Background The study aims to evaluate the accuracy of the generative adversarial networks (GAN) for reconstructing bony midfacial defects. Methods According to anatomy, the bony midface was divided into five subunit structural regions and artificial defects are manually created on the corresponding CT images. GAN is trained to reconstruct artificial defects to their previous normal shape and tested. The clinical defects are reconstructed by the trained GAN, where the midspan defects were used for qualitative evaluation and the unilateral defects were used for quantitative evaluation. The cosine similarity and the mean error are used to evaluate the accuracy of reconstruction. The Mann–Whitney U test is used to detect whether reconstruction errors were consistent in artificial and unilateral clinical defects. Results This study included 518 normal CT data, with 415 in training set and 103 in testing set, and 17 real patient data, with 2 midspan defects and 15 unilateral defects. Reconstruction of midspan clinical defects assessed by experts is acceptable. The cosine similarity in the reconstruction of artificial defects and unilateral clinical defects is 0.97 ± 0.01 and 0.96 ± 0.01, P = 0.695. The mean error in the reconstruction of artificial defects and unilateral clinical defects is 0.59 ± 0.31 mm and 0.48 ± 0.08 mm, P = 0.09. Conclusion GAN-based virtual reconstruction technology has reached a high accuracy in testing set, and statistical tests suggest that it can achieve similar results in real patient data. This study has preliminarily solved the problem of bony midfacial defect without reference.
Background: Medication-related osteonecrosis of the jaw (MRONJ) is a well-known severe adverse reaction of antiresorptive, antiangiogenic or targeted therapies, and usually occurs after tooth extraction. This review is aimed at determining the efficacy of any intervention of tooth extraction to reduce the risk of MRONJ in patients taking antiresorptive drugs, and present the distribution of evidence in these clinical questions. Methods: Primary studies and reviews were searched from nine databases (Medline, EMBase, Cochrane Library, Scopus, WOSCC, Inspec, KCI-KJD, SciELO and GIM) and two registers (ICTRP and ClinicalTrials.gov) to 30 November 2022. The risk of bias was assessed with the ROBIS tool in reviews, and the RoB 2 tool and ROBINS-I tool in primary studies. Data were extracted and then a meta-analysis was undertaken between primary studies where appropriate. Results: Fifteen primary studies and five reviews were included in this evidence mapping. One review was at low risk of bias, and one randomized controlled trial was at moderate risk, while the other eighteen studies were at high, serious or critical risk. Results of syntheses: (1) there was no significant risk difference found between drug holiday and drug continuation except for a subgroup in which drug continuation was supported in the reduced incidence proportion of MRONJ for over a 3-month follow-up; (2) the efficacy of the application of autologous platelet concentrates in tooth extraction was uncertain; (3) there was no significant difference found between different surgical techniques in any subgroup analysis; and (4) the risk difference with antibacterial prophylaxis versus control was −0.57, 95% CI −0.85 to −0.29. Conclusions: There is limited evidence to demonstrate that a drug holiday is unnecessary (and may in fact be potentially harmful) in dental practice. Primary closure and antibacterial prophylaxis are recommended despite limited evidences. All evidence have been graded as either of a low or very low quality, and thus further high-quality randomized controlled trials are needed to answer this clinical question.
Craniomaxillofacial defects caused by congenital or acquired reasons seriously affect patients' physical and mental health. How to accurately and objectively repair the morphology of craniomaxillofacial tissues and organs through surgery is a difficult problem, and the preoperative virtual design is crucial. Traditional preoperative virtual design methods include mirror technology, statistical shape model, and deformable template. However, these methods are complex, time-consuming, and only applicable to some types of defects. Therefore, a general, intelligent, and personalized craniomaxillofacial defect virtual reconstruction system is desired. To solve this problem, a novel deep learning method, RecGAN, is proposed in this paper. RecGAN can learn the bone morphology of normal people, repair the defect intelligently based on the patient's remaining bone, and fully adapt to the special conditions of different patients. Currently, there are no open-source maxillofacial data sets available. Thus, a new maxillofacial computed tomography image data set with 500 simulated cases and 100 clinical cases is constructed to train and validate the method. The experimental results show that RecGAN can effectively restore the normal bone and tissue morphology of the patient's craniomaxillofacial defect area, solve the problem that there is no objective repair method for craniomaxillofacial defect, and achieve the
With the transformation of China's economic structure and upgrading of industrial structure, basic education plays an important role.On May 21, 2021, China deliberated and adopted the Opinions on Further reducing the Burden of Homework and Off-campus Training for Students in Compulsory Education.On July 24, 2021, the Guidelines on Further Reducing the Burden of Homework and Off-campus Training for Students in Compulsory Education were issued, hereinafter referred to as "double reduction".This paper will be in the double reduction policy, revitalization of local basic education and other documents.On the basis of the previous research on the development of basic education, this paper constructs a statistical measure problem between the evaluation of the sufficient situation of the development level of basic education and the gap of regional imbalance.In addition, the method of comprehensive questionnaire was selected to design endogenous factors and exogenous factors.With the method of factor analysis, this paper explores how to promote the coordinated development of regional education ecology under the new pattern of education development implemented by double reduction policy. The conclusion of the study is that "fair and quality education" is an important part of people's yearning for a better life. With the improvement of per capita education level, it is a top priority to receive fair and quality basic education.The state has effectively improved the scale and fair full development of basic education in backward areas through policies and public funds.The imbalance of basic education equity and basic education quality is heterogeneous. It is necessary to improve the overall learning resource environment of schools by using Internet technology, build a better educational ecosystem, remove the "digital divide" and break through the "digital dividend".
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