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Temporomandibular Joint Articular Eminence Anatomy as a Predictor of Anterior Disc Displacement on MRI
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Accuracy of Predicted Angular Measurements Utilizing Virtual Surgical Planning in Bimaxillary Orthognathic Surgery for Treatment of Angle Class III Malocclusions
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Partial Response to Cervical Radiofrequency Ablation in Veteran With Severe Cervical Diffuse Idiopathic Skeletal Hyperostosis
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Assessing Non-Technical Skills in Objective Structured Teaching Encounters: What Can Be Assessed and What is the Role of Artificial Intelligence-Based Grading?
No full textBackground: Lack of non-technical skills (NTS) is associated with worsening patient outcomes and reduced quality of care. Objective Structured Teaching Encounters (OSTEs) provides a standardized environment for assessing NTS in teaching contexts, but scalable and reliable approaches are needed. Artificial intelligence (AI) may offer an opportunity to augment assessment’s efficiency and consistency. This feasibility study examined which NTS can be feasibly assessed using transcript- and video-based scoring and whether AI can discriminate levels of competency.
Methods: This retrospective study includes analysis of de-identified data from two OSTE teaching scenarios at a single academic medical center. A structured three-point rubric derived from the SCOPE model was applied across three modalities: (A) human video-based ratings, (B) human transcript-based ratings, and (C) AI-assisted transcript-based ratings. Descriptive statistics were calculated for all SCOPE elements, categories, and overall scores. Paired nonparametric sign tests compared video versus transcript ratings (RQ1) and human versus AI transcript ratings (RQ2), using IBM SPSS Statistics version 31.0.
Results: Sixteen trainees (32 OSTE encounters) were assessed. No statistically significant differences were observed between human video- and transcript-based ratings across elements, categories, or overall performance (all p \u3e .05), supporting the feasibility of transcript-based assessment. AI-assisted ratings demonstrated structured rubric application and narrative justifications but consistently produced higher median scores with reduced variability. Significant score inflation through AI-assisted ratings was observed in elements within all SCOPE categories: Decision-Making, Leading, Teamwork, Task Management, and Situation Awareness (p \u3c .05), indicating limited capability for discrimination of performance levels.
Conclusion: Both transcript- and video-based NTS assessments were feasible and produced comparable results when a structured, anchored rubric was used. Behavioral evidence was identifiable across all SCOPE cognitive and social domains, suggesting potential broad applicability across different OSTE contexts. AI-assisted scoring based solely on transcript data was operationally feasible but demonstrated limited discrimination and inflated competency ratings, reflecting current gaps in alignment with human judgment. These findings provide an important early foundation for scalable, rubric-based assessment of NTS and emphasize the need for ongoing validation, multimodal AI inputs, and sustained human oversight to ensure accuracy, fairness, and readiness for clinical practice within medical education
Herbicide Glyphosate (Roundup) Usage and Non-Hodgkin Lymphoma (NHL) Incidence in Rural vs. Urban Counties: A Population-Based Study in Nebraska
No full textThis study aimed to examine the association between glyphosate usage and Non-Hodgkin Lymphoma (NHL) at the county level in Nebraska using population-based cancer surveillance data and applied glyphosate by geographic location. A combination of statistical, rural–urban, and geospatial analytic approaches was used to assess the group differences and temporal trends between herbicide use and disease burden. Glyphosate use increased substantially over time, particularly in eastern and south-central counties with high corn and soybean production; however, there was no significant rural–urban difference. Incidence of NHL increased consistently between 1987 and 2014, and several agricultural, sparsely populated counties with the highest age-adjusted NHL rates were identified. Although the simple correlation between glyphosate usage and NHL incidence was low, multivariable regression explained county-level variation, and geospatial analyses (Bivariate LISA and Getis-Ord Gi*) identified statistically significant High–High clusters where elevated glyphosate use and higher NHL incidence co-occurred. Although ecological data cannot establish causality, the findings indicate a geographically patterned relationship between glyphosate intensity and NHL burden and highlight the need for targeted environmental monitoring and further epidemiologic investigation in high-use agricultural regions
Comparative Diagnostic Accuracy Study of Point of Care Ultrasound Techniques for Detection of Left Atrial Enlargement by Hospital Medicine Physicians from Archived Echocardiogram Images
No full textBACKGROUND: Left atrial enlargement (LAE) is predictive of cardiovascular morbidity and mortality. Prior studies of point-of-care ultrasound (POCUS) interpretation methods for identifying LAE utilized older echocardiographic reference ranges.
OBJECTIVES: Compare the test characteristics of hospitalist-performed POCUS techniques for identifying LAE as compared to contemporary echocardiographic reference ranges.
METHODS: Fully paired, comparative diagnostic accuracy study of two index tests applied to archived echocardiogram images: visual assessment of the left atrium to aorta diameter (LAE sign) and left atrial (LA) anteroposterior diameter \u3e4 cm in the parasternal long axis view. The reference test was moderate to severe LAE by echocardiography-derived left atrial volumetric index.
RESULTS: After exclusion criteria, 239 of 321 (74.5%) exams were included. The LAE sign had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 67.5%, 71.4%, 32.1%, and 91.6%. LA diameter of \u3e4 cm had a sensitivity, specificity, PPV, and NPV of 87.5%, 75.9%, 42.2%, and 96.8%. The difference in sensitivity (p = .005) and specificity (p = .049) between the index tests was statistically significant. The diameter measurement had better positive and negative likelihood ratios (LR + 3.63, LR-0.16) than the LAE sign (LR + 2.36, LR- 0.46).
CONCLUSIONS: Both POCUS techniques for diagnosing LAE performed reasonably well compared to current echocardiographic reference ranges, with LA diameter \u3e4 cm having better sensitivity and specificity than visual estimation of the LAE sign. These tests can help identify patients at risk for cardiovascular disease who may benefit from echocardiogram referral
Protocol for Screening of Small Molecules in a CLN3 Disease Patient-Specific iPSC-Derived Neuronal Progenitor Cell Model
No full textAlthough rare, CLN3 disease is the most common neurodegenerative disorder of childhood. Here, we present a protocol for screening small molecules in a CLN3 disease patient-specific induced pluripotent stem cell (iPSC)-derived neuronal progenitor cell (NPC) model. We describe steps for converting human iPSCs (hiPSCs) to neural stem cells (NSCs) and developing NPCs using feeder-free medium and cytokine-based differentiation. We then detail procedures for achieving access to mature neurons. For complete details on the use and execution of this protocol, please refer to Simeon et al
Standardizing Embolization Terminology in Non-Variceal Upper GI Bleeding: Therapeutic, Preventive, and Empiric Approaches
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Reliability of T2-weighted MRI Volumetric Measurements for Knee Effusion Assessment Following ACL Injury: An Intra-rater and Inter-rater Study
No full textPurpose: Knee effusion after anterior cruciate ligament (ACL) injury and reconstruction is associated with quadriceps dysfunction and may contribute to early osteoarthritis development. This study was subsequently designed to determine the intra-rater and inter-rater reliability of our method for volumetric quantitative measurements of knee effusion using T2-weighted magnetic resonance imaging (MRI) after ACL injury and reconstruction.
Methods: MRIs of 10 ACL-injured knees and 10 uninjured knees from participants aged 15-35 years old were included. Exclusion criteria included previous knee injury/surgery, inflammatory disease, BMI \u3e30 kg/m2, and concomitant grade III ligament tears. Two independent raters analyzed effusion volumes using custom MATLAB software on T2-weighted axial sequences. Measurements were standardized using the three-column concept for the tibial region and anatomical landmarks in the femoral region. Intra- and inter-rater reliability was assessed using intraclass correlation coefficients (ICC) with minimal detectable changes calculated. Measurement agreement was assessed using Bland-Altman plots.
Results: Effusion volumes were higher in the injured compared to uninjured knees (10.80±7.40 mL vs 1.84±0.69 mL, p\u3c 0.05). Volumetric effusion measurements demonstrated excellent intra-rater (ICC=0.993, 95% CI: 0.981-0.997) and inter-rater reliability (ICC=0.974, 95% CI: 0.907-0.991). The minimal detectable change was 0.13 mL for intra-rater measurements and 0.46 mL for inter-rater measurements. Bland-Altman plots revealed no systematic bias between raters.
Conclusions: Volumetric quantitative measurements using standard T2-weighted axial MRI sequences provide a highly reliable assessment of knee effusion after ACL injury and reconstruction. This non-invasive measurement technique offers potential for objective clinical assessment and longitudinal monitoring without requiring specialized imaging sequences