer” (SVFT) is twofold: (1) The device facilitates the clinical evaluation of established neuropsychological rehabilitation approaches, such as VRT. (2) The device enables patients to independently perform VRT based (or other) neuropsychological training methodologies flexibly and comfortably. Methods and analysis The SVFT was developed on the principles of VRT. Individual configuration of the SVFT is based on perimetric data of the respective patient’s visual field. To validate the utmost important aspect of neuropsychological rehabilitation methodologies—that is displaying stimuli precisely in desired locations in the user’s visual field—two steps were conducted in this proof-of-concept study: First, we assessed the individual “blind spots” location and extent of 40 healthy, normal sighted participants. This was done with the help of our recently developed perimetric methodology “Eye Tracking Based Visual Field Analysis” (EFA). Second, depending on the individual characteristics of every participant’s blind spots, we displayed—by means of the SVFT—15 stimuli in the respective locations of every participants’ blind spots and 85 stimuli in the surrounding, intact visual area. The ratio between visible and non-visible stimuli, which is reflected in the behavioral responses (clicks on a remote control) of the 40 participants, provides insight into the accuracy of the SVFT to display training stimuli in areas desired by the investigator. As the blind spot is a naturally occurring, absolute scotoma, we utilized this blind area as an objective criterion and a “simulated” visual field defect to evaluate the theoretical applicability of the SVFT. Results Outcomes indicate that the SVFT is highly accurate in displaying training stimuli in the desired areas of the user’s visual field with an accuracy of 99.0%. Data analysis further showed a sensitivity of .98, specificity of .99, a positive predictive value of .96, a negative predictive value of .996, a hit rate of .99, a random hit rate of .74 and a RATZ-Index of .98. This translates to 14.7% correct non-reactions, 0.7% false non-reactions, 0.3% false reactions and 84.3% correct reactions to displayed test stimuli during the evaluation study. Reports from participants further indicate that the SVFT is comfortable to wear and intuitive to use. Conclusions The SVFT can help to investigate the true effects of VRT based methodologies (or other neuropsychological approaches) and the underlying mechanisms of training-related neuroplasticity in the visual cortex in neurological patients suffering from visual field defects.

Epigenomics ◽  
2021 ◽  
Jiao Jia ◽  
Xiaofei Liu ◽  
Lina Ma ◽  
Yong Xu ◽  
Yan Ren

Aim: The aim of this study was to identify the long noncoding RNAs (lncRNAs) associated with schizophrenia (SZ) and the relationships among their expression, antipsychotic efficacy and SZ severity. Method: The diagnostic and predictive value of nine lncRNAs, Gomafu, DISC2, PSZA11, AK096174, AK123097, DB340248, uc011dma.1, ENST00000509804-1 and ENST00000509804-2, was investigated in 48 patients with SZ before and after antipsychotic treatment. Results: Gomafu, AK096174, AK123097, DB340248, uc011dma.1, ENST00000509804-1 and ENST00000509804-2 were individually and collectively associated with, and predictive of, SZ pathogenesis. Moreover, increased expression of plasma AK123097, uc011dma.1 and ENST00000509804-1 levels was reversed after 12 weeks of antipsychotic treatment, which was associated with SZ severity. Conclusion: Seven lncRNAs serve as novel biomarkers for SZ diagnosis and prognosis and three lncRNAs are potential therapeutic targets.

2021 ◽  
Feng-Wei Guo ◽  
Hong Chen ◽  
Ya-Ling Dong ◽  
Jia-nan Shang ◽  
Li-tao Ruan ◽  

Abstract Objectives: The purpose of this study was to explore the value of the LIMAV measured by ultrasound before CABG in predicting the prognosis of patients after LIMA bypass grafting. Methods: 104 patients who underwent CABG with LIMA as the bridge vessel in the cardiovascular surgery department of our hospital between May 2018 and June 2019 were selected. All patients underwent transthoracic Doppler ultrasonography to measure LIMAV preoperatively. Intraoperatively, MGF and PI of the LIMA bridge were measured using TTFM. The primary endpoint event in this study was cardiac death within 18 months after surgery. Results: The Cox survival analysis showed that the MGF , the LIMAV and LVEF were risk factors for death after CABG . The cut-offs of MGF ,LIMAV and LVEF for the prediction of death after CABG were ≤14 ml/min [AUC: 0.830; Sensitivity:100%; Specificity: 65.6%], ≤60cm/s (AUC: 0.759; Sensitivity:65.5%; Specificity:85.3%) and ≤44%(AUC:0.724; Sensitivity:50%; Specificity: 88.5% )respectively. Compared with the use of MGF, MGF+LIMAV, combination of the MGF+LIMAV+LVEF (AUC:0.929; Sensitivity:100%; Specificity: 81.1%)resulted in a stronger predictive value(MGF vs MGF+LIMAV+LVEF: p=0.02). Conclusion: LIMAV measured by transthoracic ultrasound pre-operation combined with intraoperative MGF and LVEF may have a greater value in predicting patients' risk of cardiac death after CABG.

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