搜索结果：Otolaryngologic

In clinical studies with paired organs, binary outcomes often exhibit intra-subject correlation and may include a mixture of unilateral and bilateral observations. Under Donner's constant correlation model, we develop three likelihood-based test statistics (the likelihood ratio, Wald-type, and score tests) for assessing the risk difference between two proportions. Simulation studies demonstrate good control of type I error and comparable power among the three tests, with the score test showing slightly better stability. Applications to otolaryngologic and ophthalmologic data illustrate the methods. An online calculator is also provided for power analysis and risk difference testing. The score test is recommended for practical use and future studies with combined unilateral and bilateral binary data.

This study evaluates the efficacy of vision transformer models, specifically Swin transformers, in enhancing the diagnostic accuracy of ear diseases compared to traditional convolutional neural networks. With a reported 27% misdiagnosis rate among specialist otolaryngologists, improving diagnostic accuracy is crucial. The research utilised a real-world dataset from the Department of Otolaryngology at the Clinical Hospital of the Universidad de Chile, comprising otoscopic videos of ear examinations depicting various middle and external ear conditions. Frames were selected based on the Laplacian and Shannon entropy thresholds, with blank frames removed. Initially, Swin v1 and Swin v2 transformer models achieved accuracies of 100% and 99.1%, respectively, marginally outperforming the ResNet model (99.5%). These results surpassed metrics reported in related studies. However, the evaluation uncovered a critical data leakage issue in the preprocessing step, affecting both this study and related research using the same raw dataset. After mitigating the data leakage, model performance decreased significantly. Corrected accuracies were 83% for both Swin v1 and Swin v2, and 82% for the ResNe

Clinical trials involving paired organs often yield a mixture of unilateral and bilateral data, where each subject may contribute either one or two responses under certain circumstances. While unilateral responses from different individuals can be treated as independent, bilateral responses from the same individual are likely correlated. Various statistical methods have been developed to account for this intra-subject correlation in the bilateral data, and in practice it is crucial to select an appropriate model for accurate inference. Tang et. al. (2012) discussed model selection issues using a variety of goodness-of-fit test statistics for correlated bilateral data for two groups, and Liu and Ma (2020) extended these methods to settings with $g\ge2$ groups. In this work, we investigate the goodness-of-fit statistics for the combined unilateral and bilateral data under different statistical models that address the intra-subject correlation, including the Clayton copula model, in addition to those considered in prior studies. Simulation results indicate that the performance of the goodness-of-fit tests is model-dependent, especially when the sample size is small and/or the intra-su

Surgical training remains a crucial milestone in modern medicine, with procedures such as laminectomy exemplifying the high risks involved. Laminectomy drilling requires precise manual control to mill bony tissue while preserving spinal segment integrity and avoiding breaches in the dura: the protective membrane surrounding the spinal cord. Despite unintended tears occurring in up to 11.3% of cases, no assistive tools are currently utilized to reduce this risk. Variability in patient anatomy further complicates learning for novice surgeons. This study introduces CAPTAiN, a critical anatomy-preserving and terrain-augmenting navigation system that provides layered, color-coded voxel guidance to enhance anatomical awareness during spinal drilling. CAPTAiN was evaluated against a standard non-navigated approach through 110 virtual laminectomies performed by 11 orthopedic residents and medical students. CAPTAiN significantly improved surgical completion rates of target anatomy (87.99% vs. 74.42%) and reduced cognitive load across multiple NASA-TLX domains. It also minimized performance gaps across experience levels, enabling novices to perform on par with advanced trainees. These findin

In otolaryngologic surgery, endoscopy is increasingly used to provide a better view of hard-to-reach areas and to promote minimally invasive surgery. However, the need to manipulate the endoscope limits the surgeon's ability to operate with only one instrument at a time. Currently, several robotic systems are being developed, demonstrating the value of robotic assistance in microsurgery. The aim of this literature review is to present and classify current robotic systems that are used for otological and endonasal applications. For these solutions, an analysis of the functionalities in relation to the surgeon's needs will be carried out in order to produce a set of specifications for the creation of new robots.

Astronomers have found the first confirmed atmosphere around a rocky planet in another star’s habitable zone。 The planet, LHS 1140 b, revealed its atmosphere through helium slowly leaking into space。 Located 48 light-years away, the world may have preserved its atmosphere for billions of years, making it a promising target in the search for potenti

Researchers have created cosmic dust from scratch by recreating space-like conditions inside glass tubes。 The dust contains complex carbon-rich molecules built from elements essential to life and produces infrared signals similar to real material found in space。 By studying these laboratory samples, scientists can explore how organic chemistry unfo

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A giant planet had been hiding inside one of astronomy’s most closely studied planetary systems, concealed by a bright disk of cosmic dust。 Webb revealed Beta Pictoris d through atmospheric traces of carbon monoxide, water vapor, and methane, showcasing a promising new method for finding elusive exoplanets