Are Current Patient-Reported Outcome Measures Fit for Purpose to Evaluate Unicompartmental Knee Arthroplasty?

The optimal procedure for isolated end-stage medial compartment knee osteoarthritis (OA) remains uncertain, with debate persisting between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). The aim of this narrative review is to evaluate current outcome measures in knee arthroplasty (KA) and explore how evolving patient populations and technological advancements may necessitate the use of different patient-reported outcome measures (PROMs) for evaluating UKA. While UKA offers potential advantages over TKA in early pain relief and functional outcomes, most randomised control trials using traditional PROMs have failed to show definitive superiority.

The Three-Class Annotation Method Improves the AI Detection of Early-Stage Osteosarcoma on Plain Radiographs: A Novel Approach for Rare Cancer Diagnosis.

: Developing high-performance artificial intelligence (AI) models for rare diseases is challenging owing to limited data availability. This study aimed to evaluate whether a novel three-class annotation method for preparing training data could enhance AI model performance in detecting osteosarcoma on plain radiographs compared to conventional single-class annotation. : We developed two annotation methods for the same dataset of 468 osteosarcoma X-rays and 378 normal radiographs: a conventional single-class annotation (1C model) and a novel three-class annotation method (3C model) that separately labeled intramedullary, cortical, and extramedullary tumor components.

Improved Consistency of Lung Nodule Categorization in CT Scans with Heterogeneous Slice Thickness by Deep Learning-Based 3D Super-Resolution.

: Accurate volumetric assessment of lung nodules is an essential element of low-dose lung cancer screening programs. Current guidance recommends applying specific thresholds to measured nodule volume to make the following clinical decisions. In reality, however, CT scans often have heterogeneous slice thickness which is known to adversely impact the accuracy of nodule volume assessment.

Fusion of FDG and FMZ PET Reduces False Positive in Predicting Epileptogenic Zone.

Background And Purpose: Epilepsy, a globally prevalent neurological disorder, necessitates precise identification of the epileptogenic zone (EZ) for effective surgical management. While the individual utilities of FDG PET and FMZ PET have been demonstrated, their combined efficacy in localizing the epileptogenic zone remains underexplored. We aim to improve the non-invasive prediction of epileptogenic zone (EZ) in temporal lobe epilepsy (TLE) by combining FDG PET and FMZ PET with statistical feature extraction and machine learning.

Do you know your PSMA-tracer? Variability in the biodistribution of different PSMA ligands and its potential impact on defining PSMA-positivity prior to PSMA-targeted therapy.

Background: In clinical practice, several radiopharmaceuticals are used for PSMA-PET imaging, each with distinct biodistribution patterns. This may impact treatment decisions and outcomes, as eligibility for PSMA-directed radioligand therapy is usually assessed by comparing tumoral uptake to normal liver uptake as a reference. In this study, we aimed to compare tracer uptake intraindividually in various reference regions including liver, parotid gland and spleen as well as the respective tumor-to-background ratios (TBR) of different F-labeled PSMA ligands to today's standard radiopharmaceutical Ga-PSMA-11 in a series of patients with biochemical recurrence of prostate cancer who underwent a dual PSMA-PET examination as part of an individualized diagnostic approach.

Prospective validation of ORACLE, a clonal expression biomarker associated with survival of patients with lung adenocarcinoma.

Human tumors are diverse in their natural history and response to treatment, which in part results from genetic and transcriptomic heterogeneity. In clinical practice, single-site needle biopsies are used to sample this diversity, but cancer biomarkers may be confounded by spatiogenomic heterogeneity within individual tumors. Here we investigate clonally expressed genes as a solution to the sampling bias problem by analyzing multiregion whole-exome and RNA sequencing data for 450 tumor regions from 184 patients with lung adenocarcinoma in the TRACERx study.

Balancing Data Quality and Bias: Investigating Functional Connectivity Exclusions in the Adolescent Brain Cognitive Development℠ (ABCD Study) Across Quality Control Pathways.

Analysis of resting state fMRI (rs-fMRI) typically excludes images substantially degraded by subject motion. However, data quality, including degree of motion, relates to a broad set of participant characteristics, particularly in pediatric neuroimaging. Consequently, when planning quality control (QC) procedures researchers must balance data quality concerns against the possibility of biasing results by eliminating data.

Partial PdAu nanoparticle embedding into TiO support accentuates catalytic contributions from the Au/TiO interface.

Despite the broad catalytic relevance of metal-support interfaces, controlling their chemical nature, the interfacial contact perimeter (exposed to reactants), and consequently, their contributions to overall catalytic reactivity, remains challenging, as the nanoparticle and support characteristics are interdependent when catalysts are prepared by impregnation. Here, we decoupled both characteristics by using a raspberry-colloid-templating strategy that yields partially embedded PdAu nanoparticles within well-defined SiO or TiO supports, thereby increasing the metal-support interfacial contact compared to nonembedded catalysts that we prepared by attaching the same nanoparticles onto support surfaces. Between nonembedded PdAu/SiO and PdAu/TiO, we identified a support effect resulting in a 1.

Emergency medical services level of training is associated with mortality in trauma patients: A combined prehospital and in hospital database analysis.

Background: There is conflicting evidence regarding emergency medical service (EMS) provider level of training and outcomes in trauma. We hypothesized that advanced life support (ALS) provider transport is associated with lower mortality compared with basic life support transport.

Methods: We performed secondary analysis of a combined prehospital and in-hospital database of trauma patients utilizing ESO electronic medical records from 2018 to 2022.

Comparison of Associations of Food Security Instruments and Mediators With Premature All-Cause and Cardiovascular Disease Death in US Adults.

Background: Food insecurity is associated with high morbidity and mortality and is typically measured with the 10-item US Adult Food Security Survey Module. Shorter instruments may capture similar information, but this has not been validated against mortality in general populations.

Methods: A nationally representative sample of individuals aged 20 to 74 years from the US National Health Interview Survey 2011 to 2018 was included, with deaths linked to the National Death Index through 2019.

Toward expert-level medical question answering with large language models.

Large language models (LLMs) have shown promise in medical question answering, with Med-PaLM being the first to exceed a 'passing' score in United States Medical Licensing Examination style questions. However, challenges remain in long-form medical question answering and handling real-world workflows. Here, we present Med-PaLM 2, which bridges these gaps with a combination of base LLM improvements, medical domain fine-tuning and new strategies for improving reasoning and grounding through ensemble refinement and chain of retrieval.

AMPed up immunity: 418 whole genomes reveal intraspecific diversity of koala antimicrobial peptides.

Characterising functional diversity is a vital element to understanding a species' immune function, yet many immunogenetic studies in non-model organisms tend to focus on only one or two gene families such as the major histocompatibility complex (MHC) or toll-like receptors (TLR). Another interesting component of the eukaryotic innate immune system is the antimicrobial peptides (AMPs). The two major groups of mammalian AMPs are cathelicidins and defensins, with the former having undergone species-specific expansions in marsupials.

Load-bearing capacity of screw-retained fixed dental prostheses made of monolithic zirconia on different abutment designs and abutment-free implant connection.

Objectives: A new abutment-free implant connection allows for direct screwing of FDPs on implants to avoid complications caused by cement rests or screw loosening, which may affect to screw torque and load distribution. The objective of this study was to test the initial (Fi) and final failure (Ff) loads and torque changes of abutment-free monolithic zirconia CAD-CAM fixed dental prostheses (FDPs) compared to titanium FDPs on different abutment designs.

Methods: Three-unit screw-retained FDPs (n = 50) on two implants (n = 100) were divided into groups (n = 10) based on the implant-abutment connection and material of the supra-structure: (1) abutment-free monolithic CAD-CAM zirconia FDP (Abut-free-Zr), (2) abutment-free veneered titanium FDPs (Abut-free-Ti), (3) monolithic zirconia FDPs with titanium base abutments (Zr-Ti-Base), (4) monolithic zirconia FDPs on multi-unit abutments (Zr-MU), (5) veneered titanium FDP on multi-unit abutments (Ti-MU).

Frequency of Missing TNM Stage Data for Adults With Intellectual or Developmental Disabilities in a Provincial Cancer Registry-A Brief Report.

Background: Adults with intellectual or developmental disability (IDD) are at higher risk for incomplete cancer staging.

Aim: To compare unknown stage data between those with and without IDD.

Materials And Methods: We used the Ontario Cancer Registry linked to administrative health data between 2007 and 2019.

Longitudinal association between nailfold capillaroscopy and incident interstitial lung disease: A EUSTAR database analysis.

Objectives: To evaluate (1) the association between nailfold capillaroscopy pattern and 5-year risk for incident interstitial lung disease and (2) the association between transition in nailfold capillaroscopy pattern and risk of incident interstitial lung disease.

Methods: Data of adult patients from the EUSTAR database fulfilling the ACR-EULAR criteria with a disease duration ⩽5 years, having a scleroderma pattern at nailfold capillaroscopy with high-resolution computed tomography confirmed absence of interstitial lung disease (i.e.

Rotator Cuff Repair Study Designs Correlate With Revision Shoulder Surgery Rates: A Systematic Review.

Purpose: To identify arthroscopic rotator cuff repair study groups and evaluate if study design or other study characteristics correlate with a repeat ipsilateral shoulder surgery.

Methods: A systematic search of the PubMed, Embase, and Cochrane Library databases was conducted on March 20, 2021, and April 2, 2021. The following search terms were used by 2 different researchers: ((Rotator cuff repair[Title/Abstract]) AND (Revision[Title/Abstract]) NOT (Systematic Review[Title/Abstract]) NOT (arthroplasty[Title/Abstract]).

Drop Vertical Jump Landing Mechanics Are Similar Between Patients With Quadriceps Tendon and Patellar Tendon Autografts After Anterior Cruciate Ligament Reconstruction.

Purpose: To compare the biomechanics of a drop vertical jump (DVJ) landing task and functional outcomes among patients with anterior cruciate ligament reconstruction (ACLR) with quadriceps tendon (QT) and patellar tendon (PT) autografts.

Methods: Physically active patients who underwent primary ACLR with either a QT or PT autograft were included in this study. All were within 6 months to 2 years after surgery and cleared for return to physical activity.

Using Quantitative Bias Analysis to Adjust for Misclassification of COVID-19 Outcomes: An Applied Example of Inhaled Corticosteroids and COVID-19 Outcomes.

Background: During the pandemic, there was concern that underascertainment of COVID-19 outcomes may impact treatment effect estimation in pharmacoepidemiologic studies. We assessed the impact of outcome misclassification on the association between inhaled corticosteroids (ICS) and COVID-19 hospitalisation and death in the United Kingdom during the first pandemic wave using probabilistic bias analysis (PBA).

Methods: Using data from the Clinical Practice Research Datalink Aurum, we defined a cohort with chronic obstructive pulmonary disease (COPD) on 1 March 2020.

Xalnesiran with or without an Immunomodulator in Chronic Hepatitis B.

Background: Xalnesiran, a small interfering RNA molecule that targets a conserved region of the hepatitis B virus (HBV) genome and silences multiple HBV transcripts, may have efficacy, with or without an immunomodulator, in patients with chronic HBV infection.

Methods: We conducted a phase 2, multicenter, randomized, controlled, adaptive, open-label platform trial that included the evaluation of 48 weeks of treatment with xalnesiran at a dose of 100 mg (group 1), xalnesiran at a dose of 200 mg (group 2), xalnesiran at a dose of 200 mg plus 150 mg of ruzotolimod (group 3), xalnesiran at a dose of 200 mg plus 180 μg of pegylated interferon alfa-2a (group 4), or a nucleoside or nucleotide analogue (NA) alone (group 5) in participants with chronic HBV infection who had virologic suppression with NA therapy. The primary efficacy end point was hepatitis B surface antigen (HBsAg) loss (HBsAg level, <0.

Surveillance Breast MRI in Women with a History of Breast Cancer: Association with Occurrence of Advanced Second Breast Cancer.

Background Studies on the association between surveillance breast MRI in women with a personal history of breast cancer (PHBC) and advanced second breast cancer are lacking. Purpose To investigate the association between postoperative surveillance breast MRI and advanced second breast cancer in women with a PHBC by using propensity score matching (PSM). Materials and Methods Women who underwent breast cancer surgery between January 2009 and December 2014 were retrospectively identified at a single tertiary center.

Safety and Efficacy of Remote Ischemic Conditioning in Patients With Intravenous Thrombolysis: The SERIC-IVT Trial.

Background: Approximately half of the patients with acute ischemic stroke who receive intravenous thrombolysis (IVT) do not achieve an excellent outcome. Remote ischemic conditioning (RIC) as a promising neuroprotective treatment may improve clinical outcomes in this population. This study aimed to assess the efficacy and safety of RIC in patients with IVT.

Antiviral Stewardship in Transplantation.

Though antimicrobial stewardship programs (ASPs) are required for hospitals, the involvement of transplant recipients in programmatic interventions, protocols, and metrics has historically been limited. Though there is a growing interest in studying stewardship practices in transplant patients, optimal practices have not been clearly established. A component of ASPs, antiviral stewardship (AVS), specifically targeting cytomegalovirus (CMV), has been more recently described.

The Strategic Advisory Group of Experts (SAGE) on Immunization-Past, Present and Future.

Background/objectives: In November 1999, WHO established the Strategic Advisory Group of Experts (SAGE) on Immunization as a multidisciplinary group of experts to provide high-level recommendations on vaccines and immunization.

Methods: This review provides an overview of SAGE's work in the past 25 years. It further outlines the processes and methods currently used by SAGE and highlights some of its major achievements.