Category: Statistics

Am J Trop Med Hyg. 2023 Dec 26:tpmd230479. doi: 10.4269/ajtmh.23-0479. Online ahead of print.

ABSTRACT

Improving the quality of malaria clinical case management in health facilities is key to improving health outcomes in patients. The U.S. President’s Malaria Initiative Impact Malaria Project has supported implementation of the outreach training and supportive supervision (OTSS) approach in 11 African countries to improve the quality of malaria care in health facilities through the collection and analysis of observation-based data on health facility readiness and health provider competency in malaria case management. We conducted a secondary analysis of longitudinal data collected during routine supervision in Cameroon (April 2021-March 2022), Mali (October 2020-December 2021), and Niger (November 2020-September 2021) using digitized checklists to assess how service readiness affects health worker competencies in managing patients with fever correctly and providing those with confirmed uncomplicated malaria cases with appropriate treatment and referral. Linear or logistic regression analyses were conducted to assess the effect of facility readiness and its components on observed health worker competencies. All countries demonstrated significant associations between health facility readiness and malaria case management competencies. Data from three rounds of OTSS visits in Cameroon, Mali, and Niger showed a statistically significant positive association between greater facility readiness scores (including the availability of commodities, materials, and trained staff) and health worker competency in case management. These findings provide evidence that health worker performance is likely affected by the tools and training available to them. These results reinforce the need for necessary tools and properly trained staff if high-quality malaria case management services are to be delivered at health facilities.

PMID:38150737 | DOI:10.4269/ajtmh.23-0479

Nanotechnology. 2023 Dec 27. doi: 10.1088/1361-6528/ad18e2. Online ahead of print.

ABSTRACT

Smart energy storage systems, such as electrochromic supercapacitor (ECSC) integrated technology, have drawn a lot of attention recently, numerous developments have been made owing to their reliable performance. Developing novel electrode materials for ECSCs that embed two different technologies in a material is an exciting and emerging field of research. To date, the researches of ECSCs’ electrode materials have been ongoing with excellent efforts, which need to be systematically reviewed so that they can be used for developing more efficient ECSCs. This mini-review provides general composition, main evaluation parameters and future perspectives for electrode materials of ECSCs as well as a brief overview of the published reports about ECSCs along with performance statistics on the existing literature in this field.

PMID:38150723 | DOI:10.1088/1361-6528/ad18e2

Bol Med Hosp Infant Mex. 2023;80(6):339-344. doi: 10.24875/BMHIM.23000040.

ABSTRACT

BACKGROUND: Women are the primary caregivers of children in palliative care. Research has shown that the presence of intimate partner violence at home exacerbates the vulnerability of the caregiver. Current statistics indicate a high prevalence of violence in Mexico present in the intersectionality between intimate partner violence and the role of the primary caregiver. This study aimed to describe the frequency of intimate partner violence among primary palliative caregivers at the Hospital Infantil de México Federico Gómez.

METHODS: We conducted a cross-sectional and prospective study with convenience sampling; no sample calculation was performed. All female primary caregivers of children in the palliative care unit were invited to participate. The Scale of Violence and Index of Severity of Violence was used as the measuring instrument.

RESULTS: One hundred women participated in the study by submitting their survey in a designated mailbox. No sociodemographic data or patient diagnoses were collected. The frequency of intimate partner violence was 28%, of which 16% were considered severe cases. Women reported psychological violence (36%), sexual violence (23%), and physical violence (22%).

CONCLUSIONS: Almost one-third of female primary caregivers of pediatric patients at the Hospital Infantil de México Federico Gómez have been victims of some form of violence by current partners. This study highlights a previously unreported problem and opens the door for studies to correlate intimate partner violence among primary caregivers and the quality of life of children in palliative care.

PMID:38150715 | DOI:10.24875/BMHIM.23000040

Bol Med Hosp Infant Mex. 2023;80(6):374-380. doi: 10.24875/BMHIM.23000103.

ABSTRACT

BACKGROUND: Necrotizing enterocolitis (NEC) is the most common surgical disease in the neonatal period with a high mortality rate. To date, there is no consensus on the indications for surgery in the absence of pneumoperitoneum. This study aimed to determine the indications for surgery in pre-term infants with NEC and their mortality.

METHODS: We conducted a descriptive, observational, cross-sectional, and retrospective study including pre-term infants with NEC from two perinatal hospitals in Toluca, Mexico, between 2017 and 2022. Descriptive and inferential statistics and group comparisons were performed using Fisher and Kruskal-Wallis tests.

RESULTS: Of 236 patients with NEC, 52 (22%) required surgery; we analyzed 42 cases with complete clinical records. The indications for surgery were divided into (a) clinical deterioration (33.3%); (b) radiographic findings (31%); (c) laboratory alterations (19%); and (d) positive paracentesis (16.7%). The group of radiographic findings underwent surgery later, up to 2 days after the other groups. The mortality rate of surgical NEC was 42.9%.

CONCLUSIONS: The most common indication for surgery in pre-term infants with NEC was clinical worsening despite optimal medical management; radiographic findings were the indication associated with the highest mortality. Laboratory abnormalities and positive paracentesis were the indications with the best outcomes but the least used.

PMID:38150710 | DOI:10.24875/BMHIM.23000103

Med Ultrason. 2023 Dec 27;25(4):375-383. doi: 10.11152/mu-4306.

ABSTRACT

AIMS: To develop a deep learning model, with the aid of ChatGPT, for thyroid nodules, utilizing ultrasound images. The cytopathology of the fine needle aspiration biopsy (FNAB) serves as the baseline.

MATERIAL AND METHODS: After securing IRB approval, a retrospective study was conducted, analyzing thyroid ultrasound images and FNAB results from 1,061 patients between January 2017 and January 2022. Detailed examinations of their demographic profiles, imaging characteristics, and cytological features were conducted. The images were used for training a deep learning model to identify various thyroid pathologies. ChatGPT assisted in developing this model by aiding in code writing, preprocessing, model optimization, and troubleshooting.

RESULTS: The model demonstrated an accuracy of 0.81 on the testing set, within a 95% confidence interval of 0.76 to 0.87. It presented remarkable results across thyroid subgroups, particularly in the benign category, with high precision (0.78) and recall (0.96), yielding a balanced F1-score of 0.86. The malignant category also displayed high precision (0.82) and recall (0.92), with an F1-score of 0.87.

CONCLUSIONS: The study demonstrates the potential of artificial intelligence, particularly ChatGPT, in aiding the creation of robust deep learning models for medical image analysis.

PMID:38150678 | DOI:10.11152/mu-4306

Interv Neuroradiol. 2023 Dec 27:15910199231222676. doi: 10.1177/15910199231222676. Online ahead of print.

ABSTRACT

BACKGROUND: Cerebral aneurysms are often identified and characterized on non-invasive CT Angiography (CTA) images, but digital subtraction angiography (DSA) is the gold standard for aneurysm evaluation.

OBJECTIVE: We compared cerebral aneurysm size measurements as measured from CTA processed by a semi-automated artificial intelligence software program (RAPID Aneurysm) and three-dimensional rotational DSA (3D-DSA).

METHODS: We performed a retrospective cohort study of consecutive patients with a cerebral aneurysm who underwent CTA and DSA with 3D reformations. CTA images were processed by RAPID Aneurysm to determine aneurysm height, width, and neck width. The reference standard was aneurysm measurements on 3D-DSA as measured by two neurointerventionalists. Both readers were blinded to RAPID Aneurysm measurements. Correlation and bias between these measurements were determined.

RESULTS: Results from 50 patients with 50 aneurysms were compared. 32 patients (64%) were female. Median age was 65 (IQR: 56.25-71.75). 37 patients (74%) presented with ruptured aneurysms. The aneurysms represented a range of aneurysm sizes (1.9-33.3 mm; IQR 3.6-7.2 mm). RAPID Aneurysm size measurements showed excellent correlation and low bias (correlation, mean difference) when compared to the reference standard for aneurysm height (0.98, -0.9 mm), width (0.98, 0.1 mm), and neck width (0.94, 1.1 mm). The inter-reader comparison between the two neurointerventionalists was similarly excellent for aneurysm height (0.97, -0.4 mm), width (0.98, -0.2 mm), and neck width (0.89, 0.8 mm).

CONCLUSION: RAPID Aneurysm measurement of cerebral aneurysm height, width, and neck width on CTA is strongly correlated to expert neurointerventionalist measurements on 3D-DSA.

PMID:38150662 | DOI:10.1177/15910199231222676

Med Oral Patol Oral Cir Bucal. 2023 Dec 27:26313. doi: 10.4317/medoral.26313. Online ahead of print.

ABSTRACT

BACKGROUND: Upper third molar (U3M) removal is a common surgical procedure. The aims of this study were to assess the patient-specific, radiological and surgical factors related to the difficulty of U3M removal, and to determine the incidence of intraoperative and postoperative complications.

MATERIAL AND METHODS: A prospective cohort study was carried out in adult patients undergoing U3M removal. Operative time, surgeon-reported difficulty and the Parant classification were used to assess extraction difficulty. Clinical, radiological and surgical factors were recorded to determine their relationship with surgical difficulty. A descriptive, bivariate and multivariate statistical analysis was carried out.

RESULTS: A total of 250 patients were included. The mean operative time was 10.4 (±12.3) minutes, mean surgeon-reported difficulty was 3.2/10 (±2.3). The multivariate analysis showed greater impaction against the second molar and greater soft tissue and bony impaction to significantly increase operative time and surgeon-perceived difficulty. Additionally, surgeon experience was related to perceived difficulty. The overall incidence of intraoperative complications was 0.8%, and no postoperative events were recorded.

CONCLUSIONS: Upper third molars in close relation with the roots of the adjacent second molar and with soft tissue and bony impaction are significantly more difficult to extract. Perceived difficulty was related to surgeon experience. This procedure appears to produce few intra- and postoperative complications.

PMID:38150607 | DOI:10.4317/medoral.26313

Med Oral Patol Oral Cir Bucal. 2023 Dec 27:26084. doi: 10.4317/medoral.26084. Online ahead of print.

ABSTRACT

BACKGROUND: This study’s purpose is to retrospectively evaluate the success of surgical methods used in treating Oroantral Communication (OAC).

MATERIAL AND METHODS: This study was designed as a retrospective cohort study on patients who developed OAC after surgery maxillary posterior region. The records of patients previously treated with OAC were scanned through the hospital registry software. A data set was created by recording patients’ age, gender, systemic disease, etiological reasons, and surgical methods. The primary predictor variable was the surgical method used to treat OAC. Other variables were age, gender, systemic disease and etiological reasons. The primary outcome was oroantral fistula development after the first surgical intervention. The patients who were positive in clinical examination and Valsalva test on control days were considered unsuccessful. One-way analysis of variance and Kruskal-Wallis tests were used for quantitative variables in more than two groups. Pearson chi-square test was used to compare categorical data.

RESULTS: This retrospective cohort study was completed with 605 patients who met the study criteria among 95,883 patients who underwent surgery in the maxillary posterior region. The incidence of OAC was 0.63%. The patients consisted of 238 female and 367 male patients. The mean age was 41.06±14.48 years. Buccal flap and Buccal Fat Pad methods were used most frequently in the treatment. While treatment was completed with the first surgical intervention in 592 (97.85%) patients, OAF developed in 13 (2.15%) patients. No statistically significant relation existed between surgical technique and OAF development (p>0.005). The success rate of the Buccal Flap method was 98.7%, and the Buccal Fat Pad method was 95.8%.

CONCLUSIONS: The results of this study showed that noninvasive methods in openings smaller than 5 mm and surgical treatment methods in openings larger than 5 mm have a high success rate with the limitations of present study.

PMID:38150602 | DOI:10.4317/medoral.26084

J Laparoendosc Adv Surg Tech A. 2023 Dec 27. doi: 10.1089/lap.2023.0342. Online ahead of print.

ABSTRACT

Introduction: Minimally invasive surgery for ventral hernia repair (MIS-VHR) with mesh in retromuscular plane can be performed by either transabdominally (TA-RM) or via enhanced view totally extraperitoneal approach (eTEP). Although both techniques offer the mesh extension in the best anatomical space, closure of hernia defect, avoidance of traumatic fixation, the superiority of one approach over another is not established. This systematic review and meta-analysis were set up to analyze safety and efficacy of eTEP in comparison with TA-RM. Materials and Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) framework was used as guideline to conduct systematic search of literature. Studies that provided comparative data of MIS-VHR using eTEP versus TA-RM were identified. Primary outcomes were major complications. These were defined as grade III-IV according to Clavien-Dindo classification. Secondary outcomes included: surgical site infection (SSI) rates, seroma rates, surgical site occurrence requiring procedural intervention (SSOPI), minor complications (Clavien-Dindo grade I-II), intraoperative complications, recurrence rate, postoperative ileus, duration of surgery, postoperative pain. Random- and fixed-effects models of statistical analysis were used. Risk difference (RD) was computated for binary outcomes (major and minor complications, SSI, seroma, SSOPI, recurrence, ileus) with 95% confidence intervals. I² test was used to assess statistical heterogeneity. Risk of bias assessment was performed using Newcastle-Ottawa framework. Results: There were 3 observational studies that enrolled 370 participants. In the eTEP group there were 166 patients and, in the TA-RM group there were 204 patients. There was no significant RD with regard to major complications (RD -0.02 [-0.06 to 0.02], test for overall effect: Z = 0.86 [P = .39]). There was no significant RD in occurrence of minor complications, SSI, seroma, SSOPI, recurrence, ileus. Conclusions: Both eTEP and TA-RM were found to have equal safety profile. Further high-quality studies evaluating patient reported outcomes and late recurrence may be useful. PROSPERO registration number: CRD42023429160.

PMID:38150538 | DOI:10.1089/lap.2023.0342

Ann Bot. 2023 Dec 27:mcad199. doi: 10.1093/aob/mcad199. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: In many systems, postfire vegetation recovery is characterised by temporal changes in plant species composition and richness. We attribute this to changes in resource availability with time since fire, with the magnitude of species turnover determined by the degree of resource limitation. Here we test the hypothesis that postfire species turnover in South African fynbos heathland is powered by fire-modulated changes in nutrient availability, with the magnitude of turnover in nutrient-constrained fynbos being greater than in fertile renosterveld shrubland. We also test the hypothesis that floristic overlaps between fynbos and renosterveld are attributable nutritional augmentation of fynbos soils immediately after fire.

METHODS: We use vegetation survey data from two sites on the Cape Peninsula to compare changes in species richness and composition with time since fire.

KEY RESULTS: Whereas fynbos communities display a clear decline in species richness with time since fire, no such decline is apparent in renosterveld. In fynbos, declining species richness is associated with declines in the richness of plant families having high foliar concentrations of nitrogen, phosphorus, and potassium, and possessing attributes which are nutritionally costly. By contrast, families which dominate late-succession fynbos possess adaptations for the acquisition and retention of sparse nutrients. At the family level, recently burnt fynbos is compositionally more similar to renosterveld than is mature fynbos.

CONCLUSIONS: Our data suggest that nutritionally driven species turnover contributes significantly to fynbos community richness. We propose that the extremely low baseline fertility of fynbos soils serves to lengthen the nutritional resource axis along which species can differentiate and coexist, thereby providing the opportunity for low-nutrient extremophiles to coexist spatially with more fertile adapted species. This mechanism has the potential to operate in any resource-constrained system in which episodic disturbance affects resource availability.

PMID:38150535 | DOI:10.1093/aob/mcad199