Conventional Manual Technique Research Articles

Clinical experiences with robotic computed tomography-guided interventions: A comparison with manual technique

Background: Image-guided biopsies have become standard practice; however, challenges such as multiple punctures and re-attempts can complicate procedures. The introduction of robotic guidance systems, such as MAXIO offers a potential solution for improving planning and navigation. This study evaluated the efficacy of the MAXIO needle-guiding robotic device in computed tomography (CT)-guided interventions compared with conventional manual techniques. Aims and Objectives: This study aimed to evaluate the performance of the MAXIO robotic system for CT-guided biopsies at the Barnard Institute of Radiology and compare it with the conventional manual technique. Materials and Methods: A total of sixty patients who underwent CT-guided biopsies were retrospectively divided into two groups: Group A (manual procedure) and Group B (robot-assisted procedure). The MAXIO device was utilized in combination with a Siemens 32-slice CT scanner for robot-assisted biopsies. Key parameters analyzed between the two groups included the volume CT dose index, dose-length product (DLP), target location, target depth, target size, distance from the entry point, needle angulation, procedural time, number of punctures, complications, and re-biopsy rates. Results: Significant differences were found between the two groups in the number of punctures (p = 0.002), DLP (p = 0.0001), and degree of needle angulation (p = 0.0002), with the robotic technique demonstrating a better performance. Although the procedural time was reduced in the robotic group, this difference was not statistically significant (p = 0.104). Other assessed parameters, such as complications and rebiopsy rates, showed no significant differences. Conclusion: Robotic-assisted CT-guided procedures using the MAXIO system showed improved diagnostic accuracy and safety, with reductions in radiation dose, needle manipulations, and punctures, compared to conventional manual techniques.

Robotically Assisted vs. Manual Total Hip Arthroplasty in Developmental Hip Dysplasia: A Comparative Analysis of Radiological and Functional Outcomes.

Background/Objectives: Developmental dysplasia of the hip (DDH), defined by the malalignment of the femoral head and acetabulum, is a major precursor to coxarthrosis, posing substantial challenges during total hip arthroplasty (THA). Patients with coxarthrosis secondary to DDH often exhibit acetabular bone insufficiency, which makes challenging surgical reconstruction difficult. This study aimed to compare the radiologic and functional outcomes of robotically assisted and conventional manual THA techniques in patients with coxarthrosis secondary to Crowe type III-IV DDH. Methods: This prospective study included 40 patients divided into robotically assisted (n = 20) and conventional manual (n = 20) THA groups. Evaluations encompassed hip pain (Visual Analogue Scale, VAS), function (Harris hip score and University of California, Los Angeles, activity scale), quality of life (Short Form-12), and prosthesis sensation (Forgotten Joint Score-12). Radiologic outcomes included acetabular inclination and anteversion angles. Femoral shortening, operative duration, and follow-up times were also analyzed. Results: Demographic characteristics did not differ between groups (p > 0.05). Robotically assisted THA exhibited a significantly longer operative time (171.40 ± 11.96 vs. 150.30 ± 14.67 min; p = 0.001) but a shorter follow-up (29.3 ± 8.51 vs. 52.95 ± 18.96 months; p = 0.001), without a difference in the amount of femoral shortening (p = 0.947). Despite the extended surgical duration, the two techniques achieved comparable radiologic outcomes, with no significant differences in acetabular inclination or anteversion angles (p > 0.05). Functional assessments, including Harris hip scores (73.85 vs. 73.95; p = 0.978), UCLA activity scores, and VAS, indicated similar efficacy between groups. SF-12 physical and mental quality of life and Forgotten Joint Score-12 prosthesis sensation did not differ between groups (p > 0.05). Conclusions: This study concludes that robotically assisted and conventional manual THA present similar radiologic and functional outcomes in patients with coxarthrosis secondary to Crowe type III-IV DDH, as displayed by comparable acetabular anteversion and inclination alignment, femoral shortening, hip function, pain, quality of life, and prosthesis sensation scores. While robotically assisted THA requires a longer operative time, its precision in implant placement may hold potential advantages for long-term outcomes, demanding further investigation in extended follow-up studies.

Integrating Intelligent Web Scraping Techniques in Internship Management Systems: Enhancing Internship Matching

The study explores the integration of intelligent web scraping techniques to enhance the internship matching process within internship management systems. The increasing demand for internships necessitates timely and efficient intern matching, a task that conventional manual techniques need help with due to its complexity and time-consuming nature. Intelligent web scraping algorithms and machine learning techniques analyze extensive datasets to match interns with businesses based on competencies, interests, and professional objectives. The integration leverages natural language processing to extract relevant information from internship listings and candidate profiles, enhancing the precision and effectiveness of the matching process. Additionally, clustering and matching algorithms refine recommendations, pairing students with opportunities that fit their competencies and career objectives. However, implementing intelligent web scraping raises ethical concerns, particularly regarding data privacy and algorithmic bias. Ensuring the ethical utilization of these techniques is critical for fair and unbiased internship matching. The research addresses these ethical considerations while proposing a framework for integrating intelligent web scraping into existing systems. The study reviews the literature on web scraping and machine learning in internship management, critically analyzing and synthesizing past research findings to demonstrate the efficacy of these techniques over conventional methods. The study also introduces a theoretical model for effective internship matching, investigating intelligent web scraping and machine learning techniques to optimize the process. Additionally, it examines the benefits, challenges, and limitations of integrating these techniques. The proposed intelligent web scraping approach simplifies internship matching, aligns student strengths with opportunities, enhances onboarding efficiency, and bridges academic learning with practical application.

Advancements in natural language processing: Implications, challenges, and future directions

This research delves into the latest advancements in Natural Language Processing (NLP) and their broader implications, challenges, and future directions. With the ever-increasing volume of text data generated daily from diverse sources, extracting relevant and valuable information is becoming more complex. Conventional manual techniques for handling and examining written information are laborious and susceptible to mistakes, underscoring the necessity for effective automated alternatives. The advancements in Natural Language Processing (NLP), namely in transformer-based models and deep learning techniques, have demonstrated considerable potential in improving the precision and consistency of various NLP applications. This work presents a novel approach that combines systematic review methods with sophisticated NLP approaches to enhance the overall efficiency of NLP systems. The proposed strategy guarantees an organized and clear literature review process, resulting in more informative and contextually relevant results. The report examines NLP's implications, problems, and opportunities, providing significant insights that are anticipated to propel improvements in NLP technology and its application in many industries.

Robotic-assisted unicompartmental knee arthroplasty improves functional outcomes, complications, and revisions.

Robotic-assisted unicompartmental knee arthroplasty (R-UKA) has been proposed as an approach to improve the results of the conventional manual UKA (C-UKA). The aim of this meta-analysis was to analyze the studies comparing R-UKA and C-UKA in terms of clinical outcomes, radiological results, operating time, complications, and revisions. The literature search was conducted on three databases (PubMed, Cochrane, and Web of Science) on 20 February 2024 according to the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Inclusion criteria were comparative studies, written in the English language, with no time limitations, on the comparison of R-UKA and C-UKA. The quality of each article was assessed using the Downs and Black Checklist for Measuring Quality. Among the 3,669 articles retrieved, 21 studies on 19 series of patients were included. A total of 3,074 patients (59.5% female and 40.5% male; mean age 65.2 years (SD 3.9); mean BMI 27.4 kg/m2 (SD 2.2)) were analyzed. R-UKA obtained a superior Knee Society Score improvement compared to C-UKA (mean difference (MD) 4.9; p < 0.001) and better Forgotten Joint Score postoperative values (MD 5.5; p = 0.032). The analysis of radiological outcomes did not find a statistically significant difference between the two approaches. R-UKA showed longer operating time (MD 15.6; p < 0.001), but reduced complication and revision rates compared to C-UKA (5.2% vs 10.1% and 4.1% vs 7.2%, respectively). This meta-analysis showed that the robotic approach for UKA provided a significant improvement in functional outcomes compared to the conventional manual technique. R-UKA showed similar radiological results and longer operating time, but reduced complication and revision rates compared to C-UKA. Overall, R-UKA seems to provide relevant benefits over C-UKA in the management of patients undergoing UKA.

Detection and identification of plant leaf diseases using YOLOv4.

Detecting plant leaf diseases accurately and promptly is essential for reducing economic consequences and maximizing crop yield. However, farmers' dependence on conventional manual techniques presents a difficulty in accurately pinpointing particular diseases. This research investigates the utilization of the YOLOv4 algorithm for detecting and identifying plant leaf diseases. This study uses the comprehensive Plant Village Dataset, which includes over fifty thousand photos of healthy and diseased plant leaves from fourteen different species, to develop advanced disease prediction systems in agriculture. Data augmentation techniques including histogram equalization and horizontal flip were used to improve the dataset and strengthen the model's resilience. A comprehensive assessment of the YOLOv4 algorithm was conducted, which involved comparing its performance with established target identification methods including Densenet, Alexanet, and neural networks. When YOLOv4 was used on the Plant Village dataset, it achieved an impressive accuracy of 99.99%. The evaluation criteria, including accuracy, precision, recall, and f1-score, consistently showed high performance with a value of 0.99, confirming the effectiveness of the proposed methodology. This study's results demonstrate substantial advancements in plant disease detection and underscore the capabilities of YOLOv4 as a sophisticated tool for accurate disease prediction. These developments have significant significance for everyone involved in agriculture, researchers, and farmers, providing improved capacities for disease control and crop protection.

The ROSA knee robotic system demonstrates superior precision in restoring joint line height and posterior condylar offset compared to conventional manual TKA: a retrospective case–control study

PurposeVariations in total knee arthroplasty (TKA) joint line height may lead to complications such as pain and altered joint mechanics, while posterior condylar offset (PCO) can influence knee stability.MethodsSingle-centre, single-surgeon retrospective analysis from December 2019 to May 2023 investigated primary unilateral TKA (Nexgen Legacy, Zimmer Biomet) in patients with knee osteoarthritis, using ROSA robotic system (raTKA) or conventional manual technique (mTKA). Joint line height and PCO were measured and compared in 182 raTKA and 144 mTKA patients.ResultsThe groups were matched in age (p = 0.847) and sex distribution (p = 0.2). Excellent interobserver agreement (ICC ≥ 0.9). RaTKA mean joint line height difference was − 0.0001 mm (± 3.48, 95% CI − 0.509, 0.509) (p = 0.523), − 0.951 mm for mTKA (± 4.33, 95% CI − 1.664, − 0.237) (p = 0.009). RaTKA mean PCO difference was 0.52 mm (± 2.45, 95% CI 0.160, 0.880) (p = 0.005), 1.15 mm for mTKA (± 4.01, 95% CI – 1.496, 1.818) (p < 0.001). Mean difference in joint line height of 0.95 mm between groups was significant (p = 0.027), and for PCO, it was 0.63 mm, demonstrating tendency towards significance (p = 0.08). Mean absolute value in joint line height difference between groups was not significant (p = 0.235) but highly significant for PCO (p < 0.001).ConclusionThe ROSA knee robotic system can more accurately restore joint line height and PCO compared to conventional manual TKA. The improved degree of precision raTKA offers may be a vehicle for better Patient-Reported Outcome Measures, but further correlational studies are required.

Initial stability of cementless acetabular cups using robotic‐assisted total hip arthroplasty compared with the conventional manual technique: An in vitro biomechanical study

AbstractBackgroundThe aim of this study is to determine whether the initial stability of a cementless cup with the Mako system is superior to that of a conventional manual technique using bone models.MethodsThe bone models were prepared using a polyurethane foam block. Two hemispherical cementless cups (highly porous titanium cup [Trident II Tritanium, Stryker] and hydroxyapatite‐coated titanium cup [Trident HA, Stryker]) were implanted using the Mako system. The torque of the cups was measured by rotational and lever‐out torque testing and compared with that of a conventional manual technique.ResultsThe two types of cups that were implanted using the Mako system demonstrated significantly higher mean rotational torque than that of the manual technique (p &lt; 0.01, p = 0.01, respectively).ConclusionsThis study provides the advantage of the initial stability of a cementless hemispherical cup implanted by the Mako system compared with that of the conventional manual technique.

Smartphone-based navigation system enables low-volume surgeons to perform accurate acetabular cup placement: A single-center retrospective study

PurposeUsing navigation systems during total hip arthroplasty (THA) has been reported to be useful for preventing acetabular cup malpositioning. However, only few studies have reported on the application of navigation systems to THA at low-volume hospitals owing to cost and usage complexity. Therefore, the aim of this study was to determine whether smartphone-based portable navigation using augmented reality technology would enable low-volume surgeons to perform acetabular cup placement more accurately than with the conventional manual technique. MethodsWe retrospectively compared acetabular cup placement between the navigation (n ​= ​28) and conventional (n ​= ​24) groups. The acetabular cup inclination and anteversion angles were measured using computed tomography (CT)-based planning software. Furthermore, the absolute difference between the postoperative and target angles was compared between the groups. ResultsThe absolute difference between the postoperative and target angles of cup inclination was 2.6° ​± ​2.3° in the navigation group and 5.6° ​± ​5.2° in the conventional group (p ​< ​0.01). Additionally, the cup anteversion was 3.2° ​± ​3.0° in the navigation group and 9.4° ​± ​7.1° in the conventional group (p ​< ​0.01). ConclusionsUsing a smartphone-based portable navigation system could allow for appropriate cup placement even by low-volume surgeons.

Robotic-assisted navigation system for preoperative lung nodule localization: a pilot study.

Preoperative percutaneous computed tomography (CT)-guided localization of pulmonary nodules plays a pivotal role in the diagnosis and treatment of early-stage lung cancer. However, conventional manual localization techniques have inherent limitations in achieving a high degree of accuracy. Consequently, a novel robotic-assisted navigation system was developed to attain precise localization of small lung nodules. This study aims to investigate the accuracy and safety of this system in clinical applications. Patients with peripheral solitary pulmonary nodules measuring less than 20 mm were enrolled. The robotic-assisted navigation system generated a three-dimensional (3D) model based on the patient's CT images, determining the optimal puncture path. The robotic arm then accurately located the nodule and, following percutaneous puncture, indocyanine green (ICG) was injected. The primary outcome measure was the accuracy of pulmonary nodule localization, while secondary outcomes included the complication rate, procedural duration, and total radiation exposure. A total of 33 nodules were successfully localized using the robotic-assisted navigation system and resected through video-assisted thoracoscopic surgery (VATS). The first-pass success rate was 100%, with a median deviation of 6.1 mm [interquartile range (IQR), 2.5-7.2 mm] between the localizer and the nodule. The median localization time was 25.0 minutes, and the single and cumulative exam dose-length products (DLP) were 534.0 and 1491.0 mGy·cm, respectively. Notably, no observable complications were reported during the procedures. The innovative robotic-assisted navigation system demonstrated satisfactory accuracy and holds promise for improving the percutaneous localization of lung nodules. This method represents a safe and viable alternative to traditional CT-guided manual localization techniques.

Design and Experimental Analysis of Straw Suction Unit on Straw Cover Weight Detection Machine

In response to the issues of high cost, limited detection accuracy, and significant measurement errors inherent in conventional manual techniques used to measure straw cover weight under the conservation tillage method, a dedicated straw cover weight detection machine was developed in the current study. This machine included a critical straw suction device that utilizes negative pressure to collect straw within a defined area. The efficiency of straw collection is affected by suction chamber structural parameters and transport pressure. With crushed corn straw as the research subject, the theoretical calculation of straw suspension velocity was used to determine the wind duct diameter, perform the initial design of the suction chamber structure, and select the appropriate fan. After conducting preliminary experiments, single-factor optimization tests, and orthogonal rotation experiments, we analyzed the flow field distribution patterns and identified the critical parameters for the straw cover weight suction unit. We found that the fan should operate at a speed of 2900 r/min, the diameter of the straw outlet should be 200 mm, the vertical height of the suction chamber should be 536 mm, and the bottom diameter of the suction chamber should be 800 mm. The optimization results were validated through simulation tests and bench tests, yielding an average near-ground airflow velocity of vj = 9.03 m/s and an average outlet airflow velocity of vo = 34.27 m/s, meeting the basic requirements of the suction unit. This study could provide a new approach and technical support for the automated detection of straw cover weight in conservation tillage areas.

Robot-assisted knee arthroplasty: first experience (a prospective randomized study)

Introduction Primary total knee arthroplasty has long been proven effective in the treatment of stage 3–4 knee osteoarthritis. It is well known that this intervention not only improves the quality of life, but also helps to restore the function of the joint and eliminate axial deformities.Purpose To compare early results of total knee arthroplasty using robot-assisted technology with conventional manual technique.Materials and Methods 20 patients diagnosed with stage 3 osteoarthritis of the knee joint and varus deformity of the knee joint axis were included in a prospective randomized study. Patients were divided into 2 representative groups, 10 subjects underwent robot-assisted knee arthroplasty, and the conventional manual technique was used in the other 10 patients. For clinical assessment, functional scales KSS, WOMAC, Lysholm Score were used, postoperative radiographs were evaluated.Results According to clinical functional scales, 10 days after surgery, there was an improvement in performance in the patients of both groups (p &lt; 0.05); the duration of the operation in the patients of both groups did not differ in general; intra-operative blood loss in the group with robot‑assisted arthroplasty was lower; and assessment of postoperative results by radiological imaging showed a better component positioning according to preoperative planning in the robotic group.Discussion When the operation is performed by experienced surgeons, one can expect the correct position of the components and the balance of the ligamentous apparatus in standard arthroplasty. However, the use of robot-assisted technology provides a secure intervention performance even at a hospital where a small number of such operations is performed.Conclusion Despite the high cost and the need for additional consumables, robot-assisted arthroplasty has a number of advantages over classical manual techniques. These advantages include: accurate restoration of the limb axis even in extra-articular deformities, correct position of the endoprosthesis components, reduction of intraoperative blood loss due to closed medullary canals, and safety for patients. However, the role of the surgeon in such operations remains paramount, as it is the surgeon who is responsible for planning the operation, performing it, and achieving soft tissue balance.

Comparison of Orbital Reconstructive Effect between Customized Orbital Implants Using Three-Dimensional Printed Templates and Conventional Manual-Bending Implants in Blowout Fracture Surgery

The aim of the present study was to determine the orbital reconstructive effect of customized orbital implants using three-dimensional (3D) printed templates compared with conventional manual-bending implants using computed tomography (CT)-based orbital volume measurements. This retrospective study reviewed the medical records and 3D-CT images of 90 patients who underwent medial, inferior, or inferomedial orbital wall reconstruction. The selected patients were categorized into two groups: (1) the 3D group that underwent surgery using 3D-printed customized orbital implant templates and (2) the manual group that received a conventional manual technique to mold the implant. The volume discrepancy (VD) was obtained by subtracting the volume of the contralateral unaffected eye from that of the injured eye. Of the 90 patients, 33 and 57 were divided into the 3D and manual groups, respectively. The volumes on the contralateral unaffected side and on the pre- and postoperative injured sides were 22.5 ± 2.9, 23.7 ± 3.0, and 22.3 ± 2.8 cm3 (mean ± SD), respectively, in the 3D group, and 21.5 ± 2.5, 22.7 ± 2.8, and 21.2 ± 2.7 cm3 in the manual group. The postoperative VD did not differ between the 3D (–0.2 ± 0.3 cm3) and manual (–0.3 ± 0.9 cm3) groups (p = 0.794). The volume on the postoperative injured side did not differ significantly from that on the contralateral unaffected side in the 3D group, but these did differ significantly in the manual group. Postoperative VD also increased with the preoperative VD in the manual group (Pearson correlation coefficient = 0.548, p = 0.001), whereas there was no such association in the 3D group. The orbital volume restoration effect had superior surgical outcomes for large fractures using the customized orbital implant with 3D-printed templates compared with manual-bending implants.

Registration Method of Single-Line Point Clouds and Images Based on Depth Learning

In high-definition map production, the point cloud and image data collected by the collection vehicle play a supportive role in high-definition map production. Point cloud data can provide accurate 3D spatial positioning, while image data can provide rich semantic information. The generation of high-definition maps depends on the fusion of multi-sensor data, and sensor registration is a requirement for multi-sensor fusion. The relative position between the LiDAR and the camera is largely resolved by the registration of single-line point clouds with images. Conventional manual registration techniques require a lot of labor and specialized gear for calibration, and they must be recalibrated if the distances between the sensors vary. This work suggests an online, unsupervised, and automatic deep learning-based registration approach for single-line point clouds and images. The technique was evaluated on an internal dataset, and it decreased the average displacement error to 33.22 cm and the average rotation error to 0.54° when the highest displacement error was 1.5 m and the maximum rotation error was 20°.

Conventional manual technique of post placental IUD insertion versus intra-cesarean post placental introducer withdrawal IUD insertion technique: a new standardized technique for IUD insertion during cesarean section: a randomized controlled trial

BackgroundInserting IUDs during cesarean section reduces the need for more manipulation and discomfort. The current conventional manual technique for IUD insertion during cesarean section is not standardized with many modifications and high rates of expulsion, displacement, missed threads, and discontinuation. This study aims to find a standard technique for IUD insertion during cesarean section with the least possible problems, especially displacement and missed threads.MethodsA randomized controlled study was conducted at Kasr Al-Ainy Maternity Hospital, Cairo University, Egypt. The study was performed over 12 months, from September 2020 to September 2021. Two groups of patients were selected; each group included 420 patients with a desire for IUD insertion during cesarean section. Group (A) (Control group) was subjected to a post-placental intrauterine device (Copper T380) during cesarean section using a conventional manual method; Group (B) (Study group): the IUD (Copper T380) was placed at the top of the uterine fundus using a new technique (intra-cesarean post placental introducer withdrawal IUD insertion technique).ResultsThere was a significant statistical difference between the two groups regarding displacement of the IUDs at the end of puerperium, at 6 months, non-visibility of IUD threads, and continuation of use with p-value < 0.05. There was no significant statistical difference in the term of duration of surgery.ConclusionThe new technique of post-placental IUD insertion can be the standard technique of intra-cesarean section IUD insertion as it is associated with more favorable outcomes among the included women in the form of lower incidence of IUD displacement, non-visibility of IUD threads, and higher rates of continuation without increasing the duration of surgery as compared with the conventional manual technique.Trial registrationClinicalTrial.gov ID: NCT05788354, registration date: 28/03/2023 (retrospectively registered).

Modernizing Medical Waste Management: Unleashing the Power of the Internet of Things (IoT)

The rapid technological advancements of modern times have brought about the need for an innovative and contemporary approach to medical waste management procedures. This arises from the inadequacy of conventional manual techniques in ensuring the safety of employees and the environment from infections. The increasing amount of waste produced each day can exacerbate the situation if no action is taken to address the current issue. This article presents a systematic review of the use of the Internet of Things (IoT) in medical waste management, utilizing the PRISMA approach. The adoption of the IoT in waste and medical waste monitoring is analyzed for its potential to enhance the overall waste monitoring procedure and contribute to achieving net-zero goals. Empirical evidence from studies conducted in the last five years has revealed the benefits of employing waste bin sensors as a digital surveillance tool for real-time waste status monitoring. While a few researchers have proposed the use of the IoT in medical waste monitoring, the application is currently limited to either monitoring storage facilities, waste transportation, or disposal processes, specifically. These limitations are discussed to understand the barriers that hinder further development. Among the selected analyzed studies are published articles and conference papers that offer solutions for addressing waste management issues and facilitating further development. This paper also aims to identify IoT technologies for monitoring waste and medical waste management. The digitalization of medical waste can ensure that the entire monitoring procedure is conducted directly and in real time. The collected data can be easily shared, and the condition of the waste can be updated periodically.

Embryo transfer technique affects pregnancy rates in recipient mares

Embryo transfer in horses started in the 1970′s and has evolved since then in several technical and biological areas that may influence the overall outcome. The transfer method evolved from surgical to non-surgical (NSET), with pregnancy rates for NSET related closely to operator skills. Recently, high pregnancy rates have been reported by non-specialized operators using the cervical forceps method (Cuervo Arango et al., Veterinary Record. 2018,183;10,1-5). The aim of this retrospective study was to compare pregnancy and early embryonic loss rates between conventional and cervical forceps transfer techniques (Wilsher and Allen, Equine Vet. Educ. 2004. 16; 1, 39-44), operated by two veterinarians with different degrees of experience. During the last 12 breeding seasons in a commercial equine embryo transfer program in Chile, 345 embryos were transferred by two operators with low / moderate (n=86) or high experience (n=259), using a conventional manual technique and 228 embryos were transferred by the same two operators (n=81) and (n=147) respectively, using a bovine cervix forceps/Polansky speculum technique. Embryo flushes were performed at 8 or 9 days after ovulation on 102 donor mares aged 4 to 24 years old and transferred to recipient mares (n=387) aged 3 to 12 years old. Ovulation synchrony ranged from -1 to +4 days when comparing the recipient to the donor. No medications were used during embryo transfer and procedures were done at the samefacilities. Data were analyzed by a binary logistic regression model in which pregnancy and embryo loss were treated as dependent variables, and the experience of the operator and the ET technique as independent variables. Pregnancy rates at first diagnosis (12 to 14 days post ovulation) and embryo loss rate until 60 days of gestation were compared between and within operator groups. Overall pregnancy rates were higher (P<0.001) by the cervical forceps / speculum embryo transfer technique (195/228; 85%) than with the conventional technique (236/345; 65%) in both groups combined. Early embryonic loss rate did not differ (P>0.1) between the groups (6.0 vs. 4.6%, respectively). For the conventional technique, there was a significant operator effect (P=0.015) on the pregnancy rates at the first diagnosis (57 vs. 72%); no operator effect (P>0.1) was observed when using cervical forceps (84 vs. 86 %). These results agree with the report of Cuervo-Arango et al. (2018). We also confirmed that simple bovine cervical forceps work as well as the equine specific forceps reported by Wilsher and Allen (2004). In conclusion, the cervical forceps technique yielded higher pregnancy rates, with no effect of the operator's experience compared to the conventional technique in which the skill and experience of the operator is crucial and needs time and losses to achieve.

A comparison of robotic-assisted and manual techniques in restricted kinematically aligned total knee arthroplasty: coronal alignment improvement with no significant clinical differences.

The purpose of this study was to compare radiographic and clinical outcomes of robotic-assisted and conventional manual techniques in restricted kinematically aligned TKA. Patients who underwent either manual or robotic-assisted restricted kinematically aligned TKA between 2019 and 2020 were included in this retrospective comparative study. Radiographic outcomes comprised coronal plane measurements performed through standing full-length anteroposterior radiographs. The Knee Injury and Osteoarthritis Outcome Score (KOOS), Oxford score, Visual Analog Scale pain and satisfaction score, and Forgotten Joint Score were used to determine the clinical outcome. The continuous data were compared by Student's t test according to the Kolmogorov‒Smirnov normality test. The manual group consisted of 46 patients (38 females, eight males) with a mean age of 68.1years, and the robotic group consisted of 70 patients (58 females, 12 males) with a mean age of 65.7years (n.s.). Preoperatively, no significant difference was observed between groups concerning demographic characteristics, radiographic measurements, and clinical scores except for the symptom and pain domains of the KOOS score, which was significantly worse in the manual group (p = 0.011 and 0.035, respectively). At the postoperative 2-year follow-up, we observed significant differences between groups with respect to the mean HKA angle, mMPTA, and mLDFA (p = 0.034, 0.041, and 0.005, respectively). A comparison of clinical scores at the postoperative 2-year follow-up demonstrated no significant differences between groups. The current study demonstrated that using robotic-assisted technique for restricted kinematically aligned total knee arthroplasty (TKA) resulted in significantly better outcomes compared to the conventional manual technique in achieving normal ranges of lower extremity coronal alignment measurements. While the robotic-assisted group demonstrated better clinical scores, there was no statistically significant difference in clinical outcomes between the robotic-assisted group and the control group at the two-year follow-up. Concerning clinical relevance, the restoration of original anatomy and coronal alignment, a crucial concern in restricted kinematically aligned TKA, may be better achieved by the robotic-assisted technique. Level III (Retrospective cohort study).

Técnicas endodônticas com instrumentos de Níquel Titânio: análise da qualidade e eficiência da instrumentação em molares decíduos

ABSTRACT Objective: The purpose of the present in vitro study was to evaluate the efficiency of three different instruments in the root canals of artificial primary molars as well as the quality of the fillings. Methods: Sixty artificial primary molars were divided into three groups of 20 teeth. Each group was submitted to a different technique: Group 1 - conventional manual technique using Kerr files; Group 2 - manual technique with nickel-titanium files; Group 3 - NiTi rotary technique. The root canals were filled with calcium hydroxide paste. Aspects such as homogeneity of the fillings, taper and flowability of the preparations were considered comparatively to assess the quality of the instrumentations. The non-parametric Kruskal-Wallis and Mann-Whitney tests were used to compare the efficiency of the preparation of the root canal considering the preparation times of them. Results: All three techniques were equally effective at shaping the root canals of primary teeth. The working time was shorter with the rotary instrument (p=0.000). In the pairwise comparisons, working time was shorter with the rotary instrument compared to the manual techniques with steel files (p=0.000) and NiTi files (p=0.000). Comparing the manual techniques, the working time was shorter with NiTi files compared to steel files (p=0.011). Moreover, less variability in the preparation time was found when the rotary instrument was used. Conclusions: The mechanized rotary method led to a shorter operating time in comparison to the manual techniques and is therefore a preferable option for the preparation of the root canals of primary teeth.

Effect of pre-fragmentation on efficacy and safety for phacoemulsification in femtosecond laser-assisted cataract surgery: a non-randomized clinical trial.

Ultrasound energy during phacoemulsification results in the endothelial cell loss of cornea. Crystallin lens fragmentation with softening before phacoemulsification can be used with femtosecond laser-assisted cataract surgery (FLACS) device. This non-randomized clinical trial included patients who underwent cataract surgery and not had corneal opacity. Patients who were not possible to apply the interface on the ocular surface, were excluded. Each subject was allowed to decide the surgical method by himself/herself. Cataract surgery was performed with FLACS (groups I and II) or conventional surgical technique (group III). The FLACS group was further subdivided into two groups according to whether a lens softening procedure was performed (group I) or not (group II). The nuclear density of cataract was objectively classified by Pentacam nuclear staging (PNS), preoperatively. Surgical parameters including total phacoemulsification time (TPT), cumulative dissipated energy (CDE), and the balanced salt solution (BSS) volume consumed, were measured during the surgery. Postoperative visual outcomes were evaluated at three months after the surgery, and corneal endothelial cell count (ECC) loss were calculated based on ECC measured before the surgery and two months after the surgery. Eighty-nine eyes from 89 patients were enrolled. Fifty-three were treated using FLACS (groups I; quadrant pattern with softening of pre-fragmentation, n=31 and II; sextant pattern without softening of pre-fragmentation, n=22) and 36 (group III) with the conventional manual technique. The FLACS groups (groups I and II) had statistically significant lower TPT (P<0.001), CDE (P<0.001), and BSS volumes (P<0.001) used in the nucleus removal step compared to group III. Furthermore, ECC loss in groups I (4.59%±2.57%) and II (6.10%±3.30%) were also statistically lower compared to group III (13.49%±10.55%, P<0.001). From subgroup analysis with the PNS 2, group I showed lower pre-fragmentation time, lower CDE, lower BSS volume used during nucleus removal, and lower ECC loss compared to group II (all P<0.001). Pre-fragmentation using FLACS may reduce intraoperative ultrasound energy and intraocular manipulations compared to conventional cataract surgery.