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The quality of the digital cast obtained from an intraoral scanner is an important comparison parameter for computer-aided design and computer-aided manufacturing (CAD-CAM) restorations. However, data on cast quality are typically provided by manufacturers, and objective evaluation of these devices is lacking.The purpose of this in vitro study was to build an evaluation protocol of 8 intraoral scanners by using an objective method for a small-scale model equivalent in size to a 4-tooth wide cast. In addition, a laboratory scanner was included to compare the performance of intraoral and extraoral devices.An 8-mm-thick zirconia gauge block was scanned 10 times with a laboratory scanner (Iscan D104) and 8 intraoral scanners (Omnicam, Primescan, Itero element 5D, CS 3600, TRIOS 3, Emerald, Planscan, and Medit i500). The obtained digital casts were extracted as standard tessellation language (STL) files and analyzed to evaluate the digitizing noise, dimensional trueness, and dimensional precision of each scanner. After validation of the normal distribution of the digitizing noise, dimensional trueness, and precision test results for each scanner with the Shapiro-Wilk test (α=.05), differences were determined with a 1-way ANOVA test.Statistical differences were found between scanners (P.05). The digitizing noise ranged from 3.2 ±0.6 μm with the Primescan to 15.5 ±2.5 μm with the Planscan. The dimensional trueness ranged from 19.1 ±11.5 μm for the CS3600 to 243.8 ±33.6 μm for the Planscan. The dimensional precision ranged from 7.7 ±2.4 μm for the Primescan to 53.7 ±3.4 μm for the Emerald. The group Iscan D104, Primescan, Itero 5D, CS3600, and TRIOS 3 showed minimally significant differences.Significant differences were found among the intraoral scanners for small-scale scans. The objective methodology of using a gauge block provided coherent and repeatable results.

BACKGROUND More than 20 million inguinal hernia repair (IHR) procedures are performed worldwide every year. The critical view of the myopectineal orifice (CV of the MPO) is a stepwise guide to the achievement and standardization of minimally invasive IHR (MI IHR). We propose a scoring system as an objective method for fulfillment of the CV of the MPO. METHODS The scoring system was employed for evaluation of the transabdominal preperitoneal (TAPP) technique in 15 video-recorded procedures. Two variants of the score were used: the simple CV of the MPO score (s-CVMPO score) and the extended CV of the MPO score (e-CVMPO score). The inter-rater agreement and internal consistency for both scores and the correlation between the two scores were assessed. RESULTS Inter-rater agreement with respect to satisfactory/unsatisfactory achievement of the CV of the MPO was high for both the s-CVMPO and e-CVMPO scores (κ = 1, p

Testicular torsion is a severe variant of postnatal gonad pathology in children. The speed of development of irreversible ischemic disorders determines not only the medical, but also the social significance of the problem and determines the need for accurate and rapid diagnosis and prompt provision of adequate care to the patient. The only objective method for diagnosing testicular torsion in children is ultrasound. At the same time, the characteristics of the child’s body: the small size of the object of study, low rates of intratesticular blood flow and restless behavior during the study sharply reduce the diagnostic value of the Doppler study or make it technically impossible. Thus, seroshkal ultrasound is the first stage of diagnosis of this complex emergency pathology, based on the results of which it is possible to diagnose testicular torsion with great accuracy. The publication summarizes our own experience of 110 echographic observations of postnatal testicular torsion in children older than 2 months, all cases were verified intraoperatively. A quantitative method for estimating the deformity of a twisted testicle is proposed and its statistical reliability is proved. The options presented for gray-scale changes in the structure of damaged gonads and determined their prognostic significance. The publication contains a review of the literature and is extensively illustrated.

Cloud computing is a rapidly evolving computational technology. It is a distributed computational system that offers dynamically scaled computational resources, such as processing power, storage, and applications, delivered as a service through the Internet. Virtual machines (VMs) allocation is known as one of the most significant problems in cloud computing. It aims to find a suitable location for VMs on physical machines (PMs) to attain predefined aims. So, the main purpose is to reduce energy consumption and improve resource utilization. Because the VM allocation issue is NP‐hard, meta‐heuristic and heuristic methods are frequently utilized to address it. This paper presents an energy‐aware VM allocation method using the improved grey wolf optimization (IGWO) algorithm. Our key goals are to decrease both energy consumption and allocation time. The simulation outcomes from the MATLAB simulator approve the excellence of the algorithm compared to previous works.

Objective To investigate the prevalence of compensatory hyperhidrosis following videothoracic sympathectomy to treat palmoplantar hyperhidrosis and its effect on sweating in the chest, abdomen, back and thighs. Furthermore, to evaluate the concordance between a subjective and an objective method of assessment for compensatory hyperhidrosis. Methods Forty patients with combined palmar and plantar hyperhidrosis who underwent video-assisted thoracoscopic sympathectomy (15 women and 25 men, with a mean age of 25 years) were prospectively followed for 1 year. Subjective and objective parameters were evaluated, using respectively a questionnaire and a sudorometer (Vapometer). Results In the subjective analysis, in the first month, only 10% of patients did not have compensatory hyperhidrosis, and 70% continued to report it at 1 or more sites after 1 year. In the objective analysis, 35% of the patients did not present compensatory hyperhidrosis after 1 month, and this number persisted stable, with 30% of patients remaining free of compensatory hyperhidrosis after 1 year. The most frequent area affected by compensatory hyperhidrosis was the back in both assessments. There was no positive concordance between the results of the objective and subjective analysis at any time in any of the 4 regions studied. Conclusions Compensatory hyperhidrosis is a very common postoperative side effect after videothoracic sympathectomy, occurring early after the procedure and persisting for prolonged periods of time. The most frequently affected body area is the back, and no concordance between objective and subjective assessments was observed.

Study Design: Retrospective case series.Purpose: This study aimed to examine the efficacy of composite grip strength as a marker of surgical outcome in patients with moderate to severe degenerative cervical myelopathy.Overview of Literature: Degenerative cervical myelopathy causes loss of dexterity, muscle strength, and sensations in the hand. The impact of surgical management on improvement in composite grip strength has received scant attention.Methods: This retrospective study was performed on degenerative cervical myelopathy patients with a complete composite grip strength assessment between January 2013 to January 2019. The Biometrics E-link hand kit was used for the assessment. The following parameters were measured: maximum grip strength, sustained grip strength, three-jaw pinch, maximum key pinch, and sustained key pinch. The pre- and postoperative functional status was assessed using the Nurick grade and the modified Japanese Orthopaedic Association (mJOA) score.Results: A total of 40 patients were included in the study. The mean patient age was 51.9 years. The mean preoperative Nurick grade was 3.5 and the mJOA score was 10.9. The anterior approach was used in 25 patients, and the posterior approach was used in 15 patients. Four patients developed complications. Degenerative cervical myelopathy resulted in decreased handgrip and pinch strength as compared to normative Indian data. There was a significant improvement in the postoperative composite grip strength for all five parameters. There was no differential improvement between the anterior and posterior surgical groups. The improvement in the composite grip strength correlated with the improvement in functional scores.Conclusions: Composite grip strength analysis is an objective method for assessing the impact of degenerative cervical myelopathy on grip strength and monitoring the postoperative improvement. Decompressive surgery resulted in global improvement in all the parameters of composite grip strength.

The relevance of the problem of measuring shadow activity and its significance for the purposes of macroeconomic analysis and forecasting is emphasized. The importance of forming an adequate methodological base for measuring shadow activity and developing an information support system for its research is substantiated. The existing approaches to the definition of shadow activity and methods of its measurement are analyzed. The possibility of building an information base and obtaining appropriate estimates of shadow activity on the basis of resource and use tables developed at the national level is evaluated. The possibility of using the resource approach as the most objective method of reflecting the volume and components of shadow activity at the sectoral and macro levels is studied. The conditions for the use of the resource approach are determined, taking into account the specifics of the industry features of the formation of output and intermediate consumption indicators. The possibility of constructing dynamic series of indicators constructed using the resource approach for analytical purposes is evaluated.

Background To accurately diagnose and control heart failure (HF), it is important to carry out a simple assessment of elevated pulmonary arterial wedge pressure (PAWP). The aim of this study was to develop and validate an objective method for detecting elevated PAWP by applying deep learning (DL) to a chest x-ray (CXR). Methods We enrolled 1013 consecutive patients with a right-heart catheter between October 2009 and February 2020. We developed a convolutional neural network to identify patients with elevated PAWP (> 18 mm Hg) as the actual value of PAWP to be used in the dataset for training. In the prospective validation dataset used to detect elevated PAWP, the area under the receiver operating characteristic curve (AUC) was calculated using the DL model that evaluated the CXR. Results In the prospective validation dataset, the AUC of the DL model with CXR was not significantly different from the AUC produced by brain natriuretic peptide (BNP) and the echocardiographic left-ventricular diastolic dysfunction (DD) algorithm (DL model: 0.77 vs BNP: 0.77 vs DD algorithm: 0.70; respectively; P = NS for all comparisons); it was, however, significantly higher than the AUC of the cardiothoracic ratio (DL model vs cardiothoracic ratio [CTR]: 0.66, P = 0.044). The model based on 3 parameters (BNP, DD algorithm, and CTR) was improved by adding the DL model (AUC: from 0.80 to 0.86; P = 0.041). Conclusions Applying the DL model based on a CXR (a classical, universal, and low-cost test) is useful for screening for elevated PAWP.

Aims MRI has been suggested as an objective method of assessing anterior crucate ligament (ACL) graft “ligamentization” after reconstruction. It has been proposed that the MRI appearances could be used as an indicator of graft maturity and used as part of a return-to-sport assessment. The aim of this study was to evaluate the correlation between MRI graft signal and postoperative functional scores, anterior knee laxity, and patient age at operation. Methods A consecutive cohort of 149 patients who had undergone semitendinosus autograft ACL reconstruction, using femoral and tibial adjustable loop fixations, were evaluated retrospectively postoperatively at two years. All underwent MRI analysis of the ACL graft, performed using signal-to-noise quotient (SNQ) and the Howell score. Functional outcome scores (Lysholm, Tegner, International Knee Documentation Committee (IKDC) subjective, and IKDC objective) were obtained and all patients underwent instrumented side-to-side anterior laxity differential laxity testing. Results Two-year postoperative mean outcome scores were: Tegner 6.5 (2 to 10); Lysholm 89.8 (SD 10.4; 52 to 100); and IKDC subjective 86.8 (SD 11.8; 51 to 100). The objective IKDC score was 86% A (128 patients), 13% B (19 patients), and 1% C (two patients). Mean side-to-side anterior laxity difference (134 N force) was 0.6 mm (SD 1.8; -4.1 to 5.6). Mean graft SNQ was 2.0 (SD 3.5; -14 to 17). Graft Howell scores were I (61%, 91 patients), II (25%, 37 patients), III (13%, 19 patients), and IV (1%, two patients). There was no correlation between either Howell score or SNQ with instrumented anterior or Lysholm, Tegner, and IKDC scores, nor was any correlation found between patient age and ACL graft SNQ or Howell score. Conclusion The two-year postoperative MRI appearances of four-strand, semitendinosus ACL autografts (as measured by SNQ and Howell score) do not appear to have a relationship with postoperative functional scores, instrumented anterior laxity, or patient age at surgery. Other tools for analysis of graft maturity should be developed. Cite this article: Bone Jt Open 2021;2(8):569–575.

The vertebral heart scale (VHS) has long been used as an objective standard for evaluation of cardiac silhouette size on thoracic radiographs and plays a key role in the diagnosis as well as the assessment of the severity of canine heart disease. Based on our review of the literature, there has been no published study describing an objective method for measuring overall heart size using computed tomography (CT) in canine patients. The goals of this exploratory prospective method comparison study were to describe a method for objectively evaluating heart size on canine thoracic CT images, determine whether there was a correlation between the VHS when applied to a right lateral thoracic radiograph and a sagittal image of a thoracic CT scan, and determine the effect of cardiac phase on a VHS measured on CT. A method for measuring VHS on canine CT studies was defined. Data were collected on canine patients admitted to The Ohio State Veterinary Medical Center. Each patient received an ECG-gated thoracic CT immediately followed by a right lateral thoracic radiograph. The VHS was measured on non-gated, systolic, and diastolic sagittal CT reformatted images. Our results indicated that cardiac gating may not be necessary when assessing canine heart size on CT. When comparing the VHS on gated and non-gated CT to the VHS on radiographs, there was a moderate to high degree of correlation; however, there was a high degree of variability between CT and radiography.

Learning to use a surgical microscope is a fundamental step in otolaryngology training; however, there is currently no objective method to teach or assess this skill. Tympanostomy tube placement is a common otologic procedure that requires skilled use of a surgical microscope. This study was designed to (1) implement metrics capable of evaluating microscope use and (2) establish construct validity. This was a prospective cohort study. Eight otolaryngology trainees and three otolaryngology experts were asked to use a microscope to insert a tympanostomy tube into a cadaveric myringotomy in a standardized setting. Microscope movements were tracked in a three-dimensional space, and tracking metrics were applied to the data. The procedure was video-recorded and then analyzed by blinded experts using operational metrics. Results from both groups were compared, and discriminatory metrics were determined. The following tracking metrics were identified as discriminatory between the trainee and expert groups: total completion time, operation time, still time, and jitter (movement perturbation). Many operational metrics were found to be discriminatory between the two groups, including several positioning metrics, optical metrics, and procedural metrics. Performance metrics were implemented, and construct validity was established for a subset of the proposed metrics by discriminating between expert and novice participants. These discriminatory metrics could form the basis of an automated system for providing feedback to residents during training while using a myringotomy surgical simulator. Additionally, these metrics may be useful in guiding a standardized teaching and evaluation methodology for training in the use of surgical microscopes.

PURPOSE: To evaluate an automated method for detecting the cone shape characteristics and to assess the cornea specialists' subjective variability of these measures using different maps. METHODS: Topographic images of the anterior and posterior surface of each eye were presented to 12 clinicians in two different types of map: tangential curvature and relative elevation to the best-fit sphere. They were asked to mark the cone center and its boundaries in the two maps without knowing that they belonged to the same patient. The results between the maps were compared to assess the subjective variability dependent on the map type and the automated method was compared against both estimations to assess its accuracy. RESULTS: Considering the results of anterior and posterior surfaces, there was low agreement between the cone center estimations using different types of maps for 10 of the 12 cases ( P < .05), whereas the comparison between the automated method and the two map estimations did not show differences in 11 of the 12 cases ( P > .05). There was high variability, up to 55%, among clinicians' estimations of the cone area. The results of the automated method were within the range of the expert's estimations. CONCLUSIONS: An objective, mathematically derived method of determining morphological dimensions of the cone was consistent with clinicians' evaluations. Although there was high variability among the experts' subjective estimates, which were highly influenced by the type of map, the objective method provided a reliable evaluation of the keratoconus shape independent of maps or color scale. [ J Refract Surg . 2021;37(6):414–421.]

Aim of this study is to determine the potential and working vocal range in the results of objective and subjective voice range evaluation in elementary school girls – solo singers. Theoretical part contains review of other authors’ studies related to child’s voice range from 6 to 12 years. Practical part of the study offered making of the phonetogram by using Voice Range Profile software (CSL 4500, Kay Pentax, USA) as an objective method for voice range evaluation. For subjective voice analysis, a voice range evaluation in form of vocal exercises was performed. It is understood that the objective voice evaluation reflects the potential of girls’ voice range, while the subjective evaluation – current working voice range. Fourteen girls attending solo singing classes were part of this study (medium age: 9.14 years; SD: 1.79 years; age range: 6-12 years). Three study groups were formed: 6-8 year old girls (n = 5); 9-10 year old girls (n=5); 11-12 year old girls (n=4). In 6-8 year old girls, VRP was from sol# (204.31 Hz, SD: 26, 05) to do3 (1047.72, SD: 409.70), but in subjective voice range evaluation, it was from la (220.28 Hz, SD: 18.88) to fa2 (775.90 Hz, SD: 70.64). In the group from 9-10 year old girls VRP range was from fa (171.25 Hz, SD: 16.03) to re#3 (1224.47 Hz, SD: 156.12), but current working voice range was from sol (208.79 Hz, SD: 24.90) to sol#2 (842.20 Hz, SD: 132.80). In 11-12 years old girls objective VRP results were fa# (186.54 Hz, SD: 27.76) to re#3 (1277.61 Hz, SD: 80.09), while from sol (208.23 Hz, SD: 12.16) to si2 (933.46 Hz, SD: 175.22) the work range was. In discussion part findings by other authors are compared to the objective and subjective voice range data acquired in this study. It is concluded that potential child’s voice range in girls 6-12 years of age exceeds two octaves yet working range reaches up to two octaves.

Background . Giant cell tumor of bone (GCTB) is a common benign lesion accounting for 4–9.5 % of all primary bone tumors. Although surgery is considered the method of choice in the treatment of GCT, however, denosumab, a genetically engineered drug with a novel mechanism of action, has been recently used to treat GCTB. Histological examination of a surgical specimen is undoubtedly the most objective method for assessing the effectiveness of the treatment. However, in some cases it is necessary to assess the effectiveness of conservative therapy at the stages of its implementation. The purpose of the study was to compare CT-densitometry findings with histological findings in GCTB patients treated with denosumab. Material and Methods. The study included 30 patients aged from 28 to 59 years with histologically verified GCTB, who received targeted therapy with denosumab followed by surgery. The changes in tumor structure during denosumab therapy and surgical specimens of the tumor were assessed. Results. The relationship between the CT-densitometry findings and histopathological findings of surgical specimens was revealed in GCTB patients treated with denosumab. Conclusion. CT-densitometry findings were shown can be used to predict pathological response of the tumor to denosumab treatment.

Introduction: in today’s digital environment, dry eye complaints step forward in all age groups. Along with dry eye syndrome, the diagnosis of which is not complicated, there are other causes of dryness such as dysfunction of the tear film and Meibomian glands, etc. For the early detection of the above conditions, invasive diagnostic methods are mainly used.Aim: to compare Non-Invasive Tear Breakup Time (NITBUT) assessed with LacryDiag ocular surface analyzer to results of invasive tests for dry eye syndrome diagnosis to determine the possibility of a wider use of LacryDiag in practical ophthalmology. Materials and Methods: 50 patients with dry eye, burning and feeling of a foreign body complaints participated in this study. Mean age amounted to 28.85 ± 5.86 years. NITBUT was assessed with LacryDiag ocular surface analyzer. The data obtained was compared to the results of Invasive Tear Breakup Time (TBUT) – Norne test, and Schirmer I test.Results: both quantitative and qualitative values of tear film stability were analyzed in all participants. Based on results of the Schirmer I test, patients were divided into subgroups: where it was greater than 21 mm, between 11 and 20 mm, between 6 and 10 mm, and less than 5 mm/ The mean value of the Schirmer I test result amounted to 15.32 ± 6.05 mm/5 min, NITBUT amounted to 9.59 ± 4.37 s, while invasive TBUT amounted to 8.98 ± 3.79 s. It was found that invasive TBUT is in a strong direct correlation with NITBUT values (p Conclusion: a strong correlation was found between results of invasive and non-invasive methods of tear film breakup time assessment. No correlation was found between the optical power of the cornea and the tear film disruption. The non-invasive test was found to be an effective and objective method for diagnosing dry eye.

SummaryThe worldwide production of in vitro-produced embryos in livestock species continues to grow. The current gold standard for selecting quality oocytes and embryos is morphologic assessment, yet this method is subjective and varies based on experience. There is a need for a non-invasive, objective method of selecting viable oocytes and embryos. The aim of this study was to determine if ooplasm area, diameter including zona pellucida (ZP), and ZP thickness of artificially activated oocytes and in vitro fertilized (IVF) zygotes are indicative of development success in vitro and correlated with embryo quality, as assessed by total blastomere number. Diameter affected the probability of development to the blastocyst stage in activated oocytes on day 7 (P < 0.01) and day 8 (P < 0.001), and had a tendency to affect IVF zygotes on day 8 (P = 0.08). Zona pellucida thickness affected the probability of development on day 7 (P < 0.01) and day 8 (P < 0.001) in activated oocytes, and day 8 for IVF zygotes (P < 0.05). An interaction between ZP thickness and diameter was observed on days 7 and 8 (P < 0.05) in IVF zygotes. Area did not significantly affect the probability of development, but was positively correlated with blastomere number on day 8 for IVF zygotes (P = 0.01, conditional R2 = 0.09). Physical parameters of bovine zygotes have the potential for use as a non-invasive, objective selection method. Upon further development, methods used in this study could be integrated into embryo production systems to improve IVF success.

The antioxidant activity of the drug Mexidol was quantitatively measured using an objective method. The rate constant for the reaction of Mexidol with peroxyl radicals of 1,4-dioxane was measured in 1,4-dioxane solution. Mexidol was found to inhibit oxidation of 1,4-dioxane and showed good antioxidant activity comparable to that of ionol. The obtained data were interesting for studying the mechanism of action of the antioxidant in biological systems because the physicochemical properties of 1,4-dioxane are close to those of water, in which processes associated with oxidative stress occur. Measurement of the rate constant for the reaction of the inhibitor with peroxyl radical also had fundamental importance for establishing the structure—reactivity relationship in order to predict the antioxidant activity of compounds.

SIGNIFICANCE In this study, assessments of conjunctival redness were performed to evaluate whether patients with or without dry eye disease (DED) could be discriminated based on this measure. Our findings suggest that subjectively grading redness by quadrant, as opposed to automated en face measurements, may be more suitable for this purpose. PURPOSE This study aimed to quantify bulbar redness using the validated bulbar redness (VBR) grading scale and an automated objective method (Oculus Keratograph 5M; K5M) in participants with DED and non-DED controls. METHODS Participants with DED (Ocular Surface Disease Index score ≥20 and Oxford scale corneal staining ≥2) and controls (Ocular Surface Disease Index score ≤10 and corneal staining ≤1) attended two study visits. In part 1A of visit 1, baseline bulbar redness was graded with the VBR scale in each conjunctival quadrant of both eyes, followed by automated measurements of temporal and nasal redness with the K5M. This was immediately followed by part 1B, during which a topical vasoconstrictor was instilled into both eyes. Redness assessments were repeated 5 and 30 minutes after instillation with both instruments. Participants returned 14 days later for visit 2, where the same assessments as for visit 1A were repeated. RESULTS Seventy-four participants (50 DED and 24 controls) completed the study. There were statistically significant differences in redness between the DED and control groups when assessed with the VBR scale (14/16 comparisons; all, P < .05), whereas no significant differences in K5M-derived redness between the DED and non-DED groups were found at any location or time point. Both subjective and objective instruments detected statistically significant reductions in redness 5 and 30 minutes after instillation of the vasoconstrictor (all, P < .01). CONCLUSIONS Although both subjective and objective instruments were sensitive to detecting changes in redness induced by vasoconstriction, statistically significant differences in redness between DED and control groups were only found using the VBR scale.

Introduction While the current tools to assess canine postoperative pain using physiological and behavioural parameters are reliable, an objective method such as the parasympathetic tone activity (PTA) index could improve postoperative care. The aim of the study was to determine the utility of the PTA index in assessing postoperative analgaesia. Material and Methods Thirty healthy bitches of different breeds were randomly allocated into three groups for analgaesic treatment: the paracetamol group (GPARAC, n = 10) received 15 mg/kg b.w., the carprofen group (GCARP, n = 10) 4 mg/kg b.w., and the meloxicam group (GMELOX, n = 10) 0.2 mg/kg b.w. for 48 h after surgery. GPARAC was medicated orally every 8 h, while GCARP and GMELOX were medicated intravenously every 24 h. The PTA index was used to measure the analgaesia–nociception balance 1 h before surgery (baseline), and at 1, 2, 4, 6, 8, 12, 16, 20, 24, 36, and 48 h after, at which times evaluation on the University of Melbourne Pain Scale (UMPS) was made. Results The baseline PTA index was 65 ± 8 for GPARAC, 65 ± 7 for GCARP, and 62 ± 5 for GMELOX. Postoperatively, it was 65 ± 9 for GPARAC, 63 ± 8 for GCARP, and 65 ± 8 for GMELOX. No statistically significant difference existed between baseline values or between values directly after treatments (P = 0.99 and P = 0.97, respectively). The PTA index showed a sensitivity of 40%, specificity of 98.46% and a negative predictive value of 99.07%. Conclusion Our findings suggest that the PTA index measures comfort and postoperative analgaesia objectively, since it showed a clinical relationship with the UMPS.

OBJECTIVES Cardiac surgery training has become more challenging as patients and their diagnoses become more complex. Our goal was to develop a multicategorical assessment model for evaluating residents in cardiac surgery. This model is intended to ensure goal-directed progress in their training as well as to recognize and support their surgical talents. METHODS We developed a new questionnaire in a multistage, 3-round process based on the Delphi method ‘estimate-talk-estimate’, using 55 competencies, including 38 general and 17 domain-specific competencies. Each competency is evaluated with 1 or more questions, to which 1 (not competent) to 6 (very competent) points can be chosen as an answer. RESULTS The resulting model achieved 2 main goals: first, presenting a well-defined competency list for cardiac surgical training and second, providing an objective and realistic evaluation of trainees’ abilities. Residents were assessed by all trainers to achieve a high level of objectivity. CONCLUSIONS This evaluation model is highly objective, because residents are evaluated by multiple trainers. It allows individual support and enables better transparency in residency training. Talents and skills are evaluated, recognized and adopted as a base for individual feedback and personalized training programmes.

The current study proposes a 3D objective method of evaluating facial symmetry after reconstructive surgery of orofacial structures. 3D models of the craniofacial and soft tissue surfaces were reflected about the mid-sagittal plane. The original model was aligned with the reflection and the best plane of symmetry was found. A deviation contour map quantified the areas of asymmetry and gave a global score of the asymmetry. The asymmetry scores were successfully obtained for 18 patients who had underwent reconstruction of lower face. The asymmetry values at craniofacial and soft tissue levels were moderately correlated (

Purpose To quantify metamorphopsia with a novel objective method in patients with epiretinal membrane (ERM) and to compare the relationships among metamorphopsia scores, spectral-domain optical coherence tomography (OCT) findings, and multifocal electroretinogram (mfERG) results. Methods This study included 52 eyes of 52 patients with idiopathic ERM who underwent comprehensive ophthalmologic examinations, including measurement of best-corrected visual acuity (BCVA), OCT, and mfERG. The degree of metamorphopsia was quantified using MonPack One® (Metrovision, Perenchies, France). On the topographic map of the early treatment diabetic retinopathy (ETDRS) grid, retinal thickness in the central, superior, inferior, nasal, and temporal subfields were measured, and metamorphopsia scores for each corresponding subfield were also obtained. The amplitudes and implicit times of mERG were elicited from each subfield. Then, the correlations among metamorphopsia scores, OCT findings, and mfERG responses were analyzed. Results The mean age of the patients was 65.3 ± 18.5 y, and the average metamorphopsia score of the individual subfields was 2.03 ± 1.18. Initial BCVA was 0.50 ± 0.12 logMAR, but there was no significant correlation between metamorphopsia scores and BCVA. The metamorphopsia scores from the central subfields showed significant correlations with central retinal thickness (CRT) (p = 0.001). The mean metamorphopsia scores in the central subfield showed a significant relationship with the mean N1 and P1 amplitudes (p = 0.001, p = 0.048, respectively), while no relationship was observed between metamorphopsia scores and mfERG amplitudes in other subfields. Conclusions The degree of metamorphopsia in patients with ERM could be objectively quantified in each subfield using a novel metamorphopsia test. The metamorphopsia scores were significantly correlated with retinal thickness, especially at the central subfields, and the scores in the central subfields were significantly correlated with the N1 and P1 amplitudes of mfERG. Thus, the metamorphopsia test can be a useful method to evaluate metamorphopsia symptoms for patients with ERM.

Venous ulcers in lower legs remain a profound treatment problem in contemporary medicine. Proper healing requires, among other things, sufficient blood supply and provision of suitable amount of oxygen to the treated tissues. The aim of the study was to assess the influence of combined physical therapy applied in patients with chronic venous leg ulcers on the oxygen partial pressure values. Fifty-four patients (25 females and 29 males), in the age range of 38 to 89 years with chronic venous leg ulcers, underwent a cycle of 15 procedures with the use of Laserobaria-S device. During a procedure, the patient’s lower limb was simultaneously exposed to oxygen having the pressure of 1.5 ATA, low-frequency magnetic field, and low-energy light radiation. Before procedures, directly after the first procedure, as well as on completion of the entire therapeutic cycle, the patients underwent oxygen partial pressure measurements in the tissues surrounding the ulceration area, by means of transcutaneous oximetry, with the use of Medicap Précise 8008s device. The combined physical therapy shows a statistically significant increase of oxygen partial pressure values in tissues surrounding the ulceration, from the average of 68.63 ± 17.04 mm Hg before commencing the therapeutic cycle, to the average of 74.20 ± 18.92 mm Hg after the first procedure ( P < .001) and to the average value of 83.79 ± 20.74 mm Hg ( P < .001) after completion of therapeutic cycle. Combined physical therapy procedures cause a statistically significant increase of oxygen partial pressure values in tissues surrounding the ulceration, assessed using the objective method of transcutaneous oximetry, both in women and men.

Recent advances in machine learning have led to a surge of interest in classification of the auditory brainstem response. In this work, we conducted a search in the PubMed, Google Scholar, SpringerLink, ScienceDirect, and Scopus databases, and identified twelve studies that explored the use of machine learning to classify the auditory brainstem response as a complementary and objective method to (a) help clinicians better diagnose hearing impairment by discerning between healthy and pathological auditory brainstem response waveforms, (b) present a neural marker for potential applications in hearing aid tuning, and (c) provide a biometric marker for discriminating between subjects. A comparison between the studies presented in this review is not possible as they used different test subjects, group sizes, and stimuli, and evaluated auditory brainstem response differently. Instead, the result of these studies will be presented and their limitations as well as their potential applications will be discussed. Overall, the findings of these studies suggest that ABR classification using machine learning is a promising tool for assessing patients with hearing loss, optimizing technologies for tuning hearing aids, and discriminating between subjects.