Receiver Operating Characteristic Curve Analysis Research Articles

The value of quantitative shear wave elastography combined with conventional ultrasound in evaluating and guiding fine needle aspiration biopsy of axillary lymph node for early breast cancer: implication for axillary surgical stage

ObjectivesTo investigate the value of conventional ultrasonography (US) combined with quantitative shear wave elastography (SWE) in evaluating and identifying target axillary lymph node (TALN) for fine needle aspiration biopsy (FNAB) of patients with early breast cancer.Materials and methodsA total of 222 patients with 223 ALNs were prospectively recruited from January 2018 to December 2021. All TALNs were evaluated by US, SWE and subsequently underwent FNAB. The diagnostic performances of US, SWE, UEor (either US or SWE was positive) and UEand (both US and SWE were positive), and FNAB guided by the above four methods for evaluating ALN status were assessed using receiver operator characteristic curve (ROC) analyses. Univariate and multivariate logistic regression analyses used to determine the independent predictors of axillary burden.ResultsThe area under the ROC curve (AUC) for diagnosing ALNs using conventional US and SWE were 0.69 and 0.66, respectively, with sensitivities of 78.00% and 65.00% and specificities of 60.98% and 66.67%. The combined method, UEor, demonstrated significantly improved sensitivity of 86.00% (p < 0.001 when compared with US and SWE alone). The AUC of the UEor-guided FNAB [0.85 (95% CI, 0.80–0.90)] was significantly higher than that of US-guided FNAB [0.83 (95% CI, 0.78–0.88), p = 0.042], SWE-guided FNAB [0.79 (95% CI, 0.72–0.84), p = 0.001], and UEand-guided FNAB [0.77 (95% CI, 0.71–0.82), p < 0.001]. Multivariate logistic regression showed that FNAB and number of suspicious ALNs were found independent predictors of axillary burden in patients with early breast cancer.ConclusionThe UEor had superior sensitivity compared to US or SWE alone in ALN diagnosis. The UEor-guided FNAB achieved a lower false-negative rate compared to FNAB guided solely by US or SWE, which may be a promising tool for the preoperative diagnosis of ALNs in early breast cancer, and had the potential implication for the selection of axillary surgical modality.

Rationale for adopting a combination of monoparametric MRI with the prostate-specific antigen in detecting clinically significant prostate cancer: comparison with standard biparametric and multiparametric MRI.

To compare prostate monoparametric MRI (monoMRI), which uses only diffusion-weighted imaging (DWI), with biparametric (bpMRI) and multiparametric MRI (mpMRI) in detecting clinically significant cancer (CSC) and to evaluate the effect of the combination of monoMRI results and prostate-specific antigen (PSA) level. In this study, 193 patients (average age 70.5 years; average PSA 7.9 ng/mL) underwent prebiopsy MRI and subsequent prostate biopsy from January 2020 to February 2022. Two radiologists independently reviewed the 3 MRI protocols using the Prostate Imaging Reporting and Data System (PI-RADS). Interreader agreement was assessed using the intraclass correlation coefficient (ICC), and diagnostic performance was evaluated with receiver operating characteristic (ROC) curve analysis. The Youden index was used to determine the new cutoff value of PSA for detecting CSCs in patients with negative monoMRI results. CSC was confirmed in 109 patients (56.5%). The interreader agreement on monoMRI (ICC = 0.798) was comparable to that on bpMRI and mpMRI (ICC = 0.751 and 0.714, respectively). ROC curve analysis of the 3 protocols revealed no difference in detecting CSCs (P > 0.05). Applying a new PSA cutoff value (9.5 and 7.4 ng/mL, respectively) in monoMRI-negative patients improved the sensitivity of monoMRI from 89.9% to 96.3% for Reader 1, and from 95.4% to 99.1% for Reader 2. MonoMRI based solely on DWI demonstrated similar diagnostic performance to bpMRI and mpMRI in detecting CSCs, and the combination of PSA level with monoMRI has the potential to effectively triage patients with a high likelihood of CSCs. Monoparametric MRI conducted only with diffusion-weighted imaging (DWI), may show comparable performance to biparametric and multiparametric MRI in detecting clinically significant prostate cancer. In patients with negative monoparametric MRI results, implementing a new PSA cutoff value to determine the need for a biopsy could decrease the number of missed prostate cancer.

Novel predictive factor for erectile dysfunction: systemic immune inflammation index.

Systemic immune inflammation index (SII) is a global parameter that comprehensively reflects body inflammation, this study aims to assess the correlation between this index and erectile dysfunction (ED). This cross-sectional study incorporated 164 ED patients and 95 healthy adult males. The collection of general demographic information and pertinent hematological data from the participants enabled the computation of corresponding SII values. Statistical analysis, encompassing descriptive statistics as well as normality and logistic regression analyses, was carried out employing SPSS version 26. The findings of the univariate analysis revealed a noteworthy distinction in triglyceride levels (TG) (P = 0.017) and SII (P < 0.001) between ED patients and the healthy population. Subsequent multivariate logistic regression analysis unveiled a significant association between SII (odd ratio (OR):1.012, 95% confidence interval (CI):1.008-1.015; P < 0.001) and the occurrence of ED. Since the impact value is not clearly visible, SII/100 is utilized to magnify the effect value one hundredfold. The regression analysis results indicate that the OR value of SII/100 is 3.171, and the 95% CI is 2.339-4.298 (P < 0.001). The Receiver Operating Characteristic (ROC) curve analysis ascertained an AUC of 0.863 (P < 0.001) for SII, with a determined cut-off value of 391.53(109/L), exhibiting a sensitivity of 81.7% and specificity of 83.2%. Moreover, when comparing patients with varying degrees of ED severity, both univariate (P < 0.001) and subsequent multivariate logistic regression analyses (OR: 1.007, 95% CI: 1.004-1.010; P < 0.001) underscored the significance of the SII value. At this point, SII/100 OR: 1.971, 95% CI: 1.508-2.576 (P < 0.001). The ROC curve analysis in this context demonstrated an AUC of 0.799 (P < 0.001), with a determined cut-off value of 746.63(109/L), featuring a sensitivity of 60.6% and specificity of 91.6%. These discerned outcomes affirm a correlation between SII and ED, establishing its potential not only in predicting the onset of ED but also in differentiating among various levels of ED severity.

Exploring the efficacy of structured nursing via web-based interaction platforms in sustaining hemodialysis patients.

Discussed based on the network interactive platform of structured care for patients with chronic renal failure (CRF) in the process of hemodialysis. This study seeks to elucidate the application value of structured nursing, deployed through network interaction platforms, in sustaining patients undergoing maintenance hemodialysis. A total of 62 patients diagnosed with Chronic Renal Failure (CRF) between April 2022 and August 2023 were randomly allocated into two distinct care groups: conventional and structured nursing care based on a web-interactive platform. Both cohorts were comparatively analyzed with respect to psychological states, quality of life within therapeutic interventions, and relationships with complications. Renal function indicators, including Creatinine Clearance (Ccr), Serum Creatinine (SCr), and Blood Urea Nitrogen (BUN), were subjected to Pearson analysis to appraise their predictive value in prognostication, while Receiver Operating Characteristic (ROC) curve analysis was constructed to further discern their diagnostic precision. Post-intervention, notable improvements were observed in the emotional states of patients in both cohorts, with the structured care group exhibiting significantly lower Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores (p< 0.05). Furthermore, patients under the web-interactive structured nursing regimen demonstrated superior overall adherence, a reduced incidence rate of complications, and markedly higher scores in quality of life assessments compared to those under conventional care (p< 0.05). The derived cut-off values for Ccr, SCr, and BUN were 32.5 ml/min, 251.5 umol/L, and 14.5 mmol/L, respectively, with sensitivities and specificities pegged at 0.645% and 0.645% for Ccr, 0.774% and 0.548% for SCr, and 0.774% and 0.774% for BUN. The corresponding areas under the ROC curve (AUC) for each parameter were 0.816, 0.653, and 0.856, respectively. Comprehensive hemodialysis care for patients with chronic renal failure can improve self-care ability to improve quality of life and reduce the incidence of complications, which has great potential for clinical progress and is worthy of further research.

Reference values for reticulocyte haemoglobin equivalent in healthy Chinese children under 5 years and its associations with various blood parameters

BackgroundReticulocyte haemoglobin equivalent (RET-He) is a useful tool for evaluating recent iron usage irrespective of inflammatory status. This study aims to establish a reference for RET-He among Hong Kong healthy...

Quantification of the size of subchorionic hematoma causing pregnancy-related complications: a retrospective cohort study.

This study aimed to establish criteria for defining "large" subchorionic hematoma (SCH) and assess its association with pregnancy complications. This was a retrospective cohort study conducted at our institution between 2019 and 2020. We compared the size of SCH between the pregnancy-related complication and non-complication groups, using two measurement methods. Receiver operating characteristic (ROC) curve analysis determined cutoff values. Additionally, we compared the occurrence of pregnancy complications among three groups: large SCH group (above the cutoff value), non-large SCH group (below the cutoff value), and non-SCH group. Of 1305 singleton pregnancies managed during the study, 80 cases were diagnosed with SCH. Pregnancy complications occurred in 15 patients. The patients with pregnancy complications had significantly larger SCH sizes with both measurement methods. For each method, the cutoff values calculated from the ROC curve analysis were as follows: Method 1, 25% (area under the ROC curve [AUC], 0.662); Method 2, 30% (AUC, 0.624). In Method 1, we found a significantly higher occurrence of preterm delivery in the large SCH group (24.1%) than in the non-large SCH (4.2%) and non-SCH groups (5.3%; all p < 0.01). In Method 2, there was a significantly higher occurrence of preterm delivery in the large SCH group (33.3%) than in the non-large SCH (6.5%) and non-SCH groups (5.3%; all p < 0.01). Large SCHs may indicate a high risk of pregnancy-related complications. Among these, recognizing and managing cases that exceed the aforementioned cutoff value as high-risk cases may be beneficial for reducing pregnancy complications.

Energy spectrum computed tomography multi-parameter imaging in preoperative assessment of vascular and neuroinvasive status in gastric cancer.

Vascular and nerve infiltration are important indicators for the progression and prognosis of gastric cancer (GC), but traditional imaging methods have some limitations in preoperative evaluation. In recent years, energy spectrum computed tomography (CT) multiparameter imaging technology has been gradually applied in clinical practice because of its advantages in tissue contrast and lesion detail display. To explore and analyze the value of multiparameter energy spectrum CT imaging in the preoperative assessment of vascular invasion (LVI) and nerve invasion (PNI) in GC patients. Data from 62 patients with GC confirmed by pathology and accompanied by energy spectrum CT scanning at our hospital between September 2022 and September 2023, including 46 males and 16 females aged 36-71 (57.5 ± 9.1) years, were retrospectively collected. The patients were divided into a positive group (42 patients) and a negative group (20 patients) according to the presence of LVI/PNI. The CT values (CT40 keV, CT70 keV), iodine concentration (IC), and normalized IC (NIC) of lesions in the upper energy spectrum CT images of the arterial phase, venous phase, and delayed phase 40 and 70 keV were measured, and the slopes of the energy spectrum curves [K (40-70)] from 40 to 70 keV were calculated. Arterial phase combined parameter, venous phase combined parameters (VP-ALLs), and delayed phase association parameters were calculated for patients with late-stage disease. The differences in the energy spectrum parameters between the positive and negative groups were compared, receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC), sensitivity, specificity, and optimal threshold were calculated to measure the diagnostic efficiency of each parameter. In the delayed phase, the CT40 keV, CT70 keV, K (40-70), IC, NIC, and CT70 keV and the NIC in the upper arterial and venous phases of energy spectrum CT were greater in the LVI/PNI-positive group than in the LVI-negative group. The representative parameters for the arterial phase NIC were 0.14 ± 0.04 in the positive group and 0.12 ± 0.04 in the negative group. The venous phase NIC was 0.5 (0.5, 0.6) in the positive group and 0.4 (0.4, 0.5) in the negative group. Last, for the delayed phase NIC, it was 0.6 ± 0.1 in the positive group and 0.5 ± 0.1 in the negative group (all P values are less than 0.05). ROC curve analysis demonstrated that the diagnostic efficacy of each parameter during the venous stage was superior to that during the arterial and delayed stages. Furthermore, the diagnostic efficacy of the combined parameter throughout all three stages was superior to that of any single parameter. The AUC, sensitivity, and specificity of the optimal parameter, VP-ALL, were 0.931 (95% confidence interval: 0.872-0.990), 80.95%, and 95.00%, respectively. When assessing the condition of LVI and PNI (perineural invasion) in patients with GC prior to surgery, the ability to diagnose these conditions using venous stage parameters was superior to that using arterial stage and delayed stage parameters. Furthermore, the diagnostic accuracy of using a combination of parameters was better than that of using individual parameters alone.

Correlation analysis of carotid adipose tissue density and plaque stability in patients with carotid artery stenosis

Objective: To investigate the correlation between perivascular fat density (PFD) and plaque stability in patients with carotid artery stenosis. Methods: Clinical data of 110 patients with carotid artery stenosis treated at Drum Tower Hospital, Nanjing University Medical School from January 2018 to December 2022 were retrospectively collected. Based on pathological results of carotid plaque specimens obtained from carotid endarterectomy (CEA), patients were categorized into stable plaque group (n=51) and vulnerable plaque group (n=59). All patients underwent preoperative carotid CT angiography (CTA) to measure PFD at the narrowest carotid artery. Preoperative levels of interleukin-6 (IL-6) and other hematological parameters were collected. Multivariable logistic regression analysis was used to identify factors associated with plaque stability in carotid artery stenosis patients. Area under the curve (AUC) of receiver operating characteristic (ROC) was performed to evaluate the predictive value of PFD for plaque stability. Results: The stable plaque group consisted of 43 males and 8 females with a mean age of (67.6±9.0) years, while the vulnerable plaque group comprised 48 males and 11 females with a mean age of (69.3±9.0) years. The proportions of smokers were 31.4% (16/51) and 50.8% (30/59) in the stable and vulnerable plaque groups, respectively. The proportions of patients with diabetes were 33.3% (17/51) and 52.5% (31/59), respectively. IL-6 levels were 3.46(2.67, 5.34) and 4.51(3.62, 5.51) ng/L in the stable and vulnerable groups, respectively. Mean PFD values were (-69.04±5.35) and (-63.24±6.08) HU, respectively, with maximum PFD values of (-62.90±6.98) and (-56.93±5.90) HU, respectively. The differences were statistically significant (all P<0.05). Multivariable logistic regression analysis showed that increased mean PFD (OR=1.167, 95%CI: 1.029-1.324, P=0.016) and elevated IL-6 levels (OR=1.489, 95%CI: 1.151-1.926, P=0.002) were associated with vulnerability of carotid artery plaques. ROC curve analysis results showed that a cut-off value of -65.5 HU, the AUC for predicting plaque stability based on the mean PFD was 0.756 (95%CI: 0.667-0.844, P<0.001), with sensitivity of 64.4% and specificity of 74.5%. Conclusion: Increased mean PFD at the narrowest carotid artery is associated with vulnerability of plaques in patients with carotid artery stenosis.

Study of plasma metabolic markers in unexplained recurrent spontaneous abortion based on non-target metabolomics approach

Objective: To screen plasma metabolic markers in patients with unexplained recurrent spontaneous abortion (URSA) by non-target metabolomics approach. Methods: From September 2022 to May 2023, the plasma of 23 URSA pregnant women with threatened abortion who visited the outpatient clinic of Gansu Provincial Maternity and Child-care Hospital in the first trimester (URSA group) was collected, and the plasma of 22 healthy pregnant women in the first trimester who underwent prenatal examination during the same period (normal control group) was collected. Plasma metabolomics was analyzed by ultra performance liquid chromatography (UPLC) coupled with mass spectrometry (MS), fold change analysis, principal component analysis and partial least square discriminant analysis were applied to screen for differential metabolites, and the metabolites and their pathways associated with URSA were screened using receiver operating characteristic (ROC) curve and pathway enrichment analysis. Results: There were no significant differences in age, body mass index and gestational weeks between URSA and normal control group(all P<0.05). Metabolomics analysis using UPLC-MS showed that a total of 526 metabolites were detected from plasma, of which 33 were found to be differential metabolites associated with URSA based on the screening standards. Six potential metabolites with large area under the curve (AUC) were identified by ROC curve analysis, including phosphatidylethanolamine (AUC=0.972, 95%CI: 0.920-1.000), santene hydrate (AUC=0.902, 95%CI: 0.786-0.982), L-leucine (AUC=0.884, 95%CI: 0.772-0.960), cembrene (AUC=0.881, 95%CI: 0.758-0.956), caffeine (AUC=0.875, 95%CI: 0.756-0.962), and 4-hydroxybenzoic acid propyl ester (AUC=0.864, 95%CI: 0.732-0.946). The AUC for the combined diagnosis of URSA by the six metabolites was 0.983 (95%CI: 0.929-1.000). Pathway enrichment analysis of the differential metabolites showed that the pathogenesis of URSA was associated with a variety of metabolic pathways including caffeine metabolism, glycerophospholipid metabolism, and unsaturated fatty acid biosynthesis. Conclusion: The plasma metabolic profiles of pregnant women with normal pregnancies versus URSA differ in early pregnancy, and six potential metabolites such as phosphatidylethanolamine, santene hydrate, L-leucine, cembrene, caffeine, 4-hydroxybenzoic acid propyl ester, and their metabolic pathways may be involved in the pathogenesis of URSA.

Development and validation of a risk prognostic model based on the H. pylori infection phenotype for stomach adenocarcinoma

BackgroundStomach adenocarcinoma (STAD) is one of the most common malignancies. Infection of helicobacter pylori (H. pylori) is a major risk factor that leads to the development of STAD. This study constructed a risk model based on the H. pylori-related macrophages for predicting STAD prognosis. MethodsThe single-cell RNA sequencing (scRNA-seq) dataset and the clinic information and RNA-seq datasets of STAD patients were collected for establishing a prognostic model and for validation. The “Seurat” and “harmony” packages were used to process the scRNA-seq data. Key gene modules were sectioned using the “limma” package and the “WGCNA” package. Kaplan-Meier (KM) and Receiver Operating Characteristic Curve (ROC) analyses were performed with “survminer” package. The “GSVA” package was employed for single sample gene set enrichment analysis (ssGSEA). Cell migration and invasion were measured by carrying out wound healing and trans-well assays. ResultsA total of 17397 were screened and classified into 8 cell type clusters, among which the macrophage cluster was closely associated with the H. pylori infection. Macrophages were further categorized into four subtypes (including C1, C2, C3, and C4), and highly variable genes of macrophage subtype C4 could serve as an indicator of the prognosis of STAD. Subsequently, we developed a RiskScore model based on six H. pylori -associated genes (TNFRSF1B, CTLA4, ABCA1, IKBIP, AKAP5, and NPC2) and observed that the high-risk patients exhibited poor prognosis, higher suppressive immune infiltration, and were closely associated with cancer activation-related pathways. Furthermore, a nomogram combining the RiskScore was developed to accurately predict the survival of STAD patients. ABCA1 in the RiskScore model significantly affected the migration and invasion of tumor cells. ConclusionThe gene expression profile served as an indicator of the survival for patients with STAD and addressed the clinical significance of using H. pylori-associated genes to treat STAD. The current findings provided novel understandings for the clinical evaluation and management of STAD.

Association between calcification and risk stratification in gastric gastrointestinal stromal tumors.

Risk assessment of gastric gastrointestinal stromal tumors (GISTs), particularly those with a diameter ≤ 5cm, remains a clinical challenge. Previous research has primarily focused on tumor size, ulceration, necrosis, and enhancement patterns, with less emphasis on the role of tumor calcification, which remains controversial regarding its correlation with malignancy risk. This study aims to explore the characteristics of calcification in gastric GISTs and its correlation with risk stratification as defined by the National Institutes of Health (NIH), to improve preoperative risk assessment for gastric GISTs ≤ 5cm. A retrospective analysis of 385 pathologically confirmed gastric GIST patients, including 178 with small gastric GISTs (< 2cm), was conducted. Tumors were categorized into low-risk (very low / low) and high-risk (intermediate / high) groups based on NIH criteria. Variables such as age, gender, tumor long-axis diameter, calcification rates, calcification size, the number and distribution of calcification, calcification to tumor long-axis diameter ratio were analyzed. Logistic regression was used to identify independent predictors of malignancy for gastric GISTs, with predictive values assessed via receiver operating characteristic (ROC) curves. Significant differences were found between high-risk and low-risk groups in treatment methods, tumor long-axis diameter, the ratio of calcification to tumor long-axis, and calcification distribution (P < 0.05). Calcification rates varied across risk categories, with 23.6% in very low-risk, 31.6% in low-risk, 9.8% in intermediate-risk, and 31.7% in high-risk categories (P < 0.05). In GISTs ≤ 5cm, both tumor long-axis diameter (OR = 3.07, 95% CI: 2.29-4.10) and calcification (OR = 0.36, 95% CI: 0.13-0.97) were independent predictors of malignancy risk (both P < 0.05). ROC curve analysis yielded areas of 0.849 for tumor long-axis diameter, 0.578 for calcification, and 0.862 for their combination. The study indicates lower calcification rates in intermediate-risk gastric GISTs and higher rates in other risk categories. Additionally, tumors of different sizes exhibit two distinct calcification patterns, suggesting possible differing mechanisms of calcification in tumors. Calcification in gastric GISTs ≤ 5cm acts as a protective factor against higher malignancy risk, and when combined with tumor long-axis diameter, significantly enhances predictive accuracy over long-axis diameter alone.

Decibel level of coughing as a predictor of extubation outcome in mechanically ventilated intensive care patients: A prospective, observational study

AimThis study aims to evaluate the feasibility and clinical utility of measuring cough decibel level as predictive markers for extubation outcomes in mechanically ventilated patients. DesignA prospective observational study. SettingThree interdisciplinary medical-surgical intensive care units across China. Main outcome measuresThe primary outcomes assessed were extubation results in patients. Secondary measures included the cough decibel level, semiquantitative cough intensity scores, and white card test results recorded prior to extubation. ResultsA total of 71 patients were included, 55 patients were in the extubation success group and 16 in the failure group. The mean age was 78(71,83) years, mainly male (73.2 %). Despite the baseline characteristics being mostly consistent across both groups, significant differences were noted in duration of mechanical ventilation, and intensive care units and hospital stay. Remarkably, the cough decibel was substantially lower in the extubation failure group compared to the other group (78.69 ± 8.23 vs 92.28 ± 7.01 dB). The Receiver Operating Characteristic curve analysis revealed that a cough decibel below 85.77 dB is the optimal threshold for predicting extubation failure, exhibiting an 80 % sensitivity and 91.67 % specificity. ConclusionThe study corroborates that the cough decibel level serves as a quantifiable metric in patients undergoing mechanical ventilation. It posits that the likelihood of extubation failure escalates when the cough decibel falls below 85.77 dB. Implications for clinical practiceQuantification of coughing capacity in decibels may be a good predictor of extubation outcome, thus offering assistance to healthcare professionals in evaluating the readiness of patients for extubation.

The MACROD2 rs6110695 A>G Polymorphism and the Metabolites Indoleacrylic Acid and Butyrylcarnitine Potentially Have Clinical Relevance to WBC Count Prediction.

Our previous study suggested that the Mono-ADP ribosylhydrolase 2 (MACROD2) rs6110695 A>G polymorphism is significantly associated with white blood cell (WBC) count in the Korean population. The present study aimed to evaluate the clinical relevance of the MACROD2 rs6110695 A>G polymorphism for predicting WBC count by utilizing plasma metabolites and a single-nucleotide polymorphism (SNP). Two groups were characterized by MACROD2 rs6110695 A>G SNP genotypes among 139 healthy subjects based on the genetic information provided in our previous work: rs6110695 AA genotype group (n = 129) and rs6110695 AG genotype group (n = 10). Plasma global metabolic profiling was performed using ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). To estimate the predictive abilities of WBC count models using the rs6110695 genotype and/or significant differential metabolites, multiple linear regression analysis and receiver operating characteristic (ROC) curve analysis were conducted. The AG genotype had greater WBC-to-apolipoprotein (apo) A-I ratios; counts of WBCs, lymphocytes, monocytes, and granulocytes; monocyte-to-lymphocyte ratio (MLR); and monocyte-to-platelet ratio (MPR) than the AA genotype. In terms of metabolic profile, indoleacetic acid, and butyrylcarnitine levels were considerably distinct between the two groups, and these metabolites were considered to be meaningful prognostic variables for the rs6110695 genotype. Finally, ROC curve analysis demonstrated that the model containing the rs6110695 genotype and the two main metabolites was reliable. The present study revealed that individuals carrying the rs6110695 AG genotype with high plasma indoleacrylic acid and butyrylcarnitine levels might have elevated WBC counts. The rs6110695 genotype and the concentrations of indoleacrylic acid and butyrylcarnitine could contribute to reducing the risk of chronic diseases in the future.

Exploring the diagnostic and prognostic significance of circulating tumor cells in stage II-IV colorectal cancer using a nano-based detection method.

Colorectal cancer (CRC) is a leading cause of cancer mortality globally, underscoring the urgency for a noninvasive and effective biomarker to enhance patient prognosis. Circulating tumor cells (CTCs), a potential marker for real-time tumor monitoring, are limited in clinical utility due to the low sensitivity of existing detection methods. Previously, we introduced a novel Nano-based CTCs detection method that relies on the electrical properties of cell surfaces, thus eliminating thereby obviating the need for specific molecular biomarkers. In this study, we employed this technique to evaluate the diagnostic and prognostic value of CTCs in stage II-IV CRC. A total of 194 participants were included, consisting of 136 CRC patients and 58 healthy individuals. The peripheral blood of the participants was collected, and CTCs enumeration was performed utilizing the Nano-based detection method that we newly developed. The Receiver Operating Characteristic (ROC) curve and multivariate Cox proportional-hazards analysis were employed to assess the effectiveness of CTCs for diagnosing CRC and predicting patient prognosis. The Nano-based method demonstrated an ability to differentiate CRC patients from healthy individuals with a sensitivity of 84.6% and a specificity of 94.8%. Furthermore, baseline CTCs levels were predictive of progression-free survival (PFS) in CRC patients, with lower levels associated with longer PFS compared to higher levels (4.5 months vs. 8.0 months at 15 CTCs/mL, p = 0.016; 4.4 months vs. 8.0 months at 20 CTCs/mL, p = 0.028). We also explored the dynamic changes in the number of CTCs after 1-5 cycles of chemotherapy. Patients with increasing CTCs levels typically experienced disease progression (PD), while those with decreasing levels often achieved a partial response (PR) or maintained stable disease (SD). These findings suggest that the dynamic fluctuations in CTCs counts are closely tied to the clinical course of the disease. Our study indicates the potential of Nano-based CTCs detection in diagnosing and predicting outcomes for patients with stage II-IV CRC.

Importance of biomarkers in streptococcal acute tonsillitis & peritonsillar abscess.

Background & objectives Acute tonsillitis is a disease that can often be cured with medical treatment. However, complications may occur during this disease process. One of these complications is peritonsillar abscess. In recent years, biomarkers have been frequently used in the diagnosis of diseases. The aim of the study was to reveal whether peritonsillar abscess develops after acute tonsillitis, and acute tonsillitis can be differentiated using biomarkers and which biomarker has higher predictive value for this differentiation. Methods The control group consisted of individuals who were operated for septoplasty in the otolaryngology clinic, and the acute tonsillitis group consisted of individuals diagnosed with acute tonsillitis in the same clinic. Both groups were statistically compared in terms of mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune inflammation index (SII), infection discrimination index (IDI), plateletcrit (PCT) and lymphocyte to monocyte ratio (LMR) biomarkers. Statistically, significant biomarker values were compared between the subgroups in the tonsillitis group of those who had only acute tonsillitis and those who had peritonsillar abscess due to acute tonsillitis. Receiver operating characteristics (ROC) curve analysis was performed on biomarkers for their ability to predict the presence of peritonsillar abscess. Results When the individuals who had only acute tonsillitis and those who had acute tonsillitis with peritonsillar abscess were compared in terms of biomarkers, there was a statistically significant difference between the mean MPV, SII and PCT (P=0.010, 0.021, 0.023, respectively). ROC analysis was performed to calculate the sensitivity and specificity of MPV, PCT and SII for the diagnosis of acute tonsillitis with peritonsillar abscess (sensitivity-specificity for MPV 51.9-72.7%, for SII 94.2-32.7%, for PCT 71.2-50.9%, respectively). Interpretation & conclusions MPV, SII and PCT biomarkers may be useful to help clinicians predict peritonsillar abscess due to acute tonsillitis.

Association of the visceral fat metabolic score with osteoarthritis risk: a cross-sectional study from NHANES 2009–2018

BackgroundCurrently, obesity has been recognized to be an independent risk factor for osteoarthritis (OA), and the Metabolic Score for Visceral Fat (METS-VF) has been suggested to be potentially more accurate than body mass index (BMI) in the assessment of obesity. Nevertheless, the correlation of METS-VF with OA has not been obviously revealed yet. Therefore, this study aimed to delve into the potential relationship between METS-VF and OA.MethodsBy examining data from the NHANES (2009–2018), weighted multivariate logistic regression analyses were used for assessing the correlation between METS-VF and OA. Subgroup analyses were then performed to validate the findings. Moreover, the nonlinear relationship between the two was assessed by restricted cubic spline (RCS). Receiver operating characteristic (ROC) curves were plotted to examine the diagnostic accuracy of METS-VF versus previous obesity index for OA.ResultsThis study involved 7639 participants. According to our results, METS-VF was notably related to an elevated risk of OA, regardless of the METS-VF and the trend of positive association was more pronounced with the elevating METS-VF level (p for trend < 0.05). Subgroup analyses showed that the positive association between METS-VF and prevalence of osteoarthritis persisted in all populations with different characteristics, confirming its validity in all populations. Besides, RCS results showed a significant non-linear relationship between METS-VF and OA (p-non-linear < 0.05). As indicated by the ROC curve analysis results, METS-VF was a superior predictor of OA to BMI and HC.ConclusionsThis study finds a possible nonlinear positive correlation between METS-VF and the risk of OA. In addition, METS-VF may serve as an indicator for the more accurate diagnosis of OA and provide a new way to further evaluate the relationship between visceral fat and OA.

Independent risk factors of left ventricular hypertrophy in non-diabetic individuals in Sierra Leone - a cross-sectional study

BackgroundLeft ventricular hypertrophy (LVH) is a critical factor in heart failure and cardiovascular event-related mortality. While the prevalence of LVH in diabetic patients is well-documented, its occurrence and risk factors in non-diabetic populations remain largely unexplored. This study addresses this issue by investigating the independent risk factors of LVH in non-diabetic individuals.MethodsThis cross-sectional study, conducted meticulously, utilized data from a robust and comprehensive source, DATADRYAD, in the Sierra Leone database, collected between October 2019 and October 2021, including LVH and various variables. All variables were described and screened using univariate analysis, Spearman correlation, and principal component analysis (PCA). The lipid profile, including total cholesterols (TC), triglycerides (TG), high-density lipoprotein (HDL-C), non-high-density lipoprotein (Non-HDL-C), and low-density lipoprotein cholesterol (LDL-C), TC/HDL-C ratio, TG/HDL-C ratio, Non-HDL-C /HDL-C ratio and LDL-C/HDL-C ratio, which quartiles were treated as categorical variables, with the lowest quartile serving as the reference category. Three adjusted models were constructed to mitigate the influence of other variables. To ensure the robustness of the model, receiver operating characteristic (ROC) curves were used to calculate the cutoff values by analyzing the ROC curves. A sensitivity analysis was performed to validate the findings further.ResultsThe dataset encompasses information from 2092 individuals. After adjusting for potential factors that could influence the results, we found that TC (OR = 2.773, 95%CI: 1.805–4.26), Non-HDL-C (OR = 2.74, 95%CI: 1.7723–4.236), TC/HDL-C ratio (OR = 2.237, 95%CI: 1.445–3.463), Non-HDL-C/HDL-C ratio (OR = 2.357, 95%CI: 1.548–3.588), TG/HDL-C ratio (OR = 1.513, 95%CI: 1.02–2.245) acts as independent risk factors of LVH. ROC curve analysis revealed the predictive ability of blood lipids for LVH, with Non-HDL-C exhibiting area under the curve (AUC = 0.6109), followed by TC (AUC = 0.6084).ConclusionsTC, non-HDL-C, TC/HDL-C ratio, Non-HDL-C/HDL-C ratio, and TG/HDL-C ratio were independent risk factors of LVH in non-diabetic people. Non-HDL-C and TC were found to be essential indicators for predicting the prevalence of LVH.

Improved Accuracy of the Addenbrooke's Cognitive Examination-Revised in the Diagnosis of Mild Cognitive Impairment, Mild Dementia Due to Alzheimer's Disease and Behavioral Variant Frontotemporal Dementia Using Mokken Scale Analysis.

The Addenbrooke's Cognitive Examination-Revised (ACE-R) is an accessible cognitive tool that supports the early detection of mild cognitive impairment (MCI), Alzheimer's disease (AD), and behavioral variant frontotemporal dementia (bvFTD). To investigate the diagnostic efficacy of the ACE-R in MCI, AD, and bvFTD through the identification of novel coefficients for differentiation between these diseases. We assessed 387 individuals: 102 mild AD, 37 mild bvFTD, 87 with amnestic MCI patients, and 161 cognitively unimpaired controls. The Mokken scaling technique facilitated the extraction out of the 26 ACE-R items that exhibited a common latent trait, thereby generating the Mokken scales for the AD group and the MCI group. Subsequently, we performed logistic regression, integrating each Mokken scales with sociodemographic factors, to differentiate between AD and bvFTD, as well as between AD or MCI and control groups. Ultimately, the Receiver Operating Characteristic curve analysis was employed to assess the efficacy of the coefficient's discrimination. The AD-specific Mokken scale (AD-MokACE-R) versus bvFTD exhibited an Area Under the Curve (AUC) of 0.922 (88% sensitivity and specificity). The AD-MokACE-R versus controls achieved an AUC of 0.968 (93% sensitivity, 94% specificity). The MCI-specific scale (MCI-MokACE-R) versus controls demonstrated an AUC of 0.859 (78% sensitivity, 79% specificity). The ACE-R's capacity is enhanced through statistical methods and demographic integration, allowing for accurate differentiation between AD and bvFTD, as well as between MCI and controls. This new method not only reinforces its clinical value in early diagnosis but also surpasses traditional approaches noted in prior studies.

Differentially Expressed Blood ARLNC1 in Combination with PCA3/PSA have Reassuring Clinical Applications in the Early Diagnosis of Prostate Cancer in Iranians: A pilot study.

Prostate cancer (PCA) is the second most common malignancy in Western countries. Long non-coding RNAs are new markers in disease diagnosis. Our aim of this study was to investigate liquid biopsy biomarkers with high specificity and sensitivity for early diagnosis of PCA patients in Iran. Blood specimens were collected from 29 PCA, 32 benign prostate hyperplasia (BPH), and 29 control (CTRL) individuals. Real-time PCR analyzed expression amounts of PSA, ARLNC1, UCA1, and PCA3. The ROC curve (receiver operating characteristic curve) analysis evaluated the diagnostic power of the examined molecules for PCA. There was a significant upregulation of PCA3 in PCA and BPH groups compared to the controls (p values for PCA3=< 0.001 and BPH vs. CTRL = 0.0015) while there was no significant difference between PCA and BPH individuals. A significant upregulation of ARLNC1 was seen in BPH group compared to the controls (p value=0.0042). Also, PCA3 expression level showed a significant relationship with prostate volume. There was no significant difference in UCA1 and PSA expression levels among the three groups (>0.05). The PCA3/PSA ratio was significantly increased in PCA and BPH individuals vs. the CTRL group with high sensitivity and specificity. The gene expression of PCA3 and ARLNC1 in the BPH group showed a significant relationship with age. Our findings showed that in the diagnosis of prostate cancer, measuring the expression of PCA3, PSA, and ARLNC1 genes is necessary to determine the health, benign, or cancerous status of patients' prostate. Also, selecting the PCA3/PSA ratio provides a new approach for diagnosing this cancer if confirmed in a larger clinical sample size and functional studies.

Increased UBD Is a Potential Diagnostic and Prognostic Biomarker in Glioma.

Various studies have demonstrated that ubiquitin D (UBD) is overexpressed in different cancer types and may serve as a potential prognostic factor. However, additional research is necessary to establish the prognostic significance and possible role of UBD in glioma. Transcriptomic expression data from The Cancer Genome Atlas database (TCGA) and Chinese Glioma Genome Atlas (CGGA) were analyzed to identify UBD expression differences in tumor and normal tissues. The relative levels of UBD in glioma and normal tissues were determined using qRT-PCR and WB. Logistic regression analysis was performed to investigate the association between UBD expression and clinicopathological characteristics of glioma patients. To evaluate the diagnostic and prognostic predictive values of UBD, we used Kaplan-Meier survival curves, Cox regression analysis, diagnostic receiver operating characteristic (ROC) curves, and nomogram model. We also conducted wound healing assays, transwell assays, EdU assays, and colony formation assays to verify the UBD function. Gene ontology (GO) enrichment analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, as well as gene set enrichment analysis (GSEA), were employed to determine the functions of UBD. Finally, we performed the western blot assays to assess changes in EMT markers as well as p-PI3K, p-AKT, and p-mTOR expressions. Our study revealed a remarkable increase of UBD expression in glioma samples. Cox regression analysis demonstrated that high expression of UBD mRNA was an independent prognostic factor for overall survival (OS) in TCGA. ROC curve analysis showed that UBD expression levels could differentiate glioma from adjacent normal tissues accurately. Additionally, knockdown of UBD reduced the migration, invasion, and proliferation ability of glioma cells while UBD overexpression had the opposite effect. GSEA showed that the expression of UBD involved with various pathways including epithelial-mesenchymal transition (EMT), PI3K-AKT-mTOR signaling, P53 pathway, angiogenesis, inflammatory response, KRAS signaling, hypoxia, as well as TGF-β signaling. Furthermore, our findings suggest that UBD accelerates the activation of EMT and PI3K/AKT/mTOR pathway.