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Autonomous artificial intelligence (AI) for pediatric diabetic retinal disease (DRD) screening has demonstrated safety, effectiveness, and the potential to enhance health equity and clinician productivity. We examined the cost-effectiveness of an autonomous AI strategy versus a traditional eye care provider (ECP) strategy during the initial year of implementation from a health system perspective. The incremental cost-effectiveness ratio (ICER) was the main outcome measure. Compared to the ECP strategy, the base-case analysis shows that the AI strategy results in an additional cost of $242 per patient screened to a cost saving of $140 per patient screened, depending on health system size and patient volume. Notably, the AI screening strategy breaks even and demonstrates cost savings when a pediatric endocrine site screens 241 or more patients annually. Autonomous AI-based screening consistently results in more patients screened with greater cost savings in most health system scenarios. [ABSTRACT FROM AUTHOR]

Rockfalls are among the most dangerous natural hazards. The study of these phenomena may be complex in relation to the geology and the rock mass characteristics. Recent advances on the use of remote sensing techniques made the survey of rock slopes easier and faster, increasing the amount and quality of data. At the same time, the improved availability of software for characterizing rock slopes and simulating rockfalls permits a more detailed and precise definition of rockfall hazard areas. In this context, this research highlights the importance of using remote sensing techniques in the study of these phenomena, especially in developing accurate and reliable geological and structural models. The Regional Park of Monte Conero (Ancona, Italy) is used as the case example. The study area has been investigated through conventional geological/structural surveys, UAV photogrammetry and iPad-based LiDAR. The data gathered from surveys have been used to perform rockfall simulations and define potential mitigation measures. Finally, innovative visualization techniques based on the use of Virtual Reality will be introduced for an improved interpretation of geological and structural data and simulation results. [ABSTRACT FROM AUTHOR]

Objectives: This survey was aimed to assess the knowledge and practices regarding breast cancer and its screening method among school teachers of district Swabi, Khyber Pakhtunkhwa, Pakistan. Materials and methods: This was a cross-sectional survey using 22 items of self-designed, validated, and translated questionnaire distributed amongst 177 public school female teachers distributed in February 2020 in the district of Swabi, Khyber Pakhtunkhwa (KP) province of Pakistan by using a purposive sampling method. Private school teachers and incomplete questionnaire responses were excluded. Baseline information about the age, educational status, marital status, and questionnaire was recorded on a printed proforma and was analyzed using SPSS-23. Results: All 177 participants were females with an age range of 22-60 years and a mean age of 36 + -9.37. Qualification of participants ranged from masters to Ph. D, while the number of married teachers was about 2 times that of unmarried. Most of the respondents (95%) were aware of breast cancer due to varied sources like news, media, the internet, books, or via friends and family. Almost half of the respondents had heard about BSE and about 64% were aware of its significance. About 40% were aware that BSE should be started from puberty to age 30. About 70% of participants were perceiving BSE as a good practice to prevent breast cancer. About 60% had heard of mammography and most of them considered it a useful tool to prevent breast cancer. Conclusion: Most of the participants of the study had knowledge of breast cancer gained via electronic and print media and 70 % were aware of BSE, while a small number of them were aware of mammography. This indicates that female school teachers, having better educational status, have enough knowledge and practice in breast cancer detection and prevention. [ABSTRACT FROM AUTHOR]

Objective: To compare the clinical outcome in terms of length of hospital stay, duration of chest tube drainage, conversion to open thoracotomy and post-injury chest infections; between the Early VATS and Late VATS groups. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Surgery, Benazir Bhutto Hospital, Rawalpindi Pakistan, from Oct 2020 till Sep 2022. Methodology: Sixty-two patients undergoing VATs for acute chest injury were divided into two groups; early VATs within first 5 days of chest injury and late VATs after 5th day of chest injury. Outcome variables compared between the two groups were length of hospital stay, duration of chest tube drainage, conversion to open thoracotomy and chest infection rate. Numerical data were compared using the independent sample T-test and categorical variables were compared using the Chi square test. A p-value of <0.05 was considered statistically significant. Results: In our study the Early VATS group had a significantly shorter length of hospital stay, lesser days on ventilator, shorter total duration of chest tube drainage as compared to Late VATS group. However, duration of post VATS tube drainage, requirement for secondary VATS and conversion rate to open thoracotomy were similar in both groups. Moreover, infection rate was significantly lower in the Early VATS group. Conclusion: Early VATS in chest injury is associated with better clinical outcome. [ABSTRACT FROM AUTHOR]

Introduction: Epilepsy is a disorder of the nervous system requiring prompt medical care and life-long treatment. Unfortunately, data regarding efficacy, Adverse Drug Reactions (ADRs) and Quality Of Life (QOL) in patients using different Anti-Epileptic Drugs (AEDs) is sparse. Aim: To evaluate five AEDs in comparison for efficacy in reducing seizures, improvement in QOL and ADRs due to the prescribed drug. Materials and Methods: In this cohort study, 81 epilepsy patients (age >10 years) receiving the following drugs: Levetiracetam, Lacosamide, Oxcarbazepine, Valproate and Phenytoin for atleast six months were enrolled. Quality of Life in Epilepsy Inventory–31 (QOLIE-31) questionnaire was used for measuring the QOL. Efficacy of AEDs was measured on the basis of seizure control, QOL and adverse effects. All the patients were followed-up weekly for six months for treatment response and adverse effects. Overall, QOLIE scores were calculated. T-tests, analysis of variance and regression analysis were used wherever appropriate. The p-value <0.05 was considered statistically significant. Results: Seizure control was reported in 79% of the patients. A total of 43.2% patients were reported to have experienced an ADR during the course of the study. Adverse events predominantly affected gastroenterologic, psychiatric and general body systems. Patients on Levetiracetam had the best QOL and phenytoin the least. Conclusion: Better seizure control, high medication adherence and improved QoL was seen in patients with Levetiracetam; followed by Lacosamide, Oxcarbazepine, Valproate and least in Phenytoin. [ABSTRACT FROM AUTHOR]

Objective: To determine the social and psychological domains of quality of life of children with orofacial clefts in the context of different types of clefts and educational levels., Methods: The cross-sectional study was conducted at Clapp Hospital and Mayo Hospital, Lahore, Pakistan from September 1, 2020, to January 31, 2021, and comprised subjects of either gender aged 6-18 years having orofacial clefts. Data was collected using the CLEFT-Questionnaire along with a basic demographic sheet. Data was analysed using SPSS 23., Results: Of the 80 subjects, 40(50%) each were males and females. The overall mean age was 12.41±3.39 years. A significant association of types of orofacial clefts with social function (p<0.05) and psychological function (p<0.05) was observed. The highest mean score of 27.89±3.41 and 26.11±1.76 was noted for unilateral left side cleft lip, and primary palate, respectively. No significant association of level of education with social function (p>0.05) and psychological function (p>0.05) was noted., Conclusions: Different types of orofacial clefts affected the psychological and social aspects of quality of life of patients differently, but the difference was not significantly correlated with the education level.