Discriminatory Power Research Articles

Validity and reliability study of the Turkish version of KOOS-ACL questionnaire

BackgroundThis study aimed to adapt the Knee injury and Osteoarthritis Outcome Score- Anterior Cruciate Ligament (KOOS-ACL) into Turkish and to assess its validity and reliability.MethodsThe adaptation process involved translation, back-translation, and cultural adaptation of the questionnaire. Totally 133 patients who had a diagnosis of anterior cruciate ligament tear was recruited. The reliability of the Turkish version of the KOOS-ACL was assessed using Cronbach’s alpha, item-total correlations, and ICC. EFA and CFA were performed to evaluate construct validity, supported by KMO and Bartlett’s test results. Criterion validity was examined through correlations with IKDC scores, and discriminative power was assessed using an independent samples t-test.ResultsIKDC score for evaluating knee function was 59.84 ± 21.74. The composite KOOS-ACL-Tr score was 61.95 ± 25.19. Cronbach’s Alpha value was found to be 0.952 demonstrating high reliability. KOOS-ACL-Tr scores showed a linear positive correlation with the time elapsed since injury and IKDC scores (p < 0.001) establishing concurrent validity.ConclusionsThe adapted Turkish version of the KOOS-ACL is a valid and reliable scale intended for use in monitoring patients with ACL injuries.

Early detection of heart failure using in-patient longitudinal electronic health records.

Heart Failure (HF) is common, with worldwide prevalence of 1%-3% and a lifetime risk of 20% for individuals 40 years or older. Despite its considerable health economic burden, techniques for early detection of HF in the general population are sparse. In this work we tested the hypothesis that a simple Transformer neural network, trained on comprehensive collection of secondary care data across the general population, can be used to prospectively (three-year predictive window) identify patients at an increased risk of first hospitalisation due to HF (HHF). The model was trained using routinely-collected, secondary care health data, including patient demographics, A&E attendances, hospitalisations, outpatient data, medications, blood tests, and vital sign measurements obtained across five years of longitudinal electronic health records (EHRs). The training cohort consisted of n = 183,894 individuals (n = 161,658 age/sex-matched controls and n = 22,236 of first hospitalisation due to HF after a three-year predictive window). Model performance was validated in an independent testing set of n = 8,977 patients (n = 945 HHF patients). Testing set probabilities were well-calibrated and achieved good discriminatory power with Area Under Receiver Operating Characteristic Curve (AUROC]) of 0.86, sensitivity of 36.4% (95% CI: 33.33%-39.56%), specificity of 98.26% (95% CI: 97.95%-98.53%), and PPV of 69.88% (95% CI: 65.86%-73.62%). At Probability of HHF ≥ 90% the model achieved 100% PPV (95% CI: 96.73%-100%) and sensitivity of 11.7% (95% CI: 9.72%-13.91%). Performance was not affected by patient sex or socioeconomic deprivation deciles. Performance was significantly better in Asian, Black, and Mixed ethnicities (AUROC 0.932-0.945) and in the 79-86 age group (AUROC 0.889). We present the first evidence that routinely collected secondary care health record data can be used in the general population to stratify patients at risk of first HHF.

Maternal group B Streptococcus decreases infant length and alters the early-life microbiome: a prospective cohort study

Background Maternal colonization with Group B Streptococcus (GBS) disrupts the vaginal microbiota, potentially affecting infant microbiota assembly and growth. While the gut microbiota’s importance in infant growth is recognized, the specific effects of maternal GBS on growth remain unclear. This study aimed to explore the effects of maternal vaginal GBS during pregnancy on early infant growth, microbiome, and metabolomics. Methods We recruited and classified 453 pregnant women from southern China into GBS or healthy groups based on GBS vaginal colonization. Their infants were categorized as GBS-exposed or GBS-unexposed groups. We comprehensively analyzed infant growth, gut microbiota, and metabolites during early life, along with maternal vaginal microbiota during pregnancy, using 16S rDNA sequencing and targeted metabolomics. Results GBS-exposed infants exhibited lower length-for-age z-scores (LAZ) than GBS-unexposed infants, especially at 2 months. Altered gut microbiota and metabolites in GBS-exposed infants correlated with growth, mediating the impact of maternal GBS on infant LAZ. Changes in the vaginal microbiota of the GBS group during the third trimester correlated with infant LAZ. Additionally, differences in neonatal gut microbiota, metabolites, and vaginal microbiota during pregnancy were identified between infants with overall LAZ<-1 within 8 months after birth and their counterparts, enhancing the discriminatory power of fundamental data for predicting the occurrence of LAZ<-1 during the first 8 months of life. Conclusions GBS exposure is associated with decreased infant length growth, with altered microbiota and metabolites potentially mediating the effects of maternal GBS on offspring length growth, offering potential targets for predicting and addressing growth impairment.

Prediction of left lobe hypertrophy with voxel-based dosimetry using integrated Y-90 PET/MRI after radioembolization of liver tumors with Y-90 microspheres.

The aim of this study was to investigate the relationship between voxel-based dosimetric variables derived from Y-90 PET/MRI and hypertrophy observed in the left lobe after radioembolization and to investigate if there is any difference in hypertrophy induced by glass versus resin microspheres. Voxel-based dosimetry-derived variables and their relationship with the change of the standardized future liver remnant (ΔFLR) was investigated with linear regression models. To compare and evaluate the discriminatory power of the dosimetric variables, ROC analyses were utilized. ΔFLR and kinetic growth rate (KGR) induced with glass and resin microspheres were compared using the Mann-Whitney U test. In this retrospective study, data of the 40 patients treated with Y-90 microspheres were evaluated. Among the several dosimetric variables, the mean perfused volume normal tissue dose (pDnorm), perfused normal tissue V90 (pV90), and pV100 values for glass microspheres; and the mean whole liver normal tissue dose (Dnorm), pDnorm, whole liver normal tissue V30 (nV30), nV40, and pV40 for resin microspheres had the highest relationship with ΔFLR. In the ROC analysis for glass microspheres, the optimal cut-offs to predict ΔFLR > 5% were 60.55 Gy for Dnorm, 94.21 Gy for pDnorm, 28.07% for pV90, and 24.98% for pV100. For resin microspheres, corresponding values were 23.20 Gy for Dnorm, 37.40 Gy for pDnorm, 31.50% for nV30, 24.50% for nV40, and 43.60% for pV40. No significant difference was observed between glass and resin microsphere-induced median ΔFLR, KGR values and atrophy of the right lobe. Following Y-90 radioembolization therapy with glass and resin microspheres applied to the right lobe of the liver, ΔFLR is correlated with pDnorm and Dnorm, but is also significantly related to various nV and pV values. In addition, the hypertrophy and kinetic growth rates observed with glass and resin microspheres were largely similar.

Building a Secure Digital Future: Investigating Cyber Hygiene Levels of Accounting, Finance, and Business Students

Abstract structured in:Introduction: This study aims to investigate the level of cyber hygiene among accounting, finance and business students, to identify strengths and weaknesses to inform the development of cybersecurity in education.Methods: A quantitative research design was employed, utilizing an objective online test to assess cyber hygiene knowledge. The instrument was validated through tests of validity, difficulty level, discriminatory power, and reliability. The study sample consisted of students in finance, administration and business. Data analysis involved statistical methods to compare awareness levels across the three student groups.Results: The results indicated that administration students had the highest overall cyber hygiene awareness, particularly in areas such as Rules &amp; Laws, Access &amp; Password, and Security Settings. Business students showed moderate awareness, while accounting students demonstrated significant gaps, especially in Web Access and Social Media Safety. The findings highlighted the need for targeted educational interventions to address specific weaknesses in each group.Conclusions: This study underscores the importance of cyber hygiene education, especially for accounting, finance, and business students, to prevent cyber incidents. The findings provide actionable insights for the development of curricula and training programs, which contribute to a safer digital environment in professional settings. Further research should expand sample sizes, incorporate qualitative methods, and explore the long-term effectiveness of cyber hygiene education

Human oral microbiome as forensic biomarkers for individual identification: A systematic review

: The oral microbiome is a promising and novel source of biomarkers for forensic identification. It offers distinct signatures that may differentiate individuals, sparking new avenues of research and discovery.: This systematic review is meticulously designed to comprehensively consolidate current research on oral microbiome signatures in forensic contexts, leaving no stone unturned in our quest for knowledge. It focuses explicitly on microbial diversity, community structure, and specific taxa as potential markers for individual identification.s: To identify relevant studies published between 2014 and 2024, a comprehensive search of major scientific databases was conducted. Inclusion criteria encompassed peer-reviewed articles investigating oral microbiome diversity and specific microbial markers relevant to forensic individual identification. These studies were employed to evaluate the reliability and consistency of these biomarkers across diverse populations and environmental conditions.: The review included 13 studies that met the criteria, revealing significant associations between specific oral microbial taxa and individual identification. This systematic review highlighted consistent discriminatory power and stability of microbial signatures across varied populations.: Oral microbiome analysis is promising to enhance forensic investigations by providing unique biomarkers for individual identification. However, challenges such as standardization of microbiome studies and influences of environmental factors on microbiome underscore the need for further research to validate and effectively implement oral microbiome data in forensic practice.

3D Non-separable Moment Invariants and Their Use in Neural Networks

Recognition of 3D objects is an important task in many bio-medical and industrial applications. The recognition algorithms should work regardless of a particular orientation of the object in the space. In this paper, we introduce new 3D rotation moment invariants, which are composed of non-separable Appell moments. We show that non-separable moments may outperform the separable ones in terms of recognition power and robustness thanks to a better distribution of their zero surfaces over the image space. We test the numerical properties and discrimination power of the proposed invariants on three real datasets—MRI images of human brain, 3D scans of statues, and confocal microscope images of worms. We show the robustness to resampling errors improved more than twice and the recognition rate increased by 2–10 % comparing to most common descriptors. In the last section, we show how these invariants can be used in state-of-the-art neural networks for image recognition. The proposed H-NeXtA architecture improved the recognition rate by 2–5 % over the current networks.

Comparative Study on Associations Between Lung Cancer Prognosis and Diagnostic Criteria Set by the European Palliative Care Research Collaboration and the Asian Working Group for Cachexia.

Cachexia is a poor prognostic factor in many advanced cancers. Cachexia diagnostic criteria of the European Palliative Care Research Collaboration (EPCRC) may underestimate cachexia in Asians; therefore, new criteria have been proposed by the Asian Working Group for Cachexia (AWGC). We compared both criteria to determine differences in diagnostic rates and their association with lung cancer prognosis. This single-center, retrospective cohort study considered lung cancer outpatients receiving chemotherapy. Survival was analyzed using Kaplan-Meier curves and log-rank tests. The association between cachexia diagnosis and prognosis was examined for each set of criteria using a Cox proportional hazards model. C-statistic analysis was performed to compare the discriminative power for prognosis. Among the 106 participants analyzed (median age, 75 [71-79] years; 75 males [70.8%]; 91 [85.9%] with performance status [PS] 0-1), 58 (54.7%) and 77 (72.6%) cachexia cases were diagnosed using the EPCRC and AWGC criteria, respectively. The latter encompassed all but one patient diagnosed using the EPCRC criteria. Patients with cachexia had a significantly poorer prognosis according to both criteria (EPCRC, p = 0.002; AWGC, p = 0.001). Both criteria had almost equal discriminative power for prognosis (EPCRC, C-statistic = 0.658; AWGC, C-statistic = 0.658). CRP in the AWGC criteria was most strongly related to prognosis. Cachexia was an independent poor prognostic factor in lung cancer patients receiving chemotherapy under the AWGC and EPCRC criteria, both of which had similar prognostic discriminatory power. Among CRP, anorexia, and grip strength, elevated CRP may be the most prognostically relevant parameter in the AWGC criteria.

Preoperative susceptibility to developing secondary hyperalgesia is associated with post-thoracotomy pain at 2 months.

Identifying the subset of patients at risk for developing persistent pain after surgery is clinically important as they could benefit from targeted prevention measures. In this prospective study, we investigated if the preoperative assessment of the individual susceptibility to developing experimentally induced secondary hyperalgesia is associated with post-thoracotomy pain at 2 months. Forty-one patients scheduled to undergo a posterolateral thoracotomy were recruited before surgery and followed prospectively for 2 months. The day before surgery, we experimentally induced secondary hyperalgesia at one of the two forearms and measured the change of perception to mechanical pinprick stimuli and the area of hyperalgesia. On postoperative Day 4, Day 15 and at the 2-month follow-up, patients were asked about their pain intensity at rest and during coughing and the area of secondary hyperalgesia around the scar as well as the change in perception to mechanical pinprick stimuli was measured. Of the 41 patients that were recruited only 20 could be analysed. Forty per cent reported pain at the 2-month follow-up. All of them reported cough-evoked pain and 10 per cent also reported pain at rest. A binary logistic regression model with both the magnitude and extent of experimentally induced secondary hyperalgesia was statistically significant (chi-squared = 12.439, p = 0.002, McFadden R2 = 0.462) and showed excellent discriminative power (AUC = 0.938) for the presence or absence of cough-evoked pain at the 2 month follow-up. Our findings indicate that the individual susceptibility to developing experimentally induced secondary hyperalgesia preoperatively may identify patients who are potentially vulnerable to develop persistent post-thoracotomy pain. Our data suggests that preoperatively assessed experimentally induced secondary hyperalgesia displays excellent discriminative power for the presence or absence of cough-evoked pain 2 months after thoracotomy.

Development and validation of a nomogram-based risk prediction model for carbapenem-resistant Klebsiella pneumoniae in hospitalized patients.

Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses one of the major challenges in clinical anti-infective therapy worldwide. This retrospective cohort study at a tertiary general hospital in Wuhan aimed to identify risk factors for hospital-acquired CRKP infections among 1,113 patients. All participants were aged 18 years and above, and had confirmed positive cultures for KP isolated within 48 hours post-hospitalization. Independent risk factors were identified using LASSO logistic regression and incorporated into a predictive nomogram. The factors included in the nomogram were prior carbapenem exposure, prior β-lactams-β-lactamase inhibitor combination (BLBLI) exposure, prior intensive care unit (ICU) stay, and prior mechanical ventilation. The areas under the receiver operating characteristic curve (AUC) for the nomogram were 0.793 in the training group (70% of patients) and 0.788 in the validation group (30% of patients), demonstrating its discriminatory power and predictive accuracy. The P values for the Hosmer-Lemeshow test were 0.333 and 0.684, indicating good calibration. The clinical utility of the nomogram was further supported by decision curve analysis (DCA) and clinical impact curve (CIC), demonstrating its potential to guide clinical decision-making. Our retrospective analysis identified key risk factors for CRKP infection and developed a nomogram that could effectively predict CRKP infections in hospitalized patients. Although the single-center nature of this study limits generalizability, the nomogram provides a foundation for future prospective, multicenter validations.IMPORTANCEWe established a nomogram scoring system that incorporates four key risk factors: prior carbapenem exposure, prior β-lactams-β-lactamase inhibitor combination (BLBLI) exposure, prior intensive care unit (ICU) stay, and prior mechanical ventilation. This nomogram demonstrated strong discriminatory power, excellent calibration, and significant clinical utility. This study highlights the critical risk factors associated with hospital-acquired carbapenem-resistant Klebsiella pneumoniae (CRKP) infections, providing valuable insights for clinicians to identify high-risk patients.

Clinical and Genomic Prediction of Coronary Artery Disease Subtypes.

Coronary artery disease (CAD) is a complex, heterogeneous disease with distinct etiological mechanisms. These different etiologies may give rise to multiple subtypes of CAD that could benefit from alternative preventions and treatments. However, so far, there have been no systematic efforts to predict CAD subtypes using clinical and genetic factors. Here, we trained and applied statistical models incorporating clinical and genetic factors to predict CAD subtypes in 26 036 patients with CAD in the UK Biobank. We performed external validation of the UK Biobank models in the US-based All of Us cohort (8598 patients with CAD). Subtypes were defined as high versus normal LDL (low-density lipoprotein) levels, high versus normal Lpa (lipoprotein A) levels, ST-segment-elevation myocardial infarction versus non-ST-segment-elevation myocardial infarction, occlusive versus nonocclusive CAD, and stable versus unstable CAD. Clinical predictors included levels of ApoA, ApoB, HDL (high-density lipoprotein), triglycerides, and CRP (C-reactive protein). Genetic predictors were genome-wide and pathway-based polygenic risk scores (PRSs). Results showed that both clinical-only and genetic-only models can predict CAD subtypes, while combining clinical and genetic factors leads to greater predictive accuracy. Pathway-based PRSs had higher discriminatory power than genome-wide PRSs for the Lpa and LDL subtypes and provided insights into their etiologies. The 10-pathway PRS most predictive of the LDL subtype involved cholesterol metabolism. Pathway PRS models had poor generalizability to the All of Us cohort. In summary, we present the first systematic demonstration that CAD subtypes can be distinguished by clinical and genomic risk factors, which could have important implications for stratified cardiovascular medicine.

Population Structure, Morphology, and Health Assessment of Philippine Swamp Buffalo (Bubalus kerabau, Fitzinger, 1860) in Calayan Island, Cagayan

Understanding the state of the swamp buffalo population in Calayan Island is important to strengthen the conservation and management program in the country. This study aimed to provide insights into the morphology, population structure, and health profile of the swamp buffaloes on the island. In total, 35 fresh blood samples were analyzed using 27 polymorphic microsatellite markers to determine the population structure analysis. Data were gathered for the morphological features of Calayan swamp buffaloes and served as the baseline information for the descriptive traits. Furthermore, samples were tested for surra and brucellosis using PCR and serological tests, respectively. The results showed that Calayan swamp buffaloes were morphologically bigger, except for body length, compared with other populations. A genotype analysis using microsatellite markers showed remarkable discriminatory power to distinguish distinct populations within the tested population, and could discriminate subspecies of swamp and river types plus crossbreds. The study also reports the first incidence of surra and brucellosis on the island. Overall, the new insights provided on the newly detected Philippine carabao lineage in Calayan Island would be highly recommended for the ex situ conservation and animal health control strategy. The conservation strategy would encompass collecting, cryopreserving, and storing viable germplasms from local swamp buffalo on Calayan Island.

Evaluation of Collagen Triple Helix Repeat Containing-1 protein in Postmenopausal Women with Osteoporosis

Background: The collagen triple helix repeat containing 1 (CTHRC1) protein has been connected to decreased levels of vitamin D and calcium, as well as obesity. This study aimed to investigate the relationship between CTHRC1 and osteoporosis in post-menopausal women and compare with healthy subjects. Subjects and Methods: A cross-sectional study consisted of 86 women were enrolled in this study and divided into three groups based on the results of dual-energy densitometry (DXA): 30 women with osteoporosis, 30 women with osteopenia, and 26 healthy women. Data on demographic and clinical features and laboratory values of Calcium (Ca) and Vitamin D3 (V.D3) were recorded. Results: Women with osteoporosis had significantly increased levels of CTHRC1 (P = 0.0001) compare to HS groups. The CTHRC1 showed negative correlation with Ca and V.D3 value at (r= -0.453, P=0.001 and r= -0.415, P= 0.022) respectively in osteopenia patients. CTHRC1 alone show excellent discrimination power (AUC= 0.9) in identifying women with osteoporosis. Conclusions: Serum CTHRC1 is a valid biomarker that can distinguish women with osteoporosis from HS group with high accuracy. Low calcium and vitamin D levels in this age group may be linked to an increase in the CTHRC1 levels and this could make it a Therapeutic target in future studies.

Systematic exploration of genetic traits in Qinghai Salar ethnic group through a validated InDel panel for individual identification

BackgroundInsertion/deletion polymorphism (InDel) markers, mainly characterized by diallelic length polymorphisms, have been extensively investigated in forensic applications. The Salar ethnic group is one of the ten officially recognized Muslim minorities in China, with a large population mainly residing in Qinghai Province, China, yet there have been few population genetics studies on the Salar ethnic group, let alone those using InDel markers. AimThe present study aims to explore the genetic traits and enrich the genetic resources of the Qinghai Salar ethnic group through a validated InDel panel developed in-house. Subjects and methodsForensic performance of the novel self-constructed 43-InDel panel, designed for individual identification, was evaluated in the Qinghai Salar ethnic group from China. In addition, based on these 43 InDels, the genetic characteristics of the Qinghai Salar ethnic group were systematically explored by incorporating 27 reference populations from five continents. ResultsThe results indicated that most loci in the 43-InDel panel were genetically polymorphic in the Qinghai Salar ethnic group, and the novel panel could serve as an efficient tool for individual identification of the studied group, with a combined discrimination power of more than 0.9999. Population genetics analyses demonstrated that the Qinghai Salar ethnic group was genetically closer to East Asian populations than to other continental populations, especially the Hui ethnic group in Northwest China and Han Chinese in Beijing. ConclusionIn summary, the in-house developed 43-InDel panel could be an effective tool for individual identification and provide additional genetic information for the Qinghai Salar ethnic group.

A novel resident physician examination using clinical simulation video to assess clinical competence in Japan: a cross-sectional study

BackgroundThe general medicine in-training examination (GM-ITE) assesses physicians’ clinical knowledge. This study expanded on findings from a previous pilot study to assess the relationship between general medicine in-training examination (GM-ITE) scores and the diagnostic skills of resident physicians in Japan by employing an innovative clinical simulation video (CSV-IE).MethodsThis multicenter cross-sectional study included 4,677 resident physicians who took the GMITE between January 17 and 30, 2023. Participants watched the CSV-IE, depicting an emergency room scenario, and provided a diagnosis. The CSV-IE depicts an emergency case and provides a diagnosis. Discrimination indices were used to assess the CSV-IE’s effectiveness across clinical competence domains, and multilevel logistic regression was used to analyze physician- and hospital-level factors associated with correct diagnoses.ResultsCorrect diagnoses were provided by 470 participants (10.0%). The CSV-IE demonstrated high discriminatory power across all assessed domains, including basic clinical knowledge (DI = 0.44), symptomatology and clinical reasoning (DI = 0.31), physical examination and clinical procedure (DI = 0.35), and knowledge about the disease (DI = 0.25), supporting its utility as an effective assessment tool. In the multivariable analysis, factors associated with a higher likelihood of providing a correct CSV-IE diagnosis included a higher annual number of emergency outpatients (adjusted odds ratio: 1.025; 95% confidence interval [CI]: 1.003–1.047; P = .0230) and being in a higher postgraduate year (adjusted odds ratio: 1.387; 95% CI: 1.104–1.742; P = .005). Conversely, resident physicians at university hospitals were less likely to provide a correct CSV-IE response (adjusted odds ratio: 0.624; 95% CI: 0.435–0.896; P = .0107).ConclusionsCSV-IE modules may provide an integrative and realistic evaluation of clinical competence, addressing limitations of traditional MCQ-based assessments by offering contextualized, real-world scenarios that require dynamic decision-making and diagnostic reasoning.

Development and Validation of a Screening Tool for Generalized Anxiety and Major Depressive Disorder in Patients with Chronic Obstructive Pulmonary Disease.

Anxiety and depression are often underdiagnosed in patients with chronic obstructive pulmonary disease (COPD). This study aimed to develop and validate a screening tool for anxiety and depression in COPD patients. Stable COPD patients were consecutively recruited from November 2021 to October 2023 and underwent a psychiatric interview to diagnose generalized anxiety disorder (GAD) and/or major depressive disorder (MDD) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Patients were split into training and validation sets according to their recruitment time. We assessed known risk factors and used core items from the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) to develop a prediction nomogram. Multivariable logistic regression with least absolute shrinkage and selection operator (LASSO) were used to construct the nomogram. Among the enrolled COPD patients (n = 329), 58 (25.6%) in the training cohort and 33 (32.4%) in the validation cohort were diagnosed with GAD and/or MDD. Three variables were identified in the prediction nomogram: COPD Assessment Test score and two core items from PHQ-ADS. The under the curve (AUC) value for the nomogram was 0.826 (95% CI: 0.755-0.897) and 0.855 (95% CI: 0.767-0.942) in the training and validation cohorts, respectively. The calibration curve was close to the diagonal. The discriminatory power of the screening nomogram was comparable to that of PHQ-ADS (AUC: 0.826 vs. 0.831, P = 0.832). The new screening tool for GAD and MDD in COPD patients is concise and valid, with discriminatory power comparable to existing anxiety/depression screening questionnaires.

A novel deep learning based method for myocardial strain quantification

Purpose.This paper introduces a deep learning method for myocardial strain analysis while also evaluating the efficacy of the method across a public and a private dataset for cardiac pathology discrimination.Methods.We measure the global and regional myocardial strain in cSAX CMR images by first identifying a ROI centered in the LV, obtaining the cardiac structures (LV, RV and Myo) and estimating the motion of the myocardium. Finally, we compute the strain for the heart coordinate system and report the global and regional strain.Results.We validated our method in two public datasets (ACDC, 80 subjects, and CMAC, 16 subjects) and a private dataset (SSC, 75 subjects), containing healthy and pathological cases (acute myocardial infarction, DCM and HCM). We measured the mean Dice coefficient and Hausdorff distance for segmentation accuracy, and the absolute end point error for motion accuracy, and we conducted a study of the discrimination power of the strain and strain rate between populations of healthy and pathological subjects. The results demonstrated that our method effectively quantifies myocardial strain and strain rate, showing distinct patterns across different cardiac conditions achieving notable statistical significance. Results also show that the method's accuracy is on par with iterative non-parametric registration methods and is also capable of estimating regional strain values.Conclusion.Our method proves to be a powerful tool for cardiac strain analysis, achieving results comparable to other state-of-the-art methods, and computational efficiency over traditional methods.

Polygenic Prediction of Recurrent Events After Early-Onset Myocardial Infarction.

Myocardial infarction (MI) is a complex disease caused by both lifestyle and genetic factors. This study aims to investigate the predictive value of genetic risk, in addition to traditional cardiovascular risk factors, for recurrent events following early-onset MI. The Italian Genetic Study of Early-Onset Myocardial Infarction is a cohort study enrolling patients with MI before 45 years. Monogenic variants causing familial hypercholesterolemia were identified, and a coronary artery disease polygenic score (PGS) was calculated. Ten-fold cross-validated Cox proportional hazards models were fitted sequentially including all clinical variables, the PGS, and monogenic variants on the composite outcome of cardiovascular death, recurrent MI, stroke, or revascularization. During a 19.9-year follow-up, 847 (50.7%) patients experienced recurrent events. Each 1-SD higher PGS was associated with a 21% higher hazard of recurrent events (hazard ratio, 1.21 [95% CI, 1.13-1.31]; P=4.04×10-6). Except for secondary prevention, PGS was the strongest determinant of recurrent event risk (C index, 0.56 [95% CI, 0.54-0.58]) compared with clinical risk factors. Overall, predictive performance of clinical risk factors (C index, 0.69 [95% CI, 0.67-0.71]) improved after adding the PGS (C index, 0.69 [95% CI, 0.68-0.71]; P=0.006). When dividing the population by PGS quintiles, the highest fifth had a 57% higher hazard of recurrent events than the lowest fifth (hazard ratio, 1.57 [95% CI, 1.26-1.96]; P=5.57×10-5). When compared with other clinical risk factors, PGS was the strongest predictor of event recurrence among patients with an early-onset MI. Though the discriminative power of recurrent event prediction in this cohort was modest, the addition of PGS significantly improved discrimination.

Utility of Anthropometric Indexes for Detecting Metabolic Syndrome in Resource-Limited Regions of Northwestern China: Cross-Sectional Study.

Anthropometric indexes offer a practical approach to identifying metabolic syndrome (MetS) and its components. However, there is a scarcity of research on anthropometric indexes tailored to predict MetS in populations from resource-limited regions. This study aimed to examine the association between 8 easy-to-collect anthropometric indexes and MetS, and determine the most appropriate indexes to identify the presence of MetS for adults in resource-limited areas. A total of 10,520 participants aged 18-85 years from Ningxia Hui Autonomous Region, China, were included in this cross-sectional study. Participants were recruited through a stratified sampling approach from January 1, 2020, to December 31, 2021. MetS was defined using the International Diabetes Federation (IDF) criteria. Eight anthropometric indexes were examined, including BMI, waist-to-height ratio (WHtR), weight-adjusted waist index (WWI), conicity index, a body shape index (ABSI), lipid accumulation products (LAP), visceral obesity index (VAI), and the triglyceride-glucose (TyG) index. Logistic regression analysis and restricted cubic splines (RCSs) were applied to identify the association between the anthropometric indexes. The receiver operating characteristic curve and the area under the curve (AUC) were analyzed to identify and compare the discriminative power of anthropometric indexes in identifying MetS. The Youden index was used to determine a range of optimal diagnostic thresholds. Logistic regression analysis was applied to identify the association between the anthropometric indexes. A total of 3324 (31.60%) participants were diagnosed with MetS. After adjusting for age, ethnicity, current residence, education level, habitual alcohol consumption, and tobacco use, all the 8 indexes were positively correlated with the risks of MetS (P<.05). LAP presented the highest adjusted odds ratios (adjOR 35.69, 95% CI 34.59-36.80), followed by WHtR (adjOR 29.27, 95% CI 28.00-30.55), conicity index (adjOR 11.58, 95% CI 10.95-12.22), TyG index (adjOR 5.53, 95% CI 5.07-6.04), BMI (adjOR 3.88, 95% CI 3.71-4.05), WWI (adjOR 3.23, 95% CI 3.02-3.46), VAI (adjOR 2.11, 95% CI 2.02-2.20), and ABSI (adjOR 1.71, 95% CI 1.62-1.80). Significantly nonlinear associations between the 8 indexes and the risk of MetS (all Pnonlinear<.001) were observed in the RCSs. WHtR was the strongest predictor of MetS for males (AUC 0.91, 95% CI 0.90-0.92; optimal cutoff 0.53). LAP were the strongest predictor of MetS for females (AUC 0.89, 95% CI 0.89-0.90; optimal cutoff 28.67). Statistical differences were present between WHtR and all other 7 anthropometric indexes among males and overall (all P<.05). In females, the AUC values between LAP and BMI, WWI, ABSI, conicity index, VAI, and TyG index were significantly different (P<.001). No statistical difference was observed between LAP and WHtR among females. According to 8 anthropometric and lipid-related indices, it is suggested that WHtR and LAP are the most appropriate indexes for identifying the presence of MetS in resource-limited areas.

Efficacy of B - mode and elastography ultrasound technique in the prediction of Helicobacter pylori: a prospective study

BackgroundHelicobacter pylori (HP) affect nearly 50% of the world’s population and can colonize the submucosal and mucosal layers of the stomach wall, causing inflammation leading to a thickening of these layers. The study aimed to evaluate the application value of transabdominal ultrasonography combined with elastography in the prediction of HP using HP Fecal Antigen Test as gold standard.MethodThis prospective case-control study was conducted in 174 participants classified into three groups: Group A: Symptomatic patients with thickened stomach antral and evident HP infection on fecal antigen test results, Group B: Symptomatic patients with thickened antral and no evident HP infection on fecal antigen test results, and Group C: control group of asymptomatic individuals with negative HP screening to predict the diagnostic accuracy of B-mode ultrasound and elastography in the prediction of HP pylori.ResultsPositive HP patients had higher values of antral wall thickness (AWT), mucosal layer thickness (MLT), MLT/AWT ratio, SR (strain ratio), and a combination of AWT and SR: 5.57 ± 0.55 mm, 2.96 ± 0.45 mm, 0.53 ± 0.06 mm, 3.21 ± 0.43, and 8.79 ± 0.68 mm, respectively. In comparison, negative HP patients had values of 4.61 ± 0.47 mm, 2.05 ± 0.42 mm, 0.41 ± 0.08 mm, 2.51 ± 0.42 mm, and 7.13 ± 0.62 mm, respectively, and the control groups had values of 3.53 ± 0.36 mm, 1.47 ± 0.25 mm, 0.40 ± 0.06 mm, 1.81 ± 0.41, and 5.35 ± 0.55 mm, respectively (p < 0.001). The sensitivity of B-mode ultrasonography, elastography, and the combination of the two was 98%, 95.1%, and 98.4%, respectively, and the diagnostic accuracy was 98.4%, 98.3%, and 100%, respectively.ConclusionB-mode ultrasonography and elastography exhibit high discriminatory power in distinguishing symptomatic HP patients from normal individuals and differentiating + HP from - HP, with greater discriminatory power when combined both modes.