Search Results (101)

Background/Objectives: Otolaryngologists are increasingly using head and neck ultrasound (HNUS). Determining whether a practitioner of HNUS has achieved adequate theoretical knowledge remains a challenge. This study assesses the performance of two large language models (LLMs) in generating multiple-choice questions (MCQs) for head and neck ultrasound, compared with MCQs generated by physicians. Methods: Physicians and LLMs (ChatGPT, GPT4o, and Google Gemini, Gemini Advanced) created a total of 90 MCQs that covered the topics of lymph nodes, thyroid, and salivary glands. Experts in HNUS additionally evaluated all physician-drafted MCQs using a Delphi-like process. The MCQs were assessed by an international panel of experts in HNUS, who were blinded to the source of the questions. Using a Likert scale, the evaluation was based on an overall assessment including six assessment criteria: clarity, relevance, suitability, quality of distractors, adequate rationale of the answer, and an assessment of the level of difficulty. Results: Four experts in the clinical field of HNUS assessed the 90 MCQs. No significant differences were observed between the two LLMs. Physician-drafted questions (n = 30) had significant differences with Google Gemini in terms of relevance, suitability, and adequate rationale of the answer, but only significant differences in terms of suitability compared with ChatGPT. Compared to MCQ items (n = 16) validated by medical experts, LLM-constructed MCQ items scored significantly lower across all criteria. The difficulty level of the MCQs was the same. Conclusions: Our study demonstrates that both LLMs could be used to generate MCQ items with a quality comparable to drafts from physicians. However, the quality of LLM-generated MCQ items was still significantly lower than MCQs validated by ultrasound experts. LLMs are therefore cost-effective to generate a quick draft for MCQ items that afterward should be validated by experts before being used for assessment purposes. In this way, the value of LLM is not the elimination of humans, but rather vastly superior time management. Full article

Cat owners are involved in their cats’ healthcare, including the prevention of parasitic diseases. However, a comprehensive understanding of their preferences for feline antiparasitics is lacking. This study addresses this gap through a multifaceted methodology comprising three phases. In Phase 1, the physical properties and usability aspects of seven topical antiparasitic formulations were assessed. Within Phase 2, an ease-of-use study was conducted to evaluate the cat owners’ application experience with deidentified products representing three topical antiparasitics. Phase 3 included the identification and validation of product attributes most valued by pet owners through interviews with cat owners and veterinary experts. The product attributes identified informed the subsequent quantitative discrete choice experiment (DCE), which involved 1040 cat owners from different countries (Australia/New Zealand, Canada, Greece/Spain, and the UK) and aimed to analyze their preferences based on choices among product profiles mirroring four topical antiparasitics: selamectin–sarolaner, moxidectin–fluralaner, moxidectin–imidacloprid, and eprinomectin–esafoxolaner–praziquantel. Phase 1 showed that the selamectin–sarolaner formulation exhibits minimal odor, less stickiness, and less drying time. The ease-of-use study (Phase 2) showed that the blinded product representing the selamectin–sarolaner formulation was characterized by seamless application, rapid dispensing, and a sense of control during application. The quantitative DCE study (Phase 3) indicated a preference for the product profile mirroring the selamectin–sarolaner formulation among a global sample of cat owners. Demographic characteristics such as gender, age, and insurance status influenced their preferences. Key predictors for preferring the selamectin–sarolaner formulation over at least one comparator treatment included the ability to confirm successful administration, age restrictions, ease of application, and the time before the cat could sit on furniture following administration. These findings suggest that cat owners prioritize ease of use, safety, and overall user experience, providing valuable guidance for veterinary practitioners to make informed treatment recommendations. Full article

Background: Split-thickness skin grafts (STSGs) are utilised to close wounds which cannot be closed by primary closure. Dermatome-assisted STSG harvest utilises a lubricant to control friction, which facilitates graft harvest. Many different lubricants are used during graft harvest, although little research has been conducted to identify the optimal lubricant. Furthermore, new techniques such as Meek grafting are incompatible with commonly used oil-based lubricants. Method: A literature search was conducted, following the PRISMA protocol. 173 records were screened with 6 included in this study. We also reviewed the literature on lubricants in other biotribological systems including shaving. Results: We found support for numerous lubricants, including: mineral oil, catheter gel, chlorhexidine, saline and ultrasound gel. Evidence consisted of expert opinions, and one blinded comparative review. There was no consensus on the optimal lubricant, and we did not find evidence that lubricant compatibility with Meek grafting had been assessed. Conclusions: Presently, lubrication choice in STSG harvest lacks a scientific basis, and further research is needed to design a bespoke, Meek-compatible lubricant which considers only four of Engelhardt’s characteristics (1. cost-effectiveness; 4. lubrication; 6. no side effects; 8. practicability) to be essential. This should be followed by a blinded trial of lubricants. Full article

Color blindness can create challenges in recognizing visual cues, potentially affecting players’ performance, emotional involvement, and overall gaming experience. This study examines the impact of color blindness on player engagement and emotional experiences in digital games. The research aims to analyze how color-blind individuals engage with and emotionally respond to games, offering insights into more inclusive and accessible game design. An experiment-based study was conducted using a between-group design with a total of 13 participants, including 5 color-blind and 8 non-color-blind participants (aged 18–30). The sample was carefully selected to ensure participants had similar levels of digital gaming experience and familiarity with digital games, reducing potential biases related to skill or prior exposure. A custom-designed game, “Color Quest,” was developed to assess engagement and emotional responses. Emotional responses were measured through Emotion AI analysis, video recordings, and self-reported feedback forms. Participants were also asked to rate their engagement and emotional experience on a 1 to 5 scale, with additional qualitative feedback collected for deeper insights. The results indicate that color-blind players generally reported lower engagement levels compared to non-color-blind players. Although quantitative data did not reveal a direct correlation between color blindness and visual experience, self-reported feedback suggests that color-related design choices negatively impact emotional involvement and player immersion. Furthermore, in the survey responses from participants, color-blind individuals rated their experiences lower compared to individuals with normal vision. Participants emphasized that certain visual elements created difficulties in gameplay, and alternative sensory cues, such as audio feedback, helped mitigate these challenges. This study presents an experimental evaluation of color blindness in gaming, emphasizing how sensory adaptation strategies can support player engagement and emotional experience. This study contributes to game accessibility research by highlighting the importance of perceptual diversity and inclusive sensory design in enhancing player engagement for color-blind individuals. Full article

This study aimed to clarify the menstrual experiences and perceptions of women with visual impairments in Japan. An anonymous web-based questionnaire consisting of both multiple-choice (quantitative) and open-ended (qualitative) questions was administered to female Riryouka Kyouin (visually impaired teachers who provide instruction in traditional Japanese therapeutic practices—such as acupuncture, moxibustion, and massage—to students with visual impairments) employed at prefectural schools for the blind. The multiple-choice responses suggested several difficulties in menstrual management, including challenges in detecting menstrual blood, limited access to information, and concerns related to embarrassment. The open-ended responses revealed that participants, as individuals with visual impairments who also serve as educators and healthcare professionals, expressed efforts to manage menstruation appropriately in social contexts. These findings highlight the practical experiences of visually impaired women who are actively engaged in society and suggest the importance of support approaches that respect individual autonomy in managing menstruation—a bodily practice imbued with social meaning. Full article

Background/Objectives: Distal radius fractures (DRFs) are among the most common fractures in the elderly, with increasing incidence due to population aging. Recent evidence questions the benefits of operative treatment, particularly in elderly patients. The present study aimed to assess post-traumatic osteoarthritis (OA) and patient-reported outcome measures (PROMs) after a minimum of two years of follow-up of the previously published VOLCON randomized controlled trial (RCT), which compared operative and non-operative treatments of unstable DRFs in patients aged ≥ 65 years. Methods: This study presents a minimum two-year follow-up of a single-center, assessor-blinded RCT. A total of 100 patients with unstable DRFs were randomized to either operative treatment with volar locking plating or non-operative treatment with cast immobilization. The primary outcome was post-traumatic OA, assessed using the Knirk and Jupiter classification. Secondary outcomes included PROMs (Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH)) and Patient-Rated Wrist/Hand Evaluation (PRWHE), complications, pain, grip strength, and range of motion (ROM). Statistical analyses were performed using two-way ANOVA. Results: After a median follow-up of 3.0 years, 60 patients (28 non-operative and 32 operative) were available for analysis. There was no significant difference in OA between the groups (p = 0.57). PROMs (Quick-DASH, PRWHE), pain, grip strength, and ROM were time-dependent (p < 0.001) but not treatment-dependent. Complications were more frequent in the operative group, including hardware-related issues requiring reoperation. Conclusions: At a minimum of two years of follow-up, no correlation was found between treatment choice and post-traumatic OA. Functional outcomes were similar between groups, suggesting that non-operative treatment remains a viable option for elderly patients with unstable DRFs. Full article

The interaction between antiresorptive medication and dental implant procedures remains a subject of concern complicating the decision-making process for clinicians. The aim of the study is to conduct a literature review on the relationship between dental implant placement and the incidence of osteonecrosis of the jaw (ONJ) in patients receiving antiresorptive drugs. The systematic review relied on the PRISMA statement using the PICO tool. The literature search was performed using PubMed, EBSCOhost and Scopus for RCTs, controlled clinical trials and cohort studies. The choice of reference studies was made in a blind process with a 100% agreement rate. For all included studies, quality assessment was performed. The research led to the selection of 608 results. Only five studies were included in the review. Three of the included studies were judged as having a low risk of bias. Dental implants may not be linked to a higher risk of osteonecrosis of the jaw in patients taking low-dose bone-modifying agents. The long-term survival of implants in osteoporotic patients taking oral antiresorptive medication was similar to that in a healthy population and significantly higher than in untreated controls. Full article

Background: Natural nootropic compounds are evidenced to restore brain function in clinical and older populations and are purported to enhance cognitive abilities in healthy cohorts. This study aimed to provide neurocomputational insight into the discrepancies between the remarkable self-reports and growing interest in nootropics among healthy adults and the inconclusive performance-enhancing effects found in the literature. Methods: Towards this end, we devised a randomised, double-blinded, and placebo-controlled study where participants performed a visual categorisation task prior to and following 60 days of supplementation with a plant-based nootropic, while electroencephalographic (EEG) signals were concurrently captured. Results: We found that although no improvements in choice accuracy or reaction times were observed, the application of multivariate information-theoretic measures to the EEG source space showed broadband increases in similar and complementary interdependencies across brain networks of various spatial scales. These changes not only resulted in localised increases in the redundancy among brain network interactions but also more significant and widespread increases in synergy, especially within the delta frequency band. Conclusions: Our findings suggest that natural nootropics can improve overall brain network cohesion and energetic efficiency, computationally demonstrating the beneficial effects of natural nootropics on brain health. However, these effects could not be related to enhanced rapid perceptual decision-making performance in a healthy adult sample. Future research investigating these specific compounds as cognitive enhancers in healthy populations should focus on complex cognition in deliberative tasks (e.g., creativity, learning) and over longer supplementation durations. Clinical trials registration number: NCT06689644. Full article

This study evaluates the influence of conventional versus simplified drilling protocols on bone remodeling after the osteointegration period, marginal bone loss (MBL), and primary implant stability. A randomized, double-blind clinical trial was conducted involving 44 implants in 37 patients over a two-year period. The primary outcome was peri-implant tissue stability, measured as MBL at baseline, 12 months, and 24 months. Secondary outcomes included implant stability, measured via insertion torque, and survival rates. The results indicated no significant differences in initial bone remodeling and MBL between groups after 24 months. Both protocols demonstrated high survival rates, with one implant failure recorded in the simplified protocol group. Although simplified drilling protocols may reduce surgical complexity, concerns about heat generation and reduced adaptability in osteotomy were described in the literature. This study concludes that drilling protocol choice does not significantly impact bone levels during osteointegration, crestal bone maintenance, or implant survival over 24 months, but further research is needed to explore long-term effects and prosthetic factors. Full article

Poor sleep quality is associated with unhealthy dietary choices and worse body composition among night-shift workers and women during the climacteric period. This study aimed to evaluate the effect of exogenous melatonin administration on the dietary intake and body composition in healthcare workers exposed to fixed-shift work during the climacteric period. A phase II randomized, double-blind, placebo-controlled clinical trial of climacteric women working fixed morning, afternoon, or night shifts was conducted. Baseline data collection included sociodemographic information, sleep parameters, dietary intake, and body composition using bioelectrical impedance. Participants received either 0.3 mg of melatonin or a placebo for three months. Baseline total caloric and carbohydrate intake was higher among night-shift workers than afternoon-shift workers, though afternoon-shift workers a had higher body weight and fat percentage. Post-intervention, caloric intake differences dissipated due to reduced intake among night-shift workers and increased intake among afternoon-shift workers, independent of melatonin or placebo administration. However, differences in body composition persisted. Postmenopausal participants showed reduced fat mass, while premenopausal participants experienced an increase, regardless of intervention. The results suggest that physiological nighttime melatonin doses, administered on non-consecutive nights for three months, were ineffective for changing dietary intake or body composition. Full article

Cooperative MIMO communication systems play an important role in the development of future sixth-generation (6G) wireless systems incorporating new technologies such as massive MIMO relay systems, dual-polarized antenna arrays, millimeter-wave communications, and, more recently, communications assisted using intelligent reflecting surfaces (IRSs), and unmanned aerial vehicles (UAVs). In a companion paper, we provided an overview of cooperative communication systems from a tensor modeling perspective. The objective of the present paper is to provide a comprehensive tutorial on semi-blind receivers for MIMO one-way two-hop relay systems, allowing the joint estimation of transmitted symbols and individual communication channels with only a few pilot symbols. After a reminder of some tensor prerequisites, we present an overview of tensor models, with a detailed, unified, and original description of two classes of tensor decomposition frequently used in the design of relay systems, namely nested CPD/PARAFAC and nested Tucker decomposition (TD). Some new variants of nested models are introduced. Uniqueness and identifiability conditions, depending on the algorithm used to estimate the parameters of these models, are established. Two families of algorithms are presented: iterative algorithms based on alternating least squares (ALS) and closed-form solutions using Khatri–Rao and Kronecker factorization methods, which consist of SVD-based rank-one matrix or tensor approximations. In a second part of the paper, the overview of cooperative communication systems is completed before presenting several two-hop relay systems using different codings and configurations in terms of relaying protocol (AF/DF) and channel modeling. The aim of this presentation is firstly to show how these choices lead to different nested tensor models for the signals received at destination. Then, by capitalizing on these models and their correspondence with the generic models studied in the first part, we derive semi-blind receivers to jointly estimate the transmitted symbols and the individual communication channels for each relay system considered. In a third part, extensive Monte Carlo simulation results are presented to compare the performance of relay systems and associated semi-blind receivers in terms of the symbol error rate (SER) and channel estimate normalized mean-square error (NMSE). Their computation time is also compared. Finally, some perspectives are drawn for future research work. Full article

Well-annotated gene and genomic sequences serve as a foundation for making inferences in molecular biology and evolution and can directly impact public health. The first SARS-CoV-2 genome was submitted to the GenBank database hosted by the U.S. National Center for Biotechnology Information and used to develop the two successful vaccines. Conserved protein domains are often chosen as targets for developing antiviral medicines or vaccines. Mutation and substitution patterns provide crucial information not only on functional motifs and genome/protein interactions but also for characterizing phylogenetic relationships among viral strains. These patterns, together with the collection time of viral samples, serve as the basis for addressing the question of when and where the host-switching event occurred. Unfortunately, viral genomic sequences submitted to GenBank undergo little quality control, and critical information in the annotation is frequently changed without being recorded. Researchers often have no choice but to hold blind faith in the authenticity of the sequences. There have been reports of incorrect genome annotation but no report that casts doubt on the genomic sequences themselves because it seems theoretically impossible to identify genomic sequences that may not be authentic. This paper takes an innovative approach to show that some SARS-CoV-2 genomes submitted to GenBank cannot possibly be authentic. Specifically, some SARS-CoV-2 genomic sequences deposited in GenBank with collection times in 2023 and 2024, isolated from saliva, nasopharyngeal, sewage, and stool, are identical to the reference genome of SARS-CoV-2 (NC_045512). The probability of such occurrence is effectively 0. I also compile SARS-CoV-2 genomes with changed sample collection times. One may be led astray in bioinformatic analysis without being aware of errors in sequences and sequence annotation. Full article

Background: Carpal Tunnel Syndrome (CTS) is a common condition characterized by compression of the median nerve, leading to pain, numbness, and hand dysfunction. Both manual therapy and surgical decompression are widely used interventions, but their comparative effectiveness remains uncertain. Methods: A systematic review and a meta-analysis were conducted to compare the short- and long-term efficacy of manual therapy versus surgery for CTS. Studies were selected based on randomized controlled trials (RCTs) that met the inclusion criteria, focusing on outcomes such as pain intensity, hand function, symptom severity, and quality of life. Data were extracted and analyzed by using standardized tools to assess treatment effects. Results: Five RCTs with a total of 533 participants were included. Manual therapy was more effective for short-term pain relief, with significant improvements at 1 and 3 months compared with surgery. However, at 6 to 12 months, surgical intervention provided greater improvements in hand function and symptom severity. Quality-of-life improvements were similar in both groups. Risk of bias was moderate to low across the studies, with limitations in blinding due to the nature of the interventions. Conclusions: Manual therapy offers effective short-term relief for CTS, making it a viable option for patients with mild to moderate symptoms. Surgery provides more durable, long-term outcomes, particularly for severe cases. The choice of treatment should be individualized, considering patient preferences and symptom severity. Full article

Giant cell arteritis (GCA) is a rare disease of the arteries, occurring mainly in the elderly. Although the involvement of temporal arteries can be mostly symptomatic, the occlusion of ophthalmic arteries has severe consequences. GCA affecting temporal arteries is an emergency requiring quick commencement of treatment with glucocorticoids due to the serious consequences of neglect—blindness. According to the new guidelines released by EULAR, ultrasound is the tool of choice in support of the clinical diagnosis of giant cell arteritis, replacing temporal artery biopsy (TAB), as it is a sensitive and non-invasive method that is widely available. The main limitation is that the reliability of this imaging is based on the technical expertise of ultrasonographers. However, performing imaging should not delay commencing the treatment. In this work, we present ultrasound images from a case report of a 74-year-old female patient where difficulties in establishing a diagnosis led to vision loss in both eyes. In this example, we describe the ultrasound findings in giant cell arteritis, emphasizing its usefulness in supporting a diagnosis of GCA. Full article

Phaeodactylum tricornutum (PT) is a microalgae extract that contains fucoxanthin and has been shown to enhance cognitive function in younger populations. The present study assessed if PT supplementation affects cognition in healthy, young-old, physically active adults with self-perceptions of cognitive and memory decline. Methods: Forty-three males and females (64.3 ± 6.0 years, 79.8 ± 16.0 kg, 27.0 ± 4.0 kg/m²) with perceptions of cognitive and memory decline completed the double-blind, randomized, parallel-arm, placebo-controlled intervention clinical trial. Participants were counterbalanced by sex and BMI and randomly allocated to their respective 12-week supplementation interventions, which were either the placebo (PL) or 1100 mg/day of PT containing 8.8 mg of fucoxanthin (FX). Fasting blood samples were collected, and cognitive assessments were performed during the testing session at 0, 4, and 12 weeks of intervention. The data were analyzed by multivariate and univariate general linear model (GLM) analyses with repeated measures, pairwise comparisons, and mean changes from baseline analysis with 95% confidence intervals (CIs) to assess the clinical significance of the findings. Results: FX supplementation significantly affected (p < 0.05) or exhibited tendencies toward significance (p > 0.05 to p < 0.10 with effect sizes ranging from medium to large) for word recall, picture recognition reaction time, Stroop color–word test, choice reaction time, and digit vigilance test variables. Additionally, FX supplementation promoted a more consistent clinical improvement from baseline values when examining mean changes with 95% CIs, although most differences were seen over time rather than between groups. Conclusions: The results demonstrate some evidence that FX supplementation can improve working and secondary memory, vigilance, attention, accuracy, and executive function. There was also evidence that FX promoted more positive effects on insulin sensitivity and perceptions about sleep quality with no negative effects on clinical blood panels or perceived side effects. Additional research should investigate how FX may affect cognition in individuals perceiving memory and cognitive decline. Registered clinical trial #NCT05759910. Full article