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Purpose: The purpose of this study is to identify predictors of treatment outcomes in Rapid Syllable Transition Treatment (ReST) for childhood apraxia of speech through an individual participant data meta-analysis. Method: A systematic literature search identified nine ReST studies for inclusion. Individual participant data were obtained, and studies were coded for methodological design, baseline participant characteristics, service delivery factors, and treatment outcomes. Bivariate analyses were conducted to identify potential predictor variables. Multiple linear regressions were then performed to identify predictors of treatment outcomes. Results: Data for 36 participants from seven studies were included in the statistical analyses. In multivariate modeling, better performance on treated pseudo-words posttreatment was predicted by higher baseline expressive language and Goldman-Fristoe Test of Articulation scores, lower speech inconsistency and percentage of vowels correct, and higher pretreatment accuracy on pseudo-word targets. Better performance on untreated real words posttreatment was predicted by higher pretreatment accuracy on real words. Gains in performance and retention of gains were not significantly predicted by any individual variable or combination of variables. Conclusions: Baseline speech and expressive language skills and accuracy on pseudo-words and real words were significant predictors of absolute posttreatment performance. Regardless of baseline characteristics, all children were statistically as likely to achieve gains during ReST and retain these gains for up to 4 weeks posttreatment. Large-scale prospective research is required to further examine the effects of dose frequency and co-occurring language impairments on treatment outcomes and the complex co-effects of percentage of vowels correct with other potential predictors.

Background: Sex determination is the crucial stage for developing a biological profile during the investigation of skeletal remains. An accurate determination of the sex of the unknown person is crucial by only a few bones or when multiple bones are missing or fractured. Thus, exploration of less commonly used bones like thoracic vertebrae is also required for the personal identification of an unknown individual. Methods: This systematic review summarized the different anthropometric methods used on human thoracic vertebrae for sex estimation. A comprehensive search was conducted in PubMed, Scopus, and Science Direct between 2000 and 2020. The inclusive criteria include English studies that used the anthropometric method in thoracic vertebrae for sex determination. Results: The literature search yielded 519 potentially relevant articles whereby only 22 met the inclusion criteria. This review revealed the various anthropometric methods used in thoracic vertebrae such as conventional and geometric morphometrics. Different measurements from various levels of thoracic vertebrae were used in all reviewed studies. Most of the studies showed significant differences between males and females. Conclusion: The review of all the studies revealed that T12 is the most sexually dimorphic bone among all the thoracic vertebrae. Among all the measurements from the different parts of the thoracic vertebrae, measurements from the vertebral body and pedicle revealed high accuracy of sex classification. The most advanced method in this review so far is the three-dimensional geometric morphometric method. The findings of this study may serve as a reference for future studies related to the anthropometric study of thoracic vertebrae.

The reliable classification of benign and malignant lesions in breast ultrasound images can provide an effective and relatively low-cost method for the early diagnosis of breast cancer. The accuracy of the diagnosis is, however, highly dependent on the quality of the ultrasound systems and the experience of the users (radiologists). The use of deep convolutional neural network approaches has provided solutions for the efficient analysis of breast ultrasound images. In this study, we propose a new framework for the classification of breast cancer lesions with an attention module in a modified VGG16 architecture. The adopted attention mechanism enhances the feature discrimination between the background and targeted lesions in ultrasound. We also propose a new ensembled loss function, which is a combination of binary cross-entropy and the logarithm of the hyperbolic cosine loss, to improve the model discrepancy between classified lesions and their labels. This combined loss function optimizes the network more quickly. The proposed model outperformed other modified VGG16 architectures, with an accuracy of 93%, and also, the results are competitive with those of other state-of-the-art frameworks for the classification of breast cancer lesions. Our experimental results show that the choice of loss function is highly important and plays a key role in breast lesion classification tasks. Additionally, by adding an attention block, we could improve the performance of the model.

Microaxial left ventricular assist devices (LVAD) are increasingly used to support patients with cardiogenic shock; however, outcome results are limited to single-center studies, registry data and select reviews. We conducted a systematic review and meta-analysis, searching three databases for relevant studies reporting on microaxial LVAD use in adults with cardiogenic shock. We conducted a random-effects meta-analysis (DerSimonian and Laird) based on short-term mortality (primary outcome), long-term mortality and device complications (secondary outcomes). We assessed the risk of bias and certainty of evidence using the Joanna Briggs Institute and the GRADE approaches, respectively. A total of 63 observational studies (3896 patients), 6 propensity-score matched (PSM) studies and 2 randomized controlled trials (RCTs) were included (384 patients). The pooled short-term mortality from observational studies was 46.5% (95%-CI: 42.7–50.3%); this was 48.9% (95%-CI: 43.8–54.1%) amongst PSM studies and RCTs. The pooled mortality at 90 days, 6 months and 1 year was 41.8%, 51.1% and 54.3%, respectively. Hemolysis and access-site bleeding were the most common complications, each with a pooled incidence of around 20%. The reported mortality rate of microaxial LVADs was not significantly lower than extracorporeal membrane oxygenation (ECMO) or intra-aortic balloon pumps (IABP). Current evidence does not suggest any mortality benefit when compared to ECMO or IABP. [ABSTRACT FROM AUTHOR]

The aim of the work described here was to assess the performance of automated breast ultrasound (ABUS) as an adjunct to digital breast tomosynthesis (DBT) in the screening and diagnostic setting. This cross-sectional study of women who underwent DBT and ABUS from December 2019 to March 2022 included opportunistic and targeted screening cases, as well as symptomatic women. Breast density, Breast Imaging Reporting and Data System categories and histopathology reports were collected and compared. The PPV3 (proportion of examinations with abnormal findings that resulted in a tissue diagnosis of cancer), biopsy rate (percentage of biopsies performed) and cancer detection yield (number of malignancies found by the diagnostic test given to the study sample) were calculated. A total of 1089 ABUS examinations were performed (age range: 29–85 y, mean: 51.9 y). Among these were 909 screening (83.5%) and 180 diagnostic (16.5%) examinations. A total of 579 biopsies were performed on 407 patients, with a biopsy rate of 53.2%. There were 100 (9.2%) malignant lesions, 30 (5.2%) atypical/B3 lesions and 414 (71.5%) benign cases. In 9 cases (0.08%), ABUS alone detected malignancies, and in 19 cases (1.7%), DBT alone detected malignancies. The PPV3 in the screening group was 14.6%. ABUS is useful as an adjunct to DBT in the opportunistic screening and diagnostic setting. [ABSTRACT FROM AUTHOR]

Introduction: Sex estimation is one of the primary aspects in determining the biological characteristics of an unknown adult skeleton. The variations between male and female skeletons can be attributed to a complex interplay of genetics, hormonal factors, culture, and environment. However, skeletal remains frequently found are often incomplete, with most sexually dimorphic bone like the pelvis and skull potentially absent. Hence, it is essential to conduct a comprehensive evaluation of multiple skeletal elements to attain a high degree of precision in sex estimation within forensic anthropology context. Ribs have been utilized in forensic anthropology for sex estimation since the 1980s, a comprehensive review of their sexual dimorphism is yet to be conducted. In this study, we examined various anthropological methods applied to ribs for sex estimation. Method: A systematic search was performed using PubMed, Science Direct, and Google Scholar from 2000 to 2020, retrieving a total of 10 articles that met the inclusive criteria. The search followed the main points outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: This systematic review provides a comprehensive summary of the analytical approaches employed to estimate sex using human ribs. Conclusion: The findings revealed that different part of human ribs can be reliably used for sex estimation via metric method. [ABSTRACT FROM AUTHOR]

Introduction: Multiphase computed tomography (CT) using fixed volume contrast media may lead to high radiation exposure and toxicity in patients with low body weight. We evaluated a customised weight-based protocol for multiphase CT in terms of radiation exposure, image quality and cost savings., Methods: A total of 224 patients were recruited. An optimised CT protocol was applied using 100 kV and 1 mL/kg of contrast media dosing. The image quality and radiation dose exposure of this CT protocol were compared to those of a standard 120 kV, 80 mL fixed volume protocol. The radiation dose information and CT Hounsfield units were recorded. The signal-to-noise ratio, contrast-to-noise ratio (CNR) and figure of merit (FOM) were used as comparison metrics. The images were assessed for contrast opacification and visual quality by two radiologists. The renal function, contrast media volume and cost were also evaluated., Results: The median effective dose was lowered by 16% in the optimised protocol, while the arterial phase images achieved significantly higher CNR and FOM. The radiologists' evaluation showed more than 97% absolute agreement with no significant differences in image quality. No significant differences were found in the pre- and post-CT estimated glomerular filtration rate. However, contrast media usage was significantly reduced by 1,680 mL, with an overall cost savings of USD 421 in the optimised protocol., Conclusion: The optimised weight-based protocol is cost-efficient and lowers radiation dose while maintaining overall contrast enhancement and image quality., (Copyright © 2024 Copyright: © 2024 Singapore Medical Journal.)

Radiology reporting is narrative, and its content depends on the clinician's ability to interpret the images accurately. A tertiary hospital, such as anonymous institute, focuses on writing reports narratively as part of training for medical personnel. Nevertheless, free-text reports make it inconvenient to extract information for clinical audits and data mining. Therefore, we aim to convert unstructured breast radiology reports into structured formats using natural language processing (NLP) algorithm. This study used 327 de-identified breast radiology reports from the anonymous institute. The radiologist identified the significant data elements to be extracted. Our NLP algorithm achieved 97% and 94.9% accuracy in training and testing data, respectively. Henceforth, the structured information was used to build the predictive model for predicting the value of the BIRADS category. The model based on random forest generated the highest accuracy of 92%. Our study not only fulfilled the demands of clinicians by enhancing communication between medical personnel, but it also demonstrated the usefulness of mineable structured data in yielding significant insights.