Exploratory investigation of virtual lesions in gastrointestinal endoscopy using a novel phase-shift method for three-dimensional shape measurement.

Accurate measurement of the size of lesions or distances between any two points during endoscopic examination of the gastrointestinal tract is difficult owing to the fisheye lens used in endoscopy. To overcome this issue, we developed a phase-shift method to measure three-dimensional (3D) data on a curved surface, which we present herein. Our system allows the creation of 3D shapes on a curved surface by the phase-shift method using a stripe pattern projected from a small projecting device to an object. For evaluation, 88 measurement points were inserted in porcine stomach tissue, attached to a half-pipe jig, with an inner radius of 21 mm. The accuracy and precision of the measurement data for our shape measurement system were compared with the data obtained using an Olympus STM6 measurement microscope. The accuracy of the path length of a simulated protruded lesion was evaluated using a plaster model of the curved stomach and graph paper. The difference in height measures between the measurement microscope and measurement system data was 0.24 mm for the 88 measurement points on the curved surface of the porcine stomach. The error in the path length measurement for a lesion on an underlying curved surface was <1% for a 10-mm lesion. The software was developed for the automated calculation of the major and minor diameters of each lesion. The accuracy of our measurement system could improve the accuracy of determining the size of lesions, whether protruded or depressed, regardless of the curvature of the underlying surface.

A new method to orient a 3-dimensional facial model to natural head position: A preliminary report on accuracy and reproducibility.

OBJECTIVES: To establish and validate a novel method to orient a 3-dimensional (3D) facial model to natural head position (NHP) in a stereophotogrammetric system using a 2-dimensional frontal full-face photograph of NHP. MATERIAL AND METHODS: Specific technique procedure was reported for our method, and in vitro model experiment was performed for accuracy test. A preliminary volunteer study was then planned for reproducibility test. RESULTS: The accuracy on a 3D-printed test model was within 0.15°. Within an observational cohort of 22 dental students, the angular deviations of different maxillofacial regions (e.g., central forehead, left and right zygomatic regions, apex of nose and mental region) were no more than 2° between the 3D NHP models acquired with a shorter time-interval (1 h from baseline) or a longer time-interval (7 days from baseline), which were all considered clinically insignificant. In addition, the angular deviations were significantly larger with a 7d-interval than with a 1h-interval, indicting a decline in 3D NHP reproducibility over short time duration. CONCLUSION: The current method may represent a clinically useful protocol for recording and transferring 3D NHP in stereophotogrammetry. CLINICAL RELEVANCE: It may provide reliable and meaningful reference information for evaluating craniofacial morphology, and be of clinical use in the diagnosis, treatment and follow-ups of patients with aesthetic or deformed craniofacial problems.

Endmember extraction and abundance estimation algorithm based on double-compressed sampling.

Based on double-compressed sampling, a hyperspectral spectral unmixing algorithm (SU_DCS) is proposed, which could directly complete the endmember extraction and abundance estimation. On the basis of the linear mixed model (LMM), we designed spatial and spectral sampling matrices, obtained spatial and spectral measurement data, and constructed a joint unmixing model containing endmember and abundance information. By using operator separation and Lagrangian multiplier algorithm, the endmember matrix, abundance matrix and remixing image can be quickly obtained by matrix operation. The parameters of the unmixing algorithm, including regularization parameter, convergence threshold and spatial sampling rate, are determined using synthetic simulated hyperspectral data. The proposed algorithm is applied to two kinds of real hyperspectral data, with or without ground truth, in order to verify the effectiveness and reliability of the algorithm. Firstly, we provide the performance of the algorithm on real datasets without ground truth. Compared with algorithm VCA_FCLS and algorithm CPPCA_VCA_FCLS, the endmember spectral curve extracted by the proposed SU_DCS is almost consistent with that obtained by VCA_FCLS, and is more smooth than that of obtained by CPPCA_VCA_FCLS. Additionally, the abundance estimation map estimated by the SU_DCS has consistency with the results obtained by VCA_FCLS. Moreover, the proposed SU_DCS has higher peak signal-to-noise ratio (PSNR) for remixing images with higher computational efficiency. Secondly, we provide the performance of the proposed algorithm on four real datasets with ground truth, including dataset Cuprite, dataset Samson, dataset Jasper and dataset Urban. We provide the results of endmember extraction and abundance estimation from the compressed data under different sampling rate conditions. The extracted endmember maintains good consistency with the true spectral curves, and the estimated abundance map can also maintain good spatial consistency with the ground truth. The comparison results with other four comparative algorithms also indicate that the proposed algorithm can obtain relatively accurate endmembers and abundance information from compressed data, the reliability and validity of the proposed algorithm have been proved. In summary, the main innovation of the proposed algorithm is that it can extract endmembers and estimate abundance with high accuracy from a small amount of measurement data.

Comparison of CT and MRI in diagnosing occult hip fracture: a systematic review and meta-analysis.

OBJECTIVE: To compare the diagnostic accuracy of computed tomography (CT) scans and magnetic resonance imaging (MRI) in detecting occult hip fractures. METHODS: We conducted a systematic literature review and identified 12 articles involving 1,819 participants for inclusion. Data extraction and quality assessment were performed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Publication bias was assessed with the Deek funnel plot asymmetry test. We conducted a meta-analysis using a random-effects model to derive pooled estimates of sensitivity, specificity, positive and negative likelihood ratios, and the diagnostic odds ratio, along with their 95% confidence intervals. A summary receiver operating characteristic curve was generated to illustrate the overall diagnostic accuracy. RESULTS: The methodological quality of the included studies was high, with minimal concerns about the applicability of the tests in clinical settings. Both CT and MRI showed good diagnostic efficacy for occult hip fractures. However, MRI consistently outperformed CT, exhibiting significantly higher sensitivity, specificity, and likelihood ratios, thereby providing superior accuracy in confirming or excluding occult fractures. Meta-regression analysis revealed that sequence parameters and sample size significantly influenced the differences in sensitivity and specificity between CT and MRI. CONCLUSION: Both CT and MRI are effective modalities for detecting occult hip fractures, with MRI demonstrating greater diagnostic accuracy. This meta-analysis supports the use of MRI when higher sensitivity and specificity are required in clinical practice.

Feasibility of Ultrasound-based Measurement of the Intra-scaphoid Using a Three-point Measurement Technique.

INTRODUCTION: Ultrasound is gaining popularity for diagnosing scaphoid fractures. However, it hasn't been used to assess fracture displacement, such as humpback deformity. We propose a sonographic method to measure the intra-scaphoid angle, potentially serving as an alternative to CT scans for detecting fragment malposition after a scaphoid fracture. METHODS: We recruited 11 healthy adult volunteers without wrist pathology and performed bilateral wrist ultrasounds, totaling 22 examinations. Each wrist was splinted at 50 ° extension and fully supinated. Two hand surgeons independently performed the ultrasounds. All images were then evaluated separately by two evaluators. The following measurements were taken: Inter-poles distance (IPD): Distance between the summits of the two scaphoid poles on the palmar cortex. Palmar cortical intra-scaphoid angle (PCISA): Angle between the two summits and the deepest point of the waist on the palmar cortex. Measurements were compared for inter-investigator and inter-evaluator reliability using the intraclass correlation coefficient (ICC). RESULTS: The study included four males and seven females, with an average age of 35 years (range 21-56). The mean PCISA was 142 ° (SD 10 °) and the mean IPD was 16.3 mm (SD 2.1 mm). Differences in IPD measurements averaged 0.3 mm (range 0 to 5.2 mm) among investigators and 1.0 mm (range 0.1 to 3.8 mm) among evaluators. For PCISA, the differences averaged 4 ° (range 0 to 17 °) among investigators and 6 ° (range 0 to 15 °) among evaluators. The ICC for IPD was 0.804 (investigators) and 0.572 (evaluators); for PCISA, it was 0.704 (investigators) and 0.602 (evaluators). CONCLUSION: This study presents a cost-effective and accessible sonographic technique to measure the intra-scaphoid angle. Further research is required to assess its effectiveness in scaphoid fractures and compare it to CT-based measurements like the H/L ratio, LISA, and DCA.

Validation of the lead Care II system in Cape vultures (Gyps coprotheres) in comparison to ICP-MS using pure standards.

Lead toxicosis remains a concern in raptors, especially following feeding on carcasses sourced from hunting. Rapid diagnosis of lead exposure and easy field monitoring is desirable. The LeadCareII analytical system, validated for rapid diagnoses of lead toxicity in humans, has been described as a useful evaluation system in various species. For this study we attempt to validate the LeadCareII system in the Cape Vulture (CV)(Gyps coprotheres). Blood samples from CV housed under captive conditions and low background lead exposure, were pooled and spiked with known concentrations of a lead standard (0 to 60µg/dL. Samples were analysed by the LeadCareII system and by ICP-MS. The final results showed that despite good linearity the LeadCareII system underestimated lead concentrations by up to 50%. While the results can be corrected by the derived equation, this is not supported due to the large underestimations evident. The reason for the underestimation is presently unknown.

Graphophonological-semantic flexibility and its contribution to reading comprehension in children with dyslexia: A pilot study.

Graphophonological-semantic flexibility is the cognitive flexibility in reading that enables individuals to manage multiple phonological and semantic aspects of text simultaneously. This study investigated graphophonological-semantic flexibility and its contribution to reading comprehension in children with dyslexia, comparing them to age-matched, typically developing peers. Thirty children aged 8-11 were assessed using a reading-specific sorting task, where they categorized word cards by initial phoneme and meaning within a 2x2 matrix. After sorting, participants explained their arrangements, and their sorting speed, accuracy, and composite scores were evaluated. Additionally, reading comprehension was assessed through passages followed by questions. Results revealed significant differences between children with dyslexia and their peers in sorting accuracy and composite scores. Children with dyslexia exhibited poorer accuracy and longer sorting times, leading to lower composite scores indicative of reduced graphophonological-semantic flexibility. Age showed a positive correlation with sorting accuracy and composite scores. Moreover, sorting accuracy and composite scores were strong predictors of reading comprehension. These findings suggest that children with dyslexia face challenges in managing both phonological and semantic aspects of text concurrently, highlighting the importance of graphophonological-semantic flexibility in reading development.

Accuracy of continuous glucose monitoring in the hospital setting: an observational study.

AIMS/HYPOTHESIS: Continuous glucose monitoring (CGM) improves glycaemic outcomes in the outpatient setting; however, there are limited data regarding CGM accuracy in hospital. METHODS: We conducted a prospective, observational study comparing CGM data from blinded Dexcom G6 Pro sensors with reference point of care and laboratory glucose measurements during participants' hospitalisations. Key accuracy metrics included the proportion of CGM values within ±20% of reference glucose values >5.6 mmol/l or within ±1.1 mmol/l of reference glucose values ≤5.6 mmol/l (%20/20), the mean and median absolute relative difference between CGM and reference value (MARD and median ARD, respectively) and Clarke error grid analysis (CEGA). A retrospective calibration scheme was used to determine whether calibration improved sensor accuracy. Multivariable regression models and subgroup analyses were used to determine the impact of clinical characteristics on accuracy assessments. RESULTS: A total of 326 adults hospitalised on 19 medical or surgical non-intensive care hospital floors were enrolled, providing 6648 matched glucose pairs. The %20/20 was 59.5%, the MARD was 19.2% and the median ARD was 16.8%. CEGA showed that 98.2% of values were in zone A (clinically accurate) and zone B (benign). Subgroups with lower accuracy metrics included those with severe anaemia, renal dysfunction and oedema. Application of a once-daily morning calibration schedule improved accuracy (MARD 11.4%). CONCLUSIONS/INTERPRETATION: The CGM accuracy when used in hospital may be lower than that reported in the outpatient setting, but this may be improved with appropriate patient selection and daily calibration. Further research is needed to understand the role of CGM in inpatient settings.

Deep Inspiration breath Hold facilitates surgical cavity registration on cone beam imaging for Partial breast irradiation.

BACKGROUND AND PURPOSE: The quality of the Cone Beam Computed Tomography (CBCT) images used for patient set-up is essential to avoid geographical miss when narrower margins or shorter fractionation are used for example in Accelerated Partial Breast Irradiation (APBI). This study evaluates deep inspiration breath hold (DIBH) with skin guided radiotherapy as a tool for image improvement reducing motion artifacts. MATERIALS AND METHODS: Daily CBCT images of left and right breast cancer patients with well-defined surgical cavity on CT simulation were used for this study. Only left sided CBCT were acquired with DIBH. Trained and experienced radiation therapists were asked to evaluate the image quality using a cavity visualization score (CVS), an image quality Likert score, and to perform registration shifts. Images were anonymized and therapists were blinded to the use of DIBH. RESULTS: Images from 21 patients, with 15 CBCT each, were evaluated by 6 radiation therapists, generating 4,015 evaluation points. Statistically significant improvements were observed in CVS and image quality (p < 0.001) with DIBH. Also, the rate of surgical cavity identification increased to 76 % with DIBH compared to 56 % without (p < 0.001). DIBH significantly reduced the inter-observer variability in registration shift corrections (p < 0.001) CONCLUSION: Utilizing DIBH for motion control improves both the image quality and the surgical cavity identification. This results in a decrease in registration variability, which is important for APBI accuracy.

Prevalence of and survival with cachexia among patients with cancer: A systematic review and meta-analysis.

BACKGROUND: Cachexia is associated with lower overall survival in patients with cancer; however, the relationship between the two is reported to differ according to the definitive criteria for diagnosing cachexia. OBJECTIVE: We aimed to investigate the (1) difference in the prevalence of cachexia in patients with cancer and (2) association between cachexia and overall survival, depending on the definitive criteria for diagnosing cachexia in patients with cancer. METHODS: We searched PubMed and Web of Science from their inception until July 31, 2023 to identify eligible studies. We conducted a systematic review of the prevalence of cachexia in patients with cancer and performed a meta-analysis to investigate its relationship with overall survival. RESULTS: A total of 125 articles comprising 137,960 patients were included in the systematic review, and 26 articles consisting of 11,118 patients underwent meta-analysis. The overall prevalence of cachexia in patients with cancer was 33.0% (95% confidence interval [CI], 32.8-33.3); however, it varied according to the definitive criteria for diagnosing cachexia (13.9-56.5%). According to the Fearon 2011 criteria, the prevalence of cachexia was associated with a high hazard ratio (HR) for overall survival compared to that of non-cachexia (HR: 1.58 [95% CI, 1.45-1.73]); according to the other criteria, the HR was 2.78 (95% CI, 1.88-4.11), indicating significant subgroup differences (p = 0.006). The dose-response curve indicated that the HR for overall survival plateaued at a cachexia prevalence range of 40-50% (L-shaped relationship). CONCLUSIONS: The prevalence of cachexia in patients with cancer may vary depending on the definitive criteria used to diagnose cachexia. The HR for overall survival was higher for low cachexia prevalence. The definitive criteria should be carefully considered when assessing cachexia in patients with cancer. This study was registered with PROSPERO as CRD42023435474. STATEMENT OF SIGNIFICANCE: This study provides crucial insights into the prognostic impact of the differential diagnostic criteria for cancer cachexia in clinical practice. We provide quantitative and qualitative evidence of a significant difference in the overall survival and prevalence of cachexia, depending on the definitive criteria for diagnosing cachexia in patients with cancer.

Diabetic retinopathy screening with confocal fundus camera and artificial intelligence - assisted grading.

PURPOSE: Screening for diabetic retinopathy (DR) by ophthalmologists is costly and labour-intensive. Artificial Intelligence (AI) for automated DR detection could be a clinically and economically alternative. We assessed the performance of a confocal fundus imaging system (DRSplus, Centervue SpA), coupled with an AI algorithm (RetCAD, Thirona B.V.) in a real-world setting. METHODS: 45° non-mydriatic retinal images from 506 patients with diabetes were graded both by an ophthalmologist and by the AI algorithm, according to the International Clinical Diabetic Retinopathy severity scale. Less than moderate retinopathy (DR scores 0, 1) was defined as non-referable, while more severe stages were defined as referable retinopathy. The gradings were then compared both at eye-level and patient-level. Key metrics included sensitivity, specificity all measured with a 95% Confidence Interval. RESULTS: The percentage of ungradable eyes according to the AI was 2.58%. The performances of the AI algorithm for detecting referable DR were 97.18% sensitivity, 93.73% specificity at eye-level and 98.70% sensitivity and 91.06% specificity at patient-level. CONCLUSIONS: DRSplus paired with RetCAD represents a reliable DR screening solution in a real-world setting. The high sensitivity of the system ensures that almost all patients requiring medical attention for DR are referred to an ophthalmologist for further evaluation.

Latent Reciprocal Engagement and Accuracy Variables in Social Relations Structural Equation Modeling.

The social relations model (SRM) is the standard approach for analyzing dyadic data stemming from round-robin designs. The model can be used to estimate correlation-coefficients that reflect the overall reciprocity or accuracy of judgements for individual and dyads on the sample- or population level. Within the social relations structural equation modeling framework and on the statistical grounding of stochastic measurement and classical test theory, we show how the multiple indicator SRM can be modified to capture inter-individual and inter-dyadic differences in reciprocal engagement or inter-individual differences in reciprocal accuracy. All models are illustrated on an open-access round-robin data set containing measures of mimicry, liking, and meta-liking (the belief to be liked). Results suggest that people who engage more strongly in reciprocal mimicry are liked more after an interaction with someone and that overestimating one's own popularity is strongly associated with being liked less. Further applications, advantages and limitations of the models are discussed.

Reliability and Accuracy of Ultrasound Measurement of Hip Displacement in Children with Cerebral Palsy.

OBJECTIVE: Hip migration percentage (MP) measured on anteroposterior pelvis radiographs is the gold standard to assess the severity of hip displacement in children with cerebral palsy (CP). Repeated exposure of these children to ionizing radiation under a hip surveillance program is undesirable. Recently, a semi-automatic approach to measure MPUS on ultrasound (US) images was validated in a phantom study. This pilot in vivo study applied the previous phantom method and aimed to determine the reliability and accuracy of the MPUS. METHODS: Thirty-four children (23 boys and 11 girls) aged 8.9 ± 3.1 y old and diagnosed with CP were recruited. A total of 59 hips were scanned once, while 43 of these were scanned twice to evaluate the test-retest reliability. Two raters (R1 and R2) manually measured MPUS; procedures included selecting images of interest, cropping a region of interest and removing soft tissues on hip US images. Custom software was developed to measure MP automatically after the manual pre-image processing. RESULTS: The intra-class correlation coefficients (ICC2,1) for the test-retest (R1), intra-rater (R1) and inter-rater (R1 vs R2) reliabilities were 0.90, 0.94 and 0.82, respectively. The standard error of measurement of MPUS for all three evaluations was ≤3.0%. The mean absolute difference between MPUS and MPX-ray and the percentage of MPUS within clinical acceptance error of 10% for R1 and R2 were (R1: 6.2% ± 4.9%, 84.7%) and (R2: 7.6% ± 6.1%, 73.7%), respectively. CONCLUSION: This study demonstrated that US scans were repeatable and MPUS could be measured reliably and accurately.

Augmenting intensive care unit nursing practice with generative AI: A formative study of diagnostic synergies using simulation-based clinical cases.

BACKGROUND: As generative artificial intelligence (GenAI) tools continue advancing, rigorous evaluations are needed to understand their capabilities relative to experienced clinicians and nurses. The aim of this study was to objectively compare the diagnostic accuracy and response formats of ICU nurses versus various GenAI models, with a qualitative interpretation of the quantitative results. METHODS: This formative study utilized four written clinical scenarios representative of real ICU patient cases to simulate diagnostic challenges. The scenarios were developed by expert nurses and underwent validation against current literature. Seventy-four ICU nurses participated in a simulation-based assessment involving four written clinical scenarios. Simultaneously, we asked ChatGPT-4 and Claude-2.0 to provide initial assessments and treatment recommendations for the same scenarios. The responses from ChatGPT-4 and Claude-2.0 were then scored by certified ICU nurses for accuracy, completeness and response. RESULTS: Nurses consistently achieved higher diagnostic accuracy than AI across open-ended scenarios, though certain models matched or exceeded human performance on standardized cases. Reaction times also diverged substantially. Qualitative response format differences emerged such as concision versus verbosity. Variations in GenAI models system performance across cases highlighted generalizability challenges. CONCLUSIONS: While GenAI demonstrated valuable skills, experienced nurses outperformed in open-ended domains requiring holistic judgement. Continued development to strengthen generalized decision-making abilities is warranted before autonomous clinical integration. Response format interfaces should consider leveraging distinct strengths. Rigorous mixed methods research involving diverse stakeholders can help iteratively inform safe, beneficial human-GenAI partnerships centred on experience-guided care augmentation. RELEVANCE TO CLINICAL PRACTICE: This mixed-methods simulation study provides formative insights into optimizing collaborative models of GenAI and nursing knowledge to support patient assessment and decision-making in intensive care. The findings can help guide development of explainable GenAI decision support tailored for critical care environments. PATIENT OR PUBLIC CONTRIBUTION: Patients or public were not involved in the design and implementation of the study or the analysis and interpretation of the data.

Complete-arch accuracy of seven intraoral scanners measured by the virtual-fit method.

OBJECTIVES: This study compared the accuracy of seven intraoral scanners (IOS) by the virtual-fit method. METHODS: Four maxillary arches with tooth abutments were scanned with an industrial reference scanner (n=1) and by Aoralscan3, EmeraldS, Helios600, Lumina, Mediti700, Primescan, and Trios5 IOSs (each n=12). Two complete-arch fixed frameworks were designed on each IOS scan with a 70 µm (group 70) and a 90 µm internal cement space (group 70+20, additional 20 µm at the margin). The virtual-fit method was comprised of superimposing the framework designs onto the reference scan using a non-penetrating algorithm simulating the clinical try-in. Internal and marginal gaps were measured. Precision was estimated by the mean absolute errors (MAE). RESULTS: In group 70, Mediti700 (43 µm), Primescan (42 µm), and EmeraldS were in the best homogenous subset for the marginal gap, followed by the Lumina (67 µm), Aoralscan3 (70 µm), and Trios5 (70 µm), whereas Helios600 (118 µm) was in the third subset. Based on the MAE at the margin, Mediti700, Trios5, and EmeraldS were in the first-best homogenous subset, followed by Primescan. Lumina and Helios600 were in the third subset, and Aoralscan3 was in the fourth subset. In group 70+20, the marginal gap was significantly decreased for Lumina and Aoralscan3, whereas MAE significantly decreased for EmeraldS and Aoralscan3. The rank of IOSs was similar for the internal gap. CONCLUSION: EmeraldS, Mediti700, Primescan, and Trios5 meet the marginal and internal fit criteria for fixed tooth-borne complete arch restorations. Increasing the cement space during design could enhance restoration fit. CLINICAL SIGNIFICANCE: The virtual-fit alignment method can effectively evaluate the accuracy of different intraoral scanners, offering valuable clinical guidance for distinguishing among them. Recent software and hardware versions of long-standing IOS manufacturers are suitable for fabricating complete arch restoration.

Do the porous custom implants have a position consistent with the planning and allow anatomical reconstruction of hip center of rotation in complex acetabular revisions Paprosky III?

INTRODUCTION: In revision total hip arthroplasty (THA), the advent of porous custom-made triflange acetabular implants with 3D scan planning offers a new perspective to improve implantation accuracy and anatomical restoration of the center of rotation (COR). This issue was investigated using CT-scan as the measurement tool, but in limited series (±10 cases) and without investigating the factors that may influence errors in positioning. Therefore we performed a retrospective study aiming to: (1) assess the placement accuracy of such implants with respect to the preoperative planning, (2) examine whether the volume of bone to be resected in order to apply the implant had an impact on this accuracy, (3) assess if errors in position at surgery had any influence on function, complications and survival. HYPOTHESIS: Preoperative planning could be accurately reproduced when implanting porous custom-made acetabular implants, and that accuracy would decrease in proportion to the volume of bone to be resected METHOD: Twenty patients undergoing THA revision with porous custom-made acetabular implants were included in this single-center retrospective study. Mean follow-up was 17.9 months ± 9.4 [2-45.1]. Preoperative planning was performed using 3D scanographic modeling. A post-operative CT scan was performed to assess implantation accuracy in terms of orientation and COR restitution. Demographic data, Oxford scores, complications and survival were recorded. RESULTS: Mean deviation from the preoperative planning in inclination, anteversion and rotation were 4.3 ° ± 2.5, 6.1 ° ± 4.7, and 7 ° ± 4.6, respectively. Restoration of the COR showed a mean deviation of 2.1 ± 1.3 mm anteroposteriorly, 2.5 ± 2 mm mediolaterally and 2.2 ± 1.3 mm proximodistally. In total, 45% (9/20) of implants were positioned with perfect restoration of orientation (±10 °) and COR (±5 mm). The mean planned bone resection was 8.1 ± 4.9 cm3, with placement accuracy and COR restitution decreasing significantly when the volume of bone to be resected exceeded 2.7 cm3. One dislocation was found (5%, 1/20). Survival at last follow-up was 100%, the mean Oxford score at follow-up was 31.7 ± 7.9 [16-52], without being influenced by errors in position or COR restitution. CONCLUSION: In total 45% of the implants restored an orientation and a COR as planned, particularly when the volume of bone to be resected is less than 2.7 cm3. Although these are complex cases with large amounts of bone loss, 3D manufacturing could give us hope of greater precision. The link between better precision and low bone resection volume could be an area to develop with the manufacturer in order to improve results. LEVEL OF EVIDENCE: III; diagnostic using CT in transversal retrospective study.

Comparison of the accuracy of hematological parameters in the diagnosis of neonatal sepsis: a network meta-analysis.

BACKGROUND: Currently, there are hundreds of hematological parameters used for rapid diagnosis of neonatal sepsis, but there is no network meta-analysis to compare the diagnostic efficacy of these parameters. METHODS: We searched for literature on the diagnostic neonatal sepsis and selected 20 of the most common parameters to compare their diagnostic efficacy. We used Bayesian network meta-analysis, Frequentist network meta-analysis, and individual traditional diagnostic meta-analysis to analyze the data and verify the stability of the results. Based on the above analysis, we ranked the diagnostic efficacy of 20 parameters and searched for the optimal indicator. We also conducted subgroup analysis based on different designs. GRADE was used to evaluate the quality of evidence. RESULTS: 311 articles were included in the analysis, of which 206 articles were included in the network meta-analysis. Bayesian models fond the top three of the advantage index were P-SEP, SAA, and CD64. In Individual model, P-SEP, SAA, and CD64 had the best sensitivity; ABC, SAA, and P-SEP had the best specificity. Frequentist model showed that CD64, P-SEP, and IL-10 ranked in the top three for sensitivity, while P-SEP, ABC, and I/M in specificity. Overall, P-SEP, SAA, CD64, and PCT have good sensitivity and specificity among all the three methods. The results of subgroup analysis were consistent with the overall analysis. All evidence was mostly of moderate or low quality. CONCLUSIONS: P-SEP, SAA, CD64, and PCT have good diagnostic efficacy for neonatal sepsis. However, further studies are required to confirm these findings.

Comparison of clinical/histological outcomes according to puncture sites in endoscopic ultrasound-guided fine needle biopsy for large pancreatic masses: Multicenter randomized prospective pilot study.

OBJECTIVES: There are no recommendations regarding the optimal puncture site in endoscopic ultrasound-guided fine needle biopsy (EUS-FNB). This multicenter randomized prospective study compared the diagnostic accuracy and histological findings according to the sampling site for pancreatic masses larger than 3 cm. METHODS: Consecutive patients with pancreatic masses larger than 3 cm indicated for EUS-FNB were included in the study. Patients were randomly assigned to two groups for the initial puncture site (central vs. peripheral sampling of the masses). A minimum of four passes were performed, alternating between the center and the periphery. The primary outcome was diagnostic accuracy. RESULTS: A total of 100 patients were equally divided into the central group and the peripheral group. The final diagnosis revealed malignancy in 95 patients (pancreatic cancer [n = 89], neuroendocrine tumor [n = 4], lymphoma [n = 1], metastatic carcinoma [n = 1]), and benign conditions in five patients (chronic pancreatitis [n = 4], autoimmune pancreatitis [n = 1]). There was no significant difference in diagnostic accuracy between the puncture sites. However, combining samples from both areas resulted in higher diagnostic accuracy (97.0%) compared to either area alone, with corresponding values of 88.0% for the center (P = 0.02) and 85.0% for the periphery (P = 0.006). CONCLUSIONS: Both central sampling and peripheral sampling showed equivalent diagnostic accuracy in detecting malignancy. However, combining samples from both areas generated superior diagnostic yield compared to using either sampling site alone. For pancreatic masses larger than 3 cm, it is advisable to consider sampling from various areas of the masses to maximize the diagnostic yield.

AI-based Cleft Lip and Palate Surgical Information is Preferred by Both Plastic Surgeons and Patients in a Blind Comparison.

INTRODUCTION: The application of artificial intelligence (AI) in healthcare has expanded in recent years, and these tools such as ChatGPT to generate patient-facing information have garnered particular interest. Online cleft lip and palate (CL/P) surgical information supplied by academic/professional (A/P) sources was therefore evaluated against ChatGPT regarding accuracy, comprehensiveness, and clarity. METHODS: 11 plastic and reconstructive surgeons and 29 non-medical individuals blindly compared responses written by ChatGPT or A/P sources to 30 frequently asked CL/P surgery questions. Surgeons indicated preference, determined accuracy, and scored comprehensiveness and clarity. Non-medical individuals indicated preference. Calculations of readability scores were determined using seven readability formulas. Statistical analysis of CL/P surgical online information was performed using paired t-tests. RESULTS: Surgeons, 60.88% of the time, blindly preferred material generated by ChatGPT over A/P sources. Additionally, surgeons consistently indicated that ChatGPT-generated material was more comprehensive and had greater clarity. No significant difference was found between ChatGPT and resources provided by professional organizations in terms of accuracy. Among individuals with no medical background, ChatGPT-generated materials were preferred 60.46% of the time. For materials from both ChatGPT and A/P sources, readability scores surpassed advised levels for patient proficiency across seven readability formulas. CONCLUSION: As the prominence of ChatGPT-based language tools rises in the healthcare space, potential applications of the tools should be assessed by experts against existing high-quality sources. Our results indicate that ChatGPT is capable of producing high-quality material in terms of accuracy, comprehensiveness, and clarity preferred by both plastic surgeons and individuals with no medical background.

Brain energy metabolism as an underlying basis to slow-fast cognitive phenotypes in honeybees.

In the context of slow-fast behavioral variation, fast individuals are hypothesized to be those who prioritize speed over accuracy while slow individuals are those which do the opposite. Since energy metabolism is a critical component of neural and cognitive functioning, this predicts such differences in cognitive style to be reflected at the level of the brain. We tested this idea in honeybees by first classifying individuals into slow and fast cognitive phenotypes based on a learning assay and then measuring their brain respiration with high-resolution respirometry. Our results broadly show that interindividual differences in cognition are reflected in differences in brain mass and accompanying energy use at the level of the brain and the whole animal. Bigger brains had lower mass-specific energy usage and those bees with bigger brains had a higher metabolic rate. These differences in brain respiration and brain mass were in turn associated with cognitive differences such that fast cognitive phenotypes were those bees with bigger brains while slow cognitive phenotypes were those with smaller brains. We discuss these results in the context of the role of energy in brain functioning and slow-fast decision making and speed accuracy tradeoff.