What does it mean that a screening test has a sensitivity of 80 % and a specificity of 80 %? What conclusion can be drawn as to the probability of a patient tested positive having the target disorder? Is this probability dependent on the prevalence of the target disorder? These are the questions addressed in the present paper. The classical concepts of sensitivity and specificity are presented as well as the more modern and clinically relevant concepts of the predictive values of a positive and a negative test. The author employs different didactic methods such as 2 x 2 tables, graphical illustrations and natural frequencies for elaborating on these often intermixed concepts in a clear and easily understandable way.
Klotsche, Jens; Ferger, Dietmar; Leistner, David; Pieper, Lars; Zeiher, Andreas M; Wittchen, Hans-Ulrich; Rehm, Juergen
Models that predict disease incidence or disease recurrence are attractive for clinicians as well as for patients. The usefulness of a risk prediction model is linked to the two questions whether the observed outcome is confirmed by the prediction and whether the risk prediction is accurate in predicting the future outcome, respectively. The first phrasing of the question is linked to considering sensitivity and specificity and the latter to the positive and negative predictive values. We present the measures of standardized total gain in positive and negative predictive values dealing with the performance or accuracy of the prediction model for a binary outcome. Both measures provide a useful tool for assessing the performance or accuracy of a set of predictor variables for the prediction of a binary outcome. This concept is a tool for evaluating the optimal prediction model in future research. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Soyyigit, Sadan; Goksel, Ozlem; Aydin, Omur; Gencturk, Zeynep; Bavbek, Sevim
Iodinated contrast media (ICM) can cause hypersensitivity reactions (HSR), yet data are scant about the negative predictive value (NPV) of ICM skin tests. To determine the NPV of skin tests to ICM Methods: We enrolled 73 patients with a history of HSRs to ICM, 136 subjects with no previous exposure to ICM, and, as controls, 47 subjects who had previously tolerated ICM. All the subjects had skin tests with the culprit and/or alternative ICM and were later questioned as to whether they were reexposed and/or reacted to the skin-test-negative ICM. Sixty (82.2%) and 13 (17.8%) patients had a history of immediate HSR and those with a history of nonimmediate HSR, respectively. The sensitivity and specificity of the skin tests were 18% and 97%, respectively, in patients with immediate HSR and were 23% and 99%, respectively, in patients with nonimmediate HSR. Of a total of 237 subjects with negative skin test results, 207 (87.3%) were asked about further ICM administration; 158 (84.9%) confirmed subsequent use either with (n = 15 [9.4%]) or without premedication (n = 143 [90.6%]). Of the 143 individuals, 140 tolerated skin-test-negative ICMs but three (1.9%) reacted to ICMs (two with mild nonimmediate reactions, one with a grade 1 immediate reaction). Of 20 patients who had previous HSR to ICM, 17 tolerated further skin-test-negative ICM without premedication. The NPV of ICM skin tests, therefore, was 97% (95% confidence interval, 7599%). The NPV of skin tests with ICM was high. None of the reactions in patients who had negative skin test results were severe, which may reassure physicians who hesitate to perform further evaluations in patients with negative skin test results.
Velayos Jiménez, Benito; Alcaide Suárez, Noelia; González Redondo, Guillermo; Fernández Salazar, Luis; Aller de la Fuente, Rocío; Del Olmo Martínez, Lourdes; Ruiz Rebollo, Lourdes; González Hernández, José Manuel
The impact of the accumulated experience of the capsule endoscopy (CE) reader on the accuracy of this test is discussed. To determine whether the negative predictive value of CE findings changes along the learning curve. We reviewed the first 900 CE read by 3 gastroenterologists experienced in endoscopy over 8 years. These 900 CE were divided into 3 groups (300 CE each): group 1 consisted of the sum of the first 100 CE read by each of the 3 endoscopists; group 2, the sum of the second 100 and groups 3, the sum of the third 100. Patients with normal CE were monitored for at least 28 months to estimate the negative predictive value. A total of 54 (18%) CE in group 1, 58 (19.3%) in group 2 and 47 (15.6%) in group 3 were normal, although only 34 patients in group 1, 38 in group 2 and 36 in group 3 with normal CE completed follow up and were eventually studied. The negative predictive value was 88.2% in group 1, 89.5% in group 2 and 97% in group 3 (P>.05). The negative predictive value tended to increase, but remained high and did not change significantly after the first 100 when readers are experienced in conventional endoscopy and have preliminary specific training. Copyright © 2016 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.
Fontaine-Delaruelle, Clara; Souquet, Pierre-Jean; Gamondes, Delphine; Pradat, Eric; De Leusse, Aurélie; Ferretti, Gilbert R; Couraud, Sébastien
Specimens collected by CT scan-guided transthoracic core-needle biopsy (TTNB) are frequently used for the diagnosis of lung nodules, but the clinical value of negative results has not been sufficiently investigated. We sought to determine the negative predictive value (NPV) of TTNB specimens and investigate predictive factors of negative results. All consecutive TTNBs performed in three centers between 2006 and 2012 were included. The medical charts of patients with nonmalignant TTNB specimens were reviewed and classified as true or false negatives. Binary logistic regression was used for multivariate analysis. Overall, findings from 980 TTNB specimens were included. Malignant disease was found in 79% (n = 777) of the cases, nonmalignant disease in 6% (n = 54), and "negative" results in 15% (n = 149). For the diagnosis of malignant disease, NPV was 51%. Estimated sensitivity, specificity, and accuracy were 89%, 99%, and 90%, respectively. The complication rate was 34% (life-threatening complication in 6%). In multivariate analysis, predictive factors for a false-negative result were radiologist experience (adjusted OR [AOR], 0.996; 95% CI, [0.994-0.998]), occurrence of a complication during the procedure (AOR, 1.958; 95% CI, [1.202-3.187]), and moderate to high maximum standardized uptake value on PET scan (AOR, 7.657; 95% CI, [1.737-33.763]). In 24 cases, a second TTNB was performed at the same target. The complication rate was 33%, and TTNB specimens provided diagnosis in 95% of cases with a 67% NPV. One-half of all "negative" TTNB specimen results were falsely negative for malignant diagnosis. Findings in tissue collected from a second TTNB at the same target provided a final diagnosis in most cases without increasing complication rates.
Huang, Ying; Fong, Youyi; Wei, John; Feng, Ziding
Summary A marker's capacity to predict risk of a disease depends on disease prevalence in the target population and its classification accuracy, i.e. its ability to discriminate diseased subjects from non-diseased subjects. The latter is often considered an intrinsic property of the marker; it is independent of disease prevalence and hence more likely to be similar across populations than risk prediction measures. In this paper, we are interested in evaluating the population-specific performance of a risk prediction marker in terms of positive predictive value (PPV) and negative predictive value (NPV) at given thresholds, when samples are available from the target population as well as from another population. A default strategy is to estimate PPV and NPV using samples from the target population only. However, when the marker's classification accuracy as characterized by a specific point on the receiver operating characteristics (ROC) curve is similar across populations, borrowing information across populations allows increased efficiency in estimating PPV and NPV. We develop estimators that optimally combine information across populations. We apply this methodology to a cross-sectional study where we evaluate PCA3 as a risk prediction marker for prostate cancer among subjects with or without previous negative biopsy. PMID:22021938
Umberger, Reba A; Hatfield, Linda A; Speck, Patricia M
Nurses review, evaluate, and use diagnostic test results on a routine basis. However, the skills necessary to evaluate a particular test using statistical outcome measures is often lacking. The purpose of this article is to examine and interpret the underlying principles for use of the statistical outcomes of diagnostic screening tests (sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values, with a discussion about use of SpPIn [Specificity, Positive test = rule in], and SnNOut [Sensitivity, Negative test = rule out]) in advanced nursing clinical practice. The authors focus on NPVs because test results with high NPV are useful to practitioners when considering unnecessary, costly, and possibly risky treatments, whether using clinical assessment tool, test, or procedure or using polymerase chain reaction analysis of DNA test results. In this article, the authors emphasize the use of NPV in treatment decisions by providing examples from critical care, neonatal, and advanced forensic nursing, which become a framework for assessing decisions in the clinical arena. This commentary stresses the importance of the NPV of tests in preventing, detecting, and ruling out disease, where PPV may not be relevant for that purpose. Negative predictive value percentages inform treatment decisions when the provider understands the biology, chemistry, and foundation for testing methods used in clinical practices. The art of diagnosis, confirmed in a test's high NPV (meaning the patient probably does not have the disease when the test is negative), reassures provider treatment stewardship to do no harm.
Huser, Vojtech; Cimino, James J
One of the goals of translational science is to shorten the time from discovery to clinical use. Clinical trial registries were established to increase transparency in completed and ongoing clinical trials, and they support linking trials with resulting publications. We set out to investigate precision and negative predictive value (NPV) of links between ClinicalTrials.gov (CT.gov) and PubMed. CT.gov has been established to increase transparency in clinical trials and the link to PubMed is crucial for supporting a number of important functions, including ascertaining publication bias. We drew a random sample of trials downloaded from CT.gov and performed manual review of retrieved publications. We characterize two types of links between trials and publications (NCT-link originating from MEDLINE and PMID-link originating from CT.gov).The link precision is different based on type (NCT-link: 100%; PMID-link: 63% to 96%). In trials with no linked publication, we were able to find publications 44% of the time (NPV=56%) by searching PubMed. This low NPV shows that there are potentially numerous publications that should have been formally linked with the trials. Our results indicate that existing trial registry and publisher policies may not be fully enforced. We suggest some automated methods for improving link quality.
Huser, Vojtech; Cimino, James J.
One of the goals of translational science is to shorten the time from discovery to clinical use. Clinical trial registries were established to increase transparency in completed and ongoing clinical trials, and they support linking trials with resulting publications. We set out to investigate precision and negative predictive value (NPV) of links between ClinicalTrials.gov (CT.gov) and PubMed. CT.gov has been established to increase transparency in clinical trials and the link to PubMed is crucial for supporting a number of important functions, including ascertaining publication bias. We drew a random sample of trials downloaded from CT.gov and performed manual review of retrieved publications. We characterize two types of links between trials and publications (NCT-link originating from MEDLINE and PMID-link originating from CT.gov).The link precision is different based on type (NCT-link: 100%; PMID-link: 63% to 96%). In trials with no linked publication, we were able to find publications 44% of the time (NPV=56%) by searching PubMed. This low NPV shows that there are potentially numerous publications that should have been formally linked with the trials. Our results indicate that existing trial registry and publisher policies may not be fully enforced. We suggest some automated methods for improving link quality. PMID:23304310
Yu, Jing; Onisko, Agnieszka; Austin, R Marshall
Reporting benign-appearing endometrial cells (nEMCs) in Papanicolaou (Pap) smears of women 40 years and older, introduced in The Bethesda System 2001, may be interpreted as an abnormal finding and lead to unnecessary endometrial biopsies. To our knowledge, this is the first study on the negative predictive value (NPV) of this cytology finding. An 11-year database with 1,036,629 Pap test reports and 121,079 surgical pathology reports identified reports of nEMCs in women 40 years and older with follow-up endometrial histopathology within 6 months. Endometrial carcinoma and atypical endometrial hyperplasia were chosen as relevant outcomes. NPVs were calculated. Bayesian modeling assessed the impact of age, bleeding, and postmenopausal status on risk. NPVs for patients aged 40 to 44 years and 45 to 49 years (99.5% and 99.3%, respectively) were not significantly different. NPVs for patients aged 50 to 54 years, 55 to 59 years, and 60 years and older (97.1%, 95.3%, and 94.5%, respectively) were lower than the NPV for patients aged 40 to 49 years. Bayesian modeling indicated that asymptomatic patients in all age groups 40 years and older have very low risk. Bleeding history increased risk in all age groups, especially in women 50 years and older. nEMCs in Pap test reports of women 40 years and older are a normal cytology finding in premenopausal women, which may result in unnecessary endometrial biopsies. The NPV associated with this finding for women aged 40 to 49 years exceeded 99%.
Arbuthnot, Mary; Mooney, David P
It is crucial to identify cervical spine injuries while minimizing ionizing radiation. This study analyzes the sensitivity and negative predictive value of a pediatric cervical spine clearance algorithm. We performed a retrospective review of all children <21years old who were admitted following blunt trauma and underwent cervical spine clearance utilizing our institution's cervical spine clearance algorithm over a 10-year period. Age, gender, International Classification of Diseases 9th Edition diagnosis codes, presence or absence of cervical collar on arrival, Injury Severity Score, and type of cervical spine imaging obtained were extracted from the trauma registry and electronic medical record. Descriptive statistics were used and the sensitivity and negative predictive value of the algorithm were calculated. Approximately 125,000 children were evaluated in the Emergency Department and 11,331 were admitted. Of the admitted children, 1023 patients arrived in a cervical collar without advanced cervical spine imaging and were evaluated using the cervical spine clearance algorithm. Algorithm sensitivity was 94.4% and the negative predictive value was 99.9%. There was one missed injury, a spinous process tip fracture in a teenager maintained in a collar. Our algorithm was associated with a low missed injury rate and low CT utilization rate, even in children <3years old. IV. Published by Elsevier Inc.
Frisch, L E; Milner, F H; Ferris, D G
The purpose of this study was to assess the predictive value of naked-eye inspection of the cervix (NIC) after acetic acid application as an adjunct to Papanicolaou (Pap) testing for cervical cancer screening. Study subjects were women attending a medical college student health clinic either for cervical cytologic screening (67%) or because of a recent atypical cytologic screening result (33%). All study participants received cytologic screening, cervicography, and NIC. Of the 95 patients, 71 (75%) had abnormal findings on NIC. Fifty-one patients underwent colposcopy with biopsy, including 48 of the 71 with an abnormal finding on NIC. The results of 40 of the biopsies were abnormal: 36 showed human papillomavirus or low-grade squamous intraepithelial lesions, 3 showed high-grade squamous intraepithelial lesions, and 1 showed invasive cervical cancer. Sixty-five percent (26) of the abnormal biopsy findings occurred in women with normal cytologic test results. NIC and cervicography both were effective in identifying patients with abnormalities, but the combination of NIC followed by cervicography referred fewer women for colposcopy than did a positive result on NIC alone (52% vs 75%). The combination of a negative Pap smear and a negative NIC result had a 91% predictive value for the absence of cervical intraepithelial neoplasia. This was a significant improvement over cytologic screening alone. In this study, the combination of cytologic screening (Pap smear) and NIC increased the screening yield as compared with a Pap smear alone but with some loss of positive predictive value. NIC significantly improved the predictive value of negative cytologic screening results.
Dorrius, M D; Pijnappel, R M; Sijens, P E; van der Weide, M C Jansen; Oudkerk, M
The purpose of this study is to determine whether breast MRI can provide a sufficient NPV to safely rule out malignancy in mammographic BIRADS 3 lesions. In a 3-year consecutive mammographic examination study 176 out of 4391 patients had a lesion classified as BIRADS 3. 76 out of 176 patients underwent breast MRI as diagnostic work-up. Lesions which MRI classified as BIRADS 1 or 2 were considered negative for malignancy. Sensitivity, specificity, PPV and NPV were calculated. In 27 out of 76 (35.5%) patients MRI showed no enhancement and was classified as BIRADS 1. In 25 (32.9%) patients MRI showed focal or mass enhancement classified as BIRADS 2. In these 52 (68.4%) patients no malignancy was found during at least 2 years study follow-up. The other 24 (31.6%) patients had a lesion classified as BIRADS ≥ 3. Thirteen of these 24 lesions were malignant by pathology. MRI had a sensitivity of 100% (95% CI: 75-100%), specificity of 82.5% (95% CI: 71-91%), PPV of 54.2% (95% CI: 33-74%) and NPV of 100% (95% CI: 93-100%). Breast MRI should be used in a diagnostic strategy for the work-up of noncalcified BIRADS 3 lesions. Malignancy is ruled out with a very high level of confidence in the majority of patients (68%), herewith avoiding invasive diagnostic procedures. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Wysock, James S; Mendhiratta, Neil; Zattoni, Fabio; Meng, Xiaosong; Bjurlin, Marc; Huang, William C; Lepor, Herbert; Rosenkrantz, Andrew B; Taneja, Samir S
To evaluate the cancer detection rates for men undergoing 12-core systematic prostate biopsy with negative prebiopsy multiparametric magnetic resonance imaging (mpMRI) results. Clinical data from consecutive men undergoing prostate biopsy who had undergone prebiopsy 3T mpMRI from December 2011 to August 2014 were reviewed from an institutional review board-approved prospective database. Men with negative prebiospy mpMRI results (negMRI) before biopsy were identified for the present analysis. Clinical features, cancer detection rates and negative predictive values were summarized. Seventy five men with negMRI underwent systematic 12-core biopsy during the study period. In the entire cohort, men with no previous biopsy, men with previously negative biopsy and men enrolled in active surveillance protocols, the overall cancer detection rates were 18.7, 13.8, 8.0 and 38.1%, respectively, and the detection rates for Gleason score (GS) ≥7 cancer were 1.3, 0, 4.0 and 0%, respectively. The NPVs for all cancers were 81.3, 86.2, 92.0, and 61.9, and for GS ≥7 cancer they were 98.7, 100, 96.0 and 100%, respectively. A negative prebiopsy mpMRI confers an overall NPV of 82% on 12-core biopsy for all cancer and 98% for GS ≥7 cancer. Based on biopsy indication, these findings assist in prebiopsy risk stratification for detection of high-risk disease and may provide guidance in the decision to pursue biopsy. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.
Hines, John Peyton; Howard, Brittany E; Hoxworth, Joseph M; Lal, Devyani
Objectives To study positive (PPV) and negative predictive value (NPV) of positron emission tomography with computed tomography (PET-CT) scans in determining malignancy in skull base lesions and perform a systematic literature review for optimal PET-CT interpretation. Design Retrospective case series and systematic literature review of the current English literature. Setting Tertiary referral academic medical center. Participants All patients with skull base lesions that underwent PET-CT and tissue biopsy from 2010 to 2013. Main Outcome Measures PPV and NPV of radiologist's report and standardized uptake value (SUV) cutoff of 2.5 and 3, biopsy with pathologic interpretation, clinical follow-up. Results A total of 31 PET-CT scans of 16 patients were studied; 10 PET-CT were performed upfront for diagnostic purposes and 21 were post-treatment surveillance scans. The PPV of radiologist's interpretation, SUV cutoff of 2.5, and SUV cutoff of 3.0 was 80%, 60%, and 68.4%, with a NPV of 100%, 83.3%, and 75%, respectively. Literature search yielded 500 abstracts; 7 studies met inclusion criteria for detailed review. No consensus or guidelines for optimal SUV cutoff value was found. Conclusions PET-CT based on SUV cutoff criteria alone has high NPV but low PPV in determining malignancy in skull base lesions. Interpretation by a radiologist experienced in nuclear medicine and neuroradiology, synthesizing clinical, SUV, and radiologic data are of superior value.
Yang, Jing; Long, Quanyi; Li, Hongjiang; Lv, Qing; Tan, Qiuwen
Background Positive lymph node ratio (LNR), defined as ratio of positive lymph nodes to all lymph nodes removed, is a powerful prognostic factor in invasive breast cancer. Here we focused on the impact of negative lymph node (NLN) count on the prediction of value of LNR in breast cancer survival. Methods Of 929 invasive breast cancer patients were enrolled in our retrospective study. We use Kaplan-Meier to calculate the 5-year overall survival (OS) according to different clinicopathologic parameters. The prediction value of NLN count and LNR in OS was examined. Results The optimal cutoff of NLN count was designated as 9. Five-year OS was 77.0% and 95.0% in patients with NLN of 0–9 and ≥10, respectively (P<0.001). Among 204 patients who had 0–9 NLN, 25 patients with LNR 0–20.0% had 5-year OS of 95.7%, 104 patients with LNR 20.1–65.0% had 5-year OS of 83.4%, and 75 patients with LNR 65.1–100.0% had 5-year OS of 61.7% (P<0.001); Among 725 patients who had NLN ≥10, 650 patients with LNR 0–20.0% had 5-year OS of 96.1%, 68 patients with LNR 20.1–65.0% had 5-year OS of 86.8%, and 7 patients with LNR 65.1–100% had 5-year OS of 71.4% (P<0.001). Conclusions High NLN count is associated with improved survival in invasive breast cancer patients. Combining NLN count with LNR could be considered as an alternative to LNR alone in prediction of postoperative breast cancer survival. PMID:28740666
Pilz, Guenter; Eierle, Susanne; Heer, Tobias; Klos, Markus; Ali, Eman; Scheck, Roland; Wild, Michael; Bernhardt, Peter; Hoefling, Berthold
To prospectively determine the negative predictive value of normal adenosine stress cardiac MR (CMR) in routine patients referred for evaluation of coronary artery disease (CAD), predominantly with intermediate to high pretest risk. Consecutive patients referred for coronary angiography were examined in a 1.5 Tesla whole-body scanner before catheterization. A total of 158 patients with normal CMR on qualitative assessment were included, and semiquantitative perfusion analysis was performed. Significant CAD was regarded as luminal narrowing of >or=70% in coronary angiography. In the 158 study patients, negative predictive value of normal adenosine-stress CMR for significant CAD was 96.2% (for stenosis >or=90%: 98.1%). True-negative and false-negative patients were comparable regarding clinical presentation, risk factors, and CMR findings. Semiquantitative perfusion analysis gave significantly prolonged arrival time index and peak time index in the false-negative group. Using cutoff values >1.8 for arrival time index or >1.2 for peak time index, the CMR negative predictive value increased to 98.7% (for stenosis >or=90%: to 100%). The very high negative predictive value for CAD supports CMR-based decision making for the indication to coronary angiography. Semiquantitative perfusion analysis seems promising to identify the small group of CAD patients not detectable by qualitative CMR assessment.
Zhang, Charlie; Lewis, Darrell R; Nasute, Paola; Hayes, Malcolm; Warren, Linda J; Gordon, Paula B
To determine the negative predictive value of sonographically guided 14-gauge core needle biopsy of breast masses, with detailed analysis of any false-negative cases. We reviewed 669 cases of sonographically guided 14-gauge core needle biopsies that had benign pathologic findings. Given a benign pathology on core biopsy, true-negatives had either benign pathology on surgical excision or at least 2 years of stable imaging and/or clinical follow-up; false-negatives had malignant histology on surgical excision. Follow-up was available for 339 breast lesions; 117 were confirmed to be benign via surgical excision, and 220 were stable after 2 years or more of imaging or clinical follow-up (mean follow-up time 33.1 months, range 24-64 months). The negative predictive value was determined to be 99.4%. There were 2 false-negative cases, giving a false-negative rate of 0.1%. There was no delay in diagnosis in either case because the radiologist noted discordance between imaging and core biopsy pathology, and recommended surgical excision despite the benign core biopsy pathology. Sonographically guided 14-gauge core needle biopsy provides a high negative predictive value in assessing breast lesions. Radiologic/pathologic correlation should be performed to avoid delay in the diagnosis of carcinoma.
Uz Zaman, Maseeh; Fatima, Nosheen; Zaman, Areeba; Zaman, Unaiza; Tahseen, Rabia
For vasodilator stress, myocardial perfusion imaging (MPI) with at least 12-h caffeine abstinence is recommended, as it attenuates cardiovascular hyperemic response of adenosine and dipyridamole. However, many published conflicting results have shown no significant effect upon perfusion abnormalities in MPI performed without caffeine abstinence. The aim of this study was to compare the hemodynamic changes and negative predictive value (NPV) of normal MPIs with adenosine stress performed with or without caffeine abstinence. This was a prospective study that accrued 50 patients from May 2013 till September 2013 and followed till November 2014. These patients had a normal adenosine-gated MPI (GMPI) with technetium-99m methoxy isobutyl isonitrile ((99m)Tc-MIBI) after 12-h caffeine abstinence (no-caffeine). Next day, all patients had a repeat adenosine stress within 60 min after ingestion of a cup of coffee (about 80 mg of caffeine) followed by no MPI in 30 patients due to concern about radiation dose (prior-caffeine adenosine-no MPI; group A). Twenty patients opted for a repeat MPI (prior-caffeine adenosine-MPI; group B). Adenosine-induced hemodynamic response and NPV of the normal MPI with no-caffeine and prior-caffeine protocols were compared. The mean age of the study cohort was 57 ± 9 years with a male-to-female ratio of 76:24% and mean body mass index (BMI) of 26.915 ± 4.121 kg/m(2). Prevalence of hypertension, diabetes, dyslipidemia, and positive family history were 76%, 20%, 22%, and 17%, respectively. Comparison of group A with group B revealed no significant difference in demographic parameters, hemodynamic or electrocardiography (ECG) parameters, or left ventricular (LV) function parameters during adenosine intervention with prior-caffeine and no-caffeine protocols. During the follow-up, no fatal myocardial infarction (MI) was reported but 6 nonfatal MIs were reported based upon the history of short hospitalization for chest pain but without biochemical or
Fukada, Ippei; Araki, Kazuhiro; Kobayashi, Kokoro; Shibayama, Tomoko; Takahashi, Shunji; Horii, Rie; Akiyama, Futoshi; Iwase, Takuji; Ohno, Shinji; Hatake, Kiyohiko; Hozumi, Yasuo; Sata, Naohiro; Ito, Yoshinori
Background Pathological complete response (pCR) with neoadjuvant chemotherapy (NAC) has been regarded as a surrogate endpoint for disease-free survival (DFS) and overall survival (OS) of patients with breast cancer. No consensus regarding the definition of pCR has been established; there are several definitions according to a variety of classifications. Eradication of cancer cells in both breast and lymph nodes has been better associated with improved prognosis than in the breast alone. Even in patients diagnosed as having clinically node-negative cancer before NAC, postoperative pathological examination often shows axillary lymph node metastases. Patients and Methods Of the 771 patients with breast cancer who underwent NAC in the Cancer Institute Hospital between January 2000 and May 2009, 146 patients preoperatively diagnosed as having node-negative breast cancer were retrospectively evaluated. We have made the definition of clinically lymph node-negative (N0) as follows: first, ultrasonography before NAC did not show any lymphadenopathy. Second, a cytological procedure confirmed negative study for each patient when ultrasonography suggested lymphadenopathy. Results The median observation period was 79.7 months, and the median age of the subjects was 51 years. Pathological examination at the time of the surgery showed lymph node metastases (ypN+) in 46 patients (31.5%). Histological therapeutic effects revealed ypT0/is in 9 patients (6.2%) and ypTinv in 137 (93.8%). Multivariate analysis demonstrated that younger age (49>), large tumor size, NG3, and ypN+ were significant poor prognostic factors for DFS (p = 0.020, p = 0.008, P = 0.022 and p = 0.010, respectively). Moreover, ypN+ was the only significant poor prognostic factor for OS (p = 0.022). The predictive factors of ypN+ in clinically lymph node–negative breast cancer were ypTinv (p = 0.036) and the luminal type (HR+ and HER2-) (p = 0.029). Conclusion The prognosis of clinically lymph node negative breast
Ghahramani, Fariba; Alimohamadi, Yousef; Mahboubi, Mohammad; Afrasiabi, Abdolreza
Chorionic Villous Sampling (CVS) is a diagnostic method for determining genetic disorders. The present study aimed to determine the negative predictive value of the CVS in the diagnosis of major thalassemia in genetic laboratory of Dastgheib Hospital, Shiraz, Iran. The present research was an evaluation diagnostic test conducted on 372 records of embryos examined through CVS in the genetic lab in 2010 and definitely diagnosed by electrophoresis after birth in 2012. The sensitivity and positive predictive value of the test were assessed for minor thalassemia. The negative predictive value and the specificity of this test were determined, as well. A total of 3 embryos (0.8%) were aborted due to testing. In this study, the sensitivity and specificity were 94.8% and 80.4%, respectively. Also, the negative predictive values for diagnosis of major and minor thalassemia were 100% and 89.2%, respectively. No relationships were found between the gestational age and the test results. The results of this study showed that CVS genetic testing in genetic laboratory of Dastgheib Hospital was valid and had a high diagnostic value. Thus, minor couples can undergo this test with relative safety in order to prevent major thalassemia.
Negative predictive Value of Dobutamine Stress Echocardiography for Perioperative Risk Stratification in Patients with Cardiac Risk Factors and Reduced Exercise Capacity undergoing Non-cardiac Surgery.
Go, Gus; Davies, Kathy T; O'Callaghan, Cara; Senior, Wendy; Kostner, Karam; Fagermo, Narelle; Prasad, Sandhir B
Guidelines recommend functional testing for myocardial ischaemia in the perioperative setting in patients with >1 recognised cardiac risk factors and self-reported reduced exercise capacity. We sought to determine the clinical utility of dobutamine stress echocardiography (DSE) for perioperative risk stratification in patients undergoing major noncardiac surgery. Data on 79 consecutive patients undergoing DSE for perioperative risk stratification at a single centre was retrospectively reviewed to determine rates of Major Adverse Cardiac Events (MACE) during the index hospitalisation and 30 days post discharge. Echocardiography and outcomes data were obtained via folder audit and echolab database. Out of the 79 DSEs performed for perioperative risk stratification, 11(14%) were positive (DSE+ve) and 68(86%) were negative (DSE-ve). Management in the DSE+ve group included medical optimisation without invasive intervention [n=7(64%)], diagnostic coronary angiography [n=3(27%)], and coronary artery bypass graft [n=1(9%)]. None of the patients underwent percutaneous coronary intervention pre-operatively. Perioperative MACE in the DSE+ve group was 36% compared to 4% in the DSE-ve group (p=0.006). DSE+ve was a powerful predictor of perioperative inpatient MACE (OR 12.4, 95% CI 2.3-67, p=0.003). The positive predictive value of DSE+ve status was 36%, whist the negative predictive value of DSE-ve status for perioperative MACE was 96%. DSE for perioperative risk stratification had a high clinical utility in patients undergoing major noncardiac surgery. In particular, a normal DSE had a high negative predictive value for perioperative MACE. This article is protected by copyright. All rights reserved.
Barut, Mert Ulaş; Kale, Ahmet; Kuyumcuoğlu, Umur; Bozkurt, Murat; Ağaçayak, Elif; Özekinci, Server; Gul, Talip
Background This study aimed to examine the positive and negative predictive value in the diagnosis of premalignant and malignant lesions of cervical colposcopy, the sensitivity and specificity of smear, and to evaluate the correlation with histopathology of abnormal cytology and colposcopy. Material/Methods The criteria for inclusion of patients with unhealthy cervix in the study were: Erosion, Chronic cervicitis, and Healed lacerations, Hypertrophied cervix, bleeding on touch, suspicious growth/ulcer/polyp on the cervix, and abnormal discharges from the cervix. Women with frank carcinoma cervix, pregnant females, patients with bleeding per vaginum at the time of examination, and those who had used vaginal medications, vaginal contraceptives or douches in the last 48 h of examination were excluded from the study. Demographic analysis was performed for 450 patients who were admitted to the clinic. Sensitivity, specificity, positive predictive value and negative predictive values of patients to identify cervical pathologies of smear and colposcopy were histopathologically calculated. The statistical software package SPSS 15.0 (SPSS Inc., Chicago, IL, USA) and Spearman‘s and Chi-Square tests were used for statistical analysis. Results Sensitivity, specificity, PPD and NDP of smear were 0.57%, 0.76%, 0.26%, 0.92% respectively. Sensitivity, specificity, PPD and NDP of colposcopy were 0.92%, 0.67%, 0.52%, 0.96% respectively. A statistically significant correlation was found between abnormal cytology and histopathology, and abnormal colposcopy finding and histopathology. Conclusions Women with clinical diagnosis of unhealthy cervix should be evaluated by cytology to detect any premalignant or malignant lesions. It was concluded that Pap smear, colposcopy and histopathology should be collectively evaluated to evaluate cervical findings in low socio-economic regions. PMID:26655816
Barut, Mert Ulaş; Kale, Ahmet; Kuyumcuoğlu, Umur; Bozkurt, Murat; Ağaçayak, Elif; Özekinci, Server; Gül, Talip
BACKGROUND This study aimed to examine the positive and negative predictive value in the diagnosis of premalignant and malignant lesions of cervical colposcopy, the sensitivity and specificity of smear, and to evaluate the correlation with histopathology of abnormal cytology and colposcopy. MATERIAL AND METHODS The criteria for inclusion of patients with unhealthy cervix in the study were: Erosion, Chronic cervicitis, and Healed lacerations, Hypertrophied cervix, bleeding on touch, suspicious growth/ulcer/polyp on the cervix, and abnormal discharges from the cervix. Women with frank carcinoma cervix, pregnant females, patients with bleeding per vaginum at the time of examination, and those who had used vaginal medications, vaginal contraceptives or douches in the last 48 h of examination were excluded from the study. Demographic analysis was performed for 450 patients who were admitted to the clinic. Sensitivity, specificity, positive predictive value and negative predictive values of patients to identify cervical pathologies of smear and colposcopy were histopathologically calculated. The statistical software package SPSS 15.0 (SPSS Inc., Chicago, IL, USA) and Spearman's and Chi-Square tests were used for statistical analysis. RESULTS Sensitivity, specificity, PPD and NDP of smear were 0.57%, 0.76%, 0.26%, 0.92% respectively. Sensitivity, specificity, PPD and NDP of colposcopy were 0.92%, 0.67%, 0.52%, 0.96% respectively. A statistically significant correlation was found between abnormal cytology and histopathology, and abnormal colposcopy finding and histopathology. CONCLUSIONS Women with clinical diagnosis of unhealthy cervix should be evaluated by cytology to detect any premalignant or malignant lesions. It was concluded that Pap smear, colposcopy and histopathology should be collectively evaluated to evaluate cervical findings in low socio-economic regions.
Søgaard, Kirstine Kobberøe; Thomsen, Reimar Wernich; Schønheyder, Henrik Carl; Søgaard, Mette
Health care databases are a valuable resource for infectious disease epidemiology if diagnoses are accurately coded. We examined the ability of diagnostic coding to accurately identify Gram-negative bacteremia. We randomly selected 100 patients among 1,703 patients recorded in the Danish National Patient Register with a diagnosis of either "septicemia/sepsis due to other Gram-negative organisms" (International Classification of Diseases, 10th revision [ICD-10] code A41.5) or "urosepsis" (ICD-10 code A41.9B) who had been admitted at Aalborg University Hospital, Denmark between 1994 and 2012. We estimated the positive predictive value (PPV) of these diagnoses for presence of Gram-negative bacteremia, using microbiological results from blood cultures as standard reference. Complementary clinical information was obtained from the medical records. Of the 100 patients registered with Gram-negative septicemia/sepsis or urosepsis, 72 had blood culture confirmed Gram-negative bacteremia, four patients had monomicrobial Gram-positive bacteremia, 21 patients had a negative blood culture, and three had no blood culture taken. The overall PPV of a blood culture confirmed Gram-negative bacteremia diagnosis was 72% (95% confidence interval [CI]: 62%-81%); for ICD-10 code A41.5 it was 86% (95% CI: 74%-94%) and for ICD-10 code A41.9B it was 55% (95% CI: 39%-70%). The highest PPV was achieved for diagnoses registered in the most recent calendar period (2009-2012) and for secondary discharge diagnoses. Our findings indicated good agreement between ICD-10 code A41.5 "septicemia/sepsis due to other Gram-negative organisms" and Gram-negative bacteremia, whereas ICD-10 code A41.9B "urosepsis" was not suited for identification of Gram-negative bacteremia.
Castagneto, B; Di Pietrantonj, C; Stevani, I; Anfossi, A; Arzese, M; Giorcelli, L; Giaretto, L
The importance of prognostic value of the comprehensive geriatric assessment (CGA) is well known in geriatric oncology, but there is no consensus on the use of alternative abbreviated screening methods for the evaluation of older patient disabilities. The participants in this study underwent vulnerable elderly survey 13 (VES 13) at first entry in Oncology Department and were later assessed by a geriatrician according to CGA. A score >3 for VES 13 identified patients as vulnerable. Aim of this study was to evaluate the specificity, sensibility, positive predictive value (PPV), and negative predictive value (NPV) of VES 13 versus cumulative illness rating scale (CIRS), activities of daily living (ADL), instrumental activities of daily living (IADL), and short portable mental status questionnaire (SPMSQ). Hundred and seventeen patients (mean age 78.8 years) entered the study. The NPV of VES was 74.6% for CIRS, 90.1% for IADL, 93.0% for ADL, and 100% for SPMSQ. As for PPV, the VES 13 showed no accuracy. We can conclude that VES 13 demonstrated sufficient accuracy as a screening test in identifying elderly "fit" patients in order to spare the more time-consuming CGA.
Bleker, Suzanne M; Bipat, Shandra; Spijkerboer, Anje M; van der Velden, Jacobus; Stoker, Jaap; Kenter, Gemma G
This study aimed to compare the negative predictive value (NPV) of clinical examination with or without anesthesia and magnetic resonance imaging (MRI) in identifying patients with cervical carcinoma without parametrial infiltration. This retrospective cohort study was conducted at the Academic Medical Center in Amsterdam. The medical files of 203 patients diagnosed with cervical cancer stages IB1-IIA, who underwent surgical treatment between January 1, 2003, and January 31, 2011, were reviewed. We compared clinical International Federation of Gynecology and Obstetrics staging and MRI during the staging procedure. The results were compared with the parametrial status by surgical-pathological investigation, which was considered to be the reference standard. Based on the surgical-pathological findings, 16.7% of the patients treated surgically had parametrial infiltration. For parametrial infiltration, examination under anesthesia (EUA) had an NPV of 65.3% and MRI of 76.9%, respectively. We found no significant difference between these NPVs. Examination under anesthesia and MRI are equal in identifying cervical cancer patients without parametrial infiltration with a tendency for MRI to perform better than EUA. When outpatient clinical staging is considered inconclusive, pretreatment staging may be limited to MRI. In these cases, EUA seems to have no additional value.
Forberg, Jakob L; Hilmersson, Catarina E; Carlsson, Marcus; Arheden, Håkan; Björk, Jonas; Hjalte, Krister; Ekelund, Ulf
Background Previous studies from the USA have shown that acute nuclear myocardial perfusion imaging (MPI) in low risk emergency department (ED) patients with suspected acute coronary syndrome (ACS) can be of clinical value. The aim of this study was to evaluate the utility and hospital economics of acute MPI in Swedish ED patients with suspected ACS. Methods We included 40 patients (mean age 55 ± 2 years, 50% women) who were admitted from the ED at Lund University Hospital for chest pain suspicious of ACS, and who had a normal or non-ischemic ECG and no previous myocardial infarction. All patients underwent MPI from the ED, and the results were analyzed only after patient discharge. The current diagnostic practice of admitting the included patients for observation and further evaluation was compared to a theoretical "MPI strategy", where patients with a normal MPI test would have been discharged home from the ED. Results Twenty-seven patients had normal MPI results, and none of them had ACS. MPI thus had a negative predictive value for ACS of 100%. With the MPI strategy, 2/3 of the patients would thus have been discharged from the ED, resulting in a reduction of total hospital cost by some 270 EUR and of bed occupancy by 0.8 days per investigated patient. Conclusion Our findings in a Swedish ED support the results of larger American trials that acute MPI has the potential to safely reduce the number of admissions and decrease overall costs for low-risk ED patients with suspected ACS. PMID:19545365
Martin Wilkinson, national sales manager at system protection specialist, Spirotech UK, highlights the 'potential negative consequences' of value engineering in heating system specification in the healthcare sector, and argues that system protection products such as de-aerators and dirt separators have considerable value in preventative maintenance, and in helping to extend the useful life of both the system as a whole, and its vital parts.
Mendiola, Marta; Martínez-Marin, Virginia; Herranz, Jesús; Heredia, Victoria; Yébenes, Laura; Zamora, Pilar; Castelo, Beatriz; Pinto, Álvaro; Miguel, María; Díaz, Esther; Gámez, Angelo; Fresno, Juan Ángel; de Molina, Ana Ramírez; Hardisson, David; Espinosa, Enrique; Redondo, Andrés
Bevacizumab plus weekly paclitaxel improves progression-free survival (PFS) in HER2-negative metastatic breast cancer (mBC), but its use has been questioned due to the absence of a predictive biomarker, lack of benefit in overall survival (OS) and increased toxicity. We examined the baseline tumor angiogenic-related gene expression of 60 patients with mBC with the aim of finding a signature that predicts benefit from this drug. Multivariate analysis by Lasso-penalized Cox regression generated two predictive models: one, named G-model, including 11 genes, and the other one, named GC-model, including 13 genes plus 5 clinical covariates. Both models identified patients with improved PFS (HR (Hazard Ratio) 2.57 and 4.04, respectively) and OS (HR 3.29 and 3.43, respectively). The G-model distinguished low and high risk patients in the first 6 months, whereas the GC-model maintained significance over time. PMID:26992213
Positive predictive value of high-grade prostatic intraepithelial neoplasia in initial core needle biopsies of prostate adenocarcinoma--a study with complete sampling of hemi-prostates with corresponding negative biopsy findings.
Delatour, Nicolas L D Roustan; Mai, Kien T
High-grade prostatic intraepithelial neoplasia (HGPIN) is a putative premalignant lesion of prostate adenocarcinoma (PCa). The significance of isolated HGPIN in initial biopsy cores as a marker of PCa in repeat biopsies has been extensively investigated, but little is known of the true occurrence of PCa in this setting, because repeat biopsies can miss the focus of cancer. In this study, a hemi-prostate model was used to define the true positive predictive value of HGPIN in core biopsies in predicting PCa. From 132 consecutive resected prostate specimens, 70 hemi-prostates with all corresponding biopsy cores negative for PCa were thoroughly examined. Of the 70 hemi-prostates, 38 had PCa (including 8 with clinically significant PCa), and 11 had HGPIN. In the group of 38 hemi-prostate with PCa, 7 were associated with HGPIN-positive biopsies. No statistically significant difference was found between the hemi-prostates with or without PCa, regarding the presence, microscopic pattern, or multiple core involvement of HGPIN in the biopsies. The positive predictive value of HGPIN in predicting for clinically significant PCa was 27%, the negative predictive value was 87%, the sensitivity was 38%, and the specificity was 91% (P = 0.04, statistically significant). In addition, the positive predictive value of multiple cores with HGPIN in predicting for clinically significant PCa was 75% (negative predictive value 92%). The results of the present study have failed to support HGPIN as a statistically significant predictor for the occurrence of PCa. More importantly, however, HGPIN and multiple core involvement did seem to be a useful marker for clinically significant PCa.
Predictive value and clinical utility of centrally-assessed ER, PgR and Ki-67 to select adjuvant endocrine therapy for premenopausal women with hormone receptor-positive, HER2-negative early breast cancer: TEXT and SOFT trials
Regan, Meredith M.; Pagani, Olivia; Francis, Prudence A.; Fleming, Gini F.; Walley, Barbara A.; Kammler, Roswitha; Dell'Orto, Patrizia; Russo, Leila; Szőke, János; Doimi, Franco; Villani, Laura; Pizzolitto, Stefano; Öhlschlegel, Christian; Sessa, Fausto; Cámara, Vicente Peg; Peralto, José Luis Rodríguez; MacGrogan, Gaëtan; Colleoni, Marco; Goldhirsch, Aron; Price, Karen N.; Coates, Alan S.; Gelber, Richard D.; Viale, Giuseppe
Purpose The SOFT and TEXT randomized phase III trials investigated adjuvant endocrine therapies for premenopausal women with hormone receptor-positive (HR+) early breast cancer. We investigated the prognostic and predictive value of centrally-assessed levels of estrogen receptor (ER), progesterone receptor (PgR) and Ki-67 expression in women with HER2-negative disease. Patients and Methods Of 5707 women enrolled, 4115 with HER2-negative (HR+/HER2-) disease had ER, PgR and Ki-67 centrally assessed by immunohistochemistry. Breast cancer-free interval (BCFI) was defined from randomization to first invasive local, regional or distant recurrence or contralateral breast cancer. The prognostic and predictive values of ER, PgR and Ki-67 expression levels were assessed using Cox modeling and STEPP methodology. Results In this HR+/HER2- population, the median ER, PgR and Ki-67 expression were 95%, 90% and 18% immunostained cells. As most patients had strongly ER positive tumors, the predictive value of ER levels could not be investigated. Lower PgR and higher Ki-67 expression were associated with reduced BCFI. There was no consistent evidence of heterogeneity of the relative treatment effects according to PgR or Ki-67 expression levels though there was a greater 5-year absolute benefit of exemestane+ovarian function suppression (OFS) versus tamoxifen with or without OFS at lower levels of PgR and higher levels of Ki-67. Conclusions Women with poor prognostic features of low PgR and/or high Ki-67 have greater absolute benefit from exemestane+OFS versus tamoxifen+OFS or tamoxifen-alone, but individually PgR and Ki-67 are of limited predictive value for selecting adjuvant endocrine therapy for premenopausal women with HR+/HER2- early breast cancer. PMID:26493064
Predictive value and clinical utility of centrally assessed ER, PgR, and Ki-67 to select adjuvant endocrine therapy for premenopausal women with hormone receptor-positive, HER2-negative early breast cancer: TEXT and SOFT trials.
Regan, Meredith M; Pagani, Olivia; Francis, Prudence A; Fleming, Gini F; Walley, Barbara A; Kammler, Roswitha; Dell'Orto, Patrizia; Russo, Leila; Szőke, János; Doimi, Franco; Villani, Laura; Pizzolitto, Stefano; Öhlschlegel, Christian; Sessa, Fausto; Peg Cámara, Vicente; Rodríguez Peralto, José Luis; MacGrogan, Gaëtan; Colleoni, Marco; Goldhirsch, Aron; Price, Karen N; Coates, Alan S; Gelber, Richard D; Viale, Giuseppe
The SOFT and TEXT randomized phase III trials investigated adjuvant endocrine therapies for premenopausal women with hormone receptor-positive (HR+) early breast cancer. We investigated the prognostic and predictive value of centrally assessed levels of estrogen receptor (ER), progesterone receptor (PgR), and Ki-67 expression in women with HER2-negative disease. Of 5707 women enrolled, 4115 with HER2-negative (HR+/HER2-) disease had ER, PgR, and Ki-67 centrally assessed by immunohistochemistry. Breast cancer-free interval (BCFI) was defined from randomization to first invasive local, regional, or distant recurrence or contralateral breast cancer. The prognostic and predictive values of ER, PgR and Ki-67 expression levels were assessed using Cox modeling and STEPP methodology. In this HR+/HER2- population, the median ER, PgR, and Ki-67 expressions were 95, 90, and 18 % immunostained cells. As most patients had strongly ER-positive tumors, the predictive value of ER levels could not be investigated. Lower PgR and higher Ki-67 expression were associated with reduced BCFI. There was no consistent evidence of heterogeneity of the relative treatment effects according to PgR or Ki-67 expression levels, though there was a greater 5-year absolute benefit of exemestane + ovarian function suppression (OFS) versus tamoxifen with or without OFS at lower levels of PgR and higher levels of Ki-67. Women with poor prognostic features of low PgR and/or high Ki-67 have greater absolute benefit from exemestane + OFS versus tamoxifen + OFS or tamoxifen alone, but individually PgR and Ki-67 are of limited predictive value for selecting adjuvant endocrine therapy for premenopausal women with HR+/HER2- early breast cancer.
Javaras, Kristin N; Schaefer, Stacey M; van Reekum, Carien M; Lapate, Regina C; Greischar, Lawrence L; Bachhuber, David R; Love, Gayle Dienberg; Ryff, Carol D; Davidson, Richard J
Greater levels of conscientiousness have been associated with lower levels of negative affect. We focus on one mechanism through which conscientiousness may decrease negative affect: effective emotion regulation, as reflected by greater recovery from negative stimuli. In 273 adults who were 35-85 years old, we collected self-report measures of personality including conscientiousness and its self-control facet, followed on average 2 years later by psychophysiological measures of emotional reactivity and recovery. Among middle-aged adults (35-65 years old), the measures of conscientiousness and self-control predicted greater recovery from, but not reactivity to, negative emotional stimuli. The effect of conscientiousness and self-control on recovery was not driven by other personality variables or by greater task adherence on the part of high conscientiousness individuals. In addition, the effect was specific to negative emotional stimuli and did not hold for neutral or positive emotional stimuli.
Denollet, Johan; Pedersen, Susanne S; Vrints, Christiaan J; Conraads, Viviane M
Methodological considerations and selected null findings indicate the need to reexamine the Type D construct. We investigated whether associations with cardiac events in patients with coronary artery disease (CAD) involve the specific combination of negative affectivity (NA) and social inhibition (SI), or rather the main effect of either trait alone. In this 5-year follow-up of 541 patients with CAD, the Type D construct (14-item Type D Scale) was tested by examining a) the interaction of continuous NA and SI z scores and b) a four-group classification defined by low/high trait scores. End points were major adverse cardiac events (MACEs; death, myocardial infarction [MI], coronary revascularization) and cardiac death/MI. At follow-up, 113 patients had a MACE, including 47 patients with cardiac death/MI. After adjustment for disease severity, age, sex, and main trait effects, the interaction of NA and SI z scores was associated with MACE (odds ratio [OR] = 1.36, 95% confidence interval [CI] = 1.11-1.67). This continuous measure of Type D was also associated with cardiac death/MI (OR = 1.48, 95% CI = 1.11-1.96) and remained an independent predictor of events after adjustment for depressive symptoms. Using a cutoff of 10 on both NA and SI scales, Type D was associated with an adjusted OR of 1.74 (95% CI = 1.11-2.73) for MACE and an OR of 2.35 (95% CI = 1.26-4.38) for death/MI but was unrelated to noncardiac death. Patients with high NA or SI alone were not at increased risk. Continuous (NA × SI interaction) and dichotomized measures of Type D were associated with cardiovascular events in patients with CAD. Research is needed to explore moderating factors that may alter this association.
Stefanics, Gábor; Kremláček, Jan; Czigler, István
An increasing number of studies investigate the visual mismatch negativity (vMMN) or use the vMMN as a tool to probe various aspects of human cognition. This paper reviews the theoretical underpinnings of vMMN in the light of methodological considerations and provides recommendations for measuring and interpreting the vMMN. The following key issues are discussed from the experimentalist's point of view in a predictive coding framework: (1) experimental protocols and procedures to control “refractoriness” effects; (2) methods to control attention; (3) vMMN and veridical perception. PMID:25278859
Chemoendocrine compared with endocrine adjuvant therapies for node-negative breast cancer: predictive value of centrally reviewed expression of estrogen and progesterone receptors--International Breast Cancer Study Group.
Viale, Giuseppe; Regan, Meredith M; Maiorano, Eugenio; Mastropasqua, Mauro G; Golouh, Rastko; Perin, Tiziana; Brown, Robert W; Kovács, Anikó; Pillay, Komala; Ohlschlegel, Christian; Braye, Stephen; Grigolato, Piergiovanni; Rusca, Tiziana; Gelber, Richard D; Castiglione-Gertsch, Monica; Price, Karen N; Goldhirsch, Aron; Gusterson, Barry A; Coates, Alan S
To centrally assess estrogen receptor (ER) and progesterone receptor (PgR) levels by immunohistochemistry and investigate their predictive value for benefit of chemo-endocrine compared with endocrine adjuvant therapy alone in two randomized clinical trials for node-negative breast cancer. International Breast Cancer Study Group Trial VIII compared cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy for 6 cycles followed by endocrine therapy with goserelin with either modality alone in pre- and perimenopausal patients. Trial IX compared three cycles of CMF followed by tamoxifen for 5 years versus tamoxifen alone in postmenopausal patients. Central Pathology Office reviewed 883 (83%) of 1,063 patients on Trial VIII and 1,365 (82%) of 1,669 on Trial IX and determined ER and PgR by immunohistochemistry. Disease-free survival (DFS) was compared across the spectrum of expression of each receptor using the Subpopulation Treatment Effect Pattern Plot methodology. Both receptors displayed a bimodal distribution, with substantial proportions showing no staining (receptor absent) and most of the remainder showing a high percentage of stained cells. Chemo-endocrine therapy yielded DFS superior to endocrine therapy alone for patients with receptor-absent tumors, and in some cases also for those with low levels of receptor expression. Among patients with ER-expressing tumors, additional prediction of benefit was suggested in absent or low PgR in Trial VIII but not in Trial IX. Low levels of ER and PgR are predictive of the benefit of adding chemotherapy to endocrine therapy. Low PgR may add further prediction among pre- and perimenopausal but not postmenopausal patients whose tumors express ER.
Kobe, Carsten; Dietlein, Markus; Franklin, Jeremy; Markova, Jana; Lohri, Andreas; Amthauer, Holger; Klutmann, Susanne; Knapp, Wolfram H.; Zijlstra, Josee M.; Bockisch, Andreas; Weckesser, Matthias; Lorenz, Reinhard; Schreckenberger, Mathias; Bares, Roland; Eich, Hans T.; Mueller, Rolf-Peter; Fuchs, Michael; Borchmann, Peter; Schicha, Harald; Diehl, Volker
In the HD15 trial of the German Hodgkin Study Group, the negative predictive value (NPV) of positron emission tomography (PET) using [18F]-fluorodeoxyglucose in advanced-stage Hodgkin lymphoma (HL) was evaluated. A total of 817 patients were enrolled and randomly assigned to receive BEACOPP-based chemotherapy. After completion of chemotherapy, residual disease measuring more than or equal to 2.5 cm in diameter was assessed by PET in 311 patients. The NPV of PET was defined as the proportion of PET− patients without progression, relapse, or irradiation within 12 months after PET review panel. The progression-free survival was 96% for PET− patients (95% confidence interval [CI], 94%-99%) and 86% for PET+ patients (95% CI, 78%-95%, P = .011). The NPV for PET in this analysis was 94% (95% CI, 91%-97%). Thus, consolidation radiotherapy can be omitted in PET− patients with residual disease without increasing the risk for progression or early relapse compared with patients in complete remission. The impact of this finding on the overall survival at 5 years must be awaited. Until then, response adapted therapy guided by PET for HL patients seems to be a promising approach that should be further evaluated in clinical trials. This trial is registered at http://isrctn.org study as #ISRCTN32443041. PMID:18757777
What Is the Negative Predictive Value of Multiparametric Magnetic Resonance Imaging in Excluding Prostate Cancer at Biopsy? A Systematic Review and Meta-analysis from the European Association of Urology Prostate Cancer Guidelines Panel.
Moldovan, Paul C; Van den Broeck, Thomas; Sylvester, Richard; Marconi, Lorenzo; Bellmunt, Joaquim; van den Bergh, Roderick C N; Bolla, Michel; Briers, Erik; Cumberbatch, Marcus G; Fossati, Nicola; Gross, Tobias; Henry, Ann M; Joniau, Steven; van der Kwast, Theo H; Matveev, Vsevolod B; van der Poel, Henk G; De Santis, Maria; Schoots, Ivo G; Wiegel, Thomas; Yuan, Cathy Yuhong; Cornford, Philip; Mottet, Nicolas; Lam, Thomas B; Rouvière, Olivier
It remains unclear whether patients with a suspicion of prostate cancer (PCa) and negative multiparametric magnetic resonance imaging (mpMRI) can safely obviate prostate biopsy. To systematically review the literature assessing the negative predictive value (NPV) of mpMRI in patients with a suspicion of PCa. The Embase, Medline, and Cochrane databases were searched up to February 2016. Studies reporting prebiopsy mpMRI results using transrectal or transperineal biopsy as a reference standard were included. We further selected for meta-analysis studies with at least 10-core biopsies as the reference standard, mpMRI comprising at least T2-weighted and diffusion-weighted imaging, positive mpMRI defined as a Prostate Imaging Reporting Data System/Likert score of ≥3/5 or ≥4/5, and results reported at patient level for the detection of overall PCa or clinically significant PCa (csPCa) defined as Gleason ≥7 cancer. A total of 48 studies (9613 patients) were eligible for inclusion. At patient level, the median prevalence was 50.4% (interquartile range [IQR], 36.4-57.7%) for overall cancer and 32.9% (IQR, 28.1-37.2%) for csPCa. The median mpMRI NPV was 82.4% (IQR, 69.0-92.4%) for overall cancer and 88.1% (IQR, 85.7-92.3) for csPCa. NPV significantly decreased when cancer prevalence increased, for overall cancer (r=-0.64, p<0.0001) and csPCa (r=-0.75, p=0.032). Eight studies fulfilled the inclusion criteria for meta-analysis. Seven reported results for overall PCa. When the overall PCa prevalence increased from 30% to 60%, the combined NPV estimates decreased from 88% (95% confidence interval [95% CI], 77-99%) to 67% (95% CI, 56-79%) for a cut-off score of 3/5. Only one study selected for meta-analysis reported results for Gleason ≥7 cancers, with a positive biopsy rate of 29.3%. The corresponding NPV for a cut-off score of ≥3/5 was 87.9%. The NPV of mpMRI varied greatly depending on study design, cancer prevalence, and definitions of positive mpMRI and csPCa. As
The influence of prostate-specific antigen density on positive and negative predictive values of multiparametric magnetic resonance imaging to detect Gleason score 7-10 prostate cancer in a repeat biopsy setting.
Hansen, Nienke L; Barrett, Tristan; Koo, Brendan; Doble, Andrew; Gnanapragasam, Vincent; Warren, Anne; Kastner, Christof; Bratt, Ola
To evaluate the influence of prostate-specific antigen density (PSAD) on positive (PPV) and negative (NPV) predictive values of multiparametric magnetic resonance imaging (mpMRI) to detect Gleason score ≥7 cancer in a repeat biopsy setting. Retrospective study of 514 men with previous prostate biopsy showing no or Gleason score 6 cancer. All had mpMRI, graded 1-5 on a Likert scale for cancer suspicion, and subsequent targeted and 24-core systematic image-fusion guided transperineal biopsy in 2013-2015. The NPVs and PPVs of mpMRIs for detecting Gleason score ≥7 cancer were calculated (±95% confidence intervals) for PSAD ≤0.1, 0.1-0.2, ≤0.2 and >0.2 ng/mL/mL, and compared by chi-square test for linear trend. Gleason score ≥7 cancer was detected in 31% of the men. The NPV of Likert 1-2 mpMRI was 0.91 (±0.04) with a PSAD of ≤0.2 ng/mL/mL and 0.71 (±0.16) with a PSAD of >0.2 ng/mL/mL (P = 0.003). For Likert 3 mpMRI, PPV was 0.09 (±0.06) with a PSAD of ≤0.2 ng/mL/mL and 0.44 (±0.19) with a PSAD of >0.2 ng/mL/mL (P = 0.002). PSAD also significantly affected the PPV of Likert 4-5 mpMRI lesions: the PPV was 0.47 (±0.08) with a PSAD of ≤0.2 ng/mL/mL and 0.66 (±0.10) with a PSAD of >0.2 ng/mL/mL (P < 0.001). In a repeat biopsy setting, a PSAD of ≤0.2 ng/mL/mL is associated with low detection of Gleason score ≥7 prostate cancer, not only in men with negative mpMRI, but also in men with equivocal imaging. Surveillance, rather than repeat biopsy, may be appropriate for these men. Conversely, biopsies are indicated in men with a high PSAD, even if an mpMRI shows no suspicious lesion, and in men with an mpMRI suspicious for cancer, even if the PSAD is low. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.
Silva, R; Cruz, L; Botelho, C; Castro, E; Cadinha, S; Castel-Branco, M G; Rodrigues, J
The determination of specific IgE in patients with history of penicillins hypersensitivity is simple, safe and widely available. The positive and negative predictive values of this determination, however, are not yet established. In order to evaluate them, we performed specific IgE determination and diagnostic drug challenges in a group of 22 patients with a clear history of immediate penicillins hypersensitivity but negative skin tests. In this sample, the positive and negative predictive values were 29% and 87%, respectively. This seems to indicate that a positive specific IgE is not enough to confirm the diagnosis, and further study is necessary.
Lawson, Rebecca P.; Seymour, Ben; Loh, Eleanor; Lutti, Antoine; Dolan, Raymond J.; Dayan, Peter; Weiskopf, Nikolaus; Roiser, Jonathan P.
Learning what to approach, and what to avoid, involves assigning value to environmental cues that predict positive and negative events. Studies in animals indicate that the lateral habenula encodes the previously learned negative motivational value of stimuli. However, involvement of the habenula in dynamic trial-by-trial aversive learning has not been assessed, and the functional role of this structure in humans remains poorly characterized, in part, due to its small size. Using high-resolution functional neuroimaging and computational modeling of reinforcement learning, we demonstrate positive habenula responses to the dynamically changing values of cues signaling painful electric shocks, which predict behavioral suppression of responses to those cues across individuals. By contrast, negative habenula responses to monetary reward cue values predict behavioral invigoration. Our findings show that the habenula plays a key role in an online aversive learning system and in generating associated motivated behavior in humans. PMID:25071182
Lawson, Rebecca P; Seymour, Ben; Loh, Eleanor; Lutti, Antoine; Dolan, Raymond J; Dayan, Peter; Weiskopf, Nikolaus; Roiser, Jonathan P
Learning what to approach, and what to avoid, involves assigning value to environmental cues that predict positive and negative events. Studies in animals indicate that the lateral habenula encodes the previously learned negative motivational value of stimuli. However, involvement of the habenula in dynamic trial-by-trial aversive learning has not been assessed, and the functional role of this structure in humans remains poorly characterized, in part, due to its small size. Using high-resolution functional neuroimaging and computational modeling of reinforcement learning, we demonstrate positive habenula responses to the dynamically changing values of cues signaling painful electric shocks, which predict behavioral suppression of responses to those cues across individuals. By contrast, negative habenula responses to monetary reward cue values predict behavioral invigoration. Our findings show that the habenula plays a key role in an online aversive learning system and in generating associated motivated behavior in humans.
comparing supervised classification learning algorithms. Neural computation, 10(7):1895–1923, 1998.  Thomas Dietterich. Ensemble methods in machine...2003.  Bernhard Schölkopf. The kernel trick for distances. Advances in neural information processing systems, pages 301–307, 2001.  Bernhard ...pages 371–377. IEEE, 1999.  Thomas Stibor and Jonathan Timmis. Comments on real-valued negative selection vs. real-valued positive selection and
Hagood, Elizabeth W; Gruenewald, Tara L
A considerable volume of experimental evidence demonstrates that exposure to aging stereotypes can strongly influence cognitive performance among older individuals. However, whether such effects extend to stereotypes regarding older adults' generative (i.e. contributory) worth is not yet known. The present investigation sought to evaluate the effect of exposure to positive versus negative generative value primes on an important aspect of later life functioning, memory. Participants of age 55 and older (n = 51) were randomly assigned to read a mock news article portraying older individuals as either an asset (positive prime) or a burden (negative prime) to society. Upon reading their assigned article, participants completed a post-priming memory assessment in which they were asked to recall a list of 30 words. Those exposed to the negative prime showed significantly poorer memory performance relative to those exposed to the positive prime (d = 0.75), even when controlling for baseline memory performance and sociodemographic covariates. These findings suggest that negative messages regarding older adults' generative social value impair memory relative to positive ones. Though demonstrated in the short term, these results also point to the potential consequences of long-term exposure to such negative ideologies and may indicate a need to promote more positive societal conceptualizations of older adults' generative worth.
Neyedli, Heather F; Welsh, Timothy N
It has previously been found that when participants are presented with a pair of motor prospects, they can select the prospect with the largest maximum expected gain (MEG). Many of those decisions, however, were trivial because of large differences in MEG between the prospects. The purpose of the present study was to explore participants' preferences when making non-trivial decisions between two motor prospects. Participants were presented with pairs of prospects that: 1) differed in MEG with either only the values or only the probabilities differing between the prospects; and 2) had similar MEG with one prospect having a larger probability of hitting the target and a higher penalty value and the other prospect a smaller probability of hitting the target but a lower penalty value. In different experiments, participants either had 400 ms or 2000 ms to decide between the prospects. It was found that participants chose the configuration with the larger MEG more often when the probability varied between prospects than when the value varied. In pairs with similar MEGs, participants preferred a larger probability of hitting the target over a smaller penalty value. These results indicate that participants prefer probability information over negative value information in a motor selection task.
Lee, Adabel; Hankin, Benjamin L.; Mermelstein, Robin J.
The current study examined whether negative interactions with parents and peers would mediate the longitudinal association between perceived social competence and depressive symptoms and whether a negative cognitive style would moderate the longitudinal association between negative interactions with parents and increases in depressive symptoms. Youth (N=350; 6th-10th graders) completed self-report measures of perceived social competence, negative interactions with parents and peers, negative cognitive style, and depressive symptoms at three time points. Results indicated that the relationship between perceived social competence and depressive symptoms was partially mediated by negative interactions with parents but not peers. Further, baseline negative cognitive style interacted with greater negative parent interactions to predict later depressive symptoms. PMID:20706914
Alleva, Jessica M; Lange, Wolf-Gero; Jansen, Anita; Martijn, Carolien
The current study investigated whether negative body evaluation predicts women's overestimation of negative social feedback related to their own body (i.e., covariation bias). Sixty-five female university students completed a computer task where photos of their own body, of a control woman's body, and of a neutral object, were followed by nonverbal social feedback (i.e., facial crowds with equal numbers of negative, positive, and neutral faces). Afterward, women estimated the percentage of negative, positive, and neutral social feedback that followed their own body, the control woman's body, and the neutral object. The findings provided evidence for a covariation bias: negative body evaluation predicted higher estimates of negative social feedback for women's own body, but not for the other stimuli. Additionally, the covariation bias was not explained by differences in how women interpreted the social feedback (the facial stimuli). Clinical implications of the covariation bias to body image are discussed.
Yasuda, Asako; Sato, Atsushi; Miyawaki, Kaori; Kumano, Hiroaki; Kuboki, Tomifusa
Error-related negativity (ERN) is a negative deflection in the event-related potential elicited in error trials. To examine the function of ERN, we performed an experiment in which two within-participants factors were manipulated: outcome uncertainty and content of feedback. The ERN was largest when participants expected correct feedback but received error feedback. There were significant positive correlations between the ERN amplitude and the rate of response switching in the subsequent trial, and between the ERN amplitude and the trait version score on negative affect scale. These results suggest that ERN reflects detection of a negative reward prediction error and promotes subsequent response switching, and that individuals with high negative affect are hypersensitive to a negative reward prediction error.
Cummings, Steven; Papadakis, Maxine; Melnick, Jane; Gooding, Gretchen A. W.; Tierney, Lawrence M.
To determine the predictive value of physical signs for ascites, we compared the results of physical examination with those of abdominal sonography in 90 men in hospital with liver disease. The positive predictive values of shifting dullness and prominent fluid waves were low (51% and 73%). We divided the patients into two groups: those with prolonged prothrombin times (72% prevalence of ascites by sonogram), and those with normal prothrombin times (15% prevalence). In patients with prolonged prothrombin times, a prominent fluid wave had a very high positive predictive value for ascites (96%). Many patients with prolonged prothrombin times had ascites despite negative physical signs. In contrast, in those with normal prothrombin times, both shifting dullness and prominent fluid waves were usually falsely positive. Patients with normal prothrombin times and no shifting dullness rarely (2%) had ascites. The predictive value of physical signs for ascites depends on the prevalence of ascites in groups of patients that are examined. The prothrombin time is a useful index for identifying inpatients with a high or low prevalence of ascites and the predictive value of physical signs is enhanced by interpreting them in combination with a patient's prothrombin time. PMID:3892916
Sambrook, Thomas D; Roser, Matthew; Goslin, Jeremy
Humans handle uncertainty poorly. Prospect theory accounts for this with a value function in which possible losses are overweighted compared to possible gains, and the marginal utility of rewards decreases with size. fMRI studies have explored the neural basis of this value function. A separate body of research claims that prediction errors are calculated by midbrain dopamine neurons. We investigated whether the prospect theoretic effects shown in behavioral and fMRI studies were present in midbrain prediction error coding by using the feedback-related negativity, an ERP component believed to reflect midbrain prediction errors. Participants' stated satisfaction with outcomes followed prospect theory but their feedback-related negativity did not, instead showing no effect of marginal utility and greater sensitivity to potential gains than losses.
Lee, Hee Jin; Lee, Jeong-Ju; Song, In Hye; Park, In Ah; Kang, Jun; Yu, Jong Han; Ahn, Jin-Hee; Gong, Gyungyub
The prognostic significance of tumor-infiltrating lymphocytes and immune signals has been described previously in triple-negative breast cancer (TNBC). Furthermore, recent studies have shown that immunologic parameters are relevant for the response to neoadjuvant chemotherapy (NAC) in breast cancer as well as for outcomes after adjuvant chemotherapy. However, immune signals are variable, and which signals are important is largely unknown. We, therefore, evaluated the expression of immune-related genes in TNBC treated with NAC. We retrospectively evaluated biopsy tissue from 55 patients with primary TNBC treated with NAC (anthracycline, cyclophosphamide, and docetaxel) against the NanoString nCounter GX Human Immunology Panel (579 immune-related genes). Higher expression of cytotoxic molecules, T cell receptor signaling pathway components, cytokines related to T helper cell type 1 (Th1), and B cell markers was associated with a pathologic complete response (pCR). Higher expression of NFKB1, MAPK1, TRAF1, CXCL13, GZMK, and IL7R was significantly associated with pCR, higher Miller-Payne grade, and lower residual cancer burden class. Expression of NFKB1, TRAF1, and CXCL13genes, in particular, was significantly correlated with a longer disease-free survival rate. Conversely, patients those who failed to achieve a pCR showed increased expression of genes related to neutrophils. Higher expression of cytotoxic molecules, T cell receptor signaling pathway components, Th1-related cytokines, and B cell markers is correlated with pCR and survival in TNBC patients treated with NAC. Our results suggest that the activation status of neutrophils may provide additional predictive information for TNBC patients treated with NAC.
Holmes, Candice N.
OBJECTIVE To determine whether a history of previous varicella infection provides a reliable marker for prior infection. QUALITY OF EVIDENCE MEDLINE was searched from January 1996 to May 2002 using the MeSH headings “varicella,” “chickenpox,” and “medical history taking.” Recommendations in this paper are based on evidence from well designed cross-sectional studies. MAIN MESSAGE Serologic testing is advised, rather than presumptive vaccination, for those with a negative or uncertain history of varicella; most will be immune. For those with a positive history of varicella, the advice given depends on the population. For populations at higher risk of varicella infection (eg, health care workers, pregnant women), routine serum testing is recommended. For low-risk populations, physicians could accept a positive history of varicella as a reliable indicator of immunity. CONCLUSION Most studies found that patients’ history of varicella had a high positive predictive value and a low negative predictive value. These findings suggest that a positive history of varicella is a reliable marker of disease while a negative history does not not predict lack of immunity. PMID:15732223
Prokopenko, S. M. L.; Laframboise, J. G.
A calculation by Knott, for the floating potential of a spherically symmetric synchronous-altitude satellite in eclipse, was adapted to provide simple calculations of upper bounds on negative potentials which may be achieved by electrically isolated shaded surfaces on spacecraft in sunlight. Large (approximately 60 percent) increases in predicted negative shaded-side potentials are obtained. To investigate effective potential barrier or angular momentum selection effects due to the presence of less negative sunlit-side or adjacent surface potentials, these expressions were replaced by the ion random current, which is a lower bound for convex surfaces when such effects become very severe. Further large increases in predicted negative potentials were obtained, amounting to a doubling in some cases.
Pfabigan, Daniela M; Seidel, Eva-Maria; Paul, Katharina; Grahl, Arvina; Sailer, Uta; Lanzenberger, Rupert; Windischberger, Christian; Lamm, Claus
The present study investigated whether the same visual stimulus indicating zero-value feedback (€0) elicits feedback-related negativity (FRN) variation, depending on whether the outcomes correspond with expectations or not. Thirty-one volunteers performed a monetary incentive delay (MID) task while EEG was recorded. FRN amplitudes were comparable and more negative when zero-value outcome deviated from expectations than with expected gain or loss, supporting theories emphasising the impact of unexpectedness and salience on FRN amplitudes. Surprisingly, expected zero-value outcomes elicited the most negative FRNs. However, source localisation showed that such outcomes evoked less activation in cingulate areas than unexpected zero-value outcomes. Our study illustrates the context dependency of identical zero-value feedback stimuli. Moreover, the results indicate that the incentive cues in the MID task evoke different reward prediction error signals. These prediction signals differ in FRN amplitude and neuronal sources, and have to be considered in the design and interpretation of future studies.
Schaefer, Stacey M; Morozink Boylan, Jennifer; van Reekum, Carien M; Lapate, Regina C; Norris, Catherine J; Ryff, Carol D; Davidson, Richard J
Purpose in life predicts both health and longevity suggesting that the ability to find meaning from life's experiences, especially when confronting life's challenges, may be a mechanism underlying resilience. Having purpose in life may motivate reframing stressful situations to deal with them more productively, thereby facilitating recovery from stress and trauma. In turn, enhanced ability to recover from negative events may allow a person to achieve or maintain a feeling of greater purpose in life over time. In a large sample of adults (aged 36-84 years) from the MIDUS study (Midlife in the U.S., http://www.midus.wisc.edu/), we tested whether purpose in life was associated with better emotional recovery following exposure to negative picture stimuli indexed by the magnitude of the eyeblink startle reflex (EBR), a measure sensitive to emotional state. We differentiated between initial emotional reactivity (during stimulus presentation) and emotional recovery (occurring after stimulus offset). Greater purpose in life, assessed over two years prior, predicted better recovery from negative stimuli indexed by a smaller eyeblink after negative pictures offset, even after controlling for initial reactivity to the stimuli during the picture presentation, gender, age, trait affect, and other well-being dimensions. These data suggest a proximal mechanism by which purpose in life may afford protection from negative events and confer resilience is through enhanced automatic emotion regulation after negative emotional provocation.
Schaefer, Stacey M.; Morozink Boylan, Jennifer; van Reekum, Carien M.; Lapate, Regina C.; Norris, Catherine J.; Ryff, Carol D.; Davidson, Richard J.
Purpose in life predicts both health and longevity suggesting that the ability to find meaning from life’s experiences, especially when confronting life’s challenges, may be a mechanism underlying resilience. Having purpose in life may motivate reframing stressful situations to deal with them more productively, thereby facilitating recovery from stress and trauma. In turn, enhanced ability to recover from negative events may allow a person to achieve or maintain a feeling of greater purpose in life over time. In a large sample of adults (aged 36-84 years) from the MIDUS study (Midlife in the U.S., http://www.midus.wisc.edu/), we tested whether purpose in life was associated with better emotional recovery following exposure to negative picture stimuli indexed by the magnitude of the eyeblink startle reflex (EBR), a measure sensitive to emotional state. We differentiated between initial emotional reactivity (during stimulus presentation) and emotional recovery (occurring after stimulus offset). Greater purpose in life, assessed over two years prior, predicted better recovery from negative stimuli indexed by a smaller eyeblink after negative pictures offset, even after controlling for initial reactivity to the stimuli during the picture presentation, gender, age, trait affect, and other well-being dimensions. These data suggest a proximal mechanism by which purpose in life may afford protection from negative events and confer resilience is through enhanced automatic emotion regulation after negative emotional provocation. PMID:24236176
Oyen, Wim J.G.
Abstract The predictive and prognostic value of fluorodeoxyglucose (FDG)-positron emission tomography (PET) in non-small-cell lung carcinoma, colorectal carcinoma and lymphoma is discussed. The degree of FDG uptake is of prognostic value at initial presentation, after induction treatment prior to resection and in the case of relapse of non-small cell lung cancer (NSCLC). In locally advanced and advanced stages of NSCLC, FDG-PET has been shown to be predictive for clinical outcome at an early stage of treatment. In colorectal carcinoma, limited studies are available on the prognostic value of FDG-PET, however, the technique appears to have great potential in monitoring the success of local ablative therapies soon after intervention and in the prediction and evaluation of response to radiotherapy, systemic therapy, and combinations thereof. The prognostic value of end-of treatment FDG-PET for FDG-avid lymphomas has been established, and the next step is to define how to use this information to optimize patient outcome. In Hodgkin's lymphoma, FDG-PET has a high negative predictive value, however, histological confirmation of positive findings should be sought where possible. For non-Hodgkin's lymphoma, the opposite applies. The newly published standardized guidelines for interpretation formulates specific criteria for visual interpretation and for defining PET positivity in the liver, spleen, lung, bone marrow and small residual lesions. The introduction of these guidelines should reduce variability among studies. Interim PET offers a reliable method for early prediction of long-term remission, however it should only be performed in prospective randomized controlled trials. Many of the diagnostic and management questions considered in this review are relevant to other tumour types. Further research in this field is of great importance, since it may lead to a change in the therapeutic concept of cancer. The preliminary findings call for systematic inclusion of FDG
Zhou, Yao; Vales, M Isabel; Wang, Aoxue; Zhang, Zhiwu
Accuracy of genomic prediction is commonly calculated as the Pearson correlation coefficient between the predicted and observed phenotypes in the inference population by using cross-validation analysis. More frequently than expected, significant negative accuracies of genomic prediction have been reported in genomic selection studies. These negative values are surprising, given that the minimum value for prediction accuracy should hover around zero when randomly permuted data sets are analyzed. We reviewed the two common approaches for calculating the Pearson correlation and hypothesized that these negative accuracy values reflect potential bias owing to artifacts caused by the mathematical formulas used to calculate prediction accuracy. The first approach, Instant accuracy, calculates correlations for each fold and reports prediction accuracy as the mean of correlations across fold. The other approach, Hold accuracy, predicts all phenotypes in all fold and calculates correlation between the observed and predicted phenotypes at the end of the cross-validation process. Using simulated and real data, we demonstrated that our hypothesis is true. Both approaches are biased downward under certain conditions. The biases become larger when more fold are employed and when the expected accuracy is low. The bias of Instant accuracy can be corrected using a modified formula. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Shallcross, Amanda J.; Troy, Allison S.; Boland, Matthew; Mauss, Iris B.
The present studies examined whether a tendency to accept negative emotional experiences buffers individuals from experiencing elevated negative affect during negative emotional situations (Study 1) and from developing depressive symptoms in the face of life stress (Study 2). Both studies examined female samples. This research expands on existing acceptance research in four ways. First, it examined whether acceptance has beneficial correlates when it matters most: in emotionally taxing (versus more neutral) contexts. Second, in Study 2 a prospective design was used in which acceptance was measured before stress was encountered and before outcomes were measured. Third, depressive symptoms (rather than general functioning or trauma symptoms) were examined as a particularly relevant outcome in the context of stress. Fourth, to enhance generalizability, a community sample (versus undergraduates or a purely clinical sample) was recruited. Results indicated that acceptance was correlated with decreased negative affect during a negative emotion induction but not an affectively neutral condition (Study 1). In Study 2, acceptance interacted with life stress such that acceptance predicted lower levels of depressive symptoms after higher, but not lower, life stress. These results suggest that accepting negative experiences may protect individuals from experiencing negative affect and from developing depressive symptoms. PMID:20566191
Schomberg, Jessica; Schöne, Benjamin; Gruber, Thomas; Quirin, Markus
Previous research has demonstrated that negative affect influences attentional processes. Here, we investigate whether pre-experimental negative affect predicts a hypervigilant neural response as indicated by increased event-related potential amplitudes in response to neutral and positive visual stimuli. In our study, seventeen male participants filled out the German version of the positive and negative affect schedule (Watson et al. in J Pers Soc Psychol 54:1063-1070, 1988; Krohne et al. in Diagnostica 42:139-156, 1996) and subsequently watched positive (erotica, extreme sports, beautiful women) and neutral (daily activities) photographs while electroencephalogram was recorded. In line with our hypothesis, low state negative affect but not (reduced) positive affect predicted an increase in the first positive event-related potential amplitude P1 as a typical marker of increased selective attention. As this effect occurred in response to non-threatening picture conditions, negative affect may foster an individual's general hypervigilance, a state that has formerly been associated with psychopathology only.
Barlow, Fiona Kate; Paolini, Stefania; Pedersen, Anne; Hornsey, Matthew J; Radke, Helena R M; Harwood, Jake; Rubin, Mark; Sibley, Chris G
Contact researchers have largely overlooked the potential for negative intergroup contact to increase prejudice. In Study 1, we tested the interaction between contact quantity and valence on prejudice toward Black Australians (n = 1,476), Muslim Australians (n = 173), and asylum seekers (n = 293). In all cases, the association between contact quantity and prejudice was moderated by its valence, with negative contact emerging as a stronger and more consistent predictor than positive contact. In Study 2, White Americans (n = 441) indicated how much positive and negative contact they had with Black Americans on separate measures. Although both quantity of positive and negative contact predicted racism and avoidance, negative contact was the stronger predictor. Furthermore, negative (but not positive) contact independently predicted suspicion about Barack Obama's birthplace. These results extend the contact hypothesis by issuing an important caveat: Negative contact may be more strongly associated with increased racism and discrimination than positive contact is with its reduction.
Wang, Guan-Nan; Gao, Hui; Chen, Lian; Mensah, Dennis N A; Fu, Yan
In a social network, users hold and express positive and negative attitudes (e.g. support/opposition) towards other users. Those attitudes exhibit some kind of binary relationships among the users, which play an important role in social network analysis. However, some of those binary relationships are likely to be latent as the scale of social network increases. The essence of predicting latent binary relationships have recently began to draw researchers' attention. In this paper, we propose a machine learning algorithm for predicting positive and negative relationships in social networks inspired by structural balance theory and social status theory. More specifically, we show that when two users in the network have fewer common neighbors, the prediction accuracy of the relationship between them deteriorates. Accordingly, in the training phase, we propose a segment-based training framework to divide the training data into two subsets according to the number of common neighbors between users, and build a prediction model for each subset based on support vector machine (SVM). Moreover, to deal with large-scale social network data, we employ a sampling strategy that selects small amount of training data while maintaining high accuracy of prediction. We compare our algorithm with traditional algorithms and adaptive boosting of them. Experimental results of typical data sets show that our algorithm can deal with large social networks and consistently outperforms other methods.
Wang, Guan-Nan; Gao, Hui; Chen, Lian; Mensah, Dennis N. A.; Fu, Yan
In a social network, users hold and express positive and negative attitudes (e.g. support/opposition) towards other users. Those attitudes exhibit some kind of binary relationships among the users, which play an important role in social network analysis. However, some of those binary relationships are likely to be latent as the scale of social network increases. The essence of predicting latent binary relationships have recently began to draw researchers' attention. In this paper, we propose a machine learning algorithm for predicting positive and negative relationships in social networks inspired by structural balance theory and social status theory. More specifically, we show that when two users in the network have fewer common neighbors, the prediction accuracy of the relationship between them deteriorates. Accordingly, in the training phase, we propose a segment-based training framework to divide the training data into two subsets according to the number of common neighbors between users, and build a prediction model for each subset based on support vector machine (SVM). Moreover, to deal with large-scale social network data, we employ a sampling strategy that selects small amount of training data while maintaining high accuracy of prediction. We compare our algorithm with traditional algorithms and adaptive boosting of them. Experimental results of typical data sets show that our algorithm can deal with large social networks and consistently outperforms other methods. PMID:26075404
Siegel, D; Cohen, P T; Neighbor, M; Larkin, H; Newman, M; Yajko, D; Hadley, K
We prospectively evaluate the value of fecal blood and fecal leukocytes in predicting whether acute diarrhea in adults is associated with a stool culture positive for a bacterial pathogen. One hundred thirteen patients, aged 19 to 50 years, seen in a two-year period in an urban adult outpatient setting underwent stool culture for the presenting symptom of diarrhea. Heterosexual men represented 48% of the cohort, women represented 17%, and homosexual men represented 35%. Overall, 53 (47%) of the patients had positive stool cultures for enteric pathogens. Campylobacter jejuni was the most common organism in the entire cohort, but Shigella species were most common in homosexual men. The best predictive variables for a stool culture positive for a bacterial pathogen were the presence of both fecal leukocytes and fecal blood in the stool, compared with only one or neither. When both were present, the sensitivity was 81%, the specificity 74%, and the predictive values of a positive and negative test were 81% and 83%, respectively; the likelihood ratio was 4.87. When homosexual men and the rest of the cohort were analyzed separately, the combination of fecal leukocytes and fecal blood remained the best method of predicting a positive stool culture in both. Examination of stool for fecal leukocytes and fecal blood is a rapid, reliable, and inexpensive way to differentiate between bacterial and other causes of acute diarrhea in the adult acute care setting.
Austin, R. Kirk; Dahl, A. Dennis; Wagner, Bruce D.
The relationship between sense of coherence and negative career thoughts was investigated in a non-college-based population to determine the relationship and predictive value of these factors toward career decision status. Participants completed the Orientation to Life Questionnaire, Career Thoughts Inventory, and Career Decision Profile's…
Wilcox, James; Winokur, George; Tsuang, Ming
This research addresses the relationship of formal thought disorder in the early stages of psychotic illness to the long-term outcome of mental health many years later. The specific topic of concern was to evaluate the prognostic significance of thought disorder on the severity of psychosis over time. Subjects with new-onset psychosis were evaluated on a variety of measures including education, physical health, Brief Psychiatric Rating Scale scores. They were also given the Thought, Language, and Communication Scale to evaluate thought disorder. Subjects were interviewed again at 10 and 20 years to evaluate variations in outcome. Appropriate statistical methods were used to evaluate changes in the level of functioning over time. Thought disorder was not unique to schizophrenia. Bipolar patients presented with significant positive thought disorder at the onset of psychosis. Overtime positive thought disorder gradually improved in most patients. Negative thought disorder was more persistent, especially in subjects with schizophrenia. Initial psychosis with thought disorder characterized by poverty of content seemed to be associated with poor long-term outcome. Formal thought disorder can predict outcome in some cases of psychosis. Not all types of thought disorder have the same prognostic implication. Positive forms of thought disorder (pressured speech, tangentiality) had no significant predictive value. Negative thought disorder (particularly poverty of speech and poverty of content) tend to predict a chronic, more unrelenting course of illness. Published by Elsevier Inc.
Spasibko, K. Yu.; Chekhova, M. V.; Khalili, F. Ya.
Polarization quasiprobability distribution defined in the Stokes space shares many important properties with the Wigner function for position and momentum. Most notably, they both give correct one-dimensional marginal probability distributions and therefore represent the natural choice for the probability distributions in classical hidden-variable models. In this context, negativity of the Wigner function is considered as proof of nonclassicality for a quantum state. On the contrary, the polarization quasiprobability distribution demonstrates negativity for all quantum states. This feature comes from the discrete nature of Stokes variables; however, it was not observed in previous experiments, because they were performed with photon-number averaging detectors. Here we reconstruct the polarization quasiprobability distribution of a coherent state with photon-number resolving detectors, which allows us to directly observe for the first time its negativity. Furthermore we derive a theoretical polarization quasiprobability distribution for any linearly polarized quantum state.
Meder, David; Madsen, Kristoffer H; Hulme, Oliver; Siebner, Hartwig R
Adaptive actions build on internal probabilistic models of possible outcomes that are tuned according to the errors of their predictions when experiencing an actual outcome. Prediction errors (PEs) inform choice behavior across a diversity of outcome domains and dimensions, yet neuroimaging studies have so far only investigated such signals in singular experimental contexts. It is thus unclear whether the neuroanatomical distribution of PE encoding reported previously pertains to computational features that are invariant with respect to outcome valence, sensory domain, or some combination of the two. We acquired functional MRI data while volunteers performed four probabilistic reversal learning tasks which differed in terms of outcome valence (reward-seeking versus punishment-avoidance) and domain (abstract symbols versus facial expressions) of outcomes. We found that ventral striatum and frontopolar cortex coded increasingly positive PEs, whereas dorsal anterior cingulate cortex (dACC) traced increasingly negative PEs, irrespectively of the outcome dimension. Individual reversal behavior was unaffected by context manipulations and was predicted by activity in dACC and right inferior frontal gyrus (IFG). The stronger the response to negative PEs in these areas, the lower was the tendency to reverse choice behavior in response to negative events, suggesting that these regions enforce a rule-based strategy across outcome dimensions. Outcome valence influenced PE-related activity in left amygdala, IFG, and dorsomedial prefrontal cortex, where activity selectively scaled with increasingly positive PEs in the reward-seeking but not punishment-avoidance context, irrespective of sensory domain. Left amygdala displayed an additional influence of sensory domain. In the context of avoiding punishment, amygdala activity increased with increasingly negative PEs, but only for facial stimuli, indicating an integration of outcome valence and sensory domain during probabilistic
Buchacz, Andrzej; Gałęziowski, Damian
In the paper, the known problem of vibration control, authors expanded for designing of mechatronic discrete systems that contains single or multiply piezoelectric elements connected to external electric networks. Main focus has been given for investigations in relation to damping performance and parameters study, in case of potential practical application. By different configurations of considered mechatronic discrete branched structures with two degrees of freedom, key negative parameters have been identified and investigated in case of vibration control effectiveness. Results have been presented in graphical form of amplitudes and dynamical flexibility functions.
Rodan, Ali; Fayyoumi, Ayham; Faris, Hossam; Alsakran, Jamal; Al-Kadi, Omar
Recently, telecommunication companies have been paying more attention toward the problem of identification of customer churn behavior. In business, it is well known for service providers that attracting new customers is much more expensive than retaining existing ones. Therefore, adopting accurate models that are able to predict customer churn can effectively help in customer retention campaigns and maximizing the profit. In this paper we will utilize an ensemble of Multilayer perceptrons (MLP) whose training is obtained using negative correlation learning (NCL) for predicting customer churn in a telecommunication company. Experiments results confirm that NCL based MLP ensemble can achieve better generalization performance (high churn rate) compared with ensemble of MLP without NCL (flat ensemble) and other common data mining techniques used for churn analysis.
Recently, telecommunication companies have been paying more attention toward the problem of identification of customer churn behavior. In business, it is well known for service providers that attracting new customers is much more expensive than retaining existing ones. Therefore, adopting accurate models that are able to predict customer churn can effectively help in customer retention campaigns and maximizing the profit. In this paper we will utilize an ensemble of Multilayer perceptrons (MLP) whose training is obtained using negative correlation learning (NCL) for predicting customer churn in a telecommunication company. Experiments results confirm that NCL based MLP ensemble can achieve better generalization performance (high churn rate) compared with ensemble of MLP without NCL (flat ensemble) and other common data mining techniques used for churn analysis. PMID:25879060
The evolving ease and efficiency in accessing large amounts of data presents an opportunity to execute prediction tasks based on this data. Research in learning-from-example has addressed this opportunity with algorithms that induce either decision structures (ID3) or classification rules (AQ15). Lazy learning research on the other hand, delay the model construction to strictly satisfy a prediction task. To support a prediction query against a data set, current techniques require a large amount of preprocessing to either construct a complete domain model, or to determine attribute relevance. Our work in this area is to develop an algorithm that will automatically return a probabilistic classification rule for a prediction query with equal accuracy to current techniques but with no preprocessing requirements. The proposed algorithm, DBPredictor, combines the delayed model construction approach of lazy learning along with the information theoretic measure and top-down heuristic search of learning-from-example algorithms. The algorithm induces only the information required to satisfy the prediction query and avoids the attribute relevance tests required by the nearest-neighbor measures of lazy learning.
Ruiz, R Jeanne; Trzeciakowski, Jerome; Moore, Tiffany; Ayers, Kimberly S; Pickler, Rita H
Chronic stress may accelerate cellular aging. Telomeres, protective "caps" at the end of chromosomes, modulate cellular aging and may be good biomarkers for the effects of chronic stress, including that associated with acculturation. The purpose of this analysis was to examine telomere length (TL) in acculturating Hispanic Mexican American women and to determine the associations among TL, acculturation, and psychological factors. As part of a larger cross-sectional study of 516 pregnant Hispanic Mexican American women, we analyzed DNA in blood samples (N = 56) collected at 22-24 weeks gestation for TL as an exploratory measure using monochrome multiplex quantitative telomere polymerase chain reaction (PCR). We measured acculturation with the Acculturation Rating Scale for Mexican Americans, depression with the Beck Depression Inventory, discrimination with the Experiences of Discrimination Scale, and stress with the Perceived Stress Scale. TL was negatively moderately correlated with two variables of acculturation: Anglo orientation and greater acculturation-level scores. We combined these scores for a latent variable, acculturation, and we combined depression, stress, and discrimination scores in another latent variable, "negative affectivity." Acculturation and negative affectivity were bidirectionally correlated. Acculturation significantly negatively predicted TL. Using structural equation modeling, we found the model had an excellent fit with the root mean square error of approximation estimate = .0001, comparative fit index = 1.0, Tucker-Lewis index = 1.0, and standardized root mean square residual = .05. The negative effects of acculturation on the health of Hispanic women have been previously demonstrated. Findings from this analysis suggest a link between acculturation and TL, which may indicate accelerated cellular aging associated with overall poor health outcomes.
Background Supervised machine learning approaches have been recently adopted in the inference of transcriptional targets from high throughput trascriptomic and proteomic data showing major improvements from with respect to the state of the art of reverse gene regulatory network methods. Beside traditional unsupervised techniques, a supervised classifier learns, from known examples, a function that is able to recognize new relationships for new data. In the context of gene regulatory inference a supervised classifier is coerced to learn from positive and unlabeled examples, as the counter negative examples are unavailable or hard to collect. Such a condition could limit the performance of the classifier especially when the amount of training examples is low. Results In this paper we improve the supervised identification of transcriptional targets by selecting reliable counter negative examples from the unlabeled set. We introduce an heuristic based on the known topology of transcriptional networks that in fact restores the conventional positive/negative training condition and shows a significant improvement of the classification performance. We empirically evaluate the proposed heuristic with the experimental datasets of Escherichia coli and show an example of application in the prediction of BCL6 direct core targets in normal germinal center human B cells obtaining a precision of 60%. Conclusions The availability of only positive examples in learning transcriptional relationships negatively affects the performance of supervised classifiers. We show that the selection of reliable negative examples, a practice adopted in text mining approaches, improves the performance of such classifiers opening new perspectives in the identification of new transcriptional targets. PMID:23368951
Boezeman, Edwin J.; Nieuwenhuijsen, Karen; Sluiter, Judith K.
Objectives: To test the predictive value and convergent construct validity of a 6-item work functioning screener (WFS-H). Methods: Healthcare workers (249 nurses) completed a questionnaire containing the work functioning screener (WFS-H) and a work functioning instrument (NWFQ) measuring the following: cognitive aspects of task execution and general incidents, avoidance behavior, conflicts and irritation with colleagues, impaired contact with patients and their family, and level of energy and motivation. Productivity and mental health were also measured. Negative and positive predictive values, AUC values, and sensitivity and specificity were calculated to examine the predictive value of the screener. Correlation analysis was used to examine the construct validity. Results: The screener had good predictive value, since the results showed that a negative screener score is a strong indicator of work functioning not hindered by mental health problems (negative predictive values: 94%-98%; positive predictive values: 21%-36%; AUC:.64-.82; sensitivity: 42%-76%; and specificity 85%-87%). The screener has good construct validity due to moderate, but significant (p<.001), associations with productivity (r=.51), mental health (r=.48), and distress (r=.47). Conclusions: The screener (WFS-H) had good predictive value and good construct validity. Its score offers occupational health professionals a helpful preliminary insight into the work functioning of healthcare workers. PMID:27010085
Kopplin, Laura J.; Mansberger, Steven L.
Purpose To determine the predictive value of ophthalmic screening tests with visually significant eye disease in a cohort of American Indian/Alaskan Natives from the Pacific Northwest. Design Validity assessment of a possible screening protocol. Methods Ophthalmic technicians performed a screening examination including medical and ocular history, best-corrected visual acuity, limbal anterior chamber depth assessment, frequency doubling technology perimetry (FDT, C-20-5), confocal scanning laser ophthalmoscopy, nonmydriatic digital photography, and tonometry on 429 participants. An ophthalmologist performed a comprehensive eye exam on subjects with one or more abnormal screening tests and a random selection of those with normal screening tests. We used univariate and multivariate logistic regression to determine the association between abnormal screening test results and visually significant eye disease. We also determined the predictive value of screening tests with ocular disease. Results Univariate analysis identified history of eye disease or diabetes mellitus (p<.001), visual acuity <20/40 (p<.001), abnormal/poor quality confocal scanning laser ophthalmoscopy (p<.001), abnormal FDT (p<.001), and abnormal/poor quality non-mydriatic imaging (p<.001) as associated with visually significant eye disease. A multivariate analysis found visually significant eye disease to be associated (p<.001; receiver operating curve area= .827, negative predictive value=84%) with four screening tests: visual acuity <20/40, abnormal/poor quality non-mydriatic imaging, abnormal FDT and abnormal/poor quality confocal scanning laser ophthalmoscopy. Conclusions Ophthalmic technicians performing a subset of screening tests may provide an accurate and efficient means of screening for eye disease in an American Indian/Alaskan Native population. Confirmation of these results in other populations, particularly those with a different profile of disease prevalence is needed. PMID:26052087
Kopplin, Laura J; Mansberger, Steven L
To determine the predictive value of ophthalmic screening tests with visually significant eye disease in a cohort of American Indian/Alaskan Natives from the Pacific Northwest. Validity assessment of a possible screening protocol. Ophthalmic technicians performed a screening examination including medical and ocular history, best-corrected visual acuity, limbal anterior chamber depth assessment, frequency-doubling technology perimetry (FDT, C-20-5), confocal scanning laser ophthalmoscopy, nonmydriatic digital photography, and tonometry on 429 participants. An ophthalmologist performed a comprehensive eye examination on subjects with 1 or more abnormal screening tests and a random selection of those with normal screening tests. We used univariate and multivariate logistic regression to determine the association between abnormal screening test results and visually significant eye disease. We also determined the predictive value of screening tests with ocular disease. Univariate analysis identified history of eye disease or diabetes mellitus (P < .001), visual acuity <20/40 (P < .001), abnormal/poor-quality confocal scanning laser ophthalmoscopy (P < .001), abnormal FDT (P < .001), and abnormal/poor-quality nonmydriatic imaging (P < .001) as associated with visually significant eye disease. A multivariate analysis found visually significant eye disease to be associated (P < .001; receiver operating characteristic curve area = 0.827, negative predictive value = 84%) with 4 screening tests: visual acuity <20/40, abnormal/poor-quality nonmydriatic imaging, abnormal FDT, and abnormal/poor-quality confocal scanning laser ophthalmoscopy. Ophthalmic technicians performing a subset of screening tests may provide an accurate and efficient means of screening for eye disease in an American Indian/Alaskan Native population. Confirmation of these results in other populations, particularly those with a different profile of disease prevalence, is needed. Copyright © 2015 Elsevier
Krobbuaban, Banjong; Diregpoke, Siriwan; Kumkeaw, Sujarit; Tanomsat, Malin
Preoperative evaluation of anatomical landmarks and clinical factors help identify potentially difficult laryngoscopies; however, predictive reliability is unclear. Because the ratio of height to thyromental distance (RHTMD) has a demonstrably better predictive value than the thyromental distance (TMD), we evaluated the predictive value and odds ratios of RHTMD versus mouth opening, TMD, neck movement, and oropharyngeal view (modified Mallampati). We collected data on 550 consecutive patients scheduled for elective-surgery general anesthesia requiring endotracheal intubation and then assessed all five factors before surgery. An experienced anesthesiologist, not apprised of the recorded preoperative airway assessment, performed the laryngoscopy and grading (as per Cormack and Lehane's classification). Difficult laryngoscopy (Grade 3 or 4) occurred in 69 patients (12.5%). RHTMD had a higher sensitivity, positive predictive value, and fewer false negatives than the other variables tested. In the multivariate analysis, three criteria were found independent for difficult laryngoscopy (neck movement < or =80 degrees; Mallampati Class 3 or 4, and RHTMD > or =23.5). The odds ratio (95% confidence interval) of the RHTMD, Mallampati class, and neck movement were 6.72 (3.29-13.72), 2.96 (1.63-5.35), and 2.73 (1.14-6.51), respectively. The odds ratio for RHTMD was the largest and thus may prove a useful screening test for difficult laryngoscopy.
Yoon, Song-Oh; Suk, Kwanho; Goo, Jin Kyung; Lee, Jiheon; Lee, Seon Min
In the research reported here, we proposed and demonstrated the prediction-specificity effect, which states that people's prediction of the general outcome of an event (e.g., the winner of a soccer match) is less accurate when the prediction question is framed in a more specific manner (e.g., guessing the score) rather than in a less specific manner (e.g., guessing the winner). We demonstrated this effect by examining people's predictions on actual sports games both in field and laboratory studies. In Study 1, the analysis of 19 billion bets from a commercial sports-betting business provided evidence for the effect of prediction specificity. This effect was replicated in three controlled laboratory studies, in which participants predicted the outcomes of a series of soccer matches. Furthermore, the negative effect of prediction specificity was mediated by participants' underweighting of important holistic information during decision making.
Finlay, Andrea; Wray-Lake, Laura; Warren, Michael; Maggs, Jennifer L.
Adolescent future values – beliefs about what will matter to them in the future – may shape their adult behavior. Utilizing a national longitudinal British sample, this study examined whether adolescent future values in six domains (i.e., family responsibility, full-time job, personal responsibility, autonomy, civic responsibility, and hedonistic privilege) predicted adult social roles, civic behaviors, and alcohol use. Future values positively predicted behaviors within the same domain; fewer cross-domain associations were evident. Civic responsibility positively predicted adult civic behaviors, but negatively predicted having children. Hedonistic privilege positively predicted adult alcohol use and negatively predicted civic behaviors. Results suggest that attention should be paid to how adolescents are thinking about their futures due to the associated links with long-term social and health behaviors. PMID:26279595
Finlay, Andrea; Wray-Lake, Laura; Warren, Michael; Maggs, Jennifer L
Adolescent future values - beliefs about what will matter to them in the future - may shape their adult behavior. Utilizing a national longitudinal British sample, this study examined whether adolescent future values in six domains (i.e., family responsibility, full-time job, personal responsibility, autonomy, civic responsibility, and hedonistic privilege) predicted adult social roles, civic behaviors, and alcohol use. Future values positively predicted behaviors within the same domain; fewer cross-domain associations were evident. Civic responsibility positively predicted adult civic behaviors, but negatively predicted having children. Hedonistic privilege positively predicted adult alcohol use and negatively predicted civic behaviors. Results suggest that attention should be paid to how adolescents are thinking about their futures due to the associated links with long-term social and health behaviors.
Background Human values and folklore of wildlife strongly influence the effectiveness of conservation efforts. These values and folklore may also vary with certain demographic characteristics such as gender, age, or education. Reptiles and amphibians are among the least appreciated of vertebrates and are victims of many negative values and wrong ideas resulting from the direct interpretation of folklore. We try to demonstrate how these values and folklore can affect the way people relate to them and also the possible conservation impacts on these animals. Methods A questionnaire survey distributed to 514 people in the district of Évora, Portugal, was used to obtain data regarding the hypothesis that the existence of wrong ideas and negative values contributes to the phenomenon of human-associated persecution of these animals. A structural equation model was specified in order to confirm the hypothesis about the possible relationships between the presence of perceptions and negative values about amphibians and reptiles and persecution and anti-conservation attitudes. Sociodemographic variables were also added. Results The results of the model suggest that the presence of folklore and negative values clearly predicts persecution and anti-conservation attitudes towards amphibians and reptiles. Also, the existence of folklore varies sociodemographically, but negative values concerning these animals are widespread in the population. Conclusions With the use of structural equation models, this work is a contribution to the study of how certain ideas and values can directly influence human attitudes towards herpetofauna and how they can be a serious conservation issue. PMID:22316318
Ceríaco, Luis Mp
Human values and folklore of wildlife strongly influence the effectiveness of conservation efforts. These values and folklore may also vary with certain demographic characteristics such as gender, age, or education. Reptiles and amphibians are among the least appreciated of vertebrates and are victims of many negative values and wrong ideas resulting from the direct interpretation of folklore. We try to demonstrate how these values and folklore can affect the way people relate to them and also the possible conservation impacts on these animals. A questionnaire survey distributed to 514 people in the district of Évora, Portugal, was used to obtain data regarding the hypothesis that the existence of wrong ideas and negative values contributes to the phenomenon of human-associated persecution of these animals. A structural equation model was specified in order to confirm the hypothesis about the possible relationships between the presence of perceptions and negative values about amphibians and reptiles and persecution and anti-conservation attitudes. Sociodemographic variables were also added. The results of the model suggest that the presence of folklore and negative values clearly predicts persecution and anti-conservation attitudes towards amphibians and reptiles. Also, the existence of folklore varies sociodemographically, but negative values concerning these animals are widespread in the population. With the use of structural equation models, this work is a contribution to the study of how certain ideas and values can directly influence human attitudes towards herpetofauna and how they can be a serious conservation issue.
Dale, Lourdes P; Klein, Jordana; DiLoreto, James; Pidano, Anne E; Borto, Jolanta W; McDonald, Kathleen; Olson, Heather; Neace, William P
The aim of this study was to determine the presence of negative content in commercials airing on 3 children's channels (Disney Channel, Nickelodeon, and Cartoon Network). The 1681 commercials were coded with a reliable coding system and content comparisons were made. Although the majority of the commercials were coded as neutral, negative content was present in 13.5% of commercials. This rate was significantly more than the predicted value of zero and more similar to the rates cited in previous research examining content during sporting events. The rate of negative content was less than, but not significantly different from, the rate of positive content. Thus, our findings did not support our hypothesis that there would be more commercials with positive content than with negative content. Logistic regression analysis indicated that channel, and not rating, was a better predictor of the presence of overall negative content and the presence of violent behaviors. Commercials airing on the Cartoon Network had significantly more negative content, and those airing on Disney Channel had significantly less negative content than the other channels. Within the individual channels, program ratings did not relate to the presence of negative content. Parents cannot assume the content of commercials will be consistent with the program rating or label. Pediatricians and psychologists should educate parents about the potential for negative content in commercials and advocate for a commercials rating system to ensure that there is greater parity between children's programs and the corresponding commercials.
Some space missions require a nuclear-power source to generate electrical power to meet mission objectives. At present, the nuclear-power source is an assembly of modular heat sources called the general purpose heat source (GPHS) modules. Each module comprises graphite shells designed to protect iridium-alloy clads which serve as the primary containment shells for the radioactive, heat-producing material. In the course of launching the space vehicle to perform its mission the nuclear heat source may be exposed to severe accident environments. One particular environment is a primary impact event where individual GPHS modules impact hard surfaces at speeds in the range of 50 meters per second or more. Tests have shown that some clads may be breached in particularly severe impacts and release a small fraction of their contents. This paper presents an empirical model for predicting essential ingredients for assessing the risk associated with primary impact events. The ingredients include: clad failure probability, release fraction of clad contents, characterization of the released material in terms of particle-size distribution and a means to estimate uncertainty in the prediction process. The empirical model focuses on the deformation of the clads and their capability to withstand deformation without breaching, measured by ductility. The basic criterion used to estimate all ingredients is called 'negative margin'. The procedure for estimating risk factors entails calculation of clad distortion by, e.g. hydrocode simulation, and high-strain-rate ductility of the iridium alloy. Negative margin is a linear combination of distortion and ductility. Regression equations derived from test data are used to calculate the clad failure probability and the fractional activity release as functions of negative margin. The mass-based particle-size distribution is calculated as a function of release fraction. Cumulative uncertainty in this computing process is evaluated using
Murphy, Daniel L.; Gaertner, Matthew N.
This study evaluates four growth prediction models--projection, student growth percentile, trajectory, and transition table--commonly used to forecast (and give schools credit for) middle school students' future proficiency. Analyses focused on vertically scaled summative mathematics assessments, and two performance standards conditions (high…
Murphy, Daniel L.; Gaertner, Matthew N.
This study evaluates four growth prediction models--projection, student growth percentile, trajectory, and transition table--commonly used to forecast (and give schools credit for) middle school students' future proficiency. Analyses focused on vertically scaled summative mathematics assessments, and two performance standards conditions (high…
Partin, Alan W.; Van Neste, Leander; Klein, Eric A.; Marks, Leonard S.; Gee, Jason R.; Troyer, Dean A.; Rieger-Christ, Kimberly; Jones, J. Stephen; Magi-Galluzzi, Cristina; Mangold, Leslie A.; Trock, Bruce J.; Lance, Raymond S.; Bigley, Joseph W.; Van Criekinge, Wim; Epstein, Jonathan I.
Purpose The DOCUMENT multicenter trial in the United States validated the performance of an epigenetic test as an independent predictor of prostate cancer risk to guide decision making for repeat biopsy. Confirming an increased negative predictive value could help avoid unnecessary repeat biopsies. Materials and Methods We evaluated the archived, cancer negative prostate biopsy core tissue samples of 350 subjects from a total of 5 urological centers in the United States. All subjects underwent repeat biopsy within 24 months with a negative (controls) or positive (cases) histopathological result. Centralized blinded pathology evaluation of the 2 biopsy series was performed in all available subjects from each site. Biopsies were epigenetically profiled for GSTP1, APC and RASSF1 relative to the ACTB reference gene using quantitative methylation specific polymerase chain reaction. Predetermined analytical marker cutoffs were used to determine assay performance. Multivariate logistic regression was used to evaluate all risk factors. Results The epigenetic assay resulted in a negative predictive value of 88% (95% CI 85–91). In multivariate models correcting for age, prostate specific antigen, digital rectal examination, first biopsy histopathological characteristics and race the test proved to be the most significant independent predictor of patient outcome (OR 2.69, 95% CI 1.60–4.51). Conclusions The DOCUMENT study validated that the epigenetic assay was a significant, independent predictor of prostate cancer detection in a repeat biopsy collected an average of 13 months after an initial negative result. Due to its 88% negative predictive value adding this epigenetic assay to other known risk factors may help decrease unnecessary repeat prostate biopsies. PMID:24747657
Aydin, O U; Soylu, L; Dandin, O; Uysal Aydin, E; Karademir, S
The purpose of the study was that monitoring, which is used in diagnosis of acute appendicitis, and laboratory values, were evaluated for verifying diagnosis of complicated appendicitis and these parameters revealed cut-off values in complicated acute/non-complicated appendicitis. 195 patients, who had had an operation for acute appendicitis between January 2012 and March 2015 and who were proved to have acute complicated/non-complicated appendicitis from the results of histopathology consideration, were included in this study. Patients' age, preoperative serum, WBC, CRP, NLR and BT with USG results were evaluated. RESULTS: Among the groups, there were no meaningful differences in the sense of age. Meaningful difference was obtained in between (p > 0.05), WBC, NLR, CRP and appendix diameter values.Serum in WBC >13800 (AUC = 0.614, p = 0.006, %95 GA: 0.541-0.682), in NLR > 4.87 (AUC = 0.641, p = 0.001, %95 GA: 0.569-0.708), in CRP > 5.98 (AUC = 0.651, p 11 mm (AUC = 0.630, p = 0.002, %95 GA: 0.558-0.698) values were obtained. The values that were obtained, were confirmed to be descriptive in analysis of complicated appendicitis and non-complicated appendicitis.According to the obtained cut-off values, serum WBC, diameter of appendicitis, NLR and CRP values', (OR) ratios were calculated for complicated appendicitis by being classified (odds ratio respectively; 3.103 (1.713-5.621), 2.765 (1.496-5.109), 3.025 (1.665-5.494), 2.313 (1.295-4.130)). It is important that treatment options are evaluated to be able to discriminate complicated appendicitis fast and with a high accuracy. In the case that serum WBC is higher than 13800. CRP is higher than 5.98, NLR is higher than 4.87 and appendicitis diameter is longer than 11mm, inflammation of appendicitis is complex with gangrene, perforation and abscess and it emphasizes the suggestion of surgical treatment option to patients (Tab. 4, Fig. 1, Ref. 28).
Peixoto, L A; Bhering, L L; Cruz, C D
The objective of this study was to evaluate the efficiency of artificial neural networks (ANNs) for predicting genetic value in experiments carried out in randomized blocks. Sixteen scenarios were simulated with different values of heritability (10, 20, 30, and 40%), coefficient of variation (5 and 10%), and the number of genotypes per block (150 and 200 for validation, and 5000 for neural network training). One hundred validation populations were used in each scenario. Accuracy of ANNs was evaluated by comparing the correlation of network value with genetic value, and of phenotypic value with genetic value. Neural networks were efficient in predicting genetic value with a 0.64 to 10.3% gain compared to the phenotypic value, regardless the simulated population size, heritability, or coefficient of variation. Thus, the artificial neural network is a promising technique for predicting genetic value in balanced experiments.
Rangaka, M X; Gideon, H P; Wilkinson, K A; Pai, M; Mwansa-Kambafwile, J; Maartens, G; Glynn, J R; Boulle, A; Fielding, K; Goliath, R; Titus, R; Mathee, S; Wilkinson, R J
Clinical algorithms for evaluating HIV-infected individuals for tuberculosis (TB) prior to isoniazid preventive therapy (IPT) perform poorly, and interferon-γ release assays (IGRAs) have moderate accuracy for active TB. It is unclear whether, when used as adjunct tests, IGRAs add any clinical discriminatory value for active TB diagnosis in the pre-IPT assessment. 779 sputum smear-negative HIV-infected persons, established on or about to commence combined antiretroviral therapy (ART), were screened for TB prior to IPT. Stepwise multivariable logistic regression was used to develop clinical prediction models. The discriminatory ability was assessed by receiver operator characteristic area under the curve (AUC). QuantiFERON-TB Gold in-tube (QFT-GIT) was evaluated. The prevalence of smear-negative TB by culture was 6.4% (95% CI 4.9-8.4%). Used alone, QFT-GIT and the tuberculin skin test (TST) had comparable performance; the post-test probability of disease based on single negative tests was 3-4%. In a multivariable model, the QFT-GIT test did not improve the ability of a clinical algorithm, which included not taking ART, weight <60 kg, no prior history of TB, any one positive TB symptom/sign (cough ≥ 2 weeks) and CD4+ count <250 cells per mm(3), to discriminate smear-negative culture-positive and -negative TB (72% to 74%; AUC comparison p=0.33). The TST marginally improved the discriminatory ability of the clinical model (to 77%, AUC comparison p=0.04). QFT-GIT does not improve the discriminatory ability of current TB screening clinical algorithms used to evaluate HIV-infected individuals for TB ahead of preventive therapy. Evaluation of new TB diagnostics for clinical relevance should follow a multivariable process that goes beyond test accuracy.
Mervin, Lewis H; Afzal, Avid M; Drakakis, Georgios; Lewis, Richard; Engkvist, Ola; Bender, Andreas
the results from internal and external validation of the models show differing performance between the breadth of models. The realised target prediction protocol is available at https://github.com/lhm30/PIDGIN.Graphical abstractThe inclusion of large scale negative training data for in silico target prediction improves the precision and recall AUC and BEDROC scores for target models.
Verdejo-García, Antonio; Bechara, Antoine; Recknor, Emily C; Pérez-García, Miguel
Impulsivity is predominant among users of several drugs of abuse including alcohol, cocaine, and amphetamines, and it is considered a risk factor for later development of alcohol and substance abuse and dependence. However, there is little consensus on how impulsivity should be defined and measured, and there are few studies on the relationship between separate dimensions of impulsivity and substance dependence. We used a multidimensional measure of impulsivity (the UPPS scale) to examine differences between 36 individuals with substance dependence (ISD) and 36 drug-free controls on the dimensions of urgency, lack of premeditation, lack of perseverance, and sensation seeking. In addition, we examined which dimensions of impulsivity better predicted addiction-related problems as measured with the addiction severity index. Results revealed that ISD show high scores on dimensions of urgency, lack of perseverance, and lack of premeditation (effect sizes ranging from 1.10 to 1.96), but not on sensation seeking. Among the different impulsivity dimensions, urgency was the best predictor of severity of medical, employment, alcohol, drug, family/social, legal and psychiatric problems in ISD, explaining 13-48% of the total variance of these indices. Furthermore, urgency scores alone correctly classified 83% of the participants in the ISD group. Urgency is characterized by a tendency to act impulsively in response to negative emotional states. Thus, our results could have important implications for novel treatment approaches for substance dependence focused on emotional regulation.
Caffarini, Erica M; DeMott, Joshua; Patel, Gourang; Lat, Ishaq
Various procalcitonin ranges have been established to guide antimicrobial therapy; however, there are no data that establish whether the initial procalcitonin value can determine the likelihood of a positive culture result. This study aimed to establish if the initial procalcitonin value, on clinical presentation, has a positive predictive value for any positive culture result. This was a retrospective study of 813 medical intensive care unit patients. Data collected included patient demographics, procalcitonin assay results, sources of infection, culture results, and lengths of stay. Patients were excluded if they were immunocompromised. The primary outcome of this study was to determine a procalcitonin value that would predict any positive culture. Secondary outcomes included the sensitivity, specificity, positive predictive value, and negative predictive value for procalcitonin. After exclusions, a total of 519 patient charts were reviewed to determine the impact of the initial procalcitonin value on culture positivity. In our analyses, the receiver operating characteristic values were 0.62 for all cultures, 0.49 for pulmonary infections, 0.43 for urinary tract infections, and 0.78 for bacteremia. A procalcitonin value of 3.61 ng/ml was determined to be the threshold value for a positive blood culture result (prevalence, 4%). For bacteremia, the sensitivity of procalcitonin was 75%, the specificity was 72%, the positive predictive value was 20%, and the negative predictive value was 97%. Procalcitonin was a poor predictor of culture positivity. An initial procalcitonin value of less than 3.61 ng/ml may be useful in predicting whether bacteremia is absent. Procalcitonin should not be used as the only predictor for determining initiation of antibiotic therapy. Copyright © 2017 American Society for Microbiology.
Beevers, Christopher G.; Wells, Tony T.; Miller, Ivan W.
Repeated experiences with major depressive disorder (MDD) may strengthen associations between negative thinking and dysphoria, rendering negative cognition more accessible and pronounced with each episode. According to cognitive theory, greater negative cognition should lead to a more protracted episode of depression. In this study of 121 adults…
Beevers, Christopher G.; Wells, Tony T.; Miller, Ivan W.
Repeated experiences with major depressive disorder (MDD) may strengthen associations between negative thinking and dysphoria, rendering negative cognition more accessible and pronounced with each episode. According to cognitive theory, greater negative cognition should lead to a more protracted episode of depression. In this study of 121 adults…
Based on a study that included more than 1 million women, investigators at NCI have determined that a negative test for HPV infection compared to a negative Pap test provides greater safety, or assurance, against future risk of cervical cancer.
Lee, Adabel; Hankin, Benjamin L.; Mermelstein, Robin J.
The current study examined whether negative interactions with parents and peers would mediate the longitudinal association between perceived social competence and depressive symptoms and whether a negative cognitive style would moderate the longitudinal association between negative interactions with parents and increases in depressive symptoms.…
Souchon, Nicolas; Maio, Gregory R; Hanel, Paul H P; Bardin, Brigitte
We conducted five studies testing whether an implicit measure of favorability toward power over universalism values predicts spontaneous prejudice and discrimination. Studies 1 (N = 192) and 2 (N = 86) examined correlations between spontaneous favorability toward power (vs. universalism) values, achievement (vs. benevolence) values, and a spontaneous measure of prejudice toward ethnic minorities. Study 3 (N = 159) tested whether conditioning participants to associate power values with positive adjectives and universalism values with negative adjectives (or inversely) affects spontaneous prejudice. Study 4 (N = 95) tested whether decision bias toward female handball players could be predicted by spontaneous attitude toward power (vs. universalism) values. Study 5 (N = 123) examined correlations between spontaneous attitude toward power (vs. universalism) values, spontaneous importance toward power (vs. universalism) values, and spontaneous prejudice toward Black African people. Spontaneous positivity toward power (vs. universalism) values was associated with spontaneous negativity toward minorities and predicted gender bias in a decision task, whereas the explicit measures did not. These results indicate that the implicit assessment of evaluative responses attached to human values helps to model value-attitude-behavior relations. © 2016 The Authors. Journal of Personality Published by Wiley Periodicals, Inc.
Robinson, Michael D; Liu, Tianwei
Reinforcement sensitivity theory includes the idea that people differ in their sensitivity to negative events, but relevant process-based assessments have not been developed. The present studies assessed sensitivity to negative events in terms of the extent to which negative word stimuli were perceived to be larger than neutral word stimuli. There was a general tendency to overestimate the size of negative relative to neutral words, but individuals differed substantially in this form of what is termed perceptual negativity. Of more importance, two studies (total N = 151) found systematic relationships between individual differences in perceptual negativity and reactivity to negative events in daily diary protocols. Study 1 found that within-person variations in the occurrence of daily negative events undermined goal-related optimism to a greater extent at higher, relative to lower, levels of perceptual negativity. Study 2 conceptually replicated this interaction in the context of within-person associations between the occurrence of daily negative events and antisocial behavior. These findings are important in advancing reinforcement sensitivity theory, in operationalizing a particular component of it, and in extending it to reactivity processes in daily life.
Woisard, V; Réhault, E; Brouard, C; Fichaux-Bourin, P; Puech, M; Grand, S
Screening for aspiration in patients with swallowing disorders is important in preventing complications. The tests used in this regard are insufficient due to silent aspiration relating to abnormal protective reflexes in many patients with swallowing problems. The aim of this study is to determine the predictive values of simple tests in screening for silent aspiration. The reference test used was videofluoroscopic examination on swallowing. In the presence of aspiration (FR+) the presence (ME+) or not (ME-) of a cough of throat clearing was noted. The tests being studied were a nasal test with isotonic saline and swallowing according to a set time. For screening for aspiration the presence of a "wet voice" was considered to be a sign of reduced protective reflexes. 1) During the nasal test, the results are 100% for the positive predictive value (VPp) and 83.3% for the negative predictive value (VPn); 2) These results are respectively 84.6% and 35.9% during the swallowing test. Regarding screening for silent aspiration, 1) during the nasal test, the results are 62.5% for the positive predictive value (VPp) and 36.3% for the negative predictive value (VPn); 2) These results are respectively 54.5% and 26.6% during the swallowing test. This preliminary study points out the lack of predictive value of the nasal test and the swallow test for the silent aspirations. However the results could be useful for other researchers developing other tests in this area.
Thoma, Robert J; Hanlon, Faith M; Moses, Sandra N; Ricker, Daniel; Huang, Mingxiong; Edgar, Christopher; Irwin, Jessica; Torres, Fernando; Weisend, Michael P; Adler, Lawrence E; Miller, Gregory A; Canive, Jose M
Impaired auditory sensory gating is considered characteristic of schizophrenia and a marker of the information processing deficit inherent to that disorder. Predominance of negative symptoms also reflects the degree of deficit in schizophrenia and is associated with poorer pre-morbid functioning, lower IQ, and poorer outcomes. However, a consistent relationship between auditory sensory gating and negative symptoms in schizophrenia has yet to be demonstrated. The absence of such a finding is surprising, since both impaired auditory gating and negative symptoms have been linked with impaired fronto-temporal cortical function. The present study measured auditory gating using the P50 event related potential (ERP) in a paired-click paradigm and capitalized on the relative localization advantage of magnetoencephalography (MEG) to assess auditory sensory gating in terms of the event related field (ERF) M50 source dipoles on bilateral superior temporal gyrus (STG). The primary hypothesis was that there would be a positive correlation between lateralized M50 auditory sensory gating measures and negative symptoms in patients with schizophrenia. A standard paired-click paradigm was used during simultaneous EEG and MEG data collection to determine S2/S1 sensory gating ratios in a group of 20 patients for both neuroimaging techniques. Participants were administered the Schedule for the Assessment of Negative Symptoms (SANS), the Positive and Negative Symptom Scale (PANSS), and the Calgary Depression Scale for Schizophrenia. Consistent with previous reports, there was no relationship between ERP P50 sensory gating and negative symptoms. However, right (not left) hemisphere ERF M50 sensory gating ratio was significantly and positively correlated with negative symptoms. This finding is compatible with information processing theories of negative symptoms and with more recent findings of fronto-temporal abnormality in patients with predominantly negative symptoms.
Cohen, Shlomo; Avital, Avraham; Hevroni, Avigdor; Avenshtein, Alina; Hadi, Ronen; Springer, Chaim
We evaluated the predictive values of preschool bronchial challenge with nebulized adenosine 5'-monophosphate (AMP) using the auscultation method for having asthma 5 years later. Preschool AMP challenge had a high negative (90%) and a moderate positive (67%) predictive value for asthma 5 years later. Positive predictive value increased with the age at which the challenge was performed. The degree of preschool response to AMP was associated with the severity of asthma at school age.
Erb, Hollis N
Authors who publish evaluations of dichotomous (yes/no) diagnostic tests often include the predictive values of their test at a single prior probability (eg, the prevalence of the target disease within the evaluation data set). The objectives of this technical note are to demonstrate why single-probability predictive values are misleading and to show a better way to display positive predictive values (PPV) and negative predictive values (NPV) for a newly evaluated test. Secondly, this technical note will show readers how to calculate predictive values from only sensitivity and specificity for any desired prior probability. As prior probability increases from 0% to 100%, PPV increases from 0% to 100%, but NPV goes in the opposite direction (drops from 100% to 0%). Because prior probabilities vary so greatly across situations, predictive values should be provided in publications for the full range of potential prior probabilities (if provided at all). This is easily done with a 2-curve graph displaying the predictive values (y-axis) against the prior probability (x-axis).
Van Neste, Leander; Partin, Alan W; Stewart, Grant D; Epstein, Jonathan I; Harrison, David J; Van Criekinge, Wim
Prostate cancer (PCa) diagnosis is challenging because efforts for effective, timely treatment of men with significant cancer typically result in over-diagnosis and repeat biopsies. The presence or absence of epigenetic aberrations, more specifically DNA-methylation of GSTP1, RASSF1, and APC in histopathologically negative prostate core biopsies has resulted in an increased negative predictive value (NPV) of ∼90% and thus could lead to a reduction of unnecessary repeat biopsies. Here, it is investigated whether, in methylation-positive men, DNA-methylation intensities could help to identify those men harboring high-grade (Gleason score ≥7) PCa, resulting in an improved positive predictive value. Two cohorts, consisting of men with histopathologically negative index biopsies, followed by a positive or negative repeat biopsy, were combined. EpiScore, a methylation intensity algorithm was developed in methylation-positive men, using area under the curve of the receiver operating characteristic as metric for performance. Next, a risk score was developed combining EpiScore with traditional clinical risk factors to further improve the identification of high-grade (Gleason Score ≥7) cancer. Compared to other risk factors, detection of DNA-methylation in histopathologically negative biopsies was the most significant and important predictor of high-grade cancer, resulting in a NPV of 96%. In methylation-positive men, EpiScore was significantly higher for those with high-grade cancer detected upon repeat biopsy, compared to those with either no or low-grade cancer. The risk score resulted in further improvement of patient risk stratification and was a significantly better predictor compared to currently used metrics as PSA and the prostate cancer prevention trial (PCPT) risk calculator (RC). A decision curve analysis indicated strong clinical utility for the risk score as decision-making tool for repeat biopsy. Low DNA-methylation levels in PCa-negative biopsies led
Van Neste, Leander; Partin, Alan W.; Stewart, Grant D.; Epstein, Jonathan I.; Harrison, David J.
BACKGROUND Prostate cancer (PCa) diagnosis is challenging because efforts for effective, timely treatment of men with significant cancer typically result in over‐diagnosis and repeat biopsies. The presence or absence of epigenetic aberrations, more specifically DNA‐methylation of GSTP1, RASSF1, and APC in histopathologically negative prostate core biopsies has resulted in an increased negative predictive value (NPV) of ∼90% and thus could lead to a reduction of unnecessary repeat biopsies. Here, it is investigated whether, in methylation‐positive men, DNA‐methylation intensities could help to identify those men harboring high‐grade (Gleason score ≥7) PCa, resulting in an improved positive predictive value. METHODS Two cohorts, consisting of men with histopathologically negative index biopsies, followed by a positive or negative repeat biopsy, were combined. EpiScore, a methylation intensity algorithm was developed in methylation‐positive men, using area under the curve of the receiver operating characteristic as metric for performance. Next, a risk score was developed combining EpiScore with traditional clinical risk factors to further improve the identification of high‐grade (Gleason Score ≥7) cancer. RESULTS Compared to other risk factors, detection of DNA‐methylation in histopathologically negative biopsies was the most significant and important predictor of high‐grade cancer, resulting in a NPV of 96%. In methylation‐positive men, EpiScore was significantly higher for those with high‐grade cancer detected upon repeat biopsy, compared to those with either no or low‐grade cancer. The risk score resulted in further improvement of patient risk stratification and was a significantly better predictor compared to currently used metrics as PSA and the prostate cancer prevention trial (PCPT) risk calculator (RC). A decision curve analysis indicated strong clinical utility for the risk score as decision‐making tool for repeat biopsy
Luong, Gloria; Wrzus, Cornelia; Wagner, Gert G; Riediger, Michaela
Bad moods are considered "bad" not only because they may be aversive experiences in and of themselves, but also because they are associated with poorer psychosocial functioning and health. We propose that people differ in their negative affect valuation (NAV; the extent to which negative affective states are valued as pleasant, useful/helpful, appropriate, and meaningful experiences) and that affect-health links are moderated by NAV. These predictions were tested in a life span sample of 365 participants ranging from 14-88 years of age using reports of momentary negative affect and physical well-being (via experience sampling) and assessments of NAV and psychosocial and physical functioning (via computer-assisted personal interviews and behavioral measures of hand grip strength). Our study demonstrated that the more individuals valued negative affect, the less pronounced (and sometimes even nonexistent) were the associations between everyday experiences of negative affect and a variety of indicators of poorer psychosocial functioning (i.e., emotional health problems, social integration) and physical health (i.e., number of health conditions, health complaints, hand grip strength, momentary physical well-being). Exploratory analyses revealed that valuing positive affect was not associated with the analogous moderating effects as NAV. These findings suggest that it may be particularly important to consider NAV in models of affect-health links.
Yokota, Kazuhiro; Imoto, Nobuyuki
When the weak value of a projector is 1, a quantum system behaves as in that eigenstate with probability 1. By definition, however, the weak value may take an anomalous value lying outside the range of probability like -1. From the viewpoint of a physical effect, we show that such a negative weak value of -1 can be regarded as the counterpart of the ordinary value of 1. Using photons, we experimentally verify it as the symmetrical shift in polarization depending on the weak value given by pre-postselection of the path state. Unlike observation of a weak value as an ensemble average via weak measurements, the effect of a weak value is definitely confirmed in Hong-Ou-Mandel effect: the symmetrical shift corresponding to the weak value can be directly observed as the rotation angle of a half wave plate.
Kosinski, Andrzej S.
Positive and negative predictive values are important measures of a medical diagnostic test performance. We consider testing equality of two positive or two negative predictive values within a paired design in which all patients receive two diagnostic tests. The existing statistical tests for testing equality of predictive values are either Wald tests based on the multinomial distribution or the empirical Wald and generalized score tests within the generalized estimating equations (GEE) framework. As presented in the literature, these test statistics have considerably complex formulas without clear intuitive insight. We propose their re-formulations which are mathematically equivalent but algebraically simple and intuitive. As is clearly seen with a new re-formulation we present, the generalized score statistic does not always reduce to the commonly used score statistic in the independent samples case. To alleviate this, we introduce a weighted generalized score (WGS) test statistic which incorporates empirical covariance matrix with newly proposed weights. This statistic is simple to compute, it always reduces to the score statistic in the independent samples situation, and it preserves type I error better than the other statistics as demonstrated by simulations. Thus, we believe the proposed WGS statistic is the preferred statistic for testing equality of two predictive values and for corresponding sample size computations. The new formulas of the Wald statistics may be useful for easy computation of confidence intervals for difference of predictive values. The introduced concepts have potential to lead to development of the weighted generalized score test statistic in a general GEE setting. PMID:22912343
McClimon, Brad; Rank, Matthew; Li, James
Local anesthetics are commonly used medications and can result in adverse reactions. The diagnostic workup of local anesthetic reactions remains controversial. This study was designed to determine the effectiveness of skin testing for local anesthetic allergy evaluation. A retrospective chart review was performed on patients undergoing local anesthetic skin testing. Patients were included if they underwent prick and intradermal skin testing followed by incremental subcutaneous challenge. Charts were further systematically reviewed to evaluate response to local anesthetics in the clinical setting after open subcutaneous challenge. One hundred seventy-eight patients underwent 227 local anesthetic skin tests. Two hundred twenty (97%) of the skin tests were negative. Of the negative skin tests results, 214 (97%) had negative challenge or probable non-IgE-mediated events during challenge. Three patients with six negative skin tests had a local reaction during the open subcutaneous challenge. Seven skin tests on five patients met the criteria for a positive skin test with local anesthetics. One patient had an equivocal local skin reaction with subcutaneous challenge without systemic effects. Three patients had a negative subcutaneous challenge and one patient did not undergo a challenge. Ninety-eight percent of patients receiving local anesthetics in the clinical setting after open subcutaneous challenge tolerated the medications. The negative predictive value of the local anesthetic skin test was 97% with few positive skin tests. Positive local anesthetic skin tests are uncommon and the local anesthetic skin tests have an excellent negative predictive value. Additional study with skin test-only protocols is warranted.
Martínez-Galindo, Joyce Graciela; Cansino, Selene
The aim of this study was to investigate whether the recognition of faces with neutral expressions differs when they are encoded under different emotional contexts (positive, negative or non-emotional). The effects of the emotional valence context on the subsequent memory effect (SME) and the autonomic responses were also examined. Twenty-eight participants performed a betting-game task in which the faces of their virtual opponents were presented in each trial. The probability of winning or losing was manipulated to generate positive or negative contexts, respectively. Additionally, the participants performed the same task without betting as a non-emotional condition. After the encoding phase, an old/new paradigm was performed for the faces of the virtual opponents. The recognition was superior for the faces encoded in the positive contexts than for the faces encoded in the non-emotional contexts. The skin conductance response amplitude was equivalent for both of the emotional contexts. The N170 and P300 components at occipital sites and the frontal slow wave manifested SMEs that were modulated by positive contexts; neither negative nor non-emotional contexts influenced these effects. The behavioral and neurophysiological data demonstrated that positive contexts are stronger predictors of episodic memory than negative or non-emotional contexts.
Abram, Samantha V; Karpouzian, Tatiana M; Reilly, James L; Derntl, Birgit; Habel, Ute; Smith, Matthew J
Several studies suggest facial affect perception (FAP) deficits in schizophrenia are linked to poorer social functioning. However, whether reduced functioning is associated with inaccurate perception of specific emotional valence or a global FAP impairment remains unclear. The present study examined whether impairment in the perception of specific emotional valences (positive, negative) and neutrality were uniquely associated with social functioning, using a multimodal social functioning battery. A sample of 59 individuals with schizophrenia and 41 controls completed a computerized FAP task, and measures of functional capacity, social competence, and social attainment. Participants also underwent neuropsychological testing and symptom assessment. Regression analyses revealed that only accurately perceiving negative emotions explained significant variance (7.9%) in functional capacity after accounting for neurocognitive function and symptoms. Partial correlations indicated that accurately perceiving anger, in particular, was positively correlated with functional capacity. FAP for positive, negative, or neutral emotions were not related to social competence or social attainment. Our findings were consistent with prior literature suggesting negative emotions are related to functional capacity in schizophrenia. Furthermore, the observed relationship between perceiving anger and performance of everyday living skills is novel and warrants further exploration.
Shim, Jaewoo; Oh, Seyong; Kang, Dong-Ho; Jo, Seo-Hyeon; Ali, Muhammad Hasnain; Choi, Woo-Young; Heo, Keun; Jeon, Jaeho; Lee, Sungjoo; Kim, Minwoo; Song, Young Jae; Park, Jin-Hong
Recently, negative differential resistance devices have attracted considerable attention due to their folded current–voltage characteristic, which presents multiple threshold voltage values. Because of this remarkable property, studies associated with the negative differential resistance devices have been explored for realizing multi-valued logic applications. Here we demonstrate a negative differential resistance device based on a phosphorene/rhenium disulfide (BP/ReS2) heterojunction that is formed by type-III broken-gap band alignment, showing high peak-to-valley current ratio values of 4.2 and 6.9 at room temperature and 180 K, respectively. Also, the carrier transport mechanism of the BP/ReS2 negative differential resistance device is investigated in detail by analysing the tunnelling and diffusion currents at various temperatures with the proposed analytic negative differential resistance device model. Finally, we demonstrate a ternary inverter as a multi-valued logic application. This study of a two-dimensional material heterojunction is a step forward toward future multi-valued logic device research. PMID:27819264
Shim, Jaewoo; Oh, Seyong; Kang, Dong-Ho; Jo, Seo-Hyeon; Ali, Muhammad Hasnain; Choi, Woo-Young; Heo, Keun; Jeon, Jaeho; Lee, Sungjoo; Kim, Minwoo; Song, Young Jae; Park, Jin-Hong
Recently, negative differential resistance devices have attracted considerable attention due to their folded current-voltage characteristic, which presents multiple threshold voltage values. Because of this remarkable property, studies associated with the negative differential resistance devices have been explored for realizing multi-valued logic applications. Here we demonstrate a negative differential resistance device based on a phosphorene/rhenium disulfide (BP/ReS2) heterojunction that is formed by type-III broken-gap band alignment, showing high peak-to-valley current ratio values of 4.2 and 6.9 at room temperature and 180 K, respectively. Also, the carrier transport mechanism of the BP/ReS2 negative differential resistance device is investigated in detail by analysing the tunnelling and diffusion currents at various temperatures with the proposed analytic negative differential resistance device model. Finally, we demonstrate a ternary inverter as a multi-valued logic application. This study of a two-dimensional material heterojunction is a step forward toward future multi-valued logic device research.
Shim, Jaewoo; Oh, Seyong; Kang, Dong-Ho; Jo, Seo-Hyeon; Ali, Muhammad Hasnain; Choi, Woo-Young; Heo, Keun; Jeon, Jaeho; Lee, Sungjoo; Kim, Minwoo; Song, Young Jae; Park, Jin-Hong
Recently, negative differential resistance devices have attracted considerable attention due to their folded current-voltage characteristic, which presents multiple threshold voltage values. Because of this remarkable property, studies associated with the negative differential resistance devices have been explored for realizing multi-valued logic applications. Here we demonstrate a negative differential resistance device based on a phosphorene/rhenium disulfide (BP/ReS2) heterojunction that is formed by type-III broken-gap band alignment, showing high peak-to-valley current ratio values of 4.2 and 6.9 at room temperature and 180 K, respectively. Also, the carrier transport mechanism of the BP/ReS2 negative differential resistance device is investigated in detail by analysing the tunnelling and diffusion currents at various temperatures with the proposed analytic negative differential resistance device model. Finally, we demonstrate a ternary inverter as a multi-valued logic application. This study of a two-dimensional material heterojunction is a step forward toward future multi-valued logic device research.
Brock, A J; Goody, S M G; Mead, A N; Sudwarts, A; Parker, M O; Brennan, C H
Regulatory agencies recommend that centrally active drugs are tested for abuse potential before approval. Standard preclinical assessments are conducted in rats or non-human primates (NHPs). This study evaluated the ability of the zebrafish conditioned place preference (CPP) model to predict human abuse outcomes. Twenty-seven compounds from a variety of pharmacological classes were tested in zebrafish CPP, categorized as positive or negative, and analyzed using standard diagnostic tests of binary classification to determine the likelihood that zebrafish correctly predict robust positive signals in human subjective effects studies (+HSE) and/or Drug Enforcement Administration drug scheduling. Results were then compared with those generated for rat self-administration and CPP, as well as NHP self-administration, using this same set of compounds. The findings reveal that zebrafish concordance and sensitivity values were not significantly different from chance for both +HSE and scheduling. Although significant improvements in specificity and negative predictive values were observed for zebrafish relative to +HSE, specificity without sensitivity provides limited predictive value. Moreover, assessments in zebrafish provided no added value for predicting scheduling. By contrast, rat and NHP models generally possessed significantly improved concordance, sensitivity, and positive predictive values for both clinical measures. Although there may be predictive value with compounds from specific pharmacological classes (e.g., µ-opioid receptor agonists, psychostimulants) for zebrafish CPP, altogether these data highlight that using the current methodology, the zebrafish CPP model does not add value to the preclinical assessment of abuse potential. Copyright © 2017 by The American Society for Pharmacology and Experimental Therapeutics.
Albrecht, Theresa; Wimmer, Valentin; Auinger, Hans-Jürgen; Erbe, Malena; Knaak, Carsten; Ouzunova, Milena; Simianer, Henner; Schön, Chris-Carolin
This is the first large-scale experimental study on genome-based prediction of testcross values in an advanced cycle breeding population of maize. The study comprised testcross progenies of 1,380 doubled haploid lines of maize derived from 36 crosses and phenotyped for grain yield and grain dry matter content in seven locations. The lines were genotyped with 1,152 single nucleotide polymorphism markers. Pedigree data were available for three generations. We used best linear unbiased prediction and stratified cross-validation to evaluate the performance of prediction models differing in the modeling of relatedness between inbred lines and in the calculation of genome-based coefficients of similarity. The choice of similarity coefficient did not affect prediction accuracies. Models including genomic information yielded significantly higher prediction accuracies than the model based on pedigree information alone. Average prediction accuracies based on genomic data were high even for a complex trait like grain yield (0.72-0.74) when the cross-validation scheme allowed for a high degree of relatedness between the estimation and the test set. When predictions were performed across distantly related families, prediction accuracies decreased significantly (0.47-0.48). Prediction accuracies decreased with decreasing sample size but were still high when the population size was halved (0.67-0.69). The results from this study are encouraging with respect to genome-based prediction of the genetic value of untested lines in advanced cycle breeding populations and the implementation of genomic selection in the breeding process.
Holland, John L.; Gottfredson, Gary D.
The psychological meaning and predictive value of a person's vocational aspirations were examined by applying Holland's typology to the vocational aspirations of high school juniors (N=140), and a second sample of college students studied over a one-year interval (N-624). (Author)
Elwood L., Jr. Shafer; George Moeller
If future recreation consumption and associated intangible values can be predicted, the problem of rapid decision making in recreation-resource management can be reduced, and the problems of implementing those decisions can be anticipated. Management and research responsibilities for meeting recreation demand are discussed, and proved methods for forecasting recreation...
Gungor, Ibrahim Halil; Eksi, Halil; Aricak, Osman Tolga
This study aimed at showing how the value preferences of young adults could predict the narcissistic characteristics of young adults according to structural equation modeling. 133 female (59.6%) and 90 male (40.4%), total 223 young adults participated the study (average age: 25.66, ranging from 20 to 38). Ratio group sampling method was used while…
Stettler, Nicolas; Zomorrodi, Arezoo; Posner, Jill C
The objective was to assess the predictive value of weight-for-age to identify overweight children and adolescents in the unusual research or public health situations where height is not available to calculate BMI. Data from the National Health and Nutrition Examination Survey 1999 to 2004 were used to calculate the sensitivity, specificity, and positive and negative predictive values of selected weight-for-age cut-off points to identify overweight children and adolescents (as defined by BMI >or=95th percentile). Positive and negative predictive values are dependent on prevalence and are reported here for this study population only. The 50th and 75th weight-for-age percentiles had good sensitivity (100% and 99.6%, respectively), but poor positive predictive value (23.7% and 37.0%, respectively), while the 95th and 97th percentiles had reasonable positive predictive value (80.3% and 91.5%, respectively), but limited sensitivity (82.0% and 66.7%, respectively) to identify overweight subjects. The properties of weight-for-age percentiles to identify overweight subjects differed between sex, age, and race/ethnicity but remain within a relatively narrow range. No single weight-for-age cut-off point was found to identify overweight children and adolescents with acceptable values for all properties and, therefore, cannot be used in the clinical setting. Furthermore, the positive predictive values reported here may be lower in populations with a lower prevalence of obesity. However, in unusual research or public health situations where height is not available, such as existing databases, weight-for-age percentiles may be useful to target limited resources to groups more likely to include overweight children and adolescents than the general population.
Kukk, Katrin; Akkermann, Kirsti
This study investigated the associations between emotional fluctuations and emotion regulation difficulties in predicting binge eating and overeating episodes using the experience sampling method among 97 women and 61 men. Among women, fluctuations in negative emotion, emotion regulation difficulties, restrained eating, and the interaction of negative emotion fluctuations and emotion regulation difficulties predicted binge eating. Among men, trait impulsivity and fluctuations in negative emotion predicted binge eating. However, overeating did not associate with aforementioned aspects. Results suggest that fluctuations in negative emotions should be studied in the context of emotion regulation difficulties.
Nguyen, Christopher M.; Koenigs, Michael; Yamada, Torricia H.; Teo, Shu Hao; Cavanaugh, Joseph E.; Tranel, Daniel; Denburg, Natalie L.
The Ultimatum Game (UG) is a widely used and well-studied laboratory model of economic decision-making. Here, we studied 129 healthy adults and compared demographic (i.e., age, gender, education), cognitive (i.e., intelligence, attention/working memory, speed, language, visuospatial, memory, executive functions), and personality (i.e., “Big Five”, positive affect, negative affect) variables between those with a “rational” versus an “irrational” response pattern on the UG. Our data indicated that participants with “rational” UG performance (accepting any offer, no matter the fairness) endorsed higher levels of trust, or the belief in the sincerity and good intentions of others, while participants with “irrational” UG performance (rejecting unfair offers) endorsed higher levels of negative affect, such as anger and contempt. These personality variables were the only ones that differentiated the two response patterns—demographic and cognitive factors did not differ between rational and irrational players. The results indicate that the examination of personality and affect is crucial to our understanding of the individual differences that underlie decision-making. PMID:23493494
Benton, Stephen L; Downey, Ronald G; Glider, Peggy S; Benton, Sherry A; Shin, Kanghyun; Newton, Douglas W; Arck, William; Price, Amy
This study explored how much variance in college student negative drinking consequences is explained by descriptive norm perception, beyond that accounted for by student gender and self-reported alcohol use. A derivation sample (N=7565; 54% women) and a replication sample (N=8924; 55.5% women) of undergraduate students completed the Campus Alcohol Survey in classroom settings. Hierarchical regression analyses revealed that student gender and average number of drinks when "partying" were significantly related to harmful consequences resulting from drinking. Men reported more consequences than did women, and drinking amounts were positively correlated with consequences. However, descriptive norm perception did not explain any additional variance beyond that attributed to gender and alcohol use. Furthermore, there was no significant three-way interaction among student gender, alcohol use, and descriptive norm perception. Norm perception contributed no significant variance in explaining harmful consequences beyond that explained by college student gender and alcohol use.
Tan, Chon Sern; Pooi, Ah Hin
A time series model based on multivariate power-normal distribution has been applied in the past literature on the United States (US) mortality data from the years 1933 to 2000 to forecast the future age-specific mortality rates of the years 2001 to 2010. In this paper, we show that the method based on multivariate power-normal distribution can still be used for an incomplete US mortality dataset that contains some missing values. The prediction intervals based on this incomplete training data are found to still have good ability of covering the observed future mortality rates although the interval lengths may become wider for long-range prediction.
Fang, H; King, K S; Larson, J J; Snyder, M R; Wu, T T; Gandhi, M J; Murray, J A
Tissue transglutaminase (tTG) immunoglobulin A (IgA) testing is a sensitive adjunct to the diagnosis of coeliac disease. The threshold for positivity was developed for diagnosis, with negative results reported as below the reference value (<4 U/mL). To investigate if an undetectable (tTG IgA<1.2 U/mL) is more predictive of healing compared to patients with negative but detectable serology (1.2-3.9 U/mL). We performed a retrospective study of 402 treated coeliac disease patients seen at the Mayo Clinic with negative tTG IgA values drawn within 1 month of duodenal biopsy between January 2009 and December 2015. The Corazza-Villanacci score was used to assess mucosal healing. The presence of gastrointestinal symptoms was also collected. Logistic regression was used to assess the relationship of clinical variables with a normal biopsy. Patients with undetectable titres more frequently had normal duodenal histology compared to patients with detectable tTG IgA levels (117/240 vs. 53/162; OR=1.96; 1.292, 2.961). Asymptomatic patients more frequently had normal duodenum as compared to symptomatic patients (88/163 vs. 82/239; OR=2.25; CI: 1.494, 3.377). Patients with undetectable serology and on a gluten-free diet for ≥2 years were more likely to have no villous atrophy compared to patients with detectable serology (148/192 vs. 55/88; OR=2.02; CI: 1.17, 3.49). In subjects recovering from coeliac disease with negative tTG IgA serology, an undetectable titre is associated with normal histology on follow-up biopsy. © 2017 John Wiley & Sons Ltd.
Boorman, Gary A; Foster, John R; Laast, Victoria A; Francke, Sabine
Historically it has been easier to publish positive scientific results than negative data not supporting the research hypothesis. This appears to be increasing, with fewer negative studies appearing in the literature across many disciplines. Failure to recognize the value of negative results has important implications for the toxicology community. Implications include perpetuating scientific fields based upon selective or occasionally erroneous, positive results. One example is decreased vaccination rates and increased measles infections that can lead to childhood mortality following one erroneous positive study linking vaccination to adverse effects despite multiple negative studies. Publication of negative data that challenges existing paradigms enhances progress by stopping further investment in scientifically barren topics, decreases the use of animals, and focuses research in more fruitful areas. The National Toxicology Program (NTP) publishes both positive and negative rodent data. Retrospective analysis of the NTP database has provided insights on the carcinogenic process and in the gradual acceptance of using fewer animals in safety studies. This article proposes that careful publication of both positive and negative data can enhance product safety assessment, add robustness to safety determinations in the regulatory decision-making process, and should be actively encouraged by those determining journal editorial policy. © 2015 by The Author(s).
Wagner, Dylan D; Boswell, Rebecca G; Kelley, William M; Heatherton, Todd F
Experiencing negative affect frequently precedes lapses in self-control for dieters, smokers, and drug addicts. Laboratory research has similarly shown that inducing negative emotional distress increases the consumption of food or drugs. One hypothesis for this finding is that emotional distress sensitizes the brain's reward system to appetitive stimuli. Using functional neuroimaging, we demonstrate that inducing negative affect in chronic dieters increases activity in brain regions representing the reward value of appetitive stimuli when viewing appetizing food cues. Thirty female chronic dieters were randomly assigned to receive either a negative (n = 15) or neutral mood induction (n = 15) immediately followed by exposure to images of appetizing foods and natural scenes during fMRI. Compared with chronic dieters in a neutral mood, those receiving a negative mood induction showed increased activity in the OFC to appetizing food images. In addition, activity to food images in the OFC and ventral striatum was correlated with individual differences in the degree to which the negative mood induction decreased participants' self-esteem. These findings suggest that distress sensitizes the brain's reward system to appetitive cues, thereby offering a mechanism for the oft-observed relationship between negative affect and disinhibited eating.
Wagner, Dylan D.; Boswell, Rebecca G.; Kelley, William M.; Heatherton, Todd F.
Experiencing negative affect frequently precedes lapses in self-control for dieters, smokers, and drug addicts. Laboratory research has similarly shown that inducing negative emotional distress increases the consumption of food or drugs. One hypothesis for this finding is that emotional distress sensitizes the brain’s reward system to appetitive stimuli. Using functional neuroimaging, we demonstrate that inducing negative affect in chronic dieters increases activity in brain regions representing the reward value of appetitive stimuli when viewing appetizing food cues. Thirty female chronic dieters were randomly assigned to receive either a negative (n = 15) or neutral mood induction (n = 15) immediately followed by exposure to images of appetizing foods and natural scenes during functional magnetic resonance imaging (fMRI). Compared to chronic dieters in a neutral mood, those receiving a negative mood induction showed increased activity in the orbitofrontal cortex to appetizing food images. In addition, activity to food images in the orbitofrontal cortex and ventral striatum was correlated with individual differences in the degree to which the negative mood induction decreased participants’ self-esteem. These findings suggest that distress sensitizes the brain’s reward system to appetitive cues thereby offering a mechanism for the oft-observed relationship between negative affect and disinhibited eating. PMID:22524295
Ong, Kian Chung; Loo, Chian Min; Ong, Yong Yau; Chan, Siew Pang; Earnest, Arul; Saw, Seang Mei
Normative data for cardiopulmonary exercise testing (CPET) may vary among subjects of different races. The objectives of the present study were to: (i) establish normal standards for cardiopulmonary responses during incremental cycle ergometer testing in order to derive predictive equations for clinically useful variables during CPET of Chinese subjects; and (ii) determine the validity of existing prediction equations of maximal exercise performance for use in our local Chinese population. The maximal and submaximal cardiopulmonary responses were analysed for 95 healthy sedentary adult Chinese subjects (48 men and 47 women; aged 20-70 years) who underwent CPET using a cycle ergometer and an incremental work-rate protocol until symptom limitation. Measurements, at maximal exercise, of oxygen uptake (VO2(max)), power output and heart rate were regressed on age, height, weight and gender. The predictive equations for these exercise parameters performed better than those published previously in out-sample predictive accuracy. Comparison with previous studies also showed that prediction equations of VO2(max) derived from studies based predominantly or exclusively on Caucasian populations overestimated the actual values for our subjects. Previously established prediction equations for maximal exercise performance during CPET based on non-Chinese populations may not be applicable to Chinese subjects in our population.
Whittle, Sarah; Vijayakumar, Nandita; Dennison, Meg; Schwartz, Orli; Simmons, Julian G; Sheeber, Lisa; Allen, Nicholas B
Limited attention has been directed toward the influence of non-abusive parenting behaviour on brain structure in adolescents. It has been suggested that environmental influences during this period are likely to impact the way that the brain develops over time. The aim of this study was to investigate the association between aggressive and positive parenting behaviors on brain development from early to late adolescence, and in turn, psychological and academic functioning during late adolescence, using a multi-wave longitudinal design. Three hundred and sixty seven magnetic resonance imaging (MRI) scans were obtained over three time points from 166 adolescents (11-20 years). At the first time point, observed measures of maternal aggressive and positive behaviors were obtained. At the final time point, measures of psychological and academic functioning were obtained. Results indicated that a higher frequency of maternal aggressive behavior was associated with alterations in the development of right superior frontal and lateral parietal cortical thickness, and of nucleus accumbens volume, in males. Development of the superior frontal cortex in males mediated the relationship between maternal aggressive behaviour and measures of late adolescent functioning. We suggest that our results support an association between negative parenting and adolescent functioning, which may be mediated by immature or delayed brain maturation.
Whittle, Sarah; Vijayakumar, Nandita; Dennison, Meg; Schwartz, Orli; Simmons, Julian G.; Sheeber, Lisa; Allen, Nicholas B.
Limited attention has been directed toward the influence of non-abusive parenting behaviour on brain structure in adolescents. It has been suggested that environmental influences during this period are likely to impact the way that the brain develops over time. The aim of this study was to investigate the association between aggressive and positive parenting behaviors on brain development from early to late adolescence, and in turn, psychological and academic functioning during late adolescence, using a multi-wave longitudinal design. Three hundred and sixty seven magnetic resonance imaging (MRI) scans were obtained over three time points from 166 adolescents (11–20 years). At the first time point, observed measures of maternal aggressive and positive behaviors were obtained. At the final time point, measures of psychological and academic functioning were obtained. Results indicated that a higher frequency of maternal aggressive behavior was associated with alterations in the development of right superior frontal and lateral parietal cortical thickness, and of nucleus accumbens volume, in males. Development of the superior frontal cortex in males mediated the relationship between maternal aggressive behaviour and measures of late adolescent functioning. We suggest that our results support an association between negative parenting and adolescent functioning, which may be mediated by immature or delayed brain maturation. PMID:26824348
The overall aim of our project was to quantify and characterize predictability of the climate as it pertains to decadal time scale predictions. By predictability we mean the degree to which a climate forecast can be distinguished from the climate that exists at initial forecast time, taking into consideration the growth of uncertainty that occurs as a result of the climate system being chaotic. In our project we were especially interested in predictability that arises from initializing forecasts from some specific state though we also contrast this predictability with predictability arising from forecasting the reaction of the system to external forcing – for example changes in greenhouse gas concentration. Also, we put special emphasis on the predictability of prominent intrinsic patterns of the system because they often dominate system behavior. Highlights from this work include: • Development of novel methods for estimating the predictability of climate forecast models. • Quantification of the initial value predictability limits of ocean heat content and the overturning circulation in the Atlantic as they are represented in various state of the art climate models. These limits varied substantially from model to model but on average were about a decade with North Atlantic heat content tending to be more predictable than North Pacific heat content. • Comparison of predictability resulting from knowledge of the current state of the climate system with predictability resulting from estimates of how the climate system will react to changes in greenhouse gas concentrations. It turned out that knowledge of the initial state produces a larger impact on forecasts for the first 5 to 10 years of projections. • Estimation of the predictability of dominant patterns of ocean variability including well-known patterns of variability in the North Pacific and North Atlantic. For the most part these patterns were predictable for 5 to 10 years. • Determination of
Schmidt, André; Bachmann, Rosilla; Kometer, Michael; Csomor, Philipp A; Stephan, Klaas E; Seifritz, Erich; Vollenweider, Franz X
Psychotomimetics like the N-methyl--aspartate receptor (NMDAR) antagonist ketamine and the 5-hydroxytryptamine2A receptor (5-HT2AR) agonist psilocybin induce psychotic symptoms in healthy volunteers that resemble those of schizophrenia. Recent theories of psychosis posit that aberrant encoding of prediction errors (PE) may underlie the expression of psychotic symptoms. This study used a roving mismatch negativity (MMN) paradigm to investigate whether the encoding of PE is affected by pharmacological manipulation of NMDAR or 5-HT2AR, and whether the encoding of PE under placebo can be used to predict drug-induced symptoms. Using a double-blind within-subject placebo-controlled design, S-ketamine and psilocybin, respectively, were administrated to two groups of healthy subjects. Psychological alterations were assessed using a revised version of the Altered States of Consciousness (ASC-R) questionnaire. As an index of PE, we computed changes in MMN amplitudes as a function of the number of preceding standards (MMN memory trace effect) during a roving paradigm. S-ketamine, but not psilocybin, disrupted PE processing as expressed by a frontally disrupted MMN memory trace effect. Although both drugs produced positive-like symptoms, the extent of PE processing under placebo only correlated significantly with the severity of cognitive impairments induced by S-ketamine. Our results suggest that the NMDAR, but not the 5-HT2AR system, is implicated in PE processing during the MMN paradigm, and that aberrant PE signaling may contribute to the formation of cognitive impairments. The assessment of the MMN memory trace in schizophrenia may allow detecting early phases of the illness and might also serve to assess the efficacy of novel pharmacological treatments, in particular of cognitive impairments. PMID:22030715
Schmidt, André; Bachmann, Rosilla; Kometer, Michael; Csomor, Philipp A; Stephan, Klaas E; Seifritz, Erich; Vollenweider, Franz X
Psychotomimetics like the N-methyl-D-aspartate receptor (NMDAR) antagonist ketamine and the 5-hydroxytryptamine2A receptor (5-HT(2A)R) agonist psilocybin induce psychotic symptoms in healthy volunteers that resemble those of schizophrenia. Recent theories of psychosis posit that aberrant encoding of prediction errors (PE) may underlie the expression of psychotic symptoms. This study used a roving mismatch negativity (MMN) paradigm to investigate whether the encoding of PE is affected by pharmacological manipulation of NMDAR or 5-HT(2A)R, and whether the encoding of PE under placebo can be used to predict drug-induced symptoms. Using a double-blind within-subject placebo-controlled design, S-ketamine and psilocybin, respectively, were administrated to two groups of healthy subjects. Psychological alterations were assessed using a revised version of the Altered States of Consciousness (ASC-R) questionnaire. As an index of PE, we computed changes in MMN amplitudes as a function of the number of preceding standards (MMN memory trace effect) during a roving paradigm. S-ketamine, but not psilocybin, disrupted PE processing as expressed by a frontally disrupted MMN memory trace effect. Although both drugs produced positive-like symptoms, the extent of PE processing under placebo only correlated significantly with the severity of cognitive impairments induced by S-ketamine. Our results suggest that the NMDAR, but not the 5-HT(2A)R system, is implicated in PE processing during the MMN paradigm, and that aberrant PE signaling may contribute to the formation of cognitive impairments. The assessment of the MMN memory trace in schizophrenia may allow detecting early phases of the illness and might also serve to assess the efficacy of novel pharmacological treatments, in particular of cognitive impairments.
Catalino, Lahnna I; Arenander, Justine; Epel, Elissa; Puterman, Eli
People who are more accepting of their thoughts and feelings experience fewer negative emotions. Although several studies document the connection between acceptance and negative emotions, little, if any research, sheds light on how being receptive to one's internal experience results in less negativity in everyday life. In a daily diary study (N = 183), we found that people who were more accepting of their thoughts and feelings experienced fewer daily negative emotions, and this association was partly explained by less daily stressor-related rumination. The strength of this mediational pathway differed depending upon the average perceived severity of daily stressors. When daily stressors were perceived to be more demanding, trait acceptance predicted a stronger inverse association with rumination, and rumination predicted a stronger positive association with negative emotions. These results shed light on one way acceptance of internal experience predicts less negativity, as well as the moderating role of perceived daily stress. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Burnham, Bruce R; Thompson, Donald F; Jackson, William G
The U.S. Air Force Academy (USAFA) is one of the nation's military universities, with the mission to educate and motivate cadets to be career Air Force officers. This diverse population arrives at the USAFA with varying immunization records and disease histories. Analyses of costs and benefits regarding immunization strategies rely on accurate data and assumptions used in their calculation. Health history questionnaires are a low-cost way of evaluating immunization and disease history. However, this requires a good estimate of the questionnaire's positive predictive value, which may vary among populations. This study attempts to provide a more accurate estimate of the positive predictive value of health history questionnaires regarding varicella and rubella disease and vaccination strategies for the population of fourth degree (freshman) cadets at the USAFA. We found positive predictive values of 99% for rubella and 86% for varicella. These data emphasize the importance of analyzing the specific population for which a program is intended rather than broadly applying recommendations that were developed in other populations.
Ferguson, Christopher J; Salmond, Kimberlee; Modi, Kamla
To assess the influence of media, specifically reality television, on adolescent behavior. A total of 1141 preteen and adolescent girls (age range 11-17) answered questions related to their reality television viewing, personality, self-esteem, relational aggression, appearance focus, and desire for fame. Our results indicated that the influence of reality television on adolescent behavior is complex and potentially related to the adolescents' intended uses and gratifications for using reality television. Reality television viewing was positively related to increased self-esteem and expectations of respect in dating relationships. However, watching reality television also was related to an increased focus on appearance and willingness to compromise other values for fame. Reality television viewing did not predict relational aggression. The potential influences of reality television use on adolescent girls are both positive and negative, defying easy categorization. Copyright © 2013 Mosby, Inc. All rights reserved.
Colomo, Luis; Vazquez, Ivonne; Papaleo, Natalia; Espinet, Blanca; Ferrer, Anna; Franco, Catalina; Comerma, Laura; Hernandez, Silvia; Calvo, Xavier; Salar, Antonio; Climent, Fina; Mate, José Luis; Forcada, Pilar; Mozos, Anna; Nonell, Lara; Martinez, Antonio; Carrio, Anna; Costa, Dolors; Dlouhy, Ivan; Salaverria, Itziar; Martin-Subero, Jose Ignacio; Lopez-Guillermo, Armando; Valera, Alexandra; Campo, Elias
MYC translocation is a defining feature of Burkitt lymphoma (BL), and the new category of high-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 translocations, and occurs in 6% to 15% of diffuse large B-cell lymphomas (DLBCLs). The low incidence of MYC translocations in DLBCL makes the genetic study of all these lymphomas cumbersome. Strategies based on an initial immunophenotypic screening to select cases with a high probability of carrying the translocation may be useful. LMO2 is a germinal center marker expressed in most lymphomas originated in these cells. Mining gene expression profiling studies, we observed LMO2 downregulation in BL and large B-cell lymphoma (LBCL) with MYC translocations, and postulated that LMO2 protein expression could assist to identify such cases. We analyzed LMO2 protein expression in 46 BLs and 284 LBCL. LMO2 was expressed in 1/46 (2%) BL cases, 146/268 (54.5%) DLBCL cases, and 2/16 (12.5%) high-grade B-cell lymphoma cases with MYC and BCL2 and/or BCL6 translocations. All BLs carried MYC translocation (P<0.001), whereas LMO2 was only positive in 6/42 (14%) LBCL with MYC translocation (P<0.001). The relationship between LMO2 negativity and MYC translocation was further analyzed in different subsets of tumors according to CD10 expression and cell of origin. Lack of LMO2 expression was associated with the detection of MYC translocations with high sensitivity (87%), specificity (87%), positive predictive value and negative predictive value (74% and 94%, respectively), and accuracy (87%) in CD10 LBCL. Comparing LMO2 and MYC protein expression, all statistic measures of performance of LMO2 surpassed MYC in CD10 LBCL. These findings suggest that LMO2 loss may be a good predictor for the presence of MYC translocation in CD10 LBCL.
Zhou, Qian M.; Zheng, Yingye
In many clinical applications, understanding when measurement of new markers is necessary to provide added accuracy to existing prediction tools could lead to more cost effective disease management. Many statistical tools for evaluating the incremental value (IncV) of the novel markers over the routine clinical risk factors have been developed in recent years. However, most existing literature focuses primarily on global assessment. Since the IncVs of new markers often vary across subgroups, it would be of great interest to identify subgroups for which the new markers are most/least useful in improving risk prediction. In this paper we provide novel statistical procedures for systematically identifying potential traditional-marker based subgroups in whom it might be beneficial to apply a new model with measurements of both the novel and traditional markers. We consider various conditional time-dependent accuracy parameters for censored failure time outcome to assess the subgroup-specific IncVs. We provide non-parametric kernel-based estimation procedures to calculate the proposed parameters. Simultaneous interval estimation procedures are provided to account for sampling variation and adjust for multiple testing. Simulation studies suggest that our proposed procedures work well in finite samples. The proposed procedures are applied to the Framingham Offspring Study to examine the added value of an inflammation marker, C-reactive protein, on top of the traditional Framingham risk score for predicting 10-year risk of cardiovascular disease. PMID:23263882
Bailey, Alexandria R.; Chow, Jonathan J.; Beckmann, Joshua S.; Zentall, Thomas R.
Pigeons have shown suboptimal gambling-like behavior when preferring a stimulus that infrequently signals reliable reinforcement over alternatives that provide greater reinforcement overall. As a mechanism for this behavior, recent research proposed that the stimulus value of alternatives with more reliable signals for reinforcement will be preferred relatively independently of their frequencies. The present study tested this hypothesis using a simplified design of a Discriminative alternative that, 50% of the time, led to either a signal for 100% reinforcement or a blackout period indicative of 0% reinforcement against a Nondiscriminative alternative that always led to a signal that predicted 50% reinforcement. Pigeons showed a strong preference for the Discriminative alternative that remained despite reducing the frequency of the signal for reinforcement in subsequent phases to 25% and then 12.5%. In Experiment 2, using the original design of Experiment 1, the stimulus following choice of the Nondiscriminative alternative was increased to 75% and then to 100%. Results showed that preference for the Discriminative alternative decreased only when the signals for reinforcement for the two alternatives predicted the same probability of reinforcement. The ability of several models to predict this behavior are discussed, but the terminal link stimulus value offers the most parsimonious account of this suboptimal behavior. PMID:27441394
Vermeiren, Sofie; Vella-Azzopardi, Roberta; Beckwée, David; Habbig, Ann-Katrin; Scafoglieri, Aldo; Jansen, Bart; Bautmans, Ivan
Frailty is one of the most important concerns regarding our aging population. Evidence grows that the syndrome is linked to several important health outcomes. A general overview of frailty concepts and a comprehensive meta-analysis of their relation with negative health outcomes still lacks in literature, making it difficult for health care professionals and researchers to recognize frailty and the related health risks on the one hand and on the other hand to appropriately follow up the frailty process and take substantiated action. Therefore, this study aims to give an overview of the predictive value of the main frailty concepts for negative health outcomes in community-dwelling older adults. This review and meta-analysis assembles prospective studies regarding the relation between frailty and any potential health outcome. Frailty instruments were subdivided into frailty concepts, so as to make comprehensive comparisons. Odds ratios (ORs), hazard ratios (HRs), and relative risk (RR) scores were extracted from the studies, and meta-analyses were conducted in OpenMeta Analyst software. In total, 31 articles retrieved from PubMed, Web of Knowledge, and PsycInfo provided sufficient information for the systematic review and meta-analysis. Overall, (pre)frailty increased the likelihood for developing negative health outcomes; for example, premature mortality (OR 2.34 [1.77-3.09]; HR/RR 1.83 [1.68-1.98]), hospitalization (OR 1.82 [1.53-2.15]; HR/RR 1.18 [1.10-1.28]), or the development of disabilities in basic activities of daily living (OR 2.05 [1.73-2.44]); HR/RR 1.62 [1.50-1.76]). Overall, frailty increases the risk for developing any discussed negative health outcome, with a 1.8- to 2.3-fold risk for mortality; a 1.6- to 2.0-fold risk for loss of activities of daily living; 1.2- to 1.8-fold risk for hospitalization; 1.5- to 2.6-fold risk for physical limitation; and a 1.2- to 2.8-fold risk for falls and fractures. The analyses presented in this study can be used as
Whiting, Paul S; Auston, Darryl; Avilucea, Frank R; Ross, Daniel; Archdeacon, Michael; Sciadini, Marcus; Collinge, Cory A; Sagi, Henry C; Mir, Hassan R
To identify the negative predictive value of examination under anesthesia (EUA) for determining pelvic ring stability and union without further displacement. Retrospective cohort study. Two academic Level 1 trauma centers. Thirty-four adult patients with closed pelvic ring injuries treated over a 5-year period. Pelvic stress EUA. Pelvic ring union and pelvic ring displacement at final follow-up. Thirty-four patients with closed pelvic ring injuries who underwent pelvic EUA during the study period and had a negative examination (indicating a stable pelvis) were identified. Mean age was 38 years (range 16-76), and 19 patients (55.9%) were male. Twenty-two patients (64.7%) had Young-Burgess lateral compression (LC)-1 injuries with complete sacral fractures, 4 patients (11.8%) had LC-2 injuries, and 8 patients (23.5%) had anteroposterior compression (APC)-1 injuries. Eight patients (23.5%) had associated injuries requiring restricted weight-bearing on one or both lower extremities and were excluded from the analysis. Immediate weight-bearing as tolerated was permitted bilaterally in the remaining 26 patients. Mean pelvic ring displacement at the time of injury was 3.8 mm (range 1-15 mm) for LC injuries and 9.1 mm (range 2-20 mm) for APC injuries. Patients were followed for a mean of 8 months (range 3-34 months). At final follow-up, mean displacement was 3.7 mm (range 0-17 mm) for LC injuries and 7.1 mm (range 2-19 mm) for APC injuries. Mean change in displacement from injury to union was -0.1 mm for LC injuries and -2.0 mm for APC injuries, indicating decreased pelvic ring displacement at union. All patients were able to tolerate full weight-bearing bilaterally with no pain, and there were no instances of delayed operative fixation after negative EUA. Negative pelvic EUA after closed pelvic ring injury accurately predicts pelvic stability and union without displacement after nonoperative treatment with full weight-bearing bilaterally. Unless otherwise dictated by
Stuart, S A; Wood, C M; Robinson, E S J
Predicting the risk of drug-induced adverse psychiatric effects is important but currently not possible in non-human species. We investigated whether the affective bias test (ABT) could provide a preclinical method with translational and predictive validity. The ABT is a bowl-digging task, which quantifies biases associated with learning and memory. Rats encounter independent learning experiences, on separate days, under either acute manipulations (e.g. pro-depressant vs. control) or different absolute reward values (e.g. high vs. low). A bias is observed during a preference test when an animal's choices reflect their prior experience. We investigated the effects of putative pro-depressant drug treatments following acute or chronic administration on the formation of an affective bias or reward-induced positive bias respectively. The immunomodulators LPS (10 μg·kg(-1) ), corticosterone (10 and 30 mg·kg(-1) ) and IFN-α (100 U·kg(-1) ) induced a negative affective bias following acute treatment. Tetrabenazine (1 mg·kg(-1) ) also induced a negative bias, but no effects were observed with varenicline, carbamazepine or montelukast. Chronic treatment with IFN-α (100 U·kg(-1) ) and retinoic acid (10 mg·kg(-1) ) impaired the formation of a reward-induced positive bias but did not alter sucrose preference test (SPT). The ABT has the potential to provide a novel approach to predict pro-depressant risk in a non-human species. Negative biases induced by acute treatment in the standard version of the task may also predict longer-term effects on reward processing as shown by the deficit in reward-induced positive bias following chronic treatment, an effect distinct from anhedonia in the SPT. This article is part of a themed section on Pharmacology of Cognition: a Panacea for Neuropsychiatric Disease? To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.19/issuetoc. © 2017 The Authors. British Journal of Pharmacology
Huang, Xiaolin; Shi, Lei; Suykens, Johan A K
Applying the pinball loss in a support vector machine (SVM) classifier results in pin-SVM. The pinball loss is characterized by a parameter τ. Its value is related to the quantile level and different τ values are suitable for different problems. In this paper, we establish an algorithm to find the entire solution path for pin-SVM with different τ values. This algorithm is based on the fact that the optimal solution to pin-SVM is continuous and piecewise linear with respect to τ. We also show that the nonnegativity constraint on τ is not necessary, i.e., τ can be extended to negative values. First, in some applications, a negative τ leads to better accuracy. Second, τ = -1 corresponds to a simple solution that links SVM and the classical kernel rule. The solution for τ = -1 can be obtained directly and then be used as a starting point of the solution path. The proposed method efficiently traverses τ values through the solution path, and then achieves good performance by a suitable τ. In particular, $τ = 0$ corresponds to C-SVM, meaning that the traversal algorithm can output a result at least as good as C-SVM with respect to validation error.
Wan, Zhi-Long; Fan, Hong-Yi
For the density operator (mixed state) describing chaotic light and negative-binomial field there exist the corresponding thermal vacuum state (pure state) in the real-fictitious space. Using the method of integration within ordered product of operators we find the expectation value theorem in these two thermo vacuum states respectively. The thermal average theorem of translation operator is also deduced. Application of the new thermo vacuum state in calculating photon number disturibution and fluctuation and thermal average is presented.
Timashpolsky, Alisa; Dagum, Alexander B; Sayeed, Syed M; Romeiser, Jamie L; Rosenfeld, Elisheva A; Conkling, Nicole
There are >150,000 patient visits per year to emergency rooms for facial trauma. The reliability of a computed tomography (CT) scan has made it the primary modality for diagnosing facial skeletal injury, with the physical examination playing more a cursory role. Knowing the predictive value of physical findings in facial skeletal injuries may enable more appropriate use of imaging and health care resources. A blinded prospective study was undertaken to assess the predictive value of physical examination findings in detecting maxillofacial fracture in trauma patients, and in determining whether a patient will require surgical intervention. Over a four-month period, the authors' team examined patients admitted with facial trauma to the emergency department of their hospital. The evaluating physician completed a standardized physical examination evaluation form indicating the physical findings. Corresponding CT scans and surgical records were then reviewed, and the results recorded by a plastic surgeon who was blinded to the results of the physical examination. A total of 57 patients met the inclusion criteria; there were 44 male and 13 female patients. The sensitivity, specificity, positive predictive value and negative predictive value of grouped physical examination findings were determined in major areas. In further analysis, specific examination findings with n≥9 (15%) were also reported. The data demonstrated a high negative predictive value of at least 90% for orbital floor, zygomatic, mandibular and nasal bone fractures compared with CT scan. Furthermore, none of the patients who did not have a physical examination finding for a particular facial fracture required surgery for that fracture. Thus, the instrument performed well at ruling out fractures in these areas when there were none. Ultimately, these results may help reduce unnecessary radiation and costly imaging in patients with facial trauma without facial fractures.
Timashpolsky, Alisa; Dagum, Alexander B; Sayeed, Syed M; Romeiser, Jamie L; Rosenfeld, Elisheva A; Conkling, Nicole
BACKGROUND There are >150,000 patient visits per year to emergency rooms for facial trauma. The reliability of a computed tomography (CT) scan has made it the primary modality for diagnosing facial skeletal injury, with the physical examination playing more a cursory role. Knowing the predictive value of physical findings in facial skeletal injuries may enable more appropriate use of imaging and health care resources. OBJECTIVE A blinded prospective study was undertaken to assess the predictive value of physical examination findings in detecting maxillofacial fracture in trauma patients, and in determining whether a patient will require surgical intervention. METHODS Over a four-month period, the authors’ team examined patients admitted with facial trauma to the emergency department of their hospital. The evaluating physician completed a standardized physical examination evaluation form indicating the physical findings. Corresponding CT scans and surgical records were then reviewed, and the results recorded by a plastic surgeon who was blinded to the results of the physical examination. RESULTS A total of 57 patients met the inclusion criteria; there were 44 male and 13 female patients. The sensitivity, specificity, positive predictive value and negative predictive value of grouped physical examination findings were determined in major areas. In further analysis, specific examination findings with n≥9 (15%) were also reported. CONCLUSIONS The data demonstrated a high negative predictive value of at least 90% for orbital floor, zygomatic, mandibular and nasal bone fractures compared with CT scan. Furthermore, none of the patients who did not have a physical examination finding for a particular facial fracture required surgery for that fracture. Thus, the instrument performed well at ruling out fractures in these areas when there were none. Ultimately, these results may help reduce unnecessary radiation and costly imaging in patients with facial trauma without
Kosinski, Andrzej S
Positive and negative predictive values are important measures of a medical diagnostic test performance. We consider testing equality of two positive or two negative predictive values within a paired design in which all patients receive two diagnostic tests. The existing statistical tests for testing equality of predictive values are either Wald tests based on the multinomial distribution or the empirical Wald and generalized score tests within the generalized estimating equations (GEE) framework. As presented in the literature, these test statistics have considerably complex formulas without clear intuitive insight. We propose their re-formulations that are mathematically equivalent but algebraically simple and intuitive. As is clearly seen with a new re-formulation we presented, the generalized score statistic does not always reduce to the commonly used score statistic in the independent samples case. To alleviate this, we introduce a weighted generalized score (WGS) test statistic that incorporates empirical covariance matrix with newly proposed weights. This statistic is simple to compute, always reduces to the score statistic in the independent samples situation, and preserves type I error better than the other statistics as demonstrated by simulations. Thus, we believe that the proposed WGS statistic is the preferred statistic for testing equality of two predictive values and for corresponding sample size computations. The new formulas of the Wald statistics may be useful for easy computation of confidence intervals for difference of predictive values. The introduced concepts have potential to lead to development of the WGS test statistic in a general GEE setting. Copyright © 2012 John Wiley & Sons, Ltd.
The greater-than-g acceleration of a bungee jumper discussed in a previous article in this journal by Kagan and Kott led to many lively discussions among Dutch physics teachers. These inspired me to look for an inexpensive experimental setup, suitable for use in a high school physics class, that can be used to confirm that indeed the acceleration is greater than g. In this paper I describe an exercise to compare the predicted and the measured graphs for the displacement y(t) of the jumper and the force Fb(t) exerted by the bungee on the bridge to which it is fastened. In my apparatus, the "bungee" consists of a light chain and the "jumper" is a small piece of brass. Data collection and the calculation of predicted values were carried out using Coach.2 The analysis reliably leads to the conclusion that the acceleration of the falling jumper does indeed exceed g.
Gunaydin, Gul; Selcuk, Emre; Ong, Anthony D.
Past research on emotion regulation has provided evidence that cognitive reappraisal predicts reactivity to affective stimuli and challenge tests in laboratory settings. However, little is known about how trait reappraisal might contribute to affective reactivity to everyday positive and negative events. Using a large, life-span sample of adults (N = 1755), the present study addressed this important gap in the literature. Respondents completed a measure of trait reappraisal and reported on their daily experiences of positive and negative events and positive and negative affect for eight consecutive days. Results showed that trait reappraisal predicted lower increases in negative affect in response to daily negative events and lower increases in positive affect in response to daily positive events. These findings advance our understanding of the role of reappraisal in emotion regulation by showing how individual differences in the use of this strategy relate to emotional reactions to both positive and negative events outside the laboratory. PMID:27445954
Yan, Xu; Bai, Shi-qie; Yan, Jia-jun; Hu, Chao; Li, Da-xu; You, Ming-hong; Zhang, Yu; Dao, Zhi-xue; Zhang, Chang-bing; Gan, You-min
Siberian wildrye (Elymus sibiricus L.) is one of the predominant pasture species in Qinghai-Tibet plateau of China. It supplies a large number of fodders to domestic animals in spring and winter, and provides a large proportion of the summer and autumn grazing in these alpine regions. Crude protein (CP), acid detergent fiber (ADF), neutral detergent fiber (NDF) and in vitro dry matter digestibility (IVDMD) are the most important aspects of nutritive value of forages. A successful application of near infrared spectroscopy (NIRS) in combination with partial least square regression (PLSR) for the determination of four parameters (CP, ADF, NDF and IVDMD) of Siberian wildrye was developed. The standard errors of calibration (SEC, %DM) and Rcal(2) values (in parentheses) were 0.3299(0.9945), 0.7799(0.9499), 1.3430(0.9133), and 1.3762(0.9822) for CP, ADF, NDF and IVDMD equations, respectively. The standard errors of prediction (SEP, %DM) and Rval(2) values (in parentheses) were 0.3621(0.9938), 0.7878(0.9449), 1.3852(0.8907), and 1.4303(0.9790) for CP, ADF, NDF and IVDMD, respectively. A good correlation (r>0.9438) was found between results from NIRS and the traditional chemical method, and residual predictive deviation (RPD) ranged from 3.02 to 12.63. It was concluded that NIR spectroscopic technique associated with chemometrics is sufficiently sensitive to allow the accurate prediction of the concentrations of compo nents (CP, ADF and NDF) and IVDMD of Siberian wildrye.
Kistner, Janet A.; Ziegert, Dannah I.; Castro, Rafael; Robertson, Bruce
Examined relationship of helplessness exhibited in 112 kindergarten children's responses to a challenging, developmentally appropriate task with depression and negative self-worth 5 years later. Found that helplessness in kindergarten predicted more depressive symptoms, as reported by children and their teachers, and more negative feelings of…
Gillot, S; Héduit, A
The objective of this work was to analyse the impact of different geometric and operating parameters on the alpha factor value for fine bubble aeration systems equipped with EPDM membrane diffusers. Measurements have been performed on nitrifying plants operating under extended aeration and treating mainly domestic wastewater. Measurements performed on 14 nitrifying plants showed that, for domestic wastewater treatment under very low F/M ratios, the alpha factor is comprised between 0.44 and 0.98. A new composite variable (the Equivalent Contact Time, ECT) has been defined and makes it possible for a given aeration tank, knowing the MCRT, the clean water oxygen transfer coefficient and the supplied air flow rate, to predict the alpha factor value. ECT combines the effect on mass transfer of all generally accepted factors affecting oxygen transfer performances (air flow rate, diffuser submergence, horizontal flow). (c) IWA Publishing 2008.
Swanson, Kate; Whelan, Anna R; Grobman, William A; Miller, Emily S
Umbilical cord arterial blood gas values are used to diagnose fetal acidemia; however, arterial cord blood specimens are frequently not available. We sought to assess whether umbilical cord venous blood gas values can be used to reliably predict fetal acidemia. This is an observational study of women with a singleton gestation at a single tertiary care hospital who delivered from September 2010 through August 2015 and had both umbilical cord arterial and venous blood gas samples measured. Fetal acidemia was defined in 2 ways: (1) umbilical cord arterial pH <7.0, and (2) umbilical cord arterial base deficit ≥12 mEq/L. Receiver operating characteristic curves for fetal acidemia were generated using umbilical cord venous blood gas values and the areas under the curve were calculated. Umbilical cord venous blood gas cutoffs associated with <1%, <5%, <10%, and <50% probability of acidemia were calculated. Of the 36,325 women who met inclusion criteria, 563 (1.5%) had an umbilical cord arterial pH <7.0 and 1535 (4.2%) had an umbilical cord arterial base deficit ≥12 mEq/L. Umbilical cord venous pH was highly predictive of umbilical cord arterial pH <7.0 (area under the curve, 0.955; 95% confidence interval, 0.946-0.965). Similarly, umbilical cord venous base deficit was highly predictive of umbilical cord arterial base deficit ≥12 mEq/L (area under the curve, 0.967; 95% confidence interval, 0.963-0.971). While the combination of venous pH and base deficit was statistically significantly more predictive of umbilical cord arterial pH <7.0 (area under the curve, 0.961; 95% confidence interval, 0.952-0.969; P < .001), this difference has negligible clinical meaning. Similarly, the combination of venous pH and base deficit (area under the curve, 0.967; 95% confidence interval, 0.962-0.971) was no more predictive than venous base deficit alone in the prediction of umbilical cord arterial base deficit ≥12 mEq (P = .622). The likelihood of an arterial cord venous pH <7
Over the last several years, there has been an explosion of interest and attention devoted to the problem of Uncertainty Quantification (UQ) in climate science-that is, to giving quantitative estimates of the degree of uncertainty associated with the predictions of global and regional climate models. The technical challenges associated with this project are formidable, and so the statistical community has understandably devoted itself primarily to overcoming them. But even as these technical challenges are being met, a number of persistent conceptual difficulties remain. So why is UQ so important in climate science? UQ, I would like to argue, is first and foremost a tool for communicating knowledge from experts to policy makers in a way that is meant to be free from the influence of social and ethical values. But the standard ways of using probabilities to separate ethical and social values from scientific practice cannot be applied in a great deal of climate modeling, because the roles of values in creating the models cannot be discerned after the fact-the models are too complex and the result of too much distributed epistemic labor. I argue, therefore, that typical approaches for handling ethical/social values in science do not work well here.
Potts, Geoffrey F.; Martin, Laura E.; Kamp, Siri-Maria; Donchin, Emanuel
The error-related negativity (ERN) is thought to index an anterior cingulate (ACC) behavioral monitoring system. The feedback ERN (FRN) is elicited to error feedback when the correct response is not known, but also when a choice outcome is suboptimal and to passive reward prediction violation, suggesting that the monitoring system may not be restricted to actions. This study used principal components analysis to show that the ERN consists of a single central component while the reward prediction violation FRN is comprised of central and prefrontal components. A prefrontal component is also present in action monitoring but occurs later, at the Error Positivity latency. This suggests that ACC monitors both actions and events for reward prediction error. Prefrontal cortex may update reward expectation based on the prediction violation with the latency difference due to differential processing time for motor and perceptual information. PMID:20557487
Chester, David S.; DeWall, C. Nathan; Derefinko, Karen J.; Estus, Steven; Peters, Jessica R.; Lynam, Donald R.; Jiang, Yang
Low functioning MAOA genotypes have been reliably linked to increased reactive aggression, yet the psychological mechanisms of this effect remain largely unknown. The low functioning MAOA genotype’s established link to diminished inhibition and greater reactivity to conditions of negative affect suggest that negative urgency, the tendency to act impulsively in the context of negative affect, may fill this mediating role. Such MAOA carriers may have higher negative urgency, which may in turn predict greater aggressive responses to provocation. To test these hypotheses, 277 female and male participants were genotyped for an MAOA SNP yet to be linked to aggression (rs1465108), and then reported their negative urgency and past aggressive behavior. We replicated the effect of the low functioning MAOA genotype on heightened aggression, which was mediated by greater negative urgency. These results suggest that disrupted serotonergic systems predispose individuals towards aggressive behavior by increasing impulsive reactivity to negative affect. PMID:25637908
Chester, David S; DeWall, C Nathan; Derefinko, Karen J; Estus, Steven; Peters, Jessica R; Lynam, Donald R; Jiang, Yang
Low functioning MAOA genotypes have been reliably linked to increased reactive aggression, yet the psychological mechanisms of this effect remain largely unknown. The low functioning MAOA genotype's established link to diminished inhibition and greater reactivity to conditions of negative affect suggest that negative urgency, the tendency to act impulsively in the context of negative affect, may fill this mediating role. Such MAOA carriers may have higher negative urgency, which may in turn predict greater aggressive responses to provocation. To test these hypotheses, 277 female and male participants were genotyped for an MAOA SNP yet to be linked to aggression (rs1465108), and then reported their negative urgency and past aggressive behavior. We replicated the effect of the low functioning MAOA genotype on heightened aggression, which was mediated by greater negative urgency. These results suggest that disrupted serotonergic systems predispose individuals towards aggressive behavior by increasing impulsive reactivity to negative affect.
Alonso, Ariel; Van der Elst, Wim; Meyvisch, Paul
Several methods have been developed for the evaluation of surrogate endpoints within the causal-inference and meta-analytic paradigms. In both paradigms, much effort has been made to assess the capacity of the surrogate to predict the causal treatment effect on the true endpoint. In the present work, the so-called surrogate predictive function (SPF) is introduced for that purpose, using potential outcomes. The relationship between the SPF and the individual causal association, a new metric of surrogacy recently proposed in the literature, is studied in detail. It is shown that the SPF, in conjunction with the individual causal association, can offer an appealing quantification of the surrogate predictive value. However, neither the distribution of the potential outcomes nor the SPF are identifiable from the data. These identifiability issues are tackled using a two-step procedure. In the first step, the region of the parametric space of the distribution of the potential outcomes, compatible with the data at hand, is geometrically characterized. Further, in a second step, a Monte Carlo approach is used to study the behavior of the SPF on the previous region. The method is illustrated using data from a clinical trial involving schizophrenic patients and a newly developed and user friendly R package Surrogate is provided to carry out the validation exercise. Copyright © 2016 John Wiley & Sons, Ltd.
Kulyova, S A; Karitsky, A P
Today approximately 70% of patients with Hodgkin lymphoma can be cured with the combined-modality therapy. Tumor burden, the importance of which was demonstrated 15 years ago for the first time, is a powerful prognostic factor. Data of literature of representations on predictive value of Hodgkin's lymphoma tumor burden are shown in the article. The difficult immunological relations between tumor cells and reactive ones lead to development of the main symptoms. Nevertheless, the collective sign of tumor burden shows the greatest influence on survival and on probability of resistance, which relative risk can be predicted on this variable and treatment program. Patients with bulky disease need escalated therapy with high-dose chemotherapy. Integration into predictive models of the variable will change an expected contribution of clinical and laboratory parameters in the regression analyses constructed on patients with Hodgkin's lymphoma. Today the role of diagnostic functional methods, in particular a positron emission tomography, for metabolic active measurement is conducted which allows excluding a reactive component.
Chhabra, S K
Spirometry is the most frequently performed investigation to evaluate pulmonary function. It provides clinically useful information on the mechanical properties of the lung and the thoracic cage and aids in taking management-related decisions in a wide spectrum of diseases and disorders. Few measurements in medicine are so dependent on factors related to equipment, operator and the patient. Good spirometry requires quality assured measurements and a systematic approach to interpretation. Standard guidelines on the technical aspects of equipment and their calibration as well as the test procedure have been developed and revised from time-to-time. Strict compliance with standardisation guidelines ensures quality control. Interpretation of spirometry data is based only on two basic measurements--the forced vital capacity (FVC) and the forced expiratory volume in 1 second (FEV1) and their ratio, FEV1/FVC. A meaningful and clinically useful interpretation of the measured data requires a systematic approach and consideration of several important issues. Central to interpretation is the understanding of the development and application of prediction equations. Selection of prediction equations that are appropriate for the ethnic origin of the patient is vital to avoid erroneous interpretation. Defining abnormal values is a debatable but critical aspect of spirometry. A statistically valid definition of the lower limits of normal has been advocated as the better method over the more commonly used approach of defining abnormality as a fixed percentage of the predicted value. Spirometry rarely provides a specific diagnosis. Examination of the flow-volume curve and the measured data provides information to define patterns of ventilatory impairment. Spirometry must be interpreted in conjunction with clinical information including results of other investigations.
Bain, Paul G; Kashima, Yoshihisa; Haslam, Nick
Beliefs that may underlie the importance of human values were investigated in 4 studies, drawing on research that distinguishes natural-kind (natural), nominal-kind (conventional), and artifact (functional) beliefs. Values were best characterized by artifact and nominal-kind beliefs, as well as a natural-kind belief specific to the social domain, "human nature" (Studies 1 and 2). The extent to which values were considered central to human nature was associated with value importance in both Australia and Japan (Study 2), and experimentally manipulating human nature beliefs influenced value importance (Study 3). Beyond their association with importance, human nature beliefs predicted participants' reactions to value trade-offs (Study 1) and to value-laden rhetorical statements (Study 4). Human nature beliefs therefore play a central role in the psychology of values.
Bissonette, Gregory B; Roesch, Matthew R
Many brain areas are activated by the possibility and receipt of reward. Are all of these brain areas reporting the same information about reward? Or are these signals related to other functions that accompany reward-guided learning and decision-making? Through carefully controlled behavioral studies, it has been shown that reward-related activity can represent reward expectations related to future outcomes, errors in those expectations, motivation, and signals related to goal- and habit-driven behaviors. These dissociations have been accomplished by manipulating the predictability of positively and negatively valued events. Here, we review single neuron recordings in behaving animals that have addressed this issue. We describe data showing that several brain areas, including orbitofrontal cortex, anterior cingulate, and basolateral amygdala signal reward prediction. In addition, anterior cingulate, basolateral amygdala, and dopamine neurons also signal errors in reward prediction, but in different ways. For these areas, we will describe how unexpected manipulations of positive and negative value can dissociate signed from unsigned reward prediction errors. All of these signals feed into striatum to modify signals that motivate behavior in ventral striatum and guide responding via associative encoding in dorsolateral striatum.
Roesch, Matthew R.
Many brain areas are activated by the possibility and receipt of reward. Are all of these brain areas reporting the same information about reward? Or are these signals related to other functions that accompany reward-guided learning and decision-making? Through carefully controlled behavioral studies, it has been shown that reward-related activity can represent reward expectations related to future outcomes, errors in those expectations, motivation, and signals related to goal- and habit-driven behaviors. These dissociations have been accomplished by manipulating the predictability of positively and negatively valued events. Here, we review single neuron recordings in behaving animals that have addressed this issue. We describe data showing that several brain areas, including orbitofrontal cortex, anterior cingulate, and basolateral amygdala signal reward prediction. In addition, anterior cingulate, basolateral amygdala, and dopamine neurons also signal errors in reward prediction, but in different ways. For these areas, we will describe how unexpected manipulations of positive and negative value can dissociate signed from unsigned reward prediction errors. All of these signals feed into striatum to modify signals that motivate behavior in ventral striatum and guide responding via associative encoding in dorsolateral striatum. PMID:26276036
Hayward, Lydia E; Tropp, Linda R; Hornsey, Matthew J; Barlow, Fiona Kate
Positive contact with advantaged group members can improve disadvantaged group members' attitudes towards them, yet it may also lower perceptions of group discrimination and consequent collective action. Little is known, however, about how negative contact with the advantaged predicts collective action among members of disadvantaged groups. With samples of Black and Hispanic Americans, we tested positive and negative contact with White Americans as predictors of self-reported collective action behaviour and future intentions. Across both samples, negative contact with White Americans predicted greater collective action, largely through the mechanisms of perceived discrimination and intergroup anger. Simultaneously, positive contact showed a negative indirect effect on collective action primarily through reduced anger. These findings suggest that negative contact may be a potential driver of social change among racial minorities. Implications of these findings for the contact and collective action literatures are discussed. © 2017 The British Psychological Society.
Kvalem, Ingela Lundin; von Soest, Tilmann; Roald, Helge E; Skolleborg, Knut Chr
This study investigates how personality traits in combination with frequency of and emotional reaction to negative comments about appearance while growing up are related to appearance evaluation and orientation among adult women. Nine hundred and seven participants from a representative sample of Norwegian women aged 22-55, answered questions measuring body image, personality (Big Five), and history of experiencing negative comments about appearance. Results indicated that only emotional reaction to negative comments about appearance significantly predicted both appearance evaluation and orientation, while frequency of negative comments did not. Being extrovert predicted more positive appearance evaluation and being more appearance oriented than being introvert. Scoring high on neuroticism was related to negative appearance evaluation and high appearance orientation. The findings demonstrate the importance of differentiating between the frequency and the emotional impact of teasing as well as including personality traits when studying body image.
Sambrook, Thomas D; Goslin, Jeremy
Reinforcement learning models make use of reward prediction errors (RPEs), the difference between an expected and obtained reward. There is evidence that the brain computes RPEs, but an outstanding question is whether positive RPEs ("better than expected") and negative RPEs ("worse than expected") are represented in a single integrated system. An electrophysiological component, feedback related negativity, has been claimed to encode an RPE but its relative sensitivity to the utility of positive and negative RPEs remains unclear. This study explored the question by varying the utility of positive and negative RPEs in a design that controlled for other closely related properties of feedback and could distinguish utility from salience. It revealed a mediofrontal sensitivity to utility, for positive RPEs at 275-310ms and for negative RPEs at 310-390ms. These effects were preceded and succeeded by a response consistent with an unsigned prediction error, or "salience" coding.
Yang, Pei-Ching; Chang, Chia-Chi; Chiang, Jung-Hsien; Chen, Ying-Yeh
Background Prompt recognition and intervention of negative emotions is crucial for patients with depression. Mobile phones and mobile apps are suitable technologies that can be used to recognize negative emotions and intervene if necessary. Objective Mobile phone usage patterns can be associated with concurrent emotional states. The objective of this study is to adapt machine-learning methods to analyze such patterns for the prediction of negative emotion. Methods We developed an Android-based app to capture emotional states and mobile phone usage patterns, which included call logs (and use of apps). Visual analog scales (VASs) were used to report negative emotions in dimensions of depression, anxiety, and stress. In the system-training phase, participants were requested to tag their emotions for 14 consecutive days. Five feature-selection methods were used to determine individual usage patterns and four machine-learning methods were tested. Finally, rank product scoring was used to select the best combination to construct the prediction model. In the system evaluation phase, participants were then requested to verify the predicted negative emotions for at least 5 days. Results Out of 40 enrolled healthy participants, we analyzed data from 28 participants, including 30% (9/28) women with a mean (SD) age of 29.2 (5.1) years with sufficient emotion tags. The combination of time slots of 2 hours, greedy forward selection, and Naïve Bayes method was chosen for the prediction model. We further validated the personalized models in 18 participants who performed at least 5 days of model evaluation. Overall, the predictive accuracy for negative emotions was 86.17%. Conclusion We developed a system capable of predicting negative emotions based on mobile phone usage patterns. This system has potential for ecological momentary intervention (EMI) for depressive disorders by automatically recognizing negative emotions and providing people with preventive treatments before it
Goldman, Noreen; Glei, Dana A.
Purpose In light of widespread interest in the prognostic value of biomarkers, we apply three discrimination measures to evaluate the incremental value of biomarkers –beyond self-reported measures – for predicting all-cause mortality. We assess whether all three measures –AUC, NRI(>0), and IDI – lead to the same conclusions. Methods We use longitudinal data from a nationally representative sample of older Taiwanese (n = 639, aged 54+ in 2000, examined in 2000 and 2006, with mortality follow-up through 2011). We estimate age-specific mortality using a Gompertz hazard model. Results The broad conclusions are consistent across the three discrimination measures and support the inclusion of biomarkers, particularly inflammatory markers, in household surveys. Although the rank ordering of individual biomarkers varies across discrimination measures, the following is true for all three: interleukin-6 is the strongest predictor, the other three inflammatory markers make the top 10, and homocysteine ranks second or third. Conclusions The consistency of most of our findings across metrics should provide comfort to researchers using discrimination measures to evaluate the prognostic value of biomarkers. However, because the degree of consistency varies with the level of detail inherent in the research question, we recommend that researchers confirm results with multiple discrimination measures. PMID:26419291
Calvo, Pilar; Ferreras, Antonio; Polo, Vicente; Güerri, Noemi; Seral, Pilar; Fuertes-Lazaro, Isabel; Pablo, Luis E.
Purpose. To determine whether retrobulbar blood flow (RBF) velocities are predictive of conversion to glaucoma. Methods. A total of 262 glaucoma suspects were prospectively selected. Participants had normal visual field, increased intraocular pressure, and glaucomatous optic disc appearance at baseline. Topographic analysis of the optic nerve head was performed using a confocal laser scanning ophthalmoscope and the blood flow velocity of retrobulbar vessels was measured by color Doppler imaging. Conversion to glaucoma was assessed according to the changes in the color-coded Moorfields Regression Analysis (MRA) classification of the confocal laser scanning system during a 48-month follow-up period. Survival curves and hazard ratios (HRs) for the association between RBF parameters and conversion to glaucoma were calculated. Results. End-diastolic velocity and mean velocity in the ophthalmic artery were reduced in subjects that converted to glaucoma based on MRA (36 individuals, 13.7%), while resistivity (RI) and pulsatility indices were increased in the same vessel. Patients with RI values lower than 0.75 in the ophthalmic artery had a survival rate (MRA-converters versus nonconverters) of 93.9%, whereas individuals with RI values greater than 0.75 had a survival rate of 81.7% (HR = 3.306; P = 0.002). Conclusions. Abnormal RBF velocities measured by color Doppler ultrasound may be a risk factor for conversion to glaucoma. An RI value higher than 0.75 in the ophthalmic artery was associated with the development of glaucoma. PMID:22589447
Staugaard, Søren Risløv; Johannessen, Kim Berg; Thomsen, Yvonne Duval; Bertelsen, Mette; Berntsen, Dorthe
The purpose of the present study was to examine theoretically motivated predictors for the development of positive changes following potentially traumatic experiences (i.e., posttraumatic growth). Specifically, we wanted to examine the prediction that memories of highly negative and positive deployment events predict subsequent posttraumatic growth. A total of 251 Danish soldiers (7% female, mean age 26.4) deployed to forward operating bases in Afghanistan filled out questionnaires before, during, and after deployment. This allowed us to perform prospective as well as cross-sectional analyses of the data. The main findings were that the centrality of highly emotional memories from deployment predicted growth alongside openness to experience, combat exposure, and social support. Importantly, the centrality of both positive and negative memories predicted growth equally well. The perceived importance of both negative and positive events may play an important part in the development of posttraumatic growth. © 2014 Wiley Periodicals, Inc.
De Felice, Claudio; Flori, Maria Laura; Pellegrino, Michele; Toti, Paolo; Stanghellini, Elisabetta; Molinu, Antonietta; Tosi, Piero; Bagnoli, Franco
The relationship between skin color and illness severity in the newborn remains untested. We have evaluated the predictive value of skin color readings for illness severity in a population of high-risk newborn infants. A prospective study was conducted on 107 white newborns in the intensive care unit, which were categorized as either high or low severity of illness, defined by the presence of severe neonatal morbidity. Illness severity was also determined using a Score for Neonatal Acute Physiology (SNAP). Color readings were obtained at 10 different body sites using a portable tristimulus colorimeter during the first 24 h, and color was expressed using the standard CIE L*a*b* system. Skin CIE b* values were significantly lower in the high severity group (p < 0.0001), and a significant inverse correlation with SNAP was observed (r(s) range, -0.37 to -0.71, p < 0.0001). In particular a low b* value for the abdomen was found to be a significant predictor of illness severity (92.6% sensitivity; 96.6% specificity; 96% positive predictive value; 93.7% negative predictive value; adjusted odds ratio, 14.7; 95% confidence interval, 6.4 to 33.8). Our findings indicate that skin color reflects clinical severity in the newborn and that skin colorimetry can accurately identify higher risk infants.
Miyamoto, Yuri; Boylan, Jennifer Morozink; Coe, Christopher L.; Curhan, Katherine B.; Levine, Cynthia S.; Markus, Hazel Rose; Park, Jiyoung; Kitayama, Shinobu; Kawakami, Norito; Karasawa, Mayumi; Love, Gayle D.; Ryff, Carol D.
Previous studies conducted in Western cultures have shown that negative emotions predict higher levels of pro-inflammatory biomarkers, specifically interleukin-6 (IL-6). This link between negative emotions and IL-6 may be specific to Western cultures where negative emotions are perceived to be problematic and thus may not extend to Eastern cultures where negative emotions are seen as acceptable and normal. Using samples of 1044 American and 382 Japanese middle-aged and older adults, we investigated whether the relationship between negative emotions and IL-6 varies by cultural context. Negative emotions predicted higher IL-6 among American adults, whereas no association was evident among Japanese adults. Furthermore, the interaction between culture and negative emotions remained even after controlling for demographic variables, psychological factors (positive emotions, neuroticism, extraversion), health behaviors (smoking status, alcohol consumption), and health status (chronic conditions, BMI). These findings highlight the role of cultural context in shaping how negative emotions affect inflammatory physiology and underscore the importance of cultural ideas and practices relevant to negative emotions for understanding of the interplay between psychology, physiology, and health. PMID:23911591
Miyamoto, Yuri; Boylan, Jennifer Morozink; Coe, Christopher L; Curhan, Katherine B; Levine, Cynthia S; Markus, Hazel Rose; Park, Jiyoung; Kitayama, Shinobu; Kawakami, Norito; Karasawa, Mayumi; Love, Gayle D; Ryff, Carol D
Previous studies conducted in Western cultures have shown that negative emotions predict higher levels of pro-inflammatory biomarkers, specifically interleukin-6 (IL-6). This link between negative emotions and IL-6 may be specific to Western cultures where negative emotions are perceived to be problematic and thus may not extend to Eastern cultures where negative emotions are seen as acceptable and normal. Using samples of 1044 American and 382 Japanese middle-aged and older adults, we investigated whether the relationship between negative emotions and IL-6 varies by cultural context. Negative emotions predicted higher IL-6 among American adults, whereas no association was evident among Japanese adults. Furthermore, the interaction between culture and negative emotions remained even after controlling for demographic variables, psychological factors (positive emotions, neuroticism, extraversion), health behaviors (smoking status, alcohol consumption), and health status (chronic conditions, BMI). These findings highlight the role of cultural context in shaping how negative emotions affect inflammatory physiology and underscore the importance of cultural ideas and practices relevant to negative emotions for understanding of the interplay between psychology, physiology, and health. Copyright © 2013 Elsevier Inc. All rights reserved.
Backhus, Leah M.; Varghese, Thomas K.; Manning, James P.; Cheng, Aaron M.; Mulligan, Michael S.; Wood, Douglas E.
Background A prediction model for pathologic N2 (pN2) among lung cancer patients with a negative mediastinum by positron emission tomography (PET) was recently internally validated. Our study sought to determine the external validity of that model. Methods A cohort study [2005-2013] was performed of lung cancer patients with a negative mediastinum by PET. Previously published model coefficients were used to estimate the probability of pN2 based on tumor location and size, nodal enlargement by computed tomography (CT), maximum standardized uptake value (SUVmax) of the primary tumor, N1 disease by PET, and pretreatment histology. Results Among 239 patients, 18 had pN2 [7.5%, 95% confidence interval (CI): 4.5-12%]. Model discrimination was excellent (c-statistic 0.80, 95% CI: 0.75-0.85) and the model fit the data well (P=0.191). The accuracy of the model was as follows: sensitivity 100%, 95% CI: 81-100%; specificity 49%, 95% CI: 42-56%; positive predictive value (PPV) 14%, 95% CI: 8-21%, and negative predictive value (NPV) 100%, 95% CI: 97-100%. CI inspection revealed a significantly higher c-statistic in this external validation cohort compared to the internal validation cohort. The model’s apparently poor specificity for patient selection is in fact significantly better than usual care (i.e., aggressive but allowable guideline concordant staging) and minimum guideline mandated selection criteria for invasive staging. Conclusions A prediction model for pN2 is externally valid. The high NPV of this model may allow pulmonologists and thoracic surgeons to more comfortably minimize the number of invasive procedures performed among patients with a negative mediastinum by PET. PMID:25973222
Boulay, G; Francoz, D; Doré, E; Dufour, S; Veillette, M; Badillo, M; Bélanger, A-M; Buczinski, S
The objectives of the current study were (1) to determine the gain in prognostic accuracy of preoperative l-lactate concentration (LAC) measured on farm on cows with right displaced abomasum (RDA) or abomasal volvulus (AV) for predicting negative outcome; and (2) to suggest clinically relevant thresholds for such use. A cohort of 102 cows with on-farm surgical diagnostic of RDA or AV was obtained from June 2009 through December 2011. Blood was drawn from coccygeal vessels before surgery and plasma LAC was immediately measured by using a portable clinical analyzer. Dairy producers were interviewed by phone 30 d following surgery and the outcome was determined: a positive outcome if the owner was satisfied of the overall evolution 30 d postoperatively, and a negative outcome if the cow was culled, died, or if the owner reported being unsatisfied 30 d postoperatively. The area under the curve of the receiver operating characteristic curve for LAC was 0.92 and was significantly greater than the area under the curve of the receiver operating characteristic curve of heart rate (HR; 0.77), indicating that LAC, in general, performed better than HR to predict a negative outcome. Furthermore, the ability to predict a negative outcome was significantly improved when LAC measurement was considered in addition to the already available HR data (area under the curve: 0.93 and 95% confidence interval: 0.87, 0.99). Important inflection points of the misclassification cost term function were noted at thresholds of 2 and 6 mmol/L, suggesting the potential utility of these cut-points. The 2 and 6 mmol/L thresholds had a sensitivity, specificity, positive predictive value, and negative predictive value for predicting a negative outcome of 76.2, 82.7, 53.3, and 93.1%, and of 28.6, 97.5, 75, and 84%, respectively. In terms of clinical interpretation, LAC ≤2 mmol/L appeared to be a good indicator of positive outcome and could be used to support a surgical treatment decision. The
Bertucci, François; Finetti, Pascal; Viens, Patrice; Birnbaum, Daniel
The EndoPredict (EP) signature is a prognostic 11-gene expression signature specifically developed in ER+/HER2- node-negative/positive breast cancer. It is associated with relapse-free survival in patients treated with adjuvant hormone therapy, suggesting that EP low-risk patients could be treated with adjuvant hormone therapy alone whereas high-risk patients would deserve addition of adjuvant chemotherapy. Thus, it is important to determine whether EP high-risk patients are or are not more sensitive to chemotherapy than low-risk patients. Here, we have assessed the EP predictive value for pathological complete response to neoadjuvant chemotherapy in ER+/HER2- breast cancer. We gathered gene expression and histoclinical data of 553 pre-treatment ER+/HER2- breast carcinomas treated with anthracycline-based neoadjuvant chemotherapy. We searched for correlation between the pathological complete response (pCR) and the EP score-based classification. The overall pCR rate was 12%. Fifty-one percent of samples were classified as low-risk according to the EP score and 49% as high-risk. EP classification was associated with a pCR rate of 7% in the low-risk group and 17% in the high-risk group (p < 0.001). In multivariate analysis, the EP score remained significantly associated with pCR. Many genes upregulated in the high-risk tumours were involved in cell proliferation, whereas many genes upregulated in the low-risk tumours were involved in ER-signalling and stroma. Despite higher chemosensitivity, the high-risk group was associated with worse disease-free survival. In conclusion, EP high-risk ER+/HER2- breast cancers are more likely to respond to anthracycline-based chemotherapy.
Marasanapalle, Venugopal P; Crison, John R; Devarakonda, Krishna R; Li, Xiaoling; Jasti, Bhaskara R
A drug is defined to exhibit food effects if its pharmacokinetic parameter, area under the curve (AUC₀₋∞) is different when co-administered with food in comparison with its administration on a fasted stomach. Food effects of drugs administered in immediate release dosage forms were classified as positive, negative, and no food effects. In this study, predictive models for negative food effects of drugs that are stable in the gastrointestinal tract and do not complex with Ca²⁺ are reported. An empirical model was developed using five drugs exhibiting negative food effects and seven drugs exhibiting no food effects by multiple regression analysis, based on biopharmaceutical properties generated from in vitro experiments. An oral absorption model was adopted for simulating negative food effects of model compounds using in situ rat intestinal permeability. Analysis of selected model drugs indicated that percent food effects correlated to their dissociation constant, K (K(a) or K(b)) and Caco-2 permeabilities. The obtained predictive equation was: Food effect (%)=(2.60 x 10⁵·P(app))--(2.91 x 10⁵·K)--8.50. Applying the oral absorption model, the predicted food effects matched the trends of published negative food effects when the two experimental pH conditions of fed and fasted state intestinal environment were used. A predictive model for negative food effects based on the correlation of food effects with dissociation constant and Caco-2 permeability was established and simulations of food effects using rat intestinal permeability supported the drugs? published negative food effects. Thus, an empirical and a mechanistic model as potential tools for predicting negative food effects are reported.
In Russian negative sentences the verb's direct object may appear either in the accusative case, which is licensed by the verb (as is common cross-linguistically), or in the genitive case, which is licensed by the negation (Russian-specific "genitive-of-negation" phenomenon). Such sentences were used to investigate whether case marking is employed for anticipating syntactic structure, and whether lexical heads other than the verb can be predicted on the basis of a case-marked noun phrase. Experiment 1, a completion task, confirmed that genitive-of-negation is part of Russian speakers' active grammatical repertoire. In Experiments 2 and 3, the genitive/accusative case manipulation on the preverbal object led to shorter reading times at the negation and verb in the genitive versus accusative condition. Furthermore, Experiment 3 manipulated linear order of the direct object and the negated verb in order to distinguish whether the abovementioned facilitatory effect was predictive or integrative in nature, and concluded that the parser actively predicts a verb and (otherwise optional) negation on the basis of a preceding genitive-marked object. Similarly to a head-final language, case-marking information on preverbal noun phrases (NPs) is used by the parser to enable incremental structure building in a free-word-order language such as Russian.
Dekker, Anne-Britt E; Krijnen, Pieta; Schipper, Inger B
AIM: To investigate posttraumatic cytokine alterations and their value for predicting complications and mortality in polytraumatized patients. METHODS: Studies on the use of specific cytokines to predict the development of complications and mortality were identified in MEDLINE, EMBASE, Web of Science and the Cochrane Library. Of included studies, relevant data were extracted and study quality was scored. RESULTS: Forty-two studies published between 1988 and 2015 were identified, including 28 cohort studies and 14 “nested” case-control studies. Most studies investigated the cytokines interleukin (IL)-6, IL-8, IL-10 and tumor necrosis factor (TNF-α). IL-6 seems related to muliorgan dysfunction syndrome, multiorgan failure (MOF) and mortality; IL-8 appears altered in acute respiratory distress syndrome, MOF and mortality; IL-10 alterations seem to precede sepsis and MOF; and TNF-α seems related to MOF. CONCLUSION: Cytokine secretion patterns appear to be different for patients developing complications when compared to patients with uneventful posttraumatic course. More research is needed to strengthen the evidence for clinical relevance of these cytokines. PMID:27652210
Bian, Chong; Liang, Yun; Jiang, Libo; Qian, Chen; Dong, Jian
Objectives The study aimed to retrospectively evaluate the accuracy and value of magnetic resonance imaging (MRI) in predicting pedicle involvement for patients with spine metastases. Methods Forty-five patients with a vertebral metastasis encroaching at least one pedicle were studied using MRI before surgery and regularly after surgery. Patients were categorized on the basis of their numbers of pedicle involvement (Group 1: one pedicle was involved, n = 23; Group 2: two pedicles were involved, n = 22). The diagnostic accuracy was calculated, and comparisons of intraoperative blood loss and recurrence rate between the two groups were performed. Results The overall performance of MRI in predicting the pedicle involvement was as follows: accuracy, 94.4%; sensitivity, 95.5%; and specificity, 91.3%. Less intraoperative blood loss was observed for Group 1 compared with Group 2 (1,661 ± 672 ml and 2,173 ± 790 ml, respectively, P = 0.024). Tumor relapse occurred in 8.7% (2/23) of Group 1 and in 22.7% (5/22) of Group 2 with median recurrence free survival time 14 and 9 months, respectively. Conclusions MRI is a reliable approach to assess pedicle involvement. It has potential for use in the evaluation of the clinical characteristics of patients with spine metastases. PMID:27486876
Denecker, K.; van Assche, S.; Crombez, J.; Vander Vennet, R.; Lemahieu, I.
In financial market risk measurement, Value-at-Risk (VaR) techniques have proven to be a very useful and popular tool. Unfortunately, most VaR estimation models suffer from major drawbacks: the lognormal (Gaussian) modeling of the returns does not take into account the observed fat tail distribution and the non-stationarity of the financial instruments severely limits the efficiency of the VaR predictions. In this paper, we present a new approach to VaR estimation which is based on ideas from the field of information theory and lossless data compression. More specifically, the technique of context modeling is applied to estimate the VaR by conditioning the probability density function on the present context. Tree-structured vector quantization is applied to partition the multi-dimensional state space of both macroeconomic and microeconomic priors into an increasing but limited number of context classes. Each class can be interpreted as a state of aggregation with its own statistical and dynamic behavior, or as a random walk with its own drift and step size. Results on the US S&P500 index, obtained using several evaluation methods, show the strong potential of this approach and prove that it can be applied successfully for, amongst other useful applications, VaR and volatility prediction. The October 1997 crash is indicated in time.
Bustos B, Raúl; Padilla P, Oslando
The use of biomarkers could be a tool for diagnosis, prognosis and stratifying children with sepsis. Our main goal was to analyze the value of procalcitonin (PCT), C reactive protein (CRP) and lactate in predicting mortality, septic shock and the stratification in children with suspected sepsis Prospective study in 81 patients. Plasma levels of PCT, CRP and lactate were measured at admission in the pediatric intensive care unit. Patients were categorized into systemic inflammatory response syndrome, sepsis, severe sepsis and septic shock. Concentrations of PCT (ng/mL) increased significantly according to the severity of sepsis: 0.36 (0-1.2) for systemic inflammatory response syndrome; 1.96 (0.4-3.5) for sepsis; 7.5 (3.9-11.1) for severe sepsis; and 58.9 (35.1-82.7) for septic shock (P<.001). Compared to CRP and lactate, the area under the ROC curve revealed a good discriminative power of PCT to predict septic shock and mortality, 0.91 (95% CI: 0.83-0.97) and 0.80 (95% CI: 0.69-0.88), respectively. In contrast to CRP and lactate, the determination of PCT in pediatric intensive care unit admission is a good predictor of mortality and septic shock and can stratify patients according to severity of sepsis. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.
Youngs, Noah; Penfold-Brown, Duncan; Bonneau, Richard; Shasha, Dennis
Negative examples – genes that are known not to carry out a given protein function – are rarely recorded in genome and proteome annotation databases, such as the Gene Ontology database. Negative examples are required, however, for several of the most powerful machine learning methods for integrative protein function prediction. Most protein function prediction efforts have relied on a variety of heuristics for the choice of negative examples. Determining the accuracy of methods for negative example prediction is itself a non-trivial task, given that the Open World Assumption as applied to gene annotations rules out many traditional validation metrics. We present a rigorous comparison of these heuristics, utilizing a temporal holdout, and a novel evaluation strategy for negative examples. We add to this comparison several algorithms adapted from Positive-Unlabeled learning scenarios in text-classification, which are the current state of the art methods for generating negative examples in low-density annotation contexts. Lastly, we present two novel algorithms of our own construction, one based on empirical conditional probability, and the other using topic modeling applied to genes and annotations. We demonstrate that our algorithms achieve significantly fewer incorrect negative example predictions than the current state of the art, using multiple benchmarks covering multiple organisms. Our methods may be applied to generate negative examples for any type of method that deals with protein function, and to this end we provide a database of negative examples in several well-studied organisms, for general use (The NoGO database, available at: bonneaulab.bio.nyu.edu/nogo.html). PMID:24922051
Youngs, Noah; Penfold-Brown, Duncan; Bonneau, Richard; Shasha, Dennis
Negative examples - genes that are known not to carry out a given protein function - are rarely recorded in genome and proteome annotation databases, such as the Gene Ontology database. Negative examples are required, however, for several of the most powerful machine learning methods for integrative protein function prediction. Most protein function prediction efforts have relied on a variety of heuristics for the choice of negative examples. Determining the accuracy of methods for negative example prediction is itself a non-trivial task, given that the Open World Assumption as applied to gene annotations rules out many traditional validation metrics. We present a rigorous comparison of these heuristics, utilizing a temporal holdout, and a novel evaluation strategy for negative examples. We add to this comparison several algorithms adapted from Positive-Unlabeled learning scenarios in text-classification, which are the current state of the art methods for generating negative examples in low-density annotation contexts. Lastly, we present two novel algorithms of our own construction, one based on empirical conditional probability, and the other using topic modeling applied to genes and annotations. We demonstrate that our algorithms achieve significantly fewer incorrect negative example predictions than the current state of the art, using multiple benchmarks covering multiple organisms. Our methods may be applied to generate negative examples for any type of method that deals with protein function, and to this end we provide a database of negative examples in several well-studied organisms, for general use (The NoGO database, available at: bonneaulab.bio.nyu.edu/nogo.html).
Chang, Chun Yun; Esber, Guillem R; Marrero-Garcia, Yasmin; Yau, Hau-Jie; Bonci, Antonello; Schoenbaum, Geoffrey
Correlative studies have strongly linked phasic changes in dopamine activity with reward prediction error signaling. But causal evidence that these brief changes in firing actually serve as error signals to drive associative learning is more tenuous. While there is direct evidence that brief increases can substitute for positive prediction errors, there is no comparable evidence that similarly brief pauses can substitute for negative prediction errors. Lacking such evidence, the effect of increases in firing could reflect novelty or salience, variables also correlated with dopamine activity. Here we provide such evidence, showing in a modified Pavlovian over-expectation task that brief pauses in the firing of dopamine neurons in rat ventral tegmental area at the time of reward are sufficient to mimic the effects of endogenous negative prediction errors. These results support the proposal that brief changes in the firing of dopamine neurons serve as full-fledged bidirectional prediction error signals. PMID:26642092
Jeon, Tae Joo; Cho, Jae Hee; Kim, Yeon Suk; Song, Si Young; Park, Ji Young
Background/Aims When computed tomography (CT) does not indicate choledocholithiasis in highly suspicious patients, there is no definite consensus on the subsequent modality. Endoscopic ultrasonography (EUS) indicates fewer procedure-related complications than endoscopic retrograde cholangiopancreatography (ERCP) and has a lower cost than magnetic resonance cholangiopancreatography. Therefore, we aimed to investigate the diagnostic value of EUS in patients with suspected choledocholithiasis and negative CT findings. Methods Between March 2008 and November 2014, we retrospectively evaluated 200 patients with negative CT findings and high or intermediate probabilities of choledocholithiasis. All patients initially underwent EUS followed by ERCP as a confirmatory criterion standard. The primary outcome in these patients was the accuracy of EUS in the detection of choledocholithiasis. The secondary outcome was the clinical prediction of common bile duct (CBD) stones in this group. Results EUS indicated choledocholithiasis in 165 of the 200 patients, and ERCP confirmed choledocholithiasis in 161 patients (80.5%). The accuracy of EUS in the detection of choledocholithiasis was 94.0% (sensitivity, 97.5%; specificity, 79.5%; positive predictive value, 95.2%; negative predictive value, 88.6%). A multivariate analysis demonstrated that choledocholithiasis was strongly predicted by EUS detection of choledocholithiasis, an age >55 years and a clinical diagnosis of cholangitis. Conclusions An EUS-first approach is recommended for patients with suspected CBD stones and negative CT findings. PMID:27965473
Rassouli-Kirchmeier, Roxana; Lok, Maarten Janssen; Kusters, Benno; Nagtegaal, Iris; Köster, Nils; van der Steeg, Herjan; Wijnen, Marc; de Blaauw, Ivo
The diagnosis of Hirschsprung's disease (HD) remains challenging. The identification of ganglion cells is difficult and acetycholine esterase (AChE) staining can be subject to a great variability, particularly in the neonatal period (<8 weeks). Nerve trunks greater than 40 µm are considered to be predictive for HD. The aim of this study was to evaluate the usefulness of measuring nerve trunk size in the newborn with HD. Out of 292 biopsies 69 could be reanalyzed by three independent researchers. 40 µm was used as cutoff point for nerve trunk size. They were subdivided into three groups: (a) diagnosis of HD certain at the first biopsy, (b) no HD and (c) diagnosis of HD remains doubtful and re-biopsy taken. In 87 % of group A nerve trunk size was ≥ 40 µm (SD 13.8). In 84 % of group B trunk size was < 40 µm (SD 16.2). In group C only 60 % of the patients showed a positive correlation between final diagnosis and nerve trunk size. Using 40 µm as the cutoff point gave 13 % false-negative and 16 % false-positive cases. Measurement of the nerve trunk in the neonatal period does not seem to be a reliable method for detecting HD.
Lemmens, Louise; Kos, Snjezana; Beijer, Cornelis; Brinkman, Jacoline W; van der Horst, Frans A L; van den Hoven, Leonie; Kieslinger, Dorit C; van Trooyen-van Vrouwerff, Netty J; Wolthuis, Albert; Hendriks, Jan C M; Wetzels, Alex M M
To investigate the value of sperm parameters to predict an ongoing pregnancy outcome in couples treated with intrauterine insemination (IUI), during a methodologically stable period of time. Retrospective, observational study with logistic regression analyses. University hospital. A total of 1,166 couples visiting the fertility laboratory for their first IUI episode, including 4,251 IUI cycles. None. Sperm morphology, total progressively motile sperm count (TPMSC), and number of inseminated progressively motile spermatozoa (NIPMS); odds ratios (ORs) of the sperm parameters after the first IUI cycle and the first finished IUI episode; discriminatory accuracy of the multivariable model. None of the sperm parameters was of predictive value for pregnancy after the first IUI cycle. In the first finished IUI episode, a positive relationship was found for ≤4% of morphologically normal spermatozoa (OR 1.39) and a moderate NIPMS (5-10 million; OR 1.73). Low NIPMS showed a negative relation (≤1 million; OR 0.42). The TPMSC had no predictive value. The multivariable model (i.e., sperm morphology, NIPMS, female age, male age, and the number of cycles in the episode) had a moderate discriminatory accuracy (area under the curve 0.73). Intrauterine insemination is especially relevant for couples with moderate male factor infertility (sperm morphology ≤4%, NIPMS 5-10 million). In the multivariable model, however, the predictive power of these sperm parameters is rather low. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Freund, Alexandra M; Staudinger, Ursula M
In contrast to the PASTOR model by Kalisch et al. we point to the potential negative long-term effects of positive (re)appraisals of events for resilience. This perspective posits that emotional reactions to events provide important guidelines as to which events, environments, or social relations should be sought out and which ones should be avoided in the future.
Bitan, Yuval; O'Connor, Michael F
Alarm fatigue from high false alarm rate is a well described phenomenon in the intensive care unit (ICU). Progress to further reduce false alarms must employ a new strategy. Highly sensitive alarms invariably have a very high false alarm rate. Clinically useful alarms have a high Positive-Predictive Value. Our goal is to demonstrate one approach to suppressing false alarms using an algorithm that correlates information across sensors and replicates the ways that human evaluators discriminate artifact from real signal. After obtaining IRB approval and waiver of informed consent, a set of definitions, (hypovolemia, left ventricular shock, tamponade, hemodynamically significant ventricular tachycardia, and hemodynamically significant supraventricular tachycardia), were installed in the monitors in a 10 bed cardiothoracic ICU and evaluated over an 85 day study period. The logic of the algorithms was intended to replicate the logic of practitioners, and correlated information across sensors in a way similar to that used by practitioners. The performance of the alarms was evaluated via a daily interview with the ICU attending and review of the tracings recorded over the previous 24 hours in the monitor. True alarms and false alarms were identified by an expert clinician, and the performance of the algorithms evaluated using the standard definitions of sensitivity, specificity, positive predictive value, and negative predictive value. Between 1 and 221 instances of defined events occurred over the duration of the study, and the positive predictive value of the definitions varied between 4.1% and 84%. Correlation of information across alarms can suppress artifact, increase the positive predictive value of alarms, and can employ more sophisticated definitions of alarm events than present single-sensor based systems.
Good, Jessica J.; Sanchez, Diana T.
Past research has shown that valuing gender conformity is associated with both positive and negative consequences for self-esteem and positive affect. The current research (women, n= 226; men, n= 175) explored these conflicting findings by separating out investing in societal gender ideals from personally valuing one's gender identity ("private…
Chronis, T.; Koshak, W.; McCaul, E.
This study examines the temporal (monthly) and spatial climatology (2004-2010) of the first return stroke of the cloud-to-ground (CG) lightning flash peak current (Ip) across various land/water boundaries over the contiguous United States. Four regions are examined: the Gulf of Mexico (region 1), the Florida peninsula (region 2), Lake Michigan (region 3), and part of the U.S. Mid-Atlantic (region 4). The crosss across the coastlines of regions 1, 2, and 4 show a gradual oceanward increase in the mean negative polarity CG peak current values (-Ip). This transition along the respective land/ocean boundaries is not sharp but gradual. In direct contrast with ocean, there is no consistent behavior in -Ip values as we move from land out across the fresh water of Lake Michigan (region 3). Meanwhile, the positive CG flash peak current (+Ip) values do not exhibit a consistent variation across any coastal boundary. For region 1, the -Ip values increase as we move toward the coast (southwards) especially during the wet season (June-October). This finding is in direct contrast with studies that documented winter as the season of maximum -Ip values. The zonal and seasonal variations of -Ip values across region 4 are not quite as pronounced, but the oceanic -Ip values are still larger than over the adjoining landmass. We explore in turn which up to date hypotheses pertinent to the oceanic -Ip enhancement are supported or refuted by our findings. It is concluded that the oceanic -Ip enhancement is not an artifact related to CG detection or Ip retrieval methods, nor is it likely related to the cloud top heights or CG activity. The study cannot refute the role of electrical conductivity and its contribution to CG leader attachment processes. However, given the observed "blurred transition" of the Ip values across the coastlines this paper suggests that likely the main physical mechanism is acting on the thundercloud potential. The recently suggested role of sodium chloride (Na
Morrell, Holly E R; Cohen, Lee M; McChargue, Dennis E
This study examined the association between vulnerability to depression and smoking behavior in 1214 college students (54% female), and evaluated gender and expectancies of negative affect reduction as moderators or mediators of this relationship. Depression vulnerability predicted smoking in females, but not males. The relationship between depression vulnerability and smoking status was mediated by expectancies of negative affect reduction in females only. Female college students who are vulnerable to depression may smoke because they expect smoking to relieve negative affect. Smoking interventions for college females may increase in effectiveness by targeting depression and emphasizing mood regulation. Copyright 2010 Elsevier Ltd. All rights reserved.
Manjrekar, Eishita; Berenbaum, Howard
In a sample of 304 female college students, the present study examined how body image is associated with (a) clarity of emotion; (b) attention to emotion; and (c) negative affect. Two separate facets of body image were examined: body satisfaction and body distortion. Greater clarity of emotion was associated with greater body satisfaction and less body distortion, and these associations could not be accounted for by negative affect. Body satisfaction was significantly predicted by the three-way interaction of clarity of emotion, attention to emotion, and negative affect. Attention to emotion moderated the association between clarity of emotion and body satisfaction only among high negative affect individuals. Specifically, greater clarity of emotion was associated with greater body satisfaction in all participants except those who were high in both negative affect and attention to emotion. Copyright © 2012 Elsevier Ltd. All rights reserved.
Simms, Leonard J; Yufik, Tom; Gros, Daniel F
The Big Seven model of personality includes five dimensions similar to the Big Five model as well as two evaluative dimensions—Positive Valence (PV) and Negative Valence (NV)—which reflect extremely positive and negative person descriptors, respectively. Recent theory and research have suggested that PV and NV predict significant variance in personality disorder (PD) above that predicted by the Big Five, but firm conclusions have not been possible because previous studies have been limited to only single measures of PV, NV, and the Big Five traits. In the present study, we replicated and extended previous findings using three markers of all key constructs—including PV, NV, and the Big Five—in a diverse sample of 338 undergraduates. Results of hierarchical multiple regression analyses revealed that PV incrementally predicted Narcissistic and Histrionic PDs above the Big Five and that NV nonspecifically incremented the prediction of most PDs. Implications for dimensional models of personality pathology are discussed.
Steiman, Jennifer; Soran, Atilla; McAuliffe, Priscilla; Diego, Emilia; Bonaventura, Marguerite; Johnson, Ronald; Ahrendt, Gretchen; McGuire, Kandace
Magnetic resonance imaging (MRI) is commonly used to determine residual breast disease after neoadjuvant chemotherapy (NCT) for cancer. Few studies have assessed its role in predicting nodal response, by cancer subtype. A retrospective review was completed using our institutional cancer registry. Patients who started NCT from 2005 to 2010 with clinically node positive disease were evaluated. Those who underwent post-NCT breast MRI were selected. Radiologic response was determined by an independent review. Nodal involvement was confirmed pathologically after surgery. A total of 135 patients underwent post-NCT breast MRI. The positive and negative predictive values of MRI are 93% and 26%, respectively. A subset analysis by cancer phenotype demonstrates triple negative cancers have the highest sensitivity (68%) and luminal cancers have the highest positive predictive value (100%). This study demonstrates that MRI post-NCT, even by cancer subtype, cannot reliably predict residual nodal disease because of high false-negative rates (low negative-predictive value). Copyright © 2016 Elsevier Inc. All rights reserved.
Hesse, Lutz; Heller, Günther; Kraushaar, Nicola; Wesp, Alexandra; Schroeder, Bernd; Kroll, Peter
Kroll's classification of proliferative diabetic vitreoretinopathy (PDVR) defines stage A (vitreoretinal proliferations without retinal detachment), stage B (partially detached retina not involving the macula), stage C (partially detached macula) and stage D (completely detached macula). The purpose of this study was to analyse the prognostic value of Kroll's classification in respect of the postoperative results of vitreoretinal surgery based on our group of patients. The charts of 563 patients who underwent vitrectomy because of PDVR between 1990 and 1997 were examined retrospectively. Postoperative visual acuity, possible risk factors, frequencies of silicone oil tamponade and revitrectomies were related to the preoperative staging of PDVR. The influence of possible predictive factors on the postoperative visual outcome were evaluated using multivariate logistic regression analysis. After vitreoretinal surgery mean postoperative visual acuity was significantly better in stage A compared to stage C (p < 0.01) or D (p < 0.0001). In 179 out of 563 eyes (31.7 %) revitrectomy (including silicone oil removal) was required and in 51 eyes (9.1 %) more than one revitrectomy was performed. Silicone oil tamponade was used in 22 out of 253 eyes (8.7 %) classified as stage A, in 27 out of 201 eyes (13.4 %) of stage B, in 17 out of 78 eyes (21.8 %) of stage C and in 10 of 31 eyes (32.3 %) of stage D. Postoperative increase of visual acuity of more than 3 lines was significantly less frequent in stage B (p < 0.014), C (p < 0.039) and D (p < 0.001) compared to stage A. Kroll's classification for PDVR has a high prognostic value for the postoperative visual outcome and level of surgical risk management. Thus patients with good prognosis can be identified easily, facilitating the decision for surgery.
Sun, J R; Zhang, Y N; Sun, X M; Feng, S Y; Yan, M
This study was designed to investigate the risk factors of pelvic lymph node metastasis in early stage cervical cancer in order to establish a prediction model for this metastasis and to explore the feasibility of conservative surgery. The records of 207 stage IB-IIA cervical cancer patients were retrospectivly analyzed. The risk factors of pelvic lymph node metastasis were analyzed using univariate and multivariate methods. The prediction model for pelvic lymph node metastasis was established by logistic regression. Without preoperative adjuvant therapy, the metastatic rate of pelvic lymph node in stage IB-IIA cervical cancer was 25.1%. The serum SCCAg, the tumor diameter, the depth of cervical stroma invasion, and the cervical canal involvement were revealed as the risk factors of pelvic lymph node metastasis by univariate analysis (P<0.05). Multivariate analysis showed that the serum SCCAg and the depth of cervical stroma invasion were the independent risk factors of pelvic lymph node metastasis (P<0.05, OR = 6.917, 2.227). The patients were divided into three groups according to different independent risk factors: the low-risk group, the medium-risk group, and the high-risk group, which showed metastatic rates of pelvic lymph node of 5.7%, 16.9%, and 48.7%, respectively (P<0.001). A prediction model for pelvic lymph node metastasis was established as follows: Logti(P) = -2.534 + serum SCCAg×1.934 + depth of cervical stroma invasion×0.801. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of this prediction model were 53.8%, 83.9 %, 52.8%, 84.4%, and 76.3%, respectively. The serum SCCAg and the depth of cervical stroma invasion were the independent risk factors of pelvic lymph node metastasis in early stage cervical cancer. The proposed prediction model may help to improve the conservative surgery for early stage cervical cancer.
Piazza, Cathleen C.; And Others
A stimulus preference assessment was evaluated with an adult and a child with profound mental retardation and severe self-injurious behavior, in order to better predict both the beneficial and negative side effects of stimuli in differential-reinforcement-of-other-behavior treatments. (DB)
Cohen, Lawrence H.; Gunthert, Kathleen C.; Butler, Andrew C.; Parrish, Brendt P.; Wenze, Susan J.; Beck, Judith S.
This study evaluated the predictive role of depressed outpatients' (N = 62) affective reactivity to daily stressors in their rates of improvement in cognitive therapy (CT). For 1 week before treatment, patients completed nightly electronic diaries that assessed daily stressors and negative affect (NA). The authors used multilevel modeling to…
Cohen, Lawrence H.; Gunthert, Kathleen C.; Butler, Andrew C.; Parrish, Brendt P.; Wenze, Susan J.; Beck, Judith S.
This study evaluated the predictive role of depressed outpatients' (N = 62) affective reactivity to daily stressors in their rates of improvement in cognitive therapy (CT). For 1 week before treatment, patients completed nightly electronic diaries that assessed daily stressors and negative affect (NA). The authors used multilevel modeling to…
Vallejo, Maite; Hermosillo, Antonio G; Márquez, Manlio F; Urquidez, Alma K; Sotomayor, Arturo; Salas, Elizabeth; Cárdenas, Manuel
Studies to assess the value of clinical symptoms to predict the head-up tilt test (HUT) outcome in patients with suspicion of vasovagal syncope have shown controversial results. We undertook this study to compare the frequency of symptoms between subjects with and without history of syncope, its association with syncopal spells in those with a history of syncope and positive or negative HUT, and to identify clinical predictors of HUT outcome. Sixty seven subjects with a history of unexplained syncope and 26 subjects without a history of syncope were interviewed using a structured questionnaire before undergoing HUT, which was performed first in a passive phase and, if negative, was repeated with pharmacological challenge using 5 mg of sublingual isosorbide. Questionnaire included the 16 symptoms most frequently reported in previous studies. Only five symptoms were reported more frequently by subjects with history of syncope in comparison with subjects without it: visual blurring, dysesthesia, sighing dyspnea, tremor in fingers, and diaphoresis. Comparison of symptom frequency between patients with history of syncope and positive or negative HUT revealed that only two were significantly different: nausea and hot flashes. However, a detailed analysis of the data indicates that only hot flashes occurring just before the syncope were more common in those with a positive HUT. Although some symptoms were found more frequently in patients with a history of syncope than in those without it, the use of a structured questionnaire in the group of patients failed to predict the outcome of the HUT.
Wu, San-Gang; Peng, Fang; Zhou, Juan; Sun, Jia-Yuan; Li, Feng-Yan; Lin, Qin; Lin, Huan-Xin; Bao, Yong; He, Zhen-Yu
Purpose: To assess the prognostic value of the number of negative lymph nodes (NLNs) in breast cancer patients with positive axillary lymph nodes after mastectomy and its predictive value for radiotherapy efficacy of different breast cancer subtypes (BCS). Methods: The records of 1,260 breast cancer patients with positive axillary lymph nodes who received mastectomy between January 1998 and December 2007 were reviewed. The prognostic impact and predictive value of the number of NLNs with respect to locoregional recurrence-free survival (LRFS), disease-free survival (DFS), and overall survival (OS) were analyzed. Results: The median follow-up time was 58 months, and 444 patients (35.2%) received postmastectomy radiotherapy (PMRT). Univariate and multivariate Cox survival analysis indicated the number of NLNs was an independent prognostic factor of LRFS, DFS, and OS. Patients with a higher number of NLNs had better survival. PMRT improved the LRFS of patients with ≤ 8 NLNs ( p < 0.001), while failing to improve the LRFS of patients with > 8 NLNs (p = 0.075). In patients with luminal A subtype, PMRT improved the LRFS, DFS, and OS of patients with ≤ 8 NLNs, but in patients with > 8 NLNs only the LRFS was improved. For patients with luminal B subtype, PMRT only improved the LRFS of patients with ≤ 8 NLNs. The number of NLNs had no predictive value for the efficacy with PMRT in Her2+ and triple-negative subtypes. Conclusions: The number of NLNs is a prognostic indicator in patients with node-positive breast cancer, and it can predict the efficacy of PMRT according to different BCS. PMID:25663944
Mayxay, Mayfong; Phetsouvanh, Rattanaphone; Moore, Catrin E; Chansamouth, Vilada; Vongsouvath, Manivanh; Sisouphone, Syho; Vongphachanh, Pankham; Thaojaikong, Thaksinaporn; Thongpaseuth, Soulignasack; Phongmany, Simmaly; Keolouangkhot, Valy; Strobel, Michel; Newton, Paul N
Objective To examine the accuracy of the admission tourniquet test in the diagnosis of dengue infection among Lao adults. Methods Prospective assessment of the predictive diagnostic value of the tourniquet test for the diagnosis of dengue infection, as defined by IgM, IgG and NS1 ELISAs (Panbio Ltd, Australia), among Lao adult inpatients with clinically suspected dengue infection. Results Of 234 patients with clinically suspected dengue infection on admission, 73% were serologically confirmed to have dengue, while 64 patients with negative dengue serology were diagnosed as having scrub typhus (39%), murine typhus (11%), undetermined typhus (12%), Japanese encephalitis virus (5%), undetermined flavivirus (5%) and typhoid fever (3%); 25% had no identifiable aetiology. The tourniquet test was positive in 29.1% (95% CI = 23.2–34.9%) of all patients and in 34.1% (95% CI = 27.0–41.2%) of dengue-seropositive patients, in 32.7% (95% CI = 23.5–41.8) of those with dengue fever and in 36.4% (95% CI = 24.7–48.0) of those with dengue haemorrhagic fever. Interobserver agreement for the tourniquet test was 90.2% (95% CI = 86.4–94.0) (Kappa = 0.76). Using ELISAs as the diagnostic gold standard, the sensitivity of the tourniquet test was 33.5–34%; its specificity was 84–91%. The positive and negative predictive values were 85–90% and 32.5–34%, respectively. Conclusions The admission tourniquet test has low sensitivity and adds relatively little value to the diagnosis of dengue among Lao adult inpatients with suspected dengue. Although a positive tourniquet test suggests dengue and that treatment of alternative diagnoses may not be needed, a negative test result does not exclude dengue. PMID:20958892
van Prooijen, Jan-Willem; Krouwel, André P M; Boiten, Max; Eendebak, Lennart
The "rigidity of the right" hypothesis predicts that particularly the political right experiences fear and derogates outgroups. We propose that above and beyond that, the political extremes (at both sides of the spectrum) are more likely to display these responses than political moderates. Results of a large-scale sample reveal the predicted quadratic term on socio-economic fear. Moreover, although the political right is more likely to derogate the specific category of immigrants, we find a quadratic effect on derogation of a broad range of societal categories. Both extremes also experience stronger negative emotions about politics than politically moderate respondents. Finally, the quadratic effects on derogation of societal groups and negative political emotions were mediated by socio-economic fear, particularly among left- and right-wing extremists. It is concluded that negative emotions and outgroup derogation flourish among the extremes. © 2015 by the Society for Personality and Social Psychology, Inc.
This article proposes that acculturation orientations are related to two sets of cultural values: utilitarianism (Ut) and traditionalism (Tr). While utilitarian values enhance assimilation, traditional values support language and identity maintenance. It is proposed that the propensity to either end of this value opposition can be measured by an…
This article proposes that acculturation orientations are related to two sets of cultural values: utilitarianism (Ut) and traditionalism (Tr). While utilitarian values enhance assimilation, traditional values support language and identity maintenance. It is proposed that the propensity to either end of this value opposition can be measured by an…
de Jong, Elisabeth M.; Jellesma, Francine C.; Koomen, Helma M. Y.; de Jong, Peter F.
Previous research showed that a values-affirmation intervention can help reduce the achievement gap between African American and European American students in the US. In the present study, it was examined if these results would generalize to ethnic minority students in a country outside the US, namely the Netherlands, where there is also an achievement gap between native and ethnic minority students. This type of intervention was tested in two separate studies, the first among first-year pre-vocational students (n = 361, 84% ethnic minority), and the second among sixth grade students (n = 290, 96% ethnic minority). Most minority participants had a Turkish-Dutch or Moroccan-Dutch immigrant background. In the second study, a third condition was added to the original paradigm, in which students elaborated on either their affirmation- or a control exercise with the help of a teaching assistant. We also examined whether values affirmation affected the level of problem behavior of negatively stereotyped ethnic minority youth. Contrary to what was expected, multilevel analyses revealed that the intervention had no effect on the school achievement or the problem behavior of the ethnic minority students. Possible explanations for these findings, mainly related to contextual and cultural differences between the Netherlands and the US, are discussed. PMID:27242604
Moghadam, Rosa; Lathi, Ruth B.; Shahmohamady, Babac; Saberi, Naghmeh S.; Nezhat, Ceana H.; Nezhat, Farr
Objective: We evaluated the role of MRI as a preoperative diagnostic tool for leiomyoma and adenomyosis. Method: This is a retrospective chart review at a university-based hospital. The study included 1517 women who underwent hysterectomy or myomectomy over a 5-year period, and 153 women with a preoperative pelvic MRI were included. Comparisons were made between the results of the MRI and postoperative pathology reports. Results: The MRI and pathology report were the same for 136 of 144 women with leiomyoma and 12 of 31 women with adenomyosis. The MRI had 94% sensitivity and 33% specificity for leiomyoma and 38% sensitivity and 91% specificity for adenomyosis. Positive and negative predictive values of MRI for leiomyoma were 95% and 27% with 90% accuracy. Positive and negative predictive values of MRI for adenomyosis were 52% and 85%, respectively, with 80% accuracy. Conclusion: MRI has a high sensitivity and a low specificity for diagnosing leiomyoma and a high specificity and a low sensitivity for diagnosing adenomyosis. Due to the high cost and technical variations, we suggest using MRI only as an adjunctive diagnostic tool when ultrasound is not conclusive and differentiation between the 2 pathologies ultimately affects patient management. PMID:16882423
Ober, Ulrike; Erbe, Malena; Long, Nanye; Porcu, Emilio; Schlather, Martin; Simianer, Henner
Genomic data provide a valuable source of information for modeling covariance structures, allowing a more accurate prediction of total genetic values (GVs). We apply the kriging concept, originally developed in the geostatistical context for predictions in the low-dimensional space, to the high-dimensional space spanned by genomic single nucleotide polymorphism (SNP) vectors and study its properties in different gene-action scenarios. Two different kriging methods [“universal kriging” (UK) and “simple kriging” (SK)] are presented. As a novelty, we suggest use of the family of Matérn covariance functions to model the covariance structure of SNP vectors. A genomic best linear unbiased prediction (GBLUP) is applied as a reference method. The three approaches are compared in a whole-genome simulation study considering additive, additive-dominance, and epistatic gene-action models. Predictive performance is measured in terms of correlation between true and predicted GVs and average true GVs of the individuals ranked best by prediction. We show that UK outperforms GBLUP in the presence of dominance and epistatic effects. In a limiting case, it is shown that the genomic covariance structure proposed by VanRaden (2008) can be considered as a covariance function with corresponding quadratic variogram. We also prove theoretically that if a specific linear relationship exists between covariance matrices for two linear mixed models, the GVs resulting from BLUP are linked by a scaling factor. Finally, the relation of kriging to other models is discussed and further options for modeling the covariance structure, which might be more appropriate in the genomic context, are suggested. PMID:21515573
Shokouhi, Shervin; Darazam, Ilad Alavi; Karamipour, Mehdi; Ahmadi, HasanAli; Sajadi, Mohammad M
Rapid and accurate diagnostic tests for patients with suspected bacterial meningitis is crucial to prevent subsequent mortality and morbidity. We carried out this study to determine diagnostic value of the rapid leukocyte esterase (LE) strip test to identify PMN pleocytosis in cerebral spinal fluid. A total of 126 patients with suspected meningitis were enrolled in this prospective study. Microscopic examination (cell count and differential) and leukocyte esterase (LE) rapid strip test was performed on cerebrospinal fluid (CSF) samples. Sensitivity, specificity, positive predictive value and negative predictive value of the LE test were determined. The receiver operating characteristic (ROC) was used to calculate the best cut-point values. Fifty and two (41%) of patients had pleocytosis in the CSF, while 48 (38%) patients had a positive result the using rapid strip test. The diagnostic accuracy of this test for pleocytosis translated to a sensitivity of 85% and a specificity of 86%, with an area under the curve of 0.88. The rapid LE strip test could be considered an additional test in the patient bedside for diagnosis of pleocytosis in CSF. It is a feasible test in resource-limited settings. Copyright© Bentham Science Publishers; For any queries, please email at email@example.com.
Sulieman, Lina; Fabbri, Daniel; Wang, Fei; Hu, Jianying; Malin, Bradley A
Predicting negative outcomes, such as readmission or death, and detecting high-risk patients are important yet challenging problems in medical informatics. Various models have been proposed to detect high-risk patients; however, the state of the art relies on patient information collected before or at the time of discharge to predict future outcomes. In this paper, we investigate the effect of including data generated post discharge to predict negative outcomes. Specifically, we focus on two types of patients admitted to the Vanderbilt University Medical Center between 2010-2013: i) those with an acute event - 704 hip fractures and ii) those with chronic problems — 5250 congestive heart failure (CHF) patients. We show that the post-discharge model improved the AUC of the LACE index, a standard readmission scoring function, by 20 - 30%. Moreover, the new model resulted in higher AUCs by 15 - 27% for hip fracture and 10 - 12% for CHF compared to standard models. PMID:28269914
Mahr, Cynthia V; Dengl, Markus; Nestler, Ulf; Reiss-Zimmermann, Martin; Eichner, Gerrit; Preuß, Matthias; Meixensberger, Jürgen
OBJECTIVE The aim of the study was to analyze the diagnostic and predictive values of clinical tests, CSF dynamics, and intracranial pulsatility tests, compared with external lumbar drainage (ELD), for shunt response in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS Sixty-eight consecutive patients with suspected iNPH were prospectively evaluated. Preoperative assessment included clinical tests, overnight intracranial pressure (ICP) monitoring, lumbar infusion test (LIFT), and ELD for 24-72 hours. Simple and multiple linear regression analyses were conducted to identify predictive parameters concerning the outcome after shunt therapy. RESULTS Positive response to ELD correctly predicted improvement after CSF diversion in 87.9% of the patients. A Mini-Mental State Examination (MMSE) value below 21 was associated with nonresponse after shunt insertion (specificity 93%, sensitivity 67%). Resistance to outflow of CSF (ROut) > 12 mm Hg/ml/min was false negative in 21% of patients. Intracranial pulsatility parameters yielded different results in various parameters (correlation coefficient between pulse amplitude and ICP, slow wave amplitude, and mean ICP) but did not correlate to outcome. In multiple linear regression analysis, a calculation of presurgical MMSE versus the value after ELD, ROut, and ICP amplitude quotient during LIFT was significantly associated with outcome (p = 0.04). CONCLUSIONS Despite a multitude of invasive tests, presurgical clinical testing and response to ELD yielded the best prediction for improvement of symptoms following surgery. The complication rate of invasive testing was 5.4%. Multiple and simple linear regression analyses indicated that outcome can only be predicted by a combination of parameters, in accordance with a multifactorial pathogenesis of iNPH.
MacFadden, Derek R; Coburn, Bryan; Shah, Nirav; Robicsek, Ari; Savage, Rachel; Elligsen, Marion; Daneman, Nick
Appropriate empiric antibiotic therapy in patients with bloodstream infections due to Gram-negative pathogens can improve outcomes. We evaluated the utility of prior microbiologic results for guiding empiric treatment in Gram-negative bloodstream infections. We conducted a multi-center observational cohort study, in two large health systems in Canada and the United States, including 1,832 hospitalized patients with Gram-negative bloodstream infection (community, hospital, and ICU acquired) from April 2010 to March 2015. Among 1,832 patients with Gram-negative bloodstream infection, 28% (504/1,832) of patients had a documented prior Gram-negative organism from a non-screening culture within the previous 12 months. A most-recent prior Gram-negative organism resistant to a given antibiotic was strongly predictive of the current organism's resistance to the same antibiotic. The overall specificity was 0.92 (95%CI:0.91-0.93) and positive predictive value was 0.66 (95%CI:0.61-0.70) for predicting antibiotic resistance. Specificities and positive predictive values ranged from (0.77 to 0.98) and (0.43 to 0.78) across different antibiotics, organisms, and patient subgroups. Increasing time between cultures was associated with a decrease in positive predictive value but not specificity. An heuristic based on a prior resistant Gram-negative could have been applied to 1 in 4 patients, and in these patients would have changed therapy in 1 in 5. In patients with a bloodstream infection with a Gram-negative organism, identification of a most-recent prior Gram-negative organism resistant to a drug of interest (within the last 12 months) is highly specific for resistance and should preclude use of that antibiotic. Copyright © 2017. Published by Elsevier Ltd.
Deng, Jingyu; Zhang, Rupeng; Zhang, Li; Liu, Yong; Hao, Xishan; Liang, Han
Objective To demonstrate that the seventh edition of the tumor-node-metastasis (TNM) classification for gastric cancer (GC) should be updated with the number of negative lymph nodes for the improvement of its prognostic prediction accuracy. Methods Clinicopathological data of 769 GC patients who underwent curative gastrectomy with lymphadenectomy between 1997 and 2006 were retrospectively analyzed to demonstrate the superiority of prognostic efficiency of the seventh edition of the TNM classification, which can be improved by combining the number of negative lymph nodes. Results With the Cox regression multivariate analysis, the seventh edition of the TNM classification, the number of negative nodes, the type of gastrectomy, and the depth of tumor invasion (T stage) were identified as independent factors for predicting the overall survival of GC patients. Furthermore, we confirmed that the T stage-N stage–number of negative lymph nodes–metastasis (TNnM) classification is the most appropriate prognostic predictor of GC patients by using case-control matched fashion and multinominal logistic regression. Finally, we were able to clarify that TNnM classification may provide more precise survival differences among the different TNM sub-stages of GC by using the measure of agreement (Kappa coefficient), the McNemar value, the Akaike information criterion, and the Bayesian Information Criterion compared with the seventh edition of the TNM classification. Conclusion The number of negative nodes, as an important prognostic predictor of GC, can improve the prognostic prediction efficiency of the seventh edition of the TNM classification for GC, which should be recommended for conventional clinical applications. PMID:24348906
Deng, Jingyu; Zhang, Rupeng; Zhang, Li; Liu, Yong; Hao, Xishan; Liang, Han
To demonstrate that the seventh edition of the tumor-node-metastasis (TNM) classification for gastric cancer (GC) should be updated with the number of negative lymph nodes for the improvement of its prognostic prediction accuracy. Clinicopathological data of 769 GC patients who underwent curative gastrectomy with lymphadenectomy between 1997 and 2006 were retrospectively analyzed to demonstrate the superiority of prognostic efficiency of the seventh edition of the TNM classification, which can be improved by combining the number of negative lymph nodes. With the Cox regression multivariate analysis, the seventh edition of the TNM classification, the number of negative nodes, the type of gastrectomy, and the depth of tumor invasion (T stage) were identified as independent factors for predicting the overall survival of GC patients. Furthermore, we confirmed that the T stage-N stage-number of negative lymph nodes-metastasis (TNnM) classification is the most appropriate prognostic predictor of GC patients by using case-control matched fashion and multinominal logistic regression. Finally, we were able to clarify that TNnM classification may provide more precise survival differences among the different TNM sub-stages of GC by using the measure of agreement (Kappa coefficient), the McNemar value, the Akaike information criterion, and the Bayesian Information Criterion compared with the seventh edition of the TNM classification. The number of negative nodes, as an important prognostic predictor of GC, can improve the prognostic prediction efficiency of the seventh edition of the TNM classification for GC, which should be recommended for conventional clinical applications.
Nicholson, Emma L; Bryant, Richard A; Felmingham, Kim L
Recent evidence suggests that an interaction of noradrenaline (NE) and cortisol (CORT) during encoding leads to greater consolidation of emotional memories. Convergent models of posttraumatic stress disorder (PTSD) suggest the release of CORT and NE lead to greater intrusive memories in PTSD. This study examined the effect of NE and CORT during encoding on recall and intrusive memories in PTSD. Fifty-eight participants (18 participants with PTSD, 20 trauma-exposed controls, and 20 non-trauma exposed controls) provided saliva samples of NE (indexed by salivary alpha amylase; sAA) and CORT at (a) baseline and (b) after viewing negative emotional stimuli. Delayed memory recall and number of intrusive memories of negative, neutral and positive stimuli were recorded two days after this initial testing session. The PTSD group had greater NE levels to negative stimuli and reported greater numbers of intrusive memories of negative stimuli than controls. Regression analyses revealed that the interaction of CORT and NE significantly predicted negative intrusive memories in the PTSD group. The trauma-exposed group reported significantly greater recall of negative images compared to controls, but did not differ significantly from the PTSD group. The PTSD group reported greater levels of suppression of negative images during encoding compared to the other groups. Our results confirm that the interaction of NE and CORT significantly predicts greater negative intrusive memories, but this occurs specifically in the PTSD group. This suggests that a level of heightened arousal is required for the relationship between stress hormones and emotional memory to manifest in PTSD.
Abram, Samantha V; Wisner, Krista M; Fox, Jaclyn M; Barch, Deanna M; Wang, Lei; Csernansky, John G; MacDonald, Angus W; Smith, Matthew J
Impaired cognitive empathy is a core social cognitive deficit in schizophrenia associated with negative symptoms and social functioning. Cognitive empathy and negative symptoms have also been linked to medial prefrontal and temporal brain networks. While shared behavioral and neural underpinnings are suspected for cognitive empathy and negative symptoms, research is needed to test these hypotheses. In two studies, we evaluated whether resting-state functional connectivity between data-driven networks, or components (referred to as, inter-component connectivity), predicted cognitive empathy and experiential and expressive negative symptoms in schizophrenia subjects. Study 1: We examined associations between cognitive empathy and medial prefrontal and temporal inter-component connectivity at rest using a group-matched schizophrenia and control sample. We then assessed whether inter-component connectivity metrics associated with cognitive empathy were also related to negative symptoms. Study 2: We sought to replicate the connectivity-symptom associations observed in Study 1 using an independent schizophrenia sample. Study 1 results revealed that while the groups did not differ in average inter-component connectivity, a medial-fronto-temporal metric and an orbito-fronto-temporal metric were related to cognitive empathy. Moreover, the medial-fronto-temporal metric was associated with experiential negative symptoms in both schizophrenia samples. These findings support recent models that link social cognition and negative symptoms in schizophrenia. Hum Brain Mapp 38:1111-1124, 2017. © 2016 Wiley Periodicals, Inc.
Geschwind, Nicole; Nicolson, Nancy A; Peeters, Frenk; van Os, Jim; Barge-Schaapveld, Daniela; Wichers, Marieke
Knowledge on mechanisms involved in early prediction of response to antidepressant medication may help optimize clinical decision making. Recent studies regarding response to pharmacotherapy implicate resilience-like mechanisms and involvement of positive, rather than negative emotions. The aim of the current study is to examine the contribution of early change in positive affect to the prediction of response to pharmacotherapy. Positive and negative emotions were measured at baseline and during the first week of pharmacotherapy, using experience sampling techniques. The association between early change in positive and negative emotions and severity of depressive symptoms at week six was examined in a sample of 49 depressed patients. The added benefits of measuring early change in positive emotions compared to early Hamilton Depression Rating Scale (HDRS) change alone were evaluated through model comparisons. Early improvement in positive affect during the first week of treatment predicted the continuous HDRS score (β=-0.64, p<0.001), response (50% reduction; OR=4.32, p<0.01), and remission (HDRS≤7; OR=9.29, p<0.001) at week six with moderate to large effect sizes. Effects of early change in negative emotions were only half as large and disappeared when evaluated simultaneously with early change in positive emotions. When early change in positive emotions was added to the models including early HDRS change only, all three models improved significantly. In conclusion, early change in positive rather than negative emotions best predicted response to treatment, supporting the notion that antidepressants activate resilience-like mechanisms. Moreover, monitoring of positive emotions in early stages of treatment may improve clinical decision making. Copyright © 2010 Elsevier B.V. and ECNP. All rights reserved.
Zimmermann, Ronan; Gschwandtner, Ute; Wilhelm, Frank H; Pflueger, Marlon O; Riecher-Rössler, Anita; Fuhr, Peter
EEG power in the delta, theta and beta1 bands has been shown to be positively correlated with negative symptoms in first episode psychotic patients. The present study investigates this correlation in an "at risk mental state for psychosis" (ARMS) with the aim to improve prediction of transition to psychosis. Thirteen ARMS patients with later transition to psychosis (ARMS-T) and fifteen without (follow-up period of at least 4 years) (ARMS-NT) were investigated using spectral resting EEG data (of 8 electrodes over the fronto-central scalp area placed according to the 10-20 system) and summary score of the Scale for the Assessment of Negative Symptoms (SANS). Linear regressions were used to evaluate the correlation of SANS and EEG power in seven bands (delta, theta, alpha1, alpha2, beta1, beta2, beta3) in both ARMS groups and logistic regressions were used to predict transition to psychosis. Potentially confounding factors were controlled. ARMS-T and ARMS-NT showed differential correlations of EEG power and SANS in delta, theta, and beta1 bands (p<.05): ARMS-T showed positive and ARMS-NT negative correlations. Logistic regressions showed that neither SANS score nor EEG spectral power alone predicted transition to psychosis. However, SANS score in combination with power in the delta, theta, beta1, and beta2 bands, respectively, predicted transition significantly (p<.03). ARMS-T and ARMS-NT show differential correlations of SANS summary score and EEG power in delta, theta, and beta bands. Prediction of transition to psychosis is possible using combined information from a negative symptom scale and EEG spectral data. Copyright © 2010 Elsevier B.V. All rights reserved.
Xi, Jianing; Li, Ao
Recurrent copy number aberrations (RCNAs) in multiple cancer samples are strongly associated with tumorigenesis, and RCNA discovery is helpful to cancer research and treatment. Despite the emergence of numerous RCNA discovering methods, most of them are unable to detect RCNAs in complex patterns that are influenced by complicating factors including aberration in partial samples, co-existing of gains and losses and normal-like tumor samples. Here, we propose a novel computational method, called non-negative sparse singular value decomposition (NN-SSVD), to address the RCNA discovering problem in complex patterns. In NN-SSVD, the measurement of RCNA is based on the aberration frequency in a part of samples rather than all samples, which can circumvent the complexity of different RCNA patterns. We evaluate NN-SSVD on synthetic dataset by comparison on detection scores and Receiver Operating Characteristics curves, and the results show that NN-SSVD outperforms existing methods in RCNA discovery and demonstrate more robustness to RCNA complicating factors. Applying our approach on a breast cancer dataset, we successfully identify a number of genomic regions that are strongly correlated with previous studies, which harbor a bunch of known breast cancer associated genes.
Tonnsen, Bridgette L; Malone, Patrick S; Hatton, Deborah D; Roberts, Jane E
Children with fragile X syndrome (FXS) face high risk for anxiety disorders, yet no studies have explored FXS as a high-risk sample for investigating early manifestations of anxiety outcomes. Negative affect is one of the most salient predictors of problem behaviors and has been associated with both anxiety and autistic outcomes in clinical and non-clinical pediatric samples. In light of the high comorbidity between autism and anxiety within FXS, the present study investigates the relationship between longitudinal trajectories of negative affect (between 8 and 71 months) and severity of anxiety and autistic outcomes in young males with FXS (n = 25). Multilevel models indicated associations between elevated anxiety and higher fear and sadness, lower soothability, and steeper longitudinal increases in approach. Autistic outcomes were unrelated to negative affect. These findings suggest early negative affect differentially predicts anxiety, not autistic symptoms, within FXS. Future research is warranted to determine the specificity of the relationship between negative affect and anxiety, as well as to explore potential moderators. Characterizing the relationship between early negative affect and anxiety within FXS may inform etiology and treatment considerations specific to children with FXS, as well as lend insight into precursors of anxiety disorders in other clinical groups and community samples.
The goal of the study was to determine patient factors predictive of good outcome after lumbar disc arthroplasty. Specifically, the paper examines the relationship of the preoperative Oswestry Disability Index (ODI) to patient outcome at 1 year. The study is a retrospective review of 20 patients undergoing a 1-level lumbar disc arthroplasty at the author's institution between 2004 and 2008. All data were collected prospectively. Data included the ODI, visual analog scale scores, and patient demographics. All patients underwent a 1-level disc arthroplasty at L4-5 or L5-S1. The patients were divided into 2 groups based on their baseline ODI. Patients with an ODI between 38 and 59 demonstrated better outcomes with lumbar disc arthroplasty. Only 1 (20%) of 5 patients with a baseline ODI higher than 60 reported a good outcome. In contrast, 13 (87%) of 15 patients with an ODI between 38 and 59 showed a good outcome (p = 0.03). The negative predictive value of using ODI > 60 is 60% in patients who are determined to be candidates for lumbar arthroplasty. Lumbar arthroplasty is very effective in some patients. Other patients do not improve after surgery. The baseline ODI results are predictive of outcome in patients selected for lumbar disc arthroplasty. A baseline ODI > 60 is predictive of poor outcome. A high ODI may be indicative of psychosocial overlay.
Cheung, Peter P; Mari, Karine; Devauchelle-Pensec, Valérie; Jousse-Joulin, Sandrine; D'Agostino, Maria Antonietta; Chalès, Gérard; Gaudin, Philippe; Mariette, Xavier; Saraux, Alain; Dougados, Maxime
Objective To evaluate the predictive value of tender joints compared to synovitis for structural damage in rheumatoid arthritis (RA). Methods A post hoc analysis was performed on a prospective 2-year study of 59 patients with active RA starting on antitumour necrosis factor (TNF). Tenderness and synovitis was assessed clinically at baseline, followed by blinded ultrasound assessment (B-mode and power Doppler ultrasound (PDUS)) on the hands and feet (2 wrists, 10 metacarpophalangeal, 10 proximal interphalangeal and 10 metatarsophalangeal (MTP) joints). Radiographs of these joints were performed at baseline and at 2 years. The risk of radiographic progression with respect to the presence of baseline tenderness or synovitis, as well as its persistence (after 4 months of anti-TNF), was estimated by OR (95% CI). Results Baseline tender joints were the least predictive for radiographic progression (OR=1.53 (95% CI 1.02 to 2.29) p<0.04), when compared to synovitis (clinical OR=2.08 (95% CI 1.39 to 3.11) p<0.001 or PDUS OR=1.80 (95% CI 1.20 to 2.71) p=0.005, respectively). Tender joints with the presence of synovitis were predictive of radiographic progression (OR=1.89 (95% CI 1.25 to 2.85) p=0.002), especially seen in the MTP joints. Non-tender joints with no synovitis were negatively predictive (OR=0.57 (95% CI 0.39 to 0.82) p=0.003). Persistence of tender joints was negatively predictive (OR=0.38 (95% CI 0.18 to 0.78) p=0.009) while persistence of synovitis was predictive (OR=2.41 (95% CI 1.24 to 4.67) p=0.01) of radiographic progression. Conclusions Synovitis is better than tenderness to predict for subsequent structural progression. However, coexistence of tenderness and synovitis at the level of an individual joint is predictive of structural damage, particularly in the MTP joints. Trial registration number NCT00444691. PMID:27042336
Lin, Peiliang; Huang, Xiaoming; Zheng, Chushan; Cai, Qian; Guan, Zhong; Liang, Faya; Zheng, Yiqing
The aim of this study was to evaluate the predictive value of magnetic resonance imaging (MRI) in detecting thyroid gland invasion (TGI) in patients with advanced laryngeal or hypopharyngeal carcinoma. In a retrospective chart review, 41 patients with advanced laryngeal or hypopharyngeal carcinoma underwent MRI scan before total laryngectomy and ipsilateral or bilateral thyroidectomy during the past 5 years. The MRI findings were compared with the postoperative pathological results. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Among the 41 patients, 3 had thyroid gland invasion in postoperative pathological results. MRI correctly predicted the absence of TGI in 37 of 38 patients and TGI in all 3 patients. The sensitivity, specificity, PPV, and NPV of MRI were 100.0, 97.4, 75.0, and 100 %, respectively, with the diagnostic accuracy of 97.6 %. In consideration of the high negative predictive value of MRI, it may help surgeons selectively preserve thyroid gland in total laryngectomy and reduce the incidence of hypothyroidism and hypoparathyroidism postoperatively.
Xie, Jianfeng; Ma, Xudong; Huang, Yingzi; Mo, Min; Guo, Fengmei; Yang, Yi; Qiu, Haibo
The incidence rate of infection by multidrug-resistant organisms (MDROs) can affect the accuracy of etiological diagnosis when using American Thoracic Society (ATS) guidelines. We determined the accuracy of the ATS guidelines in predicting infection or colonization by MDROs over 18 months at a single ICU in eastern China. This prospective observational study examined consecutive patients who were admitted to an intensive care unit (ICU) in Nanjing, China. MDROs were defined as bacteria that were resistant to at least three antimicrobial classes, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Pseudomonas aeruginosa, Acinetobacter baumannii. Screening for MDROs was performed at ICU admission and discharge. Risk factors for infection or colonization with MDROs were recorded, and the accuracy of the ATS guidelines in predicting infection or colonization with MDROs was documented. There were 610 patients, 225 (37%) of whom were colonized or infected with MDROs at ICU admission, and this increased to 311 (51%) at discharge. At admission, the sensitivity (70.0%), specificity (31.6%), positive predictive value (38.2%), and negative predictive value (63.5%), all based on ATS guidelines for infection or colonization with MDROs were low. The negative predictive value was greater in patients from departments with MDRO infection rates of 31-40% than in patients from departments with MDRO infection rates of 30% or less and from departments with MDRO infection rates more than 40%. ATS criteria were not reliable in predicting infection or colonization with MDROs in our ICU. The negative predictive value was greater in patients from departments with intermediate rates of MDRO infection than in patients from departments with low or high rates of MDRO infection. ClinicalTrials.gov NCT01667991.
Tian, Tian; Ruan, Miao; Yang, Wentao; Shui, Ruohong
Tumor-infiltrating lymphocytes (TILs) may be associated with clinical outcome in triple-negative breast cancers (TNBCs). However, lacking of standardized methodologies in TILs evaluation has hindered its application in clinical practice. To evaluate the prognostic role of TILs scored by methods recommended by International TILs Working Group 2014, we performed a retrospective study of TILs in 425 primary invasive TNBCs in a Chinese population with a median follow-up of 4 years. Intratumoral TILs (iTILs) and stromal TILs (sTILs) were scored respectively. The associations between TILs and disease-free survival (DFS), distant disease-free survival (DDFS) and overall survival (OS) were evaluated with COX models. ITILs were not associated with prognosis. Higher sTILs were associated with better prognosis; for every 10% increase in sTILs, a 5% reduction of risk of recurrence or death (P < 0.001), 5% reduction of risk of distant recurrence (P < 0.001), and 4% reduction of risk of death (P = 0.002) were observed. Multivariate analysis confirmed sTILs to be an independent prognostic marker. 3.5% of TNBCs had more than 50% lymphocytes (lymphocyte-predominant breast cancer, LPBC), and associations between LPBC status and prognosis were observed but did not reach statistical significance. TNBCs with more than 20% sTILs had a significantly better prognosis than the patients with no more than 20% sTILs. In conclusion, our study indicated that sTILs scored by methods recommended by International TILs Working Group 2014 were associated with the prognosis of TNBCs. STILs could be an independent prognostic biomarker in TNBCs, increasing sTILs predicting better prognosis. PMID:27323808
Almeida, Lais Pinto de; Carvalho, Fabiana Puerro de; Marques, Alexandre Gimenes; Pereira, Andrea dos Santos; Bortoleto, Renata Puzzo; Martino, Marinês Dalla Valle
To evaluate ertapenem disk performance to predict Klebsiella pneumonie carbapenemase production by Gram-negative bacilli. All Gram-negative bacilli isolated between January 2010 and June 2011 were tested by disk diffusion (Oxoid™) for sensitivity to ertapenem, meropenem and imipenem. Resistant or intermediate sensitivity strains (diameter < 22 mm for ertapenem) were also tested for the blaKPC gene by polymerase chain reaction. Disk predictive positive value for Klebsiella pneumoniae carbapenemase and specificity were calculated. Out of the 21839 cultures performed, 3010 (13.78%) were positive, and Gram-negative bacilli were isolated in 708 (23.52%) of them. Zone of inhibition diameter for ertapenem disk was < 22 mm for 111 isolates, representing 15.7% of all Gram-negative isolates. The PCR assay for blaKPC detected 40 Klebsiella pneumoniae carbapenemase-producing strains. No strains intermediate or resistant to meropenem and imipenem were sensitive to ertapenem. The ertapenem disk presented a positive predictive value of 36% to predict blaKPC and 89% specificity. The resistance of Gram-negative bacilli detected by disk diffusion against ertapenem does not predict Klebsiella pneumoniae carbapenemase production. Other mechanisms, such as production of other betalactamases and porin loss, may be implicated. The need to confirm the presence of the blaKPC is suggested. Therefore, ertapenem was a weak predictor for discriminating strains that produce Klebsiella pneumoniae carbapenemase.
Kudinova, Anastacia Y; Burkhouse, Katie L; Siegle, Greg; Owens, Max; Woody, Mary L; Gibb, Brandon E
There is a large body of research supporting the association between disrupted physiological reactivity to negative stimuli and depression. The present study aimed to examine whether physiological reactivity to emotional stimuli, assessed via pupil dilation, served as a biological marker of risk for depression recurrence among individuals who are known to be at a higher risk due to having previous history of depression. Participants were 57 women with a history of major depressive disorder (MDD). Pupil dilation to angry, happy, sad, and neutral faces was recorded. Participants' diagnoses and symptoms were assessed 24 months after the initial assessment. We found that women's pupillary reactivity to negative (sad or angry faces) but not positive stimuli prospectively predicted MDD recurrence. Additionally, we found that both hyper- and hypopupillary reactivity to angry faces predicted risk for MDD recurrence. These findings suggest that disrupted physiological response to negative stimuli indexed via pupillary dilation could serve as a physiological marker of MDD risk, thus presenting clinicians with a convenient and inexpensive method to predict which of the at-risk women are more likely to experience depression recurrence. © 2016 Society for Psychophysiological Research.
Huprich, Steven K; Nelson, Sharon M; Paggeot, Amy; Lengu, Ketrin; Albright, Jeremy
Many studies have determined that the traits of emotional dysregulation, negative affect, and impulsivity are the strongest predictors of borderline personality disorder (BPD). Although psychodynamic, empirically supported BPD treatments (i.e., transference-focused, mentalization based) focus upon changing the internal representations of self and other, no studies have simultaneously evaluated the contribution of object relations in relation to these traits in predicting BPD symptoms. This study sought to determine the combined effects of emotional dysregulation, negative affect, impulsivity, and object relations in the prediction of BPD through the use of mediation modeling in 4 a priori hypothesized relationships among these variables. One hundred sixty-nine psychiatric outpatients and 171 undergraduate students were evaluated with self-reported trait and object relations measures and were administered 2 semistructured diagnostic interviews for BPD. Although all trait and object relations measures were correlated with BPD symptoms, the best fitting model was one in which object relations partially mediated the relationship of negative affect and impulsivity with BPD symptoms. Direct effects of the traits were also observed in mediation. Self-reported object relational quality had more of an effect on the prediction of BPD than previously recognized within a trait-framework, thus further supporting the model explicated in psychodynamic and relationally based treatments for BPD. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Huang, Yi; Yu, Rongjun
Humans make predictions and use feedback to update their subsequent predictions. The feedback-related negativity (FRN) has been found to be sensitive to negative feedback as well as negative prediction error, such that the FRN is larger for outcomes that are worse than expected. The present study examined prediction errors in both appetitive and aversive conditions. We found that the FRN was more negative for reward omission vs. wins and for loss omission vs. losses, suggesting that the FRN might classify outcomes in a “more-or-less than expected” fashion rather than in the “better-or-worse than expected” dimension. Our findings challenge the previous notion that the FRN only encodes negative feedback and “worse than expected” negative prediction error. PMID:24904254
Hatta, K; Takahashi, T; Nakamura, H; Yamashiro, H; Endo, H; Kito, K; Fujii, S; Matsuzaki, I; Masui, K; Yonezawa, Y
The aim of this study was to determine whether benzodiazepine tolerance might provide a predictive marker for persistent aggression in schizophrenia. Seventy-seven male schizophrenic patients newly admitted to our psychiatric intensive care unit due to violent behavior during a 4-month period were examined. As a result, a high dose of benzodiazepine required for sedation or a short duration until regaining consciousness after the initial sedation, was related to severer aggression on waking up after sedation. Despite the small number of subjects examined, a conservative claim can be made that the level of the effect of benzodiazepine required for sedation seems to predict persistent severe aggression in schizophrenia.
Del Carpio, M; Moguilansky, S; Costa, M; Panomarenko, H; Bianchi, G; Bendersky, S; Lazcano, M; Frider, B; Larrieu, E
The usefulness of ultrasonography (US) in the early diagnosis of hydatidosis, applied in large-scale surveys to populations lacking clinical symptoms of the disease, has been amply documented. However, the rate of false positive and negative results is poorly described. Due to this, the present paper is aimed to evaluate the sensitivity, specificity and predictive value of a conventional rural ultrasonographic survey in comparison with higher imaging complexity. Accordingly, during 1997 and 1998 a total of 1054 children from 7 to 14 years of age were evaluated by means of US, in the town of Ingeniero Jacobacci, Province of Rio Negro, Argentina, employing a portable device for population studies. All detected cases were referred to a high complexity center specialized in imaging diagnosis for their re-evaluation with US, CT scanning and X-rays. A control group comprising 3 children negative by US for each positive case in the mass screening survey was selected and reexamined by US and X-rays and CT scanning in doubtful situations. Twenty-seven asymptomatic carriers were referred with images compatible with hydatid cysts, while 66 were classified as disease free. At reexamination, 24 of those diagnosed as carriers and the totality of those classified as healthy were confirmed. On the basis of our results, a sensitivity of 100%, a specificity of 95.6% and a global test value of 96.7% were estimated.
Jeffery, Unity; Deitz, Krysta; Hostetter, Shannon
Low albumin to globulin ratio has been found previously to have a high positive predictive value for feline infectious peritonitis (FIP) in cats with clinical signs highly suggestive of the disease. However, FIP can have a more vague clinical presentation. This retrospective study found that the positive predictive value of an albumin:globulin (A:G) ratio of <0.8 and <0.6 was only 12.5% and 25%, respectively, in a group of 100 cats with one or more clinical signs consistent with FIP. The negative predictive value was 100% and 99% for an A:G ratio of <0.8 and A:G<0.6%, respectively. Therefore, when the prevalence of FIP is low, the A:G ratio is useful to rule out FIP but is not helpful in making a positive diagnosis of FIP.
This mixed design study investigated the predictive and instructional uses of two different types of interim mathematics assessments given in two different districts. One district administered the same summative type of assessment three times a year, while the other district administered a different interim assessment after six-week intervals of…
Park, Heae Surng; Jang, Min Hye; Kim, Eun Joo; Kim, Hyun Jeong; Lee, Hee Jin; Kim, Yu Jung; Kim, Jee Hyun; Kang, Eunyoung; Kim, Sung-Won; Kim, In Ah; Park, So Yeon
Epidermal growth factor receptor (EGFR) is frequently overexpressed in triple-negative breast cancer and is emerging as a therapeutic target. EGFR gene copy number alteration and mutation are highly variable and scientists have been challenged to define their prognostic significance in triple-negative breast cancer. We examined EGFR protein expression, EGFR gene copy number alteration and mutation of exon 18 to 21 in 151 cases of triple-negative breast cancer and correlated these findings with clinical outcomes. In addition, intratumoral agreement of EGFR protein overexpression and gene copy number alteration was evaluated. EGFR overexpression was found in 97 of 151 cases (64%) and high EGFR gene copy number was detected in 50 cases (33%), including 3 gene amplification (2%) and 47 high polysomy (31%). Five EGFR mutations were detected in 4 of 151 cases (3%) and included G719A in exon 18 (n=1), V786M in exon 20 (n=1), and L858R in exon 21 (n=3). One case had two mutations (G719A and L858R). High EGFR copy number, but not EGFR mutation, correlated with EGFR protein overexpression. Intratumoral heterogeneity of EGFR protein overexpression and EGFR copy number alteration was not significant. In survival analyses, high EGFR copy number was found to be an independent prognostic factor for poor disease-free survival in patients with triple-negative breast cancer. Our findings showed that EGFR mutation was a rare event, but high EGFR copy number was relatively frequent and correlated with EGFR overexpression in triple-negative breast cancer. Moreover, high EGFR copy number was associated with poor clinical outcome in triple-negative breast cancer, suggesting that evaluation of EGFR copy number may be useful for predicting outcomes in patients with triple-negative breast cancer and for selecting patients for anti-EGFR-targeted therapy.
Oreg, Shaul; Katz-Gerro, Tally
This article builds on Ajzen's theory of planned behavior and on Stern et al.'s value-belief-norm theory to propose and test a model that predicts proenvironmental behavior. In addition to relationships between beliefs, attitudes, and behaviors, we incorporate Inglehart's postmaterialist and Schwartz's harmony value dimensions as contextual…
Schonhaut B, Luisa; Pérez R, Marcela; Castilla F, Ana María; Castro M, Sonia; Salinas A, Patricia; Armijo R, Iván
The Ages and Stages questionnaires (ASQ) has been recently validated in our country for developmental screening. The objective of this study is evaluate the validity of ASQ to predict low cognitive performance in the early years of schooling. Diagnostic test studies conducted on a sample of children of medium-high socioeconomic level were evaluated using ASQ at least once at 8, 18 and/or 30 months old, and later, between 6 and 9 years old, reevaluated using the Wechsler Intelligence Scale for Children-third edition (WISC-III). Each ASQ evaluation was recorded independently. WISC-III was standardized, considering underperformance when the total score were under -1 standard deviation. 123 children, corresponding to 174 ASQ assessments (42 of them were 8 months old, 55 were 18 months and 77 were 30 months of age) were included. An area under the ROC curve of 80.7% was obtained, showing higher values at 8 months (98.0%) compared to 18 and 30 months old (78.1 and 79.3%, respectively). Considering different ASQ scoring criteria, a low sensitivity (27.8 to 50.0%), but a high specificity (78.8 to 96.2%) were obtained; the positive predictive value ranged between 21 and 46%, while the negative value was 92.0-93.2%. Conclusion ASQ has low sensitivity but excellent specificity to predict a low cognitive performance during the first years of schooling, being a good alternative to monitor psychomotor development in children who attend the private sector healthcare in our country.
Ruiz-Tovar, Jaime; Oller, Inmaculada; Llavero, Carolina; Zubiaga, Lorea; Diez, María; Arroyo, Antonio; Calero, Alicia; Calpena, Rafael
A common complication after bariatric surgery is hair loss, which is related to rapid weight reduction, but zinc, iron, and other micronutrient deficiencies can also be involved. Little is studied after laparoscopic sleeve gastrectomy (LSG). A prospective observational study was performed of 42 morbidly obese females undergoing LSG. Incidence of hair loss was monitored. Micronutrients were investigated preoperatively and three, six, and 12 months after surgery. Sixteen patients (41%) reported hair loss in the postoperative course. A significant association was observed between hair loss and zinc levels (P = 0.021) but mean zinc levels were within the normal range in patients reporting hair loss. Only three patients (7.7%) presented low zinc levels, all of them reporting hair loss. There was also a significant association between iron levels and alopecia (P = 0.017), but mean values of the patients with hair loss were within normal range. Only four patients (10.2%) presented low iron levels, all of them presenting hair loss. A variable consisting of the addition of zinc + iron showed a significant association with hair loss (P = 0.013). A cutoff point was established in 115 (odds ratio, 4; P = 0.006). All the patients but two reporting hair loss presented addition levels under 115. This variable showed sensibility 88 per cent, specificity 84 per cent, positive predictive value 79 per cent, and negative predictive value 91 per cent to predict hair loss. Hair loss is a frequent condition after sleeve gastrectomy. In most cases, iron and zinc levels are within the normal range. The variable addition (zinc + iron) is a good predictor of hair loss. Patients with addition levels below 115 are fourfold more susceptible to present hair loss. In these cases, zinc supplements achieve the stop of hair loss in most cases.
Schonhaut B, Luisa; Pérez R, Marcela; Castilla F, Ana María; Castro M, Sonia; Salinas A, Patricia; Armijo R, Iván
The Ages and Stages questionnaires (ASQ) has been recently validated in our country for developmental screening. The objective of this study is evaluate the validity of ASQ to predict low cognitive performance in the early years of schooling. Diagnostic test studies conducted on a sample of children of medium-high socioeconomic level were evaluated using ASQ at least once at 8, 18 and/or 30 months old, and later, between 6 and 9 years old, reevaluated using the Wechsler Intelligence Scale for Children-third edition (WISC-III). Each ASQ evaluation was recorded independently. WISC-III was standardized, considering underperformance when the total score were under -1 standard deviation RESULTS: 123 children, corresponding to 174 ASQ assessments (42 of them were 8 months old, 55 were 18 months and 77 were 30 months of age) were included. An area under the ROC curve of 80.7% was obtained, showing higher values at 8 months (98.0%) compared to 18 and 30 months old (78.1 and 79.3%, respectively). Considering different ASQ scoring criteria, a low sensitivity (27.8 to 50.0%), but a high specificity (78.8 to 96.2%) were obtained; the positive predictive value ranged between 21 and 46%, while the negative value was 92.0-93.2%. ASQ has low sensitivity but excellent specificity to predict a low cognitive performance during the first years of schooling, being a good alternative to monitor psychomotor development in children who attend the private sector healthcare in our country. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.
Epstein, S K
Failure of weaning from mechanical ventilation is thought to result from an imbalance between respiratory muscle capacity and respiratory demand. The ratio of respiratory rate to tidal volume (f/VT, rapid shallow breathing index) during spontaneous unsupported respiration increases when this imbalance exists, and may predict the success or failure of weaning from mechanical ventilation. Using f/VT, Yang and Tobin demonstrated a positive predictive value (PPV) of 0.78 (f/VT < or = 105 and weaning success) (1). To define the etiology of the 20% false-positive rate (FPR, f/VT < or = 105 and weaning failure), 94 patients who had an f/VT determined prior to extubation were studied prospectively. Of 84 patients with an f/VT < 100, 14 required reintubation within 72 h of extubation (FPR = 0.17, PPV = 0.83). Extubation in 13 of these 14 cases failed because of congestive heart failure, upper airway obstruction, aspiration, encephalopathy, or the development of a new pulmonary process. Only one patient needed reintubation solely because of the original respiratory process. Of 10 patients extubated with an f/VT > or = 100, four required reintubation, all because of the underlying respiratory process. This study confirms the high PPV for an f/VT < 100. The FPR of approximately 0.20 is best explained by extubation failure caused by processes for which f/VT is physiologically or temporally unlikely to predict success or failure. The negative predictive value (f/VT > or = 100 but extubation success) for f/VT may be lower than previously reported.
Praneenararat, Surat; Chamroonkul, Naichaya; Sripongpun, Pimsiri; Kanngurn, Samornmas; Jarumanokul, Roongrueng; Piratvisuth, Teerha
Non-invasive models and methods to substitute liver biopsy in chronic hepatitis B (CHB) patients were investigated but their roles as predictors of significant liver histology for diagnosis of HBeAg-negative CHB patients who had indication for liver biopsy according to The American Association for the Study of Liver Diseases (AASLD) and The Asian Pacific Association for the Study of the Liver (APASL) guidelines are still unknown. This study was designed to identify predictors of significant liver necroinflammation as defined by a Histology Activity Index of necroinflammatory score ≥ 4 or Metavir necroinflammatory activity score ≥ 2 and significant liver fibrosis as defined by a Metavir fibrosis score ≥ 2 in HBeAg-negative CHB patients that had a hepatitis B virus (HBV) DNA level ≥ 2,000 IU/ml and age ≥ 40 years or elevated alanine aminotransferase level between 1-2 times the upper limit of normal. Twenty-two patients were prospectively included and performed liver biopsies. Clinical and laboratory parameters including age, gender, underlying disease, family history of cirrhosis or hepatocellular carcinoma, body mass index (BMI), HBV DNA level, HBsAg level, liver function test, complete blood count, aspartate aminotransferase-to-platelet ratio index and transient elastography were collected and analyzed with liver histology profiles. Five patients (23%) had significant liver inflammation and 7 patients (32%) had significant liver fibrosis. Factors associated with significant liver inflammation were a lower BMI and higher alkaline phosphatase level while a factor associated with significant liver fibrosis was lower age. On multivariate analysis, only HBV DNA level > 5.5 log IU/ml could predict significant liver fibrosis (odds ratio 28.012, 95% CI, 1.631-481.240, p = 0.022) and its sensitivity, specificity, positive predictive value and negative predictive value were 71.4%, 93.3%, 83.3% and 87.5% respectively. An HBV DNA level
Murty, Vishnu P; FeldmanHall, Oriel; Hunter, Lindsay E; Phelps, Elizabeth A; Davachi, Lila
Prior research illustrates that memory can guide value-based decision-making. For example, previous work has implicated both working memory and procedural memory (i.e., reinforcement learning) in guiding choice. However, other types of memories, such as episodic memory, may also influence decision-making. Here we test the role for episodic memory-specifically item versus associative memory-in supporting value-based choice. Participants completed a task where they first learned the value associated with trial unique lotteries. After a short delay, they completed a decision-making task where they could choose to reengage with previously encountered lotteries, or new never before seen lotteries. Finally, participants completed a surprise memory test for the lotteries and their associated values. Results indicate that participants chose to reengage more often with lotteries that resulted in high versus low rewards. Critically, participants not only formed detailed, associative memories for the reward values coupled with individual lotteries, but also exhibited adaptive decision-making only when they had intact associative memory. We further found that the relationship between adaptive choice and associative memory generalized to more complex, ecologically valid choice behavior, such as social decision-making. However, individuals more strongly encode experiences of social violations-such as being treated unfairly, suggesting a bias for how individuals form associative memories within social contexts. Together, these findings provide an important integration of episodic memory and decision-making literatures to better understand key mechanisms supporting adaptive behavior.
The aim of this paper is to present the values and beliefs of clinicians and non-clinicians working in not-for-profit healthcare organizations, and the positive and negative outcomes of holding such values. Ethical values are part of the essence of healthcare management and delivery. Although studies have identified what some of those values are, few studies have been undertaken to identify if the values and beliefs held are ethical, and what the outcomes, positive and negative, to holding such values are. This study was undertaken in 60 of the 65 acute care hospitals in the Republic of Ireland, and in eight regional health boards during 2001. The study population included all accessible professional clinician and non-clinician department heads. The sample size was 862 and the valid response rate was 42%. Research findings from questions requiring qualitative responses are presented and are part of a wider study. Responses were subjected to content analysis. Eleven key values identified are excellence in care delivery, positive value system, managerial receptiveness and non-receptiveness, organizational dependability and lack of dependability, peer cohesion and lack of peer cohesion, equity in care delivery, personal contribution to the organization and personal importance. Findings also demonstrated positive and negative outcomes for the organization, patients and staff as a result of the values held. Findings show that healthcare clinicians and non-clinicians demonstrated a range of values in the delivery of health care, some of which have not been identified before. Should professionals now reconsider the values required in the delivery of health care? The most widely perceived values held by both groups were similar, although clinicians perceived that non-clinicians did not hold the same ethical values and beliefs as they did, and vice-versa, demonstrating a lack of trust in each other's moral and ethical value system.
Klee, T; Pearce, K; Carson, D K
In a previous study, we reported the results of an early language screening program in which 306 children were screened using a parent-report questionnaire sent through the mail (Klee et al., 1998). A sample of the children screened were given clinical evaluations within a month of screening (n = 64) and again 1 year later (n = 36). Although the screening program correctly identified 91% of 2-year-olds with language delay, it produced a large number of over-referrals. In the present study we examine a revised screening criterion designed to reduce the number of false positives. The revised criterion generated fewer positive screens overall than the original and resulted in improved specificity (96% vs. 87%) and positive predictive value (77% vs. 51%), while maintaining the high sensitivity (91%) and negative predictive value (98%) of the original criterion. We also propose a screening score based on the new criterion, designed to inform the process of deciding which children to bring in for further evaluation.
Akroyd, Duane; Caison, Amy; Adams, Robert D
As cancer caregivers, radiation therapists experience a variety of stresses that may develop into burnout, which has been demonstrated to impact patient care, employee health, and organizational effectiveness. The purpose of the study was to assess the levels of radiation therapists' burnout at three stages. Additionally, the ability of selected workplace variables to predict each of the three stages of burnout was examined. We used descriptive and inferential statistical analyses on reliable and valid instruments, which measured stress, burnout, and social support. Radiation therapists have high levels of the first two stages of burnout: emotional exhaustion and depersonalization. Although personal stress, organizational stress, guidance, reassurance of worth, and work load predicted 50% or more of the variance in emotional exhaustion and depersonalization, their predictive ability for personal accomplishment was low. Efforts to alleviate burnout among radiation therapists within an organization should have positive effects, including increased quality of patient care, improved quality of work life, higher levels of job satisfaction, and commitment and lower staff turnover.
Ogunyemi, Dotun; De Taylor-Harris, Shawn
To assess the predictive value of standardized tests and demographic factors on performance on the National Board of Medical Examiners (NBME) Obstetrics and Gynecology (OBGYN) examination. The study included 171 students who rotated through obstetrics and gynecology from 1992 to 2001. Correlations between NBME OBGYN scores and United States Medical Licensing Examination (USMLE) step 1, MCAT and GPA scores, and temporal and demographic factors were analyzed. The mean Medical College Admission Test (MCAT), NBME and USMLE step 1 scores were 24.03, 67.47 and 194.53, respectively. Significant correlations with NMBE OBGYN were USMLE step 1 scores (r = .517, p < 0.001), MCAT scores (r = .481, p < 0.001), faculty evaluation grade (r=.223, p <0.01), OBGYN residency interest (r= .179, p < 0.05) and female gender (r=.157, p< 0.05) with a significant negative correlation with clerkship duration (r = -.208, p < 0. 01). On logistic regression analysis, USMLE, MCAT, academic year and faculty evaluation grade were independently predictive of NBME OBGYN scores. All preclinical standardized tests showed positive correlation with progressive academic years and decreasing student age. and decreasing student age. USMLE step 1, MCAT scores and faculty evaluation grades were predictive of NMBE OBGYN scores. They may be helpful in assessing third-year medical students in need of special supervision and assistance.
Grémy, F; Salmi, L R
This paper tries to review what is scientifically known about the predictive values of biological tests of HIV infection. The epidemiological situation for that infection is characterized by two facts: the very high values of sensitivity and specificity which are close to unity; the prevalence of seropositivity which is on average--at least in western countries--, very low (except for some small specific groups). Under those conditions, Negative Predictive Values are always very close to unity, and the percentage of false negative tests is extremely low. Things are quite different for Positive Predictive Value, which varies very rapidly with very small shifts or uncertainties about specificity and prevalence. In the case when prevalence is very low (general population screening) and at the same time specificity is not excellent (that means < 0.99 or even < 0.995), Positive Predictive Value is very poor and the proportion of false positive tests rather important. Indeed the analysis of scientific literature, using the method of "best synthesis evidence", reveals numerous discrepancies as to the value of specificity among different tests. Figures vary a lot from one study to another. It is not obvious which screening strategies are concerned by the results, which finally entail a strong statistical uncertainty. Finally, the figures published in the literature are given by high standard laboratories. One may fear the tests realized in routine laboratories are less reliable. As a conclusion, let us say that despite their very good quality, the biological tests, when used separately, should not be trusted without strong previous criticism when applied to samples of the general population. Any biological screening should be preceded by a clinical examination, including a precise inquiry, in order to detect people at risk, that means with a high prior probability. Clinical dialogue has moreover another great interest: it allows health consulting and education, and calls
Ng, Maggie C Y; Bowden, Donald W
Obesity is a multifactorial disease resulting from the interaction between genetic factors and lifestyle. Identification of rare genetic variations with strong effects on obesity has been useful in diagnosing and designing personalized therapy for early-onset or syndromic obesity. However, common variants identified in recent genome-wide association studies have limited clinical value.
Graves, Rose A; Pearson, Scott M; Turner, Monica G
Many biodiversity-ecosystem services studies omit cultural ecosystem services (CES) or use species richness as a proxy and assume that more species confer greater CES value. We studied wildflower viewing, a key biodiversity-based CES in amenity-based landscapes, in Southern Appalachian Mountain forests and asked (i) How do aesthetic preferences for wildflower communities vary with components of biodiversity, including species richness?; (ii) How do aesthetic preferences for wildflower communities vary across psychographic groups?; and (iii) How well does species richness perform as an indicator of CES value compared with revealed social preferences for wildflower communities? Public forest visitors (n = 293) were surveyed during the summer of 2015 and asked to choose among images of wildflower communities in which flower species richness, flower abundance, species evenness, color diversity, and presence of charismatic species had been digitally manipulated. Aesthetic preferences among images were unrelated to species richness but increased with more abundant flowers, greater species evenness, and greater color diversity. Aesthetic preferences were consistent across psychographic groups and unaffected by knowledge of local flora or value placed on wildflower viewing. When actual wildflower communities (n = 54) were ranked based on empirically measured flower species richness or wildflower viewing utility based on multinomial logit models of revealed preferences, rankings were broadly similar. However, designation of hotspots (CES values above the median) based on species richness alone missed 27% of wildflower viewing utility hotspots. Thus, conservation priorities for sustaining CES should incorporate social preferences and consider multiple dimensions of biodiversity that underpin CES supply.
Williamson, Hannah C; Karney, Benjamin R; Bradbury, Thomas N
Social-learning perspectives explicitly recognize the role of partners' personal histories and contexts as possible causes of couple communication behavior, but these assumptions are rarely tested directly, and operationalizations of context in behavioral research on couples rarely extend beyond the interacting dyad. To broaden our understanding of why couples differ in communication, the current study examined whether observed behaviors in marital interactions covary with individual experiences and contextual factors. Behaviors coded from in-home conversations of 414 ethnically diverse newlywed couples were examined simultaneously in relation to childhood and family-of-origin experiences, financial strain and stressful life events, depressive symptoms, and relationship satisfaction. A latent factor representing financial strain and stressful life events was the strongest correlate of negative communication, with higher levels of stress predicting more negativity. Relationship satisfaction was the strongest correlate of observed positivity, with higher levels of satisfaction predicting more positivity. Childhood and family experiences were unrelated to behaviors, whereas results for depressive symptoms were complex and counterintuitive. Because the negative behaviors highlighted in social-learning models of relationship functioning, and often targeted in educational interventions, covary reliably with the stresses and financial strains that couples experience, contextual factors merit greater emphasis in models designed to explain and prevent marital deterioration.
Williamson, Hannah C.; Karney, Benjamin R.; Bradbury, Thomas N.
Social-learning perspectives explicitly recognize the role of partners’ personal histories and contexts as possible causes of couple communication behavior, but these assumptions are rarely tested directly, and operationalizations of context in behavioral research on couples rarely extend beyond the interacting dyad. To broaden our understanding of why couples differ in communication, the current study examined whether observed behaviors in marital interactions covary with individual experiences and contextual factors. Behaviors coded from in-home conversations of 414 ethnically-diverse newlywed couples were examined simultaneously in relation to childhood and family-of-origin experiences, financial strain and stressful life events, depressive symptoms, and relationship satisfaction. A latent factor representing financial strain and stressful life events was the strongest correlate of negative communication, with higher levels of stress predicting more negativity. Relationship satisfaction was the strongest correlate of observed positivity, with higher levels of satisfaction predicting more positivity. Childhood and family experiences were unrelated to behaviors, whereas results for depressive symptoms were complex and counterintuitive. Because the negative behaviors highlighted in social-learning models of relationship functioning, and often targeted in educational interventions, covary reliably with the stresses and financial strains that couples experience, contextual factors merit greater emphasis in models designed to explain and prevent marital deterioration. PMID:23421833
Cox, Sylvia M L; Frank, Michael J; Larcher, Kevin; Fellows, Lesley K; Clark, Crystal A; Leyton, Marco; Dagher, Alain
The extent to which we learn from positive and negative outcomes of decisions is modulated by the neurotransmitter dopamine. Dopamine neurons burst fire in response to unexpected rewards and pause following negative outcomes. This dual signaling mechanism is hypothesized to drive both approach and avoidance behavior. Here we test a prediction deriving from a computational reinforcement learning model, in which approach is mediated via activation of the direct cortico-striatal pathway due to striatal D1 receptor stimulation, while avoidance occurs via disinhibition of indirect pathway striatal neurons secondary to a reduction of D2 receptor stimulation. Using positron emission tomography with two separate radioligands, we demonstrate that individual differences in human approach and avoidance learning are predicted by variability in striatal D1 and D2 receptor binding, respectively. Moreover, transient dopamine precursor depletion improved learning from negative outcomes. These findings support a bidirectional modulatory role for striatal dopamine in reward and avoidance learning via segregated D1 and D2 cortico-striatal pathways.
Lehmann, Brian David; Ding, Yan; Viox, Daniel Joseph; Jiang, Ming; Zheng, Yi; Liao, Wang; Chen, Xi; Xiang, Wei; Yi, Yajun
Systematic analysis of cancer gene-expression patterns using high-throughput transcriptional profiling technologies has led to the discovery and publication of hundreds of gene-expression signatures. However, few public signature values have been cross-validated over multiple studies for the prediction of cancer prognosis and chemosensitivity in the neoadjuvant setting. To analyze the prognostic and predictive values of publicly available signatures, we have implemented a systematic method for high-throughput and efficient validation of a large number of datasets and gene-expression signatures. Using this method, we performed a meta-analysis including 351 publicly available signatures, 37,000 random signatures, and 31 breast cancer datasets. Survival analyses and pathologic responses were used to assess prediction of prognosis, chemoresponsiveness, and chemo-drug sensitivity. Among 31 breast cancer datasets and 351 public signatures, we identified 22 validation datasets, two robust prognostic signatures (BRmet50 and PMID18271932Sig33) in breast cancer and one signature (PMID20813035Sig137) specific for prognosis prediction in patients with ER-negative tumors. The 22 validation datasets demonstrated enhanced ability to distinguish cancer gene profiles from random gene profiles. Both prognostic signatures are composed of genes associated with TP53 mutations and were able to stratify the good and poor prognostic groups successfully in 82%and 68% of the 22 validation datasets, respectively. We then assessed the abilities of the two signatures to predict treatment responses of breast cancer patients treated with commonly used chemotherapeutic regimens. Both BRmet50 and PMID18271932Sig33 retrospectively identified those patients with an insensitive response to neoadjuvant chemotherapy (mean positive predictive values 85%-88%). Among those patients predicted to be treatment sensitive, distant relapse-free survival (DRFS) was improved (negative predictive values 87
Zhang, Minghui; Zhang, Xiaosan; Zhao, Shu; Wang, Yan; Di, Wenyu; Zhao, Gangling; Yang, Maopeng; Zhang, Qingyuan
Triple-negative breast cancer (TNBC) is a particular type of breast cancer which is characterized by its biological aggressiveness, worse prognosis, and lack of prognostic markers or therapeutic targets in contrast with hormonal receptor-positive and human epidermal growth factor receptor 2-positive (HER2+) breast cancers. We aimed to evaluate survivin and epidermal growth factor receptor (EGFR) expression and their prognostic value and determine their relationships with the clinicopathological parameters of TNBC. A total of 136 patients who had undergone a resection of primary TNBC were enrolled at the Third Affiliated Hospital of Harbin Medical University from March 2003 to September 2005. Expression of ER, PR, HER2, EGFR, and survivin was assessed by immunohistochemistry. The association of TNBC and other clinicopathological variables and the prognostic value of survivin and EGFR expression were evaluated. Survivin was expressed in 62 (45.6 %) cases and EGFR was expressed in 82 (60.3 %) cases. Survivin expression was associated with menopausal status (P = 0.011), tumor size (P = 0.037), and lymph node status (P = 0.001). EGFR expression was associated with menopausal status (P = 0.029), lymph node status (P = 0.004), P53 expression (P = 0.001), Ki-67 expression (P = 0.028), and lymphatic vascular invasion (P = 0.037). A multivariate analysis demonstrated that tumor size (hazard ratio (HR) 1.587, 95 % confidence interval (CI) 1.081–2.330, P = 0.018 for disease-free survival (DFS); HR 1.606, 95%CI 1.096–2.354, P = 0.015 for overall survival (OS)), lymph node status (HR 2.873, 95%CI 1.544–5.344, P = 0.001 for DFS; HR 2.915, 95%CI 1.553–5.471, P = 0.001 for OS), tumor grade (HR 1.914, 95%CI 1.218–3.007, P = 0.005 for DFS; HR 1.983, 95%CI 1.228–3.203, P = 0.005 for OS), EGFR (HR 3.008, 95%CI 1.331–6.792, P = 0.008 for DFS; HR 3.151, 95%CI 1.374–7.226, P = 0.007 for OS), and survivin (HR 1
Bellolio, Enrique; Pineda, Viviana; Burgos, María Eugenia; Iriarte, M José; Becker, Renato; Araya, Juan Carlos; Villaseca, Miguel; Mardones, Noldy
To validate the BIRADS in mammography, the calculation of its predictive value in each center is required, as recommended by the American College of Radiology. To determine the predictive value of the BIRADS system in our center. All ultrasound guided needle percutaneous biopsies, performed at our center between 2006 and 2010 were reviewed. Predictive value, sensitivity, specificity and diagnostic accuracy of BIRADS were calculated, with a confidence interval of 95%. Of 1,313 biopsies available, 1,058 met the inclusion criteria. Fifty eight percent of biopsies were performed to women with mammographies classified as BIRADS 4 or 5. The presence of cancer in mammographies classified as BIRADS 0 was 4%. The prevalence of cancer for mammographies BIRADS 1, 2, 3, 4 and 5 were 0, 3, 2.7, 17.7 and 72.4% respectively. The positive and negative predictive values of BIRADS classification were 55 and 92 % respectively. In our institution BIRADS classification 4 and 5 has a high positive predictive value for detecting cancer as in developed countries.
Wang, Wenjun; Cai, Fei; Jiao, Pengfei; Pan, Lin
Many link prediction methods have been developed to infer unobserved links or predict latent links based on the observed network structure. However, due to network noises and irregular links in real network, the performances of existed methods are usually limited. Considering random noises and irregular links, we propose a perturbation-based framework based on Non-negative Matrix Factorization to predict missing links. We first automatically determine the suitable number of latent features, which is inner rank in NMF, by Colibri method. Then, we perturb training set of a network by perturbation sets many times and get a series of perturbed networks. Finally, the common basis matrix and coefficients matrix of these perturbed networks are obtained via NMF and form similarity matrix of the network for link prediction. Experimental results on fifteen real networks show that the proposed framework has competitive performances compared with state-of-the-art link prediction methods. Correlations between the performances of different methods and the statistics of networks show that those methods with good precisions have similar consistence.
Jung, Yoon Yang; Hyun, Chang Lim; Jin, Min-Sun; Park, In Ae; Chung, Yul Ri; Shim, Bobae; Lee, Kyu Ho
Purpose There is no standard targeted therapy for the treatment of triple-negative breast cancer (TNBC). Therefore, its management heavily depends on adjuvant chemotherapy. Using core needle biopsy, this study evaluated the histological factors of TNBC predicting the response to chemotherapy. Methods One hundred forty-three TNBC patients who received single-regimen neoadjuvant chemotherapy (NAC) with the combination of doxorubicin, cyclophosphamide, and docetaxel were enrolled. The core needle biopsy specimens acquired before NAC were used to analyze the clinicopathologic variables and overall performance of the predictive model for therapeutic response. Results Independent predictors of pathologic complete response after NAC were found to be higher number of tumor infiltrating lymphocytes (p=0.007), absence of clear cytoplasm (p=0.008), low necrosis (p=0.018), and high histologic grade (p=0.039). In the receiver operating characteristics curve analysis, the area under curve for the combination of these four variables was 0.777. Conclusion The present study demonstrated that a predictive model using the above four variables can predict therapeutic response to single-regimen NAC with the combination of doxorubicin, cyclophosphamide, and docetaxel in TNBC. Therefore, adding these morphologic variables to clinical and genomic signatures might enhance the ability to predict the therapeutic response to NAC in TNBC. PMID:27721875
McDermott, Jason E.; Corrigan, Abigail L.; Peterson, Elena S.; Oehmen, Christopher S.; Niemann, George; Cambronne, Eric; Sharp, Danna; Adkins, Joshua N.; Samudrala, Ram; Heffron, Fred
In this review, we provide an overview of the methods employed by four recent papers that described novel methods for computational prediction of secreted effectors from type III and IV secretion systems in Gram-negative bacteria. The results of the studies in terms of performance at accurately predicting secreted effectors and similarities found between secretion signals that may reflect biologically relevant features for recognition. We discuss the web-based tools for secreted effector prediction described in these studies and announce the availability of our tool, the SIEVEserver (http://www.biopilot.org). Finally, we assess the accuracy of the three type III effector prediction methods on a small set of proteins not known prior to the development of these tools that we have recently discovered and validated using both experimental and computational approaches. Our comparison shows that all methods use similar approaches and, in general arrive at similar conclusions. We discuss the possibility of an order-dependent motif in the secretion signal, which was a point of disagreement in the studies. Our results show that there may be classes of effectors in which the signal has a loosely defined motif, and others in which secretion is dependent only on compositional biases. Computational prediction of secreted effectors from protein sequences represents an important step toward better understanding the interaction between pathogens and hosts.
Wang, Wenjun; Cai, Fei; Jiao, Pengfei; Pan, Lin
Many link prediction methods have been developed to infer unobserved links or predict latent links based on the observed network structure. However, due to network noises and irregular links in real network, the performances of existed methods are usually limited. Considering random noises and irregular links, we propose a perturbation-based framework based on Non-negative Matrix Factorization to predict missing links. We first automatically determine the suitable number of latent features, which is inner rank in NMF, by Colibri method. Then, we perturb training set of a network by perturbation sets many times and get a series of perturbed networks. Finally, the common basis matrix and coefficients matrix of these perturbed networks are obtained via NMF and form similarity matrix of the network for link prediction. Experimental results on fifteen real networks show that the proposed framework has competitive performances compared with state-of-the-art link prediction methods. Correlations between the performances of different methods and the statistics of networks show that those methods with good precisions have similar consistence. PMID:27976672
Miendlarzewska, Ewa A.; Eryilmaz, Hamdi; Vuilleumier, Patrik
Inertia, together with intensity and valence, is an important component of emotion. We tested whether positive and negative events generate lingering changes in subsequent brain responses to unrelated threat stimuli and investigated the impact of individual anxiety. We acquired fMRI data while participants watched positive or negative movie-clips and subsequently performed an unrelated task with fearful and neutral faces. We quantified changes in amygdala reactivity to fearful faces as a function of the valence of preceding movies and cumulative neural activity evoked during them. We demonstrate that amygdala responses to emotional movies spill over to subsequent processing of threat information in a valence-specific manner: negative movies enhance later amygdala activation whereas positive movies attenuate it. Critically, the magnitude of such changes is predicted by a measure of cumulative amygdala responses to the preceding positive or negative movies. These effects appear independent of overt attention, are regionally limited to amygdala, with no changes in functional connectivity. Finally, individuals with higher state anxiety displayed stronger modulation of amygdala reactivity by positive movies. These results suggest that intensity and valence of emotional events as well as anxiety levels promote local changes in amygdala sensitivity to threat, highlighting the importance of past experience in shaping future affective reactivity. PMID:24603023
Smillie, Luke D; Cooper, Andrew J; Pickering, Alan D
Medial frontal scalp-recorded negativity occurring ∼200-300 ms post-stimulus [known as feedback-related negativity (FRN)] is attenuated following unpredicted reward and potentiated following unpredicted non-reward. This encourages the view that FRN may partly reflect dopaminergic 'reward-prediction-error' signalling. We examined the influence of a putatively dopamine-based personality trait, extraversion (N = 30), and a dopamine-related gene polymorphism, DRD2/ANKK1 (N = 24), on FRN during an associative reward-learning paradigm. FRN was most negative following unpredicted non-reward and least-negative following unpredicted reward. A difference wave contrasting these conditions was significantly more pronounced for extraverted participants than for introverts, with a similar but non-significant trend for participants carrying at least one copy of the A1 allele of the DRD2/ANKK1 gene compared with those without the allele. Extraversion was also significantly higher in A1 allele carriers. Results have broad relevance to neuroscience and personality research concerning reward processing and dopamine function.
Ho, Nerissa S. P.; Sun, Delin; Ting, Kin-Hung; Chan, Chetwyn C. H.; Lee, Tatia M. C.
This study explored the relationship of mindfulness trait with the early and late stages of affective processing, by examining the two corresponding ERP components, P2 and LPP, collected from twenty-two male Chinese participants with a wide range of meditation experiences. Multiple regression analyses was performed on the mindfulness scores, as measured by CAMS-R, with the subjective affective ratings and ERP data collected during an emotion processing task. The results showed that increased mindfulness scores predicted increased valence ratings of negative stimuli (less negative), as well as increased P2 amplitudes at the frontocentral location for positive compared to negative stimuli. Based on these findings, a plausible mechanism of mindfulness in reducing negativity bias was discussed. Moreover, our results replicated previous findings on the age-related increase of P2 amplitudes at the frontal sites for positive compared to neutral stimuli. Since the locations at which P2 amplitudes were found as associated with age and mindfulness differed, as did the emotional contents of the stimuli being compared, indicating that the effect of age did not confound our findings on mindfulness and the two factors might operate on early affective processing from distinct sources and mechanisms. PMID:26124852
Pichon, Swann; Miendlarzewska, Ewa A; Eryilmaz, Hamdi; Vuilleumier, Patrik
Inertia, together with intensity and valence, is an important component of emotion. We tested whether positive and negative events generate lingering changes in subsequent brain responses to unrelated threat stimuli and investigated the impact of individual anxiety. We acquired fMRI data while participants watched positive or negative movie-clips and subsequently performed an unrelated task with fearful and neutral faces. We quantified changes in amygdala reactivity to fearful faces as a function of the valence of preceding movies and cumulative neural activity evoked during them. We demonstrate that amygdala responses to emotional movies spill over to subsequent processing of threat information in a valence-specific manner: negative movies enhance later amygdala activation whereas positive movies attenuate it. Critically, the magnitude of such changes is predicted by a measure of cumulative amygdala responses to the preceding positive or negative movies. These effects appear independent of overt attention, are regionally limited to amygdala, with no changes in functional connectivity. Finally, individuals with higher state anxiety displayed stronger modulation of amygdala reactivity by positive movies. These results suggest that intensity and valence of emotional events as well as anxiety levels promote local changes in amygdala sensitivity to threat, highlighting the importance of past experience in shaping future affective reactivity. © The Author (2014). Published by Oxford University Press. For Permissions, please email: firstname.lastname@example.org.
Ho, Nerissa S P; Sun, Delin; Ting, Kin-Hung; Chan, Chetwyn C H; Lee, Tatia M C
This study explored the relationship of mindfulness trait with the early and late stages of affective processing, by examining the two corresponding ERP components, P2 and LPP, collected from twenty-two male Chinese participants with a wide range of meditation experiences. Multiple regression analyses was performed on the mindfulness scores, as measured by CAMS-R, with the subjective affective ratings and ERP data collected during an emotion processing task. The results showed that increased mindfulness scores predicted increased valence ratings of negative stimuli (less negative), as well as increased P2 amplitudes at the frontocentral location for positive compared to negative stimuli. Based on these findings, a plausible mechanism of mindfulness in reducing negativity bias was discussed. Moreover, our results replicated previous findings on the age-related increase of P2 amplitudes at the frontal sites for positive compared to neutral stimuli. Since the locations at which P2 amplitudes were found as associated with age and mindfulness differed, as did the emotional contents of the stimuli being compared, indicating that the effect of age did not confound our findings on mindfulness and the two factors might operate on early affective processing from distinct sources and mechanisms.
Penna, N. T.; Bos, M. S.; Baker, T. F.; Scherneck, H.-G.
The accuracy of ocean tide loading (OTL) displacement values has long been assumed to be dominated by errors in the ocean tide models used, with errors due to the convolution scheme used considered very small (2-5%). However, this paper shows that much larger convolution errors can arise at sites within approximately 150 km of the coastline, depending on the method used to refine the discrete regularly spaced grid cells of the ocean tide model to better fit the coastline closest to the site of interest. If the local water mass redistribution approach is implemented, as used in the OLFG/OLMPP software recommended in the IERS 2003 conventions, OTL height displacement errors of up to around 20% can arise, depending on the ocean tide model used. Bilinear interpolation only, as used in the SPOTL and CARGA softwares for example, is shown from extensive global and regional comparisons of OTL displacement values derived from the different methods and softwares to be more appropriate. This is verified using GPS observations. The coastal refinement approach used in the OLFG/OLMPP software was therefore changed in August 2007 to use bilinear interpolation only. It is shown that with this change, OTL displacement values computed using OLFG/OLMPP, SPOTL and CARGA invariably agree to the millimetre level for coastal sites, and better than 0.2 mm for sites more than about 150 km inland.
Karpavicius, Andrius; Dambrauskas, Zilvinas; Sileikis, Audrius; Vitkus, Dalius; Strupas, Kestutis
AIM: To analyze the prognostic value of adipokines in predicting the course, complications and fatal outcome of acute pancreatitis (AP). METHODS: We performed the search of PubMed database and the systemic analysis of the literature for both experimental and human studies on prognostic value of adipokines in AP for period 2002-2012. Only the papers that described the use of adipokines for prediction of severity and/or complications of AP were selected for further analysis. Each article had to contain information about the levels of measured adipokines, diagnosis and verification of AP, to specify presence of pancreatic necrosis, organ dysfunction and/or mortality rates. From the very beginning, study was carried out adhering to the PRISMA checklist and flowchart for systemic reviews. To assess quality of all included human studies, the Quality Assessment of Diagnostic Accuracy Studies tool was used. Because of the high heterogeneity between the studies, it was decided to refrain from the statistical processing or meta-analysis of the available data. RESULTS: Nine human and three experimental studies were included into review. In experimental studies significant differences between leptin concentrations at 24 and 48 h in control, acute edematous and acute necrotizing pancreatitis groups were found (P = 0.027 and P < 0.001). In human studies significant differences between leptin and resitin concentrations in control and acute pancreatitis groups were found. 1-3 d serum adiponectin threshold of 4.5 μg/mL correctly classified the severity of 81% of patients with AP. This threshold yielded a sensitivity of 70%, specificity 85%, positive predictive value 64%, negative predictive value88% (area under curve 0.75). Resistin and visfatin concentrations differ significantly between mild and severe acute pancreatitis groups, they correlate with severity of disease, need for interventions and outcome. Both adipokines are good markers for parapancreatic necrosis and the cut
Do negative quantifiers like “few” reduce people’s ability to rapidly evaluate incoming language with respect to world knowledge? Previous research has addressed this question by examining whether online measures of quantifier comprehension match the “final” interpretation reflected in verification judgments. However, these studies confounded quantifier valence with its impact on the unfolding expectations for upcoming words, yielding mixed results. In the current event-related potentials study, participants read negative and positive quantifier sentences matched on cloze probability and on truth-value (e.g., “Most/Few gardeners plant their flowers during the spring/winter for best results”). Regardless of whether participants explicitly verified the sentences or not, true-positive quantifier sentences elicited reduced N400s compared with false-positive quantifier sentences, reflecting the facilitated semantic retrieval of words that render a sentence true. No such facilitation was seen in negative quantifier sentences. However, mixed-effects model analyses (with cloze value and truth-value as continuous predictors) revealed that decreasing cloze values were associated with an interaction pattern between truth-value and quantifier, whereas increasing cloze values were associated with more similar truth-value effects regardless of quantifier. Quantifier sentences are thus understood neither always in 2 sequential stages, nor always in a partial-incremental fashion, nor always in a maximally incremental fashion. Instead, and in accordance with prediction-based views of sentence comprehension, quantifier sentence comprehension depends on incorporation of quantifier meaning into an online, knowledge-based prediction for upcoming words. Fully incremental quantifier interpretation occurs when quantifiers are incorporated into sufficiently strong online predictions for upcoming words. PMID:26375784
Nieuwland, Mante S
Do negative quantifiers like "few" reduce people's ability to rapidly evaluate incoming language with respect to world knowledge? Previous research has addressed this question by examining whether online measures of quantifier comprehension match the "final" interpretation reflected in verification judgments. However, these studies confounded quantifier valence with its impact on the unfolding expectations for upcoming words, yielding mixed results. In the current event-related potentials study, participants read negative and positive quantifier sentences matched on cloze probability and on truth-value (e.g., "Most/Few gardeners plant their flowers during the spring/winter for best results"). Regardless of whether participants explicitly verified the sentences or not, true-positive quantifier sentences elicited reduced N400s compared with false-positive quantifier sentences, reflecting the facilitated semantic retrieval of words that render a sentence true. No such facilitation was seen in negative quantifier sentences. However, mixed-effects model analyses (with cloze value and truth-value as continuous predictors) revealed that decreasing cloze values were associated with an interaction pattern between truth-value and quantifier, whereas increasing cloze values were associated with more similar truth-value effects regardless of quantifier. Quantifier sentences are thus understood neither always in 2 sequential stages, nor always in a partial-incremental fashion, nor always in a maximally incremental fashion. Instead, and in accordance with prediction-based views of sentence comprehension, quantifier sentence comprehension depends on incorporation of quantifier meaning into an online, knowledge-based prediction for upcoming words. Fully incremental quantifier interpretation occurs when quantifiers are incorporated into sufficiently strong online predictions for upcoming words. (c) 2016 APA, all rights reserved).
Loos, Ruth J F
Genome-wide association studies (GWAS) have revolutionised the discovery of genes for common traits and diseases, including obesity-related traits. In less then four years time, 52 genetic loci were identified to be unequivocally associated with obesity-related traits. This vast success raised hope and expectations that genetic information would become soon an integral part of personalised medicine. However, these loci have only small effects on obesity-susceptibility and explain just a fraction of the total variance. As such, their accuracy to predict obesity is poor and not competitive with the predictive ability of traditional risk factors. Nevertheless, some of these loci are being used in commercially available personal genome tests to estimate individuals' lifetime risk of obesity. While proponents believe that personal genome profiling could have beneficial effects on behaviour, early reports do not support this hypothesis. To conclude, the most valuable contribution of GWAS-identified loci lies in their contribution to elucidating new physiological pathways that underlie obesity-susceptibility.
Aslanger, Emre; Assous, Benjamin; Bihry, Nicolas; Beauvais, Florence; Logeart, Damien; Cohen-Solal, Alain
Despite being repeatedly shown that exercise training (ET) increases exercise capacity and decreases mortality in many cardiac conditions, not all patients enjoy the benefits of ET programs. We hypothesized that baseline cardiovascular mechanic properties, including cardiac systolic and diastolic functions, arterial mechanics and ventriculoarterial interaction, may have a role in predicting response to ET. Full left ventricular pressure-volume loops were constructed and arterial mechanics were evaluated using echocardiographic and tonometric measurements. A cardiopulmonary exercise (CPX) test was performed before and after the ET program. Sixty of the 75 patients with coronary artery disease or heart failure diagnoses completed the study. All of the CPX parameters showed a significant improvement with ET. The change in oxygen uptake correlated only with arterial parameters, such as compliance (r = 0.399, P = .002), end-systolic arterial elastance (r = -0.293, P = .02), aortic pulse pressure (r = -0.302, P = .02), and brachial pulse pressure (r = -0.312, P = .01). Receiver-operating characteristics analysis demonstrated that baseline arterial compliance and brachial pulse pressure predicted a significantly positive ET result with reasonable sensitivity and specificity. Patients with a more compliant arterial system improved their exercise capacity more with ET. Evaluation of baseline arterial compliance may facilitate proper patient selection and may define patients who need optimizing measures for the arterial system before commencing ET. Even a simple blood pressure measurement may give clues in this regard.
Levy, Becca R; Ferrucci, Luigi; Zonderman, Alan B; Slade, Martin D; Troncoso, Juan; Resnick, Susan M
Although negative age stereotypes have been found to predict adverse outcomes among older individuals, it was unknown whether the influence of stereotypes extends to brain changes associated with Alzheimer's disease. To consider this possibility, we drew on dementia-free participants, in the Baltimore Longitudinal Study of Aging, whose age stereotypes were assessed decades before yearly magnetic resonance images and brain autopsies were performed. Those holding more-negative age stereotypes earlier in life had significantly steeper hippocampal-volume loss and significantly greater accumulation of neurofibrillary tangles and amyloid plaques, adjusting for relevant covariates. These findings suggest a new pathway to identifying mechanisms and potential interventions related to the pathology of Alzheimer's disease.
Verhage, Marije L; Oosterman, Mirjam; Schuengel, Carlo
Infant temperamental characteristics have been found associated with decreasing parenting self-efficacy (PSE) during the first year after birth, which has been generally interpreted as a child effect on the parent. To test direction of effects, PSE was assessed during the third trimester of pregnancy and twice after birth together with perceived infant temperament in a group of first-time pregnant women (N = 616). Cross-lagged path analysis showed that PSE, even when assessed prior to birth, predicted characteristics of infant negative temperament. Infant negative temperamental characteristics were concurrently, but not prospectively, associated with decreased PSE. These findings indicate that perceptions of infant temperament may partly be shaped by parents' self-perception, rather than the other way around.
Levy, Becca R.; Ferrucci, Luigi; Zonderman, Alan B.; Slade, Martin D.; Troncoso, Juan; Resnick, Susan M.
Although negative age stereotypes have been found to predict adverse outcomes among older individuals, it was unknown whether the influence of stereotypes extends to brain changes associated with Alzheimer’s disease. To consider this possibility, we drew on the age stereotypes of dementia-free participants in the Baltimore Longitudinal Study of Aging that had been measured decades before yearly MRIs and brain autopsies were performed. Those with more negative age stereotypes earlier in life had significantly steeper hippocampal-volume loss, and significantly greater accumulation of neurofibrillary tangles and amyloid plaques at autopsy, adjusting for relevant covariates. These findings suggest a new pathway to identifying mechanisms and potential interventions related to the neuropathology of Alzheimer’s disease. PMID:26641877
Halászlaki, Csaba; Tóbiás, Bálint; Balla, Bernadett; Kósa, János P; Horányi, János; Bölöny, Eszter; Nagy, Zsolt; Speer, Gábor; Járay, Balázs; Székely, Eszter; Istók, Roland; Székely, Tamás; Putz, Zsuzsanna; Dank, Magdolna; Lakatos, Péter; Takács, István
The purpose of our prospective longitudinal study was to evaluate the predictive efficacy of genetic testing for malignancies in fine-needle aspiration biopsy samples that are cytologically benign at the time of biopsy. A total of 779 aspirated cytological samples collected from thyroid nodules of 626 patients were included in a 3-year follow-up study. Consecutive patients with cytologically benign thyroid nodules by the Bethesda System for Reporting Thyroid Cytopathology were enrolled in the study. At enrollment, somatic 1-point nucleotide polymorphisms of BRAF and RAS family genes were tested by melting-point analysis, while RET/PTC and PAX8/PPAR-gamma rearrangements were examined by real-time polymerase chain reaction. The genetic test was considered to be positive if a somatic mutation was found. Malignant cytopathologic diagnoses were confirmed by histopathology. In samples collected from 779 thyroid nodules, there were 39 BRAF, 33 RAS mutations, and 1 RET/PTC rearrangements found at the beginning of the study. No PAX8/PPAR-gamma rearrangement was identified. There were 52 malignant thyroid tumors removed during follow-up, out of which 24 contained a somatic mutation. The specificity of the presence of somatic mutations for malignancies was as high as 93.3%, and sensitivity was 46.2%. The negative predictive value of genetic testing reached 96.0%. Our results show that our set of genetic tests can predict the appearance of malignancy in benign thyroid nodules (at the beginning of follow-up) with high specificity and strong negative predictive value. BRAF = v-raf murine sarcoma viral oncogene homolog B1 FLUS = follicular lesion of undetermined significance FNAB = fine-needle aspiration biopsy FTC = follicular thyroid carcinoma HRAS = homologous to the oncogene from the Harvey rat sarcoma virus KRAS = homologous to the oncogene from the Kirsten rat sarcoma virus NRAS = first isolated from a human neuroblastoma/neuroblastoma RAS = viral oncogene homolog PAX8
Dix, Theodore; Moed, Anat; Anderson, Edward R
This study examined whether, as mothers' depressive symptoms increase, their expressions of negative emotion to children increasingly reflect aversion sensitivity and motivation to minimize ongoing stress or discomfort. In multiple interactions over 2 years, negative affect expressed by 319 mothers and their children was observed across variations in mothers' depressive symptoms, the aversiveness of children's immediate behavior, and observed differences in children's general negative reactivity. As expected, depressive symptoms predicted reduced maternal negative reactivity when child behavior was low in aversiveness, particularly with children who were high in negative reactivity. Depressive symptoms predicted high negative reactivity and steep increases in negative reactivity as the aversiveness of child behavior increased, particularly when high and continued aversiveness from the child was expected (i.e., children were high in negative reactivity). The findings are consistent with the proposal that deficits in parenting competence as depressive symptoms increase reflect aversion sensitivity and motivation to avoid conflict and suppress children's aversive behavior.
Chen, Yu-Lin; Barlow, Dave J; Kong, Xiao-Le; Ma, Yong-Min; Hider, Robert C
As a means to aid in the design of 3-hydroxypyridin-4-ones (HPOs) intended for use as therapeutic Fe(3+) chelating agents, a novel methodology has been developed using quantum mechanical (QM) calculations for predicting the iron binding affinities of the compounds (more specifically, their log K(1) values). The reported/measured HPO log K(1) values were verified through their correlation with the corresponding sum of the compounds' ligating group pK(a) values. Using a training set of eleven HPOs with known log K(1) values, reliable predictions are shown to be obtained with QM calculations using the B3LYP/6-31+G(d)/CPCM model chemistry (with Bondi radii, and water as solvent). With this methodology, the observed log K(1) values for the training set compounds are closely matched by the predicted values, with the correlation between the observed and predicted values giving r(2) = 0.9. Predictions subsequently made by this method for a test set of 42 HPOs of known log K(1) values gave predicted values accurate to within ±0.32 log units. In order to further investigate the predictive power of the method, four novel HPOs were synthesised and their log K(1) values were determined experimentally. Comparison of these predicted log K(1) values against the measured values gave absolute deviations of 0.22 (13.87 vs. 14.09), 0.02 (14.31 vs. 14.29), 0.12 (14.62 vs. 14.50), and 0.13 (15.04 vs. 15.17). The prediction methodology reported here is the first to be provided for predicting the absolute log K(1) values of iron-chelating agents in the absence of pK(a) values.
Lee, Jaehee; Lee, Shin Yup; Yoo, Seung Soo; Cha, Seung Ick; Won, Dong Il; Park, Jae Yong; Lee, Won-Kil; Kim, Chang Ho
Combining a polymerase chain reaction (PCR) test with bronchoscopy is frequently performed to allow a rapid diagnosis of smear-negative pulmonary tuberculosis (PTB). However, limited data are available concerning clinical judgment in patients with suspected PTB and AFB smear- and PCR-negative bronchial aspirates (BA). The present study evaluated the usefulness of whole-blood QuantiFERON-TB Gold In-Tube (QFT) testing in these patients. Of 166 patients with suspected PTB who had undergone bronchoscopy because of smear-negative sputum or inadequate sputum production, 93 (56%) were diagnosed with culture-positive PTB. Seventy-four patients were either AFB smear- or PCR-positive. In the 75 patients whose BA AFB smear and PCR results were both negative, 19 were finally diagnosed with PTB by culture. The QFT test had a negative predictive value of 91% for PTB. The QFT test may be useful for excluding PTB in patients with suspected PTB whose BA AFB smear and PCR results are both negative. Copyright © 2012 Elsevier Inc. All rights reserved.
Patel, Mumtaz; Agius, Steven; Wilkinson, Jack; Patel, Leena; Baker, Paul
In the UK, supervised learning events (SLE) replaced traditional workplace-based assessments for foundation-year trainees in 2012. A key element of SLEs was to incorporate trainee reflection and assessor feedback in order to drive learning and identify training issues early. Few studies, however, have investigated the value of SLEs in predicting doctors in difficulty. This study aimed to identify principles that would inform understanding about how and why SLEs work or not in identifying doctors in difficulty (DiD). A retrospective case-control study of North West Foundation School trainees' electronic portfolios was conducted. Cases comprised all known DiD. Controls were randomly selected from the same cohort. Free-text supervisor comments from each SLE were assessed for the four domains defined in the General Medical Council's Good Medical Practice Guidelines and each scored blindly for level of concern using a three-point ordinal scale. Cumulative scores for each SLE were then analysed quantitatively for their predictive value of actual DiD. A qualitative thematic analysis was also conducted. The prevalence of DiD in this sample was 6.5%. Receiver operator characteristic curve analysis showed that Team Assessment of Behaviour (TAB) was the only SLE strongly predictive of actual DiD status. The Educational Supervisor Report (ESR) was also strongly predictive of DiD status. Fisher's test showed significant associations of TAB and ESR for both predicted and actual DiD status and also the health and performance subtypes. None of the other SLEs showed significant associations. Qualitative data analysis revealed inadequate completion and lack of constructive, particularly negative, feedback. This indicated that SLEs were not used to their full potential. TAB and the ESR are strongly predictive of DiD. However, SLEs are not being used to their full potential, and the quality of completion of reports on SLEs and feedback needs to be improved in order to better identify
Bronte, Giuseppe; Terrasi, Marianna; Rizzo, Sergio; Sivestris, Nicola; Ficorella, Corrado; Cajozzo, Massimo; Di Gaudio, Francesca; Gulotta, Gaspare; Siragusa, Sergio; Gebbia, Nicola; Russo, Antonio
The role of EGFR in cancer development and progression has been recognized for long time in a variety of human malignancies including lung, head and neck, colon, breast, ovary and glioma. Recently its role as a target of antineoplastic agents has also been identified and a variety of EGFR-targeted drugs is already being used in a clinical setting and others are at present under investigation. Many data involving EGFR protein expression are now available for the choice of anti-EGFR monoclonal antibodies in colorectal cancer and with regard to EGFR gene mutations for the choice of tyrosine kinase inhibitors in lung cancer. Other EGFR-related molecular factors, including the EGFR gene copy number, are currently under investigation. This review summarizes both preclinical and clinical available data regarding EGFR genomic alterations as prognostic and predictive factors.
Lecklitner, M.L.; Austin, A.R.; Benedetto, A.R.; Growcock, G.W.
Technetium-99m DISIDA imaging was employed in 400 patients to differentiate obstruction of the common bile duct from medical and other surgical causes of hyperbilirubinemia. Sequential anterior images demonstrated variable degrees of liver uptake, yet there was no evidence of intrabiliary or extrabiliary radioactivity for at least 4 hr after injection in 25 patients. Twenty-three patients were surgically documented to have complete obstruction of the common bile duct. One patient had hepatitis, and another had sickle cell crisis without bile duct obstruction. The remaining patients had either partial or no obstruction of the common bile duct. We conclude that the presence of liver uptake without evident biliary excretion by 4 hr on cholescintigraphy is highly sensitive and predictive of total obstruction of the common bile duct.
Sauer-Zavala, Shannon; Boswell, James F.; Gallagher, Matthew W.; Bentley, Kate H.; Ametaj, Amantia; Barlow, David H.
The present study aimed to understand the contributions of both the trait tendency to experience negative emotions and how one relates to such experience in predicting symptom change during participation in the Unified Protocol (UP), a transdiagnostic treatment for emotional disorders. Data were derived from a randomized controlled trial comparing the UP to a wait-list control / delayed-treatment condition. First, effect sizes of pre- to post-treatment change for frequency of negative emotions and several variables measuring reactivity to emotional experience (emotional awareness and acceptance, fear of emotions, and anxiety sensitivity) were examined. Second, the relative contributions of change in negative emotions and emotional reactivity in predicting symptom (clinician-rated anxiety, depression, and severity of principal diagnosis) reductions were investigated. Results suggested that decreases in the frequency of negative emotions and reactivity to emotions following participation in the UP were both large in magnitude. Further, two emotional reactivity variables (fear of emotions and anxiety sensitivity) remained significantly related to symptom outcomes when controlling for negative emotions, and accounted for significant incremental variance in their prediction. These findings lend support to the notion that psychological health depends less on the frequency of negative emotions and more on how one relates to these emotions when they occur. PMID:22738907
Sauer-Zavala, Shannon; Boswell, James F; Gallagher, Matthew W; Bentley, Kate H; Ametaj, Amantia; Barlow, David H
The present study aimed to understand the contributions of both the trait tendency to experience negative emotions and how one relates to such experience in predicting symptom change during participation in the Unified Protocol (UP), a transdiagnostic treatment for emotional disorders. Data were derived from a randomized controlled trial comparing the UP to a waitlist control/delayed-treatment condition. First, effect sizes of pre- to post-treatment change for frequency of negative emotions and several variables measuring reactivity to emotional experience (emotional awareness and acceptance, fear of emotions, and anxiety sensitivity) were examined. Second, the relative contributions of change in negative emotions and emotional reactivity in predicting symptom (clinician-rated anxiety, depression, and severity of principal diagnosis) reductions were investigated. Results suggested that decreases in the frequency of negative emotions and reactivity to emotions following participation in the UP were both large in magnitude. Further, two emotional reactivity variables (fear of emotions and anxiety sensitivity) remained significantly related to symptom outcomes when controlling for negative emotions, and accounted for significant incremental variance in their prediction. These findings lend support to the notion that psychological health depends less on the frequency of negative emotions and more on how one relates to these emotions when they occur.
Pillar; Peled; Katz; Lavie
A positive diagnosis of obstructive sleep apnoea (OSA) is based on a combination of characteristic symptoms and polysomnographic findings. The present study evaluated the specificity and sensitivity of several risk factors, signs and symptoms in predicting an Apnoea Index in 86 patients referred to the sleep laboratory with suspected OSA. All 86 subjects completed a detailed questionnaire, were interviewed, underwent a brief physical examination, and then a whole-night polysomnographic study. Stepwise multiple regression analysis revealed that self reporting on apnoeas, neck circumference index (NCI), age, and a tendency to fall asleep unintentionally, were all significant positive predictors of apnoea index (AI), explaining 41.8% of the variability. The sensitivity of the model for predicting OSA (taking OSA as AI > 10) was 92.2%, specificity was 18.2% and the positive predictive value was 76.6%. Raising the cut-off AI values resulted in decreased sensitivity and increased specificity. Applying the predicting equation of AI to another group of 50 patients referred to the sleep laboratory with suspected OSA revealed similar results. However, running the equation on 105 offspring of OSA patients who did not complain of OSA-associated symptoms resulted in 32% sensitivity and 94% specificity in predicting OSA. It is concluded that questionnaires, interviews and physical examination, can only vaguely predict AI, and cannot replace polysomnographic recordings. However, the low rates of false negative in predicting AI > 10, and the low rates of false positive in predicting AI > 50, can be used for specific purposes.
Dan, Seejil; Shah, Ansal; Justo, Julie Ann; Bookstaver, P Brandon; Kohn, Joseph; Albrecht, Helmut; Al-Hasan, Majdi N
Increasing rates of fluoroquinolone resistance (FQ-R) have limited empirical treatment options for Gram-negative infections, particularly in patients with severe beta-lactam allergy. This case-control study aims to develop a clinical risk score to predict the probability of FQ-R in Gram-negative bloodstream isolates. Adult patients with Gram-negative bloodstream infections (BSI) hospitalized at Palmetto Health System in Columbia, South Carolina, from 2010 to 2013 were identified. Multivariate logistic regression was used to identify independent risk factors for FQ-R. Point allocation in the fluoroquinolone resistance score (FQRS) was based on regression coefficients. Model discrimination was assessed by the area under receiver operating characteristic curve (AUC). Among 824 patients with Gram-negative BSI, 143 (17%) had BSI due to fluoroquinolone-nonsusceptible Gram-negative bacilli. Independent risk factors for FQ-R and point allocation in FQRS included male sex (adjusted odds ratio [aOR], 1.97; 95% confidence intervals [CI], 1.36 to 2.98; 1 point), diabetes mellitus (aOR, 1.54; 95% CI, 1.03 to 2.28; 1 point), residence at a skilled nursing facility (aOR, 2.28; 95% CI, 1.42 to 3.63; 2 points), outpatient procedure within 30 days (aOR, 3.68; 95% CI, 1.96 to 6.78; 3 points), prior fluoroquinolone use within 90 days (aOR, 7.87; 95% CI, 4.53 to 13.74; 5 points), or prior fluoroquinolone use within 91 to 180 days of BSI (aOR, 2.77; 95% CI, 1.17 to 6.16; 3 points). The AUC for both final logistic regression and FQRS models was 0.73. Patients with an FQRS of 0, 3, 5, or 8 had predicted probabilities of FQ-R of 6%, 22%, 39%, or 69%, respectively. The estimation of patient-specific risk of antimicrobial resistance using FQRS may improve empirical antimicrobial therapy and fluoroquinolone utilization in Gram-negative BSI. Copyright © 2016, American Society for Microbiology. All Rights Reserved.
Dan, Seejil; Shah, Ansal; Justo, Julie Ann; Bookstaver, P. Brandon; Kohn, Joseph; Albrecht, Helmut
Increasing rates of fluoroquinolone resistance (FQ-R) have limited empirical treatment options for Gram-negative infections, particularly in patients with severe beta-lactam allergy. This case-control study aims to develop a clinical risk score to predict the probability of FQ-R in Gram-negative bloodstream isolates. Adult patients with Gram-negative bloodstream infections (BSI) hospitalized at Palmetto Health System in Columbia, South Carolina, from 2010 to 2013 were identified. Multivariate logistic regression was used to identify independent risk factors for FQ-R. Point allocation in the fluoroquinolone resistance score (FQRS) was based on regression coefficients. Model discrimination was assessed by the area under receiver operating characteristic curve (AUC). Among 824 patients with Gram-negative BSI, 143 (17%) had BSI due to fluoroquinolone-nonsusceptible Gram-negative bacilli. Independent risk factors for FQ-R and point allocation in FQRS included male sex (adjusted odds ratio [aOR], 1.97; 95% confidence intervals [CI], 1.36 to 2.98; 1 point), diabetes mellitus (aOR, 1.54; 95% CI, 1.03 to 2.28; 1 point), residence at a skilled nursing facility (aOR, 2.28; 95% CI, 1.42 to 3.63; 2 points), outpatient procedure within 30 days (aOR, 3.68; 95% CI, 1.96 to 6.78; 3 points), prior fluoroquinolone use within 90 days (aOR, 7.87; 95% CI, 4.53 to 13.74; 5 points), or prior fluoroquinolone use within 91 to 180 days of BSI (aOR, 2.77; 95% CI, 1.17 to 6.16; 3 points). The AUC for both final logistic regression and FQRS models was 0.73. Patients with an FQRS of 0, 3, 5, or 8 had predicted probabilities of FQ-R of 6%, 22%, 39%, or 69%, respectively. The estimation of patient-specific risk of antimicrobial resistance using FQRS may improve empirical antimicrobial therapy and fluoroquinolone utilization in Gram-negative BSI. PMID:26833166
Pathak, A K; Samanta, A K; Maity, D K; Mukherjee, T; Ghosh, S K
We have presented a first-principle theory-based derivation of an exact expression for the solvent number-dependent electron-detachment energy of a solvated species in the thermodynamic limit. We also propose a generalized equation bridging the electron detachment energies for small and infinitely large clusters, thus providing a new route to calculate the ionization potential of a negatively charged ion from the electron-detachment energies of its stable hydrated clusters. Most importantly, it has the ability to predict the instability range of microhydrated anions. The calculated results for the ionization potential for a number of ions are found to be in good agreement with the available experimental results, and the predicted instability range for the doubly charged anions SO₄²⁻ and C₂O₄²⁻ is also consistent with experimental and ab initio results.
van Duijvenvoorde, Anna C K; Zanolie, Kiki; Rombouts, Serge A R B; Raijmakers, Maartje E J; Crone, Eveline A
How children learn from positive and negative performance feedback lies at the foundation of successful learning and is therefore of great importance for educational practice. In this study, we used functional magnetic resonance imaging (fMRI) to examine the neural developmental changes related to feedback-based learning when performing a rule search and application task. Behavioral results from three age groups (8-9, 11-13, and 18-25 years of age) demonstrated that, compared with adults, 8- to 9-year-old children performed disproportionally more inaccurately after receiving negative feedback relative to positive feedback. Additionally, imaging data pointed toward a qualitative difference in how children and adults use performance feedback. That is, dorsolateral prefrontal cortex and superior parietal cortex were more active after negative feedback for adults, but after positive feedback for children (8-9 years of age). For 11- to 13-year-olds, these regions did not show differential feedback sensitivity, suggesting that the transition occurs around this age. Pre-supplementary motor area/anterior cingulate cortex, in contrast, was more active after negative feedback in both 11- to 13-year-olds and adults, but not 8- to 9-year-olds. Together, the current data show that cognitive control areas are differentially engaged during feedback-based learning across development. Adults engage these regions after signals of response adjustment (i.e., negative feedback). Young children engage these regions after signals of response continuation (i.e., positive feedback). The neural activation patterns found in 11- to 13-year-olds indicate a transition around this age toward an increased influence of negative feedback on performance adjustment. This is the first developmental fMRI study to compare qualitative changes in brain activation during feedback learning across distinct stages of development.
Hsu, Yi-Fang; Hämäläinen, Jarmo A; Moutsopoulou, Karolina; Waszak, Florian
While the neuronal activation in the medial frontal cortex is thought to reflect higher-order evaluation processes of reward prediction errors when a reward deviates from our expectation, there is increasing evidence that the medial frontal activity might express prediction errors in general. However, given that several studies examined the medial frontal event-related potentials (ERPs) by comparing signals triggered by different stimuli and different anticipations, it remains an open question whether the medial frontal signals are sensitive to the valence of prediction errors. Here we orthogonally manipulated expectation magnitude (i.e., large/small expectation) and expectation confirmation (i.e., fulfilled/violated expectation) in a target detection task with rewards. We found that the medial frontal ERPs were more negative-going for unexpected outcomes in comparison with expected outcomes, regardless of whether a large/small reward was expected. The result supports the idea that the medial frontal signals express prediction errors in general regardless of their valence. Copyright © 2015 Elsevier B.V. All rights reserved.
Prat, A; Lluch, A; Albanell, J; Barry, W T; Fan, C; Chacón, J I; Parker, J S; Calvo, L; Plazaola, A; Arcusa, A; Seguí-Palmer, M A; Burgues, O; Ribelles, N; Rodriguez-Lescure, A; Guerrero, A; Ruiz-Borrego, M; Munarriz, B; López, J A; Adamo, B; Cheang, M C U; Li, Y; Hu, Z; Gulley, M L; Vidal, M J; Pitcher, B N; Liu, M C; Citron, M L; Ellis, M J; Mardis, E; Vickery, T; Hudis, C A; Winer, E P; Carey, L A; Caballero, R; Carrasco, E; Martín, M; Perou, C M; Alba, E
Background: In this study, we evaluated the ability of gene expression profiles to predict chemotherapy response and survival in triple-negative breast cancer (TNBC). Methods: Gene expression and clinical–pathological data were evaluated in five independent cohorts, including three randomised clinical trials for a total of 1055 patients with TNBC, basal-like disease (BLBC) or both. Previously defined intrinsic molecular subtype and a proliferation signature were determined and tested. Each signature was tested using multivariable logistic regression models (for pCR (pathological complete response)) and Cox models (for survival). Within TNBC, interactions between each signature and the basal-like subtype (vs other subtypes) for predicting either pCR or survival were investigated. Results: Within TNBC, all intrinsic subtypes were identified but BLBC predominated (55–81%). Significant associations between genomic signatures and response and survival after chemotherapy were only identified within BLBC and not within TNBC as a whole. In particular, high expression of a previously identified proliferation signature, or low expression of the luminal A signature, was found independently associated with pCR and improved survival following chemotherapy across different cohorts. Significant interaction tests were only obtained between each signature and the BLBC subtype for prediction of chemotherapy response or survival. Conclusions: The proliferation signature predicts response and improved survival after chemotherapy, but only within BLBC. This highlights the clinical implications of TNBC heterogeneity, and suggests that future clinical trials focused on this phenotypic subtype should consider stratifying patients as having BLBC or not. PMID:25101563
Mello, Fernanda Carvalho de Queiroz; Bastos, Luiz Gustavo do Valle; Soares, Sérgio Luiz Machado; Rezende, Valéria MC; Conde, Marcus Barreto; Chaisson, Richard E; Kritski, Afrânio Lineu; Ruffino-Netto, Antonio; Werneck, Guilherme Loureiro
Background Smear negative pulmonary tuberculosis (SNPT) accounts for 30% of pulmonary tuberculosis cases reported yearly in Brazil. This study aimed to develop a prediction model for SNPT for outpatients in areas with scarce resources. Methods The study enrolled 551 patients with clinical-radiological suspicion of SNPT, in Rio de Janeiro, Brazil. The original data was divided into two equivalent samples for generation and validation of the prediction models. Symptoms, physical signs and chest X-rays were used for constructing logistic regression and classification and regression tree models. From the logistic regression, we generated a clinical and radiological prediction score. The area under the receiver operator characteristic curve, sensitivity, and specificity were used to evaluate the model's performance in both generation and validation samples. Results It was possible to generate predictive models for SNPT with sensitivity ranging from 64% to 71% and specificity ranging from 58% to 76%. Conclusion The results suggest that those models might be useful as screening tools for estimating the risk of SNPT, optimizing the utilization of more expensive tests, and avoiding costs of unnecessary anti-tuberculosis treatment. Those models might be cost-effective tools in a health care network with hierarchical distribution of scarce resources. PMID:16504086
Ojewole, Adegoke; Lowegard, Anna; Gainza, Pablo; Reeve, Stephanie M.; Georgiev, Ivelin; Anderson, Amy C.; Donald, Bruce R.
Summary Drug resistance in protein targets is an increasingly common phenomenon that reduces the efficacy of both existing and new antibiotics. However, knowledge of future resistance mutations during pre-clinical phases of drug development would enable the design of novel antibiotics that are robust against not only known resistant mutants, but also against those that have not yet been clinically observed. Computational structure-based protein design (CSPD) is a transformative field that enables the prediction of protein sequences with desired biochemical properties such as binding affinity and specificity to a target. The use of CSPD to predict previously unseen resistance mutations represents one of the frontiers of computational protein design. In a recent study (1), we used our OSPREY (Open Source Protein REdesign for You) suite of CSPD algorithms to prospectively predict resistance mutations that arise in the active site of the dihydrofolate reductase enzyme from methicillin-resistant Staphylococcus aureus (SaDHFR) in response to selective pressure from an experimental competitive inhibitor. We demonstrated that our top predicted candidates are indeed viable resistant mutants. Since that study, we have significantly enhanced the capabilities of OSPREY with not only improved modeling of backbone flexibility, but also efficient multi-state design, fast sparse approximations, partitioned rotamers for more accurate energy bounds, and a computationally efficient representation of molecular-mechanics and quantum-mechanical energy functions. Here, using SaDHFR as an example, we present a protocol for resistance prediction using the latest version of OSPREY. Specifically, we show how to use a combination of positive and negative design to predict active site escape mutations that maintain the enzyme’s catalytic function but selectively ablate binding of an inhibitor. PMID:27914058
Ojewole, Adegoke; Lowegard, Anna; Gainza, Pablo; Reeve, Stephanie M; Georgiev, Ivelin; Anderson, Amy C; Donald, Bruce R
Drug resistance in protein targets is an increasingly common phenomenon that reduces the efficacy of both existing and new antibiotics. However, knowledge of future resistance mutations during pre-clinical phases of drug development would enable the design of novel antibiotics that are robust against not only known resistant mutants, but also against those that have not yet been clinically observed. Computational structure-based protein design (CSPD) is a transformative field that enables the prediction of protein sequences with desired biochemical properties such as binding affinity and specificity to a target. The use of CSPD to predict previously unseen resistance mutations represents one of the frontiers of computational protein design. In a recent study (Reeve et al. Proc Natl Acad Sci U S A 112(3):749-754, 2015), we used our OSPREY (Open Source Protein REdesign for You) suite of CSPD algorithms to prospectively predict resistance mutations that arise in the active site of the dihydrofolate reductase enzyme from methicillin-resistant Staphylococcus aureus (SaDHFR) in response to selective pressure from an experimental competitive inhibitor. We demonstrated that our top predicted candidates are indeed viable resistant mutants. Since that study, we have significantly enhanced the capabilities of OSPREY with not only improved modeling of backbone flexibility, but also efficient multi-state design, fast sparse approximations, partitioned continuous rotamers for more accurate energy bounds, and a computationally efficient representation of molecular-mechanics and quantum-mechanical energy functions. Here, using SaDHFR as an example, we present a protocol for resistance prediction using the latest version of OSPREY. Specifically, we show how to use a combination of positive and negative design to predict active site escape mutations that maintain the enzyme's catalytic function but selectively ablate binding of an inhibitor.
Pencina, Michael J; D'Agostino, Ralph B; Pencina, Karol M; Janssens, A Cecile J W; Greenland, Philip
The discrimination of a risk prediction model measures that model's ability to distinguish between subjects with and without events. The area under the receiver operating characteristic curve (AUC) is a popular measure of discrimination. However, the AUC has recently been criticized for its insensitivity in model comparisons in which the baseline model has performed well. Thus, 2 other measures have been proposed to capture improvement in discrimination for nested models: the integrated discrimination improvement and the continuous net reclassification improvement. In the present study, the authors use mathematical relations and numerical simulations to quantify the improvement in discrimination offered by candidate markers of different strengths as measured by their effect sizes. They demonstrate that the increase in the AUC depends on the strength of the baseline model, which is true to a lesser degree for the integrated discrimination improvement. On the other hand, the continuous net reclassification improvement depends only on the effect size of the candidate variable and its correlation with other predictors. These measures are illustrated using the Framingham model for incident atrial fibrillation. The authors conclude that the increase in the AUC, integrated discrimination improvement, and net reclassification improvement offer complementary information and thus recommend reporting all 3 alongside measures characterizing the performance of the final model.
Gonzalez-Colaço Harmand, Magali; Meillon, Céline; Bergua, Valérie; Tabue Teguo, Maturin; Dartigues, Jean-François; Avila-Funes, José Alberto; Amieva, Hélène
Despite several attempts to reach a single definition of frailty, no consensus has been reached. The definitions previously published have tried to prove its utility in predicting negative health outcomes. The objective of the present study is to compare the predictive value of 3 different frailty instruments, for selected outcomes. The study sample includes 1278 participants of the Three-City study, a French prospective population-based study, assessed for frailty using Fried's phenotype criteria, Rockwood's Frailty Index and Tilburg Frailty Indicator. To assess the risk of mortality, incident disability, falls, institutionalization and hospitalization for a follow up period of 12 years, Cox proportional hazard models with delayed entry have been used. The area under the time-dependent ROC curve has been used to estimate and compare the ability of the three instruments of frailty to predict the previous adverse outcomes at 12 years. Five hundred ninety four participants were identified as non-robust with Fried's criteria; 169 with Rockwood's FI and 303 with TFI. The three scales consistently identified 91 participants as non-robust and 574 as robust. Rockwood's FI was a statistically significant predictor of mortality, incident disability and falls, and a strong predictor of hospitalization. In the absence of a "gold standard" definition of frailty, a debate on what measures and how to include them is open. A clue may be that one should select the appropriate definition according to the to-be predicted outcome, the setting and the underlying etiology of frailty. Copyright © 2017 Elsevier B.V. All rights reserved.
Varan, Hacer Dogan; Bolayir, Basak; Kara, Ozgur; Arik, Gunes; Kizilarslanoglu, Muhammet Cemal; Kilic, Mustafa Kemal; Sumer, Fatih; Kuyumcu, Mehmet Emin; Yesil, Yusuf; Yavuz, Burcu Balam; Halil, Meltem; Cankurtaran, Mustafa
Phase angle (PhA) value determined by bioelectrical impedance analysis (BIA) is an indicator of cell membrane damage and body cell mass. Recent studies have shown that low PhA value is associated with increased nutritional risk in various group of patients. However, there have been only a few studies performed globally assessing the relationship between nutritional risk and PhA in hospitalized geriatric patients. The aim of the study is to evaluate the predictive value of the PhA for malnutrition risk in hospitalized geriatric patients. One hundred and twenty-two hospitalized geriatric patients were included in this cross-sectional study. Comprehensive geriatric assessment tests and BIA measurements were performed within the first 48 h after admission. Nutritional risk state of the patients was determined with NRS-2002. Phase angle values of the patients with malnutrition risk were compared with the patients that did not have the same risk. The independent variables for predicting malnutrition risk were determined. SPSS version 15 was utilized for the statistical analyzes. The patients with malnutrition risk had significantly lower phase angle values than the patients without malnutrition risk (p = 0.003). ROC curve analysis suggested that the optimum PhA cut-off point for malnutrition risk was 4.7° with 79.6 % sensitivity, 64.6 % specificity, 73.9 % positive predictive value, and 73.9 % negative predictive value. BMI, prealbumin, PhA, and Mini Mental State Examination Test scores were the independent variables for predicting malnutrition risk. PhA can be a useful, independent indicator for predicting malnutrition risk in hospitalized geriatric patients.
López, Gemma; Lafuente, Rafael; Checa, Miguel A; Carreras, Ramón; Brassesco, Mario
Over the last years, major improvements in the field of male infertility diagnosis have been achieved. The aim of this study was to determine the diagnostic usefulness of sperm DNA integrity and sperm vacuolisation for predicting outcome in infertile couples undergoing in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) treatments. A cohort study from 152 infertile couples undergoing sperm DNA fragmentation and high-magnification tests prior to an assisted reproduction treatment was designed. We found that the most predictive cutoff for pregnancy was 25.5% of DNA fragmentation with a negative predictive value of 72.7% (P=0.02). For the degree of vacuolisation, the best predictor of pregnancy was 73.5% of vacuolated sperm grades III+IV with a negative predictive value of 39.4% (P=0.09), which was not statistically significant. In conclusion, sperm DNA fragmentation greater than 25.5% could be associated with higher probability of failure IVF treatment. Regarding the results of the sperm analysis at high magnification, they do not allow us to predict whether or not patients will become pregnant. PMID:23912311
López, Gemma; Lafuente, Rafael; Checa, Miguel A; Carreras, Ramón; Brassesco, Mario
Over the last years, major improvements in the field of male infertility diagnosis have been achieved. The aim of this study was to determine the diagnostic usefulness of sperm DNA integrity and sperm vacuolisation for predicting outcome in infertile couples undergoing in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) treatments. A cohort study from 152 infertile couples undergoing sperm DNA fragmentation and high-magnification tests prior to an assisted reproduction treatment was designed. We found that the most predictive cutoff for pregnancy was 25.5% of DNA fragmentation with a negative predictive value of 72.7% (P=0.02). For the degree of vacuolisation, the best predictor of pregnancy was 73.5% of vacuolated sperm grades III+IV with a negative predictive value of 39.4% (P=0.09), which was not statistically significant. In conclusion, sperm DNA fragmentation greater than 25.5% could be associated with higher probability of failure IVF treatment. Regarding the results of the sperm analysis at high magnification, they do not allow us to predict whether or not patients will become pregnant.
Given the turbulence of the contemporary education environment this paper argues it is necessary to adopt more flexible approaches to leadership than has traditionally been the case and involving new ways of learning and behaviours. In this regard, the paper investigates the paradoxical concept of "negative capability" and its potential…
Anjema, Karen; Hofstede, Floris C; Bosch, Annet M; Rubio-Gozalbo, M Estela; de Vries, Maaike C; Boelen, Carolien C A; van Rijn, Margreet; van Spronsen, Francjan J
It is unknown whether the neonatal tetrahydrobiopterin (BH4) loading test is adequate to diagnose long-term BH4 responsiveness in PKU. Therefore we compared the predictive value of the neonatal (test I) versus the 48-h BH4 loading test (test II) and long-term BH4 responsiveness. Data on test I (>1991, 20 mg/kg) at T = 8 (n = 85) and T = 24 (n = 5) were collected and compared with test II and long-term BH4 responsiveness at later age, with ≥30% Phe decrease used as the cut-off. The median (IQR) age at hospital diagnosis was 9 (7-11) days and the age at test II was 11.8 (6.6-13.7) years. The baseline Phe concentrations at test I were significantly higher compared to test II (1309 (834-1710) versus 514 (402-689) μmol/L, respectively, P = 0.000). 15/85 patients had a positive test I T = 8. All, except one patient who was not tested for long-term BH4 responsiveness, showed long-term BH4 responsiveness. In 20/70 patients with a negative test I T = 8, long-term BH4 responsiveness was confirmed. Of 5 patients with a test I T = 24, 1/5 was positive at both tests and showed long-term BH4 responsiveness, 2/5 had negative results at both tests and 2/5 showed a negative test I T = 24, but a positive test II with 1/2 showing long-term BH4 responsiveness. Both a positive neonatal 8- and 24-h BH4 loading test are predictive for long-term BH4 responsiveness. However, a negative test does not rule out long-term BH4 responsiveness. Other alternatives to test for BH4 responsiveness at neonatal age should be investigated.
Ma, Zhuanglin; Zhang, Honglu; Chien, Steven I-Jy; Wang, Jin; Dong, Chunjiao
To investigate the relationship between crash frequency and potential influence factors, the accident data for events occurring on a 50km long expressway in China, including 567 crash records (2006-2008), were collected and analyzed. Both the fixed-length and the homogeneous longitudinal grade methods were applied to divide the study expressway section into segments. A negative binomial (NB) model and a random effect negative binomial (RENB) model were developed to predict crash frequency. The parameters of both models were determined using the maximum likelihood (ML) method, and the mixed stepwise procedure was applied to examine the significance of explanatory variables. Three explanatory variables, including longitudinal grade, road width, and ratio of longitudinal grade and curve radius (RGR), were found as significantly affecting crash frequency. The marginal effects of significant explanatory variables to the crash frequency were analyzed. The model performance was determined by the relative prediction error and the cumulative standardized residual. The results show that the RENB model outperforms the NB model. It was also found that the model performance with the fixed-length segment method is superior to that with the homogeneous longitudinal grade segment method.
Gardy, Jennifer L; Spencer, Cory; Wang, Ke; Ester, Martin; Tusnády, Gábor E; Simon, István; Hua, Sujun; deFays, Katalin; Lambert, Christophe; Nakai, Kenta; Brinkman, Fiona S L
Automated prediction of bacterial protein subcellular localization is an important tool for genome annotation and drug discovery. PSORT has been one of the most widely used computational methods for such bacterial protein analysis; however, it has not been updated since it was introduced in 1991. In addition, neither PSORT nor any of the other computational methods available make predictions for all five of the localization sites characteristic of Gram-negative bacteria. Here we present PSORT-B, an updated version of PSORT for Gram-negative bacteria, which is available as a web-based application at http://www.psort.org. PSORT-B examines a given protein sequence for amino acid composition, similarity to proteins of known localization, presence of a signal peptide, transmembrane alpha-helices and motifs corresponding to specific localizations. A probabilistic method integrates these analyses, returning a list of five possible localization sites with associated probability scores. PSORT-B, designed to favor high precision (specificity) over high recall (sensitivity), attained an overall precision of 97% and recall of 75% in 5-fold cross-validation tests, using a dataset we developed of 1443 proteins of experimentally known localization. This dataset, the largest of its kind, is freely available, along with the PSORT-B source code (under GNU General Public License).
Background Lymphocytopenia has frequently been described in patients with malaria, but studies on its association with disease severity have yielded conflicting results. The neutrophil/lymphocyte count ratio (NLCR) has been introduced as a parameter for systemic inflammation in critically ill patients and was found, together with lymphocytopenia, to be a better predictor of bacteraemia than routine parameters like C-reactive protein and total leukocyte count. In the present study, the predictive value of the NLCR and lymphocytopenia for severe disease was evaluated in patients with imported malaria. Methods All patients diagnosed with malaria at the Harbour Hospital between January 1st 1999 and January 1st 2012 with differential white cell counts determined within the first 24 hours after admission were included in this retrospective study. Severe malaria was defined according to the WHO criteria. The performance of the NLCR and lymphocytopenia as a marker of severe malarial disease was compared back-to-back with that of C-reactive protein as a reference biomarker. Results A total of 440 patients (severe falciparum malaria n = 61, non-severe falciparum malaria n = 259, non-falciparum malaria n=120) were included in the study. Lymphocytopenia was present in 52% of all patients and the median NLCR of all patients was 3.2. Total lymphocyte counts and NLCR did not differ significantly between groups. A significant correlation of total leukocyte count and NLCR, but not lymphocyte count, with parasitaemia was found. ROC analysis revealed a good negative predictive value but a poor positive predictive value of both lymphocytopenia and NLCR and performance was inferior to that of C-reactive protein. After complete parasite clearance a significant rise in total leukocyte count and lymphocyte count and a significant decrease in NLCR was observed. Conclusion The NLCR was found to correlate with parasitaemia, but both lymphocytopenia and the NLCR were inferior to C
Dejonckheere, Egon; Bastian, Brock; Fried, Eiko I; Murphy, Sean C; Kuppens, Peter
Western societies often overemphasize the pursuit of happiness, and regard negative feelings such as sadness or anxiety as maladaptive and unwanted. Despite this emphasis on happiness, the amount of people suffering from depressive complaints is remarkably high. To explain this apparent paradox, we examined whether experiencing social pressure not to feel sad or anxious could in fact contribute to depressive symptoms. A sample of individuals (n = 112) with elevated depression scores (Patient Health Questionnaire [PHQ-9] ≥ 10) took part in an online daily diary study in which they rated their depressive symptoms and perceived social pressure not to feel depressed or anxious for 30 consecutive days. Using multilevel VAR models, we investigated the temporal relation between this perceived social pressure and depressive symptoms to determine directionality. Primary analyses consistently indicated that experiencing social pressure predicts increases in both overall severity scores and most individual symptoms of depression, but not vice versa. A set of secondary analyses, in which we adopted a network perspective on depression, confirmed these findings. Using this approach, centrality analysis revealed that perceived social pressure not to feel negative plays an instigating role in depression, reflected by the high out- and low instrength centrality of this pressure in the various depression networks. Together, these findings indicate how perceived societal norms may contribute to depression, hinting at a possible malignant consequence of society's denouncement of negative emotions. Clinical implications are discussed. © 2017 Wiley Periodicals, Inc.
Slagter, Heleen A; Georgopoulou, Katerina; Frank, Michael J
A large body of research shows that striatal dopamine critically affects the extent to which we learn from the positive and negative outcomes of our decisions. In this study, we examined the relationship between reinforcement learning and spontaneous eye blink rate (sEBR), a cheap, non-invasive, and easy to obtain marker of striatal dopaminergic activity. Based on previous findings from pharmacological and patient studies, our main prediction was that in healthy individuals, low blink rates (and concomitant lower striatal dopamine levels) would be associated with better learning from negative choices, while high blink rates (and concomitant higher striatal dopamine levels) would be associated with learning from positive choices. Behavioral analyses showed that in healthy individuals, lower blink rates were indeed associated with greater learning from negative outcomes, indicating that lower dopamine levels per se may enhance avoidance learning. Yet, higher EBR was not associated with better learning from positive outcomes. These observations support the notion that sEBR reflects tonic dopamine levels, and suggest that sEBR may specifically relate to dopamine D2 receptor function, given the importance of the dopaminergic D2 pathway in avoidance learning. More generally, these findings highlight the usefulness of sEBR as a non-invasive and cheap method for assessing the relationship between striatal dopaminergic function and behavior.
Tsikouras, Panagiotis; Koukouli, Zacharoula; Niesigk, Barbara; Manav, Bachar; Farmakides, George; Csorba, Roland; Galazios, Georgios; Teichmann, Alexander Tobias
The objective of this study is to assess retrospectively the predictive value of fetal scalp pH and base excess (BE) for fetal acidosis and poor neonatal outcome in term, low-risk, spontaneous deliveries with suspicious or pathological intrapartum cardiotocography (CTG) tracings. Umbilical artery pH and BE values obtained immediately after delivery and Apgar score were the outcomes under consideration. Statistics included receiver-operating characteristic curve (ROC) and multiple logistic regression analysis. Four hundred and six deliveries were included in the study. Scalp pH < 7.20 predicted umbilical pH ≤7.1 with 64.3% sensitivity and 92.9% specificity (p < .001). The corresponding positive-predictive value (PPV) was 24.3% and the negative-predictive value (NPV) was 98.6%. Scalp BE ≤ -7 mmol/l (a cut-off value provided by ROC curve analysis) predicted Apgar score ≤ 7 at 5 min with 61.9% sensitivity and 91.7% specificity (p < .001). The corresponding PPV and NPV were 29.5 and 97.7%, respectively. Neither scalp pH nor BE was significantly associated with umbilical BE values. Infants with intrapartum BE ≤ -7 mmol/l were 30 times on an average more likely to get a low Apgar score, independently of intrapartum pH values. Our study supports the consideration of both scalp pH and BE values, when fetal blood sampling (FBS) is used.
van Os, Jim; Lataster, Tineke; Delespaul, Philippe; Wichers, Marieke; Myin-Germeys, Inez
Background For the purpose of diagnosis, psychopathology can be represented as categories of mental disorder, symptom dimensions or symptom networks. Also, psychopathology can be assessed at different levels of temporal resolution (monthly episodes, daily fluctuating symptoms, momentary fluctuating mental states). We tested the diagnostic value, in terms of prediction of treatment needs, of the combination of symptom networks and momentary assessment level. Method Fifty-seven patients with a psychotic disorder participated in an ESM study, capturing psychotic experiences, emotions and circumstances at 10 semi-random moments in the flow of daily life over a period of 6 days. Symptoms were assessed by interview with the Positive and Negative Syndrome Scale (PANSS); treatment needs were assessed using the Camberwell Assessment of Need (CAN). Results Psychotic symptoms assessed with the PANSS (Clinical Psychotic Symptoms) were strongly associated with psychotic experiences assessed with ESM (Momentary Psychotic Experiences). However, the degree to which Momentary Psychotic Experiences manifested as Clinical Psychotic Symptoms was determined by level of momentary negative affect (higher levels increasing probability of Momentary Psychotic Experiences manifesting as Clinical Psychotic Symptoms), momentary positive affect (higher levels decreasing probability of Clinical Psychotic Symptoms), greater persistence of Momentary Psychotic Experiences (persistence predicting increased probability of Clinical Psychotic Symptoms) and momentary environmental stress associated with events and activities (higher levels increasing probability of Clinical Psychotic Symptoms). Similarly, the degree to which momentary visual or auditory hallucinations manifested as Clinical Psychotic Symptoms was strongly contingent on the level of accompanying momentary paranoid delusional ideation. Momentary Psychotic Experiences were associated with CAN unmet treatment needs, over and above PANSS
Obolski, Uri; Alon, Danny; Hadany, Lilach; Stein, Gideon Y
Blood culture isolates are the cornerstone of adequate antibiotic treatment. However, many blood cultures are contaminated with bacteria residing on the skin, the most common contaminants being coagulase-negative staphylococci (CoNS). Such contaminated cultures are mostly disregarded. In this retrospective study, we show that contaminated cultures contain diagnostic information. We tested the association between resistance profiles of CoNS contaminants and those of the actual infecting bacteria isolated subsequently from the same patient, as well as their association with short-term mortality. We identified all patients in Rabin Medical Center, Israel, with positive blood cultures during 2009-12. Data included patient demographics, hospitalization records, comorbidities, blood culture results and date of death. Our cohort consists of 2518 patients with 5290 blood cultures, where 1124 patients had 1664 blood cultures with CoNS contaminants. High overall CoNS resistance predicted high overall resistance of the subsequent bacterial isolates (P<0.004 and P<0.0006, for Gram-positive and -negative bacteria, respectively). Moreover, the resistance of CoNS contaminants to a specific antibiotic predicted the resistance of the subsequent bacterial isolates to that antibiotic (OR=5.55, 95% CI=3.54-8.66, P<10(-15) and OR=2.47, 95% CI=1.61-3.78, P<3 ×10(-5), for Gram-positive and -negative bacteria, respectively). Finally, highly resistant CoNS isolates were associated with higher short-term mortality (hazard ratio=1.71, 95% CI=1.4-2.11, P<10(-6)). Resistance patterns of CoNS contaminants predict specific and overall resistance of subsequent blood culture isolates and short-term mortality. These results may help predict patient mortality and correct empirical antibiotic therapy if blood cultures yield contaminant bacteria and imply that skin commensals may serve as an additional, non-invasive, diagnostic tool. © The Author 2014. Published by Oxford University Press on
Lefgren, Lars; Sims, David
This article develops a simple model of teacher value-added to show how efficient use of information across subjects can improve the predictive ability of value-added models. Using matched student-teacher data from North Carolina, we show that the optimal use of math and reading scores improves the fit of prediction models of overall future…
Wang, Yong; Liu, Zhi-Hong; Zhang, Hong-Liang; Luo, Qin; Zhao, Zhi-Hui; Zhao, Qing
D-dimer can be used to exclude acute pulmonary embolism (PE) for its high negative predictive value (NPV). Also, it is a predictor of recurrent venous thromboembolism (VTE) after anticoagulation withdrawal. The aim of the present study was to assess the predictive value of D-dimer for recurrent VTE when tested at hospital discharge. Plasma D-dimer levels were repeatedly measured at hospital discharge in 204 consecutive patients with the first episode of acute pulmonary embolism. Patients were categorized to two groups by D-dimer levels at hospital discharge and followed up at 3, 6, and 12 months and yearly thereafter. The primary end point was symptomatic, recurrent fatal or nonfatal VTE. D-dimer levels were persistently abnormal in 66 patients (32%). After 31±19 months follow-up, patients with persistently abnormal D-dimer level levels showed a higher rate of of recurrent VTE (14 patients, 21%) compared to those with D-dimer regression (8 patients, 6%) (P = 0.001). At the multivariate analysis, after adjustment for other relevant factors, persistently abnormal D-dimer level levels were an independent predictor of recurrent VTE in all subjects investigated, (hazard ratio, 4.10; 95% CI, 1.61-10.39; P = 0.003), especially in those with unprovoked PE (hazard ratio, 4.61; 95% CI, 1.85-11.49; P = 0.001). The negative predictive value of D-dimer was 94.2 and 92.9% in all subjects or those with unprovoked PE, respectively. Persistently abnormal D-dimer level levels at hospital discharge have a high negative predictive value for recurrence in patients with acute pulmonary embolism, especially in subjects with an unprovoked previous event.
Chen, Chia-Wei; Chu, Hsin; Tsai, Chia-Fen; Yang, Hui-Ling; Tsai, Jui-Chen; Chung, Min-Huey; Liao, Yuan-Mei; Chi, Mei-Ju; Chou, Kuei-Ru
The purpose of this study was to translate the Rowland Universal Dementia Assessment Scale into Chinese and to evaluate the psychometric properties (reliability and validity) and the diagnostic properties (sensitivity, specificity and predictive values) of the Chinese version of the Rowland Universal Dementia Assessment Scale. The accurate detection of early dementia requires screening tools with favourable cross-cultural linguistic and appropriate sensitivity, specificity, and predictive values, particularly for Chinese-speaking populations. This was a cross-sectional, descriptive study. Overall, 130 participants suspected to have cognitive impairment were enrolled in the study. A test-retest for determining reliability was scheduled four weeks after the initial test. Content validity was determined by five experts, whereas construct validity was established by using contrasted group technique. The participants' clinical diagnoses were used as the standard in calculating the sensitivity, specificity, positive predictive value and negative predictive value. The study revealed that the Chinese version of the Rowland Universal Dementia Assessment Scale exhibited a test-retest reliability of 0.90, an internal consistency reliability of 0.71, an inter-rater reliability (kappa value) of 0.88 and a content validity index of 0.97. Both the patients and healthy contrast group exhibited significant differences in their cognitive ability. The optimal cut-off points for the Chinese version of the Rowland Universal Dementia Assessment Scale in the test for mild cognitive impairment and dementia were 24 and 22, respectively; moreover, for these two conditions, the sensitivities of the scale were 0.79 and 0.76, the specificities were 0.91 and 0.81, the areas under the curve were 0.85 and 0.78, the positive predictive values were 0.99 and 0.83 and the negative predictive values were 0.96 and 0.91 respectively. The Chinese version of the Rowland Universal Dementia Assessment Scale
Marinelli, Brett; Espinet-Col, Carina; Ulaner, Gary A; McArthur, Heather L; Gonen, Mithat; Jochelson, Maxine; Weber, Wolfgang A
FDG PET/CT-based measures of tumor burden show promise to predict survival in patients with metastatic breast cancer, but the patient populations studied so far are heterogeneous. The reports may have been confounded by the markedly different prognosis of the various subtypes of breast cancer. The purpose of this study is to evaluate the correlation between tumor burden on FDG PET/CT and overall survival (OS) in patients within a defined population: metastatic triple negative breast cancer (MTNBC). FDG PET/CT scans of 47 consecutive MTNBC patients (54±12 years-old) with no other known malignancies were analyzed. A total 393 lesions were identified, and maximum standardized uptake value (SUVmax), mean SUV, metabolic tumor volume (MTV), total lesion number (TLN) and total lesion glycolysis (TLG), were measured and correlated with patient survival by Mantel-Cox tests and Cox regression analysis. At a median follow-up time of 12.4 months, 41 patients died with a median OS of 12.1 months. Patients with MTV less than 51.5 ml lived nearly three times longer (22 vs 7.1 months) than those with a higher MTV (χ2=21.3, P<0.0001). In a multivariate Cox regression analysis only TLN and MTV were significantly correlated with survival. Those with an MTV burden in the 75th percentile versus the 25th percentile had a hazard ratio of 6.94 (p=0.001). In patients with MTNBC, MTV appears to be a strong prognostic factor. If validated in prospective studies, MTV may be a valuable tool for risk stratification of MTNBC patients in clinical trials and to guide patient management. PMID:27186439
Kim, Young Bin; Lee, Sang Hyeok; Kang, Shin Jin; Choi, Myung Jin; Lee, Jung; Kim, Chang Hun
In this paper, we present a method for predicting the value of virtual currencies used in virtual gaming environments that support multiple users, such as massively multiplayer online role-playing games (MMORPGs). Predicting virtual currency values in a virtual gaming environment has rarely been explored; it is difficult to apply real-world methods for predicting fluctuating currency values or shares to the virtual gaming world on account of differences in domains between the two worlds. To address this issue, we herein predict virtual currency value fluctuations by collecting user opinion data from a virtual community and analyzing user sentiments or emotions from the opinion data. The proposed method is straightforward and applicable to predicting virtual currencies as well as to gaming environments, including MMORPGs. We test the proposed method using large-scale MMORPGs and demonstrate that virtual currencies can be effectively and efficiently predicted with it.
Kim, Young Bin; Lee, Sang Hyeok; Kang, Shin Jin; Choi, Myung Jin; Lee, Jung; Kim, Chang Hun
In this paper, we present a method for predicting the value of virtual currencies used in virtual gaming environments that support multiple users, such as massively multiplayer online role-playing games (MMORPGs). Predicting virtual currency values in a virtual gaming environment has rarely been explored; it is difficult to apply real-world methods for predicting fluctuating currency values or shares to the virtual gaming world on account of differences in domains between the two worlds. To address this issue, we herein predict virtual currency value fluctuations by collecting user opinion data from a virtual community and analyzing user sentiments or emotions from the opinion data. The proposed method is straightforward and applicable to predicting virtual currencies as well as to gaming environments, including MMORPGs. We test the proposed method using large-scale MMORPGs and demonstrate that virtual currencies can be effectively and efficiently predicted with it. PMID:26241496
Del Castillo Rodríguez, José A. García; López-Sánchez, Carmen; Soler, M. Carmen Quiles; Del Castillo-López, Álvaro García; Pertusa, Mónica Gázquez; Campos, Juan Carlos Marzo; Inglés, Cándido J.
Two predictive models are developed in this article: the first is designed to predict people' attitudes to alcoholic drinks, while the second sets out to predict the use of alcohol in relation to selected individual values. University students (N = 1,500) were recruited through stratified sampling based on sex and academic discipline. The…
Del Castillo Rodríguez, José A. García; López-Sánchez, Carmen; Soler, M. Carmen Quiles; Del Castillo-López, Álvaro García; Pertusa, Mónica Gázquez; Campos, Juan Carlos Marzo; Inglés, Cándido J.
Two predictive models are developed in this article: the first is designed to predict people' attitudes to alcoholic drinks, while the second sets out to predict the use of alcohol in relation to selected individual values. University students (N = 1,500) were recruited through stratified sampling based on sex and academic discipline. The…
Somasekar, A; James, L; Stephenson, B M; Thompson, I W; Vellacott, K D; Allison, M C
To review all preceding 'negative' large bowel investigations in patients with a final diagnosis of colorectal cancer, and to examine whether delayed diagnosis was associated with worse outcome. Details were gathered on all patients with a new diagnosis of colorectal adenocarcinoma presenting over 4.5 years. For each patient the hospital's clinical workstation and radiology and endoscopy databases were interrogated for all flexible sigmoidoscopies, colonoscopies and barium enemas during the 5 years prior to diagnosis. Among the 570 patients, 28 (5%) had undergone colonoscopy and/or flexible sigmoidoscopy that had not shown colorectal cancer during the 5 years preceding final diagnosis, and a further 28 (5%) had undergone 'negative' barium enemas. Polyp surveillance might have missed four lesions destined to become malignant. Correspondingly there were three patients undergoing IBD surveillance found to have CRC, having had a negative complete colonoscopy within the preceding 5 years. Among patients undergoing de novo colonoscopy for diagnosis the true miss rate was only one patient per year. At August 2007, 29 (58%) of those with delayed diagnosis were still alive, compared with 216 (42%) of those diagnosed during initial investigation (chi2 = 5.04, P < 0.05). Colonoscopic miss rates are in line with previous studies. The application of simple clinical ground rules will avoid most pitfalls. The methodology described herein may assist in auditing the quality assurance of lower gastrointestinal diagnostic services. Despite the delay, late diagnosis was found to be associated with improved survival and a lower likelihood of metastatic disease.
Selby, Edward A; Kranzler, Amy; Panza, Emily; Fehling, Kara B
Influenced by chaos theory, the emotional cascade model proposes that rumination and negative emotion may promote each other in a self-amplifying cycle that increases over time. Accordingly, exponential-compounding effects may better describe the relationship between rumination and negative emotion when they occur in impulsive persons, and predict impulsive behavior. Forty-seven community and undergraduate participants who reported frequent engagement in impulsive behaviors monitored their ruminative thoughts and negative emotion multiple times daily for two weeks using digital recording devices. Hypotheses were tested using cross-lagged mixed model analyses. Findings indicated that rumination predicted subsequent elevations in rumination that lasted over extended periods of time. Rumination and negative emotion predicted increased levels of each other at subsequent assessments, and exponential functions for these associations were supported. Results also supported a synergistic effect between rumination and negative emotion, predicting larger elevations in subsequent rumination and negative emotion than when one variable alone was elevated. Finally, there were synergistic effects of rumination and negative emotion in predicting number of impulsive behaviors subsequently reported. These findings are consistent with the emotional cascade model in suggesting that momentary rumination and negative emotion progressively propagate and magnify each other over time in impulsive people, promoting impulsive behavior.
Dong, X-M; Cai, R; Yang, F; Zhang, Y-Y; Wang, X-G; Fu, S-L; Zhang, J-R
To explore the correlation between plasma β2-microglobulin (β2-MG) as senescence factor with age, heart, liver and kidney function as well as the predictive value of β2-MG in human metabolism function and senescence. 387 cases of healthy people of different ages were selected and the automatic biochemical analyzer was used to test β2-MG in plasma based on immunoturbidimetry and also all biochemical indexes. The correlation between β2-MG and age, gender and all biochemical indexes was analyzed. β2-MG was positively correlated to age, r = 0.373; and the difference was of statistical significance (p < 0.010). It was significantly negative correlated to HDL-C but positively correlated to LP (a), BUN, CREA, UA, CYS-C, LDH, CK-MB, HBDH, AST, GLB and HCY. β2-MG was closely correlated to age, heart, kidney and liver biochemical indexes, which can be taken as an important biomarker for human body function and anti-senescence and have significant basic research and clinical guidance values.
Introduction This prospective study investigated the predictive value of procalcitonin (PCT) for survival in 242 adult patients with severe sepsis and septic shock treated in intensive care. Methods PCT was analyzed from blood samples of all patients at baseline, and 155 patients 72 hours later. Results The median PCT serum concentration on day 0 was 5.0 ng/ml (interquartile range (IQR) 1.0 and 20.1 ng/ml) and 1.3 ng/ml (IQR 0.5 and 5.8 ng/ml) 72 hours later. Hospital mortality was 25.6% (62/242). Median PCT concentrations in patients with community-acquired infections were higher than with nosocomial infections (P = 0.001). Blood cultures were positive in 28.5% of patients (n = 69), and severe sepsis with positive blood cultures was associated with higher PCT levels than with negative cultures (P = < 0.001). Patients with septic shock had higher PCT concentrations than patients without (P = 0.02). PCT concentrations did not differ between hospital survivors and nonsurvivors (P = 0.64 and P = 0.99, respectively), but mortality was lower in patients whose PCT concentration decreased > 50% (by 72 hours) compared to those with a < 50% decrease (12.2% vs. 29.8%, P = 0.007). Conclusions PCT concentrations were higher in more severe forms of severe sepsis, but a substantial concentration decrease was more important for survival than absolute values. PMID:21078153
Zarkesh, Marjaneh; Sedaghat, Fatemeh; Heidarzadeh, Abtin; Tabrizi, Manizheh; Bolooki-Moghadam, Kobra; Ghesmati, Soheil
Since clinical manifestations of most febrile infants younger than three months old are nonspecific, differentiation of Serious Bacterial Infection (SBI) from self-limiting viral illness is a significant challenge for pediatricians. This study was performed to assess the diagnostic value of white blood cell count (WBC), Absolute Neutrophil Count (ANC), Interleukin -6 (IL-6) and C-reactive protein (CRP) level to predict SBI in febrile infants younger than three months old who were hospitalized. This was a diagnostic test validation study. In this prospective study, 195 febrile infants admitted to 17 Shahrivar Hospital underwent a full sepsis workup including blood, urine, cerebrospinal fluid cultures and chest radiography. WBC count, ANC and CRP and Il-6 level were measured in all patients. Serum IL-6 concentration was measured by Enzyme-linked Immunosorbent Assay test. Then diagnostic, values of these tests for predicting SBI was compared with each other. Of total cases, 112 (57.4%) infants were male. SBI was diagnosed in 29 (14.9%) patients. The most common type of SBI was Urinary Tract Infection (UTI). Serum IL-6 (³20pg/dl) had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 79/1%, 91.6%,75.4%, 60.3%, respectively and for CRP (³ 10mg/l) values were 81.6%, 89.8%, 78.2%, and 52%,respectively. The predictive values of CRP and IL-6 were higher than WBC and ANC. IL-6 and CRP are more valid and better diagnostic markers for predicting SBI than WBC count and ANC. CRP level seems to be an accessible and cost-effective marker for early diagnosis of SBI. Since by no marker we can totally rule out SBI in febrile infants < three months of age, it is recommended to administer systemic antibiotics until culture results become available.
Ilivitzki, Anat; Radan, Lea; Ben-Arush, Miriam; Israel, Ora; Ben-Barak, Ayelet
Interim 18F-FDG PET helps predict outcome and tailor treatment in adults with Hodgkin disease (HD). The purpose of this study was to assess predictive values of interim 18F-FDG PET/CT in children with HD and to define the potential added value to interim PET of low-dose CT. Children were prospectively enrolled August 2002-April 2007. PET/low-dose CT was performed at staging, after 2 cycles, at the end of treatment and during follow-up (mean 45 months). Treatment was unchanged regardless of interim results. PET and low-dose CT were read independently. Of 34 enrolled children (ages 3-17 years), 27 achieved complete response, 4 had progressive disease and 3 had relapse. Interim PET alone had positive and negative predictive values of 67% and 89%, respectively. Interim low-dose CT alone had positive and negative predictive values of 35% and 100%, respectively. Interim PET/CT had positive and negative predictive values of 75% and 96%, respectively. Early interim PET/CT was a good predictor of outcome. Integrated PET and low-dose CT improved the predictive value in children with HD.
Kimura, Motohiro; Takeda, Yuji
Visual mismatch negativity (MMN) is an event-related brain potential (ERP) component that is elicited by prediction-incongruent events in successive visual stimulation. Previous oddball studies have shown that visual MMN in response to task-irrelevant deviant stimuli is insensitive to the manipulation of task difficulty, which supports the notion that visual MMN reflects attention-independent predictive processes. In these studies, however, visual MMN was evaluated in deviant-minus-standard difference waves, which may lead to an underestimation of the effects of task difficulty due to the possible superposition of N1-difference reflecting refractory effects. In the present study, we investigated the effects of task difficulty on visual MMN, less contaminated by N1-difference. While the participant performed a size-change detection task regarding a continuously-presented central fixation circle, we presented oddball sequences consisting of deviant and standard bar stimuli with different orientations (9.1 and 90.9%) and equiprobable sequences consisting of 11 types of control bar stimuli with different orientations (9.1% each) at the surrounding visual fields. Task difficulty was manipulated by varying the magnitude of the size-change. We found that the peak latencies of visual MMN evaluated in the deviant-minus-control difference waves were delayed as a function of task difficulty. Therefore, in contrast to the previous understanding, the present findings support the notion that visual MMN is associated with attention-demanding predictive processes.
Patrick, Rebecca J; Slobodian, Dana; Debanne, Sara; Huang, Ying; Wellman, Charles
Fall assessment tools are commonly used to evaluate the likelihood of fall. For patients found to be at high risk, patient-specific fall prevention interventions are implemented. The purposes of this study were to describe the population, evaluate and compare the efficacy of fall assessment tools, and suggest the best use for these tools in hospice. Data were downloaded from the electronic medical record for all patients who were admitted to and died in hospice care in 2013. Variables included demographic, clinical and initial fall assessment scores that had been computed on admission to hospice care, using our standard fall assessment tool. To facilitate comparison among three tools, additional fall assessment calculations were made for each patient using the Morse Fall Scale and MACH-10, two tools commonly used in a variety of healthcare settings. Data were available for 3446 hospice patients. Female patients were less likely to fall than males; Fallers lived longer than Nonfallers; and patients with a primary dementia diagnosis fell 10 days sooner than those with a primary non-dementia diagnosis. A comparison of three fall assessment tools revealed that no tool had a good positive predictive value, but each demonstrated a good negative predictive value. Fall assessment scores should not be used as the sole predictor of likelihood of fall, and are best used as a supplement to clinical judgement. Patients with a primary dementia diagnosis are likely to fall earlier in their hospice care than those with other primary diagnoses. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Paramasivam, Nagarajan; Linke, Dirk
The subcellular localization (SCL) of proteins provides important clues to their function in a cell. In our efforts to predict useful vaccine targets against Gram-negative bacteria, we noticed that misannotated start codons frequently lead to wrongly assigned SCLs. This and other problems in SCL prediction, such as the relatively high false-positive and false-negative rates of some tools, can be avoided by applying multiple prediction tools to groups of homologous proteins. Here we present ClubSub-P, an online database that combines existing SCL prediction tools into a consensus pipeline from more than 600 proteomes of fully sequenced microorganisms. On top of the consensus prediction at the level of single sequences, the tool uses clusters of homologous proteins from Gram-negative bacteria and from Archaea to eliminate false-positive and false-negative predictions. ClubSub-P can assign the SCL of proteins from Gram-negative bacteria and Archaea with high precision. The database is searchable, and can easily be expanded using either new bacterial genomes or new prediction tools as they become available. This will further improve the performance of the SCL prediction, as well as the detection of misannotated start codons and other annotation errors. ClubSub-P is available online at http://toolkit.tuebingen.mpg.de/clubsubp/ PMID:22073040
Vogel, Sally J; Strauss, Gregory P; Allen, Daniel N
Research has demonstrated that individuals with schizophrenia fail to appropriately use negative feedback to guide learning. These learning deficits are thought to arise from abnormalities in midbrain dopamine activity. Primary and enduring negative symptoms are also associated with abnormal dopamine activity and are expected to produce more severe deficits in learning when they present in individuals with schizophrenia. The current study examines this matter by comparing individuals with deficit syndrome schizophrenia, which is characterized by primary and enduring negative symptoms, to individuals with nondeficit syndrome schizophrenia and to normal controls in their use of positive feedback and negative feedback to guide learning on the first four cards of the WCST. Participants included 67 individuals with schizophrenia (15 deficit; 52 nondeficit syndrome) and 51 healthy controls. Accuracy data from the first 4 cards of the WCST and measures of global test performance were examined. Individuals with schizophrenia were significantly less accurate than controls in their performance on early (pre-shift) WCST trials, and this impairment was significantly greater in patients with deficit than nondeficit schizophrenia. Additionally, accuracy across the first 4 WCST cards significantly predicted the number of categories completed and percentage of perseverative errors across the entire test. These findings suggest that negative symptoms of schizophrenia are associated with difficulty using negative feedback to adaptively guide behavior, and are consistent with the notion that abnormal DA signaling contributes to the higher-order executive functioning impairments seen in schizophrenia with severe negative symptoms.
Kara, Ekrem; Sahutoglu, Tuncay; Ahbap, Elbis; Sakaci, Tamer; Koc, Yener; Basturk, Taner; Sevinc, Mustafa; Akgol, Cuneyt; Unsal, Abdulkadir
The aim of this study was to evaluate the predictive value of malnutrition-inflammation score (MIS) on short-term mortality and to identify the best cut-off point in the Turkish maintenance hemodialysis (MHD) population. A total of 100 patients on MHD were included in this prospective single-center study. Demographic, anthropometric, and biochemical data were obtained from all patients. The study population was followed up as a 12-month prospective cohort to evaluate mortality as the primary outcome. Median (IQR) age and HD vintage of 100 patients (M/F: 52/48) were 53 (39.5 - 67) years and 53.5 (11 - 104.7) months, respectively. Deceased patients (n = 7) had significantly older age (years) (50 (38.5 - 63.5) vs. 70 (62 - 82), respectively, p = 0.001), lower spKt/V (1.60 (1.40 - 1.79) vs. 1.35 (0.90 - 1.50), respectively, p = 0.002), lower triceps skinfold thickness (14 (10 - 19) vs. 9 (7 - 11), respectively, p = 0.021) and higher MIS (5 (4 - 7) vs. 10 (7 - 11), respectively, p = 0.013). In the ROC analysis, we found that the optimal cut-off value of MIS for predicting death was 6.5 with 85.7% sensitivity and 62.4% specificity (positive and negative predictive values were 0.6951 and 0.8136, respectively). Advanced age, low spKt/V, and high MIS were found to be predictors of mortality in multivariate logistic regression analysis. The 1-year mortality rate was significantly higher in MIS > 6.5 group compared to the MIS ≤ 6.5 group (14,3% (6/41) vs. 1.6% (1/59), respectively). Compared to MIS ≤ 6.5 group, 1 year survival time of the patients with MIS > 6.5 was found to be significantly lower (47.8 ± 0.16 vs. 43.6 ± 1.63 weeks, respectively, p (log-rank) = 0.012). MIS is a robust and independent predictor of short-term mortality in MHD patients. Patients with MIS > 6.5 had a significant risk, and additional risk factors associated with short-term mortality were advanced age and low spKt/V.
Petrican, Raluca; Saverino, Cristina; Rosenbaum, R. Shayna; Grady, Cheryl
Current evidence suggests that two spatially distinct neuroanatomical networks, the dorsal attention network (DAN) and the default mode network (DMN), support externally and internally oriented cognition, respectively, and are functionally regulated by a third, frontoparietal control network (FPC). Interactions among these networks contribute to normal variations in cognitive functioning and to the aberrant affective profiles present in certain clinical conditions, such as major depression. Nevertheless, their links to non-clinical variations in affective functioning are still poorly understood. To address this issue, we used fMRI to measure the intrinsic functional interactions among these networks in a sample of predominantly younger women (N = 162) from the Human Connectome Project. Consistent with the previously documented dichotomous motivational orientations (i.e., withdrawal versus approach) associated with sadness versus anger, we hypothesized that greater sadness would predict greater DMN (rather than DAN) functional dominance, whereas greater anger would predict the opposite. Overall, there was evidence of greater DAN (rather than DMN) functional dominance, but this pattern was modulated by current experience of specific negative emotions, as well as subclinical depressive and anxiety symptoms. Thus, greater levels of currently experienced sadness and subclinical depression independently predicted weaker DAN functional dominance (i.e., weaker DAN-FPC functional connectivity), likely reflecting reduced goal-directed attention towards the external perceptual environment. Complementarily, greater levels of currently experienced anger and subclinical anxiety predicted greater DAN functional dominance (i.e., greater DAN-FPC functional connectivity and, for anxiety only, also weaker DMN-FPC coupling). Our findings suggest that distinct affective states and subclinical mood symptoms have dissociable neural signatures, reflective of the symbiotic relationship
Stirzaker, Clare; Zotenko, Elena; Song, Jenny Z; Qu, Wenjia; Nair, Shalima S; Locke, Warwick J; Stone, Andrew; Armstong, Nicola J; Robinson, Mark D; Dobrovic, Alexander; Avery-Kiejda, Kelly A; Peters, Kate M; French, Juliet D; Stein, Sandra; Korbie, Darren J; Trau, Matt; Forbes, John F; Scott, Rodney J; Brown, Melissa A; Francis, Glenn D; Clark, Susan J
Epigenetic alterations in the cancer methylome are common in breast cancer and provide novel options for tumour stratification. Here, we perform whole-genome methylation capture sequencing on small amounts of DNA isolated from formalin-fixed, paraffin-embedded tissue from triple-negative breast cancer (TNBC) and matched normal samples. We identify differentially methylated regions (DMRs) enriched with promoters associated with transcription factor binding sites and DNA hypersensitive sites. Importantly, we stratify TNBCs into three distinct methylation clusters associated with better or worse prognosis and identify 17 DMRs that show a strong association with overall survival, including DMRs located in the Wilms tumour 1 (WT1) gene, bi-directional-promoter and antisense WT1-AS. Our data reveal that coordinated hypermethylation can occur in oestrogen receptor-negative disease, and that characterizing the epigenetic framework provides a potential signature to stratify TNBCs. Together, our findings demonstrate the feasibility of profiling the cancer methylome with limited archival tissue to identify regulatory regions associated with cancer.
Erten, Nilgun; Genc, Sema; Besisik, Sevgi K; Saka, Bulent; Karan, M Akif; Tascioglu, Cemil
Procalcitonin (PCT) represents a new marker of systemic inflammatory reactions to bacterial infections. The main aim in this study was to determine the diagnostic value of PCT in predicting the clinical severity of febril neutropenic attacks, compare it with that of C-reactive protein (CRP), and clarify its importance in culture-positive attacks. Between February 2001 and April 2002, 36 patients who were neutropenic due to various hematologic disorders and febrile were entered into the study. Blood samples were obtained on the first day of fever for the measurement of serum PCT and CRP levels. In clinically severe neutropenic fever attacks, means of serum PCT and CRP levels were measured as 0.93+/-1.33 ng/mL and 67+/-24 mg/L, while they were 0.37+/-0.23 ng/mL and 32+/-19 mg/L in clinically mild ones (p = 0.033 and p < 0.001). On the other hand, no statistical significance was found between culture-positive and negative attacks when either serum PCT or CRP levels were taken into consideration (p = 0.133 and p = 0.141). The specificity and positive predictive value of the serum PCT test for severe febrile neutropenia was higher than that of the serum CRP test (0.80 vs. 0.57 and 0.50 vs. 0.39). However, sensitivity and negative predictive value for CRP were higher than the values for PCT (1.00 vs. 0.40 and 1.00 vs. 0.73). Diagnostic value and positive likelihood ratio of CRP for severe febrile neutropenia were higher than those of PCT (71 vs. 67 and 2.32 vs. 2.00). PCT and CRP are comparable with each other in prediction of the clinical severity of febrile neutropenic attacks. Furthermore, serum CRP levels correlate with the duration of fever.
Bares, Martin; Brunovsky, Martin; Kopecek, Miloslav; Novak, Tomas; Stopkova, Pavla; Kozeny, Jiri; Sos, Peter; Krajca, Vladimir; Höschl, Cyril
Previous studies of patients with unipolar depression have shown that early decrease of prefrontal EEG cordance in theta band can predict clinical response to various antidepressants. We have now examined whether decrease of prefrontal quantitative EEG (QEEG) cordance value after 1 week of venlafaxine treatment predicts clinical response to venlafaxine in resistant patients. We analyzed 25 inpatients who finished 4-week venlafaxine treatment. EEG data were monitored at baseline and after 1 week of treatment. QEEG cordance was computed at three frontal electrodes in theta frequency band. Depressive symptoms and clinical status were assessed using Montgomery-Asberg Depression Rating Scale (MADRS), Beck Depression Inventory-Short Form (BDI-S) and Clinical Global Impression (CGI). Eleven of 12 responders (reduction of MADRS >or=50%) and only 5 of 13 non-responders had decreased prefrontal QEEG cordance value after the first week of treatment (p=0.01). The decrease of prefrontal cordance after week 1 in responders was significant (p=0.03) and there was no significant change in non-responders. Positive and negative predictive values of cordance reduction for response were 0.7 and 0.9, respectively. The reduction of prefrontal theta QEEG cordance value after first week of treatment might be helpful in the prediction of response to venlafaxine.
Liao, Yiming; Ji, Xiaoli; Zhang, Chengxu; Huang, Xiaolin; Xu, Yue; Yan, Feng
The fluctuation significantly affects the lifetime prediction of negative bias temperature instability (NBTI) for deeply scaled pMOSFETs. In this paper, we present a novel difference method to separate the time dependent fluctuation-related component from the NBTI quasi-static component in the threshold voltage shift. The extracted fluctuation-related component exhibits weak temperature and time dependences which is consistent with the characteristic of as-grown defect-induced trapping and detrapping while the quasi-static component presents electrical behaviors of generated-defect-induced NBTI degradation. On the basis of these results, a composite NBTI model is constructed and lifetime projection is derived for the small pMOSFETs.
Hafstad, Gertrud Sofie; Abebe, Dawit Shawel; Torgersen, Leila; von Soest, Tilmann
The objective of this study is to describe the development and examine predictors of picky eating from 1.5 to 4.5 years of age in a community sample of children. Mothers completed a questionnaire, assessing picky eating and a range of child and maternal factors, when their children were aged 1.5 (n = 913), 2.5 (n = 777), and 4.5 (n = 727) years. Picky eating increased significantly from 1.5 to 4.5 years. Lower maternal age, higher levels of child emotionality, and maternal negative affectivity at the child's age 1.5 predicted an increase in picky eating from 1.5 years to 2.5 and 4.5 years. Having siblings protected against the development of picky eating. Child and maternal temperament at a very early stage in the child's life increase the risk for picky eating later on. Copyright © 2013 Elsevier Ltd. All rights reserved.
Yang, Qingsheng; Mwenda, Kevin M; Ge, Miao
The measurement of the Erythrocyte Sedimentation Rate (ESR) value is a standard procedure performed during a typical blood test. In order to formulate a unified standard of establishing reference ESR values, this paper presents a novel prediction model in which local normal ESR values and corresponding geographical factors are used to predict reference ESR values using multi-layer feed-forward artificial neural networks (ANN). Local normal ESR values were obtained from hospital data, while geographical factors that include altitude, sunshine hours, relative humidity, temperature and precipitation were obtained from the National Geographical Data Information Centre in China.The results show that predicted values are statistically in agreement with measured values. Model results exhibit significant agreement between training data and test data. Consequently, the model is used to predict the unseen local reference ESR values. Reference ESR values can be established with geographical factors by using artificial intelligence techniques. ANN is an effective method for simulating and predicting reference ESR values because of its ability to model nonlinear and complex relationships.
Matsuda, Naoko; Kida, Kumiko; Ohde, Sachiko; Suzuki, Koyu; Yamauchi, Hideko; Nakamura, Seigo; Tsunoda, Hiroko
Ultrasound (US) is conventionally performed to determine effects of neoadjuvant chemotherapy (NAC) on breast cancer. In patients with triple-negative breast cancer (TNBC), higher pathological complete response (pCR) predicts the most favorable survival outcome. We aimed to predict pCR to NAC using echogenicity changes in US region of interest (ROI) in patients with TNBC. We retrospectively determined clinicopathological characteristics of 52 patients with primary TNBC who underwent NAC. Changes in echogenicity for pCR and non-pCR patients were calculated from ratios of tumor to fat (T/F) in their ROIs, before and after NAC, as [T/F After/T/F Before] and [T/F After - T/F Before]. Of the 52 patients (median age: 52 years; range 26-77 years), 20 (38.5%) achieved pCR, which was significantly associated with change in ROI ratio (P < 0.01). The cut-off values for ROI ratio and ROI difference were 0.8 and 0.3. Sensitivity and specificity were 73.7 and 81.8% for ROI ratio, and 70.0 and 81.3% for ROI difference. Area under the curves (AUCs) for ROI ratio and ROI difference were 0.80 [95% confidence interval (CI) 0.67-0.92] and 0.78 (95% CI 0.64-0.92), respectively. Quantification of echogenic changes by converting absolute values of tumor and fat regions can predict pCR and individual differences between tumors after NAC in patients with TNBC.
Bao, Xiaoguang; Hrovat, David; Borden, Weston; Wang, Xue B.
Cyclobutane-1,2,3,4-tetraone has been both predicted and found to have a triplet ground state, in which a b2g MO and an a2u MO is each singly occupied. In contrast, (CO)5 and (CO)6 have each been predicted to have a singlet ground state. This prediction has been tested by generating the (CO)5 - and (CO)6 - anions in the gas-phase by electrospray vaporization of solutions of, respectively, the croconate (CO)52- and rhodizonate (CO)62- dianions. The negative ion photoelectron (NIPE) spectra of the (CO)5•- radical anion give electron affinity (EA) = 3.830 eV and a singlet ground state for (CO)5, with the triplet higher in energy by 0.850 eV (19.6 kcal/mol). The NIPE spectra of the (CO)6•- radical anion give EA = 3.785 eV and a singlet ground state for (CO)6, with the triplet higher in energy by 0.915 eV (21.1 kcal/mol). (RO)CCSD(T)/aug-cc-pVTZ//(U)B3LYP/6-311+G(2df) calculations give EA values that are only ca. 1 kcal/mol lower than those measured and EST values that are only 2 - 3 kcal/mol higher than those obtained from the NIPE spectra. Thus, the calculations support the interpretations of the NIPE spectra and the finding, based on the spectra, that (CO)5 and (CO)6 both have a singlet ground state.
Guembe, M; Martín-Rabadán, P; Echenagusia, A; Camúñez, F; Rodríguez-Rosales, G; Simó, G; Echenagusia, M; Bouza, E
Cultures taken from the skin and from the hubs of short-term central venous catheters can help us to predict catheter-related bloodstream infections (C-RBSIs). The value of these cultures for such predictions has not been assessed in long-term catheters. Our objective was to assess the value of superficial cultures for the prediction of C-RBSI among patients with long-term catheters. Over a 2-year period, we prospectively obtained cultures from the skin overlying reservoir ports (group A) and from the skin insertion site and hubs of all tunneled catheters (group B). This routine was performed by vascular and interventional radiologists immediately before catheter removal (irrespective of the reason for withdrawal). Swabs were processed semiquantitatively. Catheter tips from both groups were cultured using Maki's semiquantitative technique and sonication. We also performed cultures of the reservoir ports at different sites. C-RBSI was defined as the isolation of the same species of microorganism(s) both in the colonized catheter and in at least 1 peripheral blood culture. We included 372 catheters (group A, 223; group B, 149) during the study period. The catheter colonization rate was 23.4% (87/372), and 28 patients had C-RBSI. Validity index values for the capacity of surface cultures to predict C-RBSI in groups A and B were, respectively, as follows: sensitivity, 23.5% and 45.5%; specificity, 59.7% and 63.0%; positive predictive value, 4.6% and 8.9%; and negative predictive value, 90.4% and 93.5%. Superficial cultures of patients with long-term catheters could help us to rule out the catheter as the portal of entry of bloodstream infections. Superficial cultures (from skin and hubs) proved to be a useful conservative diagnostic tool for ruling out C-RBSI among patients with long-term tunneled catheters and totally implantable venous access ports.
Martín-Rabadán, P.; Echenagusia, A.; Camúñez, F.; Rodríguez-Rosales, G.; Simó, G.; Echenagusia, M.; Bouza, E.
Cultures taken from the skin and from the hubs of short-term central venous catheters can help us to predict catheter-related bloodstream infections (C-RBSIs). The value of these cultures for such predictions has not been assessed in long-term catheters. Our objective was to assess the value of superficial cultures for the prediction of C-RBSI among patients with long-term catheters. Over a 2-year period, we prospectively obtained cultures from the skin overlying reservoir ports (group A) and from the skin insertion site and hubs of all tunneled catheters (group B). This routine was performed by vascular and interventional radiologists immediately before catheter removal (irrespective of the reason for withdrawal). Swabs were processed semiquantitatively. Catheter tips from both groups were cultured using Maki's semiquantitative technique and sonication. We also performed cultures of the reservoir ports at different sites. C-RBSI was defined as the isolation of the same species of microorganism(s) both in the colonized catheter and in at least 1 peripheral blood culture. We included 372 catheters (group A, 223; group B, 149) during the study period. The catheter colonization rate was 23.4% (87/372), and 28 patients had C-RBSI. Validity index values for the capacity of surface cultures to predict C-RBSI in groups A and B were, respectively, as follows: sensitivity, 23.5% and 45.5%; specificity, 59.7% and 63.0%; positive predictive value, 4.6% and 8.9%; and negative predictive value, 90.4% and 93.5%. Superficial cultures of patients with long-term catheters could help us to rule out the catheter as the portal of entry of bloodstream infections. Superficial cultures (from skin and hubs) proved to be a useful conservative diagnostic tool for ruling out C-RBSI among patients with long-term tunneled catheters and totally implantable venous access ports. PMID:23850957
Hu, Hai-Jie; Mao, Hui; Tan, Yong-Qiong; Shrestha, Anuj; Ma, Wen-Jie; Yang, Qin; Wang, Jun-Ke; Cheng, Nan-Sheng; Li, Fu-Yu
To examine the predictive value of tumor markers for evaluating tumor resectability in patients with hilar cholangiocarcinoma and to explore the prognostic effect of various preoperative factors on resectability in patients with potentially resectable tumors. Patients with potentially resectable tumors judged by radiologic examination were included. The receiver operating characteristic (ROC) analysis was conducted to evaluate serum carbohydrate antigenic determinant 19-9 (CA 19-9), carbohydrate antigen 125 (CA 125) and carcino embryonie antigen levels on tumor resectability. Univariate and multivariate logistic regression models were also conducted to analysis the correlation of preoperative factors with resectability. In patients with normal bilirubin levels, ROC curve analysis calculated the ideal CA 19-9 cut-off value of 203.96 U/ml in prediction of resectability, with a sensitivity of 83.7 %, specificity of 80 %, positive predictive value of 91.1 % and negative predictive value of 66.7 %. Meanwhile, the optimal cut-off value for CA 125 to predict resectability was 25.905 U/ml (sensitivity, 78.6 %; specificity, 67.5 %). In a multivariate logistic regression model, tumor size ≤3 cm (OR 4.149, 95 % CI 1.326-12.981, P = 0.015), preoperative CA 19-9 level ≤200 U/ml (OR 20.324, 95 % CI 6.509-63.467, P < 0.001), preoperative CA 125 levels ≤26 U/ml (OR 8.209, 95 % CI 2.624-25.677, P < 0.001) were independent determinants of resectability in patients diagnosed as hilar cholangiocarcinoma. Preoperative CA 19-9 and CA 125 levels predict resectability in patients with radiological resectable hilar cholangiocarcinoma. Increased preoperative CA 19-9 levels and CA 125 levels are associated with poor resectability rate.
Yick, Yee Ying; Buratto, Luciano Grüdtner; Schaefer, Alexandre
We report here a study that obtained reliable effects of emotional modulation of a well-known index of memory encoding--the electrophysiological "Dm" effect--using a recognition memory paradigm followed by a source memory task. In this study, participants performed an old-new recognition test of emotionally negative and neutral pictures encoded 1 day before the test, and a source memory task involving the retrieval of the temporal context in which pictures had been encoded. Our results showed that Dm activity was enhanced for all emotional items on a late positivity starting at ~400 ms post-stimulus onset, although Dm activity for high arousal items was also enhanced at an earlier stage (200-400 ms). Our results also showed that emotion enhanced Dm activity for items that were both recognised with or without correct source information. Further, when only high arousal items were considered, larger Dm amplitudes were observed if source memory was accurate. Three main conclusions are drawn from these findings. First, negative emotion can enhance encoding processes predicting the subsequent recognition of central item information. Second, if emotion reaches high levels of arousal, the encoding of contextual details can also be enhanced over and above the effects of emotion on central item encoding. Third, the morphology of our ERPs is consistent with a hybrid model of the role of attention in emotion-enhanced memory (Pottage and Schaefer, 2012). Copyright © 2015 Elsevier Ltd. All rights reserved.
Duchnowska, Renata; Jarząb, Michał; Żebracka-Gala, Jadwiga; Matkowski, Rafał; Kowalczyk, Anna; Radecka, Barbara; Kowalska, Małgorzata; Pfeifer, Aleksandra; Foszczyńska-Kłoda, Małgorzata; Musolino, Antonino; Czartoryska-Arłukowicz, Bogumiła; Litwiniuk, Maria; Surus-Hyla, Anna; Szabłowska-Siwik, Sylwia; Karczmarek-Borowska, Bożenna; Dębska-Szmich, Sylwia; Głodek-Sutek, Beata; Sosińska-Mielcarek, Katarzyna; Chmielowska, Ewa; Kalinka-Warzocha, Ewa; Olszewski, Wojciech P; Patera, Janusz; Żawrocki, Anton; Pliszka, Agnieszka; Tyszkiewicz, Tomasz; Rusinek, Dagmara; Oczko-Wojciechowska, Małgorzata; Jassem, Jacek; Biernat, Wojciech
Triple-negative breast cancer (TNBC) lacks expression of steroid hormone receptors (estrogen receptor α and progesterone) and epidermal growth factor receptor type 2. This phenotype shows high metastatic potential, with particular predilection to lungs and brain. Determination of TNBC transcriptomic profiles associated with high risk of brain metastasis (BM) might identify patients requiring alternative, more aggressive, or specific preventive and therapeutic approaches. Using a cDNA-mediated annealing, selection, extension, and ligation assay, we investigated expression of 29,369 gene transcripts in primary TNBC tumor samples from 119 patients-71 in discovery cohort A and 48 in independent cohort B-that included best discriminating genes. Expression of mRNA was correlated with the occurrence of symptomatic BM. In cohort A, the difference at the noncorrected P < .005 was found for 64 transcripts (P = .23 for global test), but none showed significant difference at a preset level of false-discovery rate of < 10%. Of the 30 transcripts with the largest differences between patients with and without BM in cohort A, none was significantly associated with BM in cohort B. Analysis based on the primary tumor gene transcripts alone is unlikely to predict BM development in advanced TNBC. Despite its negative findings, the study adds to the knowledge on the biology of TNBC and paves the way for future projects using more advanced molecular assays. Copyright © 2016 Elsevier Inc. All rights reserved.
Ruiz-Juretschke, F; Guzmán-de-Villoria, J G; García-Leal, R; Sañudo, J R
Microvascular decompression (MVD) is accepted as the only aetiological surgical treatment for refractory classic trigeminal neuralgia (TN). There is therefore increasing interest in establishing the diagnostic and prognostic value of identifying neurovascular compressions (NVC) using preoperative high-resolution three-dimensional magnetic resonance (MRI) in patients with classic TN who are candidates for surgery. This observational study includes a series of 74 consecutive patients with classic TN treated with MVD. All patients underwent a preoperative three-dimensional high-resolution MRI with DRIVE sequences to diagnose presence of NVC, as well as the degree, cause, and location of compressions. MRI results were analysed by doctors blinded to surgical findings and subsequently compared to those findings. After a minimum follow-up time of six months, we assessed the surgical outcome and graded it on the Barrow Neurological Institute pain intensity score (BNI score). The prognostic value of the preoperative MRI was estimated using binary logistic regression. Preoperative DRIVE MRI sequences showed a sensitivity of 95% and a specificity of 87%, with a 98% positive predictive value and a 70% negative predictive value. Moreover, Cohen's kappa (CK) indicated a good level of agreement between radiological and surgical findings regarding presence of NVC (CK 0.75), type of compression (CK 0.74) and the site of compression (CK 0.72), with only moderate agreement as to the degree of compression (CK 0.48). After a mean follow-up of 29 months (range 6-100 months), 81% of the patients reported pain control with or without medication (BNI score i-iiiI). Patients with an excellent surgical outcome, i.e. without pain and off medication (BNI score i), made up 66% of the total at the end of follow-up. Univariate analysis using binary logistic regression showed that a diagnosis of NVC on the preoperative MRI was a favorable prognostic factor that significantly increased the odds of
Liu, Ping; Li, Xin; Li, Fang-Fei; Ou-Yang, Qiao-Hong; Zhang, Hong-Xia; Feng, Tao
Early and correct diagnosis of Parkinson's disease (PD) is critical for patient counseling and therapeutic management. The diagnostic accuracy of transcranial sonography of substantia nigra (SN-TCS) for early stage PD patients remains controversial. Dopamine transporter (DAT) imaging is sensitive to detect presynaptic dopamine neuronal dysfunction, and has been studied as a diagnostic tool for degenerative Parkinsonism. To investigate the predictive value of SN-TCS for the DAT PET scans in clinically diagnosed early stage PD patients, we performed the SN-TCS and DAT Positron Emission Computed Tomography (PET) imaging examinations on 53 patients. Using the DAT PET results as clinical gold standard, the sensitivity and specificity of TCS was 68.75% and 40% respectively. The positive predictive value (PPV) of an abnormal TCS for an abnormal PET scan was 91.67%. However, the negative predictive value (NPV) for a normal PET scan was only 11.76%. The false negative rate was 31.25%. In 35 patients, the result of the SN-TCD was in accordance with the result of the DAT PET scan (Kappa=0.042, P>0.05). The consistency between SN-TCS and PET scans was poor. We conclude that SN-TCS would not be used as a diagnostic tool for early stage PD patients. Negative result of TCS could not exclude the diagnosis of PD. Further tests like DAT-PET is needed for validation. On the other hand, positive SN-TCS will reduce the added diagnostic value of a presynaptic neuronimaging scan.
Abdulnaby, Nasser Keshar; Sayed, Ashraf Othman; Shalaby, Nehad Mohamed
Background High serum uric acid (sUA) is an indicator of oxidative stress and is linked to tissue hypoxia in asthma. The objective of this case series was to investigate the prognostic role of sUA in patients with acute asthma exacerbations and the link between sUA and spirometric lung tests. Patients and methods This cross-sectional observational study included 120 patients with acute asthma exacerbations and 120 controls, categorized according to peak expiratory flow rate into moderate, and severe and life-threatening asthma. On admission, a detailed history was obtained and investigations were carried out regarding oxygen saturation (SaO2), arterial blood gas, spirometry, sUA, number of asthma exacerbations, smoking status, history of previous hospitalization, intensive care unit admission, and mechanical ventilation. Results The current study revealed higher sUA in asthmatic patients compared with healthy subjects and in severe asthma patients compared with moderate asthma patients (P<0.001). A positive correlation of sUA with asthma severity, number of asthma exacerbations and smoking index (r=0.6, 0.42 and 0.29, respectively, P<0.001) and a negative correlation of sUA with SaO2, partial pressure of arterial oxygen (PaO2), percent predicted forced vital capacity, percent predicted forced expiratory volume (FEV%) and peak expiratory flow rate percent of predicted (PEFR%; r=−0.48, −0.29, −0.44, −0.44 and −0.66, respectively, P<0.001) were observed. Degree of asthma severity, number of asthma exacerbations, and smoking index were significant predictors of high sUA (R2=0.43, P<0.001) in multiple linear regression model 1. SaO2 and PEFR% were significant predictors of high uric acid (R2=0.50, P<0.001) in model 2. The sensitivity and specificity of sUA in predicting severity of asthma at the cutoff point of 6.3 mg/dL were 80% and 90%, respectively. The odds ratios of sUA, number of asthma exacerbations, and asthma duration were 5.4, 1.95 and 1
Wu, Te Chang; Chen, Tai Yuan; Shiue, Yow Ling; Chen, Jeon Hor; Hsieh, Tsyh-Jyi; Ko, Ching Chung; Lin, Ching Po
Background The computed tomography angiography (CTA) spot sign represents active contrast extravasation within acute primary intracerebral hemorrhage (ICH) and is an independent predictor of hematoma expansion (HE) and poor clinical outcomes. The spot sign could be detected on first-pass CTA (fpCTA) or delayed CTA (dCTA). Purpose To investigate the additional benefits of dCTA spot sign in primary ICH and hematoma size for predicting spot sign. Material and Methods This is a retrospective study of 100 patients who underwent non-contrast CT (NCCT) and CTA within 24 h of onset of primary ICH. The presence of spot sign on fpCTA or dCTA, and hematoma size on NCCT were recorded. The spot sign on fpCTA or dCTA for predicting significant HE, in-hospital mortality, and poor clinical outcomes (mRS ≥ 4) are calculated. The hematoma size for prediction of CTA spot sign was also analyzed. Results Only the spot sign on dCTA could predict high risk of significant HE and poor clinical outcomes as on fpCTA ( P < 0.05). With dCTA, there is increased sensitivity and negative predictive value (NPV) for predicting significant HE, in-hospital mortality, and poor clinical outcomes. The XY value (product of the two maximum perpendicular axial dimensions) is the best predictor (area under the curve [AUC] = 0.82) for predicting spot sign on fpCTA or dCTA in the absence of intraventricular and subarachnoid hemorrhage. Conclusion This study clarifies that dCTA imaging could improve predictive performance of CTA in primary ICH. Furthermore, the XY value is the best predictor for CTA spot sign.
Perrewé, P L; Hochwarter, W A; Kiewitz, C
Perceptions of work interfering with family life and family issues interfering with work are examined as 2 distinct constructs representing work-family conflict. Experienced work-family conflict is argued to reduce one's value attainment which, in turn, lowers both job and life satisfaction. This study examines value attainment as a mediating variable in the work-family conflict and satisfaction relationship. Responses from 270 hotel managers indicate that value attainment either partially or fully mediates the relationship between work interference with family and family interference with work and both job and life satisfaction. Value attainment is argued to be a meaningful explanatory variable for the negative relationship between work-family conflict and job-life satisfaction.
Silva, G N; Tomaz, R S; Sant'Anna, I C; Carneiro, V Q; Cruz, C D; Nascimento, M
Artificial neural networks have shown great potential when applied to breeding programs. In this study, we propose the use of artificial neural networks as a viable alternative to conventional prediction methods. We conduct a thorough evaluation of the efficiency of these networks with respect to the prediction of breeding values. Therefore, we considered eight simulated scenarios, and for the purpose of genetic value prediction, seven statistical parameters in addition to the phenotypic mean in a network designed as a multilayer perceptron. After an evaluation of different network configurations, the results demonstrated the superiority of neural networks compared to estimation procedures based on linear models, and indicated high predictive accuracy and network efficiency.
Poplack, Steven P; Paulsen, Keith D; Hartov, Alexander; Meaney, Paul M; Pogue, Brian W; Tosteson, Tor D; Grove, Margaret R; Soho, Sandra K; Wells, Wendy A
Representative data are provided for three electromagnetic breast imaging techniques-near-infrared spectroscopy, electrical impedance spectroscopy, and microwave imaging spectroscopy-to serve as potential benchmarks for future investigation. The breasts of 23 women without clinical or mammographic findings of disease were imaged in the coronal plane with nonionizing radiation of varying frequencies. Average electromagnetic property values were reconstructed at each frequency on the basis of computational models of light diffusion, current flow, and microwave propagation. Electromagnetic properties were correlated with subject characteristics and between techniques. Each technique yielded information on breast tissue features (eg, conductivity, permittivity, light scattering, and absorption) that had not previously all been measured in the same individuals.
Carson, D S; Berquist, S W; Trujillo, T H; Garner, J P; Hannah, S L; Hyde, S A; Sumiyoshi, R D; Jackson, L P; Moss, J K; Strehlow, M C; Cheshier, S H; Partap, S; Hardan, A Y; Parker, K J
The neuropeptide oxytocin (OXT) exerts anxiolytic and prosocial effects in the central nervous system of rodents. A number of recent studies have attempted to translate these findings by investigating the relationships between peripheral (e.g., blood, urinary and salivary) OXT concentrations and behavioral functioning in humans. Although peripheral samples are easy to obtain in humans, whether peripheral OXT measures are functionally related to central OXT activity remains unclear. To investigate a possible relationship, we quantified OXT concentrations in concomitantly collected cerebrospinal fluid (CSF) and blood samples from child and adult patients undergoing clinically indicated lumbar punctures or other CSF-related procedures. Anxiety scores were obtained in a subset of child participants whose parents completed psychometric assessments. Findings from this study indicate that plasma OXT concentrations significantly and positively predict CSF OXT concentrations (r=0.56, P=0.0064, N=27). Moreover, both plasma (r=-0.92, P=0.0262, N=10) and CSF (r=-0.91, P=0.0335, N=10) OXT concentrations significantly and negatively predicted trait anxiety scores, consistent with the preclinical literature. Importantly, plasma OXT concentrations significantly and positively (r=0.96, P=0.0115, N=10) predicted CSF OXT concentrations in the subset of child participants who provided behavioral data. This study provides the first empirical support for the use of blood measures of OXT as a surrogate for central OXT activity, validated in the context of behavioral functioning. These preliminary findings also suggest that impaired OXT signaling may be a biomarker of anxiety in humans, and a potential target for therapeutic development in individuals with anxiety disorders.
Timsit, M; Timsit-Berthier, M; Schoenen, J; Maertens de Noordhout, A
The aim of this study was to display the result obtained by the contingent negative variation (CNV) recording in patients suffering from headache. Eighty-five patients were taken into account: 59 with migraines (M) and 26 with tension headache (TH). A typical CNV pattern (high CNV amplitude with no habituation) differentiated M from TH. Moreover, psychological data were collected through Rorschach ink blot test among 42 headache sufferers (31 M and 11 TH). The typical Rorschach repressive pattern of alexithymia was found as well in M as in TH while CNV amplitude was significantly higher in the 31 M (-25 microV) than in the 11 TH (-19 microV FP less than 0.04). Biochemical data collected among 28 patients (17 M and 11 TH) revealed a positive correlation between CNV amplitude and plasma level of noradrenaline, regardless of the type of headache (r = 0.58; P less than 0.01). Thus, besides psychological factors, catecholaminergic mechanisms seem implicated in the determination of the CNV pattern in migraine. CNV may help the clinician both to specify diagnosis and to decide between the many therapeutic strategies available.
Baliki, M.N.; Geha, P.Y.; Fields, H.L.; Apkarian, A.V.
We compared brain activations in response to acute noxious thermal stimuli in controls and chronic back pain (CBP) patients. Pain perception and related cortical activation patterns were similar in the two groups. However, nucleus accumbens (NAc) activity differentiated the groups at a very high accuracy, exhibiting phasic and tonic responses with distinct properties. Positive phasic NAc activations at stimulus onset and offset tracked stimulus salience and, in normal subjects predicted reward (pain relief) magnitude at stimulus offset. In CBP, NAc activity correlated with different cortical circuitry than normals and phasic activity at stimulus offset was negative in polarity, suggesting that the acute pain relieves the ongoing back pain. The relieving effect was confirmed in a separate psychophysical study in CBP. Therefore, in contrast to somatosensory pathways, which reflect sensory properties of acute noxious stimuli, NAc activity in humans encodes its predicted value and predicts its analgesic potential on chronic pain. PMID:20399736
Hewage, Trishan A M; Alderson, Kim L; Alderson, Andrew; Scarpa, Fabrizio
A scalable mechanical metamaterial simultaneously displaying negative stiffness and negative Poisson's ratio responses is presented. Interlocking hexagonal subunit assemblies containing 3 alternative embedded negative stiffness (NS) element types display Poisson's ratio values of -1 and NS values over two orders of magnitude (-1.4 N mm(-1) to -160 N mm(-1) ), in good agreement with model predictions.
Hocine, Aldjia; Defrance, Pierre; Lalmand, Jacques; Delcour, Christian; Biston, Patrick; Piagnerelli, Michaël
To investigate the predictive value of decreased urine output based on the Risk of renal dysfunction, Injury to the kidney, Failure of kidney function, Loss of kidney function and End-stage renal disease (RIFLE) classification on contrast- induced acute kidney injury (CA-AKI) in intensive care (ICU) patients. All patients who received contrast media (CM) injection for CT scan or coronary angiography during a 3-year period in a 24 bed medico-surgical ICU were reviewed. Daily serum creatinine concentrations and diuresis were measured for 3 days after CM injection. We identified 23 cases of CA-AKI in the 149 patients included (15.4 %). Patients who developed CA-AKI were more likely to require renal replacement therapy and had higher ICU mortality rates. At least one RIFLE urine output criteria was observed in 45 patients (30.2 %) and 14 of these 45 patients (31.1 %) developed CA-AKI based on creatinine concentrations. In 30 % of these cases, urine output decreased or didn't change after the increase in creatinine concentrations. The RIFLE urine output criteria had low sensitivity (39.1 %) and specificity (67.9 %) for prediction of CA-AKI, a low positive predictive value of 50 % and a negative predictive value of 87.2 %. The maximal dose of vasopressors before CM was the only independent predictive factor for CA-AKI. CA-AKI is a frequent pathology observed in ICU patients and is associated with increased need for renal replacement therapy and increased mortality. The predictive value of RIFLE urine output criteria for the development of CA-AKI based on creatinine concentrations was low, which limits its use for assessing the effects of therapeutic interventions on the development and progression of AKI.
Koffler, Jennifer; Sharma, Sarika; Hess, Jochen
Head and neck cancer collectively describes malignant tumors originating from the mucosal surface of the upper aerodigestive tract. These tumors pose a great threat to public health because of their high incidence and mortality. Traditional risk factors are tobacco and alcohol abuse. More recently, infection by high-risk types of human papilloma virus (HPV) has been identified as an additional risk factor, especially for oropharyngeal squamous cell carcinoma (OPSCC). Moreover, HPV-positive OPSCC is considered a distinct tumor entity with an improved clinical outcome compared to HPV-negative OPSCC. Epigenetic alterations act as key events in the pathogenesis of cancer and are of special interest for basic and translational oncology because of their reversible nature. This review provides a comprehensive summary of alterations of the epigenome in head and neck squamous cell carcinoma (HNSCC) with a focus on the methylome (hypomethylation and hypermethylation) and its predictive value in the evaluation of pathologic states and clinical outcome, or monitoring response rates to certain therapies. PMID:27308324
Liu, Yanli; Zhang, Yuchao; Li, Qingfu; Li, Junfang; Ma, Xiaotian; Xing, Jinfang; Rong, Shouhua; Wu, Zhong; Tian, Yuan; Li, Jing; Jia, Liting
Purpose miRNAs are stable and can be extracted from tissues, blood and other body fluid without degradation. miRNAs are abnormally expressed in the presence of a pathological status, including cancer. Therefore, miRNAs are ideal biomarkers for cancer diagnosis and prognosis. Patients with triple negative breast cancer (TNBC) suffer the worst prognosis, although great efforts have been made. Many studies have investigated the role of miRNAs in predicting the outcomes of TNBC patients for better adjustment of treatment. However, results were inconsistent. Thus, we performed a meta-analysis to summarize the published studies for conclusive results. Methods Eligible studies from different database were retrieved from the online databases, and we used STSTA 12.0 to analysis the prognostic role of miRNAs in triple negative breast cancer. Results Overall high miRNA expression indicated a worse survival with HR value of 1.78 (95% CI: 0.97–3.25). However, subtotal HRs of oncogenic miRNAs and tumor suppressive miRNAs were 2.73 (95% CI: 2.08–3.57; P<0.001) and 0.44 (95% CI: 0.21–0.90; P = 0.024), respectively, and no heterogeneity was observed within the subgroups. Conclusions The miRNAs showed a slightly stronger prognostic value for disease-free survival, relapse-free survival and distant metastasis-free survival compared to the overall survival of TNBC patients. Circulating miRNAs could serve as potential biomarkers for the prognosis of TNBC patients and need further investigation. PMID:28085956
Remenschneider, Aaron K; Dilger, Amanda E; Wang, Yingbing; Palmer, Edwin L; Scott, James A; Emerick, Kevin S
Preoperative localization of sentinel lymph nodes in head and neck cutaneous malignancies can be aided by single-photon emission computed tomography/computed tomography (SPECT/CT); however, its true predictive value for identifying lymph nodes intraoperatively remains unquantified. This study aims to understand the sensitivity, specificity, and positive and negative predictive values of SPECT/CT in sentinel lymph node biopsy for cutaneous malignancies of the head and neck. Blinded retrospective imaging review with comparison to intraoperative gamma probe confirmed sentinel lymph nodes. A consecutive series of patients with a head and neck cutaneous malignancy underwent preoperative SPECT/CT followed by sentinel lymph node biopsy with a gamma probe. Two nuclear medicine physicians, blinded to clinical data, independently reviewed each SPECT/CT. Activity within radiographically defined nodal basins was recorded and compared to intraoperative gamma probe findings. Sensitivity, specificity, and negative and positive predictive values were calculated with subgroup stratification by primary tumor site. Ninety-two imaging reads were performed on 47 patients with cutaneous malignancy who underwent SPECT/CT followed by sentinel lymph node biopsy. Overall sensitivity was 73%, specificity 92%, positive predictive value 54%, and negative predictive value 96%. The predictive ability of SPECT/CT to identify the basin or an adjacent basin containing the single hottest node was 92%. SPECT/CT overestimated uptake by an average of one nodal basin. In the head and neck, SPECT/CT has higher reliability for primary lesions of the eyelid, scalp, and cheek. SPECT/CT has high sensitivity, specificity, and negative predictive value, but may overestimate relevant nodal basins in sentinel lymph node biopsy. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.
Ong, Eric; Farran, Sumaya; Salloum, Michelle; Gardner, Summer; Giovinco, Nicholas; Armstrong, David G; Matthias, Kathryn R; Nix, David E; Al Mohajer, Mayar
To assess the severity of inflammation associated with diabetic foot infection (DFI), values of inflammatory markers such as white blood count (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and neutrophil to lymphocyte ratio (NLR) are often measured and tracked over time. It remains unclear if these markers can aid the clinician in the diagnosis and management of DFI, and ensure more rational use of antibiotics. Hospitalized adult patients (n = 379) with DFI were retrospectively assessed for abnormal inflammatory markers, correlation between values of inflammatory markers, and clinical diagnosis on initial admission and on last follow-up. At admission, WBC, ESR and NLR were each elevated in patients with osteomyelitis and only ESR was significantly elevated in patients with soft tissue infection only. Only WBC was significantly elevated in patients with osteomyelitis compared with uninfected diabetic feet on last follow-up. Considering the predictive performance of these inflammatory markers, they demonstrated excellent positive predictive value at admission, and excellent negative predictive value at the last follow-up visit. Moreover, the number of elevated markers was further associated with probability of infection both at admission and last follow-up.
Lak, Armin; Stauffer, William R; Schultz, Wolfram
Prediction error signals enable us to learn through experience. These experiences include economic choices between different rewards that vary along multiple dimensions. Therefore, an ideal way to reinforce economic choice is to encode a prediction error that reflects the subjective value integrated across these reward dimensions. Previous studies demonstrated that dopamine prediction error responses reflect the value of singular reward attributes that include magnitude, probability, and delay. Obviously, preferences between rewards that vary along one dimension are completely determined by the manipulated variable. However, it is unknown whether dopamine prediction error responses reflect the subjective value integrated from different reward dimensions. Here, we measured the preferences between rewards that varied along multiple dimensions, and as such could not be ranked according to objective metrics. Monkeys chose between rewards that differed in amount, risk, and type. Because their choices were complete and transitive, the monkeys chose "as if" they integrated different rewards and attributes into a common scale of value. The prediction error responses of single dopamine neurons reflected the integrated subjective value inferred from the choices, rather than the singular reward attributes. Specifically, amount, risk, and reward type modulated dopamine responses exactly to the extent that they influenced economic choices, even when rewards were vastly different, such as liquid and food. This prediction error response could provide a direct updating signal for economic values.
Li, C T; Shi, C H; Wu, J G; Xu, H M; Zhang, H Z; Ren, Y L
The selection of an appropriate sampling strategy and a clustering method is important in the construction of core collections based on predicted genotypic values in order to retain the greatest degree of genetic diversity of the initial collection. In this study, methods of developing rice core collections were evaluated based on the predicted genotypic values for 992 rice varieties with 13 quantitative traits. The genotypic values of the traits were predicted by the adjusted unbiased prediction (AUP) method. Based on the predicted genotypic values, Mahalanobis distances were calculated and employed to measure the genetic similarities among the rice varieties. Six hierarchical clustering methods, including the single linkage, median linkage, centroid, unweighted pair-group average, weighted pair-group average and flexible-beta methods, were combined with random, preferred and deviation sampling to develop 18 core collections of rice germplasm. The results show that the deviation sampling strategy in combination with the unweighted pair-group average method of hierarchical clustering retains the greatest degree of genetic diversities of the initial collection. The core collections sampled using predicted genotypic values had more genetic diversity than those based on phenotypic values.
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Predictive pulmonary-function value calculator. 868.1890 Section 868.1890 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1890 Predictive...
Humbert, Olivier; Riedinger, Jean-Marc; Charon-Barra, Céline; Berriolo-Riedinger, Alina; Desmoulins, Isabelle; Lorgis, Véronique; Kanoun, Salim; Coutant, Charles; Fumoleau, Pierre; Cochet, Alexandre; Brunotte, François
To investigate the value of the metabolic tumor response assessed with (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET), compared with clinicobiologic markers to predict pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) in women with triple-negative breast cancer (TNBC). Fifty consecutive women with TNBC and an indication for NAC were prospectively included. Different pretreatment clinical, biologic, and pathologic biomarkers, including SBR grade, the Ki-67 proliferation index, androgen receptor expression, EGF receptor (EGFR), and cytokeratin 5/6 staining, were assessed. Tumor glucose metabolism at baseline and its change after the first cycle of NAC (ΔSUVmax) were assessed using FDG-PET. The pCR rate was 42%. High Ki-67 proliferation index (P = 0.016), negative EGFR status (P = 0.042), and high ΔSUVmax (P = 0.002) were significantly associated with pCR. In multivariate logistic regression, both negative EGFR status (OR, 6.4; P = 0.043) and high ΔSUVmax (OR, 7.1; P = 0.014) were independent predictors of pCR. Using a threshold at -50%, tumor ΔSUVmax predicted pCR with a negative, a positive predictive value, and an accuracy of 79%, 70%, and 75%, respectively. Combining a low ΔSUVmax and positive EGFR status could predict non-pCR with an accuracy of 92%. It is important to define the chemosensitivity of TNBC to NAC early. Combining EGFR status and the metabolic response assessed with FDG-PET can help the physician to early predict the probability of achieving pCR or not. Given these results, the interest of response-guided tailoring of the chemotherapy might be tested in multicenter trials. Clin Cancer Res; 21(24); 5460-8. ©2015 AACR. ©2015 American Association for Cancer Research.
Seishima, Ryo; Okabayashi, Koji; Hasegawa, Hirotoshi; Tsuruta, Masashi; Hoshino, Hiroki; Yamada, Toru; Kitagawa, Yuko
To evaluate the effect of computed tomography (CT) attenuation values of ascites on gastrointestinal (GI) perforation site prediction. The CT attenuation values of the ascites from 51 patients with GI perforations were measured by volume rendering to calculate the mean values. The effect of the CT attenuation values of the ascites on perforation site prediction and postoperative complications was evaluated. Of 24 patients with colorectal perforations, the CT attenuation values of ascites were significantly higher than those in patients with perforations at other sites [22.5 Hounsfield units (HU) vs 16.5 HU, respectively, P = 0.006]. Colorectal perforation was significantly associated with postoperative complications (P = 0.038). The prediction rate of colorectal perforation using attenuation values as an auxiliary diagnosis improved by 9.8% compared to that of CT findings alone (92.2% vs 82.4%). The CT attenuation values of ascites could facilitate the prediction of perforation sites and postoperative complications in GI perforations, particularly in cases in which the perforation sites are difficult to predict by CT findings alone.
Pritchard, Tanya L; Weidemann, Gabrielle; Hogarth, Lee
Stress induction reduces people's ability to modify their instrumental choices following changes in the value of outcomes, but the mechanisms underpinning this effect have not been specified because previous studies have lacked crucial control conditions. To address this, the current study had participants learn two instrumental responses for food and water, respectively, before water was devalued by specific satiety. Choice between these two responses was then measured in extinction, reacquisition and Pavlovian to instrumental transfer (PIT) tests. Concurrently during these tests, a negative emotional appraisal group evaluated aversive images (stress induction), whereas a control group evaluated neutral images, at the same time as choosing between the two instrumental responses. Negative emotional appraisal abolished the impact of water devaluation on instrumental choice in the extinction test, but did not affect instrumental choice in the reacquisition or PIT tests. These findings suggest that negative emotional appraisal selectively impaired participants' ability to retrieve the expected value of outcomes required to make goal-directed instrumental choices in the extinction test, and that this effect was not due to task disengagement, nullification of the devaluation treatment or impaired knowledge of response-outcome relationships.
Zhang, Chunyan; Bai, Nan; Huang, Wenrong; Zhang, Pengjun; Luo, Yuan; Men, Shasha; Wen, Ting; Tong, Hongli; Wang, Shuhong; Tian, Ya-Ping
Currently, the diagnosis of acute graft-versus-host disease (aGVHD) is mainly based on clinical symptoms and biopsy results. This study was designed to further explore new no noninvasive biomarkers for aGVHD prediction/diagnosis. We profiled miRNAs in serum pools from patients with aGVHD (grades II-IV) (n = 9) and non-aGVHD controls (n = 9) by real-time qPCR-based TaqMan MicroRNA arrays. Then, predictive models were established using related miRNAs (n = 38) and verified by a double-blind trial (n = 54). We found that miR-411 was significantly down regulated when aGVHD developed and recovered when aGVHD was controlled, which demonstrated that miR-411 has potential as an indicator for aGVHD monitoring. We developed and validated a predictive model and a diagnostic model for aGVHD. The predictive model included two miRNAs (miR-26b and miR-374a), which could predict an increased risk for aGVHD 1 or 2 weeks in advance, with an AUC, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of 0.722, 76.19 %, and 69.70 %, respectively. The diagnostic model included three miRNAs (miR-28-5p, miR-489, and miR-671-3p) with an AUC, PPV, and NPV of 0.841, 85.71 % and 83.33 %, respectively. Our results show that circulating miRNAs (miR-26b and miR-374a, miR-28-5p, miR-489 and miR-671-3p) may serve as biomarkers for the prediction and diagnosis of grades II-IV aGVHD.
Palosaari, Esa; Punamäki, Raija-Leena; Peltonen, Kirsi; Diab, Marwan; Qouta, Samir R
Post traumatic cognitions (PTCs) are important determinants of post traumatic stress symptoms (PTS symptoms). We tested whether risk factors of PTS symptoms (trauma, demographics, social and family-related factors) predict PTCs and whether PTCs mediate the association between risk factors and PTS symptoms among war-affected children. The participants were 240 Palestinian children 10-12 years old, half boys and half girls, and their parents. Children reported about psychological maltreatment, sibling and peer relations, war trauma, PTCs, PTS symptoms, and depression. Parents reported about their socioeconomic status and their own PTS symptoms. The associations between the variables were estimated in structural equation models. In models which included all the variables, PTCs were predicted by and mediated the effects of psychological maltreatment, war trauma, sibling conflict, and peer unpopularity on PTS symptoms. Other predictors had statistically non-significant effects. Psychological maltreatment had the largest indirect effect (b* = 0.29, p = 0.002) and the indirect effects of war trauma (b* = 0.10, p = 0.045), sibling conflict (b* = 0.10, p = 0.045), and peer unpopularity (b* = 0.10, p = 0.094) were lower and about the same size. Age-salient social relationships are potentially important in the development of both PTCs and PTS symptoms among preadolescents. Furthermore, PTCs mediate the effects of the risk factors of PTS symptoms. The causality of the associations among the variables is not established but it could be studied in the future with interventions which improve the negative aspects of traumatized children's important social relationships.
Glucksman, Myron L; Kramer, Milton
The authors collected the initial dreams of treatment from 63 patients and independently evaluated the manifest dream report (MDR). Variables included: Affect and Valence of Affect; Associations; Psychodynamic Theme; Psychodynamic Theme as Predictor of Core Psychodynamic Issues; Transference; Gender; Psychodynamic Theme Categories; Clinical Progress in relation to Psychodynamic Theme Categories and Transference. The initial MDR invariably contains Affect that is frequently Negative. The Psychodynamic Themes of MDRs are dependable predictors of Core Psychodynamic Issues that emerge during treatment. Transference is evident in a significant number of MDRs and is often Negative. Gender of the majority of MDRs is predictable. The most frequent Psychodynamic Themes of initial MDRs fall into Relational and Injury Categories. Relational and Injury Themes, as well as Positive and Negative Transference, are associated with clinical progress. This study confirms that the initial MDR of treatment provides a significant amount of clinical and predictive information.
David A. Gansner; Owen W. Herrick
Presents a method for estimating the potential impact of gypsy moth attacks on forest-stand value. Robust regression analysis is used to develop an equation for predicting the rate of change in timber value from easy-to-measure key characteristics of stand condition.
Ochoa, Alejandro; Storey, John D.; Llinás, Manuel; Singh, Mona
E-values have been the dominant statistic for protein sequence analysis for the past two decades: from identifying statistically significant local sequence alignments to evaluating matches to hidden Markov models describing protein domain families. Here we formally show that for “stratified” multiple hypothesis testing problems—that is, those in which statistical tests can be partitioned naturally—controlling the local False Discovery Rate (lFDR) per stratum, or partition, yields the most predictions across the data at any given threshold on the FDR or E-value over all strata combined. For the important problem of protein domain prediction, a key step in characterizing protein structure, function and evolution, we show that stratifying statistical tests by domain family yields excellent results. We develop the first FDR-estimating algorithms for domain prediction, and evaluate how well thresholds based on q-values, E-values and lFDRs perform in domain prediction using five complementary approaches for estimating empirical FDRs in this context. We show that stratified q-value thresholds substantially outperform E-values. Contradicting our theoretical results, q-values also outperform lFDRs; however, our tests reveal a small but coherent subset of domain families, biased towards models for specific repetitive patterns, for which weaknesses in random sequence models yield notably inaccurate statistical significance measures. Usage of lFDR thresholds outperform q-values for the remaining families, which have as-expected noise, suggesting that further improvements in domain predictions can be achieved with improved modeling of random sequences. Overall, our theoretical and empirical findings suggest that the use of stratified q-values and lFDRs could result in improvements in a host of structured multiple hypothesis testing problems arising in bioinformatics, including genome-wide association studies, orthology prediction, and motif scanning. PMID:26575353
Ochoa, Alejandro; Storey, John D; Llinás, Manuel; Singh, Mona
E-values have been the dominant statistic for protein sequence analysis for the past two decades: from identifying statistically significant local sequence alignments to evaluating matches to hidden Markov models describing protein domain families. Here we formally show that for "stratified" multiple hypothesis testing problems-that is, those in which statistical tests can be partitioned naturally-controlling the local False Discovery Rate (lFDR) per stratum, or partition, yields the most predictions across the data at any given threshold on the FDR or E-value over all strata combined. For the important problem of protein domain prediction, a key step in characterizing protein structure, function and evolution, we show that stratifying statistical tests by domain family yields excellent results. We develop the first FDR-estimating algorithms for domain prediction, and evaluate how well thresholds based on q-values, E-values and lFDRs perform in domain prediction using five complementary approaches for estimating empirical FDRs in this context. We show that stratified q-value thresholds substantially outperform E-values. Contradicting our theoretical results, q-values also outperform lFDRs; however, our tests reveal a small but coherent subset of domain families, biased towards models for specific repetitive patterns, for which weaknesses in random sequence models yield notably inaccurate statistical significance measures. Usage of lFDR thresholds outperform q-values for the remaining families, which have as-expected noise, suggesting that further improvements in domain predictions can be achieved with improved modeling of random sequences. Overall, our theoretical and empirical findings suggest that the use of stratified q-values and lFDRs could result in improvements in a host of structured multiple hypothesis testing problems arising in bioinformatics, including genome-wide association studies, orthology prediction, and motif scanning.
Wang, Yaojia; Liu, Erfu; Liu, Huimei; Pan, Yiming; Zhang, Longqiang; Zeng, Junwen; Fu, Yajun; Wang, Miao; Xu, Kang; Huang, Zhong; Wang, Zhenlin; Lu, Hai-Zhou; Xing, Dingyu; Wang, Baigeng; Wan, Xiangang; Miao, Feng
The progress in exploiting new electronic materials has been a major driving force in solid-state physics. As a new state of matter, a Weyl semimetal (WSM), in particular a type-II WSM, hosts Weyl fermions as emergent quasiparticles and may harbour novel electrical transport properties. Nevertheless, such a type-II WSM material has not been experimentally observed. In this work, by performing systematic magneto-transport studies on thin films of a predicted material candidate WTe2, we observe notable negative longitudinal magnetoresistance, which can be attributed to the chiral anomaly in WSM. This phenomenon also exhibits strong planar orientation dependence with the absence along the tungsten chains, consistent with the distinctive feature of a type-II WSM. By applying a gate voltage, we demonstrate that the Fermi energy can be in-situ tuned through the Weyl points via the electric field effect. Our results may open opportunities for implementing new electronic applications, such as field-effect chiral devices. PMID:27725682
Smith, Justin D; Dishion, Thomas J; Shaw, Daniel S; Wilson, Melvin N
Coercive family processes are germane to the development of problem behaviors in early childhood, yet the cognitive and affective underpinnings are not well understood. We hypothesized that one antecedent of early coercive interactions is the caregiver's implicit affective attitudes toward the child, which in this article are termed relational schemas. Relational schemas have previously been linked to coercion and problem behaviors, but there has yet to be an examination of the association between relational schemas and trajectories of coercion during early childhood. We examined 731 indigent caregiver-child dyads (49 % female children) from a randomized intervention trial of the Family Check-Up. Predominantly biological mothers participated. A speech sample was used to assess relational schemas at age 2. Coercive interactions were assessed observationally each year between ages 2 and 4. Caregiver and teacher reports of children's oppositional and aggressive behaviors were collected at age 7.5 and 8.5. Path analysis revealed that negative relational schemas were associated with less steep declines in coercion during this period, which in turn were predictive of ratings of oppositional and aggressive behaviors at age 7.5/8.5 after controlling for baseline levels, positive relational schemas, child gender, ethnicity, and cumulative risk. Intervention condition assignment did not moderate this relationship, suggesting the results represent a naturally occurring process. Given the link between persistent early coercion and later deleterious outcomes, relational schemas that maintain and amplify coercive dynamics represent a potential target for early intervention programs designed to improve parent-child relationships.
Wang, Yaojia; Liu, Erfu; Liu, Huimei; Pan, Yiming; Zhang, Longqiang; Zeng, Junwen; Fu, Yajun; Wang, Miao; Xu, Kang; Huang, Zhong; Wang, Zhenlin; Lu, Hai-Zhou; Xing, Dingyu; Wang, Baigeng; Wan, Xiangang; Miao, Feng
The progress in exploiting new electronic materials has been a major driving force in solid-state physics. As a new state of matter, a Weyl semimetal (WSM), in particular a type-II WSM, hosts Weyl fermions as emergent quasiparticles and may harbour novel electrical transport properties. Nevertheless, such a type-II WSM material has not been experimentally observed. In this work, by performing systematic magneto-transport studies on thin films of a predicted material candidate WTe2, we observe notable negative longitudinal magnetoresistance, which can be attributed to the chiral anomaly in WSM. This phenomenon also exhibits strong planar orientation dependence with the absence along the tungsten chains, consistent with the distinctive feature of a type-II WSM. By applying a gate voltage, we demonstrate that the Fermi energy can be in-situ tuned through the Weyl points via the electric field effect. Our results may open opportunities for implementing new electronic applications, such as field-effect chiral devices.
Lista, F; Castillo, E; Gimbernat, H; Rodríguez-Barbero, J M; Panizo, J; Angulo, J C
To assess the ability of multiparametric prostate magnetic resonance imaging (mpMRI) to detect prostate cancer in patients with prior negative transrectal prostate biopsy (TPB). mpMRI (TSE-T2-w, DWI and DCE sequences) was performed on 1.5T (Magnetom Avanto; Siemens Healthcare Solutions) in 150 patients suspicious of prostate cancer and with negative TPB. European Society of Urogenital Radiology (ESUR) criteria were used (score 1: clinically significant disease is highly unlikely to be present; score 2: clinically significant cancer is unlikely to be present; score 3: clinically significant cancer is equivocal; score 4: clinically significant cancer is likely to be present; score 5: clinically significant cancer is highly likely to be present). PSA measurement (total and free), digital rectal examination (DRE), transrectal ultrasound (TRU) and a second TPB (at least 14 cylinders) were performed in all patients. Variables were submitted for independent blind analysis. The accuracy of each test was measured. Stepwise selection model for prediction of prostate cancer in second TPB was developed. Mean age was 66.2± 5 years (51-77), mean PSA 11.3± 9.6ng/mL (0.9-75) and mean prostatic volume 82.2±42 (20-250) cc. DRE was suspicious in 11 (7.3%) patients. The mean number of cylinders per patient sampled in second TRB was 17.6±2.7(14-22). Second TRB was positive in 28 patients (18.7%). mpMRI was positive (score 3-5) in 102 (68%), test sensibility was 92.9% and the NPV was 95.8%. The risk of prostate cancer diagnosis in second TPB is modified by: PSA velocity > 0.75 (OR 1.04 [0.99-1.08]; P=0.06), free/total ratio PSA <15% (OR 0.37 [0.13-1.05]; P=0.06), each cc. of prostate volume (OR 0.98 [0.97-1]; P=0.017) and mpMRI 3-5 (OR 7.87 [1.78-34.7]; P=0.006). Multivariate analysis reveals that mpMRI (OR 7.41 [1.65-33.28]; P=0.009) and prostatic volume (OR 0.31 [0.12-0.78]; P=0.01) are independent risk predictors of prostate cancer. According to ESUR guidelines and in patients
Gardner, M D; Dryburgh, F J; Fyffe, J A; Jenkins, A S
The algorithms used in this hospital to assess calcium status are calculated ionised serum calcium and the serum calcium concentration adjusted for albumin. In order to establish their clinical usefulness, they were compared with the ionised calcium concentration measured on the Nova 2 instrument in patients with various calcium and protein abnormalities. Good correlation was found between the measured and calculated values. The predictive values for the calculated results and for total serum calcium concentrations are presented. In this series, the derived values were useful in predicting the serum ionised calcium concentration of the patients studied.
Liu, Daipei; Peters, Herwig; Marburg, Steffen; Kessissoglou, Nicole
Two numerical methods to identify the surface areas of a vibrating structure that radiate sound are presented. The supersonic intensity identifies only the supersonic wave components of the sound field contributing to far-field radiated sound. The supersonic intensity is calculated using a two-dimensional convolution between a spatial radiation filter and the sound field. To compute the spatial radiation filter, the shortest surface distance between two points on the structure is calculated using the geodesic distance method. The non-negative intensity is based on acoustic radiation modes and identifies the radiated sound power from a vibrating structure. Numerical models of a baffled plate, a cylinder and an engine crankcase are presented. The supersonic intensity is shown to be difficult to implement at low frequencies due to the size of the spatial radiation filter and accuracy of the surface distances. A cut-off coefficient associated with the acoustic wavenumber of the spatial radiation filter is used to reduce the aperture error. A comparison of the two intensity-based techniques both in terms of a sound power ratio and the modal assurance criterion is introduced to identify the optimal values of the cut-off coefficients that result in better convergence between the intensity techniques.
He, Jin-peng; Hao, Yun; Li, Mi; Wang, Jiang; Guo, Feng-jin
According to the current treatment protocol of the Cooperative Osteosarcoma Study, it is mandatory to determine the histological response to neoadjuvant chemotherapy treatment before surgical removal of the tumor, particularly if a limb salvage procedure is planned. The aim of this systematic, retrospective study was to evaluate the ability of 2-((18) F) fluoro-2-deoxy-D-glucose positron-emission tomography/computed tomography to predict chemotherapy response of osteosarcoma and to identify a simple promising method for noninvasive evaluation of neoadjuvant chemotherapy response in osteosarcoma. The PubMed database was searched to identify and analyze relevant published reports. In particular, correlations between tumor-to-background ratio (TBR), standard uptake value (SUV) and histological response to chemotherapy were assessed. It was found that good responses are achieved in patients with TBR after chemotherapy (TBR2)/TBR before chemotherapy (TBR1) < 0.470 (positive predictive value [PPV] = 92.31%, negative predictive value [NPV] = 82.76%, sensitivity [S] = 87.80%, specificity [SP] = 88.89%), whereas poor responses occur in patients with SUV after chemotherapy/before chemotherapy (SUV2/SUV1) > 0.396 (PPV = 73.68%, NPV = 73.33%, S = 63.64%, SP = 81.48%). Changes in TBR are better predictors of chemotherapy response than SUV in osteosarcoma patients. Therefore, we believe that choice of surgical strategy is optimally based on changes in TBR. © 2014 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.
Alvarez-Alvarez, F A; Maciel-Gutierrez, V M; Rocha-Muñoz, A D; Lujan, J H; Ploneda-Valencia, C F
Acute appendicitis (AA) has a prevalence of 8% in the general population with a rate of complicated (perforated) appendicitis (CA) up to 40%. Serum fibrinogen may serve as an indicator for CA. 115 patients were included from January 2012 to December 2012 using a positive pathology report for AA as a gold standard diagnostic method. We divided the patients into two groups accordingly to the pathology report: Complicated Appendicitis and Uncomplicated Appendicitis (UA). Our primary endpoint was to compare the levels of serum fibrinogen between the two groups and find if there is a relationship between fibrinogen level and CA. 68 patients were diagnosed with UA and 47 with CA. Using a fibrinogen value of 885 mg/dl we found to be the best cut-off for predicting complicated appendicitis with a sensitivity of 86.77% (76.87-93.71 IC 95%), a specificity of 91.49 (83.51-99.46 IC 95%), a positive predictive value of 93.65 (95% CI 86.81-99.64) and, a negative predictive value of 82.69 (95% CI 65.73-87.84). In the setting of a patient with a clinical diagnosis of AA, this study demonstrates fibrinogen as a good predictor factor for appendiceal perforation. Copyright © 2015 IJS Publishing Group Limited. All rights reserved.
David, Badmus Hakeem; Olayinka O, Adegbehingbe; Oluwadare, Esan; Ayodele, Orimolade E; Joseph O, Mejabi; Olujide, Arije
To determine the predictive value of the Pirani scoring system in the need for tenotomy using the Ponseti method for management of idiopathic clubfoot. This is a prospective observational study involving patients less than 2 years of age with idiopathic clubfoot. The consenting parents and institution ethical board approved the study. The relationship between Pirani scores and the need for tenotomy was evaluated using the independent t-test and the binary logistic regression to predict the need for tenotomy. Pearson's r and Cohen's κ were used to measure correlation and agreement, respectively, between the predicted and observed values. A receiver operating characteristic curve was used to interpret sensitivity and specificity levels as well as to obtain a cutoff score for predicting the requirement for tenotomy. Eighty-four clubfeet from 50 patients were studied. Thirty-eight feet (45%) had percutaneous tenotomy. The initial total Pirani and hindfoot scores were found to predict the need for tenotomy with the model for prediction being able to predict correctly in 72.6% and 75% of the time, respectively. A higher Pirani score was associated with higher odds of requiring tenotomy (OR = 4.402, p < 0.001) and total Pirani score above the cutoff point of 4.75 predicted the need for tenotomy. The indication for tenotomy appears to be well predicted using the Pirani scoring system with the odds of requiring a tenotomy increasing by more than fourfold for every unit increase in Pirani score.
Vălenaş, Sergiu P; Szentágotai-Tătar, Aurora; Grafton, Ben; Notebaert, Lies; Miu, Andrei C; MacLeod, Colin
Rumination is a maladaptive form of repetitive thinking that enhances stress responses, and heightened disposition to engage in rumination may contribute to the onset and persistence of stress-related symptoms. However, the cognitive mechanisms through which ruminative disposition influences stress reactivity are not yet fully understood. This study investigated the hypothesis that the impact of ruminative disposition on stress reactivity is carried by an attentional bias reflecting impaired attentional disengagement from negative information. We examined the capacity of a measure of ruminative disposition to predict both attentional biases to negative exam-related information, and state anxiety, in students approaching a mid-term exam. As expected, ruminative disposition predicted state anxiety, over and above the level predicted by trait anxiety. Ruminative disposition also predicted biased attentional disengagement from, but not biased attentional engagement with, negative information. Importantly, biased attentional disengagement from negative information mediated the relation between ruminative disposition and state anxiety. These findings confirm that dispositional rumination is associated with difficulty disengaging attention from negative information, and suggest that this attentional bias may be one of the mechanisms through which ruminative disposition influences stress reactivity. Copyright © 2017 Elsevier Ltd. All rights reserved.
Olchanski, Natalia; Cohen, Joshua T; Neumann, Peter J; Wong, John B; Kent, David M
Risk prediction models allow for the incorporation of individualized risk and clinical effectiveness information to identify patients for whom therapy is most appropriate and cost-effective. This approach has the potential to identify inefficient (or harmful) care in subgroups at different risks, even when the overall results appear favorable. Here, we explore the value of personalized risk information and the factors that influence it. Using an expected value of individualized care (EVIC) framework, which monetizes the value of customizing care, we developed a general approach to calculate individualized incremental cost effectiveness ratios (ICERs) as a function of individual outcome risk. For a case study (tPA v. streptokinase to treat possible myocardial infarction), we used a simulation to explore how an EVIC is influenced by population outcome prevalence, model discrimination (c-statistic) and calibration, and willingness-to-pay (WTP) thresholds. In our simulations, for well-calibrated models, which do not over- or underestimate predicted v. observed event risk, the EVIC ranged from $0 to $700 per person, with better discrimination (higher c-statistic values) yielding progressively higher EVIC values. For miscalibrated models, the EVIC ranged from -$600 to $600 in different simulated scenarios. The EVIC values decreased as discrimination improved from a c-statistic of 0.5 to 0.6, before becoming positive as the c-statistic reached values of ~0.8. Individualizing treatment decisions using risk may produce substantial value but also has the potential for net harm. Good model calibration ensures a non-negative EVIC. Improvements in discrimination generally increase the EVIC; however, when models are miscalibrated, greater discriminating power can paradoxically reduce the EVIC under some circumstances.
Blanks, R G
The positive predictive value (PPV) for the detection of cervical intraepithelial neoplasia (CIN) grade 2 or worse of referral to colposcopy from moderate dyskaryosis or worse (equivalent to high-grade squamous intraepithelial lesion or worse) is a standard performance measure in the National Health Service cervical screening programme. The current target is to examine 'outlier' laboratories with PPVs outside the 10th-90th percentile, which automatically identifies 20% of laboratories for further investigation. A more targeted method of identifying outliers may be more useful. A similar measure to the PPV, the abnormal predictive value (APV), can be defined as the predictive value for CIN2 or worse for referrals from borderline (includes atypical squamous and glandular cells) and mild dyskaryosis (equivalent to low-grade squamous intraepithelial lesion) combined. A scatter plot of the APV versus the PPV can be produced (the APV-PPV diagram). Three kinds of 'outlier' can be defined on the diagram to help determine laboratories with unusual data. These are termed a true outlier value (TOV) or an extreme value (EV) for either PPV or APV, or a residual extreme value (REV) from the APV-PPV best line of fit. Using annual return information for 2007/8 from 124 laboratories, two were defined as having EVs for PPV (both had a relatively low PPV of 62%). For APV, four laboratories were considered to have EVs of 34%, 34%, 34% and 4% and one was considered to be a TO with an APV of 45%. Five were identified as REV laboratories, although three of these were also identified as having extreme or outlier values, leaving two that had not been identified by the other methods. A total of eight (6%) laboratories were therefore identified as meriting further investigation using this methodology. The method proposed could be a useful alternative to the current method of identifying outliers. Slide exchange studies between the identified laboratories, particularly those at opposing ends
Dietzen, D J; Ecos, K; Friedman, D; Beason, S
The pressure to reduce the cost of analytic testing makes it tempting to discontinue routine confirmation of urine specimens positive for drugs of abuse by immunoassay. Beyond the economic motivation, the requirement for confirmation should be driven by the positive predictive value of the screening tests. We have quantitated positive predictive values of our screening immunoassays in a large metropolitan Veterans Affairs Medical Center. We reviewed the confirmatory rate of urine specimens positive for drugs of abuse with Beckman Synchron reagents from June 1998 to June 1999 and tabulated the false-positive screening rate. There were 175 instances of false-positive screens during the 13 months we analyzed. Positive predictive values ranged from 0% (amphetamine) to 100% (THC). We determined that the low positive predictive value of the amphetamine assay in our laboratory was primarily due to the use of ranitidine (Zantac). Urine specimens containing greater than 43 microg/mL ranitidine were positive in our amphetamine assay. This concentration is routinely exceeded in our patients taking ranitidine. In our clinical and analytic setting, the Beckman THC assay did not require confirmation. The positive predictive values of the Beckman opiate, cocaine, barbiturate, propoxyphene, and methadone immunoassays dictate routine confirmatory testing in specimens that screen positive for these substances. Finally, because of its extreme sensitivity to ranitidine, the Beckman amphetamine assay has little utility in our laboratory setting.
Goldstein, Brandon L; Barnett, Brian R; Vasquez, Gloria; Tobia, Steven C; Kashtelyan, Vadim; Burton, Amanda C; Bryden, Daniel W; Roesch, Matthew R
The ventral striatum (VS) is thought to signal the predicted value of expected outcomes. However, it is still unclear whether VS can encode value independently from variables often yoked to value such as response direction and latency. Expectations of high value reward are often associated with a particular action and faster latencies. To address this issue we trained rats to perform a task in which the size of the predicted reward was signaled before the instrumental response was instructed. Instrumental directional cues were presented briefly at a variable onset to reduce accuracy and increase reaction time. Rats were more accurate and slower when a large versus small reward was at stake. We found that activity in VS was high during odors that predicted large reward even though reaction times were slower under these conditions. In addition to these effects, we found that activity before the reward predicting cue reflected past and predicted reward. These results demonstrate that VS can encode value independent of motor contingencies and that the role of VS in goal-directed behavior is not just to increase vigor of specific actions when more is at stake.
Bao, Xiaoguang; Hrovat, David A; Borden, Weston Thatcher; Wang, Xue-Bin
Cyclobutane-1,2,3,4-tetraone has been both predicted and found to have a triplet ground state, in which a b2g σ molecular orbital (MO) and an a2u π MO are each singly occupied. In contrast, (CO)5 and (CO)6 have each been predicted to have a singlet ground state. These predictions have been tested by generating the (CO)5(•-) and (CO)6(•-) radical anions in the gas phase, using electrospray vaporization of solutions of, respectively, the croconate (CO)5(2-) and rhodizonate (CO)6(2-) dianions. The negative ion photoelectron (NIPE) spectrum of the (CO)5(•-) radical anion gives an electron affinity of EA = 3.830 eV for formation of the singlet ground state of (CO)5. The triplet is found to be higher in energy by 0.850 eV (19.6 kcal/mol). The NIPE spectrum of the (CO)6(•-) radical anion gives EA = 3.785 eV for forming the singlet ground state of (CO)6, with the triplet state higher in energy by 0.915 eV (21.1 kcal/mol). (RO)CCSD(T)/aug-cc-pVTZ//(U)B3LYP/6-311+G(2df) calculations give EA values that are only approximately 1 kcal/mol lower than those measured and ΔE(ST) values that are 2-3 kcal/mol higher than those obtained from the NIPE spectra. Calculations of the Franck-Condon factors for transitions from the ground state of each radical anion, (CO)n(•-) to the lowest singlet and triplet states of the n = 4-6 neutrals, nicely reproduce all of the observed vibrational features in the low-binding energy regions of all three NIPE spectra. Thus, the calculations of both the energies and vibrational structures of the two lowest energy bands in each of the NIPE spectra support the interpretation of the spectra in terms of a singlet ground state for (CO)5 and (CO)6 but a triplet ground state for (CO)4.
Chen, Xianyu; He, Chao; Han, Dongdong; Zhou, Meirong; Wang, Quan; Tian, Jinhui; Li, Lun; Xu, Feng; Zhou, Enxiang; Yang, Kehu
To review the predictive values of Ki-67 before neoadjuvant chemotherapy (NAC) for breast cancer patients. PubMed and EMBASE were searched. Random-effect model meta-analysis was conducted using Revman software. High Ki-67 was associated with more pathological complete responses (pCRs) events (odds ratio: 3.10; 95% CI: 2.52-3.81; 53 studies, 10,848 patients) regardless of HR(+), HER2(+) and triple-negative breast cancer types, the definitions of pCR and cut-off points for Ki-67. Ki-67 could predict pCR in those who received anthracyclines plus taxanes, and anthracyclines only, and those from Asia and Europe. High Ki-67 before NAC was a predictor for pCR in neoadjuvant setting for breast cancer patients.
Vaala, Sarah E
Viewing television and video programming has become a normative behavior among US infants and toddlers. Little is understood about parents' decision-making about the extent of their young children's viewing, though numerous organizations are interested in reducing time spent viewing among infants and toddlers. Prior research has examined parents' belief in the educational value of TV/videos for young children and the predictive value of this belief for understanding infant/toddler viewing rates, though other possible salient beliefs remain largely unexplored. This study employs the integrative model of behavioral prediction (Fishbein & Ajzen, 2010) to examine 30 maternal beliefs about infants' and toddlers' TV/video viewing which were elicited from a prior sample of mothers. Results indicate that mothers tend to hold more positive than negative beliefs about the outcomes associated with young children's TV/video viewing, and that the nature of the aggregate set of beliefs is predictive of their general attitudes and intentions to allow their children to view, as well as children's estimated viewing rates. Analyses also uncover multiple dimensions within the full set of beliefs, which explain more variance in mothers' attitudes and intentions and children's viewing than the uni-dimensional index. The theoretical and practical implications of the findings are discussed.
Vaala, Sarah E.
Viewing television and video programming has become a normative behavior among US infants and toddlers. Little is understood about parents’ decision-making about the extent of their young children’s viewing, though numerous organizations are interested in reducing time spent viewing among infants and toddlers. Prior research has examined parents’ belief in the educational value of TV/videos for young children and the predictive value of this belief for understanding infant/toddler viewing rates, though other possible salient beliefs remain largely unexplored. This study employs the integrative model of behavioral prediction (Fishbein & Ajzen, 2010) to examine 30 maternal beliefs about infants’ and toddlers’ TV/video viewing which were elicited from a prior sample of mothers. Results indicate that mothers tend to hold more positive than negative beliefs about the outcomes associated with young children’s TV/video viewing, and that the nature of the aggregate set of beliefs is predictive of their general attitudes and intentions to allow their children to view, as well as children’s estimated viewing rates. Analyses also uncover multiple dimensions within the full set of beliefs, which explain more variance in mothers’ attitudes and intentions and children’s viewing than the uni-dimensional index. The theoretical and practical implications of the findings are discussed. PMID:25431537
Spugnesi, Laura; Gabriele, Michele; Scarpitta, Rosa; Tancredi, Mariella; Maresca, Luisa; Gambino, Gaetana; Collavoli, Anita; Aretini, Paolo; Bertolini, Ilaria; Salvadori, Barbara; Landucci, Elisabetta; Fontana, Andrea; Rossetti, Elena; Roncella, Manuela; Naccarato, Giuseppe Antonio; Caligo, Maria Adelaide
Triple negative breast cancers (TNBCs) represent about 15-20% of all breast cancer cases and are characterized by a complex molecular heterogeneity. Some TNBCs exhibit clinical and pathological properties similar to BRCA-mutated tumors, without actually bearing a mutation in BRCA genes. This "BRCAness" phenotype may be explained by germline mutations in other genes involved in DNA repair. Although respond to chemotherapy with alkylating agents, they have a high risk of recurrence and progression. Some studies have shown the efficacy of neoadjuvant therapy in TNBC patients with DNA repair defects, but proper biomarkers of DNA repair deficiency are still needed. Here, we investigated if mutations in DNA repair genes may be correlated with anthracyclines/taxanes neoadjuvant therapy response. DNA from 19 TNBC patients undergoing neoadjuvant therapy were subjected to next generation sequencing of a panel of 24 genes in DNA repair and breast cancer predisposition. In this study, 5 of 19 patients (26%) carried a pathogenic mutation in BRCA1, PALB2, RAD51C and two patients carried a probable pathogenic missense variant. Moreover, VUS (Variants of Unknown Significance) in other genes, predicted to be deleterious by in silico tools, were detected in five patients. Germline mutations in DNA repair genes were found to be associated with the group of TNBC patients who responded to therapy. We conclude that a subgroup of TNBC patients have defects in DNA repair genes, other than BRCA1, and such patients respond favourably to neoadjuvant anthracyclines/taxanes therapy. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Smith, Justin D.; Dishion, Thomas J.; Shaw, Daniel S.; Wilson, Melvin N.
Coercive family processes are germane to the development of problem behaviors in early childhood, yet the cognitive and affective underpinnings are not well understood. We hypothesized that one antecedent of early coercive interactions is the caregiver’s implicit affective attitudes toward the child, which in this article are termed relational schemas. Relational schemas have previously been linked to coercion and problem behaviors, but there has yet to be an examination of the association between relational schemas and trajectories of coercion during early childhood. We examined 731 indigent caregiver-child dyads (49% female children) from a randomized intervention trial of the Family Check-Up. Predominantly biological mothers participated. A speech sample was used to assess relational schemas at age 2. Coercive interactions were assessed observationally each year between ages 2 and 4. Caregiver and teacher reports of children’s oppositional and aggressive behaviors were collected at age 7.5 and 8.5. Path analysis revealed that negative relational schemas were associated with less steep declines in coercion during this period, which in turn were predictive of ratings of oppositional and aggressive behaviors at age 7.5/8.5 after controlling for baseline levels, positive relational schemas, child gender, ethnicity, and cumulative risk. Intervention condition assignment did not moderate this relationship, suggesting the results represent a naturally occurring process. Given the link between persistent early coercion and later deleterious outcomes, relational schemas that maintain and amplify coercive dynamics represent a potential target for early intervention programs designed to improve parent–child relationships. PMID:25208813
Dai, Yimian; Wu, Yiquan; Song, Yu; Guo, Jun
To further enhance the small targets and suppress the heavy clutters simultaneously, a robust non-negative infrared patch-image model via partial sum minimization of singular values is proposed. First, the intrinsic reason behind the undesirable performance of the state-of-the-art infrared patch-image (IPI) model when facing extremely complex backgrounds is analyzed. We point out that it lies in the mismatching of IPI model's implicit assumption of a large number of observations with the reality of deficient observations of strong edges. To fix this problem, instead of the nuclear norm, we adopt the partial sum of singular values to constrain the low-rank background patch-image, which could provide a more accurate background estimation and almost eliminate all the salient residuals in the decomposed target image. In addition, considering the fact that the infrared small target is always brighter than its adjacent background, we propose an additional non-negative constraint to the sparse target patch-image, which could not only wipe off more undesirable components ulteriorly but also accelerate the convergence rate. Finally, an algorithm based on inexact augmented Lagrange multiplier method is developed to solve the proposed model. A large number of experiments are conducted demonstrating that the proposed model has a significant improvement over the other nine competitive methods in terms of both clutter suppressing performance and convergence rate.
Pagano, D; Bonser, R; Townend, J; Ordoubadi, F; Lorenzoni, R; Camici, P
Objective—To compare the predictive value of dobutamine echocardiography (DE) and positron emission tomography (PET) in identifying reversible chronic left ventricular (LV) dysfunction (hibernating myocardium) in patients with coronary artery disease (CAD) and overt heart failure. Patients—30 patients (four women) with CAD and heart failure undergoing coronary artery bypass grafting (CABG). Methods—Myocardial viability was assessed with DE (5 and 10 µg/kg/min) and PET with [18F] 2-fluoro-2-deoxy-D-glucose (FDG) under hyperinsulinaemic euglycaemic clamp. Regional (echo) and global LV function (MUGA) were assessed at baseline and six months after CABG. Results—192 of the 336 (57%) dysfunctional LV segments improved function following CABG (hibernating) and the LV ejection fraction (EF) increased from 23(7) to 32(9)% (p < 0.0001) (in 17 patients > 5%). DE and PET had similar positive predictive values (68% and 66%) in the identification of hibernating myocardium, but DE had a significantly lower negative predictive value than PET (54% v 96%; p < 0.0001). A significant linear correlation was found between the number of PET viable segments and the changes in EF following CABG (r = 0.65; p = 0.0001). Stepwise logistic regression identified the number of PET viable segments as an independent predictor of improvement in EF > 5%, whereas the number of DE viable segments, the baseline LVEF, and wall motion were not. Conclusions—DE has a higher false negative rate than PET in identifying recoverable LV dysfunction in patients with severe postischaemic heart failure. The amount of PET viable myocardium correlates with the functional outcome following CABG. Keywords: dobutamine echocardiography; positron emission tomography; coronary artery disease; heart failure; hibernating myocardium PMID:9602663
Liu, Yinglin; Liu, Yukun; Li, Xuejiao; Jiao, Xuedan; Zhang, Rui; Zhang, Jianping
To examine peak serum levels of the β-subunit of human chorionic gonadotropin (β-hCG) for prediction of early pregnancy outcomes among women with recurrent spontaneous abortion (RSA). In a retrospective study, the medical records of pregnant women with a history of RSA treated at Sun Yat-sen Memorial Hospital, China, between January 2011 and July 2013 were reviewed. Serum β-hCG had been measured twice weekly from 5 to 13weeks of pregnancy, and pregnancy was monitored by transvaginal ultrasonography to 13(+6)weeks. Optimal cutoff for peak β-hCG level was determined by receiver operator characteristic curve analysis and Youden index. Women were divided into four groups on the basis of optimal peak β-hCG cutoff and pregnancy outcome (pregnancy at 13weeks or spontaneous abortion). Peak β-hCG levels and length of pregnancy at this peak were examined. Overall, 1240 patients were included. The optimal cutoff value of peak β-hCG was 88 468IU/L, with a sensitivity, specificity, positive predictive value, and negative predictive value for successful pregnancy of 95.6%, 88.0%, 95.6%, and 89.0%, respectively. A faster rise in β-hCG, higher peak β-hCG, and longer pregnancy length at peak β-hCG were associated with successful early pregnancy. A cutoff value of serum β-hCG of 88 000IU/L could be used to predict early pregnancy outcomes for women with a history of RSA. Copyright © 2016. Published by Elsevier Ireland Ltd.
Li, Huan; Wang, Daofeng; Wei, Wenxiao; Ouyang, Lamei; Lou, Ning
Anastomotic leak was a potentially severe life-threatening complication of esophagectomy, which drew attention in consequence of progressive dyspnea until acute respiratory distress syndrome (ARDS) due to the early asymptomatic presentation. Respiratory failure, caused by ARDS as the severe presentation of anastomotic leak, is the most common organ failure. CRP (C-reactive protein), procalcitonin (PCT), and Blood G (BG) test are the sensitivity markers for inflammatory, sepsis, and fungemia, respectively. Early recognition and intervention treatment of anastomotic leak may alleviate complication and improve outcome. We retrospectively analyzed 71 patients, accepting mechanical ventilation support because of ARDS as the complication after radical resection of esophagus cancer. Clinical data were collected from the patients' electronic medical records, including their clinically hematological examination, drainage fluid cultures, and sputum culture. Accord to appearance of anastomotic leak or not, all patients were divided into 2 groups, leak group and no-leak group. Inflammatory markers, such as CRP, PCT, and the coefficient of BG and PCT, were significantly different between the 2 groups. Respiratory index, white blood cell, hemoglobin (HBG), platelet (PLT), and other clinical factors were not significantly different between the 2 groups. Receiver operating characteristic curves were constructed to calculate the sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve for various cutoff levels of several factors. Blood G tests presented the better predicting value for anastomotic leak. Blood G tests and PCT should be tested after esophagectomy. The coefficient of PCT and BG (>260) is of great significance, and clinical value to predict anastomotic leak for patients with postesophagectomy ARDS, early PCT and BG test, and especially, dynamic variation may alleviate complication and improve outcome.
Habchi, H; Bratan, F; Paye, A; Pagnoux, G; Sanzalone, T; Mège-Lechevallier, F; Crouzet, S; Colombel, M; Rabilloud, M; Rouvière, O
To assess multiparametric magnetic resonance imaging (mp-MRI) in predicting prostate biopsy results. Patients who underwent mp-MRI prior to prostate biopsy were prospectively included. The prostate was subdivided into 14 sectors and mp-MRI findings assessed using a five-level subjective suspicion score (SSS). Biopsy included targeted samples of abnormal sectors and systematic samples of normal peripheral zone sectors. Two hundred and eighty-eight patients were included [153 biopsy naïve, 135 with negative (n = 51) or positive (n = 84) prior biopsy]. Biopsy was positive in 168 patients. mp-MRI area under the receiver operating characteristic (ROC) curve (AUC) was 69.1% (95% CI: 67.1-70.9%), 72.5% (95% CI: 69.5-76%), and 73.8% (95% CI: 68.3-79.3%) at per sector, per lobe, and per patient analysis, respectively. At the per sector level, the AUC was significantly larger if detection was limited to cancers with a Gleason score of ≥7 (72.6%; 95% CI: 69.8-75.8%; p < 0.01) or ≥8 (87.1%; 95% CI: 78.3-95.7%; p < 0.01). mp-MRI performance was significantly influenced by prostate volume (p = 0.02), the presence of a concordant hypoechoic area (p < 0.001), but not by prostate-specific antigen (PSA) value, status of prior biopsy, or radiologists' experience. SSS was significantly associated with the Gleason score in true-positive lobes and patients (p < 0.0001). Using a SSS threshold of ≥3, cancer was missed in 13/102 lobes and 4/72 patients with cancers of Gleason score ≥7. mp-MRI provides a good detection of cancers with a Gleason score of ≥7 in candidates suitable for prostate biopsy. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Wang, Jyun-Rong; Huang, Wen-Lin; Tsai, Ming-Ju; Hsu, Kai-Ti; Huang, Hui-Ling; Ho, Shinn-Ying
Numerous ubiquitination sites remain undiscovered because of the limitations of mass spectrometry-based methods. Existing prediction methods use randomly selected non-validated sites as non-ubiquitination sites to train ubiquitination site prediction models. We propose an evolutionary screening algorithm (ESA) to select effective negatives among non-validated sites and an ESA-based prediction method, ESA-UbiSite, to identify human ubiquitination sites. The ESA selects non-validated sites least likely to be ubiquitination sites as training negatives. Moreover, the ESA and ESA-UbiSite use a set of well-selected physicochemical properties together with a support vector machine for accurate prediction. Experimental results show that ESA-UbiSite with effective negatives achieved 0.92 test accuracy and a Matthews's correlation coefficient of 0.48, better than existing prediction methods. The ESA increased ESA-UbiSite's test accuracy from 0.75 to 0.92 and can improve other post-translational modification site prediction methods. An ESA-UbiSite-based web server has been established at http://iclab.life.nctu.edu.tw/iclab_webtools/ESAUbiSite/ . email@example.com. Supplementary data are available at Bioinformatics online.
Klemans, Rob J B; Otte, Dianne; Knol, Mirjam; Knol, Edward F; Meijer, Yolanda; Gmelig-Meyling, Frits H J; Bruijnzeel-Koomen, Carla A F M; Knulst, André C; Pasmans, Suzanne G M A
A diagnostic prediction model for peanut allergy in children was recently published, using 6 predictors: sex, age, history, skin prick test, peanut specific immunoglobulin E (sIgE), and total IgE minus peanut sIgE. To validate this model and update it by adding allergic rhinitis, atopic dermatitis, and sIgE to peanut components Ara h 1, 2, 3, and 8 as candidate predictors. To develop a new model based only on sIgE to peanut components. Validation was performed by testing discrimination (diagnostic value) with an area under the receiver operating characteristic curve and calibration (agreement between predicted and observed frequencies of peanut allergy) with the Hosmer-Lemeshow test and a calibration plot. The performance of the (updated) models was similarly analyzed. Validation of the model in 100 patients showed good discrimination (88%) but poor calibration (P < .001). In the updating process, age, history, and additional candidate predictors did not significantly increase discrimination, being 94%, and leaving only 4 predictors of the original model: sex, skin prick test, peanut sIgE, and total IgE minus sIgE. When building a model with sIgE to peanut components, Ara h 2 was the only predictor, with a discriminative ability of 90%. Cutoff values with 100% positive and negative predictive values could be calculated for both the updated model and sIgE to Ara h 2. In this way, the outcome of the food challenge could be predicted with 100% accuracy in 59% (updated model) and 50% (Ara h 2) of the patients. Discrimination of the validated model was good; however, calibration was poor. The discriminative ability of Ara h 2 was almost comparable to that of the updated model, containing 4 predictors. With both models, the need for peanut challenges could be reduced by at least 50%. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
García del Castillo Rodríguez, José A; López-Sánchez, Carmen; Quiles Soler, M Carmen; García del Castillo-López, Alvaro; Gázquez Pertusa, Mónica; Marzo Campos, Juan Carlos; Inglés, Candido J
Two predictive models are developed in this article: the first is designed to predict people's attitudes to alcoholic drinks, while the second sets out to predict the use of alcohol in relation to selected individual values. University students (N = 1,500) were recruited through stratified sampling based on sex and academic discipline. The questionnaire used obtained information on participants' alcohol use, attitudes and personal values. The results show that the attitudes model correctly classifies 76.3% of cases. Likewise, the model for level of alcohol use correctly classifies 82% of cases. According to our results, we can conclude that there are a series of individual values that influence drinking and attitudes to alcohol use, which therefore provides us with a potentially powerful instrument for developing preventive intervention programs.
Zheng, Yingye; Cai, Tianxi; Pepe, Margaret S; Levy, Wayne C
In a prospective cohort study, information on clinical parameters, tests and molecular markers is often collected. Such information is useful to predict patient prognosis and to select patients for targeted therapy. We propose a new graphical approach, the positive predictive value (PPV) curve, to quantify the predictive accuracy of prognostic markers measured on a continuous scale with censored failure time outcome. The proposed method highlights the need to consider both predictive values and the marker distribution in the population when evaluating a marker, and it provides a common scale for comparing different markers. We consider both semiparametric and nonparametric based estimating procedures. In addition, we provide asymptotic distribution theory and resampling based procedures for making statistical inference. We illustrate our approach with numerical studies and datasets from the Seattle Heart Failure Study.
Burns, Michelle Nicole; Nawacki, Ewa; Kwasny, Mary J.; Pelletier, Daniel; Mohr, David C.
Background Stressful life events have long been suspected to contribute to multiple sclerosis (MS) disease activity. The few studies examining the relationship between stressful events and neuroimaging markers have been small and inconsistent. This study examined whether different types of stressful events and perceived stress could predict development of brain lesions. Methods This was a secondary analysis of 121 patients with MS followed for 48 weeks during a randomized controlled trial comparing Stress Management Therapy for MS to a waitlist control. Patients underwent MRI’s every 8 weeks. Monthly, patients completed an interview measure assessing stressful life events, and self-report measures of perceived stress, anxiety, and depressive symptoms, which were used to predict the presence of gadolinium enhancing (Gd+) and T2 lesions on MRI’s 29–62 days later. Participants classified stressful events as positive or negative. Negative events were considered “major” if they involved physical threat or threat to the patient’s family structure, and “moderate” otherwise. Results Positive stressful events predicted decreased risk for subsequent Gd+ lesions in the control group (OR=.53 for each additional positive stressful event, 95% CI=.30–.91) and less risk for new or enlarging T2 lesions regardless of group assignment (OR=.74, 95% CI=.55–.99). Across groups, major negative stressful events predicted Gd+ lesions (OR=1.77, 95% CI=1.18–2.64) and new or enlarging T2 lesions (OR=1.57, 95% CI=1.11–2.23), while moderate negative stressful events, perceived stress, anxiety, and depressive symptoms did not. Conclusions Major negative stressful events predict increased risk for Gd+ and T2 lesions, while positive stressful events predict decreased risk. PMID:23680407
Grove, Tyler B; Tso, Ivy F; Chun, Jinsoo; Mueller, Savanna A; Taylor, Stephan F; Ellingrod, Vicki L; McInnis, Melvin G; Deldin, Patricia J
Most people with a serious mental illness experience significant functional impairment despite ongoing pharmacological treatment. Thus, in order to improve outcomes, a better understanding of functional predictors is needed. This study examined negative affect, a construct comprised of negative emotional experience, as a predictor of social functioning across serious mental illnesses. One hundred twenty-seven participants with schizophrenia, 113 with schizoaffective disorder, 22 with psychosis not otherwise specified, 58 with bipolar disorder, and 84 healthy controls (N=404) completed self-report negative affect measures. Elevated levels of negative affect were observed in clinical participants compared with healthy controls. For both clinical and healthy control participants, negative affect measures were significantly correlated with social functioning, and consistently explained significant amounts of variance in functioning. For clinical participants, this relationship persisted even after accounting for cognition and positive/negative symptoms. The findings suggest that negative affect is a strong predictor of outcome across these populations and treatment of serious mental illnesses should target elevated negative affect in addition to cognition and positive/negative symptoms.
Nicolazzi, E L; Forabosco, F; Fikse, W F
International genetic evaluations are a valuable source of information for decisions about the importation of (the semen of) foreign bulls. This study analyzed data from 6 countries (Australia, Canada, Italy, France, the Netherlands, and the United States) and compared international evaluations for production traits of foreign bulls (i.e., when no national daughter information was available) to their national breeding values in August 2009, which were based only on domestic daughters' data. A total of 821 bulls with highly reliable estimated breeding values (EBV) for milk, fat, and protein yield were analyzed. No evidence of systematic over- or underestimation was found in most of the countries analyzed. Observed correlations between national and international evaluations were close to 0.9 and, for most countries, generally close to their expected values (calculated from national and international EBV reliabilities). In Italy, however, higher differences between observed and expected correlations and significant mean differences between EBV for more than one trait were observed in bulls progeny-tested in the United States and in other European countries (with differences up to 33.1% of the genetic standard deviation). These results were probably induced by a relatively recent change in the model for national evaluation. The findings in this study reflect a conservative estimate of the real value of international evaluations, as changes in methodologies in either the national or the international evaluations decreased the ability of past international evaluations to predict current national evaluations. Nevertheless, our results indicate that international evaluations based on foreign information for Holstein bulls were reasonably accurate predictors of the future national breeding values based only upon domestic daughters.
Bouzas-Mosquera, Alberto; Peteiro, Jesús; Broullón, Francisco J; Calviño-Santos, Ramón; Mosquera, Víctor X; Martínez, Dolores; Yáñez, Juan C; Álvarez-García, Nemesio; Vázquez-Rodríguez, José M
To assess the value of the pretest probability (PTP) of coronary artery disease (CAD) for predicting stress testing results and coronary events in patients with acute chest pain and negative troponins. A total of 3527 patients without a history of CAD referred to our chest pain unit with suspected acute coronary syndromes, nondiagnostic ECGs, and negative troponin levels underwent exercise stress testing. PTP was estimated with the CAD consortium prediction rule, and was categorized as low (<15%), low-intermediate (15-65%), intermediate-high (66-85%), and high (>85%). The endpoints were the presence of signs of inducible myocardial ischemia on stress testing and the occurrence of coronary events within 6 months. The probability of exercise-induced myocardial ischemia was 2.6, 12.6, 42.9, and 82.1% in patients with low, low-intermediate, intermediate-high, and high PTP, respectively (Ptrend<0.001). The cumulative rate of coronary events within 6 months was also significantly lower in patients with low PTP of CAD (0.8%) than in those with low-intermediate (6.9%), intermediate-high (32.5%), or high PTP (66.7%) (Ptrend<0.001). Per 10% increment in PTP of CAD, the adjusted odds ratios for inducible myocardial ischemia and coronary events within 6 months were, respectively, 1.71 (95% confidence interval: 1.61-1.85) and 1.87 (95% confidence interval: 1.74-2.01). PTP was associated strongly with the likelihood of exercise-induced myocardial ischemia and coronary events in patients with suspected acute coronary syndromes and negative troponins. The yield of stress testing in the subset of patients with low PTP was very low.
Kragt, J J; Thompson, A J; Montalban, X; Tintoré, M; Río, J; Polman, C H; Uitdehaag, B M J
We studied the responsiveness and predictive value of two widely used clinical outcome measures that document multiple sclerosis (MS) disease progression-the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC)-in patients with primary progressive (PP) MS. Disease course in PPMS shows less fluctuation than in relapsing remitting (RR) MS. In a group of 161 patients with PPMS, EDSS and MSFC were performed at three timepoints. To assess responsiveness, mean change scores and variances were plotted against baseline scores and effect sizes were calculated. Predictive value was determined by calculating sensitivity, specificity, and likelihood ratios (LRs) of 1-year changes to predict changes over 2 years. Furthermore, multivariate logistic regression models were used to assess the predictive value of short-term worsening on EDSS and MSFC. Responsiveness of both EDSS and MSFC was shown to be limited and mean changes were highly dependent on the baseline scores. Effect sizes for EDSS and MSFC were small and inconclusive (0.239 and 0.161). The predictive value of a short-term worsening (baseline to year 1) to predict worsening in the long term (baseline to year 2) was expressed for EDSS by a sensitivity of 0.55 and a LR+ of 8.64. For MSFC, sensitivity was 0.68 and LR+ was 3.14. However, short-term worsening was a poor predictor of subsequent worsening (year 1 to year 2) for EDSS (LR+ 1.06) and this relationship was actually inverse for MSFC (LR+ 0.61). In this study over a period of 2 years in primary progressive multiple sclerosis, the Multiple Sclerosis Functional Composite (MSFC) was less responsive than the Expanded Disability Status Scale (EDSS). The predictive value of neither EDSS nor MSFC was very powerful.
Priess-Groben, Heather A; Hyde, Janet Shibley
Mathematics motivation declines for many adolescents, which limits future educational and career options. The present study sought to identify predictors of this decline by examining whether implicit theories assessed in ninth grade (incremental/entity) predicted course-taking behaviors and utility value in college. The study integrated implicit theory with variables from expectancy-value theory to examine potential moderators and mediators of the association of implicit theories with college mathematics outcomes. Implicit theories and expectancy-value variables were assessed in 165 American high school students (47 % female; 92 % White), who were then followed into their college years, at which time mathematics courses taken, course-taking intentions, and utility value were assessed. Implicit theories predicted course-taking intentions and utility value, but only self-concept of ability predicted courses taken, course-taking intentions, and utility value after controlling for prior mathematics achievement and baseline values. Expectancy for success in mathematics mediated associations between self-concept of ability and college outcomes. This research identifies self-concept of ability as a stronger predictor than implicit theories of mathematics motivation and behavior across several years: math self-concept is critical to sustained engagement in mathematics.
Jaiswal, Pranita; Jha, Shyam Narayan; Kaur, Poonam Preet; Bhardwaj, Rishi; Singh, Ashish Kumar; Wadhawan, Vishakha
Banana is an important sub-tropical fruit in international trade. It undergoes significant textural and color transformations during ripening process, which in turn influence the eating quality of the fruit. In present study, color ('L', 'a' and 'b' value) and textural attributes of bananas (peel, fruit and pulp firmness; pulp toughness; stickiness) were studied simultaneously using Hunter Color Lab and Texture Analyser, respectively, during ripening period of 10 days at ambient atmosphere. There was significant effect of ripening period on all the considered textural characteristics and color properties of bananas except color value 'b'. In general, textural descriptors (peel, fruit and pulp firmness; and pulp toughness) decreased during ripening except stickiness, while color values viz 'a' and 'b' increased with ripening barring 'L' value. Among various textural attributes, peel toughness and pulp firmness showed highest correlation (r) with 'a' value of banana peel. In order to predict textural properties using color values of banana, five types of equations (linear/polynomial/exponential/logarithmic/power) were fitted. Among them, polynomial equation was found to be the best fit (highest coefficient of determination, R(2)) for prediction of texture using color properties for bananas. The pulp firmness, peel toughness and pulp toughness showed R(2) above 0.84 with indicating its potentiality of the fitted equations for prediction of textural profile of bananas non-destructively using 'a' value.
to include body mass index or the presence of gestational diabetes and other medical conditions. However, to our knowledge the strongest predictor of...The distribution and predictive value of Bishop scores in nulliparas between 37 and 42 weeks gestation PETER E. NIELSEN, BOBBY C. HOWARD, TAMI...accuracy of Bishop scores was evaluated to predict cesarean delivery (CD) in nulliparas between 37 and 42 weeks gestation . Study design. Subjects underwent
Burris, John; McGee, Thomas J.; Hoegy, Walt; Lait, Leslie; Sumnicht, Grant; Twigg, Larry; Heaps, William
Temperature profiles acquired by Goddard Space Flight Center's AROTEL lidar during the SOLVE mission onboard NASA's DC-8 are compared with predicted values from several atmospheric models (DAO, NCEP and UKMO). The variability in the differences between measured and calculated temperature fields was approximately 5 K. Retrieved temperatures within the polar vortex showed large regions that were significantly colder than predicted by the atmospheric models.
Schäfer, Torsten; Hoelscher, Bernd; Adam, Horst; Ring, Johannes; Wichmann, H-Erich; Heinrich, Joachim
Little is known from population-based studies in children about the diagnostic values of allergen-specific IgE antibodies (RAST) and skin prick test (SPT) with respect to hay fever. We aimed to determine and compare the diagnostic values of SPT and RAST to aeroallergens with respect to the incidence of hay fever cases in schoolchildren at different cut-off points. A prospective cohort study was performed on 1100 school children (5-7 and 8-10 years). Information on a doctor's diagnosis of hay fever was obtained by questionnaire and allergic sensitization to grass and birch pollen, cat, and Dermatophagoides pteronyssinus were measured using SPT and RAST between September 1992 and July 1993. Thirty-eight children give a history of hay fever (3.5%) in 1992/93 and additionally 37 cases occurred until 1996. Allergic sensitization was present in 17.9% (SPT), 30.2% (RAST) and more frequent in children with a history of hay fever (SPT: OR 11.7, 5.5-24.7; RAST: OR 10.6, 4.3-26.4). This difference was most pronounced for sensitization to pollen allergens. The sensitivity, specificity, positive and negative predictive values (PPV, NPV) for SPT and RAST were 65.6, 83.7, 11.9, 98.6 and 79.3, 71.6, 9.3, 99.0, respectively, with differences for specificity being significant (p < 0.001). Whereas NPV were equally high for SPT (99.2) and RAST (99.3), the incidence of hay fever cases were predicted rather poorly though somewhat better by SPT than by RAST (PPV 16.7 vs. 9.8; p < 0.001) initially. With increasing cut-off point for RAST reactivity, the PPV increased and reached 25.0 at 17.5 kU/l, whereas the NPV decreased to 97.9, which was lower than that of SPT reactivity (p < 0.01). At the cut-off point of 1.5 kU/l almost identical predictive values for SPT and RAST were obtained. SPT and RAST perform better in the negative than positive prediction of hay fever cases in epidemiological studies. Differences in the predictive capabilities depend on the chosen cut-off point for RAST
Boligon, A A; Long, N; Albuquerque, L G; Weigel, K A; Gianola, D; Rosa, G J M
Genomewide marker information can improve the reliability of breeding value predictions for young selection candidates in genomic selection. However, the cost of genotyping limits its use to elite animals, and how such selective genotyping affects predictive ability of genomic selection models is an open question. We performed a simulation study to evaluate the quality of breeding value predictions for selection candidates based on different selective genotyping strategies in a population undergoing selection. The genome consisted of 10 chromosomes of 100 cM each. After 5,000 generations of random mating with a population size of 100 (50 males and 50 females), generation G(0) (reference population) was produced via a full factorial mating between the 50 males and 50 females from generation 5,000. Different levels of selection intensities (animals with the largest yield deviation value) in G(0) or random sampling (no selection) were used to produce offspring of G(0) generation (G(1)). Five genotyping strategies were used to choose 500 animals in G(0) to be genotyped: 1) Random: randomly selected animals, 2) Top: animals with largest yield deviation values, 3) Bottom: animals with lowest yield deviations values, 4) Extreme: animals with the 250 largest and the 250 lowest yield deviations values, and 5) Less Related: less genetically related animals. The number of individuals in G(0) and G(1) was fixed at 2,500 each, and different levels of heritability were considered (0.10, 0.25, and 0.50). Additionally, all 5 selective genotyping strategies (Random, Top, Bottom, Extreme, and Less Related) were applied to an indicator trait in generation G(0,) and the results were evaluated for the target trait in generation G(1), with the genetic correlation between the 2 traits set to 0.50. The 5 genotyping strategies applied to individuals in G(0) (reference population) were compared in terms of their ability to predict the genetic values of the animals in G(1) (selection
Ghanassia, E; Raynaud de Mauverger, E; Brun, J-F; Fedou, C; Mercier, J
To assess the agreement of the NCEP ATP-III and the IDF definitions of metabolic syndrome and to determine their predictive values for the diagnosis of insulin resistance. For this purpose, we recruited 150 subjects (94 women and 56 men) and determined the presence of metabolic syndrome using the NCEP-ATP III and IDF definitions. We evaluated their insulin sensitivity S(I) using Caumo's oral minimal model after a standardized hyperglucidic breakfast test. Subjects whose S(I) was in the lowest quartile were considered as insulin resistant. We then calculated sensitivity, specificity, positive and negative predictive values of both definitions for the diagnosis of insulin resistance. The prevalence of metabolic syndrome was 37.4% (NCEP-ATP III) and 40% (IDF). Agreement between the two definitions was 96%. Using NCEP-ATP III and IDF criteria for the identification of insulin resistant subjects, sensitivity was 55.3% and 63%, specificity was 68.8% and 67.8%, positive predictive value was 37.5% and 40%, negative predictive value was 81.9% and 84.5%, respectively. Positive predictive value increased with the number of criteria for both definitions. Whatever the definition, the scoring of metabolic syndrome is not a reliable tool for the individual diagnosis of insulin resistance, and is more useful for excluding this diagnosis.
Santos, Marisa D; Silva, Cristina; Rocha, Anabela; Nogueira, Carlos; Matos, Eduarda; Lopes, Carlos
Background. Neoadjuvant chemoradiotherapy (nCRT) followed by curative surgery in locally advanced rectal cancer (LARC) improves pelvic disease control. Survival improvement is achieved only if pathological response occurs. Mandard tumor regression grade (TRG) proved to be a valid system to measure nCRT response. Potential predictive factors for Mandard response are analyzed. Materials and Methods. 167 patients with LARC were treated with nCRT and curative surgery. Tumor biopsies and surgical specimens were reviewed and analyzed regarding mitotic count, necrosis, desmoplastic reaction, and inflammatory infiltration grade. Surgical specimens were classified according to Mandard TRG. The patients were divided as "good responders" (Mandard TRG1-2) and "bad responders" (Mandard TRG3-5). According to results from our previous data, good responders have better prognosis than bad responders. We examined predictive factors for Mandard response and performed statistical analysis. Results. In univariate analysis, distance from anal verge and ten other postoperative variables related with nCRT tumor response had predictive value for Mandard response. In multivariable analysis only mitotic count, necrosis, and differentiation grade in surgical specimen had predictive value. Conclusions. There is a lack of clinical and pathological preoperative variables able to predict Mandard response. Only postoperative pathological parameters related with nCRT response have predictive value.
Li, Heyse; Becker, Nathan; Raman, Srinivas; Chan, Timothy C. Y.; Bissonnette, Jean-Pierre
Purpose: There is evidence that computed tomography (CT) and positron emission tomography (PET) imaging metrics are prognostic and predictive in nonsmall cell lung cancer (NSCLC) treatment outcomes. However, few studies have explored the use of standardized uptake value (SUV)-based image features of nodal regions as predictive features. The authors investigated and compared the use of tumor and node image features extracted from the radiotherapy target volumes to predict relapse in a cohort of NSCLC patients undergoing chemoradiation treatment. Methods: A prospective cohort of 25 patients with locally advanced NSCLC underwent 4DPET/4DCT imaging for radiation planning. Thirty-seven image features were derived from the CT-defined volumes and SUVs of the PET image from both the tumor and nodal target regions. The machine learning methods of logistic regression and repeated stratified five-fold cross-validation (CV) were used to predict local and overall relapses in 2 yr. The authors used well-known feature selection methods (Spearman’s rank correlation, recursive feature elimination) within each fold of CV. Classifiers were ranked on their Matthew’s correlation coefficient (MCC) after CV. Area under the curve, sensitivity, and specificity values are also presented. Results: For predicting local relapse, the best classifier found had a mean MCC of 0.07 and was composed of eight tumor features. For predicting overall relapse, the best classifier found had a mean MCC of 0.29 and was composed of a single feature: the volume greater than 0.5 times the maximum SUV (N). Conclusions: The best classifier for predicting local relapse had only tumor features. In contrast, the best classifier for predicting overall relapse included a node feature. Overall, the methods showed that nodes add value in predicting overall relapse but not local relapse.
Sonn, Geoffrey A.; Chang, Edward; Natarajan, Shyam; Margolis, Daniel J.; Macairan, Malu; Lieu, Patricia; Huang, Jiaoti; Dorey, Frederick J.; Reiter, Robert E.; Marks, Leonard S.
Background Conventional biopsy fails to detect the presence of some prostate cancers (PCas). Men with a prior negative biopsy but persistently elevated prostate-specific antigen (PSA) pose a diagnostic dilemma, as some harbor elusive cancer. Objective To determine whether use of magnetic resonance–ultrasound (MR-US) fusion biopsy results in improved detection of PCa compared to repeat conventional biopsy. Design, setting, and participants In a consecutive-case series, 105 subjects with prior negative biopsy and elevated PSA values underwent multiparametric magnetic resonance imaging (MRI) and fusion biopsy in an outpatient setting. Intervention Suspicious areas on multiparametric MRI were delineated and graded by a radiologist; MR–US fusion biopsy was performed by a urologist using the Artemis device; targeted and systematic biopsies were obtained regardless of MRI result. Outcome measurements and statistical analysis Detection rates of all PCa and clinically significant PCa (Gleason ≥3 + 4 or Gleason 6 with maximal cancer core length ≥4 mm) were determined. The yield of targeted biopsy was compared to systematic biopsy. The ability of an MRI grading system to predict clinically significant cancer was investigated. Stepwise multivariate logistic regression analysis was performed to determine predictors of significant cancer on biopsy. Results and limitations Fusion biopsy revealed PCa in 36 of 105 men (34%; 95% confidence interval [CI], 25–45). Seventy-two percent of men with PCa had clinically significant disease; 21 of 23 men (91%) with PCa on targeted biopsy had significant cancer compared to 15 of 28 (54%) with systematic biopsy. Degree of suspicion on MRI was the most powerful predictor of significant cancer on multivariate analysis. Twelve of 14 (86%) subjects with a highly suspicious MRI target were diagnosed with clinically significant cancer. Conclusions MR-US fusion biopsy provides improved detection of PCa in men with prior negative biopsies
Grimaldi, Elizabeth M; Napper, Lucy E; LaBrie, Joseph W
Research on relational aggression (indirect and social means of inflicting harm) has previously focused on adolescent populations. The current study extends this research by exploring both the frequency of perpetrating and being the target of relational aggression as it relates to alcohol use outcomes in a college population. Further, this study examines whether positive urgency (e.g., acting impulsively in response to positive emotions) and negative urgency (e.g., acting impulsively in response to negative emotions) moderate the relationship between relational aggression and alcohol outcomes. In this study, 245 college students (65.7% female) completed an online survey. Results indicated greater frequency of perpetrating relational aggression, higher levels of positive urgency, or higher levels of negative urgency was associated with more negative consequences. Further, negative urgency moderated the relationship between frequency of perpetrating aggression and consequences such that aggression was more strongly associated with consequences for those high in urgency. Counter to the adolescent literature, the frequency of being the target of aggression was not associated with more alcohol use. These findings suggest that perpetrators of relational aggression may be at particular risk for negative alcohol-related consequences when they act impulsively in response to negative, but not positive, emotions. These students may benefit from interventions exploring alternative ways to cope with negative emotions.
Davis, Elysia Poggi; Snidman, Nancy; Wadhwa, Pathik D.; Glynn, Laura M.; Schetter, Chris Dunkel; Sandman, Curt A.
The effects of maternal antenatal and postnatal anxiety and depression on infant negative behavioral reactivity were examined in a sample of 22 mother-infant pairs. Maternal anxiety and depression were assessed by standardized measures during the third trimester of pregnancy and postpartum. Infant negative behavioral responses to novelty were…
Grimaldi, Elizabeth M.; Napper, Lucy E.; LaBrie, Joseph W.
Research on relational aggression (indirect and social means of inflicting harm) has previously focused on adolescent populations. The current study extends this research by exploring both the frequency of perpetrating and being the target of relational aggression as it relates to alcohol use outcomes in a college population. Further, this study examines whether positive urgency (e.g. acting impulsively in response to positive emotions) and negative urgency (e.g., acting impulsively in response to negative emotions) moderate the relationship between relational aggression and alcohol outcomes. In this study, 245 college students (65.7% female) completed an online survey. Results indicated greater frequency of perpetrating relational aggression, higher levels of positive urgency, or higher levels of negative urgency was associated with more negative consequences. Further, negative urgency moderated the relationship between frequency of perpetrating aggression and consequences such that aggression was more strongly associated with consequences for those high in urgency. Counter to the adolescent literature, the frequency of being the target of aggression was not associated with more alcohol use. These findings suggest that perpetrators of relational aggression may be at particular risk for negative alcohol-related consequences when they act impulsively in response to negative, but not positive, emotions. These students may benefit from interventions exploring alternative ways to cope with negative emotions. PMID:25134025
Davis, Elysia Poggi; Snidman, Nancy; Wadhwa, Pathik D.; Glynn, Laura M.; Schetter, Chris Dunkel; Sandman, Curt A.
The effects of maternal antenatal and postnatal anxiety and depression on infant negative behavioral reactivity were examined in a sample of 22 mother-infant pairs. Maternal anxiety and depression were assessed by standardized measures during the third trimester of pregnancy and postpartum. Infant negative behavioral responses to novelty were…
Chugh, Preeta Kaur; Rehan, Harmeet S; Unni, K E S; Sah, Ravinder K
Management of the disease symptomatology impacts the long-term functioning and quality of life (QOL) in psychotic patients. The aim of this research was to study the association between psychiatric symptoms (positive, negative and general psychopathology symptoms) and QOL in first-episode schizophrenia patients. Fifty-five first-episode drug-naïve schizophrenia outpatients were recruited from a tertiary care hospital in New Delhi, India. WHOQOL-Bref (World Health Organization Quality of Life) Scale was used to assess multi-dimensional domains of QOL (physical, psychological, social and environmental health). The patients were evaluated clinically using PANSS and followed up for 6 months. Multivariate analyses were carried out to outline the symptoms which are predictive of QOL in these patients. Physical well-being as assessed with WHOQOL-Bref is significantly impacted by the positive, negative and general psychopathology symptoms of the disease. General psychopathology symptoms demonstrated a strong relationship with different facets of QOL. These symptoms are predictive of physical (P=0.025) and psychological health (P=0.026), social relationships (P=0.009) and environmental QOL (P=0.022). The general psychopathology symptoms significantly impact QOL in a diverse manner. Negative symptoms have a greater influence than positive symptoms on subjective QOL. The antipsychotics focus on primary positive and negative disease symptoms. There is a need to develop a holistic approach (target non-psychotic symptoms intensively) in the disease management to prevent further long-term impairment of QOL.
LaNoue, Marianna; Graeber, David A; Helitzer, Deborah L; Fawcett, Jan
Adverse childhood events (ACE's) have been empirically related to a wide range of negative health and mental health outcomes. However, not all individuals who experience ACE's follow a trajectory of poor outcomes, and not all individuals perceive the impact of ACE's as necessarily negative. The purpose of this study was to investigate positive and negative affect as predictors of adults' ratings of both the childhood and adult impact of their childhood adversity. Self-report data on ACE experiences, including number, severity, and 'impact' were collected from 158 community members recruited on the basis of having adverse childhood experiences. Results indicated that, regardless of event severity and number of different types of adverse events experienced, high levels of negative affect were the strongest predictor of whether the adult impact of the adverse childhood events was rated as negative. All individuals rated the childhood impact of events the same. Implications are discussed.
Hayley, Alexa; Zinkiewicz, Lucy; Hardiman, Kate
Reduced consumption of meat, particularly red meat, is associated with numerous health benefits. While past research has examined demographic and cognitive correlates of meat-related diet identity and meat consumption behaviour, the predictive influence of personal values on meat-consumption attitudes and behaviour, as well as gender differences therein, has not been explicitly examined, nor has past research focusing on 'meat' generally addressed 'white meat' and 'fish/seafood' as distinct categories of interest. Two hundred and two Australians (59.9% female, 39.1% male, 1% unknown), aged 18 to 91 years (M = 31.42, SD = 16.18), completed an online questionnaire including the Schwartz Values Survey, and measures of diet identity, attitude towards reduced consumption of each of red meat, white meat, and fish/seafood, as well as self-reported estimates of frequency of consumption of each meat type. Results showed that higher valuing of Universalism predicted more positive attitudes towards reducing, and less frequent consumption of, each of red meat, white meat, and fish/seafood, while higher Power predicted less positive attitudes towards reducing, and more frequent consumption of, these meats. Higher Security predicted less positive attitudes towards reducing, and more frequent consumption, of white meat and fish/seafood, while Conformity produced this latter effect for fish/seafood only. Despite men valuing Power more highly than women, women valuing Universalism more highly than men, and men eating red meat more frequently than women, gender was not a significant moderator of the value-attitude-behaviour mediations described, suggesting that gender's effects on meat consumption may not be robust once entered into a multivariate model of MRD attitudes and behaviour. Results support past findings associating Universalism, Power, and Security values with meat-eating preferences, and extend these findings by articulating how these values relate specifically
Feys, H.; Van Hees, J.; Bruyninckx, F.; Mercelis, R.; De Weerdt, W.
OBJECTIVES—Prediction of motor recovery in the arm in patients with stroke is generally based on clinical examination. However, neurophysiological measures may also have a predictive value. The aims of this study were to assess the role of somatosensory (SSEPs) and motor (MEPs) evoked potentials in the prediction of arm motor recovery and to determine whether these measures added further predictive information to that gained from clinical examination. METHODS—Sixty four patients who had had a stroke and presented with obvious motor deficit of the arm were examined in terms of three clinical variables (motor performance, muscle tone, and overall disability) and for SSEPs and MEPs. Clinical and neurophysiological examinations were done at entry to the study (2 to 5 weeks poststroke), and at about 2 months after stroke. Further clinical follow up was conducted at 6 and 12 months after stroke. RESULTS—Neurophysiological measures made in the acute phase were of little use alone in predicting motor recovery of the arm at 2,6, and 12 months after stroke. At 2 months, the absence of SSEPs and MEPs indicated a very poor outcome. Conversely, if the responses were preserved, a great variation in motor outcome was found. Multiple regression analysis showed that the addition of SSEPs and MEPs to the clinical examination increased the possibility of predicting arm recovery in the long term. In the acute phase, the combination of the motor score and SSEPs were best able to predict outcome. The long term outcome based on variables taken at 2 months, was best predicted through incorporating the three clinical measures and MEPs. CONCLUSIONS—Neurophysiological measures alone are of limited value in predicting long term outcome. However, predictive accuracy is substantially improved through the combined use of both of these measures and clinical variables. PMID:10675214
Boland, M A; Foster, K A; Schinckel, A P; Wagner, J; Chen, W; Berg, E P; Forrest, J C
Dissected and predicted wholesale and lean boneless values for 154 pork carcasses representing seven genotypes with substantial variation in carcass composition and percentage of lean were determined. Dissected carcass value was determined using a component pricing model, and four alternative models were specified to predict that value. The models included measurements from a ruler (RULER) and two carcass evaluation technologies, Hennessy probe (PROBE) and electromagnetic scanner (EMS1). A combination of the PROBE and EMS1 models (EMS2) was also used. For wholesale value, R2 were .40, .70, .59, and .74, and the RSD were 8.18, 5.77, 6.76, and 5.38 ($/100 kg of carcass value) for RULER, PROBE, EMS1, and EMS2, respectively. For lean boneless value, the R2 were .41, .73, .59, and .74, and the RSD were 8.34, 5.67, 6.99, and 5.51 ($/100 kg of carcass value) for RULER, PROBE, EMS1, and EMS2, respectively. The results indicate that a combination of probe and electromagnetic scanner measurements provided the best fit to dissected value.
White, Stuart F; Pope, Kayla; Sinclair, Stephen; Fowler, Katherine A; Brislin, Sarah J; Williams, W Craig; Pine, Daniel S; Blair, R James R
Youths with disruptive behavior disorders, including conduct disorder and oppositional defiant disorder, show major impairments in reinforcement-based decision making. However, the neural basis of these difficulties remains poorly understood. This partly reflects previous failures to differentiate responses during decision making and feedback processing and to take advantage of computational model-based functional MRI (fMRI). Participants were 38 community youths ages 10-18 (20 had disruptive behavior disorders, and 18 were healthy comparison youths). Model-based fMRI was used to assess the computational processes involved in decision making and feedback processing in the ventromedial prefrontal cortex, insula, and caudate. Youths with disruptive behavior disorders showed reduced use of expected value information within the ventromedial prefrontal cortex when choosing to respond and within the anterior insula when choosing not to respond. In addition, they showed reduced responsiveness to positive prediction errors and increased responsiveness to negative prediction errors within the caudate during feedback. This study is the first to determine impairments in the use of expected value within the ventromedial prefrontal cortex and insula during choice and in prediction error-signaling within the caudate during feedback in youths with disruptive behavior disorders.
White, Stuart F.; Pope, Kayla; Sinclair, Stephen; Fowler, Katherine A.; Brislin, Sarah J.; Williams, W. Craig; Pine, Daniel S.; Blair, R. James R.
Objective Youths with disruptive behavior disorders, including conduct disorder and oppositional defiant disorder, show major impairments in reinforcement-based decision making. However, the neural basis of these difficulties remains poorly understood. This partly reflects previous failures to differentiate responses during decision making and feedback processing and to take advantage of computational model-based functional MRI (fMRI). Method Participants were 38 community youths ages 10–18 (20 had disruptive behavior disorders, and 18 were healthy comparison youths). Model-based fMRI was used to assess the computational processes involved in decision making and feedback processing in the ventromedial prefrontal cortex, insula, and caudate. Results Youths with disruptive behavior disorders showed reduced use of expected value information within the ventromedial prefrontal cortex when choosing to respond and within the anterior insula when choosing not to respond. In addition, they showed reduced responsiveness to positive prediction errors and increased responsiveness to negative prediction errors within the caudate during feedback. Conclusions This study is the first to determine impairments in the use of expected value within the ventromedial prefrontal cortex and insula during choice and in prediction error-signaling within the caudate during feedback in youths with disruptive behavior disorders. PMID:23450288
Shi, Hongtai; Liu, Zhenhua; Pei, Dong; Jiang, Youqin; Zhu, Haiwen; Chen, Bin
There is increasing evidence of a relationship between long non-coding RNA (lncRNA) and cancer. This study aimed to examine the prognostic value of the lncRNA ZFAS1 in esophageal squamous cell carcinoma (ESCC). The results showed that ZFAS1 expression was significantly higher in ESCC tissues compared with the corresponding adjacent normal tissues (P < 0.001). ESCC patients with high ZFAS1 expression had a poor overall survival (OS). Histological grade, T stage and ZFAS1 expression were integrated to develop the nomogram. The nomogram showed a significantly better prediction of OS for patients with lymph node-negative ESCC. The ROC curve also showed higher specificity and sensitivity for predicting 3- and 5-year ESCC patient survival compared with the AJCC staging system. The decision curve analysis also indicated a greater potential for the nomogram in clinical application compared with the AJCC staging system. Importantly, our findings were supported by a validation cohort. We retrospectively investigated 398 lymph node-negative ESCC patients. Data from the primary cohort (n = 246) were used to develop a multivariate nomogram. The nomogram was internally validated for discrimination and calibration with bootstrap samples and was externally validated with an independent patient cohort (n = 152). Our proposed nomogram, which integrates clinicopathological factors and ZFAS1 expression, can accurately predict the prognosis of lymph node-negative ESCC patients without preoperative chemoradiotherapy.
Li, Longhai; Feng, Cindy X; Qiu, Shi
An important statistical task in disease mapping problems is to identify divergent regions with unusually high or low risk of disease. Leave-one-out cross-validatory (LOOCV) model assessment is the gold standard for estimating predictive p-values that can flag such divergent regions. However, actual LOOCV is time-consuming because one needs to rerun a Markov chain Monte Carlo analysis for each posterior distribution in which an observation is held out as a test case. This paper introduces a new method, called integrated importance sampling (iIS), for estimating LOOCV predictive p-values with only Markov chain samples drawn from the posterior based on a full data set. The key step in iIS is that we integrate away the latent variables associated the test observation with respect to their conditional distribution without reference to the actual observation. By following the general theory for importance sampling, the formula used by iIS can be proved to be equivalent to the LOOCV predictive p-value. We compare iIS and other three existing methods in the literature with two disease mapping datasets. Our empirical results show that the predictive p-values estimated with iIS are almost identical to the predictive p-values estimated with actual LOOCV and outperform those given by the existing three methods, namely, the posterior predictive checking, the ordinary importance sampling, and the ghosting method by Marshall and Spiegelhalter (2003). Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.
Thompson, Sarah J; Hattotuwagama, Channa K; Holliday, John D; Flower, Darren R
Peptides are of great therapeutic potential as vaccines and drugs. Knowledge of physicochemical descriptors, including the partition coefficient logP, is useful for the development of predictive Quantitative Structure-Activity Relationships (QSARs). We have investigated the accuracy of available programs for the prediction of logP values for peptides with known experimental values obtained from the literature. Eight prediction programs were tested, of which seven programs were fragment-based methods: XLogP, LogKow, PLogP, ACDLogP, AlogP, Interactive Analysis's LogP and MlogP; and one program used a whole molecule approach: QikProp. The predictive accuracy of the programs was assessed using r2 values, with ALogP being the most effective (r 2 = 0.822) and MLogP the least (r2 = 0.090). We also examined three distinct types of peptide structure: blocked, unblocked, and cyclic. For each study (all peptides, blocked, unblocked and cyclic peptides) the performance of programs rated from best to worse is as follows: all peptides – ALogP, QikProp, PLogP, XLogP, IALogP, LogKow, ACDLogP, and MlogP; blocked peptides PLogP, XLogP, ACDLogP, IALogP, LogKow, QikProp, ALogP, and MLogP; unblocked peptides QikProp, IALogP, ALogP, ACDLogP, MLogP, XLogP, LogKow and PLogP; cyclic peptides LogKow, ALogP, XLogP, MLogP, QikProp, ACDLogP, IALogP. In summary, all programs gave better predictions for blocked peptides, while, in general, logP values for cyclic peptides were under-predicted and those of unblocked peptides were over-predicted PMID:17597897
Herrero-Vicent, Carmen; Guerrero, Angel; Gavilá, Joaquin; Gozalbo, Francisco; Hernández, Abraham; Sandiego, Sergio; Algarra, Maria Asunción; Calatrava, Ana; Guillem-Porta, Vicente; Ruiz-Simón, Amparo
In locally and locally advanced triple-negative breast cancer (TNBC), neoadjuvant chemotherapy (NAC) only induces a pCR in 30-35% of patients. Clinical and pathological factors are not enough to distinguish the patients who have no chance of a pCR or not. The tumour microenvironment is critical for cancer and tumour-infiltrating lymphocytes (TIL). Moreover, the NAC scenario is the perfect setting to study possible changes in TIL levels. Using our prospective maintained breast cancer (BC) database, we identified 164 TNBC patients treated with NAC between 1998 and 2015 with enough samples of diagnostic biopsy and after surgery. Evaluation of TILs before and after NAC followed a standardised methodology for visual assessment on haematoxylin-eosin sections and the amounts of TILs were quantitated in deciles. We categorised lymphocyte-predominant breast cancer cutoff according to a receiver operating characteristic (ROC) analysis. We categorised LPBC as involving > 40% lymphocytic infiltration tumour stroma. The primary end point was predictive value of TILs to NAC, and the secondary end point was disease-free survival (DFS). DFS was analysed using the Kaplan-Meier method and the groups were compared with a long-rank test. Univariate and multivariate Cox models were used to generate hazard ratios for determining associations between variables such as TIL after NAC and DFS. A total of 164 TNBC patients were treated with NAC and surgery. The main patients' characteristics are listed in Table 1. We identify different pathological complete response to anthracycline and taxane-based NAC; LPBC subgroup 51 from 58 patients (88%) pCR versus non- lymphocyte-predominant breast cancer (LPBC) subgroup 10 from 106 (9%) pCR, p = 0.001. At a median follow-up of 78 months, LPBC was associated with better DFS; the three-year Kaplan-Meier estimates for DFS were 2% and 30 % for patients with LPBC and non-LPBC, respectively, p = 0.01. Univariate and multivariate analysis confirmed TIL to
Fernandes Júnior, Gerardo A; Rosa, Guilherme J M; Valente, Bruno D; Carvalheiro, Roberto; Baldi, Fernando; Garcia, Diogo A; Gordo, Daniel G M; Espigolan, Rafael; Takada, Luciana; Tonussi, Rafael L; de Andrade, Willian B F; Magalhães, Ana F B; Chardulo, Luis A L; Tonhati, Humberto; de Albuquerque, Lucia G
The objective of this study was to evaluate the accuracy of genomic predictions for rib eye area (REA), backfat thickness (BFT), and hot carcass weight (HCW) in Nellore beef cattle from Brazilian commercial herds using different prediction models. Phenotypic data from 1756 Nellore steers from ten commercial herds in Brazil were used. Animals were offspring of 294 sires and 1546 dams, reared on pasture, feedlot finished, and slaughtered at approximately 2 years of age. All animals were genotyped using a 777k Illumina Bovine HD SNP chip. Accuracy of genomic predictions of breeding values was evaluated by using a 5-fold cross-validation scheme and considering three models: Bayesian ridge regression (BRR), Bayes C (BC) and Bayesian Lasso (BL), and two types of response variables: traditional estimated breeding value (EBV), and phenotype adjusted for fixed effects (Y*). The prediction accuracies achieved with the BRR model were equal to 0.25 (BFT), 0.33 (HCW) and 0.36 (REA) when EBV was used as response variable, and 0.21 (BFT), 0.37 (HCW) and 0.46 (REA) when using Y*. Results obtained with the BC and BL models were similar. Accuracies increased for traits with a higher heritability, and using Y* instead of EBV as response variable resulted in higher accuracy when heritability was higher. Our results indicate that the accuracy of genomic prediction of carcass traits in Nellore cattle is moderate to high. Prediction of genomic breeding values from adjusted phenotypes Y* was more accurate than from EBV, especially for highly heritable traits. The three models considered (BRR, BC and BL) led to similar predictive abilities and, thus, either one could be used to implement genomic prediction for carcass traits in Nellore cattle.