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BMC Oral Health Sep 2023Intra-oral scans and gypsum cast scans (OS) are widely used in orthodontics, prosthetics, implantology, and orthognathic surgery to plan patient-specific treatments,...
OBJECTIVE
Intra-oral scans and gypsum cast scans (OS) are widely used in orthodontics, prosthetics, implantology, and orthognathic surgery to plan patient-specific treatments, which require teeth segmentations with high accuracy and resolution. Manual teeth segmentation, the gold standard up until now, is time-consuming, tedious, and observer-dependent. This study aims to develop an automated teeth segmentation and labeling system using deep learning.
MATERIAL AND METHODS
As a reference, 1750 OS were manually segmented and labeled. A deep-learning approach based on PointCNN and 3D U-net in combination with a rule-based heuristic algorithm and a combinatorial search algorithm was trained and validated on 1400 OS. Subsequently, the trained algorithm was applied to a test set consisting of 350 OS. The intersection over union (IoU), as a measure of accuracy, was calculated to quantify the degree of similarity between the annotated ground truth and the model predictions.
RESULTS
The model achieved accurate teeth segmentations with a mean IoU score of 0.915. The FDI labels of the teeth were predicted with a mean accuracy of 0.894. The optical inspection showed excellent position agreements between the automatically and manually segmented teeth components. Minor flaws were mostly seen at the edges.
CONCLUSION
The proposed method forms a promising foundation for time-effective and observer-independent teeth segmentation and labeling on intra-oral scans.
CLINICAL SIGNIFICANCE
Deep learning may assist clinicians in virtual treatment planning in orthodontics, prosthetics, implantology, and orthognathic surgery. The impact of using such models in clinical practice should be explored.
Topics: Humans; Deep Learning; Algorithms; Calcium Sulfate; Dental Care; Physical Examination
PubMed: 37670290
DOI: 10.1186/s12903-023-03362-8 -
Deutsches Arzteblatt International Jan 2016Forensic age estimation is requested by courts and other government authorities so that immigrants whose real age is unknown should not suffer unfair disadvantages... (Review)
Review
BACKGROUND
Forensic age estimation is requested by courts and other government authorities so that immigrants whose real age is unknown should not suffer unfair disadvantages because of their supposed age, and so that all legal procedures to which an individual's age is relevant can be properly followed. 157 age estimations were requested in Berlin in 2014, more than twice as many as in 2004.
METHODS
This review is based on pertinent articles retrieved by a selective search in the PubMed and MEDPILOT databases, supplemented by relevant recommendations and by the findings of the authors' own research.
RESULTS
The essential components of age estimation are the history, physical examination, X-rays of the hands, panorama films of the jaws, and, if indicated, a thin-slice CT of the medial clavicular epiphyses, provided that there is a legal basis for X-ray examinations without a medical indication. Multiple methods are always used in combination, for optimal accuracy. Depending on the legal issues at hand, the examiner may be asked to estimate the individual's minimum age and/or his or her most probable age. The minimum-age concept can be used in determinations whether an individual has reached the age of legal majority. It is designed to ensure that practically all persons classified as adults have, in fact, attained legal majority, even though some other persons will be incorrectly classified as minors.
CONCLUSION
Forensic age estimation lets courts and other government authorities determine the official age of persons whose actual age is unknown-in most cases, unaccompanied refugees who may be minors. The goal is to carry out age-dependent legal procedures appropriately in accordance with the rule of law. The minimum-age concept is designed to prevent the erroneous classification of minors as legal adults.
Topics: Age Determination by Skeleton; Age Determination by Teeth; Expert Testimony; Forensic Medicine; Germany; Humans
PubMed: 26883413
DOI: 10.3238/arztebl.2016.0044 -
Brain Sciences Dec 2020Much of the spotlight for coronavirus disease 2019 (COVID-19) is on the acute symptoms and recovery. However, many recovered patients face persistent physical,...
Much of the spotlight for coronavirus disease 2019 (COVID-19) is on the acute symptoms and recovery. However, many recovered patients face persistent physical, cognitive, and psychological symptoms well past the acute phase. Of these symptoms, fatigue is one of the most persistent and debilitating. In this "perspective article," we define fatigue as and propose a model to explain potential factors contributing to post-COVID-19 fatigue. According to our model, fatigue is dependent on conditional and physiological factors. Conditional dependency comprises the task, environment, and physical and mental capacity of individuals, while physiological factors include central, psychological, and peripheral aspects. This model provides a framework for clinicians and researchers. However, future research is needed to validate our proposed model and elucidate all mechanisms of fatigue due to COVID-19.
PubMed: 33352638
DOI: 10.3390/brainsci10121012 -
Archives of Gynecology and Obstetrics Apr 2021The rapid technical development and portability of ultrasound systems over recent years has had a profound impact on the area of point-of-care-ultrasound (POCUS), both... (Review)
Review
BACKGROUND
The rapid technical development and portability of ultrasound systems over recent years has had a profound impact on the area of point-of-care-ultrasound (POCUS), both in general medicine and in obstetrics and gynecology. The use of POCUS enables the clinician to perform the ultrasound scan either at the medical office or the patient's bedside and used as an extension of the physical examination. Real-time images can immediately be correlated with the patient's symptoms, and any changes in a (critical) patient's condition can be more rapidly detected.
POCUS IN OBGYN
POCUS is also suitable for time-critical scenarios, and depending on the situation and its dynamics, the course and results of any therapy may be observed in real time. POCUS should be considered to be a routine extension of practice for most OB/GYN clinicians as it can give immediate answers to what could be life-threatening situations for the mother and/or baby. With its proven usefulness, the applications and use of POCUS should be incorporated in teaching programs for medical students, OBGYN residents and emergency physicians.
Topics: Gynecology; Humans; Obstetrics; Physical Examination; Point-of-Care Systems; Ultrasonography
PubMed: 33558990
DOI: 10.1007/s00404-021-05972-5 -
Genes Aug 2023The analysis of genetic material may be the only way to identify an unknown person or solve a criminal case. Often, the conditions in which the genetic material was... (Review)
Review
The analysis of genetic material may be the only way to identify an unknown person or solve a criminal case. Often, the conditions in which the genetic material was found determine the choice of the analytical method. Hence, it is extremely important to understand the influence of various factors, both external and internal, on genetic material. The review presents information on DNA and RNA persistence, depending on the chemical and physical factors affecting the genetic material integrity. One of the factors taken into account is the time elapsing to genetic material recovery. Temperature can both preserve the genetic material or lead to its rapid degradation. Radiation, aquatic environments, and various types of chemical and physical factors also affect the genetic material quality. The substances used during the forensic process, i.e., for biological trace visualization or maceration, are also discussed. Proper analysis of genetic material degradation can help determine the post-mortem interval (PMI) or time since deposition (TsD), which may play a key role in criminal cases.
Topics: Humans; Nucleic Acids; Forensic Genetics; RNA; Autopsy; Physical Examination
PubMed: 37628694
DOI: 10.3390/genes14081643 -
Indian Journal of Ophthalmology Dec 2022As perimetry is a psychophysical test, the thresholds obtained are not only dependent on the functional architecture of the visual system but also on a variety of...
BACKGROUND
As perimetry is a psychophysical test, the thresholds obtained are not only dependent on the functional architecture of the visual system but also on a variety of physical and cognitive factors. Factors such as, Lens rim artifact, improper refraction, miosed pupil and blepharoptosis, can affect luminance thresholds. Additionally, cognitive factors such as patient's attention, motivation, fatigue, and response bias can influence the obtained thresholds.
PURPOSE
The video describes identification of various artifacts in Humphrey visual field printout and it has some useful teaching points to recognize and learn.
SYNOPSIS
Visual field test is critical for assessment and to document progression of glaucoma, but is prone to errors and artifacts. Fortunately, the patterns of such artifactual field loss are often characteristic and easily recognizable.
HIGHLIGHTS
Several types of errors can lead to inaccurate results. Proper instructions and patient supervision during the test helps to improve the test results. The technician should ensure correct patient's data entry. Careful examination of the obtained data on the printout is essential to detect any errors that can lead to misinterpretation of visual field, false alarms, and wrong clinical conclusion.
VIDEO LINK
https://youtu.be/OWdFk4pWJkM.
Topics: Humans; Artifacts; Physical Examination; Visual Field Tests; Visual Fields
PubMed: 36453382
DOI: 10.4103/ijo.IJO_1487_22 -
Journal of Pediatric Intensive Care Jun 2019Alkalosis is a disorder of acid-base balance defined by elevated pH of the arterial blood. Metabolic alkalosis is characterized by primary elevation of the serum... (Review)
Review
Alkalosis is a disorder of acid-base balance defined by elevated pH of the arterial blood. Metabolic alkalosis is characterized by primary elevation of the serum bicarbonate. Due to several mechanisms, it is often associated with hypochloremia and hypokalemia and can only persist in the presence of factors causing and maintaining alkalosis. Respiratory alkalosis is a consequence of dysfunction of respiratory system's control center. There are no pathognomonic symptoms. History is important in the evaluation of alkalosis and usually reveals the cause. It is important to evaluate volemia during physical examination. Treatment must be causal and prognosis depends on a cause.
PubMed: 31093455
DOI: 10.1055/s-0038-1676061 -
The Journal of International Medical... Apr 2021Neuralgic amyotrophy (NA) is markedly underdiagnosed in clinical practice, and its actual incidence rate is about 1 per 1000 per year. In the current article, we provide...
Neuralgic amyotrophy (NA) is markedly underdiagnosed in clinical practice, and its actual incidence rate is about 1 per 1000 per year. In the current article, we provide an overview of essential information about NA, including the etiology, clinical manifestations, diagnostic investigations, differential diagnosis, treatment, and prognosis. The causes of NA are multifactorial and include immunological, mechanical, or genetic factors. Typical clinical findings are a sudden onset of pain in the shoulder region, followed by patchy flaccid paralysis of muscles in the shoulder and/or arm. A diagnosis of NA is based on a patient's clinical history and physical examination. Gadolinium-enhanced magnetic resonance imaging and high-resolution magnetic resonance neurography are useful for confirming the diagnosis and choosing the appropriate treatment. However, before a diagnosis of NA is confirmed, other disorders with similar symptoms, such as cervical radiculopathy or rotator cuff tear, need to be ruled out. The prognosis of NA depends on the degree of axonal damage. In conclusion, many patients with motor weakness and pain are encountered in clinical practice, and some of these patients will exhibit NA. It is important that clinicians understand the key features of this disorder to avoid misdiagnosis.
Topics: Brachial Plexus Neuritis; Humans; Magnetic Resonance Imaging; Physical Examination; Radiculopathy; Shoulder
PubMed: 33823638
DOI: 10.1177/03000605211006542 -
Cureus Apr 2023Syncope is a common chief complaint among patients presenting to the emergency department, the etiology of which can often be discerned with a thorough history and...
Syncope is a common chief complaint among patients presenting to the emergency department, the etiology of which can often be discerned with a thorough history and physical examination. Inversely, liposarcomas are rare tumors that frequently pose a diagnostic challenge as the clinical presentation is highly nonspecific and varies greatly depending on the anatomic location and size of the tumor. Here we present a case of retroperitoneal liposarcomas (RLS) presenting to the emergency department (ED) with a sole complaint of syncope, resulting in a diagnostic dilemma. This clinical scenario highlights the significance of thorough physical examination regardless of the presenting chief complaint, as unexpected physical examination findings prompted an extended work-up and thus facilitated the diagnosis, providing the opportunity for early intervention and resection of the tumor.
PubMed: 37252541
DOI: 10.7759/cureus.38253 -
BMC Medicine Aug 2023The current guidelines for survivorship in adolescents and young adults (AYA) cancer are based on studies conducted in the United States and European AYA survivors....
BACKGROUND
The current guidelines for survivorship in adolescents and young adults (AYA) cancer are based on studies conducted in the United States and European AYA survivors. However, previous studies have shown that the health-related quality of life in cancer survivors can vary depending on race, yet the long-term health differences among AYA survivors by race/ethnicity have not been fully explored. Therefore, our aim is to compare the psychosocial and physical health of AYA survivors and their matched controls across different racial and ethnic groups.
METHODS
We conducted a cross-sectional study using US National Health and Nutrition Examination Survey (NHANES) and the Korea NHANES from 2007 to 2018. We included AYA cancer survivors who were diagnosed with any type of cancer aged between 15 and 39 years, and who were adult with aged over 18 years old at survey year. We then stratified the study population by race/ethnicity with Non-Hispanic White (NHW, n = 310), African American (AA, n = 42), Hispanic (n = 81) from NHANES, and Asian (n = 389) from the Korea NHANES. We also selected 5 times age-, sex-, race-, and survey year-matched general population among participants who had never been diagnosed with cancer (N = 4110). Variables were defined using questionnaire data, physical exams, and laboratory tests.
RESULTS
Compared to NHW, Hispanics (aOR 1.15, 95% CI 1.00-1.32) had poor or fair general health, lower education (aOR 1.23, 95% CI 1.07-1.40), and lower household income (aOR 1.16, 95% CI 1.01-1.33). AA survivors were more likely to be non-coupled (aOR 1.35, 95% 1.15-1.60) and have hypertension (aOR 1.18, 95% CI 1.03-1.36). Asians were more former/current drinkers (aOR 1.21, 95% CI 1.05-1.40). NHW are more likely to experience psychological limitation. Compared to matched general, NHW and Asian survivors had poor general health and psychological health.
CONCLUSIONS
This study provides evidence for future studies concerning long-term health after AYA cancer survivorship that may vary according to race.
Topics: Humans; Adolescent; Young Adult; United States; Adult; Middle Aged; Cancer Survivors; Nutrition Surveys; Quality of Life; Cross-Sectional Studies; Race Factors; Neoplasms; Physical Examination
PubMed: 37542291
DOI: 10.1186/s12916-023-03005-3