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Nevin Manimala Statistics

Deep learning and iterative image reconstruction for head CT: Impact on image quality and radiation dose reduction-Comparative study

Neuroradiol J. 2025 May 23:19714009251345108. doi: 10.1177/19714009251345108. Online ahead of print.

ABSTRACT

Background and purpose: This study focuses on an objective evaluation of a novel reconstruction algorithm-Deep Learning Image Reconstruction (DLIR)-ability to improve image quality and reduce radiation dose compared to the established standard of Adaptive Statistical Iterative Reconstruction-V (ASIR-V), in unenhanced head computed tomography (CT). Materials and methods: A retrospective analysis of 163 consecutive unenhanced head CTs was conducted. Image quality assessment was computed on the objective parameters of Signal-to-Noise Ratio (SNR) and Contrast-to-Noise Ratio (CNR), derived from 5 regions of interest (ROI). The evaluation of DLIR dose reduction abilities was based on the analysis of the PACS derived parameters of dose length product and computed tomography dose index volume (CTDIvol). Results: Following the application of rigorous criteria, the study comprised 35 patients. Significant image quality improvement was achieved with the implementation of DLIR, as evidenced by up to a 145% and 160% increase in SNR in supra- and infratentorial regions, respectively. CNR measurements further confirmed the superiority of DLIR over ASIR-V, with an increase of 171.5% in the supratentorial region and a 59.3% increase in the infratentorial region. Despite the signal improvement and noise reduction DLIR facilitated radiation dose reduction of up to 44% in CTDIvol. Conclusion: Implementation of DLIR in head CT scans enables significant image quality improvement and dose reduction abilities compared to standard ASIR-V. However, the dose reduction feature was proven insufficient to counteract the lack of gantry angulation in wide-detector scanners.

PMID:40406852 | DOI:10.1177/19714009251345108

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Nevin Manimala Statistics

Analyses of the Effectiveness of Participation in the Ontario Surgical Quality Improvement Network

Healthc Q. 2025 Jan;27(4):72-77. doi: 10.12927/hcq.2025.27578.

ABSTRACT

This retrospective review evaluates the Ontario Surgical Quality Improvement Network’s patient outcomes and financial returns. Criteria from the Organisation for Economic Co-operation and Development Network are used to examine the program, and risk-adjusted data from the American College of Surgeons National Surgical Quality Improvement Program on four indicators spanning 2016 to 2023 were used to calculate outcomes. With reductions in post-operative complications, readmissions and length of hospital stay, the Ontario healthcare system is saving an estimated $3,000,000 per year, representing a return on investment of 38%. Similar quality improvement networks could be adopted in other jurisdictions to elevate surgical care standards.

PMID:40406844 | DOI:10.12927/hcq.2025.27578

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Nevin Manimala Statistics

Developing Personas to Enable Tailored Public Health Communications: The Case of Organ Donation in Québec

Healthc Q. 2025 Jan;27(4):64-71. doi: 10.12927/hcq.2025.27579.

ABSTRACT

In the context of long organ wait lists and few registered organ donors, Transplant Québec aimed to understand public views on deceased organ donation, as a basis for public-facing communications. It formulated four personas representing subgroups with varying views and behaviours related to organ donation. They were iteratively built via triangulation of findings from literature reviews, populational data, public polls, an expert panel and focus groups. Personas offer a more human approach to characterizing groups than statistics, which is particularly helpful for sensitive issues such as organ donation. This work may assist other organizations in tailoring public health communications.

PMID:40406843 | DOI:10.12927/hcq.2025.27579

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Nevin Manimala Statistics

Canada’s Shared Health Priorities: Measuring Progress and Bridging Data Gaps With Common Indicators

Healthc Q. 2025 Jan;27(4):11-13. doi: 10.12927/hcq.2025.27590.

ABSTRACT

In 2023, Canada’s federal, provincial and territorial governments agreed to work together to improve healthcare across four priority areas and to develop common indicators to measure progress and report back to Canadians. In October 2024, the Canadian Institute for Health Information released Taking the Pulse: Measuring Shared Priorities for Canadian Health Care, 2024, which provides baseline results for 12 of these indicators. Some of the key findings include the following: Eighty-three percent of Canadians report having access to a regular healthcare provider. Half of Canadians referred to publicly funded community mental health counselling waited 25 days or less for their first scheduled session. Only two in five Canadians have accessed their personal health information electronically.

PMID:40406832 | DOI:10.12927/hcq.2025.27590

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Nevin Manimala Statistics

Recent Stresses and Underlying System Causes of the Primary Care Crisis Point Toward Policy Solutions

Healthc Q. 2025 Jan;27(4):7-10. doi: 10.12927/hcq.2025.27591.

ABSTRACT

Across Canada, millions of people are struggling to find a family doctor, nurse practitioner or primary care clinic and millions more are attached to a clinician who is over the age of 65. Research led by INSPIRE-PHC and analyzed at ICES has demonstrated the growing number of unattached people and their higher likelihood of being of lower income, racialized and having newly arrived in Ontario. Recent stresses include population growth, declining volume of services per physician and decreased attractiveness of comprehensive primary care, while underlying system causes point to the need for organized accountable systems designed to look after the entire population.

PMID:40406831 | DOI:10.12927/hcq.2025.27591

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Nevin Manimala Statistics

Mapping of care pathways in pediatric and adult palliative care in Spain: A case study

Palliat Support Care. 2025 May 23;23:e107. doi: 10.1017/S1478951525000513.

ABSTRACT

OBJECTIVES: This study aimed to map the actual care pathways for pediatric and adult palliative care (PC) patients at a hospital in the Region of Murcia (Spain) utilizing Process Mining (PM) techniques. The goal was to identify inefficiencies and areas for improvement in providing comprehensive and coordinated care to enhance patient outcomes.

METHODS: A retrospective review of anonymized clinical records was conducted, covering data from 2002 to 2021 for adult patients and from 2001 to 2021 for pediatric patients. The final dataset for adults comprised records from 85 patients and 2,696 episodes, and, for pediatric patients, the dataset included 57 individuals with 1,912 episodes. PM techniques (concretely, PMApp) facilitated the visualization and evaluation of actual care pathways, compared to theoretical models, highlighting bottlenecks and variabilities.

RESULTS: The analysis revealed distinct care pathways for adult and pediatric patients. Pediatric pathways showed inconsistencies with theoretical models due to variability in diseases and care needs, while adult pathways aligned better with expectations. Key inefficiencies included delays in shifting to home care and multiple visits to the hospital Emergency Department before referral to specialized teams. Simplified process models provided clearer insights into frequent care pathways and highlighted critical transition points, supporting optimization strategies.

SIGNIFICANCE OF RESULTS: The findings underscore the utility of PM in enhancing care pathway transparency, identifying inefficiencies, and supporting data-driven process redesign. The study advocates for updating theoretical models and adopting structured data collection to reduce variability and improve PC delivery. These measures are critical for achieving consistent, patient-centered care across diverse healthcare settings.

PMID:40406803 | DOI:10.1017/S1478951525000513

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Nevin Manimala Statistics

The impact of systemic sclerosis on hospitalized COVID-19 patients: Analysis of the US nationwide inpatient sample (2021)

J Scleroderma Relat Disord. 2025 May 20:23971983251342065. doi: 10.1177/23971983251342065. Online ahead of print.

ABSTRACT

BACKGROUND: The study was conducted to investigate the impact of systemic sclerosis (SSc) on hospitalized COVID-19 patients.

METHOD: This retrospective observational study analyzed data from the National Inpatient Survey (NIS) in 2021. Patients hospitalized with COVID-19 were categorized into SSc and non-SSc groups. Characteristics of patients and comorbidities were compared. The primary outcome was the mortality rate. Secondary outcomes included resource utilization and acute in-hospital complications of SSc. Multivariate logistic regression analyses were conducted, with p-values < 0.05 considered statistically significant.

RESULT: Of all, 1865 patients hospitalized with COVID-19 had SSc. Patients with SSc had a higher mortality risk (aOR = 1.37 [1.03-1.82]; p = 0.032). The average cost of hospitalization was significantly higher in the SSc group (p = 0.048), with no difference in LOS (9.4 ± 0.65 days vs 8.4 ± 0.03 days; p = 0.260). COVID-19 patients with SSc significantly had a higher risk for DIC (aOR 2.82 [1.06-7.53]; p = 0.038), left-sided HF (aOR 1.76 [1.16-2.67]; p = 0.008), ventricular arrhythmia (aOR 3.17 [1.01-9.89]; p = 0.047), oxygen dependence (aOR 2.41 [1.64-3.55]; p < 0.001), cardiac arrest (aOR 2.61 [1.63-4.18]; p < 0.001), and ileus (aOR 2.61 [1.45-4.69]; p = 0.001).

CONCLUSION: Hospitalized COVID-19 patients with SSc were more likely to develop in-hospital complications and had a higher mortality risk.

PMID:40406796 | PMC:PMC12092399 | DOI:10.1177/23971983251342065

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Nevin Manimala Statistics

Bridging the Knowledge Gap: Awareness, Attitudes, and Practices Regarding Menstrual Cup Usage Among Medical Students in Chennai, India

Cureus. 2025 Apr 22;17(4):e82780. doi: 10.7759/cureus.82780. eCollection 2025 Apr.

ABSTRACT

Background In India, sanitary pads are the most used menstrual hygiene product despite potential health and environmental risks. Menstrual cups offer a safer, sustainable alternative, but lack widespread study. This study examines awareness, attitudes, and practices of menstrual cup use among medical students and factors influencing adoption. Methods This cross-sectional study was conducted at a private medical college in Chennai in India among 250 medical students. Participants were selected through simple random sampling. After obtaining informed consent, data collection was carried out using a pre-structured and pre-tested questionnaire. Data was entered into MS Excel (Microsoft® Corp., Redmond, WA, USA) and analyzed using IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States). Descriptive statistics are presented in tables, analytical statistics include the calculation of unadjusted odds ratios, followed by logistic regression analysis to assess associations between relevant variables. Results Among the 250 study participants, more than two-thirds were aged between 18 and ≤ 21 years. Poor knowledge about menstrual cups (56.4%), unfavorable attitudes (57.6%), and menstrual cup usage of 46.4% were noted among the study participants. Key factors significantly associated with poor knowledge about menstrual cups included family members who did not use menstrual cups (adjusted odds ratio (AOR) 3.21), non-availability of menstrual cups (AOR 5.12), experiencing frequent menstrual problems (AOR 2.11), and receiving doctors’ advice regarding menstrual issues (AOR 2.91). Unfavorable attitudes were linked to concerns while purchasing sanitary napkins (AOR 3.60), non-usage by family members (AOR 2.16), non-availability (AOR 3.10), menstrual issues (menorrhagia, recurrent infections), disposal concerns (AOR 2.60), and perceived difficulty of use (AOR 4.17). Conclusion This study highlights the necessity for enhanced education on menstrual hygiene practices, even within the medical community, to address the knowledge gap. It is essential to educate young medical students on the benefits and drawbacks of menstrual cups, with a focus on why they are a safer and more eco-sustainable option. Future research should be conducted in community settings to allow for the generalization of the findings.

PMID:40406792 | PMC:PMC12096921 | DOI:10.7759/cureus.82780

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Nevin Manimala Statistics

The Early Clinical and Radiographic Outcomes of Robotic-Assisted Midline Lumbar Interbody Fusion (MIDLIF) With Expandable Interbody Spacers: A Case Series

Cureus. 2025 Apr 22;17(4):e82802. doi: 10.7759/cureus.82802. eCollection 2025 Apr.

ABSTRACT

OBJECTIVE: To assess the early clinical and radiological outcomes of the midline lumbar interbody fusion (MIDLIF) approach with the use of robotic assistance and expandable spacers.

METHODS: A retrospective case series was performed on patients who underwent MIDLIF procedures for the treatment of degenerative spinal diseases, with a minimum of three months postoperative follow-up. Demographic (age, gender, body mass index [BMI], comorbidities, and diagnoses), surgical data (operative time, blood loss, hospital stay, intraoperative complications), patient-reported outcomes (PROs) (visual analogue scale [VAS] back pain and disability (Oswestry disability index [ODI]), and radiographic data were collected.

RESULTS: In total, 42 patients were included, with an average age of 53.6 years and a BMI of 28 kg/m². Surgical data showed the mean total operative time was 98.8 minutes, and the mean blood loss was 17.1 mL with no intraoperative complications. At three-month follow-up, all mean PROs showed statistically significant improvement (p<0.05) when compared with baseline. VAS back pain improved from 7.5 (standard deviation (stdev) 7.5±0.7) preoperatively to 3.0 (stdev 1.0) at three months postoperative, while ODI improved from 58.7 (stdev 7.2) to 26.3 (stdev 10.3) at the same time points. Radiographic data showed that using robotic assistance for planning and placing cortical screws yielded high accuracy, as evidenced by a mean tip deviation of 1.2 mm (stdev 0.6 mm), mean tail deviation of 1.1 mm (stdev 0.4 mm) and a mean angular offset of 1.4 mm (stdev 0.7). Two (4.8%) patients had postoperative complications at three-month follow-up, including a wound infection and one report of wound dehiscence.

CONCLUSION: MIDLIF is an efficient, reproducible surgical procedure with a low complication rate that resulted in significant improvements in early PROs. Robotic assistance for planning and placing cortical screws in MIDLIF was highly accurate. These initial findings suggest that using robotic assistance adds value to MIDLIF procedures and is a viable alternative to traditional posterior fusion procedures.

PMID:40406778 | PMC:PMC12097802 | DOI:10.7759/cureus.82802

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Nevin Manimala Statistics

Medical Students’ Perspectives on Physical, Online, and Hybrid Learning Modalities: A Mixed Methods Study From a Medical School in Mauritius

Cureus. 2025 Apr 22;17(4):e82765. doi: 10.7759/cureus.82765. eCollection 2025 Apr.

ABSTRACT

INTRODUCTION: Medical schools were not immune to the difficulties posed by the COVID pandemic. Educational institutions were shut down. By April 2020, 73.8% of registered students in 186 countries were adversely affected. The circumstances forced academic institutions to transition to emergency online teaching, despite the controversies of the effectiveness of this method. The absence of face-to-face teaching greatly impacted the clinical placements and affected the physical and practical skills training of many institutions.

OBJECTIVE: There is a dearth of data showing how medical students perceive blended learning. As far as the authors are aware, no study has ever addressed the experience of medical students regarding blended, online, and physical teaching in Mauritius. Therefore, the objective of the research is to address the challenges they faced and provide suggestions to tackle the drawbacks and help the betterment of the style of teaching with enhanced academic performance. A qualitative and quantitative assessment of the students’ experience of these three methods was conducted.

METHODS: A mixed methods study, incorporating both qualitative and quantitative data, was conducted at Sir Seewoosagur Ramgoolam Medical College, Mauritius, to understand medical students’ perceptions of online, hybrid, and physical teaching. Statistical Product and Service Solutions (SPSS, version 29; IBM SPSS Statistics for Windows, Armonk, NY) was used for quantitative data analysis, whereas NVivo 12 Plus software was used for qualitative data analysis.

RESULTS: Out of 700 participants, 568 medical students participated in the study for quantitative data synthesis, resulting in an overall response rate of 81.14% (568). A total of 224 (69.1%) female students preferred a mixture of online and in-person lectures, followed by didactic lectures (100, 30.9%) and online (0, 0%). Among all male students, 160 (65.6%) preferred a mixture of online and in-person lectures, didactic lectures (68, 27.5%), and online lectures (16, 6.6%) (p<0.05). Webex was the most popular online video conferencing application utilized for the lectures, which was preferred by 248 (76.5%) female students, followed by Zoom (52, 16%), Google Meet (20, 6.2%), and Microsoft Teams (4, 1.2%). Regarding male students, 200 (82%) students preferred Webex, Zoom (32, 13.1%), Microsoft Teams (8, 3.3%), and Google Meet (4, 1.6%), which was statistically significant (p<0.05). A total of 144 (77.8%) Mauritian students, 34 (73.9%) South Africans, and 206 (61.7%) Indian students preferred a mixture of online and in-person lectures (p<0.05). A descriptive phenomenological qualitative data analysis generated three themes from the codes were as follows: online learning system, physical learning system, and blended learning system. Each theme had three different categories – emotional, academic, and related variables. Under each category, related codes were organized.

CONCLUSION: The novelty of this study is evident, and its practical implications stretch far beyond the lockdown and COVID-19, but its findings, particularly surrounding the reduction in the loss of class times during tropical storms and hurricanes, are invaluable. The hybrid model of teaching caters to a wider audience of students and helps create a balanced mental and physical educational experience, resulting in the best outcome for students in their studies by capitalizing on the advantages of both didactic and online lectures.

PMID:40406771 | PMC:PMC12096337 | DOI:10.7759/cureus.82765