鼻内镜下咽鼓管置管术治疗分泌性中耳炎

目的探索有效治疗分泌性中耳炎的方法。方法将分泌性中耳炎患者63例（78耳）随机分成两组：实验组：在鼻内镜下,对31例（38耳）分泌性中耳炎患者行咽鼓管置管术,留管并反复注药治疗;对照组：对32例（40耳）患者使用传统的鼓膜切开置管术治疗,术后随访6～9个月,比较两组疗效。结果实验组治愈16耳,占42．1％,好转18耳,占47．4％,总有效率89．5％：对照组：治愈8耳,占20．0％,好转21耳,占52.5％,总有效率72．5％。治疗后两组差异有显著性（P〈0．05）。结论在鼻内镜下行咽鼓管置管术是在直视下操作,通过咽鼓管的自然通道插入导管,不仅避免了损伤鼓膜,也避免了咽鼓管吹张的重复操作,为临床治疗分泌性中耳炎提供了一个良好途径。     

Bibliometric and Altmetric Analysis of Retracted Articles on COVID-19

BackgroundWith greater use of social media platforms for promotions of research articles, retracted articles tend to receive approximately the same attention. We systematically analyzed retracted articles from retractionwatch.com to look at the Altmetric Attention Scores (AAS) garnered over a period of time in order to highlight the role of social media and other platforms in advertising retracted articles and its effect on the spread of misinformation.MethodsRetractionwatch.com was searched for coronavirus disease 2019 related retracted papers on November 6th, 2021. Articles were excluded based on lack of digital object identifier (DOI), if they were preprint articles, absent AAS, and incomplete AAS of pre retraction, post retraction, or both scores.ResultsA total of 196 articles were found on the Retraction Watch website of which 189 were retracted papers and 7 were expression of concern (EOC). We then identified 175 articles after excluding those that did not have a DOI and 30 preprint articles were also excluded giving 145 articles. Further exclusion of articles with absent AAS and incomplete AAS resulted in a total of 22 articles.ConclusionRetracted articles receive significant online attention. Twitter and Mendeley were the most popular medium for publicizing retracted articles, therefore more focus should be given by journals and their Twitter accounts to discredit all their retracted articles. Preprints should be reconsidered as a whole by journals due to the huge risk they carry in disseminating false information.     

Prediction of the duration needed to achieve culture negativity in patients with active pulmonary tuberculosis using convolutional neural networks and chest radiography

BackgroundWe aimed to predict the duration needed to achieve culture negativity in patients with active pulmonary tuberculosis using convolutional neural networks (CNNs) and chest radiography.MethodsMedical records were searched for eligible patients with culture-confirmed active pulmonary tuberculosis. The eligible patients were randomly assigned to the training dataset group (N = 180) and the validation dataset group (N = 59). Posteroanterior X-ray radiographs in the standing position were obtained at diagnosis. The image data were augmented by a factor of 10 by randomly shifting and rotating the original image. Thus, 1800 images (112 × 112 pixels, 8-bit grayscale) from 180 patients in the training dataset group were used for training the CNN model. The model performance was evaluated on the validation dataset.ResultsThe values predicted by the CNN model were significantly associated with the actual values (Pearson's correlation coefficient 0.392, p = 0.002). The mean absolute error was 18.0. The visualization of the layer outputs suggested that the CNN model recognized some of the chest radiographic findings that were useful in predicting the duration needed to achieve culture negativity.ConclusionsThe CNN model was useful for predicting the duration needed to achieve culture negativity in active pulmonary tuberculosis, although the accuracy was unsatisfactory. This study suggests that chest radiography findings are as important as other clinical factors for prediction and could be learned by the machine.     

Computed tomography contrast media extravasation: treatment algorithm and immediate treatment by squeezing with multiple slit incisions

In our hospital, an adverse event reporting system was initiated that alerts the plastic surgery department immediately after suspecting contrast media extravasation injury. This system is particularly important for a large volume of extravasation during power injector use. Between March 2011 and May 2015, a retrospective chart review was performed on all patients experiencing contrast media extravasation while being treated at our hospital. Immediate treatment by squeezing with multiple slit incisions was conducted for a portion of these patients. Eighty cases of extravasation were reported from approximately 218 000 computed tomography scans. The expected extravasation volume was larger than 50 ml, or severe pressure was felt on the affected limb in 23 patients. They were treated with multiple slit incisions followed by squeezing. Oedema of the affected limb disappeared after 1–2 hours after treatment, and the skin incisions healed within a week. We propose a set of guidelines for the initial management of contrast media extravasation injuries for a timely intervention. For large‐volume extravasation cases, immediate management with multiple slit incisions is safe and effective in reducing the swelling quickly, preventing patient discomfort and decreasing skin and soft tissue problems.     

The Perception Gap: Recognizing and managing the risks that arise when we get risk wrong

Many in the academic, science, and business communities are frustrated at how people perceive and respond to risk, lamenting that the lay public is sometimes more afraid of some threats than the evidence warrants, and less afraid of some dangers than the evidence warns. This is often ascribed to the alarmist way the news media cover risk-related subjects. That criticism is simplistic and unproductive, and ignores or dismisses the large body of research that finds that the perception of risk is not, and can never be, perfectly rational. Risk perception among members of the public, the media, and members of the academic, scientific, and business communities, is ultimately subjective. The gap between our fears and the evidence is not simply the product of alarmist media reporting. This ‘Perception Gap’ poses significant risks in and of itself, influencing the choices we make as individuals and as a society. The roots of the Perception Gap must be understood if we are to recognize the dangers that can arise when we sometimes get risk wrong, and in order that we may more wisely manage those risks as actively as we manage toxicological or food or other risks with which we are more familiar.     

Information on co-morbidities collected by history is useful for assigning Otitis Media risk to children

ObjectivesDetermine if a 2-Step multivariate analysis of historical symptom/sign data for comorbid diseases can abstract high-level constructs useful in assigning a child's “risk” for different Otitis Media expressions.MethodsSeventeen items related to the symptom/sign expression of hypothesized Otitis Media comorbidities were collected by history on 141 3-year-old children. Using established criteria, the children were assigned to 1 of 3 groups: Control (no significant past Otitis Media, n = 45), Chronic Otitis Media with Effusion (n = 45) and Recurrent Acute Otitis Media (n = 51). Principal Component Analysis was used to identify factors representing the non-redundant shared information among related items and Discriminant Analysis operating on those factors was used to estimate the best predictor equation for pairwise group assignments.ResultsSix multivariate factors representing the assignable comorbidities of frequent colds, nasal allergy, gastroesophageal disease (specific and general), nasal congestion and asthma were identified and explained 81% of the variance in the 17 items. Discriminant Analysis showed that, for the Control-Chronic Otitis Media with Effusion comparison, a combination of 3 factors and, for the Control-Recurrent Acute Otitis Media comparison, a combination of 2 factors had assignment accuracies of 74% and 68%, respectively. For the contrast between the two disease expressions, a 2-factor combination had an assignment accuracy of 61%.ConclusionThese results show that this analytic methodology can abstract high-level constructs, comorbidities, from low-level data, symptom/sign scores, support a linkage between certain comorbidities and Otitis Media risk and suggest that specific comorbidity combinations contain information relevant to assigning the risk for different Otitis Media expressions.     

Misrepresentation of UK homicide characteristics in popular culture

The homicide statistics of a popular UK television fictional crime series and the former Lothian & Borders police force region, Scotland were compared. This comparison was used to consider the implications for public attitudes which may influence the adoption of public health interventions to reduce homicide.217 homicides were identified by 105 perpetrators in the television series 'Midsomer Murders' between 1997 and 2011; these were compared to 55 homicides by 53 perpetrators in the regional sample between 2006 and 2011. The numbers of serial killings (p < 0.0001), planned homicides, female perpetrators (p < 0.0001), shootings (p = 0.0456) and poisonings (p = 0.0289) were higher in the fictional sample. Lothian & Borders cases were almost all single killings, mostly unplanned, with a far greater rate of homicide by kitchen knives (p < 0.0001) and hitting/kicking (p = 0.0005) by intoxicated perpetrators.Control of access to pointed kitchen knives by members of certain groups may reduce homicide rates. If the popular perception of UK homicides is influenced by popular culture, the importance of such a public health intervention may not be apparent.     

公众及媒体需求在应对突发公共卫生事件中的作用

本文对突发公共卫生事件工作中,掌握并及时满足公众及媒体对相关信息了解的重要性及必要性进行了初步探讨,为开展突发公共卫生事件的健康传播提供一种思路。     

基于DICOM标准的医学图像存储与访问的研究

本文详细介绍了基于DICOM标准的医学图像文件格式和数据元素结构,介绍了我们在Windows环境下利用C 研制实现了一个基于DICOM标准的医学图像存储与访问系统,描述了系统中医学图像的存储结构与读写算法,该方案在一个实用的口腔数字影像系统中通过了验证。