Cut-off Criteria Research Articles

CCNB2 as a potential biomarker of bladder cancer via the high throughput technology.

Bladder cancer and oral squamous cell carcinoma (OSCC) seriously affect people's health. However, the relationship between bladder cancer and OSCC remains unclear. Got GSE138206, GSE146483, GSE184616, and bladder cancer datasets GSE65635, GSE100926 from Gene Expression Omnibus database. Weighted gene co-expression network analysis was used to identify the significant module. Functional enrichment analysis was performed via the Gene Ontology analysis and Kyoto Encyclopedia of Genes and Genomes. Furthermore, the Gene Set Enrichment Analysis was also used to complete the enrichment analysis. Comparative Toxicogenomics Database found most relevant diseases to core genes. TargetScan is used to forecast analysis of microRNA and target genes. In Gene Ontology analysis, differentially expressed genes were mostly concentrated in cell differentiation, extrallular region, structural molecule activity, and actin binding. In Kyoto Encyclopedia of Genes and Genomes analysis, the differentially expressed genes were mainly enriched in PI3K-Akt signaling pathway, pathway in cancer, and extracellular matrix-receptor interaction. Seven hub genes (cyclin B2 [CCNB2], TK1, CDC20, PCNA, CKS1B, CDCA5, MCM4) were obtained. Hub genes (CCNB2, CDC20) are highly expressed in OSCC and bladder cancer samples. CCNB2 was one common oncogene of bladder cancer and OSCC.

Rethinking the paper product carbon footprint accounting standard from a life-cycle perspective

Paper products are carbon-intensive and having a huge potential for carbon reduction due to their biomass-oriented characteristics. A uniform standard for total carbon footprint (CF) accounting is vital. However, the existing standards have not yet been unified. Inconsistencies between standards cause difficulties in their use and significantly weaken the credibility and comparability of the carbon footprint of a product (CFP). This work rethought the three most widely used standards (Publicly Available Specification 2050 (PAS2050), Product Life Cycle Accounting and Reporting Standard (GHG Protocol), and Product Life Cycle Accounting and Reporting Standard (ISO14067)) from the life-cycle perspective, and established a more appropriate and comprehensive CF accounting standard for paper products (CFASPP). Sanitary pads were selected as a case study to illustrate the discrepancies between PAS 2050, the GHG Protocol, ISO 14067, and CFASPP, for which the annual production CF results were 1424.60, 1481.08, 1453.57, and 1427.04 tons of carbon dioxide equivalent (CO2e) respectively. The main reasons for the different CF results were the cut-off criteria and the inclusion or exclusion of carbon storage, delayed emissions, and energy recovery. Each element increased or decreased 22.57 (carbon storage), 29.96 (cut-off criteria), 10.4 (delayed emissions), and 27.52 (incineration with energy recovery) tons of CO2e in the results. With increasing demand, these discrepancies will become increasingly significant and may lead to corporations shouldering more or less carbon emission responsibilities by selecting different standards, which will challenge the fairness of product carbon neutrality management. CFASPP covers all paper product life-cycle stages and places greater emphasis on the aspects of carbon storage, delayed emissions, and energy recovery in incineration, which cannot be ignored for the CF accounting of paper products and other biomass-oriented products. This study aims to provide a more applicable and comprehensive guide for corporations to evaluate the CF of paper products, and to provide a reference for the construction of a carbon-neutral evaluation system.

Confirmatory Factor Analyses in Psychological Test Adaptation and Development

Confirmatory Factor Analyses in Psychological Test Adaptation and Development

P159 Development of a core set of quality of care measurements for patients with inflammatory bowel disease in Belgium

Abstract Background Uniform and standardized quality indicator (QI) measurement allows to assess quality of care (QoC) and set up quality improvement initiatives. To date there is no uniform measurement of QoC in IBD centres in Belgium. We therefore aimed to adapt existing standards of QoC to practical local needs, and to define a core set of quality measurements (QM) through a multi-stakeholder consensus. Methods A Core Team (4 IBD expert clinicians, 3 researchers) prepared and coordinated the Delphi process (Figure). Through a literature review, 221 existing QIs for IBD were identified. Second, an importance rating scale exercise was performed, leading to 58 QIs that were reformulated into practical QMs. Next, a variety of experts from different centres in Flanders were invited to rate the importance of these 58 QMs on a 10-point Likert scale. In between two consecutive online voting rounds, expert and patient (n=93) perspectives were provided. Furthermore, participants could also suggest items that were missing in the pre-selected list. A consensus threshold of ≥80% of the participants scoring the item 7, 8, 9 or 10 in voting round 2 was applied as the cut-off criterion for an item to be directly included in the final set of QMs. Newly suggested items and items that did not reach the cut-off criterion were discussed and reconsidered for inclusion in the final set during a closing consensus meeting. In order to come to a workable selection of items, participants to the consensus meeting were requested to estimate the potential for improvement of each of the selected QMs. Results In total 40 stakeholders of which 29 IBD clinicians, 7 IBD nurses, 2 paediatricians, 1 abdominal surgeon and 1 chief medical officer from 24 different Flemish centres participated in both Delphi voting rounds. Of this group, 21 IBD clinicians, 3 IBD nurses and 2 paediatricians also participated in the virtual consensus meeting. In total, 50 items reached the cut-off criterion for direct inclusion in the final QM set, the other 8 items and also 3 new items were discussed and re-voted during the consensus meeting of which 8 additionally reached the cut-off criterion to include in the final set. Based on the estimated improvement potential, 19 of these 58 QMs were prioritized and agreed to measure in clinical practice (Table). Conclusion We defined a core set of 58 QMs for IBD based on multi-stakeholder consensus. In the next phase of this project, a more condensed subset of 19 QMs with potential for improvement will be measured in IBD centres across Belgium, allowing QoC assessment, benchmarking and quality improvement initiatives.

Modification of termination of resuscitation rule with compression time interval in South Korea

This study aimed to validate the predictive performance of the termination of resuscitation (TOR) rule and examine the compression time interval (CTI) as a criterion for modifying the rule. This retrospective observational study analyzed adult out-of-hospital cardiac arrest (OHCA) patients attended by emergency medical service (EMS) providers in mixed urban–rural areas in Korea in 2020 and 2021. We evaluated the predictive performance of basic life support (BLS) and the Korean Cardiac Arrest Research Consortium (KoCARC) TOR rule using the false-positive rate (FPR) and positive predictive value (PPV). We modified the age cutoff criterion and examined the CTI as a new criterion. According to the TOR rule, 1827 OHCA patients were classified into two groups. The predictive performance of the BLS TOR rule had an FPR of 11.7% (95% confidence interval (CI): 5.9–17.5) and PPV of 98.4% (97.6–99.2) for mortality, and an FPR of 3.6% (0.0–7.8) and PPV of 78.6% (75.9–81.3) for poor neurological outcomes at hospital discharge. The predictive performance of the KoCARC TOR rule had an FPR of 5.0% (1.1–8.9) and PPV of 98.9% (98.0–99.8) for mortality, and an FPR of 3.7% (0.0–7.8) and PPV of 50.0% (45.7–54.3) for poor neurological outcomes at hospital discharge. The modified cutoff value for age was 68 years, with an area under the receiver operating characteristic curve over 0.7. In the group that met the BLS TOR rule, the cutoff of the CTI for death was not determined and was 21 min for poor neurological outcomes. In the group that met the KoCARC TOR rule, the cutoff of the CTI for death and poor neurological outcomes at the time of hospital discharge was 25 min and 21 min, respectively. The BLS TOR and KoCARC TOR rules showed inappropriate predictive performance for mortality and poor neurological outcomes. However, the predictive performance of the TOR rule could be supplemented by modifying the age criterion and adding the CTI criterion of the KoCARC.

Analysis of long noncoding RNAs and messenger RNAs expression profiles in the hearts of mice with acute viral myocarditis.

Acute viral myocarditis (AVMC) is a common acute myocardial inflammation caused by viral infections, which can lead to severe cardiac dysfunction. Several long noncoding RNAs (lncRNAs) with aberrant expression have been identified in the pathogenesis of AVMC. However, the expression profiles and functions of lncRNAs in AVMC have not been fully elucidated. In the present study, we constructed AVMC mouse models by intraperitoneal injection of coxsackievirus B3 (CVB3) and performed RNA sequencing (RNA-seq) on heart tissues to investigate the differences in lncRNAs and messenger RNAs (mRNAs) expression profiles. Based on the cutoff criteria of adjusted p-values (padj) <0.05 and |log2FoldChange| >1, a total of 1122 differentially expressed lncRNAs (DElncRNAs) and 3186 differentially expressed mRNAs (DEmRNAs) were screened, including 734 upregulated and 388 downregulated lncRNAs, 1821 upregulated and 1365 downregulated mRNAs. RT-qPCR analysis validated that the expression patterns of 12 randomly selected genes (6 DElncRNAs and 6 DEmRNAs) were highly consistent with those in RNA-seq, proving the reliability of the RNA-seq data. Then, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses revealed that differentially expressed genes were mainly involved in metabolic and immune-related processes. Furthermore, co-expression networks between DElncRNAs and DEmRNAs in cytokine-cytokine receptor interaction, MAPK signaling pathway, and PI3K-Akt signaling pathway were constructed to study the molecular interactions of these molecules. Our study, for the first time, reveals the expression profiles of lncRNAs and mRNAs associated with AVMC, which may shed light on the roles of lncRNAs in disease pathogenesis and aid in discovering new therapeutic targets.

Progress of social assessment in the framework of bioeconomy under a life cycle perspective

The bioeconomy is positioned as a sustainable pathway to address the climate crisis and decrease the consumption of fossil resources. Life cycle methodologies are recognised as useful tools for assessing sustainability issues of production and consumption patterns. Nevertheless, the Social Life Cycle Assessment (S-LCA) methodology is less explored despite its potential, although it is true that social sustainability assessment in promoting bioeconomy strategies requires more attention. This study describes the state of the art of the S-LCA methodology under the bioeconomy framework, critically analysing the main procedural and practical issues of its implementation, and the eventual specificities, as well as providing some of the challenges for future studies. This review highlights methodological weaknesses that require further research, related to the definition of system boundaries and cut-off criteria, the method of impact assessment, and the selection of societal issues and stakeholders, as well as uncertainty, among others. In addition, particularities of the bioeconomy in the life perspective were noted, such as multifunctionality and allocation issues of bio-based products, as well as the strong interest in biofuel production systems. Therefore, more efforts are desirable to address the diversity of challenges towards the progress of the S-LCA method in line with other life cycle approaches (environmental and economic). However, the updated S-LCA Guidelines represent a useful and valuable starting point on the way towards a comprehensive (i.e., diverse social concerns) and standardised social assessment under a life cycle perspective.

A new method for identifying industrial clustering using the standard deviational ellipse

Industrial agglomeration has attracted extensive attention from economists and geographers, yet it is still a challenge to identify the multi-agglomeration spatial structure and degree of industrial agglomeration in continuous space—there is still a lack of a more targeted industrial clustering method. The clustering method and the standard deviational ellipse (simply, ellipse) model have advantages in identifying the spatial structure and representing spatial information respectively. On this basis, we propose an ellipse-based approach to identifying industrial clusters. Our ellipse-based approach rests upon group nearest neighbor using the group-based nearest neighbor (GNN) ordering and spatial compactness matrix, where a number of point sequences with varying lengths, generated under the GNN ordering, are characterized by an ellipse and the elliptical parameters of these point sequences formulate the values and structure of the compactness matrix. Clustering is reformulated to identify ellipses with a specified parameter among a number of potential candidate ellipses, with significant changes (especially in the area) used as the cutoff criterion for determining the clusters’ border point. Our approach is illustrated in the location pattern of firms in Shanghai City, China in comparison with four well-known clustering methods. With the combination of elliptical parameters and spatial compactness, our approach may bring a new analytical ground for future industrial clustering research.

After the fall: Responding to the Champlain Towers building collapse.

In June 2021, a condominium in Florida collapsed, with the loss of 98 lives. Search and rescue teams spent 2 weeks, recovering the victims. This study's objective was to assess the presence of psychological symptoms that might emerge in the following months, using the PTSD Checklist for DSM-5 (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder - 7 (GAD-7), Suicide Cognitions Scale-Short (SCS-S), and the Insomnia Severity Index (ISI). A monthly survey conducted for 3 months found that overall, mean scores on these measures did not indicate significant emotional distress. We then compared the scores when the group was divided into responders who recovered human remains and those who did not. Scores were significantly higher among the subgroup that recovered human remains. Fifty-three percent (53%) of this sub-group met the cut-off score for a provisional diagnosis of PTSD, depressive disorder or generalized anxiety disorder-15% met the cut-off score criteria on the PCL-5 for probable PTSD, 36.8% for probable depressive disorder on the PHQ-9, and 26.3% for probable generalized anxiety disorder on the GAD-7. The results are consistent with other investigations examining mental health after mass disasters. Specifically, not all first responders will develop emotional distress but certain recovery activities may put some responders at higher risk, with a percentage displaying psychological distress. The results emphasize the need to assess the impact of these events on the mental health of first responders and to consider strategies to prevent or mitigate the development of impairing psychopathology.

Reading skills promotion: Results on the impact of a preschool intervention

There is a strong correlation between preschool education skills such as phonological awareness and language and success in reading and spelling acquisition. Even though, this is still not the focus of the early intervention. This study presents the preliminary results of the impact of an intervention program developed to promote reading foundation skills. The study was conducted with 627 children in the last year of preschool education (54.2% boys), ages between 4 years and 10 months and 6 years and 1 month. Participants were divided into intervention (n = 242) and comparative (n = 385) group. Language, implicit, and explicit phonological awareness, and rime implicit awareness were assessed. The intervention group reached statistically higher values in all dimensions at the post-test, a higher magnitude effect and 80% of these children entered the first-grade overpassing cut-off criteria for reading acquisition difficulties. These results support the impact of the program.

Distribution and frequency of clinical criteria and rating scales for diagnosis and assessment of catatonia in different study types

BackgroundA comprehensive assessment of catatonic symptoms is decisive for diagnosis, neuronal correlates, and evaluation of treatment response and prognosis of catatonia. Studies conducted so far used different cut-off criteria and clinical rating scales to assess catatonia. Therefore, the main aim of this study was to examine the frequency and distribution of diagnostic criteria and clinical rating scales for assessing catatonia that were used in scientific studies so far. MethodsWe conducted a systematic review using PubMed searching for articles using catatonia rating scales/criteria published from January 1st 1952 (introduction of catatonic schizophrenia to first edition of the Diagnostic and Statistical Manual of Mental Disorders [DSM]) up to December 5th, 2022. Results1928 articles were considered for analysis. 1762 (91,39 %) studies used one and 166 (8,61 %) used ≥2 definitions of catatonia. However, 979 (50,7 %) articles did not report any systematic assessment of catatonia. As for clinical criteria, DSM criteria were used by the majority of studies (n = 290; 14.0 %), followed by International Classification of Diseases (ICD) criteria (n = 61; 2.9 %). The Bush-Francis Catatonia Rating Scale (BFCRS) was found to be by far the most frequently utilized scale (n = 464; 22.4 % in the respective years), followed by Northoff Catatonia Rating Scale (NCRS) (n = 31; 1.5 % in the respective years). ConclusionDSM and ICD criteria as well as BFCRS and NCRS were most frequently utilized and can therefore be recommended as valid instruments for the assessment of catatonia symptomatology.

Correlation of CYP2R1 gene promoter methylation with circulating vitamin D levels among healthy adults.

Despite being a tropical country, vitamin D deficiency is highly prevalent in India with studies indicating 40-99 per cent prevalence. Apart from calcium and phosphate metabolism, vitamin D is involved in cell cycle regulation, cardiovascular, hepatoprotection. The metabolism of vitamin D is regulated by vitamin D tool genes (CYP2R1/CYP27B1/CYP24A1/VDR). The promoter regions of some of these genes have CpG islands, making them prone to methylation induced gene silencing, which may cause a reduction in circulating vitamin D levels. Epigenetic basis of vitamin D deficiency is yet to be studied in India, and hence, this pilot study was aimed to analyze whether methylation levels of CYP2R1 gene were correlated with the levels of 25(OH)D in healthy, adult individuals in Indian population. In this cross-sectional study, healthy adults of 18-45 yr of age with no history of malabsorption, thyroidectomy, chronic illness or therapeutic vitamin D supplementation were recruited. DNA methylation analysis was carried out by methylation specific quantitative PCR. Serum calcium, phosphate and vitamin D levels were also quantified. Statistical analysis was done by R 4.0.5 software. A total of 61 apparently healthy adults were analyzed. The serum vitamin D levels did not correlate with CYP2R1 methylation levels in our study population. Significant positive correlation was observed between age and serum vitamin D levels. Significant association of gender was found with CYP2R1 methylation levels. This study found no significant correlation between levels of CYP2R1 methylation and circulating 25(OH)D deficiency. Further studies on the Indian population having a larger sample size including entire vitamin D tool genes, among different ethnic groups may be conducted to elucidate molecular etiology of circulating 25(OH)D deficiency. The high prevalence of normal serum calcium and phosphate levels among vitamin D deficient subjects in this study coupled with the strikingly high prevalence of the deficiency at the national level, may suggest the need to revise the cut-off criteria for vitamin D deficiency in the Indian population.

Clinical Practice Guidelines for Assessment and Management of Patients with Borderline Personality Disorder.

Clinical Practice Guidelines for Assessment and Management of Patients with Borderline Personality Disorder.

Evaluation of genes and molecular pathway related pathogenesis of endometriosis: A bioinformatics approach

ObjectiveAlthough recent studies have focused on the role of genes in the pathogenesis of endometriosis, the investigation of genes and molecular pathways involved in the pathogenesis of endometriosis with a bioinformatics approach has not been addressed yet. Hence, we aimed to investigate this issue in our study. Materials and methodsThe gene expression datasets GSE7305 and GSE124010 were obtained from the GEO database, consisting of endometriosis and normal endometrial tissue samples. Differential expression analysis was performed using the R software and LIMMA package, applying cutoff criteria of p-value <0.05 and |logFC| > 1 to identify differentially expressed miRNAs (DEmiRs) and genes (DEGs). The MultiMiR package was used to predict target genes for DEmiRs, considering the overlapping predictions from multiple databases. Venn diagrams were used to establish miRNA-target relationships and identify interactions with DEGs. Functional enrichment analyses were conducted using the Enrichr analysis tool to predict the molecular function, biological processes, cellular components, and pathways associated with the target genes. Protein-protein interaction networks were constructed using the STRING database and visualized in Cytoscape, and hub genes were identified based on their centrality measures. Key hub genes were selected by considering those shared among all three centrality measures. The expression levels of hub genes were validated in endometriosis samples using ROC curves to assess diagnostic accuracy. The AUC was calculated to compare the diagnostic value of the hub genes, using GraphPad Prism version 9.1.0. ResultThe analysis identified six hub genes (CCNA2, ESR1, AURKA, MKI67, and VEGFA) in the protein-protein interaction network. Among the miRNAs, hsa-miR-29a-3p showed the highest number of interactions with these hub genes, making it the key miRNA in the study. These findings suggest the potential involvement of hsa-miR-29a-3p in regulating the expression of the identified hub genes in endometriosis. ConclusionIdentifying pathways related to the expression of hub genes can be useful in designing appropriate treatment strategies. On the other hand, examining the pathways activated by hub genes can be effective in preventing of endometriosis progression.

Gene enrichment analysis and protein–protein interaction network topology delineates S-Phase kinase-associated protein 1 and catenin beta-1 as potential signature genes linked to glioblastoma prognosis

Background: Glioblastoma (GBM) is the most malignant and accounts for 60% of brain tumors in adults. Current therapy for GBM involves surgical removal of the tumor followed by radiotherapy with concomitant adjuvant therapy temozolomide. Despite improvements in therapy, patient survival remains low. The exact etiology of a brain tumor is uncertain, and numerous unknown genes are involved in the progression of GBM. The aim of the present study was to evaluate various genes involved in GBM through bioinformatic approach. Methods: In the present study, gene expression profile of GSE68424 was retrieved from the GEO database to explore the genes in GBM. Results: Analysis of expression profile data revealed that 33 genes were upregulated and 1189 genes were downregulated based on the log2 fold change cut-off criteria. The genes S-Phase kinase-associated protein 1 (SKP1) and Catenin beta-1 (CTNNB1) have been linked to GBM prognosis. Conclusion: SKP1 and CTNNB1 were identified as a candidate gene for GBM study as a result of these findings. Catenin beta-1 was the protein with the highest closeness centrality value and is the key component of canonical Wnt signaling downstream pathway. More study is needed to establish the molecular function of SKP1 and CTNNB1 in GBM development, as well as the biomarker's specificity and sensitivity.

Changes in Serum Adiponectin and Serum Leptin Levels Can Predict Pre-Eclampsia in Pregnant Women: A Prospective Study

Background: The study aims to investigate maternal adiponectin and leptin levels as prospective markers of preeclampsia, as well as the ratio of maternal adiponectin to leptin levels. Additionally, this research investigated the relationship between these two hormones. In addition to that, the purpose of this study was to analyze the connection that exists between the two hormones. Materials and Methods: This is a study that looks forward into the foreseeable future. The pregnant women who were willing to take part in the research were split into two groups: the first group, which was referred to as the study group, consisted of fifty women who had been diagnosed with pre-eclampsia, and the second group, which was referred to as the control group, consisted of fifty normotensive women of the same gestational age who did not have proteinuria. The levels of adiponectin, leptin, and their ratio were evaluated in the maternal serum of pre-eclamptic (the study group)and normotensive women(the control group).. The comparison's outcomes were analysed Results: There was a statistically significant difference in the levels of adiponectin found in the study group compared to the levels found in the control group. When comparing the levels of leptin in the study group with the control group, there was a statistically significant difference (p&lt; 0.001) between the two groups. When compared to the control group, the ratio of adiponectin to leptin was considerably lower in the group that participated in the study (p&lt;&lt;0.001). When used as predictors of pre-eclampsia, serum leptin and the serum adiponectin/leptin ratio displayed a sensitivity of 90%, a specificity of 87.9%, a positive predictive value of 88.7%, and a negative predictive value of 73%. Additionally, the ratio of serum adiponectin to leptin exhibited a positive predictive value of 86.9 percent. Both the adiponectin/leptin ratio cutoff point and the leptin cutoff point were found to be optimal at 0.161. It was determined that a cutoff criterion of 24.1 ng/ml for serum leptin should be used. Both the adiponectin/leptin ratio and the serum leptin levels were significantly linked with significant degrees of accuracy (p &lt;0.001) in the prediction of obesity. Conclusion: In research on pre-eclampsia, the examination of the maternal leptin level should be included, and a cut-off level of greater than 24.2 ng/ml should be employed as a diagnostic biomarker. This is due to the fact that pre-eclampsia is linked to hyperleptinemia, which is a condition that is characterised by dangerously high blood pressure in the mother. The ratio of adiponectin to leptin should be checked in every instance of preeclampsia, and the diagnostic threshold should be set to less than 0.153. This ratio is a potential biomarker for preeclampsia and should be examined in every case. Keywords: Leptin, adiponectin, the ratio of adiponectin to leptin, pre-eclampsia, and biomarkers

Dynamic : An R Package for Deriving Dynamic Fit Index Cutoffs for Factor Analysis

To evaluate the fit of a confirmatory factor analysis model, researchers often rely on fit indices such as SRMR, RMSEA, and CFI. These indices are frequently compared to benchmark values of .08, .06, and .96, respectively, established by Hu and Bentler (Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55). However, these indices are affected by model characteristics and their sensitivity to misfit can change across models. Decisions about model fit can therefore be improved by tailoring cutoffs to each model. The methodological literature has proposed methods for deriving customized cutoffs, although it can require knowledge of linear algebra and Monte Carlo simulation. Given that many empirical researchers do not have training in these technical areas, empirical studies largely continue to rely on fixed benchmarks even though they are known to generalize poorly and can be poor arbiters of fit. To address this, this paper introduces the R package, dynamic, to make computation of dynamic fit index cutoffs (which are tailored to the user’s model) more accessible to empirical researchers. dynamic heavily automatizes this process and only requires a lavaan object to automatically conduct several custom Monte Carlo simulations and output fit index cutoffs designed to be sensitive to misfit with the user’s model characteristics.

Osteoarticular Infections in Children: Accurately Distinguishing between MSSA and Kingella kingae

Introduction: Osteoarticular infections (OAIs) constitute serious paediatric conditions that may cause severe complications. Identifying the causative organism is one of the mainstays of the care process, since its detection will confirm the diagnosis, enable adjustments to antibiotic therapy and thus optimize outcomes. Two bacteria account for the majority of OAIs before 16 years of age: Staphylococcus aureus is known for affecting the older child, whereas Kingella kingae affects infants and children younger than 4 years old. We aimed to better define clinical characteristic and biological criteria for prompt diagnosis and discrimination between these two OAI. Materials and methods: We retrospectively studied 335 children, gathering 100 K. kingae and 116 S. aureus bacteriologically proven OAIs. Age, gender, temperature at admission, involved bone or joint, and laboratory data including bacterial cultures were collected for analysis. Comparisons between patients with OAI due to K. kingae and those with OAI due to S. aureus were performed using the Mann−Whitney and Kruskal−Wallis tests. Six cut-off discrimination criteria (age, admission’s T°, WBC, CRP, ESR and platelet count) were defined, and their respective ability to differentiate between OAI patients due to K. kingae versus those with S. aureus was assessed by nonparametric receiver operating characteristic (ROC) curves. Results: Univariate analysis demonstrated significant differences between the two populations for age of patients, temperature at admission, CRP, ESR, WBC, and platelet count. AUC assessed by ROC curves demonstrated an exquisite ability to discriminate between the two populations for age of the patients; whereas AUC for CRP (0.79), temperature at admission (0.76), and platelet count (0.76) indicated a fair accuracy to discriminate between the two populations. Accuracy to discriminate between the two subgroups of patients was considered as poor for WBC (AUC = 0.62), and failed for ESR (AUC = 0.58). On the basis of our results, the best model to predict K. kingae OAI included of the following cut-offs for each parameter: age < 43 months, temperature at admission < 37.9 °C, CRP < 32.5 mg/L, and platelet count > 361,500/mm3. Conclusions: OAI caused by K. kingae affects primarily infants and toddlers aged less than 4 years, whereas most of the children with OAI due to MSSA were aged 4 years and more. Considering our experience on the ground, only three variables were very suggestive of an OAI caused by K. kingae, i.e., age of less than 4 years, platelet count > 400,000, and a CRP level below 32.5 mg/L, whereas WBC and ESR were relatively of limited use in clinical practice.

Categorization of the Aqueous Deficient Dry Eye by a Cut-Off Criterion of TMH Measured with Tearscope.

A decrease of the Tear Meniscus Height (TMH) has been proposed as a useful indicator for Aqueous Deficient Dry Eye (ADDE) categorization. The present study aimed to calculate a TMH cut-off criterion for the categorization or severity assessment of ADDE with the Tearscope. 200 participants with a previous Dry Eye Disease (DED) diagnosis according to TFOS DEWS-II criteria were recruited. TMH by slit-lamp illumination and Lipid Layer Pattern (LLP) with Tearscope were assessed to categorise the participants into the ADDE or the Evaporative Dry Eye (EDE) group. The ADDE group was also subdivided into Mild-moderate ADDE and Moderate-severe ADDE based on TMH with slit-lamp. Additionally, the TMH was measured by Tearscope (TMH-Tc). Receiver Operating Characteristics showed that the TMH-Tc have a diagnostic capability to differentiate between ADDE and EDE participants, and between Mild-moderate or Moderate-severe ADDE, with a cut-off value of 0.159 mm (AUC = 0.843 ± 0.035, p < 0.001; sensitivity: 86.4%; specificity: 75.4%) and 0.105 mm (AUC = 0.953 ± 0.025, p < 0.001; sensitivity: 98.1%; specificity: 80.0%), respectively. The present study proposed a cut-off criterion to differentiate between ADDE and EDE participants, or between ADDE severities through TMH assessed by Tearscope.

Refining the upper limit of normal for the ascending aorta: In search of optimal criteria -- a large database study of normal individuals.

The cutoff for dilated mid-ascending aorta (mAA) is controversial and has several definitions. The present study was carried out to determine the prevalence of mAA dilation based on published definitions and to identify the optimal cutoff. Echocardiographic studies of patients >15years of age performed at a large tertiary care center over 4years, n = 49,330, were retrospectively evaluated. Leading-edge-to-leading-edge technique was used to measure the mAA in diastole. Several cutoff criteria were included. In addition, we defined normals in our database as those who, after 28 causes of dilated aorta were excluded, were normal both clinically and echocardiographically (n = 2334). The mean age was 64.2 ± 17.1years, and 31.5% were men. The prevalence of dilated mAA based on absolute criteria with sex stratification varied between 17% and 23% and based on relative criteria (to age, body surface area, and sex) varied between 6% and 11%. It further decreased to 7.6% on the addition of narrow age stratification (10year intervals) performed on normals in our database. The multivariate adjusted R2 (for variation in mAA diameter) was 0.25 for age, decreasing to 0.12 for weight and 0.07 for sex and height. The lowest prevalence of 7.6% probably represents the optimal cutoff for dilated mAA because it includes age, which explains most of the variation in mAA, in narrow (10year) intervals only performed in our normals, which represents the largest sample size to date.