Surface Anatomy Research Articles

Influence of Laser-Induced Surface Modifications on the Fatigue Behavior of SMA Wire Actuators

Abstract Ultrashort pulse lasers are common tools for surface structuring and marking of components. However, even finest structures generated by ultrashort laser processes may affect the mechanical properties of components. In the present work, the effects of laser-induced surface modifications on the fatigue behavior of pickled nickel titanium shape memory wires are investigated. Ultrafast Bessel beams have been utilized to create small microstructure-covered grooves on a defined area on the wire’s shell surface. Subsequently, the wires underwent fatigue testing until failure. The impact of laser processing on fatigue behavior and the resulting fracture surfaces were examined using scanning electron microscopy. It was found that laser defects generated with low fluences have a negligible impact on fatigue lives, as microcracks, which may cause failure, typically initiate at other more severe types of surface defects. However, we identified certain laser scanning strategies and other conditions like increased fluences, which can affect wire surface regions to become prone to fatigue crack initiation, resulting in reduced service lives.

Magnetic Resonance Imaging Demonstrates Differences in Brow and Upper Eyelid Fat and Muscle Layers Between East Asians and Caucasians

Purpose: To objectively quantify, in East Asians and Caucasians, the width and distribution of the retro-orbicularis oculi and frontalis fat (ROOF) pad, subcutaneous fat, and orbicularis oculi muscle (OOM) at the superior orbital rim margin as well as 5 mm superior and inferior to this point. Methods: Thirty adults were studied by high-resolution, surface coil MRI. In the quasi-sagittal image through the globe center, the ROOF, subcutaneous fat, and OOM thickness were measured anterior to the orbital septum, at 3 points: at the superior orbital rim, and 5 mm superior, and 5 mm inferior to the rim. Results: Seventeen subjects were of East Asian descent and 13 were Caucasian. Mean age (±standard deviation) was 49 (±16, range 18–72 years) and 53 (±17, range 29–80 years), respectively. Subcutaneous fat, OOM, and ROOF individual and total anteroposterior layer thickness at the superior orbital rim was similar between East Asians and Caucasians, with average ROOF 63% to 66% (4.5 ± 1.0, 4.7 ± 1.5 mm) of the width at the rim, and 33% to 34% (1.7 ± 0.7–1.8 ± 1.0 mm) 5 mm superiorly. In Caucasians, 12 of 13 patients (92%) had no measurable ROOF 5 mm inferior to the orbital rim. Values for Caucasians were significantly smaller than for East Asians 5 mm under the rim, where the East Asian eyelid layers anterior to the orbital septum averaged: subcutaneous fat 0.9 ± 0.4 mm, OOM 1.2 ± 0.3 mm, ROOF 1.8 ± 1.2 mm, and preaponeurotic fat 1.1 ± 0.9 mm. At the same level, the Caucasian eyelid measured: subcutaneous fat 0.6 ± 0.5 mm and OOM 1.4 ± 0.3 mm. Conclusions: Retro-orbicularis oculi and frontalis fat is the major contributor to the anteroposterior thickness of the eyelid at the level of the superior orbital rim in both East Asians and Caucasians. In East Asians, the ROOF comprises much of the total width inferior to the superior rim, whereas the Caucasian eyelid is mostly muscular. In Caucasians, ROOF is centered around the rim and extends intra-orbitally onto the roof as opposed to East Asians in which it continues inferiorly, into the upper eyelid. These anatomic variations explain some of the differences in surface anatomy between ethnic groups.

Effects of Gigantochloa apus String Bamboo Fiber Brushes on Heat-Cured Acrylic Resin Plate Surface Roughness.

Purpose: The objective of this study was to assess the impact of string bamboo fiber brushes (Gigantochloa apus) on the surface roughness of heat-cured acrylic resin plates. Materials and Methods: This study used a pretest and posttest laboratory experiment with a control group design, with data obtained from the average surface roughness values of heat-cured acrylic resin plates after brushing using bamboo silk fiber brushes as the test group and conventional denture brushes as the control group. Results: The Shapiro-Wilk test showed that the data were normally distributed, with a total of 32 samples of heat-cured acrylic resin plates (p=0.794). The results of this study found that the average surface roughness values of the anatomical surface of heat-cured acrylic resin plates after being brushed with string bamboo fiber brushes were 0.20 µm and 0.18 µm for the nonanatomical surface. The difference in the average surface roughness of the heat-cured acrylic resin plates, both on anatomical and nonanatomical surfaces, before and after brushing with string bamboo fiber brushes, was 0.0001 (p < 0.05). Conclusion: Bamboo denture toothbrushes exhibit a lower abrasive effect than nylon denture toothbrushes, with the abrasiveness remaining below the threshold requirements established for dental materials.

"Preoperative Ultrasound Mapping of Suprascapular and Spinal Accessory Nerves: A Surgeon's Guide to Precision"

The aim of the study was to evaluate the accessibility and localization of spinal accessory and suprascapular nerves in the suprascapular region in healthy volunteers using ultrasonography. One hundred healthy volunteers were included and the location of the spinal accessory nerve (SAN) and suprascapular nerve (SSN) was assessed in the right suprascapular region. Seventy men and 30 women, (mean age 40.37 years; mean BMI 23.44kg/m2) participated in the study. Mean distance of SAN from the vertebral spinous process and medial border of the scapula was 3.80 and 0.7cm, respectively. Mean depth of SAN from the skin was 2.67cm. The mean distance of SSN from the spine was 7cm and mean depth of SSN from the skin was 3.28cm. In overweight and obese individuals, the distance of SAN from the skin and vertebral spinous process and distance of SSN from the vertebral spine increased significantly. According to gender, there was no statistically significant difference in the location of SSN and SAN; however, the distance of SSN from the vertebral spine was significantly increased with increasing age. The SSN and SAN in the suprascapular region can be consistently and reliably mapped using ultrasound. These data can also help in surface markings of both the nerves, which reduces the operating time and risk of iatrogenic injury.

Investigation of the External Anatomy and Morphology of Kunari Cattle

This study investigates the external anatomy, morphology and economic characterization of Kunari cattle, a small local breed in Afghanistan, with a focus on their unique physical traits. A total of 200 female cows, including 122 over two years old and 78 under two years old, were studied across 8 districts and 19 villages in Kunar province. The average length of the top line was 128.7±17.59 cm, the chest measurement was 131.2±SD cm, and the length below the knee was 30 cm. In terms of color, most Kunari cattle were red (38.8%), followed by black (28.6%) and red-and-white (15.3%), while fewer were black-and-white (6.1%) and white (1%). The average weight of the cattle was 188±34.72 kg, and calves averaged 70±26.7 kg. The daily milk yield averaged 4.42±1.74 kg. These findings highlight the breed's size, growth patterns, and potential for dairy farming operations, suggesting that Kunari cattle can play an essential role in livestock development in the region.

Mobile device-based 3D scanning is superior to scoliometer in assessment of adolescent idiopathic scoliosis.

Screening for adolescent idiopathic scoliosis (AIS) currently relies on clinical evaluations by trained practitioners, most commonly using a scoliometer. Modern structured light 3D scanning can generate high-quality 3D representations of surface anatomy using a mobile device. We hypothesized that a mobile-based 3D scanning system would provide accurate deformity assessments compared to a scoliometer. Between August 2020 and June 2022, patients 10-18 years being evaluated for AIS in our clinic with a scoliosis radiograph obtained within 30 days of clinic evaluation and no history of spinal surgery were enrolled. Patients had 3D scans taken in the upright and forward bend positions, and the largest angle of trunk rotation (ATR) was measured by a scoliometer. Image processing software was used to analyze trunk shift (TS), coronal balance (CB), and clavicle angle (CL) in the upright position and the largest ATR in the forward bend position. 3D and scoliometer measurements were correlated to major curve magnitude. Multiple logistic regression models were created based on 3D and scoliometer measurements, controlling for demographic covariates. Two hundred and fifty-eight patients were included in this study. Mean coronal major curve magnitude was 25.7° (range 0-100), and 59% had a thoracic major curve. There were good-to-excellent correlations between 3D and radiographic measures of TS, CB, and CL (r = 0.79, rs = 0.80, and r = 0.64, respectively, p < 0.001). Correlations between 3D and radiographic measures of largest lumbar and thoracic ATR also demonstrated good correlations (r = 0.64 for both, p < 0.001). Using Akaike's Information Criterion (AIC), a multivariable logistic regression model based on 3D scanning outperformed a scoliometer model. Mobile device-based 3D scanning of TS, CB, and TS identifies clinically relevant scoliotic deformity and is more predictive of radiographic curve magnitude than scoliometer in this population. This new modality may facilitate scoliosis screening by decreasing the need for trained personnel or dedicated equipment and clinical space to perform screening tests. II.

Traditional postero-medial ankle approach for Bartonícek type III in Volkmann Fractures: Is it useful?

There is evidence that the presence of a posterior malleolus fracture (PMF) worsens the prognosis of ankle fractures, making conservative treatment a poor choice. PMFs include a heterogeneous group of bone injury patterns that are sometimes associated to medial malleolus extensions, as well as fibula fractures or syndesmotic damage. This requires the surgeon to be well-versed in anatomy to choose the appropriate surgical approach. This study examines the relationship between the visualization of the distal posterior tibial surface through a Traditional Postero-Medial (TPM) approach in a simulated fracture pattern equivalent to Bartonícek type III fractures previously studied with axial CT images. This is an experimental analytical cross-sectional anatomical study. Twenty fresh-frozen adult cadaveric ankle/foot specimens preserved at -27 ºC at the University of Barcelona School of Medicine were examined. The traditional posteromedial approach was performed for each specimen, then anatomical measurements were performed. Subsequently, a Bartonícek type III fracture pattern was designed and generated for each of them. Finally, the anatomical view was correlated with axial CT images for each one and the fracture pattern was assessed. Measurements of Anatomical Visualization Surface (AVS), Total width of the Posterior M. (TWPM), Imaging Visualization Surface (IVS) and the Total Imaging Viewing Surface (TIVS) were recorded. Univariate and bivariate analysis was performed. The mean, standard deviation (SD), minimum and maximum values were calculated. The Intraclass Correlation Coefficient (ICC) was calculated. Of the 20 specimens, 9 were female and 11 male, with 8 right and 12 left specimens, aged between 65 and 95 years. The average Anatomical Visualization Surface (AVS) was 24.1 ± 7.49 mm. The average of the total width of the posterior muscle (TWPM) was 30.55 ± 7.19 mm. While the average visualization was 77 ± 11 %. The average Imaging Visualization Surface was 30.23 ± 6.1 mm. The average Total Imaging Visualization Surface was 37.53 ± 3.45 mm. While the average of visualization in CT was 80 ± 11 %. A degree of agreement (CCI) was obtained with a value of 0.667 CI 95 % (0.1773-0.8672). That is, the CCI is considered good (CCI value between 0.4 and 0.75). The TPM approach is a valid alternative for surgical access and visualization of the PM, including complex Bartonícek type III fractures. The TPM approach achieves axial visualization of the distal posterior tibial plafond of 77 ± 11 %.

Anatomic Surface Measurement of the Lumbar Laminae for Safely Resection During Percutaneous Endoscopic Surgery: A Computed Tomography-Based 3-Dimensional Morphometric Study

The aim of this study was to use computed tomography-based 3-dimensional morphometric imaging to precisely quantify the anatomic parameters of the lumbar laminae and increase the precision of laminar fenestration during percutaneous endoscopic spinal surgery. Lumbar computed tomography data for the L1-L5 vertebrae of 62 patients (310 total vertebrae) were collected. Laminar width, height, thickness, and bilateral angle were measured in detail, and each parameter was compared and analysed. Measurements at the upper, middle, and lower planes of the laminae yielded mean surface laminar widths of 19.90 mm, 15.64 mm, and 18.07 mm, respectively. The safe lamina resection distances were 11.21 mm, 9.35 mm, and 9.63 mm at the upper, middle, and lower planes of the laminae, respectively. The mean surface laminar height was 21.83 mm at the articular process and 22.52 mm at the base of the spinous process. The mean values for laminar thickness were 6.33 mm, 5.96 mm, and 5.98 mm at the outer, central, and inner aspects, respectively. Overall, the angle between the laminae was larger in the upper lumbar vertebrae than in the lower lumbar vertebrae, with mean bilateral laminar angles of 124.08°, 125.45°, 125.00°, 116.19°, and 108.31° for L1 to L5, respectively. This study has revealed significant anatomical diversity within the laminae of lumbar vertebral segments. These findings provide important anatomical information for surgeons performing precise laminar fenestration during endoscopic spinal surgery.

Automatic Image Registration Provides Superior Accuracy Compared with Surface Matching in Cranial Navigation.

The precision of neuronavigation systems relies on the correct registration of the patient's position in space and aligning it with radiological 3D imaging data. Registration is usually performed by the acquisition of anatomical landmarks or surface matching based on facial features. Another possibility is automatic image registration using intraoperative imaging. This could provide better accuracy, especially in rotated or prone positions where the other methods may be difficult to perform. The aim of this study was to validate automatic image registration (AIR) using intraoperative cone-beam computed tomography (CBCT) for cranial neurosurgical procedures and compare the registration accuracy to the traditional surface matching (SM) registration method based on preoperative MRI. The preservation of navigation accuracy throughout the surgery was also investigated. Adult patients undergoing intracranial tumor surgery were enrolled after consent. A standard SM registration was performed, and reference points were acquired. An AIR was then performed, and the same reference points were acquired again. Accuracy was calculated based on the referenced and acquired coordinates of the points for each registration method. The reference points were acquired before and after draping and at the end of the procedure to assess the persistency of accuracy. In total, 22 patients were included. The mean accuracy was 6.6 ± 3.1 mm for SM registration and 1.0 ± 0.3 mm for AIR. The AIR was superior to the SM registration (p < 0.0001), with a mean improvement in accuracy of 5.58 mm (3.71-7.44 mm 99% CI). The mean accuracy for the AIR registration pre-drape was 1.0 ± 0.3 mm. The corresponding accuracies post-drape and post-resection were 2.9 ± 4.6 mm and 4.1 ± 4.9 mm, respectively. Although a loss of accuracy was identified between the preoperative and end-of-procedure measurements, there was no statistically significant decline during surgery. AIR for cranial neuronavigation consistently delivered greater accuracy than SM and should be considered the new gold standard for patient registration in cranial neuronavigation. If intraoperative imaging is a limited resource, AIR should be prioritized in rotated or prone position procedures, where the benefits are the greatest.

Enhanced Prenatal and Postnatal Development Study in Marmoset Monkeys Following Administration of Felzartamab.

Felzartamab is a recombinant fully human immunoglobulin G1 anti-CD38 monoclonal antibody under clinical investigation for immune-mediated diseases. In support of felzartamab clinical development, toxicology studies were conducted in marmoset monkeys, which was the most relevant species based on CD38 binding affinity, pharmacologic activity, and target expression. The felzartamab toxicology program included an enhanced prenatal and postnatal development (ePPND) study to identify potential reproductive and postnatal development risks. In this ePPND study, pregnant marmoset monkeys were randomized to receive vehicle (0mg/kg) or felzartamab at two dose levels (15mg/kg and 75mg/kg) twice per week until parturition, and maternal animals and infants were evaluated for 6 months thereafter. Felzartamab exposure was confirmed in maternal animals and infants in both dosing groups. Overall, felzartamab was well tolerated by pregnant animals at the evaluated doses, with no effect on body weight or body weight gain during pregnancy. No felzartamab-related effects on pregnancy loss or stillbirth rate were observed, and litter counts and numbers of liveborn infants were similar between the vehicle and felzartamab groups. Among infants, there were no felzartamab-related malformations or variations in external anatomy or skeletal morphology and no felzartamab-related observations in histopathology, hematologic and immune cell development, or humoral immune response to vaccination. In conclusion, among pregnant marmoset monkeys dosed with felzartamab, the lack of reproductive toxicity and felzartamab-related effects on offspring supports the clinical evaluation of felzartamab in women of childbearing potential and further demonstrates the suitability of the marmoset monkey for ePPND studies.

Clinical Performance of 3D Printed Resin Composite Posterior Fixed Dental Prosthesis: A Permanent Solution?

This clinical trial aimed to evaluate the clinical outcomes of 3D-printed resin composite posterior fixed dental prosthesis (FDP) restorations. Between October 2020 and August 2022, 49 patients (33 females, 16 males, aged 19-60) received 68 3-unit 3D-printed resin composite posterior FDPs (ELS Even Stronger, Saremco, Switzerland). Follow-ups were conducted at baseline (2 weeks) by independent observers using modified FDI criteria, assessing anatomical form, marginal adaptation, surface roughness, color match, fracture, retention, and patient feedback. Fifty FDPs completed a 1-year follow-up, and 18 reached 2 years. The mean observation period was 14.15 months. Failures were categorized as mechanical or biological, with 19 FDPs failing: 14 mechanical (12 cohesive fractures) and 5 biological (3 needing endodontic treatment, 2 periodontal issues). Two FDPs were recemented. Three FDPs showed surface luster loss, color mismatches, and staining. The survival rate based on mechanical failures was 69.5%, dropping to 61.0% when including biological complications. After 2 years, 3D-printed resin composite FDPs demonstrated acceptable performance, with most failures due to fractures in the connector region, suggesting the need for design revisions.

Medical Alert Cards for patients with an anorectal malformation: a useful tool to increase awareness.

Anorectal malformations (ARMs) are rare congenital anomalies causing altered anatomy and frequent hospitalizations. Parental awareness and clear communication are crucial in family-centered care. This study assesses the impact of patient-held ARM Medical Alert Cards on healthcare providers and caregivers. Caregivers of children with ARMs, including cloacal anomalies, received Medical Alert Cards with (1) contact details; (2) disease-related information; and (3) patient-specific data. A survey evaluated these cards' effectiveness in enhancing ARM awareness among healthcare professionals and caregivers. Among 33 respondents, 29 (88%) found the cards helpful in increasing ARM awareness. Both caregivers and providers found the content coherent, with a median readability score of 9 (IQR 8-10). The card layout was well-received by 30 out of 32 respondents (94%), and all noted the clarity of the contact details, facilitating patient referrals to specialized care. Most caregivers (13 out of 14, 93%) expressed willingness to use these cards in medical settings. Suggestions for improvement included adding more patient-specific information, enhancing readability, and providing visual anatomy diagram. Medical Alert Cards for patients with ARMs can enhance understanding of ARMs among caregivers and healthcare providers, serving as a vital tool in patient-centered management strategies tailored to individual needs.

The Champati Slide

Here, we report some novel findings of chute experiments with native Nepalese granular seeds, called Champatis, and when mixed with other food grain of a fundamentally different physical properties, Silam. The epitomic supergrain Champati exhibits complex frictional, spin, and rolling motion. We hypothesize that the Champati slide results in an essentially unique dynamical spreading, separation from other grains, mobility, run-out, and deposition morphology. Particularly, the surface anatomy of Champati acted vitally in characterizing these aspects. We reveal spectacular dynamical flow–obstacle interaction and depositional behavior of Champati and the mixture slide. Champati slide manifests hyper-spreading in the run-out. Soon after the mass hits the ground, the behavior is unprecedented and appears to be hardly predictable, mainly around the frontal periphery. The very special properties of Champatis control the frontal spreading, rapid grain marching, and their zig-zag sporadic motion. Particle rolling, spinning, exceptionally lower frictional energy dissipation, and grain collision played the major role resulting in an unexpectedly longer travel time and distance, explaining the astonishing hypermobility of Champati grains. The obstacle substantially changes the flow dynamics as the Champati exhibits high object mobilization capacity. Due to the unique property of the Champati, the eye-catching, amazingly strong separation of Champati from Silam evolves swiftly right after the flow inception, and the process intensifies quickly. The separation length characterizes the complex interfacial momentum exchange between the phases in the mixture. The separation length between the frontal Champatis and Silam grains increases exceptionally as it does between the main body and the exclusively Silam-covered tremendously long tail of the flow in the inclined portion of the channel. These results may be useful in better understanding the phase separation, superwide-spreading and hypermobility of some geological flows, including fragmented rock avalanches, probably helping resolve some relevant standing challenges.

VertexWiseR: a package for simplified vertex-wise analyses of whole-brain and hippocampal surfaces in R

Abstract Currently, whole-brain vertex-wise analyses on brain surfaces commonly require specially configured operating systems/environments to run and are largely inaccessible to R users. As such, these analyses are inconvenient to execute and inaccessible to many aspiring researchers. To address these limitations, we present VertexWiseR, a user-friendly R package, to run cortical and hippocampal surface vertex-wise analyses, in just about any computer, requiring minimal technical expertise and computational resources. The package allows cohort-wise anatomical surface data to be highly compressed into a single, compact, easy-to-share file. Users can then run a range of vertex-wise statistical analyses with that single file without requiring a special operating system/environment and direct access to the preprocessed file directories. This enables the user to easily take the analyses ‘offline’, which would be highly appropriate and conducive in classroom settings. This R package includes a conventional suite of tools for extracting, manipulating, analysing, and visualizing vertex-wise data, and is designed to be easy for beginners to use. Furthermore, it also contains novel or advanced functionalities such as hippocampal surface analyses, meta-analytic decoding, threshold-free cluster enhancement, and mixed effects models that would appeal to experienced researchers as well. In the current report, we showcase these functionalities in the analyses of two publicly accessible datasets. Overall, our R package opens up new frontiers for the R’s user base/community and makes such neuroimaging analyses accessible to the masses.

Reduction of aortic stiffness in newly diagnosed persons with HIV-infection: modifiable vascular dysfunction after antiretroviral therapy?

Abstract Background People living with HIV (PLWH) are at an increased risk of cardiovascular disease (CVD), which is underestimated by contemporary risk stratification systems[1]. Subclinical cardiovascular abnormalities may be present at the time of HIV diagnosis and serve as potential substrate for future CVD. Aortic stiffness, as measured with pulse wave velocity (PWV), is a validated predictor of CVD [2,3] and has been shown to be elevated in PLWH at the time of HIV diagnosis compared to HIV-uninfected persons[4]. Purpose To prospectively assess the influence of contemporary antiretroviral therapy (ART) on aortic stiffness in a group of newly diagnosed PLWH in a low- to middle-income setting. Methods A group of ART naïve PLWH with modest cardiovascular risk and free from known CVD, was recruited at the time of HIV diagnosis from the Western Cape Province of South Africa. Aortic stiffness was measured using carotid-femoral PWV on a commercially available device that simultaneously measured the carotid and femoral waveforms on a supine patient in a temperature-controlled room utilising established methodology[4]. The algorithmically-calculated time delay between the upstroke of the carotid and femoral wave-forms provided the transit time (TT). Carotid femoral path distance (path length) was measured using surface anatomy. PWV was calculated as direct path length divided by TT. Aortic distensibility was expressed according to the Bramwell-Hill equation as 3.57/PWV(squared)[5]. ART was initiated and PWV was re-evaluated 9 months later. Results Seventy-three participants completed follow-up and were included. The cohort was relatively young (mean age 32±7 years) with good female representation (n=33, 45%). Most received tenofovir/lamivudine/dolutegravir (n=71, 97%) Half of the group smoked cigarettes. Two participants were controlled hypertensives, and two participants had metabolic syndrome. A significant decrease in PWV (with scaling factor of 0.8) was observed at 9 months of ART (5.93 ±1.0 vs. 5.69 ±1.0 m/s; p=0.01). Aortic distensibility increased significantly as well (0.20 [IQR: 0.16 to 0.26] vs. 0.21 [IQR: 0.19 to 0.27] mmHg-1; p=0.02). Conclusion Improvement in aortic stiffness was observed in a group of newly diagnosed PLWH after 9 months of ART-initiation. This provides evidence of a modifiable component of vascular dysfunction and, in turn, cardiovascular risk with the use of contemporary ART at 9 months. It is unknown if this effect will be sustained long-term. The use of aortic stiffness (alone or in combination with other parameters) as a predictor of cardiovascular outcomes in the ART era requires further study.Abstract figureAbstract table

In-silico insights into personalised therapy selection of anti-arrhythmic drugs and ablation using patient-specific biatrial models for atrial fibrillation

Abstract Introduction Current treatment approaches for Atrial Fibrillation (AF) often lack personalisation, adopting a one-size-fits-all paradigm that disregards inter-patient diversity and its unique interplay with therapeutic responses. In-silico drug trials have demonstrated some value in the personalisation of care; however, their integration with patient-specific anatomical data and the synergistic effects of combined therapies remain unknown. Purpose To evaluate the patient-specific response to anti-arrhythmic drugs (AADs) and their efficacy both individually and in combination with pulmonary vein isolation (PVI) using personalised biatrial models created from imaging data. Methods Patient-specific biatrial models (n=70) were constructed from late gadolinium-enhanced MRI images by manual segmentation from the Atrial Segmentation Challenge (2018) dataset (Fig.1A). Models were pre-processed with landmark selection, regional assignment, and fibre allocation before simulations (Fig.1B). PVI was modelled as electrically inert rings around the pulmonary veins (Fig.1C) and AADs were administered via ionic modulation within CARPentry software (Fig.1D). Four commonly used AADs were evaluated: vernakalant, acute and chronic amiodarone, flecainide, and digoxin. Finite element simulations were performed with the addition of AADs, both individually and in combination with PVI, to evaluate their efficacy in terminating AF (Fig.2A). These simulations were post-processed to produce phase singularity (PS) density maps to evaluate changes in wavefront patterns and locations of re-entry and wavefront break-up (Fig.2B). Results The combination of digoxin with PVI and digoxin alone demonstrated the highest effectiveness in terminating AF, both achieving success in 68.4% of cases (95% CI: 67.5% to 89.3%, p≤0.0001). This efficacy significantly exceeded that of other AADs used either alone or in combination with PVI (15.8%-57.9%), whereas PVI alone demonstrated 0% efficacy (p≤0.05). The combined therapy exhibited a multi-faceted localisation pattern (Fig.2A), with AADs initially redistributing PSs to the pulmonary veins and left atrial appendage. This redistribution resulted in synergistic effects in terminating AF episodes in 52.6% more cases when combined with PVI (Fig.2B). Comparative analyses showed an inverse correlation between baseline PS density count and anatomical surface area with AF termination across all treatments, with significant correlations observed with vernakalant alone (rho=-0.55, p≤0.05) and combined with PVI (rho=-0.77, p≤0.05). Conclusions This study demonstrates the significance of personalised treatment selection in optimising patient outcomes. Combined therapeutic interventions have shown synergistic benefits in AF termination, surpassing individual therapies in this patient-specific model cohort. This shows the translational potential of using patient-specific stratification to inform treatment selection.Biatrial model generationAF therapeutic simulation and processing

Neurosurgical skills conference for medical students: A before and after study.

Undergraduate conferences may improve exposure to neurosurgery among medical students. Hence, this study aimed to evaluate the effect of a neurosurgical skills conference on medical students' comprehension and perceptions of the specialty. A before-and-after (BA) study design was employed to assess the effects of a conference that integrated presentations with hands-on sessions. Practical workshops covered craniotomy, spinal fixation, surface anatomy, intracranial pressure (ICP) monitoring, basic surgical skills, and microsurgical simulation. Pre-conference and post-conference surveys, utilizing Likert scales, gauged participants' attitudes, prior neurosurgical exposure, and understanding of neurosurgical skills. Statistical analysis was conducted on dichotomized responses. Thirty-one participants completed both surveys, with the majority being 1st and 2nd-year medical students. Among the participants, 58.1% were female, and 77.4% identified with BAME ethnicities. Following the conference, there was a notable increase in comprehension regarding neurosurgical careers (from 58.1% to 96.8%, P < 0.001) and training criteria (from 22.6% to 93.5%, P < 0.001). The conference enhanced knowledge of indications for craniotomy (P < 0.001), ICP monitoring (P < 0.001), and spinal fixation (P < 0.001). Participants reported improved understanding of the steps involved in craniotomy (P < 0.001), familiarity with basic cranial surgical surface anatomy (P < 0.001), and confidence in performing basic surgical instrument ties (P < 0.001). Although interest in pursuing a career in neurosurgery remained high (from 87.1% to 90.3%, P = 1.000), a majority of participants, both BA the conference, expressed concerns about the impact on personal life (from 58.1% to 64.5%, P = 0.774). This study underscores the role of undergraduate mixed-method conferences in augmenting understanding of neurosurgery and nurturing early interest.

ShapeMed-Knee: A Dataset and Neural Shape Model Benchmark for Modeling 3D Femurs.

Analyzing anatomic shapes of tissues and organs is pivotal for accurate disease diagnostics and clinical decision-making. One prominent disease that depends on anatomic shape analysis is osteoarthritis, which affects 30 million Americans. To advance osteoarthritis diagnostics and prognostics, we introduce ShapeMed-Knee, a 3D shape dataset with 9,376 high-resolution, medical-imaging-based 3D shapes of both femur bone and cartilage. Besides data, ShapeMed-Knee includes two benchmarks for assessing reconstruction accuracy and five clinical prediction tasks that assess the utility of learned shape representations. Leveraging ShapeMed-Knee, we develop and evaluate a novel hybrid explicit-implicit neural shape model which achieves up to 40% better reconstruction accuracy than a statistical shape model and two implicit neural shape models. Our hybrid models achieve state-of-the-art performance for preserving cartilage biomarkers (root mean squared error ≤ 0.05 vs. ≤ 0.07, 0.10, and 0.14). Our models are also the first to successfully predict localized structural features of osteoarthritis, outperforming shape models and convolutional neural networks applied to raw magnetic resonance images and segmentations (e.g., osteophyte size and localization 63% accuracy vs. 49-61%). The ShapeMed-Knee dataset provides medical evaluations to reconstruct multiple anatomic surfaces and embed meaningful disease-specific information. ShapeMed-Knee reduces barriers to applying 3D modeling in medicine, and our benchmarks highlight that advancements in 3D modeling can enhance the diagnosis and risk stratification for complex diseases. The dataset, code, and benchmarks are freely accessible.

Exploring the anatomy of Linguatula serrata using micro-computed tomography

Micro-computed tomography (micro-CT) is an emerging tool in parasitology that can assist in analysing morphology and host-parasitic interactions. It is a non-destructive, cross-sectional imaging technique that offers good resolution and the ability to create three-dimensional (3D) reconstructions. Here, we used micro-CT to study Linguatula serrata, which is a zoonotic pentastome parasite that infects dogs and ruminants throughout the world. The aims of this study were to describe the internal and external anatomy of adult L. serrata specimens using micro-CT, and to describe and compare specimens stained with 0.3% phosphotungstic acid (PTA) and 1% iodine (I2). Ten adult L.serrata specimens were subjected to micro-CT examination. The specimens were fixed in 70% ethanol and stained with 0.3% PTA or 1% I2. Both stains offered good tissue contrast. The main identifying external features of L. serrata (hooks, mouth, buccal cadre) were clearly visible. Virtual sections and 3D reconstructions provided a good overview of the coelomic cavity, with visualisation of the digestive tract, nervous system, and male and female reproductive organs. These micro-CT images and morphological descriptions may serve as an anatomical reference for L. serrata, in particular, the internal anatomy which has not been described in recent years.

Conformal immunomodulatory hydrogels for the treatment of otitis media

Otitis media (OM), a condition stemming from the proliferation of various bacteria within the tympanic cavity (TC), is commonly addressed through the administration of ofloxacin (OFL), a fluoroquinolone antibiotic. Nevertheless, the escalating issue of antibiotic resistance and the challenge of drug leakage underscore the exploration of an alternative, more effective treatment modality in clinical practice. Here, we introduce a simple and easily implementable fluid-regulated strategy aimed at delivering immunomodulatory hydrogels into the TC, ensuring conformal contact with the irregular anatomical surfaces of the middle ear cavity to more effectively eliminate bacteria and treat OM. This innovative strategy exhibits expedited therapeutic process of antibiotic-resistant, acute and chronic OM rats, and significant reductions in the severity of tympanic membrane (TM) inflammation, residual bacteria within the TC (0.12 *105 CFU), and the thickness of TM/TC mucosa (17.63/32.43 μm), as compared to conventional OFL treatment (3.6, 0.76 *105 CFU, 48.70/151.26 μm). The broad-spectrum antibacterial and antibiofilm properties of this strategy against a spectrum of OM pathogens are demonstrated. The strategy is validated to bolster the host’s innate immune response through the stimulation of antibacterial protein synthesis, macrophage proliferation and activation, thereby accelerating bacterial eradication and inflammation resolution within the TC. This facile, cost-effective and in vivo degradable technology exhibits promising prospects for future clinical implementation.