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Journal of Orthopaedic Surgery and... Dec 2022In the emergency room, clinicians spend a lot of time and are exposed to mental stress. In addition, fracture classification is important for determining the surgical...
BACKGROUND
In the emergency room, clinicians spend a lot of time and are exposed to mental stress. In addition, fracture classification is important for determining the surgical method and restoring the patient's mobility. Recently, with the help of computers using artificial intelligence (AI) or machine learning (ML), diagnosis and classification of hip fractures can be performed easily and quickly. The purpose of this systematic review is to search for studies that diagnose and classify for hip fracture using AI or ML, organize the results of each study, analyze the usefulness of this technology and its future use value.
METHODS
PubMed Central, OVID Medline, Cochrane Collaboration Library, Web of Science, EMBASE, and AHRQ databases were searched to identify relevant studies published up to June 2022 with English language restriction. The following search terms were used [All Fields] AND (", "[MeSH Terms] OR (""[All Fields] AND "bone"[All Fields]) OR "bone fractures"[All Fields] OR "fracture"[All Fields]). The following information was extracted from the included articles: authors, publication year, study period, type of image, type of fracture, number of patient or used images, fracture classification, reference diagnosis of fracture diagnosis and classification, and augments of each studies. In addition, AI name, CNN architecture type, ROI or important region labeling, data input proportion in training/validation/test, and diagnosis accuracy/AUC, classification accuracy/AUC of each studies were also extracted.
RESULTS
In 14 finally included studies, the accuracy of diagnosis for hip fracture by AI was 79.3-98%, and the accuracy of fracture diagnosis in AI aided humans was 90.5-97.1. The accuracy of human fracture diagnosis was 77.5-93.5. AUC of fracture diagnosis by AI was 0.905-0.99. The accuracy of fracture classification by AI was 86-98.5 and AUC was 0.873-1.0. The forest plot represented that the mean AI diagnosis accuracy was 0.92, the mean AI diagnosis AUC was 0.969, the mean AI classification accuracy was 0.914, and the mean AI classification AUC was 0.933. Among the included studies, the architecture based on the GoogLeNet architectural model or the DenseNet architectural model was the most common with three each. Among the data input proportions, the study with the lowest training rate was 57%, and the study with the highest training rate was 95%. In 14 studies, 5 studies used Grad-CAM for highlight important regions.
CONCLUSION
We expected that our study may be helpful in making judgments about the use of AI in the diagnosis and classification of hip fractures. It is clear that AI is a tool that can help medical staff reduce the time and effort required for hip fracture diagnosis with high accuracy. Further studies are needed to determine what effect this causes in actual clinical situations.
Topics: Humans; Artificial Intelligence; Hip Fractures; Machine Learning; Databases, Factual; Emergency Service, Hospital
PubMed: 36456982
DOI: 10.1186/s13018-022-03408-7 -
Obesity Reviews : An Official Journal... Dec 2021Although the deleterious effects of obesity have been well documented in terms of morbidity and mortality, less is known about what it is like to live with this complex... (Review)
Review
Although the deleterious effects of obesity have been well documented in terms of morbidity and mortality, less is known about what it is like to live with this complex and chronic disease. This study systematically reviewed and synthesized peer-reviewed studies relating to the lived experience of patients with obesity. A total of 12,388 records were screened, resulting in the inclusion of 32 final studies. Meta-ethnographic synthesis of these 32 studies generated five "third-order constructs" or themes: the development of obesity; a life limited; stigma, judgment, shame, and blame; treatment and; experiences of specific or minority groups. These constructs describe, from the patient's perspective, the factors associated with the development and maintenance of obesity; the effects of the disease on their day-to-day lives; the impact of the stigma and judgment many patients are subjected to; and their experience of accessing, or trying to access, treatment for their healthcare needs. This synthesis reveals the dearth of studies that focus solely on the experience of the patient and highlights the tendency for participant-informed, rather than participatory, methods in obesity research. It concludes with a call for further participatory research into the experiences of people living with obesity.
Topics: Chronic Disease; Delivery of Health Care; Humans; Obesity; Qualitative Research
PubMed: 34402150
DOI: 10.1111/obr.13334 -
PloS One 2017This systematic review and meta-analysis aims to assess the therapeutic and adverse effects of acupuncture for benign prostatic hyperplasia (BPH) in randomized... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
This systematic review and meta-analysis aims to assess the therapeutic and adverse effects of acupuncture for benign prostatic hyperplasia (BPH) in randomized controlled trials (RCTs).
METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, the Chinese Biomedical Database, the China National Knowledge Infrastructure, the VIP Database and the Wanfang Database. Parallel-group RCTs of acupuncture for men with symptomatic BPH were included. Data from the included trials were extracted by two independent reviewers and were analyzed with The Cochrane Collaboration Review Manager software (RevMan 5.3.5) after risk of bias judgments. The primary outcome measure of this review was a change in urological symptoms.
RESULTS
Eight RCTs, which involved 661 men with BPH, were included. Follow-up varied from 4 weeks to 18 months. Pooling of the data from three trials that compared acupuncture with sham-acupuncture revealed that in the short term (4-6 weeks), acupuncture can significantly improve IPSS (MD -1.90, 95% CI -3.58 to -0.21). A sensitivity analysis of the short-term endpoint showed the same result (MD -3.01, 95% CI -5.19 to -0.84) with a borderline minimal clinical important difference (MCID). Qmax of the short-term endpoint indicated statistically positive beneficial effects of acupuncture (MD -1.78, 95%CI -3.43, -0.14). A meta-analysis after medium-term follow-up (12-18 weeks) indicated no significant effect on IPSS when the data from two trials were combined (MD -2.04, 95% CI -4.19, 0.10).
CONCLUSION
Statistically significant changes were observed in favor of acupuncture in moderate to severe BPH with respect to short-term follow-up endpoints. The clinical significance of these changes needs to be tested by further studies with rigorous designs and longer follow-up times.
TRIAL REGISTRATION NUMBER
PROSPERO CRD42014013645.
Topics: Acupuncture Therapy; Humans; Male; Prostatic Hyperplasia; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 28376120
DOI: 10.1371/journal.pone.0174586 -
The Journal of Nervous and Mental... May 2018The significant progress of psychiatry in the 20th century provided a sophisticated theoretical framework to analyze the complex relationships between crime and mental...
The significant progress of psychiatry in the 20th century provided a sophisticated theoretical framework to analyze the complex relationships between crime and mental illness. Schizophrenia has been traditionally associated with severe cognitive and affective deficits that heavily influence empathy, judgment capacities, but also control of impulsiveness. Although there is an association between psychotic disorders and absence or decrease of legal responsibility, their relationship is also determined by sociodemographic, developmental, and clinical factors. These disorders are associated not only with abolished criminal responsibility but also with diminished responsibility. We conduct a systematic literature review to examine the relation between schizophrenia and criminal responsibility. We have found that this clinical entity is often associated with diminished or abolished criminal liability. We discuss these findings, focusing on the specific deficits found in patients with schizophrenia and examining how this problem affects their behavior and eventually their accountability for their crimes.
Topics: Crime; Humans; Mental Competency; Schizophrenia; Schizophrenic Psychology; Substance-Related Disorders
PubMed: 29652769
DOI: 10.1097/NMD.0000000000000805 -
Journal of Thoracic Disease Aug 2022Mucosa-associated lymphoid tissue (MALT) lymphoma of the thymus is a rare disease. The present meta-analysis aims at accumulating current evidence to explore the...
BACKGROUND
Mucosa-associated lymphoid tissue (MALT) lymphoma of the thymus is a rare disease. The present meta-analysis aims at accumulating current evidence to explore the clinical characteristics, treatments, and prognoses of thymic MALT lymphoma.
METHODS
We searched seven databases for studies published between the start date of database establishment and September 15, 2021. We included studies of patients with histological diagnoses and excluded those without data specifically on thymic MALT lymphoma. The quality was analyzed using an assessment tool. All data were tabulated. Pooled proportion was obtained using random-effects model. Statistical analysis was performed on R statistic software.
RESULTS
Overall, 52 case reports and 13 case series were eligible. The quality of case reports was inferior to that of case series in terms of selection (P<0.001). Based on the analysis of patients in the case reports, age, gender, concurrent diseases, and tumor size did not differ between limited-stage and advanced-stage cases. Surgery is the mainstay to treat thymic MALT lymphoma. The surgical approach and extent did not influence the occurrence of events. Patients at Ann Arbor stage I were prone to not receiving postoperative therapy (P=0.011), though it may not reduce the occurrence of events (P=0.637). The five-year overall survival (OS) rate and five-year progression-free survival (PFS) rate were 97.2% and 88.4%, respectively. Patients with advanced-stage disease were more likely to suffer events (P=0.009).
CONCLUSIONS
Thymic MALT lymphoma is an extremely rare disease with a favorable prognosis. Currently available evidence is insufficient to draw solid judgments about treatment and prognosis. However, patients may benefit if thymectomy is chosen as the primary treatment. In some patients, lymph node sampling or dissection should be considered. In addition, if the patient is at an advanced-stage, postoperative therapy should be considered.
PubMed: 36071772
DOI: 10.21037/jtd-22-81 -
Scientific Reports Sep 2023A complex pattern of preservation and deterioration in metacognition in aging is found, especially regarding predicting future memory retrieval (i.e.,... (Meta-Analysis)
Meta-Analysis
A complex pattern of preservation and deterioration in metacognition in aging is found, especially regarding predicting future memory retrieval (i.e., feeling-of-knowing, FOK). While semantic FOK (sFOK) is preserved with age, studies on episodic tasks (eFOK) produce equivocal findings. We present a meta-analysis of 20 studies on eFOK and sFOK, analyzing the difference in metacognitive sensitivity between 922 younger and 966 older adults, taking into account the difference in memory performance. The sFOK studies yielded no overall age effect (8 effects, g = -0.10 [-0.29, 0.10]). However, we found a reliable age-group difference on eFOK (22 effects, g = 0.53 [0.28, 0.78]), which was moderated when considering recognition performance. Moreover, using aggregated data of 134 young and 235 older adults from published and unpublished studies from our lab, we investigated memory performance as an explanation of the eFOK deficit. We show that older adults are less metacognitively sensitive than younger adults for eFOKs which is, at least partly, due to the age-related memory decline. We highlight two non-exclusive explanations: a recollection deficit at play in the first and second order tasks, and a confound between first order performance and the measure used to assess metacognitive sensitivity.
Topics: Semantics; Mental Recall; Judgment; Recognition, Psychology; Memory, Episodic
PubMed: 37777585
DOI: 10.1038/s41598-023-36251-9 -
Disability and Rehabilitation.... Feb 2021Systematic evaluation and meta-analysis of the effects of digital noise reduction (DNR) algorithms on speech intelligibility, sound quality and listening effort in adult... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Systematic evaluation and meta-analysis of the effects of digital noise reduction (DNR) algorithms on speech intelligibility, sound quality and listening effort in adult populations.
DESIGN
Systematic review and meta-analysis.
STUDY SAMPLE
Six databases were searched for experimental studies published from 2000 to 2017 in English using the following search terms: "hearing aid" and "noise reduction". A total of 264 unique hits were obtained; out of which, 16 studies were included.
RESULTS
The population effect was estimated for speech intelligibility and other subjective measures. From six studies, the population effect estimated for speech intelligibility measures was small ( = 0.28) with zero population variance. Sample size variance accounted for all the effect size variations found across studies. The population effect for subjective measures was medium ( = 0.46 ± 0.10) as calculated from seven studies.
CONCLUSIONS
Based on a criterion of moderate evidence, this meta-analysis did not reveal a consistent improvement in speech intelligibility with DNR in adult population. The subjective outcome measures (e.g., acceptable noise level and sound quality judgment) showed a moderate positive effect of DNR.Implications for RehabilitationThe findings of the study will provide useful clinical information in follow up visits in audiologic rehabilitation.The meta-analysis of DNR informs clinicians to create realistic expectations in hearing aid users.This paper summarizes the available data on different outcome measures such as speech intelligibility, listening effort and sound quality.The results of this meta-analysis will help clinical audiologists in devising hearing aid orientation and counseling.
Topics: Hearing Aids; Hearing Loss; Humans; Noise; Prosthesis Design; Speech Intelligibility
PubMed: 31502900
DOI: 10.1080/17483107.2019.1642394 -
EXCLI Journal 2023Classic decision theory requires that rational agents show description invariance: which description is chosen should not matter for judgments, preferences, or choices... (Review)
Review
Classic decision theory requires that rational agents show description invariance: which description is chosen should not matter for judgments, preferences, or choices given the descriptions are co-extensive. Framing research has amply demonstrated a failure of description invariance by showing that the choice of the description has a systematic effect on judgments, preferences, and choices. Specifically, framing research has shown that linguistically different descriptions of seemingly equivalent options frequently lead to preference reversals. I summarize the research on framing in situations entailing risk. This includes the characterization of different research designs used, the size and robustness of the framing effects reported for those designs, and the theoretical accounts put forward to explain framing effects. The theoretical accounts are evaluated with respect to their merits, empirically and theoretically. I end by providing the implications of framing research. My central point is that the existence of framing effects points to the adaptiveness of the processes underlying human judgment and choice rather than simply showing human irrationality.
PubMed: 37927347
DOI: 10.17179/excli2023-6169 -
The Angle Orthodontist Jul 2022To review the literature systematically to compare the performance of adhesive precoated flash-free bonding systems with conventional adhesive precoated (APC) and...
OBJECTIVES
To review the literature systematically to compare the performance of adhesive precoated flash-free bonding systems with conventional adhesive precoated (APC) and operator-coated (OPC) bonding systems.
MATERIALS AND METHODS
PubMed, Cochrane Library, Web of Science, and Embase were searched for potential eligible studies. Study selection and data collection were conducted independently. Statistical analysis was performed by Review Manager 5.3. The Cochran Q test was used to test heterogeneity in the included studies. Risk of bias was evaluated using Cochrane RoB 2.0 tool for randomized controlled trials.
RESULTS
Six studies were included and the overall risk-of-bias judgment was low risk of bias to some concerns. The results of the meta-analyses showed that flash-free required significantly less bonding time than APC (mean difference [MD]: -1.56; 95% confidence intervals [CIs]: -2.56 to -0.56), and no significant differences were found in bond failure rates (risk ratio [RR]: 1.54; 95% Cis: 0.27 to 8.89) and adhesive remnant index (ARI) (MD: -0.50; 95% CIs: -1.14 to 0.14) between them. Qualitative analysis showed that flash-free might have a positive effect on enamel demineralization compared to APC but the quantity of plaque did not differ between them.
CONCLUSIONS
The flash-free bonding system significantly reduced bonding time and it had comparable bond failure rates with APC. So far, there is not enough evidence to support its positive effect on reducing enamel demineralization and the pathogenic bacteria around brackets. In summary, flash-free might be a better choice for clinical bracket bonding.
PubMed: 35834818
DOI: 10.2319/122221-932.1 -
Pain Management Nursing : Official... Aug 2022The objective of this systematic review was to identify and describe the psychometric properties of neonatal pain scales that were translated into Brazilian Portuguese... (Review)
Review
OBJECTIVES
The objective of this systematic review was to identify and describe the psychometric properties of neonatal pain scales that were translated into Brazilian Portuguese and to verify the methodological quality of these translation, transcultural adaptations and validation.
DESIGN
The present study is a systematic review. A systematic search in the literature included studies of development, validation, and transcultural adaptation of neonatal pain scales to Brazilian Portuguese. The instruments must have been developed for health care professionals to evaluate neonatal pain and stress in full-term and preterm newborns.
DATA SOURCES
The search strategy was conducted in PubMed, Web of Science, Scopus, and Scielo databases following The PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). REVIEW /ANALYSIS METHODS: A total of 1,479 publications were identified and 5 fulfilled the inclusion criteria, with 4 instruments evaluated. For the methodological quality analysis of the measurement properties of the instruments the Consensus-based Standards for Health Measurement Instruments (COSMIN) Risk of Bias checklist was used. The psychometric properties verified were internal consistency, content validity, reliability, and construct validity.
RESULTS
Three instruments reviewed were inadequate and one was doubtful.
CONCLUSIONS
The neonatal pain scales wich were cross culturally adapted to Brazilian Portuguese were shown to be of low methodological quality based on COSMIM checklist. Caution should be considered for clinical decisions about pain management judgment coming from these instruments.
Topics: Brazil; Humans; Infant, Newborn; Pain; Psychometrics; Reproducibility of Results; Surveys and Questionnaires; Translating
PubMed: 35078712
DOI: 10.1016/j.pmn.2021.12.003