-
Sensors (Basel, Switzerland) Jan 2022This study evaluates the progression of visual fatigue induced by visual display terminal (VDT) using automatically detected blink features. A total of 23 subjects were...
This study evaluates the progression of visual fatigue induced by visual display terminal (VDT) using automatically detected blink features. A total of 23 subjects were recruited to participate in a VDT task, during which they were required to watch a 120-min video on a laptop and answer a questionnaire every 30 min. Face video recordings were captured by a camera. The blinking and incomplete blinking images were recognized by automatic detection of the parameters of the eyes. Then, the blink features were extracted including blink number (BN), mean blink interval (Mean_BI), mean blink duration (Mean_BD), group blink number (GBN), mean group blink interval (Mean_GBI), incomplete blink number (IBN), and mean incomplete blink interval (Mean_IBI). The results showed that BN and GBN increased significantly, and that Mean_BI and Mean_GBI decreased significantly over time. Mean_BD and Mean_IBI increased and IBN decreased significantly only in the last 30 min. The blink features automatically detected in this study can be used to evaluate the progression of visual fatigue.
Topics: Asthenopia; Blinking; Humans; Surveys and Questionnaires; Video Recording
PubMed: 35161662
DOI: 10.3390/s22030916 -
Obesity Surgery Apr 2022Metabolic dysfunction-associated fatty liver disease-related cirrhosis is possible at the time of bariatric surgery, complicated by further liver decompensation. Hepatic...
PURPOSE
Metabolic dysfunction-associated fatty liver disease-related cirrhosis is possible at the time of bariatric surgery, complicated by further liver decompensation. Hepatic decompensation can also occur in the absence of cirrhosis but the presentation is less clear.
METHODS
We analyze the clinical characteristics, histological findings, and management of patients without cirrhosis who developed hepatic decompensation after bariatric surgery in our single tertiary-care hospital.
RESULTS
From 2014 to 2019, 6 patients underwent a transvenous liver biopsy for liver decompensation after bariatric surgery. Mean age at diagnosis was 44 years. The time between bariatric surgery and the onset of symptoms varied widely (min. 8 months, max. 17 years). Mean % of weight loss was high at 43%. The clinical presentation was as follows: fatigue and jaundice (5/6), leg edema (3/6), and ascites (1/6). Blood test showed increased transaminases (mean ALT 53 UI/L, mean AST 130 UI/L), bilirubin (mean 6 mg/dL), and INR (mean 1.5) with a low albumin level (mean 27 mg/dL). The hepatic venous pressure gradient was high (mean 10 mmHg). Histology revealed steatosis, hepatocyte ballooning but also portal inflammation with polymorphonuclear cells, and bile duct alterations. Mean fibrosis score was 2. The clinical course was favorable with nutritional support with a mean follow-up of 36 months.
CONCLUSION
Liver decompensation in the absence of cirrhosis can occur after bariatric surgery with a highly variable delay. A special histological signature is present with the coexistence of steatosis, bile duct alterations, and portal inflammation. Substantial clinical improvement with appropriate nutritional support seems to be effective.
Topics: Bariatric Surgery; Fatty Liver; Humans; Inflammation; Liver; Liver Cirrhosis; Liver Failure; Obesity, Morbid
PubMed: 35138516
DOI: 10.1007/s11695-022-05930-3 -
Ultrasound in Medicine & Biology Dec 2021Early diagnosis and treatment of rhabdomyolysis are very important, but difficult to achieve for some atypical cases. Our study was aimed at determining the diagnostic...
Early diagnosis and treatment of rhabdomyolysis are very important, but difficult to achieve for some atypical cases. Our study was aimed at determining the diagnostic value of ultrasonography in rhabdomyolysis caused by different factors. The study enrolled 50 patients with rhabdomyolysis diagnosed in our hospital. Among the 50 cases (mean age = 38.4 y, 22 women) of rhabdomyolysis, 26 cases (mean age = 35.5 y, 8 women) were induced by exercise. During the patients' first visit, 5 cases (mean age = 30.6 y, 1 woman) were suspected of having rhabdomyolysis and were diagnosed by clinicians; 12 cases (mean age = 34.8 y, 5 women) were correctly diagnosed under ultrasound; and 9 cases (mean age = 39.2 y, 2 women) were misdiagnosed. Ultrasound did not play a critical role in 24 patients (mean age = 41.5 y, 14 women) with rhabdomyolysis caused by trauma, infection, crayfish consumption, drugs, alcohol and heat stroke. We then concluded that exercise-induced rhabdomyolysis is a common type of rhabdomyolysis. Ultrasonography plays an important role in the early diagnosis of exercise-induced rhabdomyolysis but has limited value in the diagnosis of rhabdomyolysis caused by other etiologies.
Topics: Adult; Exercise; Female; Humans; Male; Rhabdomyolysis; Ultrasonography
PubMed: 34535325
DOI: 10.1016/j.ultrasmedbio.2021.08.012 -
Journal of Endocrinological... Oct 2017The purpose of this study was to inquire how patients' quality of life is affected after thyroid surgery and the factors involved.
PURPOSE
The purpose of this study was to inquire how patients' quality of life is affected after thyroid surgery and the factors involved.
METHODS
A semi-structured questionnaire and the World Health Organization Quality of Life Scale (WHOQOL-BREF) were applied to 101 patients prior to surgery. Thereafter data was collected in the early and again in the late post-operative period.
RESULTS
Mean general health score for pre-operative quality of life was 6.72 ± 1.53 (3-10), mean physical field score was 22.81 ± 2.77 (17-31), mean psychological field score was 21.69 ± 2.78 (15-28), mean social field score was 11.10 ± 1.94 (5-15) and mean environmental field score was 27.86 ± 4.30 (18-39). In the early post-operative period, mean general health score was 7.05 ± 1.45 (4-10), mean physical field score was 22.84 ± 2.83 (14-29), mean psychological field score was 21.67 ± 2.32 (16-27), mean social field score was 10.89 ± 1.96 (5-15) and mean environmental field score was 28.56 ± 4.18 (18-40). In the late post-operative period, the general health score for quality of life was 7.43 ± 1.34 (4-10), mean physical field score was 23.59 ± 2.70 (17-35), mean psychological field score was 21.75 ± 2.34 (14-29), mean social field score was 11.23 ± 1.94 (6-15) and mean on-field environment score was 29.30 ± 3.96 (16-40). The pre-operative levels of symptoms were found to be higher than early and late post-operative periods.
CONCLUSIONS
Quality of life increased after total thyroidectomy and statistically significant improvement was observed in late post-operative stage.
Topics: Adult; Aged; Female; Follow-Up Studies; Humans; Male; Middle Aged; Postoperative Complications; Quality of Life; Surveys and Questionnaires; Thyroid Gland; Young Adult
PubMed: 28397184
DOI: 10.1007/s40618-017-0635-9 -
BMC Medical Education Jul 2022During the Covid-19 pandemic, formative OSCE were transformed into online OSCE, and senior students (near peers) substituted experienced clinical teachers. The aims of...
PURPOSE OF THE ARTICLE
During the Covid-19 pandemic, formative OSCE were transformed into online OSCE, and senior students (near peers) substituted experienced clinical teachers. The aims of the study were to evaluate quality of the feedbacks given by near peers during online OSCEs and explore the experience of near-peer feedback from both learner's and near peer's perspectives.
MATERIALS AND METHODS
All 2nd year medical students (n = 158) attended an online OSCE under the supervision of twelve senior medical students. Outcome measures were 1) students' perception of the quality of the feedback through an online survey (Likert 1-5); 2) objective assessment of the quality of the feedback focusing on both the process and the content using a feedback scale (Likert 1-5); 3) experience of near peer feedback in two different focus groups.
RESULTS
One hundred six medical students answered the questionnaire and had their feedback session videotaped. The mean perceived overall quality of senior students' overall feedback was 4.75 SD 0.52. They especially valued self-evaluation (mean 4.80 SD 0.67), balanced feedback (mean 4.93 SD 0.29) and provision of simulated patient's feedback (mean 4.97 SD 0.17). The overall objective assessment of the feedback quality was 3.73 SD 0.38: highly scored skills were subjectivity (mean 3.95 SD 1.12) and taking into account student's self-evaluation (mean 3.71 (SD 0.87). Senior students mainly addressed history taking issues (mean items 3.53 SD 2.37) and communication skills (mean items 4.89 SD 2.43) during feedback. Participants reported that near peer feedback was less stressful and more tailored to learning needs- challenges for senior students included to remain objective and to provide negative feedback.
CONCLUSION
Increased involvement of near peers in teaching activities is strongly supported for formative OSCE and should be implemented in parallel even if experience teachers are again involved in such teaching activities. However, it requires training not only on feedback skills but also on the specific content of the formative OSCE.
Topics: COVID-19; Clinical Competence; Educational Measurement; Feedback; Humans; Pandemics; Peer Group; Students, Medical
PubMed: 35879752
DOI: 10.1186/s12909-022-03629-8 -
Journal of Clinical Medicine Feb 2023The aim of this study was to evaluate the results of surgical treatment of developmental dysplasia of the hip (DDH) with periacetabular osteotomy (PAO) and determine the...
The aim of this study was to evaluate the results of surgical treatment of developmental dysplasia of the hip (DDH) with periacetabular osteotomy (PAO) and determine the values of radiological parameters that would allow us to obtain an optimal clinical result. Radiological evaluation included determining the center-edge angle (CEA), medialization, distalization, femoral head coverage (FHC), and ilioischial angle as measured on a standardized AP radiograph of the hip joints. Clinical evaluation was based on the HHS, WOMAC, Merle d'Aubigne-Postel scales and Hip Lag Sign. The results of PAO presented decreased medialization (mean 3.4 mm), distalization (mean 3.5 mm), and ilioischial angle (mean 2.7°); improvement in femoral head bone cover; an increased CEA (mean 16.3°) and FHC (mean 15.2%); clinically increased HHS (mean 22 points) and M. Postel-d'Aubigne (mean 3.5 points) scores; and a decrease in WOMAC (mean 24%). HLS improved in 67% of patients after surgery. Qualification of patients with DDH for PAO should be based on the following values of three parameters: CEA < 26°, FHC < 75%, and ilioischial angle >85.9°. To achieve better clinical results, it is necessary to increase the average CEA value by 11° and the average FHC by 11% and reduce the average ilioischial angle by 3°.
PubMed: 36902624
DOI: 10.3390/jcm12051837 -
The Indian Journal of Radiology &... Apr 2023The aim of this study was to determine the changes in the mean arterial blood pressure (MAP) and mean uterine artery (UtA) pulsatility index (PI) from 11-14 to...
A Comparison of Changes in the Mean Arterial Blood Pressure and Mean Uterine Artery Pulsatility Index from 11-14 to 19-24 + 6 Gestation Weeks in Low-Risk and High-Risk Asian Indian Pregnant Women.
The aim of this study was to determine the changes in the mean arterial blood pressure (MAP) and mean uterine artery (UtA) pulsatility index (PI) from 11-14 to 19-24 + 6 gestation weeks in Asian Indian pregnant women. Clinical and demographic details, MAP, and mean UtA PI measures were ascertained for pregnant women at 11 to 14 gestation weeks and 19-24 + 6 gestation weeks. Women were categorized as a high-or-low risk for preterm preeclampsia using the Fetal Medicine Foundation algorithm and 1 in 150 cutoff. High-risk pregnant women were recommended low-dose aspirin 150 mg daily at bedtime. Changes in MAP and mean UtA PI were compared for gestational age intervals and high-and-low risk women using nonparametric tests. The study analyzed the results of 1,163 pregnant women. Both MAP (mean difference: 5.14, < 0.001) and mean UtA PI (mean difference: 0.14, < 0.001) remained significantly higher at the second-trimester assessment in high-risk pregnant women compared to low-risk pregnant women. Seventy-seven (35.16%) of the 219 pregnant women with abnormal mean UtA PI in the first trimester had an abnormal mean UtA PI in the second-trimester assessment. One hundred (10.59%) of the 944 pregnant women with normal mean UtA PI in the first trimester had an abnormal mean UtA PI in the 19-24 + 6 weeks assessment. Seventy-seven pregnant women (6.62% of 1,163 women, 95% confidence interval: 5.33, 8.20) had an abnormal mean UtA PI at both gestation age intervals. High-risk pregnant women taking low-dose aspirin daily showed a larger reduction in mean UtA PI compared to high-risk pregnant women that did not report the use of low-dose aspirin (0.89 vs. 0.62, <0.001) MAP and mean UtA PI decreased significantly from the first to the second trimester of pregnancy. Sequential assessment of the MAP and mean UtA PI in the first and second trimesters of pregnancy will be useful for fetal radiologists in India to identify a subgroup of women with abnormal mean UtA PI at both trimesters that may need more intense surveillance and follow-up till childbirth.
PubMed: 37123569
DOI: 10.1055/s-0043-1761250 -
Pathology, Research and Practice Aug 2020Endometrial ablation for abnormal uterine bleeding is used as a less invasive alternative to hysterectomy, however, in cases of treatment failure hysterectomy may be...
BACKGROUND
Endometrial ablation for abnormal uterine bleeding is used as a less invasive alternative to hysterectomy, however, in cases of treatment failure hysterectomy may be finally performed. The histologic changes in these post-treatment uteri are not well-described.
OBJECTIVE
To describe the histological findings in post-endometrial ablation uteri.
STUDY DESIGN
During a ten-year period, 321 patients were treated with endometrial ablation. Twenty-five patients (7.8%), 10 treated with NovaSure® and 15 treated with ThermaChoice® endometrial ablation were finally subjected to hysterectomy mostly due to persistent uterine bleeding. Histologic features of these hysterectomies are described.
RESULTS
The patients' age ranged from 33 to 73 years (mean 44.5) and 34-53 (mean 42) for the NovaSure® and ThermaChoice® group, respectively. The time from endometrial ablation to hysterectomy was 2-24 months (mean 8.8) and 2-60 months (mean 23.2) for the two groups, respectively (p = 0.01). Hysterectomies performed later (mean 22 months) showed no fibrosis (p = 0.04) compared with those performed earlier (mean 5 months). Endometrial lining was found more frequently in hysterectomies performed later (mean 13 months) than those performed earlier (mean 2 months, p = 0.0004). Abundant necrotic tissue of myometrial origin was found in 28% of the cases, but it was not associated with the time of hysterectomy (p = 0.2). A zonation effect and vascular changes also seen. Granulomatous reaction was not found. Ten patients (40%) harbored adenomyosis and another three (12%) extensive leiomyomas/diffuse leiomyomatosis.
CONCLUSION
Necrosis, fibrosis and vascular changes are found during the first year of post-thermal uterine effect. Hysterectomies performed later show less prominent changes and almost normal endometrial lining. Adenomyosis is found in an important part of post-endometrial ablation hysterectomies.
Topics: Adult; Aged; Endometrial Ablation Techniques; Female; Humans; Hysterectomy; Middle Aged; Radiofrequency Ablation; Retrospective Studies; Treatment Failure; Uterine Hemorrhage; Uterus
PubMed: 32475645
DOI: 10.1016/j.prp.2020.152992 -
Entropy (Basel, Switzerland) May 2021In this paper, we present order invariance theoretical results for weighted quasi-arithmetic means of a monotonic series of numbers. The quasi-arithmetic mean, or...
In this paper, we present order invariance theoretical results for weighted quasi-arithmetic means of a monotonic series of numbers. The quasi-arithmetic mean, or Kolmogorov-Nagumo mean, generalizes the classical mean and appears in many disciplines, from information theory to physics, from economics to traffic flow. Stochastic orders are defined on weights (or equivalently, discrete probability distributions). They were introduced to study risk in economics and decision theory, and recently have found utility in Monte Carlo techniques and in image processing. We show in this paper that, if two distributions of weights are ordered under first stochastic order, then for any monotonic series of numbers their weighted quasi-arithmetic means share the same order. This means for instance that arithmetic and harmonic mean for two different distributions of weights always have to be aligned if the weights are stochastically ordered, this is, either both means increase or both decrease. We explore the invariance properties when convex (concave) functions define both the quasi-arithmetic mean and the series of numbers, we show its relationship with increasing concave order and increasing convex order, and we observe the important role played by a new defined mirror property of stochastic orders. We also give some applications to entropy and cross-entropy and present an example of multiple importance sampling Monte Carlo technique that illustrates the usefulness and transversality of our approach. Invariance theorems are useful when a system is represented by a set of quasi-arithmetic means and we want to change the distribution of weights so that all means evolve in the same direction.
PubMed: 34070385
DOI: 10.3390/e23060662 -
Japanese Journal of Clinical Oncology May 2022The relationship between preoperative mean corpuscular volume and postoperative prognosis has been reported in some cancers recently, but no certain consensus has been...
OBJECTIVE
The relationship between preoperative mean corpuscular volume and postoperative prognosis has been reported in some cancers recently, but no certain consensus has been reached, especially for colorectal cancer. We evaluated the usefulness of mean corpuscular volume as a prognostic factor in colorectal cancer patients.
METHODS
This study included 1003 patients with colorectal cancer who underwent curative surgery in a single institution. The relationship between mean corpuscular volume values and postoperative recurrence was evaluated by fractional polynomial model. Based on the result, patients were divided into groups according to mean corpuscular volume values. Clinicopathological factors and long-term outcomes were compared between the groups.
RESULTS
The risk of postoperative recurrence according to mean corpuscular volume value showed a J-shaped curve, suggesting that both low and high mean corpuscular volume have high risk. Low mean corpuscular volume (≤84 fl) group was oncologically advanced in terms of pathological tumor stage, histological grade and lymphatic invasion with higher inflammation markers. High mean corpuscular volume (>95 fl) group had higher frequency of drinking habit with higher values of aspartate aminotransferase, alanine aminotransferase and γ-glutamyl transpeptidase. Abnormal mean corpuscular volume group including these two groups showed significantly worse disease-free survival than the other (P < 0.001). Multivariate analysis suggested that abnormal mean corpuscular volume was an independent risk factor for postoperative recurrence (hazard ratio, 1.344; 95% confidence interval, 1.005-1.796; P = 0.046). Furthermore, its prognostic impact was more significant in pStage III than in other stages.
CONCLUSION
Preoperative low and high mean corpuscular volume is a poor prognostic factor in colorectal cancer patients. It could be a predictive marker to estimate worse survival outcome after surgery.
Topics: Biomarkers; Colorectal Neoplasms; Disease-Free Survival; Erythrocyte Indices; Humans; Neoplasm Staging; Prognosis; Proportional Hazards Models; Retrospective Studies
PubMed: 35253057
DOI: 10.1093/jjco/hyac023