BACKGROUND:In this study, we compared the predictive accuracy of voluntary cough peak flow (V-CPF) and involuntary cough peak flow (IV-CPF) for re-intubation in mechanically ventilated subjects. METHODS: Endotracheally intubated patients who passed a spontaneous breathing trial and assessment of readiness for extubation were enrolled. Before extubation, V-CPF and IV-CPF were measured. Re-intubation was recorded at 72 h after extubation. RESULTS: A total of 115 extubations in 106 cooperative subjects (including 9 subjects with second extubation) and 5 extubations in 5 uncooperative subjects were recorded. At 72 h, 20 (17.4%) and 1 (25%) instances of re-intubation occurred in cooperative and uncooperative subjects, respectively. In cooperative subjects, those who had been successfully extubated had higher V-CPF than re-intubated subjects

BackgroundLymph node metastasis (LNM) is a critical risk factor affecting treatment strategy and prognosis in patients with early‐stage cervical cancer.PurposeTo establish a multiparametric MRI (mpMRI)‐based radiomics nomogram for preoperatively predicting LNM status.Study TypeRetrospective.PopulationAmong 233 consecutive patients, 155 patients were randomly allocated to the primary cohort and 78 patients to the validation cohort.Field StrengthRadiomic features were extracted from a 1.5T mpMRI scan (T1‐weighted imaging [T1WI], fat‐saturated T2‐weighted imaging [FS‐T2WI], contrast‐enhanced [CE], diffusion‐weighted imaging [DWI], and apparent diffusion coefficient [ADC] maps).AssessmentThe performance of the nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness. The area under the receiver operating characteristics curve (ROC AUC), accuracy, sensitivity, and specificity were also calculated.Statistical TestsThe least absolute shrinkage and selection operator (LASSO) method was used for dimension reduction, feature selection, and radiomics signature building. Multivariable logistic regression analysis was used to develop the radiomics nomogram. An independent sample t‐test and chi‐squared test were used to compare the differences in continuous and categorical variables, respectively.ResultsThe radiomic signature allowed a good discrimination between the LNM and non‐LNM groups, with a C‐index of 0.856 (95% confidence interval [CI], 0.794–0.918) in the primary cohort and 0.883 (95% CI, 0.809–0.957) in the validation cohort. Additionally, the radiomics nomogram also had a good discriminating performance and yielded good calibration both in the primary and validation cohorts (C‐index, 0.882 [95% CI, 0.827–0.937], C‐index, 0.893 [95% CI, 0.822–0.964], respectively). Decision curve analysis demonstrated that the radiomics nomogram was clinically useful.Data ConclusionA radiomics nomogram was developed by incorporating the radiomics signature with the MRI‐reported LN status and FIGO stage. This nomogram might be used to facilitate the individualized prediction of LNM in patients with early‐stage cervical cancer.Level of Evidence3Technical Efficacy Stage2 J. Magn. Reson. Imaging 2020;52:885–896.

Background Semiquantitative cough strength score (SCSS, graded 0-5) and cough peak flow (CPF) have been used to predict extubation outcome in patients in whom extubation is planned; however, the correlation of the 2 assessments is unclear. Methods In the intensive care unit of a universityaffiliated hospital, 186 patients who were ready for extubation after a successful spontaneous breathing trial were enrolled in the study. Both SCSS and CPF were assessed before extubation. Reintubation was recorded 72 hours after extubation. Results Reintubation rate was 15.1% within 72 hours after planned extubation. Patients in whom extubation was successful had higher SCSSs than did reintubated patients (mean [SD] , and 5, respectively. The discriminatory power for reintubation, evidenced by area under the receiver operating characteristic curve, was similar: 0.677 for SCSS and 0.678 for CPF (P = .97). As SCSS increased (from 0 to 1 to 2 to 3 to 4 to 5), the reintubation rate decreased (from 29.4% to 25.0% to 19.4% to 16.1% to 13.2% to 4.1%). Conclusions SCSS was convenient to measure at the bedside. It was positively correlated with CPF and had the same accuracy for predicting reintubation after planned extubation. (American Journal of Critical Care. 2015;24:e86-e90)

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Multiple SBT attempts, weak cough and low albumin were associated with increased reintubation in medical patients. This study provides information for clinical practitioners in the consideration of patient extubation.