Vadthomson3425

To evaluate the addition of digital breast tomosynthesis (DBT) in the diagnosis of breast lesions in symptomatic young Chinese women (≤30 years) diagnosed with Breast Imaging Reporting and Data System (BI-RADS) category 4 or 5 on ultrasound, and demonstrate the potential use of combining DBT with ultrasound.

This retrospective analysis included 5 years of digital mammography (DM) and DBT data (January 2015 to July 2020). In total, 768 DBT and DM examinations were performed in 713 young women. The results were determined by pathological assessment. Diagnostic performance was measured based on the sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristic area under the curve (AUC).

Compared with DM alone, DBT+DM increased the sensitivity from 82.5% to 93.2%, specificity from 70.8% to 84%, accuracy from 74% to 86.5%, NPV from 93.6% to 97.4% (all p<0.01). The AUC of DBT+DM (0.946, 95% confidence interval [CI] 0.927-0.960) was greater than that of DM (0.884, 95% CI 0.859-0.905; p<0.001). The differences in the BI-RADS category distributions of malignant and benign lesions were both statistically significant (p<0.001). DM alone led to 36 false-negative diagnoses, whereas the inclusion of DBT identified breast cancer in 22 of those cases. There were 4.9% (10/206) false-negative diagnoses in ultrasound. After adding DBT, four breast cancers were detected. An additional six breast cancers were diagnosed by biopsy based on an assessment of BI-RADS 4A by DBT/DM.

DBT+DM significantly improves the diagnostic performance in this young population, especially in young people with higher breast density. Moreover, DBT is an effective supplementary examination to ultrasound.

DBT + DM significantly improves the diagnostic performance in this young population, especially in young people with higher breast density. Moreover, DBT is an effective supplementary examination to ultrasound.

The purpose of this study was to compare color alterations (ΔE) of white-spot lesions (WSLs) bleached before versus after resin infiltration (RI).

Using the facial surfaces of bovine maxillary incisors, WSLs were created and the teeth were allocated into 2 groups (n= 45/group) bleach then RI (B-RI group) and RI then bleach (RI-B group). To determine ΔE, Commission Internationale de l'Eclairage L∗ a∗ b∗ (L∗ represents lightness, ranging from black to white [0-100]; a∗ represents green to red chromaticity [-150-+100]; and b∗ represents blue to yellow chromaticity [-100-+150]) measurements were obtained at baseline, after WSL formation, and after RI and bleaching. Representative specimens were evaluated by means of scanning electron microscopy. Statistical analyses included the Mann-Whitney U and Wilcoxon signed rank tests (P ≤ .0016) and repeated measures analysis of variance (P ≤ .05).

No differences in ΔE were found comparing B-RI with RI-B groups or when the B-RI group was compared with bleached enamel. A statistically significant difference was found when the RI-B group was compared with bleached enamel (ΔE, 0.81; P < .001), but the difference was deemed not clinically significant. Scanning electron microscopy revealed that bleaching after RI increased surface roughness of the resin.

There were no clinically significant differences in ΔE of WSLs when bleach was applied before or after RI; however, applying bleaching agent after RI roughened the surface of the resin material.

Results indicate that ΔE were not clinically significantly different between WSLs bleached before versus after RI, although it is best to sequence bleaching before RI therapy, as bleaching after RI roughened the restoration's surface.

Results indicate that ΔE were not clinically significantly different between WSLs bleached before versus after RI, although it is best to sequence bleaching before RI therapy, as bleaching after RI roughened the restoration's surface.

The purpose of this study was to evaluate the multifaceted impact of the COVID-19 pandemic on dental practices and their readiness to resume dental practice during arduous circumstances.

The authors distributed an observational survey study approved by The University of Texas Health Science Center at San Antonio Institutional Review Board to dental care practitioners and their office staff members using Qualtrics XM software. The survey was completed anonymously. The authors analyzed the data using R statistical computing software, χ

test, and Wilcoxon rank sum test.

Nearly all participants (98%) felt prepared to resume dental practice and were confident of the safety precautions (96%). Only 21% of dentists felt the COVID-19 pandemic changed their dental treatment protocols, with at least two-thirds agreeing that precautions would influence their efficiency adversely. Although most participants were satisfied with the resources their dental practice provided for support during the pandemic (95%), mostfects on dentistry and oral health and interceptive measures for better communication and programming around future challenges.

Muscular pain is the main cause of disability worldwide. Myofascial pain of orofacial origin is a frequent condition, the treatment of which is not always accomplished with traditional treatment. Botulinum toxin type A (BTA) is being studied for the treatment of this type of pain with contradicting results. Thus, the objective of this study was to assess the efficacy of BTA in the therapeutic management of masticatory myofascial pain (MFP).

A retrospective study of 100 patients with a diagnosis of MFP was conducted. The control group (50 patients) received conventional treatment (prescription of a muscle relaxant and craniocervical physical therapy). The BTA group (50 patients) received this same treatment and the infiltration of 100 units of BTA in the masticatory musculature. Subjective and objective pain ratings and range of mandibular movements were recorded before and after the treatment. No differences were found between groups in the baseline values. Statistically significant improvements were found in both groups compared with baseline values in all studied parameters. Moreover, BTA improved the subjective pain ratings compared with the control group. The administration of BTA added to the conventional treatment does not seem to improve objective pain ratings and functional measurements, but it improves the subjective pain ratings.

The addition of BTA could be beneficial in the treatment of MFP in addition to conventional treatment, but further studies are needed to elucidate the mechanisms underlying this positive effect.

The addition of BTA could be beneficial in the treatment of MFP in addition to conventional treatment, but further studies are needed to elucidate the mechanisms underlying this positive effect.

Treating pain in the context of chronic kidney disease (CKD) is challenging because of altered pharmacokinetics and pharmacodynamics, with an increased risk of toxicity and drug adverse events in this population. The aims of this systematic review and meta-analysis were to assess the prevalence of analgesic use and establish the risk of analgesics-related adverse events, in patients with CKD.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Medline, Embase, CINAHL, and CENTRAL were searched until January 2021. APD334 Random-effects meta-analyses and meta-regression were conducted to pool and summarise prevalence data and measures of association between analgesic use and adverse events.

Sixty-two studies relevant to the prevalence of analgesic use and 33 to analgesic-related adverse events were included, combining data on 2.3 and 3 million individuals, respectively. Pooled analyses found that 41% (95% confidence interval [CI], 35-48) of the CKD population regularly use analgesia. The annual period prevalence was estimated at 50% for opioids and 21% for nonsteroidal anti-inflammatory drugs (NSAID). Overall, 20% and 7% of patients with CKD are on chronic opioid or NSAID therapy, respectively. Opioid use was associated with an increased risk of death (1.61; 95% CI, 1.12-2.31; n= 7, I

= 91%), hospitalisation (1.38; 95% CI, 1.32-1.45; n=2, I

=0%), and fractures (1.51; 95% CI, 1.16-1.96; n=3, I

=54%).

High levels of analgesic consumption and related serious adverse outcomes were found in patients with CKD. Consideration needs to be given to how these patients are assessed and managed in order to minimise harms and improve outcomes.

CRD42019156491 (PROSPERO).

CRD42019156491 (PROSPERO).

The 10th version of International Classification of Diseases (ICD-10) codification system has been widely adopted by the health systems of many countries, including Spain. However, manual code assignment of Electronic Health Records (EHR) is a complex and time-consuming task that requires a great amount of specialised human resources. Therefore, several machine learning approaches are being proposed to assist in the assignment task. In this work we present an alternative system for automatically recommending ICD-10 codes to be assigned to EHRs.

Our proposal is based on characterising ICD-10 codes by a set of keyphrases that represent them. link2 These keyphrases do not only include those that have literally appeared in some EHR with the considered ICD-10 codes assigned, but also others that have been obtained by a statistical process able to capture expressions that have led the annotators to assign the code.

The result is an information model that allows to efficiently recommend codes to a new EHR based on their textual content. We explore an approach that proves to be competitive with other state-of-the-art approaches and can be combined with them to optimise results.

In addition to its effectiveness, the recommendations of this method are easily interpretable since the phrases in an EHR leading to recommend an ICD-10 code are known. Moreover, the keyphrases associated with each ICD-10 code can be a valuable additional source of information for other approaches, such as machine learning techniques.

In addition to its effectiveness, the recommendations of this method are easily interpretable since the phrases in an EHR leading to recommend an ICD-10 code are known. Moreover, the keyphrases associated with each ICD-10 code can be a valuable additional source of information for other approaches, such as machine learning techniques.Dynamic imaging is a beneficial tool for interventions to assess physiological changes. Nonetheless during dynamic MRI, while achieving a high temporal resolution, the spatial resolution is compromised. To overcome this spatio-temporal trade-off, this research presents a super-resolution (SR) MRI reconstruction with prior knowledge based fine-tuning to maximise spatial information while reducing the required scan-time for dynamic MRIs. A U-Net based network with perceptual loss is trained on a benchmark dataset and fine-tuned using one subject-specific static high resolution MRI as prior knowledge to obtain high resolution dynamic images during the inference stage. 3D dynamic data for three subjects were acquired with different parameters to test the generalisation capabilities of the network. link3 The method was tested for different levels of in-plane undersampling for dynamic MRI. The reconstructed dynamic SR results after fine-tuning showed higher similarity with the high resolution ground-truth, while quantitatively achieving statistically significant improvement.