PURPOSE: This study aimed to evaluate the efficacy of simultaneous computed tomography (CT) and quantitative CT (QCT) in patients with osteoporotic hip fracture (OHF) by analyzing the osteoporosis detection rate and physician prescription rate in comparison with those of conventional dual-energy X-ray absorptiometry (DXA). MATERIALS AND METHODS: This study included consecutive patients older than 65 years who underwent internal fixation or hip arthroplasty for OHF between February and May 2015. The patients were assigned to either the QCT (47 patients) or DXA group (51 patients). The patients in the QCT group underwent QCT with hip CT, whereas those in the DXA group underwent DXA after surgery, before discharge, or in the outpatient clinic. In both groups, the patients received osteoporosis medication according to their QCT or DXA results. The osteoporosis evaluation rate and prescription rate were determined at discharge, postoperative (PO) day 2, PO day 6, and PO week 12 during an outpatient clinic visit. RESULTS: The osteoporosis evaluation rate at PO week 12 was 70.6% (36 of 51 patients) in the DXA group and 100% in the QCT group (P < 0.01). The prescription rates of osteoporosis medication at discharge were 70.2% and 29.4% (P < 0.001) and the cumulative prescription rates at PO week 12 were 87.2% and 60.8% (P=0.003) in the QCT and DXA groups, respectively. CONCLUSION: Simultaneous CT and QCT significantly increased the evaluation and prescription rates in patients with OHF and may enable appropriate and consistent prescription of osteoporosis medication, which may eventually lead to patients' medication compliance.
Absorptiometry, Photon ; Ambulatory Care Facilities ; Arthroplasty ; Hip Fractures ; Hip ; Humans ; Medication Adherence ; Osteoporosis ; Prescriptions

Objective:To explore the influence of flipped classroom combined with case-based learning (CBL) teaching mode on teaching effect of X-ray cephalometric analysis in orthodontic experimental class.Methods:In the study, 70 undergraduates majoring in stomatology were selected as research objects and randomized into teaching reform group and traditional group in average. Flipped classroom combined with CBL teaching mode was adopted in teaching reform group, while traditional group adopted traditional teaching mode. Questionnaire was used to investigate the students' evaluation on the two teaching modes, and the accuracy of the measurement of X-ray cephalometrics of the two groups was compared and analyzed respectively. GraphPad Prism 7.03 software was used to perform t test and chi-square test. Results:Teaching reform group believed that this kind of teaching mode could improve the ability of self-study, communication coordination ability, independent problem solving ability, and logic and language expression ability, deepen the understanding of the project connotation, and apply the X-ray cephalometrics to the actual clinical case analysis and diagnosis. Compared with the traditional group, there were significant differences ( P<0.05). In the accuracy evaluation of measurement values, the absolute values of 70% measurement items in teaching reform group were higher than those in the traditional group, but the difference was not statistically significant ( P>0.05). Only in bone type Ⅲ malocclusion, the absolute values of Y-axis angle and FMA were lower than those of the traditional group, and the difference was statistically significant ( P<0.05). Conclusion:Flipped classroom combined with CBL teaching mode can help students improve self-study ability, communication cooperation ability and the ability of solving problem independently and clinical application. However, the accuracy evaluation of measurement values in teaching reform group were lower than that of the traditional group, indicating that this teaching method in the experimental teaching of X-ray cephalometric analysis needs to be further improved.

Objective:To explore the accuracy of a multi-task model based on vision Transformer for analyzing the three-dimensional (3D) upper airway and its subregions, and to evaluate its clinical applicability.Methods:According to the inclusion and exclusion criteria, cone-beam CT (CBCT) data of 10 patients [4 males and 6 females, (20.8±2.7) years] who had their first visit to the Department of Orthodontics in the Hospital of Stomatology, Wuhan University from January 2012 to January 2020 were retrospectively selected. The 3D slicer software was used to segment the upper airway and pharyngeal airway and measure their volumes as the gold standard. The Dolphin 3D software was used to segment the pharyngeal airway and its subregions and measure their volumes as the gold standard. A multi-task model based on vision Transformer developed by the research team for automatic segmentation and volume measurement of the upper airway and its subregions. All the measurements were conducted by the same attending physician. The Bland-Altman analysis and intraclass correlation coefficient ( ICC) were used to evaluate the consistency between the multi-task network and the gold standard in the upper airway segmentation and volume measurements, and the paired t test was used to compare the differences between the multi-tasking model and the gold standard. Results:The mean volume deviation of the upper airway segmented by multi-task model and 3D Slicer was -979.6 mm 3, and the ICC was 0.97. The mean volume deviation of the pharyngeal airway, nasopharynx, velopharynx, glossopharynx and hypopharynx segmented by multi-task network and Dolphin 3D were 2 069.5, -950.1, -823.6, -813.9 and 4 003.4 mm 3, respectively. In addition, ICC in pharyngeal airway, nasopharynx, velopharynx, glossopharynx and hypopharynx were 0.97, 0.94, 0.96, 0.96 and 0.69, respectively. Conclusions:The multi-task model based on vision Transformer produced different errors in the segmentation of 3D upper airway and its subregions. The segmentation of the nasopharynx, velopharynx and glossopharynx was in good agreement with the gold standard, while the segmentation of hypopharynx was poor, suggesting that the robustness and generalization of this model should be further enhanced.