Microvascular decompression for intermediate nerve neuralgia: a case report and literature review.

Intermediate nerve neuralgia (INN) is a rare craniofacial pain syndrome. The diagnosis of INN is challenging because of the complex ear sensory innervation that results in a clinical overlap with both trigeminal neuralgia (TN) and glossopharyngeal neuralgia (GPN). A 76-year-old woman with a remarkable medical history presented with right otalgia and mandibular pain for 7 years. Neurological examination revealed a diminished sensation in the distribution of the intermediate nerve (IN). Magnetic resonance imaging demonstrated an impression of the anterior inferior cerebellar artery (AICA) on the facial-vestibulocochlear nerve complex (VII/VIII complex). The patient underwent microvascular decompression (MVD) after long-term oral medication. We confirmed that the responsible vessel was close to the VII/VIII complex and isolated the vessel under the microscope via a right-sided suboccipital retrosigmoid approach. The patient's otalgia and mandibular pain disappeared after the operation. There were no additional neurological deficits. In conclusion, MVD is a safe and feasible option for patients with INN who fail to respond to adequate pharmacotherapy.

Neuroendoscopic Technique for Septated Chronic Subdural Hematoma: A Retrospective Study.

OBJECTIVES: To compare the efficacy of neuroendoscopic hematoma evacuation (NHE) and burr hole craniotomy (BHC) for treating septated chronic subdural hematoma (sCSDH) and analyze the technical advantages of NHE in sCSDH treatment by data analysis. METHODS: This study recruited 77 patients with sCSDH According to the type of operation, the patients were divided into NHE (n = 45) or BHC (n = 32) groups. Clinical data were retrospectively analyzed to evaluate and compare the efficacy of NHE and BHC for treating sCSDH. RESULTS: NHE demonstrated higher complete hematoma clearance and postoperative midline recovery rates and shorter subdural drainage and postoperative bed rest durations compared with BHC (P < 0.05). The average NHE time (72.27 ± 18.27 minutes) was longer than that of BHC (54.91 ± 16.04 minutes) (P < 0.05). The average follow-up period was 30.9 (range, 7-51) months. The results revealed that 1 and 12 cases recurred in the NHE (2.2%) and BHC (18.8%) groups, respectively (P < 0.05). Additionally, a statistically significant difference in the Modified Rankin Scale scores of the 2 groups was observed 6 months after the operation (P < 0.05). During the follow-up period, neither group demonstrated any obvious operative complications. CONCLUSIONS: NHE is more effective than BHC for treating sCSDH and is worth popularizing on a large scale; however, ways to better deal with the outer membrane of hematoma warrant further consideration.

Application of CT and MRI images based on an artificial intelligence algorithm for predicting lymph node metastasis in breast cancer patients: a meta-analysis.

BACKGROUND: This study aimed to comprehensively evaluate the accuracy and effect of computed tomography (CT) and magnetic resonance imaging (MRI) based on artificial intelligence (AI) algorithms for predicting lymph node metastasis in breast cancer patients. METHODS: We systematically searched the PubMed, Embase and Cochrane Library databases for literature from inception to June 2023 using keywords that included 'artificial intelligence', 'CT,' 'MRI', 'breast cancer' and 'lymph nodes'. Studies that met the inclusion criteria were screened and their data were extracted for analysis. The main outcome measures included sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and area under the curve (AUC). RESULTS: A total of 16 studies were included in the final meta-analysis, covering 4,764 breast cancer patients. Among them, 11 studies used the manual algorithm MRI to calculate breast cancer risk, which had a sensitivity of 0.85 (95% confidence interval [CI] 0.79-0.90; p < 0.001; I2 = 75.3%), specificity of 0.81 (95% CI 0.66-0.83; p < 0.001; I2 = 0%), a positive likelihood ratio of 4.6 (95% CI 4.0-4.8), a negative likelihood ratio of 0.18 (95% CI 0.13-0.26) and a diagnostic odds ratio of 25 (95% CI 17-38). Five studies used manual algorithm CT to calculate breast cancer risk, which had a sensitivity of 0.88 (95% CI 0.79-0.94; p < 0.001; I2 = 87.0%), specificity of 0.80 (95% CI 0.69-0.88; p < 0.001; I2 = 91.8%), a positive likelihood ratio of 4.4 (95% CI 2.7-7.0), a negative likelihood ratio of 0.15 (95% CI 0.08-0.27) and a diagnostic odds ratio of 30 (95% CI 12-72). For MRI and CT, the AUC after study pooling was 0.85 (95% CI 0.82-0.88) and 0.91 (95% CI 0.88-0.93), respectively. CONCLUSION: Computed tomography and MRI images based on an AI algorithm have good diagnostic accuracy in predicting lymph node metastasis in breast cancer patients and have the potential for clinical application.

Ordered intermetallic compounds combining precious metals and transition metals for electrocatalysis.

Ordered intermetallic alloys with significantly improved activity and stability have attracted extensive attention as advanced electrocatalysts for reactions in polymer electrolyte membrane fuel cells (PEMFCs). Here, recent advances in tuning intermetallic Pt- and Pd-based nanocrystals with tunable morphology and structure in PEMFCs to catalyze the cathodic reduction of oxygen and the anodic oxidation of fuels are highlighted. The fabrication/tuning of ordered noble metal-transition metal-bonded intermetallic PtM and PdM (M = Fe, Co) nanocrystals by using high temperature annealing treatments to promote the activity and stability of electrocatalytic reactions are discussed. Furthermore, the further improvement of the efficiency of this unique ordered intermetallic alloys for electrocatalysis are also proposed and discussed. This report aims to demonstrate the potential of the ordered intermetallic strategy of noble and transition metals to facilitate electrocatalysis and facilitate more research efforts in this field.

Synthesis of Co/CeO2 hetero-particles with abundant oxygen-vacancies supported by carbon aerogels for ORR and OER.

It is highly significant for the fabrication of rechargeable metal-air batteries to develop cost-efficient and high-performance electrocatalysts of bifunctionality for both oxygen evolution reaction (OER) and oxygen reduction reaction (ORR). Herein, we demonstrate a hybrid composed of CeO2-decorated Co nanoparticles supported on three-dimensionally porous carbon aerogels (Co-CeO2/C aerogels) as a superior bifunctional electrocatalyst. The preparation of Co-CeO2/C aerogels depends on the formation of a novel CeCl3/K3Co(CN)6-chitosan (CS) hydrogel, during which the cyanide groups of K3Co(CN)6 combines the hydroxyls in CS by hydrogen bridges, accompanying with the substitution of chloride groups in CeCl3 by cyanide groups in K3Co(CN)6. The electron spin resonance offers a convincing proof that numerous oxygen vacancies were found in Co-CeO2/C aerogels after the introduction of CeO2. The developed Co-CeO2/C aerogels showed an outstanding electrochemical performance for both OER and ORR in comparsion with RuO2 and Pt/C catalysts in 0.1 M KOH solution. A small overpotential (380 mV) and a low Tafel slope (99 mV dec-1) were observed for OER, while the half-wave potential (0.75 V) and the onset potential (0.92 V) were high for ORR. The superior performance could be put down to the multihole heterostructure, multiple components and abundant oxygen vacancies. It was very helpful for the adsorption and the catalyzation of the reactants and the efficient mass transport of reagent/product. This work paves a neoteric method to synthesize a bifunctional hybrid catalyst with a highly efficient performance of energy conversion and storage.

Cyanogel-Derived Synthesis of Porous PdFe Nanohydrangeas as Electrocatalysts for Oxygen Reduction Reaction.

It is important to develop cost-efficient electrocatalysts used in the oxygen reduction reaction (ORR) for widespread applications in fuel cells. Palladium (Pd) is a promising catalyst, due to its more abundant reserves and lower price than platinum (Pt), and doping an earth-abundant 3d-transition metal M into Pd to form Pd-M bimetallic alloys may not only further reduce the use of expensive Pd but also promote the electrocatalytic performance of ORR, owing to the synergistic effect between Pd and M. Here we report a cyanogel-derived synthesis of PdFe alloys with porous nanostructure via a simple coinstantaneous reduction reaction by using K2PdIICl4/K4FeII(CN)6 cyanogel as precursor. The synthesized PdFe alloys possess hydrangea-like morphology and porous nanostructure, which are beneficial to the electrochemical performance in ORR. The onset potential of the porous PdFe nanohydrangeas is determined to be 0.988 V, which is much more positive than that of commercial Pt/C catalyst (0.976 V) and Pd black catalyst (0.964 V). Resulting from the unique structural advantages and synergetic effect between bimetals, the synthesized PdFe nanohydrangeas with porous structure have outstanding electrocatalytic activity and stability for ORR, compared with the commercial Pd black and Pt/C.

Compositional and functional succession of bacterial and fungal communities is associated with changes in abiotic properties during pig manure composting.

While both bacteria and fungi are important for the degradation and humification of organic matter during composting, it is unclear to what extent their roles are associated with abiotic compost properties. This study evaluated changes in abiotic compost properties and the succession of bacterial and fungal communities during pig manure composting for 90 days. The compost rapidly reached thermophilic phase (>58 ℃), which lasted for 15 days. Both bacterial and fungal community compositions changed drastically during composting and while bacterial diversity increased, the fungal diversity decreased during the thermophilic phase of composting. Two taxa dominated both bacterial (Bacillales and Clostridiales) and fungal (Eurotiales and Glomerellales) communities and these showed alternating abundance fluctuations following different phases of composting. The abundance fluctuations of most dominant bacterial and fungal taxa could be further associated with decreases in the concentrations of fulvic acid, cellulose, hemicellulose and overall biodegradation potential in the compost. Moreover, bacterial predicted metabolic gene abundances dominated the first three phases of composting, while predicted fungal saprotrophic functional genes increased consistently, reaching highest abundances towards the end of composting. Finally, redundancy analysis (RDA) showed that changes in abiotic compost properties correlated with the bacterial community diversity and carbohydrate metabolism and fungal wood saprotrophic function. Together these results suggests that bacterial and fungal community succession was associated with temporal changes in abiotic compost properties, potentially explaining alternating taxa abundance patterns during pig manure composting.

Livestock Manure Type Affects Microbial Community Composition and Assembly During Composting.

Composting is an environmentally friendly way to turn plant and animal wastes into organic fertilizers. However, it is unclear to what extent the source of animal waste products (such as manure) affects the physicochemical and microbiological properties of compost. Here, we experimentally tested how the type of livestock manure of herbivores (sheep and cattle) and omnivores (pig and chicken) influences the bacterial and fungal communities and physicochemical properties of compost. Higher pH, NO3-N, Total carbon (TC) content and C/N were found in sheep and cattle manure composts, while higher EC, NH4-N, Total nitrogen (TN) and total phosphorus (TP) content were measured in pig and chicken manure composts. Paired clustering between herbivore and omnivore manure compost metataxonomy composition was also observed at both initial and final phases of composting. Despite this clear clustering, all communities changed drastically during the composting leading to reduced bacterial and fungal diversity and large shifts in community composition and species dominance. While Proteobacteria and Chloroflexi were the major phyla in sheep and cattle manure composts, Firmicutes dominated in pig and chicken manure composts. Together, our results indicate that feeding habits of livestock can determine the biochemical and biological properties of manures, having predictable effects on microbial community composition and assembly during composting. Manure metataxonomy profiles could thus potentially be used to steer and manage composting processes.

Inverse planning optimization method for intensity modulated radiation therapy.

In order to facilitate the leaf sequencing process in intensity modulated radiation therapy (IMRT), and design of a practical leaf sequencing algorithm, it is an important issue to smooth the planned fluence maps. The objective is to achieve both high-efficiency and high-precision dose delivering by considering characteristics of leaf sequencing process. The key factor which affects total number of monitor units for the leaf sequencing optimization process is the max flow value of the digraph which formulated from the fluence maps. Therefore, we believe that one strategy for compromising dose conformity and total number of monitor units in dose delivery is to balance the dose distribution function and the max flow value mentioned above. However, there are too many paths in the digraph, and we don't know the flow value of which path is the maximum. The maximum flow value among the horizontal paths was selected and used in the objective function of the fluence map optimization to formulate the model. The model is a traditional linear constrained quadratic optimization model which can be solved by interior point method easily. We believe that the smoothed maps from this model are more suitable for leaf sequencing optimization process than other smoothing models. A clinical head-neck case and a prostate case were tested and compared using our proposed model and the smoothing model which is based on the minimization of total variance. The optimization results with the same level of total number of monitor units (TNMU) show that the fluence maps obtained from our model have much better dose performance for the target/non-target region than the maps from total variance based on the smoothing model. This indicates that our model achieves better dose distribution when the algorithm suppresses the TNMU at the same level. Although we have just used the max flow value of the horizontal paths in the diagraph in the objective function, a good balance has been achieved between the dose conformity and the total number of monitor units. This idea can be extended to other fluence map optimization model, and we believe it can also achieve good performance.