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BACKGROUND: Artificial intelligence (AI) chatbots, such as ChatGPT, have made significant progress. These chatbots, particularly popular among health care professionals and patients, are transforming patient education and disease experience with personalized information. Accurate, timely patient education is crucial for informed decision-making, especially regarding prostate-specific antigen screening and treatment options. However, the accuracy and reliability of AI chatbots' medical information must be rigorously evaluated. Studies testing ChatGPT's knowledge of prostate cancer are emerging, but there is a need for ongoing evaluation to ensure the quality and safety of information provided to patients. OBJECTIVE: This study aims to evaluate the quality, accuracy, and readability of ChatGPT-4's responses to common prostate cancer questions posed by patients. METHODS: Overall, 8 questions were formulated with an inductive approach based on information topics in peer-reviewed literature and Google Trends data. Adapted versions of the Patient Education Materials Assessment Tool for AI (PEMAT-AI), Global Quality Score, and DISCERN-AI tools were used by 4 independent reviewers to assess the quality of the AI responses. The 8 AI outputs were judged by 7 expert urologists, using an assessment framework developed to assess accuracy, safety, appropriateness, actionability, and effectiveness. The AI responses' readability was assessed using established algorithms (Flesch Reading Ease score, Gunning Fog Index, Flesch-Kincaid Grade Level, The Coleman-Liau Index, and Simple Measure of Gobbledygook [SMOG] Index). A brief tool (Reference Assessment AI [REF-AI]) was developed to analyze the references provided by AI outputs, assessing for reference hallucination, relevance, and quality of references. RESULTS: The PEMAT-AI understandability score was very good (mean 79.44%, SD 10.44%), the DISCERN-AI rating was scored as "good" quality (mean 13.88, SD 0.93), and the Global Quality Score was high (mean 4.46/5, SD 0.50). Natural Language Assessment Tool for AI had pooled mean accuracy of 3.96 (SD 0.91), safety of 4.32 (SD 0.86), appropriateness of 4.45 (SD 0.81), actionability of 4.05 (SD 1.15), and effectiveness of 4.09 (SD 0.98). The readability algorithm consensus was "difficult to read" (Flesch Reading Ease score mean 45.97, SD 8.69; Gunning Fog Index mean 14.55, SD 4.79), averaging an 11th-grade reading level, equivalent to 15- to 17-year-olds (Flesch-Kincaid Grade Level mean 12.12, SD 4.34; The Coleman-Liau Index mean 12.75, SD 1.98; SMOG Index mean 11.06, SD 3.20). REF-AI identified 2 reference hallucinations, while the majority (28/30, 93%) of references appropriately supplemented the text. Most references (26/30, 86%) were from reputable government organizations, while a handful were direct citations from scientific literature. CONCLUSIONS: Our analysis found that ChatGPT-4 provides generally good responses to common prostate cancer queries, making it a potentially valuable tool for patient education in prostate cancer care. Objective quality assessment tools indicated that the natural language processing outputs were generally reliable and appropriate, but there is room for improvement.
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Educación del Paciente como Asunto , Neoplasias de la Próstata , Humanos , Masculino , Educación del Paciente como Asunto/métodos , Inteligencia ArtificialRESUMEN
Numerical simulations of D y 3+-doped aluminosilicate fiber lasers for yellow light emission are presented. The 4 F 9/2â6 H 13/2 laser transition emitting at approximately 580 nm has been developed experimentally with 445 nm diode pumping and shows promise for higher output power in both silicate and in particular fluoride glass hosts. In this report, we focus on accumulating the published spectroscopic data in order to quantify cross relaxation (CR) in each of these hosts and use it to estimate its role in the laser dynamics. The model involves calculation of the branching ratios, and radiative and nonradiative decay rates and compares well with reported experimental results. We show the important role of the background losses on previous laser performance and the relatively strong increase in the laser threshold as a result of CR despite the moderately low D y 3+ concentrations that have been experimentally tested.
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OBJECTIVE: This systematic review (PROSPERO ID: CRD42022226375) aimed to identify the eHealth literacy of men with prostate cancer, and their caregivers. METHODS: 8 databases (MEDLINE, SCOPUS, EMBASE, Web Of Science, PsycINFO, ERIC, CINAHL, Cochrane CENTRAL) and grey literature sources (e.g. Google Scholar) were searched from inception to December 2023. Articles were included if assessing eHealth/digital literacy of men with prostate cancer, or their carers', and health outcome associations. Formats such as case reports, and review papers were excluded. Records and full texts underwent independent screening and data extraction. Author disagreements were resolved by discussion. The Mixed Methods Appraisal Tool (MMAT) was used to appraise included literature, with narrative synthesis of results. RESULTS: 21,581 records were retrieved, with 7 articles satisfying inclusion criteria. A heterogenous field was characterised with lack of modern eHealth literacy measurement tools identified. Results suggest novice eHealth literacy using web 1.0 technologies. Non-validated measures of literacy demonstrate mixed results, while health outcome effects limited in scope and reliability. CONCLUSION: Prostate cancer survivors' eHealth literacy levels is likely novice, and requires further investigation. PRACTICE IMPLICATIONS: Digital technologies/resources implemented as part of patient communication practices should be vetted for quality, and tailored to patients' eHealth literacy abilities and/or needs.
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Alfabetización en Salud , Neoplasias de la Próstata , Telemedicina , Humanos , Masculino , Neoplasias de la Próstata/psicología , Cuidadores/psicologíaRESUMEN
When sight-reading a score, a timpanist needs to decide in real-time which stick to use to play a specific note while interpreting the musical material. Our main point of inquiry seeks to understand which sticking patterns performers employ and how they are affected by rhythmic stability. This paper analyzes the bi-manual sequencing (i.e., sticking) patterns of 31 timpanists in a sight-reading task. We analyze their results compared to model sticking patterns common in percussion pedagogical literature. Results show that while hand dominance plays an essential role in an individual's sticking pattern, the stability of a rhythmic pattern may also dramatically influence the observed particular sticking strategies. In areas of rhythmic stability, performers largely adhered to one of two conventional sticking patterns in the literature (dominant hand lead & alternating). Where rhythmic patterns became more unstable, the performers separated into diverse sticking groups. Moreover, several performers demonstrated sticking patterns which were hybrids or an inverse of the model sticking patterns, without any impact on the success of their sight-reading abilities. Overall, no two individual performers demonstrated the same sticking pattern. In terms of percussion pedagogy, our findings suggest that performers may benefit from an awareness of the adaptability of model sticking strategies. Lastly, we make the case for further study of rhythmic stability and bi-manual sequencing by locating the difference between notational and aural complexity.
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We reviewed the various theoretical relations that quantify light scattering under the Rayleigh-Debye-Gans (RDG) approximation and applied these relations to calculate scattering within transparent glass ceramics (TGCs) composed of large nanocrystals within a glass matrix. For a more realistic picture of scattering, we included material dispersion of the crystals and glasses across the transparency range of these materials by way of the Sellmeier equation. We first selected a number of crystal-glass sets that are near-index-matched in the visible and near-IR to fulfill one of the RDG criterion. We found that the various forms of scattering under the RDG approximation differ significantly across the visible and near-IR. We also found that the inclusion of material dispersion significantly changes the trends in the calculated scattering cross section across the studied wavelength range. Overall, we found that calculation of the scattering cross section is highly dependent on the chosen theoretical relation and that the inclusion of material dispersion is vital to better understand scattering loss in this new class of optical materials.
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An optical window is a critical component of an imaging system. When operating in harsh environments with extreme heating, nonuniform temperature changes occur throughout the window and cause nonuniform refractive index changes and mechanical deformations due to thermal expansion, which can degrade the imaging system's performance. In this paper, we present results collected from an experimental setup developed to characterize these aberrations. This setup includes a C O 2 laser for sample heating, an infrared camera for measuring front and back surface temperatures, and a visible imaging system and a wavefront sensor for measuring degradations of a collimated beam from a point source transmitted through the heated window. Sapphire samples are laser heated with a Gaussian profile to temperatures in excess of 500 K with surface temperature gradients in excess of 15 K/mm. These measurements are compared with first principles models, which show quantitative agreement for window temperatures and qualitative agreement with the transmitted wavefront and imaged point source.
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Objective: To describe a novel RoboSling technique performed at the time of robot-assisted radical prostatectomy (RARP) and its utility for enhancing urinary function recovery postoperatively. Materials and Methods: The surgical technique involves harvesting a vascularised, fascial flap from the peritoneum on the posterior aspect of the bladder. Following completion of prostatectomy, the autologous flap is tunnelled underneath the bladder and incorporated into the rectourethralis and vertical longitudinal detrusor fibres at the posterior bladder neck with a modified Rocco suture. After urethra-vesical anastomosis is completed, the corners of the flap are hitched up to Cooper's ligament bilaterally with V-Loc sutures, tensioned and secured creating a bladder neck sling. A prospective, longitudinal cohort study was performed of 193 consecutive patients undergoing RARP between December 2016 and September 2019. The first 163 patients underwent standard RARP, and the last 30 patients had the RoboSling technique performed concurrently. Continence outcomes were the primary outcomes assessed using pad number and Expanded Prostate Cancer Composite (EPIC)-urinary domain questionnaire. Operative time (OT), estimated blood loss (EBL), complications and oncological outcomes were secondary outcomes. Results: The two groups were comparable for demographics and clinicopathological variables. At 3 months, zero pad usage (p = 0.005) and continence rates, defined as EPIC score ≥ 85 (p = 0.007), were both higher in the RoboSling group. EBL, complication rate and positive surgical margin rate did not differ between the two groups. Superior zero pad usage was observed at 1 year in the RoboSling group (p = 0.029). The RoboSling technique added on average 16 min to OT. Conclusions: The RoboSling procedure at the time of RARP was associated with earlier return to continence without negatively impacting other postoperative outcomes. This improvement in continence outcomes was maintained long term.
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OBJECTIVES: The purpose of this study is to conduct the first bibliometric analysis which examines eHealth communication technologies in prostate cancer care, and the utilization of internet-based health information and communication technology by men with prostate cancer. METHODS: Original articles were extracted from the Science Citation Index Expanded (SCI-E) on Web of Science (WOS) and analyzed concerning their distributions. Quantitative guidance directed investigation of findings from previous studies and trending issues within the field. The WOS, VOSViewer and CiteSpace IV were used for information analysis. RESULTS: 302 articles were included in the final analysis. There has been a 165 % increase in productivity over the past decade. The leading country by publication was the USA (145 articles = 48.02 %). Journals which published the highest number of original articles were the Journal of Medical Internet Research (6.95 %), and Patient Education and Counseling (4.64 %). DISCUSSION AND PRACTICE IMPLICATIONS: The field of research which examines utilization and impacts of internet-based health information on men with prostate cancer is growing and diverse. Research frontiers are 'Information quality and diversity', 'eHealth literacy', 'decision making', and 'survivorship and advanced disease'. Clinicians should be aware of several significant limitations which exist within the current field of research.
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Neoplasias de la Próstata , Telemedicina , Masculino , Humanos , Comunicación , Bibliometría , Neoplasias de la Próstata/terapia , TecnologíaRESUMEN
We report the high-efficiency operation of a 3.05 µm dysprosium-doped fluoroindate glass fiber laser that is in-band pumped at 2.83 µm using an erbium-doped fluorozirconate glass fiber laser. The demonstrated slope efficiency of the free-running laser of 82% represents approximately 90% of the Stokes efficiency limit; a maximum output power of 0.36 W, the highest for a fluoroindate glass fiber laser, was recorded. Narrow-linewidth wavelength stabilization at 3.2 µm was achieved by utilizing a first-reported, to the best of our knowledge, high-reflectivity fiber Bragg grating inscribed in the Dy3+-doped fluoroindate glass. These results lay the foundation for future power-scaling of mid-infrared fiber lasers using fluoroindate glass.
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INTRODUCTION: Demand for donor kidneys far exceeds the availability of organs from deceased donors. Living donor kidneys are an important part of addressing this shortfall, and laparoscopic nephrectomy is an important strategy to reduce donor morbidity and increase the acceptability of living donation. AIM: To retrospectively review the intraoperative and postoperative safety, technique, and outcomes of patients undergoing donor nephrectomy at a single tertiary hospital in Sydney, Australia. METHOD: Retrospective capture and analysis of clinical, demographic, and operative data for all living donor nephrectomies performed between 2007 and 2022 at a single University Hospital in Sydney, Australia. RESULTS: Four hundred and seventy-two donor nephrectomies were performed: 471 were laparoscopic, two of which were converted from laparoscopic to open and hand-assisted nephrectomy, respectively, and one (.2%) underwent primary open nephrectomy. The mean warm ischemia time was 2.8 min (±1.3 SD, median 3 min, range 2-8 min) and the mean length of stay (LOS) was 4.1 days (±1.0 SD). The mean renal function on discharge was 103 µmol/L (±23.0 SD). Seventy-seven (16%) patients had a complication with no Clavien Dindo IV or V complications seen. Outcomes demonstrated no impact of donor age, gender, kidney side, relationship to the recipient, vascular complexity; or surgeon experience, on complication rate or LOS. CONCLUSION: Laparoscopic donor nephrectomy is a safe and effective procedure with minimal morbidity and no mortality in this series.
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Trasplante de Riñón , Laparoscopía , Donadores Vivos , Nefrectomía , Humanos , Australia , Riñón/fisiología , Riñón/cirugía , Laparoscopía/métodos , Nefrectomía/métodos , Estudios Retrospectivos , Recolección de Tejidos y Órganos/métodosRESUMEN
Aims: The dosages and efficacy of 14 ultraviolet (UV) decontamination technologies were measured against a SARS-CoV-2 surrogate virus that was dried onto different materials for laboratory and field testing. Methods and results: A live enveloped, ribonucleic acid (RNA) virus surrogate for SARS-CoV-2 was dried on stainless steel 304 (SS304), Navy Top Coat-painted SS304 (NTC), cardboard, polyurethane, polymethyl methacrylate (PMMA), and acrylonitrile butadiene styrene (ABS) materials at > 8.0 log10 plaque-forming units (PFU) per test coupon. The coupons were then exposed to UV radiation during both laboratory and field testing. Commercial and prototype UV-emitting devices were measured for efficacy: four handheld devices, three room/surface-disinfecting machines, five air disinfection devices, and two larger custom-made machines. UV device dosages ranged from 0.01 to 729 mJ cm-2. The antiviral efficacy among the different UV devices ranged from no decontamination up to nearly achieving sterilization. Importantly, cardboard required far greater dosage than SS304. Conclusion: Enormous variability in dosage and efficacy was measured among the different UV devices. Porous materials limit the utility of UV decontamination. Significance and impact of the study: UV devices have wide variability in dosages, efficacy, hazards, and UV output over time, indicating that each UV device needs independent technical measurement and assessment for product development prior to and during use.
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Urachal adenocarcinomas are rare cancers of the urinary bladder. Both CT and MRI are useful imaging modalities for the diagnosis and evaluation of urachal adenocarcinoma. Unlike CT or MR, there have been variable FDG PET findings with urachal tumours potentially due to considerable variation in their hypermetabolism. We present the case of a 24 year-old female patient who was diagnosed with urachal mucinous adenocarcinoma with characteristic features on CT and MRI which also exhibit moderately increased FDG avidity.
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Mode-locked mid-infrared (MIR) fiber laser research has been dominated by the generation of pulses in the picosecond regime using saturable absorbers (SAs) and more recently frequency shifted feedback (FSF). Despite the significant emphasis placed on the development of materials to serve as the SAs for the MIR, published pulse durations have been substantially longer than what has been reported in the near-infrared (NIR). In this report we present experimental data supporting the view that the majority of demonstrations involving SAs and FSF have been limited by the presence of molecular gas absorption in the free-space sections of their cavities. We show that the pulse duration is directly linked to the width of an absorption-free region of the gaseous absorption profile and that the resulting optical spectrum is nearly always bounded by strong absorption features.
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AIMS: Electrical neuromodulation of bladder function has been extensively investigated in the literature. To date, there has been no characterization of the field, and there is a lack of bibliometric literature to guide future studies. We directed this scientometric analysis to characterize the distribution, characteristics and relationships of the field, with subanalysis of top 100 articles. METHODS: The Web of Science Core Collection of the Thompson Reuters Web of Science was searched and analyzed to determine distributions and characteristics of clinical research investigating electrical neuromodulation in bladder dysfunction. Field citation and coauthorship networks were mapped, and recent citation bursts of the past decade are described. The top 100 cited articles were categorized, with level of evidence rating system applied. RESULTS: A total of 872 articles published from 1949 until October 2020 were included in field analysis. Europe demonstrated the highest continental productivity within field (n = 539, 61.81%), and the United States the top nation (35.55% of field, 39.24% of top 100 articles). The Journal of Urology has historically published the most articles in the field (n = 150, 17.20%), and top 100 articles (n = 41, 40.20%). Top 100 articles reported studies of neuromodulation effects via sacral neuromodulation (n = 59); of non-neurological bladder dysfunction (n = 72); urinary incontinence (n = 92), frequency (n = 73) and urgency (n = 68) symptomology. CONCLUSIONS: Analysis of electrical neuromodulation of bladder dysfunction literature reveals historical development, core research clusters and relationships, and an increase in publication activity over past decades.
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Incontinencia Urinaria , Urología , Bibliometría , Europa (Continente) , Humanos , Vejiga UrinariaRESUMEN
We report, to the best of our knowledge, the first mode-locked fiber laser to operate in the femtosecond regime well beyond 3 µm. The laser uses dual-wavelength pumping and nonlinear polarization rotation to produce 3.5 µm wavelength pulses with minimum duration of 580 fs at a repetition rate of 68 MHz. The pulse energy is 3.2 nJ, corresponding to a peak power of 5.5 kW.
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We demonstrate operation of a mid-infrared dysprosium-doped fiber laser with emission at 3388 nm, representing the longest wavelength yet achieved from this class of laser, to the best of our knowledge. Oscillation far removed from the Dy3+ gain peak around 3 µm is achieved through the design of a high feedback optical cavity employing a directly inscribed fiber Bragg grating as the output coupler. Laser performance is characterized by a slope efficiency with respect to injected pump power of 38% and maximum output power of 134 mW, an improvement of at least three orders of magnitude over prior attempts at long wavelength Dy3+ fiber laser operation. This wavelength coincides with a maximum in the absorption coefficient of PMMA, which we exploit for preliminary demonstration of the utility of this source in polymer processing.
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Piomiositis , Infecciones Estafilocócicas , Antibacterianos/uso terapéutico , Humanos , Músculos Pectorales/diagnóstico por imagen , Músculos Pectorales/cirugía , Piomiositis/diagnóstico por imagen , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/tratamiento farmacológicoRESUMEN
Emphysematous Pyelonephritis (EP) is a rare necrotizing renal parenchymal infection characterised by gas within the kidney parenchyma. Management with emergency nephrectomy has transitioned to a graded medical, radiological intervention and surgical approach. We present a rare case of high-risk emphysematous pyelonephritis, outlining key high risk factors and demonstrating staggered care escalation within a rural Australian referral hospital.
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The mid-infrared (MIR) represents a large portion of the electromagnetic spectrum that is progressively being exploited for an enormous number of applications. Thermal imaging cameras, dental and skin resurfacing lasers, and narcotics detectors at airports are all mainstream examples involving the MIR, but potential applications of MIR technologies are much larger. Accessing the unique opportunities afforded by the MIR is critically dependent on the specific characteristics of MIR emitting sources that become available. In this review, we survey an important enabling technology to the opening up of MIR science and applications, namely that driven by fiber-based sources of coherent MIR radiation. In this review paper, we describe many of the key advances in the innovation and development of such sources over the past few decades and discuss many of the underlying science and technology issues that have resulted in specific recent source achievements, especially in light of new applications enabled by these new source capabilities. We also discuss a few specific anticipated future needs and some potentially disruptive approaches to future MIR fiber source development.