Automated detection of enteric tubes misplaced in the respiratory tract on chest radiographs using deep learning with two centre validation.

AIM: To develop and test a model based on a convolutional neural network that can identify enteric tube position accurately on chest radiography. MATERIALS AND METHODS: The chest radiographs of adult patients were classified by radiologists based on enteric tube position as either critically misplaced (within the respiratory tract) or not critically misplaced (misplaced within the oesophagus or safely positioned below the diaphragm). A deep-learning model based on the 121-layer DenseNet architecture was developed using a training and validation set of 4,693 chest radiographs. The model was evaluated on an external test data set from a separate institution that consisted of 1,514 consecutive radiographs with a real-world incidence of critically misplaced enteric tubes. RESULTS: The receiver operator characteristic area under the curve was 0.90 and 0.92 for the internal validation and external test data sets, respectively. For the external data set with a prevalence of 4.4% of critically misplaced enteric tubes, the model achieved high accuracy (92%), sensitivity (80%), and specificity (92%) for identifying a critically misplaced enteric tube. The negative predictive value (99%) was higher than the positive predictive value (32%). CONCLUSION: The present study describes the development and external testing of a model that accurately identifies an enteric tube misplaced within the respiratory tract. This model could help reduce the risk of the catastrophic consequences of feeding through a misplaced enteric tube.

Correlations between Overexpression of SOX2OT Long Non-coding RNA and Susceptibility to Breast Cancer.

BACKGROUND AND OBJECTIVE: The SOX2OT lcnRNA has been recognized as a positive regulator in the transcription regulation of the SOX2 gene. Recent studies have approved the dysregulation of SOX2OT lncRNA expression patterns in some common cancer types, including esophageal, lung, and breast cancer. The objective of the present study was to investigate the correlation between overexpression of SOX2OT lcnRNA and susceptibility to breast cancer. METHODS: SOX2OT lncRNA expression profiling in 15 breast cancer and normal tumour-adjacent breast tissue samples was performed by using qRT-PCR. To evaluate the diagnostic potential of the SOX2OT lncRNA, we performed ROC curve analyses. RESULTS: The expression of SOX2OT lncRNA in patients suffering from breast cancer revealed a significant overexpression in comparison with the healthy group (P<0.001). Significantly, the elevated circulating SOX2OT lncRNA was found specific to breast cancer and could differentiate breast cancer from controls with 100% of both sensitivity and specificity. Based on the Kaplan- Meier analysis, there was no significant correlation between SOX2OT lcnRNA expression and overall survival. CONCLUSION: The results confirmed the association between breast cancer and higher SOX2OT lncRNA expression. According to the ROC curve results, SOX2OT lcnRNA could be a new measurable indicator of the breast cancer and a potential therapeutic target for breast cancer patients.

1916-2016: a centenary of publications.

Last year, the centenary of the 1916 Easter rising in Ireland was marked by a commemorative programme organised by the Irish government including both historical and cultural events. The main themes of these events were remembering the past, celebrating Irish achievements and imagining our future. Reviewing the medical literature offers an insight into a century of achievement and change in Irish medicine, captured from the unique perspective of Ireland's oldest medical journal. This manuscript examines papers published during the last 100 years of the Irish Journal of Medical Science, specifically examining the most cited paper from each year. The majority of top cited papers originate in Ireland (77%) with Trinity College Dublin the commonest institution (n = 12) and obstetrics the most common specialty (n = 9). The average number of citations per article was 20.56 (SD ± 22.36; range 1-118) and the article with most citations was 'Coagulative properties of cancers' published in 1958 by O'Meara et al. The mean number of citations for the top cited publication each year has increased over time. The journal continued to publish even amidst backgrounds of war and civil unrest and represents an important cultural artefact that deserves our ongoing support.

The Avocado Hand.

Accidental self-inflicted knife injuries to digits are a common cause of tendon and nerve injury requiring hand surgery. There has been an apparent increase in avocado related hand injuries. Classically, the patients hold the avocado in their non-dominant hand while using a knife to cut/peel the fruit with their dominant hand. The mechanism of injury is usually a stabbing injury to the non-dominant hand as the knife slips past the stone, through the soft avocado fruit. Despite their apparent increased incidence, we could not find any cases in the literature which describe the "avocado hand". We present a case of a 32-year-old woman who sustained a significant hand injury while preparing an avocado. She required exploration and repair of a digital nerve under regional anaesthesia and has since made a full recovery.

The Irish contribution to the plastic surgery literature: 21 years of publications.

INTRODUCTION: The Republic of Ireland has always had an influence on medicine and has produced many renowned doctors who have helped shape its history. Furthermore, many clinical articles that have originated from Ireland have changed clinical practice throughout the world. The Irish have also had an impact on the plastic surgery literature yet it has never specifically been analyzed before. The purpose of this study was to identify and analyze all papers that have originated from the plastic surgery units in the Republic of Ireland in the medical literature over the past 21 years. METHODOLOGY: Twenty-four well-known plastic surgery, hand surgery and burns journals were selected for this study. By utilizing Scopus, the largest abstract and citation database of peer-reviewed literature, we analyzed each of our chosen 24 journals looking for Irish publications. Each paper was examined for article type, authorship, year of publication, institution of origin and level of evidence. RESULTS: Papers from the Republic of Ireland were published in 20 of the 24 journals over the past 21 years. A total of 245 articles from Ireland were published in the plastic surgery, hand surgery and burns literature over the 21-year period. Of these, 111 were original articles and 73 were case reports. The institution that published the most papers over the past 21 years was University Hospital Galway (66 publications) followed by Cork University Hospital with 54 papers. The journal with the most Irish articles was the Journal of Plastic, Reconstructive and Aesthetic Surgery with 56 papers. 2014 was the year with the most publications (28 papers). Authorship numbers also increased over time as the average number of authors in 1994 was 3.5, whereas it was 5.54 in 2014. DISCUSSION: The number of publications per year continues to increase along with authorship numbers. This mirrors the trend in other specialties. Publications are now no longer required for selection on to a higher surgical training scheme. There is now a fear that the academic output of trainees will decrease as a consequence. To prevent this, each unit must actively support and encourage research activity with their trainees.