Head Volume Research Articles

Contralateral Coronal-Lambdoid Craniosynostosis Treated with Distraction Osteogenesis and Spring-Mediated Cranioplasty

Introduction: Treatment of multi-sutural craniosynostosis presents unique challenges and requires a patient specific approach. Patients with contralateral multi-suture craniosynostosis are particularly challenging as the surgical technique utilized must induce opposing forces of expansion. When patients present early in life, early dynamic expansion may be preferable to open approaches. Herein we report a 2-stage technique to treat contralateral right unicoronal and left lambdoid synostosis with simultaneous distraction osteogenesis and spring-mediated cranioplasty. Methods: A 3-month-old male presented to our clinic for concern for head asymmetry. A CT scan confirmed right coronal and left lambdoid craniosynostosis. Preoperative and postoperative head CT and 3D photogrammetry were used to compute the Head Shape Anomaly index (HSA) and difference in head volume from a personalized normative reference for shape and volume. Results: The surgery lasted 163 minutes, and the patient received a 168 mL blood transfusion. The patient was discharged after 3 days. Two springs were placed following a 1 cm strip craniectomy of the lambdoid suture, and a 40 mm uniplane cranial distractor was placed after a right fronto-orbital osteotomy. Devices were removed following activation and consolidation phases. There were no major complications. Postoperative 3D head CT showed correction of left lambdoid and right coronal craniosynostosis with improved plagiocephaly. The patient’s postoperative HSA Index improved from 4.39 pre-operatively to 2.85 at 145 days post-operatively. In addition, the difference in intracranial volume from the personalized normative reference improved from -87.35 mL pre-operatively to 1.65 mL post-operatively. Conclusion: This early dynamic expansion technique provided improved safety outcomes including decreased operative time, transfusion requirement, and hospital stay when compared to other techniques for multi-suture correction such as cranial vault reconstruction. This technique also produced desired results in shape correction and correction of volumetric anomalies. This illustrates the importance of innovation to develop patient specific surgical designs that maximize safety and morphologic outcomes.

Demonstration of Energy Loss Due to Specific Plumbing Variables, in the Hydraulics Laboratory, of UMA (SDG)

Objective: This study investigates energy losses in various pipe fittings such as bends, contractions, enlargements, and control valves, with the goal of determining the loss coefficients for each fitting. The aim is to analyze pressure drops across different fittings and evaluate how these energy losses influence the design and efficiency of hydraulic systems. Theoretical Framework: The experiment is grounded in fluid dynamics, focusing on the principles of Bernoulli’s equation, pressure drops, and the impact of various pipe fittings on energy loss in hydraulic systems. The Reynolds number, as a dimensionless measure of inertial to viscous forces, is also considered in understanding flow behavior and energy dissipation during fluid movement through pipes. Method: The research employs the F1-22 Energy Losses in Bends and Fittings apparatus attached to a hydraulic bench. Pressure drops are measured across the pipe fittings using a series of water manometer tubes, and the flow rate is controlled by a gate valve. The procedure includes recording piezometric head readings, volume, and drainage velocity to calculate the loss coefficients for each fitting. Results and Discussion: The experiment’s results reveal significant variations in energy losses across different fittings. These findings highlight the influence of fitting configurations on fluid flow and energy efficiency. The loss coefficients derived from the data provide insights into the factors that contribute to energy dissipation, helping engineers optimize hydraulic system designs. Research Implications: The study’s results are critical for optimizing the selection and design of hydraulic fittings. By understanding energy losses, engineers can design more energy-efficient systems, reducing overall operational costs and enhancing the sustainability of hydraulic infrastructure. Originality/Value: This research contributes new empirical data on energy losses in hydraulic systems, offering a deeper understanding of fluid behavior in different pipe configurations. The findings are valuable for improving the design of energy-efficient and sustainable hydraulic systems, particularly in industrial applications.

Impact of Patient-Specific Hip Joint Geometry on the Morphology of Acetabular Fractures.

Background: Acetabular fractures continue to pose a major challenge in clinical practice, not least because of the growing geriatric population. While the influence of the force vectors on fracture formation is well established, the impact of anatomical factors on fracture morphology remains poorly understood. The aim of this study was to investigate patient-specific hip joint geometry, identify structural risk factors and correlate these with the resulting fracture patterns. Methods: This retrospective cohort analysis included 226 patients (Mdn age = 58 yrs.) with acetabular fracture categorized by Judet/Letournel and the AO/OTA classification. Computed tomography (CT) datasets of the injured and contralateral sides were analyzed using multiplanar reconstruction. Parameters included modified center-edge (CE) angle (Wiberg), rotation angles (Ullmann and Anda), acetabular sector angle (Anda), true caput-collum-diaphyseal (CCD) angle, femoral head diameter and volume, as well as femoral neck length, circumference, and diameter. In addition, intrarater reliability within a subcohort was assessed for the metric measurements and inter-rater analysis for the classification of the entire sample. Results: The primary analysis showed direct effects of femoral head diameter, femoral neck length and femoral head size on the fracture type according to AO/OTA (type A/B/C), whereby this effect was particularly seen between type A and type C fractures (p = 0.001). Ordinal regression identified femoral head diameter as the only significant predictor (p = 0.02), with a 25% increased likelihood of complex fractures per unit of change. Low-energy trauma doubled the risk of severe fractures. Specific findings include a higher acetabular anteversion in anterior column fractures. Age correlated positively with the cause of injury and fracture type. The inter-rater reliability for fracture classification was excellent, as was the intrarater reliability of the measurements. Conclusions: This study suggests that anatomical factors, particularly proximal femoral geometry, have an impact on acetabular fracture morphology-in addition to factors such as trauma type and patient demographics.

Maternal fatty acid intake and human embryonic growth: the Rotterdam Periconception Cohort

The required intake of macronutrients by women during the periconceptional period for optimal fetal growth is the subject of ongoing investigation. Intake of polyunsaturated fatty acids (PUFA) is positively associated with fetal neural development, growth velocity and birth weight. However, limited evidence indicates that PUFAs play a role in embryogenesis. We aim to investigate the associations between maternal PUFA dietary intake and first trimester embryonic volume (EV) and head volume (HV). In a prospective cohort study (2013–2020), 464 pregnant women at < 8 weeks of gestation were included. Maternal dietary intake of PUFAs, including omega 3 (docosahexaenoic acid, DHA and eicosapentaeonic acid, EPA) and 6, was obtained from food frequency questionnaires, and first trimester three-dimensional ultrasound examinations were performed to measure EV and HV using Virtual Reality techniques. More than 70% of the population had omega 3 intakes below recommendations. A higher intake of PUFAs was associated with a smaller embryonic HV/EV ratio after adjusting for confounders (EPA p = 0.012, DHA p = 0.015, omega 3 and 6 p < 0.001), but no associations were found with EV or HV alone. Omega 3 from fish oil supplements alone was not associated with embryonic growth. Strong adherence to a PUFA-rich dietary pattern was associated with a smaller embryonic HV/EV ratio (DHA and EPA-rich diet p = 0.054, PUFA-rich diet p = 0.002). It is important to increase awareness of the high prevalence of omega 3-deficiency among pregnant women, and the opportunity for prevention by increasing PUFA intake, thereby reducing the risks of adverse pregnancy outcomes which originate during the periconceptional period.

Bilateral TMJ Changes Secondary to Unilateral Condylar Hyperplasia

Background: Patients with unilateral condylar hyperplasia (UCH) may present with TMJ symptoms, rather than concerns or recognition of asymmetry. Localization of TMJ pain may be on the affected (long) side, unaffected side, or both. Flattening, severe erosion and internal derangement on the opposite side can be appreciated radiologically. This can be a red herring, shielding the true diagnosis of UCH from the contralateral side. We hypothesize that excessive growth of the ipsilateral condylar neck and head on the side of UCH results in an upward and backward force on the opposite side TMJ, with resultant symptoms and findings (condylar flattening, anterior disk displacement, eminence changes). The purpose of this paper is to highlight the bilateral TMJ findings in UCH, and address potential treatment strategies. Methods: This is a retrospective study involving radiologic and biographical data from subjects with TMJ UCH, as well as controls. Patient details and high quality Cone beam CT (CBCT) scans (1 mm slices or less) were analyzed. CT scans were digitized and morphometric points were placed using Planmeca software (Hoffman Estates, Illinois). Linear and volumetric measures were taken in reference to the eminence, TMJ space, condylar position, and neck lengths. Volumetric analysis of the condylar head and neck was done using Analyze 14.0 software (Overland Park, KS, USA). Results were assessed using univariate analysis (T-Wilcoxon test). Results: Forty patients were included (29 with UCH, 11 controls). The condylar head was flatter and erosive appearing on the contralateral UCH side compared to both ipsilateral side in the same subject, and compared to controls. Analysis between the affected and unaffected sides in patients with UCH showed a significant difference in condylar head and neck length ( P = .0019) and volume ( P = .0030); anterior glenoid space ( P = .035) and vertical height of condylar eminence ( P = .00044). The difference in ramus length was not significant ( P = .6533). Between the controls and the UCH patients, there was a significant difference in the variance in condylar head and neck length ( P = 1.98e-07) and volume between the 2 sides ( P = 1.94e-08) but not ramus length ( P = 1). The vertical height of the condylar eminence was smaller on the affected side than in the controls ( P = .0018) and the anterior glenoid space was significantly smaller on the unaffected side compared to the controls ( P = .0053). Conclusion: This study highlights TMJ morphological differences in patients with UCH. These differences in condylar and glenoid morphology are consistent and should be used to aid and underpin the diagnosis and direct treatment. Importantly, patients who present with TMJ pain and erosion on one side, should be assessed for opposite side UCH, as the underlying culprit.

Enlarged choroid plexus related to atrophy of hippocampal subfield volumes and glymphatic dysfunction in benzodiazepine use disorder.

The aim of this study was to explore the relationship of choroid plexus (CP) volume with hippocampal subregion volume and glymphatic system in patients with benzodiazepine use disorders (BUD). Eighty-four participants were recruited including 23 patients with BUD, 29 patients with chronic insomnia (CI) and 32 healthy controls (HC). The morphological alterations in CP, hippocampal subfield volumes and diffusion tensor image analysis along the perivascular space (DTI-ALPS) index were compared between the three groups and the relationships between CP volume and hippocampal subfield volumes and the glymphatic system were further investigated. Compared with the HC individuals, the CP volumes augmented and hippocampal subfield volumes reduced in patients with BUD (P < .05) but not in patients with CI (P > .05). In patients with BUD, there were extensive relationships between augmented CP volume and decreased hippocampal subfield volumes (P < .05, r = -0.421--0.513). CP volume was negatively related with the DTI-ALPS index (r = -0.582, P = .004) within the BUD group. In patients with BUD, the volume of bilateral cornu ammonis (CA)1 body, molecular layer (ML) body, hippocampal tail, left CA1 head volumes, right dentate gyrus body volumes, and right CA4 body volumes were positively related with the Montreal Cognitive Assessment scores (P < .05, r = 0.422-0.683). Right CA1 and ML body volumes positively related with the Mini-Mental State Examination scores (P < .05, r = 0.503-0.575). The enlarged CP related to atrophy of hippocampal subfield volumes and the glymphatic system dysfunction were shown in BUD patients.

Repeatability and reproducibility of artificial intelligence-acquired fetal brain measurements (SonoCNS) in the second and third trimesters of pregnancy

Artificial Intelligence (AI)-based algorithms are increasingly entering clinical practice, aiding in the assessment of fetal anatomy and biometry. One such tool for evaluating the fetal head and central nervous system structures is SonoCNS™, which delineates appropriate planes for measuring head circumference (HC), biparietal diameter (BPD), occipitofrontal diameter (OFD), transcerebellar diameter (TCD), width of the posterior horn of the lateral ventricle (Vp), and cisterna magna (CM) based on a 3D volume acquired at the level of the fetal head’s thalamic plane. This study aimed to evaluate the intra- and interobserver variability of measurements obtained using this software. The study included 381 patients, 270 in their second trimester of pregnancy (70%) and 111 in the third trimester. Each patient underwent manual biometric measurements of the aforementioned structures and twice using the SonoCNS software. We calculated the intraobserver variability between the manual measurements and the average of the automated measurements, as well as the interobserver variability for automated measurements. We also compared the median examination time for manual and automated measurements. The interclass correlation coefficients (ICC) for interobserver and intraobserver variability for parameters BPD, HC, and OFD ranged from good to excellent reproducibility in the general population and subgroups (> 0.75). CM and Vp measurements, both in the general population and subgroups, fell into the category of moderate (0.5–0.75) and poor reproducibility (< 0.5). TCD measurements showed moderate (> 0.5) to good reproducibility (0.75–0.9), and OFD showed good and excellent reproducibility. The assessment of the biometry of fetal head structures using SonoCNS took an average of 63 s compared to 14 s for manual measurement (p < 0.001). The SonoCNS™ software is characterized by good to excellent reproducibility and repeatability in the measurement of fetal skull biometry (BPD, HC, and OFD), with poorer performance in measurements of intracranial structures (CM, Vp, TCD). Apart from biometric parameters, the software is useful in clinical practice for delineating appropriate planes from the acquired volume of the fetal head and shortening examination time.

Understanding the role of topography on valley floor gully and hillslope gully development in cropland of the rolling hill region of northeast China

In regions with steep slopes, the classification of permanent gully (PG) into hillslope gullies (HG) and valley floor gullies (VG) was obvious before the study began. However, in the rolling hill region (slope < 5°), the difference between HG and VG was often overlooked. Moreover, there is no standardized approach for classifying gullies, which results in ambiguity regarding the impact of topography on various developmental stages of gullies and significantly impairs the effective management of gully erosion in the rolling hill region. We propose a remote sensing-based classification method to categorize 1081 PG into VG and HG in the cropland of the rolling hill region. The high-resolution satellite images (0.7 m) from 2010 and 2021 of all PGs were used to obtain the gully development rate and distribution patterns. Among these, 79 typical PGs were investigated using UAV to acquire high-resolution DEM (5 cm), which was used to analyze the relationship between the single or composite topographic factor and gully development rates. The results show that the proposed classification method can effectively recognize the VG and HG in the rolling hill region. The average length, area, and volume of the VG were found to be 2.31, 3.15, and 6.59 times that of the HG, respectively. The rate of gully head retreat, expansion area, and volume of the VG were also 1.59, 2.48, and 5.81 times faster than that of the HG, respectively. In HG and VG, the retreat rate of gully head (Δl) both showed a positive linear correlation with the distance from the gully head to the catchment divide (LA). The extension rate of gully area (Δa) was positively linearly and exponentially correlated with composite topographic factor SA (product of local slope (S) and contributing area above the gully head (A)). Additionally, the Δa of VG was strongly related to the shape and size of A, while the Δa of HG was strongly related to S. The gully volume expansion rate (ΔV) of both HG and VG was influenced by factors such as the existing size of the gully, the contributing area of the outlet (Ao), and the elevation difference from the outlet to the gully head (h). Hence, the changes in Δl and Δa for PG are primarily attributed to hydraulic erosion, while ΔV is influenced by both hydraulic and gravitational erosion. The study has shown the non-negligible influence of HG and VG in the rolling hill region. And the composite topographic factors can also better predict the PG development rate. This study contributes to the formulation of effective soil erosion prevention strategies and sustainable land management practices.

Morphological correlates of anxiety-related experiences during a ketamine infusion

Objectives: Ketamine exerts rapid antidepressant effects by enhancing neuroplasticity, particularly in the amygdala and hippocampus—regions involved in fear processing and learning. While the role of ketamine’s dissociative effects in its antidepressant response is debated, anxiety experienced during infusion has been negatively correlated with treatment outcomes. Methods: In this single-blind, placebo-controlled study, a subset of 17 healthy volunteers (6 males, 23.12 ± 1.9 years) received intravenously a placebo in the first and 0.5 mg/kg racemic ketamine in the second session. Anxiety-related experiences were assessed by the 5D-ASC score obtained post-infusion, structural magnetic resonance imaging scans were acquired 4 h post-infusion. An anxiety-score was obtained from the 5D-ASC. Relation between post-placebo amygdala volume, hippocampal volume, and its subfields with the anxiety-score were assessed using linear regression models. Results: Results showed a statistically significant negative relation between hippocampal head volume and the anxiety score (β = −0.733, p = 0.006), with trending negative association for each subfield’s head and the score. Conclusion: These findings suggest that anxiety-related experiences during ketamine infusion may be mediated by the hippocampus, with smaller hippocampal volumes leading to more anxiety-related experiences. Thus, hippocampal subfield volumes may be used as a predictor for anxiety-related events during ketamine use and might predict treatment outcome in future approaches.

Effects of unilateral nasal obstruction on mandibular condyle in mice of different ages: An exploration based on H-type angiogenesis coupling osteogenesis.

Nasal obstruction leads to a hypoxia condition throughout the entire body. In this study, the unilateral nasal obstruction (UNO) mouse model was established by blocking the left nostril of mice. The aim of this study was to investigate the effects of UNO-induced hypoxia on mandibular condyle in juvenile (3-week-old), adolescent (6-week-old) and adult (12-week-old) male C57BL/6J mice from the perspective of H-type angiogenesis coupling osteogenesis. Firstly, UNO exerted a significant inhibitory effect on weight gain in mice of all ages. However, only in adolescent mice did UNO have an obvious detrimental effect on femoral bone mass accrual. Subsequently, micro-computed tomography (CT) analysis of mandibular condylar bone mass revealed that UNO significantly retarded condylar head volume gain but increased condylar head trabecular number (Tb.N) in juvenile and adolescent mice. Furthermore, UNO promoted the ratio of proliferative layer to cartilage layer in condylar cartilage and facilitated the chondrocyte-to-osteoblast transformation in juvenile and adolescent mice. Moreover, although UNO enhanced the positive expression of hypoxia-inducible factor (HIF)-1α in the condylar subchondral bone of mice in all ages, an increase in H-type vessels and Osterix+ cells was only detected in juvenile and adolescent mice. In summary, on the one hand, in terms of condylar morphology, UNO has a negative effect on condylar growth, hindering the increase in condylar head volume in juvenile and adolescent mice. However, on the other hand, in terms of condylar microstructure, UNO has a positive effect on condylar osteogenesis, promoting the increase of condylar Tb.N, chondrocyte-to-osteoblast transformation, HIF-1α expression, H-type angiogenesis and Osterix+ cells in juvenile and adolescent mice. Although the changes in condylar morphology and microstructure caused by UNO have not yet been fully elucidated, these findings improve our current understanding of the effects of UNO on condylar bone homeostasis.

Dendritic Spine Quantification Using an Automatic Three-Dimensional Neuron Reconstruction Software.

Synaptic connections allow for the exchange and processing of information between neurons. The post-synaptic site of excitatory synapses is often formed on dendritic spines. Dendritic spines are structures of great interest in research centered around synaptic plasticity, neurodevelopment, and neurological and psychiatric disorders. Dendritic spines undergo structural modifications during their lifespan, with properties such as total spine number, dendritic spine size, and morphologically defined subtype altering in response to different processes. Delineating the molecular mechanisms regulating these structural alterations of dendritic spines relies on morphological measurement. This mandates accurate and reproducible dendritic spine analysis to provide experimental evidence. The present study outlines a detailed protocol for dendritic spine quantification and classification using Neurolucida 360 (automatic three-dimensional neuron reconstruction software). This protocol allows for the determination of key dendritic spine properties such as total spine density, spine head volume, and classification into spine subtypes thus enabling effective analysis of dendritic spine structural phenotypes.

Three-dimensional mapping of necrotic lesions for early-stage osteonecrosis of the femoral head

BackgroundThere is a scarcity of evidence regarding the potential relationship between the size and location of necrotic lesions, which must be understood to provide optimal joint-preserving treatment. The purpose of this study was to characterize the distribution patterns of necrotic lesions of varying sizes in early-stage osteonecrosis of femoral head (ONFH) with the use of three-dimensional mapping.MethodsWe retrospectively evaluated clinical CT images of the hips that were performed in the Third Hospital of Hebei Medical University from January 2018 to December 2022 and collected all CT images diagnosed with stage I and II ONFH. Three-dimensional structures that included both necrotic lesions and normal areas of the femoral heads were reconstructed and divided into eight regions to record their size and location. CT images for all lesions were superimposed onto a standard template, and three-dimensional mapping was created to determine the presence of concentrated areas of lesions.ResultsIn a cohort of 143 patients with stage I and II ONFH, a total of 150 hips were reviewed. For lesions with less than 15% of the femoral head volume, necrotic lesions predominantly involve regions I, III, and V, with region I showing concentration. For lesions with volumes ranging from 15 to 30%, necrotic lesions exhibited a wider distribution across regions I, II, III, IV, V, and VII, with significant concentrations in regions I, III, and V. For lesions exceeding 30% of the femoral head volume, the necrotic lesions were extensively distributed across nearly the entire femoral head, with a notable expansion of the concentrated necrotic areas.ConclusionsThe distribution of necrotic lesions varies with lesion size, with smaller lesions primarily concentrated in the anterior and medial regions of the femoral head, particularly in the anterosuperior region, while larger lesions expand to the lateral and inferior regions. These findings enhance existing classification systems and provide crucial insights for guiding hip-preserving surgical planning and approaches.

Paediatric computed tomography diagnostic reference levels in Africa: A systematic review.

Improvements in computed tomography (CT) technology in terms of image quality and reduction in absorbed dose have increased its applications in medical imaging. Diagnostic reference levels (DRLs) help to identify high radiation doses that are unusually delivered to patients undergoing exposure to ionising radiation. The aim of this review was to provide an overview of published studies by African researchers towards establishing paediatric CT DRLs in Africa. The search for articles was conducted using some relevant literature search engines including PubMed, Scopus, Science Direct, Google Scholar and Web of Science. Two reviewers were involved in the article selection process which involved a three-stage screening process of identifying; article titles, abstracts and full-test reading. One hundred and seventy-four articles were identified from the database, PubMed (30), Scopus (21), Google Scholar (53), Web of Science (25) and Science Direct (45). Fifty duplicated articles were excluded before screening. Twelve peer-reviewed articles were included in this study based on the inclusion criteria. DRL values in terms of computed tomography dose index volume of head for the age groupings 0-1, 1-5, 5-10 and 10-15 were 27, 36.6, 39.5 and 47.5 mGy while the dose length product values were 461.6, 664, 872 and 978 mGy.cm respectively. The DRLs were calculated as 75th percentile of the local DRLs reported by the 12 articles included in this review. This review has shown that only few of the African countries (19%) have published studies on paediatric CT DRLs. There were variations in the DRLs published by the various authors which indicate that harmonisation and standardisation of paediatric CT protocols is essential for the optimisation of paediatric doses.

Competitive processes shape multi-synapse plasticity along dendritic segments

Neurons receive thousands of inputs onto their dendritic arbour, where individual synapses undergo activity-dependent plasticity. Long-lasting changes in postsynaptic strengths correlate with changes in spine head volume. The magnitude and direction of such structural plasticity - potentiation (sLTP) and depression (sLTD) - depend upon the number and spatial distribution of stimulated synapses. However, how neurons allocate resources to implement synaptic strength changes across space and time amongst neighbouring synapses remains unclear. Here we combined experimental and modelling approaches to explore the elementary processes underlying multi-spine plasticity. We used glutamate uncaging to induce sLTP at varying number of synapses sharing the same dendritic branch, and we built a model incorporating a dual role Ca2+-dependent component that induces spine growth or shrinkage. Our results suggest that competition among spines for molecular resources is a key driver of multi-spine plasticity and that spatial distance between simultaneously stimulated spines impacts the resulting spine dynamics.

Properties of layer V pyramidal neurons in the primary motor cortex that represent acquired motor skills

Layer V neurons in primary motor cortex (M1) are required for motor skill learning. We analyzed training-induced plasticity using a whole-cell slice patch-clamp technique with a rotor rod task, and found that training induces diverse changes in intrinsic properties and synaptic plasticity in M1 layer V neurons. Although the causal relationship between specific cellular changes and motor performance is unclear, by linking individual motor performance to cellular/synaptic functions, we identified several cellular and synaptic parameters that represent acquired motor skills. With respect to cellular properties, motor performance was positively correlated with resting membrane potential and fast afterhyperpolarization, but not with the membrane resistance, capacitance, or threshold. With respect to synaptic function, the performance was positively correlated with AMPA receptor-mediated postsynaptic currents, but not with GABAA receptor-mediated postsynaptic currents. With respect to live imaging analysis in Thy1-YFP mice, we further demonstrated a cross-correlation between motor performance, spine head volume, and self-entropy per spine. In the present study, we identified several changes in M1 layer V pyramidal neurons after motor training that represent acquired motor skills. Furthermore, training increased extracellular acetylcholine levels known to promote synaptic plasticity, which is correlated with individual motor performance. These results suggest that systematic control of specific intracellular parameters and enhancement of synaptic plasticity in M1 layer V neurons may be useful for improving motor skills.

Sources of Discrepancy between Retinal Nerve Fiber Layer and Bruch’s Membrane Opening-Minimum Rim Width Thickness in Eyes with Glaucoma

To compare the discrepancies between circumpapillary retinal nerve fiber layer (RNFL) and Bruch's membrane opening-minimum rim width (BMO-MRW) thickness in glaucoma eyes. A cross-sectional observational study. One hundred eighty-six eyes (118 patients) with glaucoma. OCT optic nerve head volume scans of patients enrolled in the Advanced Glaucoma Progression Study at the final available visit were exported. The RNFL and BMO-MRW measurements were averaged into corresponding 7.5° sectors, and the nasal sector data were excluded from analyses. A 2-stage screening process was used to identify true mismatches between the RNFL and BMO-MRW measurements, in which either the RNFL or BMO-MRW value was in the less than first percentile range while its counterpart was in the greater than first percentile range on the temporal-superior-nasal-inferior-temporal curve. The prevalence of these mismatches was mapped, and corresponding images were reviewed to determine the underlying cause of these discrepancies. Proportion of mismatches between RNFL and BMO-MRW, location of mismatches between RNFL and BMO-MRW, anatomical causes of mismatches between RNFL and BMO-MRW. Mismatch analysis revealed true mismatches between RNFL and BMO-MRW in 7.7% of sectors. High BMO-MRW with low corresponding RNFL mismatches were most frequently located at the 45° and 322.5° sectors, whereas high RNFL with corresponding low BMO-MRW mismatches peaked at the 75° sector. Large blood vessels accounted for 90.9% of high RNFL with low BMO-MRW mismatches. Small to large blood vessels accounted for 62.9% of high BMO-MRW with low RNFL mismatches; the remaining mismatches could be attributed to retinoschisis or inclusion of outer retinal layers in BMO-MRW measurements. Although overall agreement between RNFL and BMO-MRW measurements is good in areas with advanced damage, blood vessels and other anatomical factors can cause discrepancies between the 2 types of structural measurements and need to be considered when evaluating the utility of such measurements for detection of change. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Three-dimensional analysis of age and sex differences in femoral head asphericity in asymptomatic hips in the United States.

The sphericity of the femoral head is a metric used to evaluate hip pathologies and is associated with the development of osteoarthritis and femoral-acetabular impingement. To analyze the three-dimensional asphericity of the femoral head of asymptomatic pediatric hips. We hypothesized that femoral head asphericity will vary significantly between male and female pediatric hips and increase with age in both sexes. Computed tomography scans were obtained on 158 children and adolescents from a single institution in the United States (8-18 years; 50% male) without hip pain. Proximal femoral measurements including the femoral head diameter, femoral head volume, residual volume, asphericity index, and local diameter difference were used to evaluate femoral head sphericity. In both sexes, the residual volume increased by age (P < 0.05). Despite significantly smaller femoral head size in older ages (> 13 years) in females, there were no sex-differences in residual volume and aspherity index. There were no age-related changes in mean diameter difference in both sexes (P = 0.07) with no significant sex-differences across different age groups (P = 0.06). In contrast, there were significant increases in local aspherity (maximum diameter difference) across whole surface of the femoral head and all quadrants except the inferior regions in males (P = 0.03). There were no sex-differences in maximum diameter difference at any regions and age group (P > 0.05). Increased alpha angle was only correlated to increased mean diameter difference across overall surface of the femoral head (P = 0.024). There is a substantial localized asphericity in asymptomatic hips which increases with age in. While 2D measured alpha angle can capture overall asphericity of the femoral head, it may not be sensitive enough to represent regional asphericity patterns.

Seminal Morphology and Organ Morphometrics of Rabbit Bucks Fed Piliostigma thonningii Essential Oil Supplemented Diet

This study aimed to investigate whether the inclusive supplementation of Piliostigma thonningii essential oil in rabbit diet was beneficial to their seminal morphometrics. Forty-five clinically healthy weaned male Dutch rabbits of about five weeks of age were used for the experiment. The rabbits were divided into three treatment groups, with fifteen rabbits per group and balanced for their body weight such that rabbits in each group had similar average initial BW of 0.27 kg. The experimental rabbits were administered P. thonningii essential oil at 0, 2 and 4 ml/kg for treatments T1, T2 and T3, respectively for 12 weeks. The results showed that left testis weight increased with increasing levels of P. thonningii essential oil supplementation. The normal cells, right testis weight and right and left testis volume were higher in T2 and T3 treatments than in T1. Right and left testis lengths were higher in T3 treatment than T1, with T2 being intermediate between T1 and T3. Mid-piece droplet, coiled tail, detached head, free tail, bent tail, right and left epididymis volume, head weight and length, body weight and length, weight and tail length and weight were not affected by treatments. It is concluded that P. thonningii essential oil supplementation improved some organ morphometrics without necessarily affecting sperm morphology in the experimental rabbit bucks.

Bilateral alloplastic temporomandibular joint reconstruction with orthognathic surgery: a case report of idiopathic condylar resorption

Idiopathic condylar resorption (ICR) also known as cheerleader’s syndrome, progressive condylar resorption, idiopathic condylysis, and condylar atrophy can be defined as chronic ongoing changes of condylar shape and decrease in mass. It is characterized by an excessive physical stress to the articular structures of the temporomandibular joint (TMJ) that exceeds the normal adaptive capacity. Consequently, leading to decrease condylar head volume, decrease ramus height, progressive mandibular retrusion in adults, or decreased growth rate in adolescents. A case report of a 30-year-old female based on the history, clinical, and radiographic examination has class II skeletal relationship secondary to bilateral ICR, receded chin, vertical maxillary excess (VME) and canting. Surgical treatment plan was established using 3D Systems, Inc., (“3DS”) VSP® and case was managed by bilateral total alloplastic temporomandibular joint reconstruction (BATMJR) with orthognathic surgery to do LeFort I, bilateral condylectomy, genioplasty, and inferior border osteotomy. The case report includes one-year follow-up which shows stable outcome, emphasizing long-term success of comprehensive treatment strategy in addressing skeletal class II malocclusion associated with ICR.

Multi-modal segmentation with missing image data for automatic delineation of gross tumor volumes in head and neck cancers.

Head and neck (HN) gross tumor volume (GTV) auto-segmentation is challenging due to the morphological complexity and low image contrast of targets. Multi-modality images, including computed tomography (CT) and positron emission tomography (PET), are used in the routine clinic to assist radiation oncologists for accurate GTV delineation. However, the availability of PET imaging may not always be guaranteed. To develop a deep learning segmentation framework for automated GTV delineation of HN cancers using a combination of PET/CT images, while addressing the challenge of missing PET data. Two datasets were included for this study: Dataset I: 524 (training) and 359 (testing) oropharyngeal cancer patients from different institutions with their PET/CT pairs provided by the HECKTOR Challenge; Dataset II: 90 HN patients(testing) from a local institution with their planning CT, PET/CT pairs. To handle potentially missing PET images, a model training strategy named the "Blank Channel" method was implemented. To simulate the absence of a PET image, a blank array with the same dimensions as the CT image was generated to meet the dual-channel input requirement of the deep learning model. During the model training process, the model was randomly presented with either a real PET/CT pair or a blank/CT pair. This allowed the model to learn the relationship between the CT image and the corresponding GTV delineation based on available modalities. As a result, our model had the ability to handle flexible inputs during prediction, making it suitable for cases where PET images are missing. To evaluate the performance of our proposed model, we trained it using training patients from Dataset I and tested it with Dataset II. We compared our model (Model 1) with two other models which were trained for specific modality segmentations: Model 2 trained with only CT images, and Model 3 trained with real PET/CT pairs. The performance of the models was evaluated using quantitative metrics, including Dice similarity coefficient (DSC), mean surface distance (MSD), and 95% Hausdorff Distance (HD95). In addition, we evaluated our Model 1 and Model 3 using the 359 test cases in Dataset I. Our proposed model(Model 1) achieved promising results for GTV auto-segmentation using PET/CT images, with the flexibility of missing PET images. Specifically, when assessed with only CT images in Dataset II, Model 1 achieved DSC of 0.56±0.16, MSD of 3.4±2.1mm, and HD95 of 13.9±7.6mm. When the PET images were included, the performance of our model was improved to DSC of 0.62±0.14, MSD of 2.8±1.7mm, and HD95 of 10.5±6.5mm. These results are comparable to those achieved by Model 2 and Model 3, illustrating Model 1's effectiveness in utilizing flexible input modalities. Further analysis using the test dataset from Dataset I showed that Model 1 achieved an average DSC of 0.77, surpassing the overall average DSC of 0.72 among all participants in the HECKTOR Challenge. We successfully refined a multi-modal segmentation tool for accurate GTV delineation for HN cancer. Our method addressed the issue of missing PET images by allowing flexible data input, thereby providing a practical solution for clinical settings where access to PET imaging may be limited.