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Intelligent Information Management 2024年第1期16卷 10-20页

作者： Neil Capes hiran Patel Islam Sarhan Gur-Aziz S. Sidhu Neil Ashwood Andrew Dekker Department of Trauma & Orthopaedics University Hospitals Derby and Burton Derby United Kingdom Department of Trauma & Orthopaedics University Hospital Lewisham London United Kingdom Research Institute University of Wolverhampton Wolverhampton United Kingdom

ChatGPT has obvious benefits in the way it can interrogate vast amounts of reference information and utilise metadata generation to answer questions posed to it and is freely available having been developed through human feedback. Already there are ethical and practical implications on its impact on learning and research. Artificial Intelligence (AI) has been seen as a way of improving healthcare provision by delivering more robust outcomes but measuring these and implementing AI within this setting is at present limited and disjointed. Methods: ChatGPT was interrogated to see what it felt were the barriers to its implementation within healthcare and in particular orthopaedic practice. The evidence for this determination was then examined for validity and applicability for a practical roll out at a Trust, Regional or National level. Results: AI can synthesise a vast amount of information to help it answer specific questions. The context and structure of any question will determine the usefulness of the answer which can then be used to develop practical solutions based on experience and resource limitations. Conclusions: AI has a role in service development and can quickly focus a working group to areas to consider when practically implementing change.

关键词： Artificial Intelligence ChatGPT

Acceptability and Feasibility of YouthCHAT to Detect Psychosocial Problems in Young People with Congenital Heart Disease

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International Journal of Mental Health Promotion 2021年第2期23卷 221-230页

作者： hiran Thabrew Harshali Kumar Vanessa Garcia-Hoyos Felicity Goodyear-Smith Department of Psychological Medicine Faculty of Medical and Health SciencesUniversity of AucklandAuckland1023New Zealand Adult Congenital Heart Disease Service Paediatric and Congenital CardiologyStarship HospitalAuckland1023New Zealand Department of General Practice and Primary Health Care University of AucklandAuckland1023New Zealand

Objective:Young people with congenital heart disease(CHD)are at increased risk of psychosocial issues,includ-ing anxiety and depression that can affect their medical care and quality of *** open trial investigated the acceptability,feasibility and preliminary effectiveness of YouthCHAT,a tablet-based screener,designed to identify similar issues to a face to face psychosocial assessment,with young people who have ***:Youth-CHAT was administered to 44 such young people aged 15–25 years attending a specialist outpatient clinic at a New Zealand tertiary *** outcomes were(i)acceptability and(ii)feasibility of YouthCHAT,assessed via feedback from young people and clinicians and(iii)detection rates for each domain of YouthCHAT,measured by mental health or lifestyle issue being‘present’or‘absent’.Results:YouthCHAT was quick to complete(mean 9 min and 7 s)and well-received by young people(overall rating 7 out of 10)and *** of anxiety,substance use and other issues were similar to those in a previous study of young people with mixed long-term physical ***,rates of depression(41%)and life stresses(98%)were notably ***:Although further research is required,our results provide initial evidence that YouthCHAT is a viable and accep-table psychosocial screener with which to improve the holistic care of young people with CHD.

关键词： Screening adolescent anxiety depression congenital heart disease

Quality of life and depression among patients with high myopia in Nigeria:a cross sectional study

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International Journal of Ophthalmology(English edition) 2023年第12期16卷 2071-2081页

作者： Uchechukwu Levi Osuagwu Kelechukwu Enyinnaya Ahaiwe Nnaemeka Meribe ElizabethDennis Nkanga Bernadine nsa Ekpenyong Affiong Andem Ibanga Piwuna ChristopherGoson Dennis George Nkanga Bathurst Rural Clinical School(BRCS) School of MedicineWestern Sydney UniversityBathurstNSW 2795Australia African Vision Research Institute University of KwaZulu-Natal DurbanDurban 4001South Africa Department of Ophthalmology University of Calabar Teaching HospitalCalabarCross River State 540281Nigeria Department of Politics Media and PhilosophyLa Trobe UniversityMelbourneVictoria 3086Australia Department of Ophthalmology Faculty of Clinical SciencesUniversity of CalabarCross River State 540281Nigeria Department of Public Health University of CalabarCalabarCross River State 540281Nigeria Department of Psychiatry College of Health SciencesUniversity of JosJosPlateau 930001Nigeria

AIM:To evaluate the quality of life(QOL)and level of depression among participants with high myopia in Nigeria and the demographic factors associated with these ***:This cross-sectional study was conducted on 100 adult participants with high myopia(defined as refractive error≤-5.00 D or worse,and uncorrected visual acuity worse than 6/18 in the better seeing eye)attending ophthalmology centres in Nigeria from 2 October 2021 to 30 August *** means and standard deviations were calculated for each of the four domains of World Health Organization Quality of life scale(WHOQOL-BREF)using the transformed *** Beck Depression Inventory(BDI)scale was used to assess the level of ***:The highest and the lowest mean scores of WHOQOL-BREF domains were found for the psychological and physical health domains(mean percentage scores were 67.0[95% confidence intervals(CI)64.1-68.9]and 55.3(95%CI 51.8-58.8,P<0.001),***-way analysis of variance(ANOVA)revealed significant differences in physical health with educational status(higher among those with tertiary education:mean difference 0.9,95%CI-0.2-2.1;P=0.049),differences in psychological health with working status(higher among those who were working 1.2,95%CI 0.3-2.1;P=0.012).Also,the result showed a statistically significant association between environmental health and marital status(higher among non-married:1.7,95%CI-0.9-2.3;P=0.012)while overall health was associated with place of residence(higher in urban areas:2.3,95%CI 1.2-3.5;P=0.024).For depression,one in every nine participants reported major depressive symptom,mostly younger people(aged 16-29 vs 30-49y:17.0%vs 0,P=0.019),and slightly more women than men(14.3%vs 0,P=0.064).There were significant negative correlations between the depression scores and psychological health(r=-0.48,P<0.001),physical health(r=-0.29,P=0.002),social and relationship(r=-0.49,P<0.001),environmental(r=-0.48,P<0.001)and overall health(r=-0.49,P<0.001)C

关键词： myopia uncorrected refractive error vision impairment low vision quality of life Africa

How Should we Treat Patients Too Sick to Have Anatomic Resection?

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How Should we Treat Patients Too Sick to Have Anatomic Resec...

Chinese EFL Teachers' Pragmatic Competence in China

第四届中国肿瘤学术大会暨第五届海峡两岸肿瘤学术会议

作者： hiran Fernando MD Protocol chair American College of Surgeons Oncology Group

＜正＞Phase Ⅲ Randomized Study of Sublobar Resection With Versus Without Intraoperative Brachytherapy in High - Risk Patients With Stage Ⅰ Non-Small Cell Lung Cancer Disease Characteristics: Suspected or proven non - small cell lung cancer （NSCLC）, meeting both of the following criteria: Pre - operative criteria Lung nodule suspicious for clinical stage I NSCLC Mass ＜ 3 cm in maximum diameter by CT scan Clinical stage IA OR selected stage IB with visceral pleural involvement Intra - operative criteria Histologically proven stage I NSCLC

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海外英语 2016年第6期 231-234页

作者：杨晓霞 Prannapha Mode-hiran 泰国朱拉隆功大学

The focus of this study is to outline the survey results carried out on the pragmatic competence of the High School Chinese EFL Teachers in China. The research participants in this study comprised of 40 teachers. The tools used to carry out the research included: a) a questionnaire made up of two parts: the background information of the respondents, and the Multiple Choice Discourse Completion Test(MDCT).b) the retrospective interview questions. The main purpose of the MDCT is to examine the level of pragmatic competence of the teachers by analyzing their practical shortcomings. On analyzing the results on the data collected from the teachers, the extent of the Chinese EFL teacher's pragmatic competence was observed. Analysis of the answers obtained from the teachers also implied how the High School EFL teachers can help in developing the level of the student's pragmatic competence. The analysis of the results showed the various responses to the questionnaire questions based on the items of the speeches showing the different points of weakness that need to be improved.

关键词： EFL pragmatic competence China High school

Outcomes of Ureterorenoscopy for Lower Pole Kidney Stones (≤3 cm) to the Omar Bongo Ondimba Army Instruction Hospital

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Open Journal of Urology 2022年第8期12卷 440-448页

作者： Smith Giscard Olagui Mariette nsa Bidzo Crepin Olende Jean Placide Owono Bouengou Urology and Visceral Service Military Instruction of Omar Bongo Ondimba Hospital Libreville Gabon Department of Urology Faculty of Medicine University of Health Sciences Libreville Gabon Urology Service Military Instruction of Omar Bongo Ondimba Hospital Libreville Gabon Visceral Service Military Instruction of Omar Bongo Ondimba Hospital Libreville Gabon Faculty of Medicine University of Health Sciences Libreville Gabon

Introduction: The management of kidney stones has benefited from endoscopic techniques, in particular the development of flexible ureteroscopy (ureterorenoscopy). This endoscopic treatment has made it possible to treat many upper urinary tract stones, with satisfactory results and less morbidity. This innovative minimally invasive technique was introduced in our country in 2018. It is not practiced in all health structures. We report our experience. Objectives: The aim of our study was to evaluate the place of flexible ureteroscopy laser, its feasibility, and the results on stones up to 30 mm in size only in the lower calicial group, while assessing the postoperative quality of life. Patients and Methods: We conducted a monocentric observational retrospective study at the Omar Bongo Ondimba Army Training Hospital (OBO ATH) on 22 patients with symptomatic inferior caliciel stones, over a period of January 2019 and December 2020 treated by flexible ureteroscopy laser (FUR-L), once or twice depending on the size of the residual fragments. Results: All the patients had symptomatic urolithiasis, diagnosed on the clinical elements, and confirmed in 77% by urinary computed tomography. The average age was 35.47 years ± 12, with a clear female predominance (64%). All the stones sat in the lower chalice. 66.5% of stones were larger than 10 mm. 75% of patients were “stones free” after one FUR-L session, and 100% after the second session. 10% of patients still had residual pain at 01 month which was absent at 03 month. 18% of postoperative urinary tract infections were treated with antibiotics. 90% of the patients had resumed an activity prior to 1 month. At 1 month and 3 months, 82% and 100% respectively were satisfied with the mode of treatment according to self-questioning. Conclusion: FUR-L remains a therapeutic modality for stones in the lower calicial group, for stones whose diameter is close to 30 mm. A sequential approach should be considered for diameter stone up to 30

关键词： Renal Stone Lower Calyx Group Flexible Ureteroscopy (FUR) Laser (L)

Bacterial entombment by intratubular mineralization following orthograde mineral trioxide aggregate obturation: a scanning electron microscopy study

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International Journal of Oral Science 2014年第4期6卷 227-232页

作者： Jun Sang Yoo Seok-Woo Chang So Ram Oh hiran Perinpanayagam Sang-Min Lim Yeon-Jee Yoo Yeo-Rok Oh Sang-Bin Woo Seung-Hyun Han Qiang Zhu Kee-Yeon Kum Department of Dentistry U Dental Hospital Department of Conservative Dentistry School of Dentistry Kyung Hee University Department of Conservative Dentistry Dental Research Institute Seoul National University Dental Hospital Seoul National University School of Dentistry Division of Restorative Dentistry Schulich School of Medicine & Dentistry University of Western Ontario Department of Conservative Dentistry Jukjeon Dental Hospital College of Dentistry Dankook University Department of Oral Microbiology & Immunology Dental Research Institute and BK21 Program Seoul National University School of Dentistry Division of Endodontology Department of Oral Health and Diagnostic Sciences School of Dental Medicine University of Connecticut Health Center

The time domain entombment of bacteria by intratubular mineralization following orthograde canal obturation with mineral trioxide aggregate（MTA） was studied by scanning electron microscopy（SEM）. Single-rooted human premolars（n560） were instrumented to an apical size #50/0.06 using ProF ile and treated as follows： Group 1（n510） was filled with phosphate buffered saline（PBS）; Group 2（n510） was incubated with Enterococcus faecalis for 3 weeks, and then filled with PBS; Group 3（n520） was obturated orthograde with a paste of OrthoM TA（BioM TA, Seoul, Korea） and PBS; and Group 4（n520） was incubated with E. faecalis for 3 weeks and then obturated with OrthoM TA–PBS paste. Following their treatments, the coronal openings were sealed with PBS-soaked cotton and intermediate restorative material（IRM）, and the roots were then stored in PBS for 1, 2, 4, 8 or 16 weeks. After each incubation period, the roots were split and their dentin/MTA interfaces examined in both longitudinal and horizontal directions by SEM. There appeared to be an increase in intratubular mineralization over time in the OrthoM TA-filled roots（Groups 3 and 4）. Furthermore, there was a gradual entombment of bacteria within the dentinal tubules in the E. faecalis inoculated MTA-filled roots（Group 4）. Therefore, the orthograde obturation of root canals with OrthoM TA mixed with PBS may create a favorable environment for bacterial entombment by intratubular mineralization.

关键词： bacterial entombment intratubular mineralization orthograde canal obturation scanning electron microscopy tag-like structure

Prediction of Driver Gene Matching in Lung Cancer NOG/PDX Models Based on Artificial Intelligence

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Engineering 2022年第8期8卷 102-114页

作者： Yayi He Haoyue Guo Li Diao Yu Chen Junjie Zhu hiran C.Fernando Diego Gonzalez Rivas Hui Qi Chunlei Dai Xuzhen Tang Jun Zhu Jiawei Dai Kan He Dan Chan Yang Yang School of Medicin5 Tongji UniversityShanghai 200092China Department of Medical Oncology Shanghai Pulmonary HospitalSchool of Medicin5Tongji UniversityShanghai 200433China Department of Automation School of Electronic Information and Electrical Engineerin7Shanghai Jiao Tong UniversityShanghai 200240China Spine Center Orthopedic DepartmentShanghai Changzheng HospitalShanghai 200003China Department of Thoracic Surgery Shanghai Pulmonary HospitalSchool of Medicin5Tongji UniversityShanghai 200433China School of Materials Science and Engineerin7 Tongji UniversityShanghai 201804China Department of Thoracic Surgery Allegheny General HospitalPittsburg8PA 15212USA Department of Thoracic Surgery and Minimally Invasive Thoracic Surgery Unit(UCTMI) Coruna University HospitalCoruna 15006Spain Oncology and Immunology BU Research Service DivisionWuXi Appte3Shanghai 200131China SJTU–Yale Joint Center for Biostatistics and Data Scienc5 Department of Bioinformatics and BiostatisticsSchool of Life Sciences and BiotechnologyShanghai Jiao Tong UniversityShanghai 200240China Division of Medical Oncology Department of Medicin5University of Colorado Anschutz Medical CampusAuror1CO 80045USA

Patient-derived tumor xenografts(PDXs)are a powerful tool for drug discovery and screening in ***,current studies have led to little understanding of genotype mismatches in PDXs,leading to massive economic ***,we established PDX models from 53 lung cancer patients with a genotype matching rate of 79.2%(42/53).Furthermore,17 clinicopathological features were examined and input in stepwise logistic regression(LR)models based on the lowest Akaike information criterion(AIC),least absolute shrinkage and selection operator(LASSO)-LR,support vector machine(SVM)recursive feature elimination(SVM-RFE),extreme gradient boosting(XGBoost),gradient boosting and categorical features(Cat Boost),and the synthetic minority oversampling technique(SMOTE).Finally,the performance of all models was evaluated by the accuracy,area under the receiver operating characteristic curve(AUC),and F1 score in 100 testing *** multivariable LR models revealed that age,number of driver gene mutations,epidermal growth factor receptor(EGFR)gene mutations,type of prior chemotherapy,prior tyrosine kinase inhibitor(TKI)therapy,and the source of the sample were powerful ***,Cat Boost(mean accuracy=0.960;mean AUC=0.939;mean F1 score=0.908)and the eight-feature SVM-RFE(mean accuracy=0.950;mean AUC=0.934;mean F1 score=0.903)showed the best performance among the ***,application of the SMOTE improved the predictive capability of most models,except Cat *** on the SMOTE,the ensemble classifier of single models achieved the highest accuracy(mean=0.975),AUC(mean=0.949),and F1 score(mean=0.938).In conclusion,we established an optimal predictive model to screen lung cancer patients for non-obese diabetic(NOD)/Shi-scid,interleukin-2 receptor(IL-2R)γ^(null)(NOG)/PDX models and offer a general approach for building predictive models.

关键词： Machine learning Patient-derived tumor xenografts NOG mice

Artificial Intelligence;a Pragmatic Approach to Implementation in Medicine, a Review of the literature and a Survey of Local Practice in Midlands in UK

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International Journal of Intelligence Science 2023年第3期13卷 63-79页

作者： Neil Capes hiran Patel Islam Sarhan Neil Ashwood Andrew Dekker Ramy Shehata Department of Trauma & Orthopaedics University Hospitals Derby and Burton Derby UK University of Wolverhampton Research Institute Wolverhampton UK Department of Trauma and Orthopaedics Surgery Raigmore Hospital Inverness North of Scotland

The use of Artificial Intelligence (AI) for clinical pathway management and decision making is believed to improve clinical care and has been used to improve pathways for treatment in most medical disciplines. Methods: A literature review was undertaken to identify the hurdles and steps required to introduce supported clinical decision-making using AI within hospitals. This was supported by a survey of local hospital practice within the Midlands of the United Kingdom to see what systems had been introduced and were functioning effectively. Results: It is unclear how to practically implement systems using AI within medicine easily. Algorithmic medicine based on a set of rules calculated from data only takes a clinician so far to deliver patient centred optimal treatment. AI facilitates a clinician’s ability to assimilate data from disparate sources and can help with some of the analysis and decision making. However, learning remains organic and the subtleties of difference between patients, care providers who exhibit non-verbal communication for instance make it difficult for an AI to capture all the pertinent information required to make the correct clinical decision for any given individual. Hence it assists rather than controls any process in clinical practice. It also must continually renew and adapt considering changes in practise and trends as the goalposts change to meet fluctuations in resources and workload. Precision surgery is benefiting from robotic-assisted surgery in parts driven by AI and being used in 80% of trusts locally. Conclusion: The use of AI in clinical practice remains patchy with it being adopted where research groups have studied a more effective method of monitoring or treatment. The use of robotic-assisted surgery on the other hand has been more rapid as the precision of treatment that this provides appears attractive in improving clinical care.

关键词： Artificial Intelligence Local Practice in Midlands AI in Medicine

Radiographic Circularity of Capitellum and Its Relation to the Range of Motion

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Open Journal of Orthopedics 2023年第5期13卷 205-212页

作者： Islam Mubark Neil Ashwood Amr Abouelela hiran Patel Hamzah Khan Quentin Fogg University Hospitals of Derby and Burton NHS Foundation Trust Derby UK Department of Computer Science University of Wolverhampton Wolverhampton UK Department of Anatomy The University of Melbourne Melbourne Australia Research Institute University of Wolverhampton Wolverhampton UK

Background: The shape of the capitellum has been traditionally described in anatomy books as part of a sphere. Alteration in the capitellar morphology following pathologies such as fractures, osteochondrosis, and degenerative arthritis has been associated with less optimum functional results. Aim: To define the relationship between the sphericity of the capitellar morphology as measured on trauma series plain radiographs and the elbow range of motion. Methods: 40 patients were included in the study. All patients recruited from the upper limb clinics presented with non-elbow joint-related complaints. The elbow range of motion was measured using a standardized technique. Digital anteroposterior and lateral radiographs of patients’ elbows were used to measure capitellar circularity using the ImageJ processing program and circularity calculation equation. Correlation analyses were conducted between the degree of capitellar sphericity and elbow range of motion. Results: The results of measurements from the anteroposterior radiographs showed a positive correlation between increased circularity and an increase in the range of flexion, pronation, and supination. The range of extension decreased with the increased circularity of the capitellum. This trend was repeated with measures of lateral radiographs but was statistically not significant. Conclusion: Native capitellar circularity has an impact on the elbow range of motion. This should be put into consideration when dealing with pathologies that affect capitellar morphology.

关键词： Capitellum Circularity Anatomy Range of Motion Elbow Joint