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https://www.readbyqxmd.com/read/28627112/asymptotic-distribution-of-%C3%A2-auc-nris-and-idi-based-on-theory-of-u-statistics
#1
Olga V Demler, Michael J Pencina, Nancy R Cook, Ralph B D'Agostino
The change in area under the curve (∆AUC), the integrated discrimination improvement (IDI), and net reclassification index (NRI) are commonly used measures of risk prediction model performance. Some authors have reported good validity of associated methods of estimating their standard errors (SE) and construction of confidence intervals, whereas others have questioned their performance. To address these issues, we unite the ∆AUC, IDI, and three versions of the NRI under the umbrella of the U-statistics family...
June 19, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28614421/zero-calcium-score-as-a-filter-for-further-testing-in-patients-admitted-to-the-coronary-care-unit-with-chest-pain
#2
Luis Cláudio Lemos Correia, Fábio P Esteves, Manuela Carvalhal, Thiago Menezes Barbosa de Souza, Nicole de Sá, Vitor Calixto de Almeida Correia, Felipe Kalil Beirão Alexandre, Fernanda Lopes, Felipe Ferreira, Márcia Noya-Rabelo
Background: The accuracy of zero coronary calcium score as a filter in patients with chest pain has been demonstrated at the emergency room and outpatient clinics, populations with low prevalence of coronary artery disease (CAD). Objective: To test the gatekeeping role of zero calcium score in patients with chest pain admitted to the coronary care unit (CCU), where the pretest probability of CAD is higher than that of other populations. Methods: Patients underwent computed tomography for calcium scoring, and obstructive CAD was defined by a minimum 70% stenosis on invasive angiography...
June 12, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28605634/atomoxetine-a-norepinephrine-reuptake-inhibitor-reduces-seizure-induced-respiratory-arrest
#3
Honghai Zhang, Haiting Zhao, Hua-Jun Feng
Sudden unexpected death in epilepsy (SUDEP) is a devastating epilepsy complication, and no effective preventive strategies are currently available for this fatal disorder. Clinical and animal studies of SUDEP demonstrate that seizure-induced respiratory arrest (S-IRA) is the primary event leading to death after generalized seizures in many cases. Enhancing brain levels of serotonin reduces S-IRA in animal models relevant to SUDEP, including the DBA/1 mouse. Given that serotonin in the brain plays an important role in modulating respiration and arousal, these findings suggest that deficits in respiration and/or arousal may contribute to S-IRA...
June 9, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28571186/clinical-and-laboratory-profile-of-urinary-tract-infections-in-type-2-diabetics-aged-over-60-years
#4
Sadhna Sharma, Biju Govind, Sujeet Kumar Naidu, Srinivas Kinjarapu, Mohammed Rasool
INTRODUCTION: Urinary tract infections are frequently encountered among diabetic patients and the incidence rate increases with age. There have been growing research to identify the clinical profile of urinary tract infections in diabetic patients. However, such studies on elderly patients are rare. AIM: To determine the risk factors, clinical/laboratory profiles, causative organisms and antimicrobial susceptibilities in type 2 diabetics aged over 60 years. MATERIALS AND METHODS: This prospective single centre study was conducted at NRI Medical College and General Hospital, Guntur, India, between November 2012 and November 2014...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28566362/importance-and-added-value-of-functional-impairment-to-predict-mortality-a-cohort-study-in-swedish-medical-inpatients
#5
Gustav Torisson, Lars Stavenow, Lennart Minthon, Elisabet Londos
BACKGROUND: Accurate estimation of prognosis in multimorbid hospital patients could improve quality of care. This study aims to determine the relative importance and added value of a performance-based activities of daily living (ADL) measure with regard to mortality prediction. METHODS: 200 inpatients, aged over 60 years, were recruited at the Department of General Internal Medicine at a tertiary university hospital. Two nested survival models were built, one with established risk factors (age, sex, Charlson comorbidity index, haemoglobin, albumin, body mass index and glomerular filtration rate), and one using the same covariates with the Gottfries-Bråne-Steen (GBS)-ADL measure added...
May 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28557805/cancer-cell-death-pathways-caused-by-photothermal-and-photodynamic-effects-through-gold-nanoring-induced-surface-plasmon-resonance
#6
Yulu He, Jen-Hung Hsiao, Jian-He Yu, Po-Hao Tseng, Wei-Hsiang Hua, Meng-Chun Low, Yu-Hsuan Tsai, Cheng-Jin Cai, Cheng-Che Hsieh, Yean-Woei Kiang, C C Yang, Zhenxi Zhang
The different death pathways of cancer cells under the conditions of the photothermal (PT), effect, photodynamic (PD) effect, and their combination are evaluated. By incubating cells with Au nanoring (NRI) either linked with the photosensitizer, AlPcS, or not, the illumination of a visible continuous laser for exciting the photosensitizer or an infrared femtosecond laser for exciting the localized surface plasmon resonance of Au NRI, leads to various PT and PD conditions for study. Three different staining dyes are used for identifying the cell areas of different damage conditions at different temporal points of observation...
July 7, 2017: Nanotechnology
https://www.readbyqxmd.com/read/28552392/diagnostic-accuracy-and-prognostic-valued-of-plasmatic-cystatin-c-in-children-undergoing-pediatric-cardiac-surgery
#7
Massimiliano Cantinotti, Raffaele Giordano, Marco Scalese, Sabrina Molinaro, Simona Storti, Bruno Murzi, Vitali Pak, Vincenzo Poli, Giorgio Iervasi, Aldo Clerico
BACKGROUND: Diagnosis and treatment of acute kidney injury (AKI) is often delayed in children after cardiac surgery due to the lack of an early biomarker of renal damage. Our aim was to evaluate the diagnostic accuracy of plasma cystatin-C as an early biomarker of AKI and its prognostic value in pediatric cardiac surgery. METHODS: Cystatin-C and creatinine were measured pre-operatively and at 2-6-12h post-surgery. The primary outcome was: AKI (defined as an increase of ≥1...
May 26, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28549896/concordance-among-methods-of-nutritional-assessment-in-patients-included-on-the-waiting-list-for-liver-transplantation
#8
María Teresa García-Rodríguez, Beatriz López-Calviño, María Del Carmen Piñón-Villar, Alejandra Otero-Ferreiro, Francisco Suárez-López, Manuel Gómez-Gutiérrez, Sonia Pértega-Díaz, María Teresa Seoane-Pillado, Salvador Pita-Fernández
BACKGROUND: The aim of the present study was to determine the extent of malnutrition in patients waiting for a liver transplant. The agreement among the methods of nutritional assessment and their diagnostic validity were evaluated. METHODS: Patients on the waiting list for liver transplantation (n = 110) were studied. The variables were: body mass index, analytical parameters, liver disease etiology, and complications. Liver dysfunction was evaluated using the Child-Pugh Scale...
May 23, 2017: Journal of Epidemiology
https://www.readbyqxmd.com/read/28549614/validation-and-comparison-of-four-models-to-calculate-pretest-probability-of-obstructive-coronary-artery-disease-in-a-chinese-population-a-coronary-computed-tomographic-angiography-study
#9
Jia Zhou, Yujie Liu, Lingyu Huang, Yahang Tan, Xingchen Li, Hong Zhang, Yanhe Ma, Ying Zhang
OBJECTIVE: We sought to compare the performance of the updated Diamond-Forrester method (UDFM), Duke clinical score (DCS), Genders clinical model (GCM) and Genders extended model (GEM) in a Chinese population referred to coronary computed tomography angiography (coronary CTA). BACKGROUND: The reliability of existing models to calculate the pretest proability (PTP) of obstructive coronary artery disease (CAD) have not been fully investigated, especially in a Chinese population...
July 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28541925/improvement-screening-for-ultra-high-dimensional-data-with-censored-survival-outcomes-and-varying-coefficients
#10
Mu Yue, Jialiang Li
Motivated by risk prediction studies with ultra-high dimensional bio markers, we propose a novel improvement screening methodology. Accurate risk prediction can be quite useful for patient treatment selection, prevention strategy or disease management in evidence-based medicine. The question of how to choose new markers in addition to the conventional ones is especially important. In the past decade, a number of new measures for quantifying the added value from the new markers were proposed, among which the integrated discrimination improvement (IDI) and net reclassification improvement (NRI) stand out...
May 18, 2017: International Journal of Biostatistics
https://www.readbyqxmd.com/read/28531894/evaluation-of-absolute-serum-creatinine-changes-in-staging-of-cirrhosis-induced-acute-renal-injury-and-its-association-with-long-term-outcomes
#11
Fangfang Zhou, Qun Luo, Lina Han, Huadong Yan, Wenhong Zhou, Zemin Wang, Yumei Li
BACKGROUND/AIMS: To assess the prognostic accuracy of absolute serum creatinine (sCr) changes ('Delta-sCr') on the long-term outcomes in cirrhotic patients, and evaluate the performance of the 'Delta-sCr' approach to stage acute kidney injury (AKI), compared with the Kidney Disease Improving Global Outcomes (KDIGO) criteria. METHODS: We conducted a retrospective analysis of 333 hospitalized patients. We classified AKI stages using two methods: 1) KDIGO AKI criteria; 2) 'Delta-sCr' system, defined by the difference between the baseline and the peak sCr value during the hospitalization...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28528984/risk-reclassification-ability-of-uric-acid-for-cardiovascular-outcomes-in-essential-hypertension
#12
Maria Perticone, Giovanni Tripepi, Raffaele Maio, Antonio Cimellaro, Desirée Addesi, Rossella Baggetta, Angela Sciacqua, Giorgio Sesti, Francesco Perticone
BACKGROUND: Hyperuricemia is associated with incident cardiovascular events in different settings of patients. We tested whether the inclusion of uric acid (UA) in Cox models including standard risk factors allows to better stratify cardiovascular risk in a cohort of 1522 naïve hypertensives with preserved renal function. METHODS: We used multiple Cox regression models to assess the independent effect of UA on cardiovascular outcomes, and Harrell'C index, Net Reclassification Index (NRI), and Integrated Discrimination Improvement (IDI) as indicators of the additional prognostic value of UA beyond and above that provided by standard risk factors and estimated glomerular filtration rate (e-GFR)...
May 13, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28513919/functional-status-and-mortality-prediction-in-community-acquired-pneumonia
#13
Kyeongman Jeon, Hongseok Yoo, Byeong-Ho Jeong, Hye Yun Park, Won-Jung Koh, Gee Young Suh, Eliseo Guallar
BACKGROUND AND OBJECTIVE: Poor functional status (FS) has been suggested as a poor prognostic factor in both pneumonia and severe pneumonia in elderly patients. However, it is still unclear whether FS is associated with outcomes and improves survival prediction in community-acquired pneumonia (CAP) in the general population. METHODS: Data on hospitalized patients with CAP and FS, assessed by the Eastern Cooperative Oncology Group (ECOG) scale were prospectively collected between January 2008 and December 2012...
May 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28511690/development-of-a-clinical-prediction-algorithm-for-knee-osteoarthritis-structural-progression-in-a-cohort-study-value-of-adding-measurement-of-subchondral-bone-density
#14
Michael P LaValley, Grace H Lo, Lori Lyn Price, Jeffrey B Driban, Charles B Eaton, Timothy E McAlindon
BACKGROUND: Risk prediction algorithms increase understanding of which patients are at greatest risk of a harmful outcome. Our goal was to create a clinically useful prediction algorithm for structural progression of knee osteoarthritis (OA), using medial joint space loss as a proxy; and to quantify the benefit of including periarticular bone mineral density (BMD) in the algorithm. METHODS: Participants were from the Osteoarthritis Initiative (OAI) Progression Cohort, with X-ray readings of medial joint space at 36- and 48-month visits, and a 30- or 36-month medial-to-lateral tibial BMD ratio (M:L BMD ratio) value...
May 16, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28495537/impact-of-nutritional-state-on-critical-limb-ischemia-early-outcomes-denucriticc-study
#15
Lucie Salomon du Mont, Betty Leclerc, Marie-Catherine Morgant, Guillaume Besch, Aline Laubriet, Eric Steinmetz, Simon Rinckenbach
INTRODUCTION: Despite current progress, the prognosis of critical limb ischemia (CLI) remains poor. The ageing of the population, the increasing prevalence of diabetes mellitus, and the stability of tabacco use will increase the prevalence of CLI. CLI patients have risk factors for malnutrition and the impact of malnutrition on morbidity and mortality has been demonstrated in the general population. However, we have little information on the consequences of the consequences of undernutrition in the CLI population...
May 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28493646/validation-of-the-no-objective-testing-rule-and-comparison-to-the-heart-pathway
#16
Jason P Stopyra, Chadwick D Miller, Brian C Hiestand, Cedric W Lefebvre, Bret A Nicks, David M Cline, Kim L Askew, Robert F Riley, Gregory B Russell, James W Hoekstra, Simon A Mahler
BACKGROUND: The No Objective Testing Rule (NOTR) is a decision aid designed to safely identify Emergency Department (ED) patients with chest pain who do not require objective testing for coronary artery disease. OBJECTIVES: To validate the NOTR in a cohort of US ED patients with acute chest pain and compare its performance to the HEART Pathway. METHODS: A secondary analysis of 282 participants enrolled in the HEART Pathway Randomized Controlled Trial was conducted...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28490621/plasma-7-ketocholesterol-levels-and-the-risk-of-incident-cardiovascular-events
#17
Min Wang, Weiqing Long, Di Li, Duan Wang, Yuan Zhong, Di Mu, Jiayi Song, Min Xia
OBJECTIVE: 7-Ketocholesterol (7-KC), a major oxidation product of cholesterol, is found in human atherosclerotic plaque and more atherogenic than cholesterol in animal models. This study was designed to investigate the association of plasma 7-KC level with the incident cardiovascular disease (CVD) events in general population. METHODS: We measured plasma 7-KC concentrations at baseline in 1944 participants free from CVD in a community-based cohort study. The primary endpoint was incident of a major adverse cardiovascular event...
May 10, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28481840/age-shock-index-is-superior-to-shock-index-and-modified-shock-index-for-predicting-long-term-prognosis-in-acute-myocardial-infarction
#18
Tongtong Yu, Chunyang Tian, Jia Song, Dongxu He, Zhijun Sun, Zhaoqing Sun
BACKGROUND: Shock index (SI) has been reported to help us predict adverse prognosis in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). However, the prognostic value of age SI and modified shock index (MSI) in AMI undergoing PCI is unknown. Moreover, the prognostic performance of admission age SI is not compared with SI, MSI and the Global Registry of Acute Coronary Events (GRACE) risk score. METHODS: 1,864 AMI patients undergoing PCI were analyzed in a retrospective cohort study...
May 5, 2017: Shock
https://www.readbyqxmd.com/read/28432897/hba1c-variability-in-type-2-diabetes-is-associated-with-the-occurrence-of-new-onset-albuminuria-within-three-years
#19
Sreemanee Raaj Dorajoo, Joceline Shi Ling Ng, Jessica Hui Fen Goh, Su Chi Lim, Chun Wei Yap, Alexandre Chan, Joyce Yu Chia Lee
AIMS: To evaluate the association between HbA1c coefficient of variation (HbA1c-CV) and 3-year new-onset albuminuria risk. METHODS: A retrospective cohort study involving 716 normoalbuminuric type 2 diabetes patients was conducted between 2010 and 2014. HbA1c-CV was used to categorize patients into low, moderate or high variability groups. Multivariate logistic models were constructed and validated. Integrated discrimination (IDI) and net reclassification (NRI) improvement indices were used to quantify the added predictive value of HbA1c-CV...
February 14, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28430976/acute-and-chronic-noradrenergic-effects-on-cortical-excitability-in-healthy-humans
#20
Hsiao-I Kuo, Walter Paulus, Giorgi Batsikadze, Asif Jamil, Min-Fang Kuo, Michael A Nitsche
Background: Noradrenaline is a major neuromodulator in the central nervous system, and it is involved in the pathophysiology of diverse neuropsychiatric diseases. Previous transcranial magnetic stimulation (TMS) studies suggested that acute application of selective noradrenaline reuptake inhibitors (NRI) enhances cortical excitability in the human brain. However, other, such like clinical effects, usually require prolonged NRI treatment, which might go along with different physiological effects...
April 19, 2017: International Journal of Neuropsychopharmacology
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