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1.
Victoria L. Parker Matthew C. Winter John A. Tidy Barry W. Hancock Julia E. Palmer Naveed Sarwar Baljeet Kaur Katie McDonald Xianne Aguiar Kamaljit Singh Nick Unsworth Imran Jabbar Allan A. Pacey Robert F. Harrison Michael J. Seckl 《International journal of cancer. Journal international du cancer》2023,152(5):986-997
Gestational trophoblastic neoplasia (GTN) patients are treated according to the eight-variable International Federation of Gynaecology and Obstetrics (FIGO) scoring system, that aims to predict first-line single-agent chemotherapy resistance. FIGO is imperfect with one-third of low-risk patients developing disease resistance to first-line single-agent chemotherapy. We aimed to generate simplified models that improve upon FIGO. Logistic regression (LR) and multilayer perceptron (MLP) modelling (n = 4191) generated six models (M1-6). M1, all eight FIGO variables (scored data); M2, all eight FIGO variables (scored and raw data); M3, nonimaging variables (scored data); M4, nonimaging variables (scored and raw data); M5, imaging variables (scored data); and M6, pretreatment hCG (raw data) + imaging variables (scored data). Performance was compared to FIGO using true and false positive rates, positive and negative predictive values, diagnostic odds ratio, receiver operating characteristic (ROC) curves, Bland-Altman calibration plots, decision curve analysis and contingency tables. M1-6 were calibrated and outperformed FIGO on true positive rate and positive predictive value. Using LR and MLP, M1, M2 and M4 generated small improvements to the ROC curve and decision curve analysis. M3, M5 and M6 matched FIGO or performed less well. Compared to FIGO, most (excluding LR M4 and MLP M5) had significant discordance in patient classification (McNemar's test P < .05); 55-112 undertreated, 46-206 overtreated. Statistical modelling yielded only small gains over FIGO performance, arising through recategorisation of treatment-resistant patients, with a significant proportion of under/overtreatment as the available data have been used a priori to allocate primary chemotherapy. Streamlining FIGO should now be the focus. 相似文献
2.
Aliyah Hussein Kiran Sran Imran Ali Janine Woellner Helen Wilcox Stephen D. Marks Helen Jones Chris Callaghan 《Pediatric transplantation》2020,24(4)
Transplant ureteric stent insertion reduces the incidence of MUCs, but it is not known whether routine PSRGU is needed to detect unmasked MUCs. This study evaluated whether routine PSRGU in the pRTR is a useful tool to identify MUCs before they become clinically apparent. A retrospective analysis was undertaken of the clinical outcomes following elective stent removal from pediatric kidney‐only transplant recipients at two London centers between 2012 and 2016. Our policy was to perform PSRGU either routinely or urgently if there were concerning symptoms or biochemical evidence of renal allograft dysfunction. Elective stent removal was performed in 86% (97 of 113 pRTR), and 75 (77%) of whom had routine PSRGU at a median (IQR) of 6 (2‐8) days after stent removal. There were changes to management in 3 (4%) of pRTR with PSRGU identifying no MUC. Nineteen patients (25%) had urgent PSRGU, most commonly due to renal allograft dysfunction, at a median (IQR) of 5.5 (2.7‐12.3) days after stent removal. Of these, two pRTR required ureteric intervention. For our current practice of removing transplant stents at 4‐6 weeks post‐transplantation, our study has found no evidence to support routine PSRGU after elective stent removal. 相似文献
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Yasser Samman Imran Masood Vijay Vardhan Killampalli Neil Howell E. Kaya Alpar Sunil K. Banerjee 《European Journal of Trauma》2005,31(2):133-137
Background and Purpose:
Management of rib fractures constitutes a major part of the trauma workload of any unit. Rib fractures result in disrupted chest wall mechanics and ventilatory insufficiency. The ability of a lung injury scoring system to predict the degree of respiratory dysfunction after rib fractures was evaluated. 相似文献7.
H Abdel-Dayem K Mahajan A Owuwanne S Ericsson K Nawaz K Kouris E Higazy M Awdeh 《European journal of nuclear medicine》1988,14(2):98-104
Intravenously injected 99mTc-DTPA was evaluated in 64 patients for its efficiency in detecting and localizing sites of acute upper and lower gastrointestinal (G.I.) bleeding. These studies were correlated with endoscopic and surgical findings. There were 34 bleeders and 30 non bleeders giving a sensitivity of 90%, specificity of 82% and accuracy of 86%. Of these, 49 were upper G.I. studies (stomach 21 and duodenum 28) and 15 were lower G.I. studies (small intestine 8, large bowel 7). Of the 49 upper G.I. studies, 27 showed active bleeding while 22 showed no bleeding at the time of the study resulting in a sensitivity of 87.5%, specificity of 76% and accuracy of 82%. Of the 15 lower G.I. studies, 7 were bleeders while 8 were non bleeders. All the lower G.I. bleeding sites were accurately localized with the 99mTc-DTPA. An incidental finding of these studies was the localization of 99mTc-DTPA in the site of inflammatory and malignant lesions of the G.I. tract. Of the 64 studies, 18 inflammatory and malignant lesions were detected with the IV injected 99mTc-DTPA; 10 were bleeders while 8 were non bleeders. Image subtraction of early from delayed images was helpful to differentiate bleeding from non bleeding cases in this last group of studies. 相似文献
8.
Identification of novel steroid-response elements. 总被引:3,自引:0,他引:3
9.
The authors report two rare cases of 'non-syndromic spontaneous keloids' occuring in siblings. This represents another unexplored area in the field of 'keloid challenge', warranting further research and development. 相似文献
10.
Recombinant Helicobacter bilis Protein P167 for Mouse Serodiagnosis in a Multiplex Microbead Assay 下载免费PDF全文
Sunlian Feng Lon V. Kendall Emir Hodzic Scott Wong Edward Lorenzana Kimberly Freet Karin S. Ku Paul A. Luciw Stephen W. Barthold Imran H. Khan 《Clinical and Vaccine Immunology : CVI》2004,11(6):1094-1099
Infection of mice with Helicobacter bilis is widespread in research and commercial mouse colonies. Therefore, sensitive, specific, and high-throughput assays are needed for rapid and accurate testing of mice in large numbers. This report describes a novel multiplex assay, based on fluorescent microbeads, for serodetection of H. bilis infection. The assay requires only a few microliters of serum to perform and is amenable to a high-throughput format. Individual microbead sets were conjugated to purified, H. bilis-specific, recombinant proteins P167C and P167D and bacterial membrane extracts from H. bilis and Helicobacter hepaticus. For detecting H. bilis infection in the microbead multiplex assay, P167C and P167D provided significantly higher sensitivities (94 and 100%, respectively) and specificities (100 and 95%, respectively) than membrane extract (78% sensitivity and 65% specificity). Microbead multiplex assay results were validated by enzyme-linked immunosorbent assay. Purified recombinant proteins showed low batch-to-batch variation; this feature allows for ease of quality control, assay robustness, and affordability. Thus, recombinant antigens are highly suitable in the multiplex microbead assay format for serodetection of H. bilis infection. 相似文献