Modeling hybrid rough set-based classification procedures to identify hemodialysis adequacy for end-stage renal disease patients

Healthcare problems observed in the majority of end-stage renal disease (ESRD) patients regarding hemodialysis (HD) treatment are serious issues for the Taiwanese healthcare services, and an interesting topic is thus the adequacy of HD therapy. This study successfully models a hybrid procedure to measure HD adequacy to assess therapeutic effects and to explore the relationship between accuracy and coverage for interested parties. The proposed model has better accuracy, a lower standard deviation, and fewer attributes than the listed methods under various evaluation criteria. The study results are useful to subsequent researchers to develop suitable applications, and to ESRD patients and their doctors to ensure satisfactory medical quality.     

Towards a consensus for classification of mandibular condyle fractures

The merits of surgical treatment of fractures of the mandibular condyle versus non-surgical management remains highly controversial, despite a large volume of literature dedicated to this topic. One reason the controversy remains, is because most of the outcomes in the literature are not directly comparable. The disparate range of condylar fracture classifications used is one of the reasons that studies are not comparable. We sought to review classification systems for condylar fractures used in the recent scientific literature.Review of the literature from 2016 to 2019, looking for papers relating to fractures of the mandibular condyle. Papers identified were assessed for type of study, focus of study, classification system used.88 studies were identified, including prospective and retrospective cohort studies, randomised and non-randomised prospective studies, randomised controlled trials and case series. More studies focussed on epidemiological factors than surgical access, fixation or outcomes. 31 used no classification system, whilst 17 used unique classification systems and 40 used previously referenced classification systems.Classification systems are used to help separate clinical problems into distinguishable groups, where there is a difference in management or outcome depending on the distinguishing features.There is currently a wide diversity of classification systems used for condyle fractures, and as a result, comparisons of surgical access, fixation and outcomes are difficult to make. Having a single classification system across the published literature would allow easier comparison and the classification proposed by the AO group is recommended for future use.     

A New MRI Grading System for Cervical Foraminal Stenosis Based on Axial T2-Weighted Images

ObjectiveThe purpose of this study was to evaluate the reliability of a new magnetic resonance imaging (MRI) grading system for cervical neural foraminal stenosis (NFS).ResultsFor the distinction among the three individual grades at all six neural foramina, the ICC ranged from 0.68 to 0.73, indicating fair to good reproducibility. The percentage agreement ranged from 60.2% to 70.6%, and the kappa values (κ = 0.50-0.58) indicated fair to moderate agreement. The percentages of intraobserver agreement ranged from 85.4% to 93.8% (κ = 0.80-0.92), indicating near perfect agreement.ConclusionThe new MRI grading system shows sufficient interobserver and intraobserver agreement to reliably assess cervical NFS.     

跟距骨联合的MRI诊断价值探讨

目的分析跟距骨联合的MRI表现及分型,探讨其临床价值。方法对我院2011年4月—2013年4月间经手术、病理证实的25例跟距骨联合的MRI资料进行回顾性分析,其中男22例,女3例,平均年龄(33.76±13.12)岁;左侧跟距骨联合13例,右侧12例。分析跟距骨联合MRI直接征象和继发征象,按发生部位分型,并按冠状面像(部分结合矢状面像)进行形态分型。结果直接征象中完全骨性联合1例(4%),MRI表现为中距跟关节骨髓连接,纤维性联合14例(56%),软骨性联合10例(40%),MRI上均表现为联合处间隙变窄,边缘不规则。纤维性联合在MR T1WI、T2WI、抑脂序列上均呈低信号;软骨性联合的MRI信号近似软骨或液体,T1WI上呈中等强度信号,T2WI及抑脂序列上呈中等至高信号。继发征象中骨髓水肿20例(80%),"醉酒侍者征"9例(36%),"距骨喙征"3例(12%),"驼背跟骨征"2例(8%),骨折1例(4%)。按部位分型为:中距跟关节7例(28%),后距跟关节4例(16%),关节外型14例(56%),前距跟关节5例(20%)均合并与其他跟距骨联合。按形态分型为:Ⅰ型14例(56%),Ⅱ型3例(12%),Ⅲ型7例(28%),Ⅳ型1例(4%)。结论 MRI能够清晰显示跟距骨联合的组织类型、发生部位和形态等,可为临床提供有价值的诊断信息。