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Reducing patient morbidity is one of the challenging goals of proper surgical techniques. The rehabilitation success begins with a good surgical plan. Scientifically proven biomaterials are excellent options to overcome the lack of autologous bone for maxillary reconstructions. This case report presents a clinical case of maxillary reconstruction combining guided bone regeneration with xenograft blocks and maxillary sinus elevation. This technique achieved maxillary rehabilitation with a fixed implant-supported prosthesis of a challenging case. The clinical case has an 18-month follow-up with no major complications and excellent clinical and radiographic results. [ABSTRACT FROM AUTHOR]

Spiral phase contrast imaging alleviates the information load by extracting the geometric features of objects and is one of the most representative branches of instant imaging processing. The self-healing capacity of edge detectors can enhance their robustness to obstacles in practical applications. Here, a self-healing spiral phase contrast imaging scheme is proposed and experimentally demonstrated by a liquid crystal edge detector combining a spiral phase, an axicon phase, and a lens phase. The spiral phase is encoded into a liquid crystal by photopatterning. Self-healing contrast imaging is characterized by a series of edge images of both high-contrast amplitude-type and low-contrast phase-type objects. This work extends the self-healing capacity of these detectors to instant imaging processing and paves the way for optical applications with self-healing features. [ABSTRACT FROM AUTHOR]

Purpose: To compare image quality and radiation exposure between super- and ultra-high-resolution helical and super-high-resolution volumetric CT of the temporal bone. Methods: Six cadaveric temporal bone specimens were used to evaluate key temporal bone structures using the following CT reconstruction and acquisition modes: helical and single-volume acquisition modes in super-high resolution (0.25-mm slice thickness, 10242 matrix), and helical mode in ultra-high resolution (0.25-mm slice thickness, 20482 matrix). Two observers performed 5 previously described preoperative measurements, measured noise and signal-to-noise ratios for air, and noise for bone, and rated the visualization of 5 anatomical structures on a 4-point scale, for each reconstruction mode. Radiation dose exposure was recorded for each examination. Results: There was no significant difference between any of the quantitative or qualitative measurements in any of the reconstruction and acquisition modes. There was a slight increase in noise and a decrease in signal-to-noise ratio in the air using the single-volume mode (115 ± 13.1 HU and 8.37 ± 0.91, respectively) compared to the helicoidal super-high-resolution (92.4 ± 11.8 HU and 10.8 ± 1.26, respectively) and helicoidal ultra-high-resolution (91.1 ± 10.7 HU and 10.9 ± 1.39, respectively) modes (P <.002). The volumic CT dose index was 50.9 mGy with helical acquisition and 29.8 mGy with single-volume acquisition mode (P <.0001). Conclusion: The single-volume super-high-resolution acquisition mode allows a reduction in radiation dose exposure without compromising image quality compared to helical scanning, but with a slightly lower signal-to-noise ratio in air with the single-volume mode, while there was no difference in image quality between the helical super- and ultra-high-resolution modes. [ABSTRACT FROM AUTHOR]

This article discusses a study on the prevalence of isolated inter-scalene compression in patients with suspected thoracic outlet syndrome (TOS). The study used photoplethysmography to analyze arterial and venous results in 116 subjects. The results showed that a significant proportion of limbs had isolated arterial inflow or venous outflow impairment. The authors suggest that this method of analysis can help differentiate between arterial and venous compression and potentially aid in the evaluation and treatment of TOS. Additionally, the document includes a study on TOS using photoplethysmography to assess hemodynamic responses, which found that symptoms were present in more than half of the limbs with apparently normal responses. The document also provides a list of references related to TOS, covering various aspects of the condition. [Extracted from the article]

Objectives: To compare diagnostic accuracy of a deep learning artificial intelligence (AI) for cervical spine (C-spine) fracture detection on CT to attending radiologists and assess which undetected fractures were injuries in need of stabilising therapy (IST). Methods: This single-centre, retrospective diagnostic accuracy study included consecutive patients (age ≥18 years; 2007–2014) screened for C-spine fractures with CT. To validate ground truth, one radiologist and three neurosurgeons independently examined scans positive for fracture. Negative scans were followed up until 2022 through patient files and two radiologists reviewed negative scans that were flagged positive by AI. The neurosurgeons determined which fractures were ISTs. Diagnostic accuracy of AI and attending radiologists (index tests) were compared using McNemar. Results: Of the 2368 scans (median age, 48, interquartile range 30–65; 1441 men) analysed, 221 (9.3%) scans contained C-spine fractures with 133 IST. AI detected 158/221 scans with fractures (sensitivity 71.5%, 95% CI 65.5–77.4%) and 2118/2147 scans without fractures (specificity 98.6%, 95% CI 98.2–99.1). In comparison, attending radiologists detected 195/221 scans with fractures (sensitivity 88.2%, 95% CI 84.0–92.5%, p < 0.001) and 2130/2147 scans without fracture (specificity 99.2%, 95% CI 98.8–99.6, p = 0.07). Of the fractures undetected by AI 30/63 were ISTs versus 4/26 for radiologists. AI detected 22/26 fractures undetected by the radiologists, including 3/4 undetected ISTs. Conclusion: Compared to attending radiologists, the artificial intelligence has a lower sensitivity and a higher miss rate of fractures in need of stabilising therapy; however, it detected most fractures undetected by the radiologists, including fractures in need of stabilising therapy. Clinical relevance statement The artificial intelligence algorithm missed more cervical spine fractures on CT than attending radiologists, but detected 84.6% of fractures undetected by radiologists, including fractures in need of stabilising therapy. Key Points: The impact of artificial intelligence for cervical spine fracture detection on CT on fracture management is unknown. The algorithm detected less fractures than attending radiologists, but detected most fractures undetected by the radiologists including almost all in need of stabilising therapy. The artificial intelligence algorithm shows potential as a concurrent reader. [ABSTRACT FROM AUTHOR]

Myocardial revascularization in patients presenting with an anterior mediastinal mass poses considerable challenges. In this report, we outline two cases involving patients with anterior mediastinal masses who underwent surgical resection alongside concurrent myocardial revascularization. One patient underwent coronary artery bypass graft surgery, while the other was treated by percutaneous coronary intervention with drug‐eluting stent placement. Both patients fully recovered from the relative procedures and were discharged within two weeks post‐surgery, ultimately diagnosed with thymoma. The concomitant intervention offered the advantage of promptly addressing both conditions, and it was performed safely through a collaborative multidisciplinary effort. [ABSTRACT FROM AUTHOR]

Background While retention appliances are widely used in orthodontics, there is still no evidence-based consensus regarding the optimal type of appliance or time of retention. Objectives To compare chairside rectangular chain retainers, which can be placed in one sitting, with conventional multi-stranded bonded retainers regarding their levels of stability, biological side effects, complications, and patient experiences. Trial design A single-centre, two-arm, parallel-group randomized controlled trial. Methods In total, 48 patients were included in this single-centre, randomized controlled trial conducted in Varberg, Region Halland, Sweden. The patients were randomized to two groups: the chairside rectangular chain retainer group, using the Ortho FlexTech retainer (OFT); and the conventional retainer group, using the 0.0195 Penta One multi-stranded spiral wire (PeO). The primary outcome was Little´s irregularity index (LII) evaluated at debond (T0) and at 3 months (T3) and 12 months (T12). The secondary outcomes were inter-canine distance (ICD), plaque index (PI), calculus index (CI), bleeding on probing (BoP), and caries, evaluated at T0, T3, and T12, as well as patients' perceptions, evaluated at T3 and T12, and technical complications that were registered throughout the study period. The Mann–Whitney U -test was used for continuous variables for inter-group comparisons, and the Wilcoxon Signed Rank test was used for intra-group comparisons. Results There were no statistically significant differences between the groups regarding LII, biological side effects, technical complications, or patients' experiences. However, there was a small but statistically significant difference between the groups regarding the maintenance of the ICD. Within the OFT group, there was a significant increase in CI, and within the PeO group, there was a significant increase in BoP. Conclusions In terms of clinical relevance, the chairside rectangular chain retainer and the conventional multi-stranded spiral wire provide similar outcomes with respect to the stability of alignment, biological side-effects, technical complications, and patients' experiences short-term. Trial registration VGFOUreg–929962. Keywords: Orthodontic retainers; fixed retainers; retention; stability [ABSTRACT FROM AUTHOR]

Background Purpose Methods Results Conclusions Organ doses in spiral CT scans depend on the tube start angle.To determine the effective dose in single source CT (SSCT) and dual source CT (DSCT) scans as a function of tube start angle and spiral pitch value to identify the dose reduction potential by selecting the optimal start angle.Using Monte Carlo simulations, dose values for different tube positions with an angular increment of 10∘$10^\circ$ and a longitudinal increment of 4.5mm$4.5 \,\mathrm{m}\mathrm{m}$ were simulated over a range of 31.5cm$31.5 \,\mathrm{c}\mathrm{m}$ with collimations of 40mm$40\, \mathrm{mm}$, 60mm$60\, \mathrm{mm}$, and 80mm$80 \,\mathrm{m}\mathrm{m}$. The simulations were performed for the thorax region of six adult patients based on clinical CT data. From the resulting dose distributions, organ doses and effective dose were determined as a function of tube angle and longitudinal position. Using these per‐view dose data, the individual organ doses, as well as the total effective dose, were determined for spiral scans with and without tube current modulation (TCM) with pitch values ranging from 0.5 to 1.5 for SSCT and up to 3.0 for DSCT. The dose of the best and worst tube start angle in terms of dose was determined and compared to the mean dose over all tube start angles.With increasing pitch and collimation, the dose variations from the effective dose averaged over all start angles increase. While for a collimation of 40mm$40 \,\mathrm{m}\mathrm{m}$, the variations from the mean dose value stay below 5%$5 \%$ for SSCT, we find that for a spiral scan with a pitch of 3.0 for DSCT with TCM and collimation of 80mm$80 \,\mathrm{m}\mathrm{m}$, the dose for the best starting angle is on average 16%$16 \%$ lower than the mean value and 28%$28 \%$ lower than the maximum value.Variation of the tube start angle in spiral scans exhibits substantial differences in radiation dose especially for high pitch values and for high collimations. Therefore, we suggest to control the tube start angle to minimize patient risk. [ABSTRACT FROM AUTHOR]

This article provides a comprehensive overview of falls in older adults, highlighting the importance of assessing potential trauma and the cause of the fall. It discusses common causes of falls, such as syncope, polypharmacy, and infection, and emphasizes the need for tailored evaluation and management based on the patient's specific presentation and comorbidities. The article also addresses the evaluation and management of traumatic brain injury, anticoagulation reversal, spinal cord injury, skeletal injuries, and syncope in older adults. It concludes by discussing cost considerations, abuse, and appropriate disposition for these patients. Overall, this document offers valuable information for researchers and library patrons interested in understanding the complexities of caring for older adults. [Extracted from the article]

The Australian National Lung Cancer Screening Program is launching in 2025 and will provide low-dose CT scans every two years to eligible current or ex-smokers aged 50 to 70. Lung cancer is a leading cause of cancer-related deaths in Australia, and the program aims to detect the disease early and improve survival rates. The article discusses the management of pulmonary nodules found during screening, the importance of histopathological confirmation and staging for diagnosis, and the need for a multidisciplinary approach for complex cases. It also explores the potential benefits and harms of screening, including smoking cessation opportunities, radiation exposure, false positives, psychological burden, and overdiagnosis. The role of GPs in screening is highlighted, and the success of the program will depend on effective implementation and uptake. The document is a compilation of various sources on lung cancer screening, providing a comprehensive overview of research and implementation for library patrons conducting research on the topic. [Extracted from the article]

Abstract Objectives To evaluate the effect of eliminating the traditional preparatory fasting policy before contrast-enhanced CT on acute adverse reactions and to identify potential risk factors in a Spanish population sample, since many European patients still experience this unnecessary measure in clinical practice. Methods Outpatients who underwent non-emergency CT to either 6 h of solid food fasting (control group) or an unrestricted consumption of solids (intervention group). Adverse reactions during contrast media administration and up to 30 min afterward were recorded and their incidence was calculated. Using univariate and multivariate logistic regression analyses, various patient-related and technical factors were evaluated to identify risk factors for nausea and vomiting. Results One thousand one hundred three patients were evaluated, 560 patients in the control group, and 543 patients in the intervention group. Moderate and severe acute adverse reactions were not identified in either group. No statistical difference was found in the overall acute adverse reactions (hypersensitivity and chemotoxicity) incidence between groups (3.21% vs 2.30% p = 0.36). The total incidence of emetic adverse reactions (nausea and vomiting) was significantly lower in the intervention group than in the control group (0.92% vs 2.86% p = 0.02). Multivariate logistic regression analysis revealed that fasting, age, allergies, neurological diseases, and contrast media concentration were independent risk factors for nausea and vomiting. Conclusion Unrestricted food intake did not increase the overall incidence of acute adverse reactions and diminished the incidence of nausea and vomiting. Trial registration ANZCTR, ACTRN12623000071628. Registered 23 January 2023—retrospectively registered, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384985&showOriginal=true&isReview=true . Critical relevance statement This randomized clinical trial carried out in adults undergoing a non-emergent CT scan demonstrates that fasting as a preparation before a contrast-enhanced CT scan should be discontinued and reserved only for certain specific imaging tests. Key Points Despite low osmolar CT contrast media becoming ubiquitous, preparatory fasting is still widely practiced. The overall incidence of acute adverse reactions was unchanged after abolishing preparative fasting. Traditional preparatory fasting should be discontinued and reserved only for certain specific imaging tests. Graphical Abstract

Rationale Methods Results Conclusions Mass spectrometry (MS) is introduced to high school students in the UK in many pre‐university course syllabi. As such, we have identified the use of MS as a key technique that should be taught practically to undergraduates from the outset of their studies. This mini‐review describes how we introduce and develop students' use of MS throughout our three‐year undergraduate spiral curriculum practical programme, using atmospheric pressure chemical ionization MS (APCI‐MS).We have used an Advion ExpressionL spectrometer, fitted with an atmospheric solids analysis probe or a Plate Express TLC sampler for sample introduction.We have successfully demonstrated the use of APCI‐MS in a range of practicals and experiments covering organic and organometallic chemistries, with large cohorts of students gaining hands‐on instrumental experience in authentic research settings.APCI‐MS has proven to be an easy‐to‐use and valuable addition to our undergraduate practical course. The robustness of the spectrometer enables routine use by large cohorts of students with minimal supervision, and routine maintenance can be carried out by non‐specialist technicians. Students can readily process and interpret results for a series of routine analyses, as well as demonstrate uses in problem‐solving exercises. [ABSTRACT FROM AUTHOR]

This article discusses the successful treatment of staghorn stones using flexible ureteroscopy and thulium fiber laser lithotripsy. Staghorn stones are a complex form of kidney stones that are difficult to treat. The traditional treatment method, percutaneous nephrolithotomy (PNL), is associated with high complications and multiple treatment sessions. However, flexible ureteroscopy (FURS) with thulium fiber laser lithotripsy has shown promising results in treating larger renal stones. The study conducted a prospective investigation to determine the viability of this treatment option. The article provides details on the patient population, surgical intervention, operative parameters, postoperative care, and outcome measures. The study found that the use of flexible ureteroscopy with thulium fiber laser lithotripsy resulted in a stone-free rate of 53% after the initial treatment and a low rate of postoperative complications. The authors suggest that further research is needed to compare this treatment method with percutaneous nephrolithotomy. [Extracted from the article]

BACKGROUND: Due to the young age of children, the occipital condyle and foramen magnum are not fully developed, and they are prone to various diseases and injuries in the occipitocervical junction, which requires surgical treatment in severe cases. However, anatomical parameters for the development of the occipital condyle and foramen magnum in children are lacking. OBJECTIVE: To measure the morphological structure of the occipital condyle and foramen magnum by three-dimensional reconstruction technique, and to provide important anatomical parameters for occipitocervical junction lesions, related surgical procedures and forensic identification. METHODS: Imaging data of 389 cases of primitive children and adolescents involved in skull base undergoing spiral CT scanning (247 males and 142 females) aged 1-18 years were collected and divided into 1-3-year-old group, 4-6-year-old group, 7-9-year-old group, 10-12-year-old group, 13-15-year-old group, and 16-18-year-old group according to their age. Mimics 16.0 software was used to reconstruct the skull base and measure the length and width of the foramen magnum. A formula was used to calculate the area and index of the foramen magnum. We measured the length, width and height of the occipital condyle, the angle between the long axis and the sagittal axis of the occipital condyle (O-S angle), the included angle between the midpoint of the front and back edges of the foramen magnum and the connection between the back edge of occipital condyle and the intersection point of the foramen magnum (F-O angle), and the included angle between the midpoint of the front and back edges of the foramen magnum and the midpoint of the back wall of the sublingual neural tube (F-H angle). Gender, side and age differences were analyzed among the indicators. RESULTS AND CONCLUSION: (1) In foramen magnum measurement, there was no significant difference between sexes in the index of the foramen magnum (P > 0.05), but there were significant differences in length, width and area of the foramen magnum (P < 0.05). (2) The O-S angle, F-O angle and F-H angle of the occipitral condyle were not significantly different between genders (P > 0.05), but length, width and height of the occipital condyle were significantly different between genders (P < 0.05). (3) There were no significant differences in the length of the occipital condyle among different groups (P > 0.05), but there were significant differences in the width and height of the occipital condyle, O-S angle, F-O angle and F-H angle among different groups (P < 0.05). (4) Length, width and area of the foramen magnum, length, width and height of the occipital condyle showed a wavy increasing trend with the increase of age, while O-S, F-O and F-H angles showed a wavy decreasing trend with the increase of age, while the index of the foramen magnum showed no significant change. (5) In conclusion, there are gender and lateral differences in the morphological indexes of the foramen magnum and the occipital condyle in children. These differences can provide an important reference for clinical surgical approach selection and forensic examination. [ABSTRACT FROM AUTHOR]

Objective: it aimed to explore the value of multislice helical computed tomography (MSCT) in the diagnosis and surgical treatment of primary tracheal tumors. Methods: 64 patients with the primary tracheal tumor who were diagnosed in Wuxi Second People’s Hospital from March 2020 to March 2021 were selected as the research objects. MSCT imaging was performed on all patients, and suitable surgical methods. The pathological results were compared with original CT, CT virtual endoscopy (CTVE), and Comparisons were made using CT threedimensional reconstruction images to evaluate the accuracy of MSCT diagnosis. Parameters such as postoperative complications and survival rates were observed to assess surgical effectiveness and safety. Results: Compared with original CT images (70%, 72%, 70%), the diagnostic accuracy of VR images (80%, 80%, 80%), MPVR images (85%, 90%, 92%), and CTVE images (100%, 100%, 100%) was remarkably improved (P<0.05). The threeyear survival rate of patients with smooth muscle tumors, malignant tumors, salivary gland adenoma, papillary tumors, and inflammatory polyp was markedly lower than that of the one-year survival rate, with a significant difference (P<0.05). The incidence of postoperative complications was 14.1%, with three cases resulting in complication-related deaths. Conclusion: the diagnostic accuracy of MSCT imaging of primary tracheal tumor was high. The diagnostic accuracy of CTVE was higher than that of VR and MPVR. Besides, surgical treatment of primary tracheal tumor had a substantial effect, with no serious postoperative complications. [ABSTRACT FROM AUTHOR]

Objectives : Petrous bone cholesteatoma (PBC) is a rare condition of the petrous portion of the temporal bone. Treatment of choice consists of radical surgical removal, paying attention to protect the facial nerve and inner ear as far as possible. The aim of the present study was to evaluate the efficacy of modified translabyrinthine techniques in preserving hearing function and the use of the adjuvant endoscopic techniques in a group of PBC patients. Methods : This study comprised 16 cases of PBCs surgically treated in our Department. Pre- and post-operative hearing status was assessed with pure tone audiometry and speech discrimination and graded according to the Gardner- Robertson classification system. Facial function was based on the House Brackman (HB) classification. PBCs were grouped using Sanna's classification. The choice of surgical technique was based on the above findings together with preoperative evidence. Post-operative follow-up ranged from 1 to 10 years and also included Computed Tomography and Magnetic Resonance Imaging assessment. Results : PBCs were classified as follows: 37.5% infralabyrinthine; 43.75% supralabyrinthine; and 18.75% massive. Preservation of the bone conduction threshold was feasible in 62.5% of patients. For supralabyrinthine PBCs a subtotal petrosetomy was performed in all cases and hearing preservation was possible in 57% of them: an adjuvant endoscopic approach was performed in 43%. Infralabyrinthine PBCs were treated using a modified translabyrinthine approach with preservation of bone conduction in 83% of patients; an adjuvant endoscopic approach was performed in 50% cases. One patient with a massive cholesteatoma was treated by modified translabyrinthine approach, preserving a serviceable level of hearing. In all massive cases, an adjuvant endoscopic approach was performed. In 2 patients with preoperative palsy, facial nerve function showed an improvement. The follow-up period revealed evidence of limited recurrence at CT imaging in 2 patients. Conclusions : The introduction of modified surgical approaches, able to preserve the anatomical-functional structures, have shown an improvement of post-operative hearing outcomes. [ABSTRACT FROM AUTHOR]

Background: Intrahospital transportation (IHT) of patients with traumatic brain injury (TBI) is common and may have adverse consequences, incurring inherent risks. The data on the frequency and severity of clinical complications linked with IHT are contradictory, and there is no agreement on whether it is safe or potentially challenging for neurocritical care unit patients. Continuous intracranial pressure (ICP) monitoring is essential in neurointensive care. The role of ICP monitoring and management of cerebral autoregulation impairments in IHT of patients with severe TBI is underinvestigated. The purpose of this nonrandomized retrospective single-center study was to assess the dynamics of ICP and an improved pressure reactivity index (iPRx) as a measure of autoregulation during IHT. Methods: Seventy-seven men and fourteen women with severe TBI admitted in 2012–2022 with a mean age of 33.2 ± 5.2 years were studied. ICP and arterial pressure were invasively monitored, and cerebral perfusion pressure and iPRx were calculated from the measured parameters. All patients were subjected to dynamic helical computed tomography angiography using a 64-slice scanner Philips Ingenuity computed tomography scan 1–2 days after TBI. Statistical analysis of all results was done using a paired t-test, and p was preset at < 0.05. The logistic regression analysis was performed for cerebral ischemia development dependent on intracranial hypertension and cerebrovascular reactivity. Results: IHT led to an increase in ICP in all the patients, especially during vertical movement in an elevator (maximum 75.2 mm Hg). During the horizontal transportation on the floor, ICP remained increased (p < 0.05). The mean ICP during IHT was significantly higher (26.1 ± 13.5 mm Hg, p < 0.001) than that before the IHT (19.9 ± 5.3 mm Hg). The mean iPRx after and before IHT was 0.52 ± 0.04 and 0.23 ± 0.14, respectively (p < 0.001). Conclusions: Both horizontal and vertical transportation causes a significant increase in ICP and iPRx in patients with severe TBI, potentially leading to the outcome worsening. [ABSTRACT FROM AUTHOR]

Objective To explore the efficacy of a novel and simple manual bone cone drilling hematoma drainage for hypertensive intracerebral hemorrhage. Methods From January 2021 to December 2022, 103 patients with hypertensive intracerebral hemorrhage at The Affiliated Bozhou Hospital of Anhui Medical University were included. They were treated with traditional bone cone drilling hematoma drainage (traditional group, n = 51) and novel-type bone cone drilling hematoma drainage (novel-type group, n = 52). Based on pre- and post-surgery head CT results, the hematoma clearance rate and accuracy of catheter placement were calculated. National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of neurological deficits, and modified Rankin Scale (mRS) was used to evaluate the neurological functional prognosis. Results The hematoma clearance rate in the novel-type group [(45.54 ± 24.23)% vs. (35.08 ± 6.49)%; t = 3.008, P = 0.004] and the accuracy of catheter placement [90.38% (47/52) vs. 68.63% (35/51); χ² = 7.509, P = 0.006] were significantly higher than those of the traditional group. The novel-type group and the traditional group showed statistically significant differences in hematoma volume (F = 9.157, P = 0.003) and mRS score (F = 4.412, P = 0.038). The postoperative hematoma volume (t = - 4.625, P = 0.000) and mRS score (t = - 2.712, P = 0.008) of the novel-type group were lower than those of the traditional group. Statistically significant differences were observed in hematoma volume (F = 280.635, P = 0.000), NIHSS score (F = 443.320, P = 0.000) and mRS score (F = 552.781, P = 0.000) before and after surgery in the 2 groups; the hematoma volume (t = 10.233, P = 0.000; t = 19.906, P = 0.000), NIHSS score (t = 14.576, P = 0.000; t = 15.286, P = 0.000) and mRS score (t = 20.201, P = 0.000; t = 13.511, P = 0.000) after operation were lower than those before operation in the 2 groups. Conclusions The novel and simple manual bone cone drilling hematoma drainage is a safe and effective treatment for hypertensive intracerebral hemorrhage. [ABSTRACT FROM AUTHOR]

Pigs as laboratory animals are used in preclinical studies aimed at developing medical devices for cardiac surgery. The anatomy of the cardiovascular system of these animals has been well studied and acknowledged as suitable for use and the testing of new cardiovascular devices developed for humans. However, there are no morphometric characteristics of the aortic root and thoraco-abdominal part of porcine aorta. This can lead to difficulties in experimental surgery and even result in the death of experimental animals due to the mismatch in the size of the implantable devices. Thus, such information is essential to enhance the efficiency of surgical technologies used for eliminating aortic pathologies in their various sections. The purpose of our research is to study the anatomy of the aorta in mini pigs and to assess whether the size, age, and sex of the animals affect the size of the main structures in their aortas. In addition, we attempted to compare the results obtained by transesophageal echocardiography (TEE) and angiography. We studied 28 laboratory mini pigs, dividing them into three groups by body weight (40–70 kg, 71–90 kg, and 90 kg). We did not find any relationship between the external somatometric characteristics of the animals and the size of their aortas. Animals have individual anatomical variability in their cardiovascular systems, which means that they need to be examined in terms of preoperative planning by any available method—echocardiography, angiography, or multispiral computed tomography (CT). [ABSTRACT FROM AUTHOR]

Recent advances in identifying giant molecular filaments in Galactic surveys allow us to study the interstellar material and its dense, potentially star forming phase on scales comparable to resolved extragalactic clouds. Two large filaments detected in the 13CO/C18O(J  = 3–2) Heterodyne Inner Milky Way Plane Survey (CHIMPS) survey, one in the Sagittarius-arm and one in an interarm region, were mapped with dense gas tracers inside a 0.06 square degrees area and with a spatial resolution of around 0.4 and 0.65 pc at the distance of the targets using the 30 m telescope of the Institut de Radioastronomie Millimétrique (IRAM) to investigate the environmental dependence of the dense gas fraction. The N2H+(1 − 0) transition, an excellent tracer of the dense gas, was detected in parsec-scale, elliptical clumps and with a filling factor of around 8.5  per cent in our maps. The N2H+-emitting areas appear to have higher dense gas fraction (e.g. the ratio of N2H+ and 13CO emission) in the interarm than in the arm which is opposite to the behaviour found by previous studies, using dust emission rather than N2H+ as a tracer of dense gas. However, the arm filament is brighter in 13CO and the infrared emission of dust, and the dense gas fraction determined as above is governed by the 13CO brightness. We caution that measurements regarding the distribution and fraction of dense gas on these scales may be influenced by many scale- and environment-dependent factors, as well as the chemistry and excitation of the particular tracers, then consider several scenarios that can reproduce the observed effect. [ABSTRACT FROM AUTHOR]

Precision and intelligence in evaluating the complexities of middle ear structures are required to diagnose auriculotemporal and ossicle-related diseases within otolaryngology. Due to the complexity of the anatomical details and the varied etiologies of illnesses such as trauma, chronic otitis media, and congenital anomalies, traditional diagnostic procedures may not yield accurate diagnoses. This research intends to enhance the diagnosis of diseases of the auriculotemporal region and ossicles by combining High-Resolution Spiral Computed Tomography (HRSCT) scanning with Deep Learning Techniques (DLT). This study employs a deep learning method, Convolutional Neural Network-UNet (CNN-UNet), to extract sub-pixel information from medical photos. This method equips doctors and researchers with cutting-edge resources, leading to groundbreaking discoveries and better patient healthcare. The research effort is the interaction between the CNN-UNet model and high-resolution Computed Tomography (CT) scans, automating activities including ossicle segmentation, fracture detection, and disruption cause classification, accelerating the diagnostic process and increasing clinical decision-making. The suggested HRSCT-DLT model represents the integration of high-resolution spiral CT scans with the CNN-UNet model, which has been fine-tuned to address the nuances of auriculotemporal and ossicular diseases. This novel combination improves diagnostic efficiency and our overall understanding of these intricate diseases. The results of this study highlight the promise of combining high-resolution CT scanning with the CNN-UNet model in otolaryngology, paving the way for more accurate diagnosis and more individualized treatment plans for patients experiencing auriculotemporal and ossicle-related disruptions. [ABSTRACT FROM AUTHOR]

Coronary artery three‐dimensional reconstruction is essential for preventing, diagnosing, and treating coronary heart disease. This study introduces SegUnet, a lightweight hybrid CNN‐Transformer network for pixel‐level segmentation of coronary artery computed tomography angiography (CTA) slices to enhance the precision of coronary artery reconstruction. The overall SegUnet adopts a U‐shaped encoder‐decoder structure, with a hierarchical Transformer structure serving as the encoder to extract global contextual information; the decoder is enhanced with spatial attention mechanism (SAM) and residual structure to improve its perception and adaptive adjustment abilities for coronary artery vessels. In contrast to other methods, we propose an interpolation‐based multi‐feature fusion bridge to integrate multi‐scale features between encoder levels, capturing their semantic dependencies. Experimental results show that SegUnet achieves a prediction accuracy of 97.23% on the test set of coronary arteries 2D slices. Moreover, the network exhibits excellent performance on Synapse Multi‐Organ Segmentation, highlighting the superiority, effectiveness, and robustness of our proposed method. The outstanding performance of SegUnet in coronary artery segmentation has elevated the quality of three‐dimensional reconstruction of the coronary arteries, exerting a positive impact on the enhancement of diagnosis and treatment of coronary artery diseases. [ABSTRACT FROM AUTHOR]

Subclavian steal syndrome (SSS) is a rare vascular condition characterized by retrograde blood flow in the vertebral artery, often discovered incidentally in asymptomatic patients. We present a 65-year-old male with recurrent transient ischemic attacks (TIAs) attributed to 99% stenosis at the origin of the left subclavian artery, leading to SSS. Diagnostic modalities included duplex ultrasound, confirming inverted left vertebral artery flow, and multi-slice computed tomography angiography, confirming the diagnosis. Despite an unsuccessful attempt at balloon angioplasty, successful vascular surgery was performed, establishing a left carotid-vertebral artery bypass. The patient recovered well without complications. This case underscores the importance of considering SSS in TIA cases, utilizing non-invasive diagnostic tools, and highlighting the successful management of symptomatic SSS through surgical intervention. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to compare the outcomes, success rate, and complications of performing elective ureteroscopy at different times: <1 week from renal colic initiation (early) and more than 1 week from renal colic initiation (late) in patients with ureteral stone larger than 6 mm. Materials and Methods: This comparative observational study was conducted on 338 consecutive patients. Patients were evaluated in two groups: patients who underwent ureteroscopy in <1 week (A) and patients who underwent ureteroscopy in more than 1 week (B) from renal colic initiation. Helical unenhanced computed tomography was used to assess the size, location, and hardness of stone for all patients. Operation success was defined as complete clearance of stone with no stone residue (stone free) at 2-week postoperative ultrasonography with no need to further interventions. Operation data were collected using medical records, and postoperative complications were investigated at 2 weeks postoperative follow-up visits. Results: Group A included 165 patients and Group B included 173 patients. The overall mean stone size was 8.60 ± 1.12 mm: for Group A 9.13 ± 0.94 mm and for Group B 8.10 ± 1.04 mm (P < 0.001). Stone residues were found in 11 patients: 9 in Group A (5.4%) and 2 in Group B (1.1%) (P = 0.026). Nine patients needed repeated ureteroscopy: 8 (4.8%) in Group A and 1 (0.6%) in Group B (P = 0.015). A double-J stent was used for 85 (51.5%) patients in Group A and 66 (38.2%) patients in Group B (P = 0.016). Major intraoperative complications did not happen in any patients. Fifty-three (32.1%) patients in Group A and 28 (16.2%) patients in Group B suffered from postoperative complications (P = 0.001). Conclusion: Our study revealed that performing elective ureteroscopy with an interval of more than 1 week from the onset of renal colic in combination with medical treatments was associated with less need for double-J stent placement, less need for repeated ureteroscopy, and fewer postoperative complications compared to performing elective ureteroscopy in <1 week from the renal colic onset in nonemergent patients with ureteral stone larger than 6 mm. Although the rate of ureteroscopy failure was higher among the patients who underwent ureteroscopy in <1 week from their renal colic initiation, there was no statistically significant relationship between performing ureteroscopy in <1 week and an increased risk for ureteroscopy failure. [ABSTRACT FROM AUTHOR]

BACKGROUND: With the widespread use of low-dose spiral computed tomography (LDCT) and increasing awareness of personal health, the detection rate of pulmonary nodules is steadily rising. OBJECTIVE: To evaluate the success rate and safety of two different models of Hook-Wire needle localization procedures for pulmonary small nodule biopsy. METHODS: Ninety-four cases with a total of 97 pulmonary small nodules undergoing needle localization biopsy were retrospectively analyzed. The cases were divided into two groups: Group A, using breast localization needle steel wire (Bard Healthcare Science Co., Ltd.); Group B, using disposable pulmonary nodule puncture needle (SensCure Biotechnology Co., Ltd.). All patients underwent video-assisted thoracoscopic surgery (VATS) for nodule removal on the same day after localization and biopsy. The puncture localization operation time, success rate, complications such as pulmonary hemorrhage, pneumothorax, hemoptysis, and postoperative comfort were observed and compared. RESULTS: In Group A, the average localization operation time for 97 nodules was 15.47 ± 5.31 minutes, with a success rate of 94.34%. The complication rate was 71.69% (12 cases of pneumothorax, 35 cases of pulmonary hemorrhage, 2 cases of hemoptysis), and 40 cases of post-localization discomfort were reported. In Group B, the average localization operation time was 25.32 ± 7.83 minutes, with a 100% success rate. The complication rate was 29.55% (3 cases of pneumothorax, 15 cases of pulmonary hemorrhage, 0 cases of hemoptysis), and 3 cases reported postoperative discomfort. According to the data analysis in this study, Group B had a lower incidence of puncture-related complications than Group A, along with a higher success rate and significantly greater postoperative comfort. CONCLUSIONS: The disposable pulmonary nodule puncture needle is safer and more effective in pulmonary small nodule localization biopsy, exhibiting increased comfort compared to the breast localization needle. Additionally, the incidence of complications is significantly lower. [ABSTRACT FROM AUTHOR]

Our study aimed to evaluate modified patient-specific surgical-guide-assisted precise treatment of unilateral comminuted zygomaticomaxillary complex (ZMC) fractures. The retrospective non-randomized study was conducted in a single hospital in China. All patients diagnosed with unilateral comminuted ZMC fractures between January 1, 2018 and December 31, 2022 were retrospectively reviewed. All patients underwent preoperative spiral computed tomography (CT). CT data were processed using software to DICOM format and transferred to Proplan CMF3.0 for preoperative virtual surgical planning and postoperative evaluation. All data were extracted from standardized electronic medical records. All statistical analyses were performed using SPSS version 20.0. The chi-square test and t -test were used for statistical analyses. The 54 included patients were divided into two comparable, equal cohorts of 27 patients, and followed up for at least 6 months. Fracture reduction was assisted using the modified patient-specific surgical guides in the guide group (23 males, four females; mean age 37.74 ± 12.07 years) and without the modified patient-specific surgical guides in the control group (20 males, seven females; mean age 37.44 ± 13.58 years). In the guide group, the mean eminence deviation between the affected and unaffected sides was 1.01 ± 0.92 mm, and the mean width deviation between the affected and unaffected sides was 1.29 ± 1.32 mm. In the control group, the mean eminence deviation between the affected and unaffected sides was 1.99 ± 1.69 mm, and the mean width deviation between the affected and unaffected sides was 2.68 ± 2.01 mm. The differences in facial protrusion (p = 0.001) and width (p = 0.003) symmetry between the affected and healthy sides of the two groups were statistically significant (p < 0.05). In conclusion, applying the modified patient-specific surgical guides to unilateral comminuted zygomaticomaxillary complex fracture reduction has the advantages of greater predictability and effectiveness, and improved bilateral ZMC symmetry. It should be noted that this approach would be especially beneficial for less-experienced surgeons. [ABSTRACT FROM AUTHOR]

This study assesses the morphological effectiveness of benign prostatic hyperplasia (BPH) surgery using multislice spiral computed tomography three-dimensional imaging (CT3D) with urethral contrast. Twenty-five male patients with BPH and bladder outlet obstruction (BOO) who underwent bipolar transurethral resection of the prostate were selected. Preoperative and postoperative CT3D indicators of retrograde and voiding cystourethrography, including bladder neck diameter, length of the posterior urethra, and degree of prostate protrusion into the bladder and upper and lower diameter of the prostate were used to assess bladder neck and posterior urethra morphology and BOO severity. In addition, preoperative and postoperative International Prostate Symptom Scores and maximum urine flow rates were compared. Postoperative CT3D was used to evaluate changes following obstruction relief postsurgery. Preoperative CT3D indicated significant BOO, whereas postoperative imaging showed improved patency but with irregular posterior urethral lumens and varying degrees of residual glandular tissue. Comparative analysis of preoperative and postoperative bladder outlet metrics revealed significant changes (p < 0.05). Urethral contrast CT3D effectively visualizes the prostate, bladder neck, and prostatic urethra. It quantifies changes in the urethral lumen postsurgery, correlating the extent of posterior urethral lumen spaciousness with urinary flow rates. [ABSTRACT FROM AUTHOR]

Introduction: The National Lung Screening Trial (NLST) identified individuals at high risk for lung cancer and showed that serial low‑dose helical computed tomography could identify lung cancer at an earlier stage, leading to mortality reduction. However, there is little evidence regarding the effectiveness of the NLST criteria for the Asian population. Methods: We performed a retrospective audit in our hospital from January 2018 to December 2018, with the aim to describe the characteristics of patients diagnosed with lung cancer and to identify patients who would miss out on lung cancer screening when the NLST criteria was applied. Results: We found that only 38.1% of our cohort who were diagnosed with lung cancer met the NLST criteria strictly by age and smoking status. Patients who met the screening criteria would have derived significant benefits from it, as 85.4% of our patients had presented at an advanced stage and 54.6% died within 1 year. When the United States Preventive Services Task Force criteria was applied, it increased the sensitivity of lung cancer diagnosis to 58.7%. Only 15.5% of the female patients with lung cancer met the NLST criteria; their low smoking quantity was a significant contributing factor for exclusion. Conclusion: The majority of Singapore patients diagnosed with lung cancer, especially females, would not have been identified with the NLST criteria. However, those who met the inclusion criteria would have benefited greatly from screening. Extending the screening age upper limit may yield benefits and improved sensitivity in the Singapore context. [ABSTRACT FROM AUTHOR]

Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare benign disease associated with the formation of multiple cartilaginous nodules in the synovial tissue of the TMJ. This can result in pain, swelling, clicking, limited mouth opening, and osseous degenerative joint changes. A retrospective cross-sectional study was performed to summarize the clinical features, radiographic findings, and surgical and histopathological findings of TMJ SC patients who underwent open surgery over a 24-year period. A radiographic scoring system was used to evaluate osseous changes and correlate condyle and joint fossa degeneration. The study included 38 patients and focused on 38 joints. All 38 of these joints showed degenerative changes in the condyle, while 37 showed osseous degenerative changes in the articular fossa. The degree of condylar degenerative changes was related to the duration of the chief complaints (r = 0.342, P = 0.036) and the histopathological stage of the TMJ SC (r = 0.440, P = 0.006), while the degree of joint fossa degenerative changes was associated with the radiographic extent of the SC (r = 0.504, P = 0.001), type of calcification (r = 0.365, P = 0.024), and the histopathological stage (r = 0.458, P = 0.004). [ABSTRACT FROM AUTHOR]

The article focuses on questioning the necessity of stone analysis and 24-hour urine testing in managing renal stone disease. Topics include the limitations of 24-hour urine analysis, such as variability in results and patient inconvenience, the challenges of conducting reliable stone composition analysis, and the argument for using empiric treatment over routine testing for most kidney stone patients.

Piezoelectric tetragonal barium titanate surface deposited with tiny gold nanoparticles and then coated by polydopamine to achieve combined photothermal enhanced sonodynamic therapy for tumor treatment. [Display omitted] • A novel multifunctional BTs-based nanoplatform called BTAPs was successfully fabricated. • BTAP NPs exhibits a synergistic enhancement in piezocatalytic therapy and photothermal therapy (PTT). • Piezocatalytic therapy effect could be improved by the deposition of ultra-small Au NPs. • BTAP NPs achieved effective tumor destruction and CT imaging at a low dose in vitro and vivo. Non-centrosymmetric tetragonal barium titanate nanocrystals have the potential to serve as piezoelectric catalysts in cancer therapy. When exposed to ultrasound irradiation, BaTiO 3 can generate reactive oxygen species with a noninvasive and deep tissue-penetrating approach. However, the application of BaTiO 3 in cancer nanomedicine is limited by their biosafety, biocompatibility, and dosage efficiency. To explore the potential application of BaTiO 3 in nanomedical cancer treatment, we introduced ultra-small Au nanoparticles onto the surface of BaTiO 3 to enhance the piezoelectric catalytic performance. Additionally, we also coated the BaTiO 3 with polydopamine to improve their biosafety and biocompatibility. This led to the preparation of a novel multifunctional BaTiO 3 -based nanoplatform called BTAPs. In vitro and in vivo experiments demonstrated that the incorporation of Au dopants and polydopamine coating successfully improved the piezoelectric catalysis properties and biocompatibility of BaTiO 3. Compared with unmodified BaTiO 3 , BTAPs achieved a similar piezoelectric catalytic effect at a low dose (0.3 mg ml−1 in vitro and 10 mg kg−1 in vivo). Moreover, BTAPs also exhibited enhanced properties in computed tomography imaging and photothermal effects in vivo. Therefore, BTAPs offer valuable insights into the advantages and limitations of piezoelectric catalytic nanomedicine in cancer treatment. [ABSTRACT FROM AUTHOR]

Increased pressure and shear stress distributions at the limb–socket interface are hypothesised to result from changes in the residual limb shape and volume, which can cause socket fit difficulties. Accurate residual limb volume measurements may aid clinicians in developing strategies to accommodate volume fluctuations. This review primarily aims to analyse the techniques available for measuring the residual lower limb volume that may be used in clinical settings, as documented in the works published over the previous four decades. A comprehensive search of articles in PubMed, ScienceDirect, Web of Science, and Google Scholar identified 904 articles, and further analysis resulted in only 39 articles being chosen to be analysed. Based on the findings, there are nine techniques available to measure the residual limb volume: water displacement, anthropometric measurement, contact probes, optical scanning, spiral X-ray computed tomography (SXCT), magnetic resonance imaging (MRI), ultrasound, laser scanning, and bioimpedance. Considering the variety of techniques for determining residual limb volume, it is critical to choose the ones that best suit clinicians' objectives, and each technique has potential sources of error that should be avoided by taking precautionary action. A comprehensive study of the measurement techniques is needed since researchers have developed and extensively utilised many new measuring devices, especially handheld 3D laser scanners. [ABSTRACT FROM AUTHOR]

Optical glass BK7 is an amorphous crown glass widely used in the aviation industry and high-power laser equipment due to its mechanical and optical properties. With the hard surface and brittle nature, the grinding process is one of the standard machining methods of BK7. Fracture is a dominant mechanism in removing brittle materials, which causes surface and sub-surface defects in the workpiece. Prediction of the depth of sub-surface damage (SSD) that has occurred allows the optimal reduction or even elimination of sub-surface defects in the finish grinding stage. This research aimed to comprehensively investigate the multifaceted influence of seven pertinent parameters on the depth of sub-surface damage (SSD) and surface roughness (SR) resulting from the grinding process. More specifically, it delved into the effects of the grinding wheel's movement direction under varying contact conditions, including angular grinding, vertical grinding, and face grinding, focusing on three critical aspects: the maximum undeformed chip thickness, depth of sub-surface damage, and resulting surface roughness. The contact conditions between the grinding wheel and the workpiece were systematically classified into four groups based on predetermined input parameters to facilitate in-depth analysis. Subsequently, the resulting outputs were evaluated and compared across these diverse contact conditions. The comparative examination between theoretical equations and experimental findings unveiled a maximum deviation of 10 % in SSD depths and 15.61 % in SR estimations. Furthermore, this study's experimental assessments identified nonlinear and monotonic relationships between the depth of SSD, surface roughness, and the maximum undeformed chip thickness (h m). The experimental relationships and the measured results notably highlighted observed discrepancies of 4.27 %, 10 %, and 10 % for the respective parameters (SSD, surface roughness, and h m). • The effect of the spiral speed on the surface and subsurface defects had not been evaluated with the cup grinding wheel. • Maximum undeformed chip thickness (h m) relations were modified based on the grinding conditions. • The SSD depth and the SR value in four grinding conditions with cup wheels were theoretically and experimentally evaluated. • The SR values and SSD depth can be changed according to the workpiece radius based on the grinding conditions. • Monotonic non-linear relations are obtained based on the experimenral results to calculate SSD depth in terms of SR value. [ABSTRACT FROM AUTHOR]

Purpose: The determinism of the sex is of most importance for reconstruction of the biological profile of deceased individuals. In this study, we aim to implement a technique to improve the accessibility of sex determination by the study of the bony labyrinth on cone-beam computed tomography (CBCT) and computed tomography (CT) scans. Methods: CBCT and CT scans of temporal bones performed between 2014 and 2022 were collected with demographic information. The width of the lateral (LSCw), posterior (PSCw), and anterior semicircular canal (ASCw) was measured. The primary outcome was the diagnostic performance of the individual linear measures and the product of these measures. This analysis is supplemented by establishing thresholds using ROC curves. Inter-judge and intra-judge reliability evaluation was performed blinded in randomly selected exams. Results: One hundred forty-one petrous bones were included for analysis of their imaging. The analysis of the PSCw, ASCw, and ASCw*PSCw for sex determination was associated with area under curves of 0.88 ± 0.11, 0.82 ± 0.14, and 0.84 ± 0.10 respectively and accuracies of 0.74 ± 0.13, 0.78 ± 0.11, and 0.79 ± 0.13 respectively. In ROC-curve analysis, a PSCw*ASCw product > 48.5 allows to determine a male sex with > 95% specificity and a sensitivity of 50.1%. A PSCw*ASCw product ≤ 43 allows to determine a female sex with 88% specificity and 64% sensitivity. Reproducibility analyses showed good to excellent intra-judge and inter-judge reproducibility for ASCw and PSCw. Conclusion: Linear measurement of the semicircular canals of the vestibule on CBCT or CT could provide easy-to-use sex determination of the majority of females and males with a good predictive value. [ABSTRACT FROM AUTHOR]

The objective of this study is to determine whether the morphometric evaluation of the foramen magnum using computed tomography can be used as an accurate tool in estimating the sex of an individual. An extensive search of the databases, PubMed, ProQuest, Google Scholar, and Scopus, was carried out to procure articles that fulfilled the inclusion criteria. The AQUA tool was used to assess the quality of the included studies. A random effects model was used for the meta-analysis of the eligible studies using the STATA software, version 16, 2019 at 95% CI and p ≤ 0.05. Eleven eligible articles that measured the transverse and sagittal diameters of the foramen magnum using computed tomography were included in this study. The sagittal diameter of the foramen magnum was greater than the transverse diameter, and both the diameters were greater in males than in females. Meta-analysis revealed that both transverse and sagittal diameters were more reliable for male sex estimation. Since there is a dimensional variation between the male and female foramen magnum, it can be used for initial sex identification and also as an auxiliary to other advanced methods of sex estimation. [ABSTRACT FROM AUTHOR]

Joint effusion is diagnostically important. The canine carpal joint effusion, which is sometimes difficult to detect clinically, has received less attention in diagnostic ultrasound (US) studies. The aim of the present study was to provide a description of the morphological appearance of the canine carpal joint cavities and recesses using US, radiography, helical computed tomography (CT) and three‐dimensional volume rendering technique (3D‐VRT) images and to prove the applicability of musculoskeletal US for the detection of artificial carpal joint effusion in dogs. The understanding of the characteristics of these structures in normal patients is essential in the diagnosis. Twenty‐eight clinically and radiologically unremarkable canine carpal cadavers of different breeds were examined, representative images were selected and anatomical structures were labelled. The canine carpal joint cavities and in particular its recesses had a complex appearance with a basic structure found in all dogs: Antebrachiocarpal joint: dorsoproximal antebrachiocarpal recess, dorsodistal antebrachiocarpal recess, medial antebrachiocarpal recess, lateral antebrachiocarpal recess and five palmar antebrachiocarpal recesses. Middle carpal joint: two dorsal middle carpal recesses, medial common middle carpal and carpometacarpal recess, lateral common middle carpal and carpometacarpal recess, four palmar middle carpal recesses. The carpometacarpal joint had dorsal and palmar funnel‐shaped and irregular, finely tubular extensions, the most prominent ran dorsal to metacarpal III, the maximum distal end represented the proximal metacarpal diaphysis. All recesses presented ultrasonographically as a generalized anechogenic to hypoechoic filled continuation of the articular capsule with an indistinct peripheral hypoechogenic to isoechogenic fine capsule, the synovial‐connective tissue interface was difficult to identify. The novel results of this study provide the first morphological description of the ultrasonographic, radiographic and computed tomographic arthrographic appearance of the canine carpal joint cavities and recesses with different injection volumes. The canine carpal joint cavities and in particular its recesses had a complex appearance with a basic structure found in all dogs. The applicability of musculoskeletal US to visualize an artificial carpal effusion has been demonstrated. The results of this study, and in particular US, give the practitioner an advantage in visualizing joint effusion and assist in the decision to perform arthrocentesis. [ABSTRACT FROM AUTHOR]

Portal vein thrombosis (PVT), one of the most prevalent hepatic vascular conditions in patients with liver cirrhosis (LC), is associated with high mortality rates. An imbalance between a disintegrin-like metalloproteinase with thrombospondin type-1 motifs 13 (ADAMTS-13) enzyme and von Willebrand factor (VWF) is responsible for hypercoagulability, including spontaneous thrombus formation in blood vessels. Herein, we aimed to identify potential prognostic and diagnostic biomarkers in Japanese patients with LC and PVT. In total, 345 patients were divided into two groups: 40 patients who developed PVT (PVT group) and 305 who did not develop PVT (NPVT group). Among the 345 patients with LC, 81% (279/345) were deemed ineligible due to the presence of preventive comorbidities, active or recent malignancies, and organ dysfunction. The remaining 66 patients were divided into two groups: the PVT group (n = 33) and the NPVT group (n = 33). Plasma ADAMTS-13 activity (ADAMTS-13:AC) and the vWF antigen (VWF:Ag) were measured using enzyme-linked immunosorbent assays. Contrast-enhanced, three-dimensional helical computed tomography (CT) was used to detect and characterize PVT. ADAMTS-13:AC was significantly lower in the PVT group than in the NPVT group. No significant differences in plasma vWF:Ag or liver stiffness were observed between the two groups. ADAMTS-13:AC of <18.8 was an independent risk factor for PVT on multivariate analyses (odds ratio: 1.67, 95% confidence interval: 1.21–3.00, p < 0.002). The receiver operating characteristic analysis of ADAMTS-13:AC revealed an area under the curve of 0.913 in PVT detection. Patients with PVT having ADAMTS-13:AC ≥18.8 (n = 17) had higher albumin levels and better prognoses than those with ADAMTS-13:AC <18.8 (n = 16). No significant correlations of ADAMTS-13:AC levels with either fibrin degradation product or D-dimer levels were observed. ADAMTS-13:AC levels could be potential diagnostic and prognostic biomarkers for PVT in Japanese patients with LC. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this systematic review was to evaluate outcomes following both operative and nonoperative management of spiral oblique fractures of the fifth metatarsal. Methods: During November 2023, the PubMed, Embase and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following operative and nonoperative management of dancer's fractures. Data regarding subjective clinical outcomes, radiological outcomes, complications and failure rates were extracted and analysed. Results: Ten studies were included in this review. In total, 125 patients underwent operative treatment for dancer's fractures and 365 patients underwent nonoperative treatment for dancer's fractures. The weighted mean follow‐up in the operative cohort was 15.3 ± 32.7 months and the weighted mean follow‐up in the nonoperative cohort was 30.6 ± 24.3 months. The overall union rate in the operative cohort was 99.2% and the overall union rate in the nonoperative cohort was 98.6%. The weighted mean time to return to sport was 15.4 ± 6.7 and 22.4 ± 4.4 weeks in the operative cohort and nonoperative cohort, respectively. The complication rate in the operative cohort and nonoperative cohort was 12.0% and 15.1%, respectively. Conclusion: This current systematic review demonstrated comparable radiographic outcomes together with low failure rate and low complication rate following both operative and nonoperative management of dancer's fracture at short‐term follow‐up. However, faster return to sport rates was observed in the operative cohort, suggesting that surgical management of displaced spiral oblique fractures of the fifth metatarsal should be the mainstay treatment option. However, the under‐reporting of data, marked heterogeneity between studies and paucity of comparative studies limits the generation of any robust conclusions; thus, further high‐quality comparative studies are warranted. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]

Objectives: To compare clinical image quality and perceived impact on diagnostic interpretation of chest CT findings between ultra-high-resolution photon-counting CT (UHR-PCCT) and conventional high-resolution energy-integrating-detector CT (HR-EIDCT) using visual grading analysis (VGA) scores. Materials and methods: Fifty patients who underwent a UHR-PCCT (matrix 512 × 512, 768 × 768, or 1024 × 1024; FOV average 275 × 376 mm, 120 × 0.2 mm; focal spot size 0.6 × 0.7 mm) between November 2021 and February 2022 and with a previous HR-EIDCT within the last 14 months were included. Four readers evaluated central and peripheral airways, lung vasculature, nodules, ground glass opacities, inter- and intralobular lines, emphysema, fissures, bullae/cysts, and air trapping on PCCT (0.4 mm) and conventional EIDCT (1 mm) via side-by-side reference scoring using a 5-point diagnostic quality score. The median VGA scores were compared and tested using one-sample Wilcoxon signed rank tests with hypothesized median values of 0 (same visibility) and 2 (better visibility on PCCT with impact on diagnostic interpretation) at a 2.5% significance level. Results: Almost all lung structures had significantly better visibility on PCCT compared to EIDCT (p < 0.025; exception for ground glass nodules (N = 2/50 patients, p = 0.157)), with the highest scores seen for peripheral airways, micronodules, inter- and intralobular lines, and centrilobular emphysema (mean VGA > 1). Although better visibility, a perceived difference in diagnostic interpretation could not be demonstrated, since the median VGA was significantly different from 2. Conclusion: UHR-PCCT showed superior visibility compared to HR-EIDCT for central and peripheral airways, lung vasculature, fissures, ground glass opacities, macro- and micronodules, inter- and intralobular lines, paraseptal and centrilobular emphysema, bullae/cysts, and air trapping. Clinical relevance statement: UHR-PCCT has emerged as a promising technique for thoracic imaging, offering improved spatial resolution and lower radiation dose. Implementing PCCT into daily practice may allow better visibility of multiple lung structures and optimization of scan protocols for specific pathology. Key Points: • The aim of this study was to verify if the higher spatial resolution of UHR-PCCT would improve the visibility and detection of certain lung structures and abnormalities. • UHR-PCCT was judged to have superior clinical image quality compared to conventional HR-EIDCT in the evaluation of the lungs. UHR-PCCT showed better visibility for almost all tested lung structures (except for ground glass nodules). • Despite superior image quality, the readers perceived no significant impact on the diagnostic interpretation of the studied lung structures and abnormalities. [ABSTRACT FROM AUTHOR]

Acute intestinal obstruction is a frequently encountered condition characterized by sudden abdominal pain, and its prompt and accurate diagnosis plays a crucial role in the management and prognosis of patients. Although traditional abdominal X-ray imaging has certain limitations in identifying acute ileus, the emergence of multi-slice spiral CT has offered potential as a non-invasive diagnostic tool. Thus, this study aimed to assess the diagnostic efficacy of abdominal radiographs and multi-slice spiral CT in acute ileus and explore their respective advantages and limitations. A total of 64 patients diagnosed with acute intestinal obstruction and admitted to our hospital between March 2021 and March 2022 for surgical intervention were selected for this study. All patients initially underwent conventional abdominal X-ray examinations, followed by multi-slice spiral CT scans after a 12-hour interval. In the case of acute intestinal obstruction patients, multi-slice spiral CT demonstrated superior diagnostic performance compared to abdominal X-ray plain film. The use of multi-slice spiral CT resulted in enhanced diagnostic experience, lower rates of missed diagnosis and misdiagnosis. [ABSTRACT FROM AUTHOR]

To retrospectively analyze the accuracy of radiotherapy using cone beam computed tomography (CBCT), Styrofoam fixation, and breast bracket fixation in the chest wall target area and supraclavicular lymphatic drainage area (supraclavicular target area) of patients with breast cancer.and compare the setting efficiency and comfort satisfaction. A total of 65 patients with postoperative lymphatic metastasis of breast cancer, including 36 cases of Styrofoam fixation and 29 cases of breast bracket fixation, were recruited from March 2021 to August 2022 and retrospectively analyzed. All the patients underwent CBCT scans weekly, and the setup errors of the chest wall and supraclavicular target volume were compared and recorded. The planning target volume (PTV) margins of the two groups were calculated using the correlation MPTV = 2.5Σ + 0.7σ. The setup time and comfort satisfaction scores of the two groups were recorded and analyzed. The correlations among errors in each direction were analyzed using the Pearson correlation analysis. There was a significant difference in the left-right direction (X) axis of the chest wall target area between the Styrofoam and breast bracket groups (1.59 ± 1.47 mm vs. 2.05 ± 1.64 mm, P = 0.012). There were statistical differences in the ventrodorsal direction (Z) and bed angle of the supraclavicular target area, the data were (1.36 ± 1.27 mm vs. 1.75 ± 1.55 mm, P = 0.046; 0.47 ± 0.47° vs. 0.66 ± 0.59°, P = 0.006, respectively). In the X, Y, and Z directions, the respective PTV margins of the two groups in the chest wall target area were 5.01 mm, 5.99 mm, and 5.47 mm in the Styrofoam group, while those in the breast bracket group were 6.10 mm, 6.34 mm, and 6.10 mm, respectively. Moreover, the PTV margins of the supraclavicular target in the three directions were 3.69 mm, 3.86 mm, and 4.28 mm in the Styrofoam group, while those in the breast bracket group were 3.99 mm, 3.72 mm, and 5.45 mm, respectively. The setup time of the two groups was 3.4 ± 1.1 min and 5.5 ± 3.1 min (P = 0.007). The subjective comfort satisfaction scores of the two groups were 27.50 ± 1.24 and 25.44 ± 1.23 (P < 0.001). The application of Styrofoam fixation in radiotherapy of breast cancer in the supraclavicular lymph node area has several advantages as compared to breast bracket fixation, including higher positioning accuracy, smaller external expansion boundary, improved work efficiency, and patients' comfort, which might provide a reference for clinical work. [ABSTRACT FROM AUTHOR]

Objective. This study aims to explore the relationships between serum indoxyl sulfate (IS) and Klotho protein levels with vascular calcification in patients with chronic kidney disease (CKD) stages 3–5. Methods. From December 2021 to January 2023, a total of 108 CKD patients in stages 3–5 were enrolled in this cross-sectional investigation. Demographic information and routine clinical biochemistry test results were gathered. Serum levels of IS and Klotho were quantified through enzyme-linked immunosorbent assays. Furthermore, multislice spiral computed tomography was employed to evaluate vascular calcification. The association between serum IS or Klotho levels and abdominal aorta calcification was assessed using univariate analysis and logistic regression analyses. Results. With the progression of CKD stages, serum creatinine, phosphorus, intact parathyroid hormone (iPTH), serum IS, and abdominal aortic calcification exhibited incremental trends, while serum calcium and Klotho protein levels showed a diminishing trend, with statistically significant differences (P < 0. 05). Significant differences were observed in age, blood phosphorus, calcium, total parathyroid hormone, serum IS, and Klotho protein levels between patients with and without aortic calcification (P < 0. 05). Logistic regression analysis demonstrated that advanced age, high IS level, and low Klotho protein level were independent risk factors for abdominal aortic calcification in CKD patients (P < 0. 05). Conclusion. This study indicates elevated serum IS levels and decreased Klotho protein levels in CKD patients. High IS level and low Klotho level were independent risk factors for abdominal aortic calcification. [ABSTRACT FROM AUTHOR]

Background: Breast computed tomography (CT) is an emerging breast imaging modality, and ongoing developments aim to improve breast CT's ability to detect microcalcifications. To understand the effects of different parameters on microcalcification detectability, a virtual clinical trial study was conducted using hybrid images and convolutional neural network (CNN)‐based model observers. Mathematically generated microcalcifications were embedded into breast CT data sets acquired at our institution, and parameters related to calcification size, calcification contrast, cluster diameter, cluster density, and image display method (i.e., single slices, slice averaging, and maximum‐intensity projections) were evaluated for their influence on microcalcification detectability. Purpose: To investigate the individual effects and the interplay of parameters affecting microcalcification detectability in breast CT. Methods: Spherical microcalcifications of varying diameters (0.04, 0.10, 0.15, 0.20, 0.25, 0.30, 0.35, 0.40 mm) and native intensities were computer simulated to portray the partial volume effects of the imaging system. Calcifications were mathematically embedded into 109 patient breast CT volume data sets as individual calcifications or as clusters of calcifications. Six numbers of calcifications (1, 3, 5, 7, 10, 15) distributed within six cluster diameters (1, 3, 5, 6, 8, 10 mm) were simulated to study the effect of cluster density. To study the role of image display method, 2D regions of interest (ROIs) and 3D volumes of interest (VOIs) were generated using single slice extraction, slice averaging, and maximum‐intensity projection (MIP). 2D and 3D CNNs were trained on the ROIs and VOIs, and receiver operating characteristic (ROC) curve analysis was used to evaluate detection performance. The area under the ROC curve (AUC) was used as the primary performance metric. Results: Detection performance decreased with increasing section thickness, and peak detection performance occurred using the native section thickness (0.2 mm) and MIP display. The MIP display method, despite using a single slice, yielded comparable performance to the native section thickness, which employed 50 slices. Reduction in slices did not sacrifice detection accuracy and provided significant computational advantages over multi‐slice image volumes. Larger cluster diameters resulted in reduced overall detectability, while smaller cluster diameters led to increased detectability. Additionally, we observed that the presence of more calcifications within a cluster improved the overall detectability, while fewer calcifications decreased it. Conclusions: As breast CT is still a relatively new breast imaging modality, there is an ongoing need to identify optimal imaging protocols. This work demonstrated the utility of MIP presentation for displaying image volumes containing microcalcification clusters. It is likely that human observers may also benefit from viewing MIPs compared to individual slices. The results of this investigation begin to elucidate how model observers interact with microcalcification clusters in a 3D volume, and will be useful for future studies investigating a broader set of parameters related to breast CT. [ABSTRACT FROM AUTHOR]

Single‐fiber imaging technology offers unique insights for research and inspection in difficult‐to‐reach and narrow spaces. In particular, ultra‐compact multimode fiber (MMF) imaging, has received increasing interest over the past decade. However, MMF imaging will be seriously distorted when subjected to dynamic perturbations due to time‐varying mode coupling, and the imaging of space objects via Gaussian beam will be relatively degraded at the edge due to insufficient contrast. Here, a robust super‐resolution image transmission method based on a ring core fiber (RCF) with orbital angular momentum (OAM) is proposed and experimentally demonstrated. The OAM modes propagating in the RCF form a series of weakly coupled mode groups, making the imaging system robust to external perturbations. In addition, a spiral phase plate is used as a vortex filter to produce OAM for edge enhancement, thus improving the image resolution. Furthermore, a few‐shot U‐Transformer neural network is proposed to enhance the resilience of the developed RCF‐OAM imaging system against environmental perturbations. Finally, the developed RCF‐OAM imaging system achieves biological image transmission, demonstrating the practicality of the scheme. This pioneering RCF OAM image transmission system may have broad applications, potentially revolutionizing fields such as biological imaging and industrial non‐destructive testing. [ABSTRACT FROM AUTHOR]

Background and Objective. One of the illnesses with most significant mortality and morbidity rates worldwide is lung cancer. From CT images, automatic lung tumor segmentation is significantly essential. However, segmentation has several difficulties, such as different sizes, variable shapes, and complex surrounding tissues. Therefore, a novel enhanced combined intelligent system is presented to predict lung cancer in this research. Methods. Non-small cell lung cancer should be recognized for detecting lung cancer. In the pre-processing stage, the noise in the CT images is eliminated by using an average filter and adaptive median filter, and histogram equalization is used to enhance the filtered images to enhance the lung image quality in the proposed model. The adapted deep belief network (ADBN) is used to segment the affected region with the help of network layers from the noise-removed lung CT image. Two cascaded RBMs are used for the segmentation process in the structure of ADBN, including Bernoulli-Bernoulli (BB) and Gaussian-Bernoulli (GB), and then relevant significant features are extracted. The hybrid spiral optimization intelligent-generalized rough set (SOI-GRS) approach is used to select compelling features of the CT image. Then, an optimized light gradient boosting machine (LightGBM) model using the Ensemble Harris hawk optimization (EHHO) algorithm is used for lung cancer classification. Results. LUNA 16, the Kaggle Data Science Bowl (KDSB), the Cancer Imaging Archive (CIA), and local datasets are used to train and test the proposed approach. Python and several well-known modules, including TensorFlow and Scikit-Learn, are used for the extensive experiment analysis. The proposed research accurately spot people with lung cancer according to the results. The method produced the least classification error possible while maintaining 99.87% accuracy. Conclusion. The integrated intelligent system (ADBN-Optimized LightGBM) gives the best results among all input prediction models, taking performance criteria into account and boosting the system's effectiveness, hence enabling better lung cancer patient diagnosis by physicians and radiologists. [ABSTRACT FROM AUTHOR]

Objective This study investigated the safety and efficacy of sclerotherapy with intralesional bleomycin injection (IBI) for retrobulbar orbital low-flow vascular lesions under multi-slice computed tomography (CT) guidance. Methods Between January 2010 and September 2021, consecutive patients with retrobulbar orbital low-flow vascular lesions who underwent CT-guided IBI at a tertiary centre in Taiwan were enrolled. Their medical records and imaging data were retrospectively collected. Results This study enrolled 13 patients (7 male and 6 female patients; age range: 1-57 years; mean age: 25.9 years) with lymphatic malformation (LM, n  = 4), venolymphatic malformation (n  = 1), and venous malformation (VM, n  = 8). The overall radiological response rate was 76.9% (10 of 13); the radiological response rate was 75.0% in the VM group (6 of 8) and 75.0% in the LM group (3 of 4). Moreover, 3 patients (23.1%) had minor complications and 1 (7.7%) had a major complication. The mean clinical and radiological follow-up was 8.3 months and no recurrence or progression was reported. Conclusion CT-guided IBI is an effective and relatively safe minimally invasive treatment for retrobulbar orbital low-flow vascular lesions, with an overall radiological response rate of 76.9% in a mean of 1.5 sessions and a low complication rate. Advances in knowledge CT-guided sclerotherapy with IBI is a relatively safe, effective, and feasible alternative treatment option for retrobulbar orbital low-flow vascular lesions. [ABSTRACT FROM AUTHOR]

Aims Nasal septoplasty is one of the most frequently performed surgical procedures with several common and uncommon complications. Although rare, intracranial adverse events of septorhinoplasty are life-threatening, and there are few case reports of fatal intracranial complications. Patient & Methods A healthy 47-year-old woman underwent septorhinoplasty, then had a decreased level of consciousness and finally died due to subarachnoid and intraventricular hemorrhage caused by a bone fragment isolated from the fractured sphenoid sinus. Findings The complication was attributed to the surgeon’s carelessness, and he was considered liable for patient death due to medical negligence. Conclusion Surgeon experience in septoplasty surgery is essential, and meticulous attention to anatomical landmarks is paramount to prevent a serious outcome that may lead to patient death and surgeon conviction. [ABSTRACT FROM AUTHOR]

Background: The slice spacing has a crucial role in the accuracy of computed tomography (CT) images in sagittal and coronal planes. However, there is no practical method for measuring the accuracy of the slice spacing. Purpose: This study proposes a novel method to automatically measure the slice spacing using the American Association of Physicists in Medicine (AAPM) CT performance phantom. Methods: The AAPM CT performance phantom module 610-04 was used to measure slice spacing. The process of slice spacing measurement involves a pair of axial images of the module containing ramp aluminum objects located at adjacent slice positions. The middle aluminum plate of each image was automatically segmented. Next, the two segmented images were combined to produce one image with two stair objects. The centroid coordinates of two stair objects were automatically determined. Subsequently, the distance between these two centroids was measured to directly indicate the slice spacing. For comparison, the slice spacing was calculated by accessing the slice position attributes from the DICOM header of both images. The proposed method was tested on phantom images with variations in slice spacing and field of view (FOV). Results: The results showed that the automatic measurement of slice spacing was quite accurate for all variations of slice spacing and FOV, with average differences of 9.0% and 9.3%, respectively. Conclusion: A new automated method for measuring the slice spacing using the AAPM CT phantom was successfully demonstrated and tested for variations of slice spacing and FOV. Slice spacing measurement may be considered an additional parameter to be checked in addition to other established parameters. [ABSTRACT FROM AUTHOR]

The innervation of the pelvic wall muscles is not very clear. This study aimed to reveal the division of neuromuscular compartments and localize the surface position and depth of the center of the intramuscular nerve-dense region (CINDR) of the pelvic wall muscles based on Sihler's staining. Twenty-four adult cadavers were used. To localize the CINDR of the pelvic wall muscles, horizontal (H) and longitudinal (L) reference lines were drawn, and Sihler's staining was used to reveal the intramuscular nerve distribution. The CINDR projection points (P and P′ points) behind and in front of the body surface, the positions of the P points projected onto the H and L lines (PH and PL points), and the depth of CINDR were determined by spiral computed tomography scanning. The piriformis and obturator internus muscles can be divided into two and three neuromuscular compartments, respectively. The PH of CINDR of the piriformis muscle was located at 22.61 ± 2.66% of the H line, the PL was at 28.53 ± 6.08% of the L line, and the puncture depth of the piriformis muscle was at 24.64 ± 2.16% of the PP′ line. The PH of CINDR of the obturator internus muscle was at 16.49 ± 1.20% of the H line, the PL was at 10.94 ± 1.09% of its L line, and the puncture depth was 6.26 ± 0.38 cm. These findings may guide the design of the compartmentalized transplantation of the pelvic wall muscles and improve the target localization efficiency and efficacy for injecting botulinum toxin A to treat pelvic wall muscle spasm. [ABSTRACT FROM AUTHOR]