Grading System Research Articles

ChatGPT versus human essayists: an exploration of the impact of artificial intelligence for authorship and academic integrity in the humanities

Generative AI has prompted educators to reevaluate traditional teaching and assessment methods. This study examines AI’s ability to write essays analysing Old English poetry; human markers assessed and attempted to distinguish them from authentic analyses of poetry by first-year undergraduate students in English at the University of Oxford. Using the standard UK University grading system, AI-written essays averaged a score of 60.46, whilst human essays achieved 63.57, a margin of difference not statistically significant (p = 0.10). Notably, student submissions applied a nuanced understanding of cultural context and secondary criticism to their close reading, while AI essays often described rather than analysed, lacking depth in the evaluation of poetic features, and sometimes failing to properly recognise key aspects of passages. Distinguishing features of human essays included detailed and sustained analysis of poetic style, as well as spelling errors and lack of structural cohesion. AI essays, on the other hand, exhibited a more formal structure and tone but sometimes fell short in incisive critique of poetic form and effect. Human markers correctly identified the origin of essays 79.41% of the time. Additionally, we compare three purported AI detectors, finding that the best, ‘Quillbot’, correctly identified the origin of essays 95.59% of the time. However, given the high threshold for academic misconduct, conclusively determining origin remains challenging. The research also highlights the potential benefits of generative AI’s ability to advise on structuring essays and suggesting avenues for research. We advocate for transparency regarding AI’s capabilities and limitations, and this study underscores the importance of human critical engagement in teaching and learning in Higher Education. As AI’s proficiency grows, educators must reevaluate what authentic assessment is, and consider implementing dynamic, holistic methods to ensure academic integrity.

Assessment of the Quality of Stapedotomy Videos on YouTube Using the IVORY Grading System.

Assessment of the Quality of Stapedotomy Videos on YouTube Using the IVORY Grading System.

Percutaneous External Fixation of Redistributed Orbital Fat in Transcutaneous Lower Eyelid Blepharoplasty.

While percutaneous external fixation has gained popularity in transconjunctival blepharoplasty due to its simplicity and minimal incision, internal fixation remains the standard approach in transcutaneous blepharoplasty. This study aims to assess the safety and effectiveness of percutaneous external fixation specifically in transcutaneous fat repositioning blepharoplasty. From May 2022 to December 2023, a consecutive cohort of 97 patients underwent this surgical technique. Building upon the principles of transconjunctival fat repositioning, the procedure involved a minimal incision targeting the muscle layer, a conservative release of the tear trough ligament, and the repositioning of fat secured with percutaneous external fixation. Surgical outcomes were evaluated using the Barton grading system and FACE-Q scales for patient-reported outcomes. Following a mean follow-up of 7.2 months (ranging from 6 to 17 months), a resolution of tear trough deformities and eyelid bags was achieved in over 92% of cases. Notably, significant improvements (P < 0.05) were observed in lower eyelid aesthetics as measured by the FACE-Q scale, with a concomitant enhancement in patients' social confidence (P < 0.05). Overall, patients expressed satisfaction with their decision to undergo the procedure (71.0±19.1). Complications necessitating revision surgery included isolated cases of hematoma evacuation, fat injection, excision of excess fat, and skin excision. External fixation in transcutaneous blepharoplasty is technically less complex and minimally invasive, effectively securing transposed fat pedicles safely, presenting a viable alternative to conventional fixation techniques.

Predictors of Conservative Management Failure in Pediatric Renal Trauma: National Trauma Database Insights

Aim of the studyThis study aimed to evaluate contemporary management strategies of pediatric renal trauma, focusing on the failure of conservative management and identifying its predictors. MethodsThe National Trauma Database (2018–2021) was queried for pediatric patients (≤18 years) with renal injury, identified via AIS codes aligned with the AAST kidney injury grading system. Urological surgical procedures were identified via ICD-10 Procedure Codes. Patients were categorized into immediate surgical management (within 4 h), conservative management (no surgery), and failed conservative management (surgery after 4 h). Demographics, injury characteristics, and clinical data were analyzed using descriptive and univariate statistical analyses (Wilcoxon Rank Sum, Chi-square, Odds Ratios). ResultsOf 7266 pediatric renal trauma patients, most were white (63.4 %) males (69.1 %), aged 12–18 (76.6 %), suffering from unintentional blunt trauma (86.9 %). Most (n = 6610, 95 %) received conservative management; however, 4.5 % (n = 298) failed. Common surgical interventions included ureteral stent placement (n = 200, 59 %), renal IR procedures (n = 44, 13 %), and nephrectomy (n = 33, 9.7 %). Nephrectomy rates at low AAST kidney injury grades (I–II) were higher with upfront surgical management (n = 7, 3.5 %) than with failed conservative management (n = 0). Predictors of failed conservative management included higher Injury Severity Score (ISS) and higher AAST kidney injury grades (III–V) (p < 0.05). ConclusionConservative management failed in 4.5 % of paediatric renal trauma cases, associated with higher AAST kidney injury grade and ISS. Upfront surgical management correlated with a higher nephrectomy rate at lower injury grades compared to failed conservative management. Refinement of pediatric trauma protocols is needed for optimal care. Level of EvidenceIII.

Automated grading system for quantifying KOH microscopic images in dermatophytosis

Concerning the progression of dermatophytosis and its prognosis, quantification studies play a significant role. Present work aims to develop an automated grading system for quantifying fungal loads in KOH microscopic images of skin scrapings collected from dermatophytosis patients. Fungal filaments in the images were segmented using a U-Net model to obtain the pixel counts. In the absence of any threshold value for pixel counts to grade these images as low, moderate, or high, experts were assigned the task of manual grading. Grades and corresponding pixel counts were subjected to statistical procedures involving cumulative receiver operating characteristic curve analysis for developing an automated grading system. The model’s specificity, accuracy, precision, and sensitivity metrics crossed 92%, 86%, 82%, and 76%, respectively. ’Almost perfect agreement’ with Fleiss kappa of 0.847 was obtained between automated and manual gradings. This pixel count-based grading of KOH images offers a novel, cost-effective solution for quantifying fungal load.

Biofilms and microbiome profiles in chronic wounds: links to antibiotic use and wound severity in a Sri Lankan cohort.

We have characterized the microbiome of infected chronic diabetic wounds (CDWs), exploring associations with antibiotic use and wound severity in a Sri Lankan cohort. Fifty CDW patients were enrolled, 38 of whom received antibiotics. Tissue biopsies were analysed by microbiome profiling, and wounds were graded using the University of Texas Wound Grading System. Biofilm presence was assessed in 20 wounds. The microbiome was largely dominated by Enterobacteriaceae, Pseudomonadaceae, Streptococcaceae, and Corynebacteriaceae. Proteobacteria levels were significantly higher in antibiotic-treated wounds (P=.019), with increased Pseudomonas abundance. Wounds were categorized as grade 1 (10), grade 2 (29), and grade 3 (11). Alpha diversity varied by wound grade (P=.015), with grade 2 wounds showing the highest diversity and grade 3 the lowest. All 20 tested wounds were biofilm-positive, and community composition varied more in antibiotic-treated wounds (P=.004). CDW microbiomes were dominated by Enterobacteriaceae and Pseudomonadaceae, with elevated Proteobacteria in antibiotic-treated wounds. Alpha diversity correlated with wound severity, peaking in grade 2 wounds. The high prevalence of biofilms in wounds underscores the need for management of CDWs that address microbial complexity.

Meta-analysis of RCTs on the safety of non-fixation of mesh in TAPP inguinal hernia repair: an updated meta-analysis

ObjectiveThis meta-analysis aims to compare the clinical efficacy of mesh non-fixation and fixation in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair, systematically evaluating the application value of the mesh non-fixation technique in clinical settings.MethodsA computerized search of PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov databases was conducted to identify randomized controlled trials (RCTs) comparing mesh non-fixation and fixation in TAPP inguinal hernia repair. Meta-analysis was performed using RevMan 5.3 software, and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) evidence grading system was employed for outcome quality assessment. Publication bias analysis was performed using Begg’s test. A trial sequential analysis (TSA) was performed using TSA 0.9.5.10 Beta software.ResultsA total of nine RCTs involving 1,879 inguinal hernia patients were included. Meta-analysis results demonstrated that, compared to the fixation group, the non-fixation group exhibited significantly lower seroma occurrence rate [RR = 0.43, 95% CI (0.20, 0.89), P = 0.02, heterogeneity P = 0.28, I²=22%], Visual Analog Scale (VAS) pain score at 6 months postoperatively [MD=-0.21, 95% CI (-0.29, -0.12), P < 0.00001, heterogeneity P = 0.34, I²=0%], and cost [MD=-3.23 thousand yuan, 95% CI (-4.26, -2.19), P < 0.00001, heterogeneity P = 0.0003, I²=92%]. There were no statistically significant differences in overall complication rate [RR = 0.88, 95% CI (0.62, 1.23), P = 0.45, heterogeneity P = 0.11, I²=44%], overall infection event rate [RR = 0.96, 95% CI (0.36, 2.56), P = 0.93, heterogeneity P = 0.62, I²=0%] and recurrence rate [RR = 0.75, 95% CI (0.28, 1.99), P = 0.56, heterogeneity P = 0.44, I²=0%] between the two groups. The results of the TSA indicated that the observed lower seroma occurrence rate in the non-fixation group compared to the fixation group requires further validation through the inclusion of additional RCTs.ConclusionMesh non-fixation in TAPP inguinal hernia repair is deemed safe and does not elevate the risk of hernia recurrence. However, given certain limitations in this study, future comprehensive and reliable validation will require further multicenter, high-quality, large-sample double-blind RCTs.

The Presentation, Clinical Diagnosis, Risk Factors, and Management of Rapidly Progressive Hip Osteoarthritis: A Narrative Literature Review.

Rapidly progressive hip osteoarthritis (RPOH) is a rare and severe form of osteoarthritis (OA), marked by the rapid degeneration and destruction of the femoral head, often within months. Despite its unclear etiology, several factors such as subchondral fractures and immune responses have been proposed as possible contributors. This narrative review aims to synthesize current knowledge on the pathogenesis, risk factors, clinical presentation, imaging features, and grading systems of RPOH. Predominantly affecting elderly females, RPOH presents distinctive challenges in both diagnosis and management due to its abrupt onset and severity. Known risk factors include advanced age, female gender, obesity, intra-articular corticosteroids use, and long-term hemodialysis. Clinically, RPOH is characterized by severe pain during active weight-bearing movements, despite patients presenting a normal range of motion during passive examination in the early stages. While several classification systems exist, there is no universal standard, complicating differential diagnosis and clinical approaches. This review emphasizes the necessity for early diagnostic methods utilizing specific biomarkers, rapid differential diagnosis, and targeted, personalized interventions based on individual risk factors.

Application of a Modified SegFormer Architecture for Gleason Pattern Segmentation

A key element of morphological assessment in prostate cancer (PCa) diagnostics is the Gleason score, which is based on the architecture of tumor growth in biopsy or prostatectomy samples. During this process, biopsies from the prostate's pathological areas are evaluated to identify the most common and severe architectural patterns (referred to as Gleason patterns), each of which is assigned a score in the Gleason grading system. The resulting total score serves as a critical predictor for disease progression and metastasis. This research focuses on enhancing the efficiency of morphological examination in PCa by utilizing automatic segmentation of Gleason patterns in whole slide images (WSI) in *.svs format, with 40x magnification and an average spatial resolution of 0.258 microns per pixel. Segmentation was performed using a neural network with a SegFormer architecture, supplemented by an EdgeNeXt (small variant) subnet. The proposed solution successfully identified Gleason patterns of grades 3, 4, and 5. The best model performance for detecting combined Gleason patterns 3, 4, 5, and 4, 5 was achieved with input images sized 512x512 (tile size) and a batch size of 8, resulting in an F-score of 0.835 and 0.769, respectively.

Delving into diversity: Exploring different risk factors of premature greying of hair.

Dear Madam, Hair is said to grey prematurely when a minimum of five grey hairs occur before the age of 20 in Caucasians, 25 in Asians and 30 in Africans1. Some authors propose using 25 years as a cut-off for people in the South Asian subcontinent. Also, there's no universal grading system for premature greying of hair (PGH). This letter addresses the various evolving risk factors for PGH in young adults worldwide. PGH may be familial or genetically influenced, traveling in an Autosomal Dominant pattern. A positive family history, in particular the paternal history is the most powerful risk factor2. PGH is also linked to nutritional deficiencies including vitamins (especially B12) and minerals. For example in one study, significantly lower levels of serum calcium, ferritin, vitamin B12, and high HDL were observed in patients3. T3 and T4 act on hair follicles to cause melanogenesis and their deficiency is therefore associated with PGH, alopecia, and changes in hair morphology. Another study found notably reduced levels of copper in cases (PGH) as compared to the control group. This study, however, did not observe lower levels of zinc or iron among the affected population. A separate case-control study concerning the association of epidemiological and biochemical factors with PGH reported that a significantly higher percentage of individuals with premature greying had atopic diathesis, led sedentary lifestyles, had family histories of the condition, smoked, and had reported higher levels of perceived stress compared to controls. Though, interestingly enough, regular application of hair oil seemed to confer a safeguarding effect against premature greying. Upon further review of the literature, it became apparent that both BMI and exposure to sunlight emerged as substantial predictors of PGH. Despite the prescription of various vitamins and minerals like biotin, calcium pantothenate, zinc, copper, and selenium (all of which have been recognized as risk factors), the outcomes have been disappointing. Calcium pantothenate is frequently recommended for premature greying of hair (PGH)4. This highlights an existing knowledge gap concerning the precise causative risk factors, necessitating further investigation for a comprehensive understanding and improved management of individuals experiencing premature greying of hair.

Significance of intrarenal vascular lesions in Ig A nephropathy prognosis

BackgroundImmunoglobulin A nephropathy (IgAN) is the predominant primary glomerulonephritis globally and remains a subject of active research with a focus on understanding its course and prognosis. Although vascular lesions are associated with IgAN, the current histopathological grading systems do not consider intrarenal vascular lesions when predicting patient prognosis. Therefore, this retrospective study conducted at Kyungpook National University Hospital between October 2016 and December 2021, aimed to elucidate the significance of intrarenal vascular lesions in IgAN by comparing the clinical data of patients with and without such lesions.MethodsData of patients with biopsy-confirmed primary IgAN between October 2016 and June 2021 at Kyungpook National University Hospital (Daegu, South Korea) were collected, and their medical records were reviewed. All slides from these 138 cases were independently pathologically reviewed by two nephropathologists (Y. J. K. and M. S. K.) using light microscope. The vascular lesions included in this study were fibrous intimal thickening, arteriolar wall thickening, and arteriolar hyalinosis. All cases were reviewed according to the Oxford Classification of IgA Nephropathy (2016) and Haas classification.ResultsOf the 138 patients, 88 exhibited at least one intrarenal vascular lesion. Patients with arteriolar wall thickening demonstrated a reduced estimated glomerular filtration rate (eGFR), elevated serum creatinine level and urine protein-to-creatinine ratio, an increased proportion of global glomerulosclerosis, and a higher histologic grade of interstitial fibrosis and tubular atrophy at the time of biopsy.ConclusionArteriolar wall thickening in IgAN are associated with reduced eGFR and global glomerulosclerosis. Moreover, reduced eGFR and global glomerulosclerosis are correlated with the progression to end-stage renal disease. Although the direct correlation between vascular lesions and end-stage renal disease is not entirely clear, a marginally significant association (log-rank test, p = 0.06) was observed with arterial wall thickening. This study suggests the potential importance of vascular lesions in the prognosis of IgAN, encouraging further investigation using larger cohort studies to establish a clearer association.

BeGrading: large language models for enhanced feedback in programming education

AbstractIn recent years, large language models (LLMs) have gained significant traction across various domains, including education. This paper explores the application of LLMs in grading programming assignments. By leveraging data collected from existing programming assignments and their corresponding grades, we aim to develop a robust LLM-based grading system. We also incorporate augmented data representing various grading scenarios to enhance the model’s performance and ensure comprehensive coverage across all grading levels. Our approach involves training the LLM on this combined dataset to enable accurate and consistent evaluation of programming assignments. The proposed model, BeGrading, aims to reduce the grading burden on educators and provide timely and objective feedback to students. Compared to the Codestral model, our proposed model demonstrates an absolute difference rate of 19%, equivalent to $$\pm 0.95$$ ± 0.95 out of 5. This is acceptable for using a small, fine-tuned model with optimized data. Additionally, the Codestral model compared to the dataset optimized score shows a difference of 15% equivalent to a margin of $$\pm 0.75$$ ± 0.75 out of 5. Preliminary results demonstrate the potential of LLMs to perform grading tasks with a high degree of reliability, opening avenues for further research and practical applications in automated education systems.

Evaluating the Effectiveness of Probiotic Supplementation in Combination With Doxycycline for the Treatment of Moderate Acne: A Randomized Double-Blind Controlled Clinical Trial.

Acne is a chronic inflammatory skin disease that negatively affects patients' quality of life. Increasing antibiotic resistance is making acne less responsive to treatment. Probiotics are live microorganisms that can provide health benefits by fighting pathogens and maintaining intestinal homeostasis and skin microbiome balance. This study investigates the effects of probiotics in the treatment of acne vulgaris. In this randomized controlled clinical trial, 80 patients with moderate acne were divided into two groups of 40. All patients received the same topical treatment, which consisted of a daily antibacterial face wash and Adapalene gel every other night. The control group received one capsule of doxycycline (100 mg) daily, whereas the intervention group received one probiotic capsule daily in addition to doxycycline. Patients underwent photography of facial acne lesions, and treatment response was assessed using the global acne grading system (GAGS) and acne grading method at baseline, as well as during follow-up visits at 1, 2, and 3 months. The global acne grading system indicated that both groups showed improvement. However, analyses revealed that outcomes were significantly better in the doxycycline plus probiotics group for the forehead (p = 0.018), chin (p = 0.021), and nose (p = 0.021). No significant differences were observed for the left and right cheeks, back, and chest areas, with the mean GAGS score reduction between the two groups differing by only 2%. Treatment with probiotics significantly reduced the severity of lesions compared to the control group (p < 0.001). The acne grading method also indicated that the intervention group had a significantly better treatment response than the control group (p < 0.001). Furthermore, treatment with probiotics did not result in any side effects. Probiotics can serve as an effective and safe treatment option, enhancing the outcomes of routine acne treatments, particularly for patients with acne on the forehead, chin, and nose.

Hemophagocytic Lymphohistiocytosis (HLH): A Clinical and Pathological Grading System Based on the Presence of Hemophagocytosis

Abstract Introduction/Objective Hemophagocytic lymphohistiocytosis (HLH) is a heterogeneous group of disorders resulting from uncontrolled immune activation leading to severe hyperinflammation. The syndrome can be primary (genetic) or secondary to infections, malignancies, or autoimmune diseases. The diagnosis of HLH is challenging due to its nonspecific clinical presentation and the overlap with other conditions. This study aims to establish a reliable diagnostic approach for HLH by evaluating the accuracy of bone marrow histomorphological criteria in diagnosing the disease. Methods/Case Report We conducted a retrospective analysis of clinical and pathological data from patients diagnosed with HLH over a 12year period and included 38 patients with suspected HLH. A grading system for hemophagocytosis was developed based on the extent and frequency of hemophagocytic activity observed in bone marrow biopsies. Hemophagocytosis is categorized into four grades: Grade 0 indicates its absence, Grade 1 describes mild hemophagocytosis with less than 2 histiocytes containing hemophagocytosis per slide, Grade 2 denotes moderate hemophagocytosis with 3 to 5 histiocytes per slide, and Grade 3 signifies severe hemophagocytosis with more than 5 histiocytes per slide. Clinical data, comprising laboratory parameters and treatment outcomes, were analyzed in relation to the histologic grading of hemophagocytosis. Results (if a Case Study enter NA) Among the cases, grade 1 had 1 resolved case, 4 cases meeting 2 criteria all resolved, and 13 cases meeting 4 or more criteria resulted in 5 deaths and 8 resolutions. Grade 2 included 10 cases, with 2 meeting 2 criteria and resolving, and 8 meeting 4 or more criteria resulting in 5 deaths and 3 resolutions. Grade 3 comprised 10 cases, with 3 meeting 3 criteria and resolving, 3 meeting 5 or 7 criteria resulting in 1 death and 2 resolutions each, and 4 meeting 6 or 8 criteria resulting in 2 deaths and 2 resolutions each. Conclusion In our retrospective analysis of bone marrow biopsies from 38 patients with suspected HLH, our results indicate that the presence and extent of hemophagocytosis strongly suggest HLH. Implementing these criteria significantly improved diagnostic accuracy, reducing misdiagnosis rates and enabling timely therapy initiation. This study underscores the value of bone marrow histomorphological criteria in diagnosing HLH and stresses their importance in the standard diagnostic process for suspected HLH cases.

Preliminary application of ulnar cortex transverse transport technique in treatment of upper extremity thromboangiitis obliterans

To investigate the feasibility and effectiveness of ulnar cortex transverse transport technique in treating upper extremity thromboangiitis obliterans (TAO). A retrospective analysis was conducted on the clinical data of 7 male patients with upper extremity TAO who were admitted and met the inclusion criteria between January 2019 and July 2022. The patients ranged in age from 32 to 50 years, with a mean age of 40.1 years. The disease duration ranged from 6 to 24 months, averaging 13.6 months. The smoking history ranged from 8 to 31 years, with a mean of 18.4 years. All patients presented with finger ulcers or gangrene, including 1 case affecting the thumb and index finger, 1 case affecting the index and middle fingers, 1 case affecting the middle and ring fingers, 1 case affecting only the ring finger, and 3 cases affecting the ring and little fingers. The preoperative visual analogue scale (VAS) score was 9.1±0.7. All patients underwent treatment with the ulnar cortext transverse transport technique. The wound healing time and the disappearance time of rest pain were recorded. The VAS score was used to assess the degree of hand pain before and after operation. Serum interleukin 6 (IL-6) levels were measured before operation and at 1 month after operation. Computed tomography angiography (CTA) of the affected limb was performed before operation and at 3 months after operation to evaluate changes in blood vessels. The clinical outcomes were evaluated at 1 year after operation based on the Patwa and Krishnan grading system. All 7 patients were followed up 12-17 months, with an average of 13.7 months. All patients experienced successful healing of ulcers, with wound healing time ranging from 14 to 21 days, averaging 17.3 days. During the follow-up, no complication occurred, and there was no recurrence of ulcers. The disappearance time of rest pain ranged from 8 to 15 days, averaging 12.1 days. The pre- and post-operative (1-month) serum IL-6 levels were (25.1±5.9) pg/mL and (11.9±2.9) pg/mL, respectively, with a significant difference ( t=5.363, P=0.002). CTA examination at 3 months after operation revealed partial revascularization of upper extremity arteries and establishment of collateral circulation, showing significant improvement compared to preoperative status. The VAS scores at 1, 7, 28 days, and 6 months postoperatively were 6.4±0.8, 3.7±0.8, 0.6±0.8, and 0.1±0.4, respectively, all of which significantly improved compared to preoperative scores ( P<0.05). Furthermore, the VAS scores gradually decreased over time, with significant differences observed between postoperative time points ( P<0.05). At 1 year after operation, the effectiveness of all 7 patients were evaluated as excellent based on the Patwa and Krishnan grading system. The ulnar cortex transverse transport technique can improve blood circulation in the upper limb of patients with TAO, reconstruct microcirculation, inhibit inflammation, promote ulcer healing, and alleviate limb pain.

Assessing the Role of Artificial Intelligence in the Creation of Patient Educational Videos for Corneal Refractive Surgery.

We aim to assess the ability of artificial intelligence (AI) to generate patient educational videos for various corneal refractive surgeries. Three AI text-to-video platforms (InVideo (San Francisco, CA), ClipTalk (San Francisco, CA), and EasyVid (Los Angeles, CA)) were used to create patient educational videos for laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and small incision lenticule extraction (SMILE), respectively. Videos for LASIK and PRK from the American Academy of Ophthalmology (AAO) and a SMILE video from Zeiss served as controls for each surgery. A three-point grading system (from zero to three, with zero being the worst and three being the best in each category) was used to compare videos in terms of "image accuracy," "script accuracy," "image clarity," and "script alignment." In terms of image accuracy, the control videos outperformed InVideo, EasyVid, and ClipTalk for LASIK (3 versus 0.667 versus 0 versus 0; p<0.005), PRK (3 versus 1 versus 0.33 versus 0; p<0.05 for InVideo, p<0.005 all), and SMILE (3 versus 0.33 versus 0 versus 0.33; p<0.005), respectively. With a few exceptions, all three AI models performed similarly to the control videos in terms of script accuracy, image clarity, and script alignment. In their current state, AI text-to-video generators can produce surgical educational videos for patients with accurate script narration and high image clarity, although these platforms are not yet capable of producing medically accurate images to go along with these scripts. Further improvements in the medical accuracy of these images must be made to make these videos more appropriate for patient consumption.

Single-centre retrospective analysis: 16 cases of percutaneous nephrolithotripsy complicating hepatic puncture injury in a 7-year experience.

The aim of this retrospective analytical study was to investigate the diagnosis and management of liver puncture injuries caused by percutaneous nephrolithotripsy (PCNL). The clinical data of 1069 patients who underwent PCNL between Oct. 2017 and Apr. 2024 were analyzed. The diagnosis of liver puncture injury was confirmed by postoperative examination of three-dimensional reconstruction computed tomography (3D-CT) findings, and the data from these patients were statistically and retrospectively analyzed. A total of 16 cases were collected, including 9 males and 7 females, with an average age of 58.31 ± 14.30years, a mean body mass index (BMI) of 23.54 ± 3.88kg/m2. Liver puncture injury was identified and classified as tangential or penetrating according to the anatomy of the nephrostomy tube and liver. The average decrease in hemoglobin level after operation was 14.25 ± 11.97g/L. One patients received blood transfusions for preoperative anemia and postoperative blood loss, and all patients were cured and discharged after delaying the removal of nephrostomy tube under conservative treatment, the time of nephrostomy tube removal after a single PCNL procedure was 6.44 ± 1.26days. This article proposes a grading system for PCNL-complicated liver puncture injuries that will help physicians to better understand their characteristics and guide the development of management. In the absence of obvious signs of peritonitis and hemodynamic stability, conservative treatment of the liver puncture injury caused by PCNL is safe and effective.

Radioligand therapy in the therapeutic strategy for patients with gastro-entero-pancreatic neuroendocrine tumors: a consensus statement from the Italian Association for Neuroendocrine Tumors (Itanet), Italian Association of Nuclear Medicine (AIMN), Italian Society of Endocrinology (SIE), Italian Association of Medical Oncology (AIOM).

This paper outlines the consensus of the Italian Association for Neuroendocrine Tumors(Itanet), the Italian Association of Nuclear Medicine (AIMN), the Italian Society of Endocrinology (SIE), and the Italian Association of Medical Oncology (AIOM) on treating neuroendocrine neoplasms (NENs)with radioligand therapy (RLT). A list of 10 questions regarding using RLT ingastroenteropancreatic neuroendocrine tumors (GEP-NETs) was addressed after a careful review of theavailable literature. compiling information from the MEDLINE database, augmented with expert opinionsand recommendations, aligns with the latest scientific research and the author's extensive knowledge.The recommendations are evaluated using the GRADE system, showcasing the level of evidence andthe strength of the recommendations. Specifically, this paper focuses on thesubcategories of well-differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NETs) thatexpress somatostatin receptors and are considered suitable for RLT, according to internationalguidelines.

Combination of intravoxel incoherent motion histogram parameters and clinical characteristics for predicting response to neoadjuvant chemoradiation in patients with locally advanced rectal cancer.

To explore the value of histogram parameters derived from intravoxel incoherent motion (IVIM) for predicting response to neoadjuvant chemoradiation (nCRT) in patients with locally advanced rectal cancer (LARC). A total of 112 patients diagnosed with LARC who underwent IVIM-DWI prior to nCRT were enrolled in this study. The true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and microvascular volume fraction (f) calculated from IVIM were recorded along with the histogram parameters. The patients were classified into the pathological complete response (pCR) group and the non-pCR group according to the tumor regression grade (TRG) system. Additionally, the patients were divided into low T stage (yp T0-2) and high T stage (ypT3-4) according to the pathologic T stage (ypT stage). Univariate logistic regression analysis was implemented to identify independent risk factors, including both clinical characteristics and IVIM histogram parameters. Subsequently, models for Clinical, Histogram, and Combined Clinical and Histogram were constructed using multivariable binary logistic regression analysis for the purpose of predicting pCR. The area under the receiver operating characteristic (ROC) curve (AUCs) was employed to evaluate the diagnostic performance of the three models. The values of D_ kurtosis, f_mean, and f_ median were significantly higher in the pCR group compared with the non-pCR group (all P < 0.05). The value of D*_ entropy was significantly lower in the pCR group compared with the non-pCR group (P < 0.05). The values of D_ kurtosis, f_mean, and f_ median were significantly higher in the low T stage group compared with the high T stage group (all P < 0.05). The value of D*_ entropy was significantly lower in the low T stage group compared with the high T stage group (P < 0.05). The ROC curves indicated that the Combined Clinical and Histogram model exhibited the best diagnostic performance in predicting the pCR patients with AUCs, sensitivity, specificity, and accuracy of 0.916, 83.33%, 85.23%, and 84.82%. The histogram parameters derived from IVIM have the potential to identify patients who have achieved pCR. Moreover, the combination of IVIM histogram parameters and clinical characteristics enhanced the diagnostic performance of IVIM histogram parameters.

Comparison of Outcomes of Bell’s Palsy Patients Treated with Steroid and Steroid with Antiviral Drug in a Tertiary Care Hospital

Background: Bell’s palsy is the most common acute mononeuropathy associated with idiopathic unilateral facial weakness, characterized by facial asymmetry. Though steroids have effectiveness in managing Bell’s palsy, the use of antiviral is still debatable. Objective: To compare the outcome of Bell’s palsy with treatment by steroid versus combination of steroid and antiviral drugs. Methodology: A prospective analytical study was performed on 84 patients with acute Bell’s palsy attending at Neurology outpatient department of Mymensingh Medical College Hospital from July 2014 to June 2016. The patients were divided into two groups purposively after initial assessment as per House-Brackmann grading system (HBS). Group-I patients were treated with oral prednisolone and oral valacyclovir and Group-II patients were treated with oral prednisolone only. Both groups received facial exercises as per demonstration and proper eye care throughout the study period. Follow-up was done after 2 weeks, 4 weeks and 3 months for collection of data about recovery according to reassessment. Results: The analysis revealed that recovery rates at all 3 follow-ups were higher in the combination group than that of the prednisolone-only group [29(67.44%) versus 18 (43.90%) at 2nd week follow-up, 35(81.39%) versus 25(60.97%) at 4th week follow up and 40 (93.02%) versus 30(73.17%) at 3rd month follow-up]. Moreover, the expected recovery rate was higher in severe Bell’s palsy patients in the combination group than in steroid-alone group (22, 88.0% complete recovery versus 13, 54.17% complete recovery at the end of 3 months of treatment) [p=0.034]. haemorrhagic shock, spinal cord damage, septic shock and crush syndrome. Conclusion: The study showed antiviral (valacyclovir) plus steroid (prednisolone) to be more effective than steroid (prednisolone) alone in the treatment of Bell’s palsy. Moreover, outcome was more favorable in combination groups presenting with severe disease. Lessen their severity. Journal of Monno Medical College December, 2023; 9 (2):58-62