Triglyceride/low-density-lipoprotein cholesterol ratio is the most valuable predictor for increased small, dense LDL in type 2 diabetes patients

Background Small, dense low-density lipoprotein (sd-LDL) increases in type 2 diabetes patients and causes arteriosclerosis. Non–high-density-lipoprotein cholesterol (non–HDL-C) is thought to be useful for predicting arteriosclerosis and sd-LDL elevation; however, there are no data about whether the triglyceride /low-density-lipoprotein cholesterol (TG/LDL-C) ratio is a valuable predictor for sd-LDL. Methods A total of 110 type 2 diabetes patients with hypertriglyceridemia were analyzed. No patients were treated with fibrates, but 47 patients were treated with statins. LDL-C was measured by the direct method. LDL-migration index (LDL-MI) using electrophoresis (polyacrylamide gel, PAG) was calculated, and a value ≥0.400 was determined to indicate an increase in sd-LDL. Simple regression analyses were carried out between LDL-MI and lipid markers. Receiver operating characteristic curves of lipid markers for predicting high LDL-MI were applied to determine the area under the curve (AUC), sensitivity, specificity, and cut-off point. Results LDL-MI correlated negatively with LDL-C (P = 0.0027) and PAG LDL fraction (P < 0.0001) and correlated positively with TGs, non–HDL-C, TG/LDL-C ratio, TG/HDL-C ratio, and non–HDL-C/HDL-C ratio among all study patients. Similar results were obtained for patients analyzed according to statin treatment. The AUCs (95% confidence interval) were 0.945 (0.884-1.000) for TG/LDL-C ratio and 0.614 (0.463-0.765) for non–HDL-C in patients without statins (P = 0.0002). The AUCs were 0.697 (0.507-0.887) for TG/LDL-C and 0.682 (0.500-0.863) for non–HDL-C in patients treated with statins. The optimal cut-off point for TG/LDL-C ratio for increased LDL-MI was 1.1 (molar ratio) regardless of statin treatment. The sensitivity and specificity of the TG/LDL-C ratio (90.0 and 93.9%, respectively) were higher than those of non–HDL-C (56.7 and 78.8%, respectively) in patients without statins. Conclusions The TG/LDL-C ratio is a reliable surrogate lipid marker of sd-LDL and superior to non–HDL-C in type 2 diabetes patients not treated with statins.

Efficacy of Serial Ultrasonographic Examinations in Predicting Return to Play in Agility Dogs with Shoulder Lameness

The aim of this study is to investigate the use of shoulder ultrasound as a method of predicting the likelihood of returning to competition in agility dogs with shoulder teno-muscular injuries after a standardised rehabilitation protocol. Thirty-two agility dogs with a clinical and ultrasonographic diagnosis of shoulder teno-muscular injury were included in a prospective study with physical and ultrasound examinations at the time of diagnosis (T0) and at two (T2), four (T4) and six (T6) months; during this period, the dogs received rehabilitation treatments. The endpoint of the study was to obtain information regarding participation in agility competitions 12 months after diagnosis, based on telephone interviews with the owners. The clinical lameness score (CLS) and the ultrasound lesion score (ULS) were used as outcome measurements. The CLS indicated partial recovery from a shoulder injury at T2 (78%), while the ULS indicated no satisfactory recovery at T2 in any patient. At 4 months, the CLS alone was not a valuable predictor of full recovery from a shoulder injury in agility dogs. Relative Risk indicated that, at T2, ultrasound was 23.8 times more valuable in identifying a shoulder lesion as compared to clinical lameness score (CLS), and it was 2.53 times more valuable at T4.

Why Not Interview?

Honesty-Humility is a valuable predictor in personnel selection; however, problems with self-report measures create a need for new tools to judge this trait. Therefore, this research examines the interview as an alternative for assessing Honesty-Humility and how to improve judgments of Honesty-Humility in the interview. Using trait activation theory, we examined the impact of interview question type on Honesty-Humility judgment accuracy. We hypothesized that general personality-tailored questions and probes would increase the accuracy of Honesty-Humility judgments. Nine hundred thirty-three Amazon Mechanical Turk workers watched and rated five interviews. Results found that general questions with probes and specific questions without probes led to the best Honesty-Humility judgments. These findings support the realistic accuracy model and provide implications for Honesty-Humility-based interviews.

Optimal value of CA19-9 determined by KRAS-mutated circulating tumor DNA contributes to the prediction of prognosis in pancreatic cancer patients

Despite the acceptance of carbohydrate antigen 19-9 (CA19-9) as a valuable predictor for the prognosis of pancreatic ductal adenocarcinoma (PDAC), its cutoff value remains controversial. Our previous study showed a significant correlation between CA19-9 levels and the presence of KRAS-mutated ctDNA in the blood of patients with PDAC. Based on this correlation, we investigated the optimal cutoff value of CA19-9 before surgery. Continuous CA19-9 values and KRAS-mutated ctDNAs were monitored in 22 patients with unresectable PDAC who underwent chemotherapy between 2015 and 2017. Receiver operating characteristic curve analysis identified 949.7 U/mL of CA19-9 as the cutoff value corresponding to the presence of KRAS-mutated ctDNA. The median value of CA19-9 was 221.1 U/mL. Subsequently, these values were verified for their prognostic values of recurrence-free survival (RFS) and overall survival (OS) in 60 patients who underwent surgery between 2005 and 2013. Multivariate analysis revealed that 949.7 U/mL of CA19-9 was an independent risk factor for OS and RFS in these patients (P = 0.001 and P = 0.010, respectively), along with lymph node metastasis (P = 0.008 and P = 0.017), unlike the median CA19-9 level (P = 0.150 and P = 0.210). The optimal CA19-9 level contributes to the prediction of prognosis in patients with PDAC before surgery.

Shrinkage by the third month predicts long-term response of macroprolactinoma after cabergoline

Objective: Transsphenoidal surgery (TSS) is mainly indicated in prolactinomas when dopamine agonist treatment fails. However, there is no established early predictor of cabergoline (CBG) response. The present study was aimed to identify predictors of CBG resistance in order to select patients who may benefit from early TSS. Design: retrospective longitudinal study Methods: We reviewed the medical record of patients diagnosed with prolactinoma after 2010. Inclusion criteria: macroprolactinomas under CBG treatment with serial prolactin levels and MRI before treatment and 3 and 12 months afterwards. The main outcome was tumour size shrinkage ≥50% after 12 months of CBG (TS_50). The capacity of the most important clinical and biochemical variables in predicting the main outcome was examined. Results: A total of 185 prolactinomas where included: 124 (67.0 %) were microadenomas and 61 (33.0%) were macroadenomas of which 27 patients meet de inclusion criteria; median age [42.5 years; (IQR: 28.0)]. The median of follow up was [67.5 months; (IQR: 30.2)]. Ten patients (37.0%) underwent surgery after more than one year of CBG. The volume reduction at the first MRI (3-4 months) was the unique valuable predictor: [OR: 1.16 (IC 95% 1.02-1.32)] of TS_50. A tumour volume shrinkage ≥30% in the first 3-4 months of CBG therapy predicts TS_50 with an AUC [ 0.95 (CI: 0.76-0.99)]. Conclusion: Tumor shrinkage in the first 3-4 month after starting treatment with CBG is a good tool for predicting the long term response and can help clinicians to take more appropriated and personalized decisions.

Optimal Value of CA19-9 Determined by KRAS-Mutated Circulating Tumor DNA Contributes to the Prediction of Prognosis in Pancreatic Cancer Patients

Despite the acceptance of carbohydrate antigen 19-9 (CA19-9) as a valuable predictor for the prognosis of pancreatic ductal adenocarcinoma (PDAC), controversy remains with regards to its cutoff. Our previous study showed a significant correlation between CA19-9 levels and the presence of KRAS-mutated ctDNA in the blood of patients with PDAC. Based on this correlation, we investigated the optimal cutoff value of CA19-9 before surgery. Continuous CA19-9 values and KRAS-mutated ctDNAs were monitored in 22 patients with unresectable PDAC who underwent chemotherapy between 2015 and 2017. Receiver operating characteristic curve analysis identified 949.7 U/mL of CA19-9 as the cutoff value corresponding to the presence of KRAS-mutated ctDNA. The median value of CA19-9 was 221.1 U/mL. These values were then verified for their prognostic values of recurrence-free survival (RFS) and overall survival (OS) in 60 patients who underwent surgery between 2005 and 2013. Multivariate analysis revealed that 949.7 U/mL of CA19-9 was an independent risk factor for OS and RFS in these patients (P=0.001 and P=0.010, respectively), along with lymph node metastasis (P=0.008 and P=0.017), but the median CA19-9 level was not (P=0.150 and P=0.210). The optimal CA19-9 level contributes to the prediction of prognosis in patients with PDAC before surgery.

D-dimer is Valuable for Predicting the Extension of Isolated Distal Deep Vein Thrombosis of the Lower Limb in Neurocritical Patients: A Retrospective Observational Study

Background: Isolated distal deep vein thrombosis (IDDVT) of the lower limb and its extension to the proximal deep veins have high incidence rates in patients with acute brain injury (ABI). The objective of the study was to determine the value of dynamic changes in coagulation function in predicting the occurrence and extension of IDDVT.Methods: In this retrospective cohort study, ABI patients during the perioperative period in a neurocritical care unit (NICU) of a university hospital were identified from September 2019 to September 2020. Complete compression ultrasound was used by a senior sonographer to diagnose the occurrence and extension of IDDVT. Coagulation function was recorded at a series of time points during the perioperative period.Results: A total of 245 ABI patients were identified, including 46 acute traumatic brain injury patients, 117 acute hemorrhagic stroke patients, 36 acute ischemic stroke patients and 46 acute aneurysmal subarachnoid hemorrhage patients. Most of the patients were elderly and male, and most had severe cases. The rates of IDDVT occurrence and extension were 62% and 21%, respectively. Age, GCS score at admission, NICU length of stay were risk factors for IDDVT occurrence. None of coagulation indices was a sensitive predictor of IDDVT occurrence. The elevation of D-dimer on days 5-7 was the most valuable predictor of IDDVT extension (the area under the ROC was 0.89, with a 95% CI of 0.82-0.95, and the sensitivity and specificity were 0.86 and 0.81, respectively with the cutoff of 8.9 mg/L).Conclusions: The occurrence and extension of IDDVT are common in ABI patients during the perioperative period, particularly in elderly patients with severe cases. D-dimer level on days 5-7 is the most valuable predictor of IDDVT extension in ABI patients.