Prediction of perioperative parameters of laparoscopic organ-sparing interventions on the kidney taking into account the surgeon's "learning curve"

2021 ◽  
Author(s):  
V.N. Gridin ◽  
I.A. Kuznetsov ◽  
A.I. Gazov ◽  
E.S. Sirota
Keyword(s):  
Logistic Regression ◽  
Comparative Analysis ◽  
Learning Curve ◽  
Multilayer Perceptron ◽  
Regression Line ◽  
Integrated Approach ◽  
Duration Of Surgery ◽  
Surgical Tactics ◽  
The Impact

The paper considers an integrated approach for constructing models for predicting the perioperative parameters of laparoscopic kidney resections, which include the duration of the operation, the time of thermal ischemia, and the glomerular filtration rate 24 hours after the operation. The approach is based on the principle of expanding the feature space, extracted from the analysis of the surgeon's "learning curve" data when mastering laparoscopic kidney resections. The aim of this work is to predict the main perioperative parameters that have the most significant impact on the surgical tactics of treatment at the stage of planning surgery. New methods have been developed for identifying significant parameters that take into account the complexity of the operation and the qualifications of the surgeon based on his “learning curve”. The parameters to be distinguished include: “complexity of the operation” based on nephrometric indices (RENAL, PADUA and C-index); the average value of the predicted perioperative parameters of surgical interventions depending on the complexity; slope and standard error based on the regression line of predicted perioperative parameters. Models were developed for predicting the perioperative parameters of laparoscopic organ-preserving kidney interventions using modern approaches based on machine learning, which are based on the algorithms “decision trees”, “multilayer perceptron”, “Naïve Bayes”, “logistic regression”. A comparative analysis of the quality of the developed models was carried out, as a result of which the best result was obtained using the “logistic regression” algorithm. The F-measure was used as a metric. A comparative analysis of the developed models was carried out to assess the impact on the final quality of the new selected features. For the predicted parameter “time of thermal ischemia” the increase was from 9.68% to 16.68%; for the predicted parameter “duration of surgery” the increase was from 2.76% to 4.08%. At the same time, for the predicted parameter “GFR in 24 hours” there was no significant increase, and for the “multilayer perceptron” algorithm it turned out to be negative. The obtained forecasting models can be used in applied software solutions that act as decision support systems in determining the surgical tactics of treating patients with localized formations of the renal parenchyma. Such software solutions can be implemented as a web service or as a separate program.

scholarly journals COMPARISON OF CAREGIVERS FROM DIVERSE COMMUNITIES WHO IMMIGRATED TO OR WERE BORN IN THE US

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S955-S955
Author(s):  
Lauren Stratton ◽  
David Bass ◽  
Rachel Schaffer ◽  
Sara Powers ◽  
Ocean Le ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Comparative Analysis ◽  
Service Providers ◽  
The Us ◽  
Diverse Communities ◽  
Health Related ◽  
Similarities And Differences ◽  
Racial Ethnic ◽  
Selection Of

Abstract The Diverse Elders Coalition, in partnership with its six member organizations and the Benjamin Rose Institute on Aging, completed a national survey of 840 family and friend caregivers from diverse racial, ethnic, and sexual orientation communities to understand their unique caregiving issues and challenges. Data from a subsample of 369 caregivers identifying as Hispanic/Latino, Asian, Southeast Asian or multiple ethnicities were analyzed to understand similarities and differences between caregivers born in the US and who immigrated to the US. The Stress Process Conceptual Model guided selection of characteristics used for comparative analysis. Results of logistic regression revealed that caregivers born in the US were younger (B=-.08, p<.001), had higher educational degrees (B=.42, p<.001), and higher incomes (B=.34, p=.002). They assisted care receivers with more health-related tasks (B=.27, p=.013), but fewer culture-related tasks (B=-.51, p=.002); reported higher levels of strain in their relationship with care receivers (B=.66, p=.038); and were less satisfied with the quality of care receivers’ healthcare (B=-.62, p=.042). In terms of reasons for being a caregiver, there were no significant differences in cultural commitment to caring for older family members, however those born in the US were more likely to report providing care because it was more convenient for them than for other family and friends (B=.99, p=.002). Understanding the needs of diverse caregivers has implications for healthcare and service providers, such as providing training on diverse needs. Additionally, the differences between US born and immigrant caregivers highlights implications on the dynamic between caregivers and their care receiver.

Sleep Bruxism and Anxiety Impacts in Quality of Life Related to Oral Health of Brazilian Children and their Families

2017 ◽  
Vol 41 (3) ◽  
pp. 179-185 ◽  
Author(s):  
Nashalie Andrade de Alencar ◽  
Cecília Sued Leão ◽  
Anna Thereza Thomé Leão ◽  
Ronir Raggio Luiz ◽  
Andréa Fonseca-Gonçalves ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
Oral Health ◽  
Trait Anxiety ◽  
Sleep Bruxism ◽  
Study Data ◽  
Healthy Children ◽  
Socioeconomic Characteristics ◽  
The Impact

Objective: This study aimed to assess the impact of parent reported sleep bruxism, trait anxiety and sociodemographic/socioeconomic features on quality of life related to oral health (OHRQoL) of children and their families. Study Design: Healthy children aged 3–7 years, with (n=34) and without (n=32) bruxism were select for this study. Data was collected by applying the following instruments: The Early Childhood Oral Health Scale (B-ECOHIS) and Trait-anxiety Scale (TAS). The sociodemographic/socioeconomic characteristics were obtained by interviews with parents. Multiple logistic regression tests were performed to observe the influence of sociodemographic/socioeconomic characteristics, bruxism and trait-anxiety on the children's OHRQoL. Results: No association between sleep bruxism and all evaluated sociodemographic/socioeconomic conditions, with exception of being the only child (p=0.029), were observed. Mean B-ECOHIS and TAS scores were different (p<0.05) between children with (3.41 ± 4.87; 45.09 ± 15.46, respectively) and without (0.63 ± 1.28; 29.53 ± 11.82, respectively) bruxism. Although an association between bruxism and OHRQoL (p=0.015) was observed, it was dropped (p=0.336; OR=1.77) in the logistic regression model. Trait anxiety was the variable responsible for the impact on the OHRQoL of children (p=0.012; OR=1.05). Conclusion: Our results indicated anxiety as the main factor that interfered in the OHRQoL of children with sleep bruxism

Environmental Quality of Impact Drills

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Beata Hricová ◽  
Ervin Lumnitzer
Keyword(s):  
Life Cycle ◽  
Comparative Analysis ◽  
Environmental Impact ◽  
Environmental Quality ◽  
Environmental Performance ◽  
Analysis Method ◽  
Technical Parameters ◽  
Production Stage ◽  
The Impact

AbstractEnvironmental performance of each product is defined already at the stage of its design - in its pre-production stage. Environmental quality of the product is one of the most important factors of environmental performance of a product. Environmental quality includes a range of criteria that indicate the nature of the product and its environmental impact throughout its life cycle. The comparative analysis method is one of the ways to assess the environmental quality of the product. The article gives a specific example of the assessments carried out on the impact drills (of one specific brand) with different technical parameters.

scholarly journals Irritable bowel syndrome: towards an integrated approach

1999 ◽  
Vol 4 (1) ◽  
pp. 45-46 ◽  
Author(s):  
Anita D Stuart ◽  
H Gertie Pretorius ◽  
Lynette Van der Merwe
Keyword(s):  
North Carolina ◽  
Irritable Bowel Syndrome ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Symptoms ◽  
Integrated Approach ◽  
Gastrointestinal Disorders ◽  
University Of North Carolina ◽  
Irritable Bowel ◽  
The Impact

Functional Gastrointestinal Disorders are defined as chronic or recurrent gastrointestinal symptoms characterized by abdominal pain, constipation and/or diarrhoea (Tally, 1994; University of North Carolina, 1998). These disorders are of concern because of their high incidence, associated morbidity, expense and the impact of these disorders on people's quality of life. Drossman (1993, in University of North Carolina (UNC), 1998) found that of 5 400 U.S. households, 69% of people met the criteria for at least one of the functional gastrointestinal disorders which represents a 59% increase in the incidence of functional gastrointestinal disorders since 1983 (Drossman, in UNC, 1998; Drossman, 1983). In particular, Irritable Bowel Syndrome (IBS) sufferers account for 2,4 - 3,5 million visits to doctors annually. Furthermore, IBS sufferers spend $40 million annually on treatment for their condition. They also tend to have 3 to 4 times more disability days than other workers, which illustrates the debilitating effect of this disorder (Drossman, in UNC, 1998). It is therefore necessary that the etiology of IBS be researched, as well as the course and management of this debilitating disease. The studies presented in this series aimed to improve the understanding of the multiple agents that influence the development and course of IBS.

scholarly journals Effects of Integration on the Cost Reduction in Distribution Network Design for Perishable Products

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Z. Firoozi ◽  
N. Ismail ◽  
S. Ariafar ◽  
S. H. Tang ◽  
M. K. M. A. Ariffin ◽  
...  
Keyword(s):  
Network Design ◽  
Integrated Approach ◽  
Mixed Integer ◽  
Location Decisions ◽  
Perishable Products ◽  
Integrated Method ◽  
The Cost ◽  
The Impact ◽  
Decoupled Method

Perishable products, which include medical and pharmaceutical items as well as food products, are quite common in commerce and industries. Developing efficient network designs for storage and distribution of perishable products plays a prominent role in the cost and quality of these products. This paper aims to investigate and analyze the impact of applying an integrated approach for network design of perishable products. For this purpose, the problem has been formulated as a mixed integer nonlinear mathematical model that integrates inventory control and facility location decisions. To solve the integrated model, a memetic algorithm (MA) is developed in this study. For verification of the proposed algorithm, its results are compared with the results of an adapted Lagrangian relaxation heuristic algorithm from the literature. Moreover, sensitivity analysis of the main parameters of the model is conducted to compare the results of the integrated approach with a decoupled method. The results show that as the products become more perishable, application of an integrated method becomes more reasonable in comparison with the decoupled one.

scholarly journals Pre-operative predictors of difficult laparoscopic cholecystectomy and its correlation with post-cholecystectomy syndrome and its impact on quality of life in North Indian population

2021 ◽  
Author(s):  
Priyanka Agrawal ◽  
Mahboob Alam ◽  
Dhirendra Pratap ◽  
Krishna K. Singh ◽  
Lokesh Gupta ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Standard Technique ◽  
Prior History ◽  
Clinical Predictors ◽  
Duration Of Surgery ◽  
History Of ◽  
The Impact

Background: Laparoscopic cholecystectomy (LC) is the most preferable surgical procedure worldwide. LC is not completely risk-free and 2 to 15% of attempted LC procedures have to be converted to open cholecystectomy. The aim of the study was to assess the predictors of difficult LC procedures and for knowing the impact of difficult LC procedures on post-cholecystectomy syndrome and quality of life of patients.Methods: A prospective observational study was conducted on patients who underwent LC. Clinical, demographic, radiological and biochemical parameters along with detailed history of patients were documented. Laparoscopic cholecystectomy was then done on patients using standard technique. Level of difficulty in LC procedure was assessed and graded. Occurrence of post-cholecystectomy syndrome was investigated and quality of patient’s life was assessed using SF-36 inventory.Results: The difficulty rate in LC procedure was observed to be 17.4%. The clinical predictors of difficult LC procedures were old age and prior history of abdominal surgery. Contracted gall bladder, peripancreatic fluid and thick gallbladder wall were radiological predictors and presence of adhesions, longer duration of surgery and conversion to open procedures were intraoperative predictors of difficult LC procedures. Early PCS was affected by difficult LC procedures; though with passage of time it reduced. Post-operative quality of life was affected more by PCS incidence than the difficult LC procedure.Conclusions: The findings of the study would help in anticipating predictors of difficult LC procedures and in understanding the phenomenology and determinants of PCS along with its relationship with operative difficulty and quality of life of patients.

scholarly journals Differentiated treatment tactics in surgery of liver echinococcosis

2020 ◽  
Vol 174 (5) ◽  
pp. 72-77
Author(s):  
A. M. Shamsiev ◽  
J. A. Shamsiev ◽  
K. E. Rakhmanov ◽  
S. S. Davlatov
Keyword(s):  
Postoperative Complications ◽  
Integrated Approach ◽  
Disease Recurrence ◽  
Medical Institute ◽  
Preventive Chemotherapy ◽  
Residual Cavity ◽  
Laparotomy Wound ◽  
Surgical Tactics ◽  
Surgery Department

Purpose of the study. Improving the quality of treatment for liver echinococcosis by improving surgical tactics and developing eff ective methods to reduce disease recurrence. Materials and methods: 371 patients with echinococcosis of the liver, who were admitted to the surgery department of the 2nd clinic of Samarkand State Medical Institute, were examined. Of the 371 patients in 311 (83.8%) patients, the disease was detected for the fi rst time and in 60 (16.2%) patients, echinococcosis was recurrent. The results of the study: compared with 2005–2008. the incidence of postoperative complications decreased from 13.1 to 4.3%. Complications such as suppuration of the residual cavity (6 times), suppuration of the laparotomy wound (2 times), the formation of bile fi stulas (3 times), and no subphrenic abscesses began to occur much less frequently. The duration of inpatient treatment after surgery decreased by 2 times compared with the control — from 21.2 ± 1.2 to 10.9 ± 0.3 days. Conclusions: the developed algorithm for choosing the tactics of surgical treatment of liver echinococcosis, taking into account the integrated approach to choosing access, the method of treatment and elimination of the residual cavity, as well as preventive chemotherapy, has improved the quality of care by reducing the frequency of immediate postoperative complications from 12.5% to 4, 3% (p = 0.027 according to the χ2 criterion) and relapse of the disease from 11.9% to 2.6% (p = 0.031 according to the χ2 criterion).

scholarly journals Factors influencing exclusive breastfeeding duration in Pakistan: a population-based cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sidra Arif ◽  
Hina Khan ◽  
Muhammad Aslam ◽  
Muhammad Farooq
Keyword(s):  
Logistic Regression ◽  
Survival Analysis ◽  
Exclusive Breastfeeding ◽  
Maternal Education ◽  
Binary Logistic Regression ◽  
World Health ◽  
Breastfeeding Duration ◽  
The Impact ◽  
The Relationship

Abstract Background Breastfeeding has the most profound impact on infant health and wellness, and also have significant implications for the mother. The duration of the breastfeeding determines the infant’s protection from malnutrition and other common infectious diseases; consequently, the World Health Organization (WHO) recommends exclusive breastfeeding (EBF) six months, followed by gradual weaning and breastfeeding until the baby is two years old. In Pakistan, the practice of breastfeeding is heavily dependent upon certain demographic, economic, social, and biological factors, which ultimately impact the quality of care provided to the infant and their health. The aim of this paper, therefore, is to measure the impact of these factors on the exclusive breastfeeding duration in Pakistan. Methods The data for the study has been collected from Pakistan Demographic and Health Survey (PDHS) for the year 2017–18. Binary logistic regression model and survival analysis are used to determine the relationship between the independent and dependent variables. Results We use a binary logistic regression to estimate the effect of each factor on the duration of EBF. The binary logistic regression finds significant relationships between region, maternal education, wealth index, size of a child, watching television, delivery by cesarean, and maternal age and EBF. We then use log-likelihood, AIC, BIC criteria to determine if a parametric or non-parametric model would provide a better fit; based on these results we fit an Inverse Gaussian (Weibull) distribution for the survival analysis. These results show that there are more significant factors associated with EBF duration in parametric survival analysis than in the binary logistic regression results. Thus, the survival analysis is a better method for predicting the relationship between the duration of EBF and its factors. Furthermore, logically EBF is designated to be done for six months which would not be properly gauged with a binary response variable. Conclusions The results of this study provide proof that exclusive breastfeeding is a common practice among women in Pakistan, and to improve the quality of post-natal care, health policy in the country needs to focus on the existing demographic and social factors which are found significant in this study.

scholarly journals Improvement of surgical tactics in acute destructive cholecystitis

2021 ◽  
pp. 17-22
Author(s):  
Z. Y. Saydullaev ◽  
S. S. Davlatov ◽  
K. E. Rakhmanov
Keyword(s):  
Surgical Treatment ◽  
Integrated Approach ◽  
World Health ◽  
Medical Institute ◽  
State Medical Institute ◽  
Number Of Patients ◽  
The World ◽  
Surgical Tactics ◽  
Health Organization

Abstract. Relevance. According to the World Health Organization, in the world due to the increase in the incidence of cholelithiasis, there is an increase in the number of patients with destructive forms of this pathology. The aim of the study is to improve the quality of treatment of patients with acute destructive cholecystitis by improving surgical tactics. Materials and research methods. The work is based on the assessment of the results of surgical treatment of patients with acute destructive cholecystitis who were treated in the surgical departments of the 1st clinic of the Samarkand State Medical Institute (clinical base of the departments of surgical diseases No. 1 and general surgery of the Samarkand State Medical Institute) for the period from 2016 to 2020. Conclusions. The tactics of surgical treatment of patients with destructive cholecystitis, taking into account an integrated approach to the choice of access, made it possible to improve the quality of care by reducing the frequency of immediate postoperative complications from 13.4% (11 patients in the comparison group) to 1.7% (2 patients in the main group).

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