Current Practice Research Articles

Professional soccer practitioners' perceptions of using performance analysis technology to monitor technical and tactical player characteristics within an academy environment: A category 1 club case study.

This study aimed to identify professional soccer practitioners' perceptions of the application of performance analysis technology within a single academy club. Secondary aims were to understand the importance that practitioners place on monitoring technical and tactical player characteristics, current practices, and barriers to implementing wearable technology. Utilising a mixed method design, forty-four professional soccer academy practitioners (Age = 32 ± 5.8; Years of experience = 8.5 ± 6.2) completed an online survey intended to examine present trends, professional practices, and perceptions regarding the monitoring of technical and tactical metrics. Frequency and percentages of responses for individual items were calculated. Subsequently, eleven participants who were directly involved with the monitoring of players were recruited to participate in a semi-structured interview. Interview data was transcribed and analysed using a combination of deductive and inductive approaches to identify key themes. The main findings across both phases of the study were that (1) technical and tactical metrics are monitored more frequently in matches (Technical: 89%; tactical: 91%) than training (Technical: 80%; Tactical 64%), predominantly due to time constraints and staffing numbers. Accordingly, practitioners believe that it would be beneficial to have an automated way of tracking technical (79%) and tactical (71%) metrics and would consider using a foot-mounted IMU to do so (technical (68%) and tactical (57%)). (2) Monitoring technical and tactical metrics is beneficial to assist with player development and to enrich feedback provision (3) Key stake holders, coaches and players should be informed of the relevance and rationale for monitoring. (4) For successful implementation and continued uptake, the information delivered needs to be both meaningful and easy to understand. Findings suggest that although participants appreciate the need to collect technical and tactical metrics, they are keen to ensure that wearable-derived data does not replace experiential and contextual knowledge. Accordingly, practitioners need to work closely with coaches to determine the contexts in which metrics may or may not prove useful. However, as the sample comprised of participants from a single academy, further studies including more practitioners are warranted. Likewise, future research could also extend to include academy soccer players perceptions too.

Introduction to the Special Issue on Perspectives on Recommender Systems Evaluation

Evaluation plays a vital role in recommender systems—in research and practice—whether for confirming algorithmic concepts or assessing the operational validity of designs and applications. It may span the evaluation of early ideas and approaches up to elaborate implementations of systems integrated into everyday product settings; it may target a wide spectrum of different factors being evaluated. In this special issue, we explore recommender systems evaluation—theory and practice—while considering a diverse set of perspectives. These include recommender systems purposes, stakeholders, methodological approaches, and consequences. The collection of articles in this special issue offers insightful analyses of current recommender system evaluation practices, acknowledging their limitations, and setting out future research directions. As recommender systems evolve, the need for adequate evaluation methods and approaches increases. This special issue sheds light on areas undergoing development or requiring added attention from the research and practitioner communities in recommender systems. The compilation serves as a call to the recommender systems research community, motivating continued research and exploration of evaluation metrics, methods, and strategies.

Fostering an ideology of inclusivity: shared critical dialogue and self-reflexivity in the English classroom

ABSTRACT Despite a reported sociocultural shift in the public perception of rights affecting LGBTQ+ individuals and some changes in governmental policies and laws, there has not yet been a resulting shift in the overall K-12 pedagogical paradigm. Within the classroom, LGBTQ+ individuals and students growing up in LGBTQ+ households are frequently and actively silenced and, therefore, marginalised and stigmatised while LGBTQ+ topics and curricula are intentionally avoided. LGBTQ+ students, students raised in LGBTQ+ families, and LGBTQ+ educators may struggle to feel included within the heteronormative school environment. This lack of LGBTQ+ representation highlights potentially damaging implications for the microsystem of students, parents, and educators. To meet the needs of its LGBTQ+ population, schools must re-evaluate their current inclusivity practices and examine possible interventions to increase inclusion. Through a synthesis and discussion of the research literature rooted in Freire’s (2017) critical dialogue, the author examines possible solutions to increase perceptions of inclusion for the LGBTQ+ community from within the English classroom.

Status and Future Directions for Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Disease With and Without Pulmonary Hypertension: A Scientific Statement From the American Heart Association.

Balloon pulmonary angioplasty continues to gain traction as a treatment option for patients with chronic thromboembolic pulmonary disease with and without pulmonary hypertension. Recent European Society of Cardiology guidelines on pulmonary hypertension now give balloon pulmonary angioplasty a Class 1 recommendation for inoperable and residual chronic thromboembolic pulmonary hypertension. Not surprisingly, chronic thromboembolic pulmonary hypertension centers are rapidly initiating balloon pulmonary angioplasty programs. However, we need a comprehensive, expert consensus document outlining critical concepts, including identifying necessary personnel and expertise, criteria for patient selection, and a standardized approach to preprocedural planning and establishing criteria for evaluating procedural efficacy and safety. Given this lack of standards, the balloon pulmonary angioplasty skill set is learned through peer-to-peer contact and training. This document is a state-of-the-art, comprehensive statement from key thought leaders to address this gap in the current clinical practice of balloon pulmonary angioplasty. We summarize the current status of the procedure and provide a consensus opinion on the role of balloon pulmonary angioplasty in the overall care of patients with chronic thromboembolic pulmonary disease with and without pulmonary hypertension. We also identify knowledge gaps, provide guidance for new centers interested in initiating balloon pulmonary angioplasty programs, and highlight future directions and research needs for this emerging therapy.

Contemporary Management and Outcomes of Veterans Hospitalized With Alcohol Withdrawal: A Multicenter Retrospective Cohort Study.

Few studies describe contemporary alcohol withdrawal management in hospitalized settings or review current practices considering the guidelines by the American Society of Addiction Medicine (ASAM). We conducted a retrospective cohort study of patients hospitalized with alcohol withdrawal on medical or surgical wards in 19 Veteran Health Administration (VHA) hospitals between October 1, 2018, and September 30, 2019. Demographic and comorbidity data were obtained from the Veteran Health Administration Corporate Data Warehouse. Inpatient management and hospital outcomes were obtained by chart review. Factors associated with treatment duration and complicated withdrawal were examined. Of the 594 patients included in this study, 51% were managed with symptom-triggered therapy alone, 26% with fixed dose plus symptom-triggered therapy, 10% with front loading regimens plus symptom-triggered therapy, and 3% with fixed dose alone. The most common medication given was lorazepam (87%) followed by chlordiazepoxide (33%), diazepam (14%), and phenobarbital (6%). Symptom-triggered therapy alone (relative risk [RR], 0.68; 95% confidence interval [CI], 0.57-0.80) and front loading with symptom-triggered therapy (RR, 0.75; 95% CI, 0.62-0.92) were associated with reduced treatment duration. Lorazepam (RR, 1.20; 95% CI, 1.02-1.41) and phenobarbital (RR, 1.28; 95% CI, 1.06-1.54) were associated with increased treatment duration. Lorazepam (adjusted odds ratio, 4.30; 95% CI, 1.05-17.63) and phenobarbital (adjusted odds ratio, 6.51; 95% CI, 2.08-20.40) were also associated with complicated withdrawal. Overall, our results support guidelines by the ASAM to manage patients with long-acting benzodiazepines using symptom-triggered therapy. Health care systems that are using shorter acting benzodiazepines and fixed-dose regimens should consider updating alcohol withdrawal management pathways to follow ASAM recommendations.

Pain management after tonsil surgery in children and adults-A national survey related to pain outcome measures from the Swedish Quality Register for tonsil surgery.

The primary aim of this study was to describe the current practice regarding pain management in relation to tonsil surgery among Ear Nose and Throat (ENT) clinics in Sweden. The secondary aim was to determine the impact of the provider's regime of rescue analgesics on the pain related Patient Reported Outcome Measures (pain-PROMs) from the Swedish Quality Register for Tonsil Surgery (SQTS). A descriptive cross-sectional study originating from a validated web-based questionnaire. The survey enrolled one respondent from each ENT clinic (47/48 participated) nationally. Pain-PROMs from the SQTS, recorded from October 2019 to October 2022, were included (8163 tonsil surgeries). Paracetamol was used by all enrolled ENT clinics as preemptive analgesia. The addition of COX inhibitors was used in 40% of the clinics. Betamethasone was usually administered, to prevent pain and nausea (92%). All clinics gave postdischarge instructions on multimodal analgesia with COX inhibitors and paracetamol. Rescue analgesics were prescribed after tonsillectomy for 77% of adults, 62% of older children, 43% of young children and less often after tonsillotomy. The most frequently prescribed rescue analgesic was clonidine in children (55%) and oxycodone in adults (72%). A high proportion of patients reported contact with health care services due to postoperative pain (pain-PROMs/ SQTS). Tonsillectomy procedures were associated with the highest rates of contacts (children/adolescents 13-15%; adults 26%), while tonsillotomy were associated with lower rates, (5-7% of children/adolescents). There was no significant difference in the frequency of health care contacts due to pain regarding whether clinics routinely prescribed rescue analgesics or not after tonsillectomy. The Swedish analgesic regimen after tonsil surgery is good overall. Nevertheless, there is a need for increased awareness and knowledge to achieve optimal patient recovery. Pain-PROM data demonstrate the call for improvement in pain management after tonsil surgery.

Distributionally-Informed Recommender System Evaluation

Current practice for evaluating recommender systems typically focuses on point estimates of user-oriented effectiveness metrics or business metrics, sometimes combined with additional metrics for considerations such as diversity and novelty. In this article, we argue for the need for researchers and practitioners to attend more closely to various distributions that arise from a recommender system (or other information access system) and the sources of uncertainty that lead to these distributions. One immediate implication of our argument is that both researchers and practitioners must report and examine more thoroughly the distribution of utility between and within different stakeholder groups. However, distributions of various forms arise in many more aspects of the recommender systems experimental process, and distributional thinking has substantial ramifications for how we design, evaluate, and present recommender systems evaluation and research results. Leveraging and emphasizing distributions in the evaluation of recommender systems is a necessary step to ensure that the systems provide appropriate and equitably distributed benefit to the people they affect.

The transparency of quantitative empirical legal research published in highly ranked law journals (2018–2020): an observational study

Background Scientists are increasingly concerned with making their work easy to verify and build upon. Associated practices include sharing data, materials, and analytic scripts, and preregistering protocols. This shift towards increased transparency and rigor has been referred to as a “credibility revolution.” The credibility of empirical legal research has been questioned in the past due to its distinctive peer review system and because the legal background of its researchers means that many often are not trained in study design or statistics. Still, there has been no systematic study of transparency and credibility-related characteristics of published empirical legal research. Methods To fill this gap and provide an estimate of current practices that can be tracked as the field evolves, we assessed 300 empirical articles from highly ranked law journals including both faculty-edited journals and student-edited journals. Results We found high levels of article accessibility (86%, 95% CI = [82%, 90%]), especially among student-edited journals (100%). Few articles stated that a study’s data are available (19%, 95% CI = [15%, 23%]). Statements of preregistration (3%, 95% CI = [1%, 5%]) and availability of analytic scripts (6%, 95% CI = [4%, 9%]) were very uncommon. (i.e., they collected new data using the study’s reported methods, but found results inconsistent or not as strong as the original). Conclusion We suggest that empirical legal researchers and the journals that publish their work cultivate norms and practices to encourage research credibility. Our estimates may be revisited to track the field’s progress in the coming years.

Clinical Trials That Have Changed Clinical Practice and Care of Pregnant People With HIV.

Over the last 4 decades, significant advances in the care of HIV during pregnancy have successfully reduced, and nearly eliminated, the risk of perinatal HIV transmission. The baseline risk of transmission without intervention (25% to 30%) is now <1% to 2% in the United States with contemporary antepartum, intrapartum, and postnatal interventions. In this review, we discuss 3 landmark clinical trials that substantially altered obstetric practice for pregnant individuals with HIV and contributed to this extraordinary achievement: 1) the Pediatric AIDS Clinical Trials Group 076 Trial determined that antepartum and intrapartum administration of antiretroviral drug zidovudine to the pregnant individual, and postnatally to the newborn, could reduce the risk of perinatal transmission by approximately two-thirds; 2) the European Mode of Delivery Collaboration Trial demonstrated performance of a prelabor cesarean birth before rupture of membranes among pregnant people with viremia reduced the risk of perinatal transmission compared with vaginal birth; and 3) the International Maternal Pediatric Adolescent AIDS Clinical Trials Network 2010 Trial identified that dolutegravir-containing, compared with efavirenz-containing, antiretroviral regimens during pregnancy achieved a significantly higher rate of viral suppression at delivery with shorter time to viral suppression, with fewer adverse pregnancy outcomes. Collectively, these trials not only advanced obstetric practice but also advanced scientific understanding of the timing, mechanisms, and determinants of perinatal HIV transmission. For each trial, we will describe key aspects of the study protocol and outcomes, insights gleaned about the dynamics of perinatal transmission, how each study changed clinical practice, and relevant updates to current practice since the trial's publication.

Opinion, uptake and current practice of robot-assisted upper gastrointestinal and oesophagogastric surgery in the UK: AUGIS national survey results.

The uptake of upper gastrointestinal (GI) robotic surgery in the United Kingdom (UK), and Europe more widely, is expanding rapidly. This study aims to present a current snapshot of the practice and opinions of the upper GI community with reference to robotic surgery, with an emphasis on tertiary cancer (oesophagogastric) resection centres. An electronic survey was circulated to the UK upper GI surgical community via national mailing lists, social media and at an open-invitation conference on robotic upper GI surgery in January 2023. The survey included questions on surgeons' current practice or planned adoption (if any) of robotics at individual and unit level, and their opinions on robotic upper GI surgery in general. Priority ranking and Likert-scale response options were used. In total, 81 respondents from 43 hospitals were included. Thirty-four resectional centres responded, including 30 of 31 (97%) recognised upper GI cancer centres in England. Respondents reported performing robotic surgery in 21 of 34 (61.8%) resectional centres, with a median of 65 procedures per centre performed at the time of the survey (range 0-500, interquartile range 93.75). Every centre without a robotic programme expressed a desire or had active plans to implement one. Respondents ranked surgeon ergonomics as the most important reason for pursuing robotics, followed by improvements in patient outcomes and oncological efficacy. Robotic upper GI practice is nascent but rapidly growing in the UK with plans for uptake in almost all tertiary centres. There is growing opinion that this is likely to become the predominant surgical approach in future with benefits to both patients and surgeons. This snapshot offers a point of reference to all stakeholders in upper GI surgery.

Enhanced Machine Learning-based Diagnostic Model for Lassa Fever

The research presents a machine learning-based model for the diagnosis of Lassa fever. The development of the ML Model involves the collection of the Lassa fever dataset from the Infectious Diseases Control Centre of the Federal Medical Centre, Owo Ondo state, it was preprocessed and Five machine learning algorithms namely Naïve Bayes (NB), Artificial Neural Network (ANN), Support Vector Machine (SVM), k-Nearest Neighbour (k-NN) and Decision Tree were trained and tested using 10-fold cross-validation technique and evaluated using standard metrics. Four of the classifiers had an accuracy of 90% and above while k-Nearest Neighbour had the lowest accuracy of 87.7%. Naïve Bayes and Support Vector Machine performed well with an accuracy of 93.2% and Precision of 97.0%. The AUC measure for the NB and SVM algorithm was calculated to be 92.9 %. The Diagnostic Accuracy (DA) of the Existing Method (EM) calculated using standard metrics and evaluated through simple statistical techniques was 61.1%. The Machine Learning (ML) models performed better and more effectively in aiding the diagnosis of Lassa fever cases than the EM as determined from the dataset. The recommended ML model also has the potential to improve Medical diagnosis and eliminate the cumbersome, time-consuming and costly nature of manual monitoring of Lassa suspects in the current practice and can serve as a basis for further investigation/implementation of ML applications in the diagnosis of other similar diseases.

Nurse-led family-based approach in primary health care for patients with type 2 diabetes mellitus: a qualitative study

ABSTRACT Purpose The prevalence of Type 2 diabetes is rapidly increasing, with 537 million people estimated to have diabetes in 2021. The literature suggests that nurses can deliver effective person-centred diabetes care and that families can be essential in supporting patients. Thus, a Nurse-led Family-based (NLFB) approach may be particularly effective. This study aims to explore the perceptions of nurses, adults with type 2 diabetes, and family members regarding the NLFB intervention. Methods Guided by the UK Medical Research Council Framework, this seminal study adopted a qualitative, descriptive approach with content analysis. Data were obtained through 16 semi-structured, in-depth interviews. Themes emerged based on an inductive process using constant comparison (Graneheim and Lundman 2004). The COREQ checklist was used in ensuring rigour. Results Three main themes emerged includes: (1) nurses’ experiences with current diabetes care practices, (2) stakeholders’ views on the development of a NLFB approach, and (3) merging the nurse-led family aspects into the diabetes care. The key challenges are the dominant medical model, lack of specialist nurses, and time. The key facilitators are knowledge and social support. Conclusion The study recommends stakeholders embrace nursing empowerment strategies and involve families to enhance the nurses’ advanced roles and family inclusion in healthcare.

Automated whole slide morphometry of sural nerve biopsy using machine learning.

The morphometry of sural nerve biopsies, such as fibre diameter and myelin thickness, helps us understand the underlying mechanism of peripheral neuropathies. However, in current clinical practice, only a portion of the specimen is measured manually because of its labour-intensive nature. In this study, we aimed to develop a machine learning-based application that inputs a whole slide image (WSI) of the biopsied sural nerve and automatically performs morphometric analyses. Our application consists of three supervised learning models: (1) nerve fascicle instance segmentation, (2) myelinated fibre detection and (3) myelin sheath segmentation. We fine-tuned these models using 86 toluidine blue-stained slides from various neuropathies and developed an open-source Python library. Performance evaluation showed (1) a mask average precision (AP) of 0.861 for fascicle segmentation, (2) box AP of 0.711 for fibre detection and (3) a mean intersection over union (mIoU) of 0.817 for myelin segmentation. Our software identified 323,298 nerve fibres and 782 fascicles in 70 WSIs. Small and large fibre populations were objectively determined based on clustering analysis. The demyelination group had large fibres with thinner myelin sheaths and higher g-ratios than the vasculitis group. The slope of the regression line from the scatter plots of the diameters and g-ratios was higher in the demyelination group than in the vasculitis group. We developed an application that performs whole slide morphometry of human biopsy samples. Our open-source software can be used by clinicians and pathologists without specific machine learning skills, which we expect will facilitate data-driven analysis of sural nerve biopsies for a more detailed understanding of these diseases.

Horizontal transverse isotropy anisotropic parameter inversion via azimuthal seismic velocity anisotropy and its application to anisotropic 3D in-situ stress estimation

Anisotropic parameter inversion in horizontal transverse isotropy (HTI) media plays an important role in predicting the fracture density and the anisotropic in-situ stress for unconventional reservoirs. The current industry practice is to use the azimuthal PP-wave reflection coefficient to estimate the HTI anisotropic parameters. Based on the linear slip theory, we develop an innovative approach that uses azimuthal P-wave phase velocity to calculate HTI anisotropic parameters, which presents superiority over the conventional azimuthal PP-wave reflection coefficient inversion. Specifically, we first verify that the azimuthal P-wave phase velocity is for the HTI elliptical fitting than the azimuthal PP-wave reflection coefficient using the analytical formulations. Second, we sort the prestack wide-azimuth data into offset vector tile sectors and perform amplitude-variation-with-offset inversion at each azimuth. Third, we apply an elliptical fitting to the obtained azimuthal P-wave phase velocities to estimate the HTI anisotropic parameters, fracture density, and fracture direction. Fourth, based on the HTI mechanical earth model, we formulate a cost-effective 3D in-situ stress estimation method using the obtained elastic parameters and fracture compliance. Finally, field examples from the Zhaotong area, China, demonstrate that the estimated fracture density and anisotropic in-situ stress are more accurate and have higher resolution compared with conventional methods. The dominant stress regime in the study area is a strike-slip faulting regime with a governing orientation of northeast–southwest and presents good alignments with well logs, which demonstrates the reliability and accuracy of our method for predicting fracture density and anisotropic in-situ stress.

Harmonizing Hearts: Exploring the Impact of Music Therapy on Cardiovascular Health.

Music therapy (MT) is a music intervention involving a credentialed professional and a client, which has gained increasing recognition in current practices as an adjunct therapy for various conditions, including cardiovascular diseases (CVDs). MT demonstrates notable physiological as well as psychological effects leading to lowered anxiety, depression, and systolic blood pressure in patients with CVDs as well as having effects on heart rate and heart rate variability in healthy subjects. MT emerges as a promising adjunct in the prevention and rehabilitation of CVDs and its holistic impact on physiological and psychological parameters underscores its potential as a noninvasive, cost-effective intervention. Existing literature shows heterogeneity in methods in the studies such as the genre and quality of music utilized as well outcomes. While further research is warranted to optimize protocols and assess long-term effects, the current evidence highlights MT's substantial benefits in cardiovascular health care, making it a promising asset in modern therapeutic approaches. This comprehensive review explores the multifaceted role of MT in CVDs, discussing its mechanisms and clinical applications.

Robotic surgery for deep-infiltrating endometriosis: is it time to take a step forward?

Endometriosis is a chronic debilitating disease that affects nearly 10% of women of the reproductive age. Although the treatment modalities of endometriosis are numerous, surgical excision of the endometriotic implants and nodules remains the sole cytoreductive approach. Laparoscopic excision of endometriosis was proven to be beneficial in improving the postoperative pain and fertility. Moreover, it was also proved to be safe and efficient in treating the visceral localization of deep endometriosis, such as urinary and colorectal endometriosis. More recently, robotic-assisted surgery gained attention in the field of endometriosis surgery. Although the robotic technology provides a 3D vision of the surgical field and 7-degree of freedom motion, the safety, efficacy, and cost-effectiveness of this approach are yet to be determined. With this paper, we aim to review the available evidence regarding the role of robotic surgery in the management of endometriosis along with the current practices in the field.

En route to decoloniality—a different light on Northern research on urban refugees in Southern contexts: a case from Jordan

Abstract This article examines opposing viewpoints on Northern research interventions in Southern cities regarding urban refugees. While some argue for a complete boycott of Northern interventions, others perpetuate colonial attitudes of patronization. Engaging with decolonial perspectives, this article aims to bridge the gap between current practices and a desired decolonial future in refugee studies. By reflecting on personal experiences, it highlights the usually unnoticed dynamics of North–South partnerships, academic and non-academic, in refugee studies. The article explores the Northern presence in the South, focusing on Jordan. It analyses four primary trends of Northern conduct in Jordan: the shift from women empowerment to climate change, rapid out-of-touch fieldwork, the Four Seasons Phenomenon, and the add-on partners. Finally, it seeks a middle ground by providing guidance to both Northern and Southern entities, facilitating better partnerships. This article aims to raise awareness and guide experts, scholars, and INGOs in refugee studies and other disciplines.

The Future of Tourism: Examining the Potential Applications of Large Language Models

Large language models such as the Generative Pre-trained Transformer (GPT) have recently gained attention for their impressive natural language processing capabilities. While their potential to revolutionize various industries is still being explored, the tourism industry stands to benefit significantly from their use. In this study, we conduct an early assessment of the impact potential of GPTs on the tourism industry using a mixed-methods approach. We first analyze the existing literature on the use of GPTs in the tourism industry and identify several potential applications such as personalized travel recommendations, language translation, and chatbots. We then collect data from various stakeholders in the tourism industry through surveys and interviews to understand their current practices and their willingness to adopt GPT-based solutions. Our results indicate that while there is a high level of awareness and interest in GPTs among tourism professionals, the adoption of these technologies is currently limited. The main barriers identified include a lack of technical expertise, concerns around data privacy and security, and the high cost of implementing GPT-based solutions. However, those who have adopted GPTs report significant benefits in terms of increased efficiency and improved customer satisfaction. To further explore the potential of GPTs in the tourism industry, we conduct a pilot study to develop a GPT-based travel recommendation system. The system uses GPT to generate personalized travel itineraries based on user preferences and feedback. Our evaluation of the system indicates that it performs well in terms of accuracy and user satisfaction, demonstrating the potential for GPTs to provide personalized and tailored experiences to travellers. Overall, our study provides an early look at the impact potential of GPTs on the tourism industry and identifies several avenues for future research. We recommend that tourism professionals and researchers collaborate to address the current barriers to adoption and explore the full range of applications for GPTs in the industry.

Medication-related osteonecrosis of the jaw: evolving research for multimodality medical management.

Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating side effect of antiresorptive and antiangiogenic agents that can lead to progressive bone destruction in the maxillofacial region. Dental surgery, including tooth extractions, commonly trigger the onset of MRONJ. While guidelines suggest avoiding extraction when possible, complete avoidance is not always feasible, as necrosis can develop from dental and periodontal disease without dental procedures. The goal of this article is to provide an update review of current preventive and therapeutic approaches for MRONJ. A comprehensive electronic search was conducted on PubMed/MEDLINE, Embase, and Scopus databases. All English articles encompassing randomized controlled trials, systematic reviews, observational studies, and case studies were reviewed. The current medical treatments and adjuvant therapies for managing MRONJ patients were critically assessed and summarized. Pentoxifylline and alpha tocopherol (PENT-E), teriparatide, photobiomodulation (PBM), photodynamic therapy (PDT), and the use of growth factors have shown to enhance healing in MRONJ patients. Implementing these methods alone or in conjunction with surgical treatment has been linked to reduced discomfort and improved wound healing and increased new bone formation. While several adjuvant treatment modalities exhibit promising results in facilitating the healing process, current clinical practice guidelines predominantly recommend antibiotic therapy as a non-surgical approach, primarily addressing secondary infections in necrotic areas. However, this mainly addresses the potential infectious complication of MRONJ. Medical approaches including PENT-E, teriparatide, PBM, and PDT can result in successful management and should be considered prior to taking a surgical approach. Combined medical management for both preventing and managing MRONJ holds potential for achieving optimal clinical outcomes and avoiding surgical intervention, requiring further validation through larger studies and controlled trials.

The role of early cerebral edema and hematoma assessment in aneurysmal subarachnoid hemorrhage (a-SAH) in predicting structural brain abnormalities in cognitive impairments-- case controlled study.

Early assessment and management of cerebral edema and hematoma following aneurysmal subarachnoid hemorrhage (a-SAH) can significantly impact clinical cognitive outcomes. However, current clinical practices lack predictive models to identify early structural brain abnormalities affecting cognition. To address this gap, we propose the development of a predictive model termed the a-SAH Early Brain Edema/Hematoma Compression Neural (Structural Brain) Networks Score System (SEBE-HCNNSS). In this study, 202 consecutive patients with spontaneous a-SAH underwent initial computed tomography (CT) or magnetic resonance imaging (MRI) scans within 24 hours of ictus with follow-up 2 months after discharge. Using logistic regression analysis (univariate and multivariate), we evaluated the association of clinically relevant factors and various traditional scale ratings with cognitive impairment (CI). Risk factors with the highest area under the curve (AUC) values were included in the multivariate analysis and least absolute shrinkage and selection operator (LASSO) analysis or Cox regression analysis. A total of 177 patients were enrolled in the study, and 43 patients were classified with a high SEBE-HCNNSS grade (3 to 5). After a mean follow-up of 2 months, 121 individuals (68.36%) with a-SAH and 3 control subjects developed incident CI. The CT inter-observer reliability of the SEBE-HCNNSS scale was high, with a Kappa value of 1. Furthermore, ROC analysis identified the SEBE-HCNNSS scale (OR 3.322, 95% CI 2.312-7.237, P=0.00025) as an independent predictor of edema, CI, and unfavorable prognosis. These results were also replicated in a validation cohort. Overall, the SEBE-HCNNSS scale represents a simple assessment tool with promising predictive value for CI and clinical outcomes post-a-SAH. Our findings indicate its practical utility as a prognostic instrument for risk evaluation after a-SAH, potentially facilitating early intervention and treatment.