Medicine
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Observational Study
Apoptosis in cerebrospinal fluid as outcome predictors in severe traumatic brain injury: An observational study.
Traumatic brain injury (TBI), due to its high mortality and morbidity, is an important research topic. Apoptosis plays a pathogenic role in a series of neurological disorders, from neurodegenerative diseases to acute neurological lesions. In this study, we analyzed the association between apoptosis and the Glasgow Outcome Scale (GOS), to examine the potential of apoptosis as a biomarker for a TBI outcome. ⋯ However, the AUC for their combined prediction was 0.978, with a specificity and sensitivity of 96.0% and 95.2%, respectively, showing that the combined prediction was more reliable than that of the 2 separate factors. We demonstrated that caspase-3, cytochrome C, sFas, and caspase-9 were significantly increased in the CSF of patients following severe TBI. Furthermore, we found that ICP and caspase-3 were more reliable for outcome prediction in combination, rather than separately.
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Convolutional neural networks (CNNs), a particular type of deep learning architecture, are positioned to become one of the most transformative technologies for medical applications. The aim of the current study was to evaluate the efficacy of deep CNN algorithm for the identification and classification of dental implant systems. A total of 5390 panoramic and 5380 periapical radiographic images from 3 types of dental implant systems, with similar shape and internal conical connection, were randomly divided into training and validation dataset (80%) and a test dataset (20%). ⋯ The test dataset was used to assess the accuracy, sensitivity, specificity, receiver operating characteristic curve, area under the receiver operating characteristic curve (AUC), and confusion matrix compared between deep CNN and periodontal specialist. We found that the deep CNN architecture (AUC = 0.971, 95% confidence interval 0.963-0.978) and board-certified periodontist (AUC = 0.925, 95% confidence interval 0.913-0.935) showed reliable classification accuracies. This study demonstrated that deep CNN architecture is useful for the identification and classification of dental implant systems using panoramic and periapical radiographic images.
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In cases of persistent pupillary membrane (PPM), the eye is usually slightly microphthalmic and emmetropia or hyperopia is often present, yet severe myopia is reportedly rare. Here we presented a case of PPM complicated by vitreomacular traction syndrome and posterior staphyloma due to severe myopia. ⋯ The findings in this case show that when required, vitrectomy should be considered based upon the preoperative Optical coherence tomography findings for PPM.
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Meta Analysis
Interventions to reduce burnout of physicians and nurses: An overview of systematic reviews and meta-analyses.
Numerous systematic reviews and meta-analyses on the interventions to reduce burnout of physicians and nurses have been published nowadays. This study aimed to summarize the evidence and clarify a bundled strategy to reduce burnout of physicians and nurses. ⋯ Burnout is a complicated problem and should be dealt with by using bundled strategy. The existing overview clarified evidence to reduce burnout of physicians and nurses, which provided a basis for health policy makers or clinical managers to design simple and feasible strategies to reduce the burnout of physicians and nurses, and to ensure clinical safety.
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Review Case Reports
Primary pulmonary extranodal natural killer/T-cell lymphoma (ENKTL), nasal type: Two case reports and literature review.
Extranodal natural killer/T-cell lymphoma (ENKTL) - nasal type is an aggressive form of malignant non-Hodgkin lymphoma with a very poor prognosis. Especially primary pulmonary ENKTL is a relatively rare form of non-Hodgkin lymphoma. Until now, the prevalence of primary pulmonary ENKTL is unknown. Since 2001, only 18 cases of primary pulmonary ENKTL have been published, in addition to the 2 cases reported here. ⋯ The diagnosis of ENKTL should be considered when patients present with fever and expansile consolidation of the lung not responding to antibiotics. The diagnosis depends on histopathology and immunophenotyping. Percutaneous transthoracic needle biopsy is a safe and effective biopsy method. Chemotherapy may improve the prognosis, but this should be confirmed by prospective multicenter studies.