Background: With the convert of educational concept, flipped classroom has been adopted gradually in radiology courses as a new teaching mode. Considering no evidence has been concluded to illustrate the effectiveness of of flipped classroom over traditional instructor-centered lectures in radiology education, this meta-analysis was conducted to provide empirical evidence for the reform of pedagogical. Methods: Studies were retrieved from six databases, including Pubmed, Embase, Web of Science, Wanfang Data, CNKI, and VIP, from their inception to 16 February 2020. Literature selection and data extraction were completed by two reviewers independently. The effect size of each index was expressed as the odds ratio (OR) for a categorical variable and standard mean difference (SMD) for a continuous variable, each with corresponding 95% confidence interval (95% CI). Results: A total of 19 studies with 2114 participants were deemed to be eligible for inclusion. The results of this meta-analysis indicated that: the newly emerged flipped classroom represented significant advantage versus traditional lecture in improving theoretical performance (SMD 1.12, 95% CI 0.61–1.63, P < .001), as well as in cultivating students’ practical skills (SMD 2.59, 95% CI 1.69–3.59, P < .001). In the subjective findings of investigation, more positive responses were attained in students who took radiology subjects in flipped classroom, covering course satisfaction (OR 1.70, 95% CI 1.35–2.14, P < .001), improvement of teamwork ability (OR 1.80, 95% CI 1.21–2.67, P = .004), self-directed learning and reflection (OR 1.98, 95% CI 1.31–2.97, P = .001), and subjective cognition on consolidation of knowledge mastery (OR 1.38, 95% CI 1.19–1.60, P < .001). Conclusion: Flipped classroom displays multiple advantages versus traditional lecture-based teaching mode, which is well worth further promoting and applying in the process of radiology education.

Bladder cancer is a fatal cancer that happens in the genitourinary tract with quite high morbidity and mortality annually. The high level of recurrence rate ranging from 50 to 80% makes bladder cancer one of the most challenging and costly diseases to manage. Faced with various problems in existing methods, a recently emerging concept for the measurement of imaging biomarkers and extraction of quantitative features called “radiomics” shows great potential in the application of detection, grading, and follow-up management of bladder cancer. Furthermore, machine-learning (ML) algorithms on the basis of “big data” are fueling the powers of radiomics for bladder cancer monitoring in the era of precision medicine. Currently, the usefulness of the novel combination of radiomics and ML has been demonstrated by a large number of successful cases. It possesses outstanding strengths including non-invasiveness, low cost, and high efficiency, which may serve as a revolution to tumor assessment and emancipate workforce. However, for the extensive clinical application in the future, more efforts should be made to break down the limitations caused by technology deficiencies, inherent problems during the process of radiomic analysis, as well as the quality of present studies.

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Objective The purpose of this study is to explore: 1) whether the extent of facet joint distraction affects functional outcomes following single-level anterior cervical disc replacement (ACDR) for cervical spondylotic radiculopathy and 2) whether the extent of facet joint distraction correlates with the cervical sagittal parameters. Methods We performed a retrospective analysis on 70 patients who had undergone a single-level ACDR to treat cervical spondylotic radiculopathy between January 2014 and December 2018. Pre- and post-operative lateral cervical spine X-ray radiographs were collected to determine radiographic parameters, including C0-C2 angle, C2-C7 angle, C7 Slope (C7S), T1 Slope (T1S), C2–C7 sagittal vertical axis (SVA), C2-C7 range of motion (ROM), Segmental ROM, disc height (DH) and inter-facet distance (ID). And the extend of facet joint distraction was evaluated by the two indexes: degree of intervertebral distraction (DID) defined and degree of facet joint distraction (DFJD). The visual analog scale (VASneck) and the Neck Disability Index scores (NDI) were adopted to demonstrate functional outcomes. Patients with the functional outcome improvement below the average were set as the positive group in the receiver operating characteristic (ROC) curve analysis, to find an optimal cut-off value of extent of facet joint distraction. Results VASneck and NDI scores improved significantly from pre- to post-operation among the entire cohort, and DFJD had a statistically significant negative correlation with ΔVASneck (p < 0.001) and ΔNDI (p < 0.001). According to ROC curve analysis, the cut-off value of DFJD for differing the appropriate and excessive distraction groups was set at 29.16% (sensitivity = 70.73%, specificity = 67.86%). Between these two groups, the ΔT1S, ΔROM, ΔVASneck, and ΔNDI were significantly different (p < 0.05). Conclusion Single-segment ACDR may improve the functional outcome of patients with cervical spondylotic radiculopathy. However, those whose DFJD was greater than 29.16% had worse VASneck and NDI scores, as well as a lower ΔT1S and a lower ΔROM.

Background Craniocervical range of motion (CROM) is a crucial index for assessing the neck's function. Its accurate evaluation could assist in detecting certain disorders, optimizing the therapy, and tracking intervention progress. In recent years, as VR technology has advanced rapidly, it has been widely applied in the medical field as it can simulate the real world. However, whether the novel immersive VR device could achieve a good performance in evaluating CROM remains explored. Methods This research aims to verify intra- and inter-rater reliability and validity of an immersive virtual reality (VR) device in measuring craniocervical range of motion (CROM) and compare its performance with the universal goniometer. Forty-two healthy adults without neck disorders were recruited for CROM measurement using an immersive VR device and a universal goniometer. We considered all six aspects of freedom, including flexion, extension, right/left lateral flexion, and right/left rotation. Two raters participated in the examination. The first rater was required to repeat measurements twice with a five-minute interval using an immersive VR device to evaluate intra-rater reliability while also measuring the same subject with the same subject universal goniometer. To ascertain inter-rater reliability, the second rater conducted the third examination using the immersive VR device. A two-way random effect model was employed in calculating intra-rater and inter-rater reliability (intra-class correlation coefficient (ICC)). Results The immersive VR device revealed excellent reliability of intra-rater (ICC from 0.885 for right rotation to 0.978 for extension) and inter-rater (ICC from 0.770 for left rotation to 0.920 for left lateral flexion). By analyzing Bland-Altman plot, a small mean difference (≤1.64°) was revealed between the immersive VR device and universal goniometer. They demonstrated an excellent agreement in measuring CROM (r values from 0.833 to 0.964). Conclusions In healthy subjects, the immersive VR device provided excellent intra-rater and inter-rater reliability and a high agreement with the universal goniometer. Whether VR devices could achieve a similar performance between patients with neck disorders still requires future investigation.