Mobile Health Assessment of Traumatic Dental Injuries Using Smartphone-Acquired Photographs: A Multicenter Diagnostic Accuracy Study.

Background: Mobile health (mHealth) has an emerging potential for remote assessment of traumatic dental injuries (TDI) and support of emergency care. This study aimed to determine the diagnostic accuracy of TDI detection from smartphone-acquired photographs. Methods: The upper and lower anterior teeth of 153 individuals aged ≥ 6 years were photographed using a smartphone camera app. The photos of 148 eligible participants were reviewed independently by a dental specialist, two general dentists, and two dental therapists, using predetermined TDI classification and criteria. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and inter-rater reliability were estimated to evaluate the diagnostic performance of the photographic method relative to the reference standard established by the dental specialist. Results: Of the 1,870 teeth screened, one-third showed TDI; and one-seventh of the participants had primary or mixed dentitions. Compared between the specialist's reference standard and four dental professionals' reviews, the diagnostic sensitivity and specificity for TDI versus non-TDI were 59-95% and 47-93%, respectively, with better performance for urgent types of TDI (78-89% and 99-100%, separately). The diagnostic consistency was also better for the primary/mixed dentitions than the permanent dentition. Conclusion: This study suggested a valid mHealth practice for remote assessment of TDI. A better diagnostic performance in the detection of urgent types of TDI and examination of the primary/mixed dentition was also reported. Future directions include professional development activities involving dental photography and photographic assessment, incorporation of a machine learning technology to aid photographic reviews, and randomized controlled trials in multiple clinical settings.

Increased prevalence of the null allele of the p.Arg577Ter variant in the ACTN3 gene in Brazilian long-distance athletes: A retrospective study.

INTRODUCTION: The phenotypic consequences of the p.Arg577Ter variant in the α-actinin-3 (ACTN3) gene are suggestive of a trade-off between performance traits for speed and endurance sports. Although there is a consistent association of the c.1729C allele (aka R allele) with strength/power traits, there is still a debate on whether the null allele (c.1729T allele; aka X allele) influences endurance performance. The present study aimed to test the association of the ACTN3 p.Arg577Ter variant with long-distance endurance athlete status, using previously published data with the Brazilian population. METHODS: Genotypic data from 203 long-distance athletes and 1724 controls were analysed in a case-control approach. RESULTS: The frequency of the X allele was significantly higher in long-distance athletes than in the control group (51.5% vs. 41.4%; p = 0.000095). The R/X and X/X genotypes were overrepresented in the athlete group. Individuals with the R/X genotype instead of the R/R genotype had a 1.6 increase in the odds of being a long-distance athlete (p = 0.012), whereas individuals with the X/X genotype instead of the R/R genotype had a 2.2 increase in the odds of being a long-distance athlete (p = 0.00017). CONCLUSION: The X allele, mainly the X/X genotype, was associated with long-distance athlete status in Brazilians.

Quantitative Performance Evaluation of Commonly Used Colormaps for Image Display in Myocardial Perfusion Imaging: Analysis based on Perceptual Metrics.

Objectives: To quantitatively evaluate the performance of the most used colormaps in image display using perceptual metrics and to what extent these measures are congruent with the true intensity or uptake of pixels at different levels of defect severity in simulated cardiac images. Methods: Six colormaps, labeled "Gray", "Thermal", "Cool", "CEqual", "Siemens" and "S Pet" extracted from FIJI ImageJ software are included. Colormap data are converted from the red, green, blue color space to CIELAB. Perceptual metrics for measuring "color difference" were calculated, including difference (ΔE76) and "speed". The pairwise color difference in every two levels or entries is visualized in a 2-dimensional "heatmap distance matrix" for each colormap. Curves are plotted for each colormap and compared. In addition, to apply this technique to clinical images, simulated short-axis cardiac slices with incremental defect severity (10% grading) were employed. The circumferential profile curves of true pixel intensity, lightness or luminance, and color difference are plotted simultaneously for each defect severity to visualize the concordance of the three curves in various colormaps. Results: In 0% defect, all the curves are at the highest level, except for "s pet", in that the lightness is not at its maximum value. In the phantom with 10% defect (or 90% of maximum value), discrepancies among curves appear. In "Siemens", the ΔE76 drops sharply. In "Siemens" colormap, the ΔE76 drops sharply. In 80% defect, ΔE76 curve, in "gray" colormap drops more slowly than other curves of other colormaps. In "s pet", lightness curve rises paradoxically, although the count intensity and ΔE76 curve match. In 70% defect, again, the curves are in good agreement in "thermal", "Siemens" and "cequal". However, a consistent lag exists in "gray". Up to 50% defect, curves maintain their expected pattern, but in defects more severe than 40%, lightness and ΔE76 curves in "cool" and "cequal" rise paradoxically, and in "thermal", they start to slow down in descent. In "Siemens", falling pattern of the three curves continues. For "s pet" colormap, an erratic pattern of lightness and ΔE76 curves exists. Conclusion: Of 6 colormaps investigated for estimating defect severity, "grayscale" is less favorable than others and "thermal" performs slightly better. "S pet" or rainbow, which is used traditionally by many practitioners, is strongly discouraged. The "Siemens" colormap suffers from decreased discriminating power in the range of mild to moderate/severe. In contrast, the "cool" and "cequal" colormaps outperform the other colormaps employed in this study to some extent, although they have some shortcomings.

The benefits of flushing with Lemuru fish oil as a source of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on the performance of reproductive parameters in Garut ewes.

This study aimed to evaluate and analyze the effects of a flushing diet containing Docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA) from Lemuru (Sardinella sp) fish oil on the reproductive performance parameters of Garut ewes. Forty (n = 40) primiparous Garut ewes aged 12-14 months with an average body weight of 28.92 ± 4.94 kg were assigned into four experimental treatment groups. The experimental diets contained roughage: concentrate (30:70%) designated as control concentrate (CNT), flushing concentrate with 6% palm oil (PO), flushing concentrate with 3% palm oil mixed with 3% lemuru oil as DHA and EPA sources (PFO), and flushing concentrate with the addition of 6% lemuru oil (FO). Treatment animals were fed two weeks before and after conception and parturition (8 weeks of total flushing treatment). The addition of fish oil at either 3% (PFO) or 6% (FO) resulted in significantly higher reproductive performance of ewes by increasing the litter size, as reflected by the birth of multiple kids (P < 0.05) compared to CNT and PO. Adding fish oil (PFO and FO) also maintains gestation, resulting in increased lamb yield, especially in the FO treatment, which yields the highest lamb yield (0% single lamb birth). The lamb male ratio was also higher with fish oil supplementation (PFO and PO) (P < 0.05). This research revealed a positive effect of 6% Lemuru oil on decreasing embryo loss and increasing the proportion of twin births. These findings thus support the hypothesis that ration flushing with double the required DHA and EPA from 6% Lemuru fish oil (FO) resulted in significantly higher reproductive performance in Garut sheep.

Dewatering performance of aerobic granular sludge under centrifugal with different sludge conditioning agent.

The aerobic granular sludge(AGS) technology draw scientific researchers attention, and more and more scientific research focuses on it, due to its superior advantages, such as good settling performance, high biological phase, high toxicity resistance and multiple biological effects. With the rapid development of AGS technology, a considerable amount of residual AGS will be produced, and dehydration is the biggest bottleneck of sludge reduction. This study investigated the dewatering process and method of residual AGS cultured by continuous flow experiment. Experiments were conducted using centrifugal dewatering technology with a dosing scheme to analyze the granular sludge dewatering process, and investigate the release process of EPS component in AGS dewatering. Our results implied the specific resistance of AGS has a very low value ((1.82 ± 0.03) × 109 m/kg) and it was not obvious for the conditioning effect of chemical conditioner on AGS dewatering. However, the moisture content can be reduced to 63.5% after dewatering with the presence of inorganic substances. The addition of drinking water treatment plant sludge (Alum sludge) can improve the efficiency of the dewatering of AGS. A possible dewatering process of AGS dewatering was proposed which was divided into two stages: First, a considerable amount of free water in the sludge was quickly removed under the action of gravity without pressure filtration. Second, the bound water release required cooperation between applying centrifugal or pressing force to grind granular cells and separate protein-like substances with the inorganic matter inside the granular sludge. The possible mechanism of AGS dewatering and hypothesis dewatering process are useful to optimize the AGS dewatering process.

Unskilled and unaware: second-order judgments increase with miscalibration for low performers.

Overestimation and miscalibration increase with a decrease in performance. This finding has been attributed to a common factor: participants' knowledge and skills about the task performed. Researchers proposed that the same knowledge and skills needed for performing well in a test are also required for accurately evaluating one's performance. Thus, when people lack knowledge about a topic they are tested on, they perform poorly and do not know they did so. This is a compelling explanation for why low performers overestimate themselves, but such increases in overconfidence can also be due to statistical artifacts. Therefore, whether overestimation indicates lack of awareness is debatable, and additional studies are needed to clarify this issue. The present study addressed this problem by investigating the extent to which students at different levels of performance know that their self-estimates are biased. We asked 653 college students to estimate their performance in an exam and subsequently rate how confident they were that their self-estimates were accurate. The latter judgment is known as second-order judgments (SOJs) because it is a judgment of a metacognitive judgment. We then looked at whether miscalibration predicts SOJs per quartile. The findings showed that the relationship between miscalibration and SOJs was negative for high performers and positive for low performers. Specifically, for low performers, the less calibrated their self-estimates were the more confident they were in their accuracy. This finding supports the claim that awareness of what one knows and does not know depends in part on how much one knows.

Mn/carbon aerogels derived from the water-induced self-assembly of UIO-66 (Mn) for the thermal decomposition of ammonium perchlorate.

In solid propellants, combustion catalysts play a crucial role. Here, we introduce a convenient method for the self-assembly of UIO-66 (Mn) in the presence of water, leading to the preparation of Mn/C aerogels. The aerogels were successfully utilized in the thermocatalytic decomposition of ammonium perchlorate (AP). The results indicate that the incorporation of 2% mass fraction of Mn/C aerogels enhances the peak temperature of AP decomposition by approximately 87.5°C. Mn/C aerogels demonstrate excellent catalytic performance. In combination with kinetics, we propose a thermal catalytic mechanism.

Variations in strength-speed-power performance across the season: do true changes occur in elite rugby players?

This study aimed to determine, through the use of a highly sensitive statistical tool, whether real changes in performance were present; and compare the rates of meaningful variations in strength, speed, and power parameters at different time-points during the competitive season in national team rugby players. Thirty-two players were assessed 5 times across the season using the following tests: squat jump and countermovement jump tests; 30-m sprint velocity; and one-repetition maximum (1RM) in the half-squat and bench-press exercises. A repeated-measures analysis of variance was conducted to test for differences between successive time-points. Individual coefficients of variation values were used to set target scores for post-measurements and examine whether changes in performance parameters were greater than the natural test variance, thus providing an indication of whether "true changes" occurred. No significant changes were detected in the vertical jump height, 1RM measures, and sprint velocity and momentum throughout the 11-month period (P > 0.05). True changes occurred much more frequently for strength-power measures than for sprint velocity and momentum. Elite rugby union players did not exhibit significant variations in neuromuscular performance across the competitive period, when a group-based analysis was conducted. However, at the individual level, "true changes" in strength-power-(but not in speed-) related qualities were consistently observed over the competitive season.

A new approach to comparing the demands of small-sided games and soccer matches.

To improve soccer performance, coaches should be able to replicate the match's physical efforts during the training sessions. For this goal, small-sided games (SSGs) are widely used. The main purpose of the current study was to develop similarity and overload scores to quantify the degree of similarity and the extent to which the SSG was able to replicate match intensity. GPSs were employed to collect external load and were grouped in three vectors (kinematic, metabolic, and mechanical). Euclidean distance was used to calculate the distance between training and match vectors, which was subsequently converted into a similarity score. The average of the pairwise difference between vectors was used to develop the overload scores. Three similarity (Simkin, Simmet, Simmec) and three overload scores (OVERkin, OVERmet, OVERmec) were defined for kinematic, metabolic, and mechanical vectors. Simmet and OVERmet were excluded from further analysis, showing a very large correlation (r > 0.7, p < 0.01) with Simkin and OVERkin. The scores were subsequently analysed considering teams' level (First team vs. U19 team) and SSGs' characteristics in the various playing roles. The independent-sample t-test showed (p < 0.01) that the First team presented greater Simkin (d = 0.91), OVERkin (d = 0.47), and OVERmec (d = 0.35) scores. Moreover, a generalized linear mixed model (GLMM) was employed to evaluate differences according to SSG characteristics. The results suggest that a specific SSG format could lead to different similarity and overload scores according to the playing position. This process could simplify data interpretation and categorize SSGs based on their scores.

Biological maturity vs. relative age: Independent impact on physical performance in male and female youth handball players.

Maturity status and relative age are two of the determining factors in talent development. The aim of the study was to analyze the influence of biological maturity status and relative age on physical performance in young male and female handball players. The sample included 48 males (14.11 ± 1.17 years) and 41 females (14.25 ± 1.64 years) players from one Spanish professional handball academy. Anthropometric data (height, sitting height, body mass and self-reported biological parent heights) and physical performance data (CMJ, DJ, 20 m speed, T-test and throwing velocity) were collected. Biological maturity status was determined as the percentage of predicted adult height, while relative age was estimated in birth quartiles based on biennial age grouping (Q1-Q8). The results showed a positive correlation between maturity status and CMJ in male players (p < 0.01). Differences in CMJ performance according to maturity status were identified (p < 0.05), with higher jump heights being recorded especially in early maturing boys (p < 0.01) and first lines and wings (p < 0.05). The variance in CMJ test scores could be explained by the maturity status by 42.90% in U-15 (p < 0.05) and 72.60% in U-16 male players (p < 0.001). By contrast, no differences were found in girls (p > 0.05). Moreover, no relationships were found between relative age and indices of physical performance (p > 0.05). Overall, maturity status had greater impacts on the tests of physical performance than relative age. Stakeholders should monitor the maturity status of young handball players to avoid physical performance biases that do not allow them to develop their sporting potential.

Analysing substitutions in recent World Cups and European Championships in male and female elite football - influence of new substitution rules.

Substitutions play a key role in modern football and can substantially affect the physical and overall performance of a team, and the recent substitution rule changes are worth investigating. This study explored the characteristics of substitutions, including different substitution rules, game results, sex, competition stages, tournaments and penalty shoot-outs success rates. We analysed data from a total of 3,738 substitutions from the last 10 years (2013-2023) of European Championships and World Cups, both men's and women's games. Non-parametric tests and chi-square tests were used for statistical analysis with the significance level set at p < 0.05. With the 5-substitution rule, 48% more substitutions occurred compared to the 3-substitution rule (4.26 ± 1.07 vs. 2.87 ± 0.43, p < 0.05) with a slight increase in the average substitution time (70.6 ± 14.3 vs. 69.2 ± 14.6 min, p < 0.05), and 10% more substitutions in the men's game compared to the women's game (p < 0.05). The timing of the first substitution was slightly different in the knock-out stage compared to group stage (59.8 ± 14.7 vs. 57.2 ± 13.3 min, p < 0.05), and the timing for the winning team and drawing team was later than for the losing team (p < 0.05). A total of 13.2% goals were scored by substitutes, with no significant difference between the 5-substitution rule (15.9%) vs the 3-substition rule (12.5%) (p > 0.05). Interestingly, substitute players had a lower success rate in penalty shoot-out compared to starters (61 vs. 74%, p < 0.05). Additionally, substitute player goal scorers entered the pitch later (p < 0.05) in male games compared to female games and in knock-out stage games compared to group games. This study highlights the importance of substitution rules and timing in modern elite football matches. The timing of the first substitution, introduction of substitutes in knock-out stages, and a lower success rate of substitute players in penalty shoot-outs are crucial factors to consider. Coaches can use this information to make strategic substitution decisions to improve team performance.

Blood flow restriction as a post-exercise recovery strategy: A systematic review of the current status of the literature.

The aim of this study was to systematically review the current literature on blood flow restriction (BFR) as a post-exercise recovery strategy. Experimental studies investigating the effect of BFR on recovery after exercise were included. Only studies meeting the following inclusion criteria were selected: (a) studies investigating about BFR as a post-exercise recovery strategy in athletes and healthy individuals; (b) the full text being available in English; (c) experimental research study design. Studies that exclusively analyzed BFR as a recovery strategy during the exercise (e.g., recovery strategy between bouts of exercise) were excluded. A literature review was conducted on the PubMed, Cochrane, and Web of Science electronic databases up until May 7th, 2023. The main findings were that (i) 9 studies investigated passive BFR as a post-exercise recovery strategy, which shows a significant lack of research in both team and individual sports (especially in female populations), and only 2 studies used active BFR protocols; (ii) although a high quality range of studies was observed, there were methodological limitations such as BFR interventions that were usually conducted after fatiguing protocols or fitness tests, which may not represent the real exercise (e.g., a sprint session of 6 sets of 50 m may induce muscle damage but it does not represent the demands of a team sport like rugby or soccer); (iii) there is a lack of consistency in BFR protocols (e.g., number of cycles or duration of the occlusion-reperfusion periods) for recovery; (iv) some studies showed beneficial effects while others found no positive or detrimental effects of BFR as a post-exercise recovery strategy in comparison with the control/SHAM group. In conclusion, only 11 studies investigated BFR as a post-exercise recovery strategy and there is not any significant amount of evidence in team or individual sports (especially in female populations). BFR could be a potential post-exercise recovery strategy, but practitioners should use caution when applying this method of recovery for their athletes and clients. In addition, it would be of interest for high performance-related practitioners to have a better understanding of the benefits of BFR interventions combined with either active or passive forms of exercise as a post-exercise recovery strategy.

Sodium bicarbonate and beta-alanine supplementation: Is combining both better than either alone? A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to determine the effect of combined beta-alanine (BA) and sodium bicarbonate (SB) supplementation on exercise capacity and performance. Four databases (PubMed, SPORTDiscus, Web Of Science and MEDLINE) were searched using relevant terms for studies involving healthy (e.g. no chronic diseases or conditions) male or female adults of any training status (athletes, physically active and non-athletes) and that investigated BA and SB in isolation and combination at any dose on an exercise outcome. Ten studies, totalling 243 individuals, met the criteria with 12 outcomes for each nutritional supplement. No ergogenic effect was detected in this meta-analysis for BA (SMD = 0.18, 95% CI: -0.06; 0.43, p = 0.13, tau2 = 0, tau = 0, I2 = 0.0%) or SB (SMD = 0.17, 95% CI: -0.08; 0.41, p = 0.16, tau2 = 0, tau = 0, I2 = 0.0%) in isolation. However, there was a beneficial effect for the combination of BA and SB (SMD = 0.32, 95% CI: 0.07; 0.57, p = 0.02, tau2 = 0, tau = 0, I2 = 0.0%). Meta-regression identified no differences between supplementing with BA or SB separately (F = 0.58; p = 0.57). Combining BA and SB improved exercise performance, however, there was no benefit in taking these supplements individually.

Match running performance is influenced by possession and team formation in an English Premier League team.

The aim of this study was to examine the possession (very low, low, high, and very high), team formation (3-5-2 and 4-3-3) and position (centre-backs, full-backs, centre midfielders, attacking midfielders, and centre forwards) on match load across two consecutive seasons in elite soccer. Twenty-seven English Premier League outfield players were recruited. Data was monitored through an 18 Hz Global Positioning System and a 25 Hz semi-automated camera tracking system, respectively, and all variables were analysed per minute. Main effects for formation on total distance (TD) (p = 0.006; η 2 = 0.010), high-speed running (HSR) (p = 0.009; η 2 = 0.009), number of high metabolic load (HML) efforts (p = 0.004; η 2 = 0.011) were observed. In addition, there were significant interaction effects with formation × possession on TD (p < 0.001; η 2 = 0.043), HSR (p = 0.006; η 2 = 0.018), sprinting (p < 0.001; η 2 = 0.030), HML efforts (p < 0.001; η 2 = 0.035), accelerations (p < 0.001; η 2 = 0.025). From the position-specific analysis, only the running performance of centre-backs was affected by formation or positional factors. These results indicate that formation and possession can have a significant impact on TD, HSR, and HML distance. Furthermore, players performed more high-intensity efforts in 3-5-2 than 4-3-3 formation. These findings suggest that coaches can evaluate running performance in the context of formation and possession and tailor tactical strategies to optimise physical performance.

Effects of different ischemic pressures on bar velocity during the bench press exercise: A randomized crossover trial.

The main objective of this study was to evaluate the effects of different ischemic pressures applied during rest intervals on bar velocity during the bench press exercise. 10 resistance-trained males (age = 23.2 ± 2.7 years; body mass = 83.9 ± 9 kg; body height = 181 ± 5.2 cm; bench press 1 repetition maximum (1RM) = 125 ± 16.4 kg; training experience = 5.4 ± 3.4 years) participated in the study. During 4 experimental sessions, following a randomized crossover design, the subjects performed 5 sets of 3 repetitions of the bench press exercise with a load of 60% 1RM under conditions: with ischemia (50% or 80% of arterial occlusion pressure), with SHAM ischemia (20 mmHg) and without ischemia (control condition). For the ischemic conditions cuffs were applied before each set for 6.5 min and released 30 s before the start of the set as reperfusion (6.5 min ischemia + 0.5 min reperfusion). In the control condition, ischemia was not applied. The two-way repeated measures ANOVA showed no significant condition × set interaction for mean bar velocity (MV; p = 0.17) and peak bar velocity (PV; p = 0.66). There was also no main effect of condition for MV (p = 0.58) and PV (p = 0.61). The results indicate that ischemic or SHAM treatment (6.5 minutes ischemia or SHAM + 30 s reperfusion) does not affect mean and peak bar velocity during the bench press exercise regardless of the applied pressure.

Acute effects of exercise-induced muscle damage on sprint and change of direction performance: A systematic review and meta-analysis.

The aim of this study is to determine the acute effects of resistance and plyometric training on sprint and change of direction (COD) performance in healthy adults and adolescents. A systematic literature search was conducted via Medline, Cinahl, Scopus and SportDiscus databases for studies that investigated: 1) healthy male, female adults, or adolescents; and 2) measured sprint or change of direction performance following resistance and plyometric exercises. Studies were excluded if: 1) resistance or plyometric exercises was not used to induce muscle damage; 2) conducted in animals, infants, elderly; 3) sprint performance and/or agility performance was not measured 24 h post muscle damaging protocol. Study appraisal was completed using the Kmet Quality Scoring for Quantitative Study tool. Forest plots were generated to quantitatively analyse data and report study statistics for statistical significance and heterogeneity. The included studies (n = 20) revealed sprint and COD performance was significantly impaired up to 72 hr following resistance and plyometric exercises; both protocols significantly increased creatine kinase (CK), delayed-onset muscle soreness (DOMS) and decreased countermovement jump (CMJ) up to 72 hr. The systematic review of 20 studies indicated that resistance and plyometric training significantly impaired sprint and COD performance up to 72 hours post-exercise. Both training protocols elevated exercise-induced muscle damage (EIMD) markers (CK, DOMS) and decreased CMJ performance within the same timeframe.

The acute effects of nonsleep deep rest on perceptual responses, physical, and cognitive performance in physically active participants.

This study aimed to examine the effect of nonsleep deep rest (NSDR) on physical and cognitive performance, as well as sleepiness, acute readiness, recovery, stress, and mood state in physically active participants. A total of 65 physically active participants (42 male, 23 female) were randomly assigned into two groups: an experimental group (NSDR, n = 34), in which participants completed a 10-min NSDR intervention, and a control group (CON, n = 31), whereby participants sat passively for 10 min. Testing measures were assessed immediately pre and 10 min post each condition and comprised completing a hand grip strength dynamometer test and a countermovement jump test on force plates, cognitive function measures via a psychomotor vigilance task (PVT-B), and a Simon task test, along with four questionnaires to assess sleep, recovery, and mood state. A significant Group × Time interaction favored the NSDR condition for handgrip strength, median reaction time during the PVT-B, and accuracy percentage during the Simon task. Questionnaire responses demonstrated NSDR to be associated with significant benefits to physical readiness, emotional balance, overall recovery, negative emotional state, overall stress, and tension in comparison to CON (p < .05). The NSDR intervention could be a valuable strategy for acutely enhancing overall well-being and readiness.

The verification of the utility of a commercially available phantom combination for quality control in contrast-enhanced mammography.

Contrast-enhanced mammography is being increasingly implemented clinically, providing much improved contrast between tumour and background structures, particularly in dense breasts. Although CEM is similar to conventional mammography it differs via an additional exposure with high energy X-rays (≥ 40 kVp) and subsequent image subtraction. Because of its special operational aspects, the CEM aspect of a CEM unit needs to be uniquely characterised and evaluated. This study aims to verify the utility of a commercially available phantom set (BR3D model 020 and CESM model 022 phantoms (CIRS, Norfolk, Virginia, USA)) in performing key CEM performance tests (linearity of system response with iodine concentration and background subtraction) on two models of CEM units in a clinical setting. The tests were successfully performed, yielding results similar to previously published studies. Further, similarities and differences in the two systems from different vendors were highlighted, knowledge of which may potentially facilitate optimisation of the systems.

The trend of the quality of cause-of-death data and its association with socio-economic indicators in Serbia in the period 2005-19.

This study aims to evaluate the temporal trend in the quality of cause-of-death data and garbage code profiles and to determine its association with socio-economic status in Serbia. A longitudinal study was assessed using data from mortality registers from 2005 to 2019. Computer application Analysis of Causes of National Deaths for Action (ANACONDA) calculates the distribution of garbage codes by severity and composite quality indicator: Vital Statistics Performance Index for Quality (VSPI(Q)). A relationship between VSPI(Q) and country development was estimated by analysing two socio-economic indicators: the Socio-demographic Index and the Human Development Index (HDI). Serbia indicates progress in strengthening cause-of-death statistics. The steady upward trend of the VSPI(Q) index has risen from 55.6 (medium quality) to 70.2 (high quality) over the examined years. Significant reduction of 'Insufficiently specified causes with limited impact' (Level 4) and an increase in the trend of 'High-impact garbage codes' (Levels 1 to 3) were evident. Decreased deaths of no policy value (annual percentage change of -1.41%) have manifested since 2014. A strong positive association between VSPI(Q) and socio-economic indicators was assessed, where the HDI has shown a stronger association with VSPI(Q). Improved socio-economic conditions on the national level are followed by enhanced cause-of-death data quality. Upcoming actions to improve quality should be directed at high-impact garbage codes. The study underlines the need to prioritise the education and training of physicians with a crucial role in death certification to overcome many cause-of-death quality issues identified in this assessment.

Is Boundary Annotation Necessary? Evaluating Boundary-Free Approaches to Improve Clinical Named Entity Annotation Efficiency: Case Study.

BACKGROUND: Named entity recognition (NER) is a fundamental task in natural language processing. However, it is typically preceded by named entity annotation, which poses several challenges, especially in the clinical domain. For instance, determining entity boundaries is one of the most common sources of disagreements between annotators due to questions such as whether modifiers or peripheral words should be annotated. If unresolved, these can induce inconsistency in the produced corpora, yet, on the other hand, strict guidelines or adjudication sessions can further prolong an already slow and convoluted process. OBJECTIVE: The aim of this study is to address these challenges by evaluating 2 novel annotation methodologies, lenient span and point annotation, aiming to mitigate the difficulty of precisely determining entity boundaries. METHODS: We evaluate their effects through an annotation case study on a Japanese medical case report data set. We compare annotation time, annotator agreement, and the quality of the produced labeling and assess the impact on the performance of an NER system trained on the annotated corpus. RESULTS: We saw significant improvements in the labeling process efficiency, with up to a 25% reduction in overall annotation time and even a 10% improvement in annotator agreement compared to the traditional boundary-strict approach. However, even the best-achieved NER model presented some drop in performance compared to the traditional annotation methodology. CONCLUSIONS: Our findings demonstrate a balance between annotation speed and model performance. Although disregarding boundary information affects model performance to some extent, this is counterbalanced by significant reductions in the annotator's workload and notable improvements in the speed of the annotation process. These benefits may prove valuable in various applications, offering an attractive compromise for developers and researchers.