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2.
Arch Dermatol Res ; 316(7): 359, 2024 Jun 08.
Artículo en Inglés | MEDLINE | ID: mdl-38850412

RESUMEN

Post-acne erythema (PAE) is a bothering skin condition that emerges from inflammatory acne and persists after its resolution. It is characterized by telangiectasia and erythematous macules. the role of 1064-nm Nd: YAG when combined with low-dose isotretinoin in the acne erythema treatment. forty-eight PAE patients were involved in the study. They were divided into two groups; group (A) patients administering a low dose of oral isotretinoin (10 mg/day) and underwent a total of six two-week interval sessions of 1064 ND-YAG laser treatment, group (B) patients administering a low dose of oral isotretinoin (10 mg/day) only. All adverse effects experienced during the course of therapy were documented, and photos were taken before the start of the treatment and following the end of the treatment duration. Following the completion of the therapeutic intervention, a significant improvement in clinical condition was observed in both groups, with more improvement in group (A) compared to group (B) as evidenced by a notable improvement in the score on the Clinician Erythema Assessment Scale (CEAS) and also a significant decrease in the mean value of optical density of the erythema. combined 1064-nm Nd: YAG with low-dose isotretinoin may be an efficient and secure line in the PAE treatment. Also, the combined therapy had superior results when compared to low-dose isotretinoin alone.


Asunto(s)
Acné Vulgar , Fármacos Dermatológicos , Eritema , Isotretinoína , Láseres de Estado Sólido , Humanos , Isotretinoína/administración & dosificación , Isotretinoína/efectos adversos , Isotretinoína/uso terapéutico , Eritema/etiología , Eritema/diagnóstico , Eritema/tratamiento farmacológico , Acné Vulgar/tratamiento farmacológico , Acné Vulgar/terapia , Acné Vulgar/diagnóstico , Femenino , Masculino , Láseres de Estado Sólido/uso terapéutico , Láseres de Estado Sólido/efectos adversos , Adulto , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/efectos adversos , Adulto Joven , Resultado del Tratamiento , Adolescente , Terapia Combinada/métodos , Terapia Combinada/efectos adversos
3.
BMC Oral Health ; 24(1): 609, 2024 May 25.
Artículo en Inglés | MEDLINE | ID: mdl-38796434

RESUMEN

BACKGROUND: High speed electric handpieces have recently been growing in popularity among dental professionals. Advantages include smoother surface preparation and increased cutting efficiency. AIM: The primary objective was to compare enamel surface roughness following resin cleanup after bracket debonding using highspeed air turbine versus electric handpiece. The secondary objective was to record the time needed for resin-clean up. METHOD: Forty deidentified freshly extracted human premolars were cleaned and sectioned at the cement-enamel junction. The crowns were embedded in acrylic blocks. Enamel surface roughness parameters (Ra, Rz, Rp and Rv) were measured using a stylus profilometer. Brackets were bonded using a light-cure orthodontic adhesive and stored in distilled water for 24 h. Following bracket debonding, the specimens were randomly divided into 2 groups: First group: resin clean-up was carried out using a 12-fluted carbide bur mounted on a high-speed air turbine; and second group: where an electric handpiece was used. Surface roughness parameters were measured following resin clean up and after polishing using pumice and a rubber cup. Time needed for resin clean-up was recorded. Differences in enamel surface roughness and time between groups were compared using repeated measures ANOVA and independent samples t-test, respectively at P ≤ 0.05. RESULTS: The electric handpiece groups showed significantly higher values for Ra, Rz and Rp both following resin cleanup and polishing. Time taken for resin cleanup was significantly longer for the electric handpiece group. CONCLUSION: Considering both surface roughness and time, electric handpiece do not seem to add greater effectiveness or efficiency to resin cleanup following orthodontic bracket debonding.


Asunto(s)
Desconsolidación Dental , Esmalte Dental , Equipo Dental de Alta Velocidad , Propiedades de Superficie , Humanos , Desconsolidación Dental/métodos , Técnicas In Vitro , Cementos de Resina/química , Soportes Ortodóncicos , Factores de Tiempo , Diente Premolar , Pulido Dental/métodos
4.
PeerJ ; 12: e17007, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38584941

RESUMEN

Soybean milk is a rich plant-based source of protein, and phenolic compounds. This study compared the nutritional value of soybean milk, flour, soy protein isolate (SPI) and evaluated the impact of prepared vitamin E/calcium salt/soy protein isolate nanoparticles (ECSPI-NPs) on fortification of developed soybean milk formulations. Results indicated that soybean flour protein content was 40.50 g/100 g, that fulfills 81% of the daily requirement (DV%), the unsaturated fatty acids (USFs), oleic and linoleic content was 21.98 and 56.7%, respectively, of total fatty acids content. In soybean milk, essential amino acids, threonine, leucine, lysine achieved 92.70, 90.81, 77.42% of amino acid scores (AAS) requirement values respectively. Ferulic acid was the main phenolic compound in soybean flour, milk and SPI (508.74, 13.28, 491.78 µg/g). Due to the moisture content of soybean milk (88.50%) against (7.10%) in soybean flour, the latest showed higher nutrients concentrations. The prepared calcium (20 mM/10 g SPI) and vitamin E (100 mg/g SPI) nanoparticles (ECSPI-NPs) exhibited that they were effectively synthesized under transmission electron microscope (TEM), stability in the zeta sizer analysis and safety up to IC50 value (202 ug/mL) on vero cell line. ECSPI-NPs fortification (NECM) enhanced significantly phenolic content (149.49 mg/mL), taste (6.10), texture (6.70) and consumer overall acceptance (6.54). Obtained results encourage the application of the prepared ECSPI-NPs for further functional foods applications.


Asunto(s)
Glycine max , Proteínas de Soja , Calcio de la Dieta/análisis , Ácidos Grasos/análisis , Leche/química , Proteínas de Soja/análisis
5.
Artículo en Inglés | MEDLINE | ID: mdl-38155012

RESUMEN

INTRODUCTION: Aligning dental arches in orthognathic treatment after undergoing LeFort I osteotomy or bilateral sagittal split osteotomy (BSSO) relies on occlusal splints, which do not provide precise control over the condylar head. AIM OF THE STUDY: To clinically and radiographically assess the accuracy of computer-assisted design and manufactured (CAD/CAM) surgical guide for condylar positioning in a BSSO. MATERIALS AND METHODS: The study recruited 8 patients with a non-syndromic dentofacial deformity who underwent a BSSO. Surgery was planned according to CAD/CAM technology. After osteotomy, a pre-operative guide was used, followed by a repositioning guide. Computed tomography scans were conducted on all patients 1 week pre-operatively, immediately, and 3 months postoperatively. RESULTS: The data are presented as median values with the 25th and 75th percentiles. Eight patients (37.50% females and 62.50% males) between the ages of 19 and 24 underwent BSSOs. The surgical procedure successfully corrected their skeletal deformities. The absolute change between immediate postoperative and pre-operative condylar angle was 0.15 (0.00-0.3). The absolute change between 3 months postoperative and pre-operative condylar angle was 0.20 (0.00-0.30). CONCLUSION: The stability of the condylar head in position is well assessed by 3-dimensional condylar positioning devices designed and manufactured by CAD/CAM technology in the mandibular BSSO.


Asunto(s)
Cóndilo Mandibular , Osteotomía Sagital de Rama Mandibular , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Diseño Asistido por Computadora , Mandíbula , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/cirugía , Osteotomía Mandibular , Osteotomía Sagital de Rama Mandibular/métodos , Tomografía Computarizada por Rayos X
6.
J Am Coll Radiol ; 20(11S): S433-S454, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-38040463

RESUMEN

Total knee arthroplasty is the most commonly performed joint replacement procedure in the United States. This manuscript will discuss the recommended imaging modalities for six clinical variants; 1. follow-up of symptomatic or asymptomatic patients with a total knee arthroplasty. Initial imaging, 2. Suspected infection after total knee arthroplasty. Additional imaging following radiographs, 3. Pain after total knee arthroplasty. Infection excluded. Suspect aseptic loosening or osteolysis or instability. Additional imaging following radiographs, 4. Pain after total knee arthroplasty. Suspect periprosthetic or hardware fracture. Additional imaging following radiographs, 5. Pain after total knee arthroplasty. Measuring component rotation. Additional imaging following radiographs, and 6. Pain after total knee arthroplasty. Suspect periprosthetic soft-tissue abnormality unrelated to infection, including quadriceps or patellar tendinopathy. Additional imaging following radiographs. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Dolor Crónico , Humanos , Artralgia/diagnóstico por imagen , Dolor Crónico/diagnóstico por imagen , Diagnóstico por Imagen/métodos , Radiografía , Sociedades Médicas , Estados Unidos
7.
AJR Am J Roentgenol ; 2023 09 06.
Artículo en Inglés | MEDLINE | ID: mdl-37672330

RESUMEN

The importance of developing a robust remote workforce in academic radiology has come to the forefront due to several converging factors. COVID-19, and the abrupt transformation it precipitated in terms of how radiologists worked, has been the biggest impetus for change; concurrent factors such as increasing examination volumes and radiologist burnout have also contributed. How to best advance the most desirable and favorable aspects of remote work while preserving an academic environment that fulfills the tripartite mission is a critical challenge that nearly all academic institutions face today. In this article, we discuss current challenges in academic radiology, including effects of the COVID-19 pandemic, from three perspectives-the radiologist, the learner, and the health system-addressing the following topics: productivity, recruitment, wellness, clinical supervision, mentorship and research, educational engagement, radiologist access, investments in technology, and radiologist value. Throughout, we focus on the opportunities and drawbacks of remote work, to help guide its effective and reliable integration into academic radiology practices.

8.
BMC Oral Health ; 23(1): 583, 2023 08 21.
Artículo en Inglés | MEDLINE | ID: mdl-37605187

RESUMEN

BACKGROUND: Retainer is a necessary procedure when orthodontic treatment complete to avoid relapse due to periodontal fiber elasticity and to allow for alveolar bone regeneration. Compare the influence of vertical force on the failure of three fixed retainers: CAD/CAM polyether ether ketone (PEEK), CAD/CAM fiber glass reinforced composites (FRCs), and lingual retainer wire "Bond-A-Braid™". MATERIALS AND METHODS: One hundred and eight maxillary first premolars teeth were randomly allocated to three groups: Group A (CAD/CAM PEEK), Group B (CAD/CAM FRC), and Group C (lingual retainer wire " Bond-A-Braid™"). These retainers were bonded using Assure Plus Bonding Resin and GO TO Paste. For each specimen, a loading cycling and thermocycling machine was used. The failure debonding forces were measured on the interproximal segments using a universal testing machine with a cross-head speed of 1 mm/min. The adhesive remnant index (ARI) was calculated after identifying types of failure with a stereomicroscope at (X 20) magnification. RESULTS: Group B and group C showed the highest failure bonding forces, with a mean of 209.67 ± 16.15 and 86.81 ± 4.59 N, respectively. However, Group A had a statistically significant lower bond failure force, with a mean value of 45.73 ± 4.48 N. At baseline, there was a statistically significant difference in connector retainer displacement between the three studied groups (p < .001). The ARI score was not statistically significant (p < .001) between the three study groups; for groups A and B, the ARI was predominantly score 3, and group C showed a mixed score of 2 and 3. The failure mode of retainers was investigated using an optical stereomicroscope. In group B, there was a cohesive breakdown in the retainer, and groups A and C exhibited failures primarily in the adhesive at the retainer interface. CONCLUSION: All groups differed significantly, with group A having the lowest debonding force and group B having the highest. Furthermore, there was not a substantial variation in ARI, but there was a significant difference in connector retainer displacement and the types of failure amongst the three groups.


Asunto(s)
Benzofenonas , Proyectos de Investigación , Humanos , Cetonas , Éteres
9.
Emerg Radiol ; 30(5): 577-587, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37458917

RESUMEN

PURPOSE: Previous investigations into the causes of error by radiologists have addressed work schedule, volume, shift length, and sub-specialization. Studies regarding possible associations between radiologist errors and radiologist age and timing of residency training are lacking in the literature, to our knowledge. The aim of our study was to determine if radiologist age and residency graduation date is associated with diagnostic errors. METHODS: Our retrospective analysis included 1.9 million preliminary interpretations (out of a total of 5.2 million preliminary and final interpretations) of imaging examinations by 361 radiologists in a US-based national teleradiology practice between 1/1/2019 and 1/1/2020. Quality assurance data regarding the number of radiologist errors was generated through client facility feedback to the teleradiology practice. With input from both the client radiologist and the teleradiologist, the final determination of the presence, absence, and severity of a teleradiologist error was determined by the quality assurance committee of radiologists within the teleradiology company using standardized criteria. Excluded were 3.2 million final examination interpretations and 93,963 (1.8%) of total examinations from facilities reporting less than one discrepancy in examination interpretation in 2019. Logistic regression with covariates radiologist age and residency graduation date was performed for calculation of relative risk of overall error rates and by major imaging modality. Major errors were separated from minor errors as those with a greater likelihood of affecting patient care. Logistic regression with covariates radiologist age, residency graduation date, and log total examinations interpreted was used to calculate odds of making a major error to that of making a minor error. RESULTS: Mean age of the 361 radiologists was 51.1 years, with a mean residency graduation date of 2001. Mean error rate for all examinations was 0.5%. Radiologist age at any residency graduation date was positively associated with major errors (p < 0.05), with a relative risk 1.021 for each 1-year increase in age and relative risk 1.235 for each decade as well as for minor errors (p < 0.05, relative risk 1.007 for each year, relative risk 1.082 for each decade). By major imaging modality, radiologist age at any residency graduation date was positively associated with computed tomography (CT) and X-ray (XR) major and minor error, magnetic resonance imaging (MRI) major error, and ultrasound (US) minor error (p < 0.05). Radiologist age was positively associated with odds of making a major vs. minor error (p < 0.05). CONCLUSIONS: The mean error rate for all radiologists was low. We observed that increasing age at any residency graduation date was associated with increasing relative risk of major and minor errors as well as increasing odds of a major vs. minor error among providers. Further study is needed to corroborate these results, determine clinical relevance, and highlight strategies to address these findings.


Asunto(s)
Radiólogos , Tomografía Computarizada por Rayos X , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Errores Diagnósticos , Ultrasonografía
10.
J Am Coll Radiol ; 20(10): 1063-1071, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37400045

RESUMEN

PURPOSE: The aim of this study was to assess academic rank differences between academic emergency and other subspecialty diagnostic radiologists. METHODS: Academic radiology departments likely containing emergency radiology divisions were identified by inclusively merging three lists: Doximity's top 20 radiology programs, the top 20 National Institutes of Health-ranked radiology departments, and all departments offering emergency radiology fellowships. Within departments, emergency radiologists (ERs) were identified via website review. Each was then matched on career length and gender to a same-institutional nonemergency diagnostic radiologist. RESULTS: Eleven of 36 institutions had no ERs or insufficient information for analysis. Among 283 emergency radiology faculty members from 25 institutions, 112 career length- and gender-matched pairs were included. Average career length was 16 years, and 23% were women. The mean h indices for ERs and non-ERs were 3.96 ± 5.60 and 12.81 ± 13.55, respectively (P < .0001). Non-ERs were twice as likely as ERs (0.21 versus 0.1) to be associate professors at h index < 5. Men had nearly 3 times the odds of advanced rank compared with women (odds ratio, 2.91; 95% confidence interval, 1.02-8.26; P = .045). Radiologists with at least one additional degree had nearly 3 times the odds of advancing rank (odds ratio, 2.75; 95% confidence interval, 1.02-7.40; P = .045). Each additional year of practice increased the odds of advancing rank by 14% (odds ratio, 1.14; 95% confidence interval, 1.08-1.21; P < .001). CONCLUSIONS: Academic ERs are less likely to achieve advanced rank compared with career length- and gender-matched non-ERs, and this persists even after adjusting for h index, suggesting that academic ERs are disadvantaged in current promotions systems. Longer term implications for staffing and pipeline development merit further attention as do parallels to other nonstandard subspecialties such as community radiology.


Asunto(s)
Radiología , Masculino , Estados Unidos , Humanos , Femenino , Radiólogos , Centros Médicos Académicos , Recursos Humanos , National Institutes of Health (U.S.) , Docentes Médicos
11.
BMC Oral Health ; 23(1): 440, 2023 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-37393280

RESUMEN

BACKGROUND: Development of white spot lesions (WSLs) is common among orthodontic patients. Several measures have been introduced to prevent and remineralize the lesions. Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is used for both prevention and remineralization. The effect of its application before bonding is controversial. This systematic review was conducted to investigate the most up to date available literature regarding the effect of CPP-ACP enamel pre-treatment on shear bond strength (SBS) of metallic orthodontic brackets. METHODS: A search was conducted in electronic databases (MEDLINE (via PubMed), Scopus, Cochrane Library, Web of Science and Google scholar (grey literature)) up to March 29th, 2023. The inclusion criteria included in vitro studies comparing the SBS of metal orthodontic brackets following pre-treatment of enamel using CPP-ACP versus control. The exclusion criteria included study types other than in vitro studies, studies conducted on non-human enamel, or studies using CPP-ACP in combination with another intervention. The included studies were analysed by two reviewers, independently. The risk of bias assessment was done using a modified risk of bias tool. A Meta-analysis was performed. I2 values and Q-test were used for assessment of heterogeneity. Results were displayed in forest plots with a random-effects model. Standardized mean difference, standard error (SE) and 95% confidence intervals were calculated for all studies. RESULTS: The search resulted in 76 articles. After duplicate removal and assessment for eligibility, 15 studies were included in the review. High statistical heterogeneity was found among the included studies using I2 values and Q-Test (I2 = 95.147%; Q = 288.456; df = 14; P < 0.001). The overall effect of CPP-ACP pre-treatment on the SBS of metal orthodontic brackets was not significant (Mean difference = 1.163 MPa, SE = 0.757, 95% CI = -0.321, 2.648, p value = 0.125). The use of CPP-ACP for prevention of WSLs did not significantly affect the SBS of brackets (Standardized mean difference = 1.009, SE = 0.884, 95% CI = -0.723, 2.740, p value = 0.254). No significant change was found when CPP-ACP was used for remineralization of WSLs (Standardized mean difference = 1.501, SE = 1.087, 95% CI = -0.630, 3.632, p value = 0.167). CONCLUSIONS: Within the limitations of the study, the evidence suggests that the use of CPP-ACP for either prevention or remineralization of WSLs before bonding does not affect the SBS of metal orthodontic brackets.


Asunto(s)
Caseínas , Proyectos de Investigación , Humanos , Caseínas/uso terapéutico , Bases de Datos Factuales , Esmalte Dental
12.
Emerg Radiol ; 30(4): 453-463, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37349643

RESUMEN

PURPOSE: To assess if patients who underwent head computed tomography (CT) experienced disparities in the emergency department (ED) and if the indication for head CT affected disparities. METHODS: This study employed a retrospective, IRB-approved cohort design encompassing four hospitals. All ED patients between January 2016 and September 2020 who underwent non-contrast head CTs were included. Furthermore, key time intervals including ED length of stay (LOS), ED assessment time, image acquisition time, and image interpretation time were calculated. Time ratio (TR) was used to compare these time intervals between the groups. RESULTS: A total of 45,177 ED visits comprising 4730 trauma cases, 5475 altered mental status cases, 11,925 cases with head pain, and 23,047 cases with other indications were included. Females had significantly longer ED LOS, ED assessment time, and image acquisition time (TR = 1.012, 1.051, 1.018, respectively, P-value < 0.05). This disparity was more pronounced in female patients with head pain complaints compared to their male counterparts (TR = 1.036, 1.059, and 1.047, respectively, P-value < 0.05). Black patients experienced significantly longer ED LOS, image acquisition time, and image assessment time (TR = 1.226, 1.349, and 1.190, respectively, P-value < 0.05). These disparities persisted regardless of head CT indications. Furthermore, patients with Medicare/Medicaid insurance also faced longer wait times in all the time intervals (TR > 1, P-value < 0.001). CONCLUSIONS: Wait times for ED head CT completion were longer for Black patients and Medicaid/Medicare insurance holders. Additionally, females experienced extended wait times, particularly when presented with head pain complaints. Our findings underscore the importance of exploring and addressing the contributing factors to ensure equitable and timely access to imaging services in the ED.


Asunto(s)
Servicio de Urgencia en Hospital , Medicare , Anciano , Humanos , Masculino , Femenino , Estados Unidos , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Cefalea , Tiempo de Internación
14.
J Pers Med ; 13(5)2023 Apr 27.
Artículo en Inglés | MEDLINE | ID: mdl-37240918

RESUMEN

Full thickness cartilage defects in cases of knee osteoarthritis are challenging in nature and are difficult to treat. The implantation of three-dimensional (3D) biofabricated grafts into the defect site can be a promising biological one-stage solution for such lesions that can avoid different disadvantages of the alternative surgical treatment options. In this study, the short-term clinical outcome of a novel surgical technique that uses a 3D bioprinted micronized adipose tissue (MAT) graft for knee cartilage defects is assessed and the degree of incorporation of such graft types is evaluated via arthroscopic and radiological analyses. Ten patients received 3D bioprinted grafts consisting of MAT with an allogenic hyaline cartilage matrix on a mold of polycaprolactone, with or without adjunct high tibial osteotomy, and they were monitored until 12 months postoperatively. Clinical outcomes were examined with patient-reported scoring instruments that consisted of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score and the Knee Injury and Osteoarthritis Outcome Score (KOOS). The graft incorporation was assessed using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score. At 12 months follow-up, cartilage tissue biopsy samples were taken from patients and underwent histopathological examination. In the results, at final follow-up, the WOMAC and KOOS scores were 22.39 ± 7.7 and 79.16 ± 5.49, respectively. All scores were significantly increased at final follow-up (p < 0.0001). MOCART scores were also improved to a mean of 82.85 ± 11.49, 12 months after operation, and we observed a complete incorporation of the grafts with the surrounding cartilage. Together, this study suggests a novel regeneration technique for the treatment of knee osteoarthritis patients, with less rejection response and better efficacy.

15.
Clin Imaging ; 96: 9-14, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36731373

RESUMEN

PURPOSE: Evaluate if disparities in the emergency department (ED) imaging timeline exist, and if disparities are altered during high volume periods which may stress resource availability. METHODS: This retrospective study was conducted at a four-hospital healthcare system. All patients with at least one ED visit containing imaging from 1/1/2016 to 9/30/2020 were included. Peak hours were defined as ED encounters occurring between 5 pm and midnight, while all other ED encounters were non-peak hours. Patient-flow data points included ED length of stay (LOS), image acquisition time, and diagnostic image assessment time. RESULTS: 321,786 total ED visits consisted of 102,560 during peak hours and 219,226 during non-peak hours. Black patients experienced longer image acquisition and image assessment times across both time periods (TR = 1.030; p < 0.001 and TR = 1.112; p < 0.001, respectively); Black patients also had increased length of stay compared to White patients, which was amplified during peak hours. Likewise, patients with primary payer insurance experienced significantly longer image acquisition and image assessment times in both periods (TR > 1.00; p < 0.05 for all). Females had longer image acquisition and image assessment time and the difference was more pronounced in image acquisition time during both peak and non-peak hours (TR = 1.146 and TR = 1.139 respectively with p < 0.001 for both). CONCLUSION: When measuring radiology time periods, patient flow throughout the ED was not uniform. There was unequal acceleration and deceleration of patient flow based on racial, gender, age, and insurance status. Segmentation of patient flow time periods may allow identification of causes of inequity such that disparities can be addressed with targeted actions.


Asunto(s)
Diagnóstico por Imagen , Servicio de Urgencia en Hospital , Femenino , Humanos , Estudios Retrospectivos , Tiempo de Internación , Factores de Tiempo
16.
Acad Radiol ; 30(7): 1481-1487, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-36710101

RESUMEN

RATIONALE AND OBJECTIVES: To evaluate radiology residents' perspectives regarding inclusion of artificial intelligence/ machine learning (AI/ML) education in the residency curriculum. MATERIALS AND METHODS: An online anonymous survey was sent to 759 residents at 21 US radiology residency programs. Resident demographics, sub-specialty interests, educational background and research experiences, as well as the awareness, availability, and usefulness of various resources for AI/ML education were collected. RESULTS: The survey response rate was 27% (209/759). A total of 74% of respondents were male, 80% were training at large university programs, and only a minority (<20) had formal education or research experience in AI/ML. All four years of training were represented (range: 20%-38%). The majority of the residents agreed or strongly agreed (83%) that AI/ML education should be a part of the radiology residency curriculum and that such education should equip them with the knowledge to troubleshoot an AI tool in practice / determine whether a tool is working as intended (82%). Among the residency programs that offer AI/ML education, the most common resources were lecture series (43%), national informatics courses (28%), and in-house/institutional courses (26%). About 24% of the residents reported no AI/ML educational offerings in their residency curriculum. Hands on AI/ML laboratory (67%) and lecture series (61%) were reported as the most beneficial or effective. The majority of the residents preferred AI/ML education offered as a continuous course spanning the radiology residency (R1 to R4) (76%), followed by mini fellowship during R4 (32%) and as a course during PGY1 (21%). CONCLUSION: Residents largely favor the inclusion of formal AI/ML education in the radiology residency curriculum, prefer hands-on learning and lectures as learning tools, and prefer a continuous AI/ML course spanning R1-R4.


Asunto(s)
Internado y Residencia , Radiología , Humanos , Masculino , Estados Unidos , Femenino , Inteligencia Artificial , Radiología/educación , Radiografía , Curriculum , Aprendizaje Automático , Encuestas y Cuestionarios
17.
Radiol Clin North Am ; 61(1): 151-166, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36336388

RESUMEN

Although superficial infections can often be diagnosed and managed clinically, physical examination may lack sensitivity and specificity, and imaging is often required to evaluate the depth of involvement and identify complications. Depending on the area of involvement, radiography, ultrasound, CT, MR imaging, or a combination of imaging modalities may be required. Soft tissue infections can be nonnecrotizing or necrotizing, with the later having a morbid and rapid course. Infectious tenosynovitis most commonly affects the flexor tendon sheaths of the hand, characterized by thickened and enhancing synovium with fluid-filled tendon sheaths.


Asunto(s)
Bursitis , Infecciones de los Tejidos Blandos , Tenosinovitis , Humanos , Infecciones de los Tejidos Blandos/diagnóstico por imagen , Bursitis/diagnóstico por imagen , Tenosinovitis/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Radiografía
18.
AJR Am J Roentgenol ; 220(2): 265-271, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36000666

RESUMEN

BACKGROUND. Increases in the use of CT to evaluate patients presenting with trauma have raised concern about inappropriate imaging. The evolving utilization of CT for trauma evaluation may be impacted by injury severity. OBJECTIVE. The purpose of this study was to explore patterns in utilization of chest and abdominopelvic CT among trauma-related emergency department (ED) visits across the United States. METHODS. This retrospective study was conducted with national commercial claims information extracted from the MarketScan Commercial Database. Trauma-related ED encounters were identified from the 2011-2018 MarketScan database files and classified by injury severity score (minor, intermediate, and major injuries) on the basis of International Classification of Diseases codes. ED encounters were also assessed for chest CT, abdominopelvic CT, and single-encounter chest and abdominopelvic CT examinations. Utilization per 1000 trauma-related ED encounters was determined. Multivariable Poisson regression models were used to determine incidence rate ratios (IRRs) as a measure of temporal changes in utilization. RESULTS. From 2011 to 2018, 8,369,092 trauma-related ED encounters were identified (5,685,295 for minor, 2,624,944 for intermediate, and 58,853 for major injuries). Utilization of chest CT per 1000 trauma-related ED encounters increased from 4.9 to 13.5 examinations (adjusted IRR, 1.15 per year; minor injuries, from 2.2 to 7.7 [adjusted IRR, 1.17]; intermediate injuries, from 8.5 to 21.5 [adjusted IRR, 1.16]; major injuries, from 117.8 to 200.1 [adjusted IRR, 1.08]). Utilization of abdominopelvic CT per 1000 trauma-related ED encounters increased from 7.5 to 16.4 (adjusted IRR, 1.12; minor injuries, 4.8 to 12.2 [adjusted IRR, 1.13]; intermediate injuries, 10.6 to 21.7 [adjusted IRR, 1.13]; major injuries, 134.8 to 192.6 [adjusted IRR, 1.07]). Utilization of single-encounter chest and abdominopelvic CT per 1000 trauma-related ED encounters increased from 3.4 to 8.9 [adjusted IRR, 1.16; minor injuries, 1.1 to 4.6 [adjusted IRR, 1.18]; intermediate injuries, 6.4 to 16.4 [adjusted IRR, 1.16]; major injuries, 99.6 to 179.9 [adjusted IRR, 1.08]). CONCLUSION. National utilization of chest and abdominopelvic CT for trauma-related ED encounters increased among commercially insured patients from 2011 to 2018, particularly for single-encounter chest and abdominopelvic CT examinations and for minor injuries. CLINICAL IMPACT. Given concerns about increased cost and detection of incidental findings, further investigation is warranted to explore the potential benefit of single-encounter chest and abdominopelvic CT examinations of patients with minor injuries and to develop strategies for optimizing appropriateness of imaging orders.


Asunto(s)
Servicio de Urgencia en Hospital , Tórax , Humanos , Estados Unidos , Estudios Retrospectivos , Tomografía Computarizada por Rayos X/métodos , Bases de Datos Factuales
19.
Front Nutr ; 9: 929977, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35845781

RESUMEN

Plant-derived phenolic compounds have numerous biological effects, including antioxidant, anti-inflammatory, and neuroprotective effects. However, their application is limited because they are degraded under environmental conditions. The aim of this study was to microencapsulate plant phenolic extracts using a complex coacervation method to mitigate this problem. Red beet (RB), broccoli (BR), and spinach leaf (SL) phenolic extracts were encapsulated by complex coacervation. The characteristics of complex coacervates [zeta potential, encapsulation efficiency (EE), FTIR, and morphology] were evaluated. The RB, BR, and SL complex coacervates were incorporated into an ultrafiltered (UF) cheese system. The chemical properties, pH, texture profile, microstructure, and sensory properties of UF cheese with coacervates were determined. In total, 54 male Sprague-Dawley rats were used, among which 48 rats were administered an oral dose of AlCl3 (100 mg/kg body weight/d). Nutritional and biochemical parameters, including malondialdehyde, superoxide dismutase, catalase, reduced glutathione, nitric oxide, acetylcholinesterase, butyrylcholinesterase, dopamine, 5-hydroxytryptamine, brain-derived neurotrophic factor, and glial fibrillary acidic protein, were assessed. The RB, BR, and SL phenolic extracts were successfully encapsulated. The RB, BR, and SL complex coacervates had no impact on the chemical composition of UF cheese. The structure of the RB, BR, and SL complex coacervates in UF cheese was the most stable. The hardness of UF cheese was progressively enhanced by using the RB, BR, and SL complex coacervates. The sensory characteristics of the UF cheese samples achieved good scores and were viable for inclusion in food systems. Additionally, these microcapsules improved metabolic strategies and neurobehavioral systems and enhanced the protein biosynthesis of rat brains. Both forms failed to induce any severe side effects in any experimental group. It can be concluded that the microencapsulation of plant phenolic extracts using a complex coacervation technique protected rats against AlCl3-induced neuroinflammation. This finding might be of interest to food producers and researchers aiming to deliver natural bioactive compounds in the most acceptable manner (i.e., food).

20.
Environ Sci Process Impacts ; 24(5): 805-824, 2022 May 25.
Artículo en Inglés | MEDLINE | ID: mdl-35481471

RESUMEN

Wastewater treatment wetlands are aquatic systems where diverse dissolved organic matter (DOM) compositions physically interact. Complex photochemical behaviors ensue, leading to uncertainties in the prediction of indirect photodegradation rates for organic contaminants. Here, we evaluate the photosensitization ability of whole water DOM samples from a treatment wetland and wastewater treatment plant (WWTP) in North Carolina to photodegrade target pharmaceuticals. Optical characterization using ultraviolet-visible and excitation-emission matrix spectroscopy shows that wetland DOM has higher aromaticity than WWTP DOM and that WWTP secondary treatment processes increase aromaticity, overall molecular weight, and humic character of wastewater DOM. Our application of a reversed-phase HPLC method to assess DOM polarity distinctly reveals that a subset of the wetland samples possesses an abundance of hydrophobic DOM moieties. Hydroxyl radicals (˙OH) mediate the majority (>50%) of the indirect photodegradation for amoxicillin (AMX), atenolol (ATL), and 17α-ethinylestradiol (EE2), while singlet oxygen (1O2) is presumed to be solely responsible for the photodegradation of cimetidine (CME). Our findings suggest that hydrophobic interactions and improved accessibility to photogenerated reactive intermediates lead to significant increases in photosensitization efficiencies and overall indirect photodegradation rates of AMX, ATL, and EE2 for the hydrophobic wetland samples. In contrast, CME photosensitization yields are unaffected by polarity and trend positively with optical indicators of sunlight-induced DOM photobleaching and humification, suggesting that wetland processing favors faster 1O2 photogeneration. These relationships highlight the uncertainties in photosensitization yields and effects of DOM optical properties and polarity on the photochemical fate of organic contaminants.


Asunto(s)
Contaminantes Químicos del Agua , Purificación del Agua , Materia Orgánica Disuelta , Preparaciones Farmacéuticas , Fotólisis , Contaminantes Químicos del Agua/química , Humedales
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