Tag: pubmed

BMC Surg. 2024 Dec 31;24(1):426. doi: 10.1186/s12893-024-02724-5.

ABSTRACT

PURPOSE: This retrospective cohort study aimed to identify factors associated with preoperative deep venous thrombosis (DVT) in elderly patients with femoral neck fractures, and to investigate whether combining these factors could improve the ability to predict DVT.

METHOD: Medical records and laboratory test results were reviewed patients presenting with a femoral neck fracture and receiving routine chemoprophylaxis for DVT between January 2020 and December 2023 in a tertiary referral, university-affiliated hospital. Preoperative DVT was confirmed by Doppler ultrasound or CT venography. Demographic, injury, comorbidity, and laboratory variables were analyzed using univariate and multivariate approaches. The performance of combined predictive factors was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS: Among the 499 patients included, 47 (9.4%) were diagnosed with a preoperative DVT. In the univariate analysis, five variables were found to be statistically significant, including alcohol consumption (P = 0.017), history of renal disease (P < 0.001), elevated D-dimer level (both traditional and age-adjusted cut-off used) (P = 0.007 or < 0.003), increased platelet distribution width (PDW) (P < 0.001) and reduced albumin in continuous or categorical variable (P = 0.027, P = 0.002). Multivariate analysis confirmed all except alcohol consumption as independent predictors (all P < 0.05). ROC curve analysis showed that combining these four significant variables with age improved the ability to predict preoperative DVT, with an area under the curve of 0.749 (95% CI: 0.676-0.822, P < 0.001), sensitivity of 0.617, and specificity of 0.757.

CONCLUSION: This study identified several factors associated with preoperative DVT, and combining them demonstrated improved performance in predicting DVT, which can facilitate risk assessment, stratification and improved management in clinical practice.

PMID:39736660 | DOI:10.1186/s12893-024-02724-5

BMC Musculoskelet Disord. 2024 Dec 30;25(1):1094. doi: 10.1186/s12891-024-08256-6.

ABSTRACT

BACKGROUND: The optimal length of thromboprophylaxis after total hip or knee arthroplasty (THA and TKA) is unknown. Fast-track protocols have improved patient care and led to shorter immobilization and length of stay (LOS) after THA and TKA, thereby diminishing venous thromboembolism (VTE) risk. Here, we investigated risk stratification-based thromboprophylaxis after fast-track THA and TKA.

METHODS: A retrospective register study was conducted in two Finnish hospitals using a fast-track protocol for THA and TKA. These hospitals use risk stratification-based planning of thromboprophylaxis, including risk evaluation of patients’ personal VTE risk. Patients at low risk received thromboprophylaxis solely during hospitalization, provided this lasted five days or less. All VTEs and clinically relevant bleedings were obtained from Finnish hospital discharge registers between 1 January 2020 and 31 December 2021 to determine VTE incidences and clinically relevant bleedings 90 days after surgery.

RESULTS: During the study period 3 713 arthroplasties were performed (1 636 THAs and 2 077 TKAs). The 90-day incidence of VTE was 0.7% (CI 0.4 to 0.9), and 25 VTEs occurred within 90 days of surgery. These VTEs comprised 12 pulmonary embolisms and 13 deep vein thromboses, none of which was fatal. The incidence of clinically relevant bleedings (n = 57) within 90 days of surgery was 1.5% (CI 1.1 to 1.9). One intracranial bleeding was fatal. The bleedings typically occurred at the operational site.

CONCLUSION: Risk stratification-based thromboprophylaxis appears safe for fast-track THA and TKA patients as the incidences of VTEs and clinically relevant bleedings were low.

PMID:39736658 | DOI:10.1186/s12891-024-08256-6

BMC Oral Health. 2024 Dec 30;24(1):1573. doi: 10.1186/s12903-024-05267-6.

ABSTRACT

BACKGROUND: Short fiber-reinforced composites (SFRCs) are restorative materials for large cavities claimed to effectively resist crack propagation. This study aimed to compare the mechanical properties and physical characteristics of five commercially available SFRCS (Alert, Fibrafill Flow, Fibrafill Dentin, everX Flow, and everX Posterior) against a conventional particulate-filled composite (PFC, Essentia Universal).

METHODS: The following characteristics were evaluated in accordance with ISO standards: flexural strength and modulus and fracture toughness. FTIR-spectrometry was used to calculate the degree of monomer conversion (DC%). The two-body wear test was performed in a ball-on-flat configuration using a chewing simulator with 15,000 cycles. A non-contact 3D optical profilometer was utilized to measure wear depth. The tensilometer method was used to quantify polymerization shrinkage-stress. Posterior composite crowns (n = 8) were made and quasi-statically loaded until fracture. The microstructure of the SFRCs were assessed using scanning electron microscopy. ANOVA was applied to statistically interpret the results, and then the post hoc Tukey’s analysis was performed.

RESULTS: Among the evaluated composites, SFRC (everX Flow) had the lowermost wear depth (20.4 μm) and uppermost fracture toughness (2.8 MPa m^1/2) values (p < 0.05). Fibrafill Flow (92 MPa) and Fibrafill Dentin (98 MPa) showed the lowest flexural strength values (p < 0.05). The used SFRCs exhibited equivalent values (p > 0.05) of shrinkage stress, except for everX Flow which had the highest value (5.3 MPa). everX Flow composite crowns presented significantly greater fracture resistance (3870 ± 260 N) (p < 0.05) than that of the other SFRCs tested.

CONCLUSION: Significant differences were found between the investigated characteristics of different commercially available SFRCs. It is noteworthy that certain SFRCs exhibited behavior comparable to that of conventional PFC, while others demonstrated superior performance.

PMID:39736654 | DOI:10.1186/s12903-024-05267-6

J Cardiothorac Surg. 2024 Dec 30;19(1):689. doi: 10.1186/s13019-024-03211-x.

ABSTRACT

OBJECTIVES: Compare the differences in perioperative clinical characteristics of lung cancer patients of different genders who have undergone VATS lobectomy, and explore the impact of these differences on the short-term prognosis of patients.

METHODS: A total of 338 consecutive patients with lung cancer who underwent VATS lobectomy in our hospital from August 2021 to August 2022 were retrospectively analyzed, they were divided into male group and female group. The perioperative characteristics and short-term prognosis of different groups were compared. The multivariate binary logistic regression analysis was used to analyze the risk factors.

RESULTS: There were statistically significant differences between male and female patients in age of onset, body surface area (BSA), smoking rate, alcohol consumption rate, hypertension incidence, pulmonary function and clinical stage. There were statistically significant differences between male and female patients in operation time and lymph node dissection. The probability of postoperative complications, such as pulmonary infection, persistent air leakage and severe subcutaneous emphysema, in male patients was significantly higher than that in female patients. The average daily postoperative thoracic drainage volume in male patients was considerably higher than that in female patients, and the postoperative duration of thoracic drainage tube and hospital stay in male patients were significantly longer than those in female patients. After multiple regression analysis, low FEVI values in males was found to be an independent risk factor for postoperative complications.

CONCLUSIONS: Compared with female patients, male patients with lung cancer are more likely to have unfavorable factors such as older age, higher smoking rate, poor pulmonary function and late clinical stage of tumors when they undergoing VATS surgery treatment. The appropriate thoracic drainage time can be selected according to gender differences to shorten the length of hospital stay. The incidence of postoperative complications is higher in male patients, especially those with poor pulmonary function, and active perioperative intervention is required to reduce the incidence of postoperative complications.

PMID:39736652 | DOI:10.1186/s13019-024-03211-x

BMC Med Educ. 2024 Dec 30;24(1):1560. doi: 10.1186/s12909-024-06397-9.

ABSTRACT

BACKGROUND: In China, investigations into the efficacy of neurological clinical teaching try to ascertain the impacts of various teaching methods on intervention outcomes. However, these studies often suffer from limited sample sizes, single-center studies and low quality, compounded by the lack of direct comparative analyses between teaching methods, thereby leaving the identification of the most effective method unresolved. This study aims to compare the effectiveness of various teaching methods in the standardized training of Chinese neurology clinicians to inform an optimal teaching model utilizing a Bayesian network meta-analysis (NMA) approach.

METHODS: A comprehensive computer search was conducted to identify randomized controlled trials (RCTs) assessing the efficacy of 7 teaching methods: problem-based learning (PBL), case-based learning (CBL), flipped classroom model (FCM), evidence-based medicine (EBM), clinical practice (CP), team-based learning (TBL), and lecture-based learning (LBL). The search, which spanned databases including the China National Knowledge Infrastructure (CNKI), Chinese Citation Database (CDD), China Science Periodical Database (CSPD), Chinese BioMedical Literature Database (CBM), PubMed, Web of Science, and the Cochrane Library, covered the period from the inception of these databases to April 1, 2023. The quality of the included studies was evaluated, and the data were analyzed in R 4.3.2 and Stata 17.0 software.

RESULTS: From the 31 studies included, comprising 2124 subjects, significant findings emerged. In theoretical examinations, a statistically significant difference was noted among the teaching methods, with CBL, PBL, TBL, FCM, and EBM showing superior performance over the LBL method. The effectiveness ranking of these methods was as follows: CBL > PBL > TBL > FCM > EBM > CP > LBL. In terms of practical skills examinations, a similar pattern of effectiveness was observed. Here, the order of effectiveness was CBL > EBM > PBL > TBL > FCM > CP > LBL.

CONCLUSIONS: This NMA indicated that the modern teaching pedagogies, particularly CBL, could be effective in neurology education, and might help improve the theoretical examinations and practical skills of neurology clinicians. Fully tapping into the strengths of modern teaching methods in neurology teaching will require additional work and advancing research.

PMID:39736639 | DOI:10.1186/s12909-024-06397-9

Fluids Barriers CNS. 2024 Dec 30;21(1):108. doi: 10.1186/s12987-024-00611-y.

ABSTRACT

BACKGROUND: Disproportionately enlarged subarachnoid space hydrocephalus (DESH) is one of the neuroradiological characteristics of idiopathic normal pressure hydrocephalus (iNPH), which makes statistical analyses of brain images difficult. This study aimed to develop and validate methods of accurate brain segmentation and spatial normalisation in patients with DESH by using the Computational Anatomy Toolbox (CAT12).

METHODS: Two hundred ninety-eight iNPH patients with DESH and 25 healthy controls (HCs) who underwent cranial MRI were enrolled in this study. We selected the structural images of 169 patients to create customised tissue probability maps and diffeomorphic anatomical registration through exponentiated Lie algebra (DARTEL) templates for patients with DESH (DESH-TPM and DESH-Template). The structural images of 38 other patients were used to evaluate the validity of the DESH-TPM and DESH-Template. DESH-TPM and DESH-Template were created using the 114 well-segmented images after the segmentation processing of CAT12. In the validation study, we compared the accuracy of brain segmentation and spatial normalisation among three conditions: customised condition, applying DESH-TPM and DESH-Template to CAT12 and patient images; standard condition, applying the default setting of CAT12 to patient images; and reference condition, applying the default setting of CAT12 to HC images.

RESULTS: In the validation study, we identified three error types during segmentation. (1) The proportions of misidentifying the dura and/or extradural structures as brain structures in the customised, standard, and reference conditions were 10.5%, 44.7%, and 13.6%, respectively; (2) the failure rates of white matter hypointensity (WMH) cancellation in the customised, standard, and reference conditions were 18.4%, 44.7%, and 0%, respectively; and (3) the proportions of cerebrospinal fluid (CSF)-image deficits in the customised, standard, and reference conditions were 97.4%, 84.2%, and 28%, respectively. The spatial normalisation accuracy of grey and white matter images in the customised condition was the highest among the three conditions, especially in terms of superior convexity.

CONCLUSIONS: Applying the combination of the DESH-TPM and DESH-Template to CAT12 could improve the accuracy of grey and white matter segmentation and spatial normalisation in patients with DESH. However, this combination could not improve the CSF segmentation accuracy. Another approach is needed to overcome this challenge.

PMID:39736638 | DOI:10.1186/s12987-024-00611-y

Brief Funct Genomics. 2024 Dec 30:elae049. doi: 10.1093/bfgp/elae049. Online ahead of print.

ABSTRACT

OBJECTIVE: The primary objective of this study is to investigate various applications of artificial intelligence (AI) and statistical methodologies for analyzing and managing peritoneal metastases (PM) caused by gastrointestinal cancers.

METHODS: Relevant keywords and search criteria were comprehensively researched on PubMed and Google Scholar to identify articles and reviews related to the topic. The AI approaches considered were conventional machine learning (ML) and deep learning (DL) models, and the relevant statistical approaches included biostatistics and logistic models.

RESULTS: The systematic literature review yielded nearly 30 articles meeting the predefined criteria. Analyses of these studies showed that AI methodologies consistently outperformed traditional statistical approaches. In the AI approaches, DL consistently produced the most precise results, while classical ML demonstrated varied performance but maintained high predictive accuracy. The sample size was the recurring factor that increased the accuracy of the predictions for models of the same type.

CONCLUSIONS: AI and statistical approaches can detect PM developing among patients with gastrointestinal cancers. Therefore, if clinicians integrated these approaches into diagnostics and prognostics, they could better analyze and manage PM, enhancing clinical decision-making and patients’ outcomes. Collaboration across multiple institutions would also help in standardizing methods for data collection and allowing consistent results.

PMID:39736152 | DOI:10.1093/bfgp/elae049

Pol J Vet Sci. 2024 Sep;27(3):481-485. doi: 10.24425/pjvs.2024.151742.

ABSTRACT

Ultrasonographic renal length-to-aorta ratio is an ideal reflection of renal health in dogs. Earlier studies have highlighted the need for breed-specific reference intervals for this parameter. The aim of this study was to establish a breed-specific reference interval of kidney length to aorta ratio (KL:Ao) in Chippiparai dogs, a breed of Indian sighthounds. The KL:Ao ratio was recorded in 45 Chippiparai dogs, classified into 3 age groups. A narrow breed specific range of 7.07 to 7.74 was arrived at for adult Chippiparai dogs, and a strong relationship between age and body weight and KL:Ao was observed using regression analysis. These findings can be extrapolated and utilized by other sighthounds.

PMID:39736146 | DOI:10.24425/pjvs.2024.151742

Brief Funct Genomics. 2024 Dec 30:elae048. doi: 10.1093/bfgp/elae048. Online ahead of print.

ABSTRACT

When the traditional random forest (RF) algorithm is used to select feature elements in biostatistical data, a large amount of noise data and parameters can affect the importance of the selected feature elements, making the control of feature selection difficult. Therefore, it is a challenge for the traditional RF algorithm to preserve the accuracy of algorithm results in the presence of noise data. Generally, directly removing noise data can result in significant bias in the results. In this study, we develop a new algorithm, standardized threshold, and loops based random forest (STLBRF), and apply it to the field of gene expression data for feature gene selection. This algorithm, based on the traditional RF algorithm, combines backward elimination and K-fold cross-validation to construct a cyclic system and set a standardized threshold: error increment. The algorithm overcomes the shortcomings of existing gene selection methods. We compare ridge regression, lasso regression, elastic net regression, the traditional RF algorithm, and our improved RF algorithm using three real gene expression datasets and conducting a quantitative analysis. To ensure the reliability of the results, we validate the effectiveness of the genes selected by these methods using the Random Forest classifier. The results indicate that, compared to other methods, the STLBRF algorithm achieves not only higher effectiveness in feature gene selection but also better control over the number of selected genes. Our method offers reliable technical support for feature expression analysis and research on biomarker selection.

PMID:39736135 | DOI:10.1093/bfgp/elae048

Pol J Vet Sci. 2024 Sep;27(3):487-490. doi: 10.24425/pjvs.2024.151743.

ABSTRACT

The aim of this study was to evaluate the association between spontaneous echocardiographic contrast (SEC) and left atrial (LA) parameters such as size, volume, and function in cats with hypertrophic cardiomyopathy (HCM). Cats were assigned into following groups: clinically healthy cats (n=8), HCM without SEC (n=12), and HCM with SEC (n=8). Left atrial shortening fraction (LAFS%) and left atrial fractional area change (LAFAC) had statistical significance between groups. In conclusion, compared to the healthy individuals, the presence of a decreased trend in levels of LAFS% and LAFAC in HCMSEC cats could be a predictive marker for the thromboembolic risk assessment. Further studies enrolling the asymptomatic HCM cats need to be conducted to define a cut-off value of LAFS% and LAFAC before the SEC formation.

PMID:39736131 | DOI:10.24425/pjvs.2024.151743