phoenix: an R package and Python module for calculating the Phoenix pediatric sepsis score and criteria.

Objectives: The publication of the Phoenix criteria for pediatric sepsis and septic shock initiates a new era in clinical care and research of pediatric sepsis. Tools to consistently and accurately apply the Phoenix criteria to electronic health records (EHRs) is one part of building a robust and internally consistent body of research across multiple research groups and datasets. Materials and Methods: We developed the phoenix R package and Python module to provide researchers with intuitive and simple functions to apply the Phoenix criteria to EHR data. Results: The phoenix R package and Python module enable researchers to apply the Phoenix criteria to EHR datasets and derive the relevant indicators, total scores, and sub-scores. Discussion: The transition to the Phoenix criteria marks a major change in the conceptual definition of pediatric sepsis. Applicable across differentially resourced settings, the Phoenix criteria should help improve clinical care and research. Conclusion: The phoenix R package and Python model are freely available on CRAN, PyPi, and GitHub. These tools enable the consistent and accurate application of the Phoenix criteria to EHR datasets.

¿Cómo planifico una cirugía de escoliosis idiopática del adolescente? Sistematización de un método de planificación preoperatoria / How do I plan adolescent idiopathic scoliosis surgery? Systematization of a preoperative planning method

La planificación preoperatoria resulta fundamental en la cirugía de escoliosis idiopática del adolescente (EIA) para determinar los niveles a fusionar y realizar el procedimiento con mayor precisión y diligencia. Sin embargo, su realización protocolizada no está tan extendida entre los especialistas en formación. El objetivo de este artículo es describir en detalle el método de planificación preoperatoria en la EIA empleado en una unidad especializada de raquis infantil y del adolescente de un centro de referencia, así como, la logística y la táctica, apoyado en un software gratuito de medición digital semiautomática y planificación. Se muestran 3 casos representativos de diferentes deformidades vertebrales, intervenidos mediante una artrodesis vertebral posterior tras una planificación preoperatoria según el método descrito. Este método resulta muy adecuado para el cirujano en formación al aunar las ventajas de los métodos tradicionales y los más modernos, y ser sencillo, de bajo coste, accesible, reproducible y con carácter formativo.(AU)

Preoperative planning is essential in adolescent idiopathic scoliosis (AIS) surgery to determine the fusion levels and to perform the procedure with greater precision and diligence. However, the protocolized performance of such planning is not as widespread among specialists in training. The aim of this article is to describe in detail the preoperative planning method for AIS used in a specialized pediatric and adolescent spine unit of a referral center, as well as the logistics and the tactics, supported a free semi-automatic digital measurement and planning software. Three representative cases of different vertebral deformities, treated by posterior spinal fusion after preoperative planning according to the method, are shown. This method is highly suitable for the trainee surgeon as it combines the advantages of traditional and modern methods, and is simple, low cost, accessible, reproducible and with an educational character.(AU)

[Translated article] How do I plan adolescent idiopathic scoliosis surgery? Systematization of a preoperative planning method / ¿Cómo planifico una cirugía de escoliosis idiopática del adolescente? Sistematización de un método de planificación preoperatoria

La planificación preoperatoria resulta fundamental en la cirugía de escoliosis idiopática del adolescente (EIA) para determinar los niveles a fusionar y realizar el procedimiento con mayor precisión y diligencia. Sin embargo, su realización protocolizada no está tan extendida entre los especialistas en formación. El objetivo de este artículo es describir en detalle el método de planificación preoperatoria en la EIA empleado en una unidad especializada de raquis infantil y del adolescente de un centro de referencia, así como, la logística y la táctica, apoyado en un software gratuito de medición digital semiautomática y planificación. Se muestran 3 casos representativos de diferentes deformidades vertebrales, intervenidos mediante una artrodesis vertebral posterior tras una planificación preoperatoria según el método descrito. Este método resulta muy adecuado para el cirujano en formación al aunar las ventajas de los métodos tradicionales y los más modernos, y ser sencillo, de bajo coste, accesible, reproducible y con carácter formativo.(AU)

Preoperative planning is essential in adolescent idiopathic scoliosis (AIS) surgery to determine the fusion levels and to perform the procedure with greater precision and diligence. However, the protocolized performance of such planning is not as widespread among specialists in training. The aim of this article is to describe in detail the preoperative planning method for AIS used in a specialized pediatric and adolescent spine unit of a referral center, as well as the logistics and the tactics, supported a free semi-automatic digital measurement and planning software. Three representative cases of different vertebral deformities, treated by posterior spinal fusion after preoperative planning according to the method, are shown. This method is highly suitable for the trainee surgeon as it combines the advantages of traditional and modern methods, and is simple, low cost, accessible, reproducible and with an educational character.(AU)

A novel mathematical model and application software for estimating the age of necrophagous fly larvae.

The change in larval body length of necrophagous flies during their development is a key indicator for estimating larval age. However, existing forensic entomological models have limitations in this regard. In this study, a logistic algorithm was used to establish a general model for estimating the minimum postmortem interval (PMImin) using larval body length. The new model was used to simulate the relationship between larval body length and developmental time of eight species of necrophagous flies. The model parameters of body length variation with developmental time of the different species were calculated. Computer software was developed based on the established logistic model. The advantage of the new model is that each parameter has a biological meaning and can be used to estimate the age of larvae at any temperature and any larval body length. Cross-validation of the model showed that the overall mean accuracy of the fitted growth curves for the eight necrophagous fly larvae was 82.7%, the mean accuracy of age extrapolations for seven necrophagous fly species ranged from 76.8% to 92.9%, while the accuracy of age extrapolations for only one species was lower (i.e., 63.3%). This study provides a new method to estimate the PMImin based on larval body length, and the developed computer software will facilitate its application in forensic entomology.

[Translated article] How do I plan adolescent idiopathic scoliosis surgery? Systematization of a preoperative planning method.

Preoperative planning is essential in adolescent idiopathic scoliosis (AIS) surgery to determine the fusion levels and to perform the procedure with greater precision and diligence. However, the protocolized performance of such planning is not as widespread among specialists in training. The aim of this article is to describe in detail the preoperative planning method for AIS used in a specialised paediatric and adolescent spine unit of a referral centre, as well as the logistics and the tactics, supported a free semi-automatic digital measurement and planning software. Three representative cases of different vertebral deformities, treated by posterior spinal fusion after preoperative planning according to the method, are shown. This method is highly suitable for the trainee surgeon as it combines the advantages of traditional and modern methods, and is simple, low-cost, accessible, reproducible and with an educational character.

Practical application of the linkage disequilibrium method for estimating contemporary effective population size: A review.

The method to estimate contemporary effective population size (Ne ) based on patterns of linkage disequilibrium (LD) at unlinked loci has been widely applied to natural and managed populations. The underlying model makes many simplifying assumptions, most of which have been evaluated in numerous studies published over the last two decades. Here, these performance evaluations are reviewed and summarized, with a focus on information that facilitates practical application to real populations in nature. Potential sources of bias that are discussed include calculation of r2 (a measure of LD), adjustments for sampling error, physical linkage, age structure, migration and spatial structure, mutation and selection, mating systems, changes in abundance, rare alleles, missing data, genotyping errors, data filtering choices and methods for combining multiple Ne estimates. Factors that affect precision are reviewed, including pseudoreplication that limits the information gained from large genomics datasets, constraints imposed by small samples of individuals, and the challenges in obtaining robust estimates for large populations. Topics that merit further research include the potential to weight r2 values by allele frequency, lump samples of individuals, use genotypic likelihoods rather than called genotypes, prune large LD values and apply the method to species practising partial monogamy.

Are multi-detector computed tomography and cone-beam computed tomography exams and software accurate to measure the upper airway? A systematic review.

BACKGROUND: Cone-beam computed tomography (CBCT) has several applications in various fields of dental medicine such as diagnosis and treatment planning. When compared to computed tomography (CT), CBCT's radiation exposure dose is decreased by 3%-20%. However, CBCT produces more scattered signals and may present poorer image quality when compared to medical CT. OBJECTIVES: To review the findings regarding the accuracy of multi-detector computed tomography (MDCT) and CBCT and to compare the different software programs that segment the upper airway. SEARCH METHODS: Three databases (PubMed, Medline, and Web of Science) were searched for articles and a manual search was performed. SELECTION CRITERIA: The inclusion criteria were defined following the PICO framework: P-any patient with a CBCT or CT; I-dimensional evaluation of the upper airway using MDCT or CBCT; C-phantoms; O-the primary outcome was MDCT and CBCT accuracy, the secondary outcome was the evaluation and comparison of software programs used to segment the upper airway. DATA COLLECTION AND ANALYSIS: Articles that met eligibility criteria were assessed using the Critical Appraisal Skills Program Checklist. RESULTS: Among the 16 eligible studies, 6 articles referred to the accuracy of MDCTs or CBCTs and 10 to the accuracy of the software. Most articles were qualified as high quality. CONCLUSIONS: MDCT and CBCT scans' accuracy in upper airway dimensional measurements depends on machine brand, parameters, and segmentation technique. Regarding the segmentation technique, 12 programs were studied. Most either underestimated or overestimated upper airway measurements. In particular, OnDemand3D and INVIVO showed poor accuracy. On the contrary, Invesalius, and MIMICS were accurate in assessing nasal cavities when using an interactive threshold. However, results varied due to methodological differences among the studies. Finally, fully automatic segmentation based on artificial intelligence may represent the future of airway segmentation because it is faster and seems to be accurate. However, further studies are necessary. REGISTRATION: This study was registered in Prospero (International Prospective Register of Systematic Reviews) with the ID number CRD42022373998.

DentaSeal: A school-based dental sealant efficiency assessment tool to support statewide monitoring and reporting: A field report.

BACKGROUND: The evidence base supports effectiveness of dental sealants for prevention of childhood caries in school-aged children. OBJECTIVE: This study describes planning, development, usability testing and outcomes following implementation of DentaSeal, a web-based application designed to accurately track unique student data and generate reports for all Wisconsin school-based sealant placement (SP) programs. METHODS: Application software development was informed by a steering committee of representative stakeholders who were interviewed to inform design and provide feedback for design of DentaSeal during development and evaluation. Software development proceeded based on wireframes developed to build architectural design. Usability testing followed and informed any required adjustments to the application. The DentaSeal prototype was beta tested and fully implemented subsequently in the public health sector. RESULTS: The DentaSeal application demonstrated capacity to: 1) track unique student SP data and longitudinal encounter history, 2) generate reports and 3) support administrative tracking. In 2019, DentaSeal captured SP data of 47 school-based programs in Wisconsin that sponsored > 7,000 program visits for 184,000 children from 62 counties. Delivery of > 548,000 SP services were catalogued. CONCLUSIONS: For public health initiatives targeting reduction in caries incidence, web-based applications such as DentaSeal represent useful longitudinal tracking tools for cataloguing SP in school-based program participants.

The diagnostic performance of the Java-based software colorization tool in the diagnosis of dental caries: an in vitro study.

OBJECTIVE: This in vitro study aimed to compare the diagnostic outcomes of caries detection in premolar and molar teeth on digital periapical radiographs viewed as grayscale images and in the Java-based software (JBS) pseudocolor spectrum. METHOD AND MATERIALS: The study comprised 92 premolar or molar human teeth (n = 46 with caries and n = 46 without clinical caries). For each tooth, digital periapical radiographic images (DPRIs), JBS pseudocolor images, and stereomicroscope images were collected, and caries presence and depth were recorded. In JBS pseudocolor images, regions of interest (ROIs) were detected, and ROI values for caries area (ROI1), non-caries area (ROI2), mesial area (ROI3), and distal area (ROI4) were obtained. The degree of inter-observer agreement was determined using the kappa coefficient, and the sensitivity and specificity of the methods were assessed using ROC analysis. RESULTS: While neither method was consistent with stereomicroscopy in determining caries depth (P < .005), for both observers the kappa value of JBS pseudocolor images were slightly higher than those for DPRIs. ROI1 was found to be significantly lower than ROI2 (P < .001), whereas no difference was found between ROI3 and ROI4 (P = .877). For both observers, the sensitivity and specificity obtained from JBS pseudocolor were above 89%. CONCLUSION: JBS pseudocolor images can be used for caries detection and offer high sensitivity and specificity.

How do I plan adolescent idiopathic scoliosis surgery? Systematization of a preoperative planning method. / ¿Cómo planifico una cirugía de escoliosis idiopática del adolescente? Sistematización de un método de planificación preoperatoria.

Preoperative planning is essential in adolescent idiopathic scoliosis (AIS) surgery to determine the fusion levels and to perform the procedure with greater precision and diligence. However, the protocolized performance of such planning is not as widespread among specialists in training. The aim of this article is to describe in detail the preoperative planning method for AIS used in a specialized pediatric and adolescent spine unit of a referral center, as well as the logistics and the tactics, supported a free semi-automatic digital measurement and planning software. Three representative cases of different vertebral deformities, treated by posterior spinal fusion after preoperative planning according to the method, are shown. This method is highly suitable for the trainee surgeon as it combines the advantages of traditional and modern methods, and is simple, low cost, accessible, reproducible and with an educational character.

Validating Human-Operant Software: A Case Example.

Human-operant experiments conducted with computer software facilitate translational research by assessing the generality of basic research findings and exploring previously untested predictions about behavior in a cost-effective and efficient manner. However, previous human-operant research with computer-based tasks has included little or no description of rigorous validation procedures for the experimental apparatus (i.e., the software used in the experiment). This omission, combined with a general lack of guidance regarding how to thoroughly validate experimental software, introduces the possibility that nascent researchers may insufficiently validate their computer-based apparatus. In this paper, we provide a case example to demonstrate the rigor required to validate experimental software by describing the procedures we used to validate the apparatus reported by Smith and Greer (2021) to assess relapse via a crowdsourcing platform. The validation procedures identified several issues with early iterations of the software, demonstrating how failing to validate human-operant software can introduce confounds into similar experiments. We describe our validation procedures in detail so that others exploring similar computer-based research may have an exemplar for the rigorous testing needed to validate computer software to ensure precision and reliability in computer-based, human-operant experiments.

Gluclas: A software for computer-aided modulation of glucose infusion in glucose clamp experiments.

BACKGROUND AND OBJECTIVE: The glucose clamp (GC) is an experimental technique for assessing several aspects of glucose metabolism. In these experiments, investigators face the non-trivial challenge of accurately adjusting the rate of intravenous glucose infusion to drive subjects' blood glucose (BG) concentration towards a desired plateau level. In this work we present Gluclas, an open-source software to support researchers in the modulation of glucose infusion rate (GIR) during GC experiments. METHODS: Gluclas uses a proportional-integrative-derivative controller to provide GIR suggestions based on BG measurements. The controller embeds an anti-wind-up scheme to account for actuator physical limits and suitable corrections of control action to accommodate for possible sampling jitter due to manual measurement and actuation. The software also provides a graphic user interface to increase its usability. A preliminary validation of the controller is performed for different clamp scenarios (hyperglycemic, euglycemic, hypoglycemic) on a simulator of glucose metabolism in healthy subjects, which also includes models of measurement error and sampling delay for increased realism. In silico trials are performed on 50 virtual subjects. We also report the results of the first in-vivo application of the software in three subjects undergoing a hypoglycemic clamp. RESULTS: In silico, during the plateau period, the coefficient of variation (CV) is in median below 5% for every protocol, with 5% being considered the threshold for sufficient quality. In terms of median [5th percentile, 95th percentile], average BG level during the plateau period is 12.18 [11.58 - 12.53] mmol/l in the hyperglycemic clamp (target: 12.4 mmol/), 4.92 [4.51 - 5.14] mmol/l in the euglycemic clamp (target: 5.5 mmol/) and 2.38 [2.33 - 2.64] in the hypoglycemic clamp (target: 2.5 mmol/). Results in vivo are consistent with those obtained in silico during the plateau period: average BG levels are between 2.56 and 2.68 mmol/l (target: 2.5 mmol/l); CV is below 5% for all three experiments. CONCLUSIONS: Gluclas offered satisfactory control for tested GC protocols. Although its safety and efficacy need to be further validated in vivo, this preliminary validation suggest that Gluclas offers a reliable and non-expensive solution for reducing investigator bias and improving the quality of GC experiments.

Planificar fracturas es sencillo: desarrollo de un método básico de planificación digital basado en la técnica tradicional con lápiz y papel / Fracture planning is easy: Development of a basic method of digital planning based on the traditional pencil and paper technique

Introducción: La planificación preoperatoria constituye una herramienta fundamental en el manejo de fracturas; sin embargo, su aplicación práctica dista de lo deseado, quizá debido a la ausencia de un método básico y sencillo, adaptado a los tiempos actuales. Describimos un método de planificación digital, entre lo tradicional y lo tecnológico, que conserva su esencia educativa, permite comprender la fractura e individualizar la osteosíntesis. Material y métodos: Tras el análisis inicial de la fractura y características del paciente, se realizan diferentes mediciones en las imágenes de Rx y TC con un programa de imagen médica digital. Estas imágenes se copian en un programa de presentación (Microsoft® PowerPoint o Keynote ©Apple Inc.), en el que se reproducen con el puntero del ordenador los principales fragmentos y líneas de fractura. A continuación, estos se mueven a una posición reducida y se representan gráficamente los implantes para la fijación interna junto con un guion de la estrategia quirúrgica. Resultados: Mostramos 4 casos de diferentes tipos de fracturas intervenidas mediante reducción y osteosíntesis tras una planificación preoperatoria según el método descrito. Se detallan los puntos básicos para la planificación quirúrgica, logística, táctica y los resultados radiológicos postoperatorios de cada caso. Conclusiones: A pesar del auge de programas informáticos avanzados de planificación, los métodos tradicionales con lápiz y papel siguen siendo fundamentales, más aún para el traumatólogo en formación. El método de planificación digital descrito resulta muy adecuado para este objetivo, al aunar las ventajas de ambos métodos: sencillez, accesibilidad, rapidez, bajo coste, reproducibilidad, carácter formativo y eficacia y por posibilitar la simulación, correcciones y la reutilización de casos.(AU)

Introduction: Preoperative planning constitutes a fundamental tool in the management of fractures; however, its practical application is far from the desired, perhaps due to the absence of a basic and simple method, adapted to the current times. We describe a digital planning method, halfway between the traditional and the technological, which preserves its educational essence, allows the understanding of the fracture and the individualization of the osteosynthesis. Material and methods: After the initial analysis of the fracture and the patient's characteristics, different measurements are made on X-ray and CT images with a digital medical imaging software. These images are then copied into a presentation program (Microsoft® PowerPoint or Keynote ©Apple Inc.), in which the main fragments and fracture lines are traced with the computer pointer. These are subsequently moved into a reduced position and the implants for internal fixation are graphically represented together with a guide of the surgical strategy. Results: We show 4 cases of different types of fractures operated through reduction and osteosynthesis after preoperative planning according to the described method. The basic points for the surgical planning, logistics, tactics and postoperative radiological results of each case are detailed. Conclusions: Despite rise of advanced planning software, traditional paper and pencil methods are still fundamental, even more so for the trauma surgeon in training. The digital planning method described is very appropriate for this purpose, as it combines the advantages of both methods: simplicity, accessibility, quickness, low-cost, reproducibility, educational character, efficiency and possibility of simulation, corrections and reuse of cases.(AU)

[Translated article] Fracture planning is easy: Development of a basic method of digital planning based on the traditional pencil and paper technique / Planificar fracturas es sencillo: desarrollo de un método básico de planificación digital basado en la técnica tradicional con lápiz y papel

Introducción: La planificación preoperatoria constituye una herramienta fundamental en el manejo de fracturas; sin embargo, su aplicación práctica dista de lo deseado, quizá debido a la ausencia de un método básico y sencillo, adaptado a los tiempos actuales. Describimos un método de planificación digital, entre lo tradicional y lo tecnológico, que conserva su esencia educativa, permite comprender la fractura e individualizar la osteosíntesis. Material y métodos: Tras el análisis inicial de la fractura y características del paciente, se realizan diferentes mediciones en las imágenes de Rx y TC con un programa de imagen médica digital. Estas imágenes se copian en un programa de presentación (Microsoft® PowerPoint o Keynote ©Apple Inc.), en el que se reproducen con el puntero del ordenador los principales fragmentos y líneas de fractura. A continuación, estos se mueven a una posición reducida y se representan gráficamente los implantes para la fijación interna junto con un guion de la estrategia quirúrgica. Resultados: Mostramos 4 casos de diferentes tipos de fracturas intervenidas mediante reducción y osteosíntesis tras una planificación preoperatoria según el método descrito. Se detallan los puntos básicos para la planificación quirúrgica, logística, táctica y los resultados radiológicos postoperatorios de cada caso. Conclusiones: A pesar del auge de programas informáticos avanzados de planificación, los métodos tradicionales con lápiz y papel siguen siendo fundamentales, más aún para el traumatólogo en formación. El método de planificación digital descrito resulta muy adecuado para este objetivo, al aunar las ventajas de ambos métodos: sencillez, accesibilidad, rapidez, bajo coste, reproducibilidad, carácter formativo y eficacia y por posibilitar la simulación, correcciones y la reutilización de casos.(AU)

Introduction: Preoperative planning constitutes a fundamental tool in the management of fractures; however, its practical application is far from the desired, perhaps due to the absence of a basic and simple method, adapted to the current times. We describe a digital planning method, halfway between the traditional and the technological, which preserves its educational essence, allows the understanding of the fracture and the individualization of the osteosynthesis. Material and methods: After the initial analysis of the fracture and the patient's characteristics, different measurements are made on X-ray and CT images with a digital medical imaging software. These images are then copied into a presentation program (Microsoft® PowerPoint or Keynote ©Apple Inc.), in which the main fragments and fracture lines are traced with the computer pointer. These are subsequently moved into a reduced position and the implants for internal fixation are graphically represented together with a guide of the surgical strategy. Results: We show 4 cases of different types of fractures operated through reduction and osteosynthesis after preoperative planning according to the described method. The basic points for the surgical planning, logistics, tactics and postoperative radiological results of each case are detailed. Conclusions: Despite rise of advanced planning software, traditional paper and pencil methods are still fundamental, even more so for the trauma surgeon in training. The digital planning method described is very appropriate for this purpose, as it combines the advantages of both methods: simplicity, accessibility, quickness, low-cost, reproducibility, educational character, efficiency and possibility of simulation, corrections and reuse of cases.(AU)

[Translated article] Fracture planning is easy: Development of a basic method of digital planning based on the traditional pencil and paper technique.

INTRODUCTION: Preoperative planning constitutes a fundamental tool in the management of fractures; however, its practical application is far from the desired, perhaps due to the absence of a basic and simple method, adapted to the current times. We describe a digital planning method, halfway the traditional and the technological, which preserves its educational essence, allows for the understanding of the fracture and the individualisation of the osteosynthesis. MATERIAL AND METHODS: After the initial analysis of the fracture and the patient's characteristics, different measurements are made on X-ray and CT images with a digital medical imaging software. These images are then copied into a presentation programme (Microsoft® PowerPoint or Keynote ©Apple Inc.), in which the main fragments and fracture lines are traced with the computer pointer. These are subsequently moved into a reduced position and the implants for internal fixation are graphically represented together with a guide of the surgical strategy. RESULTS: We show 4 cases of different types of fractures operated through reduction and osteosynthesis after preoperative planning according to the described method. The basic points for the surgical planning, logistics, tactics and postoperative radiological results of each case are detailed. CONCLUSIONS: Despite the rise of advanced planning software, traditional paper and pencil methods are still fundamental, even more so for the trauma surgeon in training. The digital planning method described is very appropriate for this purpose, as it combines the advantages of both methods: simplicity, accessibility, quickness, low cost, reproducibility, educational character, efficiency and possibility of simulation, corrections and reuse of cases.

Development of an Architecture to Implement Machine Learning Based Risk Prediction in Clinical Routine: A Service-Oriented Approach.

BACKGROUND: Patients at risk of developing a disease have to be identified at an early stage to enable prevention. One way of early detection is the use of machine learning based prediction models trained on electronic health records. OBJECTIVES: The aim of this project was to develop a software solution to predict cardiovascular and nephrological events using machine learning models. In addition, a risk verification interface for health care professionals was established. METHODS: In order to meet the requirements, different tools were analysed. Based on this, a software architecture was created, which was designed to be as modular as possible. RESULTS: A software was realised that is able to automatically calculate and display risks using machine learning models. Furthermore, predictions can be verified via an interface adapted to the need of health care professionals, which shows data required for prediction. CONCLUSION: Due to the modularised software architecture and the status-based calculation process, different technologies could be applied. This facilitates the installation of the software at multiple health care providers, for which adjustments need to be carried out at one part of the software only.

Prototype: An application that can change the physical activity levels of children and adolescents / Protótipo: um aplicativo que pode mudar os níveis de atividade física de crianças e adolescentes

In the challenge of making children and young people more physically active, possibilities of unit-ing knowledge between digital games and physical activity and, as a product, the exergames have emerged. Using this method as a possibility of behavior change, the present study aimed to present a prototype of an exergame that stimulates the increase of physical activity levels in adolescents. In order for the user to be able to use the exergame as a mobile application, it is necessary to register initially with personal and anthropometric data, establish goals by time, and then start using it. The proposal is to make the application available to schools and students for research, evaluating the in-fluence of the exergame on the level of habitual physical activity, displacement, participation in phys-ical education classes, motivation and interest for changing behavior of physical activity through-out the day, among other parameters. Equipping Physical Education professionals with these new healthcare tools is necessary, and they can be pedagogical for the paradigm shift on how to contribute to a healthier aging and with more quality of life

No desafio de tornar crianças e jovens mais fisicamente ativas, surgem possibilidades de união de conhe-cimentos entre jogos digitais e atividade física e como produto os exergames. Utilizando este método como possibilidade de mudanças de comportamento, o presente estudo teve como objetivo apresentar um protótipo de exargame que estimule o aumento dos níveis de atividade física em adolescentes. Para que o usuário possa utilizar o exergame em formato de aplicativo móvel, se faz necessário fazer inscrição inicial com seus dados pessoais e antropométricos estabelecimento de objetivos por tempo para na sequência possa iniciar a utilização. A proposta é disponibilizar o aplicativo para as escolas e estudantes para realização de pesquisas, avaliando a influência do exergame sobre o nível de atividade física habitual, de deslocamento, participação nas aulas de educação física, motivação e interesse para a mudança de comportamento de atividade física durante todo o dia, entre outros parâmetros. Instrumentalizar os professores de Educação Física sobre o cuidado com a saúde, através destas novas ferramentas é necessário e podem ser pedagógicas para mudança de paradigmas sobre como contribuir para um envelhecimento mais saudável e com mais qualidade de vida

Osteotomy training for dental students using three-dimensional simulation software and maxillofacial three-dimensional-printed models.

PURPOSE/OBJECTIVES: Simulated educational models of teeth, bones, and gums have been used for a long time in procedural skills training in dentistry.  The advent of three-dimensional (3D) printing technologies and additive manufacturing has facilitated the production of more advanced 3D printed models that can be utilized for surgical and dental training together with other technologies (e.g., 3D scanners and image analysis software). METHODS: We conducted training on osteotomy in the maxilla and mandible using maxillofacial simulation software (MSS) and a 3D-printed model for 5th-year undergraduate dental students (13 students in 2017 and 11 students in 2018 with more than half of their results). We compared the group (13 students) who performed osteotomy after participating in the simulation lecture with those (11 students) who performed osteotomy after performing self-simulation (they were instructed to bring their personal computers and install the MSS) using tests and questionnaires (pre- and post-curriculum). RESULTS: The average test score was significantly higher in the group who performed osteotomy using the 3D-printed model after performing self-simulation; participants in this group had acquired a better understanding of the surgical procedure. Comparison using questionnaires showed a significant difference in the students' understanding of instruments and surgical techniques between both groups. CONCLUSION: The MSS and 3D printed models are widely used clinically. Incorporating these in the curriculum will help accelerate student development. In addition, prompt education on the purpose and usefulness of these tools will not only facilitate simulation software and 3D-printed model-based treatment plan in the clinic but also promote further research.

Fracture planning is easy: Development of a basic method of digital planning based on the traditional pencil and paper technique. / Planificar fracturas es sencillo: desarrollo de un método básico de planificación digital basado en la técnica tradicional con lápiz y papel.

INTRODUCTION: Preoperative planning constitutes a fundamental tool in the management of fractures; however, its practical application is far from the desired, perhaps due to the absence of a basic and simple method, adapted to the current times. We describe a digital planning method, halfway between the traditional and the technological, which preserves its educational essence, allows the understanding of the fracture and the individualization of the osteosynthesis. MATERIAL AND METHODS: After the initial analysis of the fracture and the patient's characteristics, different measurements are made on X-ray and CT images with a digital medical imaging software. These images are then copied into a presentation program (Microsoft® PowerPoint or Keynote ©Apple Inc.), in which the main fragments and fracture lines are traced with the computer pointer. These are subsequently moved into a reduced position and the implants for internal fixation are graphically represented together with a guide of the surgical strategy. RESULTS: We show 4 cases of different types of fractures operated through reduction and osteosynthesis after preoperative planning according to the described method. The basic points for the surgical planning, logistics, tactics and postoperative radiological results of each case are detailed. CONCLUSIONS: Despite rise of advanced planning software, traditional paper and pencil methods are still fundamental, even more so for the trauma surgeon in training. The digital planning method described is very appropriate for this purpose, as it combines the advantages of both methods: simplicity, accessibility, quickness, low-cost, reproducibility, educational character, efficiency and possibility of simulation, corrections and reuse of cases.

The Effect of Automated Mammogram Orders Paired With Electronic Invitations to Self-schedule on Mammogram Scheduling Outcomes: Observational Cohort Comparison.

BACKGROUND: Screening mammography is recommended for the early detection of breast cancer. The processes for ordering screening mammography often rely on a health care provider order and a scheduler to arrange the time and location of breast imaging. Self-scheduling after automated ordering of screening mammograms may offer a more efficient and convenient way to schedule screening mammograms. OBJECTIVE: The aim of this study was to determine the use, outcomes, and efficiency of an automated mammogram ordering and invitation process paired with self-scheduling. METHODS: We examined appointment data from 12 months of scheduled mammogram appointments, starting in September 2019 when a web and mobile app self-scheduling process for screening mammograms was made available for the Mayo Clinic primary care practice. Patients registered to the Mayo Clinic Patient Online Services could view the schedules and book their mammogram appointment via the web or a mobile app. Self-scheduling required no telephone calls or staff appointment schedulers. We examined uptake (count and percentage of patients utilizing self-scheduling), number of appointment actions taken by self-schedulers and by those using staff schedulers, no-show outcomes, scheduling efficiency, and weekend and after-hours use of self-scheduling. RESULTS: For patients who were registered to patient online services and had screening mammogram appointment activity, 15.3% (14,387/93,901) used the web or mobile app to do either some mammogram self-scheduling or self-cancelling appointment actions. Approximately 24.4% (3285/13,454) of self-scheduling occurred after normal business hours/on weekends. Approximately 9.3% (8736/93,901) of the patients used self-scheduling/cancelling exclusively. For self-scheduled mammograms, there were 5.7% (536/9433) no-shows compared to 4.6% (3590/77,531) no-shows in staff-scheduled mammograms (unadjusted odds ratio 1.24, 95% CI 1.13-1.36; P<.001). The odds ratio of no-shows for self-scheduled mammograms to staff-scheduled mammograms decreased to 1.12 (95% CI 1.02-1.23; P=.02) when adjusted for age, race, and ethnicity. On average, since there were only 0.197 staff-scheduler actions for each finalized self-scheduled appointment, staff schedulers were rarely used to redo or "clean up" self-scheduled appointments. Exclusively self-scheduled appointments were significantly more efficient than staff-scheduled appointments. Self-schedulers experienced a single appointment step process (one and done) for 93.5% (7553/8079) of their finalized appointments; only 74.5% (52,804/70,839) of staff-scheduled finalized appointments had a similar one-step appointment process (P<.001). For staff-scheduled appointments, 25.5% (18,035/70,839) of the finalized appointments took multiple appointment steps. For finalized appointments that were exclusively self-scheduled, only 6.5% (526/8079) took multiple appointment steps. The staff-scheduled to self-scheduled odds ratio of taking multiple steps for a finalized screening mammogram appointment was 4.9 (95% CI 4.48-5.37; P<.001). CONCLUSIONS: Screening mammograms can be efficiently self-scheduled but may be associated with a slight increase in no-shows. Self-scheduling can decrease staff scheduler work and can be convenient for patients who want to manage their appointment scheduling activity after business hours or on weekends.