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Nevin Manimala Statistics

Efficacy of the Short-Term versus Long-Term Administration of Antimicrobial Prophylaxis in Gastric Cancer Surgery: A Meta-Analysis of Randomized Controlled Trials

Surg Infect (Larchmt). 2022 Sep;23(7):625-633. doi: 10.1089/sur.2022.179.

ABSTRACT

Background: We performed a meta-analysis to confirm the efficacy of short-term compared with long-term administration of antimicrobial prophylaxis in gastric cancer surgery. Methods: Randomized controlled trials of the efficacy of short-term versus long-term administration of antimicrobial prophylaxis in gastric cancer surgery were searched using the MEDLINE, EMBASE, and the Cochrane Controlled Trials Register databases. The data were evaluated and statistically analyzed using RevMan version 5.3.0. Five studies including 2,053 participants who received short-term versus long-term administration of antimicrobial prophylaxis in gastric cancer surgery were considered. Results: There was no significant difference in the surgical site infection (SSI) rate between the short-term group and the long-term group (8.1% vs. 9.2%; odds ratio [OR], 0.87; 95% confidence interval [CI], 0.64-1.09; p = 0.39). Hierarchical analysis also showed no significant differences in incisional-site incisions, organ/space incisions, or leakage. Multivariable analysis showed no significant differences in gender, age (>65 years), body mass index (>25 kg/m2), D2, operation time (>3 hours), pathologic stage 3, blood loss, combined resection, diabetes mellitus, total gastrectomy, or blood transfusion between the two groups. Conclusions: Short-term administration of antimicrobial prophylaxis did not increase the incidence of SSIs after gastrectomy.

PMID:36049075 | DOI:10.1089/sur.2022.179

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Novel Board Game versus Active Case-Based Discussion to Teach Final-Year Veterinary Students the Diagnostic Approach to Clinical Cases

J Vet Med Educ. 2022 Sep 1:e20210016. doi: 10.3138/jvme-2021-0016. Online ahead of print.

ABSTRACT

Traditional lectures, where students listen passively, often do not reflect the complexity of real-life decision-making situations. Furthermore, modern students are using online devices for daily activities, and this has a challenging side effect for educators, as many people these days can only maintain their focus if topics are discussed in concise and engaging ways. For these reasons, there is growing interest in the use of games for educational purposes. The aim of this study was to introduce a board game based on the Clue game for final-year veterinary students during their practical activity in large animal medicine. This type of learning process was compared with a classical case-based discussion and evaluated via a survey delivered to the students to both test their acquired knowledge and obtain their evaluation of the activity. A total of 49 students were enrolled in this study. While the board game was evaluated significatively better than the traditional class, no statistically significant differences were observed for the answers given to questions assessing their veterinary skills. The proposed game requires few resources other than a case-based visual materials and analyses from clinical patients, a board, two dice, and some imagination to create cases at the appropriate level for students’ knowledge. We conclude that this board game-based activity represents innovative techniques to teach clinical approaches in an interactive way with the same utility as a traditional class but is more enjoyable for the students.

PMID:36049070 | DOI:10.3138/jvme-2021-0016

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Confidence among Veterinary Students to Perform Canine Orchiectomy: The Impact of Live Animal Surgical Clinical Training

J Vet Med Educ. 2022 Sep 1:e20220054. doi: 10.3138/jvme-2022-0054. Online ahead of print.

ABSTRACT

Canine orchiectomy (COE) is one of the most commonly performed procedures in small animal veterinary surgery. The aim of this study was to assess veterinary students’ confidence in performing this surgery in relation to their previous surgical experience of the procedure. The hypothesis was that confidence to perform canine orchiectomies among recent veterinary graduates increased when having participated in the procedure as part of practical surgical training. A cross-sectional survey was conducted and included 65 fifth-year veterinary graduate students at the Swedish University of Agriculture in Uppsala, Sweden. The survey investigated how differences in experience of COE affected students’ confidence to perform the procedure. Of the responding students, 24.6% had performed the procedure, 47.7% had observed the procedure live, and 27.7% had not seen nor performed the procedure. They were asked how confident they were to perform the procedure both with and without assistance. Data were compared using a non-parametric test (Mann-Whitney U test). The results showed a statistically significant increase in confidence to perform COEs in the group that had previously performed or observed COE compared with the group that had neither performed nor observed the procedure. In conclusion, veterinary students’ participation in COEs significantly contributed to their clinical confidence to perform the procedure.

PMID:36049062 | DOI:10.3138/jvme-2022-0054

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Predicting Tracheal Work of Breathing in Neonates Based on Radiological and Pulmonary Measurements

J Appl Physiol (1985). 2022 Sep 1. doi: 10.1152/japplphysiol.00399.2022. Online ahead of print.

ABSTRACT

Tracheomalacia is an airway condition in which the trachea excessively collapses during breathing. Neonates diagnosed with tracheomalacia require more energy to breathe, and the effect of tracheomalacia can be quantified by assessing flow-resistive work of breathing (WOB) in the trachea using computational fluid dynamics (CFD) modeling of the airway. However, CFD simulations are computationally expensive; the ability to instead predict WOB based on more straightforward measures would provide a clinically useful estimate of tracheal disease severity. The objective of this study is to quantify the WOB in the trachea using CFD and identify simple airway and/or clinical parameters that directly relate to WOB. This study included 30 neonatal intensive care unit subjects (15 with tracheomalacia, 15 without tracheomalacia). All subjects were imaged using ultrashort echo time (UTE) MRI. CFD simulations were performed using patient-specific data obtained from MRI (airway anatomy, dynamic motion, and airflow rates) to calculate the WOB in the trachea. Several airway and clinical measurements were obtained and compared with the tracheal resistive WOB. The maximum percent change in the tracheal cross-sectional area (ρ=0.560, p=0.001), average glottis cross-sectional area (ρ=-0.488, p=0.006), minute ventilation (ρ=0.613, p<0.001), and lung tidal volume (ρ=0.599, p<0.001) had significant correlations with WOB. A multivariable regression model with three independent variables (minute ventilation, average glottis cross-sectional area, and minimum of the eccentricity index of the trachea) can be used to estimate WOB more accurately (R2=0.726). This statistical model may allow clinicians to estimate tracheal resistive WOB based on airway images and clinical data.

PMID:36049059 | DOI:10.1152/japplphysiol.00399.2022

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Action-Specific Perception & Performance on a Fitts’s Law Task in Virtual Reality: The Role of Haptic Feedback

IEEE Trans Vis Comput Graph. 2022 Sep 1;PP. doi: 10.1109/TVCG.2022.3203003. Online ahead of print.

ABSTRACT

While user’s perception and performance are predominantly examined independently in virtual reality, the Action-Specific Perception (ASP) theory postulates that the performance of an individual on a task modulates this individual’s spatial and time perception pertinent to the task’s components and procedures. This paper examines the association between performance and perception and the potential effects that tactile feedback modalities could generate. This paper reports a user study (N=24), in which participants performed a standardized Fitts’s law target acquisition task by using three feedback modalities: visual, visuo-electrotactile, and visuo-vibrotactile. The users completed 3 Target Sizes × 2 Distances × 3 feedback modalities = 18 trials. The size perception, distance perception, and (movement) time perception were assessed at the end of each trial. Performance-wise, the results showed that electrotactile feedback facilitates a significantly better accuracy compared to vibrotactile and visual feedback, while vibrotactile provided the worst accuracy. Electrotactile and visual feedback enabled a comparable reaction time, while the vibrotactile offered a substantially slower reaction time than visual feedback. Although amongst feedback types the pattern of differences in perceptual aspects were comparable to performance differences, none of them was statistically significant. However, performance indeed modulated perception. Significant action-specific effects on spatial and time perception were detected. Changes in accuracy modulate both size perception and time perception, while changes in movement speed modulate distance perception. Also, the index of difficulty was found to modulate all three perceptual aspects. However, individual differences appear to affect the magnitude of action-specific effects. These outcomes highlighted the importance of haptic feedback on performance, and importantly the significance of action-specific effects on spatial and time perception in VR, which should be considered in future VR studies.

PMID:36048989 | DOI:10.1109/TVCG.2022.3203003

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Impact of serum vitamin D levels on periodontal healing outcomes: a preliminary cohort study

Int J Dent Hyg. 2022 Sep 1. doi: 10.1111/idh.12619. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluated the relationship between serum vitamin D levels and periodontal healing outcomes in patients with mild or moderate periodontitis.

METHODS: Serum vitamin D levels and periodontal pockets and gingival bleeding were evaluated in 51 patients before and six months after non-surgical periodontal treatment. A t-test and chi-square test were used to analyze the data (p ≤ 0.05).

RESULTS: The mean reduction of periodontal pocket depth was statistically significant higher in patients with vitamin D ≥ 30 ng/mL compared to those with < 30 ng/mL (CI= -0.23 – 0.42, p= 0.05), but not clinically significant. Vitamin D level was not associated with the percentage of sites gingival bleeding on probing at the final evaluation (OR= 0.58, 95% CI= 0.17-1.99, p= 0.39).

CONCLUSION: Lower serum vitamin D level was associated with a slightly reduced periodontal healing after non-surgical periodontal therapy, which should be further investigated in a larger population.

PMID:36048921 | DOI:10.1111/idh.12619

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Communicative competence in family physicians in a family medicine unit

Rev Med Inst Mex Seguro Soc. 2022 Aug 31;60(5):563-568.

ABSTRACT

BACKGROUND: Communication in the health field is essential, since it depends on it that the physician has complete and accurate information to carry out the fulfillment of his functions. The relationship with the medical staff leads the patient to feel listened to and cared for, in order to understand their state of health.

OBJECTIVE: To know the perception of patients about the communicative competence of family physicians during the consult at the Family Medicine Unit No. 27.

MATERIAL AND METHODS: Descriptive and cross-sectional study that identifies patients who attended Family Medicine Unit No. 27 in Tijuana in September 2021. The Communication Assessment Tool was applied to participants to measure the perception of communicative competence of doctors. The responses obtained were collected and analyzed with descriptive statistics.

RESULTS: 200 patients who met selection criteria were studied, made up of patients on morning and afternoon shifts equally. 54.6% of the studied population considers the communicative competence of family doctors to be excellent.

CONCLUSIONS: The communicative competence in the family physicians of the studied unit had a better result than others studies of several countries; however, it has areas of opportunity to optimize this competence, since medical knowledge must include the area of communication and interpersonal relationships.

PMID:36048909

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Is vaccination against Covid-19 associated with autoimmune rheumatic disease flare? A self-controlled case series analysis

Rheumatology (Oxford). 2022 Sep 1:keac484. doi: 10.1093/rheumatology/keac484. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the association between vaccination against Covid-19 and autoimmune rheumatic disease (AIRD) flare.

METHODS: Patients with AIRDs vaccinated against Covid-19 who consulted for disease flare between 01/12/2020 and 31/12/2021 were ascertained in Clinical Practice Research Datalink (Aurum). AIRD flare was defined as consultation for AIRD with corticosteroid prescription on the same day or the next day. Vaccination was defined using date of vaccination and product code. The observation period was partitioned into vaccine-exposed (21-days after vaccination), pre-vaccination (7-days before vaccination), and remaining vaccine-unexposed periods. Participants contributed data with multiple vaccinations and outcomes. Season adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CI) were calculated using self-controlled case-series analysis.

RESULTS: Data for 3554 AIRD cases, 72% female, mean age 65 years, and 68.3% with rheumatoid arthritis were included. Covid-19 vaccination was associated with significantly fewer AIRD flares in the 21-day vaccine-exposed period when all vaccinations were considered (aIRR(95%CI) 0.89(0.80-0.98)). Using dose-stratified analyses there was a statistically significant negative association in 21-days after first Covid-19 vaccination but no association after the second or third Covid-19 vaccinations (aIRR(95%CI) 0.76(0.66-0.89), 0.94(0.79-1.11) and 1.01(0.85-1.20) respectively). On AIRD type stratified analyses, vaccination was not associated with disease flares. Vaccination without or after SARS-CoV-2 infection, and with vectored DNA or mRNA vaccines associated with comparable reduced risk of AIRD flares in the vaccine-exposed period after first Covid-19 vaccination.

CONCLUSION: Vaccination against Covid-19 was not associated with increased AIRD flares regardless of prior Covid-19, AIRD type, and whether mRNA or DNA vaccination technology were used.

PMID:36048896 | DOI:10.1093/rheumatology/keac484

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Effects of mobile Health (mHealth) application on cervical cancer prevention knowledge and screening among women social support groups with low-socioeconomic status in Mysuru city, Southern India

PLoS One. 2022 Sep 1;17(9):e0273070. doi: 10.1371/journal.pone.0273070. eCollection 2022.

ABSTRACT

BACKGROUND: Cervical cancer is an important area of action because of the mortality and morbidity of the disease, and the potential for effective prevention by screening. Involving the social support groups by health education improves cervical cancer screening and early detection of the disease in the community. In the ongoing efforts to strengthen cervical cancer prevention, control, and management, digital health and technology will have a significant role to play.

OBJECTIVE: To assess the effectiveness of the mHealth-based intervention on cervical cancer preparedness among women social support groups.

MATERIALS & METHODS: A pre-post interventional study was conducted among women social support groups from lower socio-economic status, identified from the field practice area. Purposive sampling technique was employed. A Cervical Cancer Awareness Measure (CAM) instrument was used to assess the cancer preparedness among the social support group women After taking inputs from the stakeholders’ mobile health application was developed. The mHealth educational intervention was given to 102 women. Both pre-and post-test questionnaires were administered through mHealth application to assess the change in knowledge after a gap of 1 month to 2 months. The data obtained was coded and entered into Microsoft Excel worksheet 2016 and was later imported and analyzed using SPSS version 22 (licensed to the Institute). The difference in median scores of knowledge and practice were interpreted as statistically significant at p value of < 0.05.

RESULTS & CONCLUSION: Before the intervention only 13 (12.7%) of them had heard about cervical cancer. There was a significant increase in the knowledge about warning signs & symptoms, risk factors of cervical cancer, and HPV vaccination. Around 5% increase in Pap smear test uptake.

PMID:36048892 | DOI:10.1371/journal.pone.0273070

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Spontaneous hemoperitoneum in pregnancy: Italian prospective population-based cohort study

Acta Obstet Gynecol Scand. 2022 Sep 1. doi: 10.1111/aogs.14431. Online ahead of print.

ABSTRACT

INTRODUCTION: Spontaneous hemoperitoneum in pregnancy is defined as a sudden non-traumatic intraperitoneal bleeding in pregnancy and up to 42 days postpartum. In the present study we aim to estimate the incidence and investigate the risk factors, the management and the outcomes of spontaneous hemoperitoneum in pregnancy in order to improve its clinical identification and reduce avoidable maternal deaths.

MATERIAL AND METHODS: This is a prospective population-based cohort study, set in maternity units from nine Italian regions covering 75% of the national births. The study population comprises all women admitted for spontaneous intraperitoneal hemorrhage during pregnancy and up to 42 days postpartum between November 2017 and March 2020. Incident cases were reported by trained clinicians through electronic data collection forms. Descriptive statistics were performed. The main outcome measures included incidence rate of spontaneous hemoperitoneum in pregnancy, association with potential risk factors, clinical management and maternal and perinatal outcomes.

RESULTS: Twenty-nine cases met the adopted definition of spontaneous hemoperitoneum in pregnancy with an estimated incidence rate of 0.04 per 1000 births. An increased risk ratio (RR) of this condition was observed in pregnancies conceived by assisted reproductive technology (RR = 6.60, 95% CI 2.52-17.29), in the case of multiple pregnancies (RR = 6.57, 95% CI 1.99-21.69) and maternal age ≥35 years (RR 2.10, 95% CI 1.01-4.35). In 17/29 cases the bleeding site was intra-pelvic (23.5% in the posterior uterine wall and 35.2% in the left hemipelvis). Laparotomy represented the surgical treatment in 27 cases (93%), and most women underwent a cesarean delivery (92.6%). Median blood loss was 1900 mL, one hysterectomy was necessary, and two women died. Twenty-two preterm births were recorded.

CONCLUSIONS: Spontaneous hemoperitoneum in pregnancy is a rare, life-threatening condition associated with high perinatal morbidity and mortality. Maternal age ≥35 years, multiple pregnancies and assisted reproductive technology were associated to a higher risk of the condition. Two women of 29 died and 70% of births occurred preterm.

PMID:36047477 | DOI:10.1111/aogs.14431