Milan Ultrasound Criteria predict relapse of ulcerative colitis in remission

Introduction Bowel ultrasound is a non-invasive alternative to endoscopy for assessing the disease activity of ulcerative colitis; however, it is unclear whether bowel ultrasound can predict subsequent relapse from remission. Materials and Methods A retrospective cohort study enrolled patients with ulcerative colitis who underwent bowel ultrasound between July 2018 and July 2021 during clinical remission (patient-reported outcome-2 ≤ 1 and no rectal bleeding) for at least 3 months and were followed up for 1 year. Ultrasonographic findings (bowel wall thickness, bowel wall flow, bowel wall stratification, and enlarged lymph nodes), Milan Ultrasound Criteria, Mayo endoscopic subscore, C-reactive protein, and fecal calprotectin levels and their association with subsequent clinical relapse were assessed. Relapse was defined as rectal bleeding score ≥ 1, stool frequency score ≥ 2, or treatment intensification for symptoms. Results 31% of the patients (18/58) relapsed within 1 year. No single ultrasonographic finding predicted relapse, whereas Milan Ultrasound Criteria > 6.2 (p = 0.019), Mayo endoscopic subscore ≥ 1 (p = 0.013), and fecal calprotectin ≥ 250 μg/g (p = 0.040) were associated with a shorter time to relapse in the log-rank test. Milan Ultrasound Criteria > 6.2 (hazard ratio 3.22; 95% confidence interval 1.14-9.08, p = 0.027) and Mayo endoscopic subscore ≥ 1 (hazard ratio 8.70; 95% confidence interval 1.11-68.1, p = 0.039) showed a higher risk of relapse according to a Cox proportional hazards model. Discussion/Conclusion Bowel ultrasound can predict subsequent clinical relapse from remission in patients with ulcerative colitis using the Milan Ultrasound Criteria

Automatic Puncture Timing Detection for Multi-Camera Injection Motion Analysis

Precisely detecting puncture times has long posed a challenge in medical education. This challenge is attributable not only to the subjective nature of human evaluation but also to the insufficiency of effective detection techniques, resulting in many medical students lacking full proficiency in injection skills upon entering clinical practice. To address this issue, we propose a novel detection method that enables automatic detection of puncture times during injection without needing wearable devices. In this study, we utilized a hardware system and the YOLOv7 algorithm to detect critical features of injection motion, including puncture time and injection depth parameters. We constructed a sample of 126 medical injection training videos of medical students, and skilled observers were employed to determine accurate puncture times. Our experimental results demonstrated that the mean puncture time of medical students was 2.264 s and the mean identification error was 0.330 s. Moreover, we confirmed that there was no significant difference (p = 0.25 with a significance level of α = 0.05) between the predicted value of the system and the ground truth, which provides a basis for the validity and reliability of the system. These results show our system’s ability to automatically detect puncture times and provide a novel approach for training healthcare professionals. At the same time, it provides a key technology for the future development of injection skill assessment systems

Injectable phase-separated tetra-armed poly(ethylene glycol) hydrogel scaffold allows sustained release of growth factors to enhance the repair of critical bone defects

With the rising prevalence of bone-related injuries, it is crucial to improve treatments for fractures and defects. Tissue engineering offers a promising solution in the form of injectable hydrogel scaffolds that can sustain the release of growth factors like bone morphogenetic protein-2 (BMP-2) for bone repair. Recently, we discovered that tetra-PEG hydrogels (Tetra gels) undergo gel-gel phase separation (GGPS) at low polymer content, resulting in hydrophobicity and tissue affinity. In this work, we examined the potential of a newer class of gel, the oligo-tetra-PEG gel (Oligo gel), as a growth factor-releasing scaffold. We investigated the extent of GGPS occurring in the two gels and assessed their ability to sustain BMP-2 release and osteogenic potential in a mouse calvarial defect model. The Oligo gel underwent a greater degree of GGPS than the Tetra gel, exhibiting higher turbidity, hydrophobicity, and pore formation. The Oligo gel demonstrated sustained protein or growth factor release over a 21-day period from protein release kinetics and osteogenic cell differentiation studies. Finally, BMP-2-loaded Oligo gels achieved complete regeneration of critical-sized calvarial defects within 28 days, significantly outperforming Tetra gels. The easy formulation, injectability, and capacity for sustained release makes the Oligo gel a promising candidate therapeutic biomaterial