In Silico Investigation against Inhibitors of Alpha-Amylase Using Structure-based Screening, Molecular Docking, and Molecular Simulations Studies.

Type-II diabetes mellitus is a chronic disorder that results from fluctuations in the glucose level leading to hyperglycemia with severe adverse effects increasing worldwide. Alpha-Amylase is the key enzyme involved in the mechanism of glucose formation therefore Alpha-Amylase inhibitors have become a therapeutic target in the development of new leads as they have the potential to suppress glucose levels. Existing drugs targeting Alpha-Amylase highlight major drawbacks in terms of poor absorption rate that causes several gastrointestinal issues. So, this research is aimed to develop novel inhibitors interacting with Alpha-Amylase's active site using structural-based screening, binding pattern analysis, and molecular dynamic simulation. Hence, to search for a potential lead, we analyzed a total of 133 valiolamine derivatives and 535 desoxynojirimycin derivatives that exhibited drug-like properties screened through Lipinski filters. Virtual screening followed by binding interaction analysis we identified ten compounds that exhibited better binding energy scores compared to the standard drugs voglibose and miglitol, used in our study. The docking analysis, ADMET and metabolic site prediction estimated the best top two compounds with good drug profiles. Further, top compounds VG9 and VG15 were promoted to simulation study using the Biovia Discovery study to access the stability at a time interval of 100 ns. MD simulation results revealed that our compound VG9 possesses better conformational stability in the complex to the active site residues of Alpha-Amylase target protein than standard drug voglibose. Thus, our investigation revealed that compound VG9 also exhibits the best pharmacokinetic as well as binding affinity results and could act as a potential lead compound targeting Alpha-Amylase for Type II diabetes.

Virtual bracket removal: a comparative assessment of different software packages.

BACKGROUND: High precision intra-oral scans, coupled with advanced software, enable virtual bracket removal (VBR) from digital models. VBR allows the delivery of retainers and clear aligners promptly following debonding, thus reducing the patients' appointments and minimizing the likelihood of tooth movement. The objective of this study was to compare the enamel surface before bonding and after VBR using three different Computer-aided design (CAD) software and to compare their accuracy. METHODS: Maxillary scans of 20 participants starting orthodontic treatment were selected for inclusion in the study, who exhibited mild to moderate crowding and required bonding of brackets on the labial surface of permanent maxillary teeth (from the maxillary left first molar to the maxillary right first molar). Two intra-oral scans were conducted on the same day, before bonding and immediately after bonding using CEREC Omnicam (Sirona Dental Systems, Bensheim, Germany). The virtual removal of the brackets from the post-bonding models was performed using OrthoAnalyzer (3Shape, Copenhagen, Denmark), Meshmixer (Autodesk, San Rafael, Calif, USA), and EasyRx (LLC, Atlanta, GA, USA) software. The models that underwent VBR were superimposed on the pre-bonding models by Medit Link App (Medit, Seoul, South Korea) using surface-based registration. The changes in the enamel surface following VBR using the three software packages were quantified using the Medit Link App. RESULTS: There was a significant difference among the 3Shape, Meshmixer, and EasyRx software in tooth surface change following VBR. Specifically, EasyRx exhibited lower levels of accuracy compared to the other two VBR software programs (p<.001, p<.001). A significant difference in enamel surface change was observed between tooth segments across all software groups, in both incisors and molars, with VBR of the molars exhibiting the lowest level of accuracy (3Shape p=.002, Meshmixer p<.001, EasyRx p<.001). Regarding the direction of tooth surface changes following VBR, it was observed that all three groups exhibited a significant increase in the percentage of inadequate bracket removal across all teeth segments. CONCLUSIONS: 3Shape and Meshmixer manual VBR software were found to be more accurate than EasyRx automated software, however, the differences were minimal and clinically insignificant.

The real-time hand and object recognition for virtual interaction.

Recognizing hand-object interactions presents a significant challenge in computer vision. It arises due to the varying nature of hand-object interactions. Moreover, estimating the 3D position of a hand from a single frame can be problematic, especially when the hand obstructs the view of the object from the observer's perspective. In this article, we present a novel approach to recognizing objects and facilitating virtual interactions, using a steering wheel as an illustrative example. We propose a real-time solution for identifying hand-object interactions in eXtended reality (XR) environments. Our approach relies on data captured by a single RGB camera during a manipulation scenario involving a steering wheel. Our model pipeline consists of three key components: (a) a hand landmark detector based on the MediaPipe cross-platform hand tracking solution; (b) a three-spoke steering wheel model tracker implemented using the faster region-based convolutional neural network (Faster R-CNN) architecture; and (c) a gesture recognition module designed to analyze interactions between the hand and the steering wheel. This approach not only offers a realistic experience of interacting with steering-based mechanisms but also contributes to reducing emissions in the real-world environment. Our experimental results demonstrate the natural interaction between physical objects in virtual environments, showcasing precision and stability in our system.

Research on 3D virtual vision matching based on interactive color segmentation.

Given the prevalent issues surrounding accuracy and efficiency in contemporary stereo-matching algorithms, this research introduces an innovative image segmentation-based approach. The proposed methodology integrates residual and Swim Transformer modules into the established 3D Unet framework, yielding the Res-Swim-UNet image segmentation model. The algorithm estimates the disparateness of segmented outputs by employing regression techniques, culminating in a comprehensive disparity map. Experimental findings underscore the superiority of the proposed algorithm across all evaluated metrics. Specifically, the proposed network demonstrates marked improvements, with IoU and mPA enhancements of 2.9% and 162%, respectively. Notably, the average matching error rate of the algorithm registers at 2.02%, underscoring its efficacy in achieving precise stereoscopic matching. Moreover, the model's enhanced generalization capability and robustness underscore its potential for widespread applicability.

Comparing virtual reality and simulation to teach the assessment and management of acute surgical scenarios: A pilot study.

Background and Aims: Traditional apprenticeship-based surgical training presents with challenges, especially in acute scenarios. Simulation provides the current standard of facilitating surgical training in a low-risk environment but is restricted by limited accessibility and high costs. Virtual reality (VR) offers immersive three-dimensional computer-generated training scenarios and can connect users from various locations. We aimed to compare the performance of junior doctors to manage an acute surgical scenario using VR and mannequin-based simulation. We hypothesised that VR would be as effective as mannequin-based simulation in performance outcomes. Methods: This multicentre, randomised controlled pilot study was conducted with eighteen junior doctor volunteers (Foundation and Core Trainee Year 1). Ten were randomly allocated to VR and eight to mannequin-based simulation. Participants completed questionnaires and a 15-min pneumothorax scenario. Quantitative metrics included overall score, time-to-critical decisions, and academic buoyancy scores (ABS). Qualitative metrics included participants' likes and dislikes of their allocated simulation modality. Results: VR participants scored significantly higher than mannequin-based simulation participants in overall scores (74.30% (SD ± 5.08%) vs. 59.75% (SD ± 10.14) (p = 0.04)), and technical skills aspects (77.20% (SD ± 8.01%) vs. 65.00% (SD ± 8.21%) (p = 0.01)). Mannequin-based simulation participants initiated critical decisions faster and demonstrated a trend towards a faster mean time-to-completion (p = 0.06). ABS scores increased for both study groups, though was only significant for VR participants (p ≤ 0.01). VR participants liked how VR fostered independent learning but disliked the formulaic content and impaired communication-learning compared to mannequin-based simulation. Conclusion: Both VR and mannequin-based simulation training are effective in training junior doctors in acute surgical scenarios but present different educational benefits. Future research should recruit a larger sample size for a full comparative randomised controlled trial.

Digital health intervention in patients undergoing cardiac rehabilitation: systematic review and meta-analysis.

Background: Cardiovascular disease (CVD) continues to be the foremost mortality internationally. Cardiac rehabilitation has proven as an effective program in reducing CVD burden. Participation in cardiac rehabilitation programs is very low. Digital health intervention emerged as an alternative method to deliver Cardiac rehabilitation. This review aimed to investigate the impact of digital health intervention on the outcomes of interest. Methods: the following databases: PubMed, CINAHL, Scopus, and Cochrane Library have been searched to retrieve randomized controlled trials that examine the impact of digital health intervention on blood pressure, body mass index, lipid profile, blood glucose, Six-Minute Walk Test, and peak oxygen consumption. filters were set to include studies published in English between 2000-2023. Results: Nineteen studies were included in this review. Six-Minute Walk Test (MD = 16.70; 95% CI: 6.00 to 27.39, p = 0.000) and maximal oxygen consumption (SMD = 0.27; 95% CI: 0.08 to 0.45, p = 0.004) significantly improved following digital health intervention, after employing the sensitivity analysis significant improvement was observed in systolic (MD = -2.54; 95% CI: -4.98 to -0.11, p = 0.04) and diastolic blood pressure (SMD = -2.0182; 95% CI: -3.9436 to -0.0928, p = 0.04) favoring experimental groups. Subgroup analysis revealed significant improvement in quality of life after three months of follow-up (SMD = 0.18; 95% CI: 0.05 to 0.31, p = 0.00), no significant differences have been observed in body mass index, lipid profile, and blood glucose. Conclusion: The findings emphasize the significant impact of digital vs CBCR or usual care on physical capacity, blood pressure, and quality of life. Despite the non-statistically significant differences in body mass index and lipid profile, the comparable effect between the two methods suggests the superiority of digital over CBCR or usual care due to its convenient nature, accessibility, and cost-effectiveness.

The Effect of Traumatic Brain Injury on Memory.

Having a good memory is essential for carrying out daily tasks. People cannot study, plan, remember or navigate life effectively if they are memoryless. People may be at risk when mistakes made in the past will be repeated and lessons regarding danger cannot be learned. In the community, traumatic brain injury (TBI) is common and individuals with TBI frequently have memory problems. It is crucial to study how TBI affects memory to better understand the underlying mechanism and to tailor rehabilitation for patients with a range of pathologies and severity levels. Thus, this paper aimed to review studies related to TBI's effect on memory. This review examined recent studies to learn more regarding and comprehend the connection between TBI and memory, including short-term memory (STM), working memory (WM) and long-term memory (LTM). This will undoubtedly have a big impact on how memory problems that may arise after TBI will be addressed. Virtual reality and other technological advancements have given the medical community a new way to investigate rehabilitative therapy.

Expanding the empirical study of virtual reality beyond empathy to compassion, moral reasoning, and moral foundations.

This study utilizes a controlled experimental design to investigate the influence of a virtual reality experience on empathy, compassion, moral reasoning, and moral foundations. With continued debate and mixed results from previous studies attempting to show relationships between virtual reality and empathy, this study takes advantage of the technology for its ability to provide a consistent, repeatable experience, broadening the scope of analysis beyond empathy. A systematic literature review identified the most widely used and validated moral psychology assessments for the constructs, and these assessments were administered before and after the virtual reality experience. The study is comprised of two pre-post experiments with student participants from a university in the United States. The first experiment investigated change in empathy and moral foundations among 44 participants, and the second investigated change in compassion and moral reasoning among 69 participants. The results showed no significant change in empathy nor compassion, but significant change in moral reasoning from personal interest to post-conventional stages, and significant increase in the Care/harm factor of moral foundations. By testing four of the primary constructs of moral psychology with the most widely used and validated assessments in controlled experiments, this study attempts to advance our understanding of virtual reality and its potential to influence human morality. It also raises questions about our self-reported assessment tools and provides possible new insights for the constructs examined.

The Rise of Virtual Health Care: Transforming the Health Care Landscape in the Kingdom of Saudi Arabia: A Review Article.

BACKGROUND: The rise of virtual healthcare underscores the transformative influence of digital technologies in reshaping the healthcare landscape. As technology advances and the global demand for accessible and convenient healthcare services escalates, the virtual healthcare sector is gaining unprecedented momentum. Saudi Arabia, with its ambitious Vision 2030 initiative, is actively embracing digital innovation in the healthcare sector. METHODS: In this narrative review, we discussed the key drivers and prospects of virtual healthcare in Saudi Arabia, highlighting its potential to enhance healthcare accessibility, quality, and patient outcomes. We also summarized the role of the COVID-19 pandemic in the digital transformation of healthcare in the country. Healthcare services provided by Seha Virtual Hospital in Saudi Arabia, the world's largest and Middle East's first virtual hospital, were also described. Finally, we proposed a roadmap for the future development of virtual health in the country. RESULTS AND CONCLUSIONS: The integration of virtual healthcare into the existing healthcare system can enhance patient experiences, improve outcomes, and contribute to the overall well-being of the population. However, careful planning, collaboration, and investment are essential to overcome the challenges and ensure the successful implementation and sustainability of virtual healthcare in the country.

Examination of Factors Influencing Patient Satisfaction with Virtual Clinic Experience During COVID-19 in MNGHA, Saudi Arabia.

Introduction: The COVID-19 pandemic crisis brought great challenges on health care systems around the world, forcing many services to slow or temporarily shut down, including medical services in Saudi Arabia (SA). Health care institutions had to adapt new strategies such as virtual clinics to continue delivering care in light of the situation. Virtual clinics and telemedicine are relatively new and limited literature is available regarding patient's experience in SA. Therefore, the aim of this study is to assess and evaluate the levels of patients' satisfaction with the experience of services provided by virtual clinics at the Ministry of National Guard Health Affairs. Method: A retrospective cross-sectional study based on secondary data collected by the corporate patient experience department at MNGHA. The analysis included all virtual clinics' visits from four MNGHA regions (Central, Eastern, Western, and AlMadinah) between April 19 and May 15, 2020. Findings: The results showed that more than half of our study participants were females (57%) (N = 7,803) and (64%) (N = 8,696) were between the age of 21-64 years. Most of the participants were from the Central region (73%) (N = 10,026). More than half of virtual visits were to hospitals (66%) (N = 9,098). Results from the ordinal regression showed that age, gender, region and, survey method were significantly associated with extreme satisfaction score (4.21-5.0). Males were more likely to be extremely satisfied than females (OR = 1.088), and patients between the ages of 6-20 were extremely satisfied compared with the age group 41-64 (OR = 1.309). Eastern region was more likely to be extremely satisfied than central region (OR = 1.121). Patients surveyed by calls were more likely to be extremely satisfied compared with SMS surveys (OR = 1.808), whereas facility type showed no significance. The overall satisfaction score was 4.1 out of 5. Interpretation: According to our findings, the majority of patients were satisfied with the experiences of virtual clinics at MNGHA. Therefore, we recommend exploring more frequent use of virtual clinics when appropriate beyond the pandemic. Virtual clinics can minimize the risk of disease transmission, save travel time, and is considered a cost-effective alternative to traditional clinics.

Optimizing group work strategies in virtual dissection.

Due to its haptic and interactive nature, virtual anatomy provides an opportunity for small-group learning, enabling students to develop their group work skills before they graduate. However, there is currently little practical guidance supported by pedagogic principles detailing how to incorporate it into curricula. Anatomy educators at the University of Plymouth conducted action research aiming to capture students' overall perceptions of the virtual anatomy platform Anatomage. Questioning the benefits and challenges students face while interacting with Anatomage prompted the creation of evidence-based interventions to be later evaluated. Although a plethora of themes were identified, this report specifically examines those relating to group work. Thematic analysis of initial focus group data found group size and group dynamics impacted students' experience with the platform. Following the implementation of interventions to resolve these issues, a questionnaire and second series of focus groups were conducted to determine whether they were successful. Additional subthemes found from these data included facilitation, social pressure, peer learning and working with friends. This study contributed to the improvement of small group learning and integration of virtual anatomy into curricula based on student and staff feedback. As such, these data support the development of effective group working skills which are fundamental for healthcare professionals and widely recognized by regulators such as the General Medical Council and Health and Care Professions Council. In this report, the authors provide practical advice informed by pedagogy and principles from management and psychology to provide a multidisciplinary perspective.

Scene semantics affects allocentric spatial coding for action in naturalistic (virtual) environments.

Interacting with objects in our environment requires determining their locations, often with respect to surrounding objects (i.e., allocentrically). According to the scene grammar framework, these usually small, local objects are movable within a scene and represent the lowest level of a scene's hierarchy. How do higher hierarchical levels of scene grammar influence allocentric coding for memory-guided actions? Here, we focused on the effect of large, immovable objects (anchors) on the encoding of local object positions. In a virtual reality study, participants (n = 30) viewed one of four possible scenes (two kitchens or two bathrooms), with two anchors connected by a shelf, onto which were presented three local objects (congruent with one anchor) (Encoding). The scene was re-presented (Test) with 1) local objects missing and 2) one of the anchors shifted (Shift) or not (No shift). Participants, then, saw a floating local object (target), which they grabbed and placed back on the shelf in its remembered position (Response). Eye-tracking data revealed that both local objects and anchors were fixated, with preference for local objects. Additionally, anchors guided allocentric coding of local objects, despite being task-irrelevant. Overall, anchors implicitly influence spatial coding of local object locations for memory-guided actions within naturalistic (virtual) environments.

Integrating virtual patients into undergraduate health professions curricula: a framework synthesis of stakeholders' opinions based on a systematic literature review.

BACKGROUND: Virtual patients (VPs) are widely used in health professions education. When they are well integrated into curricula, they are considered to be more effective than loosely coupled add-ons. However, it is unclear what constitutes their successful integration. The aim of this study was to identify and synthesise the themes found in the literature that stakeholders perceive as important for successful implementation of VPs in curricula. METHODS: We searched five databases from 2000 to September 25, 2023. We included qualitative, quantitative, mixed-methods and descriptive case studies that defined, identified, explored, or evaluated a set of factors that, in the perception of students, teachers, course directors and researchers, were crucial for VP implementation. We excluded effectiveness studies that did not consider implementation characteristics, and studies that focused on VP design factors. We included English-language full-text reports and excluded conference abstracts, short opinion papers and editorials. Synthesis of results was performed using the framework synthesis method with Kern's six-step model as the initial framework. We appraised the quality of the studies using the QuADS tool. RESULTS: Our search yielded a total of 4808 items, from which 21 studies met the inclusion criteria. We identified 14 themes that formed an integration framework. The themes were: goal in the curriculum; phase of the curriculum when to implement VPs; effective use of resources; VP alignment with curricular learning objectives; prioritisation of use; relation to other learning modalities; learning activities around VPs; time allocation; group setting; presence mode; VPs orientation for students and faculty; technical infrastructure; quality assurance, maintenance, and sustainability; assessment of VP learning outcomes and learning analytics. We investigated the occurrence of themes across studies to demonstrate the relevance of the framework. The quality of the studies did not influence the coverage of the themes. CONCLUSIONS: The resulting framework can be used to structure plans and discussions around implementation of VPs in curricula. It has already been used to organise the curriculum implementation guidelines of a European project. We expect it will direct further research to deepen our knowledge on individual integration themes.

Effectiveness of virtual and augmented reality for cardiopulmonary resuscitation training: a systematic review and meta-analysis.

BACKGROUND: Virtual reality (VR) and augmented reality (AR) are emerging technologies that can be used for cardiopulmonary resuscitation (CPR) training. Compared to traditional face-to-face training, VR/AR-based training has the potential to reach a wider audience, but there is debate regarding its effectiveness in improving CPR quality. Therefore, we conducted a meta-analysis to assess the effectiveness of VR/AR training compared with face-to-face training. METHODS: We searched PubMed, Embase, Cochrane Library, Web of Science, CINAHL, China National Knowledge Infrastructure, and Wanfang databases from the inception of these databases up until December 1, 2023, for randomized controlled trials (RCTs) comparing VR- and AR-based CPR training to traditional face-to-face training. Cochrane's tool for assessing bias in RCTs was used to assess the methodological quality of the included studies. We pooled the data using a random-effects model with Review Manager 5.4, and assessed publication bias with Stata 11.0. RESULTS: Nine RCTs (involving 855 participants) were included, of which three were of low risk of bias. Meta-analyses showed no significant differences between VR/AR-based CPR training and face-to-face CPR training in terms of chest compression depth (mean difference [MD], -0.66 mm; 95% confidence interval [CI], -6.34 to 5.02 mm; P = 0.82), chest compression rate (MD, 3.60 compressions per minute; 95% CI, -1.21 to 8.41 compressions per minute; P = 0.14), overall CPR performance score (standardized mean difference, -0.05; 95% CI, -0.93 to 0.83; P = 0.91), as well as the proportion of participants meeting CPR depth criteria (risk ratio [RR], 0.79; 95% CI, 0.53 to 1.18; P = 0.26) and rate criteria (RR, 0.99; 95% CI, 0.72 to 1.35; P = 0.93). The Egger regression test showed no evidence of publication bias. CONCLUSIONS: Our study showed evidence that VR/AR-based training was as effective as traditional face-to-face CPR training. Nevertheless, there was substantial heterogeneity among the included studies, which reduced confidence in the findings. Future studies need to establish standardized VR/AR-based CPR training protocols, evaluate the cost-effectiveness of this approach, and assess its impact on actual CPR performance in real-life scenarios and patient outcomes. TRIAL REGISTRATION: CRD42023482286.

Machine learning for high-precision simulation of dissolved organic matter in sewer: Overcoming data restrictions with generative adversarial networks.

Understanding the transformation process of dissolved organic matter (DOM) in the sewer is imperative for comprehending material circulation and energy flow within the sewer. The machine learning (ML) model provides a feasible way to comprehend and simulate the DOM transformation process in the sewer. In contrast, the model accuracy is limited by data restriction. In this study, a novel framework by integrating generative adversarial network algorithm-machine learning models (GAN-ML) was established to overcome the drawbacks caused by the data restriction in the simulation of the DOM transformation process, and humification index (HIX) was selected as the output variable to evaluate the model performance. Results indicate that the GAN algorithm's virtual dataset could generally enhance the simulation performance of regression models, deep learning models, and ensemble models for the DOM transformation process The highest prediction accuracy on HIX (R2 of 0.5389 and RMSE of 0.0273) was achieved by the adaptive boosting model which belongs to ensemble models trained by the virtual dataset of 1000 samples. Interpretability analysis revealed that dissolved oxygen (DO) and pH emerge as critical factors warranting attention for the future development of management strategies to regulate the DOM transformation process in sewers. The integrated framework proposed a potential approach for the comprehensive understanding and high-precision simulation of the DOM transformation process, paving the way for advancing sewer management strategy under data restriction.

Digital technology revolutionizing mandibular fracture treatment: a comparative analysis of patient-specific plates and conventional titanium plates.

OBJECTIVES: The treatment of fractures prioritizes the restoration of functionality through the realignment of fractured segments. Conventional methods, such as titanium plates, have been employed for this purpose; however, certain limitations have been observed, leading to the development of patient-specific plates. Furthermore, recent advancements in digital technology in dentistry enable the creation of virtual models and simulations of surgical procedures. The aim was to assess the clinical effectiveness of patient-specific plates utilizing digital technology in treating mandibular fractures compared to conventional titanium plates. MATERIALS AND METHODS: Twenty patients diagnosed with mandibular fractures were included and randomly assigned to either the study or control groups. The surgical procedure comprised reduction and internal fixation utilizing patient-specific plates generated through virtual surgery planning with digital models for the study group, while the control group underwent the same procedure with conventional titanium plates. Assessment criteria included the presence of malunion, infection, sensory disturbance, subjective occlusal disturbance and occlusal force in functional maximum intercuspation (MICP). Statistical analysis involved using the Chi-square test and one-way repeated measures analysis of variance. RESULTS: All parameters showed no statistically significant differences between the study and control groups, except for the enhancement in occlusal force in functional MICP, where a statistically significant difference was observed (p = 0.000). CONCLUSION: Using patient-specific plates using digital technology has demonstrated clinical effectiveness in treating mandibular fractures, offering advantages of time efficiency and benefits for less experienced surgeons. CLINICAL RELEVANCE: Patient-specific plates combined with digital technology can be clinically effective in mandibular fracture treatment.

Ensemble docking based virtual screening of SARS-CoV-2 main protease inhibitors.

During the first years of COVID-19 pandemic, X-ray structures of the coronavirus drug targets were acquired at an unprecedented rate, giving hundreds of PDB depositions in less than a year. The main protease (Mpro) of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) is the primary validated target of direct-acting antivirals. The selection of the optimal ensemble of structures of Mpro for the docking-driven virtual screening campaign was thus non-trivial and required a systematic and automated approach. Here we report a semi-automated active site RMSD based procedure of ensemble selection from the SARS-CoV-2 Mpro crystallographic data and virtual screening of its inhibitors. The procedure was compared with other approaches to ensemble selection and validated with the help of hand-picked and peer-reviewed activity-annotated libraries. Prospective virtual screening of non-covalent Mpro inhibitors resulted in a new chemotype of thienopyrimidinone derivatives with experimentally confirmed enzyme inhibition.

Diagnostic efficiency of intravoxel incoherent motion-based virtual magnetic resonance elastography in pulmonary neoplasms.

BACKGROUND: The aim of the study were as below. (1) To investigate the feasibility of intravoxel incoherent motion (IVIM)-based virtual magnetic resonance elastography (vMRE) to provide quantitative estimates of tissue stiffness in pulmonary neoplasms. (2) To verify the diagnostic performance of shifted apparent diffusion coefficient (sADC) and reconstructed virtual stiffness values in distinguishing neoplasm nature. METHODS: This study enrolled 59 patients (37 males, 22 females) with one pulmonary neoplasm who underwent computed tomography-guided percutaneous transthoracic needle biopsy (PTNB) with pathological diagnosis (26 adenocarcinoma, 10 squamous cell carcinoma, 3 small cell carcinoma, 4 tuberculosis and 16 non-specific benign; mean age, 60.81 ± 9.80 years). IVIM was performed on a 3 T magnetic resonance imaging scanner before biopsy. sADC and virtual shear stiffness maps reflecting lesion stiffness were reconstructed. sADC and virtual stiffness values of neoplasm were extracted, and the diagnostic performance of vMRE in distinguishing benign and malignant and detailed pathological type were explored. RESULTS: Compared to benign neoplasms, malignant ones had a significantly lower sADC and a higher virtual stiffness value (P < 0.001). Subsequent subtype analyses showed that the sADC values of adenocarcinoma and squamous cell carcinoma groups were significantly lower than non-specific benign group (P = 0.013 and 0.001, respectively). Additionally, virtual stiffness values of the adenocarcinoma and squamous cell carcinoma subtypes were significantly higher than non-specific benign group (P = 0.008 and 0.001, respectively). However, no significant correlation was found among other subtype groups. CONCLUSIONS: Non-invasive vMRE demonstrated diagnostic efficiency in differentiating the nature of pulmonary neoplasm. vMRE is promising as a new method for clinical diagnosis.

Introducing Virtual Shared Medical Appointments as a Novel Treatment Platform for Functional Movement Disorders.

The landscape of medical care has rapidly evolved with technological advancements, particularly through the widespread adoption of virtual appointments catalyzed by the COVID-19 pandemic. This shift has transcended geographical barriers, enhancing access for underserved populations and those with disabilities to specialized healthcare providers. A notable development stemming from this trend is the emergence of virtual shared medical appointments (VSMAs), which integrate group-based education with telemedicine technology. While VSMAs have demonstrated efficacy in conditions such as obesity, diabetes, and neurological disorders, their effectiveness in managing Functional Movement Disorders (FMD) is currently under investigation. FMDs pose unique challenges in diagnosis and acceptance, with high rates of misdiagnosis and treatment delays. VSMAs offer a promising solution by providing educational modules and fostering peer support among patients with similar diagnoses. At the Cleveland Clinic Center for Neurological Restoration, VSMAs have been embraced to enhance care standards for FMD patients. The program facilitates educational sessions and follow-up meetings to improve treatment adherence and psychological well-being. Early outcomes indicate increased patient acceptance and engagement, with significant program growth observed. Ongoing research aims to evaluate stakeholder perspectives and refine session content to further reduce stigma and the healthcare burden associated with FMDs.

Incorporating Technology Adoption in Medical Education: A Qualitative Study of Medical Students' Perspectives.

Introduction: The integration of technology into medical education has witnessed significant growth in recent years, with tools such as virtual reality, artificial intelligence, and telemedicine gaining prominence. These tool in medical education, offering immersive, experiential learning experiences. Methods: We approached medical students currently enrolled in medical education programs and who are familiar with and actively use AI in medical education. Initially, we invited 21 random students to participate in the study; however, only 13 agreed to interviews. Some students cited their busy exam schedules as the reason for not participating. The participants were informed of the objective of the study before the commencement of the recorded interviews. Semi-structured interviews were used to guide the record interviews. Audio recordings were transcribed and analyzed using Atlas.ti, a qualitative data analysis software. Results: Participants exhibited a diverse range of perceptions and levels of awareness regarding VR, AI, and telemedicine technologies. Learning with virtual reality was considered to be fun, memorable, inclusive, and engaging by participants. The use of virtual reality technology is seen as complementing current teaching and learning approaches, helping to build learners' confidence, as well as providing medical students with a safe environment for problem-solving and trial-and-error learning. The students reported that AI was seen as a potential game-changer in the healthcare sector. Participants hoped that telemedicine would provide healthcare services to remote and underserved populations. Conclusion: The study conducted focus group discussions with medical students and residents in Saudi Arabia to explore their views on integrating VR, AI, and telemedicine in medical education and practice. Their insights highlight the need for informed decision-making and strategic development to optimize the benefits and address challenges like initial investments, technical issues, ethics, and regulations. These considerations are crucial for fully realizing the potential benefits of technology in medical education globally.