Operating Characteristics Curve Research Articles

Longitudinal Phospho-tau217 Predicts Amyloid Positron Emission Tomography in Asymptomatic Alzheimer’s Disease

BackgroundBlood-based AD biomarkers such as plasma P-tau217 are increasingly used in clinical trials as a screening tool.ObjectivesTo assess the utility of an electrochemiluminescence (ECL) immunoassay in predicting brain amyloid PET status in cognitively unimpaired individuals.SettingPlasma samples collected at baseline, week 12, and week 240 or endpoint originated from the Anti-Amyloid Treatment in Asymptomatic Alzheimer’s Disease (A4) trial and the companion Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) study.ParticipantsBoth A4 and LEARN enrolled eligible cognitively unimpaired persons 65 to 85 years. Individuals with elevated brain amyloid PET levels were eligible for the A4 Study, while those without elevated brain amyloid PET levels were eligible for the LEARN Study.InterventionParticipants in the A4 Study received intravenous solanezumab (up to 1600 mg) or placebo every 4 weeks. The LEARN Study is an observational study without intervention.MeasurementsPlasma P-tau217 concentration levels from A4 Study participants were measured using an ECL immunoassay. Receiver Operating Characteristic (ROC) curve analysis was performed for each biomarker against amyloid positivity, defined by ≥22 CL and ≥ 33 CL.ResultsReceiver operating characteristic curve (ROC) analysis indicates high diagnostic value of P-tau217 in individuals with amyloid PET ≥ 20 (Area under the ROC (AUROC): 0.87) and ≥ 33 CL (AUROC: 0.89). Repeated testing with the placebo group taken 12 weeks apart (range: 68 to 143 days) and the LEARN participants taken between 1.4 and 1.75 years resulted in a strong positive correlation (Corr. 0.91 (0.90 to 0.92)).ConclusionAn ECL immunoassay testing plasma P-tau217 accurately predicts amyloid PET positivity in cognitively unimpaired individuals. Our future analyses aim to determine if use of this assay may reduce the screening burden of preclinical individuals into anti-amyloid clinical trials.

Identification of ROS and KEAP1-related genes and verified targets of α-hederin induce cell death for CRC.

In this study, we analyzed and verified differentially expressed genes (DEGs) in ROS and KEAP1 crosstalk in oncogenic signatures using GEO data sets (GSE4107andGSE41328). Multiple pathway enrichment analyses were finished based on DEGs. The genetic signature for colorectal adenocarcinoma (COAD) was identified by using the Cox regression analysis. Kaplan-Meiersurvival and receiver operating characteristiccurve analysis were used to explore the prognosis value of specific genes in COAD. The potential immune signatures and drug sensitivity prediction were also analyzed. Promising small-molecule agents were identified and predicted targets of α-hederin in SuperPred were validated by molecular docking. Also, expression levels of genes and Western blot analysis were conducted. In total, 48 genes were identified as DEGs, and the hub genes such as COL1A1, CXCL12, COL1A2, FN1, CAV1, TIMP3, andIGFBP7 were identified. The ROS and KEAP1-associated gene signatures comprised of hub key genes were developed for predicting the prognosis and evaluating the immune cell responses and immune infiltration in COAD. α-hederin, a potential anti-colorectal cancer(CRC) agent, was found to enhance the sensitivity of HCT116 cells, regulate CAV1 and COL1A1, and decrease KEAP1, Nrf2, and HO-1 expression significantly. KEAP1-related genes could be an essential mediator of ROS in CRC, and KEAP1-associated genes were effective in predicting prognosis and evaluating individualized CRC treatment. Therefore, α-hederin may be an effective chemosensitizer for CRC treatments in clinical settings.

Full Outline of Unresponsiveness Score versus Glasgow Coma Scale in Predicting Clinical Outcomes in Altered Mental Status.

Full outline of unresponsiveness (FOUR) score has advantages over Glasgow Coma Scale (GCS); as it can be used in intubated patients and provides greater neurological details. It has been studied mainly in the trauma and neuroscience setting. Our primary objective was to compare the FOUR versus GCS score as predictors of mortality at 30 days and poor functional outcome at 3 months among nontrauma patients in the emergency department (ED). This prospective observational study was conducted on adult patients presenting with altered mental status (duration <7 days) in the ED (March 2019-November 2020). Data collection included demographic and clinical features, the GCS and FOUR scores, the feasibility of acquiring and interpreting FOUR on a Likert scale, duration of hospital stay, 30-day mortality, and functional outcome at 3 months on the modified Rankin Scale. Trained emergency medicine residents managing the patient collected the data. The area under receiver's operating characteristics curve (AUROC) was used to compare the accuracy of the GCS and FOUR scores in predicting outcomes. The FOUR score equivalent of GCS cutoffs for categorizing neurological impairment (mild, moderate, and severe) was also investigated. Two hundred and ninety-one patients were included, with a mean age of 50.3 years and 67.4% males. Most patients (40.2%) had altered mental status for 1-3 days and hepatic encephalopathy was the most common ED diagnosis. The mortality at 30 days was 66.7% (194 of 291), and 88% (256 of 291) of patients had poor functional outcomes at 3 months. The AUROCs for predicting 30-day mortality were similar for both the scores (GCS: 0.70, FOUR: 0.71, and the P value for difference: 0.9). Similarly, the AUROCs for predicting 3-month poor functional outcome were 0.683 and 0.669 using GCS and FOUR, respectively, with a nonsignificant difference (P = 0.82). The FOUR score strata of 14-16, 11-13, and 0-10 were found to be equivalent to the GCS scores of 13-15 (mild), 9-12 (moderate), and 3-8 (severe). The feasibility of acquiring and interpreting GCS and FOUR scores on the Likert scale was found to be "easy." The FOUR score is similar to GCS in predicting mortality at 30 days and poor neurological outcomes at 3 months among nontrauma patients of ED. Moreover, it was found that the FOUR score is "easy" to assess and interpret by the emergency residents.

Higher serum Lp-PLA2 is associated with cognitive impairment in Parkinson's disease patients.

To explore the association between lipoprotein-associated phospholipase A2 (Lp-PLA2) and the risk of cognitive impairment in Parkinson's disease (PD-CI). A case-control study involving 100 hospitalized PD patients and 60 healthy controls was carried out. Serum Lp-PLA2 level was detected by automatic biochemical analyzer. Based on whether Parkinson's patients have cognitive impairment, PD patients were subdivided to analyze the clinical value of Lp-PLA2. Relationship between Lp-PLA2 and PD-CI risk was analyzed by logistic regression. Diagnostic value of Lp-PLA2 in PD-CI patients was investigated using receiver's operator characteristic curves. The levels of serum Lp-PLA2 activity in Parkinson's disease with normal cognition (PD-NC) and PD-CI patients were significantly higher than those in healthy controls (HCs), respectively. Furthermore, compared to the PD-NC group, the serum Lp-PLA2 activity level was significantly higher in PD-CI patients. Multivariable logistic regression analysis indicated that higher Lp-PLA2 level was an independent risk factor for PD patients with cognitive impairment. Moreover, the area under the efficacy curve of Lp-PLA2 for predicting PD-CI is 0.659. Our study shows that higher levels of Lp-PLA2 activity in PD patients are associated with the risk of developing cognitive impairment. Therefore, given the wide availability, safety, and convenience of monitoring serum Lp-PLA2 activity, it may serve as an early biomarker for cognitive impairment in PD patients.

Fast Power Coefficient vs. Tip–Speed Ratio Curves for Small Wind Turbines with Single-Variable Measurements following a Single Test Run

Small wind turbines (SWTs) face tremendous challenges in being developed into a more reliable and widespread energy solution, with a number of efficiency, reliability, and cost issues that are yet to be resolved. As part of the development stages of an SWT, testing the resulting efficiency and determining appropriate working ranges are of high importance. In this paper, a methodology is presented for testing SWTs to obtain characteristic performance curves such as Cp (power coefficient) vs. TSR (tip–speed ratio), and torque vs. ω, in a simpler and faster yet accurate manner as an alternative energy solution when a wind tunnel is not available. The performance curves are obtained with the SWT mounted on a platform moving along a runway, requiring only a few minutes of data acquisition. Furthermore, it is only required to measure a single variable, i.e., the generator output voltage. A suitable physics-based mathematical model for the system allows for deriving the desired performance curves from this set of minimal data. The methodology was demonstrated by testing a prototype SWT developed by the authors. The tested prototype had a permanent magnet synchronous generator, but the methodology can be applied to any type of generator with a suitable mathematical model. Given its level of simplicity, accuracy, low cost, and ease of implementation, the proposed testing method has advantages that are helpful in the development process of SWTs, especially if access to a proper wind tunnel is prevented for any reason. To validate the methodology, Cp vs. TSR curves were obtained for an SWT prototype tested under different test conditions, arriving always at the same curve as would be expected. In this case, the test prototype reached a maximum power coefficient (Cp) of 0.35 for wind velocities from 20 to 50 km/h for a TSR of 5.5.

An Analysis of the Mean Chart Under OC Function for Correlated Data

In this paper, we determine and illustrate the effects of correlation between the observations on the operating characteristics curve, Type-I error and Average Run length. In addition, for different correlated coefficient the control limits have been developed. To study the effect of correlated observations the OC curves, Type-I error, ARL and factor A have been worked out using various equation and values are given in Tables 1 to 4. To give a visual comparison of OC function and ARL, curves have been drawn in Figures 1 to 6. It is found that correlation between observations seriously affected the OC, Type-I error, ARL and factor A for the mean chart when standards are known. When the center line and control limits are based on the large value. Thus, it will be healthy contribution in manufacturing process which tracks important product characteristics in industry.

Toward the use of MRI measurements of bound and pore water in fracture risk assessment.

The current clinical assessment of fracture risk lacks information about the inherent quality of a person's bone tissue. Working toward an imaging-based approach to quantify both a bone tissue quality marker (tissue hydration as water bound to the matrix) and a bone microstructure marker (porosity as water in pores), we hypothesized that the concentrations of bound water (Cbw) are lower and concentrations of pore water (Cpw) are higher in patients with osteoporosis (OP) than in age- and sex-matched adults without the disease. Using recent developments in ultrashort echo time (UTE) magnetic resonance imaging (MRI), maps of Cbw and Cpw were acquired from the uninjured distal third radius (Study 1) of 20 patients who experienced a fragility fracture of the distal radius (Fx) and 20 healthy controls (Non-Fx) and from the tibia mid-diaphysis (Study 2) of 30 women with clinical OP (low T-scores) and 15 women without OP (normal T-scores). In Study 1, Cbw was significantly lower (p=0.0018) and Cpw was higher (p=0.0022) in the Fx than in the Non-Fx group. In forward stepwise, logistic regression models using Bayesian Information Criterion for selecting the best set of predictors (from imaging parameters, age, BMI, and DXA scanner type), the area-under-the-receiver operator characteristics-curve (AUC with 95% confidence intervals) was 0.73 (0.56, 0.86) for hip aBMD (best predictors without MRI) and 0.86 (0.70, 0.95) for the combination of Cbw and Cpw (best predictors overall). In Study 2, Cbw was significantly lower (p=0.0005) in women with OP (23.8±4.3 1H mol/L) than in women without OP (29.9±6.4 1H mol/L); Cpw was significantly higher by estimate of 2.9 1H mol/L (p=0.0298) with clinical OP, but only when accounting for the type of UTE-MRI scan with 3D providing higher values than 2D (p<0.0001). Lastly, Cbw, but not Cpw, was sensitive to bone forming osteoporosis medications over 12-months. UTE-MRI-derived measurements of bound and pore water concentrations are potential, aBMD-independent predictors of fracture risk.

Performance Evaluation and Optimal Design Analysis of Continuous-Operation Solar-Driven Cooling Absorption Systems With Thermal Energy Storage

Abstract A solar absorption cooling system consisting of a flat plate collector, thermal energy storage tank, and absorption chiller is analyzed in this work. A dimensionless model is developed from the energy balance on each component and the chiller’s characteristic performance curves. The model is used to determine the interaction and influence of different parameters such as tank size, solar collector area, chiller size, cooling load, cooling temperature, heat loss, and mass flow rates on the performance. From the analysis, smaller solar collector areas are required for lower cooling loads and smaller tank volumes. A specific cooling load of 1 × 10−5 will require a specific solar collector area between two and six times larger, depending on the initial tank temperature, than the area required for a baseline system that considers typical commercial design and operation parameters. A similar behavior was observed for the specific tank volume. For the baseline system, the minimum specific area of the collector of 9.57 is achieved for an initial tank temperature of 1.19. For a cooling load of 1 × 10−5, the optimum initial tank temperature will be 1.11 that results in a minimum specific solar collector area of 25.26. A specific tank volume of 4 × 10−4 will also have an optimum initial tank temperature of 1.11 that minimizes the specific solar collector area to a value of 28.18. The approach and analysis in this work can be used to determine design parameters for solar absorption cooling systems based on a proper relation among system’s dimensions to achieve optimum operation.

Development and Validation of a Three-Parameter Scoring System for Monitoring HIV/AIDS Patients in Low-Resource Settings Using Hematological Parameters.

This study aimed to test the validity of a composite score using complete blood count (CBC) for monitoring HIV patients receiving antiretroviral therapy (ART) in the absence of viral load and CD4 count. This retrospective cohort study analyzed the laboratory data of 82 HIV patients who had pre- and post-treatment viral load, CD4 count, and CBC data. Pre- and post-treatment data were pooled to analyze the correlation of CBC parameters with Polymerase Chain Reaction (PCR) ranks and their performance in indicating a CD4 count<200 cells/mm3 using the Operating Characteristics Curve (ROC), with the determination of cutoffs. A score combining the significant parameters was tested to predict a CD4 count of <200. Total lymphocyte count (TLC), percentage (TLP), and hemoglobin concentration (Hb) were the most significant parameters, showing negative correlations with PCR (Spearman's Rho = -0.357 to -0.242). The risk of acquired immunodeficiency syndrome (AIDS) was independently associated with TLC<1345 cells/mm3 (OR=2.92), TLP<29.07% (OR=3.53), and Hb<10.55 mg/dL (OR=3.60). A combined score of 2-3 indicated a CD4 count<200 with an odds ratio of 8.3-86.7. The proposed 3-parameter score combining the use of TLC, TLP, and Hb, is an affordable and practical approach that may have clinical utility in monitoring HIV patients receiving ART in low-resource settings.

Psychometric properties of the Chinese version of the PROMIS-Cancer-Anxiety item bank assessed using a graded response model

ObjectiveThis study aimed to examine the psychometric properties of the Chinese version of the Patient-Reported Outcome Measurement Information System (PROMIS)-Cancer-Anxiety item bank using a graded response model in a sample of patients with cancer. MethodsA cross-sectional study was conducted and the Chinese version of the PROMIS-Cancer-Anxiety item bank was used to measure anxiety in patients with cancer. The unidimensional structure of the item bank was evaluated using principal component analysis. Residual correlations and the graphs of item mean scores conditional on the rest scores were examined to evaluate the local independence and monotonicity of the items, respectively. Item characteristics were described using item parameter estimates and item information. Operating characteristic curves (OCCs) and test information curve (TIC) were also plotted. Measurement invariance across age, gender, and education level was assessed to identify possible differential item functioning (DIF). ResultsA total of 1075 patients with cancer were enrolled. Under the assumptions of unidimensionality, local independence, and monotonicity, the discrimination parameters a ranged from 2.30 to 5.47, and the threshold parameters b ranged from b1 = −2.87 to b4 = 3.21 with proper intervals. Completely overlapped category curves were not observed among the OCCs of any items. Item information and TIC showed that the item bank had a wide measurement range. The DIFs for age, gender, and education level for all items were not remarkable. ConclusionsThe results supported using the Chinese version of the PROMIS-Cancer-Anxiety item bank to measure anxiety and develop a computerized adaptive testing (CAT) system for anxiety in patients with cancer.

Single-item depression screening with the Neurobehavioral Symptom Inventory (NSI): Do scores assist clinicians with predicting need for mental health interventions?

The purpose of this study was to examine the relationship between a single item for depression from the Neurobehavioral Symptom Inventory (NSI) and a common depression screening measure to predict need for further mental health consultation for veterans with traumatic brain injury (TBI). Three hundred eighty veterans referred to a Veterans Affairs Health Care System TBI clinic for evaluation were administered the NSI and a common depression screening measure (Beck Depression Inventory-Second Edition; BDI-II). Receiver Operating Characteristic (ROC) curve analyses were conducted to determine best cutoff scores on the BDI-II corresponding with a single item of the NSI item pertaining to depression (i.e., "depressed or sad"). Using multiclass ROC curve analyses, results suggested that a minimum score of 3 (severe) on the specific NSI item indicated need for further mental health referral without warranting additional screening for depression. Analyses further demonstrated that removal of invalid NSI protocols did not significantly change ROC curve findings. Therefore, the NSI item for depression can still be used for making clinical decisions despite the protocol being considered otherwise invalid. Implications for treatment and recommendations for screening are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Power curves of megawatt-scale battery storage technologies for frequency regulation and energy trading

Large-scale stationary battery energy storage systems (BESS) continue to increase in number and size. Most systems have been put into operation for grid services because of their technical capabilities. With increasing and more dynamic energy prices, their use in short-term energy trading such as day-ahead and intraday trading has also been gaining importance. In current technical and economic simulations and trading models, batteries are often used as an energy reservoir that can charge and discharge a constant power specified by the energy over a certain time. However, this simplification can lead to wrong results and makes economic assessments difficult. In order to successfully use BESS in energy trading, their real operating ranges and limits must be investigated, since batteries respectively BESS cannot deliver the same power over the entire state of charge (SOC) range. With a performance test of our hybrid BESS M5BAT, we show the characteristic performance curves for different battery technologies and consequently suitable operating ranges in a large-scale system configuration. The results show the wide range of challenges such as battery aging and balancing states that occur in the real-world implementation of BESS. The lithium-ion batteries of the system under test have a remaining usable energy between 75 % and 90 %, depending on the type of lithium-ion battery, while the usable energy of the lead acid batteries is only 60 %. The lithium-ion batteries were able to deliver a constant power output in the SOC range between 10 % and 80 %, which is a necessary requirement in short-term energy trading. The lead-acid batteries could only be discharged at full power in the range of 100 %–50 % SOC and charged at full power between 0 % and 50 %. In the performance test, balancing was a limiting factor for lithium-ion batteries, while aging was the limiting factor for lead-acid batteries. Based on our findings, estimates for other existing BESS can be made to determine feasible operating ranges of these batteries for short-term energy trading. This also provides a guideline for individual tests that should be carried out on other BESS for verification.

Identification of ischemia-causing lesions using coronary plaque quantification and changes in fractional flow reserve derived from computed tomography across the lesion.

This study sought to evaluate the association between coronary plaque characteristics, changes in the fractional flow reserve (FFR) derived from computed tomography across the lesion (ΔFFRCT), and lesion-specific ischemia using the FFR in patients with suspected or known coronary artery disease. The study assessed coronary computed tomography (CT) angiography stenosis, plaque characteristics, ΔFFRCT, and FFR in 164 vessels of 144 patients. Obstructive stenosis was defined as stenosis ≥50%. An area under the receiver -operating characteristics curve (AUC) analysis was conducted to define the optimal thresholds for ΔFFRCT and the plaque variables. Ischemia was defined as a FFR of ≤0.80. The optimal cut-off value of ΔFFRCT was 0.14. Low-attenuation plaque (LAP) ≥76.23 mm3 and a percentage aggregate plaque volume (%APV) ≥28.91% can be used to predict ischemia independent of other plaque characteristics. The addition of LAP ≥76.23 mm3 and %APV ≥28.91% improved the discrimination (AUC, 0.742 vs. 0.649, P=0.001) and reclassification abilities [category-free net reclassification index (NRI), 0.339, P=0.027; relative integrated discrimination improvement (IDI) index, 0.093, P<0.001] of the assessments compared to the stenosis evaluation alone, and the addition of information about ΔFFRCT ≥0.14 further increased the discrimination (AUC, 0.828 vs. 0.742, P=0.004) and reclassification abilities (NRI, 1.029, P<0.001; relative IDI, 0.140, P<0.001) of the assessments. The addition of the plaque assessment and ΔFFRCT to the stenosis assessments improved the identification of ischemia compared to the stenosis assessment alone.

Operating Characteristic Curves of Optical Packet-Switching Using Optical Code-Division Multiplexing for Label Switching

In this paper, the operating characteristic curves (OCCs) of optical code-division multiplexing (OCDM) technology for label switching of an optical packet-switching (OPS) network was evaluated. A node structure for processing the packets, with spectral-amplitude-coding (SAC) labels, considering a balanced detector and an optical switch, was developed and modeled. The effects of decoding noises on the performance of both M-sequence and stuffed quadratic congruence (SQC) labeling systems were addressed. Hypothesis testing was applied to the decoder to investigate the results of label recognition. The null and alternative hypotheses were, respectively, defined as a decoder receiving the matching and mismatching labels. Due to the noise effects, the decoder output may not reflect the label status correctly. Type I error occurs when the null hypothesis is true while accepting the alternative one. Type II error occurs when the alternative hypothesis is true while accepting the null one. Analytic equations of both errors were given, considering a desired packet that was missed and an undesired packet shown in a switched path. The trade-off between these two errors, regarding the decoder threshold, was demonstrated in operating characteristic curves (OCCs). A better OCC could be found when a packet had more labeled payload bits, or when the utilized label code had a lower auto-to-cross-correlation ratio.

Value of optical coherence tomography measurement of macular thickness and optic disc parameters for glaucoma screening in patients with high myopia

The basic method of glaucoma diagnosis is visual field examination, however, in patients with high myopia, the diagnosis of glaucoma is difficult. To explore the value of optical coherence tomography (OCT) for measuring optic disc parameters and macular thickness as a screening tool for glaucoma in patients with high myopia. Visual values (contrast sensitivity, color vision, and best-corrected visual acuity) in three groups, patients with high myopia in Group A, patients with high myopia and glaucoma in Group B, and patients with high myopia suspicious for glaucoma in Group C, were compared. Optic disc parameters, retinal nerve fiber layer (RNFL) thickness, and ganglion cell layer (GCC) thickness were measured using OCT technology and used to compare the peri-optic disc vascular density of the patients and generate receiver operator characteristic (ROC) test performance curves of the RNFL and GCC for high myopia and glaucoma. Of a total of 98 patients admitted to our hospital from May 2018 to March 2022, totaling 196 eyes in the study, 30 patients with 60 eyes were included in Group A, 33 patients with 66 eyes were included in Group B, and 35 patients with 70 eyes were included in Group C. Data were processed for Groups A and B to analyze the efficacy of RNFL and GCC measures in distinguishing high myopia from high myopia with glaucoma. The area under the ROC curve was greater than 0.7, indicating an acceptable diagnostic value. The value of OCT measurement of RNFL and GCC thickness in diagnosing glaucoma in patients with high myopia and suspected glaucoma is worthy of development for clinical use.

MP47-15 THE AI-R.E.N.A.L. + SCORE SURPASSES THE HUMAN EXPERT-GENERATED R.E.N.A.L. SCORE IN PREDICTING ONCOLOGIC OUTCOMES OF RENAL TUMORS

You have accessJournal of UrologyCME1 Apr 2023MP47-15 THE AI-R.E.N.A.L. + SCORE SURPASSES THE HUMAN EXPERT-GENERATED R.E.N.A.L. SCORE IN PREDICTING ONCOLOGIC OUTCOMES OF RENAL TUMORS Nour Abdallah, Tarik Benidir, Nicholas Heller, Andrew Wood, Fabian Isensee, Resha Tejpaul, Dillon Corrigan, Chalairat Suk-Ouichai, Onuralp Ergun, Alex You, Erick Remer, Samuel Haywood, Venkatesh Kirshnamurthi, Steven Campbell, Nikolaos Papanikolopoulos, and Christopher Weight Nour AbdallahNour Abdallah More articles by this author , Tarik BenidirTarik Benidir More articles by this author , Nicholas HellerNicholas Heller More articles by this author , Andrew WoodAndrew Wood More articles by this author , Fabian IsenseeFabian Isensee More articles by this author , Resha TejpaulResha Tejpaul More articles by this author , Dillon CorriganDillon Corrigan More articles by this author , Chalairat Suk-OuichaiChalairat Suk-Ouichai More articles by this author , Onuralp ErgunOnuralp Ergun More articles by this author , Alex YouAlex You More articles by this author , Erick RemerErick Remer More articles by this author , Samuel HaywoodSamuel Haywood More articles by this author , Venkatesh KirshnamurthiVenkatesh Kirshnamurthi More articles by this author , Steven CampbellSteven Campbell More articles by this author , Nikolaos PapanikolopoulosNikolaos Papanikolopoulos More articles by this author , and Christopher WeightChristopher Weight More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003293.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The R.E.N.A.L. nephrometry score is a widely accepted surgical aid for extirpation of a renal mass. Excluding the tumor's location (anterior/posterior), the score categorizes variables that are otherwise continuous in nature to facilitate it. It has not yet been universally adopted at the point of care due to its ambiguity, time consumption, and interobserver variability. We previously showed that the artificial intelligence (AI)-generated R.E.N.A.L. score was non-inferior to the human-generated score in predicting perioperative and oncologic outcomes. We hypothesize that we can surpass the predictive ability of human-generated R.E.N.A.L. scores by creating an AI-generated R.E.N.A.L. score+ (AI+ score) with continuous variables rather than ordinal. METHODS: We had 300 patients with preoperative computed tomography scan showing suspected renal cancer at a single institution. Human score was tabulated by 3 trained medical personnel blinded to AI-generated scores. Deep neural network approach was used to automatically segment kidneys into normal parenchyma and tumor, and geometric algorithms were used to estimate the score's components as continuous variables rather than ordinal. Operating characteristic curves (ROC) were created from logistic regression models, and areas under the curve (AUC) were compiled to evaluate the discriminatory ability of the AI+ score vs ordinally-derived AI and human-generated scores for the oncologic outcomes. We assessed the relative importance of the AI+ score components with respect to the odds of outcome through fit logistic regression models using standardized values. RESULTS: The median age was 60 years (IQR 51-68), and 40% were female. The median tumor size was 4.2 cm (2.6-6.12), and 92% were malignant, including 27%, 37%, and 23% with high-stage, high-grade, and necrosis, respectively. The AI+ score had a superior discriminatory ability for each oncologic outcome, including the prediction of malignancy, high stage, high grade, and tumor necrosis (Figure 1). The “R” component had the highest predictive odds ratio for oncologic outcomes. CONCLUSIONS: The AI+ score was superior in predicting meaningful oncologic outcomes compared to ordinal AI-generated and human-generated scores in a non-ambiguous time-efficient manner. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e649 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nour Abdallah More articles by this author Tarik Benidir More articles by this author Nicholas Heller More articles by this author Andrew Wood More articles by this author Fabian Isensee More articles by this author Resha Tejpaul More articles by this author Dillon Corrigan More articles by this author Chalairat Suk-Ouichai More articles by this author Onuralp Ergun More articles by this author Alex You More articles by this author Erick Remer More articles by this author Samuel Haywood More articles by this author Venkatesh Kirshnamurthi More articles by this author Steven Campbell More articles by this author Nikolaos Papanikolopoulos More articles by this author Christopher Weight More articles by this author Expand All Advertisement PDF downloadLoading ...

Transient Numerical Simulation of a Large-Sized Cement-Mill Fan for Performance Prediction

In many engineering applications, particle-laden flows are a necessary part of the conveying process, but in other situations, they could have unintended consequences that must be avoided. As a part of the exhausting process, the induced cement-mill fan (FN-280) installed in a cement plant operates under critical conditions with the presence of high content of cement particles. Over time the dragged solid particles erode the rotating and stationary parts of the fan causing their damage. If one decides on a numerical approach to predict regions most prone to erosion and track the solid particle's trajectory within the fan domain by assuming a one-way coupling regime between the continuous and discrete solid phases, a deep insight into the flows physics within the centrifugal fan is required. With this aim, a three-dimensional numerical approach for the hole unsteady flow in a large-sized industrial centrifugal fan has been carried out in this paper. A fully resolved sliding mesh approach was employed to take into account the unsteady interaction between the impeller and the discharge volute. Based on the characteristic performance curves, the numerical results of the unsteady simulation at four operating conditions are validated with the experimental data. The comparisons reveal that the results of the unsteady simulation are in an acceptable level of agreement with the experiment, demonstrating the validity of the modelling approach adopted in this study.

Ferroptosis-related lncRNA model based on CFAP58-DT for predicting prognosis and immunocytes infiltration in endometrial cancer.

Endometrial cancer (EC) is a kind of common gynecological tumor. Further study on the markers related to the prognosis of endometrial cancer is important for women worldwide. The Cancer Genome Atlas (TCGA) database was used to obtain the transcriptome profiling and clinical data. A model was built using packages based on R software. Immune-related databases were employed to analyze the infiltration of immunocytes. Quantitative real-time PCR (qRT-PCR), cell counting kit-8 (CCK-8), and transwell assays were utilized to investigate the role of CFAP58-DT in EC. Following Cox regression analysis, 1,731 ferroptosis-related long non-coding RNA (lncRNA) were screened, and a 9-related lncRNA prognostic model was constructed. Patients were classified as high- and low-risk according to their expression spectrum. Kaplan-Meier (KM) analysis showed that the prognosis of low-risk patients was poor. Operating characteristic curves, decision curve analysis, and a nomogram suggested the model could independently guide prognostic evaluation, with higher sensitivity, specificity, and efficiency than other common clinical characteristics. Gene Set Enrichment Analysis (GSEA) was conducted to determine the enriched pathways among the two groups and evaluation of the immune-infiltrating conditions were performed to help improve immune therapy. Finally, we conducted cytological studies on the model's most important indicators. Overall, we identified a prognostic ferroptosis-related lncRNA model based on CFAP58-DT for predicting the prognosis and immune-infiltrating conditions in EC. We concluded that the potential oncogenic role of CFAP58-DT can further guide immunotherapy and chemotherapy.

The Influence of Tip Clearance on the Performance of a High-Speed Inducer Centrifugal Pump under Different Flow Rates Conditions

The influence mechanism of the blade tip clearance (TC) of an inducer on the performance of a centrifugal pump at high speed was researched under different flow rate conditions in this work. An experiment on the pump’s external performance was carried out, and numerical calculation was also performed under four different TCs. The full characteristic performance curves, static pressure and pressure pulsation distributions of the pump were obtained. Through the research and analysis, it was found that the influence of the TC on the efficiency and the head of the centrifugal pump are related to the flow rate. Under the influence of a large flow rate, the increase in the TC is helpful to improve the efficiency and the head of the pump. The increase in the TC helps to weaken the gap jet effect on the inducer. The inlet jet of the inducer, caused by TC leakage, will form a low-pressure vortex zone at the inlet of the inducer. The splitter-bladed inducer’s pressure pulsation is affected by the TC. The peak pressure pulsation at the monitoring point at the short blades is larger than that at the long blades. With the increase in TC, the cavitation degree at the inlet of the long blade of the inducer is decreased, while the cavitation degree at the short blade is deepened. It is also found that the TC has little effect on the radial force of the inducer and the impeller. These results will provide the design basis for the tip clearance of an inducer.

Statistical Quality Inspection Methodology in Production of Precast Concrete Elements

Today, prefabricated concrete elements are used in many construction areas, including in industrial, public, and residential construction; this was confirmed via questionnaire research. In the article, the prospects for precast concrete development are presented, and the factors determining the use of this technology are defined. Based on a review of the literature, it was shown that currently, higher-quality prefabricated elements are primarily created through the implementation of innovative materials and production technologies. For this reason, the lack of research regarding quality control in prefabricated elements based on statistical quality control is particularly noticeable. The quality control process is one of the most important distinguishing features in prefabrication due to the increasingly stringent expectations of customers; it helps to ensure that the desired durability of implemented constructions is achieved. Issues related to assessing the effectiveness of standard procedures presented in this paper were analyzed using statistical methods in the form of OC (operating characteristic) and AOQ (average outgoing quality) curves. Thus, a new approach was proposed because these methods have not been previously used in precast concrete. The shape of the curves obtained confirmed the significant dependence of the value of the acceptance probability on the defectiveness of production. In AQL control systems based on OC and AOQ curves, it is necessary to calculate the current average defectiveness, which should be treated as a basis for the decision to switch from one type of control (normal, tightened, or reduced) to another. In this respect, the standard requirements of quality control have been simplified, and it has not been considered necessary to determine the average defectiveness value in production processes. The examples included in this study, including the analysis of curb production data, clearly show the harmful effects of ignoring the actual process defectiveness. As a result of the calculations, it was found that the average actual defectiveness of the curbs produced could not be equated with batch defectiveness. The analyses carried out in this study prove that equating batch defectiveness with process defectiveness is not an appropriate approach, which was confirmed through the producer's/customer's risk analysis. The approach proposed in this study, the analysis of OC and AOQ curves, is an innovative solution in prefabrication and can be an effective tool for managing the quality of prefabricated products, taking into account economic boundary conditions.