Lack of association of cranial lacunae with intracranial hypertension in children with Crouzon syndrome and Apert syndrome: a 3D morphometric quantitative analysis

Purpose Cranial lacunae (foci of attenuated calvarial bone) are CT equivalents ofBcopper beating seen on plain skull radio-graphs in children with craniosynostosis. The qualitative presence of copper beating has not been found to be useful for the diagnosis of intracranial hypertension (IH) in these patients. 3D morphometric analysis (3DMA) allows a more systematic and quantitative assessment of calvarial attenuation. We used 3DMA to examine the relationship between cranial lacunae and IH in children with Crouzon and Apert syndromic craniosynostosis

A population-specific material model for sagittal craniosynostosis to predict surgical shape outcomes

Sagittal craniosynostosis consists of premature fusion (ossification) of the sagittal suture during infancy, resulting in head deformity and brain growth restriction. Spring-assisted cranioplasty (SAC) entails skull incisions to free the fused suture and insertion of two springs (metallic distractors) to promote cranial reshaping. Although safe and effective, SAC outcomes remain uncertain. We aimed hereby to obtain and validate a skull material model for SAC outcome prediction. Computed tomography data relative to 18 patients were processed to simulate surgical cuts and spring location. A rescaling model for age matching was created using retrospective data and validated. Design of experiments was used to assess the effect of different material property parameters on the model output. Subsequent material optimization—using retrospective clinical spring measurements—was performed for nine patients. A population-derived material model was obtained and applied to the whole population. Results showed that bone Young’s modulus and relaxation modulus had the largest effect on the model predictions: the use of the population-derived material model had a negligible effect on improving the prediction of on-table opening while significantly improved the prediction of spring kinematics at follow-up. The model was validated using on-table 3D scans for nine patients: the predicted head shape approximated within 2 mm the 3D scan model in 80% of the surface points, in 8 out of 9 patients. The accuracy and reliability of the developed computational model of SAC were increased using population data: this tool is now ready for prospective clinical application

Early Exposure to Traumatic Stressors Impairs Emotional Brain Circuitry

<div><p>Exposure to early life trauma (ELT) is known to have a profound impact on mental development, leading to a higher risk for depression and anxiety. Our aim was to use multiple structural imaging methods to systematically investigate how traumatic stressors early in life impact the emotional brain circuits, typically found impaired with clinical diagnosis of depression and anxiety, across the lifespan in an otherwise healthy cohort. MRI data and self-reported histories of ELT from 352 healthy individuals screened for no psychiatric disorders were analyzed in this study. The volume and cortical thickness of the limbic and cingulate regions were assessed for all participants. A large subset of the cohort also had diffusion tensor imaging data, which was used to quantify white matter structural integrity of these regions. We found a significantly smaller amygdala volume and cortical thickness in the rostral anterior cingulate cortex associated with higher ELT exposure only for the adolescence group. White matter integrity of these regions was not affected. These findings demonstrate that exposure to early life trauma is associated with alterations in the gray matter of cingulate-limbic regions during adolescence in an otherwise healthy sample. These findings are interesting in the context that the affected regions are central neuroanatomical components in the psychopathology of depression, and adolescence is a peak period for risk and onset of the disorder.</p> </div

Grey matter and white matter regions of interest used in the study.

<div><p>(top row) Different brain lobes (A) and the rostral and caudal anterior cingulate sub-regions (B) parcelled using freesurfer for a representative dataset (bottom row (C)). Fractional anisotropy skeleton (in green) representing the major white matter tracts for all subjects is overlaid on the MNI standard brain. Sections of the tract sekeleton representing the cingulate and limbic white matter tracts are shown: cingulum cingulate bundle (orange); cingulum hippocampus bundle (pink); fornix (yellow); stria (blue) and uncinate fasciculus (red).</p> <p>Abbreviations: ACC, anterior cingulate cortex.</p></div

Development of a New Patient-reported Outcome Measure for Ear Conditions: The EAR-Q

Background:. Patient-reported outcome measures are widely used to improve health services and patient outcomes. The aim of our study was to describe the development of 2 ear-specific scales designed to measure outcomes important to children and young adults with ear conditions, such as microtia and prominent ears. Methods:. We used an interpretive description qualitative approach. Semi-structured qualitative and cognitive interviews were performed with participants with any type of ear condition recruited from plastic surgery clinics in Canada, Australia, United States, and United Kingdom. Participants were interviewed to elicit new concepts. Interviews were audio-recorded, transcribed, and coded using the constant comparison approach. Experts in ear reconstruction were invited to provide input via an online Research Electronic Data Capture survey. Results:. Participants included 25 patients aged 8–21 years with prominent ears (n = 9), microtia (n = 14), or another condition that affected ear appearance (n = 2). Analysis of participant qualitative data, followed by cognitive interviews and expert input, led to the development and refinement of an 18-item ear appearance scale (eg, size, shape, look up close, look in photographs) and a 12-item adverse effects scale (eg, itchy, painful, numb). Conclusions:. The EAR-Q in currently being field-tested internationally. Once finalized, we anticipate the EAR-Q will be used in clinical practice and research to understand the patient’s perspective of outcomes following ear surgery

A framework for embedding Aboriginal knowledges and perspectives and Torres Strait Islander knowledges and perspectives in curriculum at USC

The University of the Sunshine Coast recognises that respect for Aboriginal and Torres Strait Islander¹ peoples, land, cultures and histories is critical to working together for better outcomes for all Australians and achieving our commitment to advance human rights within a tolerant and inclusive society. The University is committed to providing all students with the opportunity to encounter and engage with Aboriginal and Torres Strait Islander knowledges and perspectives² as an integral part of their program of study. The principles contained in this framework are expressed within the curriculum in a range of USC programs and they have been an inherent part of the way that curriculum has been designed and provided to meet the expectations of staff, students and the professions associated with these programs. This framework provides a whole of University approach for broadening the scope of the embedding work to encompass all programs and therefore reach all students. It is envisaged that through the adoption and implementation of this framework: • USC graduates will be able to work effectively with and for Aboriginal and Torres Strait Islander communities and families to address matters of equity and social justice for Aboriginal and Torres Strait Islander people. • USC graduates will have developed this capacity by engaging with Aboriginal and Torres Strait Islander knowledges and perspectives² within a discipline context. • The University will benefit by attracting and retaining Aboriginal and Torres Strait Islander students and staff, and building relationships with local Aboriginal and Torres Strait Islander communities. The commitment to this work is expressed in the University’s 2016-2020 Strategic Plan, Academic Plan, and the USC Innovate Reconciliation Action Plan 2017-2019. This framework is informed by a comprehensive review of available frameworks and guidelines for embedding Aboriginal and Torres Strait Islander knowledges and perspectives in university curriculum³, including those adopted by Universities Australia in 2011.4 This framework consists of seven guiding principles and a set of institutional enablers that underpin successful implementation. It sets out various approaches to conducting the embedding work, and provides a matrix of student learning outcomes, scaffolded for both content and level. The whole of University action plan, which accompanies the framework, sets out the details of the activities to achieve the embedding work, including the timeframe and reporting progress