WorldWideScience

Sample records for prognostic score ips

  1. Evaluation of the International Prognostic Score (IPS-7) and a Simpler Prognostic Score (IPS-3) for advanced Hodgkin lymphoma in the modern era.

    Science.gov (United States)

    Diefenbach, Catherine S; Li, Hailun; Hong, Fangxin; Gordon, Leo I; Fisher, Richard I; Bartlett, Nancy L; Crump, Michael; Gascoyne, Randy D; Wagner, Henry; Stiff, Patrick J; Cheson, Bruce D; Stewart, Douglas A; Kahl, Brad S; Friedberg, Jonathan W; Blum, Kristie A; Habermann, Thomas M; Tuscano, Joseph M; Hoppe, Richard T; Horning, Sandra J; Advani, Ranjana H

    2015-11-01

    The International Prognostic Score (IPS-7) is the most commonly used risk stratification tool for advanced Hodgkin lymphoma (HL), however recent studies suggest the IPS-7 is less discriminating due to improved outcomes with contemporary therapy. We evaluated the seven variables for IPS-7 recorded at study entry for 854 patients enrolled on Eastern Cooperative Oncology Group 2496 trial. Univariate and multivariate Cox models were used to assess their prognostic ability for freedom from progression (FFP) and overall survival (OS). The IPS-7 remained prognostic however its prognostic range has narrowed. On multivariate analysis, two factors (age, stage) remained significant for FFP and three factors (age, stage, haemoglobin level) for OS. An alternative prognostic index, the IPS-3, was constructed using age, stage and haemoglobin level, which provided four distinct risk groups [FFP (P = 0·0001) and OS (P IPS-3 outperformed the IPS-7 on risk prediction for both FFP and OS by model fit and discrimination criteria. Using reclassification calibration, 18% of IPS-7 low risk patients were re-classified as intermediate risk and 13% of IPS-7 intermediate risk patients as low risk. For patients with advanced HL, the IPS-3 may provide a simpler and more accurate framework for risk assessment in the modern era. Validation of these findings in other large data sets is planned. © 2015 John Wiley & Sons Ltd.

  2. Decreased Prognostic Value of International Prognostic Score in Chinese Advanced Hodgkin Lymphoma Patients Treated in the Contemporary Era

    Directory of Open Access Journals (Sweden)

    Qin Wang

    2016-01-01

    Conclusions: The IPS has decreased the prognostic value in Chinese advanced HL patients treated in the contemporary era. More prognostic factors are needed to supplement this original scoring system so as to identify different risk populations more accurately.

  3. Comparison of Myelodysplastic Syndrome Prognostic Scoring Systems

    Science.gov (United States)

    Bektaş, Özlen; Üner, Ayşegül; Eliaçık, Eylem; Uz, Burak; Işık, Ayşe; Etgül, Sezgin; Bozkurt, Süreyya; Haznedaroğlu, İbrahim Celalettin; Göker, Hakan; Sayınalp, Nilgün; Aksu, Salih; Demiroğlu, Haluk; Özcebe, Osman İlhami; Büyükaşık, Yahya

    2016-01-01

    Objective: Myelodysplastic syndrome (MDS) is a clonal hematopoietic stem cell disease. Patients are at risk of developing cytopenias or progression to acute myeloid leukemia. Different classifications and prognostic scoring systems have been developed. The aim of this study was to compare the different prognostic scoring systems. Materials and Methods: One hundred and one patients who were diagnosed with primary MDS in 2003-2011 in a tertiary care university hospital’s hematology department were included in the study. Results: As the International Prognostic Scoring System (IPSS), World Health Organization Classification-Based Prognostic Scoring System (WPSS), MD Anderson Prognostic Scoring System (MPSS), and revised IPSS (IPSS-R) risk categories increased, leukemia-free survival and overall survival decreased (p<0.001). When the IPSS, WPSS, MPSS, and IPSS-R prognostic systems were compared by Cox regression analysis, the WPSS was the best in predicting leukemia-free survival (p<0.001), and the WPSS (p<0.001) and IPSS-R (p=0.037) were better in predicting overall survival. Conclusion: All 4 prognostic systems were successful in predicting overall survival and leukemia-free survival (p<0.001). The WPSS was found to be the best predictor for leukemia-free survival, while the WPSS and IPSS-R were found to be the best predictors for overall survival. PMID:26376664

  4. Comparison of Myelodysplastic Syndrome Prognostic Scoring Systems

    Directory of Open Access Journals (Sweden)

    Özlen Bektaş

    2016-05-01

    Full Text Available Objective: Myelodysplastic syndrome (MDS is a clonal hematopoietic stem cell disease. Patients are at risk of developing cytopenias or progression to acute myeloid leukemia. Different classifications and prognostic scoring systems have been developed. The aim of this study was to compare the different prognostic scoring systems. Materials and Methods: One hundred and one patients who were diagnosed with primary MDS in 2003-2011 in a tertiary care university hospital’s hematology department were included in the study. Results: As the International Prognostic Scoring System (IPSS, World Health Organization Classification-Based Prognostic Scoring System (WPSS, MD Anderson Prognostic Scoring System (MPSS, and revised IPSS (IPSS-R risk categories increased, leukemia-free survival and overall survival decreased (p<0.001. When the IPSS, WPSS, MPSS, and IPSS-R prognostic systems were compared by Cox regression analysis, the WPSS was the best in predicting leukemia-free survival (p<0.001, and the WPSS (p<0.001 and IPSS-R (p=0.037 were better in predicting overall survival. Conclusion: All 4 prognostic systems were successful in predicting overall survival and leukemia-free survival (p<0.001. The WPSS was found to be the best predictor for leukemia-free survival, while the WPSS and IPSS-R were found to be the best predictors for overall survival.

  5. Assessing calibration of prognostic risk scores.

    Science.gov (United States)

    Crowson, Cynthia S; Atkinson, Elizabeth J; Therneau, Terry M

    2016-08-01

    Current methods used to assess calibration are limited, particularly in the assessment of prognostic models. Methods for testing and visualizing calibration (e.g. the Hosmer-Lemeshow test and calibration slope) have been well thought out in the binary regression setting. However, extension of these methods to Cox models is less well known and could be improved. We describe a model-based framework for the assessment of calibration in the binary setting that provides natural extensions to the survival data setting. We show that Poisson regression models can be used to easily assess calibration in prognostic models. In addition, we show that a calibration test suggested for use in survival data has poor performance. Finally, we apply these methods to the problem of external validation of a risk score developed for the general population when assessed in a special patient population (i.e. patients with particular comorbidities, such as rheumatoid arthritis). © The Author(s) 2013.

  6. Prognostic factors and scoring system for survival in colonic perforation.

    Science.gov (United States)

    Komatsu, Shuhei; Shimomatsuya, Takumi; Nakajima, Masayuki; Amaya, Hirokazu; Kobuchi, Taketsune; Shiraishi, Susumu; Konishi, Sayuri; Ono, Susumu; Maruhashi, Kazuhiro

    2005-01-01

    No ideal and generally accepted prognostic factors and scoring systems exist to determine the prognosis of peritonitis associated with colonic perforation. This study was designed to investigate prognostic factors and evaluate the various scoring systems to allow identification of high-risk patients. Between 1996 and 2003, excluding iatrogenic and trauma cases, 26 consecutive patients underwent emergency operations for colorectal perforation and were selected for this retrospective study. Several clinical factors were analyzed as possible predictive factors, and APACHE II, SOFA, MPI, and MOF scores were calculated. The overall mortality was 26.9%. Compared with the survivors, non-survivors were found more frequently in Hinchey's stage III-IV, a low preoperative marker of pH, base excess (BE), and a low postoperative marker of white blood cell count, PaO2/FiO2 ratio, and renal output (24h). According to the logistic regression model, BE was a significant independent variable. Concerning the prognostic scoring systems, an APACHE II score of 19, a SOFA score of 8, an MPI score of 30, and an MOF score of 7 or more were significantly related to poor prognosis. Preoperative BE and postoperative white blood cell count were reliable prognostic factors and early classification using prognostic scoring systems at specific points in the disease process are useful to improve our understanding of the problems involved.

  7. Predicting Acute Pancreatitis Severity: Comparison of Prognostic Scores

    OpenAIRE

    Simoes, Marco; Alves, Patricia; Esperto, Helder; Canha, Catarina; Meira, Elisa; Ferreira, Erica; Gomes, Manuel; Fonseca, Isabel; Barbosa, Benilde; Costa, Jose Nascimento

    2011-01-01

    Background Acute pancreatitis has a broad clinical spectrum, from mild illness to multiple organ failure and death. Prognostic scores have been developed or adapted to predict disease severity. This study aimed to compare the prognostic scores according to sensitivity and specificity, receiver operating characteristic curves and area under the curve. Statistical correlation with disease severity, length of hospital stay, mortality and complication rates. Methods Retrospective analysis of the ...

  8. A simple prognostic scoring system for typhoid ileal perforation peritonitis.

    Science.gov (United States)

    Singh, Hemant; Mishra, Arpan; Sharma, Dhananjaya; Somashekar, Uday

    2010-10-01

    The increasing awareness of the worse than expected outcome after typhoid ileal perforation (TIP) prompted us to prospectively prognosticate patients with the help of the Jabalpur prognostic score (JPS), a simplified scoring system for peptic perforation peritonitis (PPP). Eighty-two consecutive patients with TIP were studied from May 2005 to August 2008 in the Department of Surgery, NSCB Government Medical College, Jabalpur (MP), India. Six parameters used in the JPS were recorded: age, heart rate, mean blood pressure, serum creatinine, any co-morbid illness and perforation-operation interval. JPS correlated with morbidity and mortality in TIP patients and, as the score increased, so did the morbidity and mortality. Survivors had a significantly lower mean score (3.86 ± 2.23) than non-survivors (7.94 ± 3.6; P PPP patients. JPS can be easily modified for TIP (JPS-TIP) and can be easily used for its prognostication.

  9. Propensity Score Matching within Prognostic Strata

    Science.gov (United States)

    Kelcey, Ben

    2013-01-01

    A central issue in nonexperimental studies is identifying comparable individuals to remove selection bias. One common way to address this selection bias is through propensity score (PS) matching. PS methods use a model of the treatment assignment to reduce the dimensionality of the covariate space and identify comparable individuals. parallel to…

  10. Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction

    OpenAIRE

    Correia, Luis C. L.; Guilherme Garcia; Felipe Kalil; Felipe Ferreira; Manuela Carvalhal; Ruan Oliveira; André Silva; Isis Vasconcelos; Caio Henri; Márcia Noya-Rabelo

    2014-01-01

    Background: The TIMI Score for ST-segment elevation myocardial infarction (STEMI) was created and validated specifically for this clinical scenario, while the GRACE score is generic to any type of acute coronary syndrome. Objective: Between TIMI and GRACE scores, identify the one of better prognostic performance in patients with STEMI. Methods: We included 152 individuals consecutively admitted for STEMI. The TIMI and GRACE scores were tested for their discriminatory ability (C-stati...

  11. Myelodysplastic syndromes: a scoring system with prognostic significance.

    Science.gov (United States)

    Mufti, G J; Stevens, J R; Oscier, D G; Hamblin, T J; Machin, D

    1985-03-01

    141 patients with MDS were classified according to the FAB criteria and followed up for a period of 4-192 months. It was recognized that patients with RAEBT had a uniformly poor prognosis. However, there was a wide variation in survival among the other subgroups. A score of 1 was assigned to each of the following presenting haematological features: bone marrow blasts greater than or equal to 5%, platelets less than or equal to 100 X 10(9)/l, neutrophils less than or equal to 2.5 X 10(9)/l and Hb less than or equal to 10.0 g/dl. Therefore the score for each patient ranged between 0 and 4. There were no statistically significant differences between those patients who scored 0 or 1, or between those who scored 2 and 3. Therefore patients were put into three groups: Group A (score 0 or 1), Group B (score 2 or 3), Group C (score 4). The differences in survival between each of the three groups are highly significant (P less than 0.00001). This system further separates patients with RA, RAS, RAEB into good and bad prognostic groups. This study also confirms that deaths due to cytopenias are more common than those due to transformation to AML. The use of this scoring system in conjunction with the FAB criteria for MDS should serve as a prognostic tool on which to base treatment.

  12. Thai venous stroke prognostic score: TV-SPSS.

    Science.gov (United States)

    Poungvarin, Niphon; Prayoonwiwat, Naraporn; Ratanakorn, Disya; Towanabut, Somchai; Tantirittisak, Tassanee; Suwanwela, Nijasri; Phanthumchinda, Kamman; Tiamkoa, Somsak; Chankrachang, Siwaporn; Nidhinandana, Samart; Laptikultham, Somsak; Limsoontarakul, Sansern; Udomphanthuruk, Suthipol

    2009-11-01

    Prognosis of cerebral venous sinus thrombosis (CVST) has never been studied in Thailand. A simple prognostic score to predict poor prognosis of CVST has also never been reported. The authors are aiming to establish a simple and reliable prognostic score for this condition. The medical records of CVST patients from eight neurological training centers in Thailand who received between April 1993 and September 2005 were reviewed as part of this retrospective study. Clinical features included headache, seizure, stroke risk factors, Glasgow coma scale (GCS), blood pressure on arrival, papilledema, hemiparesis, meningeal irritation sign, location of occluded venous sinuses, hemorrhagic infarction, cerebrospinal fluid opening pressure, treatment options, length of stay, and other complications were analyzed to determine the outcome using modified Rankin scale (mRS). Poor prognosis (defined as mRS of 3-6) was determined on the discharge date. One hundred ninety four patients' records, 127 females (65.5%) and mean age of 36.6 +/- 14.4 years, were analyzed Fifty-one patients (26.3%) were in the poor outcome group (mRS 3-6). Overall mortality was 8.4%. Univariate analysis and then multivariate analysis using SPSS version 11.5 revealed only four statistically significant predictors influencing outcome of CVST They were underlying malignancy, low GCS, presence of hemorrhagic infarction (for poor outcome), and involvement of lateral sinus (for good outcome). Thai venous stroke prognostic score (TV-SPSS) was derived from these four factors using a multiple logistic model. A simple and pragmatic prognostic score for CVST outcome has been developed with high sensitivity (93%), yet low specificity (33%). The next study should focus on the validation of this score in other prospective populations.

  13. Does the modified Glasgow Prognostic Score (mGPS) have a prognostic role in esophageal cancer?

    Science.gov (United States)

    Walsh, Siun M; Casey, Sarah; Kennedy, Raymond; Ravi, Narayanasamy; Reynolds, John V

    2016-06-01

    The modified Glasgow Prognostic Score (mGPS), which combines indices of decreased plasma albumin and elevated CRP, has reported independent prognostic significance in colorectal cancer, but its value in upper gastrointestinal cancer is unclear. The aim of this study was to assess the prognostic significance of mGPS in patients with operable esophageal malignancy. Patients undergoing resection with curative intent between January 2008 and June 2013 were included. The mGPS was scored as 0, 1, or 2 based on CRP(>10 mg/L) and albumin(<35g/L). The mGPS score (0 vs. 1/2 combined) was correlated with patient and tumor characteristics, and operative and oncologic outcomes. Two hundred and twenty-three patients were included. Median (range) follow-up was 21(12-70) months. The mGPS was 0 in 174 patients(78%). mGPS was significantly associated with positive nodal status(P = 0.008) and stage ≥III (P = 0.017). There was a significant improvement in overall survival in patients with mGPS = 0 (47.8 vs. 37.5 months, P = 0.014) but in multivariate analysis, only TNM-stage and nodal status were found to be independent prognostic indicators. mGPS is associated with advanced stage but has no independent prognostic significance and does not impact on operative outcomes. Consequently, this data does not support its routine application in patient selection or prognostication. J. Surg. Oncol. 2016;113:732-737. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  14. [Prognostic value of GRACE scores versus TIMI score in acute coronary syndromes].

    Science.gov (United States)

    Correia, Luis C L; Freitas, Rafael; Bittencourt, Ana P; Souza, Alexandre C; Almeida, Maria C; Leal, Jamile; Esteves, José Péricles

    2010-05-01

    Although the TIMI score is the one most frequently used in acute coronary syndromes (ACS) without ST-segment elevation, the GRACE score has potential prognostic superiority, as it was created based on an observational registry, part of the variables is treated in a semi-quantitative form and renal function is taken into account in its calculation. To test the hypothesis that the GRACE risk score has superior in-hospital prognostic value, when compared to the TIMI score in patients admitted with ACS. Individuals with unstable angina or myocardial infarction without ST-segment elevation, consecutively admitted at the Coronary Unit between August 2007 and January 2009, were included in the study. A total of 154 patients aged 71 +/- 13 years, of which 56% were females, with a GRACE median of 117 and a TIMI median of 3 were studied. During the hospitalization period, the incidence of events was 8.4% (12 deaths and 1 non-fatal infarction). The Hosmer-Lemeshow test applied to the GRACE score presented an chi2 of 5.3 (P = 0.72), whereas the TIMI score presented an chi2 of 1.85 (P = 0.60). Therefore, both scores presented good calibration. As for the analysis of discrimination, the GRACE score presented a C-statistics of 0.91 (95%CI= 0.86 - 0.97), significantly superior to the C-statistics of 0.69 of the TIMI score (95%CI = 0.55 - 0.84) - P = 0.02 for the difference between the scores. Regarding the prediction of hospital events in patients with ACS, the GRACE score has superior prognostic capacity when compared to the TIMI score.

  15. Prognostic value of TIMI score versus GRACE score in ST-segment elevation myocardial infarction.

    Science.gov (United States)

    Correia, Luis C L; Garcia, Guilherme; Kalil, Felipe; Ferreira, Felipe; Carvalhal, Manuela; Oliveira, Ruan; Silva, André; Vasconcelos, Isis; Henri, Caio; Noya-Rabelo, Márcia

    2014-08-01

    The TIMI Score for ST-segment elevation myocardial infarction (STEMI) was created and validated specifically for this clinical scenario, while the GRACE score is generic to any type of acute coronary syndrome. Between TIMI and GRACE scores, identify the one of better prognostic performance in patients with STEMI. We included 152 individuals consecutively admitted for STEMI. The TIMI and GRACE scores were tested for their discriminatory ability (C-statistics) and calibration (Hosmer-Lemeshow) in relation to hospital death. The TIMI score showed equal distribution of patients in the ranges of low, intermediate and high risk (39 %, 27 % and 34 %, respectively), as opposed to the GRACE Score that showed predominant distribution at low risk (80 %, 13 % and 7%, respectively). Case-fatality was 11%. The C-statistics of the TIMI score was 0.87 (95%CI = 0.76 to 0.98), similar to GRACE (0.87, 95%CI = 0.75 to 0.99) - p = 0.71. The TIMI score showed satisfactory calibration represented by χ2 = 1.4 (p = 0.92), well above the calibration of the GRACE score, which showed χ2 = 14 (p = 0.08). This calibration is reflected in the expected incidence ranges for low, intermediate and high risk, according to the TIMI score (0 %, 4.9 % and 25 %, respectively), differently to GRACE (2.4%, 25% and 73%), which featured middle range incidence inappropriately. Although the scores show similar discriminatory capacity for hospital death, the TIMI score had better calibration than GRACE. These findings need to be validated populations of different risk profiles.

  16. Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Luis C. L. Correia

    2014-08-01

    Full Text Available Background: The TIMI Score for ST-segment elevation myocardial infarction (STEMI was created and validated specifically for this clinical scenario, while the GRACE score is generic to any type of acute coronary syndrome. Objective: Between TIMI and GRACE scores, identify the one of better prognostic performance in patients with STEMI. Methods: We included 152 individuals consecutively admitted for STEMI. The TIMI and GRACE scores were tested for their discriminatory ability (C-statistics and calibration (Hosmer-Lemeshow in relation to hospital death. Results: The TIMI score showed equal distribution of patients in the ranges of low, intermediate and high risk (39 %, 27 % and 34 %, respectively, as opposed to the GRACE Score that showed predominant distribution at low risk (80 %, 13 % and 7%, respectively. Case-fatality was 11%. The C-statistics of the TIMI score was 0.87 (95%CI = 0.76 to 0.98, similar to GRACE (0.87, 95%CI = 0.75 to 0.99 - p = 0.71. The TIMI score showed satisfactory calibration represented by χ2 = 1.4 (p = 0.92, well above the calibration of the GRACE score, which showed χ2 = 14 (p = 0.08. This calibration is reflected in the expected incidence ranges for low, intermediate and high risk, according to the TIMI score (0 %, 4.9 % and 25 %, respectively, differently to GRACE (2.4%, 25% and 73%, which featured middle range incidence inappropriately. Conclusion: Although the scores show similar discriminatory capacity for hospital death, the TIMI score had better calibration than GRACE. These findings need to be validated populations of different risk profiles.

  17. Prognostic Value of Gai′s Plaque Score and Agatston Coronary Artery Calcium Score for Functionally Significant Coronary Artery Stenosis

    OpenAIRE

    Chuang Zhang; Shuang Yang; Lu-Yue Gai; Zhi-Qi Han; Qian Xin; Xiao-Bo Yang; Jun-Jie Yang; Qin-Hua Jin

    2016-01-01

    Background: The prognostic values of the coronary computed tomography angiography (CCTA) score for predicting future cardiovascular events have been previously demonstrated in numerous studies. However, few studies have used the rich information available from CCTA to detect functionally significant coronary lesions. We sought to compare the prognostic values of Gai's plaque score and the coronary artery calcium score (CACS) of CCTA for predicting functionally significant coronary lesions, us...

  18. Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin's lymphoma: a report from a joint Italian-Danish study

    DEFF Research Database (Denmark)

    Loft, Annika; Gallamini, Andrea; Hutchings, Martin

    2007-01-01

    PURPOSE: Starting from November 2001, 260 newly diagnosed patients with Hodgkin's lymphoma (HL) were consecutively enrolled in parallel Italian and Danish prospective trials to evaluate the prognostic role of an early interim 2-[(18)F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET...... the prognostic value of IPS and emerges as the single most important tool for planning of risk-adapted treatment in advanced HL.......-PET) scan and the International Prognostic Score (IPS) in advanced HL, treated with conventional ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) therapy. PATIENTS AND METHODS: Most patients (n = 190) presented with advanced disease (stages IIB through IVB), whereas 70 presented in stage IIA...

  19. Validation of the prognostic value of histologic scoring systems in primary sclerosing cholangitis

    DEFF Research Database (Denmark)

    de Vries, Elisabeth M G; de Krijger, Manon; Färkkilä, Martti

    2017-01-01

    Histologic scoring systems specific for primary sclerosing cholangitis (PSC) are not validated. We recently determined the applicability and prognostic value of three histological scoring systems in a single PSC cohort. The aim of this study was to validate their prognostic use and reproducibility...

  20. A prognostic scoring system for arm exercise stress testing

    National Research Council Canada - National Science Library

    Xie, Yan; Xian, Hong; Chandiramani, Pooja; Bainter, Emily; Wan, Leping; Martin, 3rd, Wade H

    2016-01-01

    ...% for patients unable to perform leg exercise. Thus, our objective was to develop an arm exercise ECG stress test scoring system, analogous to the Duke Treadmill Score, for predicting outcome in these individuals...

  1. Prognostic Value of Gai's Plaque Score and Agatston Coronary Artery Calcium Score for Functionally Significant Coronary Artery Stenosis.

    Science.gov (United States)

    Zhang, Chuang; Yang, Shuang; Gai, Lu-Yue; Han, Zhi-Qi; Xin, Qian; Yang, Xiao-Bo; Yang, Jun-Jie; Jin, Qin-Hua

    2016-12-05

    The prognostic values of the coronary computed tomography angiography (CCTA) score for predicting future cardiovascular events have been previously demonstrated in numerous studies. However, few studies have used the rich information available from CCTA to detect functionally significant coronary lesions. We sought to compare the prognostic values of Gai's plaque score and the coronary artery calcium score (CACS) of CCTA for predicting functionally significant coronary lesions, using fractional flow reserve (FFR) as the gold standard. We retrospectively analyzed 107 visually assessed significant coronary lesions in 88 patients (mean age, 59.6 ± 10.2 years; 76.14% of males) who underwent CCTA, invasive coronary angiography, and invasive FFR measurement. An FFR significant coronary stenosis. Lesions were divided into two groups using an FFR cutoff value of 0.80. We compared Gai's plaque scores and CACS between the two groups and evaluated the correlations of these scores with FFR. The statistical methods included unpaired t-test, Mann-Whitney U-test, and Spearman's correlation coefficients. Coronary lesions with FFR Gai's scores than those with FFR ≥0.80. Gai's score had the strongest correlation with FFR (r = -0.48, P arteries and a single artery. Both CACS in a single artery and Gai's plaque score demonstrated a good capacity to assess functionally significant coronary artery stenosis when compared to the gold standard FFR. However, Gai's plaque score was more predictive of FFR Gai's score can be easily calculated in daily clinical practice and could be used when considering revascularization.

  2. Prognostic Gleason grade grouping: data based on the modified Gleason scoring system

    Science.gov (United States)

    Pierorazio, Phillip M.; Walsh, Patrick C.; Partin, Alan W.; Epstein, Jonathan I.

    2014-01-01

    Objective • To investigate pathological and short-term outcomes since the most recent Gleason system modifications by the International Society of Urological Pathology (ISUP) in an attempt to divide the current Gleason grading system into prognostically accurate Gleason grade groups. Patients and Methods • We queried the Johns Hopkins Radical Prostatectomy Database (1982–2011), approved by the institutional review board, for men undergoing radical prostatectomy (RP) without a tertiary pattern since 2004 and identified 7869 men. • Multivariable models were created using preoperative and postoperative variables; prognostic grade group (Gleason grade ≤6; 3 + 4; 4 + 3; 8; 9–10) was among the strongest predictors of biochemical recurrence-free (BFS) survival. Results • Significant differences were noted among the Gleason grade groups at biopsy; differences were noted in the race, PSA level, clinical stage, number of positive cores at biopsy and the maximum percentage of positive cores among the Gleason grade groups at RP. • With a median (range) follow-up of 2 (1–7) years, 5-year BFS rates for men with Gleason grade ≤6, 3 + 4, 4 + 3, 8 and 9–10 tumours at biopsy were 94.6, 82.7, 65.1, 63.1 and 34.5%, respectively (P Gleason grading system for prostate carcinoma accurately categorize patients by pathological findings and short-term biochemical outcomes but, while retaining the essence of the Gleason system, there is a need for a change in its reporting to more closely reflect tumour behaviour. • We propose reporting Gleason grades, including prognostic grade groups which accurately reflect prognosis as follows: Gleason score ≤6 (prognostic grade group I); Gleason score 3+4=7 (prognostic grade group II); Gleason score 4+3=7 (prognostic grade group III); Gleason score 4+4=8 (prognostic grade group (IV); and Gleason score 9–10 (prognostic grade group (V). PMID:23464824

  3. A prognostic scoring system for arm exercise stress testing.

    Science.gov (United States)

    Xie, Yan; Xian, Hong; Chandiramani, Pooja; Bainter, Emily; Wan, Leping; Martin, Wade H

    2016-01-01

    Arm exercise stress testing may be an equivalent or better predictor of mortality outcome than pharmacological stress imaging for the ≥50% for patients unable to perform leg exercise. Thus, our objective was to develop an arm exercise ECG stress test scoring system, analogous to the Duke Treadmill Score, for predicting outcome in these individuals. In this retrospective observational cohort study, arm exercise ECG stress tests were performed in 443 consecutive veterans aged 64.1 (11.1) years. (mean (SD)) between 1997 and 2002. From multivariate Cox models, arm exercise scores were developed for prediction of 5-year and 12-year all-cause and cardiovascular mortality and 5-year cardiovascular mortality or myocardial infarction (MI). Arm exercise capacity in resting metabolic equivalents (METs), 1 min heart rate recovery (HRR) and ST segment depression ≥1 mm were the stress test variables independently associated with all-cause and cardiovascular mortality by step-wise Cox analysis (all pArm exercise scores for the other outcome end points yielded C-statistic values of 0.77-0.79 before and 0.82-0.86 after adjustment for significant covariates versus 0.64-0.72 for best fit pharmacological myocardial perfusion imaging models in a cohort of 1730 veterans who were evaluated over the same time period. Arm exercise scores, analogous to the Duke Treadmill Score, have good power for prediction of mortality or MI in patients who cannot perform leg exercise.

  4. Prognostic factors and a survival score for patients with metastatic spinal cord compression from colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Rades, D.; Douglas, S.; Huttenlocher, S. [Luebeck Univ. (Germany). Dept. of Radiation Oncology; Veninga, T. [Dr. Bernard Verbeeten Institute, Tilburg (Netherlands). Dept. of Radiation Oncology; Bajrovic, A. [University Medical Center Eppendorf, Hamburg (Germany). Dept. of Radiation Oncology; Rudat, V. [Saad Specialist Hospital Al-Khobar (Saudi Arabia). Dept. of Radiation Oncology; Schild, S.E. [Mayo Clinic, Scottsdale, AZ (United States). Dept. of Radiation Oncology

    2012-12-15

    Background: This study aimed to identify independent prognostic factors and to create a survival score for patients with metastatic spinal cord compression (MSCC) from colorectal cancer (CRC). Patients and methods: Data from 121 patients irradiated for MSCC from CRC were retrospectively analyzed. Eleven potential prognostic factors were investigated including tumor type, age, gender, Eastern Cooperative Oncology Group performance status score (ECOG-PS), number of involved vertebrae, ambulatory status prior to radiotherapy (RT), other bone metastases, visceral metastases, interval from cancer diagnosis to RT of MSCC, time of developing motor deficits prior to RT, and the RT schedule. Results: On multivariate analysis, improved motor function was significantly associated with an ECOG-PS of 1-2 (p = 0.011) and a slower development of motor deficits (p < 0.001). Improved local control was significantly associated with absence of visceral metastases (p = 0.043) and longer-course RT (p = 0.008). Improved survival was significantly associated with an ECOG-PS of 1-2 (p < 0.001), ambulatory status (p < 0.001), absence of visceral metastases (p < 0.001), and a slower development of motor deficits (p = 0.047). These four prognostic factors were included in a survival score. The score for each factor was determined by dividing the 6-month survival rate by 10. The prognostic score represented the sum of the factor scores. Four prognostic groups were designed; the 6-month survival rates were 0% for 8-12 points, 26% for 13-18 points, 62% for 20-23 points, and 100% for 24-27 points (p < 0.001). Conclusion: This study identified several independent prognostic factors for treatment outcomes in patients irradiated for MSCC from CRC. The survival prognosis of these patients can be estimated with a new score. (orig.)

  5. A Survey of Attitudes towards the Clinical Application of Systemic Inflammation Based Prognostic Scores in Cancer

    Directory of Open Access Journals (Sweden)

    David G. Watt

    2015-01-01

    Full Text Available Introduction. The systemic inflammatory response (SIR plays a key role in determining nutritional status and survival of patients with cancer. A number of objective scoring systems have been shown to have prognostic value; however, their application in routine clinical practice is not clear. The aim of the present survey was to examine the range of opinions internationally on the routine use of these scoring systems. Methods. An online survey was distributed to a target group consisting of individuals worldwide who have reported an interest in systemic inflammation in patients with cancer. Results. Of those invited by the survey (n=238, 65% routinely measured the SIR, mainly for research and prognostication purposes and clinically for allocation of adjuvant therapy or palliative chemotherapy. 40% reported that they currently used the Glasgow Prognostic Score/modified Glasgow Prognostic Score (GPS/mGPS and 81% reported that a measure of systemic inflammation should be incorporated into clinical guidelines, such as the definition of cachexia. Conclusions. The majority of respondents routinely measured the SIR in patients with cancer, mainly using the GPS/mGPS for research and prognostication purposes. The majority reported that a measure of the SIR should be adopted into clinical guidelines.

  6. Fuzzy logic-based prognostic score for outcome prediction in esophageal cancer.

    Science.gov (United States)

    Wang, Chang-Yu; Lee, Tsair-Fwu; Fang, Chun-Hsiung; Chou, Jyh-Horng

    2012-11-01

    Given the poor prognosis of esophageal cancer and the invasiveness of combined modality treatment, improved prognostic scoring systems are needed. We developed a fuzzy logic-based system to improve the predictive performance of a risk score based on the serum concentrations of C-reactive protein (CRP) and albumin in a cohort of 271 patients with esophageal cancer before radiotherapy. Univariate and multivariate survival analyses were employed to validate the independent prognostic value of the fuzzy risk score. To further compare the predictive performance of the fuzzy risk score with other prognostic scoring systems, time-dependent receiver operating characteristic curve (ROC) analysis was used. Application of fuzzy logic to the serum values of CRP and albumin increased predictive performance for 1-year overall survival (AUC=0.773) compared with that of a single marker (AUC=0.743 and 0.700 for CRP and albumin, respectively), where the AUC denotes the area under curve. This fuzzy logic-based approach also performed consistently better than the Glasgow Prognostic Score (GPS) (AUC=0.745). Thus, application of fuzzy logic to the analysis of serum markers can more accurately predict the outcome for patients with esophageal cancer.

  7. Clinical gestalt versus prognostic scores for prognostication of patients with acute symptomatic pulmonary embolism.

    Science.gov (United States)

    Quezada, Carlos Andrés; Zamarro, Celia; Gómez, Vicente; Guerassimova, Ina; Nieto, Rosa; Barbero, Esther; Chiluiza, Diana; Barrios, Deisy; Morillo, Raquel; Jiménez, David

    2017-12-21

    To determine the accuracy of clinical gestalt to identify patients with acute symptomatic pulmonary embolism (PE) at low-risk for short-term complications. This study included a total of 154 consecutive patients diagnosed with acute symptomatic PE in a tertiary university hospital. We compared the prognostic accuracy of the Pulmonary Embolism Severity Index (PESI), the simplified PESI (sPESI), and clinical gestalt of 1) 2senior physicians (one with and one without experience in the management of patients with PE), 2) a fourth-year resident of Pneumology, 3) a third-year resident of Pneumology, and 4) a second-year resident of Pneumology. The primary outcome was all-cause mortality during the first month after the diagnosis of PE. Thirty-day all-cause mortality was 8.4% (13/154; 8.4%; 95% confidence interval [CI], 4.1-12.8%). The PESI and clinical gestalt classified more patients as low-risk, compared to the sPESI (36.4%, 31.3% y 28.6%, respectively). There were no deaths in the sPESI low-risk category (negative predictive value 100%). Prognostic accuracy increased with increasing experience (84.6 vs. 92.3%; P=.049). The sPESI showed the best accuracy at correctly identifying low-risk patients with acute symptomatic PE. Clinical gestalt is not inferior to standardized clinical prediction rules to prognosticate patients with acute PE. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  8. The Basilar Artery on Computed Tomography Angiography Prognostic Score for Basilar Artery Occlusion.

    Science.gov (United States)

    Alemseged, Fana; Shah, Darshan G; Diomedi, Marina; Sallustio, Fabrizio; Bivard, Andrew; Sharma, Gagan; Mitchell, Peter J; Dowling, Richard J; Bush, Steven; Yan, Bernard; Caltagirone, Carlo; Floris, Roberto; Parsons, Mark W; Levi, Christopher R; Davis, Stephen M; Campbell, Bruce C V

    2017-03-01

    Basilar artery occlusion is associated with high risk of disability and mortality. This study aimed to assess the prognostic value of a new radiological score: the Basilar Artery on Computed Tomography Angiography (BATMAN) score. A retrospective analysis of consecutive stroke patients with basilar artery occlusion diagnosed on computed tomographic angiography was performed. BATMAN score is a 10-point computed tomographic angiography-based grading system which incorporates thrombus burden and the presence of collaterals. Reliability was assessed with intraclass coefficient correlation. Good outcome was defined as modified Rankin Scale score of ≤3 at 3 months and successful reperfusion as thrombolysis in cerebral infarction 2b-3. BATMAN score was externally validated and compared with the Posterior Circulation Collateral score. The derivation cohort included 83 patients with 41 in the validation cohort. In receiver operating characteristic (ROC) analysis, BATMAN score had an area under receiver operating characteristic curve of 0.81 (95% confidence interval [CI], 0.7-0.9) in derivation cohort and an area under receiver operating characteristic curve of 0.74 (95% CI, 0.6-0.9) in validation cohort. In logistic regression adjusted for age and clinical severity, BATMAN score of BATMAN score of BATMAN score had greater accuracy compared with Posterior Circulation Collateral score ( P =0.04). The addition of collateral quality to clot burden in BATMAN score seems to improve prognostic accuracy in basilar artery occlusion patients. © 2017 American Heart Association, Inc.

  9. Development and validation of a prognostic score during tuberculosis treatment.

    Science.gov (United States)

    Pefura-Yone, Eric Walter; Balkissou, Adamou Dodo; Poka-Mayap, Virginie; Fatime-Abaicho, Hadja Koté; Enono-Edende, Patrick Thierry; Kengne, André Pascal

    2017-04-08

    Death under care is a major challenge for tuberculosis (TB) treatment programs. We derived and validated a simple score to predict mortality during tuberculosis treatment in high endemicity areas. We used data for patients aged ≥15 years, diagnosed and treated for tuberculosis at the Yaounde Jamot Hospital between January 2012 and December 2013. Baseline characteristics associated with mortality were investigated using logistic regressions. A simple prognosis score (CABI) was constructed with regression coefficients for predictors in the final model. Internal validation used bootstrap resampling procedures. Models discrimination was assessed using c-statistics and calibration assessed via calibration plots and the Hosmer and Lemeshwow (H-L) statistics. The optimal score was based on the Youden's index. A total of 2250 patients (men 57.2%) with a mean age of 35.8 years were included; among whom 213 deaths (cumulative incidence 9.5%) were recorded. Clinical form of tuberculosis (C), age (A, years), adjusted body mass index (B, BMI, kg/m 2 ) and status for HIV (Human immunodefiency virus) infection (I) were significant predictors in the final model (p < 0.0001) which was of the form Death risk = 1/(1 + e - (-1.3120 + 0.0474 ∗ age - 0.1866 ∗ BMI + 1.1637 (if smear negative TB) + 0.5418(if extra - pulmonary TB) + 1.3820(if HIV+)) ). The c-statistic was 0.812 in the derivation sample and 0.808 after correction for optimism. The calibration was good [H-Lχ 2  = 6.44 (p = 0.60)]. The optimal absolute risk threshold was 4.8%, corresponding to a sensitivity of 81% and specificity of 67%. The preliminary promising findings from this study require confirmation through independent external validation studies. If confirmed, the model derived could facilitate the stratification of TB patients for mortality risk and implementation of additional monitoring and management measures in vulnerable patients.

  10. Integrative prognostic risk score in acute myeloid leukemia with normal karyotype

    National Research Council Canada - National Science Library

    Damm, Frederik; Heuser, Michael; Morgan, Helen; Wagner, Katharina; Görlich, Kerstin; Großhennig, Anika; Hamwi, Iyas; Thol, Felicitas; Surdziel, Ewa; Fiedler, Walter; Lübbert, Michael; Kanz, Lothar; Reuter, Christoph; Heil, Gerhard; Delwel, Ruud; Löwenberg, Bob; Valk, Peter; Krauter, J; Ganser, Arnold

    2011-01-01

    .... Integrative prognostic risk score (IPRS) was modeled in 181 patients based on age, white blood cell count, mutation status of NPM1, FLT3-ITD, CEBPA, single nucleotide polymorphism rs16754, and expression levels of BAALC, ERG, MN1, and WT1...

  11. Outcome prediction in gastroschisis - The gastroschisis prognostic score (GPS) revisited.

    Science.gov (United States)

    Puligandla, Pramod S; Baird, Robert; Skarsgard, Eric D; Emil, Sherif; Laberge, Jean-Martin

    2017-05-01

    The GPS enables risk stratification for gastroschisis and helps discriminate low from high morbidity groups. The purpose of this study was to revalidate GPS's characterization of a high morbidity group and to quantify relationships between the GPS and outcomes. With REB approval, complete survivor data from a national gastroschisis registry was collected. GPS bowel injury scoring was revalidated excluding the initial inception/validation cohorts (>2011). Length of stay (LOS), 1st enteral feed days (dFPO), TPN days (dTPN), and aggregate complications (COMP) were compared between low and high morbidity risk groups. Mathematical relationships between outcomes and integer increases in GPS were explored using the entire cohort (2005-present). Median (range) LOS, dPO, and dTPN for the entire cohort (n=849) was 36 (26,62), 13 (9,18), and 27 (20,46) days, respectively. High-risk patients (GPS≥2; n=80) experienced significantly worse outcomes than low risk patients (n=263). Each integer increase in GPS was associated with increases in LOS and dTPN by 16.9 and 12.7days, respectively (pGPS effectively discriminates low from high morbidity risk groups. Within the high risk group, integer increases in GPS produce quantitatively differentiated outcomes which may guide initial counseling and resource allocation. IIb. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Prediction of surgical outcome in compressive cervical myelopathy: A novel clinicoradiological prognostic score

    Directory of Open Access Journals (Sweden)

    Rishi Anil Aggarwal

    2016-01-01

    Full Text Available Context: Preoperative severity of myelopathy, age, and duration of symptoms have been shown to be highly predictive of the outcome in compressive cervical myelopathy (CCM. The role of radiological parameters is still controversial. Aims: Define the prognostic factors in CCM and formulate a prognostic score to predict the outcome following surgery in CCM. Settings and Design: Retrospective. Materials and Methods: This study included 78 consecutive patients with CCM treated surgically. The modified Japanese Orthopaedic Association (mJOA scale was used to quantify severity of myelopathy at admission and at 12-month follow-up. The outcome was defined as "good" if the patient had mJOA score ≥16 and "poor" if the score was <16. Age, sex, duration of symptoms, comorbidities, intrinsic hand muscle wasting (IHMW, diagnosis, surgical technique, Torg ratio, instability on dynamic radiographs, and magnetic resonance imaging (MRI signal intensity changes were assessed. Statistics: Statistical Package for the Social Sciences (SPSS (version 20.0 was used for statistical analysis. The association was assessed amongst variables using logistic regression analysis. Parameters having a statistically significant correlation with the outcome were included in formulating a prognostic score. Results: Severity of myelopathy, IHMW, age, duration, diabetes, and instability on radiographs were predictive of the outcome with a P value <0.01. Genders, diagnosis, surgical procedure, Torg ratio, and intensity changes on MRI were not significantly related to the outcome. A 8-point scoring system was devised incorporating the significant clinicoradiological parameters, and it was found that nearly all patients (97.82% with a score below 5 had good outcome and all patients (100% with a score above 5 had poor outcome. The outcome is difficult to predict with a score of 5. Conclusions: Clinical parameters are better predictors of the outcome as compared to radiological findings

  13. Prognostic scoring system for peripheral nerve repair in the upper extremity.

    Science.gov (United States)

    Galanakos, Spyridon P; Zoubos, Aristides B; Mourouzis, Iordanis; Ignatiadis, Ioannis; Bot, Arjan G J; Soucacos, Panayotis N

    2013-02-01

    So far, predictive models with individualized estimates of prognosis for patients with peripheral nerve injuries are lacking. Our group has previously shown the prognostic value of a standardized scoring system by examining the functional outcome after acute, sharp complete laceration and repair of median and/or ulnar nerves at various levels in the forearm. In the present study, we further explore the potential mathematical model in order to devise an effective prognostic scoring system. We retrospectively collected medical record data of 73 cases with a peripheral nerve injury in the upper extremity in order to estimate which patients would return to work, and what time was necessary to return to the pre-injury work. Postoperative assessment followed the protocol described by Rosén and Lundborg. We found that return to pre-injury work can be predicted with high sensitivity (100%) and specificity (95%) using the total numerical score of the Rosén and Lundborg protocol at the third follow-up interval (TS3) as well as the difference between the TS3 and the total score at second follow-up interval (TS2). In addition, the factors age and type of injured nerve (median, ulnar, or combined) can determine the time of return to work based on a mathematical model. This prognostic protocol can be a useful tool to provide information about the functional and social prospects of the patients with these types of injuries. Copyright © 2012 Wiley Periodicals, Inc.

  14. Prognostic impact of absolute lymphocyte count/absolute monocyte count ratio and prognostic score in patients with nasal-type, extranodal natural killer/T-cell lymphoma.

    Science.gov (United States)

    Li, Na; Zhang, Li; Song, Hao-Lan; Zhang, Jing; Weng, Hua-Wei; Zou, Li-Qun

    2017-05-01

    Nasal-type, extranodal natural killer/T-cell lymphoma is a heterogeneous disorder with poor prognosis, requiring risk stratification in this population. The combined value of baseline absolute lymphocyte count and absolute monocyte count provided prognostic information in some malignancies. However, the evidence requires validation in extranodal natural killer/T-cell lymphoma. Aiming to investigate the prognostic significance of absolute lymphocyte count/absolute monocyte count ratio and absolute lymphocyte count/absolute monocyte count prognostic score for extranodal natural killer/T-cell lymphoma, a retrospective research was carried out. A total of 264 patients with newly diagnosed extranodal natural killer/T-cell lymphoma were analyzed in this study. The patients' absolute lymphocyte count and absolute monocyte count tested at initial diagnosis were collected. Receiver operating curve analysis showed that the optimal cut-off values for absolute lymphocyte count and absolute monocyte count were 1.0 × 10(9) and 0.5 × 10(9)L(-1), respectively, and for absolute lymphocyte count/absolute monocyte count ratio was 2.85. After a median follow-up of 27 months (range 1-87 months), the 3-year overall survival and progression-free survival was 75.4% and 67.6%, respectively. Patients with absolute lymphocyte count/absolute monocyte count ratio ≥ 2.85 had better 3-year overall survival and progression-free survival than those with absolute lymphocyte count/absolute monocyte count ratio lymphocyte count/absolute monocyte count prognostic score, significant difference has been noticed in 3-year overall survival and progression-free survival (p lymphocyte count/absolute monocyte count prognostic score was associated with poorer survival. The International Prognostic Index and Korean Prognostic Index were used for prognosis and showed no significant difference. When adding absolute lymphocyte count/absolute monocyte count ratio and absolute lymphocyte count/absolute monocyte

  15. A combined pulmonary function and emphysema score prognostic index for staging in Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Boutou, Afroditi K; Nair, Arjun; Douraghi-Zadeh, Dariush; Sandhu, Ranbir; Hansell, David M; Wells, Athol U; Polkey, Michael I; Hopkinson, Nicholas S

    2014-01-01

    Chronic Obstructive Pulmonary Disease (COPD) is characterized by high morbidity and mortality. Lung computed tomography parameters, individually or as part of a composite index, may provide more prognostic information than pulmonary function tests alone. To investigate the prognostic value of emphysema score and pulmonary artery measurements compared with lung function parameters in COPD and construct a prognostic index using a contingent staging approach. Predictors of mortality were assessed in COPD outpatients whose lung computed tomography, spirometry, lung volumes and gas transfer data were collected prospectively in a clinical database. Univariate and multivariate Cox proportional hazard analysis models with bootstrap techniques were used. 169 patients were included (59.8% male, 61.1 years old; Forced Expiratory Volume in 1 second % predicted: 40.5±19.2). 20.1% died; mean survival was 115.4 months. Age (HR = 1.098, 95% Cl = 1.04-1.252) and emphysema score (HR = 1.034, 95% CI = 1.007-1.07) were the only independent predictors of mortality. Pulmonary artery dimensions were not associated with survival. An emphysema score of 55% was chosen as the optimal threshold and 30% and 65% as suboptimals. Where emphysema score was between 30% and 65% (intermediate risk) the optimal lung volume threshold, a functional residual capacity of 210% predicted, was applied. This contingent staging approach separated patients with an intermediate risk based on emphysema score alone into high risk (Functional Residual Capacity ≥210% predicted) or low risk (Functional Residual Capacity Emphysema score-Functional Residual Capacity index might provide a better separation of high and low risk patients with COPD, than other individual predictors alone.

  16. Circulating levels of GH predict mortality and complement prognostic scores in critically ill medical patients.

    Science.gov (United States)

    Schuetz, Philipp; Müller, Beat; Nusbaumer, Charly; Wieland, Melanie; Christ-Crain, Mirjam

    2009-02-01

    Circulating levels of GH are increased during critical illness and correlate with outcome in children with meningococcal sepsis. We assessed the prognostic implications of GH on admission and during follow-up in critically ill adult patients admitted to a medical intensive care unit. We measured GH, IGF1 and IGF-binding protein3 (IGFBP-3) plasma concentrations in 103 consecutive critically ill patients and compared it with two clinical severity scores (APACHE II, SAPS II). Median GH levels on admission were similar in septic (n=53) and non-septic (n=50) patients and about 7-fold increased in the 24 non-survivors as compared with survivors (9.50 (interquartile ranges (IQR) 3.53-18.40) vs 1.4 (IQR 0.63-5.04), PAPACHE II: AUC 0.71 (95% CI, 0.58-0.83), P=0.16, SAPS II: AUC 0.75 (95% CI, 0.63-0.86, P=0.36)). GH improved the prognostic accuracy of the APACHE II score to an AUC of 0.78 (95% CI, 0.66-090, P=0.04) and tended to improve the SAPS II score to an AUC of 0.79 (95% CI, 0.67-0.90, P=0.09). GH plasma concentrations on admission are independent predictors for mortality in adult critically ill patients and may complement existing risk prediction scores, namely the APACHE II and the SAPS II score.

  17. Increased Prognostic Value of Query Amyloid Late Enhancement Score in Light-Chain Cardiac Amyloidosis.

    Science.gov (United States)

    Wan, Ke; Sun, Jiayu; Han, Yuchi; Liu, Hong; Yang, Dan; Li, Weihao; Wang, Jie; Cheng, Wei; Zhang, Qing; Zeng, Zhi; Chen, Yucheng

    2017-11-02

    Late gadolinium enhancement (LGE) pattern is a powerful imaging biomarker for prognosis of cardiac amyloidosis. It is unknown if the query amyloid late enhancement (QALE) score in light-chain (AL) amyloidosis could provide increased prognostic value compared with LGE pattern.Methods and Results:Seventy-eight consecutive patients with AL amyloidosis underwent contrast-enhanced cardiovascular magnetic resonance imaging. Patients with cardiac involvement were grouped by LGE pattern and analyzed using QALE score. Receiver operating characteristic curve was used to identify the optimal cut-off for QALE score in predicting all-cause mortality. Survival of these patients was analyzed with the Kaplan-Meier method and multivariate Cox regression. During a median follow-up of 34 months, 53 of 78 patients died. The optimal cut-off for QALE score to predict mortality at 12-month follow-up was 9.0. On multivariate Cox analysis, QALE score ≥9 (HR, 5.997; 95% CI: 2.665-13.497; P<0.001) and log N-terminal pro-brain natriuretic peptide (HR, 1.525; 95% CI: 1.112-2.092; P=0.009) were the only 2 independent predictors of all-cause mortality. On Kaplan-Meier analysis, patients with subendocardial LGE can be further risk stratified using QALE score ≥9. The QALE scoring system provides powerful independent prognostic value in AL cardiac amyloidosis. QALE score ≥9 has added value to differentiate prognosis in AL amyloidosis patients with a subendocardial LGE pattern.

  18. A Novel Prognostic Scoring System Using Inflammatory Response Biomarkers for Esophageal Squamous Cell Carcinoma.

    Science.gov (United States)

    Hirahara, Noriyuki; Tajima, Yoshitsugu; Fujii, Yusuke; Yamamoto, Tetsu; Hyakudomi, Ryoji; Hirayama, Takanori; Taniura, Takahito; Ishitobi, Kazunari; Kidani, Akihiko; Kawabata, Yasunari

    2017-07-25

    We describe a novel scoring system, namely the inflammatory response biomarker (IRB) score. The aim of this study is to evaluate the clinical value of IRB score in patients undergoing curative resection for esophageal squamous cell carcinoma (SCC). We retrospectively reviewed patients who underwent curative esophagectomy. We evaluated IRB score in both non-elderly (4), a high neutrophil-to-lymphocyte ratio (NLR) (>1.6), and a low platelet-to-lymphocyte ratio (PLR) (<147) were each scored as 1, and the remaining values were scored as 0; the individual scores were then summed to produce the IRB score (range 0-3). Univariate analyses demonstrated that the TNM pStage (p < 0.0001), tumor size (p = 0.002), LMR (p = 0.0057), PLR (p = 0.0328) and IRB score (p = 0.0003) were significant risk factors for a worse prognosis. On multivariate analysis, the TNM pStage (p < 0.0001) and IRB score (p = 0.0227) were independently associated with worse prognosis in overall patients. Among non-elderly patients, multivariate analyses demonstrated that the pStage (p = 0.0015) and IRB score (p = 0.0356) were independent risk factors for a worse prognosis. Among elderly patients, multivariate analysis demonstrated that the pStage (p = 0.0016), and IRB score (p = 0.0102) were independent risk factors for a worse prognosis. The present study provides evidence that the preoperative IRB score can be considered a promising independent prognostic factor of cancer-specific survival in patients undergoing curative resection for SCC, and that its predictive ability is useful in both non-elderly and elderly patients.

  19. Validation of a prognostic score for early mortality in severe head injury cases.

    Science.gov (United States)

    Gómez, Pedro A; de-la-Cruz, Javier; Lora, David; Jiménez-Roldán, Luis; Rodríguez-Boto, Gregorio; Sarabia, Rosario; Sahuquillo, Juan; Lastra, Roberto; Morera, Jesus; Lazo, Eglis; Dominguez, Jaime; Ibañez, Javier; Brell, Marta; de-la-Lama, Adolfo; Lobato, Ramiro D; Lagares, Alfonso

    2014-12-01

    Traumatic brain injury (TBI) represents a large health and economic burden. Because of the inability of previous randomized controlled trials (RCTs) on TBI to demonstrate the expected benefit of reducing unfavorable outcomes, the IMPACT (International Mission on Prognosis and Analysis of Clinical Trials in TBI) and CRASH (Corticosteroid Randomisation After Significant Head Injury) studies provided new methods for performing prognostic studies of TBI. This study aimed to develop and externally validate a prognostic model for early death (within 48 hours). The secondary aim was to identify patients who were more likely to succumb to an early death to limit their inclusion in RCTs and to improve the efficiency of RCTs. The derivation cohort was recruited at 1 center, Hospital 12 de Octubre, Madrid (1990-2003, 925 patients). The validation cohort was recruited in 2004-2006 from 7 study centers (374 patients). The eligible patients had suffered closed severe TBIs. The study outcome was early death (within 48 hours post-TBI). The predictors were selected using logistic regression modeling with bootstrapping techniques, and a penalized reduction was used. A risk score was developed based on the regression coefficients of the variables included in the final model. In the validation set, the final model showed a predictive ability of 50% (Nagelkerke R(2)), with an area under the receiver operating characteristic curve of 89% and an acceptable calibration (goodness-of-fit test, p = 0.32). The final model included 7 variables, and it was used to develop a risk score with a range from 0 to 20 points. Age provided 0, 1, 2, or 3 points depending on the age group; motor score provided 0 points, 2 (untestable), or 3 (no response); pupillary reactivity, 0, 2 (1 pupil reacted), or 6 (no pupil reacted); shock, 0 (no) or 2 (yes); subarachnoid hemorrhage, 0 or 1 (severe deposit); cisternal status, 0 or 3 (compressed/absent); and epidural hematoma, 0 (yes) or 2 (no). Based on the risk

  20. Does C-reactive Protein Add Prognostic Value to GRACE Score in Acute Coronary Syndromes?

    Energy Technology Data Exchange (ETDEWEB)

    Correia, Luis Cláudio Lemos, E-mail: lccorreia@terra.com.br; Vasconcelos, Isis; Garcia, Guilherme; Kalil, Felipe; Ferreira, Felipe; Silva, André; Oliveira, Ruan; Carvalhal, Manuela; Freitas, Caio; Noya-Rabelo, Márcia Maria [Escola Bahiana de Medicina e Saúde Pública, Salvador, BA (Brazil); Hospital São Rafael, Salvador, BA (Brazil)

    2014-05-15

    The incremental prognostic value of plasma levels of C-reactive protein (CRP) in relation to GRACE score has not been established in patients with acute coronary syndrome (ACS) with non-ST segment elevation. To test the hypothesis that CRP measurements at admission increases the prognostic value of GRACE score in patients with ACS. A total of 290 subjects, consecutively admitted for ACS, with plasma material obtained upon admission CRP measurement using a high-sensitivity method (nephelometry) were studied. Cardiovascular outcomes during hospitalization were defined by the combination of death, nonfatal myocardial infarction or nonfatal refractory angina. The incidence of cardiovascular events during hospitalization was 15% (18 deaths, 11 myocardial infarctions, 13 angina episodes) with CRP showing C-statistics of 0.60 (95% CI = 0.51-0.70, p = 0.034) in predicting these outcomes. After adjustment for the GRACE score, elevated CRP (defined as the best cutoff point) tended to be associated with hospital events (OR = 1.89, 95% CI = 0.92 to 3.88, p = 0.08). However, the addition of the variable elevated CRP in the GRACE model did not result in significant increase in C-statistics, which ranged from 0.705 to 0.718 (p = 0.46). Similarly, there was no significant reclassification of risk with the addition of CRP in the predictor model (net reclassification = 5.7 %, p = 0.15). Although CRP is associated with hospital outcomes, this inflammatory marker does not increase the prognostic value of the GRACE score.

  1. Performance of four ischemic stroke prognostic scores in a Brazilian population

    Directory of Open Access Journals (Sweden)

    Gustavo W. Kuster

    2016-02-01

    Full Text Available ABSTRACT Objective Ischemic stroke (IS prognostic scales may help clinicians in their clinical decisions. This study aimed to assess the performance of four IS prognostic scales in a Brazilian population. Method We evaluated data of IS patients admitted at Hospital Paulistano, a Joint Commission International certified primary stroke center. In-hospital mortality and modified Rankin score at discharge were defined as the outcome measures. The performance of National Institutes of Health Stroke Scale (NIHSS, Stroke Prognostication Using Age and NIHSS (SPAN-100, Acute Stroke Registry and Analysis of Lausanne (ASTRAL, and Totaled Health Risks in Vascular Events (THRIVE were compared. Results Two hundred six patients with a mean ± SD age of 67.58 ± 15.5 years, being 55.3% male, were included. The four scales were significantly and independently associated functional outcome. Only THRIVE was associated with in-hospital mortality. With area under the curve THRIVE and NIHSS were the scales with better performance for functional outcome and THRIVE had the best performance for mortality. Conclusion THRIVE showed the best performance among the four scales, being the only associated with in-hospital mortality.

  2. Prognostic Utility of a New mRNA Expression Signature of Gleason Score.

    Science.gov (United States)

    Sinnott, Jennifer A; Peisch, Sam F; Tyekucheva, Svitlana; Gerke, Travis; Lis, Rosina; Rider, Jennifer R; Fiorentino, Michelangelo; Stampfer, Meir J; Mucci, Lorelei A; Loda, Massimo; Penney, Kathryn L

    2017-01-01

    Gleason score strongly predicts prostate cancer mortality; however, scoring varies among pathologists, and many men are diagnosed with intermediate-risk Gleason score 7. We previously developed a 157-gene signature for Gleason score using a limited gene panel. Using a new whole-transcriptome expression dataset, we verified the previous signature's performance and developed a new Gleason signature to improve lethal outcome prediction among men with Gleason score 7. We generated mRNA expression data from prostate tumor tissue from men in the Physicians' Health Study and Health Professionals Follow-Up Study (N = 404) using the Affymetrix Human Gene 1.0 ST microarray. The Prediction Analysis for Microarrays method was used to develop a signature to distinguish high (≥8) versus low (≤6) Gleason score. We evaluated the signature's ability to improve prediction of lethality among men with Gleason score 7, adjusting for 3 + 4/4 + 3 status, by quantifying the area under the receiver operating characteristic (ROC) curve (AUC). We identified a 30-gene signature that best distinguished Gleason score ≤6 from ≥8. The AUC to predict lethal disease among Gleason score 7 men was 0.76 [95% confidence interval (CI), 0.67-0.84] compared with 0.68 (95% CI, 0.59-0.76) using 3 + 4/4 + 3 status alone (P = 0.0001). This signature was a nonsignificant (P = 0.09) improvement over our previous signature (AUC = 0.72). Our new 30-gene signature improved prediction of lethality among men with Gleason score 7. This signature can potentially become a useful prognostic tool for physicians to improve treatment decision making. Clin Cancer Res; 23(1); 81-87. ©2016 AACRSee related commentary by Yin et al., p. 6. ©2016 American Association for Cancer Research.

  3. Bicarbonate can improve the prognostic value of the MELD score for critically ill patients with cirrhosis.

    Science.gov (United States)

    Chen, Cheng-Yi; Pan, Chi-Feng; Wu, Chih-Jen; Chen, Han-Hsiang; Chen, Yu-Wei

    2014-07-01

    The prognosis of critically ill patients with cirrhosis is poor. Our aim was to identify an objective variable that can improve the prognostic value of the Model of End-Stage Liver Disease (MELD) score in patients who have cirrhosis and are admitted to the intensive care unit (ICU). This retrospective cohort study included 177 patients who had liver cirrhosis and were admitted to the ICU. Data pertaining to arterial blood gas-related parameters and other variables were obtained on the day of ICU admission. The overall ICU mortality rate was 36.2%. The bicarbonate (HCO3) level was found to be an independent predictor of ICU mortality (odds ratio, 2.3; 95% confidence interval [CI], 1.0-4.8; p = 0.038). A new equation was constructed (MELD-Bicarbonate) by replacing total bilirubin by HCO3 in the original MELD score. The area under the receiver operating characteristic curve for predicting ICU mortality was 0.76 (95% CI, 0.69-0.84) for the MELD-Bicarbonate equation, 0.73 (95% CI, 0.65-0.81) for the MELD score, and 0.71 (95% CI, 0.63-0.80) for the Acute Physiology and Chronic Health Evaluation II score. Bicarbonate level assessment, as an objective and reproducible laboratory test, has significant predictive value in critically ill patients with cirrhosis. In contrast, the predictive value of total bilirubin is not as prominent in this setting. The MELD-Bicarbonate equation, which included three variables (international normalized ratio, creatinine level, and HCO3 level), showed better prognostic value than the original MELD score in critically ill patients with cirrhosis.

  4. 30-Day Mortality in Acute Pulmonary Embolism: Prognostic Value of Clinical Scores and Anamnestic Features.

    Directory of Open Access Journals (Sweden)

    Andreas Gunter Bach

    Full Text Available Identification of high-risk patients with pulmonary embolism is vital. The aim of the present study was to examine clinical scores, their single items, and anamnestic features in their ability to predict 30-day mortality.A retrospective, single-center study from 06/2005 to 01/2010 was performed. Inclusion criteria were presence of pulmonary embolism, availability of patient records and 30-day follow-up. The following clinical scores were calculated: Acute Physiology and Chronic Health Evaluation II, original and simplified pulmonary embolism severity index, Glasgow Coma Scale, and euroSCORE II.In the study group of 365 patients 39 patients (10.7% died within 30 days due to pulmonary embolism. From all examined scores and parameters the best predictor of 30-day mortality were the Glasgow Coma scale (≤ 10 and parameters of the circulatory system including presence of mechanical ventilation, arterial pH (< 7.335, and systolic blood pressure (< 99 mm Hg.Easy to ascertain circulatory parameters have the same or higher prognostic value than the clinical scores that were applied in this study. From all clinical scores studied the Glasgow Coma Scale was the most time- and cost-efficient one.

  5. Prognostic value of serum biomarkers in association with TIMI risk score for acute coronary syndromes.

    Science.gov (United States)

    Manenti, Euler R E; Bodanese, Luiz Carlos; Camey, Suzi Alves; Polanczyk, Carisi A

    2006-09-01

    Markers of neurohormonal activation and inflammation play a pivotal role in non-ST-elevation acute coronary syndromes (NSTE-ACS). We hypothesized that other biochemical markers could add prognostic value on Thrombolysis In Myocardial Infarction (TIMI) risk score to predict major cardiovascular events in patients with NSTE-ACS. In a cohort of 172 consecutive patients with NSTE-ACS, TIMI score was assessed in the first 24 h, and blood samples were collected for measurement of N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein, CD40 ligand, and creatinine. Major clinical outcomes (death and cardiovascular hospitalization) were accessed at 30 days and 6 months. Multivariate logistic regression was applied to identify markers significantly associated with outcomes and, based on individual coefficients, an expanded score was developed. Of 172 patients, 42% had acute myocardial infarction. The unadjusted 30-day event rate increased with age (odds ratio [OR] = 1.03; 95% confidence interval [CI] 1.00-1.06), creatinine (OR = 2.4; 1.4-4.1), TIMI score (OR = 1.6; 1.2-2.2), troponin I (OR = 3.4; 1.5-7.7), total CK (OR = 2.7; 1.2-6.1), and NT-proBNP (OR = 2.9; 1.3-6.3) levels. In multivariate analysis, TIMI risk score, creatinine, and NT-proBNP remained associated with worse prognosis. Multimarker Expanded TIMI Risk Score [TIMI score + (2 X creatinine [in mg/dl]) + (3, if NT-proBNP > 400 pg/ml)] showed good accuracy for 30-day (c statistic 0.77; p score were 7, 26, and 75%, respectively (p TIMI risk score provide a better risk stratification than either test alone.

  6. Development and validation of a prognostic scoring system for patients with chronic myelomonocytic leukemia.

    Science.gov (United States)

    Such, Esperanza; Germing, Ulrich; Malcovati, Luca; Cervera, José; Kuendgen, Andrea; Della Porta, Matteo G; Nomdedeu, Benet; Arenillas, Leonor; Luño, Elisa; Xicoy, Blanca; Amigo, Mari L; Valcarcel, David; Nachtkamp, Kathrin; Ambaglio, Ilaria; Hildebrandt, Barbara; Lorenzo, Ignacio; Cazzola, Mario; Sanz, Guillermo

    2013-04-11

    The natural course of chronic myelomonocytic leukemia (CMML) is highly variable but a widely accepted prognostic scoring system for patients with CMML is not available. The main aim of this study was to develop a new CMML-specific prognostic scoring system (CPSS) in a large series of 558 patients with CMML (training cohort, Spanish Group of Myelodysplastic Syndromes) and to validate it in an independent series of 274 patients (validation cohort, Heinrich Heine University Hospital, Düsseldorf, Germany, and San Matteo Hospital, Pavia, Italy). The most relevant variables for overall survival (OS) and evolution to acute myeloblastic leukemia (AML) were FAB and WHO CMML subtypes, CMML-specific cytogenetic risk classification, and red blood cell (RBC) transfusion dependency. CPSS was able to segregate patients into 4 clearly different risk groups for OS (P FAB and WHO subtypes, recognizes the importance of RBC transfusion dependency and cytogenetics, and offers a simple and powerful CPSS for accurately assessing prognosis and planning therapy in patients with CMML.

  7. Moderate precision of prognostic scoring systems in a consecutive, prospective cohort of 544 patients with metastatic spinal cord compression

    DEFF Research Database (Denmark)

    Morgen, Søren Schmidt; Nielsen, Dennis Hallager; Larsen, Claus Falck

    2014-01-01

    cohort of patients with metastatic spinal cord compression (MSCC). METHODS: In 2011, we conducted a prospective cohort study of 544 patients who were consecutively admitted with MSCC to one treatment facility. Patients estimated survival were assessed with the Tokuhashi Revised score and the Tomita score...... and compared to the observed survival. We assessed how precise the scoring systems predicted survival with McNemar's test. The prognostic value was illustrated with Kaplan-Meier curves, and the individual prognostic components were analyzed with Cox regression analysis. RESULTS: The mean age was 65 years...

  8. Prognostic value of plasma and urine glycosaminoglycan scores in clear cell renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Francesco Gatto

    2016-11-01

    Full Text Available The prognosis of metastatic clear cell renal cell carcinoma (ccRCC vastly improved since the introduction of antiangiogenic targeted therapy. However, it is still unclear which biological processes underlie ccRCC aggressiveness and affect prognosis. Here, we checked whether a recently discovered systems biomarker based on plasmatic or urinary measurements of glycosaminoglycans aggregated into diagnostic scores correlated with ccRCC prognosis.Thirty-one patients with a diagnosis of ccRCC (23 metastatic were prospectively enrolled and their urine and plasma biomarker scores were correlated to progression-free survival (PFS and overall survival (OS as either a dichotomous (Low vs. High or a continuous variable in a multivariate survival analysis.The survival difference between High vs. Low-scored patients was significant in the case of urine scores (2-year PFS rate = 53.3% vs. 100%, p = 310-4 and 2-year OS rate = 73.3% vs. 100%, p = 0.0078 and in the case of OS for plasma scores (2-year PFS rate = 60% vs. 84%, p = 0.0591 and 2-year OS rate = 66.7% vs. 90%, p = 0.0206. In multivariate analysis, the urine biomarker score was an independent predictor of PFS (HR: 4.62, 95% CI: 1.66 to 12.83, p = 0.003 and OS (HR: 10.13, 95% CI: 1.80 to 57.04, p = 0.009.This is the first report on an association between plasma or urine GAG scores and the prognosis of ccRCC patients. Prospective trials validating the prognostic and predictive role of this novel systems biomarker are warranted.

  9. Comparison of scores for bimodality of gene expression distributions and genome-wide evaluation of the prognostic relevance of high-scoring genes

    Science.gov (United States)

    2010-01-01

    Background A major goal of the analysis of high-dimensional RNA expression data from tumor tissue is to identify prognostic signatures for discriminating patient subgroups. For this purpose genome-wide identification of bimodally expressed genes from gene array data is relevant because distinguishability of high and low expression groups is easier compared to genes with unimodal expression distributions. Recently, several methods for the identification of genes with bimodal distributions have been introduced. A straightforward approach is to cluster the expression values and score the distance between the two distributions. Other scores directly measure properties of the distribution. The kurtosis, e.g., measures divergence from a normal distribution. An alternative is the outlier-sum statistic that identifies genes with extremely high or low expression values in a subset of the samples. Results We compare and discuss scores for bimodality for expression data. For the genome-wide identification of bimodal genes we apply all scores to expression data from 194 patients with node-negative breast cancer. Further, we present the first comprehensive genome-wide evaluation of the prognostic relevance of bimodal genes. We first rank genes according to bimodality scores and define two patient subgroups based on expression values. Then we assess the prognostic significance of the top ranking bimodal genes by comparing the survival functions of the two patient subgroups. We also evaluate the global association between the bimodal shape of expression distributions and survival times with an enrichment type analysis. Various cluster-based methods lead to a significant overrepresentation of prognostic genes. A striking result is obtained with the outlier-sum statistic (p genes with heavy tails generate subgroups of patients with different prognosis. Conclusions Genes with high bimodality scores are promising candidates for defining prognostic patient subgroups from expression

  10. Meningioma surgery in the very old-validating prognostic scoring systems.

    Science.gov (United States)

    Konglund, Ane; Rogne, Siril G; Helseth, Eirik; Meling, Torstein R

    2013-12-01

    Several studies acknowledge a higher risk of morbidity and mortality following intracranial meningioma surgery in the elderly, yet there is no consensus with regards to risk factors. Four prognostic scoring systems have been proposed. To evaluate their usefulness, we assess the very old meningioma patients in our neuro-oncological database according to the four methods, and correlate the findings with mortality and morbidity. We retrospectively calculated scores according to the Clinical-Radiological Grading System (CRGS), the Sex, Karnofsky Performance Scale, American Society of Anesthesiology Class, Location of Tumor, and Peritumoral Edema grading system (SKALE), the Geriatric Scoring System (GSS) and the Charlson Comorbidity Index (CCI) from all patients aged 80-90 years who had primary surgery for intracranial meningiomas 2003-2013 (n = 51), and related our findings to morbidity and mortality. The mortality rates were 3.9 %, 5.9 % and 15.7 % at 30-days, 3-months and 1-year post-surgery. The rate of complications requiring surgery was 13.7 %, 5.9 % had evacuation of intracerebral hematomas and two patients (3.9 %) had surgery for intracranial infection/osteitis. 15.7 % of the patients were neurologically worsened on discharge. The patients with SKALE scores ≤ 8 had significantly increased mortality rates. The GSS, the CRGS and the CCI were not found to correlate with mortality. Retrospectively evaluating four proposed scoring systems, we find that the SKALE score reflects the mortality at 1 month and 1 year following primary surgery for intracranial meningiomas in our very old patients. It may represent a helpful adjunct to their preoperative assessment.

  11. Prognostic performance of critical care scores in patients undergoing transcatheter aortic valve implantation.

    Science.gov (United States)

    Georgiadou, Panagiota; Analitis, Antonis; Sbarouni, Eftihia; Voudris, Vassilis

    2016-08-01

    Critical care management of patients undergoing transcatheter aortic valve implantation (TAVI) is a major determinant of their outcome. The aim of this study was to compare the prognostic performance of four general scoring systems [Acute Physiology and Chronic Health Evaluation (APACHE), Simplified Acute Physiology Score (SAPS), Sequential Organ Failure Assessment (SOFA), and MultiOrgan Dysfunction (MOD) scores] in TAVI patients. Between 1 June 2008 and 30 June 2014, 75 patients (81.2 ± 6.4 years old, 36 men and 39 women) who underwent TAVI were scored during the first 24 h of their stay at the intensive care unit (ICU). The outcome measures were in-hospital and 30-day mortality and in-hospital and 30-day morbidity defined as myocardial infarction, implantation of permanent pacemaker, stroke, tamponade, major bleeding, vascular access site complications and prolonged ventilation. Four patients (5.3%) died in ICU and one more during follow-up, indicating a 30-day mortality rate of 6.6%. Regarding in-hospital mortality, the area under the ROC curve (AUC) was 0.92 for SAPS II, 0.88 for APACHE II, 0.73 for MODS and 0.74 for SOFA. Regarding 30 day-mortality, SAPS II and APACHE II performed equally higher (AUC = 0.88) than the other two scores (0.79 for MODS and 0.80 for SOFA). SAPS II had the best calibration among all four scores for in-hospital and 30-day mortality ( χ 2  = 3.06 and χ 2  = 3.29, respectively). AUCs for in-hospital and 30-day morbidity were above 0.7 for SAPS II and APACHE II. SAPS II and APACHE II are reliable mortality and morbidity risk stratification models for TAVI patients with high calibration and discrimination.

  12. Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics has received considerable attention recently as an emerging sub-discipline within SHM. Prognosis is here strictly defined as “predicting the time at...

  13. A new Leukemia Prognostic Scoring System for refractory/relapsed adult acute myelogeneous leukaemia patients: a GOELAMS study.

    Science.gov (United States)

    Chevallier, P; Labopin, M; Turlure, P; Prebet, T; Pigneux, A; Hunault, M; Filanovsky, K; Cornillet-Lefebvre, P; Luquet, I; Lode, L; Richebourg, S; Blanchet, O; Gachard, N; Vey, N; Ifrah, N; Milpied, N; Harousseau, J-L; Bene, M-C; Mohty, M; Delaunay, J

    2011-06-01

    A simplified prognostic score is presented based on the multivariate analysis of 138 refractory/relapsed acute myeloid leukaemia (AML) patients (median age 55 years, range: 19-70) receiving a combination of intensive chemotherapy+Gemtuzumab as salvage regimen. Overall, 2-year event-free survival (EFS) and overall survival (OS) were 29±4% and 36±4%, respectively. Disease status (relapse Leukemia Prognostic Scoring System was then validated on an independent cohort of 111 refractory/relapsed AML patients. This new simplified prognostic score, using three clinical and biological parameters routinely applied, allow to discriminate around two third of the patients who should benefit from a salvage intensive regimen in the setting of refractory/relapsed AML patients. The other one third of the patients should receive investigational therapy.

  14. Improved risk stratification by the integration of the revised international prognostic scoring system with the myelodysplastic syndromes comorbidity index.

    Science.gov (United States)

    van Spronsen, M F; Ossenkoppele, G J; Holman, R; van de Loosdrecht, A A

    2014-12-01

    Myelodysplastic syndromes (MDS) comprise bone marrow failure diseases with a diverse clinical outcome. For improved risk stratification, the International Prognostic Scoring System (IPSS) has recently been revised (IPSS-R). This single-centre study aimed to validate the IPSS-R and to evaluate prior prognostic scoring systems for MDS. We retrospectively analysed 363 patients diagnosed with MDS according to the FAB criteria between 2000 and 2012. The IPSS, MD Anderson Risk Model Score (MDAS), World Health Organisation (WHO)-classification based Prognostic Scoring System (WPSS), refined WPSS (WPSS-R), IPSS-R and MDS-Comorbidity Index (MDS-CI) were applied to 222 patients considered with primary MDS following the WHO criteria and their prognostic power was investigated. According to the IPSS-R, 18 (8%), 81 (37%), 50 (23%), 43 (19%) and 30 (13%) patients were classified as very low, low, intermediate, high and very high risk with, respectively, a median overall survival of 96 (95% Confidence interval (CI) not reached), 49 (95% CI 34-64), 22 (95% CI 0-49), 19 (95% CI 11-27) and 10 (95% CI 6-13) months (pMDS-CI refined the risk stratification of MDS patients stratified according to the IPSS-R. In conclusion, accounting for the disease status by means of the IPSS-R and comorbidity through the MDS-CI considerably improves the prognostic assessment in MDS patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Application of different prognostic scoring systems and comparison of the FAB and WHO classifications in Korean patients with myelodysplastic syndrome.

    Science.gov (United States)

    Lee, J-H; Lee, J-H; Shin, Y-R; Lee, J-S; Kim, W-K; Chi, H-S; Park, C-J; Seo, E-J; Lee, K-H

    2003-02-01

    We retrospectively studied 227 patients with MDS (1) to identify the prognostic factors of survival and acute leukemia evolution in Korean patients with MDS, (2) to apply different prognostic scoring systems to the same group of patients, and (3) to compare the FAB with the WHO classification. Six scoring systems were applied to the patients, and the FAB and WHO classifications were compared. The patients' median age was 57 years. The median survival time was 21 months, and age, dysgranulopoiesis and the IPSS cytogenetic groups were independent prognostic factors for survival. Acute leukemia occurred in 34 patients, and the cumulative incidence was 27.1% at 3 years. Marrow blast percentage was the only independent prognostic factor for acute leukemia evolution. Most scoring systems successfully discriminated risk groups for survival and acute leukemia evolution, but patient distribution into risk groups varied according to the scoring systems. Refractory cytopenia with multilineage dysplasia and RAEB II seemed to have different prognoses from RA or RARS and RAEB I, respectively. In summary, our MDS patients had different disease natures from those of Western countries regarding clinical features, prognostic factors and cytogenetic profiles. Although the WHO classification seems to improve the FAB classification, further studies are warranted to validate the utility of the WHO classification before it is accepted for routine clinical use. Our study has the limitations of retrospective analysis, and our results should be verified in future prospective studies.

  16. Prognostic scoring systems for mortality in intensive care units--the APACHE model.

    Science.gov (United States)

    Niewiński, Grzegorz; Starczewska, Małgorzata; Kański, Andrzej

    2014-01-01

    The APACHE (Acute Physiology and Chronic Health Evaluation) scoring system is time consuming. The mean time for introducing a patient's data to APACHE IV is 37.3 min. Nevertheless, statisticians have known for years that the higher the number of variables the mathematical model describes, the more accurate the model. Because of the necessity of gathering data over a 24-hour period and of determining one cause for ICU admission, the system is troublesome and prone to mistakes. The evolution of the APACHE scoring system is an example of unfulfilled hopes for accurately estimating the risk of death for patients admitted to the ICU; satisfactory prognostic effects resulting from the use of APACHE II and III have been recently studied in patients undergoing liver transplantations. Because no increase in the predictive properties of successive versions has been observed, the search for other solutions continues. The APACHE IV scoring system is helpful; however, its use without prepared spreadsheets is almost impractical. Therefore, although many years have passed since its original publication, APACHE II or its extension APACHE III is currently used in clinical practice.

  17. Development and performance of a diagnostic/prognostic scoring system for breakthrough pain

    Directory of Open Access Journals (Sweden)

    Samolsky Dekel BG

    2017-05-01

    Full Text Available Boaz Gedaliahu Samolsky Dekel,1–3 Marco Palma,4 Maria Cristina Sorella,1–3 Alberto Gori,3 Alessio Vasarri,3 Rita Maria Melotti1–3 1Department of Medicine and Surgery Sciences, University of Bologna, 2Department of Emergency-Urgency, Bologna’s University Teaching Hospital, Policlinic S. Orsola-Malpighi, 3University of Bologna, Post Graduate School of Anaesthesia and Intensive Care, 4Collegio Superiore, Istituto di Studi Superiori – ISS, University of Bologna, Bologna, Italy Objectives: Variable prevalence and treatment of breakthrough pain (BTP in different clinical contexts are partially due to the lack of reliable/validated diagnostic tools with prognostic capability. We report the statistical basis and performance analysis of a novel BTP scoring system based on the naïve Bayes classifier (NBC approach and an 11-item IQ-BTP validated questionnaire. This system aims at classifying potential BTP presence in three likelihood classes: “High,” “Intermediate,” and “Low.”Methods: Out of a training set of n=120 mixed chronic pain patients, predictors associated with the BTP likelihood variables (Pearson’s χ2 and/or Fisher’s exact test were employed for the NBC planning. Adjusting the binary classification to a three–likelihood classes case enabled the building of a scoring algorithm and to retrieve the score of each predictor’s answer options and the Patient’s Global Score (PGS. The latter medians were used to establish the NBC thresholds, needed to evaluate the scoring system performance (leave-one-out cross-validation.Results: Medians of PGS in the “High,” “Intermediate,” and “Low” likelihood classes were 3.44, 1.53, and −2.84, respectively. Leading predictors for the model (based on score differences were flair frequency (∆S=1.31, duration (∆S=5.25, and predictability (∆S=1.17. Percentages of correct classification were 63.6% for the “High” and of 100.0% for either the “Intermediate” and

  18. Q fever pneumonia in French Guiana: prevalence, risk factors, and prognostic score.

    Science.gov (United States)

    Epelboin, Loïc; Chesnais, Cédric; Boullé, Charlotte; Drogoul, Anne-Sophie; Raoult, Didier; Djossou, Félix; Mahamat, Aba

    2012-07-01

    Community-acquired pneumonia (CAP) is the major manifestation of Q fever, an emerging disease in French Guiana. Consequently, the empirical antibiotherapy used for the treatment of CAP combines doxycycline and the recommended amoxicillin. Our objectives were to estimate the prevalence of Q fever pneumonia and to build a prediction rule to identify patients with Q fever pneumonia for empirical antibiotic guidance. A retrospective case-control study was conducted on inpatients admitted with CAP in the Department of Infectious Diseases of Cayenne Hospital from 2004 to 2007. Serodiagnosis for Coxiella burnetii was performed for all patients. Risk factor analysis was performed using multivariate logistic regression, and a prognostic score was computed using bootstrap procedures. The score performance characteristics were used to choose the best prediction rule to identify patients with Q fever pneumonia. One hundred thirty-one patients with CAP were included and the Q fever pneumonia prevalence was 24.4% (95% confidence interval [CI], 17.1-31.9). In multivariate analysis, male sex, middle age (age, 30-60 years), headache, leukocyte count 185 mg/L were independently associated with Q fever pneumonia. Patients with a predictive score ≤3 had a low risk of Q fever pneumonia with a negative predictive value of 0.97 (95% CI, .90-1) and a sensitivity of 0.97 (95% CI, .89-1). The prediction rule described here accurately identifies patients with low risk of Q fever pneumonia and may help physicians to make more rational decisions about the empirical use of antibiotherapy. Further prospective studies should be performed to validate this score.

  19. Evaluation of Modified Glasgow Prognostic Score for Pancreatic Cancer: A Retrospective Cohort Study.

    Science.gov (United States)

    Imaoka, Hiroshi; Mizuno, Nobumasa; Hara, Kazuo; Hijioka, Susumu; Tajika, Masahiro; Tanaka, Tsutomu; Ishihara, Makoto; Yogi, Tatsuji; Tsutsumi, Hideharu; Fujiyoshi, Toshihisa; Sato, Takamitsu; Shimizu, Yasuhiro; Niwa, Yasumasa; Yamao, Kenji

    2016-02-01

    The modified Glasgow prognostic score (mGPS) is known to be useful in determining the prognosis of cancers. However, the utility of mGPS for pancreatic cancer (PC) has been examined based primarily on a surgical series of early-stage cancers. The purpose of this study was to examine the utility of mGPS for PC of all stages using a retrospective cohort design. We conducted a retrospective cohort study using data from a computerized database. A total of 807 patients with pathologically confirmed PC were analyzed (mGPS-0, n = 620; mGPS-1, n = 153; mGPS-2, n = 34). Median overall survival (OS) was significantly worse for the mGPS-1 group than for the mGPS-0 group (5.8 vs 15.8 months, respectively) but was comparable between the mGPS-2 and mGPS-1 groups (4.8 vs 5.8 months, respectively). After adjustment, both mGPS-1 and mGPS-2 were independent predictive factors of OS (mGPS-1: hazard ratio, 1.772; 95% confidence interval, 1.417-2.215; mGPS-2: hazard ratio, 2.033; 95% confidence interval, 1.284-3.219). Subgroup analysis showed that OS was significantly worse in the mGPS-1 and mGPS-2 groups than in the mGPS-0 group for all except the following 2 subgroups: localized disease and curative resection. The present results show that the mGPS is an independent prognostic factor in patients with PC, especially for advanced-stage disease.

  20. Postoperative outcome after oesophagectomy for cancer: Nutritional status is the missing ring in the current prognostic scores.

    Science.gov (United States)

    Filip, B; Scarpa, M; Cavallin, F; Cagol, M; Alfieri, R; Saadeh, L; Ancona, E; Castoro, C

    2015-06-01

    Several prognostic scores were designed in order to estimate the risk of postoperative adverse events. None of them includes a component directly associated to the nutritional status. The aims of the study were the evaluation of performance of risk-adjusted models for early outcomes after oesophagectomy and to develop a score for severe complication prediction with special consideration regarding nutritional status. A comparison of POSSUM and Charlson score and their derivates, ASA, Lagarde score and nutritional index (PNI) was performed on 167 patients undergoing oesophagectomy for cancer. A logistic regression model was also estimated to obtain a new prognostic score for severe morbidity prediction. Overall morbidity was 35.3% (59 cases), severe complications (grade III-V of Clavien-Dindo classification) occurred in 20 cases. Discrimination was poor for all the scores. Multivariable analysis identified pulse, connective tissue disease, PNI and potassium as independent predictors of severe morbidity. This model showed good discrimination and calibration. Internal validation using standard bootstrapping techniques confirmed the good performance. Nutrition could be an independent risk factor for major complications and a nutritional status coefficient could be included in current prognostic scores to improve risk estimation of major postoperative complications after oesophagectomy for cancer. Copyright © 2015. Published by Elsevier Ltd.

  1. Development of a Prognostic Score Using the Complete Blood Cell Count for Survival Prediction in Unselected Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Fang Chongliang

    2013-01-01

    Full Text Available Objective. The purpose of this study was to develop a new prognostic scoring system for critically ill patients using the simple complete blood cell count (CBC. Methods. CBC measurements in samples from 306 patients in an intensive care unit were conducted with automated analyzers, including levels of neutrophils, lymphocytes, erythrocytes, hemoglobin, and platelets. The time of sampling and the time of death were recorded. Z values were calculated according to the measured values, reference mean values, and standard deviations. The prognostic score was equivalent to the median of the Z value of each of the measured parameters. Results. There was a significant correlation between survival time and neutrophil, lymphocyte, and platelet levels (P<0.05. Prognostic scores were calculated from the Z value of these three parameters. Survival times decreased as the prognostic score increased. Conclusions. This study suggests that a model that uses levels of neutrophils, lymphocytes, and platelets is potentially useful in the objective evaluation of survival time or disease severity in unselected critically ill patients.

  2. [The shoulder-hand syndrome after stroke: clinical factors of severity and value of prognostic score of Perrigot].

    Science.gov (United States)

    Daviet, J C; Preux, P M; Salle, J Y; Lebreton, F; Munoz, M; Dudognon, P; Pelissier, J; Perrigot, M

    2001-07-01

    The purposes of this study were to evaluate the prognostical factors of reflex sympathetic dystrophy in stroke patients in attempt to improve the Perrigot prognostical score. This prospective study included 28 stroke patients with reflex sympathetic dystrophy. An initial clinical assessment including Perrigot score was made at the time of admission (before the end of the first month) and a second evaluation of reflex sympathetic dystrophy at the end of the third month. Patients were assessed using Motricity Index, Ashworth scale, de Bats grading (for glenohumeral alignment), Labrousse criteria (for reflex sympathetic dystrophy severity), and MADRS depression scale. Sensory deficit and unilateral neglect were noted. The length of stay in acute ward was 16 days. The Perrigot score was correlated with the reflex sympathetic dystrophy severity (r = 0.7, p shoulder subluxation. It wasn't possible to improve the Perrigot prognostical score. Perrigot score predict reflex sympathetic dystrophy severity and the result of therapy. The shoulder subluxation which is not included in this score appears to be not predictive. Shoulder subluxation is simply a marker of a severe paresis.

  3. Generation and validation of a prognostic score to predict outcome after re-irradiation of recurrent glioma

    Energy Technology Data Exchange (ETDEWEB)

    Combs, Stephanie E.; Welzel, Thomas; Debus, Juergen [Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany)], E-mail: Stephanie.combs@med.uni-heidelberg.de; Edler, Lutz; Rausch, Renate [German Cancer Research Center (dkfz), Dept. of Biostatistics, Heidelberg (Germany); Wick, Wolfgang [Univ. Hospital of Heidelberg, Dept. of Neurooncology, Heidelberg (Germany)

    2013-01-15

    Re-irradiation using high-precision radiation techniques has been established within the clinical routine for patients with recurrent gliomas. In the present work, we developed a practical prognostic score to predict survival outcome after re-irradiation. Patients and methods. Fractionated stereotactic radiotherapy (FSRT) was applied in 233 patients. Primary histology included glioblastoma (n = 89; 38%), WHO Grade III gliomas (n = 52; 22%) and low-grade glioma (n = 92; 40%). FSRT was applied with a median dose of 36 Gy in 2 Gy single fractions. We evaluated survival after re-irradiation as well as progression-free survival after re-irradiation; prognostic factors analyzed included age, tumor volume at re-irradiation, histology, time between initial radiotherapy and re-irradiation, age and Karnofsky Performance Score. Results. Median survival after FSRT was 8 months for glioblastoma, 20 months for anaplastic gliomas, and 24 months for recurrent low-grade patients. The strongest prognostic factors significantly impacting survival after re-irradiation were histology (p <0.0001) and age (<50 vs. ={>=}50, p < 0.0001) at diagnosis and the time between initial radiotherapy and re-irradiation {<=}12 vs. >12 months (p < 0.0001). We generated a four-class prognostic score to distinguish patients with excellent (0 points), good (1 point), moderate (2 points) and poor (3-4 points) survival after re-irradiation. The difference in outcome was highly significant (p < 0.0001). Conclusion. We generated a practical prognostic score index based on three clinically relevant factors to predict the benefit of patients from re-irradiation. This score index can be helpful in patient counseling, and for the design of further clinical trials. However, individual treatment decisions may include other patient-related factors not directly influencing outcome.

  4. [Assessment of Cachexia in Head and Neck Cancer Patients Based on a Modified Glasgow Prognostic Score].

    Science.gov (United States)

    Matsuzuka, Takashi; Suzuki, Masahiro; Saijoh, Satoshi; Ikeda, Masakazu; Imaizumi, Mitsumasa; Nomoto, Yukio; Matsui, Takamichi; Tada, Yasuhiro; Omori, Koichi

    2016-02-01

    We retrospectively analyzed 54 patients who died of head and neck squamous cell caricinoma regarding the process and duration of cachexia using the modified Glasgow Prognostic Score (mGPS). The patients were classified as having cachexia when the serum albumin level was less than 3.5 mg/dL and the C-reactive protein (CRP) level was more than 0.5 mg/dL. The number of patients with cachexia was eight (8%) at the first visit and 50 (93%) at the time of death. In the 50 patients, the median and average time of having cachexia was 59 and 95 days, respectively. Thirty-two of the 50 patients (64%) died within three months after the presence of cachexia was confirmed. In this study, the time of having cachexia was so short, then the policy of care should be converted from aggressive into supportive in patients classified as having cachexia. mGPS would be an accurate assessment tool for cachexia and ascertain the end stage of head and neck cancer patients.

  5. Relationship between nutritional status and the Glasgow Prognostic Score in patients with colorectal cancer.

    Science.gov (United States)

    Maurício, Sílvia Fernandes; da Silva, Jacqueline Braga; Bering, Tatiana; Correia, Maria Isabel Toulson Davisson

    2013-04-01

    The association between nutritional status and inflammation was assessed in patients with colorectal cancer and to verify their association with complications during anticancer treatment. The agreement between the Subjective Global Assessment (SGA) and different nutritional assessment methods was also evaluated. A cross-sectional, prospective, and descriptive study was performed. The nutritional status was defined by the SGA and the severity of inflammation was defined by the Glasgow Prognostic Score (GPS). The complications were classified using the Common Toxicity Criteria, version 3. Anthropometric measurements such as body mass index, triceps skinfold, midarm circumference, midarm muscle area, and adductor pollicis muscle thickness were also performed, as were handgrip strength and phase angle. The chi-square test, Fisher exact test, Spearman correlation coefficient, independent t test, analysis of variance, Gabriel test, and κ index were used for the statistical analysis. P cancer (60.4 ± 14.3 y old) were included. The nutritional status according to the SGA was associated with the GPS (P nutritional assessment methods with the SGA, there were statistically significant differences. Malnutrition is highly prevalent in patients with colorectal cancer. The nutritional status was associated with the GPS. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Glasgow Prognostic Score (GPS) can be a useful indicator to determine prognosis of patients with colorectal carcinoma.

    Science.gov (United States)

    Nozoe, Tadahiro; Matono, Rumi; Ijichi, Hideki; Ohga, Takefumi; Ezaki, Takahiro

    2014-01-01

    The Glasgow Prognostic Score (GPS), an inflammation-based score, has been used to predict the biologic behavior of malignant tumors. The aim of the current study was to elucidate a further significance of GPS in colorectal carcinoma. Correlation of GPS and modified GPS (mGPS), which are composed of combined score provided for serum elevation of C-reactive protein and hypoalbuminemia examined before surgical treatment, with clinicopathologic features was investigated in 272 patients with colorectal carcinoma. Survival of GPS 1 patients was significantly worse than that of GPS 0 patients (P= 0.009), and survival of GPS 2 patients was significantly worse than that of GPS 1 patients (P GPS (P GPS and mGPS could classify outcome of patients with a clear stratification, and could be applied as prognostic indicators in colorectal carcinoma.

  7. Prognostic Utility of Cell Cycle Progression Score in Men With Prostate Cancer After Primary External Beam Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Freedland, Stephen J., E-mail: steve.freedland@duke.edu [Department of Surgery, Durham VA Medical Center, Durham, North Carolina (United States); Department of Surgery (Urology), Duke University School of Medicine, Durham, North Carolina (United States); Department of Pathology, Duke University School of Medicine, Durham, North Carolina (United States); Gerber, Leah [Department of Surgery, Durham VA Medical Center, Durham, North Carolina (United States); Department of Surgery (Urology), Duke University School of Medicine, Durham, North Carolina (United States); Department of Pathology, Duke University School of Medicine, Durham, North Carolina (United States); Reid, Julia; Welbourn, William; Tikishvili, Eliso; Park, Jimmy; Younus, Adib; Gutin, Alexander; Sangale, Zaina; Lanchbury, Jerry S. [Myriad Genetics, Inc, Salt Lake City, Utah (United States); Salama, Joseph K. [Department of Radiation Oncology, Durham VA Medical Center, Durham, North Carolina (United States); Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina (United States); Stone, Steven [Myriad Genetics, Inc, Salt Lake City, Utah (United States)

    2013-08-01

    Purpose: To evaluate the prognostic utility of the cell cycle progression (CCP) score, a RNA signature based on the average expression level of 31 CCP genes, for predicting biochemical recurrence (BCR) in men with prostate cancer treated with external beam radiation therapy (EBRT) as their primary curative therapy. Methods and Materials: The CCP score was derived retrospectively from diagnostic biopsy specimens of men diagnosed with prostate cancer from 1991 to 2006 (n=141). All patients were treated with definitive EBRT; approximately half of the cohort was African American. Outcome was time from EBRT to BCR using the Phoenix definition. Median follow-up for patients without BCR was 4.8 years. Association with outcome was evaluated by Cox proportional hazards survival analysis and likelihood ratio tests. Results: Of 141 patients, 19 (13%) had BCR. The median CCP score for patient samples was 0.12. In univariable analysis, CCP score significantly predicted BCR (P=.0017). The hazard ratio for BCR was 2.55 for 1-unit increase in CCP score (equivalent to a doubling of gene expression). In a multivariable analysis that included Gleason score, prostate-specific antigen, percent positive cores, and androgen deprivation therapy, the hazard ratio for CCP changed only marginally and remained significant (P=.034), indicating that CCP provides prognostic information that is not provided by standard clinical parameters. With 10-year censoring, the CCP score was associated with prostate cancer-specific mortality (P=.013). There was no evidence for interaction between CCP and any clinical variable, including ethnicity. Conclusions: Among men treated with EBRT, the CCP score significantly predicted outcome and provided greater prognostic information than was available with clinical parameters. If validated in a larger cohort, CCP score could identify high-risk men undergoing EBRT who may need more aggressive therapy.

  8. Prognostic significance of global grading system of Gleason score in patients with prostate cancer with bone metastasis.

    Science.gov (United States)

    Kambara, Tsunehito; Oyama, Tetsunari; Segawa, Atsuki; Fukabori, Yoshitatsu; Yoshida, Ken-Ichiro

    2010-06-01

    To investigate the influence of the revised Gleason grading system (GGS, revised at a consensus conference organized by the International Society of Urological Pathology in 2005) on prediction of prognosis for patients with prostate cancer with bone metastasis. Prostatic needle biopsy specimens from 113 patients with prostate cancer with bone metastasis were scored using the conventional GGS (CGGS), modified global GGS (MGGGS), and modified highest GGS (MHGGS). The patients were divided into two groups (Gleason score or = 8) using each grading system. Prostate-specific antigen failure-free survival after hormone therapy (HT) was estimated retrospectively. The Cox proportional hazard method was used for univariate and multivariate analysis. Patients with a Gleason score of score of > or = 8 according to each GGS. However, the better prognosis patients were detected more precisely by the CGGS and MGGGS than the MHGGS. Multivariate analysis showed that the CGGS and MGGGS were significant prognostic indicators for the outcome of HT after adjustment for other prognostic factors. These results suggest that the CGGS and MGGGS are more useful than the MHGGS as prognostic indicators for HT. Further evaluation in larger series is needed to define its clinical usefulness.

  9. The Predictive Prognostic Values of Serum TNF-α in Comparison to SOFA Score Monitoring in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Ayman Abd Al-Maksoud Yousef

    2013-01-01

    Full Text Available Background. The use of inflammatory markers to follow up critically ill patients is controversial. The short time frame, the need for frequent and serial measurement of biomarkers, the presence of soluble receptor and their relatively high cost are the major drawbacks. Our study’s objective is to compare the prognostic values of serum TNF-α and SOFA score monitoring in critically ill patients. Patients and Methods. A total of ninety patients were included in the study. Forty-five patients developed septic complication (sepsis group. Forty-five patients were critically ill without evidence of infectious organism (SIRS group. Patients’ data include clinical status, central venous pressure, and laboratory analysis were measured. A serum level of TNF-α and SOFA score were monitored. Results. Monitoring of TNF-α revealed significant elevation of TNF-α at 3rd and 5th days of ICU admission in both groups. Monitoring of SOFA score revealed significant elevation of SOFA scores in both groups throughout their ICU stay, particularly in nonsurvivors. Positive predictive ability of SOFA score was demonstrated in critically ill patients. Conclusion. Transient significant increase in serum levels of TNF-α were detected in septic patients. Persistent elevation of SOFA score was detected in nonsurvivor septic patients. SOFA score is an independent prognostic value in critically ill patients.

  10. Prognostic Value of Gai′s Plaque Score and Agatston Coronary Artery Calcium Score for Functionally Significant Coronary Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Chuang Zhang

    2016-01-01

    Conclusions: Both CACS in a single artery and Gai's plaque score demonstrated a good capacity to assess functionally significant coronary artery stenosis when compared to the gold standard FFR. However, Gai's plaque score was more predictive of FFR <0.80. Gai's score can be easily calculated in daily clinical practice and could be used when considering revascularization.

  11. Comparison of prognostic impact of absolute lymphocyte count, absolute monocyte count, absolute lymphocyte count/absolute monocyte count prognostic score and ratio in patients with diffuse large B cell lymphoma.

    Science.gov (United States)

    Markovic, Olivera; Popovic, Lazar; Marisavljevic, Dragomir; Jovanovic, Darjana; Filipovic, Branka; Stanisavljevic, Dejana; Matovina-Brko, Gorana; Hajder, Jelena; Matkovic, Tatjana; Živkovic, Radmila; Stanisavljevic, Natasa; Todorović, Milena; Petrovic, Dragana; Mihaljevic, Biljana

    2014-03-01

    The combination of absolute lymphocyte count (ALC) and absolute monocyte count (AMC) at diagnosis has prognostic relevance in patients with diffuse large B cell lymphoma (DLBCL). The present study was designed to investigate the prognostic significance of ALC and AMC and to determine whether ALC/AMC ratio or ALC/AMC prognostic score is better predictor of outcome in DLBCL. We retrospectively analyzed the prognostic significance of ALC and AMC, ALC/AMC ratio and ALC/AMC prognostic score at diagnosis in 222 DLBCL patients treated with R-CHOP. ROC analysis showed that optimal cut-off values of AMC and ALC/AMC ratio with the best sensitivity and specificity were 0.59×10(9)/L and 2.8, respectively. Cut-off of ALC was determined according to the literature data (1×10(9)/L). Low ALC, high AMC, low ALC/AMC ratio and high ALC/AMC prognostic score were in significant association with lower rate of therapy response and survival. In contrast, these parameters were not in significant correlation with relapse rate. The patients with low ALC, "high" AMC, low ALC/AMC ratio and high ALC/AMC prognostic score at diagnosis had significantly shorter EFS and OS. In multivariate analysis all tested parameters (ALC, AMC, ALC/AMC prognostic score and ALC/AMC ratio) are independent risk factors along with "bulky" disease and IPI. All tested parameters (ALC, AMC, ALC/AMC score and ALC/AMC ratio) may be useful prognostic factors in DLBCL patients. ALC/AMC score has a slight advantage as it allows the classification of patients into three prognostic groups. Further studies are needed to determine which of these parameters has the highest predictive value. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  12. LIPID PROFILE OF CIRRHOTIC PATIENTS AND ITS ASSOCIATION WITH PROGNOSTIC SCORES: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Lílian BASSANI

    2015-09-01

    Full Text Available BackgroundIn cirrhosis the production of cholesterol and lipoproteins is altered.ObjectiveEvaluate the lipid profile by measuring total cholesterol, very low-density lipoprotein, low-density lipoprotein, high-density lipoprotein and triglyceride levels in patients with cirrhosis caused by alcoholism and/or hepatitis C virus infection and determine its association with Child-Pugh and MELD scores.MethodsCross-sectional retrospective study of patients treated at the outpatient clinic in Porto Alegre, Brazil, from 2006 to 2010.ResultsIn total, 314 records were reviewed, and 153 (48.7% met the inclusion criteria, of which 82 (53.6% had cirrhosis that was due to hepatitis C virus infection, 50 (32.7% were due to alcoholism, and 21 (13.7% were due to alcoholism and hepatitis C virus infection. The total cholesterol levels diminished with a Child-Pugh progression (P20 was associated with lower total cholesterol levels (<100mg/dL; P<0.001, very low-density lipoprotein (<16 mg/dL; P=0.006, and low-density lipoprotein (<70 mg/dL; P=0.003. Inverse and statistically significant correlations were observed between Child-Pugh and all the lipid fractions analyzed (P<0.001. The increase in MELD was inversely correlated with reduced levels intotal cholesterol (P<0.001, high-density lipoprotein (P<0.001, low-density lipoprotein (P<0.001, very low-density lipoprotein (P=0.030 and triglyceride (P=0.003.ConclusionA reduction in the lipid profile in patients with cirrhosis due to hepatitis C virus infection and/or alcoholism was significantly associated with the Child-Pugh and MELD prognostic markers. These results suggest that the lipid profile may be used as a tool to assist in evaluating liver disease.

  13. Naples Prognostic Score, Based on Nutritional and Inflammatory Status, is an Independent Predictor of Long-term Outcome in Patients Undergoing Surgery for Colorectal Cancer.

    Science.gov (United States)

    Galizia, Gennaro; Lieto, Eva; Auricchio, Annamaria; Cardella, Francesca; Mabilia, Andrea; Podzemny, Vlasta; Castellano, Paolo; Orditura, Michele; Napolitano, Vincenzo

    2017-12-01

    The existing scores reflecting the patient's nutritional and inflammatory status do not include all biomarkers and have been poorly studied in colorectal cancers. The purpose of this study was to assess a new prognostic tool, the Naples prognostic score, comparing it with the prognostic nutritional index, controlling nutritional status score, and systemic inflammation score. This was an analysis of patients undergoing surgery for colorectal cancer. The study was conducted at a university hospital. A total of 562 patients who underwent surgery for colorectal cancer in July 2004 through June 2014 and 468 patients undergoing potentially curative surgery were included. MaxStat analysis dichotomized neutrophil:lymphocyte ratio, lymphocyte:monocyte ratio, prognostic nutritional index, and the controlling nutritional status score. The Naples prognostic scores were divided into 3 groups (group 0, 1, and 2). The receiver operating characteristic curve for censored survival data compared the prognostic performance of the scoring systems. Overall survival and complication rates in all patients, as well as recurrence and disease-free survival rates in radically resected patients, were measured. The Naples prognostic score correlated positively with the other scoring systems (p < 0.001) and worsened with advanced tumor stages (p < 0.001). Patients with the worst Naples prognostic score experienced more postoperative complications (all patients, p = 0.010; radically resected patients, p = 0.026). Compared with group 0, patients in groups 1 and 2 had worse overall (group 1, HR = 2.90; group 2, HR = 8.01; p < 0.001) and disease-free survival rates (group 1, HR = 2.57; group 2, HR = 6.95; p < 0.001). Only the Naples prognostic score was an independent significant predictor of overall (HR = 2.0; p = 0.03) and disease-free survival rates (HR = 2.6; p = 0.01). The receiver operating characteristic curve analysis showed that the Naples prognostic score had the best prognostic

  14. A New Prognostic Score Supporting Treatment Allocation for Multimodality Therapy for Malignant Pleural Mesothelioma: A Review of 12 Years' Experience.

    Science.gov (United States)

    Opitz, Isabelle; Friess, Martina; Kestenholz, Peter; Schneiter, Didier; Frauenfelder, Thomas; Nguyen-Kim, Thi Dan Linh; Seifert, Burkhardt; Hoda, Mir Alireza; Klepetko, Walter; Stahel, Rolf A; Weder, Walter

    2015-11-01

    Treatment of malignant pleural mesothelioma (MPM) remains a clinical challenge. The aim of this study was to identify selection factors for allocation of MPM patients to multimodal therapy based on survival data from 12 years of experience. Eligible patients had MPM of all histological subtypes with clinical stage T1-3 N0-2 M0. Induction chemotherapy consisted of cisplatin/gemcitabine (cis/gem) or cisplatin/pemetrexed (cis/pem), followed by extrapleural pneumonectomy (EPP). Multivariate analysis was performed to assess independent prognosticators for overall survival (OS). A Multimodality Prognostic Score was developed based on clinical variables available before surgery. From May 1999 to August 2011, 186 MPM patients were intended to be treated with induction chemotherapy followed by EPP. Hematologic toxicity was significantly less frequent after cis/pem compared to cis/gem, but there was no difference in response or OS between the regimens. One hundred and twenty-eight patients underwent EPP with a 30-day mortality of 4.7%. Fifty-two percent of the patients received adjuvant radiotherapy. The median OS of patients undergoing EPP was significantly longer with 22 months (95% confidence interval: 20-24) when compared to 11 months (9-12) for patients treated without EPP. A prognostic score was defined considering tumor volume, histology, C-reactive protein level, and response to chemotherapy that identified patient groups not benefitting from multimodality treatment which was confirmed in an independent cohort. Patients receiving induction chemotherapy followed by EPP for MPM of all histological subtypes and irrespective of nodal status showed a median survival of 22 months. A prognostic score is proposed to help patient allocation for surgery after validation in an independent cohort.

  15. Prognostic Value of High-Sensitivity Cardiac Troponin T Compared with Risk Scores in Stable Cardiovascular Disease.

    Science.gov (United States)

    Biener, Moritz; Giannitsis, Evangelos; Kuhner, Manuel; Zelniker, Thomas; Mueller-Hennessen, Matthias; Vafaie, Mehrshad; Trenk, Dietmar; Neumann, Franz-Josef; Hochholzer, Willibald; Katus, Hugo A

    2017-05-01

    Risk stratification of patients with cardiovascular disease remains challenging despite consideration of risk scores. We aimed to evaluate the prognostic performance of high-sensitivity cardiac troponin T in a low-risk outpatient population presenting for nonsecondary and secondary prevention. All-cause mortality, a composite of all-cause mortality, acute myocardial infarction, and stroke (end point 2), and a composite of all-cause mortality, acute myocardial infarction, stroke and rehospitalization for acute coronary syndrome, and decompensated heart failure (end point 3) were defined. The prognostic performance of high-sensitivity cardiac troponin T on index visit was compared with the PROCAM score and 3 FRAMINGHAM subscores. In 693 patients with a median follow-up of 796 days, we observed 16 deaths, 32 patients with end point 2, and 83 patients with end point 3. All risk scores performed better in the prediction of all-cause mortality in nonsecondary prevention (area under the curve [AUC]: PROCAM: 0.922 vs 0.523, P = .001, consistent for all other scores). In secondary prevention, high-sensitivity cardiac troponin T outperformed all risk scores in the prediction of all-cause mortality (ΔAUC: PROCAM: 0.319, P risk scores. Our findings on the prediction of all-cause mortality compared with the FRAMINGHAM-Hard Coronary Heart Disease score were confirmed in an independent validation cohort on 2046 patients. High-sensitivity troponin T provides excellent risk stratification regarding all-cause mortality and all-cause mortality, acute myocardial infarction, and stroke in a secondary prevention cohort in whom risk scores perform poorly. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. A comparison of the prognostic value of preoperative inflammation-based scores and TNM stage in patients with gastric cancer

    Directory of Open Access Journals (Sweden)

    Pan QX

    2015-06-01

    Full Text Available Qun-Xiong Pan,* Zi-Jian Su,* Jian-Hua Zhang, Chong-Ren Wang, Shao-Ying KeDepartment of Oncosurgery, Quanzhou First Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, People’s Republic of China*These authors contributed equally to this workBackground: People’s Republic of China is one of the countries with the highest incidence of gastric cancer, accounting for 45% of all new gastric cancer cases in the world. Therefore, strong prognostic markers are critical for the diagnosis and survival of Chinese patients suffering from gastric cancer. Recent studies have begun to unravel the mechanisms linking the host inflammatory response to tumor growth, invasion and metastasis in gastric cancers. Based on this relationship between inflammation and cancer progression, several inflammation-based scores have been demonstrated to have prognostic value in many types of malignant solid tumors.Objective: To compare the prognostic value of inflammation-based prognostic scores and tumor node metastasis (TNM stage in patients undergoing gastric cancer resection.Methods: The inflammation-based prognostic scores were calculated for 207 patients with gastric cancer who underwent surgery. Glasgow prognostic score (GPS, neutrophil lymphocyte ratio (NLR, platelet lymphocyte ratio (PLR, prognostic nutritional index (PNI, and prognostic index (PI were analyzed. Linear trend chi-square test, likelihood ratio chi-square test, and receiver operating characteristic were performed to compare the prognostic value of the selected scores and TNM stage.Results: In univariate analysis, preoperative serum C-reactive protein (P<0.001, serum albumin (P<0.001, GPS (P<0.001, PLR (P=0.002, NLR (P<0.001, PI (P<0.001, PNI (P<0.001, and TNM stage (P<0.001 were significantly associated with both overall survival and disease-free survival of patients with gastric cancer. In multivariate analysis, GPS (P=0.024, NLR (P=0.012, PI (P=0.001, TNM stage (P<0.001, and degree of

  17. Report on outcomes of hypomethylating therapy for analyzing prognostic value of Revised International Prognostic Scoring System for patients with lower-risk myelodysplastic syndromes.

    Science.gov (United States)

    Lee, Yoo Jin; Park, Sung Woo; Lee, In Hee; Ahn, Jae Sook; Kim, Hyeoung Joon; Chung, Joo Seop; Shin, Ho Jin; Lee, Won Sik; Lee, Sang Min; Joo, Young Don; Kim, Hawk; Lee, Ho Sup; Kim, Yang Soo; Cho, Yoon Young; Moon, Joon Ho; Sohn, Sang Kyun

    2016-10-01

    The outcomes for patients with lower-risk myelodysplastic syndromes (LR-MDS) by the International Prognostic Scoring System (IPSS) vary widely. For more precise prognostication, this study evaluates the prognostic value of revised IPSS with the response to hypomethylating therapy (HMT). Using the Korean MDS Working Party database, treatment outcomes for 236 patients with HMT were retrospectively evaluated. The patients were then reclassified into very low/low (VL/L), intermediate (INT), and high (H) risk groups according to IPSS-R. According to the HMT response, the 3-year overall survival (OS) did not differ between the response group (37.9 ± 9.1 %) and the stable group (52.9 ± 6.6 %, p = 0. 782). When reclassifying according to IPSS-R, 42 patients (20.8 %) were reclassified into the H risk group. Most of them did not have benefit from continued HMT and progressed to secondary failure. The median OS was 59.0 months (range, 40.0-77.9 months) for the VL/L risk group, 31 months (range, 22.7-439.3 months) for the INT risk group, and 20.0 months (range, 15.9-24.1 months) for the H risk group (p risk group according to IPSS-R (HR = 3.054, p risk according to IPSS-R (HR = 4.912, p = 0.003), and transformation to AML (HR = 2.158, p = 0.002). If IPSS-R reclassifies LR-MDS patients as H risk, these patients should be considered for early allo-HCT, regardless of the current benefits from HMT.

  18. Prognostic value of early warning scores in the emergency department (ED) and acute medical unit (AMU): A narrative review.

    Science.gov (United States)

    Nannan Panday, R S; Minderhoud, T C; Alam, N; Nanayakkara, P W B

    2017-10-06

    A wide array of early warning scores (EWS) have been developed and are used in different settings to detect which patients are at risk of deterioration. The aim of this review is to provide an overview of studies conducted on the value of EWS on predicting intensive care (ICU) admission and mortality in the emergency department (ED) and acute medical unit (AMU). A literature search was conducted in the bibliographic databases PubMed and EMBASE, from inception to April 2017. Two reviewers independently screened all potentially relevant titles and abstracts for eligibility. 42 studies were included. 36 studies reported on mortality as an endpoint, 13 reported ICU admission and 9 reported the composite outcome of mortality and ICU admission. For mortality prediction National Early Warning Score (NEWS) was the most accurate score in the general ED population and in those with respiratory distress, Mortality in Emergency Department Sepsis score (MEDS) had the best accuracy in patients with an infection or sepsis. ICU admission was best predicted with NEWS, however in patients with an infection or sepsis Modified Early Warning Score (MEWS) yielded better results for this outcome. MEWS and NEWS generally had favourable results in the ED and AMU for all endpoints. Many studies have been performed on ED and AMU populations using heterogeneous prognostic scores. However, future studies should concentrate on a simple and easy to use prognostic score such as NEWS with the aim of introducing this throughout the (pre-hospital and hospital) acute care chain. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  19. Prognostic values of pneumonia severity index, CURB-65 and expanded CURB-65 scores in community-acquired pneumonia in Zagazig University Hospitals

    Directory of Open Access Journals (Sweden)

    Samah M. Shehata

    2017-07-01

    Conclusions: Expanded CURB-65 score is simple, objective and more accurate scoring system for evaluation of CAP severity and can improve the efficiency of predicting the mortality in CAP patients, better than CURB-65 and PSI scores. Also, Expanded CUEB-65 may generate new therapeutic and prognostic modality in CAP especially in patients with liver cirrhosis.

  20. The 5-minute Apgar Score as a Prognostic Factor for Development and Progression of Retinopathy of Prematurity.

    Science.gov (United States)

    Marinov, Vasil G; Koleva-Georgieva, Desislava N; Sivkova, Nelly P; Krasteva, Maya B

    2017-03-01

    A low Apgar score at 5 minutes has been shown to be a risk factor for development of retinopathy of prematurity (ROP). To examine the prognostic value of Apgar score at 5 minutes for development and progression of ROP. The study included 132 preterm infants who were screened from 4th week of life onward. Of these, 118 newborns were given Apgar score at 5 minutes. The prognostic significance of this index was studied as an absolute value and as a value ≤ 6. The patients were divided into two groups: group I had no evidence of ROP (n=82) and group II had some signs of ROP (n = 36). Group II was further divided into group IIA - spontaneously regressed cases (n=22), and group IIB with cases which progressed to treatment stages (n=14). We investigated 15 maternal and 20 newborn presumable risk factors for development and progression of ROP. Mann-Whitney U test, χ2 or Fisher's exact test were used in the statistical analysis. Logistic regression was performed to find significant and independent risk factors for manifestation and progression of ROP. A low 5-minute Apgar score and an Apgar score of 6 or less at 5 minutes were not statistically significant risk factors of ROP (р=0.191, р=0.191, respectively), but were significant risk factors for the manifested ROP to progress to stages requiring treatment (p=0.046, р=0.036, respectively). An Apgar score at 5 minutes of 6 or less was a significant and independent risk factor for progression of ROP to stages requiring treatment.

  1. Performance Status, Prognostic Scoring, and Parenteral Nutrition Requirements Predict Survival in Patients with Advanced Cancer Receiving Home Parenteral Nutrition.

    Science.gov (United States)

    Keane, Niamh; Fragkos, Konstantinos C; Patel, Pinal S; Bertsch, Friderike; Mehta, Shameer J; Di Caro, Simona; Rahman, Farooq

    2018-01-01

    We describe a cohort of Home Parenteral Nutrition (HPN) patients with advanced cancer in order to identify factors affecting prognosis. Demographic, anthropometric, biochemical and medical factors, Karnofsky Performance Status (KPS), Glasgow Prognostic Score (GPS), and PN requirements were recorded. Univariate and multivariate analyses were performed including Kaplan-Meier curves, Cox Regression, and correlation analyses. In total, 107 HPN patients (68 women, 39 men, mean age 57 yr) with advanced cancer were identified. The main indications for HPN were bowel obstruction (74.3%) and high output ostomies (14.3%). Cancer cachexia was present in 87.1% of patients. The hazard ratio (HR) for upper gastrointestinal and "other" cancers vs. gynaecological malignancy was 1.75 (p = 0.077) and 2.11 (p = 0.05), respectively. KPS score, GPS, PN volume, and PN potassium levels significantly predicted survival (HRKPS ≥50 vs 0.05). Most patients passed away in their homes or hospice (77.9%). Performance status, prognostic scoring, and PN requirements may predict survival in patients with advanced cancer receiving HPN.

  2. Ganga hospital open injury severity score - A score to prognosticate limb salvage and outcome measures in Type IIIb open tibial fractures

    Directory of Open Access Journals (Sweden)

    Rajasekaran S

    2005-01-01

    Full Text Available Background: Gustilo′s grade IIIB classification includes a wide spectrum of injuries and is limited by high inter and intra observer error rates. Methods: A trauma score for grade IIIB open tibial fractures was devised to assess injury to three components; the covering tissues, musculotendinous units and bone with the severity scale in each category from one to five. Seven co-morbid conditions known to influence the prognosis were each given a score of two and summed up. Results : Ninety six consecutive Grade IIIB open injuries of tibia were prospectively evaluated. At 3-5 year follow up, of the 88 available, final score was less than five in 6 patients (Group I, between six and ten in 48 (Group II, eleven to fifteen in 29 (Group III and above 16 in five (Group IV. All patients in Group IV and one in Group III with score of fifteen underwent amputation. There was a significant difference (p less than 0.001 between the three groups in the requirement for flap (16.7,75&100 percent, time for union (16.3,24.9 &46.9, incidence of deep infection (0,22.9 &60.7 percent, number of surgical procedures (1.2,3.1 &6.3 and inpatient days (12.5,22.6 &59.4. A score of greater than three in any one component required special skills in management and interfered with healing of other structures. Conclusion: The scoring system was easy to apply and had a high degree of interobservor aggreement rate. This comprehensive score reliably prognosticates both limb salvage and outcome measures in severe open injuries of tibia.

  3. Risk assessment in sepsis: a new prognostication rule by APACHE II score and serum soluble urokinase plasminogen activator receptor.

    Science.gov (United States)

    Giamarellos-Bourboulis, Evangelos J; Norrby-Teglund, Anna; Mylona, Vassiliki; Savva, Athina; Tsangaris, Iraklis; Dimopoulou, Ioanna; Mouktaroudi, Maria; Raftogiannis, Maria; Georgitsi, Marianna; Linnér, Anna; Adamis, George; Antonopoulou, Anastasia; Apostolidou, Efterpi; Chrisofos, Michael; Katsenos, Chrisostomos; Koutelidakis, Ioannis; Kotzampassi, Katerina; Koratzanis, George; Koupetori, Marina; Kritselis, Ioannis; Lymberopoulou, Korina; Mandragos, Konstantinos; Marioli, Androniki; Sundén-Cullberg, Jonas; Mega, Anna; Prekates, Athanassios; Routsi, Christina; Gogos, Charalambos; Treutiger, Carl-Johan; Armaganidis, Apostolos; Dimopoulos, George

    2012-08-08

    Early risk assessment is the mainstay of management of patients with sepsis. APACHE II is the gold standard prognostic stratification system. A prediction rule that aimed to improve prognostication by APACHE II with the application of serum suPAR (soluble urokinase plasminogen activator receptor) is developed. A prospective study cohort enrolled 1914 patients with sepsis including 62.2% with sepsis and 37.8% with severe sepsis/septic shock. Serum suPAR was measured in samples drawn after diagnosis by an enzyme-immunoabsorbent assay; in 367 patients sequential measurements were performed. After ROC analysis and multivariate logistic regression analysis a prediction rule for risk was developed. The rule was validated in a double-blind fashion by an independent confirmation cohort of 196 sepsis patients, predominantly severe sepsis/septic shock patients, from Sweden. Serum suPAR remained stable within survivors and non-survivors for 10 days. Regression analysis showed that APACHE II ≥ 17 and suPAR ≥ 12 ng/ml were independently associated with unfavorable outcome. Four strata of risk were identified: i) APACHE II APACHE II APACHE II ≥ 17 and suPAR APACHE II ≥ 17 and suPAR ≥ 12 ng/ml with mortality 51.7%. This prediction rule was confirmed by the Swedish cohort. A novel prediction rule with four levels of risk in sepsis based on APACHE II score and serum suPAR is proposed. Prognostication by this rule is confirmed by an independent cohort.

  4. Procalcitonin Improves the Glasgow Prognostic Score for Outcome Prediction in Emergency Patients with Cancer: A Cohort Study

    Directory of Open Access Journals (Sweden)

    Anna Christina Rast

    2015-01-01

    Full Text Available The Glasgow Prognostic Score (GPS is useful for predicting long-term mortality in cancer patients. Our aim was to validate the GPS in ED patients with different cancer-related urgency and investigate whether biomarkers would improve its accuracy. We followed consecutive medical patients presenting with a cancer-related medical urgency to a tertiary care hospital in Switzerland. Upon admission, we measured procalcitonin (PCT, white blood cell count, urea, 25-hydroxyvitamin D, corrected calcium, C-reactive protein, and albumin and calculated the GPS. Of 341 included patients (median age 68 years, 61% males, 81 (23.8% died within 30 days after admission. The GPS showed moderate prognostic accuracy (AUC 0.67 for mortality. Among the different biomarkers, PCT provided the highest prognostic accuracy (odds ratio 1.6 (95% confidence interval 1.3 to 1.9, P<0.001, AUC 0.69 and significantly improved the GPS to a combined AUC of 0.74 (P=0.007. Considering all investigated biomarkers, the AUC increased to 0.76 (P<0.001. The GPS performance was significantly improved by the addition of PCT and other biomarkers for risk stratification in ED cancer patients. The benefit of early risk stratification by the GPS in combination with biomarkers from different pathways should be investigated in further interventional trials.

  5. Prognostic Value of A Qualitative Brain MRI Scoring System After Cardiac Arrest

    NARCIS (Netherlands)

    Hirsch, Karen G.; Mlynash, Michael; Jansen, Sofie; Persoon, Suzanne; Eyngorn, Irina; Krasnokutsky, Michael V.; Wijman, Christine A. C.; Fischbein, Nancy J.

    2015-01-01

    BACKGROUND AND PURPOSETo develop a qualitative brain magnetic resonance imaging (MRI) scoring system for comatose cardiac arrest patients that can be used in clinical practice. METHODSConsecutive comatose postcardiac arrest patients were prospectively enrolled. Routine MR brain sequences were scored

  6. Comparison of prognostic risk scores after successful primary percutaneous coronary intervention.

    Science.gov (United States)

    Synetos, Andreas; Georgiopoulos, George; Pylarinou, Voula; Toutouzas, Konstantinos; Maniou, Katerina; Drakopoulou, Maria; Tolis, Panagiotis; Karanasos, Antonios; Papanikolaou, Aggelos; Latsios, George; Tsiamis, Eleftherios; Tousoulis, Dimitrios

    2017-03-01

    The aim of this study was to compare the predictive ability of clinical risk scores (ACEF, EuroSCORE and EuroSCORE II) to angiographic (SYNTAX score) and combined risk scores (Global Risk Score and Clinical SXscore) towards cardiovascular death and/or major adverse cardiac events (MACE) in patients with ST-segment elevation acute myocardial infarction (STEMI) managed with primary percutaneous coronary intervention (pPCI). A total of 685 patients successfully treated with pPCI were evaluated and the risk scores were calculated. The primary endpoint was the 2-year incidence of fatal cardiac events. Secondary end points were target lesion failure (TLF), repeat revascularization (RR) and MACE. Patients distributed in the highest tertile of EuroSCORE II presented increased rates of CV death (CVD), all-cause mortality and MACE (p<0.001 for all). EuroSCORE II was associated with increased C-statistics (0.873, 95% CIs: 0.784-0.962 and 0.825, 95% CIs: 0.752-0.898 respectively) for predicting CVD and MACE over competing risk scores (p<0.05). EuroSCORE II conferred incremental discrimination (Harrell's C, p<0.05 for all, apart from CSS for predicting CVD) and reclassification value (Net Reclassification Index, p<0.05 for all, apart from CSS for reclassifying MACE) over alternative risk scores for study's main endpoints. EuroSCORE II independently predicted CVD (HR=1.06, 95% CIs: 1.03-1.09, p<0.001) and MACE (HR=1.07, 95% CIs: 1.04-1.10, p<0.001). EuroSCORE II has the best predictive ability of CVD and/or MACE after successful pPCI for the treatment of STEMI. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Pittsburgh response to endovascular therapy score as a pre-treatment prognostic tool: External validation in Trevo2.

    Science.gov (United States)

    Ali Raza, Syed; Xiang, Bin; Jovin, Tudor G; Liebeskind, David S; Shields, Ryan; Nogueira, Raul G; Rangaraju, Srikant

    2017-07-01

    Background Optimal patient selection is needed to maximize the therapeutic benefit of endovascular therapy for large vessel occlusion stroke. Aims To validate the Pittsburgh response to endovascular therapy (PRE) score in a randomized controlled trial (Trevo2) comparing stent retriever (Trevo) to the Merci device. Methods Trevo2 participants with internal carotid, M1 and M2 middle cerebral artery occlusions with prospectively collected baseline stroke severity (NIHSS), degree of hypodensity (CT ASPECTS), and three-month modified Rankin Scale (mRS) were included. Multivariable regression was used to confirm association between PRE score variables (age, NIHSS, and ASPECTS), medical comorbidities, randomization arm, and reperfusion status (mTICI2B/3) with good outcome (three-month modified Rankin Scale 0-2). Predictive power (area under the receiver operating characteristic curve) for good outcome of pre-treatment prognostic scores (PRE, THRIVE, HIAT2) was compared. Rates of good outcome were compared between successfully reperfused (mTICI2B/3) and non-reperfused (mTICI0-2A) patients across previously identified PRE score risk groups. Results Age, NIHSS, ASPECTS, reperfusion status, and randomization arm were independent predictors of good outcome. PRE score had moderate predictive power (AUC = 0.75) for good outcome and was comparable to other pre-treatment scores. Reperfusion resulted in maximal treatment benefit in patients with PRE score 0-24 (60% vs. 12.5%, p = 0.002) but not in those with PRE ≥50 (11.8% vs. 0.0%, p = 0.49). Conclusion The PRE score is a validated predictor of functional outcome and a tool for patient selection for endovascular therapy in anterior large vessel occlusion stroke. Our finding of limited benefit of reperfusion in patients with PRE score ≥50 needs to be prospectively validated.

  8. Prognostic significance of APACHE II score and plasma suPAR in Chinese patients with sepsis: a prospective observational study.

    Science.gov (United States)

    Liu, Xuan; Shen, Yong; Li, Zhihua; Fei, Aihua; Wang, Hairong; Ge, Qinmin; Pan, Shuming

    2016-07-29

    Timely risk stratification is the key strategy to improve prognosis of patients with sepsis. Previous study has proposed to develop a powerful risk assessment rule by the combination of Acute Physiology and Chronic Health Evaluation II (APACHE II) score and plasma soluble urokinase plasminogen activator receptor (suPAR). That reaffirmation of suPAR as a prognostic marker in Chinese patients with severe sepsis is the aim of the study. A total of 137 consecutive Chinese patients with sepsis were enrolled in a prospective study cohort. Demographic and clinical characteristics, conventional risk factors and important laboratory data were prospectively recorded. Sequential plasma suPAR concentrations were measured by an enzymeimmunoabsorbent assay on days 1, 3, and 7 after admission to the intensive care unit (ICU). Receiver operating characteristic (ROC) curves and Cox regression analysis were used to examine the performance of suPAR in developing a rule for risk stratification. The results showed that plasma suPAR concentrations remained relatively stable within survivors and non-survivors during the first week of disease course. Regression analysis indicated that APACHE II ≥15 and suPAR ≥10.82 ng/mL were independently associated with unfavorable outcome. With the above cutoffs of APACHE II and suPAR, strata of disease severity were determined. The mortality of each stratum differed significantly from the others. Combination of APACHE II score and suPAR may supply the powerful prognostic utility for the mortality of sepsis.

  9. Efficacy of NETDC (New England Trophoblastic Disease Center prognostic index score to predict gestational trophoblastic tumor from hydatidiform mole

    Directory of Open Access Journals (Sweden)

    Khrismawan Khrismawan

    2004-03-01

    Full Text Available A prospective longitudinal analytic study assessing the efficacy of NETDC (New England Trophoblastic Disease Center prognostic index score in predicting malignancy after hydatidiform mole had been performed. Of the parameter evaluated; age of patients, type of hydatidiform mole, uterine enlargement, serum hCG level, lutein cyst, and presence of complicating factors were significant risk factors for malignancy after hydatidiform mole were evacuated (p<0.032. The study were done on 50 women diagnosed with hydatidiform mole with 1 year observation (January 2001-December 2002 at the Department of Obstetrics and Gynecology, Mohammad Hoesin Hospital, Palembang. The results showed that the NETDC prognostic index score predicted malignancy in 50% of high risk group and 10% in low risk group (p<0.05. This showed a higher number than that found by the WHO (19%-30%. The risk for incidence of  malignancy after hydatidiform mole in the high risk group is 9.0 times higher compared to that of the low risk group (CI: 1.769-45.786. (Med J Indones 2004; 13: 40-6 Keywords: New England Trophoblastic Disease Center (NETDC, gestational trophoblastic tumor, hydatidiform mole, high and low risk

  10. Prognostic evaluation of patients undergoing living-donor liver transplant by APACHE II and MELD scores.

    Science.gov (United States)

    Zhang, Zheng-Yun; Chen, Rui; Zhou, Zun-Qiang; Peng, Cheng-Hong; Zhou, Guang-Wen

    2015-02-01

    We hypothesized that the combination of APACHE II and Model for End-Stage Liver Disease systems would work satisfactorily in patients admitted to intensive care unit after living-donor liver transplant. Data were retrospectively collected from the database of our surgical team. The study included 38 patients (hepatitis B virus cirrhosis, 47.4%; hepatocellular carcinoma, 28.9%; other diseases, 23.7%). Laboratory values were obtained. Vital signs, Glasgow Coma scale scores, and urine output were abstracted. Variables included age, sex, acute physiology score, APACHE II score, APACHE II-predicted intensive care unit and hospital mortality, predicted length of intensive care unit, and hospital stay. Patients' actual length of intensive care unit and hospital stays, intensive care unit and hospital discharge status, and discharge location were recorded. Standardized mortality ratios were calculated. Discrimination and calibration of APACHE II were assessed. All patients were divided into 3 groups: Model for End-Stage Liver Disease score: >25, 18 to 25, and APACHE II scores of survivors and non-survivors were 13.03 and 23.67. Mean risk of death was 7.05% and 25.07%. APACHE II scores and risk of death between survivors and non-survivors was significantly different (P APACHE II score and Model for End-Stage Liver Disease score in the receiving operating characteristic curve was 20 and 25. Patients with APACHE II scores greater than 20 or Model for End-Stage Liver Disease scores greater than 25 had higher predicted hospital mortality after living-donor liver transplant. The modified APACHE II model provides an accurate prognosis of patients receiving a living-donor liver transplant. The combined application of Model for End-Stage Liver Disease score and APACHE II score can improve the predictive accuracy.

  11. Controlling Nutritional Status (CONUT) score is a prognostic marker for gastric cancer patients after curative resection.

    Science.gov (United States)

    Kuroda, Daisuke; Sawayama, Hiroshi; Kurashige, Junji; Iwatsuki, Masaaki; Eto, Tsugio; Tokunaga, Ryuma; Kitano, Yuki; Yamamura, Kensuke; Ouchi, Mayuko; Nakamura, Kenichi; Baba, Yoshifumi; Sakamoto, Yasuo; Yamashita, Yoichi; Yoshida, Naoya; Chikamoto, Akira; Baba, Hideo

    2017-06-27

    Controlling Nutritional Status (CONUT), as calculated from serum albumin, total cholesterol concentration, and total lymphocyte count, was previously shown to be useful for nutritional assessment. The current study investigated the potential use of CONUT as a prognostic marker in gastric cancer patients after curative resection. Preoperative CONUT was retrospectively calculated in 416 gastric cancer patients who underwent curative resection at Kumamoto University Hospital from 2005 to 2014. The patients were divided into two groups: CONUT-high (≥4) and CONUT-low (≤3), according to time-dependent receiver operating characteristic (ROC) analysis. The associations of CONUT with clinicopathological factors and survival were evaluated. CONUT-high patients were significantly older (p nutritional status but also for predicting long-term OS in gastric cancer patients after curative resection.

  12. Pro-atrial natriuretic peptide is a prognostic marker in sepsis, similar to the APACHE II score: an observational study.

    Science.gov (United States)

    Morgenthaler, Nils G; Struck, Joachim; Christ-Crain, Mirjam; Bergmann, Andreas; Müller, Beat

    2005-02-01

    Additional biomarkers in sepsis are needed to tackle the challenges of determining prognosis and optimizing selection of high-risk patients for application of therapy. In the present study, conducted in a cohort of medical intensive care unit patients, our aim was to compare the prognostic value of mid-regional pro-atrial natriuretic peptide (ANP) levels with those of other biomarkers and physiological scores. Blood samples obtained in a prospective observational study conducted in 101 consecutive critically ill patients admitted to the intensive care unit were analyzed. The prognostic value of pro-ANP levels was compared with that of the Acute Physiology and Chronic Health Evaluation (APACHE) II score and with those of various biomarkers (i.e. C-reactive protein, IL-6 and procalcitonin). Mid-regional pro-ANP was detected in EDTA plasma from all patients using a new sandwich immunoassay. On admission, 53 patients had sepsis, severe sepsis, or septic shock, and 68 had systemic inflammatory response syndrome. The median pro-ANP value in the survivors was 194 pmol/l (range 20-2000 pmol/l), which was significantly lower than in the nonsurvivors (median 853.0 pmol/l, range 100-2000 pmol/l; P protein, and similar to the AUC for the APACHE II score. Pro-ANP appears to be a valuable tool for individual risk assessment in sepsis patients and for stratification of high-risk patients in future intervention trials. Further studies are needed to validate our results.

  13. PREDICTING PROGNOSTIC VALUE OF OCULAR TRAUMA SCORE (OTS IN AN OPEN GLOBE INJURY IN TERTIARY EYE CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Rahul

    2015-10-01

    Full Text Available AIM : To evaluate the prognostic value of OTS in open globe injuries. MATERIAL METHOD : Retrospective analysis of 77 eyes with open globe injuries was done from 01/07/2013 to 31/12/2014. Patients were assigned raw score sum based on initial V/A, and ocular findings then classified into 5 categories for predicting final visual outcome based on ocular Trauma score (OTS. RESULT : We estimated final V/A in 77 cases of open globe injuries (64.93% had raw sc ore between 65.91 (category 3, 4 Six months after the injury, 42.85% patients of categories 1 (raw score 0 - 44 achieved V/A of PL/HM as compared to 17% in OTS study. 16 patients with raw compared to OTS study. We reported comparable visual outcome with OT S study except in category 1 & 2. CONCLUSION: OTS score is valuable in triage, patient counseling and decision making for the management of ocular trauma. We recommend that OTS should be used routinely for open globe injuries as it is a simple guide

  14. QT dispersion and prognostication of the outcome in acute cardiotoxicities: A comparison with SAPS II and APACHE II scoring systems.

    Science.gov (United States)

    Hassanian-Moghaddam, Hossein; Amiri, Hassan; Zamani, Nasim; Rahimi, Mitra; Shadnia, Shahin; Taherkhani, Maryam

    2014-06-01

    We aimed to evaluate the efficacy of QT dispersion (QTD) in determining the outcome of the patients poisoned by cardiotoxic medications and toxins. Patients who referred to our emergency department (ED) due to acute toxicity with any cardiotoxic medication or toxin and were admitted to medical toxicology intensive care unit (MTICU) were enrolled into the study. A questionnaire containing the demographic characteristics, vital signs, laboratory tests, electrocardiographic (ECG) parameters of the first ECG taken on MTICU or ED admission, simplified acute physiology score (SAPS), and acute physiology and chronic health evaluation (APACHE) score was filled for every single patient. QTD was manually calculated. The patients were divided into two groups of survivors and non-survivors and compared. Although QTD was not significantly different between the survivors and non-survivors (P = 0.8), SAPS II and APACHE II score were so. SAPS and APACHE had the highest sensitivity and specificity in determining the patients' mortality, respectively. SAPS had the highest sensitivity, and QTD had the highest specificity in predicting the later development of the complications. SAPS II and APACHE II scoring systems are the best systems for prognostication of death in patients with acute cardiotoxic medication-induced poisonings. QTD can be successfully used for the prediction of complications.

  15. Validation of new prognostic and predictive scores by sequential testing approach

    Energy Technology Data Exchange (ETDEWEB)

    Nieder, Carsten [Radiation Oncology Unit, Nordland Hospital, Bodo (Norway); Inst. of Clinical Medicine, Univ. of Tromso (Norway); Haukland, Ellinor; Pawinski, Adam; Dalhaug, Astrid [Radiation Oncology Unit, Nordland Hospital, Bodo (Norway)

    2010-03-15

    Background and Purpose: For practitioners, the question arises how their own patient population differs from that used in large-scale analyses resulting in new scores and nomograms and whether such tools actually are valid at a local level and thus can be implemented. A recent article proposed an easy-to-use method for the in-clinic validation of new prediction tools with a limited number of patients, a so-called sequential testing approach. The present study evaluates this approach in scores related to radiation oncology. Material and Methods: Three different scores were used, each predicting short overall survival after palliative radiotherapy (bone metastases, brain metastases, metastatic spinal cord compression). For each scenario, a limited number of consecutive patients entered the sequential testing approach. The positive predictive value (PPV) was used for validation of the respective score and it was required that the PPV exceeded 80%. Results: For two scores, validity in the own local patient population could be confirmed after entering 13 and 17 patients, respectively. For the third score, no decision could be reached even after increasing the sample size to 30. Conclusion: In-clinic validation of new predictive tools with sequential testing approach should be preferred over uncritical adoption of tools which provide no significant benefit to local patient populations. Often the necessary number of patients can be reached within reasonable time frames even in small oncology practices. In addition, validation is performed continuously as the data are collected. (orig.)

  16. Overall Survival in Spine Myeloma Metastases: Difficulties in Predicting With Prognostic Scores.

    Science.gov (United States)

    Amelot, Aymeric; Cristini, Joseph; Salaud, Céline; Moles, Alexis; Hamel, Olivier; Moreau, Philippe; Bord, Eric; Buffenoir, Kevin

    2017-03-15

    Fifty-one patients with spinal multiple myeloma (MM) metastases were operated and followed between January 2004 and July 2014. The aim of this study was to consider the efficiency of surgical prognosis scores in the management of spinal metastases myelomas. The spine is the most common site of bone metastases in MM. Surgery in spine metastases MM is a matter of debate and its impact on the increase of a patient's survival time is not clear. Several surgical survival scores have been developed to determine the best treatment in these patients. We studied 51 patients operated for spinal MM metastases between January 2004 and July 2014. We determined the Tokuhashi and Tomita survival scores and compared them with documented patient survivals. The two scores were also compared with the International Staging System (ISS). Median survival (MS) was 108 months [standard deviation (SD) 62] for ISS I, 132.2 (SD 40) for ISS II, and 45.5 months (SD 16.3) for ISS III (P = 0.09). According to Tokuhashi survival score, 21 patients (41.2%) will survive 12 months. According to Tomita et al., 50 patients (98%) will survive >49.9 months and 1 patient (2%) spine surgical prognosis scores are not accurate and are not able to predict the survival of patients with spine myeloma metastases. Spine surgeons have to be guided not by the initial ISS stage but rather by spinal instability and neurological status. N/A.

  17. Computed tomographic findings in dogs with head trauma and development of a novel prognostic computed tomography-based scoring system.

    Science.gov (United States)

    Chai, Orit; Peery, Dana; Bdolah-Abram, Tali; Moscovich, Efrat; Kelmer, Efrat; Klainbart, Sigal; Milgram, Joshua; Shamir, Merav H

    2017-09-01

    OBJECTIVE To characterize CT findings and outcomes in dogs with head trauma and design a prognostic scale. ANIMALS 27 dogs admitted to the Koret School Veterinary Teaching Hospital within 72 hours after traumatic head injury that underwent CT imaging of the head. PROCEDURES Data were extracted from medical records regarding dog signalment, history, physical and neurologic examination findings, and modified Glasgow coma scale scores. All CT images were retrospectively evaluated by a radiologist unaware of dog status. Short-term (10 days after trauma) and long-term (≥ 6 months after trauma) outcomes were determined, and CT findings and other variables were analyzed for associations with outcome. A prognostic CT-based scale was developed on the basis of the results. RESULTS Cranial vault fractures, parenchymal abnormalities, or both were identified via CT in 24 of 27 (89%) dogs. Three (11%) dogs had only facial bone fractures. Intracranial hemorrhage was identified in 16 (59%) dogs, cranial vault fractures in 15 (56%), midline shift in 14 (52%), lateral ventricle asymmetry in 12 (44%), and hydrocephalus in 7 (26%). Hemorrhage and ventricular asymmetry were significantly and negatively associated with short- and long-term survival, respectively. The developed 7-point prognostic scale included points for hemorrhage, midline shift or lateral ventricle asymmetry, cranial vault fracture, and depressed fracture (1 point each) and infratentorial lesion (3 points). CONCLUSIONS AND CLINICAL RELEVANCE The findings reported here may assist in determining prognoses for other dogs with head trauma. The developed scale may be useful for outcome assessment of dogs with head trauma; however, it must be validated before clinical application.

  18. Does continuous ST-segment monitoring add prognostic information to the TIMI, PURSUIT, and GRACE risk scores?

    Science.gov (United States)

    Carmo, Pedro; Ferreira, Jorge; Aguiar, Carlos; Ferreira, António; Raposo, Luís; Gonçalves, Pedro; Brito, João; Silva, Aniceto

    2011-07-01

    Recurrent ischemia is frequent in patients with non-ST-elevation acute coronary syndromes (NST-ACS), and portends a worse prognosis. Continuous ST-segment monitoring (CSTM) reflects the dynamic nature of ischemia and allows the detection of silent episodes. The aim of this study is to investigate whether CSTM adds prognostic information to the risk scores (RS) currently used. We studied 234 patients with NST-ACS in whom CSTM was performed in the first 24 hours after admission. An ST episode was defined as a transient ST-segment deviation in ≥1 lead of ≥ 0.1 mV, and persisting ≥1 minute. Three RS were calculated: Thrombolysis in Myocardial Infarction (TIMI; for NST-ACS), Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Supression Using Integrilin (PURSUIT; death/MI model), and Global Registry of Acute Coronary Events (GRACE). The end point was defined as death or nonfatal myocardial infarction (MI), during 1-year follow-up. ST episodes were detected in 54 patients (23.1%) and associated with worse 1-year outcome: 25.9% end point rate versus 12.2% (Odds Ratio [OR]= 2.51; 95% Confidence Interval [CI], 1.18-5, 35; P = 0.026). All three RS predicted 1-year outcome, but the GRACE (c-statistic = 0.755; 95% CI, 0.695-0.809) was superior to both TIMI (c-statistic = 0.632; 95% CI, 0.567-0.694) and PURSUIT (c-statistic = 0.644; 95% CI: 0.579-0.706). A GRACE RS > 124 showed the highest accuracy for predicting end point. The presence of ST episodes added independent prognostic information the TIMI RS (hazard ratio [HR]= 2.23; 95% CI, 1.13-4.38) and to PURSUIT RS (HR = 2.03; 95% CI, 1.03-3.98), but not to the GRACE RS. CSTM provides incremental prognostic information beyond the TIMI and PURSUIT RS, but not the GRACE risk score. Hence, the GRACE risk score should be the preferred stratification model in daily practice. ©2011, Wiley Periodicals, Inc.

  19. Can Procalcitonin Add to the Prognostic Power of the Severity Scoring System in Adults with Pneumonia?

    Science.gov (United States)

    Naderi, HamidReza; Sheybani, Fereshte; Sarvghad, MohammadReza; Nooghabi, Mehdi Jabbari

    2015-01-01

    The first decision confronting clinicians in the management of patients with community acquired pneumonia (CAP) is whether the patient is to be hospitalized or not. We sought to validate the pneumonia scoring system and assess the power of procalcitonin (PCT) level to predict in-hospital mortality (IHM) and intensive vasopressor and respiratory support (IVRS) requirements in patients with CAP. A total of 120 patients with CAP were evaluated for severity of illness based on the defined scoring systems including pneumonia severity index (PSI), confusion, urea, respiratory rate, blood pressure, age>65 (CURB-65), confusion, respiratory rate, blood pressure, age>65 (CRB-65), infectious diseases society of America/American thoracic society 2007 criteria (IDSA/ATS 2007) and systolic blood pressure, multilobar infiltrate, albumin, respiratory rate, tachycardia, confusion, low oxygen, low pH (SMART-COP). Demographic, clinical, laboratory and radiographic data were collected prospectively. The accuracy of each scoring system in predicting IVRS requirement and IHM was assessed from the area under the receiver operating characteristic (ROC) curve (AUC). Level of PCT was determined by semi-quantitative PCT-Q method (BRAHMS). The accuracy of the defined scoring systems, PCT levels and each scoring system plus PCT levels in prediction of IHM and IVRS requirement was analyzed. The accuracy of PCT levels in predicting IHM and IVRS requirement based on AUC was 0.542 and 0.658, respectively and the best threshold was ≥ 2ng/mL for both of them. Adding the level of procalcitonin to different scoring systems (based on the defined scoring systems) improved the accuracy of all systems. We do not suggest using the PCT level alone as a predictor for mortality and IVRS requirement. Instead, we suggest PSI plus PCT and IDSA/ATS 2007 plus PCT as accurate predictors for IHM and SMART-COP plus PCT for IVRS requirement in patients who presented with CAP.

  20. [Apache III score: a prognostic factor in pressure ulcer development in an intensive care unit].

    Science.gov (United States)

    Almirall Solsona, D; Leiva Rus, A; Gabasa Puig, I

    2009-01-01

    OBJECTIVE. To analyze total APACHE III score association to pressure ulcers development in patients hospitalized in an intensive care unit (ICU). Prospective cohort study conducted in an intensive care unit of the Hospital General de VIC. All the patients hospitalized between January 2001 to December 2001 were enrolled. Age, gender, length of stay, total Norton and APACHE III score and pressure sore development were collected. Pressure sore incidence was 12.5% of the patients. The factors were significantly associated with the appearance of pressure sores in those patients with a length of stay in the intensive care unit, total Norton and severity of the disease measured by the APACHE III score. Patients having the greatest risk of pressure ulcers development were those whose Norton score was less than or equal to 14, and an APACHE III score higher than or equal to 50 (Odds Ratio: 37.9, 95% CI 11.16-128.47) The severity of the diseases measured with the APACHE III scale showed a relationship with the appearance of in-hospital pressure ulcers. The joint use of the APACHE III and Norton scale could be a good strategy to detect patients with very high risk of suffering pressure sores.

  1. TIMI risk score for acute myocardial infarction according to prognostic stratification.

    Science.gov (United States)

    Pereira, Jaqueline Locks; Sakae, Thiago Mamôru; Machado, Michele Cardoso; Castro, Charles Martins de

    2009-08-01

    The TIMI (Thrombolysis in Myocardial Infarction) risk score is derived from clinical trial involving patients who are eligible for fibrinolysis. As the risk profiles of these cases differ from those found in non-selected populations, it is important to review the applicability of the score in usual clinical conditions. To evaluate the management and clinical evolution of hospital inpatients with acute myocardial infarction, according to risk stratification by the TIMI score. We evaluated, retrospectively, 103 cases of acute myocardial infarction with ST-segment elevation admitted to the Hospital Nossa Senhora da Conceição - Tubarão, in 2004 and 2005. The cases were analyzed in three risk groups according to the TIMI score. The hospital mortality after infarction was 17.5%. In the low-risk group there was no death. The mortality was 8.1% in the medium risk group and 55.6% in the high-risk group. The risk of death in cases of high risk was 14.1 times higher than in the cases of medium and low risk (95% CI = 4.4 to 44.1 and p risk group in relation to the low risk group (95% CI = 0.27 to 0.85, p = 0.004). There was a progressive increase in mortality and incidence of in-hospital complications according to the stratification by the TIMI score. High risk patients received thrombolytic less frequently than the patients at low risk.

  2. Preeclampsia in kidney transplanted women; Outcomes and a simple prognostic risk score system

    Science.gov (United States)

    Reisæter, Anna Varberg; Zucknick, Manuela; Lorentzen, Bjørg; Vangen, Siri; Henriksen, Tore; Michelsen, Trond Melbye

    2017-01-01

    Women pregnant following kidney transplantation are at high risk of preeclampsia. Identifying the effects of preeclampsia on pregnancy outcome and allograft function in kidney transplanted women, and predicting which women will require more targeted follow-up and possible therapeutic intervention, could improve both maternal and neonatal outcome. In this retrospective cohort study of all pregnancies following kidney transplantation in Norway between 1969 and 2013, we used medical records to identify clinical characteristics predictive of preeclampsia. 175 pregnancies were included, in which preeclampsia was diagnosed in 65. Pregnancies with preeclampsia had significantly higher postpartum serum creatinine levels, higher risks of preterm delivery, caesarean delivery, and small for gestational age infants. In the final multivariate model chronic hypertension (aOR = 5.02 [95% CI, 2.47–10.18]), previous preeclampsia (aOR = 3.26 [95% CI, 1.43–7.43]), and elevated serum creatinine (≥125 μmol/L) at the start of pregnancy (aOR = 5.79 [95% CI, 1.91–17.59]) were prognostic factors for preeclampsia. Based on this model the risk was 19% when none of these factors were present, 45–59% risk when one was present, 80–87% risk when two were present, and 96% risk when all three were present. We suggest that the risk of preeclampsia in pregnancies in kidney transplanted women can be predicted with these variables, which are easily available at the start of pregnancy. PMID:28319175

  3. IDH mutation status trumps the Pignatti risk score as a prognostic marker in low-grade gliomas.

    Science.gov (United States)

    Etxaniz, Olatz; Carrato, Cristina; de Aguirre, Itziar; Queralt, Cristina; Muñoz, Ana; Ramirez, José L; Rosell, Rafael; Villà, Salvador; Diaz, Rocio; Estival, Ana; Teixidor, Pilar; Indacochea, Alberto; Ahjal, Sara; Vilà, Laia; Balañá, Carme

    2017-11-01

    Management of low-grade gliomas (LGG) is based on clinical and radiologic features, including the Pignatti prognostic scoring system, which classifies patients as low- or high-risk. To determine whether molecular data can offer advantages over these features, we have examined the prognostic impact of several molecular alterations in LGG. In a cohort of 58 patients with LGG, we have retrospectively analyzed clinical and molecular characteristics, including the Pignatti criteria, IDH mutations, TP53 mutations, the 1p/19q deletion, and MGMT methylation, and correlated our findings with progression-free survival (PFS) and overall survival (OS). Mean age of patients was 45 years; 71% were classified as low-risk by the Pignatti system. IDH mutations were detected in 62%, p53 mutations in 17%, the 1p/19q codeletion in 46%, and MGMT methylation in 40% of patients. Survival analyses were performed in the 49 patients without contrast enhancement. In the univariate analysis, IDH mutations, the 1p/19q codeletion, and the combination of IDH mutations with the 1p/19q codeletion were associated with both longer PFS (P = 0.006, P = 0.037, and P = 0.003, respectively) and longer OS (P IDH mutations as a factor for greater risk of progression [hazard ratio (HR) = 3.1; P = 0.007]and death (HR = 6.4; P IDH mutations may be more effective than the Pignatti score in discriminating low- and high-risk patients with LGG.

  4. Additive prognostic value of the SYNTAX score over GRACE, TIMI, ZWOLLE, CADILLAC and PAMI risk scores in patients with acute ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention.

    Science.gov (United States)

    Brkovic, Voin; Dobric, Milan; Beleslin, Branko; Giga, Vojislav; Vukcevic, Vladan; Stojkovic, Sinisa; Stankovic, Goran; Nedeljkovic, Milan A; Orlic, Dejan; Tomasevic, Miloje; Stepanovic, Jelena; Ostojic, Miodrag

    2013-08-01

    This study evaluated additive prognostic value of the SYNTAX score over GRACE, TIMI, ZWOLLE, CADILLAC and PAMI risk scores in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). All six scores were calculated in 209 consecutive STEMI patients undergoing pPCI. Primary end-point was the major adverse cardiovascular event (MACE--composite of cardiovascular mortality, non-fatal myocardial infarction and stroke); secondary end point was cardiovascular mortality. Patients were stratified according to the SYNTAX score tertiles (≤12; between 12 and 19.5; >19.5). The median follow-up was 20 months. Rates of MACE and cardiovascular mortality were highest in the upper tertile of the SYNTAX score (p score was independent multivariable predictor of MACE and cardiovascular mortality when added to GRACE, TIMI, ZWOLLE, and PAMI risk scores. However, the SYNTAX score did not improve the Cox regression models of MACE and cardiovascular mortality when added to the CADILLAC score. The SYNTAX score has predictive value for MACE and cardiovascular mortality in patients with STEMI undergoing primary PCI. Furthermore, SYNTAX score improves prognostic performance of well-established GRACE, TIMI, ZWOLLE and PAMI clinical scores, but not the CADILLAC risk score. Therefore, long-term survival in patients after STEMI depends less on detailed angiographical characterization of coronary lesions, but more on clinical characteristics, myocardial function and basic angiographic findings as provided by the CADILLAC score.

  5. Applicability and prognostic value of histologic scoring systems in primary sclerosing cholangitis.

    Science.gov (United States)

    de Vries, Elisabeth M G; Verheij, Joanne; Hubscher, Stefan G; Leeflang, Mariska M G; Boonstra, Kirsten; Beuers, Ulrich; Ponsioen, Cyriel Y

    2015-11-01

    Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease. At present, there is no appropriate histologic scoring system available for PSC, evaluating both degree of necroinflammatory activity (grade) and fibrosis (stage). The aim of this study was to assess if three scoring systems, commonly used in different liver diseases could be applied for grading and/or staging of PSC. Sixty-four PSC patients from a Dutch cohort, who underwent diagnostic liver biopsy, were included. Staging was scored using Ishak, Nakanuma, and Ludwig systems. Grading was scored using Ishak and Nakanuma systems. Three measures of outcome were defined; transplant-free survival, time to liver transplantation (LTx) and occurrence of cirrhosis related symptoms (CRS). Association of grade and stage with outcome was estimated using Kaplan-Meier log-rank test, and Cox regression analysis. Correlation with biochemistry was assessed by Spearman's rank test. There were strong associations between disease stage measured by Ishak, Nakanuma, and Ludwig staging systems with both outcome measuring transplant-free survival (Hazard ratio (HR) 2.56; 95% CI 1.11-5.89, HR 6.53; 95% CI 2.01-21.22, HR 1.94; 95% CI 1.00-3.79, respectively), and time to LTx (HR 4.18; 95%CI 1.51-11.56, HR 7.05; 95% CI 1.77-28.11, HR 3.13; 95%CI 1.42-6.87, respectively). Ishak and Nakanuma grading systems were not associated with CRS. Weak correlations between histopathology and liver biochemistry were shown. Applying the Nakanuma, Ishak, and Ludwig histopathological staging systems is feasible and clinically relevant given their association with transplant-free survival and time to LTx. This suggests that these staging systems could be likely candidates for surrogate endpoints and stratification purposes in clinical trials in PSC. Copyright © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  6. Neutrophil/Lymphocyte Ratio, Lymphocyte/Monocyte Ratio, and Absolute Lymphocyte Count/Absolute Monocyte Count Prognostic Score in Diffuse Large B-Cell Lymphoma: Useful Prognostic Tools in the Rituximab Era.

    Science.gov (United States)

    Ho, Ching-Liang; Lu, Chieh-Sheng; Chen, Jia-Hong; Chen, Yu-Guang; Huang, Tzu-Chuan; Wu, Yi-Ying

    2015-06-01

    The neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), and absolute lymphocyte count/absolute monocyte count prognostic score (ALC/AMC PS) have been described as the most useful prognostic tools for patients with diffuse large B-cell lymphoma (DLBCL). We retrospectively analyzed 148 Taiwanese patients with newly diagnosed diffuse large B-cell lymphoma under rituximab (R)-CHOP-like regimens from January 2001 to December 2010 at the Tri-Service General Hospital and investigated the utility of these inexpensive tools in our patients. In a univariate analysis, the NLR, LMR, and ALC/AMC PS had significant prognostic value in our DLBCL patients (NLR: 5-year progression-free survival [PFS], P = 0.001; 5-year overall survival [OS], P = 0.007. LMR: PFS, P = 0.003; OS, P = 0.05. PFS, P < 0.001; OS, P < 0.001). In a separate multivariate analysis, the ALC/AMC PS appeared to interact less with the other clinical factors but retained statistical significance in the survival analysis (PFS, P = 0.023; OS, P = 0.017). The akaike information criterion (AIC) analysis produced scores of 388.773 in the NLR, 387.625 in the LMR, and 372.574 in the ALC/AMC PS. The results suggested that the ALC/AMC PS appears to be more reliable than the NLR and LMR and may provide additional prognostic information when used in conjunction with the International Prognostic Index.

  7. Development and external validation of a clinical prognostic score for death in visceral leishmaniasis patients in a high HIV co-infection burden area in Ethiopia.

    Directory of Open Access Journals (Sweden)

    Charles Abongomera

    Full Text Available In Ethiopia, case fatality rates among subgroups of visceral leishmaniasis (VL patients are high. A clinical prognostic score for death in VL patients could contribute to optimal management and reduction of these case fatality rates. We aimed to identify predictors of death from VL, and to develop and externally validate a clinical prognostic score for death in VL patients, in a high HIV co-infection burden area in Ethiopia.We conducted a retrospective cohort study in north west Ethiopia. Predictors with an adjusted likelihood ratio ≥1.5 or ≤0.67 were retained to calculate the predictor score. The derivation cohort consisted of 1686 VL patients treated at an upgraded health center and the external validation cohort consisted of 404 VL patients treated in hospital. There were 99 deaths in the derivation cohort and 53 deaths in the external validation cohort. The predictors of death were: age >40 years (score +1; HIV seropositive (score +1; HIV seronegative (score -1; hemoglobin ≤6.5 g/dl (score +1; bleeding (score +1; jaundice (score +1; edema (score +1; ascites (score +2 and tuberculosis (score +1. The total predictor score per patient ranged from -1 to +5. A score of -1, indicated a low risk of death (1.0%, a score of 0 an intermediate risk of death (3.8% and a score of +1 to +5, a high risk of death (10.4-85.7%. The area under the receiver operating characteristic curve was 0.83 (95% confidence interval: 0.79-0.87 in derivation, and 0.78 (95% confidence interval: 0.72-0.83 in external validation.The overall performance of the score was good. The score can enable the early detection of VL cases at high risk of death, which can inform operational, clinical management guidelines, and VL program management. Implementation of focused strategies could contribute to optimal management and reduction of the case fatality rates.

  8. Comparison of discrimination and prognostic value of two US Doppler scoring systems in rheumatoid arthritis patients

    DEFF Research Database (Denmark)

    Ellegaard, Karen; Terslev, Lene; Christensen, Robin

    2014-01-01

    OBJECTIVES: The aim of this paper is to investigate sensitivity to change (SRM), predictive validity and discriminative ability of a quantitative (QS) and a semi-quantitative (SQS) Doppler ultrasound scoring systems in patients with rheumatoid arthritis (RA) treated with anti-TNF-α therapy. METHODS......: RA patients with wrist joint affection treated with TNF-α inhibitor were followed for one year. The wrist was examined with Doppler before initiating therapy and after one year. DAS28 was determined at both visits. One person trained in the SQS system and one in the QS system evaluated the anonymised...... images. The SRM, predictive validity and discriminative ability for both systems were calculated using DAS28 as the measure of disease improvement. RESULTS: Fourty-six patients with RA (80% females) were included. The mean Doppler activity at baseline was QS:24.4% (SD=17.7%) and SQS:2.0 (SD=0...

  9. A novel scoring system for prognostic prediction in d-galactosamine/lipopolysaccharide-induced fulminant hepatic failure BALB/c mice

    Directory of Open Access Journals (Sweden)

    Gao Yan

    2009-12-01

    Full Text Available Abstract Background It is frequently important to identify the prognosis of fulminant hepatic failure (FHF patients as this will influence patient management and candidacy for liver transplantation. Therefore, a novel scoring system based on metabonomics combining with multivariate logistic regression was developed to predict the prognosis of FHF mouse model. Methods BALB/c mice were used to construct FHF model. Parts of plasma were collected at 4, 5, and 6-h time points after treatment, respectively, and detected using gas chromatography/time-of-flight mass spectrometry (GC/TOFMS. The acquired data were processed using partial least square discriminant analysis (PLS-DA. The metabolic markers identified were used to construct a scoring system by multivariate regression analysis. Results 28 mice of survival group and 28 of dead group were randomly selected and analyzed. PLS regression analysis showed that both the PLS models of 5 h and 6 h after d-galactosamine/lipopolysaccharide treatment demonstrated good performances. Loadings plot suggested that phosphate, beta-hydroxybutyrate (HB, urea, glucose and lactate concentrations in plasma had the highest weightings on the clustering differences at the three time points. By the multivariate logistic regression analysis, the death/survival index (DSI was constructed based on relative concentrations of HB, urea and phosphate. It provided general accurate rate of prediction of 93.3% in the independent samples. Conclusions The novel scoring system based on metabonomics combining with multivariate logistic regression is accurate in predicting the prognosis of FHF mouse model and may be referred in clinical practice as a more useful prognostic tool with other available information.

  10. Design and Validation of the GI-NEC Score to Prognosticate Overall Survival in Patients With High-Grade Gastrointestinal Neuroendocrine Carcinomas.

    Science.gov (United States)

    Lamarca, Angela; Walter, Thomas; Pavel, Marianne; Borbath, Ivan; Freis, Patricia; Nuñez, Barbara; Childs, Alexa; McNamara, Mairéad G; Hubner, Richard A; Garcia-Carbonero, Rocio; Meyer, Tim; Valle, Juan W; Barriuso, Jorge

    2017-01-01

    Prognostic markers for risk stratification of patients with gastrointestinal high-grade neuroendocrine carcinomas (GI-NECs) are lacking; we designed and validated a prognostic score for overall survival (OS). Consecutive patients diagnosed in five neuroendocrine specialist European centers were included. Patients were divided into three cohorts: a training cohort (TC), an external validation cohort (EVC), and a prospective validation cohort (PVC). Prognostic factors were identified by log-rank test, Cox-regression, and logistic regression analyses. The derived score was internally and externally validated. All statistical tests were two-sided. Of 395 patients screened, 313 were eligible (TC = 109 patients, EVC = 184 patients, and PVC = 20 patients). The derived prognostic score included five variables: presence of liver metastases, alkaline phosphatase (ALK), lactate dehydrogenase (LDH), Eastern Cooperative Oncology Group performance status (ECOG PS), and Ki67. In multivariable analysis, the score was prognostic for OS (hazard ratio [HR] = 1.86, 95% confidence interval [CI] = 1.47 to 2.35, P EVC and PVC, in which our score was able to prognosticate for OS when adjusted for other prognostic variables in the multivariable analysis (HR = 1.85, 95% CI = 1.27 to 2.71, P = .001; and HR = 4.51, 95% CI = 1.87 to 10.87, P = .001, respectively). The score classified patients into two groups with incremental risk of death: group A (0-2 points, 181 patients [63.9%], median OS = 19.4 months, 95% CI = 16.1 to 25.1) and group B (3-6 points, 102 patients [36.1%], median OS = 5.2 months, 95% CI = 3.6 to 6.9). The GI-NEC score identifies two distinct patient cohorts; it provides a tool for clinicians when making treatment decisions and may be used as a stratification factor in future clinical trials. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  11. IP-10 is an important chemokine secreted by tumor infiltrating lymphocytes and is an independent prognostic factor in triple-negative breast cancer patients

    DEFF Research Database (Denmark)

    Elias, Daniel; Ditzel, Henrik; Kupisiewicz, Kasia

    related to lymphocyte activation, pro- and anti-inflammatory responses, cell stress and apoptotic cell clearance, including IP-10, CCL5, FCRL5, PINX1 and PSR. Co-culture experiments showed that TNBC cell lines stimulated high level expression of IP-10 (258 vs 189 pg/ml p= 0.043), IFNg (170 vs 98 pg/ml, p......-10 was strongly associated with PFS independently of CXCR3 expression, while neither IFNγ (p=0.43) nor CXCR3 (p=0.72) correlated to PFS. Evaluation of CD8+ T cell infiltration levels in the same patient population showed that the level of CD8+ T cell infiltration was also significantly associated...... with PFS (HR 0.7, 95% CI 0.5-0.98, p=0.04). Multivariate analysis of the correlation of IP-10 expression with PFS showed that IP-10 correlated with PFS (HR 0.6, 95% CI 0.38-0.94, P=0.028) independent of the level of CD8+ T cell infiltration, tumor size, lymph node status, malignancy grade or age...

  12. Association between pretreatment Glasgow prognostic score and gastric cancer survival and clinicopathological features: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Zhang CX

    2016-06-01

    Full Text Available Chun-Xiao Zhang,* Shu-Yi Wang,* Shuang-Qian Chen, Shuai-Long Yang, Lu Wan, Bin Xiong Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors and Hubei Cancer Clinical Study Center, Wuhan, Hubei, People’s Republic of China *These authors contributed equally to this work Background: Glasgow prognostic score (GPS is widely known as a systemic inflammatory-based marker. The relationship between pretreatment GPS and gastric cancer (GC survival and clinicopathological features remains controversial. The aim of the study was to conduct a meta-analysis of published studies to evaluate the association between pretreatment GPS and survival and clinicopathological features in GC patients. Methods: We searched PubMed, Embase, MEDLINE, and BioMed databases for relevant studies. Combined analyses were used to assess the association between pretreatment GPS and overall survival, disease-free survival, and clinicopathological parameters by Stata Version 12.0. Results: A total of 14 studies were included in this meta-analysis, including 5,579 GC patients. The results indicated that pretreatment high GPS (HGPS predicted poor overall survival (hazard ratio =1.51, 95% CI: 1.37–1.66, P<0.01 and disease-free survival (hazard ratio =1.45, 95% CI: 1.26–1.68, P<0.01 in GC patients. Pretreatment HGPS was also significantly associated with advanced tumor–node–metastasis stage (odds ratio [OR] =3.09, 95% CI: 2.11–4.53, P<0.01, lymph node metastasis (OR =4.60, 95% CI: 3.23–6.56, P<0.01, lymphatic invasion (OR =3.04, 95% CI: 2.00–4.62, P<0.01, and venous invasion (OR =3.56, 95% CI: 1.81–6.99, P<0.01. Conclusion: Our meta-analysis indicated that pretreatment HGPS could be a predicative factor of poor survival outcome and clinicopathological features for GC patients. Keywords: Glasgow prognostic score, gastric cancer, survival, clinicopathological feature

  13. Impact of the degree of anemia on the outcome of patients with myelodysplastic syndrome and its integration into the WHO classification-based Prognostic Scoring System (WPSS).

    Science.gov (United States)

    Malcovati, Luca; Della Porta, Matteo G; Strupp, Corinna; Ambaglio, Ilaria; Kuendgen, Andrea; Nachtkamp, Kathrin; Travaglino, Erica; Invernizzi, Rosangela; Pascutto, Cristiana; Lazzarino, Mario; Germing, Ulrich; Cazzola, Mario

    2011-10-01

    Anemia is an established negative prognostic factor in myelodysplastic syndromes but the relationship between its degree and clinical outcome is poorly defined. We, therefore, studied the relationship between severity of anemia and outcome in myelodysplastic syndrome patients. We studied 840 consecutive patients diagnosed with myelodysplastic syndromes at the Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, and 504 patients seen at the Heinrich-Heine-University Hospital, Düsseldorf, Germany. Hemoglobin levels were monitored longitudinally and analyzed by means of time-dependent Cox's proportional hazards regression models. Hemoglobin levels lower than 9 g/dL in males (HR 5.56, P=0.018) and 8 g/dL in females (HR=5.35, P=0.026) were independently related to reduced overall survival, higher risk of non-leukemic death and cardiac death (Panemia, defined as hemoglobin below these thresholds, was found to be as effective as transfusion-dependency in the prognostic assessment. After integrating this definition of severe anemia into the WHO classification-based Prognostic Scoring System, time-dependent regression and landmark analyses showed that the refined model was able to identify risk groups with different survivals at any time during follow up. Accounting for severity of anemia through the WHO classification-based Prognostic Scoring System provides an objective criterion for prognostic assessment and implementation of risk-adapted treatment strategies in myelodysplastic syndrome patients.

  14. Prognostic value of an ocular trauma score in ocular firecracker trauma.

    Science.gov (United States)

    Qi, Ying; Zhu, Yu

    2013-01-01

    The aim of this study was to report the incidence and management of ocular firecracker trauma and to assess the predictive value of an Ocular Trauma Score (OTS) in ocular firecracker trauma. The study includes consecutive case study and retrospective analysis of ocular firecracker trauma. Numerical values rendered to the OTS variables (visual acuity, rupture, endophthalmitis, perforating or penetrating injury, retinal detachment, and afferent pupillary defect) at presentation were summated and converted to OTS categories. The likelihood of the final visual acuities in each category were calculated. The sensitivity and specificity of OTS were also determined. Forty-eight patients (54 eyes) were enrolled in the study. Male patients accounted for 85.4%. Of the total patients, 62.5% were younger than 15 years. Bystanders accounted for 47.9%. The average follow up was 18.5±3.6 months. The most common clinical manifestation was ocular penetrating or perforating injury. Of the total number of patients, 53.7% had best-corrected vision, at the time of their last follow up, ranging from 20/50-20/200. The OTS has 100% sensitivity and specificity to predict nonlight perception, light perception/hand motion, and 1/200-19/200. The OTS has 45% sensitivity and 100% specificity to predict vision of 20/200-20/50. The OTS has 100% sensitivity and 65% specificity to predict vision of ≥20/40. The clinical manifestations of ocular firecracker trauma in Zhengzhou are more severe than in other countries, but similar to reports of other cities of comparable size to that in China. The OTS has good predictive value for ocular firecracker trauma with 100% sensitivity and specificity to predict a final vision of nonlight perception, light perception/hand motion, and 1/200-19/200.

  15. Does the RIFLE Classification Improve Prognostic Value of the APACHE II Score in Critically Ill Patients?

    Science.gov (United States)

    Wahrhaftig, Kátia M; Correia, Luis C L; Matias, Denise; De Souza, Carlos A M

    2013-01-01

    Introduction. The RIFLE classification defines three severity criteria for acute kidney injury (AKI): risk, injury, and failure. It was associated with mortality according to the gradation of AKI severity. However, it is not known if the APACHE II score, associated with the RIFLE classification, results in greater discriminatory power in relation to mortality in critical patients. Objective. To analyze whether the RIFLE classification adds value to the performance of APACHE II in predicting mortality in critically ill patients. Methods. An observational prospective cohort of 200 patients admitted to the ICU from July 2010 to July 2011. Results. The age of the sample was 66 (±16.7) years, 53.3% female. ICU mortality was 23.5%. The severity of AKI presented higher risk of death: class risk (RR = 1.89 CI:0.97-3.38, P = 0.001), grade injury (RR = 3.7 CI:1.71-8.08, P = 0.001), and class failure (RR = 4.79 CI:2.10-10.6, P = 0.001). The APACHE II had C-statistics of 0.75, 95% (CI:0.68-0.80, P = 0.001) and 0.80 (95% CI:0.74 to 0.86, P = 0.001) after being incorporated into the RIFLE classification in relation to prediction of death. In the comparison between AUROCs, P = 0.03. Conclusion. The severity of AKI, defined by the RIFLE classification, was a risk marker for mortality in critically ill patients, and improved the performance of APACHE II in predicting the mortality in this population.

  16. Does the RIFLE Classification Improve Prognostic Value of the APACHE II Score in Critically Ill Patients?

    Directory of Open Access Journals (Sweden)

    Kátia M. Wahrhaftig

    2013-01-01

    Full Text Available Introduction. The RIFLE classification defines three severity criteria for acute kidney injury (AKI: risk, injury, and failure. It was associated with mortality according to the gradation of AKI severity. However, it is not known if the APACHE II score, associated with the RIFLE classification, results in greater discriminatory power in relation to mortality in critical patients. Objective. To analyze whether the RIFLE classification adds value to the performance of APACHE II in predicting mortality in critically ill patients. Methods. An observational prospective cohort of 200 patients admitted to the ICU from July 2010 to July 2011. Results. The age of the sample was 66 (±16.7 years, 53.3% female. ICU mortality was 23.5%. The severity of AKI presented higher risk of death: class risk (RR = 1.89 CI:0.97–3.38, , grade injury (RR = 3.7 CI:1.71–8.08, , and class failure (RR = 4.79 CI:2.10–10.6, . The APACHE II had C-statistics of 0.75, 95% (CI:0.68–0.80, and 0.80 (95% CI:0.74 to 0.86, after being incorporated into the RIFLE classification in relation to prediction of death. In the comparison between AUROCs, . Conclusion. The severity of AKI, defined by the RIFLE classification, was a risk marker for mortality in critically ill patients, and improved the performance of APACHE II in predicting the mortality in this population.

  17. Prognostic Value of Coronary Computed Tomography (CT) Angiography and Coronary Artery Calcium Score Performed Before Revascularization.

    Science.gov (United States)

    Fujimoto, Shinichiro; Kondo, Takeshi; Kumamaru, Kanako K; Shinozaki, Tomohiro; Takamura, Kazuhisa; Kawaguchi, Yuko; Matsumori, Rie; Hiki, Makoto; Miyauchi, Katsumi; Daida, Hiroyuki; Rybicki, Frank J

    2015-08-21

    Cardiac events after revascularization are equally attributable to recurrence at site of culprit lesions and development of nonculprit lesions. We evaluated the hypothesis that coronary computed tomography (CT) angiography and coronary artery calcium score (CACS) performed before revascularization predicts cardiac events after treatment. Among 2238 consecutive patients without known coronary artery disease who underwent coronary CT angiography and CACS, 359 patients underwent revascularization within 30 days after CT; in 337 of 359 (93.9%) follow-up clinical information was available. In addition to known cardiac risk factors, CT findings were evaluated as predictors of cardiac events after revascularization: CACS and the presence of CT-verified high-risk plaque (CT-HRP). Improvement of predictive accuracy by including CT findings was evaluated from a discrimination (Harrell's C-statistics) standpoint. During the follow-up period (median: 673, interquartile range: 47 to 1529 days), a total of 98 cardiac events occurred. Cox proportional hazard model revealed that age, diabetes, triglyceride, CACS, and nonculprit CT-HRP were significant predictors of overall cardiac events. Although not statistically significant, discriminatory power was greater for the model with CACS (C-stat: 63.2%) and the model with both CACS and CT-HRP (65.8%) compared to the model including neither CACS nor CT-HRP (60.7%). High CACS and the presence of nonculprit CT-HRP performed before revascularization are significant predictors of cardiac events after revascularization. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  18. Predicting outcome after traumatic brain injury: development of prognostic scores based on the IMPACT and the APACHE II.

    Science.gov (United States)

    Raj, Rahul; Siironen, Jari; Kivisaari, Riku; Hernesniemi, Juha; Skrifvars, Markus B

    2014-10-15

    Prediction models are important tools for heterogeneity adjustment in clinical trials and for the evaluation of quality of delivered care to patients with traumatic brain injury (TBI). We sought to improve the predictive performance of the IMPACT (International Mission for Prognosis and Analysis of Clinical Trials) prognostic model by combining it with the APACHE II (Acute Physiology and Chronic Health Evaluation II) for 6-month outcome prediction in patients with TBI treated in the intensive care unit. A total of 890 patients with TBI admitted to a large urban level 1 trauma center in 2009-2012 comprised the study population. The IMPACT and the APACHE II scores were combined using binary logistic regression. A randomized, split-sample technique with secondary bootstrapping was used for model development and internal validation. Model performance was assessed by discrimination (by area under the curve [AUC]), calibration, precision, and net reclassification improvement (NRI). Overall 6-month mortality was 22% and unfavorable neurological outcome 47%. The predictive power of the new combined IMPACT-APACHE II models was significantly superior, compared to the original IMPACT models (AUC, 0.81-0.82 vs. 0.84-0.85; p0.05). However, NRI showed a significant improvement in risk stratification of patients with unfavorable outcome by the IMPACT-APACHE II models, compared to the original models (NRI, 5.4-23.2%; pAPACHE II with the IMPACT, improved 6-month outcome predictive performance is achieved. This may be applicable for heterogeneity adjustment in forthcoming TBI studies.

  19. Traumatic extremity arterial injury in children: Epidemiology, diagnostics, treatment and prognostic value of Mangled Extremity Severity Score

    Directory of Open Access Journals (Sweden)

    Lange Nadine

    2010-04-01

    Full Text Available Abstract Background Traumatic paediatric arterial injuries are a great challenge due to low incidence and specific characteristics of paediatric anatomy and physiology. The aim of the present study was to investigate their epidemiology, diagnostic and therapeutic options and complications. Furthermore, the prognostic value of the Mangled Extremity Severity Score (MESS was evaluated. Methods In a retrospective clinical study 44 children aged 9.0 ± 3.2 years treated for traumatic extremity arterial lesions in our Level I trauma center between 1971 and 2006 were enrolled. Exclusion criteria were age > 14, venous and iatrogenic vascular injury. Demographic data, mechanism of injury, severity of arterial lesions (by Vollmar and MESS, diagnostic and therapeutic management, complications and outcome were evaluated. Results The most commonly injured vessel was the femoral artery (25% followed by the brachial artery (22.7%. The mechanism of injury was penetrating (31.8%, isolated severe blunt extremity trauma (29.6%, multiple trauma (25% and humeral supracondylar fractures (13.6%. In 63.6% no specific vascular diagnostic procedure was performed in favour of emergency surgery. Surgical reconstructive strategies were preferred (68.2%. A MESS Conclusions Traumatic paediatric vascular injuries are very rare. The most common situations of vascular lesions in childhood were penetrating injuries and fractures of the extremities either as isolated injuries or in multiply injured patients. In paediatric patients, the MESS could serve as a basis for decision making for limb salvage or amputation.

  20. Antibody performance in ChIP-sequencing assays: From quality scores of public data sets to quantitative certification [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Marco-Antonio Mendoza-Parra

    2016-03-01

    Full Text Available We have established a certification system for antibodies to be used in chromatin immunoprecipitation assays coupled to massive parallel sequencing (ChIP-seq. This certification comprises a standardized ChIP procedure and the attribution of a numerical quality control indicator (QCi to biological replicate experiments. The QCi computation is based on a universally applicable quality assessment that quantitates the global deviation of randomly sampled subsets of ChIP-seq dataset with the original genome-aligned sequence reads. Comparison with a QCi database for >28,000 ChIP-seq assays were used to attribute quality grades (ranging from ‘AAA’ to ‘DDD’ to a given dataset. In the present report we used the numerical QC system to assess the factors influencing the quality of ChIP-seq assays, including the nature of the target, the sequencing depth and the commercial source of the antibody.  We have used this approach specifically to certify mono and polyclonal antibodies obtained from Active Motif directed against the histone modification marks H3K4me3, H3K27ac and H3K9ac for ChIP-seq. The antibodies received the grades AAA to BBC (www.ngs-qc.org. We propose to attribute such quantitative grading of all antibodies attributed with the label “ChIP-seq grade”.

  1. Short- and Long-Term Prognostic Utility of the HEART Score in Patients Evaluated in the Emergency Department for Possible Acute Coronary Syndrome.

    Science.gov (United States)

    Jain, Tarun; Nowak, Richard; Hudson, Michael; Frisoli, Tiberio; Jacobsen, Gordon; McCord, James

    2016-06-01

    The HEART score is a risk-stratification tool that was developed and validated for patients evaluated for possible acute coronary syndrome (ACS) in the emergency department (ED). We sought to determine the short-term and long-term prognostic utility of the HEART score. A retrospective single-center analysis of 947 patients evaluated for possible ACS in the ED in 1999 was conducted. Patients were followed for major adverse cardiac events (MACEs) at 30 days: death, acute myocardial infarction, or revascularization procedure. All-cause mortality was assessed at 5 years. The HEART score was compared with the Thrombolysis in Myocardial Infarction (TIMI) score. At 30 days, 14% (135/947) of patients had an MACE: 48 deaths (5%), 84 acute myocardial infarctions (9%), and 48 (5%) revascularization procedures. The MACE rate in patients with HEART score ≤3 was 0.6% (1/175) involving a revascularization procedure, 9.5% (53/557) in patients with HEART score between 4 and 6, and 38% (81/215) with HEART score ≥7. The C-statistic for the HEART score was 0.82 and 0.68 for the TIMI score for predicting 30-day MACE (P < 0.05). Patients with HEART score ≤3 had lower 5-year mortality rate compared with those with TIMI score of 0 (10.6% vs. 20.5%, P = 0.02). The HEART score is a valuable risk-stratification tool in predicting not only short-term MACE but also long-term mortality in patients evaluated for possible ACS in the ED. The HEART score had a superior prognostic value compared with the TIMI score.

  2. Prognostic significance of multiple-detector computed tomography in conjunction with TIMI risk score for patients with non-ST elevation acute coronary syndrome.

    Science.gov (United States)

    Noda, Mayumi; Takagi, Atsushi; Kuwatsuru, Ryohei; Mitsuhashi, Norio; Kasanuki, Hiroshi

    2008-05-01

    Risk stratification among patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) has been made by clinical scoring. Recently, multiple-detector computed tomography (MDCT) appeared to provide noninvasive coronary angiography (CAG). To clarify the prognostic significance of MDCT, we aimed to evaluate the clinical utility of MDCT in the early management and in predicting the long-term prognosis of NSTE-ACS with low to intermediate risk. Among 84 consecutive patients with NSTEACS, risk stratification using a TIMI risk score was done. A total of 48 patients were categorized as low to intermediate risk. Multiple-detector CT was performed in 30 patients using 16-slice MDCT. MDCT detected coronary stenoses in 18 patients. Compared to invasive CAG, MDCT successfully depicted the coronary stenosis (P TIMI risk score appeared to demonstrate prognostic significance in patients with NSTE-ACS.

  3. Prognostic value of malnutrition assessed by Controlling Nutritional Status score for long-term mortality in patients with acute heart failure.

    Science.gov (United States)

    Iwakami, Naotsugu; Nagai, Toshiyuki; Furukawa, Toshiaki A; Sugano, Yasuo; Honda, Satoshi; Okada, Atsushi; Asaumi, Yasuhide; Aiba, Takeshi; Noguchi, Teruo; Kusano, Kengo; Ogawa, Hisao; Yasuda, Satoshi; Anzai, Toshihisa

    2017-03-01

    The prognostic value of nutritional status is poorly understood and evidence-based nutritional assessment indices are required in acute heart failure (AHF). We investigated the prognostic value of malnutrition assessed by the Controlling Nutritional Status (CONUT) score (range 0-12, higher=worse, consisting of serum albumin, cholesterol and lymphocytes) in AHF patients. The CONUT score was measured on admission in 635 consecutive AHF patients. The primary outcome was all-cause death. Median CONUT score was 3 (interquartile range 2 to 5). During the median follow-up of 324days, CONUT score was independently associated with death (HR 1.26, 95% CI 1.11-1.42, Pnutritional markers in HF. Furthermore, addition of the CONUT score to an established risk prediction model from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure study significantly increased the C-statistic from 0.75 to 0.77 (P=0.02). The net reclassification improvement afforded by CONUT score was 21% for all-cause death, 27% for survival and 49% overall (Pnutritional indices. Moreover, addition of the score to the existing risk prediction model significantly increased the predictive ability for death, indicating beneficial clinical application of the CONUT score in AHF patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Comparison of the prognostic value of normal regadenoson with normal adenosine myocardial perfusion imaging with propensity score matching.

    Science.gov (United States)

    Iqbal, Fahad M; Hage, Fadi G; Ahmed, Ali; Dean, Phillip J; Raslan, Saleem; Heo, Jaekyeong; Iskandrian, Ami E

    2012-10-01

    The aim of this study was to test the hypothesis that patients with normal regadenoson myocardial perfusion imaging (MPI) have a low rate of cardiac events, similar to patients with normal adenosine MPI. Regadenoson, a new selective adenosine A(2A) receptor agonist, is now a widely used stress agent for MPI. The low rate of cardiac events in patients with normal adenosine MPI is well-documented, but the prognostic implications of a normal regadenoson MPI have not been examined and compared with those with adenosine. Data on primary composite endpoint (cardiac death, myocardial infarction, and coronary revascularization) were collected for 2,000 patients (1,000 regadenoson, and 1,000 adenosine stress) with normal myocardial perfusion and left ventricular ejection fraction referred for vasodilator MPI. In addition, propensity scores were used to assemble a balanced cohort of 505 pairs of patients who were balanced on 36 baseline characteristics. The primary endpoint occurred in 21 (2.1%; 1.1%/year) patients in the regadenoson group and 33 (3.3%; 1.7%/year) patients in the adenosine group (hazard ratio [HR] for regadenoson vs. adenosine: 0.62; 95% confidence interval [CI]: 0.36 to 1.08; p = 0.090). In the propensity-matched pairs, the primary endpoint occurred in 7 (1.4%; 0.7%/year) patients in the regadenoson group and 13 (2.6%; 1.3%/year) patients in the adenosine group (matched HR: 0.58; 95% CI: 0.23 to 1.48; p = 0.257). Cardiac deaths were infrequent in the entire sample and in the propensity-matched groups; the cardiac death rate was 0.9%/year and 1.15%/year in the regadenoson and adenosine groups (HR: 0.77; 95% CI: 0.42 to 1.43; p = 0.404) in the pre-match sample and 0.5%/year and 0.7%/year in the matched groups, respectively (HR: 0.83; 95% CI: 0.25 to 2.73; p = 0.763). Major cardiac events are infrequent in patients with normal regadenoson MPI. These findings provide assurance that normal MPI using a simpler stress protocol with regadenoson provides prognostic

  5. Does high-sensitivity C-reactive protein add prognostic value to the TIMI-Risk Score in individuals with non-ST elevation acute coronary syndromes?

    Science.gov (United States)

    Correia, Luis C L; Lima, José C; Rocha, Mário S; D'Oliveira Junior, Argemiro; Péricles Esteves, J

    2007-01-01

    C-reactive protein (CRP) measured at hospital arrival of patients with non-ST elevation acute coronary syndromes (ACS) may add prognostic information to the TIMI-Risk Score. Eighty-six consecutive patients admitted with unstable angina or non-ST-elevation acute myocardial infarction and symptoms onset within the prior 48 h were included. Recurrent cardiovascular events during hospitalization were defined as non-fatal myocardial infarction or death. Serum CRP was measured immediately at hospital arrival and its prognostic value in relation to in-hospital cardiovascular events was tested by the area under the ROC curve and adjusted for TIMI risk predictors by logistic regression analysis. In addition, a CRP modified TIMI-Risk score was created by adding 2 points if CRP greater than the cut-off proposed by the ROC curve analysis. The accuracy of this new score was compared with the usual TIMI-Risk Score. A significant predictive value of CRP in relation to in-hospital cardiovascular events was indicated by an area under the ROC curve of 0.80 (95% CI=0.66 to 0.93, p=0.009). C-reactive protein cut-off point of best prognostic performance was 7.2 mg/l. In the multivariate analysis, increased CRP (>7.2 mg/l) remained a significant predictor of events after adjustment for TIMI risk predictors (OR=14; 95% CI=1.6-121; p=0.018). The area under the ROC curve for the TIMI-Risk Score was 0.87 (95% CI=0.76-0.99, p=0.001). The addition of CRP to the TIMI-Risk Score improved its prognostic value (area under the ROC curve=0.93; 95% CI=0.87-0.99, pscore is demonstrated by a higher specificity (86% vs. 63%, pTIMI-Risk Score. CRP measured at admission of patients with non-ST-elevation acute coronary syndromes adds prognostic information to the TIMI-Risk Score. Additionally, the incorporation of this variable into the TIMI-Risk Score calculation is an effective manner to utilize CRP for risk stratification.

  6. The sequential organ failure assessment (SOFA) score is prognostically superior to the model for end-stage liver disease (MELD) and MELD variants following paracetamol (acetaminophen) overdose.

    Science.gov (United States)

    Craig, D G N; Reid, T W D J; Wright, E C; Martin, K G; Davidson, J S; Hayes, P C; Simpson, K J

    2012-03-01

    The prognostic value of the model for end-stage liver disease (MELD) and sodium-based MELD variants in predicting survival following paracetamol overdose remains unclear. To examine the prognostic accuracy of sodium-based MELD variants in paracetamol-induced acute liver injury compared with the sequential organ failure assessment (SOFA) score. Retrospective analysis of 138 single time point paracetamol overdoses admitted to a tertiary liver centre. Individual laboratory samples were correlated with the corresponding clinical parameters in relation to time post-overdose, and the daily MELD, MELD-Na, MELDNa, MESO, iMELD, UKELD, updated MELD and SOFA scores were calculated. Sixty-six (47.8%) patients developed hepatic encephalopathy, of whom 7 were transplanted and 21 died without liver transplantation. SOFA had a significantly greater area under the receiver operator characteristic for the prediction of spontaneous survival compared with MELD at both 72 (P = 0.024) and 96 (P = 0.017) h post-overdose. None of the sodium-based MELD variants improved the prognostic accuracy of MELD. A SOFA score >6 by 72 h or >7 by 96 h, post-overdose predicted death/transplantation with a negative predictive value of 96.9 (95% CI 90.2-99.4) and 98.8 (95% CI 93.6-99.9) respectively. SOFA and MELD had similar accuracy for predicting the development of hepatic encephalopathy (P = 0.493). The SOFA score is superior to MELD in predicting spontaneous survival following paracetamol-induced acute liver injury. Modification of the MELD score to include serum sodium does not improve prognostic accuracy in this setting. SOFA may have potential as a quantitative triage marker following paracetamol overdose. © 2012 Blackwell Publishing Ltd.

  7. Prognostic impact of nutritional status assessed by the Controlling Nutritional Status score in patients with stable coronary artery disease undergoing percutaneous coronary intervention.

    Science.gov (United States)

    Wada, Hideki; Dohi, Tomotaka; Miyauchi, Katsumi; Doi, Shinichiro; Konishi, Hirokazu; Naito, Ryo; Tsuboi, Shuta; Ogita, Manabu; Kasai, Takatoshi; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

    2017-11-01

    Recently, malnutrition has been shown to be related to worse clinical outcomes in patients with heart failure. However, the association between nutritional status and clinical outcomes in patients with coronary artery disease (CAD) remains unclear. We investigated the prognostic value of malnutrition assessed by the Controlling Nutritional Status (CONUT; range 0-12, higher = worse, consisting of serum albumin, cholesterol and lymphocytes) score in patients with CAD. The CONUT score was measured on admission in a total of 1987 patients with stable CAD who underwent elective percutaneous coronary intervention (PCI) between 2000 and 2011. Patients were divided into two groups according to their CONUT score (0-1 vs. ≥2). The incidence of major adverse cardiac events (MACE), including all-cause death and non-fatal myocardial infarction, was evaluated. The median CONUT score was 1 (interquartile range 0-2). During the median follow-up of 7.4 years, 342 MACE occurred (17.2%). Kaplan-Meier curves revealed that patients with high CONUT scores had higher rates of MACE (log-rank p Nutritional status assessed by the CONUT score was significantly associated with long-term clinical outcomes in patients with CAD. Pre-PCI assessment of the CONUT score may provide useful prognostic information.

  8. Neutrophil/Lymphocyte Ratio, Lymphocyte/Monocyte Ratio, and Absolute Lymphocyte Count/Absolute Monocyte Count Prognostic Score in Diffuse Large B-Cell Lymphoma

    Science.gov (United States)

    Ho, Ching-Liang; Lu, Chieh-Sheng; Chen, Jia-Hong; Chen, Yu-Guang; Huang, Tzu-Chuan; Wu, Yi-Ying

    2015-01-01

    Abstract The neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), and absolute lymphocyte count/absolute monocyte count prognostic score (ALC/AMC PS) have been described as the most useful prognostic tools for patients with diffuse large B-cell lymphoma (DLBCL). We retrospectively analyzed 148 Taiwanese patients with newly diagnosed diffuse large B-cell lymphoma under rituximab (R)-CHOP-like regimens from January 2001 to December 2010 at the Tri-Service General Hospital and investigated the utility of these inexpensive tools in our patients. In a univariate analysis, the NLR, LMR, and ALC/AMC PS had significant prognostic value in our DLBCL patients (NLR: 5-year progression-free survival [PFS], P = 0.001; 5-year overall survival [OS], P = 0.007. LMR: PFS, P = 0.003; OS, P = 0.05. ALC/AMC PS: PFS, P < 0.001; OS, P < 0.001). In a separate multivariate analysis, the ALC/AMC PS appeared to interact less with the other clinical factors but retained statistical significance in the survival analysis (PFS, P = 0.023; OS, P = 0.017). The akaike information criterion (AIC) analysis produced scores of 388.773 in the NLR, 387.625 in the LMR, and 372.574 in the ALC/AMC PS. The results suggested that the ALC/AMC PS appears to be more reliable than the NLR and LMR and may provide additional prognostic information when used in conjunction with the International Prognostic Index. PMID:26091479

  9. Ogbuewu, IP

    African Journals Online (AJOL)

    Ogbuewu, IP. Vol 13 (2011) - Articles Egg Production Potentials of Muscovy Ducks (Cairina moschata) Raised Under Three Management Systems in the Humid Tropics Abstract. ISSN: 1119-4308. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL ...

  10. Mobile IP

    NARCIS (Netherlands)

    Heijenk, Geert; Sallent, S.; Pras, Aiko

    1999-01-01

    The Internet is growing exponentially, both in the amount of traffic carried, and in the amount of hosts connected. IP technology is becoming more and more important, in company networks (Intranets), and also in the core networks for the next generation mobile networks. Further, wireless access to

  11. High resolution Chromatin Immunoprecipitation (ChIP) sequencing reveals novel bindings targets and prognostic role for SOX11 in Mantle cell lymphoma

    Science.gov (United States)

    Kuo, Pei-Yu; Leshchenko, Violetta V.; Fazzari, Melissa J.; Perumal, Deepak; Gellen, Tobias; He, Tianfang; Iqbal, Javeed; Baumgartner-Wennerholm, Stefanie; Nygren, Lina; Zhang, Fan; Zhang, Weijia; Suh, K. Stephen; Goy, Andre; Yang, David T.; Chan, Wing-Chung; Kahl, Brad S.; Verma, Amit K.; Gascoyne, Randy D.; Kimby, Eva; Sander, Birgitta; Ye, B. Hilda; Melnick, Ari M.; Parekh, Samir

    2015-01-01

    SOX11 (Sex determining region Y-box 11) expression is specific for MCL as compared to other Non-Hodgkin's lymphomas. However, the function and direct binding targets of SOX11 in MCL are largely unknown. We used high-resolution ChIP-Seq to identify the direct target genes of SOX11 in a genome-wide, unbiased manner and elucidate its functional significance. Pathway analysis identified WNT, PKA and TGF-beta signaling pathways as significantly enriched by SOX11 target genes. qCHIP and promoter reporter assays confirmed that SOX11 directly binds to individual genes and modulates their transcription activities in these pathways in MCL. Functional studies using RNA interference demonstrate that SOX11 directly regulates WNT in MCL. We analyzed SOX11 expression in three independent well-annotated tissue microarrays from the University of Wisconsin (UW), Karolinska Institute and British Columbia Cancer Agency (BCCA). Our findings suggest that high SOX11 expression is associated with improved survival in a subset of MCL patients, particularly those treated with intensive chemotherapy. Transcriptional regulation of WNT and other biological pathways affected by SOX11 target genes may help explain the impact of SOX11 expression on patient outcomes. PMID:24681958

  12. Prognostic Discrimination Using a 70-Gene Signature among Patients with Estrogen Receptor-Positive Breast Cancer and an Intermediate 21-Gene Recurrence Score

    Directory of Open Access Journals (Sweden)

    Sung Gwe Ahn

    2013-12-01

    Full Text Available The Oncotype DX® recurrence score (RS predictor has been clinically utilized to appropriately select adjuvant chemotherapy for patients with estrogen receptor (ER-positive early breast cancer. However, the selection of chemotherapy for patients with intermediate RSs remains controversial. We assessed the prognostic value of a 70-gene signature (70GS among patients with ER-positive breast cancer and intermediate RSs. In addition, we sought to identify genes associated with poor 70GS scores based on gene expression profiling (GEP. GEP was performed using gene expression data from 186 patients with ER-positive breast cancer. The RS and 70GS score were calculated on the basis of GEP. Among 186 patients, 82 ER-positive patients with intermediate RSs were identified. These patients were stratified by 70GS, overall survival (OS significantly differed according to 70GS (p = 0.013. In a supervised hierarchical analysis according to 70GS, the expression of several representative genes for cell proliferation was significantly higher in the poor 70GS cluster than in the good 70GS cluster. Furthermore, among these patients, FOXM1, AURKA, AURKB, and BIRC5 displayed prognostic significance for OS. In conclusion, 70GS can help to discriminate survival differences among ER-positive patients with intermediate RSs. FOXM1, AURKA, AURKB, and BIRC5, are associated with poor 70GS scores.

  13. Preoperative Prognostic Factors After Liver Resection for Non-Colorectal, Non-Neuroendocrine Liver Metastases and Validation of the Adam Score in an Asian Population.

    Science.gov (United States)

    Sim, Dayna P Y; Goh, Brian K P; Lee, Ser-Yee; Chan, Chung-Yip; Tan, Iain B H; Cheow, Peng-Chung; Jeyaraj, Premaraj; Chow, Pierce K H; Ooi, London L P J; Chung, Alexander Y F

    2017-09-05

    Historically, the benefit of liver resection for non-colorectal, non-neuroendocrine (NCNN) liver metastases has been controversial. This study aims to determine the preoperative prognostic factors of liver resection for NCNN liver metastases and validate the Adam score in an Asian population. Consecutive patients who underwent liver resection for NCNN liver metastases were identified retrospectively from a prospective liver resection database of the single institution between 2001 and 2014. Univariate Cox regression models were used to identify associations with outcome variables. Recurrence-free interval and overall survival were determined using the Kaplan-Meier method and compared using log-rank test. Seventy-eight consecutive patients were identified, which met the study criteria. Univariate analysis demonstrated that adenocarcinoma histology of primary cancer, disease-free interval and number of nodules were significant predictors of survival. Four of the six components of Adam score were significant predictors of survival. These were the presence of extrahepatic metastases, R2 resection, disease-free interval and type of a primary tumour. The total Adam score was also a significant predictor of survival. Liver resection for NCNN liver metastases is a safe and viable treatment option in carefully selected patients. Significant preoperative prognostic factors include adenocarcinoma primary tumours, disease-free interval and number of nodules. The total Adam score was a good predictor of overall survival and can be used to risk stratify patients undergoing hepatic resection for NCNN liver metastases.

  14. Secondary Cutaneous Diffuse Large B-cell Lymphoma has a Higher International Prognostic Index Score and Worse Prognosis Than Diffuse Large B-cell Lymphoma, Leg Type.

    Science.gov (United States)

    Lee, Woo Jin; Won, Kwang Hee; Won, Chong Hyun; Chang, Sung Eun; Choi, Jee Ho; Moon, Kee Chan; Park, Chan-Sik; Huh, Jooryung; Suh, Cheolwon; Lee, Mi Woo

    2016-02-01

    Diffuse large B-cell lymphoma (DLBCL) can be separated into 2 groups: nodal and extranodal disease. The aim of this study was to analyse the clinical features of skin lesions and survival outcomes of cutaneous DLBCL according to the primary tumour site. A total of 44 patients with cutaneous DLBCL were classified as primary cutaneous DLBCL, leg type or cutaneous DLBCL secondary to primary disease. Although skin lesion characteristics did not differ significantly between groups, extensive cutaneous lesions were more often observed in secondary cutaneous DLBCL compared with DLBCL, leg type. Secondary cutaneous DLBCL was more commonly associated with an advanced stage and higher International Prognostic Index score than DLBCL, leg type. DLBCL, leg type demonstrated a better survival outcome than secondary cutaneous DLBCL. The multiplicity of skin lesions and time-point of cutaneous involvement were associated with prognosis in secondary cutaneous DLBCL. Survival outcomes and prognostic factors differ depending on the primary tumour site of cutaneous DLBCL.

  15. Prognostic value of diffusion-weighted imaging summation scores or apparent diffusion coefficient maps in newborns with hypoxic-ischemic encephalopathy.

    Science.gov (United States)

    Cavalleri, Francesca; Lugli, Licia; Pugliese, Marisa; D'Amico, Roberto; Todeschini, Alessandra; Della Casa, Elisa; Gallo, Claudio; Frassoldati, Rossella; Ferrari, Fabrizio

    2014-09-01

    The diagnostic and prognostic assessment of newborn infants with hypoxic-ischemic encephalopathy (HIE) comprises, among other tools, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps. To compare the ability of DWI and ADC maps in newborns with HIE to predict the neurodevelopmental outcome at 2 years of age. Thirty-four term newborns with HIE admitted to the Neonatal Intensive Care Unit of Modena University Hospital from 2004 to 2008 were consecutively enrolled in the study. All newborns received EEG, conventional MRI and DWI within the first week of life. DWI was analyzed by means of summation (S) score and regional ADC measurements. Neurodevelopmental outcome was assessed with a standard 1-4 scale and the Griffiths Mental Developmental Scales - Revised (GMDS-R). When the outcome was evaluated with a standard 1-4 scale, the DWI S scores showed very high area under the curve (AUC) (0.89) whereas regional ADC measurements in specific subregions had relatively modest predictive value. The lentiform nucleus was the region with the highest AUC (0.78). When GMDS-R were considered, DWI S scores were good to excellent predictors for some GMDS-R subscales. The predictive value of ADC measurements was both region- and subscale-specific. In particular, ADC measurements in some regions (basal ganglia, white matter or rolandic cortex) were excellent predictors for specific GMDS-R with AUCs up to 0.93. DWI S scores showed the highest prognostic value for the neurological outcome at 2 years of age. Regional ADC measurements in specific subregions proved to be highly prognostic for specific neurodevelopmental outcomes.

  16. Prognostic value of diffusion-weighted imaging summation scores or apparent diffusion coefficient maps in newborns with hypoxic-ischemic encephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Cavalleri, Francesca; Todeschini, Alessandra [Azienda Unita Sanitaria Locale di Modena, Neuroradiology Unit, Department of Neuroscience, Nuovo Ospedale Civile S. Agostino Estense di Modena, Modena (Italy); Lugli, Licia; Pugliese, Marisa; Della Casa, Elisa; Gallo, Claudio; Frassoldati, Rossella; Ferrari, Fabrizio [Modena University Hospital, Institute of Pediatrics and Neonatal Medicine and NICU, Modena (Italy); D' Amico, Roberto [University of Modena and Reggio Emilia, Department of Clinical and Diagnostic Medicine and Public Health, Modena (Italy)

    2014-09-15

    The diagnostic and prognostic assessment of newborn infants with hypoxic-ischemic encephalopathy (HIE) comprises, among other tools, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps. To compare the ability of DWI and ADC maps in newborns with HIE to predict the neurodevelopmental outcome at 2 years of age. Thirty-four term newborns with HIE admitted to the Neonatal Intensive Care Unit of Modena University Hospital from 2004 to 2008 were consecutively enrolled in the study. All newborns received EEG, conventional MRI and DWI within the first week of life. DWI was analyzed by means of summation (S) score and regional ADC measurements. Neurodevelopmental outcome was assessed with a standard 1-4 scale and the Griffiths Mental Developmental Scales - Revised (GMDS-R). When the outcome was evaluated with a standard 1-4 scale, the DWI S scores showed very high area under the curve (AUC) (0.89) whereas regional ADC measurements in specific subregions had relatively modest predictive value. The lentiform nucleus was the region with the highest AUC (0.78). When GMDS-R were considered, DWI S scores were good to excellent predictors for some GMDS-R subscales. The predictive value of ADC measurements was both region- and subscale-specific. In particular, ADC measurements in some regions (basal ganglia, white matter or rolandic cortex) were excellent predictors for specific GMDS-R with AUCs up to 0.93. DWI S scores showed the highest prognostic value for the neurological outcome at 2 years of age. Regional ADC measurements in specific subregions proved to be highly prognostic for specific neurodevelopmental outcomes. (orig.)

  17. Decreased Norton's functional score is an independent long-term prognostic marker in hospital survivors of acute myocardial infarction. Soroka Acute Myocardial Infarction II (SAMI-II) project.

    Science.gov (United States)

    Silber, Hagar; Shiyovich, Arthur; Gilutz, Harel; Ziedenberg, Hanna; Abu Tailakh, Muhammad; Plakht, Ygal

    2017-02-01

    Patient function is a risk factor of mortality following acute myocardial infarction (AMI). Norton scale (NS) was originally developed to estimate the risk for pressure ulcers. It contains 5 domains: mental condition, physical condition, mobility, activity in daily living and incontinence. To evaluate NS as long-term prognostic marker following AMI. A retrospective study based on computerized medical records of AMI patient hospitalized in a tertiary medical center in 2004-2012. NS scores and patients' characteristics were collected from computerized databases. The primary outcome was all-cause long-term (up-to 10-years) mortality. Overall 6964 patients were included; mean age 67.3±14.1years, 68.1% males. Mean NS score was 17.8±3; of which 21.1% had low-NS (≤16). Patients with low-NS had increased prevalence of hypertension, diabetes and renal disease, 3-vessel coronary artery disease, more often Non ST-Elevation Myocardial Infarction (NSTEMI) and in-hospital complications. Throughout the follow-up period cumulative mortality rate in patients with low- and high-NS groups were 97.3% and 43% respectively (AdjHR 1.66; 95% CI: 1.521-1.826; p<0.001). Furthermore, a reduction in one point in the NS score inversely associated with increased risk for mortality (AdjHR 1.10; 95% CI: 1.12-1.22; p<0.001). NS is an independent long-term prognostic marker for all-cause mortality in hospital survivors with a gradual "dose-response" effect. This data emphasizes the importance prognostic implication of the general functional status on the prognosis of AMI patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. An accurate prostate cancer prognosticator using a seven-gene signature plus Gleason score and taking cell type heterogeneity into account.

    Directory of Open Access Journals (Sweden)

    Xin Chen

    Full Text Available One of the major challenges in the development of prostate cancer prognostic biomarkers is the cellular heterogeneity in tissue samples. We developed an objective Cluster-Correlation (CC analysis to identify gene expression changes in various cell types that are associated with progression. In the Cluster step, samples were clustered (unsupervised based on the expression values of each gene through a mixture model combined with a multiple linear regression model in which cell-type percent data were used for decomposition. In the Correlation step, a Chi-square test was used to select potential prognostic genes. With CC analysis, we identified 324 significantly expressed genes (68 tumor and 256 stroma cell expressed genes which were strongly associated with the observed biochemical relapse status. Significance Analysis of Microarray (SAM was then utilized to develop a seven-gene classifier. The Classifier has been validated using two independent Data Sets. The overall prediction accuracy and sensitivity is 71% and 76%, respectively. The inclusion of the Gleason sum to the seven-gene classifier raised the prediction accuracy and sensitivity to 83% and 76% respectively based on independent testing. These results indicated that our prognostic model that includes cell type adjustments and using Gleason score and the seven-gene signature has some utility for predicting outcomes for prostate cancer for individual patients at the time of prognosis. The strategy could have applications for improving marker performance in other cancers and other diseases.

  19. Overexpression of epidermal growth factor receptor as a prognostic factor in colorectal cancer on the basis of the Allred scoring system

    Directory of Open Access Journals (Sweden)

    Rokita M

    2013-07-01

    Full Text Available Marta Rokita,1 Rafal Stec,1 Lubomir Bodnar,1 Radoslaw Charkiewicz,2 Jan Korniluk,1 Marta Smoter,1 Marzena Cichowicz,3 Lech Chyczewski,4 Jacek Nikliński,2 Wojciech Kozłowski,3 Cezary Szczylik11Department of Oncology, Military Institute of Medicine, Central Teaching Hospital, Warsaw, Poland; 2Department of Clinical Molecular Biology, Medical University of Bialystok, Bialystok, Poland; 3Department of Pathology, Military Institute of the Health Services in Warsaw, Warsaw, Poland; 4Department of Clinical Pathology, Medical University of Bialystok, Bialystok, PolandBackground: Overexpression of epidermal growth factor receptor (EGFR is found in many types of neoplasms. The aim of the study was to evaluate EGFR expression in colorectal cancer (CRC specimens and to determine whether EGFR expression correlates with clinicopathological data and overall survival.Patients and methods: Tissue specimens from 181 consecutive CRC patients treated at the Military Institute of Medicine in 2006–2010 were collected and examined for EGFR expression, by immunohistochemistry staining. The staining intensity and percentage of cells with membranous EGFR expression were scored and then grouped according to the parameters of the Allred Scoring system. Cutoff values were subjected to further statistical analysis. Univariate tests and a multivariate Cox proportional hazards model were used in data analysis.Results: EGFR was overexpressed in 96 of 181 CRC specimens (53%. EGFR expression was not correlated with other clinicopathological variables. On univariate analysis, overexpression of EGFR, determined by PS (percentage score (>3 and total score (sum of PS and intensity score (>4, was associated with poor overall survival. On multivariate analysis, EGFR overexpression (PS > 3 was an independent adverse prognostic factor (hazard ratio [HR] 1.62; 95% confidence interval [CI]: 1.03–2.53. Elevated carcinoembryonic antigen (CEA serum concentration before treatment

  20. A new prognostic scale for the early prediction of ischemic stroke recovery mainly based on traditional Chinese medicine symptoms and NIHSS score: a retrospective cohort study.

    Science.gov (United States)

    Cao, Ke-Gang; Fu, Cai-Hong; Li, Huan-Qin; Xin, Xi-Yan; Gao, Ying

    2015-11-16

    Ischemic stroke (IS) is a common disease, often resulting in death or disability. Previous studies on prognosis of stroke mainly focused on the baseline condition or modern expensive tests. However, the change of clinical symptoms during acute stage is considerably neglected. In our study, we aim to develop a new prognostic scale to predict the 90-day outcome of IS patients. In this retrospective cohort study, a secondary data analysis was performed on 489 patients extracted from 1046 patients of 4 hospitals. A new prognostic scale was constructed to predict the recovery of IS mainly based on the National Institutes of Health Stroke Scale (NIHSS) score, traditional Chinese Medicine (TCM) symptoms & signs and the changes during the first 3 days of patients in the 3 TCM hospitals. Receiver Operating Characteristic (ROC) curve was used to determine the cutoff point for prediction. In the end, the scale was used to test the outcome of IS patients in Xuanwu hospital. The new prognostic scale was composed of 8 items including age degree (OR = 3.32; 95 % CI: 1.72-6.42), history of diabetes mellitus (DM) (OR = 2.20; 95 % CI: 1.19-4.08), NIHSS score (OR = 3.08; 95 % CI: 2.16-4.40), anxiety (OR = 3.17; 95 % CI: 1.90-5.29) and irritability (OR = 4.61; 95 % CI: 1.36-15.63) on the 1st day of illness onset, change in NIHSS score (OR = 2.49; 95 % CI: 1.31-4.73), and circumrotating (OR = 7.80; 95 % CI: 1.98-30.64) and tinnitus (OR = 13.25; 95 % CI: 1.55-113.34) during the first 3 days of stroke onset. The total score of the scale was 16.5 and the cutoff point was 9.5, which means patients would have poor outcome at 90 days of stroke onset if the score was higher than 9.5. The new scale was validated on the data of Xuanwu hospital, and the value of its sensitivity, specificity and overall accuracy were 69.6 %, 83.3 % and 75.0 % respectively. The 8-item scale, mainly based on TCM symptoms, NIHSS score and their changes during the first 3 days, can predict the 90-day outcome for IS

  1. Nutritional Risk in Major Abdominal Surgery: Protocol of a Prospective Observational Trial to Evaluate the Prognostic Value of Different Nutritional Scores in Pancreatic Surgery.

    Science.gov (United States)

    Probst, Pascal; Haller, Sebastian; Dörr-Harim, Colette; Bruckner, Thomas; Ulrich, Alexis; Hackert, Thilo; Diener, Markus K; Knebel, Phillip

    2015-11-16

    The influence of patients' preoperative nutritional status on their clinical outcome has already been proven. Therefore, patients with malnutrition are in need of additional therapeutic efforts. However, for pancreatic surgery, evidence suggesting the adequacy of existing nutritional assessment scores to estimate malnutrition associated with postoperative outcome is limited. The aim of the observational trial "Nutritional Risk in Major Abdominal Surgery (NURIMAS) Pancreas" is to prospectively assess and analyze different nutritional assessment scores for their prognostic value on postoperative complications in patients undergoing pancreatic surgery. All patients scheduled to receive elective pancreatic surgery at the University Hospital of Heidelberg will be screened for eligibility. Preoperatively, 12 nutritional assessment scores will be collected and patients will be assigned either at risk or not at risk for malnutrition. The postoperative course will be followed prospectively and complications according to the Clavien-Dindo classification will be recorded. The prognostic value for complications will be evaluated for every score in a univariable and multivariable analysis corrected for known risk factors in pancreatic surgery. Final data analysis is expected to be available during Spring 2016. The NURIMAS Pancreas trial is a monocentric, prospective, observational trial aiming to find the most predictive clinical nutritional assessment score for postoperative complications. Using the results of this protocol as a knowledge base, it is possible to conduct nutritional risk-guided intervention trials to prevent postoperative complications in the pancreatic surgical population. germanctr.de: DRKS00006340; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00006340 (Archived by WebCite at http://www.webcitation.org/6bzXWSRYZ).

  2. Implementation of EuroSCORE II as an adjunct to APACHE II model and SOFA score, for refining the prognostic accuracy in cardiac surgical patients.

    Science.gov (United States)

    Tsaousi, G G; Pitsis, A A; Ioannidis, G D; Pourzitaki, C K; Yannacou-Peftoulidou, M N; Vasilakos, D G

    2015-12-01

    The aim of this paper was to assess the comparable applicability of European System for Cardiac Operative Risk Evaluation II (EuroSCORE II), Acute Physiology and Chronic Health Evaluation (APACHE II) and Sequential Organ Failure (SOFA) scores, in cardiac surgical population, on the basis of morbidity and mortality. EuroSCORE II, APACHE II score and SOFA score derivatives such as TMS (total maximum SOFA), MaxSOFA (single-day maximum total), SOFA 1 (admission SOFA), ΔSOFA (TMS minus SOFA 1), ΔmaxSOFA (MaxSOFA minus SOFA 1) and mean SOFA (daily SOFA to ICU stay), were prospectively calculated for 1058 consecutive patients admitted to postcardiac surgery intensive care unit (ICU). The study endpoints were length of ICU stay (LOS-ICU) and hospital mortality. A disproportionate elevation of the studied algorithms was associated with prolonged LOS-ICU (PAPACHE II in cardiac surgical population. Thus, EuroSCORE II emerges as an imperative adjunct to ICU-based APACHE II and SOFA algorithms as it enables risk stratification, morbidity and mortality prediction even from preoperative assessment.

  3. Validation of cytogenetic risk groups according to International Prognostic Scoring Systems by peripheral blood CD34+FISH: results from a German diagnostic study in comparison with an international control group.

    Science.gov (United States)

    Braulke, Friederike; Platzbecker, Uwe; Müller-Thomas, Catharina; Götze, Katharina; Germing, Ulrich; Brümmendorf, Tim H; Nolte, Florian; Hofmann, Wolf-Karsten; Giagounidis, Aristoteles A N; Lübbert, Michael; Greenberg, Peter L; Bennett, John M; Solé, Francesc; Mallo, Mar; Slovak, Marilyn L; Ohyashiki, Kazuma; Le Beau, Michelle M; Tüchler, Heinz; Pfeilstöcker, Michael; Nösslinger, Thomas; Hildebrandt, Barbara; Shirneshan, Katayoon; Aul, Carlo; Stauder, Reinhard; Sperr, Wolfgang R; Valent, Peter; Fonatsch, Christa; Trümper, Lorenz; Haase, Detlef; Schanz, Julie

    2015-02-01

    International Prognostic Scoring Systems are used to determine the individual risk profile of myelodysplastic syndrome patients. For the assessment of International Prognostic Scoring Systems, an adequate chromosome banding analysis of the bone marrow is essential. Cytogenetic information is not available for a substantial number of patients (5%-20%) with dry marrow or an insufficient number of metaphase cells. For these patients, a valid risk classification is impossible. In the study presented here, the International Prognostic Scoring Systems were validated based on fluorescence in situ hybridization analyses using extended probe panels applied to cluster of differentiation 34 positive (CD34(+)) peripheral blood cells of 328 MDS patients of our prospective multicenter German diagnostic study and compared to chromosome banding results of 2902 previously published patients with myelodysplastic syndromes. For cytogenetic risk classification by fluorescence in situ hybridization analyses of CD34(+) peripheral blood cells, the groups differed significantly for overall and leukemia-free survival by uni- and multivariate analyses without discrepancies between treated and untreated patients. Including cytogenetic data of fluorescence in situ hybridization analyses of peripheral CD34(+) blood cells (instead of bone marrow banding analysis) into the complete International Prognostic Scoring System assessment, the prognostic risk groups separated significantly for overall and leukemia-free survival. Our data show that a reliable stratification to the risk groups of the International Prognostic Scoring Systems is possible from peripheral blood in patients with missing chromosome banding analysis by using a comprehensive probe panel (clinicaltrials.gov identifier:01355913). Copyright© Ferrata Storti Foundation.

  4. Validation of cytogenetic risk groups according to International Prognostic Scoring Systems by peripheral blood CD34+FISH: results from a German diagnostic study in comparison with an international control group

    Science.gov (United States)

    Braulke, Friederike; Platzbecker, Uwe; Müller-Thomas, Catharina; Götze, Katharina; Germing, Ulrich; Brümmendorf, Tim H.; Nolte, Florian; Hofmann, Wolf-Karsten; Giagounidis, Aristoteles A. N.; Lübbert, Michael; Greenberg, Peter L.; Bennett, John M.; Solé, Francesc; Mallo, Mar; Slovak, Marilyn L.; Ohyashiki, Kazuma; Le Beau, Michelle M.; Tüchler, Heinz; Pfeilstöcker, Michael; Nösslinger, Thomas; Hildebrandt, Barbara; Shirneshan, Katayoon; Aul, Carlo; Stauder, Reinhard; Sperr, Wolfgang R.; Valent, Peter; Fonatsch, Christa; Trümper, Lorenz; Haase, Detlef; Schanz, Julie

    2015-01-01

    International Prognostic Scoring Systems are used to determine the individual risk profile of myelodysplastic syndrome patients. For the assessment of International Prognostic Scoring Systems, an adequate chromosome banding analysis of the bone marrow is essential. Cytogenetic information is not available for a substantial number of patients (5%–20%) with dry marrow or an insufficient number of metaphase cells. For these patients, a valid risk classification is impossible. In the study presented here, the International Prognostic Scoring Systems were validated based on fluorescence in situ hybridization analyses using extended probe panels applied to cluster of differentiation 34 positive (CD34+) peripheral blood cells of 328 MDS patients of our prospective multicenter German diagnostic study and compared to chromosome banding results of 2902 previously published patients with myelodysplastic syndromes. For cytogenetic risk classification by fluorescence in situ hybridization analyses of CD34+ peripheral blood cells, the groups differed significantly for overall and leukemia-free survival by uni- and multivariate analyses without discrepancies between treated and untreated patients. Including cytogenetic data of fluorescence in situ hybridization analyses of peripheral CD34+ blood cells (instead of bone marrow banding analysis) into the complete International Prognostic Scoring System assessment, the prognostic risk groups separated significantly for overall and leukemia-free survival. Our data show that a reliable stratification to the risk groups of the International Prognostic Scoring Systems is possible from peripheral blood in patients with missing chromosome banding analysis by using a comprehensive probe panel (clinicaltrials.gov identifier:01355913). PMID:25344522

  5. Comparison of prognostic scores and surgical approaches to treat spinal metastatic tumors: A review of 57 cases

    Directory of Open Access Journals (Sweden)

    Bekar Ahmet

    2008-08-01

    Full Text Available Abstract Surgical treatment of metastatic spinal cord compression with or without neural deficit is controversial. Karnofsky and Tokuhashi scores have been proposed for prognosis of spinal metastasis. Here, we conducted a retrospective analysis of Karnofsky and modified Tokuhashi scores in 57 consecutive patients undergoing surgery for secondary spinal metastases to evaluate the value of these scores in aiding decision making for surgery. Comparison of preoperative Karnofsky and modified Tokuhashi scores with the type of the surgical approach for each patient revealed that both scores not only reliably estimate life expectancy, but also objectively improved surgical decisions. When the general status of the patient is poor (i.e., Karnofsky score less than 40% or modified Tokuhashi score of 5 or greater, palliative treatments and radiotherapy, rather than surgery, should be considered.

  6. [Determination of prognostic value of the OESIL risk score at 6 months in a Colombian cohort with syncope evaluated in the emergency department; first Latin American experience].

    Science.gov (United States)

    Díaz-Tribaldos, Diana Carolina; Mora, Guillermo; Olaya, Alejandro; Marín, Jorge; Sierra Matamoros, Fabio

    2017-07-14

    To establish the prognostic value, with sensitivity, specificity, positive predictive value, and negative predictive value for the OESIL syncope risk score to predict the presentation of severe outcomes (death, invasive interventions, and readmission) after 6 months of observation in adults who consulted the emergency department due to syncope. Observational, prospective, and multicentre study with enrolment of subjects older than 18 years, who consulted in the emergency department due to syncope. A record was mad of the demographic and clinical information of all patients. The OESIL risk score was calculated, and severe patient outcomes were followed up during a 6 month period using telephone contact. A total of 161 patients met the inclusion criteria and were followed up for 6 months. A score above or equal to 2 in the risk score, classified as high risk, was present in 72% of the patients. The characteristics of the risk score to predict the combined outcome of mortality, invasive interventions, and readmission for a score above or equal to 2 were 75.7, 30.5, 43.1, and 64.4% for sensitivity, specificity, positive predictive value, and negative predictive value, respectively. A score above or equal to 2 in the OESIL risk score applied in Colombian population was of limited use to predict the studied severe outcomes. This score will be unable to discriminate between patients that benefit of early admission and further clinical studies. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  7. A STUDY OF SILVER STAINING NUCLEOLAR ORGANISING REGIONS AGNOR SCORE AS PROGNOSTIC MARKER IN BREAST LESIONS IN A TERTIARY CARE HOSPITAL IN HYDERABAD

    Directory of Open Access Journals (Sweden)

    Bhavani Shankar Nithyananda

    2017-10-01

    Full Text Available BACKGROUND Nucleolar Organising Regions (NORS are segments of DNA closely associated with nucleolus, which code for ribosomal DNA consisting of non-histone proteins, which are argyrophilic. They are demonstrated as black, brown spots on staining with silver colloidal staining technique. Hence, they are called AgNORs. The assessment of AgNORs correlates with rate of proliferation, cell cycle time, since shorter the cell cycle, greater the ribosomal activity and protein synthesis higher AgNOR count. 1 AgNORs have been studied on NHL, GIT neoplasms, skin, gynaecological neoplasms, pulmonary neoplasms, prostate, bladder and breast cancer. In breast cancer, AgNOR can be used for early detection, grading and staging of disease. In this study, we have tried to correlate AgNOR character to morphological prognostic markers. MATERIALS AND METHODS A total of 159 cases presenting with lump in the breast were included in the study. Specimens were subjected to histopathological examination. Sections cut three micron thickness were stained for AgNOR with silver colloidal AgNOR staining technique. AgNOR count was done on both benign and malignant lesions. RESULTS Benign breast lesions were more common compared to malignant lesions. The age of the patients ranged from 15-79 yrs. The mean age for benign lesions was 31 yrs. and for malignant lesions 43 yrs. The most common benign lesion was fibroadenoma and most common malignant lesion was infiltrating ductal carcinoma. AgNOR spots were seen as black/brown spots. AgNOR score was higher in malignant lesions when compared to benign lesions. Among malignant lesions, AgNOR score was found to be higher in high grade, metastatic tumours. CONCLUSION AgNOR count is a useful technique, which can supplement other prognostic markers like Ki-67, mitotic index. A long follow up study is required to confirm the prognostic utility of AgNOR count done in this study

  8. Evaluation of the diagnostic and prognostic use of gated myocardial perfusion single-photon emission computed tomography in patients with acute chest pain: comparison with the SYNTAX score.

    Science.gov (United States)

    Karacavus, Seyhan; Tutus, Ahmet; Topsakal, Ramazan; Kula, Mustafa; Celik, Ahmet; Abdulrezzak, Ummuhan; Durukan, Polat

    2015-09-01

    The aim of this study was to evaluate the diagnostic and prognostic efficacy of gated single-photon emission computed tomography (GSPECT) in patients with acute chest pain and to compare quantitative GSPECT parameters and the coronary angiographic SYNTAX score. A total of 168 patients who presented with clinical symptoms of acute chest pain were enrolled in the study. Study participants were divided into two groups according to the risk of acute coronary syndrome (ACS): low-intermediate and high risk. All participants underwent rest or stress-GSPECT (R/S-GSPECT). Coronary angiography was performed in all high-risk patients and the SYNTAX score was determined. All patients were followed for 24 ± 3 months and monitored for the occurrence of major adverse coronary events (MACE). Among patients with low-intermediate ACS risk, R-GSPECT and S-GSPECT were associated with 100 and 86% sensitivity, 99 and 98% specificity, 100 and 98% negative predictive value, 80 and 86% positive predictive value, and 98 and 97% accuracy, respectively. At follow-up, MACE occurred in 16 patients. Among high-risk patients, GSPECT quantitative parameters were the most significant predictors of MACE in Cox regression analysis. R/S-GSPECT, a noninvasive diagnostic method, is associated with an excellent safety profile and exceptional diagnostic and prognostic accuracy in cases of ACS.

  9. Proposal and validation of prognostic scoring systems for IgG and IgA monoclonal gammopathies of undetermined significance.

    Science.gov (United States)

    Rossi, Francesca; Petrucci, Maria Teresa; Guffanti, Andrea; Marcheselli, Luigi; Rossi, Davide; Callea, Vincenzo; Vincenzo, Federico; De Muro, Marianna; Baraldi, Alessandra; Villani, Oreste; Musto, Pellegrino; Bacigalupo, Andrea; Gaidano, Gianluca; Avvisati, Giuseppe; Goldaniga, Maria; Depaoli, Lorenzo; Baldini, Luca

    2009-07-01

    The presenting clinico-hematologic features of 1,283 patients with IgG and IgA monoclonal gammopathies of undetermined significance (MGUS) were correlated with the frequency of evolution into multiple myeloma (MM). Two IgG MGUS populations were evaluated: a training sample (553 patients) and a test sample (378 patients); the IgA MGUS population consisted of 352 patients. Forty-seven of the 553 training group patients and 22 of 378 test group IgG patients developed MM after a median follow-up of 6.7 and 3.6 years, respectively. Multivariate analysis showed that serum monoclonal component (MC) levels of sample. Thirty of the 352 IgA patients developed MM after a median follow-up of 4.8 years, and multivariate analysis showed that hemoglobin levels of <12.5 g/dL and reduced serum polyclonal immunoglobulin correlated with progression. A pooled statistical analysis of all of the patients confirmed the validity of Mayo Clinic risk model showing that IgA class, serum MC levels, and light-chain proteinuria are the most important variables correlated with disease progression. Using simple variables, we validated a prognostic model for IgG MGUS. Among the IgA cases, the possible prognostic role of hemoglobin emerged in addition to a decrease in normal immunoglobulin levels.

  10. Prospective trial to evaluate the prognostic value of different nutritional assessment scores in pancreatic surgery (NURIMAS Pancreas).

    Science.gov (United States)

    Probst, P; Haller, S; Bruckner, T; Ulrich, A; Strobel, O; Hackert, T; Diener, M K; Büchler, M W; Knebel, P

    2017-07-01

    Preoperative nutritional status has an impact on patients' clinical outcome. For pancreatic surgery, however, it is unclear which nutritional assessment scores adequately assess malnutrition associated with postoperative outcome. Patients scheduled for elective pancreatic surgery at the University of Heidelberg were screened for eligibility. Twelve nutritional assessment scores were calculated before operation, and patients were categorized as either at risk or not at risk for malnutrition by each score. The postoperative course was monitored prospectively by assessors blinded to the nutritional status. The primary endpoint was major complications evaluated for each score in a multivariable analysis corrected for known risk factors in pancreatic surgery. Overall, 279 patients were analysed. A major complication occurred in 61 patients (21·9 per cent). The proportion of malnourished patients differed greatly among the scores, from 1·1 per cent (Nutritional Risk Index) to 79·6 per cent (Nutritional Risk Classification). In the multivariable analysis, only raised amylase level in drainage fluid on postoperative day 1 (odds ratio (OR) 4·91, 95 per cent c.i. 1·10 to 21·84; P = 0·037) and age (OR 1·05, 1·02 to 1·09; P = 0·005) were significantly associated with major complications; none of the scores was associated with, or predicted, postoperative complications. None of the nutritional assessment scores defined malnutrition relevant to complications after pancreatic surgery and these scores may thus be abandoned. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  11. Shanghai Score: A Prognostic and Adjuvant Treatment-evaluating System Constructed for Chinese Patients with Hepatocellular Carcinoma after Curative Resection

    Directory of Open Access Journals (Sweden)

    Hui-Chuan Sun

    2017-01-01

    Conclusions: Based on the largest cohort up to date, we established Shanghai Score – an individualized outcome prediction system specifically designed for Chinese HCC patients after surgery. The Shanghai Score web server provides an easily accessible tool to stratify the prognosis of patients undergoing liver resection for HCC.

  12. Comparison of prognostic value of echographic [corrected] risk score with the Thrombolysis in Myocardial Infarction (TIMI) and Global Registry in Acute Coronary Events (GRACE) risk scores in acute coronary syndrome.

    Science.gov (United States)

    Bedetti, Gigliola; Gargani, Luna; Sicari, Rosa; Gianfaldoni, Maria Luisa; Molinaro, Sabrina; Picano, Eugenio

    2010-12-15

    Risk stratification in patients with acute coronary syndromes (ACS) is achieved today by clinical models, "blind" to the prognostic support of imaging methods. To assess the value of simple at rest cardiac chest sonography in predicting the intra- and extrahospital risk of death or myocardial infarction, we enrolled 470 consecutive in-patients (312 men, age 71 ± 12 years) who had been admitted for ACS. On admission, all had received a clinical score using the Global Registry in Acute Coronary Events and Thrombolysis in Myocardial Infarction systems and, within 1 to 12 hours, a comprehensive cardiac-chest ultrasound scan. Each of the 16 echocardiographic parameters evaluating left and right, systolic and diastolic, ventricular function and structure, was scored from 0 (normal) to 3 (severely abnormal). The median follow-up was 5 months (interquartile range 1 to 10). Patients with hard events (n = 102) could be separated from patients without events (n = 368) using the Global Registry in Acute Coronary Events score, Thrombolysis in Myocardial Infarction score, and several echocardiographic parameters. On multivariate Cox analysis, ejection fraction (hazard ratio 1.45, 95% confidence interval 1.02 to 2.08, p = 0.040), tricuspid annular plane systolic excursion (hazard ratio 1.66, 95% confidence interval 1.13 to 2.45, p = 0.010) and ultrasound lung comets (hazard ratio 1.69, 95% confidence interval 1.25 to 2.27, p = 0.001) were independent predictors of cardiac events. The 3-variable echocardiographic score (from 0, normal to 9, severe abnormalities in ejection fraction, ultrasound lung comets, and tricuspid annular plane systolic excursion) effectively stratified patients and added value (hazard ratio 2.52, 95% confidence interval 1.89 to 3.37, p score (hazard ratio 1.60, 95% confidence interval 1.07 to 2.39, p = 0.003). In conclusion, for patients with ACS, effective risk stratification can be achieved with cardiac and chest ultrasound imaging parameters, adding

  13. The C-reactive protein/albumin ratio, a validated prognostic score, predicts outcome of surgical renal cell carcinoma patients.

    Science.gov (United States)

    Guo, Shengjie; He, Xiaobo; Chen, Qian; Yang, Guangwei; Yao, Kai; Dong, Pei; Ye, Yunlin; Chen, Dong; Zhang, Zhiling; Qin, Zike; Liu, Zhuowei; Xue, Yunfei; Zhang, Meng; Liu, Ruiwu; Zhou, Fangjian; Han, Hui

    2017-03-06

    The preoperative C-reactive protein/Albumin (CRP/Alb) ratio has been shown to be valuable in predicting the prognosis of patients with certain cancers. The aim of our study is to explore its prognostic value in patients with renal cell carcinoma (RCC). A retrospective study was performed in 570 RCC patients underwent radical or partial nephrectomy including 541 patients who received full resection of localized (T1-3 N0/+ M0) RCC. The optimal cutoff value of CRP/Alb was determined by the receive operating characteristic (ROC) analysis. The impact of the CRP/Alb and other clinicopathological characteristics on overall survival (OS) and disease-free survival (DFS) was evaluated using the univariate and multivariate Cox regression analysis. The optimal cutoff of CRP/Alb ratio was set at 0.08 according to the ROC analysis. Multivariate analysis indicated that CRP/Alb ratio was independently associated with OS of RCC patients underwent radical or partial nephrectomy (hazard ratio [HR]: 1.94; 95% confidence interval [95% CI]: 1.12-3.36; P = 0.018), and DFS of localized RCC patients underwent full resection (HR: 2.14; 95% CI: 1.22-3.75; P = 0.008). Elevated CRP/Alb ratio was an independent prognostic indicator for poor OS in patients underwent radical or partial nephrectomy and DFS of localized RCC patients underwent full resection. Overall, CRP/Alb may help to identify patients with high relapse risk.

  14. Prognostic significance of global grading system of Gleason score in patients with prostate cancer with bone metastasis

    National Research Council Canada - National Science Library

    Kambara, Tsunehito; Oyama, Tetsunari; Segawa, Atsuki; Fukabori, Yoshitatsu; Yoshida, Ken-Ichiro

    2010-01-01

    ...) on prediction of prognosis for patients with prostate cancer with bone metastasis. PATIENTS AND METHODS Prostatic needle biopsy specimens from 113 patients with prostate cancer with bone metastasis were scored using the conventional GGS (CGGS...

  15. Longitudinal IP-10 Serum Levels Are Associated with the Course of Disease Activity and Remission in Patients with Rheumatoid Arthritis.

    Science.gov (United States)

    van Hooij, Anouk; Boeters, Debbie M; Tjon Kon Fat, Elisa M; van den Eeden, Susan J F; Corstjens, Paul L A M; van der Helm-van Mil, Annette H M; Geluk, Annemieke

    2017-08-01

    Although rheumatoid arthritis (RA) is a chronic, persistent autoimmune disease, 10 to 15% of RA patients achieve sustained disease-modifying antirheumatic drug (DMARD)-free remission over time. The biological mechanisms underlying the resolution of persistent inflammation in RA are still unidentified, and there is a lack of prognostic markers. It is well established that increased serum levels of gamma interferon-induced protein 10 (IP-10) are associated with (acute) increased inflammatory responses (e.g., in leprosy). In order to assess the potential of IP-10 as a diagnostic tool for inflammatory episodes of RA, we performed a retrospective study and assessed IP-10 levels in longitudinally banked serum samples obtained from patients upon first diagnosis of RA. The selection consisted of 15 persistent RA patients and 19 patients who achieved DMARD-free sustained remission. IP-10 levels, measured by use of a user-friendly quantitative lateral flow assay (LFA), showed up to 170-fold variation interindividually, and baseline IP-10 levels could not be differentiated between the two patient groups. However, a difference in the change in IP-10 levels between the first and last visits (ΔIP-10) was observed (P = 0.003) between DMARD-free (median ΔIP-10, -662 pg/ml [decrease]) and persistent (median ΔIP-10, 468 pg/ml [increase]) RA patients. Moreover, intraindividual changes in IP-10 levels during the course of disease corresponded to the disease activity score (DAS) (P = 0.05). These data indicate that IP-10 is associated with disease activity and perseverance of RA. The association of IP-10 with DAS indicates that this tool may be a practical diagnostic aid to help in monitoring disease progression in RA patients and may also find applications in other chronic diseases with exacerbated inflammatory episodes. Copyright © 2017 American Society for Microbiology.

  16. Prognostic impact of residual SYNTAX score in patients with ST-elevation myocardial infarction and multivessel disease: Analysis of an 8-year all-comers registry.

    Science.gov (United States)

    Braga, Carlos Galvão; Cid-Alvarez, Ana Belén; Diéguez, Alfredo Redondo; Alvarez, Belén Alvarez; Otero, Diego López; Sánchez, Raymundo Ocaranza; Pena, Xoan Sanmartin; Salvado, Violeta González; Trillo-Nouche, Ramiro; González-Juanatey, José R

    2017-09-15

    The residual SYNTAX score (rSS) was designed and validated to quantify the burden of residual coronary artery disease after percutaneous coronary intervention (PCI). The aim of this study was to assess the prognostic impact of rSS in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease undergoing primary-PCI. This retrospective cohort study included 1499 consecutive patients with STEMI who underwent primary-PCI between January 2008 and December 2015. After exclusion criteria, the multivessel disease cohort (n=535) was divided into three groups, according to rSS: complete revascularization (rSS=0; n=198), reasonable incomplete revascularization (0rSSrSS≥8; n=99). In-hospital mortality was significantly lower in patients with complete and reasonable incomplete revascularization, when compared to those with incomplete revascularization (1.5% vs. 1.7% vs. 9.0%, prSS was positively correlated with MACE (25.3% for rSS=0 vs. 31.1% for 0rSSrSS≥8, p=0.001) and all-cause mortality (5.1% vs. 10.5% vs. 19.2%, p=0.001). The rSS was also an independent predictor of MACE (when compared with complete revascularization, odds ratio [OR] was 1.5 for reasonable incomplete and 1.8 for incomplete revascularization) and all-cause mortality during follow-up (OR 2.9 for reasonable incomplete and 3.9 for incomplete revascularization), adding prognostic value over control variables and GRACE. In a real-world cohort of patients with STEMI and multivessel disease who underwent PCI, the rSS added important prognostic information over control variables and GRACE, being an independent predictor of MACE and all-cause mortality during follow-up. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Primary radiotherapy or postoperative radiotherapy in patients with head and neck cancer. Comparative analysis of inflammation-based prognostic scoring systems

    Energy Technology Data Exchange (ETDEWEB)

    Selzer, Edgar; Grah, Anja [Medical University of Vienna, Department of Radiotherapy, Vienna (Austria); Heiduschka, Gregor; Thurnher, Dietmar [Medical University of Vienna, Otorhinolaryngology - Head and Neck Surgery, Vienna (Austria); Kornek, Gabriela [Medical University of Vienna, Medicine I - Division of Clinical Oncology, Vienna (Austria)

    2015-01-13

    Inflammation-based scoring systems have potential value in evaluating the prognosis of cancer patients; however, detailed comparative analyses in well-characterized head and neck cancer patient collectives are missing. We analyzed overall survival (OS) in locally advanced head and neck cancer patients who were treated with curative intent by primary radiotherapy (RT) alone, by RT in combination with cetuximab (RIT) or with cisplatin (RCHT), and by primary surgery followed by postoperative radiotherapy (PORT). The primary RT collective (N = 170) was analyzed separately from the surgery plus RT group (N = 148). OS was estimated using the Kaplan-Meyer method. Cox proportional-hazard regression models were applied to compare the risk of death among patients stratified according to risk factors and the inflammation-based Glasgow Prognostic Score (GPS), the modified GPS (mGPS), the neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), and the prognostic index (PI). A prognostic relevance of the scoring systems for OS was observed in the primarily irradiated, but not in the PORT collective. OS was 35.5, 18.8, and 15.4 months, respectively, according to GPS 0, 1, and 2. OS according to mGPS 0-2 was identical. The PLR scoring system was not of prognostic relevance, while OS was 27.3 months in the NLR 0 group and 17.3 months in the NLR 1 group. OS was 35.5 months in PI 0, 16.1 months in PI 1, and 22.6 months in PI 2. GPS/mGPS scoring systems are able to discriminate between three risk groups in primarily, but not postoperatively irradiated locally advanced head and neck cancer patients. (orig.) [German] Entzuendungsbasierte Bewertungssysteme haben eine potenzielle Bedeutung fuer die Beurteilung der Prognose von Krebspatienten. Derzeit fehlen jedoch ausreichend detailliert durchgefuehrte Analysen in Kollektiven von Patienten mit Kopf-Hals-Tumoren. Untersucht wurde das Gesamtueberleben (''overall survival'', OS) von Patienten mit lokal

  18. Validation of Prognostic Scores to Predict Short-term Mortality in Patients with Acute-on-Chronic Liver Failure.

    Science.gov (United States)

    Song, Do Seon; Kim, Tae Yeob; Kim, Dong Joon; Kim, Hee Yeon; Sinn, Dong Hyun; Yoon, Eileen L; Kim, Chang Wook; Jung, Young Kul; Suk, Ki Tae; Lee, Sang Soo; Lee, Chang Hyeong; Kim, Tae Hun; Choe, Won Hyeok; Yim, Hyung Joon; Kim, Sung Eun; Baik, Soon Koo; Jang, Jae Young; Kim, Hyoung Su; Kim, Sang Gyune; Yang, Jin Mo; Sohn, Joo Hyun; Choi, Eun Hee; Cho, Hyun Chin; Jeong, Soung Won; Kim, Moon Young

    2017-09-16

    The aim of this study was to validate the Chronic Liver Failure-Sequential Organ Failure Assessment score (CLIF-SOFAs), CLIF consortium organ failure score (CLIF-C OFs), CLIF-C acute-on-chronic liver failure score (CLIF-C ACLFs), and CLIF-C acute decompensation score (CLIF-C ADs) in Korean chronic liver disease patients with acute deterioration. ACLF was defined by either the Asian Pacific Association for the Study of the Liver ACLF Research Consortium (AARC) or CLIF-C criteria. The diagnostic performances for short-term mortality were compared by the area under the receiver operating characteristics (AUROC) curve. Among a total of 1470 patients, 252 patients were diagnosed with ACLF according to the CLIF-C (197 patients) or AARC definition (95 patients). As the ACLF grades increased, the survival rates became significantly lower. The AUROCs of the CLIF-SOFAs, CLIF-C OFs and CLIF-C ACLFs were significantly higher than those of the Child-Pugh, Model for End-stage Liver Disease (MELD), and MELD-Na scores in ACLF patients according to the CLIF-C definition (all Pliver specific scores in ACLF patients according to the CLIF-C definition, but not in ACLF patients according to the AARC definition. The CLIF-SOFAs, CLIF-C OFs, and CLIF-C ACLFs are useful scoring systems that provide accurate information on prognosis in patients with ACLF according to the CLIF-C definition, but not the AARC definition. This article is protected by copyright. All rights reserved.

  19. Pretreatment Modified Glasgow Prognostic Score Predicts Clinical Outcomes After Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kishi, Takahiro; Matsuo, Yukinori, E-mail: ymatsuo@kuhp.kyoto-u.ac.jp; Ueki, Nami; Iizuka, Yusuke; Nakamura, Akira; Sakanaka, Katsuyuki; Mizowaki, Takashi; Hiraoka, Masahiro

    2015-07-01

    Purpose: This study aimed to evaluate the prognostic significance of the modified Glasgow Prognostic Score (mGPS) in patients with non-small cell lung cancer (NSCLC) who received stereotactic body radiation therapy (SBRT). Methods and Materials: Data from 165 patients who underwent SBRT for stage I NSCLC with histologic confirmation from January 1999 to September 2010 were collected retrospectively. Factors, including age, performance status, histology, Charlson comorbidity index, mGPS, and recursive partitioning analysis (RPA) class based on sex and T stage, were evaluated with regard to overall survival (OS) using the Cox proportional hazards model. The impact of the mGPS on cause of death and failure patterns was also analyzed. Results: The 3-year OS was 57.9%, with a median follow-up time of 3.5 years. A higher mGPS correlated significantly with poor OS (P<.001). The 3-year OS of lower mGPS patients was 66.4%, whereas that of higher mGPS patients was 44.5%. On multivariate analysis, mGPS and RPA class were significant factors for OS. A higher mGPS correlated significantly with lung cancer death (P=.019) and distant metastasis (P=.013). Conclusions: The mGPS was a significant predictor of clinical outcomes for SBRT in NSCLC patients.

  20. Valor prognóstico do Escore de Risco GRACE versus Escore de Risco TIMI em síndromes coronarianas agudas Valor pronóstico del score de riesgo GRACE versus score de riesgo TIMI en síndromes coronarios agudos Prognostic Value of GRACE Scores versus TIMI Score in acute coronary syndromes

    Directory of Open Access Journals (Sweden)

    Luis C. L. Correia

    2010-05-01

    ótesis de que el Score de Riesgo GRACE tiene superior valor pronóstico hospitalario, comparado con el Score TIMI en pacientes ingresados con SCA. MÉTODOS: Fueron incluidos individuos con angina inestable o infarto de miocardio sin supradesnivel del segmento ST, consecutivamente internados en Unidad Coronaria entre agosto de 2007 y enero de 2009. RESULTADOS: Fueron estudiados 154 pacientes, edad 71 ± 13 años, el 56% del sexo femenino, mediana de GRACE de 117 y mediana de TIMI de 3. Durante el período de internación, la incidencia de eventos fue del 8,4% (12 fallecimientos y 1 infarto no fatal. El test de Hosmer-Lemeshow aplicado al Score GRACE presentó χ² de 5,3 (P = 0,72, mientras que el Score TIMI presentó χ² de 1,85 (P = 0,60. De esta forma, ambos scores presentaron buena calibración. En cuanto al análisis de discriminación, el Score GRACE presentó estadística-C de 0,91 (95% IC = 0,86 - 0,97, significativamente superior a la estadística-C de 0,69 del Score TIMI (95% IC = 0,55 - 0,84 - P = 0,02 para diferencia entre los scores. CONCLUSIÓN: Con relación a la predicción de eventos hospitalarios en pacientes con SCA, el Score GRACE tiene capacidad pronóstica superior al compararlo con el Score TIMI.BACKGROUND: Although the TIMI score is the one most frequently used in acute coronary syndromes (ACS without ST-segment elevation, the GRACE score has potential prognostic superiority, as it was created based on an observational registry, part of the variables is treated in a semi-quantitative form and renal function is taken into account in its calculation. OBJECTIVE: To test the hypothesis that the GRACE risk score has superior in-hospital prognostic value, when compared to the TIMI score in patients admitted with ACS. METHODS: Individuals with unstable angina or myocardial infarction without ST-segment elevation, consecutively admitted at the Coronary Unit between August 2007 and January 2009, were included in the study. RESULTS: A total of 154 patients

  1. IP over DWDM Technologies

    OpenAIRE

    Qiong Wang

    2012-01-01

    This study has discussed some shortages of IP over SDH used currently, and has proposed the necessities of IP over DWDM. It has given the structure of IP over DWDM, and has explained why it can increase its bandwidth when transiting IP packets over DWDM. The study has also discussed the two methods of realizing IP over DWDM transmission network.

  2. Prognostic Value of Risk Factors, Calcium Score, Coronary CTA, Myocardial Perfusion Imaging, and Invasive Coronary Angiography in Kidney Transplantation Candidates

    DEFF Research Database (Denmark)

    Winther, Simon; Svensson, My; Jørgensen, Hanne Skou

    2017-01-01

    OBJECTIVES: This study sought to perform a prospective head-to-head comparison of the predictive value of clinical risk factors and a variety of cardiac imaging modalities including coronary artery calcium score (CACS), coronary computed tomography angiography (CTA), single-photon emission computed...... tomography (SPECT), and invasive coronary angiography (ICA) on major adverse cardiac events (MACE) and all-cause mortality in kidney transplantation candidates. BACKGROUND: Current guidelines recommend screening for coronary artery disease in kidney transplantation candidates. Furthermore, noninvasive stress...... imaging is recommended in current guidelines, despite its low diagnostic accuracy and uncertain prognostic value. METHODS: The study prospectively evaluated 154 patients referred for kidney transplantation. All patients underwent CACS, coronary CTA, SPECT, and ICA testing. The clinical endpoints were...

  3. Implications of Alternative Hepatorenal Prognostic Scoring Systems in Acute Heart Failure (from DOSE-AHF and ROSE-AHF).

    Science.gov (United States)

    Grodin, Justin L; Gallup, Dianne; Anstrom, Kevin J; Felker, G Michael; Chen, Horng H; Tang, W H Wilson

    2017-06-15

    Because hepatic dysfunction is common in patients with heart failure (HF), the Model for End-Stage Liver Disease (MELD) may be attractive for risk stratification. Although alternative scores such as the MELD-XI or MELD-Na may be more appropriate in HF populations, the short-term clinical implications of these in patients with acute heart failure (AHF) are unknown. The MELD-XI and MELD-Na were calculated at baseline in 453 patients with AHF in the DOSE-AHF and ROSE-AHF trials. The correlations and associations for each score with cardiorenal biomarkers, short-term end points at 72 hours including worsening renal function and clinical events to 60 days were determined. The median MELD-XI and MELD-Na was 16 and 17, respectively. Both were correlated with baseline cystatin C, amino terminus pro-B-type natriuretic peptide, and plasma renin activity (p 0.05 for both) at 72 hours. Neither score was associated with worsening renal function or worsening HF (p >0.05 for all). Similarly, both the MELD-XI and MELD-Na were not associated with 60-day death/any rehospitalization and 60-day death/HF rehospitalization in adjusted analyses when analyzes as a dichotomous or continuous variable (p >0.05 for all). In conclusion, the alternative MELD scores correlated with baseline cardiorenal biomarkers, and lower baseline MELD scoring was associated with higher diuretic efficiency and a slight increase in cystatin C through 72 hours. However, MELD-Na and MELD-XI were not predictive of 60-day clinical events. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. NCCN-IPI score-independent prognostic potential of pretreatment uric acid levels for clinical outcome of diffuse large B-cell lymphoma patients

    Science.gov (United States)

    Prochazka, Katharina T; Melchardt, Thomas; Posch, Florian; Schlick, Konstantin; Deutsch, Alexander; Beham-Schmid, Christine; Weiss, Lukas; Gary, Thomas; Neureiter, Daniel; Klieser, Eckhard; Greil, Richard; Neumeister, Peter; Egle, Alexander; Pichler, Martin

    2016-01-01

    Background: Blood-based parameters are gaining increasing interest as potential prognostic biomarkers in patients with diffuse large B-cell lymphoma (DLBCL). The aim of this study was to comprehensively evaluate the prognostic significance of pretreatment plasma uric acid levels in patients with newly diagnosed DLBCL. Methods: The clinical course of 539 DLBCL patients, diagnosed and treated between 2004 and 2013 at two Austrian high-volume centres with rituximab-based immunochemotherapy was evaluated retrospectively. The prognostic influence of uric acid on overall survival (OS) and progression-free survival (PFS) were studied including multi-state modelling, and analysis of conditional survival. Results: Five-year OS and PFS were 50.4% (95% CI: 39.2–60.6) and 44.0% (33.4–54.0) in patients with uric acid levels above the 75th percentile of the uric acid distribution (Q3, cut-off: 6.8 mg dl−1), and 66.2% (60.4–71.5) and 59.6% (53.7–65.0%) in patients with lower levels (log-rank P=0.002 and P=0.0045, respectively). In univariable time-to-event analysis, elevated uric acid levels were associated with a worse PFS (hazard ratio (HR) per 1 log increase in uric acid 1.47, 95% CI: 1.10–1.97, P=0.009) and a worse OS (HR=1.60, 95% CI: 1.16–2.19, P=0.004). These associations prevailed upon multivariable adjustment for the NCCN-IPI score. Uric acid levels significantly improved the predictive performance of the R-IPI and NCCN-IPI scores, and in multi-state analysis, it emerged as a highly significant predictor of an increased risk of death without developing recurrence (transition-HR=4.47, 95% CI: 2.17–9.23, Puric acid levels predict poor long-term outcomes in DLBCL patients beyond the NCCN-IPI risk index. PMID:27764838

  5. Validation and Extension of the Prolonged Mechanical Ventilation Prognostic Model (ProVent) Score for Predicting 1-Year Mortality after Prolonged Mechanical Ventilation.

    Science.gov (United States)

    Udeh, Chiedozie I; Hadder, Brent; Udeh, Belinda L

    2015-12-01

    Prognostic models can inform management decisions for patients requiring prolonged mechanical ventilation. The Prolonged Mechanical Ventilation Prognostic model (ProVent) score was developed to predict 1-year mortality in these patients. External evaluation of such models is needed before they are adopted for routine use. The goal was to perform an independent external validation of the modified ProVent score and assess for spectrum extension at 14 days of mechanical ventilation. This was a retrospective cohort analysis of patients who received prolonged mechanical ventilation at the University of Iowa Hospitals. Patients who received 14 or more days of mechanical ventilation were identified from a database. Manual review of their medical records was performed to abstract relevant data including the four model variables at Days 14 and 21 of mechanical ventilation. Vital status at 1 year was checked in the medical records or the social security death index. Logistic regressions examined the associations between the different variables and mortality. Model performance at 14 to 20 days and 21+ days was assessed for discrimination by calculating the area under the receiver operating characteristic curve, and calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test. A total of 180 patients (21+ d) and 218 patients (14-20 d) were included. Overall, 75% were surgical patients. One-year mortality was 51% for 21+ days and 32% for 14 to 20 days of mechanical ventilation. Age greater than 65 years was the strongest predictor of mortality at 1 year in all cohorts. There was no significant difference between predicted and observed mortality rates for patients stratified by ProVent score. There was near-perfect specificity for mortality in the groups with higher ProVent scores. Areas under the curve were 0.69 and 0.75 for the 21+ days and the 14 to 20 days cohorts respectively. P values for the Hosmer-Lemeshow statistics were 0.24 for 21+ days and 0.22 for 14 to

  6. Additive prognostic value of coronary artery calcium score and renal function in patients with acute chest pain without known coronary artery disease: up to 5-year follow-up.

    Science.gov (United States)

    Chaikriangkrai, Kongkiat; Nabi, Faisal; Mahmarian, John J; Chang, Su Min

    2015-12-01

    Long-term incremental prognostic value of renal function over coronary artery calcium score (CACS) in symptomatic patients without known coronary artery disease (CAD) is unclear. The objective of this study was to examine additive prognostic value of renal function over CACS in patients with acute chest pain suspected of CAD. Renal function and CACS were assessed in patients without known CAD who presented to the emergency department with chest pain from 2005 to 2008. Renal function was assessed using estimated glomerular filtration rate (eGFR), and chronic kidney disease (CKD) was defined as eGFR 400: HR 8.88, p renal function and CACS significantly improved the overall predictive performance (p renal function were independent predictors for future cardiac events and provided additive prognostic value to each other and over either Framingham risk categories or TIMI risk score.

  7. Early onset hyperuricemia is a prognostic marker for kidney graft failure: Propensity score matching analysis in a Korean multicenter cohort.

    Directory of Open Access Journals (Sweden)

    Miyeun Han

    Full Text Available It remains inconclusive whether hyperuricemia is a true risk factor for kidney graft failure. In the current study, we investigated the association of hyperuricemia and graft outcome. We performed a multi-center cohort study that included 2620 kidney transplant recipients. The patients were classified as either normouricemic or hyperuricemic at 3 months after transplantation. Hyperuricemia was defined as a serum uric acid level ≥ 7.0 mg/dL in males or ≥ 6.0 mg/dL in females or based on the use of urate-lowering medications. The two groups were compared before and after propensity score matching. A total of 657 (25.1% patients were classified as hyperuricemic. The proportion of hyperuricemic patients increased over time, reaching 44.2% of the total cohort at 5 years after transplantation. Estimated glomerular filtration rate and donor type were independently associated with hyperuricemia. Hyperuricemia was associated with graft loss according to multiple Cox regression analysis before propensity score matching (hazard ratio [HR] = 1.56, 95% confidence interval [CI] = 1.14-2.13, P = 0.005 as well as after matching (HR = 1.65, 95% CI = 1.13-2.42, p = 0.010. Cox regression models using time-varying hyperuricemia or marginal structural models adjusted with time-varying eGFR also demonstrated significant hazards of hyperuricemia for graft loss. Cardiovascular events and recipient survival were not associated with hyperuricemia. Overall, hyperuricemia, especially early onset after transplantation, showed an increased risk for graft failure. Further studies are warranted to determine whether lowering serum uric acid levels would be beneficial to graft survival.

  8. Prognostic significance of primary Gleason pattern in Japanese men with Gleason score 7 prostate cancer treated with radical prostatectomy.

    Science.gov (United States)

    Miyake, Hideaki; Muramaki, Mototsugu; Furukawa, Junya; Tanaka, Hirokazu; Inoue, Taka-aki; Fujisawa, Masato

    2013-11-01

    To evaluate the significance of the primary Gleason pattern in patients with Gleason score (GS) 7 prostate cancer treated with radical prostatectomy. This study included 959 consecutive Japanese men who underwent radical prostatectomy without neoadjuvant therapies and were subsequently diagnosed as having GS 7 prostate cancer based on the modified International Society of Urological Pathology (ISUP) 2005 Gleason grading system. Of these 959 patients, 666 (69.4%) and 293 (30.6%) had GS 3+4 and GS 4+3 tumors, respectively. There were significant differences in the prostate-specific antigen (PSA) level, biopsy GS, pathologic T stage, lymphatic invasion, microvenous invasion, and perineural invasion between these 2 groups. During the mean observation of 48.9 months, biochemical recurrence occurred in 211 patients (22.0%), and there was a significant difference in the biochemical recurrence-free survival between patients with GS 3+4 tumors and those with GS 4+3 tumors. Of several factors examined, biochemical recurrence-free survival was significantly associated with the PSA level, biopsy Gleason score, capsular penetration, seminal vesicle invasion, surgical margin status, lymphatic invasion, microvenous invasion, perineural invasion, and primary Gleason pattern, among which the PSA level, capsular penetration, seminal vesicle invasion, and surgical margin status, but not primary Gleason pattern, appeared to be independent predictors of biochemical recurrence. Despite the lack of an independent significance, primary Gleason pattern based on the modified ISUP 2005 Gleason grading system is shown to be significantly associated with the biochemical outcome of Japanese men with GS 7 prostate cancer. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Prognostic impact of the residual SYNTAX score on in-hospital outcomes in patients undergoing primary percutaneous coronary intervention.

    Science.gov (United States)

    Khan, Razi; Al-Hawwas, Malek; Hatem, Raja; Azzalini, Lorenzo; Fortier, Annik; Joliecoeur, E Marc; Tanguay, Jean-Francois; Lavoie-L'Allier, Philippe; Ly, Hung Q

    2016-11-01

    This study sought to assess the impact of residual coronary artery disease (CAD), using the residual SYNTAX score (rSS), on in-hospital outcomes after primary percutaneous intervention (PPCI). The study also aimed to determine independent predictors for high rSS. Residual CAD has been associated with worsened prognosis in patients undergoing PCI for non-ST acute coronary syndromes. The rSS is a systematic angiographic score that measures the extent and complexity of residual CAD after PCI. Data from 243 consecutive patients undergoing PPCI for ST-elevation myocardial infarction (STEMI) were analyzed. The rSS was derived from post-PPCI angiography. Patients were dichotomized into low (rSS (≥8) groups and outcomes were compared between groups. The primary outcome of net adverse cardiovascular events (NACE) consisted of a composite of in-hospital death, congestive heart failure (CHF), recurrent MI and bleeding. The mean rSS was 4.7 (±7.2). A high rSS was associated with the primary outcome (P rSS was also an independent predictor of the primary outcome with an OR of 3.82. Independent predictors of a high rSS included a history of diabetes (OR 2.8), previous MI (OR 5.75), 2-vessel disease (VD) (OR 15.48, vs. 1-VD) and 3-VD (OR 57.06, vs. 1-VD). Residual CAD, as assessed by the rSS, confers a worsened prognosis in patients undergoing PPCI. Diabetes, previous MI and multi-vessel disease were independent predictors of a high rSS. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  10. Comparison of the prognostic value of Chronic Liver Failure Consortium scores and traditional models for predicting mortality in patients with cirrhosis.

    Science.gov (United States)

    Antunes, Artur Gião; Teixeira, Cristina; Vaz, Ana Margarida; Martins, Cláudio; Queirós, Patrícia; Alves, Ana; Velasco, Francisco; Peixe, Bruno; Oliveira, Ana Paula; Guerreiro, Horácio

    2017-04-01

    Recently, the European Association for the Study of the Liver - Chronic Liver Failure (CLIF) Consortium defined two new prognostic scores, according to the presence or absence of acute-on-chronic liver failure (ACLF): the CLIF Consortium ACLF score (CLIF-C ACLFs) and the CLIF-C Acute Decompensation score (CLIF-C ADs). We sought to compare their accuracy in predicting 30- and 90-day mortality with some of the existing models: Child-Turcotte-Pugh (CTP), Model for End-Stage Liver Disease (MELD), MELD-Na, integrated MELD (iMELD), MELD to serum sodium ratio index (MESO), Refit MELD and Refit MELD-Na. Retrospective cohort study that evaluated all admissions due to decompensated cirrhosis in 2 centers between 2011 and 2014. At admission each score was assessed, and the discrimination ability was compared by measuring the area under the ROC curve (AUROC). A total of 779 hospitalizations were evaluated. Two hundred and twenty-two patients met criteria for ACLF (25.9%). The 30- and 90-day mortality were respectively 17.7 and 37.3%. CLIF-C ACLFs presented an AUROC for predicting 30- and 90-day mortality of 0.684 (95% CI: 0.599-0.770) and 0.666 (95% CI: 0.588-0.744) respectively. No statistically significant differences were found when compared to traditional models. For patients without ACLF, CLIF-C ADs had an AUROC for predicting 30- and 90-day mortality of 0.689 (95% CI: 0.614-0.763) and 0.672 (95% CI: 0.624-0.720) respectively. When compared to other scores, it was only statistically superior to MELD for predicting 30-day mortality (p=0.0296). The new CLIF-C scores were not statistically superior to the traditional models, with the exception of CLIF-C ADs for predicting 30-day mortality. Copyright © 2017 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  11. Additive prognostic value of NT-proBNP over TIMI risk score in intermediate-risk patients with acute coronary syndrome.

    Science.gov (United States)

    Eren, Nihan Kahya; Ertaş, Faruk; Yüksek, Umit; Cakir, Cayan; Nazli, Cem; Köseoğlu, Mehmet; Ergene, Oktay

    2009-01-01

    We evaluated the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) for further risk stratification of intermediate-risk patients with non-ST elevation acute coronary syndromes (NSTE-ACS). The study included 137 intermediate-risk patients (85 men, 52 women; mean age 62+/-11 years) with ACS, based on the TIMI risk score (scores 3 to 5). Serum NT-proBNP levels were measured 12 hours after the last anginal episode. The patients were divided into four groups according to the following NT-proBNP quartiles: 17-310 pg/ml (n=34), 313-688 pg/ml (n=35), 724-2,407 pg/ml (n=34), and 2,575-24,737 pg/ml (n=34). Primary endpoint of the study was mortality. The mean follow-up was 21.8+/-7.1 months. There were 27 deaths (19.7%), 14 of which were in the 4th quartile (4th vs 1st, 2nd, and 3rd quartiles: p=0.02, p=0.01, and pTIMI risk score, ejection fraction, and age. Patients who died were older (65.6+/-11.9 years vs 60.7+/-11.0 years; p=0.048) and had a lower ejection fraction (46.3+/-11% vs 54.1+/-9.8%; pTIMI risk scores of 3, 4, and 5 were 25.9%, 29.6%, and 44.4%, respectively (p=0.58 for TIMI 3 vs 4; p=0.001 for TIMI 3 vs 5; p=0.013 for TIMI 4 vs 5). Cox proportional hazards regression analysis showed that only TIMI risk score was an independent predictor of mortality (hazard ratio 2.3, 95% confidence interval 1.4-3.8, p=0.001). NT-proBNP has an additive predictive value over TIMI risk score in predicting long-term mortality in intermediate-risk patients with ACS.

  12. [Development and validation of risk score model for acute myocardial infarction in China: prognostic value thereof for in hospital major adverse cardiac events and evaluation of revascularization].

    Science.gov (United States)

    Wu, Xiao-fan; Lü, Shu-zheng; Chen, Yun-dai; Pan, Wei-qi; Song, Xian-tao; Li, Jing; Liu, Xin; Wang, Xi-zhi; Zhang, Li-jie; Ren, Fang; Luo, Jing-guang

    2008-07-08

    To develop a simple risk score model of in-hospital major adverse cardiac events (MACE) including all-cause mortality, new or recurrent myocardial infarction (MI), and evaluate the efficacy about revascularization on patients with different risk. The basic characteristics, diagnosis, therapy, and in-hospital outcomes of 1512 ACS patients from Global Registry of Acute Coronary Events (GRACE) study of China were collected to develop a risk score model by multivariable stepwise logistic regression. The goodness-of-fit test and discriminative power of the final model were assessed respectively. The best cut-off value for the risk score was used to assess the impact of revascularization for ST-elevation MI (STEMI) and non-ST elevation acute coronary artery syndrome (NSTEACS) on in-hospital outcomes. (1) The following 6 independent risk factors accounted for about 92.5% of the prognostic information: age > or =80 years (4 points), SBP or =90 mm Hg (2 points), Killip II (3 points), Killip III or IV (9 points), cardiac arrest during presentation (4 points), ST-segment elevation (3 points) or depression (5 points) or combination of elevation and depression (4 points) on electrocardiogram at presentation. (2) CHIEF risk model was excellent with Hosmer-Lemeshow goodness-of-fit test of 0.673 and c statistics of 0.776. (3)1301 ACS patients previously enrolled in GRACE study were divided into 2 groups with the best cut-off value of 5.5 points. The impact of revascularization on the in-hospital MACE of the higher risk subsets was stronger than that of the lower risk subsets both in STEMI [OR (95% CI) = 0.32 (0.11, 0.94), chi2 = 5.39, P = 0.02] and NSTEACS [OR (95% CI) = 0.32 (0.06, 0.94), chi2 =4.17, P = 0.04] population. However, both STEMI (61.7% vs. 78.3%, P = 0.000) and NSTEACS (42.0% vs 62.3%, P = 0.000) patients with the risk scores more than 5.5 points had lower revascularization rates. The risk score provides excellent ability to predict in-hospital death or (re) MI

  13. PVM and IP multicast

    Energy Technology Data Exchange (ETDEWEB)

    Dunigan, T.H.; Hall, K.A.

    1996-12-01

    This report describes a 1994 demonstration implementation of PVM that uses IP multicast. PVM`s one-to-many unicast implementation of its pvm{_}mcast() function is replaced with reliable IP multicast. Performance of PVM using IP multicast over local and wide-area networks is measured and compared with the original unicast implementation. Current limitations of IP multicast are noted.

  14. Long-term prognostic value of risk scores after drug-eluting stent implantation for unprotected left main coronary artery: A pooled analysis of the ISAR-LEFT-MAIN and ISAR-LEFT-MAIN 2 randomized clinical trials.

    Science.gov (United States)

    Xhepa, Erion; Tada, Tomohisa; Kufner, Sebastian; Ndrepepa, Gjin; Byrne, Robert A; Kreutzer, Johanna; Ibrahim, Tareq; Tiroch, Klaus; Valgimigli, Marco; Tölg, Ralf; Cassese, Salvatore; Fusaro, Massimiliano; Schunkert, Heribert; Laugwitz, Karl L; Mehilli, Julinda; Kastrati, Adnan

    2017-01-01

    To evaluate the long-term prognostic value of risk scores in the setting of drug-eluting stent (DES) implantation for uLMCA. Data on the prognostic value of novel risk scores developed to select the most appropriate revascularization strategy in patients undergoing DES implantation for uLMCA disease are relatively limited. The study represents a patient-level pooled analysis of the ISAR-LEFT-MAIN (607 patients randomized to paclitaxel-eluting or sirolimus-eluting stents) and the ISAR-LEFT-MAIN-2 (650 patients randomized to everolimus-eluting or zotarolimus-eluting stents) randomized trials. The Syntax Score (SxScore) as well the Syntax Score II (SS-II), the EuroSCORE and the Global Risk Classification (GRC) were calculated. The primary outcome was all-cause mortality. At a mean follow-up of 3 years there were 160 deaths (12.7%). The death-incidence was significantly higher in the upper tertiles than in the intermediate or lower ones for all risk scores (log-rank test P risk scores were able to stratify the mortality risk at long-term follow-up. EuroSCORE was the only risk score that significantly improved the discriminatory power of a multivariable model to predict long-term mortality. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. Prognostic Model for Resected Squamous-Cell Lung Cancer: External Multicenter Validation and Propensity Score Analysis exploring the Impact of Adjuvant and Neoadjuvant Treatment.

    Science.gov (United States)

    Pilotto, Sara; Sperduti, Isabella; Leuzzi, Giovanni; Chiappetta, Marco; Mucilli, Felice; Ratto, Giovanni Battista; Lococo, Filippo; Filosso, Pierluigi; Spaggiari, Lorenzo; Novello, Silvia; Milella, Michele; Santo, Antonio; Scarpa, Aldo; Infante, Maurizio; Tortora, Giampaolo; Facciolo, Francesco; Bria, Emilio

    2017-12-18

    We developed one of the first clinicopathological prognostic nomograms for resected squamous cell lung cancer (SQLC). Herein, we validate the model in a larger multicenter cohort and we explore the impact of adjuvant/neoadjuvant treatment (ANT). Resected SQLC patients from January 2002 to December 2012 in six institutions were eligible. To each patient was assigned a prognostic score based on those clinicopathological factors included in the model (age, T-descriptor according to TNM 7th edition, lymph nodes, grading). Kaplan-Meier analysis for disease-free/cancer-specific/overall survival (DFS/CSS/OS) was performed according to three-class risk model. Harrell's C-statistics were adopted for model validation. The effect of ANT was adjusted with propensity score (PS). Data from 1,375 patients was gathered (median age: 68 years; male: 86.8%; T-descriptor 1-2/3-4: 71.7%/24.9%; nodes negative/positive: 53.4%/46.6%; grading 1-2/3: 35.0%/41.1%). Data for survival analysis was available for 1,097 patients. With a median follow-up of 55 months, patients at low risk had a significantly longer DFS versus intermediate (HR 1.67, 95% CI 1.40-2.01) and high risk (HR 2.46, 95% CI 1.90-3.19), as well as for CSS (HR 2.46, 95% CI 1.80-3.36; HR 4.30, 95% CI 2.92-6.33) and OS (HR 1.79, 95% CI 1.48-2.17; HR 2.33, 95% CI 1.76-3.07). A trend in favor of ANT was observed for intermediate/high risk patients, particularly for CSS (p=0.06; 5-year CSS 72.7% versus 60.8%). A model based on a combination of easily available clinicopathological factors effectively stratifies resected SQLC patients in three-risk classes. Copyright © 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

  16. Prognostic performance of the Simplified Acute Physiology Score II in major Croatian hospitals: a prospective multicenter study.

    Science.gov (United States)

    Desa, Kristian; Peric, Mladen; Husedzinovic, Ino; Sustic, Alan; Korusic, Andelko; Karadza, Vjekoslav; Matlekovic, Drazen; Prstec-Veronek, Branka; Zuvic-Butorac, Marta; Sokolic, Jadranko; Siranovic, Mladen; Bosnjak, Danica; Spicek-Macan, Jasna; Gustin, Denis; Ozeg-Jakopovic, Drazenka

    2012-10-01

    To perform an external validation of the original Simplified Acute Physiology Score II (SAPS II) system and to assess its performance in a selected group of patients in major Croatian hospitals. A prospective, multicenter study was conducted in five university hospitals and one general hospital during a six-month period between November 1, 2007 and May 1, 2008. Standardized hospital mortality ratio (SMR) was calculated from the mean predicted mortality of all the 2756 patients and the actual mortality for the same group of patients. The validation of SAPS II was made using the area under receiver operating characteristic curve (AUC), 2×2 classification tables, and Hosmer-Lemeshow tests. The predicted mortality was as low as 14.6% due to a small proportion of medical patients and the SMR being 0.89 (95% confidence interval [CI], 0.78-0.98). The SAPS II system demonstrated a good discriminatory power as measured by the AUC (0.85; standard error [SE]=0.012; 95% CI=0.840-0.866; P<0.001). This system significantly overestimated the actual mortality (Hosmer-Lemeshow goodness-of-fit H statistic: χ(2) =584.4; P<0.001 and C statistics: χ(2)(8) =313.0; P<0.001) in the group of patients included in the study. The SAPS II had a good discrimination, but it significantly overestimated the observed mortality in comparison with the predicted mortality in this group of patients in Croatia. Therefore, caution is required when an evaluation is performed at the individual level.

  17. Long-term prognostic impact of CT-Leaman score in patients with non-obstructive CAD: Results from the COronary CT Angiography EvaluatioN For Clinical Outcomes InteRnational Multicenter (CONFIRM) study.

    Science.gov (United States)

    Andreini, Daniele; Pontone, Gianluca; Mushtaq, Saima; Gransar, Heidi; Conte, Edoardo; Bartorelli, Antonio L; Pepi, Mauro; Opolski, Maksymilian P; Ó Hartaigh, Bríain; Berman, Daniel S; Budoff, Matthew J; Achenbach, Stephan; Al-Mallah, Mouaz; Cademartiri, Filippo; Callister, Tracy Q; Chang, Hyuk-Jae; Chinnaiyan, Kavitha; Chow, Benjamin J W; Cury, Ricardo; Delago, Augustin; Hadamitzky, Martin; Hausleiter, Joerg; Feuchtner, Gudrun; Kim, Yong-Jin; Kaufmann, Philipp A; Leipsic, Jonathon; Lin, Fay Y; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J; Villines, Todd C; Dunning, Allison; Marques, Hugo; Rubinshtein, Ronen; Hindoyan, Niree; Gomez, Millie; Min, James K

    2017-03-15

    Non-obstructive coronary artery disease (CAD) identified by coronary computed tomography angiography (CCTA) demonstrated prognostic value. CT-adapted Leaman score (CT-LeSc) showed to improve the prognostic stratification. Aim of the study was to evaluate the capability of CT-LeSc to assess long-term prognosis of patients with non-obstructive (CAD). From 17 centers, we enrolled 2402 patients without prior CAD history who underwent CCTA that showed non-obstructive CAD and provided complete information on plaque composition. Patients were divided into a group without CAD and a group with non-obstructive CAD (CAD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Prognostic performance of MR-pro-adrenomedullin in patients with community acquired pneumonia in the Emergency Department compared to clinical severity scores PSI and CURB.

    Directory of Open Access Journals (Sweden)

    Jacopo Maria Legramante

    Full Text Available (i evaluate the performance of MR-pro-ADM in reflecting the outcome and risk for CAP patients in the emergency department, and (ii compare the prognostic performance of MR-pro-ADM with that of clinical scores PSI and CURB65.Observational prospective, single-center study in patients with suspected community acquired pneumonia (CAP. Eighty one patients underwent full clinical and laboratory assessment as by protocol, and were followed up a 28 days. Primary endpoints measured were: death, death at 14 days, non-invasive mechanical ventilation (NIMV, endotracheal intubation (EI, ICU admission, overall hospital stay >10 days, emergency department stay >4 days. The discriminative performance of MR-pro-ADM and clinical scores was assessed by AUROC analysis.The distribution for MR-pro-ADM followed an upward trend, increasing with the increase of both PSI (p10 days and DE stay >4 days, compared to the PSI and CURB (though difference not statistically significant. For each endpoint measured, the best thresholds values for Mr-pro-ADM were: 1.6 (specificity 76.5%; sensitivity 77.8% for death; 2.5 (specificity 88.9%; sensitivity 80.0% for death at 14 days; 1.5 (specificity 77.0%; sensitivity 87.5% for NIMV; 2.4 (specificity 88.7%; sensitivity 83.3% for endotracheal intubation; 0.9 (specificity 53.5%; sensitivity 70.6% for DE stay greater than 4 days; 1.9 (specificity 82.1%; sensitivity 55.3% for hospital stay greater than 10 days. The AUC for the combination of MR-pro-ADM and PSI was 81.29% [63.41%-99.17%], but not in a statistically significant manner compared to the AUCs of the single predictors. Conversely, the AUC for the combination of MR-pro-ADM and CURB65 was 87.58% [75.54%-99.62%], which was significantly greater than the AUC of CURB65 (p = 0.047 or PSI (p = 0.017 alone.The present study confirms that assessment of MR-pro-ADM levels in CAP patients in addition to CURB scores increases the prognostic accuracy of CURB alone and may help rule out

  19. Validation of the revised International Prognostic Scoring System in patients with myelodysplastic syndrome in Japan: results from a prospective multicenter registry.

    Science.gov (United States)

    Kawabata, Hiroshi; Tohyama, Kaoru; Matsuda, Akira; Araseki, Kayano; Hata, Tomoko; Suzuki, Takahiro; Kayano, Hidekazu; Shimbo, Kei; Zaike, Yuji; Usuki, Kensuke; Chiba, Shigeru; Ishikawa, Takayuki; Arima, Nobuyoshi; Nogawa, Masaharu; Ohta, Akiko; Miyazaki, Yasushi; Mitani, Kinuko; Ozawa, Keiya; Arai, Shunya; Kurokawa, Mineo; Takaori-Kondo, Akifumi

    2017-05-11

    The Japanese National Research Group on Idiopathic Bone Marrow Failure Syndromes has been conducting prospective registration, central review, and follow-up study for patients with aplastic anemia and myelodysplastic syndrome (MDS) since 2006. Using this database, we retrospectively analyzed the prognosis of patients with MDS. As of May 2016, 351 cases were registered in this database, 186 of which were eligible for the present study. Kaplan-Meier analysis showed that overall survival (OS) curves of the five risk categories stipulated by the revised international prognostic scoring system (IPSS-R) were reasonably separated. 2-year OS rates for the very low-, low-, intermediate-, high-, and very high-risk categories were 95, 89, 79, 35, and 12%, respectively. In the same categories, incidence of leukemic transformation at 2 years was 0, 10, 8, 56, and 40%, respectively. Multivariate analysis revealed that male sex, low platelet counts, increased blast percentage (>2%), and high-risk karyotype abnormalities were independent risk factors for poor OS. Based on these data, we classified Japanese MDS patients who were classified as intermediate-risk in IPSS-R, into the lower risk MDS category, highlighting the need for careful assessment of treatments within low- and high-risk treatment protocols.

  20. Mobile IP: Security & application

    NARCIS (Netherlands)

    Tuquerres, G.; Salvador, M.R.; Sprenkels, Ron

    1999-01-01

    As required in the TGS Mobile IP Advanced Module, this paper presents a survey of common security threats which mobile IP networks are exposed to as well as some proposed solutions to deal with such threats.

  1. Ensuring Software IP Cleanliness

    Directory of Open Access Journals (Sweden)

    Mahshad Koohgoli

    2007-12-01

    Full Text Available At many points in the life of a software enterprise, determination of intellectual property (IP cleanliness becomes critical. The value of an enterprise that develops and sells software may depend on how clean the software is from the IP perspective. This article examines various methods of ensuring software IP cleanliness and discusses some of the benefits and shortcomings of current solutions.

  2. Retrospective study on prognostic importance of serum procalcitonin and amino - terminal pro - brain natriuretic peptide levels as compared to Acute Physiology and Chronic Health Evaluation IV Score on Intensive Care Unit admission, in a mixed Intensive Care Unit population

    Directory of Open Access Journals (Sweden)

    Chitra Mehta

    2016-01-01

    Full Text Available Background: Timely decision making in Intensive Care Unit (ICU is very essential to improve the outcome of critically sick patients. Conventional scores like Acute Physiology and Chronic Health Evaluation (APACHE IV are quite cumbersome with calculations and take minimum 24 hours. Procalcitonin has shown to have prognostic value in ICU/Emergency department (ED in disease states like pneumonia, sepsis etc. NTproBNP has demonstrated excellent diagnostic and prognostic importance in cardiac diseases. It has also been found elevated in non-cardiac diseases. We chose to study the prognostic utility of these markers on ICU admission. Settings and Design: Retrospective observational study. Materials and Methods: A Retrospective analysis of 100 eligible patients was done who had undergone PCT and NTproBNP measurements on ICU admission. Their correlations with all cause mortality, length of hospital stay, need for ventilator support, need for vasopressors were performed. Results: Among 100 randomly selected ICU patients, 28 were non-survivors. NTproBNP values on admission significantly correlated with all cause mortality (P = 0.036, AUC = 0.643 and morbidity (P = 0.000, AUC = 0.763, comparable to that of APACHE-IV score. PCT values on admission did not show significant association with mortality, but correlated well with morbidity and prolonged hospital length of stay (AUC = 0.616, P = 0.045. Conclusion: The current study demonstrated a good predictive value of NTproBNP, in terms of mortality and morbidity comparable to that of APACHE-IV score. Procalcitonin, however, was found to have doubtful prognostic importance. These findings need to be confirmed in a prospective larger study.

  3. Prognostic Value of Coronary Artery Calcium Score in Acute Chest Pain Patients Without Known Coronary Artery Disease: Systematic Review and Meta-analysis.

    Science.gov (United States)

    Chaikriangkrai, Kongkiat; Palamaner Subash Shantha, Ghanshyam; Jhun, Hye Yeon; Ungprasert, Patompong; Sigurdsson, Gardar; Nabi, Faisal; Mahmarian, John J; Chang, Su Min

    2016-12-01

    Coronary artery calcium score (CACS) is a well-established test for risk stratifying asymptomatic patients. Recent studies also indicate that CACS may accurately risk stratify stable patients presenting to the emergency department (ED) with acute chest pain; however, many were underpowered. The purpose of this systematic review and meta-analysis is to evaluate the prognostic value and accuracy of a zero (normal) CACS for identifying patients at acceptable low risk for future cardiovascular events who might be safely discharged home from the ED. We searched multiple databases for longitudinal studies of CACS in symptomatic patients without known coronary artery disease that reported major adverse cardiovascular events (MACEs), including death and myocardial infarction. Pooled risk ratios, sensitivity, specificity, and likelihood ratios were analyzed. Eight studies evaluated 3,556 patients, with a median follow-up of 10.5 months. Pooled prevalence of zero CACS was 60%. Patients with CACS=0 had a significantly lower risk of cardiovascular events compared with those with CACS greater than 0 (MACEs: relative risk 0.06, 95% confidence interval 0.04 to 0.11, I(2)=0%; death/myocardial infarction: relative risk 0.19; 95% confidence interval 0.08 to 0.47, I(2)=0%). The pooled event rates for CACS=0 (MACEs 0.8%/year; death/myocardial infarction 0.5%/year) were significantly lower than for CACS greater than 0 (MACEs 14.6%/year; death/myocardial infarction 3.5%/year). Analysis of summary testing parameters showed a sensitivity of 96%, specificity of 60%, positive likelihood ratio of 2.36, and negative likelihood ratio of 0.07. Acute chest pain patients without history of coronary artery disease, ischemic ECG changes, or increased cardiac enzyme levels commonly have a CACS of zero, with a very low subsequent risk of MACEs or death or myocardial infarction. This meta-analysis proffers the potential role of initial CACS testing for avoiding unnecessary hospitalization and further

  4. Prognostic correlation of cell cycle progression score and Ki-67 as a predictor of aggressiveness, biochemical failure, and mortality in men with high-risk prostate cancer treated with external beam radiation therapy.

    Science.gov (United States)

    López, Iván Henríquez; Parada, David; Gallardo, Pablo; Gascón, Marina; Besora, Arnau; Peña, Karla; Riu, Francesc; Arquez Pianetta, Miquel; Abuchaibe, Oscar; Torres Royò, Laura; Arenas, Meritxell

    2017-01-01

    Ki-67 is a proliferation marker in prostate cancer. A prognostic RNA signature was developed to characterize prostate cancer aggressiveness. The aim was to evaluate prognostic correlation of CCP and Ki-67 with biochemical failure (BF), and survival in high-risk prostate cancer patients (pts) treated with radiation therapy (RT). CCP score and Ki-67 were derived retrospectively from pre-treatment paraffin-embedded prostate cancer tissue of 33 men diagnosed from 2002 to 2006. CCP score was calculated as an average expression of 31 CCP genes. Ki-67 was determined by IHC. Single pathologist evaluated all tissues. Factors associated to failure and survival were analyzed. Median CCP score was 0.9 (-0-1 - 2.6). CCP 0: 1 pt; CCP 1: 19 pts; CCP 2: 13 pts. Median Ki-67 was 8.9. Ki-67 cutpoint was 15.08%. BF and DSM were observed in 21% and 9%. Ki-67 ≥ 15% predicted BF (p = 0.043). With a median follow-up of 8.4 years, 10-year BF, OS, DM and DSM for CCP 1 vs. CCP 2 was 76-71% (p = 0.83), 83-73% (p = 0.86), 89-85% (p = 0.84), and 94-78% (p = 0.66). On univariate, high Ki-67 was correlated with BF (p = 0.013), OS (p = 0.023), DM (p = 0.007), and DSM (p = 0.01). On Cox MVA, high Ki-67 had a BF trend (p = 0.063). High CCP score was not correlated with DSM. High Ki-67 significantly predicted outcome and provided prognostic information. CCP score may improve accuracy stratification. We did not provide prognostic correlation of CCP and DSM. It should be validated in a larger cohort of pts.

  5. Prognostic implications of serial risk score assessments in patients with pulmonary arterial hypertension: a Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL) analysis.

    Science.gov (United States)

    Benza, Raymond L; Miller, Dave P; Foreman, Aimee J; Frost, Adaani E; Badesch, David B; Benton, Wade W; McGoon, Michael D

    2015-03-01

    Data from the Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL) were used previously to develop a risk score calculator to predict 1-year survival. We evaluated prognostic implications of changes in the risk score and individual risk-score parameters over 12 months. Patients were grouped by decreased, unchanged, or increased risk score from enrollment to 12 months. Kaplan-Meier estimates of subsequent 1-year survival were made based on change in the risk score during the initial 12 months of follow-up. Cox regression was used for multivariable analysis. Of 2,529 patients in the analysis cohort, the risk score was decreased in 800, unchanged in 959, and increased in 770 at 12 months post-enrollment. Six parameters (functional class, systolic blood pressure, heart rate, 6-minute walk distance, brain natriuretic peptide levels, and pericardial effusion) each changed sufficiently over time to improve or worsen risk scores in ≥5% of patients. One-year survival estimates in the subsequent year were 93.7%, 90.3%, and 84.6% in patients with a decreased, unchanged, and increased risk score at 12 months, respectively. Change in risk score significantly predicted future survival, adjusting for risk at enrollment. Considering follow-up risk concurrently with risk at enrollment, follow-up risk was a much stronger predictor, although risk at enrollment maintained a significant effect on future survival. Changes in REVEAL risk scores occur in most patients with pulmonary arterial hypertension over a 12-month period and are predictive of survival. Thus, serial risk score assessments can identify changes in disease trajectory that may warrant treatment modifications. Copyright © 2015 International Society for Heart and Lung Transplantation. All rights reserved.

  6. Prognostic factors in Chinese patients with prostate cancer receiving primary androgen deprivation therapy: validation of Japan Cancer of the Prostate Risk Assessment (J-CAPRA) score and impacts of pre-existing obesity and diabetes mellitus.

    Science.gov (United States)

    Hu, Meng-Bo; Yang, Tian; Hu, Ji-Meng; Zhu, Wen-Hui; Jiang, Hao-Wen; Ding, Qiang

    2018-01-06

    Our aim was to determine the prognostic factors in Chinese patients with prostate cancer receiving primary androgen deprivation therapy (PADT), validate the Japan Cancer of the Prostate Risk Assessment (J-CAPRA) score, and investigate the impacts of pre-existing obesity and diabetes mellitus (DM). The study enrolled Chinese patients diagnosed with prostatic adenocarcinoma and treated with bilateral orchiectomy as PADT at Huashan Hospital, Fudan University (Shanghai, China), from January 2003 to December 2015. The overall survival (OS) and prognostic value of J-CAPRA score, pre-existing obesity, DM, and various clinicopathological variables were analyzed. Of the 435 patients enrolled, 174 (40.0%) deaths occurred during follow-up; 3- and 5-year OS were 74.0 and 58.9%, respectively. Multivariate analysis identified that higher Gleason score and metastasis were both correlated with worse OS and that higher J-CAPRA score was correlated with worse OS [hazard ratio (HR) 1.110, 95% confidence interval (CI) 1.035-1.190, P = 0.003). Different risk categories based on J-CAPRA score showed good stratification in OS (log-rank P = 0.015). In subgroup analysis, pre-existing obesity as a protective factor in younger patients (age ≤ 65, HR 0.271, 95% CI 0.075-0.980, P = 0.046) and pre-existing DM as a risk factor in older patients (> 75, HR 1.854, 95% CI 1.026-3.351, P = 0.041) for OS were recognized, and the prediction accuracy of J-CAPRA was elevated after incorporating pre-existing obesity and DM. The J-CAPRA score presented with good OS differentiation among Chinese patients under PADT. Younger patients (age ≤ 65) had better OS with pre-existing obesity, while older patients (age > 75) had worse OS with pre-existing DM.

  7. Evaluation of IP Portfolios

    DEFF Research Database (Denmark)

    Søberg, Peder Veng

    2009-01-01

    As a result of an inquiry concerning how to evaluate IP (intellectual property) portfolios in order to enable the best possible use of IP resources within organizations, an IP evaluation approach primarily applicable for patents and utility models is developed. The developed approach is useful...... in order to discuss, visualize and align IPR issues with different management functions within the organization. Unlike existing approaches the present approach takes into account such value indicators as remaining lifetime, geographical range, broadness of scope and product strategic considerations...

  8. Agency IP Data

    Data.gov (United States)

    National Aeronautics and Space Administration — Public data set for NASA Agency Intellectual Property (IP). The distribution contains both Patent information as well as General Release of Open Source Software.

  9. A versão simplificada do Therapeutic Intervention Scoring System e seu valor prognóstico La versión simplificada del Therapeutic Intervention Scoring System y su valor pronóstico The simplified version of Therapeutic Intervention Scoring System and its prognostic value

    Directory of Open Access Journals (Sweden)

    Maria Cláudia Moreira da Silva

    2004-06-01

    Full Text Available O estudo avalia a capacidade do Therapeutic Intervention Scoring System (TISS-28 de discriminar pacientes internados em UTI, prováveis de morrer daqueles possíveis de sobreviver e estabelecer a pontuação limiar para alta probabilidade de morte. Os resultados, obtidos da amostra de 200 pacientes internados em 14 UTIs do Município de São Paulo, mostraram que o TISS-28 apresentou associação com mortalidade (p=0,0001. O ponto de corte estabelecido foi 21. Encontrou-se que 80,88% dos que morreram tinham pontuação do TISS-28 maior ou igual, e 68,18% dos sobreviventes tinham pontuação menor que 21. Além disso, quanto ao valor prognóstico do TISS-28, constatou-se acurácia de 0,72.El estudio evalúa la capacidad del Therapeutic Intervention Scoring System (TISS-28 para discriminar pacientes internados en UCI, probables de morir de aquellos posibles de sobrevivir y establecer la puntuación límite para la alta probabilidad de muerte. Los resultados, obtenidos de la muestra de 200 pacientes internados en 14 UCIs del Municipio de São Paulo, mostraron que el TISS-28 presentó asociación con la mortalidad (p=0,0001. El punto de corte establecido fue 21. Se encontró que el 80.88% de los que murieron tenían puntuación del TISS-28 mayor o igual, y 68.18% de los sobrevivientes tenían puntuación menor que 21. Además de eso, en cuanto al valor pronóstico del TISS-28, se constató exactitud de 0.72.The study evaluates the competence of the "TISS-28" to distinguish inpatients at the ICU, between the ones likely to die from the ones likely to survive and to establish a threshold score for high likelihood to death. The findings obtained by the sample of 200 inpatients at 14 ICUs in Sao Paulo County showed that the TISS-28 presented association with mortality (p=0.0001. The cutting score established was 21. It was found that 80.88% of those who died had the TISS-28 score similar or higher and 68.18% of survivors had the score below 21

  10. Risk stratification and prognostic value of grace and timi risk scores for female patients with non-st segment elevation acute coronary syndrome.

    Science.gov (United States)

    Zhu, Hang; Xue, Hao; Wang, Haotian; Chen, Yundai; Zhou, Shanshan; Tian, Feng; Hu, Shunying; Wang, Jing; Yang, Junjie; Zhang, Tao

    2015-01-01

    To investigate the value of Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) risk scores for risk stratification and prognosis in female patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). Non-elderly (TIMI scores. Patients were followed up for 1 year to record the mortality and incidence of major adverse cardiac events (MACE). Differences in mortality and MACE incidence between the two scoring systems were compared by the area under the ROC curve. The area under ROC curve corresponding to the mortality and MACE incidence in any period by the GRACE scoring system was significantly larger than the TIMI scoring system in the elderly patients (PTIMI scores were greater than 1 (PTIMI were adoptable in clinical risk stratification and prognosis of female patients with NSTE-ACS at different age groups. GRACE showed better accuracy than the TIMI scores.

  11. Short- and long-term prognostic value of the TIMI risk score after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

    NARCIS (Netherlands)

    Damman, Peter; Woudstra, Pier; Kuijt, Wichert J.; Kikkert, Wouter J.; van de Hoef, Tim P.; Grundeken, Maik J.; Harskamp, Ralf E.; Henriques, Jose P. S.; Piek, Jan J.; Tijssen, Jan G. P.; de Winter, Robbert J.

    2013-01-01

    We investigated the short- and long-term predictive value of the TIMI risk score regarding mortality for patients treated with primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI). Data on the long-term predictive value of the TIMI risk score is sparse. We

  12. Short- and long-term prognostic value of the TIMI risk score after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.

    Science.gov (United States)

    Damman, Peter; Woudstra, Pier; Kuijt, Wichert J; Kikkert, Wouter J; van de Hoef, Tim P; Grundeken, Maik J; Harskamp, Ralf E; Henriques, Jose P S; Piek, Jan J; Tijssen, Jan G P; de Winter, Robbert J

    2013-02-01

    We investigated the short- and long-term predictive value of the TIMI risk score regarding mortality for patients treated with primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI). Data on the long-term predictive value of the TIMI risk score is sparse. We used data from 3,609 STEMI patients undergoing PPCI in a high-volume PCI center in The Netherlands. Cumulative event rates according to TIMI score variables were estimated with the Kaplan-Meier method and compared with the log-rank test. The original TIMI risk score was modified based on the availability of the data in the single center registry. Higher TIMI scores were associated with significantly higher mortality at short- and long-term follow-up (P 100 beats per minute, or systolic blood pressure TIMI risk score has both short- and long-term discriminative value. The different variables contained in the TIMI risk score predict short-term prognosis, others predominantly long-term mortality, whereas some are predictive for both. © 2012, Wiley Periodicals, Inc.

  13. Risk stratification and prognostic value of grace and timi risk scores for female patients with non-st segment elevation acute coronary syndrome

    Science.gov (United States)

    Zhu, Hang; Xue, Hao; Wang, Haotian; Chen, Yundai; Zhou, Shanshan; Tian, Feng; Hu, Shunying; Wang, Jing; Yang, Junjie; Zhang, Tao

    2015-01-01

    Aim: To investigate the value of Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) risk scores for risk stratification and prognosis in female patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). Methods: Non-elderly (risk groups according to their GRACE and TIMI scores. Patients were followed up for 1 year to record the mortality and incidence of major adverse cardiac events (MACE). Differences in mortality and MACE incidence between the two scoring systems were compared by the area under the ROC curve. Results: The area under ROC curve corresponding to the mortality and MACE incidence in any period by the GRACE scoring system was significantly larger than the TIMI scoring system in the elderly patients (Pscores. Risk ratio values of Cox regression analysis based on GRACE and TIMI scores were greater than 1 (PTIMI were adoptable in clinical risk stratification and prognosis of female patients with NSTE-ACS at different age groups. GRACE showed better accuracy than the TIMI scores. PMID:26064307

  14. An Advanced Deep Learning Approach for Ki-67 Stained Hotspot Detection and Proliferation Rate Scoring for Prognostic Evaluation of Breast Cancer.

    Science.gov (United States)

    Saha, Monjoy; Chakraborty, Chandan; Arun, Indu; Ahmed, Rosina; Chatterjee, Sanjoy

    2017-06-12

    Being a non-histone protein, Ki-67 is one of the essential biomarkers for the immunohistochemical assessment of proliferation rate in breast cancer screening and grading. The Ki-67 signature is always sensitive to radiotherapy and chemotherapy. Due to random morphological, color and intensity variations of cell nuclei (immunopositive and immunonegative), manual/subjective assessment of Ki-67 scoring is error-prone and time-consuming. Hence, several machine learning approaches have been reported; nevertheless, none of them had worked on deep learning based hotspots detection and proliferation scoring. In this article, we suggest an advanced deep learning model for computerized recognition of candidate hotspots and subsequent proliferation rate scoring by quantifying Ki-67 appearance in breast cancer immunohistochemical images. Unlike existing Ki-67 scoring techniques, our methodology uses Gamma mixture model (GMM) with Expectation-Maximization for seed point detection and patch selection and deep learning, comprises with decision layer, for hotspots detection and proliferation scoring. Experimental results provide 93% precision, 0.88% recall and 0.91% F-score value. The model performance has also been compared with the pathologists' manual annotations and recently published articles. In future, the proposed deep learning framework will be highly reliable and beneficial to the junior and senior pathologists for fast and efficient Ki-67 scoring.

  15. Prognostic Value of the Thrombolysis in Myocardial Infarction Risk Score in ST-Elevation Myocardial Infarction Patients With Left Ventricular Dysfunction (from the EPHESUS Trial).

    Science.gov (United States)

    Popovic, Batric; Girerd, Nicolas; Rossignol, Patrick; Agrinier, Nelly; Camenzind, Edoardo; Fay, Renaud; Pitt, Bertram; Zannad, Faiez

    2016-11-15

    The Thrombolysis in Myocardial Infarction (TIMI) risk score remains a robust prediction tool for short-term and midterm outcome in the patients with ST-elevation myocardial infarction (STEMI). However, the validity of this risk score in patients with STEMI with reduced left ventricular ejection fraction (LVEF) remains unclear. A total of 2,854 patients with STEMI with early coronary revascularization participating in the randomized EPHESUS (Epleronone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study) trial were analyzed. TIMI risk score was calculated at baseline, and its predictive value was evaluated using C-indexes from Cox models. The increase in reclassification of other variables in addition to TIMI score was assessed using the net reclassification index. TIMI risk score had a poor predictive accuracy for all-cause mortality (C-index values at 30 days and 1 year ≤0.67) and recurrent myocardial infarction (MI; C-index values ≤0.60). Among TIMI score items, diabetes/hypertension/angina, heart rate >100 beats/min, and systolic blood pressure TIMI score items, aside from age, were significantly associated with MI recurrence. Using a constructed predictive model, lower LVEF, lower estimated glomerular filtration rate (eGFR), and previous MI were significantly associated with all-cause mortality. The predictive accuracy of this model, which included LVEF and eGFR, was fair for both 30-day and 1-year all-cause mortality (C-index values ranging from 0.71 to 0.75). In conclusion, TIMI risk score demonstrates poor discrimination in predicting mortality or recurrent MI in patients with STEMI with reduced LVEF. LVEF and eGFR are major factors that should not be ignored by predictive risk scores in this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Main clinical factors influencing early mortality in a cohort of patients with severe alcoholic hepatitis, and evaluation trough ROC curves of different prognostic scoring systems

    Directory of Open Access Journals (Sweden)

    Fátima Higuera-de la Tijera

    2014-10-01

    Conclusions: The development of HE is the main factor associated to early mortality. Coexistence of cirrhosis is a factor that worsen the prognosis. Lille score is the most accurate for predict early mortality.

  17. The prognostic utility of the SYNTAX score on 1-year outcomes after revascularization with zotarolimus- and everolimus-eluting stents: a substudy of the RESOLUTE All Comers Trial

    DEFF Research Database (Denmark)

    Garg, Scot; Serruys, Patrick W; Silber, Sigmund

    2011-01-01

    This study assessed the ability of the SYNTAX score (SXscore) to stratify risk in patients treated with percutaneous coronary intervention (PCI) using zotarolimus-eluting or everolimus-eluting stents....

  18. Prognostic significance of Gleason score 7 (3+4 and Gleason score 7 (4+3 in prostatic adenocarcinoma in relation to clinical stage, androgen tissue status and degree of neuroendocrine differentiation

    Directory of Open Access Journals (Sweden)

    Mijović M.

    2014-01-01

    Full Text Available Prognosis and choice of treatment of adenocarcinoma of the prostate (ADCP directly depend on the numerous of predictive factors, among which the most important are summary histological tumor grade (Gleason score, which is the sum of the first and second dominant histological grade and clinical stage. According to recent research these factors include androgen tissue status and degree of neuroendocrine differentiation. The importance of the first and second dominant histological grade becomes particularly important in ADCP Gleason score 7. Tumors with worse prognosis considered to be ADCP of higher Gleason score, the advanced clinical stage, androgen independent tumors and tumors that show a higher degree of neuroendocrine differentiation. The aim of the study was to determine the predictive significance of ADCP Gleason score 7 (3+4 and ADCP Gleason score 7 (4+3 in relation to clinical stage, androgen tissue status and degree of focal neuroendocrine differentiation. The study included 33 ADCP of Gleason score 7,26 (78.79% ADCP 7 (3+4 and 7 (21.21% ADCP 7 (4+3. All tumors are most often diagnosed with stage D2, when there are already distant metastases. ADCP of Gleason score 7 (4+3 were diagnosed more often at this stage, among them there are more androgen independent tumors and they show a greater degree of focal neuroendocrine differentiation. All the results are in accordance with data from the literature suggesting that ADCP of Gleason score 7 (4+3 have a worse prognosis than ADCP of Gleason score 7 (3 +4.

  19. Mobile IP and protocol authentication extension

    OpenAIRE

    Nguyen, Phuc V.

    2011-01-01

    Mobile IP is an open standard, defined by the Internet Engineering Task Force (IETF) RFC 3220. By using Mobile IP, you can keep the same IP address, stay connected, and maintain ongoing applications while roaming between IP networks. Mobile IP is scalable for the Internet because it is based on IP - any media that can support IP can support Mobile IP.

  20. The Prognostic Scoring System Establishment and Validation for Chronic Atrial Fibrillation Patients Receiving Modified Cox-Maze IV and Concomitant Cardiac Surgery.

    Directory of Open Access Journals (Sweden)

    Feng-Chun Tsai

    Full Text Available Traditional Cox maze III is the gold standard for treatment of atrial fibrillation (AF. Because of its invasiveness, it has been replaced by a simplified procedure involving radiofrequency ablation of modified Cox maze IV. Although the modified Cox maze IV has the advantages of simplicity and less morbidity, a lower rate of sinus rhythm conversion has been reported. We try to establish a scoring system to predict the outcome of this procedure.The derivation group consisted of 287 patients with structural heart disease and chronic AF who underwent cardiac surgery and modified Cox-maze IV procedure between August 2005 and March 2013. Demographics, clinical and laboratory variables were retrospectively collected as sinus conversional predictors. Overall sinus conversion rate was 75.8%. The parameters of the Soft Markers Scoring system included AF duration, preoperative left atrial (LA size, rheumatic pathology and postoperative LA remodeling. We compared 80 patients from another hospital between January 2004 and December 2011 as a validation group to evaluate the power of the scoring system. Soft Markers Score indicated a good discriminative power by using the areas under the receiver operating characteristic curve (AUROC: 0.759 ± 0.032. The score was further divided into three groups: low (0-2, intermediate (3-5, and high (6-10, with predicted sinus conversion rates of 92.4%, 74.2%, and 47.8%, respectively.In patients with chronic AF receiving modified Cox-maze IV procedure, the Soft Markers Score demonstrated good discriminative power of predicting sinus recovery in our patients and applied well to the other validation populations.

  1. Prognostic factors for open globe injuries and correlation of Ocular Trauma Score at a tertiary referral eye care centre in Singapore

    Directory of Open Access Journals (Sweden)

    Rupesh Agrawal

    2013-01-01

    Full Text Available Objective: To evaluate the factors influencing final vision outcome after surgical repair of open globe injuries and to correlate the Ocular trauma score. Materials and Methods: Retrospective case analysis of patients with open globe injuries at a tertiary referral eye care centre in Singapore was performed. Pre-operative factors affecting final vision outcome in patients with open globe injury and correlation of ocular trauma score in our study with international ocular trauma scoring system was performed. Results: Case records of 172 eyes with open globe injury were analyzed. Mean age was 36. 67 years. Mean follow up was 12.26 m. Males were pre-dominantly affected. Initial visual acuity was ≥20/40, 20/50 < 20/200, 20/200- CF, HM- PL and NLP in 24 (14%, 39 (22.7%, 16 (9.3%, 66 (38.4% and 27 (15.7% eyes respectively. Final visual acuity was ≤20/40, 20/50 < 20/200, 20/200- 1/200, HM- PL and NLP in 76 (44.2%, 28 (16.3%, 11 (6.4%, 30 (17.4% and 27 (15.7% eyes respectively. Ocular trauma score in our study correlates with international ocular trauma scoring system. Conclusion: The present study showed pre-operative variables such as mode of injury, pre-operative visual acuity, traumatic cataract, hyphaema, relative afferent papillary defect, vitreous lossand vitreous hemorrhage to be adversely affecting the final vision outcome. Our study showed a good synchrony with international ocular trauma score (OTS and based on this study we were able to validate application of OTS in Singapore population. Recognizing these factors can help the surgeon in evidence based counseling.

  2. Work ability as prognostic risk marker of disability pension : Single-item work ability score versus multi-item work ability index

    NARCIS (Netherlands)

    Roelen, C.A.M.; Rhenen, van W.; Groothoff, J.W.; Klink, van der J.J.L.; Twisk, W.R.; Heymans, M.W.

    2014-01-01

    Work ability predicts future disability pension (DP). A single-item work ability score (WAS) is emerging as a measure for work ability. This study compared single-item WAS with the multi-item work ability index (WAI) in its ability to identify workers at risk of DP.

  3. Prognostic discrimination based on the EUTOS long-term survival score within the International Registry for Chronic Myeloid Leukemia in children and adolescents

    DEFF Research Database (Denmark)

    Millot, Frédéric; Guilhot, Joëlle; Suttorp, Meinolf

    2017-01-01

    The EUTOS Long-Term Survival score was tested in 350 children with chronic myeloid leukemia in first chronic phase treated with imatinib and registered in the International Registry for Childhood Chronic Myeloid Leukemia. With a median follow up of 3 years (range, 1 month to 6 years) progression ...

  4. Prognostic impact of admission blood glucose for all-cause mortality in patients with acute coronary syndromes: added value on top of GRACE risk score.

    Science.gov (United States)

    Timóteo, Ana T; Papoila, Ana L; Rio, Pedro; Miranda, Fernando; Ferreira, Maria L; Ferreira, Rui C

    2014-09-01

    Abnormal glucose metabolism is a predictor of worse outcome after acute coronary syndrome (ACS). However, this parameter is not included in risk prediction scores, including GRACE risk score. We sought to evaluate whether the inclusion of blood glucose at admission in a model with GRACE risk score improves risk stratification. Study of consecutive patients included in a single centre registry of ACS. Our primary endpoint was the occurrence of all-cause mortality at one-year follow-up. The ability of the two logistic regression models (GRACE risk score alone and in combination with blood glucose) to predict death was analysed. Continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI), with corresponding 95% confidence intervals (CIs), were also calculated. We included 2099 patients, with a mean age of 64 (SD=13) years, 69% males. In our sample, 55.1% presented with ST-segment elevation ACS and 13.1% in Killip class ≥ 2. Only 25% were known diabetic at admission. In-hospital mortality was 5.8% and 9.7% at one-year follow-up. The best cut-point for blood glucose was 160 mg/dl (sensitivity 62% and specificity 68%), and 35.2% of the patients had increased levels. This group was elderly, had more prevalence of cardiovascular risk factors, worse renal function and GRACE score as well as more frequently Killip class ≥2. Treatment was similar in both groups besides less frequent use of clopidogrel in high glycaemic patients. The hyperglycaemia group had higher one-year mortality (17.2% vs. 5.6%, pimprovement in both the NRI (37%) and the IDI (0.021), suggesting effective reclassification. A blood glucose level on admission ≥ 160 mg/dl is an independent predictor of mortality in medium-term follow-up. It offers an incremental predictive value when added to the GRACE risk score, although with a modest magnitude of improvement, probably due to the high predictive performance of the GRACE risk score alone. © The European Society of

  5. Comparison of the prognostic predictive value of the TIMI, PAMI, CADILLAC, and GRACE risk scores in STEACS undergoing primary or rescue PCI.

    Science.gov (United States)

    Méndez-Eirín, Elizabet; Flores-Ríos, Xacobe; García-López, Fernando; Pérez-Pérez, Alberto J; Estévez-Loureiro, Rodrigo; Piñón-Esteban, Pablo; Aldama-López, Guillermo; Salgado-Fernández, Jorge; Calviño-Santos, Ramón A; Vázquez Rodríguez, José M; Vázquez-González, Nicolás; Castro-Beiras, Alfonso

    2012-03-01

    We sought to compare the predictive value of the Thrombolysis In Myocardial Infarction (TIMI), Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC), Primary Angioplasty in Myocardial Infarction (PAMI), and Global Registry for Acute Coronary Events (GRACE) scores for the outcome of ST-segment elevation acute coronary syndrome undergoing urgent percutaneous coronary intervention. We performed a retrospective analysis of a cohort composed of all consecutive patients with ST-segment elevation acute coronary syndrome treated by urgent percutaneous coronary intervention between 2006 and 2010 (n=1503). TIMI, PAMI, CADILLAC, and GRACE risk scores were calculated for each patient according to different clinical variables. We assessed the predictive accuracy of these scores for death, reinfarction, and target-vessel revascularization at 30 days and 1 year, using the C statistic, which was obtained by means of logistic regression and ROC curves. The TIMI, PAMI, CADILLAC and GRACE showed an excellent predictive value for 30-day and 1-year mortality (C statistic range, 0.8-0.9), with superiority of the TIMI, CADILLAC, and GRACE risk models. The performance of these 4 scores was poor for both reinfarction and target-vessel revascularization (C statistic, 0.5-0.6). The TIMI, PAMI, CADILLAC, and GRACE scores provide excellent information to stratify the risk of mortality in patients treated by percutaneous coronary intervention. The TIMI, CADILLAC, and GRACE models have higher predictive accuracy. The usefulness of these models for reinfarction and target-vessel revascularization prediction is questionable. Copyright © 2011 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  6. Aberrant Promoter Methylation of Protocadherin8 (PCDH8) in Serum is a Potential Prognostic Marker for Low Gleason Score Prostate Cancer.

    Science.gov (United States)

    Lin, Ying-Li; Li, Yan-Li; Ma, Jian-Guo

    2017-10-13

    BACKGROUND PCDH8 is a newly-discovered suppressor gene that is frequently inactivated by aberrant methylation in several human cancers, including prostate cancer. The identification of PCDH8 methylation can be used as a potential predictive biomarker. Prostate cancer patients with high Gleason score are considered as being at high risk for tumor recurrence and progression, and adjuvant therapy is often routinely performed in clinical practice. In the present study, we did not measure the methylation of PCDH8 in these patients. The main purpose of the present study was to evaluate the clinical significance of PCDH8 methylation in serum of prostate cancer patients with low Gleason score. MATERIAL AND METHODS PCDH8 methylation in serum samples of 117 patients and 47 controls was checked by methylation-specific PCR (MSP). Then, we correlated PCDH8 methylation status with the clinicopathological parameters of prostate cancer patients with low Gleason score and patient outcomes. RESULTS We found that PCDH8 was more frequently methylated in serum samples of patients with prostate cancer than in controls. PCDH8 methylation was correlated with advanced clinical stage (P=0.021), higher level of preoperative PSA (P=0.008), and positive lymph node metastasis (P=0.010). Moreover, patients with PCDH8 methylation had worse biochemical recurrence (BCR)-free survival (PGleason score were: PCDH8 methylation in serum (Exp (B)=3.147, 95% CI: 1.152-7.961, P=0.007), clinical stage (Exp (B)=2.53, 95% CI: 1.032-4.763, P=0.025) and lymph node status (Exp (B)=1.476, 95% CI: 1.107-4.572, P=0.042). CONCLUSIONS Our study indicated that PCDH8 methylation in serum occurred frequently in prostate cancer patients and was correlated with risk factors for poor outcome. The methylation of PCDH8 in serum is a potential predictive marker for prostate cancer patients with low Gleason score after surgery.

  7. Prognostic value of perfusion defect volume at dual energy CTA in patients with pulmonary embolism: Correlation with CTA obstruction scores, CT parameters of right ventricular dysfunction and adverse clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Apfaltrer, Paul, E-mail: paul.apfaltrer@medma.uni-heidelberg.de [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Bachmann, Valentin, E-mail: valentin.bachmann@googl.com [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Meyer, Mathias, E-mail: mr.meyer.mathias@gmail.com [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Henzler, Thomas, E-mail: Thomas.Henzler@umm.de [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Barraza, John M., E-mail: barraza@musc.edu [Department of Radiology and Radiological Science, Medical University of South Carolina, PO Box 250322, 169 Ashley Avenue, Charleston, SC 29425 (United States); Gruettner, Joachim, E-mail: joachim.gruettner@umm.de [1st Department of Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Walter, Thomas, E-mail: Thomas.Walter2@umm.de [1st Department of Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Department of Radiology and Radiological Science, Medical University of South Carolina, PO Box 250322, 169 Ashley Avenue, Charleston, SC 29425 (United States); and others

    2012-11-15

    Purpose: To investigate the prognostic value of perfusion defect volume (PDvol) at dual-energy-CT-angiography (DE-CTA) in patients with acute pulmonary embolism (PE) by correlating PDvol with CTA-obstruction-scores (OS), CT parameters of right-ventricular-dysfunction (RVD), and adverse-clinical-outcome. Materials and methods: DE-CTA of 60 patients (mean age: 65 {+-} 14.4 years) with PE were analyzed. Iodine maps were generated, and normalized PDvol - defined as volume of perfusion defects/total lung volume - was quantified. Furthermore, established prognostic parameters (Qanadli and Mastora-OS, and CT parameters of RVD) were obtained. CT parameters of RVD - namely the right ventricle/left ventricle (RV/LV) diameter ratio measured on transverse sections (RV/LVtrans), four-chamber views (RV/LV4ch), and RV/LV volume ratios (RV/LVvol) - were assessed. PDvol was correlated with OS, CT parameters of RVD and adverse clinical outcome (defined as the need for intensive care treatment or death). Results: 10 of 60 patients with PE experienced adverse clinical outcome. Patients with adverse clinical outcome showed significantly higher PDvol (35 {+-} 11% vs. 23 {+-} 10%, p = 0.002), RV/LV ratios (RV/LV4ch 1.46 {+-} 0.32 vs. 1.18 {+-} 0.26, p = 0.005; RV/LVvol 2.25 {+-} 1.33 vs. 1.19 {+-} 0.56, p = 0.002) and higher Mastora global scores (52 vs. 13, p = 0.02) compared to those without adverse clinical outcome. A weak correlation was observed between PDvol and the Mastora global score (r = 0.5; p = 0.0003), as well as between PDvol and RV/LV4Ch (r = 0.432, p = 0.0006). No correlation was found between PDvol and the Qanadli score or the remainder of the RVD-CT parameters. Conclusion: The extent of perfusion defects as assessed by DE-CTA correlates with adverse clinical outcome in patients with PE. Therefore, volumetric quantification of perfusion defects at DE-CTA allows the identification of low-risk patients who do not require intensified monitoring and treatment.

  8. Briefer assessment of social network drinking: A test of the Important People Instrument-5 (IP-5).

    Science.gov (United States)

    Hallgren, Kevin A; Barnett, Nancy P

    2016-12-01

    The Important People instrument (IP; Longabaugh et al., 2010) is one of the most commonly used measures of social network drinking. Although its reliability and validity are well-supported, the length of the instrument may limit its use in many settings. The present study evaluated whether a briefer, 5-person version of the IP (IP-5) adequately reproduces scores from the full IP. College freshmen (N = 1,053) reported their own past-month drinking, alcohol-related consequences, and information about drinking in their close social networks at baseline and 1 year later. From this we derived network members' drinking frequency, percentage of drinkers, and percentage of heavy drinkers, assessed for up to 10 (full IP) or 5 (IP-5) network members. We first modeled the expected concordance between full-IP scores and scores from simulated shorter IP instruments by sampling smaller subsets of network members from full IP data. Then, using quasi-experimental methods, we administered the full IP and IP-5 and compared the 2 instruments' score distributions and concurrent and year-lagged associations with participants' alcohol consumption and consequences. Most of the full-IP variance was reproduced from simulated shorter versions of the IP (ICCs ≥ 0.80). The full IP and IP-5 yielded similar score distributions, concurrent associations with drinking (r = 0.22 to 0.52), and year-lagged associations with drinking. The IP-5 retains most of the information about social network drinking from the full IP. The shorter instrument may be useful in clinical and research settings that require frequent measure administration, yielding greater temporal resolution for monitoring social network drinking. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. Stud.IP

    OpenAIRE

    Stockmann, Ralf; Berg, Alexander

    2005-01-01

    Dieser Beitrag beschreibt die Konzeption, den Funktionsumfang und Erfahrungswerte der Open-Source-eLearning-Plattform Stud.IP. Der Funktionsumfang umfasst für jede einzelne Veranstaltung Ablaufpläne, das Hochladen von Hausarbeiten, Diskussionsforen, persönliche Homepages, Chaträume u.v.a. Ziel ist es hierbei, eine Infrastruktur des Lehrens und Lernens anzubieten, die dem Stand der Technik entspricht. Wissenschaftliche Einrichtungen finden zudem eine leistungsstarke Umgebung zur Verwaltung ihr...

  10. The effectiveness of the APACHE II, SAPS II and SOFA prognostic scoring systems in patients with haematological malignancies in the intensive care unit.

    Science.gov (United States)

    Sawicka, Wioletta; Owczuk, Radosław; Wujtewicz, Magdalena Anna; Wujtewicz, Maria

    2014-01-01

    Cancer-related mortality remains the second most common cause of death in Poland. In many cases, the occurrence of treatment-related complications requires admission to the intensive care unit (ICU). The aim of this study was to assess the clinical application of the APACHE II, SAPS II and SOFA scales to evaluate the risk of death in patients with haematological malignancies treated in the ICU. This study's analysis included 99 patients, who were each assigned to one of the following two groups: surviving patients who were discharged from the ICU (n = 24); and patients who died in the ICU (n = 75). Analysis was performed using demographic, clinical and laboratory data obtained during the patient's admission to the ICU and also during the first 24 hours of intensive therapy. Patient assessment was performed using the APACHE II, SAPS II and SOFA scoring systems as well as other clinical variables. Univariate logistic regression identified the following risk factors of death in patients with haematological malignancies: systolic (P = 0.006), diastolic (P = 0.01) and mean arterial pressure values (P = 0.009); occurrence of acute kidney injury; neutrophil (P = 0.009) and platelet count in the peripheral blood (P = 0.001); and the SAPS II (P = 0.00005), SOFA (P = 0.00009) and APACHE II (P = 0.0007) scores. SAPS II score was the only independent risk factor of patient death in multivariate analysis (P = 0.0004; unitary OR 1.052 [95% CI: 1.022-1.082]). Of all the applied patient assessment scales, only the SAPS II score was found to be useful in subjects with haematological malignancies hospitalised in the ICU.

  11. Prognostic significance of Gleason score 7 (3+4) and Gleason score 7 (4+3) in prostatic adenocarcinoma in relation to clinical stage, androgen tissue status and degree of neuroendocrine differentiation

    OpenAIRE

    Mijović M.; Vukićević D.; Đerković B.; Nedeljković V.; Vitković L.

    2014-01-01

    Prognosis and choice of treatment of adenocarcinoma of the prostate (ADCP) directly depend on the numerous of predictive factors, among which the most important are summary histological tumor grade (Gleason score, which is the sum of the first and second dominant histological grade) and clinical stage. According to recent research these factors include androgen tissue status and degree of neuroendocrine differentiation. The importance of the first and second dominant histological grade become...

  12. Prognostic ability of EndoPredict compared to research-based versions of the PAM50 risk of recurrence (ROR) scores in node-positive, estrogen receptor-positive, and HER2-negative breast cancer. A GEICAM/9906 sub-study.

    Science.gov (United States)

    Martin, Miguel; Brase, Jan C; Ruiz, Amparo; Prat, Aleix; Kronenwett, Ralf; Calvo, Lourdes; Petry, Christoph; Bernard, Philip S; Ruiz-Borrego, Manuel; Weber, Karsten E; Rodriguez, César A; Alvarez, Isabel M; Segui, Miguel A; Perou, Charles M; Casas, Maribel; Carrasco, Eva; Caballero, Rosalía; Rodriguez-Lescure, Alvaro

    2016-02-01

    There are several prognostic multigene-based tests for managing breast cancer (BC), but limited data comparing them in the same cohort. We compared the prognostic performance of the EndoPredict (EP) test (standardized for pathology laboratory) with the research-based PAM50 non-standardized qRT-PCR assay in node-positive estrogen receptor-positive (ER+) and HER2-negative (HER2-) BC patients receiving adjuvant chemotherapy followed by endocrine therapy (ET) in the GEICAM/9906 trial. EP and PAM50 risk of recurrence (ROR) scores [based on subtype (ROR-S) and on subtype and proliferation (ROR-P)] were compared in 536 ER+/HER2- patients. Scores combined with clinical information were evaluated: ROR-T (ROR-S, tumor size), ROR-PT (ROR-P, tumor size), and EPclin (EP, tumor size, nodal status). Patients were assigned to risk-categories according to prespecified cutoffs. Distant metastasis-free survival (MFS) was analyzed by Kaplan-Meier. ROR-S, ROR-P, and EP scores identified a low-risk group with a relative better outcome (10-year MFS: ROR-S 87 %; ROR-P 89 %; EP 93 %). There was no significant difference between tests. Predictors including clinical information showed superior prognostic performance compared to molecular scores alone (10-year MFS, low-risk group: ROR-T 88 %; ROR-PT 92 %; EPclin 100 %). The EPclin-based risk stratification achieved a significantly improved prediction of MFS compared to ROR-T, but not ROR-PT. All signatures added prognostic information to common clinical parameters. EPclin provided independent prognostic information beyond ROR-T and ROR-PT. ROR and EP can reliably predict risk of distant metastasis in node-positive ER+/HER2- BC patients treated with chemotherapy and ET. Addition of clinical parameters into risk scores improves their prognostic ability.

  13. Spontaneous, resolving S1Q3T3 in pulmonary embolism: A case report and literature review on prognostic value of electrocardiography score for pulmonary embolism.

    Science.gov (United States)

    Cygan, Lukasz D; Weizberg, Moshe; Hahn, Barry

    2016-09-01

    Electrocardiography findings in patients with pulmonary embolism have been investigated since 1935. As medicine has evolved, more effective modalities have surpassed the electrocardiogram in diagnostic utility. Despite the advent of these other modalities, the diagnosis of pulmonary embolism remains elusive and the prognosis is variable amongst each clinical presentation of its pathology. After presenting a case of a resolving S1Q3T3 in subsequent electrocardiogram findings of a patient with pulmonary embolism, this literature review will provide information on a 21-point electrocardiogram scoring system that helps the emergency physician stratify the risk of a patient with an acute presentation of pulmonary embolism. Why should emergency care staff be aware of this? Given the time-sensitive nature of diagnosis and appropriate treatment, Electrocardiogram continues to be a tool in the assessment of patients with a clinical suspicion of pulmonary embolism. Based on the information provided, 21-point electrocardiogram score has been shown to have strong usefulness in assessing prognosis of patients presenting with acute pulmonary embolism. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Impact of renal dysfunction on the prognostic value of the TIMI risk score in patients with non-ST elevation acute coronary syndrome.

    Science.gov (United States)

    Go, Jason; Narmi, Ann; Sype, John; Mooss, Aryan; Hilleman, Daniel E

    2011-01-01

    The thrombolysis-in-myocardial-infarction risk score (TRS) is a validated risk-assessment tool based on randomized clinical trials. Its applicability to an unselected group of patients seen in general clinical practice may be limited as renal dysfunction was an exclusion criteria in the original trials upon which the TRS was determined. Consecutive patients with non-ST elevation acute coronary syndrome were stratified based on renal function. Normal renal function was defined as a creatinine clearance (CrCl) of more than 60 ml/min, moderate renal dysfunction was defined as a CrCl of at least 30 ml/min but 60 ml/min or less, and severe renal dysfunction was defined as a CrCl of less than 30 ml/min. A TRS was calculated using the original seven criteria (TRS-7) which did not consider renal function. A second TRS was calculated using the original seven criteria plus the addition of renal dysfunction if the CrCl was 60 ml/min or less (TRS-8 ≤ 60). A third TRS was calculated using the original seven criteria plus renal dysfunction if the CrCl was less than 30 ml/min (TRS-80.05). At a calculated TRS of 6 or 7, the TRS-8scores of 6 or more. When considered in the context of clinical practice, the use of the TRS-8 ≤ 60 and TRS-8<30 rather than the TRS-7 would not be expected to substantially change the management strategy for patients presenting with non-ST elevation acute coronary syndrome.

  15. Clinico-epidemiological study of caustic substance ingestion accidents in children in Anatolia: the DROOL score as a new prognostic tool.

    Science.gov (United States)

    Uygun, I; Aydogdu, B; Okur, M H; Arayici, Y; Celik, Y; Ozturk, H; Otcu, S

    2012-01-01

    To examine the clinico-epidemiological details of paediatric caustic substance ingestion (CSI) accidents in Turkey. To present the new DROOL Score (DS), which the authors developed based on the severity and duration of initial signs and symptoms (ISSs) to predict oesophageal stricture (OS) without endoscopy, and to present our management protocol based on immediate feeding, early detection, and oesophageal balloon dilatation (OBD) of OS with no barium study. We prospectively reviewed the records of 202 children admitted with a history of CSI within 48 hours. Patient, parent, caustic substance, and accident characteristics were noted in detail. Patients were fed as soon as they could swallow saliva. Diagnoses of OS were made earlier via timely endoscopy (mean, 10-14 days after CSI) for patients with persistent dysphagia and OBD was started earlier. ISSs and DSs were analyzed. OS treatment results were compared between early (10-14 days) and late (> or = 21 days) dilatation patients who were referred for OBD by other hospitals. In total, 144 (71%) incidents occurred within the parents' home and 44 (22%) occurred at another individual's home. The caustic substances were frequently sold in non-original containers (68.8%). Most patients' parents had low incomes and were poorly educated. Ninety-six children had no ISSs, whereas 106 patients had ISSs. Seventeen symptomatic patients had persistent dysphagia after 10-14 days. Timely endoscopy was performed within 10-14 days for these patients only, and OS was diagnosed and successfully treated. DSs were significantly lower in patients with OS than those without (p or = 21 days). OBD can then also be started earlier in these patients.

  16. Complementary prognostic values of ST segment deviation and Thrombolysis In Myocardial Infarction (TIMI) risk score in non-ST elevation acute coronary syndromes: Insights from the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) study.

    Science.gov (United States)

    Huynh, Thao; Nasmith, James; Luong, The Minh; Bernier, Martin; Pharand, Chantal; Xue-Qiao, Zhao; Giugliano, Robert P; Theroux, Pierre

    2009-12-01

    Although the Thrombolysis In Myocardial Infarction (TIMI) score incorporates ST deviation, it does not account for characteristics of the ST deviations. In the present study, it was hypothesized that the magnitude and characteristics of ST deviation may add to the prognostic values of the TIMI risk score in acute coronary syndrome (ACS) patients, particularly in lower-risk patients with a TIMI risk score of less than 5. To evaluate the prognostic value of combining the TIMI risk score and characteristics of ST deviation in patients with non-ST elevation ACS and a TIMI risk score of less than 5. The death/myocardial infarction (MI) rates of 1296 patients enrolled in the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) angiographic substudy were examined. Patients without a TIMI risk score of 5 or greater, and without an ST deviation of 1 mm or greater had the lowest six-month rate of death/ MI (5%). In patients with a TIMI risk score of less than 5, the six-month death/MI rate was increased in those with ST depression of 2 mm or greater compared with patients with a similar TIMI risk score and without ST deviation of 1 mm or greater (24% versus 5%, PTIMI risk score of less than 5. ST segment deviation of 2 mm or greater confers additional prognostic information in non-ST elevation ACS patients with a TIMI risk score of less than 5. Patients with a TIMI risk score of less than 5 and ST deviation of 2 mm or less had the lowest risk of six-month death/MI.

  17. Foundations of hardware IP protection

    CERN Document Server

    Torres, Lionel

    2017-01-01

    This book provides a comprehensive and up-to-date guide to the design of security-hardened, hardware intellectual property (IP). Readers will learn how IP can be threatened, as well as protected, by using means such as hardware obfuscation/camouflaging, watermarking, fingerprinting (PUF), functional locking, remote activation, hidden transmission of data, hardware Trojan detection, protection against hardware Trojan, use of secure element, ultra-lightweight cryptography, and digital rights management. This book serves as a single-source reference to design space exploration of hardware security and IP protection. · Provides readers with a comprehensive overview of hardware intellectual property (IP) security, describing threat models and presenting means of protection, from integrated circuit layout to digital rights management of IP; · Enables readers to transpose techniques fundamental to digital rights management (DRM) to the realm of hardware IP security; · Introduce designers to the concept of salutar...

  18. Vertical displacement of Ips Latidens and Ips Pini

    Science.gov (United States)

    Daniel R. Miller

    2000-01-01

    The effect of semiochemical interruptants was examined for Ips latidens (LeConte) and Ips pini (Say) using artificial trees (tall-traps) consisting of an array of seven Lindgren multiple-funnel traps suspended vertically on a rope ladder. S-(+)- Ipsdienol reduced the numbers of I. latidens captured in (±)-ipsenol...

  19. Identification of a major IP5 kinase in Cryptococcus neoformans confirms that PP-IP5/IP7, not IP6, is essential for virulence

    OpenAIRE

    Cecilia Li; Sophie Lev; Adolfo Saiardi; Desmarini Desmarini; Sorrell, Tania C.; Djordjevic, Julianne T.

    2016-01-01

    Fungal inositol polyphosphate (IP) kinases catalyse phosphorylation of IP3 to inositol pyrophosphate, PP-IP5/IP7, which is essential for virulence of Cryptococcus neoformans. Cryptococcal Kcs1 converts IP6 to PP-IP5/IP7, but the kinase converting IP5 to IP6 is unknown. Deletion of a putative IP5 kinase-encoding gene (IPK1) alone (ipk1Δ), and in combination with KCS1 (ipk1Δkcs1Δ), profoundly reduced virulence in mice. However, deletion of KCS1 and IPK1 had a greater impact on virulence attenua...

  20. Beyond iPS!

    Directory of Open Access Journals (Sweden)

    Editorial

    2012-01-01

    Full Text Available It’s undoubtedly a jubilant moment for scientists and clinicians working in the stem cell arena as Prof. Gurdon and Prof. Shinya Yamanaka have been chosen for the Nobel Prize in Physiology & Medicine this year. The mystery of cell biology is something unfathomable and probably the work of this duo as well as the other scientists, who have put their hands on in- vitro de-differentiation have opened our eyes to a new window or a new paradigm in cell biology. The iPS invention has brought a lot of hope in terms of potential direct benefits to treat several diseases, which have no definite options at the moment. But, we envisage that several spin-offs could come out of this invention and one very significant spin-off finding recently witnessed is the finding by Prof. Masaharu Seno and his team of researchers at the Okayama University, Japan (Chen L, et al. 2012, PLoS ONE 7(4:e33544.doi:10.1371/journal.pone.0033544. According to Prof. Seno, mouse iPS cells (miPS when cultured in the conditioned medium derived from cancer cell lines, differentiate into cancer stem cells (CSCs. While differentiating into CSCs, they do retain the potential to develop endothelial progenitor cells. Several questions arise here: 1.Are these miPS derived CSCs really pluripotent, even if the terminal differentiation destined to specific phenotypes? 2.Shouldn’t the Cancer Stem Cells be termed as cancer progenitor cells, as till date they are considered to be producing only cancer cells but not pluripotent to yield other types of normal tissues? The spin-offs could be infinite as the process of differentiation and de-differentiation happening due to trillions of signals and pathways, most still remaining not-so-well understood. A special mention should be made to Prof. Shinya Yamanaka as he has several sterling qualities to be a role-model for budding scientists. Apart from his passion for science, which made him shift his career from orthopedics to a cell biologist, his

  1. Identification of a major IP5 kinase in Cryptococcus neoformans confirms that PP-IP5/IP7, not IP6, is essential for virulence.

    Science.gov (United States)

    Li, Cecilia; Lev, Sophie; Saiardi, Adolfo; Desmarini, Desmarini; Sorrell, Tania C; Djordjevic, Julianne T

    2016-04-01

    Fungal inositol polyphosphate (IP) kinases catalyse phosphorylation of IP3 to inositol pyrophosphate, PP-IP5/IP7, which is essential for virulence of Cryptococcus neoformans. Cryptococcal Kcs1 converts IP6 to PP-IP5/IP7, but the kinase converting IP5 to IP6 is unknown. Deletion of a putative IP5 kinase-encoding gene (IPK1) alone (ipk1Δ), and in combination with KCS1 (ipk1Δkcs1Δ), profoundly reduced virulence in mice. However, deletion of KCS1 and IPK1 had a greater impact on virulence attenuation than that of IPK1 alone. ipk1Δkcs1Δ and kcs1Δ lung burdens were also lower than those of ipk1Δ. Unlike ipk1Δ, ipk1Δkcs1Δ and kcs1Δ failed to disseminate to the brain. IP profiling confirmed Ipk1 as the major IP5 kinase in C. neoformans: ipk1Δ produced no IP6 or PP-IP5/IP7 and, in contrast to ipk1Δkcs1Δ, accumulated IP5 and its pyrophosphorylated PP-IP4 derivative. Kcs1 is therefore a dual specificity (IP5 and IP6) kinase producing PP-IP4 and PP-IP5/IP7. All mutants were similarly attenuated in virulence phenotypes including laccase, urease and growth under oxidative/nitrosative stress. Alternative carbon source utilisation was also reduced significantly in all mutants except ipk1Δ, suggesting that PP-IP4 partially compensates for absent PP-IP5/IP7 in ipk1Δ grown under this condition. In conclusion, PP-IP5/IP7, not IP6, is essential for fungal virulence.

  2. Unjuk Kerja IP PBX Asterisk dan FreeSWITCH pada Topologi Bertingkat di Jaringan Kampus

    Directory of Open Access Journals (Sweden)

    Iwan Setiawan

    2017-08-01

    Full Text Available Internet Protocol-based Private Branch Exchange (IP PBX diperlukan untuk menghubungkan panggilan antar perangkat komunikasi Voice over Internet Protocol (VoIP di sebuah jaringan lokal (LAN. Dengan adanya IP PBX, layanan VoIP dapat disediakan di atas jaringan data/IP yang sudah tergelar. Penelitian ini kami lakukan untuk mengetahui unjuk kerja VoIP pada dua IP PBX yang menggunakan perangkat lunak server Asterisk dan FreeSWITCH. Kami merancang sebuah arsitektur jaringan eksperimen yang diadaptasi dari topologi bertingkat pada jaringan kampus (CAN di lokasi penelitian dengan hierarki perangkat yang terdiri dari core switch, distribution switch, dan access switch. Kedua IP PBX ditempatkan pada hierarki yang berbeda pada topologi jaringan tersebut agar dapat diketahui pengaruhnya terhadap unjuk kerja VoIP. Konsep eksperimen ini diharapkan dapat menjadi salah satu dasar untuk mendesain arsitektur IP PBX secara terpusat dan tersebar pada jaringan kampus. Unjuk kerja VoIP kami ukur dengan parameter-parameter Quality of Service (QoS dan Quality of Experience (QoE. Selain itu, kami juga mengukur konsumsi prosesor dan memori yang dipakai oleh perangkat lunak server VoIP pada saat komunikasi terjadi. Pengukuran dilakukan dengan skenario phone-to-phone pada jaringan eksperimen yang terhubung ke jaringan kampus aktif. Hasil penelitian menunjukkan bahwa penempatan IP PBX di hierarki yang berbeda pada topologi jaringan berpengaruh terhadap unjuk kerja VoIP khususnya pada IP PBX Asterisk. Ketika dibandingkan, unjuk kerja IP PBX FreeSWITCH dalam hal QoS dan QoE sedikit lebih baik daripada Asterisk pada rerata latensi/delay, jitter, Mean Opinion Score (MOS, dan konsumsi memori yaitu 41,012 ms, 0,060 ms, 5, dan 1 % untuk IP PBX 1 serta 41,016 ms, 0,066 ms, 5, dan 0,5 % untuk IP PBX 2

  3. Gevaar VoIP voor telecomsector overdreven

    NARCIS (Netherlands)

    Deventer, M.O. van; Wegberg, M. van

    2004-01-01

    Het is een hype Voice-over-IP (VoIP) voor te stellen als een ontwrichtende technologie die de telecomindustrie ingrijpend zal veranderen. Maar hoe ontwrichtend is VoIP eigenlijk? Oskar van Deventer en Marc van Wegberg analyseren drie vormen van VoIP en laten zien dat alleen ‘VoIP-chat’ potentieel

  4. Hardware IP security and trust

    CERN Document Server

    Bhunia, Swarup; Tehranipoor, Mark

    2017-01-01

    This book provides an overview of current Intellectual Property (IP) based System-on-Chip (SoC) design methodology and highlights how security of IP can be compromised at various stages in the overall SoC design-fabrication-deployment cycle. Readers will gain a comprehensive understanding of the security vulnerabilities of different types of IPs. This book would enable readers to overcome these vulnerabilities through an efficient combination of proactive countermeasures and design-for-security solutions, as well as a wide variety of IP security and trust assessment and validation techniques. This book serves as a single-source of reference for system designers and practitioners for designing secure, reliable and trustworthy SoCs.

  5. Infection Probability Score, APACHE II and KARNOFSKY scoring systems as predictors of bloodstream infection onset in hematology-oncology patients

    Directory of Open Access Journals (Sweden)

    Terzis Konstantinos

    2010-05-01

    Full Text Available Abstract Background Bloodstream Infections (BSIs in neutropenic patients often cause considerable morbidity and mortality. Therefore, the surveillance and early identification of patients at high risk for developing BSIs might be useful for the development of preventive measures. The aim of the current study was to assess the predictive power of three scoring systems: Infection Probability Score (IPS, APACHE II and KARNOFSKY score for the onset of Bloodstream Infections in hematology-oncology patients. Methods A total of 102 patients who were hospitalized for more than 48 hours in a hematology-oncology department in Athens, Greece between April 1st and October 31st 2007 were included in the study. Data were collected by using an anonymous standardized recording form. Source materials included medical records, temperature charts, information from nursing and medical staff, and results on microbiological testing. Patients were followed daily until hospital discharge or death. Results Among the 102 patients, Bloodstream Infections occurred in 17 (16.6% patients. The incidence density of Bloodstream Infections was 7.74 per 1,000 patient-days or 21.99 per 1,000 patient-days at risk. The patients who developed a Bloodstream Infection were mainly females (p = 0.004, with twofold time mean length of hospital stay (p Conclusion Between the three different prognostic scoring systems, Infection Probability Score had the best sensitivity in predicting Bloodstream Infections.

  6. Aircraft Anomaly Prognostics Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Ridgetop Group will leverage its proven Electromechanical Actuator (EMA) prognostics methodology to develop an advanced model-based actuator prognostic reasoner...

  7. Running TCP/IP over ATM Networks.

    Science.gov (United States)

    Witt, Michael

    1995-01-01

    Discusses Internet protocol (IP) and subnets and describes how IP may operate over asynchronous transfer mode (ATM). Topics include TCP (transmission control protocol), ATM cells and adaptation layers, a basic architectural model for IP over ATM, address resolution, mapping IP to a subnet technology, and connection management strategy. (LRW)

  8. Offloading IP Flows onto Lambda-Connections

    NARCIS (Netherlands)

    Fioreze, Tiago; Oude Wolbers, Mattijs; van de Meent, R.; Pras, Aiko

    2007-01-01

    Optical networks are capable of switching IP traffic via lambda connections. In this way, big IP flows that overload the regular IP routing level may be moved to the optical level, where they get better Quality of Service (QoS). At the same time, the IP routing level is off-loaded and can serve

  9. DNA-ČIP TEHNOLOGIJA

    OpenAIRE

    BOLARIĆ, SNJEŽANA; Trusk, Marija; Kozumplik, Vinko; Vokurka, Aleš

    2009-01-01

    Usporedno s razvojem DNA molekularnih markera kao ishodišnih tehnologija analiza DNA, 90-tih godina prošlog stoljeća znanstvenici su počeli razvijati novu tehnologiju nazvanu DNA-čip. Naziv dolazi od toga što se, tehnički gledano, na maloj staklenoj površini nalaze oligonukleotidni lanci poznatog slijeda baza, što podsječa na elektronički čip. Ostali nazivi koji se spominju u literaturi su: biochip, DNA microarray, gene array, gene chip i drugi. Prema namjeni eksperimenata razvijena su tri gl...

  10. Security Risks in IP Telephony

    Directory of Open Access Journals (Sweden)

    Filip Rezac

    2010-01-01

    Full Text Available This paper deals with VoIP communication security and various techniques of VoIP attacks. We divided these threats in several categories according to their specific behaviour and their impact on the affected system. We also tried to find effective methods to prevent or mitigate these attacks. We focused our work on Spam over Internet Telephony (SPIT as a real threat for the future. We have developed both a tool generating SPIT attacks and AntiSPIT tool defending communication systems against SPIT attacks. AntiSPIT represents an effective protection based on statistical blacklist and works without participation of the called party which is a significant advantage.

  11. Avaliação prognóstica da doença coronária estável através de um novo escore Evaluación pronóstica de la enfermedad coronaria estable a través de un nuevo score New prognostic score for stable coronary disease evaluation

    Directory of Open Access Journals (Sweden)

    Fernanda Coutinho Storti

    2011-05-01

    simplificado. MÉTODOS: Un nuevo score se aplicó en 372 coronariópatas multiarteriales y función ventricular preservada, el 71,8% varones, edad media de 59,5 (± 9,07 años, randomizados para angioplastia, revascularización quirúrgica y tratamiento clínico, seguidos de cinco años. Muerte cardiovascular fue el resultado primario. El infarto de miocardio no fatal, la muerte y la re-intervención formaron el desenlace combinado secundario. El score se basó en una ecuación previamente validada resultante de la suma de 1 punto a: sexo masculino, antecedentes de infarto, angina, diabetes, uso de insulina y todavía un punto por cada década de vida después de 40 años. Prueba positiva añadida 1 punto. RESULTADOS: Hubo 36 muertes (10 en el grupo de angioplastia, 15 en el grupo de revascularización y 11 en el grupo clínico, p = 0,61. Se observó 93 eventos combinados: 37 en el grupo angioplastia, 23 en el grupo revascularización y 33 en el grupo clínico (p = 0,058. Presentaron score clínico > 5 puntos y 216 > 6 puntos 247 pacientes. El valor de corte > 5 o > 6 puntos identificó un mayor riesgo, con p = 0,015 y p = 0,012, respectivamente. La curva de sobrevida mostró una incidencia de muerte después de la aleatorización que aquellos con score > 6 puntos (p = 0,07, y una incidencia de eventos combinados diferentes entre los pacientes con score 6 puntos (p = 0,02. CONCLUSIÓN: El nuevo score demostró consistencia en la evaluación pronóstica del coronariópata estable multiarterial. (Arq Bras Cardiol 2011;96(5:411-419BACKGROUND: The need to improve the exercise testing accuracy, pushed the development of scores, whose applicability was already broadly recognized. OBJECTIVE: Prognostic evaluation of stable coronary disease through a new simplified score. METHODS: A new score was applied in 372 multivessel coronary patients with preserved ventricular function, 71.8% male, age: 59.5 (± 9.07 years old, randomized to medical treatment, surgery (CABG or angioplasty (PTCA

  12. Continuously Connected With Mobile IP

    Science.gov (United States)

    2002-01-01

    Cisco Systems developed Cisco Mobile Networks, making IP devices mobile. With this innovation, a Cisco router and its connected IP devices can roam across network boundaries and connection types. Because a mobile user is able to keep the same IP address while roaming, a live IP connection can be maintained without interruption. Glenn Research Center jointly tested the technology with Cisco, and is working to use it on low-earth-orbiting research craft. With Cisco's Mobile Networks functionality now available in Cisco IOS Software release 12.2(4)T, the commercial advantages and benefits are numerous. The technology can be applied to public safety, military/homeland security, emergency management services, railroad and shipping systems, and the automotive industry. It will allow ambulances, police, firemen, and the U.S. Coast Guard to stay connected to their networks while on the move. In the wireless battlefield, the technology will provide rapid infrastructure deployment for U.S. national defense. Airline, train, and cruise passengers utilizing Cisco Mobile Networks can fly all around the world with a continuous Internet connection. Cisco IOS(R) Software is a registered trademark of Cisco Systems.

  13. Introduction to IP address management

    CERN Document Server

    Rooney, Tim

    2010-01-01

    "The book begins with a basic overview of IP networking, followed by chapters describing each of the three core IPAM technologies: IPv4 and IPv6 addressing, DHCP, and DNS. The next three chapters describe IPAM management techniques and practice, followed by chapters on IPv4-IPv6 co-existence, security and the IPAM business case"--

  14. Clustering of IP3 receptors by IP3 retunes their regulation by IP3 and Ca2+

    OpenAIRE

    Taufiq-Ur-Rahman,; Skupin, Alexander; Falcke, Martin; Taylor, Colin W.

    2009-01-01

    The versatility of Ca2+ signals derives from their spatio-temporal organization1,2. For Ca2+ signals initiated by inositol trisphosphate (IP3) this requires local interactions between IP3 receptors (IP3R)3,4 mediated by their rapid stimulation and slower inhibition4 by cytosolic Ca2+. This allows hierarchical recruitment of Ca2+ release events as the IP3 concentration increases5. Single IP3R respond first, then clustered IP3R open together giving a local Ca2+ puff, and as puffs become more fr...

  15. Impact of the revised International Prognostic Scoring System, cytogenetics and monosomal karyotype on outcome after allogeneic stem cell transplantation for myelodysplastic syndromes and secondary acute myeloid leukemia evolving from myelodysplastic syndromes: a retrospective multicenter study of the European Society of Blood and Marrow Transplantation.

    Science.gov (United States)

    Koenecke, Christian; Göhring, Gudrun; de Wreede, Liesbeth C; van Biezen, Anja; Scheid, Christof; Volin, Liisa; Maertens, Johan; Finke, Jürgen; Schaap, Nicolaas; Robin, Marie; Passweg, Jakob; Cornelissen, Jan; Beelen, Dietrich; Heuser, Michael; de Witte, Theo; Kröger, Nicolaus

    2015-03-01

    The aim of this study was to determine the impact of the revised 5-group International Prognostic Scoring System cytogenetic classification on outcome after allogeneic stem cell transplantation in patients with myelodysplastic syndromes or secondary acute myeloid leukemia who were reported to the European Society for Blood and Marrow Transplantation database. A total of 903 patients had sufficient cytogenetic information available at stem cell transplantation to be classified according to the 5-group classification. Poor and very poor risk according to this classification was an independent predictor of shorter relapse-free survival (hazard ratio 1.40 and 2.14), overall survival (hazard ratio 1.38 and 2.14), and significantly higher cumulative incidence of relapse (hazard ratio 1.64 and 2.76), compared to patients with very good, good or intermediate risk. When comparing the predictive performance of a series of Cox models both for relapse-free survival and for overall survival, a model with simplified 5-group cytogenetics (merging very good, good and intermediate cytogenetics) performed best. Furthermore, monosomal karyotype is an additional negative predictor for outcome within patients of the poor, but not the very poor risk group of the 5-group classification. The revised International Prognostic Scoring System cytogenetic classification allows patients with myelodysplastic syndromes to be separated into three groups with clearly different outcomes after stem cell transplantation. Poor and very poor risk cytogenetics were strong predictors of poor patient outcome. The new cytogenetic classification added value to prediction of patient outcome compared to prediction models using only traditional risk factors or the 3-group International Prognostic Scoring System cytogenetic classification. Copyright© Ferrata Storti Foundation.

  16. Implementasi Server VoIP Berbasis SIP Pada LAN Nirkabel

    Directory of Open Access Journals (Sweden)

    Mohammad Shoffa Al Arofat

    2013-03-01

    Full Text Available Voice over Internet Protocol (VoIP merupakan teknologi yang memungkinkan percakapan suara jarak jauh melalui protokol internet. Dalam telekomunikasi, diperlukan teknologi pensinyalan yang berguna untuk membangun, mengawasi, dan melepas hubungan antara dua titik. Salah satu teknologi pensinyalan yang banyak digunakan untuk VoIP adalah Session Initiation Protocol, dengan implementasinya yang berupa perangkat lunak Open SIP Server. Selain pensinyalan, ada beberapa parameter yang perlu diperhatikan dalam implementasi VoIP, yaitu Mean Opinion Score (MOS, network impairment, dan bandwidth. Pengujian dilakukan terhadap enam codec, yaitu G.722, PCMA, PCMU, Speex, GSM, dan BV16. Berdasarkan hasil analisis dapat diambil kesimpulan bahwa codec yang menggunakan bandwidth paling rendah adalah Speex (27,12 kbps; Rata-rata delay yang dihasilkan oleh sipdroid lebih baik daripada jitsi.

  17. Analyzing of MOS and Codec Selection for Voice over IP Technology

    Directory of Open Access Journals (Sweden)

    Mohd Nazri Ismail

    2009-01-01

    Full Text Available In this research, we propose an architectural solution to implement the voice over IP (VoIP service in campus environment network. Voice over IP (VoIP technology has become a discussion issue for this time being. Today, the deployment of this technology on an organization truly can give a great financial benefit over traditional telephony. Therefore, this study is to analyze the VoIP Codec selection and investigate the Mean Opinion Score (MOS performance areas evolved with the quality of service delivered by soft phone and IP phone. This study focuses on quality of voice prediction such as i accuracy of MOS between automated system and human perception and ii different types of codec performance measurement via human perception using MOS technique. In this study, network management system (NMS is used to monitor and capture the performance of VoIP in campus environment. In addition, the most apparent of implementing soft phone and IP phone in campus environment is to define the best codec selection that can be used in operational environment. Based on the finding result, the MOS measurement through automated and manual system is able to predict and evaluate VoIP performance. In addition, based on manual MOS measurement, VoIP conversations over LAN contribute more reliability and availability performance compare to WAN.

  18. Internetworking with TCP/IP

    CERN Document Server

    Comer, Douglas E

    2014-01-01

    An internationally best-selling, conceptual introduction to the TCP/IP protocols and Internetworking, this book interweaves a clear discussion of fundamentals and scientific principles with details and examples drawn from the latest technologies. Leading author Douglas Comer covers layering and packet formats for all the Internet protocols, includingTCP, IPv4, IPv6, DHCP, and DNS. In addition, the text explains new trends in Internet systems, including packet classification, Software Defined Networking (SDN), and mesh protocols used in The Internet of Things. The text is appropriate for individuals interested in learning more about TCP/IP protocols, Internet architecture, and current networking technologies, as well as engineers who build network systems. It is suitable for junior to graduate-level courses in Computer Networks, Data Networks, Network Protocols, and Internetworking.

  19. OSI and TCP/IP

    Science.gov (United States)

    Randolph, Lynwood P.

    1994-01-01

    The Open Systems Interconnection Transmission Control Protocol/Internet Protocol (OSI TCP/IP) and the Government Open Systems Interconnection Profile (GOSIP) are compared and described in terms of Federal internetworking. The organization and functions of the Federal Internetworking Requirements Panel (FIRP) are discussed and the panel's conclusions and recommendations with respect to the standards and implementation of the National Information Infrastructure (NII) are presented.

  20. Role of Ipsdienol, Ipsenol, and cis-Verbenol in chemical ecology of Ips avulsus, Ips calligraphus, and Ips grandicollis (Coleoptera: Curculionidae: Scolytinae)

    Science.gov (United States)

    Jeremy D. Allison; Jessica I. McKenney; Daniel R. Miller; Matthew L. Gimmel

    2012-01-01

    ABSTRACT Stressed or damaged pine (Pinus sp.) trees in the southeastern United States are often colonized simultaneously by three southern Ips species (Coleoptera: Curculionidae: Scolytinae): small southern pine engraver, Ips avulsus (Eichhoff); sixspined ips, Ips calligraphus (Germar); and...

  1. Desempenho de seis modelos de predição prognóstica em pacientes críticos que receberam suporte renal extracorpóreo Performance of six prognostic scores in critically ILL patients receiving renal replacement therapy

    Directory of Open Access Journals (Sweden)

    Elizabeth R. Maccariello

    2008-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Não existe consenso sobre qual modelo prognóstico deva ser utilizado em pacientes com disfunção renal aguda (DRA. O objetivo deste estudo foi avaliar o desempenho de seis escores de prognóstico em pacientes que necessitaram de suporte renal. MÉTODO: Coorte prospectiva de pacientes internados nas unidades de terapia intensiva (UTI de três hospitais terciários que necessitaram de suporte renal por DRA durante 32 meses. Foram excluídos os pacientes crônicos em programa de diálise ou com BACKGROUND AND OBJECTIVES: There is no consensus about prognostic scores for use in patients with acute kidney injury (AKI. The aim of this study was to evaluate the performance of six prognostic scores in predicting hospital mortality in patients with AKI and need for renal replacement therapy (RRT. METHODS: Prospective cohort of patients admitted to the intensive care units (ICU of three tertiary care hospitals that required RRT for AKI over a 32-month period. Patients with end-stage renal disease and those with ICU stay < 24h were excluded. Data from the first 24h of ICU admission were used to calculate SAPS II and APACHE II scores, and data from the first 24h of RRT were used in the calculation of LOD, ODIN, Liaño and Mehta scores. Discrimination was evaluated using the area under ROC curve (AUROC and calibration using the Hosmer-Lemeshow goodness-of-fit test. The hospital mortality was the end-point of interest. RESULTS: 467 patients were evaluated. Hospital mortality rate was 75%. Mean SAPS II and APACHE II scores were 48.5 ±11.2 and 27.4 ± 6.3 points, and median LOD score was 7 (5-8 points. Except for Mehta score (p = 0.001, calibration was appropriate in all models. However, discrimination was uniformly unsatisfactory; AUROC ranged from 0.60 for ODIN to 0.72 for SAPS II and Mehta scores. In addition, except for Mehta, all models tended to underestimate hospital mortality. CONCLUSIONS: Organ dysfunction, general and

  2. Ips Bark Beetles in the South

    Science.gov (United States)

    Michael D. Conner; Robert C. Wilkinson

    1983-01-01

    Ips beetles usually attack weakened, dying, or recently felled trees and fresh logging debris. Large numbers Ips may build up when natural events such as lightning storms, ice storms, tornadoes, wildfires, and droughts create large amounts of pine suitable for the breeding of these beetles. Ips populations may also build up following forestry activities, such as...

  3. Comparação entre dois escores de prognóstico (PRISM e PIM em unidade de terapia intensiva pediátrica Comparison of two prognostic scores (PRISM and PIM at a pediatric intensive care unit

    Directory of Open Access Journals (Sweden)

    Vanessa Feller Martha

    2005-06-01

    Full Text Available OBJETIVO: Comparar o desempenho do PRISM (Pediatric Risk of Mortality e o PIM (Pediatric Index of Mortality em uma unidade de terapia intensiva pediátrica geral investigando a relação existente entre a mortalidade e a sobrevivência observadas com a mortalidade e sobrevivência estimadas pelos dois escores. MÉTODOS: Estudo de coorte contemporâneo realizado entre 1° de junho de 1999 a 31 de maio de 2000 na unidade de terapia intensiva pediátrica do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul. Os critérios de inclusão no estudo e o cálculo do PRISM e do PIM foram feitos conforme preconizado e utilizando as fórmulas de seus artigos originais. Para estatística, utilizou-se o teste z de Flora, teste de ajuste de Hosmer-Lemeshow, área sob a curva típica de um recebedor operador de características (curva ROC e teste de correlação de Spearman. O estudo foi aprovado pelo Comitê da instituição. RESULTADOS: Internaram na unidade de terapia intensiva pediátrica 498 pacientes, sendo 77 excluídos. Dos 421 pacientes estudados, 33 (7,83% foram a óbito. A mortalidade estimada pelo PRISM foi de 30,84 (7,22%, com standardized mortality rate 1,07 (0,74-1,50, z = -0,45. Pelo PIM, foi de 26,13 (6,21%, com standardized mortality rate 1,26 (0,87-1,77, z = -1,14. O teste de ajuste de Hosmer-Lemeshow obteve um qui-quadrado 9,23 (p = 0,100 para o PRISM e 27,986 (p OBJECTIVE: To compare the performance of the PRISM (Pediatric Risk of Mortality and the PIM (Pediatric Index of Mortality scores at a general pediatric intensive care unit, investigating the relation between observed mortality and survival and predicted mortality and survival. METHODS: A contemporary cohort study undertaken between 1 June 1999 and 31 May 2000 at the Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas pediatric intensive care unit. The inclusion criteria and the PRISM and PIM calculations were performed as set out

  4. Challenges Regarding IP Core Functional Reliability

    Science.gov (United States)

    Berg, Melanie D.; LaBel, Kenneth A.

    2017-01-01

    For many years, intellectual property (IP) cores have been incorporated into field programmable gate array (FPGA) and application specific integrated circuit (ASIC) design flows. However, the usage of large complex IP cores were limited within products that required a high level of reliability. This is no longer the case. IP core insertion has become mainstream including their use in highly reliable products. Due to limited visibility and control, challenges exist when using IP cores and subsequently compromise product reliability. We discuss challenges and suggest potential solutions to critical application IP insertion.

  5. Mobile-ip Aeronautical Network Simulation Study

    Science.gov (United States)

    Ivancic, William D.; Tran, Diepchi T.

    2001-01-01

    NASA is interested in applying mobile Internet protocol (mobile-ip) technologies to its space and aeronautics programs. In particular, mobile-ip will play a major role in the Advanced Aeronautic Transportation Technology (AATT), the Weather Information Communication (WINCOMM), and the Small Aircraft Transportation System (SATS) aeronautics programs. This report presents the results of a simulation study of mobile-ip for an aeronautical network. The study was performed to determine the performance of the transmission control protocol (TCP) in a mobile-ip environment and to gain an understanding of how long delays, handoffs, and noisy channels affect mobile-ip performance.

  6. Optical switching using IP protocol

    Science.gov (United States)

    Utreras, Andres J.; Gusqui, Luis; Reyes, Andres; Mena, Ricardo I.; Licenko, Gennady L.; Amirgaliyev, Yedilkhan; Komada, Paweł; Luganskaya, Saule; Kashaganova, Gulzhan

    2017-08-01

    To understand and evaluate the Optical Layer, and how it will affect the IP protocols over WDM (Switching), the present analyse is proposed. Optical communications have attractive proprieties, but also have some disadvantages, so the challenge is to combine the best of both branches. In this paper, general concepts for different options of switching are reviewed as: optical burst switching (OBS) and automatically switching optical network (ASON). Specific details such as their architectures are also discussed. In addition, the relevant characteristics of each variation for switching are reviewed.

  7. TCP/IP Network Administration

    CERN Document Server

    Hunt, Craig

    2002-01-01

    This complete guide to setting up and running a TCP/IP network is essential for network administrators, and invaluable for users of home systems that access the Internet. The book starts with the fundamentals -- what protocols do and how they work, how addresses and routing are used to move data through the network, how to set up your network connection -- and then covers, in detail, everything you need to know to exchange information via the Internet. Included are discussions on advanced routing protocols (RIPv2, OSPF, and BGP) and the gated software package that implements them, a tutorial

  8. IPS y el Tercer Mundo

    Directory of Open Access Journals (Sweden)

    Roberto Savio

    2015-01-01

    Full Text Available CHASQUI, entrevistó al periodista italo-argentino Roberto Savio, director fundador de la IPS, quien respondió a interrogantes como: En América Latina no hay sociedades de comunicación sino de información? ¿ Por qué y cúal la diferencia? ¿Cómo se puede hacer una sociedad comunicacional en A. Latina? ¿Cuál es la diferencia entre comunicación alternativa y popular? ¿Qué hacer para ampliar el mercado de lectores?¿Qué opina de ASIN y ALASE?

  9. IP Profiling via Service Cluster Membership Vectors

    Energy Technology Data Exchange (ETDEWEB)

    Bartoletti, A

    2009-02-23

    This study investigates the feasibility of establishing and maintaining a system of compact IP behavioral profiles as a robust means of computer anomaly definition and detection. These profiles are based upon the degree to which a system's (IP's) network traffic is distributed among stable characteristic clusters derived of the aggregate session traffic generated by each of the major network services. In short, an IP's profile represents its degree of membership in these derived service clusters. The goal is to quantify and rank behaviors that are outside of the statistical norm for the services in question, or present significant deviation from profile for individual client IPs. Herein, we establish stable clusters for accessible features of common session traffic, migrate these clusters over time, define IP behavior profiles with respect to these clusters, migrate individual IP profiles over time, and demonstrate the detection of IP behavioral changes in terms of deviation from profile.

  10. Voice over IP in Wireless Heterogeneous Networks

    DEFF Research Database (Denmark)

    Fathi, Hanane; Chakraborty, Shyam; Prasad, Ramjee

    with the deployment of wireless heterogeneous systems, both speech and data traffic are carrried over wireless links by the same IP-based packet-switched infrastructure. However, this combination faces some challenges due to the inherent properties of the wireless network. The requirements for good quality VoIP...... communications are difficult to achieve in a time-varying environment due to channel errors and traffic congestion and across different systems. The provision of VoIP in wireless heterogeneous networks requires a set of time-efficient control mechanisms to support a VoIP session with acceptable quality....... The focus of Voice over IP in Wierless Heterogeneous Networks is on mechanisms that affect the VoIP user satisfaction  while not explicitly involved in the media session. This relates to the extra delays introduced by the security and the signaling protocols used to set up an authorized VoIP session...

  11. Validation of the Spanish version of the Irrational Procrastination Scale (IPS.

    Directory of Open Access Journals (Sweden)

    Georgina Guilera

    Full Text Available The present study is centered in adapting and validating a Spanish version of the Irrational Procrastination Scale (IPS. The sample consists of 365 adults aged 18-77 years (M = 37.70, SD = 12.64. Participants were administered two measures of procrastination, the IPS and the Decisional Procrastination Questionnaire, as well as the Big Five Inventory, and the Satisfaction With Life Scale. First, the factor and replication analysis revealed that the internal structure of the scale is clearly one-dimensional, supporting the idea that IPS seems to measure general procrastination as a single trait. Second, the internal consistency is satisfactory as is the temporal stability of the IPS scores. Third, the correlations encountered between the IPS scores and other measures of procrastination, personality traits and satisfaction with life are all in the expected direction and magnitude. Finally, consistent with previous research, procrastination is related to age, with the youngest being the most procrastinating group. This study represents the first attempt in adapting and validating the IPS measure of procrastination into Spanish. Results suggest that the Spanish version of the IPS offers valid and reliable scores when applied to adult population.

  12. Validation of the Spanish version of the Irrational Procrastination Scale (IPS).

    Science.gov (United States)

    Guilera, Georgina; Barrios, Maite; Penelo, Eva; Morin, Christopher; Steel, Piers; Gómez-Benito, Juana

    2018-01-01

    The present study is centered in adapting and validating a Spanish version of the Irrational Procrastination Scale (IPS). The sample consists of 365 adults aged 18-77 years (M = 37.70, SD = 12.64). Participants were administered two measures of procrastination, the IPS and the Decisional Procrastination Questionnaire, as well as the Big Five Inventory, and the Satisfaction With Life Scale. First, the factor and replication analysis revealed that the internal structure of the scale is clearly one-dimensional, supporting the idea that IPS seems to measure general procrastination as a single trait. Second, the internal consistency is satisfactory as is the temporal stability of the IPS scores. Third, the correlations encountered between the IPS scores and other measures of procrastination, personality traits and satisfaction with life are all in the expected direction and magnitude. Finally, consistent with previous research, procrastination is related to age, with the youngest being the most procrastinating group. This study represents the first attempt in adapting and validating the IPS measure of procrastination into Spanish. Results suggest that the Spanish version of the IPS offers valid and reliable scores when applied to adult population.

  13. The Spacelab IPS Star Simulator

    Science.gov (United States)

    Wessling, Francis C., III

    The cost of doing business in space is very high. If errors occur while in orbit the costs grow and desired scientific data may be corrupted or even lost. The Spacelab Instrument Pointing System (IPS) Star Simulator is a unique test bed that allows star trackers to interface with simulated stars in a laboratory before going into orbit. This hardware-in-the loop testing of equipment on earth increases the probability of success while in space. The IPS Star Simulator provides three fields of view 2.55 x 2.55 degrees each for input into star trackers. The fields of view are produced on three separate monitors. Each monitor has 4096 x 4096 addressable points and can display 50 stars (pixels) maximum at a given time. The pixel refresh rate is 1000 Hz. The spectral output is approximately 550 nm. The available relative visual magnitude range is 2 to 8 visual magnitudes. The star size is less than 100 arc seconds. The minimum star movement is less than 5 arc seconds and the relative position accuracy is approximately 40 arc seconds. The purpose of this paper is to describe the LPS Star Simulator design and to provide an operational scenario so others may gain from the approach and possible use of the system.

  14. Myelodysplastic syndrome: classification and prognostic systems

    Directory of Open Access Journals (Sweden)

    Rosangela Invernizzi

    2011-12-01

    Full Text Available Myelodysplastic syndromes (MDS are acquired clonal disorders of hematopoiesis, that are characterized most frequently by normocellular or hypercellular bone marrow specimens, and maturation that is morphologically and functionally dysplastic. MDS constitute a complex hematological problem: differences in disease presentation, progression and outcome have made it necessary to use classification systems to improve diagnosis, prognostication and treatment selection. On the basis of new scientific and clinical information, classification and prognostic systems have recently been updated and minimal diagnostic criteria forMDS have been proposed by expert panels. In addition, in the last few years our ability to define the prognosis of the individual patient with MDS has improved. In this paper World Health Organization (WHO classification refinements and recent prognostic scoring systems for the definition of individual risk are highlighted and current criteria are discussed. The recommendations should facilitate diagnostic and prognostic evaluations in MDS and selection of patients for new effective targeted therapies.

  15. Implementasi Sistem IP PBX menggunakan Briker

    Directory of Open Access Journals (Sweden)

    DWI ARYANTA

    2017-06-01

    Full Text Available Abstrak VoIP (Voice over Internet Protocol adalah komunikasi suara jarak jauh yang digunakan melalui jaringan IP. Pada penelitian ini dirancang sistem IP PBX dengan menggunakan teknologi berbasis VoIP. IP PBX adalah perangkat switching komunikasi telepon dan data berbasis teknologi Internet Protocol (IP yang mengendalikan ekstension telepon analog maupun ekstension IP Phone. Software VirtualBox digunakan dengan tujuan agar lebih memudahkan dalam sistem pengoperasian Linux yang dimana program untuk membuat IP PBX adalah menggunakan Briker yang bekerja pada Operating System Linux 2.6. Setelah proses penginstalan Briker pada Virtualbox dilakukan implementasi jaringan IP PBX. Setelah mengimplementasikan jaringan IP PBX sesuai dengan topologi, kemudian melakukan pengujian success call rate dan analisis Quality of Service (QoS. Pengukuran QoS menggunakan parameter jitter, delay, dan packet loss yang dihasilkan dalam sistem IP PBX ini. Nilai jitter sesama user Briker (baik pada smartphone maupun komputer mempunyai rata-rata berada pada nilai 16,77 ms. Sedangkan nilai packetloss yang didapat pada saat terdapat pada saat user 1 sebagai pemanggil telepon adalah 0%. Sedangkan persentase packet loss pada saat user 1 sebagai penerima telepon adalah 0,01%. Nilai delay pada saat berkomunikasi antar user berada pada 11,75 ms. Secara keseluruhan nilai yang didapatkan melalui penelitian ini, dimana hasil pengujian parameter-parameter QOS sesuai dengan standar yang telah direkomendasikan oleh ITU dan didapatkan nilai QoS dengan hasil “baik”. Kata Kunci : Briker, VoIP, QoS, IP PBX, Smartphone. Abstract VoIP (Voice over Internet Protocol is a long-distance voice communications over IP networks are used. In this study, IP PBX systems designed using VoIP -based technologies. IP PBX is a telephone switching device and data communication technology-based Internet Protocol (IP which controls the analog phone extensions and IP Phone extensions. VirtualBox software is

  16. Applying a gaming approach to IP strategy.

    Science.gov (United States)

    Gasnier, Arnaud; Vandamme, Luc

    2010-02-01

    Adopting an appropriate IP strategy is an important but complex area, particularly in the pharmaceutical and biotechnology sectors, in which aspects such as regulatory submissions, high competitive activity, and public health and safety information requirements limit the amount of information that can be protected effectively through secrecy. As a result, and considering the existing time limits for patent protection, decisions on how to approach IP in these sectors must be made with knowledge of the options and consequences of IP positioning. Because of the specialized nature of IP, it is necessary to impart knowledge regarding the options and impact of IP to decision-makers, whether at the level of inventors, marketers or strategic business managers. This feature review provides some insight on IP strategy, with a focus on the use of a new 'gaming' approach for transferring the skills and understanding needed to make informed IP-related decisions; the game Patentopolis is discussed as an example of such an approach. Patentopolis involves interactive activities with IP-related business decisions, including the exploitation and enforcement of IP rights, and can be used to gain knowledge on the impact of adopting different IP strategies.

  17. Vaccines and IP Rights: A Multifaceted Relationship.

    Science.gov (United States)

    Durell, Karen

    2016-01-01

    Just as there are many forms of vaccines and components to vaccines-particular compositions, delivery systems, components, and distribution networks-there are a variety of intellectual property (IP) protections applicable for vaccines. IP rights such as patent, copyright, trademarks, plant breeders' rights, and trade secrets may all be applicable to vaccines. Thus, discussion of IP rights and vaccines should not begin and end with the application of one IP right to a vaccine. The discussion should engage considerations of multiple IP rights applicable to a vaccine and how these can be utilized in an integrated manner in a strategy aimed at supporting the development and distribution of the vaccine. Such an approach to IP rights to vaccines allows for the integrated rights to be considered in light of the justifications for protecting vaccines with IP rights, as well as the issues relating to specific IP rights for vaccines, such as compulsory license regimes, available humanitarian purpose IP credits, etc. To view vaccines as the subject of multiple IP protections involves a refocusing, but the outcome can provide significant benefits for vaccine development and distribution.

  18. Performance of VoIP on HSDPA

    DEFF Research Database (Denmark)

    Wang, Bang; Pedersen, Klaus I.; Kolding, Troels E.

    2005-01-01

    This paper provides packet scheduler design and performance simulations for running VoIP services over high-speed downlink packet access (HSDPA) in WCDMA. The main challenge of supporting VoIP service on HSDPA is the tight delay requirement combined with the small VoIP packet size. A packet...... scheduler design incorporating VoIP packet aggregation and user multiplexing is proposed and the VoIP capacity is studied for a macro-cellular environment. Results are obtained for different delay budgets and packet scheduling settings, using either blind round robin or a slightly modified version...... of proportional fair scheduling. For proportional fair scheduling with code-multiplexing of 4-users, the downlink VoIP cell capacity on HSDPA is found to be in the range 72-104 users depending on whether the delay budget for the Node-B scheduling and user reception equals 80 ms or 150 ms, respectively....

  19. Additive prognostic value of left ventricular ejection fraction to the TIMI risk score for in-hospital and long-term mortality in patients with ST segment elevation myocardial infarction.

    Science.gov (United States)

    Wei, Xue-Biao; Liu, Yuan-Hui; He, Peng-Cheng; Jiang, Lei; Zhou, Ying-Ling; Chen, Ji-Yan; Tan, Ning; Yu, Dan-Qing

    2017-01-01

    To investigate whether the addition of left ventricular ejection fraction (LVEF) to the TIMI risk score enhances the prediction of in-hospital and long-term death in ST segment elevation myocardial infarction (STEMI) patients. 673 patients with STEMI were divided into three groups based on TIMI risk score for STEMI: low-risk group (TIMI ≤3, n = 213), moderate-risk group (TIMI 4-6, n = 285), and high-risk group (TIMI ≥7, n = 175). The predictive value was evaluated using the receiver operating characteristic. Multivariate logistic regression was used to determine risk predictors. The rates of in-hospital death (0.5 vs 3.2 vs 10.3 %, p risk group. Multivariate analysis showed that TIMI risk score (OR 1.24, 95 % CI 1.04-1.48, P = 0.015) and LVEF (OR 3.85, 95 % CI 1.58-10.43, P = 0.004) were independent predictors of in-hospital death. LVEF had good predictive value for in-hospital death (AUC: 0.838 vs 0.803, p = 0.571) or 1-year death (AUC: 0.743 vs 0.728, p = 0.775), which was similar to TIMI risk score. When compared with the TIMI risk score alone, the addition of LVEF was associated with significant improvements in predicting in-hospital (AUC: 0.854 vs 0.803, p = 0.033) or 1-year death (AUC: 0.763 vs 0.728, p = 0.016). The addition of LVEF to TIMI risk score enhanced net reclassification improvement (0.864 for in-hospital death, p value to TIMI risk score.

  20. Universal Space IP Transparent Proxy Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Communications applications are strategically moving toward Internet Protocol-based architectures and technologies. Despite IP's huge potential, (e.g. cost...

  1. A methodology review on the incremental prognostic value of computed tomography biomarkers in addition to Framingham risk score in predicting cardiovascular disease: the use of association, discrimination and reclassification.

    Science.gov (United States)

    Pang, Chun Lap; Pilkington, Nicola; Wei, Yinghui; Peters, Jaime; Roobottom, Carl; Hyde, Chris

    2018-02-21

    Computed tomography (CT) biomarkers claim to improve cardiovascular risk stratification. This review focuses on significant differences in incremental measures between adequate and inadequate reporting practise. Studies included were those that used Framingham Risk Score as a baseline and described the incremental value of adding calcium score or CT coronary angiogram in predicting cardiovascular risk. Searches of MEDLINE, EMBASE, Web of Science and Cochrane Central were performed with no language restriction. Thirty five studies consisting of 206,663 patients (men = 118,114, 55.1%) were included. The baseline Framingham Risk Score included the 1998, 2002 and 2008 iterations. Selective reporting, inconsistent reference groupings and thresholds were found. Twelve studies (34.3%) had major and 23 (65.7%) had minor alterations and the respective Δ AUC were significantly different (p = 0.015). When the baseline model performed well, the Δ AUC was relatively lower with the addition of a CT biomarker (Spearman coefficient = - 0.46, p analysis, calibration, validation, multivariable and AUC documentation (all p Risk Score alone. Inadequate reporting of discrimination inflates effect estimate, however, that is not necessarily the case for reclassification.

  2. Prognostic Performance Metrics

    Data.gov (United States)

    National Aeronautics and Space Administration — This chapter presents several performance metrics for offline evaluation of prognostics algorithms. A brief overview of different methods employed for performance...

  3. Prognostics for Microgrid Components

    Science.gov (United States)

    Saxena, Abhinav

    2012-01-01

    Prognostics is the science of predicting future performance and potential failures based on targeted condition monitoring. Moving away from the traditional reliability centric view, prognostics aims at detecting and quantifying the time to impending failures. This advance warning provides the opportunity to take actions that can preserve uptime, reduce cost of damage, or extend the life of the component. The talk will focus on the concepts and basics of prognostics from the viewpoint of condition-based systems health management. Differences with other techniques used in systems health management and philosophies of prognostics used in other domains will be shown. Examples relevant to micro grid systems and subsystems will be used to illustrate various types of prediction scenarios and the resources it take to set up a desired prognostic system. Specifically, the implementation results for power storage and power semiconductor components will demonstrate specific solution approaches of prognostics. The role of constituent elements of prognostics, such as model, prediction algorithms, failure threshold, run-to-failure data, requirements and specifications, and post-prognostic reasoning will be explained. A discussion on performance evaluation and performance metrics will conclude the technical discussion followed by general comments on open research problems and challenges in prognostics.

  4. Localitzador Gràfic de Direccions IP 'IpLocInspector'

    OpenAIRE

    Ordóñez Chapado, Miguel

    2006-01-01

    En aquest treball s'ha desenvolupat una aplicació capaç de localitzar adreces IP. En este trabajo se ha desarrollado una aplicación capaz de localizar direcciones IP. In this work an application was developed capable of locating IP addresses.

  5. Comparing genome-wide chromatin profiles using ChIP-chip or ChIP-seq

    NARCIS (Netherlands)

    Johannes, Frank; Wardenaar, Rene; Colomé Tatché, Maria; Mousson, Florence; de Graaf, Petra; Mokry, Michal; Guryev, Victor; Timmers, H. Th. Marc; Cuppen, Edwin; Jansen, Ritsert C.; Bateman, Alex

    2010-01-01

    Motivation: ChIP-chip and ChIP-seq technologies provide genomewide measurements of various types of chromatin marks at an unprecedented resolution. With ChIP samples collected from different tissue types and/ or individuals, we can now begin to characterize stochastic or systematic changes in

  6. Comparing genome-wide chromatin profiles using ChIP-chip or ChIP-seq

    NARCIS (Netherlands)

    Johannes, F.; Wardenaar, R.; Colome-Tatche, M.; Mousson, F.; de Graaf, P.; Mokry, M.; Guryev, V.; Timmers, H.T.; Cuppen, E.; Jansen, R.

    2010-01-01

    MOTIVATION: ChIP-chip and ChIP-seq technologies provide genome-wide measurements of various types of chromatin marks at an unprecedented resolution. With ChIP samples collected from different tissue types and/or individuals, we can now begin to characterize stochastic or systematic changes in

  7. Prognostic utility of plasma S100A12 levels to establish a novel scoring system for predicting mortality in maintenance hemodialysis patients: a two-year prospective observational study in Japan

    Directory of Open Access Journals (Sweden)

    Shiotsu Yayoi

    2013-01-01

    Full Text Available Abstract Background S100A12 protein is an endogenous receptor ligand for advanced glycation end products. In this study, the plasma S100A12 level was assessed as an independent predictor of mortality, and its utility in clinical settings was examined. Methods In a previous cross-sectional study, plasma S100A12 levels were measured in 550 maintenance hemodialysis patients to determine the association between S100A12 and the prevalence of cardiovascular diseases (CVD. In this prospective study, the risk of mortality within a two-year period was determined. An integer scoring system was developed to predict mortality on the basis of the plasma S100A12 levels. Results Higher plasma S100A12 levels (≥18.79 ng/mL were more closely associated with higher all-cause mortality than lower plasma S100A12 levels (P = 0.001. Multivariate Cox proportional hazards analysis revealed higher plasma S100A12 levels [hazard ratio (HR, 2.267; 95% confidence interval (CI, 1.195–4.302; P = 0.012], age ≥65 years (HR, 1.961; 95%CI, 1.017–3.781; P = 0.044, serum albumin levels P = 0.012, and history of CVD (HR, 2.068; 95%CI, 1.146–3.732; P = 0.016 to be independent predictors of two-year all-cause mortality. The integer score was derived by assigning points to these factors and determining total scores. The scoring system revealed trends across increasing scores for predicting the all-cause mortality [c-statistic = 0.730 (0.656–0.804]. The resulting model demonstrated good discriminative power for distinguishing the validation population of 303 hemodialysis patients [c-statistic = 0.721 (0.627–0.815]. Conclusion The results indicate that plasma S100A12 level is an independent predictor for two-year all-cause mortality. A simple integer scoring system was therefore established for predicting mortality on the basis of plasma S100A12 levels.

  8. 75 FR 13235 - IP-Enabled Services

    Science.gov (United States)

    2010-03-19

    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 63 IP-Enabled Services AGENCY: Federal Communications Commission ACTION: Final rule... interconnected Voice over Internet Protocol (VoIP) service the discontinuance obligations that apply to domestic...

  9. Escore para avaliação do estado nutricional: seu valor na estratificação prognóstica de portadores de cardiomiopatia dilatada e insuficiência cardíaca avançada Score for nutritional status evaluation: the role played in the prognostic stratification of dilated cardiomyopathy and advanced heart failure patients

    Directory of Open Access Journals (Sweden)

    Luiz Guilherme Veloso

    2006-08-01

    Full Text Available OBJETIVO: Desenvolver método de avaliação do estado nutricional do paciente através de escore que expresse o estado nutricional de maneira universal e verificar se esse escore seria eficaz na estratificação prognóstica de pacientes com insuficiência cardíaca (IC avançada. MÉTODOS: Para compor o escore foram selecionados métodos de avaliação que procurassem quantificar forma de medida do estado nutricional: a porcentagem ideal do peso, a espessura da prega tricipital, os percentis da circunferência da massa muscular do braço, os níveis séricos de albumina, a contagem global de linfócitos. Para validá-lo, aplicou-se o escore num grupo de 95 pacientes com idade inferior a 65 anos, sem evidências de doenças consumptivas e analisou-se se esse escore manteria correlação com os dados clínicos da IC e permitiria estratificar o prognóstico. RESULTADOS: A situação nutricional esteve alterada nos pacientes e escore elevado sugerindo desnutrição moderada ou intensa foi observado em 31/95 (32,6% dos casos. Não houve correlação entre os valores do escore nutricional, duração dos sintomas e grau de disfunção ventricular. Os pacientes com escore nutricional elevado apresentaram tendência de maior mortalidade (p=0,0606. CONCLUSÕES: Os dados sugerem que a desnutrição atinge cerca de 1/3 dos pacientes com IC avançada. Um escore que englobou cinco parâmetros de avaliação nutricional teve boa correlação com a avaliação clínica e permitiu avaliar globalmente a desnutrição de portadores de IC. Escore superior a 8 identificou pacientes com maior probabilidade de morrer, confirmando que pacientes mais desnutridos têm pior evolução.OBJECTIVE: Develop a method for the evaluation of patient’s nutritional status through a score that expresses universal nutritional status, as well as investigate if that score would be efficient for the prognostic stratification of advanced heart failure (HF pts. METHODS: The score was

  10. Impact of the International Prognostic Scoring System cytogenetic risk groups on the outcome of patients with primary myelodysplastic syndromes undergoing allogeneic stem cell transplantation from human leukocyte antigen-identical siblings: a retrospective analysis of the European Society for Blood and Marrow Transplantation-Chronic Malignancies Working Party

    NARCIS (Netherlands)

    Onida, F.; Brand, R.; Biezen, A. van; Schaap, M.; Borne, P.A. von dem; Maertens, J.; Beelen, D.W.; Carreras, E.; Alessandrino, E.P.; Volin, L.; Kuball, J.H.; Figuera, A.; Sierra, J.; Finke, J.; Kroger, N.; Witte, T.J. de

    2014-01-01

    Acquired chromosomal abnormalities are important prognostic factors in patients with myelodysplastic syndromes treated with supportive care and with disease-modifying therapeutic interventions, including allogeneic hematopoietic stem cell transplantation. To assess the prognostic impact of

  11. Securing VoIP keeping your VoIP network safe

    CERN Document Server

    (Bud) Bates, Regis J Jr

    2015-01-01

    Securing VoIP: Keeping Your VoIP Network Safe will show you how to take the initiative to prevent hackers from recording and exploiting your company's secrets. Drawing upon years of practical experience and using numerous examples and case studies, technology guru Bud Bates discusses the business realities that necessitate VoIP system security and the threats to VoIP over both wire and wireless networks. He also provides essential guidance on how to conduct system security audits and how to integrate your existing IT security plan with your VoIP system and security plans, helping you prevent

  12. Space Network IP Services (SNIS): An Architecture for Supporting Low Earth Orbiting IP Satellite Missions

    Science.gov (United States)

    Israel, David J.

    2005-01-01

    The NASA Space Network (SN) supports a variety of missions using the Tracking and Data Relay Satellite System (TDRSS), which includes ground stations in White Sands, New Mexico and Guam. A Space Network IP Services (SNIS) architecture is being developed to support future users with requirements for end-to-end Internet Protocol (IP) communications. This architecture will support all IP protocols, including Mobile IP, over TDRSS Single Access, Multiple Access, and Demand Access Radio Frequency (RF) links. This paper will describe this architecture and how it can enable Low Earth Orbiting IP satellite missions.

  13. GPU Accelerated Prognostics

    Science.gov (United States)

    Gorospe, George E., Jr.; Daigle, Matthew J.; Sankararaman, Shankar; Kulkarni, Chetan S.; Ng, Eley

    2017-01-01

    Prognostic methods enable operators and maintainers to predict the future performance for critical systems. However, these methods can be computationally expensive and may need to be performed each time new information about the system becomes available. In light of these computational requirements, we have investigated the application of graphics processing units (GPUs) as a computational platform for real-time prognostics. Recent advances in GPU technology have reduced cost and increased the computational capability of these highly parallel processing units, making them more attractive for the deployment of prognostic software. We present a survey of model-based prognostic algorithms with considerations for leveraging the parallel architecture of the GPU and a case study of GPU-accelerated battery prognostics with computational performance results.

  14. IPS guidestar selection for stellar mode (ASTRO)

    Science.gov (United States)

    Mullins, Larry; Wooten, Lewis

    1988-01-01

    This report describes how guide stars are selected for the Optical Sensor Package (OSP) for the Instrument Pointing System (IPS) when it is operating in the stellar mode on the ASTRO missions. It also describes how the objective loads are written and how the various roll angles are related; i.e., the celestial roll or position angle, the objective load roll angles, and the IPS gimbal angles. There is a brief description of how the IPS operates and its various modes of operation; i.e., IDOP, IDIN, and OSPCAL.

  15. RIDES: Robust Intrusion Detection System for IP-Based Ubiquitous Sensor Networks

    Directory of Open Access Journals (Sweden)

    Sungwon Lee

    2009-05-01

    Full Text Available TheIP-based Ubiquitous Sensor Network (IP-USN is an effort to build the “Internet of things”. By utilizing IP for low power networks, we can benefit from existing well established tools and technologies of IP networks. Along with many other unresolved issues, securing IP-USN is of great concern for researchers so that future market satisfaction and demands can be met. Without proper security measures, both reactive and proactive, it is hard to envisage an IP-USN realm. In this paper we present a design of an IDS (Intrusion Detection System called RIDES (Robust Intrusion DEtection System for IP-USN. RIDES is a hybrid intrusion detection system, which incorporates both Signature and Anomaly based intrusion detection components. For signature based intrusion detection this paper only discusses the implementation of distributed pattern matching algorithm with the help of signature-code, a dynamically created attack-signature identifier. Other aspects, such as creation of rules are not discussed. On the other hand, for anomaly based detection we propose a scoring classifier based on the SPC (Statistical Process Control technique called CUSUM charts. We also investigate the settings and their effects on the performance of related parameters for both of the components.

  16. RIDES: Robust Intrusion Detection System for IP-Based Ubiquitous Sensor Networks

    Science.gov (United States)

    Amin, Syed Obaid; Siddiqui, Muhammad Shoaib; Hong, Choong Seon; Lee, Sungwon

    2009-01-01

    The IP-based Ubiquitous Sensor Network (IP-USN) is an effort to build the “Internet of things”. By utilizing IP for low power networks, we can benefit from existing well established tools and technologies of IP networks. Along with many other unresolved issues, securing IP-USN is of great concern for researchers so that future market satisfaction and demands can be met. Without proper security measures, both reactive and proactive, it is hard to envisage an IP-USN realm. In this paper we present a design of an IDS (Intrusion Detection System) called RIDES (Robust Intrusion DEtection System) for IP-USN. RIDES is a hybrid intrusion detection system, which incorporates both Signature and Anomaly based intrusion detection components. For signature based intrusion detection this paper only discusses the implementation of distributed pattern matching algorithm with the help of signature-code, a dynamically created attack-signature identifier. Other aspects, such as creation of rules are not discussed. On the other hand, for anomaly based detection we propose a scoring classifier based on the SPC (Statistical Process Control) technique called CUSUM charts. We also investigate the settings and their effects on the performance of related parameters for both of the components. PMID:22412321

  17. RIDES: Robust Intrusion Detection System for IP-Based Ubiquitous Sensor Networks.

    Science.gov (United States)

    Amin, Syed Obaid; Siddiqui, Muhammad Shoaib; Hong, Choong Seon; Lee, Sungwon

    2009-01-01

    The IP-based Ubiquitous Sensor Network (IP-USN) is an effort to build the "Internet of things". By utilizing IP for low power networks, we can benefit from existing well established tools and technologies of IP networks. Along with many other unresolved issues, securing IP-USN is of great concern for researchers so that future market satisfaction and demands can be met. Without proper security measures, both reactive and proactive, it is hard to envisage an IP-USN realm. In this paper we present a design of an IDS (Intrusion Detection System) called RIDES (Robust Intrusion DEtection System) for IP-USN. RIDES is a hybrid intrusion detection system, which incorporates both Signature and Anomaly based intrusion detection components. For signature based intrusion detection this paper only discusses the implementation of distributed pattern matching algorithm with the help of signature-code, a dynamically created attack-signature identifier. Other aspects, such as creation of rules are not discussed. On the other hand, for anomaly based detection we propose a scoring classifier based on the SPC (Statistical Process Control) technique called CUSUM charts. We also investigate the settings and their effects on the performance of related parameters for both of the components.

  18. ChIP-seq guidelines and practices of the ENCODE and modENCODE consortia

    Science.gov (United States)

    Landt, Stephen G.; Marinov, Georgi K.; Kundaje, Anshul; Kheradpour, Pouya; Pauli, Florencia; Batzoglou, Serafim; Bernstein, Bradley E.; Bickel, Peter; Brown, James B.; Cayting, Philip; Chen, Yiwen; DeSalvo, Gilberto; Epstein, Charles; Fisher-Aylor, Katherine I.; Euskirchen, Ghia; Gerstein, Mark; Gertz, Jason; Hartemink, Alexander J.; Hoffman, Michael M.; Iyer, Vishwanath R.; Jung, Youngsook L.; Karmakar, Subhradip; Kellis, Manolis; Kharchenko, Peter V.; Li, Qunhua; Liu, Tao; Liu, X. Shirley; Ma, Lijia; Milosavljevic, Aleksandar; Myers, Richard M.; Park, Peter J.; Pazin, Michael J.; Perry, Marc D.; Raha, Debasish; Reddy, Timothy E.; Rozowsky, Joel; Shoresh, Noam; Sidow, Arend; Slattery, Matthew; Stamatoyannopoulos, John A.; Tolstorukov, Michael Y.; White, Kevin P.; Xi, Simon; Farnham, Peggy J.; Lieb, Jason D.; Wold, Barbara J.; Snyder, Michael

    2012-01-01

    Chromatin immunoprecipitation (ChIP) followed by high-throughput DNA sequencing (ChIP-seq) has become a valuable and widely used approach for mapping the genomic location of transcription-factor binding and histone modifications in living cells. Despite its widespread use, there are considerable differences in how these experiments are conducted, how the results are scored and evaluated for quality, and how the data and metadata are archived for public use. These practices affect the quality and utility of any global ChIP experiment. Through our experience in performing ChIP-seq experiments, the ENCODE and modENCODE consortia have developed a set of working standards and guidelines for ChIP experiments that are updated routinely. The current guidelines address antibody validation, experimental replication, sequencing depth, data and metadata reporting, and data quality assessment. We discuss how ChIP quality, assessed in these ways, affects different uses of ChIP-seq data. All data sets used in the analysis have been deposited for public viewing and downloading at the ENCODE (http://encodeproject.org/ENCODE/) and modENCODE (http://www.modencode.org/) portals. PMID:22955991

  19. 77 FR 33227 - Assessment Questionnaire-IP Sector Specific Agency Risk Self Assessment Tool (IP-SSARSAT)

    Science.gov (United States)

    2012-06-05

    ... SECURITY Assessment Questionnaire--IP Sector Specific Agency Risk Self Assessment Tool (IP-SSARSAT) AGENCY... Protection and Programs Directorate (NPPD), Office of Infrastructure Protection (IP), Sector Outreach and...--Assessment Questionnaire--IP Sector Specific Agency Risk Self Assessment Tool (IP-SSARSAT). DHS previously...

  20. PENGARUH KEGIATAN EKSTRAKURIKULER TERHADAP PRESTASI BELAJAR IPS MELALUI MOTIVASI BELAJAR

    Directory of Open Access Journals (Sweden)

    Yayan Inriyani

    2017-07-01

    Full Text Available Extracurricular activities will have great contribution to develop and accommodate those two factors. The ex post facto design will be employed in this research. Instrument to get data from students extracurricular activities and motivation, concurrently students achievement from students' report book, SPSS for windows version 20 will be employ to analyze score from questionnaire using path analyzis. And the findings are (1 there is significant impact between extracurricular activities to students' achievement in social science and students' motivation, (2 there is significant impact between extracurricular activities to students' motivation, (3 there is non-direct impact between extracurricular activities to students' achievement through motivation. Students' motivation variable was reinforce the direct impact of extracurricular activities to students' achievement in social science. Kegiatan ekstrakurikuler berkontribusi dalam kegiatan siswa di sekolah. Jenis penelitian ini termasuk penelitian ex post facto. Data menggunakan angket sebagai instrumen variabel kegiatan ekstrakurikuler dan motivasi belajar, prestasi belajar diambil dari nilai rapot semester ganjil. Perolehan hasil menggunakan path analyzis dibantu SPSS for windows versi 20. Analisis data menjelaskan hasilnya (1 terdapat pengaruh langsung yang signifikan antara kegiatan ekstrakurikuler terhadap prestasi belajar IPS dan kegiatan ekstrakurikuler terhadap motivasi belajar siswa, (2 terdapat pengaruh langsung yang signifikan antara motivasi terhadap prestasi belajar IPS, dan (3 terdapat pengaruh tidak langsung antara kegiatan ekstrakurikuler terhadap prestasi belajar siswa melalui motivasi belajar. Variabel motivasi belajar memperkuat pengaruh langsung kegiatan ekstrakurikuler terhadap prestasi belajar IPS bagi siswa.

  1. Intellectual Property and Strategic Agreements (IP/SA) | FNLCR

    Science.gov (United States)

    What does IP/SA handle? IP/SA handles all invention issues including patents and copyrights. All employee inventionreports are filed through the IP/SA office for all activities under the OTS contract.Additionally,&nbs

  2. The prognostic relevance of estimates of proliferative activity in early breast cancer

    DEFF Research Database (Denmark)

    Offersen, B V; Sørensen, Flemming Brandt; Knoop, A

    2003-01-01

    AIMS: Immunohistochemical estimates of cell proliferation evaluated with MIB-1 antibody have been suggested as prognostic indicators in different types of carcinoma. This study investigates whether MIB-1 scores add additional prognostic impact when evaluated together with classical clinicopatholo......AIMS: Immunohistochemical estimates of cell proliferation evaluated with MIB-1 antibody have been suggested as prognostic indicators in different types of carcinoma. This study investigates whether MIB-1 scores add additional prognostic impact when evaluated together with classical...... and number of mitoses included in the analysis, MIB-1 estimates showed no independent prognostic impact.CONCLUSIONS: High MIB-1 estimates did not add independent prognostic information at diagnosis when evaluated together with classical prognostic markers of early breast cancer....

  3. The prognostic relevance of estimates of proliferative activity in early breast cancer

    DEFF Research Database (Denmark)

    Offersen, B V; Sørensen, Flemming Brandt; Knoop, A

    2003-01-01

    AIMS: Immunohistochemical estimates of cell proliferation evaluated with MIB-1 antibody have been suggested as prognostic indicators in different types of carcinoma. This study investigates whether MIB-1 scores add additional prognostic impact when evaluated together with classical clinicopatholo......AIMS: Immunohistochemical estimates of cell proliferation evaluated with MIB-1 antibody have been suggested as prognostic indicators in different types of carcinoma. This study investigates whether MIB-1 scores add additional prognostic impact when evaluated together with classical...... and number of mitoses included in the analysis, MIB-1 estimates showed no independent prognostic impact. CONCLUSIONS: High MIB-1 estimates did not add independent prognostic information at diagnosis when evaluated together with classical prognostic markers of early breast cancer....

  4. Prognostic modeling in pediatric acute liver failure.

    Science.gov (United States)

    Jain, Vandana; Dhawan, Anil

    2016-10-01

    Liver transplantation (LT) is the only proven treatment for pediatric acute liver failure (PALF). However, over a period of time, spontaneous native liver survival is increasingly reported, making us wonder if we are overtransplanting children with acute liver failure (ALF). An effective prognostic model for PALF would help direct appropriate organ allocation. Only patients who would die would undergo LT, and those who would spontaneously recover would avoid unnecessary LT. Deriving and validating such a model for PALF, however, encompasses numerous challenges. In particular, the heterogeneity of age and etiology in PALF, as well as a lack of understanding of the natural history of the disease, contributed by the availability of LT has led to difficulties in prognostic model development. Several prognostic laboratory variables have been identified, and the incorporation of these variables into scoring systems has been attempted. A reliable targeted prognostic model for ALF in Wilson's disease has been established and externally validated. The roles of physiological, immunological, and metabolomic parameters in prognosis are being investigated. This review discusses the challenges with prognostic modeling in PALF and describes predictive methods that are currently available and in development for the future. Liver Transplantation 22 1418-1430 2016 AASLD. © 2016 by the American Association for the Study of Liver Diseases.

  5. Long-term follow-up of autologous stem cell transplantation in patients with diffuse mantle cell lymphoma in first disease remission: the prognostic value of beta2-microglobulin and the tumor score.

    Science.gov (United States)

    Khouri, Issa F; Saliba, Rima M; Okoroji, Grace-Julia; Acholonu, Sandra A; Champlin, Richard E

    2003-12-15

    The current study was conducted to analyze the long-term results of autologous stem cell transplantation (ASCT) in patients with diffuse mantle cell lymphoma (MCL) in first disease remission. Thirty-three patients were treated. Thirty-one patients had Ann Arbor Stage III or Stage IV disease. The hyper-CVAD regimen (hyperfractionated intense-dose cyclophosphamide, vincristine, continuous intravenous infusion of doxorubicin, and dexamethasone, alternating with high doses of cytarabine and methotrexate plus leucovorin rescue) was used for cytoreduction before ASCT. Patients were consolidated with high-dose cyclophosphamide (120 mg/kg), total body irradiation, and ASCT. At a median follow-up of 49 months, the overall survival and disease-free-survival rates at 5 years were estimated to be 77% and 43%, respectively. Patients whose M. D. Anderson Lymphoma Tumor Score (TS) was 1 (P = 0.02). A beta2-microglobulin (beta2m)level 3 mg/L) (P = 0.0001). ASCT may prolong the overall survival in a subset of patients with MCL. This improvement has been observed for the most part in patients with low beta2m levels (< or = 3 mg/L) and TS (< or = 1). Randomized trials are required to fully assess the benefits of this strategy. Copyright 2003 American Cancer Society.

  6. Prognostic value of the monoethylglycinexylidide test in alcoholic cirrhosis.

    Science.gov (United States)

    Bhise, Satish B; Dias, Remeth J; Mali, Kailas K

    2007-01-01

    The existing conventional liver function tests (LFTs) are indirect, inferior and have limited prognostic value. Therefore, the monoethylglycinexylidide (MEGX) test, which provides a direct measure of the actual functional state of the liver, is proposed as a real-time liver function test. The objective of this study was to assess the prognostic value of the MEGX test in cirrhosis by comparing it with Child-Turcotte-Pugh (CTP), the Mayo end stage liver disease (MELD) and discriminant function (DF) scores. The study was carried out in Satara, India during the period of January 2005 to June 2006 and included 79 adult alcoholic cirrhotic patients. The serum specimen from each patient was analyzed using conventional LFTs and the MEGX test. The prognostic scores-CTP, MELD and DF scores were calculated and statistical analyses was performed. Based on receiver operating characteristic (ROC) curves, the MELD score and MEGX60 showed excellent sensitivity and specificity. The comparison of area under ROC curves showed that MELD and MEGX60 had superior prognostic accuracy when compared to other scores. Kaplan-Meier survival curves for corresponding cutoff values clearly differentiated between patients with different survival times. The MEGX test has shown more sensitivity, specificity and accuracy than CTP and DF scores in determining cases with the possibility of three- and six-month survival. Thus, it can be concluded that MEGX test along with MELD, is an effective prognostic tool in the hands of clinicians for predicting short-term survival.

  7. Apgar Scores

    Science.gov (United States)

    ... Stages Listen Español Text Size Email Print Share Apgar Scores Page Content Article Body As soon as ... baby's general condition at birth. What Does the Apgar Test Measure? The test measures your baby's: Heart ...

  8. Early FDG-PET assessment in combination with clinical risk scores determines prognosis in recurring lymphoma

    NARCIS (Netherlands)

    Schot, Bart W.; Zijlstra, Josee M.; Sluiter, Wilm J.; van Imhoff, Gustaaf W.; Pruim, Jan; Vaalburg, Willem; Vellenga, Edo

    2007-01-01

    This study was set up to demonstrate whether prognostic classification based on the secondary age-adjusted International Prognostic Index (sAA-IPI) for recurring aggressive non-Hodgkin lymphoma (NHL) or the prognostic score for recurring Hodgkin lymphoma (HL) can be improved by including the

  9. Prognostics of Power MOSFET

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper demonstrates how to apply prognostics to power MOSFETs (metal oxide field effect transistor). The methodology uses thermal cycling to age devices and...

  10. Palliative medicine review: prognostication.

    Science.gov (United States)

    Glare, Paul A; Sinclair, Christian T

    2008-01-01

    Prognostication, along with diagnosis and treatment, is a traditional core clinical skill of the physician. Many patients and families receiving palliative care want information about life expectancy to help plan realistically for their futures. Although underappreciated, prognosis is, or at least should be, part of every clinical decision. Despite this crucial role, expertise in the art and science of prognostication diminished during the twentieth century, due largely to the ascendancy of accurate diagnostic tests and effective therapies. Consequently, "Doctor, how long do I have?" is a question most physicians find unprepared to answer effectively. As we focus on palliative care in the twenty-first century, prognostication will need to be restored as a core clinical proficiency. The discipline of palliative medicine can provide leadership in this direction. This paper begins by discussing a framework for understanding prognosis and how its different domains might be applied to all patients with life limiting illness, although the main focus of the paper is predicting survival in patients with cancer. Examples of prognostic tools are provided, although the subjective assessment of prognosis remains important in the terminally ill. Other issues addressed include: the importance of prognostication in terms of clinical decision-making, discharge planning, and care planning; the impact of prognosis on hospice referrals and patient/family satisfaction; and physicians' willingness to prognosticate.

  11. The Prognostic Value of Serum Biomarkers in Localized Bone Sarcoma

    DEFF Research Database (Denmark)

    Aggerholm-Pedersen, Ninna; Maretty-Kongstad, Katja; Keller, Johnny

    2016-01-01

    cases. Adjusting for confounders such as comorbidity and age is an essential safeguard against erroneous conclusions regarding the possible prognostic value of these biomarkers. The aim of this study was to assess the prognostic value of a battery of pretreatment biomarkers in the serum of patients......, lymphocytes, and sodium were collected from the patient records. The prognostic values of overall and disease-specific mortality were tested for each individual biomarker as well as for the Glasgow prognostic score (GPS) and for a new composite score incorporating five biomarkers (Aarhus composite biomarker...... for comorbidity and other confounders, it was found that elevated levels of CRP, low hemoglobin, low sodium, high GPS, and high ACBS were associated with increased overall mortality. Furthermore, elevated levels of CRP, low hemoglobin, high GPS, and high ACBS were associated with increased disease...

  12. A Video Quality Assessment Method for VoIP Applications Based on User Experience

    Science.gov (United States)

    Wang, Zedong; Wang, Jing; Wang, Fei; Li, Chengcai; Fei, Zesong; Rahim, Tariq

    2017-12-01

    An objective video quality assessment method is proposed to evaluate the video quality in voice over internet protocol (VoIP) applications under network distortion. The fluency and the clarity of videos are two main parts of the factors that affect user experience, thus the method evaluates these two parts to assess the distortions of videos in VoIP applications caused by codec and packet loss. The clarity of the video is measured by calculating block artifacts and frame blurring. Video blocking artifacts are measured by splitting the picture into small blocks and calculating the difference of the pixels around each border while video blurring is measured by getting edge information through Sobel operator, and counting the gradient histogram. Then the video clarity can be measured by a weighted sum of block artifacts score and blurring score using linear regression. The scores are also normalized in order to eliminate the impact of different video contents. The video fluency is calculated by counting the wrong frame in the video. Finally, a weighted sum of video clarity score and video fluency score can represent the quality of the video. The experimental results show that the objective quality scores have a strong correlation with the subjective quality scores, and the algorithm concludes two parts of user experience other than just image quality, which is more comprehensive and it can be used in video quality assessment in VoIP applications.

  13. iTAR: a web server for identifying target genes of transcription factors using ChIP-seq or ChIP-chip data.

    Science.gov (United States)

    Yang, Chia-Chun; Andrews, Erik H; Chen, Min-Hsuan; Wang, Wan-Yu; Chen, Jeremy J W; Gerstein, Mark; Liu, Chun-Chi; Cheng, Chao

    2016-08-12

    characteristic binding profiles and the density plot of normalized regulatory scores. The iTAR web server is a useful tool in identifying TF target genes from ChIP-seq/ChIP-chip data and discovering biological insights.

  14. A prognostic index for locoregional recurrence after neoadjuvant chemotherapy

    OpenAIRE

    Herrero-Vicent, C; Guerrero-Zotano, A; Gavil?-Gregori, J; Hern?ndez-Blanquisett, A; Sandiego-Contreras, S; Samper-Hiraldo, JM; Guillem-Porta, V; Ruiz-Sim?n, A

    2016-01-01

    Background The appropriate selection criteria for breast-conserving surgery (BCS) or mastectomy after neoadjuvant chemotherapy (NAC) are poorly defined. The aim of this study is to analyse the incidence and prognostic factors for locoregional recurrence (LRR) in patients with breast cancer (BC) treated with NAC to develop a prognostic score to help with clinical decision-making. Materials and methods Using our retrospective maintained BC database, we identified 730 patients treated with NAC (...

  15. Integrative analysis of ChIP-chip and ChIP-seq dataset.

    Science.gov (United States)

    Zhu, Lihua Julie

    2013-01-01

    Epigenetic regulation and interactions between transcription factors and regulatory genomic regions play crucial roles in controlling transcriptional regulatory networks that drive development, environmental responses, and disease. Chromatin immunoprecipitation (ChIP) followed by high-throughput sequencing (ChIP-seq) and ChIP followed by genomic tiling microarray hybridization (ChIP-chip) are the two of the most widely used technologies for genome-wide identification of DNA protein interactions and histone modification in vivo. Many algorithms and tools have been developed and evaluated that allow identification of transcription factor binding sites from ChIP-seq or ChIP-chip datasets. However, binding site identification is only the first step; the ultimate goal is to discover the regulatory network of the transcription factor (TF). Here, we present a common workflow for downstream analysis of ChIP-chip and ChIP-seq with an emphasis on annotating binding sites and integration with gene expression data to identify direct and indirect targets of the TF. These tools will help with the overall goal of unraveling transcriptional regulatory networks using datasets publicly available in GEO.

  16. Capturing value from Intellectual Property (IP) in a global environment

    DEFF Research Database (Denmark)

    Alcácer, Juan; Beukel, Karin; Cassiman, Bruno

    2017-01-01

    in patents, trademarks, and industrial designs used by firms to protect their IP globally. We then show that IP protection remains fragmented; the quality of IP applications might be questionable; and developing a comprehensive IP footprint worldwide is very costly. Growing numbers of applications...

  17. A survey of IP over ATM architectures

    Energy Technology Data Exchange (ETDEWEB)

    Chen, H.; Tsang, R.; Brandt, J.; Hutchins, J.

    1997-07-01

    Over the past decade, the Internet has burgeoned into a worldwide information highway consisting of approximately 5 million hosts on over 45,000 interconnected networks. This unprecedented growth, together with the introduction of multimedia workstations, has spurred the development of innovative applications that require high speed, low latency, and real-time transport. Today`s Internet can neither scale in its bandwidth nor guarantee the Quality of Services (QoS) necessary to meet these performance requirements. Many network researchers propose to use the Asynchronous Transfer Mode (ATM) technology as the underlying infrastructure for the next generation of workgroup, campus, and enterprise IP networks. Since ATM is significantly different from today`s legacy network technologies, efficient implementation of IP over ATM is especially challenging. This tutorial paper covers several existing proposals that integrate IP over ATM.

  18. Optimization of OSPF Routing in IP Networks

    Science.gov (United States)

    Bley, Andreas; Fortz, Bernard; Gourdin, Eric; Holmberg, Kaj; Klopfenstein, Olivier; Pióro, Michał; Tomaszewski, Artur; Ümit, Hakan

    The Internet is a huge world-wide packet switching network comprised of more than 13,000 distinct subnetworks, referred to as Autonomous Systems (ASs) autonomous system AS . They all rely on the Internet Protocol (IP) internet protocol IP for transport of packets across the network. And most of them use shortest path routing protocols shortest path routing!protocols , such as OSPF or IS-IS, to control the routing of IP packets routing!of IP packets within an AS. The idea of the routing is extremely simple — every packet is forwarded on IP links along the shortest route between its source and destination nodes of the AS. The AS network administrator can manage the routing of packets in the AS by supplying the so-called administrative weights of IP links, which specify the link lengths that are used by the routing protocols for their shortest path computations. The main advantage of the shortest path routing policy is its simplicity, allowing for little administrative overhead. From the network engineering perspective, however, shortest path routing can pose problems in achieving satisfactory traffic handling efficiency. As all routing paths depend on the same routing metric routing!metric , it is not possible to configure the routing paths for the communication demands between different pairs of nodes explicitly or individually; the routing can be controlled only indirectly and only as a whole by modifying the routing metric. Thus, one of the main tasks when planning such networks is to find administrative link weights that induce a globally efficient traffic routing traffic!routing configuration of an AS. It turns out that this task leads to very difficult mathematical optimization problems. In this chapter, we discuss and describe exact integer programming models and solution approaches as well as practically efficient smart heuristics for such shortest path routing problems shortest path routing!problems .

  19. Secure IP mobility management for VANET

    CERN Document Server

    Taha, Sanaa

    2013-01-01

    This brief presents the challenges and solutions for VANETs' security and privacy problems occurring in mobility management protocols including Mobile IPv6 (MIPv6), Proxy MIPv6 (PMIPv6), and Network Mobility (NEMO). The authors give an overview of the concept of the vehicular IP-address configurations as the prerequisite step to achieve mobility management for VANETs, and review the current security and privacy schemes applied in the three mobility management protocols. Throughout the brief, the authors propose new schemes and protocols to increase the security of IP addresses within VANETs in

  20. Analysis list: Terf2ip [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Terf2ip Embryonic fibroblast + mm9 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/target/Terf...2ip.1.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/target/Terf2ip.5.tsv http://dbarchive.bio...sciencedbc.jp/kyushu-u/mm9/target/Terf2ip.10.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/colo/Terf2ip

  1. 76 FR 81955 - Assessment Questionnaire-IP Sector Specific Agency Risk Self Assessment Tool (IP-SSARSAT)

    Science.gov (United States)

    2011-12-29

    ... SECURITY Assessment Questionnaire--IP Sector Specific Agency Risk Self Assessment Tool (IP-SSARSAT) AGENCY... Protection and Programs Directorate (NPPD), Office of Infrastructure Protection (IP), Sector Specific Agency.../IP/SSA EMO, 245 Murray Lane SW., Mail Stop 0640, Arlington, VA 20598-0630. Emailed requests should go...

  2. Escore TIMI no infarto agudo do miocárdio conforme níveis de estratificação de prognóstico Score TIMI en el infarto agudo de miocardio según niveles de estratificación de pronóstico TIMI risk score for acute myocardial infarction according to prognostic stratification

    Directory of Open Access Journals (Sweden)

    Jaqueline Locks Pereira

    2009-08-01

    Full Text Available FUNDAMENTO: O escore de risco TIMI (thrombolysis in myocardial infarction é derivado de ensaio clínico envolvendo pacientes elegíveis para fibrinólise. Como o perfil de risco desses casos difere do encontrado em populações não selecionadas, é importante que se analise a aplicabilidade do escore em condições clínicas habituais. OBJETIVO: Avaliar o manejo e a evolução hospitalar de pacientes internados com infarto agudo do miocárdio conforme estratificação de risco pelo escore TIMI. MÉTODOS: Foram avaliados, retrospectivamente, 103 casos de infarto agudo do miocárdio com supradesnivelamento do segmento ST, admitidos no Hospital Nossa Senhora da Conceição, em Tubarão, nos anos de 2004 e 2005. Os casos foram analisados em três grupos de risco de acordo com o escore TIMI. RESULTADOS: A mortalidade hospitalar pós-infarto foi de 17,5%. No grupo de baixo risco não houve óbito. A mortalidade foi de 8,1% no grupo de médio risco e de 55,6% no de alto risco. O risco de morte para casos de alto risco foi 14,1 vezes maior em relação aos casos de médio e baixo risco (IC95% = 4,4 a 44,1 e pFUNDAMENTO: El score de riesgo TIMI (thrombolysis in myocardial infarction se derivó de ensayo clínico que implicó a pacientes elegibles para fibrinólisis. Como el perfil de riesgo de esos casos difiere del encontrado en poblaciones no seleccionadas, es importante que se analice la aplicabilidad del score en condiciones clínicas habituales. OBJETIVO: Evaluar el manejo y la evolución hospitalaria de pacientes internados con infarto agudo de miocardio de acuerdo con la estratificación de riesgo mediante la puntuación TIMI. MÉTODOS: Se evaluaron, retrospectivamente, 103 casos de infarto agudo de miocardio con supradesnivelamiento del segmento ST, ingresados en el Hospital Nossa Senhora da Conceição, en Tubarão, en los años de 2004 y 2005. Se analizaron los casos en tres grupos de riesgo según el score TIMI. RESULTADOS: La mortalidad

  3. Prognostics of Power MOSFET

    Science.gov (United States)

    Celaya, Jose Ramon; Saxena, Abhinav; Vashchenko, Vladislay; Saha, Sankalita; Goebel, Kai Frank

    2011-01-01

    This paper demonstrates how to apply prognostics to power MOSFETs (metal oxide field effect transistor). The methodology uses thermal cycling to age devices and Gaussian process regression to perform prognostics. The approach is validated with experiments on 100V power MOSFETs. The failure mechanism for the stress conditions is determined to be die-attachment degradation. Change in ON-state resistance is used as a precursor of failure due to its dependence on junction temperature. The experimental data is augmented with a finite element analysis simulation that is based on a two-transistor model. The simulation assists in the interpretation of the degradation phenomena and SOA (safe operation area) change.

  4. ChIP-chip versus ChIP-seq: Lessons for experimental design and data analysis

    Science.gov (United States)

    2011-01-01

    Background Chromatin immunoprecipitation (ChIP) followed by microarray hybridization (ChIP-chip) or high-throughput sequencing (ChIP-seq) allows genome-wide discovery of protein-DNA interactions such as transcription factor bindings and histone modifications. Previous reports only compared a small number of profiles, and little has been done to compare histone modification profiles generated by the two technologies or to assess the impact of input DNA libraries in ChIP-seq analysis. Here, we performed a systematic analysis of a modENCODE dataset consisting of 31 pairs of ChIP-chip/ChIP-seq profiles of the coactivator CBP, RNA polymerase II (RNA PolII), and six histone modifications across four developmental stages of Drosophila melanogaster. Results Both technologies produce highly reproducible profiles within each platform, ChIP-seq generally produces profiles with a better signal-to-noise ratio, and allows detection of more peaks and narrower peaks. The set of peaks identified by the two technologies can be significantly different, but the extent to which they differ varies depending on the factor and the analysis algorithm. Importantly, we found that there is a significant variation among multiple sequencing profiles of input DNA libraries and that this variation most likely arises from both differences in experimental condition and sequencing depth. We further show that using an inappropriate input DNA profile can impact the average signal profiles around genomic features and peak calling results, highlighting the importance of having high quality input DNA data for normalization in ChIP-seq analysis. Conclusions Our findings highlight the biases present in each of the platforms, show the variability that can arise from both technology and analysis methods, and emphasize the importance of obtaining high quality and deeply sequenced input DNA libraries for ChIP-seq analysis. PMID:21356108

  5. Teaching Network Security with IP Darkspace Data

    Science.gov (United States)

    Zseby, Tanja; Iglesias Vázquez, Félix; King, Alistair; Claffy, K. C.

    2016-01-01

    This paper presents a network security laboratory project for teaching network traffic anomaly detection methods to electrical engineering students. The project design follows a research-oriented teaching principle, enabling students to make their own discoveries in real network traffic, using data captured from a large IP darkspace monitor…

  6. Wireless IP and building the mobile Internet

    National Research Council Canada - National Science Library

    Dixit, Sudhir; Prasad, Ramjee

    2003-01-01

    ..., as well as the shortage of technical material in a single place in the field of wireless IP and closely related technologies that form the critical success factors. Therefore, we decided to invite the experts who are truly active in the field: the equipment manufacturers, mobile operators, and those working in research laboratories and unive...

  7. PERBANDINGAN KINERJA IP SEC DAN SSL

    Directory of Open Access Journals (Sweden)

    Dessyanto Boedi P

    2015-04-01

    Full Text Available Ipsec (IP Security and SSL (Secure Socket Layer is the most widely used techniques to secure data communications over the Internet. Both of these techniques has advantages and disadvantages of each. The purpose of this study is to present an analysis of the two techniques above in terms of security and performance.

  8. Relationship between Interplanetary (IP) Parameters and ...

    Indian Academy of Sciences (India)

    environment results in various space weather changes, including the phenomenon of the geomagnetic storm and its manifestations (Chapman 1936). Since the 1960s, orbiting and geostationary satellites have made it possible to study the linkage between solar emissions, their manifestations in IP space, and geomagnetic ...

  9. IP-I0 BASED IMMUNOLOGICAL MONITORING

    DEFF Research Database (Denmark)

    2008-01-01

    The present invention relates to an immunological method and, more particularly, a method for measuring cell-mediated immune reactivity (CMI) in mammals based on the production of IP-10.The invention further discloses an assay and a kit for measuring CMI to an antigen using whole blood or other...

  10. Prognostic factors in oligodendrogliomas

    DEFF Research Database (Denmark)

    Westergaard, L; Gjerris, F; Klinken, L

    1997-01-01

    An outcome analysis was performed on 96 patients with pure cerebral oligodendrogliomas operated in the 30-year period 1962 to 1991. The most important predictive prognostic factors were youth and no neurological deficit, demonstrated as a median survival for the group younger than 20 years of 17...

  11. Opportunities for IP  in Communications Beyond 3G

    DEFF Research Database (Denmark)

    Nielsen, Thomas Toftegaard; Jacobsen, Rune H.

    2005-01-01

    Future communication will be based on TCP/IP as common network and transport layers to provide global connectivity to users and applications. IP is used to provide ubiquitous access across different access networks and exploits the benefits of a common connectivity layer while reducing the cost...... of operation and maintenance of the network. This paper discusses the opportunities for IP in the evolution towards a future broadband, all-IP mobile communication network. In particular, we argue for three opportunities for the future: Interworking access technologies over IP, IP layer transparency...

  12. Modelling ChIP-seq Data Using HMMs.

    Science.gov (United States)

    Vinciotti, Veronica

    2017-01-01

    Chromatin ImmunoPrecipitation-sequencing (ChIP-seq) experiments have now become routine in biology for the detection of protein binding sites. In this chapter, we show how hidden Markov models can be used for the analysis of data generated by ChIP-seq experiments. We show how a hidden Markov model can naturally account for spatial dependencies in the ChIP-seq data, how it can be used in the presence of data from multiple ChIP-seq experiments under the same biological condition, and how it naturally accounts for the different IP efficiencies of individual ChIP-seq experiments.

  13. Automatic Classification of Attacks on IP Telephony

    Directory of Open Access Journals (Sweden)

    Jakub Safarik

    2013-01-01

    Full Text Available This article proposes an algorithm for automatic analysis of attack data in IP telephony network with a neural network. Data for the analysis is gathered from variable monitoring application running in the network. These monitoring systems are a typical part of nowadays network. Information from them is usually used after attack. It is possible to use an automatic classification of IP telephony attacks for nearly real-time classification and counter attack or mitigation of potential attacks. The classification use proposed neural network, and the article covers design of a neural network and its practical implementation. It contains also methods for neural network learning and data gathering functions from honeypot application.

  14. Significance analysis of prognostic signatures.

    Directory of Open Access Journals (Sweden)

    Andrew H Beck

    Full Text Available A major goal in translational cancer research is to identify biological signatures driving cancer progression and metastasis. A common technique applied in genomics research is to cluster patients using gene expression data from a candidate prognostic gene set, and if the resulting clusters show statistically significant outcome stratification, to associate the gene set with prognosis, suggesting its biological and clinical importance. Recent work has questioned the validity of this approach by showing in several breast cancer data sets that "random" gene sets tend to cluster patients into prognostically variable subgroups. This work suggests that new rigorous statistical methods are needed to identify biologically informative prognostic gene sets. To address this problem, we developed Significance Analysis of Prognostic Signatures (SAPS which integrates standard prognostic tests with a new prognostic significance test based on stratifying patients into prognostic subtypes with random gene sets. SAPS ensures that a significant gene set is not only able to stratify patients into prognostically variable groups, but is also enriched for genes showing strong univariate associations with patient prognosis, and performs significantly better than random gene sets. We use SAPS to perform a large meta-analysis (the largest completed to date of prognostic pathways in breast and ovarian cancer and their molecular subtypes. Our analyses show that only a small subset of the gene sets found statistically significant using standard measures achieve significance by SAPS. We identify new prognostic signatures in breast and ovarian cancer and their corresponding molecular subtypes, and we show that prognostic signatures in ER negative breast cancer are more similar to prognostic signatures in ovarian cancer than to prognostic signatures in ER positive breast cancer. SAPS is a powerful new method for deriving robust prognostic biological signatures from clinically

  15. TCP/IP Implementations and Vendors Guide,

    Science.gov (United States)

    1986-02-01

    IMAGEN and others. The applications are integrated inwo the generic device, pathname...8217 . + ’. ’, " . . " .’ .- . - .- - - -- .. .- . . . . ’ - . . + ’ - .’ . . . , . ..++ - . -. ". , .-’ . , , - - . . . -+ ’- - - - , , - - , . . .. ... , - . % F 2.8. Imagen 2.8.1. Imprint-10 PRODUCT NAME: IMPRINT-10 TCP/IP Ethernet Printer DESCRIPTION: 4. The IMPRINT-10 is an...hardware O/S: Proprietary, not user-programmable IMPLEMENTATION-LANGUAGE: C DISTRIBUTOR: Imagen Corporation 2660 Marine

  16. La competenza per materia delle sezioni IP

    OpenAIRE

    Luigi Carlo Ubertazzi

    2004-01-01

    Italian Law 12/12/2002, n. 273 [0] as implemented through the Legislative Decree 168/2003 [1] has created "specialized sections" for IP-related matters in the courts (both first and second level) of Bari, Bologna, Catania, Firenze, Genova, Milano, Napoli, Palermo, Roma, Torino, Trieste and Venezia. These sections "deal with cases of national and communitarian trademarks, patents for inventions and new plant varieties, utility models, pictures and models, author rights and all cases of unfair ...

  17. Research study on IPS digital controller design

    Science.gov (United States)

    Kuo, B. C.; Folkerts, C.

    1976-01-01

    The performance is investigated of the simplified continuous-data model of the Instrument Pointing System (IPS). Although the ultimate objective is to study the digital model of the system, knowledge on the performance of the continuous-data model is important in the sense that the characteristics of the digital system should approach those of the continuous-data system as the sampling period approaches zero.

  18. Intellectual Property and Strategic Agreements (IP/SA) | FNLCR Staging

    Science.gov (United States)

    IP/SA handles all invention issues including patents and copyrights. All employee inventionreports are filed through the IP/SA office for all activities under the OTS contract.Additionally,request for assignment ofcopyri

  19. Media Distribution in Heterogeneous Environments using IP-Multicast

    OpenAIRE

    Parnes, Peter

    1998-01-01

    This document discusses problems and solutions around distribution of media in heterogeneous environments when using IP-multicast. This document discusses problems and solutions around distribution of media in heterogeneous environments when using IP-multicast.

  20. Role of ipsdienol, ipsenol, and cis-verbenol in chemical ecology of Ips avulsus, Ips calligraphus, and Ips grandicollis (Coleoptera: Curculionidae: Scolytinae).

    Science.gov (United States)

    Allison, Jeremy D; McKenney, Jessica L; Miller, Daniel R; Gimmel, Matthew L

    2012-06-01

    Stressed or damaged pine (Pinus sp.) trees in the southeastern United States are often colonized simultaneously by three southern Ips species (Coleoptera: Curculionidae: Scolytinae): small southern pine engraver, Ips avulsus (Eichhoff); sixspined ips, Ips calligraphus (Germar); and eastern fivespined ips, Ips grandicollis (Eichhoff). All three species mediate colonization of host material with volatile pheromones. All of the southern Ips produce cis-verbenol, and either ipsdienol or ipsenol, and electrophysiological studies have demonstrated that all three southern Ips are able to detect all three compounds. This study examined the role of ipsdienol, ipsenol, and cis-verbenol in the chemical ecology of the southern Ips in Georgia and Louisiana. The most attractive blends of pheromones, with the fewest number of components, were ipsdienol plus ipsenol for I. avulsus, cis-verbenol plus ipsdienol for I. calligraphus, and either cis-verbenol plus ipsenol or ipsdienol plus ipsenol for I. grandicollis. Cross-attraction of I. grandicollis to the pheromone blend most attractive to I. avulsus was observed. Although the presence of heterospecific pheromone reduced the catches of all three species (i.e., the tertiary blend captured fewer beetles than the most attractive binary blends) in both states (significantly in two cases), high numbers of all three species were still captured in traps baited with all three compounds. These results suggest that the pheromones cis-verbenol, ipsdienol, and ipsenol can be combined for monitoring all three species of the southern Ips simultaneously.

  1. Interobserver agreement of gleason score and modified gleason score in needle biopsy and in surgical specimen of prostate cancer

    OpenAIRE

    Veloso,Sergio G.; Lima,Mario F.; Salles,Paulo G.; Berenstein,Cynthia K.; Scalon, Joao D.; Bambirra, Eduardo A.

    2007-01-01

    INTRODUCTION: Gleason score, which has a high interobserver variability, is used to classify prostate cancer. The most recent consensus valued the tertiary Gleason pattern and recommended its use in the final score of needle biopsies (modified Gleason score). This pattern is considered to be of high prognostic value in surgical specimens. This study emphasized the evaluation of the modified score agreement in needle biopsies and in surgical specimen, as well as the interobserver variability o...

  2. Dynamic Mobile IP routers in ad hoc networks

    NARCIS (Netherlands)

    Kock, B.A.; Schmidt, J.R.

    2005-01-01

    This paper describes a concept combining mobile IP and ad hoc routing to create a robust mobile network. In this network all nodes are mobile and globally and locally reachable under the same IP address. Essential for implementing this network are the dynamic mobile IP routers. They act as gateways

  3. A Survey of Voice over IP Security Research

    Science.gov (United States)

    Keromytis, Angelos D.

    We present a survey of Voice over IP security research. Our goal is to provide a roadmap for researchers seeking to understand existing capabilities and, and to identify gaps in addressing the numerous threats and vulnerabilities present in VoIP systems. We also briefly discuss the implications of our findings with respect to actual vulnerabilities reported in a variety VoIP products.

  4. Impact of genome assembly status on ChIP-Seq and ChIP-PET data mapping

    Directory of Open Access Journals (Sweden)

    Sachs Laurent

    2009-12-01

    Full Text Available Abstract Background ChIP-Seq and ChIP-PET can potentially be used with any genome for genome wide profiling of protein-DNA interaction sites. Unfortunately, it is probable that most genome assemblies will never reach the quality of the human genome assembly. Therefore, it remains to be determined whether ChIP-Seq and ChIP-PET are practicable with genome sequences other than a few (e.g. human and mouse. Findings Here, we used in silico simulations to assess the impact of completeness or fragmentation of genome assemblies on ChIP-Seq and ChIP-PET data mapping. Conclusions Most currently published genome assemblies are suitable for mapping the short sequence tags produced by ChIP-Seq or ChIP-PET.

  5. Prognostic value of predischarge 12 lead electrocardiogram after myocardial infarction compared with other routine clinical variables

    NARCIS (Netherlands)

    Fioretti, P.; Tijssen, J. G.; Azar, A. J.; Lazzeroni, E.; Brower, R. W.; ten Katen, H. J.; Lubsen, J.; Hugenholtz, P. G.

    1987-01-01

    The prognostic value of QRS score (Selvester), ST depression, ST elevation, extrasystoles, P terminal force in V1, and QTc derived from the predischarge 12 lead electrocardiogram was assessed after myocardial infarction in 474 patients without intraventricular conduction defects, ventricular

  6. How can we integrate IP strategy with corporate strategy? Combining IP strategy with management strategy making process

    OpenAIRE

    田中, 義敏; Tanaka, Yoshitoshi

    2013-01-01

    Intellectual property systems have been introduced and used in manycountries as a global standard. However, its practical utilisation is still not yetmature because of the lack of IP strategy. Each enterprise has to define aunique IP strategy and be differentiated by other enterprises because the outsideenvironment and internal resource are different. IP people have to havebetter understandings on strategy making process, which is fundamental to themanagement field. In addition, IP strategy s...

  7. Boey Score in Predicting Mortality in Patients with Perforated Peptic ...

    African Journals Online (AJOL)

    Background: A number of prognostic factors for morbidity and mortality following perforated peptic ulcer have been reported, but the most well known is Boey's score which is simple with a high predictive value. Aim: The aim of this study was to predict mortality in patients with perforated peptic ulcer using the Boey's score.

  8. Impact of artefact removal on ChIP quality metrics in ChIP-seq and ChIP-exo data.

    Directory of Open Access Journals (Sweden)

    Thomas Samuel Carroll

    2014-04-01

    Full Text Available With the advent of ChIP-seq multiplexing technologies and the subsequent increase in ChIP-seq throughput, the development of working standards for the quality assessment of ChIP-seq studies has received significant attention. The ENCODE consortium’s large scale analysis of transcription factor binding and epigenetic marks as well as concordant work on ChIP-seq by other laboratories has established a new generation of ChIP-seq quality control measures. The use of these metrics alongside common processing steps has however not been evaluated. In this study, we investigate the effects of blacklisting and removal of duplicated reads on established metrics of ChIP-seq quality and show that the interpretation of these metrics is highly dependent on the ChIP-seq preprocessing steps applied. Further to this we perform the first investigation of the use of these metrics for ChIP-exo data and make recommendations for the adaptation of the NSC statistic to allow for the assessment of ChIP-exo efficiency.

  9. Impact of artifact removal on ChIP quality metrics in ChIP-seq and ChIP-exo data

    Science.gov (United States)

    Carroll, Thomas S.; Liang, Ziwei; Salama, Rafik; Stark, Rory; de Santiago, Ines

    2014-01-01

    With the advent of ChIP-seq multiplexing technologies and the subsequent increase in ChIP-seq throughput, the development of working standards for the quality assessment of ChIP-seq studies has received significant attention. The ENCODE consortium's large scale analysis of transcription factor binding and epigenetic marks as well as concordant work on ChIP-seq by other laboratories has established a new generation of ChIP-seq quality control measures. The use of these metrics alongside common processing steps has however not been evaluated. In this study, we investigate the effects of blacklisting and removal of duplicated reads on established metrics of ChIP-seq quality and show that the interpretation of these metrics is highly dependent on the ChIP-seq preprocessing steps applied. Further to this we perform the first investigation of the use of these metrics for ChIP-exo data and make recommendations for the adaptation of the NSC statistic to allow for the assessment of ChIP-exo efficiency. PMID:24782889

  10. Analysis list: Atf7ip [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Atf7ip Pluripotent stem cell + mm9 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/target/Atf7ip....1.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/target/Atf7ip.5.tsv http://dbarchive.biosc...iencedbc.jp/kyushu-u/mm9/target/Atf7ip.10.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/colo/Atf7ip.Plurip...otent_stem_cell.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/colo/Pluripotent_stem_cell.gml ...

  11. The relation of innate and adaptive immunity with viral-induced acute asthma attacks: Focusing on IP-10 and cathelicidin.

    Science.gov (United States)

    Arikoglu, T; Akyilmaz, E; Yildirim, D D; Batmaz, S B; Ulger, S T; Aslan, G; Kuyucu, S

    Despite growing evidence suggesting potential association between innate and adaptive immunity in viral-induced acute asthma, there is paucity of data in this area. This study aimed to investigate the association of innate and adaptive immunity with acute asthma attacks by analysing the role of IFN-γ-inducible protein 10 (IP-10), TLR2, cathelicidin, vitamin D and cytokines. This prospective study included 33 patients with viral-induced acute asthma and 30 children with controlled asthma. Nasopharyngeal swab samples were collected for virus identification and asthma attack scores assessed in acute asthma group. Blood sampling for IP-10, TLR2, cathelicidin, vitamin D levels, and spirometric indices were employed. Serum IP-10 and cathelicidin levels of acute asthma group were significantly higher and vitamin D levels were lower than controlled asthma group (IP-10; p=0.006, cathelicidin; p=0.002, vitamin D; p, TLR2 (p=0.05) and spirometric indices (p=0.002) in all asthmatics and a significant positive correlation with parameters of asthma attack severity (p=0.03) in acute asthma group. Higher cathelicidin values showed significant positive relation to IP-10 (beta coefficient: 33, p=0.02). Serum IP-10 levels higher than 38.9pg/ml (sensitivity: 85%, specificity: 47%, p=0.002) were predictive of virus-induced asthma. Serum IP-10 and vitamin D levels were found to be significantly related to viral-asthma attacks (IP-10; aOR: 8.93, p=0.03 and vitamin D; aOR: 0.82, p=0.001). Innate immunity biomarkers such as serum IP-10 and cathelicidin can be used to predict viral-induced acute asthma. These biomarkers may provide potential new treatment targets for acute asthma. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  12. Evolving science enhanced with iPS

    Directory of Open Access Journals (Sweden)

    Editor

    2007-11-01

    Full Text Available Dear friends, Greetings from all in the team. With the stage set for online submissions and the review-response-revision-resubmission process standardized, we have come with the first regular issue and from now there will be quarterly issues of the journal. Since the starting of the JSRM in a short span there have been a lot of developments, which we would rather say as "evolutions" keeping in mind, the recent iPS! This evolution we would like you to see from a background of the various developments in the art and science of medicine throughout in the past three centuries. We have come across the era of investigative tools such as bamboo made laryngoscopes to era of vaccines and antibiotics followed by the era of revolutionary non-invasive procedures and recently the nano technology based drugs and now the iPS! Macro to Micro, but still more to go. All through the influence of the society, religions, philosophies have been playing a very important role in every step the science of biology moves ahead. Starting with the contraception, assisted reproduction then the gene modified plants....and now the embryonic stem cells! With the advent of the iPS, though the issues of oncogenes, teratoma yet to be ruled out, we have found there is a way which can bypass the ES cells! Hats off to those scientists who have burnt their midnight oil to have found this way out! The lesson we learn is to explore things with an open mind and continue to proceed further without spending much time fingers crossed. Yours sincerely,The Editorial team.

  13. ejIP: A TCP/IP Stack for Embedded Java

    DEFF Research Database (Denmark)

    Schoeberl, Martin

    2011-01-01

    To enable Java on resource constraint embedded devices, the whole system should be implemented in a single programming language to avoid overheads on language boundaries. However, most of the functionality that is dedicated to the operating system layer is usually written in C. In this paper we...... present the design and implementation of a network stack written entirely in Java. This implementation serves as an example how to implement system functions in a safe language and gives evidence that Java can be used for operating system related functionality. The described TCP/IP stack ejIP has already...... been successfully used in industrial projects on pure Java embedded systems....

  14. Evaluation of VoIP QoS Performance in Wireless Mesh Networks

    Directory of Open Access Journals (Sweden)

    Mohammad Tariq Meeran

    2017-07-01

    Full Text Available The main focus of this research article is the evaluation of selected voice over Internet protocol (VoIP solutions in wireless mesh network (WMN scenarios. While WMNs have self-healing, self-forming, and dynamic topology features, they still pose challenges for the implementation of multimedia applications such as voice in various scenarios. Therefore, various solutions to make WMN more suitable for VoIP application have been proposed in the scientific literature. In this work, we have extensively explored a set of applicable scenarios by conducting experiments by means of a network simulator. The following scenarios were selected as the most representatives for performance evaluation: first responders, flooded village, remote village, and platoon deployment. Each selected scenario has been studied under six sub-scenarios corresponding to various combinations of the IEEE 802.11g, 802.11n, 802.11s, and 802.11e standards; the G.711 and G.729 codecs; and the ad hoc on demand distance vector (AODV and hybrid wireless mesh protocol (HWMP routing protocols. The results in terms of quality of service (measured with the mean opinion score rating scale, supported by the analysis of delay, jitter and packet loss, show that 802.11g integration with both VoIP codecs and AODV routing protocol results in better VoIP performance as compared to most other scenarios. In case of 802.11g integration with 802.11s, VoIP performance decreases as compared to the other sub-scenarios without 802.11s. The results also show that 802.11n integration with 802.11e decreases VoIP performance in larger deployments. We conclude the paper with some recommendations in terms of combinations of those standards and protocols with a view to achieve a higher quality of service for the given scenarios.

  15. The IPS Learning Community: A Longitudinal Study of Sustainment, Quality, and Outcome.

    Science.gov (United States)

    Bond, Gary R; Drake, Robert E; Becker, Deborah R; Noel, Valerie A

    2016-08-01

    Implementations of evidence-based mental health practices often disappear quickly, and few studies have examined sustainment. Since 2001, the Individual Placement and Support (IPS) learning community has promoted dissemination, implementation, sustainment, and expansion of IPS by using multiple strategies: online training, in-person training and technical assistance, technical assistance teleconferences, annual meetings, stakeholder conference calls, fidelity assessments, and transparency of outcomes. This study examined sustainment of IPS over a two-year period among programs in the learning community in the United States. The authors interviewed IPS team leaders in 129 programs actively participating in the learning community in 2012 and 2014. The structured interview addressed questions about program status, funding, and quality improvement activities. Simultaneously, the learning community tracked program-level data on IPS fidelity and employment rates. The study examined two-year program sustainment and changes in employment rates, fidelity, funding, and quality improvement activities. In 2012, 129 participating sites had been active for an average of 4.5 years. At two-year follow-up, 124 (96%) sites were sustained. The sustaining sites maintained quality improvement activities, expanded funding sources, and increased employment rates (41% to 43%; p=.04) and fidelity scores (103.8 to 108.4; p=.002). Nearly all programs participating in a learning community in 2012 continued to provide IPS services over the next two years, exceeding sustainment rates for evidence-based practices reported in the literature. Quality indicators also improved, suggesting that learning community activities fostered sustainment and quality. Controlled studies must compare specific learning community approaches with usual methods of sustainment.

  16. Cell-type specificity of ChIP-predicted transcription factor binding sites

    Directory of Open Access Journals (Sweden)

    Håndstad Tony

    2012-08-01

    Full Text Available Abstract Background Context-dependent transcription factor (TF binding is one reason for differences in gene expression patterns between different cellular states. Chromatin immunoprecipitation followed by high-throughput sequencing (ChIP-seq identifies genome-wide TF binding sites for one particular context—the cells used in the experiment. But can such ChIP-seq data predict TF binding in other cellular contexts and is it possible to distinguish context-dependent from ubiquitous TF binding? Results We compared ChIP-seq data on TF binding for multiple TFs in two different cell types and found that on average only a third of ChIP-seq peak regions are common to both cell types. Expectedly, common peaks occur more frequently in certain genomic contexts, such as CpG-rich promoters, whereas chromatin differences characterize cell-type specific TF binding. We also find, however, that genotype differences between the cell types can explain differences in binding. Moreover, ChIP-seq signal intensity and peak clustering are the strongest predictors of common peaks. Compared with strong peaks located in regions containing peaks for multiple transcription factors, weak and isolated peaks are less common between the cell types and are less associated with data that indicate regulatory activity. Conclusions Together, the results suggest that experimental noise is prevalent among weak peaks, whereas strong and clustered peaks represent high-confidence binding events that often occur in other cellular contexts. Nevertheless, 30-40% of the strongest and most clustered peaks show context-dependent regulation. We show that by combining signal intensity with additional data—ranging from context independent information such as binding site conservation and position weight matrix scores to context dependent chromatin structure—we can predict whether a ChIP-seq peak is likely to be present in other cellular contexts.

  17. Prognostic factors in oligodendrogliomas

    DEFF Research Database (Denmark)

    Westergaard, L; Gjerris, F; Klinken, L

    1997-01-01

    .5 years and for the group older than 60 years of 13 months. The group without neurological deficits had a 5-years survival of 43 per cent while the group with deficits had a 5-years survival of 5 per cent. The 5-years survival for oligodendroglioma of grade II was 46 per cent and for grade III 10 per cent......An outcome analysis was performed on 96 patients with pure cerebral oligodendrogliomas operated in the 30-year period 1962 to 1991. The most important predictive prognostic factors were youth and no neurological deficit, demonstrated as a median survival for the group younger than 20 years of 17...

  18. La competenza per materia delle sezioni IP

    Directory of Open Access Journals (Sweden)

    Luigi Carlo Ubertazzi

    2004-12-01

    Full Text Available Italian Law 12/12/2002, n. 273 [0] as implemented through the Legislative Decree 168/2003 [1] has created "specialized sections" for IP-related matters in the courts (both first and second level of Bari, Bologna, Catania, Firenze, Genova, Milano, Napoli, Palermo, Roma, Torino, Trieste and Venezia. These sections "deal with cases of national and communitarian trademarks, patents for inventions and new plant varieties, utility models, pictures and models, author rights and all cases of unfair competition when these cases interfere with the protection of industrial and intellectual property". This paper discusses the different positions of Italian law scholars and lawyers as to whether the list of subjects, on which the specialized sections are competent as written in the law, is intensive or extensive - in other words, whether the specialized sections should take care *only* of the matters that the law clearly specifies, or whether they should take care of everything "related to" intellectual and industrial property. In this paper several justifications are made for giving full responsibility to IP sections over all law cases dealing with intellectual property (extensive interpretation, together with a rebuttal of the most relevant positions advocating an intensive interpretation of the law.

  19. IPS - a vision aided navigation system

    Science.gov (United States)

    Börner, Anko; Baumbach, Dirk; Buder, Maximilian; Choinowski, Andre; Ernst, Ines; Funk, Eugen; Grießbach, Denis; Schischmanow, Adrian; Wohlfeil, Jürgen; Zuev, Sergey

    2017-04-01

    Ego localization is an important prerequisite for several scientific, commercial, and statutory tasks. Only by knowing one's own position, can guidance be provided, inspections be executed, and autonomous vehicles be operated. Localization becomes challenging if satellite-based navigation systems are not available, or data quality is not sufficient. To overcome this problem, a team of the German Aerospace Center (DLR) developed a multi-sensor system based on the human head and its navigation sensors - the eyes and the vestibular system. This system is called integrated positioning system (IPS) and contains a stereo camera and an inertial measurement unit for determining an ego pose in six degrees of freedom in a local coordinate system. IPS is able to operate in real time and can be applied for indoor and outdoor scenarios without any external reference or prior knowledge. In this paper, the system and its key hardware and software components are introduced. The main issues during the development of such complex multi-sensor measurement systems are identified and discussed, and the performance of this technology is demonstrated. The developer team started from scratch and transfers this technology into a commercial product right now. The paper finishes with an outlook.

  20. Inositol hexaphosphate (IP6) blocks proliferation of human breast cancer cells through a PKCdelta-dependent increase in p27Kip1 and decrease in retinoblastoma protein (pRb) phosphorylation.

    Science.gov (United States)

    Vucenik, Ivana; Ramakrishna, Gayatri; Tantivejkul, Kwanchanit; Anderson, Lucy M; Ramljak, Danica

    2005-05-01

    Inositol hexaphosphate (IP6) is a naturally occurring polyphosphorylated carbohydrate with demonstrated anti-proliferative and anti-cancer activity in mammary cells. We hypothesized that IP6 modulates cell cycle proteins by action on cytoplasmic signaling molecules. The effects of both pharmacological (2 mM) and physiological (100 microM) doses of IP6 on major PKC isoforms (PKCalpha, delta, epsilon, beta and zeta), PI3-K/Akt and ras/Erk1/2 were evaluated. Treatment of MCF-7 human breast cancer cells with 2 mM IP6 for 24 h caused a 3.1-fold increase in the expression of anti-proliferative PKCdelta. Similar results were observed with 100 microM IP6 at only 30-60 min post-treatment. IP6 also caused an increase in PKCdelta activity, shown by its translocation from cytosol to membrane. No changes in expression of PKC alpha, delta, epsilon, beta and zeta were detected. Additionally, IP6 caused a decrease of Erk1/2 and Akt activity. Among cell cycle control proteins, IP6 resulted in increased p27Kip1 protein levels and marked reduction of pRb phosphorylation. Specificity of the IP6 effects on p27Kip1 and pRb in MCF-7 cells (hormone-dependent) were additionally confirmed in highly invasive hormone-independent MDA-MB 231 breast cancer cells. Use of specific pharmaclogical inhibitors of PKC delta, MEK/Erk, and PI3K/Akt pathways indicated that the IP6-mediated effects on PKC delta were responsible for up-regulation of p27Kip, and pRb hypo-phosphorylation. In addition, IP6-induced apoptosis detected in MCF-7 cells appeared also to be PKC delta-dependent. Our data suggest potential usefulness of IP6 as a novel therapeutic modulator of PKC delta and p27Kip1, an important prognostic factor in human breast cancers.

  1. Chromatin immunoprecipitation (ChIP) of plant transcription factors followed by sequencing (ChIP-SEQ) or hybridization to whole genome arrays (ChIP-CHIP)

    NARCIS (Netherlands)

    Kaufmann, K.; Muiño, J.M.; Østerås, M.; Farinelli, L.; Krajewski, P.; Angenent, G.C.

    2010-01-01

    Chromatin immunoprecipitation (ChIP) is a powerful technique to study interactions between transcription factors (TFs) and DNA in vivo. For genome-wide de novo discovery of TF-binding sites, the DNA that is obtained in ChIP experiments needs to be processed for sequence identification. The sequences

  2. Prognostic factors in lupus nephritis

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Starklint, Henrik; Halberg, Poul

    2006-01-01

    To evaluate the prognostic significance of clinical and renal biopsy findings in an unselected cohort of patients with systemic lupus erythematosus (SLE) and nephritis.......To evaluate the prognostic significance of clinical and renal biopsy findings in an unselected cohort of patients with systemic lupus erythematosus (SLE) and nephritis....

  3. Requirements Specifications for Prognostics: An Overview

    Data.gov (United States)

    National Aeronautics and Space Administration — With recent advancements in prognostics methodologies there has been a significant interest in maturing Prognostics and Health Management (PHM) to increase its...

  4. On Applying the Prognostic Performance Metrics

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics performance evaluation has gained significant attention in the past few years. *As prognostics technology matures and more sophisticated methods for...

  5. Metrics for Offline Evaluation of Prognostic Performance

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostic performance evaluation has gained significant attention in the past few years.*Currently, prognostics concepts lack standard definitions and suffer from...

  6. Applications of the international scoring system for Disseminated Intravascular Coagulopathy (DIC and its interaction with Sequential Organ Failure Assessment Score (SOFA in prediction of prognosis and final outcome in ICU

    Directory of Open Access Journals (Sweden)

    Ahmed Rostom

    2013-01-01

    Conclusion: A significant correlation exists between SOFA and DIC scores together in critically ill patients with APACHE II score ⩾25 as regards MODS and mortality. The combination of DIC and SOFA scores highly improves the prognostic performance of either score alone. It's recommended to combine these scores together for better mortality prediction.

  7. KAJIAN INDUCED PLURIPOTENT STEMCELL (iPS (HARAPAN DAN TANTANGAN

    Directory of Open Access Journals (Sweden)

    Masagus Zainuri

    2014-05-01

    Full Text Available AbstractInduced Pluripotent Stemcell (iPS are adult cells which the genetic information in the nucleus of those cells being reprogrammed (reprogram by inserting exogenous pluripotential genes. The exogenous gene transduction is using vectors, such as lentivirus, retrovirus, or adenovirus, which suppressed the gene expression of the original cells, so they will express the transduced exogenous gene. Viral vectors are then used to reprogramming and producing iPS clones that are pluripotent. iPS derived from adult cells of patient with certain diseases will be used as a tool to study the mechanisms of those specific diseases and the effects of selected drugs against the diseases. Several previous studies have shown that iPS clones developed from specific genetic disease have its original genotype and retain the character of the response to the drug that similar as the original adult cells. Opportunities for the utilization of autologous iPS cell therapy in the future is wide open as expected iPS transplant will not be rejected when transplanted back to the patient. Behind all its potential, iPS production is still facing some problems to be applicable clinically. The use of viruses as vectors may cause problems due to virus gene sequences may be integrated into the genome of the DNA donor cell, thereby causing mutations of the iPS clones. Several subsequent studies have succeeded in replacing the use of viruses as vectors, but the level of efficiency obtained is still very low. Another problem that arises is that epigenetic changes may occur in iPS cultures. Many advanced research related to iPS may be developed in Indonesia and is necessary to improve the production efficiency of iPS and solve iPS clones epigenetic changes problems in the future.Keywords: iPS, pluripotency, transduction, transfection.AbstrakInduced Pluripotent Stemcell (iPS adalah sel somatic dewasa yang informasi genetika dalam inti selnyadiprogram ulang (reprogram dengan cara

  8. Human iPS cell-derived dopaminergic neurons function in a primate Parkinson's disease model.

    Science.gov (United States)

    Kikuchi, Tetsuhiro; Morizane, Asuka; Doi, Daisuke; Magotani, Hiroaki; Onoe, Hirotaka; Hayashi, Takuya; Mizuma, Hiroshi; Takara, Sayuki; Takahashi, Ryosuke; Inoue, Haruhisa; Morita, Satoshi; Yamamoto, Michio; Okita, Keisuke; Nakagawa, Masato; Parmar, Malin; Takahashi, Jun

    2017-08-30

    Induced pluripotent stem cells (iPS cells) are a promising source for a cell-based therapy to treat Parkinson's disease (PD), in which midbrain dopaminergic neurons progressively degenerate. However, long-term analysis of human iPS cell-derived dopaminergic neurons in primate PD models has never been performed to our knowledge. Here we show that human iPS cell-derived dopaminergic progenitor cells survived and functioned as midbrain dopaminergic neurons in a primate model of PD (Macaca fascicularis) treated with the neurotoxin MPTP. Score-based and video-recording analyses revealed an increase in spontaneous movement of the monkeys after transplantation. Histological studies showed that the mature dopaminergic neurons extended dense neurites into the host striatum; this effect was consistent regardless of whether the cells were derived from patients with PD or from healthy individuals. Cells sorted by the floor plate marker CORIN did not form any tumours in the brains for at least two years. Finally, magnetic resonance imaging and positron emission tomography were used to monitor the survival, expansion and function of the grafted cells as well as the immune response in the host brain. Thus, this preclinical study using a primate model indicates that human iPS cell-derived dopaminergic progenitors are clinically applicable for the treatment of patients with PD.

  9. [Expression and prognostic significance of microenvironment related prognostic factors in patients with classical Hodgkin's lymphoma].

    Science.gov (United States)

    Wang, T T; Li, S X; Xia, B; Zhao, H F; Xu, W; Yang, H L; Wang, X F; Yu, Y; Sun, B C; Zhang, Y Z

    2017-05-16

    Objective: To observe the expression of three microenvironment related prognostic factors, i. e. programmed death 1 (PD-1), forkhead box protein 3(FOXP3) and colony-stimulating factor 1 receptor(CSF-1R) protein in classical Hodgkin's lymphoma (CHL) patients, and to explore the correlation between the protein expression and the prognosis of the patients. Methods: A total of 45 cases of CHL patients, who had been admitted to the Tianjin Medical University Cancer Institute and Hospital and Chinese PLA General Hospital from February 2005 to August 2010 were analyzed, including clinical features, prognostic factors, and treatment regimens. CHL patients' specimens were collected and the expression of PD-1, FOXP3, and CSF-1R proteins analyzed by immunohistochemical staining. Epstein-Barr virus encoded mRNA (EBER) was detected by in situ hybridization analysis. The relationship between the protein expression of PD-1, FOXP3 and CSF-1R and the patients' outcome was analyzed with clinical and follow-up data. Survival analysis was performed by Kaplan-Meier method, the Cox proportional hazard model was used to perform multivariate analysis. Results: In this cohort of 45 CHL patients, PD-1 positive was found in 7 cases (15.6%), FOXP3 high expression in 23 cases (51.1%), CSF-1R positive in 18 cases (40.0%). In the univariate analysis, the expression of FOXP3 and CSF-1R, International Prognostic Index (IPI) score, Ann Arbor stage and EBER were related with the patients' 5-year overall survival (OS); IPI score, the expression of FOXP3 and EBER were related with the patients' 5-year progress-free survival (PFS). Multivariate analysis indicated that CSF-1R protein expression was the independent prognostic factor affecting the patients' 5-year OS(HR: 8.918, P=0.020), and FOXP3 protein expression was the independent prognostic factor affecting the patients' 5-year PFS (HR: 0.122, PCSF-1R and EBV may be independent prognostic factors of CHL and this study may provide novel strategies

  10. Bacterial brain abscesses: prognostic value of an imaging severity index

    Energy Technology Data Exchange (ETDEWEB)

    Demir, M.K. [Department of Radiology, Trakya University School of Medicine, Edirne (Turkey)]. E-mail: demirkemal@superonline.com; Hakan, T. [Department of Neurosurgery, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Kilicoglu, G. [Department of Radiology, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Ceran, N. [Department of Infectious Disease, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Berkman, M.Z. [Department of Neurosurgery, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Erdem, I. [Department of Infectious Disease, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey); Goektas, P. [Department of Infectious Disease, Haydarpasa Numune Education and Research Hospital, Istanbul (Turkey)

    2007-06-15

    Aim: To assess the correlation between imaging findings [computed tomography (CT) or magnetic resonance imaging (MRI)] and neurological status before and after the treatment of bacterial brain abscesses. Materials and methods: CT and MRI images of 96 patients with brain abscesses were retrospectively evaluated in terms of the number, location and size of lesions, and the presence and extent of perilesional oedema and midline shift. An imaging severity index (ISI) based on these different radiological parameters was calculated. Initial Glasgow Coma Scale (GCS) scores and ISI were assessed and the prognostic value of these two indices was calculated. The Pearson correlation test, Mann-Whitney test, Chi-square test, receiver-operating characteristic (ROC) analysis, together with comparison of ROC analyses and Fisher's exact test were used. Results: There was a negative correlation between ISI and the initial GCS values: ISI increased as the GCS score decreased, indicating an inverse relationship (r = -0.51, p < 0.0001). There was a significant difference between the ISI and GCS scores of patients with an adverse event compared with patients with good recovery. Outcome was significantly worse in patients with initial ISI over the calculated cut-off values of 8 points or GCS scores under the cut-off value of 13 points. Conclusion: ISI is a useful prognostic indicator for bacterial brain abscess patients and correlates strongly with the patient outcome for all parameters studied. ISI score had a better prognostic value than GCS.

  11. Platform for capacity reservation in IP networks

    Directory of Open Access Journals (Sweden)

    Maksić Nataša

    2013-01-01

    Full Text Available The fast development of multimedia devices and services causes the need for increase of the transport capacity of packet networks. OSPF-TE uses both the information about network topology and the link utilization when finding the routing path. Accordingly, it might find path even in the cases when the shortest path routing would cause overloaded link and dropped packets. In this paper we develop the platform for capacity reservation in IP networks. We implement OSPF-TE protocol as an extension of the existing OSPF. In addition, the basic functionalities of the reservation protocol and the user interface are implemented. We present the simulation environment for the verification of our implementation and for the analysis of various routing algorithms based on the information conveyed by OSPF-TE.

  12. Telemetry and Communication IP Video Player

    Science.gov (United States)

    OFarrell, Zachary L.

    2011-01-01

    Aegis Video Player is the name of the video over IP system for the Telemetry and Communications group of the Launch Services Program. Aegis' purpose is to display video streamed over a network connection to be viewed during launches. To accomplish this task, a VLC ActiveX plug-in was used in C# to provide the basic capabilities of video streaming. The program was then customized to be used during launches. The VLC plug-in can be configured programmatically to display a single stream, but for this project multiple streams needed to be accessed. To accomplish this, an easy to use, informative menu system was added to the program to enable users to quickly switch between videos. Other features were added to make the player more useful, such as watching multiple videos and watching a video in full screen.

  13. PENGEMBANGAN BUKU AJAR IPS SD BERBASIS KONTEKSTUAL

    Directory of Open Access Journals (Sweden)

    Dina Fitrohtur Rohmah

    2017-05-01

    Full Text Available Text book is an instructional material which is often used in learning. Text book which is used in learning should be contextual with students’ characteristic and environment. The aim of this research is to develop supplement book in learning that is contextual Social Studies Textbooks which is valid, interesting, practical, and effective. Data are collected by questionnaire, test, and documentation. Based on data analysis, it shows that the text book is valid, interseting, practical, and effective to use in learning. Buku ajar merupakan bahan ajar yang sering digunakan dalam pembelajaran. Buku ajar yang digunakan dalam pembelajaran hendaknya kontekstual dengan karakteristik dan lingkungan siswa. Tujuan penelitian ini untuk mengembangkan buku suplemen dalam pembelajaran berupa buku ajar IPS SD berbasis kontekstual yang valid, menarik, praktis, dan efektif. Data dikumpulkan melalui angket, tes, dan dokumentasi. Berdasarkan analisis data, menunjukkan bahwa buku yang dikembangkan valid, menarik, praktis, dan efektif digunakan dalam pembelajaran.

  14. Machinability of IPS Empress 2 framework ceramic.

    Science.gov (United States)

    Schmidt, C; Weigl, P

    2000-01-01

    Using ceramic materials for an automatic production of ceramic dentures by CAD/CAM is a challenge, because many technological, medical, and optical demands must be considered. The IPS Empress 2 framework ceramic meets most of them. This study shows the possibilities for machining this ceramic with economical parameters. The long life-time requirement for ceramic dentures requires a ductile machined surface to avoid the well-known subsurface damages of brittle materials caused by machining. Slow and rapid damage propagation begins at break outs and cracks, and limits life-time significantly. Therefore, ductile machined surfaces are an important demand for machine dental ceramics. The machining tests were performed with various parameters such as tool grain size and feed speed. Denture ceramics were machined by jig grinding on a 5-axis CNC milling machine (Maho HGF 500) with a high-speed spindle up to 120,000 rpm. The results of the wear test indicate low tool wear. With one tool, you can machine eight occlusal surfaces including roughing and finishing. One occlusal surface takes about 60 min machining time. Recommended parameters for roughing are middle diamond grain size (D107), cutting speed v(c) = 4.7 m/s, feed speed v(ft) = 1000 mm/min, depth of cut a(e) = 0.06 mm, width of contact a(p) = 0.8 mm, and for finishing ultra fine diamond grain size (D46), cutting speed v(c) = 4.7 m/s, feed speed v(ft) = 100 mm/min, depth of cut a(e) = 0.02 mm, width of contact a(p) = 0.8 mm. The results of the machining tests give a reference for using IPS Empress(R) 2 framework ceramic in CAD/CAM systems. Copyright 2000 John Wiley & Sons, Inc.

  15. Extending Tactical Fleet Communications Through VoIP

    Science.gov (United States)

    2014-09-01

    Router Network SPIT Spam-over-Internet- Telephony SRTP Secure Real-time Transport Protocol SVoIP Secure Voice Over IP TCP Transmission Control...that encodes and decodes (digital to analog or analog to digital) a signal for efficient transmission . In VoIP terminology the term codec describes the...designed for this purpose [47]. It takes an analog audio signal on a voice interface port and converts it to RTP audio packets for digital transmission

  16. Diffusion of IP Telephony in Undergraduate Private Colleges

    Directory of Open Access Journals (Sweden)

    Patrick C. Olson, PhD

    2007-02-01

    Full Text Available Over the summer of 2000 Menlo College implemented enterprise wide Internet Protocol (IP Telephony (Voice over Internet Protocol [VoIP]. More than five years have passed, and analysts are predicting that in the near future the only available Private Branch Exchange (PBX solutions will be VoIP [4]. In view of this market trend, the diffusion of this technology in these institutions seems slow. The Menlo College implementation is very successful, but has the concept diffused to other institutions? What factors influence the diffusion of this technology to other institutions? This paper examines the status of VoIP at these institutions.

  17. Mobile location services over the next generation IP core network

    DEFF Research Database (Denmark)

    Thongthammachart, Saowanee; Olesen, Henning

    2003-01-01

    network is changing from circuit-switched to packet-switched technology and evolving to an IP core network based on IPv6. The IP core network will allow all IP devices to be connected seamlessly. Due to the movement detection mechanism of Mobile IPv6, mobile terminals will periodically update....... The concept of mobile location services over the next generation IP networks is described. We also discuss the effectiveness of the short-range wireless network regarding a mobile user's position inside buildings and hotspot areas....

  18. Overview of the Moral Status of iPS Cells.

    Science.gov (United States)

    Martinho, Andreia Martins

    2016-07-01

    The production of induced pluripotent stem (iPS) cells in 2006 by Takahashi and Yamanaka was a major breakthrough in stem cell research. IPS cells technology holds great promise for cell therapy, disease modelling, and drug testing, but it poses ethical questions concerning the moral status of somatic cells, which can re-gain pluripotency (iPS cells). This article provides an overview of the arguments that substantiate the debate on the moral assessment of iPS cells: potentiality argument; relational properties/standard view; and genetic basis for moral status.

  19. Distinct iPS Cells Show Different Cardiac Differentiation Efficiency.

    Science.gov (United States)

    Ohno, Yohei; Yuasa, Shinsuke; Egashira, Toru; Seki, Tomohisa; Hashimoto, Hisayuki; Tohyama, Shugo; Saito, Yuki; Kunitomi, Akira; Shimoji, Kenichiro; Onizuka, Takeshi; Kageyama, Toshimi; Yae, Kojiro; Tanaka, Tomofumi; Kaneda, Ruri; Hattori, Fumiyuki; Murata, Mitsushige; Kimura, Kensuke; Fukuda, Keiichi

    2013-01-01

    Patient-specific induced pluripotent stem (iPS) cells can be generated by introducing transcription factors that are highly expressed in embryonic stem (ES) cells into somatic cells. This opens up new possibilities for cell transplantation-based regenerative medicine by overcoming the ethical issues and immunological problems associated with ES cells. Despite the development of various methods for the generation of iPS cells that have resulted in increased efficiency, safety, and general versatility, it remains unknown which types of iPS cells are suitable for clinical use. Therefore, the aims of the present study were to assess (1) the differentiation potential, time course, and efficiency of different types of iPS cell lines to differentiate into cardiomyocytes in vitro and (2) the properties of the iPS cell-derived cardiomyocytes. We found that high-quality iPS cells exhibited better cardiomyocyte differentiation in terms of the time course and efficiency of differentiation than low-quality iPS cells, which hardly ever differentiated into cardiomyocytes. Because of the different properties of the various iPS cell lines such as cardiac differentiation efficiency and potential safety hazards, newly established iPS cell lines must be characterized prior to their use in cardiac regenerative medicine.

  20. Inositol hexaphosphate (IP6): a novel treatment for pancreatic cancer.

    Science.gov (United States)

    Somasundar, Ponnandai; Riggs, Dale R; Jackson, Barbara J; Cunningham, Cynthia; Vona-Davis, Linda; McFadden, David W

    2005-06-15

    Inositol hexaphosphate (IP6) is a naturally occurring polyphosphorylated carbohydrate found in food sources high in fiber content. IP6 has been reported to have significant inhibitory effects against a variety of primary tumors including breast and colon. The effects of IP6 have not been evaluated in pancreatic cancer. We hypothesized that IP6 would significantly inhibit cell growth and increase the apoptotic rate of pancreatic cancer in vitro. Two pancreatic cancer cell lines (MIAPACA and PANC1) were cultured using standard techniques and treated with IP6 at doses of 0.5, 1.0, and 5.0 mm. Cell viability was measured by MTT at 24 and 72 h. Apoptosis was evaluated by Annexin V-FITC and results calculated using FACS analysis. Statistical analysis was performed by ANOVA. Significant reductions (P < 0.01) in cellular proliferation were observed with all IP6 concentrations tested in both cell lines and at both time points. Reductions in cell proliferation ranged from 37.1 to 91.5%. IP6 increased early and late apoptotic activity (P < 0.01). Treatment of pancreatic cancer with the common dietary polyphosphorylated carbohydrate IP6 significantly decreased cellular growth and increased apoptosis. Our findings suggest that IP6 has the potential to become an effective adjunct for pancreatic cancer treatment. Further in vivo and human studies are needed to evaluate safety and clinical utility of this agent in patients with pancreatic cancer.

  1. Whole Genome Chromatin IP-Sequencing (ChIP-Seq) in Skeletal Muscle Cells.

    Science.gov (United States)

    So, Karl Kamhei; Peng, Xianlu Laura; Sun, Hao; Wang, Huating

    2017-01-01

    Transcriptional control of gene expression in skeletal muscle cell is involved in different processes ranging from muscle formation to regeneration. The identification of an increasing number of transcription factors, co-factors, and histone modifications has been greatly advanced by methods that allow studies of genome-wide chromatin-protein interactions. Chromatin immunoprecipitation with massively parallel DNA sequencing, or ChIP-seq, is a powerful tool for identifying binding sites of TFs/co-factors and histone modifications. The major steps of this technique involve immunoprecipitation of fragmented chromatin, followed by high-throughput sequencing to identify the protein bound regions genome-wide. Here, in this protocol, we will illustrate how the entire ChIP-seq is performed using global H3K27ac profiling in myoblast cells as an example.

  2. Secure Protocol and IP Core for Configuration of Networking Hardware IPs in the Smart Grid

    Directory of Open Access Journals (Sweden)

    Marcelo Urbina

    2018-02-01

    Full Text Available Nowadays, the incorporation and constant evolution of communication networks in the electricity sector have given rise to the so-called Smart Grid, which is why it is necessary to have devices that are capable of managing new communication protocols, guaranteeing the strict requirements of processing required by the electricity sector. In this context, intelligent electronic devices (IEDs with network architectures are currently available to meet the communication, real-time processing and interoperability requirements of the Smart Grid. The new generation IEDs include an Field Programmable Gate Array (FPGA, to support specialized networking switching architectures for the electric sector, as the IEEE 1588-aware High-availability Seamless Redundancy/Parallel Redundancy Protocol (HSR/PRP. Another advantage to using an FPGA is the ability to update or reconfigure the design to support new requirements that are being raised to the standards (IEC 61850. The update of the architecture implemented in the FPGA can be done remotely, but it is necessary to establish a cyber security mechanism since the communication link generates vulnerability in the case the attacker gains physical access to the network. The research presented in this paper proposes a secure protocol and Intellectual Property (IP core for configuring and monitoring the networking IPs implemented in a Field Programmable Gate Array (FPGA. The FPGA based implementation proposed overcomes this issue using a light Layer-2 protocol fully implemented on hardware and protected by strong cryptographic algorithms (AES-GCM, defined in the IEC 61850-90-5 standard. The proposed secure protocol and IP core are applicable in any field where remote configuration over Ethernet is required for IP cores in FPGAs. In this paper, the proposal is validated in communications hardware for Smart Grids.

  3. Quantification of histone modification ChIP-seq enrichment for data mining and machine learning applications

    Directory of Open Access Journals (Sweden)

    Bekiranov Stefan

    2011-08-01

    Full Text Available Abstract Background The advent of ChIP-seq technology has made the investigation of epigenetic regulatory networks a computationally tractable problem. Several groups have applied statistical computing methods to ChIP-seq datasets to gain insight into the epigenetic regulation of transcription. However, methods for estimating enrichment levels in ChIP-seq data for these computational studies are understudied and variable. Since the conclusions drawn from these data mining and machine learning applications strongly depend on the enrichment level inputs, a comparison of estimation methods with respect to the performance of statistical models should be made. Results Various methods were used to estimate the gene-wise ChIP-seq enrichment levels for 20 histone methylations and the histone variant H2A.Z. The Multivariate Adaptive Regression Splines (MARS algorithm was applied for each estimation method using the estimation of enrichment levels as predictors and gene expression levels as responses. The methods used to estimate enrichment levels included tag counting and model-based methods that were applied to whole genes and specific gene regions. These methods were also applied to various sizes of estimation windows. The MARS model performance was assessed with the Generalized Cross-Validation Score (GCV. We determined that model-based methods of enrichment estimation that spatially weight enrichment based on average patterns provided an improvement over tag counting methods. Also, methods that included information across the entire gene body provided improvement over methods that focus on a specific sub-region of the gene (e.g., the 5' or 3' region. Conclusion The performance of data mining and machine learning methods when applied to histone modification ChIP-seq data can be improved by using data across the entire gene body, and incorporating the spatial distribution of enrichment. Refinement of enrichment estimation ultimately improved accuracy

  4. Telomere reprogramming and maintenance in porcine iPS cells.

    Directory of Open Access Journals (Sweden)

    Guangzhen Ji

    Full Text Available Telomere reprogramming and silencing of exogenous genes have been demonstrated in mouse and human induced pluripotent stem cells (iPS cells. Pigs have the potential to provide xenotransplant for humans, and to model and test human diseases. We investigated the telomere length and maintenance in porcine iPS cells generated and cultured under various conditions. Telomere lengths vary among different porcine iPS cell lines, some with telomere elongation and maintenance, and others telomere shortening. Porcine iPS cells with sufficient telomere length maintenance show the ability to differentiate in vivo by teratoma formation test. IPS cells with short or dysfunctional telomeres exhibit reduced ability to form teratomas. Moreover, insufficient telomerase and incomplete telomere reprogramming and/or maintenance link to sustained activation of exogenous genes in porcine iPS cells. In contrast, porcine iPS cells with reduced expression of exogenous genes or partial exogene silencing exhibit insufficient activation of endogenous pluripotent genes and telomerase genes, accompanied by telomere shortening with increasing passages. Moreover, telomere doublets, telomere sister chromatid exchanges and t-circles that presumably are involved in telomere lengthening by recombination also are found in porcine iPS cells. These data suggest that both telomerase-dependent and telomerase-independent mechanisms are involved in telomere reprogramming during induction and passages of porcine iPS cells, but these are insufficient, resulting in increased telomere damage and shortening, and chromosomal instability. Active exogenes might compensate for insufficient activation of endogenous genes and incomplete telomere reprogramming and maintenance of porcine iPS cells. Further understanding of telomere reprogramming and maintenance may help improve the quality of porcine iPS cells.

  5. Telomere reprogramming and maintenance in porcine iPS cells.

    Science.gov (United States)

    Ji, Guangzhen; Ruan, Weimin; Liu, Kai; Wang, Fang; Sakellariou, Despoina; Chen, Jijun; Yang, Yang; Okuka, Maja; Han, Jianyong; Liu, Zhonghua; Lai, Liangxue; Gagos, Sarantis; Xiao, Lei; Deng, Hongkui; Li, Ning; Liu, Lin

    2013-01-01

    Telomere reprogramming and silencing of exogenous genes have been demonstrated in mouse and human induced pluripotent stem cells (iPS cells). Pigs have the potential to provide xenotransplant for humans, and to model and test human diseases. We investigated the telomere length and maintenance in porcine iPS cells generated and cultured under various conditions. Telomere lengths vary among different porcine iPS cell lines, some with telomere elongation and maintenance, and others telomere shortening. Porcine iPS cells with sufficient telomere length maintenance show the ability to differentiate in vivo by teratoma formation test. IPS cells with short or dysfunctional telomeres exhibit reduced ability to form teratomas. Moreover, insufficient telomerase and incomplete telomere reprogramming and/or maintenance link to sustained activation of exogenous genes in porcine iPS cells. In contrast, porcine iPS cells with reduced expression of exogenous genes or partial exogene silencing exhibit insufficient activation of endogenous pluripotent genes and telomerase genes, accompanied by telomere shortening with increasing passages. Moreover, telomere doublets, telomere sister chromatid exchanges and t-circles that presumably are involved in telomere lengthening by recombination also are found in porcine iPS cells. These data suggest that both telomerase-dependent and telomerase-independent mechanisms are involved in telomere reprogramming during induction and passages of porcine iPS cells, but these are insufficient, resulting in increased telomere damage and shortening, and chromosomal instability. Active exogenes might compensate for insufficient activation of endogenous genes and incomplete telomere reprogramming and maintenance of porcine iPS cells. Further understanding of telomere reprogramming and maintenance may help improve the quality of porcine iPS cells.

  6. Protection against cancer by dietary IP6 and inositol.

    Science.gov (United States)

    Vucenik, Ivana; Shamsuddin, AbulKalam M

    2006-01-01

    Inositol hexaphosphate (IP(6)) is a naturally occurring polyphosphorylated carbohydrate, abundantly present in many plant sources and in certain high-fiber diets, such as cereals and legumes. In addition to being found in plants, IP(6) is contained in almost all mammalian cells, although in much smaller amounts, where it is important in regulating vital cellular functions such as signal transduction, cell proliferation, and differentiation. For a long time IP(6) has been recognized as a natural antioxidant. Recently IP(6) has received much attention for its role in cancer prevention and control of experimental tumor growth, progression, and metastasis. In addition, IP(6) possesses other significant benefits for human health, such as the ability to enhance immune system, prevent pathological calcification and kidney stone formation, lower elevated serum cholesterol, and reduce pathological platelet activity. In this review we show the efficacy and discuss some of the molecular mechanisms that govern the action of this dietary agent. Exogenously administered IP(6) is rapidly taken up into cells and dephosphorylated to lower inositol phosphates, which further affect signal transduction pathways resulting in cell cycle arrest. A striking anticancer action of IP(6) was demonstrated in different experimental models. In addition to reducing cell proliferation, IP(6) also induces differentiation of malignant cells. Enhanced immunity and antioxidant properties also contribute to tumor cell destruction. Preliminary studies in humans show that IP(6) and inositol, the precursor molecule of IP(6), appear to enhance the anticancer effect of conventional chemotherapy, control cancer metastases, and improve quality of life. Because it is abundantly present in regular diet, efficiently absorbed from the gastrointestinal tract, and safe, IP(6) + inositol holds great promise in our strategies for cancer prevention and therapy. There is clearly enough evidence to justify the

  7. Prognostic significance of the number of postoperative intraperitoneal chemotherapy cycles for patients with advanced epithelial ovarian cancer.

    Science.gov (United States)

    Suidan, Rudy S; Zhou, Qin; Iasonos, Alexia; O'Cearbhaill, Roisin E; Chi, Dennis S; Long Roche, Kara C; Tanner, Edward J; Denesopolis, John; Barakat, Richard R; Zivanovic, Oliver

    2015-05-01

    Phase 3 trials have demonstrated a survival advantage for patients with optimally debulked epithelial ovarian cancer who received intravenous (IV) and intraperitoneal (IP) chemotherapy compared with IV therapy alone. This was despite a significant proportion of patients in the IV/IP arms not completing all 6 planned cycles. Our objective was to evaluate the prognostic significance of the number of IV/IP cycles administered. Data were analyzed for all patients with stage III to IV epithelial ovarian cancer who underwent optimal primary cytoreduction followed by 1 or more cycles of IV/IP chemotherapy from January 2005 to July 2011 at our institution. A landmark analysis was performed to associate progression-free survival (PFS) and overall survival (OS) with the number of IV/IP cycles given. We identified 201 patients; 26 (13%) received 1 to 2 cycles of IV/IP chemotherapy, 41 (20%) received 3 to 4 cycles, and 134 (67%) received 5 to 6 cycles. The 5-year PFS for patients who received 1 to 2, 3 to 4, and 5 to 6 cycles was 18%, 29%, and 17%, respectively. The 5-year OS for patients who received 1 to 2, 3 to 4, and 5 to 6 cycles was 44%, 54%, and 57%, respectively. There was no significant difference in PFS (P = 0.31) or OS (P = 0.14) between the 3 groups. The most common reason for discontinuing IV/IP therapy was treatment-related toxicity (77%). Postoperative complications were the most common reason for not initiating IV/IP therapy (42%) in patients who subsequently transitioned to it. We did not detect a significant survival difference between patients who received 1 to 2, 3 to 4, or 5 to 6 IV/IP chemotherapy cycles. Women may still derive a survival benefit if they receive fewer than 6 IV/IP cycles.

  8. PENGEMBANGAN PERANGKAT PEMBELAJARAN IPS DENGAN PENDEKATAN INQUIRY

    Directory of Open Access Journals (Sweden)

    Lisna Handayani

    2015-08-01

    Full Text Available Tujuan  penelitian adalah menghasilkan perangkat pembelajaran IPS dengan Pendekatan Inquiry. Penelitian pengembangan ini menggunakan langkah-langkah Borg and Gall yang terdiri dari tiga tahapan utama yaitu pendahuluan, pengembangan dan validasi. Data yang diperoleh adalah hasil belajar, aktivitas diskusi dan respon peserta didik. Data dianalisis menggunakan analisis deskriptif dan uji t. Penggunaan pendekatan inquiry sebagai salah satau strategi pembelajaran IPS dapat dilakukan dengan mempersiapkan terlebih dahulu perangkat pembelajarannya. Hasil pengembangan divalidasi oleh pakar, diujicobakan pada kelas terbatas dan selanjutnya dilakukan ujicoba pada kelas eksperimen yang dibandingkan hasilnya dengan kelas kontrol. Perangkat pembelajaran tergolong efektif untuk meningkatkan hasil belajar peserta didik di kelas VII SMP Negeri 2 Jepara, terbukti dari adanya peningkatan yang nyata terbukti dari hasil uji paired sampel t-test dengan nilai signifikansi 0,000 <0,05, dan terjadi peningkatan yang tinggi (gain > 0,7, serta hasil belajar yang dicapai berbeda secara signifikan dengan kelompok kontrol. Di samping hasil belajar, pembelajaran yang dilakukan juga berdampak pada proses belajar yang membawa tingginya aktivitas peserta didik dalam memberikan gagasan, kerjasama, inisiatif, keaktifan dan kedisiplinan. The purpose of this research is creating Social Lesson Material with Inquiry Approach.This developing of the research is used of  the steps of Borg and Gall. They are Introducing, developing and evaluating. Learning materials are developed and validity by expert. Datas are gooten by study result, discussion activity and students, respone. Analizing datas are used descriptive analize and t- try out. The use of inquiry approach as one of learning strategy on Social Lesson Material can be done by preparing those. The result of  developing are being validity by expert,  try out on limited group and experiment group ad compare with control group

  9. Towards Prognostics for Electronics Components

    Data.gov (United States)

    National Aeronautics and Space Administration — Electronics components have an increasingly critical role in avionics systems and in the development of future aircraft systems. Prognostics of such components is...

  10. Standardizing Research Methods for Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics and health management (PHM) is a maturing system engineering discipline. As with most maturing disciplines, PHM does not yet have a universally accepted...

  11. IP-10 release assays in the diagnosis of tuberculosis infection

    DEFF Research Database (Denmark)

    Ruhwald, Morten; Aabye, Martine G; Ravn, Pernille

    2012-01-01

    The current state-of-the-art tests for infection with Mycobacterium tuberculosis - the IFN-γ release assays - rely on accurate measurement of the cytokine IFN-γ. Many other potential biomarkers are expressed in concert with IFN-γ, and IP-10 in particular has shown promising results. IP-10...

  12. Capturing value from IP in a global environment

    DEFF Research Database (Denmark)

    Alcacer, Juan; Beukel, Karin; Cassiman, Bruno

    of patenting globally. For trademarks and industrial designs, globalization has created more potential infringers and an increase in piracy, as evidenced by a significant increase in customs seizures. The problems with IP even go beyond individual firms, as when governments use IP policies to favor local firms...

  13. Special rights for the development of Indigenous Peoples (IPS) in ...

    African Journals Online (AJOL)

    Indigenous Peoples (IPs) have been subjected to a series of humiliation, discrimination and in some cases dis-membership of a state. This is germane, but not peculiar, to the developing states with special reference to Africa. Globalization and efforts to link human, cultural and social rights to the IPs remain blurred and ...

  14. Probabilistic Route Selection Algorithm for IP Traceback

    Science.gov (United States)

    Yim, Hong-Bin; Jung, Jae-Il

    DoS(Denial of Service) or DDoS(Distributed DoS) attack is a major threaten and the most difficult problem to solve among many attacks. Moreover, it is very difficult to find a real origin of attackers because DoS/DDoS attacker uses spoofed IP addresses. To solve this problem, we propose a probabilistic route selection traceback algorithm, namely PRST, to trace the attacker's real origin. This algorithm uses two types of packets such as an agent packet and a reply agent packet. The agent packet is in use to find the attacker's real origin and the reply agent packet is in use to notify to a victim that the agent packet is reached the edge router of the attacker. After attacks occur, the victim generates the agent packet and sends it to a victim's edge router. The attacker's edge router received the agent packet generates the reply agent packet and send it to the victim. The agent packet and the reply agent packet is forwarded refer to probabilistic packet forwarding table (PPFT) by routers. The PRST algorithm runs on the distributed routers and PPFT is stored and managed by routers. We validate PRST algorithm by using mathematical approach based on Poisson distribution.

  15. Research on implementation of proxy Arp in IP DSLAM

    Science.gov (United States)

    Cheng, Chuanqing; Wang, Li; Huang, Qiugen

    2005-02-01

    While the ethernet is applied more and more in public network environment and xdsl service become the most common access mode ,IP kenel DSLAM undertakes some functions such as service distribution and convergence ,security management and customer management.Facing the contradiction of the need of port isolation and the shortage of ip address,VLAN aggregation technology is applied in DSLAM.How to implement the communicatio between the two vlan but share the same ip subnet,proxy arp does this. This paper introduces how to implement proxy arp in the DSLAM. TCP/IP communication detail procedure betweent two host ,the relation of VLAN and network segment are discussed. The proxy arp model and its implementation in IP DSLAM is also expatiated in this paper and a conformance tesing is given.

  16. COPAR: A ChIP-Seq Optimal Peak Analyzer.

    Science.gov (United States)

    Tang, Binhua; Wang, Xihan; Jin, Victor X

    2017-01-01

    Sequencing data quality and peak alignment efficiency of ChIP-sequencing profiles are directly related to the reliability and reproducibility of NGS experiments. Till now, there is no tool specifically designed for optimal peak alignment estimation and quality-related genomic feature extraction for ChIP-sequencing profiles. We developed open-sourced COPAR, a user-friendly package, to statistically investigate, quantify, and visualize the optimal peak alignment and inherent genomic features using ChIP-seq data from NGS experiments. It provides a versatile perspective for biologists to perform quality-check for high-throughput experiments and optimize their experiment design. The package COPAR can process mapped ChIP-seq read file in BED format and output statistically sound results for multiple high-throughput experiments. Together with three public ChIP-seq data sets verified with the developed package, we have deposited COPAR on GitHub under a GNU GPL license.

  17. Defining bacterial regulons using ChIP-seq.

    Science.gov (United States)

    Myers, Kevin S; Park, Dan M; Beauchene, Nicole A; Kiley, Patricia J

    2015-09-15

    Chromatin immunoprecipitation followed by high-throughput sequencing (ChIP-seq) is a powerful method that identifies protein-DNA binding sites in vivo. Recent studies have illustrated the value of ChIP-seq in studying transcription factor binding in various bacterial species under a variety of growth conditions. These results show that in addition to identifying binding sites, correlation of ChIP-seq data with expression data can reveal important information about bacterial regulons and regulatory networks. In this chapter, we provide an overview of the current state of knowledge about ChIP-seq methodology in bacteria, from sample preparation to raw data analysis. We also describe visualization and various bioinformatic analyses of processed ChIP-seq data. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Defining Bacterial Regulons Using ChIP-seq Methods

    Science.gov (United States)

    Myers, Kevin S.; Park, Dan M.; Beauchene, Nicole A.; Kiley, Patricia J.

    2015-01-01

    Chromatin immunoprecitation followed by high-throughput sequencing (ChIP-seq) is a powerful method that identifies protein-DNA binding sites in vivo. Recent studies have illustrated the value of ChIP-seq in studying transcription factor binding in various bacterial species under a variety of growth conditions. These results show that in addition to identifying binding sites, correlation of ChIP-seq data with expression data can reveal important information about bacterial regulons and regulatory networks. In this chapter, we provide an overview of the current state of knowledge about ChIP-seq methodology in bacteria, from sample preparation to raw data analysis. We also describe visualization and various bioinformatic analyses of processed ChIP-seq data. PMID:26032817

  19. Computational methodology for ChIP-seq analysis

    Science.gov (United States)

    Shin, Hyunjin; Liu, Tao; Duan, Xikun; Zhang, Yong; Liu, X. Shirley

    2015-01-01

    Chromatin immunoprecipitation coupled with massive parallel sequencing (ChIP-seq) is a powerful technology to identify the genome-wide locations of DNA binding proteins such as transcription factors or modified histones. As more and more experimental laboratories are adopting ChIP-seq to unravel the transcriptional and epigenetic regulatory mechanisms, computational analyses of ChIP-seq also become increasingly comprehensive and sophisticated. In this article, we review current computational methodology for ChIP-seq analysis, recommend useful algorithms and workflows, and introduce quality control measures at different analytical steps. We also discuss how ChIP-seq could be integrated with other types of genomic assays, such as gene expression profiling and genome-wide association studies, to provide a more comprehensive view of gene regulatory mechanisms in important physiological and pathological processes. PMID:25741452

  20. Prognostic biomarkers in osteoarthritis

    Science.gov (United States)

    Attur, Mukundan; Krasnokutsky-Samuels, Svetlana; Samuels, Jonathan; Abramson, Steven B.

    2013-01-01

    Purpose of review Identification of patients at risk for incident disease or disease progression in osteoarthritis remains challenging, as radiography is an insensitive reflection of molecular changes that presage cartilage and bone abnormalities. Thus there is a widely appreciated need for biochemical and imaging biomarkers. We describe recent developments with such biomarkers to identify osteoarthritis patients who are at risk for disease progression. Recent findings The biochemical markers currently under evaluation include anabolic, catabolic, and inflammatory molecules representing diverse biological pathways. A few promising cartilage and bone degradation and synthesis biomarkers are in various stages of development, awaiting further validation in larger populations. A number of studies have shown elevated expression levels of inflammatory biomarkers, both locally (synovial fluid) and systemically (serum and plasma). These chemical biomarkers are under evaluation in combination with imaging biomarkers to predict early onset and the burden of disease. Summary Prognostic biomarkers may be used in clinical knee osteoarthritis to identify subgroups in whom the disease progresses at different rates. This could facilitate our understanding of the pathogenesis and allow us to differentiate phenotypes within a heterogeneous knee osteoarthritis population. Ultimately, such findings may help facilitate the development of disease-modifying osteoarthritis drugs (DMOADs). PMID:23169101

  1. A risk score for predicting mortality in patients with asymptomatic mild to moderate aortic stenosis

    DEFF Research Database (Denmark)

    Holme, Ingar; Pedersen, Terje R; Boman, Kurt

    2012-01-01

    BackgroundPrognostic information for asymptomatic patients with aortic stenosis (AS) from prospective studies is scarce and there is no risk score available to assess mortality.ObjectivesTo develop an easily calculable score, from which clinicians could stratify patients into high and lower risk ...... of mortality, using data from the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study.MethodA search for significant prognostic factors (p...

  2. Anti-angiogenic activity of inositol hexaphosphate (IP6).

    Science.gov (United States)

    Vucenik, Ivana; Passaniti, Antonino; Vitolo, Michele I; Tantivejkul, Kwanchanit; Eggleton, Paul; Shamsuddin, Abulkalam M

    2004-11-01

    A significant anticancer activity of the naturally occurring carbohydrate inositol hexaphosphate (IP(6)) has been reported against numerous cancer models. Since tumors require angiogenesis for growth and metastasis, we hypothesize that IP(6) reduces tumor growth by inhibiting angiogenesis. Because angiogenesis depends on the interaction between endothelial and tumor cells, we investigated the effect of IP(6) on both. IP(6) inhibited the proliferation and induced the differentiation of endothelial cells in vitro; the growth of bovine aortic endothelial cells (BAECs) evaluated by MTT proliferation assay was inhibited in a dose-dependent manner (IC(50) = 0.74 mM). The combination of IP(6) and vasostatin, a calreticulin fragment with anti-angiogenic activity, was synergistically superior in growth inhibition than either compound. IP(6) inhibited human umbilical vein endothelial cell (HUVEC) tube formation (in vitro capillary differentiation) on a reconstituted extracellular matrix, Matrigel, and disrupted pre-formed tubes. IP(6) significantly reduced basic fibroblast growth factor (bFGF)-induced vessel formation (P < 0.01) in vivo in Matrigel plug assay. Exposure of HepG2, a human hepatoma cell line, to IP(6) for 8 h, resulted in a dose-dependent decrease in the mRNA levels of vascular endothelial growth factor (VEGF), as assessed by RT-PCR. IP(6) treatment of HepG2 cells for 24 h also significantly reduced the VEGF protein levels in conditioned medium, in a concentration-dependent manner (P = 0.012). Thus, IP(6) has an inhibitory effect on induced angiogenesis.

  3. A highly efficient and effective motif discovery method for ChIP-seq/ChIP-chip data using positional information.

    Science.gov (United States)

    Ma, Xiaotu; Kulkarni, Ashwinikumar; Zhang, Zhihua; Xuan, Zhenyu; Serfling, Robert; Zhang, Michael Q

    2012-04-01

    Identification of DNA motifs from ChIP-seq/ChIP-chip [chromatin immunoprecipitation (ChIP)] data is a powerful method for understanding the transcriptional regulatory network. However, most established methods are designed for small sample sizes and are inefficient for ChIP data. Here we propose a new k-mer occurrence model to reflect the fact that functional DNA k-mers often cluster around ChIP peak summits. With this model, we introduced a new measure to discover functional k-mers. Using simulation, we demonstrated that our method is more robust against noises in ChIP data than available methods. A novel word clustering method is also implemented to group similar k-mers into position weight matrices (PWMs). Our method was applied to a diverse set of ChIP experiments to demonstrate its high sensitivity and specificity. Importantly, our method is much faster than several other methods for large sample sizes. Thus, we have developed an efficient and effective motif discovery method for ChIP experiments.

  4. Inositol hexakisphosphate (IP6) generated by IP5K mediates cullin-COP9 signalosome interactions and CRL function.

    Science.gov (United States)

    Scherer, Paul C; Ding, Yan; Liu, Zhiqing; Xu, Jing; Mao, Haibin; Barrow, James C; Wei, Ning; Zheng, Ning; Snyder, Solomon H; Rao, Feng

    2016-03-29

    The family of cullin-RING E3 Ligases (CRLs) and the constitutive photomorphogenesis 9 (COP9) signalosome (CSN) form dynamic complexes that mediate ubiquitylation of 20% of the proteome, yet regulation of their assembly/disassembly remains poorly understood. Inositol polyphosphates are highly conserved signaling molecules implicated in diverse cellular processes. We now report that inositol hexakisphosphate (IP6) is a major physiologic determinant of the CRL-CSN interface, which includes a hitherto unidentified electrostatic interaction between the N-terminal acidic tail of CSN subunit 2 (CSN2) and a conserved basic canyon on cullins. IP6, with an EC50 of 20 nM, acts as an intermolecular "glue," increasing cullin-CSN2 binding affinity by 30-fold, thereby promoting assembly of the inactive CRL-CSN complexes. The IP6 synthase, Ins(1,3,4,5,6)P5 2-kinase (IPPK/IP5K) binds to cullins. Depleting IP5K increases the percentage of neddylated, active Cul1 and Cul4A, and decreases levels of the Cul1/4A substrates p27 and p21. Besides dysregulating CRL-mediated cell proliferation and UV-induced apoptosis, IP5K depletion potentiates by 28-fold the cytotoxic effect of the neddylation inhibitor MLN4924. Thus, IP5K and IP6 are evolutionarily conserved components of the CRL-CSN system and are potential targets for cancer therapy in conjunction with MLN4924.

  5. Attributes associated with probability of infestation by the pinon Ips, Ips confusus, (Coleoptera: Scolytidae) in pinon pine, Pinus edulis

    Science.gov (United States)

    Jose F. Negron; Jill L. Wilson

    2008-01-01

    (Please note, this is an abstract only) We examined attributes associated with the probability of infestation by pinon ips (Ips confusus), in pinon pine (Pinus edulis), in an outbreak in the Coconino National Forest, Arizona. We used data collected from 87 plots, 59 infested and 28 uninfested, and a logistic regression approach to estimate the probability of...

  6. Surgical apgar score predicts early complication in transfemoral amputees

    DEFF Research Database (Denmark)

    Wied, Christian; Foss, Nicolai Bang; Kristensen, Morten T

    2016-01-01

    AIM: To assess whether the surgical apgar score (SAS) is a prognostic tool capable of identifying patients at risk of major complications following lower extremity amputations surgery. METHODS: This was a single-center, retrospective observational cohort study conducted between January 2013 and A...

  7. Pavement scores synthesis.

    Science.gov (United States)

    2009-02-01

    The purpose of this synthesis was to summarize the use of pavement scores by the states, including the : rating methods used, the score scales, and descriptions; if the scores are used for recommending pavement : maintenance and rehabilitation action...

  8. An IP-10 (CXCL10)-Derived Peptide Inhibits Angiogenesis

    Science.gov (United States)

    Yates-Binder, Cecelia C.; Rodgers, Margaret; Jaynes, Jesse; Wells, Alan; Bodnar, Richard J.; Turner, Timothy

    2012-01-01

    Angiogenesis plays a critical role in processes such as organ development, wound healing, and tumor growth. It requires well-orchestrated integration of soluble and matrix factors and timely recognition of such signals to regulate this process. Previous work has shown that newly forming vessels express the chemokine receptor CXC receptor 3 (CXCR3) and, activation by its ligand IP-10 (CXCL10), both inhibits development of new vasculature and causes regression of newly formed vessels. To identify and develop new therapeutic agents to limit or reverse pathological angiogenesis, we identified a 21 amino acid fragment of IP-10, spanning the α-helical domain residues 77–98, that mimic the actions of the whole IP-10 molecule on endothelial cells. Treatment of the endothelial cells with the 22 amino acid fragment referred to as IP-10p significantly inhibited VEGF-induced endothelial motility and tube formation in vitro, properties critical for angiogenesis. Using a Matrigel plug assay in vivo, we demonstrate that IP-10p both prevented vessel formation and induced involution of nascent vessels. CXCR3 neutralizing antibody was able to block the inhibitory effects of the IP-10p, demonstrating specificity of the peptide. Inhibition of endothelial function by IP-10p was similar to that described for IP-10, secondary to CXCR3-mediated increase in cAMP production, activation of PKA inhibiting cell migration, and inhibition of VEGF-mediated m-calpain activation. IP-10p provides a novel therapeutic agent that inhibits endothelial cell function thus, allowing for the modulation of angiogenesis. PMID:22815829

  9. Inositol hexaphosphate (IP6) inhibits cellular proliferation in melanoma.

    Science.gov (United States)

    Rizvi, Irfan; Riggs, Dale R; Jackson, Barbara J; Ng, Alex; Cunningham, Cynthia; McFadden, David W

    2006-06-01

    Inositol Hexaphosphate (IP6) is a naturally occurring polyphosphorylated carbohydrate found in food sources high in fiber content. We have previously reported IP6 to have significant inhibitory effects against pancreatic cancer in vitro. We hypothesized that the IP6 would significantly inhibit cell growth of cutaneous melanoma in vitro. The melanoma line HTB68 was cultured using standard techniques and treated with IP6 at doses ranging from 0.2 to 1.0 mM/well. Cell viability was measured by MTT at 72 h. VEGF production was measured in the cell supernatants by ELISA. Apoptosis was evaluated by Annexin V-FITC and results calculated using FACS analysis. Statistical analysis was performed by ANOVA. Significant reductions (P < 0.001) in cellular proliferation were observed with IP6. Overall, IP6 exhibited a mean inhibition of cell growth of 52.1 +/- 11.5% (range, 1.6-83.0%) at 72 h of incubation. VEGF production was significantly reduced (P < 0.001) by the addition of IP6 (7.5 pg/ml) compared to control (40.9 pg/ml). IP6 significantly increased (P = 0.029) late apoptosis from 5.3 to 7.0% gated events. No changes in necrosis or early apoptosis were observed. Adjuvant treatment of melanoma continues to challenge clinicians and patients. Our findings that IP6 significantly decreased cellular growth, VEGF production and increased late apoptosis in melanoma suggest its potential therapeutic value. Further in vivo studies are planned to evaluate safety and clinical utility of this agent.

  10. Protecting LHC IP1/IP5 Components Against Radiation Resulting from Colliding Beam Interactions

    CERN Document Server

    Mokhov, N V; Kerby, J S; Strait, J B

    2003-01-01

    Beam-induced energy deposition in the LHC high luminosity interaction region (IR) components due to both pp collisions and beam loss in the IR vicinity is a significant challenge for the design of the high luminosity insertions. It was shown in our previous studies that a set of absorbers would reduce both the peak power density and total heat load to tolerable levels. In this paper the results of further optimization and comprehensive MARS calculations are summarized for the LHC lattice, version 6.4, for the updated IP1 and IP5 layouts and a baseline pp-collision source term. Power density, power dissipation, particle fluxes and spectra, accumulated dose and residual dose rates are studied in the components of the inner triplets including their TAS absorbers, the TAN neutral beam absorbers, separation dipoles, and quadrupoles of the outer triplets and possible collimators there. Results are given for the nominal luminosity of 1034 cm-2 s-1. The current design is proved to provide the best safety margin under...

  11. On the Cryptographic Features of a VoIP Service

    Directory of Open Access Journals (Sweden)

    Dimitrios Alvanos

    2018-01-01

    Full Text Available Security issues of typical Voice over Internet Protocol (VoIP applications are studied in this paper; in particular, the open source Linphone application is being used as a case study. An experimental analysis indicates that protecting signalling data with the TLS protocol, which unfortunately is not always the default option, is needed to alleviate several security concerns. Moreover, towards improving security, it is shown that a VoIP application may operate over a virtual private network without significantly degrading the overall performance. The conclusions of this study provide useful insights to the usage of any VoIP application.

  12. Lessons from Korea Telecom's VoIP testbed

    Science.gov (United States)

    Lee, Ki Jong; Yang, Junhwan; Kim, Dongkweon

    2001-07-01

    This paper describers the results and lessons from the voice over IP trial service on the Korea Telecom's VoIP Testbed. The testbed was made up of four different vendors' systems and solutions constituted four separate zones. Even though the backbone network of the testbed was not commercial IP network, we could comprehend some engineering parameters essential to packetized voice QoS. And we got some know-how. These kinds of results will be much help to traditional telco confronted with many difficult issues especially on packet voice network.

  13. Actuator development for the Instrument Pointing System (IPS)

    Science.gov (United States)

    Suttner, K.

    1984-01-01

    The mechanisms of the instrument pointing system (IPS) are described. Particular emphasis is placed on the actuators which are necessary for operating the IPS. The actuators are described as follows: (1) two linear actuators that clamp the gimbals down during ascent and descent; (2) two linear actuators that attach the payload to the IPS during the mission, and release it into the payload clamps; (3) one rotational actuator that opens and closes the payload clamps; and (4) three identical drive units that represent the three orthogonal gimbal axes and are the prime movers for pointing. Design features, manufacturing problems, test performance, and results are presented.

  14. A Novel Smart Meter Controlling System with Dynamic IP Addresses

    DEFF Research Database (Denmark)

    Manembu, Pinrolinvic; Welang, Brammy; Kalua Lapu, Aditya

    2017-01-01

    Smart meters are the electronic devices for measuring energy consumption in real time. Usually, static public IP addresses are allocated to realize the point-to-point (P2P) communication and remote controlling for smart metering systems. This, however, restricts the wide deployment of smart meters......, due to the deficiency of public IP resources. This paper proposes a novel subscription-based communication architecture for the support of dynamic IP addresses and group controlling of smart meters. The paper evaluates the proposed architecture by comparing the traditional P2P architecture...

  15. Application of Mobile-ip to Space and Aeronautical Networks

    Science.gov (United States)

    Leung, Kent; Shell, Dan; Ivancic, William D.; Stewart, David H.; Bell, Terry L.; Kachmar, Brian A.

    2001-01-01

    The National Aeronautics and Space Administration (NASA) is interested in applying mobile Internet protocol (mobile-ip) technologies to its space and aeronautics programs. In particular, mobile-ip will play a major role in the Advanced Aeronautic Transportation Technology (AAT-F), the Weather Information Communication (WINCOMM), and the Small Aircraft Transportation System (SATS) aeronautics programs. This paper describes mobile-ip and mobile routers--in particular, the features, capabilities, and initial performance of the mobile router are presented. The application of mobile-router technology to NASA's space and aeronautics programs is also discussed.

  16. Optimizing Low Speed VoIP Network for Rural Next Generation Network (R-NGN

    Directory of Open Access Journals (Sweden)

    Yoanes Bandung

    2007-11-01

    Full Text Available In this research, we propose an optimization method based-on E-Model for designing an efficient low speed VoIP network for Rural Next Generation Network (R-NGN. We are choosing 128 kbps and 256 kbps bandwidth as the typical community link to be used in the designing of R-NGN infrastructure. The method is based on selection of some VoIP network parameters such as voice coder, communication protocol, packet loss level, network utilization and resource allocation. We draw analytic approach for achieving rating value (R of E-model that represent level of quality of service. In this approach, we focus on delay and packet loss calculation to find the rating value. We state the rating value = 70 as minimum level of quality of service for each call, equivalent to 3.6 of Mean Opinion Score (MOS. In our experiments, either G.723.1 5.3 kbps or G.729 is chosen for maximizing the number of VoIP calls, it depends on link utilization and level of packet loss.

  17. Reliable Mobile IP Multicast Based on Hierarchical Local Registration

    National Research Council Canada - National Science Library

    Huanming Zhang; Quanlong Guan; Zi Zhao Zhu; Weiqi Luo

    2014-01-01

    .... In order to resolve the problems of multicast reliability in wireless networks, a framework architecture of the mobile IP multicast is proposed, which is a reliable multicast architecture based...

  18. Telemetry Transmission over Internet Protocol (TMoIP) Standard

    Science.gov (United States)

    2010-10-01

    which might go to network-critical traffic such as Routing Information Protocol (RIP) and Open Shortest Path First ( OSPF ) table updates. Values five and...Protocol (TMoIP), RCC Standard 218-10, October 2010 B-4 OSPF Open Shortest Path First: a protocol used by IP routers to determine most efficient paths...for traffic. It is generally acknowledged that OSPF is superior to and the successor to Routing Information Protocol (RIP). packet A formatted

  19. Mathematical Representation of VoIP Connection Delay

    Directory of Open Access Journals (Sweden)

    M. Halas

    2007-09-01

    Full Text Available The main topic of this article is to define mathematical formulation of VoIP connection delay model. It handles about all partial delay components, the mechanism of their generation, facilities and their mathematical formulation. Thereafter based on mathematical formulation of all partial delay components, the final mathematical model of whole VoIP call delay is created. In conclusion of this article the results of the designed mathematical model are compared with the experimentally gained results.

  20. Validation of the Essen Stroke Risk Score and the Stroke Prognosis Instrument II in Chinese patients.

    Science.gov (United States)

    Meng, Xia; Wang, Yilong; Zhao, Xingquan; Wang, Chunxue; Li, Hao; Liu, Liping; Zhou, Yong; Xu, Jie; Wang, Yongjun

    2011-12-01

    Little was known about the predictive accuracy of the Essen Stroke Risk Score and the Stroke Prognostic Instrument II in Chinese patients with stroke. We evaluated the predictive accuracy of both Essen Stroke Risk Score and Stroke Prognostic Instrument II scores for both recurrent stroke and combined vascular events using data from a prospective cohort of 11 384 patients with acute ischemic stroke and transient ischemic attack admitted to 132 urban hospitals throughout China. The cumulative 1-year event rates were 16% (95% CI, 15%-16%) for recurrent stroke and 18% (95% CI, 18%-19%) for combined vascular events. Both event rates were significantly higher in patients with transient ischemic attack and increased significantly from lower to higher Essen Stroke Risk Score and Stroke Prognostic Instrument II categories. Essen Stroke Risk Score and Stroke Prognostic Instrument II had similar predictive accuracies for each study outcome. In Chinese patients with ischemic stroke or transient ischemic attack, both Essen Stroke Risk Score and Stroke Prognostic Instrument II scores are equally able to stratify the risk of recurrent stroke and combined vascular events.

  1. A Generic Software Architecture For Prognostics

    Science.gov (United States)

    Teubert, Christopher; Daigle, Matthew J.; Sankararaman, Shankar; Goebel, Kai; Watkins, Jason

    2017-01-01

    Prognostics is a systems engineering discipline focused on predicting end-of-life of components and systems. As a relatively new and emerging technology, there are few fielded implementations of prognostics, due in part to practitioners perceiving a large hurdle in developing the models, algorithms, architecture, and integration pieces. As a result, no open software frameworks for applying prognostics currently exist. This paper introduces the Generic Software Architecture for Prognostics (GSAP), an open-source, cross-platform, object-oriented software framework and support library for creating prognostics applications. GSAP was designed to make prognostics more accessible and enable faster adoption and implementation by industry, by reducing the effort and investment required to develop, test, and deploy prognostics. This paper describes the requirements, design, and testing of GSAP. Additionally, a detailed case study involving battery prognostics demonstrates its use.

  2. Distributed Prognostics Based on Structural Model Decomposition

    Data.gov (United States)

    National Aeronautics and Space Administration — Within systems health management, prognostics focuses on predicting the remaining useful life of a system. In the model-based prognostics paradigm, physics-based...

  3. CATCHprofiles: Clustering and Alignment Tool for ChIP Profiles

    DEFF Research Database (Denmark)

    G. G. Nielsen, Fiona; Galschiøt Markus, Kasper; Møllegaard Friborg, Rune

    2012-01-01

    Chromatin Immuno Precipitation (ChIP) profiling detects in vivo protein-DNA binding, and has revealed a large combinatorial complexity in the binding of chromatin associated proteins and their post-translational modifications. To fully explore the spatial and combinatorial patterns in ChIP-profil......Chromatin Immuno Precipitation (ChIP) profiling detects in vivo protein-DNA binding, and has revealed a large combinatorial complexity in the binding of chromatin associated proteins and their post-translational modifications. To fully explore the spatial and combinatorial patterns in Ch......IP-profiling data and detect potentially meaningful patterns, the areas of enrichment must be aligned and clustered, which is an algorithmically and computationally challenging task. We have developed CATCHprofiles, a novel tool for exhaustive pattern detection in ChIP profiling data. CATCHprofiles is built upon...... a computationally efficient implementation for the exhaustive alignment and hierarchical clustering of ChIP profiling data. The tool features a graphical interface for examination and browsing of the clustering results. CATCHprofiles requires no prior knowledge about functional sites, detects known binding patterns...

  4. IP voice over ATM satellite: experimental results over satellite channels

    Science.gov (United States)

    Saraf, Koroush A.; Butts, Norman P.

    1999-01-01

    IP telephony, a new technology to provide voice communication over traditional data networks, has the potential to revolutionize telephone communication within the modern enterprise. This innovation uses packetization techniques to carry voice conversations over IP networks. This packet switched technology promises new integrated services, and lower cost long-distance communication compared to traditional circuit switched telephone networks. Future satellites will need to carry IP traffic efficiently in order to stay competitive in servicing the global data- networking and global telephony infrastructure. However, the effects of Voice over IP over switched satellite channels have not been investigated in detail. To fully understand the effects of satellite channels on Voice over IP quality; several experiments were conducted at Lockheed Martin Telecommunications' Satellite Integration Lab. The result of those experiments along with suggested improvements for voice communication over satellite are presented in this document. First, a detailed introduction of IP telephony as a suitable technology for voice communication over future satellites is presented. This is followed by procedures for the experiments, along with results and strategies. In conclusion we hope that these capability demonstrations will alleviate any uncertainty regarding the applicability of this technology to satellite networks.

  5. Homogeneous datasets of triple negative breast cancers enable the identification of novel prognostic and predictive signatures.

    Directory of Open Access Journals (Sweden)

    Thomas Karn

    Full Text Available BACKGROUND: Current prognostic gene signatures for breast cancer mainly reflect proliferation status and have limited value in triple-negative (TNBC cancers. The identification of prognostic signatures from TNBC cohorts was limited in the past due to small sample sizes. METHODOLOGY/PRINCIPAL FINDINGS: We assembled all currently publically available TNBC gene expression datasets generated on Affymetrix gene chips. Inter-laboratory variation was minimized by filtering methods for both samples and genes. Supervised analysis was performed to identify prognostic signatures from 394 cases which were subsequently tested on an independent validation cohort (n = 261 cases. CONCLUSIONS/SIGNIFICANCE: Using two distinct false discovery rate thresholds, 25% and <3.5%, a larger (n = 264 probesets and a smaller (n = 26 probesets prognostic gene sets were identified and used as prognostic predictors. Most of these genes were positively associated with poor prognosis and correlated to metagenes for inflammation and angiogenesis. No correlation to other previously published prognostic signatures (recurrence score, genomic grade index, 70-gene signature, wound response signature, 7-gene immune response module, stroma derived prognostic predictor, and a medullary like signature was observed. In multivariate analyses in the validation cohort the two signatures showed hazard ratios of 4.03 (95% confidence interval [CI] 1.71-9.48; P = 0.001 and 4.08 (95% CI 1.79-9.28; P = 0.001, respectively. The 10-year event-free survival was 70% for the good risk and 20% for the high risk group. The 26-gene signatures had modest predictive value (AUC = 0.588 to predict response to neoadjuvant chemotherapy, however, the combination of a B-cell metagene with the prognostic signatures increased its response predictive value. We identified a 264-gene prognostic signature for TNBC which is unrelated to previously known prognostic signatures.

  6. IP6K gene identification in plant genomes by tag searching

    OpenAIRE

    Fassetti, Fabio; Leone, Ofelia; Palopoli, Luigi; Rombo, Simona E.; Saiardi, Adolfo

    2011-01-01

    Background Plants have played a special role in inositol polyphosphate (IP) research since in plant seeds was discovered the first IP, the fully phosphorylated inositol ring of phytic acid (IP6). It is now known that phytic acid is further metabolized by the IP6 Kinases (IP6Ks) to generate IP containing pyro-phosphate moiety. The IP6K are evolutionary conserved enzymes identified in several mammalian, fungi and amoebae species. Although IP6K has not yet been identified in plant chromosomes, t...

  7. Molecular Classification Substitutes for the Prognostic Variables Stage, Age, and MYCN Status in Neuroblastoma Risk Assessment

    Directory of Open Access Journals (Sweden)

    Carolina Rosswog

    2017-12-01

    Full Text Available BACKGROUND: Current risk stratification systems for neuroblastoma patients consider clinical, histopathological, and genetic variables, and additional prognostic markers have been proposed in recent years. We here sought to select highly informative covariates in a multistep strategy based on consecutive Cox regression models, resulting in a risk score that integrates hazard ratios of prognostic variables. METHODS: A cohort of 695 neuroblastoma patients was divided into a discovery set (n = 75 for multigene predictor generation, a training set (n = 411 for risk score development, and a validation set (n = 209. Relevant prognostic variables were identified by stepwise multivariable L1-penalized least absolute shrinkage and selection operator (LASSO Cox regression, followed by backward selection in multivariable Cox regression, and then integrated into a novel risk score. RESULTS: The variables stage, age, MYCN status, and two multigene predictors, NB-th24 and NB-th44, were selected as independent prognostic markers by LASSO Cox regression analysis. Following backward selection, only the multigene predictors were retained in the final model. Integration of these classifiers in a risk scoring system distinguished three patient subgroups that differed substantially in their outcome. The scoring system discriminated patients with diverging outcome in the validation cohort (5-year event-free survival, 84.9 ± 3.4 vs 63.6 ± 14.5 vs 31.0 ± 5.4; P < .001, and its prognostic value was validated by multivariable analysis. CONCLUSION: We here propose a translational strategy for developing risk assessment systems based on hazard ratios of relevant prognostic variables. Our final neuroblastoma risk score comprised two multigene predictors only, supporting the notion that molecular properties of the tumor cells strongly impact clinical courses of neuroblastoma patients.

  8. Melanoma prognostic model using tissue microarrays and genetic algorithms.

    Science.gov (United States)

    Gould Rothberg, Bonnie E; Berger, Aaron J; Molinaro, Annette M; Subtil, Antonio; Krauthammer, Michael O; Camp, Robert L; Bradley, William R; Ariyan, Stephan; Kluger, Harriet M; Rimm, David L

    2009-12-01

    As a result of the questionable risk-to-benefit ratio of adjuvant therapies, stage II melanoma is currently managed by observation because available clinicopathologic parameters cannot identify the 20% to 60% of such patients likely to develop metastatic disease. Here, we propose a multimarker molecular prognostic assay that can help triage patients at increased risk of recurrence. Protein expression for 38 candidates relevant to melanoma oncogenesis was evaluated using the automated quantitative analysis (AQUA) method for immunofluorescence-based immunohistochemistry in formalin-fixed, paraffin-embedded specimens from a cohort of 192 primary melanomas collected during 1959 to 1994. The prognostic assay was built using a genetic algorithm and validated on an independent cohort of 246 serial primary melanomas collected from 1997 to 2004. Multiple iterations of the genetic algorithm yielded a consistent five-marker solution. A favorable prognosis was predicted by ATF2 ln(non-nuclear/nuclear AQUA score ratio) of more than -0.052, p21(WAF1) nuclear compartment AQUA score of more than 12.98, p16(INK4A) ln(non-nuclear/nuclear AQUA score ratio) of < or = -0.083, beta-catenin total AQUA score of more than 38.68, and fibronectin total AQUA score of < or = 57.93. Primary tumors that met at least four of these five conditions were considered a low-risk group, and those that met three or fewer conditions formed a high-risk group (log-rank P < .0001). Multivariable proportional hazards analysis adjusting for clinicopathologic parameters shows that the high-risk group has significantly reduced survival on both the discovery (hazard ratio = 2.84; 95% CI, 1.46 to 5.49; P = .002) and validation (hazard ratio = 2.72; 95% CI, 1.12 to 6.58; P = .027) cohorts. This multimarker prognostic assay, an independent determinant of melanoma survival, might be beneficial in improving the selection of stage II patients for adjuvant therapy.

  9. Inositol hexakisphosphate (IP6) generated by IP5K mediates cullin-COP9 signalosome interactions and CRL function

    National Research Council Canada - National Science Library

    Paul C. Scherer; Yan Ding; Zhiqing Liu; Jing Xu; Haibin Mao; James C. Barrow; Ning Wei; Ning Zheng; Solomon H. Snyder; Feng Rao

    2016-01-01

    .... We now report that inositol hexakisphosphate (IP6) is a major physiologic determinant of the CRL-CSN interface, which includes a hitherto unidentified electrostatic interaction between the N-terminal acidic tail of CSN subunit 2 (CSN2...

  10. Long-term prognostic value of the combination of EORTC risk group calculator and molecular markers in non-muscle-invasive bladder cancer patients treated with intravesical Bacille Calmette-Guérin

    Directory of Open Access Journals (Sweden)

    Sultan S Alkhateeb

    2011-01-01

    Conclusion: Molecular markers have a long-term prognostic value when combined with EORTC scoring system and they may be used to improve the predictive accuracy of currently existing scoring system. Larger series are needed to confirm these findings.

  11. Malignant cord compression: A critical appraisal of prognostic factors predicting functional outcome after surgical treatment

    Directory of Open Access Journals (Sweden)

    Cornelia Putz

    2010-01-01

    Full Text Available Objectives: Advanced tumor disease and metastatic spinal cord compression (MSCC are two entities with a high impact on patients′ quality of life. However, prognostic factors on the outcome after primary decompressive surgery are less well-defined and not yet standardized. The aim of this review was to identify prognostic variables that predict functional or ambulatory outcomes in surgically treated patients with symptomatic MSCC. Materials and Methods: We conducted MEDLINE database searches using relevant keywords in order to identify abstracts referring to prognostic factors on ambulatory outcomes in surgically treated MSCC patients. Details of all selected articles were assembled and the rates of ambulation were stratified. Results: Evidence from five retrospective comparative trials and one observational prospective study summarizes different prognostic factors with a positive or negative influence on postoperative ambulatory status. Ambulatory patients maintaining ambulation status after decompression of the spinal cord constituted 62.1%. The overall rate of MSCC patients losing the ability to ambulate was 7.5% compared to 23.5 % who regained ambulation. Preoperative ambulation status, time to surgery, compression fracture and individual health status seem to be the most relevant prognostic factors for ambulatory outcome. Conclusions: There is a lack of standardized prognostic tools which allow predicting outcome in surgically treated patients. A quantitative score consisting of reliable prognostic tools is essential to predict loss and/or regain of ambulation and requires validation in future prospective clinical trials.

  12. Cytogenetic Prognostication Within Medulloblastoma Subgroups

    Science.gov (United States)

    Shih, David J.H.; Northcott, Paul A.; Remke, Marc; Korshunov, Andrey; Ramaswamy, Vijay; Kool, Marcel; Luu, Betty; Yao, Yuan; Wang, Xin; Dubuc, Adrian M.; Garzia, Livia; Peacock, John; Mack, Stephen C.; Wu, Xiaochong; Rolider, Adi; Morrissy, A. Sorana; Cavalli, Florence M.G.; Jones, David T.W.; Zitterbart, Karel; Faria, Claudia C.; Schüller, Ulrich; Kren, Leos; Kumabe, Toshihiro; Tominaga, Teiji; Shin Ra, Young; Garami, Miklós; Hauser, Peter; Chan, Jennifer A.; Robinson, Shenandoah; Bognár, László; Klekner, Almos; Saad, Ali G.; Liau, Linda M.; Albrecht, Steffen; Fontebasso, Adam; Cinalli, Giuseppe; De Antonellis, Pasqualino; Zollo, Massimo; Cooper, Michael K.; Thompson, Reid C.; Bailey, Simon; Lindsey, Janet C.; Di Rocco, Concezio; Massimi, Luca; Michiels, Erna M.C.; Scherer, Stephen W.; Phillips, Joanna J.; Gupta, Nalin; Fan, Xing; Muraszko, Karin M.; Vibhakar, Rajeev; Eberhart, Charles G.; Fouladi, Maryam; Lach, Boleslaw; Jung, Shin; Wechsler-Reya, Robert J.; Fèvre-Montange, Michelle; Jouvet, Anne; Jabado, Nada; Pollack, Ian F.; Weiss, William A.; Lee, Ji-Yeoun; Cho, Byung-Kyu; Kim, Seung-Ki; Wang, Kyu-Chang; Leonard, Jeffrey R.; Rubin, Joshua B.; de Torres, Carmen; Lavarino, Cinzia; Mora, Jaume; Cho, Yoon-Jae; Tabori, Uri; Olson, James M.; Gajjar, Amar; Packer, Roger J.; Rutkowski, Stefan; Pomeroy, Scott L.; French, Pim J.; Kloosterhof, Nanne K.; Kros, Johan M.; Van Meir, Erwin G.; Clifford, Steven C.; Bourdeaut, Franck; Delattre, Olivier; Doz, François F.; Hawkins, Cynthia E.; Malkin, David; Grajkowska, Wieslawa A.; Perek-Polnik, Marta; Bouffet, Eric; Rutka, James T.; Pfister, Stefan M.; Taylor, Michael D.

    2014-01-01

    Purpose Medulloblastoma comprises four distinct molecular subgroups: WNT, SHH, Group 3, and Group 4. Current medulloblastoma protocols stratify patients based on clinical features: patient age, metastatic stage, extent of resection, and histologic variant. Stark prognostic and genetic differences among the four subgroups suggest that subgroup-specific molecular biomarkers could improve patient prognostication. Patients and Methods Molecular biomarkers were identified from a discovery set of 673 medulloblastomas from 43 cities around the world. Combined risk stratification models were designed based on clinical and cytogenetic biomarkers identified by multivariable Cox proportional hazards analyses. Identified biomarkers were tested using fluorescent in situ hybridization (FISH) on a nonoverlapping medulloblastoma tissue microarray (n = 453), with subsequent validation of the risk stratification models. Results Subgroup information improves the predictive accuracy of a multivariable survival model compared with clinical biomarkers alone. Most previously published cytogenetic biomarkers are only prognostic within a single medulloblastoma subgroup. Profiling six FISH biomarkers (GLI2, MYC, chromosome 11 [chr11], chr14, 17p, and 17q) on formalin-fixed paraffin-embedded tissues, we can reliably and reproducibly identify very low-risk and very high-risk patients within SHH, Group 3, and Group 4 medulloblastomas. Conclusion Combining subgroup and cytogenetic biomarkers with established clinical biomarkers substantially improves patient prognostication, even in the context of heterogeneous clinical therapies. The prognostic significance of most molecular biomarkers is restricted to a specific subgroup. We have identified a small panel of cytogenetic biomarkers that reliably identifies very high-risk and very low-risk groups of patients, making it an excellent tool for selecting patients for therapy intensification and therapy de-escalation in future clinical trials. PMID

  13. The prognostic value of copeptin in patients with acute chest pain.

    Science.gov (United States)

    Marston, Nicholas A; Maisel, Alan S

    2014-10-01

    The prognostic value of copeptin in acute chest pain is an area of rapid growth and research interest. Copeptin has already established a role in early diagnosis and rule out of acute myocardial infarction, but as its use increases much of the attention has been directed at the prognostic value of copeptin. This article reviews the growing body of evidence supporting the use of copeptin to further risk-stratify chest pain patients. The studies included address a variety of populations ranging from all patients presenting with chest pain to those who are at high risk, diagnosed with acute coronary syndrome or found to have left ventricular dysfunction. Many of the studies compare and combine the prognostic value of copeptin with other prognostic markers such as troponin, brain natriuretic peptide and Global Registry of Acute Coronary Events scores. Caveats of copeptin are also discussed such as gender differences, cutoff points and the importance of timing in the copeptin assay.

  14. Validation of a prognostic index for Huntington's disease.

    Science.gov (United States)

    Long, Jeffrey D; Langbehn, Douglas R; Tabrizi, Sarah J; Landwehrmeyer, Bernhard G; Paulsen, Jane S; Warner, John; Sampaio, Cristina

    2017-02-01

    Characterizing progression in Huntington's disease is important for study the natural course and selecting appropriate participants for clinical trials. The aim was to develop a prognostic index for motor diagnosis in Huntington's disease and examine its predictive performance in external observational studies. The prediagnosis Neuro-biological Predictors of Huntington's Disease study (N = 945 gene-positive) was used to select a Cox regression model for computing a prognostic index. Cross-validation was used for selecting a model with good internal validity performance using the research sites as natural splits of the data set. Then, the external predictive performance was assessed using prediagnosis data from three additional observational studies, The Cooperative Huntington Observational Research Trial (N = 358), TRACK-HD (N = 118), and REGISTRY (N = 480). Model selection yielded a prognostic index computed as the weighted combination of the UHDRS total motor score, Symbol Digit Modalities Test, baseline age, and cytosine-adenine-guanine expansion. External predictive performance was very good for the first two of the three studies, with the third being a much more progressed cohort than the other studies. The databases were pooled and a final Cox regression model was estimated. The regression coefficients were scaled to produce the prognostic index for Huntington's disease, and a normed version, which is scaled relative to a 10-year 50% probability of motor diagnosis. The positive results of this comprehensive validity analysis provide evidence that the prognostic index is generally useful for predicting Huntington's disease progression in terms of risk of future motor diagnosis. The variables for the index are routinely collected in ongoing observational studies and the index can be used to identify cohorts for clinical trial recruitment. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

  15. The centriolar satellite protein SSX2IP promotes centrosome maturation.

    Science.gov (United States)

    Bärenz, Felix; Inoue, Daigo; Yokoyama, Hideki; Tegha-Dunghu, Justus; Freiss, Stephanie; Draeger, Stefanie; Mayilo, Dmytro; Cado, Ivana; Merker, Sabine; Klinger, Maren; Hoeckendorf, Burkhard; Pilz, Sahra; Hupfeld, Kerstin; Steinbeisser, Herbert; Lorenz, Holger; Ruppert, Thomas; Wittbrodt, Joachim; Gruss, Oliver J

    2013-07-08

    Meiotic maturation in vertebrate oocytes is an excellent model system for microtubule reorganization during M-phase spindle assembly. Here, we surveyed changes in the pattern of microtubule-interacting proteins upon Xenopus laevis oocyte maturation by quantitative proteomics. We identified the synovial sarcoma X breakpoint protein (SSX2IP) as a novel spindle protein. Using X. laevis egg extracts, we show that SSX2IP accumulated at spindle poles in a Dynein-dependent manner and interacted with the γ-tubulin ring complex (γ-TuRC) and the centriolar satellite protein PCM-1. Immunodepletion of SSX2IP impeded γ-TuRC loading onto centrosomes. This led to reduced microtubule nucleation and spindle assembly failure. In rapidly dividing blastomeres of medaka (Oryzias latipes) and in somatic cells, SSX2IP knockdown caused fragmentation of pericentriolar material and chromosome segregation errors. We characterize SSX2IP as a novel centrosome maturation and maintenance factor that is expressed at the onset of vertebrate development. It preserves centrosome integrity and faithful mitosis during the rapid cleavage division of blastomeres and in somatic cells.

  16. Security of IP Telephony in Ecuador: Online Analysis

    Directory of Open Access Journals (Sweden)

    José Estrada

    2016-06-01

    Full Text Available Telephony is a global service and thus telephone networks have been a coveted target for criminals. Now that voice can be transported over IP and that multiple services are integrated in a convergent model through Internet, there are more incentives to attack and more attackers. Moreover, the development of open source telephone applications has encouraged the massive use of IP telephony, but not an increased awareness about embedded security risks. Due to the current and intensive adoption of IP telephony systems in Ecuador, we conducted an exploration based on public information to obtain statistics about telephone systems connected to Internet in Ecuador. Additionally, using a deliberately vulnerable IP telephony system, we collected more data to do a preliminary analysis of threats to such systems. We found that hundreds of telephone systems were publicly available on the Internet and using outdated versions of Asterisk-based applications. We also found thousands of malicious interactions on the IP telephony system we deployed on the Internet.

  17. Scoring nail psoriasis

    NARCIS (Netherlands)

    Klaassen, K.M.G.; Kerkhof, P.C.M. van de; Bastiaens, M.T.; Plusje, L.G.; Baran, R.L.; Pasch, M.C.

    2014-01-01

    BACKGROUND: Scoring systems are indispensable in evaluating the severity of disease and monitoring treatment response. OBJECTIVE: We sought to evaluate the competence of various nail psoriasis severity scoring systems and to develop a new scoring system. METHODS: The authors conducted a prospective,

  18. Preterm birth and cerebral palsy. Predictive value of pregnancy complications, mode of delivery, and Apgar scores

    DEFF Research Database (Denmark)

    Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

    1997-01-01

    .01), and low Apgar scores at 1 minute (45% vs. 36%, p or = 3 (adjusted OR = 1.53 (95% CI 1.00-2.34), p Pregnancy...... complications preceding preterm birth did not imply a higher risk of cerebral palsy. Delivery by Cesarean section was a prognostic factor for developing cerebral palsy, and the predictive value of Apgar scores was highly limited....

  19. Preterm birth and cerebral palsy. Predictive value of pregnancy complications, mode of delivery, and Apgar scores

    DEFF Research Database (Denmark)

    Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

    1997-01-01

    .01), and low Apgar scores at 1 minute (45% vs. 36%, p or = 3 (adjusted OR = 1.53 (95% CI 1.00-2.34), p ... complications preceding preterm birth did not imply a higher risk of cerebral palsy. Delivery by Cesarean section was a prognostic factor for developing cerebral palsy, and the predictive value of Apgar scores was highly limited....

  20. APACHE III score is superior to King's College Hospital criteria, MELD score and APACHE II score to predict outcomes after liver transplantation for acute liver failure.

    Science.gov (United States)

    Fikatas, P; Lee, J-E; Sauer, I M; Schmidt, S C; Seehofer, D; Puhl, G; Guckelberger, O

    2013-01-01

    The Model for End-Stage Liver Disease score and King's College Hospital (KCH) criteria are accepted prognostic models acute liver failure (ALF), while the use of (APACHE) scores predict to outcomes of emergency liver transplantation is rare. The present study included 87 patients with ALF who underwent liver transplantation. We calculated (KCH) criteria, as well as MELD, APACHE II, and APACHE III scores at the listing date for comparison with 3-month outcomes. According to the Youden-Index, the best cut-off value for the APACHE II score was 8.5 with 100% sensitivity, 49% specificity, 24% positive predictive value (PPV), and 100% negative predictive value (NPV). Patients with APACHE III cut-off was 80. The APACHE III score demonstrated the highest specificity and PPV (90% specificity, 50% PPV). The NPV was 92%. With a 90-point threshold the specificity increased to 98% with 75% PPV and 89% NPV. Only 1 of 4 patients with a score >90 survived transplantation (P = .001). MELD score and KCH criteria were not significant (P > .05). According to the Hosmer-Lemeshow test, only the APACHE III score adequately describe the data. The APACHE III score was superior to KCH criteria, MELD score, and APACHE II score to predict outcomes after transplantation for ALF. It is a valuable parameter for pretransplantation patient selection. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Speciální aplikace VoIP

    OpenAIRE

    Lembard, Tomáš

    2011-01-01

    Cílem této diplomové práce je návrh a následná realizace zařízení pro přenos hlasu v lokální síti a popisem použitých obvodů a řešení po stránce hw i sw. Zabývá se problematikou digitalizace nízkofrekvenčních signálů, strukturou IP a UDP protokolů, implementací TCP/IP stacku cIPS The aim of this master's thesis is suggestion and following realization of voice transmission over the local network equipment and a description of used circuits and solutions in terms of hardware and software. Th...

  2. Capturing value from IP in a global environment

    DEFF Research Database (Denmark)

    Alcacer, Juan; Beukel, Karin; Cassiman, Bruno

    Executive Summary The authors argue that challenges to capturing value from know-how and reputation through the use of different IP tools will be an increasingly important matter of strategy for global enterprises. This has important implications for management practice. Global enterprises......), develop their know-how, and build and maintain their reputation globally during the last decades. We focus on three tools: patents, trademarks, and industrial designs. We find that, although most IP applications come from a few countries (the United States, European Union, Japan, China, and South Korea......), most growth in IP activity has come from middle-income countries, especially in Asia. We observe important differences in the origins of this growth. For example, while in India most applicants were foreign firms, in China most were local. However, most Indian innovations are also applied overseas...

  3. Re-evaluation of Mannheim prognostic index in perforative peritonitis: prognostic role of advanced age. A prospective cohort study.

    Science.gov (United States)

    Neri, Alessandro; Marrelli, Daniele; Scheiterle, Maximilian; Di Mare, Giulio; Sforza, Simone; Roviello, Franco

    2015-01-01

    Peritonitis from perforation of abdominal viscera is associated with high mortality. In western countries individuals older than 65 years constitute a significant proportion of the population and intra abdominal infections are more challenging to manage in these aged patients. This prospective cohort study included 143 consecutive patients operated on for primary perforative peritonitis. The aim of the study was to assess the prognostic efficacy of Mannheim Peritonitis Index (MPI) in a population with a significant proportion of older patients and to substantiate advanced age as an independent prognostic factor. Patients' informations were collected both on hospitalization and after surgical exploration; severity of peritonitis was evaluated using the MPI. The prognostic value of MPI was compared to older age and other clinical variables. The intra-hospital mortality was 25.2%. According to the MPI score, the ROC curve identified 21 as cut-off value with a sensitivity of 86% and a specificity of 59% in predicting the risk of death. MPI score and age over 80 years old resulted independent predictors of mortality at multivariate analysis. In the subgroup of patients with MPI score≥21, the mortality rate was 46.4% for patients older than 80 years old and 38.3% for younger patients (p=0.07); in patients with MPI score<21, the mortality of those aged more than 80 years reached 33.3% compared to 3.4% for younger patients (p=0.001). Age older than 80 years is strongly related to major increase in mortality rates and should be taken into account together with the MPI score in planning the surgical approach and the post-operative care. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  4. Analytic prognostic for petrochemical pipelines

    CERN Document Server

    Jaoude, Abdo Abou; El-Tawil, Khaled; Noura, Hassan; Ouladsine, Mustapha

    2012-01-01

    Pipelines tubes are part of vital mechanical systems largely used in petrochemical industries. They serve to transport natural gases or liquids. They are cylindrical tubes and are submitted to the risks of corrosion due to high PH concentrations of the transported liquids in addition to fatigue cracks due to the alternation of pressure-depression of gas along the time, initiating therefore in the tubes body micro-cracks that can propagate abruptly to lead to failure. The development of the prognostic process for such systems increases largely their performance and their availability, as well decreases the global cost of their missions. Therefore, this paper deals with a new prognostic approach to improve the performance of these pipelines. Only the first mode of crack, that is, the opening mode, is considered.

  5. Prognostic stratification of ulcerated melanoma

    DEFF Research Database (Denmark)

    Bønnelykke-Behrndtz, Marie L; Schmidt, Henrik; Christensen, Ib J

    2014-01-01

    OBJECTIVES: For patients with melanoma, ulceration is an important prognostic marker and interestingly also a predictive marker for the response of adjuvant interferon. A consensual definition and accurate assessment of ulceration are therefore crucial for proper staging and clinical management. We...... stratification of ulcerated lesions. METHODS: From H&E-stained sections, the status (presence vs absence), extent (percentage of the total tumor length), and type (infiltrative vs attenuative) of ulceration and epidermal involvement were evaluated from 385 patients with cutaneous melanoma. RESULTS: The presence...... of ulceration (hazard ratio [HR], 1.83), an attenuative type of ulceration (HR, 3.02), and excessive ulceration (HR, 3.57) were independent predictors of poor melanoma-specific survival. Further subdivision of minimal/moderate ulceration showed independent prognostic value only for lesions with epidermal...

  6. Prognostic stratification in pulmonary hypertension: A multi-biomarker approach.

    Science.gov (United States)

    Plácido, Rui; Cortez-Dias, Nuno; Robalo Martins, Susana; Gomes Almeida, Ana; Calisto, Carina; Gonçalves, Susana; Sadoune, Malha; Nunes Diogo, António; Mebazaa, Alexandre; Pinto, Fausto José

    2017-02-01

    Pulmonary hypertension (PH) covers a group of conditions characterized by an increase in pulmonary vascular resistance leading to right ventricular failure. Risk stratification is crucial for adequate prognostic and therapeutic assessment. However, the accuracy of conventional parameters is limited, especially biomarkers. To determine the prognostic value of new biomarkers and their combination in a multi-biomarker approach to predict outcome in patients with PH. In this prospective cohort study, PH patients underwent clinical, echocardiographic and laboratory assessment, including quantification of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and of the following new biomarkers: mid-regional pro-adrenomedullin (MR-proADM), copeptin, endothelin-1, mid-regional pro-atrial natriuretic peptide (MR-proANP) and soluble ST2 (sST2), the interleukin-33 receptor. The accuracy of the different parameters for predicting all-cause mortality and death or hospitalization of cardiac causes was determined. The prognostic value of a multi-biomarker score based on the tertile distribution of serum NT-proBNP, MR-proANP, renin and sST2 was compared to conventional markers. Forty-three patients (72.1% female, age 59±15 years) were included, most of whom (65.1%) had group 1 PH. During a median follow-up of 34 months, 26% of the patients died and 35% were hospitalized for cardiac causes. Atrial and ventricular dimensions and right ventricular fractional area change were prognostic predictors. Log NT-proBNP (HR: 31.14; 95% CI: 3.12-310.7; p=0.003) and renin (HR: 1.02; 95% CI: 1.005-1.038; p=0.009) were independent predictors of mortality. MR-proANP (HR: 1.008; 95% CI 1.004-1.011; p<0.001) and sST2 (HR: 1.005; 95% CI 1.001-1.009; p=0.04) were predictors of death or hospitalization. The prognostic value of the multi-biomarker score was higher than any of the conventional parameters, and enabled identification of risk groups (the high-risk group had three-year mortality of 77

  7. [New advance of research on prognostic factors in myelodysplastic syndrome--review].

    Science.gov (United States)

    Wei, Jia; Chen, Yan

    2008-12-01

    Myelodysplastic syndrome (MDS) represents a heterogeneous group of myeloid malignancies characterized by abnormal differentiation and maturation of myeloid cells, bone marrow failure, and a genetic instability with enhanced risk to transform to acute myeloid leukemia. Many factors influence on the prognosis of MDS. The prognosis of MDS subtypes has been changing with the application of World Health Organization (WHO) classification and different new prognostic scoring system, the technology development of cytogenetics and flow cytometry, and the advent of new drugs. A series of recent literatures are summarized on different prognostic factors of MDS. In this review, the controversy in application of WHO classification, MDS prognosis in relation with prognostic scoring system, cytogenetics, immunophenotype and therapeutics were discussed.

  8. The need for additional genetic markers for MDS stratification: what does the future hold for prognostication?

    Science.gov (United States)

    Otrock, Zaher K.; Tiu, Ramon V.; Maciejewski, Jaroslaw P.; Sekeres, Mikkael A.

    2013-01-01

    Myelodysplastic syndromes (MDS) constitute a heterogeneous group of clonal hematopoietic disorders. Metaphase cytogenetics (MC) has been the gold standard for genetic testing in MDS, but it can detect clonal cytogenetic abnormalities in only 50% of cases. New karyotyping tests include fluorescence in situ hybridization (FISH), array-based comparative genomic hybridization (aCGH), and single nucleotide polymorphism arrays (SNP-A). These techniques have increased the detected genetic abnormalities in MDS, many of which confer prognostic significance to overall and leukemia-free survival. This has eventually increased our understanding of MDS genetics. With the help of new technologies, we anticipate that the existing prognostic scoring systems will incorporate mutational data into their parameters. This review discusses the progress in MDS diagnosis through the use of array-based technologies. We also discuss the recently investigated genetic mutation in MDS, and revisit the MDS classification and prognostic scoring systems. PMID:23373781

  9. Prognostic information in administrative co-morbidity data following coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Zabell; Hvelplund, Anders; Rasmussen, Søren

    2010-01-01

    Objectives: The aim of this study was to evaluate the prognostic information obtainable from administrative data with respect to 30-day mortality following coronary artery bypass grafting (CABG) and to compare it with the European System for Cardiac Operative Risk Evaluation (EuroSCORE) recorded...... in a clinical database. Methods: We used a co-morbidity index calculated from administrative data in the Danish National Patient Register by means of all admissions 1 year prior to CABG. In addition, each CABG was categorised as being isolated or not, and acute or not. The prognostic power of the co......-morbidity index was compared to that achieved using EuroSCORE from a clinical database comprising information on all patients treated with CABG in Denmark. The outcome was all-cause mortality within 30 days after CABG and the prognostic power was evaluated using logistic regression analyses. Results: We...

  10. Microleakage of IPS empress 2 inlay restorations luted with self-adhesive resin cements.

    Science.gov (United States)

    Cal, E; Celik, E U; Turkun, M

    2012-01-01

    To assess the microleakage of three self-adhesive and one etch-and-rinse resin cements when luting IPS Empress 2 (Ivoclar Vivadent, Liechtenstein) all-ceramic inlay restorations to the prepared cavities in extracted human molars. The cylindrical Class V cavities were prepared on the buccal surfaces of 40 extracted human third molars using diamond burs. The IPS Empress 2 ceramic inlays were placed with Multilink Sprint (Ivoclar Vivadent), RelyX Unicem (3M ESPE, USA), G-Cem (GC, Japan), or Variolink II (Ivoclar Vivadent) as the control group. After storage in distilled water at 37°C for 24 hours, samples were subjected to 1000 thermal cycles between baths of 5°C and 55°C, with a dwell time of 30 seconds. The microleakage scores were examined on the occlusal and gingival margins at 30× magnification after each sample was stained with 0.5% basic fuchsin and sectioned into three parts using a thin diamond blade (Isomet, Buehler, USA) (n=40). The extent of microleakage on both occlusal and gingival margins of the restorations was scored and recorded. The microleakage data were analyzed using Kruskall-Wallis and Mann-Whitney U-tests. Statistically significant differences were observed between the groups in both margins according to the Kruskall-Wallis and Mann-Whitney U-tests (pVariolink II Variolink II = RelyX Unicem adhesive resin cements displayed higher microleakage scores on the occlusal margins, whereas on the gingival margins RelyX Unicem showed comparable microleakage results with the control samples.

  11. Prognostic value of epicardial fat volume measurements by computed tomography: a systematic review of the literature.

    Science.gov (United States)

    Spearman, James V; Renker, Matthias; Schoepf, U Joseph; Krazinski, Aleksander W; Herbert, Teri L; De Cecco, Carlo N; Nietert, Paul J; Meinel, Felix G

    2015-11-01

    To perform a systematic review of the growing body of literature evaluating the prognostic value of epicardial fat volume (EFV) quantified by cross-sectional imaging. Two independent reviewers performed systematic searches on both PubMed and Scopus using search terms developed with a medical librarian. Peer-reviewed articles were selected based on the inclusion of outcome data, utilization of epicardial fat volume and sufficient reporting for analysis. A total of 411 studies were evaluated with nine studies meeting the inclusion criteria. In all, the studies evaluated 10,252 patients. All nine studies were based on CT measurements. Seven studies evaluated the prognostic value of EFV unadjusted for calcium score, and six of these studies found a significant association between EFV and clinical outcomes. Seven studies evaluated the incremental value of EFV beyond calcium scoring, and six of these studies found a significant association. The majority of studies suggest that EFV quantification is significantly associated with clinical outcomes and provides incremental prognostic value over coronary artery calcium scoring. Future research should use a binary cutoff of 125 mL for evaluation of EFV to provide consistency with other research. • Epicardial fat volume (EFV) has prognostic value for adverse cardiac events • Establishment of standardized quantitative categories for EFV is needed • Quantification of EFV could improve risk assessment with calcium scoring.

  12. Preoperative prognostic factors for mortality in peptic ulcer perforation: a systematic review

    DEFF Research Database (Denmark)

    Møller, Morten Hylander; Adamsen, S.; Thomsen, R.W.

    2010-01-01

    metabolic acidosis, tachycardia, acute renal failure, low serum albumin level, high American Society of Anaesthesiologists score, and preoperative delay >24 h were associated with poor prognosis. Conclusions. In patients with PPU, a number of negative prognostic factors can be identified prior to surgery...

  13. Prognostic information in administrative co-morbidity data following coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Abildstrøm, Steen Zabell; Hvelplund, Anders; Rasmussen, Søren

    2010-01-01

    The aim of this study was to evaluate the prognostic information obtainable from administrative data with respect to 30-day mortality following coronary artery bypass grafting (CABG) and to compare it with the European System for Cardiac Operative Risk Evaluation (EuroSCORE) recorded in a clinical...

  14. Factor Structure of the Rorschach Prognostic Rating Scale and Its Relation to Therapeutic Outcome

    Science.gov (United States)

    Auerbach, Stephen M.; Edinger, Jack D.

    1976-01-01

    This study evaluated the factor structure of the Rorschach Prognostic Rating Scale (RPRS) in order to: (a) test the assumption that the RPRS represents a unitary response system and (b) determine the efficacy of employing population specific factor scores as predictors of therapy outcome. (Author/NG)

  15. IP-Based TV Technologies, Services and Multidisciplinary Applications

    NARCIS (Netherlands)

    O.M. Bonastre; M.J. Montpetit; P.S. Cesar Garcia (Pablo Santiago)

    2013-01-01

    htmlabstractThe move to Internet Protocol (IP)-based content delivery services has challenged the television industry by allowing high-quality television content to be delivered using the Internet, wired and wireless, private and public. The new convergence paradigm is already playing out its

  16. Construction of a nuclear data server using TCP/IP

    Energy Technology Data Exchange (ETDEWEB)

    Kawano, Toshihiko; Sakai, Osamu [Kyushu Univ., Fukuoka (Japan)

    1997-03-01

    We construct a nuclear data server which provides data in the evaluated nuclear data library through the network by means of TCP/IP. The client is not necessarily a user but a computer program. Two examples with a prototype server program are demonstrated, the first is data transfer from the server to a user, and the second is to a computer program. (author)

  17. Credibility and validation of simulation models for tactical IP networks

    NARCIS (Netherlands)

    Boltjes, B.; Thiele, F.; Diaz, I.F.

    2007-01-01

    The task of TNO is to provide predictions of the scalability and performance of the new all-IP tactical networks of the Royal Netherlands Army (RNLA) that are likely to be fielded. The inherent properties of fielded tactical networks, such as low bandwidth and Quality of Service (QoS) policies

  18. The Verb Always Leaves IP in V2 Clauses

    DEFF Research Database (Denmark)

    Schwartz, Bonnie D.; Vikner, Sten

    2007-01-01

    (1989) we claimed that all V2 clauses were CPs, and we referred to this analysis as the 'traditional' analysis. In this paper we shall call it the 'V2 outside IP' analysis, and by using this term we want to convey that although in what follows we will adhere to the view that the verb moves to Cº, any......-initial and non-subject-initial V2 clauses, the former being only IPs and the latter CPs, as suggested by Travis (1984, 1986, 1991) and Zwart (1990, 1991). Below we will refer to this analysis as the 'V2 asymmetry' analysis. The other alternative analysis is that V2 takes place inside IP, as suggested by Diesing......The verb second (V2) phenomenon, as it is found in the Germanic languages, has been the focus of much attention within recent syntactic research. In most of the literature on V2, it is assumed that the verb in all V2 clauses has moved to a head position outside IP, e.g. Cº. In Schwartz & Vikner...

  19. Designing TCP/IP Checksum Function for Acceleration in FPGA

    African Journals Online (AJOL)

    etim

    bus speed limits. Consequently, for a higher throughput and speedy delivery of information between hosts on the internet, there is the need to identify those performance-critical TCP/IP functions ... instruction fetching and decoding, bus speed constraints, latency due to buffer/memory ... functions in FPGA that can be updated.

  20. TTI ARO Opportunity Fund: IPS | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This funding will allow the Think Tank Initiative grantee, the Institute of Policy Studies of Sri Lanka (IPS), to undertake quality, policy-oriented labour migration research. The research will focus on some of the issues identified by the National Human Resources and Employment Policy for Sri Lanka.

  1. Changepoint detection techniques for VoIP traffic

    NARCIS (Netherlands)

    Mandjes, M.; Zuraniewski, P.W.

    2013-01-01

    The control of communication networks critically relies on procedures capable of detecting unanticipated load changes. In this chapter we present an overview of such techniques, in a setting in which each connection consumes roughly the same amount of bandwidth (with VoIP as a leading example). For

  2. Changepoint Detection Techniques for VoIP Traffic

    NARCIS (Netherlands)

    Mandjes, M.; Żuraniewski, P.; Biersack, E.; Callegari, C.; Matijasevic, M.

    2013-01-01

    The control of communication networks critically relies on procedures capable of detecting unanticipated load changes. In this chapter we present an overview of such techniques, in a setting in which each connection consumes roughly the same amount of bandwidth (with VoIP as a leading example). For

  3. Empirical assessment of VoIP overload detection tests

    NARCIS (Netherlands)

    Żuraniewski, P.; Mandjes, M.; Mellia, M.

    2010-01-01

    The control of communication networks critically relies on procedures capable of detecting unanticipated load changes. In this paper we explore such techniques, in a setting in which each connection consumes roughly the same amount of bandwidth (with VoIP as a leading example). We focus on

  4. Biobjective VoIP Service Management in Cloud Infrastructure

    Directory of Open Access Journals (Sweden)

    Jorge M. Cortés-Mendoza

    2016-01-01

    Full Text Available Voice over Internet Protocol (VoIP allows communication of voice and/or data over the internet in less expensive and reliable manner than traditional ISDN systems. This solution typically allows flexible interconnection between organization and companies on any domains. Cloud VoIP solutions can offer even cheaper and scalable service when virtualized telephone infrastructure is used in the most efficient way. Scheduling and load balancing algorithms are fundamental parts of this approach. Unfortunately, VoIP scheduling techniques do not take into account uncertainty in dynamic and unpredictable cloud environments. In this paper, we formulate the problem of scheduling of VoIP services in distributed cloud environments and propose a new model for biobjective optimization. We consider the special case of the on-line nonclairvoyant dynamic bin-packing problem and discuss solutions for provider cost and quality of service optimization. We propose twenty call allocation strategies and evaluate their performance by comprehensive simulation analysis on real workload considering six months of the MIXvoip company service.

  5. Aspects of the epidemiology of intestinal parasitosis (IP) in children ...

    African Journals Online (AJOL)

    Background: Intestinal parasitoses (IP) have been demonstrated to pose a major public health problem in the tropics. It is hypothesized that children are continually exposed to re- infection despite interventions. We conducted this hospital-based study to investigate knowledge, practices and perceptions among mothers of ...

  6. TTI ARO Opportunity Fund: IPS | CRDI - Centre de recherches pour ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This funding will allow the Think Tank Initiative grantee, the Institute of Policy Studies of Sri Lanka (IPS), to undertake quality, policy-oriented labour migration research. The research will focus on some of the issues identified by the National Human Resources and Employment Policy for Sri Lanka.

  7. Voice over IP phone calls from your smartphone

    CERN Multimedia

    2014-01-01

    All CERN users do have a Lync account (see here) and can use Instant Messaging, presence and other features. In addition, if your number is activated on Lync IP Phone(1) system then you can make standard phone calls from your computer (Windows/Mac).   Recently, we upgraded the infrastructure to Lync 2013. One of the major features is the possibility to make Voice over IP phone calls from a smartphone using your CERN standard phone number (not mobile!). Install Lync 2013 on iPhone/iPad, Android or Windows Phone, connect to WiFi network and make phone calls as if you were in your office. There will be no roaming charges because you will be using WiFi to connect to CERN phone system(2). Register here to the presentation on Tuesday 29 April at 11 a.m. in the Technical Training Center and see the most exciting features of Lync 2013.   Looking forward to seeing you! The Lync team (1) How to register on Lync IP Phone system: http://information-technology.web.cern.ch/book/lync-ip-phone-serv...

  8. TCP/IP communication between two USRP-E110

    OpenAIRE

    Sanabria-Russo, Luis

    2012-01-01

    This short report intends to provide an overview of the procedure and statistics of establishing a TCP/IP link between two USRP-E110. The testings are performed using an example GNURadio code and the networking protocol stack provided by the Linux operating system embedded in the USRP-E110.

  9. Load characterization and anomaly detection for voice over IP traffic

    NARCIS (Netherlands)

    M.R.H. Mandjes (Michel); I. Saniee; A. Stolyar

    2005-01-01

    textabstractWe consider the problem of traffic anomaly detection in IP networks. Traffic anomalies typically arise when there is focused overload or when a network element fails and it is desired to infer these purely from the measured traffic. We derive new general formulae for the variance of the

  10. Managing wireless IP-Connectivity Experience as Mobile Social Media

    NARCIS (Netherlands)

    Rigolin Ferreira Lopes, R.; van Beijnum, Bernhard J.F.; dos Santos Moreira, Edson

    2010-01-01

    Social media is the meaningful digital content that results from interaction or collaboration between users through web-based applications, e.g. blogs and virtual communities. While on the move, people can create or consume mobile social media using portable devices with IP-connectivity. Our

  11. QoS-aware bandwidth provisioning for IP network links

    NARCIS (Netherlands)

    van den Berg, H; Mandjes, M.R.H.; van de Meent, R.; Pras, A.; Roijers, F.; Venemans, P.H.A.

    2006-01-01

    Current bandwidth provisioning procedures for IP network links are mostly based on simple rules of thumb, using coarse traffic measurements made on a time scale of e.g., 5 or 15 minutes. A crucial question, however, is whether such coarse measurements give any useful insight into the capacity

  12. QoS aware bandwidth provisioning of IP links

    NARCIS (Netherlands)

    van den Berg, Hans Leo; Altman, E; Mandjes, M.R.H.; van de Meent, R.; Pras, Aiko; Roijers, Frank; Venemans, Pieter

    Current bandwidth provisioning procedures for IP network links are mostly based on simple rules of thumb, using coarse traffic measurements made on a time scale of e.g., 5 or 15 min. A crucial question, however, is whether such coarse measurements give any useful insight into the capacity actually

  13. QoS-aware bandwidth provisioning for IP network links

    NARCIS (Netherlands)

    Berg, J.L. van den; Mandjes, M.; Meent, R. van de; Pras, A.; Roijers, F.; Venemans, P.

    2006-01-01

    Current bandwidth provisioning procedures for IP network links are mostly based on simple rules of thumb, using coarse traffic measurements made on a time scale of e.g., 5 or 15 min. A crucial question, however, is whether such coarse measurements give any useful insight into the capacity actually

  14. VoIP makes voice heard--functionality is up.

    Science.gov (United States)

    Wade, Phil; Wakelam, Mathew

    2008-05-01

    Phil Wade, sales and marketing director, and Mathew Wakelam, VoIP product manager, at alarm and communication specialist Static Systems Group, discuss wireless VoLP's potential in healthcare establishments and examine how, in particular, the technology can be successfully integrated with nurse call systems.

  15. Sensing CMEs Propagating in the Interplanetary Medium. MEXART IPS Observations

    Science.gov (United States)

    Gonzalez-Esparza, A.; Romero Hernandez, E.; Aguilar-Rodriguez, E.; Ontiveros-Hernandez, V.; Rodriguez-Martinez, M. R.; Mejia-Ambriz, J. C.

    2014-12-01

    The Mexican Array Radiotelescope (MEXART) is a ground instrument fully dedicated to perform Interplanetary Scintillation (IPS) observations to track large-scale solar wind disturbances within the Sun and the Earth. The MEXART is located at Michoacan (19 degrees 48' North, 101 degrees 41' West) and has an operation frequency of 140 MHz. The IPS technique is based on the scintillations that interplanetary disturbances (e.g., ICMEs) causes on the signal of small diameter cosmic radio sources detected by a radiotelescope. We report the tracking of the first solar disturbances detected by the instrument during the maximum of solar cycle 24. We estimated solar wind velocities and scintillation indexes (m). We present the first curves of the variation of the scintillating index with respect to the heliocentric distance for some strong radio sources using IPS observations at 140 MHZ. We identified events associated with strong scintilltaion in our data. We combine the IPS data with white light chronograph observations to identify the first CMEs in the interplanetary medium detected by the instrument.

  16. PENGARUH PEMANFAATAN PERPUSTAKAAN TERHADAP PRESTASI BELAJAR IPS MELALUI MOTIVASI BELAJAR

    Directory of Open Access Journals (Sweden)

    Nurhayani Nurhayani

    2017-11-01

    Full Text Available The purpose of this research was to investigate the effect of the use of libraries on social study learning achievement through learning motivation, either directly or indirectly. The type of this research was quantitative Ex post facto. The sampling technique used probability sampling with total of the students consisted of 156. Collecting data used a Likert questionnaire and students’ report documentation. The data analysis used path analysis and assisted by SPSS for windows version 20. The results (1 there was a direct effect of the use of libraries on the learning motivation; (2 there was a direct effect of the use of libraries to the learning achievement of Social Study; (3 there was a direct effect of learning motivation towards learning achievement of Social Study; (4 there was an indirect effect on social study learning achievement library through learning motivation. Penelitian ini bertujuan untuk mengetahui pengaruh pemanfaatan perpustakaan terhadap prestasi belajar IPS melalui motivasi belajar, baik secara langsung maupun tidak langsung. Jenis penelitian adalah kuantitatif Ex Post Facto. Teknik pengambilan sampel menggunakan probability sampling sebanyak 156 siswa. Pengumpulan data menggunakan angket skala likert dan dokumentasi nilai rapor. Analisis data menggunakan analisis jalur dan dibantu program SPSS for window versi 20. Hasil penelitian (1 terdapat pengaruh langsung pemanfaatan perpustakaan terhadap motivasi belajar; (2 terdapat pengaruh langsung pemanfaatan perpustakaan terhadap Prestasi belajar IPS; (3 terdapat pengaruh langsung motivasi belajar terhadap prestasi belajar IPS; (4 terdapat pengaruh tidak langsung pemanfaatan perpustakaan terhadap prestasi belajar IPS melalui motivasi belajar.

  17. Sister broods in the spruce bark beetle, Ips typographus (L.)

    Czech Academy of Sciences Publication Activity Database

    Davídková, Markéta; Doležal, Petr

    2017-01-01

    Roč. 405, DEC 01 (2017), s. 13-21 ISSN 0378-1127 Grant - others:Lesy ČR(CZ) 08/2009- 2015 Institutional support: RVO:60077344 Keywords : re-emergence * sister broods * Ips typographus Subject RIV: EH - Ecology, Behaviour OBOR OECD: Zoology Impact factor: 3.064, year: 2016 http://www.sciencedirect.com/science/article/pii/S0378112717309507

  18. Understanding Innovative Potential (IP) in an ICT Context

    DEFF Research Database (Denmark)

    Rai, Sudhanshu

    a dynamic perspective in its conception, operation and instantiation. I conclude this paper with insights on what I call the dynamic IP threshold arguing that being dynamic cannot be seen as a point in time but a threshold existing over time. I then discuss some implications. I suggest that firms need...

  19. Generic Software Architecture for Prognostics (GSAP) User Guide

    Science.gov (United States)

    Teubert, Christopher Allen; Daigle, Matthew John; Watkins, Jason; Sankararaman, Shankar; Goebel, Kai

    2016-01-01

    The Generic Software Architecture for Prognostics (GSAP) is a framework for applying prognostics. It makes applying prognostics easier by implementing many of the common elements across prognostic applications. The standard interface enables reuse of prognostic algorithms and models across systems using the GSAP framework.

  20. Identification of prognostic different subgroups in triple negative breast cancer by Her2-neu protein expression.

    Science.gov (United States)

    Schmidt, Gilda; Meyberg-Solomayer, Gabriele; Gerlinger, Christoph; Juhasz-Böss, Ingolf; Herr, Daniel; Rody, Achim; Liedtke, Cornelia; Solomayer, Erich-Franz

    2014-12-01

    Many patients with triple negative breast cancer (TNBC) have a poor outcome, but not all of them. This study has the aim to analyse the prognostic impact of tumour size, nodal status, grading, Her2-neu (human epithelial growth factor receptor 2) score and Ki-67 index. The main goal of this analysis is to find out if there are any differences in survival between patients with TNBC and a Her2-neu score 0 versus 1+2. Retrospectively, we studied a cohort of 121 patients with TNBC, diagnosed at the Saarland University Medical Center between December 2004 and June 2013. We compared the disease-free survival (DFS) and overall survival (OS) in those women on the basis of the different Her2-neu scores (0 versus 1 or 2 with negative FISH). One hundred and twenty one patients were included in this study. 58.68 % of them had a T2-4 tumour. 39.67 % were nodal positive and 67.77 % had high-grade tumours. The Her2-neu score was determined in 119 patients. 54.62 % of them had a score 0. In the 103 patients with a Ki-67 determination, the mean index was 44.5 %. We found that tumour size, nodal status and Her2-neu score are important prognostic factors. Patients with a Her2-neu score 0 had a significantly poorer outcome regarding DFS and OS. In contrast, the expression level of Ki-67 and the grading do not seem to have any prognostic value in TNBC. Besides tumour stage, grading and nodal status, the Her2-neu score 0 is able to function as a prognostic factor in patients with TNBC.

  1. CtIP Mutations Cause Seckel and Jawad Syndromes.

    Directory of Open Access Journals (Sweden)

    Per Qvist

    2011-10-01

    Full Text Available Seckel syndrome is a recessively inherited dwarfism disorder characterized by microcephaly and a unique head profile. Genetically, it constitutes a heterogeneous condition, with several loci mapped (SCKL1-5 but only three disease genes identified: the ATR, CENPJ, and CEP152 genes that control cellular responses to DNA damage. We previously mapped a Seckel syndrome locus to chromosome 18p11.31-q11.2 (SCKL2. Here, we report two mutations in the CtIP (RBBP8 gene within this locus that result in expression of C-terminally truncated forms of CtIP. We propose that these mutations are the molecular cause of the disease observed in the previously described SCKL2 family and in an additional unrelated family diagnosed with a similar form of congenital microcephaly termed Jawad syndrome. While an exonic frameshift mutation was found in the Jawad family, the SCKL2 family carries a splicing mutation that yields a dominant-negative form of CtIP. Further characterization of cell lines derived from the SCKL2 family revealed defective DNA damage induced formation of single-stranded DNA, a critical co-factor for ATR activation. Accordingly, SCKL2 cells present a lowered apoptopic threshold and hypersensitivity to DNA damage. Notably, over-expression of a comparable truncated CtIP variant in non-Seckel cells recapitulates SCKL2 cellular phenotypes in a dose-dependent manner. This work thus identifies CtIP as a disease gene for Seckel and Jawad syndromes and defines a new type of genetic disease mechanism in which a dominant negative mutation yields a recessively inherited disorder.

  2. Metrics for Evaluating Performance of Prognostic Techniques

    Data.gov (United States)

    National Aeronautics and Space Administration — Prognostics is an emerging concept in condition basedmaintenance(CBM)ofcriticalsystems.Alongwith developing the fundamentals of being able to confidently predict...

  3. Health Monitoring and Prognostics for Computer Servers

    Data.gov (United States)

    National Aeronautics and Space Administration — Abstract Prognostics solutions for mission critical systems require a comprehensive methodology for proactively detecting and isolating failures, recommending and...

  4. Embedded Diagnostics & Prognostics Wireless Sensing Platforms

    National Research Council Canada - National Science Library

    Ousachi, Mark; Scott, Andrew; Yee, David; Hosmer, Thomas; Daniszewski, Dave

    2004-01-01

    An embedded diagnostics and prognostics architecture affects several aspects associated with military ground vehicles such as improved safety, reduction in maintenance times, weapon system readiness...

  5. A DISTRIBUTED PROGNOSTIC HEALTH MANAGEMENT ARCHITECTURE

    Data.gov (United States)

    National Aeronautics and Space Administration — This paper introduces a generic distributed prognostic health management (PHM) architecture with specific application to the electrical power systems domain. Current...

  6. Simulating Degradation Data for Prognostic Algorithm Development

    Data.gov (United States)

    National Aeronautics and Space Administration — PHM08 Challenge Dataset is now publicly available at the NASA Prognostics Respository + Download INTRODUCTION - WHY SIMULATE DEGRADATION DATA? Of various challenges...

  7. A Survey of Artificial Intelligence for Prognostics

    Data.gov (United States)

    National Aeronautics and Space Administration — Integrated Systems Health Management includes as key elements fault detection, fault diagnostics, and failure prognostics. Whereas fault detection and diagnostics...

  8. Clinical and Histopathological Prognostic Factors in Chondrosarcomas

    Directory of Open Access Journals (Sweden)

    Bjarne Lund

    1997-01-01

    Full Text Available Purpose. In an attempt to identify clinical and histopathological factors of prognostic importance in chondrosarcomas, 115 cases of malignant and borderline chondromatous tumours were reviewed.

  9. Clinicopathologic features and prognostic indicators in Chinese patients with myelofibrosis.

    Science.gov (United States)

    Gill, Harinder; Leung, Anskar Y H; Chan, Chi-Chung; Lau, June S M; Chan, Candia; Yip, Sze-Fai; Liu, Herman; Kho, Bonnie; Mak, Vivien; Lee, Harold K K; Lin, Shek-Ying; Lau, Chi-Kuen; Kwong, Yok-Lam

    2016-01-01

    To define the clinicopathologic features, outcome, and prognostic indicators of myelofibrosis (MF) in Asian patients. Two hundred and seventy consecutive Chinese patients (primary MF, n = 207; post-polycythemia vera MF, n = 27; and post-essential thrombocythemia MF, n = 36) from seven regional referral hospitals were analyzed. The median overall survival (OS) for primary MF was 66 months. Multivariate analysis showed that age >65 years (P = 0.02), platelet count year cumulative risk of leukemic transformation was 28%. On multivariate analysis, unfavorable karyotypes significantly predicted inferior leukemia-free survival (LFS) (P = 0.03). In secondary MF, the 10-year cumulative risk of leukemic transformation was 31%. Circulating blasts ≥1% significantly predicted inferior LFS (P = 0.04). The international prognostic scoring system (IPSS) and dynamic IPSS were not significant survival predictors in our cohort. Eighteen patients underwent allogeneic hematopoietic stem cell transplantation. The median OS post-transplantation was merely 19 months. Platelet count 1% were negative prognostic indicators. Conclusion Chinese MF patients were similar to Western patients in clinicopathologic features and outcome.

  10. [Cytogenetics of myelodysplastic syndromes and its impact as prognostic factor].

    Science.gov (United States)

    Borjas-Gutiérrez, César; Domínguez-Cruz, Martín Daniel; González-García, Juan Ramón

    2017-01-01

    Myelodysplastic syndromes (MDS) are a group of disorders of the hematopoietic stem cell. They are characterized by cytopenia(s), dysplasia of one or more cell lines, ineffective hematopoiesis, and an increased risk for developing acute myelogenous leukemia. The classification of MDS has been complicated due to the great heterogeneity in clinical phenotype as well as in the morphological and cytogenetic characteristics. The prognostic value of cytogenetic abnormalities in MDS has been analyzed in multicenter studies. This approach raised the development of the revised International Prognostic Scoring System (IPSS-R), which analyzes five prognostic variables, among which the cytogenetic study stands out. According to the cytogenetic findings, a classification of MDS in five subgroups was developed. Knowledge of the cytogenetic abnormalities has led to the study of genes involved in various chromosomal rearrangements. Moreover, DNA sequencing has helped to identify mutations in approximately 50 genes related to signal transduction, DNA methylation, transcriptional regulation, and RNA splicing. Therefore, the cytogenetic study should be used to improve the classification and therapeutic management of MDS. This approach will be an essential tool for the development of targeted therapy protocols.

  11. Dynamic assessment of RBC-transfusion dependency improves the prognostic value of the revised-IPSS in MDS patients.

    Science.gov (United States)

    Hiwase, Devendra K; Singhal, Deepak; Strupp, Corinna; Chhetri, Rakchha; Kutyna, Monika M; Wee, L Amilia; Harrison, Peter B; Nath, Shriram V; Wickham, Nicholas; Hui, Chi-Hung; Gray, James X; Bardy, Peter; Ross, David M; Lewis, Ian D; Reynolds, John; To, L Bik; Germing, Ulrich

    2017-06-01

    RBC-transfusion dependency (RBC-TD) is an independent prognostic factor for poor overall survival (OS) in the WHO classification-based prognostic scoring system (WPSS) for MDS patients. However, WPSS did not include cytopenia, whereas revised International Prognostic Scoring System (IPSS-R) did not include RBC-TD. Thus, neither of these prognostic scoring systems incorporates both cytopenia and RBC-TD. We aimed to test whether RBC-TD adds prognostic value to the IPSS-R. We analyzed MDS patients not treated with disease-modifying therapy, and enrolled in SA-MDS Registry (derivation cohort; n = 295) and Dusseldorf registry (Germany; validation cohort; n = 113) using time-dependent Cox proportional regression and serial landmark analyses. In the derivation cohort, RBC-TD patients had inferior OS compared to RBC transfusion-independent (RBC-TI) patients (P MDS is associated with poor OS, independent of IPSS-R. This study demonstrates that dynamic assessment of RBC-TD provides additional prognostic value to IPSS-R and should be included in treatment decision algorithms for MDS patients. © 2017 Wiley Periodicals, Inc.

  12. SCORE - A DESCRIPTION.

    Science.gov (United States)

    SLACK, CHARLES W.

    REINFORCEMENT AND ROLE-REVERSAL TECHNIQUES ARE USED IN THE SCORE PROJECT, A LOW-COST PROGRAM OF DELINQUENCY PREVENTION FOR HARD-CORE TEENAGE STREET CORNER BOYS. COMMITTED TO THE BELIEF THAT THE BOYS HAVE THE POTENTIAL FOR ETHICAL BEHAVIOR, THE SCORE WORKER FOLLOWS B.F. SKINNER'S THEORY OF OPERANT CONDITIONING AND REINFORCES THE DELINQUENT'S GOOD…

  13. Galectins-1, -3, and -7 Are Prognostic Markers for Survival of Ovarian Cancer Patients

    Directory of Open Access Journals (Sweden)

    Heiko Schulz

    2017-06-01

    Full Text Available There is a tremendous need for developing new useful prognostic factors in ovarian cancer. Galectins are a family of carbohydrate binding proteins which have been suggested to serve as prognostic factors for various cancer types. In this study, the presence of Galectin-1, -3, and -7 was investigated in 156 ovarian cancer specimens by immunochemical staining. Staining was evaluated in the cytoplasm and nucleus of cancer cells as well as the peritumoral stroma using a semi quantitative score (Remmele (IR score. Patients’ overall survival was compared between different groups of Galectin expression. Galectin (Gal-1 and -3 staining was observed in the peritumoral stroma as well as the nucleus and cytoplasm of tumor cells, while Gal-7 was only present in the cytoplasm of tumor cells. Patients with Gal-1 expression in the cytoplasm or high Gal-1 expression in the peritumoral stroma showed reduced overall survival. Nuclear Gal-3 staining correlated with a better outcome. We observed a significantly reduced overall survival for cases with high Gal-7 expression and a better survival for Gal-7 negative cases, when compared to cases with low expression of Gal-7. We were able to show that both tumor and stroma staining of Gal-1 could serve as negative prognostic factors for ovarian cancer. We were able to confirm cytoplasmic Gal-7 as a negative prognostic factor. Gal-3 staining in the nucleus could be a new positive prognosticator for ovarian cancer.

  14. Galectins-1, -3, and -7 Are Prognostic Markers for Survival of Ovarian Cancer Patients.

    Science.gov (United States)

    Schulz, Heiko; Schmoeckel, Elisa; Kuhn, Christina; Hofmann, Simone; Mayr, Doris; Mahner, Sven; Jeschke, Udo

    2017-06-08

    There is a tremendous need for developing new useful prognostic factors in ovarian cancer. Galectins are a family of carbohydrate binding proteins which have been suggested to serve as prognostic factors for various cancer types. In this study, the presence of Galectin-1, -3, and -7 was investigated in 156 ovarian cancer specimens by immunochemical staining. Staining was evaluated in the cytoplasm and nucleus of cancer cells as well as the peritumoral stroma using a semi quantitative score (Remmele (IR) score). Patients' overall survival was compared between different groups of Galectin expression. Galectin (Gal)-1 and -3 staining was observed in the peritumoral stroma as well as the nucleus and cytoplasm of tumor cells, while Gal-7 was only present in the cytoplasm of tumor cells. Patients with Gal-1 expression in the cytoplasm or high Gal-1 expression in the peritumoral stroma showed reduced overall survival. Nuclear Gal-3 staining correlated with a better outcome. We observed a significantly reduced overall survival for cases with high Gal-7 expression and a better survival for Gal-7 negative cases, when compared to cases with low expression of Gal-7. We were able to show that both tumor and stroma staining of Gal-1 could serve as negative prognostic factors for ovarian cancer. We were able to confirm cytoplasmic Gal-7 as a negative prognostic factor. Gal-3 staining in the nucleus could be a new positive prognosticator for ovarian cancer.

  15. The Apgar Score.

    Science.gov (United States)

    2015-10-01

    The Apgar score provides an accepted and convenient method for reporting the status of the newborn infant immediately after birth and the response to resuscitation if needed. The Apgar score alone cannot be considered as evidence of, or a consequence of, asphyxia; does not predict individual neonatal mortality or neurologic outcome; and should not be used for that purpose. An Apgar score assigned during resuscitation is not equivalent to a score assigned to a spontaneously breathing infant. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists encourage use of an expanded Apgar score reporting form that accounts for concurrent resuscitative interventions. Copyright © 2015 by the American Academy of Pediatrics.

  16. Prognostic Factors in Hodgkin's Disease

    DEFF Research Database (Denmark)

    Specht

    1996-01-01

    Prognostic factors in Hodgkin's disease (HD) are reviewed. The Ann Arbor staging classification remains the basis for evaluation of patients with HD. However, subgroups of patients with differing prognoses exist within the individual stages. In pathological stages I and II, the number of involved...... of extent of disease such as erythrocyte sedimentation rate, anemia, and serum albumin. In advanced disease the number of involved nodal and extranodal regions, the total tumor burden, B symptoms, age, gender, histology, and a number of hematologic and biochemical indicators are significant. Research...

  17. A randomised controlled trial of time-limited individual placement and support: IPS-LITE trial.

    Science.gov (United States)

    Burns, Tom; Yeeles, Ksenija; Langford, Oliver; Montes, Maria Vazquez; Burgess, Jennifer; Anderson, Catriona

    2015-10-01

    Individual placement and support (IPS) has been repeatedly demonstrated to be the most effective form of mental health vocational rehabilitation. Its no-discharge policy plus fixed caseloads, however, makes it expensive to provide. To test whether introducing a time limit for IPS would significantly alter its clinical effectiveness and consequently its potential cost-effectiveness. Referrals to an IPS service were randomly allocated to either standard IPS or to time-limited IPS (IPS-LITE). IPS-LITE participants were referred back to their mental health teams if still unemployed at 9 months or after 4 months employment support. The primary outcome at 18 months was working for 1 day. Secondary outcomes comprised other vocational measures plus clinical and social functioning. The differential rates of discharge were used to calculate a notional increased capacity and to model potential rates and costs of employment. A total of 123 patients were randomised and data were collected on 120 patients at 18 months. The two groups (IPS-LITE = 62 and IPS = 61) were well matched at baseline. Rates of employment were equal at 18 months (IPS-LITE = 24 (41%) and IPS = 27 (46%)) at which time 57 (97%) had been discharged from the IPS-LITE service and 16 (28%) from IPS. Only 11 patients (4 IPS-LITE and 7 IPS) obtained their first employment after 9 months. There were no significant differences in any other outcomes. IPS-LITE discharges generated a potential capacity increase of 46.5% compared to 12.7% in IPS which would translate into 35.8 returns to work in IPS-LITE compared to 30.6 in IPS over an 18-month period if the rates remained constant. IPS-LITE is equally effective to IPS and only minimal extra employment is gained by persisting beyond 9 months. If released capacity is utilised with similar outcomes, IPS-LITE results in an increase by 17% in numbers gaining employment within 18 months compared to IPS and will increase with prolonged follow-up. IPS-LITE may be more cost

  18. The Bandim tuberculosis score

    DEFF Research Database (Denmark)

    Rudolf, Frauke; Joaquim, Luis Carlos; Vieira, Cesaltina

    2013-01-01

    Background: This study was carried out in Guinea-Bissau ’ s capital Bissau among inpatients and outpatients attending for tuberculosis (TB) treatment within the study area of the Bandim Health Project, a Health and Demographic Surveillance Site. Our aim was to assess the variability between 2...... physicians in performing the Bandim tuberculosis score (TBscore), a clinical severity score for pulmonary TB (PTB), and to compare it to the Karnofsky performance score (KPS). Method : From December 2008 to July 2009 we assessed the TBscore and the KPS of 100 PTB patients at inclusion in the TB cohort and...

  19. [Retinal Cell Therapy Using iPS Cells].

    Science.gov (United States)

    Takahashi, Masayo

    2016-03-01

    Progress in basic research, starting with the work on neural stem cells in the middle 1990's to embryonic stem (ES) cells and induced pluripotent stem (iPS) cells at present, will lead the cell therapy (regenerative medicine) of various organs, including the central nervous system to a big medical field in the future. The author's group transplanted iPS cell-derived retinal pigment epithelial (RPE) cell sheets to the eye of a patient with exudative age-related macular degeneration (AMD) in 2014 as a clinical research. Replacement of the RPE with the patient's own iPS cell-derived young healthy cell sheet will be one new radical treatment of AMD that is caused by cellular senescence of RPE cells. Since it was the first clinical study using iPS cell-derived cells, the primary endpoint was safety judged by the outcome one year after surgery. The safety of the cell sheet has been confirmed by repeated tumorigenisity tests using immunodeficient mice, as well as purity of the cells, karyotype and genetic analysis. It is, however, also necessary to prove the safety by clinical studies. Following this start, a good strategy considering cost and benefit is needed to make regenerative medicine a standard treatment in the future. Scientifically, the best choice is the autologous RPE cell sheet, but autologous cell are expensive and sheet transplantation involves a risky part of surgical procedure. We should consider human leukocyte antigen (HLA) matched allogeneic transplantation using the HLA 6 loci homozyous iPS cell stock that Prof. Yamanaka of Kyoto University is working on. As the required forms of donor cells will be different depending on types and stages of the target diseases, regenerative medicine will be accomplished in a totally different manner from the present small molecule drugs. Proof of concept (POC) of photoreceptor transplantation in mouse is close to being accomplished using iPS cell-derived photoreceptor cells. The shortest possible course for treatment

  20. Integration of estrogen and progesterone receptors with pathological and molecular prognostic factors in breast cancer patients.

    Science.gov (United States)

    Gago, F E; Tello, O M; Diblasi, A M; Ciocca, D R

    1998-12-01

    In this study we have examined biopsies from women with localized primary breast cancer to investigate the prognostic performance of estrogen receptors (ER) and progesterone receptors (PR) for estimating the metastatic probability of the patients, and to explore whether discrimination gets better by combining clinicopathological and other molecular parameters into a score. This prospective study involved 205 patients with a median follow-up of 5 y. Among the evaluated clinicopathological data were: patient's age; tumor size; axillary lymph node involvement; and tumor grade. The most representative tumor samples were derived to a single laboratory for immunohistochemical evaluation of the following molecular markers: ER, PR, proliferating cell nuclear antigen (PCNA), p53 protein product, erbB-2 (HER-2/neu) oncoprotein, and P170 glycoprotein (mdrl gen product). Distant metastases (study endpoint) appeared in 19.5% (40/205) of the patients, most of these patients presented a mixture of poor, regular and good prognostic factors. Disease-free survival analysis procedures (Kaplan-Meier method) identified tumor size, axillary lymph node involvement, tumor grade, receptor status, PCNA, p53, erbB-2 and P170 as useful prognostic factors. Proportional hazard regression analysis (Cox) identified in order of importance erbB-2, tumor size, receptors status, tumor grade and PCNA as useful prognostic factors. To facilitate the evaluation of the prognostic factors, a practical and simple score system was derived. A high pathological score identified 65% of the patients that developed distant metastases, while a high molecular score was obtained in 57% of patients with metastatic disease. There was a significant improvement in the diagnosis of probability of being with distant metastases when the pathological score was combined with the molecular score, 82% of the patients with distant metastases showed an elevated combined score. Validation of this scoring system will need further

  1. Prognostic radiographic aspects of spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Saraste, H.; Brostroem, L.A.; Aparisi, T.

    1984-01-01

    A series of 202 patients (133 men, 69 women) with lumbar spondylolysis were examined radiographically on two occasions, first at the time of diagnosis and later at a follow-up, after an observation period of 20 years or more. The films from patients in groups without and with moderate and severe olisthesis were evaluated with respect to variables describing lumbosacral lordosis, wedging of the spondylolytic vertebra, lengths of the transverse processes and iliolumbar ligaments, disk height, progression of slipping, and influence on measured olisthesis of lumbar spine flexion and extension at the radiographic examination. The evaluation was made with special attention to possible signs which could be predictive for the prognosis of vertebral slipping. Progression of slipping did not differ between patients diagnosed as adults or adolescents. Reduction of disk height was correlated to the degree of slipping present at the initial examination and to the progression of olisthesis. Flexion and extension of the lumbar spine did not modify the degree of olisthesis. Data concerning the lengths of the transverse processes and the iliolumbar ligaments, and lumbar lordosis, cannot be used for prognostic purposes. The lumbar index reflecting the degree of wedge deformity of the spondylolytic vertebra was shown to be the only variable of prognostic value for the development of vertebral slipping.

  2. Validation of the Revised Individual Placement and Support Fidelity Scale (IPS-25).

    Science.gov (United States)

    Bond, Gary R; Peterson, Alison E; Becker, Deborah R; Drake, Robert E

    2012-08-01

    The individual placement and support (IPS) model of supported employment for people with severe mental illness is an evidence-based practice. The 15-item IPS Fidelity Scale (IPS-15) was developed to measure program fidelity and has been shown to have good psychometric properties, including predictive validity. On the basis of field experience and research updates, the authors developed an expanded and revised version of this scale, the IPS-25, also known as the Supported Employment Fidelity Scale. This study evaluated the psychometric properties of the IPS-25. In addition to data on the local unemployment rate and program longevity, the authors collected IPS-25 ratings and employment data for 79 sites in eight states participating in a learning collaborative devoted to implementing the IPS model. Descriptive data for items and the total scale and predictive validity were examined. Internal consistency reliability for the IPS-25 was .88. Predictive validity, measured as the correlation between the IPS-25 and site-level employment rate, was .34. Eight of the IPS-25 items were significantly positively correlated with employment rate. Items related to the vocational generalist role, disclosure, follow-along support, and vocational unit were the most strongly correlated with employment. Program longevity was positively associated with employment, whereas the unemployment rate was not. The IPS-25 has promising psychometric properties, with greater precision and content coverage than the IPS-15. However, it has not demonstrated an advantage over the IPS-15 in predictive validity. Research directly comparing the two scales is needed.

  3. Volleyball Scoring Systems.

    Science.gov (United States)

    Calhoun, William; Dargahi-Noubary, G. R.; Shi, Yixun

    2002-01-01

    The widespread interest in sports in our culture provides an excellent opportunity to catch students' attention in mathematics and statistics classes. One mathematically interesting aspect of volleyball, which can be used to motivate students, is the scoring system. (MM)

  4. Early warning scores.

    Science.gov (United States)

    2012-09-27

    A free app available from the Apple App Store is aimed at supporting health professionals in Wales to use the National Early Warning Score (NEWS). The tool helps staff identify patients who are developing serious illness.

  5. Aggressive fibromatosis - impact of prognostic variables on ...

    African Journals Online (AJOL)

    South African Journal of Surgery ... To determine the impact of prognostic variables on local control in patients with aggressive fibromatosis treated with or without radiation. Materials and methods. ... The addition of radiation therapy to surgery as well as other known prognostic parameters did not impact on local control.

  6. A prognostic index for locoregional recurrence after neoadjuvant chemotherapy.

    Science.gov (United States)

    Herrero-Vicent, C; Guerrero-Zotano, A; Gavilá-Gregori, J; Hernández-Blanquisett, A; Sandiego-Contreras, S; Samper-Hiraldo, J M; Guillem-Porta, V; Ruiz-Simón, A

    2016-01-01

    The appropriate selection criteria for breast-conserving surgery (BCS) or mastectomy after neoadjuvant chemotherapy (NAC) are poorly defined. The aim of this study is to analyse the incidence and prognostic factors for locoregional recurrence (LRR) in patients with breast cancer (BC) treated with NAC to develop a prognostic score to help with clinical decision-making. Using our retrospective maintained BC database, we identified 730 patients treated with NAC (327 patients treated with BCS and 403 patients treated with mastectomy) between 1998 and 2014. To identify variables associated with an increased LRR rate, we performed firstly Kaplan-Meier curves, with comparisons among groups using log-rank test, and then, significant variables were included in a multivariate analysis using Cox proportional hazards. The prognostic index was developed by assigning score 0 (favourable) or score 1 (unfavourable) for each significant variable of multivariate analysis and was created separately for patients with BCS and mastectomy. At a median follow-up of 72 months, the 6-year cumulative incidence of LRR was 7.2% ( ± 3%) for BCS and 7.9% ( ± 3%) for mastectomy. By univariate analysis, variables associated with an increased LRR were for BCS: HER2 positive, grade III, ductal carcinoma in situ (DCIS), No-pCR (ypTis, ypN0), and age < 40 years; and for mastectomy, HER2-positive, DCIS, No-pCR, and LVI. By multivariate analysis, variables associated with an increased LRR were for BCS: HER2 positive (HR: 11.1, p = 0.001), DCIS (HR: 3.1, p = 0.005), and age < 40 years (HR: 2.8, p = 0.02); and for mastectomy: HER2 positive (HR: 9.5, p = 0.03), DCIS (HR: 2.7, p = 0.01), No-pCR (HR: 11.4, p = 0.01), and age < 40 years (HR: 2.8, p = 0.006). The score stratified patients into three subsets with statistically different levels of risk for LRR. For BCS, the six-year LRR rates were 3%, 13%, and 33% for the low (score 0, n = 120), intermediate (score 1, n = 95) and high (score 2-3, n = 27) risk

  7. Fatigue as prognostic risk marker of mental sickness absence in white collar employees.

    Science.gov (United States)

    Roelen, C A M; Heymans, M W; van Rhenen, W; Groothoff, J W; Twisk, J W R; Bültmann, U

    2014-06-01

    To investigate fatigue as prognostic risk marker for identifying working employees at risk of long-term sickness absence (SA). At baseline, fatigue was measured in 633 white collar employees with the checklist individual strength (CIS) including scales for fatigue severity, reduced concentration, reduced motivation, and reduced physical activity. SA was medically certified by an occupational physician in the 3rd or 4th SA week with diagnostic codes according to the 10th version of the International Classification of Diseases. Medically certified SA was retrieved at the individual level from an occupational health register after 1-year follow-up. CIS scores were investigated as prognostic risk markers predicting medically certified SA and particularly SA certified as mental SA. 614 employees (N = 378 men and N = 236 women) had complete data and were eligible for analysis; 63 (10 %) had medically certified SA of whom 39 (6 %) had mental SA. Fatigue severity and total CIS scores were associated with medically certified SA in men, but poorly discriminated between men with and without medically certified SA. Fatigue severity, reduced concentration, reduced motivation, and total CIS scores were also associated with mental SA in men. CIS and its reduced concentration scale were valid prognostic risk markers of mental SA. CONCLUSION Fatigue was a prognostic risk marker of mental SA in white collar men. The CIS should be further validated as a screening tool for the risk of mental SA in white collar working populations.

  8. Crecimiento estructurado y sostenible de NovaIP SAS

    OpenAIRE

    Urrutia Muñoz, Nidia Johana

    2016-01-01

    El presente documento tiene como objetivo, el diseño del plan estratégico para el crecimiento estructurado y sostenible de la compañía Colombia de telecomunicaciones NovaIP SAS. NovaIP SAS es una compañía colombiana multilatina, del sector de las tecnologías de la información y las comunicaciones, fundada en Cali en el año 2013. Nace con el propósito de ofrecer soluciones informáticas y de telecomunicaciones innovadoras y a la medida para los sectores público y privado, en pequeñas y media...

  9. Congested Link Inference Algorithms in Dynamic Routing IP Network

    Directory of Open Access Journals (Sweden)

    Yu Chen

    2017-01-01

    Full Text Available The performance descending of current congested link inference algorithms is obviously in dynamic routing IP network, such as the most classical algorithm CLINK. To overcome this problem, based on the assumptions of Markov property and time homogeneity, we build a kind of Variable Structure Discrete Dynamic Bayesian (VSDDB network simplified model of dynamic routing IP network. Under the simplified VSDDB model, based on the Bayesian Maximum A Posteriori (BMAP and Rest Bayesian Network Model (RBNM, we proposed an Improved CLINK (ICLINK algorithm. Considering the concurrent phenomenon of multiple link congestion usually happens, we also proposed algorithm CLILRS (Congested Link Inference algorithm based on Lagrangian Relaxation Subgradient to infer the set of congested links. We validated our results by the experiments of analogy, simulation, and actual Internet.

  10. Concordance for prognostic models with competing risks

    DEFF Research Database (Denmark)

    Wolbers, Marcel; Blanche, Paul; Koller, Michael T

    2014-01-01

    The concordance probability is a widely used measure to assess discrimination of prognostic models with binary and survival endpoints. We formally define the concordance probability for a prognostic model of the absolute risk of an event of interest in the presence of competing risks and relate i...... of the working model. We further illustrate the methods by computing the concordance probability for a prognostic model of coronary heart disease (CHD) events in the presence of the competing risk of non-CHD death.......The concordance probability is a widely used measure to assess discrimination of prognostic models with binary and survival endpoints. We formally define the concordance probability for a prognostic model of the absolute risk of an event of interest in the presence of competing risks and relate...

  11. Model-Based Prognostics of Hybrid Systems

    Science.gov (United States)

    Daigle, Matthew; Roychoudhury, Indranil; Bregon, Anibal

    2015-01-01

    Model-based prognostics has become a popular approach to solving the prognostics problem. However, almost all work has focused on prognostics of systems with continuous dynamics. In this paper, we extend the model-based prognostics framework to hybrid systems models that combine both continuous and discrete dynamics. In general, most systems are hybrid in nature, including those that combine physical processes with software. We generalize the model-based prognostics formulation to hybrid systems, and describe the challenges involved. We present a general approach for modeling hybrid systems, and overview methods for solving estimation and prediction in hybrid systems. As a case study, we consider the problem of conflict (i.e., loss of separation) prediction in the National Airspace System, in which the aircraft models are hybrid dynamical systems.

  12. Prognostic molecular markers in cancer - quo vadis?

    Science.gov (United States)

    Søland, Tine M; Brusevold, Ingvild J

    2013-09-01

    Despite the tremendous number of studies of prognostic molecular markers in cancer, only a few such markers have entered clinical practise. The lack of clinical prognostic markers clearly reflects limitations in or an inappropriate approach to prognostic studies. This situation should be of great concern for the research community, clinicians and patients. In the present review, we evaluate immunohistochemical prognostic marker studies in oral squamous cell carcinomas (OSCC) from 2006 to 2012. We comment upon general issues such as study design, assay methods and statistical methods, applicable to prognostic marker studies irrespective of cancer type. The three most frequently studied markers in OSCC are reviewed. Our analysis revealed that most new molecular markers are reported only once. To draw conclusions of clinical relevance based on the few markers that appeared in more than one study was problematic due to between-study heterogeneity. Currently, much valuable tissue material, time and money are wasted on irrelevant studies. © 2013 John Wiley & Sons Ltd.

  13. Implementation of Cloud Computing into VoIP

    Directory of Open Access Journals (Sweden)

    Floriana GEREA

    2012-08-01

    Full Text Available This article defines Cloud Computing and highlights key concepts, the benefits of using virtualization, its weaknesses and ways of combining it with classical VoIP technologies applied to large scale businesses. The analysis takes into consideration management strategies and resources for better customer orientation and risk management all for sustaining the Service Level Agreement (SLA. An important issue in cloud computing can be security and for this reason there are several security solution presented.

  14. Science spin: iPS cell research in the news.

    Science.gov (United States)

    Caulfield, T; Rachul, C

    2011-05-01

    Big scientific developments have always been spun to meet particular social agendas. We have seen it in the context of global warming, nuclear power, and genetically modified organisms. But few stories illustrate the phenomenon of spin as well as the reaction, and concomitant media coverage, that surrounded the November 2007 announcement regarding the reprogramming of skin cells to produce cells with qualities comparable to those of human embryonic stem cells (hESCs) known as induced pluripotent stem (iPS) cells.

  15. Demand Engineering: IP Network Optimisation Through Intelligent Demand Placement

    OpenAIRE

    Evans, John; Afrakteh, Arash; Xiu, Ruoyang

    2016-01-01

    Traffic engineering has been used in IP and MPLS networks for a number of years as a tool for making more efficient use of capacity by explicitly routing traffic demands where there is available network capacity that would otherwise be unused. Deployment of traffic engineering imposes an additional layer of complexity to network design and operations, however, which has constrained its adoption for capacity optimisation. The rise of Software Defined Networks has renewed interest in the use of...

  16. A Multimedia over IP Integrated System for Military Communications

    Science.gov (United States)

    2006-12-01

    Alessandro Cignoni, Carlo Roatta *Istituto per le Telecomunicazioni e l’Elettronica “Giancarlo Vallauri” Telecommunications Department Viale Italia n°72...for a real battlefield scenario. Cignoni, A.; Garroppo, R.G.; Martucci, A.; Roatta , C. (2006) A Multimedia over IP Integrated System for Military...October 2003. Rome, 18-19 April 2005 RTO-IST-054 Paper 14 Alessandro CIGNONI, Rosario G. GARROPPO, Alessandro MARTUCCI, Carlo ROATTA A Multimedia

  17. The Utility of Scoring Systems in Predicting Early and Late Mortality in Alcoholic Hepatitis: Whose Score Is It Anyway?

    Directory of Open Access Journals (Sweden)

    Naaventhan Palaniyappan

    2012-01-01

    Full Text Available Background. Alcoholic hepatitis (AH is a distinct clinical entity in the spectrum of alcoholic liver disease with a high short-term mortality. Several scoring systems are being used to assess the severity of AH but the ability of these scores to predict long-term survival in these patients is largely unknown. Aims. We aim to assess the utility of five different scoring systems Child Pugh (CP, model for end-stage liver disease (MELD, Maddrey’s discriminant function (mDF, Glasgow AH score (GAHS, and age-bilirubin-INR-creatinine (ABIC score in predicting shot-term and long-term survival in patients with AH. Methods. Patients with histological evidence of AH were identified from our database. The clinical and biochemical parameters were used to calculate the 5 different scores. The prognostic utility of these scores was determined by generating an ROC curve for survival at 30 days, 90 days, 6 months, and 1 year. Results and Conclusions. All 5 scores with the exception of CP score have a similar accuracy in predicting the short-term prognosis. However, they are uniformly poor in predicting longer-term survival with AUROC not exceeding 0.74. CP score is a very poor predictor of survival in both short and long term. Abstinence from alcohol was significantly (<0.05 associated with survival at 1 year.

  18. Watermarking strategies for IP protection of micro-processor cores

    Science.gov (United States)

    Parrilla, L.; Castillo, E.; Meyer-Bäse, U.; García, A.; González, D.; Todorovich, E.; Boemo, E.; Lloris, A.

    2010-04-01

    Reuse-based design has emerged as one of the most important methodologies for integrated circuit design, with reusable Intellectual Property (IP) cores enabling the optimization of company resources due to reduced development time and costs. This is of special interest in the Field-Programmable Logic (FPL) domain, which mainly relies on automatic synthesis tools. However, this design methodology has brought to light the intellectual property protection (IPP) of those modules, with most forms of protection in the EDA industry being difficult to translate to this domain. However, IP core watermarking has emerged as a tool for IP core protection. Although watermarks may be inserted at different levels of the design flow, watermarking Hardware Description Language (HDL) descriptions has been proved to be a robust and secure option. In this paper, a new framework for the protection of μP cores is presented. The protection scheme is derived from the IPP@HDL procedure and it has been adapted to the singularities of μP cores, overcoming the problems for the digital signature extraction in such systems. Additionally, the feature of hardware activation has been introduced, allowing the distribution of μP cores in a "demo" mode and a later activation that can be easily performed by the customer executing a simple program. Application examples show that the additional hardware introduced for protection and/or activation has no effect over the performance, and showing an assumable area increase.

  19. A Framework for an IP-Based DVB Transmission Network

    Directory of Open Access Journals (Sweden)

    Nimbe L. Ewald-Arostegui

    2010-01-01

    Full Text Available One of the most important challenges for next generation all-IP networks is the convergence and interaction of wireless and wired networks in a smooth and efficient manner. This challenge will need to be faced if broadcast transmission networks are to converge with IP infrastructure. The 2nd generation of DVB standards supports the Generic Stream, allowing the direct transmission of IP-based content using the Generic Stream Encapsulation (GSE, in addition to the native Transport Stream (TS. However, the current signalling framework is based on MPEG-2 Tables that rely upon the TS. This paper examines the feasibility of providing a GSE signalling framework, eliminating the need for the TS. The requirements and potential benefits of this new approach are described. It reviews prospective methods that may be suitable for network discovery and selection and analyses different options for the transport and syntax of this signalling metadata. It is anticipated that the design of a GSE-only signalling system will enable DVB networks to function as a part of the Internet.

  20. 47 CFR 64.606 - VRS and IP Relay provider and TRS program certification.

    Science.gov (United States)

    2010-10-01

    ... Services and Related Customer Premises Equipment for Persons With Disabilities § 64.606 VRS and IP Relay... establishes that its program in no way conflicts with federal law. (2)Requirements for VRS and IP Relay...