Short-term changes in Arctic sea-ice concentration (SIC) are largely driven by weather, and strong ice loss typically occurs during intense Arctic cyclones causing unusually warm and stormy conditions. Such conditions are prolonged when several cyclones follow rapidly on each other. Here, we analyze changes in SIC for such periods of serial cyclone clustering utilizing satellite observations and reanalysis data from 1979-2024. While cyclones generally decrease SIC compared to non-cyclone conditions, cyclone clusters impact the ice approximately 2.5 times longer and cause two times stronger overall SIC-reductions than solitary cyclones. The amount of SIC-loss due to cyclone clusters scales with the intensity and number of clustered cyclones, and intensified SIC-loss occurs from 2004-2024 compared to 1979-1999, even within fixed SIC-categories. These findings highlight the relevance of accumulated impacts of clustered weather events for Arctic sea-ice variability and emphasize the need to understand drivers of serial cyclone clustering in the Arctic.
Availability of the hepatitis B virus (HBV) vaccine in the United States since 1982 and recommendations for universal/catch-up vaccination of infants and children since the 1990s may be associated with lower HBV prevalence among people with human immunodeficiency virus (HIV; PWH) born after 1980. Active HBV infection prevalence, defined as the proportion of patients with a positive hepatitis B surface antigen result, was assessed among PWH at entry into a clinical cohort. Patients were categorized into birth-year cohorts of 1940-1959, 1960-1979, or 1980-1999 and then further dichotomized into pre- and post-1980 birth-year cohorts. Log binomial regression was used to assess the association of birth-year cohort with hepatitis B surface antigen positivity, adjusting for race/ethnicity, HIV infection risk factor, baseline HIV viral load and CD4+ cell count, HBV active therapy, and year of/age at cohort entry. Among 5598 PWH, most were male (67%) and Black (77%), with a mean age (SD) of 39.7 (9.6) years at cohort entry. Approximately a third of the participants (30%) identified as men who have sex with men, and 39% reported a history of injection drug use. At cohort entry, the majority had a CD4+ cell count <350/µL and a viral load >1000 copies/mL. The HBV prevalence was 6.7% overall but varied by birth-year cohort: 6.2% for 1940-1959, 7.9% for 1960-1979, and 2.6% for 1980-1999. The risk of HBV infection was lower in the post-1980 than in the pre-1980 cohort (adjusted prevalence ratio, 0.19 [95% confidence interval, .09- .42]). PWH born after 1980 had a lower prevalence of HBV coinfection than those born before 1980, supporting the potential impact of universal childhood HBV vaccination.
Global climate warming has intensified in recent years, with extreme weather events occurring more frequently and severely impacting ecosystems and social production. According to the "China Climate Change Blue Book (2023)," China's temperature rise rate exceeds the global average, with increasingly significant impacts on ecosystems. Hyphantria cunea, an invasive forest pest first discovered in China in 1979, has spread widely, causing serious damage to forestry and agriculture and posing a significant threat to China's ecological security. To address this threat, this study employed seven modeling algorithms (GLM, GBM, CTA, ANN, SRE, FDA, MARS, RF, and MaxEnt) from the R Biomod2 package to develop an ensemble model. The core research objective of this work is to quantify climate-driven range shifts of H. cunea under ongoing global climate change. Previous nationwide SDM studies on invasive forest pests have consistently demonstrated that climatic variables dominate broad-scale nationwide suitable habitat patterns at the macro-regional level. Supplementary topographic, vegetation cover, and human land-use disturbance layers were incorporated to capture fine-scale habitat filtering effects and long-distance pest dispersal facilitated by human activities, which together fully characterize the suitable regional environments of this pest. By integrating climate, topography, vegetation, and human disturbance data, we predicted the potential geographical distribution of H. cunea in China under four future climate scenarios (SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5). The ensemble model achieved excellent performance with TSS and ROC values of 0.901 and 0.984, respectively. Currently, highly suitable areas for H. cunea are concentrated in 12 provinces, including Shandong, Jiangsu, Hebei, Henan, and Anhui, covering 56.33 × 104 km2, with Shandong showing the highest proportion (25.48%). The suitable habitat range is projected to expand northeastward, with significant increases under high emission scenarios (SSP5-8.5). Analysis of environmental variables reveals that nighttime light brightness, precipitation in the warmest season, the seasonal temperature variation coefficient, and average temperature in the driest season are key factors influencing H. cunea distribution. Nighttime light brightness shows the highest contribution (27.7%), indicating significant human impact on species spread. Response curves suggest that H. cunea favors warm, humid areas with pronounced seasonal changes. This study demonstrates that climate change will increase H. cunea expansion risk, necessitating strengthened cross-regional monitoring and biological control techniques. These findings provide a scientific foundation for understanding H. cunea spatiotemporal distribution patterns under future climate scenarios and for developing effective prevention and control strategies.
Rural communities face worsening surgical access because of hospital closures and workforce shortages. Although osteopathic physicians have historically practiced in rural settings, their contribution to the contemporary rural surgical workforce remains poorly defined. Cross-sectional analysis of 74,404 US attending surgeons across seven specialties using the 2023 Centers for Medicare & Medicaid Services Doctors and Clinicians database. Practice addresses were linked to 2020 Rural-Urban Commuting Area codes, Area Deprivation Index quintiles, and census tract population density. Rural practice (mean Rural-Urban Commuting Area score ≥4) was modeled using multivariable logistic regression adjusted for specialty, graduation cohort, sex, Census division, and state urbanization, with state-clustered standard errors. Rural practice was more common among DO than MD surgeons (18.3% vs 9.7%; risk difference, 8.6 percentage points; 95% CI, 7.6-9.6). Across all specialties, DO surgeons practiced in more socioeconomically deprived communities. After adjustment, DO surgeons had twice the odds of rural practice compared with MD surgeons (OR, 2.05; 95% CI, 1.85-2.28). Rural areas had 13.8 surgeons per 100,000 residents versus 23.6 per 100,000 in metropolitan areas. Surgeons graduating in 2010 or later had approximately half the odds of rural practice compared with those graduating in 1979 or earlier (adjusted OR, 0.48; 95% CI, 0.42-0.56). Osteopathic surgeons disproportionately practice in rural and socioeconomically disadvantaged communities, identifying an important workforce component for maintaining rural surgical access. The declining likelihood of rural practice among more recent training cohorts raises concerns regarding the future rural surgical workforce.
Water hyacinth (Pontederia crassipes) is one of the most aggressive aquatic weeds globally, posing ecological, economic, and social threats to freshwater ecosystems. In response to its widespread proliferation, numerous control strategies have been developed and tested across different regions. This systematic review evaluates global efforts to manage water hyacinth, with a particular focus on the effectiveness, sustainability, and practical applicability of biological, chemical, physical, and integrated control methods. A total of 141 peer-reviewed articles and case studies published between 1979 and 2024 were analyzed using structured keyword searches across academic databases. The review found that biological control is the most widely employed strategy (56.8%), particularly in Africa, which accounted for more than half of the global research efforts on water hyacinth management. Among chemical methods, herbicides such as 2,4-D and glyphosate have demonstrated high efficacy but raise concerns regarding environmental and socioeconomic impacts. Physical processes, while safe, are labor-intensive and less feasible on larger scales. Integrated approaches, which combine multiple strategies, emerged as the most sustainable and context-sensitive option. Notably, the potential for water hyacinth utilization, especially in pollution control (27.08%), bioenergy, composting, and handicrafts, offers an additional pathway for sustainable management. This review emphasizes the importance of integrated and sustainable approaches, encouraging future efforts to focus on technological innovations and practical utilization.
Neurosurgical fellowships to obtain additional surgical training after residency are a career option widely available to the newer generation of neurosurgeons. This study aims to analyze current trends in fellowship training among spine neurosurgeons in Florida and factors that influence the choice of fellowship based on year, location, and academic trajectory. This retrospective cross-sectional study collected demographic data and bibliometric information on neurosurgeons specializing in spine, comparing those with fellowship training and those without. The information was gathered from the American Association of Neurological Surgeons and the Florida Department of Health databases.  Results: A total of 113 spine-specialized neurosurgeons with active medical licenses were identified in the state of Florida at the time of this study in 2026. A proportion (23.53%; n = 12) of Florida-based spine neurosurgeons obtained their fellowship training in Florida, most commonly at the University of Miami/Jackson Health System. Out of a total of 113, only two (1.77%) spine neurosurgeons are female, and four (3.54%) have osteopathic doctoral degrees (D.O.). In 1960-1964 and 1975-1979, none (n = 0) had completed a spine fellowship, while 33.33% (n = 1) had done so in 1970-1974. The proportion was 28.57% (n = 2) in 1980-1984 and 16.67% (n = 2) in 1985-1989. An overall increase was observed in subsequent years: 23.53% (n = 4) in 1990-1994, 47.83% (n = 11) in 1995-1999, 50.00% (n = 4) in 2000-2004, 62.50% (n = 5) in 2005-2009, and 75.00% (n = 6) in 2010-2014. The highest percentage was observed in 2015-2019 at 73.33% (n = 11), followed by 66.67% (n = 6) in 2020-present.  Over the past 60+ years, there has been an increase in the number of Florida-based spine neurosurgeons pursuing fellowship training, with the highest percentage seen in those graduating from 2015-2019. However, there is still a low representation of female and osteopathic spine neurosurgeons in Florida. This growing trend of spine-specialization highlights a potential shift in neurosurgery career trajectories and has important implications for future workforce planning and patient care in spine surgery.
Over the years, diagnostic arthroscopy has been the key to accurately diagnosing lesions in the knee. However, accessing the posterior compartment of the knee remains a challenge for upcoming arthroscopy surgeons. Gillquist was the first surgeon to publish a technique for accessing the posteromedial compartment in 1979, following which several techniques were developed, like modified Gillquist and switching stick maneuvers. According to Gillquist, "posterior compartments are the litterbox of the knee" and the advantages of posterior evaluation include evaluation of ramp lesions, remnants after partial meniscectomy, loose bodies, and to safely create posterior portals for arthroscopic visualization, posterior cruciate ligament (PCL) surgery and ramp repair. However, there is a risk of damaging the lateral portion of the medial femoral condyle chondral damage and broken arthroscope while attempting these blind maneuvers, and these techniques require expertise and more operative time. Our approach aims to simplify these procedures, reducing the time require to access the posteromedial compartment while minimizing the risk of unintended damage to the medial femoral condyle cartilage.
Recently, the possibility of extending the so-called 14-Day Rule on human embryonic research has received increased attention, but many ethical, legal, scientific and logistical questions about doing so remain. When the 14-Day Rule was developed in 1979, human embryos could only be cultured for 3-5 days. Recently, embryos have been cultured for up to 13 or 14 days, which has the potential to provide important health benefits. Statements advocating extending the Rule have all stipulated that public engagement is essential. But crucial challenges arise, which have received relatively little attention, regarding specifically what and how to communicate about these controversial topics to policymakers, journalists and the public-what precisely to convey, how exactly such public discussions should occur, what content such communication should include, what obstacles may emerge and how best to respond to these barriers. Particular ethical, attitudinal, psychological, political, historical, educational and logistical obstacles emerge. Terms other than embryo 'destruction', for instance, may help. Empirical survey research is urgently needed to comprehend how policymakers and the public view and understand these issues and what educational approaches will be most effective. This paper examines challenges that emerge, suggests ways of addressing these and highlights needs for enhancing education, communication and literacy concerning relevant scientific and ethical issues. The enactment of ethically informed policy requires attention to not only what policies to pursue but how to communicate about these to stakeholders. Advocates for extensions of the Rule should recognise and begin to address these challenges as soon as possible.
The purpose was to identify the 100 most-cited scientific publications in ankle cartilage and provide an analysis of their main characteristics. The Web of Science (Clarivate) database was searched in April 2025 to obtain data and metrics on ankle cartilage research. The search list was sorted by the number of citations, and articles were included or excluded based on their relevance to ankle cartilage research. The information extracted for each article included the publication year, citation count, author's name, country of origin, journal name, article type, citation density and the level of evidence. The 100 studies generated a total of 17,208 citations, with an average of 172 citations per article. The most-cited article was cited 489 times. The 100 studies included in this analysis were published between 1979 and 2018. In total, these articles represented 13 different countries of origin. The United States represented 38 of the 100 articles. The Netherlands, Italy and Germany followed with nine articles, and South Korea with seven articles. The most prevalent study designs were case series, and the most prevalent level of evidence was Level IV (69 studies). The present research concludes that the 100 most-cited publications in cartilage lesions of the ankle research were cited a total of 17,208 times. Case series and cohort studies were among the most frequently used study designs with an overall relatively low-level of evidence. The present work may function as a reference standard to help direct orthopaedic providers to the 100 most-cited studies in cartilage lesions of the ankle. N/A.
Concerns regarding cancer incidence, particularly non-Hodgkin lymphoma, among U.S. Air Force missile community members prompted the initiation of the Missile Community Cancer Study. This phased, retrospective process study was designed around the unique needs of the Missile Community and adapted to these requirements. A cohort of all active duty Department of the Air Force (DAF) service members from 1976 to 2010 (N∼1.82 million), including approximately 65,000 personnel in missile-related career fields, was created via multiple data sources through a phased approach. Phase 1A examined Department of Defense (DoD) electronic health records (EHR) (2001-2020); Phase 1B added DoD and Department of Veterans Affairs (VA) cancer registry data (1976-2020) and VA EHR (1991-2020); and Phase 1C analyzed cancer mortality using National Death Index data (1979-2020). Armed Forces Health Surveillance Division and Surveillance, Epidemiology, and End Results cancer incidence and mortality case definitions were applied. In Phase 1A, 4,865 incident cancers were identified from the DoD EHR across the cohort, including 198 cases in the missile community. After adding DoD and VA registry data and VA EHR data in Phase 1B, an additional 50,359 cases were identified, including 1,641 missile community cases. Mortality analysis (Phase 1C) identified 37,100 cancer deaths across the cohort, including 1,145 in the missile community. Across Phases 1A, 1B, and 1C, no statistically significant excess incidence or mortality of non-Hodgkin lymphoma or the 13 other study cancers was observed in the missile community compared to other DAF members or the U.S. population. The overlap between EHRs and cancer registries within both the VA and DoD systems found over half of EHR-identified cases were also included in their respective cancer registries and 76.1% of all Phase 1 cancer cases were captured in a registry. This study's multi-phase approach with both internal and external comparison groups enhanced the comprehensiveness and accuracy of cancer case identification. The phased data linkage and validation approach provided a replicable framework for epidemiological cancer studies in military populations, illustrating methods for integrating and prioritizing data sources to address health concerns. The findings may ultimately guide future epidemiologic studies of cancer in the military to select optimal datasets, optimizing resource utilization and streamlining study timelines.
Organ transplantation is the ultimate treatment that extends and improves the quality of life for patients with end-stage organ failure, and among these, brain-dead organ donation enables life-sustaining heart and lung transplants. Since the first kidney transplantation from a brain-dead donor in Korea in 1979, the Organs Transplant Act was enacted in 1999 and comprehensively revised in 2010. This amendment marked a shift in the national framework from "Preventing Organ Trafficking and Ensuring Fair Allocation" toward "Establishing an Active Organ Procurement System" to promote donation. The number of brain-dead donors increased every year from 2010 to 2016 following the comprehensive amendment of the Organs Transplant Act. Since 2017, however, this trend has plateaued and subsequently declined, raising concerns about the widening gap between organ supply and demand, increasing reliance on living donation, and prolonged waiting times and mortality among transplant candidates. The major underlying causes of brain death, including traumatic brain injury, intracranial hemorrhage, and hypoxic brain injury, are frequently encountered in neurocritical care. Therefore, neurosurgeons play a crucial role in the brain-dead organ donation pathway. This review examines the institutional framework and current status of brain-dead organ donation in Korea. It also discusses the major clinical conditions leading to brain-dead organ donation and explores the role of neurosurgeons, as well as points of collaboration with the Korea Organ Donation Agency.
The reliability of transfer parameters in radiological assessment is essential for estimating the food chain transfer of radionuclides, which commonly uses the concentration ratio (CRplant-soil) as a key parameter in evaluating ingestion dose exposure to humans. Rice (Oryza sativa L.) is a staple food consumed by half of the world's population, and it plays a particularly significant role in Thailand's diet and economy. The CRrice-soil dataset reported by the International Atomic Energy Agency (IAEA) shows high variability across different environments (temperate and tropical), with a notable scarcity of related parameters such as soil properties within specific study sites. This scarcity is particularly evident in Thailand, where CRrice-soil data have been reported in only a few studies. This study determined CRrice-soil values for natural radionuclides (40K, 226Ra, 228Ra, and 228Th) and trace elements (As, Cd, Co, Cr, Cs, Cu, Li, Ni, Pb, Rb, Se, Sr, Th, Tl, U, Y, and Zn) using 295 paired samples of soil and rice plants (root, stem, and grain) collected from Thailand's principal rice-growing areas. The arithmetic mean CRrice-soil values from this study were generally higher than those reported in international references (IAEA TRS 472 and MODARIA II TECDOC-1979). For most elements, CR values in rice plant parts decreased in the order CRroot > CRstem > CRgrain. A significant negative correlation between CRrice-soil values and soil physicochemical properties (pH, CEC, and OM) was observed using Spearman's rho. Spatial variation in CRrice-soil was also linked to soil texture. This study provides the first macro-scale quantification of CRrice-soil values in Thai rice and may support radiological assessments in tropical and international contexts.
To evaluate national mortality trends associated with choking before and after the introduction of the Heimlich maneuver in 1974. We analyzed CDC Multiple Cause-of-Death data from 1970 to 2021 to identify deaths in which choking was the primary cause, using ICD-8, -9, and -10 codes. Deaths in which choking was coded only as a contributing cause were excluded. Mortality rates were stratified by age (15-64 and ≥ 65); for data from 1979 to 2021, deaths were additionally stratified by location (inpatient vs. outpatient) within each age stratum. Temporal trends were assessed using Joinpoint regression, with annual percentage change (APC) as the primary outcome. Among individuals aged 15-64, choking mortality increased from 1970 to 1975 (APC +2.45%) then declined significantly from 1975 to 1985 (APC -5.15%) and continued to decrease through 2021. Outpatient deaths in this age group declined consistently from 1979 to 2021. Among adults ≥ 65 years, no sustained mortality reduction was observed; inpatient deaths in this group fluctuated with alternating periods of increase and decrease. A sustained decline in choking-related mortality among nonelderly adults coincided temporally with the introduction and widespread adoption of the Heimlich maneuver, particularly in outpatient settings. No corresponding reduction was observed among older adults in inpatient settings. These findings are consistent with a population-level benefit of the maneuver in community settings, though causality cannot be established from these data. Tailored preventive strategies are needed for high-risk elderly populations.
This study uses an intersectional framework to evaluate age, period, and birth cohort trends in activity limitations among adults aged 30-45. We estimated cohort effects for activity limitation prevalence using cross-sectional data from the National Health Interview Survey between 1973 and 2016. We conducted an Age-Period-Cohort (APC) analysis using the median polish approach to calculate the prevalence ratios (PR) estimating birth cohort effects. We then calculated stratified estimates for Black and white women and men. The overall prevalence of activity limitations was higher in more recent birth cohorts than the earliest cohorts identified in the study. The cohort effect was 1.04 (95% CI:1.00, 1.07) for the 1979-1982 birth cohort and 1.04 (95% CI: 0.99-1.08) for the 1983-1986 birth cohort relative to referent 1943-1946 birth cohort. When stratified by race and gender, this cohort effect was only seen in White men. For Black men, significant cohort effects were pronounced in individuals born between the late 1940s and mid-1950s. There were no significant cohort effects for Black women or White women, however Black women had higher prevalence across time periods and age groups relative to White Women. Modeling race and gender separately obscures important differences in activity limitation trends across populations. Findings highlight the importance of an intersectional approach to understanding health inequities with respect to activity limitations, an outcome that reflects the interaction of health, the social environment, and structural ableism.
Given the alarming rise in physical inactivity among Iranian children and adolescents, the present study aimed to analyze policy documents focused on promoting physical activity in this age group. This qualitative study employed a document analysis methodology. Policy documents concerning the promotion of physical activity among Iranian children and adolescents were analyzed using the four-stage READ framework. Thematic analysis was conducted to identify key themes through systematic coding and categorization. The reviewed documents covered a period spanning from 1979 to 2024. The analysis of 36 documents revealed that current policies mainly focus on five key areas including school-based approaches, resources and infrastructure, intersectoral collaboration, education and public awareness, and monitoring and evaluation. The findings indicated that despite their diversity, these policies often lack coherence, clearly defined implementation strategies, and effective evaluation systems. Additionally, institutional collaboration and the adoption of modern technologies have been limited. These results could serve as a foundation for improving future policymaking.
Lung cancer screening implementation is taking shape worldwide. Programme design requires specifying eligibility criteria, screening interval, and the optimal age range. We estimate benefits and harms of competing strategies, integrating NELSON results, smoking cessation interventions, contemporary treatment costs, and the management of feasible CT capacity. 1080 strategies are evaluated using the MISCAN-Lung microsimulation model, calibrated to NELSON and NLST data. 1945-1979 Dutch cohorts are simulated using a representative smoking history generator. For each strategy, the (cost-)effectiveness is evaluated, as well as CT requirements and the incremental benefit of a smoking cessation intervention (pharmacotherapy). Lung cancer screening was found to be cost-effective overall. Risk-based recruitment (PLCOm2012) is more efficient than pack-year-based criteria. Annual screening ages 55-75 from > 1.5% lung cancer risk is cost-efficient (ICER < €20 k), and would cost €12,201 per quality-adjusted life-year (QALY) relative to no screening (or €19,713 compared to less intensive screening). Population-wide, lung cancer mortality would be reduced by 10.8% (1072 cases/year) at full uptake, or by 6.2% at 50% uptake. For the first three years, at 50% uptake of screening, the strategy requires a 16.1% increase of national CT volume. Nearly half of CT costs are offset by reductions in terminal care expenditures. Integrated smoking cessation is cost-effective at €10,043/QALY (relative to screening without integrated cessation), yielding 32% additional life-years gained. Lung cancer screening is increasingly cost-effective and may be critically considered for implementation, including integrated smoking cessation. We find annual screening ages 55-75 for those > 1.5% (PLCOm) risk to be within a €20 k willingness-to-pay and feasible CT requirements.
The PIRAGUA_atmos_analysis and PIRAGUA_hydro_analysis datasets have been developed to support a comprehensive assessment of current water resources across the Pyrenees region, encompassing Spain, France, and Andorra. PIRAGUA_atmos_analysis is a daily, gridded dataset of near-surface meteorological variables designed to serve as input for hydrological and land-surface models. It is based on the SAFRAN reanalysis framework and assimilates observational data from both the Spanish and French meteorological agencies, covering the hydrological years from September 1979 to August 2014. PIRAGUA_hydro_analysis provides monthly water balance components derived from the SASER and SWAT hydrological models for the 1981-2010 period, driven by PIRAGUA_atmos_analysis forcing. This article documents the development of both datasets and illustrates their potential applications. Alongside the datasets, we provide example R scripts for data exploration, an interactive visualization and analysis platform, and access through a dedicated geo-server. These resources aim to foster transparency, reproducibility, and informed decision-making in regional water management and planning.
Obesity is a global health threat, especially among women of reproductive age, and it adversely affects the health of both mothers and their children. This study aimed to identify and analyze the causes and management challenges of maternal obesity in Iran from the perspectives of key informants. This is a qualitative study. We conducted semi-structured, in-depth interviews with 20 experts, from September to December 2023. We analyzed data using Leichter's (1979) framework through an inductive-deductive approach, facilitated with MAXQDA 2020 software. We identified challenges in managing maternal obesity and categorized them into 10 main categories and 21 sub-categories, grouped within five constructs according to Leichter's framework: Situational factors (climate changes and international sanctions), Structural factors (high prevalence of overweight and obesity among women and unfavorable economic conditions), Socio-cultural factors (misconceptions and misuse of traditional Iranian medicine), Environmental or International factors (social norms and values, and the limited influence of international organizations), and Governance and Executive factors (weak governance by the Ministry of Health and Medical Education (MoHME) and poor inter-sectoral cooperation). Addressing maternal obesity is essential to achieve Sustainable Development Goals (SDGs), particularly in low- and middle-income countries (LMICs). Current challenges such as food insecurity, economic decline, and insufficient maternal awareness threaten maternal health in relation to obesity. Tackling these issues requires a coordinated, multi-sectoral approach involving healthcare system strengthening, public awareness campaigns, and empowerment of women and families. Prioritizing maternal obesity within national health agendas is critical for an effective response. Further research on maternal obesity in Iran is recommended to uncover root causes and develop effective interventions, providing policymakers with the evidence needed for informed decision-making.
Scaphocephaly, the most common single-suture craniosynostosis, results from premature sagittal suture closure. Surgery aims to restore normal skull morphology and prevent raised intracranial pressure. We used artificial intelligence-based methods to assess craniofacial morphology in patients with nonsyndromic scaphocephaly, comparing pre- and postoperative 2-dimensional (2D) facial photographs with controls to evaluate the outcomes of 2 age-specific techniques and identify the key morphological parameters. We analyzed a database of 1369 patients (1979-2023) using 1544 2D frontal and lateral photographs, including 358 patients with scaphocephaly-130 treated with Renier H-cranioplasty and 119 with total vault remodeling (TVR). Our approach combined automatic facial landmark detection, point-cloud superimposition, geometric morphometrics, texture analysis, classification algorithms, and generation of synthetic patient faces. Patients treated with Renier H-cranioplasty were compared with those treated with TVR. Significant morphological differences were found between patients with scaphocephaly and controls, both before and after surgery. Postoperatively, patients retained a distinguishable craniofacial phenotype, indicating that surgery did not fully normalize the skull shape. Early Renier H-cranioplasty reduced the anteroposterior diameter more effectively than late TVR. Both techniques had limited impact on posterior cranial vault morphology. Artificial intelligence-based analysis of 2D facial photographs provided valuable insights into diagnosis and surgical morphological outcomes in scaphocephaly. Postoperatively, patients maintained a nonnormalized phenotype, with early correction yielding better results than late remodeling. Further studies are needed to correlate these shape modifications with intracranial pressure values.
In 2013, the Cytopathology Committee of the College of American Pathologists conducted its first survey on the practice patterns of laboratories performing respiratory cytology. To capture current laboratory practices, recognize changes in respiratory cytopathology practices over the last decade, and provide insight into future directions for improvement. The survey was mailed to 1979 laboratories. The survey results show a high demand for respiratory cytology. There has been a shift regarding the preferred technique to endobronchial ultrasound-guided fine-needle aspirations as one of the most frequently processed and interpreted specimens, and the most commonly performed intraprocedural assessments. The pathologist alone mostly performed intraprocedural assessments, followed by the cytotechnologist alone. The immunostaining markers used to differentiate non-small carcinomas were most commonly the panel p63, CK5/6, and p40 for squamous cell carcinoma or TTF-1 and Napsin A for adenocarcinoma, compared with a single stain for either. Molecular testing for non-small cell lung carcinomas was commonly performed, with most molecular testing being sent to an outside laboratory. Immunohistochemical stains were validated in half of the institutions, with a high number responding that they were unsure of the validation performed in their laboratories. This follow-up study of our original study has shown significant advances in the field of respiratory cytology. The data also showed a few areas, specifically validation of cytology preparations for ancillary testing and molecular testing, which may benefit from guidelines to standardize cytopathology practice and ensure quality care.