DigitalCommons@KCU (Kansas City Univ.)
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Structural Adaptations of the Anterolateral Complex of the Knee and Associated Tissues: A Comparative Anatomical and Histological Analysis of Knees With and Without an Anterolateral Ligament
No full textThe anterolateral ligament (ALL) is considered a secondary stabilizer of internal rotation and, due to proximity to the lateral collateral ligament (LCL), it may contribute to anterolateral rotatory stability. This study characterized the anatomy of the ALL and associated tissues of the anterolateral complex (ALC) to determine if structural and histological compensatory adaptations exist in patients without an ALL. Forty-nine cadaveric knees were dissected from distal-to-proximal using established landmarks with the aid of internal rotation stress to localize the ALL (if present), LCL, iliotibial band (ITB), and anterolateral capsule. The width and thickness of ALL and LCL were measured with digital calipers at the origin, middle, and insertion, and cross-sectional areas were calculated. ALL and LCL length and ITB thickness were also obtained. Samples of each tissue were stained with hematoxylin and eosin and picrosirius red, and histological images were evaluated with ImageJ to quantify collagen density (mean gray value [mgv]) and quantity (percent coverage). Size measurements and collagen characteristics were compared between ALL-present and ALL-deficient knees. The ALL was identified in 63% of knees with mean cross-sectional areas of 8.9, 5.8, and 9.7 mm2 at the origin, middle, and insertion, respectively. Mean collagen density of the ALL was 106.9 mgv on a scale of 0 (black) to 255 (white), and overall collagen quantity was 40.3%. Proximal LCL width (p = 0.04), distal LCL thickness (p = 0.03), and cross-sectional area (p = 0.01), and ITB thickness (p = 0.02) were significantly greater in ALL-deficient knees. A significantly higher collagen density was found within the LCL (p = 0.04), and higher overall quantity of collagen within the LCL (p \u3c 0.01) and ITB (p \u3c 0.01), of ALL-deficient knees. Gross anatomical and histological alterations exist in knees without an ALL compared with those with an ALL. These may reflect adaptations in the ALC and LCL that are present to compensate for the absence of the anterolateral rotatory stability afforded by the ALL
ChatGPT vs. Gemini: Comparative Accuracy and Efficiency in Lung-RADS Score Assignment From Radiology Reports
Get PDFObjective: To evaluate the accuracy of large language models (LLMs) in generating Lung-RADS scores based on lung cancer screening low-dose computed tomography radiology reports.
Material and methods: A retrospective cross-sectional analysis was performed on 242 consecutive LDCT radiology reports generated by cardiothoracic fellowship-trained radiologists at a tertiary center. LLMs evaluated included ChatGPT-3.5, ChatGPT-4o, Google Gemini, and Google Gemini Advanced. Each LLM was used to assign Lung-RADS scores based on the findings section of each report. No domain-specific fine-tuning was applied. Accuracy was determined by comparing the LLM-assigned scores to radiologist-assigned scores. Efficiency was assessed by measuring response times for each LLM.
Results: ChatGPT-4o achieved the highest accuracy (83.6 %) in assigning Lung-RADS scores compared to other models, with ChatGPT-3.5 reaching 70.1 %. Gemini and Gemini Advanced had similar accuracy (70.9 % and 65.1 %, respectively). ChatGPT-3.5 had the fastest response time (median 4 s), while ChatGPT-4o was slower (median 10 s). Higher Lung-RADS categories were associated with marginally longer completion times. ChatGPT-4o demonstrated the greatest agreement with radiologists (κ = 0.836), although it was less than the previously reported human interobserver agreement.
Conclusion: ChatGPT-4o outperformed ChatGPT-3.5, Gemini, and Gemini Advanced in Lung-RADS score assignment accuracy but did not reach the level of human experts. Despite promising results, further work is needed to integrate domain-specific training and ensure LLM reliability for clinical decision-making in lung cancer screening
4-1BB Antibodies in Oncology Clinical Trials: A Review
Get PDF4-1BB is a transmembrane glycoprotein found on T lymphocytes, and signaling through 4-1BB activates and differentiates CD3+ and CD8+ T cells. The ability of 4-1BB to stimulate cytotoxic T-cell responses makes it a promising target for therapeutic cancer immunotherapy development. 4-1BB antibodies have shown promising antitumor activity in preclinical studies and clinical trials. Common side effects include transaminase elevation, cytopenias, fatigue, and nausea. This clinical review summarizes past and current 4-1BB antibodies in oncology clinical trials
Corrigendum to: Carpal Tunnel Dimensions Following Osteopathic Manipulation Utilizing Dorsal Carpal Arch Muscle Energy: A Pilot Study
Get PDFEnhancing the Research Enterprise at a Health Sciences University: A Call for an Institutional Paradigm Shift
Get PDFBackground:
There exists a rapidly growing need for a universally robust research enterprise at health sciences universities because of recent changes in the medical education landscape. This study aimed to evaluate student perceptions of (and challenges conducting) research and to implement effective strategies to expose students to enhanced resources and training.
Materials and Methods:
An anonymous survey developed using participatory research methods was disseminated to all students at a graduate health sciences university in 2023. This measured their engagement in research, resource needs, and barriers. Descriptive statistics quantitively analyzed factors that influence student participation in research, perceived benefits, and obstacles to performing research. Content analyses of open-ended responses outlined strategies to improve the research endeavor.
Results:
Of 580 responses, the vast majority (78%) were “interested” or “very interested” in performing research, but only 36% were actively engaged in projects. The most commonly cited benefit of research was to improve competitiveness for future training opportunities (431 [18%] responses). Frequently listed barriers to conducting research were lack of time within the curriculum (290 [27%] responses), inadequate institutional support (278 [26%]), and faculty unavailability (207 [19%]). Students proposed multiple initiatives to enhance research infrastructure, including a central communication website to exchange research ideas, expansion of research mentors and opportunities/partnerships, and hiring research-focused support staff.
Conclusions:
A critical need exists at health sciences universities for a shift toward universal recognition of the need for an enhanced research enterprise that addresses key barriers to student engagement. This study proposes strategies to achieve an active research model
A Case Report of Cardiac Ascites in Morquio Syndrome Complicated by Pulmonary Hypertension
Get PDFMorquio syndrome, or mucopolysaccharidosis type IV (MPS IV), is a rare lysosomal storage disorder characterized by skeletal dysplasia and dysostosis multiplex. While primarily associated with skeletal manifestations, MPS IV can also affect systemic organs. Here, we present a case of a 64-year-old woman with MPS IVC who presented with cardiac ascites. The patient\u27s disease course was characterized by idiopathic pulmonary hypertension to cor pulmonale and subsequent cardiac ascites formation. Utilizing paracentesis with cytology as well as an analysis of the patient\u27s clinical history and disease progression, we provide insights into the interplay between Morquio syndrome and cardiac ascites