bluuebunny/crossref_metadata_2025 huggingface dataset:
A physical and concise halo model based on the depletion radius
Authors: Zhou Yifeng , Han Jiaxin
Published: August 2023

We develop a self-consistent and accurate halo model by partitioning matter according to the depletion radii of haloes. Unlike conventional models that define haloes with the virial radius while relying on a separate exclusion radius or ad hoc fixes to account for halo exclusion, our model distributes mass across all scales self-consistently and accounts for both the virialized and non-virialized matter distribution around each halo. Using a cosmological simulation, we show that our halo definition leads to very simple and intuitive model components, with the one-halo term given by the Einasto profile with no truncation needed, and the halo–halo correlation function following a universal power-law form down to the halo boundary. The universal halo–halo correlation also allows us to easily model the distribution of unresolved haloes as well as diffuse matter. Convolving the halo profile with the halo–halo correlation function, we obtain a complete description of the halo–matter correlation across all scales, which self-consistently accounts for halo exclusion at the transition scale. Mass conservation is explicitly maintained in our model, and the scale dependence of the classical halo bias is easily reproduced. Our model can successfully reconstruct the halo–matter correlation function within an accuracy of 9 per cent for halo virial masses in the range of 1011.5h−1 M⊙ < Mvir < 1015.35h−1 M⊙ at z = 0, and covers the radial range of 0.01 h−1 Mpc < r < 20 h−1 Mpc. We also show that our model profile can accurately predict the characteristic depletion radius at the minimum bias and the splash-back radius at the steepest density slope locations.
Genetic Incompatibilities and Evolutionary Rescue by Wild Relatives Shaped Grain Amaranth Domestication
Authors: Gonçalves-Dias José , Singh Akanksha , Graf Corbinian , Stetter Markus G
Published: August 2023

Crop domestication and the subsequent expansion of crops have long been thought of as a linear process from a wild ancestor to a domesticate. However, evidence of gene flow from locally adapted wild relatives that provided adaptive alleles into crops has been identified in multiple species. Yet, little is known about the evolutionary consequences of gene flow during domestication and the interaction of gene flow and genetic load in crop populations. We study the pseudo-cereal grain amaranth that has been domesticated three times in different geographic regions of the Americas. We quantify the amount and distribution of gene flow and genetic load along the genome of the three grain amaranth species and their two wild relatives. Our results show ample gene flow between crop species and between crops and their wild relatives. Gene flow from wild relatives decreased genetic load in the three crop species. This suggests that wild relatives could provide evolutionary rescue by replacing deleterious alleles in crops. We assess experimental hybrids between the three crop species and found genetic incompatibilities between one Central American grain amaranth and the other two crop species. These incompatibilities might have created recent reproductive barriers and maintained species integrity today. Together, our results show that gene flow played an important role in the domestication and expansion of grain amaranth, despite genetic species barriers. The domestication of plants was likely not linear and created a genomic mosaic by multiple contributors with varying fitness effects for today’s crops.
Assessing the crisis management of the COVID-19 pandemic: a study of inquiry commission reports in Norway and Sweden
Authors: Christensen Tom , Lægreid Per
Published: August 2023

This article examines the inquiry reports from the commissions charged with investigating government crisis management of the COVID-19 pandemic in Norway and Sweden. Such postcrises commissions have been a common feature in many countries as they seek to systematize their experiences and learn from the crisis. In this article, we used various dimensions of governance capacity and governance legitimacy as assessment criteria. It reveals that the commissions’ assessment criteria were not very specific in their reports, but a reanalysis of their findings shows that governance capacity and governance legitimacy dimensions are useful to assess the reports themselves. The two reports reveal a lack of preparedness in both countries, but they differ in their conclusions about governance regulation and output legitimacy.
DNA Markers, Pathogenicity Test, and Multilocus Sequence Analysis to Differentiate and Characterize Cereal-Specific Xanthomonas translucens Strains
Authors: Hong Eunhye , Bankole Ibukunoluwa A. , Zhao Bin , Shi Gongjun , Buck James W. , Feng Jie , Curland Rebecca D. , Baldwin Thomas , Chapara Venkata , Liu Zhaohui
Published: August 2023

Xanthomonas translucens contains a group of bacterial pathogens that are closely related and have been divided into several pathovars based on their host range. X. translucens pv. undulosa (Xtu) and X. translucens pv. translucens (Xtt) are two important pathovars that cause bacterial leaf streak disease on wheat and barley, respectively. In this study, DNA markers were developed to differentiate Xtu and Xtt and were then used to characterize a collection of X. translucens strains with diverse origins, followed by confirmation and characterization with pathogenicity tests and multilocus sequence analysis/typing (MLSA/MLST). We first developed cleaved amplified polymorphic sequence markers based on the single-nucleotide polymorphisms within a cereal pathovar-specific DNA sequence. In addition, two Xtt-specific markers, designated Xtt-XopM and Xtt-SP1, were developed from comparative genomics among the sequenced Xtt/Xtu genomes. Using the developed markers, a collection of X. translucens strains were successfully identified as Xtu or Xtt. Pathogenicity tests on wheat and barley plants and MLSA of four housekeeping genes validated the pathovar assignation of those strains. Furthermore, MLSA revealed distinct subclades within both Xtu and Xtt groups. Seven and three sequence types were identified from MLST for Xtu and Xtt strains, respectively. The establishment of efficient Xtt/Xtu differentiation methods and characterization of those strains will be useful in studying disease epidemiology and host−pathogen interactions and breeding programs when screening for sources of resistance for these two important bacterial pathogens.
Motor-sparing peripheral nerve blocks for hip and knee surgery
Authors: Restrepo-Holguin Mariana , Kopp Sandra L. , Johnson Rebecca L.
Published: August 2023

Purpose of review

To summarize the recent literature describing and comparing novel motor-sparing peripheral nerve block techniques for hip and knee surgery. This topic is relevant because the number of patients undergoing same day discharge after hip and knee surgery is increasing. Preserving lower extremity muscle function is essential to facilitate early physical therapy for these patients.

Recent findings

Distal peripheral nerve blocks may allow for preserved quadriceps motor strength and comparable analgesia to traditional techniques. However, few studies in hip and knee populations include strength or function as primary outcomes. For hip surgeries, studies have failed to show analgesic differences between regional blocks and periarticular infiltration. Similarly for knee arthroplasty in the absence of periarticular infiltration, recent evidence suggests adding combinations of blocks (ACB plus iPACK or genicular nerve blocks) may balance pain control and early ambulation.

The use of motor-sparing peripheral nerve block techniques enables early ambulation, adequate pain control, and avoidance of opioid-related side effects facilitating outpatient/ambulatory lower extremity surgery. Further studies of these techniques for continuous peripheral nerve block catheters are needed to assess if extended blockade continues to provide motor-sparing and opioid-sparing benefits.
Anesthesia for same day neurosurgery with updates on awake craniotomy and awake spine surgery
Authors: Ajayan Neeraja , Hrishi Ajay Prasad , Rath Girija Prasad
Published: August 2023

Purpose of review

This article delves into recent advances in same-day neurosurgery (SDNS), specifically concerning indications, perioperative protocol, safety, and outcomes. Additionally, it explores the recent updates on awake craniotomy and awake spine surgery.

Recent findings

There is an evolving body of literature on studies about SDNS that reaffirm its safety and feasibility. awake craniotomy is associated with lesser neurological deficits and better survival benefits in patients with lesions in eloquent areas. Monitored anesthesia care, compared with the asleep–awake–asleep technique, is associated with lower failure rates, shorter procedure time, and shorter length of stay. However, the incidence of intraoperative seizures is lower with the asleep–awake–asleep technique. Propofol-based and dexmedetomidine-based anesthesia are similar with regard to procedure duration, intraoperative adverse events, and patient satisfaction; however, surgeon satisfaction is higher with dexmedetomidine-based anesthesia. In spine surgery, regional anesthesia when compared with general anesthesia, is associated with less intraoperative blood loss and a lower incidence of postoperative nausea and vomiting after 24 h. In addition, implementing an enhanced multimodal analgesia protocol improved disability scores and reduced the likelihood of postoperative complications.

SDNS offers promising prospects for patients and healthcare providers alike, with the potential to provide well tolerated, efficient, and cost-effective neurosurgical care in carefully selected cases.
Spine surgery under neuraxial vs. general anesthesia: the current state of comparative outcomes research
Authors: Amoroso Krizia , Hughes Alexander P. , Soffin Ellen M.
Published: August 2023

Purpose of review

The impact of primary anesthetic technique on outcomes after spine surgery is controversial. Given frequent calls for well designed prospective comparative studies of neuraxial anesthesia vs. general anesthesia and recent reports of ‘awake spine surgery’ successes in the surgical literature, an updated evidence review is indicated.

Recent findings

Systematic reviews, population-based and retrospective cohort studies suggest few significant differences in important complications or global recovery between anesthetic techniques. On the basis of overall low-to-moderate quality evidence, neuraxial anesthesia is associated with statistically significant benefits for several individual outcomes compared with general anesthesia, including improved intraoperative hemodynamic stability, less postoperative nausea and vomiting, lower early pain scores and shorter length of hospital stay. There are ongoing calls for well designed, adequately powered prospective studies.

Our understanding of the risks, benefits and comparative outcomes between neuraxial anesthesia and general anesthesia for spine surgery is evolving. Although the results derived from this body of literature suggest specific benefits of neuraxial anesthesia, further research is required before widespread recommendations for either technique can be made. Until then, both neuraxial anesthesia and general anesthesia are reasonable choices for lumbar spine surgery of short duration, in appropriately selected patients.
Unanswered questions of anesthesia neurotoxicity in the developing brain
Authors: Ing Caleb , Vutskits Laszlo
Published: August 2023

Purpose of review

This article reviews recent advances and controversies of developmental anesthesia neurotoxicity research with a special focus on the unanswered questions in the field both from clinical and preclinical perspectives.

Recent findings

Observational cohort studies of prenatal and early childhood exposure to anesthesia have reported mixed evidence of an association with impaired neurodevelopment. Meta-analyses of currently available studies of early childhood exposure to anesthesia suggest that, while limited to no change in general intelligence can be detected, more subtle deficits in specific neurodevelopmental domains including behavior and executive function may be seen. Several studies have evaluated intraoperative blood pressure values and neurocognitive outcomes and have not found an association. Although many animal studies have been performed, taking into consideration other peri-operative exposures such as pain and inflammation may help with translation of results from animal models to humans.

Advances have been made in the field of developmental anesthetic neurotoxicity over the past few years, including the recognition that anesthetic exposure is associated with deficits in certain cognitive domains but not others. Although the most important question of whether anesthetic agents actually cause long-term neurodevelopmental effects in children has still not been answered, results from recent studies will guide further studies necessary to inform clinical decision-making in children.
Innovations in diagnostic and treatment options for pediatric epilepsy and their anesthetic implications
Authors: Chen Michael I. , Lee David , Wong Becky J.
Published: August 2023

Purpose of review

To provide an overview of anesthetic techniques for innovative diagnostic and therapeutic epilepsy procedures performed on pediatric patients.

Recent findings

Recent studies have been published on the anesthetic consideration for functional MRI, robotic-assisted stereoelectroencephalography, high-intensity focused ultrasound, and magnetoencephalography. These articles describe the anesthesia management, risks, and outcome for these procedures.

The number of diagnostic and treatment options being used for the management of pediatric epilepsy has increased significantly. In the past few years, a handful of articles have been published, which describe the anesthetic considerations for these procedures. These studies are helpful to anesthesiologists who are planning an upcoming anesthetic or who are developing a ‘best practice’ model for their institution. Because unlike other diagnostic studies, failure to understand what effects anesthetics have on the brain, may negate the utility of the study. Although these new findings can be used to provide some anesthesia practice recommendations for epilepsy procedures in which the best management is still unclear, additional high-quality studies are needed.
Needs assessment of menopause education in United States obstetrics and gynecology residency training programs
Authors: Allen Jennifer T. , Laks Shahar , Zahler-Miller Carolyn , Rungruang Bunja J. , Braun Kelli , Goldstein Steven R. , Schnatz Peter F.
Published: August 2023

Objective

This study aimed to assess the variance in menopause education, educational resources, and the needs of obstetrics and gynecology (ObGyn) residency programs by conducting a national survey of program directors (PDs).

Methods

In 2022, an institutional review board–approved Web-based Qualtrics survey was designed and distributed electronically to 145 US ObGyn residency PDs. The survey consists of 15 questions. The main outcomes are reported using descriptive statistics.

Results

The survey was completed by 99 of 145 PDs (68.3%). Almost all participants (92.9%) strongly agreed that residents nationwide should have access to a standardized menopause curriculum that could be utilized in their programs. Only 31.3% reported having a menopause curriculum in their residency program. Of the programs with a menopause curriculum, 96.8% reported using lectures, 77.4% reported assigned readings, and 74.2% had either dedicated menopause clinics or other clinics with a high volume of menopausal patients. Of all programs surveyed, only 29.3% reported that trainees had dedicated time assigned to a menopause clinic. A total of 83 of 99 PDs agreed or strongly agreed that their programs needed more menopause educational resources, and most (89.7%) stated they were likely or very likely to use self-paced menopause modules that include performance feedback if available.

Conclusions

Data from the needs assessment questionnaire revealed that menopause education and resources vary across residency programs, with the majority lacking a dedicated menopause curriculum. Most PDs expressed a desire for more educational resources and standardized training materials, and preferred to access an online national menopause curriculum.
Review of Targeted Therapy, Vismodegib, for the Treatment of Periocular Basal Cell Carcinoma
Authors: Singalavanija Tassapol , Ceylanoglu Kubra Serbest , Juntipwong Sarinee , Beser Buse Guneri , Elner Victor Maurice , Worden Francis Paul , Demirci Hakan
Published: August 2023

Purpose:

Periocular locally advanced basal cell carcinoma (POLA-BCC) is characterized by orbital involvement and/or extensive invasion of periocular structures. Hedgehog pathway inhibitors have been used for POLA-BCC with promising outcomes.

Methods:

The authors reviewed 11 articles published in English literature from January 2012 to July 2022 and reported the outcomes of patients with POLA-BCC who were treated with vismodegib.

Results:

A total of 384 patients were treated with vismodegib. The mean age was 72 years, and the median treatment duration was 9 months. The overall response rate was 75% with a median follow-up time of 14.4 months. Following vismodegib treatment, the median number of patients who required adjuvant surgery was 43% with a median time to surgery of 6.5 months. The exenteration rate was 6% (overall 8 patients). In total 93.7% of patients experienced grade I adverse events, 26.7% to 37.5% grade II, 8.8% to 10% grade III–IV, and 0.8% to 4.8% grade V. Major side effects included dysgeusia (30–100%), muscle spasm (15–100%), alopecia (47–75%), weight loss (23–83%), and decreased appetite (19–42%). The median percentage of patients who discontinued treatment due to toxicity was 29% with a median interval of 5 months before the development of side effects. The median recurrence rate following discontinuation of vismodegib was 7.8% with a median recurrence duration of 20 months.

Conclusions:

In patients with POLA-BCC, vismodegib, a hedgehog pathway inhibitor, provided high rates of orbital preservation, reducing exenteration rates to 6%. Neoadjuvant therapy with vismodegib can also be suggested for patients with POLA-BCC. While extremely effective, side effects lead to temporary or permanent discontinuation of vismodegib in small numbers of patients.
Structural Limits of Orbital Compliance and Treatment Options for Pathologic Orbital Pressure
Authors: Chelnis James , Kim Juliet , Meador Andrew , Oester Alan E. , Fleming James C. , Fowler Brian T.
Published: August 2023

Purpose:

The integrity of the orbit has a finite structural limit due to the compliance of its tissue. The authors investigate these limits to quantify them and inform the treatment of heightened ocular and orbital pressure.

Methods:

Cadaveric study with 12 orbits being volumized before randomization of treatment for pathologic levels of ocular and orbital pressure. First-line and second-line treatment was chosen randomly (lateral cantholysis, superior septolysis, inferior septolysis). Prior to treatment, IOP, orbital compartment pressure, and axial globe projection was measured after delivery of each 1cc aliquot and surgical treatment.

Results:

Orbital compartment pressure and IOP were well correlated (r = 0.99). The average reduction in IOP after treatment averaged a 56.2 mm Hg reduction in IOP. All treatments were statistically equivalent (p < 0.01). Loss of compliance (PLOC) was determined when the mean plus 1 standard deviation of change in IOP/ml volume was achieved with simultaneous change in exophthalmometry of <0.5 mm change/ml added volume, indicating an acceleration in pressure in the face of a steady volume. This criteria was met for 11 of 12 orbits. The 12th orbit missed this threshold by 1 mm Hg in IOP. PLOC occurred at an average IOP of 43.0 mm Hg (±5.8 mm Hg, 90% CI) and after an average injection of 13 ml (±1.4 mm, 90% CI). Additionally, lateral cantholysis, superior septolysis, and inferior septolysis were statistically equivalent in reducing IOP after PLOC.

Conclusions:

IOP and orbital compartment pressure are excellent proxies for each other in the authors’ model. Orbital compliance is a mathematic phenomenon that can be quantified, as evident in this investigation. PLOC can inform timing for orbital decompressions in the presence of heightened IOP. Multiple procedures can be used to extinguish dangerously high orbital compartment pressure.
Neoadjuvant Chemotherapy in a Case of Nonresectable Papillary Squamous Cell Carcinoma of the Palpebral Conjunctiva
Authors: Alam Md. Shahid , Sen Ahana , Biswas Bivas
Published: August 2023

The role of neoadjuvant chemotherapy (NACT) in eyelid and orbital malignancies is not well defined. It has been tried with good success in cases of eyelid sebaceous gland carcinoma but there is very limited literature on its role in cases of ocular surface squamous neoplasia. A 54-year-old man presented with gradually increasing swelling of the right upper eyelid for the past 2 years. On examination, a large friable papillary mass was found covering the entire conjunctival surface (T3N0M0). Incisional biopsy from the mass was suggestive of papillary squamous cell carcinoma. There was no lymph node or distant metastasis as confirmed by whole-body positron emission tomography-CT scan. A trial of NACT (3 cycles of paclitaxel and cisplatin) was given and the mass shrunk in size considerably making it amenable to surgical resection. The conjunctival surface healed completely and there was no recurrence at 1 year of follow up. NACT can be tried in unresectable large ocular surface neoplasia to make the tumor more amenable to surgical resection.
Exploring the Barriers and Enablers to Implementing a 16-Week Low-Carbohydrate Diet for Patients With Diabetic Cardiomyopathy
Authors: Kleissl-Muir Sabine , Driscoll Andrea , Owen Alice , Zinn Caryn , Rasmussen Bodil
Published: August 2023

Aims

Cardiac dysfunction in patients with diabetes, referred to as diabetic cardiomyopathy, is primarily precipitated by dysregulations in glucose and lipid metabolism. Diet and lifestyle changes are considered crucial for successful heart failure and diabetes management and are often difficult to achieve. Low-carbohydrate diets (LCDs) have gained popularity for the management of metabolic diseases. Although quantitative research in this field is evolving, little is known about the personal experience of patients with diabetic cardiomyopathy on specific diets. The aim of this qualitative study was to identify enablers and barriers of patients with diabetic cardiomyopathy who engage in an LCD. It further explored patients' perception of dietary education and dietary support received while in hospital.

Methods and Results

Participants who previously consented to a 16-week LCD trial were invited to share their experiences. Nine patients agreed to be interviewed. Semistructured interviews and a focus group interview were conducted, which were transcribed verbatim. Data were analyzed by using the 6-step approach for thematic analysis. Four themes were identified: (1) nutrition literacy (2) disease-related health benefits, (3) balancing commitments, and (4) availability of resources and support.

Conclusion

Improvements in disease-related symptoms acted as strong enablers to engage in an LCD. Barriers such as access to resources and time constraints were identified. These challenges may be overcome with efficient communication and ongoing dietary support. More research exploring the experience of patients with diabetic cardiomyopathy on an LCD are warranted.
Fat Grafting in Vulvar Lichen Sclerosus: Long Term Follow-Up
Authors: Boero Veronica , Brambilla Massimiliano , Di Loreto Eugenia , Cetera Giulia Emily , Cipriani Sonia , Boggio Francesca , Monti Ermelinda , Libutti Giada , Caia Carlotta , Parazzini Fabio
Published: August 2023

Objective

The rationale for the use of autologous fat grafting in the treatment of vulvar lichen sclerosus (VLS) consists in reduction of inflammation, regeneration of tissues, volume increase, and pain fiber control. The main outcome of our study was the evaluation of patients' satisfaction after treatment. Secondary outcomes included modifications in symptoms, psychosexual wellbeing, vulvar hydration, and histology after surgery.

Methods

Eligible for this study were women aged 18–85 years with a histological diagnosis of VLS who underwent at least one autologous vulvar fat grafting at our center, between 2010 and 2019. In 2021, all women underwent a clinical reevaluation, comprehensive of vulvoscopy, vulvar biopsy, and handing out of validated questionnaires.

Results

Overall, 88.7% of patients declared themselves very satisfied/satisfied with the procedure. All symptoms were improved postsurgery; in particular, the difference was statistically significant for pruritus, burning, and dyspareunia (p < .05). Sexual function was also improved at time of reevaluation, as were depressive and anxiety symptoms (p < .05). No cases of vulvar intraepithelial neoplasia or cancer occurred during follow-up and vulvar architecture remained stable, although patients reported a significantly reduced need for topical steroids (p < .0001). Lastly, in postoperative biopsies, inflammatory infiltrate was stable or reduced, and the distribution of elastic fibers was comparable or restored in most patients.

Conclusions

Patient satisfaction with fat grafting is detectable up to 11 years after surgery, and as such, it may represent a valid therapeutic option in selected cases of VLS.
Accuracy of Preoperative Cochlear Duct Length Estimation and Angular Insertion Depth Prediction
Authors: Breitsprecher Tabita , Mlynski Robert , Völter Christiane , Van de Heyning Paul , Van Rompaey Vincent , Dazert Stefan , Weiss Nora M.
Published: August 2023

Objective

In cochlear implantation with flexible lateral wall electrodes, a cochlear coverage of 70% to 80% is assumed to yield an optimal speech perception. Therefore, fitting the cochlear implant (CI) to the patient’s individual anatomy has gained importance in recent years. For these reasons, the optimal angular insertion depth (AID) has to be calculated before cochlear implantation. One CI manufacturer offers a software that allows to visualize the AID of different electrode arrays. Here, it is hypothesized that these preoperative AID models overestimate the postoperatively measured insertion angle. This study aims to investigate the agreement between preoperatively estimated and postoperatively measured AID.

Study Design

Retrospective cross-sectional study.

Setting

Single-center tertiary referral center.

Patients

Patients undergoing cochlear implantation.

Intervention

Preoperative and postoperative high-resolution computed tomography (HRCT).

Main Outcome Measures

The cochlear duct length was estimated by determining cochlear parameters (A value and B value), and the AID for the chosen electrode was (i) estimated by elliptic circular approximation by the software and (ii) measured manually postoperatively by detecting the electrode contacts after insertion.

Results

A total of 80 HRCT imaging data sets from 69 patients were analyzed. The mean preoperative AID estimation was 662.0° (standard deviation [SD], 61.5°), and the mean postoperatively measured AID was 583.9° (SD, 73.6°). In all cases (100%), preoperative AID estimation significantly overestimated the postoperative determined insertion angle (mean difference, 38.1°). A correcting factor of 5% on preoperative AID estimation dissolves these differences.

Conclusions

The use of an electrode visualization tool may lead to shorter electrode array choices because of an overestimation of the insertion angle. Applying a correction factor of 0.95 on preoperative AID estimation is recommended.
Development of an Optimized Protocol for Cochlear Implant Care to Increase Cochlear Implant Access
Authors: Berg Katelyn A. , Holder Jourdan T. , Gifford René H.
Published: August 2023

Objective

To develop an evidence-based protocol for audiology-based, cochlear implant (CI) programming in the first year after activation.

Study Design

Retrospective case review.

Setting

CI program at a tertiary medical center.

Patients

One-hundred seventy-one patients (178 ears; mean age at implantation, 62.3 yr; 44.4% female) implanted between 2016 and 2021 with postlingual onset of deafness and no history of CI revision surgery. Patients included here had confirmed CI programming optimization based on CI-aided thresholds in the 20- to 30-dB-HL range as well as upper stimulation levels guided by electrically evoked stapedial reflex thresholds.

Main Outcome Measures

Consonant-nucleus-consonant monosyllabic word recognition scores in the CI-alone and bilateral best-aided conditions at five time points: preoperative evaluation, and 1, 3, 6, and 12 months after activation.

Results

For both the CI-alone and bilateral best-aided conditions, consonant-nucleus-consonant word recognition significantly improved from preoperative evaluation to all postactivation time points. For the CI-alone condition, no significant differences were observed between 3 and 6 months, or from 6 to 12 months after activation. In contrast, for the bilateral best-aided condition, significant differences were observed between 1 and 3 months, and 3 and 6 months, but no difference in scores between 6 and 12 months.

Conclusions

Based on the current data set and associated analyses, CI centers programming adult patients could eliminate either the 3- or 6-month visit from their clinical follow-up schedule if patient mapping of lower and upper stimulation levels is validated via CI-aided audiometric thresholds and electrically evoked stapedial reflex thresholds, respectively.
Construction and Application of a Nomogram for Predicting Benign and Malignant Parotid Tumors
Authors: Liu Shuo , Yu Baoting , Zheng Xuewei , Guo Hao , Shi Lingxue
Published: August 2023

Objective

A prediction model of benign and malignant differentiation was established by magnetic resonance signs of parotid gland tumors to provide an important basis for the preoperative diagnosis and treatment of parotid gland tumor patients.

Methods

The data from 138 patients (modeling group) who were diagnosed based on a pathologic evaluation in the Department of Stomatology of Jilin University from June 2019 to August 2021 were retrospectively analyzed. The independent factors influencing benign and malignant differentiation of parotid tumors were selected by logistic regression analysis, and a mathematical prediction model for benign and malignant tumors was established. The data from 35 patients (validation group) who were diagnosed based on pathologic evaluation from September 2021 to February 2022 were collected for verification.

Results

Univariate and multivariate logistic regression analysis showed that tumor morphology, tumor boundary, tumor signal, and tumor apparent diffusion coefficient (ADC) were independent risk factors for predicting benign and malignant parotid gland tumors (P < 0.05). Based on multivariate logistic regression analysis of the modeling group, a mathematical prediction model was established as follows: Y = the ex/(1 + ex) and X = 0.385 + (1.416 × tumor morphology) + (1.473 × tumor border) + (1.306 × tumor signal) + (2.312 × tumor ADC value). The results showed that the area under the receiver operating characteristic curve of the model was 0.832 (95% confidence interval, 0.75–0.91), the sensitivity was 82.6%, and the specificity was 70.65%. The validity of the model was verified using validation group data, for which the sensitivity was 85.71%, the specificity was 96.4%, and the correct rate was 94.3%. The results showed that the area under receiver operating characteristic curve was 0.936 (95% confidence interval, 0.83–0.98).

Conclusions

Combined with tumor morphology, tumor ADC, tumor boundary, and tumor signal, the established prediction model provides an important reference for preoperative diagnosis of benign and malignant parotid gland tumors.
Comparison Between a Modified Fast 3-Dimensional Turbo Spin-Echo and Diffusion-Weighted Imaging With Background Suppression in Evaluation of Lumbosacral Plexus and Its Branches
Authors: Zhang Nan , Zeng Jiaqi , Lv Peng , Miao Xiyin , Chen Caizhong , Lin Jiang
Published: August 2023

Objectives

To compare the fast 3-dimensional NerveVIEW (3D NerveVIEW) with diffusion-weighted imaging with background suppression (DWIBS) in imaging of lumbosacral plexus and its branches.

Methods

A prospective study was performed on 30 healthy volunteers and patients who had undergone compressed sensing 3D NerveVIEW and DWIBS scans. There were 11 healthy subjects, 15 patients with lumbar disc herniation, and 4 patients with chronic inflammatory demyelinating polyradiculoneuropathy. Image quality was rated using a 4-point subjective scale. Quantitative evaluation of the nerves was done by measuring signal-to-noise ratio, contrast-to-noise ratio, and signal-to-background ratio, and the consistency in the measurements of nerve root cross-sectional areas was also assessed. The differences of signal-to-noise ratio, contrast-to-noise ratio, signal-to-background ratio, and the scores of image quality between 2 sequences were compared.

Results

The overall average image quality score of 3D NerveVIEW was significantly higher than that of DWIBS (2.72 ± 0.45 and 2.45 ± 0.81, respectively; P < 0.01). In terms of individual nerves, there was no significant difference between the 2 sequences in the display of the nerves from L2 to S1; however, 3D NerveVIEW was significantly better than DWIBS in demonstration of the S2–S3 nerves, as well as the nerve details. Regarding quantitative measurements, these sequences achieved comparable results with excellent interobserver agreements.

Conclusion

Fast 3D NerveVIEW was superior to DWIBS with improved conspicuity of small distal nerves of S2–S3 and nerve details.
Segmentation-Based Analysis of T2- and T1-Weighted Dynamic Magnetic Resonance Images Provides Adequate Observer Agreement in the Evaluation of Interstitial Lung Disease
Authors: Ruano Carina A. , Veiga José , Antunes Natalie , Carvalho Vera B. , Fernandes Otília , Borba Alexandra , Oliveira Francisco P. M. , Moraes-Fontes Maria Francisca , Bilhim Tiago , Irion Klaus L.
Published: August 2023

Objective

The aim of the study is to quantify observer agreement in the magnetic resonance imaging (MRI) classification of inflammatory or fibrotic interstitial lung disease (ILD).

Methods

Our study is a preliminary analysis of a larger prospective cohort. The MRI images of 18 patients with ILD (13 females; mean age, 65 years) were acquired in a 1.5 T scanner and included axial fat-saturated T2-weighted (T2-WI, n = 18) and coronal fat-saturated T1-weighted images before and 1, 3, 5, and 10 minutes after gadolinium administration (n = 16). The MRI studies were evaluated with 2 different methods: a qualitative evaluation (visual assessment and measurement of few regions of interest; evaluations were performed independently by 5 radiologists and 3 times by 1 radiologist) and a segmentation-based analysis with software extraction of signal intensity values (evaluations were performed independently by 2 radiologists and twice by 1 radiologist). Interstitial lung disease was classified as inflammatory or fibrotic, based on previously described imaging criteria.

Results

Regarding the qualitative evaluation, intraobserver agreement was excellent (κ = 0.92, P < 0.05) for T2-WI and fair (κ = 0.29, P < 0.05) for T1 dynamic study, while interobserver agreement was moderate (κ = 0.56, P < 0.05) and poor (κ = 0.11, P = 0.18), respectively. In contrast, upon segmentation-based analysis, intraobserver and interobserver agreement were excellent for T2-WI (κ = 0.886, P < 0.001; κ = 1.00, P < 0.001; respectively); for T1-WI, intraobserver agreement was excellent (κ = 0.87, P < 0.05) and interobserver agreement was good (κ = 0.75, P < 0.05).

Conclusions

Segmentation-based MRI analysis is more reproducible than a qualitative evaluation with visual assessment and measurement of few regions of interest.
Apparent Variation in Measurement Size of Colorectal Cancer Metastases to the Liver on Dual Contrast MRI
Authors: Ngnitewe Massa'a Ruben , Wawrzyn Peter , Mao Lu , Reeder Scott B. , Kelcz Frederick , Wentland Andrew L.
Published: August 2023

Purpose

The aim of this study was to formally investigate the apparent variation in lesion size of hepatic metastatic lesions from colorectal cancer on hepatobiliary phase (HBP) and dual contrast images of magnetic resonance imaging performed with both hepatobiliary and extracellular contrast agents.

Methods

Patients with known colorectal carcinoma who had undergone dual contrast liver magnetic resonance imaging were identified in our institutional database. Metastatic lesions were measured semiautomatically on both HBP and dual contrast images with a custom software tool that automatically identifies the lesion edge and thereby the lesion diameter. Lesion measurements from both sets of images were compared with a Student t test and Bland-Altman analysis. Lesions were also measured on both HBP and dual contrast images by 2 fellowship-trained abdominal radiologists. Measurements from the software and radiologists were compared with a Student t test and Bland-Altman analysis; interreader agreement was evaluated with the intraclass correlation coefficient.

Results

A total of 70 liver lesions in 39 patients was identified. Software-based measurements were significantly larger on HBP than dual contrast images (P < 0.001), with a mean lesion size of 10.9 ± 4.2 mm for HBP and 10.5 ± 4.2 mm for dual contrast measurements. Radiologist-based measurements showed a similar trend, with HBP measurements being significantly larger than dual contrast measurements (P < 0.001). Bland-Altman analysis indicated a mean bias ± 2 SD of +0.4 ± 1.6 mm for software-based measurements and +0.9 ± 2.9 mm and +0.7 ± 2.1 mm for readers 1 and 2, respectively. The intraclass correlation coefficient for interreader agreement was 0.9.

Conclusions

Both software-based and radiologist-based measurements of colorectal cancer liver metastases are significantly larger on HBP than dual contrast images. Based on these findings, we recommend that longitudinal assessment be performed consistently on either HBP or dual contrast phases to avoid introduction of avoidable variability.
Usefulness of Ag Additional Filter on Image Quality and Radiation Dose for Low-Dose Chest Computed Tomography
Authors: Kawamoto Keishin , Sato Hideyuki , Kogure Yosuke
Published: August 2023

Objective

This study aimed to evaluate the effect of a silver (Ag) additional filter on dose characteristics and image quality in low-dose chest computed tomography (CT).

Methods

A dose evaluation phantom, physical evaluation phantom, and chest phantom were scanned with and without an Ag additional filter. The doses were adjusted so that the displayed the volume CT dose indexes (CTDIvol) were from 0.3 to 1.6 mGy. For dose characteristics, the spectrum of photon energies and the measured CTDIvol were calculated for each scanning condition. For task-based image quality analysis, task transfer function, noise power spectrum, and system performance were evaluated. Streak artifacts, image noise, and contrast-to-noise ratio were quantified using a chest phantom.

Results

With the Ag additional filter, mean energy was 22% higher and the CTDIvol was approximately 30% lower than those without the Ag additional filter. The task transfer function and noise power spectrum with the Ag additional filter were lower than those without the Ag additional filter. The system performance with the Ag additional filter was similar to that without the Ag additional filter. The Ag additional filter reduced streak artifact near the lung apex and image noise in the lung fields. The contrast-to-noise ratio was slightly higher with the Ag additional filter than that without the Ag additional filter.

Conclusions

The output dose and spatial resolution with the Ag additional filter were lower than those without the Ag additional filter. However, this filter helped reduce the radiation dose, image noise, and streak artifacts, particularly when scanning at ultralow doses.
Idiopathic Palatal Fistula of the Left Soft Palate
Authors: Suzuki Yushi , Toriumi Masahiro , Takano Junji
Published: August 2023

Palatal fistulas, often congenital or trauma-induced, are occasionally encountered in the field of plastic surgery. We report a case of a non-medial 3 mm soft palate fistula in a 43-year-old woman, with no apparent trigger or history of local trauma or infection. The fistula, extending 2 cm toward the lateral pharyngeal wall, was surgically removed under general anesthesia as it was impacting the patient’s quality of life. The lumen was stained, and the fistula was removed in one mass. The excised tissue was covered with stratified squamous epithelium and was surrounded by adherent tonsil tissue. No recurrence was observed postoperatively. Despite an initial suspicion of a congenital cause, the fistula’s lateral extension and histology suggested a possible origin from the second pharyngeal pouch. To date, there are no reports of fistulas opening on the soft palate. Therefore, this presents an exceptionally rare instance of a soft palate fistula.
Prognostic Relevance of Primary Tumor Sidedness in Early-Stage Colorectal Cancer
Authors: Ouchi Akira , Sadachi Ryo , Hamaguchi Tetsuya , Tsukamoto Shunsuke , Shimada Yasuhiro , Inomata Masafumi , Takii Yasumasa , Komori Koji , Shiomi Akio , Shiozawa Manabu , Ohue Masayuki , Watanabe Jun , Ito Masaaki , Kawashima Yoshiyuki , Kobatake Takaya , Souda Hiroaki , Saida Yoshihisa , Hashimoto Tadayoshi , Sano Yusuke , Kanemitsu Yukihide ,   on behalf of the JCOG Colorectal Cancer Study Group
Published: August 2023

Objective:

To determine the genuine prognostic relevance of primary tumor sidedness (PTS) in patients with early-stage colorectal cancer (CRC).

Summary Background Data:

The prognostic relevance of PTS in early-stage CRC remains a topic of debate. Several large epidemiological studies investigated survival only and did not consider the risk of recurrence so far.

Methods:

Patients with stage II/III adenocarcinoma of the colon and upper rectum from four randomized controlled trials (RCTs) were analyzed. Survival outcomes were compared according to the tumor location: right-sided (cecum to transverse colon) or left-sided (descending colon to upper rectum).

Results:

A total of 4,113 patients were divided into a right-sided group (N=1,349) and a left-sided group (N=2,764). Relapse-free survival after primary surgery was not associated with PTS in all patients and each stage (HRadjusted 1.024 [95% CI 0.886–1.183] in all patients; 1.327 [0.852–2.067] in stage II; and 0.990 [0.850–1.154] in stage III). Also, overall survival after primary surgery was not associated with PTS in all patients and each stage (HRadjusted 0.879 [95% CI 0.726–1.064] in all patients; 1.517 [0.738–3.115] in stage II; and 0.840 [0.689–1.024] in stage III). In total, 795 patients (right-sided, N=257; left-sided, N=538) developed recurrence after primary surgery. PTS was significantly associated with overall survival after recurrence (HRadjusted 0.773 [95% CI 0.627–0.954]).

Conclusions:

PTS had no impact on the risk of recurrence for stage II/III CRC. Treatment stratification based on PTS is unnecessary for early-stage CRC.
Asymmetry of brain development in adolescent rats studied by 3.0 T magnetic resonance imaging
Authors: Zeng Chen , Li Yehan , Deng Hao , Luo Xing , Xiao Ruhui , Zhang Chuan , Yang Hanfeng
Published: August 2023

To study the developmental patterns of brain structure in adolescent rats based on the registration with the SIGMA template by 3.0T MRI. Forty male Sprague–Dawley rats (180–220 g) were randomly divided into four groups. Rats in the four groups underwent 3.0 T MRI head scans at 7, 11, 15, and 19 weeks of age, respectively. The voxel-based morphological analysis of the rat brain was performed by coregistration with the SIGMA rat brain template. 3.0 T MRI can be used to study the anatomical structure of the rat brain by registration with the SIGMA template The gray matter volume of the bilateral hippocampus and bilateral entorhinal cortex increased significantly in the development of the rat from 7 to 19 weeks of age. In this period, the subtle structure of the rat brain is asymmetrically developed. The rat aged 7–19 weeks has asymmetrical gray matter volume development in the bilateral entorhinal cortex and hippocampus.
Gray matter density changes in children with congenital severe sensorineural deafness: a voxel-based morphometric study
Authors: Zhang Yingxing , Liu Jie , Wang Ya
Published: August 2023

Early hearing loss could cause abnormal brain development, which has been linked to the complex process known as cross-modal neuroplasticity. However, previous studies investigating the brain structure of infants with congenital severe sensorineural hearing loss (CSSHL) are scarce and have yielded inconsistent results. This study aimed to further explore the gray matter (GM) density changes in children with CSSHL. Fifteen children aged 0–5 years with CSSHL and 11 healthy children as controls (aged 0–5 years) were recruited. Each participant underwent a structural MRI scan. The voxel-based morphometry method was performed to evaluate GM density for each participant and analyze their characteristics. It was discovered that: (1) GM density of the right superior temporal gyrus and caudate in the CSSHL group was smaller than that of healthy controls (HC). However, GM density was larger in the left posterior central gyrus, superior frontal gyrus, inferior parietal lobule and right cerebellum in the CSSHL group compared with HC. (2) The GM density value of the left superior frontal gyrus and inferior parietal lobule was negatively correlated with age. However, the GM density value of the right superior temporal gyrus in the CSSHL group was positively correlated with age. Compared with HC, the GM density of CSSHL children was larger in somatosensory areas (including left superior frontal gyrus, posterior central gyrus, inferior parietal lobule and right cerebellum), whereas GM density was smaller in auditory-related areas (such as the right superior temporal gyrus and caudate). Moreover, GM density change was influenced by the duration of hearing deprivation.
Long-term remission following esketamine nasal spray sessions in a patient with severe and highly treatment-resistant depression: a single-case report
Authors: Arrighi Lucas , Maakaron Eloïse , Korchia Théo , Lançon Christophe , Richieri Raphaëlle
Published: August 2023

About 30% of patients with major depressive disorder have treatment-resistant depression (TRD). Recently, intranasal esketamine was approved as a treatment option after the failure of two antidepressant trials. We report a patient with multiresistant depression that was successfully and safely treated with esketamine nasal spray. This 31-year-old inpatient with severe, chronic, and multi-TRD received an acute course of intranasal esketamine (84 mg). Previously, 14 different antidepressants, alone or in potentiation, and several neurostimulation techniques had been unsuccessful. Over 20 bi-weekly sessions, she had no significant adverse effects and was stabilized into remission. During the maintenance phase and 1 year after, she continues to be stable. This case report provides an example of a patient with severe TRD that showed significant improvement after treatment with intranasal esketamine.