High-Resolution 3T MRI of the Membranous Labyrinth Using Deep Learning Reconstruction.

Background And Purpose: The labyrinth is a complex anatomical structure in the temporal bone. However, high-resolution imaging of its membranous portion is challenging due to its small size and the limitations of current MRI techniques. Deep Learning Reconstruction (DLR) represents a promising approach to advancing MRI image quality, enabling higher spatial resolution and reduced noise.

Lifting Triplet Degeneracy Through Organic-Cation Driven Structural Perturbation to Modulate Luminescence of Sb-Doped Double Perovskite.

The spin-orbit coupling (SOC) and the Jahn-Teller effect (JTE) alter the orbital degeneracy in materials, leading to unique optical, electronic, and magnetic properties essential in spintronics, quantum computing, and light-emitting diodes (LEDs). Here, the study employs luminescent p-xylylenediammonium (PXA) instead of Cs in CsNaInCl to yield 2D Sb-doped (PXA)NaInCl double perovskite and demonstrates a non-degenerate triplet state resulting from enhanced JTE in the strong SOC regime, featuring distinct emission centers. Consequently, a broadband emission from both PXA and [SbCl] spans the entire spectrum (350-750 nm), representing a rare single-source multi-emissive 2D perovskite.

Associations of Midlife Leukocyte Telomere Length With Measures of Left Atrial Function in Community-Dwelling Older Adults: The ARIC Study.

Background: It is unknown whether atrial myopathy, ascertained by poor left atrial (LA) function, is associated with biological aging independent of chronological age. Such an association would indicate that atrial myopathy may be preventable by intervening on modifiable risk factors that accelerate aging. Therefore, we evaluated associations of midlife leukocyte telomere length (LTL, a measure of biological aging) with measures of LA function (a surrogate for LA myopathy).

Congenital Absence of Stapes Footplate: Enhanced Characterization With Photon Counting Detector CT.

We report the presentation and management of a unique case of bilateral congenitally absent stapes footplates, with an open vestibule, in a pediatric patient. This case adds to the few prior reports of this rare anomaly and highlights the advanced diagnostic imaging capability of the Photon Counting Detector CT (PCD-CT).

Inner Ear Signal Abnormalities of Adjacent Intracranial Lipochoristoma.

Background And Purpose: Inner ear signal abnormalities commonly develop in cases of vestibular schwannoma and are associated with hearing loss. Whether such signal alterations occur in other masses of the internal auditory canal (IAC), however, remains unknown. Here, we assessed inner ear signal abnormalities of lipochoristomas, historically termed "lipomas," involving the IAC and cerebellopontine angle (CPA).

A Rare Case of Osteoblastic Osteosarcoma of the Temporal Bone and Comprehensive Review of the Literature.

Introduction: Although osteosarcoma represents the most common primary malignant bone tumor in children, they comprise only 0.2% of all cancers. Osteosarcoma frequently involves long bones; however, 8% of osteosarcomas involve the skull or mandible.

Outcomes for Hispanic patients undergoing open bypass in BEST-CLI.

Objectives: Hispanic patients have a higher prevalence of peripheral artery disease (PAD) risk factors, undergo revascularization at lower rates, and have higher rates of major amputation. This study compares outcomes after open surgical revascularization within the Best Endovascular vs Best Surgical Therapy in Patients with Critical Limb Ischemia (BEST-CLI) Trial between Hispanic and non-Hispanic White patients.

Methods: In a secondary analysis of BEST-CLI, open surgical cohorts were combined (cohort 1, suitable single segment greater saphenous vein [n = 484]; cohort 2, lack of suitable single segment greater saphenous vein [n = 150]) and examined, by ethnicity, for the following 1-year outcomes: (1) above-ankle amputation, (2) major reintervention, (3) major adverse limb event (a composite of major amputation and major reintervention), and (4) survival.

Peritumoral Hyperintense Signal on Postcontrast FLAIR Images Surrounding Vestibular Schwannomas following Stereotactic Radiosurgery.

Background And Purpose: Prior investigations have noted the presence of peritumoral hyperintense signal (a "halo") around vestibular schwannomas on postcontrast 3D T2 FLAIR images. This study evaluated this phenomenon in a cohort of patients undergoing stereotactic radiosurgery.

Materials And Methods: A retrospective review was completed of consecutive patients with presumed vestibular schwannomas undergoing stereotactic radiosurgery.

Detection of Extracochlear Electrodes Using Electrical Field Imaging (EFI).

Objective: To analyze the use of electrical field imaging (EFI) in the detection of extracochlear electrodes in cochlear implants (CI).

Study Design: Retrospective cohort study.

Setting: Tertiary academic medical center.

Improved visualization of the inferior tympanic and mastoid canaliculi with photon counting detector CT.

Purpose: To compare the performance of the photon-counting detector (PCD)-CT versus a state-of-the-art energy-integrating detector (EID)-CT to identify segments of the inferior tympanic canaliculus (Jacobsons nerve) and the mastoid canaliculus (Arnolds nerve).

Materials & Methods: Patients were prospectively recruited to undergo temporal bone CT on both EID-CT (Siemens Somatom Force) and PCD-CT (Siemens NAEOTOM Alpha) scanners under an IRB-approved protocol. Three neuroradiologists reviewed cases by consensus comparing the ability to identify the proximal, mid, and distal segments of the inferior tympanic canaliculus/Jacobsons nerve and mastoid canaliculus/Arnolds nerve on each scanner using 5-point Likert scales (with 1 indicating EID is far superior to PCD, 3 indicating they are equivalent, and 5 indicating PCD is far superior to EID).

Cochlear Implantation With Sporadic Inner Ear Schwannomas: Outcomes in 106 Patients From an International Multi-Institutional Study.

Objective: To evaluate cochlear implant speech perception among patients with sporadic inner ear schwannoma who underwent ipsilateral implantation.

Study Design: Retrospective multi-institutional cohort study.

Setting: Eleven tertiary academic medical centers across Germany, Denmark, and the United States.

Evaluation of Vestibular Schwannoma Size across Time: How Well Do the Experts Perform and What Can Be Improved?

Background And Purpose: 2D linear measurements are often used in routine clinical practice during vestibular schwannoma (VS) follow-up, primarily due to wider availability and ease of use. We sought to determine the radiologist's performance compared with 3D-volumetry, along with the impact of the number of linear measurements, slice thickness, and tumor volumes on these parameters.

Materials And Methods: Specificity and accuracy estimates and 95% confidence intervals were calculated for the entire cohort and subgroups on the basis of volumes (<400, 400-800, >800 mm), slice thickness (≤1.

Medially Migrating Vestibular Schwannomas: A Review of 10 Cases.

Objective: To analyze cases of medial migration of vestibular schwannomas to propose an underlying mechanism.

Study Design: Retrospective chart review.

Patients: Ten patients from one institution with sporadic vestibular schwannomas that demonstrated medial migration toward the cerebellopontine angle on serial imaging were reviewed.

Ultra-High-Resolution Photon-Counting-Detector CT with a Dedicated Denoising Convolutional Neural Network for Enhanced Temporal Bone Imaging.

Background And Purpose: Ultra-high-resolution (UHR) photon-counting-detector (PCD) CT improves image resolution but increases noise, necessitating the use of smoother reconstruction kernels that reduce resolution below the 0.125-mm maximum spatial resolution. A denoising convolutional neural network (CNN) was developed to reduce noise in images reconstructed with the available sharpest reconstruction kernel while preserving resolution for enhanced temporal bone visualization to address this issue.

Muscle Architecture Properties of the Deep Region of the Supraspinatus: A Cadaveric Study.

Background: The supraspinatus is most frequently involved in rotator cuff tears, a common orthopaedic condition. However, the architecture of this muscle has been described only for the superficial, anterior, and posterior regions.

Purpose: To determine the muscle architecture of the deep supraspinatus.

Vestibular Schwannoma-Related Increased Labyrinthine Postgadolinium 3D-FLAIR Signal Intensity and Association with Hearing Impairment.

Background And Purpose: Vestibular schwannomas (VSs) are benign neurogenic tumors commonly associated with progressive unilateral hearing loss, tinnitus, and vestibular symptoms. Growing evidence links signal changes in the VS-adjacent labyrinth with sensorineural hearing loss. This study seeks to quantify the association of labyrinthine signal on postgadolinium 3D-FLAIR imaging correlates with hearing loss and to evaluate potential longitudinal changes over time.

Sustained Performance of Cardiac Arrest Prevention in Pediatric Cardiac Intensive Care Units.

Importance: The Pediatric Cardiac Critical Care Consortium (PC4) cardiac arrest prevention (CAP) quality improvement (QI) project facilitated a decreased in-hospital cardiac arrest (IHCA) incidence rate across multiple hospitals. The sustainability of this outcome has not been determined.

Objective: To examine the IHCA incidence rate at participating hospitals after the QI project ended and discern which factors best aligned with sustained improvement.

Fast Non-contrast MR Angiography Using a Zigzag Centric k - k k-space Trajectory and Exponential Refocusing Flip Angles with Restoration of Longitudinal Magnetization.

Purpose: Fresh blood imaging (FBI) utilizes physiological blood signal differences between diastole and systole, causing a long acquisition time. The purpose of this study is to develop a fast FBI technique using a centric k - k k-space trajectory (cFBI) and an exponential refocusing flip angle (eFA) scheme with fast longitudinal restoration.

Methods: This study was performed on 8 healthy subjects and 2 patients (peripheral artery disease and vascular disease) with informed consent, using a clinical 3-Tesla MRI scanner.

Analysis of Surgeon and Center Case Volume and Stroke or Death after Transcarotid Artery Revascularization.

Background: It has been suggested that the annual hospital volume of cases may affect the number of adverse events after carotid endarterectomy (CEA). We aim to study the associations between hospital as well as surgeon volume and the risk of stroke or death after transcarotid artery revascularization (TCAR).

Study Design: Retrospective review of the Vascular Quality Initiative data of patients undergoing TCAR from 2016 to 2021.

Photon-Counting CT in the Head and Neck: Current Applications and Future Prospects.

Photon-counting detectors (PCDs) represent a major milestone in the evolution of CT imaging. CT scanners using PCD systems have already been shown to generate images with substantially greater spatial resolution, superior iodine contrast-to-noise ratio, and reduced artifact compared with conventional energy-integrating detector-based systems. These benefits can be achieved with considerably decreased radiation dose.

Cochlear Implantation in Patients With Osteolytic Labyrinthitis: A Case Series.

Objective: To describe the rare process of osteolytic labyrinthitis, previously referred to as labyrinthine sequestrum, which involves progressive obliteration of the bony and membranous labyrinth with eventual supplantation with soft tissue and, in some cases, bony sequestrum.

Patients: Three patients with diverse presentations of osteolytic labyrinthitis from two tertiary care academic medical centers.

Interventions: Case series report analyzing the relevant clinical, radiologic, pathologic, and surgical data on our patients with osteolytic labyrinthitis and comparing these index cases to the existing literature.

Stapedotomy Versus Cochlear Implantation for Far Advanced Otosclerosis: Insights From a Patient With Matched Preoperative and Postoperative Function.

Objective: To examine patient preference after stapedotomy versus cochlear implantation in a unique case of a patient with symmetrical profound mixed hearing loss and similar postoperative speech perception improvement.

Patients: An adult patient with bilateral symmetrical far advanced otosclerosis, with profound mixed hearing loss.

Intervention: Stapedotomy in the left ear, cochlear implantation in the right ear.

Storylines of family medicine III: core principles-primary care, systems and family.

is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'III: core principles-primary care, systems, and family', authors address the following themes: 'Continuity of care-building therapeutic relationships over time', 'Comprehensiveness-combining breadth and depth of scope', 'Coordination of care-managing multiple realities', 'Access to care-intersectional, systemic, and personal', 'Systems theory-a core value in patient-centered care', 'Family-oriented practice-supporting patients' health and well-being', 'Family physician as family member' and 'Family in the exam room'. May readers develop new understandings from these essays.