Recent studies have analysed birth-related clavicular fractures to propose time frames for healing that could be applied to dating of all fractures in cases of suspected child abuse.

To assess differences in healing rates between femoral fractures and birth-related clavicular fractures in infants and young children.

A retrospective 5-year pilot study of femoral fractures in children younger than 3 years of age was performed. Anonymised radiographs were independently scored by two radiologists for stages of fracture healing. In cases of reader disagreement, radiographs were independently scored by a third radiologist.

In total, 74 radiographs (30 children) met the inclusion criteria. Fracture healing evolved over time with subperiosteal new bone formation (SPNBF) appearing first, followed by callus then remodelling. A power calculation for a single proportion, with a level of confidence of 95% and a margin of error of 5%, showed that in a definitive study, 359 radiographs would be required.

Although the overall pattern of healing is similar, in this small pilot study, the earliest times for SPNBF and callus formation in femoral fractures appeared to lag behind healing of birth-related clavicular fractures. Remodelling appeared earlier than remodelling of clavicular fractures. A power calculation has determined numbers of femoral radiographs (359) required for a definitive study.

Although the overall pattern of healing is similar, in this small pilot study, the earliest times for SPNBF and callus formation in femoral fractures appeared to lag behind healing of birth-related clavicular fractures. Remodelling appeared earlier than remodelling of clavicular fractures. A power calculation has determined numbers of femoral radiographs (359) required for a definitive study.

Surgical resection is the only curative treatment for pancreatic cancer. Arterial resection and reconstruction during pancreaticoduodenectomy for advanced pancreatic cancer remain controversial due to a high rate of complications.

We report two cases of pancreatic cancer with hepatic artery resection and reconstruction using the right gastroepiploic artery during pancreaticoduodenectomy after neoadjuvant therapy.

The patients underwent pancreaticoduodenectomy with resection of the right hepatic and common hepatic arteries. Achieving direct anastomosis was difficult; therefore, we planned hepatic artery reconstruction using the right gastroepiploic artery. We performed the reconstruction using an interrupted suture with end-to-end anastomosis. The first patient developed a postoperative pancreatic fistula, while the postoperative course of the second patient was uneventful. However, there were no adverse events related to the arterial reconstruction. R0 resection was achieved, and postoperative computed tomography revealed good patency of the reconstructed artery.

Hepatic artery reconstruction using the right gastroepiploic artery in pancreatic cancer might be technically safe and might become one of the alternative options.

Hepatic artery reconstruction using the right gastroepiploic artery in pancreatic cancer might be technically safe and might become one of the alternative options.

Frailty has been discussed as a predictor of morbidity and mortality for liver cirrhosis. The aim of our study is to evaluate the role of frailty in liver transplantation, particularly for patients with MELD scores < 15.

All patients listed for liver transplantation between September 2015 and November 2018 were prospectively included in the study. Frailty was assessed by Fried’s frailty classification. Pre-, intra-, and postoperative data were prospectively recorded. Univariate and multivariate regression analyses were performed. The ethical approval of the institutional board review was obtained for the study.

There were 114 patients included in the study, and their median MELD score was 16. Of these, 86 patients were defined as frail (75.4%). A total of 62 patients (54.4%) underwent liver transplantation, 11 (17.7%) died postoperatively, and 24 patients (21.0%) died while on the waitlist. All postoperative mortality cases were frail, and only 3 patients (12.5%) were non-frail in the waitlist mortality group. There were 14 patients who had MELD scores of <15 (58.3%). The overall survival of non-frail patients was significantly better than that of frail patients. The multivariate regression analyses identified frailty criteria, including unintended weight loss and low hand grip strength, and platelet count and being married or living in a solid partnership were prognostic factors for survival in all patients.

The addition of frailty assessment can be beneficial for predicting mortality after liver transplantation, especially in patients with low MELD score. Frail patients on the waitlist have significant risk for mortality even with low MELD score.

The addition of frailty assessment can be beneficial for predicting mortality after liver transplantation, especially in patients with low MELD score. Frail patients on the waitlist have significant risk for mortality even with low MELD score.The spatial-numerical association of response codes (SNARC) effect showed that small/large numbers represented in the left/right space facilitated left/right responses, respectively. However, the processing stage (semantic representation or response selection) of the SNARC effect is still controversial. To investigate this issue, we adopted a modified magnitude comparison task in which the effects of SNARC, Stroop (semantic-representation stage), and Simon (response-selection stage) could be simultaneously induced. The processing stages of the SNARC effect were investigated by examining the interactions among these effects. According to the additive factor logic, if two effects are interactive, then they occur in the same stage; if two effects are additive, then they occur in different stages. Across two experiments, the SNARC effect interacted with the Stroop effect and with the Simon effect. These results suggested that the SNARC effect occurred in both the semantic-representation and response-selection stages and provided insight into that the SNARC effect might have two originating sources.Mindfulness attracted increased research interests in the last decade, reporting an overall beneficial effect of this practice on cognitive performances. Nevertheless, recently a possible detrimental impact of mindfulness has been underlined. While the effect of mindfulness on memory remains under-explored, recent studies have observed an increased false-memory susceptibility after mindfulness practice. A possible explanatory mechanism has been suggested, related to the nature of the studied material. For semantically related information, mindfulness would increase false memories; however, the addition of rich perceptual information could prevent this detrimental effect. The present study aimed to verify this hypothesis by testing the impact of state mindfulness induced by a short meditation session, and dispositional mindfulness on the production of false memory for pictorial material presented in a complex virtual environment. We employed a virtual reality version of the Deese-Roediger-McDermott paradigm (DRM), a classical protocol to induce false memories. Contrary to previous studies, we did not observe any effect of mindfulness on false or correct memories (free recall and recognition) after a short mindfulness practice session compared to a control condition. Nonetheless, we found a beneficial effect of mindfulness practice on memory sensitivity. Additionally, we reported a positive and negative effect of dispositional mindfulness on memory outcomes. While the Non-Reactivity facet was associated with overall better memory performances, we observed an association between the Acting with Awareness facet and an increased recollection of lures. We discuss these findings in line with a recent proposal on the link between mindfulness and episodic memory.To evaluate factors affecting the outcomes of short-term Mono-J insertion for 6 h following ureteroscopic stone removal. Patients treated with a Mono-J for 6 h after ureterorenoscopy and stone removal were analysed. FaST 1 and 2 (Fast Track Stent Studies), two consecutive single academic centre studies, were conducted between August 2014 and April 2018. In each study, we randomized patients with renal or ureteral calculi to two groups before ureterorenoscopy. FaST 1 compared a Mono-J insertion for 6 h versus Double-J insertion for 3-5 days after ureterorenoscopy. FaST 2 compared a Mono-J insertion to a tubeless procedure in the same clinical setting. All patients were pre-stented for 3-5 days before URS. The study endpoint was stent-related symptoms as assessed by a validated questionnaire (USSQ). Results were stratified by clinical parameters, stone characteristics and operation details. 108 of 156 initially randomized patients undergoing ureterorenoscopy were included. USSQ scores covering the time 3-5 weeks after stone removal showed a significantly reduced urinary symptoms and pain index compared to the scores before ureterorenoscopy. USSQ results before and after stone removal did not correlate with stone size or operation time and did not differ significantly depending on stone localization, the treating endourologist, or ureterorenoscopic device used (p > 0.05). Six patients (5%) required reintervention. Following secondary ureterorenoscopy and ureteral drainage with a Mono-J for 6 h, quality of life is independent of stone size and localization, operation time, the treating endourologist, and the URS device used.

The present scoping review aims to assess the non-inferiority of distributed learning over centrally and locally trained machine learning (ML) models in medical applications.

We performed a literature search using the term „distributed learning” OR „federated learning” in the PubMed/MEDLINE and EMBASE databases. No start date limit was used, and the search was extended until July 21, 2020. We excluded articles outside the field of interest; guidelines or expert opinion, review articles and meta-analyses, editorials, letters or commentaries, and conference abstracts; articles not in the English language; and studies not using medical data. Selected studies were classified and analysed according to their aim(s).

We included 26 papers aimed at predicting one or more outcomes namely risk, diagnosis, prognosis, and treatment side effect/adverse drug reaction. Distributed learning was compared to centralized or localized training in 21/26 and 14/26 selected papers, respectively. Regardless of the aim, the type of input, the method, and the classifier, distributed learning performed close to centralized training, but two experiments focused on diagnosis. In all but 2 cases, distributed learning outperformed locally trained models.

Distributed learning resulted in a reliable strategy for model development; indeed, it performed equally to models trained on centralized datasets. Sensitive data can get preserved since they are not shared for model development. Distributed learning constitutes a promising solution for ML-based research and practice since large, diverse datasets are crucial for success.

Distributed learning resulted in a reliable strategy for model development; indeed, it performed equally to models trained on centralized datasets. Sensitive data can get preserved since they are not shared for model development. Distributed learning constitutes a promising solution for ML-based research and practice since large, diverse datasets are crucial for success.