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Objectives: Adenoid cystic carcinoma (ACC) is a commonly encountered salivary gland malignancy. However, it rarely occurs in the gingiva, an area generally thought to be devoid of minor salivary glands. We present a case occurring in this unusual site and review other reported cases. Methods: A 56 year-old male presented with a right-sided mandibular toothache for 1 year and underwent dental extraction. Due to persistent pain, follow up examination revealed a large gingival lesion. A biopsy was positive for adenoid cystic carcinoma. Results: The patient underwent a complete right segmental mandibulectomy and was reconstructed with a fibular osteocutaneous free flap. Three months postoperatively, during the planning for adjuvant radiation therapy, the patient developed pain in the left mandible. Imaging revealed extensive involvement of the left native mandible. Deep bone biopsies in several areas of the left mandible revealed ACC. He then underwent a complete left hemi-mandibulectomy and reconstruction with a fibular osteocutaneous free flap. Tensor fascia lata suspension slings were placed due to concern for an open mouth deformity attributable to disruption of bilateral masticator slings. He will undergo adjuvant radiation therapy. Our review of the literature revealed 50 cases of gingival ACC published since 1972. Disease recurrence and distant metastases were noted in several patients, occurring at the latest after 30 years follow-up. Conclusions: Given its indolent behavior, high proclivity for late recurrence and metastasis, and overall infrequency, ACC represents a pathology that requires early diagnosis and comprehensive long-term surveillance. While ACC is well described in oral cavity sites with high densities of minor salivary glands, it is not commonly seen in the gingiva. As such, gingival ACC may display a unique biological and/or clinical character. We offer the first literature review of this rare entity.

This study aims to construct a brand-new ophthalmic disease screening task and establish a practically valuable ophthalmic disease screening model in the case of insufficient data.The main methods are as follows: firstly, we mixed data from different sources (these data may come from different cameras, including different fundus diseases) to get a new dataset. Based on this dataset, we conducted subsequent experiments on fundus multi-disease screening. However, in the past public datasets, each dataset often only corresponded to the screening diagnosis of one disease. Secondly, we proposed a method to simulate the characteristics of different fundus cameras by using a method based on style transfer, and to augment the training data, so that the model could learn the features of ophthalmic diseases in a more comprehensive way. Finally, a robust disease screening model based on few-shot learning was constructed on the combined dataset, and compared with benchmark algorithms.We focused on the study of eye disease screening methods based on the metric-based few-shot learning model, data augmentation methods, and focus on key technologies such as data augmentation based on style transfer. Experiments have shown that our method can significantly improve the generalization ability of the disease screening model.By introducing few-shot learning theory and data augmentation based on style transfer into ophthalmic disease screening, the generalization ability of the model is greatly improved, and it has certain practical value.

Low-risk papillary thyroid carcinoma (LR-PTC) can be managed by immediate surgery (IS) or active surveillance (AS). We compare the psychological impact of these treatments on patients with LR-PTC.Psychological data were collected over 1 year, with assessments at the time of treatment decision (T1), at 6 months (T2) and 12 months (T3) follow-up. Assessments included 13 validated psychological tools.Of 27 enrolled patients, 20 chose AS and 7 chose IS. The average times to T2 and T3 were 5.7 and 11.3 months, respectively. For both groups, Impact of Events Scale scores significantly decreased (p = 0.001) at T2, and depressive/anxiety symptoms remained low.This study demonstrates the feasibility of assessing psychological outcomes among patients treated for LR-PTC. Further studies are needed to evaluate the impact of AS versus IS on quality of life and changes that patients experience over longer time periods following their treatment decision.

Oropharyngeal squamous carcinomas cause significant morbidity and mortality. Poor prognosticators include lymphovascular and perineural invasion. Extratumoral phenotypes of these histologic findings confer worse prognoses.We report eight cases of recurrent oropharyngeal cancer with diffuse extratumoral lymphovascular invasion (ELVI) or extratumoral perineural invasion (EPNI) and review the existing literature.On salvage resection for recurrence following primary radiation or chemoradiation, six patients manifested ELVI and two showed EPNI. These patterns conferred difficulty with complete surgical clearance; final pathologic analysis demonstrated positive margins for all eight patients. The six patients with ELVI were p16+ and the two with EPNI were p16-. Currently, two patients are deceased and six patients are alive at an average follow-up of 17.4 months. Of the six living patients, 2 have a new recurrence and are in hospice while 4 have no evidence of disease.ELVI and EPNI have received little consideration in the literature as unique histopathologic features of oropharyngeal squamous carcinoma. We present the first series on these adverse extratumoral features in recurrent disease. We call attention to these unique histologic features in the setting of recurrent oropharyngeal cancer to encourage others to track the results of therapeutic intervention and to identify successful strategies for treatment.

Study Design: case series. Objective: The restoration of defects in a single procedure with microvascular free flap reconstruction has become a mainstay of head and neck surgery. Yet in patients with complex defects and pre-existing comorbid medical conditions, a staged-reconstructive approach can enhance the safety of the procedure and improve the patient’s outcome. Methods: We present 3 representative case examples of a larger series of patients who underwent reconstruction of major defects and discuss the usefulness of a staged-reconstructive approach in the management of complex patients. Results: All 3 patients, with an existing composite defect in the setting of prior radiation therapy, underwent successful staged-reconstructive surgery using a variety of free tissue and regional flap transfers. Conclusions: A staged approach facilitates the reconstruction of complex composite defects, increases vessel availability, and mitigates the risk of flap failure. Although this approach commits the patient to multiple procedures and a more prolonged plan of care, it is preferable to 1 operation in specific complex situations with adverse, high-risk clinical features.

终末期心力衰竭是导致心血管病患者死亡的主要原因之一，也是临床治疗的难点。目前心脏移植仍是终末期心力衰竭治疗的最终方法。有关心脏移植术后的康复国内少见报道，移植术前的预康复未见报道。该文报道一例以运动为基础的终末期心力衰竭患者心脏移植术前和术后的全程康复治疗，以期为此类患者的康复治疗提供参考。.

Purpose To explore the value of ultrasound in the treatment of bone union at the docking site by accordion technique. Methods Sixteen patients were recruited. The accordion operation was performed at the docking site after bone transport. The specific operation process was compression, suspension of adjustment, distraction, retraction. Ultrasound was used to monitor the hematoma, blood flow and callus in and around the docking site at each stage. Results (1) At the compression, there were 14 cases with hematoma and 2 cases without hematoma. (2) The size of hematoma was negatively correlated with the bone healing time of the docking site and the blood flow resistance index. (3) The Adler grading of blood flow gradually increased before the retraction, and then gradually decreased. But the degree of callus mineralization continued to rise. Conclusion (1) Ultrasound can dynamically monitor the change trend of hematoma, blood flow and new callus at the docking site during accordion operation, so as to predict the tendency of bone healing at the docking site. (2) This study can preliminarily demonstrate that the compression stress applied in accordion technique can promote the bone healing at the docking site.

OBJECTIVES/HYPOTHESIS The primary objective of this study was to assess the safety of parathyroidectomy during pregnancy as treatment for hyperparathyroidism (HPTH) in comparison to nonsurgical management plans. Secondary outcomes involved analyzing the safety of surgery in the third trimester and the benefit of operating on asymptomatic pregnant patients. STUDY DESIGN Systematic review. METHODS PRISMA-guided systematic review of all cases of primary hyperparathyroidism during pregnancy published in peer-reviewed English journals on PubMed/MEDLINE, EMBASE, and SCOPUS from 1980 to 2020. RESULTS A total of 75 manuscripts were included in this review describing 382 cases of gestational hyperparathyroidism. The median maternal age was 31 years. Overall, 108 cases (28.3%) underwent parathyroidectomy during pregnancy while 274 cases (71.7%) were treated nonsurgically. The majority of surgeries took place during the second trimester (67.6%). Complications and/or deaths were less likely to occur after surgery in the second trimester (4.48%) as compared to surgery in the third trimester (21.1%). Nine surgically treated cases resulted in infant complications and/or death; however, none of these nine cases had any surgical complications. Despite these complications, the overall infant complication rate for patients who underwent surgical treatment remained lower than that of patients treated with conservative therapy (9.1% vs. 38.9%). CONCLUSIONS This review suggests that for all pregnant patients with diagnosed HPTH, parathyroidectomy should be considered regardless of symptomatology. Our data suggest that parathyroidectomy is associated with fewer risks than more conservative treatments and results in better fetal outcomes. Surgery during the third trimester is feasible and surgery should be considered in both symptomatic and asymptomatic patients. Laryngoscope, 131:1915-1921, 2021.

SUMMARY: The osteomyocutaneous iliac crest free flap is a reconstructive option for segmental mandibular or complex palatomaxillary defects. Familiarity with the radiographic appearance of free flaps such as the iliac crest is necessary for the postoperative evaluation of patients after mandibular, maxillary, or palatal reconstructions because it allows radiologists to properly monitor and interpret the appearance of the flap over time. This study presents a retrospective review of 5 patients who underwent palatomaxillary reconstruction with an iliac crest free flap at our institution. The imaging appearances of the 5 patients were analyzed to determine the key radiographic characteristics of a healthy and successful iliac crest free flap. Radiographic fluency with the imaging appearance of the iliac crest free flap, as well as the new anatomy of the region in the postoperative period, will allow for better interpretation of the flap appearance on imaging and will prevent false identification of tumor recurrence.

Open-mouth deformity after mandibular resection presents a challenge for surgeons and patients, contributing to significant functional and cosmetic morbidity. We present an innovative surgical technique to prevent or correct open-mouth deformity. Tensor fascia lata slings were utilized in combination with maxillomandibular fixation to surgically correct or prevent open-mouth deformity in four patients who had previously undergone mandibulectomy or at the time of a contralateral mandibulectomy following prior hemimandibulectomy and reconstruction. Two patients achieved favorable outcomes, including oral competence and improved resting jaw position, while open-mouth deformity could not be corrected for one patient. Another patient remains in the early postoperative period following a secondary procedure to correct open-mouth deformity. Open-mouth deformity is a functional/aesthetic problem that has not been addressed in the literature. Use of tensor fascia lata slings to suspend the mandible is a novel approach to the surgical management of open-mouth deformity.

Computation offloading is a hot research topic in mobile edge computing (MEC). Computation offloading among multiedge nodes in heterogeneous networks can help reduce offloading cost. In addition, the unmanned aerial vehicles (UAVs) play a key role in MEC, where UAVs in the air communicate with ground base stations to improve the network performance. However, limited channel resources can lead to the increase of transmission delay and the decline of communication quality. Effective channel selection mechanisms can help address those issues by improving transmission rate and ensuring communication quality. In this paper, we study channel selection during communication between multiple UAVs and base stations in an MEC system with heterogeneous networks. To maximize the transmission rate of each UAV user, we formulate a channel selection problem and model it as a noncooperative game. Then, we prove the existence of Nash equilibrium (NE). In addition, we design a multiple UAV-enabled transmission channel selection (UTCS) algorithm to obtain the equilibrium strategy profile of all the UAV users. Experimental results validate that UTCS algorithm can converge after a finite number of iterations and it outperforms random transmission algorithm (RTA) and sequential transmission algorithm (STA).

Nonadiabatic holonomic gates provide an effective means to perform high-speed and error-resilient manipulation of quantum states. It is practically important to realize nonadiabatic holonomic multiqubit controlled gates since multiqubit controlled gates are widely used in quantum information processing. Rydberg atoms are an appealing physical system for the realization of nonadiabatic holonomic multiqubit controlled gates as the Rydberg-mediated interaction is beneficial to couple two qubits. In this paper, we put forward a scheme for the realization of nonadiabatic holonomic multiqubit controlled gates based on Rydberg atoms, where an $(n+1)$-qubit controlled-$(\mathrm{n}\ifmmode\cdot\else\textperiodcentered\fi{}\mathbf{\ensuremath{\sigma}})$ gate can be realized by $(2n\ensuremath{-}1)$ basic operations. Moreover, the effective coupling between two qubits is in the first-order strength of Rabi frequencies, which allows for the implementation of quantum gates within a short duration.

The impacts of thiamin and pyridoxine along with YAN on alcoholic fermentation and hydrogen sulphide production by Saccharomyces cerevisiae were studied. Using a synthetic grape juice medium, three fermentation trials were conducted; (i) 2 × 3 factorial design with thiamin (0, 0·2, or 0·5 mg l-1 ) and YAN (60 or 250 mg l-1 ) as variables, (ii) 2 × 3 factorial design with pyridoxine (0, 0·25, or 0·5 mg l-1 ) and YAN (60 or 250 mg l-1 ) as variables, and (iii) 3 × 3 factorial design with thiamin (0, 0·2 or 0·5 mg l-1 ) and pyridoxine (0, 0·25 or 0·5 mg l-1 ) as variables in media containing 60 mg l-1 YAN. Although the progress of fermentations was affected by thiamin or pyridoxine, YAN had a larger impact than either vitamin. H2 S production was significantly lower with increasing amounts of thiamin in those fermentations under low YAN (60 mg l-1 ) while even lower amounts ( 110 µg l-1 ), with the lowest production in media with pyridoxine and high YAN (

Background Schwannomas are rare benign tumors that arise from the Schwann cells of the nerve sheath. Schwannomas are characteristically indolent, growing approximately 1–3 mm a year. We report a case of cervical sympathetic chain schwannoma (CSCS) with a rapid rate of growth while being regularly imaged for another disease process. Methods A 57-year-old female with a history of papillary thyroid cancer (PTC) presented with a left level IV neck mass discovered on a routine ultrasound. The mass was not visualized on her most recent ultrasound 11 months prior. Results The patient underwent extracapsular enucleation of the schwannoma, which arose from the cervical sympathetic chain. Final pathology confirmed the diagnosis of a benign schwannoma. Conclusions This case serves as a reminder that not all benign CSCSs are indolent and also highlights the fact that the rapid rate of growth of these lesions is not necessarily indicative of a malignant transformation.

Background Devascularization of the parathyroid glands is generally accepted as the most common mechanism for iatrogenic hypocalcemia, a frequently seen complication of both total and completion thyroidectomy procedures. Much has been written about iatrogenic hypoparathyroidism, but few papers have precisely delineated the arterial supply of the parathyroid glands and the common anatomical variations that may impact parathyroid preservation during thyroid surgery. Methods We offer an illustrated review and discussion of the only two anatomic studies published in the medical literature focusing on parathyroid vasculature. In addition, we examine current techniques of parathyroid identification, preservation, and classification. Findings A surgical technique that preserves the parathyroid arteries is vital to preserving the viability of the parathyroid gland(s) during thyroid surgery. In 1907, Halsted and Evans described a technique of ligating the distal branches of the thyroid arteries beyond the origin of the parathyroid arteries, a technique termed ultra-ligation. In 1982, Flament et al.. reported three distinct anatomical variations of the parathyroid arteries which place the parathyroid blood supply at risk for devascularization during thyroid surgery. Our review also highlights novel techniques that aid surgeons in identification and assessment of the parathyroid glands. Conclusions Recognition of the variations of parathyroid anatomy and their potential to lead to devascularization aids thyroid surgeons in their pursuit of parathyroid preservation. An awareness of the variety of novel parathyroid identification and preservation techniques can assist surgeons to achieve this goal.

Purpose: The varied treatment options available to patients with HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) can cause significant patient confusion. In particular, transoral robotic surgery (TORS) has become widely used for treatment of HPV-positive OPSCC. As patients commonly refer to the internet for additional information, we aim to evaluate the quality of online patient educational materials for TORS in comparison to other otolaryngology surgical procedures. Methods: The terms “transoral robotic surgery,” “glossectomy,” “thyroidectomy,” and “neck dissection” were searched on Google. Flesch reading ease, Flesh-Kincaid Grade Level, MD review rates, and PEMAT understandability and actionability were assessed for each search term. Google trends was used to determine search interest for each term between May 2015 and May 2020. Results: Of the 30 TORS websites that met inclusion criteria, the average FRE and FKGL scores were 40.74 and 11.60 (that of an average high school senior). The FRE and FKGL scores for TORS were all statistically significantly lower than those of all comparator search terms ( P Conclusions: In comparison to other common otolaryngology procedures, TORS websites are the least patient friendly. As TORS becomes a more widely used procedure, it is critical that TORS websites become higher quality resources that patients can reliably reference.

Background Second branchial cleft cysts (SBCCs) are congenital benign tumors that comprise up to 90% of all branchial cleft anomalies. SBCCs typically present in the lateral neck along the anterior border of the upper third of the sternocleidomastoid muscle. We describe a case of a SBCC presenting in an unusual location in the lower neck close to midline. Methods An 18-year-old male presented with a 2-year history of a neck mass in the suprasternal notch. Imaging findings were reviewed with a head and neck radiologist who felt that the findings were highly suggestive of a fourth branchial cleft cyst. Results The patient underwent surgical excision of the mass. Final pathologic evaluation confirmed the diagnosis of a second branchial cleft cyst. Conclusions Though extremely uncommon, second branchial cleft cysts can extend to the suprasternal notch and should not be excluded from the differential diagnoses of lower neck masses.

Summary Full waveform inversion (FWI) has been applied with great success to build velocity model, which is typically used in RTM or least squares reverse time migration (LSRTM) to produce high resolution images. With the fast advancements in the computer industry and the progress of the FWI algorithm, high resolution FWI has become common practices. Nevertheless, it is still computationally expensive to invert a velocity model that is directly interpretable using FWI. In this paper, we propose a unified approach for the inversion of velocity model and the image. Starting at lowest frequency possible that the input data support, FWI gradually moves to higher frequencies, which allows it to invert a broad band velocity model. A reflectivity model is then computed directly from a velocity model inverted from FWI without the need of migration as it is in a typical workflow. Numerical examples show that the reflectivity image derived from a 15 HZ FWI velocity model have better resolution and improved continuity compared to the images from RTM and LSRTM. These benefits partially come from the contribution of both refraction and reflection energy used in FWI.

The fibular free flap (FFF) is commonly used for head and neck bony reconstruction. Ossification of the vascular pedicle has been reported but is an uncommon complication of this procedure. Ossification of the pedicle with FDG avidity has not been identified in the literature. Here we present a case of FDG avid free flap ossification seen on PET/CT imaging in a patient who developed trismus after fibular free flap reconstruction of a maxillary defect for a primary squamous cell carcinoma of the palate. The FDG avidity of the free flap ossification and trismus were both concerning for recurrent squamous cell carcinoma.

BACKGROUND Metastatic thyroid carcinoma to retropharyngeal and parapharyngeal (RP/PP) lymph nodes is rare. Literature suggests previous lateral neck dissection (LND) may alter patterns of lymphatic drainage in the neck, predisposing to these less common sites of spread. METHODS PRISMA-guided systematic search for all published cases detailing RP/PP metastases of well-differentiated thyroid carcinoma from 1970 to 2019. RESULTS Seventy articles were identified and 44 were included, along with seven cases treated at our institution, totaling 239 cases. Cases represented both retropharyngeal (60.7%) and parapharyngeal (39.3%) metastases identified in the initial (27.6%) and recurrent (72.4%) setting. CONCLUSION RP/PP metastases generally present in the recurrent setting. RP/PP metastases often represent high-risk disease, and surgical treatment is recommended.

Extraskeletal Ewing sarcoma (EES) is a rare soft tissue tumor, and EES of the head and neck is particularly rare. Radiographic imaging of these lesions is crucial given their anatomical complexity and infrequent incidence. Conventional EES imaging features include a large, hyperintense, heterogeneously enhancing lesion, with frequent invasion of local structures. In this case report, a 19-year old male presented with left facial swelling and pain. He underwent sclerotherapy and bleomycin treatment for a presumed lymphatic malformation. Initial imaging demonstrated a rim-enhancing lesion within the left buccal space with no muscle invasion or bony erosion present. Two years later, imaging identified an enlarging buccal mass with destruction of the zygomatic arch and inferolateral orbital wall. The patient underwent surgical resection of the mass. Pathology confirmed the mass to be a small round blue cell tumor and FISH testing confirmed the presence of the EWSR1 gene arrangement that is consistent with EES. The patient tolerated the procedure well and underwent chemoradiation therapy. At three years postoperatively, the patient remains disease free. The presented case demonstrates an unusual presentation of a buccal space EES as a rim-enhancing, centrally hypointense mass with no bony erosion or muscular invasion. The location and atypical imaging appearance of this case offer insight for future diagnosis of EES.

Objectives Nasopharyngeal carcinoma (NPC) is a rare form of squamous cell carcinoma. Primary NPC is generally treated with radiation and chemotherapy, though recurrence and distant metastases are common. Reports of noncontiguous metastasis to the middle ear and external ear canal (EAC) are rare. Materials and methods Case presentation of a female patient previously treated for NPC, who developed an EAC metastasis. A literature review of all reported cases of metastatic NPC in the middle ear and EAC is also included. Results A patient presenting with noncontiguous metastasis of NPC to the EAC was treated with surgical resection followed by chemotherapy and radiation. The patient successfully completed treatment and is currently alive but with suspected distant metastatic disease at 11 months following treatment. Conclusions NPC metastasis to the EAC is extremely rare. Treatment options are varied, and prognosis is generally poor. The case presented here shows better outcomes than many previous reports.

Background The radial forearm free flap (RFFF) is a versatile flap commonly used in head and neck reconstructive surgery. We describe the use of a composite RFFF that includes muscle for reconstruction of a hostile wound of the posterior pharyngeal wall. Methods A 54-year-old male with a history of recurrent right palatine tonsil HPV+ squamous cell carcinoma developed severe soft tissue necrosis of the posterior pharyngeal wall secondary to reirradiation. The defect was reconstructed with a composite RFFF that included the brachioradialis (BR) muscle and the flexor digitorum superficialis (FDS) muscle. Results Restoration of this complex defect was successfully accomplished with minimal donor site functional deficits and satisfactory functional outcomes including decannulation and resumption of oral intake. Conclusion This composite RFFF can be effectively used to reconstruct a hostile wound of the posterior pharyngeal wall. Incorporation of muscle in the reconstruction of complex wounds with soft tissue necrosis is beneficial.

A measurement of the branching fraction of the decay Bs0→KS0KS0 is performed using proton-proton collision data corresponding to an integrated luminosity of 5 fb-1 collected by the LHCb experiment between 2011 and 2016. The branching fraction is determined to be B(Bs0→KS0KS0)=[8.3±1.6(stat)±0.9(syst)±0.8(norm)±0.3(fs/fd)]×10-6, where the first uncertainty is statistical, the second is systematic, and the third and fourth are due to uncertainties on the branching fraction of the normalization mode B0→φKS0 and the ratio of hadronization fractions fs/fd. This is the most precise measurement of this branching fraction to date. Furthermore, a measurement of the branching fraction of the decay B0→KS0KS0 is performed relative to that of the Bs0→KS0KS0 channel, and is found to be B(B0→KS0KS0)B(Bs0→KS0KS0)=[7.5±3.1(stat)±0.5(syst)±0.3(fs/fd)]×10-2.

Background: Coronavirus disease 2019 (COVID-19) has rapidly spread to more than 200 countries. Thus far, reports regarding multi-center data from throughout gestation in women with COVID-19 and newborn outcomes are scarce.Methods: We retrospectively reviewed data from 92 pregnant women with COVID-19 (PW-COVID-19) and their 78 newborns from 27 hospitals in 12 regions of Hubei, China. The demographic, epidemiological, clinical, laboratory, and therapeutic data and pregnancy, perinatal, and neonatal outcomes were analyzed. Follow-up was censored until April 7, 2020.Findings: Median maternal age was 31.0 years (IQR 28·0-33·0), with nine patients in the first trimester, five in the second trimester, and 78 in the third trimester. None of the patients died, and most (92·4%) recovered and were discharged. Seventy-five deliveries (including three sets of twins) comprised 66 cesarean sections and nine vaginal deliveries, with 21 preterm and 57 full-term infants. Seventeen live births had radiological findings of pulmonary infection. One newborn tested positive for SARS-CoV-2 nucleic acid, and three newborns were viral antibody-positive: two IgG (+) and IgM (-), and one IgG (+) and IgM (+). The median suspected duration of virus exposure was 7 days (IQR 0 to 27).Interpretation: Compared to the pregnant women with other viral infections, such as SARS, MERS, and Zika virus infection, PW-COVID-19 had similar manifestations and relatively better outcomes. The termination time and delivery mode in PW-COVID-19 should be evaluated based on both the maternal and fetal situations. The possibility of maternal-to-fetal transmission of SARS-CoV-2 requires further investigation.Authors Shujie Liao and Renjie Wang contributed equally to this work.

Here, a novel carrier fabricated by the interaction of negatively charged heparin and positively charged PEI and Ca

Background Radiographic imaging is often used to determine basal cell carcinoma (BCC) extension and invasion and to define a surgical plan. However, imaging modalities may overestimate tumor invasion and lead to unnecessarily aggressive treatment. Methods A 77-year-old woman was seen with a growing BCC of the scalp with MRI imaging indicative of calvarial diploic space invasion. The patient underwent Mohs surgery followed by a parietal craniectomy. Results Contrary to the MRI findings, histological evaluation of the cortical parietal calvarium and the diploic space did not demonstrate BCC. Conclusions Surgeons should be wary of diploic space changes in the absence of cortical erosion demonstrated in MRI as it may not explicitly indicate tumor invasion. Biopsy of the diploe is necessary in such cases to determine the surgical course and to avoid morbidity associated with calvarium removal.

A measurement of the Ξ cc + + $$ {\varXi}_{cc}^{++} $$ mass is performed using data collected by the LHCb experiment between 2016 and 2018 in pp collisions at a centre-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 5.6 fb −1. The Ξ cc + + $$ {\varXi}_{cc}^{++} $$ candidates are reconstructed via the decay modes Ξ cc + + → Λ c + K − π + π + $$ {\varXi}_{cc}^{++}\to {\varLambda}_c^{+}{K}^{-}{\pi}^{+}{\pi}^{+} $$ and Ξ cc + + → Ξ c + π + $$ {\varXi}_{cc}^{++}\to {\varXi}_c^{+}{\pi}^{+} $$ . The result, 3621.55 ± 0.23 (stat) ± 0.30 (syst) MeV/c 2, is the most precise measurement of the Ξ cc + + $$ {\varXi}_{cc}^{++} $$ mass to date.