Diagnostic Credibility Research Articles

Diagnostic Accuracy of Immunohistochemical Expression of p16, MDM2, and CDK4 in Well-Differentiated and De-Differentiated Liposarcoma in MDM2 Fluorescent in situ Hybridisation Confirmed Cases.

To establish the diagnostic utility of immunohistochemistry markers p16 along with MDM2 and CDK-4 in confirming the diagnosis of well-differentiated and de-differentiated liposarcoma while taking Fluorescent in situ Hybridisation (FISH) as a gold standard. A cross-sectional study. Place and Duration of the Study: Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from 30th January 2022 to 30th June 2023. A standard panel of three immunohistochemistry markers p16, MDM2, and CDK4 were applied to 36 cases of atypical lipomatous tumours, well-differentiated liposarcoma (WDLPS), and de-differentiated liposarcoma (DDLPS), on which the gold standard FISH was already performed. The sample size was calculated with the help of a WHO calculator taking prevalence 1-2% in Pakistani population. Qualitative variables such as gender and site of tumour were presented by calculating frequency and percentages and comparison of Immunohistochemistry results with FISH was done by using a 2x2 table. The sensitivity and specificity of this triple marker panel for detecting WDLPS/DDLPS were 43.47% and 15.38%, respectively. The sensitivity and specificity of CDK4 for detecting WDLPS / DDLPS were 82.6% and 15.4%, those of MDM2 were 73.9% and 61.5 %, and those of p16 were 60.9% and 53.8%, respectively. Among all three markers, CDK4 was the most sensitive and MDM2 was the most specific marker for detecting WDLPS-DDLPS. It also showed that a combination of these three markers improves the diagnostic credibility of the immunohistochemistry in diagnosing DDLPS and WDLPS but FISH is the most reliable and confirmatory method. De-differentiated liposarcoma, Well-differentiated liposarcoma, P16, CDK4, MDM2.

Modele dyskryminacyjne jako instrument oceny zagrożenia upadłością przedsiębiorstw

In Poland, the interest in discriminatory models dates back to 1994 (26 years after the publication of the assumptions of the E. Altman model). The aim of the research was an attempt to critically evaluate, in terms of methodology, the phenomenon of using discriminatory models in the procedure of examining the financial condition of enterprises. The article also attempts to evaluate the state of research in the national literature concerning the subject of discriminatory methods in assessing the financial condition and risk of bankruptcy of enterprises. In the literature, it is still noted that discriminatory methods, from a methodological point of view are unjustifiably described as having a timeless value and sectoral universality. An attempt was made to verify two research theses: the frequency of using particular discriminatory models in the national literature on the subject is not equivalent to a hierarchy of their diagnostic reliability and the discriminatory models do not have the value of sectoral universality. Critical reference was made to numerous cases of simplifications and methodological errors occurring in the national literature on the subject. The research included 132 Polish discriminatory models, the methodological assumptions of which were published in the years 1994–2020, however, for 102 models, the teaching population does not exceed 100 entities. Only in three studies were the number of enterprises higher than 1,000 (they ranged from 1,353 to 11,000). Numerous errors and methodological simplifications have been shown in attempts to apply this method, which reduces the diagnostic credibility of the obtained results, and in extreme cases even disqualifies them. This paradox was also pointed out, as numerous studies have shown that Polish enterprises do not use modern methods of bankruptcy forecasting, or they only apply them sporadically. In the surveyed population of 132 discriminatory models, the most common are the current liquidity ratio (50 models), the rate of return on investment (34), the total debt ratio (31), the asset turnover ratio (29), the ratio of financing assets with working capital (21) and the ratio of financing liabilities with a financial surplus (20).

The Reliability between Placido Topography and Scheimpflug Topography in Normal Corneas with Astigmatism less Than 0.50 Dc

Purpose: This Clinical research was targeted to experimentally investigate the reliability between Placido topography and Scheimpflug topography in normal corneas with astigmatism ≤ ±0.50 Dc by comparing the refractive powers at the 4 main meridians (180⁰ - 90⁰) in order to study any differences between the two topographers and their reliability. Comparing the reliability measurements of Placido disk topography (CSO- Modi 02 Corneal Topographer with Phoenix Full & Pupil Module Software) with those of a high-resolution rotating Scheimpflug camera (Pentacam-Oculus,) and assess the agreement between these two topographers in measuring corneal power in normal eyes without astigmatism (≤ 0.50 Dc).
 Methods and Materials: Measurements were taken from 56 eyes corresponding to a proportion of patients, of which 26 were men with a mean age of ± 30 years and 30 were women with a mean age of ± 27 years. Refractive power maps were taken from the anterior cornea, having results for the steep meridian value (Ks), the flat meridian value (Kf), mean keratometric value (Km), and cornea astigmatism (Ks-Kf). The same examiner took all the data from measuring these 56 eyes. The results for each refractive map from the two topographers was taken with values for meridians (180⁰- 90⁰). Then the there was a statistical analysis comparing the values of (CSO) and (Pentacam) for those 56 eyes measured.
 Results: The statistical analysis for all meridians based on the results and as far as normal corneas with astigmatism ≤ ±0.50 Dc are concerned, the Placido topography (CSO) and Scheimpflug imaging technique (Pentacam), can be considered as equivalent in terms of diagnostic credibility and accuracy for primary health care, fitting contact lenses, etc. as the correlation coefficient r did not show any important differences for both instruments. For the 90⁰ meridian the correlation coefficient was 0.79, Significance level P=0.0001 and 95% confidence interval ranges from 0.67 to 0.87. For the 180⁰ meridian the correlation coefficient was 0.48, Significance level P<0.0001 and 95% confidence interval ranges from 0.25 to 0.66.
 Conclusion: In terms of diagnosis of pathology and follow-up, contact lens fitting especially for the anterior cornea surface these two instruments can work quite the same that’s why a small clinical practitioner should have at least a Placido topographer. Corneal topography is an important instrument in order to measure the shape and refractive power of the cornea. Corneal topography gives practitioners an important tool to fit contact lenses asses the power and the cornea shape and helps to evaluate complications of the contact lens in relation with the corneal surface. These instruments continue to develop techniques and software in order to investigate and evaluate corneal surfaces and the integrity of the tear film, so that they can provide better solutions for their contact lens patients.

Scientific solution to a complex problem: physiology and multidisciplinary team improve understanding and outcome in chronic constipation and faecal incontinence.

There is a lack of diagnostic credibility to direct focused management for children with chronic constipation (CC) and faecal incontinence (FI). The aim is to assess the impact of an innovative Children's Anorectal Physiology Service (CAPS) focusing on improving outcomes in children with CC/FI. Prospective data: demographics, bowel and quality of life (QoL)/risk of distress questionnaires. Diagnostics: awake high-resolution anorectal manometry (AHRAM), endoanal ultrasound and transit marker studies (TMS). Total patients: 112; 66 males (59%); median 9years (17months to 16years). Patient groups included: 89 (79%) had functional CC/FI; 9 (8%), Hirschsprung's disease; 12 (11%), anorectal malformations and 2 (2%), trauma. St Marks Incontinence score (SMIS) abnormal in 91 (81%) and Cleveland Constipation Score (CCS) in 101 (90%) patients. Anorectal manometry: 94 (84%) awake and 18 (17%) under anaesthesia. Play specialist input 37 (33%) patients. AHRAM abnormal 65 (58%): sphincter dysfunction 36 (32%) and altered rectal sensation: hyposensitive 22% (20/91); 21% (19/91) hypersensitive. TMS normal in 64 (57%), 17 (15%) slow transit and 27 (24%) rectal evacuatory disorder. Risk of distress in 38% and poor QoL in 55% patients which correlated with abnormal SMIS (p = 0.02). Patient/parent satisfaction improved significantly (p < 0.05). Scientific investigations combined with multidisciplinary team improve patient satisfaction and reduces patient self-report illness severity. A complex problem requires a scientific solution.

Preclinical Evaluation of the Hsp70 Peptide Tracer TPP-PEG24-DFO[89Zr] for Tumor-Specific PET/CT Imaging.

High precision in vivo PET/CT imaging of solid tumors improves diagnostic credibility and clinical outcome of patients. An epitope of the oligomerization domain of Hsp70 is exclusively exposed on the membrane of a large variety of tumor types, but not on normal cells, and thus provides a universal tumor-specific target. Here we developed a novel PET tracer TPP-PEG24-DFO[89Zr] based on the tumor cell-penetrating peptide probe TPP, which specifically recognizes membrane Hsp70 (mHsp70) on tumor cells. The implemented PEG24 moiety supported tracer stability and improved biodistribution characteristics in vivo The K d of the tracer ranged in the low nanomolar range (18.9 ± 11.3 nmol/L). Fluorescein isothiocyanate (FITC)-labeled derivatives TPP-[FITC] and TPP-PEG24-[FITC] revealed comparable and specific binding to mHsp70-positive 4T1, 4T1+, a derivative of the 4T1 cell line sorted for high Hsp70 expression, and CT26 tumor cells, but not to mHsp70-negative normal fibroblasts. The rapid internalization kinetics of mHsp70 into the cytosol and the favorable biodistribution of the peptide-based tracer TPP-PEG24-DFO[89Zr] in vivo enabled a tumor-specific accumulation with a high tumor-to-background contrast and renal body clearance. The tumor-specific enrichment of the tracer in 4T1+ (6.2 ± 1.1%ID/g), 4T1 (4.3 ± 0.7%ID/g), and CT26 (2.6 ± 0.6%ID/g) mouse tumors with very high, high, and intermediate mHsp70 densities, respectively, reflected mHsp70 expression profiles of the different tumor types, whereas benign mHsp70-negative fibroblastic hyperplasia showed no tracer accumulation (0.2 ± 0.03%ID/g). The ability of our chemically optimized peptide-based tracer TPP-PEG24-DFO[89Zr] to detect mHsp70 in vivo suggests its broad applicability in targeting and imaging with high specificity for any tumor type that exhibits surface expression of Hsp70.Significance: A novel peptide-based PET tracer against the oligomerization domain of Hsp70 has potential for universal tumor-specific imaging in vivo across many tumor type. Cancer Res; 78(21); 6268-81. ©2018 AACR.

Automatic Prostate Cancer Segmentation Using Kinetic Analysis in Dynamic Contrast-Enhanced MRI

Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) provides functional information on the microcirculation in tissues by analyzing the enhancement kinetics which can be used as biomarkers for prostate lesions detection and characterization. The purpose of this study is to investigate spatiotemporal patterns of tumors by extracting semi-quantitative as well as wavelet-based features, both extracted from pixel-based time-signal intensity curves to segment prostate lesions on prostate DCE-MRI. Quantitative dynamic contrast-enhanced MRI data were acquired on 22 patients. Optimal features selected by forward selection are used for the segmentation of prostate lesions by applying fuzzy c-means (FCM) clustering. The images were reviewed by an expert radiologist and manual segmentation performed as the ground truth. Empirical results indicate that fuzzy c-mean classifier can achieve better results in terms of sensitivity, specificity when semi-quantitative features were considered versus wavelet kinetic features for lesion segmentation (Sensitivity of 87.58% and 75.62%, respectively) and (Specificity of 89.85% and 68.89 %, respectively). The proposed segmentation algorithm in this work can potentially be implemented for automatic prostate lesion detection in a computer aided diagnosis scheme and combined with morphologic features to increase diagnostic credibility.

Stan badań nad wiarygodnością diagnostyczną modeli dyskryminacyjnych

The article attempts to synthesize the state of research on the diagnostic credibility of discriminatory models used to assess the financial standing of enterprises. The considerations confirmed the validity of the thesis formulated by E. Mączynska and M. Zawadzki that “there is no single and only right business model for assessing the bankruptcy risk for a business”.

The diagnostic credibility of second impact syndrome: A systematic literature review.

The purpose of this review was to examine current literature to determine whether or not enough evidence exists to support a World Health Organization (WHO) recognized ICD-10 case definition for Second Impact Syndrome (SIS). Systematic literature review. A sensitive search strategy was developed in order to include all relevant literature. Data were extracted and placed into a diagnostic framework constructed based upon previously accepted ICD-10 diagnoses. The quality of included studies was assessed using a checklist developed specifically for case reports. The literature search yielded 338 articles. After duplicates were removed, the remaining 222 articles were screened. Seventy-five articles were assessed for full-text eligibility, which resulted in eight case studies appropriate for this review. Significant information regarding imaging and confirmed signs and symptoms is mixed or absent. Information exists to support possible at-risk populations, signs and symptoms. At present, there lacks a unique presentation scheme of SIS to support a standardized WHO case definition. Furthermore, future studies are needed to better understand and define at risk populations, diagnostic signs and symptoms, and the multisystem consequences of Second Impact Syndrome.

Compression evaluation of surgery video recordings retaining diagnostic credibility (compression evaluation of surgery video)

AbstractWider dissemination of medical digital video libraries is affected by two correlated factors, resource effective content compression that directly influences its diagnostic credibility. It has been proved that it is possible to meet these contradictory requirements halfway for long-lasting and low motion surgery recordings at compression ratios close to 100 (bronchoscopic procedures were a case study investigated). As the main supporting assumption, it has been accepted that the content can be compressed as far as clinicians are not able to sense a loss of video diagnostic fidelity (a visually lossless compression).Different market codecs were inspected by means of the combined subjective and objective tests toward their usability in medical video libraries. Subjective tests involved a panel of clinicians who had to classify compressed bronchoscopic video content according to its quality under the bubble sort algorithm. For objective tests, two metrics (hybrid vector measure and hosaka Plots) were calculated frame by frame and averaged over a whole sequence.

Counseling Students' Attribution of Diagnostic Credibility to Clinical Supervisors

Research on factors influencing diagnostic credibility has not been widespread. In this study, agreement ratings for a clinical diagnosis were compared for two groups of students receiving supervision from differently credentialed hypothetical supervisors. Implications of these findings are discussed relative to preparation practices and improving clinical practice. As 190 students who had completed either less than one-half (n = 112) or more than one-half (n = 78) of their programs in 9 institutions gave mean ratings of about 5 on a 10-point scale, they did not differentially rate diagnostic credibility of the hypothetical supervisors having credentials as psychiatrists, doctorate-holding counselor education faculty, doctorate-holding psychologists, and doctoral students holding master's degrees in counselor education.