Objective assessment of visual attention in orthognathic surgery training based on eye tracking.

The aim of this study was to investigate the differences in visual attention between novices and orthognathic experts, as well as to provide evidence for use in developing and optimizing training strategies for orthognathic surgery. Novice and orthognathic experts were recruited, and their distributions of visual attention were monitored via an eye-tracking device while they watched orthognathic surgery videos. The percentages of visual fixation duration devoted to the areas of interest - surgical objects, instruments controlled by the main surgeon, and instruments controlled by the assistants - in each orthognathic surgery section were analyzed and compared between the two groups using repeated-measures factorial analysis of variance (ANOVA). In total, there were 18 participants, comprising both novices (n = 9) and experts (n = 9). For all sections of orthognathic surgery, the percentage of fixation duration on surgical objects was significantly higher for the novices than for the experts (p = 0.031, p = 0.005, p = 0.026, p = 0.047, p = 0.047, p = 0.031, p = 0.027, p = 0.034, p = 0.008, and p = 0.016). During the maxillary segment separation as part of Le Fort I osteotomy and the splitting of the mandible as part of bilateral sagittal split osteotomy, the novices also had a higher percentage of fixation duration on the instruments controlled by the main surgeon, as compared with the experts (p = 0.007 and p = 0.048, respectively). Novices invested great cognitive effort into the surgical objects in each section of orthognathic surgery, including the instruments controlled by the main surgeon in the maxillary segment separation and the splitting of the mandible. Strengthening this aspect of instruction could help novices reduce their cognitive load and achieve mastery more efficiently.

Exploring the distribution of visual attention in genioplasty trainees using eye-tracking technology.

PURPOSE: This study aimed to investigate the visual attention of genioplasty trainees using eye-tracking technology, with the goal of providing insights for optimizing genioplasty training strategies. METHODS: Trainees were recruited for the study, and their visual attention distribution was monitored with an eye-tracking device while they watched a genioplasty procedure video. The percentage of fixation durations dedicated to areas of interest (surgical objects, instruments manipulated by the primary surgeon, and instruments controlled by assistants) were analyzed for each phase of the procedure. RESULTS: A total of 20 surgical trainees (8 males, 12 females; mean age, 27.8 years; range, 22-35 years) participated in the study. During the soft tissue reflection phase, trainees' percentage fixation durations on instruments controlled by the primary surgeon were higher than on surgical objects, but the difference was not significant (p > 0.05). The percentage fixation durations on instruments controlled by assistants were significantly lower than on those controlled by the primary surgeon or on surgical objects (p < 0.05). In the osteotomy, bone fixation, and suturing phases, the percentage fixation durations on surgical objects were highest, followed by instruments manipulated by the primary surgeon and those controlled by assistants, with significant differences (p < 0.05). CONCLUSION: Surgical trainees need to invest significant cognitive effort in focusing on the instruments manipulated by the primary surgeon and the surgical objects during the soft tissue reflection phase, as well as on surgical objects during the osteotomy, fixation, and suturing phases. Emphasizing these elements during instruction can help trainees reduce their cognitive load and effectively master genioplasty techniques.

The effectiveness of tamsulosin hydrochloride with terazosin combination therapy for chronic prostatitis Type-III b.

Objectives: To study the therapeutic effects of combined tamsulosin hydrochloride and terazosin treatment for patients with chronic prostatitis Type-III b. Methods: This study involved 180 patients with chronic prostatitis Type-III b treated between January 2018 and December 2020 conducted at Nanhua Hospital Affiliated to Nanhua University. Patients were randomly divided into two equal groups: one receiving oral terazosin hydrochloride tablets only (control group), and one orally receiving both tamsulosin hydrochloride sustained-release tablets and terazosin hydrochloride tablets (observation group). Outcome measurements included symptom scoring, inflammatory cytokine levels, as well as white blood cell and lecithin body counts in the prostatic fluid. Results: After 30 days of treatment, the observation group showed greater treatment effectiveness (86.67% vs. 73.33%, P<0.05). QLS, USS, PS, and NIH-CPSI symptom scores were lower in the observation group than the control group (P<0.05). No differences in adverse event distribution and incidence were noted. EPS IL-2 increased more in the observation group, while PGE-2, MIP-1α, and MIP-2 decreased more in the observation group. WBC levels decreased more in the observation group, while lecithin body levels increased more in the observation group. Conclusion: The combination of tamsulosin hydrochloride and terazosin for the treatment of patients with chronic prostatitis Type-III b has a significant effect. This approach reduced patient symptoms, lowered inflammatory biomarkers, and generally improved quality of life. This approach appears to have clinical value worthy of future investigation.

Perception of the Nose and Lower Face Before and After Orthognathic Surgery in Subjects with Dento-maxillofacial Deformities: An Eye-Tracking Study.

BACKGROUND: Dento-maxillofacial deformities are often associated with nasal deviation, and patients often complain of nasal deviation after orthognathic surgery. This study aimed to quantitatively evaluate the facial visual attention given to dento-maxillofacial deformities accompanying nasal deviation from the perspective of patients and determine whether orthognathic surgery could alter this outcome. METHODS: The scanning paths of 137 patients were recorded using an eye-tracking device; recordings were made while the patients viewed images of dento-maxillofacial deformities associated with various degrees of nasal deviation before or after orthognathic surgery. Visual attention focused on the lower face and nose was analyzed. RESULTS: When viewing postoperative faces, the participants focused more visual attention on noses and less on the lower face than they did on preoperative faces. Interestingly, for preoperative faces, nasal deviation could significantly increase participants' visual attention to the lower face, and visual attention to noses was significantly increased when noses were deviated 12°, while for postoperative faces, a nasal deviation of 4° or more was associated with a significant increase in participants' visual attention to the nose. CONCLUSIONS: Patients tended to focus their visual attention on the lower region of preoperative faces and ignored nose irregularities. Orthognathic surgery can alter visual attention, shifting it from the lower face to the nose, and a deviation of 4° or more could be a potential concern for patients. Clinicians must inform patients preoperatively about preexisting nasal deviations, which can guide surgical planning and help manage patient expectations. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Do Orthognathic Patients and Persons Without Facial Deformities Have Different Visual Attention to Menton Deviation?

PURPOSE: This study aimed to quantify how menton deviation influenced facial visual attention of orthognathic patients and persons without facial deformities, and to explore differences between them. MATERIALS AND METHODS: The visual scanning paths of 260 participants (Group I, 130 orthognathic participants; Group II, 130 participants without facial deformities) while observing images reflecting normal subjects and those with different menton deviation degrees were recorded with an eye-tracking device. The fixation duration [FD] and first fixation time [FFT]) on the areas of interest for each group were compared. RESULTS: Although Group I devoted longer FD to the lower face than the Group II when observing a normal face (P < 0.05), a menton deviation of 3°D was associated with a significantly longer FD and earlier FFT for both groups ( P < 0.05). As the severity of the menton deviation increased, this trend became more obvious, and the visual attention paid to the eyes and nose decreased (FD decreased, FFT delayed), especially for Group II ( P < 0.05). CONCLUSIONS: A menton deviation of 3° can induce abnormally increased visual attention to the lower face in both orthognathic patients and persons without facial deformities. With increased menton deviation, this trend will be more obvious, and the visual attention to the eyes and nose will also be affected, especially for persons without facial deformities, attention to the eyes will be significantly reduced.

Facial visual attention to menton deviation: An objective evaluation by laypeople.

PURPOSE: This study aimed to quantitatively evaluate whether the severity of menton deviation (MD) influenced facial perceptions of laypeople. We also aimed to determine the effectiveness of surgery in normalizing the distribution of the facial visual attention of laypeople. METHODS: The scanning paths of 177 laypeople were recorded using an eye tracking device while observing images of individuals without MD and pre- and post-treatment subjects with different degrees of MD. The fixation durations on the areas of interest (AOIs) in each group were compared and analysed. RESULTS: When observing the images of non-MD subjects, the eyes were the focus of the most significant fixation (higher than the fixations on the nose and lower face). When the MD increased to 3°, attention on the lower face increased (p = 0.001) with decreased attention to the eyes (p = 0.0126). At an MD of 9°, attention to the lower face sharply increased, even more so than that to the eyes, with decreased attention to the nose (p = 0.0104). Compared with the findings for the post-treatment images, the laypeople who observed the pretreatment images focused longer on the lower face and less on the eyes and nose (p = 0.001, p = 0.0322 and p = 0.0023, respectively). The distribution of the fixation duration when observing the post-treatment images was similar to that when observing the images of the non-MD subjects. CONCLUSIONS: Laypeople can perceive an MD of 3°, which causes changes in the distribution of visual attention, with attention focusing on the MD. When the deviation reaches 9°, it is very noticeable. Surgery can normalize the distribution of the facial visual attention of laypeople, as shown by the responses to the post-treatment images.

MiRNA-200a induce cell apoptosis in renal cell carcinoma by directly targeting SIRT1.

Accumulating evidence indicates that microRNAs are implicated in tumor initiation and progression through negatively regulating oncogenes or tumor suppressor genes. In the present study, we report that the expression of miR-200a was significantly lower in renal cell carcinoma (RCC) specimens and RCC cell lines. Restoration of miR-200a suppressed cell growth, arrested cell cycle progression, and promoted cell apoptosis in RCC cell lines. We next used qRT-PCR array technology to identify Sirtuin 1 (SIRT1) as one of the downregulated proteins during miR-200a overexpression in 786-O cells. Following a further assay by luciferase reporter system, SIRT1 was validated as a direct target of miR-200a. Moreover, siRNA-mediated knockdown of SIRT1 could partially phenocopy the effects of miR-200a overexpression. In contrast, overexpression of truncated SIRT1 (without an endogenous 3'-UTR) could rescue the effect of miR-200a overexpression on 786-O cells, which suggested that SIRT1 3'-UTR is targeted by miR-200a specifically. These observations provide further evidence for a critical tumor-suppressive role of the miR-200a in RCC in addition to identifying a novel regulatory mechanism, which may contribute to SIRT1 upregulation in RCC.