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Physical Review Letters Sep 2023An amplitude analysis of B^{0}→J/ψϕK_{S}^{0} decays is performed using proton-proton collision data, corresponding to an integrated luminosity of 9 fb^{-1},...
An amplitude analysis of B^{0}→J/ψϕK_{S}^{0} decays is performed using proton-proton collision data, corresponding to an integrated luminosity of 9 fb^{-1}, collected with the LHCb detector at center-of-mass energies of 7, 8, and 13 TeV. Evidence with a significance of 4.0 standard deviations of a structure in the J/ψK_{S}^{0} system, named T_{ψs1}^{θ}(4000)^{0}, is seen, with its mass and width measured to be 3991_{-10}^{+12} _{-17}^{+9} MeV/c^{2} and 105_{-25}^{+29} _{-23}^{+17} MeV, respectively, where the first uncertainty is statistical and the second systematic. The T_{ψs1}^{θ}(4000)^{0} state is likely to be the isospin partner of the T_{ψs1}^{θ}(4000)^{+} state, previously observed in the J/ψK^{+} system of the B^{+}→J/ψϕK^{+} decay. When isospin symmetry for the charged and neutral T_{ψs1}^{θ}(4000) states is assumed, the signal significance increases to 5.4 standard deviations.
PubMed: 37832008
DOI: 10.1103/PhysRevLett.131.131901 -
Translational Stroke Research Apr 2024The objective of this study is to conduct a systematic review and meta-analysis aimed at evaluating the efficacy and safety of flow-diverting devices (FDs) treatment for...
The objective of this study is to conduct a systematic review and meta-analysis aimed at evaluating the efficacy and safety of flow-diverting devices (FDs) treatment for intracranial vertebral artery (VA) aneurysms. We searched PubMed, Web of Science, OVID, and Embase for English-language studies up to February 2024 and included clinical studies on FD treatment of intracranial VA aneurysms. Sensitivity analysis evaluated outcome stability. Of 2273 articles, 29 studies involving 541 aneurysms treated with FDs were included. Based on the Methodological Index for Non-Randomized Studies (MINORS), six were high-quality and 23 moderate quality. FD treatment showed a 95% rate of favorable clinical outcomes (95% CI, 89-99%), 81% (95% CI, 74-88%) complete aneurysmal occlusion, 4% (95% CI, 2-7%) ischemic complication incidence, 1% (95% CI, 0-3%) hemorrhagic complication incidence, 95% (95% CI, 87-100%) posterior inferior cerebellar artery (PICA) preservation, and 6% (95% CI, 3-10%) in-stent stenosis or occlusion across clinical and angiographic follow-up periods of 13.62 months (95% CI, 10.72-16.52) and 11.85 months (95% CI, 9.36-14.33), respectively. Subgroup analyses, based on a 12-month angiographic follow-up threshold, indicated no statistically significant differences in rates of complete aneurysm occlusion, PICA preservation, or in-stent stenosis or occlusion incidence (p > 0.05) between subgroups. Moreover, significant differences were observed in clinical and angiographic outcomes between ruptured and unruptured aneurysms, particularly in hemorrhagic complications (p < 0.05), without significant disparity in ischemic complications (p > 0.05). The results' stability was confirmed via sensitivity analysis. FDs treatment for VA aneurysms is efficacious and safe, offering high rates of positive clinical and angiographic outcomes with minimal complications, underscoring FDs' viability as a treatment option for VA aneurysms. The study was registered with PROSPERO (registration number: CRD42024499894).
PubMed: 38602659
DOI: 10.1007/s12975-024-01251-y -
Clinical Neuroradiology Mar 2024To evaluate diagnostic image quality of ultra-high-resolution computed tomography angiography (UHR-CTA) in neurovascular imaging as compared to normal resolution...
OBJECTIVE
To evaluate diagnostic image quality of ultra-high-resolution computed tomography angiography (UHR-CTA) in neurovascular imaging as compared to normal resolution CT-angiography (NR-CTA).
MATERIAL AND METHODS
In this retrospective single-center study brain and neck CT-angiography was performed using an ultra-high-resolution computed tomography scanner (n = 82) or a normal resolution CT scanner (NR-CTA; n = 73). Ultra-high-resolution images were reconstructed with a 1024 × 1024 matrix and a slice thickness of 0.25 mm, whereas NR-CT images were reconstructed with a 512 × 512 matrix and a slice thickness of 0.5 mm. Three blinded neuroradiologists assessed overall image quality, artifacts, image noise, overall contrast and diagnostic confidence using a 4-point Likert scale. Furthermore, the visualization and delineation of supra-aortic arteries with an emphasis on the visualization of small intracerebral vessels was assessed using a cerebral vascular score, also utilizing a 4-point Likert scale. Quantitative analyses included signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), noise and the steepness of gray value transition. Radiation exposure was determined by comparison of computed tomography dose index (CTDIvol), dose length product (DLP) and mean effective dose. Interrater agreement was evaluated via determining Fleiss-Kappa.
RESULTS
Ultra-high-resolution CT-angiography (UHR-CTA) yielded excellent image quality with superior quantitative (SNR: p < 0.001, CNR: p < 0.001, steepness of gray value transition: p < 0.001) and qualitative results (overall image quality: 4 (Inter quartile range (IQR) = 4-4); p < 0.001, diagnostic confidence: 4 (IQR = 4-4); p < 0.001) compared to NR-CT (overall image quality: 3 (IQR = 3-3), diagnostic confidence: 3 (IQR = 3-4)). Furthermore, UHR-CT enabled significantly superior delineation and visualization of all vascular segments, from proximal extracranial vessels to the smallest peripheral cerebral branches (e.g.
, UHR-CTA PICA
4 (3-4) vs. NR-CTA PICA: 3 (2-3); UHR-CTA P4: 4 (IQR = 3-4) vs. NR-CTA P4: 2 (IQR = 2-3); UHR-CTA M4: 4 (IQR = 4-4) vs. NR-CTA M4: 3 (IQR = 2-3); UHR-CTA A4: 4 (IQR = 3-4) vs. NR-CTA A4: 2 (IQR = 2-3); all p < 0.001). Noteworthy, a reduced mean effective dose was observed when applying UHR-CT (NR-CTA: 1.8 ± 0.3 mSv; UHR-CTA: 1.5 ± 0.5 mSv; p < 0.001).
CONCLUSION
Ultra-high-resolution CT-angiography improves image quality in neurovascular imaging allowing the depiction and evaluation of small peripheral cerebral arteries. It may thus improve the detection of pathologies in small cerebrovascular lesions and the resulting diagnosis.
Topics: Humans; Computed Tomography Angiography; Retrospective Studies; Tomography, X-Ray Computed; Angiography; Signal-To-Noise Ratio; Radiation Dosage; Radiographic Image Interpretation, Computer-Assisted
PubMed: 37831106
DOI: 10.1007/s00062-023-01348-1 -
Journal of Neurosurgical Sciences Oct 2023Posterior inferior cerebellar artery (PICA) aneurysms are uncommon vascular lesions of the posterior fossa. In addition to aneurysmal morphology, structural anatomic... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Posterior inferior cerebellar artery (PICA) aneurysms are uncommon vascular lesions of the posterior fossa. In addition to aneurysmal morphology, structural anatomic considerations may confer additional procedural risk, and as a result there is currently no consensus as to whether a surgical or endovascular approach offers greater safety and efficacy for patients.
EVIDENCE ACQUISITION
We systematically examined peer-reviewed literature describing PICA aneurysm treatment planning from January 2000 to May 2021 using the PRISMA methodology. A meta-analysis of proportions was performed. Certainty of the evidence was assessed using the GRADE approach.
EVIDENCE SYNTHESIS
Fifty-eight studies including 1673 PICA aneurysms were analyzed. Overall treatment occlusion rate was 97% (95% confidence interval [CI]: 93-100%) for surgery and 85% (95% CI: 78-92%) for endovascular therapy. The recurrence rate was 6% in the endovascular group and 1% for surgery. Overall morbidity and mortality were 16% and 7%, respectively. Intraoperative complications occurred in 9% of the surgical patients.
CONCLUSIONS
Despite a large body of literature, analysis indicates that 62% of studies had moderate or serious risk of bias, suggesting very-low certainty results. Therefore, treatment via either approach should be determined on a case-by-case basis and according to institutional experience.
Topics: Humans; Intracranial Aneurysm; Treatment Outcome; Embolization, Therapeutic; Endovascular Procedures; Vertebral Artery
PubMed: 35416457
DOI: 10.23736/S0390-5616.22.05710-1 -
Frontiers in Neurology 2023Aneurysms on the posterior inferior cerebellar artery (PICA) may not be the major part of intracranial aneurysm. Especially, an aneurysm located on the bilateral...
INTRODUCTION
Aneurysms on the posterior inferior cerebellar artery (PICA) may not be the major part of intracranial aneurysm. Especially, an aneurysm located on the bilateral posterior inferior cerebellar anastomotic artery has abnormal anatomical characteristics in the vessel wall and then causes stroke including subarachnoid hemorrhage. This case report explores the direct resection of a ruptured aneurysm associated with the bilateral anomalous anastomotic artery of PICA.
METHODS
The case report discusses a 53-year-old woman who suffered from sudden severe headache and vomiting for more than 3 h admitted to our hospital. Emergency computed tomography (CT) revealed subarachnoid hemorrhage (SAH) in the third and fourth ventricles. Preoperative 3 Dimensions-digital subtraction angiography (3-D DSA) indicated a ruptured aneurysm located on the bilateral posterior inferior cerebellar anastomotic artery. Postoperative pathological findings indicated the characteristics of parent artery PICA and control aneurysm. The authors performed an overview of PICA aneurysms with anomalous variation in the Pubmed, Web of Science, and Medline databases. The search was until 1 August 2023. Related terms "posterior inferior cerebellar artery" And "aneurysm" AND "anatomical variants" were used to search the review. The reasons for anomalous variation anastomosis between bilateral PICAs were analyzed.
RESULTS
The aneurysm was resected successfully. Post-operative 3-D DSA revealed the disappearance of the aneurysm. The vessel wall of anastomotic PICA showed neovascularized hyperplasia, abnormal arrangement of smooth muscle, CD31+ endothelial cells, and SMA+ smooth muscle cells. In contrast, when it came to aneurysm, the wall at the location of the fracture thinned, which could be used to explain that the local nodular protrusion was formed and CD31+ endothelial cells existed. No neurological deficits were found at her 1-year follow-up visit (mRS score of 0).
CONCLUSION
Direct resection of ruptured aneurysm associated with bilateral anomalous posterior inferior cerebellar anastomotic arteries was an effective treatment and careful consideration of the anatomical characteristics concerning the interesting aneurysm and the variant PICA was critical for sate treatment. Also, the literature on the lesion was reviewed.
PubMed: 38107645
DOI: 10.3389/fneur.2023.1281124 -
Microvascular decompression for hemifacial spasm after Bell's palsy: a retrospective clinical study.Neurosurgical Review Feb 2024This study aimed to investigate the clinical characteristics of hemifacial spasm (HFS) after Bell's palsy and to evaluate the therapeutic efficacy of microvascular...
OBJECTIVE
This study aimed to investigate the clinical characteristics of hemifacial spasm (HFS) after Bell's palsy and to evaluate the therapeutic efficacy of microvascular decompression (MVD).
METHODS
A retrospective analysis was conducted on 18 patients who underwent MVD for HFS after Bell's palsy at our institution between January 1, 2017, and December 31, 2021. Clinical presentations, intraoperative findings, postoperative outcomes, and complications were comprehensively assessed.
RESULTS
Neurovascular compression (NVC) was identified in all the 18 patients. The offending vessels included anterior inferior cerebellar artery (AICA) in 6 patients (33.3%), posterior inferior cerebellar artery (PICA) in 7 patients (38.9%), vertebral artery (VA) combined with AICA in 3 patients (16.7%), and VA alongside PICA in 2 patients (11.1%). Notably, marked arachnoid membrane adhesion was evident in 11 patients (61.1%). 15(83.3%) patients were cured immediately after MVD, delayed relief was found in 3 (16.7%) patients. During the follow-up period, recurrence was not documented. Surgical complications were limited to facial paralysis in 3 patients and auditory impairment in 1 patient. No additional surgical complications were recorded.
CONCLUSIONS
In patients manifesting HFS after Bell's palsy, NVC predominantly underlies the etiology. MVD is a reliably safe and efficacious therapeutic intervention.
Topics: Humans; Hemifacial Spasm; Bell Palsy; Facial Paralysis; Retrospective Studies; Microvascular Decompression Surgery; Treatment Outcome
PubMed: 38396231
DOI: 10.1007/s10143-024-02328-w -
Acta Neurochirurgica Mar 2024Neurovascular compression of the rostral ventrolateral medulla (RVLM) has been described as a possible cause of refractory essential hypertension. We present the case of...
Neurovascular compression of the rostral ventrolateral medulla (RVLM) has been described as a possible cause of refractory essential hypertension. We present the case of a patient affected by episodes of severe paroxysmal hypertension, some episodes associated with vago-glossopharyngeal neuralgia. Classical secondary forms of hypertension were excluded. Imaging revealed a neurovascular conflict between the posterior inferior cerebellar artery (PICA) and the ventrolateral medulla at the level of the root entry zone of the ninth and tenth cranial nerves (CN IX-X REZ). A MVD of a conflict between the PICA and the RVLM and adjacent CN IX-X REZ was performed, resulting in reduction of the frequency and severity of the episodes. Brain MRI should be performed in cases of paroxysmal hypertension. MVD can be considered in selected patients.
Topics: Humans; Medulla Oblongata; Hypertension; Vagus Nerve; Glossopharyngeal Nerve Diseases; Pressure
PubMed: 38488893
DOI: 10.1007/s00701-024-06032-y -
Animals : An Open Access Journal From... Apr 2024Due to the fencing of the Przewalski's gazelle (), the microcytic anemia incidence rate continues to increase. The primary pathological symptoms include emaciation,...
Due to the fencing of the Przewalski's gazelle (), the microcytic anemia incidence rate continues to increase. The primary pathological symptoms include emaciation, anemia, pica, inappetence, and dyskinesia. To investigate the cause of microcytic anemia ailment in the Przewalski's gazelle, the Upper Buha River Area with an excessive incidence was chosen as the experimental pasture, and the Bird Island Area without microcytic anemia disease was chosen as the control field. Then, the mineral contents in the soil, forage, blood, and liver, as well as the blood routine parameters and biochemical indexes were measured. The findings showed that the experimental pasture had much lower Se content in the soil and forage than the control field ( < 0.01), while the impacted pasture had significantly higher S content in the forage. The damaged gazelles had considerably lower Se and Cu contents and higher S content in the blood and liver than the healthy gazelles ( < 0.01). The presences of Hb, HCT, MCV, and MCH were significantly decreased compared to those in healthy gazelles ( < 0.01). The experimental group had a significantly lower level of GSH-Px activity in their serums compared to the control group ( < 0.01). In the treatment experiment, ten gazelles from the affected pasture were orally administered CuSO, 6 g/animal once every 10 days for two consecutive times, and all gazelles were successfully cured. Therefore, it is possible that low Se content in the soil induced an increase in the absorption of S content by forage, leading to the deficiency of secondary Cu in the Przewalski's gazelles, resulting in microcytic anemia.
PubMed: 38612353
DOI: 10.3390/ani14071114 -
Parasitology Research Dec 2023Species of the genus Morishitium Witenberg, 1928 are parasites of the body cavity, air sacs, and lungs of birds. At least 14 species are considered valid, but molecular...
Species of the genus Morishitium Witenberg, 1928 are parasites of the body cavity, air sacs, and lungs of birds. At least 14 species are considered valid, but molecular confirmation of their status is lacking. Here, we provide the first molecular data on Morishitium dollfusi isolated from their type host Pica pica, compared them with previously reported molecular data from Morishitium polonicum isolated from their type and paratype hosts, Turdus merula and Turdus philomelos, and performed extensive measurements of 511 individuals of Morishitium spp. across a broad host spectrum, at multiple infection intensities, and year-round. We analyzed the molecular phylogenetics of Morishitium spp. adults isolated from bird hosts of Czech origin and provide comparative measurements of the analyzed specimens. Based on the molecular examination of morphologically identified specimens of M. dollfusi and M. polonicum (CO1, ND1, and ITS2 markers), we propose synonymization of Morishitium dollfusi (Timon-David, 1950) with Morishitium polonicum (Machalska, 1980) (isolates of European origin). The three markers were either identical (CO1, ITS2) or formed haplotypes shared by the two species (ND1). Morphological analyses revealed a continuum of key identification features for the two above-named species, although we used specimens matching the original descriptions and isolated them from the type hosts. Therefore, Morishitium polonicum is a junior synonym of Morishitium dollfusi. Attention is needed regarding the status of East Asian isolates identified previously as M. polonicum (or M. polonicum malayense). The molecular analysis revealed that these isolates form a distinct clade, and further research is needed to produce data allowing the likely separation of the malayense clade as a separate species.
Topics: Humans; Animals; Pica; Trematoda; Songbirds; Passeriformes; Lizards; Phylogeny
PubMed: 37864718
DOI: 10.1007/s00436-023-08006-y -
Operative Neurosurgery (Hagerstown, Md.) Apr 2024Posterior inferior cerebellar artery (PICA) aneurysms account for 0.3% of all intracranial aneurysms, and they commonly present with a complex fusiform morphology that...
Dolichoectatic Posterior Inferior Cerebellar Artery Aneurysm Treated With Excision and Posterior Inferior Cerebellar Artery Double Reimplantation Bypass: 2-Dimensional Operative Video.
Posterior inferior cerebellar artery (PICA) aneurysms account for 0.3% of all intracranial aneurysms, and they commonly present with a complex fusiform morphology that necessitates unique bypass strategies.1-5 An adolescent boy with a familial predisposition to aneurysmal subarachnoid hemorrhage was identified as harboring a fusiform aneurysm of the right distal PICA, characterized by 2 outflow branches. Our recommended treatment strategy involved a right far lateral craniotomy, followed by P1 PICA reanastomosis and P2 PICA reimplantation. Informed written consent was obtained. On exposure, the aneurysm was trapped, and the inflow and 2 outflow PICA branches were excised. Revascularization was established through a P1 PICA end-to-end reanastomosis using running continuous suturing techniques, followed by P2 PICA end-to-side reimplantation into a more distal portion of PICA. Subsequent indocyanine green videoangiography confirmed patency of the P2 PICA reimplantation; however, the initial P1 PICA reanastomosis was noted to be thrombosed. After several unsuccessful attempts to dissolve the thrombus, the decision was made to proceed with a P2 PICA side-to-side in situ reimplantation into the V4 segment of the vertebral artery. Indocyanine green videoangiography and postoperative digital subtraction angiography confirmed patency of the PICA double reimplantation bypass. The patient tolerated the procedure well and was discharged home at his neurological baseline. This video showcases the microsurgical treatment of a complex dolichoectatic, distal PICA aneurysm using a double reimplantation technique, in addition to highlighting bypass decision-making processes for managing complex PICA aneurysms.
PubMed: 38687093
DOI: 10.1227/ons.0000000000001188