251 research outputs found
HE4 as a Biomarker for Endometrial Cancer
There are currently no blood biomarkers in routine clinical use in endometrial carcinoma (EC). Human epididymis protein 4 (HE4) is a glycoprotein that is overexpressed in the serum of patients with EC, making it a good candidate for use as a diagnostic and/or prognostic biomarker. HE4 is correlated with poor prognostic factors, including stage, myometrial invasion and lymph node metastases, which means it could be used to guide decisions regarding the extent of surgery and need for adjuvant therapy. Serum HE4 has also shown promise for predicting responses to progestin therapy in early-stage EC. The use of algorithms and indices incorporating serum HE4 and other biomarkers, including clinical and imaging variables, is an area of increasing interest. Serum HE4 levels rise with age and renal dysfunction, which may affect the interpretation of results. This review covers the evidence supporting the use of HE4 as an EC biomarker for diagnosis, prognosis, recurrence monitoring, and prediction of therapy response. The evidence for combining serum HE4 with other biomarkers, including clinical and imaging variables, its value as a biomarker in other biofluids and potential challenges of its clinical use are also discussed
Postpartum contraception counseling and uptake in an uninsured population
Objective: Assess postpartum contraceptive preferences and use before and after implementation of interventions to improve contraceptive counseling at a free clinic for uninsured pregnant patients. Methods: This was a pre- and post-intervention observational study in Iowa City, Iowa, that included patients from February 2019 – December 2021. Multilingual educational charts and an electronic medical record (EMR) template reminder to prompt antenatal contraceptive discussion were implemented in April 2021. Results: There were 117 pre-intervention patients and 33 post-intervention. Prior to the intervention, 30% of patients had no documentation of contraceptive counseling; afterward, 3% had no documentation (p=.001). Thirty-three percent of patients obtained highly or moderately effective contraception prior to the interventions and 52% did after (p=.068). Conclusions: Multi-lingual educational handouts and an EMR template reminder were associated with increased postpartum contraceptive counseling; contraceptive use also generally increased with the interventions. Increasing access to contraceptive education may increase contraceptive autonomy in underserved populations
Serum CA125 and HE4 as Biomarkers for the Detection of Endometrial Cancer and Associated High-Risk Features
Early detection of endometrial cancer improves survival. Non-invasive diagnostic biomarkers would improve triage of symptomatic women for investigations. This study aimed to determine the diagnostic accuracy of serum Cancer Antigen 125 (CA125) and Human Epididymis 4 (HE4) for endometrial cancer and associated high-risk features. Serum samples from women investigated for gynaecological symptoms or diagnosed with endometrial cancer were analysed for CA125 and HE4. Conventional diagnostic metrics were calculated. In total, 755 women were included; 397 had endometrial cancer. Serum CA125 and HE4 were significantly elevated in cases compared with controls (both p < 0.001), and with pathological markers of disease severity (p < 0.05). A combination of CA125 and HE4 detected endometrial cancer with an area under the curve (AUC) of 0.77 (95% CI: 0.74–0.81). In a model with body mass index (BMI) and parity, HE4 predicted endometrial cancer in pre-menopausal women with an AUC of 0.91 [sensitivity = 84.5%, specificity = 80.9% (p < 0.001)]. In women with abnormal ultrasound, HE4 ≥ 77 pmol/L improved specificity compared with imaging alone [68.6% (95% CI: 75.0–83.6) vs. 34.4% (95% CI: 27.1–42.3), respectively], but at a cost to sensitivity. HE4 ≥ 77 pmol/L improved the detection of myometrial invasion ≥50% in women with stage I disease compared with magnetic resonance imaging (MRI) alone [sensitivity = 100% (95% CI: 54.1–100)]. CA125 ≥ 35 U/mL did not add to imaging. HE4 is a good predictor of poor prognostic features which could assist staging investigations
PulsarX: a new pulsar searching package -I. A high performance folding program for pulsar surveys
Pulsar surveys with modern radio telescopes are becoming increasingly
computationally demanding. This is particularly true for wide field-of-view
pulsar surveys with radio interferometers, and those conducted in real or
quasi-real time. These demands result in data analysis bottlenecks that can
limit the parameter space covered by the surveys and diminish their scientific
return. In this paper, we address the computational challenge of `candidate
folding' in pulsar searching, presenting a novel, efficient approach designed
to optimise the simultaneous folding of large numbers of pulsar candidates. We
provide a complete folding pipeline appropriate for large-scale pulsar surveys
including radio frequency interference (RFI) mitigation, dedispersion, folding
and parameter optimization. By leveraging the Fast Discrete Dispersion Measure
Transform (FDMT) algorithm proposed by Zackay et al. (2017), we have developed
an optimized, and cache-friendly implementation that we term the pruned FDMT
(pFDMT). The pFDMT approach efficiently reuses intermediate processing results
and prunes the unused computation paths, resulting in a significant reduction
in arithmetic operations. In addition, we propose a novel folding algorithm
based on the Tikhonov-regularised least squares method (TLSM) that can improve
the time resolution of the pulsar profile. We present the performance of its
real-world application as an integral part of two major pulsar search projects
conducted with the MeerKAT telescope: the MPIfR-MeerKAT Galactic Plane Survey
(MMGPS) and the Transients and Pulsars with MeerKAT (TRAPUM) project. In our
processing, for approximately 500 candidates, the theoretical number of
dedispersion operations can be reduced by a factor of around 50 when compared
to brute-force dedispersion, which scales with the number of candidates.Comment: Accepted for publication in A&
Using polygenic scores for identifying individuals at increased risk of substance use disorders in clinical and population samples
HE4 as a Biomarker for Endometrial Cancer
From MDPI via Jisc Publications RouterHistory: accepted 2021-09-17, pub-electronic 2021-09-23Publication status: PublishedFunder: Manchester Biomedical Research Centre; Grant(s): IS-BRC-1215-20007Funder: National Institute for Health Research; Grant(s): NIHR300650There are currently no blood biomarkers in routine clinical use in endometrial carcinoma (EC). Human epididymis protein 4 (HE4) is a glycoprotein that is overexpressed in the serum of patients with EC, making it a good candidate for use as a diagnostic and/or prognostic biomarker. HE4 is correlated with poor prognostic factors, including stage, myometrial invasion and lymph node metastases, which means it could be used to guide decisions regarding the extent of surgery and need for adjuvant therapy. Serum HE4 has also shown promise for predicting responses to progestin therapy in early-stage EC. The use of algorithms and indices incorporating serum HE4 and other biomarkers, including clinical and imaging variables, is an area of increasing interest. Serum HE4 levels rise with age and renal dysfunction, which may affect the interpretation of results. This review covers the evidence supporting the use of HE4 as an EC biomarker for diagnosis, prognosis, recurrence monitoring, and prediction of therapy response. The evidence for combining serum HE4 with other biomarkers, including clinical and imaging variables, its value as a biomarker in other biofluids and potential challenges of its clinical use are also discussed
Comparison of two immunoassays for the measurement of serum HE4 for ovarian cancer.
INTRODUCTION: The use of Human Epididymis Protein 4 (HE4) as a biomarker for ovarian cancer is gaining traction, providing the impetus for development of a high throughput automated HE4 assay that is comparable to the conventional manual enzyme immunometric-assay (EIA). The aim of this study was to compare two immunoassay methods for the measurement of serum HE4. MATERIALS AND METHODS: 1348 serum samples were analysed for serum HE4 using both the EIA and the automated chemiluminescent immunoassay (CLEIA) methods. HE4 values were compared using a Passing-Bablok regression and agreement assessed using Lin's concordance correlation coefficient (CCC). The absolute and percentage bias of the CLEIA compared to EIA was determined. RESULTS: There was moderate agreement between the two methods (CCC 0.929, 95%CI 0.923-0.936). Passing-Bablok regression demonstrated an overestimation of the CLEIA [constant 4.44 (95%CI 2.96-5.68), slope 1.04 (95%CI 1.02-1.07)]. The CLEIA method had a mean percentage bias of 16.25% compared to the EIA method. CONCLUSION: The CLEIA significantly overestimated serum HE4 values compared to the EIA, which could impact clinical interpretation and patient management. Further studies are required to develop an appropriate cut-off depending on the population being investigated and the analytic method being used
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