Search

Abstract Several studies suggested the utility of artificial intelligence (AI) in screening left ventricular hypertrophy (LVH). We hence conducted systematic review and meta-analysis comparing diagnostic accuracy of AI to Sokolow–Lyon’s and Cornell’s criteria. Our aim was to provide a comprehensive overview of the newly developed AI tools for diagnosing LVH. We searched MEDLINE, EMBASE, and Cochrane databases for relevant studies until May 2023. Included were observational studies evaluating AI’s accuracy in LVH detection. The area under the receiver operating characteristic curves (ROC) and pooled sensitivities and specificities assessed AI’s performance against standard criteria. A total of 66,479 participants, with and without LVH, were included. Use of AI was associated with improved diagnostic accuracy with summary ROC (SROC) of 0.87. Sokolow–Lyon’s and Cornell’s criteria had lower accuracy (0.68 and 0.60). AI had sensitivity and specificity of 69% and 87%. In comparison, Sokolow–Lyon’s specificity was 92% with a sensitivity of 25%, while Cornell’s specificity was 94% with a sensitivity of 19%. This indicating its superior diagnostic accuracy of AI based algorithm in LVH detection. Our study demonstrates that AI-based methods for diagnosing LVH exhibit higher diagnostic accuracy compared to conventional criteria, with notable increases in sensitivity. These findings contribute to the validation of AI as a promising tool for LVH detection.

Background: The multiplicity of interventions for the treatment of cerebral palsy (CP) can cause confusion about which are most suited to certain individuals. Hypothesis is that goal-directed therapy (GDT) can guide integrating therapies to improve clinical outcomes compared with conventional therapy (CT). Method: A prospective, assessor-blinded, randomized controlled trial was done with 23 children with CP (mean age, 4 years 4 months old; SD 1y4mo), who were divided into groups according to their level of gross motor function: GDT and CT. Both groups received 12 physiotherapy (PT) sessions and advice on daily home programs. The GDT group additionally had a team meeting to set a specific goal, and PT programs were shaped toward that goal. Assessments were done at baseline and after treatments, using the Thai-version Gross Motor Function Measure (GMFM-66), CP-Quality of Life (CP-QOL), caregiver burden, and home program compliance. Results: After the treatments, the GDT group showed significant improvements in GMFM-66, CP-QOL, and caregiver burden, while the CT group revealed improvements in caregiver burden and some domains of the GMFM, including sitting and crawling & kneeling. Comparisons between groups found GDT was more effective than CT in improving GMFM-66 and CP-QOL. Home program compliance was higher in the GDT (69%) than the CT group (42%). Conclusion: GDT demonstrated clear gains for children with CP regarding gross motor function and QOL improvements. Team communication toward a customized goal was crucial, empowering the children and their caregivers to comply with home programs to achieve the set goal.

Objective: To determine whether adding a parent training program utilizing the Developmental Individual-difference Relationship-based (DIR/Floortime®) approach for children with developmental disabilities can improve their capacities for attention and initiation. Methods: Forty-eight pairs of parents and their preschool children with developmental disabilities were randomly assigned to three 1-hour one on one DIR/Floortime® parent training sessions during a 4-month period or to a control group. Results: Between-group comparison demonstrated a significant difference in favor of the intervention group for attention (F(1, 46) = 34.52, p = .031, ph2 = .099) and initiation composite scores (F(1, 46) = 6.55, p = .014, ph2 = .127). Effect sizes were medium to large for the attention composite score (Cohen’s d = .526) and initiation composite score (Cohen’s d = .653) respectively. Conclusion: Adding a modest home-based DIR/Floortime® parent training approach may yield clinically meaningful improvements in attention and initiation for children with a range of developmental challenges.

Objective: The study objective is to adapt the Lymphoedema functioning, disability and health questionnaire (Lymph-ICF) for use in the Thai language and to investigate the validity and reliability of the Thai version. Materials and Methods: This study was done in 5 stages in line with established guidelines for cross-cultural adaptation of self-report measures; 1) Initial translation 2) Synthesis of the translations 3) Back translation 4) Expert committee review and 5) Test of the prefinal version. The face validity was assessed by interview content experts. In the assessment of the validity of the construct, the Spearman correlation coefficient was used to examine the correlations between the scores of the Thai Lymph-ICF and the scores of the Thai EQ-5D-5L. The intraclass correlation coefficient (ICC) was used to establish test-retest reliability while Cronbach’s alpha was used to determine the internal consistency of the whole questionnaire and of each domain. Results: Fifty participants were evaluated for validity and reliability. Face validity was supported. Construct validity showed strong correlations between the scores of the Thai Lymph-ICF and the scores of the Thai EQ-5D-5L. Internal consistency and test-retest reliability were both excellent. Conclusion: The Lymph-ICF Thai version was shown to be both valid and reliable for evaluating the quality of life of patients with breast cancer-related lymphoedema.

This pilot study was designed to test the efficacy of adding home-based Developmental, Individual-Difference, Relationship-Based (DIR)/Floortime[TM] intervention to the routine care of preschool children with autistic spectrum disorder. Measures of functional emotional development and symptom severity were taken. It was found that after the parents added home-based DIR/Floortime[TM] intervention at an average of 15.2 hours/week for three months, the intervention group made significantly greater gains in all three measures employed in the study: Functional Emotional Assessment Scale (FEAS) (F = 5.1, p = 0.031), Childhood Autism Rating Scale (F = 2.1, p = 0.002), and the Functional Emotional Questionnaires (F = 6.8, p = 0.006). This study confirms the positive results obtained by a previous DIR pilot study (Solomon et al., 2007). (Contains 2 tables.)

Objective: This study aimed to examine the sensitivity and specificity of the Thai version of the Functional Emotional Developmental Questionnaire (FEDQ) as a screening tool for children with delayed development. Methods: The FEDQ was translated with standard method. The final version of the FEDQ was administered by caregivers of the children. The experts’ opinions of the children’s development were used as the gold standard. All of the children who were categorized as “Functional Delay” and fifty-five children categorized as “Functional Normal” were randomly selected and sent to the assessor to perform Denver II Development Screening test (DDST). Results: Ninety respondents (86%) of 113 respondents were mothers. The mean age of the children was 22.7 months (range 4-42). The Thai version of the FEDQ had a satisfactory internal consistency (Cronbach's alpha = 0.83) Test-retest reliability was acceptable with the intra-class correlation coefficient of 0.89 (95% CI 0.82 to 0.93). When the cut point of 0.5 level less than age-appropriated functional developmental was used, the Thai version of the FEDQ had a sensitivity of 0.82, a specificity of 0.54, positive predictive value (PPV) of 0.32, negative predictive value (NPV) of 0.92, and an accuracy of 0.80. The diagnostic agreement of the Thai version of the FEDQ and Denver II Development Screening Test (DDST) was fair (Kappa = 0.31). Conclusion: The Thai version of the FEDQ was found to be a reliable and valid caregiver-assessment to screen for children with delayed development at a cut-off point of 0.5 level less than age-appropriated functional developmental level. More studies with a larger sample size with the parent of the children less than 12 months of age should be performed. Keywords: The Functional Emotional Developmental Questionnaire, screening test, child development

Objective: The purpose of the study was to evaluate the performance of two low cost hand-made silicone gel cushions designed for low income communities, called Silicone 1 and Silicone 2. Methods: Two silicone gel cushions were made with the same formula. The barrier surrounding of the Silicone 1 and the Silicone 2 were cross-linked poly-dimethylsiloxane (PDMS) and a polypropylene plastic bag respectively. Their pressure reducing characteristics were compared with the Reston® gel cushion now used in the Siriraj Hospital. A sample of 17 healthy volunteers tested the three cushions to evaluate the peak interface pressure in supine, semi-Fowler, lateral bending and sitting positions. All of the subjects are blinded to the types of the cushion. Results: It was shown that the peak interface pressures decreased significantly after the cushions were applied between the subjects and the standard hospital mattress in supine and lateral bending positions and between the subjects and wheelchair seat in sitting position. In semi-Fowler, only the Silicone 1 could reduce the peak pressure significantly (P< 0.05). Multiple comparison by Bonferrini test showed that in supine position both silicone gel cushions could significantly reduce peak interface pressure better than Reston® cushion (P

Buddhist walking meditation (BWM) is widely practiced in many countries. However, there is a lack of evidence relating to its effectiveness for patients with heart failure (HF). To determine the effects of a six-week BWM program on exercise capacity, quality of life, and hemodynamic response in patients with chronic HF. Patients with HF were randomly assigned to a BWM program or an aerobic exercise program. Each group trained at least three times a week during the six-week study period. The outcome measures included exercise capacity (six-minute walk test), disease-specific quality of life (Minnesota Living with Heart Failure Questionnaire), and hemodynamic response (blood pressure and heart rate) immediately after the six weeks of training. The study enrolled 48 patients with a mean age of 65 years and a New York Heart Association functional class of II and III. At baseline, there were no significant differences in their clinical and demographic characteristics or the outcome measures. Although six patients withdrew, all participants were included in the intention-to-treat analysis. There was no statistically significant increase in the functional capacity of the BWM group; however, there was a significant improvement for the aerobic group. With both groups, there was no significant improvement in quality of life or most hemodynamic responses. The six-week BWM program did not improve the functional capacity, quality of life, or hemodynamic characteristics of the HF patients, compared with the values of the patients in the aerobic exercise program. [ABSTRACT FROM AUTHOR]

Background: Low-to-zero fluoroscopic navigation systems lower radiation exposure which improves health outcomes. Conventional x-ray fluoroscopy (CF) has long been the standard to guide to catheter location for cardiac ablation. With advancements in technology, alternative safety navigation systems have been developed. Three primary modalities commonly utilized are three-dimensional electroanatomic mapping (3D-EAM), magnetic navigation system (MNS), and intracardiac echocardiography (ICE), all of which can reduce radiation exposure during the procedure., Objective: We aim to compare the efficacy and safety among ICE, EAM, MNS, and CF in ablation of atrioventricular nodal reentrant tachycardia (AVNRT)., Methods: This is a meta-analysis consisting of observational studies and randomized controlled trials, which evaluated the performance of navigation systems of catheter ablation in AVNRT patients. Primary endpoint was to access the AVNRT recurrence after the procedure during follow-up periods. Secondary endpoints were technical success, fluoroscopic time, fluoroscopic dose area product, radiofrequency ablation time, and adverse events. Random-effect model was applied for pooled estimated effects of included studies., Results: A total of 21 studies (21 CF, 2 ICE, 9 EAM, 11 MNS) including 1716 patients who underwent catheter ablation for AVNRT treatment were analyzed. Of these, 16 were observational studies and 5 were randomized controlled trials., Primary Outcome: Point estimation of AVNRT recurrence showed ICE exhibited a pooled odds ratio (ORs) of 1.06 (95% confidence interval [CI]: 0.064-17.322), MNS with ORs of 0.51 (95% CI: 0.214-1.219], and EAM with ORs of 0.394 (95% CI: 0.119-1.305) when compared to CF., Secondary Outcomes: EAM had significant higher technical success with ORs of 2.781 (95% CI: 1.317-5.872) when compared to CF. Regarding fluoroscopy time, EAM showed the lowest time with mean differences (MD) of -10.348 min (95% CI: -13.385 to -7.3101) and P-score of 0.998. It was followed by MNS with MD of -3.712 min (95% CI: -7.128 to -0.295) and P-score of 0.586, ICE with MD of -1.150 min (95% CI: -6.963 to 4.662) with a P-score of 0.294 compared to CF, which has a P-score of 0.122. There were insignificant adverse events across the procedures., Conclusion: AVNRT ablation navigated by low-to-zero fluoroscopic navigation systems achieves higher efficacy and comparable safety to conventional fluoroscopywhile also reducing risk of radiation exposure time., (© 2024 Wiley Periodicals LLC.)

Introduction: Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common supraventricular tachycardia referred for ablation. Periprocedural conduction system damage was a primary concern during AVNRT ablation. This study aimed to assess the incidence of permanent atrioventricular (AV) block and the success rate associated with different types of catheters in slow pathway ablation., Method: A literature search was performed to identify studies that compared various techniques, including types of radiofrequency ablation (irrigated and nonirrigated) and different sizes of catheter tip cryoablation (4, 6, and 8-mm), in terms of their outcomes related to permanent atrioventricular block and success rate. To assess and rank the treatments for the different outcomes, a random-effects model of network meta-analysis, along with p-scores, was employed., Results: A total of 27 studies with 5110 patients were included in the analysis. Overall success rates ranged from 89.78% to 100%. Point estimation showed 4-mm cryoablation exhibited an odds ratio of 0.649 (95%CI: 0.202-2.087) when compared to nonirrigated RFA. Similarly, 6-mm cryoablation had an odds ratio of 0.944 (95%CI: 0.307-2.905), 8-mm cryoablation had an odds ratio of 0.848 (95%CI: 0.089-8.107), and irrigated RFA had an odds ratio of 0.424 (95%CI: 0.058-3.121) compared to nonirrigated RFA., Conclusion: Our study found no significant difference in the incidence of permanent AV block between the types of catheters. The success rates were consistently high across all groups. These findings emphasize the potential of both RF ablation (irrigated and nonirrigated catheter) and cryoablation as viable options for the treatment of AVNRT, with similar safety and efficacy profile., (© 2024 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC.)