High Success Rate Research Articles

A CBCT study of changes in temporomandibular joint morphology with immediate implant placement and immediate loaded full-arch fixed dental prostheses.

Dental implants are becoming a popular treatment of choice. Immediate implant placement with immediate loaded full-arch fixed dental prostheses (IPILFFDP) presents an attractive solution for edentulous and partially edentulous patients because of its high success rate, reduction in overall treatment time, and improved esthetics. However, whether it can minimize the risk of temporomandibular disorder (TMD) has not been previously studied. To quantitatively evaluate the temporomandibular joint (TMJ) morphology changes before and after IPILFFDP, using cone beam computed tomography (CBCT). Twelve participants without TMJ symptoms undergoing IPILFFDP were included in the study. Preoperative and 1-year postoperative assessment of CBCT scans were performed on 18 items related to TMJ and vertical dimensions. Mimics software was used for data analysis. T-test, Pearson, and Spearman correlation analyses were performed. There were no significant differences in bilateral joints between pre and post IPILFFDP. Compared with pre-treatment CBCT, post-treatment CBCT showed a significant increase in posterior joint space. There was an approximately 2mm increase in the vertical dimension after IPILFFDP, which is correlated with an increase in the medial joint space. For patients without TMJ-related signs and symptoms, the IPILFFDP could keep the neuromuscular memory of patient's facial muscles and occlusion, and use adapted centric posture as a guide, which led to more precise restoration of the original jaw position and may shed light in future related clinical studies.

Five-year retrospective analysis of Bakri balloon tamponade for obstetric haemorrhage and patient survey at a single tertiary centre.

Intrauterine balloon tamponade (IUBT), specifically the usage of Bakri balloon tamponade (BBT), is an effective conservative management technique for postpartum haemorrhage (PPH). The primary objective was to evaluate local guidelines and contribute to evidence regarding ideal duration for BBT. The secondary objectives were to consider impacts on maternal-foetal wellbeing, and optimise healthcare efficiency by reducing length of ICU admissions. This five-year retrospective case series analysed 132 cases of obstetric ICU admissions requiring Bakri balloon insertion for PPH within our centre. Additionally, a prospective patient experience survey was conducted over six-month period, involving 22 obstetric patients who required unplanned ICU admissions. Bakri balloon insertion was successful in 95%, whilst 5% experienced failure, necessitating further interventions (uterine artery embolisation) or return to theatre (hysterectomy). The success group demonstrated significant reductions in median blood loss (1.8 L vs. 2.5 L, p = 0.016) and difference in median duration of BBT (18.3 vs. 3.92 hours, p = 0.001). The prospective patient survey revealed a high level of satisfaction of care. Approximately 50% breastfed prior to discharge, on average commencing 23.4 hours post-delivery. This study demonstrates a high success rate of BBT, with failures typically occurring within median duration 3.9 hours. Considering the separation of mother from baby during the Bakri balloon's presence in ICU, we propose timely removal at around six hours, as failures are unlikely post this timeframe, or nursing these women in a neonatal care setting to facilitate earlier mother-baby bonding.

Impact of Image Content on Medical Crowdfunding Success: A Machine Learning Approach.

As crowdfunding sites proliferate, visual content often serves as the initial bridge connecting a project to its potential backers, underscoring the importance of image selection in effectively engaging an audience. This paper aims to explore the relationship between images and crowdfunding success in cancer-related crowdfunding projects. We used the Alibaba Cloud platform to detect individual features in images. In addition, we used the Recognize Anything Model to label images and obtain content tags. Furthermore, the discourse atomic topic model was used to generate image topics. After obtaining the image features and image content topics, we built regression models to investigate the factors that influence the results of crowdfunding success. Images with a higher proportion of young people (β=0.0753; P<.001), a larger number of people (β=0.00822; P<.001), and a larger proportion of smiling faces (β=0.0446; P<.001) had a higher success rate. Image content related to good things and patient health also contributed to crowdfunding success (β=0.082, P<.001; and β=0.036, P<.001, respectively). In addition, the interaction between image topics and image characteristics had a significant effect on the final fundraising outcome. For example, when smiling faces are considered in conjunction with the image topics, using more smiling faces in the rest and play theme increased the amount of money raised (β=0.0152; P<.001). We also examined causality through a counterfactual analysis, which confirmed the influence of the variables on crowdfunding success, consistent with the results of our regression models. In the realm of web-based medical crowdfunding, the importance of uploaded images cannot be overstated. Image characteristics, including the number of people depicted and the presence of youth, significantly improve fundraising results. In addition, the thematic choice of images in cancer crowdfunding efforts has a profound impact. Images that evoke beauty and resonate with health issues are more likely to result in increased donations. However, it is critical to recognize that reinforcing character traits in images of different themes has different effects on the success of crowdfunding campaigns.

Displacement of maxillary dental implants: a case series on various scenarios.

Oral rehabilitation with dental implants is a common procedure in modern dentistry due to its high success rates. However, complications such as implant displacement can occur, particularly in the maxillary region due to factors like atrophied maxilla, thin alveolar bone, and low bone density. This case series explores scenarios of maxillary dental implant displacement, emphasizing the impact of immediate preoperative imaging on patient outcomes. Three cases of maxillary implant displacement are presented, each illustrating a different scenario. Complications resulting from the displacement of implants into adjacent structures such as the maxillary sinus and nasal cavity are described. All cases involved implants that were displaced during second-stage surgery, occurring four to six months post-implantation. Removal attempts used transnasal endoscopic, intraoral, or combined approaches, with only one implant successfully retrieved. Delays in surgery ranged up to 72h, leading to one implant being swallowed and another unlocated. Outcomes varied, with some patients requiring hospitalization for up to five days. This series highlights the crucial role of immediate preoperative 3D imaging in precisely locating displaced implants to ensure their safe and efficient removal. While implant displacement may not always be preventable, optimizing the timeframe between diagnostic imaging and surgical intervention can significantly enhance management. Accurately locating the implant minimizes treatment invasiveness and patient discomfort, thereby improving clinical outcomes.

Biomedical research grant resubmission: rates and factors related to success – a scoping review

ObjectivesMost first-time biomedical research grant applications are not funded. In the challenging research funding climate, resubmitting a grant application is a necessary task for scientists. Identifying which factors influence their...

Outcomes of Left Main Chronic Total Occlusion Percutaneous Coronary Interventions.

Percutaneous coronary intervention (PCI) of left main (LM) chronic total occlusions (CTO) has received limited study. We compared the clinical and procedural characteristics and outcomes of patients who underwent LM versus non-LM CTO PCI at 41 US and non-US centers between 2012 and 2024. During the study period 85 of 15,254 CTO PCIs (0.6%) performed in 14,969 patients were LM CTO PCIs. LM CTO PCI patients were older, had higher rates of dyslipidemia and heart failure and most (88.8%) had prior coronary artery bypass graft surgery (CABG). They were more likely to have moderately or severely calcified lesions (80.7% vs. 45.7%, p < 0.001) and had higher J-CTO (2.76 ± 1.17 vs. 2.37 ± 1.26, p = 0.008), PROGRESS-CTO MACE (3.56 vs. 2.57, p < 0.001), Mortality (2.45 vs. 1.68, p < 0.001), Pericardiocentesis (2.74 vs. 1.87, p < 0.001), Acute MI (1.72 vs. 0.89, p < 0.001) and Perforation (3.21 vs. 2.19, p < 0.001) scores. There was no difference in technical success (80.5% vs. 87.2%, p = 0.086) or major cardiovascular adverse events (MACE) (2.4% vs. 2.0%, p = 0.700). LM CTO PCI patients with and without prior CABG surgery had similar technical success and MACE. The retrograde approach in prior CABG patients was more likely to be performed through saphenous vein grafts. LM CTO PCI is infrequently performed, is associated with high comorbidity burden and angiographic complexity but can be performed with high success and acceptable complication rates.

Myoneurectomy for Adductor Spasmodic Dysphonia: Long-Term Outcomes, Complications, and Recurrence.

To evaluate the long-term results of endoscopic myoneurectomy (EMN) of the thyroarytenoid (TA) muscle for the treatment of adductor spasmodic dysphonia (AdSD), with an emphasis on vocal outcomes, adverse effects, and recurrence. A total of 48 patients underwent up to three EMNs of the TA muscle and were followed for at least 18 months to evaluate the efficacy, based on patient and examiner assessments, and safety of the procedure(s). Vocal outcomes were evaluated through the use of the 30-item Voice Handicap Index (VHI-30) questionnaire and subjective (patient-reported) assessment. In this group, 38 patients (79.2%) were considered successful. The median VHI-30 score at baseline was 97, decreasing to 26 after treatment, and the median subjective postprocedural improvement was 88.5%. The most common adverse effects were granulomas (in 18 cases), glottic insufficiency (in two), and dyspnea (in one). Although up to three procedures can be needed to achieve a high success rate, EMN of the TA muscle can provide excellent benefits in terms of vocal function with a low rate of complications. 4 Laryngoscope, 2024.

BN SO26 - Predicting successful and safe day-case laparoscopic cholecystectomy: Validation of the Cholecystectomy as a Day Case (CAAD) score

Abstract Background Day case surgery is a major target for the NHS as it improves patient satisfaction and reduces financial costs. The CAAD score, using pre-operative variables from clinic letters and electronic sources, aids in selecting patients for day-case lists. This study assessed the validity of the CAAD score in predicting successful and safe day-case laparoscopic cholecystectomy (LC) at an isolated day unit. Method A retrospective analysis was performed on patients scheduled for elective LC between January 2020 and March 2022. Outcomes (same day discharge rate, length of stay, conversion to open, bile leak, mortality) were stratified by CAAD score (≤5, &amp;gt;5). Statistical analyses included Chi square and independent t-tests using SPSS 28.0. Results 58 patients were analysed.18/38 patients with CAAD ≤5 achieved same day discharge compared to 4/20 with CAAD &amp;gt;5 (p&amp;lt;0.05). 36 patients stayed for ≥1 day. The mean length of hospitalization was 1.38 days (range 1-2) for the 13 patients with CAAD ≤5. 15 patients with CAAD &amp;gt;5 stayed significantly longer i.e. 2.53 days (range 1-10) (p &amp;lt;0.05). Longer stay for scores &amp;gt;5 was due to difficult dissection (13%), conversion to open (13%) and drain insertion (7%). For scores ≤5, reasons were drain insertion, postoperative pain, nausea, and difficult dissection, each at 8%. No major complications were noted in either group. Conclusion The CAAD score is a predictive tool for successful and safe day-case LC, correlating lower scores with higher success rates and shorter hospital stays. Implementing the CAAD score can improve patient selection, potentially reduce unnecessary overnight stays, and support operational efficiency in isolated day units.

Evaluation of V-type titanium cable internal fixation for the treatment of young adult fifth lumbar spondylolysis: technical notes and a retrospective clinical study.

Various strategies, each with its own set of limitations, are available for managing lumbar spondylolysis. In response, our department has developed an innovative solution: a V-shaped titanium cable integrated with a pedicle screw internal fixation system specifically designed for lumbar spondylolysis in young adults. The objective of this study was to thoroughly investigate the long-term efficacy of V-type titanium cable internal fixation for the management of spondylolysis, especially in young adults. Twenty-one patients with fifth lumbar spondylolysis were treated using V-shaped titanium cables and pedicle screw internal fixation at the General Hospital Xinjiang Military Command. The duration of low back pain before surgery was 6 ~ 48 (15.85 ± 11.57) months. The Medtronic (S7) navigation system was used during surgery to guide the placement of pedicle screws, aiming to avoid damaging the L4-5 facet joint by positioning the screws lower and further to the side. Intraoperative indices (operative time and intraoperative blood loss) were recorded. The visual analog scale (VAS), Oswestry Disability Index (ODI), pelvic incidence (PI), and intraoperative imaging measurements of screw accuracy were meticulously recorded and assessed in a comprehensive manner. This thorough evaluation was conducted both intraoperatively and throughout the follow-up period, which lasted for at least one year.The Macnab efficacy criteria were used to assess postoperative outcomes during the final follow-up period. All patients successfully completed the 1-year follow-up on time. Two patients experienced postoperative wound liquefaction and successfully recovered after undergoing dressing changes. The average duration of the surgical procedure was 113.09 ± 6.97min, and an intraoperative blood loss of 50.47 ± 21.32 millilitres was observed. Significant differences were noted in visual analog scale (VAS) scores before and after surgery at various time intervals, indicating improvement with the progression of rehabilitation exercises. No significant changes were found in the pelvic incidence (PI), and there were no notable differences between the preoperative and postoperative periods. No loosening, breakage, or failure of the internal fixation was found during the long-term follow-up. Furthermore, there were no serious complications, such as infection or vascular or nerve injuries. occurred during the procedure. A patient who presented with a considerable cryptic fissure of sacrum 1 experienced dural injury during the surgical procedure. Intraoperatively, dural sutures were skillfully applied, and the adjacent muscles were fortified. Remarkably, the patient achieved successful healing in a single stage. On the first day postsurgery, a gradual improvement in mobility was noted. The use of a V-shaped titanium cable in conjunction with a pedicle screw internal fixation system for the management of fifth lumbar spondylolysis in young individuals is characterized by its ease of execution and ability to yield favorable outcomes. This approach relies on the prerequisite that patients with minimal intervertebral disc injury or mild lumbar spondylolisthesis demonstrate high overall success rates but experience low failure rates associated with internal fixation. Most significantly, this technique involves segmental internal fixation, which safeguards the functional spinal unit (FSU).

BN SO52 - Innovative Tools for Laparoscopic Bile Duct Exploration (LCBDE) in Torbay Hospital

Abstract Background Laparoscopic bile duct exploration (LCBDE) is a minimally invasive technique used to manage common bile duct (CBD) stones. The procedure has evolved significantly with the development of specialized tools that enhance efficacy and patient outcomes. This abstract aims to discuss the various tools employed for LCBDE at Torbay Hospital, highlighting their specific uses, benefits, and outcomes. Method We conducted a retrospective analysis of LCBDE procedures performed at Torbay Hospital. The tools used included the Pusen ‘Skinny scope’, Ambscope, Nathenson tipless basket, GB stone retrieval basket, and Rotacrusher. Data were collected on the types of tools used, procedural success rates, stone clearance rates, and any complications Results The Pusen ‘Skinny scope’ (3mm) was used in 60% of cases for transcystic exploration, showing high success in stone visualization and retrieval. The Ambscope (5mm) was used in 30% of cases for choledochotomy, effectively accessing larger stones. The Nathenson tipless basket retrieved up to 8mm stones in 45% of cases. The GB stone retrieval basket extracted non-disposable stones up to 2cm. The Rotacnsher, used for large stones in choledochotomy, was highly effective but needed larger port access. Laser and mechanical lithotripters fragmented stones larger than 1cm with an 85% success rate. Overall stone clearance was 90% with minimal complications. Conclusion The use of specialized tools in LCBDE at Torbay Hospital has significantly improved the management of CBD stones. The Pusen ‘Skinny scope’ and Ambscope provide excellent visualization and access, while the Nathenson tipless basket and GB stone retrieval basket offer reliable stone extraction capabilities. Advanced lithotripters further enhance the ability to manage larger stones. These tools collectively contribute to high success rates and favorable patient outcomes, reinforcing the value of LCBDE in modern surgical practice.

Safe Anesthesia Practices for Minimally Invasive, Image-guided Procedures: CT, MRI, and Ultrasound

Background: The demand for minimally invasive, image-guided procedures, such as CT, MRI, and ultrasound, is increasing. Understanding the role of anesthesia in enhancing patient safety, comfort, and procedural success is essential. Methods: This study was conducted at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, over two years, involving 150 patients. Anesthesia techniques were categorized as general anesthesia, sedation, and local anesthesia. Patient outcomes, complications, and satisfaction scores were recorded and analyzed. Results: In this study, general anesthesia was administered to 65 patients (43.3% of cases), sedation was used for 56 patients (37.3%), and local anesthesia was applied to 29 patients (19.3%). The overall procedural success rate was high, at 141 successful completions (94%), with minor complications occurring in 7 patients (4.7%) and major complications in 2 patients (1.3%). Patient satisfaction scores indicated that 96 participants (64%) reported being very satisfied with their anesthesia experience, while 45 patients (30%) indicated they were satisfied. These findings highlight the effectiveness and safety of the selected anesthesia practices in minimally invasive, image-guided procedures, demonstrating a strong correlation between appropriate anesthesia techniques and positive patient outcomes. The data underscore the importance of tailored anesthesia protocols to enhance procedural success and patient satisfaction in this clinical setting. Conclusion: The study demonstrates that tailored anesthesia practices can achieve high success rates and patient satisfaction in minimally invasive, image-guided procedures. Despite the low incidence of complications, ongoing research is needed to refine anesthesia protocols and explore advanced, image-guided techniques to further enhance patient safety and comfort.

Contemporary Outcomes of Degenerative Mitral Valve Surgery in a Regional Tertiary Care Center

Objective: As percutaneous mitral valve techniques become more prevalent, it is important to evaluate the contemporary outcomes of surgical mitral valve interventions. This study assessed the current results and procedural trends of mitral valve surgery for degenerative mitral regurgitation (DMR) at a regional tertiary care center. Methods: Data were analyzed from 693 consecutive DMR patients who underwent isolated mitral valve operations, with or without tricuspid valve repair and atrial fibrillation ablation between 2017 and 2024. The outcomes were defined according to MVARC criteria. The study endpoints included successful mitral valve repair, in-hospital results, and operative and long-term mortality. Logistic regression was applied to assess the impact of valve lesions and patient risk factors on the probability of valve repair. Survival was analyzed using Kaplan–Meier methodology. The follow up was 100% complete. Results: Mitral valve repair was performed in 90.9% of cases, with only 0.9% requiring the conversion to replacement due to unsuccessful repair. Posterior leaflet lesions had the highest success rate (93.4%), while anterior leaflet lesions had a lower rate (86.2%), with anterior pathology being a negative predictor of repair (OR 2.57, p = 0.02). The type of lesion (prolapse vs. flail), the commissural involvement, and the increased risk for SAM had no statistically significant impact on valve repair outcome. Less invasive transaxillary access was used in 63.2% of patients, and its adoption increased significantly (from 50.9% to 67.4% p = 0.03) over time, resulting in more frequent fast-track extubation and home discharges. The rate of in-hospital mortality was 0.6%, while the rate of 5-year survival was 95.5%. Conclusions: Contemporary surgical techniques for DMR lead to high repair rates and excellent recovery outcomes. Despite the rise in transcatheter options, our findings confirm that surgery remains the gold standard for most DMR patients.

Robotic Management of Complex Obstructive Megaureter Needing Ureteral Dismembering and/or Tapering in Children: A Single-Center Case Series

Background and Objectives: Robot-assisted extravesical ureteral reimplantation (REVUR) has been described as valuable alternative to open reimplantation in the pediatric population. This study aimed to report the outcome of REVUR in children with complex obstructed megaureter (COM) needing ureteral dismembering and/or tapering. Materials and Methods: The records of patients with COM, who received REVUR with ureteral dismembering and/or tapering over the last 3 years (2021–2024), were retrospectively reviewed. The inclusion criteria for COM included previous surgery, paraureteral diverticula, or ectopic megaureter. Results: A total of 16 patients (15 boys), with a median age of 7.8 years (range 2–16), were treated over the study period. COM was associated with paraureteral diverticula (n = 6), previous failed endoscopic balloon dilation (n = 4), ectopic megaureter (n = 2), and previous bulking agent endoscopic injection causing iatrogenic ureteral obstruction (n = 4). Presentation symptoms included febrile urinary tract infections (n = 8), flank pain (n = 4), hematuria (n = 2), and pseudo-incontinence (n = 2). All surgical procedures were accomplished robotically without conversions or intra-operative complications. Ureteral tapering was performed in 7/16 (43.7%). The median operative time (including robot docking) was 220 min (range 155–290). The median length of stay was 3.8 days (range 3–7). The indwelling double J stent was removed 4–6 weeks postoperatively. Clavien 2 grade complications occurred postoperatively in 2/16 (12.5%). At median follow-up of 34.5 months, all patients were asymptomatic and showed improved hydroureteronephrosis on ultrasound and improved drainage on diuretic renogram. Conclusions: This study demonstrates that robot-assisted extravesical ureteral reimplantation is a safe and effective treatment for primary obstructive megaureter and other complex ureteral anomalies in our patient cohort. The procedure showed low complication rates, high success rates, and favorable long-term outcomes, supporting the feasibility and effectiveness of robotic surgery for these conditions.

Patellae as a source of DNA in forensic and archaeological analysis.

Analysing genetic material from skeletonised human remains has become valuable in forensic and archaeological contexts. While the petrous bone is often preferred for DNA extraction, its availability is not guaranteed, and because of destructive sampling, it is not frequently used in forensic cases. This study explores the potential of patellae as an alternative source of bone material for genetic investigations. Forty-five patellae were sampled from a post-World War II mass grave and an archaeological Christian cemetery dated from the 13th to 19th centuries. A full demineralisation extraction method was used to obtain the DNA, and real-time PCR quantification was used to determine the quantity and quality of DNA. To evaluate the suitability of patellae for forensic and archaeological analyses, short tandem repeat (STR) typing was performed using the ESI17 Fast PCR amplification kit (Promega). To explore the difference in DNA yield, DNA degradation and STR typing success between the post-World War II and archaeological patellae, statistical analysis was performed. The results revealed significantly higher DNA yield and STR typing success in WWII patellae and higher degradation of DNA in archaeological patellae, highlighting the impact of environmental exposure time on genetic material preservation. Almost all WWII patellae achieved a high success rate in STR typing with full profiles generated. More than half of the archaeological patellae showed high STR typing performance and highly informative partial profiles were obtained, indicating the suitability of patellae not only for forensic purposes but also for archaeological genetic analyses.

Clinical Results of Percutaneous Transhepatic Biliary Drainage With Different Hepatic Access and Methods in the Treatment of Obstructive Jaundice.

Percutaneous transhepatic biliary drainage (PTBD) is a common procedure for biliary obstruction jaundice caused by biliary tract obstruction. PTBD can be performed using external or external-internal methods, by the right or left lobe approach. However, differences in both the method used and the hepatic approach may affect success rates and complications. Therefore, this study aimed to examine the outcomes and complications of PTBD and compare them according to different methods and hepatic approaches. Patients who underwent PTBD procedures in our interventional radiology department due to benign or malignant pathologies between March 2021 and March 2024 were included in the study. The diagnoses of the patients, and total and direct bilirubin values before and after the procedure were recorded. The clinical results and the complications of PTBD were compared statistically according to the hepatic approach and method. Univariate logistic regression analysis was performed to determine significant factors associated with PTBD success and complications. Sixty patients were included in our study (32 men, 28 women; mean age: 67.14±13.61y). The most common indication was malignant bile duct obstruction (90%). The obstruction was mostly at the level of the common bile duct (46.7%). The success rate of PTBD was the highest with the left-side external biliary drainage approach (left-side external biliary drainage, 81.2%; right-side internal-external biliary drainage, 77.8%; right-side external biliary drainage, 69.2%; P=0.596). The complication rate was higher for right-side access (right side 15.9%, left side 12.5%, P=0.744). Univariate logistic regression analysis revealed that PTBD success in females was 5 times higher than in males [Exp(B): 5.000, β: 1.609, P<0.05]. Univariate logistic regression analysis revealed that methods used, entry lobes, and entry levels did not significantly affect PTBD success and complication incidence (P>0.05). All approaches and methods used during PTBD were associated with low complications and high success rates. Nevertheless, external biliary drainage with right hepatic access has the lowest clinical success rate and a higher complication rate than the left-lobe approach. We observed that left-sided external biliary drainage was the most successful method and had fewer complications.

Clinical Efficacy of CBCT and 3D-Printed Replicas in Molar Autotransplantation: A Controlled Clinical Trial.

To evaluate the efficacy of the combined cone-beam (CBCT)/3D-replicas protocol on the clinical and radiographic outcomes of autotransplanted molars. Controlled clinical trial registered ISRCTN13563091 from August 2019 to September 2022. Patients aged 13-22 years requiring permanent premolar extraction and having at least one non-erupted third molar were enrolled at the Institute of Stomatology, Stradins University, Riga, Latvia. Patients in the 3D-replicas (n = 30) underwent maxillary CBCT scans and had 3D-printed replicas of the third molar fabricated, while the control group (n = 28) did not. The clinical outcomes included tooth mobility, bleeding on probing, and periodontal pocket depth assessed at 3, 6, and 12 months. The radiographic outcomes included root development, obliteration, periapical status, and crown changes at 12 months. Of the 55 patients assigned to interventions, 46 completed the study. No significant differences in survival and radiographic outcomes were found between the control (n = 22) and 3D-replica group (n = 24): root development (p = 0.3), root resorption (p = 0.057), periapical status (p = 0.7), and crown/root ratio change (p = 0.4). Logistic regression showed no significant associations between radiologic predictors (root resorption: p = 0.4; periapical status: p > 0.9; root development: p = 0.8). Significant clinical outcome predictors included total operative time (β = 0.0043, p = 0.049), Moorrees' stage (stage 4: β = -0.31, p < 0.001; stage 5: β = -0.39, p < 0.001), and four donor placement times (β = 0.93, p < 0.001), but group assignment was not a significant predictor. The CBCT/3D-replica protocol showed no significant differences in the clinical or radiological outcomes. The high success rates in both groups suggest that the protocol is valuable primarily for optimizing surgical efficiency and as a training tool for clinicians.

Comparison of outcomes of labor induction with dinoprostone vaginal insert (PROPESS) and double balloon cook catheter in term nulliparous pregnancies.

This retrospective study aimed to compare the outcomes of dinoprostone vaginal insert (PROPESS) and double balloon cook catheter (DBC) in term nulliparous pregnancies. A total of 1682 cases were enrolled, all of which were divided into two groups: PROPESS and DBC. The primary outcomes were rate of vaginal delivery (VD) and cesarean section (CS) and successful VD within 24 h and CS indications; the secondary outcomes were labor duration, oxytocin augmentation, complications during labor, maternal/neonatal outcomes, and predictors of successful VD within 24 h. There was no statistical difference in the rates of VD between the PROPESS group (73.74%) and the DBC group (77.73%) (p = 0.36). The VD rate within 24 h was significantly higher in PROPESS group than in the DBC group (55.45% vs. 38.43%, p < 0.001). The occurrence of nonreassuring fetal heart rate (NRFHR) patterns was higher in the CS indications of the PROPESS group than in the DBC group (56.86% vs. 37.81%, p < 0.001). The oxytocin augmentation was significantly lower in the PROPESS group than in the DBC group (52.79% vs. 94.9%, p < 0.001). The incidence of chorioamnionitis was significantly higher in the DBC group as compared with PROPESS group (4.36% vs. 1.34%, p < 0.001), while neonatal outcomes were comparable between the two groups. PROPESS (p < 0.001, odds ratio [OR] 2.478, 95% confidence interval [CI] 1.718-3.574), oxytocin augmentation (p < 0.001, OR 32.759, 95% CI 20.654-51.958), and amniotomy (p = 0.016, OR 1.897, 95% CI 1.331-2.704) were predictors of VD within 24 h. The effectiveness of delivery was comparable between the two groups. The PROPESS group resulted in a high successful VD rate within 24 h, although accompanied by NRFHR occurrence. Two cases with fetal presentation change (cephalic to breech) and four cases with umbilical cord prolapse were observed in the DBC group. PROPESS, oxytocin augmentation, and amniotomy were associated with VD interval within 24 h.

Feasibility, efficacy, and safety of core needle biopsy as a first-line method for cervical lymphadenopathy.

This study aimed to determine the feasibility, diagnostic efficacy, and safety of ultrasound-guided core needle biopsy (CNB) as a first-line biopsy method for cervical lymphadenopathy of non-thyroid origin. This retrospective cohort study included consecutive patients with cervical lymphadenopathy in whom US-guided CNB was used as the first-line biopsy method for cervical lymph nodes (LNs) of presumed non-thyroid origin. The coaxial CNB technique was routinely used, while the tilting and hydrodissection CNB techniques were selectively employed for small high-risk LNs. The primary endpoint of this study was the diagnostic efficacy of CNB, evaluated by the rate of inconclusive results (nondiagnostic and indeterminate) and diagnostic accuracy (criterion 1: malignant results; criterion 2: malignant or indeterminate result). The secondary outcomes included the feasibility and safety of CNB, assessed based on the technical success rate and complication rate, respectively. The rates of nondiagnostic, indeterminate, and inconclusive results were 0.7%, 3.4%, and 4.1%, respectively. The sensitivity, specificity, and accuracy of CNB for malignant LNs were 96.2%, 100%, and 97.8%, respectively, with criterion 1, and these values were all 99.8% with criterion 2. The technical success rate of CNB was 99.3%. There were no major complications and 7 cases (0.6%) of minor complications (asymptomatic hematomas). CNB was technically feasible, effective, and safe as a first-line biopsy method for cervical lymphadenopathy of non-thyroid origin with high diagnostic accuracy for malignant nodal disease. Question The role of US-guided CNB as a first-line biopsy method for cervical LNs has not yet been verified and established. Findings US-guided CNB, as a first-line method, demonstrated a high technical success rate and diagnostic accuracy for malignant nodes, with few minor complications. Clinical relevance US-guided CNB can be used as an effective first-line biopsy method for cervical lymphadenopathy and will enable accurate diagnosis of malignant LNs.

Percutaneous transhepatic biliary drainage in patients with cholestasis following liver transplantation.

Biliary strictures are among the most common complications following liver transplantation (LT). If endoscopic retrograde cholangiography fails, percutaneous transhepatic biliary drainage (PTBD) may serve as an alternative approach. Description of clinical important short- and long-term outcomes as well as outcome prediction following PTBD after LT are scarce. We analyzed outcomes of 56 liver-transplanted adults with biliary complications receiving a PTBD. We described the safety and longitudinal laboratory changes. We analyzed as endpoints, incidence of biliary complications, need for surgical biliary revision/re-LT and overall-survival at 12- and 60-months. We used simple comparison tests accordingly and performed competing risk analysis and multivariate competing risk regression as well as log-rank test and cox proportional hazard regression for further analysis. PTBD procedures had a high technical success rate (98%) and tolerable safety profile. Multiple laboratory indicators improved during follow-up (37 patients with complete biochemical follow-up). Incidence of subsequent biliary complications was highly dependent on the nature of present biliary strictures (Anastomotic stricture (AS): adjusted SHR: 0.26, 95% CI: 0.09-0.78, p = 0.016). Need for surgical biliary revision/re-LT remained below 15%. 12-month survival was significantly better, if drainage into the small intestine was achieved at first attempt compared to completely external drainage (internal: 92.9 vs. external: 67.9%, p = 0.018). Patients with AS had a numerically higher long-term-survival and higher C-reactive-protein (CRP) and lower body-mass-index (BMI) at baseline were significantly associated with inferior short- and long-term-survival. PTBD for biliary complications following LT had a high technical success and a tolerable safety profile. Incidence of subsequent biliary complications was highly dependent on the nature of biliary strictures and increased mortality was found in patients with higher CRP, lower BMI and failure of initial PTBD internalization.

Optimization of Communication Signal Adversarial Examples by Selectively Preserving Low-Frequency Components of Perturbations

Achieving high attack success rate (ASR) with minimal perturbed distortion has consistently been a prominent and challenging research topic in the field of adversarial examples. In this paper, a novel method to optimize communication signal adversarial examples is proposed by focusing on low-frequency components of perturbations (LFCP). Observations on model attention towards DCT coefficients reveal the crucial role of LFCP within adversarial examples in altering the model’s predictions. As a result, selectively preserving LFCP is established as the fundamental concept of the optimization strategy. By utilizing the binary search algorithm, which considers the inconsistency in the model’s predictions as a constraint, LFCP can be effectively identified, and the aim of minimizing perturbed distortion while maintaining ASR can be achieved. Experimental results conducted on a publicly available dataset, six adversarial attacks and two DNN models, indicate that the proposed method not only significantly minimizes perturbed distortion for FGSM, BIM, PGD, and MI-FGSM but also achieves a modest improvement in ASR. Notably, even for DeepFool and BS-FGM, which introduce small perturbations and exhibit high ASRs, the proposed method can still deliver feasible performance.