Diameter and dissection of the abdominal aorta and the risk of distal aortic reoperation after surgery for type A aortic dissection

BACKGROUND

Surgery for Stanford type A aortic dissection (TAAD) is associated with an increased risk of late aortic reoperations due to degeneration of the dissected aorta.

METHODS

The subjects of this analysis were 990 TAAD patients who survived surgery for acute TAAD and had complete data on the diameter and dissection status of all aortic segments.

RESULTS

After a mean follow-up of 4.2 ± 3.6 years, 60 patients underwent 85 distal aortic reoperations. Ten-year cumulative incidence of distal aortic reoperation was 9.6%. Multivariable competing risk analysis showed that the maximum preoperative diameter of the abdominal aorta (SHR 1.041, 95%CI 1.008-1.075), abdominal aorta dissection (SHR 2.133, 95%CI 1.156-3.937) and genetic syndromes (SHR 2.840, 95%CI 1.001-8.060) were independent predictors of distal aortic reoperation. Patients with a maximum diameter of the abdominal aorta >30 mm and/or abdominal aortic dissection had a cumulative incidence of 10-year distal aortic reoperation of 12.0% compared to 5.7% in those without these risk factors (adjusted SHR 2.076, 95%CI 1.062-4.060).

CONCLUSION

TAAD patients with genetic syndromes, and increased size and dissection of the abdominal aorta have an increased the risk of distal aortic reoperations. A policy of extensive surgical or hybrid primary aortic repair, completion endovascular procedures for aortic remodeling and tight surveillance may be justified in these patients.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04831073.

No evidence of an association between size and levels of four per- and polyfluorinated substances (PFAS) in perch (Perca fluviatilis)

It was assessed how the size of perch (Perca fluviatilis) is related to levels of four per- and polyfluorinated substances (PFAS) in its muscle tissue. These were PFOS, PFNA, PFOA, and PFHxS, for which the sum, denoted as ΣPFAS4, has a tolerable intake derived by the European Food Safety Authority. The results indicate that, in contrast to, e.g., mercury levels, ΣPFAS4 levels in perch muscle do not increase with increasing weight of the fish, which implies that consuming larger perch does not increase the risk of exceeding the TWI of ΣPFAS4, in relation to consuming smaller perch. Therefore, for risk assessment, analyzing samples of smaller perch is sufficient, demanding less effort to catch. The credibility of the results was strengthened by applying the same statistical model to mercury levels in the same samples. As expected, larger fish had generally higher levels than small fish for mercury.

Stability and dispersibility of microplastics in experimental exposure medium and their dimensional characterization by SMLS, SAXS, Raman microscopy, and SEM

The plastic production that contributes to the global plastic reservoir presents a major challenge for society in managing plastic waste and mitigating the environmental damage of microplastic (MP) pollution. In the environment, the formation of biomolecular corona around MPs enhance the stability of MP suspensions, influencing the bioavailability and toxicity of MPs. Essential physical properties including MP stability, dispersibility, agglomeration, and dimensional size must be precisely defined and measured in complex media taking into account the formation of a protein corona. Using static multiple light scattering (SMLS), small angle X-ray scattering (SAXS), Raman microscopy, and scanning electron microscopy (SEM), we measured the particle size, density, stability, and agglomeration state of polyethylene and polypropylene MPs stabilized in aqueous suspension by BSA. SEM analysis revealed the formation of nanoplastic debris as MP suspensions aged. Our results suggest that protein adsorption favors the formation of secondary nanoplastics, potentially posing an additional threat to ecosystems. This approach provides analytical methodologies by integrating SEM, SMLS, and SAXS, for characterizing MP suspensions and highlights the effect of the protein corona on size measurements of micro/nanoplastics. Our analysis demonstrates the detectability of secondary nanoplastics by SEM, paving the way for monitoring and controlling human exposure.

Variance aftereffect within and between sensory modalities for visual and auditory domains

We can grasp various features of the outside world using summary statistics efficiently. Among these statistics, variance is an index of information homogeneity or reliability. Previous research has shown that visual variance information in the context of spatial integration is encoded directly as a unique feature, and currently perceived variance can be distorted by that of the preceding stimuli. In this study, we focused on variance perception in temporal integration. We investigated whether any variance aftereffects occurred in visual size and auditory pitch. Furthermore, to examine the mechanism of cross-modal variance perception, we also investigated whether variance aftereffects occur between different modalities. Four experimental conditions (a combination of sensory modalities of adaptor and test: visual-to-visual, visual-to-auditory, auditory-to-auditory, and auditory-to-visual) were conducted. Participants observed a sequence of visual or auditory stimuli perturbed in size or pitch with certain variance and performed a variance classification task before and after the variance adaptation phase. We found that in visual size, within modality adaptation to small or large variance, resulted in a variance aftereffect, indicating that variance judgments are biased in the direction away from that of the adapting stimulus. In auditory pitch, within modality adaptation to small variance caused variance aftereffect. For cross-modal combinations, adaptation to small variance in visual size resulted in variance aftereffect. However, the effect was weak, and variance aftereffect did not occur in other conditions. These findings indicate that the variance information of sequentially presented stimuli is encoded independently in visual and auditory domains.

Proposal for considerations during human iPSC-derived cardiac organoid generation for cardiotoxicity drug testing

Human iPSC-derived cardiac organoids (hiPSC-COs) for cardiotoxicity drug testing via the variety of cell lines and unestablished protocols may lead to differences in response results due to a lack of criteria for generation period and size. To ensure reliable drug testing, it is important for researchers to set optimal generation period and size of COs according to the cell line and protocol applied in their studies. Hence, we sought to propose a process to establish minimum criteria for the generation duration and size of hiPSC-COs for cardiotoxic drug testing. We generated hiPSC-COs of different sizes based on our protocol and continuously monitored organoids until they indicated a minimal beating rate change as a control that could lead to more accurate beating rate changes on drug testing. Calcium transients and physiological tests to assess the functionality of hiPSC-COs on selected generation period, which showed regular cardiac beating, and immunostaining assays to compare characteristics were performed. We explained the generation period and size that exhibited and maintained regular beating rate changes on hiPSC-COs, and lead to reliable response results to cardiotoxicity drugs. We anticipate that this study will offer valuable insights into considering the appropriate generation period and size of hiPSC-COs ensuring reliable outcomes in cardiotoxicity drug testing.

Mean orientation discrimination based on proximal stimuli

Ensemble perception refers to the ability to accurately and rapidly perceive summary statistical representations of specific features from a group of similar objects. However, the specific type of representation involved in this perception within a three-dimensional (3-D) environment remains unclear. In the context of perspective viewing with stereopsis, distal stimuli can be projected onto the retina as different forms of proximal stimuli based on their distances, despite sharing similar properties, such as object size and spatial frequency. This study aimed to investigate the effects of distal and proximal stimuli on the perception of summary statistical information related to orientation. In our experiment, we presented multiple Gabor patches in a stereoscopic environment, allowing us to measure the discrimination threshold of the mean orientation. The object size and spatial frequency were fixed for all patches regardless of depth. However, the physical angular size and absolute spatial frequency covaried with the depth. The results revealed the threshold elevation with depth expansion, especially when the patches formed two clusters at near and far distances, leading to large variations in their retinotopic representations. This finding indicates a minor contribution of similarity of the distal stimuli. Subsequent experiments demonstrated that the variability in physical angular size of the patches significantly influenced the threshold elevation in contrast to that of binocular disparity and absolute spatial frequency. These findings highlight the critical role of physical angular size variability in perceiving mean orientations within the 3-D space.

Embosphere microspheres size for bronchial artery embolization in patients with hemoptysis caused by bronchiectasis: a retrospective comparative analysis of 500-750 versus 700-900 μm microspheres

BACKGROUND

Bronchial arterial embolization (BAE) has been accepted as an effective treatment for bronchiectasis-related hemoptysis. However, rare clinical trials compare different sizes of specific embolic agents. This study aims to evaluate whether different Embosphere microsphere sizes change the outcome of BAE.

METHODS

A retrospective review was conducted on consecutive patients with bronchiectatic hemoptysis who were scheduled to undergo BAE treatment during a period from January 2018 to December 2022. The patients received BAE using microspheres of different sizes: group A patients were treated with 500-750 μm microspheres, and group B patients were treated with 700-900 μm microspheres. The cost of embolic microspheres (Chinese Yuan, CNY), duration of hospitalization, complications, and hemoptysis-free survival were compared between patients in group A and those in group B. A Cox proportional hazards regression model was used to identify predictors of recurrent hemoptysis.

RESULTS

Median follow-up was 30.2 months (range, 20.3-56.5 months). The final analysis included a total of 112 patients (49-77 years of age; 45 men). The patients were divided into two groups: group A (N = 68), which received 500-750 μm Embosphere microspheres, and group B (N = 44), which received 700-900 μm Embosphere microspheres. Except for the cost of embolic microspheres(group A,5314.8 + 1301.5 CNY; group B, 3644.5 + 1192.3 CNY; p = 0.042), there were no statistically significant differences in duration of hospitalization (group A,7.2 + 1.4 days; group B, 8 + 2.4days; p = 0.550), hemoptysis-free survival (group A, 1-year, 2-year, 3-year, 85.9%, 75.8%, 62.9%; group B, 1-year, 2-year, 3-year, 88.4%, 81.2%,59.4%;P = 0.060), and complications(group A,26.5%; group B, 38.6%; p = 0.175) between the two groups. No major complications were observed. The multivariate analysis results revealed that the presence of cystic bronchiectasis (OR 1.61, 95% CI 1.12-2.83; P = 0.001) and systemic arterial-pulmonary shunts (SPSs) (OR 1.52, 95% CI 1.10-2.72; P = 0.028) were independent risk factors for recurrent bleeding.

CONCLUSIONS

For the treatment of BAE in patients with bronchiectasis-related hemoptysis, 500-750 μm diameter Embosphere microspheres have a similar efficacy and safety profile compared to 700-900 μm diameter Embosphere microspheres, especially for those without SPSs or cystic bronchiectasis. Furthermore, the utilization of large-sized (700-900 μm) Embosphere microspheres is associated with the reduced cost of an embolic agent.

The contribution of semantic distance knowledge to size constancy in perception and grasping when visual cues are limited

To achieve a stable perception of object size in spite of variations in viewing distance, our visual system needs to combine retinal image information and distance cues. Previous research has shown that, not only retinal cues, but also extraretinal sensory signals can provide reliable information about depth and that different neural networks (perception versus action) can exhibit preferences in the use of these different sources of information during size-distance computations. Semantic knowledge of distance, a purely cognitive signal, can also provide distance information. Do the perception and action systems show differences in their ability to use this information in calculating object size and distance? To address this question, we presented 'glow-in-the-dark' objects of different physical sizes at different real distances in a completely dark room. Participants viewed the objects monocularly through a 1-mm pinhole. They either estimated the size and distance of the objects or attempted to grasp them. Semantic knowledge was manipulated by providing an auditory cue about the actual distance of the object: "20 cm", "30 cm", and "40 cm". We found that semantic knowledge of distance contributed to some extent to size constancy operations during perceptual estimation and grasping, but size constancy was never fully restored. Importantly, the contribution of knowledge about distance to size constancy was equivalent between perception and action. Overall, our study reveals similarities and differences between the perception and action systems in the use of semantic distance knowledge and suggests that this cognitive signal is useful but not a reliable depth cue for size constancy under restricted viewing conditions.

Improved Staging of Ciliary Body and Choroidal Melanomas Based on Estimation of Tumor Volume and Competing Risk Analyses

PURPOSE

The current, 8th edition of the American Joint Committee on Cancer (AJCC) anatomic classification and staging model for uveal melanoma does not fully separate survival estimates for patients with advanced stages of the disease (e.g., IIIB and IIIC). Furthermore, some tumors in higher size categories have a smaller volume than tumors in lower categories. Therefore, we developed a novel model for prognostication of metastatic mortality based on estimations of tumor volume.

DESIGN

Retrospective, multicenter case series of patients with uveal melanoma involving the choroid, ciliary body, or both.

PARTICIPANTS

Six thousand five hundred twenty-eight consecutively registered patients treated at 3 tertiary ocular oncology centers on 2 continents between 1981 and 2022.

METHODS

Data on survival, tumor size, and extent were collected for all 6528 patients. Tumor volume was estimated using a simple equation based on largest basal diameter and thickness. Volume-based size categories and stages were developed and validated in independent patient cohorts using competing risk analyses, and correlations with cytogenetic and cytomorphologic features were examined.

MAIN OUTCOME MEASURE

Cumulative incidence of metastatic death.

RESULTS

The 6528 patients were distributed over 7 stages based on estimated tumor volume and anatomic extent (V stages IA, IB, IIA, IIB, IIIA, IIIB, and IIIC), with a 15-year incidence of metastatic death ranging from 7% to 77%. A new category, V1min, and corresponding stage IA, were introduced, indicating an excellent prognosis. Metastatic mortality in V stage IIIC was significantly higher than that in V stage IIIB (P = 0.03), whereas incidence curves crossed for patients in AJCC stages IIIC vs. IIIB (P = 0.53). Univariable and multivariable competing risk regressions demonstrated higher Wald statistics for V stages compared with AJCC stages (1152 vs. 1038 and 71 vs. 17, respectively). The frequency of monosomy 3, gain of chromosome 8q, and epithelioid cytomorphologic features increased with tumor volume (R2 = 0.70, R2 = 0.50, and R2 = 0.71, respectively; P < 0.001) and showed similar correlations with both AJCC and V stages.

CONCLUSIONS

Anatomic classification and staging of ciliary body and choroidal melanomas based on estimation of tumor volume improves prognostication of metastatic mortality.

FINANCIAL DISCLOSURE(S)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Evaluation of PHASES Score for Predicting Rupture of Intracranial Aneurysms: Significance of Aneurysm Size

BACKGROUND

Recent data have identified that certain risk factors for rupture differ between small and larger intracranial aneurysms (IAs). Such differing risk factors make up 5 out of the 6 predictor variables used in the PHASES score, which raises the question on whether IA size has a significant effect on the score's performance.

METHODS

Patients who were diagnosed with an IA incidentally or due to a subarachnoid hemorrhage between 2015 and 2023 were selected for potential inclusion. The median IA size of the cohort was chosen as the cutoff point to categorize small and large (6 mm). The PHASES score was calculated for all patients, and a receiver operating characteristic curve analysis was performed to evaluate the classification accuracy of PHASES in predicting rupture for small and large IAs.

RESULTS

A total of 677 IAs were included. Among the IAs, 400 (58.9%) presented as UIAs and 279 (41.0%) as subarachnoid hemorrhage. The average PHASES score was 2.9 and 6.5 for small (n = 322) and large (n = 355) IAs, respectively. The PHASES score performed significantly lower for predicting rupture in smaller IAs (area under the curve: 0.634) compared with the larger (area under the curve: 0.741) (P = 0.00083).

CONCLUSIONS

PHASES was shown to underperform on small IAs. The decision to treat small unruptured IAs remains highly controversial, and the development of a new score to estimate the annual rupture rate while accounting for IA morphology is of great need. Our findings can help encourage future researchers to develop such a score.

Development of a novel CT-based index for predicting the number of extracorporeal shockwave lithotripsy (ESWL) sessions required for successful fragmentation of obstructing pancreatic duct stones

BACKGROUND & AIM

Extracorporeal shock wave lithotripsy (ESWL) is used for the treatment of pancreatic duct stones (PDS) in patients with chronic pancreatitis (CP). We aimed to develop a CT based index to predict the required number of ESWL sessions for technical success.

METHODS

We retrospectively evaluated patients with PDS secondary to CP who underwent ESWL. Technical success was defined as the complete fragmentation of stones to <3 mm. CT features including PDS size, number, location, and density in Hounsfield units (HU) were noted. We analyzed the relationship between PDS characteristics and the number of ESWL sessions required for technical success. A multiple linear regression model was used to combine size and density into the pancreatic duct stone (PDS) index that was translated into a web-based calculator.

RESULTS

There were 206 subjects (mean age 38.6 ± 13.7 years, 59.2% male) who underwent ESWL. PDS size showed a moderate correlation with the number of ESWL sessions (r = 0.42, p < 0.01). PDS in the head required a fewer number of sessions in comparison to those in the body (1.4 ± 0.6 vs. 1.6 ± 0.7, p = 0.01). There was a strong correlation between PDS density and the number of ESWL sessions (r = 0.617, p-value <0.01). The PDS index {0.3793 + [0.0009755 x PDS density (HU)] + [0.02549 x PDS size (mm)]} could accurately predict the required number of ESWL sessions with an AUC of 0.872 (p < 0.01).

CONCLUSION

The PDS index is a useful predictor of the number of ESWL sessions needed for technical success that can help in planning and patient counseling.

Exploring water-absorbing capacity: a digital image analysis of seeds from 120 wheat varieties

Wheat is a staple food crop that provides a significant portion of the world's daily caloric intake, serving as a vital source of carbohydrates and dietary fiber for billions of people. Seed shape studies of wheat typically involve the use of digital image analysis software to quantify various seed shape parameters such as length, width, area, aspect ratio, roundness, and symmetry. This study presents a comprehensive investigation into the water-absorbing capacity of seeds from 120 distinct wheat lines, leveraging digital image analysis techniques facilitated by SmartGrain software. Water absorption is a pivotal process in the early stages of seed germination, directly influencing plant growth and crop yield. SmartGrain, a powerful image analysis tool, was employed to extract precise quantitative data from digital images of wheat seeds, enabling the assessment of various seed traits in relation to their water-absorbing capacity. The analysis revealed significant transformations in seed characteristics as they absorbed water, including changes in size, weight, shape, and more. Through statistical analysis and correlation assessments, we identified robust relationships between these seed traits, both before and after water treatment. Principal Component Analysis (PCA) and Agglomerative Hierarchical Clustering (AHC) were employed to categorize genotypes with similar trait patterns, providing insights valuable for crop breeding and genetic research. Multiple linear regression analysis further elucidated the influence of specific seed traits, such as weight, width, and distance, on water-absorbing capacity. Our study contributes to a deeper understanding of seed development, imbibition, and the crucial role of water absorption in wheat. These insights have practical implications in agriculture, offering opportunities to optimize breeding programs for improved water absorption in wheat genotypes. The integration of SmartGrain software with advanced statistical methods enhances the reliability and significance of our findings, paving the way for more efficient and resilient wheat crop production. Significant changes in wheat seed shape parameters were observed after imbibition, with notable increases in area, perimeter, length, width, and weight. The length-to-width ratio (LWR) and circularity displayed opposite trends, with higher values before imbibition and lower values after imbibition.

[Impact of the Size and Depth of Pulmonary Nodules on the Surgical Approach for Lung Resection in the Treatment of Early-stage Lung Cancer ≤2 cm]

BACKGROUND

Current studies suggest that for early-stage lung cancers with a component of ground-glass opacity measuring ≤2 cm, sublobar resection is suitable if it ensures adequate margins. However, lobectomy may be necessary for some cases to achieve this. The aim of this study was to explore the impact of size and depth on surgical techniques for wedge resection, segmentectomy, and lobectomy in early-stage lung cancer ≤2 cm, and to determine methods for ensuring a safe resection margin during sublobar resections.

METHODS

Clinical data from 385 patients with early-stage lung cancer ≤2 cm, who underwent lung resection in 2022, were subject to a retrospective analysis, covering three types of procedures: wedge resection, segmentectomy and lobectomy. The depth indicator as the OA value, which is the shortest distance from the inner edge of a pulmonary nodule to the opening of the corresponding bronchus, and the AB value, which is the distance from the inner edge of the nodule to the pleura, were measured. For cases undergoing lobectomy and segmentectomy, three-dimensional computed tomography bronchography and angiography (3D-CTBA) was performed to statistically determine the number of subsegments required for segmentectomy. The cutting margin width for wedge resection and segmentectomy was recorded, as well as the specific subsegments and their quantities removed during lung segmentectomy were documented.

RESULTS

In wedge resection, segmentectomy, and lobectomy, the sizes of pulmonary nodules were (1.08±0.29) cm, (1.31±0.34) cm and (1.50±0.35) cm, respectively, while the depth of the nodules (OA values) was 6.05 (5.26, 6.85) cm, 4.43 (3.27, 5.43) cm and 3.04 (1.80, 4.18) cm for each procedure, showing a progressive increasing trend (P<0.001). The median resection margin width obtained from segmentectomy was 2.50 (1.50, 3.00) cm, significantly greater than the 1.50 (1.15, 2.00) cm from wedge resection (P<0.001). In wedge resections, cases where AB value >2 cm demonstrated a higher proportion of cases with resection margins less than 2 cm compared to those with margins greater than 2 cm (29.03% vs 12.90%, P=0.019). When utilizing the size of the nodule as the criterion for resection margin, the instances with AB value >2 cm continued to show a higher proportion in the ratio of margin distance to tumor size less than 1 (37.50% vs 17.39%, P=0.009). The median number of subsegments for segmentectomy was three, whereas lobectomy cases requiring segmentectomy involved five subsegments (P<0.001).

CONCLUSIONS

The selection of the surgical approach for lung resection is influenced by both the size and depth of pulmonary nodules. This study first confirms that larger portions of lung tissue must be removed for nodules that are deeper and larger to achieve a safe margin. A distance of ≤2 cm from the inner edge of the pulmonary nodule to the nearest pleura may be the ideal indication for performing wedge resection.

Cellular effects of microplastics are influenced by their dimension: Mechanistic relationships and integrated criteria for particles definition

The definition of microplastics (MPs) is nowadays too generic from a biological perspective, since different characteristics of these particles might influence their effects. To provide experimental evidence that size is an important factor to be considered, Mediterranean mussels Mytilus galloprovincialis were exposed to five size classes of polyethylene fragments (PE-MPs, 20-50 μm, 50-100 μm, 100-250 μm, 250-500 μm, 500-1000 μm). After 10 days of exposure, MPs ingestion and mechanistic relationships between particles size and cellular effects were analysed through a wide panel of biological alterations, including immune system responses, cholinergic function, antioxidant system, lipid metabolism and peroxidation. Results were further elaborated through a Weight of Evidence approach, summarizing the overall biological significance of obtained results in a hazard index based on the number and magnitude of variations and their toxicological relevance. PE-MPs 500-1000 μm were identified as the less biologically reactive size class due to the limited ingestion of particles coupled with the lack of biological effects, followed by PE-MPs 250-500 μm, which slightly altered the cholinergic function and lysosomal membranes. Conversely, PE-MPs smaller than 250 μm provoked a more consistent onset of biological alterations in terms of immune system composition and functioning, redox homeostasis, and lipid metabolism. The overall findings of this study highlight the importance of considering the size of particles for monitoring and risk assessment of MPs, introducing a more integrated evaluation of plastic pollution that, beside particles concentration, should adequately weigh those characteristics triggering the onset of biological effects.

Evaluation of Size, Laterality, and Location of Unilateral Vocal Fold Lesions on Voice Quality

INTRODUCTION

The presence of a vocal fold mass implies high mechanical stress at the vocal fold base during vibration and an impaired glottic closure. However, evidence about its potential effects on diagnostic tools used in voice evaluation is lacking. We aimed to evaluate the impact of the location, laterality, and size of a unilateral unique vocal fold lesion on patient self-assessment questionnaires, acoustic-aerodynamic voice measures, and perceptual voice evaluation (GRBAS scale).

METHODS

A retrospective chart review involving patients with a diagnosis of a unique unilateral vocal fold lesion and a complete voice evaluation was performed. A total of 58 patients were enrolled and demographics, characteristics of the vocal fold lesion (size, laterality, and location), self-assessment questionnaires, acoustic-aerodynamic measures, and perceptual evaluation (GRBAS scale) were analyzed. Pearson correlation and ANOVA analysis were completed to evaluate the correlation between the clinical characteristics of the vocal fold mass and self-assessment questionnaires, and to compare the level of significance for the differences between the continuous variables between groups of patients once stratified according to the location or laterality of the vocal fold mass.

RESULTS

Glottal Function Index was found to correlate with the location of the vocal fold mass (P < 0.05), however, no correlation was found when evaluating the Reflux Symptom Index or the Voice Handicap Index (P > 0.05). Patients with a lesion located in the anterior-middle 2/3 of the vocal fold were found to have a higher mean Glottal Function Index and (G) component of the GRBAS scale (P < 0.05). No differences were observed when analyzing the remaining self-assessment questionnaires or the acoustic-aerodynamic voice measures according to size, location, or laterality of the vocal fold lesion (P > 0.05).

CONCLUSION

The size and location of unilateral vocal fold lesions were found to have no effect on the majority of measures analyzed in this study. This is the first study we know of to assess the effect that laterality of the vocal fold lesion may have on the self-assessment questionnaires, audio-perceptual, and acoustic-aerodynamic measures included in this study. Our study found no significant differences in regard to laterality. This may indicate that other factors (eg, stiffness of lesion, amount of extraneous muscle tension, etc) could have more of an impact on audio-perceptual, self-assessment questionnaires, and acoustic-aerodynamic measures. Further research with larger cohort sizes and possibly prospective analysis is needed.

Microplastics alter the equilibrium of plant-soil-microbial system: A meta-analysis

Microplastics (MPs) are widely identified as emerging hazards causing considerable eco-toxicity in terrestrial ecosystems, but the impacts differ in different ecosystem functions among different chemical compositions, morphology, sizes, concentrations, and experiment duration. Given the close relationships and trade-offs between plant and soil systems, probing the "whole ecosystem" instead of individual functions must yield novel insights into MPs affecting terrestrial ecosystems. Here, a comprehensive meta-analysis was employed to reveal an unambiguous response of the plant-soil-microbial system to MPs. Results showed that in view of plant, soil, and microbial functions, the general response patterns of plant and soil functions to MPs were obviously opposite. For example, polyethylene (PE) and polyvinyl chloride (PVC) MPs highly increased plant functions, while posed negative effects on soil functions. Polystyrene (PS) and biodegradable (Bio) MPs decreased plant functions, while stimulating soil functions. Additionally, low-density polyethylene (LDPE), PE, PS, PVC, Bio, and granular MPs significantly decreased soil microbial functions. These results clearly revealed that MPs alter the equilibrium of the plant-soil-microbial system. More importantly, our results further revealed that MPs tended to increase ecosystem multifunctionality, e.g., LDPE and PVC MPs posed positive effects on ecosystem multifunctionality, PE, PS, and Bio MPs showed neutral effects on ecosystem multifunctionality. Linear regression analysis showed that under low MPs size (<100 µm), ecosystem multifunctionality was gradually reduced with the increased size of MPs. The response of ecosystem multifunctionality showed a concave shape pattern along the gradient of experimental duration which was lower than 70 days. More importantly, there was a threshold (i.e., 5% w/w) for the effects of MPs concentration on ecosystem multifunctionality, i.e., under low concentration (< 5% w/w), ecosystem multifunctionality was gradually increased with the increased concentration of MPs, while ecosystem multifunctionality was gradually decreased under high concentration (i.e., > 5% w/w). These findings emphasize the importance of studying the effects of MPs on plant-soil-microbial systems and help us identify ways to reduce the eco-toxicity of MPs and maintain environmental safety in view of an ecology perspective.

A Latest Review on Micro- and Nanoplastics in the Aquatic Environment: The Comparative Impact of Size on Environmental Behavior and Toxic Effect

Micro and nanoplastics (MNPs) have attracted growing global research attention due to their distinct environmental impacts, addressing escalating concerns. The diverse materials, sizes, and shapes of MNPs result in a range of environmental impacts. Size, a crucial characteristic of MNPs, influences their environmental behavior, affecting processes like migration, sedimentation, aggregation, and adsorption. Moreover, size modulates the biodistribution and toxicity of MNPs in aquatic organisms. This review delves into the comprehensive impacts of plastic size, with a primary focus on environmental behavior and toxic effects. Ultimately, this review emphasizes the ecological implications of MNP size, laying a foundation for future research in this field.

The size coding of responses: The size of switches and the force feedback

We aimed to understand which factors have a functional role in the size coding of responses, either the size of the switches or the force required to trigger each switch. This question is of relevance because it allows a better understanding of processes underlying action coding. In each trial, participants saw a small or large object. Depending on its colour, the participants had to press one of two switches. In the "size" condition, the response device consisted of two switches of different visual size, but both required the same amount of force. In the "force-feedback" condition, the response device consisted in two switches of identical visual size, but one switch required more force than the other. We found a compatibility effect in the "size," not in the "force-feedback" condition, supporting that the size-coding of responses would be due to the size of the switches.

Host-related traits influence the microbial diversity of the invasive signal crayfish Pacifastacus leniusculus

The microbiome influences a variety of host-environment interactions, and there is mounting evidence of its significant role in biological invasions. During invasion, shifts in microbial diversity and function can occur due to both changing characteristics of the novel environment and physiological condition of the host. The signal crayfish (Pacifastacus leniusculus) is one of the most successful crayfish invaders in Europe. During range expansion, its populations often exhibit differences in many traits along the invasion range, including sex-composition, size-structure and aggressiveness, but to date it was not studied whether crayfish traits can also drive changes in the host microbiome. Thus, we used 16S rRNA gene amplicon sequencing to examine the effects of host-related traits, namely total length (TL), body condition index (FCF), hepatosomatic index (HSI) and sex on the microbial diversity of the signal crayfish. We examined both external (exoskeletal) and internal (intestinal, hepatopancreatic, hemolymph) microbiomes of 110 signal crayfish individuals from four sites along its invasion range in the Korana River, Croatia. While sex did not exhibit a significant effect on the microbial diversity in any of the examined tissues, exoskeletal, intestinal and hemolymph microbial diversity significantly decreased with increasing crayfish size. Additionally, significant effects of signal crayfish condition (FCF, HSI) on microbial diversity were recorded in the hepatopancreas, a main energy storage organ in crayfish that supports reproduction and growth and also regulates immune response. Our findings provide a baseline for evaluating the contribution of microbiome to an invader's overall health, fitness and subsequent invasion success.

Feasibility of anaerobic co-digestion of biodegradable plastics with food waste, investigation of microbial diversity and digestate phytotoxicity

The effects of biodegradable plastics of different thicknesses (30 and 40 μm) and sizes (20 × 20, 2 × 2, and 1 × 1 mm) on anaerobic digestion of food waste and digestate phytotoxicity were investigated. Methane productions (38 days) for the groups with 20 × 20, 2 × 2, and 1 × 1 mm of 30 μm plastics were 92.46, 138.27, and 259.95 mL/gVSremoval, respectively which are nearly 58 % higher than the control group (58.86 mL/gVSremoval). Methane production in 40 μm plastics groups was lower than in 30 μm groups of equal size. All sizes of 30 µm plastics promoted substrate hydrolysis, acidification, and relative abundance of key hydrolytic bacteria and methanogens. Phytotoxicity tests results showed that seed root elongation was inhibited in groups with 40 μm plastics. In conclusion, 30 μm biodegradable plastics were more suitable for anaerobic digestion with food waste than 40 μm.

Controlled hydrogel-based encapsulation of macrophages determines cell survival and functionality upon cryopreservation

The development of novel cell-based therapies has increased the necessity to improve the long-term storage of cells. The current method of cryopreservation is far from optimal, causing ice-associated mechanical and osmotic damage to sensitive cells. Cell encapsulation is emerging as a new strategy to overcome those current limitations; however, few data are applicable to slow freezing, with conflicting results and multiple experimental conditions. The objective of this research work was to evaluate the impact of capsule size and encapsulation method on cell survival and functionality after a conventional freezing protocol. To this end, cells were encapsulated in alginate beads of different sizes, spanning the range of 200-2000 µm thanks to multiple extrusion techniques and conditions, and further cryopreserved using a slow cooling rate (-1°C/min) and 10 % DMSO as cryoprotectant. Our data show that there is a strong correlation between bead size and cell survival after a slow cooling cryopreservation process, with cell viabilities ranging from 7 to 70 % depending on the capsule size, with the smallest capsules (230 µm) achieving the highest level of survival. The obtained results indicate that the beads' diameter, rather than their morphology or the technique used, plays a significant role in the post-thawing cell survival and functionality. These results show that a fine control of cell encapsulation in alginate hydrogels is required when it comes to overcoming the current limitations of long-term preservation techniques by slow cooling.

Crucial physicochemical factors mediating mitochondrial toxicity of nanoparticles at noncytotoxic concentration

Nanomaterials have been extensively applied in multiple industries, among which silver nanoparticles (AgNPs), silicon dioxide nanoparticles (SiNPs), and gold nanoparticles (AuNPs) have become representative of widely consumed NPs. Limited knowledge is available regarding the subcellular responses of NPs with different physicochemical properties, i.e. material type and size, under the noncytotoxic concentrations. Macrophages are important sensitive cells exposed to NPs, and mitochondria are sensitive organelles that respond at the subcellular level. Herein, we found that sublethal concentrations of AgNPs and SiNPs, not AuNPs, decreased the mitochondrial membrane potential (MMP) and tubular mitochondria, and further resulted in an increase of ROS level and a decrease of ATP generation. AgNPs and SiNPs can also disturb mitochondrial dynamics manifested as increasing Mfn2 expression and decreasing Drp1 expression. Further assessments for mitochondrial function showed that AgNPs and SiNPs exposure led to a decrease in the gene expressions related to complex I (Ndufa8 and Ndufs2), complex III (Uqcrc2 and Uqcrfs1), complex IV (Cox6b1), and activity of complex I, suggesting their potential roles in impairing cellular respiration. In terms of the effects of NPs with different sizes, stronger toxicity was observed in smaller-sized nanoparticles. Among the above mitochondrial changes, we identified that ROS, ATP, MMP, tubular mitochondria, and expression of Drp1 were relatively sensitive indicators in subcellular response to NPs. With the above sensitive indicators, the comparison of heterogeneity between material type and size of the NPs showed that material type occupied a main influence on subcellular mitochondrial effects. Our finding provided important data on the potential subcellular risks of NPs, and indicated the vital role of material type for a better understanding of the nanomaterial biological safety.

Adsorption behavior of triclosan on polystyrene nanoplastics: The roles of particle size, surface functionalization, and environmental factors

Nanoplastics (NPs) contribute substantially to the transport of waterborne pollutants. Triclosan (TCS) has a high potential to contact with NPs because of their prevalence in natural waters. Herein, this study investigated the adsorption behavior of TCS on differently sized and functionalized polystyrene (PS) NPs. The effects of environmental factors such as pH, salinity, and dissolved organic matter (DOM) were also evaluated. Results suggest that the adsorption equilibrium constant (kd) of TCS in pristine PSNP suspensions followed the order as: PSNPs-50 nm (4.39 L·g-1) > PSNPs-100 nm (2.78 L·g-1) > PSNPs-200 nm (2.59 L·g-1) > PSNPs-500 nm (1.36 L·g-1) ≈ PSNPs-900 nm (1.36 L·g-1). For the functionalized PSNPs (i.e., PSNPs-COOH, PSNPs-NH2), the values of specific surface area normalized kd called kd, SSA were higher than those of pristine PSNPs. Meanwhile, TCS adsorption on two functionalized PSNPs remained stable and then decreased as salinity increased, while an opposite trend was observed toward pristine PSNPs. All these suggested that physicochemical properties of PSNPs (e.g., particle size and surface functional groups) are important factors influencing their adsorption capacity. When the solution pH raised, the adsorbed amounts of TCS on all tested PSNPs prone to decline. However, DOM only affected the adsorption behavior of PSNPs-50 nm, probably owing to its aggregation with tiny PSNPs and the induced secondary adsorption.

The diagnostic value of ultrasound on different-sized thyroid nodules based on ACR TI-RADS

OBJECTIVES

The thyroid nodule is one of the most common endocrine system diseases. Risk classification models based on ultrasonic features have been created by multiple professional societies, including the American College of Radiology (ACR), which published the Thyroid Imaging Reporting and Data System (TI-RADS) in 2017. The effect of the size in the diagnostic value of ultrasound remains not well defined. The purposes of our study aims to explore diagnostic value of the ACR TI-RADS on different-sized thyroid nodules.

METHODS

A total of 1183 thyroid nodules were selected from 952 patients with thyroid nodules confirmed by surgical pathology from January 2021 to October 2022. Based on the maximum diameters of the nodules, they were stratified into groups A ( ≤ 10 mm), B ( > 10 mm, < 20 mm) and C ( ≥ 20 mm). The ultrasonic features of the thyroid nodules in each group were evaluated and scored based on ACR TI-RADS, and the receiver operating characteristic curve (ROC) was plotted to determine the optimal cut-off value for the ACR TI-RADS scores and categories in each group. Finally, the diagnostic efficacy of ACR TI-RADS on different-sized thyroid nodules was analyzed.

RESULTS

Among the 1183 thyroid nodules, 340 were benign, 10 were low-risk and 833 were malignant. For the convenience of statistical analysis, low-risk thyroid nodules were classified as malignant in this study. The ACR TI-RADS scores and categorical levels of malignant thyroid nodules in each group were higher than those of benign ones (p < 0.05). The areas under the ROCs (AUCs) plotted based on scores were 0.741, 0.907, and 0.904 respectively in the three groups, and the corresponding optimal cut-off values were > 6 points, > 5 points and > 4 points respectively. While the AUCs of the ACR TI-RADS categories were 0.668, 0.855, and 0.887 respectively in each group, with the optimal cut-off values were all > TR4. Besides, for thyroid nodules of larger sizes, ACR TI-RADS exhibited weaker sensitivity with lower positive prediction value (PPV), but the specificity and negative prediction value (NPV) were both higher, presenting with statistically significant differences (p < 0.05).

CONCLUSION

For thyroid nodules of different sizes, the diagnostic efficacy of ACR TI-RADS varies as well. The system shows better diagnostic efficacy on thyroid nodules of > 10 mm than on those ≤ 10 mm. Considering the favorable prognosis of thyroid microcarcinoma and the low diagnostic efficacy of ACR TI-RADS on it, the scoring and classification of thyroid micro-nodules can be left out in appropriate cases, so as to avoid the over-diagnosis and over-treatment of thyroid microcarcinoma to a certain extent.

Beyond grasping: Syllables processing influences mere manual keypress

We aimed to better understand the link between vocalization and grasping. We especially test whether neurocognitive processes underlying this interaction are not grasping specific. To test this hypothesis, we used the procedure of a previous experiment, showing that silently reading the syllable KA and TI can facilitate power- and precision-grip responses, respectively. In our experiment, the participants have to silently read the syllable KA or TI but, according to the color of the syllables, have merely to press a large or small switch (we removed the grasping component of responses). Responses on the large switch were faster when the syllable KA was read compared with TI and conversely for the responses carried out on the small switch. This result supports that the influence of vocalization is not restricted to grasping responses, and, in addition, it supports an alternative, non-grasping-specific model of interactions between vocalization and grasping.

Perceived image size modulates visual memory

Previous studies have demonstrated that visual memory is improved when stimuli are processed by larger cortical regions. For example, a physically large stimulus that recruits larger areas of the retinotopic cortex is better remembered. However, the spatial extent of neural responses in the visual cortex is not only modulated by the retinal size of a stimulus, but also by the perceived size of the stimulus. In this online study, we modulated the perceived size of the visual stimuli using the Ebbinghaus illusion and asked participants to remember the stimuli. The results showed that perceptually larger images were remembered better than perceptually smaller but physically same-sized images. Our finding supports the idea that visual memory is modulated by top-down feedback from higher visual regions to the early visual cortex.

Size and charge effects of metal nanoclusters on antibacterial mechanisms

Nanomaterials, specifically metal nanoclusters (NCs), are gaining attention as a promising class of antibacterial agents. Metal NCs exhibit antibacterial properties due to their ultrasmall size, extensive surface area, and well-controlled surface ligands. The antibacterial mechanisms of metal NCs are influenced by two primary factors: size and surface charge. In this review, we summarize the impacts of size and surface charge of metal NCs on the antibacterial mechanisms, their interactions with bacteria, and the factors that influence their antibacterial effects against both gram-negative and gram-positive bacteria. Additionally, we highlight the mechanisms that occur when NCs are negatively or positively charged, and provide examples of their applications as antibacterial agents. A better understanding of relationships between antibacterial activity and the properties of metal NCs will aid in the design and synthesis of nanomaterials for the development of effective antibacterial agents against bacterial infections. Based on the remarkable achievements in the design of metal NCs, this review also presents conclusions on current challenges and future perspectives of metal NCs for both fundamental investigations and practical antibacterial applications.

Iron particles lower than 10 μm in drinking water dominate particle catalysis effect on disinfection byproduct formation

Iron particles could catalyze disinfection by-product (DBP) formation in drinking water distribution systems (DWDS), but the catalytic effects of iron particles considering size effects have not been focused. Here, we first found that fine particles (lower than 10 μm) dominated the particle catalysis effect of the iron particles on the formation of DBPs containing multiple Cl atoms (DBP-3Cl), especially those with aromatic structure and containing multiple N atoms (DBP-3N). The loose deposit particles were filtered through 50 μm (F50), 10 μm (F10) and 1 μm (F10) membranes, and their turbidity values were 231.6, 53.4 and 1.1 NTU, respectively. In mass ratio, F50, F10 and F1 accounted for 84 %, 15 % and 1 % of unfiltered samples. Notably, the lower mass F10 generated more DBP-3Cl and DBP-3N than F50. Metal crystals and natural organic matters showed little difference among different sizes. The high catalytic activity of particles in F10 due to size effect was proved to be the essential mechanism. F1 contained few particles to affect DBP formation. In toxicity evaluation, the toxicity of F10 was even higher than F50. Therefore, fine particles with sizes lower than 10 μm may play a dominate role in the catalytic effect on DBP transformation in DWDS.

A fast, easy and reliable method for hamstrings graft size prediction in anterior cruciate ligament reconstruction

PURPOSE

The aim of this study is to describe and validate a simple and reliable method to pre-operatively predict the size of the ACL graft in the double strand technique with autologous semitendinosus-gracilis tendons on the same MRI used for ACL rupture diagnosis.

METHODS

The study included 92 patients, with a median age of 31 years (IQR 26-41 years), 73/92 (79%) of whom were males. All patients that underwent an ACL reconstruction with doubled ST + GT between 2017 and 2022 were counted in the study.

RESULTS

Overall, the median predicted graft diameter from MR imaging was similar to the actual graft diameter with no significant differences (n.s.). Regarding the comparison between predicted and actual graft size, concordance was 78/92 (85%, 95% CI 76-91%), with κ = 0.797 which corresponds to a level of agreement defined as "Strong". Tendon sizes calculated on pre-operative MRI were evaluated both with intra-observer and inter-observer reliability demonstrating a statistically reproducible method. The predicted graft was then compared to the reported one with a statistically significant reliability found.

CONCLUSION

This study can help the surgeons to perform a fast pre-operative planning of an ACL reconstruction for graft selection. If the planned graft with ST and GT is smaller than 8 mm, the clinician can decide to switch to a different type of graft or plan a different graft preparing technique and, therefore, reduce the risk of post-operative ligament re-rupture. The method proposed is reliable and reproducible. The major strength of the planning technique proposed is that it relies on data that are already available for the clinician before surgery, without the need of further analysis.

LEVEL OF EVIDENCE

IV.

Impact of Tumor Size on the Difficulty of Laparoscopic Major Hepatectomies: An International Multicenter Study

INTRODUCTION

Although tumor size (TS) is known to affect surgical outcomes in laparoscopic liver resection (LLR), its impact on laparoscopic major hepatectomy (L-MH) is not well studied. The objectives of this study were to investigate the impact of TS on the perioperative outcomes of L-MH and to elucidate the optimal TS cutoff for stratifying the difficulty of L-MH.

METHODS

This was a post-hoc analysis of 3008 patients who underwent L-MH at 48 international centers. A total 1396 patients met study criteria and were included. The impact of TS cutoffs was investigated by stratifying TS at each 10-mm interval. The optimal cutoffs were determined taking into consideration the number of endpoints which showed a statistically significant split around the cut-points of interest and the magnitude of relative risk after correction for multiple risk factors.

RESULTS

We identified 2 optimal TS cutoffs, 50 mm and 100 mm, which segregated L-MH into 3 groups. An increasing TS across these 3 groups (≤ 50 mm, 51-100 mm, > 100 mm), was significantly associated with a higher open conversion rate (11.2%, 14.7%, 23.0%, P < 0.001), longer operating time (median, 340 min, 346 min, 365 min, P = 0.025), increased blood loss (median, 300 ml,  ml, 400 ml, P = 0.002) and higher rate of intraoperative blood transfusion (13.1%, 15.9%, 27.6%, P < 0.001). Postoperative outcomes such as overall morbidity, major morbidity, and length of stay were comparable across the three groups.

CONCLUSION

Increasing TS was associated with poorer intraoperative but not postoperative outcomes after L-MH. We determined 2 TS cutoffs (50 mm and 10 mm) which could optimally stratify the surgical difficulty of L-MH.

Cranial asymmetry in odontocetes: a facilitator of sonic exploration?

Directional cranial asymmetry is an intriguing condition that has evolved in all odontocetes which has mostly been associated with sound production for echolocation. In this study, we investigated how cranial asymmetry varies across odontocete species both in terms of quality (i.e., shape), and quantity (magnitude of deviation from symmetry). We investigated 72 species across all ten families of Odontoceti using two-dimensional geometric morphometrics. The average asymmetric shape was largely consistent across odontocetes - the rostral tip, maxillae, antorbital notches and braincase, as well as the suture crest between the frontal and interparietal bones were displaced to the right, whereas the nasal septum and premaxillae showed leftward shifts, in concert with an enlargement of the right premaxilla and maxilla. A clear phylogenetic signal related to asymmetric shape variation was identified across odontocetes using squared-change parsimony. The magnitude of asymmetry was widely variable across Odontoceti, with greatest asymmetry in Kogiidae, Monodontidae and Globicephalinae, followed by Physeteridae, Platanistidae and Lipotidae, while the asymmetry was lowest in Lissodelphininae, Phocoenidae, Iniidae and Pontoporiidae. Ziphiidae presented a wide spectrum of asymmetry. Generalized linear models explaining magnitude of asymmetry found associations with click source level while accounting for cranial size. Using phylogenetic generalized least squares, we reconfirm that source level and centroid size significantly predict the level of cranial asymmetry, with more asymmetric marine taxa generally consisting of bigger species emitting higher output sonar signal, i.e. louder sounds. Both characteristics theoretically support foraging at depth, the former by allowing extended diving and the latter being adaptive for prey detection at longer distances. Thus, cranial asymmetry seems to be an evolutionary pathway that allows odontocetes to devote more space for sound-generating structures associated with echolocation and thus increases biosonar search range and foraging efficiency beyond simple phylogenetic scaling predictions.

Diagnosis of chronic pancreatitis using semi-quantitative MRI features of the pancreatic parenchyma: results from the multi-institutional MINIMAP study

PURPOSE

To determine the diagnostic performance of parenchymal MRI features differentiating CP from controls.

METHODS

This prospective study performed abdominal MRI scans at seven institutions, using 1.5 T Siemens and GE scanners, in 50 control and 51 definite CP participants, from February 2019 to May 2021. MRI parameters included the T1-weighted signal intensity ratio of the pancreas (T1 score), arterial-to-venous enhancement ratio (AVR) during venous and delayed phases, pancreas volume, and diameter. We evaluated the diagnostic performance of these parameters individually and two semi-quantitative MRI scores derived using logistic regression: SQ-MRI Model A (T1 score, AVR venous, and tail diameter) and Model B (T1 score, AVR venous, and volume).

RESULTS

When compared to controls, CP participants showed a significantly lower mean T1 score (1.11 vs. 1.29), AVR venous (0.86 vs. 1.45), AVR delayed (1.07 vs. 1.57), volume (54.97 vs. 80.00 ml), and diameter of the head (2.05 vs. 2.39 cm), body (2.25 vs. 2.58 cm), and tail (1.98 vs. 2.51 cm) (p < 0.05 for all). AUCs for these individual MR parameters ranged from 0.66 to 0.79, while AUCs for the SQ-MRI scores were 0.82 and 0.81 for Model A (T1 score, AVR venous, and tail diameter) and Model B (T1 score, AVR venous, and volume), respectively. After propensity-matching adjustments for covariates, AUCs for Models A and B of the SQ-MRI scores increased to 0.92 and 0.93, respectively.

CONCLUSION

Semi-quantitative parameters of the pancreatic parenchyma, including T1 score, enhancement ratio, pancreas volume, diameter and multi-parametric models combining these parameters are helpful in diagnosis of CP. Longitudinal analyses including more extensive population are warranted to develop new diagnostic criteria for CP.

Morphometric Comparison of Tympanic Membrane in Unilateral Mucosal Chronic Otitis Media

Previous studies of the middle ear in Chronic Otitis Media have focussed on radiological assessment of temporal bone; endoscopic studies were focussed on perforation size and location. The malleus handle (manubrium) is a constant ossicular feature visible on otoendoscopy. It's relative position may indicate the previously documented differences in ossicular chain and middle ear cleft development relative to the tympanic ring and inner ear capsule between affected ear and contralateral ear.

DESIGN

descriptive.

SETTING

hospital based.

SUBJECTS

84 patients with unilateral mucosal chronic otitis media.

METHODS

each patient underwent Otoendoscopy and the findings were recorded through a camera connected to a laptop. Using image j software these images were analysed. Participants were of mean age of 35 years with left preponderance, and no gender preponderance was found. In our study, majority of the perforations were small sized perforations. The malleus handle foreshortening was about 92.6% compared to unaffected ear which was statistically insignificant. There was a significant inter group difference in the distance between the tip of the manubrium and the inferior annulus-which was decreased in affected ears and in the distance from the lateral process to the anterior tympanic ring-which was increased in affected ears. There was no difference in the malleo scutal angles. These differences were not dependent on the site or size of the perforation. The differences we found between ears were unexpected. The significance of the differences in the shape of the tympanic membrane between affected and unaffected ears in unilateral mucosal COM need further study. We did not find a statistically significant difference in the malleo-scutal angles between ears.

Social network analysis by Turiyam graphs

OBJECTIVE

A single valued neutrosophic set represented the uncertainty of real life situations in terms of membership [Formula: see text], indeterminacy [Formula: see text] and non-membership [Formula: see text] degree. However, this uncertainty cannot be limited to those three degrees; there is also an additional refusal degree. For this issue, the Turiyam set is an appropriate tool, which described the neutrosophic refusal degree of this situation as a liberal [Formula: see text] degree in addition to those three degrees. The graphical representation of this situation is required for knowledge processing. For this purpose, the Turiyam graph was introduced as an extension of the single valued neutrosophic graph. This graph is helpful when the depictions of the vertices or their relationships or both, are considered in terms of membership [Formula: see text], indeterminacy [Formula: see text], non-membership [Formula: see text] and liberal [Formula: see text] degrees. The goal of this paper is to introduce the degree, order and size in the context of Turiyam graphs and examine a social network (SN) with the help of this graph.

RESULTS

In this regard, the degree, order and size in the context of Turiyam graphs are studied. The feasibility of this Turiyam graph is shown by employing its concept in a social network (SN). Finally, the advantage of the Turiyam graph over the existing graph theories is recognized by viewing its better framework.

Residual fragment size following retrograde intrarenal surgery: a critical evaluation of related variables

Given the limited data on the predictive factors of residual kidney stone size after flexible ureteroscopy (fURS), this study aims to investigate the variables affecting residual stone size. The medical records of 642 patients without complications being treated for kidney stones with fURS between July 2014 and May 2022 were reviewed retrospectively, and the information of the 170 patients in whom residual stones were found was recorded. In addition to patient-specific factors and stone characteristics, length of postoperative hospital stay, postoperative fever, and preoperative antiaggregant use were evaluated. Of the 170 patients ultimately included in the study. The mean age was 51.56 (± 14.70). The mean stone size was 14.01 mm (± 5.75), the mean residual stone size was 7.04 mm (± 2.51), and the mean stone density was 829 Hounsfield units (± 395.06). The mean infundibulopelvic angle (IPA) was 49.37º (± 15.37), and 41.2% of the stones were non-opaque. The mean parenchymal thickness was 22.88 mm (± 5.55). 34 patients were on antiaggregant therapy. Preoperative stone size increases in stone density and decreases in IPA were found to be correlated with increase residual stone size (p < 0.001, p < 0.001, and p < 0.001, respectively). In addition, larger residual stones were observed after the fURS procedure in patients using anticoagulants and those without hydronephrosis (p = 0.02 and p = 0.016, respectively). Use of reliable predictive factors to forecast residual stone size after fURS may help to inform those treated and enable urologists to design rational surgical strategies.

Analyze of spatial extent and current condition of land use land cover dynamics for the period 1990-2020 Wayu-Tuka district, western Ethiopia

LULC variation has increased in many parts of the world recent years. Analyzing LULC is valuable to ability to grasp for spatial extent, patterns and impacts of the dynamics. This research examines the magnitudes and trends of LULC dynamics of Wayu-Tuka District, Western Ethiopia for a period of 1990-2020. Data were acquired from Landsat images (i.e, TM from 1990 to 2000, ETM+ from 2010 and OLI 2020). LULC classes were classified (from Landsat images) to develop land use land cover change maps for the study area. Landsat images were grouped via supervised classification method and maximum likelihood classifier (MLC). Accuracy scores and kappa a coefficient was used to confirm the accuracy categorized for LULC classes. Forest, settlement area, cultivated area, water body, and bare land are the main land use land cover categories identified in the study area. At the study district, forest coverage decreased progressively within the past three decades (1990-2020) from 12.4% in 1990 to 2.6% in 2020. The settlements, cultivated lands and water bodies have been explained by a average rate of 0.41% per year and forest land has been reduced by 0.33% per year. The study identified the major drivers of land use/land cover dynamics such as expansion of agricultural land, extraction of fuel woodland, illegal settlements and illegal logging was the key factors of LULC changes in the field of the study. In expressions of historical and current LULC, the analysis indicated that in the three decades years' viewpoint; changes in agriculture land expansion and expansion of settlement land have had a strong impact on the LULC dynamics. The few remaining forest area coverage of the District shall be completely vanished unless measures are taken to curb these declining trends. Therefore, relevant stakeholders should take integrated actions to rehabilitate degraded landscapes through afforestation and reforestation programmes.

Evaluating the microbial aerosol generated by dental instruments: addressing new challenges for oral healthcare in the hospital infection

BACKGROUND

Using a rotary instrument or ultrasonic instrument for tooth preparation is a basic operation in the dental clinic that can produce a significant number of droplets and aerosols. The dental droplet and aerosol can lead to the transfer of harmful germs. The goal of this study was to analyze the properties of microbiological aerosol created by droplets and aerosol generated by three common tooth-preparation instruments.

METHODS

Streptococcus mutans UA159 was used as the biological tracer to visualize the droplets and aerosols. The passive sampling method was used to map the three-dimensional spatial distribution and the six-stage Andersen microbial sampler (AMS) was used as the active sampling method to catch aerosol particles at a specific time.

RESULTS

The aerosol concentration is related to instruments, three-dimensional spatial distribution, and dissipation time. Most aerosols were generated by air turbines. More microorganisms are concentrated at the 1.5 m plane. The majority of the post dental procedure contamination was detected within the 0-10-min period and it decreased rapidly within 30 min.

CONCLUSION

This study is conducive to the proposal and improvement of relevant infection control measures in dental procedures and provides a basis for the assessment of measures, reducing the risk of nosocomial infection.

Does Size Really Matter? A Review on How to Determine the Optimal Umbilical Size During an Abdominoplasty

Background

The umbilicus has historical significance regarding health and beauty principles. The visually pleasing aesthetic of the umbilicus has become a vital standard for the perceived success of an abdominoplasty procedure. While the ideal position and shape of the umbilicus have been studied extensively in literature, less is known about the optimal size. Herein, the authors provide a comprehensive literature review to help determine the ideal umbilical size.

Methods

A computerized search in the PubMed database was performed to identify articles that discussed ideal umbilical size.

Results

The review was performed in July 2022. A total of 21 articles were initially identified, only 6 of which discussed umbilical size. References from the included articles were also evaluated for relevance and resulted in 10 additional articles in the final review. Most of the articles indicated that a smaller umbilicus was found to be aesthetically pleasing, but a numerical range of values were not specified.

Conclusions

Although the literature on the ideal umbilical size is sparse, the consensus is toward a smaller, vertically oriented umbilicus.

Exploring the vertical transport of microplastics in subsurface environments: Lab-scale experiments and field evidence

Microplastics (MPs) defined as smaller 5 mm plastic particles have received increasing attention due to their global occurrence and potential toxicity. This study investigated the effects of environmental factors (rainfall intensity, 13 and 29 mm/h) and MP characteristics (morphology (fiber, flake, and film), polymer type (polypropylene (PP), polyethylene terephthalate (PET), and polystyrene (PS)) and size (100-300, 300-500, and 500-1000 μm)) on the vertical transport of MP in unsaturated soil conditions using lab-scale column experiments. Additionally, the occurrence and characteristics of MP detected in soil/sediment (total 13 samples) and groundwater samples (total 6 samples) were explored in the field study. Laboratory-scale column experiments revealed that heavy rainfall intensity (29 mm/h) increased the degree of MP vertical transport in unsaturated soil conditions and MP fibers showed the greatest vertical mobility among the various morphologies of MPs assessed. For the polymer type and size, the lighter PP polymer or the larger size of MP (500-1000 μm) showed higher mobility. In the field study, a statistical difference in MP abundance was observed depending on the population density and degree of urban development in both soil and groundwater samples. Comparing to the two different types of environmental media samples obtained from the same site, there was a significant difference in the composition of polymer types present while statistically no difference in MP abundance was observed between the two media samples (i.e., soil or sediment and groundwater). In addition, MP fibers and polyethylene (PE) were predominantly detected in our two study areas. These results suggest that various types of MP can pass through the unsaturated zone by water infiltration, even if it takes a long time to reach groundwater. Overall, we found that the degree of vertical transport of the MPs was highly sensitive to environmental conditions and MP characteristics.

Preoperative imaging accuracy in size determination of prostate cancer in men undergoing radical prostatectomy for clinically localised disease

OBJECTIVES

To compare the accuracy of pre-surgical prostate size measurements using mpMRI and USWE with imaging-based 3D-printed patient-specific whole-mount moulds facilitated histopathology, and to assess whether size assessment varies between clinically significant and non-significant cancerous lesions including their locations in different zones of the prostate.

METHODS

The study population included 202 men with clinically localised prostate cancer opting for radical surgery derived from two prospective studies. Protocol-based imaging data was used for measurement of size of prostate cancer in clinically localised disease using MRI (N = 106; USWE (N = 96). Forty-eight men overlapped between two studies and formed the validation cohort. The primary outcome of this study was to assess the accuracy of pre-surgical prostate cancerous size measurements using mpMRI and USWE with imaging-based 3D-printed patient-specific whole-mount moulds facilitated histopathology as a reference standard. Independent-samples T-tests were used for the continuous variables and a nonparametric Mann-Whitney U test for independent samples was applied to examine the distribution and median differences between mpMRI and USWE groups.

RESULTS

A significant number of men had underestimation of prostate cancer using both mpMRI (82.1%; 87/106) and USWE (64.6%; 62/96). On average, tumour size was underestimated by a median size of 7 mm in mpMRI, and 1 mm in USWE. There were 327 cancerous lesions (153 with mpMRI and 174 for USWE). mpMRI and USWE underestimated the majority of cancerous lesions (108/153; 70.6%) and (88/174; 50.6%), respectively. Validation cohort data confirmed these findings MRI had a nearly 20% higher underestimation rate than USWE (χ² (1, N = 327) = 13.580, p = 0.001); especially in the mid and apical level of the gland. Clinically non-significant cancers were underestimated in significantly higher numbers in comparison to clinically significant cancers.

CONCLUSIONS

Size measurement of prostate cancers on preoperative imaging utilising maximum linear extent technique, underestimated the extent of cancer. Further research is needed to confirm our observations using different sequences, methods and approaches for cancer size measurement.

Design, physicochemical characterisation, and in vitro cytotoxicity of cisplatin-loaded PEGylated chitosan injectable nano / sub-micron crystals

The study aimed to develop cisplatin-loaded PEGylated chitosan nanoparticles. The optimal batch of cisplatin-loaded PEGylated chitosan nanoparticles had a + 49.9 mV zeta potential, PDI of 0.347, and % PDI of 58.9. Nanoparticle zeta size was 741.4 z. d.nm, the size in diameter was 866.7 ± 470.5 nm, and nanoparticle conductivity in colloidal solution was 0.739 mS/cm. Differential scanning calorimetry (DSC) revealed that cisplatin-loaded PEGylated chitosan nanoparticles had sharp endothermic peaks at temperatures at 168.6 °C. The thermogravimetric analysis (TGA) showed the weight loss of cisplatin-loaded PEGylated chitosan nanoparticles, which was observed as 95% at 262.76 °C. XRD investigation on cisplatin-loaded PEGylated chitosan nanoparticles exhibited distinct peaks at 2θ as 9.7°, 20.4°, 22.1°, 25.3°, 36.1°, 38.1°, 39.5°, 44.3°, and 64.5°, confirming crystalline structure. The ¹H NMR analysis showed the fingerprint region of cisplatin-loaded PEGylated chitosan nanoparticles as 0.85, 1.73, and 1.00 ppm in the proton dimension and de-shielded proton peaks appeared at 3.57, 3.58, 3.58, 3.59, 3.65, 3.67, 3,67, 3,67, 3.70, 3.71, 3.77, 3.78 and 4.71 ppm. The ¹³C NMR spectrum showed specified peaks at 63.18, 69.20, and 70.77 ppm. The FT-IR spectra of cisplatin loaded PEGylated nanoparticles show the existence of many fingerprint regions at 3186.52, 2931.68, 1453.19, 1333.98, 1253.71, 1085.19, 1019.60, 969.98, 929.53, 888.80, 706.13, and 623.67 cm^-1. The drug release kinetics of cisplatin loaded PEGylated chitosan nanoparticles showed zero order kinetics with 48% of drug release linearity fashion which has R² value of 0.9778. Studies on the MCF-7 ATCC human breast cancer cell line in vitro revealed that the IC50 value 82.08 µg /mL. Injectable nanoparticles had good physicochemical and cytotoxic properties. This method is novel since the application of the PEGylation processes leads to an increased solubility of chitosan nanoparticles at near neutral pH.

Measurement artifacts in the dithiothreitol (DTT) oxidative potential assay caused by interactions between aqueous metals and phosphate buffer

Metals in particulate matter (PM) are hypothesized to have enhanced toxicity based on their ability to catalyze reactive oxygen species (ROS) formation. Acellular assays are used to measure the oxidative potential (OP) of PM and its individual components. Many OP assays, including the dithiothreitol (DTT) assay, use a phosphate buffer matrix to simulate biological conditions (pH 7.4 and 37 °C). Prior work from our group observed transition metal precipitation in the DTT assay, consistent with thermodynamic equilibria. In this study, we characterized the effects of metal precipitation on OP measured by the DTT assay. Metal precipitation was affected by aqueous metal concentrations, ionic strength, and phosphate concentrations in ambient PM sampled in Baltimore, MD and a standard PM sample (NIST SRM-1648a, Urban Particulate Matter). Critically, differences in metal precipitation induced differing OP responses of the DTT assay as a function of phosphate concentration in all PM samples analyzed. These results indicate that comparison of DTT assay results obtained at differing phosphate buffer concentrations is highly problematic. Further, these results have implications for other chemical and biological assays that use phosphate buffer for pH control and their use to infer PM toxicity.

Among-individual variation in the swimming behaviour of the amphipod Gammarus pulex under dark and light conditions

In recent years, considerable computational advancements have been made allowing automated analysis of behavioural endpoints using video cameras. However, the results of such analyses are often confounded by a large variation among individuals, making it problematic to derive endpoints that allow distinguishing treatment effects in behavioural studies. In this study, we quantitatively analysed the effects of light conditions on the swimming behaviour of the freshwater amphipod Gammarus pulex by high-throughput tracking, and attempted to unravel among individual variation using size and sex. For this, we developed the R-package Kinematics, allowing for the rapid and reproducible analysis of the swimming behaviour (speed, acceleration, thigmotaxis, curvature and startle response) of G. pulex, as well as any other organism. Our results show a considerable amount of variation among individuals (standard deviation ranging between 5 and 115 % of the average swimming behaviour). The factors size and sex and the interaction between the two only explained a minor part of this found variation. Additionally, our study is the first to quantify the startle response in G. pulex after the light is switched on, and study the variability of this response between individuals. To analyse this startle response, we established two metrics: 1) startle response magnitude (the drop in swimming velocity directly after the light switches on), and 2) startle response duration (the time it takes to recover from the drop in swimming velocity to average swimming speed). Almost 80 % of the individuals showed a clear startle response and, therefore, these metrics demonstrate a great potential for usage in behavioural studies. The findings of this study are important for the development of appropriate experimental set-ups for behavioural experiments with G. pulex.

An Update on Appendiceal Neuroendocrine Tumors

The mainstay of appendiceal neuroendocrine neoplasm (aNEN) treatment is surgery, based on simple appendectomy or right-sided hemicolectomy with lymphadenectomy (RHC). The majority of aNENs are adequately treated with appendectomy, but current guidelines have poor accuracy in terms of selecting patients requiring RHC, especially in aNENs 1-2 cm in size. Simple appendectomy is curative for appendiceal NETs (G1-G2) < 1 cm (if the resection status is R0), whereas RHC with lymph node dissection is recommended in tumors ≥ 2 cm in diameter, based on the high risk of nodal metastases in these cases. The clinical management of aNENs 1-2 cm in size is more controversial because lymph node or distant metastases are uncommon but possible. In our opinion, patients with tumor size > 15 mm or with grading G2 (according to WHO 2010) and/or lympho-vascular invasion should be referred for radicalization with RHC. However, decision-making in these cases should include discussion within a multidisciplinary tumor board at referral centers with the aim of offering each patient a tailored treatment, also considering that relatively young patients with long-life expectancy represent the majority of cases.

Physicochemical characterization and quantification of nanoplastics: applicability, limitations and complementarity of batch and fractionation methods

A comprehensive physicochemical characterization of heterogeneous nanoplastic (NPL) samples remains an analytical challenge requiring a combination of orthogonal measurement techniques to improve the accuracy and robustness of the results. Here, batch methods, including dynamic light scattering (DLS), nanoparticle tracking analysis (NTA), tunable resistive pulse sensing (TRPS), transmission electron microscopy (TEM), and scanning electron microscopy (SEM), as well as separation/fractionation methods such as centrifugal liquid sedimentation (CLS) and field-flow fractionation (FFF)-multi-angle light scattering (MALS) combined with pyrolysis gas chromatography mass spectrometry (pyGC-MS) or Raman microspectroscopy (RM) were evaluated for NPL size, shape, and chemical composition measurements and for quantification. A set of representative/test particles of different chemical natures, including (i) polydisperse polyethylene (PE), (ii) (doped) polystyrene (PS) NPLs, (iii) titanium dioxide, and (iv) iron oxide nanoparticles (spherical and elongated), was used to assess the applicability and limitations of the selected methodologies. Particle sizes and number-based concentrations obtained by orthogonal batch methods (DLS, NTA, TRPS) were comparable for monodisperse spherical samples, while higher deviations were observed for polydisperse, agglomerated samples and for non-spherical particles, especially for light scattering methods. CLS and TRPS offer further insight with increased size resolution, while detailed morphological information can be derived by electron microscopy (EM)-based approaches. Combined techniques such as FFF coupled to MALS and RM can provide complementary information on physical and chemical properties by online measurements, while pyGC-MS analysis of FFF fractions can be used for the identification of polymer particles (vs. inorganic particles) and for their offline (semi)quantification. However, NPL analysis in complex samples will continue to present a serious challenge for the evaluated techniques without significant improvements in sample preparation.

What function of nanoparticles is the primary factor for their hyper-toxicity?

Nanomaterials have applications in environmental protection, hygiene, medicine, agriculture, and the food industry due to their enhanced bio-efficacy/toxicity as science and technology have progressed, notably nanotechnology. The extension in the use of nanoparticles in day-to-day products and their excellent efficacy raises worries about safety concerns associated with their use. Therefore, to understand their safety concerns and find the remedy, it is imperative to understand the rationales for their enhanced toxicity at low concentrations to minimize their potential side effects. The worldwide literature quotes different nanoparticle functions responsible for their enhanced bio-efficacy/ toxicity. Since the literature on the comparative toxicity study of nanoparticles of different shapes and sizes having different other physic-chemical properties like surface areas, surface charge, solubility, etc., evident that the nanoparticle's toxicity is not followed the fashion according to their shape, size, surface area, surface charge, solubility, and other Physico-chemical properties. It raises the question then what function of nanoparticle is the primary factor for their hyper toxicity. Why do non-spherical and large-sized nanoparticles show the same or higher toxicity to the same or different cell line or test organism instead of having lower surface area, surface charge, larger size, etc., than their corresponding spherical and smaller-sized nanoparticles? Are these factors a secondary, not primary, factor for nanoparticles hyper-toxicity? If so, what function of nanoparticles is the primary function for their hyper-toxicity? Therefore, in this article, literature related to the comparative toxicity of nanoparticles was thoroughly studied, and a hypothesis is put forth to address the aforesaid question, that the number of atoms/ions/ molecules per nanoparticles is the primary function of nanoparticles toxicity.

Statistical analysis of biomechanical properties and size of the sternum and its fracture risk in a Japanese sample

OBJECTIVE

Sternal fractures can have life-threatening complications. To understand chest injury mechanisms, sufficient data regarding the mechanical properties and structure of the sternum are required. The aim of this study was to examine the mechanical properties and size of the sternum in a Japanese forensic sample.

MATERIALS AND METHODS

Sterna were obtained from 120 Japanese dead bodies of known age and sex. The sample thickness (ST) and the sample width (SW) were measured using a computed tomographic image. Three-point-bending tests were conducted using a three-point-bending apparatus to assess the fracture load (FL) of the sample. Then, the flexural strength (FS) was calculated and the natural logarithm of FL (ln FL) and FS (ln FS) were also calculated.

RESULTS

The values of ST, ln FL, and ln FS for male samples were significantly greater than those for female samples. Both ln FL and ln FS had significant negative correlations with age regardless of sex; the Pearson product-moment correlation coefficients were larger for female samples than for male samples. Although age was significantly negatively correlated with SW in female samples, there was no significant correlation between age and SW in male samples. No significant correlations were found between age and ST regardless of sex.

CONCLUSION

This is the first study to present quantitative data on the biomechanical properties of the sternum. Because of the smaller sternal strength of elderly women, it is especially important for them to avoid the risk of sternal fractures.

Size- and surface functionalization-driven molecular interaction of CdSe quantum dots with jack bean urease: multispectroscopic, thermodynamic, and AFM approach

Quantum dots (QDs) with distinctive optical properties have been extensively researched and developed for usage in solar cells, imaging, drug delivery, cellular targeting, etc. But the inevitable production of QDs can lead to their unavoidable release and increased environmental concentration. Depending on morphological and surface properties, QDs at the nano-bio interface considerably impact the activity and structure of bio-molecules. The present study investigates the interaction of metalloenzyme jack bean urease (JBU) and bi-sized CdSe QDs (2.43 nm and 3.63 nm), surface-functionalized to mercaptopropionic acid (MPA) (-COOH), L-cysteine (CYS), L-glutathione (GSH), N-acetyl L-cysteine (NAC) (-COOH, -NH₂), and cysteamine hydrochloride (CYST) (-NH₂) to assess any alterations in JBU's binding, microenvironment, structure, exciton lifetime, and activity. JBU catalyzes the hydrolysis of urea to produce ammonia and carbon dioxide; any changes in its properties could threaten the survival of several microbes and plants. Spectroscopy techniques such as UV-Vis, fluorescence, circular dichroism, synchronous, time-resolved fluorescence, atomic force microscopy, and JBU activity assay were studied. Results suggested highly spontaneous and energy-favored interactions, which involved static quenching and hydrophobic forces of varied magnitude, dependent on QDs properties. The size, surface modifications, and dosage of QDs significantly impacted the secondary structure and activity of JBUs. Even though the larger sizes of the relevant modifications demonstrated stronger binding, the smaller sizes had the greatest impact on α-helicity and activity. CYST-capped QDs with an average number of the binding site (n) = 1, reduced α-helicity by 16% and activity by 22-30% at 7 nM concentration. In contrast, MPA-capped QDs with n < 1 had the least effect on α-helical structure and activity. The smaller GSH-capped QDs increased the activity by 9%, via partially restoring JBU's α-helical content. The study thus thoroughly analyzed the impact of varied-size and surface-functionalized QDs on the structure and function of JBU, which can be exploited further for several biomedical applications.

The large cytoplasmic volume of oocyte

The study of the size of cells and organelles has a long history, dating back to the 1600s when cells were defined. In particular, various methods have elucidated the size of the nucleus and the mitotic spindle in several species. However, little research has been conducted on oocyte size and organelles in mammals, and many questions remain to be answered. The appropriate size is essential to cell function properly. Oocytes have a very large cytoplasm, which is more than 100 times larger than that of general somatic cells in mammals. In this review, we discuss how oocytes acquire an enormous cytoplasmic size and the adverse effects of a large cytoplasmic size on cellular functions.

Quantified flow and angioarchitecture show similar associations with hemorrhagic presentation of brain arteriovenous malformations

INTRODUCTION

The purpose of our study was to elucidate the impact of brain arteriovenous malformation (BAVM) flow and wall shear stress (WSS) on angioarchitecture and to evaluate their association with hemorrhagic presentations.

MATERIALS AND METHODS

Forty-one patients with BAVMs were evaluated by phase-contrast MR angiography. Volume flow rate and WSS were quantified. Angioarchitectural features such as location, angiogenesis, venous stenosis, venous ectasia, venous phlebitis, venous rerouting, exclusive deep vein and venous sac were evaluated by two neuroradiologists. The correlation between BAVM flow and size was evaluated with Spearman correlation coefficients. Differences of size, flow, and WSS between the hemorrhagic and non-hemorrhagic groups, the seizure and non-seizure groups, and between the different groups based on angioarchitecture were evaluated with Mann-Whitney U tests. Accuracy in predicting hemorrhage was evaluated with receiver operating characteristic curves.

RESULT

BAVM flow was highly correlated with volume (ρ = 0.77). Higher flow was more commonly associated with angiogenesis, venous ectasia, venous rerouting, and venous phlebitis. Flow and angioarchitecture showed similar efficacy in differentiating hemorrhagic from non-hemorrhagic BAVMs. WSS did not demonstrate differences across any clinical groups.

CONCLUSION

Flow quantification and angioarchitecture analysis of BAVMs showed similar efficacy as evaluated by associations with hemorrhagic presentation. High flow affects both arterial and venous angioarchitecture, reflecting the nature of low vascular resistance in BAVMs.