XÁC ĐỊNH TRUNG VỊ CỦA CÁC BIOMARKER TRONG TẦM SOÁT LỆCH BỘI QUÝ 1 THAI KÌ TẠI BỆNH VIỆN ĐẠI HỌC Y DƯỢC TP. HỒ CHÍ MINH

Đặt vấn đề: Thay đổi nồng độ PAPP-A và free beta-hCG (fβ-hCG) trong máu mẹ được chứng minh là có liên quan đến nguy cơ mắc hội chứng Down ở thai nhi. Một số nghiên cứu cho thấy trung vị hai chất này thay đổi theo chủng tộc và không thể giải thích được bằng hiệu chỉnh cân nặng mẹ. Mỗi dân tộc nên có giá trị tham chiếu riêng cho dân số mình. Mục tiêu: Xác định giá trị trung vị của PAPP-A và fβ-hCG của dân số đại học Y Dược Tp. Hồ Chí Minh (ĐHYD). Phương pháp: Nghiên cứu báo cáo loạt ca hồi và tiến cứu 2873 thai phụ đến khám tại đơn vị chẩn đoán trước sanh bệnh viện ĐHYD TP. Hồ Chí Minh được sàng lọc quí 1 thai kì bằng combined test. Kết quả: Trung vị dự đoán: PAPP-A=214,3 – 5,384 x (ngày tuổi thai) + 0,03415 x (ngày tuổi thai)2 r=0,9677; fβ-hCG = 10^ (-0,06799 x (ngày tuổi thai) + 7,581) r= 0,991; Mô hình điều MoM theo cân nặng mẹ: PAPP-A MoM hiệu chỉnh = 0,3628*EXP(0,01705*cân nặng Kg); fβ-hCG MoM hiệu chỉnh = 1,665*EXP(-0,005857*cân nặng Kg); Trung vị MoM PAPP-A khi sử dụng mô hình đặc trưng cho dân số ĐHYD là 0,896 khác biệt với trung vị MoM PAPP-A khi sử dụng mô hình của FMF là 1,064 (95% CI, p< 0.05). Trung vị MoM fβ-hCG khi sử dụng mô hình đặc trưng cho dân số ĐHYD là 1,221 khác biệt với trung vị MoM fβ-hCG khi sử dụng mô hình của FMF là 1,433 (95% CI, p< 0.05). So sánh hai mô hình: Tỉ lệ dương tính của test sàng lọc khi áp dụng MoM- FMF là 7,62%.Tỉ lệ dương tính của test sàng lọc khi áp dụng MoM-ĐHYD là 8,8%. Khi áp dụng MoM-ĐHYD: Tỉ lệ phát hiện là 100%. Tỉ lệ tiên đoán dương: 7,11%; Tỉ lệ dương giả: 8,18%. Kết luận: Mỗi chủng tộc nên áp dụng giá trị trung vị PAPP-A và fβ-hCG riêng của dân số mình cho sàng lọc lệch bội ba tháng đầu thai kì bằng combined test.

Diagnosis Value of Colposcope Combined with Serum Squamous Cell Carcinoma Antigen, Carbohydrate Antigen 125, and Carcinoembryonic Antigen for Moderate to Advanced Cervical Cancer Patients Treated with Modified Fuzheng Peiyuan Decoction

Objective. To explore the diagnosis value of colposcope combined with serum squamous cell carcinoma antigen (SCC-Ag), carbohydrate antigen 125 (CA125), and carcinoembryonic antigen (CEA) for moderate to advanced cervical cancer patients treated with modified Fuzheng Peiyuan decoction. Methods. The clinical data of 43 moderate to advanced cervical cancer patients treated in Suzhou Hospital of Traditional Chinese Medicine from July 2018 to July 2019 were selected for the retrospective analysis, and 43 healthy women undergoing physical examination in our medical center in the same period were selected as the control group. The cervical cancer patients accepted the modified Fuzheng Peiyuan decoction treatment, the detection of SCC-Ag, CA125, and CEA and colposcope examination were performed to all research subjects, and the changes in indicators such as KPS scores and lesion perfusion parameters in cervical cancer patients before and after treatment were monitored, so as to analysis the clinical diagnosis value of combined diagnosis in treated patients. Results. After treatment, the mean KPS scores were greatly higher and various blood perfusion parameters of lesions and serum SCC-Ag, CA125, and CEA levels were remarkably lower than before ( P value <0.001 for all); the area under the curve of combined test was significantly larger than that of single test, and the sensitivity and specificity of the combined test were the highest; and after medication, the total incidence rate of toxic and side effects was 11.63%. Conclusion. Fuzheng Peiyuan decoction has significant effect in treating moderate to advanced cervical cancer, and colposcope combined with serum test presents more accurate and credible diagnosis results and has great significance for future treatment, which shall be promoted and applied.

Cost of providing cell-free DNA screening for Down syndrome in Finland using different strategies

Introduction A financial analysis is carried out to assess costs and benefits of providing cell-free DNA screening in Finland, using different strategies. Materials and methods Three cell-free DNA screening strategies are considered: Primary, all women; Secondary, those with positive Combined test; and Contingent, the 10–30% with the highest Combined test risks. Three costs are estimated: additional cost for 10,000 pregnancies compared with the Combined test; ‘marginal’ cost of avoiding a Down syndrome birth which occurs in a pregnancy that would have been false-negative using the Combined test; and marginal cost of preventing the iatrogenic loss of a non-Down syndrome birth which occurs in a pregnancy that would have been false-positive. Results Primary cell-free DNA will require additional funds of €250,000. The marginal cost per Down syndrome birth avoided is considerably less than the lifetime medical and indirect cost; the marginal cost per unaffected iatrogenic fetal loss prevented is higher than one benefit measure but lower than another. If the ultrasound component of the Combined test is retained, as would be in Finland, the additional funds required rise to €992,000. Secondary cell-free DNA is cost-saving as is a Contingent strategy with 10% selected but whilst when 20–30% costs rise they are much less than for the Primary strategy and are cost-beneficial. Conclusions When considering the place of cell-free DNA screening it is important to make explicit the additional and marginal costs of different screening strategies and the associated benefits. Under most assumptions the balance is favorable for Contingent screening.

Lightning Protection of the Explosion Airflow Arc-Quenching Gap for 110 kV Transmission Lines

With the increase in the voltage level and number of transmission lines, the probability of lightning strikes on transmission lines is significantly increased, while lightning breakage accidents occur frequently. Therefore, an explosion airflow arc-quenching gap for 110 kV transmission lines was developed based on the idea of rapid extinction. A mathematical model of the detonation wave based on the CJ (Chapman–Jouget) detonation wave theory was developed to calculate the detonation air pressure and analyze its influencing factors. ANSYS software and the magnetohydrodynamic (MHD) model were used to simulate the process of detonation airflow coupled with an arc, and the simulation results indicated that the power frequency arc was evidently suppressed with the influence of airflow, which can effectively prevent arcing. A combined impulse and power frequency test and arc-quenching tests were performed to verify the effectiveness of the arc-quenching gap. The results of the combined test indicated that the arc burn time was 0.1 ms and that no power frequency continuous current was displayed. The results ensured the accuracy of the simulation model. The results of the arc-quenching tests proved that the explosion airflow can extinguish a power frequency arc with an amplitude of 40 kA in half of a power frequency arc cycle.

Functional Measurement Applied to Engineering Students’ Test Anxiety Judgment for Online and Face-to-face Tests

<p style="text-align: justify;">This study explored the cognitive mechanism behind information integration in the test anxiety judgments in 140 engineering students. An experiment was designed to test four factors combined (test goal orientation, test cognitive functioning level, test difficulty and test mode). The experimental task required participants to read 36 scenarios, one at a time and then estimate how much test anxiety they would experience in the evaluation situation described in each scenario. The results indicate three response styles (low, moderate, and high-test anxiety) among the participants. The orientation and difficulty of each given exam scenario were the most critical factors dictating test anxiety judgments. Only the moderate test anxiety group considered the test mode to be a third relevant factor. The integration mechanism for Cluster 1 was multiplicative, while for Clusters 2 and 3, it was summative. Furthermore, these last two clusters differed in terms of the valuation of the factors. These results suggest that programs that help students to cope with test anxiety need to take into account the valuation and integration mechanism that students use to integrate different information in specific examination contexts, since the way students assess their internal and external circumstances can influence how they deal with evaluative situations.</p>

A combined test for feature selection on sparse metaproteomics data - alternative to missing value imputation

One of the difficulties encountered in the statistical analysis of metaproteomics data is the high proportion of missing values, which are usually treated by imputation. Nevertheless, imputation methods are based on restrictive assumptions regarding missingness mechanisms, namely "at random" or "not at random". To circumvent these limitations in the context of feature selection in a multi-class comparison, we propose a univariate selection method that combines a test of association between missingness and classes, and a test for difference of observed intensities between classes. This approach implicitly handles both missingness mechanisms. We performed a quantitative and qualitative comparison of our procedure with imputation-based feature selection methods on two experimental data sets. Whereas we observed similar performances in terms of prediction, the feature ranking from various imputation-based methods was strongly divergent. We showed that the combined test reaches a compromise by correlating reasonably with other methods.