Objectives
This study assesses the ability to reconstruct costal cartilage images by using three‐dimensional visualisation software (Mimics) based on semi‐automated segmentation algorithm and to ...investigate its reliability and validity with an anthropometric analysis.
Design
Observational prospective study.
Setting
Plastic surgery department of a tertiary hospital.
Participants
Twenty‐two microtia patients who underwent autologous ear reconstruction.
Main outcome measures
Preoperative thoracic computed tomography data were processed to Mimics software for three‐dimensional costal cartilage imaging. The length, width, thickness and volume of the 9th costal cartilages were calculated from these images and compared with the direct measurements (DM) obtained intraoperatively.
Results
The intra‐examiner reliability and inter‐examiner reliability were high in terms of all four measurements (intraclass correlation coefficients, ICC: 0.876‐0.984). There were no significant differences between image‐based anthropometry and DM in the linear measurements except for the volume (P < .05). The mean volume calculation error of Mimics was −0.08 ± 0.13 mL. No correlation was found between the anthropometric variables and the absolute errors (P > .05). Furthermore, Bland‐Altman plots were used to evaluate the agreement between the two methods.
Conclusions
Despite a very small error was found in volume calculation, Mimics software was accurate and reliable in linear calculation. Three‐dimensional costal cartilage imaging was found to be an efficient tool for morphological evaluation of costal cartilages. We believe that with the application of individualised cartilage models based on three‐dimensional printing, the use of customised ear framework carving will be practicable in surgical training.
Objective To evaluate health-related quality of life (HRQoL) in children with cyclic vomiting syndrome (CVS) and to compare child self-reports with those of their parents and with published reports ...of children with irritable bowel syndrome (IBS), children with organic gastrointestinal disorders, and a healthy control group. Study design Sixty-eight children aged 5-18 years with CVS confirmed in a gastroenterology clinic completed the Pediatric Quality of Life Inventory (PedsQL). Eighty-two parents completed the parent-proxy PedsQL for children aged 2-18 years. These results were compared with published data for children with IBS, organic gastrointestinal disorders, and a healthy control group using ANOVA. Intraclass correlation was used to evaluate concordance between child and parent reports of HRQoL. Results HRQoL reported on the PedsQL by children with CVS was lower than that reported by children with IBS ( P < .01) and healthy controls ( P < .001), but did not differ from that reported by children with organic gastrointestinal disorders. Children with CVS also had lower HRQoL compared with healthy controls by parent-proxy report on the PedsQL ( P < .001). Correlations between HRQoL reports by parents and children were moderate to good (intraclass correlation coefficients, 0.504-0.805; P < .01). Duration of CVS episodes, delay in CVS diagnosis, and number of school days missed due to CVS were associated with lower parent-rated HRQoL ( P = .01). Conclusion Children with CVS reported lower HRQoL compared with those with IBS, and both parents and children reported lower HRQoL compared with healthy controls. Parent and child ratings of HRQoL converged. Improved recognition of CVS and school support might help mitigate the impact of CVS on HRQoL.
Bladder cancer, the most common malignancy of the urinary tract is a leading cause of morbidity and mortality. But cystoscopy, which is till now the mainstay of screening, is an invasive, high-cost ...method with low sensitivity especially for flat lesions.
To find a non-invasive and effective screening method with liquid-based cytology (LBC) using The Paris System (TPS) and CK20 immunocytochemistry.
It was a prospective study including the patients with clinical or cystoscopic diagnosis of urinary bladder space occupying lesions (SOL). Both conventional (CC) and liquid-based cytology slides were prepared from urine samples. Slides were evaluated by two trained pathologists and categorized according to TPS guidelines. CK20 immunocytochemistry (ICC) was also performed. Consequent formalin-fixed paraffin embedded sections were blindly examined by another pathologist and was taken as gold standard for comparison.
All the statistical analysis were done using MedCalc version 15.8 Mariakerke, Belgium: MedCalc Software 2015.
The study included 150 cases with a mean age of 62.4 years. Five cases revealed unsatisfactory smears. Rest of the cases were categorized as the following: 18.1% as NH-GUC, 8% as LGUN, 22.1% as AUC, 15.4% as SH-GUC, 32.9% as HGUC. Kappa value of CC and LBC were strong (0.854). LBC alone showed very low specificity (58%) and PPV (74.8%) which improved on application of ICC (specificity: 97.4%, PPV: 96.3%).
We conclude that CK20 ICC offers potential for accurate, non-invasive detection and surveillance of bladder cancer and is a better tool when combined with liquid-based cytology, reported using The Paris System.
This article examines historical injustices and transitional justice interventions that were initiated after the 2007 electoral conflict in the quest for conflict transformation in Kenya. During the ...mediation led by Kofi Annan that culminated in the signing of the National Accord in February 2008, transitional justice was emphasised as critical in attaining conflict transformation. In response, the Truth, Justice and Reconciliation Commission (TJRC) and International Criminal Court (ICC) interventions initiated a complementary restorative retributive approach in the pursuit of transitional justice in the country. Based on content analysis of fieldwork data extracted from twenty-five focus group discussions within a sampled cluster of ten counties, this study examines and presents the experiences and perceptions of victims of historical injustices, on the one hand, and the experiences and perceptions of interveners of conflict transformation programmes, on the other hand. This is with a view to explicating the outcomes and impacts of transitional justice interventions in conflict transformation in Kenya in the post-National Accord era. In the findings, a key argument is raised that unresolved three-tier historical injustices remain critical constraints in the pursuit of transitional justice and in the quest for effective conflict transformation in Kenya.
Analysis of gene expression data by clustering and visualizing played a central role in obtaining biological knowledge. Here, we used Pearson's correlation coefficient of multiple‐cumulative ...probabilities (PCC‐MCP) of genes to define the similarity of gene expression behaviors. To answer the challenge of the high‐dimensional MCPs, we used icc‐cluster, a clustering algorithm that obtained solutions by iterating clustering centers, with PCC‐MCP to group genes. We then used t‐statistic stochastic neighbor embedding (t‐SNE) of KC‐data to generate optimal maps for clusters of MCP (t‐SNE‐MCP‐O maps). From the analysis of several transcriptome data sets, we demonstrated clear advantages for using icc‐cluster with PCC‐MCP over commonly used clustering methods. t‐SNE‐MCP‐O was also shown to give clearly projecting boundaries for clusters of PCC‐MCP, which made the relationships between clusters easy to visualize and understand.
Clustering analysis is used to search gene expression data for patterns and to group genes into expression clusters that provide additional insight into biological function. Here, we use Pearson's correlation coefficient of multiple‐cumulative probabilities (PCC‐MCP) of genes in combination with icc‐cluster (a clustering algorithm that obtains the optimal solutions by iterating clustering centers) to identify and classify patterns of gene expression, and t‐statistic stochastic neighbor embedding (t‐SNE) to generate optimal maps for clusters of MCP (t‐SNE‐MCP‐O maps). We demonstrate clear advantages of icc‐cluster with PCC‐MCP over commonly used clustering methods, and show that t‐SNE‐MCP‐O gives good 2D projections, which makes the relationships between MCP clusters easy to visualize and understand.
Children often present at the emergency department with a suspected elbow fracture. Sometimes, the only radiological finding is a ‘fat pad sign’ (FPS) as a result of hydrops or haemarthros. This sign ...could either be the result of a fracture, or be due to an intra-articular haematoma without a concomitant fracture. There are no uniform treatment guidelines for this common population. The aims of this study were (1) to obtain insight into FPS definition, diagnosis, and treatment amongst international colleagues, and (2) to identify a uniform definition based on radiographic measurements with optimal cut-off points via a receiver operating characteristic (ROC) curve. An online international survey was set up to assess the diagnostic and treatment strategies, criteria, and definitions of the FPS, the probability of an occult fracture, and the presence of an anterior and/or posterior FPS on 20 radiographs. Additionally, the research team performed radiographic measurements to identify cut-off values for a positive FPS, as well as test–retest reliability and inter-rater reliability via intraclass correlation coefficients (ICC). A total of 133 (paediatric) orthopaedic surgeons completed the survey. Definitions, further diagnostics, and treatments varied considerably amongst respondents. Angle measurements of the fat pad as related to the humeral axis line showed the highest reliability (test–retest ICC, 0.95 (95% CI 0.88–0.98); inter-rater ICC, 0.95 (95% CI 0.91–0.98)). A cut-off angle of 16° was defined a positive anterior FPS (sensitivity, 1.00; specificity, 0.87; accuracy, 99%), based on the respondents’ assessment of the radiographs in combination with the research team’s measurements. Any visible posterior fat pad was defined as a positive posterior FPS. This study provides insight into the current diagnosis and treatment of children with a radiological fat pad sign of the elbow. A clear, objective definition of a positive anterior FPS was identified as a ≥16° angle with respect to the anterior humeral line.
The rights of victims at the International Criminal Court ('ICC' or 'Court') mirror their normative rights in international human rights law - victims' rights to truth, justice, and reparations. ...However, the reality of victim participation is oftentimes formalistic, overlooking victims' priorities. This is demonstrated by the lesser importance given to violations of social and economic ('ES') rights by the ICC, which are privileged by victims as being central to addressing their immediate needs, and are often a contributing factor to the root causes of conflict. This article suggests three ways in which the ICC can incorporate an ES rights perspective within its victims' mandate, by reference to the case of The Prosecutor v. Dominic Ongwen. Firstly, the ICC must ensure a broad interpretation of truth where socio-economic causes and effects of conflict are considered as part of victims' right to the truth in judicial pronouncements. Secondly, the Office of the Prosecutor must ensure that socio-economic violence is broadly reflected within the scope of the charges brought forward against an accused person/s where relevant. Lastly, the ICC Trust Fund for Victims must act with speed to ensure immediate assistance to victims and reparation orders must seek to dismantle pervasive systems of structural inequalities.
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