Normal Reference Research Articles

The reference ranges for fetal ductus venosus flow velocities and calculated waveform indices and their predictive values for right heart diseases.

This study endeavors to establish comprehensive normal reference ranges and Z score formulas for ductus venosus (DV) flow velocity parameters and calculated waveform indices across different gestational ages in low-risk fetuses. Furthermore, we aim to validate the predictive capabilities of these Z score calculation formulas in fetuses with diverse right heart diseases. 8,953 singleton low-risk fetuses and 70 fetuses diagnosed with different types of right heart diseases were retrospectively enrolled. The DV blood flow velocities during the cardiac cycle (ventricular systolic wave velocity [S], ventricular diastolic wave velocity [D], atrial contraction wave velocity [A], and time-averaged maximum velocity [Tamx]) and calculated waveform indices (preload index [PLI], peak velocity index [PVI], pulsatility index [PI], S/A, and S/D) were obtained. Ninety low-risk fetuses were randomly selected as the control group to verify the predictive value of the Z score model for fetuses with different types of right heart diseases. As gestational age increased (16-39weeks), the mean values of S, D, A, and Tamx progressively increased; conversely, the mean values of PLI, PVI, PI, and S/A decreased, respectively, and the median value of S/D remained stable. The Z score-transformed A, PLI, PVI, PI, and S/A could serve as predictors of overall right heart diseases. Different DV Doppler parameter Z scores exhibited varying predictive values for different subtypes of right heart diseases. Normal reference ranges and corresponding Z score calculation formulas for DV hemodynamic parameters were established, which have demonstrated significant diagnostic values in identifying right heart diseases.

Related studies on measuring the normal values of optic nerve sheath diameter in healthy Chinese adults based on CT scans.

To measure the normal reference value of optic nerve sheath diameter (ONSD) and its correlation with eyeball transverse diameter (ETD), age and sex in Chinese adults by CT. The data of healthy adults who underwent head scan in Baotou Central Hospital from March 2022 to May 2023 were retrospectively collected. The ETD of both eyes and the ONSD (ONSD3mm, ONSD10mm) at 3mm and 10mm behind the eyeball were measured, and the relationship between ONSD and age, sex and ETD was analyzed by linear regression. A total of 360 subjects were included, 180 males and 180 females, aged 48.5 (33.00, 63.00) years. The average ONSD3mm, 10mm and ETD of 360 included subjects were 5.28 (95% CI 5.23-5.32) mm, 4.34 (95% CI 4.30-4.37) mm and 22.47 (95% CI 22.38-22.56) mm, respectively. Univariate linear regression analysis showed that gender (P < 0.001) and ETD (P < 0.001) were the influencing factors of the mean ONSD. Further multivariate linear regression analysis also showed that gender (P < 0.001) and ETD (P < 0.01) were associated with ONSD values. The comparison of parameters between different genders showed that the values of all parameters in males were greater than those in females, and the difference between the two groups was statistically significant (P < 0.001). In addition, we further measured the ONSD/ETD values, which averaged 0.24 (0.23-0.24) at 3mm and 0.19 (0.19-0.20) at 10mm. The average ONSD3mm, 10mm and ETD of healthy Chinese adults were 5.28 (95% CI 5.23-5.32) mm, 4.34 (95% CI 4.30-4.37) mm and 22.47 (95% CI 22.38-22.56) mm, respectively. At the same time, it is found that gender and ETD are the influencing factors of ONSD, and the diameter of ONSD is different between men and women.

Shear wave elastography of the deltoid muscle in healthy volunteers - quantifying age-dependent normal values.

Reverse shoulder arthroplasty (RSA) is performed for various shoulder pathologies. Inadequate tensioning of the deltoid muscle can lead to complications, highlighting the need for optimization. Preoperative quantification of deltoid health may improve operative execution and outcomes. Shear wave elastography (SWE) quantifies stiffness as a marker for muscle health and tensioning. This study establishes normal reference values for the deltoid in healthy individuals. 40 participants were enrolled, 10 in each 18-30, 31-40, 41-55, and 55 + age groups. Two operators performed SWE in 3 deltoid regions, and the intra- and inter-operator agreement was assessed. Mean values were 23.2 ± 4.6, 26.4 ± 5.6, and 17.9 ± 5.2 kPa for the anterior, lateral, and posterior regions. The posterior region did not show any age dependency. However, there were significant differences between the age groups of 18-30 and 55 + years in the anterior (19.7 ± 3.7 vs. 26.7 ± 5.3 kPa) and lateral (22.0 ± 5.4 vs. 30.2 ± 8.8 kPa). Intra-operator reliability ranged from 0.45 to 0.60, and inter-reader agreement from 0.57 to 0.85. This study provides reference values of deltoid stiffness which could serve as a comparison with clinical measurements for RSA operative planning and execution and prediction of surgical outcomes.

Reference ranges ("normal values") for cardiovascular magnetic resonance (CMR) in adults and children: 2025 update.

Quantitative assessment of morphological and functional cardiac parameters by cardiovascular magnetic resonance (CMR) is essential for research and routine clinical practice. Beyond established parameters of chamber size and function, tissue properties such as relaxation times play an increasing role. Normal reference ranges are required for interpretation of results obtained by quantitative CMR. Since the last publication of the "normal value review" in 2020 many new publications related to CMR reference values have been published, which were integrated in this update. The larger sample size provides greater statistical confidence in the estimates of upper and lower limits, and enables further partitioning, e.g., by age and ethnicity for several parameters. Previous topics were expanded by new sections.

Assessment of cardiac structure and function 1.5 years after COVID-19: results from the EPILOC study

Abstract Background Impaired left and right ventricular function have been observed mainly in hospitalized patients with acute SARS-CoV-2 infection. The long-term cardiac sequelae have not yet been conclusively clarified in large, well-defined cohorts. In addition, it is not yet certain whether cardiac function is related to persistent cardiopulmonary symptoms or reduced exercise capacity after COVID-19. Purpose Differences in cardiac structure and function in patients with suspected post-COVID syndrome (PCS) and in recovered control patients (CON) were analysed with regard to the association with cardiopulmonary symptoms and physical performance. Methods In this multicentre study, transthoracic echocardiography was performed in 1154 individuals (49±12 years, 760 women) 1.5 years after SARS-CoV-2 infection (October 2020 till April 2021) in southwest Germany. Left and right ventricular global longitudinal strain (LV/RV GLS) and RV free wall strain (FWS) were determined with post-processing software in 679 PCS and 475 CON. Cardiopulmonary exercise testing (CPET) was performed with a ramp protocol on a bicycle ergometer. Results PCS showed lower LV GLS (-20.25% vs. -20.73%, p=0.003), diastolic function (E/A 1.16 vs. 1.21, p=0.022) and TAPSE (24.45 vs. 25.05, p=0.022) compared to CON, while RV strain values did not differ. Echocardiographic parameters were within the normal clinical reference range. LV GLS was negatively associated with VO2max (p=0.004) and positively associated with rapid physical exhaustion (p=0.050), but not with cardiopulmonary symptoms. Conclusions Significantly reduced cardiac function in PCS compared to CON 1.5 years after SARS-CoV-2 infection could indicate long-term left myocardium involvement, while signs of RV involvement were inconsistent. The differences between the groups appear to be small and could be explained by deconditioning due to PCS or the more frequent presence of cardiovascular disease in PCS. Nevertheless, it cannot be ruled out that a slight reduction in cardiac function and physical performance could be a long-term consequence of COVID-19 in patients with persistent symptoms. Further (long-term) studies are therefore necessary to investigate the connection between persistent exercise intolerance and cardiac involvement. This could lead to further diagnostic steps and therapy recommendations.

Echocardiographic nomograms of heart chambers and great arteries in peruvian children living at high altitude according to sex

Abstract Background Reference values in pediatric echocardiography are crucial for clinical decision making. The availability of nomograms may support interpretation of the echocardiographic findings and clinical diagnosis. Cardiac chamber dimensions vary according to body size, age, sex, and to some extent, geographic background in children. Purpose The aim of this study was to establish two-dimensional and M-mode echocardiographic reference values for cardiac chambers, outflow tracts and great vessels for school children living at high altitude, differentiated between male and female. Methods This is a post-hoc analysis from a cluster randomized cross-sectional survey of rheumatic heart disease in school children in Arequipa, Peru. Children with normal echocardiographic screening were included for this sub-study. The echocardiograms were acquired with a portable machine and the images were analyzed centrally with a standardized methodology. Body surface area (BSA) was used as an independent variable to predict the mean values of echocardiographic measurements for both male and female groups. Reference values are presented with z-scores and nomograms based on the sex. Results A total of 985 students from ages 5-16 years were included. The Haycock formula provided the best fit and was used when presenting data as predicted values for a given BSA. The z-score and nomograms for all essential dimensional measures of cardiac chambers and great vessel, as well as functional surrogates are presented based on sex. Left ventricular chamber and mass are presented in Figure 1 and right ventricular dimensions are presented in Figure 2. Conclusions Normal reference values and nomograms of cardiac chamber, outflow tracts and great arteries in healthy school children living at high altitude based on sex were reported. These data partly cover a gap in existing pediatric echocardiographic nomograms. Left ventricular chamber and mass Right ventricular dimensions

Evolution of Sagittal Spinal Alignment During Pubertal Growth: A Large-Scale Study in a Chinese Pediatric Population.

Previous studies have reported normative data for sagittal spinal alignment in asymptomatic adults. The sagittal spinal alignment change in European children was recently reported. However, there is a lack of studies on the normative reference values of sagittal spinal and pelvic alignment and how these parameters change at different growth stages in Chinese children. The aims of this study were to establish the normative reference values of sagittal spinopelvic parameters in Chinese children, to investigate their variation during growth, and to compare these parameters between Chinese and European populations. The radiographic data of 1,916 healthy Chinese children (female:male sex ratio, 1.02:1; mean age, 11.9 ± 4.3 years) were analyzed in a retrospective, single-center study. Full-spine radiographs were utilized to measure several sagittal parameters, including pelvic parameters, T1-T12 thoracic kyphosis (TK), and L1-S1 lumbar lordosis (LL). TK was divided into proximal, middle, and distal parts, and LL was divided into proximal and distal parts. Patients were stratified into 5 groups according to skeletal maturity (based on age, Risser sign, and triradiate cartilage status). During skeletal growth, pelvic incidence (PI) increased from 31.3° to 38.4° (p < 0.001), and pelvic tilt (PT) increased from 7.8° to 12.2° (p < 0.001). There were also increases in LL (from 45.0° to 46.3°; p = 0.020) and proximal LL (from 14.5° to 15.9°; p = 0.023). The peak of change in PI occurred between Groups 1 and 2 (from 31.3° to 35.8°; p = 0.011). The peak of change in LL was observed between Groups 1 and 3 (from 45.0° to 47.7°; p = 0.008). The peak of change in proximal LL (from 14.5° to 15.9°; p = 0.039) and distal TK (from 6.1° to 6.9°; p = 0.039) occurred between Groups 1 and 5. A subgroup comparison showed that age and TK were significantly higher in male patients than in female patients across the skeletal growth groups. This was a comprehensive study of sagittal alignment in a large cohort of Chinese children. These findings can serve as age, sex, and ethnicity-specific reference values for spine surgeons when assessing and planning correction surgery for pediatric patients. The sagittal alignment variations during skeletal growth were different from those in European children, representing a unique cascade effect occurring during skeletal maturation in the Chinese population. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Implementation of Compensation-Sensitive Shot-Style-Feedback of Aiming Point Training Data at the Swiss Shooting Federation

Introduction The practical application of scientific knowledge is essential for improving performance in Olympic air rifle shooting. At the Swiss Shooting Federation, for example, we have implemented an innovative training concept based on our research into compensation-sensitive shot styles and the importance of individual movement phases (Tartaruga &amp; Kredel, 2021, 2022, 2024). Methods We have been collecting SCATT training sessions from athletes via email and utilizing a MATLAB script that waits for and automatically analyses incoming data. The analysis is performed according to the methods proposed in our study, including the use of a validated movement phase segmentation algorithm of aiming point trajectory data and the identification of compensation-sensitive shot styles based on this data. We consider athlete-specific preferences and compare current data with results from the last ten years to provide a social and normative reference orientation. Results Through individualised analysis of shooting data, coaches can develop tailored training plans that address the specific needs of each athlete and receive immediate feedback on the technical impact of recent training sessions on different technical characteristics. Comparison of historical data also provides valuable insight into performance development across disciplines, gender, and age for specific technical characteristics. These insights are used to optimize coaches’ education programs by providing a generalised understanding of the technical development of young athletes in shooting. Furthermore, some technical characteristics even have predictive validity for real shooting performance and therefore appear to be suitable for talent identification. Discussion/Conclusion The integration of compensation-sensitive shot-styles and the consideration of individual preferences have led to a higher acceptance of the tailored feedback reports than the previous more generalised reports. In the future, we plan to extend these approaches by applying them to other disciplines within the shooting sports. In addition, we would like to scientifically validate specific training interventions to promote successful shot styles, with the aim to provide evidence-based training recommendations in the future. In our view, this project serves as a good example of how challenging real-world problems brought up by coaches and embedded scientists can be jointly structured and solved at federation and university level, and how their solution can ultimately lead to practical tools reshaping and improving a federation’s process landscape.

Brain volume metric analysis is correlated with aging changes and sex differences in Thai older adults

Introduction: Normative data on structural brain volume changes with age and sex differences are required as a reference standard for future research and clinical use. Methods: We studied a two-center, metropolitan-based, prospective cohort of adults aged fifty-five years and older who were recruited from community-dwelling settings and outpatient clinics without cognitive impairment at baseline and who were followed up for 2 years. The clinical data, neuropsychological tests, and brain MRI obtained with FreeSurfer software were utilized for quantitative volumetric measurements. Results: A total of 296 participants were recruited at the beginning, with 17 participants (5.8%, excluding 2 subjects with claustrophobia) excluded due to abnormal MRI findings and 27 participants (9.1%) excluded due to MCI/dementia. Among the 250 remaining, 14 patients dropped out or were lost to follow-up, and 35 had MCI or AD converters (14.8%). The remaining 201 subjects with normal cognitive function aged 55-85 years were analyzed for structural brain volume. There were significant correlations between age and brain parameters, including the hippocampus, corpus callosum, thalamus and ventricular volume changes (p value &lt; 0.05). There were significant differences between males and females in total intracranial volume, caudate, temporal lobe, and ventricle volumes in subjects aged 65–74 years, and in total intracranial volume and ventricle volumes in subjects aged 55–64 years (p value &lt; 0.05). Conclusion: Age and sex contributed to differences in brain structure and ventricular volume. These data could be used as a normative reference for clinical interpretation in people up to 85 years old and for understanding the physiological aging-related changes in the brain.

P-52 ASYMPTOMATIC MIXED PITUITARY MACROADENOMA IN A YOUNG MALE PATIENT

Abstract Introduction Central hyperthyroidism due to a thyrotropin (TSH)-secreting pituitary adenoma is a rare cause of hyperthyroidism, representing 0.5-1.0% of all pituitary adenomas. The etiopathogenesis of TSH-secreting-adenomas is unknown and no definite role for various oncogenes has been proven. Plurihormonal pituitary adenomas reveal greater tumor recurrence and local invasion than do mono-secreting pituitary adenomas and therefore they need to be followed more closely. Clinical Case We present the case of a 19-year-old male who was admitted to the endocrinology clinic, was asymptomatic, and had abnormal thyroid tests during routine examinations. Laboratory tests revealed TSH 1.33 (normal RI), freeT4 2.5 (high), freeT3 6.78 (high), and the patient had tachycardia (pulse 120/min) on physical examination, but had no complaints. Thyroid antibody tests were negative, and ultrasonography revealed normal thyroid gland size and homogeneous parenchyma. Alpha subunit test was requested with suspicion of TSHoma and genetic test was requested considering thyroid hormone receptor resistance. In the pituitary panel tests, the patient's GH and IGF1 tests were found to be high for his age and gender, The lowest GH value in the GH-OGTT test was 3.95 ng/mL. LH was high but testosterone was within the normal reference range. The patient was found to have mandibular prognathism and his secondary sex characteristics were normal. Pituitary MRI revealed a nodular appearance on the left side of the pituitary gland, measuring 13x9 mm, hypointense on T1A, hyperintense on T2A, and showing contrast medium uptake. The infundibulum deviates to the right, and there is no pressure on the optic chiasm. Visual field test was normal. AlphaSubunit pituitary tumor marker value was found to be high at 1.9ng/mL (RIs ≤0.5). The genetic test for resistance to thyroid hormone, also came back normal. The patient underwent endoscopic transsphenoidal pituitary adenomectomy due to pituitary macroadenoma by an experienced neurosurgeon. No postoperative complications developed. In cytopathological evaluation, histochemical studies performed with silver stain showed that the reticulin roof was lost. In immunohistochemical studies, SF-1, PIT-1, LH (diffuse), GH (densely granular), TSH (rare) and LMWK (perinuclear cytoplasmic weighted) were positive. T-PIT and Prolactin were negative. Ki-67 proliferation index was 5%. Postoperative pituitary tests were normal and no deficiency was observed and no treatment was required. At the postoperative 3rd month follow-up, the lowest GH value in the GH-OGTT test was 0.16 ng/mL, and no residual mass was observed in the pituitary MRI. The patient, who had no postoperative complaints, is being followed up by the endocrinology clinic. Conclusion Mixed pituitary tumors are rare and can sometimes appear as silent tumors, but may be aggressive during follow-up, so better follow-up is necessary.Table 1:Pituitary panel biochemical results

(In)completing Accounting: Financial Managers and Quality Reforms in the Danish Health System

This study investigates the way that managers operating in the Danish health system encounter, make sense of, and enact a series of different reforms equipping and encouraging them to attend to and improve the quality of medical care. Our attention focuses on the conditions under which managers are enabled to perceive the incompleteness of the accounting systems and metrics, which shape and are shaped by how the reforms are enacted and what they ultimately mean in practice. On this basis we offer novel insights into the process we refer to as incompleting accounting, which we show involves and relates to managerial actions and intentions, and design characteristics of the accounting systems themselves. Illuminating the relationship between incompleting accounting at the level of practice, and completing quality at the level of policy, also allows us to provide a normative assessment of the different quality improvement regimes. Finally, we contribute to debates about the breaking down of distinctions between medical and managerial forms of knowledge and action, highlighting among other things a new direction of hybridization brought about as an indirect effect of accounting for quality.

Normative Values of Rhinology Questionnaires in Young Adults: A Tool to Identify Candidates for Rhinoplasty

Objective: Normative values of Rhinoplasty Outcome Evaluation (ROE) and Functional Rhinoplasty Outcome Inventory 17 (FROI-17) allow the monitoring of surgery outcomes. The objective of our study was to determine the reference norms of these disease-specific questionnaires in the age group that most often seeks rhinoplasty. Methods: The normative values of the ROE and FROI-17 questionnaires were calculated for 570 (459 women and 111 men) young adults at the mean age of 19.3 ± 1.3 years, range 18–25 years. Each participant underwent an ENT examination. All those who obtained a positive result were asked to complete two questionnaires: ROE and FROI-17. Results: The mean total ROE score was 13.4 ± 2.3, with a median of 13 and a range from 7 to 24. The mean overall FROI-17 score was 9.1 ± 13.3, with a median of 4 and a range from 4 to 72. For nasal symptoms, the mean was 4.0 ± 6.0, with a median of 1 and a range from 0 to 29. We observed a statistically significant difference between men and women only for the normative values of nasal symptoms (mean 4.0 ± 5.9 and median 2 (0–27) vs. mean 3.7 ± 6.5 and median 0 (0–29)). Additionally, there was a statistically significant correlation between the normative values of the ROE and FROI-17 scores (ρs = −0.413 for all participants, ρs = −0.314 for women, and ρs = −0.437 for men). Conclusions: The established normative values for the ROE and FROI-17 questionnaires among young, healthy individuals without nasal abnormalities can assist in the initial assessment of individuals seeking rhinoplasty. Deviations from these normative values in the ROE and FROI-17 questionnaires results may serve as indicators of potential concerns, such as body dysmorphic disorder (BDD).

Evaluating Biomechanical and Viscoelastic Properties of Masticatory Muscles in Temporomandibular Disorders: A Patient-Centric Approach Using MyotonPRO Measurements

The temporomandibular joint (TMJ) is essential for chewing and speaking functions, as well as for making facial expressions. However, this joint can be affected by disorders, known as temporomandibular disorders (TMDs), induced by complex causes that lead to limitations in daily activities. Building on the methodology and findings from our previous study on TMJ function, our research aims to apply the established criteria and norms to patients with TMDs. The primary goal is to evaluate the applicability and clinical relevance of these reference norms in predicting the severity and progression of TMJ disorders within a clinical population. Using non-invasive myotonic measurements, we evaluated 157 subjects, including both non-TMD-affected and TMD-affected individuals. To achieve optimal results, five primary parameters (frequency, stiffness, decrement, relaxation time, and creep) were analyzed using statistical–physical tools, providing quantitative functionality degrees across different previously examined clinical groups. The obtained results identified significant quantitative markers for early diagnosis and personalized treatment of TMJ disorders. This interdisciplinary approach leads to a deeper understanding of TMJ dysfunctions and makes a meaningful contribution to clinical practice, providing more precise tools for managing and treating this complex condition.

ЭЛЕМЕНТНЫЙ СТАТУС ЖИВОТНЫХ И ЕГО РАСПРЕДЕЛЕНИЕ В СРЕДЕ ТЕЛОК С РАЗЛИЧНЫМ АЛЛЕЛЬНЫМ НАБОРОМ ГЕНОВ, АССОЦИИРОВАННЫХ С КАЧЕСТВОМ ГОВЯДИНЫ

The purpose of the study is to determine the effect of polymorphism of the CAPN1 and TG5 genes on the elemental status of heifers in the conditions of the technogenic zone of the Southern Urals. The study was conducted at Sovkhoz Bredinsky LLC, Chelyabinsk Region, on 40 heads of Simmental Bredinsky meat-type heifers. Laboratory studies were carried out at the Center for Collective Use of the Federal State Budgetary Scientific Institution of the Federal Scientific Center of the BST RAS. According to the results of genotyping, biosubstrates in the form of wool were taken from animals of different genotypes and sent to Mikronutrienty LLC (Moscow), where their elemental composition was determined by mass spectrometry using a Nexion 300D quadrupole mass spectrometer (Perkin Elmer, USA). The results indicate a moderate heterogeneity of the genotyped population for the CAPN1 gene and a significant shift in heterozygosity for the TG5 gene. The elemental status of the animals is reflected in a graph that does not show any excess of toxic elements of the upper limits of the reference values for the Southern Urals zone, with the exception of the excess of the upper centiles of the reference norms for some essential elements, such as Mg (265.3 µg/g), K (2840.7) and Na (1571.6 µg/g), which is associated with the peculiarities of the geochemical conditions of the area. The results of the analysis of the distribution of the content of elements in the hair of 15–16-month-old heifers, depending on the polymorphism of the CAPN1 and TG5 genes, showed the lack of reliability of the dependence of the content of elements in the hair of animals on the genotype according to the polymorphic state of the above genes. At the same time, some peculiarities in the distribution of magnesium were observed for the TG5 gene, the amount of which in animals with the TT genotype was 2.1 times less than in analogues with the CC genotype, and for zinc, on the contrary, it was 33.2 % more (P &gt; 0.05). To obtain reliable values, it is necessary to repeat the studies on a larger sample.

Thirty years later: the lingering effects of adolescent idiopathic scoliosis surgery with third-generation implants on quality of life.

To determine patient-reported clinical status in a cohort of patients operated on during adolescence for adolescent idiopathic scoliosis (AIS) using Cotrel-Dubousset instrumentation after a minimum follow-up (FU) of 25years. Multicentric cross-sectional observational study. We assessed the clinical status of patients using the lumbar-pain numeric rating scale (NRS), ODI, SRS-22r, SF-36, and EQ-5D-5L. For NRS and SRS-22r, the reported "Patient Acceptable Symptom State" (PASS +) was used as a reference for normality. Further, normative data were used for SF-36 and EQ-5D-5L. Out of 226 eligible patients, 152 (67% of the total; 87% female) were included (mean FU = 29.6years). The mean age at FU was 45.1years (SD3.4; range 36-55). The PASS + status was achieved by 56.7% of patients on the SRS-22 subtotal score, 56% of patients in the NRS and 56.8% in the ODI questionnaire achieving PASS + state. Significant differences were found between the normative values for the SF-36 and EQ-5D-5L scores, but the magnitude of the differences was not clinically relevant. Clinically significant differences were found for SF-36 bodily pain (43.0 vs. 50.0; p < 0.001), SF-36 PCS (42.8 vs. 50.0; p = 0.0001) and EQ-5D-5L pain score, with the scoliotic population having 4.1 times more risk of severe/extreme pain than their peers. Thirty years after surgery, AIS patients have more pain and worse physical functioning than their peers. However, the differences are not clinically relevant except for pain and physical activity. Further, on average, the former are in good clinical condition, although surgery has not normalized their lives.

Retrospective analysis of hepatic copper concentrations in an internal feeding colony of dogs fed a broad range of foods.

To examine the effects of age, sex, year of death/sample collection, and liver histopathology on liver copper concentrations in dogs fed a wide variety of commercial dog foods throughout their lives. This study utilized all bioarchived liver samples collected during necropsy at time of death from 2006 to 2022 from dogs housed in a closed feeding colony. Liver samples were analyzed on a dry matter basis for copper concentration by inductively coupled plasma-optical emission spectrometry and did not require specific criteria for selection. The effects of animal age, year of death/collection, sex, and liver histopathology on liver copper concentrations were assessed. Liver samples were analyzed from 296 dogs. Age and sex had no effect on liver copper concentrations, which increased linearly over time by an average of 3.41 ppm per year but remained within the normal reference range. Quantile regression indicated that the lowest 5% and highest 5% of liver copper concentrations analyzed were not changing and only a slight increase (3.7 ppm per year) was observed in the lower 25th quantile. The mean copper concentration of abnormal liver histopathology samples was not different from the mean copper concentration of normal liver histopathology samples. Histopathologic findings or animal demographic did not impact liver copper concentrations over a 16-year period. Liver copper concentration increased linearly but remained within the normal reference range. Mean liver copper concentrations for each year remained within normal limits. Studies assessing the impact of specific nutrient profiles and sources in various populations are warranted.

Validity of the Alberta Infants Motor Scale in Norwegian infants aged 6-9 months through comparison with Canadian and Dutch scores.

The Alberta Infant Motor Scale (AIMS) is widely used to assess infant motor development but has shown limited cross-cultural validity in various populations. The distribution of the original AIMS scores has not been cross-culturally validated for Norwegian infants. This study aimed to evaluate the applicability of the Canadian AIMS norm reference for Norwegian infants aged 6-9 months and compare their percentile rankings with the Canadian and Dutch norms. In this cross-sectional study, AIMS scores from a sample of 189 Norwegian infants aged 6-9 months were compared to the Canadian and Dutch norms. Total raw scores from the Canadian norms were compared to those of the Norwegian sample, and the percentiles of the Canadian and Dutch sample were compared to tentative Norwegian percentiles. Norwegian infants aged 6-9 months consistently scored lower on the AIMS than their Canadian counterparts (p < 0.001), with 81% scoring at or below the 50th percentile and 18% falling at or below cut-off indicating possible motor delay. Using the Dutch norms, 20% of the Norwegian sample scored at or below the 50th percentile, while only 1% scored at or below the cut-off. A comparison of the percentile ranks showed that Canadian norms had the highest ranks for all age groups, followed by the Norwegian sample and subsequently the Dutch norms. The observed difference is considered clinically significant. Neither Canadian nor Dutch AIMS norms are valid for Norwegian infants due to the Canadian norms being too stringent and the Dutch norms being too lenient. A thorough cross-cultural validation for infants 0-18 months to establish Norwegian-specific AIMS norms is recommended.

Analysis of Dynamic Mandibular Movement of Patients With Condylar Hyperplasia Treated With Orthognathic Surgery and Condylectomy.

To assess the dynamic mandibular movement of patients with condylar hyperplasia before and after simultaneous orthognathic surgery and condylectomy through an intraoral approach. Two groups of patients diagnosed with unilateral condylar hyperplasia were studied: the preoperative group consisted of 23 patients and the postoperative group consisted of 13 patients who had undergone simultaneous orthognathic surgery and condylectomy through an intraoral approach with follow-up for more than 1 year. The normal reference value was obtained from 11 individuals without oral and maxillofacial diseases. Three-dimensional mandibular movement trajectories and electromyography of masticatory muscles were recorded. Patients showed no limitation in mandibular border movement before surgery, but the average amplitude of electromyography of the lower head of lateral pterygoid muscle on the affected side was lower than normal reference value. After condylectomy, the maximum mouth opening decreased [32.00 (26.55, 36.20) mm], mandibular movement deviated to the affected side, and the maximum distance in protrusive movement of the mandibular incisal point and the movement to the normal side were both significantly lowered. Amplitude of electromyography of the lateral pterygoid muscle on the normal side increased in the postoperative group compared with the preoperative group. Patients with condylar hyperplasia had a restriction in protrusive and to the normal side movement, and mandibular movement deflected to the affected side after condylectomy, which indicates the necessity of postoperative individualized rehabilitation training.

Vi-PLUS: Pioneering Plane-Wave Ultrasound to Assess Breast Glandular Tissue in Healthy Women-A Pilot Study.

This study pioneers the application of the ViPLUS module, utilizing plane-wave ultrasound to measure breast tissue viscosity and elasticity. The primary goal was to establish normal reference values for viscosity in healthy women. Secondary objectives included exploring correlations between breast tissue viscosity and breast density categories, hormonal influences, and menstrual cycle phases. A prospective study was conducted on 245 asymptomatic women. Viscosity and elasticity measurements were obtained using the ViPLUS module, ensuring high reliability with stringent quality control measures. Data were statistically analyzed to evaluate correlations and group differences. The median viscosity value for normal breast parenchyma was 1.7 Pa.s, with no significant variations based on breast density, menopausal status, or menstrual cycle phase. A strong correlation (rho = 0.866, p < 0.001) was observed between elasticity and viscosity values. The findings suggest that breast viscosity is consistent across diverse physiological states, indicating its potential as an independent diagnostic marker. This parameter could be pivotal in future breast cancer screening strategies, especially for younger women and those with dense breasts.

Clinical validation of artificial intelligence-based single-subject morphometry without normative reference database.

Single-subject voxel-based morphometry (VBM) is a powerful technique for reader-independent detection of brain atrophy in structural magnetic resonance imaging (MRI) to support the (differential) diagnosis and staging of neurodegenerative diseases in individual patients. However, VBM is sensitive to the MRI scanner platform and details of the acquisition sequence. To mitigate this limitation, we recently proposed and technically validated a convolutional neural network (CNN)-based VBM which does not rely on a normative reference database. Clinical validation of CNN-based VBM. CNN-based VBM was compared with conventional VBM based on a mixed-scanner normative database in 227 consecutive patients (66.0 ± 9.6 years, 53.3% female) with suspected dementing neurodegenerative disease. VBM maps were interpreted visually by two experienced readers, first with respect to the presence of any neurodegenerative disease, then for the differentiation between Alzheimer's disease (AD)-typical and non-AD atrophy patterns. A Likert 6-score was used for both tasks. Simultaneously acquired positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) served as reference standard. Repeated-measures ANOVA revealed a significant impact of the VBM method on the visual detection of any neurodegenerative disease (p < 0.001). Balanced accuracy/sensitivity/specificity were 80.4/86.3/74.5% for CNN-based VBM versus 75.7/79.5/71.8% for conventional VBM. Differentiation between AD and non-AD typical atrophy patterns did not differ between both VBM methods (p = 0.871). CNN-based VBM provides clinically useful accuracy for the detection of neurodegeneration-suspect atrophy with higher sensitivity than conventional VBM with a mixed-scanner normative reference database and without compromising specificity.