Significant Improvement Research Articles

성찰적 글쓰기 수업에서 ChatGPT 활용 여부에 따른 대학생의 쓰기효능감과 학업성취도의 비교 연구

Objectives This study aims to explore the potential of using ChatGPT as an alternative to address the difficulties faced by freshmen in university writing classes and empirically verify its impact on writing efficacy and academic achievement. Methods The study involved 130 students from a four-year university in Gyeonggi Province enrolled in a Basic Writing course. After the midterm exam, students were divided into an experimental group using ChatGPT and a control group that did not. A pre- and post-survey on writing efficacy was conducted, and data on academic ach ievement were collected through midterm and final exam scores, along with qualitative data from students' re flective journals and instructor observation logs. Results The statical and qualitative analysis revealed that students who used ChatGPT showed significant im provement in overall writing efficacy, particularly in expressive functions. By referencing ideas and vocabulary pro vided by ChatGPT, students were able to ease difficulties in generating and expressing their own ideas, expanding their thinking to express themselves more creatively and effectively. In terms of academic achievement, the ChatGPT group performed significantly better on the final exam compared to the control group. Correlation analy sis between writing efficacy and academic achievement showed that grammar and expression functions had a stronger correlation with academic performance than structural functions. Conclusions These results suggest that the samples and personalized feedback provided by ChatGPT improved students' self-editing abilities in writing, boosted their motivation and engagement, and ultimately led to better academic outcomes. This study offers empirical evidence that AI tools like ChatGPT can enhance creative ex pression, writing efficacy, and academic performance by providing individualized feedback in writing education. It also offers valuable insights into effectively integrating AI tools in educational settings.

Post-therapeutic support and rehabilitation for breast cancer women in complete remission in a thermal resort: study protocol for the PACThe Real-Life conditions observational trial

BackgroundOver the past twenty years, the post-cancer rehabilitation has been developed, usually in a hospital setting. Although this allows better care organization and improved security, it is perceived as stressful and restrictive by the “cancer survivor”. Therefore, the transfer of benefits to everyday life is more difficult, or even uncertain. Staying in a thermal resort seemed to offer a good compromise: the security and structure of centralized reception in a thermal resort for treatment and medical supervision, and accommodation in a hotel with full dietary board. It combines institutional quality and security with the freedom of real life and the dynamics of a group formed under innovative conditions. This rehabilitation procedure was tested with the program PACThe (Program of Accompanying women after breast Cancer treatment completion in Thermal resorts) which was evaluated at one year in a randomized controlled trial involving 251 patients [1] and at five years in another study [2]. The results shown a significative improvement in many areas such as quality of life, functional abilities and sleep. The aim of this study is therefore to confirm the benefits of the PACThe program at six months for breast cancer women in complete remission in real-life conditions.MethodsThe project PACThe Real-Life conditions is an observational trial in which 400 breast cancer women in complete remission will be sent to a 3 week thermal “post-cancer rehabilitation” program. Primary objective is to assess the quality of life until 12 months. The outcome will be measured with the self-questionnaire SF-36 [3] at five timepoints (inclusion visit, end of thermal resort, 6 months post-cure, 12 months post-cure and 18 months post-cure). The duration of patient participation in the study will therefore be 18 months. The main analysis will consist of comparing the SF-36 global score at 6 months with the baseline.DiscussionThis study aims to investigate the improvements in quality of life of 3 weeks stay at thermal resort for breast cancer women in complete remission. The comprehensive overview of the program PACThe will likely contribute to enhancing thermal therapy post-cancer rehabilitation in this population in real life conditions.Trial registrationThe PACThe Real-Life conditions trial is a prospective observational study registered at the ANSM registry (2022-A00171-42) on March 1, 2022. This study has been registered on ClinicalTrials.gov: NCT05433077. Protocol: version 4, 22 December 2022.

ROLE OF UPASHAYA IN THE MANAGEMENT OF VIPADIKA KUSHTHA – A CASE REPORT

Upashaya refers to an "Aushadhadijanitasukhanubandhaupashaya" that brings in the comfort, relaxation, and relief of symptoms through Aushadha, Ahara and Vihara. It can be considered a symptomatic treatment, actual treatment, and diagnostic tool. In today's context, utilising Upashaya is crucial for guiding the appropriate treat-ment plan, especially in specific disease-related conditions. Upashaya is classified into two main types: Viparee-ta and Vipareetaarthakari. Among these, Vipareeta Upashaya is the most commonly referenced and practiced; Ubhaya Vipareeta Aushadha is one among the Vipareeta Upashaya, which means Medicines that act as both the cause of the disease and the disease itself. To highlight its role in Upashaya, it is necessary to analyse this con-cept with the intention of practically validating it, for which Vipadika kushta has been taken up for the study. Vipadika kushta is one of the Kshudra Kushta. It is Vata Kaphaja Vyadhi, which is characterised by Sphu-tana(Fissure)either in Pani (palm) or Pada(soles) or both with Teevra Vedana (severe pain). Based on the sources, the incidence rate is 3–4%, but it is one of the major cosmetic issues as well as a hurdle for carrying out routine work. This is the case report of the successful management of Vipadika Kushtha with a single formula-tion, Tila kusumadi Lepa—a 35-year-old male patient who presented with a complaint of Cracks on both feet with severe pain. The patient was given Ayurveda treatment for 15 days. After follow-up, significant improve-ment was observed in signs and symptoms. The present case highlights the potential of a single formulation in managing Vipadika Kushtha.

CLINICAL EVALUATION OF JATIPHALADI LEPA IN THE MANAGEMENT OF MUKHADUSHIKA: INSIGHTS FROM YOGARATNAKARA

Background: Mukhadushika (acne vulgaris) is a prevalent dermatological condition described in Ayurveda as resulting from the vitiation of Vata, Kapha, and Rakta. Effective management necessitates treatments with Vata-Kapha pacifying and Rakta-shodhana (blood-purifying) properties. Jatiphaladi Lepa, an Ayurvedic formulation, was selected for its potential to address these factors. Objective: This study aimed to evaluate the efficacy of Jatiphaladi Lepa in managing Mukhadushika and its ability to restore homeostasis of Vata, Kapha, and Rakta. Materials and Methods: A total of 60 subjects with Mukhadushika were divided into two groups: Group A (trial group, 30 subjects) received Jatiphaladi Lepa with a prescribed diet, while Group B (control group, 30 subjects) followed the diet plan alone. In Group A, Jatiphaladi Lepa was applied once daily for 30 days, with follow-ups every 15 days. Group B adhered only with the diet chart with similar follow-ups. Results: The trial group significantly reduced symptoms, especially in managing Yuvan Pidaka (acne lesions). The formulation effectively restored the balance of Vata, Kapha, and Rakta. Conclusion: Jatiphaladi Lepa is an effective Ayurvedic treatment for Mukhadushika. It offers significant im-provements by addressing the condition's root causes, as described in Ayurveda.

Vesicovaginal fistula post-vaginal delivery late revelation: A case report

Introduction: This study presents a compelling clinical case involving a 43-year-old woman who encountered a vesicovaginal fistula subsequent to vaginal delivery. The narrative encompasses the occurrence, diagnosis, and subsequent management of this rare postpartum complication. Case Report: A 43-year-old woman with an unscarred uterus experienced the conventional signs of postpartum recovery but developed hematuria and vaginal urinary leakage on the seventh postpartum day. Clinical assessment confirmed a vesicovaginal fistula due to partial uterine dehiscence. Diagnostic procedures and the subsequent successful surgical intervention are detailed, followed by the postoperative surveillance strategy and a one-month post-surgery evaluation. Conclusion: This case study demonstrates the successful management of a postpartum vesicovaginal fistula through surgical intervention, resulting in complete closure of the fistula and significant improvement in urinary symptoms. It highlights the importance of timely diagnosis and appropriate surgical intervention in managing such rare complications following vaginal delivery.

A CLINICAL STUDY TO EVALUATE THE EFFECT OF NAGARADI KWATHA AND CHANDRAPRABHA VATI IN MOOTRASHMARI W.S.R. TO UROLITHIASIS

Ashmari is the formation of stone in Mootravaha srotas, resulting in severe pain as given by the enemy. It is an effect of the complex, physicochemical process that involves a sequence of events in the formation of any urinary stones, including urinary saturation, supersaturation, nucleation and growth of crystals, aggregation and retention of crystals, and finally, stone formation. It affects about 12% of the world's population at some stage in their lifetime in all age groups, sexes, and races but occurs more frequently in men than women aged 20 to 49 years. In India, about 12% of the total population is expected to have urinary stones in their life, out of which 50% may end up with loss of kidney function. Contemporary treatment such as Lithotripsy (ESWL), Percutaneous Nephrolithotomy (PCNL), Retrograde Intra-renal surgery (RIRS), and Laparoscopic Ureter lithotomy adopted in the condition of Urolithiasis is quite costly with high incidence of recurrence. For the present study, Nagaradi Kwatha and Chandraprabha Vati were administered for 14 days. Each patient was observed on the 0-day, 7th, and 15th day of drug intervention with said parameters. The study showed significant clinical improvement in reducing the shoola, mootradosha, Kruchramutrata, and Sarakta mootrata and showed good response in disintegration and the expulsion of Ashmari.

Management of Traumatic Undiagnosed Condyle Fracture in Children

Background: Condyle trauma is considered to be the major cause of TMJ ankylosis but it is also the most neglected and under-managed problem in children. ?TMJ ankylosis leads to be malocclusion and facial disfigurement. The aim of early treatment is to restore the mandibular mobility and to enhance further growth in order to reduce the possibility of future facial asymmetry. Patients and Methods: We report two patients with inability to open mouth few months following injury. They most probably suffered missed diagnosis condyle fracture by the previous physician. The latest physical examination and radiological finding shows the mandible was micrognathic and unilateral TMJ ankylosis was confirmed. A sequential protocol of TMJ ankylosis management based on aggressive resection of ankylotic mass was performed and followed withphysiotherapy.Result: In 2 month-follow up, both patients showed significant improvement in mouth opening and the mastication function was restored, accompanied with physical therapy to gain maximum mouth opening for at least a year.Summary: A detail history, clinical and functional examination, radiographic examination facilitating correct diagnosis followed by immediate surgical intervention, and physiotherapy can help us to restore physical, psychological, and emotional health of the child patient.

Frontoethmoidal Encephalomeningocele Revisited : The Convenience Of Teamwork Approach, A CaseSeries

Background: Frontoethmoidal encephalomeningocele (FEEM) is a congenital defect of the skull which poses many problems to the patient as it results in many craniofacial and neural morbidities. While recently surgical correction of this disease is done in a single-stage procedure, many in Indonesia still perform twostage surgery which bears more risks and is technically difficult to achieve good aesthetic results. This case series intend to assess the feasibility and convenience of teamwork approach between plastic surgeon and neurosurgeon in correcting FEEM in a single-stage operation. Methods:We reviewed 8 patients with FEEM treated in Plastic and Reconstructive Surgery Division, Cipto Mangunkusumo Hospital Jakarta from November 2005 until March 2010. Four of the cases were secondary cases from Neurosurgery Department, and the other 4 cases were treated in single-stage operation, in teamwork with Neurosurgery Department, using the Chula technique. Results of each surgery was assessed using objective parameters, which are Intercanthal Distance (ICD) and Interorbital Distance (IOD); and also subjective parameters which is aesthetic improvement.Result: All of the patients showed significant improvements in ICD and IOD measurements. No complication was found intra and post-operatively. All patients, especially the ones treated with singlestage surgery show good aesthetic results. Conclusion: To achieve goals of defect correction and aesthetically pleasant appearance, single-stage surgery in teamwork with the neurosurgery department seems to be most suitable and convenient.

A Multicomponent Eye Cream Helps Alleviate Signs of Aging in Indian Women: A Single Center, Non-Randomized Clinical Study

Introduction: The area around the eye shows the first signs of fatigue and aging. The use of suitable topical treatments can help manage the periorbital area. In this study, the efficacy of a multicomponent cream in improving the aesthetics around the eye area was ex-amined in 8 weeks. Methods: The study was a non-comparative, single-blind trial conducted on 50 Indian volun-teers with skin types III and IV for 56 days. The safety and cosmetic acceptability of the eye cream were determined by self-evaluation. The ability of the product to improve skin hydra-tion and elasticity was determined by instrumental analysis and aesthetic features by derma-tologist evaluation. Results: In an 8-week assessment, the use of the eye cream twice daily resulted in improved skin hydration by 55.82% compared to baseline. A significant reduction in the appearance of dark circles under the eye, puffiness, wrinkles, and fine lines was reported. Conclusion: While the skin around the eyes shows early signs of aging, regular use of cosmet-ic creams with active components, such as peptides niacinamide, can lead to significant im-provement in overall aesthetic appearance.

Enhancing user experience in online learning environments: Design, evaluation, and usability techniques

This study aims to enhance user experience on online learning platforms by investigating design principles, usability evaluation techniques, and rede-sign processes. A total of 150 participants, divided equally among students, educators, and professionals, were stratified by age, gender, education level, and familiarity with online learning. Various evaluation methods, including heuristic evaluation, guideline reviews, and cognitive walkthroughs, were employed. Metrics such as task success rate, time-on-task, and Net Promoter Score (NPS) were used to quantify user satisfaction and effectiveness. Addi-tionally, five qualitative interviews were conducted for deeper insights. The results revealed specific usability issues and demonstrated the effectiveness of the applied evaluation techniques. Post-redesign metrics indicated signif-icant improvements in user satisfaction and engagement. The study under-scores the importance of a multi-faceted approach to design and evaluation in online learning platforms and suggests avenues for future research.

Parasellar region meningiomas with optic canal (OC) invasion: Correlation between the degree of decompression of the OC and the improvement of visual acuity.

To evaluate the correlation between the degrees of circumferential decompression of the optic canal (OC) and the improvement of visual acuity in patients with parasellar meningiomas (PMs) with optic canal invasion. This is a monocentric retrospective study conducted at author's institution. The visual acuity was evaluated preoperative and at 3-months after surgery with Snellen acuity test. The degree of decompression of the OC was calculated through postoperative multiplanar CT-scan reconstructions in coronal plane at intraorbital opening (IOO), intracranial opening (ICO) and middle point between them (MP). OC was then divided in two segments (anterior and posterior). 29 consecutive patients were identified. Improvement of visual acuity was observed in 18 patients (62 %). Mean decompression achieved at ICO, MP and IOO was 226.2°± 43.6° (range: 68.7°-297.1°), 217.5°± 37.2° (range: 75.3°-268.7°) and 204.6°± 41.2° (range: 67.3°-252.6°) respectively. A decompression > 90° of the anterior segment of the OC, a decompression > 180° of the posterior segment and a full-length decompression > 90° were associated visual acuity improvement at univariate analysis (p = 0.010, p = 0.002 and p < 0.001, respectively). A decompression > 180° of the posterior segment and a full-length decompression > 90° of the OC maintained statistical significance at multivariate analysis (p = 0.030 and p = 0.035, respectively). Anterior segment decompression > 90° and posterior segment decompression > 180° were associated with improvement of visual acuity at 3 months after surgery. A full-length decompression of the optic canal > 90° showed better visual outcome, while a full-length decompression > 180° did not seem to be related to significative improvements in visual acuity.

Clinical and imaging outcomes of 100 patients with cerebrospinal fluid-venous fistulas treated by transvenous embolization

BackgroundCerebrospinal fluid-venous fistulas (CSFVF) are a common cause of spontaneous intracranial hypotension (SIH). Transvenous embolization has emerged as a reliable treatment option. We review the clinical presentation, imaging, and clinical...

Effect of Health Education on Knowledge and Perceptions Regarding Cervical Cancer Screening and Prevention among Female Students of a Medical College in Rawalpindi, Pakistan: Pre and Post Analysis

Objective: To evaluate and compare the knowledge and attitude of future female health care providers regarding pap smear screening for cervical cancer at a medical and dental institution in Pakistan. The quality of knowledge of the students was analysed to measure the efficacy of awareness intervention sessions of the students. This was aimed to highlight their role in public awareness and identify the deficit thereof in their training towards practicing preventive community medicine. Study Design: This was a pre and post analysis comparative study. Place and Duration of Study: Conducted at Army Medical College Rawalpindi Pakistan, over an 8-months period from Nov 2019 to Jun 2020. Methodology: A total of 754 responses, pre intervention -401- and one-month later post intervention-353 were collected through a validated questionnaire by convenience sampling. Changes in the knowledge and attitude of students using an independent sample t test were determined one month after 20-minute educational intervention detailing cervical cancer and its screening. Association between course and year of study on the knowledge and attitude scores was determined bycomparing means using ANOVA tables. Results: Comparison of pre and post intervention scores revealed a statistically significant difference in knowledge (p&lt; 0.001)and attitude (p=0.002) with a change in mean knowledge scores from 46.31±15.93 to 74.03±15.71 and mean attitude scores from 45.84±14.37 to 48.86±12.54 after the intervention. MBBS students showed a statistically significant improvement in attitude (p&lt;0.001) than their BDS counterparts (p=0.535). Conclusion: Pre-intervention knowledge and attitude was inadequate. The intervention was successful with a significant increase in scores. Emphasis should be on implementing national HPV vaccination and cervical screening awareness campaigns.

Neural Inference Search for Multiloss Segmentation Models.

Semantic segmentation is vital for many emerging surveillance applications, but current models cannot be relied upon to meet the required tolerance, particularly in complex tasks that involve multiple classes and varied environments. To improve performance, we propose a novel algorithm, neural inference search (NIS), for hyperparameter optimization pertaining to established deep learning segmentation models in conjunction with a new multiloss function. It incorporates three novel search behaviors, i.e., Maximized Standard Deviation Velocity Prediction, Local Best Velocity Prediction, and n -dimensional Whirlpool Search. The first two behaviors are exploratory, leveraging long short-term memory (LSTM)-convolutional neural network (CNN)-based velocity predictions, while the third employs n -dimensional matrix rotation for local exploitation. A scheduling mechanism is also introduced in NIS to manage the contributions of these three novel search behaviors in stages. NIS optimizes learning and multiloss parameters simultaneously. Compared with state-of-the-art segmentation methods and those optimized with other well-known search algorithms, NIS-optimized models show significant improvements across multiple performance metrics on five segmentation datasets. NIS also reliably yields better solutions as compared with a variety of search methods for solving numerical benchmark functions.

A Collaborative Multimodal Learning-Based Framework for COVID-19 Diagnosis.

The pandemic of coronavirus disease 2019 (COVID-19) has led to a global public health crisis, which caused millions of deaths and billions of infections, greatly increasing the pressure on medical resources. With the continuous emergence of viral mutations, developing automated tools for COVID-19 diagnosis is highly desired to assist the clinical diagnosis and reduce the tedious workload of image interpretation. However, medical images in a single site are usually of a limited amount or weakly labeled, while integrating data scattered around different institutions to build effective models is not allowed due to data policy restrictions. In this article, we propose a novel privacy-preserving cross-site framework for COVID-19 diagnosis with multimodal data, seeking to effectively leverage heterogeneous data from multiple parties while preserving patients' privacy. Specifically, a Siamese branched network is introduced as the backbone to capture inherent relationships across heterogeneous samples. The redesigned network is capable of handling semisupervised inputs in multimodalities and conducting task-specific training, in order to improve the model performance of various scenarios. The framework achieves significant improvement compared with state-of-the-art methods, as we demonstrate through extensive simulations on real-world datasets.

Functional Outcome of Tibialis Posterior Tendon Transfer to Tibialis Anterior &amp; Peroneus Longus among Foot Drop Patients- a Prospective Study

Introduction: Foot drop is described as the loss of active ankle dorsiflexion due to neurologic, systemic, or traumatic causes. The purpose of this study was to assess the functional outcome of tibialis posterior tendon transfer to tibialis anterior and peroneus longus in patients with foot drop. Aim of the study: The aim of this study was to evaluate the functional outcome of tibialis posterior tendon transfer to tibialis anterior and peroneus longus in patients with foot drop. Methods: This study was a randomized clinical trial that evaluate the results of tibialis posterior tendon transfer surgeries for patients with foot drop. The patients met certain inclusion and exclusion criteria, and gave written consent before the surgeries. The patients were followed up for six months after the surgery, and evaluated using the Stanmore assessment questionnaire and other measures. Result: The study enrolled 30 patients (26 males and 4 females) with mean age being 35.40 years. We evaluate tibialis posterior tendon transfer to tibialis anterior and peroneus longus for foot drop in the patients. After 24 weeks, all patient improved in foot dorsiflexion, eversion, function, posture, and satisfaction. 26 (86.70%) patients did not need orthosis and 28 (93.30%) had balanced foot posture with no deformity. Conclusion: The results showed all patient had significant improvement after the surgery. Therefore, this study concluded that tibialis posterior tendon transfer can be used effectively and safely for the management of foot drop.

Combinatorial prediction of therapeutic perturbations using causally-inspired neural networks.

As an alternative to target-driven drug discovery, phenotype-driven approaches identify compounds that counteract the overall disease effects by analyzing phenotypic signatures. Our study introduces a novel approach to this field, aiming to expand the search space for new therapeutic agents. We introduce PDGrapher, a causally-inspired graph neural network (GNN) designed to predict combinatorial perturbagens - sets of therapeutic targets - capable of reversing disease effects. Unlike methods that learn responses to perturbations, PDGrapher solves the inverse problem, which is to infer the perturbagens necessary to achieve a specific response - i.e., directly predicting perturbagens by learning which perturbations elicit a desired response. By encoding gene regulatory networks or protein-protein interactions, PDGrapher can predict unseen chemical or genetic perturbagens, aiding in the discovery of novel drugs or therapeutic targets. Experiments across nine cell lines with chemical perturbations show that PDGrapher successfully predicted effective perturbagens in up to 13.33% additional test samples and ranked therapeutic targets up to 35% higher than the competing methods, and the method shows competitive performance across ten genetic perturbation datasets. A key innovation of PDGrapher is its direct prediction capability, which contrasts with the indirect, computationally intensive models traditionally used in phenotype-driven drug discovery that only predict changes in phenotypes due to perturbations. The direct approach enables PDGrapher to train up to 25 times faster than methods like scGEN and CellOT, representing a considerable leap in efficiency. Our results suggest that PDGrapher can advance phenotype-driven drug discovery, offering a fast and comprehensive approach to identifying therapeutically useful perturbations.

Talking Face Generation With Audio-Deduced Emotional Landmarks.

The goal of talking face generation is to synthesize a sequence of face images of the specified identity, ensuring the mouth movements are synchronized with the given audio. Recently, image-based talking face generation has emerged as a popular approach. It could generate talking face images synchronized with the audio merely depending on a facial image of arbitrary identity and an audio clip. Despite the accessible input, it forgoes the exploitation of the audio emotion, inducing the generated faces to suffer from emotion unsynchronization, mouth inaccuracy, and image quality deficiency. In this article, we build a bistage audio emotion-aware talking face generation (AMIGO) framework, to generate high-quality talking face videos with cross-modally synced emotion. Specifically, we propose a sequence-to-sequence (seq2seq) cross-modal emotional landmark generation network to generate vivid landmarks, whose lip and emotion are both synchronized with input audio. Meantime, we utilize a coordinated visual emotion representation to improve the extraction of the audio one. In stage two, a feature-adaptive visual translation network is designed to translate the synthesized landmarks into facial images. Concretely, we proposed a feature-adaptive transformation module to fuse the high-level representations of landmarks and images, resulting in significant improvement in image quality. We perform extensive experiments on the multi-view emotional audio-visual dataset (MEAD) and crowd-sourced emotional multimodal actors dataset (CREMA-D) benchmark datasets, demonstrating that our model outperforms state-of-the-art benchmarks.

Apremilast Amorphous Solid Dispersions: Formulation Optimization using QbD and Comprehensive In vitro-In silico Assessment

Aim: The study aims to develop a 3rd generation amorphous solid dispersion (ASD) of Apremilast (APST) employing the Design of Experiment (DoE) methodology, followed by a thorough assessment including in silico pharmacokinetics. Background: APST, classified as a BCS-Class IV molecule due to its low solubility and permea-bility, exhibits highly variable oral bioavailability across different species. Objective: In this study, a 3rd generation ASD of APST was developed using the DoE approach. Methods: The miscibility of APST within polymers was assessed using solubility parameters and Flory Huggin equations. Phase solubility studies were conducted to identify the most suitable polymer-surfactant combination for maximizing drug solubility. The produced solid dispersions were characterized using FTIR, DSC, XRD, DVS, and SEM. Results: The combination of APST and Soluplus® in a 1:5 ratio resulted in the highest improve-ment in solubility and dissolution, with vitamin E TGPS being identified as the most efficient sur-factant. Stability studies were carried out, and findings revealed that the ASD remained stable un-der accelerated conditions for up to 3 months, suggesting its suitability for scaling up for industri-al applications. In silico predictions of the pharmacokinetics of APST following oral administra-tion of solid dispersion formulations were determined by PBBM using GastroPlus™. Conclusion: The simulation of oral absorption profiles for APST showed a significant improve-ment in both Cmax and AUC for the solid dispersion formulations compared to plain drugs. This study makes a significant contribution to the field of pharmaceutical science by addressing the formulation complexities inherent in poorly water-soluble compounds like APST.

The use of a modern robotic system for the treatment of severe knee deformities.

Robotic-assisted total knee arthroplasty (TKA) have shown promising results in recent years with improved clinical outcomes using standard primary implants. The purpose of this study was to assess the experience of a single center in correcting severe coronal deformities with the use of a robotic-assisted TKA system and an increased constrained implant. Between July 2020 and December 2022, 30 knees in 28 patients with a major deformity and an associated ligament laxity requiring an increased constrained implant treated using an imageless robotic-assisted TKA were prospectively enrolled. Patients included in the study showed a minimum 15 degrees varus or 10 degrees valgus deviation. 20 cases were varus knees and 10 cases were valgus knees. Postoperative neutral alignment was defined as 0∘± 2.5∘. A CCK implant was used in 20 cases while a Constrained Posterior Stabilized implant was used in 10 cases. A neutral alignment was achieved in all patients. At a minimum 6 months follow up (f-u 6-30 months) clinical outcomes including ROM, KSS, HSS, OKS and WOMAC showed significant improvement and no major complications were registered. The robotic system showed the achievement of a mechanical alignment with reliable radiographic outcomes and clinical results in the treatment of major deformities of the lower limb with the use of higher constrained implants at short term follow up. Further follow up and studies are necessary to confirm and verify these promising outcomes.