METHODS: Two blinded reviewers searched PubMed, Embase, Scopus, Web of Science, and IEEE Xplore databases, then selected and graded the risk of bias of observational studies of adults (≥ 18 years) comparing the diagnostic performance of AI algorithms using craniofacial photographs, versus conventional OSA diagnostic criteria (i.e. apnea-hypopnea index [AHI]). Studies were excluded if they detected apneic events without diagnosing OSA. AI models evaluated with a random split test set or k-fold cross-validation were included in a Bayesian bivariate meta-analysis.
RESULTS: From 5,147 records, 6 studies were included, containing 10 AI models trained/tested on 1,417/983 participants. The risk of bias was low. AI trained on craniofacial photographs achieved a pooled 84.9% sensitivity (95% credible interval [95% CrI]: 77.1-90.7%) and 71.2% specificity (95% CrI: 60.7-81.4%). Bayesian meta-regression identified deep learning (convolutional neural networks) as the most accurate AI algorithm (91.1% sensitivity, 79.2% specificity) comparable to home sleep apnea tests. AHI cutoffs, OSA prevalence, feature engineering, input data, camera type and informativeness of Bayesian prior did not alter diagnostic accuracy. There was no substantial publication bias.
CONCLUSION: AI trained on craniofacial photographs have high diagnostic accuracy and should be considered as a low-cost OSA screening tool. Future work focused on deep learning using smartphone images could improve the feasibility of this approach in primary care.
METHODS: We used the synthetic control method (SCM) under assumption of partial interference to evaluate the direct and spillover PEs of Wolbachia-mediated introgression in a long-running operational trial of the intervention in Malaysia. Synthetic controls (SCs), which comprise of a weighted sum of non-spillover controls, were constructed for each directly-treated and spillover site in the pre-intervention period to account for historical imbalances in dengue risk and risk trajectories. SCs were compared to directly/spillover-treated sites to estimate the impact of Wolbachia-introgression on dengue incidence across each site, calendar year and intervention time. Robustness checks, including visual inspections, root-mean-square error (RMSE) calculations, in-space and in-time placebo checks, and permutation tests, were used to inspect the model's ability in attributing dengue incidence reductions to the Wolbachia interventions.
FINDINGS: The direct and spillover PEs of Wolbachia on dengue incidence were expressed as a percentage reduction of dengue incidence, or the absolute case reductions, by comparing SCs to actual intervention/spillover sites. Findings indicate a direct reduction in dengue incidence by 64.35% (95% CI: 63.50-66.71, p
PURPOSE: The purpose of this clinical study was to evaluate the effectiveness of traditional chairside practice and WhatsApp in improving patient knowledge of denture care and their awareness of the impact of edentulism on general health.
MATERIAL AND METHODS: Sixty-two participants who attended the Polyclinic Kulliyyah of Dentistry, IIUM Kuantan in 2022 for removable prosthesis fabrication were recruited. The participants were randomized into 2 groups: control (traditional chairside) and intervention (WhatsApp) group. Video intervention was sent via WhatsApp to the participants. Pretreatment and posttreatment questionnaires were distributed from March to September 2022 to survey their sociodemographic data, knowledge of denture care, and awareness of the effect of edentulism on general health. Data were obtained and checked for normality using the Shapiro-Wilk test. Data were analyzed using the Mann-Whitney U and Wilcoxon-Paired Signed-Rank tests (α=.05).
RESULTS: Eighty-two percent of participants favored WhatsApp as a tool for receiving information and used it daily (66.1%). The level of overall knowledge and awareness increased in groups after denture insertion instruction. Participants' knowledge of denture care (P=.001) and awareness of the effect of edentulism on general health (P=.001) improved significantly in the WhatsApp intervention group compared with the control group.
CONCLUSIONS: WhatsApp can be used as an alternative tool for improving denture care knowledge among denture wearers; increased awareness was observed with WhatsApp compared with the traditional chairside approach.
MATERIALS AND METHODS: A single-centered, prospective observational study was conducted among 46 patients with type 2 diabetes mellitus and concomitant chronic kidney disease stage 2 and 3 who were on three different types of basal insulin (Glargine U-100, Levemir, and Insulatard), fasted in Ramadan 2022. All variables were listed as median (IQR). Hypoglycaemia events and glycemic variability obtained from Freestyle Libre continuous glucose monitoring were compared between insulin groups. Changes in glycated haemoglobin, fasting plasma glucose, renal profile, body weight, body mass index, and waist circumference pre and post-Ramadan were evaluated.
RESULTS: The glycaemic variability was found highest in Insulatard with a median (IQR) of 37.2(33)% versus Levemir 34.4(32.4)% versus Glargine U-100 36.8(30.6)%, p = NS. Levemir had reported the lowest median time of below range of 2.5(13)% followed by Glargine 4(25)% and Insulatard 5(8)%; p = NS. The findings of this study indicated that glycated haemoglobin, fasting plasma glucose, renal profile, body weight, body mass index, and waist circumference did not alter statistically between the three groups post-Ramadan. Individually, Insulatard showed a significant reduction in weight and waist circumference (0.9kg, p = 0.026; 0.44 cm, p = 0.008) while Levemir showed a reduction in waist circumference (0.75cm, p = 0.019).
CONCLUSION: This study revealed that Insulatard, Levemir, and Glargine demonstrated similar levels of safety and efficacy among those with diabetic kidney disease who observed fasting during Ramadan.
AIMS: To evaluate the efficacy and safety of treatment according to subtypes, compared with empirical proton pump inhibitor (PPI), in the initial treatment of FD.
METHODS: We performed a single-blinded, randomised controlled trial of adults with FD. In the intervention group (treatment according to subtype), patients were categorised into epigastric pain syndrome (treatment esomeprazole); postprandial distress syndrome (PDS; treatment itopride) and overlap (treatment itopride, maintain, add/or switch to esomeprazole at week 4). The control group received esomeprazole only. The primary efficacy outcome was the assessment of global symptom improvement (primary end point: best two points from the 7-point Likert scale) over 8 weeks. Secondary outcomes included assessment of the change in nine individual upper gastrointestinal symptoms, quality of life (Short-Form Nepean Dyspepsia Index) and adverse events.
RESULTS: We randomised 180 patients (median age: 50; 68.7% female 56.7% PDS) 1:1 into intervention and control arms. The percentage of patients achieving the primary efficacy outcome were 74.4% and 72.2%, respectively (p = 0.74). The improvement of individual symptoms in both groups were similar. The SF-NDI improved after treatment in both groups (p