Multidimensional Analysis of the Adult Human Heart in Health and Disease Using Hierarchical Phase-Contrast Tomography.

Background Current clinical imaging modalities such as CT and MRI provide resolution adequate to diagnose cardiovascular diseases but cannot depict detailed structural features in the heart across length scales. Hierarchical phase-contrast tomography (HiP-CT) uses fourth-generation synchrotron sources with improved x-ray brilliance and high energies to provide micron-resolution imaging of intact adult organs with unprecedented detail. Purpose To evaluate the capability of HiP-CT to depict the macro- to microanatomy of structurally normal and abnormal adult human hearts ex vivo. Materials and Methods Between February 2021 and September 2023, two adult human donor hearts were obtained, fixed in formalin, and prepared using a mixture of crushed agar in a 70% ethanol solution. One heart was from a 63-year-old White male without known cardiac disease, and the other was from an 87-year-old White female with a history of multiple known cardiovascular pathologies including ischemic heart disease, hypertension, and atrial fibrillation. Nondestructive ex vivo imaging of these hearts without exogenous contrast agent was performed using HiP-CT at the European Synchrotron Radiation Facility. Results HiP-CT demonstrated the capacity for high-spatial-resolution, multiscale cardiac imaging ex vivo, revealing histologic-level detail of the myocardium, valves, coronary arteries, and cardiac conduction system across length scales. Virtual sectioning of the cardiac conduction system provided information on fatty infiltration, vascular supply, and pathways between the cardiac nodes and adjacent structures. HiP-CT achieved resolutions ranging from gross (isotropic voxels of approximately 20 µm) to microscopic (approximately 6.4-µm voxel size) to cellular (approximately 2.3-µm voxel size) in scale. The potential for quantitative assessment of features in health and disease was demonstrated. Conclusion HiP-CT provided high-spatial-resolution, three-dimensional images of structurally normal and diseased ex vivo adult human hearts. Whole-heart image volumes were obtained with isotropic voxels of approximately 20 µm, and local regions of interest were obtained with resolution down to 2.3-6.4 µm without the need for sectioning, destructive techniques, or exogenous contrast agents. Published under a CC BY 4.0 license Supplemental material is available for this article. See also the editorial by Bluemke and Pourmorteza in this issue.

Evaluation of the Reproducibility of Nonverbal Facial Expressions Using a 3D Motion Capture System.

OBJECTIVE: To evaluate the reproducibility of three nonverbal facial expressions using a three-dimensional motion capture system. DESIGN: Prospective, cross-sectional, controlled study. SETTING: Glasgow Dental Hospital and School, University of Glasgow, United Kingdom. PATIENTS AND PARTICIPANTS: Thirty-two subjects, 16 males and 16 females. METHODS: With a three-dimensional video passive stereophotogrammetry imaging system, maximal smile, cheek puff, and lip purse were captured for each subject. Anatomical facial landmarks were digitized on the first frame and then tracked automatically. The same facial expressions were captured 15 minutes later. MAIN OUTCOME MEASURES: The magnitude of each expression and speed of landmark displacement were calculated. The landmark motion curves were spatially and temporally aligned to calculate the similarity of the dynamic movements of the same landmarks between the captures. RESULTS: There were no significant differences between individuals for magnitude (P = .892) or for speed (P = .456). There were significant differences in landmark movement similarity (P = .011); similarity was more reproducible for maximal smile. There was no significant gender effect on the difference in magnitude. There was a significant gender effect on speed to reach maximal smile (P = .044) and a pursed-lip expression (P = .038). There was a significant gender effect on landmark movement similarities (P = .031) for cheek puff expression. CONCLUSIONS: There were no differences in magnitude and speed for maximal smile, cheek puff, and lip purse between the two captures for all participants. For individual expressions, maximal smile expression had the highest similarity value for individual landmarks.

Coming to a practice near you? Community-acquired meticillin resistant Staphylococcus aureus (CA-MRSA).

UNLABELLED: Hospital-acquired meticillin resistant Staphylococcus aureus (HA-MRSA) arose in the 1960s, but the last decade saw the emergence of a new entity: community-acquired MRSA (CA-MRSA). Unlike HA-MRSA, patients affected by CA-MRSA have no obvious risk factors and may present with recurrent skin and soft tissue infections (SSTI) or, rarely, severe necrotizing pneumonia. This article provides an overview of CA-MRSA and reinforces the standard infection control procedures required to prevent further spread. CLINICAL RELEVANCE: The dental team require an awareness of emerging infections, their relevance to dentistry and the infection control procedures necessary to prevent transmission.