METHODS: We recruited individuals newly diagnosed at our centre from 2016-2020 and analysed data of those who died. Patients were stratified to older (≥50 years) or younger (<50 years) based on their age at diagnosis and attributes were compared. The Cox proportional multivariable model was used to identify factors associated with all-cause mortality.
RESULTS: Among 75 deaths reported, the majority of deaths were AIDS-related and late presentation was common in both age groups. The majority of deaths occurred in the first 12 months after care presentation and over two-thirds in both groups disengaged from care prior to death. Older age remained an independent factor associated with death after adjusting for confounders including opportunistic infections, late presentation to care, ART initiation and chronic comorbidities at presentation.
CONCLUSION: Most causes of death in our setting were AIDS-related and associated with late care presentation both in young and older individuals, although older age at diagnosis remained an independent risk factor. Our findings highlight the urgent need to encourage prompt ART initiation following diagnosis, especially in older adults.
METHODS: Data from 43 lung transplant recipients (1021 tacrolimus concentrations) administered an immediate-release oral formulation of tacrolimus were used to evaluate the predictive performance of 17 published population pharmacokinetic models for tacrolimus. Data were collected from immediately after transplantation up to 90 days after transplantation. Model performance was evaluated using (1) prediction-based assessments (bias and imprecision) of individual predicted tacrolimus concentrations at the fourth dosing based on 1 to 3 previous dosings and (2) simulation-based assessment (prediction-corrected visual predictive check; pcVPC). Both assessments were stratified based on concomitant azole antifungal use. Model performance was clinically acceptable if the bias was within ±20%, imprecision was ≤20%, and the 95% confidence interval of bias crossed zero.
RESULTS: In the presence of concomitant antifungal therapy, no model showed acceptable performance in predicting tacrolimus concentrations at the fourth dosing (n = 33), and pcVPC plots displayed poor model fit to the data set. However, this fit slightly improved in the absence of azole antifungal use, where 4 models showed acceptable performance in predicting tacrolimus concentrations at the fourth dosing (n = 33).
CONCLUSIONS: Although none of the evaluated models were appropriate in guiding tacrolimus dosing in lung transplant recipients receiving concomitant azole antifungal therapy, 4 of these models displayed potential applicability in guiding dosing in recipients not receiving concomitant azole antifungal therapy. However, further model refinement is required before the widespread implementation of such models in clinical practice.
METHODS: We employed a methodical bibliometric approach, making use of Scopus and Web of Science (WoS) databases for gathering literatures. We planned our search strategy, concentrating on terms linked to "breast imaging," "image quality," and "diagnostic accuracy" to ensure a systematic examination of the subject. The enhanced search functions in these databases enabled us to narrow down and improve our findings, choosing only the articles, conference papers, and book sections that are most relevant. After conducting a thorough screening process to remove duplicates and evaluate significance, we utilized ScientoPy and VOSviewer software for an in-depth bibliometric analysis. This helped to explore trends in publications, patterns of citations, and thematic groups, giving us a better understanding of how the field has changed and where it currently stands. Our approach prioritized assessing methodological quality and bias in the studies we included, guaranteeing the reliability of our findings.
RESULTS: We reviewed 2984 relevant publications, revealing a consistent annual growth rate of 2.8% in breast imaging research, with the United States and Europe leading in contributions. The study found that advancements in radiological technologies and international collaboration are driving forces behind the field's expansion. Key subject areas such as 'Radiology, Nuclear Medicine, and Medical Imaging' dominated, underscoring their impact on diagnostic quality. Notable authors and institutions have been identified for their influential research, characterized by high citation metrics and significant scholarly impact.
CONCLUSION: The study shows a continuous increase in research on breast imaging, considered by new technologies and teamwork defining the present time. The assessment highlights a key move towards utilizing digital imaging methods and computational analysis, affecting the improvement of future diagnostic procedures and patients' results. The study highlights the importance of continued international collaborations to tackle the new barriers in breast imaging and make the most of technological progress.
IMPLICATIONS FOR PRACTICE: This study shows a focus on using interdisciplinary methods and cutting-edge technology in breast imaging to help healthcare professionals improve their performance and accuracy in diagnosis. Recognizing vital research and emerging trends should guide clinical guidelines, radiology training, and patient care plans to encourage the use of effective techniques and stimulate innovation in diagnostic approaches.
METHODS: From 500 patient CBCT scans, 787 maxillary premolar teeth were evaluated. The sample was divided by gender and age (10-20, 21-30, 31-40, 41-50, 51-60, and 61 years and older). Ahmed et al. classification system was used to record root canal morphology.
RESULTS: The most frequent classifications for right maxillary 1st premolars were 2MPM1 B1 L1 (39.03%) and 1MPM1 (2.81%), while the most frequent classifications for right maxillary 2nd premolars were 2MPM1 B1 L1 (39.08%) and 1MPM1 (17.85%). Most of the premolars typically had two roots (left maxillary first premolars: 81.5%, left maxillary second premolars: 82.7%, right maxillary first premolars: 74.4%, right maxillary second premolars: 75.7%). Left and right maxillary 1st premolars for classes 1MPM1 and 1MPM1-2-1 showed significant gender differences. For classifications 1MPM1 and 1MPM1-2-1, age-related changes were seen in the left and right maxillary first premolars.
CONCLUSION: This study provides novel insights into the root canal anatomy of maxillary premolars within the Saudi population, addressing a notable gap in the literature specific to this demographic. Through CBCT imaging and analysis of large sample sizes, the complex and diverse nature of root canal morphology in these teeth among Saudi individuals is elucidated. The findings underscore the importance of CBCT imaging in precise treatment planning and decision-making tailored to the Saudi population. Consideration of age and gender-related variations further enhances understanding and aids in personalized endodontic interventions within this demographic.
MATERIAL AND METHODS: A cross-sectional selective study was conducted from 140 clinical specialists (Surgery = 24, Pathology = 31, Radiology = 35, Gynecology = 35, Pediatric = 17) from the neglected southern Punjab region of Pakistan. The study was analyzed using χ2 - the test of association and the nexus between different factors was examined by multinomial logistic regression.
RESULTS: Out of 140 respondents, 34 (24.3%) believed hospitals were ready for AI, while 81 (57.9%) disagreed. Additionally, 42(30.0%) were concerned about privacy violations, and 70(50%) feared AI could lead to unemployment. Specialists with less than 6 years of experience are more likely to embrace AI (p = 0.0327, OR = 3.184, 95% C.I; 0.262, 3.556) and those who firmly believe that AI knowledge will not replace their future tasks exhibit a lower likelihood of accepting AI (p = 0.015, OR = 0.235, 95% C.I: (0.073, 0.758). Clinical specialists who perceive AI as a technology that encompasses both drawbacks and benefits demonstrated a higher likelihood of accepting its adoption (p = 0.084, OR = 2.969, 95% C.I; 0.865, 5.187).
CONCLUSION: Clinical specialists have embraced AI as the future of the medical field while acknowledging concerns about privacy and unemployment.
METHODS: This was a clinical trial (NCT05455840) to evaluate the feasibility and safety of utilizing the da Vinci® SP system (Intuitive Surgical, Sunnyvale, CA, USA) for trans-subxiphoid single-port surgery in patients with anterior mediastinal disease. The primary endpoints encompassed conversion rates and the secondary endpoints included the occurrence of perioperative complications.
RESULTS: Between August 2022 and April 2023, a total of 15 patients (7 men and 8 women; median age = 56 years, interquartile range [IQR]: 49 to 65 years) underwent trans-subxiphoid robotic surgery using da Vinci SP platform for maximal thymectomy (n = 2) or removal of anterior mediastinal masses (n = 13). All surgical procedures were carried out with success, with no need for conversion to open surgery or the creation of additional ports. The median docking time was 2 min (IQR: 1 to 4 min), while the console time had a median of 152 min (IQR: 95 to 191 min). There were no postoperative complications and patients experienced a median postoperative hospital stay of 2 days with no unplanned 30-day readmission.
CONCLUSIONS: This study shows that trans-subxiphoid single-port robotic surgery employing the da Vinci SP system in patients with anterior mediastinal disease is clinically viable with acceptable safety and short-term outcomes.
METHODS: A comprehensive bibliographic search for Malaysian studies on diabetes knowledge was conducted in PubMed, Scopus and Google Scholar. Relevant literature was systematically selected and described; pertinent data were extracted; and data on diabetes knowledge levels and their associated factors were synthesised. The quality of the identified studies was assessed using a Joanna Briggs Institute critical appraisal tool.
RESULTS: Thirty Malaysian cross-sectional studies that measured diabetes knowledge levels were retrieved. Nineteen of them used a named diabetes knowledge measurement tool, with 14 using the 14-item Michigan Diabetes Knowledge Test. A low knowledge level was prevalent among patients with diabetes mellitus (pooled mean knowledge score=6.92, proportion of patients with a low knowledge level=47.97%). The knowledge score was associated with some sociodemographic variables, health literacy, self-care and glycaemic control.
CONCLUSION: The association of diabetes knowledge with diabetes outcomes (e.g. self-care and glycaemic control) reflects the potential of the former as a target of intervention. Periodic measurement of diabetes knowledge in healthcare settings and among populations can help in assessing the effectiveness of diabetes educational interventions. Concerted efforts to improve diabetes knowledge among Malaysians have the potential to fill knowledge-practice gaps.
METHODS: This qualitative study was conducted among public PHCPs across six states in Malaysia. Purposive and snowball sampling methods were used. Fifteen primary healthcare doctors and nurses underwent in-depth interviews. Recruitment was stopped when data saturation was achieved. Data were thematically analysed.
RESULTS: Four themes emerged: 1) views towards vaccination and vaccine hesitancy, 2) disparity in strategies and resources used among PHCPs, 3) fixed-minded vaccine deniers and religious incompatibility: the two towering hurdles and 4) negative impact after encounters with vaccine hesitancy.
CONCLUSION: Malaysian PHCPs encounter negative experiences with vaccine hesitancy, impacting them negatively. These experiences are attributed to the challenges and lack of standardised resources for reference. These findings suggest the development of a more flexible policy, a training module inclusive of all professional roles and a standardised repository of resources for managing vaccine hesitancy.
METHODS: A community-based survey was conducted among families residing in the field practice area of an outreach centre for more than a year. Data were collected using a questionnaire administered to adults aged >18 years. Collected data were entered into and analysed using the Statistical Package for the Social Sciences version 16.0.
RESULTS: Approximately 65.1% of the respondents were aged 31-59 years, and 67.4% were women. Among 126 surveyed households, 50.7% had utilised services from the outreach centre. The facilitators of utilisation among 64 households included proximity to their area of residence (90.6%) and availability of good-quality services (40.6%). The most common barriers included a lack of awareness (30.9%) and inconvenient timings (18.2%) of the healthcare centre. The respondents aged <18 years (odds ratio [OR]=7.64; 95% confidence interval [CI]=4.37-13.37) and >45 years (OR=2.65; 95% CI=1.57-4.47) had higher odds of utilising services than those aged 18-45 years. The female respondents (OR=2.89; 95% CI=1.86-4.51) were more likely to utilise services than the male respondents.
CONCLUSION: Creating awareness regarding the outreach healthcare centre and designing services based on the observed needs of the community can further improve the utilisation of services provided at the healthcare centre.
METHODS: In this qualitative study, in-depth interviews were conducted among primary caregivers of school-aged children with learning disabilities who were attending schools in Sisaket Province, were aged 6-12 years and achieved good academic performance. Twenty-one caregivers were interviewed regarding the care of their children. The contents of the interviews were analysed.
RESULTS: Two major themes concerning the provision of familial support for children with learning disabilities to achieve good academic performance emerged: (1) understanding and modifying the care provided to children with learning disabilities and (2) facilitating and promoting children's learning.
CONCLUSION: Families and caregivers of children with learning disabilities must have a comprehensive understanding of the disorder to assist with skill development and provide emotional support.