3-D Ultrasound Imaging Reliability of Measuring Dysplasia Metrics in Infants

Developmental dysplasia of the hip is a hip abnormality that ranges from mild acetabular dysplasia to irreducible femoral head dislocations. While 2-D B-mode ultrasound (US)-based dysplasia metrics or disease metrics are currently used clinically to diagnose developmental dysplasia of the hip, such estimates suffer from high inter-exam variability. In this work, we propose and evaluate 3-D US-derived dysplasia metrics that are automatically computed and demonstrate that these automatically derived dysplasia metrics are considerably more reproducible. The key features of our automatic method are (i) a random forest-based learning technique to remove regions across the coronal axis that do not contain bone structures necessary for dysplasia-metric extraction, thereby reducing outliers; (ii) a bone segmentation method that uses rotation-invariant and intensity-invariant filters, thus remaining robust to signal dropout and varying bone morphology; (iii) a novel slice-based learning and 3-D reconstruction strategy to estimate a probability map of the hypoechoic femoral head in the US volume; and (iv) formulae for calculating the 3-D US-derived dysplasia metrics. We validate our proposed method on real clinical data acquired from 40 infant hip examinations. Results show a considerable (around 70%) reduction in variability in two key 3-D US-derived dysplasia metrics compared with their 2-D counterparts.     

Allograft use in anterior cruciate ligament reconstruction surgery: a review of the current literature

Anterior cruciate ligament reconstruction (ACLR) surgery plays an important role in restoring stability and function to the knee joint following ACL rupture. Owing to an increase in activity levels and sports participation, ACLR has become one of the most commonly performed procedures world-wide. Graft choice may influence clinical outcomes, and therefore the optimal graft remains widely debated. Whilst, historically, autograft tissue has been the preferred choice, the past decade has seen a steady increase in the popularity of allografts. This demand is partly driven by improvements in graft availability, procurement processes and safety; but more importantly a desire to eliminate issues related to donor site morbidity from graft harvest. Despite this, there remains controversy surrounding the use of allograft in ACLR surgery, with much of the literature demonstrating conflicting evidence on functional and survivorship outcomes. In this article we review the current literature surrounding allograft use in ACLR, from the biology of allograft integration, through to outcomes in clinical practice.     

Psychometric properties of the Persian version of the Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC) in unsuccessful sexual situations

The aim of this study was to translate and adapt to Persian, and to assess psychometric properties of the Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC). A total of 265 Iranian participants (121 women and 144 men) were recruited for this study. A principal component analysis (PCA) with varimax rotation and subsequent confirmatory factor analysis revealed a best fitting five-factor structure similar to the original QCSASC: Incompetence, Undesirability, Abandon/Rejection, Powerless/Helpless, and Difference. However, in the Iranian sample, the original Self-Depreciation dimension was included in the Incompetence and Undesirability factors. An Abandon/Rejection dimension was also evident, and may be explained by cultural, social, and religious factors in the Iranian culture. Additionally, reliability analysis has supported the internal consistency (adequate Cronbach's alpha values) and temporal stability (test–retest reliability) of the QCSASC in an Iranian sample. The findings suggest the adequacy of the Persian version of the QCSASC to assess cognitive schemas in sexual context among Iranian men and women.     

Grading Facial Nerve Function Following Combined Static and Mimetic Surgical Techniques

Objective To present a grading scale to assess the functional recovery of the facial nerve in patients who have undergone mimetic and static surgical techniques for facial reanimation. Study design This is a proposed new facial nerve grading system that will be demonstrated with specific case presentations. All patients underwent a variety of neural grafting, microvascular free-flap reconstruction, or surgical static procedures. Results The proposed facial nerve grading scale is one that has not been described previously in the literature and is applicable to a unique patient population. Its ease of use in this patient population will allow otolaryngologists to assess facial recovery accurately and quickly in cases where the facial nerve is not anatomically intact. Conclusion The proposed facial recovery grading scale provides an efficient means of grading facial recovery for a unique group of patients who previously could not be followed. The proposed scale is practical and easy to use in a clinical setting.