Investigation of diagnostic value of artificial intelligence systems in the diagnosis of breast cancer based on histopathological images using Meta-MUMS DTA tool

ORIGINAL ARTICLES Epidemiology Biostatistics and Public Health - 2020, Volume 17, Number 2Investigation of diagnostic value of artificial intelligence systems in the diagnosis of breast cancer based on histopathological images using Meta-MUMS DTA toolInvestigation of diagnostic value of artificialintelligence systems in the diagnosis of breastcancer based on histopathological imagesusing Meta-MUMS DTA toolABSTRACTBackground: Various artificial intelligence systems are available for diagnosing breast cancer based onhistopathological images. Assessing the performance of existing methodologies for breast cancer diagnosis is vital.Methods: The SCOPUS database has been searched for studies up to December 15, 2018. We extracted the data,including "true positive," "true negative," "false positive," and "false negative". The pooled sensitivity, pooled specificity,positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, area under the curve of summary receiveroperating characteristic curve were useful in assessing the diagnostic accuracy. Egger's test, Deeks' funnel plot, SVE(Smoothed Variance regression model based on Egger’s test), SVT (Smoothed Variance regression model based onThompson’s method), and trim and fill methodologies were essential tests for publication bias identification.Results: Three studies with eight approaches from thirty-seven articles were found eligible for further analysis. Asensitivity of 0.95, a specificity of 0.78, a PLR of 7525, an NLR of 0.06, a DOR of 88.15, and an AUC of 0.953showed high significant heterogeneity; however, the reason was not the threshold effect. The publication bias wasdetected by SVE, SVT, and trim and fill analysis.Conclusion: The artificial intelligent (AI) systems play a pivotal role in the diagnosis of breast cancer usinghistopathological cell images and are important decision-makers for pathologists. The analyses revealed that theoverall accuracy of AI systems is promising for breast cancer; however, the pooled specificity is lower than pooledsensitivity. Moreover, the approval of the results awaits conducting randomized clinical trials with sufficient dat

A meta-analysis of systematic reviews and meta-analyses to evaluate the psychological consequences of COVID-19

Abstract Background Several meta-analysis studies have been reported in the literature on the incidence of psychopathological conditions resulting from the COVID-19 pandemic. This investigation aims to compile and analyze the findings of previously published meta-analysis research, as shown by the present meta-analysis of previous meta-analysis studies. Methods The PubMed and Scopus databases were searched from 1 January 2019 to 30 May 2022. The procedure was carried out according to the PRISMA flow chart and the qualities of the identified studies were analyzed using AMSTAR 2. Heterogeneities and risk of bias were assessed using the Meta-MUMS tool. The corresponding results, forest and funnel plots of the psychological consequences of COVID-19 were synthesized. Results Eleven meta-analysis studies were included. Random-effects meta-analysis of anxiety and depression showed (ER = 0.318 p-value < 0.001, ER = 0.295 p-value < 0.001) high heterogeneities (I2 = 99.70%, I2 = 99.75) between studies. Random-effects meta-analyses of sleep difficulties and insomnia were shown (ER = 0.347 p-value < 0.001, ER = 0.265, p-value < 0.001) along with heterogeneities (I2 = 99.89, I2 = 99.64). According to the random meta-analysis of post-traumatic stress syndrome (PTSS) and post-traumatic stress disorder (PTSD) (ER = 0.246, p-value = 0.001, ER = 0.223 p-value < 0.001) with heterogeneities (I2 = 99.75, I2 = 99.17). Random-effects meta-analyses of somatic and fear symptoms have been shown (ER = 0.16 p-value < 0.001, ER = 0.41, p-value = 0.089) with high heterogeneities (I2 = 99.62, I2 = 98.63). Random-effects meta-analysis of obsessive–compulsive symptoms and distress (ER = 0.297 p-value = 0.103; ER = 0.428, p-value = 0.013) with high heterogeneity, as I2 = 99.38%. Subgroup analysis of all symptoms and Egger's tests for detecting publication bias were also assessed. Conclusion The data from the current meta-analysis showed different psychological disorders of COVID-19 during the pandemic. Clinicians should be aware of the prevalence with which COVID-19-infected patients experience emotional distress, anxiety, fatigue, and PTSD. About half of the included systematic reviews (SRs)/meta-analyses (MAs) suffered from poorer methodological quality and increased risk of bias, reducing confidence in the findings. There must be more SRs/MAs and high-quality clinical trials conducted to confirm these findings

A systematic review and meta-analysis on the outcomes of extracorporeal shock wave compared to ureteroscopic lithotripsy for the treatment of ureteral stones

المخلص: أهداف البحث: في هذه المراجعة النظامية والتحليل الشامل، سعى المؤلفون لمعرفة أي من الإجراءات، تفتيت الحصى بالموجات الصدمية خارج الجسم أو تفتيت الحصى بالمنظار البولي، هو الأكثر ملاءمة لعلاج حصى الحالب. طرق البحث: تم إجراء الدراسة الحالية والبحث في قواعد بيانات جوجل سكولار وبوب ميد باستخدام إرشادات بريزما. تم النظر في إجراءات تفتيت الحصى بالموجات الصدمية خارج الجسم مقابل تفتيت الحصى بالمنظار البولي لتحقيق النتائج. قمنا بتقييم مضاعفات كل طريقة، البول الدموي، التمزق، الفشل، إزالة الحصى، توقف الحصى في البداية، وقت العملية، حجم الحصى، الإجراء المساعد، والنتائج الشاملة لتوقف الحصى. تم إجراء التحليل الشامل واختبار التباين وتحليل المجموعة الفرعية والانحدار الميتا وتحليلات الحساسية واختبارات إيجر وإيجر ذو التباين الملساء وتومسون ذو التباين الملساء للكشف عن تحيز النشر لجميع النتائج من الإجراءين.النتائج:حسب عشر دراسات مؤهلة، تم إجراء تحليل شامل لبيانات 1509 مرضى. تم علاج 677 مريضا باستخدام تقنية الصدمات الكهربائية خارج الجسم لتفتيت الحصوات ، وتم علاج الباقي (عدد = 832) باستخدام إجراء تفتيت الحصوات بالمنظار البولي. كانت النتائج على النحو التالي: المضاعفات (معدل الأخطار النسبية = 0.780 ، قيمة الاحتمال = 0.269 ، ك = 13.465 ، قيمة الاحتمال = 0.062، اي2 = 48.011). معدل نسبة الدم في البول (معدل الأخطار النسبية = 0.782 ، قيمة الاحتمال = 0.657 ، ك = 19.056 ، قيمة الاحتمال = 0.001 ، اي2 = 79.01) ، الثقب (معدل الأخطار النسبية = 0.13 ، قيمة الاحتمال = 0.003 ، ك = 0.159 ، قيمة الاحتمال = 0.997 ، اي2 = 0) ، فشل العلاج (معدل الأخطار النسبية = 0.329 ، قيمة الاحتمال = 0.369 ، ك = 22.659 ، قيمة الاحتمال <0.001 ، اي2 = 77.934) ، نسبة تفتيت الحصوات (معدل الأخطار النسبية = 0.699 ، قيمة الاحتمال = 0.374 ، ك = 24.957 ، قيمة الاحتمال <0.001 ، اي2 = 75.959) ، ونسبة الحصوات الحرة بشكل عام (معدل الأخطار النسبية = 0.428 ، قيمة الاحتمال = 0.005 ، ك = 21.462 ، قيمة الاحتمال = 0.011 ، اي2 = 58.066) ، وزمن العملية الجراحية (الانحراف المعياري الموحد = -29.314 ، قيمة الاحتمال <0.001 ، ك = 827.872 ، قيمة الاحتمال <0.001 ، اي2 = 99.758) ، وحجم الحصوات (الانحراف المعياري الموحد = -0.723 ، قيمة الاحتمال = 0.04 ، ك = 261.353 ، قيمة الاحتمال <0.001 ، اي2 = 96.939) ، والنسبة المبدئية للحصوات الحرة (معدل الأخطار النسبية = 0.236 ، قيمة الاحتمال <0.001 ، ك = 7.446 ، قيمة الاحتمال <= 0.059 ، اي2 = 59.712) ، والإجراءات البولية الإضافية (معدل الأخطار النسبية = 0.996 ، قيمة الاحتمال = 0.991 ، ك = 0.816 ، قيمة الاحتمال = 0.665 ، اي2 = 0). الاستنتاجات: أشارت هذه الدراسة إلى أن عمليات تفتيت الحصوات بالموجات الصدمية خارج الجسم وتفتيت الحصوات بالمنظار ضرورية في علاج حصوات الحالب، على الرغم من أن معدل التثقيب أعلى في تفتيت الحصوات بالمنظار مقارنة بإجراءات تفتيت الحصوات بالموجات الصدمية خارج الجسم. في الواقع، تعد المعدلات الإجمالية الخالية من الحصوات أفضل في إجراء تفتيت الحصوات بالمنظار. Abstract: Objectives: In this systematic review and meta-analysis, we sought to identify whether extracorporeal shockwave lithotripsy (ESWL) or ureteroscopic lithotripsy (URSL) is the most appropriate method for treating ureteral stones. Methods: We identified relevant literature by searching the Google Scholar and PubMed databases in accordance with PRISMA guidelines. We focused on the outcomes of extracorporeal shockwave lithotripsy and ureteroscopic lithotripsy. For each method, we compared complications, hematuria, perforation, failure, stone clearance, initial stone-free, operating time, stone size, auxiliary procedures, and overall stone-free outcomes. Our analysis involved meta-analysis, heterogeneity testing, subgroup analysis, meta-regression sensitivity analyses, Egger's tests, Smoothed Variance Egger's (SVE) testing, and Smoothed Variance Thomson (SVT) testing. In addition, we detected publication bias for all outcomes related to the two procedures. Results: Based on ten eligible studies, we conducted a meta-analysis on a total of 1509 patients. Extracorporeal shockwave lithotripsy was used to treat 677 patients; the remaining 832 patients were treated by the ureteroscopic lithotripsy procedure. Considering the meta-analysis statistical parameters including odds ratio (OR), standardized mean difference (SMD), Q, I2 and their p-values, the overall stone-free, operating time, stone size outcomes were identified with significant OR, SMD, and Q values. The hematuria, failure, and stone clearance outcomes were determined to have significant Q values. The perforation and initial stone free outcomes had significant OR values. And, complications and auxiliary urinary procedures were not significant in terms of OR and Q values. Conclusions: Analysis indicated that ESWL and URSL procedures are essential for the treatment of ureteral stones, even though the perforation rate is higher for URSL than for ESWL. Overall stone-free rates were better for the URSL procedure

Multi-vesicular pulmonary hydatid cyst, the potent underestimated factor in the formation of daughter cysts of pulmonary hydatid disease

Pulmonary multi-vesicular hydatid disease (HD) with Echinococcus granulosus is rare. A 28-year-old woman presented to our center with cough and respiratory distress. Chest x-ray and computerized tomography scan revealed bilateral giant cysts with water-lily sign (ruptured hydatid cysts). The left cyst was in vicinity of heart. With thoracotomy cysts of both lungs were removed. Thousands of translucent, homogenized small daughter cysts were discovered from the left side cyst. Pathologic examinations revealed the ruptured hydatid cysts of both lungs with daughter cysts on the left lung cyst. To best of our knowledge probably this is the first report of multi-vesicular HD in lung. We suppose that the heart pulsation was effective in the formation of daughter cysts

Thoracobiliary Fistula of Calcified Hydatid Cyst of the Liver

Thoracobiliary fistula is a rare complication of hydatid cystdisease of the liver especially in calcified form. Given the rarityand high mortality of such fistula, it is not surprising thatthere is no consensus about surgical treatment of this condition.In the present paper we report two cases of thoracobiliaryfistula of complicated calcified hydatid cyst of the liver. A 64-year-old man with cough and biliary sputum and a 66-year-oldman with cough and right biliary pleural effusion (pleurobiliaryfistula). The patients underwent left hepatectomy withcholecystectomy and T-tube choledochal drainage in one patientand successful decortication of the lung, and cystectomywith excision of calcified pericystectomy of the liver in anotherpatient. Pathologic examinations revealed calcified hydatidcysts of the liver. Because of poor prognosis of thoracobiliaryfistula, radical surgical intervention is recommended

Simple tube thoracostomy versus surgical debridement in complicated parapneumonic empyema management

Background: Approach to treat empyema following pulmonary infection, especially in the second stage, is disputed. Therefore, this research aimed to compare the effect of simple tube thoracostomy versus surgical debridement in complicated parapneumonic empyema management. Methods: This prospective randomized trial was conducted in Thoracic Surgery Department of Imam Khomeini Hospital of Tabriz and Dr. Shariati Hospital of Isfahan cities, Iran from March 2003 to September 2015. 104 patients with stage II empyema, divided into two groups (52 patients in each group). Group 1 was treated with simple tube thoracostomy and group 2 with surgical debridement with thoracotomy or thoracoscopy and patients had at least 2 referral after discharge. Personal information, medical history and information of complications and recurrence were recorded in two forms. Finally, data analysis was done by SPSS software version 22 (IBM SPSS, Armonk, NY, USA) and methods of Chi-square test and independent sample t-test. Results: The age-mean of patients under study was 48.17±11.13 years in group 1 and 46.21±13.58 years in group 2 and the most patients were middle-aged (between 40 to 50 years). The number of men in both groups was more than women. 44.23% of patients in group 1 and 38.46% of patients in group 2 had a history of smoking. Duration of hospitalization (P=0.005), a chest tube duration (P=0.004) and duration of treatment (P=0.005) in group 2 was significantly higher than group 1. The complications (P=0.172) and recurrence (P=0.324) in group 2 are non-significantly more than group 1. The complications of treatment, after a week in group 1, are non-significantly higher than group 2 (P=0.690), but complications of treatment after a month in both groups were equal (P=1). Conclusion: Duration of hospitalization, chest tube insertion time and duration of treatment in simple chest tube drainage treatment is shorter than surgery treatment (thoracoscopy or thoracotomy) and simple chest tube drainage treatment is more effectiveness way to treat patients with complicated parapneumonic empyema in stage 2

Comparison of Pulmonary Hydatid Disease between Children and Adults

ABSTRACT Background: Hydatid disease is a parasitic infestation which is endemic in many sheep and cattle raising areas and is stil