Diagnostic Yield of Bronchoscopic Techniques in Evaluating Primary Lung Cancer: The Philippine General Hospital (PGH) Experience

Objectives. To determine the overall diagnostic yield of bronchoscopy-guided sampling methods in detecting lung cancer at the University of the Philippines, Philippine General Hospital. The diagnostic yield, equivalent to sensitivity, is defined as the number of bronchoscopic sampling or biopsy procedures with a diagnosis of malignancy divided by the total number of confirmed malignant cases.Methods. This is a cross-sectional, retrospective sensitivity study involving bronchoscopy procedures from January 2014 to December 2018. Surgical Pathology and Cytology Reports of eligible cases were accessed through the institutional Laboratory Information System. Sensitive patient information was omitted, and each case was assigned a unique code. The overall diagnostic yield/sensitivity of bronchoscopy and the diagnostic yield/sensitivity of each technique were calculated.Results. A total of 100 patients satisfied the inclusion and exclusion criteria. Primary lung malignancies are more common in males and the elderly. The most common primary lung cancer is adenocarcinoma (33%). Bronchoscopy, regardless of whether single or multiple techniques were used, has a diagnostic yield of 86% (CI: 77.6-92.1%). Of the individual techniques, those that obtain solid tissues (endobronchial and transbronchial biopsies; 88.2% [CI: 78.1-94.8%] and 80.0% [CI: 28.4-99.5%], respectively) have higher yields compared to techniques that obtain cytologic samples (bronchial washing and brushing; 54.2% [43.7-64.4%] and 70.1% [58.6-80%], respectively).Conclusion. Bronchoscopy, as a diagnostic procedure for pulmonary malignancies, has relatively high sensitivity and may be used for lesions located centrally and can be inspected visually. A multidisciplinary approach to patient selection for bronchoscopy helps improve the utility of the various bronchoscopic techniques.

Critical Review on the Chemical Aspects of Cannabidiol (CBD) and Harmonization of Computational Bioactivity Data

: Cannabidiol (CBD) is a non-psychotropic phytocannabinoid which represents one of the constituents of the “phytocomplex” of Cannabis sativa. This natural compound is attracting growing interest since when CBD-based remedies and commercial products were marketed. This review aims to exhaustively address the extractive and analytical approaches that have been developed for the isolation and quantification of CBD. Recent updates on cutting-edge technologies were critically examined in terms of yield, sensitivity, flexibility and performances in general, and are reviewed alongside original representative results. As an add-on to currently available contributions in the literature, the evolution of the novel, efficient synthetic approaches for the preparation of CBD, a procedure which is appealing for the pharmaceutical industry, is also discussed. Moreover, with the increasing interest on the therapeutic potential of CBD and the limited understanding of the undergoing biochemical pathways, the reader will be updated about recent in silico studies on the molecular interactions of CBD towards several different targets attempting to fill this gap. Computational data retrieved from the literature have been integrated with novel in silico experiments, critically discussed to provide a comprehensive and updated overview on the undebatable potential of CBD and its therapeutic profile.

Soft Computing Prediction of Oil Extraction from Huracrepitan Seeds

This study analyses the extraction process parameters of huracrepitan seed oil using the Adaptive Neuro-Fuzzy Inference System (ANFIS) and Artificial Neural Network (ANN). The experiments were conducted at temperature (60–80 °C), time (4–6 h), and solute/solvent ratio (0.05–0.10) with output parameter as oil yield. Sensitivity analysis shows that temperature and time had the most significant effect on the oil yield. The oil yield estimation performance indicators are: ANN (<i>R</i><sup>2</sup> = 0.999, MSE = 5.63192E-13), ANFIS (<i>R</i><sup>2</sup> = 0.36927, MSE = 0.42331). The results show that ANN gave a better prediction than ANFIS.

Future Wheat Yield Variabilities and Water Footprints Based on the Yield Sensitivity to Past Climate Conditions

This article analyzed the wheat yield variabilities and water footprints under projected future climate based on wheat yield sensitivity to past (1980–2017) trends of maximum temperature (Tmax), minimum temperature (Tmin), solar radiation (Rn) and rainfall (P) for the semi-arid condition of Punjab, Pakistan. The past and projected future trends of the climate variables were identical featuring prominent Tmin rise than Tmax accompanied by Rn and P declines. Based on the past influences and the projected future trends of the climate variables, Tmin was the principal driver of wheat yield decline followed by the Tmax, P and Rn. Wheat evapotranspiration and net irrigation water requirement declined due to the influence of both decrease of growing season length and Rn for the first half of 21st-century, and this trend reversed during the second half of 21st-century. These phenomena were caused by different degree of climate warming between the two-time slices. Due to future wheat yield decline and a gradual rise in green water scarcity the blue and grey water footprints rise consistently particularly during 2nd-time slices. CO2 enrichment showed limited mitigation potential of nullifying the warming-induced threats on future wheat yield and water footprints.

Brush Cytology Performance for the Assessment of Biliopancreatic Strictures

Introduction: Brush cytology is commonly used during endoscopic retrograde cholangiopancreatography for the diagnostic evaluation of biliopancreatic strictures. However, since the overall sensitivity of brush cytology is poor, the exclusion of malignancy is difficult. Recognition of factors related to the patient, technique or lesion may help improve the diagnostic yield of brush cytology. The objective of this study was to evaluate the diagnostic yield of brush cytology in the assessment of biliopancreatic strictures and identify predictive factors associated with a positive diagnosis of malignancy. Methods: Retrospective study that evaluated all consecutive patients that underwent brush cytology for the investigation of biliopancreatic strictures in a tertiary center, between January 2012 and January 2018. Results: One hundred and sixty-five patients that underwent 182 procedures were included. A diagnosis of malignancy was confirmed in 110 patients (66.7%), of whom 62 had positive brush cytology (sensitivity 53.7%, specificity 98.5%, accuracy 69.8%). On the multivariate analysis, age ≥68 years (OR 4.83, 95% CI 1.04–22.37) and lesions suspicious of metastasis on cross-sectional imaging (OR 8.58, 95% CI 1.70–43.38) were independently associated with a positive result. Subanalysis of the patients presenting with these two factors (n = 26) revealed an increase in the diagnostic yield (sensitivity 80.8%). Conclusion: Age ≥68 years and lesions suspicious of metastasis on cross-sectional imaging are independent factors associated with a positive result. Patient selection taking these factors into account may increase the diagnostic yield of brush cytology.