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The Morphology of the Pituitary Gland: A Meta-Analysis with Implications for Diagnostic Imaging. Brain Sci 2023; 13:brainsci13010089. [PMID: 36672070 PMCID: PMC9856875 DOI: 10.3390/brainsci13010089] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023] Open
Abstract
The objective of this meta-analysis was to present transparent data on the morphology of the pituitary gland (PG) using the available data in the literature. The main online medical databases, such as PubMed, Embase, Scopus, and Web of Science, were searched to gather all relevant studies regarding PG morphology. The mean overall volume of the PG was found to be 597.23 mm3 (SE = 28.81). The mean overall height of the PG was established to be 5.64 mm (SE = 0.11). The mean overall length of the PG was found to be 9.98 mm (SE = 0.26). In the present study, the PG's overall morphology and morphometric features were analyzed. Our results showed that, on average, females from Asia have the highest volume of PG (706.69 mm3), and males from Europe have the lowest (456.42 mm3). These values are crucial to be aware of because they represent the normal average properties of the PG, which may be used as reference points when trying to diagnose potential pathologies of this gland. Furthermore, the present study's results prove how the PG's size decreases with age. The results of the present study may be helpful for physicians, especially surgeons, performing procedures on the PG.
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Wu X, Kuang W, Zheng J, Yang Z, Ren M, Yang R, Yuan W. Skeletal Maturation in Patients With Cleft Lip and/or Palate: A Systematic Review. Cleft Palate Craniofac J 2021; 59:307-319. [PMID: 33827285 DOI: 10.1177/10556656211007680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The objective of this systematic review was to evaluate the evidence regarding skeletal maturation in patients with cleft lip and/or palate (CL/P) and to investigate whether the skeletal maturation is delayed in these patients. DESIGN Systematic review. METHODS Electronic and manual searches of scientific literature were conducted in 4 databases (MEDLINE, Embase, Cochrane Library, and Web of Science). Cohort studies that compared the skeletal maturation of patients with CL/P with that of children without CL/P were eligible for inclusion. The quality of included cohort studies was assessed using the Newcastle-Ottawa Scale. PATIENTS AND PARTICIPANTS Patients of any sex and ethnicity with CL/P and children without CL/P were included in this systematic review. MAIN OUTCOME MEASURES Difference in skeletal maturation between patients with CL/P and patients without CL/P. RESULTS Thirteen retrospective cohort studies were included in this systematic review. Ten studies were considered of high quality and 3 were considered of general quality. The results of the included studies comparing skeletal maturation of patients with CL/P and children without CL/P were heterogeneous. CONCLUSION Heterogeneity of skeletal maturation assessment methods, chronological age, sex, cleft type, and race may influence the final results of clinical studies on skeletal maturation in patients with CL/P. Overall, there is limited evidence to determine whether the skeletal maturation level of patients with CL/P is delayed compared to that of normal children. Further studies are needed to determine the skeletal maturation patterns in patients with CL/P.
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Affiliation(s)
- Xiaoyi Wu
- School of Stomatology, Wuhan University, Hubei, People's Republic of China.,State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Hubei, People's Republic of China
| | - Wenying Kuang
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Hubei, People's Republic of China.,State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Hubei, People's Republic of China
| | - Jie Zheng
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Hubei, People's Republic of China.,State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Hubei, People's Republic of China
| | - Zhengkun Yang
- School of Stomatology, Wuhan University, Hubei, People's Republic of China
| | - Meiqing Ren
- School of Stomatology, Wuhan University, Hubei, People's Republic of China
| | - Ruicong Yang
- School of Stomatology, Wuhan University, Hubei, People's Republic of China
| | - Wenjun Yuan
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Hubei, People's Republic of China
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Akay G, Eren I, Karadag O, Gungor K. Three-dimensional assessment of the sella turcica: comparison between cleft lip and palate patients and skeletal malocclusion classes. Surg Radiol Anat 2020; 42:977-983. [PMID: 32356044 DOI: 10.1007/s00276-020-02481-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/23/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE The main aim of the present study was to investigate the dimensions and morphological appearance of the sella turcica in cleft lip and palate patients using cone-beam computed tomography (CBCT) images, compared to non-cleft individuals. METHODS CBCT images of 40 (20 females and 20 males) cleft lip and palate patients and 60 (27 males and 33 females) non-cleft individuals were assessed, retrospectively. The linear dimensions (depth, diameter and length) of the sella turcica and inter-clinoid distance were measured. Sella turcica shapes were examined in the cleft lip and palate patients and non-cleft individuals. Non-cleft individuals were divided into skeletal malocclusion classes. All variables were analyzed using the Kruskal-Wallis test, Mann-Whitney U tests and Chi-square test. RESULTS No significant difference was observed between individuals with and without cleft in the linear dimensions (depth, diameter and length) of the sella turcica (p > 0.05). However, a significant difference was found in the inter-clinoid distance between patients with cleft and non-cleft individuals (p < 0.05). Comparison of the sella turcica shape between skeletal malocclusion classes and patients with cleft showed significant differences (p < 0.05). CONCLUSIONS No significant difference was determined in the depth, diameter, or length of the sella turcica in cleft patients when compared with non-cleft individuals. The inter-clinoid distance was lower in cleft patients than in non-cleft individuals, and this difference was statistically significant.
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Affiliation(s)
- Gulsun Akay
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey.
| | - Ilkay Eren
- Ministry of Health, Osmanlı Oral and Dental Health Center, Ankara, Turkey
| | - Ozge Karadag
- Department of Statistics, Graduate School of Science and Engineering, Hacettepe University, Ankara, Turkey
| | - Kahraman Gungor
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Sundell AL, Nilsson AK, Marcusson A, Törnhage CJ. Body Mass Index and Association With Caries in School-Aged Children With Orofacial Cleft: A Case-Control Study. Cleft Palate Craniofac J 2019; 57:169-176. [PMID: 31450975 DOI: 10.1177/1055665619868862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Data on the association between body mass index (BMI) and dental caries in children with orofacial clefts are sparse. Therefore, studies on the impact of BMI on caries frequency in children with cleft lip and/or palate (CL/P) are of importance. The aim of the current study was to investigate the association between BMI and frequency of dental caries in children with and without CL/P. Height, weight, and BMI in children with CL/P were also compared to controls. DESIGN This study used a cross-sectional case-control design. PARTICIPANTS One hundred and thirty-nine 5- and 10-year-old children with CL/P and 299 age-matched controls. MAIN OUTCOME MEASURES Caries was recorded according to the International Caries Detection and Assessment System. Height and weight were recorded, and BMI was calculated as weight/height2. RESULTS There was no correlation between BMI and caries frequency. Weight, height, and BMI were significantly lower in all children with CL/P compared to controls. After adjustment for international adoption, only BMI was significantly lower in CL/P children compared to controls. Non-adopted children with CL/P were significantly heavier and longer than adopted children with CL/P. CONCLUSIONS Five- and 10-year-old children with corrected CL/P seemed to have a lower BMI than controls, but there was no association between BMI and caries frequency. Internationally adopted children with CL/P were lighter and shorter than non-adopted CL/P children and controls.
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Affiliation(s)
- Anna Lena Sundell
- Department of Pediatric Dentistry, Institute for Postgraduate Dental Education, Jönköping, Sweden
| | | | - Agneta Marcusson
- Department of Dentofacial Orthopedics, Maxillofacial Unit, Linköping University, Linköping, Sweden
| | - Carl-Johan Törnhage
- Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden.,Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Morphometric Analysis of Sella Turcica Using Cone-Beam Computed Tomography in Patients With Cleft Lip and Palate. J Craniofac Surg 2019; 31:306-309. [PMID: 31449220 DOI: 10.1097/scs.0000000000005881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The purpose of this study is to evaluate morphometric analysis of sella turcica using cone-beam computed tomography (CBCT) in patients with cleft lip and palate (CLP) and healthy controls. METHODS Cone-beam computed tomography images of 68 patients (36 males, 32 females, age range 7-20 years) with CLP and 68 healthy individuals (36 males, 32 females, age range 8-19 years) were examined retrospectively. Sella turcica shapes were analyzed by 2 different methods in CLP and control groups. Length, depth, and diameter of sella turcica were measured in both groups. The data were statistically assessed by age, gender using Independent t-test and one-way analysis. RESULTS Diameter of sella turcica was smaller in CLP group compared to healthy individuals (P < .05). Length and depth of sella turcica were lower than in control group, but not statistically significant (P > .05). Sella turcica shape significantly differed between groups (P < .05). The most common sella turcica types were flattened and irregular shapes in CLP group, whereas round and normal shapes were in control group. There was no significant difference between groups in any dimension of sella turcica by gender (P > .05). Sella turcica depth was significantly higher at age of 15 years and above in CLP group. CONCLUSION This study showed that flattened and irregular shapes of sella turcica were the most common types in CLP group. Smaller sella turcica was detected in CLP group compared to healthy individuals. Cone-beam computed tomography can be useful for evaluation of sella turcica.
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Nicholls W, Harper C, Robinson S, Persson M, Selvey L. Adult-Specific Life Outcomes of Cleft Lip and Palate in a Western Australian Cohort. Cleft Palate Craniofac J 2018; 55:1419-1429. [PMID: 29620916 DOI: 10.1177/1055665618768540] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND People with a cleft of the lip and/or palate (CL/P) differ from their peers due to their facial appearance, hearing and speech difficulties, and the significant time spent attending appointments and recovering from surgical interventions. These differences may impact life outcomes including occupation, income, education, relationships, psychosocial health issues, and lifestyle choices. METHODOLOGY A self-administered questionnaire was posted to 338 former and current patients of the Cleft Lip and Palate Unit of Princess Margaret Hospital (PMH), Perth, Western Australia. RESULTS Completed questionnaires were returned by 158 former and current patients. In comparison to the Australian Bureau of Statistics, study participants attained equivalent highest education levels, full-time annual income levels, occupational categories, employment rates, and home ownership levels. They did not marry later and demonstrated positive health-related lifestyle behaviors. However independent living was significantly delayed, and the number of romantic relationships, marriages, and children was lower, with separation/divorce rates also being lower. A key finding was that 78% of participants self-reported that they experienced at least 1 psychosocial health issue and more than half experienced anxiety and/or depression. CONCLUSION When comparing the sociological outcomes for the study participants, the psychosocial outcomes were the areas of most concern. Further investigation is required to determine the causes for the high self-reported rates of anxiety and/or depression found in this study.
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Affiliation(s)
- Wendy Nicholls
- 1 Dental Department/Cleft Lip and Palate Unit, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Craig Harper
- 2 School of Computing, Curtin University, Perth, Western Australia, Australia
| | - Suzanne Robinson
- 3 School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Martin Persson
- 4 Centre for Appearance Research, University of West England, Bristol, United Kingdom
| | - Linda Selvey
- 3 School of Public Health, Curtin University, Perth, Western Australia, Australia
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Cesur E, Altug AT, Toygar-Memikoglu U, Gumru-Celikel D, Tagrikulu B, Erbay E. Assessment of sella turcica area and skeletal maturation patterns of children with unilateral cleft lip and palate. Orthod Craniofac Res 2018; 21:78-83. [DOI: 10.1111/ocr.12219] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2018] [Indexed: 11/26/2022]
Affiliation(s)
| | - A. T. Altug
- Department of Orthodontics; School of Dentistry; University of Ankara; Ankara Turkey
| | - U. Toygar-Memikoglu
- Department of Orthodontics; School of Dentistry; University of Ankara; Ankara Turkey
| | - D. Gumru-Celikel
- Department of Orthodontics; School of Dentistry; University of İstanbul; İstanbul Turkey
| | - B. Tagrikulu
- Department of Orthodontics; School of Dentistry; University of İstanbul; İstanbul Turkey
| | - E. Erbay
- Department of Orthodontics; School of Dentistry; University of İstanbul; İstanbul Turkey
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Yasa Y, Bayrakdar IS, Ocak A, Duman SB, Dedeoglu N. Evaluation of Sella Turcica Shape and Dimensions in Cleft Subjects Using Cone-Beam Computed Tomography. Med Princ Pract 2017; 26:280-285. [PMID: 27855395 PMCID: PMC5588386 DOI: 10.1159/000453526] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 11/16/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the morphology of the sella turcica and measure its size in cleft and noncleft subjects. MATERIAL AND METHODS Cone-beam computed tomography (CBCT) images of 54 individuals (29 males; 25 females) with cleft and 85 (22 males; 63 females) without cleft were used for this study. Syndromic patients with cleft(s) were not included because of possible additional endocrinological and/or morphological disorders. Linear measurements included length, depth, and diameter. The shape of the sella turcica was analyzed in the cleft and noncleft groups. An independent t test was conducted to evaluate differences between genders and groups. One-way ANOVA was used to compare age groups. RESULTS The length (p < 0.001) of the sella turcica was smaller in noncleft subjects than in cleft subjects. Diameter (p = 0.014) and depth (p = 0.005) showed as constantly increasing from an age <15 to >25 years in the overall assessment. The distribution of the shape of the sella turcica differed significantly between groups (p < 0.001). CONCLUSIONS In this study, CBCT was used to assess the morphology of the sella turcica. A majority of the subjects with cleft had a flattened sella turcica compared to that of the control group. A shorter length of the sella turcica was more evident in the cleft subjects than in the control group.
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Affiliation(s)
- Yasin Yasa
- Department of Maxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, Turkey
- *Dr. Yasin Yasa, Department of Maxillofacial Radiology, Faculty of Dentistry, Ordu University, 94. Sokak, No:2, TR-52100 Ordu (Turkey), E-Mail
| | | | - Ali Ocak
- Ataturk University, Erzurum, Turkey
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Crês MC, Marques IL, Bettiol H. Evaluation of Delayed Puberty in Adolescents with Cleft Lip/Palate. Cleft Palate Craniofac J 2016; 53:464-8. [DOI: 10.1597/14-175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To assess the frequency of delayed puberty in adolescents with cleft lip and/or cleft palate (CL/P). Design This was a cross-sectional study of 203 patients with CL/P and no associated syndromes treated at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil. We evaluated boys aged 14-19 years and girls aged 13-18 years. The patients were classified according to Tanner stages of sexual development. The age of menarche was recorded. Patients were assigned to three groups according to cleft type: isolated cleft lip (CL), cleft lip and palate (CLP), and isolated cleft palate (CP). The results were expressed as frequencies and averages and compared with pubertal changes described for typically developing adolescents as reported in the literature. Results Subjects were 115 boys and 88 girls. All boys in the CL group and the CP group had already started puberty, and two boys in the CLP group (2.3%) had delayed puberty. All girls had started puberty. The average age at menarche was 12.3 years in the CL group, 12.1 years in the CLP group, and 12.5 years in the CP group. Conclusions The frequency of delayed puberty and the average age at menarche in adolescents with CL/P and no associated genetic syndromes or anomalies were within the expected range for typically developing adolescents (i.e., those without CL/P) in the same age group.
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Affiliation(s)
- Maria Cristina Crês
- Pediatrician Endocrinologist, Hospital Estadual Bauru, FAMESP/Organização Social de Saúde, Bauru, Brazil
| | - Ilza Lazarini Marques
- Pediatrician and Director of Medical Service, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil
| | - Heloisa Bettiol
- University of São Paulo, Department of Pediatrics, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, Brazil
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Genetics of cleft lip and/or cleft palate: Association with other common anomalies. Eur J Med Genet 2014; 57:381-93. [DOI: 10.1016/j.ejmg.2014.04.003] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/03/2014] [Indexed: 12/16/2022]
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Lipinski RJ, Holloway HT, O'Leary-Moore SK, Ament JJ, Pecevich SJ, Cofer GP, Budin F, Everson JL, Johnson GA, Sulik KK. Characterization of subtle brain abnormalities in a mouse model of Hedgehog pathway antagonist-induced cleft lip and palate. PLoS One 2014; 9:e102603. [PMID: 25047453 PMCID: PMC4105496 DOI: 10.1371/journal.pone.0102603] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 06/20/2014] [Indexed: 11/19/2022] Open
Abstract
Subtle behavioral and cognitive deficits have been documented in patient cohorts with orofacial clefts (OFCs). Recent neuroimaging studies argue that these traits are associated with structural brain abnormalities but have been limited to adolescent and adult populations where brain plasticity during infancy and childhood may be a confounding factor. Here, we employed high resolution magnetic resonance microscopy to examine primary brain morphology in a mouse model of OFCs. Transient in utero exposure to the Hedgehog (Hh) signaling pathway antagonist cyclopamine resulted in a spectrum of facial dysmorphology, including unilateral and bilateral cleft lip and palate, cleft of the secondary palate only, and a non-cleft phenotype marked by midfacial hypoplasia. Relative to controls, cyclopamine-exposed fetuses exhibited volumetric differences in several brain regions, including hypoplasia of the pituitary gland and olfactory bulbs, hyperplasia of the forebrain septal region, and expansion of the third ventricle. However, in affected fetuses the corpus callosum was intact and normal division of the forebrain was observed. This argues that temporally-specific Hh signaling perturbation can result in typical appearing OFCs in the absence of holoprosencephaly--a condition classically associated with Hh pathway inhibition and frequently co-occurring with OFCs. Supporting the premise that some forms of OFCs co-occur with subtle brain malformations, these results provide a possible ontological basis for traits identified in clinical populations. They also argue in favor of future investigations into genetic and/or environmental modulation of the Hh pathway in the etiopathogenesis of orofacial clefting.
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Affiliation(s)
- Robert J. Lipinski
- The Bowles Center for Alcohol Studies, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- * E-mail:
| | - Hunter T. Holloway
- The Bowles Center for Alcohol Studies, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Shonagh K. O'Leary-Moore
- The Bowles Center for Alcohol Studies, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Jacob J. Ament
- The Bowles Center for Alcohol Studies, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Stephen J. Pecevich
- The Bowles Center for Alcohol Studies, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Gary P. Cofer
- Center for In Vivo Microscopy, Duke University, Durham, North Carolina, United States of America
| | - Francois Budin
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Joshua L. Everson
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - G. Allan Johnson
- Center for In Vivo Microscopy, Duke University, Durham, North Carolina, United States of America
| | - Kathleen K. Sulik
- The Bowles Center for Alcohol Studies, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina, United States of America
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