ABSTRACT
BACKGROUND: There is a growing concern with inappropriate, excessive perioperative blood transfusions. Understanding the influence of low preoperative hemoglobin (Hgb) on perioperative blood transfusion (PBT) in head and neck cancer (HNC) surgery with free flap reconstruction may help guide clinical practice to reduce inappropriate treatment among these patients. The objective is to synthesize evidence regarding the association between preoperative Hgb and PBT among major HNC free flap surgeries. METHODS: Terms and synonyms for HNC surgical procedures, Hgb and PBT were used to search MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials and Cochrane Database of Reviews from inception to February 2020. Reference lists of included full texts and studies reporting the preoperative Hgb, anemia or hematocrit (exposure) and the PBT (outcome) in major HNC surgery with free flap reconstruction were eligible. Studies examining esophageal, thyroid and parathyroid neoplasms were excluded; as were case reports, case series (n < 20), editorials, reviews, perspectives, viewpoints and responses. Two independent, blinded reviewers screened titles, abstracts and full texts in duplicate. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was followed. A random-effects model was used to pool reported data. The primary outcome was the proportion of patients who had a PBT. Subgroup analysis examined sources of heterogeneity for perioperative predictors of PBT (age, sex, flap type, flap site and preoperative Hgb). We also examined mean preoperative Hgb in the PBT and no PBT groups. RESULTS: Patients with low preoperative Hgb were transfused more than those with normal Hgb (47.62%, 95% CI = 41.19-54.06, I2 = 0.00% and 13.92%, 95% CI = 10.19-17.65, I2 = 20.69%, respectively). None of the predictor variables explained PBT. The overall pooled mean preoperative Hgb was 12.96 g/dL (95% CI = 11.33-14.59, I2 = 0.00%) and was 13.58 g/dL (95% CI = 11.95-15.21, I2 = 0.00%) in the no PBT group and 12.05 g/dL (95% CI = 10.01 to 14.09, I2 = 0.00%) in the PBT group. CONCLUSIONS: The heterogeneity between studies, especially around the trigger for PBT, highlights the need for additional research to guide clinical practice of preoperative Hgb related to PBT to enhance patient outcomes and improve healthcare stewardship.
Subject(s)
Blood Transfusion , Head and Neck Neoplasms , Hemoglobins , Humans , Anemia , Surgical Procedures, Operative , Head and Neck Neoplasms/surgeryABSTRACT
This research aims to describe information technology and its' modernization, the Internet, and sports psychology. A research study based on primary data collected used open-ended and closed-ended questions related to the variable and defined Internet modernization and sports psychology. This research study determines by smart PLS software. It generates a different result, including indicator correlations, discriminant validity, model fitness analysis, composite reliability, and an intelligent PLS Algorithm model related to the variables. Information technology is the leading independent variable. The Internet and sports psychology are both dependent variables. The result found that information technology presents significant and positive relation to the modernization of the Internet. Information technology also shows the direct impact and significance of sport psychology It plays a vital role in the modernization internet also sports psychology performance.(AU)
Subject(s)
Humans , Internet , Social Change , Information Technology , Athletic Performance , Psychology, Sports , SportsABSTRACT
This study's major objective is to examine the impact of human-computer interaction on innovation and sports psychology. This research study utilized questions linked to independent and dependent variables based on primary data analysis to assess the research. This research study on human-computer interaction conducted in China also discusses innovation and sports psychology. Human-computer interaction is the primary independent variable; it encompasses computer science, cognitive science, and human factor engineering, all regarded as independent variables. Innovation and sports psychology are viewed as dependent factors. This research is based on original data from assessing the outcome with intelligent PLS software and generating useful results. The correlation, R-square, F-square values, and weighted average analysis illustrate the intelligent PLS Algorithm model. The overall findings indicate that human-computer interaction has a favorable and significant effect on innovation and sports psychology. Computer science has direct effects on sports psychology as well. Cognitive science has a close relationship with innovation and sports psychology.(AU)
