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Background: Natural head position (NHP), pharyngeal airway and maxillofacial growth pattern are correlated. The author's previous studies proved that following surgical correction of Skeletal Class II malocclusion, the over‐extended NHP returned upright, and the pharyngeal airway space (PAS) dimension expanded. Objective: The present study compares the post‐operative change in NHP and PAS after orthognathic surgery in Skeletal Class II and III malocclusion patients. Methods: Patients receiving orthognathic procedures to correct Skeletal Class II or III malocclusions were reviewed in this retrospective study. Pre‐operative and 6‐week post‐operative cone‐beam computed tomography datasets were collected. Variables representing the craniofacial pattern, the NHP and the PAS were measured three‐dimensionally. Post‐operative variables were compared with their pre‐operative counterparts using either repeat‐measure 2‐way analysis of variance or Wilcoxon matched‐pairs signed rank test. Results: Thirty cases of Skeletal Class II malocclusion and 13 cases of Skeletal Class III malocclusion were collected. Preoperatively, the inter‐group differences were significant in craniofacial pattern (68.14 ± 3.552 degree vs. 79.63 ± 2.497 degree, p <.0001) and the NHP (68.77 ± 11.02 degree vs. 82.83 ± 7.738 degree, p =.0002) while not significant in PAS; after surgery, the intergroup differences in craniofacial pattern and the NHP between groups decreased, and the PAS increased in both groups. Conclusion: Orthognathic surgery may improve compromised NHP and increase PAS in Skeletal Class II and III malocclusion patients. [ABSTRACT FROM AUTHOR]

Purpose: We examined magnetic field dependent SNR gains and ability to capture them with multichannel receive arrays for human head imaging in going from 7 T, the most commonly used ultrahigh magnetic field (UHF) platform at the present, to 10.5 T, which represents the emerging new frontier of >10 T in UHFs. Methods: Electromagnetic (EM) models of 31‐channel and 63‐channel multichannel arrays built for 10.5 T were developed for 10.5 T and 7 T simulations. A 7 T version of the 63‐channel array with an identical coil layout was also built. Array performance was evaluated in the EM model using a phantom mimicking the size and electrical properties of the human head and a digital human head model. Experimental data was obtained at 7 T and 10.5 T with the 63‐channel array. Ultimate intrinsic SNR (uiSNR) was calculated for the two field strengths using a voxelized cloud of dipoles enclosing the phantom or the digital human head model as a reference to assess the performance of the two arrays and field depended SNR gains. Results: uiSNR calculations in both the phantom and the digital human head model demonstrated SNR gains at 10.5 T relative to 7 T of 2.6 centrally, ˜2 at the location corresponding to the edge of the brain, ˜1.4 at the periphery. The EM models demonstrated that, centrally, both arrays captured ˜90% of the uiSNR at 7 T, but only ˜65% at 10.5 T, leading only to ˜2‐fold gain in array SNR in going from 7 to 10.5 T. This trend was also observed experimentally with the 63‐channel array capturing a larger fraction of the uiSNR at 7 T compared to 10.5 T, although the percentage of uiSNR captured were slightly lower at both field strengths compared to EM simulation results. Conclusions: Major uiSNR gains are predicted for human head imaging in going from 7 T to 10.5 T, ranging from ˜2‐fold at locations corresponding to the edge of the brain to 2.6‐fold at the center, corresponding to approximately quadratic increase with the magnetic field. Realistic 31‐ and 63‐channel receive arrays, however, approach the central uiSNR at 7 T, but fail to do so at 10.5 T, suggesting that more coils and/or different type of coils will be needed at 10.5 T and higher magnetic fields. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance imaging (MRI) has become an important diagnostic tool for paediatric patients. The association between dental restorations and MRI artefacts/distortions, however, is unclear. Aim: To investigate the association between dental restorations and artefacts in head MRI in children. Design: This retrospective analysis included patients who underwent head MRI and dental examination at Ramathibodi Hospital from January 2015 to March 2021. From dental records and dental radiographs, a dentist reviewed the amount and type of restorative materials used. Two radiologists examined the MRI scans in five sequences for the presence of distortions and quantified the magnitude and grading of any artefacts. Results: Ninety‐four patients aged 3–15 years were included. Twenty‐four patients who received preformed metal crowns (PMCs) had MRI distortions. Subjects with no restorations or with tooth‐coloured material or amalgam restorations or both did not exhibit distortions. The number of PMCs was related to the size of an artefact. Almost all distortions were confined to the oral cavity and maxillary sinus and did not affect the diagnostic brain area. Conclusion: Among the commonly used dental restorative materials for children, only PMCs were associated with artefacts on head MRI scans. [ABSTRACT FROM AUTHOR]

Summary A 20‐year‐old Irish Sport Horse gelding was presented to the Royal Veterinary College Equine Referral Hospital for investigation of left‐sided epistaxis, depression and gait abnormalities of approximately 1 month duration. Physical examination and cranial nerve evaluation were unremarkable. A small amount of haemorrhagic discharge was noted from the left nostril. Gait evaluation was suggestive of proprioceptive deficits. Computed tomography (CT) identified a mass lesion within the left conchofrontal and sphenopalatine sinuses extending through the cribriform plate into the calvarium. Histopathology of the mass revealed a neuroendocrine neoplasm, for which a diagnosis of esthesioneuroblastoma was favoured. This case highlights the usefulness of CT for the identification and extent of an intracranial mass and therefore its prognosis, however, histopathological examination was necessary to confirm the diagnosis. [ABSTRACT FROM AUTHOR]

Background and aim: Head and neck nuclear protein of testis carcinoma (HN‐NUT) is a rare form of carcinoma diagnosed by NUT immunohistochemistry positivity and/or NUTM1 translocation. Although the prototype of HN‐NUT is a primitive undifferentiated round cell tumour (URC) with immunopositivity for squamous markers, it is our observation that it may assume variant histology or immunoprofile. Methods: We conducted a detailed clinicopathological review of a large retrospective cohort of 30 HN‐NUT, aiming to expand its histological and immunohistochemical spectrum. Results: The median age of patients with HN‐NUT was 39 years (range = 17–86). It affected the sinonasal tract (43%), major salivary glands (20%), thyroid (13%), oral cavity (7%), larynx (7%), neck (7%) and nasopharynx (3%). Although most cases of HN‐NUT (63%) contained a component of primitive URC tumour, 53% showed other histological features and 37% lacked a URC component altogether. Variant histological features included basaloid (33%), differentiated squamous/squamoid (37%), clear cell changes (13%), glandular differentiation (7%) and papillary architecture (10%), which could co‐exist. While most HN‐NUT were positive for keratins, p63 and p40, occasional cases (5–9%) were entirely negative. Immunopositivity for neuroendocrine markers and thyroid transcription factor‐1 was observed in 33 and 36% of cases, respectively. The outcome of HN‐NUT was dismal, with a 3‐year disease specific survival of 38%. Conclusions: HN‐NUT can affect individuals across a wide age range and arise from various head and neck sites. It exhibits a diverse spectrum of histological features and may be positive for neuroendocrine markers, potentially leading to underdiagnosis. A low threshold to perform NUT‐specific tests is necessary to accurately diagnose HN‐NUT. [ABSTRACT FROM AUTHOR]

Background: Cervical posture affects swallowing function through contractile and non‐contractile structures. Craniocervical flexor endurance training (CCFET), which focuses on the activation of deep cervical muscles, is used to ensure cervical posture stability. Objective: The aim of this study was to investigate the effect of CCFET on the suprahyoid muscles (SH), which play an important role in swallowing function. Methods: Eighty healthy individuals (52 female and 28 male, mean age 21.77 ± 1.81 years) were recruited and randomly assigned to groups that underwent either deep cervical flexor (DCF) training with a pressure biofeedback unit (CCFET group, n = 41) or no intervention (control group, n = 39). The intervention was applied for 4 weeks (five sessions per week). Static endurance and activation of DCF muscles (Craniocervical Flexion Test, CCFT), tragus–wall distance (TWD) for forward head posture and surface electromyographic (sEMG) activation of suprahyoid muscles were evaluated. Results: The endurance and activation of the DCF muscles were significantly increased in the CCFET group (p = <.001). In the CCFET group, TWD significantly lower than the control group (p = <.001) Peak SH amplitude and mean SH amplitude were lower in the CCFET group compared to the control group (p =.013, p =.003). Conclusion: The study shows that 4 weeks of CCFET reduced SH muscle activation, allowing the same work to be done with fewer motor units. CCFET can be included in rehabilitation programs as an additional method that has an effect on the muscles involved in swallowing by providing cervical motor control. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the functional and prognostic outcomes associated with the internal mammary artery perforator (IMAP) flap in various head and neck defect repairs, given the current lack of clarity on its effectiveness. We performed a systematic review of various databases: PubMed, Embase, Scopus, Web of Science, and ScienceDirect using keywords such as "Internal mammary artery perforator flap" and "IMAP." Screening and data extractions were performed by two individual reviewers. Articles were considered eligible if they included sufficient information on IMAP flap features, their applications in the head and neck, and outcomes. From 264 articles analyzed, 24 studies were included for qualitative analysis. Out of which, 125 patients who received internal mammary artery perforator flaps were included. Most of the patients, 103 (88%), received pedicled IMAP flaps, and 22 (12%) received IMAP free flaps. The second internal mammary artery (IMA) was favored as the single perforator (81.5%), with the combination of the first and second IMA being the primary choice for dual perforators (92.5%). IMAP flaps were predominantly single perforator flaps (65%), with 35% being dual perforator flaps. Among various applications, IMAP flaps are commonly employed in the reconstruction of neck defects (25.5%), pharyngocutaneous fistula repair (20.8%), and burn scar contracture restoration (8%). Only seven (5.6%) patients had flap complications, including venous congestion (1.6%), partial necrosis (1.6%), complete necrosis (1.6%), and incision dehiscence (0.8%). Donor sites were predominantly closed by the primary closure (92%). 3.2% of donor sites had minor complications. The average follow‐up was 12.6 (IQR: 6–18) months. This systematic review highlights the effectiveness and safety of IMAP flaps in head and neck reconstruction, with positive outcomes and minimal complications. [ABSTRACT FROM AUTHOR]

Background: Medication related osteonecrosis of the jaw (MRONJ) requiring free flap (FF) reconstruction is uncommon with limited reported findings. Methods: Multicenter, retrospective case series of 49 consecutive adult patients presenting with advanced MRONJ requiring FF reconstruction from 2010 to 2022. Perioperative complications and outcomes were analyzed. Results: Eighty‐two percent (n = 40) of cases were of the mandible and 18% (n = 9) were of the maxilla. The mean follow‐up was 15 months (±19.6). The majority of FF survived (96%, n = 47). FF reconstructions of the maxilla were more likely to require postoperative debridement (56%, 95% CI [27, 81%] vs. 15%, 95% CI [7, 25%], p = 0.008) or develop intraoral bone exposure (56%, 95% CI [27, 81%] vs. 18%, 95% CI [9, 27%], p = 0.02). Most patients (71%, n = 35) received preoperative antibiotics which was associated with a higher rate of FF survival (100% vs. 86%, 95% CI [60, 96%], p = 0.02) and fewer complications. Conclusions: Patients undergoing FF reconstruction for MRONJ do well with high rates of FF success. MRONJ of the maxilla have a higher rate of some complications. Preoperative antibiotics correlated with higher FF survival and fewer postoperative complications. [ABSTRACT FROM AUTHOR]

Head and neck cancer (HNC) is the seventh most common cancer globally, resulting in 440 000 deaths per year. While there have been advancements in chemoradiotherapy and surgery, relapse occurs in more than half of HNCs, and these patients have a median survival of 10 months and a 2‐year survival of < 20%. Only a subset of patients displays durable benefits from immunotherapies in metastatic and recurrent HNC, making it critical to understand the tumor microenvironment (TME) underpinning therapy responses in HNC. To recognize biological differences within the TME that may be predictive of immunotherapy response, we applied cutting‐edge geospatial whole‐transcriptome profiling (NanoString GeoMx Digital Spatial Profiler) and spatial proteomics profiling (Akoya PhenoCycler‐Fusion) on a tumor microarray consisting of 25 cores from 12 patients that included 4 immunotherapy‐unresponsive (8 cores) and 2 immunotherapy‐responsive patients (5 cores), as well as 6 immunotherapy naïve patients (12 cores). Through high‐plex, regional‐based transcriptomic mapping of the tumor and TME, pathways involved with the complement system and hypoxia were identified to be differentially expressed in patients who went on to experience a poor immunotherapy response. Single‐cell, targeted proteomic analysis found that immune cell infiltration of the cancer cell mass and interactions of CD8 T cells with tumor and other immune cells were associated with positive immunotherapy response. The relative abundance of specific tumor phenotypes and their interactions with various immune cells was identified to be different between response groups. This study demonstrates how spatial transcriptomics and proteomics can resolve novel alterations in the TME of HNC that may contribute to therapy sensitivity and resistance. [ABSTRACT FROM AUTHOR]

This paper tackles the issue of whether syntactic head movement exists in Japanese. Sato & Hayashi (2018) and Sato & Maeda (2021) propose that Verb‐Echo Answers (VEAs), an instance of fragment answers, in Japanese are derived via the so‐called Verb‐stranding TP‐Ellipsis (VTPE; i.e., TP‐ellipsis accompanied by verb‐raising to C), thereby claiming that head movement exists in Japanese as a syntactic operation. In response, this paper argues that pro and Argument Ellipsis (AE) in Japanese sufficiently account for the key observations presented in their works. Specifically, a careful examination of the discourse in each question‐answer pair reveals that the seemingly problematic scope patterns in VEAs do not call for the VTPE analysis. We also show that the unacceptability of voice mismatches in VEAs can be explained by a discourse‐based analysis within the Question Under Discussion framework. Further, we provide an extensive discussion on the alleged evidence against the pro/AE analysis concerning adjunct‐inclusive readings. We show that negative scope reversal effects, which Sato & Maeda (2021) argue occur in VTPE, do not occur between adjuncts and negation in the novel data. Given this, we discuss possible ways to account for the availability of adjunct‐inclusive readings in VEAs with no recourse to VTPE, and suggest avenues for future research. The proposed analyses of VEAs shed new light on intriguing aspects of ellipsis phenomena, which involve complex interactions between syntax, semantics, and pragmatics. [ABSTRACT FROM AUTHOR]

Inkjet is a versatile non‐contact printing technique that uses droplets of ink jetted from nozzles to print on a variety of substrates. Although some modern piezoelectric printheads support high viscosity fluids (>10 cP), they are currently expensive and may not be suited for many benchtop experiments in research environment. Here, the design, fabrication by 3D‐printing (no cleanroom processes or silicon micromachining are involved) and testing of a multi‐purpose single‐nozzle piezoelectric dispenser/printhead for medium‐viscosity fluids (10–60 cP) is reported. Custom control electronics are developed to drive the printhead. The design features a 200 μm diameter nozzle, suitable for nL drop generation with solutions containing nm sized particles, thus allowing the deposition of μm thick layers of functional inks in a single printing pass. The inkjet dispenser is first tested with glycerol solutions, resulting in drops of 1.9–3.6 nL with typical drop velocity of 0.5–1.3 m s−1. The developed piezoelectric dispensing system is then demonstrated in the printing of a two‐layer capacitive sensor, using silver nanoparticle ink (conductive ink) and a transparent encapsulant ink (dielectric ink). The reported piezoelectric dispenser design can be optimized for many research purposes, allowing the dispensing of functional chemicals, materials, and biomolecules. [ABSTRACT FROM AUTHOR]

Introduction: A significant number of head computed tomography (CT) scans are performed annually. However, due to the close proximity of the thyroid gland to the radiation field, this procedure can expose the gland to ionising radiation. Consequently, this study aimed to estimate organ dose, effective dose (ED) and lifetime attributable risk (LAR) of thyroid cancer from head CT scans in adults. Methods: Head CT scans of 74 patients (38 males and 36 females) were collected using three different CT scanners. Age, sex, and scanning parameters, including scan length, tube current–time product (mAs), pitch, CT dose index, and dose‐length product (DLP) were collected. CT‐Expo software was used to calculate thyroid dose and ED for each patient based on scan parameters. LARs were subsequently computed using the methodology presented in the Biologic Effects of Ionizing Radiation (BEIR) Phase VII report. Results: Although the mean thyroid organ dose (2.66 ± 1.03 mGy) and ED (1.6 ± 0.4 mSv) were slightly higher in females, these differences were not statistically significant compared to males (mean thyroid dose, 2.52 ± 1.31 mGy; mean ED, 1.5 ± 0.4 mSv). Conversely, there was a significant difference between the mean thyroid LAR of females (0.91 ± 1.35) and males (0.20136 ± 0.29) (P = 0.001). However, the influencing parameters were virtually identical for both groups. Conclusions: The study's results indicate that females have a higher LAR than males, which can be attributed to higher radiation sensitivity of the thyroid in females. Thus, additional care in the choice of scan parameters and irradiated scan field for female patients is recommended. [ABSTRACT FROM AUTHOR]

Background: Jaw clenching improves dynamic reactive balance on an oscillating platform during forward acceleration and is associated with decreased mean sway speed of different body regions. Objective: It is suggested that jaw clenching as a concurrent muscle activity facilitates human motor excitability, increasing the neural drive to distal muscles. The underlying mechanism behind this phenomenon was studied based on leg and trunk muscle activity (iEMG) and co‐contraction ratio (CCR). Methods: Forty‐eight physically active and healthy adults were assigned to three groups, performing three oral motor tasks (jaw clenching, tongue pressing against the palate or habitual lower jaw position) during a dynamic one‐legged stance reactive balance task on an oscillating platform. The iEMG and CCR of posture‐relevant muscles and muscle pairs were analysed during platform forward acceleration. Results: Tongue pressing caused an adjustment of co‐contraction patterns of distal muscle groups based on changes in biomechanical coupling between the head and trunk during static balancing at the beginning of the experiment. Neither iEMG nor CCR measurement helped detect a general neuromuscular effect of jaw clenching on the dynamic reactive balance. Conclusion: The findings might indicate the existence of robust fixed patterns of rapid postural responses during the important initial phases of balance recovery. [ABSTRACT FROM AUTHOR]

Background: An international multidisciplinary panel of experts aimed to provide consensus guidelines describing the optimal intratumoral and intranodal injection of NBTXR3 hafnium oxide nanoparticles in head and neck squamous cell carcinoma (HNSCC) of the oral cavity, oropharynx, and cervical lymph nodes and to review data concerning safety, feasibility, and procedural aspects of administration. Methods: The Delphi method was used to determine consensus. A 4‐member steering committee and a 10‐member monitoring committee wrote and revised the guidelines, divided into eight sections. An independent 3‐member reading committee reviewed the recommendations. Results: After two rounds of voting, strong consensus was obtained on all recommendations. Intratumoral and intranodal injection was deemed feasible. NBTXR3 volume calculation, choice of patients, preparation and injection procedure, potential side effects, post injection, and post treatment follow‐up were described in detail. Conclusions: Best practices for the injection of NBTXR3 were defined, thus enabling international standardization of intratumoral nanoparticle injection. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Concerns are prevalent about preterm infant long‐term growth regarding plotting low on growth charts at discharge, stunting, underweight, high body fat and subsequent cardiometabolic morbidities.To examine (a) longitudinal growth patterns of extremely and very preterm infants to 3 years corrected age (CA) (outcome), categorised by their birthweight for gestational age: small, appropriate and large for gestational age (SGA, AGA and LGA, respectively) (exposure); and (b) the ability of growth faltering (<−2 z‐scores) to predict suboptimal cognitive scores at 3 years CA.Post‐discharge head, length, weight and weight‐4‐length growth patterns of the PreM Growth cohort study infants born <30 weeks and < 1500 g, who had dietitian and multi‐disciplinary support before and after discharge, were plotted against the World Health Organization growth standard. Infants with brain injuries, necrotising enterocolitis and bronchopulmonary dysplasia were excluded.Of the included 405 infants, the proportions of infants with anthropometric measures > − 2 z‐scores improved with age. The highest proportions <−2 z‐scores for length (24.2%) and weight (24.0%) were at 36 gestational weeks. The proportion with small heads was low by 0 months CA (1.8%). By 3 years CA, only a few children plotted lower than −2 z‐scores for length, weight‐4‐length and weight (<6%). After zero months CA, high weight‐4‐length and body mass index > + 2 z‐scores were rare (2.1% at 3 years CA). Those born SGA had higher proportions with shorter heights (16.7% vs. 5.2%) and lower weights (27.8% vs. 3.5%) at 3 years CA compared to those born AGA. The ability of growth faltering to predict cognitive scores was limited (AUROC 0.42, 95% CI 0.39, 0.45 to 0.52, 95% CI 0.41, 0.63).Although children born <30 weeks gestation without major neonatal morbidities plot low on growth charts at 36 weeks CA most catch up to growth chart curves by 3 years CA. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to conduct a systematic review of head and neck Ewing sarcoma (ES) concerning patients' demographic and clinical features, histopathological findings, treatment, follow‐up, and survival rate. Materials and Methods: An electronic search was undertaken in four databases. Articles describing case reports or case series were included. Outcomes were evaluated by the Kaplan–Meier method along with Cox regression. Results: The search yielded 186 studies describing 227 ES cases. The mean age was 22.7 years, and males were slightly more affected. Interestingly, more than half the cases were diagnosed up to 20 years. The respiratory tract was the most reported site, followed by the jawbones. Clinically, symptomatic swelling or nodules were described, with a mean duration of 4 months. Management involved multimodal treatment regimens. Local recurrence, lymph node and distant metastasis were observed in 10.7%, 12.6%, and 20.3% of cases, respectively. Statistical analysis revealed that older patients with distant metastasis had a lower overall survival rate (p < 0.05). Conclusion: This study provides an overall view of head and neck ES that can assist oral and maxillofacial pathologists with the diagnosis and extend the knowledge of surgeons and oncologists about this condition. [ABSTRACT FROM AUTHOR]

Capybara is considered the largest living rodent and is widespread distributed in the South America and in the Brazilian territory. The purpose of this study was to provide the anatomical description of the brain in the capybara (Hydrochoerus hydrochaeris) using magnetic resonance imaging (MRI). Brains of ten normal capybaras were imaged and sectioned in the anatomical studies. MRI was acquired on 0.25 Tesla equipment, promoting good‐quality images capable to identify and classify the main anatomical structures of clinical interest. MRI reference images were validated by comparing them with gross anatomical sections. The capybara sulci and gyri were named for its similar location and orientation to those described in the previous descriptions in the capybara and in the domestic dog. Capybaras presented prominent cerebral sulcus and gyrus in relation to other caviomorph rodents, but in reduced number when compared to domestic animals and other wild mammals such as elephants and giraffes. The findings of this study indicate that the shape of the capybara brain is remarkably similar to that of the caviomorph rodents with a higher neocortilization. The capybara rhinencephalon was well‐developed implying a good sense of smell. Due to this development of the rhinencephalon, we can suggest that capybara brain is a macrosmatic brain. The MRI and gross anatomical sections of capybara brain may help veterinary researchers and clinicians increase the accuracy of brain MRI scans interpretation in these animals. [ABSTRACT FROM AUTHOR]

Bushizheia yangi O'Flynn & Liu, a euarthropod from the lower Cambrian (Series 2, Stage 3) Chengjiang Konservat‐Lagerstätte, possesses both raptorial frontal appendages sharing traits with stem‐group euarthropods, and deuteropodan characters shared by all extant euarthropods (e.g. dorsal arthrodization and arthropodization of all limbs). Microtomography of new specimens of B. yangi shows previously unknown details of head morphology: a six‐segmented head composed of an ocular segment that carries diminutive paired stalked eyes, a post‐ocular segment with deutocerebral frontal appendages, and four subsequent cephalic segments each bearing a pair of appendages. The phylogenetic position of B. yangi in the euarthropod stem‐group adds support to a six‐segmented head being an ancestral state for Deuteropoda. This study also reports the first occurrence of possible eggs closely associated with B. yangi. The homology of raptorial frontal appendages between lower stem‐group euarthropod radiodonts and deuteropods (i.e. upper stem and crown‐group euarthropods) is strengthened by similarity and phylogenetic continuity between B. yangi, its likely sister taxon Kiisortoqia soperi Stein, from the Sirius Passet Konservat‐Lagerstätte, and other euarthropod taxa. [ABSTRACT FROM AUTHOR]

Background: To assess the frequency of patient‐reported outcomes (PROs) and non‐PROs in randomized controlled trials (RCTs) addressing head/neck cancers. Methods: We included RCTs about interventions to treat head/neck cancers. PubMed was searched on September 16, 2022 and included studies published during three periods (2000–2002, 2010–2012, and 2020–2022). Data on types of outcomes and instruments to measure them were extracted and organized into PROs and non‐PROs, and temporal trends for reporting outcomes were determined. Results: There was a reduction in the frequency of non‐PROs (40% to 22%) and an increase in PROs (5% to 19%) over 20 years. The frequency of reporting both non‐PROs and PROs seemed to be stable over the same period (55% to 58%). A great variety of instruments to measure PROs and non‐PROs was identified. Conclusions: There has been a growth in the types of PROs in more recent years, and they were more frequently reported in RCTs. However, head/neck cancer trials with a combination of PROs and non‐PROs were the most prevalent. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the value of individual laboratory tests and combinations of tests for predicting disease severity. Methods: We retrospectively reviewed 62 patients with space infections in the oral and maxillofacial head and neck regions. Patients were divided into three groups according to severity. Laboratory tests associated with disease severity were identified. Results: As the severity of infection increased, leukocytes, neutrophils, C‐reactive protein (CRP), procalcitonin (PCT), soluble interleukin receptor (sILR) 2, IL6, and creatinine (CR) increased. In the ROC analysis of group 1 (moderate infection) versus group 2 (severe infection), the area under the curve (AUC) values for leukocytes (AUC = 0.724), neutrophils (AUC = 0.714), PCT (AUC = 0.762) and a combination of the 3 tests (AUC = 0.768) suggested a strong predictive value. Furthermore, in the ROC analysis of group 2 (severe infection) versus group 3 (extremely severe infection), the AUC values for CRP (AUC = 0.84), PCT (AUC = 0.799), sIL2R (AUC = 0.937), IL6 (AUC = 0.863) and a combination of the four tests (AUC = 0.943) suggested a strong predictive value. Conclusions: Leukocytes, neutrophils, and PCT were associated with multispace infection and high severity. CRP, PCT, sIL2R, and/or IL6 were associated with extremely severe infections occurring in the oral and maxillofacial head and neck regions. [ABSTRACT FROM AUTHOR]

Key Points: Head and neck mucosal melanomas have a diverse mutational landscape with low mutational burden.A molecular subset (∼13%) has ROS1 mutations, which is an actionable driver mutation.ROS1‐mutated patients have improved overall survival likely due to high mutational burden. [ABSTRACT FROM AUTHOR]

Aim: The chin‐down posture is a widely used compensatory manoeuvre for patients with dysphagia. The aim of this study was designed to systematically measure the effectiveness of chin‐down manoeuvre application. Methodology: We retrieved the PubMed, Web of Science, Embase, Cochrane Library, EBSCO, Medline, CNKI, WANFANG, VIP and SinoMed databases from inception to 30 August 2022. Raters independently screened literature according to inclusion and exclusion criteria. The quality of the included literature was evaluated, and data were extracted. The software Review Manager software 5.3 was used for statistical analysis. Results: Fourteen studies with a total of 571 patients were included in this meta‐analysis. The meta‐analysis indicated that chin‐down manoeuvre could significantly reduce the risk of aspiration (MD = −1.35, 95% CI [−2.25, −0.44], Z = 2.92, p <.01), decrease the chin angle (MD = −12.20, 95% CI [−14.61, −9.79], Z = 9.91, p <.001), shorten oral transit time (MD = −0.81, 95% CI [−1.20, −0.43], Z = 4.17, p <.001), reduce the maximum swallowing pressure at upper oesophageal sphincter (MD = −82.07, 95% CI [−112.77, −51.37], Z = 5.24, p <.001) and decrease pharyngeal residue. Conclusions: Existing evidence indicated that chin‐down manoeuvre could reduce the risk of aspiration and pharyngeal residue, decrease the maximum swallowing pressure at UES. More large‐sample, high‐quality clinical trials are still needed in the future to further ascertain the results of this research. [ABSTRACT FROM AUTHOR]

Background: The involvement of the KMT2 methyltransferase family in the pathogenesis of head and neck squamous cell carcinoma (HNSCC) remains elusive. Method: This study adhered to the PRISMA guidelines, employing a search strategy in the LIVIVO, PubMed, Scopus, Embase, Web of Science, and Google Scholar databases. The methodological quality of the studies was assessed by the Joanna Briggs Institute. Results: A total of 33 studies involving 4294 individuals with HNSCC were included in this review. The most important alteration was the high mutational frequency in the KMT2C and KMT2D genes, with reported co‐occurrence. The expression of the KMT2D gene exhibited considerable heterogeneity across the studies, while limited data was available for the remaining genes. Conclusions: KMT2C and KMT2D genes seem to have tumor suppressor activities, with involvement of cell cycle inhibitors, regulating different pathways that can lead to tumor progression, disease aggressiveness, and DNA damage accumulation. [ABSTRACT FROM AUTHOR]

Objective: To characterize adverse events, provide a safety profile, and understand patient outcomes after complications arising from LigaSure and Harmonic use in the head and neck region. Methods: Retrospective analysis of adverse events from the Manufacturer and User Facility Device Experience (MAUDE) between January 2013 and 2023. Results: A total of 158 LigaSure and 159 Harmonic events were extracted. There were significantly more reports of Harmonic device overheating (6.9% vs. 0.6%, p = 0.003) and spontaneous self‐activation (4.4% vs. 0%, p = 0.032). Although intra‐operative and post‐operative complications were similar among both groups, there were significantly more intra‐operative bleeding events for LigaSure as compared to Harmonic (8.2% vs. 0.0%, p = 0.001). Conclusion: Understanding technical complications and adverse events attributable to LigaSure and Harmonic devices enables the development of clinically relevant risk mitigation strategies. Surgeons should avoid improper use by remaining vigilant of device functionality and temperature changes. [ABSTRACT FROM AUTHOR]

Purpose: Radiofrequency (RF) exposure during MR examination is limited by IEC 60601‐2‐33 to prevent thermal hazards to patients. These limits are also the basis to derive the maximum induced field for the demonstration of MR safety of implants per ISO/TS 10974 (2018). One limit is the head‐averaged specific absorption rate (SAR), for which the head extent is defined differently by MR and implant vendors. The purpose of this technical note is to inform MR safety stakeholders on the sensitivity of safety evaluations due to different head extent definitions. Methods: RF distributions from the validated MRIxViP exposure libraries of 12 high‐resolution human anatomical models were scaled to the normative SAR limits for different definitions of the head extent to compare the corresponding induced SAR and electric (E‐)field levels. Results: The definitions of the head extent used by major implant vendors and defined in ISO/TS 10974 (2018) are larger than those introduced in IEC 60601‐2‐33 (2022), resulting in lower RF head exposure by up to 2.4 dB (factor 1.7). Other proposed definitions of the head result in intermediate values. Conclusion: The different head extents result in different maximum RF exposures affecting the risk assessment by up to a factor of 1.7. The results of this study can be used to estimate the additional uncertainty in safety assessments. Future revisions of MR standards should eliminate this inconsistency. [ABSTRACT FROM AUTHOR]

Cystic lesions of the anterior head and neck region are a challenging and frequent finding on cytological smears. The scant amount of cellular material in cystic slides poses the greatest difficulty to interpretation, so that frequently they are diagnosed as inadequate or with minimal cellular component. Despite the majority of cystic lesions being benign, a minor portion consist of malignant cystic entities. In these latter cases, the evidence of very scant malignant cells can be misdiagnosed and/or underestimated, leading to a false negative diagnosis. Many papers have already described and detailed the range of possible benign and malignant cystic lesions in head and neck. In the current review we have focused on the less common entities that often lead to serious misinterpretation. [ABSTRACT FROM AUTHOR]

Purpose: Neurovascular MRI suffers from a rapid drop in B1+ into the neck when using transmit head coils at 7 T. One solution to improving B1+ magnitude in the major feeding arteries in the neck is to use custom RF shims on parallel‐transmit head coils. However, calculating such shims requires robust multichannel B1+ maps in both the head and the neck, which is challenging due to low RF penetration into the neck, limited dynamic range of multichannel B1+ mapping techniques, and B0 sensitivity. We therefore sought a robust, large‐dynamic‐range, parallel‐transmit field mapping protocol and tested whether RF shimming can improve carotid artery B1+ magnitude in practice. Methods: A pipeline is presented that combines B1+ mapping data acquired using circularly polarized (CP) and CP2‐mode RF shims at multiple voltages. The pipeline was evaluated by comparing the predicted and measured B1+ for multiple random transmit shims, and by assessing the ability of RF shimming to increase B1+ in the carotid arteries. Results: The proposed method achieved good agreement between predicted and measured B1+ in both the head and the neck. The B1+ magnitude in the carotid arteries can be increased by 43% using tailored RF shims or by 37% using universal RF shims, while also improving the RF homogeneity compared with CP mode. Conclusion: B1+ in the neck can be increased using RF shims calculated from multichannel B1+ maps in both the head and the neck. This can be achieved using universal phase‐only RF shims, facilitating easy implementation in existing sequences. [ABSTRACT FROM AUTHOR]

This article discusses a case of a 58-year-old police inspector who presented with unusual symptoms including involuntary forward bending of the head and neck, trunk leaning to the left, low volume speech, erectile dysfunction, chest discomfort when supine, disturbed sleep, clumsiness, thinning of the right leg, weight loss, and other neurological symptoms. After diagnosis, the patient received immunotherapy treatment which resulted in significant improvement in symptoms. The article highlights the challenges in recognizing and diagnosing this novel autoimmune disorder, known as Anti-IgLON5 Antibody disease, and emphasizes the importance of early diagnosis and treatment. [Extracted from the article]

Background: Cutaneous angiosarcoma is an aggressive tumor commonly found in the head and neck region. There is no consensus regarding the definitive treatment for angiosarcoma. Methods: This was a retrospective chart review that evaluated 64 patients from 1983 to 2019. Demographic and clinical variables were examined for impact on recurrence using the time to recurrence and the overall survival in Kaplan–Meier curves. Results: Average age at diagnosis was 71 (32–95) years, with a 2.8 male: female ratio. Surgery was utilized in 62% of patients, with mean defect size of 11.4 ± 8.1 cm. Recurrence was found in 70% of patients, and mean time to recurrence was 15.3 ± 12.3 months. Decreased recurrence was associated with use of intraoperative frozen section analysis (p =.036) and negative margins (p =.086). Two‐year overall survival was 80%, and recurrence free survival was 30%. Conclusions: Negative margins are associated with decreased recurrence, and intraoperative frozen section analysis may be considered to obtain preliminary surgical margins. Level of Evidence: 4. [ABSTRACT FROM AUTHOR]

Purpose: Secondary dose calculation (SDC) with an independent algorithm is one option to perform plan‐specific quality assurance (QA). While measurement‐based QA can potentially detect errors in plan delivery, the dose values are typically only compared to calculations on homogeneous phantom geometries instead of patient CT data. We analyzed the sensitivity and specificity of an SDC software by purposely introducing different errors and determined thresholds for optimal decisions. Methods: Thirty head and neck VMAT plans and 30 modifications of those plans, including errors related to density and beam modelling, were recalculated using RadCalc with a Monte Carlo algorithm. Decision thresholds were obtained by receiver operating characteristics (ROC) analysis. For comparison, measurement‐based QA using the ArcCHECK phantom was carried out and evaluated in the same way. Results: Despite optimized decision thresholds, none of the systems was able to reliably detect all errors. ArcCHECK analysis using a 2%/2 mm criterion with a threshold of 91.1% had an area under the curve (AUC) of 0.80. Evaluating differences in recalculated and planned DVH parameter of the target structures in RadCalc with a 2% threshold an AUC of 0.86 was achieved. Out‐of‐field deviations could be attributed to weaknesses in the beam model. Conclusions: Secondary dose calculation with RadCalc is an alternative to established measurement‐based phantom QA. Different tools catch different errors; therefore, a combination of approaches should be preferred. [ABSTRACT FROM AUTHOR]

The scale morphology of pleuronectiforms in the Gulf of Oman remains insufficiently known. This study used light microscopy and morphological analysis to examine scale variation across the flank of four Tonguefishes species; Cynoglossus arel, C. bilineatus, C. lingua, and C. puncticeps. Scales were extracted from six flank regions, three on the eyed and blind sides, respectively. The most differentiated species was C. arel, which showed significant differences in four size variables in five regions. In Cynoglossus arel and C. lingua, the scales of the eyed side were ctenoid, and those scales from the blind side were cycloid; C. puncticeps have ctenoid scales on both flank sides and C. bilineatus has cycloid scales on both sides. All species' scales on the blind side have fewer ctenial spines (except in C. bilineatus). This study indicated that scale morphology demonstrated considerable variation among the flank regions of the examined species. As a result, the scales from the head and the trunk regions of the eyed side and the scales from the head region of the blind side have a good power of species separation in this family. [ABSTRACT FROM AUTHOR]

Background: The functional integration of the jaw and neck motor systems, of great importance to everyday oral activities, is established in early childhood. Detailed characterisation of this developmental progress is largely unknown. Objective: To establish developmental changes in jaw–neck motor function in children over the ages 6–13 years compared to adults. Methods: Jaw and head movement kinematics during jaw opening–closing and chewing were longitudinally recorded in 20 Swedish children (8 girls) at 6 (6.3 ± 0.4), 10 (10.3 ± 0.3) and 13 (13.5 ± 0.7) years of age and 20 adults (9 women, 28.2 ± 6.7). Movement amplitudes, jaw movement cycle time (CT), coefficient of variation (CV) and head/jaw ratio for amplitudes were analysed. Linear mixed effect analysis and Welch's t‐test were used. Results: Children showed pronounced movement variability and longer CT at 6 and 10 years old during opening and chewing (p <.001). Compared to adults, 6‐year‐olds showed higher head/jaw ratios (p <.02) and longer CT (p <.001) during opening and chewing, and higher CV‐head (p <.001) during chewing. Whereas 10‐year‐olds showed larger jaw and head amplitudes (p <.02) and longer CT (p <.001) during opening, and longer CT (p <.001) and higher CV‐head (p <.001) during chewing. For 13‐year‐olds, longer CT (p <.001) during chewing was found. Conclusion: Children showed pronounced movement variability and longer movement cycle time at 6–10 years and developmental progress in jaw–neck integration from 6 to 13 years, with 13‐year‐olds displaying adult‐like movements. These results add new detailed understanding to the typical development of integrated jaw–neck motor function. [ABSTRACT FROM AUTHOR]

This paper investigates the suitability and interpretability of a data‐driven deep learning algorithm for multi cross sectional overstrength factor prediction. For this purpose, we first compile datasets consisting of experiments from literature on the overstrength factor of circular, rectangular and square hollow sections as well as I‐ and H‐sections. We then propose a novel multi‐head encoder architecture consisting of three input heads (one head per section type represented by respective features), a shared embedding layer as well as a subsequent regression tail for predicting the overstrength factor. By construction, this multi‐head architecture simultaneously allows for (i) the exploration of the nonlinear embedding of different cross‐sectional profiles towards the overstrength factor within the shared layer, and (ii) a forward prediction of the overstrength factor given profile features. Our framework enables for the first time an exploration of cross‐section similarity w.r.t. the overstrength factor across multiple sections and hence provides new domain insights in bearing capacities of steel cross‐sections, a much wider data exploration, since the encoder‐regressor can serve as meta model predictor. We demonstrate the quality of the predictive capabilities of the model and gain new insights of the latent space of different steel sections w.r.t. the overstrength factor. Our proposed method can easily be transferred to other multi‐input problems of Scientific Machine Learning. [ABSTRACT FROM AUTHOR]

Summary: Head pose classification is an important part of the preprocessing process of face recognition, which can independently solve application problems related to multi‐angle. But, due to the impact of the COVID‐19 coronavirus pandemic, more and more people wear masks to protect themselves, which covering most areas of the face. This greatly affects the performance of head pose classification. Therefore, this article proposes a method to classify the head pose with wearing a mask. This method focuses on the information that is helpful for head pose classification. First, the H‐channel image of the HSV color space is extracted through the conversion of the color space. Then use the line portrait to extract the contour lines of the face, and train the convolutional neural networks to extract features in combination with the grayscale image. Finally, stacked generalization technology is used to fuse the output of the three classifiers to obtain the final classification result. The results on the MAFA dataset show that compared with the current advanced algorithm, the accuracy of our method is 94.14% on the front, 86.58% on the more side, and 90.93% on the side, which has better performance. [ABSTRACT FROM AUTHOR]

Objective: Currently, there is no up‐to‐date guideline for the treatment of buccal mucosal squamous cell carcinoma (BMSCC) in the Netherlands. A questionnaire was used to investigate the opinions of Dutch head and neck surgeons on BMSCC of the cheek treatment. Methods: A questionnaire was sent to all 91 head and neck surgeons in the Netherlands. Their opinions on surgical tumor‐free margins, through‐and‐through defects, and indications for local adjuvant therapy were questioned. Results: The response rate was 51%. To prevent a through‐and‐through defect, 67% of the surgeons would accept a deep clinical (macroscopic) margin of ≤5 mm. The less adverse histological characteristics a tumor has, the less consensus there is amongst the surgeons for local adjuvant treatment in case of close margins. Conclusion: There is no consensus amongst Dutch head and neck surgeons about the optimal treatment for BMSCC of the cheek. There are different opinions on acceptable resection margins, indications for a through‐and‐through defect, and indications for adjuvant treatment. BMSCC of the cheek treatment should be more uniform and less surgeon dependent. Level of evidence: N/A [ABSTRACT FROM AUTHOR]

Background: The study investigates the prognostic significance of lymph node ratio (LNR) on patients with head and neck squamous cell carcinoma (HNSCC) with coexistence of multiple adverse pathological features. Methods: In total, 100 patients with coexistence of perineural invasion, lymphovascular invasion, and extranodal extension of first primary HNSCC treated with radical surgery followed by adjuvant chemoradiotherapy were enrolled. Results: The optimal LNR cut‐off value for predicting overall survival (OS) and cancer specific survival (CSS) was 7%. In Cox model, we observed that LNR ≥7% was a statistically significant unfavorable predictor of OS (HR: 2.689; 95% CI: 1.228–5.889; p = 0.013) and CSS (HR: 3.162; 95% CI: 1.234–8.102; p = 0.016). Conclusion: For HNSCC patients with coexistence of multiple adverse pathological features, LNR is an independent survival predictor. Novel intensified treatments are needed for the subgroup of patients with a high LNR. [ABSTRACT FROM AUTHOR]

Background: Head and neck solitary fibrous tumors (SFTs) are rare neoplasms, with few large‐scale studies describing this entity. We evaluated the demographics and correlates of survival in a large series of SFT patients. Methods: The 2004–2017 National Cancer Database was queried for head and neck SFT patients receiving definitive surgery. Cox proportional‐hazards and Kaplan–Meier analyses assessed overall survival (OS). Results: Of 135 patients, sinonasal (33.1%) and orbital (25.9%) SFTs were most common. Approximately 93% of SFTs were invasive and 64% were classified as hemangiopericytomas. The 5‐year OS of skull base SFTs (84.5%) was lower than sinonasal (98.7%) and orbital (90.7%) SFTs (all p < 0.05). Government insurance exhibited higher mortality (HR 5.116; p < 0.001) and lower OS (p = 0.001). Conclusion: Head and neck SFTs presented with distinct prognoses based on anatomical origin. Overall survival was particularly worse in patients with skull base SFTs or government insurance. Prognostically, hemangiopericytomas were indistinct from other SFTs. [ABSTRACT FROM AUTHOR]

Background: Transperineal ultrasound (TPUS) has become an increasingly popular tool in obstetrics due to its objective, non‐invasive, and real‐time imaging capabilities. Aim: This review aims to describe the basic approaches, current utilization, and potential future applications of TPUS. Materials & Method: A comprehensive literature review on TPUS was conducted. In addition, discussions at academic meetings and congress focused on TPUS were also considered. Results: TPUS was initially used in prostate biopsies and is currently applied to evaluating fetal head descent in labor, with the angle of progression being the most widely used parameter. It is more tolerated than conventional invasive or expensive methods, such as digital vaginal examinations or MRIs. Additionally, TPUS can assess the internal rotation of the fetal head in the birth canal. Discussion: Compared to other imaging modalities like MRI and CT scans, TPUS is easier to perform and more cost‐effective. It also provides real‐time imaging, allowing for quick and accurate assessments. It also help clinicians make critical decisions regarding the mode of delivery and identify patients at high risk for fecal incontinence postpartum. With its many benefits, TPUS has the potential to become a standard tool in urogynecology and obstetrics. Conclusions: Transperineal ultrasound is a non‐invasive imaging modality that is well‐tolerated and easy to understand for patients and their family and help medical staff support the patients. Transperineal ultrasound can be applied in real‐time monitoring of labor progress, helping predict the possibility of vaginal delivery during labor, and further research in this area is warranted. [ABSTRACT FROM AUTHOR]

Objectives: In the United Kingdom, head and neck cancer (HNC) cases continue to rise and are the fourth commonest cancers in men. Additionally, in the last decade, the incidence rise in women is twice their male counterpart, signifying the need for robust and dynamic triaging systems to maintain high pick‐up rates across both genders. This study investigates local risk factors associated with HNC and reviews the most commonly used guidelines and risk calculator tool for two‐week‐wait (2ww) HNC clinics. Design: Six‐year retrospective case–control analysis of 2ww HNC clinics within a district general hospital in Kent studying symptoms and risk factors. Results: Two hundred cancer patients (128M:72F) were identified and compared against 200 randomised non‐cancer patients (78M:122F). Increasing age, male gender, smoking, previous cancer and neck lumps were statistically relevant risk factors for HNC (p <.001). HNC mortality at 1 and 5 years was 21% and 26%, respectively. Adjusting guidelines to improve local services obtained the following area under curve (AUC) scores: NICE guidelines 67.3, Pan‐London 58.0 and HNC risk calculator version 2 (HaNC‐RC V.2) 76.5. Our adjusted HaNC‐RC V.2 improved sensitivity by 10% to 92%, and theoretically reduces local general practice referrals by 61% when utilising triaging staff. Conclusion: Our data portray the primary risk factors as increasing age, male gender and smoking for this demographic. The presence of a neck lump was the most significant symptom within our cohort. This study demonstrates a critical balance when adjusting sensitivity and specificity of guidelines and proposes that departments adjust diagnostic tools for their local demographic to improve referral numbers and patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Comparisons of patient‐reported donor site morbidity based on the Disabilities in Arm, Shoulder, and Hand (DASH) instrument across upper trunk free flaps in head and neck surgery, including radial forearm (RFFF), osteocutaneous radial forearm (OCRFF), scapular tip (STFF), and serratus anterior (SAFF) free flaps, may help inform donor tissue selection. Methods: In this meta‐analysis, 12 studies were included and the primary outcome was average DASH score. Results: The pooled DASH scores were 12.14 (95% CI: 7.40–16.88) for RFFF (5 studies), 17.99 (11.87–24.12) for OCRFF (2 studies), 12.19 (8.74–15.64) for STFF (3 studies), and 16.49 (5.92–27.05) for SAFF (2 studies) and were not significantly different. Conclusions: Results suggest that patients generally function well, with minimal to mild donor site morbidity, when assessed at an average of 20 months after flap harvest. These results are based on few effects from primarily retrospective studies of fair quality, and further research is needed. [ABSTRACT FROM AUTHOR]

With complex head and neck diseases that closely approximate crucial organs or have advanced spread and cannot be surgically resected, intensity modulated proton beam radiotherapy is favored due to its superior dose targeting through magnetic manipulation of the proton energy. A radiation mask and an oral positioning device immobilize craniofacial, cervical, and oral structures for accurate and reliable radiation delivery. Widely available prefabricated thermoplastic oral positioning devices are manufactured in standardized forms and materials that unpredictably affect the proton beams' pathways and range. This technique article showcases a workflow that combines analog and digital dental techniques to produce a customized 3D‐printed oral positioning device within 2 appointments. [ABSTRACT FROM AUTHOR]

Background: Patients treated for head and neck cancer are at high risk of developing head and neck lymphedema (HNL). We describe outcomes of HNL management at an Australian institution from 2018 to 2020. Methods: Electronic records from Chris O'Brien Lifehouse were retrospectively reviewed from January 1, 2018 to December 31, 2020. Objective changes in HNL were assessed using The M. D. Anderson Cancer Center (MDACC) HNL rating scale and Assessment of Lymphedema of the Head and Neck (ALOHA). Results: Among the 100 patients referred for management of HNL, surgery was the most frequent treatment modality (80%; 70% with neck dissection) and 69% underwent radiotherapy. Manual lymphatic drainage (MLD) was most often prescribed (96%), followed by self‐MLD (93%). Small but significant improvements in ALOHA measurements were observed for 50 patients (50%). Only 5/29 (17%) patients had post‐treatment improvements on the MDACC scale. Conclusions: Standardized, prospective measurement of treatment approaches and outcomes is needed to further evaluate the service. [ABSTRACT FROM AUTHOR]

Background: The utilization of an arteriovenous loop is an underreported technique that affords the creation of reliable vascular options. Understanding the efficacy and impacting variables of microvascular reconstruction with an arteriovenous loop can be critical to its use. Methods: Multi‐institutional study of 36 patients who underwent vein grafting or AV loop with free tissue transfer. Results: 58.3% of patients received prior radiation and 38.9% prior flap reconstruction. Flap success for vein grafting was 76% and AV loop was 100% (p = 0.16). Success for the radiated cohort was 90.5% and non‐radiated 80% (p = 0.63). Flap success for the radiated, vein grafted patient was 83.3% and 100% flap success rate for radiated, AV loop patient (p = 0.49). Overall flap survival was 83.3% versus 97% overall success rate in the United States. Conclusion: The AV loop is a viable modality for vessel‐depleted free tissue reconstruction. Radiation and previous surgery do not significantly impact flap success rates. [ABSTRACT FROM AUTHOR]

Purpose: Dynamic glucose‐enhanced (DGE) MRI relates to a group of exchange‐based MRI techniques where the uptake of glucose analogues is studied dynamically. However, motion artifacts can be mistaken for true DGE effects, while motion correction may alter true signal effects. The aim was to design a numerical human brain phantom to simulate a realistic DGE MRI protocol at 3T that can be used to assess the influence of head movement on the signal before and after retrospective motion correction. Methods: MPRAGE data from a tumor patient were used to simulate dynamic Z‐spectra under the influence of motion. The DGE responses for different tissue types were simulated, creating a ground truth. Rigid head movement patterns were applied as well as physiological dilatation and pulsation of the lateral ventricles and head‐motion‐induced B0‐changes in presence of first‐order shimming. The effect of retrospective motion correction was evaluated. Results: Motion artifacts similar to those previously reported for in vivo DGE data could be reproduced. Head movement of 1 mm translation and 1.5 degrees rotation led to a pseudo‐DGE effect on the order of 1% signal change. B0 effects due to head motion altered DGE changes due to a shift in the water saturation spectrum. Pseudo DGE effects were partly reduced or enhanced by rigid motion correction depending on tissue location. Conclusion: DGE MRI studies can be corrupted by motion artifacts. Designing post‐processing methods using retrospective motion correction including B0 correction will be crucial for clinical implementation. The proposed phantom should be useful for evaluation and optimization of such techniques. [ABSTRACT FROM AUTHOR]

Objectives: Lymphomas represent around 10% of head and neck neoplasms, among which the diffuse large B‐cell lymphoma (DLBCL) is the most common histologic subtype. In the present study, we characterized demographic parameters, anatomical sites, and survival rates of patients in a Brazilian cancer center. Materials and methods: Single‐center retrospective epidemiological study of 243 head and neck DLBCL patients. Demographic characteristics, tumor localization, HIV status, lactate dehydrogenase (LDH) activity, and treatment modality were obtained from electronic medical records. Results: The most common primary head and neck tumor location in patients with DLBCL was Waldeyer's ring. Interestingly, age above 80 years, male gender, high LDH levels, and HIV positivity were significantly associated with shorter overall survival (OS) rates and increased risk of death. We further demonstrated that treatment had a protective effect, improving OS, and reducing risk of death. Notably, we found no benefit of combination of chemotherapy and radiotherapy versus isolated treatment modalities. Conclusion: The study showed that primary head and neck DLBCL is more incident in middle age and elderly patients with a small male patients' majority in a Brazilian population. Moreover, we observed a 3‐year OS rate of almost 60% and multivariate analysis showed that treatment was the only protective factor. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to construct a formula to predict L3 skeletal muscle cross‐sectional area (CSA) from C3 CSA and to select the cutoff values to evaluate the nutritional status in OSCC. Materials and Methods: A total of 220 OSCC patients in Nanfang Hospital were divided into two groups: the training set (n = 100) and the validation set (n = 120). Patients in the training set were performed the preoperative whole‐body positron emission tomography‐computed tomography (PET/CT) scans, and patients in the validation set received preoperative head‐and‐neck computed tomography (CT) scans. C3 CSA and L3 CSA were delineated. The predictive formula was established, and the gender‐specific thresholds of malnutrition were obtained by X‐tile software in training set. Finally, the formula and cutoff values were validated. Results: The predictive formula was successfully established. The gender‐specific cutoff values for L3 SMI were 55.0 cm2/m2 for men and 36.6 cm2/m2 for women. There were no differences between the overall survival (OS) of patients diagnosed with malnutrition and that of patients who are not malnutrition. Conclusions: Our studies reveal that the L3 CSA could be calculated by C3 CSA conveniently with our formula in OSCC, which allowed us to assess malnutrition with head‐and‐neck CT image. However, there is no direct connection found between malnutrition and OS in OSCC. Hence, further studies with a larger sample size may be required. [ABSTRACT FROM AUTHOR]

Purpose: MRI studies in human subjects often require multiple scanning sessions/visits. Changes in a subject's head position across sessions result in different alignment between brain tissues and the magnetic field which leads to changes in magnetic susceptibility. These changes can have considerable impacts on acquired signals. Head ALignment Optimization (HALO), a software tool was developed by the authors for active head alignment between sessions. Methods: HALO provides real‐time visual feedback of a subject's current head position relative to the position in a previous session. The tool was evaluated in a pilot sample of seven healthy human subjects. Results: HALO was shown to enable subjects to actively align their head positions to the desired position of their initial sessions. The subjects were able to improve their head alignment significantly using HALO and achieved good alignment with their first session meeting stringent criteria similar to that used for within‐run head motion (less than 2 mm translation or 2 degrees rotation in any direction from the desired position). Moreover, we found a negative correlation between the post‐alignment rotation and similarity in inter‐session BOLD patterns around the air‐tissue interface near sinus which further highlighted the impact of tissue‐field alignment on BOLD data quality. Conclusion: Utilization of HALO in longitudinal studies may help to improve data quality by ensuring the consistency of susceptibility gradients in brain tissues across sessions. HALO has been made publicly available. [ABSTRACT FROM AUTHOR]

Background: CT head is commonly performed in the setting of delirium and altered mental status (AMS), with variable yield. We aimed to evaluate the yield of CT head in hospitalized patients with delirium and/or AMS across a variety of clinical settings and identify factors associated with abnormal imaging. Methods: We included studies in adult hospitalized patients, admitted to the emergency department (ED) and inpatient medical unit (grouped together) or the intensive care unit (ICU). Patients had a diagnosis of delirium/AMS and underwent a CT head that was classified as abnormal or not. We searched Medline, Embase and other databases (informed by PRISMA guidelines) from inception until November 11, 2021. Studies that were exclusively performed in patients with trauma or a fall were excluded. A meta-analysis of proportions was performed; the pooled proportion of abnormal CTs was estimated using a random effects model. Heterogeneity was determined via the I² statistic. Factors associated with an abnormal CT head were summarized qualitatively. Results: Forty-six studies were included for analysis. The overall yield of CT head in the inpatient/ED was 13% (95% CI: 10.2%–15.9%) and in ICU was 17.4% (95% CI: 10%–26.3%), with considerable heterogeneity (I2 96% and 98% respectively). Heterogeneity was partly explained after accounting for study region, publication year, and representativeness of the target population. Yield of CT head diminished after year 2000 (19.8% vs. 11.1%) and varied widely depending on geographical region (8.4%–25.9%). The presence of focal neurological deficits was a consistent factor that increased yield. Conclusion: Use of CT head to diagnose the etiology of delirium and AMS varied widely and yield has declined. Guidelines and clinical decision support tools could increase the appropriate use of CT head in the diagnostic etiology of delirium/AMS. [ABSTRACT FROM AUTHOR]

Background: Our study investigates the prognostic significance of spindle cell histology on overall survival (OS) of conventional head and neck squamous cell carcinoma (HNSCC). Methods: The 2004 to 2017 National Cancer Database was queried for patients with head and neck spindle cell carcinoma (HNSpCC) (n = 1572) or HNSCC (n = 242 697) of the oral cavity, major salivary glands, sinonasal tract, oropharynx, hypopharynx, and larynx treated with curative intent. Results: Patients with HNSpCC presented more frequently with higher‐grade tumors and cN0 disease than those with HNSCC (p < 0.001). In the oral cavity, the HR for death for SpCC compared with SCC was 1.33 (p < 0.001). In the oropharynx, the HR for death for SpCC compared with SCC was 1.47 (p = 0.028). Conclusions: After adjusting for patient, tumor, and treatment characteristics, SpCC histology had an independent adverse prognostic effect on OS in the oral cavity and oropharynx. SpCC histology does not necessarily portend poorer survival in all HNSCC. Level of Evidence: 4. [ABSTRACT FROM AUTHOR]