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BACKGROUND: Sympathetic-mediated vasoconstriction from the superior cervical ganglion (SCG) is a significant contributor to cerebral vasospasm. Inhibition of the SCG has been shown to improve cerebral blood flow and reverse cerebral vasospasm in swine models. We evaluated the efficacy of a novel minimally invasive endovascular approach to target and pharmacologically inhibit the SCG, using a Micro-Infusion Device for transmural drug delivery. METHODS: Eight SCGs in four Yorkshire swine were surgically identified. After confirming appropriate sympathetic-mediated intracranial vasoconstriction response with SCG stimulation, an endovascular Micro-Infusion Device was used for transmural targeting of the SCG and delivery of 1.5-2 mL of 1% lidocaine-contrast mixture to the perivascular space. Digital subtraction angiography was obtained at: (1) baseline; (2) with SCG stimulation; and (3) after lidocaine delivery to the SCG using the Micro-Infusion Device with concurrent SCG stimulation. Vessel diameters were measured and compared. RESULTS: Endovascular transmural delivery of lidocaine to the SCG and carotid perivascular tissue using the Micro-Infusion Device successfully inhibited sympathetic-mediated vasoconstriction response. Measured vessel diameters after lidocaine delivery were comparable to baseline despite SCG stimulation. CONCLUSION: A novel endovascular technique of transmural delivery of lidocaine to the SCG and carotid artery perivascular tissues successfully inhibits the sympathetic input to the cerebral vasculature and modulates sympathetic-mediated cerebral vasospasm. These results suggest promising steps towards translation to potential clinical use for patients suffering from cerebral vasospasm.

Fibroelastolytic papulosis (FEP) is an acquired cutaneous disorder of elastin that encompasses both white fibrous papulosis of the neck (WFPN) and pseudoxanthoma elasticum (PXE)-like papillary dermal elastolysis (PDE). Although FEP is a benign acquired disorder, it shares overlapping clinical features with pseudoxanthoma elasticum (PXE), a genetic disorder with systemic manifestations. We report two cases of FEP, including the WFPN and PXE-like PDE variants, in elderly women. In one case, a woman in her 70s with hyperlipidemia and chronic kidney disease presented with white-to-yellow, smooth, monomorphic papules coalescing into plaques on the posterior neck and bilateral antecubital fossa. A punch biopsy and elastic stain revealed a loss of elastic fibers in the papillary dermis. Based on these findings, we diagnosed our patient with PXE-like PDE. In another case, a woman in her 60s with no significant medical history similarly presented with skin-colored, smooth monomorphic papules on the posterior and anterior neck. A punch biopsy was also performed and an elastic stain showed a loss of elastic fibers in the papillary dermis, confirming the diagnosis of WFPN. Although rare, FEP is an important entity for dermatologists to recognize and differentiate from PXE given the potential for systemic complications in PXE.

BACKGROUND: Detailed descriptions of clinical signs associated with radiological findings of the caudal cervical vertebral column are not available. OBJECTIVES/HYPOTHESES: Describe the clinical features associated with neck pain or stiffness, neck-related thoracic limb lameness, proprioceptive ataxia consistent with a cervicothoracic spinal cord or nerve lesion, and their frequency of occurrence compared with control horses. ANIMALS: A total of 223 Warmblood horses. METHODS: Case-control study. Controls and cases were recruited prospectively. All horses underwent predetermined lameness and neurologic examinations. The frequency of occurrence of each clinical feature was compared between cases and controls and relative risk (RR) were calculated. RESULTS: Ninety-six cases and 127 controls were included. Forty-seven (49%) of the cases were classified as neurologic, 31 (32.3%) had thoracic limb lameness, and 18 (18.7%) had neck stiffness or pain or both. Focal caudal cervical muscle atrophy (46, 47.9%), hypoesthesia (38, 39.6%), patchy sweating (16, 16.7%), hyperesthesia (11, 11.5%), and pain upon firm pressure applied over the caudal cervical articular process joints and transverse processes (58, 60.4%) were only observed in cases (P

Trigeminal schwannomas are rare tumours comprising 0.2% of all intracranial tumours and 0.5% of all head and neck tumours. Patients with trigeminal schwannomas presented with facial hypoesthesia and pain. We presented a case with left bulging oropharynx. The CT scan showed a 3.8x2.6x4.9cm left parapharyngeal tumour compressed to the oropharynx and middle cranial fossa. We performed 3 ways in two times of operation to excise the whole tumour. We chose the transoral approach for parapharyngeal space, trans-parotid approach for deep parotid part and the endoscopic endonasal trans-pterygoid approach and trans-maxillary with Canine fossa trephination for intracranial lesions. The pathology showed schwannoma. A huge schwannoma extended from intracranial to several spaces is difficult to resect just by one approach. We should separate the tumour to several parts by clinical image before the operation and design a plan to remove the whole tumour in different approach. The different space of tumour involvement had several ways to access. We needed to choose the less harm but with better surgical field. [ABSTRACT FROM AUTHOR]

Tracheobronchial chondritis is a rare immune-related adverse event (irAE) associated with immune checkpoint inhibitors. We report a case wherein tracheobronchial chondritis occurred while administering nivolumab for recurrent hypopharyngeal squamous cell carcinoma (SCC) in a man diagnosed with T2N3bM0 stage IVB hypopharyngeal SCC. After treatment with cisplatin and radiotherapy followed by left and right neck dissection, local recurrence was observed in the hypopharynx. Because of the difficulty of salvage surgery, we administered 240 mg/body of nivolumab. After 9 cycles of nivolumab, the patient was judged to have complete response. After 10 cycles, he had cough and sputum, for which prompting us to perform imaging tests. Computed tomography (CT) showed edematous thickening around the trachea and bilateral bronchi and elevated amounts of adjacent subcutaneous fat tissue. Positron emission tomography-CT showed diffuse fluorodeoxyglucose uptake in the trachea and bilateral bronchi, bronchial endoscopy showed redness and swelling throughout the bronchi, and biopsy showed partial mucosal erosion, inflammatory cell (lymphocyte) infiltration, interstitial edema, and desmoplasia. The patient was diagnosed with tracheobronchial chondritis as an irAE resulting from administering anti-programmed death-1 monoclonal antibody. After four-day prednisolone treatment, his cough and sputum disappeared; after two weeks, tracheobronchial chondritis no longer appeared on CT. [ABSTRACT FROM AUTHOR]

Duplication, accessory slips, and division of the rectus capitis posterior muscles are rare anatomical variations. Here we report a case of unilateral doubling of rectus capitis posterior major, and doubling of rectus capitis posterior minor with an accessory slip originating from the spinous process of the second cervical vertebra. The gross anatomical characteristics, clinical significance, and relationship of suboccipital musculature to the cervical myodural bridge is discussed in this report. Knowledge of rectus capitis posterior muscle variations may be of interest to clinicians practicing surgical approaches to the posterior cervical region due to the close proximity of the variations to typical muscular and neurovascular structures of the suboccipital region and potential association with the cervical myodural bridge. [ABSTRACT FROM AUTHOR]

Objective: The present study describes a rare anatomical variation of the anterior jugular vein (AJV) and discusses its clinical relevance. Methods: A head and neck specimen fixed in 10% formaldehyde from a 42-year-old female cadaver was submitted to angio technique with pre-vulcanized latex and water-soluble ink. During a routine dissection for the discipline of topographic anatomy, the presence of an arcuate AJV was detected in the anterior triangle of the neck. Results: An arcuate AJV was formed by the confluence of the submental and facial veins in the left submandibular region, which presented a complex network of anastomoses superficially to the left submandibular gland. After its origin, this vessel curved to the right at the level of the laryngeal prominence and followed the medial border of the right sternohyoid muscle to flow into the right AJV. In this topography, the arcuate AJV was located between the sternocleidomastoid muscle's anterior margin and the thyroid gland's right lobe. The presence of anastomoses between the two AJVs communicating the submandibular triangles was not detected. Conclusion: The arcuate AJV is a relevant anatomical variant in the superficial venous drainage of the neck that should be known by head and neck surgeons and radiologists to avoid surgical iatrogenic events. [ABSTRACT FROM AUTHOR]

Purpose: To report the morphologic and spatial relationships of a bilateral sternalis muscle variant. Methods: Routine cadaveric dissection in an undergraduate anatomy laboratory revealed two sternalis muscles parasternal to the sternal body. Subsequent fine prosection of the anterior thoracic wall and neck was carried out to uncover the soft tissue attachments of both sternalis muscles. Positional relationship to neighboring anterior thoracic and neck structures, and geometric dimensions of the muscle bellies and tendons, were documented. Results: Both sternalis muscles were imbedded in the pectoral fascia, with their muscle fibers running obliquely to the midsternal line. The right sternalis muscle was notably larger in length, width, and thickness compared to the sternalis muscle on the left. The right sternalis muscle featured a distinct superior cord-like intermediate tendon that traversed superolateral and fused directly with the contralateral sternomastoid and sterno-occipital portions of the left sternocleidomastoid muscle. The superior tendon of the left sternalis muscle was aponeurotic and affixed to the cord-tendon of the right sternalis muscle. A distinct tendinous entheses for the sternal head for both sternocleidomastoid muscles were noted at the manubrial body. Conclusions: This case report describes a unique bilateral sternalis muscle variant with conjoined sternocleidomastoid muscle integration. This anatomical description of a sternalis-sternocleidomastoid muscle morphology may supplement radiographic interpretations and support diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Aim: To determine differences in physical examination findings between people with acute whiplash-associated disorders (WAD) with and without headache. Methods: In this cross-sectional study, participants with acute WAD were evaluated to assess differences in the presence of physical impairments. The following were assessed: pain intensity on manual palpation the over spinous process of C1-C3, zygapophyseal joints of C0-C4, and trapezius, sternocleidomastoid, suboccipitalis, masseter and temporalis muscles; cervical range of motion (ROM); flexion-rotation test (FRT); forward head posture; cranio-cervical flexion test (CCFT); neck flexor and extensor endurance; pressure-pain thresholds (PPT) over neural structures and upper limb neural tests (ULNT) in addition to median UNLT + CCF. Correlation analyses were performed to assess the association between examination findings and headache intensity. Logistic regression and discriminant analyses were also performed. Results: Forty-seven participants (26 men and 21 women; mean age = 38.9 years old) were included in the study. 60% of the participants presented with headache. Several examination findings were significantly different between groups. A group of examination findings composed of neck endurance, manual palpation over cervical and muscular structures, PPT, CCFT, ROM and FRT could discriminate between groups with a sensitivity of 86.7% and specificity of 90%. Conclusions: Several neuromusculoskeletal features are different between people with acute WAD with or without headache. A combination of features could distinguish between groups with high levels of sensitivity and specificity. [ABSTRACT FROM AUTHOR]

Background: Harlequin syndrome is a rare autonomic condition consisting of unilateral facial flushing and sweating induced by heat, emotion or physical activity. The affected side presents anhidrosis and midline facial pallor due to denervation of the sympathetic fibers. Case Description: This case describes a patient who reported right-side redness of the face associated with hyperhidrosis during physical activity. She had two previous major motor vehicle accidents. The patient demonstrated difficulties in the visual accommodation of the left eye, but cranial nerve assessment was unremarkable; the patient was then referred to an ophthalmologist, who excluded any autonomic dysfunction as the primary cause of convergence and visual acuity. Outcomes: A left-sided sympathetic dysfunction with Harlequin sign diagnosis was made followed by a progressive compensatory adaptation of the right face. The patient was educated and reassured about the benign nature of her problem. Discussion: Knowledge of the autonomic nervous system is still limited in clinical practice. Although challenging, physiotherapists should develop the knowledge and ability needed to perform appropriate assessment of autonomic dysfunctions. Conclusion: A dispositional reasoning model should be considered in differential diagnosis. [ABSTRACT FROM AUTHOR]

Papillary thyroid carcinoma, the most common subtype of thyroid malignancy, rarely presents with ulcerated cutaneous spread. Given the rarity of such a clinical presentation, the diagnosis may be delayed and often the initial diagnosis may be incorrect. Few case reports have been published in the literature noting unusual or interesting presentations of thyroid carcinomas with cutaneous spread. A case of a 60-year-old female who presented with an ulcerated anterior neck lesion, who was investigated fully radiologically and histopathologically and went through intricate surgical and adjuvant treatment following the diagnosis of papillary carcinoma thyroid presenting with ulcerated cutaneous lesion is being discussed here. [ABSTRACT FROM AUTHOR]

Embryonal rhabdomyosarcoma is the malignant mesenchymal proliferation of undifferentiated skeletal muscle. It is the most common soft tissue tumour found in children. Head and neck location accounts for 40% of the cases with the most common variants being of embryonal Nasopharyngeal RMS is a type of parameningeal RMS (arising from tissues adjacent to the meninges) having propensity for CNS and known for having a poorer prognosis, early recurrence, rapid growth and invasion to adjacent structures. Other types of RMS include orbital and non-orbital/non-parameningeal. Here, we encountered a rare case of a 5 year old boy presenting with complaints of epistaxis. On anterior rhinoscopy of the nose, no apparent mass could be visualised. However, on oral examination, a right sided oropharyngeal bulge was noted. Clinical evidence was corroborated radiologically with MRI neck findings which suggested a hyperintense lesion with heterogeneous enhancement in the region of right side of nasopharynx extending laterally into parapharyngeal region and carotid space, encasing the right internal carotid artery with narrowing of nasopharyngeal airway. Hence, biopsy was taken from the nasopharynx and a diagnosis of embryonal rhabdomyosarcoma - botryoid type was made which was confirmed with IHC markers. [ABSTRACT FROM AUTHOR]

Creating tight and durable profile neck results has perhaps become the principal objective of many surgeons. On social media such results are quickly recognized by colleagues and potential clients alike, much more so than "en-face" results. Yet individual patient characteristics play an essential role in determining if such results are technically possible and also dictate which techniques are required to achieve it. In many patients, these techniques involve manipulation of the deeper neck structures and are oriented more laterally than the direct submental region. Each surgeon needs to decide which technique feels proportionate in terms of an individualized risk–benefit analysis. [ABSTRACT FROM AUTHOR]

I converted to the extended deep plane facelift and neck lift with a shorter skin flap elevation in the face to achieve a more complete release of the facial ligaments to obtain more mobilization of the skin/superficial musculoaponeurotic system composite flap, and a more medial suspension resulting in improved correction of the midface, nasolabial fold, marionette fold and jowl. Treatment of the deep neck structures allowed for more refinement of the submentum in the deep neck lift procedures as well. In this article, we shall review the surgical technique of the deep plane facelift and neck lift as well as postoperative management pearls, the management of complications from the procedure, and the incorporation of ancillary procedures. [ABSTRACT FROM AUTHOR]

In this article, Dr. Stephen W. Perkins, a seasoned facial plastic surgeon, presents his refined techniques in facelift surgery developed over four decades of practice. His evolution from traditional methods to the current composite tissue deep plane facelift is elucidated. His composite tissue deep plane facelift involves meticulous dissection and repositioning of the superficial musculoaponeurotic system (SMAS) and platysma in the deep plane, as well as incorporating his innovative "Perkins' Kelly clamp anterior platysmaplasty." This technique, refined through years of experience, aims for natural, enduring results, crucially addressing patient concerns such as jowling and neck laxity. Long-term analysis reveals the advantages of Dr. Perkins' technique, particularly in achieving sustained cervicomental angle improvement for over a decade postoperatively. This article underscores the importance of understanding deep plane facelift techniques, distinguishing between different approaches, and tailoring surgical interventions to individual patient characteristics. Dr. Perkins' comprehensive approach, incorporating advancements in surgical technique and meticulous patient care protocols, exemplifies the goal of achieving natural, long-lasting facial rejuvenation. [ABSTRACT FROM AUTHOR]

Patients seek second facelifts either due to dissatisfaction with the primary procedure or years later after continued face and neck aging following successful first surgery. Previous surgical anatomical disruption, deformity of tension and vector, scar formation and skin excision compounded by the proliferation of historical energy-based skin treatments, thread lift procedures, and injectables make revision rhytidectomy a complex process of causal identification and surgical repair. Patients seeking revision due to dissatisfaction with a primary procedure, or worse visible deformity, have a heightened sense of anxiety which necessitates accurate diagnosis, careful examination, comprehensive documentation, and confidence in any planned secondary intervention as well as conservative expectation management. This article outlines the author's approach to identify the challenges posed and successfully perform secondary and revision rhytidectomy using a modified extended deep plane approach. [ABSTRACT FROM AUTHOR]

The aged neck is the most common motivator for patients seeking facial rejuvenation. Unlike the deflated midface, surgical treatment is still the gold standard for optimal outcomes. It is our view that the majority etiology of both the aged neck and deflated midface is gravity's effects on the superficial soft tissue envelope, leading to soft tissue redundancy. It is also our view that the deep-plane rhytidectomy is supported by anatomy, embryology, and clinical evidence as the best methodology to treat soft tissue redundancy without producing the aesthetic and longevity issues associated with superficial musculoaponeurotic system techniques. As one of the early pioneers in deep-plane rhytidectomy, the lead author will define contemporary advances in deep-plane technique such as dissection entry point, flap design, and flap fixation concepts that allow aggressive approach to treating both the aged neck and deflated midface. [ABSTRACT FROM AUTHOR]

This article seeks to expand on our understanding of lifting by utilizing the benefits of deep plane release and repositioning. The deep plane is a more logical and natural approach to lifting of the face and neck, lifting along the natural anatomic glide planes. Deep plane face and neck lifting have demonstrated superior results in the authors' experience with less dependence on ancillary measures such as fat grafting or implantation for midface volumization. The deep plane technique allows for the face and neck to be treated and lifted as a single composite unit, providing a more natural and long-lasting result and less distortion of underlying structures (i.e., mimetic muscle function). Among facelift surgeons, there is still debate and discussion over treatment of various regions including submandibular gland prominence, jowling and deepened prejowl sulcus, anterior digastric prominence, and a low hyoid. In this article, given the opportunity to share personal experiences, we seek to provide additional insight on the merits of deep plane release in rhytidectomy and our novel approaches to avoiding surgical failures. [ABSTRACT FROM AUTHOR]

The fundamental goal of modern face and neck lifting is to enhance and restore a more youthful facial appearance by addressing soft tissue descent. There are variations in described facelift technique including superficial musculoaponeurotic system (SMAS) flaps, composite flaps, deep plane, skin flaps, and subperiosteal facelifts, among others. The term "deep plane rhytidectomy" was originally described by Hamra. This term has since been linked with facelift surgery with recent advances including incision placement, treatments of SMAS–platysma complex, and mastoid crevasse among others. In the lead authors' experience, using deep plane techniques have demonstrated superior facial surgical rejuvenation results with less dependence on ancillary measures such as fat grafting or implantation for midface volumization. In order to successfully perform any face or neck lift, it is key to understand the relationship of the skin, the fat compartments, and the ligamentous attachments. This chapter details the anatomy of the deep plane of the face and neck and explains some nuances as it relates to surgical lifting. We also describe recent anatomical revelations of the mandibular ligament and its management in deep plane face lifting. In this chapter, given this opportunity to share personal experiences and preferences, the authors hope to describe relevant anatomy for the deep plane and provide some clarity on the merits of deep plane face and neck lift technique. [ABSTRACT FROM AUTHOR]

Rhytidectomy has witnessed significant advancements in recent years, particularly in the realms deep plane facelift and more aggressive neck contouring. As the procedures have become increasingly intricate and invasive, the imperative to develop refined tools and methodologies has risen. These tools and methods are essential not only for the evaluation of aesthetic outcomes but also for the comprehensive assessment of inherent risks and the holistic enhancement of patients' quality of life. [ABSTRACT FROM AUTHOR]

Objectives: A pyriform sinus fistula (PSF) is a rare congenital anomaly due to failed obliteration of the third or fourth pharyngeal pouch. Diagnosis and management of PSF remains controversial. We present a case of PSF and discuss its diagnosis and management. Methods: Case report and literature review. Results: A 26-year-old female with a chronic left lateral neck abscess was diagnosed with a left PSF. She underwent surgery through a combined approach to close the openings of the PSF, internally and externally. We first placed a blunted ET tube into the internal opening of the PSF. We then performed an external transcervical approach to close the PSF at the cricothyroid membrane. Briefly, after a neck debridement and washout of the chronic neck infection, we identified the recurrent laryngeal nerve (RLN) in Lore's triangle. We performed left hemithyroidectomy to facilitate the dissection and protection of the RLN to its entrance into the larynx. A flexible laryngoscope was then inserted into the left piriform sinus through the ET tube to guide external dissection by transillumination. The scar tissue attached to the superior pole of the left thyroid lobe was then ligated and divided along the cricothyroid membrane. Lastly, we cauterized the internal opening of the PSF. The patient has remained recurrence-free for 1.5 years with normal vocal cord mobility. Histopathology revealed presence of a squamous-lined tract adjacent to the thyroid tissue. Conclusions: Surgical treatment for patients with PSF should be aimed at closing the internal and external openings of the PSF, debriding chronic neck infection, and protecting the laryngeal nerves, instead of removing the entire tract. A concurrent hemithyroidectomy facilitates the identification and protection of the RLN, as well as excision of the tract. Differentiation between third and fourth branchial cleft fistulae may not be clinically necessary, as it is unlikely to alter the therapeutic plan. [ABSTRACT FROM AUTHOR]

Adenoid ameloblastoma (AA) was recently recognised as a separate tumour type in the most recent World Health Organisation (WHO) classification of head and neck tumours. This decision has been considered controversial by several groups, who have described AA as a subtype of ameloblastoma, a hybrid odontogenic tumour or to fall within the spectrum of other recognised odontogenic tumours, including dentinogenic ghost cell tumour and adenomatoid odontogenic tumour. Here we review the reasons for the WHO decision to classify AA as a separate tumour type. We also critique molecular and histological findings from recent reports published since the WHO classification. While acknowledging that the classification of tumours is constantly evolving, the balance of current evidence suggests that AA should remain a distinct tumour type, and not a subtype of ameloblastoma, pending further molecular characterisation. [ABSTRACT FROM AUTHOR]

In monitoring transmission line external damage prevention, due to the limited memory computing power of the equipment, the image needs to be transmitted to the data center at regular intervals, resulting in a high false negative rate. Therefore, this paper proposes a target detection method based on lightweight YOLOv5s. First, DSConv and improved E‐ELAN are used in Backbone to reduce the model's parameters. Then, GSConv and VoV‐GSCSP are introduced in Neck to reduce the complexity of the model. Finally, the Mish activation function achieves more effective feature transfer. According to the experimental findings, the proposed model's parameters are about 37% smaller than the original model's, and the calculation amount is about 53% smaller. The detection accuracy on the self‐built data set is the same, which proves that the proposed algorithm can reduce the model while maintaining high detection performance. It has specific practical significance for the terminal real‐time detection of external mechanical damage targets. © 2024 Institute of Electrical Engineers of Japan and Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

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]

It is necessary to analyse the injury risk caused by UAV to establish management standards. A lightweight quadrotor UAV was used to assess the risk of human head and neck injury, taking the impact speed, UAV position, and impact angle into account. First, the MAVIC2 UAV- Hybrid III dummy impacting FE model was developed and verified against the UAV impact tests. Second, lots of simulations were conducted under different impact scenarios to analyse the head and neck injury. Under vertical impact condition, HIC and Nij grew exponentially as the impact speed increased. While under the horizontal impact condition, HIC increased in the form of the power function and Nij increased exponentially. Under vertical impact condition at 20 m/s (maximum flight speed, corresponding to the impact energy of 181.4 J), the HIC was 54% of the threshold, while the Nij was 88% of the threshold, which illustrated that the injury risk of the neck was high, while that of the head was low. Under horizontal impact condition at 20 m/s (181.4 J), the HIC was 51% of the threshold, and the Nij was 24% of the threshold, which illustrated that the injury risk of both the head and neck was low. HIC declined exponentially as the impact angle increased, whereas Nij increased in the form of the power function. Among all the impact positions, the UAV's arm caused the least injury risk, while the transverse falling attitude between the two arms and the reverse vertical falling attitude generated higher injury risks. [ABSTRACT FROM AUTHOR]

Background Every region of the face may bear the signs of aging. Treating isolated areas without adequate anatomical knowledge can lead to incomplete or artificial-looking results and decrease patient satisfaction. The authors' "Full SMAS" technique for complete rejuvenation addresses the anatomical continuity of the superficial musculoaponeurotic system (SMAS)-platysma to the deep-plane suspension of the face. Objectives The aim of this study was to evaluate the contribution of endoscopic techniques to traditional facelift and neck lift procedures. Procedures treating from the frontal and temporal regions of the superior part of the face to its mid and lower parts, including the cervical region, were evaluated. Methods Treatment of the 3 sub-SMAS layers of the face was performed using endoscopy for repositioning the frontal region and midface. This procedure involved frontal and zygomatic-masseter ligament release, open treatment of the lower subplatysmal section, and the complete release of the retaining ligaments of the face and approach to the jowl. Results One hundred sixty-one patients underwent the Full SMAS technique, leading to long-lasting results, low complication rates, and high patient satisfaction. Conclusions The Full SMAS is a systematic technique that provides complete facial rejuvenation by combining an endoscopic approach for the temporal and midface regions with traditional open approaches for the lower face and neck. Treating the temporal and midface regions by minimally invasive techniques (endoscopy) reduces the possibility of permanent nerve injuries, provides smaller scars, and creates natural, long-lasting results. Level of Evidence: 4 (Therapeutic) [ABSTRACT FROM AUTHOR]

Background: The scapula free flap is becoming increasingly more utilized in head and neck reconstruction due to its natural geometry and soft tissue versatility. This study reviews the incidence rate, risk factors, and treatments of complications of scapula donor site morbidity. Methods: A review was performed for articles published between October 1990 and November 2022 in Medline (OVID), PubMed, Web of Science, and CENTRAL. After screening, 24 articles meeting the criteria were included. Results: Overall, 660 head and neck surgeries with the scapula donor bone across 24 studies were included. Twenty studies of 612 scapula free flaps reported a pooled postoperative complication rate of 10.7%, with no major complications. Seven studies of 199 scapula reconstructions showed a mean Disability of Arm, Shoulder and Hand (DASH) score of 14.39/100. Conclusion: With its low rate of morbidity, the scapula flap presents itself as a good alternative for patients at risk for poor healing. [ABSTRACT FROM AUTHOR]

Introduction: Cervical spine defects result in spinal instability, putting the spinal cord and vertebral arteries at risk of damage and possibly devastating neurological injuries. The fibula free flap can span the spinal defects for stability. There is a paucity of literature on this technique. Method: Multi‐institutional retrospective case series reviewing patients who underwent cervical spine reconstruction with a fibula free flap. Patient demographic information, comorbidities, characteristics of cervical spine defects, and free flap complications were collected. Results: A total of 1187 fibula free flaps across 10 different institutions were reviewed. Thirteen patients (1.09%) underwent cervical spine reconstruction with a fibula free flap. Average age was 52.3 years old with an age range of 12–79 years. There were six males (46.1%) and seven females (53.8%). The most common defect etiology was infection (n = 6, 46.1%). Most commonly involved cervical spine level of the defect was C5 (n = 10) followed by C6 (n = 9) and C4 (n = 8). The majority of reconstructed defects spanned three or more cervical levels, (n = 9, 69.2%). Facial artery was the most common arterial anastomosis (n = 8). Eight patients (61.5%) required a tracheostomy during their postoperative course. None of the patients had symptomatic or radiographic nonunion. Conclusion: This case series demonstrates that a vascularized fibula flap is a potential reconstructive option for cervical spine defects, especially in defects greater than three cervical levels, in the setting of infection, and previously radiated patients. Level of Evidence: 4 Laryngoscope, 134:4923–4928, 2024 [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aim Methods Conclusions Interest in aesthetic procedures that help maintain a youthful look is on the rise. While many nonsurgical techniques focus on facial rejuvenation, there is a need for a detailed review of treatments, specifically for nonfacial areas.This review explores various clinic‐based methods for revitalizing the neck, chest, and hands, with a particular emphasis on different laser treatments.For this second part of the review, we conducted a comprehensive search on PubMed to evaluate the effectiveness of various laser treatments. The review covers treatment parameters such as wavelength, fluence, and pulse, along with outcomes, follow‐up care, and potential side effects. A discussion on the role of sclerotherapy in treating these areas was also included.This article compiles recent findings on the safety and effectiveness of these treatments, showcasing progress in laser technologies and the growing trend of noninvasive body rejuvenation. It offers practical insights for both practitioners and patients looking for reliable options in nonsurgical body treatments. [ABSTRACT FROM AUTHOR]

The lack of obvious difference between germinated seeds and non-germinated seeds will cause the low accuracy of detecting rice seed germination rate, remains a challenging issue in the field. In view of this, a new model named Rice Seed Germination-YOLOV8 (RSG-YOLOV8) is proposed in this paper. This model initially incorporates CSPDenseNet to streamline computational processes while preserving accuracy. Furthermore, the BRA, a dynamic and sparse attention mechanism is integrated to highlight critical features while minimizing redundancy. The third advancement is the employment of a structured feature fusion network, based on GFPN, aiming to reconfigure the original Neck component of YOLOv8, thus enabling efficient feature fusion across varying levels. An additional detection head is introduced, improving detection performance through the integration of variable anchor box scales and the optimization of regression losses. This paper also explores the influence of various attention mechanisms, feature fusion techniques, and detection head architectures on the precision of rice seed germination rate detection. Experimental results indicate that RSG-YOLOV8 achieves a mAP50 of 0.981, marking a 4% enhancement over the mAP50 of YOLOv8 and setting a new benchmark on the RiceSeedGermination dataset for the detection of rice seed germination rate. [ABSTRACT FROM AUTHOR]

Background: Parathyroid cysts account for a small percentage of parathyroid lesions and are more prevalent in females. Cystic parathyroid hyperplasia is exceptionally rare, with only two cases reported thus far. This case report provides the readers with the first multimodality imaging in cystic parathyroid hyperplasia as well as the authors' first experience in using a 4D computed tomography (CT) scan in our institution while the systematic review will comprehensively search and present similar cases. Main text: The literature search started and ended on August 4, 2024. We searched five academic databases: MEDLINE, Cochrane Library, Pubmed, Science Direct, and Google Scholar. The studied population was all patients with cystic parathyroid gland hyperplasia, confirmed by histopathology. A total of 205 articles were initially identified, out of which 29 duplicates were promptly eliminated, leaving 176 unique articles for screening. Following the evaluation of titles and abstracts, ultimately only two studies were included in the systematic review. A 61-year-old male presented with recurrent abdominal pain and weight loss. Ultrasound revealed a left neck mass, cystic. The laryngeal CT scan agreed with the ultrasound while the Technetium-99 sestamibi scan suggested a thyroid lesion. A 4D CT scan confirmed a lobulated cystic lesion in the left parathyroid region. The patient underwent successful surgery, and histopathology confirmed parathyroid hyperplasia with a pseudocyst appearance. Conclusions: This case report presents the first imaging multimodality in cystic parathyroid hyperplasia while highlighting the rarity of this case, with two cases worldwide. In addition, this article describes our institution's first experience with a 4D CT scan. [ABSTRACT FROM AUTHOR]

Background: Swellings of the neck are a common presentation encountered by surgeons in outpatient settings, often prompting early medical attention due to their visibility and potential cosmetic concerns. Neck masses can range from reactive lymphadenitis to malignant lesions. Aim of the study: This observational study aimed to investigate the clinical profile and etiopathology of neck masses within the Indian population. Methods: Over a six-month period, patients presenting with neck swellings at the Department of ENT in a multi-speciality government hospital, Delhi, were included. 100 patients were included in the study. Detailed demographic data and presenting symptoms were recorded, along with local examination findings and cytological analysis using fine needle aspiration cytology (FNAC). Results: The study population predominantly consisted of individuals aged 21 to 30 (30%) and 11 to 20 (22%), with females comprising 68% of the total, male to female ratio being 0.6:1. The most common etiologies observed were infective or inflammatory (42%), followed by thyroid-related conditions (35%). Tubercular lymphadenitis was the most common among infective etiology, accounting for 36% of these cases. Notable variations were observed across age groups, with younger demographics showing higher prevalence of benign and inflammatory conditions, while older individuals presented with diverse etiologies including thyroid nodules and salivary gland tumors. Conclusion: The age distribution data of patients presenting with neck masses provides valuable insights into the epidemiology and etiology of such conditions across different age groups. FNAC remains a valuable and cost-effective diagnostic tool for evaluating superficial and deep-seated lesions in the head and neck region. It offers reliable categorization of lesions due to its high sensitivity and specificity. [ABSTRACT FROM AUTHOR]

Introduction: In response to the current mainstream deep learning detection methods with a large number of learned parameters and the complexity of apple leaf disease scenarios, the paper proposes a lightweight method and names it LCGSC-YOLO. This method is based on the LCNet(A Lightweight CPU Convolutional Neural Network) and GSConv(Group Shuffle Convolution) module modified YOLO(You Only Look Once) framework. Methods: Firstly, the lightweight LCNet is utilized to reconstruct the backbone network, with the purpose of reducing the number of parameters and computations of the model. Secondly, the GSConv module and the VOVGSCSP (Slim-neck by GSConv) module are introduced in the neck network, which makes it possible to minimize the number of model parameters and computations while guaranteeing the fusion capability among the different feature layers. Finally, coordinate attention is embedded in the tail of the backbone and after each VOVGSCSP module to improve the problem of detection accuracy degradation issue caused by model lightweighting. Results: The experimental results show the LCGSC-YOLO can achieve an excellent detection performance with mean average precision of 95.5% and detection speed of 53 frames per second (FPS) on the mixed datasets of Plant Pathology 2021 (FGVC8) and AppleLeaf9. Discussion: The number of parameters and Floating Point Operations (FLOPs) of the LCGSC-YOLO are much less thanother related comparative experimental algorithms. [ABSTRACT FROM AUTHOR]

Background: We present the case of a rare occurrence of an anterior mediastinal mature teratoma extending into the neck, commonly referred to as a cervicothoracic mature teratoma. Case presentation: A 19-year-old female presented with right-sided neck pain and swelling, which were found to be attributed to a 14 cm cystic lesion originating from the right thyroid lobe and extending into the mediastinum. A diagnosis of mediastinal teratoma with extension to the neck was made. Robot-assisted thymectomy was initiated but was complicated by dense tumor adherence to the superior vena cava and brachiocephalic veins, prompting a switch to a midline sternotomy. Simultaneous resection of the right thyroid lobe was performed due to inflammation. The transition to a midline sternotomy allowed successful excision of the tumor, which was confirmed to be a mature teratoma confined to the thoracic region. The patient's favorable postoperative course led to discharge on day 5 with no recurrence at nine months. Conclusions: Emphasizing the challenges and the importance of prompt intervention in the management of mediastinal teratomas with neck extension. [ABSTRACT FROM AUTHOR]

Background: To explore the management of lymphatic malformation in head and neck. Methods: This is a retrospective study at a single center. Data on demographic, surgery, sclerotherapy and follow-up information were collected from our Vascular Anomalies Center database. Patients with lymphatic malformation of head and neck who had undergone surgery and sclerotherapy between March 2020 and March 2024 were included. Results: There were 94 patients in this study, the lesion sites included head (n = 60), tongue (n = 7), neck (n = 41), pharynx (n = 7), and head and neck (n = 7). Symptoms included bleeding (n = 6), infection (n = 2), dyspnea (n = 2), dysphonia (n = 4), and dysphagia (n = 4). Lymphatic malformation included macrocystic (n = 61), microcystic (n = 12) and mixed (n = 21). Surgeries for LM included radical resection, subtotal or partial resection and staged surgeries. Sclerotherapies included bleomycin monotherapy and combined sclerotherapy with ethanol and bleomycin, under ultrasound or fluoroscopy guidance. The follow-up period was from 3 months to 1 year. The therapeutic effect was evaluated according to the size of the treatment area. 55 patients, 21 patients, 11 patients and 7 patients were evaluated with excellent, good, moderate and no response, respectively. Conclusion: Surgical resection, sclerotherapy and the combination of the two are efficacious treatment modalities for head and neck LM. Combined with oral drugs and other new therapies may be warranted in future for challenging conditions. [ABSTRACT FROM AUTHOR]

Background Musculoskeletal injuries (MSKIs) represent the most substantial and enduring threat to U.S. military readiness. Previous studies have focused on narrow surveillance periods, single branches of service, and used variable approaches for MSKI identification and classification. Therefore, the goals of this retrospective population study were to report the incidence, prevalence, and types of MSKIs sustained by active duty service members (ADSMs) across four Services in direct care (DC) and private sector care (PC) settings over fiscal years (FYs) 2010–2021, and to quantify and describe associated health care utilization and PC costs over the same period. Methods This study included ADSMs from the Air Force, Army, Marine Corps, and Navy. Prevalence and incidence rates for Head/Neck, Upper Extremity (UE), Spine (upper back, middle back, lower back, pelvic), and Lower Extremity (LE) MSKIs in ADSMs, associated health care utilization, and PC costs were derived by querying electronic health records from DC, PC claims, and theater medical data from the Military Health System Data Repository. Patient episodes of care and associated PC costs related to MSKIs in DC and PC settings were classified into mutually exclusive outpatient encounter categories and acute inpatient stays, body regions, and Services. Results Over FY10–21, the most prevalent MSKIs were LE (24–29%) followed by Spine (17–20%), UE (14–16%), and Head/Neck (6–8%). Across FY10–21, soldiers were more likely to sustain LE MSKI than Airmen (risk ratio 1.12–1.30) and Marines demonstrated an increasing risk of LE MSKI prevalence and incidence (relative to Airmen) over the study period. The rise in prevalence of LE, Spine, UE, and Head/Neck MSKIs over FY10–21 was accompanied by increased health care utilization and reliance on PC care, especially same-day surgeries (SDS). PC reliance for SDS increased across body regions from FY10 to its peak in FY20 (Head/Neck: 22.7% to 49.7%, Spine: 37.1% to 57.0%, LE: 38.6% to 51.5%, UE: 40.4% to 53.5%). In FY21, the MHS incurred the highest PC costs for LE MSKIs ($132,242,289), followed by Spine ($98,738,863), UE ($92,118,071), and Head/Neck ($42,718,754). Conclusions To our knowledge, this is the first population study of MSKIs in ADSMs spanning the ICD-10 CM transition (FY15–16) that includes the four Services. Across Services, MSKIs in the U.S. military remain a prevalent and persistent problem. Consistent with prior research, the LE was the most common and costly body region affected by MSKIs. Service members with MSKIs demonstrated an increasing reliance on PC for MSKI care, particularly SDS, over the study period. Expanding future research efforts to include all Services to assess risk factors and patient outcomes for treatments across DC and PC settings is vital to mitigate the threat posed by MSKIs to the readiness of the U.S. Armed Forces. [ABSTRACT FROM AUTHOR]

Introduction Musculoskeletal injuries (MSKIs) are highly prevalent and costly conditions among active duty service members (ADSMs), and female service members sustain these injuries at a higher rate than men. However, lack of women-specific research regarding MSKIs in the U.S. military has limited Department of Defense (DoD) leadership from assessing and addressing the burden of these conditions. The purposes of this study were to report the incidence, prevalence, and types of MSKIs sustained by female ADSMs across the four services in direct care (DC) and private sector care (PC) settings from fiscal years (FYs) 2016 through 2021 and to quantify and describe the health care utilization and private sector costs associated with MSKIs in women over the same period. Materials and Methods This retrospective, longitudinal population study included ADSMs from the Air Force, Army, Marine Corps, and Navy. Prevalence and incidence rates for Head/Neck, Upper Extremity (UE), Spine, and Lower Extremity (LE) MSKIs in female ADSMs, associated health care utilization, and private sector costs were derived by querying electronic health records from military treatment facilities, PC claims, and theater medical data from the Military Health System Data Repository from October 1, 2015 to September 30, 2021 (FY16–21). Health care utilization associated with MSKIs among female ADSMs for each body region in DC and PC settings was classified into mutually exclusive outpatient encounter categories and acute inpatient stays. PC MSKI-associated costs in service women were captured for each year and categorized by service, body region, and setting. Results In FY21, 10.8% (n  = 27,976) of female ADSMs sustained Head/Neck MSKI, 16.3% (n  = 42,294) UE MSKI, 23.6% (n  = 61,048) Spine MSKI, and 33.3% (n  = 86,235) LE MSKI. Across the study period, female ADSMs had a 25%–29% higher risk of any MSKI (risk ratio (RR) 1.25–1.29) relative to men. Female soldiers had the highest annual prevalence of MSKIs (62.1%–66.4%), while female Marines had the highest risk of MSKI relative to men (RR 1.40–1.47) for all four major body regions. From FY16 to FY21, the body region with the highest risk of MSKI relative to men was Head/Neck (RR 1.61–1.63), while the region with the lowest relative risk was UE (RR 1.05–1.10). LE MSKIs represented the most common and costly type of injury in female ADSMs, with 406,997 outpatient DC and 87,374 PC encounters in FY21. Total PC costs of LE MSKI for female ADSMs were $30,643,535 in FY21 alone. Conclusions This is the first population-level assessment of MSKI prevalence, incidence rates, health care utilization, and PC costs over a 6-year period for service women in the military health system (MHS). Female ADSMs sustain MSKIs at a higher rate than their male counterparts. Given the critical role of service women in the military, MHS leaders, researchers, and public health officials should continue to explore the underlying causes of these disparities in MSKI rates between the sexes, by expanding research efforts to all services and military settings. [ABSTRACT FROM AUTHOR]

Background Musculoskeletal injuries (MSKIs) represent the most common, costly, and impactful medical conditions affecting active duty service members (ADSMs) of the United States Armed Forces. Inconsistent, variable MSKI surveillance methods and often incompletely described criteria for cohort selection, injuries, incidence, and prevalence have limited efforts to observe longitudinal trends, identify gaps in care, or highlight specific military branches or sites that could benefit from enhanced MSKI intervention protocols. The purpose of this manuscript is to present a comprehensive, well-documented, and reproducible framework for capturing and categorizing MSKI burden, healthcare utilization, and private sector costs for ADSMs across a 12-year period spanning the International Classification of Diseases, 10th Revision, Clinical Modification transition. Methods This was a retrospective, longitudinal population study, including ADSMs from the Air Force, Army, Marine Corps, and Navy. Prevalence and incidence rates for Upper Extremity, Lower Extremity, Spine, and Head/Neck MSKIs, associated health care utilization, and private sector costs were obtained by querying electronic health records from military treatment facilities, private sector care (PC) claims, and theater medical data from October 1, 2010 to September 30, 2021 (Fiscal Years 10-21), using the Military Health System Data Repository. Utilization associated with MSKIs per body region in the direct care and PC settings was classified into mutually exclusive outpatient encounter categories and acute inpatient stays. PC MSKI-associated costs were captured per year and categorized by service, body region, and setting. Conclusions MSKI surveillance research in ADSMs has been impacted by variable, often incompletely described methods. While our approach is not without limitations, our aim was to present a well-documented, reproducible methodology for MSKI investigation in military personnel. By presenting a comprehensive blueprint for capturing and categorizing MSKI care in U.S. service members, our goal is for this methodology to enhance the efforts of researchers, public health officials, and Military Health System leaders to combat MSKIs, the primary medical threat to military readiness. [ABSTRACT FROM AUTHOR]

Background Active duty service members (ADSMs) of the U.S. Armed Forces are uniquely at risk for musculoskeletal injuries (MSKIs) of the Head/Neck region, including the eye and face, from training with head gear, donning Kevlar, operating aircraft, and maintaining sitting or standing postures for prolonged durations. The purposes of this descriptive study were to report the prevalence/incidence, health care utilization, and health care costs attributable to Head/Neck MSKIs across the Services from fiscal years (FYs) 2016 to 2021. Methods This was a retrospective, longitudinal population study, including ADSMs from the Air Force, Army, Marine Corps, and Navy. Prevalence and incidence rates for Head/Neck MSKIs, associated health care utilization, and private sector costs were obtained by querying electronic health records from military treatment facilities, private sector care (PC) claims, and theater medical data from October 1, 2015 to September 30, 2021 (FYs 16–21), using the Military Health System Data Repository. Utilization associated with Head/Neck MSKIs in both the direct care and PC settings was classified into mutually exclusive outpatient encounter categories and acute inpatient stays. PC costs related to Head/Neck MSKIs were captured for each year. Results In FY21, 109,683 ADSMs sought care for Head/Neck MSKIs, representing 7.3% of the U.S. Armed Forces. The prevalence of Head/Neck MSKIs ranged from 6.9 to 7.8% during FY16–21, with the highest annual prevalence among the Air Force (8.0–9.4%) and Army (7.9–8.8%). Within direct care across the services, Soldiers presented for the highest proportion (45.9–47.9%) of outpatient encounters for Head/Neck MSKI annually. The Air Force relied most heavily on PC for outpatient Head/Neck MSKI care, which accounted for $9,134,741 in PC costs and comprised 37.2% of all PC encounters in FY21. Conclusions This retrospective, descriptive study established prevalence/incidence, health care utilization, and PC costs for Head/Neck MSKIs across the services from FY16–21, emphasizing the burden of Head/Neck MSKIs among the U.S. Armed Forces, with PC costs amounting to $42,912,940 in FY21 alone. [ABSTRACT FROM AUTHOR]

Addressing the issue of inadequate dynamic object detection accuracy in current road driving warning systems, this study proposes the RepBF‐YOLOv8 detection algorithm aimed at efficient risk identification. The backbone network of YOLOv8n is replaced with the lightweight RepViT architecture, which is more suitable for visual tasks. This replacement simplifies the traditional structure, reduces the complexity of the backbone network, maximizes performance enhancement, and minimizes latency. Additionally, the FPN in the neck section is upgraded to Bi‐FPN, which reduces nodes and span connections and incorporates rapid normalization to achieve fast multi‐scale feature fusion. For risk grading, the algorithm infers distances and collision times, categorizing detected objects into high, medium, and low‐risk levels, and uses different colors to warn the driver. Comparative experimental results show that the optimized algorithm improves Precision by 1.7%, Recall by 2.3%, mAP@0.5 by 1.53%, and mAP@0.5:0.95 by 2.91%. In road tests, the risk warning system achieves a frame detection rate ranging from a minimum of 38.4 fps to a maximum of 59.0 fps. The detection confidence for various objects remains above 0.71, reaching as high as 0.98. Specifically, the "Car" confidence ranges from 0.81 to 0.98, demonstrating the accuracy and robustness of vehicle risk detection. [ABSTRACT FROM AUTHOR]

Simple Summary: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer, with the head and neck region being the most common location. Perineural invasion (PNI), or the invasion of cancer into and around nerves, is a high-risk factor in cSCC associated with poor outcomes. The mechanisms of PNI in cSCC are poorly understood, but recent studies suggest that cross-communication between nerve components and cancer is a contributing factor. A better understanding of the mechanisms that promote PNI may lead to new therapies that improve outcomes in cSCC patients. Background/Objectives: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer, with a lifetime risk of 14–20% that is rising every year. Although prognosis for cSCC is generally good, certain high-risk features of cSCC portend increased rates of nodal and distant metastasis, recurrence, and disease-specific mortality. One such high-risk factor is perineural invasion (PNI), which is broadly defined as the invasion of cancer into and around nerves. Compared to other high-risk factors, PNI presence is associated with the highest risk for locoregional and distant metastasis. Still, the mechanisms underlying the pathogenesis of PNI remain poorly understood. Recent studies suggest the migration and invasion of tumors into nerves is a result of complex molecular crosstalk within the tumor-nerve microenvironment, wherein the milieu of signaling molecules simultaneously promote neuronal growth and tumor cell invasion. Methods: Understanding the molecular and cellular mechanisms that promote PNI will lead to future developments of targeted therapies that may improve locoregional control and survival. Results/Conclusions: In our article, we aim to provide a comprehensive review of recent findings about the pathogenesis of PNI, clinical implications of PNI-positive disease in cSCC, available treatment modalities, and potential future therapeutic targets. [ABSTRACT FROM AUTHOR]

Automotive glass is one of the key components in manufacturing engineering, and the inspection of defects is essentially an important item of quality evaluation. Deep learning has become a promising technology and is very suitable for defect detection. However, a unified method to detect all kinds of defects is very difficult due to the few publicly available image datasets of automotive glass, and it is a challenge to deploy high-precision models in resource-constrained edge devices. Focusing on these problems, defect detection in automotive glass based on modified YOLOv5 with pseudo-tagging and dual lightweight strategy is developed in this paper. First, aiming at the problem that the defect samples are extremely lacking, combined pseudo-labeling and traditional data expansion methods have been explored to effectively increase the number of samples for meeting the requirement of deep learning model training, thus improving the performance of the detection model. Second, double lightweight modules, MobileNetV3, and Ghost module are introduced into the backbone and the neck network of the YOLOv5 model, respectively, for reducing the complexity of the model. In addition, a multi-scale feature fusion (M-SFF) module, which riches the semantic and spatial information of feature maps, is added to the output of the backbone to further improve the detection accuracy of the model. The effectiveness of each innovation module was verified through ablation experiment and horizontal comparative experimentally. Experimental results show that the complexity and deployment difficulty of the improved YOLOv5 model are significantly reduced, the floating-point operations per second (FLOPs) values and weight sizes are significantly smaller than those of other models, and the detection performance is also improved based on the original YOLOv5, an average accuracy increase of 3.9 % on average, precision slightly decreased, and recall rates increased by 7.6 % . The method is appropriate for applications in the defect inspection of automotive glass. [ABSTRACT FROM AUTHOR]

Botulinum injection is a well-known non-surgical intervention utilized in the management of myofascial pain syndrome (MPS). However, sparse evidence exists regarding the utility of ultrasound guidance of injectate or lidocaine as a predictive marker of patient response to botulinum toxin A (BTX-A). A 39-year-old male active duty service member demonstrated typical signs and symptoms of MPS. He reported a 10-year history of neck and back spasms that were triggered by exertion but also could occur spontaneously. Based on the characteristic regional motor-sensory defects, treatment options were discussed. With shared decision-making, the patient opted to try ultrasound-guided injection of lidocaine followed by xenomin brand BotoxA. Immediately following lidocaine injection, the patient reported complete relief of symptoms. Both injections were uncomplicated, and the patient reported great reduction in symptoms during the subsequent visit 2 months later. Relief of pain following ultrasound-guided injection of lidocaine may serve as an indicator of successful patient response to BTX-A in patients with MPS. [ABSTRACT FROM AUTHOR]

Objective: To analyze the effects on pain and disability recovery after a whiplash of a guided neck-specific exercise therapy, compared to a different or an unguided neck-specific exercise therapy. Design: A literature search was conducted from inception to May 31, 2023, in three electronic databases: PubMed, ScienceDirect, and Web of Science. Eleven randomized controlled trials were included. Metaanalyses were performed with Review Manager software. The standardized mean difference with a 95% confidence interval was used to measure the effect sizes and only short-term time points were considered. Results: Not all studies reported a significant decrease of pain and disability in the neck-specific exercise group compared to controls. However, meta-analyses demonstrated a significantly greater decrease in neck pain (standardized mean difference: −0.25; 95% confidence interval: [−0.38, −0.12]; P=0.0002) and neck-disability index (standardized mean difference: −0.35; 95% confidence interval: [−0.54, −0.15]; P=0.0005) in the neck-specific exercise group. Conclusions: In addition to the benefits that a guided neck-specific exercise therapy has on motivation and program adherence, it provides greater benefits in pain and disability than a different or unguided neck-specific exercise therapy. Positive results are observed primarily with intervention periods of more than 6 wks and at least two sessions per week. [ABSTRACT FROM AUTHOR]

Background: There is limited knowledge about the possible long‐term effects on jaw motor function after whiplash trauma. Objectives: The primary aim was to evaluate integrated jaw and head–neck movement amplitudes during jaw function in individuals 2 years after whiplash trauma, compared to controls. The secondary aim was to evaluate changes between the acute stage and a 2‐year follow‐up in terms of jaw and head–neck movement amplitudes during jaw function. Methods: This study included 28 cases exposed to a whiplash trauma 2 years earlier (13 women) and 28 controls (13 women) without previous neck trauma. Head and jaw movement amplitudes were recorded during maximal jaw opening–closing movements using an optoelectronic 3D recording system. For a subpopulation of 12 cases and 15 controls, recordings had also been performed in the acute stage after the whiplash trauma. Jaw and head movement amplitudes were analysed using linear regression with group and sex as independent variables. The subpopulation longitudinal analysis was adjusted for movement amplitudes at baseline. Results: Jaw movement amplitudes were significantly associated with group (coefficient: −0.359: 95% CI: −10.70 to −1.93, p =.006) with smaller amplitudes of jaw movements for whiplash cases. Head movement amplitudes were not associated with group (coefficient: −0.051, 95% CI: −4.81 to 3.20, p =.687). In the longitudinal analysis, both jaw and head movement amplitudes showed significant associations between baseline and the 2‐year follow‐up. Conclusion: The present findings indicate that the effects on jaw function in terms of jaw opening capacity in the acute stage after whiplash trauma do not spontaneously recover. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study sought to estimate the overall cumulative incidence and odds of Hospital-acquired venous thromboembolism (VTE) among critically ill children with and without exposure to invasive ventilation. In doing so, we also aimed to describe the temporal relationship between invasive ventilation and hospital-acquired VTE development. METHODS: We performed a retrospective cohort study using Virtual Pediatric Systems (VPS) data from 142 North American pediatric ICUs among children < 18 y of age from January 1, 2016-December 31, 2022. After exclusion criteria were applied, cohorts were identified by presence of invasive ventilation exposure. The primary outcome was cumulative incidence of hospital-acquired VTE, defined as limb/neck deep venous thrombosis or pulmonary embolism. Multivariate logistic regression was used to determine whether invasive ventilation was an independent risk factor for hospital-acquired VTE development. RESULTS: Of 691,118 children studied, 86,922 (12.4%) underwent invasive ventilation. The cumulative incidence of hospital-acquired VTE for those who received invasive ventilation was 1.9% and 0.12% for those who did not (P < .001). The median time to hospital-acquired VTE after endotracheal intubation was 6 (interquartile range 3-14) d. In multivariate models, invasive ventilation exposure and duration were each independently associated with development of hospital-acquired VTE (adjusted odds ratio 1.64 [95% CI 1.42-1.86], P < .001; and adjusted odds ratio 1.03 [95% CI 1.02-1.03], P < .001, respectively). CONCLUSIONS: In this multi-center retrospective review from the VPS registry, invasive ventilation exposure and duration were independent risk factors for hospital-acquired VTE among critically ill children. Children undergoing invasive ventilation represent an important target population for risk-stratified thromboprophylaxis trials. [ABSTRACT FROM AUTHOR]

In the process of dense vehicles traveling fast, there will be mutual occlusion between vehicles, which will lead to the problem of deterioration of the tracking effect of different vehicles, so this paper proposes a research method of virtual simulation video vehicle target tracking based on you only look once (YOLO)v5s and deep simple online and realtime tracking (DeepSort). Given that the DeepSort algorithm is currently the most effective tracking method, this paper merges the YOLOv5 algorithm with the DeepSort algorithm. Then it adds the efficient channel attention networks (ECA-Net) focusing mechanism at the back for the cross-stage partial bottleneck with 3 convolutions (C3) modules about the YOLOv5 backbone network and before the up-sampling of the Neck feature pyramid. The YOLOv5 algorithm adopts expected intersection over union (EIOU) instead of complete intersection over union (CIOU) as the loss function of the target frame regression. The improved YOLOv5 algorithm is named YOLOv5-Block. The experimental results show that in the special vehicle target detection (TD) and tracking in the virtual simulation environment, The YOLOv5-Block algorithm has an average accuracy (AP) of 99.5%, which significantly improves the target recognition correctness for typical occlusion cases, and is 1.48 times better than the baseline algorithm. After the virtual simulation video sequence test, multiple objects tracking accuracy (MOTA) and various objects tracking precision (MOTP) improved by 10.7 and 1.75 percentage points, respectively, and the number of vehicle target identity document (ID) switches decreased. Compared with recent mainstream vehicle detection and tracking models, the YOLOv5-Block+Deepsort algorithm can accurately and continuously complete the detection and tracking tasks of special vehicle targets in different scenes. [ABSTRACT FROM AUTHOR]

Objectives: To assess the interaction of multiple rearward-facing (RF) and forward-facing (FF) CRS restrained pediatric occupants on their kinetics in oblique impacts. Methods: A Q3s and a Q1.5 ATD were restrained in 2 CRSs of varying widths—standard (503mm) and slim-fit (425mm)—in the 2 rear outboard seats of a 2023 compact sedan rigidized rear seat bench. A surrogate door structure was mounted at the left outboard location. The Q1.5 was seated in an RF configuration, and the Q3s was seated in RF or FF configurations across tests. The ATDs were restrained as follows: (1) both ATDs in standard CRSs and (2) both ATDs in slim-fit CRSs, switching between the outboard seats for a total of 8 conditions. The condition with the highest head kinetic metrics from these tests was reproduced in a ninth test with the rear seat's center armrest lowered between CRSs. The entire environment was subjected to an oblique impact at 60° using the FMVSS 213 impact pulse. Results: The Q3s' head contacted the nearby CRS shell when seated farside. When seated nearside, the Q3s' head contacted the surrogate door structure in 1 of 4 conditions. The Q1.5's head contacted the nearby CRS in 2 of 4 conditions when seated farside. The Q3s when seated RF had higher HIC15 and head 3ms clip acceleration (H3ms), regardless of farside or nearside position. When seated farside, upper neck tensile force (Fz) for the Q3s in FF configuration (2,317.4 and 2,077.9 N) was higher than that in RF configuration (1,850.8 and 1,802.8 N). When seated nearside, the same in FF configuration (701.3 and 1,029.4 N) was lower than that in RF configuration (997.6 and 1,261.7 N). Repeating the condition with the highest head kinetic metrics (HIC15 = 1246; H3ms = 114.4 g) but lowering the center armrest between the CRSs resulted in lower head kinetic metrics (HIC15 = 916, H3ms = 93.5 g). Conclusions: In most cases, the farside seated ATD's head contacted the nearside CRS shell, resulting in elevated injury metric numbers and higher loading in both CRS types. The nearside ATD did not experience detrimental effects of the interaction with the farside occupant and CRS. [ABSTRACT FROM AUTHOR]

Benefiting from advancements in generic object detectors, significant progress has been achieved in the field of face detection. Among these algorithms, the You Only Look Once (YOLO) series plays an important role due to its low training computation cost. However, we have observed that face detectors based on lightweight YOLO models struggle with accurately detecting small faces. This is because they preserve more semantic information for large faces while compromising the detailed information for small faces. To address this issue, this study makes two contributions to enhance detection performance, particularly for small faces: (1) modifying the neck part of the architecture by integrating a Gather-and-Distribute mechanism instead of the traditional Feature Pyramid Network to tackle the information fusion challenges inherent in YOLO-based models; and (2) incorporating an additional detection head specifically designed for detecting small faces. To evaluate the performance of the proposed face detector, we introduce a new dataset named XD-Face for the face detection task. In the experimental section, the proposed model is trained using the Wider Face dataset and evaluated on both Wider Face and XD-face datasets. Experimental results demonstrate that the proposed face detector outperforms other excellent face detectors across all datasets involving small faces and achieved improvements of 1.1%, 1.09%, and 1.35% in the AP50 metric on the WiderFace validation dataset compared to the baseline YOLOv5s-based face detector. [ABSTRACT FROM AUTHOR]