-
PloS One 2023Image dehazing models are critical in improving the recognition and classification capabilities of image-related artificial intelligence systems. However, existing...
Image dehazing models are critical in improving the recognition and classification capabilities of image-related artificial intelligence systems. However, existing methods often ignore the limitations of receptive field size during feature extraction and the loss of important information during network sampling, resulting in incomplete or structurally flawed dehazing outcomes. To address these challenges, we propose a multi-level perception fusion dehazing network (MPFDN) that effectively integrates feature information across different scales, expands the perceptual field of the network, and fully extracts the spatial background information of the image. Moreover, we employ an error feedback mechanism and a feature compensator to address the loss of features during the image dehazing process. Finally, we subtract the original hazy image from the generated residual image to obtain a high-quality dehazed image. Based on extensive experimentation, our proposed method has demonstrated outstanding performance not only on synthesizing dehazing datasets, but also on non-homogeneous haze datasets.
Topics: Artificial Intelligence; Empirical Research; Recognition, Psychology; Research Design; Perception
PubMed: 37782670
DOI: 10.1371/journal.pone.0285137 -
ALTEX 2024Many laboratory procedures generate data on properties of chemicals, but they cannot be equated with toxicological "test methods". This apparent discrepancy is not...
Many laboratory procedures generate data on properties of chemicals, but they cannot be equated with toxicological "test methods". This apparent discrepancy is not limited to in vitro testing, using animal-free new approach methods (NAM), but also applies to animal-based testing approaches. Here, we give a brief overview of the differences between data generation and the setup or use of a complete test method. While there is excellent literature available on this topic for specialists (GIVIMP guidance; ToxTemp overview), a brief overview and easily-accessible entry point may be useful for a broader community. We provide a single figure to summarize all test method elements and processes required in the development (setup and adaptation) of a test method. The exposure scheme, the endpoint, and the test system are briefly outlined as fundamental elements of any test method. A rationale is provided, why they are not sufficient. We then explain the importance and role of purpose definition (including some information on what is modelled) and the prediction model, aka data interpretation procedure, which depends on the purpose definition, as further essential elements. This connection exemplifies that all fundamental elements are interdependent, and none can be omitted. Finally, discussion is provided on validation as a measure to provide confidence in the reliability, performance, and relevance of a test method. In this sense, validation may be considered a sixth fundamental element for practical use of test methods.
Topics: Animals; Humans; Reproducibility of Results; Research Design; Biological Science Disciplines
PubMed: 38207287
DOI: 10.14573/altex.2401041 -
BMJ Open Aug 2023Suicide is an important public health problem. Providing evidence-based psychosocial interventions to individuals presenting with self-harm is recognised as an important...
INTRODUCTION
Suicide is an important public health problem. Providing evidence-based psychosocial interventions to individuals presenting with self-harm is recognised as an important suicide prevention strategy. Therefore, it is crucial to understand which intervention is most effective in preventing self-harm repetition. We will evaluate the comparative efficacy of psychosocial interventions for the prevention of self-harm in adults.
METHODS AND ANALYSIS
We will perform a systematic review and network meta-analysis (NMA) of randomised controlled trials (RCTs) testing psychosocial interventions for the prevention of self-harm repetition. We will include RCTs in adults (mean age: 18 years or more) who presented with self-harm in the 6 months preceding enrolment in the trial. Interventions will be categorised according to their similarities and underpinning theoretical approaches (eg, cognitive behavioural therapy, case management). A health sciences librarian will update and adapt the search strategy from the most recent Cochrane pairwise systematic review on this topic. The searches will be performed in MEDLINE (Ovid), Embase (Ovid), PsycInfo (Ovid), CINAHL (EBSCO), Cochrane Central (Wiley), Cochrane Protocols (Wiley), LILACS and PSYNDEX from 1 July 2020 (Cochrane review last search date) to 1 September 2023. The primary efficacy outcome will be self-harm repetition. Secondary outcomes will include suicide mortality, suicidal ideation and depressive symptoms. Retention in treatment (ie, drop-outs rates) will be analysed as the main acceptability outcome. Two reviewers will independently assess the study eligibility and risk of bias (using RoB-2). An NMA will be performed to synthesise all direct and indirect comparisons. Ranked forest plots and Vitruvian plots will be used to represent graphically the results of the NMA. Credibility of network estimates will be evaluated using Confidence in NMA (CINeMA).
ETHICS AND DISSEMINATION
As this is the protocol for an aggregate-data level NMA, ethical approval will not be required. Results will be disseminated at national/international conferences and in peer-review journals.
TRIAL REGISTRATION NUMBER
CRD42021273057.
Topics: Adult; Humans; Adolescent; Network Meta-Analysis; Psychosocial Intervention; Self-Injurious Behavior; Suicide; Public Health; Systematic Reviews as Topic; Meta-Analysis as Topic
PubMed: 37620269
DOI: 10.1136/bmjopen-2023-072289 -
BMJ Open Sep 2023Following the discovery of various effects on skin function by modifying endocannabinoid systems, multiple preclinical studies have revealed the promise of cannabis and...
INTRODUCTION
Following the discovery of various effects on skin function by modifying endocannabinoid systems, multiple preclinical studies have revealed the promise of cannabis and cannabinoids in the treatment of a variety of skin diseases. However, its clinical efficacy is still debated.
METHODS AND ANALYSIS
The protocol has been prepared using the Preferred Items for Systematic Review and Meta-analysis Protocols guidelines. A systematic search will be conducted using PubMed, EMBASE, SCOPUS, the Cochrane Central Register of Controlled Trials and Web of Science. We will include randomised controlled trials and observational studies investigating alterations to dermatological characteristics following administration of cannabis and cannabinoids for dermatological diseases and disorders. The two reviewers will perform both the title and abstract and full-text screenings. The Cochrane Risk-of-Bias 2 and ROBINS-1 tools will be used to evaluate the risk of bias. If a group of comparable studies for each quantitative outcome can be discovered, we will conduct a random effects meta-analysis. We will investigate heterogeneity using a combination of visual inspection of the forest plot, the Cochran's Q test and Higgins' test [I2]. Sensitivity analyses will be performed to assess the statistical robustness of the primary outcome. To evaluate a publication bias, the Egger's regression asymmetry test and funnel plots will be considered.
ETHICS AND DISSEMINATION
This study does not require ethical approval because no original data will be collected. The findings will be presented at conferences and published in peer-reviewed journals.
PROSPERO REGISTRATION NUMBER
CRD42023397189.
Topics: Humans; Cannabinoids; Cannabis; Dermatology; Systematic Reviews as Topic; Meta-Analysis as Topic; Cannabinoid Receptor Agonists
PubMed: 37699631
DOI: 10.1136/bmjopen-2023-075007 -
BMJ Open Nov 2023Healthcare data analytics is a methodological approach to the systematic analysis of health data, and it provides opportunities for healthcare professionals to improve...
INTRODUCTION
Healthcare data analytics is a methodological approach to the systematic analysis of health data, and it provides opportunities for healthcare professionals to improve health system management, patient engagement, budgeting, planning and performing evidence-based decision-making. Literature suggests that certain skills and/or competencies for health professionals working with big data in health care would be required. A review of the skills and competencies in health data analytics required by health professionals is needed to support the development or re-engineering of curriculum for health professionals to ensure they develop the abilities to make evidence-based decisions that ultimately can lead to the effective and efficient functioning of a healthcare system.
METHODS
Using Arksey and O'Malley's framework, this study will review literature published in English from January 2012 to December 2022. The database search includes Academic Search Complete, CINAHL, and MEDLINE via EBSCOhost, PubMed, Science Direct, Scopus, and Taylor and Francis. The reference lists of key studies will be searched to identify additional appropriate studies to include. The review will be conducted using an inclusion and exclusion criteria. Iterative processes will be involved at the various stages of search strategy piloting, screening and data extraction. Articles will be reviewed through a two-step process (title and abstract, and full-text review) by at least two reviewers. Data will be described quantitatively and/or qualitatively and presented in diagrams and tables.
ETHICS AND DISSEMINATION
Ethical clearance has been received, and strict protocol measures will be followed to ensure the data reported is of quality and relevant to the review purpose. The results will be disseminated through a peer-reviewed scientific journal, presentation at national and/or international conferences, and other platforms such as social media (eg, LinkedIn, Twitter), and relevant stakeholders.
Topics: Humans; Data Science; Curriculum; Research Design; Health Personnel; Patient Participation; Review Literature as Topic
PubMed: 37989378
DOI: 10.1136/bmjopen-2022-070596 -
Family Medicine Mar 2024Proficiency in procedural care achieved during residency is a major driver of family physician scope of practice. To date, no inventory exists of the advanced procedures...
BACKGROUND AND OBJECTIVES
Proficiency in procedural care achieved during residency is a major driver of family physician scope of practice. To date, no inventory exists of the advanced procedures and clinical skills performed by teaching family physicians. This study comprises the first such survey and assesses the attitude of respondents toward the importance of family physicians performing procedures.
METHODS
We sent a clinical skills inventory to a convenience sample of teaching family physicians employed at 18 medical school-affiliated, community, and military residency programs across the United States.
RESULTS
The overall response rate was 46% (N=337). Respondents performed a median of 12 advanced procedures and clinical skills (IQR: 8-18). Endorsed procedures ranged from skin biopsy (n=316, 93.8%) and joint injection (n=279, 82.8%) to colonoscopy (n=21, 6.2%) and cesarean delivery (n=23, 6.8%), and reported skills ranged from medication-assisted treatment (n=181, 53.7%) to highly active antiretrovial therapy (n=35, 10.4%). Gender and career stage were associated with statistically significant differences in endorsement of specific procedures. For example, fracture management was more likely to be performed by late- versus early-career faculty (54.1% vs 24.2%, P<.001) and by male versus female respondents (54.9% vs 24.2%, P<.001). Most respondents (84.3%) agreed that future family physicians should learn procedures and advanced clinical skills.
CONCLUSIONS
Family medicine teaching faculty perform a wide array of procedures and advanced skills. Apparent differences by career stage and gender identity in the performance of some of the procedural and skill areas may portend a shift in the procedural training of future family physicians.
Topics: Pregnancy; Humans; Male; Female; United States; Family Practice; Gender Identity; Physicians, Family; General Practitioners; Surveys and Questionnaires; Internship and Residency; Clinical Competence; Teaching
PubMed: 38241746
DOI: 10.22454/FamMed.2024.197714 -
Journal of Orthopaedic Surgery and... Aug 2023Our aim was to determine the best operative procedure in human participants with a displaced or non-displaced femoral neck fracture comparing cannulated screw (CS)... (Meta-Analysis)
Meta-Analysis
Cannulated screws versus dynamic hip screw versus hemiarthroplasty versus total hip arthroplasty in patients with displaced and non-displaced femoral neck fractures: a systematic review and frequentist network meta-analysis of 5703 patients.
BACKGROUND
Our aim was to determine the best operative procedure in human participants with a displaced or non-displaced femoral neck fracture comparing cannulated screw (CS) fixation, dynamic hip screw (DHS) fixation, hemiarthroplasty (HA), and total hip arthroplasty (THA) in terms of surgical and functional outcomes, reoperation and postoperative complications.
METHODS
We searched PubMed, The Cochrane Library, Clinical trials, CINAHL, and Embase for randomized controlled trials (RCTs) or quasi-RCTs up to 31 July 2022. A frequentist network meta-analysis was performed to assess the comparative effects of the four operative procedures, using fixed-effects and random-effects models. Mean differences (MDs) with 95% confidence intervals (CIs) were estimated for continuous variables and odds ratios (ORs) with 95% CIs were estimated for binary variables.
RESULTS
A total of 33 RCTs with 5703 patients were included in our network meta-analysis. CS fixation was best in terms of operation time (CS: MD = - 57.70, 95% CI - 72.78; - 42.62; DHS: MD = - 53.56, 95% CI - 76.17; - 30.95; HA: MD = - 20.90, 95% CI - 30.65; - 11.15; THA: MD = 1.00 reference) and intraoperative blood loss (CS: MD = - 3.67, 95% CI - 4.44; - 2.90; DHS: MD = - 3.20, 95% CI - 4.97; - 1.43; HA: MD = - 1.20, 95% CI - 1.73; - 0.67; THA: MD = 1.00 reference). In life quality and functional outcome, measured at different time points with EQ-5D and the Harris Hip Score (HHS), THA ranked first and HA second (e.g. EQ-5D 2 years postoperatively: CS: MD = - 0.20, 95% CI - 0.29; - 0.11; HA: MD = - 0.09, 95% CI - 0.17; - 0.02; THA: MD = 1.00 reference; HHS 2 years postoperatively: CS: MD = - 5.50, 95% CI - 9.98; - 1.03; DHS: MD = - 8.93, 95% CI - 15.08; - 2.78; HA: MD = - 3.65, 95% CI - 6.74; - 0.57; THA: MD = 1.00 reference). CS fixation had the highest reoperation risk, followed by DHS fixation, HA, and THA (CS: OR = 9.98, 95% CI 4.60; 21.63; DHS: OR = 5.07, 95% CI 2.15; 11.96; HA: OR = 1.60, 95% CI 0.89; 2.89; THA: OR = 1.00 reference).
CONCLUSION
In our cohort of patients with displaced and non-displaced femoral neck fractures, HHS, EQ-5D, and reoperation risk showed an advantage of THA and HA compared with CS and DHS fixation. Based on these findings, we recommend that hip arthroplasty should be preferred and internal fixation of femoral neck fractures should only be considered in individual cases.
LEVEL OF EVIDENCE I
a systematic review of randomized controlled trials.
TRIAL REGISTRATION
PROSPERO on 10 August 2022 (CRD42022350293).
Topics: Humans; Arthroplasty, Replacement, Hip; Hemiarthroplasty; Network Meta-Analysis; Femoral Neck Fractures; Bone Screws; Fracture Fixation, Internal
PubMed: 37626370
DOI: 10.1186/s13018-023-04114-8 -
ALTEX 2024Historical data from control groups in animal toxicity studies is currently mainly used for comparative purposes to assess validity and robustness of study results. Due...
Historical data from control groups in animal toxicity studies is currently mainly used for comparative purposes to assess validity and robustness of study results. Due to the highly controlled environment in which the studies are performed and the homogeneity of the animal collectives it has been proposed to use the historical data for building so-called virtual control groups, which could replace partly or entirely the concurrent control. This would constitute a substantial contribution to the reduction of animal use in safety studies. Before the concept can be implemented, the prerequisites regarding data collection, curation and statistical evaluation together with a validation strategy need to be identified to avoid any impairment of the study outcome and subsequent consequences for human risk assessment. To further assess and develop the concept of virtual control groups the transatlantic think tank for toxicology (t⁴) sponsored a workshop with stakeholders from the pharmaceutical and chemical industry, academia, FDA, pharmaceutical, contract research organizations (CROs), and non-governmental organizations in Washington, which took place in March 2023. This report summarizes the current efforts of a European initiative to share, collect and curate animal control data in a centralized database and the first approaches to identify optimal matching criteria between virtual controls and the treatment arms of a study as well as first reflections about strategies for a qualification procedure and potential pitfalls of the concept.
Topics: Animals; Control Groups; Pharmaceutical Preparations; Research
PubMed: 38043132
DOI: 10.14573/altex.2310041 -
BMJ Open Nov 2023Several key symptoms must be present for the accurate diagnosis of patients with postoperative cardiac delirium. Some patients present with symptoms of delirium but do...
The risk factors for and the frequency and outcomes of subsyndromal delirium among patients who have undergone cardiac surgery: a protocol for systematic review and meta-analysis.
INTRODUCTION
Several key symptoms must be present for the accurate diagnosis of patients with postoperative cardiac delirium. Some patients present with symptoms of delirium but do not meet the diagnostic criteria for delirium; such individuals are considered to have having subsyndromal delirium (SSD). SSD is associated with misdiagnosis and poor outcomes. However, to date, no systematic review (SR) has examined the frequency of, risk factors for, and outcomes of SSD among adults who have undergone cardiac surgery.
METHODS AND ANALYSIS
The aim of this SR is to identify those studies that have explored SSD after cardiac surgery. MeSH and free entry terms associated with "subsyndromal delirium" and "subclinical delirium" will be used to search for relevant studies. The PubMed, Web of Science, OVID, Cochrane Library, CINAHL, EMBASE, PsycINFO, China National Knowledge Infrastructure, Wanfang data, VIP database and SinoMed will be searched from inception to the date of retrieval without any restrictions. The primary outcomes will be the frequency of SSD, the risk factors for SSD, and the outcomes of SSD. Analyses will be performed using STATA V.16.0, and descriptive analyses will be performed if the data are not suitable for meta-analysis (ie, data with significant heterogeneity or from different comparisons).
ETHICS AND DISSEMINATION
The SR will examine the frequency of, risk factors for and outcomes of SSD in adults who have undergone cardiac surgery. The results will provide guidance for the identification of knowledge gaps in this field, and areas for further research will be highlighted. The review protocol will be submitted for publication in peer-reviewed journals for dissemination of the findings. Individual patient data will not be included in this protocol, so ethical approval will not be needed.
PROSPERO REGISTRATION NUMBER
CRD42022379211.
Topics: Adult; Humans; Delirium; Systematic Reviews as Topic; Meta-Analysis as Topic; Cardiac Surgical Procedures; Emergence Delirium; Risk Factors; Research Design
PubMed: 37968002
DOI: 10.1136/bmjopen-2022-070624 -
PharmacoEconomics Sep 2023Compensation mechanisms and multiplier effects may affect productivity losses due to illness, disability, or premature death of individuals. Hence, they are important in...
BACKGROUND
Compensation mechanisms and multiplier effects may affect productivity losses due to illness, disability, or premature death of individuals. Hence, they are important in estimating productivity losses and productivity costs in the context of economic evaluations of health interventions. This paper presents a systematic literature review of papers focusing on compensation mechanisms and multiplier effects, as well as whether and how they are included in health economic evaluations.
METHODS
The systematic literature search was performed covering EconLit and PubMed. A data-extraction form was developed focusing on compensation mechanisms and multiplier effects.
RESULTS
A total of 26 studies were included. Of these, 15 were empirical studies, three studies were methodological studies, two studies combined methodological research with empirical research, four were critical reviews, one study was a critical review combined with methodological research, and one study was a cost-benefit analysis. No uniform definition of compensation mechanisms and multiplier effects was identified. The terminology used to describe compensation mechanisms and multiplier effects varied as well. While the included studies suggest that both multipliers as well as compensation mechanisms substantially impact productivity cost estimates, the available evidence is scarce. Moreover, the generalizability as well as validity of assumptions underlying the calculations are unclear. Available measurement methods for compensation mechanisms and multiplier effects differ in approaches and are hardly validated.
CONCLUSION
While our review suggests that compensation mechanisms and multiplier effects may have a significant impact on productivity losses and costs, much remains unclear about their features, valid measurement, and correct valuation. This hampers their current inclusion in economic evaluation, and therefore, more research into both phenomena remains warranted.
Topics: Humans; Economics, Medical; Cost-Benefit Analysis; Research Design
PubMed: 37592122
DOI: 10.1007/s40273-023-01304-4