L-PRF (leukocyte- and platelet-rich fibrin) is one of the four families of platelet concentrates for surgical use and is widely used in oral and maxillofacial regenerative therapies. The first objective of this article was to evaluate the mechanical vibrations appearing during centrifugation in four models of commercially available table-top centrifuges used to produce L-PRF and the impact of the centrifuge characteristics on the cell and fibrin architecture of a L-PRF clot and membrane. The second objective of this article was to evaluate how changing some parameters of the L-PRF protocol may influence its biological signature, independently from the characteristics of the centrifuge. In the first part, four different commercially available centrifuges were used to produce L-PRF, following the original L-PRF production method (glass-coated plastic tubes, 400 g force, 12 minutes). The tested systems were the original L-PRF centrifuge (Intra-Spin, Intra-Lock, the only CE and FDA cleared system for the preparation of L-PRF) and three other laboratory centrifuges (not CE/FDA cleared for L-PRF): A-PRF 12 (Advanced PRF, Process), LW-UPD8 (LW Scientific) and Salvin 1310 (Salvin Dental). Each centrifuge was opened for inspection, two accelerometers were installed (one radial, one vertical), and data were collected with a spectrum analyzer in two configurations (full-load or half load). All clots and membranes were collected into a sterile surgical box (Xpression kit, Intra-Lock). The exact macroscopic (weights, sizes) and microscopic (photonic and scanning electron microscopy SEM) characteristics of the L-PRF produced with these four different machines were evaluated. In the second part, venous blood was taken in two groups, respectively, Intra-Spin 9 ml glass-coated plastic tubes (Intra-Lock) and A-PRF 10 ml glass tubes (Process). Tubes were immediately centrifuged at 2700 rpm (around 400 g) during 12 minutes to produce L-PRF or at 1500 rpm during 14 minutes to produce A-PRF. All centrifugations were done using the original L-PRF centrifuge (Intra-Spin), as recommended by the two manufacturers. Half of the membranes were placed individually in culture media and transferred in a new tube at seven experimental times (up to 7 days). The releases of transforming growth factor β-1 (TGFβ-1), platelet derived growth factor AB (PDGF-AB), vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2) were quantified using ELISA kits at these seven experimental times. The remaining membranes were used to evaluate the initial quantity of growth factors of the L-PRF and A-PRF membranes, through forcible extraction. Very significant differences in the level of vibrations at each rotational speed were observed between the four tested centrifuges. The original L-PRF centrifuge (Intra-Spin) was by far the most stable machine in all configurations and always remained under the threshold of resonance, unlike the three other tested machines. At the classical speed of production of L-PRF, the level of undesirable vibra...
Colposcopy is widely used to detect cervical cancers, but experienced physicians who are needed for an accurate diagnosis are lacking in developing countries. Artificial intelligence (AI) has been recently used in computer-aided diagnosis showing remarkable promise. In this study, we developed and validated deep learning models to automatically classify cervical neoplasms on colposcopic photographs. Pre-trained convolutional neural networks were fine-tuned for two grading systems: the cervical intraepithelial neoplasia (CIN) system and the lower anogenital squamous terminology (LAST) system. The multi-class classification accuracies of the networks for the CIN system in the test dataset were 48.6 ± 1.3% by Inception-Resnet-v2 and 51.7 ± 5.2% by Resnet-152. The accuracies for the LAST system were 71.8 ± 1.8% and 74.7 ± 1.8%, respectively. The area under the curve (AUC) for discriminating high-risk lesions from low-risk lesions by Resnet-152 was 0.781 ± 0.020 for the CIN system and 0.708 ± 0.024 for the LAST system. The lesions requiring biopsy were also detected efficiently (AUC, 0.947 ± 0.030 by Resnet-152), and presented meaningfully on attention maps. These results may indicate the potential of the application of AI for automated reading of colposcopic photographs. Cervical cancer is the fourth most common cancer in women worldwide, and the second most common cancer among females in developing countries 1. Screening is the principal prevention method aimed at reducing mortality rates. Screening includes certain steps, including population-based Papanicolaou (Pap) testing, colposcopydirected biopsy of suspicious lesions, and the treatment of confirmed pre-cancer lesions 2,3. In women with low-grade intraepithelial lesions (LSIL) or high-grade intraepithelial lesions (HSIL), the risk of pre-cancer is medium to high, and immediate referral for colposcopy is necessary. However, referring all women with atypical squamous cells of undetermined significance (ASC-US) is considered inefficient, as the risk of such cases being pre-cancerous is lower 4. Screening programs have been successful in the developed countries, leading to an approximately 80% decrease in the cervical cancer incidence over the past 4 decades. In contrast, the increase in cervical cancer incidence reported in developing countries 5 has been attributed to the unsuccessful implementation of screening programs. This, has been attributed to logistics in health systems, infrastructural inadequacies, and the lack of expert physicians capable of introducing screening programs and follow-up 6 .
Background and ObjectivesHigh-dose systemic steroid therapy is the mainstay treatment for sudden sensorineural hearing loss (SSNHL). Recovery rates from SSNHL range are about 47-63% and are influenced by various prognostic factors. To evaluate the prognostic value of specific clinical parameters, we reviewed 289 cases by clinical and statistical analysis.Subjects and MethodsThis study included 289 patients with SSNHL who visited the Department of Otolaryngology at Soonchunhyang University Hospital from January 2005 to December 2012. The cases were reviewed retrospectively based on clinical charts. Hearing improvement was evaluated in relation to pure-tone audiogram results, duration between SSNHL onset and time of initial treatment, seasonal incidence, dizziness, patient age, degree of hearing loss, patterns of initial pure-tone audiogram and presence of underlying disease.ResultsHearing improvement was observed in 196 of 289 (67.8%) patients; such improvement began within 7 days in most patients, followed by rapid hearing recovery. Cases that failed to show improvement within 14 days were unlikely to achieve hearing recovery. The more severe the hearing loss during the early stage, the lower the hearing recovery rates. Patients aged less than 60 years appear to have better prognosis of hearing improvement compared to those who are over 60 years.ConclusionsImportant prognostic factors for recovery in patients with SSNHL include the time of initiating treatment after symptom onset, the degree of early-stage hearing loss, and the age of the affected patient.
The rate of unmarried young women seeking repeated abortions was high in China on 2000. The rate of consistent condom use was low, and the rate of contraceptive failure was higher.
Background: The age-related effects on various aspects of swallowing have been reported in studies on the temporal relationship between hyolaryngeal movement and bolus location, as well as the extent of hyolaryngeal movement. However, few studies have described the temporal and spatial relationships concurrently. Objective: The main purpose of this study was to define the kinematics of the hyoid bone and epiglottis, during swallowing, on the temporal and spatial relationships concurrently in healthy subjects, and to investigate the influence of aging on hyolaryngeal movement. Methods: We performed a two-dimensional motion analysis of the hyoid bone and epiglottis using videofluoroscopy images in 69 normal subjects. The trajectories of the hyolaryngeal movement and passage of a bolus were superimposed to form one plot. Temporal measurements included initiation and duration of the hyoid bone and epiglottis movement compared to their movement with the bolus. The spatial measurements included vertical and horizontal excursion of the hyoid bone, and the rotational angle of the epiglottis. Results: The duration of supraglottis closure, and the maximal vertical excursion of the hyoid bone were increased in older subjects, more than 65 years of age, compared to younger subjects (p < 0.05). Other temporal and spatial measurements were not statistically significant in the comparisons among the age groups. The vertical distance of the cervical vertebra was related to vertical excursion of the hyoid bone (p = 0.002), and the horizontal distance from the chin to the cervical vertebra was related to the horizontal excursion of the hyoid bone (p = 0.003). Conclusion: This paper describes a method for assessing temporal and spatial relationships of hyolaryngeal movement, and the passage of a bolus during swallowing. The two-dimensional kinematic swallowing motion analyses that were developed provided useful data that changed with age.
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