Explore the vast range of titles available.

Forensic dental examination has played an important role in personal identification (PI). However, PI has essentially been based on traditional visual comparisons of ante- and postmortem dental records and radiographs, and there is no globally accepted PI method based on digital technology. Although many effective image recognition models have been developed, they have been underutilized in forensic odontology. The aim of this study was to verify the usefulness of PI with paired orthopantomographs obtained in a relatively short period using convolutional neural network (CNN) technologies. Thirty pairs of orthopantomographs obtained on different days were analyzed in terms of the accuracy of dental PI based on six well-known CNN architectures: VGG16, ResNet50, Inception-v3, InceptionResNet-v2, Xception, and MobileNet-v2. Each model was trained and tested using paired orthopantomographs, and pretraining and fine-tuning transfer learning methods were validated. Higher validation accuracy was achieved with fine-tuning than with pretraining, and each architecture showed a detection accuracy of 80.0% or more. The VGG16 model achieved the highest accuracy (100.0%) with pretraining and with fine-tuning. This study demonstrated the usefulness of CNN for PI using small numbers of orthopantomographic images, and it also showed that VGG16 was the most useful of the six tested CNN architectures.

Background We aimed to evaluate the length of hospital stay following total knee arthroplasty to determine the impact of relevant factors using data from the Diagnosis Procedure Combination database. Methods This was a retrospective observational study. The study cohort included 5,831 patients who had osteoarthritis of the knee and had undergone total knee replacement between February 2018 and October 2022 at 38 hospitals. Results Multivariate analysis showed that the factors influencing the length of stay included: age ( p  < 0.001), height ( p  < 0.001), weight ( p  = 0.049), body mass index ( p  = 0.008), Barthel index ( p  < 0.001), method of anesthesia ( p  < 0.001), bone transplant ( p  = 0.010), timing of postoperative rehabilitation ( p  < 0.001), atrial fibrillation ( p  < 0.001), chronic pain ( p  < 0.001), and number of institutionally treated cases ( p  < 0.001) ( r  = 0.451, p  < 0.001). Conclusions Shorter or longer hospital stays were found to be associated with the patients’ background characteristics and facility-specific factors; these can lead to more accurate estimates of the length of hospital stay and appropriate allocation of resources.

This study conducted large-eddy simulations (LES) of fully developed turbulent flow within and above explicitly resolved buildings in Tokyo and Nagoya, Japan. The more than 100 LES results, each covering a 1,000 1,000 m area with 2-m resolution, provide a database of the horizontally-averaged turbulent statistics and surface drag corresponding to various urban morphologies. The vertical profiles of horizontally-averaged wind velocity mostly follow a logarithmic law even for districts with high-rise buildings, allowing estimates of aerodynamic parameters such as displacement height and roughness length using the von Karman constant 0.4. As an alternative derivation of the aerodynamic parameters, a regression of roughness length and variable Karman constant was also attempted, using a displacement height physically determined as the central height of drag action. Although both the regression methods worked, the former gives larger (smaller) values of displacement height (roughness length) by 20–25 % than the latter. The LES database clearly illustrates the essential difference in bulk flow properties between real urban surfaces and simplified arrays. The vertical profiles of horizontally-averaged momentum flux were influenced by the maximum building height and the standard deviation of building height, as well as conventional geometric parameters such as the average building height, frontal area index, and plane area index. On the basis of these investigations, a new aerodynamic parametrization of roughness length and displacement height in terms of the five geometric parameters described above was empirically proposed. The new parametrizations work well for both real urban morphologies and simplified model geometries.

PurposeTibial condylar valgus osteotomy (TCVO) is a type of opening-wedge high tibial osteotomy for advanced medial knee osteoarthritis (OA) with subluxated lateral joint. We report the concept, the current surgical technique with a locking plate, and the short-term clinical and radiological results of this procedure.Methods11 knees with medial OA and a widened lateral joint were treated by TCVO (KL stage III: 6, IV: 5). In this procedure, by the L-shaped osteotomy from the medial side of the proximal tibia to the intercondylar eminence and the valgus correction, lateralization of the mechanical axis and reduction of the subluxated lateral joint are obtained with early postoperative weight-bearing. Before, 6 months, 1, and 5 years after the operation, a visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), alignment of the lower extremity, and congruency and stability of the femorotibial joint were investigated.ResultsThe VAS improved from an average of 73 mm to 13 mm, and the total WOMAC score from 52 to 14 before to 5 years after the operation, respectively. The mechanical axis changed from 1 to 60%, and the FTA changed from 186° to 171°. The joint line convergence angle (JLCA) changed from 6° to 1°, and the angle difference of JLCA between varus and valgus stress improved from 8° to 4° after the procedure.ConclusionImprovements in pain and activities of daily living were observed by TCVO along with valgus correction of the lower extremity and stabilization of the femorotibial joint.

Nitric oxide (NO) is an unstable signalling molecule synthesized de novo mainly from L -arginine by NO synthase (NOS) enzymes. Nitrite reduction can also produce NO, predominantly within body fluids (for example, saliva, sweat and blood plasma) and under extreme hypoxic and acidic conditions. It remains unknown if intracellular canonical signalling pathways regulate nitrite-dependent NO production. Here we examine NO production in the skin, a hypoxic tissue enriched in nitrites wherein NO has important roles in wound healing and other biological processes. We show that activation of TRPV3, a heat-activated transient receptor potential ion channel expressed in keratinocytes, induces NO production via a nitrite-dependent pathway. TRPV3 and nitrite are involved in keratinocyte migration in vitro and in wound healing and thermosensory behaviours in vivo . Our study demonstrates that activation of an ion channel can induce NOS-independent NO production in keratinocytes. Nitric oxide can be produced by nitric oxide synthase or by nitrite reduction, but whether the latter occurs inside cells is unknown. Here, the TRPV3 ion channel is shown to induce nitrite-dependent nitric oxide production in keratinocytes, where it has a role in thermosensory behaviour and wound healing.

Background Hyperexcitability of neuronal networks can lead to excessive release of the excitatory neurotransmitter glutamate, which in turn can cause neuronal damage by overactivating NMDA-type glutamate receptors and related signaling pathways. This process (excitotoxicity) has been implicated in the pathogenesis of many neurological conditions, ranging from childhood epilepsies to stroke and neurodegenerative disorders such as Alzheimer’s disease (AD). Reducing neuronal levels of the microtubule-associated protein tau counteracts network hyperexcitability of diverse causes, but whether this strategy can also diminish downstream excitotoxicity is less clear. Methods We established a cell-based assay to quantify excitotoxicity in primary cultures of mouse hippocampal neurons and investigated the role of tau in exicitotoxicity by modulating neuronal tau expression through genetic ablation or transduction with lentiviral vectors expressing anti-tau shRNA or constructs encoding wildtype versus mutant mouse tau. Results We demonstrate that shRNA-mediated knockdown of tau reduces glutamate-induced, NMDA receptor-dependent Ca 2+ influx and neurotoxicity in neurons from wildtype mice. Conversely, expression of wildtype mouse tau enhances Ca 2+ influx and excitotoxicity in tau-deficient ( Mapt −/− ) neurons. Reconstituting tau expression in Mapt −/− neurons with mutant forms of tau reveals that the tau-related enhancement of Ca 2+ influx and excitotoxicity depend on the phosphorylation of tau at tyrosine 18 (pY18), which is mediated by the tyrosine kinase Fyn. These effects are most evident at pathologically elevated concentrations of glutamate, do not involve GluN2B–containing NMDA receptors, and do not require binding of Fyn to tau’s major interacting PxxP motif or of tau to microtubules. Conclusions Although tau has been implicated in diverse neurological diseases, its most pathogenic forms remain to be defined. Our study suggests that reducing the formation or level of pY18-tau can counteract excitotoxicity by diminishing NMDA receptor-dependent Ca 2+ influx.

Ebstein's anomaly (EA) is a rare congenital defect of the tricuspid valve (TV), typically characterized by downward displacement of the septal and posterior leaflets into the right ventricle, resulting in tricuspid regurgitation (TR), right heart enlargement, and heart failure. While surgical outcomes for EA have improved significantly in pediatric and young adult populations, data on surgical intervention in elderly patients remain limited. Elderly patients often present with comorbidities and diminished physiological reserve, which complicate both surgical decision-making and perioperative management. We present two elderly patients with EA who underwent TV surgery. Case 1 involved a 73-year-old man with a long-standing history of severe TR, cardiomegaly, alcoholic cirrhosis, and chronic kidney disease. Despite preserved biventricular systolic function on echocardiography, signs of right ventricular dysfunction were present. The patient underwent tricuspid valve replacement (TVR) due to concerns about tissue fragility and prolonged bypass time. Although initially stable postoperatively, he developed aspiration pneumonia followed by septic shock and ultimately died from multiorgan failure on postoperative day 73. Case 2 involved a 71-year-old woman with preserved cardiac function and mild frailty. She underwent tricuspid valvuloplasty using the cone technique. Despite temporary postoperative circulatory instability requiring mechanical circulatory support, she recovered well and was discharged on postoperative day 80. These cases highlight the importance of individualized surgical planning in elderly EA patients. While echocardiographic indices may suggest preserved ventricular function, they may not fully reflect clinical reserve, particularly in long-standing disease. Earlier surgical intervention, prior to the onset of irreversible right ventricular remodeling or systemic decline, may improve outcomes even in elderly patients. Evaluation of frailty, comorbidities, and right ventricular function should guide the decision-making process. Our experience suggests that timely and tailored surgical strategies can lead to acceptable outcomes in selected elderly patients with EA.

Nitric oxide (NO) can induce acute pain in humans and plays an important role in pain sensitization caused by inflammation and injury in animal models. There is evidence that NO acts both in the central nervous system via a cyclic GMP pathway and in the periphery on sensory neurons through unknown mechanisms. It has recently been suggested that TRPV1 and TRPA1, two polymodal ion channels that sense noxious stimuli impinging on peripheral nociceptors, are activated by NO in heterologous systems. Here, we investigate the relevance of this activation. We demonstrate that NO donors directly activate TRPV1 and TRPA1 in isolated inside-out patch recordings. Cultured primary sensory neurons display both TRPV1- and TRPA1-dependent responses to NO donors. BH4, an essential co-factor for NO production, causes activation of a subset of DRG neurons as assayed by calcium imaging, and this activation is at least partly dependent on nitric oxide synthase activity. We show that BH4-induced calcium influx is ablated in DRG neurons from TRPA1/TRPV1 double knockout mice, suggesting that production of endogenous levels of NO can activate these ion channels. In behavioral assays, peripheral NO-induced nociception is compromised when TRPV1 and TRPA1 are both ablated. These results provide genetic evidence that the peripheral nociceptive action of NO is mediated by both TRPV1 and TRPA1.

Background Pulmonary hypertension (PH) detection in cats may be challenging. Pulmonary venous stenosis (PVS) is rare in cats and can lead to PH. The only reported PVS case received a post-mortem diagnosis. Imaging during the cat's lifetime established the diagnosis in this case. Case presentation A 2 year-old Norwegian Forest cat was diagnosed with pulmonary oedema and PH secondary to cor triatriatum sinister (CTS) and showed improved breathing following two subcutaneous furosemide treatments, 1 and 2 mg/kg, during an overnight stay at the referral veterinary hospital. Sildenafil alone (0.69 mg/kg, PO, BID) was prescribed post-discharge to address PH without diuretics. Post-discharge from the referral veterinary hospital, collapse and pre-syncope were suspected to be due to PH. Consequently, sildenafil was titrated weekly, starting at 1.09 mg/kg BID and increasing to 1.63 mg/kg BID. Pre-syncope and collapse resolved, and pulmonary opacities reduced considerably, although concerns remained that increased pulmonary blood flow to suspected CTS from sildenafil might worsen cardiogenic pulmonary oedema. The patient was also treated with rivaroxaban (2.5 mg/head, SID), considering the increased risk of thrombus formation due to blood flow stasis and endothelial damage. Thirty-eight days later, the cat presented for the first time to our hosipital (Azabu University Veterinary Teaching Hospital) for examination. On echocardiography, a continuous mosaic blood flow (maximum and minimum velocity, 3.14 m/s; estimated pressure gradient, 39.4 mmHg) was observed in two enlarged pulmonary veins. Pulmonary artery enlargement (main pulmonary artery to thoracic aorta ratio: 1.90), pulmonary vein stenosis (PVS), and diffuse bilateral ground-glass lung opacities were observed using computed tomography. PH with unilateral PVS involving two out of the three right pulmonary veins, specifically the right cranial and right middle pulmonary veins, along with pulmonary parenchymal disease, was diagnosed. The cat was further treated with furosemide (1 mg/kg, BID, PO) with no clinical signs but succumbed to acute dyspnoea 51 days after the first visit. Conclusions Unilateral PVS should be considered in young cats with a localised alveolar pattern and no left atrial enlargement, because the prognosis may be poor. Severe PH with PVS may coexist with lung disease. If sildenafil is used, it should be started at a low dose and monitored closely.

IntroductionHigh-resolution peripheral quantitative computed tomography (HR-pQCT) has enabled us to observe the changes in bone microarchitecture over time in vivo. In this study, the process of fracture healing was analyzed using HR-pQCT in patients with distal radius fracture who underwent osteosynthesis.Materials and methodsA total of 10 fracture sites identified from four patients with a distal radius fracture who underwent internal fixation with a volar locking plate (mean age 68.8 years, all women) were investigated. HR-pQCT was performed within a week (baseline) 4, 12, and 24 weeks after fracture. Rectangular region of interest (ROI) was established in the fracture site, inner callus, and external callus area, and the changes in bone mineral density (BMD) in each region were analyzed.ResultsFrom baseline to 24 weeks post-fracture, the BMD changed from 105.5 (95% CI 98.6–113) to 428.0 (331–554) mgHA/ccm at the fracture site, from 111.0 (104–119) to 375.3 (290–486) mgHA/ccm at the inner callus area, and from 98.5 (91.6–106) to 171.6 (132–222) mgHA/ccm at the external callus area. The BMD increased at the fracture site and inner callus area, but increased only slightly at the external callus area. At 24 weeks post-fracture, the BMD at the fracture site and inner callus area was significantly higher than the external callus area.ConclusionIn the healing process of postoperative distal radius fractures, increased BMD at the inner surface of the fracture site was confirmed in all fractures. Bone formation on the endosteal side may be a necessary condition for bone union of distal radius fractures.