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Aims: Optokinetic-based paradigms used to derive objective visual acuity suffer so far from low predictive power. Arguably, the contribution of the peripheral stimulation and the discrepancy between detection and discrimination threshold can bias the outcomes. In this respect, high-pass filtered stimuli (HPSs) have the advantage of activating only the foveal region and their detection and discrimination thresholds converge. In this exploratory study a novel optokinetic-based induction method (named “ghost oktotype”) that uses HPSs is probed. The aim was to establish whether this type of procedure is worth being extensively investigated. Study Design: Analytical transversal study. Place and Duration of Study: Department of Ophthalmology, University of Turin, Italy, between June 2023 and June 2024. Methodology: After testing for their subjective acuity (expressed as logMAR) at ten different defocusing conditions, four normal and cooperative subjects were repeatedly administered sequences of HPS-Landolt rings arranged on a serial pattern that drifted horizontally. Their angular size was logarithmically reduced and objective acuity was computed for each defocusing condition as a function of the smallest size of the rings that evoked the optokinetic reflex (logMAER). The estimate was compared to the subjective values obtained both at the conventional Landolt-C ETDRS charts and with modified ETDRS charts made up of high-pass filtered Landolt Cs. Results: The repeatability of the HPS-based optokinetic paradigm was good in the three subjects (ICC=0.77; 0.86; 0.89) and the outcomes were significantly correlated with the conventional ETDRS values (R2=0.96, R2=0.88, R2=0.81: P<0.001). Nevertheless, objective visual acuity was lower (higher logMAER) compared to the subjective, conventional assessment with the ETDRS chart, especially at the highest acuities. This difference decreased when logMAER was compared to the subjective discrimination acuity (logMAR) measured with the HPS-ETDRS charts, and, supposedly, to detection acuity. Conclusion: According to these preliminary results, high-pass filtered stimuli reduce the mismatch between subjective and objective acuity. Within this frame, the “ghost” oktotype could be a promising tool to assess visual acuity in non-collaborative patients and is worth being extensively investigated. Forthcoming studies could support our impression i.e., that detection and not resolution is the main requisite for the optokinetic response. This peculiarity must be considered when investigating the potential of the optokinetic-based paradigms to derive resolution acuity.
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Introducción La progresión del cáncer de mama involucra mecanismos fisiológicos como metástasis. Los retrasos en diagnóstico y tratamiento aumentan el riesgo de mortalidad y se asocian a barreras de acceso a la salud. En Chile, el cáncer de mama es altamente prevalente y su diagnóstico temprano ha mejorado, aunque persisten disparidades en el proceso de enfermedad. Este estudio caracterizó exámenes de diagnóstico y etapificación, tiempos de espera y perfiles sociodemográficos para identificar demoras e inequidades en la atención. Métodos Estudio de encuesta. Utilizando una muestra no probabilística, se aplicó un cuestionario en plataforma encriptada previo consentimiento informado. En el instrumento se recogieron datos de exámenes solicitados, tiempos asociados, etapificación y características sociodemográficas. Estas variables fueron analizadas utilizando estadística descriptiva, test de asociación, intervalos de confianza y test de comparación utilizando . Resultados Se logró una muestra de 263 personas. Los exámenes más solicitados fueron biopsia (99,62%) y exámenes de sangre (80,23%). La mediana de exámenes solicitados fue de 6 (Q1:4, Q3:8), con media 5,87 (desviación estándar: 2,24). No se observaron diferencias significativas en el porcentaje de personas a quienes se solicitó la totalidad de exámenes según variables estudiadas. Los intervalos día-hora-resultado oscilaron entre 1 y 365 días. La mediana día-hora-resultado de la biopsia fue de 15 días (Q1:10, Q3:30). Las personas entre 40 y 49 años, no residentes de la capital, pertenecientes al quintil I de ingreso, con educación media, del sistema público de salud, con diagnóstico en etapa tardía presentaron mayores medianas de día-hora-resultado en biopsia. No hubo diferencia significativa en la cantidad de exámenes solicitados según etapificación (I a II y III a IV). Conclusiones La biopsia en Chile es el examen de elección para la confirmación diagnóstica en cáncer de mama. Otros exámenes son solicitados independientemente de la etapa del diagnóstico, existiendo una discordancia con las recomendaciones de la guía clínica. El pronóstico del cáncer es crucial, especialmente en países con mayores inequidades.
Introduction Breast cancer progression involves physiological mechanisms such as metastasis. Delays in diagnosis and treatment increase the risk of mortality and are associated with barriers to healthcare access. In Chile, breast cancer is highly prevalent, and early diagnosis has improved, although disparities in the disease evolution persist. This study characterized diagnostic and staging tests, waiting times, and sociodemographic profiles to identify delays and inequities in care. Methods Survey study. Using a non-probabilistic sample, a questionnaire was applied in an encrypted platform with prior informed consent. The instrument collected data on requested tests, associated times, staging, and sociodemographic characteristics. These variables were analyzed using descriptive statistics, tests of association, confidence intervals, and comparison tests using bootstrapping. Results A sample of 263 persons was obtained. The most requested tests were biopsy (99.62%) and blood tests (80.23%). The median number of tests requested was six (Q1:4, Q3:8), with a mean of 5.87 (standard deviation: 2.24). No significant differences were observed in the percentage of persons from whom the total number of examinations were requested according to the studied variables. The day-hour-result intervals ranged from 1 to 365 days. The median day-hour-result of the biopsy was 15 days (Q1:10, Q3:30). People between 40 and 49 years old, non-residents of the capital city, belonging to income quintile I, with high school education, from the public health system, with late-stage diagnosis had higher median day-hour-result in biopsy. There was no significant difference in the number of requested tests according to staging (I and II, or III and IV). Conclusions Biopsy in Chile is the test of choice for diagnostic confirmation in breast cancer. Other tests are requested regardless of the diagnosis stage, contrary to the recommendations of clinical guidelines. Cancer prognosis is crucial, especially in countries with greater inequalities.
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Background: Diabetic nephropathy (DN) is a signi?cant complication of diabetes mellitus and is the leading cause of End-Stage Renal Disease (ESRD) globally. Early detection is crucial to prevent progression to ESRD. This study evaluates the effectiveness of Renal Artery Doppler ultrasound in the early identi?cation of DN. The study aims to assess the accuracy and reliability of Renal Artery DopplerAim and Objective: ultrasound in detecting early-stage DN. It seeks to identify speci?c Doppler parameters, such as resistive index, pulsatility index, and peak systolic velocity. Additionally, the study explores the correlation between Renal Artery Doppler ?ndings and traditional markers of DN, including the urinary albumin-to-creatinine ratio (ACR) and estimated glomerular ?ltration rate (eGFR). In this cross-sectional observational study,Methods: 150 diabetic patients aged 18-75 years were evaluated. Renal Artery Doppler parameters, including resistive index (RI), pulsatility index (PI), and peak systolic velocity (PSV), were measured and compared with ACR and eGFR. The resistive index (RI) showed a strong positiveResults: correlation with ACR (r = 0.68, p < 0.001) and a negative correlation with eGFR (r = -0.52, p < 0.001). The pulsatility index (PI) also correlated with ACR (r = 0.64, p < 0.001) and eGFR (r = -0.49, p < 0.001). The Renal Artery Doppler ultrasound demonstrated a sensitivity of 89.5%, a speci?city of 83.2%, a positive predictive value (PPV) of 85.7%, a negative predictive value (NPV) of 87.1%, and an overall diagnostic accuracy of 86.3%. These results suggest that Renal Artery Doppler ultrasound, particularly through the measurement of resistive and pulsatility indices, is a reliable and accurate method for early detection of diabetic nephropathy. This tool can be effectively used in clinical settings to monitor diabetic patients, enabling timely intervention to prevent or slow the progression of kidney disease. Renal Artery Doppler ultrasound is a reliable, non-Conclusion: invasive diagnostic tool for the early detection of diabetic nephropathy, offering high diagnostic accuracy.
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Artificial intelligence (AI) keeps an eye on people in clinical studies to find out when bad things happen. This is a big way that AI is changing healthcare. It goes into a lot of detail about how AI has changed this field and stresses how important it is to use complicated formulas, always keep an eye on things, and follow the rules. These days, we have tools like deep learning frameworks, controlled and unsupervised learning models, and others that help us find bad things faster and more accurately. Tracking in real time is possible with early warning systems and constant data analysis. It helps make sure the experiment is done right and puts the safety of the people being tested first. AI-driven tracking systems can only work in an honest and reliable way if they follow the rules set by regulatory bodies such as the FDA and the EMA. The fact that AI has the ability to change the way medical research is done today, with benefits like making it faster and more accurate, makes its problems even more important. The report comes to the conclusion that more research, better teamwork, and a wider use of AI technologies are needed to make it more reliable to find bad events in clinical studies over time.
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One of the integral part of the network analysis is finding groups of nodes that exhibit similar properties. Community detection techniques are a popular choice to find such groups or communities within a network and it relies on graph-based methods to achieve this goal. Finding communities in biological networks such as gene co-expression networks are particularly important to find groups of genes where we can focus on further downstream analysis and find valuable insights regarding concerned diseases. Here, we present an effective community detection method called community detection using centrality-based approach (CDCA), designed using the graph centrality approach. The method has been tested using four benchmark bulk RNA-seq datasets for schizophrenia and bipolar disorder, and the performance has been proved superior in comparison to several other counterparts. The quality of communities are determined using intrinsic graph properties such as modularity and homogeneity. The biological significance of resultant communities is decided using the pathway enrichment analysis.
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Urine sample validity testing is critical in medical diagnostics, forensic investigations, and workplace drug screening to ensure accurate and reliable results. The increasing sophistication of tampering methods, such as adulteration and substitution, necessitates the development of advanced testing techniques. This review explores the latest advancements in urine validity testing, including the integration of machine learning (ML) and artificial intelligence (AI) with high-resolution mass spectrometry (HRMS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS). These technologies enhance the detection of novel chemical and biological markers, such as unique metabolite profiles, polyglycole patterns, and DNA methylation markers (e.g., TWIST1 and NID2). The identification of new biomarkers and the application of multi-modal analytical approaches provide comprehensive and sensitive detection of tampering. Future directions in the field focus on refining these technologies, ensuring ethical data handling, and expanding regulatory frameworks to protect privacy and enhance the reliability of testing protocols. The advancements discussed promise significant improvements in the detection and prevention of urine sample tampering, ensuring the integrity of testing processes across various applications.
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This study critically evaluates the effectiveness of public health policies and programs targeting Alzheimer's and dementia care in the United States, with a specific emphasis on early detection, disparities in access to care, and variations in service quality between urban and rural healthcare facilities. The research utilizes a representative sample sourced from national databases, including the World Bank’s Quality of Government (QoG) dataset, CDC’s Alzheimer’s Disease and Healthy Aging Data Portal, and the Alzheimer's Association. Logistic regression models were employed to assess the influence of early detection programs on patient outcomes, while disparities in access to care were analyzed through regression models that incorporated demographic and geographic data from the National Institute on Aging and the CDC. The study also conducted extensive surveys targeting patients and healthcare providers across various settings to evaluate service quality. The findings reveal that while early detection programs are indispensable, their mere availability does not guarantee improved patient outcomes unless accompanied by high-quality implementation strategies. Significant disparities in access to care were identified, particularly along the lines of age and race, with minority groups and younger populations experiencing more significant barriers. Additionally, the study revealed pronounced differences in service quality between urban and rural areas, with rural healthcare facilities lagging in patient satisfaction, staff qualifications, and facility resources. The study recommends several targeted interventions: enhancing the quality and implementation of early detection programs, particularly in underserved areas; addressing disparities in care access by expanding Medicaid coverage and increasing funding for community health initiatives; and investing in rural healthcare infrastructure to bridge the gap in service quality and improve the overall care and support for Alzheimer’s and dementia patients, particularly in marginalized communities.
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For optimal cervical cancer care pathway, effective communication among colposcopist professionals regarding colposcopic findings, diagnosis, and treatment of intraepithelial lesions is crucial; standardization of the colposcopic report may serve as a beneficial strategy for this purpose. Elaborate and validate the colposcopic report for screening intraepithelial lesions and cervical cancer using a committee of specialists. This validation study used the item-level content validity index (I-CVI) to verify the agreement of judges per item, and the scale-level content validity index (S-CVI) to determine the mean of the proportion of items classified as "no disagreement"; items with an I-CVI?0.80 and S-CVI?0.90 were considered approved. The binomial test was used to select the items that should be revised based on the p value of the proportion (rejecting the H0 if p?0.8); statistical significance was set at p<0.05. Results: Seven judges participated in this study. The 11 items of the Colposcopic Report were validated, but items classified as “disagreement” (1, 2, 5, and 9) or “neither agree nor disagree” (3, 10, and 11) were taken to a consensus meeting. Six of the seven judges of the first stage participated in the consensus meeting. Suggestions for modifying item nine were not accepted, and item 11 underwent a slight modification. The colposcopic report was validated and achieved greater reliability, suggesting its inclusion in the cancer information system.
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Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, primarily affecting the lungs. While pulmonary TB (PTB) is the most prevalent form, comprising the majority of cases, extrapulmonary TB (EPTB) presents unique diagnostic and therapeutic challenges. TB spreads through the air when individuals with lung TB cough, sneeze, or spit. Aim: We aim to conduct a comprehensive comparative analysis of molecular diagnostic methods versus conventional techniques for detecting PTB. Results: Among 1100 samples analyzed, 384 cases (34.90%) of TB were identified, encompassing both pulmonary and extrapulmonary forms. The highest number of samples was collected from individuals aged 21–40, 41–60, and 61–80 years. In particular, 70 out of 114 pus samples (61.40%) tested positive for EPTB. In contrast, only 5 out of 79 pleural fluid samples (6.33%) and 16 out of 32 lymph node samples (50%) tested positive for EPTB. Conclusion: These findings highlight the critical need for ongoing research and the development of accurate, sensitive, and accessible diagnostic methods to combat TB effectively. PTB was observed to be more prevalent, affecting a larger proportion of individuals, while EPTB accounted for a smaller, though significant, number of cases.
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Background : The presence of living micro-organisms in blood is known as bloodstream infection. It can be leading to sepsis, a critical condition associated with mortality ranging from 14% to 34%. Blood cultures are still considered the gold standard test for the detection of bacteremia and fungemia. The bacterial load in blood culture is assessed by the parameter of time to positivity in an automated system. Materials and Methods : It was a prospective observational study conducted 3 months after IEC approval. A minimum of one & maximum of three samples were collected from each patient. After receiving them at the microbiology laboratory all bottles were loaded into the BacT/ALERT machine. All the signaled positive bottles were studied for a time to detection and factors influencing it and the second objective was to observe the effect of loading delay on isolation rate and time to detection. The following parameters were prospectively extracted from BacT/ALERT systems� software the cell number, loading time, signal positive time and unloading time (hour, minute). Observations : A total of 761 blood culture bottles were received during the study period. Maximum bottles were received from male as compared to female patients. Maximum blood cultures were received from the 0-10 years of age group followed by from 21-30 years and from 51-60 years. The mean TTD for all the isolates was 22.71 hours. 81% of true pathogens were detected within 24 hours and 98% of true pathogens were detected within 72 hours. We observed that inadequate blood volume took longer TTP for GNB & Yeast isolates than adequate volume bottles. The true pathogen positivity rate decreases in case of loading delay. The mean unloading time during routine & emergency hours was 0.6 hours & 1.6 hours. Conclusion : As positive blood cultures are critical alerts; every step should be taken to decrease the loading & unloading delay of blood culture bottles for the final reduction of turn-around time and timely intimation of positive blood culture results to clinicians.
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The study of Land Use/Land Cover (LULC) is crucial for managing natural resources in response to increasing human demands in today's ecosystem. This research primarily employs Geographic Information System (GIS) and land use data to path changes in Dharmavaram mandal, situated in the Ananthapur district of Andhra Pradesh, India. The focus of this paper is on analyzing and recognizing alterations in LULC between 2017 and 2023 using Esri Land cove Sentinel-2 10 metre Land use and Land cover data. The integration of remote sensing technology and GIS tools has facilitated the monitoring of land use and land cover changes over time. This technology has unveiled changes at both regional and global levels, providing substantial bene?ts to the scienti?c community.
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Background: Prostate cancer poses a significant health concern in males, exhibiting diverse manifestations ranging from slow to aggressive progression. Diagnostic challenges persist due to limitations of conventional methods like DRE and PSA tests, prompting interest in MRI screening for its enhanced sensitivity and specificity thereby reducing unnecessary biopsy. Methods: This retrospective study, conducted in (Govt Doon Medical College Hospital, a tertiary care centre in Uttarakhand, Northern India, enrolled 100 participants with prostate-specific antigen (PSA) levels above 3 ng/ml. Patients underwent Magnetic resonance imaging (MRI) screening and clinical evaluation, with biopsy confirmation if abnormalities were detected. Primary outcomes assessed prostate cancer incidence over seven years, with secondary outcomes including high-grade disease detection and overall survival. Statistical analyses utilized SPSS 27 for correlations and logistic regression. Results: The study includes 100 prostate cancer cases, categorized into locoregional and advanced prostate cancer groups. Locoregional cases (60 in number, were in the age range of 65-69 yrs, exhibited T3 TNM classification (41.6%) with unknown nodal involvement (66.6%) and absence of distant metastasis (63.3%). Advanced cases (40 in number) shared similar demographics, notably with 82.5% aged 65-69. Comparing MRI and biopsy outcomes, the experimental group detected more cancers (100%) than the reference group (66%). MRI-targeted biopsies showed promise in detecting significant cancers while identifying more clinically insignificant ones. Conclusion: The study demonstrates MRI's potential in detecting prostate cancer, particularly in cases with higher PSA levels or advanced stages. The findings underscore the importance of MRI as a complementary tool in prostate cancer screening, warranting further investigation.
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Rubella is still considered a dangerous infectious disease, especially for pregnant women. The symptoms of rubella can be similar to those of other illnesses. Therefore, an early and accurate diagnosis of the rubella virus will help doctors make a reasonable treatment plan. This study presents the development and characterization of a novel lateral flow immunochromatographic assay test strip for rapid recognition of rubella virus antigen. Rabbit polyclonal antibodies against rubella virus were purified with a purity of 95%. Optimal conditions for the production of the main components of a test strip were determined. Anti-rubella virus polyclonal antibodies were physically adsorbed onto the star-shaped gold nanoparticles at the optimal concentration of 1.0 ?g/ml at 25°C for 30 min. The amounts of antibody per conjugate pad and immobilized on the test line were 0.2 ?g/pad and 4.5 ?g/cm, respectively. The properties of the test strip were characterized by testing mock clinical specimens. Reproducibility and repeatability were achieved at 100%. The limit of detection of the test strip was determined to be as low as 5 × 105 virus particles/mL. The test strip did not cross-react with six different potential interfering pathogens. The sensitivity and specificity of the test strip were determined by testing with 400 mock clinical samples and reached 99.5% and 98.5%, respectively. The Kappa statistics (k coefficient = 0.98) showed very good agreement between the generated test strip and real-time PCR results. According to the findings, the test strip can be used as an additional rapid test tool for the detection of rubella virus.
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Background: The diagnosis of tuberculous pleural effusion (TPE) poses a massive problem during tuberculosis (TB) control worldwide. This study set out to find the role of Interferon Gamma (IFN-?) and Adenosine Deaminase (ADA) in pleural fluid as markers for early diagnosis of TPE to improve the accuracy and, hence, the opportunity for early and effective intervention for patients. Aims and Objectives: (i) The aims and objectives of the study are to compare the levels of IFN-? and ADA in pleural fluid samples from patients with tuberculous and non-TPEs; (ii) to determine the diagnostic accuracy of these biomarkers in differentiating TPE from other causes; and (iii) to analyze the correlation of IFN-? and ADA levels with other routine diagnostic parameters for TB. Materials and Methods: The study adopted a forward- looking, case–control methodology to compare outcomes across groups. One hundred individuals presenting with pleural effusion were selected for participation. This cohort was divided evenly, with 50 individuals identified with TPE and 50 showing non-tuberculous types of effusion, including those caused by parapneumonic and cancerous processes. Eligible participants were aged between 20 and 60 years and tested negative for the human immunodeficiency virus. Exclusion criteria included pleural effusion arising from viral infections, pregnancy or breastfeeding status, adverse drug reactions affecting the skin, or empyema. Thoracocentesis was performed to collect pleural fluid following participants’ informed consent under sterile conditions. The analysis of pleural fluid encompassed measurements of IFN-? through enzyme- linked immunosorbent assay techniques and ADA levels through an ADA assay kit. In addition, venous blood was drawn to conduct routine hematological and biochemical tests, including evaluating serum lactate dehydrogenase, total protein, albumin, and cholesterol levels. Results: It was found that the mean level of IFN-? was significantly (P < 0.00001) higher in patients with TPE, 186.66 ± 134.46 pg/mL, as compared to the level in non-tuberculous effusion 47.53 ± 68.94 pg/mL. Similarly, the difference in ADA level was also significant (P = 0.016) between the two groups. The mean level of ADA was significantly (P = 0.016) higher in TPE, 135.93 ± 239 U/L, compared to the level in non-tuberculous effusion, 58.86 ± 87.83 U/L. Conclusion: The significant elevation in IFN-? and ADA levels in TPE patients re-emphasizes their potential as specific markers in this clinical condition and suggests considering IFN-? in combination with ADA as valuable parameters in the differentiation of tuberculous from non-tuberculous effusions and thereby, this advancementin the realm of quick markers of diagnosis would play a crucial role in the refinement of diagnosis strategy in TB which would be of immense help in improving the patients’ outcome.
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Introduction: Antibiotic resistance is rising worldwide, posing a challenge for contemporary medicine. Metallo-beta-lactamases (MBLs) confer resistance to beta-lactam antibiotics other than monbactams. It threatens public health because of its vast scope of action and quick spread. The study was undertaken to assess the occurrence of MBL in clinical isolates of Pseudomonas aeruginosa in the Enugu metropolis and to determine their resistance profile. Materials and Methods: The work was conducted from October 2020 to July 2021 in the microbiology laboratory of the University of Nigeria Teaching Hospital, Ituku-Ozalla. A total of 127 non-duplicate bacterial isolates recovered from clinical samples including wounds, urine, sputum, ear discharge, and catheter tip processed in the microbiology laboratory of four referral hospitals within the Enugu metropolis was used for the study. Isolates were identified and characterized using standard microbiology protocols. Antimicrobial susceptibility was done using the Kirby-Bauer disc diffusion method. Phenotypic detection of Metallo-beta-lactamase production was done using the Combined Disk diffusion Test (CDDT). Results: Of the 127 isolates, 68 (53.5%) were resistant to imipenem. Among these, 35 strains were positive for MBL production while 33 isolates were non-MBL producers. The highest percentage occurrence of MBL producers was recorded from catheter tips 33% followed by urine 30.6%. Both MBL producers and non-MBL producers displayed high resistance to most of the antibiotics used except Aztreonam. Conclusion: The overall occurrence of MBL among Pseudomonas aeruginosa in our study was found to be 27.6%. MBL-producing strains showed higher resistance than the non-MBL-producing strains. Aztreonam was the most potent antibiotic. The most effective approaches to combating this organism include early detection, stringent antibiotic regimens, and adherence to infection control measures.
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Introducción: las lesiones premalignas y malignas del complejo bucal se incrementan en la población, lo que demanda una correcta ejecución del Programa de Detección Precoz del Cáncer Bucal (PDCB). En el trabajo se exponen las transformaciones en el nivel de conocimientos de pacientes y estomatólogos acerca de las afecciones concernientes al PDCB para perfeccionar su ejecución. Método: se realizó una intervención educativa en el área de salud Julio Antonio Mella del municipio Camagüey desde mayo de 2022 hasta junio de 2023, con la participación de 36 pacientes y 30 estomatólogos. Las fuentes de información fueron la historia clínica, un cuestionario y una prueba de entrada y salida, aplicados a pacientes y estomatólogos respectivamente, antes y después de la intervención; para constatar las transformaciones. Resultados: antes de la intervención los pacientes estaban mal informados sobre las consecuencias nocivas de hábitos tóxicos, higiénicos y dietéticos, así como desconocimiento de la importancia del correcto autoexamen bucal; los que alcanzaron en su mayoría un alto nivel de conocimientos con la intervención. Los estomatólogos mejoraron sus conocimientos sobre diagnóstico y seguimiento de lesiones pre malignas y malignas del complejo maxilofacial. Discusión: la adecuada ejecución del PDCB descansa tanto en pacientes como en estomatólogos y aunque las investigaciones se enfocan a los primeros por los beneficios reportados; la superación de posgrado constituye una vía para sistematizar conocimientos y fortalecer competencias profesionales que impacten de manera positiva en el PDCB. La intervención educativa se considera satisfactoria al elevar el nivel de conocimientos de pacientes y estomatólogos, lo que demuestra sus potencialidades para perfeccionar la ejecución del PDCB.
Introduction: premalignant and malignant lesions of de oral area increase in the population which demands a correct implementation of the Early Detection of Oral Cancer Program. In this work transformations are exposed knowledge level of both patients and dentists regarding lesions concerning the Early Detection of Oral Cancer Program (EDOCP). Method: educational intervention was carried out in Julio Antonio Mella health area of Camaguey municipality from May 2022 to June 2023 which 36 patients and 30 Deontologists. Information sources were the Clinical History, a questionnaire and a test applied to patients and Deontologists respectively, before and after the intervention, to confirm the transformations in the sample. Results: Prior to intervention patients were poorly informed about consequences of toxic, hygienic and dietetic habits combined with lack of knowledge regarding importance of a correct oral self-examination whose knowledge improved to reach a high level in most of them after the intervention. Deontologists improved their knowledge on diagnosis and follow-up of premalignant and malignant lesions affecting the maxillofacial complex. Discussion: correct application of the EDOCP depends on both patients and deontologists, however reserchers focus on the former due to the reported benefits; the postgraduate training is a way to systematize knowledge and strengthen professional competences with positive impact on EDOCP. The educational intervention was satisfactory since it improved the level of knowledge of both patients and dentists which shows its potential on a correct implementation of the Early Detection of Oral Cancer Program.
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Antecedentes En Chile, la prevalencia del Trastorno por Déficit de Atención con Hiperactividad (TDAH) se estima en un 10%. Frente a esta realidad, las políticas públicas promueven la detección oportuna de esta condición, suscitándose sin embargo problemas de sobre y sub-diagnóstico atribuibles a la falta de escalas actualizadas. Objetivo El propósito de este estudio fue evaluar las propiedades psicométricas de la escala Conners-3 en su forma abreviada de auto-reporte en niños y adolescentes chilenos. Método Se aplicó el Conners-3, y una medida de validez convergente (BRIEF-2), a una muestra no probabilística (n = 265) de estudiantes de enseñanza básica y media (8-18 años). Se efectuó un análisis de la correlación ítem-test e inter-escalar, seguido de un análisis factorial confirmatorio (AFC), finalizando con un análisis de consistencia interna. Resultados Todos los ítems presentaron una correlación ítem-escala aceptable. La estructura interna de cinco factores del AFC coincide con la original, las cuales además presentaron una consistencia interna aceptable y evidencia de validez convergente así como divergente. Conclusiones La escala Conners-3 presenta propiedades psicométricas aceptables para ser usada en la fase de detección del TDAH, recomendándose su uso como parte de una evaluación integral que incorpore otros métodos de evaluación.
Background In Chile, it is estimated that the prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) is at 10%. Faced with this reality, public policies promote the timely detection of this condition; however, this situation generates over and underdiagnosis problems attributable to the lack of updated scales. Objective The purpose of this study was to assess the psychometric properties of the Conners-3 Rating Scale in its self-report short form in Chilean children and adolescents. Method The Conners-3 Self-report Scale and a convergent validity measure (BRIEF-2) were applied to a non-probability sample (n = 265) of elementary and high school students (8 to 18 years old). A confirmatory factor analysis (CFA) was carried out, in addition to an internal consistency analysis and an item-total and inter-scale correlation analysis. Results All the items presented an acceptable item-scale correlation. The five-factor internal structure of the CFA coincides with the original. Scales also presented an acceptable internal consistency and evidence of convergent validity. Conclusions the Conners-3 Self-report Scale presents acceptable psychometric properties for use in the detection phase of ADHD; furthermore, its use is suggested as part of a comprehensive assessment that incorporates other assessment methods.
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Abstract Currently, the percentage of traffic accidents has increased, and according to statistics, this percentage will continue to increase every year, so it is necessary to develop new technologies to prevent this kind of accidents. This paper presents a drowsiness detection system based on electroencephalogram (EEG) signals using a pair of channels (Fp1 and Fp2) applied to drivers before entering their vehicles. First, this model detects the relationship between the area under the curve (AUC) of alpha brain waves, an effective parameter for detecting drowsiness. Then, the extracted information is passed to a fuzzy expert system (FES) that classifies the subject's state as "alert" or "sleepy"; the criterion used was a threshold and training with subjective levels. The proposed system was compared with neural network models, such as support vector machine (SVM), K nearest neighbors (KNN), and random forest (RF). Measurements of one hundred and twenty minutes were performed on each of the ten drivers for two days to test the system. The tests confirm that this system is suitable for preventive measures and that the fuzzy system is superior to traditional neural network methods.
Resumen Actualmente, el porcentaje de accidentes de tráfico ha aumentado, y según las estadísticas, este porcentaje seguirá aumentando cada año, por lo que es necesario desarrollar nuevas tecnologías para prevenir este tipo de accidentes. Este trabajo presenta un sistema de detección de somnolencia basado en señales de electroencefalograma (EEG) utilizando un par de canales (Fp1 y Fp2) aplicado a los conductores antes de entrar en sus vehículos. En primer lugar, este modelo detecta la relación entre el área bajo la curva (AUC) de las ondas cerebrales alfa, un parámetro eficaz para detectar la somnolencia. A continuación, la información extraída se pasa a un sistema experto difuso (FES) que clasifica el estado del sujeto como "alerta" o "somnoliento"; el criterio utilizado fue un umbral y el entrenamiento con niveles subjetivos. El sistema propuesto se comparó con modelos de redes neuronales, como la máquina de vectores de soporte (SVM), K vecinos más cercanos (KNN) y el bosque aleatorio (RF). Se realizaron mediciones de ciento veinte minutos en cada uno de los diez conductores durante dos días para probar el sistema. Las pruebas confirman que este sistema es adecuado para las medidas preventivas y que el sistema difuso es superior a los métodos tradicionales de redes neuronales.
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Resumen Antecedentes: La resonancia magnética (RM) de próstata es uno de los métodos diagnósticos para la identificación del carcinoma de próstata. La escala PI-RADS (Prostate Imaging and Reporting Data System) es el sistema usado para la interpretación de estas imágenes. Es importante, para su reproducibilidad, la estandarización y la evaluación de dicha escala. Objetivo: Determinar la concordancia inter- e intraobservador de la versión 2.1 del PI-RADS. Material y métodos: Estudio observacional retrospectivo, evaluando 129 RM de pacientes con sospecha de cáncer de próstata por tres radiólogos con diferentes años de experiencia y en dos momentos del tiempo, usando el puntaje PI-RADS 2.1. Se evaluó la concordancia intra- e interobservador. Resultados: La concordancia interobservador fue sustancial (kappa > 0,6) en todos los observadores, siendo la categoría 5 la de mayor acuerdo interobservador. Se observó una alta reproducibilidad intraobservardor, con la mayor kappa siendo de 0,856. Cuando se realizó el análisis según años de experiencia de los radiólogos, la concordancia interobservador fue significativa en todos los casos. Conclusiones: El sistema de clasificación PI-RADS 2.1 es reproducible para las diferentes categorías y aumenta la concordancia cuando se trata de lesiones con mayor probabilidad de cáncer clínicamente significativo.
Abstract Background: Magnetic Resonance Imaging (MRI) of the prostate is a key diagnostic tool for identifying prostate carcinoma. The Prostate Imaging-Reporting and Data System (PI-RADS) scale is the standard system for interpreting these images. Standardizing and evaluating this scale is crucial for ensuring consistent and reproducible results. Objective: This study aims to assess both the interobserver and intraobserver agreement of the PI-RADS version 2.1. Material and methods: In this retrospective observational study, 129 prostate MRI scans from patients with suspected prostate cancer were evaluated. Three radiologists, each with different levels of experience, analyzed these scans at two separate times using the PI-RADS 2.1 scoring system. Both intraobserver and interobserver agreements were measured. Results: The study found substantial interobserver agreement (kappa > 0.6) across all categories, with category 5 showing the highest level of agreement. Intraobserver reproducibility was also high, with the highest kappa value reaching 0.856. Further analysis based on the radiologists years of experience revealed significant interobserver agreement in all instances. Conclusions: The PI-RADS 2.1 classification system demonstrates high reproducibility across different categories, particularly for lesions more likely to be clinically significant cancers. This underscores its reliability in varied diagnostic scenarios.
ABSTRACT
INTRODUCTION: We aimed to develop a decision aid to support shared-decision making between physicians and women with average breast cancer risk when deciding whether to participate in breast cancer screening. METHODS: We included women at average risk of breast cancer and physicians involved in supporting the decision of breast cancer screening from an Academic Hospital in Buenos Aires, Argentina. We followed the International Patient Decision Aid Standards to develop our decision aid. Guided by a steering group and a multidisciplinary consultancy group including a patient advocate, we reviewed the evidence about breast cancer screening and previous decision aids, explored the patients' information needs on this topic from the patients' and physicians' perspective using semi-structured interviews, and we alpha-tested the prototype to determine its usability, comprehensibility and applicability. RESULTS: We developed the first prototype of a web-based decision aid to use during the clinical encounter with women aged 40 to 69 with average breast cancer risk. After a meeting with our consultancy group, we developed a second prototype that underwent alpha-testing. Physicians and patients agreed that the tool was clear, useful and applicable during a clinical encounter. We refined our final prototype according to their feedback. CONCLUSION: We developed the first decision aid in our region and language on this topic, developed with end-users' input and informed by the best available evidence. We expect this decision aid to help women and physicians make shared decisions during the clinical encounter when talking about breast cancer screening.