Increased cochlear radiation dose predicts delayed hearing loss following both stereotactic radiosurgery and fractionated stereotactic radiotherapy for vestibular schwannoma.

PURPOSE: Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) are noninvasive therapies for vestibular schwannomas providing excellent tumor control. However, delayed hearing loss after radiation therapy remains an issue. One potential target to for improving hearing rates is limiting radiation exposure to the cochlea. METHODS: We retrospectively reviewed 100 patients undergoing either SRS with 12 Gy (n = 43) or fSRT with 50 Gy over 28 fractions (n = 57) for vestibular schwannoma. Univariate and multivariate analysis were carried out to identify predictors of hearing loss as measured by the Gardner Robertson scale after radiation therapy. RESULTS: Deterioration of hearing occurred in 30% of patients with SRS and 26% with fSRT. The overall long term (> 2 year) progression rates were 20% for SRS and 16% for fSRT. Patients with a decrease in their Gardner Robertson hearing score and those that loss serviceable hearing had significantly higher average minimal doses to the cochlea in both SRS and fSRT cohorts. ROC analysis showed that a cut off of 5 Gy and 35 Gy, for SRS and fSRT respectively, predicted hearing loss with high sensitivity/specificity. CONCLUSION: Our data suggests the minimal dose of radiation that the cochlear volume is exposed to is a predictor of delayed hearing loss after either SRS or fSRT. A threshold of 5 Gy/35 Gy may lead to improved hearing preservation after radiotherapy. Further prospective multi center studies can further elucidate this mechanism.

Evaluation of the Flexural Strength of Submicron Hybrid Composite using Different Fabrication Methods: An in vitro Study.

AIM: The aim of this study is to perform three-point bend test on submicron hybrid composite fabricated with direct and indirect veneer technique. MATERIALS AND METHODS: A total of 20 maxillary anterior teeth were selected, and labial reduction of 0.5 to 0.75 mm with a chamfered finish line for veneer preparation was done. Teeth were divided into two groups depending on fabrication technique being used: group I-veneers fabricated with light and group II-veneers fabricated with light and heat (PHOTOPOL). Specimens were tested under universal testing machine (UTM) where load was applied at a crosshead speed of 1 mm/min with a pointer of 1 mm diameter. Data were statistically analyzed. RESULTS: The results showed highly significant difference between the two groups with the mean value of group I (246.7 ± 2.285 N) and group II (531.1 ± 4.411 N). CONCLUSION: The curing mechanism involving light and heat increases the fracture resistance of the veneers. CLINICAL SIGNIFICANCE: Within the limitations of this study, the results led to the conclusion that the association of common composites with a simple postcure heat treatment may be an alternative for current indirect composite systems, although more studies are needed to assess other properties of the composites for this application.

Postoperative Pneumolabyrinth Following the Middle Cranial Fossa Approach for Superior Semicircular Canal Dehiscence Repair, 2014-2020.

OBJECTIVE: The present study investigates risk factors and clinical outcomes of postoperative pneumolabyrinth following the middle cranial fossa approach for superior semicircular canal dehiscence repair, a complication that has not been documented previously. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary/quaternary care referral center. METHODS: We conducted a retrospective review of 332 middle cranial fossa procedures from 2014 to 2020 at a tertiary/quaternary care institution. Upon identifying pneumolabyrinth cases from postoperative computed tomography temporal bone scans, we conducted multivariable logistic regression analysis to explore demographic and clinical factors that were independently linked to this complication. We also compared the rates of postoperative symptoms among patients with different grades of pneumolabyrinth. RESULTS: We identified 41 (12.3%) pneumolabyrinth cases. Patients with older age, higher preoperative pure tone average, and frank dehiscence were at higher risk for pneumolabyrinth. Furthermore, patients with pneumolabyrinth reported significantly higher rates of postoperative dizziness and exhibited significantly greater pure tone average and air-bone gap postoperatively as compared with patients without pneumolabyrinth. Finally, higher-grade pneumolabyrinth was associated with increased rates of postoperative hearing loss, and grade III pneumolabyrinth was associated with higher rates of postoperative tinnitus vs grade I and II cases. CONCLUSION: Pneumolabyrinth following the middle cranial fossa approach was associated with poor clinical outcomes, including dizziness and auditory impairment. Old age, high preoperative pure tone average, and frank dehiscence were risk factors for this complication. The highlighted parameters may be important to note when considering this approach as a treatment option and while monitoring postoperative recovery.

Molecular diversity of entodiniomorphid ciliate Troglodytella abrassarti and its coevolution with chimpanzees.

The entodiniomorphid ciliate Troglodytella abrassarti is a colonic mutualist of great apes. Its host specificity makes it a suitable model for studies of primate evolution. We explored molecular diversity of T. abrassarti with regard to large geographical distribution and taxonomic diversity of its most common host, the chimpanzee. We found a very low diversification of T. abrassarti in chimpanzees across Africa. Distribution of two types of T. abrassarti supports evolutionary separation of the Western chimpanzee, P. t. verus, from populations in Central and East Africa. Type I T. abrassarti is probably a derived form, which corresponds with the Central African origin of chimpanzees and a founder event leading to P. t. verus. Exclusivity of the respective types of T. abrassarti to Western and Central/Eastern chimpanzees corroborates the difference found between an introduced population of presumed Western chimpanzees on Rubondo Island and an autochthonous population in mainland Tanzania. The identity of T. abrassarti from Nigerian P. t. ellioti and Central African chimpanzees suggests their close evolutionary relationship. Although this contrasts with published mtDNA data, it corroborates current opinion on the exclusive position of P. t. verus within the chimpanzee phylogeny. The type of T. abrassarti occurring in Central and East African common chimpanzee was confirmed also in bonobos. This may point to the presence of an ancestral Type II found throughout the Lower Guinean rainforest dating back to the common Pan ancestor. Alternatively, the molecular uniformity of T. abrassarti may imply a historical overlap of the species' distribution ranges.

Classifier Fusion for Detection of COVID-19 from CT Scans.

The coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. COVID-19 is found to be the most infectious disease in last few decades. This disease has infected millions of people worldwide. The inadequate availability and the limited sensitivity of the testing kits have motivated the clinicians and the scientist to use Computer Tomography (CT) scans to screen COVID-19. Recent advances in technology and the availability of deep learning approaches have proved to be very promising in detecting COVID-19 with increased accuracy. However, deep learning approaches require a huge labeled training dataset, and the current availability of benchmark COVID-19 data is still small. For the limited training data scenario, the CNN usually overfits after several iterations. Hence, in this work, we have investigated different pre-trained network architectures with transfer learning for COVID-19 detection that can work even on a small medical imaging dataset. Various variants of the pre-trained ResNet model, namely ResNet18, ResNet50, and ResNet101, are investigated in the current paper for the detection of COVID-19. The experimental results reveal that transfer learned ResNet50 model outperformed other models by achieving a recall of 98.80% and an F1-score of 98.41%. To further improvise the results, the activations from different layers of best performing model are also explored for the detection using the support vector machine, logistic regression and K-nearest neighbor classifiers. Moreover, a classifier fusion strategy is also proposed that fuses the predictions from the different classifiers via majority voting. Experimental results reveal that via using learned image features and classification fusion strategy, the recall, and F1-score have improvised to 99.20% and 99.40%.

Campylobacter troglodytis sp. nov., isolated from feces of human-habituated wild chimpanzees (Pan troglodytes schweinfurthii) in Tanzania.

The transmission of simian immunodeficiency and Ebola viruses to humans in recent years has heightened awareness of the public health significance of zoonotic diseases of primate origin, particularly from chimpanzees. In this study, we analyzed 71 fecal samples collected from 2 different wild chimpanzee (Pan troglodytes) populations with different histories in relation to their proximity to humans. Campylobacter spp. were detected by culture in 19/56 (34%) group 1 (human habituated for research and tourism purposes at Mahale Mountains National Park) and 0/15 (0%) group 2 (not human habituated but propagated from an introduced population released from captivity over 30 years ago at Rubondo Island National Park) chimpanzees, respectively. Using 16S rRNA gene sequencing, all isolates were virtually identical (at most a single base difference), and the chimpanzee isolates were most closely related to Campylobacter helveticus and Campylobacter upsaliensis (94.7% and 95.9% similarity, respectively). Whole-cell protein profiling, amplified fragment length polymorphism analysis of genomic DNA, hsp60 sequence analysis, and determination of the mol% G+C content revealed two subgroups among the chimpanzee isolates. DNA-DNA hybridization experiments confirmed that both subgroups represented distinct genomic species. In the absence of differential biochemical characteristics and morphology and identical 16S rRNA gene sequences, we propose to classify all isolates into a single novel nomenspecies, Campylobacter troglodytis, with strain MIT 05-9149 as the type strain; strain MIT 05-9157 is suggested as the reference strain for the second C. troglodytis genomovar. Further studies are required to determine whether the organism is pathogenic to chimpanzees and whether this novel Campylobacter colonizes humans and causes enteric disease.

Automated Diagnosis of COVID-19 Using Deep Features and Parameter Free BAT Optimization.

Background: Accurate and fast diagnosis of COVID-19 is very important to manage the medical conditions of affected persons. The task is challenging owing to shortage and ineffectiveness of clinical testing kits. However, the existing problems can be improved by employing computational intelligent techniques on radiological images like CT-Scans (Computed Tomography) of lungs. Extensive research has been reported using deep learning models to diagnose the severity of COVID-19 from CT images. This has undoubtedly minimized the manual involvement in abnormality identification but reported detection accuracy is limited. Methods: The present work proposes an expert model based on deep features and Parameter Free BAT (PF-BAT) optimized Fuzzy K-nearest neighbor (PF-FKNN) classifier to diagnose novel coronavirus. In this proposed model, features are extracted from the fully connected layer of transfer learned MobileNetv2 followed by FKNN training. The hyperparameters of FKNN are fine-tuned using PF-BAT. Results: The experimental results on the benchmark COVID CT scan data reveal that the proposed algorithm attains a validation accuracy of 99.38% which is better than the existing state-of-the-art methods proposed in past. Conclusion: The proposed model will help in timely and accurate identification of the coronavirus at the various phases. Such kind of rapid diagnosis will assist clinicians to manage the healthcare condition of patients well and will help in speedy recovery from the diseases. Clinical and Translational Impact Statement - The proposed automated system can provide accurate and fast detection of COVID-19 signature from lung radiographs. Also, the usage of lighter MobileNetv2 architecture makes it practical for deployment in real-time.

Does Presence of role Models at Undergraduate Training Level Impact the Choice of Specialization as Maxillofacial Surgery for Young Women Dental Graduates?: Qualitative Study and Review Of Literature.

INTRODUCTION: Even though dentistry is becoming a women-dominated profession, this is not translating into the choosing oral and maxillofacial surgery as a specialization. Hence, this study was undertaken to analyse factors impacting the choice of specialization and what impact does presence of role models as an intervention have on the attitudes of these young women on their overall career choice decisions. PURPOSE: This qualitative study was undertaken with the aim of understanding and analyzing the impact of role models on the overall shift in attitude of young women graduate students towards oral and maxillofacial surgery as a specialty. METHODS: Eleven women maxillofacial faculties from all over the country participated in this study conducted during the 2020 Pandemic. In this study, through the online teaching programme, the influence of women teaching faculties in the form of role models was statistically analysed on 103 attendees out of 140 who answered the survey questionnaire. The sessions were conducted on Zoom platform in the form of lectures of graduate course topics as defined by Dental Council of India. The overall attitudinal shift was then statistically analysed through Chi-square test. RESULT: Out of 140 students, 103 students responded to the survey questionnaire. Responses of these students were statistically analysed with Chi-square test. The p value <.05 confirmed the hypothesis that presence of role models does have an impact on the choice of specialization. CONCLUSION: The sample size of this was small and the period of follow-up was short, four months. In order to validate these results, larger cohort and longitudinal studies of long follow-up are needed. In spite of these drawbacks, the results of this study highlight, with the help of the literature, the important role a woman mentor positively plays in career choice and other aspects of women surgeon's professional life.

Artificial Intelligence in Epilepsy.

BACKGROUND: The study of seizure patterns in electroencephalography (EEG) requires several years of intensive training. In addition, inadequate training and human error may lead to misinterpretation and incorrect diagnosis. Artificial intelligence (AI)-based automated seizure detection systems hold an exciting potential to create paradigms for proper diagnosis and interpretation. AI holds the promise to transform healthcare into a system where machines and humans can work together to provide an accurate, timely diagnosis, and treatment to the patients. OBJECTIVE: This article presents a brief overview of research on the use of AI systems for pattern recognition in EEG for clinical diagnosis. MATERIAL AND METHODS: The article begins with the need for understanding nonstationary signals such as EEG and simplifying their complexity for accurate pattern recognition in medical diagnosis. It also explains the core concepts of AI, machine learning (ML), and deep learning (DL) methods. RESULTS AND CONCLUSIONS: In this present context of epilepsy diagnosis, AI may work in two ways; first by creating visual representations (e.g., color-coded paradigms), which allow persons with limited training to make a diagnosis. The second is by directly explaining a complete automated analysis, which of course requires more complex paradigms than the previous one. We also clarify that AI is not about replacing doctors and strongly emphasize the need for domain knowledge in building robust AI models that can work in real-time scenarios rendering good detection accuracy in a minimum amount of time.

Analysis of temporal bone thickness outside of the petrous temporal bone between superior semicircular canal dehiscence and normal patients.

BACKGROUND: SSCD is a rare inner ear disorder. This study aims to compare the thickness of the temporal bone beyond the petrous portion between healthy subjects and those with SSCD to determine whether the etiopathology of SSCD is localized to the petrous temporal bone or generalized to other parts of the temporal bone. METHODS: A retrospective chart review of electronic medical records from September 2011 to February 2018 was conducted at a single-institution study at the University of California, Los Angeles. Participants were divided into two groups: Group 1 had a confirmed diagnosis of SSCD, while Group 2 had no known ear or temporal bone pathology. Participants' high-resolution coronal and axial temporal bone computed tomography scans were analyzed. Regions within the temporal bone were measured and compared between the two groups. RESULTS: A total of 262 scans were included. Group 1 consisted of 103 scans, while Group 2 consisted of 159 scans. There was no statistically significant difference in the thickness of temporal bones between patients diagnosed with SSCD and patients without otologic disease. CONCLUSION: The results suggest that the etiology of SSCD is limited to the petrous portion of the temporal bone. SSCD may be unrelated to a larger process of global temporal bone degeneration. Additional clinical screening for regions outside the petrous temporal bone is not warranted unless SSCD patients present with symptoms characteristic of other temporal bone pathologies.

Concurrent superior semicircular canal dehiscence and endolymphatic hydrops: A novel case series.

INTRODUCTION: Superior semicircular canal dehiscence (SSCD) is characterized by CT-confirmed bony erosion over the superior semicircular canal, creating vestibular and auditory symptoms. Endolymphatic hydrops (EH) is characterized by an MRI-confirmed excess of endolymph within the scala media that distorts the membranous labyrinth. While there is overlap in symptoms, the two diseases result from different pathophysiologies and require different interventions. PRESENTATION OF CASES: A retrospective chart review was conducted at the University of California, Los Angeles on a database of 270 adult SSCD patients, gathered between March 2011 and February 2020. A review of clinical notes, post-operative findings, and imaging was performed for 16 patients who had both CT-confirmed SSCD and an MRI of the internal auditory canal (IAC). Three cases of concurrent SSCD and EH were identified. Medical and surgical history, symptom progression pre- and post-operatively, and treatment outcomes were gathered. One patient's symptoms were resolved via mycophenolate mofetil, another's via hydrochlorothiazide, and the third's via hydrochlorothiazide and bilateral hearing aids. DISCUSSION: Post-surgical persistence of SSCD symptoms that are mutually shared with EH is the strongest indicator that a physician should investigate for concurrent EH. VEMP and audiogram testing in these cases can be misleading and should not be relied on as rule-in or rule-out tests. CONCLUSION: Concurrent SSCD and EH is a rare but treatable entity. Physicians should consider ordering an MRI of the IAC if SSCD patients' symptoms persist or recur after a successful surgery.

Fecal bacterial diversity of human-habituated wild chimpanzees (Pan troglodytes schweinfurthii) at Mahale Mountains National Park, Western Tanzania.

Although the intestinal flora of chimpanzees has not been studied, insight into this dynamic environment can be obtained through studies on their feces. We analyzed fecal samples from human-habituated, wild chimpanzees at Mahale Mountains National Park, Tanzania, and compared microbial community profiles to determine if members of the same social group were similar. Between July and December 2007, we collected fresh fecal samples from 12 individuals: four juveniles, four adolescents, and four adults, including three parent-offspring pairs. Each sample was analyzed using Terminal-Restriction Fragment Length Polymorphism of amplified 16S rRNA genes. Twelve different profiles were generated, having between 1 and 15 Terminal-Restriction Fragments (T-RFs). Overall, a total of 23 different T-RFs were produced. Putative assignments of T-RFs corresponded to the phyla Firmicutes (Clostridia, Bacilli, and Lactobacilli), Bacteroidetes, Tenericutes (Mollicutes Class), Actinobacteria, and Proteobacteria, as well as to uncultured or unidentified organisms. Firmicutes and Bacteroidetes phyla and Mollicutes Class were the most commonly assigned in 11, 8, and 8 of the samples, respectively, with this being the first report of Mollicutes in wild chimpanzees. Principal Components Analysis (PCA) revealed clustering of nine samples, and 80.5% of the diversity was accounted for by three samples. Morisita indices of community similarity ranged between 0.00 and 0.89, with dissimiliarity (<0.5) between most samples when compared two at a time. Our findings suggest that, although phylotypes are common among individuals, profiles among members of the same social group are host-specific. We conclude that factors other than social group, such as kinship and age, may influence fecal bacterial profiles of wild chimpanzees, and recommend that additional studies be conducted.

Gastrointestinal parasites of the chimpanzee population introduced onto Rubondo Island National Park, Tanzania.

The release of any species into a novel environment can evoke transmission of parasites that do not normally parasitize the host as well as potentially introducing new parasites into the environment. Species introductions potentially incur such risks, yet little is currently known about the parasite fauna of introduced primate species over the long term. We describe the results of long-term monitoring of the intestinal parasite fauna of an unprovisioned, reproducing population of chimpanzees introduced 40 years earlier (1966-1969) onto Rubondo Island in Lake Victoria, Tanzania, a non-native habitat for chimpanzees. Two parasitological surveys (March 1997-October 1998 and October 2002-December 2005) identified Entamoeba spp. including E. coli, Iodamoeba buetschlii, Troglodytella abrassarti, Chilomastix mesnili, Trichuris sp., Anatrichosoma sp., Strongyloides spp., Strongylida fam. gen. sp., Enterobius anthropopitheci, Subulura sp., Ascarididae gen. sp., and Protospirura muricola. The parasite fauna of the Rubondo chimpanzees is similar to wild chimpanzees living in their natural habitats, but Rubondo chimpanzees have a lower prevalence of strongylids (9%, 3.8%) and a higher prevalence of E. anthropopitheci (8.6%, 17.9%) than reported elsewhere. Species prevalence was similar between our two surveys, with the exception of Strongyloides spp. being higher in the first survey. None of these species are considered to pose a serious health risk to chimpanzees, but continued monitoring of the population and surveys of the parasitic fauna of the two coinhabitant primate species and other animals, natural reservoir hosts of some of the same parasites, is important to better understand the dynamics of host-parasite ecology and potential long-term implications for chimpanzees introduced into a new habitat.

"Too much information with little meaning," relevance of preoperative laboratory testing in elective oral and maxillofacial surgeries: A systematic integrative review.

AIM: In the recent times due to accessibility of tools and advent of technology advising battery of laboratory tests prior to any electeve surgical procedure has become a norm. This review aims at investigating relevance of such tests in healthy patients undergoing routine elective oral and maxillofacial surgical procedures. METHODS: Various search engines were thoroughly searched to identify relevant literature. The population of interest was asymptomatic adults above 18 years of age undergoing elective surgery. RESULTS: The preoperative tests of interest for the current study included complete blood count, coagulation tests, biochemistry, and chest X-rays. An algorithm for preoperative tests has been proposed. CONCLUSION: We conclude that advising battery of routine tests in such patients leads to further delays and rise in overall cost of the surgery.

Prevalence of foot problems and its related associations in Intellectually Disable (Special Olympic) Indian population.

OBJECTIVES: To determine the prevalence of foot problems and its related associations in different regions across India among people with Intellectual Disabilities (ID) stratified by age and gender. METHOD: A survey was done among a randomly chosen sample of 1517 Indian inhabitants (8-50 years of age) residing in different regions of the country under the drive named Healthy Athlete (HA) Fit Feet Screening Program of Special Olympics Bharat. Chi-Square test is used to draw an inference of prevalence of different foot conditions among the population from different age groups and from different genders. RESULTS: The percentage of Healthy Athletes with the normal foot in Bhiwadi, Warangal, Ajmer, Bhopal, Guwahati, and Jodhpur was 48.14%, 53.92%, 55.82%, 27.31%, 54.47%, and 76.34%. The percentage of athletes with foot problems from these areas was 53.08%, 46.07%, 44.1%, 72.69%, 45.53%, and 26.35%. Moreover, on analyzing the athletes with foot problems on the basis of the age group, it was found that the middle age group athletes from Bhopal had the highest incidence of more frequent foot problems. Furthermore, on comparing the prevalence of foot problem on basis of gender it was found that female athletes have more prevalence than men. CONCLUSION: The numerical results indicate the middle age group subjects have statistically significant higher tendencies towards the foot problems in contrast to the lower and the higher age group subjects Also, the prevalence of the foot problems and their related associations in women are higher compared to men.

Thinning or dehiscence of bone in structures of the middle cranial fossa floor in superior semicircular canal dehiscence.

BACKGROUND: Superior semicircular canal dehiscence (SSCD) is a rare inner ear disorder; currently, it is unknown whether the etiopathology underlying this structural irregularity affects neighboring structures. The goal is to investigate the prevalence of bone thinning in areas of the middle cranial fossa (MCF) floor in SSCD and non-SSCD patients. METHODS: This retrospective study analyzed 100 patients from March 2011 to June 2017 at a tertiary referral center. 100 patients undergoing 118 SSCD repair surgeries (18 bilateral) were identified. 12 SSCD ears were excluded due to lack of pre-operative computed tomography (CT) scans or history of prior SSCD repair at an outside facility. Non-SSCD ears were identified from routinely-obtained CT scans for temporal bone fracture (fractured sides excluded) for a total of 101 ears; 26 non-SSCD ears were excluded due to lack of high-resolution imaging. RESULTS: Univariate analyses reveal that SSCD diagnosis is associated with higher rates of geniculate ganglion (GG) dehiscence compared with non-SSCD controls (42.7 vs. 24%; χ2(1) = 9.69,P = 0.008). Individuals with SSCD depicted significantly thinner bone overlying the geniculate ganglion (GG) (0.23 ± 1.2 mm) compared to controls (0.28 ± 1.8 mm, (t(1 6 4)) = 2.1, P = 0.04). SSCD patients presented thinner bone overlying the internal auditory canal (IAC) (0.33 ± 1.3 mm) compared to patients without SSCD (0.46 ± 1.6 mm, (t(2 5 7) = 6.4, P < 0.001). CONCLUSIONS: The increased prevalence of dehiscence of the MCF in this cohort of SSCD patients compared to non-SSCD patients suggests that the etiology underlying SSCD affects surrounding structures.

A Woman Oral and Maxillofacial Surgeon of India: Is She Satisfied with Her Career Choice?

Just as other surgical fields, maxillofacial surgery also was considered a male-dominated field since long. In the recent past, though, we are witnessing change in this trend. Dentistry in general, and maxillofacial surgery in particular, is seeing a large number of women choosing it as their career option, more so in the last decade and a half. This study was conducted in order to understand issues affecting women maxillofacial surgeons in their career as an academician or a private practitioner. We wanted to analyze the factors leading to career satisfaction and estimate the current work scenario for women maxillofacial surgeons. Since the study is one of its first in the country, the conclusions are not definite. Further studies in the future are needed to understand various factors affecting position of women maxillofacial surgeons in academics, private practice, and residents and role of gender in career advancement and in pursuing leadership positions.

CT evaluation of normal bone thickness overlying the superior semicircular canal.

Superior semicircular canal dehiscence (SSCD) is a rare inner ear disorder with variable amounts of auditory and vestibular dysfunction. In addition to the absence of bone overlying the superior semicircular canal, thinning of bone in this area can also initiate the vestibulocochlear symptoms of SSCD. We evaluated normal bone thickness overlying the course of the semicircular canal using computed tomography (CT) scans and assessed correlations between bone thickness and age, gender, and location of the thinnest bone. A single-institution retrospective chart review was conducted on 133 high-resolution CT scans from 76 healthy, asymptomatic patients between ages 9 and 96 years. These CT scans of the temporal bone were obtained between January 2012 and August 2017. The superior semicircular canal dome thickness at the apex was reported with a mean of 1.25 mm for all 76 patients; the 10th percentile was 0.60 mm, and the 90th percentile was 2.08 mm. The thinnest area of bone at any location yielded a mean of 0.86 mm. The normal bone thickness overlying the superior semicircular canal does not depend on gender or age. The thinnest location was evenly distributed across the superior semicircular canal. A bone thickness of 0.40 mm or greater was present in 90% of normal patients based on CT scan measurements at the thinnest location.

Descriptive epidemiology of fatal respiratory outbreaks and detection of a human-related metapneumovirus in wild chimpanzees (Pan troglodytes) at Mahale Mountains National Park, Western Tanzania.

Over the past several years, acute and fatal respiratory illnesses have occurred in the habituated group of wild chimpanzees at the Mahale Mountains National Park, Tanzania. Common respiratory viruses, such as measles and influenza, have been considered possible causative agents; however, neither of these viruses had been detected. During the fatal respiratory illnesses in 2003, 2005 and 2006, regular observations on affected individuals were recorded. Cause-specific morbidity rates were 98.3, 52.4 and 33.8%, respectively. Mortality rates were 6.9, 3.2 and 4.6%; all deaths were observed in infants 2 months-2 years 9 months of age. Nine other chimpanzees have not been seen since the 2006 outbreak and are presumed dead; hence, morbidity and mortality rates for 2006 may be as high as 47.7 and 18.5%, respectively. During the 2005 and 2006 outbreaks, 12 fecal samples were collected from affected and nonaffected chimpanzees and analyzed for causative agents. Analysis of fecal samples from 2005 suggests the presence of paramyxovirus, and in 2006 a human-related metapneumovirus was detected and identified in an affected chimpanzee whose infant died during the outbreak. Our findings provide preliminary evidence that the causative agent associated with these illnesses is viral and contagious, possibly of human origin; and that, possibly more than one agent may be circulating in the population. We recommend that baseline health data be acquired and food wadge and fecal samples be obtained and bio-banked as early as possible when attempting to habituate new groups of chimpanzees or other great apes. For already habituated populations, disease prevention strategies, ongoing health monitoring programs and reports of diagnostic findings should be an integral part of managing these populations. In addition, descriptive epidemiology should be a major component of disease outbreak investigations.

A novel fully automatic multilevel thresholding technique based on optimized intuitionistic fuzzy sets and tsallis entropy for MR brain tumor image segmentation.

In the present paper, a hybrid multilevel thresholding technique that combines intuitionistic fuzzy sets and tsallis entropy has been proposed for the automatic delineation of the tumor from magnetic resonance images having vague boundaries and poor contrast. This novel technique takes into account both the image histogram and the uncertainty information for the computation of multiple thresholds. The benefit of the methodology is that it provides fast and improved segmentation for the complex tumorous images with imprecise gray levels. To further boost the computational speed, the mutation based particle swarm optimization is used that selects the most optimal threshold combination. The accuracy of the proposed segmentation approach has been validated on simulated, real low-grade glioma tumor volumes taken from MICCAI brain tumor segmentation (BRATS) challenge 2012 dataset and the clinical tumor images, so as to corroborate its generality and novelty. The designed technique achieves an average Dice overlap equal to 0.82010, 0.78610 and 0.94170 for three datasets. Further, a comparative analysis has also been made between the eight existing multilevel thresholding implementations so as to show the superiority of the designed technique. In comparison, the results indicate a mean improvement in Dice by an amount equal to 4.00% (p < 0.005), 9.60% (p < 0.005) and 3.58% (p < 0.005), respectively in contrast to the fuzzy tsallis approach.