Perception and satisfaction of blind individuals regarding an electronic cane prototype with a wearable haptic device

ABSTRACT Purpose: This study aimed to evaluate the perception and degree of satisfaction of blind individuals regarding an electronic cane prototype with a wearable haptic interface. Methods: Two scenarios with different obstacles were created to conduct tests with the canes (the user's cane and the prototype one). The perception and satisfaction of participants regarding the electronic cane were assessed using a questionnaire, the number of collisions during the tests, and the time each individual took to complete the course in each scenario. Results: Ten blind individuals who used the white cane participated in this study. Eight were males, and two were females. Their age ranged from 23 to 43 (average 32.3 ± 7.13 years and median 32 years). There was a tendency for fewer collisions with ground obstacles when the electronic cane was used than when the white cane was used. However, there was no statistically significant difference between the number of collisions and the course completion time in each scenario with either canes tested. Conclusion: Overall, the perception and satisfaction of individuals regarding the prototype used were positive.

La importancia del sueño en los adolescentes: impacto de variables sociodemográficas y de factores personales / The Importance of Sleep in Adolescents: Impact of Sociodemographic Variables and Personal Factors

Resumen Objetivo: Ante la escasez de investigaciones que traten de manera conjunta el conocimiento, la calidad y la higiene del sueño en el adolescente, el objetivo del presente estudio es analizar las diferencias y las relaciones que existen entre estas variables en función de características sociodemográficas y personales. Método: A través de los instrumentos Sleep Beliefs Scale (SBS), Spanish Adolescents and Young Adults Pittsburgh Sleep Quality Index (AYA-PSQI-S) y Adolescents Sleep Hygiene Scale Revied (ASHSr), se midieron las características del sueño de 140 estudiantes (M = 16,75; DE = 0,75). Resultados: El 89,3% de los adolescentes presentaban problemas de sueño, subyacentes de la mejorable higiene del sueño por parte del 62,2% y de un escaso conocimiento general del sueño. El sexo femenino y el alumnado en cursos superiores presentaron mayores problemas para conciliar el sueño, somnolencia y una baja gestión cognitiva-emocional (p < 0,05). La higiene del sueño (β = - 0,344), la edad (β = 0,154) y el autoconcepto (β = -0,349) son los factores que predijeron significativamente (p < 0,05) la calidad del sueño del adolescente. Conclusiones: La adquisición de una adecuada higiene del sueño se vuelve fundamental para mejorar la calidad del descanso y la funcionalidad diurna en adolescentes, destacando su importancia, sobre todo, en niveles académicos avanzados y en el caso específico de las mujeres.

Abstract Objective: Given the scarcity of research addressing the intersection of knowledge, sleep quality, and hygiene among adolescents, the primary objective of this study is to analyse the variations and correlations among these variables based on socio-demographic and personal characteristics. Method: The Sleep Beliefs Scale (SBS), the Spanish Adolescents and Young Adults Pittsburgh Sleep Quality Index (AYA-PSQI-S), the Adolescents Sleep Hygiene Scale Revied (ASHSr) were used to measure the sleep characteristics of the 140 Spanish students (M = 16,75; SD = 0,75). Results: Sleep problems were found in 89,3% of the adolescents, underlying poor sleep hygiene in 62,2% and poor general sleep knowledge (SBS = 12,04). Females and students in higher grades presented greater problems in falling asleep, sleepiness, and poor cognitive-emotional management (p < 0,05). Sleep hygiene (β = - 0,344), age (β = 0,154), and self-concept (β = -0,349) were the factors that significantly (p < 0,05) predicted adolescent sleep quality. Conclusions: The acquisition of proper sleep hygiene becomes crucial to enhance the quality of rest and daytime functionality in adolescents, emphasizing its significance, especially in advanced academic levels and specifically in the case of females.

Simulating graphene-based single-electron transistor: incoherent current effects due to the presence of electron-electron interaction.

Carbon-based nanostructures have unparalleled electronic properties. At the same time, using an allotrope of carbon as the contacts can yield better device control and reproducibility. In this work, we simulate a single-electron transistor composed of a segment of a graphene nanoribbon coupled to carbon nanotubes electrodes. Using the non-equilibrium Green's function formalism we atomistically describe the electronic transport properties of the system including electron-electron interactions. Using this methodology we are able to recover experimentally observed phenomena, such as the Coulomb blockade, as well as the corresponding Coulomb diamonds. Furthermore, we separate the different contributions to transport and show that incoherent effects due to the interaction play a crucial role in the transport properties depending on the region of the stability diagram being considered.

Corner and edge states in topological Sierpinski Carpet systems.

Fractal lattices, with their self-similar and intricate structures, offer potential platforms for engineering physical properties on the nanoscale and also for realizing and manipulating high order topological insulator states in novel ways. Here we present a theoretical study on localized corner and edge states, emerging from topological phases in Sierpinski Carpet within a $\pi$-flux regime. A topological phase diagram is presented correlating the quadrupole moment with different hopping parameters. Particular localized states are identified following spatial signatures in distinct fractal generations. The specific geometry and scaling properties of the fractal systems can guide the supported topological states types and their associated functionalities. A conductive device is proposed by coupling identical Sierpinski Carpet units providing transport response through projected edge states which carry on the details of the system's topology. Our findings suggest that fractal lattices may also work as alternative routes to tune energy channels in different devices.

A DFT study of the effect of hydrostatic pressure on the structure and electronic properties of sarcosine crystal.

CONTEXT: We perform density functional theory calculations to study the dependence of the structural and electronic properties of the amino acid sarcosine crystal structure on hydrostatic pressure application. The results are analyzed and compared with the available experimental data. Our findings indicate that the crystal structure and properties of sarcosine calculated using the Grimme dispersion-corrected PBE functional (PBE-D3) best agree with the available experimental results under hydrostatic pressure of up to 3.7 GPa. Critical structural rearrangements, such as unit cell compression, head-to-tail compression, and molecular rotations, are investigated and elucidated in the context of experimental findings. Band gap energy tuning and density of state shifts indicative of band dispersion are presented concerning the structural changes arising from the elevated pressure. The calculated properties indicate that sarcosine holds great promise for application in electronic devices that involve pressure-induced structural changes. METHODS: Three widely used generalized gradient approximation functionals-PBE, PBEsol, and revPBE-are employed with Grimme's D3 dispersion correction. The non-local van der Waals density functional vdW-DF is also evaluated. The calculations are performed using the projector-augmented wave method in the Quantum Espresso software suite. The geometry optimization results are visualized using VMD. The Multiwfn and NCIPlot programs are used for wavefunction and intermolecular interaction analyses.

Communication, Shared Decision-making and Goals of Care in the ICU through Electronic Health Records: A Scoping Review.

Introduction: The care of critically ill patients involves communication and shared decision-making with families and determination of goals of care. Analyzing these aspects through electronic health records (EHRs) can support research in ICUs, associating them with outcomes. This review aims to explore studies that examine these topics. Methods: A scoping review was conducted through a systematic literature search of articles in PubMed, Web of Science, and Embase databases using MESH terms up to 2024, conducted in ICU settings, focusing on communication with families, shared decision-making, goals, and end-of-life care. Results: A total of 10 articles were included, divided into themes: Records and family, and records in quality improvement projects. Variables based on records with common characteristics were identified. Outcome analysis was performed through questionnaires to family members, healthcare professionals or by analyzing care processes. The studies revealed associations between family members' perceptions and mental health symptoms and documented elements such as communication, therapeutic limitations, social and spiritual support. Studies evaluating quality communication improvement projects did not show significant impact on documented care, except for those that assessed improvements based on palliative care. Conclusion: The analysis of documented care for critically ill patients can be conducted from various perspectives. Processes amenable to improvement, such as communication with family members, definition of goals of care, limitations, shared decision-making, evaluated through EHRs, are associated with mental health symptoms and perceptions of families of critically ill patients. Documentation-based studies can contribute to improvements in patient- and family-centered care in the ICU. How to cite this article: de Aquino VW, da Silveira GF, Boniatti MM, Terres MS. Communication, Shared Decision-making and Goals of Care in the ICU through Electronic Health Records: A Scoping Review. Indian J Crit Care Med 2024;28(10):977-987.

Validity and Reproducibility of a Culture-Specific Electronic Food Frequency Questionnaire: A Trinidad and Tobago Diet Assessment Study.

Nutritional epidemiologists use culture-specific food frequency questionnaires (FFQs) to assess the dietary intake of groups based on country, region or ethnic groups. This study aimed to validate a culture-specific semi-quantitative electronic Food Frequency Questionnaire (e-FFQ) to estimate food group intake in the adult population of Trinidad and Tobago. A 139-item semi-quantitative e-FFQ containing local dishes and street food was administered twice to adults 18 years and older and compared against four 1-day food records (FRs) using digital photographs, which served as the reference method. The validity and reproducibility of the e-FFQ food group intake estimates were determined using paired t-tests, bivariate correlations, and cross-classifications. Reproducibility correlations between the reported food group intakes in the first and repeat administration of the e-FFQ ranged from moderate (r = .44, P ≤ .0001) for sweetened beverages to high (r = .91 P ≤ .0001) for alcohol. The cross-classification agreements ranged from 70% (street food) to 92% (alcohol). Energy-adjusted deattenuated validity correlations between the e-FFQ and FR ranged from (r = .08) for water to (r = .81) for food from animal sources, with a mean validity correlation of .36. An average of 68% of the e-FFQ estimates was correctly classified within the ±1 quintile of the exact agreement with the FRs. Agreements between the e-FFQ and FRs ranged from 55% for street foods to 95% for water, all significant at P ≤ .0001. This study shows that the culture-specific e-FFQ is a valid tool for assessing and ranking food category intake estimates of the adult population living in Trinidad and Tobago.

Reactivity assessment of oligomeric systems associated with crystalline and amorphous cellulose for bioethanol production: a DFT study.

CONTEXT: The production of bioethanol from renewable raw materials is a decisive factor in the economic development of many countries. However, the complexity of the processes and the numerous experimental variables involved require a deeper understanding of the chemical reactions that take place during bioethanol production to define optimal parameters. Here, we have employed density functional theory-based calculations to investigate the local reactivity of oligomeric systems by considering crystalline and amorphous cellulose models to better understand some details regarding pulp pretreatment processes. Our results evidence a higher chemical susceptibility of amorphous portions of cellulose to chemicals typically employed in acid hydrolysis. Additionally, we observed that glucose monomers coming from cellulose hydrolysis may undergo oxidation, leading to the formation of byproducts such as hydroxymethylfurfural (HMF), acetic acid, formic acid, and levulinic acid. The analysis of local chemical softness indexes indicated that cellulose hydrolysis may be associated with intermediate chemical steps. Finally, we investigated the influence of distinct solvents (dielectric constants) on the local reactivity of the systems, evidencing a relevant role of the solvent dielectric constant for cellulose degradation in glucose. METHODS: Initial three-dimensional structures were constructed. Pre-optimizations were performed in a Hartree-Fock (HF) approach employing the PM7 semi-empirical hamiltonian. The structures were then re-optimized via density functional theory (DFT). The local reactivity study of the systems was conducted through the condensed-to-atoms Fukui indexes (CAFI). Systematic changes of the dielectric constants were also considered in geometry optimization and CAFI calculations to estimate the influence of solvents on the reactivity of the systems.

Analytical potential energy functions for CO + in its ground and excited electronic states.

CONTEXT: Accurate functions to analytically represent the potential energy interactions of CO + diatomic system in X 2 Σ + , A 2 Π , and B 2 Σ + electronic states are proposed. The new functions depend upon only four parameters directly obtained from experimental data, without any fitting procedure. These functions have been developed from the modified generalized potential proposed by Araújo and Ballester. The function for the X 2 Σ + electronic state represents a significant improvement to the previously proposed model. To quantify the accuracy of the potential energy functions, the Lippincont test is used. The novel potential was also compared with the classical Morse potential and with the recently proposed Improved Generalized Pöschl-Teller potential. Furthermore, the main spectroscopic constants and vibrational energy levels are calculated and compared for all potentials. The present results agree excellently with the experiment Rydberg-Klein-Rees (RKR) potentials. METHODS: The rovibrational energy levels of the proposed diatomic potentials were asserted by solving radial the Schrödinger equation of the nuclear motion with the aid of the LEVEL program.

Mapping the evaluation of the electronic health system PEC e-SUS APS in Brazil: a scoping review protocol.

BACKGROUND: The Brazilian Ministry of Health has developed and provided the Citizen's Electronic Health Record (PEC e-SUS APS), a health information system freely available for utilization by all municipalities. Given the substantial financial investment being made to enhance the quality of health services in the country, it is crucial to understand how users evaluate this product. Consequently, this scoping review aims to map studies that have evaluated the PEC e-SUS APS. METHODS: This scoping review is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) framework, as well as by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Checklist extension for scoping reviews (PRISMA-ScR). The research question was framed based on the "CoCoPop" mnemonic (Condition, Context, Population). The final question posed is, "How has the Citizen's Electronic Health Record (PEC e-SUS APS) been evaluated?" The search strategy will be executed across various databases (LILACS, PubMed/MEDLINE, Scopus, Web of Science, ACM Digital Library, and IEEE Digital Library), along with gray literature from ProQuest Dissertation and Theses Global and Google Scholar, with assistance from a professional healthcare librarian skilled in supporting systematic reviews. The database search will encompass the period from 2013 to 2024. Articles included will be selected by three independent reviewers in two stages, and the findings will undergo a descriptive analysis and synthesis following a "narrative review" approach. Independent reviewers will chart the data as outlined in the literature. DISCUSSION: The implementation process for the PEC e-SUS APS can be influenced by the varying characteristics of the over 5500 Brazilian municipalities. These factors and other challenges encountered by health professionals and managers may prove pivotal for a municipality's adoption of the PEC e-SUS APS system. With the literature mapping to be obtained from this review, vital insights into how users have evaluated the PEC will be obtained. SYSTEMATIC REVIEW REGISTRATION: The protocol has been registered prospectively at the Open Science Framework platform under the number 10.17605/OSF.IO/NPKRU.

Electronic cigarettes: "wolves in sheep's clothing".

OBJECTIVE: To provide cutting-edge information on the impact and risks of using Electronic Nicotine Delivery Systems (ENDS) by children and adolescents, based on the latest evidence published in the literature. DATA SOURCE: A comprehensive search was carried out on PubMed, using the expressions ''electronic cigarettes'' OR ''electronic nicotine delivery systems" OR "vaping" AND ''adolescent'' AND "risks" AND ''acute lung injury'. All retrieved articles had their titles and abstracts read to identify and fully read the papers reporting the most recent evidence on each subject. SUMMARY OF FINDINGS: The use of ENDS has alarmingly increased in Brazil and around the world. The possibility of customizing use, the choice of flavors and nicotine content, and the general notion that these devices are harmless when compared to conventional cigarettes are some of the factors responsible for this increase. Numerous scientific studies have proven that electronic cigarettes have serious consequences for the respiratory system, such as EVALI (E-cigarette or Vaping-Associated Lung Injury) and difficult-to-control asthma, as well as harmful effects on the neurological, cardiovascular, gastrointestinal, and immunological systems. High concentrations of nicotine make many young people addicted to this substance. In Brazil, commercialization, import, and advertising are prohibited. The viable interventions to address the use of these devices in children and adolescents are prevention and behavioral counseling. CONCLUSION: There is clear scientific evidence that these devices pose a risk to the physical and mental health of children and adolescents.

Reducción del error de prescripción y de sus efectos adversos en el área pediátrica de cuidados intensivos / Reduction of prescription error and its adverse effects in the pediatric intensive care area

Resumen Introducción : La prescripción es el nodo del manejo y uso de medicamentos que con mayor frecuencia presen ta errores de medicación, según diversos estudios. Este estudio tiene como objetivo analizar las prescripciones antes y después de la incorporación de una ronda multi disciplinar en el área de cuidados intensivos pediátricos y su implicación en la ocurrencia de eventos adversos por medicamentos. Métodos : Se trata de un estudio antes y después, no controlado. Resultados : Se estudiaron 100 pacientes antes y 100 después, rango 1-17 años, edad media: 6.4 DE: 8.7. El 55.5% (n = 111) eran varones. Se detectó un error de prescripción antes de la intervención del 12% (n = 12) y después de intervención, del 0%, p = 0.001. Se detectó un total de 45 eventos adversos por 100 ingresos y 38 eventos por 100 ingresos, antes y después de la inter vención respectivamente (p > 0.05). Conclusión : La intervención fue útil para disminuir el error de prescripción en esta muestra de pacientes.

Abstract Introduction : Prescription is the node of medication management and use that most frequently presents medication errors, according to various studies. This study aims to analyze prescriptions before and after the incorporation of a multidisciplinary round in the pediatric intensive care area and its implication in the occurrence of adverse drug events. Methods : This is an uncontrolled before and after study. Results : 100 patients were studied before and 100 after, range 1-17 years, mean age: 6.4 SD: 8.7. 55.5% (n = 111) were men. A prescription error was detected before the intervention of 12% (n = 12) and after 0% of the inter vention, 0%, p = 0.001. A total of 45 adverse events were detected, that is, 45 adverse events per 100 admissions and 38, that is, 38 events per 100 admissions, before and after the intervention respectively (p > 0.05). Conclusion : The intervention was useful to reduce prescription error in this sample of patients.

Advantages of a Data-Capture System with Video to Record Neonatal Resuscitation Interventions.

OBJECTIVE: To assess the completeness and accuracy of neonatal resuscitation documentation the electronic medical record (EMR) compared with a data-capture system including video. STUDY DESIGN: Retrospective observational study of 226 infants assessed for resuscitation at birth between April 2019 and October 2021 at Sharp Mary Birch Hospital, San Diego. Completeness was defined as the presence of documented resuscitative interventions in the EMR. We assessed the timing and frequency of interventions to determine the accuracy of the EMR documentation using video recordings as an objective record for comparison. Inaccuracy of EMR documentation was scored as missing (not documented), under-reported, or over-reported. RESULTS: Overall, the completeness of resuscitation interventions documented in the EMR was high (85%-100%), but the accuracy of documentation varied between 39% and 100% Modes of respiratory support were accurately captured in 96%-100% of the EMRs. Time to successful intubation (39%) and maximum fraction of inspired oxygen (47%) were the least accurately documented interventions in the EMR. Under-reporting of interventions with several events (eg, number of positive pressure ventilation events and intubation attempts) were also common errors in the EMR. CONCLUSIONS: The self-reported modes of respiratory support were accurately documented in the EMR, whereas the timing of interventions was inaccurate when compared with video recordings. The use of a video-capture system in the delivery room provided a more objective record of the timing of specific interventions during neonatal resuscitations.

Complete pacemaker failure following lightning strike injury: A case report.

INTRODUCTION: Modern cardiovascular implantable electronic devices (CIEDs) have mechanisms that prevent damage from external electric shocks, and malfunction following accidental electrocution is rare. However, the effects of lightning injuries in patients with CIEDs are uncertain. CASE PRESENTATION: A 74-year-old man with a dual-chamber pacemaker due to complete heart block was struck by a lightning while farming. He had no serious injury at the time and sought medical evaluation 1 month later, when he presented with asymptomatic bradycardia. Device interrogation suggested major battery and lead damage, requiring extraction and subsequent placement of a new pacing system. DISCUSSION: While a previous report depicted pacing threshold elevation without extensive device impairment, our patient presented with major damage to the whole pacing system. The factors contributing to these divergent outcomes are unclear. Differences in injury mechanism, pacemaker model, and the pattern of electric current dispersion within the device may each play a part in this discrepancy.

Ab initio electronic absorption spectra of para-nitroaniline in different solvents: Intramolecular charge transfer effects.

Intramolecular charge transfer (ICT) effects of para-nitroaniline (pNA) in eight solvents (cyclohexane, toluene, acetic acid, dichloroethane, acetone, acetonitrile, dimethylsulfoxide, and water) are investigated extensively. The second-order algebraic diagrammatic construction, ADC(2), ab initio wave function is employed with the COSMO implicit and discrete multiscale solvation methods. We found a decreasing amine group torsion angle with increased solvent polarity and a linear correlation between the polarity and ADC(2) transition energies. The first absorption band involves π → π* transitions with ICT from the amine and the benzene ring to the nitro group, increased by 4%-11% for different solvation models of water compared to the vacuum. A second band of pNA is characterized for the first time. This band is primarily a local excitation on the nitro group, including some ICT from the amine group to the benzene ring that decreases with the solvent polarity. For cyclohexane, the COSMO implicit solvent model shows the best agreement with the experiment, while the explicit model has the best agreement for water.

Molecular spectroscopy, solvent effect, and DFT studies of azithromycin solvate.

Azithromycin ethanol solvate monohydrate [C38H72N2O120.5(C2H6O)H2O], abbreviated by AZM-MH-EtOH, was synthesized by slow evaporation method and investigated by powder X-ray diffraction, Raman and infrared (IR) spectroscopy combined with density functional theory (DFT) studies. Electronic and vibrational properties were properly investigated based on a theoretical study of solvation effects, using implicit solvation and solute electron density models. The electronic and vibrational studies were evaluated under aqueous, ethanolic, and vacuum conditions. The electronic structure calculations indicated that the AZM-MH-EtOH is chemically more stable in solvents compared to vacuum condition. Ultraviolet-visible (UV-vis) measurements confirmed the stability of the material in ethanolic medium, due to higher absorbance values compared to the aqueous medium. Vibrational changes were observed in the Raman and IR bands, which have connection with hydrogen bonds. The experimental vibration modes showed better accordance with the predicted modes' values under solvation effects, but a slight divergence is noticed when we compared to vibration modes obtained in vacuum. Furthermore, the results have revealed a greater affinity profile of AZM-MH-EtOH for water and ethanol solvents compared to theoretical data under vacuum condition.

Analytical methods and experimental quality in studies targeting carbonyls in electronic cigarette aerosols.

We provide an extensive review of 14 studies (11 independent and three industry-funded) on emissions generated by Electronic Cigarettes (ECs), specifically focusing on the evaluation of carbonyls present in these emissions and emphasizing a meticulous evaluation of their analytical methods and experimental procedures. Since the presence of carbonyl by-products in EC aerosol is concerning, it is important to evaluate the reliability of emission studies quantifying these compounds by verifying their compliance with the following criteria of experimental quality: authors must 1) supply sufficient information on the devices and experimental procedures to allow for potentially reproducing or replicating the experiments, 2) use of appropriate puffing protocols that approach consumer usage as best as possible, 3) use of appropriate analytical methods and 4) usage of blank samples to avoid false positive detection. Outcomes were classified in terms of the fulfilment of these conditions as reliable in seven studies, partially reliable in five studies, and unreliable in two studies. However, only five studies used blank samples and six studies failed the reproducibility criterion. Carbonyl yields were far below their yields in tobacco smoke in all reproducible studies, even in the partially reliable ones, thus supporting the role of ECs (when properly tested and operated) as harm reduction products. This review highlights the necessity to evaluate the quality of laboratory standards in testing EC emissions to achieve an objective assessment of the risk profile of ECs.

Cascade Proportional-Integral Control Design and Affordable Instrumentation System for Enhanced Performance of Electrolytic Dry Cells.

In this paper, we present a cost-effective system for monitoring and controlling alkaline electrolyzers, intending to improve hydrogen gas production on a laboratory scale. Our work includes two main innovations. Firstly, we suggest an approach to calibrate a standard air flow meter to accurately measure the flow of hydrogen-rich gas from electrolyzers, improving measurement accuracy while keeping costs low. Secondly, we introduce a unique cascade control method to manage hydrogen-rich gas production in the electrolyzer, ensuring precise control over gas flow rates. By combining affordable, energy-efficient devices with a PI control system, we achieve efficient gas production through electrolysis, replacing manual control approaches. Experimental results confirm the effectiveness of our cascade control method, demonstrating stable operation with minimal errors. These results provide a foundation for further research into control strategies to enhance the performance of electrolytic cells.

[Acute apical abscess and associated factors in patients during the covid-19 pandemic in a health center in Acapulco, Mexico.] / Absceso apical agudo y factores asociados en pacientes durante la pandemia de covid-19 en un centro de salud de acapulco, méxico.

Objective: To estimate the prevalence of acute apical abscess and identify associated factors in patients of a health center from Acapulco, Mexico. Material and methods: Epidemiological study that collected clinical records of patients during the period of october 2021. Sociodemographic and housing information was collected, as well as personal pathological and non-pathological history and a record of the diagnosis of the periapical lesion based on its clinical characteristics issued by the operator on duty. Through multivariate analysis, a factor associated with acute apical abscess was identified with the odds ratio and its 95% confidence interval as estimators of the strength of association with CIETmap statistical software. Results: The 37% (32/87) of patients were diagnosed with the infection. In terms of gender, females were the most affected with a proportion of 56% (18/32). The most common cause was caries with 72% (23/32). The right upper second premolar was the most affected tooth with 25% (8/32). One associated factor was identified, age 36 to 62 years (ORa=3.54; CI95%a=1.27 -16.62). Conclusion: The morbidity rate of the infection was moderate, and it is a common pathology in stomatological emergency consultations, so it is important for the professional in charge of the area to manage it clinically. It will be important to implement oral health education strategies aimed at different age groups to raise awareness of the cariogenic process and its consequences.

Accurate prediction of all-cause mortality in patients with metabolic dysfunction-associated steatotic liver disease using electronic health records.

INTRODUCTION AND OBJECTIVES: Despite the huge clinical burden of MASLD, validated tools for early risk stratification are lacking, and heterogeneous disease expression and a highly variable rate of progression to clinical outcomes result in prognostic uncertainty. We aimed to investigate longitudinal electronic health record-based outcome prediction in MASLD using a state-of-the-art machine learning model. PATIENTS AND METHODS: n = 940 patients with histologically-defined MASLD were used to develop a deep-learning model for all-cause mortality prediction. Patient timelines, spanning 12 years, were fully-annotated with demographic/clinical characteristics, ICD-9 and -10 codes, blood test results, prescribing data, and secondary care activity. A Transformer neural network (TNN) was trained to output concomitant probabilities of 12-, 24-, and 36-month all-cause mortality. In-sample performance was assessed using 5-fold cross-validation. Out-of-sample performance was assessed in an independent set of n = 528 MASLD patients. RESULTS: In-sample model performance achieved AUROC curve 0.74-0.90 (95 % CI: 0.72-0.94), sensitivity 64 %-82 %, specificity 75 %-92 % and Positive Predictive Value (PPV) 94 %-98 %. Out-of-sample model validation had AUROC 0.70-0.86 (95 % CI: 0.67-0.90), sensitivity 69 %-70 %, specificity 96 %-97 % and PPV 75 %-77 %. Key predictive factors, identified using coefficients of determination, were age, presence of type 2 diabetes, and history of hospital admissions with length of stay >14 days. CONCLUSIONS: A TNN, applied to routinely-collected longitudinal electronic health records, achieved good performance in prediction of 12-, 24-, and 36-month all-cause mortality in patients with MASLD. Extrapolation of our technique to population-level data will enable scalable and accurate risk stratification to identify people most likely to benefit from anticipatory health care and personalized interventions.