Objective The objective of this observational study was to evaluate telediagnosis of oral lesions using smartphone photography. Materials and Methods Individuals with visible oral lesions composed a convenience sample. The lesions were photographed using a smartphone camera and emailed along with clinical information to three evaluators, who formulated up to two diagnostic hypotheses for each case. A total of 235 photographs from 113 clinical cases were obtained. The evaluators answered questions regarding referral decisions, requests for additional tests, diagnostic difficulties, and image quality. The diagnostic hypotheses were compared to the gold standard by means of percent agreement and kappa coefficient. Consensual face‐to‐face diagnoses of three specialists—when only a clinical diagnosis was necessary—or histopathological results—when a biopsy was necessary—were considered the gold standard. Results The telediagnosis was similar to the gold standard in 76% of the cases, and kappa coefficients showed almost perfect agreement (k = 0.817–0.903). The evaluators considered that referrals could have been avoided on an average of 35,4% of the cases. Conclusion Diagnosis of oral lesions using images taken with a smartphone showed almost perfect agreement and diagnostic accuracy comparable to face‐to‐face diagnosis.
To identify the main barriers to dental care access for patients with inherited bleeding (IBD) and hemoglobin disorders (HbD). Methods: Patients with IBD and HbD were invited to participate in this study between August 2019 and March 2020. Data were collected through a questionnaire consisting of socioeconomic and demographic items and questions about access to dental services and history of dental treatment. Univariate and multiple Poisson regression model was used to determine associations between professional refusal of dental care and other co-variables (p < .05). Results:The participants (29.1%) have already had professional refusal of dental care and participants with IBD (53.2%) did not feel confident with their local dentist due to their bleeding tendency. Most (64.6%) felt apprehensive about visiting the local dentist and high prevalence of refusal to provide dental care was associated with age (prevalence ratio [PR] = 1.021; 95% confidence interval [CI] = 1.010-1.032). Individuals with low bleeding risk were less likely to be denied dental care by a professional compared to those with high bleeding risk (PR = 0.536; 95%CI = 0.291-0.990). Conclusion: Professional refusal of dental care was high among patients with IBD, particularly older adults and with an increased risk of bleeding.
Avaliações das estimativas de disponibilidade hídrica quantitativas se relacionam às gestões territorial de bacias hidrográficas e dos recursos hídricos, e contribuem para o entendimento da segurança hídrica destes espaços, podendo, ainda, orientar práticas de conservação do solo e água, avaliações e monitoramentos quali-quantitativos. Por consequência, a partir de métodos desta estimação, é possível avaliar os aspectos das demandas hídricas e quais as suas dinâmicas, sobretudo, no território das bacias hidrográficas e de conjuntos de municípios. A Região Metropolitana de Belo Horizonte (RMBH), porção central de Minas Gerais, é composta por 34 municípios, contidos, majoritariamente, nas Circunscrições Hidrográficas das bacias dos rios das Velhas (SF5) e Paraopeba (SF3), pressionadas quanto às demandas múltiplas pelos recursos hídricos, incluindo a preponderância do abastecimento público, dos usos industriais e para a mineração. Este estudo objetivou estimar a demanda e disponibilidade hídricas no recorte da RMBH inserido na SF5, avaliando 21 municípios e 12 Unidades Territoriais Estratégicas do Comitê desta bacia. Promoveu discussão regional sobre a disponibilidade, a partir de dados dos usuários de água até novembro/2019. Os cálculos foram baseados no método da avaliação da demanda e disponibilidade hídrica proposto por Semad e Seapa (2016), tendo sido encontrados 9,86% dos trechos em estado de atenção, 57,34% em indisponibilidade, considerando somente os trechos com captação. Os resultados da aplicação deste modelo foram, posteriormente, avaliados à luz da comparação da evolução e distribuição espacial dos usos da terra (entre 1998-2018), em observância, sobretudo, à espacialidade dos trechos com captação, em relação ao crescimento urbano e usos preponderantes. No entanto, estes resultados se mostraram conservadores diante da perspectiva do uso da terra e do ano hidrológico que competiu ao modelo, sinalizando que a metodologia deveria ser, primordialmente, empregada conectada a outras análises. Diante do modelo e seus resultados, refletiu-se sobre a responsabilidade frente às respostas de aplicações como estas, vínculos à gestão das águas e sobre as potencialidades e limitações destas estimativas, quando empregadas, sobretudo no ambiente técnico-científico das Geociências.
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