Maximum Width Research Articles

Traumatic Aortic Disruption Index is Associated with Mortality and Urgency of Stent Grafting in Blunt Thoracic Aortic (Grade 3) Injuries

ObjectiveDelayed stent grafting for blunt thoracic aortic injuries (BTAI) is current standard of care. However, given the heterogeneity of pseudoaneurysm presentations, it is currently unclear which severe BTAIs require more urgent intervention. We hypothesize that a Traumatic Aortic Disruption Index (TADI) calculation based on sagittal computed tomography angiography (CTA) imaging measurements would correlate with urgency of stent grafting. MethodsAll patients at a level-1 trauma center with BTAIs over a 12-year period were identified. A TADI score was then calculated using the length of pseudoaneurysm (L), maximum width of pseudoaneurysm (W), and normal adjacent aortic diameter (NA) (Figure1). Patient presentation, injury characteristics, timing of stent grafting, and outcomes were then evaluated. ResultsForty-two patients were diagnosed with BTAIs. Mean age was 37.6 years, with a median injury severity score (ISS) of 29. Overall mortality was 11.9%. TADI scores ranged from 3.6 to 158.6. Compared to patients with a TADI<28, patients with TADI>28 had similar median ISS scores (34 vs 29, p=0.16), and rates of both traumatic brain injury (33.3% vs 42.0%, p=0.53) and non-aortic hemorrhage control procedures (44.4% vs 33.3%, p=0.3). TADI>28 patients had a lower initial mean systolic BP (98.5 vs 121.9, p=.003), more severe hypotension (lowest systolic 77.0 vs 91.2, p=.034), lower initial GCS (6 vs 13, p=.039), higher mean admission lactate (4.6 vs 3.3, p=.036), and higher overall mortality (23.8% vs 0%, p=.048). Patients with TADI>28 received stent grafting at significantly shorter median time intervals from injury identification (median 4 hrs vs 14 hrs, p=.001). Overall causes of mortality were aortic hemorrhage related (n=3, 60%) and traumatic brain injury (n=2, 40%). ConclusionThis simple-to-calculate index is independently correlated with mortality and urgency of stent grafting in blunt trauma patients with similar ISS. Patients with TADI scores >28 were more likely to undergo urgent stent grafting, thereby suggesting a trend in practice patterns with higher scores representing injuries that should be considered for expedited operative management. The TADI score should be validated in a larger sample of blunt trauma patients as an injury prioritization tool in the multi-system injured patient.

Vegetative growth, flowering pattern and yield of mango (Mangifera indica L.) as affected by exogenous application of paclobutrazol and KNO3

Studied the response of different flowering regulatory agro-chemicals had a significantly positive impact on vegetative growth, flowering pattern and yield attributes of mango, during 2015-16 and 2016-17. Paclobutrazol is associated with a shorter internodal length and the highest flowering intensity. The study was laid out with 7 treatments in randomized block design and replicated thrice were applied on north Indian mango cultivars "Dashehari" and "Kesar" under the Banswara condition of Rajasthan. The results revealed that most of the flowering parameters were better performed with paclobutrazol @ 3.0 ml m-2 soil drench application mid-September (number of flowers/10 tagged panicle, per cent hermaphrodite flowers, per cent fruit set, least length and width of panicle) and foliar application of potassium nitrate 25 g l -1 observed maximum height and width of panicle, fruit weight, yield kg tree-1, yield t/ha.

Numerical Simulation of Hydraulic Fracture Propagation in Unconsolidated Sandstone Reservoirs

In order to comprehensively understand the complex fracture mechanisms in thick and loose sandstone formations, we have carefully developed a coupled finite element numerical model that captures the complex interactions between fluid flow and solid deformation. This model is the cornerstone of our future exploration. Based on this model, the crack propagation problem of hydraulic fracturing under different engineering and geological conditions was studied. In addition, we conducted in-depth research on the key factors that shape the geometry of hydraulic fractures, revealing their subtle differences and complexities. It is worth noting that the sharp contrast between the stress profile and mechanical properties between the production layer and the boundary layer often leads to fascinating phenomena, such as the vertical merging of hydraulic fracture propagation. The convergence of cracks originating from adjacent layers is a recurring theme in these strata. Sensitivity analysis clarified our understanding, revealing that increased elastic modulus promotes longer crack propagation paths. As the elastic modulus increases from 12 GPa to 18 GPa, overall, the maximum crack width slightly decreases, with a less than 10% reduction rate. The increased fluid leakage rate will significantly shorten the length and width of hydraulic fractures (with a maximum decrease of over 70% in fracture width). The increase in viscosity of fracturing fluid causes a change in fracture morphology, with a reduction in length of about 32% and an increase in fracture width of about 25%. It is worth noting that as the leakage rate of fracturing fluid increases, the importance of the viscosity of fracturing fluid decreases relatively. Strategies such as increasing fluid viscosity or adding anti-filtration agents can alleviate these challenges and improve the efficiency of fracturing fluids. In summary, our research findings provide valuable insights that can provide information and optimization for hydraulic fracturing filling and fracturing strategies in loose sandstone formations, promoting more efficient and influential oil and gas extraction work.

Bond-slip model of corroded plain round bars in low-strength concrete under cyclic and monotonic loading

The effect of corrosion on the overall behavior of beam-type bond-slip samples constructed from low-strength concrete and plain round bars was examined in this study. First, a set of nominally identical specimens underwent testing under both monotonic and cyclic loading, and subsequently, the bond-slip interaction was assessed for each individual sample. The observed failure mode for plain round bars was direct pullout without concrete splitting apart, characterized by the loss of cohesion between the rebar and the adjacent concrete surface. Then, an analytical relationship was established by fitting a curve to the average experimental data using the method of least squares. Corrosion-degradation in the bond stress was considered by incorporating an exponential component into the equation of the reference bond-slip curve (i.e., null corrosion). Besides, the degradation in bond strength was predicted as a function of corrosion level, which is in the form of an exponential curve. The maximum surface crack width, an easily quantified variable on-site, was correlated with the bond strength of corroded bars. The regression analysis successfully established the optimal relationship between the maximum surface crack width and the corrosion level in an exponential form as well. Notably, the majority of the data in all cases fell within the 95% confidence interval.

Experimental and analytical study on the bending performance of UHPC‐NC narrow steel box composite beams under negative moments

AbstractA novel UHPC‐NC composite structure was proposed to enhance the load‐bearing capacity of concrete beam bridges under negative bending moments. Parameters including steel fiber content in UHPC, reinforcement ratio, and steel box filling height were varied across 8 UHPC‐NC narrow steel box composite beam specimens. The study involved testing, and measurement of failure modes, crack distribution, deformation characteristics, and crack widths. Additionally, a method for calculating maximum crack widths was developed based on crack distribution patterns. Furthermore, a computational model for predicting the ultimate bearing capacity of UHPC‐NC narrow steel box composite beams was constructed. The computed results aligned closely with experimental findings, validating the accuracy of the proposed computational model.

7029 Changes In Adrenal Gland Size Seen By Linear Assessment On Routine Abdominal CT During Critical Illness

Abstract Disclosure: D.R. Vangipuram: None. N. Bhagat: None. R. Borkar: None. N.T. Mazengia: None. S. Williams, MD: None. S.K. Majumdar: None. Introduction: During acute stress, the hypothalamus-pituitary-adrenal (HPA) axis is activated, ultimately releasing adrenocorticotropic hormone (ACTH) from the pituitary gland, which stimulates cortisol synthesis and release from the adrenal gland. During this process, ACTH also increases adrenal blood flow which may result in noticeable changes in adrenal gland size on imaging. A previous study compared adrenal gland volume in patients with and without sepsis and concluded that adrenal gland volume was found to be nearly double in sepsis compared with patients without sepsis(1). Another study that evaluated adrenal gland size on MDCT, to provide normal values for volumetry and linear dimensions, found a concordance between volumetric and linear assessment (by cumulative width), though volumetry was more reproducible(2). Method: This is a retrospective study that included 50 adult patients (age 18 and over) who underwent a non-contrast or contrast CT scan of the abdomen within 5 years prior to admission to the Intensive Care Unit (ICU) with any critical illness, and then had another CT of the abdomen during the admission to the ICU. We measured the maximum width of the body (corpus) and that of the medial and lateral limbs of both the adrenal glands, perpendicular to the long axis, as seen on CT. The total (cumulative) width was calculated by adding the width of the corpus and both the limbs of each adrenal gland. The measurements were made by two different radiologists, who were blinded both to the before/after ICU admission CTs, and to each other’s measurements. Results: There was concordance in the measurements made by both the radiologists. We used the averages of both their measurements for analysis. The mean cumulative width of each adrenal gland, i.e., corpus+medial limb+lateral limb (in mm), was: Right adrenal before ICU admission 13.52 (± 3.20); during ICU admission 13.24 (± 3.13); p 0.444. Left adrenal before ICU admission 16.03 (± 3.18); during ICU admission 15.12 (± 3.47); p 0.021. Conclusion: There was a statistically significant decrease in the size of the left adrenal gland during critical illness, but no significant change in the right. Our findings do not suggest an increase in adrenal gland size during ICU admission.

Development of maxillary sinuses in relation to the development of cranium in children on computed tomography imaging

There are available studies assessing the development of maxillary sinuses in relation to the viscerocranium. However, there are no publications analyzing the development of maxillary sinuses in relation to the development of the cranium, i.e. both the viscerocranium and the neurocranium. The aim of the study was to analyze the correlation between the dimensions of maxillary sinuses and anthropometric measurements of the cranium in children. The study was retrospective and was conducted at the based on the results of head computed tomography investigation. The study group included 180 girls and 180 boys, aged from birth to 18 years. To assess the correlation between the degree of development of the paranasal sinuses and the growth of the cranium, standard anthropometric points on the skull and strictly defined dimensions of the height, length, width, and volume of right and left maxillary sinuses were used. In the study group, both in girls and boys, a statistically significant positive correlation was found at the significance level of p < 0.0001 between: the height, length, width and volume of right and left maxillary sinuses, and cranial maximum length (glabella-opisthocranion), its maximum width (euryon-euryon), height (basion-bregma) and the length of the cranial base (basion-nasion) and the dimension of the subspinale-opisthocranion in children. Our study showed a statistically significant positive correlation between the development of maxillary sinuses and the growth of the cranium in children.

Management of soft rot in pakchoi (Brassica chinensis L.) using polyphenols from pineapple peel waste

Soft rot is one of the most susceptible soil-borne diseases of pakchoi (Brassica chinensis L.), severely hindering its industrial development. The research aimed to evaluate the application effect of polyphenols extracted from pineapple peel waste in improving the rhizosphere soil environment of pakchoi infected by soft rot and promoting plant health and growth. We found that using pineapple peel polyphenols (PPPs) at 4 mg/mL concentration (P1 treatment) significantly improved soil quality, reduced pakchoi disease incidence, and effectively promoted pakchoi growth. Compared with the control group (CK), the P1 treatment led to a marked 79.97 % reduction in diseased pakchoi leaves. Meanwhile, the rhizosphere soil structure showed reduced diseased genera and increased beneficial bacterial phyla, along with boosted soil enzyme activities. Furthermore, P1 treatment improved key growth parameters of pakchoi, including neck thickness (62.07 %), plant height (57.43 %), fresh weight (154.52 %), dry weight (121.88 %), maximum leaf length (47.28 %), width (30.98 %), and total chlorophyll content (50.11 %). The application of PPPs has shown significant effects in enhancing the ecological environment of the diseased soil and reducing the incidence of soft rot disease of pakchoi and has great potential in increasing the yield of pakchoi. This study offers an eco-friendly and sustainable approach for the valorization of PPPs and the management of soil-borne diseases, which holds profound implications for enhancing crop quality, soil health, and human well-being.

In vivo assessment of catheter-tissue contact using tissue proximity indication and its impact on cardiac lesion formation in pulsed field ablation

BackgroundNo evidence exists regarding whether tissue proximity indication (TPI), an impedance-based contact indicator, can improve in vivo lesion formation and durability during pulsed field ablation (PFA). ObjectiveThis in vivo study investigated the relationship between catheter-tissue contact and lesion formation. MethodsIn 5 porcine subjects, PFA applications were delivered at 35 atrial target sites using the VARIPULSE variable-loop circular catheter with the CARTO 3 mapping system. We compared acute ablative low-voltage zones (LVZs; <0.5 mV), chronic LVZs, and pathologic lesions between no/minimum contact (TPI-negative/flickering TPI-positive status) and consistent tissue contact (consistent TPI-positive status) for typical clinical scenarios and tissue tenting (TPI-positive status with electrodes extensively away from the 3-dimensional mapping surface) for safety margin. Ultrasound imaging also confirmed contact category assessments. ResultsAcute and chronic LVZs were significantly larger with consistent contact compared with no/minimum contact, including pathologic lesion length (36.0 ± 12.5 mm vs 17.4 ± 15.2 mm; P = .002) and maximum width (10.3 ± 2.7 mm vs 5.7 ± 5.1 mm; P = .035); results with tenting (length: 34.6 ± 11.7; width: 11.3 ± 1.9 mm) were comparable to consistent contact. Lesion transmurality was achieved in all lesions with consistent contact or tissue tenting but only in 54.5% with no/minimum contact (P = .001 for each). The TPI-based electrode contact distance, measured as the cumulative length of the multielectrode catheter tip positive for TPI, significantly correlated with lesion length, maximum width, and transmurality. ConclusionConsistent TPI-based contact during PFA was strongly associated with distinct chronic transmural lesions, emphasizing the importance of tissue contact in optimizing circumferential lesion formation with circular PFA catheters.

Tumour-pleura relationship on computed tomography (CT) provides effective risk stratification for peripheral pulmonary nodules with Lung Imaging Reporting and Data System (Lung-RADS) score of 4X.

Pulmonary nodules with Lung Imaging Reporting and Data System (Lung-RADS) 4X are of greater clinical significance, and accurate differentiation of pathological types and visceral pleural invasion (VPI) of Lung-RADS 4X peripheral pulmonary nodules before treatment can aid in stratification. This study set out to investigate whether the tumour-pleura relationship on computed tomography (CT) can provide effective risk stratification for peripheral pulmonary nodules with Lung-RADS 4X. This was a single institution, retrospective study of 482 consecutive patients with Lung-RADS score 4X, who were pathologically diagnosed with tuberculous granuloma and adenocarcinoma from January 2019 to December 2023. We assessed clinical factors (baseline characteristics and tumour markers) and CT findings. Univariate and multivariate logistic regression analyses were used to determine the classification of pulmonary nodules and predictors of VPI. Multivariate analysis revealed that gender [odds ratio (OR) =0.392; P<0.001], carcinoembryonic antigen (CEA) level (OR =8.331; P<0.001), type of nodules (OR =13.551 and 7.478; P<0.001 and P=0.016) and maximum base width of soft tissue component on the pleura side (OR =0.857; P=0.005) were significant independent factors for distinguishing tuberculous granuloma from adenocarcinoma. And the type of linear connection between lesion and pleura (OR =3.936; P<0.001), and the maximum base width of soft tissue components on the pleura side (OR =1.359; P=0.001) were correlated independently with VPI. The area under the curve (AUC) for predicting pulmonary nodules classification was 82.60% [95% confidence interval (CI): 78.85-86.35%), and the AUC for predicting VPI was 76.10% (95% CI: 69.83-82.38%). The tumour-pleura relationship will be helpful in further risk stratification for peripheral pulmonary nodules with a score of Lung-RADS 4X.

Morphological and Structural Characterization of Shortening Landforms on Mars

AbstractThe lithosphere of Mars accommodates horizontal shortening through folding and faulting, producing landforms described as wrinkle ridges or lobate scarps. Despite this nomenclature, we lack a deep understanding of the drivers of morphological differences observed between landform types. This study aims to develop a quantitative model for shortening landform classification based on surface morphology, subsurface architecture, and strain accommodation, facilitating interpretations of where and how lithospheric stresses are recorded. We developed this model by mapping 100 shortening landforms in a Geographic Information System, recording 12 unique geomorphic parameters such as length and asymmetry, and estimating the strain of each landform. We conducted a Discriminant Function Analysis (DFA) using surface morphometrics. This DFA produced a predictive linear function for categorizing wrinkle ridges and lobate scarps and for quantifying which landforms were exemplars within those categories. The three most influential variables on the surface morphometry DFA were the maximum width, forelimb slope, and back limb length. We then modeled the subsurface structural geology of 50 landforms using MOVE Structural Geology Modeling Software and conducted a second DFA based on subsurface metrics. DFA was most influenced by the dip and depth of the lower ramp base. When both surface morphology and subsurface geometry are input into single DFA, wrinkle ridges and lobate scarps can be distinguished quantitatively 96% of the time. Our results also show that lobate scarps accommodate more strain and imply that studies should consider landform type when interpreting local, regional, and global geological stress histories.

Do Anatomical Variations of Sphenoid Sinus Influence Sella Exposure and Residual Disease in Pituitary Surgery? - A Study in an Indian Population.

Introduction Endoscopic transsphenoidal surgery (ETS) is the standard practice in pituitary surgeries. The sellar exposure becomes the main factor which determines the residual disease in ETS. Not many studies can be found in the literature on the influence of anatomical variations of the sphenoid on intraoperative sella exposure. Objective The aim of the current study is to ascertain whether sphenoid sinus variations play a role in sellar exposure and residual tumor volume. Methods This is a prospective study conducted in a south Indian tertiary care center between June 2020 to June 2022, with 21 study participants who were scheduled to have ETS. The relation of preoperative computed tomography (CT) and magnetic resonance imaging (MRI) parameters with the intraoperative area of sellar exposure and residual tumor volume was evaluated. Results Sphenoid sinus dimensions, like presellar width (mean = 1.89 ± 0.51 cm), maximum width (mean = 2.94 ± 1.09 cm), presellar depth (mean = 1.14 ± 0.55 cm), suprasellar depth (mean = 1.08 ± 0.24 cm), infrasellar depth (mean = 2.36 ± 0.92 cm), presellar height (mean = 2.22 ± 0.47 cm), or the 9 internal carotid artery (ICA)-related measures, did not have any correlation with the mean intraoperative area of sellar exposure (0.57 ± 0.28 cm 2 ). Also, the adequacy of sellar exposure did not relate to the residual tumor. Preoperative tumor volume was found to be higher (20.2 [55.3-13.2] cm 3 ) in patients with residual tumor compared with those with no residual tumor (5.9 [6.8-5.2] cm 3 ). Tumor extension had a significant association with the residual tumor volume. Conclusion According to the present study, anatomical variations of the sphenoid sinus do not influence the adequacy of sellar exposure. Further studies need to be undertaken concerning residual tumor volume as well as preoperative tumor volume and extension.

Investigation of the dynamic mechanical response of corroded ultra-high performance fiber reinforced concrete (UHPFRC) with initial defects

This study addresses the dynamic mechanical response of the corroded ultra-high-performance fiber-reinforced concrete (UHPFRC) with initial defects, considering the possibility of corrosion deterioration induced by various pre-existing cracks during the long-term service life. For this purpose, an integrated accelerated corrosion method and Split Hopkinson Pressure Bar (SHPB)/high-speed camera etc. techniques are employed. Results show that increasing pre-impacting damage promotes the crack density and maximum width by 32.4%–62.3 % and 1.11–1.8 times, respectively. In terms of mechanical properties, coupling damages of initial defects and corrosion have adverse effects on the dynamic mechanical response. Typical fib Model Code 2010 applies to predict the DIF evolution of the corroded UHPFRC with initial defects. Numerous shear cracks are created at an angle along the weak interface as the corroded specimens with initial defects are again subjected to axial loading, revealing the associated failure mechanism. These results shed light on the dynamic response of corroded UHPFRC containing various initial defects and the failure mechanism gives some reference to service status evaluation.

Study on the influence of heave plate on energy capture performance of central pipe oscillating water column wave energy converter

This paper proposes a novel central pipe oscillating water column (OWC) wave energy converter (WEC) with a heave plate and investigates the influence of heave plate on energy capture performance of the OWC WEC through numerical methods. First, dynamic equations are established for floater and water column. Then, energy capture performance of the WEC is computed by solving relative motion equations using numerical methods. Wave tank experiments are conducted to validate the proposed numerical models. Finally, the influences of heave plate opening diameter and connecting column length on energy capture performance are investigated based on the proposed numerical models. The results indicate that increasing heave plate opening diameter decreases both the maximum capture width ratio (CWR) and response period. And increasing connecting column length widens the response bandwidth. When the heave plate opening diameter decreases from 350 mm to 0, the maximum CWR increases from 30.05% to 41.68% and the response period increases from 1.28 s to 1.72 s. When the connecting column length increases from 225 mm to 600 mm, the response band extends by 0.1 s. The proposed device and the obtained analysis results are of great significance for broadband and efficient wave energy generation.

Sensitivity and energy resolution of the Balqarad clover detector

Abstract This study investigates operational modes and veto techniques using the Balqarad clover system, focusing on energy resolution parameters like Full Width at Half Maximum (FWHM) and Full Width at Tenth Maximum (FWTM). Comparing with the GAMMA-X detector, clover consistently shows lower FWHM values (e.g., 1.08 keV vs. 1.45 keV for 133Ba), highlighting its higher precision. The clover system also achieves lower Minimum Detectable Activity (MDA) values (ranging from 1.19 to 1.56 Bq for 60Co and 137Cs in direct and addback modes), underscoring its enhanced performance compared to literature data. Practical MDA calculations using a reference soil sample reinforce the advantage of addback mode over direct mode in achieving more accurate measurements. These findings stress the critical importance of selecting the right measurement system for precise applications like radiation monitoring and nuclear safety assessments.

Experiment and numerical simulation on bearing capacity of partial steel-ultra-high-performance concrete continuous composite beams

Due to high strength, toughness and durability, ultra-high-performance concrete (UHPC) can be applied in replacing the cracked concrete slab in the negative moment region of newly built steel-ordinary concrete (OC) continuous composite beams, as well as in repairing old composite beams. To investigate the failure mode, crack propagation, stiffness degradation and bearing capacity of the partial steel-UHPC continuous composite beam, a test model with an UHPC slab over the negative moment region were designed and fabricated to compare with a steel-OC model with the same conditions. Similar failure mode was observed in the loading test of two models. Nevertheless, the maximum crack width in the UHPC slab is only 0.17 mm, much smaller than that in the OC slab. Compared with the steel-OC composite beam, vertical deflection of the partial steel-UHPC composite beam decreases by 32.7 %, and its cracking load and ultimate bearing capacity increase by 50 % and 6.4 %, respectively. The results show that the substitution of the OC with the UHPC in the negative bending moment area significantly improves the crack resistance, delays the crack propagation, increases the bending stiffness, and improves the working performance of composite beams with cracks, displaying good advantages in economy and in reality. Parametric analysis demonstrates that the height of steel beam is the most important factor, and cross section of the steel beam is suggested to be given priority in design so as to take advantages of partial steel-UHPC composite beams. The research also provides an option for the repair of old concrete slabs in steel-OC continuous composite beams.

Experimental and numerical study on polypropylene fibers reinforced concrete slabs with corroded reinforcement under monotonic loading

The degradation of structural performance due to reinforcement corrosion in reinforced concrete (RC) structures and the subsequent measures to improve the mechanical properties of corroded RC structures have garnered significant interest. This study investigates the structural performance of corroded polypropylene fiber RC slabs through both experimental and numerical approaches. Specimens were subjected to accelerated corrosion via electrochemical methods to simulate rebar corrosion. Key experimental parameters include polypropylene fiber volume fractions of 0% and 3%, design corrosion levels of 0%, 5%, and 10%, and both one-way and two-way constraints. The Digital Image Correlation (DIC) technique was employed for data acquisition. Load, deflection, strain, and crack morphology data were collected during loading. Results indicate that reinforcement corrosion increases the maximum crack width during loading, while a 3% polypropylene fiber volume fraction reduces this width by 20% to 48% at the same load level. Polypropylene fibers also enhance the peak loads and corresponding deflections of unidirectional and bidirectional specimens, with a more pronounced increase in unidirectional specimens of 11.3% and 15.4%, respectively. Although corrosion reduces the load-carrying capacity of the specimens, the inclusion of 3% polypropylene fibers significantly mitigates this reduction. A numerical model, incorporating rebar corrosion and polypropylene fibers through appropriate material constitutive models, was developed and validated against experimental results. The model accurately simulates the mechanical behavior of polypropylene fiber RC slabs with corroded reinforcement.

Predicting Swallowing Recovery in Subacute Stroke Patients via Temporal and Spatial Parameters of Videofluoroscopy.

The purpose of this study was to identify the temporal and spatial parameters of videofluoroscopic swallowing study (VFSS) that could predict the recovery of swallowing function in subacute stroke patients. We included 102 patients who were admitted to the Department of Rehabilitation Medicine between 2019 and 2022. Patients were classified into good and poor prognosis groups according to whether they had restored prestroke swallowing function or were able to consume sufficient nutrition via oral feeding to meet their body's needs. Univariate and multivariate regression analyses were used to identify the predictors. Calibration and discrimination were tested using the Hosmer-Lemeshow test and area under the curve (AUC), respectively. Of the 102 included patients, 51 had a good prognosis for swallowing function within 6 months of onset. The final multivariate regression model included three significant factors: laryngeal closure duration (LCD) (OR: 0.998; 95% CI: 0.996-0.999; p < 0.05), maximum width of the upper esophageal sphincter opening (MWUESO) (OR: 1.251; 95% CI: 1.073-1.458; p < 0.05), and pharyngeal residual grade (PRG) (p < 0.05). The shorter LCD and larger MWUESO were positive predictors of good swallowing function outcomes, while higher PRG was a negative predictor of good outcomes. The AUC for PRG, MWUESO, and LCD were 0.767 (p < 0.05), 0.738 (p < 0.05), and 0.681 (p < 0.05), respectively. Identifying prognostic factors for the recovery of swallowing function in patients with poststroke dysphagia is essential for developing treatment strategies. The findings of this study may provide an important reference for developing appropriate therapeutic interventions to promote the recovery of swallowing function in stroke patients.

Development of an ultrasound-based metric of muscle functional capacity for use in patients with neuromuscular disease.

Spinal muscular atrophy (SMA) and Duchenne muscular dystrophy (DMD) are progressive neuromuscular disorders characterized by severe muscle weakness and functional decline (Pillen et al., Muscle Nerve 2008; 37(6):679-693). With new therapeutics, objective methods with increased sensitivity are needed to assess muscle function. Ultrasound imaging is a promising approach for assessing muscle fat and fibrosis in neuromuscular disorders. This study builds on prior work by combining ultrasound-based measurements of muscle size, shape, and quality, relating these measures to muscle strength, and proposing a multivariable image-based estimate of muscle function. Maximum voluntary elbow flexion torque of 36 participants (SMA, DMD, and healthy controls) was measured by hand-held dynamometry and elbow flexor muscles were imaged using ultrasound. Muscle size (cross-sectional area, maximum Feret diameter or width, and thickness), quality (echogenicity, texture anisotropy index), and cross-sectional shape (diameter ratio) were measured. Multivariable regression was used to select ultrasound measurements that predict elbow flexion torque. Significant differences were observed in muscle size (decreased), shape (thinned), and quality (decreased) with increased disease severity and compared to healthy participants. CSA (brachioradialis R2 = 0.51), maximum Feret diameter (biceps R2 = 0.49, brachioradialis R2 = 0.58) and echogenicity (brachioradialis R2 = 0.61) were most correlated with torque production. Multivariable regression models identified that muscle size (CSA, maximum Feret diameter) and quality (echogenicity) were both essential to predict elbow flexion torque (R2 = 0.65). A multivariable approach combining muscle size and quality improves strength predictions over single variable approaches. These methods present a promising avenue for the development of sensitive and functionally relevant biomarkers of neuromuscular disease.

Morphometric evaluation of suprascapular notch and superior angle of the scapula using three-dimensional computed tomography in the Indian population

BackgroundAmong the various aspects of scapular anatomy, the suprascapular notch has gained attention as its anatomical variation is a predisposing factor for compression of the suprascapular nerve in this region, potentially impacting orthopedic surgery. This study aims to investigate the morphology of suprascapular notch (SSN) and its variation with age and sexual dimorphism. It also seeks to classify and correlate the superior angle of the scapula with the SSN in the Indian population. MethodsA retrospective analysis of 360 computed tomography scans of scapulae of 180 adults was conducted. The morphology of SSN was classified according to Rengachary's classification (types I-VI), and the maximum depth (MD) and maximum width (MW) of SSN were measured. The superior angle of the scapula was classified based on morphological characteristics. ResultsType I SSN was the most prevalent, suggesting lower susceptibility to suprascapular nerve entrapment. Males had significantly greater MD than females. Identical types of SSN and superior angles on both sides of the scapula were statistically significant, though variations on each side were also observed. There was no significant difference in age. The superior angle of the scapula was classified into four types: Hilly, mountain peak, crescent, and chimney, with the hilly type being the most common. No correlation was found between SSN and the superior angle. ConclusionThese findings may provide a comprehensive understanding necessary for accurate diagnoses of related abnormalities and for performing safe and effective endoscopic and open surgical procedures in the suprascapular region.