Comparing two vascular division techniques in laparoscopic varicocelectomy. A prospective study. / Comparación de dos técnicas de sección vascular en la varicocelectomía laparoscópica. Estudio prospectivo.

INTRODUCTION: Varicocele is the abnormal dilatation of the pampiniform plexus. It occurs in 15-20% of pre-adolescent/adult males. Varicocele diagnosis is important since it can induce testicular hypertrophy and fertility issues in adulthood. The objective of this study was to assess whether complications, including varicocele recurrence, depend on the vascular occlusion technique used -clipping + division vs. vascular sealer- in the laparoscopic Palomo technique used in our institution. MATERIALS AND METHODS: A longitudinal, prospective study was carried out from 2017 to 2021. Two therapeutic groups were created according to the vascular occlusion method used during laparoscopic varicocelectomy -clipping + division vs. vascular sealer. Patients were randomly allocated to the groups in a systematic alternating consecutive manner. Variables -age, varicocele grade according to the Dubin-Amelar classification, postoperative complications, follow-up, and varicocele recurrence- were analyzed according to the method employed. RESULTS: A total of 37 boys, with a mean age of 12 years (10-15 years) and a mean follow-up of 12 months, were studied. In 20 patients (54.1%), clipping + division was used, and in the remaining 17 (45.9%), the vascular sealer was employed. 24.3% had symptomatic Grade II varicocele and 75.7% had Grade III varicocele. 32.4% of the children had postoperative complications during follow-up. 29.7% of the patients had hydrocele following surgery -8 boys from the sealing group and 3 boys from the clipping group-, with 13.5% requiring re-intervention as a result of this. None of the patients had varicocele recurrence. CONCLUSIONS: The laparoscopic Palomo technique is safe and effective, with good results in pediatric patients and few postoperative complications, regardless of the vascular occlusion device used. In our study, no statistically significant differences regarding the use of clipping or vascular sealer in this laparoscopic technique were found. However, further studies with a larger sample size are required to find potential differences.

INTRODUCCION: El varicocele es la dilatación anormal del plexo pampiniforme. Puede afectar al 15-20% de los varones preadolescentes-adultos. La importancia de su diagnóstico radica en que puede inducir hipotrofia testicular y problemas de fertilidad en la etapa adulta. El objetivo de este estudio es evaluar si existe mayor índice de complicaciones, incluyendo la recurrencia del varicocele, dependiendo de la técnica de oclusión vascular utilizada: clip y sección o sellador vascular, en la técnica de Palomo laparoscópico en nuestro centro. MATERIAL Y METODOS: Estudio longitudinal prospectivo que se realiza de 2017 a 2021. Se crean dos grupos terapéuticos según el método de oclusión vascular utilizada durante la varicocelectomía laparoscópica: clip y sección o sellador vascular. Los pacientes son incluidos en un grupo mediante asignación sistemática consecutiva alternante. Se realiza el análisis de las variables: edad, grado de varicocele según la clasificación de Dubin-Amelar, complicaciones postquirúrgicas, seguimiento y recurrencia del varicocele, según el método empleado. RESULTADOS: Se intervinieron un total de 37 niños, con edad media de 12 años (10-15 años) y una media de seguimiento de 12 meses. En 20 pacientes (54,1%), se utilizó clip y sección, y en los 17 restantes (45,9%), sellador vascular. El 24,3% presentaba varicocele Grado II sintomático y el 75,7%, Grado III. El 32,4% de los niños presentó alguna complicación postquirúrgica durante el seguimiento. El 29,7% de los pacientes presentó hidrocele tras la intervención, perteneciendo 8 niños al grupo de sellado y 3 niños al de clipaje. El 13,5% de estos precisó reintervención por este motivo. Ningún paciente presentó recurrencia del varicocele. CONCLUSIONES: La técnica de Palomo laparoscópica es una técnica segura y efectiva que presenta buenos resultados en pacientes pediátricos, ya que presenta pocas complicaciones postquirúrgicas, independientemente del dispositivo de oclusión vascular que se utilice. En nuestro estudio, no se ha demostrado que existan diferencias estadísticamente significativas en cuanto al uso de clip o sellador vascular en esta técnica laparoscópica. No obstante, es preciso realizar más estudios con mayor tamaño muestral para hallar posibles diferencias.

A tale of a threshing machine: Images of the Voigt-Leibniz mathematical-agricultural machine at the beginning of the 18th century.

This paper examines how a certain threshing machine was developed and improved by Jobst Heinrich Voigt and Gottfried Wilhelm Leibniz between 1699 and 1700. While this machine was based on various mechanical principles and instruments, including the pinned drum mechanism first noted by Georg Philipp Harsdörffer, it was later reconceptualized as a 'mathematical' machine. I claim that such a positioning was not unique to this machine, but part of a wider movement during the 18th century that considered various artisanal instruments as mathematical, as well as agricultural and artisanal knowledge as scientific. Examining the development and subsequent reception of this machine, I show that during the first decades of the 18th century these conceptions gave rise to a double image of this machine, and hence of agricultural knowledge in general: on the one hand, this machine was considered as more efficient and productive (while still in need of improvement); on the other hand, it was viewed, either implicitly or explicitly, as something that should be studied by mathematicians, thus reflecting a changing image of mathematics.

Comparing Cyclic Fatigue Resistance and Free Recovery Transformation Temperature of NiTi Endodontic Single-File Systems Using a Novel Testing Setup.

The aim of this study was to assess the effect of body temperature (37 °C) on the cyclic fatigue resistance of three endodontic single-file systems using a new testing setup. One Shape® new generation (OS), WaveOne™ (WO) and WaveOne® GOLD (WOG), which are made from different NiTi alloys and operated in different motions (rotation/reciprocation), were evaluated. The study design included four groups. Each group comprised 30 files, 10 files of each of the three file systems, tested at 20 ± 2 °C (group 1 and 3) and at 37 ± 1 °C (group 2 and 4). All files were tested in a custom-made metal block with artificial canals of 60° angle, and a 5 mm and 3 mm radius of curvature, respectively. A heating element was attached to replicate a temperature of 37 °C. Files were introduced 18 mm into the canals and operated until failure. Transformation temperatures of five samples of each of the tested file systems were determined via the bend and free recovery (BFR) method. With the exception of WOG in canals with a 3 mm radius of curvature (p = 0.075), all the tested file systems showed statistically significantly less time needed to fracture when operated at 37 ± 1 °C compared to at 20 ± 2 °C in canals with a 5 mm and 3 mm radius of curvature using Mann-Whitney U test (p < 0.05). All file systems showed transformation temperatures below the body temperature. We concluded that body temperature directly affects the cyclic fatigue resistance of all tested file systems. Bend and free recovery can be suitable for the determination of austenite finish temperatures (Af) of endodontic instruments as it allows testing a longer portion of the instrument.

Effect of Sterilization and Irrigating Solutions on Nanostructure Alteration of Ni-Ti Rotary Instruments in Endodontics: An Atomic Force Microscopic Study.

Aim: This study aimed to evaluate the effect of 5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA) and sterilization on the nanostructural alteration of nickel titanium (Ni-Ti) rotary file systems in endodontics using the atomic force microscopy (AFM). Materials and Methods: The study was performed on four commercially available rotary Ni-Ti files: group I-Vortex Blue (Dentsply), group II-ProTaper Next (Dentsply), group III-Mtwo (VDW), and group IV-iRaCe (FKG). Each group was divided into four subgroups (n = 4), that is, subgroup A-control (new rotary file), subgroup B-subjected for five cycles of autoclave, subgroup C-immersed in 5.25% NaOCl for 5 minutes, and subgroup D-immersed in 17% EDTA solutions for 5 minutes. All the specimens were evaluated with AFM using roughness average (RA) and root-mean-square (RMS) values for surface roughness. Results: Among control groups, Vortex Blue showed the least RA and RMS values; the highest surface roughness was seen with Mtwo files. All the Ni-Ti rotary files showed a statistically significant (P <0.05) increase in surface hardness when subjected to autoclave and treatment with different irrigating solutions. In particular, 17% EDTA caused the highest surface deterioration in all the groups. Conclusion: AFM analysis revealed increased surface roughness values recorded for all the rotary files when treated with irrigating solutions and autoclave cycles.

Postoperative pain after single-visit root canal treatments in necrotic teeth comparing instruments' kinematics and apical instrumentation limits - a prospective randomized multicenter clinical trial.

OBJECTIVES: This prospective randomized multicenter clinical trial (PRMCT) investigated postoperative pain after single-visit root canal treatments in teeth affected by pulp necrosis (PN), and asymptomatic apical periodontitis (AAP) (with apical radiolucent areas) or normal periradicular tissues (without apical radiolucent areas) comparing different instruments' kinematics and apical instrumentation limits. METHODS: Before chemomechanical preparation, 240 patients/teeth were randomly distributed into four groups (n = 60) according to the instruments' kinematics (rotary or reciprocating) and apical instrumentation limits (with or without intentional foraminal enlargement [IFE]). After that, specimens were submitted to the same irrigation and obturation techniques, and the patients were referred to undergo the definitive restorations. No medication was prescribed, but the patients were instructed to take either paracetamol (750 mg every 6 h for three days) or ibuprofen (600 mg every 6 h for three days) in pain cases. Postoperative pain incidence and levels were assessed at 24-, 48-, and 72 h following treatment completion according to a verbal rating scale (VRS) following a score. The Kolmogorov-Smirnov test was applied to assess the normality of the data. Mann-Whitney U, Chi-square, Friedman's ANOVA, and Friedman's multiple 2 to 2 comparison tests were employed to identify potential significant statistical differences among the variables in the study groups (P < .05). RESULTS: Significant statistical differences were only observed among the groups considering tooth, periradicular status, and the occurrence of overfilling (sealer extrusion) (P < 0.00). Patients with teeth instrumented through rotary kinematics and without IFE experienced lower rates of postoperative pain; however, this difference was relevant only at 24 h (P < 0.05). CONCLUSIONS: Postoperative pain was lower after using a rotary file system (Profile 04) inserted up to the apical constriction (AC). However, this finding was just statistically meaningful at 24 h. TRIAL REGISTRATION: This PRMCT was approved by the Human Research Ethics Committee of the Paranaense University - UNIPAR, Francisco Beltrão, PR, Brazil (CAAE. 46,774,621.6.0000.0109) on 02/09/2021. It was registered at The Brazilian Registry of Clinical Trials - ReBEC (RBR-3r967t) on 01/06/2023, was performed according to the Principles of the Helsinki Declaration and is reported following the Consolidated Standards of Reporting Trials Statement.

Comparación de dos técnicas de sección vascular en lavaricocelectomía laparoscópica. Estudio prospectivo / Comparing two vascular division techniques in laparoscopic varicocelectomy. A prospective study

Introducción: El varicocele es la dilatación anormal del plexopampiniforme. Puede afectar al 15-20% de los varones preadolescentes-adultos. La importancia de su diagnóstico radica en que puede inducirhipotrofia testicular y problemas de fertilidad en la etapa adulta. El objetivo de este estudio es evaluar si existe mayor índice de complicaciones,incluyendo la recurrencia del varicocele, dependiendo de la técnica deoclusión vascular utilizada: clip y sección o sellador vascular, en latécnica de Palomo laparoscópico en nuestro centro.Material y métodos: Estudio longitudinal prospectivo que se realizade 2017 a 2021. Se crean dos grupos terapéuticos según el método deoclusión vascular utilizada durante la varicocelectomía laparoscópica:clip y sección o sellador vascular. Los pacientes son incluidos en ungrupo mediante asignación sistemática consecutiva alternante. Se realizael análisis de las variables: edad, grado de varicocele según la clasifica-ción de Dubin-Amelar, complicaciones postquirúrgicas, seguimiento yrecurrencia del varicocele, según el método empleado.Resultados: Se intervinieron un total de 37 niños, con edad mediade 12 años (10-15 años) y una media de seguimiento de 12 meses. En20 pacientes (54,1%), se utilizó clip y sección, y en los 17 restantes(45,9%), sellador vascular. El 24,3% presentaba varicocele Grado IIsintomático y el 75,7%, Grado III. El 32,4% de los niños presentó algunacomplicación postquirúrgica durante el seguimiento. El 29,7% de lospacientes presentó hidrocele tras la intervención, perteneciendo 8 niñosal grupo de sellado y 3 niños al de clipaje. El 13,5% de estos precisóreintervención por este motivo. Ningún paciente presentó recurrenciadel varicocele. Conclusiones: La técnica de Palomo laparoscópica es una técnicasegura y efectiva que presenta buenos resultados en pacientes pediátricos...(AU)

Introduction: Varicocele is the abnormal dilatation of the pampiniform plexus. It occurs in 15-20% of pre-adolescent/adult males.Varicocele diagnosis is important since it can induce testicular hyper-trophy and fertility issues in adulthood. The objective of this studywas to assess whether complications, including varicocele recurrence,depend on the vascular occlusion technique used –clipping + divisionvs. vascular sealer–in the laparoscopic Palomo technique used inour institution. Materials and methods: A longitudinal, prospective study wascarried out from 2017 to 2021. Two therapeutic groups were createdaccording to the vascular occlusion method used during laparoscopicvaricocelectomy –clipping + division vs. vascular sealer. Patients wererandomly allocated to the groups in a systematic alternating consecutivemanner. Variables –age, varicocele grade according to the Dubin-Amelarclassification, postoperative complications, follow-up, and varicocelerecurrence– were analyzed according to the method employed.Results: A total of 37 boys, with a mean age of 12 years (10-15years) and a mean follow-up of 12 months, were studied. In 20 patients (54.1%), clipping + division was used, and in the remaining 17(45.9%), the vascular sealer was employed. 24.3% had symptomaticGrade II varicocele and 75.7% had Grade III varicocele. 32.4% of thechildren had postoperative complications during follow-up. 29.7% ofthe patients had hydrocele following surgery –8 boys from the seal-ing group and 3 boys from the clipping group–, with 13.5% requiringre-intervention as a result of this. None of the patients had varicocelerecurrence. Conclusions: The laparoscopic Palomo technique is safe and ef-fective, with good results in pediatric patients and few postoperativecomplications, regardless of the vascular occlusion device used...(AU)

Laparoscopy training of novices with complex curved instruments using 2D- and 3D-visualization.

PURPOSE: Beside many advantages, disadvantages such as reduced degrees of freedom and poorer depth perception are still apparent in laparoscopic surgery. 3D visualization and the development of complex instruments are intended to counteract the disadvantages. We want to find out whether the use of complex instruments and 3D visualization has an influence on the performance of novices. METHODS: 48 medical students with no experience in laparoscopic surgery or simulator-based laparoscopy training were included. They were randomized in four groups according to a stratification assessment. During a structured training period they completed the FLS-Tasks "PEG Transfer", "Pattern Cut" and "Intracorporeal Suture" and a transfer task based on these three. Two groups used conventional laparoscopic instruments with 3D or 2D visualization, two groups used complex curved instruments. The groups were compared in terms of their performance. RESULTS: In 2D laparoscopy there was a better performance with straight instruments vs. curved instruments in PEG Transfer and Intracorporeal Suture. In the transfer task, fewer errors were made with straight instruments. In 2D vs. 3D laparoscopy when using complex curved instruments there was an advantage in Intracorporeal Suture and PEG Transfer for 3D visualization. Regarding the transfer exercise, a better performance was observed and fewer errors were made in 3D group. CONCLUSION: We could show that learning laparoscopic techniques with complex curved instruments is more difficult with standard 2D visualization and can be overcome using 3D optics. The use of curved instruments under 3D vision seems to be advantageous when working on more difficult tasks.

Factorial analysis of the Brazilian-Portuguese version of the Work Ability Index, reproducibility and validity of the single item and the short version for online application.

BACKGROUND: The Work Ability Index (WAI) assesses work demands, health status, and physical and mental resources. OBJECTIVES: To evaluate the measurement properties of the WAI, single-item work ability score (WAS), and short version for online applications. METHODS: One hundred three workers completed the 3 versions of the WAI and the Perceived Stress Scale (PSS-10) questionnaire. The reproducibility and construct validity of the 3 versions of the WAI and their concurrent validity with the PSS-10 were tested. Statistical tests were performed with IBM® SPSS 28.0. RESULTS: The test-retest reliability of the WAI, WAS, and WAI short version ranged from good to excellent. The WAI and WAI short version showed excellent internal consistency. The construct validity of the WAS was moderate and positive and it was excellent and positive for the WAI short version. Concurrent validity of the WAI, WAS, and WAI short version was moderate and negative, and item mental resources were strong and negative. Factor analysis reached an acceptable level for all indexes (≥ 0.90). The analysis with two factors reached an acceptable level for all indexes (≥ 0.90) and was the best model. CONCLUSION: The reliability and construct and concurrent validity of the various versions of the WAI were strong to excellent in online applications. Confirmatory factor analysis demonstrated a new grouping of items for the WAI Brazilian version. However, it is necessary to be careful in the choice due to the distribution model of items in health domains and aspects of work.

Miniaturized Near-Infrared spectrophotometers in forensic analytical science - a critical review.

The advent of miniaturized NIR instruments, also known as compact, portable, or handheld, is revolutionizing how technology can be employed in forensics. In-field analysis becomes feasible and affordable with these new instruments, and a series of methods has been developed to provide the police and official agents with objective, easy-to-use, tailored, and accurate qualitative and quantitative forensic results. This work discusses the main aspects and presents a comprehensive and critical review of compact NIR spectrophotometers associated with analytical protocols to produce information on forensic matters.

Prospective evaluation of a novel device for ultrasound-guided percutaneous treatment of carpal tunnel and trigger finger disease. Efficacy and safety of sono-instruments®.

PURPOSE: To evaluate the safety and effectiveness of percutaneous release procedures under sonography using Sono-Instruments® in the treatment of carpal tunnel syndrome (CTS) and trigger finger (TF). METHODS: Prospective study involving 30 patients, divided into two groups (15 CTS, and 15 TF). The primary outcomes were surgical performance-related outcomes (visibility, ease of use, satisfaction, duration) using Sono-Instruments® and patient-related outcomes (pain, activity limitations, time to return to work, functional scores). Secondary outcomes included complications. Patients were followed for two months post-operatively. RESULTS: In the CTS group, the average age of the patients was 58.7 years. The percutaneous release of the transverse carpal ligament was effectively completed in all cases, with excellent device performance and no adverse events. At one week, all patients could wash their hands, 80% could perform activities of daily living, and 80% of those working had returned to their activities. At two months, all patients had resumed all activities. Pillar pain was still present in 53.3%. In the TF group, the patients had an average age of 57.9 years. The percutaneous release of the A1 annular pulley was successful in all cases, with excellent device performance and no adverse events. At one week, all patients could wash their hands, 93.3% could do all activities of daily living, and 75% of those working were back to their professional activities. At two months, all patients were back to all activities of daily living and work. The DASH score was significantly improved at two months, compared to preoperative, for both groups (p < 0.001). CONCLUSION: Percutaneous sono-guided release using Sono-Instruments® is safe and efficient, and associated with quick functional recovery. LEVEL OF EVIDENCE: II.

Laparoscopic right colectomy: correct technique based on key anatomical principles.

Since the early1990s, laparoscopic right colon resections have been the most performed advanced laparoscopic procedures just after laparoscopic left colectomies and sigmoid resections. Indications for laparoscopic right colectomies are either benign or malignant diseases. Despite its many indications, a laparoscopic right or extended right colectomy is mostly performed for cancer of the caecum, the ascending colon, the hepatic flexure or the proximal transverse colon. Worldwide, colorectal cancer is the third most diagnosed cancer: an estimated 1,880,725 people were diagnosed with colorectal cancer in 2020, out of which 1,148,515 were colon cancer cases and 40% were located in the right colon. These figures make an oncologic sound surgery for right colon cancer of the utmost relevance. More recently, complete mesocolic excision has been advocated as the optimal choice in term of radicality, especially in node-positive patients with right colon cancer. Laparoscopic standard right colectomy and extended right colectomy with or without CME should be performed according to defined principles based on a close knowledge of key anatomical landmarks. This knowledge will allow to trace anatomical structures and drive instruments along the correct surgical planes and has its foundations in teachings from surgeons and scientists of past and present time.

Ergonomic RFID tag placement on surgical instruments - a preliminary user study.

OBJECTIVES: RFID tags on surgical instruments allow tracking of individual instruments. However, the tags on the instruments can restrict the handling, potentially increasing patient risks. Previous studies analyzed hand contact areas to identify potential locations for tags. However, the studies did not conduct interaction tests using instruments equipped with RFID tags, potentially neglecting the influence of haptic perception. In addition, previous studies required time-consuming evaluations by clinicians. METHODS: Therefore, the present study aims to verify the previous findings in interaction-centered tests with clinicians using real RFID tags on the instruments. Additionally, we had instrument design experts rate RFID tag positions and examined whether they could predict the clinician's preferred tag positions. RESULTS: We found that nearly all RFID tag positions decreased the user satisfaction of clinicians compared to a reference instrument. Compared to previous studies, our study shows that the RFID tag influences the orientations in which an instrument can be comfortably held, which was criticized by clinicians. Instrument design experts could only predict the clinician's preferred tag positions for some instruments. CONCLUSIONS: Therefore, we recommend investigating further changes to instrument design, for what the "ideal" positions proposed by the clinicians in this study can provide initial pointers.

The stigma towards mental illness: Portuguese validation of the Opening Minds Stigma Scale for Healthcare Providers (OMS-HC).

Background: Stigma toward mental illness significantly contributes to a lower quality of healthcare that can be provided. There are few studies on this topic in Portugal, so validating a scale that can evaluate and study the stigma is paramount. The aim of this study was to validate the Opening Minds Stigma Scale for Portuguese healthcare professionals. Methods: A total of 503 participants were included in this study, and the majority was female (81.1%). The sample consisted mainly of psychologists (39.4%) and physicians (30.8%). Reliability and validity analyses were conducted and included exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results: Our results suggest that a 12-item model was the most appropriate (RMSEA = 0.026, SRMR = 0.057, CFI = 0.979, TLI = 0.973, GFI = 0.955) compared to our 15-item model and the original model. Items 8, 9 and 10 were removed. The 12-item scale's internal consistency was adequate (α = 0.71; ω = 0.72). Conclusion: The 12-item model of the scale showed good reliability and validity and is appropriate for use with Portuguese healthcare professionals.

Development of a core set of outcome measures to be applied toward breast cancer-related lymphedema core outcome domains.

PURPOSE: For breast cancer survivors (BCS) living with breast cancer-related lymphedema (BCRL), what outcome measures (OMs) are recommended to be used to measure standardized outcome domains to fully assess the burden of the disease and efficacy of interventions? An integral component of a standardized core outcome set (COS) are the OMs used to measure the COS. METHODS: A supplemental online survey was linked to a Delphi study investigating a COS for BCRL. OMs were limited to a maximum of 10 options for each outcome domain (OD). There were 14 ODs corresponding to the International Classification of Functioning, Disability, and Health (ICF) framework and respondents rated the OMs with a Likert level of recommendation. The feasibility of the listed OMs was also investigated for most outpatient, inpatient, and research settings. RESULTS: This study identified 27 standardized OMs with a few ODs having 2-3 highly recommended OMs for proper measurement. A few of the recommended OMs have limitations with reliability due to being semi-quantitative measures requiring the interpretation of the rater. CONCLUSION: Narrowing the choices of OMs to 27 highly recommended by BCRL experts may reduce selective reporting, inconsistency in clinical use, and variability of reporting across interdisciplinary healthcare fields which manage or research BCRL. There is a need for valid, reliable, and feasible OMs that measure tissue consistency. Measures of upper extremity activity and motor control need further research in the BCS with BCRL population.

SonicGuard Sensor-A Multichannel Acoustic Sensor for Long-Term Monitoring of Abdominal Sounds Examined through a Qualification Study.

Auscultation is a fundamental diagnostic technique that provides valuable diagnostic information about different parts of the body. With the increasing prevalence of digital stethoscopes and telehealth applications, there is a growing trend towards digitizing the capture of bodily sounds, thereby enabling subsequent analysis using machine learning algorithms. This study introduces the SonicGuard sensor, which is a multichannel acoustic sensor designed for long-term recordings of bodily sounds. We conducted a series of qualification tests, with a specific focus on bowel sounds ranging from controlled experimental environments to phantom measurements and real patient recordings. These tests demonstrate the effectiveness of the proposed sensor setup. The results show that the SonicGuard sensor is comparable to commercially available digital stethoscopes, which are considered the gold standard in the field. This development opens up possibilities for collecting and analyzing bodily sound datasets using machine learning techniques in the future.

Contextual measurement model and quantum theory.

We develop a contextual measurement model (CMM) that is used for the clarification of the quantum foundations. This model matches Bohr's views on the role of experimental contexts. CMM is based on a contextual probability theory that is connected with generalized probability theory. CMM covers measurements in classical, quantum and semi-classical physics. The CMM formalism is illustrated by a few examples. We consider the CMM framing of classical probability, the von Neumann measurement theory and the quantum instrument theory. CMM can also be applied outside of physics, e.g. in cognition, decision-making and psychology, the so-called quantum-like modelling.

Patient-Reported Outcome Measures in Neuromuscular Diseases: A Scoping Review.

 Patient-reported outcome measures (PROMs) are valuable in comprehensively understanding patients' health experiences and informing healthcare decisions in research and clinical care without clinicians' input. Until now, no central resource containing information on all PROMS in neuromuscular diseases (NMD) is available, hindering the comparison and choice of PROMs used to monitor NMDs and appropriately reflect the patient's voice. This scoping review aimed to present a comprehensive assessment of the existing literature on using PROMs in children and adults with NMD. A scoping methodology was followed using Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines to assess the literature on PROMs in NMDs. Eligibility criteria encompassed articles describing psychometric development or evaluation of generic or disease-specific PROM-based instruments for adults and children with specific NMDs. The data charting process involved extracting measurement properties of included PROMs, comprising validity, reliability, responsiveness, and interpretability information. The review identified 190 PROMs evaluated across 247 studies in individuals with NMDs. The majority of PROMs were disease specific. The physical functioning domain was most assessed. Validity was the most frequently investigated measurement property, with a limited number of PROMs sufficiently evaluated for a range of psychometric characteristics. There is a strong need for further research on the responsiveness and interpretability of PROMs and the development of PROMs on social functioning in NMD.

Manual Instruments as an Alternative to Drilling for Bony Exposure in Skull Base Surgery: Concept and Technique.

Background Drilling in neurosurgery is an integral part of surgical exposure, especially in skull base approaches and craniovertebral junction (CVJ) surgeries. Most of such drillings are done in close proximity to the neurovascular structures in skull base surgeries and cervical-medullary junction or facet/pedicle in CVJ surgeries. Reluctance to drilling among young neurosurgeons is due to less hands-on experience during training and also, in the early part of the career, due to fear of injury to neurovascular structures. Methods Five commonest bone removals for skull base region and CVJ surgeries that can be safely done using manual instruments were identified based on experiences of senior authors. The authors highlight key technical nuances to widen surgical corridors using manual instruments safely for skull base surgical approaches. Results Basic neuroanatomical concepts and basic physics help in using manual instruments safely for bone removals in various skull base surgical approaches. Conclusions Manual instruments may be used for bone removals in selected skull base surgical approaches, which help young neurosurgeons to perform these surgeries in limited-resource settings.

A scientometric analysis of bone cutting tools & methodologies: Mapping the research landscape.

This study undertakes a Scientometric analysis of bone-cutting tools, investigating a corpus of 735 papers from the Scopus database between 1941 and 2023. It employs bibliometric methodologies such as keyword coupling, co-citation, and co-authorship analysis to map the intellectual landscape and collaborative networks within this research domain. The analysis highlights a growing interest and significant advancements in bone-cutting tools, focusing on their design, the materials used, and the cutting processes involved. It identifies key research fronts and trends, such as the emphasis on surgical precision, material innovation, and the optimization of tool performance. Further, the study reveals a broad collaboration among researchers from various disciplines, including engineering, materials science, and medical sciences, reflecting the field's interdisciplinary nature. Despite the progress, the analysis points out several gaps, notably in tool design optimization and the impact of materials on bone health. This comprehensive review not only charts the evolution of bone-cutting tool research but also calls attention to areas requiring further investigation, aiming to inspire future studies that address these identified gaps and enhance surgical outcomes.

The Influence of Nickel-Titanium (Ni-Ti) Rotary Instrument Systems on Debris and Smear Layer Formation in Endodontic Procedures: An In Vitro Scanning Electron Microscopy Study.

Background Successful endodontic treatment relies on the effective removal of debris and the prevention of smear layer formation within the root canals. The choice of nickel-titanium (Ni-Ti) rotary instrument systems can significantly impact these outcomes. Aim This study aims to evaluate and compare the debris and smear layer formation in root canals of extracted mandibular second premolar teeth following instrumentation with the ProTaper Universal (Dentsply Sirona, Charlotte, NC) (Group II), Twisted File (Kerr Endodontics, Gilbert, AZ) (Group III), and XP Endo (FKG Dentaire, La Chaux-de-Fonds, Switzerland) (Group IV) Ni-Ti rotary instrument systems. Methods In this in vitro study, 60 extracted mandibular second premolar teeth were randomly divided into four groups, each containing 15 teeth. Group I served as the control with no instrumentation. Groups II, III, and IV were instrumented with the ProTaper Universal rotary file, the Twisted File, and the XP Endo file systems, respectively. Debris and smear layer formation were evaluated through scanning electron microscopy (SEM), and photomicrographs were scored using a standardized index. Results Group II (ProTaper) exhibited the highest mean debris and smear layer scores, with values of 3.50 and 2.70, respectively. Group IV (XP Endo) demonstrated the least debris and smear layer formation, with mean scores of 2.65 and 2.08, respectively. Statistical analysis confirmed significant differences among the groups for both debris and smear layer formation. Conclusion The results highlight the practical importance of selecting appropriate Ni-Ti rotary instrument systems to minimize debris and smear layer formation during endodontic procedures. The XP Endo file system showed promise as a favorable choice in this regard, but further clinical research is needed to validate these findings.