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Este estudo teve como objetivo avaliar o dimorfismo sexual em uma coleção de mandíbulas portuguesas através de uma metodologia métrica digital, utilizando análise estatística descritiva, inferencial e multivariada para identificar quais parâmetros são mais dimórficos e quais são os melhores preditores de sexo. Trinta e três mandíbulas (14 mulheres e 19 homens) e pertences pessoais foram fotograficamente registrados com código e sexo. Os dados foram coletados por tomografia e as medidas foram feitas pelo software Simplant Pro. Foram registrados a largura máxima e mínima do ramo mandibular, altura condilar, altura do processo coronoide, altura da sínfise mandibular, ângulo mandibular, distâncias bimentual, biantegonial, bigonial e bicondilar e comprimento máximo mandibular. A análise estatística foi realizada utilizando IBM® SPSS. Os resultados mostraram diferenças estatisticamente significativas para os seguintes parâmetros: altura do processo coronoide, altura do côndilo, comprimento máximo da mandíbula e largura mínima do ramo mandibular. Na análise estatística multivariada foi possível identificar a altura do processo coronoide como melhor preditor de sexo com precisão em 72,2% dos casos. Isto permite uma diferenciação mais fácil entre mandíbulas femininas e masculinas com uma precisão de 64,3% e 78,9%, respectivamente. Foi possível concluir que a altura do processo coronoide é o parâmetro mais dimórfico e o melhor preditor de sexo na amostra.
This study aimed to assess sex dimorphism in a collection of Portuguese mandibles through a digital metric methodology by using descriptive, inferential, and multivariate statistical analysis to identify which parameters are the most dimorphic and which are the best sex predictors. Thirty-three mandibles (14 females and 19 males) and personal belongings were photographically registered with code and sex. Data was collected using tomography, and measurements were made using the Simplant Pro software. The maximum and minimum width of the mandibular ramus, condylar height, coronoid process height, mandibular symphysis height, mandibular angle, bi-mental, bi-antegonial, bi-gonial and bi-condylar distances, and maximal mandibular length were registered. Statistical analysis was performed using IBM® SPSS. The results showed statistically significant differences for the following parameters: coronoid process height, condyle height, the maximum length of the mandible, and the minimum width of the mandibular ramus. In the multivariate statistical analysis, it was possible to identify the coronoid process height as the best sex predictor accurately in 72.2% of cases. This allows for easier differentiation between female and male mandibles with an accuracy of 64.3% and 78.9%, respectively. It was possible to conclude that the coronoid process height is the most dimorphic parameter and the best sex predictor in the sample.
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Objetivo: Determinar las habilidades y conocimientos sobre las tecnologías de la información y la comunicación (TIC) de los ingresantes a la carrera de Licenciatura en Enfermería de una institución superior pública de Bahía Blanca, Provincia de Buenos Aires, Argentina. Metodología: Estudio observacional, descriptivo, transversal y cuantitativo. Se implementó un instrumento conformado por 59 preguntas con opciones de respuesta cerrada orientado a valorar las competencias digitales en los ingresantes a la carrera. Resultados: Participaron 386 ingresantes, mayormente de género femenino (85.49 %), del primer ciclo (74.35 %) y con 20 años o menos de edad (47.15 %). El 98.19 % tenía acceso a internet, el 79.27 % tiene computadora y más del 80 % tiene un amplio uso de redes sociales (WhatsApp, Instagram) y correo electrónico. Los ingresantes se autoevaluaron competentes en el programa MS Word, mientras que en MS Excel se declararon menos competentes. Hay desconocimiento y bajo desarrollo de habilidades para generar contenido, y un amplio despliegue de habilidades para buscar y descargar información de la web. La edad, el género, el tiempo diario de uso de internet y el ciclo de ingreso mostraron relación con el dominio de las herramientas digitales aplicadas a la educación. Conclusiones: Se identificó un desarrollo intermedio de competencias digitales aplicadas a la educación, lo que podría ameritar el diseño de programas que nivelen estas habilidades durante el proceso de ingreso o durante la formación.
Objetivo: determinar habilidades e conhecimentos sobre as tecnologias da informação e comunicação (TIC) dos calouros no curso de bacharelado em enfermagem em uma instituição pública de ensino superior na cidade de Bahía Blanca, província de Buenos Aires, Argentina. Metodologia: estudo observacional, descritivo, transversal e quantitativo. Foi utilizado um instrumento composto por 59 perguntas com opções de resposta fechada para avaliar as competências digitais dos calouros do curso. Resultados: Participaram 386 estudantes, em sua maioria do gênero feminino (85,49 %), do primeiro ciclo estudantil (74,35 %) e com idade igual ou inferior a 20 anos (47,15 %). 98,19 % tinham acesso à internet, 79,27 % tinham computador e mais de 80 % usavam amplamente as redes sociais (WhatsApp, Instagram) e o e-mail. Os calouros se auto-avaliaram competentes no programa MS Word, enquanto no MS Excel se declararam menos competentes. Há desconhecimento e baixo desenvolvimento de habilidades para gerar conteúdo e uma ampla demonstração de habilidades para pesquisar e baixar informações da web. A idade, o gênero, o tempo diário de uso da Internet e o ciclo de ingresso estudantil mostraram relação com o domínio das ferramentas digitais aplicadas à educação. Conclusões: Foi identificado um desenvolvimento intermediário de competências digitais aplicadas à educação, o que poderia demandar a concepção de programas que nivelem essas competências durante o processo de admissão ou durante a formação.
Objective: To determine the skills and knowledge about information and communication technologies (ICT) of entrants to the Bachelor's Degree in Nursing at a public higher institution in Bahía Blanca, Province of Buenos Aires, Argentina. Methodology: Observational, descriptive, transversal and quantitative study. An instrument was implemented consisting of 59 questions with closed response options aimed at assessing digital competencies in those entering the career. Results: 386 entrants participated, mostly female (85.49 %), from the first cycle (74.35 %) and 20 years old or younger (47.15%). 98.19 % had access to the internet, 79.27 % have a computer and more than 80 % have extensive use of social networks (WhatsApp, Instagram) and email. The entrants evaluated themselves as competent in the MS Word program, while in MS Excel they declared themselves less competent. There is a lack of knowledge and low development of skills to generate content and a wide range of skills to search and download information from the web. Age, gender, daily time of Internet use and entry cycle showed a relationship with the mastery of digital tools applied to education. Conclusions: An intermediate development of digital competencies applied to education was identified, and a high one for the use of social networks. The variables age, gender, daily time of Internet use and entry cycle were related to the knowledge and skills for using ICT applied to education.
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El artículo se centra en la aplicación de tecnología CAD/CAM en la odontología, específicamente en la fabricación de prótesis dentales totales. Este avance ha transformado la forma en que se diseñan y producen estas prótesis, emergiendo la fabricación de ella mediante capas sucesivas a base de tecnologías de impresión 3D como la estereolitografía, el procesamiento digital de luz y la pantalla de cristal líquido. En la presente revisión se profundizó en aspectos clínicos y biomecánicos, evaluando la retención, adaptación de la base, resistencia a la flexión y límite elástico de las prótesis. Los resultados indican que las prótesis digitales ofrecen mejor retención y adaptación en comparación con los métodos convencionales, aunque no hay diferencias estadísticamente significativas en resistencia a la flexión. También se exploraron aspectos económicos, destacando la reducción de costos y ahorro de tiempo en el proceso clínico con el enfoque digital. Los pacientes experimentan mayor satisfacción con prótesis impresas en 3D en términos de comodidad y eficiencia. Sin embargo, existen limitaciones, como la dificultad en la evaluación estética de prótesis monocromáticas, además de la dependencia de técnicas convencionales para evaluar la funcionalidad del paciente. La tecnología CAD/CAM ha revolucionado la fabricación de prótesis dentales totales, ofreciendo ventajas y beneficios. Este avance tecnológico promete mantener su relevancia en la comunidad científica y odontológica.
The article focuses on the application of CAD/CAM technology in dentistry, specifically in the manufacturing of complete dentures. This advance has transformed the way these dentures are designed and produced, with the manufacturing of layers emerging through successive 3D printing technologies such as stereolithography, digital light processing and liquid crystal display. In the present review clinical and biomechanical aspects were delved into, evaluating retention, adaptation of the base, resistance to flexion and elastic limit of the prostheses. The results indicate that digital prostheses offer better retention and adaptation compared to conventional methods, although there are no statistically significant differences in bending resistance. Economic aspects were also explored, highlighting the cost reduction and time savings in the clinical process with the digital approach. Patients experience greater satisfaction with 3D printed dentures in terms of comfort and efficiency. However, there are limitations, such as the difficulty in the aesthetic evaluation of monochromatic dentures, in addition to the dependence on conventional techniques to evaluate the patient's functionality. CAD/CAM technology has revolutionized the manufacturing of total dental prostheses, offering advantages and benefits. These technological advance promises to maintain its relevance in the scientific and dental community.
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Os avanços dos softwares cirúrgicos e de imagem permitiram a introdução do planejamento em ambiente tridimensional virtual em cirurgia ortognática, o qual tem auxiliado os cirurgiões na tomada de decisões. Nesse contexto, o objetivo deste trabalho é ilustrar um caso clínico de um paciente padrão face III assimétrico utilizando os recursos de diagnóstico e planejamento em ambiente virtual. Neste contexto, a evolução do planejamento virtual auxilia o cirurgião em casos complexos, entretanto é necessária uma curva de aprendizado e melhores estudos clínicos independentes, para avançarmos na obtenção de maior previsibilidade dos resultados em planejamentos em cirurgia ortognática em âmbito virtual... (AU)
Advances in surgical and imaging software allowed the introduction of three-dimensional virtual planning in orthognathic surgery, assisting surgeons in decision making. In this context, the objective was to demonstrate a case report of a facial pattern face III asymmetric patient using diagnostic tools and planning in virtual environment. In this context, the evolution of virtual planning helps the surgeon in complex cases, however, a learning curve and better independent clinical studies are necessary to advance in obtaining greater predictability of results in orthognathic surgery planning in a virtual environment... (AU)
Los avances en software quirúrgico y de imagen han permitido introducir la planificación en un entorno virtual tridimensional en cirugía ortognática, lo que ha ayudado a los cirujanos en la toma de decisiones. En este contexto, el objetivo de este trabajo es ilustrar un caso clínico de un paciente con patrón cara III asimétrico utilizando recursos de diagnóstico y planificación en un entorno virtual. En este contexto, la evolución de la planificación virtual ayuda al cirujano en casos complejos, sin embargo, es necesaria una curva de aprendizaje y mejores estudios clínicos independientes para avanzar en la obtención de una mayor previsibilidad de los resultados en la planificación de la cirugía ortognática en un entorno virtual... (AU)
الموضوعات
Humans , Male , Adult , Imaging, Three-Dimensional , Surgery, Computer-Assisted , Mandible/surgery , Clinical Decision-Makingالملخص
The COVID pandemic has instilled fear in the community creating challenges for household data collection. A community-based household survey was planned to assess knowledge and perception about air pollution caused by vehicular traffic and related ailments among residents of Delhi along with willingness to accept (WTA)/willingness to pay (WTP) discount/premium to discontinue/continue the use of private vehicles for their daily office commute. Access into households was difficult due to heightened sensitivity in post COVID situation. Respondents were not available during working hours. Researchers reached out to participants at workplaces, community events, during weekends or after office hours. Safety of researchers due to odd working hours was a concern. Researchers in post-pandemic world need to plan for multiple modes to access participants. Timelines of the data collection phase need to be sensitive for higher proportion of refusals and necessary permissions. Higher investments in effective communication skills are necessary.
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Resumen La mayor accesibilidad a los tratamientos de reproducción asistida (RA) y los avances de la criobiología produjeron cambios en los laboratorios de andrología. El objetivo de este trabajo fue analizar la demanda y evolución de las variables seminales en las últimas dos décadas, caracterizar el laboratorio andrológico actual, evaluar el impacto de la incorporación del aseguramiento de la calidad y la inclusión de los sistemas computarizados (CASA). Se utilizaron datos de las medias mensuales del control de calidad interno (n=22 528) y encuestas a profesionales de laboratorios andrológicos (n=65) y a médicos especialistas en fertilidad (n=33). La demanda global se redujo significativamente con el aumento de las solicitudes de primera vez. El volumen y recuento, variables dependientes de andrógenos, disminuyeron con los años. El criterio estricto en morfología disminuyó el porcentaje de normales; la mitad de los médicos encuestados recibieron resultados entre 0 y 10% y el 40% consideró que ponía en riesgo el valor clínico de la variable. El sistema CASA permitió objetivar la cinética espermática e incrementar el porcentaje de progresivos rápidos, pero pocos laboratorios lo incorporaron. El 66% de los médicos resuelven el factor andrológico severo por tratamientos clínicos y el 95% utiliza técnicas de RA. El análisis de semen es ejecutado fundamentalmente por bioquímicos especializados, con baja adhesión a la automatización y acreditación del laboratorio, pero con participación en programas de evaluación externa de calidad. La demanda disminuyó como consecuencia del aumento del tratamiento por RA. La reducción del porcentaje de formas normales compromete su utilidad clínica.
Abstract Increasing availability to assisted reproduction (AR) treatments in Argentina and advances in cryobiology resulted in changes in andrology laboratories. The aim of this study was to evaluate the demand and evolution of seminal variables in the last two decades, characterise the current andrology laboratory, evaluate the impact of the incorporation of quality assurance and the introduction of computer assisted semen analysis (CASA). Data were taken from internal quality control (IQC) monthly means (n=22 528) and professionals in charge of laboratories (n=65) and fertility physicians' (n=33) surveys. Overall demand decreased significantly while first-time orders increased. Sperm volume and sperm count -androgen dependent parameters- decreased over the years. Strict morphology criteria reduced the percentage of normal results; half of the physicians received results between 0 and 10% and 40% considered that it compromised the clinical value of the variable. The CASA system made it possible to objectify sperm kinetic, increasing the percentage of fast progressives, but few laboratories have incorporated it. Sixty-six percent of physicians resolve severe andrological factor by clinical treatments and 95% use AR techniques in those cases. Semen analysis is mainly performed by specialised biochemists, with low adherence to laboratory automatisation and accreditation, but with participation in external quality assessment programmes. The demand decreased because of the increase in AR treatment. The lower percentage of normal forms compromises their clinical utility.
Resumo O aumento do acesso aos tratamentos de reprodução assistida (RA) e os avanços na criobiologia levaram a mudanças nos laboratórios de andrologia. O objetivo deste trabalho foi analisar a demanda e a evolução das variáveis de sêmen nas últimas duas décadas, caracterizar o laboratório de andrologia atual, avaliar o impacto da incorporação da garantia da qualidade e a inclusão dos sistemas computadorizados (CASA). Foram utilizados dados das médias mensais do controle de qualidade interno (n= 22 528) e pesquisas a profissionais de laboratórios andrológicos e a médicos especialistas em fertilidade (n=33). A demanda geral diminuiu significativamente com o aumento das solicitações de primeira vez. O volume e a contagem de esperma, parâmetros dependentes de andrógenos, diminuíram ao longo dos anos. O critério morfológico rigoroso diminuiu a porcentagem de normais; metade dos médicos entrevistados recebeu resultados entre 0 e 10% e 40% considerou que isso comprometía o valor clínico do parâmetro. O sistema CASA, permitiu objetivar a cinética espermática e aumentar o percentual de progressões rápidas, mas poucos laboratórios o incorporaram. 66% dos médicos resolvem o fator andrológico grave por tratamentos clínicos e 95% utilizam técnicas de RA nesses casos. A análise do sêmen é realizada principalmente por bioquímicos especializados, com baixa aderência à automação e acreditação laboratorial, mas com participação em programas de avalação externa de qualidade. A demanda diminuiu como consequência do aumento do tratamento por RA. A diminuição em percentagem de formas normais compromete sua utilidade clínica.
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Introducción: La modelación de los flujos de pacientes se considera una herramienta clave para el análisis y mejora de las trayectorias intrahospitalarias. Objetivo: Desarrollar y validar, en un servicio de cirugía general, un modelo matemático para la gestión de flujos de pacientes en servicios hospitalarios. Métodos: Se desarrolló una investigación de tipo cuantitativa descriptiva. Se analizaron diferentes modelos de gestión y se identificaron brechas a solventar. Para su concepción se diseñó un procedimiento metodológico que tiene en cuenta la agrupación de pacientes en categorías diagnósticas mayores, en función de características clínicas homogéneas y similar consumo de recursos. Resultados: Se identificó como problema principal la insuficiente gestión de los flujos de pacientes. Se construyó un modelo matemático de simulación discreta que se validó mediante la comparación de datos reales del servicio y las opiniones subjetivas de especialistas. Se identificó que los recursos limitantes del sistema son las enfermeras y las camas con porcentajes de utilización de 93,377 % y 89,265 % respectivamente. Conclusiones: Se desarrolla un modelo para la gestión de los flujos de pacientes en el servicio de cirugía general y se demuestra su influencia en el análisis, el proceso de toma de decisiones y la mejora de la gestión.
Introduction: Patient flow modeling is considered a key tool for the analysis and improvement of in-hospital trajectories. Objective: To develop and validate a mathematical model for the patient flows management in hospital in a General Surgery service. Methods: A descriptive quantitative research was developed. Different management models were analyzed and gaps to be solved were identified. For its conception, a methodological procedure was designed that takes into account the grouping of patients in Major Diagnostic Categories according to homogeneous clinical characteristics and similar resource consumption. Results: Insufficient patient flow management was identified as the main problem. A mathematical model of discrete simulation was built and validated by comparing real data from the service and the subjective opinions of specialists. It was identified that the limiting resources of the system are nurses and beds with utilization percentages of 93.377% and 89.265% respectively. Conclusions: A model for the patient flows management in the General Surgery service is developed and its influence on the analysis, decision-making process and management improvement is demonstrated.
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RESUMEN Recientes investigaciones destacan la importancia de la ciberseguridad en la creciente era digital. El 83% de las organizaciones han experimentado brechas de seguridad en el 2022, costándoles en promedio 4,35 millones de dólares americanos por incidente. En Perú, la ciberseguridad está regulada por diversas normas, estableciendo medidas de protección de datos y la seguridad informática. Objetivo Describir la situación de la ciberseguridad en los servicios de apoyo al médico ocupacional (SAMO). Material y métodos Se incluyeron 11 SAMO. Se elaboró un cuestionario no validado para recolectar la información consentida sobre la gestión de la ciberseguridad de los SAMO que brindaban servicio a un importante proyecto de construcción en Lima Metropolitana. Resultados La mayoría de los establecimientos de salud (más del 80%) tuvo planes de respuesta a incidentes de seguridad cibernética para garantizar una respuesta rápida ante un ataque cibernético; realizaban copias de seguridad de los datos críticos con regularidad y los almacenaban en un lugar diferente a establecimiento; y actualizaban regularmente los sistemas operativos y programas de softwares buscando asegurar que se utilizan versiones seguras. Conclusión Existe una gestión de la seguridad informática predominantemente reactiva. El reporte discute la importancia de la ciberseguridad, resaltando la exposición de la información médica y los servicios a riesgos cibernéticos y planteamos retos futuros para la ciberseguridad, subrayando la importancia de la preparación ante amenazas futuras en un entorno en constante transformación digital.
SUMMARY Recent investigations emphasize the importance of cybersecurity in the growing digital era; 83% of organizations experienced breaks in cyber security in 2022, spending a mean of 4,35 million dollars per incident. Cybersecurity in Peru is regulated by legal norms aimed at protecting data and providing informatic security. Objective To describe cybersecurity in the support services to occupational physicians (SSOP) in the city of Lima. Methods A non-validated survey was created and distributed to 11 SSOPs in Lima that provide a service to an important building project in Lima. Results More than 80% of health care establishments had a response plan against cybernetic attacks; security copies of the data were done regularly storing them in a different place than the establishment and regularly updated security software's. Conclusion The cybersecurity program is reactive. We discuss the importance of cybersecurity and analyze future challenges as well as emphasize the importance of preemptive preparedness in an environment of constant digital transformation.
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RESUMEN El diseño asistido por computadora y la fabricación asistida por ordenador (CAD-CAM, por sus siglas en inglés) se ha aplicado en odontología para la confección y el análisis de diversos tratamientos dentales. Inicia con la captura de imágenes a través de escáneres intraorales, contando con diversos tipos de softwares y sistemas de exportación de imágenes y tecnología. Las ventajas de este flujo de trabajo digital son el mejor ajuste, el empleo de menor tiempo clínico y la celeridad en tratamientos dentales, además de que brinda una mayor practicidad en el uso de los cirujanos dentistas. La precisión que brinda es clínicamente aceptable en comparación con los métodos convencionales, por lo cual existe suficiente evidencia para su validez; sin embargo, se debe tener en cuenta que diversos factores pueden alterar el resultado, como la experiencia del operador, el tipo de escáner, el tipo de software, la actualización del software, el principio de escaneo del escáner, el ambiente, la secuencia de escaneo y las estructuras bucales. El presente artículo de revisión tiene como objetivo analizar la literatura sobre las diferentes características y propiedades que presentan los escáneres intraorales en la actualidad, así como la evidencia de los posibles beneficios y la precisión de las técnicas de impresión digital frente a las técnicas de impresión convencionales.
ABSTRACT Computer-aided design and computer-aided manufacturing (CAD-CAM) has been applied in dentistry for the preparation and analysis of various dental treatments. It starts with capturing images through intraoral scanners, having different types of software and image export systems and technology. The advantages of this digital workflow are the following: better adjustment, shorter clinical time, and speed in dental treatments, in addition to providing greater practicality for dental surgeons. The accuracy he provide is clinically acceptable in comparison with conventional methods, so there is sufficient evidence for their validity; however, it should be taken into account that several factors can alter the result, such as the operator's experience, the type of scanner, the type of software, the software update, the scanning principle of the scanner, the environment, the scanning sequence, and the oral structures. The present review article aims to analyze the literature on the different characteristics and properties that intraoral scanners present today and the evidence of the potential benefits and accuracy of digital impression techniques versus conventional impression techniques.
RESUMO O desenho assistido por computador e o fabrico assistido por computador (CAD-CAM) têm sido aplicados na medicina dentária para a preparação e análise de vários tratamentos dentários. Começa com a captura de imagens através de scanners intraorais, com vários tipos de software e sistemas e tecnologia de exportação de imagens. As vantagens deste fluxo de trabalho digital são as seguintes: melhor ajuste, menor tempo clínico, rapidez nos tratamentos dentários, além de proporcionar maior praticidade no uso dos cirurgiões-dentistas. A precisão que proporcionam é clinicamente aceitável quando comparada com os métodos convencionais, pelo que existem evidências suficientes para a sua validade; no entanto, deve ter-se em conta que vários fatores podem alterar o resultado, tais como a experiência do operador, o tipo de scanner, o tipo de software, a atualização do software, o princípio de digitalização do scanner, o ambiente, a sequência de digitalização e as estruturas orais. Este artigo de revisão tem como objetivo analisar a literatura sobre as diferentes características e propriedades dos scanners intraorais atuais, bem como a evidência dos potenciais benefícios e precisão das técnicas de moldagem digital em comparação com as técnicas de moldagem convencionais.
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Objective:To establish and assess the precision of pre-surgical condyle position planning using mandibular movement trajectory data for orthognathic surgery.Methods:Skull data from large-field cone beam computed tomography(CBCT)and dental oral scan data were imported into IVSPlan 1.0.25 software for 3D reconstruction and fusion,creating 3D models of the maxilla and mandible.Trajectory da-ta of mandibular movement were collected using a mandibular motion recorder,and the data were inte-grated with the jaw models within the software.Subsequently,three-dimensional trajectories of the con-dyle were obtained through matrix transformations,rendering them visually accessible.A senior oral and maxillofacial surgeon with experience in both diagnosis and treatment of temporomandibular joint disease and orthognathic surgery selected the appropriate condyle position using the condyle movement trajectory interface.During surgical design,the mobile mandibular proximal segment was positioned accordingly.Routine orthognathic surgical planning was completed by determining the location of the mandibular distal segment,which was based on occlusal relationships with maxilla and facial aesthetics.A virtual mandible model was created by integrating data from the proximal and distal segment bone.Subsequently,a solid model was generated through rapid prototyping.The titanium plate was pre-shaped on the mandibular model,and the screw hole positions were determined to design a condylar positioning guide device.In accordance with the surgical plan,orthognathic surgery was performed,involving mandibular bilateral sagittal split ramus osteotomy(SSRO).The distal segment of the mandible was correctly aligned inter-maxillary,while the proximal bone segment was positioned using the condylar positioning guide device and the pre-shaped titanium plate.The accuracy of this procedure was assessed in a study involving 10 patients with skeletal class Ⅱ malocclusion.Preoperative condyle location planning and intraoperative po-sitioning were executed using the aforementioned techniques.CBCT data were collected both before the surgery and 2 weeks after the procedure,and the root mean square(RMS)distance between the preope-rative design position and the actual postoperative condyle position was analyzed.Results:The RMS of the condyle surface distance measured was(1.59±0.36)mm(95%CI:1.35-1.70 mm).This value was found to be significantly less than 2 mm threshold recommended by the expert consensus(P<0.05).Conclusion:The mandibular trajectory may play a guiding role in determining the position of the mandibular proximal segment including the condyle in the orthognathic surgery.Through the use of a con-dylar positioning guide device and pre-shaped titanium plates,the condyle positioning can be personalized and customized with clinically acceptable accuracy.
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Objective:To compare the trueness of incisal guidance of implant-supported single crowns designed by patient-specific motion(PSM)with that designed by average-value virtual articulator(AVA).Methods:The study had recruited 12 participants with complete dentition and stable incisal guidance.An intraoral scanner was used to scan digital casts and record two types of patient-specific mo-tion(data only including protrusive movement,and data including protrusive movement and lateral pro-trusive movement).The lingual surfaces of the maxillary incisors which guided the protrusive movement was selected and elevated to create a reference cast.A maxillary central incisor of original casts was vir-tually extracted and implanted to generate a working cast.The Dental system software program was used to design implant-supported single crowns with the anatomical coping design method.The incisal guidance was designed by different methods.The incisal guidance in control group was designed by the average-value virtual articulator.The incisal guidance in experiment groups was designed by the patient-specific motion only including protrusive movement(PSM1)and with the patient-specific motion including protru-sive movement and lateral protrusive movement(PSM2).The incisal guidance of prosthesis designed by these 3 methods were compared with the original incisal guidance in Geomagic Control 2015(3DSystem,America).The measurements included:Average of positive values,ratio of positive area and maximum value reflecting supra-occlusion;average of negative values,ratio of negative area and minimum value re-flecting over-correction;and root mean square reflecting overall deviation.Results:Statistical data were collected using the median(interquartile range)method.The average of positive values,ratio of positive area and average of negative values of the PSM2 group were smaller than those of the control group[8.0(18.8)μm vs.37.5(47.5)μm;0vs.7.2%(38.1%);-109.0(63.8)μm vs.-66.5(64.5)μm],and the ratio of negative area of PSM2 group was larger than those of the control group[52.9%(47.8%)vs.17.3%(45.3%)],with significant differences(P all<0.05).The ratio of positive area[0.1%(7.0%)]and average of negative values[-97.0(61.5)μm]of PSM1 group,were smaller than those of the control group,and the ratio of negative area[40.7%(39.2%)]of the PSM1 group was larger than that of the control group,with significant differences(P<0.05).The average of positive values[20.0(42.0)μm]and ratio of positive area of PSM1 group was larger than that of the PSM2 group with significant differences(P<0.05).Conclusion:To establish the incisor guidance of implant-supported single crowns,compared with the average-value virtual articulator and the patient-specific motion only including protrusive movement,the patient-specific motion including protrusive movement and lateral protrusive movement is more conducive to reducing the protrusive interference of prosthesis and improving the occlusal fit.
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Objective:Aiming at the problem of target user electroencephalogram (EEG) recognition, an EEG recognition method was presented based on common spatial patterns (CSP) and transfer learning.Methods:Firstly, preprocess was adopted on the original EEG data, and time windows 0.5~2.5 s and broad frequency band 8~30 Hz EEG signals, which contained α and β wave, were selected. Here event-related desynchronization (ERD) phenomenon existed significant differences. Afterwards, by CSP preprocessed EEG signals of multi-user were conducted to extract feature and feature vectors were obtained, respectively. Finally, by transfer learning target user EEG recognition was completed.Results:In channel Cz, ERD of right hand motor imagery was higher than ERD of foot motor imagery. The classification accuracy of users aa, al, av, aw, and ay were 93.8%, 100.0%, 84.2%, 94.6%, and 94.4%, respectively. The average classification accuracy was 92.4%, which was better than the commonly used classifiers SVM and EM. The method was only lower than the method of the first winner in the competition adopted by Tsinghua University 1.8%.Conclusions:EEG recognition method based on CSP and transfer learning increased target user EEG recognition performance by using non-target users and had important implications for the study of motor imagery brain-computer interface.
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The effective local management of oligometastatic non-small cell lung cancer (NSCLC) has the potential to prolong patients' survival. The role of radiotherapy as a local treatment modality in patients with oligometastatic NSCLC, whether as first-line therapy or consolidation therapy, remains uncertain. Several studies have demonstrated that stereotactic ablative radiotherapy can offer clinical benefits for patients with oligometastatic NSCLC without increasing adverse reactions. Furthermore, the exploration of the potential synergistic effects of combining radiotherapy and immunotherapy on extending progression-free survival and overall survival in patients with oligometastatic NSCLC is also a topic worthy of attention.
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Objective To explore the dilution conditions and standards in detecting the semen samples with high sperm concentration using computer-aided sperm analysis(CASA)systems.Methods CASA systems with 10 μm depth disposable counting chambers were used for the examination.The samples were divided into undiluted group(Group 1∶sperm concentration<50×106/mL)and diluted groups(Group 2∶50×106/mL≤ sperm concentration<100× 106/mL;Group 3∶sperm concentration≥100× 106/mL).When sperm concentration<50×106/mL,no dilution was performed.When sperm concentration≥50× 106/mL,the samples were diluted with saline at 1∶n/(50×106)ratio(n=sperm concentration,n/[50×106]rounded down)to<50×106/mL of sperm concentration.The sperm concentration,progressive motility(PR),non-progressive motility(NP),total motility(PR+NP)and immotile sperm percent-age(IM)were analyzed before and after dilution.The consistency of results pre-and post-dilution was compared.ROC curve was used to analyze the optimal dilution threshold.Results The differences in the parameters pre-and post-dilution gradually rosed with the increased sperm concentration.ROC curve analysis showed optimal dilution thresholds were 133.05 × 106/mL,101.75 × 106/mL,118.60×106/mL,90.90×106/mL,111.83×106/mL for the sperm concentration,PR+NP,PR,NP and IM respectively.Considering sperm concentration and NP were most affected the undiluted high concentration samples,the optimal comprehensive dilution threshold was determined as 125.08× 106/mL.Conclusion When sperm concentration exceeds 125×106/mL,it is recommended to dilute semen sample with normal saline.
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Objective To investigate the imaging features of intestinal schwannoma(IS)in order to improve the diagnostic ability of the disease.Methods The clinical and imaging data of 14 patients with surgically and pathologically confirmed IS were retrospectively analyzed,including the location,size,morphology,nature,growth pattern,CT density,MRI signal,PET/CT metabolism and other characteristics of the tumors.Results Of the 14 IS cases,the lesions of 3 cases were located in the duodenum,2 cases in the cecum,8 cases in the colon and 1 case in the rectum.The lesions were all round or oval,with an average maximum diameter of(2.4±1.1)cm.The lesions were solid in 13 cases,extraluminal growth in 10 cases,cystic degeneration in 1 case and myxoid degeneration in 1 case.Chronic inflammatory lymph nodes were seen around the diseased intestines in 9 cases,and the short diameter of lymph nodes was greater than 5 mm in 6 cases.All 14 cases of IS showed low attenuation on plain CT scan,and progressive enhancement after contrast injection,including 1 case of mild enhancement,2 cases of moderate enhancement,and 11 cases of obvious enhancement.Two cases of IS showed low signal intensity on T1WI,slightly high signal intensity on T2WI,significantly high signal intensity on DWI,and obvious progressive enhancement after contrast injection on MRI.Two cases of IS showed high metabolism on 18F-FDG-PET/CT,and the SUVmax was 9.4 and 8.8,respectively.Conclusion The imaging findings of IS were characteristic to a certain extent.They mainly manifested as solid nodules or masses derived from the intestinal submucosa,with uniform attenuation or signal intensity,obvious progressive enhancement after contrast injection,obvious hypermetabolism on 18F-FDG-PET/CT,and slightly larger homogeneous lymph nodes were common around the lesions.
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Objective:To retrospectively evaluate the clinical outcomes of autonomous dental implant robot(ADIR)assisted implant surgery in 1-year follow-up.Methods:20 patients with tooth missing underwent implantation surgery by ADIR were incuded.The plat-form deviation,apex deviation and angular deviation of the implants were analyzed.The marginal bone height and peri-implant soft tis-sue health were measured and observed immediately,6 months and 12 months after the restoration.Results:The platform deviation,apex deviation and angular deviation of 20 implants at the 3 follow-up examinations were(0.34±0.11)mm,(0.34±0.15)mm and(0.82°±0.38°),respectively.There was no significant difference in the accuracy of different implant diameter and length(P>0.05).During the follow-up period,all implants had successful osseointegration,stable marginal bone height,and acceptable peri-implant soft tissue condition.Conclusion:The 1-year follow-up indicates that ADIR can achieve promising clinical performance.Long-term follow-up studies are still necessary for verification.
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Objective To investigate the value of computer-assisted quantification of pulmonary embolism volume(PEV)in identifying mild-to-high-risk acute pulmonary embolism(APE).Methods We retrospectively enrolled 143 patients with suspected APE confirmed by computed tomography pulmonary angiography(CTPA)at Yan'an University Affiliated Hospital from January 2017 to December 2020.According to the 2018 Chinese Guidelines for Diagnosis,Treatment and Prevention of Pulmonary Thromboembolism,all the patients were divided into low-risk group(n=88)and mild-to-high-risk group(n=55).We collected the patients'basic demographic data,clinical manifestations,and serum levels of N-terminal-B type natriuretic peptide precursor(NT-proBNP)and D-dimer.Based on CTPA images,the degree of pulmonary thromboembolism was artificially evaluated to obtain the pulmonary artery occlusion index(PAOI).The thrombus was segmented using the pulmonary embolism detection tool based on digital lung,and PEV was calculated.We compared the differences in clinical and laboratory indicators and PAOI and PEV between the two risk groups.We analyzed the value of PAOI and PEV in identifying mild-to-high-risk APE using receiver operating characteristic(ROC)curves,and used Logistic regression analysis to identify independent risk factors in predicting mild-to-high-risk APE.Different models were established.Results Compared with the low-risk group,APE patients in the mild-to-high-risk group were older(P<0.05),had lower diastolic blood pressure(P<0.05),higher levels of D-dimer and NT-proBNP(P<0.05),lower levels of platelet count,arterial oxygen partial pressure and arterial carbon dioxide partial pressure(P<0.05),and higher levels of PAOI and PEV(P<0.001).ROC curve analysis showed that the area under the curve for PEV in identifying mild-to-high-risk APE was 0.809(95%CI:0.734-0.884),while that for PAOI was 0.753(95%CI:0.667-0.839).Logistic regression analysis showed that PEV and NT-proBNP were independent risk factors for mild-to-high-risk APE(P<0.05).Conclusion PEV and NT-proBNP are independent risk factors for mild-to-high-risk APE.
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BACKGROUND:Current rehabilitation programs are effective in treating post-stroke sequelae,but the treatment cycle is long and the labor cost is high.Brain-computer interface technology can be used for the treatment of post-stroke patients by extracting signals from the brain's neural activity through special equipment and converting this signal into commands that can be recognized by a computer. OBJECTIVE:To analyze and summarize the application of brain-computer interface technology in the upper limb motor function rehabilitation of stroke patients in recent years and to explore the clinical value of brain-computer interface technology in the upper limb function rehabilitation of stroke patients. METHODS:CNKI and PubMed were retrieved for relevant literature published from 2000 to 2022.The keywords were"stroke,electroencephalogram,brain-computer interface,upper limb,virtual reality technology,functional electrical stimulation,exoskeleton"in Chinese and"stroke,brain-computer interface,computer assistance,upper limb,virtual reality technology,functional electrical stimulation,exoskeleton"in English. RESULTS AND CONCLUSION:The brain-computer interface has shown promise for the restoration of upper limb motor function in stroke patients and has been shown to produce results that are unattainable with conventional treatments,and is well worth further research and promotion,but the mechanisms have not been fully elucidated.Also the ability to accurately decode all degrees of freedom of upper limb movements to provide flexible and natural control remains a challenge from the perspective of brain-computer interface systems that capture electroencephalogram signals from patients.Future research should focus on clarifying the specific neural mechanisms by which brain-computer interface technology facilitates upper limb motor recovery after stroke and identifying rehabilitation options such as brain-computer interfaces combined with external devices to facilitate upper limb motor function recovery in stroke patients.
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BACKGROUND:In recent years,computer-assisted navigation has gradually attracted attention in the medical field.Some scholars have reported that the clinical effects of computer navigation in total knee arthroplasty vary.To explore the clinical effect of the new generation of Brainlab Knee 3 navigation system,this study is conducted. OBJECTIVE:To analyze the application effect of computer navigation system(Brainlab Knee 3)combined with gap balance technology in total knee arthroplasty. METHODS:A total of 71 patients received total knee arthroplasty at the Department of Joint Surgery of Dalian Second People's Hospital from November 2020 to May 2021.In the navigation group,35 patients underwent total knee arthroplasty by computer navigation combined with gap balance.In the traditional group,36 patients underwent osteotomy with traditional surgical instruments.The difference between medial and lateral joint spaces,knee range of motion,hospital for special surgery knee score,hip-knee-ankle angle,deviation values of coronal femoral component angle,coronal tibial component angle,and sagittal tibial component angle were compared between the two groups. RESULTS AND CONCLUSION:(1)In the navigation group,the differences of intraoperative medial and lateral joint gap at knee extension 0,1,and 2 mm were found in 19,14,and 2 cases,respectively.The gap difference was 0 mm in 18 cases,1 mm in 15 cases and 2 mm in 2 cases at 90° degree knee flexion.In the traditional group,the gap difference at knee extention was 0 mm in 10 cases,1 mm in 20 cases,and 2 mm in 6 cases.The gap difference at 90 degree knee flexion was 0 mm in 10 cases,1 mm in 15 cases and 2 mm in 8 cases.(2)The operation time in the navigation group was longer than that in the traditional group(P<0.05),and two patients in the navigation group developed lower limb intermuscular vein thrombosis after surgery,and none of the patients in the traditional group had complications.(3)The range of motion between the two groups increased significantly at 6 and 12 months after surgery,and the range of motion in the navigation group was higher than that in the traditional group(P<0.05).(4)At 12 months after surgery,the hospital for special surgery knee scores of both groups increased significantly,and the hospital for special surgery knee score in the navigation group was higher than that in the traditional group(P<0.05).(5)At 6 months after surgery,the deviation values of hip-knee-ankle angle,coronal femoral component angle,coronal tibial component angle,and sagittal tibial component angle of navigation group were significantly lower than those in the traditional group(P<0.05).(6)The results showed that computer navigation technique combined with gap balance in total knee arthroplasty had advantages in postoperative range of motion,lower limb alignment and the accuracy of tibial prosthesis component position,and joint function recovered well.
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Objective To explore the clinical efficacy of acupuncture combined with computer speech disorder correction training in the treatment of children with autism.Methods A total of 108 children with autism admitted to the Department of Pediatrics,Puyang Oilfield General Hospital Affiliated to Xinxiang Medical University from December 2019 to December 2021 were selected as the research subjects.According to the treatment methods,the children were divided into the control group and the observation group,with 54 children in each group.The children in the control group received computer speech disorder correction training,while the children in the.observation group received acupuncture treatment on the basis of the control group,and all children were treated for 4 months.Before and after treatment,the severity of symptoms of children was evaluated by the childhood autism rating scale(CARS),the treatment effectiveness of language function of children was evaluated by the language delayed development test(S-S method),the abnormal behavior of children was evaluated by the autism behavior checklist(ABC),and the central nervous system function of children was evaluated by the Gesell development scale(GDS).The satisfaction of the children's family members was evaluated by the Chinese version of critical care family satisfaction survey(C-CCFSS).Results There was no significant difference in the CARS score of children between the two groups before treatment(P>0.05);after treatment,the CARS score of children in the observation group was significantly lower than that in the control group(P<0.05);there was no significant difference in the CARS score before and after treatment in the control group(P>0.05);the CARS score of children in the observation group after treatment was significantly lower than that before treatment(P<0.05).The total effective rates of language function therapy of children in the control group and observation group were 83.33%(45/54)and 96.30%(52/54),respectively;the total effective rate of language function therapy of children in the observation group was significantly higher than that in the control group(x2=4.960,P<0.05).Before treatment,there was no significant difference in the each item scores and scores total scores of ABC of children between the two groups(P>0.05);the each item scores and total scores of ABC of children in the two groups after treatment were significantly lower than those before treatment(P<0.05);after treatment,the each item scores and total scores of ABC of children in the observation group were significantly lower than those in the control group(P<0.05).Before treatment,there was no signifi-cant difference in GDS score of children between the two groups(P>0.05);after treatment,the GDS score of children in the observation group was significantly higher than that in the control group(P<0.05);there was no significant difference in GDS score of children before and after treatment in the control group(P>0.05);the GDS score of children in the observation group after treatment was significantly higher than that before treatment(P<0.05).The satisfaction of family member of children in the control group and the observation group was 81.48%(44/54)and 94.44%(51/54),respectively.The satisfaction of family member of children in the observation group was significantly higher than that in the control group(x2=4.285,P<0.05).Conclusion Acupuncture combined with computer speech disorder correction training can effectively improve the severity of the clinical symptoms and abnormal behavior of children with autism,promote language function and intellectual recovery,and has high family satisfaction,which is worthy of clinical promotion and application.