A Spherical Cap Model of Epidural Hematomas.

Background Epidural hematomas (EDHs), which have a characteristic biconvex shape, are a type of post-traumatic intracranial mass. EDHs and other types of intracranial hematomas are often diagnosed with computed tomography (CT). The volumes of EDHs are important in treatment decisions and prognosis. Their volumes are usually estimated on CT using the "ABC" method, which is based on the ellipsoid shape rather than their biconvex shape. Objective To simulate the biconvex shape, we modeled the geometry of EDHs with two spherical caps. We aim to provide simpler estimation of EDH volumes in clinical settings, and eventually recommend a threshold for surgical evacuation. Methods Applying the relationship between the sphere radius, spherical cap height, and base circle radius, we derived formulas for the shape of an EDH, relating its largest diameter and location to the other two diameters. We also estimated EDH volumes using the spherical cap volume and conventional ABC formulas and then constructed a lookup table accordingly. Results Validation of the model was performed using 14 CT image sets from previously reported patients with EDHs. Our geometric model demonstrated accurate predictions. The model also allows reducing the number of parameters to be measured in the ABC method from three to one, the hematoma length, showcasing its potential as a reliable tool for clinical decision-making. Based on our model, an EDH longer than 7 cm would occupy more than 30 mL of the intracranial volume. Conclusion The proposed model offers a streamlined approach to estimating EDH volumes, reducing the complexity of parameters required for clinical assessments. We recommend a length of 7 cm as a threshold for surgical evacuation of EDHs. This acceleration in decision-making is crucial for managing critically injured patients with traumatic brain injuries. Further validation across diverse patient populations will enhance the generalizability and utility of this geometric modeling approach in clinical settings.

Performing the ABC Method Twice for Gastric Cancer Risk Stratification: A Retrospective Study Based on Data from a Large-Scale Screening Facility.

The ABC method is a classification method used for stratifying the risk of gastric cancer. However, whether the ABC method should be performed only once or multiple times throughout an individual's lifetime remains unclear. Therefore, this study aimed to analyze whether performing ABC screening twice in a lifetime is useful. We retrospectively analyzed the data of individuals who participated in health checkups in 2010 and 2015. We collected data on patient characteristics, pepsinogen levels, anti-Helicobacter pylori antibody titers, and the presence of gastric cancer. Overall, 7129 participants without a history of H. pylori eradication were included in this study. The participants' average age in 2010 was 48.4 ± 8.3 years, and 58.1% were male. In addition, 11 and 20 cases of new H. pylori infection (0.15%) and spontaneous eradication (0.28%), respectively, were recorded. No significant difference was found in the incidence of gastric cancer between participants who underwent the ABC method once and those who underwent it twice (Group A: 0.16% vs. 0.16%; Group B: 0.47% vs. 0.39%; and Group C + D: 1.97% vs. 1.82%). Therefore, performing the ABC method twice, 5 years apart, does not significantly improve gastric cancer risk stratification.

Development of a modified ABC method among Helicobacter pylori infected but serum pepsinogen test-negative individuals.

BACKGROUND: Although the ABC method for gastric cancer (GC) screening has been widely adopted in Japan, it may not be suitable for other countries due to population heterogeneity and different tumor histology. We aim to develop a modified ABC method to improve GC screening performance, especially among Helicobacter pylori (Hp) infected but serum pepsinogen (sPG) test-negative individuals. METHODS: A total of 4745 participants were recruited from Tianjin, China, and were classified into four groups by combined assay for Hp infection and sPG concentrations: Group A (Hp [-], PG [-]), Group B (Hp [+], PG [-]), Group C (Hp [+], PG [+]), and Group D (Hp [-], PG [+]). We used receiver-operating characteristic (ROC) curves analysis and minimum p value method to determine the optimal cutoff point for PG II in Group B. We performed logistic regressions to examine the risk of GC across different subgroups. In addition to the derivation set, the performance of the modified ABC method was also evaluated in an external set involving 16,292 participants from Liaoning, China. RESULTS: In the modified ABC method, we further classified Group B as low-risk (Group B1) and high-risk subgroups (Group B2) using optimal sPG II cutoff point (20.0 ng/mL) by ROC curves analysis and minimum p value method. Compared with Group B1, Group B2 had a significantly higher risk of GC (adjusted OR = 2.54, 95% CI = 1.94-3.33). The modified ABC method showed good discrimination for GC (AUC = 0.61, 95% CI = 0.59-0.63) and improved risk reclassification (NRI = 0.11, p < .01). Similar results were observed in the validation dataset. CONCLUSIONS: The modified ABC method can effectively identify high-risk population for GC among Hp-infected but sPG test-negative participants in China.

Likelihood-Free Dynamical Survival Analysis applied to the COVID-19 epidemic in Ohio.

The Dynamical Survival Analysis (DSA) is a framework for modeling epidemics based on mean field dynamics applied to individual (agent) level history of infection and recovery. Recently, the Dynamical Survival Analysis (DSA) method has been shown to be an effective tool in analyzing complex non-Markovian epidemic processes that are otherwise difficult to handle using standard methods. One of the advantages of Dynamical Survival Analysis (DSA) is its representation of typical epidemic data in a simple although not explicit form that involves solutions of certain differential equations. In this work we describe how a complex non-Markovian Dynamical Survival Analysis (DSA) model may be applied to a specific data set with the help of appropriate numerical and statistical schemes. The ideas are illustrated with a data example of the COVID-19 epidemic in Ohio.

Comparative Study on Different Serology Risk Stratification Combined With Endoscopy for Screening of Early Gastric Cancer / 胃肠病学

Background:One effective method for detecting stomach cancer is serological screening.Aims:To improve the prognosis and better direct clinical practice,this research compares the usefulness of the new scoring system and the ABC method in the screening of high-risk lesions of gastric cancer.Methods:This study involved the consecutive enrollment of 2 306 individuals(of whom 1 232 were male and 1 074 were female)who had gastroscopy at the Physical Examination Department of Xiamen Humanity Hospital between December 2020 and December 2022 and were above the age of 40.Before endoscopy,the population was classified as low-risk,intermediate-risk,and high-risk based on the serological ABC method and the new scoring system,respectively,and based on the age,gender,serum Helicobacter pylori antibody,PGR,and G-17 test findings of the studied population.An analysis was conducted on the identification of high-risk lesions of stomach cancer using the two distinct approaches,and the usefulness of the two distinct techniques for identifying high-risk lesions associated with stomach cancer was assessed.Results:Based on the serological ABC method of 2 306 patients,there were 1 293 cases in the low-risk group,856 cases in the intermediate-risk group,and 157 cases in the high-risk group.Of the three groups,759 cases(58.7%)had high-risk lesions of gastric cancer,492 cases(57.5%)in the intermediate-risk group,and 82 cases(52.2%)in the high-risk group.There were 1 899 cases in the low-risk category,383 cases in the intermediate-risk group,and 27 cases in the high-risk group,based on the novel scoring system.Among them,1 044 patients had high-risk stomach cancer lesions found.There were 18 instances(75.0%)in the high-risk group and 271 cases(70.8%)in the intermediate-risk group.The identification rate of high-risk lesions of gastric cancer in the new scoring method increases progressively as the group grade rises(χ2=35.482,P<0.001).Conclusions:While both approaches are useful for identifying high-risk gastric cancer lesions,the novel scoring system may be more beneficial for identifying these lesions early on.

Identification of Helicobacter pylori-related gastric cancer risk using serological gastritis markers and endoscopic findings: a large-scale retrospective cohort study.

BACKGROUND: Gastric cancer remains a severe public health problem worldwide, particularly in Japan. Recent studies have demonstrated that serum markers are beneficial for risk stratification in gastric cancer development. We aimed to evaluate the usefulness of serum markers either alone or in combination (serum markers plus endoscopy) for effective risk stratification of gastric cancer development. METHODS: We enrolled 22,736 patients aged 20-95 years who underwent blood sampling and endoscopic examination at Hiroshima University Hospital in Japan between 1990 and 2014. The serum pepsinogen (PG) levels and anti-Helicobacter pylori antibody (Hp-Ab) titers were evaluated in each patient. The enrolled patients were matched with the database of the Hiroshima Prefecture Regional Cancer Registry. We processed the medical records and excluded patients with possible confounding factors for PG levels, such as proton pump inhibitor use, prior successful eradication therapy, post-gastrectomy, severe hepatorenal dysfunction, Zollinger-Ellison syndrome, and autoimmune gastritis. Among the remaining 5131 patients, we reviewed records of endoscopic examinations and selected 1507 patients (mean age, 62.5 years; 985 men and 522 women) who underwent endoscopic examination more than three months after blood sampling. First, based on the ABC method, patients were classified as follows: High PG levels and negative Hp-Ab, group A, high PG levels and positive Hp-Ab, group B, low PG levels and positive Hp-Ab, group C, and low PG levels and negative Hp-Ab, group D. Group A was further classified into two subgroups using endoscopic findings: true A without atrophic gastritis and pseudo A with atrophic gastritis. All patients underwent annual endoscopy follow-up. RESULTS: Among the 1,507 patients (mean age, 62.5 years; 985 men), 24 were diagnosed with newly developed gastric cancer. No significant difference in cancer development was found between group A (PG negative and Hp-Ab negative) and the other groups. Remarkably, no true A group subjects developed gastric cancer. CONCLUSIONS: The combination of serum markers and endoscopic findings is essential for the risk evaluation of gastric cancer.

Risk factors for gastric cancer in Japan in the 2010s: a large, long-term observational study.

BACKGROUND: The numbers of Helicobacter pylori (HP)-infected individuals and deaths due to gastric cancer are decreasing in Japan. We aimed to determine whether the serological test for chronic gastritis (the ABC method) is still useful for gastric cancer risk stratification in the 2010s and to analyze risk factors for developing gastric cancer in Japan. METHODS: In this prospective study, we monitored 20773 individuals for the incidence of gastric cancer from 2010 to 2019. The relationships between blood sampling results, physical examination, and lifestyle in 2010 and the cumulative incidence of gastric cancer were analyzed. RESULTS: A total of 19343 participants who met the study criteria were analyzed. Overall, 0.08% of participants in group A (9/11717), 0.63% in group B (28/4452), 2.05% in group C (43/2098), 1.52% in group D (1/66), and 0.30% in group E (3/1010) developed gastric cancer. Cox hazard analysis showed that age ≥ 50 years; groups B, C, and D according to the ABC method; and current smoking habits were independent risk factors for gastric cancer. The hazard ratios (HRs) of the incidence of gastric cancer were 6.7 in group B and 21.7 in groups C and D, while the HRs of group E was 2.8, which was not significantly different from that of group A. The incidence of gastric cancer was not statistically significantly different between those with and without successful HP eradication in groups B, C, and D during follow-up. CONCLUSIONS: The ABC method was still useful for gastric cancer risk stratification in the 2010s.

Human gastric cancer risk screening: From rat pepsinogen studies to the ABC method.

We examined the development of gastric cancer risk screening, from rat pepsinogen studies in an experimental rat gastric carcinogenesis model induced with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) and human pepsinogen studies in the 1970s and 1980s to the recent "ABC method" for human gastric cancer risk screening. First, decreased expression or absence of a major pepsinogen isozyme, PG1, was observed in the rat gastric mucosa from the early stages of gastric carcinogenesis to adenocarcinomas following treatment with MNNG. In the 1980s, decreases in PGI in the human gastric mucosa and serum were identified as markers of atrophic gastritis. In the 1990s, other researchers revealed that chronic infection with Helicobacter pylori (Hp) causes atrophic gastritis and later gastric cancer. In the 2000s, a gastric cancer risk screening method combining assays to detect serum anti-Hp IgG antibody and serum PGI and PGII levels, the "ABC method", was established. Eradication of Hp and endoscopic follow-up examination after the ABC method are recommended to prevent gastric cancer.

Scoring model for discriminating gastric cancer risk in patients with negative serum pepsinogen and anti-Helicobacter pylori antibody results.

BACKGROUND: The ABC test measures serum pepsinogen and anti-Helicobacter pylori IgG antibody levels to predict precancerous conditions in the stomach and gastric cancer. However, a limitation of this test is that the gastric cancer risk is not negligible in patients with a negative result. METHODS: Based on their ABC results, 1157 patients were classified into Groups A (n = 392), B (n = 479), C (n = 247), and D (n = 39). In Group A, 24.2% of patients had atrophic gastritis and/or intestinal metaplasia and had thus been incorrectly assigned to Group A. Patients in Group A were then assigned to derivation (n = 236) and validation (n = 156) cohorts by 3:2 random sampling. Logistic regression analyses were performed to identify the factors discriminating between a correct (true) and incorrect (false) Group A classification. RESULTS: A 4-point discriminative model was constructed based on a high-negative H. pylori IgG antibody titer and the patient's age (50-64 and ≥65 years). The areas under the receiver operating characteristic curve for the derivation and validation cohorts were 0.868 and 0.894, respectively. In the validation cohort, the addition of a discriminative model score ≥2 to the ABC method showed a similar accuracy for predicting gastric cancer risk compared with the ABC method alone (93.8% vs. 92.4%). CONCLUSION: The 4-point discriminative model may help identify patients with a normal serological test who are nonetheless at risk of developing gastric cancer.

Modeling the Transmission of Vibrio aestuarianus in Pacific Oysters Using Experimental Infection Data.

Vibrio aestuarianus is a bacterium related to mortality outbreaks in Pacific oysters, Crassostrea gigas, in France, Ireland, and Scotland since 2011. Knowledge about its transmission dynamics is still lacking, impairing guidance to prevent and control the related disease spread. Mathematical modeling is a relevant approach to better understand the determinants of a disease and predict its dynamics in imperfectly observed pathosystems. We developed here the first marine epidemiological model to estimate the key parameters of V. aestuarianus infection at a local scale in a small and closed oyster population under controlled laboratory conditions. Using a compartmental model accounting for free-living bacteria in seawater, we predicted the infection dynamics using dedicated and model-driven collected laboratory experimental transmission data. We estimated parameters and showed that waterborne transmission of V. aestuarianus is possible under experimental conditions, with a basic reproduction number R0 of 2.88 (95% CI: 1.86; 3.35), and a generation time of 5.5 days. Our results highlighted a bacterial dose-dependent transmission of vibriosis at local scale. Global sensitivity analyses indicated that the bacteria shedding rate, the concentration of bacteria in seawater that yields a 50% chance of catching the infection, and the initial bacterial exposure dose W0 were three critical parameters explaining most of the variation in the selected model outputs related to disease spread, i.e., R0, the maximum prevalence, oyster survival curve, and bacteria concentration in seawater. Prevention and control should target the exposure of oysters to bacterial concentration in seawater. This combined laboratory-modeling approach enabled us to maximize the use of information obtained through experiments. The identified key epidemiological parameters should be better refined by further dedicated laboratory experiments. These results revealed the importance of multidisciplinary approaches to gain consistent insights into the marine epidemiology of oyster diseases.

Long-Term Effects of a Behavioural Management Technique for Nurses on Aggressive Behaviour in Brain-Injured Patients.

OBJECTIVE: The ABC method (Antecedent events, target Behaviours, Consequent events) is a behavioural management technique developed for nurses. The objective of the present study was to examine the long-term effects of the ABC method on aggressive behaviour in 40 patients with acquired brain injury. METHOD: Four aggression outcome measures and a questionnaire about the implementation of the ABC method were filled out by the nursing staff in this longitudinal intervention study. RESULTS: Contrary to expectations, a significant increase of aggression was found on two aggression measures. A possible explanation may be that the ABC method increased awareness of aggression in the nursing staff. Results of the implementation questionnaire indicated that the ABC method was not part of usual care at the long-term follow-up. CONCLUSIONS: It seems that the quality of the implementation process was insufficient to find an effect of the ABC method on aggression. Suggestions for improving the implementation process are made in this paper.

The utility of two marine community indices to assess the environmental degradation of lotic systems using fish communities.

Multimetric approaches are commonly used to evaluate the ecological status of aquatic ecosystems. However, it has been recommended that the sensitivity of existing methods be improved through the investigation of the potential of new metrics to detect environmental disturbances. In this study we tested the effectiveness of two community indices (Taxonomic distinctness index (TDI) and Abundance biomass comparison (ABC) method), primarily proposed for marine ecosystems, to identify sites with different levels of environmental degradation in lotic systems using fish community data. Fish samples were collected over the period 2003-2011 at 131 sampling stations. To generate water and habitat quality classes, a self-organizing map (SOM) based on environmental data was applied. Gradients over the SOM map were investigated for the values of the TDI and ABC indices. The results of this study reveal that the values of both the TDI and ABC indices are highly correlated with water and habitat quality gradients. However, despite the observed correlation, the utility of TDI as a potential metric in bioassessment programs is rather limited, due to its lack of discriminatory power. In contrast, the ABC method could be proposed as a novel metric, but can only be applied in type-specific multimetric approaches.

Predictors of Gastric Neoplasia in Cases Negative for Helicobacter pylori Antibody and with Normal Pepsinogen.

BACKGROUND/AIM: Individuals negative for Helicbacter pylori antibody and with a normal pepsinogen test (group A) are regarded as being at low risk in serum gastric cancer screening known as the ABC method, and endoscopy is not recommended; however, this group may include 2-10% of gastric cancer cases. PATIENTS AND METHODS: A total of 345 individuals who underwent upper gastrointestinal endoscopy and were classified by ABC as group A (H. pylori antibody titer <10 U/ml, and pepsinogen-I >70 ng/ml or I/II ratio >3) were enrolled, and predictors of gastric neoplasia were investigated. RESULTS: Ten gastric neoplasia cases (gastric cancer and adenoma) were found to be included. Multiple logistic regression analyses identified H. pylori antibody titer ≥3 U/ml (odds ratio=14.4, 95% confidence interval=2.7-76.9; p<0.01) and pepsinogen-I/II ratio ≤4.3 ng/ml (odds ratio=10.0, 95% confidence interval=2.1-47.9; p<0.01), but not age as independent predictive factors of neoplasia. CONCLUSION: Endoscopy should be considered in individuals with H. pylori antibody titer of ≥3 U/ml and a pepsinogen-I/II ratio of ≤4.3 in those classed as group A by ABC method.

Analysis and Optimization of Work Efficiency of Intelligent Dispensing System in Outpatient Pharmacy of Our Hospital / 中国药房

OBJECTIVE:To improve the working efficiency of the drug delivery system. METHODS:The kinds of drugs in delivery system and manual dispensing window were adjusted through comparing the number of prescriptions and drug box dis-pensed by the system and manual window in our hospital before adjustment (Jun. 2014),combining with analysis of EIQ(En-try-item-quantity)-ABC. The improvement effect was evaluated through analyzing related index after adjustment(Aug. 2014). RE-SULTS:The data before adjustment showed the workload of the delivery system was lower than that of manual delivery in term of the number of drug box (P=0.000),and they were similar in term of the number of prescription (P=0.122). The drug delivery system was significantly better than manual delivery in terms of two indexes after resetting the type of drugs in the system(P=0.000). CONCLUSIONS:Optimized delivery system can effectively improve the working efficiency.

Using single-case experimental design methodology to evaluate the effects of the ABC method for nursing staff on verbal aggressive behaviour after acquired brain injury.

The ABC method is a basic and simplified form of behavioural modification therapy for use by nurses. ABC refers to the identification of Antecedent events, target Behaviours, and Consequent events. A single-case experimental AB design was used to evaluate the effects of the ABC method on a woman diagnosed with olivo-ponto-cerebellar ataxia. Target behaviour was verbal aggressive behaviour during ADL care, assessed at 9 time points immediately before implementation of the ABC method and at 36 time points after implementation. A randomisation test showed a significant treatment effect between the baseline and intervention phases (t = .58, p = .03; ES [Nonoverlap All Pairs] = .62). Visual analysis, however, showed that the target behaviour was still present after implementation of the method and that on some days the nurses even judged the behaviour to be more severe than at baseline. Although the target behaviour was still present after treatment, the ABC method seems to be a promising tool for decreasing problem behaviour in patients with acquired brain injury. It is worth investigating the effects of this method in future studies. When interpreting single-subject data, both visual inspection and statistical analysis are needed to determine whether treatment is effective and whether the effects lead to clinically desirable results.

Distribution of Neuropeptides in Nasal Polyp and Polypoid Mucosa / 대한이비인후과학회지

BACKGROUND: The pathogenesis of nasal polyp is not well understood, however the common pathway of nasal polyp formation is tissue edema. Factors that are known to predispose tissue edema include histamine, arachidonic acid metabolites, serotonin and peptidergic neuro-transmitters. OBJECTIVES: To elucidate the pathophysiological roles of peptidergic neurotransmitters on the polyp formation, we investigated the distribution of several immunoreactive nerve fibers. MATERIALS AND METHODS: We obtained normal middle turbinate mucosa, edematous middle turbinate mucosa, polypoid middle turbinate mucosa and nasal polyp tissue from 5 patients at the time of surgery and we determined the distribution of substance P(SP) immunoreactive, vasoactive intestinal peptide(VIP) immunoreactive and neuropeptide-Y(NPY) immunoreactive nerve fibers in the above tissues using avidin-biotin complex(ABC) immunohistochemical method. RESULTS: Fine varicose peptidergic nerve fibers were found numerously in normal mucosa and they were decreased in number in the edematous mucosa. However the peptidergic nerve fibers were hardly found in the polypoid mucosa and the pedicle of polyp, and no nerve fibers were found in the apex of polyp except VIP-immunoreactive nerve fibers. CONCLUSION: Decreasing tendency of distribution of these peptidergic nerve fibers in the order of edematous mucosa, polypoid mucosa, and polyp may indicate the denervation of autonomic nervous system. These phenomenon suggests the important role of peptidergic neurotransmitters in the early stage of polyp formation. However, once the polyp has been formed, contribution of the peptidergic neurotransmitters is considered to be negligible.