Evaluation Of Significant Differences Research Articles

Necessity and impact of specialization of large foundation model for medical segmentation tasks.

Large foundation models, such as the Segment Anything Model (SAM), have shown remarkable performance in image segmentation tasks. However, the optimal approach to achieve true utility of these models for domain-specific applications, such as medical image segmentation, remains an open question. Recent studies have released a medical version of the foundation model MedSAM by training on vast medical data, who promised SOTA medical segmentation. Independent community inspection and dissection is needed. Foundation models are developed for general purposes. On the other hand, stable delivery of reliable performance is key to clinical utility. This study aims at elucidating the potential advantage and limitations of landing the foundation models in clinical use by assessing the performance of off-the-shelf medical foundation model MedSAM for the segmentation of anatomical structures in pelvic MR images. We also explore the simple remedies by evaluating the dependency on prompting scheme. Finally, we demonstrate the need and performance gain of further specialized fine-tuning. MedSAM and its lightweight version LiteMedSAM were evaluated out-of-the-box on a public MR dataset consisting of 589 pelvic images split 80:20 for training and testing. An nnU-Net model was trained from scratch to serve as a benchmark and to provide bounding box prompts for MedSAM. MedSAM was evaluated using different quality bounding boxes, those derived from ground truth labels, those derived from nnU-Net, and those derived from the former two but with 5-pixel isometric expansion. Lastly, LiteMedSAM was refined on the training set and reevaluated on this task. Out-of-the-box MedSAM and LiteMedSAM both performed poorly across the structure set, especially for disjoint or non-convex structures. Varying prompt with different bounding box inputs had minimal effect. For example, the mean Dice score and mean Hausdorff distances (in mm) for obturator internus using MedSAM and LiteMedSAM were {0.251±0.110, 0.101±0.079} and {34.142±5.196, 33.688±5.306}, respectively. Fine-tuning of LiteMedSAM led to significant performance gain, improving Dice score and Hausdorff distance for the obturator internus to 0.864±0.123 and 5.022±10.684, on par with nnU-Net with no significant difference in evaluation of most structures. All segmentation structures benefited significantly from specialized refinement, at varying improvement margin. While our study alludes to the potential of deep learning models like MedSAM and LiteMedSAM for medical segmentation, it highlights the need for specialized refinement and adjudication. Off-the-shelf use of such large foundation models is highly likely to be suboptimal, and specialized fine-tuning is often necessary to achieve clinical desired accuracy and stability.

Implementation of the C4.5 and Naive Bayes Algorithms to Predict Student Graduation

This research aims to determine student graduation using two data mining methods, namely the Naive Bayes Classifier and the C4.5 Algorithm. Research stages include data analysis, data pre-processing, model design in data mining, classification results, method evaluation, and evaluation results. This research uses student data consisting of training data and testing data to evaluate the performance of the two methods in predicting student graduation based on attributes such as attendance scores, behavior scores, Final Semester Examination (UAS) scores, and report card scores. The classification results show significant differences between the two methods. The Naive Bayes Classifier produces predictions that 37 students pass and 17 students do not pass, while the C4.5 Algorithm predicts that 30 students pass and 24 students do not pass. This difference in results indicates that there are differences in the approaches of the two methods to student graduation data, with the Naive Bayes Classifier tending to provide more positive predictions than the C4.5 Algorithm. Evaluation of the performance of the method shows that the Naive Bayes Classifier has an accuracy rate of 100%, which is a perfect result, while the C4.5 Algorithm has an accuracy rate of 89%. This significant difference in evaluation results confirms that the Naive Bayes Classifier is superior in classifying student graduation compared to the C4.5 Algorithm in the context of this research. These findings can help in making decisions regarding student graduation evaluations in the future.

Exploring unknown parent groups and metafounders in single-step genomic best linear unbiased prediction: Insights from a simulated cattle population

This study explores how the metafounder (MF) concept enhances genetic evaluations in dairy cattle populations using single-step genomic best linear unbiased prediction (ssGBLUP). By improving the consideration of relationships among founder populations, MF ensures accurate alignment of pedigree and genomic relationships. The research aims to propose a method for grouping MF based on genotypic information, assess different approaches for estimating the gamma matrix, and compare unknown parent groups (UPG) and MF methodologies across various scenarios, including those with low and high pedigree completeness based on a simulated dairy cattle population. In the scenario where unknown ancestors are rare, the impact of UPG or MF on breeding values is minimal but MF still performs slightly better compared with UPG. The scenario with lower genotyping rates and more unknown parents shows significant differences in evaluations with and without UPG and also compared with MF. The study shows that ssGBLUP evaluations where UPG are considered via Quaas-Pollak-transformation in the pedigree-based and genomic relationship matrix (UPG_fullQP) results in double counting and subsequently in a pronounced bias and overdispersion. Another focus is on the estimation of the gamma matrix, emphasizing the importance of crossbred genotypes for accuracy. Challenges emerge in classifying animals into subpopulations and further into MF or UPG, but the method used in this study, which is based on genotypes, results in predictions which are comparable to those obtained using the true subpopulations for the assignment. Estimated validation results using the linear regression method confirm the superior performance of MF evaluations, although differences compared with true validations are smaller. Notably, UPG_fullQP's extreme bias is less evident in routine validation statistics.

Evaluation of the use of Court Video Conference Hearings in Angeles City, Philippines

The COVID-19 pandemic prompted courts worldwide to swiftly transition to online operations, including virtual hearings, to maintain continuity amid health concerns. This shift signifies a lasting impact on the justice system. Despite this, research on the effectiveness and challenges of court videoconferencing, particularly in the Philippines, remains limited. This study aimed to address this gap by employing a descriptive-evaluative approach and surveying 213 respondents, including court officers, prosecutors, lawyers, jail officers, and police officers, in Angeles City. The study assessed challenges such as procedural integrity and technical glitches, as well as perspectives on judicial efficiency and cost effectiveness. Findings revealed significant hurdles in videoconference hearings, yet respondents recognized their benefits in expediting case resolutions and enhancing security. Interestingly, there was no significant difference in evaluations across respondent groups. Interviews corroborated survey results, highlighting concerns and benefits of videoconference hearings. Addressing challenges while leveraging benefits is crucial, requiring investment in technological literacy, internet connectivity, and procedural integrity safeguards. Policymakers should also explore solutions to infrastructure limitations, fostering widespread adoption of videoconference hearings for a more effective and fair legal system.

PCA-pump for analgesia following pediatric scoliosis surgery: bolus administration with/without basal infusion.

The aim of this study is to compare the use of two different opioid delivery systems (bolus PCA with/without basal infusion) to control postoperative pain and evaluate the side effect profile in pediatric patients undergoing scoliosis surgery. 38 patients who underwent posterior spinal fusion for adolescent idiopathic scoliosis were included in the study. Patients were randomly divided into 2 groups by the computer. Patients who received only bolus PCA were named Group 1, and patients who received bolus PCA with basal infusion were named Group 2.Morphine consumption, postoperative pain assessmentduring rest, movement and coughing with numeric rating scale (NRS) and the Wong -Baker pain scale, heart rate and average blood pressure, sedation levels withRamsey sedation scale and side effects such as nausea, vomiting, itching, desaturation, and urinary retention were recorded. Total mean morphine consumption (mg) was 32.7 ± 9.7 in Group 1 and 43.4 ± 9.1 in Group 2. The mean morphine consumption (mg) at 12-24hours and 0-48hours in Group 1 was statistically lower than Group 2 (p = 0.001). There was no significant difference between the groups in terms of median NRS scores (p = 0.55). There was no statistically significant difference in the evaluation of the groups in terms of Wong-Baker pain scale. Wong-Baker pain scale is p:0.66 at the 2nd hour, p:0.951 at the 12th hour and p:0.467 at the 24th hour.There was no statistically significant difference in Ramsay Sedation Scale evaluation between groups during each follow-up time (p > 0.05). The Ramsay Sedation Scale was p: 0.94 at the 2nd hour, p:1.0 at the 12th hour, and p:1.0 at the 24th hour. The duration of vomiting between 0-2h, 2-24h and 0-48h was higher in Group 2 (p = 0.001, p = 0.024, p = 0.001). The two administration settings of morphine sulphate by PCA pump have shown to be equally effective in the treatment of postoperative pain following PSF. In addition, PCA with basal infusion administration causes more opioid consumption and more systemic side effects. Therefore, the use of only bolus PCA in pediatric scoliosis surgery should be encouraged. LevelII, Randomized Controlled Trial.

Gender and Professional Title Use in Internal Medicine Resident Narrative Assessments.

Background: Residency is a time of personal and professional growth. Resident assessment and feedback are an integral part of that process. However, assessment may be influenced by various types of bias, including gender bias. Women are less likely than men to be identified by their professional titles in many settings. The use of professional titles for residents in written assessments is unknown and may be a marker of bias. Objective: To assess for differences and trends regarding the use of professional and personal titles in formal resident assessments related to gender-based resident-faculty pairs. Methods: Electronic assessments of postgraduate year 1 (PGY1) internal medicine residents from the 2019-2020 academic year were used. Professional title use was analyzed, as it relates to resident-faculty gendered dyads, among other variables. The primary outcome of professional title usage was split into a binary variable by professional versus other titles and analyzed using logistic regression and random-effects model. Results: We analyzed 1,363 unique electronic assessments (37.8% from female faculty). Female residents were more likely to be addressed by a professional title than their male colleagues (odds ratio [OR], 1.7; confidence interval [CI], 1.2-2.4; p = 0.02). We found no difference in professional title usage based on resident-faculty gendered dyads. After adjusting for repeated faculty and resident encounters with random-effects model, secondary analysis found no significant difference in evaluation of word count between gendered dyads. Conclusions: The analysis found no significant difference in professional title usage based on resident-faculty dyads. In our analysis, female residents were significantly more likely to have their professional title used on assessments than male residents.

Facial profile esthetics and its correlation with cephalometric measurements in Class II patients before and after functional orthodontic treatment: perception of orthodontists and laypersons

Orthodontists heavily rely on cephalometric measurements to evaluate the esthetic outcomes of orthodontic treatments, while patients’ assessments of profile attractiveness are influenced by their personal esthetic preferences. The objective of this study was to compare facial esthetic evaluations between orthodontists and laypersons, examine the correlation between cephalometric measurements and assessments of facial attractiveness, and identify the cephalometric measurements that are most associated with profile attractiveness in teenage Class II patients. This study included 28 patients (17 boys and 11 girls, mean age of 11.83 ± 1.48 years) who fulfilled the inclusion criteria and were treated with activator appliances. An experienced orthodontist conducted objective cephalometric analyses before and after the treatment. The standard profiles of patients, pre- and post-treatment, were independently evaluated by 10 orthodontists and 20 laypersons. Pearson correlation analysis was used to analyze the relationships between objective cephalometric values and subjective facial esthetic ratings. The results indicated that laypersons generally assigned lower ratings to facial attractiveness compared to orthodontists. Significant differences in evaluations between orthodontists and laypersons were noted in the ratings of the upper lip position before treatment and the ratings of overall attractiveness, lower lip position and chin position after treatment. In addition, there were substantial correlations between objective measurements and the subjective scores provided by orthodontists. In contrast, the esthetic evaluations by laypersons correlated with only a limited set of objective measurements. The positions of the upper and lower incisors, the relationship of the upper and lower lip to E-line, and the Mentocervical Angle showed significant correlations with esthetic scores. In conclusion, the study reveals that laypersons were more critical of facial profiles compared to orthodontists. Notably, the positions of the upper and lower incisors, the E-line and the Mentocervical Angle had a significant impact on facial esthetics, highlighting their importance in evaluating orthodontic outcomes.

Continuous Electrocardiographic Monitoring for 24 Hours Before Death in Patients with Terminal Cancer.

Purposeless physiological monitoring at the end-of-life is not recommended. However, studies on how families feel regarding the death of patients with terminal cancer without continuous electrocardiographic monitoring (CEM) are lacking. To explore the impact on the quality of care and the feelings and psychological distress experienced by families when CEM is not used during the 24 hours preceding a patient's death. In this multicenter cross-sectional, self-report questionnaires were distributed to 1087 bereaved families at Japanese specialized palliative care units in 2018. Out of 671 responses, 394 valid responses were analyzed. Families of nonmonitored patients (NM-group) accounted for 79.2%, while those with bedside electrocardiogram monitoring (MB-group) and remote nurse station monitoring (MC-group) comprised 11.9% and 8.9%, respectively. In the NM-group, 85.5% expressed satisfaction without CEM, which was more than 10% lower than other groups. While 14% in the NM-group desired patient monitoring, families who received adequate explanations about CEM had lower proportions compared to the MB-group (P = .021). Univariate analyses showed no significant differences in evaluations of the quality of care and families' psychological distress (mean scores of Overall Care Satisfaction, Care Evaluation Scale, Good Death Inventory, Brief Grief Questionnaires) across all groups. While the majority of NM-group were satisfied with their patient's care without CEM, the proportion of dissatisfied families was higher than in other groups. Although not using CEM is not a major hindrance to end-of-life care for patients with terminal cancer, providing sufficient explanations may be important for satisfactory care.

The scrotum: A comparison of men's and women's aesthetic assessments.

Cosmetic surgery is a growing trend. Opportunities for an individual to attain their personal aesthetic ideal via plastic surgery have now extended as far as the genital area. Adaptive surgery on intimate areas of the body may take place for physical complaints, but may instead be due to a desire to conform to a particular ideal. Breast operations, labia reductions, and penis lengthening are long-established interventions, the motives for which a number of previous studies have examined. Tightening of the scrotum, by contrast, is a new trend in the aesthetic surgery market. Notwithstanding its rapid increase, studies have yet to investigate aesthetic preferences as regards the scrotum. Accordingly, the aim of the present study is to compare men's and women's evaluation of various sizes of scrotum, to the end of assisting people opting to undergo this procedure in taking decisions on their visual preferences. The participants in this study rated a number of photographs of scrotums, in nine different lengths and widths, and completed a questionnaire whose aim was to determine whether assessments differed by gender. Further, we considered whether the variables of age, extraversion, openness to experience, and consumption of pornography influenced participants' evaluations. We found no significant differences in evaluation of the aesthetic of scrotums in relation to any of these personality traits. The results show what sizes (lengths and widths) of scrotum the participants judged to be the most and least attractive. The esthetics of the scrotum is little explored. In this study, only normal deviations were considered, i.e. within one standard adjustment. Further studies should consider extremes. Ultimately, it was barely possible to identify a "beautiful" scrotum; we must instead speak of the least ugly.

Developing quality standards for Vocational Rehabilitation Programs for people with disabilities in the Kingdom of Saudi Arabia and verifying their applicability to those programs

Background: Quality standards for vocational rehabilitation programs (QSVRs) are essential for all Vocational Rehabilitation Programs (VRPs) [1]. Objectives: This study aims to identify the most significant quality standards for vocational rehabilitation programs (QSVRPs) in Saudi Arabia from the perspective of the study participants. It also intends to assess the applicability of these standards. Additionally, the study seeks to examine potential statistical differences in participant responses based on gender, educational level, and workplace. Methodology: The study employed a descriptive analytical approach, involving the development and administration of a questionnaire to a sample of 31 VRP workers. Results: The study's findings indicate that the most important standards within QSVRPs are evaluation, guidance and counseling, preparation, training, employment, and follow-up. Furthermore, the study reveals that there are no statistically significant differences in the evaluation of the importance of QSVRPs among the participants, regardless of their gender, educational level, or place of work. The applicability of these QSVRPs was rated as "high," with no statistically significant differences in participant evaluations based on the study's variables.

Teachers of English and their Perceptions towards ESL Errors

This study entitled 'Teachers of English and their Perceptions towards ESL Errors' aimed at evaluating and determining gravity of grammatical errors in terms of acceptability and intelligibility judgments. Quantitative research methodology was utilized in this study. The data was gathered with the aid of a questionnaire prepared on the basis of the result of error analysis conducted earlier. The questionnaires were mailed to English teachers of different private and public schools, colleges and universities of Nepal and worldwide. Two hundred twenty (220) useable surveys were collected altogether for the study: 100 surveys from Nepali English teachers, 100 surveys from native English speaking teachers, 20 each from Britain, Australia, New Zealand, Canada and America, and likewise, 20 surveys from non-Nepali English teachers. Received responses were analyzed and explained descriptively. The findings of the study showed that the native English teachers evaluated the errors far more leniently than Nepali and non- Nepali English teachers. There is no any significant difference in evaluation of errors found in between Nepali and non-Nepali English teachers, but compared to native English teachers, they were found statistically and significantly different in their judgments of errors in acceptability and intelligibility both. On the other hand, while comparing judgments of learners' errors in between the native English teachers; it was revealed that there were not any significant differences found there. It is recommended that the native English speaking teachers’ perception of errors be rightly explored and accordingly evaluation scales be developed and the teachers be made aware of such universal rating scales of grammatical errors while evaluating learners' errors.

Reconciling participatory and evidence-based policymaking in the EU Better Regulation policy: mission (im)possible?

ABSTRACT Modern systems of governance are increasingly adopting measures aimed at fostering public participation in policymaking, while embedding decisions in scientific evidence under the label of Better Regulation policy. Existing research identifies tensions between participatory and evidence-based approaches. This prompts questions about one of the most ambitious reforms to combine and enhance participatory and evidence-based tools of policymaking, initiated by the European Commission in 2016. We assess the extent to which this reform successfully combined and expanded the participatory layer of supranational policymaking while also strengthening its evidence-based credentials by analysing stakeholders’ evaluations. We find that stakeholders assess both sets of measures as part of a single, integrated dimension. Participatory measures received slightly better appraisals and were better known, but both sets of measures were evaluated positively and there are no significant differences in evaluations across stakeholder categories. This points to the complementarity of measures from a stakeholder perspective.

Spatial difference of Chinese public awareness of soil and water conservation and perception of information construction

Most previous studies focused on farmers' awareness of soil and water conservation and technology, but ignored the importance of public awareness of soil and water conservation. In this study, a survey was conducted in 10 provinces with varying degrees of soil and water loss in China, and 1021 valid samples were obtained. Data were analyzed in SPSS 24.0 with independent sample t-tests, correlation analysis and regression analysis. The final results are as follows: in terms of soil and water loss, compared to those in the less serious region, participants in the serious region had a higher score on knowledge and perceived importance, and a more positive evaluation of future development of SWC and stronger intention to act as a supporter for SWC. However, there were no significant differences in evaluation of the major of SWC between less serious and serious regions. In addition, participants’ knowledge had a positive impact on behavioral intention. The perceived importance, major recognition and participants’ evaluation of future development mediated the relationship between participants’ knowledge about water loss and soil erosion and their behavior intention. For informatization in SWC, there were no differences between the serious region and less serious region regarding participants’ evaluation of intuitiveness, accuracy, affordability, and easiness. Furthermore, participants in the less serious region had a more positive evaluation for timeliness of informatization of soil and water conservation than those in the serious region.

Impact of video quality when evaluating video-assisted cardiopulmonary resuscitation: a randomized, controlled simulation trial

BackgroundAlthough not routinely established during cardiopulmonary resuscitation (CPR), video-assisted CPR has been described as beneficial in the communication with emergency medical service (EMS) authorities in out-of-hospital cardiac arrest scenarios. Since the influence of video quality has not been investigated systematically and due to variation of quality of a live-stream video during video-assisted CPR, we investigated the influence of different video quality levels during the evaluation of CPR performance in video sequences.MethodsSeven video sequences of CPR performance were recorded in high quality and artificially reduced to medium and low quality afterwards. Video sequences showed either correct CPR performance or one of six typical errors: too low and too high compression rate, superficial and increased compression depth, wrong hand position and incomplete release. Video sequences were randomly assigned to the different quality levels. During the randomised and double-blinded evaluation process, 46 paramedics and 47 emergency physicians evaluated seven video sequences of CPR performance in different quality levels (high, medium and low resolution).ResultsOf 650 video sequences, CPR performance was evaluable in 98.2%. CPR performance was correctly evaluated in 71.5% at low quality, in 76.8% at medium quality, and in 77.3% at high quality level, showing no significant differences depending on video quality (p = 0.306). In the subgroup analysis, correct classification of increased compression depth showed significant differences depending on video quality (p = 0.006). Further, there were significant differences in correct CPR classification depending on the presented error (p < 0.001). Allegedly errors, that were not shown in the video sequence, were classified in 28.3%, insignificantly depending on video quality. Correct evaluation did not show significant interprofessional differences (p = 0.468).ConclusionVideo quality has no significant impact on the evaluation of CPR in a video sequence. Even low video quality leads to an acceptable rate of correct evaluation of CPR performance. There is a significant difference in evaluation of CPR performance depending on the presented error in a video sequence.Trial registrationGerman Clinical Trial Register (Registration number DRKS00015297) Registered on 2018-08-21.

Aesthetic components of index of orthodontic treatment need in Serbian adolescents

Background/Aim. The biggest motivating factor for undertaking orthodontic treatment is poor dental aesthetics as a consequence of occlusal abnormalities. The aim of this study was to determine the need for orthodontic treatment, based on the aesthetic components of the Index of Orthodontic Treatment Need (IOTN), to compare the degree of aesthetic component of IOTN and the subjective perception of individuals about their dental aesthetics, but also to compare their evaluation of the aesthetic component of IOTN in comparison with the evaluation of the therapist. Methods. The study was conducted on a sample of 316 students aged 15?19 years who did not have an orthodontic treatment prior to the survey. The research was carried out using the IOTN. The IOTN consists of dental and aesthetic components based on which the need for therapy was determined. The aesthetic component of the index was noted by the therapist (specialist of orthodontics) as well as the subject. Results. According to the grades of subjects, the need for orthodontic treatment was present in 0.38% of male subjects and 2% of female subjects. According to the evaluations of the therapists, the need for orthodontic treatment was present in 7.52% of male subjects and 8% of female subjects. Observing all subjects, the need for orthodontic treatment was present in 0.63% of subjects, and according to the therapist, the need for orthodontic treatment was present in 7.59% of subjects. The mentioned difference was statistically significant. Conclusion. Obtained results show that there is a significant difference in evaluation of dental aesthetics and the need for orthodontic treatment between the subjects and therapists. This can be a cause for concern because patients who are not aware of their orthodontic abnormality can limit the need for further treatment.

EUCALYPTUS SPP. GLUED LAMINATED TIMBER WITH REINFORCED FIBER FINGER-JOINTS

Reinforcement for flexion in structural elements with finger-joints using fibers has emerged as a particularly suitable technique for timber. Thus, the objective of this study was to evaluate the performance of Glued Laminated Timber (GLULAM) produced with Eucalyptus spp. wood and three reinforcement compositions, “Glass”, “Glass2” and “Carbon” regarding parallel-to-grain tensile strength, normal tensile strength, shear strength and the three-point bending test. All the tests were performed according to the NBR 7190/1997 using the Tukey test for statistical analyzes and a 95% confidence interval. The performance of the Eucalyptus spp. GLULAM did not present significant differences in evaluation of the bonding lines. However, the “Glass 2” and “Carbon” treatments were significantly superior to the GLULAM samples without reinforcement in bending strength, reaching increments of 37.8% and 40.5%, respectively. The modulus of elasticity did not differ significantly between them. A tensile rupture was observed in the region of the finger-joints in all the evaluated samples; however, the flexural tensions were superior to the parallel-to-grain tensile strengths, indicating an influence of the timber thickness and reinforcement thickness on the performance of the reinforced joints. Thus, it is possible to conclude that applying concentrated reinforcement in the region of the finger-joints significantly improves the performance of Eucalyptus spp. GLULAM samples.

Patient satisfaction as an element of healthcare quality - a single-center Polish survey.

ObjectivesThe aims of the study were to define the level of patient satisfaction with services provided by selected departments of the Institute, and to identify changes that should be introduced to the process of quality management in healthcare services.Material and methodsA total of 455 patients from three departments of the National Institute of Geriatrics, Rheumatology and Rehabilitation in Warsaw, hospitalized between January 2016 and March 2018 were assessed retrospectively. Statistical analyses were conducted with the use of IBM SPSS Statistics 25 software.ResultsPatients at the Institute gave the highest rates to the courtesy and kindness of doctors and nurses (mean 4.77 and 4.73, respectively), the doctor’s interest in a patient’s well-being, and the nurses’ dexterity in performing medical procedures (4.63 and 4.72, respectively) The lowest-rated were the quality of meals (mean 3.77) and the waiting time for hospital admission on an appointed day (mean 4.07). The study demonstrated statistically significant differences in evaluations made by female and male patients: women had worse opinions about maintenance of intimacy during medical procedures, whereas men gave lower ratings to the size of served meals. The level of satisfaction in all analyzed aspects increased with older age. However, a higher level of patient education correlated negatively with satisfaction from the waiting time for hospital admission on an appointed day, the ability to receive information about the disease and treatment process, cleanliness and accessibility of bathrooms and toilets, or the ability to easily move around the Institute.ConclusionsAccessibility of medical services, as well as attitudes and competences of the medical staff, are all key factors in ensuring quality care. The conditions of a hospital stay also shape the patients’ opinions in a significant way. Therefore, taking into account the patients’ opinions should become an important goal in the process of improving healthcare quality.

Brain Structural Magnetic Resonance Imaging for Joint Independent Component Analysis in Schizophrenic Patients.

In past magnetic resonance imaging studies, normal participants and schizophrenia patients have usually been compared using imaging processing modes with only one parameter. A more extensive evaluation of significant differences between gray and white matter in Schizophrenic patents was necessary. Voxel based morphometry was used to separate brain images into gray matter and white matter. Then, the images were mapped to Montreal Neurological Institute space, and DARTEL analytic template was applied for image calibration with statistical parametric mapping. Finally, joint independent component analysis was employed to analyze the gray and white matter of brain images from Schizophrenic patients and normal controls. In this study, joint independent component analysis was used to discriminate clinical differences in magnetic resonance imaging signals between Schizophrenic patients and normal controls. Region of interest analyses has repeatedly shown gray matter reduction in the superior temporal gyrus of Schizophrenic patients. These results strongly support previous studies regarding brain volume in schizophrenic patients. The connection networks in frontal and temporal lobes evidently did not differ between normal participants and schizophrenia patients.

Superb microvascular imaging is a rational choice for accurate Bosniak classification of renal cystic masses.

Bosniak classification system provides a fine imaging evaluation for the malignant cystic renal masses. Superb microvascular imaging (SMI) is a new ultrasonic technique which apply advanced clutter suppression to reflect microflow information. The aim of this study was to evaluate the performance of ultrasound Bosniak classification aided by SMI in diagnosis of cystic renal masses. By comparing with contrast-enhanced ultrasound (CEUS) and pathology, we evaluated the sensitivity, specificity and accuracy of conventional ultrasound and SMI combination in the diagnosis of renal cystic masses. Color Doppler Flow image (CDFI) and SMI had significant difference in evaluation the blood flow and Bosniak classification for cystic renal mass of IIf, III and IV (p = 0.020). SMI was consistent with CEUS for cystic renal mass Bosniak classification of IIf, III and IV. Although, CEUS had highest sensitivity of 97.4%, SMI had the highest area under curve in differential diagnosis malignance from benign masses [area under curve = 0.869 (0.743 - 0.995), p < 0.001]. SMI can display better in observing blood flow in septa and solid structures of renal cystic lesions compared with CDFI, thus, it can perform more accurate Bosniak classification for renal cystic mass. SMI and CEUS are consistent in Bosniak classification. Bosniak classification aided by SMI maybe an accurate non-invasive ultrasonic examination in distinguishing benign and malignant renal cystic lesions. Conventional ultrasound had limited ability to distinguish malignance in Bosniak classifications IIf and III. SMI can display better in observing blood flow in septa and solid structures of renal cystic lesions compared with CDFI.

Conceptual Basis of Exercise Therapy in Medical Rehabilitation: Results of a National Survey in Germany

The aim of this article is to obtain nationwide information about contentual and conceptual characteristics of exercise therapy in medical rehabilitation. It investigates the question to what extend these characteristics differ, depending on indication fields and structural features of rehabilitation centres. In a nationwide cross-sectional study, 1146 rehabilitation centres of all indication fields have been contacted in order to recruit exercise therapists in charge for a pseudonymised written survey. For the analysis, 713 questionnaires from 529 rehabilitation centres were consulted. Analysis of variance of the indication fields has shown significant differences in evaluation of influenceability of the rehabilitants' starting conditions as well as in the estimated importance of exercise-therapy-related content. Also structural features of the rehabilitation centres contributed to further clarification of variance. There is a contentual and conceptual variety in exercise therapy. Besides indication-specific differences, there are considerable variances which suggest differences between rehabilitation centres within the same indication field.