Background: Burn injuries with ≥70% total body surface area (TBSA) are especially acute and life-threatening, leading to severe complications and terrible prognosis, while a powerful model for the prediction of overall survival (OS) is lacking. The objective of this study is to identify prognostic factors for the OS of patients with burn injury ≥70% TBSA and construct and validate a feasible predictive model. Materials and methods: Patients diagnosed with burns ≥70% TBSA admitted and treated between 2010 and 2020 in our hospital were included. A cohort of the patients from the Kunshan explosion were assigned as the validation set. The χ ² test and K-M survival analysis were conducted to identify potential predictors for OS. Then, multivariate Cox regression analysis was performed to identify the independent factors. Afterward, we constructed a nomogram to predict OS probability. Finally, the Kunshan cohort was applied as an external validation set. Results: Sex, the percentage of third-degree and fourth-degree burns as well as organ dysfunction were identified as significant independent factors. A nomogram only based on the factors of the individuals was built and evidenced to have promising predictive accuracy, accordance, and discrimination by both internal and external validation. Conclusions: This study recognized significant influencing factors for the OS of patients with burns ≥70% TBSA. Furthermore, our nomogram proved to be an effective tool for doctors to quickly evaluate patients’ outcomes and make appropriate clinical decisions at an early stage of treatment.

Background: Precise acetabular cup placement in total hip arthroplasty (THA) heavily relies on surgeons’ visual judgment of angles. However, whether inherent visual angle misperception among surgeons affects surgical outcomes remains unclear. This study is the first to reveal that surgeons universally exhibit visual angle misperception, a key factor causing the cup implant positioning deviations in THA. Methods: We validated this phenomenon through three steps. Experimental validation: Five surgeons were asked completed 2D angle assessments to verify the visual angle misperception. Surgical simulation: A self-developed “Dynamic Angle-Measuring System (DAMS)” simulated cup implantation for assessing the impact of angle misperception on cup orientation. Clinical data: Retrospective analysis of 853 THA cases (683 patients) between 2015 and 2019 were collected for comparing mismatches between actual cup angles and surgeons’ target angles, and between experienced and junior surgeons. Results: All surgeons exhibited visual angle misperception in 2D and 3D angle assessments, with greater impact on anteversion than abduction angles. In in vitro simulations, discrepancies between actual and targeted anteversion angles were statistically significant (e.g., 16.8° vs. 20.0°, 22.6° vs. 25.0°; P < 0.05). These findings were corroborated in the in vivo data (e.g., 15.3° vs. 20.0°, 22.4° vs. 25.0°; P < 0.05), with an individualized fixed deviation among surgeons. Clinically, increased surgical experience only reduced the dispersion (SD value) without eliminating visual angle misperception bias. Conclusions: Our study is the first to provide that visual angle misperception is a hidden cause of cup positioning bias in THA, and experience alone cannot eliminate this bias causing by visual angle misperception, although experience reduced variability in placement. Recognizing and addressing this cognitive bias, and further targeted training to improve spatial perception, compensate inherent angle misperception bias, may lead to better patient outcomes.

Osteolytic diseases constitute a category of conditions characterised by persistent bone tissue destruction, commonly observed in pathological states such as osteomyelitis, periodontitis, metastatic bone cancer, and osteoporosis. Conventional therapeutic approaches...

Engagement in learning is widely recognized as the time and effort students put into achieving their desired goals and can be measured by the Utrecht Work