Mean Width Research Articles

Density affects plant size in the Gobi Desert

Plant size is a crucial functional trait with substantial implications in agronomy and forestry. Understanding the factors influencing plant size is essential for ecosystem management and restoration efforts. Various environmental factors and plant density play significant roles in plant size. However, how plant size responds to mean annual precipitation (MAP), mean annual temperature (MAT), and density in the arid areas remains incomplete. To address this knowledge gap, we conducted comprehensive vegetation surveys in the Gobi Desert in northwestern China with a MAP below 250 mm. We also collected climate data to disentangle the respective influences of climate and density on the community-weighted plant height, crown length, and crown width. Our observations revealed that the community-weighted mean plant height, crown length, and width demonstrated a positive association with MAT but negative relationships with both MAP and density. These patterns can be attributed to the predominance of shrubs over herbs in arid regions, as shrubs tend to be larger in size. The proportion of shrubs increases with MAT, while it decreases with MAP and density, resulting in higher plant height and larger crown dimensions. Although both MAP and MAT affect plant size in the Gobi Desert, our findings highlight the stronger role of plant density in regulating plant size, indicating that the surrounding plant community and competition among individuals are crucial drivers of plant size patterns. Our findings provide valuable guidance for nature-based solutions for vegetation restoration and ecosystem management, highlighting the importance of considering plant density as a key factor when designing and implementing restoration strategies in arid areas.

Assessment of the Nasopalatine Canal in Patients Requiring Dental Implants in the Maxillary Anterior Region Using Cone Beam Computed Tomography.

To assess the nasopalatine canal in patients requiring dental implants in the maxillary anterior region using cone beam computed tomography (CBCT). About 56 patients requiring dental implants in the maxillary anterior region of either gender reporting to the daily Outpatient Department, Department of Oral Medicine and Radiology aged between 18 and 60 years were selected. They were subjected to a CBCT scan using Newtom Giano CBCT machine (NewTom, Imola, Italy). Newtom New Technologysoftware and a slice thickness of 0.3 mm were used. For assessment of the implant site at the maxillary anterior region, alveolar bone width in the anterior region of the canal at the upper, middle, and lower third, incisive foramen diameter (IFD), nasopalatine canal length (NPCL), canal diameter in the floor of the nasal fossa and nasopalatine canal morphology was determined. Out of 56 patients, males comprised 30 and females 26. The mean bone height in 11 regions was 15.6±3.9, in 12, 16.2±2.7 mm, in 13 was 15.5±2.4 mm, in 21 was 13.7±4.2 mm, in 22 was 14.7±3.6 mm, in 23 was 16.7±1.5 mm. A non-significant difference was observed when comparing the bone height at different implant sites (p>0.05). The mean bone width at 3 mm and 6 mm from an alveolar crest in 11 regions was 4.3 mm and 5.3 mm, in 12 was 5.7 mm and 6.2 mm, in 13 was 3.7 mm and 4.6 mm, in 21 regions was 4.1 mm and 5.5 mm, in 22 regions was 4.6 mm and 5.7 mm and in 23 regions was 4.0 mm and 4.9 mm, respectively. A significant difference was observed when comparing the bone width at 3 mm and 6 mm at different implant sites (p<0.05).Nasopalatine canal type was A in 42 (75%), B in 13 (23.2%), and C in 1 (1.8%) patient. The mean alveolar bone width in the anterior region of the canal at the upper third was 10.1 mm, in the middle third was 7.4 mm, and in the lower third was 5.2 mm. The mean IFD was 4.6 mm, the NPCL was 13.5 mm, and the canal diameter on the floor of the nasal fossawas 3.8 mm. A significant difference was observed in comparing nasopalatine canal type (p<0.05). For the clinician to assess implant placement in the maxillary esthetic zone, CBCT imaging of the nasopalatine canal is crucial. It is possible to prevent intraoperative and postoperative complications such as hemorrhage, sensory impairment, osseointegration failure, and nasopalatine duct cyst formation.

Radiative characteristics of large-scale fire whirl: An experimental study

Flame radiative characteristics, depending on the flame type, flame scale, and fuel type, are key parameters that determine fire spread and thermal hazards. Accurate prediction of flame radiation in large-scale natural fires requires detailed information on radiative characteristics. This paper presented an experimental study on the radiative properties of large-scale fire whirls with RP-5 aviation fuel. The maximum flame height and mean width reached 21.40 m and 3.60 m, respectively. Unlike large-scale free pool fires, the radial stabilization effect of the fire whirl suppressed the unstable toroidal vortex structures and the smoke production significantly. Most of the flame was high-temperature and high-emissive power areas in the large-scale fire whirl, and the emissive power exceeded 100 kW/m2 on about 60 % flame area. The flame temperature and emissive power first increased with height, then stabilized and decreased in the upper part of the fire whirl. The peak flame temperature, mean flame temperature, and mean emissive power all increased with an increase in the flame width. The mean emissive power ranged from 93.06 to 157.47 kW/m2, 2.3–3.9 times the values in free pool fires of the same scale. The solid flame radiation model could effectively predict the instantaneous radiative heat fluxes from large-scale fire whirls to distant external targets with the corrections of atmospheric transmissivity. The semi-empirical correlation of the radiative fraction based on the turbulent dissipation showed that neither the flame size nor heat release rate affects the radiative fraction, consistent with the our and other researchers’ experimental data from medium to large-scale fire whirls.

The Distal Oblique Bundle in the Distal Forearm: From Anatomical Features to Clinical Implementation.

Background and objective The distal oblique bundle (DOB) is nowadays recognized as thethickest component of the distal interosseous membrane (DIOM). It is neither thought to be a clear-cut ligament, and nor does it follow the typical configuration of the rest of the DIOM. It is not always present and some studies have raised disputes about its prevalence and a few anatomical features. In this study, we aimed to provide data on the prevalence and anatomical features of the DOB, which are of great importance at this early stage of research into the topic. Our findings have been correlated with current knowledge and are expected to contribute to clinical implementation. Materials and methods Twenty-eightfresh-frozen forearms were utilized for measurements. Specifically, mean length, width, distance from the middle of the bundle's insertion to the ulna to the tip of the styloid process of the ulna, as well as the distance from the midpoint of its insertion to the radius to the tip of the radiuses' styloid process were calculated. The prevalence was described with a cutoff thickness point of 0.5 mm. Early results based on three cases of DOB reconstruction with the "Riggenbach" technique due to distal radioulnar joint (DRUJ) instability were documented. Results Eleven DOBs were reported out of the 28 specimens, suggesting a prevalence of 39.3%. The mean thickness was 0.88 mm (range: 0.6-1.3 mm), the mean width was 5.22 mm (range: 2.2-8.4 mm), and the mean length was 25.68 mm (range: 22.7-29.2 mm). Proximally, the mean distance from the bundle's ulnar insertion to the tip of the styloid process of the ulna was 51.02 mm (range: 45.5-55.6 mm) while distally, the mean distance from the bundle's insertion to the radius to the tip of the styloid process of the radius was 34.5 mm (range: 31.3-37.7 mm). After a follow-up of at least six months, improvement was evident in all measured areas in the three patients who underwent surgery. Additionally, they reported satisfaction and accomplishment of their preoperative goals. Conclusions Discrepancies in measurements in some anatomic features between studies are probably due to variations in specimen types, measurement methods, and sites. Efforts must continue to be made on a more extensive scale and in a more standardized manner for more factual results and conclusions. "Reconstruction-recreation" or "original construction-creation" procedures yield promising results in a fast, simple, and less invasive manner than traditional methods of DRUJ stabilization.

Abdominal wall mass resections: single-center closure practices and outcomes following oncologic resections of abdominal wall fascia.

Radical resections for abdominal wall tumors are rare, thus yielding limited data on reconstruction of defects. We describe surgical management and long-term outcomes following radical tumor resection. This was a single-center retrospective review of patients between January 2010 and December 2022. Variables included operative characteristics, wound complications, hernia development, tumor recurrence, and reoperation. A multivariable analysis compared wound morbidity for suture and mesh repairs while adjusting for defect width, fascial closure, and CDC wound class. 120 patients were identified. Mean follow-up was 3.9 ± 3.4years. Seventy-five (62.5%) of the masses were primary; most commonly desmoid (n = 25) and endometrioma (n = 27). Forty-five masses were metastases. Mean tumor width was 6.2 ± 3.4cm; mean defect width was 8.1 ± 4.1cm. Sixty-one patients (50.8%) had mesh placed, with variation in technique. Postoperative CT scans were available for 88 (73.3%) patients. Forty SSOs (33.3%), 11 SSIs (9.2%), and 18 (15%) SSOPIs occurred within 30 days. On multivariable analysis, increased defect width was associated with SSOPI (OR 1.17, p = 0.041) and CDC wound class II-III was associated with SSI (OR 8.38 and 49.1, p < 0.05) and SSOPI (OR 5.77 and 17.4, p < 0.05); mesh was not associated with these outcomes. Seven patients (5.8%) underwent 30-day reoperations and 35 (20.8%) required additional operations after 30 days. Thirteen percent developed abdominal wall (n = 8) or intra-abdominal tumor recurrence (n = 8) requiring reoperation. Twenty-seven (22.5%) patients developed hernias with a mean fascial defect width of 9.8 ± 7.2cm. Abdominal wall mass resections are morbid, often contaminated cases with high postoperative complication rates. Risks and benefits of mesh implantation should be tailored on an individual basis.

Geo-environmental factors controlling gully distribution at the local scale in a Mediterranean environment

The study was conducted with a view to identifying the primary factors controlling the formation and evolution of gullies in Central Portugal. A total of 38 permanent gullies were identified in an 11 km2 area. Their mean length, maximum width, and mean width were 105 m, 6.8 m, and 3.8 m, respectively, based on orthophotograph analysis. The gullies are located in an area of highly weathered granites which led to the formation of deeply weathered mantles. To understand gully distribution, 11 geo-environmental controlling factors were selected. Group Analysis (GA) identified two groups of gullies. These are differentiated not only by morphological aspects but also by geo-environmental elements. One group (Gg1) is characterised by being larger in size, and these tend to be located on hillslopes with a higher slope. The second group (Gg2) contains the smaller gullies that are located on the lower slopes of hillsides. Principal component analysis (PCA) identifies as controlling factors the slope, topographic ruggedness index (TRI), and vegetation gain (VG), after the October 2017 wildfire. Although this wildfire affected all the study area, the creation of higher burn severity mosaics positively enhanced the drainage and accelerated the gully erosion of Gg1, as well as the location of the nearest roads and paths, which emerge as a primary factor in the initiation and enlargement of this group of gullies. This study helps to better identify the current gully erosion conditions, and this can provide an important reference for risk assessment and control of gully erosion. Given the size of the gullies and the likelihood that recurring forest fires will affect the study area, some vital gully erosion control practices should be implemented urgently.

Correlation between Peripheral Blood and Bone Marrow Somatic Mutations Among Patients with Suspected or Established Myelodysplastic Syndromes from the National MDS Study

INTRODUCTION: Myelodysplastic Syndromes (MDS) are caused by progressive clonal dominance of mutated hematopoietic stem cells. While assessment of mutations in peripheral blood (PB) is an established standard for monitoring patients with some diseases such as chronic myeloid leukemia, the sensitivity and precision of PB screening and monitoring for somatic mutations in patients with MDS and related conditions such as clonal cytopenias of undetermined significance (CCUS) is less certain. Multiple published guidelines require bone marrow (BM) evaluations for the above, an invasive procedure not often performed outside of clinical trials. We compared somatic mutations and variant allele frequencies (VAFs) in paired PB and BM samples to assess the utility of PB results as a surrogate for diagnosis and monitoring. METHODS: The National MDS Natural History Study (National MDS Study) is an observational longitudinal cohort study of cytopenic patients suspected of having a diagnosis of MDS. All patients have PB and BM sampled when entering the study, prior to formal diagnosis. For this study, paired PB and BM baseline DNA samples from 36 patients were assessed for somatic mutations. Only subjects with minimum of one variant detected in their BM were included in this study. DNA was extracted from PB using an automated FlexSTAR (AutoGen) and from BM cell pellets using a QIAamp DNA Mini Kit (QIAGEN). Targeted exon sequencing of 96 genes was performed using a NovaSeq 6000 at a mean coverage of &amp;gt;1,200X and a mean breadth (bases covered at ≥100X) of &amp;gt;99.9%. Reads were aligned against a patched version of the build GRCh38 using BWA-MEM. VarScan2 was used to detect single nucleotide variants and short insertions/deletions with a minimum VAF of 2% and 5%, respectively. Resulting variants from 53 genes were manually reviewed to retain likely disease-causing variants. Correlation analysis between PB and BM VAFs was performed using Pearson correlation and linear regression. To confirm paired samples were sourced from the same subject, the Somalier software using a set of highly polymorphic SNPs across different ancestries was utilized to ensure a high level of relatedness. RESULTS: The 36 patients included 10 (28%) with MDS, 2 (6%) with MDS/MPN, 1 (3%) with AML (&amp;lt;30% blasts), and 23 (64%) with CCUS. The median age was 73 years (Table 1). Five of 36 patients had circulating PB blasts. Among the 191 mutations identified, the most common were TET2 (27%), SRSF2 (13%), DNMT3A (9%), SF3B1 (8%), and ASXL1 (8%). Correlation analysis of mutations (n=180) shared between paired PB and BM samples indicated a linear relationship between VAFs detected in PB and BM (Pearson correlation r=0.95, Figure 1), with a slight increase in variance observed with increasing VAFs. The deviation from the perfect (grey line) to the observed (yellow line) linear fit indicated that PB VAFs underestimated VAFs in BM by approximately 23% overall (Figure 1). For example, a BM VAF of 0.20 translated to a mean PB VAF of 0.16 based on the regression fit. The lower sensitivity was confirmed when looking at the number of total missed variants (present in BM, absent in PB): 9 of 101 (9%). Two mutations were detected in PB, but not BM. These mutations and diagnoses were 1) ETNK1 (VAF 0.026) in a patient with MDS-EB-1; and 2) CBL (VAF 0.021) in a patient with MDS with isolated del5q. Next, we assessed the relationship between percent of detected mutations and minimum VAF that was detected using linear regression and found that the higher the minimum VAF, the lower the percent of missed mutations. For example, for a 0.1, 0.2, and 0.3 minimum VAF, 11%, 9%, and 8% of BM mutations were missed, respectively. There was no difference in concordance between MDS and CCUS. SUMMARY &amp; CONCLUSIONS: PB can be used to reliably identify somatic mutations in patients with suspected or established MDS and related conditions. Linear correlation between PB and BM VAFs showed, unsurprisingly, that BM mutations with higher VAFs are more likely to be detected. If PB is positive, this method of variant detection may be used potentially to diagnose and monitor. However, if negative (or if VAF is less than 0.10), bone marrow genomics are still necessary to exclude detectable clonal mutations. For quantitative predictive tools that use VAFs, PB VAFs would need to be corrected to improve predictive results; our estimated linear regression equation could be used to guide this in a larger prospective study.

Mean platelet volume and platelet distribution width as predicting biomarkers of hepatitis C related hepatocellular carcinoma

Background and Aims: Besides their role in hemostasis and thrombosis; platelets have roles in innate and adaptive immune responses, atherosclerosis, lymphatic vessel development, angiogenesis and carcinogenesis .The relation between platelets and cancer is well-known and thrombocytosis may occur as a paraneoplastic syndrome. Several studies reported a correlation of high platelet count with poor prognosis in different malignancies. The aim of this study was to explore the predictive values of platelet count (PLC), mean platelet volume (MPV) &amp; platelet distribution width (PDW) in HCV related HCC, as well as their association with tumor burden. Method: The study was conducted on two groups of patients, group 1; included patients with naive HCV related HCC and group 2; included patients with chronic HCV cirrhosis. Liver biochemical tests, AFP, serum creatinine, multi-phasic contrast enhanced abdominal CT and or MRI were done at baseline for all cases. In Group 1, non-invasive diagnosis of HCC in cirrhotic patients according to the EASL guidelines &amp; Barcelona Clinic Liver Cancer (BCLC) staging was done. In Group 2, liver cirrhosis was diagnosed through liver histology or a combination of radiographic, clinical, and laboratory findings. CBC was done for all participating patients using automated hematology analyzer with reporting of PLC, MPV&amp; PDW. Results: Group 1 included 144 patients, while group 2 included 116 patients. In group 1, the age was significantly older &amp; the number of males was significantly higher. PLC was significantly lower in group 1 than group 2. In group 1, PLC was &lt; 150× 109/L (thrombocytopenia) in 71.6% of the cases, while it was normal in 28.4% of them. The median HCC diameter was significantly larger in patients with normal PLC than thrombocytopenic patients. There was significant positive correlation of PLC with BCLC stage. PLC was significantly higher in late than early BCLC stage. In group 1; PLC at cut off value of 134.5×109/L predicted late BCLC stages; with sensitivity of 44.1%, specificity of 82.5%, AUC of 0.65 &amp; p = 0.006. There was insignificant difference between both groups regarding PDW. There was insignificant difference between both groups regarding PDW. There was insignificant difference between both groups regarding the MPV. In group 1; PDW was ≥14.5% in 79% &amp; &lt;14.5% in 21% of the patients while MPV was ≥10.4 fl in 52.1% of the patients &amp; &lt;10.4 fl in 47.9% of them. There was insignificant correlation of MPV &amp; PDW with BCLC stage. PDW at cut off value of 15.05% predicted HCV related HCC with sensitivity = 62, 2%, specificity = 58, 1 %, AUC = 57, 8 %, p = 0.043. There was significant negative correlation of the MPV with serum AFP level. MPV was significantly smaller in late than early BCLC stage. On multivariate logistic regression analysis, gender, patient status of performance (PS), Alpha fetoprotein (AFP), PLC, Albumin -Bilirubin (ALBI) grade and Model of End stage Liver Disease (MELD) score, were significant predictors of HCV related HCC, while age, PDW, MPV and Child -Turcotte -Pugh (CTP) score were not significant predictors. Conclusion: PLC was significant predictors of HCV related HCC. HCV related HCC patients with normal PLC had larger tumor diameter. PLC positively correlated with BCLC stage. In HCV related HCC cases, PLC at cut off value of 134.5×109/L may predict late BCLC stages. PDW at cut off 15.05% may predict HCV related HCC. MPV was significantly smaller in late than early BCLC stages &amp; it negatively correlated with serum AFP level. MPV was not significant predictors of HCV related HCC.

Introducing activation functions into segmented regression model to address lag effects of interventions

The interrupted time series (ITS) design is widely used to examine the effects of large-scale public health interventions and has the highest level of evidence validity. However, there is a notable gap regarding methods that account for lag effects of interventions.To address this, we introduced activation functions (ReLU and Sigmoid) to into the classic segmented regression (CSR) of the ITS design during the lag period. This led to the proposal of proposed an optimized segmented regression (OSR), namely, OSR-ReLU and OSR-Sig. To compare the performance of the models, we simulated data under multiple scenarios, including positive or negative impacts of interventions, linear or nonlinear lag patterns, different lag lengths, and different fluctuation degrees of the outcome time series. Based on the simulated data, we examined the bias, mean relative error (MRE), mean square error (MSE), mean width of the 95% confidence interval (CI), and coverage rate of the 95% CI for the long-term impact estimates of interventions among different models.OSR-ReLU and OSR-Sig yielded approximately unbiased estimates of the long-term impacts across all scenarios, whereas CSR did not. In terms of accuracy, OSR-ReLU and OSR-Sig outperformed CSR, exhibiting lower values in MRE and MSE. With increasing lag length, the optimized models provided robust estimates of long-term impacts. Regarding precision, OSR-ReLU and OSR-Sig surpassed CSR, demonstrating narrower mean widths of 95% CI and higher coverage rates.Our optimized models are powerful tools, as they can model the lag effects of interventions and provide more accurate and precise estimates of the long-term impact of interventions. The introduction of an activation function provides new ideas for improving of the CSR model.

Natural Canopy Disturbance Patterns and Ecological Silviculture in the Alabama Fall Line Hills

Abstract As a natural disturbance-based approach to silviculture is increasingly embraced by forest managers, quantitative reference conditions of natural disturbance patterns are paramount. We used LiDAR data to quantify resultant structural patterns from an EF3 tornado on the Oakmulgee Ranger District of Talladega National Forest in the Alabama Fall Line Hills, USA. We found the zone of catastrophic disturbance totaled 123 ha, had a mean width of 360 m, and residual trees were randomly distributed. This zone was buffered by an edge zone of intermediate-severity disturbance where trees were removed individually and in groups. The edge zone averaged 220 m in width. In total, the study area included seventy-nine stands and the percentage of stand area damaged ranged from &amp;lt; 1% to 94%. We suggest that clearcut, seed tree, and shelterwood with reserves regeneration methods may be appropriate analogs to natural canopy disturbance in the Fall Line Hills region. These catastrophic disturbance entries should be buffered from undisturbed neighborhoods by a system that retains mature forest structures and would constitute a zone of intermediate-severity disturbance. Our approach may be used as a template to expand our understanding of natural canopy disturbance patterns in other regions and forest types. Study Implications: In regions where tornadoes are a natural component of the disturbance regime, including much of the southeastern United States, we suggest that clearcut, seed tree, or shelterwood with reserves regeneration methods may be used to approximate the zone of catastrophic disturbance that corresponds to the tornado track. We observed that reserve tree spatial patterns were random, but residual trees could be selected based on desired species or protection of important biophysical features such as seeps. Surrounding the catastrophic disturbance zone was an edge zone of intermediate-severity disturbance where trees were removed individually and in variably sized groups. We suggest that the structural patterns documented in this edge zone may be created through variable retention harvesting.

Long-term evolution of meandering channel planforms in response to the mean annual flow and width–depth ratio

A depth-averaged linearized meander evolution model was used to numerically evaluate the spatiotemporal evolution of the meandering channel centerline in the plane at various mean annual flows and width–depth ratios for capturing the overall average trend of the meandering channel planform. This analysis was done to better understand the consistent responses of the river morphology to possible future tectonic and climatic changes. The computational cases included an idealized sine-generated meandering channel with a moderate maximum deflection angle and a typical natural meander for the Jiyun River in China. The study results showed phased development and response characteristics of the meandering channel centerline (to the mean annual flow), along with increases in the specified mean annual width (B)–depth (H) ratio (represented by B/H). First, the spatial meander straightening trend over time weakened during Phase 1 (B/H ≤ 16.5) and gradually changed to a meander developing trend during Phase 2 (16.5 < B/H ≤ 27) with an overall insensitivity to the flow magnitude. Second, starting from the downstream tail during Phase 3 (27 < B/H ≤ 28.9), the symmetric development form along the transverse direction (perpendicular to the mean flow direction) was disrupted, while flow effects were highlighted when the mean annual B/H exceeded 28. Finally, an obvious onset and jump process of the channel sensitivity in response to flow occurred during Phase 4 (28.9 < B/H ≤ 29.5). These event characteristics are very similar to the transition from laminar to turbulent flow in fluid mechanics. This study provides insights for more in-depth exploration of meandering mechanisms and technical support for effective river management.

Association of concomitant continuous pain in trigeminal neuralgia with a narrow foramen ovale.

The pathogenesis of concomitant continuous pain remains unclear and is worthy of further study. In this clinical study, we aimed to explore the potential role of a narrow foramen ovale in the development of concomitant continuous pain. A total of 108 patients with classical trigeminal neuralgia affecting the third branch of the trigeminal nerve and 46 healthy individuals were enrolled in this study. Three-dimensional reconstructed computerized tomography images of all participants were collected, and the morphometric features of the foramen ovale were examined by two investigators who were blinded to the clinical data of the patients. In this cohort, patients with concomitant continuous pain suffered from more sensory abnormalities (18.4% vs. 2.9%, p = 0.015) and responded more poorly to medication (74.3% vs. 91.9%, p = 0.018) than patients without concomitant continuous pain. While no significant differences regarding the mean length (5.02 mm vs. 5.36 mm, p > 0.05) and area (22.14 mm2 vs. 23.80 mm2, p > 0.05) were observed between patients with and without concomitant continuous pain, the mean width of the foramen ovale on the affected side in patients with concomitant continuous pain was significantly narrower than that in patients without concomitant continuous pain (2.01 mm vs. 2.48 mm, p = 0.003). This neuroimaging and clinical study demonstrated that the development of concomitant continuous pain was caused by the compression of the trigeminal nerve owing to a narrow foramen ovale rather than responsible vessels in classical trigeminal neuralgia.

Evaluation of Endo Perio Lesions Using Cone Beam Computed Tomography (CBCT) - A Cross Sectional Study.

An accurate assessment of the disease extent and lesion size is needed for appropriate therapy decisions of endodontic-periodontic (endo-perio) lesions. CBCT imaging with less radiation and high spatial resolution can provide a comprehensive evaluation of endo-perio lesions. A total of 71 teeth with endo-perio lesions were assessed using CBCT. Periodontal bone defects were studied for bone loss pattern (horizontal/vertical) along with bone loss levels on mesial and distal sides in association with furcation involvement. The periapical lesions were studied for their prevalence and extent based on CBCT PAI Score. Horizontal and vertical bone loss were detected in 54 teeth (76.1%) and 17 teeth (23.95%), respectively. Mean crestal bone loss levels on mesial and distal aspects were 4.80 ± 3.21 mm and 5.74 ± 3.91 mm, respectively. The mean height, width, and depth of furcation defects were 3.19 ± 2.99 mm, 1.94 ± 0.98 mm, and 4.44 ± 1.92 mm, respectively. Periapical lesions were recorded in 55 teeth (77.5%). A CBCT PAI score of 5 was scored in 35 teeth with a mean lesion diameter of 11.3 ± 2.83 mm, while 16 teeth had healthy periapical tissues (scores of 0 and 1). CBCT is a valuable diagnostic tool that can help assess endo-perio lesions by providing morphometric measurements of periodontal bone defects and the extent of associated periapical lesions.

A radiological analysis of pelvic fixation trajectories: patient series.

Three well-defined methods for pelvic fixation are used for biomechanical support in spine fusion constructs: iliac, recessed iliac, and S2-alar-iliac (S2AI) screws. The authors compared the maximum screw sizes that could be placed with these techniques by using image-guidance software and high-resolution computed tomography scans from 20 randomly selected patients. Six trajectories were plotted per side, beginning at recognized starting points (standard or recessed posterior superior iliac spine [PSIS] or S2AI screw) and ending at the anterior inferior iliac spine (AIIS) or supra-acetabular notch (SAN). The mean maximum screw length and width ranged from 80.0 ± 32.2 mm to 140.8 ± 22.6 mm and from 8.25 ± 1.2 mm to 13.0 ± 2.7 mm, respectively, depending on the trajectory. Statistically significant differences in length were found between the standard and recessed PSIS trajectories to the AIIS (p < 0.001) and between the standard PSIS-to-AIIS trajectory and the S2AI-to-AIIS (p = 0.007) or S2AI-to-SAN (p < 0.001) trajectories. The most successful trajectory was the PSIS to SAN (95%, 38/40). The traditional iliac screw trajectory enabled the longest and widest screw trajectories and highest rate of successful screw placement with the fewest theoretical breaches more reliably than recessed and S2AI trajectories. These findings may help surgeons plan for maximum screw purchase for pelvic fixation.

Trabeculae in the basilar venous plexus: anatomical and histological study with application to intravascular procedures.

Few studies have examined the basilar venous plexus (BVP) and to our knowledge, no previous study has described its histology. The present anatomical study was performed to better elucidate these structures. In ten cadavers, the BVP was dissected. The anatomical and histological evaluation of the intraluminal trabeculae within this sinus were evaluated. Once all gross measurements were made, the clivus and overlying BVP were harvested and submitted for histological analysis. A BVP was identified in all specimens and in each of these, intraluminal trabeculae were identified. The mean number of trabeculae per plexus was five. These were most concentrated in the upper half of the clivus and were more often centrally located. These septations traveled in a posterior to anterior direction and usually, from inferiorly to superiorly however some were noted to travel horizontally. In a few specimens the trabeculae had wider bases, especially on the posterior attachment to the meningeal layer of dura mater. More commonly, the trabeculae ended in a denticulate form at their two terminal ends. The trabeculae were on average were 0.85 mm in length. The mean width of the trabeculae was 0.35 mm. These septations were consistent with the cords of Willis as are found in the lumen of some of the other intradural venous sinuses. An understanding of the internal anatomy of the BVP can aid in our understanding of venous pathology. Furthermore, this knowledge will benefit patients undergoing interventional treatments that involve the BVP.

Premorbid glenoid anatomy reconstruction from contralateral shoulder 3-dimensional measurements: a computed tomography scan analysis of 260 shoulders

Total shoulder arthroplasty (TSA) aims to reconstruct the premorbid anatomy of a pathologic shoulder. A healthy contralateral shoulder could be useful as a template in planning TSA. The symmetry between the left and right shoulders in healthy patients remains to be proved. The purpose of this study was to compare the 3-dimensional anatomy of the glenoid between sides in a healthy population. A multinational computed tomography scan database was retrospectively reviewed for all healthy bilateral shoulders in patients aged between 18 and 50 years. One hundred thirty pairs of healthy shoulder computed tomography scans were analyzed, and glenoid version, inclination, width, and height, as well as glenoid lateral offset and scapula lateral offset, were measured. All anatomic measures were computed with Blueprint, validated 3-dimensional planning software. The intraclass correlation coefficient was determined for each measure between left and right shoulders. The minimal detectable change (MDC) was calculated using the following formula: MDC=2×1.96×Standarderrorofmeasurement. The comparison between 130 pairs of healthy scapulae showed statistically significant differences in absolute values between right and left glenoid version (-5.3° vs. -4.6°, P<.01), inclination (8.4° vs. 9.3°, P<.01), and width (25.6 mm vs. 25.4 mm, P<.01), as well as scapula offset (105.8 mm vs. 106.2 mm, P<.01). Glenoid height was comparable between right and left shoulders (33.3 mm vs. 33.3 mm, P=.9). The differences between the means were always inferior to the MDC regarding glenoid version, inclination, height, and width, as well as scapula offset. Very strong intraclass correlation coefficients between the left and right shoulders were found for all evaluated paired measures. Healthy contralateral scapulae are highly reliable to predict inclination, height, width, and scapula offset and are reliable to predict version of a given scapula. Paired right and left scapulae were not statistically symmetrical regarding mean glenoid version, inclination, and width, as well as scapula offset. Nevertheless, the reported differences were not higher than the MDC for this cohort, confirming that healthy contralateral shoulders can be a useful template in TSA preoperative planning.

Morphometric analysis of adult human mandible and their ratios

Mandible is the strongest bone in the face region required for the process of mastication. The inferior alveolar nerve travels inside the bone in the mandibular canal to supply the lower teeth. The measurement of various parameters of mandible allows the proper localisation of nerve for anaesthetic block. Also, the ratios between factors assists during surgeries. A cross-sectional observational study was conducted on 97 dry adult human mandibles. Height of symphysis menti, ramus breadth and height, and distance of mandibular foramen from mandibular notch and base of mandible of both sides are measured. Ratios between ramus height and breadth and distances of mandibular foramen from above mentioned landmarks were computed. The mean height of symphysis menti was found to be 25.52 ± 4.32 mm. The mean values of height of ramus on right side was 46.18 ± 4.43 mm and on left was 46.57 ± 4.24 mm. The mean breadth of ramus was 32.29 ± 3.57 mm (right side) and 32.59 ± 3.75 mm (left side). It was found that mandibular foramen was closer to the mandibular notch than to the base of mandible on both sides. The ratios between the right and left side showed no significant differences.Inferior alveolar nerve block is required in various dental procedures for which mandibular foramen localisation is must. Dimensions of mandible help in surgical restructuring. Similarly, it aids in understanding the evolution of the bone.

Predictors of pain development for contralateral asymptomatic degenerative rotator cuff tears based on features of an ipsilateral painful cuff tear: a prospective longitudinal cohort study

Prior rotator cuff disease natural history studies have focused on tear-related factors that predict disease progression within a given shoulder. The purpose of this study is to examine both patient and tear-related characteristics of a painful rotator cuff tear that predict future pain development and functional impairment in a shoulder with a contralateral asymptomatic cuff tear. This is prospective longitudinal cohort study of subjects ≤65 years who underwent surgery for a painful degenerative rotator cuff tear and possessed an asymptomatic contralateral tear. Subjects were followed prospectively with shoulder ultrasound, physical examination and functional score assessment. Primary outcome was change in ASES score at 2 years. Secondary outcomes included WORC, PROMIS, HADS depression/anxiety, and VR-12 mental component scores. Sixty-five subjects were included with mean follow-up 37 (range 24-42) months. Seventeen (26%) developed contralateral shoulder pain at median 15.2(10.5) months. No difference in age, sex, CCI, occupational demand noted between subjects who did and did not develop pain. In the presenting painful shoulder there was no difference in baseline tear size, muscle degeneration, or biceps pathology between groups. The mean baseline tear length (8.6 vs. 3.8 mm, p=0.0008) and width (8.4 vs. 3.2 mm, p=0.0004) were larger in asymptomatic shoulders that subsequently developed pain compared to those that did not. However, there was no difference mean tear enlargement (length p=0.51, width p=0.90). There were no differences in baseline ASES, WORC, PROMIS scores or HADS depression/anxiety scores between shoulders that did and did not develop pain; however, subjects who developed pain reported lower baseline VR-12 MCS scores (53.3 vs 57.6, p=0.04). Shoulders that developed pain had higher VAS pain scores (2.9 [2.5] vs. 0.6 [1.0], p=0.016, lower ASES scores (7 [33] vs. 100[11.6], p=0.001) and significant changes in all WORC scales with pain onset compared to those that remained asymptomatic. There was no significant difference in changes of HADS anxiety/depression scores but a significant increase in VR-12 MCS scores in subjects who developed pain (7.1[12.6] vs. -1.9[8.7], p=0.036). A quarter of patients with painful cuff tear developed pain in a contralateral asymptomatic cuff tear that resulted in a measurable decline in function within 3 years. Analysis showed only baseline tear size of the asymptomatic shoulder was predictive of pain development. There were no tear-related features of the presenting painful rotator cuff tear or indices of mental health and physical function/occupational demand that were predictive of future pain development at short-term follow-up.

Restorative effects of Silymarin milk thistle on the liver following paracetamol-induced hepatotoxicity in adult albino rats

Background: Paracetamol-induced hepatotoxicity has been on the rise worldwide and there is a need for restorative measures to  counter its effect. Silymarin milk thistle is an herb that has been used for the treatment of liver conditions. This current study aimed at  determining the restorative effects of silymarin milk thistle on the liver morphology and terminal body weight of paracetamol-induced  hepatotoxicity among albino rats.&#x0D; Methodology: This study was conducted at Maseno University, and a posttest-only experimental  design was used. A total of 24 adult albino rats were randomly selected and grouped into four groups, each consisting of six albino rats. Positive control received (5 days of high-dose paracetamol 750mg/kbwt) and negative control received no drug intervention. Three  experimental groups received high-dose paracetamol for five days and were thereafter given varying doses of silymarin milk thistle (low- dose group: 200 mg/kbwt, medium-dose: 400 mg/kbwt and high-dose: 600 mg/kbwt) of silymarin milk thistle. Gross liver morphological  data and body weight were expressed as mean ± SEM. A one-way ANOVA analysis of variance was used to test the mean groups and a  post hoc test was used to test the difference between the mean groups. A p ≤ 0.05 was found to have statistical significance at a 95%  confidence interval.&#x0D; Results: This current study found that there was a significant (p≤ 0.0001) increase in mean weight, volume, length,  and width of the liver in the high dose silymarin milk thistle group as compared to the positive control group. There was a significant (p≤  0.0001) reduction in the terminal mean body weight of the rats in the positive control group, low dose silymarin group and the medium  dose silymarin group respectively, as compared to the negative control group.&#x0D; Conclusion: Silymarin milk thistle was found to have  restorative effects on the liver morphology and body weight following paracetamol toxicity at high dose. 

EVALUATION OF THE OLFACTORY FOSSA WITH COMPUTED TOMOGRAPHY FOR ENDOSCOPIC SURGERY

OBJECTIVE: The aim of this case-control study is to assess the olfactory fossa (OF) anatomy in computed tomography (CT) images of patients with clinical and radiological diagnoses of sinusitis as well as those of patients of a control group. MATERIAL AND METHODS: 100 patients without sinusitis and 100 patients with a clinical and radiological diagnosis of chronic sinusitis who were referred for CT scans were included. The OF types were recorded according to the Keros classification. Medial ethmoid roof point (MERP) height, cribriform plate (CP) height and width, OF depth and width, and angle of lateral lamella-cribriform plate (ALLCP) were also measured. RESULTS: The mean depth of OF was 5.9 mm and 6.1 mm on the right and left sides, respectively. The most common type was type 2 on the right (51%) and left (45.5%) sides. The mean height of the MERP was 27.9 mm in both the right and left sides. The mean height of CP was 22.0 mm and 21.8 mm on the right and left sides, respectively. The mean width of the OF was 4.1 mm and 3.4 mm on the right and left sides, respectively. The mean width of CP was 2.8 mm and 2.4 mm on the right and left sides, respectively.The mean right and left ALLCP were 77.6° and 79.1°, respectively. No significant difference was found between the parameters in the case and control groups. CONCLUSIONS: According to the results, the presence of sinusitis has no effect on the anatomy of the OF. However, preoperative evaluation of the OF anatomy is very important in minimizing complications that may occur during functional endoscopic sinus surgery (FESS).