Search Results (424)

Background/Objectives: Artificial intelligence (AI) is rapidly emerging as a transformative force in healthcare education, including orthodontics. This systematic review and meta-analysis aimed to evaluate the integration of AI into orthodontic training programs, focusing on its effectiveness in improving diagnostic accuracy, learner engagement, and the perceived quality of AI-generated educational content. Materials and Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Embase through May 2025. Eligible studies involved AI-assisted educational interventions in orthodontics. A mixed-methods approach was applied, combining meta-analysis and narrative synthesis based on data availability and consistency. Results: Seven studies involving 1101 participants—including orthodontic students, clinicians, faculty, and program directors—were included. AI tools ranged from cephalometric landmarking platforms to ChatGPT-based learning modules. A fixed-effects meta-analysis using two studies yielded a pooled Global Quality Scale (GQS) score of 3.69 (95% CI: 3.58–3.80), indicating moderate perceived quality of AI-generated content (I² = 64.5%). Due to methodological heterogeneity and limited statistical reporting in most studies, a narrative synthesis was used to summarize additional outcomes. AI tools enhanced diagnostic skills, learner autonomy, and perceived satisfaction, particularly among students and junior faculty. However, barriers such as limited curricular integration, lack of training, and faculty skepticism were recurrent. Conclusions: AI technologies, especially ChatGPT and digital cephalometry tools, show promise in orthodontic education. While learners demonstrate high acceptance, full integration is hindered by institutional and perceptual challenges. Strategic curricular reforms and targeted faculty development are needed to optimize AI adoption in clinical training. Full article

Background/Objectives: The objective of this study was to validate a new parent-reported scale for tracking Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). PANS is a condition characterized by a sudden and severe onset of neuropsychiatric symptoms. To meet diagnostic criteria, an individual must present with either obsessive–compulsive disorder (OCD) or severely restricted food intake, accompanied by at least two additional cognitive, behavioral, or emotional symptoms. These may include anxiety, emotional instability, depression, irritability, aggression, oppositional behaviors, developmental or behavioral regression, a decline in academic skills such as handwriting or math, sensory abnormalities, frequent urination, and enuresis. The onset of symptoms is usually triggered by an infection or an abnormal immune/inflammatory response. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a subtype of PANS specifically linked to strep infections. Methods: We developed a 101-item PANS/PANDAS and Related Inflammatory Brain Disorders Treatment Evaluation Checklist (PTEC) designed to assess changes to a patient’s symptoms over time along 10 subscales: Behavior/Mood, OCD, Anxiety, Food intake, Tics, Cognitive/Developmental, Sensory, Other, Sleep, and Health. The psychometric quality of PTEC was tested with 225 participants. Results: The internal reliability of the PTEC was excellent (Cronbach’s alpha = 0.96). PTEC exhibited adequate test–retest reliability (r = 0.6) and excellent construct validity, supported by a strong correlation with the Health subscale of the Autism Treatment Evaluation Checklist (r = 0.8). Conclusions: We hope that PTEC will assist parents and clinicians in the monitoring and treatment of PANS. The PTEC questionnaire is freely available at neuroimmune.org/PTEC. Full article

Numerical weather prediction of warm season rainfall remains challenging and skill at achieving this is often much lower than during the cold season. Prior studies have shown that displacement errors play a large role in the poor skill of these forecasts, but less is known about how such errors compare to other sources of error, particularly within forecasts from convection-allowing ensembles. The present study uses the Method for Object-based Diagnostic Evaluation to develop a climatology of errors for precipitation objects from High-Resolution Ensemble Forecasting forecasts for mesoscale convective systems during the warm seasons from 2018 to 2023 in the United States. It is found that displacement errors in all ensemble members are generally not systematic, and on average are between 100 and 150 km. Errors are somewhat smaller in September, possibly reflecting increased forcing from synoptic-scale systems. Although most ensemble members have a negative error for the 10th percentile of rainfall intensity, the error becomes positive for heavier amounts. However, the total system rainfall is less than that observed for all members except the 12 UTC NAM. This is likely due to the negative errors for area that are present in all models, except again in the 12 UTC NAM. Full article

Background/Objectives: In Germany, the provision of healthcare for post-COVID patients primarily lies with general practitioners (GPs), who often lack the necessary knowledge and skills. As part of the PostCovidCare pilot study (PCC), case management software incorporating a symptom diary was introduced and piloted in n = 10 GP practices with n = 33 included patients involved (September 2022–March 2023). This study aimed to explore patients’ experiences. Methods: Semi-structured telephone interviews were transcribed and analyzed using qualitative content analysis. A total of n = 10 patient interviews were conducted (July–September 2023). Results: Patients’ experiences were heterogeneous. The service was largely structured, involving an extensive initial assessment, follow-up appointments, questionnaires, and support from medical assistants, but technical problems with the symptom diary occurred. The GP consultation played a prominent role. Positive aspects included being actively asked about their symptoms, being given a lot of time, initiating diagnostic and therapeutic measures, and having a closer relationship with their GP. Negative aspects included the time taken, resulting exhaustion, duplication of efforts, and insufficient involvement in the consultation process. Conclusions: The pilot study conducted at an early stage of the post-COVID era demonstrated the basic feasibility of case management in primary care from patients’ perspectives. In addition, for future projects, it is important to integrate patients into the design from the outset, adapt the software to users’ needs, and consider care providers’ perspectives. Full article

Background: The prevalence of mental health problems among young adults has increased exponentially worldwide, with significant implications for public health. This study explores the structural and intermediate social determinants of health associated with emotional well-being and distress in Colombian young adults. Methods: A cross-sectional study was conducted with 1232 university students aged 18–28 years residing in Cali, Colombia. The Social Determinants of Mental Health Questionnaire for Young Adults (SDMH) was administered to assess structural and intermediate determinants. Participants were categorized into two groups: those with mental health diagnoses (n = 252) and those without (n = 980). Descriptive, comparative association and predictive analyses were conducted. Results: Significant differences were found between groups, with diagnosed participants showing higher exposure to violence and suicidal ideation. Women with diagnoses predominantly presented anxiety and depression, while men showed more externalizing symptoms. Violence experiences emerged as the strongest predictors of emotional distress in both groups. Psychosocial life skills and perceived social support were the most robust protective factors for emotional well-being, regardless of diagnostic status. Conclusions: This study reveals that multiple risk factors accumulate rather than single extreme factors characterizing mental health vulnerability. Violence prevention, life skills development, and social support enhancement should be prioritized in public health interventions for young adults. The findings emphasize the need for multisectoral approaches addressing social determinants to promote youth mental health. Full article

Objectives: The primary objective of this study was to determine whether motor disorders are significantly more prevalent in children with Autism Spectrum Disorder (ASD) without co-occurring genetic or neurological conditions compared to neurotypical children. Another aim was to explore the applicability of the MABC-2 test for assessing motor skills in a Polish cohort of children with ASD. Additionally, this study sought to develop a basic framework for motor skill assessment in children with autism. Methods: This study included 166 Caucasian children, both sexes, aged 5–12 years, without intellectual disability (IQ ≥ 70), without concomitant genetic or neurological disorders, particularly epilepsy or cerebral palsy. The study group consisted of children with ASD (n = 71), and the control group consisted of neurotypical children (n = 95). The participants were assessed with the Movement Assessment Battery for Children–second edition (MABC-2), MABC-2 checklist and the Developmental Coordination Disorder Questionnaire (DCDQ), used as a reference point. Results: The children with ASD obtained significantly lower MABC-2 test results in all subtests in comparison with the control group. The children with suspected or diagnosed coordination disorders were characterized by a significantly greater number of co-occurring non-motor factors than the other participants of this study. MABC-2 test showed greater consistency with DCDQ than with the MABC-2 questionnaire. Conclusions: Children with ASD present a lower level of manual dexterity and balance and greater difficulties in performing tasks, including throwing and catching, in comparison with neurotypical children. The MABC-2 test with the MABC-2 checklist and DCDQ questionnaire constitute a complementary diagnostic tool. Full article

Background: The effective use of electronic health records (EHRs) is an essential clinical skill, but medical schools have traditionally provided limited systematic teaching on the topic. Inefficient use of EHRs results in delays in diagnosis, fragmented care, and clinician burnout. This study investigates the impact on medical students’ confidence, efficiency, and proficiency in extracting clinically pertinent information from patient records following an organised EHR teaching programme. Methods: This observational cohort involved 60 final-year medical students from three London medical schools. Participants received a structured three-phase intervention involving an introductory workshop, case-based hands-on practice, and guided reflection on EHR navigation habits. Pre- and post-intervention testing involved mixed-method surveys, simulated case tasks, and faculty-assessed data retrieval exercises to measure changes in students’ confidence, efficiency, and ability to synthesise patient information. Quantitative data were analysed using paired t-tests, while qualitative reflections were theme-analysed to identify shifts in clinical reasoning. Results: All 60 students successfully finished the intervention and assessments. Pre-intervention, only 28% students reported feeling confident in using EHRs effectively, with a confidence rating of 3.0. Post-intervention, 87% reported confidence with a rating of 4.5 (p < 0.01). Efficiency in the recovery of critical patient information improved from 3.2 to 4.6 (p < 0.01). Students also demonstrated enhanced awareness regarding system-related issues, such as information overload and fragmented documentation, and provided recommendations on enhancing data synthesis for clinical decision making. Conclusions: This study emphasises the value of structured EHR instruction in enhancing the confidence and proficiency of medical students in using electronic records. The integration of structured EHR education to medical curricula can better prepare future physicians in managing information overload, improve diagnostic accuracy, and enhance the quality of patient care. Future research should explore the long-term impact of structured EHR training on clinical performance, diagnostic accuracy, and patient outcomes during real-world clinical placements and postgraduate training. Full article

Thoracic injuries account for a high percentage of combat casualty mortalities, with 80% of preventable deaths resulting from abdominal or thoracic hemorrhage. An effective method for detecting and triaging thoracic injuries is point-of-care ultrasound (POCUS), as it is a cheap and portable noninvasive imaging method. POCUS image interpretation of pneumothorax (PTX) or hemothorax (HTX) injuries requires a skilled radiologist, which will likely not be available in austere situations where injury detection and triage are most critical. With the recent growth in artificial intelligence (AI) for healthcare, the hypothesis for this study is that deep learning (DL) models for classifying images as showing HTX or PTX injury, or being negative for injury can be developed for lowering the skill threshold for POCUS diagnostics on the future battlefield. Three-class deep learning classification AI models were developed using a motion-mode ultrasound dataset captured in animal study experiments from more than 25 swine subjects. Cluster analysis was used to define the “population” based on brightness, contrast, and kurtosis properties. A MobileNetV3 DL model architecture was tuned across a variety of hyperparameters, with the results ultimately being evaluated using images captured in real-time. Different hyperparameter configurations were blind-tested, resulting in models trained on filtered data having a real-time accuracy from 89 to 96%, as opposed to 78–95% when trained without filtering and optimization. The best model achieved a blind accuracy of 85% when inferencing on data collected in real-time, surpassing previous YOLOv8 models by 17%. AI models can be developed that are suitable for high performance in real-time for thoracic injury determination and are suitable for potentially addressing challenges with responding to emergency casualty situations and reducing the skill threshold for using and interpreting POCUS. Full article

Accurate, rapid and inexpensive diagnosis of poultry respiratory pathogens remains a challenge, especially in many developing countries. Meanwhile, poultry respiratory pathogens are a major threat to poultry production worldwide, accounting for billions of dollars in economic loss to the sector. Early and accurate diagnosis of these diseases is critical for economic poultry production. Molecular diagnostic methods, including PCR-based techniques, have been developed and used to fill this gap, but unfortunately, these techniques require skilled technicians, relatively costly equipment and reagents and can only be performed in a laboratory setting. This warrants the development of other diagnostic tools, which can be used in the field even by unskilled personnel. In this review, we discussed the genesis, challenges, advances and prospects of loop-mediated isothermal amplification (LAMP) for the detection of poultry respiratory pathogens at the flock side, especially in resource-constrained countries. We highlighted the application of LAMP in routine poultry disease surveillance and early outbreak detection, underscoring its value as a transformative diagnostic tool in poultry production. The development and use of a point-of-care (POC) LAMP assay that can be used to screen for these poultry respiratory pathogens simultaneously enhance disease surveillance and diagnosis. Full article

Background/Objectives: This study evaluates the diagnostic and referral skills of final-year dental students at Al-Iraqia University using a questionnaire based on malocclusion cases ranging from mild to severe. Methods: The questionnaire, featuring photos and radiographs of five selected treated cases from two textbooks, was answered by 165 students who were asked to assess each case and determine whether orthodontic or surgical treatment was necessary, as well as to identify factors contributing to an unesthetic profile, such as irregular teeth. Frequency distribution and the Chi-square test were used for statistical analysis. Results: The results indicated good overall clinical competence. The unesthetic profile and irregular teeth were the main reasons for referring both Class II and III cases for surgery, with mandibular retrusion being the most common factor in aesthetic concerns. Maxillary protrusion was less frequently selected as a key factor in Class II malocclusion cases. Conclusions: The findings suggest that students demonstrated a high level of diagnostic accuracy in identifying treatment needs for various malocclusion cases. Full article

Background: Physical activity (PA) has been shown to prevent Alzheimer’s disease (AD) by reducing amyloid accumulation, lowering inflammatory factors, and increasing hippocampal grey matter. While high lifetime PA engagement is associated with a reduced risk of AD, the relationship between specific types of PA and early-stage AD remains unclear. As AD primarily affects cognitive function before physical capabilities, PA engagement—an important factor in PA—needs further investigation. Objectives: This study explores the potential association between current participation in open-skill sports (OSSs) versus closed-skill sports (CSSs) and early-stage AD. Methods: The sample (N = 128) included a cognitively healthy (HC, n = 78) group and an Alzheimer’s disease (AD) group, combining amnestic mild cognitive impairment due to AD patients (n = 22) and early-stage Alzheimer’s dementia patients (n = 28), reflecting the continuum of progression from aMCI to dAD (n = 50). PA was assessed with the Physical Activity Scale for the Elderly questionnaire, specifically focusing on PA within the last seven days. The statistical analyses included Mann–Whitney U tests and backwards stepwise logistic regression models. Results: Key predictors of group classification (AD vs. NC) included sex, high frequency of PA, and high duration of PA, each for the last seven days. Participation in OSS was significantly associated with medium PA frequency, high PA duration, both within the last seven days, and age, but not with diagnostic status. No statistically significant differences in PA levels (OSSs or CSSs) executed within the last seven days were observed between the AD and HC groups. Conclusions: Participation in OSSs or CSSs within the last seven days was only a marginally significant predictor of AD vs. HC status, and a diagnosis of AD was not predictive of OSS participation within the last seven days. Given the protective role of PA in AD, future research should aim to identify specific PA types that effectively support cognitive health in older adults with early cognitive decline. Full article

Background/Objectives: Canadian guidelines for diagnosing fetal alcohol spectrum disorder (FASD) strongly recommend using direct measures to assess brain domains whenever possible. Executive functioning, one of the brain domains assessed, can be measured using direct and indirect measures; however, research has found discrepancies between these two forms of assessment and has not examined this relationship using ratings from the newest version of one of the most commonly used indirect measure of executive functioning, the second version of the Behavior Rating Inventory of Executive Functioning (BRIEF2). Academic achievement may also help explain discrepancies between these forms of assessment, especially in indirect executive functioning skills at school, because many of the items on the BRIEF2 Teacher Form are related to school skills. This study aimed to examine the relationship between direct measures of executive functioning, indirect measures of executive functioning, and academic achievement. Methods: Charts of 74 children who completed an FASD diagnostic assessment in Canada were included in this study (61% males; 58% with FASD; M_age = 11.77). Direct and indirect measures of executive functioning across settings and academic achievement were assessed. Results: Few correlations between corresponding BRIEF2 and direct measures of executive functioning were significantly associated. There were several significant correlations between academic achievement and (a) educator ratings on the BRIEF2 and (b) direct measures of executive functioning. None of the caregiver ratings on the BRIEF2 were significantly associated with academic achievement. Conclusions: The results suggest that academic performance is related to BRIEF2 ratings of executive functioning skills at school and direct measures of executive functioning. Aside from a few exceptions, direct and indirect measures of the same executive functioning skill were not correlated. Full article

Background: Prostate-specific membrane antigen (PSMA)-PET imaging has significantly improved prostate cancer (PCa) staging, yet its interpretation remains challenging, even for experienced specialists. No prior study has assessed urologists’ ability to interpret PSMA-PET. Methods: We conducted a multicenter prospective study involving 63 urologists from eight Italian institutions. Participants evaluated 20 PSMA-PET scans of high-risk PCa cases, with no clinical information provided. Proficiency was defined as correctly identifying at least two of three staging components (T, N, M) in ≥75% of cases. Associations between performance and factors such as hierarchy (resident vs. consultant), institution type, surgical volume, and multidisciplinary team (MDT) presence were analyzed using univariable and multivariable logistic regression. Results: Only one participant achieved full staging proficiency, while 44% reached the ≥75% threshold for partial (almost correct) staging. Urologists from centers with ≥300 PCa diagnoses per year demonstrated better T and M stage identification. Institutions with ≥150 robot-assisted radical prostatectomies (RARPs) per year and those with MDTs showed higher accuracy in M staging. No significant predictors of proficiency emerged in the multivariable analysis, although hierarchy and surgical volume approached significance for nodal metastasis detection. Conclusion: PSMA-PET interpretation is complex for urologists, with particular challenges in T and M staging. High institutional case volumes and MDT involvement may enhance interpretation skills. Structured training programs and increased exposure to multidisciplinary imaging discussions are essential to optimize urologists’ diagnostic proficiency and ultimately improve patient care. Full article

Headache represents one of the most prevalent and disabling conditions in the pediatric population, with significant repercussions on mental and psychological well-being, as well as on academic achievement and social functioning, ultimately leading to a marked reduction in quality of life. Currently, the diagnosis of headache is based on the clinical criteria of the third edition of the International Classification of Headache Disorders (ICHD-3). However, the characteristics of headache may differ between adults and children, as well as the ability of children to provide a complete description of the pain and associated symptoms. The immature narrative skills of children can represent a limitation in defining the clinical phenotype of headache, making the diagnosis more complex. This is even more challenging when extracting information about the characteristics of the headache in children whose verbal expression is poorly developed or completely absent. Given these limitations, clinical psychology has long used drawing as an effective diagnostic instrument to bypass verbal communication barriers. This tool provides unique access to children’s psychological and emotional states, as a direct window into their inner world and as an expressive medium that often generates more detailed, accurate, and clinically actionable information, compared to verbal reports alone. For these reasons, drawing has been recognized as a valuable diagnostic tool for decades, with multiple studies demonstrating specificity and accuracy rates comparable to standard clinical assessments. Particularly for young children, drawings may give access to fundamental information that might otherwise remain inaccessible, thereby allowing both accurate diagnosis and individualized treatment planning. Multiple studies have highlighted and confirmed the graphic differences between representations of various types of headaches and the undeniable utility of an “artistic diagnosis” alongside the clinical one. Furthermore, the literature suggests and encourages the use of drawing in clinical practice, both in the diagnostic process and during subsequent follow-up, as an effective, enjoyable, easy-to-use, and low-cost resource. Accordingly, we propose a narrative review accompanied by a curated collection of drawings that may help identify and categorize specific correlations between graphic representations and clinical phenotypes, such as pain location, quality, intensity, association with nausea and vomiting, photophobia and phonophobia, and types of migraine aura. Our goal is to create a visual reference that can aid clinicians in the accurate interpretation of children’s drawings. Additionally, we aim to promote the integration of this method into routine clinical practice to improve diagnostic precision and support a more child-centered model of care. We also hope to propose new iconographic models to further enrich the diagnostic framework. Full article

The electrocardiogram (ECG) remains a cornerstone of modern cardiology, providing rapid, non-invasive, and widely accessible diagnostic insights. While ECG interpretation is an essential skill for clinicians, certain patterns can be subtle or atypical, posing diagnostic challenges. In our previous review (doi.org/10.3390/jpm12111754), we explored several uncommon ECG syndromes with significant clinical implications. However, the spectrum of electrocardiographic abnormalities extends far beyond those initially discussed. In this second installment, we expand our discussion of rare and underrecognized ECG syndromes, including Long QT, Jervell and Lange-Nielsen, Romano–Ward, Andersen–Tawil, Timothy, Short QT, and Twiddler’s syndromes, as well as Noonan, Barlow’s, Bundgaard, BRASH, Carvajal, Naxos, and Danon disease. We highlight their clinical context, characteristic findings, and implications for diagnosis and management. These conditions range from acute, life-threatening emergencies requiring immediate intervention to chronic electrical disorders necessitating long-term monitoring and risk stratification. By broadening our focus, we aim to enhance awareness and recognition of these entities, ultimately improving patient outcomes through timely and accurate diagnosis. Full article