Matrix analysis for the identification of risk factors for choking and coughing while eating in disabled elderly individuals / 上海预防医学

ObjectiveTo identify factors related to the occurrence of choking and coughing while eating in the disabled elderly and conduct importance matrix analysis to provide a reference basis for controlling choking on food in the disabled elderly. MethodsA convenience sampling method was used to select 80 disabled elderly individuals in a hospital between October 2019 and April 2022 as the study population. The occurrence of choking and coughing while eating was recorded， and a questionnaire was administered to collect general information. Additionally， assessments were conducted using the intelligent mental status examination scale （MMSE）， oral health checklist （BOHSE）， eating assessment tool⁃10 （EAT-10）， and chewing function evaluations. Univariate and multifactorial analyses were conducted to analyze the influencing factors of choking and coughing while eating in the elderly with disabilities. ResultsThe incidence of choking and coughing while eating was 52.50% （42/80） among the 80 disabled elderly. The degree of disability （OR=2.895， 95%CI： 1.352‒6.201）， age （OR=4.040， 95%CI： 1.121‒14.562）， BOHSE score （OR=2.473， 95%CI： 1.002‒6.102）， EAT-10 score （OR=5.345， 95%CI： 2.112‒13.527）， and chewing function score （OR=3.453， 95%CI： 1.247‒9.562） were identified as risk factors for choking and coughing while eating in the disabled elderly. The MMSE score （OR=0.343， 95%CI： 0.135‒0.869） was identified as a protective factor. The importance matrix analysis indicated that EAT-10 score， MMSE score， and chewing function had high importance with slightly lower difficulty in improvement， and were thus listed as items in the priority improvement area. Age and degree of disability had high importance and high difficulty in improvement， and therefore belonged to the suboptimal improvement area. BOHS score was slightly lower both in importance and difficulty of improvement， entering the alternative improvement area. ConclusionAge， degree of disability， BOHSE score， EAT-10 score， and chewing function score are risk factors for the occurrence of choking and coughing while eating， while the MMSE score is a protective factor. The importance matrix analysis can provide a basis for targeted intervention in clinical practice.

Research progress on three-dimensional evaluation methods for facial asymmetry / 口腔疾病防治

@#Facial symmetry evaluation has always been a hot topic of concern for doctors who engage in the study of facial beauty disciplines such as orthodontics, dentistry, and plastic surgery. Although scholars at home and abroad have carried out much research on the evaluation of facial symmetry with a variety of emerging technologies and methods, there is still a lack of unified standards for the evaluation of facial asymmetry due to the complexity of the content and methods and individual subjectivity. Facial asymmetry involves changes in the length, width and height of the face. It is a complex dental and maxillofacial malformation whose early identification and accurate evaluation are particularly important. Clinically, in addition to the necessary dental and maxillofacial examinations, it is also necessary to evaluate facial asymmetry with the help of corresponding auxiliary methods. This paper gives a summary of the commonly used three-dimensional evaluation methods. The evaluation methods of facial asymmetry can be divided into 5 categories: qualitative analysis, quantitative analysis, dynamic analysis, mathematical analysis, and artificial intelligence analysis. After the analysis and summarization of the characteristics, advantages and limitations of each method in clinical applications, it is found that although these methods vary in accuracy, evaluation scope, diagnosis nature and calculation method, etc., the three-dimensional evaluation methods are more objective, more accurate and more convenient and will become the mainstream evaluation method for facial asymmetry with further development of three-dimensional measurement technologies.

Research on the key driving factors of the transformation of scientific and technological achievements in public hospitals / 中华医院管理杂志

Objective:To learn the key driving factors in the management of scientific and technological achievements transformation in public hospitals, so as to provide basis for improving the effectiveness of achievements transformation.Methods:From March to July 2021, 1 226 medical staff from 7 municipal hospitals in Hangzhou were investigated by stratified random sampling. The questionnaire included the main demographic information, the perceived importance and actual performance of the management mechanism(6 dimensions, 18 items)which was scored by Likert 5. Descriptive analysis was carried out and paired samples were compared by t-test, and the difference was significant when P<0.05. Importance matrix analysis was carried out on all items to identify the key driving factors for the transformation of achievements in public hospitals. Results:1 157 valid questionnaires were finally included. The difference between the scores of perceived importance and actual performance of the various management mechanisms was significance( P<0.001). The gap was presented as follows: evaluation mechanism(1.29), investment mechanism(0.88), organization and leadership mechanism(0.87), guarantee mechanism of services(0.44), benefit and distribution mechanism(0.15), incentive mechanism(-0.11). Matrix analysis results showed that, " special funds support" , " grasp market demand and accurately connect" , " formulate corresponding supporting systems" , " professional transformation team with multidisciplinary background" , " classified and multi-level achievement transformation evaluation index system" , " full life cycle management" , " incorporate into central work and key tasks" and " scientific and technological achievement transformation reporting system and application monitoring system" were the key driving factors for the transformation of scientific and technological achievements in public hospitals. Conclusions:The perceived importance of medical staff to the transformation of scientific and technological achievements in public hospitals is acceptable, while the actual performance is relatively weak. The management effectiveness should be improved and give priority to consolidate the management foundation, build index evaluation system, provide the life cycle management service and improve scientific interaction as well as consultation service mechanism.

Always, better control-vital, essential and non-essential matrix analysis of pharmaceuticals inventory management at selected public health facilities of Jimma zone southwest Ethiopia: facility based cross sectional study design

Background:Always, better control(ABC)-vital, essential and non-essential (VEN) matrix analysis has a key role in assisting decisions making in medicine selection, purchasing and inventory management and hence help in reducing cost, identifying medicine use problems and improve efficiency in the pharmaceutical supply system. Studies on analysis of pharmaceuticals expenditures throughout the country were very limited, in Jimma zone no studies found yet. The objective of the study was, therefore, to analyze pharmaceuticals based on cost and criticality aspects and identify those which require stringent managerial control at selected public health facilities of Jimma zone Southwest Ethiopia. Methods:Health facility-based, cross-sectional, study design using a quantitative method in which ABC, VEN and ABC-VEN matrix analysis techniques were utilized to analyse pharmaceutical inventory management system at selected public health facilities of Jimma zone. Results:The ABC analysis shows that class A items accounted for 53(15.3%), whereas class B and C items accounted for 72(20.8%) and 221(63.8%) number of items at selected public health facilities of Jimma zone. VEN analysis showed that 132 items (59.7%) were categorized as vital and consumes 61.4% ($248,372) of the annual pharmaceuticals expenditures (APE). Whereas, 55 items (24.8%) and 34 items (15.3%) were categorized under essential and less/non-essential with a total APE of 31.1% ($126,020) and 7.4%($30,008)respectively. From ABC-VEN matrix analysis, the majority of items were category I pharmaceuticals.Conclusions:Majority of items at a selected public health facility were category I and most of the category I pharmaceuticals, in turn, were Class A and V items which require great attention for their control and availability

A method for constructing three-dimensional face symmetry reference plane based on weighted shape analysis algorithm / 北京大学学报(医学版)

OBJECTIVE@#To establish a novel method based on three-dimensional (3D) shape analysis and weighted Procrustes analysis (WPA) algorithm to construct a 3D facial symmetry reference plane (SRP), automatically assigning weight to facial anatomical landmarks. The WPA algorithm suitability for commonly observed clinical cases of mandibular deviation were analysed and evaluated.@*METHODS@#Thirty patients with mandibular deviation were recruited for this study. The 3D facial SRPs were extracted independently based on original-mirror alignment method. Thirty-two anatomical landmarks were selected from the overall region by three times to obtain the mean coordinate. The SRP of experimental groups 1 and 2 were using the standard Procrustes analysis (PA) algorithm and WPA algorithm, respectively. A reference plane defined by experts based on regional iterative closest point (ICP) algorithm, served as the ground truth. Three experts manually selecting facial regions with good symmetry for original model, and common region was included in the study. The angle error values between the SRP of WPA algorithm in the experimental group 1 and the truth plane were evaluated in this study, and the SRP of PA algorithm of experimental group 2 was calculated in the same way. Statistics and measurement analysis were used to comprehensively evaluate the clinical suitability of the WPA algorithm to calculate the SRP. A paired t-test analysis (two-tailed) was conducted to compare the angles.@*RESULTS@#The average angle error between the SRP of WPA algorithm and the ground truth was 1.53°±0.84°, which was smaller than that between the SRP of PA and the ground truth (2.06°±0.86°). There were significant differences in the angle errors among the groups (P < 0.05). For the patients with severe mandibular deviation that the distance between pogonion and facial midline greater than 12 mm, the average angle error of the WPA algorithm was 0.86° smaller than that of the PA algorithm.@*CONCLUSION@#The WPA algorithm, based on weighted shape analysis, can provide a more adaptable SRP than the standard PA algorithm when applied to mandibular deviation patients and preliminarily simulate the diagnosis strategies of clinical experts.

Analysis of Monitoring Focus Drugs in an Obstetrics and Gynecology Hospital Based on ABC-VEN Matrix Analysis / 中国药房

OBJECTIVE：To investigate drug use in an obstetrics and gynecology hospital and confirm the types of drugs that need to be monitored so as to provide reference for rational drug use in clinic. METHODS： Activity based classification （ABC） analysis， Vital-Essential-Nonessential Medicine （VEN） analysis and ABC-VEN matrix analysis were used to statistically analyze the types of drugs in the inpatients and outpatients of this hosptial during Jan. 2016-Dec. 2017， and consumption sum in the hospital so as to determine the types of monitoring focus drugs. RESULTS： The drugs were divided into class A， B， and C by using ABC analysis， and the constitute ratio of them were 6.08％， 7.71％ and 86.21％； the constitute ratio of consumption sum were 70.97％， 19.07％ and 9.96％， respectively. The drugs were divided into class V， E and N， and the constitute ratio of them were 36.51％， 43.61％ and 19.88％； constituent ratios of their consumption sum were 31.89％， 33.89％ and 34.22％， respectively. The drugs were divided into group Ⅰ （class AV， AE， AN， BV， CV）， group Ⅱ （class BE， CE， BN） and group Ⅲ （class CN） by using ABC-VEN matrix analysis； the constitute ratios of accumulative number of drug type were 40.56％， 44.43％ and 15.01％，while those of accumulative consumption sum were 77.29％， 20.52％ and 2.19％， respectively. Among class N， the constituent ratio of consumption sum of class AN as Chinese patent medicine， blood substitutes and perfusion solutions were higher， being 12.48％ and 7.92％； that of class BN as Chinese patent medicine was higher， being 3.21％； those of class CN as Chinese patent medicine， sex hormones and modulators of the genital system were higher， being 1.14％， 0.50％. CONCLUSIONS： In the Obstetrics and Gynecology Hospital， consumption sum of class A is the main part of the total consumption sum of drugs， and they should be seleted according to therapeutic efficacy. Active regulatory policies should be adopted for class V and E so that more drug types that possess cost- effectiveness advantages； for class N， management control and reasonable utilization should be monitored closely to reduce irrational drug use. Some Chinese patent medicines， blood substitutes and perfusion solutions among class AN should be monitored and controlled emphatically.

Quantitative evaluation of the facial morphology of a Tolteca figurine from Mexico using geometric morphometric approaches / Evaluación cuantitativa de la morfología facial de una figura Tolteca de México utilizando la morfometría geométrica

Morphometric approaches can be combined with 2D or 3D imaging to quantitatively evaluate craniofacial medical conditions depicted in material culture and to learn more about the culture being studied. A terra-cotta figurine (circa 500 A.D.) from the Tolteca culture of Mexico has previously been qualitatively "diagnosed" with Down syndrome (DS) based on the presence or absence of facial features typically associated with trisomy 21. The purpose of this research is to quantitatively test the hypothesis that the Tolteca figurine exhibits facial features consistent with DS. Landmarks (n = 24) were acquired from sex- and age-matched (5-20 yrs) facial images of DS individuals (n = 32), euploid individuals (n = 32), and the Tolteca figurine. Landmark coordinates were subjected to geometric morphometric analyses, and the results suggest that the Tolteca figurine displays facial morphology consistent with DS.

Con el objetivo de evaluar cuantitativamente las complejas condiciones medicas craneofaciales, se pueden combinar los enfoques morfométricos con imágenes 2D o 3D representadas en la cultura material, para un mayor conocimiento referente al estudio cultural. Una figura de terracota (alrededor del 500 DC) de la cultura Tolteca de México ha sido previamente y cualitativamente "diagnosticada" con Síndrome de Down en base a la presencia o ausencia de rasgos faciales típicamente asociados con trisomía 21. El propósito de esta investigación fue comprobar cuantitativamente la hipótesis de que esta figura de la cultura Tolteca exhibe rasgos faciales consistentes con Síndrome de Down. Se identificaron puntos de referencia similares (n = 24) según sexo y edad (5-20 años) a imágenes faciales de individuos con Síndrome de Down (n = 32), individuos euploides (n = 32) y de la figura Tolteca. Los puntos de referencia fueron sometidos a un análisis morfométrico geométrico, y los resultados sugieren que la morfología facial de la figura Tolteca es consistente con el Síndrome de Down.

Difference in dental arch form between Angle Ⅱ division 1 and normal occlusion assessed by Euclidean distance matrix analysis / 实用口腔医学杂志

Objective: To evaluate differences in dental arch forms between the subjects with Angle II division 1(AngleⅡ1 ) and those with normal occlusion. Methods:60 AngleⅡ1 patients and 60 normal occlusion subjects aged 13-17 years old were selected. Fourteen landmarks, corresponding to the cusp tips and incisor edges, were identified on the upper and lower dental casts of all subjects by YM-21115 three dimension measuring machine. Arch form differences between AngleⅡ1 and normal occlusion subjects were assessed by Euclidean distance matrix analysis (EDMA). Results:(1) In both sexes, the upper arch of AngleⅡ1 subjects was larger than that of normal occlusion (1.8% for females and 2.7% for males); and arch shape difference was also significantly different(P