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Objective: Management of limb ischemia in the setting of malignancy with history of resection and/or radiation presents a unique challenge. Radiation arteritis contributing to limb ischemia may not respond to endovascular intervention. Furthermore, significant tissue scarring from extensive resection and/or radiation can increase the risk of complications with open intervention and limit revascularization options. Utilization of an axillary to popliteal artery bypass using a lateral approach to the popliteal artery has been described as a reasonable alternative in these challenging cases. Case Report: The patient is a 68-year-old male with history of liposarcoma of the left groin, scrotum, and medial thigh for which he underwent multiple resections, flap reconstruction, and skin graft. He had a recurrence 2 years later and underwent repeat resection, placement of brachytherapy catheters, vertical rectus abdominal flap, and external beam radiation. He now presents with Rutherford 2B acute limb ischemia with associated left foot drop. Computed tomography angiography was performed and revealed an occluded left common femoral artery stent, proximal left superficial and deep femoral artery occlusion, and thrombosis of the left femoral vein. An attempt was made at endovascular recanalization without success. He subsequently underwent left axillary-to-lateral above knee popliteal artery bypass with a 6 mm ringed polytetrafluoroethylene graft, tibial thrombectomy, and 4 compartment fasciotomy. Results: Post-operatively, his pain resolved. He continued to have left foot drop but recovered his ability to ambulate with a walker. He was ultimately discharged on post-operative day 11 to an inpatient rehabilitation facility on aspirin and apixaban. Conclusion: Hostile groin secondary to infection, malignancy requiring resection/radiation presents a unique challenge for revascularization. When endovascular revascularization or obturator bypass are not feasible options, axillary-to-lateral above knee popliteal artery bypass is a described, feasible alternative approach to restore blood flow in this challenging patient population. [ABSTRACT FROM AUTHOR]

Introduction: The preservation of the bladder neck during robot-assisted radical prostatectomy (RARP) could improve urinary continence recovery and limit the risk of positive surgical margins (PSMs). We refined our lateral approach to the bladder neck technique and compared its outcomes with those of the standard anterior approach. Material and methods: From a retrospective analysis of 599 consecutive RARPs, 171 patients treated with the lateral and 171 patients treated with the anterior approach were pair-matched 1:1 on the basis of age, grade, and pathological stage. We described our surgical technique and compared the two approaches in terms of basal PSMs, recovery of urinary continence, and complications. Results: As compared to the anterior approach, the lateral approach had shorter operative times and comparable rates of basal PSMs and postoperative complications. The rates of urinary continence after one, three, and 12 months were comparable between the two groups and were generally higher in localized disease. At regression analysis, predictors of urinary incontinence were only age, pathological stage T3b, ISUP grade 5 and nerve-sparing surgery. Conclusions: The lateral approach leads to an anatomical dissection of the bladder neck without increasing the risk of PSMs. However, no significant benefits in terms of continence recovery were demonstrated over the standard anterior approach. [ABSTRACT FROM AUTHOR]

Objective: This meta-analysis evaluates the comparative efficacy of lateral unicompartmental arthroplasty (UKA) versus medial UKA in treating unicompartmental knee osteoarthritis (KOA). Methods: We systematically searched Cochrane, PubMed, Embase, and Web of Science databases from January 2000 to September 2024. Literature screening, quality assessment, and data extraction were conducted based on predefined inclusion and exclusion criteria. Review Manager 5.4 software was used to analyze postoperative functional scores, pain scores, aseptic loosening, progression of contralateral arthritis, and prosthesis survival. Results: Fifteen cohort studies, encompassing 2,592 knees with medial UKA and 614 knees with lateral UKA, were included. The analysis showed no statistically significant differences in functional scores [SMD = 0.11, 95% CI (− 0.10, 0.33), I2 = 64%, P = 0.31], pain scores [SMD = 0.23, 95% CI: (− 0.22, 0.67), I2 = 91%, P = 0.32], aseptic loosening [OR = 1.33, 95% CI: (0.31, 5.78), I2 = 0%, P = 0.70], progression of contralateral arthritis [OR = 0.37, 95% CI: (0.07, 1.91), I2 = 0%, P = 0.23], short- to intermediate-term survival [OR = 1.40, 95% CI: (0.84, 2.35), I2 = 0%, P = 0.20], and long-term survival [OR = 1.12, 95% CI: (0.61, 2.05), I2 = 0%, P = 0.70]. Conclusion: Our findings indicate no significant differences in functional outcomes, pain relief, aseptic loosening, progression of contralateral arthritis, or prosthesis survival between lateral and medial UKA. Thus, both approaches are reliable options for patients with unicompartmental KOA. [ABSTRACT FROM AUTHOR]

Flexible photodetectors have garnered significant attention in recent years due to their potential applications in emerging fields such as artificial intelligence, medical diagnostics, and wearable devices. Quasi‐2D perovskites exhibit remarkable optoelectronic properties, excellent environmental stability, and mechanical flexibility, making them promising materials for flexible photodetectors. Achieving precise control over the morphology of these materials is crucial for enhancing device performance. In this study, periodic wrinkle structures are introduced into quasi‐2D perovskite films by applying pre‐stretching stress to a flexible substrate. These results indicate that these ordered wrinkle structures facilitate grain movement during formation, enabling smaller grains to fill pores and surround larger grains. This process leads to a denser film with a mixed 2D‐3D phase architecture, enhancing charge transfer efficiency and prolonging carrier lifetime in the perovskite films. Consequently, the responsivity of the resulting flexible perovskite photodetector significantly increased, reaching 86.7 A W−1, which is 2.5 times higher than that of the unstretched device. Furthermore, the wrinkled structures enhanced mechanical tolerance, allowing the photodetector to retain 80% of its initial responsivity even after 10 000 stretching cycles. These findings highlight the potential of wrinkled structures to significantly enhance the performance of flexible perovskite optoelectronic devices. [ABSTRACT FROM AUTHOR]

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Aim: The study evaluates the impact of patient positioning on radiation doses received during fluoroscopy in proximal femoral nailing for hip fractures. With the increasing use of minimally invasive, imaging-guided procedures, it is crucial to assess radiation exposure risks to both patients and healthcare workers. Prior research indicates that various factors, including patient positioning, can influence radiation doses. Materials and Methods: This study included patients who underwent proximal femoral nailing for hip fractures from January 2023 to May 2024. Patients’ positions were supine on a traction table, lateral decubitus position on a radiolucent table. Fluoroscopy data, including fluoroscopy time, dose-area product (DAP), and radiation dose, along with patient demographics and body mass index (BMI), were analyzed. Results: A total of 114 patients were included. There were no significant differences in demographic characteristics between the groups. The mean fluoroscopy time was 42.02±25.75 seconds, with no significant difference between positions. The mean radiation dose was 18.72±16.24 milligray (mGy), and the mean DAP was 3.50±3.07 Gy-cm², with no significant differences across positions. However, a statistically significant positive correlation was found between BMI values and dose mGy values (r=0.242, p=0.009). Similarly, a statistically significant positive correlation was observed between BMI values and DAP values (r=0.243, p=0.009). However, the mean number of fluoroscopic shots was significantly higher in the supine position compared to the lateral position. Conclusion: Patient positioning did not significantly affect fluoroscopy time or radiation dose proximal femoral nailing procedures for hip fractures. However, the number of fluoroscopic shots was lower in the lateral position. High BMI was positively correlated with dose mGy and DAP values except for time. The findings highlight the importance of considering BMI in radiation dose management and suggest that the lateral position may be preferable for minimizing radiation exposure.

Introduction: Due to bony changes and narrow lumbar interspinous spaces, performing a neuraxial block becomes difficult in older patients undergoing lower limb arthroplasties. Aim: To formulate a difficulty predictor score (MUSG score) for anticipating difficult Central Neuraxial Blocks (CNB) and to compare lumbar spine radiological findings with clinical findings. Materials and Methods: A cross-sectional study was conducted on 166 patients admitted for knee or hip arthroplasties from March 2023 to March 2024 in the main operation theatre complex of a tertiary care hospital. All patients were advised to get X-rays of the lumbosacral spine in both anteroposterior and lateral views before surgery. The total difficulty predictor score was calculated from the X-rays based on the presence or absence of scoliosis, bony osteophytes, angulation of spinous processes, calcification of the ligamentum flavum, and the ratio of inner and outer visible interspinous space. The minimum score was 5 and the maximum was 12. The individual score at each interspinous level was calculated and selected the space with the minimum score for the CNB. A comparison was also made with the clinically selected best space, which was identified using the traditional palpation technique. A block was labeled difficult if there were more than two attempts for spinal and epidural block, respectively. All collected data were entered into a Microsoft Excel sheet and analysed using Microsoft Excel software. Results: The study patients had a mean age of 59.83 years. The total difficulty predictor score (MUSG Score) of the lumbar spine was 5 in 3 patients (1.8%), 6-9 in 140 patients (84.3%), and ≥10 in 23 patients (13.9%). However, the minimum score at the best interspinous space was 5 in 15 patients (9%), 6-9 in 151 patients (91%), and none had a score of 10 or more. From radiological imaging, the spaces with minimal scores were in the order of L2-L3 (76), L3-L4 (62), and L1-L2 (28); while on clinical examination, they were – L2-L3 (96), L3-L4 (43), L1-L2 (23). The difference between the two was statistically significant (p-value

There is a paucity of data available on the context preceding anterior fusion failure or the need for a posterior fusion, the timing of the second operation, or any correlation between the different instrumentation and failure rates. A retrospective chart review was performed of 131 identified patients who underwent anterolateral corpectomy and fusion for a thoracolumbar burst fracture from 2000 to 2012 in a single institution. 96 patients had clinical and radiographic follow up of greater than two months. Mean kyphosis correction from preoperative (14.1°) to postoperative kyphosis (6.3°) was 7.7° and 37% had loss of kyphotic correction at follow-up. In a univariate analysis, use of a bone strut graft (OR 3.2, p = 0.01), point-loaded graft position (OR 4.9, p = 0.005), end plate damage/subsidence (OR 6.7, p < 0.0001), and graft to endplate width ratio of ≤ 45% on AP x-ray (OR 3.0, p = 0.02) were associated with loss of kyphotic correction. 41% demonstrated scoliosis of ≥ 5° at follow-up. Graft location towards the left of midline (OR 8.6, p < 0.0001), point-loaded graft position (OR 3.8, p = 0.01), and end plate damage/subsidence (OR 5.5, p = 0.0001) were also associated with scoliosis at the time of final follow-up. Five patients required posterior fusion and fifteen patients continued to have daily pain, only one of which was determined to be related to kyphosis. Use of a bone strut graft versus expandable cage, graft location, graft position, presence of early or late subsidence and width of the graft may be associated with loss of kyphotic correction and scoliosis. [ABSTRACT FROM AUTHOR]

Objectives To assess whether vestibular prehabilitation with intratympanic gentamicin is a useful preoperative adjunct in allowing for early mobilization and short length of stay in patients with vestibular schwannoma (VS). Design Retrospective single-center study and literature review. Setting Tertiary neurosurgical center. Participants Adult patients undergoing surgery for VS. Main Outcome Measures Our primary outcome measures were evidence of compensation following prehabilitation (defined as saccades becoming more covert and clustered on video head impulse testing—vHIT), length of stay, and days until mobilization. Secondary outcome measures were reduction in gain on vHIT following treatment as well as need for antiemetics postoperatively. Results Ten patients have been treated at our center and the majority have shown preoperative reduction in gain and evidence of compensation on vHIT. Median time to mobilization was 1 day and modal length of stay was 6 days. We found the current evidence to be variable, with small sample sizes and significant variation in outcome measures used. Conclusion Overall we have found that the use of vestibular prehabilitation enables early mobilization, shortened length of stay and appears to be a promising preoperative adjunct in this population. Further research and assessment with a multicenter prospective clinical trial is merited. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to analyze the data collected on lateral incisional hernias (LIH) in the National Incisional Hernia Registry (EVEREG) and assess current practices and outcomes in LIH repair. Methods: A retrospective cohort study was conducted using LIH data recorded over 10 years (2012–2022). Comorbidities, hernia characteristics, short-term complications, and recurrences were studied, along with their association with the type of approach used, either open or laparoscopic, in elective surgery. Results: 1742 LIH cases were studied. According to the EHS classification, these included L1 409 (23.5%), L2 388 (22.3%), L3 565 (32.4%), L4 150 (8.6%) and combined 230 (13.2%). An open approach was performed in 1528 (87.7%) cases and laparoscopic in 214 (12.3%). The median age was 66 ± 12.45 years, with a majority of males, 934 (53.6%). The median body mass index was 29 ± 5.18 kg/m2. The most observed comorbidity was arterial hypertension (957 patients, 55%). A specialist was present in 638 interventions (56%). The 24-month follow-up was 17.9%, and recurrence in those cases was 27.2%, with a higher incidence when there was no specialist present during the intervention, onlay mesh position, and larger defect size. Conclusions: Surgery for LIH is common, although laparoscopic approach remains infrequent. Furthermore, it is associated with a high percentage of recurrences that increases when there is no specialist in abdominal wall surgery present. [ABSTRACT FROM AUTHOR]

Introduction: Due to bony changes and narrow lumbar interspinous spaces, performing a neuraxial block becomes difficult in older patients undergoing lower limb arthroplasties. Aim: To formulate a difficulty predictor score (MUSG score) for anticipating difficult Central Neuraxial Blocks (CNB) and to compare lumbar spine radiological findings with clinical findings. Materials and Methods: A cross-sectional study was conducted on 166 patients admitted for knee or hip arthroplasties from March 2023 to March 2024 in the main operation theatre complex of a tertiary care hospital. All patients were advised to get X-rays of the lumbosacral spine in both anteroposterior and lateral views before surgery. The total difficulty predictor score was calculated from the X-rays based on the presence or absence of scoliosis, bony osteophytes, angulation of spinous processes, calcification of the ligamentum flavum, and the ratio of inner and outer visible interspinous space. The minimum score was 5 and the maximum was 12. The individual score at each interspinous level was calculated and selected the space with the minimum score for the CNB. A comparison was also made with the clinically selected best space, which was identified using the traditional palpation technique. A block was labeled difficult if there were more than two attempts for spinal and epidural block, respectively. All collected data were entered into a Microsoft Excel sheet and analysed using Microsoft Excel software. Results: The study patients had a mean age of 59.83 years. The total difficulty predictor score (MUSG Score) of the lumbar spine was 5 in 3 patients (1.8%), 6-9 in 140 patients (84.3%), and =10 in 23 patients (13.9%). However, the minimum score at the best interspinous space was 5 in 15 patients (9%), 6-9 in 151 patients (91%), and none had a score of 10 or more. From radiological imaging, the spaces with minimal scores were in the order of L2-L3 (76), L3-L4 (62), and L1-L2 (28); while on clinical examination, they were - L2-L3 (96), L3-L4 (43), L1-L2 (23). The difference between the two was statistically significant (p-value <0.05). The time required for the block procedure was longer in patients with a score of 6-9 (13.99 minutes) than in those with a score of 5 (11.13 minutes). Haemodynamic changes from baseline were also more pronounced in patients with a score of 6-9 compared to those with a score of 5. Conclusion: CNBs in patients undergoing hip and knee arthroplasties are easier to perform with the help of the difficulty predictor score (MUSG Score). A difficulty predictor score of 5 is associated with an easier block compared to higher scores. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the long-term survivorship and functional outcomes of fixed-bearing lateral unicompartmental knee arthroplasty (UKA) in a young patients' population with osteoarthritis limited to the lateral compartment. Methods: The study included a cohort of consecutive patients who underwent lateral UKA between January 2008 and December 2014 at a single high-volume surgical center. The surgical procedures were performed by experienced surgeons using a lateral parapatellar approach and fixed-bearing implants. Patient follow-up included a retrospective re-evaluation, clinical assessments, patient-reported outcome measures (PROMs), and X-ray analysis. Results: A total of 40 lateral UKAs were analyzed, with 19 performed on the left and 21 on the right knee. The mean age of the patients at the time of surgery was 57.6 years, and the mean BMI was 24.8. At the final follow-up, 80% of patients achieved excellent outcomes (OKS > 41), and 20% had good outcomes (OKS: 34–41). No patients exhibited fair or poor outcomes. The mean FJS at the final follow-up was 82.8. The mean WOMAC was 10.5. Kaplan–Meier survival analysis revealed a survivorship rate of 93.1% at 10 years, considering revision for any reason as endpoint. Conclusions: Lateral UKA proved to be an effective treatment option for osteoarthritis affecting the lateral compartment of the knee. The study demonstrated a high survivorship rate and favorable functional outcomes at a mean follow-up of 132.7 months. These findings highlight the potential benefits of fixed-bearing lateral UKA in selected patients with lateral compartment knee pathology. [ABSTRACT FROM AUTHOR]

Background: Skull base fracture management depends on location, severity, and can range from observation to surgical intervention. A comparison between the different locations of skull base fractures, namely anterior versus lateral, with regards to hospital length of stay (LOS), need for intensive care, and surgery has not been studied. Methods: Patients with skull base fractures between 2012 and 2019 were reviewed. Demographics and inpatient events were collected. Multivariate logistic and linear regressions evaluated the association between fracture location, multiple traumas, loss of consciousness, and mechanism of injury with hospital course and sequalae. Results: There were 134 patients (74.6% male) with skull base fractures (67 anterior and 67 lateral), with an average age of 44.2 years. The mechanism of injury was more likely to be MVCs in anterior fractures and falls in lateral fractures (MVC: 56.7% vs 34.3%; falls: 28.4% vs 44.8%, P =.03). Patients with anterior fractures were more likely to undergo any surgery (P <.002), and surgeries for facial fractures (P <.005), but less likely to need ICU care (P =.01). When admitted, patients with anterior skull base fractures had longer ICU stays (P =.03). They were also more likely to experience vision difficulties whereas patients with lateral fractures were more likely to experience hearing loss (P =.02). Conclusion: Patients with lateral skull base fractures are more likely to require an ICU admission compared to anterior fractures, but anterior fractures are more likely to need surgery and have longer ICU stays when admitted. A better understanding of the expected hospital course for patients based on skull base fracture location can improve care-coordination, hospital resource management and patient counseling. [ABSTRACT FROM AUTHOR]

Pesticides have been reported in treated wastewater effluent at concentrations that exceed aquatic toxicity thresholds, indicating that treatment may be insufficient to adequately address potential pesticide impacts on aquatic life. Gaining a better understanding of the relative contribution from specific use patterns, transport pathways, and flow characteristics is an essential first step to informing source control measures. The results of this study are the first of their kind, reporting pesticide concentrations at sub-sewershed sites within a single sewer catchment to provide information on the relative contribution from various urban sources. Seven monitoring events were collected from influent, effluent, and seven sub-sewershed sites to capture seasonal variability. In addition, samples were collected from sites with the potential for relatively large mass fluxes of pesticides (pet grooming operations, pest control operators, and laundromats). Fipronil and imidacloprid were detected in most samples (>70%). Pyrethroids were detected in >50% of all influent and lateral samples. There were significant removals of pyrethroids from the aqueous process stream within the facility to below reporting limits. Imidacloprid and fiproles were the only pesticides that were detected above reporting limits in effluent, highlighting the importance of source identification and control for the more hydrophilic compounds. Single source monitoring revealed large contributions of fipronil, imidacloprid, and permethrin originating from a pet groomer, with elevated levels of cypermethrin at a commercial laundry location. The results provide important information needed to prioritize future monitoring efforts, calibrate down-the-drain models, and identify potential mitigation strategies at the site of pesticide use to prevent introduction to sewersheds.

Background: Lateral lumbar interbody fusion (LLIF) is commonly used to address various lumbar pathologies. LLIF using the prone transpsoas (PTP) approach has several potential advantages, allowing simultaneous access to the anterior and posterior columns of the spine. The aim of this study was to report the 1-year outcomes of LLIF via PTP. Methods: This is a retrospective review of 97 consecutive patients who underwent LLIF via PTP. Radiographic parameters, including lumbar-lordosis, segmental-lordosis, anterior disc height, and posterior disc height, were measured on preoperative, initial-postoperative, and 1-year postoperative imaging. Patient-reported outcomes measures, including Oswestry Disability Index, visual analog scale (VAS), pain EQ5D, and postoperative complications, were reviewed. Results: Ninety-seven consecutive patients underwent 161 levels of LLIF. Fifty-seven percent underwent 1-level LLIF, 30% 2-level LLIF, 6% 3-level LLIF, and 7% 4-level LLIF. The most common level was L4 to L5 (35%), followed by L3 to L4 (33%), L2 to L3 (21%), and L1 to L2 (11%). Significant improvements were noted at initial and 1-year postoperative periods in lumbar-lordosis (2° ± 10°, P = 0.049; 3° ± 9°, P = 0.005), segmental-lordosis (6° ± 5°, P < 0.001; 5° ± 5°, P < 0.001), anterior disc height (8 mm ± 4 mm, P < 0.001; 7 mm ± 4 mm, P < 0.001), and posterior disc height (3 mm ± 2 mm, P < 0.001; 3 mm ± 2 mm, P < 0.001). Significant improvements were seen in Oswestry Disability Index at 6 weeks (P = 0.002), 6 months (P < 0.001), and 1 year (P < 0.001) postoperatively; pain EQ5D at 6 weeks (P < 0.001), 6 months (P < 0.001), and 1 year (P < 0.001) postoperatively; and leg and back visual analog scale at 2 weeks (P < 0.001), 6 months (P < 0.001), and 1 year (P < 0.001) postoperatively. The average length of stay was 2.5 days, and the most common complications were ipsilateral hip flexor pain (46%), weakness (59%), and contralateral hip flexor pain (29%). Conclusion: PTP is a novel way of performing LLIF. These 1-year data support that PTP is an effective, safe, and viable approach with similar patient-reported outcome measures and complications profiles as LLIF performed in the lateral decubitus position. [ABSTRACT FROM AUTHOR]

The transpsoas lateral lumbar interbody fusion (LLIF) procedure is a minimally invasive lumbar spine approach that provides indirect neural decompression, improved sagittal alignment, and a high fusion rate. Typically accompanied by posterior pedicle screw insertion, there has been interest in performing LLIF in a single position to decrease cost and time under anesthesia. However, there is a paucity of direct comparisons between single-position LLIF via prone versus lateral decubitus positioning. Therefore, this study aims to compare the outcomes of a single surgeon performing prone versus lateral single-position LLIF, inclusive of the L4–L5 level. A retrospective review was performed of a consecutive case series of patients who underwent either prone or lateral, single-position LLIF by a single surgeon. All cases involved the L4–L5 level. Demographic data, perioperative details, clinical outcomes, and preoperative and postoperative lumbar lordosis were recorded. Sixty-three patients underwent lateral and 16 patients underwent prone single-position LLIF. Demographics and average interbody size were similar between groups. Operative time, change in lumbar lordosis, and length of hospital stay did not differ between the 2 positions. Both groups performed similarly in terms of preoperative and postoperative visual analog score pain score and complications. Patients who underwent lateral position LLIF ambulated farther on postoperative day 1 (250 feet vs. 200 feet, P = 0.015). Average time to follow up was 53 weeks. This study demonstrates promising preliminary results indicating that single-position LLIF performs well, even at the L4–L5 level, in both the prone and lateral positions. [ABSTRACT FROM AUTHOR]

Endoscopic posterior cervical foraminotomy is gaining popularity among endoscopic spine surgeons for the treatment of radiculopathy caused by foraminal stenosis. This study describes a technique using the lateral decubitus position for endoscopic posterior cervical foraminotomy under monitored anesthesia care and local anesthesia only. A total of 10 patients with contraindications to general anesthesia underwent the procedure, resulting in improvement in cervical radicular pain with no perioperative complications. The findings suggest that this approach is a viable alternative for patients at high risk of general anesthesia care, expanding the surgical options for the treatment of radiculopathy. [ABSTRACT FROM AUTHOR]

The lateral hypothalamus (LH) has a heterogeneous cytoarchitectonic organization that has not been elucidated in detail. In this work, we analyzed within the framework of the prosomeric model the differential expression pattern of 59 molecular markers along the ventrodorsal dimension of the medial forebrain bundle in the mouse, considering basal and alar plate subregions of the LH. We found five basal (LH1-LH5) and four alar (LH6-LH9) molecularly distinct sectors of the LH with neuronal cell groups that correlate in topography with previously postulated alar and basal hypothalamic progenitor domains. Most peptidergic populations were restricted to one of these LH sectors though some may have dispersed into a neighboring sector. For instance, histaminergic Hdc-positive neurons were mostly contained within the basal LH3, Nts (neurotensin)- and Tac2 (tachykinin 2)-expressing cells lie strictly within LH4, Hcrt (hypocretin/orexin)-positive and Pmch (pro-melanin-concentrating hormone)-positive neurons appeared within separate LH5 subdivisions, Pnoc (prepronociceptin)-expressing cells were mainly restricted to LH6, and Sst (somatostatin)-positive cells were identified within the LH7 sector. The alar LH9 sector, a component of the Foxg1-positive telencephalo-opto-hypothalamic border region, selectively contained Satb2-expressing cells. Published studies of rodent LH subdivisions have not described the observed pattern. Our genoarchitectonic map should aid in systematic approaches to elucidate LH connectivity and function.

Creative thinking is open thinking that comes out of the usual sequence to be a diversified thinking that leads to the generation of more than one answer to the problem. It is defined as the mental process that we use to reach new ideas and visions, or that leads to amalgamation and harmony between ideas or things that were previously considered unrelated. Creativity is a blessing from God Almighty bestowed upon man, and that every person is in need of it; Because creativity makes human life more enjoyable, more entertaining, and more developed, and it is the basic tool that each of us needs to achieve and achieve what he wants to achieve in all its diversity, and to produce new, unfamiliar ideas that are characterized by originality. Creativity is not limited to a specific art or activity, it includes all types of arts, literature, sciences, various works, and so on. It is not limited to a group or an individual. Creativity is the highest level of human cognitive activity and the most important educational outcome, as it represents a means of self-expression, and when subjected to evaluation, it urges the individual to produce something new or different and at the same time carries the character of the individual that distinguishes him from others. Lateral thinking methods contribute to developing the designer's ability to deal with challenges and life situations in a more creative way. It gives him the power to produce original and unique ideas, so the research deals with how to take advantage of lateral thinking methods in support of the industrial design strategy and reach a new strategy supported by lateral thinking methods, in an effort to generalize and consolidate the concept and practice of lateral thinking among students and practitioners of industrial design to reach designs characterized by creativity. By studying creativity and presenting its concepts and characteristics, the research also presented the concept of creative thinking and lateral thinking, and then presented the design strategy and schemes for explaining lateral thinking methods and analysing them to determine points of compatibility and then developing a new design strategy supported by lateral thinking methods.

The article examines the issue of preschool teachers professional training, its artistic component in particular. The need for an innovator teacher's training who, in accordance with the pace of world changes, is ready to modernize the educational process, has been updated; a conscious understanding of the education of a creative, free and multifaceted personality by introducing it to the world of art and possesses the necessary methodological tools. It was noted that an artistic interaction with preschool age children needs a modified logical and sequential support. A theoretical analysis of studying an issue of artistic and creative interaction between teachers and early and preschool age children in native and foreign scientific literature is presented. The position of the need to form preschool children's artistic and creative competence through appealing to their sensory sphere, and the development of empathy is substantiated. The toolkit for tasks implementation of early age and preschool children art-world is revealed, namely, art communication is characterized as a form of integrated interaction between an adult and a child, which contains elements of an artistically productive, musical, theatrical component and in which any of these components can dominate or unfold separately. Effective means of preschool teachers training to conduct art-communication have been determined, in particular, clusters of art-communication (mind map) have been identified according to the algorithm «I hear – see – feel – know – act». The results of the ascertainment stage of the research on the readiness of creation and implementation of art-communication clusters in the educational process of kindergarten by preschool teachers are described. The criteria for the formation of the skills of moderating clusters of art communication by teachers of kindergarten are outlined: motivational-emotional, knowledge-theoretical, reflective-empathetic, practical-active. Empirical research methods are quantitatively and qualitatively characterized: questionnaires using Google form online resource; a method of pedagogical observation of teachers' activities; an interviewing. It was found out that the middle (lateral – close to the middle) and low (juvenile – hidden) levels prevail among the respondents.

Measuring tools designed to objectively determine equine noseband tightness are inserted on the dorsal nasal planum in a rostro-caudal direction. The lateral aspect of the horse’s head has several areas where minimal soft tissue intervenes between the skin and underlying bone, which makes them potentially useful sites for measuring noseband tightness. One hundred horses were fitted with a snaffle bridle with a cavesson, Swedish or dropped noseband in random order. The tightness of each noseband type was adjusted sequentially to 2.0, 1.5, 1.0, 0.5 and 0.0 finger-equivalents using an ISES Taper Gauge. For each adjustment, a digital calliper determined the distance (mm) between the inner surface of the noseband at three lateral locations: (1) lateral nasal bone, (2) lateral maxilla rostral to the facial crest, and (3) lateral mandible. Friedman’s analysis was used to test the differences between locations (p < 0.02). No differences were found between 2.0 and 1.5 finger-equivalent tightness at the nasal and maxillary sites for the cavesson (p = 0.89, p = 0.03, respectively) and Swedish (p = 0.06, p = 0.40, respectively) noseband. When adjusted between 2.0 to 0.5 finger-equivalent tightness, the coefficient of variation was “good” for the nasal (16%) and maxilla (19%) sites. These results indicate that a lateral measuring site may provide a suitable addition to dorsal midline measurements.

Introduction: Preservation of life, preservation of limb, and preservation of eyesight are the priorities for military medical personnel when attending to casualties. The incidences of eye injuries in modern warfare have increased significantly, despite personal eye equipment for service members. Serious eye injuries are often overlooked or discovered in a delayed fashion because they accompany other life- and limb-threatening injuries, which are assigned a higher priority. Prehospital military ocular trauma care is to shield the eye and evacuate the casualty to definitive ophthalmic care as soon as possible, with exceptions for treatment of ocular chemical injury and orbital compartment syndrome. Retrospective analysis of eye injuries in recent conflicts identified gaps in clinical capabilities with up to 96% of ocular injuries being suboptimally managed. Ocular compartment syndrome (OCS) is a complication associated with orbital hemorrhage, where significant morbidity occurs as a result of increasing intracompartment pressure. The ischemic tolerance of the retina and optic nerve is approximately 90 minutes, so OCS must be rapidly diagnosed and aggressively treated through lateral canthotomy/cantholysis (LC/C) to prevent permanent vision loss. LC/C procedures consist of using hemostats to crush the lateral canthal fold and cutting the lateral canthal tendon from the inferior crus to relieve increasing intracompartment pressure. The purpose of this study was to examine the baseline capabilities of military physicians and surgeons to accurately and independently perform the LC/C procedures and identify performance gaps that could be closed through focused professional development activities.Materials and Methods: This study received institutional review board approval at our institution. A total of 60 subjects voluntarily participated in the study from emergency medicine (15), general surgery (28), and ophthalmology (17). All procedural assessments were performed 1:1 by expert faculty ocular trauma specialists using a high-reliability eye trauma simulator (Sonalysts, Inc.). The competency standard was set at independent and accurate completion of all procedural components and all critical procedural components. Analyses were performed using descriptive statistics and analysis of variance to examine between-group differences (P < 0.05).Results: There was a significant difference between the total score performance and the critical score performance for the three groups (P < 0.001). Outcomes indicate a significant linear relationship between the expertise level of the clinical provider and the procedural performance of LC/C. Outcomes demonstrate the baseline surgical capabilities of the general surgeons transferred to LC/C performance; however, they were unfamiliar with the anatomy and the procedural techniques and requirements. The group of emergency medicine participants demonstrated performance gaps not only in the same areas as the general surgeons but also in their baseline surgical abilities. This suggests that different professional development activities are necessary for surgeons and physicians tasked with performing LC/V procedures.Conclusions: We identified significant performance gaps among emergency medicine physicians, general surgeons, and ophthalmologists in their abilities to recognize and treat OCS through LC/C procedures. These sight-saving procedures are a critical competency for forward-situated clinicians in expeditionary contexts. We identified the need for targeted approaches to professional development for closing the performance gaps for both emergency medicine physicians and general surgeons. [ABSTRACT FROM AUTHOR]

This study examined phonetic backward transfer in 'Glaswasians', the ethnolinguistic minority of first-generation bilingual immigrant Indians in Glasgow (Scotland), who present a situation of contact between their native languages of Hindi and Indian English (L1s) and the dominant host language and dialect, Glaswegian English (L2). This was examined in relation to the Revised Speech Learning Model (SLM-r) and Speech Accommodation Framework. These predict that the migrants' L1 sound categories can either shift to become more Glaswegian-like ('assimilation' or 'convergence') or exaggeratedly Indian-like ('dissimilation' or 'divergence') or remain unchanged. The effect of Indian and Glaswegian Contact on transfer was also investigated. Two control groups (Indians and Glaswegians) and the experimental group (Glaswasians) were recorded reading English and Hindi sentences containing multiple phones which were examined for multiple phonetic features (/t/—VOT, /l/—F2-F1 difference, /b d g/—Relative Burst Intensity). In both languages, Glaswasian /t/ and /g/ became more Glaswegian-like (assimilation), whereas F2-F1 difference in /l/ became exaggeratedly Indian-like (dissimilation). Higher Indian Contact was associated with more native-like values in /t/ and /l/ in Hindi but had no influence on /g/. Higher Glaswegian Contact was related to increased assimilation of /g/ in English but had no effect on /l/ and /t/. [ABSTRACT FROM AUTHOR]

Most social species self-organize into dominance hierarchies1,2, which decreases aggression and conserves energy3,4, but it is not clear how individuals know their social rank. We have only begun to learn how the brain represents social rank5-9 and guides behaviour on the basis of this representation. The medial prefrontal cortex (mPFC) is involved in social dominance in rodents7,8 and humans10,11. Yet, precisely how the mPFC encodes relative social rank and which circuits mediate this computation is not known. We developed a social competition assay in which mice compete for rewards, as well as a computer vision tool (AlphaTracker) to track multiple, unmarked animals. A hidden Markov model combined with generalized linear models was able to decode social competition behaviour from mPFC ensemble activity. Population dynamics in the mPFC predicted social rank and competitive success. Finally, we demonstrate that mPFC cells that project to the lateral hypothalamus promote dominance behaviour during reward competition. Thus, we reveal a cortico-hypothalamic circuit by which the mPFC exerts top-down modulation of social dominance.

This paper reconstructs Proto-Naish initials with lateral main consonants using data from three Naish languages: Lijiangba Naxi (LJ), Malimasa (MM), and Yongning Na (YN). The methodology of using conservative languages, such as Written Tibetan, Burmese, and rGyalrong, in interpreting sound correspondences is emphasized. At least five lateral initials should be reconstructed to Proto-Naish. Initial correspondences relevant to laterals are also discussed. [ABSTRACT FROM AUTHOR]

Lateral lumbar interbody fusion (LLIF) is a popular technique as it allows for the placement of a large interbody implant through a retroperitoneal, transpsoas working corridor. Historically, the interbody is placed with the patient in lateral decubitus and then repositioned to prone for the posterior instrumentation. While this has been an effective and successful technique, removing the interoperative flip would improve the efficiency of these cases. This has led to modified LLIF approaches including single-position prone LLIF (pLLIF). This modification has shown to be an efficient and powerful technique; however, learning to navigate the LLIF approach in the prone position has its own challenges. The purpose of this article is to provide a detailed description of our pLLIF technique while simultaneously introducing surgical tips to overcome the challenges of the approach and optimize the implantation of the interbody device. Novel Techniques & Technology. [ABSTRACT FROM AUTHOR]

Aim: When young patients are congenitally missing anterior teeth, different treatment modalities can be used to complement the dental arch. This article proposes a new treatment modality for the replacement of anterior teeth, the cantilever contact‐point resin bonded bridge (CCP‐RBB). Materials and Methods: In this proof of principle study, CCP‐RBB's delivered by one operator were clinically assessed. Patients who were missing maxillary incisors and had suitable intra‐oral conditions for a contact‐point cantilever RBB were included. Three cases are presented to describe all adhesive steps. This proof of principle clinical study is presented with up to 60 months follow‐up of the cantilever contact resin bonded bridges. Results: A total of 19 CCP‐RBB's were evaluated after a mean period of 29.8 months. None of the restorations exhibited failure, carious lesions or fractures during the follow‐up periods, demonstrating an absence of restoration debonding or the need for repair. Conclusion: The new cantilever contact‐point resin bonded bridge exhibited an excellent treatment modality without failure or debonding up to 5 years. More and extended duration in vivo studies are needed to evaluate this new treatment modality. Clinical Significance: In this proof of principle the new cantilever contact‐point resin bonded bridge obtained excellent results up to 5 years of clinical follow‐up. [ABSTRACT FROM AUTHOR]

The article examines the issue of preschool teachers professional training, its artistic component in particular. The need for an innovator teacher's training who, in accordance with the pace of world changes, is ready to modernize the educational process, has been updated; a conscious understanding of the education of a creative, free and multifaceted personality by introducing it to the world of art and possesses the necessary methodological tools. It was noted that an artistic interaction with preschool age children needs a modified logical and sequential support. A theoretical analysis of studying an issue of artistic and creative interaction between teachers and early and preschool age children in native and foreign scientific literature is presented. The position of the need to form preschool children's artistic and creative competence through appealing to their sensory sphere, and the development of empathy is substantiated. The toolkit for tasks implementation of early age and preschool children art-world is revealed, namely, art communication is characterized as a form of integrated interaction between an adult and a child, which contains elements of an artistically productive, musical, theatrical component and in which any of these components can dominate or unfold separately. Effective means of preschool teachers training to conduct art-communication have been determined, in particular, clusters of artcommunication (mind map) have been identified according to the algorithm «I hear - see - feel - know - act». The results of the ascertainment stage of the research on the readiness of creation and implementation of art-communication clusters in the educational process of kindergarten by preschool teachers are described. The criteria for the formation of the skills of moderating clusters of art communication by teachers of kindergarten are outlined: motivational-emotional, knowledge-theoretical, reflective-empathetic, practical-active. Empirical research methods are quantitatively and qualitatively characterized: questionnaires using Google form online resource; a method of pedagogical observation of teachers' activities; an interviewing. It was found out that the middle (lateral - close to the middle) and low (juvenile - hidden) levels prevail among the respondents. [ABSTRACT FROM AUTHOR]

Purpose: In patients with monocompartmental knee osteoarthritis, unicompartmental knee arthroplasty (UKA) can be performed. This study compared the medial versus lateral UKA in patients with monocompartimental knee arthroplasty. It was hypothesised that both implants achieve a similar outcome in OKS. Methods: The UKAs were fixed-bearing medial PPK (Zimmer-Biomet, Warsaw, Indiana, USA) and fixed-bearing lateral Zuk (Lima Corporate, Udine, Italy). An intraarticular drain was placed and removed on the first postoperative day. Enoxaparin sodium 4000 units subcutaneously daily for 45 days was used as thromboembolic prophylaxis. The Italian version of the OKS was used for the clinical assessment. The following complications were also recorded: anterior knee pain, infection and revision surgeries. Results: Data from 203 patients were collected. The mean age of the patients was 68.9 ± 6.7 years and the mean BMI was 28.1 ± 4.1 kg/m2. The mean OKS on admission was 22.1 ± 4.5 points. On admission, women, patients older than 70 years, and those with a BMI lower than 28 kg/m2 who underwent lateral UKA evidenced lower OKS. At the last follow-up, 26.7 and 26.9 months for the lateral and medial UKA, respectively, no between groups difference in OKS was evidenced. No patients experienced complications. Conclusion: Medial and lateral UKA achieve similar outcomes in OKS at a minimum of two years of follow-up. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the graft maturation and safety of single-incision bone bridge lateral meniscus allograft transplantation (LMAT). Methods: This study involved 35 patients who underwent LMAT between 2019 and 2020. All patients completed at least 2 years of follow-up (median 34 months; range 24–43) and underwent preoperative magnetic resonance imaging (MRI) to assess the trajectory safety of the leading suture passer and all-inside suture instrument (Fast-Fix). Graft status was evaluated according to the Stoller classification. Results: Based on preoperative MRI measurements, the expected trajectory of the leading suture passer did not transect the common peroneal nerve (CPN), with the closest distance between the expected trajectory and CPN being 1.4 mm and the average distance being 6.8 ± 3.2 mm. The average distance from the lateral meniscal posterior horn (LMPH) to the popliteal neurovascular bundle (PNVB) was 7.4 ± 2.6 mm and the nearest was 4.8 mm. The expected trajectory of the all-inside suturing instrument did not transect the PNVB when the distance was at least 12 mm, from the most lateral margin of the posterior cruciate ligament (PCL). Grade 3 signal intensity in the posterior third of the allograft on MRI was observed in 6 of 35 (17.1%) patients. Amongst the grade 3 signal intensities in the posterior one-third of the allografts, 3 of the 35 (8.5%) LMATs had a distorted contour. Conclusion: The single-incision bone bridge LMAT technique introduced in this study is a convenient approach that preserves neurovascular safety and provides good results for the distortion of the posterior horn of the allograft and graft maturation. The safety zone for the penetrating devices during the procedure extended from 12 mm laterally to the most lateral margin of the PCL to the medial margin of the popliteal hiatus. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

Abstract Introduction Tympanoplasty is a surgical method, to eradicate middle ear infection and improve its function. In tympanoplasty graft can be by overlay or underlay technique. In underlay technique the graft material can be placed either medial or lateral to the handle of malleus. Objective: To compare the outcome of the surgery when the temporalis fascia graft is placed medial or lateral to the handle of malleus, in terms of complete take up of the graft and hearing improvement after the surgery. Materials & methods A prospective and comparative hospital-based study was done in the Otorhinolaryngology (ENT) department of a tertiary referral hospital of Kolkata, from 1st January, 2021 to 30th June, 2022 (18 months). 60 patients were included in the study. Results We found that association of tympanic membrane status with group was not statistically significant after 1 month of surgery (p=1.0000) and after 3 months of surgery (p=0.6711). Distribution of mean postoperative hearing gain after 3 months of surgery with group was not statistically significant (p=0.3020). Conclusion We found both the techniques are equally effective in terms of complete graft take up and post operative hearing gain after 3 months follow up.

Experimental research controls for past experience, yet prior experience influences how we learn. Here, we tested whether we could recruit a neural population that usually encodes rewards to encode aversive events. Specifically, we found that GABAergic neurons in the lateral hypothalamus (LH) were not involved in learning about fear in naïve rats. However, if these rats had prior experience with rewards, LH GABAergic neurons became important for learning about fear. Interestingly, inhibition of these neurons paradoxically enhanced learning about neutral sensory information, regardless of prior experience, suggesting that LH GABAergic neurons normally oppose learning about irrelevant information. These experiments suggest that prior experience shapes the neural circuits recruited for future learning in a highly specific manner, reopening the neural boundaries we have drawn for learning of particular types of information from work in naïve subjects.

The contribution of heat transfer mechanisms for different configurations of opposed flow flame spread on cast PMMA is presented. Three opposed flow flame spread scenarios are considered, each in a quiescent atmosphere: downward spread on a vertical surface, buoyant horizontal spread (i.e. a pool fire-type spread), and lateral spread along a vertical surface. Video analysis and temperature measurements were used to determine flame spread rates; average flame spread rates were found to be 2.67, 2.54, and 3.54 mm/min for downward, horizontal, and lateral spread, respectively. These differences result from the varying magnitudes of the heat transfer mechanisms (e.g. gas-phase heat transfer and conduction through the solid) due to the changes in the flame characteristics. Past studies have investigated these regimes of flame spread, but have not directly compared experiments from the configurations used here to identify the relative importance of each heat transfer mechanism. Using temperature measurements, the thermal gradient, and hence conductive heat fluxes through the solid, were quantified. This allowed the different rates of heat transfer to be compared across each configuration. Downward and horizontal flame spread displayed similar flame spread rates and similar heat transfer contributions for both the gas phase and solid phase. However, lateral flame spread displayed characteristically higher rates of gas-phase heat transfer compared to downward and horizontal. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Soil Sciences & Agricultural Engineering is the property of Egyptian National Agricultural Library (ENAL) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Soil Sciences & Agricultural Engineering is the property of Egyptian National Agricultural Library (ENAL) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Despite their precarious behavioral classification (benign and low grade on histopathology yet behaviorally malignant), great strides have been taken to improve prognostication and treatment paradigms for patients with skull base chordoma. With respect to surgical techniques, lateral transcranial (TC) approaches have traditionally been used, however endoscopic endonasal approaches (EEA) have been advocated for midline lesions. Nonetheless, due to the rarity of this pathology (0.2% of all intracranial neoplasms), investigations within the literature remain limited to small retrospective series. Furthermore, radiotherapeutic treatments investigated to date have proven largely ineffective. Methods: Accordingly, we performed a systematic review in order to profile surgical and survival outcomes for skull base chordoma. Fixed and random-effect meta-analyses were performed for categorical variables including GTR, STR, 5-year OS, 10-year OS, 5-year PFS, and 10-year PFS. Additionally, we pooled eligible studies for formal meta-analysis to compare outcomes by surgical approach (lateral versus midline). Statistical analyses were performed using R Studio 'metafor' package or Cochrane Review Manager. Furthermore, meta-analysis of pooled mortality rates and sub-analyses of operative margin and surgical complications were used to compare midline versus lateral approaches via the Mantel-Haenszel method. We considered all p-values < 0.05 to be statistically significant. Results: Following the systematic search and screen, 55 studies published between 1993 and 2022 reporting data for 2453 patients remained eligible for analysis. Sex distribution was comparable between males and females, with a slight predominance of male-identifying patients (0.5625 [95% CI: 0.5418; 0.3909]). Average age at diagnosis was 42.4 ± 12.5 years, while average age of treatment initiation was 43.0 ± 10.6 years. Overall, I2 value indicated notable heterogeneity across the 55 studies [I2 = 56.3% (95%CI: 44.0%; 65.9%)]. With respect to operative margins, the rate of GTR was 0.3323 [95% CI: 0.2824; 0.3909], I2 = 91.9% [95% CI: 90.2%; 93.4%], while the rate of STR was significantly higher at 0.5167 [95% CI: 0.4596; 0.5808], I2 = 93.1% [95% CI: 91.6%; 94.4%]. The most common complication was CSF leak (5.4%). In terms of survival outcomes, 5-year OS rate was 0.7113 [95% CI: 0.6685; 0.7568], I2 = 91.9% [95% CI: 90.0%; 93.5%]. 10-year OS rate was 0.4957 [95% CI: 0.4230; 0.5809], I2 = 92.3% [95% CI: 89.2%; 94.4%], which was comparable to the 5-year PFS rate of 0.5054 [95% CI: 0.4394; 0.5813], I2 = 84.2% [95% CI: 77.6%; 88.8%] and 10-yr PFS rate of 0.4949 [95% CI: 0.4075; 0.6010], I2 = 14.9% [95% CI: 0.0%; 87.0%]. There were 55 reported deaths for a perioperative mortality rate of 2.5%. The relative risk for mortality in the midline group versus the lateral approach group did not indicate any substantial difference in survival according to laterality of approach (-0.93 [95% CI: -1.03, -0.97], I2 = 95%, (p < 0.001). Conclusion: Overall, these results indicate good 5-year survival outcomes for patients with skull base chordoma; however, 10-year prognosis for skull base chordoma remains poor due to its radiotherapeutic resistance and high recurrence rate. Furthermore, mortality rates among patients undergoing midline versus lateral skull base approaches appear to be equivocal. [ABSTRACT FROM AUTHOR]

Researchers can investigate many aspects of animal ecology through noninvasive photo–identification. Photo–identification is becoming more efficient as matching individuals between photos is increasingly automated. However, the convolutional neural network models that have facilitated this change need many training images to generalize well. As a result, they have often been developed for individual species that meet this threshold. These single‐species methods might underperform, as they ignore potential similarities in identifying characteristics and the photo–identification process among species.In this paper, we introduce a multi‐species photo–identification model based on a state‐of‐the‐art method in human facial recognition, the ArcFace classification head. Our model uses two such heads to jointly classify species and identities, allowing species to share information and parameters within the network. As a demonstration, we trained this model with 50,796 images from 39 catalogues of 24 cetacean species, evaluating its predictive performance on 21,192 test images from the same catalogues. We further evaluated its predictive performance with two external catalogues entirely composed of identities that the model did not see during training.The model achieved a mean average precision (MAP) of 0.869 on the test set. Of these, 10 catalogues representing seven species achieved a MAP score over 0.95. For some species, there was notable variation in performance among catalogues, largely explained by variation in photo quality. Finally, the model appeared to generalize well, with the two external catalogues scoring similarly to their species' counterparts in the larger test set.From our cetacean application, we provide a list of recommendations for potential users of this model, focusing on those with cetacean photo–identification catalogues. For example, users with high quality images of animals identified by dorsal nicks and notches should expect near optimal performance. Users can expect decreasing performance for catalogues with higher proportions of indistinct individuals or poor quality photos. Finally, we note that this model is currently freely available as code in a GitHub repository and as a graphical user interface, with additional functionality for collaborative data management, via Happywhale.com. [ABSTRACT FROM AUTHOR]

Purpose: Due to low incidence of isolated lateral osteoarthritis (OA), there are limited data on whether a fixed-bearing (FB) or a mobile-bearing (MB) design is superior for lateral unicompartmental knee replacement (UKR). The aim of this matched-pairs analysis was to compare both designs in terms of implant survival and clinical outcome. Methods: Patients who received MB-UKR (Group A) and FB-UKR (Group B) at a single centre were matched according to gender, age at time of surgery and body mass index (BMI). Survivorship analysis was performed with the endpoint set as "revision for any reason". Clinical outcome was assessed using the Oxford knee score (OKS), visual analogue scale for pain (VAS), patients' satisfaction, University of California Los Angeles activity scale (UCLA) and the Tegner activity score (TAS). Results: A total of 60 matched pairs were included with a mean follow-up (FU) of 3.4 ± 1.3 (range 1.2–5.0) years in Group A and 2.7 ± 1.2 (range 1.0–5.0) years in Group B. Survivorship between both groups differed significantly (Group A: 78.7%; Group B: 98.3%, p = 0.003) with bearing dislocation being the most common reason for revision in Group A (46.2%). The relative and absolute risk reduction were 92.2% and 20%, respectively, with 5 being the number needed to treat. There were no differences in OKS (Group A: 41.6 ± 6.5; Group B: 40.4 ± 7.7), VAS (Group A: 2.9 ± 3.2; Group B: 1.6 ± 2.2), UCLA (Group A: 5.7 ± 1.3; Group B: 5.9 ± 1.8) and TAS (Group A: 3.0 ± 1.0; Group B: 3.1 ± 1.2) between both groups on follow-up. Conclusion: Despite modern prosthesis design and surgical technique, implant survival of lateral MB-UKR is lower than that of FB-UKR on the short- to mid-term due to bearing dislocation as the most common cause of failure. Since clinical results are equivalent in both groups, FB-UKR should be preferred in treatment of isolated lateral OA. Level of evidence: Retrospective case–control study, Level III. [ABSTRACT FROM AUTHOR]

The current study investigated the merger-in-progress between word-initial nasal and lateral consonants in Fuzhou Min, examining the linguistic and social factors that modulate the merger. First, the acoustic cues to the l-n distinction were examined in Fuzhou Min. Acoustic analyses suggested a collapse of phonemic contrast between prescriptive L and N (phonemes in the unmerged system), with none of the six acoustic cues showing any difference across L and N. Linear discriminant analysis did identify acoustically distinct [l] and [n] tokens, although the mapping onto the phonetic space of prescriptive L and N substantially overlapped. Speakers of all ages and both genders tended to produce [l], and low vowels correlated with more [n]-like classification. In perception, AX discrimination data showed Fuzhou Min listeners confused both prescriptive L and N and acoustic [l] and [n]. Greater sensitivity to the acoustic differences occurred in the context of low vowels and a nasal coda, supported by the acoustics of the stimuli, and younger listeners were more sensitive to the difference between [l] and [n] than older listeners. In two-alternative forced choice (2AFC) identification, Fuzhou Min listeners also identified the merged form as L more frequently than N, with more L responses elicited in the context of low vowels and in the absence of nasal codas. Overall, although Fuzhou Min speakers produced some acoustically distinct [l] and [n] tokens in the context of a sound merger, these productions did not map onto prescriptive L and N. In addition, younger listeners were more sensitive to the acoustic distinction than older listeners, suggesting an emerging acoustic contrast possibly arising due to contact with Mandarin. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer behaves differently according to the primary tumor location. Medially located breast tumors were thought to have a worse prognosis than laterally located breast tumors. Studies showed that central tumors tend to present at a relatively more advanced stage with more features of a locally advanced disease. Lateral, medial, and central breast tumors are not well studied in Bahrain and worldwide; therefore, we aimed to clarify the incidence & clinicopathological characteristics of each and to explore the impact of primary tumor location on the prognosis. Materials and Methods: This is a cross-sectional, retrospective review involving 233 consecutive breast cancer Bahraini female patients that were divided into 3 groups in relation to primary tumor location: lateral, medial, and central. Pertinent clinicopathological variables were analyzed in relation to the primary tumor localization in the breast. Results: Lateral breast cancer patients (N=133, 57.1%), medial breast cancer patients (N=64, 27.5%), and central breast cancer patients (N=36, 15.4%). Chi-square test showed a significant association between central tumor location and tumor size (p-value=0.008), lymph node status (p-value=0.010), and tumor stage (p-value=<0.001). Conclusion: This is the first study from Bahrain regarding the possible impact of primary tumor location on the outcome of breast cancer. Although the lateral breast tumors have the highest incidence, the central tumors were more likely to present with a locally advanced disease, larger than 5 cm tumor size, and axillary lymph node metastasis. They also tended to have a higher ratio of lymphovascular invasion and HER2 over expression. Multicenter meta-analysis is needed to evaluate the real impact of primary tumor location and internal mammary lymph node evaluation on the outcome of breast cancer. [ABSTRACT FROM AUTHOR]