Tag: nevin manimala

Knee. 2023 Sep 11;44:253-261. doi: 10.1016/j.knee.2023.08.018. Online ahead of print.

ABSTRACT

BACKGROUND: Patient satisfaction following primary total knee arthroplasty (TKA) is a crucial part to evaluate the success of the procedure. The purpose of this study was to develop to predict patient satisfaction following TKA.

METHODS: Satisfaction outcome data after 435 consecutive conventional TKAs performed between August 2020 and December 2021 were retrospectively collected. The total 26 input data were collected. The most favorable algorithm was first found using logistic regression (LR) and machine learning (ML) algorithms. To evaluate the predictive performance of the models, both area under curve (AUC) and F1-score were used as the primary metrics. The shapley additive explanations (SHAP) feature explanation in XGBoost and LR analysis were performed to interpret the model.

RESULTS: The performance of extreme gradient boosting classifier (XGBoost) was only higher than that of conventional LR in AUC (0.782 vs. 0.689). Comparing the F-1 score, only XGBoost showed better performance than LR (0.857 vs. 0.800). The most predictive feature in XGBoost was Short Form-36 physical and mental component summary scores (SF-36 MCS), followed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, Bone mineral density (BMD). In the LR analysis, lumbar spine disease, WOMAC pain, and BMD were statistically significant.

CONCLUSION: XGboost showed the best performance and was superior to conventional LR in the prediction of patient satisfaction after TKA. The SF-36 MCS was the most important feature in the ML model. WOMAC pain and BMD were meaningful variables and demonstrated a linear relationship with satisfaction in both the LR and ML models.

LEVEL OF EVIDENCE: Retrospective cohort study; Level of evidence 3.

PMID:37703604 | DOI:10.1016/j.knee.2023.08.018

J Plast Reconstr Aesthet Surg. 2023 Aug 19;86:58-64. doi: 10.1016/j.bjps.2023.08.011. Online ahead of print.

ABSTRACT

BACKGROUND: To enhance the success rate of alveolar bone grafting, it is crucial to identify the factors that may influence the postoperative bone formation. This study aimed to investigate the impact of various osseous structure characteristics of alveolar clefts on the survival ratio of autogenous cancellous bone particle grafts.

METHODS: A retrospective study was conducted on 60 patients who underwent surgery performed by the same surgeon between 2016 and 2022. Two researchers measured and recorded the bone defect volume (DV), postoperative bone formation volume at 1 year, contact area between the graft and the bone surface within the cleft (S), cleft width (CW), osseous occlusion relationships, and presence of a cleft palate and initial bone bridge within the cleft for each patient. Pearson correlation analysis, Spearman’s correlation analysis, and multiple linear regression analysis were performed.

RESULTS: The analysis results revealed statistical correlations between DV, CW, ratio of S to DV, cleft palate, initial bone bridge presence, and occlusion relationships with the survival rate. Multiple linear regression analysis showed that initial bone bridge and occlusion relationships affected the graft survival rate.

CONCLUSIONS: Based on the presence of initial bone bridges and occlusions, we can make a rough estimate of the postoperative bone formation outcome in patients. However, the underlying mechanisms by which these two factors influence the bone formation require further investigation. In addition, preoperative orthodontic treatment to improve occlusal relationships may improve the postoperative bone formation outcomes in alveolar bone grafting.

PMID:37703598 | DOI:10.1016/j.bjps.2023.08.011

J Stroke Cerebrovasc Dis. 2023 Sep 11;32(10):107302. doi: 10.1016/j.jstrokecerebrovasdis.2023.107302. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to analyze the factors affecting the long-term quality of life of patients with mild stroke and evaluate the differences according to age and sex.

MATERIALS AND METHODS: The Korean Stroke Cohort for functioning and rehabilitation data was used, and patients with mild stroke with a National Institute of Health Stroke Scale score of < 5 were included. Quality of life after 6 months was analyzed using EuroQol-5 dimensions. Demographic and clinical characteristics were evaluated, and factors affecting the quality of life at 6 months were analyzed.

RESULTS: Age, current drinking, marital status, length of stay, and modified Rankin Scale, Fugl-Meyer assessment, Functional Independence Measure, and Geriatric Depression Scale scores affected the quality of life at 6 months in patients with mild stroke. Fugl-Meyer assessment score was a predictor for those aged < 65 years, while the functional ambulatory category was a predictor for those aged ≥ 65 years. Predictors of quality of life, excluding alcohol consumption, were comparable between male and female.

CONCLUSIONS: Among patients aged <65 years, individuals who consumed alcohol, and those who showed better motor function and fewer comorbidities had a higher quality of life. Among patients aged ≥65 years, quality of life was higher in males, younger age, married individuals, those with diabetes, and those with a better walking ability. Among male, individuals who consumed alcohol had a higher quality of life. Rehabilitation treatment should prioritize improving modifiable factors to enhance the quality of life in patients with mild stroke.

PMID:37703592 | DOI:10.1016/j.jstrokecerebrovasdis.2023.107302

Bol Med Hosp Infant Mex. 2023;80(4):242-246. doi: 10.24875/BMHIM.23000032.

ABSTRACT

BACKGROUND: Arterial oxygen saturation (S_aO₂) values are used to make clinical decisions that might change a patient’s prognosis, and it has been proposed as the fifth vital sign. This study aimed to determine the variation of S_aO₂ at different altitudes above sea level (ASL) in healthy Mexican full-term newborns.

METHODS: From July 2018 to June 2019, a cross-over study was conducted in six hospitals at different altitudes ASL in Mexico. S_aO₂ was measured in 4015 newborns after the first 24 h of birth and before leaving the hospital using pulse oximetry. We analyzed three groups: < 250 m ASL (group 1), 1500 m ASL (group 2), and 2250 m ASL (group 3).

RESULTS: The mean S_aO₂ was 97.6 ± 1.8%. For group 1, mean oxygen saturation was 98.2 ± 1.9%; for group 2, 96.7 ± 1.9%, and for group 3, 96.0 ± 2.1%. A statistically significant difference was observed among the groups (p < 0.001), and this difference was higher between groups 1 and 2 (1.5%, p < 0.001). Linear regression analysis showed a decrease in oxygen saturation of 1.01% for every 1000 m ASL.

CONCLUSIONS: We demonstrated a statistically significant reduction in S_aO₂ levels at higher altitudes. This observation can be relevant for clinical decision-making based on pulse oximetry such as critical congenital heart disease screening in Mexico, where more than half of the population lives above 1500 m ASL.

PMID:37703553 | DOI:10.24875/BMHIM.23000032

Rhinology. 2023 Sep 13. doi: 10.4193/Rhin23.204. Online ahead of print.

ABSTRACT

This meta-analysis aims to investigate the outcome of sinonasal adenoid cystic carcinoma (snAdCC). We followed PRISMA guidelines and included studies reporting 5-year overall survival (OS) rates for snAdCC. Eligible studies were identified through a literature search and assessed using JBI critical appraisal checklist. A total of 17 studies were included comprising 2259 patients (mean age: 58.1 years, 52.7% female, 47.3% male). The meta-analysis demonstrated that the 5-year OS, 10-year OS, and 5-year disease-free survival (DFS) were 68%, 40%, and 47.2%, respectively. Descriptive statistics on study level showed high rates of locally advanced tumor stages at diagnosis: 23% cT3, 53% cT4, 3.4% N+, and 4.2% M+. 29.7% of the tumors were in the nasal cavity, 67.6% in the paranasal sinuses. The maxillary, ethmoid, sphenoid, and frontal sinus were affected in 50.9%, 7.2%, 4%, and 0.5%, of cases. A combination of surgery and radiotherapy was used in 45.4% of the patients and 19.3% of patients received surgery only. In conclusion, these findings emphasize the significance of thorough surveillance for individuals with snAdCC to identify any potential recurrence or progression of the disease.

PMID:37703531 | DOI:10.4193/Rhin23.204

Am J Hosp Palliat Care. 2023 Sep 13:10499091231200639. doi: 10.1177/10499091231200639. Online ahead of print.

ABSTRACT

Objective: Palliative care often plays a pivotal role in supporting informal caregivers of persons living with dementia who experience a lack of continuity in care. Dementia caregiver activation, the caregiver’s willingness and ability to navigate care needs, requires communication skills for developing relationships with healthcare providers. Communication activation is important because caregivers facilitate physician and patient information exchange. This study aimed to explore changes in communication outcomes (attitude, knowledge, and skills) and impact on caregiver communication activation (confidence, self-report) following completion of a brief communication module. Methods: A 15-minute asynchronous online module was developed to provide caregivers with communication skills for working with doctors and nurses. Caregivers completed pre/post module measures of communication outcomes, a vignette for applying communication strategies and were interviewed within a week of module completion to assess self-reported communication activation. Module acceptability was also evaluated. Results: Communication knowledge (P < .01) significantly increased and nearly all participants (99%) demonstrated use of module-specific communication skills after completing the module. While not statistically significant, caregiver attitudes were in the expected direction. Caregiver self-reported communication confidence (P < .001) significantly increased and 84% of caregivers described communication activation at post-module. Caregivers (83%) were likely to recommend the module. Conclusions: The brief communication module for dementia caregivers in this project offers an online resource with low time-burden that results in caregiver communication activation. Future testing in the clinical setting will increase understanding of its efficacy and integration and could be a viable resource for palliative care providers.

PMID:37703530 | DOI:10.1177/10499091231200639

Fam Community Health. 2023 Oct-Dec 01;46(4):242-249. doi: 10.1097/FCH.0000000000000377.

ABSTRACT

Existing research has established the detrimental effects of food insecurity on health. However, understanding of the social conditions that may moderate this relationship remains limited. To address this gap, the study investigates two questions: First, does marital status moderate the association between food insecurity and self-rated health? Second, if such moderation exists, does its impact vary based on gender? Data from the 2017-2018 Canadian Community Health Survey, a nationally representative survey conducted by Statistics Canada (n =101 647), were utilized for this investigation. The findings demonstrated that individuals living in food-insecure households reported poorer self-rated mental and general health. However, the negative impact of food insecurity on both health outcomes was less pronounced among married individuals than among their unmarried counterparts. Furthermore, the stress-buffering role of marriage was found to be more substantial among men than among women. In light of the significant stress-buffering role of marriage revealed in this study, it is crucial for policies to aim at providing comparable coping resources to unmarried individuals, particularly women.

PMID:37703512 | DOI:10.1097/FCH.0000000000000377

J Am Coll Surg. 2023 Sep 13. doi: 10.1097/XCS.0000000000000863. Online ahead of print.

ABSTRACT

BACKGROUND: High-quality computed tomography (CT) can exclude HVI in patients with an A-SBS but performs poorly at identifying HVI. Delay in diagnosis of HVI has significant consequences necessitating timely identification.

STUDY DESIGN: This multicenter, prospective observational study conducted at nine trauma centers between August 2020-October 2021 included adult trauma patients with A-SBS who underwent abdominal CT prior to surgery. HVI was determined intra-operatively and physiologic, examination, laboratory, and imaging findings were collected. Lasso and probit regression selected predictor variables and coefficients were used to assign integer points for the HVI Score. Validation was performed by comparing area under receiver operating curves (AUROC).

RESULTS: Analysis included 473 in the development set and 203 in the validation set. The HVI Score includes initial systolic blood pressure < 110mmHg, abdominal tenderness, guarding, and select abdominal CT findings. The derivation set has an AUROC of 0.96 and the validation set has an AUROC of 0.91. The HVI Score ranges from 0-17 with score 0-5 having a HVI risk of 0.03-5.36%, 6-9 having a risk of 10.65-44.1%, and 10-17 having a risk of 58.59-99.72%.

CONCLUSIONS: This multicenter study developed and validated a novel HVI Score incorporating readily available physiologic, examination, and CT findings to risk stratify patients with an abdominal SBS. The HVI Score can be used to guide decisions regarding management of a patient with an abdominal SBS and suspected HVI.

PMID:37703489 | DOI:10.1097/XCS.0000000000000863

Chaos. 2023 Sep 1;33(9):093117. doi: 10.1063/5.0156025.

ABSTRACT

Synchronization of chaotic systems is usually investigated for structurally equivalent systems typically coupled through linear diffusive functions. Here, we focus on a particular type of coupling borrowed from a nonlinear control theory and based on the optimal placement of a sensor-a device measuring the chosen variable-and an actuator-a device applying the actuating (control) signal to a variable’s derivative-in the response system, leading to the so-called flat control law. We aim to investigate the dynamics produced by a response system that is flat coupled to a drive system and to determine the degree of generalized synchronization between them using statistical and topological arguments. The general use of a flat control law for getting generalized synchronization is discussed.

PMID:37703476 | DOI:10.1063/5.0156025

Rev Esc Enferm USP. 2023 Aug 28;57:e20230047. doi: 10.1590/1980-220X-REEUSP-2023-0047en. eCollection 2023.

ABSTRACT

OBJECTIVE: To compare nursing staff workload and dimensioning measured by two patient classification systems.

METHOD: Cross-sectional study, developed in a clinical inpatient unit of a large hospital in southern Brazil, between June and August 2022. Included patients (n = 260) were assessed through two different patient classification systems. The dimensioning calculation provided by the standard and descriptive statistics were applied.

RESULTS: Of the total number of patients, 1,248 classifications were performed with each of the classification systems. One of the instruments showed a concentration of demand for minimal care (54.5%) and the other for intermediate care (63.4%). The anticipation of required nursing hours was discrepant (235.58 and 298.16 hours), as well as the projected nursing staff, which was of 53 and 67 workers, respectively.

CONCLUSION: Measurement of workload and dimensioning were different when using two patient classification systems in the same sample. Additional accuracy studies shall be carried out.

PMID:37703470 | DOI:10.1590/1980-220X-REEUSP-2023-0047en