Clinical Evaluation Research Articles

A novel MAOA gene variant: Brunner syndrome, a rare syndrome, is associated with a wide range of psychiatric symptoms.

Brunner syndrome is a rare genetic disorder that associated with mutations in the MAOA gene. It has been linked to a number of psychiatric disorders. We present detailed information on psychiatric evaluation of a case carrying a novel MAOA gene variant of p.(Thr408Met). The patient was referred to our clinic with a history of attention problems, motor coordination difficulties and a tendency to bite objects. Following a comprehensive psychiatric evaluation, the patient was diagnosed with developmental coordination disorder, articulation disorder and attention deficit hyperactivity disorder (ADHD). MAOA mutations are rarely reported in the literature. To date, a total of 23 MAOA gene variants, mostly missense variants, have been reported through the HGMD database (Professional 2023.4). Neurodevelopmental symptoms may vary in severity and diversity among patients with Brunner syndrome. Different degrees of intellectual disability have been found in previously reviewed cohorts of Brunner syndrome. In our affected patient, cognitive development and academic achievement were at a similar level to his peers. Additionally, our patient exhibited symptoms suggestive of developmental coordination disorder. Our findings show that genetic mutations in MAOA can lead to a wide range of clinical symptoms and underline the need for comprehensive genetic and clinical evaluations.

Anti-inflammatory properties of ophioglonin derived from the fern Ophioglossum vulgatum L. via inactivating NF-κB and MAPK signaling pathways.

Medicinal plants contain bioactive compounds that have therapeutic effects on human health. Ophioglossum vulgatum L. is a representative species of the fern genus Ophioglossum that has anti-inflammatory properties as recognized in folk medicine. Herein, we performed a nitric oxide (NO) assay-guided screening in RAW264.7 cells to investigate the active components of the plant. We found that ophioglonin (OPN), a characteristic homoflavonoid of the genus Ophioglossum, is one of the bioactive components. Therefore, we performed a comparative analysis of the isolated compounds and found that OPN has effects similar to those of isolated dihydroquercetin and luteolin at the concentrations tested. The antioxidant and anti-inflammatory activities of OPN were extensively validated using lipopolysaccharide -stimulated RAW264.7 cells, mouse bone marrow-derived macrophages (BMDMs), and peritoneal exudate macrophages (PEMs). In vivo experiments with a carrageenan-induced mouse paw edema model further confirmed the anti-inflammatory effect of OPN. Additionally, we found that OPN and Ophioglossum vulgatum extracts inhibit the activation of signal transducers, NF-ĸB p65, IĸBα, ERK, p38, and JNK, consistent with the findings of pathway enrichment analysis. This work reinforces the anti-inflammatory properties of Ophioglossum vulgatum and indicates that OPN is a promising therapeutic agent for inflammation-associated disorders. Further clinical evaluations, including clinical trials, would be beneficial to validate the anti-inflammatory properties of OPN.

Deep learning-based automatic contour quality assurance for auto-segmented abdominal MR-Linac contours

Objective.Deep-learning auto-segmentation (DLAS) aims to streamline contouring in clinical settings. Nevertheless, achieving clinical acceptance of DLAS remains a hurdle in abdominal MRI, hindering the implementation of efficient clinical workflows for MR-guided online adaptive radiotherapy (MRgOART). Integrating automated contour quality assurance (ACQA) with automatic contour correction (ACC) techniques could optimize the performance of ACC by concentrating on inaccurate contours. Furthermore, ACQA can facilitate the contour selection process from various DLAS tools and/or deformable contour propagation from a prior treatment session. Here, we present the performance of novel DL-based 3D ACQA models for evaluating DLAS contours acquired during MRgOART.Approach.The ACQA model, based on a 3D convolutional neural network (CNN), was trained using pancreas and duodenum contours obtained from a research DLAS tool on abdominal MRIs acquired from a 1.5 T MR-Linac. The training dataset contained abdominal MR images, DL contours, and their corresponding quality ratings, from 103 datasets. The quality of DLAS contours was determined using an in-house contour classification tool, which categorizes contours as acceptable or edit-required based on the expected editing effort. The performance of the 3D ACQA model was evaluated using an independent dataset of 34 abdominal MRIs, utilizing confusion matrices for true and predicted classes.Main results.The ACQA predicted 'acceptable' and 'edit-required' contours at 72.2% (91/126) and 83.6% (726/868) accuracy for pancreas, and at 71.2% (79/111) and 89.6% (772/862) for duodenum contours, respectively. The model successfully identified false positive (extra) and false negative (missing) DLAS contours at 93.75% (15/16) and %99.7 (438/439) accuracy for pancreas, and at 95% (57/60) and 98.9% (91/99) for duodenum, respectively.Significance.We developed 3D-ACQA models capable of quickly evaluating the quality of DLAS pancreas and duodenum contours on abdominal MRI. These models can be integrated into clinical workflow, facilitating efficient and consistent contour evaluation process in MRgOART for abdominal malignancies.

Serratus Anterior Plane Block Remote Learning Curriculum.

Regional anesthesia aids in management of acute pain in the emergency department, but many emergency physicians remain inadequately trained. Further complicating medical education, our academic center continues to use remote learning as the primary setting for residency didactics. This project aims to create a remote conference session on ultrasound-guided serratus anterior plane blocks (USG-SAPB). We used the ADDIE (analyze, design, develop, implement, evaluate) model for curricular design, with emergency medicine residents as our intended learners. For the analyze element, we examined clinical need and resident program evaluation feedback. For design, we utilized best practices for remote learning, principles of mental rehearsal, and multimodal instructional theory. For develop, we completed recruitment of faculty leads, materials, and beta testing of each component. We implemented our 50-minute session on the videoconferencing platform Zoom. For evaluate, we created a program evaluation survey based on Kirkpatrick's evaluation model. Seventeen learners completed the evaluation. For Kirkpatrick level 1, 94% reported being very or extremely satisfied. For Kirkpatrick level 2, 91% ranked their presession confidence level in performing USG-SAPB as not at all or slightly confident, compared to the postsession, where 88% ranked themselves as moderately, very, or extremely confident. For Kirkpatrick level 3, 94% reported that they would incorporate at least a moderate amount of content into clinical practice. This remote learning session on USG-SAPB demonstrated high levels of learner satisfaction, improvement in learner confidence, and potential to impact learners' clinical practice. Future studies can elucidate patient outcomes related to educational sessions.

ANKS6 Variants Underlie Polycystic Kidneys in Prenatal and Neonatal Cases

Background: Nephronophthisis (NPHP) is an autosomal recessive genetic disorder that can cause early-onset kidney failure. ANKS6 plays an important role in early kidney development and encodes a protein that interacts with other proteins within the primary cilium. ANKS6 mutations are known to cause nephronophthisis 16 (NPHP-16). Little is known regarding fetal ultrasound imaging and the antenatal diagnosis of fetuses with ANKS6-associated kidney disease. Here, we report the detection of ANKS6 variants in consanguineous families with polycystic kidney antenatally and in the early stages of life. Methods: Three unrelated Saudi Arabian patients (two prenatal patients and one neonate) were investigated. These cases were referred to the hospital due to the presence of echogenic kidneys on antenatal scanning. After clinical and phenotypic evaluation, whole-exome sequencing (WES) was performed on the cord and peripheral blood to identify the molecular genetic causes associated with the echogenic kidney phenotypes. Results: Two homozygous sequence variants were detected in ANKS6. The homozygous missense novel variant ANKS6: c.1159A>C was detected in Families 1 and 2. In the third family, the known homozygous loss-of-function variant ANKS6: c.907+2T>A was detected. Conclusions: We identified homozygous ANKS6 variants in three families presenting with antenatal polycystic kidney disease. The findings provide an expanded clinical presentation of ANKS6 and emphasize the utility of WES in the diagnosis of echogenic kidneys in prenatal settings.

Changes in Clinical Competence of Novice Physical Therapists During Their First Year of Employment: A Single Center Retrospective Observational Study in Japan

Background and Objectives: This study aimed to examine the development of clinical competence of novice physical therapists (PTs) during their first year of employment, following the implementation of an original in-house educational program. The educational program was designed to offer diverse training opportunities at an early stage, during the first year of employment. Methods: Thirty-eight novice PTs (21 males and 17 females, mean age 23.4 ± 3.2 years) participated in this study. All participants underwent educational programs and a self-assessment using the Clinical Competence Evaluation Scale in Physical Therapy (CEPT) on the first day of employment (entry-level) and after 1, 3, 6, and 12 months of employment. The total score and CEPT component-wise scores—“knowledge,” “clinical reasoning,” “skill,” “communication,” “attitude,” “self-education,” and “self-management”—at the 4 assessment points (1, 3, 6, and 12 months) were compared with values on the first day. Results: The total scores at 3, 6, and 12 months of employment were significantly higher than those on the first day of employment (P < .05). Among the total scores on the 7 components, those for “knowledge,” “clinical reasoning,” “skill,” and “communication” at 3, 6, and 12 months after employment were also significantly higher than those on the first day of employment (P < .05). The scores for “attitude” and “self-education” 12 months after employment were significantly higher than those on the first day of employment. However, the “self-management” scores at 1, 3, 6, and 12 months after employment did not significantly change compared with those on the first day of employment. Conclusions: The total score was significantly higher after 3 months. The participant’s clinical competence may have improved because they participated in an educational program related to “knowledge,” “clinical reasoning,” “skills,” and “communication” at an earlier stage in the first year. However, their progress was comparatively slower in other areas, suggesting that the content might not have been sufficient. This study revealed the effectiveness of the educational program on novice PTs’ clinical competence at a single institution in Japan. Positive outcomes were obtained for several parameters. Furthermore, the results reveal the need for content modifications within the educational program to improve PTs’ performance across all evaluated items.

Measuring autism with the ADOS-2 using a bifactor model.

The measurement of autism characteristics can be challenging due to variability of social impairments and restricted and repetitive behaviors or interests (RRBs). Psychometrically strong measures such as the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) can improve our capacity for thorough autism assessment. The conceptualization of the ADOS-2 has been shaped by research exploring the structure of its items, which evaluate autism traits associated with social affect and RRBs. Continuously refining our understanding of these items and their relations to other characteristics, such as cognition, is crucial for more accurate autism assessment and diagnosis. This study used data from a sample of 188 school-age children with mostly average cognitive functioning referred for clinical autism evaluations to (1) test the dimensionality of the ADOS-2, Module 3 (appropriate for children with relatively higher verbal ability), across two sets of items (i.e., algorithm only, algorithm with three non-algorithm RRB items) using confirmatory factor analysis (CFA) and (2) examine the relations of cognition to the dimensions tested in the ADOS-2. A bifactor model, featuring a general autism trait and two subfactors (RRB and Social Affect), provided superior fit for algorithm-only and algorithm with three non-algorithm items. Cognitive functioning was not significantlyrelated to the general or specific factors in the model with only algorithm items. While the findings support the validity of the ADOS-2, it may not fully capture RRBs among children referred for autism. This study enhances our understanding of the ADOS-2, highlighting the utility of a bifactor model for characterizing its dimensionality, measuring autism traits with minimal cognitive influence, and identifying its limitations in assessing RRBs.

Clinical Evaluation of Violet Light Filtration and High-Resolution Lathing on a Diffractive Extended Depth of Focus IOL.

This study is a prospective, randomized, subject/evaluator-masked clinical trial in a single-center clinical setting. The purpose of the study is to compare the clinical performance of Tecnis Symfony Optiblue IOL (models ZXR00V and ZXW150) with violet light filter (VLF) and manufacturing improvements versus Tecnis Symfony IOL (models ZXR00 and ZXT150) with ultraviolet light filter (UVF) in patients undergoing cataract surgery. Patients with cataracts aged ≥ 22years were randomly assigned 1:1 to bilateral implantation with ZXR00V/ZXW150 (VLF group) or ZXR00/ZXT150 (UVF group). Key endpoints at 6months postoperative included patient reported nighttime dysphotopsia symptoms, 25% low contrast visual acuity with glare, and patient satisfaction. Sixty patients were implanted with ZXR00V/ZXW150 (30) or ZXR00/ZXT150 (30). At 6months, the VLF group did not show a statistically significant differences in mean monocular photopic uncorrected distance visual acuity (UCDVA), best-corrected distance visual acuity (BCDVA), uncorrected near visual acuity (UCNVA) (40cm), or distance-corrected near visual acuity (DCNVA) (40cm) compared to the UVF group. At 1month, patients in the VLF group reported significantly less difficulty due to halo (p = 0.016) and starburst (p = 0.028) symptoms. By the 6months, dysphotopsia complaints were no longer significantly different between the groups. Although the VLF group trended toward better low contrast visual acuity and patient satisfaction, statistical significance was not reached. Managing the patients' expectations is key to achieving success. At the 1-month visit the patients who reported dysphotopsia complaints in the VLF group had significantly less difficulty with starbursts and halos as compared to the UVF group. By the 6-month visit, there was no significant difference between the two groups in the difficulty with starbursts and halos. ClinicalTrials.gov identifier, NCT06567834.

Xenon and Argon as Neuroprotective Treatments for Perinatal Hypoxic-Ischemic Brain Injury: A Preclinical Systematic Review and Meta-Analysis.

Xenon and argon are currently being evaluated as potential neuroprotective treatments for acquired brain injuries. Xenon has been evaluated clinically as a treatment for brain ischemia with equivocal results in small trials, but argon has not yet undergone clinical evaluation. Several preclinical studies have investigated xenon or argon as treatments in animal models of perinatal hypoxic-ischemic encephalopathy (HIE). A systematic review of MEDLINE and Embase databases was performed. After screening of titles, abstracts, and full text, data were extracted from included studies. A pairwise meta-analysis of neuroprotective efficacy was performed using a random effects model. Heterogeneity was investigated using subgroup analysis, funnel plot asymmetry, and Egger's regression. The protocol was prospectively registered on PROSPERO (CRD42022301986). A total of 21 studies met the inclusion criteria. The data extracted included measurements from 1591 animals, involving models of HIE in mice, rats, and pigs. The meta-analysis found that both xenon and argon had significant (P < .0001) neuroprotective efficacies. The summary estimate for xenon was 39.7% (95% confidence interval [CI], 28.3%-51.1%) and for argon it was 70.3% (95% CI, 59.0%-81.7%). The summary effect for argon was significantly (P < .001) greater than that of xenon. Our results provide evidence supporting further investigation of xenon and argon as neuroprotective treatments for HIE.

Investigating the effect of synbiotic supplementation on inflammatory indices in critically ill septic children: a protocol study for randomized control trial

BackgroundSepsis, a severe inflammatory response to infection, is a global health priority due to its high mortality and long-term disability rates. Its pathophysiology involves both inflammation and immune suppression. Managing sepsis requires significant healthcare resources and expenditure, with sepsis being a leading cause of hospital costs. Gut microbiotas play a crucial role in sepsis, and probiotics show promise in managing it by restoring microbial balance. Despite advances, targeted therapies for sepsis remain elusive, necessitating innovative approaches such as probiotic therapy.MethodFifty-four eligible patients with sepsis will be randomly assigned to either the synbiotic or placebo group. The synbiotic supplement, KidiLact, comprises ten probiotic strains and prebiotic fructooligosaccharides. Participants will receive two sachets daily for 7 days, mixed with sterile water and administered orally or via gavage. Inflammatory factors including interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) will be evaluated. Anthropometric measurements, nutritional assessment, biochemical analysis, and clinical evaluation will be conducted to assess treatment outcomes. Statistical analysis will be performed to compare results between the two groups, employing SPSS version 19 with a significance level of P < .05.ConclusionThis randomized clinical trial aims to evaluate synbiotic supplementation effects on inflammatory markers and clinical outcomes in pediatric sepsis patients in the pediatric intensive care unit (PICU). Probiotics have shown promise in reducing proinflammatory cytokines like IL-6, TNF-α, and CRP, which are vital in the inflammatory response. Synbiotics can enhance gut integrity, preventing pathogen translocation and reducing inflammation. If our expectations regarding the effects of probiotics are correct, we can use them as a cost-effective supplement to improve the condition of pediatric sepsis in hospitals.Trial registrationIRCT,IRCT20230523058266N1 Registered 30 October 2023, https://irct.behdasht.gov.ir/trial/71397.

Anterior Cruciate Ligament Allograft Reconstruction in Females Can Produce Outcomes Comparable to Those of Autografts in Male Counterparts.

There are unique anatomic and geometric risk factors that contribute to higher injury rates of the anterior cruciate ligament (ACL) in women. Allografts are an important alternative option for female patients. Patients who underwent primary ACL reconstruction were retrospectively evaluated. The case group comprised female patients with ACL allograft reconstruction, and the control group comprised male patients with ACL reconstruction. Functional and clinical evaluations were based on the pre- and postoperative Cybex test, Lysholm score, International Knee Documentation Committee subjective and objective measurement criteria, and Tegner Activity Scale questionnaires. Radiological comparisons were performed using the femorotibial angle (FTA), posterior tibial slope (PTS), and intercondylar notch width (INW). The roof inclination angle (RIA) was assessed using magnetic resonance imaging. The two groups [female (44) and male (88)] had an average follow-up period of 57.9±19.3 months and average ages of 36.5±10.9 and 35.2±11.7 years, respectively. Functional and clinical outcomes showed no differences between the groups, except that the return to the pre-injury activity level was higher in the female group (95% vs. 77%, P<0.001). The female group showed larger FTA and PTS and smaller INW and RIA than those of the male group (P<0.001, 0.008, <0.001 and 0.035, respectively). Female ACL allograft reconstruction showed comparable outcomes to those of their male counterparts, and the return to pre-injury activity levels was significantly higher in women. However, women showed lower activity levels and were more vulnerable to geometric risk factors than their male counterparts.

P-60888434-1348 - External sinus lift using piezoelectric device with staged or simultaneous implant placement: Clinical and radiological success evaluation of outcomes.

P-60888434-1348 - External sinus lift using piezoelectric device with staged or simultaneous implant placement: Clinical and radiological success evaluation of outcomes.

Accuracy of alternative PHQ-9 scoring algorithms to screen for depression in people living with HIV in Sub-Saharan Africa.

Screening for depression remains a priority for people living with HIV (PLWH) accessing care. The nine-item Patient Health Questionnaire (PHQ-9) is a widely used depression screening tool, but has limited accuracy when applied across various cultural contexts. We aimed to evaluate the performance of alternative PHQ-9 scoring algorithms in sub-Saharan African PLWH. five HIV programs in Cameroon, Côte d'Ivoire, Kenya, Senegal and the Republic of Congo. Adult PLWH were screened for depression during the 2018-2022 period. Diagnosis confirmation was done by psychiatrist blinded clinical evaluation (gold standard). Diagnostic performances, including sensitivity, and area under the curve (AUC)) of the traditional PHQ-9 scoring (positive screening - score≥10) was compared to alternative scoring algorithms including: i) the presence of ≥1 mood symptom (PHQ-9 items 1&2) combined with ≥2 other symptoms listed in the PHQ-9, and ii) a simplified recoding of each 4-response item into two categories (absence/presence). A total of 735 participants were included (54% female, median age 42 years [IQR 34-50]). Depression was diagnosed by a psychiatrist in 95(13%) participants. Alternative scoring sensitivities (0.59 to 0.74) were higher than that of the traditional score's (0.39). Compared to traditional scoring, AUC were significantly higher for PHQ-9 alternative scoring. Across settings, alternative scoring algorithms increased sensitivity and reduced variability. As a primary screening test, new scoring algorithms appeared to improve the PHQ-9 sensitivity in identifying depression and reduce heterogeneity across settings. This alternative might be considered to identify PLWH in need of referral for further diagnostic evaluations.

18 Past and current care practices for neonates with complex medical needs: A scoping review to support clinical program evaluation

Abstract Background Neonates with complex medical needs (NCMN) are a rapidly growing patient population internationally. Although NCMN are a relatively small proportion of all Neonatal Intensive Care Unit (NICU) admissions, they are high healthcare utilizers. Since 2018, a dedicated Neonatal Complex Care Team (NCCT) has cared for NCMN at a large quaternary care center. The NCCT cares for NCMN in a dedicated, single-family room, patient area within the NICU. This model of care has yet to be evaluated for its potential impact on healthcare outcomes. Objectives The objective of the scoping review is to determine the breadth of available literature on the care practices for the management of NCMN and to collate the available evidence to define outcome measures to be used in a formal program evaluation. Design/Methods The review followed the PRISMA extension for scoping reviews and utilized resources from the Joanna Briggs Institute. The two databases that were utilized include Medline via OVID and CINAHL. The dates for included publications are January 1st 1993, until July 15th 2023. Only studies published in English and primary research were included. Two independent reviewers performed the initial title and abstract screening, and the full text review. The data extraction was completed by one independent reviewer. Results 102 articles were included in the title and abstract screen, and 12 were considered for full text review. Four articles were included. Interventions discussed in the included articles ranged from discharge conferences with patient’s caregivers, to the implementation of an entirely new model of care. Multidisciplinary health care teams appear to be integral to the in-hospital care and smooth discharge of NCMN. We identified that caregiver involvement and satisfaction are important to the discharge process as they are primarily responsible for their infant’s care after discharge, and so it is important that the specifics of care are communicated and taught effectively. The outcomes of interest identified as most useful for clinical program evaluation were length of stay and readmission rate. Additionally there was limited data reported on long-term health outcomes of this patient population. Conclusion This scoping review identified few articles that reported new models of care, a lack of consistent outcomes used in evaluating existing care models and overall a gap in research in this rapidly growing patient population. There is more work to be done to improve care of NCMN and our findings will be used in designing future studies that evaluate care models.

Accuracy of pre-operative tumor size assessment compared to final pathology and frequency of adjuvant treatment in patients with FIGO 2018 stage IB2 cervical cancer

ObjectiveThe primary aim of our study was to compare tumor size assessment by pre-operative evaluation (physical examination and/or imaging) with tumor size on final pathology. As a secondary outcome, we...

Large language models for structured reporting in radiology: past, present, and future.

Structured reporting (SR) has long been a goal in radiology to standardize and improve the quality of radiology reports. Despite evidence that SR reduces errors, enhances comprehensiveness, and increases adherence to guidelines, its widespread adoption has been limited. Recently, large language models (LLMs) have emerged as a promising solution to automate and facilitate SR. Therefore, this narrative review aims to provide an overview of LLMs for SR in radiology and beyond. We found that the current literature on LLMs for SR is limited, comprising ten studies on the generative pre-trained transformer (GPT)-3.5 (n = 5) and/or GPT-4 (n = 8), while two studies additionally examined the performance of Perplexity and Bing Chat or IT5. All studies reported promising results and acknowledged the potential of LLMs for SR, with six out of ten studies demonstrating the feasibility of multilingual applications. Building upon these findings, we discuss limitations, regulatory challenges, and further applications of LLMs in radiology report processing, encompassing four main areas: documentation, translation and summarization, clinical evaluation, and data mining. In conclusion, this review underscores the transformative potential of LLMs to improve efficiency and accuracy in SR and radiology report processing. KEY POINTS: Question How can LLMs help make SR in radiology more ubiquitous? Findings Current literature leveraging LLMs for SR is sparse but shows promising results, including the feasibility of multilingual applications. Clinical relevance LLMs have the potential to transform radiology report processing and enable the widespread adoption of SR. However, their future role in clinical practice depends on overcoming current limitations and regulatory challenges, including opaque algorithms and training data.

Surgical Outcome of Tumors of Spinal cord, Nerve roots, Meninges, and Vertebral column – Our Experience in Tertiary level Hospital

Background: Spinal cord tumors can result in dramatic neurological and functional disabilities in the patients. We aimed to know the different types of spinal tumors and the correlation between clinical presentation and pathological findings and compare the outcomes of these tumors postoperatively. Methods: A total of 410 patients were included in the retrospective study group. The duration of the study was January 2016 to October 2022 (82 months). After a thorough clinical evaluation, patients were subjected to magnetic resonance imaging (MRI) and then surgery. They were described based on age, sex, location of the tumor, type of the tumor, symptoms, histopathological type, surgical resection, and complications. Results: The study included 229 (56%) males and 181 (44%) females and their ages ranged from 6 years to 74 years. Out of the 410 patients, 203(49.51%) had intradural extramedullary, 121(29.51%) had extradural and 86(20.98%) had intradural intramedullary spinal tumors. A predilection towards the thoracic region (39.50%) and cervical region (28.40%). Lumbar region (20.10%) and Sacral region (4.10%), Cervicodorsal region (1.40%), Dorsolumbar region (3.00%), and Craniovertebral junction (3.50%) were seen. The tumors were excised completely in 72.68% of the patients while neartotal resection was done in 17.82%, subtotal resection in 7.32%, and only biopsy in 2.2% of patients. Histopathologically most of the tumors were Schwannoma (38.78%), then Meningioma (11.71%), Ependymoma (11.70%), Astrocytoma (10.98%), and others were found. There was significant improvement (33.66%) in the modified McCormicks score at discharge follow-up. Conclusions: Intradural extramedullary is the most common spinal cord tumor. The majority of the cases presented with sensorimotor symptoms and pain is the predominant clinical complaint. Spinal cord tumors are most commonly observed in the 2nd to 4th decade of life with a gradual decline in the incidence towards the extremes of age group. Surgery is the definitive treatment and the aim of the surgery is gross total resection Bang. J Neurosurgery 2024; 13(2): 112-120

Investigation of Acoustic Voice Characteristics of Individuals Diagnosed with Muscle Tension Dysphonia.

Muscle tension dysphonia (MTD) is a functional voice condition that causes irregular and imbalanced laryngeal and paralaryngeal muscle activation. Our study aimed to examine the acoustic characteristics of patients with MTD and reveal the differences between genders. The study retrospectively reviewed the acoustic examination findings from the files of patients diagnosed with MTD during evaluations in the laryngology outpatient clinic at a tertiary reference hospital between 2015 and 2022. The parameters assessed in prolonged vowel phonation analysis were fundamental frequency (F0), jitter, shimmer, noise-to-harmonic-to-ratio, and soft phonation index; in the counting task analysis, they were intensity, frequency, and semitone. Gender differences in acoustic measurements obtained during prolonged vowel phonation and counting tasks were also examined. The study included 80 individuals diagnosed with MTD. Although all parameters in the acoustic analysis of/a/ phonation were increased, differences were statistically significant only in the F0 and jitter parameters between females and males (p≤0.05). In the analysis of the counting task, the mean and minimum F0 parameters were significantly higher in females than in males (p=0.000). The mean dB level was decreased, particularly in the counting task, but the results for the intensity parameter did not differ significantly between genders (p>0.05). The values in the acoustic voice analysis parameters of patients with MTD were determined. These acoustic parameters are thought to guide the clinician in evaluating voice and determining voice therapy goals for MTD patients.

Clinical and Radiologic Evaluation of Mucopolygen Complex on Patients Who Underwent Arthroscopic Full Thickness Supraspinatus Tendon Repair

Clinical and Radiologic Evaluation of Mucopolygen Complex on Patients Who Underwent Arthroscopic Full Thickness Supraspinatus Tendon Repair

Infrared thermal imaging for assessing human perspiration and evaluating antiperspirant product efficacy

In humans, perspiration regulates core body temperature. Therefore, objectively evaluating it is essential for studying sweat gland function and mechanisms, particularly in antiperspirant efficacy studies. Various approaches have been developed for measuring human perspiration and evaluating antiperspirant efficacy, but are unsuitable for robust and routine clinical testing applications. This paper shows how infrared thermography, utilizing both high- and low-resolution modes, functions as a multiscale imaging modality. The high-resolution mode extracts physiological parameters (respiratory ~ 0.3 Hz and heart rate ~ 1.0 Hz) and visualizes the reduction of the sweat pore radii (from 359 ± 155 μm to 161 ± 47 μm) after antiperspirant application, consistent with known mechanisms of pore plugging and constriction induced by aluminum salts. The low-resolution mode quantitatively maps sweat retention in underarm clothing. All study participants in a clinical trial showed reduced sweat retention on their T-shirts due to antiperspirants, with reductions ranging from approximately 37–97% and an average reduction of 77.7 ± 22.1% using the developed methodology and tested antiperspirant. Overall, this non-invasive technique presents significant potential for clinical and personal care product evaluations, particularly in the early stages of product development.