Category: Nevin Manimala

Psychon Bull Rev. 2024 Oct 24. doi: 10.3758/s13423-024-02601-5. Online ahead of print.

ABSTRACT

Recent developments in artificial intelligence (AI) have led to changes in healthcare. Government and regulatory bodies have advocated the need for transparency in AI systems with recommendations to provide users with more details about AI accuracy and how AI systems work. However, increased transparency could lead to negative outcomes if humans become overreliant on the technology. This study investigated how changes in AI transparency affected human decision-making in a medical-screening visual search task. Transparency was manipulated by either giving or withholding knowledge about the accuracy of an ‘AI system’. We tested performance in seven simulated lab mammography tasks, in which observers searched for a cancer which could be correctly or incorrectly flagged by computer-aided detection (CAD) ‘AI prompts’. Across tasks, the CAD systems varied in accuracy. In the ‘transparent’ condition, participants were told the accuracy of the CAD system, in the ‘not transparent’ condition, they were not. The results showed that increasing CAD transparency impaired task performance, producing an increase in false alarms, decreased sensitivity, an increase in recall rate, and a decrease in positive predictive value. Along with increasing investment in AI, this research shows that it is important to investigate how transparency of AI systems affect human decision-making. Increased transparency may lead to overtrust in AI systems, which can impact clinical outcomes.

PMID:39448515 | DOI:10.3758/s13423-024-02601-5

Planta. 2024 Oct 24;260(6):125. doi: 10.1007/s00425-024-04548-2.

ABSTRACT

In the present review, we discussed the detailed signaling cascades via membrane transporters that confer plant tolerance to abiotic stresses and possible significant use in plant development for climate-resilient crops. Plant transporters play significant roles in nutrient uptake, cellular balance, and stress responses. They facilitate the exchange of chemicals and signals across the plant’s membrane by signal transduction, osmotic adjustment, and ion homeostasis. Therefore, research into plant transporters is crucial for understanding the mechanics of plant stress tolerance. Transporters have potential applications in crop breeding for increased stress resistance. We discuss new results about various transporter families (ABC, MATE, NRAMP, NRT, PHT, ZIP), including their functions in abiotic stress tolerance and plant development. Furthermore, we emphasize the importance of transporters in plant responses to abiotic stresses such as drought, cold, salt, and heavy metal toxicity, low light, flooding, and nutrient deficiencies. We discuss the transporter pathways and processes involved in diverse plant stress responses. This review discusses recent advances in the role of membrane transporters in abiotic stress tolerance in Arabidopsis and other crops. The review contains the genes discovered in recent years and associated molecular mechanisms that improve plants’ ability to survive abiotic stress and their possible future applications by integrating membrane transporters with other technologies.

PMID:39448443 | DOI:10.1007/s00425-024-04548-2

J Math Biol. 2024 Oct 24;89(5):54. doi: 10.1007/s00285-024-02153-1.

ABSTRACT

This paper is concerned with spatiotemporal dynamics of a fractional diffusive susceptible-infected-susceptible (SIS) epidemic model with mass action infection mechanism. Concretely, we first focus on the existence and stability of the disease-free and endemic equilibria. Then, we give the asymptotic profiles of the endemic equilibrium on small and large diffusion rates, which can reveal the impact of dispersal rates and fractional powers simultaneously. It is worth noting that we have some counter-intuitive findings: controlling the flow of infected individuals will not eradicate the disease, but restricting the movement of susceptible individuals will make the disease disappear.

PMID:39448396 | DOI:10.1007/s00285-024-02153-1

Pediatr Surg Int. 2024 Oct 24;40(1):273. doi: 10.1007/s00383-024-05864-0.

ABSTRACT

BACKGROUND: Congenital heart disease (CHD) care has evolved during the past decades. Advances in care have contributed to improved survival among CHD patients. Children with CHD are requiring interventions for non-CHD related medical issues that occur in the general pediatric population.

METHODS: A retrospective review of the Pediatric Health Information System (PHIS) database from January 1, 2004, to July 31, 2023. Discharges of patients with an admitting/principal diagnosis of appendicitis were evaluated and categorized as CHD or non-CHD.

RESULTS: A total of 319,228 patients were identified with 1,25,858(39.4%) female, 1,38,966(43.5%) white, and median age of 11[IQR:8-14] years. 708(0.2%) had CHD with 85(12%) of them having a diagnosis consistent with single-ventricle CHD (SV-CHD). In univariate analysis, CHD patients were more likely to undergo conservative treatment (n = 172(24.2%)vs n = 59,358(18.6%)) and less likely to undergo laparoscopic appendectomy (n = 483(68.2%) vs n = 2,35,324(73.8%))(p < 0.001) compared to non-CHD. After adjustment, CHD patients had increased odds of undergoing open appendectomy compared to non-CHD. CHD patients were more likely to have an ICU admission (OR:8.36(95%CI 6.35-10.00),p < 0.001) and had a 77.6%(95%CI 40.89-123.93) increase in length of stay (LOS) (p < 0.001).

CONCLUSION: CHD patients are more likely to have an open appendectomy than non-CHD patients. These findings suggest a distinctive pattern in the care of CHD patients compared to non-CHD. Overall, CHD patients had a more intense level of care with longer LOS and increased ICU admissions. Further work is needed to evaluate drivers of management decisions, the role of conservative treatment with antibiotics alone in the CHD population, and the potential impacts and safety of a laparoscopic approach.

PMID:39448395 | DOI:10.1007/s00383-024-05864-0

BJU Int. 2024 Oct 24. doi: 10.1111/bju.16539. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the relationship between renal pelvis pressure and infection after ureteroscopy, using a live swine model.

MATERIALS AND METHODS: In anaesthetised pigs, a 1-h ureteroscopy was performed using a pressure-sensing guidewire, with renal pelvis pressure maintained at either 37 mmHg or 75 mmHg for the entire procedure and infusion with saline alone or with a standardised concentration of uropathogenic Escherichia coli strain CFT073 (1.5 × 10⁷ colony-forming units [CFU]/mL). Venous blood sampling was performed during and after the procedure. Vital signs, inflammatory biomarkers, and renal tissue and blood cultures were assessed.

RESULTS: In 21 pig kidneys, study groups were: 37 mmHg with saline irrigation (n = 3); 75 mmHg with saline irrigation (n = 4); 37 mmHg with saline irrigation with 1.5 × 10⁷ CFU/mL E. coli (n = 7); and 75 mmHg with saline irrigation with 1.5 × 10⁷ CFU/mL E. coli (n = 7). Statistically significant changes in inflammatory biomarkers were most pronounced in the group with 75 mmHg saline irrigation + E. coli and were significantly elevated compared with the control group and the group receiving E. coli irrigation at 37 mmHg. Positive blood cultures were noted in 5/7 animals treated with E. coli at 75 mmHg; no others developed bacteraemia.

CONCLUSION: In this swine model of ureteroscopy, irrigation with saline + E. coli at a renal pelvis pressure of 75 mmHg resulted in bacteraemia and inflammatory biomarker elevations significantly greater than both E. coli irrigation with renal pelvis pressure maintained at 37 mmHg and the control.

PMID:39448382 | DOI:10.1111/bju.16539

J World Fed Orthod. 2024 Oct 23:S2212-4438(24)00083-3. doi: 10.1016/j.ejwf.2024.09.009. Online ahead of print.

ABSTRACT

BACKGROUND: This study used cone-beam computed tomography (CBCT) via voxel-based superimposition to evaluate lip and incisor changes after orthodontic treatment with four premolar extractions (Ext) versus nonextraction (Non-Ext) among African American (AA) and White (W) patients.

METHODS: A total of 240 CBCTs of 120 adolescent orthodontic patients with Class I skeletal/dental relationships were included. Patients were initially divided according to treatment, and then each group was subdivided according to patients’ ethnicity (Ext/W = 30, Ext/AA = 30, Non-Ext/W = 30, and Non-Ext/AA = 30). CBCTs were imported into Invivo6 for voxel-based superimposition. Lip and incisor measurements were recorded. Independent t tests and two-way ANOVA were used for statistical assessment.

RESULTS: The Non-Ext/W group had a greater increase in all outcome variables compared with the Non-Ext/AA group, with a significant change in volume and position of upper (UL) and lower lips (LL), inclination of upper (U1) and lower incisors (L1), and position of U1. The Ext/AA group had a greater decrease in all measured outcomes compared with the Ext/W group, with significant change in inclination of U1 and L1, and position and volume of LL. W patients had more crowding than AA patients in both treatment approaches. Retraction ratios of 6.5:1 and 2.1:1 were recorded between the U1 and UL positions, and L1 and LL positions, respectively. There were no direct interaction effects between ethnicity and treatment, nor were there any significant effects of ethnicity after controlling for the covariates.

CONCLUSIONS: Ethnicity alone has no impact on incisor and lip position after treatment. However, ethnicity in the form of initial presentation of malocclusion can have a significant influence.

PMID:39448364 | DOI:10.1016/j.ejwf.2024.09.009

J Tissue Viability. 2024 Oct 5:S0965-206X(24)00151-7. doi: 10.1016/j.jtv.2024.10.003. Online ahead of print.

ABSTRACT

BACKGROUND: Pressure injuries are associated with significant clinical complications with negative effects on the patient’s emotional, psychological, social and physical wellbeing. However, in Australia little is known about the knowledge and attitudes of nurses towards hospital-acquired pressure injuries.

OBJECTIVE: To determine nurse knowledge and attitudes towards hospital-acquired pressure injuries and to identify barriers towards prevention.

METHODS: A cross-sectional study following the STROBE statement was conducted between May to July in 2017. All nurses at a major metropolitan teaching hospital in Western Australia were invited to participate. Nurse knowledge and attitude to pressure injury were assessed using validated Pressure Ulcer Knowledge Assessment tool, and Attitude towards Pressure Ulcer Prevention tool. An open-ended question asked about the barriers to pressure injury prevention. Quantitative data were analysed using descriptive and inferential statistics and answers for the open-ended question were analysed using thematic analysis.

RESULTS: Data from 224 nurses (response rate 19.0 %) were analysed. While nurses displayed a satisfactory attitude towards hospital-acquired pressure injury prevention, most nurses lacked adequate knowledge of the stages, causes and prevention of pressure injuries. Thematic analysis of responses to the open-ended question yielded two main themes: modifiable barriers to pressure injury prevention were lack of knowledge, attitude of pressure injury prevention and the scarcity of resources. Non-modifiable barriers to pressure injury prevention were the nursing environment and patient characteristics.

CONCLUSION: Most nurses have satisfactory attitude towards pressure injury prevention, but inadequate knowledge about pressure injuries. Barriers to pressure injury prevention are attributed to nurse working environments, particularly impeded by staffing, time constraints and resources.

PMID:39448363 | DOI:10.1016/j.jtv.2024.10.003

J Geriatr Oncol. 2024 Oct 23:102131. doi: 10.1016/j.jgo.2024.102131. Online ahead of print.

NO ABSTRACT

PMID:39448360 | DOI:10.1016/j.jgo.2024.102131

Eur Urol Oncol. 2024 Oct 23:S2588-9311(24)00223-2. doi: 10.1016/j.euo.2024.09.014. Online ahead of print.

ABSTRACT

BACKGROUND: Avelumab first-line maintenance treatment was approved for patients with advanced urothelial carcinoma (aUC) without progression following platinum-based chemotherapy (PBC), based on the results from the JAVELIN Bladder 100 phase 3 trial.

OBJECTIVE: To report the results from AVENANCE, a real-world study of avelumab first-line maintenance treatment.

DESIGN, SETTING, AND PARTICIPANTS: This is a retrospective and prospective, noninterventional study (NCT04822350). Eligible patients with aUC without progression on first-line PBC were enrolled at 82 centers in France between July 2021 and May 2022. The effectiveness population included 595 patients. The median follow-up was 26.3 mo.

INTERVENTION: Previous, ongoing, or planned avelumab first-line maintenance treatment.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Overall survival (OS) from avelumab initiation (primary endpoint) and safety were evaluated.

RESULTS AND LIMITATIONS: The median age was 73.0 yr, and performance status was 0/1 in 91% of patients and ≥2 in 9.3%. The most common prior first-line chemotherapy regimen was carboplatin plus gemcitabine (61%). At data cutoff (December 7, 2023), the median duration of avelumab treatment was 5.6 mo, 125 patients remained on avelumab, and 55% had received second-line treatment. The median OS from avelumab initiation was 21.3 mo (95% confidence interval [CI], 17.6-24.6), and the median progression-free survival was 5.7 mo (95% CI, 5.2-6.5). In exploratory analyses of this population without disease progression on PBC, the median OS from the start of first-line PBC was 26.5 mo overall, and in subgroups that received second-line enfortumab vedotin (n = 55) or PBC (n = 79), it was 41.5 and 24.5 mo, respectively.

CONCLUSIONS: Real-world data from AVENANCE confirm the effectiveness and safety of avelumab first-line maintenance treatment in a heterogeneous population, supporting its recommendation for cisplatin-eligible and cisplatin-ineligible patients with aUC who are progression free after first-line PBC. In an exploratory analysis, a small subgroup that received a treatment sequence of first-line PBC without disease progression followed by avelumab first-line maintenance and second-line enfortumab vedotin had a median OS of >3 yr.

PATIENT SUMMARY: A French real-world study, called AVENANCE, looked at avelumab maintenance treatment in people with advanced urothelial cancer whose tumor disappeared, shrank, or stopped growing with chemotherapy. Overall, results were consistent with those seen in a previous clinical trial, and on average, people treated with avelumab maintenance lived for 26.5 mo from the start of chemotherapy. Analyses of different groups of people found that survival varied, with people living for an average of 18-42 mo depending on what treatment they received after they finished avelumab treatment.

PMID:39448350 | DOI:10.1016/j.euo.2024.09.014

Ann Chir Plast Esthet. 2024 Oct 23:S0294-1260(24)00162-6. doi: 10.1016/j.anplas.2024.09.002. Online ahead of print.

ABSTRACT

INTRODUCTION: The success of surgeries involving free flaps largely depends on accurate preoperative mapping of perforator arteries. Various imaging techniques, such as Doppler ultrasound and CT angiography, are typically used, each having its advantages and disadvantages in terms of cost, accuracy, and patient risk. The main objective of our study is to compare the effectiveness of the FLIR One device for detecting these arteries compared with traditional methods. Thermal imaging appears to be a simpler, less expensive, and less invasive alternative for surgical planning.

MATERIAL AND METHOD: The study, conducted at the Regional Hospital Center of Nancy, included 25 free flaps (DIEP) on an exclusively female cohort of 22 patients, with follow-up from 2022 to 2023. Before the procedure, an abdominal-pelvic CT angiography was performed, followed by additional evaluation with thermal imaging using FLIR One and acoustic Doppler examination on the eve of the operation. This approach aimed to provide precise mapping of vascular perforators for each patient. Three different operators performed these markings, and the results were then compared with intraoperative observations. The imaging protocol also included a Doppler examination to validate the results of the thermal imaging. Statistical analyses with intraclass correlation coefficients (ICC) were performed to evaluate the correlation between different preoperative localization methods of perforating vessels.

RESULTS: In 22 patients undergoing 25 DIEP flaps for breast reconstructions, three imaging techniques were used to identify vascular perforators: thermal imaging with FLIR, acoustic Doppler, and CT angiography. FLIR identified the most perforators (n=137), followed by acoustic Doppler (n=128) and CT angiography (n=126). Comparing these with intraoperative results, 66% of perforators identified by FLIR were confirmed, 70% for acoustic Doppler, and 95% for CT angiography. The ICCs shows a significant correlation between these imaging techniques and intraoperative results. FLIR demonstrated a strong correlation with intraoperative observations (ICC of 0.74, P<0.001), followed by a moderate correlation with acoustic Doppler (ICC of 0.56, P<0.03) and CT angiography (ICC of 0.52, P<0.006).

CONCLUSION: The study concludes that thermal imaging with FLIR is a reliable and effective tool for locating vascular perforators. Although the study and FLIR have their own limitations, the tool presents several advantages such as ease of use, speed, and affordability. These characteristics make FLIR particularly attractive as a complement to traditional detection methods, such as acoustic Doppler and CT angiography.

PMID:39448346 | DOI:10.1016/j.anplas.2024.09.002