Irregular Contours Research Articles

Temporary external skin plication: a helpful new technique in gynecomastia surgery.

The aim of this study was to elucidate the external temporary skin plication (ETSP) technique in gynecomastia surgery and evaluate its role in mitigating complications and enhancing cosmetic outcomes. This study was conducted on patients diagnosed with gynecomastia, explicitly falling under Rohrich Grades IIB and III, with dermal quality being a crucial determinant. Between September 2018 and November 2021, surgical interventions were performed on 96 qualifying patients by the senior author. The operative protocol consisted of ultrasonic and suction-assisted liposuction, supplemented by lateral periareolar piecemeal gland excision. Within the cohort, 42 patients were subjected to the novel ETSP technique. In contrast, the remaining 54 patients underwent standard treatment, serving as the control group for subsequent comparative assessment. One patient required revisions for contour irregularities, while partial nipple necrosis was observed in two patients but healed without surgical intervention. However, saucer-like deformity and total nipple necrosis were not observed in our series. The overall complication rate in our series was 19%, with 9.5% of cases requiring revision. In our control group, the overall complication rate in our series was found to be 22%, with 13% of cases requiring revision. ETSP provides a homogeneous spread of the excess skin and greatly reduces or eliminates the amount of skin fold formation. ETSP reduces the need for possible skin excision and reduces visible scars and incisions, and it helps improve the results of skin-protective surgeries that are widespread today.

Smooth muscle tumours of the uterus: MR imaging malignant predictive features-a 12-year analysis in a referral hospital in Portugal.

To evaluate the magnetic resonance imaging (MRI) features that may help distinguish leiomyosarcomas from atypical leiomyomas (those presenting hyperintensity on T2-W images equal or superior to 50% compared to the myometrium). The authors conducted a retrospective single-centre study that included a total of 57 women diagnosed with smooth muscle tumour of the uterus, who were evaluated with pelvic MRI, between January 2009 and March 2020. All cases had a histologically proven diagnosis (31 Atypical Leiomyomas-ALM; 26 Leiomyosarcomas-LMS). The MRI features evaluated in this study included: age at presentation, dimension, contours, intra-tumoral haemorrhagic areas, T2-WI heterogeneity, T2-WI dark areas, flow voids, cyst areas, necrosis, restriction on diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) values, signal intensity and heterogeneity after contrast administration in T1-WI, presence and location of unenhanced areas. The association between the MRI characteristics and the histological subtype was evaluated using Chi-Square and ANOVA tests. The MRI parameters that showed a statistically significance correlation with malignant histology and thus most strongly associated with LMS were found to be: irregular contours (p < 0.001), intra-tumoral haemorrhagic areas (p = 0.028), T2-WI dark areas (p = 0.016), high signal intensity after contrast administration (p = 0.005), necrosis (p = 0.001), central location for unenhanced areas (p = 0.026), and ADC value lower than 0.88 × 10-3 mm2/s (p = 0.002). With our work, we demonstrate the presence of seven MRI features that are statistically significant in differentiating between LMS and ALM.

Protective effects of Urtica dioica on the cerebral cortex damage induced by Potassium bromate in adult male albino rats

ABSTRACT Potassium bromate is used in cheese production, beer making and is also used in pharmaceutical and cosmetic. It is a proven carcinogen as it is a strong oxidizing agent that generates free radicals during xenobiotic metabolism. Urtica dioica (Ud) (from the plants’ family of Urticaceae) is a plant that has long been used as a medicinal plant in many parts of the world. It has been shown to have anti-inflammatory, antioxidant and immunosuppressive properties. So, this study aimed to clarify the effect of Potassium bromate on the histological structure of cerebral cortex of adult male albino rats, evaluate the possible protective role of Urtica dioica. Thirty adult healthy male albino rats were divided into three groups; group I (Control group), group II (KBrO3 treated group). Group III (KBrO3 and Urtica dioica treated group).At the end of the experiment, rats in all groups were anesthetized and specimens were processed for light and electron microscope. Morphometric and statistical analyses were also performed. Nerve cells of the treated group showed irregular contours, dark nuclei, irregular nuclear envelopes, dilated RER cisternae, and mitochondria with ruptured cristae. Vacuolated neuropil was also observed. Immunohistochemically, stained sections for GFAP showed strong positive reaction in the processes of astrocytes. Recovery group showed revealed nearly the same as the histological picture as the control group. In conclusion, potassium bromate induces degenerative effects on neurons of cerebral cortex and urtica dioica provide an important neuroprotective effects against these damaging impacts through their antioxidant properties.

RADT-04. DOSE PAINTING WITH THE GAMMA KNIFE LIGHTNING OPTIMIZER TO ESCALATE RADIATION DOSE TO RESIDUAL TUMOR WITHIN BRAIN METASTASIS RESECTION CAVITIES

Abstract BACKGROUND The novel Gamma Knife (GK) Lightning optimizer allows simultaneous automated optimization of multiple intracranial radiotherapy targets. We used this optimizer to create a dose-painting treatment plan where an escalated dose was prescribed to residual disease within a brain metastasis resection cavity. We validated this method by measuring dose-delivery accuracy using radiochromic film in an anthropomorphic phantom. METHODS A 15.7cc irregular contour was drawn to represent a brain metastasis resection cavity, a 2mm expansion contour created, and a 1.6cc contour drawn representing a nodule of residual disease. In GammaPlan v11.3.1, three targets were created with overlapping dose matrices. Targets were prescribed 3Gy (2mm expansion), 4Gy (resection cavity), and 5Gy (residual disease) in one fraction. On the GK Icon system, an occipital mold was made, an unexposed film placed in the phantom’s cranium, cone-beam coregistration conducted, and treatment delivered. The film was scanned and calibrated for absolute dosimetry. To evaluate dose-painting accuracy, global gamma index (GI) analyses were performed at various dose and distance tolerances, excluding points below 30% of the maximum dose. RESULTS An 18-minute treatment plan with 40 shots was created and delivered. Prescription isodose lines were 3Gy at 55% (2mm expansion, mean 4.8Gy), 4Gy at 69% (resection cavity, mean 5.2Gy), and 5Gy at 75% (residual disease, mean 6.1Gy). All target volumes had ≥ 99% prescription dose coverage and the maximum dose was 6.9Gy. Paddick conformality indices were 0.79 (2mm expansion), 0.74 (resection cavity), and 0.15 (residual disease). Gamma index pass rate/mean GI/median GI were 73%/0.68/0.55 at 1%/1mm tolerance, 85%/0.58/0.48 at 2%/1mm tolerance, and 97%/0.34/0.28 at 2%/2mm tolerance. An average of 17,883 points were evaluated per analysis. CONCLUSIONS We successfully performed GK dose painting with the Lightning optimizer, verifying dose delivery within clinically acceptable tolerances. Future work is needed to determine optimal dose levels for use in clinical practice.

Preoperative assessment of peripheral vascular invasion of pancreatic ductal adenocarcinoma based on high-resolution MRI

ObjectivesPreoperative imaging of vascular invasion is important for surgical resection of pancreatic ductal adenocarcinoma (PDAC). However, whether MRI and CT share the same evaluation criteria remains unclear. This study aimed to compare the diagnostic accuracy of high-resolution MRI (HR-MRI), conventional MRI (non-HR-MRI) and CT for PDAC vascular invasion.MethodsPathologically proven PDAC with preoperative HR-MRI (79 cases, 58 with CT) and non-HR-MRI (77 cases, 59 with CT) were retrospectively collected. Vascular invasion was confirmed surgically or pathologically. The degree of tumour-vascular contact, vessel narrowing and contour irregularity were reviewed respectively. Diagnostic criteria 1 (C1) was the presence of all three characteristics, and criteria 2 (C2) was the presence of any one of them. The diagnostic efficacies of different examination methods and criteria were evaluated and compared.ResultsHR-MRI showed satisfactory performance in assessing vascular invasion (AUC: 0.87–0.92), especially better sensitivity (0.79–0.86 vs. 0.40–0.79) than that with non-HR-MRI and CT. HR-MRI was superior to non-HR-MRI. C2 was superior to C1 on CT evaluation (0.85 vs. 0.79, P = 0.03). C1 was superior to C2 in the venous assessment using HR-MRI (0.90 vs. 0.87, P = 0.04) and in the arterial assessment using non-HR-MRI (0.69 vs. 0.68, P = 0.04). The combination of C1-assessed HR-MRI and C2-assessed CT was significantly better than that of CT alone (0.96 vs. 0.86, P = 0.04).ConclusionsHR-MRI more accurately assessed PDAC vascular invasion than conventional MRI and may contribute to operative decision-making. C1 was more applicable to MRI scans, and C2 to CT scans. The combination of C1-assessed HR-MRI and C2-assessed CT outperformed CT alone and showed the best efficacy in preoperative examination of PDAC.

Is Bipolar Radiofrequency-Assisted Liposuction Equivalent to Open Anterior Platysmaplasty in Facelift Surgery?

BackgroundDuring facelift surgery, anterior platysmaplasty (AP) has been used for decades, but it limits lateral advancement and can induce contour irregularities. Radiofrequency-assisted-liposuction (RF) in the anterior neck can avoid these disadvantages by tightening skin without open surgery. PurposeThe purpose of the study was to compare the esthetic outcomes in facelift surgery with AP and RF. Study designA five-year retrospective cohort study was performed on facelift patients treated by a single surgeon. Exclusions were single-side surgery, previous facelift, chin/lip augmentation/reduction, and inadequate data. Primary predictor variableThe predictor variable was neck management technique (AP vs RF). Outcome variablesThe primary outcome variable was the change in cervicomental-angle (CMA) following surgery as measured on facial photographs. Secondary outcomes included distance changes from the central CMA point in vertical and horizontal planes to repeatable reference planes. CovariatesCovariates were age, BMI, ASA classification, smoking, and simultaneous procedures. AnalysesThe statistical analysis was performed using Wilcoxon sum-rank, Fisher exact, Kruskal-Wallis tests, Pearson’s correlation, and linear regressions. The level of statistical significance was P<.05. ResultsThere were 132 patients included in the study; 67 received AP and 65 received RF. AP trended toward better performance in CMA change in the unadjusted analysis (-18.7° ± 13.8° versus -22.3° ± 13.7°, respectively, P=.08). AP and RF performed similarly in the adjusted analysis (P=.29). Techniques were similar in horizontal distance change to the CMA (P=.31). RF was associated with less change in the vertical distance to the CMA in the unadjusted analysis (-11.9mm ± 11.0mm versus -6.7mm ± 8.7mm, respectively, P=.01) and adjusted analysis (β=4.3mm, 95% CI .8 to 7.9mm, P=.02). ConclusionUtilization of the RF technique for management of the anterior neck in facelift surgery is associated with similar outcomes to the AP technique in horizontal distance to the CMA but, AP performed better in CMA change and vertical distance to the CMA.

New insights into histopathological features of Warthin-like papillary thyroid carcinoma

Background. The Warthin-like variant of papillary thyroid carcinoma (WLPTC) is a rare papillary thyroid carcinoma that is considered to be a subtype of the oncocytic variant. Purpose of the study: to present the diagnostic and clinical features, the oncological and surgical management of a patient with WLPTC as well as its discussion with other relevant studies. Materials and methods. We report a case of Warthin-like papillary thyroid carcinoma in a 31-year-old woman with Hashimoto thyroiditis. Results. The patient was admitted to the hospital with the presence of a node in the thyroid gland. Thyroid ultrasound showed a 24-mm nodule with oval shape and irregular contours in the left lobe. A fine-needle aspiration biopsy was performed, and a diagnosis of papillary thyroid carcinoma was made. The patient underwent thyroidectomy, bilateral modified and central neck dissection, lymphadenectomy. Histopathological examination suggested a WLPTC coexisting with chronic thyroiditis, metastases to the lymph nodes 2, 3, 4 on the left and 6 neck compartments. The patient underwent postoperative I131 ablation therapy. Conclusions. WLPTC is a recently described variant of papillary thyroid cancer that is frequently associated with lymphocytic thyroiditis. The correct cytological and histomorphological features are of utmost importance to render the diagnosis of WLPTC for better management. A surgical and postoperative treatment is identical to that in classic differentiated thyroid cancer, having a favorable outcome due to a low recurrence rate. A surgical management should be thyroidectomy and dissection of central neck compartment as well as lateral dissection in cases of suspicions for metastases in the lymph nodes or metastases confirmed preoperatively by a fine-needle aspiration biopsy.

Recognition of building shape in maps using deep graph filter neural network

Shape is one of the core features of the buildings which are the main elements of the map. The building shape recognition is widely used in many spatial applications. Due to the irregularity of the building contour, it is still challenging for building shape recognition. Inspired by graph signal processing theory, we propose a deep graph filter neural network (DGFN) for the shape recognition of buildings in maps. First, we regard shape recognition as a combination of subjective and objective graph signal filtering process. Second, we construct a shape features extraction framework from the perspective of shape details, shape structure and shape local information. Third, DGFN model can fulfil the tasks of shape classification and shape embedding of building at the same time. Finally, multi angle experiments verify our viewpoint of shape recognition mechanism, and the comparison with similar algorithms proves the high accuracy and availability of DGFN model.

Clinical and radiological features associated with EGFR mutation in non-small-cell lung cancer: a study of 149 cases

BackgroundLung cancer is the leading cause of cancer death in the world. Non-small-cell lung cancer (NSCLC) accounts for 85% of primary lung tumors. Epidermal growth factor receptors (EGFRs) are found on the surface of tumor cells, and their role is to send a growth signal to the cell nucleus. Tumor cells with EGFR mutations are very sensitive to cancer treatments called "Targeted Therapies." The search for EGFR mutations requires lung biopsies. Some studies have shown a correlation between clinico-radiological characteristics and the EGFR mutation. In this study, an attempt was made to identify the relevant clinico-radiological characteristics associated with the EGFR mutation in patients with NSCLC.ObjectivesThe main objective of this study was to evaluate the clinico-radiological characteristics useful for predicting the risk of EGFR mutation in patients with NSCLC.Materials and methodsThis is a retrospective cross-sectional study, carried out in 149 patients followed up for lung adenocarcinoma who benefited from an EGFR mutation study at the anatomopathology department of the University Hospital of Fez, spread over a period of 4 years (between January 2018 and December 2021). A database was compiled from this study, including sociodemographic, clinical, anatomopathological and radiological data. A statistical analysis was carried out in order to identify the factors associated with EGFR mutation.ResultsAccording to the inclusion and exclusion criteria, of the 149 patients included, the mean age was 61.05 + / − 11.095 years. Males predominated with a percentage of 70.5% (n = 105). Fifty-seven point seven percent of patients were smokers or ex-smokers. Forty-one patients had an EGFR mutation, representing a percentage of 27.5%. Multivariate analysis by logistic regression revealed an association of the EGFR mutation with irregular contours (ORA = 6.43; CI95% 1.26;32.78), with the presence of spiculations (ORA = 5.81; CI95% 1.96;17.22), with pleural attachment (ORA = 3.53; CI95% 1.32;9.42), with heterogeneous enhancement (ORA = 30.679; CI95% 5.149;182.778), with absence of emphysema (ORA = 4.815; CI95% 1.966;17.220) and with presence of distant metastasis (ORA = 4.123; CI95% 1.373;12.383).ConclusionsThis study provides substantial evidence to support the assertion that irregular contours, the presence of spiculations, pleural attachment, heterogeneous enhancement, the absence of emphysema and the presence of distant metastasis are statistically correlated with EGFR mutations. The model developed within this study, encompassing all relevant clinical and CT characteristics, has demonstrated its effectiveness as a reliable predictor for EGFR mutations (AUC: 0.7659) and consequently as a key determinant of EGFR-TKI treatment response.

Open Otoplasty Through Ventral Skin Incision and Abrasion of the Antihelix Under Vision.

Common otoplasties through incisions behind the ear with blind scoring or scratching the anterior perichondrium often leave an irregular surface of the antihelix. To avoid these tiny side effects, a skin incision along the ventral antihelical fold (scapha) is used to thin and fold the flat antihelix under vision. After local anesthesia of the ventral ear skin, an incision along the scapha allows its blunt lifting toward the concha and to expose the cartilaginous antihelix. Its future shape is marked and the thickness of the cartilage is thinned with a dermabrader by approximately half or until one sees the gray of the inner cartilage. The now missing perichondrium causes the antihelix to fold by itself with an absolute smooth surface and is fixed with three absorbable mattress sutures. The technique has been developed in 1985 in Frankfurt and has since been performed on over 1000 patients with optimal results and a low complication rate. The skin flap is so well perfused that no skin necrosis and only 5.7% wound healing problems were experienced. This approach from ventral is safe, timesaving, and avoids contour irregularities of the antihelix often seen after traditional techniques. It can be left to beginners in plastic surgery without hesitation. The fear of hypertrophic scars or even keloids can be dispelled with the fact that ear keloids only occur after wound infection. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Acute ischemic stroke in a caucasian male with long chiari network, interatrial septal aneurysm and patent foramen ovale: A case report

A 49-year-old Caucasian male, left-handed, with no known comorbidities, working as a middle school teacher, presented to the emergency room with a sudden-onset left hand weakness described as difficulty gripping with no other associated symptoms. A non-smoker, non-alcoholic beverage drinker, with no illicit drug use. There was no significant history of any neurological disease in the family background but his father has a history of interatrial septal aneurysm. Physical, cardiologic and neurologic examination at the emergency department were unremarkable aside from the weakness on his left hand and a mild sensory deficit on the left upper extremity. A cranial magnetic resonance imaging with magnetic resonance angiography was done which showed a hyperacute infarct in the right frontal lobe, with paucity of vessels and attenuation of flow-related signals in the M4 perforators of the right middle cerebral artery and contour irregularities along the intradural segment of the right vertebral artery relating to atherosclerotic changes (Figure 1). Patient was given a recombinant tissue plasminogen activator since he came in at the 3rd hour post-ictus. Laboratory tests done at the emergency department showed normal complete blood count, routine blood chemistry, A further work-up was done which showed a slightly elevated LDL on Lipid profile, and other parameters within normal limit.

Urothelial carcinoma of the urethra: A new case and review of the literature

The urothelial carcinoma of the male urethra is a rare entity. This study reports a case of the urethra’s urothelial carcinoma in a 71-year-old man who sought medical attention for an ulcerative-burgeoning swelling of the penis, centered on the meatus region (annex 1, 2). The pelvic MRI performed had revealed a well-limited tissular ulcerative-burgeoning structure localized at the same level as the glans, with irregular contours. Its’ histological examination has confirmed a urothelial carcinoma of the urethra. The patient refused any additional treatment, the lymphadenectomy included. He then presented a local recurrence 4 months later.

Addressing the Gray Zone in Affirmative Mastectomy: An Analysis of Fischer 2 Patients.

Surgical decision making in gender-affirming mastectomy (GAM) is based on a patient's classification using the Fischer scale. Fischer 1 patients are excellent candidates for periareolar (PA) approach and Fischer 3 patients almost exclusively undergo double incision with free nipple grafting (DIFNG). Fischer 2 patients are in a gray zone in which decision making is more challenging. In this patient population, periareolar approaches can lead to increased complication and revision rates but free grafting procedures seem excessive. We have created a treatment algorithm to address Fischer 2 patients and additionally developed a novel technique, the batwing, to provide patients with more options. A retrospective chart review was undertaken to analyze the Fischer classification of all patients undergoing top surgery by a single surgeon at an academic institution from 2014 to 2021. The choice of surgical technique used as well as the outcomes of GAM among Fischer 2 patients was analyzed. Four hundred four patients underwent GAM, and 51 (11%) had Fischer 2 classification. The surgical techniques used were PA (27%), batwing (39%), nipple-sparing double incision (NSDI, 24%), and DIFNG (10%). Of those, 10% had major complications and 20% requested revision for contour irregularities. Major complication rates for PA, batwing, NSDI, and DIFNG were as follows: 2 of 14 patients (14%), 1 of 20 patients (5%), 1 of 12 patients (8%), and 1 of 5 patients (20%), respectively. The revision rate by technique was PA (36%), batwing (15%), NSDI (17%), and DIFNG (0%). For Fischer 2 patients, batwing and NSDI techniques avoid the need for free nipple graft while providing better exposure, improved control of nipple-areolar complex position, and decreased rate of revision as compared with the PA technique. The complication rate was not significantly different. We present an algorithm accounting for Fischer grade, unique patient characteristics, and patient desires.

Calculation of Road Traffic Noise, Development of Data, and Spatial Interpolations for Traffic Noise Visualization in Three-dimensional Space

Road traffic noise visualization is vital in three-dimensional (3D) space. Designing noise observation points (NOPs) and the developments of spatial interpolations are key elements for the visualization of traffic noise in 3D. Moreover, calculating road traffic noise levels by means of a standard noise model is vital. This study elaborates on the developments of data and spatial interpolations in 3D noise visualization. In 3D spatial interpolation, the value is interpolated in both horizontal and vertical directions. Eliminating flat triangles is vital in the vertical direction. Inverse distance weighted (IDW), kriging, and triangular irregular network (TIN) are widely used to interpolate noise levels. Because these interpolations directly support the interpolation of three parameters, the developments of spatial interpolations should be applied to interpolate noise levels in 3D. The TIN noise contours are primed to visualize traffic noise levels while IDW and kriging provide irregular contours. Further, this study has identified that the TIN noise contours fit exactly with NOPs in 3D. Moreover, advanced kriging interpolation such as empirical Bayesian kriging (EBK) also provides irregular shape contours and this study develops a comparison for such contours. The 3D kriging in EBK provides a significant approach to interpolate noise in 3D. The 3D kriging voxels show a higher accurate visualization than TIN noise contours.

Machine learning for classification of cutaneous sebaceous neoplasms: implementing decision tree model using cytological and architectural features

BackgroundThis observational study aims to describe and compare histopathological, architectural, and nuclear characteristics of sebaceous lesions and utilized these characteristics to develop a predictive classification approach using machine learning algorithms.MethodsThis cross-sectional study was conducted on Iranian patients with sebaceous tumors from two hospitals between March 2015 and March 2019. Pathology slides were reviewed by two pathologists and the architectural and cytological attributes were recorded. Multiple decision tree models were trained using 5-fold cross validation to determine the most important predictor variables and to develop a simple prediction model.ResultsThis study assessed the characteristics of 123 sebaceous tumors. Histopathological findings, including pagetoid appearance, neurovascular invasion, atypical mitosis, extensive necrotic area, poor cell differentiation, and non-lobular tumor growth pattern, as well as nuclear features, including highly irregular nuclear contour, and large nuclear size were exclusively observed in carcinomatous tumors. Among non-carcinomatous lesions, some sebaceoma and sebaceous adenoma cases had features like high mitotic activity, which can be misleading and complicate diagnosis. Based on multiple decision tree models, the five most critical variables for lesion categorization were identified as: basaloid cell count, peripheral basaloid cell layers, tumor margin, nuclear size, and chromatin.ConclusionsThis study implemented a machine learning modeling approach to help optimally categorize sebaceous lesions based on architectural and nuclear features. However, studies of larger sample sizes are needed to ensure the accuracy of our suggested predictive model.

Computer tomography-based shape of tumor contour and texture of tumor heterogeneity are independent prognostic indicators for clinical T1b-T2 renal cell carcinoma.

To evaluate association between computer tomography (CT)-based features of renal cell carcinoma (RCC) and survival outcomes. Data of 958 patients with clinical T1b-T2 RCC who underwent partial/radical nephrectomy from June 2003 to March 2022 were retrospectively evaluated. CT images of patients were reviewed by two radiologists for texture analysis of tumor heterogeneity and shape analysis of tumor contour. Patients were divided into three groups according to patterns of CT-based features: (1) favorable feature group (n = 117); (2) intermediate feature group (n = 606); and (3) unfavorable feature group (n = 235). Kaplan-Meier survival analysis and multivariate Cox regression analysis were performed to evaluate overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS). RCCs with unfavorable CT-based feature showed larger size on CT, higher nuclear grade, higher rate of histologic necrosis, and higher rate of capsular invasion than those in the other two groups (all p < 0.001). Unfavorable feature was associated with poorer OS (p = 0.001), CSS (p < 0.001), and RFS (p < 0.001) on Kaplan-Meier analysis. In multivariate analysis, intermediate and unfavorable features were independent predictors for recurrence (hazard ratio [HR] 2.51, 95% confidence interval [CI] 1.09-5.79, p = 0.031 and HR 3.71, 95% CI 1.58-8.73, p = 0.003, respectively), but not for overall death or RCC-specific death. A combination of irregular tumor contour feature with heterogeneous tumor texture feature on CT is associated with poor RFS in clinical T1b-T2 RCC preoperatively.

Branding with music: How can music contour and tonality enhance perceived brand innovativeness and brand evaluations?

AbstractA large and growing number of brands use music in their marketing communications to influence consumer perceptions. This article offers an answer to how brands can leverage the characteristics of music pieces to convey an innovative image and boost brand evaluations among consumers. The authors bridge prior research in psychology, marketing, and musicology to demonstrate that using music pieces with an irregular contour or unstable tonality in communications can make brands appear more innovative. The difficulty that consumers experience in cognitively processing music pieces with these characteristics (disfluency) mediates these effects. Additionally, this research shows that branding with music that has an irregular contour or unstable tonality can either positively or negatively impact brand evaluations. This is contingent on whether brand communication includes information about brand innovativeness or brand liking. This article identifies the characteristics of music that influence perceived brand innovativeness and brand evaluations and offers a theoretical lens for understanding these effects. It also reveals which brands can benefit from using music pieces with an irregular contour or unstable tonality, as well as when they can benefit from it. Additionally, it provides practical recommendations for music selection.

Imaging Characteristics Predictive of Cervical Extranodal Tumor Extension in Patients With Head and Neck Squamous Cell Carcinoma.

The aims of the study were to determine the predictive imaging findings of extranodal extension (ENE) in metastatic cervical lymph nodes of head and neck squamous cell carcinoma and to investigate the interobserver agreement among radiologists with different experience levels. Patients with cervical lymph node dissection and who had metastatic lymph nodes and preoperative imaging were included. Three radiologists evaluated nodal necrosis, irregular contour, gross invasion, and perinodal fat stranding. They also noted their overall impression regarding the presence of the ENE. Sensitivity, specificity, odds ratios based on logistic regression, and interobserver agreement of ENE status were calculated. Of 106 lymph nodes (that met inclusion criteria), 31 had radiologically determined ENE. On pathologic examination, 22 of 31 nodes were positive for ENE. The increasing number of metastatic lymph nodes was associated with the presence of the ENE ( P = 0.010). Irregular contour had the highest sensitivity (78.6%) and gross invasion had the highest specificity (96%) for the determination of the ENE. The radiologists' impression regarding the presence of the pathlogical ENE had 39.3% sensitivity and 82% specificity. Metastatic lymph nodes with a perinodal fat stranding and with the longest diameter of greater than 2 cm were found to be strong predictors of the ENE. The gross invasion demonstrated the highest κ value (0.731) among the evaluated imaging criteria. In the assessment of ENE, the gross invasion had the highest specificity among imaging features and showed the highest interobserver agreement. Perinodal fat stranding and the longest diameter of greater than 2 cm in a metastatic lymph node were the best predictors of the ENE.

Ultrasound Findings of Suspected Breast Cancer Lesions in Females Accessing Breast Ultrasound Services in Selected Hospitals in Lusaka, Zambia

Background: Breast cancer is the most common malignancy among women in Zambia. Ultrasound can be a useful tool for early diagnosis of breast cancer based on the breast lesions’ features. However, an overlap in the ultrasound features of malignant and benign breast tumours has been noticed together with a paucity of information on the ultrasound features that are more suggestive of breast cancer. Objective: The purpose of this study was to identify ultrasound features of suspected breast cancer lesions which may assist in ascertaining a high breast cancer or benign breast disease suspicion index, that may be used to prioritise patients requiring further and urgent management for breast cancer. Methods: Systematic random sampling was used for the selection of participants in this study. The selected patients first underwent an ultrasound scan in the Ultrasound department to obtain the breast lesion ultrasound features. The histology results for the same patients were then obtained from the University Teaching Hospital (UTH) histology laboratory or the histology report filed in the patient’s medical file. Results: Irregular shape of breast lesions, vertical orientation of breast lesions, hypoechogenicity of breast lesions, complex echo pattern of breast lesions, irregular or spiculated margin contours of breast lesions, compression of breast lesion surrounding tissue, absence of hyperechogenic spots in breast lesions and a breast lesion boundary with neither a hyperechoic halo nor thin capsule (None) were found to be associated with breast cancer. No breast lesion showed less than 3 ultrasound features suspicious for breast cancer. Hyperechoic spots in breast lesions were found to be associated with non-cancerous breast lesions. Conclusion: Low-resource countries, such as Zambia, where access to imaging diagnostic equipment such as Mammography and Magnetic Resonance Imaging machines (MRI), and histology examinations are scarce, the preceding ultrasound findings .......

FBC-ANet: A Semantic Segmentation Model for UAV Forest Fire Images Combining Boundary Enhancement and Context Awareness

Forest fires are one of the most serious natural disasters that threaten forest resources. The early and accurate identification of forest fires is crucial for reducing losses. Compared with satellites and sensors, unmanned aerial vehicles (UAVs) are widely used in forest fire monitoring tasks due to their flexibility and wide coverage. The key to fire monitoring is to accurately segment the area where the fire is located in the image. However, for early forest fire monitoring, fires captured remotely by UAVs have the characteristics of a small area, irregular contour, and susceptibility to forest cover, making the accurate segmentation of fire areas from images a challenge. This article proposes an FBC-ANet network architecture that integrates boundary enhancement modules and context-aware modules into a lightweight encoder–decoder network. FBC-Anet can extract deep semantic features from images and enhance shallow edge features, thereby achieving an effective segmentation of forest fire areas in the image. The FBC-ANet model uses an Xception network as the backbone of an encoder to extract features of different scales from images. By transforming the extracted deep semantic features through the CIA module, the model’s feature learning ability for fire pixels is enhanced, making feature extraction more robust. FBC-ANet integrates the decoder into the BEM module to enhance the extraction of shallow edge features in images. The experimental results indicate that the FBC-ANet model has a better segmentation performance for small target forest fires compared to the baseline model. The segmentation accuracy on the dataset FLAME is 92.19%, the F1 score is 90.76%, and the IoU reaches 83.08%. This indicates that the FBC-ANet model can indeed extract more valuable features related to fire in the image, thereby better segmenting the fire area from the image.