Search

The current study employed a within-participant design to analyze the effects of head movements in three conditions (i.e., head nodding, head shaking, and no head movements) during positive (motivational) self-talk among 22 male cyclists. After the self-talk and head-movements task, physical performance (i.e., anaerobic power) was assessed using a Wingate Test for each experimental condition. Each cyclist participated individually on three separate days, completing one of the three experimental conditions each day. We hypothesized and found that the head-nodding condition resulted in greater physical performance (i.e., mean and peak power) than the no-head-movements condition. This is the first time that head nodding has been shown to improve physical performance compared with no head movements during encouraging and self-assuring self-talk. Relevantly, these findings emphasize the importance of focusing on athletes' nonverbal behavior (e.g., head movements) when engaging in positive (motivational) self-talk to perform better. [ABSTRACT FROM AUTHOR]

Driving posture can lead to musculoskeletal pain. Most work focuses on the lower back; therefore, we know little about automobile seat design and neck posture. This study evaluated an automobile driver seat that individualized upper back support to improve head and neck posture. Specifically, we examined the system's impact on anterior head translation with secondary outcomes of spine posture and perceptions of comfort/well-being compared with a control. Forty participants were block randomized to experience either the activated or deactivated version of the same seating system first. Participants completed two 30-minute simulated driving trials, separated by washout, with continuous measures of anterior head translation, spine posture, and pelvis orientation. Perceptions of comfort/well-being were assessed by survey and open-ended questions immediately following each condition. Small, but statistically significant decreases in anterior head translation and posterior pelvic tilt occurred with the activated seat system. Participants reported lower satisfaction with the activated seat system. Order of the 2 seat conditions affected differences in pelvis orientation and participant perceptions of comfort/well-being. An anthropometric-based seat system targeting upper back support can significantly affect head and pelvic posture but not satisfaction during simulated driving. Future work should examine long-term impacts of these posture changes on health outcomes. [ABSTRACT FROM AUTHOR]

Most studies of developing visual attention are conducted using screen-based tasks in which infants move their eyes to select where to look. However, real-world visual exploration entails active movements of both eyes and head to bring relevant areas in view. Thus, relatively little is known about how infants coordinate their eyes and heads to structure their visual experiences. Infants were tested every 3 months from 9 to 24 months while they played with their caregiver and three toys while sitting in a highchair at a table. Infants wore a head-mounted eye tracker that measured eye movement toward each of the visual targets (caregiver's face and toys) and how targets were oriented within the head-centered field of view (FOV). With age, infants increasingly aligned novel toys in the center of their head-centered FOV at the expense of their caregiver's face. Both faces and toys were better centered in view during longer looking events, suggesting that infants of all ages aligned their eyes and head to sustain attention. The bias in infants' head-centered FOV could not be accounted for by manual action: Held toys were more poorly centered compared with non-held toys. We discuss developmental factors-attentional, motoric, cognitive, and social-that may explain why infants increasingly adopted biased viewpoints with age.

The size of the human head is highly heritable, but genetic drivers of its variation within the general population remain unmapped. We perform a genome-wide association study on head size (N = 80,890) and identify 67 genetic loci, of which 50 are novel. Neuroimaging studies show that 17 variants affect specific brain areas, but most have widespread effects. Gene set enrichment is observed for various cancers and the p53, Wnt, and ErbB signaling pathways. Genes harboring lead variants are enriched for macrocephaly syndrome genes (37-fold) and high-fidelity cancer genes (9-fold), which is not seen for human height variants. Head size variants are also near genes preferentially expressed in intermediate progenitor cells, neural cells linked to evolutionary brain expansion. Our results indicate that genes regulating early brain and cranial growth incline to neoplasia later in life, irrespective of height. This warrants investigation of clinical implications of the link between head size and cancer.

OBJECTIVE: Identification of EEG waveforms is critical for diagnosing Lennox-Gastaut Syndrome (LGS) but is complicated by the progressive nature of the disease. Here, we assess the interrater reliability (IRR) among pediatric epileptologists for classifying EEG waveforms associated with LGS. METHODS: A novel automated algorithm was used to objectively identify epochs of EEG with transient high power, which were termed events of interest (EOIs). The algorithm was applied to EEG from 20 LGS subjects and 20 healthy controls during NREM sleep, and 1350 EOIs were identified. Three raters independently reviewed the EOIs within isolated 15-second EEG segments in a randomized, blinded fashion. For each EOI, the raters assigned a waveform label (spike and slow wave, generalized paroxysmal fast activity, seizure, spindle, vertex, muscle, artifact, nothing, or other) and indicated the perceived subject type (LGS or control). RESULTS: Labeling of subject type had 85% accuracy across all EOIs and an IRR of κ =0.790, suggesting that brief segments of EEG containing high-power waveforms can be reliably classified as pathological or normal. Waveform labels were less consistent, with κ =0.558, and the results were highly variable for different categories of waveforms. Label mismatches typically occurred when one reviewer selected nothing, suggesting that reviewers had different thresholds for applying named labels. SIGNIFICANCE: Classification of EEG waveforms associated with LGS has weak IRR, due in part to varying thresholds applied during visual review. Computational methods to objectively define EEG biomarkers of LGS may improve IRR and aid clinical decision-making.

The diversity of vertebrate skeletons is often attributed to adaptations to distinct ecological factors such as diet, locomotion, and sensory environment. Although the adaptive evolution of skull, appendicular skeleton, and vertebral column is well studied in vertebrates, comprehensive investigations of all skeletal components simultaneously are rarely performed. Consequently, we know little of how modes of evolution differ among skeletal components. Here, we tested if ecological and phylogenetic effects led to distinct modes of evolution among the cranial, appendicular and vertebral regions in extant carnivoran skeletons. Using multivariate evolutionary models, we found mosaic evolution in which only the mandible, hindlimb and posterior (i.e. last thoracic and lumbar) vertebrae showed evidence of adaptation towards ecological regimes whereas the remaining skeletal components reflect clade-specific evolutionary shifts. We hypothesize that the decoupled evolution of individual skeletal components may have led to the origination of distinct adaptive zones and morphologies among extant carnivoran families that reflect phylogenetic hierarchies. Overall, our work highlights the importance of examining multiple skeletal components simultaneously in ecomorphological analyses. Ongoing work integrating the fossil and palaeoenvironmental record will further clarify deep-time drivers that govern the carnivoran diversity we see today and reveal the complexity of evolutionary processes in multicomponent systems.

The "Supplementary Material" from "Frontiers in Neuroscience" presents simulated epochs and localization of brain networks at various signal-to-noise ratios. It includes figures showing original and reconstructed data for different networks. The material quantifies localization errors using maximal distances as thresholds and compares subject-specific and average head models. The study evaluates factors affecting the accuracy of brain activity localization, providing insights into the impact of variables like signal-to-noise ratio and head models on the results. [Extracted from the article]

Background/Objectives: Basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) are non-melanoma skin cancers (NMSCs) and the most prevalent cancers in the United States. Image-guided superficial radiotherapy (IGSRT) is a relatively new treatment option that uses high-resolution dermal ultrasound integrated with superficial radiotherapy to improve tumor visualization. IGSRT is a clinically equivalent non-surgical alternative to Mohs micrographic surgery at 2 years of follow-up in early-stage NMSC, but larger cohort studies with longer follow-up periods that allow for analysis of patient outcomes by demographic and disease characteristics are needed. Methods: This large, retrospective cohort study was conducted to determine the effect of risk factors (tumor location, tumor stage, and sex) on 2-, 4-, and 6-year freedom from recurrence rates in 19,988 NMSC lesions treated with IGSRT, including lesions with complete treatment courses. Results: Overall freedom from recurrence rates were 99.68% at 2 years, 99.54% at 4 years, and 99.54% at 6 years; rates did not differ significantly by tumor location (head/neck versus other locations, p = 0.9) or sex (male versus female, p = 0.4). In contrast, there was a significant difference in freedom from recurrence rates when analyzed by tumor stage (p = 0.004). Conclusions: There was no significant effect of tumor location or sex on freedom from recurrence in IGSRT-treated NMSC. Although there was a significant difference according to tumor stage, freedom from recurrence rates exceeded 99% at all stages. [ABSTRACT FROM AUTHOR]

The clinical examination of patients with cervical spine pathology includes measures of posture, mobility, strength, and stability. The forward head position as measured by craniovertebral angle (CVA) has been suggested as a risk factor for cervical spine pathology. The purpose of this study was to describe CVA reference values in healthy adults and assess the relationship with age and sex. This prospective cross-sectional observational study measured the CVA in 122 healthy adults using digital analysis of a lateral view photograph. To facilitate this analysis, a marker was placed at the level of the C7 vertebra, with the tragus of the ear visible in the photograph. The CVA was measured using Kinovea 0.8.15 software, where the CVA was calculated using the intersection of a horizontal line with a line joining the spinous process of C7 and the tragus of the ear. Mean CVA values were 48.76° (6.77) across all participants, 50.07° (6.63) for females, and 47.46° (6.71) for males. Linear regression analysis indicated significant relationships with age and with sex. The study established CVA reference values in healthy adults and identified a significant difference in head position between males and females and a 1.6° decrease in CVA per decade of increased age. [ABSTRACT FROM AUTHOR]

Objectives The study aimed to explore the impact of various head positions on the distortion product otoacoustic emissions (DPOAE) amplitudes, identifying the specific DPOAE frequencies showing the effect was also of interest. Materials and Methods DPOAEs were recorded from the right ears of 50 normal-hearing individuals in six head positions, supine, and five sitting positions (head erect, roll left, roll right, pitch backward, and pitch forward). DPOAEs were averaged and measured for their overall and frequency-specific amplitudes at 1 kHz, 1.5 kHz, 2 kHz, 3 kHz, 4 kHz, 6 kHz, and 8 kHz. Statistical Analysis To investigate the statistical significance of the observed mean differences, the data was tested using repeated measures of analysis of variance (ANOVA) following the Shapiro–Wilk normality test. The pair-wise comparison was tested using the Bonferroni post-hoc test and one-sided Bayesian paired sample t-test. Results The results of ANOVA revealed a significant main effect of head posture only at 1 kHz. The Bonferroni post-hoc test and one-sided Bayesian paired sample t-test results showed significantly higher DPOAE amplitude in the head erect compared to the supine position. There were no significant differences between other pairs of head postures. Conclusion Head posture is a trivial influencing factor of DPOAEs and hence, does not require consideration in interpreting DPOAEs. [ABSTRACT FROM AUTHOR]

Many recent studies have used boil-and-bite style instrumented mouthguards to measure head kinematics during impact in sports. Instrumented mouthguards promise greater accuracy than their predecessors because of their superior ability to couple directly to the skull. These mouthguards have been validated in the lab and on the field, but little is known about the effects of decoupling during impact. Decoupling can occur for various reasons, such as poor initial fit, wear-and-tear, or excessive impact forces. To understand how decoupling influences measured kinematic error, we fit a boil-and-bite instrumented mouthguard to a 3D-printed dentition mounted to a National Operating Committee on Standards for Athletic Equipment (NOCSAE) headform. We also instrumented the headform with linear accelerometers and angular rate sensors at its center of gravity (CG). We performed a series of pendulum impact tests, varying impactor face and impact direction. We measured linear acceleration and angular velocity, and we calculated angular acceleration from the mouthguard and the headform CG. We created decoupling conditions by varying the gap between the lower jaw and the bottom face of the mouthguard. We tested three gap conditions: 0 mm (control), 1.6 mm, and 4.8 mm. Mouthguard measurements were transformed to the CG and compared to the reference measurements. We found that gap condition, impact duration, and impact direction significantly influenced mouthguard measurement error. Error was higher for larger gaps and in frontal (front and front boss) conditions. Higher errors were also found in padded conditions, but the mouthguards did not collect all rigid impacts due to inherent limitations. We present characteristic decoupling time history curves for each kinematic measurement. Exemplary frequency spectra indicating characteristic decoupling frequencies are also described. Researchers using boil-and-bite instrumented mouthguards should be aware of their limitations when interpreting results and should seek to address decoupling through advanced post-processing techniques when possible. [ABSTRACT FROM AUTHOR]

Accurate segmentation of organs at risk (OARs) is a crucial step in the precise planning of radiotherapy for head and neck tumors. However, manual segmentation methods using CT images, which are still predominantly applied in clinical settings, are inefficient and expensive. Additionally, existing segmentation methods struggle with small organs and have difficulty managing the complex interdependencies between organs. To address these issues, this study proposed an OAR-UNet segmentation method based on a U-shaped architecture with two key designs. To tackle the challenge of segmenting small organs, a Local Feature Perception Module (LFPM) is developed to enhance the sensitivity of the method to subtle structures. Furthermore, a Cross-shaped Transformer Block (CSTB) with a cross-shaped attention mechanism is introduced to improve the ability of the model to capture and process long-distance dependency information. To accelerate the convergence of the Transformer, we designed a Local Encoding Module (LEM) based on depthwise separable convolutions. In our experimental evaluation, we utilized two publicly available datasets, SegRap2023 and PDDCA, achieving Dice coefficients of 78.22% and 89.42%, respectively. These results demonstrate that our method outperforms both previous classic methods and state-of-the-art (SOTA) methods. [ABSTRACT FROM AUTHOR]

The article presents a case of a small-for-gestational-age female infant born at 36 weeks, who exhibited intracranial abnormalities potentially linked to congenital infections and genetic disorders. Topics include the diagnostic challenges of differentiating between congenital infections such as cytomegalovirus (CMV) and genetic conditions like COL4A1-associated brain small vessel disease, as well as the implications of early diagnosis and treatment for improving neurological outcomes.

Previous research has shown that prosodic structure can regulate the relationship between co-speech gestures and speech itself. Most co-speech studies have focused on manual gestures, but head movements have also been observed to accompany speech events by Munhall, Jones, Callan, Kuratate, and Vatikiotis-Bateson [(2004). Psychol. Sci. 15(2), 133–137], and these co-verbal gestures may be linked to prosodic prominence, as shown by Esteve-Gibert, Borrás-Comes, Asor, Swerts, and Prieto [(2017). J. Acoust. Soc. Am. 141(6), 4727–4739], Hadar, Steiner, Grant, and Rose [(1984). Hum. Mov. Sci. 3, 237–245], and House, Beskow, and Granström [(2001). Lang. Speech 26(2), 117–129]. This study examines how the timing and magnitude of head nods may be related to degrees of prosodic prominence connected to different focus conditions. Using electromagnetic articulometry, a time-varying signal of vertical head movement for 12 native French speakers was generated to examine the relationship between head nod gestures and F0 peaks. The results suggest that speakers use two different alignment strategies, which integrate both temporal and magnitudinal aspects of the gesture. Some evidence of inter-speaker preferences in the use of the two strategies was observed, although the inter-speaker variability is not categorical. Importantly, prosodic prominence itself is not the cause of the difference between the two strategies, but instead magnifies their inherent differences. In this way, the use of co-speech head nod gestures under French focus conditions can be considered as a method of prosodic enhancement. [ABSTRACT FROM AUTHOR]

Background: Concerns are prevalent about preterm infant long‐term growth regarding plotting low on growth charts at discharge, stunting, underweight, high body fat and subsequent cardiometabolic morbidities. Objectives: To examine (a) longitudinal growth patterns of extremely and very preterm infants to 3 years corrected age (CA) (outcome), categorised by their birthweight for gestational age: small, appropriate and large for gestational age (SGA, AGA and LGA, respectively) (exposure); and (b) the ability of growth faltering (<−2 z‐scores) to predict suboptimal cognitive scores at 3 years CA. Methods: Post‐discharge head, length, weight and weight‐4‐length growth patterns of the PreM Growth cohort study infants born <30 weeks and < 1500 g, who had dietitian and multi‐disciplinary support before and after discharge, were plotted against the World Health Organization growth standard. Infants with brain injuries, necrotising enterocolitis and bronchopulmonary dysplasia were excluded. Results: Of the included 405 infants, the proportions of infants with anthropometric measures > − 2 z‐scores improved with age. The highest proportions <−2 z‐scores for length (24.2%) and weight (24.0%) were at 36 gestational weeks. The proportion with small heads was low by 0 months CA (1.8%). By 3 years CA, only a few children plotted lower than −2 z‐scores for length, weight‐4‐length and weight (<6%). After zero months CA, high weight‐4‐length and body mass index > + 2 z‐scores were rare (2.1% at 3 years CA). Those born SGA had higher proportions with shorter heights (16.7% vs. 5.2%) and lower weights (27.8% vs. 3.5%) at 3 years CA compared to those born AGA. The ability of growth faltering to predict cognitive scores was limited (AUROC 0.42, 95% CI 0.39, 0.45 to 0.52, 95% CI 0.41, 0.63). Conclusions: Although children born <30 weeks gestation without major neonatal morbidities plot low on growth charts at 36 weeks CA most catch up to growth chart curves by 3 years CA. [ABSTRACT FROM AUTHOR]

Simple Summary: With the aim of offering precision medicine to our patients, accurate lymph node staging of head and neck (HN) cancer patients is a major challenge, as it determines whether neck dissection is indicated. For many years, the indication for this surgery has been histological predictors from the primary tumor only, and efforts are converging to develop non-invasive techniques to exclude occult metastases with certainty. FDG PET-CT plays a dominant role in this respect. The aim of our systematic review and meta-analysis was to determine the overall diagnostic performance of FDG PET-CT for the detection of LN metastases from HN squamous cell carcinoma (HNSCC) in patients with clinically node-negative necks. Because of an estimated 20–30% prevalence of occult lymph node (LN) metastases in patients with head and neck squamous cell carcinoma (HNSCC), neck dissection is often proposed, despite its potential morbidity. In this systematic review and meta-analysis, the diagnostic performance of FDG PET-CT in detecting occult LN metastases was evaluated in patients with clinically negative necks (cN0) and in whom histopathology of a neck dissection specimen served as gold standard. Overall, 16 studies out of 2062 screened on PubMed and EMBASE fulfilled the inclusion criteria (n = 1148 patients). Seven of these sixteen studies were split into two or three studies because they contained data that could be processed distinctly in our meta-analysis. For this reason, a total of 25 studies were identified and included in the analysis (n total = 1918 patients). The overall prevalence of metastatic nodes per patient was 22.67%. The pooled sensitivity, specificity, diagnostic odds ratios, and negative predictive value (NPV) were 0.71 (95%CI: 0.66–0.75), 0.90 (95%CI: 0.84–0.93), 20.03 (95%CI: 13.51–29.70), and 0.92 (95%CI: 0.89–0.95), respectively. The main causes of inter-study heterogeneity included different reference standards (evaluation per patient, per neck side, or per neck level). The current meta-analysis showed that FDG PET-CT has a high specificity and NPV for ruling out nodal involvement in cN0 necks, but a limited sensitivity. [ABSTRACT FROM AUTHOR]

Three dimensional (3D) kinematic analysis based on motion capture can study synchronized data from the integrated jaw and neck motor system. Jaw function is commonly estimated on linear outcome variables of motion range. By combining jaw border movements in three planes the functional range of motion could be described by movement area and volume measures. Can we ensure the accuracy, test-retest reliability, and intra-individual variability with 3D kinematic analysis for estimating jaw functional range of motion (ROM), including jaw movement area and volume and jaw and head linear measures? Accuracy was estimated by applying the method to a set of beakers with known volume, based on the percentage deviation and Pearson correlation coefficient between target and estimated values. Test-retest reliability was then analysed on maximum jaw movements performed in a pre-determined movement sequence by 17 pain-free participants (25.4 years ± 2.4) to estimate jaw functional ROM. Intraclass correlation coefficients (ICC) were calculated, and Bland-Altman plots were constructed. Coefficient of variation (CV) tested the within session reliability. The accuracy in volume and area measurements were high with a percentage deviation (0.03±0.59) and (1.2±0.45), respectively, with a strong linear relationship (R2=0.99) between target and estimated values. The test-retest reliability showed moderate to excellent reliability, and Bland-Altman plots showed good agreement. Overall, CVs showed high repeatability, but jaw movements in horizontal directions were less reliable and presented higher variability. The study with 3D kinematic analysis of jaw functional ROM, provides a methodological basis for accurate and reliable measurements. The study presents a new way to estimate jaw functional ROM measures, useful for evaluation in clinical intervention, for instance in pain and jaw dysfunction. Moreover, the natural biological movement variability and the complexity of the interplay of jaw-head movement will be emphasised. • A new kinematic method to estimate jaw functional range of motion. • The accuracy in area and volume measurements were high. • Jaw and head linear movement displacements showed high test-retest reliability. • The method has potential to evaluate dysfunctions in jaw-neck motor system. [ABSTRACT FROM AUTHOR]

Background: Many patients critically ill with COVID-19 develop acute respiratory distress syndrome (ARDS) necessitating mechanical ventilation and proning. Although proning is lifesaving, it has been linked to the occurrence of facial pressure injuries (PIs). Objectives: To evaluate the incidence and use of prevention strategies and identify predictors of facial PIs in patients who received ventilator and proning treatments in COVID-designated intensive care units at 2 large quaternary medical centers in the Midwest. Method: This was a retrospective cohort study using data extracted from an electronic health record between October 2020 and February 2022. Demographics, clinical and care variables, and PI outcomes were analyzed to identify predictors of PI using logistic and Cox regression. Results: The cohort (N = 150) included patients from 2 units, unit a (n = 97) and unit b (n = 53) with a mean age of 60 years, with 68% identifying as male. Patients were vented for an average of 18 (SD, 16.2) days and proned for an average of 3 (SD, 2.5) days. Many (71%) died. Over half (56%) developed facial PI with a proning-exposure-adjusted incidence rate of 18.5%. Patients with PI were significantly different in several factors. Logistic regression showed predictors of PIs were duration of mechanical ventilation (in days; P = .02) and head turned (P = .01). Cox regression also identified head turn as predictive (P < .01), with Black/African American race as protective (P = .03) Discussion: Critically ill patients with COVID-19 receiving ventilator and proning therapy developed facial PIs despite the use of recommended prevention practices. Further research on effective PI prevention strategies is needed. [ABSTRACT FROM AUTHOR]

Objectives: Ultrasound (US)-guided procedures can be used in the evaluation and treatment of neck masses. However, these procedures need to be practiced before being executed on humans. The aim of this study is to evaluate the efficacy of a training program using a gelatin phantom to practice US-guided procedures. Methods: This program included a lecture and practice with a gelatin phantom. We recruited doctors from different hospitals to practice US-guided procedures, including fine-needle aspiration (FNA), core needle biopsy (CNB), percutaneous ethanol injection (PEI), and radiofrequency ablation (RFA). We used a questionnaire with a 5-point scale to evaluate the effectiveness of practicing US-guided procedures under a gelatin phantom. Results: Forty-four doctors participated, and 37 of them completed the questionnaires. After training, the mean (SD) scores of the doctors were 4.68 (0.47) for "Satisfaction with this course," 4.54 (0.61) for "Ease in practicing FNA&CNB using the phantom," 4.49 (0.61) for "Ease in practicing PEI using the phantom," 4.49 (0.65) for "Ease in practicing RFA using the phantom," and 4.57 (0.55) for "The course effectively familiarizing participants with US-guided procedures." Participants without experience in US examination had higher scores than those with previous US experience, but the difference was not statistically significant. Conclusion: A combination of lectures and hands-on practice of US-guided procedures using a gelatin phantom is an effective educational method for doctors interested in head and neck US. After the training program, doctors gained a better understanding of the necessary steps and skills required for these procedures. They can correctly insert the instruments into the target lesion and perform different US-guided procedures. [ABSTRACT FROM AUTHOR]

Background: Natural head position (NHP), pharyngeal airway and maxillofacial growth pattern are correlated. The author's previous studies proved that following surgical correction of Skeletal Class II malocclusion, the over‐extended NHP returned upright, and the pharyngeal airway space (PAS) dimension expanded. Objective: The present study compares the post‐operative change in NHP and PAS after orthognathic surgery in Skeletal Class II and III malocclusion patients. Methods: Patients receiving orthognathic procedures to correct Skeletal Class II or III malocclusions were reviewed in this retrospective study. Pre‐operative and 6‐week post‐operative cone‐beam computed tomography datasets were collected. Variables representing the craniofacial pattern, the NHP and the PAS were measured three‐dimensionally. Post‐operative variables were compared with their pre‐operative counterparts using either repeat‐measure 2‐way analysis of variance or Wilcoxon matched‐pairs signed rank test. Results: Thirty cases of Skeletal Class II malocclusion and 13 cases of Skeletal Class III malocclusion were collected. Preoperatively, the inter‐group differences were significant in craniofacial pattern (68.14 ± 3.552 degree vs. 79.63 ± 2.497 degree, p <.0001) and the NHP (68.77 ± 11.02 degree vs. 82.83 ± 7.738 degree, p =.0002) while not significant in PAS; after surgery, the intergroup differences in craniofacial pattern and the NHP between groups decreased, and the PAS increased in both groups. Conclusion: Orthognathic surgery may improve compromised NHP and increase PAS in Skeletal Class II and III malocclusion patients. [ABSTRACT FROM AUTHOR]

This study was conducted to achieve an understanding of the potential applications of Kinesio Taping® (KT) in the craniomaxillofacial region. A comprehensive search of pertinent literature was performed through PubMed, Medline, Google Scholar, ProQuest, and ScienceDirect. The focused question that was addressed was, "What are the potential applications of KT in the craniomaxillofacial region?". The preliminary search identified 52 studies. Once duplicates were removed, the remaining 43 titles/abstracts were screened, where 9 studies were excluded and the remaining 34 were assessed. Three additional studies were obtained through reference review of the retrieved articles. KT is being used for the management of various conditions, including temporomandibular joint disorders, side effects associated with maxillofacial surgeries, various neurological conditions, etc. KT has not been proven as a reliable independent treatment option; however, it is considered to be useful as a complementary option to improve treatment outcomes for various conditions. [ABSTRACT FROM AUTHOR]

Mohs Micrographic Surgery (MMS) for treatment of melanoma offers several advantages over wide local excision (WLE), including complete histologic margin evaluation, same-day resection and closure, and sparing of healthy tissue in critical anatomic sites. Recently, a large volume of clinical data demonstrating efficacy in MMS treatment of melanoma was published, leading to emerging patient safety considerations of incurred treatment costs, risk of tumor upstaging, and failure of care coordination for sentinel lymph node biopsy (SLNB). MMS offers a safe, effective, and value-based treatment for both melanoma in situ (MIS) and invasive melanoma (IM), particularly with immunohistochemistry use on frozen sections. Compared to wide local excision, MMS treatment demonstrates similar or improved outcomes for local tumor recurrence, melanoma-specific survival, and overall survival at long-term follow-up. Tumor upstaging risk is low, and if present, alteration to clinical management is minimal. Discussion of SLNB for eligible head and neck IM cases should be done prior to MMS. Though challenging, successful multidisciplinary coordination of SLNB with MMS has been demonstrated. Herein, we provide a detailed clinical review of evidence for MMS treatment of cutaneous melanoma and offer recommendations to address current controversies surrounding the evolving paradigm of surgical management for both MIS and invasive melanoma (IM). [ABSTRACT FROM AUTHOR]

Transformative processes generally occur singly and jointly involving the whole body. Rarely, they appear simultaneously as distinct transformative phenomena. The case study relates to a corpse found inside a storage tank in a rather unusual position, during the winter months. On external examination carried out at the crime scene, both legs and feet were out of the well bending over the storage tank and showing skeletonisation and tissue defects due to biting inflicted by the environmental macrofauna. The thighs were also skeletonised, inside the well but not immersed in the water, as was the torso which, however, was entirely corified. The colliquated shoulders, head and upper limbs were fully immersed into the water as well as the macerated hands. The corpse was exposed simultaneously to three different environmental conditions: the external setting with changes in temperature, rainfall and the action of the macro fauna, the unventilated and humid setting inside the tank, and lastly the stored water. The corpse, lying in a specific position and being exposed to different atmospheric conditions, underwent four post-mortem changes at the same time, making it challenging to estimate the time of death, based only on the available data and macroscopic findings. [ABSTRACT FROM AUTHOR]

This article addresses calculation of the thermophysical processes occurring in a thermoelectric device (TED) for the correction of cerebral hyperthermia by cooling the head. The computational model consists of solutions to three problems: determination of the temperature field of the head area undergoing cooling; determination of the parameters of the thermoelectric modules (TEM) included in the TED; determination of the characteristics of the heat removal system from the hot junctions of the thermal elements in the thermal modules. [ABSTRACT FROM AUTHOR]

Purpose: We examined magnetic field dependent SNR gains and ability to capture them with multichannel receive arrays for human head imaging in going from 7 T, the most commonly used ultrahigh magnetic field (UHF) platform at the present, to 10.5 T, which represents the emerging new frontier of >10 T in UHFs. Methods: Electromagnetic (EM) models of 31‐channel and 63‐channel multichannel arrays built for 10.5 T were developed for 10.5 T and 7 T simulations. A 7 T version of the 63‐channel array with an identical coil layout was also built. Array performance was evaluated in the EM model using a phantom mimicking the size and electrical properties of the human head and a digital human head model. Experimental data was obtained at 7 T and 10.5 T with the 63‐channel array. Ultimate intrinsic SNR (uiSNR) was calculated for the two field strengths using a voxelized cloud of dipoles enclosing the phantom or the digital human head model as a reference to assess the performance of the two arrays and field depended SNR gains. Results: uiSNR calculations in both the phantom and the digital human head model demonstrated SNR gains at 10.5 T relative to 7 T of 2.6 centrally, ˜2 at the location corresponding to the edge of the brain, ˜1.4 at the periphery. The EM models demonstrated that, centrally, both arrays captured ˜90% of the uiSNR at 7 T, but only ˜65% at 10.5 T, leading only to ˜2‐fold gain in array SNR in going from 7 to 10.5 T. This trend was also observed experimentally with the 63‐channel array capturing a larger fraction of the uiSNR at 7 T compared to 10.5 T, although the percentage of uiSNR captured were slightly lower at both field strengths compared to EM simulation results. Conclusions: Major uiSNR gains are predicted for human head imaging in going from 7 T to 10.5 T, ranging from ˜2‐fold at locations corresponding to the edge of the brain to 2.6‐fold at the center, corresponding to approximately quadratic increase with the magnetic field. Realistic 31‐ and 63‐channel receive arrays, however, approach the central uiSNR at 7 T, but fail to do so at 10.5 T, suggesting that more coils and/or different type of coils will be needed at 10.5 T and higher magnetic fields. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance imaging (MRI) has become an important diagnostic tool for paediatric patients. The association between dental restorations and MRI artefacts/distortions, however, is unclear. Aim: To investigate the association between dental restorations and artefacts in head MRI in children. Design: This retrospective analysis included patients who underwent head MRI and dental examination at Ramathibodi Hospital from January 2015 to March 2021. From dental records and dental radiographs, a dentist reviewed the amount and type of restorative materials used. Two radiologists examined the MRI scans in five sequences for the presence of distortions and quantified the magnitude and grading of any artefacts. Results: Ninety‐four patients aged 3–15 years were included. Twenty‐four patients who received preformed metal crowns (PMCs) had MRI distortions. Subjects with no restorations or with tooth‐coloured material or amalgam restorations or both did not exhibit distortions. The number of PMCs was related to the size of an artefact. Almost all distortions were confined to the oral cavity and maxillary sinus and did not affect the diagnostic brain area. Conclusion: Among the commonly used dental restorative materials for children, only PMCs were associated with artefacts on head MRI scans. [ABSTRACT FROM AUTHOR]

Craniofacial development is a critical aspect of pediatric growth, influencing fields such as physical anthropology, pediatrics, forensic sciences, and clinical practice. Objectives: This study aimed to assess the trends in craniofacial measurements and indices in Latvian children aged 1–15. Methods: The anthropometrical measurements (head circumference, length, width, facial length, and width) were conducted on 375 children according to the guidelines by R. Martin, K. Saller, and J. Prīmanis at the Anthropology laboratory at the Institute of Anatomy and Anthropology, Rīga Stradiņš University. The cephalic index (CI) and the facial or prosopic index (PI) were calculated, allowing for a detailed examination of cranial and facial proportions. The data were analyzed using descriptive and inferential statistics, including the Pearson Chi-square test and the Spearman correlation coefficient. Results: The findings revealed a consistent increase in head circumference with age, with boys generally having slightly larger heads than girls. The boys and girls exhibited growth in head length and width, particularly noticeable between 1 and 2 years of age. Facial length and width increased with age, with boys typically having longer facial lengths and broader faces than girls. The most common cephalic index category is mesocephaly, which accounts for 52.85% of the population, followed by dolichocephaly at 32.94%. Brachycephaly and hyperbrachycephaly are less prevalent, representing 11.36% and 2.86% of the population. Regarding the facial index categories, hypereuryprosopic is the most prevalent, representing 45.54% of the population, closely followed by euryprosopic at 43.74%. Mesoprosopic is significantly less common, representing only 9.95%. The least common categories are leptoprosopic and hyperleptoprosopic, with prevalences of 0.64% and 0.12%, respectively. The indices analysis showed variations across age groups, with dolichocephaly being more common at younger ages and decreasing over time. Brachycephaly and hyperbrachycephaly remained relatively stable or decreased slightly with age, while mesocephaly displayed less variation. The relationship between the FI and CI in younger age groups was typically weak to moderate and inverse, with a significance level of p < 0.001 or p < 0.01. However, no meaningful correlation was observed in older children aged 14–15. Conclusions: This study provides valuable insights into the craniofacial development of Latvian children, highlighting the measurements, cranial and facial types, and their variations across age groups. [ABSTRACT FROM AUTHOR]

Background: Thirty years ago, the first attempt by Saliba and colleagues was made to reduce the negative effects (hypercarbia) of exogenous surfactant (ES) by slowing its administration. Sixteen years later, we observed the first less invasive surfactant administration (LISA) attempt by Kribs and colleagues. Many studies, since that time, have tried to minimize the invasiveness of ES and subsequent cerebral blood flow perturbations through studies using near-infrared spectroscopy (NIRS). We sought to address this medical challenge by identifying a less problematic modality of ES administration by delivering multiple aliquots of ES instead of a single one, as typically performed. The aim of this study was to test the hypothesis that a different way of administering ES using more aliquots could be a safe alternative that should be assessed in further studies. Methods: Patients between 26 + 0 and 35 + 6 weeks of gestational age (GA) requiring ES administration were enrolled (April 2023–February 2024). Differently fractioned doses were delivered according to an arbitrary standard dosage (0.3 mL per aliquot in babies < 29 weeks; 0.6 mL in babies ≥ 29 weeks), while NIRS and transcutaneous CO2 (tCO2) monitoring were always performed. ES's effectiveness was assessed based on the reduction in the Oxygen Saturation Index (OSI) after administration. Persistent desaturation, bradycardia, and airway obstruction were defined as adverse effects and used to evaluate safety during ES administration, as well as variability in NIRS-rSO2 values and tCO2. Results: Twenty-four patients were enrolled with a median GA of 29 weeks (IQR 4.5) and BW of 1223 ± 560 g. In addition, 50% of the cohort received fewer than three aliquots, whereas the other 50% received more than three. Monitoring was started before the procedure and continued 30′ after the last ES aliquot administration. The variability in NIRS-SpO2 values was significantly higher in the group (p = 0.007) with a lower number of aliquots administered. Similarly, increased NIRS-rSO2 values (p = 0.003) and increased tCO2 levels (p = 0.005) were observed in infants who underwent an ES split after the administration of a low number of aliquots. Conclusions: Our data obtained from the group with > 3 fractionated doses of ES seem to justify the preparation of a more robust study, as the combination of reduced NIRS variability and reduced tCO2 maximum levels is consistent with more stable cerebral blood flow during the challenging time of ES administration. [ABSTRACT FROM AUTHOR]

Summary A 20‐year‐old Irish Sport Horse gelding was presented to the Royal Veterinary College Equine Referral Hospital for investigation of left‐sided epistaxis, depression and gait abnormalities of approximately 1 month duration. Physical examination and cranial nerve evaluation were unremarkable. A small amount of haemorrhagic discharge was noted from the left nostril. Gait evaluation was suggestive of proprioceptive deficits. Computed tomography (CT) identified a mass lesion within the left conchofrontal and sphenopalatine sinuses extending through the cribriform plate into the calvarium. Histopathology of the mass revealed a neuroendocrine neoplasm, for which a diagnosis of esthesioneuroblastoma was favoured. This case highlights the usefulness of CT for the identification and extent of an intracranial mass and therefore its prognosis, however, histopathological examination was necessary to confirm the diagnosis. [ABSTRACT FROM AUTHOR]

A 59-year-old woman presented to our clinic with a 3.5× 3-cm protruding mass on her forehead. A skull X-ray revealed a radiolucent osteolytic lesion on the left side of the frontal bone. Additionally, computed tomography showed a 3.1× 1.7× 3.6-cm mass exhibiting a “sunburst” pattern situated between the outer and inner tables of the skull, just superior and lateral to the left frontal sinus. This pattern suggested the presence of an intraosseous vascular malformation (IVM). The lesion was approached via a bicoronal incision. En-bloc resection was performed, removing the mass along with approximately 0.5 cm of the surrounding normal bone without injury to the exposed frontal sinus mucosa. The exposed mucosa was reinforced with a galeal flap, and cranioplasty with bone cement was performed to repair the resulting bony defect. Pathological examination confirmed a diagnosis of intraosseous cavernous-type malformation with mixed cavernous and capillary histological features. We report this case of IVM and review the existing literature, highlighting the satisfactory functional and aesthetic outcomes after surgery. [ABSTRACT FROM AUTHOR]

The aim of this study is to calculate the gains of the quantified visually enhanced vestibulo-ocular reflex (qVVOR) and the quantified vestibulo-ocular reflex suppression (qVORS), using a specific system to generate a visual suppression index (SI) in healthy subjects obtained through the gains of qVVOR and qVORS, and to determine the normal values of the index, as well as the influence of age and sex variables on the SI. Methods. This prospective observational clinical study includes 83 healthy subjects who underwent the head impulse and suppression tests (HIMP and SHIMP, respectively), qVVOR, and qVORS tests, all of the vHIT. The sinusoidal tests (qVVOR and qVORS) were conducted at an intended frequency of 0.75 Hz. The gains of these tests were calculated using a system specifically designed for this purpose. A formula for the SI was established using a ratio of the gains from these tests. Two SI values are presented: unilateral, distinct for each direction of head movement, and bilateral, representing the suppression of both sides simultaneously. Results. Mean gains for the qVVORs were 0.981 ± 0.070 and 0.978 ± 0.077 for the rightwards and leftwards qVVORs, respectively. The gains for the suppressed tests were 0.334 ± 0.112 and 0.353 ± 0.110 for the rightwards and leftwards qVORSs, respectively. A difference of 0.05 Hz was observed between the expected (0.75 Hz) and the obtained frequency of head movement, which is statistically significant (p < 0.001). The SI was 0.342 ± 0.118 for the right side (right SI) and 0.363 ± 0.117 for the left side (left SI). The bilateral SI had a mean value of 0.295 ± 0.104. No significant differences in the SI were noted according to the subject's age. The SI for women was lower than in the case of males. Conclusions: The VVOR/VORS quantification algorithm allows for the reliable calculation of the numerical gain of qVVOR and qVORS with mathematical soundness and consistency of results. Our data support the use of a single or specific measure for direction of head movement; although significant differences exist, these differences are not clinically relevant. [ABSTRACT FROM AUTHOR]

Background and aim: Head and neck nuclear protein of testis carcinoma (HN‐NUT) is a rare form of carcinoma diagnosed by NUT immunohistochemistry positivity and/or NUTM1 translocation. Although the prototype of HN‐NUT is a primitive undifferentiated round cell tumour (URC) with immunopositivity for squamous markers, it is our observation that it may assume variant histology or immunoprofile. Methods: We conducted a detailed clinicopathological review of a large retrospective cohort of 30 HN‐NUT, aiming to expand its histological and immunohistochemical spectrum. Results: The median age of patients with HN‐NUT was 39 years (range = 17–86). It affected the sinonasal tract (43%), major salivary glands (20%), thyroid (13%), oral cavity (7%), larynx (7%), neck (7%) and nasopharynx (3%). Although most cases of HN‐NUT (63%) contained a component of primitive URC tumour, 53% showed other histological features and 37% lacked a URC component altogether. Variant histological features included basaloid (33%), differentiated squamous/squamoid (37%), clear cell changes (13%), glandular differentiation (7%) and papillary architecture (10%), which could co‐exist. While most HN‐NUT were positive for keratins, p63 and p40, occasional cases (5–9%) were entirely negative. Immunopositivity for neuroendocrine markers and thyroid transcription factor‐1 was observed in 33 and 36% of cases, respectively. The outcome of HN‐NUT was dismal, with a 3‐year disease specific survival of 38%. Conclusions: HN‐NUT can affect individuals across a wide age range and arise from various head and neck sites. It exhibits a diverse spectrum of histological features and may be positive for neuroendocrine markers, potentially leading to underdiagnosis. A low threshold to perform NUT‐specific tests is necessary to accurately diagnose HN‐NUT. [ABSTRACT FROM AUTHOR]

In the developmental phase of passenger automobile hoods, it is crucial to take dent resistance and pedestrian head protection performances into account. And maintaining a performance balance between the two aspects has proven challenging. With few studies on how to effectively maintain the balance, in this paper, a certain passenger car hood was used as a basic model to investigate structural improvement directions that benefit both performances, by modifying several key variables of the honeycomb shaped inner panel one at a time and then outputting results of hood dent resistance and headform impact through Abaqus and LS-DYNA, respectively. The results indicated that raising the honeycomb inner panel structure at positions with poor stiffness contributes to improvements in dent resistance and pedestrian head protection performance, reflecting in a maximum stiffness increase of 50% and a reduction of 2.98% in the average value of HIC15 change rate. And other alternative improvement options, as well as their effects on dent resistance and pedestrian head protection performance, were provided, providing insights for optimizing the structure of vehicle hood inner panels. [ABSTRACT FROM AUTHOR]

The perception of a talker's head orientation is an ecologically relevant task. Humans are able to discriminate changes in talker head orientation using acoustic cues. Factors that may influence measures of this ability have not been well characterized. Here, we examined the minimum audible change in head orientation cues (MACHO) using diotic stimuli. The effects of several factors were tested: talker and gender, stimulus bandwidth (full-band vs low-pass filtered at 8 or 10 kHz), transducer (loudspeaker vs headphone), stimulus uncertainty (interleaved vs blocked presentation of four talkers), and vocal production mode (speech vs singing). The best performance of ∼41° was achieved for full-band, blocked presentation of speech over a loudspeaker. Greater stimulus uncertainty (interleaved presentation) worsened the MACHO by 26%. Bandlimiting at 8 and 10 kHz worsened performance by an additional 22% and 14%, respectively. At equivalent overall sound levels, performance was better for speech than for singing. There was some limited evidence for the transducer influencing the MACHO. These findings suggest the MACHO relies on multiple factors manipulated here. One of the largest, consistent effects was that of talker, suggesting head orientation cues are highly dependent on individual talker characteristics. This may be due to individual variability in speech directivity patterns. [ABSTRACT FROM AUTHOR]

Objectives Head and neck mucosal melanoma (HNMM) is a rare malignancy with high mortality. This study evaluates the impact of treatment delays on overall survival in HNMM. Design/Setting/Participants A retrospective review of patients with surgically managed HNMM treated with adjuvant radiation was performed from the 2004–2016 National Cancer Database. Main Outcome Measures Durations of diagnosis-to-treatment initiation (DTI), surgery-to-radiotherapy initiation (SRT), duration of radiotherapy (RTD), surgery-to-immunotherapy initiation (SIT), diagnosis-to-treatment end (DTE), and total treatment package (TTP) were calculated. Results A total of 1,011 patients (50.7% female, 90.5% Caucasian) met inclusion criteria. Median DTI, SRT, RTD, SIT, DTE, and TTP were 30, 49, 41, 102, 119, and 87 days, respectively. Only longer DTE was associated with decreased mortality (hazard ratio, 0.720; 95% confidence interval, 0.536–0.965; p = 0.028). Conclusion DTI, SRT, RTD, SIT, and TTP do not significantly affect overall survival in patients with HNMM who undergo surgery and adjuvant radiation. Longer DTE is associated with improved survival in this population. Level of Evidence 4. [ABSTRACT FROM AUTHOR]

Simple Summary: The Sanmartinero creole bovine (SM) is found in the department of Meta (Colombian Orinoquia) and derives from the bullfighting cattle introduced by the Spanish in the 15th century. Its adaptation process has allowed it to develop adaptive characteristics to live in extreme climatic environments. Although there are studies on its reproductive and productive characteristics, little is known about possible asymmetries in some biological structures. Fluctuating asymmetry allows us to detect a possible developmental instability that may be caused by stressful conditions. The aim of our study was to present the current state of developmental instability in two bilateral cephalic characters of the SM creole bovine. The results showed a fluctuating asymmetry biased to the left for ear and horn length, and to the right for ear width and horn perimeter. We consider that the environment in which it lives may have an impact on the development of cephalic structures, creating stress in the animal, which causes the detected asymmetry. However, the authors are not aware of any studies on this topic. Asymmetric studies can indicate disturbances in the developmental process. Fluctuating asymmetry (FA) is considered an indicator of stress. The Sanmartinero (SM) creole bovine is native to the department of Meta (Colombian Orinoquia) and its adaptation process has allowed it to live in extreme tropical environments. The aim of this cross-sectional and descriptive study was to present the current state of the knowledge of asymmetries in some cephalic characters of the SM creole bovine. A total of 94 animals were studied (18 uncastrated males and 76 females) from three different farms, with an age range of 0.5–10 years. For each animal, two measurements of the ear (width and length) and two measurements of the horn (perimeter and length) were obtained in vivo. The degree of asymmetry was calculated as (R − L)/(R + L). Bilateral differences pointed towards a fluctuating asymmetry (e.g., a random variation in the trait that is expected to be perfectly symmetrical) biased towards right for ear width and horn perimeter, and towards left for ear and horn length. Since the development of these structures—ears and horns—is under the control of the same set of genes, the fluctuating asymmetry could constitute a reflection of a normal condition. [ABSTRACT FROM AUTHOR]

The Canadian Association of Radiologists (CAR) Head and Neck Expert Panel consists of radiologists, a laryngologist and laryngeal surgeon, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 11 clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 17 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 26 recommendation statements across the 11 scenarios. This guideline presents the methods of development and the referral recommendations for sinus disease, tinnitus, thyroid and parathyroid disease, neck mass of unknown origin, acute sialadenitis, chronic salivary conditions, and temporomandibular joint dysfunction. [ABSTRACT FROM AUTHOR]

Purpose: Differentiating benign lipomas from malignant causes is challenging and preoperative investigative guidelines are not well-defined. The purpose of this study was to retrospectively identify cases of head and neck lipomas that were surgically resected over a 5-year period and to identify the radiological modality chosen and features discussed in the final report. Multidisciplinary outcomes and pathology reports were examined with a view to identifying high risk features of a lipoma to aid in future risk stratification. Methods: Retrospective chart review of pathology characteristics, radiological features (modality, size, calcifications, septations, globular/nodular foci), multidisciplinary discussion and history of presenting complaint was performed. Results: Two liposarcomas and 138 lipomas were identified. Twenty-two percent of all lipomas received radiological investigation. Twenty-two percent of imaging referrals were possibly inappropriate. Furthermore, radiological features suggestive of malignancy were not present in the final radiology report, X2 = 28.8, p < 0.0001. Conclusion: As expected, the incidence of liposarcoma is low. There is limited awareness of radiology referral guidelines superimposed with a tendency to over-investigate lipomas. Furthermore, radiological features suggestive of malignancy were inconsistently reported on and not documented in multidisciplinary discussions. Therefore, we propose a multidisciplinary checklist for referring physicians and radiologists to aid in diagnostic work-up. [ABSTRACT FROM AUTHOR]

Background: Cervical posture affects swallowing function through contractile and non‐contractile structures. Craniocervical flexor endurance training (CCFET), which focuses on the activation of deep cervical muscles, is used to ensure cervical posture stability. Objective: The aim of this study was to investigate the effect of CCFET on the suprahyoid muscles (SH), which play an important role in swallowing function. Methods: Eighty healthy individuals (52 female and 28 male, mean age 21.77 ± 1.81 years) were recruited and randomly assigned to groups that underwent either deep cervical flexor (DCF) training with a pressure biofeedback unit (CCFET group, n = 41) or no intervention (control group, n = 39). The intervention was applied for 4 weeks (five sessions per week). Static endurance and activation of DCF muscles (Craniocervical Flexion Test, CCFT), tragus–wall distance (TWD) for forward head posture and surface electromyographic (sEMG) activation of suprahyoid muscles were evaluated. Results: The endurance and activation of the DCF muscles were significantly increased in the CCFET group (p = <.001). In the CCFET group, TWD significantly lower than the control group (p = <.001) Peak SH amplitude and mean SH amplitude were lower in the CCFET group compared to the control group (p =.013, p =.003). Conclusion: The study shows that 4 weeks of CCFET reduced SH muscle activation, allowing the same work to be done with fewer motor units. CCFET can be included in rehabilitation programs as an additional method that has an effect on the muscles involved in swallowing by providing cervical motor control. [ABSTRACT FROM AUTHOR]

Importance: We compile and analyze ancient literature related to Baihui (GV20) moxibustion and summarize the development of its ancient clinical application. Observations: The Chinese Medical Classic (5th edition) was used as the search source to screen and organize articles related to Baihui moxibustion to establish a database. We created indexing norms according to study characteristics and indexed books, dynasties, literary styles, disease key words, matching acupoints, combinations, moxibustion amounts, and moxa cone sizes. SPSS version 24.0 software was used to calculate the index results. A total of 320 articles that met the requirements were finally included and were attributed to 99 ancient books, spanning from the Western Han Dynasty to the Qing Dynasty. A total of 45 keywords were used for disease evidence: the most frequent occurrences were internal medicine (primary category), limb meridians (secondary category), and head diseases (specific patterns). Conclusions and Relevance: Baihui moxibustion has been updated and developed in the literature over the ages, and the method of Baihui moxibustion is diverse. The main treatment rule of Baihui moxibustion considers the whole body and close treatment of partial diseases. Baihui moxibustion also has the rule of following meridian indications, with treatment based on syndrome differentiation and compatible application. Baihui moxibustion alone has a relatively strong effect of raising yang and lifting the sunken, which can treat the sinking of qi and deficiency. [ABSTRACT FROM AUTHOR]

Copyright of Acta Agriculturae Zhejiangensis is the property of Acta Agriculturae Zhejiangensis Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Surgical pathology of the head and neck is one of the more challenging areas in all of diagnostic pathology. Its unparalleled diversity and complexity renders it highly vulnerable to diagnostic error compelling unconstrained access to specialized diagnostic expertise. Digital pathology (DP) is a state-of-the-art tool that could facilitate access to specialized expertise, but it is relatively untested in the context of pathology consultations. In a collaboration between Labcorp Dianon and a large academic hospital with subspecialized surgical pathology, DP was implemented to provide the pathology community access to head and neck pathology expertise. From this collaborative experience, glass slides from consecutive consult cases that had been previously diagnosed using DP were reviewed by an expert consultant in a blinded manner following an extended wash-out period. The intraobserver discrepancy rate was recorded. Major discrepancies were defined as those resulting in significant impact on clinical management and/or prognosis, whereas minor discrepancies were those with no impact on care or prognosis. Slides from 57 cases were available for review. The average wash-out period was 19 months. Five discrepancies were recorded (intraobserver concordance rate of 91%). All discrepancies were minor (major discrepancy rate, 0%; minor discrepancy rate, 9%). On appraisal of the discrepant cases, discordant diagnoses were attributed to subjective differences in interpretation rather than objective differences related to the inferiority of DP. DP decreased the median turnaround time by 97% (from 70 h 26 min to 2 h 25 min). DP provides efficient and fast access to expert consultants. The speed of case delivery does not compromise diagnostic precision. Discrepancies are uncommon, minor, and reflect subjective interpretative differences inherent to difficult and ambiguous head and neck cases, and not the inferiority of DP as a diagnostic platform. High concordance can be achieved even for those difficult and complex cases that are concentrated in the consultation practice. This observation carries profound implications regarding universal health care access to specialized diagnostic expertise. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the functional and prognostic outcomes associated with the internal mammary artery perforator (IMAP) flap in various head and neck defect repairs, given the current lack of clarity on its effectiveness. We performed a systematic review of various databases: PubMed, Embase, Scopus, Web of Science, and ScienceDirect using keywords such as "Internal mammary artery perforator flap" and "IMAP." Screening and data extractions were performed by two individual reviewers. Articles were considered eligible if they included sufficient information on IMAP flap features, their applications in the head and neck, and outcomes. From 264 articles analyzed, 24 studies were included for qualitative analysis. Out of which, 125 patients who received internal mammary artery perforator flaps were included. Most of the patients, 103 (88%), received pedicled IMAP flaps, and 22 (12%) received IMAP free flaps. The second internal mammary artery (IMA) was favored as the single perforator (81.5%), with the combination of the first and second IMA being the primary choice for dual perforators (92.5%). IMAP flaps were predominantly single perforator flaps (65%), with 35% being dual perforator flaps. Among various applications, IMAP flaps are commonly employed in the reconstruction of neck defects (25.5%), pharyngocutaneous fistula repair (20.8%), and burn scar contracture restoration (8%). Only seven (5.6%) patients had flap complications, including venous congestion (1.6%), partial necrosis (1.6%), complete necrosis (1.6%), and incision dehiscence (0.8%). Donor sites were predominantly closed by the primary closure (92%). 3.2% of donor sites had minor complications. The average follow‐up was 12.6 (IQR: 6–18) months. This systematic review highlights the effectiveness and safety of IMAP flaps in head and neck reconstruction, with positive outcomes and minimal complications. [ABSTRACT FROM AUTHOR]

Background: Medication related osteonecrosis of the jaw (MRONJ) requiring free flap (FF) reconstruction is uncommon with limited reported findings. Methods: Multicenter, retrospective case series of 49 consecutive adult patients presenting with advanced MRONJ requiring FF reconstruction from 2010 to 2022. Perioperative complications and outcomes were analyzed. Results: Eighty‐two percent (n = 40) of cases were of the mandible and 18% (n = 9) were of the maxilla. The mean follow‐up was 15 months (±19.6). The majority of FF survived (96%, n = 47). FF reconstructions of the maxilla were more likely to require postoperative debridement (56%, 95% CI [27, 81%] vs. 15%, 95% CI [7, 25%], p = 0.008) or develop intraoral bone exposure (56%, 95% CI [27, 81%] vs. 18%, 95% CI [9, 27%], p = 0.02). Most patients (71%, n = 35) received preoperative antibiotics which was associated with a higher rate of FF survival (100% vs. 86%, 95% CI [60, 96%], p = 0.02) and fewer complications. Conclusions: Patients undergoing FF reconstruction for MRONJ do well with high rates of FF success. MRONJ of the maxilla have a higher rate of some complications. Preoperative antibiotics correlated with higher FF survival and fewer postoperative complications. [ABSTRACT FROM AUTHOR]

Head and neck squamous cell carcinomas (HNSCCs) have an increasing incidence, high recurrence, and an overall unfavorable prognosis despite numerous treatment options. The distinct immune landscape of HNSCC suggests a potential for immune-related biomarkers to aid classification and treatment planning. Immunoscore, a multiplex measure of tumor-infiltrating immune cells, is currently approved in colorectal carcinoma and is under investigation in various other cancer types. Recent studies have tried to implement the immunoscore and other novel immune cell-based scoring systems in HNSCC as predictors of survival. This study provides an overview of tumor-infiltrating immune cells and their prognostic significance, as well as a comparative summary of studies introducing an immunoscore in HNSCC. With sufficient insight of the current literature, future studies could lead to the definition and validation of a new immune-based classification system for HNSCC. Such a classification strategy could be the basis for patient selection and, thus, optimize treatment outcomes and reduce unwanted complications. The heterogeneity of HNSCC subtypes, as well as the intratumoral variability of immune infiltrates, should be accounted for in the immunoscore. [ABSTRACT FROM AUTHOR]

To increase granularity in human neuroimaging science, we designed and built a next-generation 7 Tesla magnetic resonance imaging scanner to reach ultra-high resolution by implementing several advances in hardware. To improve spatial encoding and increase the image signal-to-noise ratio, we developed a head-only asymmetric gradient coil (200 mT m-1, 900 T m-1s-1) with an additional third layer of windings. We integrated a 128-channel receiver system with 64- and 96-channel receiver coil arrays to boost signal in the cerebral cortex while reducing g-factor noise to enable higher accelerations. A 16-channel transmit system reduced power deposition and improved image uniformity. The scanner routinely performs functional imaging studies at 0.35-0.45 mm isotropic spatial resolution to reveal cortical layer functional activity, achieves high angular resolution in diffusion imaging and reduces acquisition time for both functional and structural imaging.

BACKGROUND: Langerhans cell histiocytosis (LCH) is a neoplastic transformation of myeloid precursors that commonly presents as an osteolytic lesion of the long or flat bones in children. Aneurysmal bone cysts (ABC) are benign neoplasms that frequently affect the metaphysis of long bones and the spine, often revealing a rapidly expansile lesion with fluid-fluid levels. LCH with secondary ABC-like changes is a rare condition that has only been reported five times, with two presentations in the cranium. The aim of this paper is to review the etiology, clinical and radiographic presentations, and treatment of this condition, as well as to present a novel case on the topic. CASE DESCRIPTION: We describe a 5-year-old boy with a rapidly growing head mass and eye pain resulting in a diagnosis of LCH with secondary ABC-like changes. Radiography demonstrated an expansile, lytic lesion of the left parietal bone with fluid-fluid levels. A confirmatory diagnosis was made through histopathology, demonstrating an inflammatory, histiocytic infiltrate staining positive for CD1a, CD68, CD207 (Langerin), and S-100. The lesion was surgically excised, and the patient recovered without any complications. CONCLUSION: We present a novel case of LCH with secondary ABC-like changes managed with surgical excision. While a radiographic workup with multiple imaging modalities is helpful for diagnosis, a thorough immunohistochemical analysis is essential as imaging characteristics are variable and nonspecific. Furthermore, surgical excision should be considered first-line treatment for lesions involving the skull in surgically accessible areas as it is curative, alleviates symptoms, and allows for histopathological diagnosis.

Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive cutaneous sarcoma with a propensity for recurrence. Its management, particularly in the head and neck (H&N) region, presents unique challenges. This study aimed to evaluate the effectiveness of Mohs micrographic surgery (MMS) compared to wide local excision (WLE) in treating H&N DFSP and its impact on recurrence rates and tissue preservation. A comprehensive search was conducted in PubMed/MEDLINE, yielding 29 relevant studies. We included studies comparing MMS and WLE in adult patients with H&N DFSP and reporting local recurrence outcomes. Data were analyzed using random effects analysis, with a meta-analysis performed for comparative studies. Analysis of studies demonstrated a lower recurrence for MMS. Comparative analysis of five studies involving 117 patients showed a significantly lower recurrence rate in the MMS group (2%) compared to the WLE group (19%). Margin status varied between studies, with some achieving negative margins at shorter distances. In the management of H&N DFSP, MMS has emerged as a superior surgical technique, consistently associated with reduced recurrence rates and the potential for tissue preservation. The adoption of MMS should be considered for its capacity to achieve negative margins with fewer processing steps, particularly in anatomically complex regions like the H&N. [ABSTRACT FROM AUTHOR]

Objective Error in birthweight prediction by sonographic estimated fetal weight (EFW) has clinical implications, such as avoidable cesarean or misclassification of fetal risk in labor. We aimed to evaluate optimal timing of ultrasound and which fetal measurements contribute to error in fetal ultrasound estimations of birth size at the extremes of birthweight. Study Design We compared differences in head circumference (HC), abdominal circumference (AC), femur length, and EFW between ultrasound and corresponding birth measurements within 14 (n = 1,290) and 7 (n = 617) days of birth for small- (SGA, <10th percentile), appropriate- (AGA, 10th–90th), and large-for-gestational age (LGA, >90th) newborns. Results Average differences between EFW and birthweight for SGA neonates were: −40.2 g (confidence interval [CI]: −82.1, 1.6) at 14 days versus 13.6 g (CI: −52.4, 79.7) at 7 days; for AGA, −122.4 g (−139.6, −105.1) at 14 days versus −27.2 g (−50.4, −4.0) at 7 days; and for LGA, −242.8 g (−306.5, −179.1) at 14 days versus −72.1 g (−152.0, 7.9) at 7 days. Differences between fetal and neonatal HC were larger at 14 versus 7 days, and similar to patterns for EFW and birthweight, differences were the largest for LGA at both intervals. In contrast, differences between fetal and neonatal AC were larger at 7 versus 14 days, suggesting larger error in AC estimation closer to birth. Conclusion Using a standardized ultrasound protocol, SGA neonates had ultrasound measurements closer to actual birth measurements compared with AGA or LGA neonates. LGA neonates had the largest differences between fetal and neonatal size, with measurements 14 days from delivery showing 3- to 4-fold greater differences from birthweight. Differences in EFW and birthweight may not be explained by a single fetal measurement; whether estimation may be improved by incorporation of other knowable factors should be evaluated in future research. Key Points Ultrasound measurements may be inadequate to predict neonatal size at birth. Birthweight estimation error is higher for neonates >90th percentile. There is higher error in AC closer to birth. [ABSTRACT FROM AUTHOR]

Infants are sensitive to distortions to the global configurations of bodies by 3.5 months of age, suggesting an early onset of body knowledge. It is unclear, however, whether such sensitivity indicates knowledge of the location of specific body parts or solely reflects sensitivity to the overall gestalt of bodies. This study addressed this issue by examining whether, like adults, infants attend to specific locations where body parts have been reorganized. Results show that adults and 5‐month‐olds, but not 3.5‐month‐olds, allocated more attention to the body joint areas (e.g., where the arm connects to the shoulder) that were reorganized versus ones that were typical. To examine whether this kind of processing is driven by low‐level features, 5‐month‐olds were tested on images in which the head was removed. Infants no longer exhibited differential scanning of typical versus reorganized bodies. Results suggest that 5‐month‐olds are sensitive to the location of body parts, thereby demonstrating adult‐like response patterns consistent with early expertise in body processing. The contrasting failure of 3.5‐month‐olds to exhibit sensitivity to the reorganization suggests a developmental change between these ages. [ABSTRACT FROM AUTHOR]