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1.
Plant Divers ; 46(5): 611-620, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39290883

RESUMEN

Tropical regions have provided new insights into how ecological communities are assembled. In dry coastal communities, water stress has been hypothesized to determine plant assembly structure by favoring preadapted lineages from neighboring ecosystems, consistent with functional clustering. However, it is unclear whether this hypothesis is sufficient to explain how coastal communities in tropical ecosystems are assembled. Here, we test whether water stress or other factors drive community assembly in woody plant communities across the coastal zone of Brazil, a tropical ecosystem. We characterized functional and phylogenetic structures of these communities and determined the underlying environmental factors (e.g., water stress, historical climate stability, edaphic constraints, and habitat heterogeneity) that drive their community assembly. Assemblages of coastal woody species show geographically varied patterns, including stochastic arrangements, clustering, and overdispersion of species relative to their traits and phylogenetic relatedness. Topographic complexity, water vapor pressure, and soil nutrient availability best explained the gradient in the functional structure. Water deficit, water vapor pressure, and soil organic carbon were the best predictors of variation in phylogenetic structure. Our results support the water-stress conservatism hypothesis on functional and phylogenetic structure, as well as the effect of habitat heterogeneity on functional structure and edaphic constraints on functional and phylogenetic structure. These effects are associated with increased phenotypic and phylogenetic divergence of woody plant assemblages, which is likely mediated by abiotic filtering and niche opportunities, suggesting a complex pattern of ecological assembly.

2.
BMC Med Inform Decis Mak ; 24(1): 258, 2024 Sep 16.
Artículo en Inglés | MEDLINE | ID: mdl-39285457

RESUMEN

PURPOSE: The European health data space promises an efficient environment for research and policy-making. However, this data space is dependent on high data quality. The implementation of electronic medical record systems has a positive impact on data quality, but improvements are not consistent across empirical studies. This study aims to analyze differences in the changes of data quality and to discuss these against distinct stages of the electronic medical record's adoption process. METHODS: Paper-based and electronic medical records from three surgical departments were compared, assessing changes in data quality after the implementation of an electronic medical record system. Data quality was operationalized as completeness of documentation. Ten information that must be documented in both record types (e.g. vital signs) were coded as 1 if they were documented, otherwise as 0. Chi-Square-Tests were used to compare percentage completeness of these ten information and t-tests to compare mean completeness per record type. RESULTS: A total of N = 659 records were analyzed. Overall, the average completeness improved in the electronic medical record, with a change from 6.02 (SD = 1.88) to 7.2 (SD = 1.77). At the information level, eight information improved, one deteriorated and one remained unchanged. At the level of departments, changes in data quality show expected differences. CONCLUSION: The study provides evidence that improvements in data quality could depend on the process how the electronic medical record is adopted in the affected department. Research is needed to further improve data quality through implementing new electronical medical record systems or updating existing ones.


Asunto(s)
Exactitud de los Datos , Registros Electrónicos de Salud , Servicio de Cirugía en Hospital , Registros Electrónicos de Salud/normas , Humanos , Alemania , Estudios Longitudinales , Servicio de Cirugía en Hospital/normas , Análisis de Documentos
3.
Sci Rep ; 14(1): 20307, 2024 09 02.
Artículo en Inglés | MEDLINE | ID: mdl-39218966

RESUMEN

Citizen science data on biodiversity has experienced significant growth, largely driven by advancements in technology that facilitate data sharing. In recent years, mobile applications have provided a substantial boost to both the collection and sharing of this data. While this accessible information is undoubtedly valuable, we must consider the numerous biases present in this data when used for high-quality research. In this study, we analyse citizen science data for the birds of the Iberian Peninsula, comprising over 23 million unique records after filtering for duplicates (i.e., instances where the same observation was uploaded more than once). Using a 10 × 10 km square grid, we present information on well-surveyed cells (completeness) as well as temporal, taxonomic, geographical, and land use coverages. We found that the completeness of information is generally high, with better coverage around densely populated areas such as major cities and coastal regions, as well as popular birding destinations, which are frequently visited. The Mediterranean ecoregion and wetlands exhibit the highest levels of surveying. Furthermore, we observed an increase in temporal coverage since the 1980s and broad taxonomic coverage across all bird orders in the Iberian region. Our results underscore the utility of citizen science for many locations, as expressed in 10 × 10 km cells. However, they also highlight the inadequate data completeness across part of the territory, particularly in forested or sparsely inhabited areas. These findings not only identify cells suitable for bird diversity or conservation studies but also indicate areas where citizen-driven bird recording efforts should be encouraged.


Asunto(s)
Biodiversidad , Aves , Ciencia Ciudadana , Animales , España , Exactitud de los Datos , Portugal , Conservación de los Recursos Naturales/métodos
4.
Digit Health ; 10: 20552076241278692, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39221084

RESUMEN

Purpose: Chat Generative Pre-trained Transformer (ChatGPT) is now utilized in various fields of healthcare in order to obtain answers to questions related to healthcare-related problems and to evaluate available information. Primary hyperparathyroidism is a common endocrine disorder. We aimed to evaluate the accuracy and quality of ChatGPT's responses to questions specific to hyperparathyroidism cases discussed at multidisciplinary endocrinology meetings. Methods: ChatGPT-4 was asked to respond to 10 hyperparathyroidism cases evaluated at multidisciplinary endocrinology meetings. The accuracy, completeness, and quality of the responses were scored independently by two endocrinologists. Accuracy and completeness were evaluated on the Likert scale, and quality was evaluated on the global quality scale (GQS). Results: No misleading information was detected in the responses. In terms of diagnosis, the mean accuracy scores (ranging from 1 to 5) were 4.9 ± 0.1 and the mean completeness scores (ranging from 1 to 3) were 3.0. In the responses given in terms of further examination, the mean accuracy and completeness scores were 4.8 ± 0.13 and 2.6 ± 0.16, respectively. The mean accuracy and completeness scores for treatment recommendations were 4.9 ± 0.1 and 2.4 ± 0.16, respectively. The GQS evaluation result was 80% high quality and 20% medium quality. Conclusion: In this study, the accuracy and quality rates of ChatGPT-4 were generally high in responding to questions as to hyperparathyroidism patients. It can be concluded that artificial intelligence may serve as a valuable tool in healthcare. However, the limitations and risks of ChatGPT should also be evaluated.

5.
JMIR Public Health Surveill ; 10: e59446, 2024 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-39045828

RESUMEN

Background: South Korea has implemented a hand, foot, and mouth disease (HFMD) surveillance system since 2009 to monitor incidence trends and identify disease burden. This nationwide surveillance involves a network of approximately 100 pediatric clinics that report all probable and confirmed HFMD cases. Following the COVID-19 pandemic, infectious disease surveillance systems must be evaluated to ensure the effective use of limited public health resources. Objective: This study aimed to evaluate the HFMD sentinel surveillance system in South Korea from 2017 to 2022, focusing on the transition period after the COVID-19 pandemic. Methods: We retrospectively reviewed the HFMD sentinel surveillance system from the Korea Disease Control and Prevention Agency using systematic guidelines for public health surveillance system evaluation developed by the US Centers for Disease Control and Prevention. We assessed the system's overall performance in 5 main factors: timeliness, stability, completeness, sensitivity, and representativeness (ie, the age and geographic distribution of sentinels). We rated these factors as weak, moderate, or good. Results: Our study showed that the completeness, sensitivity, and age representativeness of the HFMD surveillance performance were temporarily reduced to moderate levels from 2020 to 2021 and recovered in 2022, while the timeliness and geographic representativeness were maintained at a good level throughout the study period. The stability of the surveillance was moderate from 2017 to 2021 and weak in 2022. Conclusions: This is the first study to evaluate the HFMD surveillance system after the acute phase of the COVID-19 pandemic. We identified a temporarily reduced level of performance (ie, completeness, sensitivity, and age-specific representativeness) during the acute phase of the pandemic and good performance in 2022. Surveillance system evaluation and maintenance during public health emergencies will provide robust and reliable data to support public health policy development. Regular staff training programs and reducing staff turnover will improve HFMD surveillance system stability.


Asunto(s)
Enfermedad de Boca, Mano y Pie , Vigilancia de Guardia , Humanos , Enfermedad de Boca, Mano y Pie/epidemiología , Estudios Retrospectivos , República de Corea/epidemiología , Preescolar , Lactante , Niño , COVID-19/epidemiología , COVID-19/prevención & control , Recién Nacido
6.
Int J Equity Health ; 23(1): 143, 2024 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-39026324

RESUMEN

BACKGROUND: Race and ethnicity are important drivers of health inequalities worldwide. However, the recording of race/ethnicity in data systems is frequently insufficient, particularly in low- and middle-income countries. The aim of this study is to descriptively analyse trends in data completeness in race/color records in hospital admissions and the rates of hospitalizations by various causes for Blacks and Whites individuals. METHODS: We conducted a longitudinal analysis, examining hospital admission data from Brazil's Hospital Information System (SIH) between 2010 and 2022, and analysed trends in reporting completeness and racial inequalities. These hospitalization records were examined based on year, quarter, cause of admission (using International Classification of Diseases (ICD-10) codes), and race/color (categorized as Black, White, or missing). We examined the patterns in hospitalization rates and the prevalence of missing data over a period of time. RESULTS: Over the study period, there was a notable improvement in data completeness regarding race/color in hospital admissions in Brazil. The proportion of missing values on race decreased from 34.7% in 2010 to 21.2% in 2020. As data completeness improved, racial inequalities in hospitalization rates became more evident - across several causes, including assaults, tuberculosis, hypertensive diseases, at-risk hospitalizations during pregnancy and motorcycle accidents. CONCLUSIONS: The study highlights the critical role of data quality in identifying and addressing racial health inequalities. Improved data completeness has revealed previously hidden inequalities in health records, emphasizing the need for comprehensive data collection to inform equitable health policies and interventions. Policymakers working in areas where socioeconomic data reporting (including on race and ethnicity) is suboptimal, should address data completeness to fully understand the scale of health inequalities.


Asunto(s)
Sistemas de Información en Salud , Disparidades en el Estado de Salud , Disparidades en Atención de Salud , Sistemas de Información en Hospital , Femenino , Humanos , Masculino , Brasil , Sistemas de Información en Salud/normas , Disparidades en Atención de Salud/estadística & datos numéricos , Sistemas de Información en Hospital/normas , Hospitalización/estadística & datos numéricos , Estudios Longitudinales , Grupos Raciales/estadística & datos numéricos , Factores Socioeconómicos , Población Blanca/estadística & datos numéricos , Población Negra/estadística & datos numéricos
7.
Popul Health Metr ; 22(1): 12, 2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38879515

RESUMEN

BACKGROUND: Heterogeneity in national SARS-CoV-2 infection surveillance capabilities may compromise global enumeration and tracking of COVID-19 cases and deaths and bias analyses of the pandemic's tolls. Taking account of heterogeneity in data completeness may thus help clarify analyses of the relationship between COVID-19 outcomes and standard preparedness measures. METHODS: We examined country-level associations of pandemic preparedness capacities inventories, from the Global Health Security (GHS) Index and Joint External Evaluation (JEE), on SARS-CoV-2 infection and COVID-19 death data completion rates adjusted for income. Analyses were stratified by 100, 100-300, 300-500, and 500-700 days after the first reported case in each country. We subsequently reevaluated the relationship of pandemic preparedness on SARS-CoV-2 infection and age-standardized COVID-19 death rates adjusted for cross-country differentials in data completeness during the pre-vaccine era. RESULTS: Every 10% increase in the GHS Index was associated with a 14.9% (95% confidence interval 8.34-21.8%) increase in SARS-CoV-2 infection completion rate and a 10.6% (5.91-15.4%) increase in the death completion rate during the entire observation period. Disease prevention (infections: ß = 1.08 [1.05-1.10], deaths: ß = 1.05 [1.04-1.07]), detection (infections: ß = 1.04 [1.01-1.06], deaths: ß = 1.03 [1.01-1.05]), response (infections: ß = 1.06 [1.00-1.13], deaths: ß = 1.05 [1.00-1.10]), health system (infections: ß = 1.06 [1.03-1.10], deaths: ß = 1.05 [1.03-1.07]), and risk environment (infections: ß = 1.27 [1.15-1.41], deaths: ß = 1.15 [1.08-1.23]) were associated with both data completeness outcomes. Effect sizes of GHS Index on infection completion (Low income: ß = 1.18 [1.04-1.34], Lower Middle income: ß = 1.41 [1.16-1.71]) and death completion rates (Low income: ß = 1.19 [1.09-1.31], Lower Middle income: ß = 1.25 [1.10-1.43]) were largest in LMICs. After adjustment for cross-country differences in data completeness, each 10% increase in the GHS Index was associated with a 13.5% (4.80-21.4%) decrease in SARS-CoV-2 infection rate at 100 days and a 9.10 (1.07-16.5%) decrease at 300 days. For age-standardized COVID-19 death rates, each 10% increase in the GHS Index was with a 15.7% (5.19-25.0%) decrease at 100 days and a 10.3% (- 0.00-19.5%) decrease at 300 days. CONCLUSIONS: Results support the pre-pandemic hypothesis that countries with greater pandemic preparedness capacities have larger SARS-CoV-2 infection and mortality data completeness rates and lower COVID-19 disease burdens. More high-quality data of COVID-19 impact based on direct measurement are needed.


Asunto(s)
COVID-19 , Salud Global , Preparación para una Pandemia , Humanos , COVID-19/mortalidad , COVID-19/prevención & control , COVID-19/epidemiología
8.
Ann Surg Oncol ; 2024 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-38918326

RESUMEN

BACKGROUND: Cytoreductive surgery (CRS) is a widely acknowledged treatment approach for peritoneal metastasis, showing favorable prognosis and long-term survival. Intraoperative scoring systems quantify tumoral burden before CRS and may predict complete cytoreduction (CC). This study reviews the intraoperative scoring systems for predicting CC and optimal cytoreduction (OC) and evaluates the predictive performance of the Peritoneal Cancer Index (PCI) and Predictive Index Value (PIV). METHODS: Systematic searches were conducted in Embase, MEDLINE, and Web of Science. Meta-analyses of extracted data were performed to compare the absolute predictive performances of PCI and PIV. RESULTS: Thirty-eight studies (5834 patients) focusing on gynecological (n = 34; 89.5%), gastrointestinal (n = 2; 5.3%) malignancies, and on tumors of various origins (n = 2; 5.3%) were identified. Seventy-seven models assessing the predictive performance of scoring systems (54 for CC and 23 for OC) were identified with PCI (n = 39/77) and PIV (n = 16/77) being the most common. Twenty models (26.0%) reinterpreted previous scoring systems of which ten (13%) used a modified version of PIV (reclassification). Meta-analyses of models predicting CC based on PCI (n = 21) and PIV (n = 8) provided an AUC estimate of 0.83 (95% confidence interval [CI] 0.79-0.86; Q = 119.6, p = 0.0001; I2 = 74.1%) and 0.74 (95% CI 0.68-0.81; Q = 7.2, p = 0.41; I2 = 11.0%), respectively. CONCLUSIONS: Peritoneal Cancer Index models demonstrate an excellent estimate of CC, while PIV shows an acceptable performance. There is a need for high-quality studies to address management differences, establish standardized cutoff values, and focus on non-gynecological malignancies.

9.
J Am Med Inform Assoc ; 31(8): 1648-1656, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-38916911

RESUMEN

OBJECTIVE: Author name incompleteness, referring to only first initial available instead of full first name, is a long-standing problem in MEDLINE and has a negative impact on biomedical literature systems. The purpose of this study is to create an Enhanced Author Names (EAN) dataset for MEDLINE that maximizes the number of complete author names. MATERIALS AND METHODS: The EAN dataset is built based on a large-scale name comparison and restoration with author names collected from multiple literature databases such as MEDLINE, Microsoft Academic Graph, and Semantic Scholar. We assess the impact of EAN on biomedical literature systems by conducting comparative and statistical analyses between EAN and MEDLINE's author names dataset (MAN) on 2 important tasks, author name search and author name disambiguation. RESULTS: Evaluation results show that EAN improves the number of full author names in MEDLINE from 69.73 million to 110.9 million. EAN not only restores a substantial number of abbreviated names prior to the year 2002 when the NLM changed its author name indexing policy but also improves the availability of full author names in articles published afterward. The evaluation of the author name search and author name disambiguation tasks reveal that EAN is able to significantly enhance both tasks compared to MAN. CONCLUSION: The extensive coverage of full names in EAN suggests that the name incompleteness issue can be largely mitigated. This has significant implications for the development of an improved biomedical literature system. EAN is available at https://zenodo.org/record/10251358, and an updated version is available at https://zenodo.org/records/10663234.


Asunto(s)
Autoria , MEDLINE , Publicaciones Periódicas como Asunto , Nombres
10.
J Geom Anal ; 34(7): 214, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38706721

RESUMEN

We investigate the geometry of the space of immersed closed curves equipped with reparametrization-invariant Riemannian metrics; the metrics we consider are Sobolev metrics of possible fractional-order q∈[0,∞). We establish the critical Sobolev index on the metric for several key geometric properties. Our first main result shows that the Riemannian metric induces a metric space structure if and only if q>1/2. Our second main result shows that the metric is geodesically complete (i.e., the geodesic equation is globally well posed) if q>3/2, whereas if q<3/2 then finite-time blowup may occur. The geodesic completeness for q>3/2 is obtained by proving metric completeness of the space of Hq-immersed curves with the distance induced by the Riemannian metric.

11.
Langenbecks Arch Surg ; 409(1): 117, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38598044

RESUMEN

BACKGROUND: The oncologic safety and surgical completeness of remote-access thyroidectomies are not yet clearly established. This study evaluates the oncologic outcomes and surgical completeness of three prevalent remote-access thyroidectomies: the gasless transaxillary approach (GTAA), bilateral axillo-breast approach (BABA), and transoral approach (TOA), in comparison with conventional transcervical thyroidectomy (CTT). METHODS: Literature searches were conducted in PubMed, EMBASE, and the Cochrane Library databases, covering the period from 2000 to 2023. Network meta-analyses were performed on selected studies, focusing on recurrence and surgical completeness. Surgical completeness was assessed using stimulated serum thyroglobulin levels and the count of retrieved lymph nodes. RESULTS: The review included 48 studies, encompassing a total of 16,356 patients. The number of retrieved lymph nodes was comparable among BABA, TOA, and CTT, while GTAA might be less effective. Stimulated serum thyroglobulin levels showed no significant differences across the four groups. However, the proportion of patients with stimulated thyroglobulin levels below 1.0 ng/mL was significantly lower in GTAA compared to the other groups. The overall recurrence rates were 1.31% for CTT, 0.89% for GTAA, 0.62% for BABA, and 0% for TOA, with no significant differences in recurrence rates when adjusted for follow-up duration. CONCLUSIONS: This study demonstrated that the oncologic outcomes of GTAA, BABA, and TOA are comparable to those of CTT, based on recurrence rates. In terms of surgical completeness, BABA and TOA showed equivalence to CTT, whereas GTAA might be inferior to the other techniques.


Asunto(s)
Tiroglobulina , Tiroidectomía , Humanos , Mama , Metaanálisis en Red
12.
Genome Biol ; 25(1): 92, 2024 04 11.
Artículo en Inglés | MEDLINE | ID: mdl-38605401

RESUMEN

BACKGROUND: In the metagenomic assembly of a microbial community, abundant species are often thought to assemble well given their deeper sequencing coverage. This conjuncture is rarely tested or evaluated in practice. We often do not know how many abundant species are missing and do not have an approach to recover them. RESULTS: Here, we propose k-mer based and 16S RNA based methods to measure the completeness of metagenome assembly. We show that even with PacBio high-fidelity (HiFi) reads, abundant species are often not assembled, as high strain diversity may lead to fragmented contigs. We develop a novel reference-free algorithm to recover abundant metagenome-assembled genomes (MAGs) by identifying circular assembly subgraphs. Complemented with a reference-free genome binning heuristics based on dimension reduction, the proposed method rescues many abundant species that would be missing with existing methods and produces competitive results compared to those state-of-the-art binners in terms of total number of near-complete genome bins. CONCLUSIONS: Our work emphasizes the importance of metagenome completeness, which has often been overlooked. Our algorithm generates more circular MAGs and moves a step closer to the complete representation of microbial communities.


Asunto(s)
Metagenoma , Microbiota , Microbiota/genética , Algoritmos , Bacterias/genética , Metagenómica/métodos
13.
JMIR Med Inform ; 12: e54278, 2024 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-38578684

RESUMEN

BACKGROUND: Despite the potential of routine health information systems in tackling persistent maternal deaths stemming from poor service quality at health facilities during and around childbirth, research has demonstrated their suboptimal performance, evident from the incomplete and inaccurate data unfit for practical use. There is a consensus that nonfinancial incentives can enhance health care providers' commitment toward achieving the desired health care quality. However, there is limited evidence regarding the effectiveness of nonfinancial incentives in improving the data quality of institutional birth services in Ethiopia. OBJECTIVE: This study aimed to evaluate the effect of performance-based nonfinancial incentives on the completeness and consistency of data in the individual medical records of women who availed institutional birth services in northwest Ethiopia. METHODS: We used a quasi-experimental design with a comparator group in the pre-post period, using a sample of 1969 women's medical records. The study was conducted in the "Wegera" and "Tach-armacheho" districts, which served as the intervention and comparator districts, respectively. The intervention comprised a multicomponent nonfinancial incentive, including smartphones, flash disks, power banks, certificates, and scholarships. Personal records of women who gave birth within 6 months before (April to September 2020) and after (February to July 2021) the intervention were included. Three distinct women's birth records were examined: the integrated card, integrated individual folder, and delivery register. The completeness of the data was determined by examining the presence of data elements, whereas the consistency check involved evaluating the agreement of data elements among women's birth records. The average treatment effect on the treated (ATET), with 95% CIs, was computed using a difference-in-differences model. RESULTS: In the intervention district, data completeness in women's personal records was nearly 4 times higher (ATET 3.8, 95% CI 2.2-5.5; P=.02), and consistency was approximately 12 times more likely (ATET 11.6, 95% CI 4.18-19; P=.03) than in the comparator district. CONCLUSIONS: This study indicates that performance-based nonfinancial incentives enhance data quality in the personal records of institutional births. Health care planners can adapt these incentives to improve the data quality of comparable medical records, particularly pregnancy-related data within health care facilities. Future research is needed to assess the effectiveness of nonfinancial incentives across diverse contexts to support successful scale-up.

14.
BMC Surg ; 24(1): 127, 2024 Apr 27.
Artículo en Inglés | MEDLINE | ID: mdl-38678205

RESUMEN

BACKGROUND: The endoscopic thyroidectomy areola approach (ETAA) has been widely applied for papillary thyroid carcinoma (PTC), but leaves scars and is not truly minimally invasive. The oral vestibular approach (ETOVA) leaves no scars and is even more minimally invasive. However, there have been few comparative studies of ETAA and ETOVA for PTC. The purpose of our research was to compare two PTC treatment methods in terms of feasibility, safety, efficacy, and cosmetic results. METHODS: A total of 129 patients with PTC underwent thyroidectomy combined with central lymph node dissection by the same surgeon. Among them, 79 patients underwent the ETOVA, and the others underwent the ETAA. We compared the two groups in terms of operative outcomes, postoperative complications, and cosmetic results. RESULTS: No significant differences were found in the clinical characteristics between the ETOVA and ETAA groups. There were no significant differences in the number of removed lymph nodes (P = 0.279) or the number of positive lymph nodes (P = 0.569), but the ETOVA group had a higher number of removed lymph nodes. There was also no significant difference in blood loss volume(P = 0.180), postoperative drainage volume (P = 0.063), length of hospital stay (P = 0.182), transient RLN injury rate (P = 1.000), permanent RLN injury rate (P = 1.000), or recurrence rate (P = 1.000). The ETOVA was a longer operation than the ETAA was (P < 0.01). The ETOVA group had less pain (VAS 1: P < 0.01, VAS 3: P = 0.001), less neck discomfort (1 month after surgery: P = 0.009, 3 months after surgery: P = 0.033), and better cosmetic results (P = 0.001). CONCLUSIONS: The ETOVA is not inferior to the ETAA in terms of safety and curability of PTC and is advantageous in terms of central lymph node dissection, minimal invasiveness, and cosmetic results. TRIAL REGISTRATION: This study was approved by the Ethics Committee of Zhongshan Hospital of Xiamen University (2017 V1.0). No funding was received.


Asunto(s)
Endoscopía , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides , Tiroidectomía , Humanos , Tiroidectomía/métodos , Femenino , Masculino , Neoplasias de la Tiroides/cirugía , Cáncer Papilar Tiroideo/cirugía , Cáncer Papilar Tiroideo/patología , Persona de Mediana Edad , Adulto , Endoscopía/métodos , Resultado del Tratamiento , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Estudios de Factibilidad , Escisión del Ganglio Linfático/métodos
15.
Int J Neural Syst ; 34(6): 2450034, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38623650

RESUMEN

Spiking Neural P Systems (SNP) are well-established computing models that take inspiration from spikes between biological neurons; these models have been widely used for both theoretical studies and practical applications. Virus machines (VMs) are an emerging computing paradigm inspired by viral transmission and replication. In this work, a novel extension of VMs inspired by SNPs is presented, called Virus Machines with Host Excitation (VMHEs). In addition, the universality and explicit results between SNPs and VMHEs are compared in both generating and computing mode. The VMHEs defined in this work are shown to be more efficient than SNPs, requiring fewer memory units (hosts in VMHEs and neurons in SNPs) in several tasks, such as a universal machine, which was constructed with 18 hosts less than the 84 neurons in SNPs, and less than other spiking models discussed in the work.


Asunto(s)
Potenciales de Acción , Modelos Neurológicos , Redes Neurales de la Computación , Neuronas , Neuronas/fisiología , Neuronas/virología , Potenciales de Acción/fisiología , Humanos , Simulación por Computador , Animales
16.
Cureus ; 16(3): e56134, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38487648

RESUMEN

Introduction Discharge summaries (DS) allow continued patient care after being discharged from the hospital. Only a few quality improvement projects (QIPs) focused on assessing and improving the quality and completeness of DS at tertiary care hospitals have been undertaken in Pakistan. This QIP aimed to evaluate and enhance the quality and completeness of DS at a tertiary care hospital in Pakistan to facilitate seamless healthcare transitions. Methods A QIP was conducted in the medical unit of a tertiary care hospital in Rawalpindi, Pakistan. The DS were assessed using the e-discharge summary self-assessment checklist devised by the Royal College of Physicians (RCP). This QIP was done by the plan, do, study, act (PDSA) cycle. The PDSA cycle comprised two audit cycles and an intervention in between them. The first audit cycle (AC) was conducted on 150 DS. Its duration was from March 2023 to June 2023. An educational workshop was conducted before the re-audit cycle (RAC) to address deficiencies and reinforce the implementation of the guidelines provided by the RCP. The RAC was conducted from June 2023 to August 2023. 100 DS were studied and analyzed to assess for improvement in the completeness of DS. Frequencies and percentages were calculated in each audit cycle. The Chi-squared test was applied to compare the statistical difference between the results of both audit cycles. Results A total of 150 DS were analyzed in the first AC and 100 DS in the RAC. The results of the first AC show that the details of any allergies were recorded only in 3% of the DS; this percentage significantly improved to 51% after the RAC (p-value <0.05). Relevant past medical history was included in 52% and 88% of the DS during the first AC and RAC, respectively (p-value <0.05). Secondary diagnoses were written in 54% and 71% of the DS during the first AC and RAC, respectively (p-value <0.05). Details of relevant investigations were included in 60% and 88% of the DS during the first AC and RAC, respectively (p-value <0.05). The post-discharge management plan was written in 90% and 98% of the DS during the first AC and RAC, respectively (p-value <0.05). The follow-up plan was written clearly in 65% and 93% of the DS during the first AC and RAC, respectively (p-value <0.05).  Conclusion The DS was found to be incomplete after analyzing the results of the first AC. The details related to allergies, medications, operations, and procedures were found to be missing in the majority of the cases. No mention of the patient's concerns or expectations was made in the DS. The results of the RAC showed improvement in the level of completeness of DS. The majority of the weak points observed after the first AC seemed to have improved after the RAC, which shows that intervention proved to be quite effective in improving the completeness and quality of DS. The RAC showed significant improvement in the completeness of the details relating to investigations, allergies, past medical history, secondary diagnoses, and the post-discharge follow-up plan. QIP must be routinely carried out to assess and improve the completeness and quality of DS at hospitals.

17.
Ecancermedicalscience ; 18: 1672, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38439807

RESUMEN

Background: Cancer registries are valuable resources for cancer control and research. To justify their purpose, their data should be of satisfactory quality by being comparable internationally, complete in their coverage, valid in their values and timely in reporting. This study aimed to assess the quality of the Ratnagiri Population Based Cancer Registry's data for the years 2017-18 across the four dimensions of data quality. Methods: Regarding comparability, the registry procedure was reviewed vis-à-vis the rules they follow for cancer registry operation. We have used four methods for validity: re-abstraction and re-coding, diagnostic criteria methods- like the percentage of microscopically verified (MV%) and of death certificate only (DCO%) cases, missing information like proportion of cases of primary site unknown (PSU%) and internal validity. Semi-quantitative methods were employed for assessing completeness. Timeliness for all years of registry functioning was assessed qualitatively. Results: The overall accuracy rate of the registry was found to be 91.1% (94.7% for demographic and 88% for tumour details). Mortality to incidence ratios were found to be 0.50 for females and 0.59 for males. MV% was found to be 90.8% for males and 91.5% for females. The average number of sources per case was found to be 1.5. DCO% was found to be 2.7%. PSU% was 7.4%. Conclusion: We have positive results regarding the data's validity and comparability, but there is scope for improvement concerning completeness. Continuous training of the registry personnel and monitoring of the registry is recommended.

18.
Ecol Evol ; 14(2): e10857, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38304273

RESUMEN

Tracking the state of biodiversity over time is critical to successful conservation, but conventional monitoring schemes tend to be insufficient to adequately quantify how species' abundances and distributions are changing. One solution to this issue is to leverage data generated by citizen scientists, who collect vast quantities of data at temporal and spatial scales that cannot be matched by most traditional monitoring methods. However, the quality of citizen science data can vary greatly. In this paper, we develop three metrics (inventory completeness, range completeness, spatial bias) to assess the adequacy of spatial observation data. We explore the adequacy of citizen science data at the species level for Australia's terrestrial native birds and then model these metrics against a suite of seven species traits (threat status, taxonomic uniqueness, body mass, average count, range size, species density, and human population density) to identify predictors of data adequacy. We find that citizen science data adequacy for Australian birds is increasing across two of our metrics (inventory completeness and range completeness), but not spatial bias, which has worsened over time. Relationships between the three metrics and seven traits we modelled were variable, with only two traits having consistently significant relationships across the three metrics. Our results suggest that although citizen science data adequacy has generally increased over time, there are still gaps in the spatial adequacy of citizen science for monitoring many Australian birds. Despite these gaps, citizen science can play an important role in biodiversity monitoring by providing valuable baseline data that may be supplemented by information collected through other methods. We believe the metrics presented here constitute an easily applied approach to assessing the utility of citizen science datasets for biodiversity analyses, allowing researchers to identify and prioritise regions or species with lower data adequacy that will benefit most from targeted monitoring efforts.

19.
Front Cardiovasc Med ; 11: 1342409, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38370154

RESUMEN

Revascularization completeness after percutaneous coronary intervention (PCI) is associated with improved long-term outcomes. Mechanical circulatory support [intra-aortic balloon pump (IABP) or Impella] is used during high-risk PCI (HR-PCI) to enhance peri-procedural safety and achieve more complete revascularization. The relationship between revascularization completeness [post-PCI residual SYNTAX Score (rSS)] and left ventricular ejection fraction (LVEF) in HR-PCI has not been established. We investigated LVEF predictors at 90 days post-PCI with Impella or IABP support. Individual patient data (IPD) were analyzed from PROTECT II (NCT00562016) in the base case. IPD from PROTECT II and RESTORE-EF (NCT04648306) were naïvely pooled in the sensitivity analysis. Using complete cases only, linear regression was used to explore the predictors of LVEF at 90 days post-PCI. Models were refined using stepwise selection based on Akaike Information Criterion and included: treatment group (Impella, IABP), baseline characteristics [age, gender, race, New York Heart Association Functional Classification, LVEF, SYNTAX Score (SS)], and rSS. Impella treatment and higher baseline LVEF were significant predictors of LVEF improvement at 90 days post-PCI (p ≤ 0.05), and a lower rSS contributed to the model (p = 0.082). In the sensitivity analysis, Impella treatment, higher baseline LVEF, and lower rSS were significant predictors of LVEF improvement at 90 days (p ≤ 0.05), and SS pre-PCI contributed to the model (p = 0.070). Higher baseline LVEF, higher SS pre-PCI, lower rSS (i.e. completeness of revascularization), and Impella treatment were predictors of post-PCI LVEF improvement. The findings suggest potential mechanisms of Impella include improving the extent and quality of revascularization, and intraprocedural ventricular unloading.

20.
Accid Anal Prev ; 197: 107469, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38218131

RESUMEN

The causes of accidents are studied in the belief that by finding causes, accidents can be prevented by removing or controlling their causes. It follows that the risk factors that have traditionally been regarded as contributing to accidents can only be regarded as causes if it is possible to alter them by means of one or more road safety measures. Risk factors are causes if their relationship to accidents can be changed by implementing one or more road safety measures influencing the risk factors. Hence, road safety measures that could have been implemented to change risk factors identified as contributing to an accident, but have not, are also causes of accidents. Many of the human factors that have traditionally been identified as risk factors for accidents, like age, gender, driving experience, expectations or involuntary inattention are not causes of accidents, because they cannot be changed by means of any realistic road safety measure. What cannot be changed (could not have been different) is not a cause. It is possible, both in case studies and in statistical analyses, to determine when a set of factors precipitating or contributing to accidents is complete. A list of road safety measures that could have been implemented is only limited by our creativity and imagination and will therefore never be complete.


Asunto(s)
Accidentes de Tránsito , Cognición , Humanos , Accidentes de Tránsito/prevención & control , Factores de Riesgo , Causalidad , Proyectos de Investigación
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