Visual Evaluation Research Articles

Fibrous Tissue Semantic Segmentation in CT Images of Diffuse Interstitial Lung Disease.

Interstitial-lung-disease progression assessment and diagnosis via radiological findings on computed tomography images require significant time and effort from expert physicians. Accurate results from these analyses are critical for treatment decisions. Automatic semantic segmentation of radiological findings has been developed recently using convolutional neural networks (CNN). However, on the one hand, few works present individual performance scores for radiological findings that allow for accurately measuring fibrosis segmentation performances; on the other hand, the poorly annotated quality of available databases may mislead researcher observations. This study presents a CNN methodology employing three different architectures (U-net, LinkNet, and FPN) with transfer learning and data augmentation to enhance the performance in semantic segmentation of fibrosis-related radiological findings (FRF). In addition, considering the poor quality of manual CT tagging on available datasets, we use two alternative evaluation strategies, first using only the fibrosis region of interest. Second, re-tagging and validating the test set by an expert pulmonologist. Using DICOM images from the Interstitial Lung Diseases Database, the implemented approach achieves a Jaccard Score Index of 0.7355 with a standard deviation of 0.0699 and a Dice Similarity Coefficient of 0.8459 with a standard deviation of 0.0470 comparable to state-of-the-art performance in FRF semantic segmentation. Also, a visual evaluation of the images automatically tagged by our proposal was performed by a pulmonologist. Our proposed method successfully identifies these FRF areas, demonstrating its effectiveness. Also, the pulmonologist revealed discrepancies in the dataset tags, indicating deficiencies in FRF annotations.

Systematic review and meta-analysis of conventional medical management in a patient population with refractory chronic pain suitable to receive a spinal cord stimulation system.

The aim of this review was to systematically identify all evidence that used conventional medical management (CMM) as a comparator in randomised controlled trials (RCTs) of spinal cord stimulation (SCS) therapy, and to conduct a meta-analysis to investigate if continued CMM provides statistical or clinically meaningful pain relief and whether CMM effects have improved over the last few decades. Databases were searched from inception to June 2024 for RCTs that compared SCS to CMM. The primary outcome of the review was absolute change in pain intensity from baseline to the last available follow-up in the CMM group, measured using a visual analogue scale or numerical rating scale. The measure of treatment effect for absolute change and percentage change in pain intensity from baseline was mean difference (MD) and 95% confidence interval (CI). Risk of bias (RoB) was assessed by using the revised Cochrane RoB tool. The protocol for this review is registered on PROSPERO (CRD42023449215). Meta-analysis of absolute change in pain intensity from baseline to last follow-up shows that CMM is not associated with any significant reductions in pain intensity (MD -0.11; 95% CI: -0.32 to 0.11; moderate certainty). Similar results were observed for percent change in pain intensity from baseline to last follow-up (MD -3.22%; 95% CI: -12.59% to 6.14%; moderate certainty). No significant differences were observed when considering decade of publication of the RCT for absolute (p = 0.065; moderate certainty) or percent change in pain intensity (p = 0.524; moderate certainty). Meta-analysis for 6-month follow-up and sensitivity analysis shows similar numerical results. Our findings show that continued CMM for a population eligible for SCS does not provide meaningful pain relief and has not considerably changed over the last few decades. The use of CMM as the control to evaluate relative SCS treatment effects should be reassessed.

Transcranial direct current stimulation alleviates the pain severity in people suffering from knee osteoarthritis: a systematic review and meta-analysis.

Considerable research has shown the benefits of transcranial direct current stimulation (tDCS) for the alleviation of pain associated with knee osteoarthritis (KOA). Still, a large variance in study protocols and observations across publications exists. We here thus completed a systematic review and meta-analysis to comprehensively and quantitatively characterize the effects of tDCS on KOA-related pain. A search strategy based on the Population, Intervention, Comparison, Outcome, and Study design (PICOS) principle was used to obtain the publications in 7 databases. Studies exploring the effects of tDCS on KOA-related pain were screened, and eligible studies were included. Ten studies of 518 participants using Visual Analogue Scale or Numeric Rating Scale to assess pain were included in the systematic review, and 9 of them were included in meta-analysis. The quality of these studies was good. Compared to control, tDCS induced significant short-term improvements in KOA-related pain with medium heterogeneity (standardized mean difference [SMD] = -0.91, 95% confidence interval [-1.24, -0.58], P < 0.001, I2 = 61%). Subgroup analyses showed that both home-based (SMD = -1.32, 95% CI [-1.65, -0.99], P < 0.001, I 2 = 0%) and laboratory-based intervention (SMD = -0.66, 95% CI [-0.99, -0.33], P < 0.001, I 2 = 40%) with at least 5 sessions per week (SMD = -1.02, 95% CI [-1.41, -0.64], P < 0.001, I 2 = 65%) and/or with a total number of at least 10 sessions (SMD = -1.12, 95% CI [-1.51, -0.74], P < 0.001, I 2 = 59%) can induce maximum benefits for the alleviation of KOA-related pain. The results here showed that tDCS is of great promise to alleviate KOA-related pain. Still, future studies with more rigorous design are needed to confirm the observations from this work, which can ultimately help the determination of appropriate intervention protocol that can maximize such benefits.

Feasibility and Applicability of Implementing the Framework for Comprehensive Understanding of Structural Stigma in Mental Healthcare Systems: A Case Example of Nepal.

Mental health-related structural stigma is a multifaceted issue that significantly impacts access to quality mental healthcare, particularly in low-resource settings like Nepal. Therefore, there is a clear need to understand the complexities and identify gaps for targeted interventions through evaluations of various dimensions of structural stigma within healthcare systems. This study aimed to assess the feasibility and applicability of a mental health-related structural stigma measurement framework through its implementation in Nepal's healthcare system. A mixed-methods approach was employed, involving data mapping, key informant interviews and rating exercises with diverse stakeholders, including policymakers, health workers and people with lived experience (PWLEs). A visual analogue scale or Red/Amber/Green (RAG) rating scale was used to rate each indicator within the framework for the level of structural stigma based on the mapped information and their experiences. Data collection was carried out from May to June 2024. Twenty key informants were interviewed for this exercise. Most indicators within the framework were endorsed as yellow, followed by red by participants referring to mid to high levels of structural stigma within the healthcare system. The findings also revealed that the stakeholders perceived the framework as acceptable and applicable for measuring mental health-related structural stigma in the healthcare system. However, challenges were noted regarding the clarity of some indicators, limitations of the three-coloured visual analogue rating and the need for comparator conditions. The study underscores the measurement framework's value as a tool for identifying and addressing structural stigma in a mental healthcare system in a low-resource setting. Stakeholder engagement and contextual adaptation are crucial for its successful implementation. The insights gained can inform structural reforms and improve mental health service delivery, ultimately promoting greater equity and access for PWLEs. This framework being assessed in this study (FOCUS-MHS) was developed through extensive consultation with People with Lived Experiences (PWLEs) in Nepal and globally with the Global Mental Health Peer Network along with other stakeholders. Identification of documents, policies and studies, along with qualitative information mapped within the indicators, was informed by PWLEs involved in local study sites and by policymakers and health administrators. The reflections of the study participants-PWLEs, health administrators and policymakers, have guided further refinement of the framework for future use.

Higher Rates of Visualization for Axillary Reverse Mapping Using Indocyanine Green Fluorescence Compared With Blue Dye.

Successful axillary reverse mapping (ARM) during lymph node surgery for breast cancer has the potential to reduce risk of lymphedema. Standard of care uses blue dye for ARM; however, recent imaging advances with near-infrared indocyanine green (ICG) fluorescence has demonstrated potential to improve intraoperative ARM imaging. The objective was to determine the feasibility of using ICG fluorescence through the OnLume Avata System for ARM. Breast cancer patients undergoing axillary lymph node dissection and were to undergo ARM were enrolled. Lymphatic structures were visualized using ICG fluorescence and blue dye. Real-time fluorescence images were acquired with the OnLume Avata System preincision, intraoperatively, and post dissection during the ARM. Preincision images were quantitatively analyzed for lymphatic fluorescence signal in terms of contrast-to-noise ratio. Imaging data were evaluated in terms of binary visualization rates and signal-to-background ratio. Lymph nodes, lymphatic vessels, and lymph pooling were observed with fluorescence more frequently than blue dye. For seven out of eight cases, at least one vessel was visualized near the axilla preincision. In all eight cases, ICG fluorescence was noted during the procedure with five cases visualizing intact lymphatics at the end of the procedure. The ambient-light compatibility of the imager allowed the surgeon to operate with image guidance throughout the ARM procedure. The Avata demonstrated superior identification and visualization with ICG when compared to blue dye for visualizing lymphatic structures in real time with minimal disruption to the clinical workflow.

Full-time domain rust expansion investigation and visual evaluation of reinforced concrete under synergistic protection

Full-time domain rust expansion investigation and visual evaluation of reinforced concrete under synergistic protection

Pragmatic algorithm for visual assessment of 4-Repeat tauopathies in [18F]PI-2620 PET Scans.

Standardized evaluation of [18F]PI-2620 tau-PET scans in 4R-tauopathies represents an unmet need in clinical practice. This study aims to investigate the effectiveness of visual evaluation of [18F]PI-2620 images for diagnosing 4R-tauopathies and to develop a straight-forward reading algorithm to improve objectivity and data reproducibility. A total of 83 individuals with [18F]PI-2620 PET scans were included. Participants were classified as probable 4R-tauopathies (n = 29), Alzheimer's disease (AD) (n = 20), α-synucleinopathies (n = 15), and healthy controls (n = 19) based on clinical criteria. Visual assessment of tau-PET scans (choice: 4R-tauopathy, AD-tauopathy, no-tauopathy) was conducted using either 20-40-minute or 40-60-minute intervals, with raw (common) and cerebellar grey matter scaled standardized reading settings (intensity-scaled). Two readers evaluated scans independently and blinded, with a third reader providing consensus in case of discrepant primary evaluation. A regional analysis was performed using the cortex, basal ganglia, midbrain, and dentate nucleus. Sensitivity, specificity, and interrater agreement were calculated for all settings and compared against the visual reads of parametric images (0-60-minutes, distribution volume ratios, DVR). Patients with 4R-tauopathies in contrast to non-4R-tauopathies were detected at higher sensitivity in the 20-40-minute frame (common: 79%, scaled: 76%) compared to the 40-60-minute frame (common: 55%, scaled: 62%), albeit with reduced specificity in the common setting (20-40-min: 78%, 40-60-min: 95%), which was ameliorated in the intensity-scaled setting (20-40-min: 91%, 40-60-min: 96%). Combined assessment of multiple brain regions did not significantly improve diagnostic sensitivity, compared to assessing the basal ganglia alone (76% each). Evaluation of intensity-scaled parametric images resulted in higher sensitivity compared to intensity-scaled static scans (86% vs. 76%) at similar specificity (89% vs. 91%). Visual reading of [18F]PI-2620 tau-PET scans demonstrated reliable detection of 4R-tauopathies, particularly when standardized processing methods and early imaging windows were employed. Parametric images should be preferred for visual assessment of 4R-tauopathies.

Impact of enhanced chest CT with three-dimensional reconstruction combined with preoperative olive oil administration on the incidence of postoperative chylothorax: a retrospective study

BackgroundChylothorax is a rare but potentially life-threatening complication after esophageal cancer resection. This study aims to investigate the impact of a strategy combining preoperative three-dimensional (3D) reconstruction of contrast-enhanced chest CT with olive oil ingestion on the incidence of chylothorax following esophageal cancer resection.MethodsWe retrospectively analyzed the clinical data of 357 patients who underwent esophageal cancer resection in the Department of Thoracic Surgery at Gansu Provincial People’s Hospital from January 2019 to June 2024. Among them, 179 patients who underwent preoperative 3D reconstruction of contrast-enhanced chest CT combined with oral olive oil administration were assigned to the 3D reconstruction group, while 158 patients who did not receive these interventions served as the control group. The primary outcome measures included the incidence of chylous leakage and related perioperative outcomes.ResultsAll patients in both groups underwent surgeries successfully without any perioperative deaths. Compared to the control group, the 3D reconstruction group exhibited a significant decrease in the incidence of postoperative chylothorax (0% versus 8.2%, P < 0.001). The visualization rate of the thoracic duct during surgery was higher in the 3D reconstruction group compared to the control group (93.85% vs. 48.73%). Furthermore, patients in the 3D reconstruction group had less intraoperative bleeding (P = 0.003), shorter postoperative hospital stays (P = 0.003), and reduced chest drainage in the first three postoperative days (P < 0.001).ConclusionThis study reveals that preoperative three-dimensional reconstruction of chest using enhanced CT allows for the anticipation of thoracic duct anatomy. Additionally, the combination of preoperative oral olive oil administration significantly enhances the intraoperative visualization of the thoracic duct. This integrated strategy effectively reduces the incidence of postoperative chylothorax, demonstrating promising clinical application prospects.

Augmenting motion artifacts to enhance auto-contouring of complex structures in cone-beam computed tomography imaging

Objective. To develop an augmentation method that simulates cone-beam computed tomography (CBCT) related motion artifacts, which can be used to generate training-data to increase the performance of artificial intelligence models dedicated to auto-contouring tasks.Approach.The augmentation technique generates data that simulates artifacts typically present in CBCT imaging. The simulated pseudo-CBCT (pCBCT) is created using interleaved sequences of simulated breath-hold and free-breathing projections. Neural networks for auto-contouring of head and neck and bowel structures were trained with and without pCBCT data. Quantitative and qualitative assessment was done in two independent test sets containing CT and real CBCT data focus on four anatomical regions: head, neck, abdomen, and pelvis. Qualitative analyses were conducted by five clinical experts from three different healthcare institutions.Main results.The generated pCBCT images demonstrate realistic motion artifacts comparable to those observed in real CBCT data. Training a neural network with CT and pCBCT data improved Dice similarity coefficient (DSC) and average contour distance (ACD) results on CBCT test sets. The results were statistically significant (p-value ⩽.03) for bone-mandible (model without/with pCBCT: 0.91/0.92 DSC,p⩽ .01; 0.74/0.66 mm ACD,p⩽.01), brain (0.34/0.93 DSC,p⩽ 1 × 10-5; 17.5/2.79 mm ACD,p= 1 × 10-5), oral-cavity (0.81/0.83 DSC,p⩽.01; 5.11/4.61 mm ACD,p= .02), left-submandibular-gland (0.58/0.77 DSC,p⩽.001; 3.24/2.12 mm ACD,p⩽ .001), right-submandibular-gland (0.00/0.75 DSC,p⩽.1 × 10-5; 17.5/2.26 mm ACD,p⩽ 1 × 10-5), left-parotid (0.68/0.78 DSC,p⩽ .001; 3.34/2.58 mm ACD,p⩽.01), large-bowel (0.60/0.75 DSC,p⩽ .01; 6.14/4.56 mm ACD,p= .03) and small-bowel (3.08/2.65 mm ACD,p= .03). Visual evaluation showed fewer false positives, false negatives, and misclassifications in artifact-affected areas. Qualitative analyses demonstrated that, auto-generated contours are clinically acceptable in over 90% of cases for most structures, with only a few requiring adjustments.Significance.The inclusion of pCBCT improves the performance of trainable auto-contouring approaches, particularly in cases where the images are prone to severe artifacts.

AutoPVPrimer: A comprehensive AI-Enhanced pipeline for efficient plant virus primer design and assessment.

Plant viruses pose a significant threat to global agriculture and require efficient tools for their timely detection. We present AutoPVPrimer, an innovative pipeline that integrates artificial intelligence (AI) and machine learning to accelerate the development of plant virus primers. The pipeline uses Biopython to automatically retrieve different genomic sequences from the NCBI database to increase the robustness of the subsequent primer design. The design_primers_with_tuning module uses a random forest classifier that optimizes parameters and provides flexibility for different experimental conditions. Quality control measures, including the evaluation of poly-X content and melting temperature, increase primer reliability. Unique to AutoPVPrimer is the visualize_primer_dimer module, which supports the visual evaluation of primer dimers-a feature missing in other tools. Primer specificity is validated via primer BLAST, which contributes to the overall efficiency of the pipeline. AutoPVPrimer has been successfully applied to the tomato mosaic virus, proving its adaptability and efficiency. The modular design allows customization by the user and extends the applicability to different plant viruses and experimental scenarios. The pipeline represents a significant advance in primer design and provides researchers with an effective tool to accelerate molecular biology experiments. Future developments aim to extend compatibility and incorporate user feedback to consolidate AutoPVPrimer as an innovative contribution to the bioinformatics toolbox and a promising resource for the advancement of plant virology research.

Radiosurgery versus radiation therapy for long term local control rate of craniopharyngioma: a meta-analysis.

Craniopharyngiomas are challenging benign tumors arising from Rathke's pouch remnants, often requiring multidisciplinary management due to their proximity to critical neurovascular structures. This meta-analysis systematically compares conventional radiation therapy (RT) and stereotactic radiosurgery (RS) in treating residual or recurrent craniopharyngiomas. A comprehensive literature search identified 44 studies, including 46 reports, meeting inclusion criteria such as progression-free survival (PFS) and post-radiotherapy complications. Data extraction followed PRISMA guidelines. The pooled 5-year PFS favored RT (0.843; 95% CI: 0.767-0.898) over RS (0.680; 95% CI: 0.631-0.727), as did 10-year PFS (RT: 0.813; 95% CI: 0.683-0.888; RS: 0.553; 95% CI: 0.470-0.634). RT demonstrated mitigating tumor recurrence risks. Visual and hormonal complication rates between the modalities were comparable (visual: ~4%; hormonal: ~6%). RT consistently achieved superior long-term PFS compared to RS, reaffirming its role as the standard for adjuvant therapy in craniopharyngiomas. This analysis highlights the need for tailored treatment strategies balancing efficacy and safety, ultimately enhancing patient outcomes.

Is There Novel 18F-FDG Biodistribution in the Digital PET/CT Era? A Real-World Data Analysis.

Background: This retrospective multicenter study investigated the biodistribution of Fluorodeoxyglucose (18F-FDG) in the positron emission tomography (PET)/computed tomography (CT) in digital PET/CT (dPET) compared to analog PET/CT (aPET), focusing differences in physiological uptake in reference and small structures across various scanner models. Materials and Methods: One hundred thirty patients with similar preimaging conditions underwent both dPET and aPET imaging within 6 months. Visual evaluations and paired comparative analyses of semiquantitative parameters were performed for small and reference structures. Results: 18F-FDG uptake was higher in both reference and small structures for dPET compared to three different aPET scanners. The Siemens mCT20-4R (mCT20) demonstrated comparable results to dPET. Notably, mCT20 had higher standardized uptake value (SUVmax) for the conus medullaris (CM) (3.20 vs. 2.76). CM was most highly visible with dPET on visual evaluation by physicians. Conclusions: Digital PET/CT provides higher SUV values in both small and reference structures. This leads to improved visualization of 18F-FDG physiological biodistribution. Given the growing adoption of dPET technology, these advancements should be carefully considered in image interpretation and clinical research.

PSMA PET/CT based multimodal deep learning model for accurate prediction of pelvic lymph-node metastases in prostate cancer patients identified as candidates for extended pelvic lymph node dissection by preoperative nomograms.

To develop and validate a prostate-specific membrane antigen (PSMA) PET/CT based multimodal deep learning model for predicting pathological lymph node invasion (LNI) in prostate cancer (PCa) patients identified as candidates for extended pelvic lymph node dissection (ePLND) by preoperative nomograms. [68Ga]Ga-PSMA-617 PET/CT scan of 116 eligible PCa patients (82 in the training cohort and 34 in the test cohort) who underwent radical prostatectomy with ePLND were analyzed in our study. The Med3D deep learning network was utilized to extract discriminative features from the entire prostate volume of interest on the PET/CT images. Subsequently, a multimodal model i.e., Multi kernel Support Vector Machine was constructed to combine the PET/CT deep learning features, quantitative PET and clinical parameters. The performance of the multimodal models was assessed using final histopathology as the reference standard, with evaluation metrics including area under the receiver operating characteristic curve (AUC), calibration curve, decision curve analysis, and compared with available nomograms and PET/CT visual evaluation result. Our multimodal model incorporated clinical information, maximum standardized uptake value (SUVmax), and PET/CT deep learning features. The AUC for predicting LNI was 0.89 (95% confidence interval [CI] 0.81-0.97) for the final model. The proposed model demonstrated superior predictive accuracy in the test cohort compared to PET/CT visual evaluation result, the Memorial Sloan Kettering Cancer Center (MSKCC) and the Briganti-2017 nomograms (AUC 0.85 [95% CI 0.69-1.00] vs. 0.80 [95% CI 0.64-0.95] vs. 0.79 [95% CI 0.61-0.97] and 0.69 [95% CI 0.50-0.88], respectively). The proposed model showed similar calibration and higher net benefit as compared to the traditional nomograms. Our multimodal deep learning model, which incorporates preoperative PSMA PET/CT imaging, shows enhanced predictive capabilities for LNI in clinically localized PCa compared to PSMA PET/CT visual evaluation result and existing nomograms like the MSKCC and Briganti-2017 nomograms. This model has the potential to reduce unnecessary ePLND procedures while minimizing the risk of missing cases of LNI.

Assessing visual quality of historical agricultural landscapes: a study of dovecotes in the Isfahan Plain

Understanding the visual evaluation of historical agricultural landscapes by various communities is essential for conserving landscapes and managing the growth of residential areas adjacent to these landscapes. This research assesses the quality of agricultural landscapes surrounding dovecotes in the Isfahan Plain of Iran. To this end, visual concepts introduced by Tveit et al. along with a normative indicator (pleasantness), were questioned. Three respondent groups, categorised based on their knowledge and life experience with dovecotes (experts, no-experience group, close-experience group), responded to a picture inquiry. Finally, the statistical results of the groups indicated that all the examined visual concepts were related to pleasantness and collectively formed the visual integrity of these agricultural landscapes. It was also found that in some evaluated concepts, people’s life experiences influence landscape assessment. This means that people with a deeper experience and background regarding historical agricultural landscapes will appreciate these landscapes more.

MM-PCQA+: Advancing Multi-Modal Learning for Point Cloud Quality Assessment

The importance of visual quality in point clouds has been significantly underlined due to the rapid rise in 3D vision applications which aim to deliver affordable and superior user experiences. Reviewing the evolution of point cloud quality assessment (PCQA), it’s observed that visual quality evaluation typically employs single-modal data, either sourced from 2D projections or the 3D point clouds. The 2D projections possess abundant texture and semantic information while they are heavily reliant on viewpoints. In contrast, 3D point clouds are more reactive to geometric distortions and viewpoint-invariant. Consequently, to maximize the benefits of both point cloud and image modalities, we present an advanced no-reference Multi-Modal Point Cloud Quality Assessment (MM-PCQA+) metric. Specifically, we divide the point clouds into sub-models to reflect local geometric distortions such as point shifting and down-sampling. Afterwards, we render the point clouds using a cube-like projection setup and sample the projections of interest using a point-visible-ratio for image feature extraction. In order to fulfill these objectives, the sub-models and projected images are encoded using point-based and image-based neural networks. Lastly, we implement symmetric cross-modal attention to amalgamate multi-modal quality-aware features. Experimental results demonstrate that our metric surpasses all state-of-the-art methods and significantly advances beyond previous no-reference PCQA methods.

The effect of dynamic neuromuscular stabilization technique combined with Kinesio Taping on neuromuscular function and pain self-efficacy in individuals with chronic nonspecific low back pain: A randomized trial.

This study investigates the therapeutic efficacy of dynamic neuromuscular stabilization (DNS) technology paired with Kinesio Taping in patients with persistent nonspecific low back pain, as well as the effect on neuromuscular function and pain self-efficacy. A randomized controlled clinical study was conducted to collect clinical data on DNS combined with KT for the treatment of chronic nonspecific low back pain from November 2023 to April 2024. The inclusion criteria were patients with chronic nonspecific lower back pain, aged between 18 and 30 years old, and without serious underlying medical conditions, such as cardiac disease, hypertension, and diabetes. The control group received Kinesio Tape therapy, and the experimental group received a combination of Kinesio Tape therapy and DNS technology. The treatment lasted for 6 weeks, 3 times a week. Patients were examined before and after treatment using the Visual Analog Rating Scale, Oswestry Dysfunction Score, and Pain Self-Efficacy Questionnaire. Multifidus and transversus abdominis muscle strength was tested using surface electromyography signals, and the patient's joint mobility, maximal isometric muscle strength, and muscular endurance were tested using the Davy Spine Rehabilitation System. Internal lumbar and abdominal pressures were assessed using stabilizer pressure biofeedback. A total of 32 subjects (17 males and 15 females) were enrolled, of which 16 were in the experimental group and 16 in the control group. After the treatment, the patients in both groups showed significant improvements in the visual analogue scale, Oswestry disability index, Chinese version of Pain Self-Efficacy Questionnaire (PSEQ), joint mobility, maximum isometric strength, muscle endurance, abdominal pressure, transverse abdominal muscle and multifidus muscle scales compared with the pretreatment results. (Chinese version of Pain Self-Efficacy Questionnaire) scales were significantly improved compared with the pretreatment; joint mobility, maximal isometric muscle strength, muscular endurance, intra-abdominal pressure, transversus abdominis and multifidus AEMG (average electromyography) were more significantly improved, and the differences were statistically significant (P < .05). The experimental group showed more significant improvement than the control group (P < .05). DNS technology paired with Kinesio Taping can considerably improve neuromuscular function and enhance pain self-efficacy in chronic nonspecific low back pain patients, reducing discomfort and improving dysfunction.

Cerebral Microbleeds and Amyloid Pathology Estimates From the Amyloid Biomarker Study

Baseline cerebral microbleeds (CMBs) and APOE ε4 allele copy number are important risk factors for amyloid-related imaging abnormalities in patients with Alzheimer disease (AD) receiving therapies to lower amyloid-β plaque levels. To provide prevalence estimates of any, no more than 4, or fewer than 2 CMBs in association with amyloid status, APOE ε4 copy number, and age. This cross-sectional study used data included in the Amyloid Biomarker Study data pooling initiative (January 1, 2012, to the present [data collection is ongoing]). Data from 15 research and memory clinic studies were pooled and harmonized. Participants included individuals for whom data on age, cognitive status, amyloid status, and presence of CMBs were available. Data were analyzed from October 22, 2023, to April 26, 2024. The main outcomes were age, cognitive status, amyloid status and presence, location, and number of CMBs. Presence of amyloid pathology was determined based on 42 amino acid-long form of amyloid-β peptide (Aβ42) levels in cerebrospinal fluid or on amyloid-positron emission tomography. Presence and, in a subset, location (lobar vs deep) and number of CMBs were determined on magnetic resonance imaging (locally with visual rating). Among 4080 participants included in the analysis, the mean (SD) age was 66.5 (8.9) years, and 2241 (54.9%) were female. A total of 2973 participants had no cognitive impairment (cognitive unimpairment [CU]), and 1107 had mild cognitive impairment (MCI) or AD dementia (ADD). One thousand five hundred and thirteen participants (37.1%) had amyloid pathology, 1368 of 3599 (38.0%) with data available were APOE ε4 carriers, and 648 (15.9%) had CMBs. In the CU group, amyloid pathology and APOE ε4 copy number were not associated with presence of any, no more than 4, or fewer than 2 CMBs but were associated with increased odds of lobar CMBs (odds ratio [OR] for amyloid, 1.42 [95% CI, 1.20-1.69], P < .001; OR for 2 vs 0 alleles, 1.81 [95% CI, 1.19-2.74], P = .006; OR for 1 vs 0 alleles, 1.10 [95% CI, 0.83-1.46], P = .49; and OR for 2 vs 1 allele, 1.64 [95% CI, 0.90-2.97], P = .11; overall P = .02). In the MCI-ADD group, amyloid pathology was associated with presence of any CMBs (OR, 1.51 [95% CI, 1.17-1.96], P = .002), no more than 4 CMBs (OR, 1.44 [95% CI, 1.18-1.82], P = .002), and fewer than 2 CMBs (OR 1.34 [95% CI, 1.03-1.74], P = .03) but not lobar CMBs. APOE ε4 copy number was associated with presence of any (OR for 2 vs 0 alleles, 1.72 [95% CI, 0.88-3.35], P = .11; OR for 1 vs 0 alleles, 0.78 [95% CI, 0.59-1.04], P = .09; and OR for 2 vs 1 allele, 2.20 [95% CI, 1.32-3.67], P = .002; overall P < .001) and no more than 4 CMBs (OR for 2 vs 0 alleles, 1.31 [95% CI, 0.64-2.68], P = .45; OR for 1 vs 0 alleles, 0.75 [95% CI, 0.54-1.04], P = .08; and OR for 2 vs 1 allele, 1.76 [95% CI, 0.97-3.19], P = .06; overall P = .03) but not with fewer than 2 or lobar CMBs. Prevalence estimates of CMBs ranged from 6% at 50 years of age in a non-APOE ε4 allele carrier with no amyloid pathology and no cognitive impairment to 52% at 90 years of age in an APOE ε4 homozygote carrier with amyloid pathology and cognitive impairment. In this cross-sectional study of 4080 participants, prevalence estimates of CMBs were associated with amyloid status, APOE ε4 copy number, and age. CMB prevalence estimates may help inform safety evaluations for antiamyloid clinical trials.

Improving sonographic visualisation of the appendix in a regional referral hospital

Ultrasound is a first-line and often preferred imaging modality in the diagnosis of acute appendicitis. When the appendix is not visualised during a dedicated appendix ultrasound study, patients may require...

Enhancing black mulberry storage with sodium caseinate and gum tragacanth edible films

A bright future lies ahead for the application of natural biocomposites in the food industry. In this research, edible biocomposite films were created using sodium caseinate (SC)-gum tragacanth (GT) and incorporating carum carvi seed essential oil (EO) as a nanoemulsion. Different ratios of oil were used as variables. The physical properties, structural morphology, mechanical characteristics, and thermal behavior of the films were evaluated. Furthermore, the preservative effects of these edible films were studied to prolong the shelf life of black mulberries over a period of 10 days at 4 °C. The findings indicated that the increase of EO content to the edible films resulted in a significant increase in thickness, tensile strength, opacity and water vapor permeability. Conversely, the elongation at break, water solubility and moisture content decreased with the rise in oil content up to 3.9%. Also the visual appearance and sensory evaluation of the fruits revealed that black mulberries covered with edible films containing 2.6 and 3.9% oil were more preferred compared to the other groups. The integration of caraway oil into the SC-GT biocomposite has been investigated for the first time, demonstrating that the resulting films are effective in prolonging the shelf life of black mulberries.

Usage and awareness of nutritional screening tools by nurses caring for pediatric patients in Yozgat province

Aims: Malnutrition is a significant health issue in children and is closely related to prolonged hospital stays, increased complications, and mortality risk in hospitalized children. Effective use of nutritional screening tools is crucial for early detection of malnutrition. In this context, the active use of nutritional screening tools, the skill to use these tools, and the level of awareness about these tools among nurses who closely care for pediatric patients are vital factors that can potentially improve pediatric patients' health. Our study examines the usage and awareness of nutritional screening tools among nurses caring for pediatric patients in Yozgat province, a region with unique healthcare challenges and opportunities. Methods: The study was planned as a prospective, descriptive, and cross-sectional design. Ninety-four nurses caring for pediatric patients in Yozgat province and its districts were administered an online questionnaire of 22 questions, which was designed to assess their knowledge, skills, and attitudes towards nutritional screening tools. The questionnaire was distributed through a secure online platform and included both closed-ended and open-ended questions. Data were evaluated using descriptive statistics with SPSS version 27.0. Results: Of the participants, 78.7% were female and 21.3% were male. 60.6% of the participants were in the age range of 25-34 years, 62.8% had a bachelor's degree, 66% worked at state university hospitals, 30.9% had 6-10 years of professional experience, 74.5% were service nurses, and 39.4% had been involved with pediatric patients for 0-1 years. The most frequently cared age group was 3-6 years (19.9%) and 1-3 years (18.1%). 27.7% of the participants assessed nutrition risk status using visual assessment, 25.5% through anthropometric measurements, and 34% reported referring the physician and dietitian for intervention in risk detection. 47.9% indicated the presence of a screening scale in their institution, 57.1% used the form, 25.5% did not know the name of the screening scale, and 6.4% used the StrongKids scale. Conclusion: Our study determined that nurses caring for pediatric patients often consider the screening scale as a secondary option for identifying the nutrition risk status, predominantly performing visual and anthropometric evaluations, and did not demonstrate sufficient proficiency or importance regarding screening scales. Although the determination of risk status varies according to the scale used, the significance of screening scales in detecting malnutrition is substantial. Therefore, our study recommends that necessary training be provided to pediatric nurses to use these tools more effectively and that current practices be reviewed. This will not only enable better assessment of the nutritional status of pediatric patients but also instill hope for the implementation of steps to prevent malnutrition.