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Ciftci R, Secgin Y, Oner Z, Toy S, Oner S. Age Estimation Using Machine Learning Algorithms with Parameters Obtained from X-ray Images of the Calcaneus. Niger J Clin Pract 2024; 27:209-214. [PMID: 38409149 DOI: 10.4103/njcp.njcp_602_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/02/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Determination of bone age is a critical issue for forensics, surgery, and basic sciences. AIM This study aims to estimate age with high accuracy and precision using Machine Learning (ML) algorithms with parameters obtained from calcaneus x-ray images of healthy individuals. METHOD The study was carried out by retrospectively examining the foot X-ray images of 341 people aged 18-65 years. Maximum width of the calcaneus (MW), body width (BW), maximum length (MAXL), minimum length (MINL), facies articularis cuboidea height (FACH), maximum height (MAXH), and tuber calcanei width (TKW) parameters were measured from the images. The measurements were then grouped as 20-45 years of age, 46-64 years of age, 65 and older, and age estimation was made by using these at the input of ML models. RESULTS As a result of the ML input of the measurements obtained, a 0.85 Accuracy (Acc) rate was obtained with the Extra Tree Classifier algorithm. The accuracy rate of other algorithms was found to vary between 0.78 and 0.82. The contribution of parameters to the overall result was evaluated by using the shapley additive explanations (SHAP) analyzer of Random Forest algorithm and the MAXH parameter was found to have the highest contribution in age estimation. CONCLUSIONS As a result of our study, calcaneus bone was found to have high accuracy and precision in age estimations.
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Affiliation(s)
- R Ciftci
- Department of Anatomy, Faculty of Medicine, Gaziantep Islam Science and Technology University, Gaziantep, Türkiye
| | - Y Secgin
- Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Türkiye
| | - Z Oner
- Department of Anatomy, Faculty of Medicine, İzmir Bakırçay University, İzmir, Türkiye
| | - S Toy
- Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Türkiye
| | - S Oner
- Department of Radiology, Faculty of Medicine, İzmir Bakırçay University, İzmir, Türkiye
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Toy S, Daly Guris RJ. How to conduct survey-based research. Anaesthesia 2022. [PMID: 36515113 DOI: 10.1111/anae.15943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 12/15/2022]
Affiliation(s)
- S Toy
- Department of Basic Science Education, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - R J Daly Guris
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Senol D, Bodur F, Secgın Y, Bakıcı RS, Sahin NE, Toy S, Öner S, Oner Z. Sex prediction with morphometric measurements of first and fifth metatarsal and phalanx obtained from X-ray images by using machine learning algorithms. Folia Morphol (Warsz) 2022; 82:704-711. [PMID: 35607870 DOI: 10.5603/fm.a2022.0052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The aim of this study is to predict sex with machine learning (ML) algorithms by making morphometric measurements on radiological images of the first and fifth metatarsal and phalanx bones. MATERIALS AND METHODS In this study, radiologic images of 263 individuals (135 female, 128 male) between the ages of 27 and 60 were analysed retrospectively. The images in digital imaging and communications in medicine (DICOM) format were transferred to personal workstation Radiant DICOM Viewer programme. Length and width measurements of the first and fifth metatarsal and foot phalanx bones were performed on the transferred images. In addition, the ratios of the total length of the first proximal and distal phalanx and length of the first metatarsal and total length of fifth proximal, middle, and distal phalanx and maximum length of fifth metatarsal were calculated. RESULTS As a result of machine learning algorithms, highest accuracy, specificity, sensitivity, and Matthews correlation coefficient values were found as 0.85, 0.86, 0.85, and 0.71, respectively with decision tree algorithm. It was found that accuracy rates of other algorithms varied between 0.74 and 0.83. CONCLUSIONS As a result of our study, it was found that sex estimation was made with high accuracy rate by using machine learning algorithms on X-ray images of the first and fifth metatarsal and foot phalanx. We think that in cases when pelvis, cranium and long bones are harmed and examination is difficult, bones of the first and fifth metatarsal and foot phalanx can be used for sex estimation.
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Affiliation(s)
- D Senol
- Department of Anatomy, Faculty of Medicine, Düzce University, Düzce, Turkey.
| | - F Bodur
- Department of Anatomy, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - Y Secgın
- Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Turkey
| | - R S Bakıcı
- Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Turkey
| | - N E Sahin
- Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Turkey
| | - S Toy
- Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Turkey
| | - S Öner
- Department of Radiology, Faculty of Medicine, İzmir Bakırçay University, İzmir, Turkey
| | - Z Oner
- Department of Anatomy, Faculty of Medicine, İzmir Bakırçay University, İzmir, Turkey
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Senol D, Ozbag D, Dedeoglu N, Cevirgen F, Toy S, Ogeturk M, Kose E. Comparison of anthropometric and conic beam computed tomography measurements of patients with and without difficult intubation risk according to modified mallampati score: New markers for difficult intubation. Niger J Clin Pract 2021; 24:1609-1615. [PMID: 34782498 DOI: 10.4103/njcp.njcp_694_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background The aim of this study was to compare the anthropometric and cone beam computed tomography (CBCT) measurements taken from risk-free and risky groups by using the modified Mallampati score (MMS). Patients and Methods A total of 176 volunteers between the ages of 18 and 65 in four different MMS classes were included in the study. The patients in classes MMS I and MMS II were accepted as risk-free and the patients in classes MMS III and MMS IV were accepted as risky for intubation. The Mann-Whitney U test was performed on the data to compare the anthropometric and radiological measurements taken from the risk-free and risky groups. A receiver operating characteristic (ROC) analysis was applied to the parameters that had a statistically significant difference. Results According to the analysis results, statistically significant differences were found in the neck circumference (NC), maximum interincisal distance (MID), thyromental distance (TMD) and sternomental distance (SMD) of the anthropometric measurements of men and women between the risk-free and risky groups (P < 0.05). In terms of CBCT measurements, the thickness of the tongue (TT), distance between the uvula and posterior wall of pharynx (U-Ph), distance between posterior nasal spine and nasopharynx (Snp-Nph) and length of the epiglottis (LE) were found to have statistically significant differences between the risk-free and risky groups of men and women (P < 0.05). Conclusion The NC, MID, TMD and SMD anthropometric measurements and TT, U-Ph, Snp-Nph and LE radiologic measurements were found to support MMS, which is one of the most widely used bedside intubation prediction tests. In addition to the inclusion of CBCT for intubation prediction, U-Ph and Snp-Nph radiologic measurements were added as difficult intubation markers.
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Affiliation(s)
- D Senol
- Department of Anatomy, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - D Ozbag
- Department of Anatomy, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - N Dedeoglu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inönü University, Malatya, Turkey
| | - F Cevirgen
- Department of Anatomy, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - S Toy
- Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Turkey
| | - M Ogeturk
- Department of Anatomy, Faculty of Medicine, Fırat University, Elazığ, Turkey
| | - E Kose
- Department of Anatomy, Faculty of Medicine, İnönü University, Malatya, Turkey
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Ahluwalia T, Toy S, Gutierrez C, Boggs K, Douglass K. Feasible and effective use of a simulation-based curriculum for post-graduate emergency medicine trainees in India to improve learner self-efficacy, knowledge, and skills. Int J Emerg Med 2021; 14:42. [PMID: 34315407 PMCID: PMC8314604 DOI: 10.1186/s12245-021-00363-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pediatric emergency medicine training is in its infancy in India. Simulation provides an educational avenue to equip trainees with the skills to improve pediatric care. We hypothesized that a simulation-based curriculum can improve Indian post-graduate emergency medicine (EM) trainees' self-efficacy, knowledge, and skills in pediatric care. METHODS We designed a simulation-based curriculum for management of common pediatric emergencies including sepsis, trauma, and respiratory illness and pediatric-specific procedures including vascular access and airway skills. Training included didactics, procedural skill stations, and simulation. Measures included a self-efficacy survey, knowledge test, skills checklist, and follow-up survey. Results were analyzed using the Wilcoxon signed-rank test and paired-samples t test. A 6-month follow-up survey was done to evaluate lasting effects of the intervention. RESULTS Seventy residents from four academic hospitals in India participated. Trainees reported feeling significantly more confident, after training, in performing procedures, and managing pediatric emergencies (p < 0.001). After the simulation-based curriculum, trainees demonstrated an increase in medical knowledge of 19% (p < 0.01) and improvement in procedural skills from baseline to mastery of 18%, 20%, 16%, and 19% for intubation, bag-valve mask ventilation, intravenous access, and intraosseous access respectively (p < 0.01). At 6-month follow-up, self-efficacy in procedural skills and management of pediatric emergencies improved from baseline. CONCLUSIONS A simulation-based curriculum is an effective and sustainable way to improve Indian post-graduate EM trainees' self-efficacy, knowledge, and skills in pediatric emergency care.
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Affiliation(s)
- T Ahluwalia
- Division of Emergency Medicine, Children's National Medical Center, 111 Michigan Ave NW, Washington DC, 20010, USA. .,Department of Pediatrics, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, 20010, USA.
| | - S Toy
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, USA
| | - C Gutierrez
- Division of Emergency Medicine, Children's National Medical Center, 111 Michigan Ave NW, Washington DC, 20010, USA.,Department of Pediatrics, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, 20010, USA
| | - K Boggs
- Department of Pediatrics, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, 20010, USA
| | - K Douglass
- George Washington University School of Medicine and Public Health, Washington DC, USA
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Garg A, Toy S, Tripodis Y, Cook J, Cordella N. Influence of maternal depression on household food insecurity for low-income families. Acad Pediatr 2015; 15:305-10. [PMID: 25454368 DOI: 10.1016/j.acap.2014.10.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 10/03/2014] [Accepted: 10/05/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To examine whether maternal depression predicts future household food insecurity for low-income families. METHODS This was a secondary data analysis using data from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). The study cohort consisted of 2917 low-income mothers, defined as <185% federal poverty level, who were food secure at baseline. Maternal data collected when children were 9 and 24 months of age were used. Data at 9 months were considered baseline, and data at 24 months were considered follow-up. Baseline maternal depressive symptoms were measured by a 12-item abbreviated version of the Center for Epidemiologic Studies Depression Scale. Household food insecurity at follow-up was measured by the US Department of Agriculture Household Food Security Scale. RESULTS At baseline, 16% of mothers were depressed (raw score >9). Most mothers were white, unemployed, and born in the United States. The majority received Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (86%); 39% received Supplemental Nutrition Assistance Program (SNAP). At follow-up, 11.8% of mothers reported household food insecurity. In multivariable analysis, maternal depression at baseline was significantly associated with food insecurity at follow-up (adjusted odds ratio 1.50; 95% confidence interval 1.06-2.12). CONCLUSIONS Our results suggest that maternal depression is an independent risk factor for household food insecurity in low-income families with young children. Multidisciplinary interventions embedded within and outside the pediatric medical home should be developed to identify depressed mothers and link them to community-based mental health and food resources. Further longitudinal and interventional studies are needed to understand and address the complex relationship between poverty, maternal depression, social safety nets, and food insecurity.
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Affiliation(s)
- Arvin Garg
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Mass.
| | - Sarah Toy
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Mass
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, Mass
| | - John Cook
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Mass
| | - Nick Cordella
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Mass
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Abstract
OBJECTIVE To evaluate the effect of a clinic-based screening and referral system (Well Child Care, Evaluation, Community Resources, Advocacy, Referral, Education [WE CARE]) on families' receipt of community-based resources for unmet basic needs. METHODS We conducted a cluster randomized controlled trial at 8 urban community health centers, recruiting mothers of healthy infants. In the 4 WE CARE clinics, mothers completed a self-report screening instrument that assessed needs for child care, education, employment, food security, household heat, and housing. Providers made referrals for families; staff provided requisite applications and telephoned referred mothers within 1 month. Families at the 4 control community health centers received the usual care. We analyzed the results with generalized mixed-effect models. RESULTS Three hundred thirty-six mothers were enrolled in the study (168 per arm). The majority of families had household incomes <$20,000 (57%), and 68% had ≥ 2 unmet basic needs. More WE CARE mothers received ≥ 1 referral at the index visit (70% vs 8%; adjusted odds ratio [aOR] = 29.6; 95% confidence interval [CI], 14.7-59.6). At the 12-month visit, more WE CARE mothers had enrolled in a new community resource (39% vs 24%; aOR = 2.1; 95% CI, 1.2-3.7). WE CARE mothers had greater odds of being employed (aOR = 44.4; 95% CI, 9.8-201.4). WE CARE children had greater odds of being in child care (aOR = 6.3; 95% CI, 1.5-26.0). WE CARE families had greater odds of receiving fuel assistance (aOR = 11.9; 95% CI, 1.7-82.9) and lower odds of being in a homeless shelter (aOR = 0.2; 95% CI, 0.1-0.9). CONCLUSIONS Systematically screening and referring for social determinants during well child care can lead to the receipt of more community resources for families.
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Affiliation(s)
- Arvin Garg
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts;
| | - Sarah Toy
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts
| | - Yorghos Tripodis
- Boston University School of Public Health, Department of Biostatistics, Boston, Massachusetts; and
| | - Michael Silverstein
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts
| | - Elmer Freeman
- Center for Community Health Education, Research and Service, Northeastern University, Boston, Massachusetts
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Piper DW, Pym BM, Toy S, Gellatly R, Byth K, Seville P. The effect of maintenance cimetidine therapy on the medical, social and economic aspects of patients with chronic gastric ulcers. A placebo-controlled prospective study. Med J Aust 1986; 145:400-3. [PMID: 3093827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We studied the effect of cimetidine maintenance therapy on the socioeconomic life of patients with gastric ulcers in the year after healing and the extent to which treatment was cost-effective. One hundred and seventy patients with a healed ulcer were studied for periods of up to one year after healing; 116 patients completed one year of observation. A double-blind randomized prospective study was performed that compared cimetidine (400 mg at night) with placebo. Analysis was performed on the intention-to-treat principle. The treated group showed benefit over the placebo group; major or minor symptoms were experienced on fewer days, and more months were symptom-free. Male patients were wakened with ulcer pain on fewer nights, led a more normal social life, and had less ulcer-related sick-leave; female patients had less total sick leave. The proven ulcer recurrence rate was lower in the treated group. Fewer endoscopies were performed in this group and the resultant cost saving was equivalent to the cost expenditure on cimetidine treatment. A modest saving in wages was afforded treated patients in the workforce, due to the reduction in sick leave. The principal benefit of cimetidine treatment appeared to be the lessening of the pain and discomfort and, hence, the distress and anxiety that was associated with ulcer disease. The cost-saving due to the reduced number of endoscopies compensated for the cost-expenditure of the cimetidine treatment.
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