Purpose: This study was performed to assess the performance and accuracy of artificial intelligence (AI) in the detection and diagnosis of maxillary sinus pathologies using computed tomography (CT)/cone-beam computed tomography (CBCT) imaging. Materials and Methods: A comprehensive literature search was conducted across 4 databases: Google Scholar, BioMed Central (BMC), ProQuest, and PubMed. Combinations of keywords such as “DCNN,” “deep learning,” “convolutional neural network,” “machine learning,” “predictive modeling,” and “data mining” were used to identify relevant articles. The study included articles that were published within the last 5 years, written in English, available in full text, and focused on diagnostic accuracy. Results: Of an initial 530 records, 12 studies with a total of 3,349 patients (7,358 images) were included. All articles employed deep learning methods. The most commonly tested pathologies were maxillary rhinosinusitis and maxillary sinusitis, while the most frequently used AI models were convolutional neural network architectures, including ResNet and DenseNet, YOLO, and U-Net. DenseNet and ResNet architectures have demonstrated superior precision in detecting maxillary sinus pathologies due to their capacity to handle deeper networks without overfitting. The performance in detecting maxillary sinus pathology varied, with an accuracy ranging from 85% to 97%, a sensitivityof 87% to 100%, a specificity of 87.2% to 99.7%, and an area under the curve of 0.80 to 0.91. Conclusion AI with various architectures has been used to detect maxillary sinus abnormalities on CT/CBCT images, achieving near-perfect results. However, further improvements are needed to increase accuracy and consistency.

The goals of antimicrobial treatment of end-of-life (EOL) infections are variously defined, raising complex questions about the management futility, ethical aspects, psychosocial burden, and the risk of emerging antimicrobial resistance. The author searched PubMed, Scopus, and Web of Science databases to retrieve relevant articles published from May 1, 2000, to April 30, 2024, on EOL infections and emerging multidrug-resistant organisms.The titles and abstracts of retrieved articles were screened, duplicate records were excluded, and the eligibility of selected papers was assessed. Sixty-one articles were included; the prevalence of EOL infections and antimicrobial therapy were calculated, the common sites and characteristics of EOL infections were identified, and the extent of emerging multidrug-resistant organisms among EOL patients, especially the "superbugs" ones, were estimated.The review indicates that infections are common in terminally ill patients, the prevalence of irrational antimicrobial prescriptions is high globally, with antimicrobials frequently administered until death. Limited data regarding antimicrobial resistance are available, and they cover short periods, while many of those patients survive longer with modern healthcare and become an essential reservoir for emerging multidrug-resistant organisms. This underscores the importance of antimicrobial stewardship programs and the urgent need for further research in this oftenoverlooked study area.

Purpose: This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines. Materials and Methods: A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method. Results: Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT’s future use, despite pending guidelines support. Conclusions This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.

BACKGROUND: Factor H and membrane inhibitor of reactive lysis (CD59) are key regulators of complement activation.Mesenchymal stem cells (MSCs) secrete Factor H and express CD59 to protect themselves from complement-mediated damage. Severe hypoxia found to decrease the survival chances of MSCs after transplantation; however, little is known about the impact of severe hypoxia on modulating the complement system activity and its effect on MSCs survival. Our study seeks to explore the effect of severe hypoxia on modulating the complement cascade in MSCs. METHODS: Human adipose tissue-derived MSCs (hAD-MSCs) were cultured under severe hypoxia using 400 lM Cobalt Chloride (CoCl2) for 48 h. The protein expressions of survival marker; Phosphoinositide 3-kinases (PI3K), and proapoptotic marker; Caspase-3 were assessed using western blotting. The level of complement system related factors; Factor H, CD59, C3b, iC3b, C5b, C9, and the complement membrane attack complex (MAC) were analyzed using Elisa assays, western blotting, and immunocytochemistry. RESULTS: Our results showed for the first time that severe hypoxia can significantly impair Factor H secretion and CD59 expression in MSCs. This has been associated with upregulation of MAC complex and increased level of cell lysis and apoptosis marked by downregulation of PI3K and upregulation of Annexin v and Caspase-3. CONCLUSION The loss of Factor H and CD59 in hypoxic MSCs can initiate their lysis and apoptosis mediated by activating MAC complex. Preserving the level of Factor H and CD59 in MSCs has significant clinical implication to increase their retention rate in hypoxic conditions and prolong their survival.

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

Background: and Purpose Acute ischemic stroke (AIS) is a leading cause of disability worldwide. While intravenous thrombolysis is recommended within 4.5 hours of last known well (LKW) time, many patients present beyond this window. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating tenecteplase (TNK) administration in AIS patients within 4.5 to 24 hours of LKW. The primary outcomes assessed functional independence and ordinal modified Rankin Scale (mRS) shift at 90 days. Safety outcomes included symptomatic intracranial hemorrhage (sICH) and mortality at 90 days. Results: Three RCTs were included, comprising 1,054 patients (532 TNK and 522 standard medical therapy) with a mean age of 69 years, 59% males, and median baseline National Institutes of Health Stroke Scale score of 10.5. TNK treatment was associated with mRS 0–2 at 90 days (odds ratio [OR]: 1.33, 95% confidence interval [CI]: 1.04–1.70, P=0.023), indicating a 33% higher likelihood of achieving functional independence. However, the ordinal mRS shift showed no significant difference (standardized mean difference: 0.01, 95% CI: -0.37–0.39, P=0.09). Safety outcomes indicated no difference in the rates of sICH (OR: 2.07, 95% CI: 0.86–5.00, P=0.1), and no difference in 90-day mortality (OR: 1.08, 95% CI: 0.76–1.53, P=0.67). Conclusion This meta-analysis suggests TNK might be safe and effective for selected AIS patients in the 4.5- to 24-hour time window, offering improved functional outcomes without a significant increase in hemorrhagic complications.

Haptic dental simulators are gaining recognition for training dental students. However, there needs to be more evidence of their pedagogical effectiveness. The primary aims were to (1) identify the published studies related to the application of virtual reality (VR) and haptic technology in the restorative dentistry training of dental students, (2) recognize the outcome criteria used in the published studies, and (3) determine the subjective evaluation of VR and haptic technology in the restorative dentistry training by the students. A comprehensive literature search was conducted to find scholarly articles that assessed the utilization of VR and haptics in training students in restorative dentistry. The investigation was performed via seven online databases: Scopus, Web of Science Core Collection, PubMed, Science Direct Freedom Collection, Latin American & Caribbean Health Sciences Literature (LILACS), EMBASE, and MEDLINE. Of the 268 potential articles assessed, 22 met the inclusion criteria. Findings demonstrated feasibility and acceptability. Additionally, there was improved motor skill acquisition and retention and less time for dental restoration after haptic virtual reality training. With the rising evidence of efficacy and increased utilization of digital technologies, virtual reality, and haptics has a role in improving students’ education outcomes.

Purpose: This study was performed to assess the performance and accuracy of artificial intelligence (AI) in the detection and diagnosis of maxillary sinus pathologies using computed tomography (CT)/cone-beam computed tomography (CBCT) imaging. Materials and Methods: A comprehensive literature search was conducted across 4 databases: Google Scholar, BioMed Central (BMC), ProQuest, and PubMed. Combinations of keywords such as “DCNN,” “deep learning,” “convolutional neural network,” “machine learning,” “predictive modeling,” and “data mining” were used to identify relevant articles. The study included articles that were published within the last 5 years, written in English, available in full text, and focused on diagnostic accuracy. Results: Of an initial 530 records, 12 studies with a total of 3,349 patients (7,358 images) were included. All articles employed deep learning methods. The most commonly tested pathologies were maxillary rhinosinusitis and maxillary sinusitis, while the most frequently used AI models were convolutional neural network architectures, including ResNet and DenseNet, YOLO, and U-Net. DenseNet and ResNet architectures have demonstrated superior precision in detecting maxillary sinus pathologies due to their capacity to handle deeper networks without overfitting. The performance in detecting maxillary sinus pathology varied, with an accuracy ranging from 85% to 97%, a sensitivityof 87% to 100%, a specificity of 87.2% to 99.7%, and an area under the curve of 0.80 to 0.91. Conclusion AI with various architectures has been used to detect maxillary sinus abnormalities on CT/CBCT images, achieving near-perfect results. However, further improvements are needed to increase accuracy and consistency.

The goals of antimicrobial treatment of end-of-life (EOL) infections are variously defined, raising complex questions about the management futility, ethical aspects, psychosocial burden, and the risk of emerging antimicrobial resistance. The author searched PubMed, Scopus, and Web of Science databases to retrieve relevant articles published from May 1, 2000, to April 30, 2024, on EOL infections and emerging multidrug-resistant organisms.The titles and abstracts of retrieved articles were screened, duplicate records were excluded, and the eligibility of selected papers was assessed. Sixty-one articles were included; the prevalence of EOL infections and antimicrobial therapy were calculated, the common sites and characteristics of EOL infections were identified, and the extent of emerging multidrug-resistant organisms among EOL patients, especially the "superbugs" ones, were estimated.The review indicates that infections are common in terminally ill patients, the prevalence of irrational antimicrobial prescriptions is high globally, with antimicrobials frequently administered until death. Limited data regarding antimicrobial resistance are available, and they cover short periods, while many of those patients survive longer with modern healthcare and become an essential reservoir for emerging multidrug-resistant organisms. This underscores the importance of antimicrobial stewardship programs and the urgent need for further research in this oftenoverlooked study area.