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Arthroscopy : the Journal of... May 2024Our aim was to determine the diagnostic accuracy of native MRI regarding different ligamentous lesions of the wrist and to analyze the influence of technical...
PURPOSES
Our aim was to determine the diagnostic accuracy of native MRI regarding different ligamentous lesions of the wrist and to analyze the influence of technical characteristics, such as field strength, application of fat saturation, 3D sequences, and wrist coils.
METHODS
The systematic search was performed using MEDLINE, Embase, and CENTRAL databases. Studies that were published before the 12 of February 2024 were included. All studies comparing the diagnostic accuracy of native wrist MRI to that of wrist arthroscopy for suspected ligamentous lesions were included. Results were analyzed by anatomic localization and technical aspects of the MRI. To assess the quality of included studies, we used the revised QUADAS-2 tool.
RESULTS
The systematic search revealed 5,181 articles. Thirty-seven studies, reporting 3893 ligamentous lesions, were eligible for inclusion. The studies displayed heterogeneity in terms of technical conditions, such as field strength, the use of wrist coils, the application of 3D sequences and fat saturation. Research methods also varied. Overall sensitivity and specificity were 0.78 (0.66 - 0.86) and 0.81 (0.70 - 0.89) for 1.5T MRI, while sensitivity was 0.73 (0.68 - 0.78) and specificity was 0.90 (0.59 - 0.98) for 3T MRI. There was no significant difference between the two subgroups (p=0,3807 and p=0,4248). Sensitivity was 0.82 (0.75 - 0.87) for triangular fibrocartilage complex (TFCC) lesions, 0.63 (0.50 - 0.74) for scapholunate ligament (SL) tears, and 0.41 (0.25 - 0.60) for lunotriquetral ligament (LT) lesions. Specificity for TFCC lesions was 0.82 (0.73 - 0.89), for SL tears 0.86 (0.73 - 0.93), and for LT lesions 0.93 (0.81 - 0.98).
CONCLUSION
The sensitivity and specificity of MRI is influenced by the anatomic location of the lesion and technical conditions. In terms of diagnostic accuracy, no significant difference was found between 1.5T and 3T MRI.
LEVEL OF EVIDENCE
III. Systematic review of Level II. - III.
PubMed: 38735416
DOI: 10.1016/j.arthro.2024.04.029 -
Critical Reviews in Oncogenesis 2024Deep learning (DL) is poised to redefine the way medical images are processed and analyzed. Convolutional neural networks (CNNs), a specific type of DL architecture, are...
Deep learning (DL) is poised to redefine the way medical images are processed and analyzed. Convolutional neural networks (CNNs), a specific type of DL architecture, are exceptional for high-throughput processing, allowing for the effective extraction of relevant diagnostic patterns from large volumes of complex visual data. This technology has garnered substantial interest in the field of neuro-oncology as a promising tool to enhance medical imaging throughput and analysis. A multitude of methods harnessing MRI-based CNNs have been proposed for brain tumor segmentation, classification, and prognosis prediction. They are often applied to gliomas, the most common primary brain cancer, to classify subtypes with the goal of guiding therapy decisions. Additionally, the difficulty of repeating brain biopsies to evaluate treatment response in the setting of often confusing imaging findings provides a unique niche for CNNs to help distinguish the treatment response to gliomas. For example, glioblastoma, the most aggressive type of brain cancer, can grow due to poor treatment response, can appear to grow acutely due to treatment-related inflammation as the tumor dies (pseudo-progression), or falsely appear to be regrowing after treatment as a result of brain damage from radiation (radiation necrosis). CNNs are being applied to separate this diagnostic dilemma. This review provides a detailed synthesis of recent DL methods and applications for intratumor segmentation, glioma classification, and prognosis prediction. Furthermore, this review discusses the future direction of MRI-based CNN in the field of neuro-oncology and challenges in model interpretability, data availability, and computation efficiency.
Topics: Humans; Glioma; Prognosis; Brain Neoplasms; Neural Networks, Computer; Deep Learning; Magnetic Resonance Imaging; Image Processing, Computer-Assisted
PubMed: 38683153
DOI: 10.1615/CritRevOncog.2023050852 -
Frontiers in Oncology 2024Radiotherapy, a primary treatment for malignant cancer, presents significant clinical challenges globally due to its associated adverse effects, especially with the...
BACKGROUND
Radiotherapy, a primary treatment for malignant cancer, presents significant clinical challenges globally due to its associated adverse effects, especially with the increased survival rates of cancer patients. Radiation induced heart disease (RIHD) significantly impacts the long-term survival and quality of life of cancer survivors as one of the most devastating consequences. Quite a few studies have been conducted on preclinical and clinical trials of RIHD, showing promising success to some extent. However, no researchers have performed a comprehensive bibliometric study so far.
OBJECTIVE
This study attempts to gain a deeper understanding of the focal points and patterns in RIHD research and to pinpoint prospective new research avenues using bibliometrics.
METHODS
The study group obtained related 1554 publications between 1990 and 2023 on the Web of Science Core Collection (WOSCC) through a scientific search query. Visualization tools like CiteSpace and VOSviewer were utilized to realize the visual analysis of countries, authors, journals, references and keywords, identifying the hotspots and frontiers in this research field.
RESULTS
After collecting all the data, a total of 1554 documents were categorized and analyzed using the above tools. The annual number of publications in the field of RIHD shows a continuous growth trend. In 2013, there was a significant rise in the number of linked publications, with the majority of authors being from the USA, according to the statistics. Among all the journals, published the most relevant papers. Cluster analysis of the references showed that research on RIHD has focused on breast cancer, non-small cell lung cancer (NSCLC), and Hodgkin's lymphoma (also among the three main clusters), preclinical research, childhood cancer, heart dose, coronary artery disease, etc, which are also hot topics in the field. High-frequency keywords in the analysis include risk factors, cancer types, heart disease, survival, trials, proton therapy (PT), etc.
CONCLUSION
Future research on RIHD will mostly focus on thoracic cancer, whose exact cause is yet unknown, with preclinical trials playing an important role. Preventing, consistently monitoring, promptly diagnosing, and timely treating are crucial to decreasing RIHD and extending the life expectancy of cancer survivors.
PubMed: 38655134
DOI: 10.3389/fonc.2024.1362673 -
Environment International May 2024The technological applications of radiofrequency electromagnetic fields (RF-EMF) have been steadily increasing since the 1950s exposing large proportions of the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The technological applications of radiofrequency electromagnetic fields (RF-EMF) have been steadily increasing since the 1950s exposing large proportions of the population. The World Health Organization (WHO) is assessing the potential health effects of exposure to RF-EMF.
OBJECTIVES
To systematically assess the effects of exposure to RF-EMF on self-reported non-specific symptoms in human subjects and to assess the accuracy of perceptions of presence or absence of RF-EMF exposure.
METHODS
Eligibility criteria: experimental studies carried out in the general population and in individuals with idiopathic environmental intolerance attributed to EMF (IEI-EMF), in any language.
INFORMATION SOURCES
Medline, Web of Science, PsycInfo, Cochrane Library, Epistemonikos, Embase and EMF portal, searched till April 2022. Risk of Bias (ROB): we used the RoB tool developed by OHAT adapted to the topic of this review.
SYNTHESIS OF RESULTS
we synthesized studies using random effects meta-analysis and sensitivity analyses, where appropriate.
RESULTS
Included studies: 41 studies were included, mostly cross over trials and from Europe, with a total of 2,874 participants.
SYNTHESIS OF RESULTS
considering the primary outcomes, we carried out meta-analyses of 10 exposure-outcomes pairs. All evidence suggested no or small non-significant effects of exposure on symptoms with high (three comparisons), moderate (four comparisons), low (one comparison) and very low (two comparisons) certainty of evidence. The effects (standard mean difference, where positive values indicate presence of symptom being exposed) in the general population for head exposure were (95% confidence intervals) 0.08 (-0.07 to 0.22) for headache, -0.01 (-0.22 to 0.20) for sleeping disturbances and 0.13 (-0.51 to 0.76) for composite symptoms; and for whole-body exposure: 0.09 (-0.35 to 0.54), 0.00 (-0.15 to 0.15) for sleeping disturbances and -0.05 (-0.17 to 0.07) for composite symptoms. For IEI-EMF individuals SMD ranged from -0.19 to 0.11, all of them with confidence intervals crossing the value of zero. Further, the available evidence suggested that study volunteers could not perceive the EMF exposure status better than what is expected by chance and that IEI-EMF individuals could not determine EMF conditions better than the general population.
DISCUSSION
Limitations of evidence: experimental conditions are substantially different from real-life situations in the duration, frequency, distance and position of the exposure. Most studies were conducted in young, healthy volunteers, who might be more resilient to RF-EMF than the general population. The outcomes of interest in this systematic review were symptoms, which are self-reported. The available information did not allow to assess the potential effects of exposures beyond acute exposure and in elderly or in chronically ill people. It cannot be ruled out that a real EMF effect in IEI-EMF groups is masked by a mix with insensitive subjects. However, studies on symptoms reporting and/or field perceptions did not find any evidence that there were particularly vulnerable individuals in the IEI-EMF group, although in open provocation studies, when volunteers were informed about the presence or absence of EMF exposure, such differences were consistently observed.
INTERPRETATION
available evidence suggests that acute RF-EMF below regulatory limits does not cause symptoms and corresponding claims in the everyday life are related to perceived and not to real EMF exposure status.
Topics: Humans; Electromagnetic Fields; Self Report; Environmental Exposure; Radio Waves
PubMed: 38640611
DOI: 10.1016/j.envint.2024.108612 -
Bulletin Du Cancer May 2024Given the current global cancer epidemic across the world, the need for healthcare professionals in this field is crucial. Little is known about the factors that drive... (Review)
Review
INTRODUCTION
Given the current global cancer epidemic across the world, the need for healthcare professionals in this field is crucial. Little is known about the factors that drive medical students toward oncology.
METHOD
We conducted a systematic review of the literature (from 1980 to the present), using several search equations and selecting original articles written in English based on qualitative or quantitative surveys, to understand what motivates medical students to choose oncology.
RESULTS
We identified only seven articles that reported quantitative surveys; no qualitative surveys were found. These seven surveys are composed of closed-ended questions and are pragmatic questionnaires based on field knowledge, but without an underlying theory. These studies most often interrogate students already oriented towards oncology. The following five concepts associated with the choice of oncology had the highest recurrence among these seven surveys, which had been conducted in different countries and at various times: interest in cancer management, initiation of the specialty during the 2nd cycle, job opportunities, low working hours, and quality of life.
DISCUSSION
The literature on this topic is particularly scarce. No qualitative studies have been published in the English language. The limited data in the literature do not allow us to fully comprehend the problem.
Topics: Humans; Students, Medical; Career Choice; Medical Oncology; Motivation; Quality of Life; Surveys and Questionnaires; Neoplasms
PubMed: 38553287
DOI: 10.1016/j.bulcan.2024.02.003 -
Radiotherapy and Oncology : Journal of... Jun 2024This systematic review examines the role of dosimetric parameters in predicting temporal lobe necrosis (TLN) risk in nasopharyngeal carcinoma (NPC) patients treated with... (Meta-Analysis)
Meta-Analysis Review
This systematic review examines the role of dosimetric parameters in predicting temporal lobe necrosis (TLN) risk in nasopharyngeal carcinoma (NPC) patients treated with three-dimensional conformal RT (3D-CRT), intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). TLN is a serious late complication that can adversely affect the quality of life of NPC patients. Understanding the relationship between dosimetric parameters and TLN can guide treatment planning and minimize radiation-related complications. A comprehensive search identified relevant studies published up to July 2023. Studies reporting on dosimetric parameters and TLN in NPC patients undergoing 3D-CRT, IMRT, and VMAT were included. TLN incidence, follow-up duration, and correlation with dosimetric parameters of the temporal lobe were analyzed. The review included 30 studies with median follow-up durations ranging from 28 to 110 months. The crude incidence of TLN varied from 2.3 % to 47.3 % and the average crude incidence of TLN is approximately 14 %. Dmax and D1cc emerged as potential predictors of TLN in 3D-CRT and IMRT-treated NPC patients. Threshold values of >72 Gy for Dmax and >62 Gy for D1cc were associated with increased TLN risk. However, other factors should also be considered, including host characteristics, tumor-specific features and therapeutic factors. In conclusion, this systematic review highlights the significance of dosimetric parameters, particularly Dmax and D1cc, in predicting TLN risk in NPC patients undergoing 3D-CRT, IMRT, and VMAT. The findings provide valuable insights that can help in developing optimal treatment planning strategies and contribute to the development of clinical guidelines in this field.
Topics: Humans; Nasopharyngeal Carcinoma; Temporal Lobe; Necrosis; Radiation Injuries; Nasopharyngeal Neoplasms; Radiotherapy, Intensity-Modulated; Radiotherapy Dosage; Radiotherapy, Conformal
PubMed: 38537680
DOI: 10.1016/j.radonc.2024.110258 -
Technology in Cancer Research &... 2024This review investigates peripheral dose levels in electron beam treatments, comparing different manufacturers including Varian, Elekta, and Siemens. Accurate... (Review)
Review
This review investigates peripheral dose levels in electron beam treatments, comparing different manufacturers including Varian, Elekta, and Siemens. Accurate measurement of peripheral dose is vital for patient safety and precise radiation delivery in radiation therapy. This review followed PRISMA standards, conducting a comprehensive literature search from 1978 to July 2023. Emphasis was on identifying studies analyzing peripheral doses related to various electron beam energies, beam angle, field sizes, cutouts, and applicator combinations. Three major databases including PubMed, Web of Science, and Scopus were searched. A total of 7 articles were included in this review. Strategies such as bolus materials, personalized cutouts, and optimal treatment procedures have all been developed to reduce peripheral radiation exposure and enhance patient safety. Ongoing research in this field is focused on further minimizing the risks associated with out-of-field radiation by improving dose delivery systems. The literature emphasizes importance of precision in electron beam radiation therapy, highlighting the critical need for managing peripheral doses and optimizing hardware to ensure patient safety. It advocates for the use of advanced tools and protocols to maintain a balance between effective treatment while protecting healthy tissues. Continuous research, careful treatment planning, and effective management of peripheral doses are essential.
Topics: Humans; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; Electrons; Phantoms, Imaging; Particle Accelerators
PubMed: 38515394
DOI: 10.1177/15330338241239144 -
Surgical Endoscopy May 2024Ultrasound has been nicknamed "the surgeon's stethoscope". The advantages of laparoscopic ultrasound beyond a substitute for the sense of touch are considerable,... (Review)
Review
INTRODUCTION
Ultrasound has been nicknamed "the surgeon's stethoscope". The advantages of laparoscopic ultrasound beyond a substitute for the sense of touch are considerable, especially for robotic surgery. Being able to see through parenchyma and into vascular structures enables to avoid unnecessary dissection by providing a thorough assessment at every stage without the need for contrast media or ionising radiation. The limitations of restricted angulation and access within the abdominal cavity during laparoscopy can be overcome by robotic handling of miniaturised ultrasound probes and the use of various and specific frequencies will meet tissue- and organ-specific characteristics. The aim of this systematic review was to assess the reported applications of intraoperative ultrasound-guided robotic surgery and to outline future perspectives.
METHODS
The study adhered to the PRISMA guidelines. PubMed, Google Scholar, ScienceDirect and ClinicalTrials.gov were searched up to October 2023. Manuscripts reporting data on ultrasound-guided robotic procedures were included in the qualitative analysis.
RESULTS
20 studies met the inclusion criteria. The majority (53%) were related to the field of general surgery during liver, pancreas, spleen, gallbladder/bile duct, vascular and rectal surgery. This was followed by other fields of oncological surgery (42%) including urology, lung surgery, and retroperitoneal lymphadenectomy for metastases. Among the studies, ten (53%) focused on locating tumoral lesions and defining resection margins, four (15%) were designed to test the feasibility of robotic ultrasound-guided surgery, while two (10.5%) aimed to compare robotic and laparoscopic ultrasound probes. Additionally two studies (10.5%) evaluated the robotic drop-in probe one (5%) assessed the hepatic tissue consistency and another one (5%) aimed to visualize the blood flow in the splenic artery.
CONCLUSION
The advantages of robotic instrumentation, including ergonomics, dexterity, and precision of movements, are of relevance for robotic intraoperative ultrasound (RIOUS). The present systematic review demonstrates the virtue of RIOUS to support surgeons and potentially reduce minimally invasive procedure times.
Topics: Robotic Surgical Procedures; Humans; Ultrasonography, Interventional; Laparoscopy
PubMed: 38512350
DOI: 10.1007/s00464-024-10772-4 -
International Journal of Surgery... Jun 2024Computer-aided drug design (CADD) is a drug design technique for computing ligand-receptor interactions and is involved in various stages of drug development. To better...
AIM
Computer-aided drug design (CADD) is a drug design technique for computing ligand-receptor interactions and is involved in various stages of drug development. To better grasp the frontiers and hotspots of CADD, we conducted a review analysis through bibliometrics.
METHODS
A systematic review of studies published between 2000 and 20 July 2023 was conducted following the PRISMA guidelines. Literature on CADD was selected from the Web of Science Core Collection. General information, publications, output trends, countries/regions, institutions, journals, keywords, and influential authors were visually analyzed using software such as Excel, VOSviewer, RStudio, and CiteSpace.
RESULTS
A total of 2031 publications were included. These publications primarily originated from 99 countries or regions led by the U.S. and China. Among the contributors, MacKerell AD had the highest number of articles and the greatest influence. The Journal of Medicinal Chemistry was the most cited journal, whereas the Journal of Chemical Information and Modeling had the highest number of publications.
CONCLUSIONS
Influential authors in the field were identified. Current research shows active collaboration between countries, institutions, and companies. CADD technologies such as homology modeling, pharmacophore modeling, quantitative conformational relationships, molecular docking, molecular dynamics simulation, binding free energy prediction, and high-throughput virtual screening can effectively improve the efficiency of new drug discovery. Artificial intelligence-assisted drug design and screening based on CADD represent key topics that will influence future development. Furthermore, this paper will be helpful in better understanding the frontiers and hotspots of CADD.
Topics: Bibliometrics; Humans; Computer-Aided Design; Drug Design; Molecular Docking Simulation
PubMed: 38502850
DOI: 10.1097/JS9.0000000000001289 -
Journal of Medical Internet Research Mar 2024Loneliness and social isolation are major public health concerns for older adults, with severe mental and physical health consequences. New technologies may have a great... (Review)
Review
BACKGROUND
Loneliness and social isolation are major public health concerns for older adults, with severe mental and physical health consequences. New technologies may have a great impact in providing support to the daily lives of older adults and addressing the many challenges they face. In this scenario, technologies based on voice assistants (VAs) are of great interest and potential benefit in reducing loneliness and social isolation in this population, because they could overcome existing barriers with other digital technologies through easier and more natural human-computer interaction.
OBJECTIVE
This study aims to investigate the use of VAs to reduce loneliness and social isolation of older adults by performing a systematic literature review and a bibliometric cluster mapping analysis.
METHODS
We searched PubMed, Embase, and Scopus databases for articles that were published in the last 6 years, related to the following main topics: voice interface, VA, older adults, isolation, and loneliness. A total of 40 articles were found, of which 16 (40%) were included in this review. The included articles were then assessed through a qualitative scoring method and summarized. Finally, a bibliometric analysis was conducted using VOSviewer software (Leiden University's Centre for Science and Technology Studies).
RESULTS
Of the 16 articles included in the review, only 2 (13%) were considered of poor methodological quality, whereas 9 (56%) were of medium quality and 5 (31%) were of high quality. Finally, through bibliometric analysis, 221 keywords were extracted, of which 36 (16%) were selected. The most important keywords, by number of occurrences and by total link strength; results of the analysis with the Association Strength normalization method; and default values were then presented. The final bibliometric network consisted of 36 selected keywords, which were grouped into 3 clusters related to 3 main topics (ie, VA use for social isolation among older adults, the significance of age in the context of loneliness, and the impact of sex factors on well-being). For most of the selected articles, the effect of VA on social isolation and loneliness of older adults was a minor theme. However, more investigations were done on user experience, obtaining preliminary positive results.
CONCLUSIONS
Most articles on the use of VAs by older adults to reduce social isolation and loneliness focus on usability, acceptability, or user experience. Nevertheless, studies directly addressing the impact that using a VA has on the social isolation and loneliness of older adults find positive and promising results and provide important information for future research, interventions, and policy development in the field of geriatric care and technology.
Topics: Humans; Aged; Loneliness; Social Isolation; Bibliometrics; Cluster Analysis; Databases, Factual
PubMed: 38498039
DOI: 10.2196/50534