Determinants of masticatory performance assessed by mixing ability tests.

STATEMENT OF PROBLEM: Studies determining the main predictors of masticatory performance by using mixing ability tests are sparse. PURPOSE: The purpose of this clinical study was to identify potential determinants of masticatory performance assessed by analyzing a patient's masticatory ability using bicolored chewing gum and visual, quantitative, and interactive methods. MATERIAL AND METHODS: Nondental participants attending healthcare centers were consecutively recruited in Granada, Spain. The inclusion criteria were older than18 years and resident in the coverage area of the reference healthcare centers for at least the previous 6 months. The participants were excluded if they had received dental treatment in the previous 6 months or they were unable to communicate. The masticatory performance was determined by using 2-colored chewing gum (Kiss 3 white and blue; Smint) that was masticated for a total of 20 strokes. The masticated gum was crushed between 2 transparent glass slides, creating a 1-mm-thick specimen that was subsequently scanned. The mixed-color area was calculated as a percentage by using Photoshop as described by Schimmel et al and designated as the standard method. In addition, all images made were analyzed by using the Web application the Chewing Performance Calculator. In addition, the masticated bolus was inspected visually, and mastication performance was classified as being poor, moderate, or good. Sociodemographic data, as well as data on behaviors, medical and nutritional status, health-related quality of life, saliva, and general oral health, were collected for all participants to identify the main determinants of masticatory performance. RESULTS: One hundred thirty-seven participants were enrolled. The masticatory performance values obtained using both methods (standard method and Chewing Performance Calculator) were significantly greater for well masticated gum (P<.001), which had been visually classified as being poorly masticated (69.1% for standard method and 43.5% for Chewing Performance Calculator), moderately masticated (89.7% for standard method and 67.3% for Chewing Performance Calculator), and well masticated (97.3% for standard method and 80.3% for Chewing Performance Calculator). The bivariate analyses revealed that masticatory performance was significantly higher in younger people (<65 years) (P=.008), who also had a higher basal salivary flow rate (P<.001), were nondenture users (P=.002), and had more standing teeth and occlusal units (P<.001). However, the multiple regression analyses showed that the number of occlusal units was the only significant predictor of masticatory performance. In addition, the mean masticatory performance (95% confidence interval: 47.7% to 56.8%) was found to be greatly improved (by 1.2% to 2.2%), with each occlusal unit, in accordance with the Chewing Performance Calculator and between 0.8% and 1.8% according to the standard method; the basal masticatory performance was calculated as 72.1% to 81.2% (95% confidence interval). CONCLUSIONS: The number of occlusal units is one of the main predictors of masticatory performance when a 2-color bolus is used to test mixing ability.

Glimpse: A Gaze-Based Measure of Temporal Salience.

Temporal salience considers how visual attention varies over time. Although visual salience has been widely studied from a spatial perspective, its temporal dimension has been mostly ignored, despite arguably being of utmost importance to understand the temporal evolution of attention on dynamic contents. To address this gap, we proposed Glimpse, a novel measure to compute temporal salience based on the observer-spatio-temporal consistency of raw gaze data. The measure is conceptually simple, training free, and provides a semantically meaningful quantification of visual attention over time. As an extension, we explored scoring algorithms to estimate temporal salience from spatial salience maps predicted with existing computational models. However, these approaches generally fall short when compared with our proposed gaze-based measure. Glimpse could serve as the basis for several downstream tasks such as segmentation or summarization of videos. Glimpse's software and data are publicly available.

No Interface, No Problem: Gesture Recognition on Physical Objects Using Radar Sensing.

Physical objects are usually not designed with interaction capabilities to control digital content. Nevertheless, they provide an untapped source for interactions since every object could be used to control our digital lives. We call this the missing interface problem: Instead of embedding computational capacity into objects, we can simply detect users' gestures on them. However, gesture detection on such unmodified objects has to date been limited in the spatial resolution and detection fidelity. To address this gap, we conducted research on micro-gesture detection on physical objects based on Google Soli's radar sensor. We introduced two novel deep learning architectures to process range Doppler images, namely a three-dimensional convolutional neural network (Conv3D) and a spectrogram-based ConvNet. The results show that our architectures enable robust on-object gesture detection, achieving an accuracy of approximately 94% for a five-gesture set, surpassing previous state-of-the-art performance results by up to 39%. We also showed that the decibel (dB) Doppler range setting has a significant effect on system performance, as accuracy can vary up to 20% across the dB range. As a result, we provide guidelines on how to best calibrate the radar sensor.

Chewing Performance Calculator: An interactive clinical method for quantifying masticatory performance.

STATEMENT OF PROBLEM: There is a need to quantitatively differentiate between impaired and normal mastication by using straightforward and reliable methods because currently available methods are expensive, complex, and time-consuming. PURPOSE: The purpose of this clinical study was to assess the reliability, validity, and clinical utility of a new Web-based software program designed to calculate masticatory performance, the Chewing Performance Calculator (CPC) measuring masticatory performance (MP), by analyzing the area of mixed bicolored chewing gum. MATERIAL AND METHODS: One hundred and ten participants were consecutively recruited from the School of Dentistry of the University of Salamanca. MP was determined by using 2-colored chewing gum that was masticated for a total of 20 strokes. The masticated gum was then flattened between 2 transparent glass tiles, generating a 1-mm-thick specimen that was scanned to calculate the percentage of area where the 2 colors were mixed. The area was calculated by using a photo-editing software program as described by Schimmel et al (standard method). In addition, all the images were analyzed by using the CPC Web application, which took as input the image of the masticated bolus enclosed in a custom plastic platen that allowed 3 parts of the image to be selected interactively: the platen, the bolus background, and the mixed color fraction of the bolus. The application then computed MP as a percentage. Additionally, an oral examination was carried out to record the number of occlusal units. These data were used to assess the validity of CPC by using the Pearson correlation coefficient. Construct validity was assessed by using ANOVA by comparing the MP scores obtained for masticated gums, classified upon inspection as being poorly, moderately, or highly mixed. The time spent evaluating the specimens with GSM and CPC methods was also recorded and used to indicate the usefulness of the procedure. RESULTS: The MP was found to range between 5.2% and 100% (95% CI: 80.8-88.8) with the GSM and between 9.2% and 96.4% (95% CI: 60.0-67.6) with the CPC. The time needed to calculate MP by using the GSM was significantly higher (235.2 versus 260.5 seconds) than that with the CPC (42.3 to 48.6 seconds). Both methods were significantly intercorrelated (r=0.65; P<.001) and correlated with the number of occlusal units (r=0.54 for CPC and r=0.40 for GSM). The correlation coefficient of MP calculated by using CPC (r=0.54; P<.001) was greater than that calculated by using GSM (r=0.40; P<.001). Moreover, both methods showed adequate construct validity because the values calculated for MP significantly increased as the mixing of the masticated gums also increased, subjectively classified as poor, moderate, and high. CONCLUSIONS: The CPC software program allowed MP to be determined in a valid and easy-to-use manner by using 2-colored chewing gum.

Sneaky emotions: impact of data partitions in affective computing experiments with brain-computer interfacing.

Brain-Computer Interfacing (BCI) has shown promise in Machine Learning (ML) for emotion recognition. Unfortunately, how data are partitioned in training/test splits is often overlooked, which makes it difficult to attribute research findings to actual modeling improvements or to partitioning issues. We introduce the "data transfer rate" construct (i.e., how much data of the test samples are seen during training) and use it to examine data partitioning effects under several conditions. As a use case, we consider emotion recognition in videos using electroencephalogram (EEG) signals. Three data splits are considered, each representing a relevant BCI task: subject-independent (affective decoding), video-independent (affective annotation), and time-based (feature extraction). Model performance may change significantly (ranging e.g. from 50% to 90%) depending on how data is partitioned, in classification accuracy. This was evidenced in all experimental conditions tested. Our results show that (1) for affective decoding, it is hard to achieve performance above the baseline case (random classification) unless some data of the test subjects are considered in the training partition; (2) for affective annotation, having data from the same subject in training and test partitions, even though they correspond to different videos, also increases performance; and (3) later signal segments are generally more discriminative, but it is the number of segments (data points) what matters the most. Our findings not only have implications in how brain data are managed, but also in how experimental conditions and results are reported.

On-device query intent prediction with lightweight LLMs to support ubiquitous conversations.

Conversational Agents (CAs) have made their way to providing interactive assistance to users. However, the current dialogue modelling techniques for CAs are predominantly based on hard-coded rules and rigid interaction flows, which negatively affects their flexibility and scalability. Large Language Models (LLMs) can be used as an alternative, but unfortunately they do not always provide good levels of privacy protection for end-users since most of them are running on cloud services. To address these problems, we leverage the potential of transfer learning and study how to best fine-tune lightweight pre-trained LLMs to predict the intent of user queries. Importantly, our LLMs allow for on-device deployment, making them suitable for personalised, ubiquitous, and privacy-preserving scenarios. Our experiments suggest that RoBERTa and XLNet offer the best trade-off considering these constraints. We also show that, after fine-tuning, these models perform on par with ChatGPT. We also discuss the implications of this research for relevant stakeholders, including researchers and practitioners. Taken together, this paper provides insights into LLM suitability for on-device CAs and highlights the middle ground between LLM performance and memory footprint while also considering privacy implications.

MCJ: A mitochondrial target for cardiac intervention in pulmonary hypertension.

Pulmonary hypertension (PH) can affect both pulmonary arterial tree and cardiac function, often leading to right heart failure and death. Despite the urgency, the lack of understanding has limited the development of effective cardiac therapeutic strategies. Our research reveals that MCJ modulates mitochondrial response to chronic hypoxia. MCJ levels elevate under hypoxic conditions, as in lungs of patients affected by COPD, mice exposed to hypoxia, and myocardium from pigs subjected to right ventricular (RV) overload. The absence of MCJ preserves RV function, safeguarding against both cardiac and lung remodeling induced by chronic hypoxia. Cardiac-specific silencing is enough to protect against cardiac dysfunction despite the adverse pulmonary remodeling. Mechanistically, the absence of MCJ triggers a protective preconditioning state mediated by the ROS/mTOR/HIF-1α axis. As a result, it preserves RV systolic function following hypoxia exposure. These discoveries provide a potential avenue to alleviate chronic hypoxia-induced PH, highlighting MCJ as a promising target against this condition.

Virtual angioscopy assessment for acute type B aortic dissection endovascular repair.

INTRODUCTION: Virtual angioscopy 3D reconstruction (VA) based on Multidetector computed tomography (m-CT) can be an important tool in endovascular aortic repair assessment. Here, we present a case of an acute type B aortic dissection, evaluated with preoperative virtual angioscopy 3D reconstruction (VA). CASE REPORT: A 60 years-old-man presented with type B acute aortic dissection. Due to renal malperfusion and uncontrolled hypertension TEVAR and renal stenting was performed based on m-CT and VA images. DISCUSSION: Aortic dissection endovascular repair requires an accurate evaluation based on M-CT or magnetic resonance angiography (MRA). VA is a CT-based 3D reconstruction that provides a sort of information comparable to intravascular ultrasound (IVUS) that can be very helpful when it is not available and has many other potential applications in vascular surgery.

Process-Oriented Instrument and Taxonomy for Teaching Surgical Procedures in Medical Training: The Ultrasound-Guided Insertion of Central Venous Catheter.

Procedural training is relevant for physicians who perform surgical procedures. In the medical education field, instructors who teach surgical procedures need to understand how their students are learning to give them feedback and assess them objectively. The sequence of steps of surgical procedures is an aspect rarely considered in medical education, and state-of-the-art tools for giving feedback and assessing students do not focus on this perspective. Process Mining can help to include this perspective in this field since it has recently been used successfully in some applications. However, these previous developments are more centred on students than on instructors. This paper presents the use of Process Mining to fill this gap, generating a taxonomy of activities and a process-oriented instrument. We evaluated both tools with instructors who teach central venous catheter insertion. The results show that the instructors found both tools useful to provide objective feedback and objective assessment. We concluded that the instructors understood the information provided by the instrument since it provides helpful information to understand students' performance regarding the sequence of steps followed.

Triple-wire: a variation of the "Preclose" technique.

We describe a technical modification of the "Preclose" technique that changes the cross-pattern sutures created with the Prostar XL as in a previously described variation using the Proglide device for longitudinal interrupted sutures. This technique was used in 19 femoral arteries, with satisfactory hemostasis achieved in 17. The variation we describe creates a percutaneous longitudinal interrupted suture that closely resembles a surgical interrupted suture. It adds minimal operative time, no additional technical demands, and no significant material cost. Additionally, it allows better control over suture placement and insertion of a balloon catheter for better proximal bleeding control.

Process-Oriented Feedback through Process Mining for Surgical Procedures in Medical Training: The Ultrasound-Guided Central Venous Catheter Placement Case.

Developing high levels of competence in the execution of surgical procedures through training is a key factor for obtaining good clinical results in healthcare. To improve the effectiveness of the training, it is advisable to provide feedback to each student tailored to how the student has performed the procedure on each occasion. Current state-of-the-art feedback is based on Checklists and Global Rating Scales, which indicate whether all process steps have been carried out and the quality of each execution step. However, there is a process perspective that is not captured successfully by these instruments, e.g., steps performed, but in an undesired order, group of activities that are repeated an unnecessary number of times, or an excessive transition time between two consecutive steps. In this research, we propose a novel use of process mining techniques to effectively identify desired and undesired process patterns regarding rework, the order in which activities are performed, and time performance, in order to complement the tailored feedback for surgical procedures using a process perspective. The proposed approach was applied to analyze a real case of ultrasound-guided Central Venous Catheter placement training. It was quantitatively and qualitatively validated that the students who participated in the training program perceived the process-oriented feedback they received as favorable for their learning.

p38γ and δ promote heart hypertrophy by targeting the mTOR-inhibitory protein DEPTOR for degradation.

Disrupted organ growth leads to disease development. Hypertrophy underlies postnatal heart growth and is triggered after stress, but the molecular mechanisms involved in these processes are largely unknown. Here we show that cardiac activation of p38γ and p38δ increases during postnatal development and by hypertrophy-inducing stimuli. p38γ/δ promote cardiac hypertrophy by phosphorylating the mTORC1 and mTORC2 inhibitor DEPTOR, which leads to its degradation and mTOR activation. Hearts from mice lacking one or both kinases are below normal size, have high levels of DEPTOR, low activity of the mTOR pathway and reduced protein synthesis. The phenotype of p38γ/δ(-/-) mice is reverted by overactivation of mTOR with amino acids, shRNA-mediated knockdown of Deptor, or cardiomyocyte overexpression of active p38γ and p38δ. Moreover, in WT mice, heart weight is reduced by cardiac overexpression of DEPTOR. Our results demonstrate that p38γ/δ control heart growth by modulating mTOR pathway through DEPTOR phosphorylation and subsequent degradation.

Formulation of (18)F-FDG: pH adjustment of buffered solution.

UNLABELLED: The steam-sterilized (18)F-FDG of our laboratory frequently has a pH of around 6.5. To avoid decomposition, we studied the possibility of adjusting the pH by adding a pharmaceutical compound but without modifying the usual production sequence and reagents. METHODS: Citric acid in 4 concentrations (0.01, 0.03, 0.05, and 0.06 M) was added to routine batches of (18)F-FDG. Established pharmacopeia quality controls at 0 and 12 h after synthesis were run, and the dilution effect was checked. RESULTS: A 0.06 M concentration of 1:15 v/v citric acid brought about a pH range of 5.46-5.68; did not change significantly after 1/10 dilution; and did not interfere with quality control. The results of quality control 12 h after dispensing were in the desired range. CONCLUSION: A 0.06 M concentration of 1:15 v/v citric acid modifies pH in a buffered (18)F-FDG solution without the need to change the synthesizer protocol or reagent composition. This new formulation allows pH adjustment; is an easy, reliable, and safe method with no technical difficulties; and does not interfere with the quality of the radiopharmaceutical.

[Arterial trauma in hip arthroplasty]. / Traumatismos arteriales en artroplastia de cadera.

INTRODUCTION: Arterial injuries due to total hip arthroplasty can be a serious complication. The risk of vascular injury is related to proximity of the structures, tractions, and the aggressive use of instruments. OBJECTIVES: To analyze the frequency, injury mechanism, clinical presentation and therapeutic options in this kind of injury. PATIENTS AND METHOD: A group of 4162 patients subjected to total hip arthroplasty between 1986 and 2006 (reinterventions 7.2%). We describe 8 cases (5 women and 3 men) with a mean age of 61 years (reinterventions 50%). The vascular surgery was performed at less than 1 hour (n = 4), 6 hours (n = 2), 16 hours (n = 1) and 20 days (n = 1). RESULTS: The most frequent locations were external iliac artery (n = 3), common femoral (n = 3), internal iliac (n = 1) and deep femoral (n = 1). The clinical presentation was, internal bleeding (50%), acute limb ischemia (37%) and subacute limb ischemia (13%). The surgical interventions were bypass (50%), arteriorrhaphy (25%), primary repair (12.5%), and thrombectomy and patching (12.5%). One case was reoperated 6 years later, as we found a false anastomotic aneurism in a previous ilio-femoral bypass. The death and amputation rates were 0%. CONCLUSIONS: Although these injuries are rare, they involve a life-threatening complication. The external iliac artery/common femoral artery are the most frequent location. Most patients required a bypass, although the surgical technique depends on the injury location.

Esofagólisis por toracoscopía en cáncer del tercio medio del esófago: comunicación preliminar / Esophagolysis for thoracoscopy in mid-third esophageal cancer: preliminar report

Se presenta la experiencia con abordaje videotoracoscópico para realizar la esofagólisis del segmento torácico, en el cáncer del esófago medio. Se fundamenta su conveniencia en la eventual ventaja de eludir la toracotomía posterolateral convencional y sus complicaciones postoperatorias. Se describe la técnica y se presenta la serie inicial de 3 casos realizados entre mayo y agosto de 1992. El tiempo operatorio promedio fue de 90 minutos y la estadía postoperatoria, de 20 días. No se observó complicaciones atribuibles a la técnica