Introduction: Odontogenic extraoral sinus tracts are rare conditions that can be misdiagnosed as skin lesions and lead to unnecessary treatments. They are caused by dental infections spreading through bone and draining externally. Conservative nonsurgical endodontic treatment should be pursued first. However, conventional instrumentation and irrigation techniques cannot fully decontaminate root canal systems. New disinfection techniques, including ultrasonic activation of irrigation, photodynamic therapy (PDT), and lasers, have been developed as adjunctive techniques. Photobiomodulation (PBM) (also known as low-level laser therapy) has also demonstrated beneficial effects on tissue healing. Case Presentation: This report presents a case of an extraoral sinus tract associated with a necrotic mandibular molar that was treated successfully with nonsurgical endodontic therapy using ultrasonically-activated PDT, PBM, and high-intensity laser therapy (HILT). Six- and 12-month follow-ups showed resolution of the sinus tract and healing of the apical lesion radiographically. The extraoral lesion had diminished significantly. Conclusion: Combining nonsurgical endodontic treatment with PDT with ultrasonic activation, PBM, and HILT allowed successful management of an odontogenic extraoral sinus tract without surgical intervention. Using PDT combined with ultrasonic activation enhanced disinfection while PBM and HILT improved wound healing. This report demonstrates a conservative approach to treating these lesions.

Separating an endodontic instrument is one of the most frequent errors during a root canal treatment. If endodontic instruments get separated, it could hinder disinfection and prevent access to the apical portion of the root. It compromises the success of the treatment by impeding the proper debris removal from the canal. But now that techniques and tools have advanced, it is feasible to remove a separated instrument from the root canal successfully. This case report presents the management of a separated instrument, demonstrating the successful removal of the separated instrument.

The number of published literature on the effect of ultrasonic cavitation and advanced oxidation pretreatment on the dewatering performance of anaerobically digested sludge is very limited. This study aims at determining the optimum operating conditions of large-scale filtering centrifuges in wastewater treatment plants. The optimum dose of hydrogen peroxide, ultrasonic power, ultrasonic duration, ultrasonic pulse and particle size distribution for improved dewatering performance were determined in this study. In addition, shear stress-shear rate and viscosity-shear rate rheograms were developed to show the rheological flow properties for varying ultrasonic power and treatment duration. Optimum sonication power, time, pulse and amplitude were determined to be 14 W, 1 min, 55/5 and 20%, respectively. At a pH of 6.8, the optimum concentration of hydrogen peroxide was found to be 43.5 g/L. The optimum hydrogen peroxide dose in the combined conditioning experiments was determined to be 500 mg/L at a pH of 3. Under these optimum conditions, capillary suction time was reduced significantly by 71.1%. This study helps to reduce polymer consumption and provides the optimum pretreatment and dewatering operating conditions, and better monitoring and control in the dewatering unit has significant impact in the overall economy of wastewater treatment plants.

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BACKGROUND: Parturients are prone to postdural puncture headache (PDPH) after epidural puncture. Cerebral venous sinus thrombosis (CVST) is a fatal complication of PDPH. The main symptom of both is headache, however, the mechanism is not similar. For persistent PDPH, early differential diagnosis from CVST is essential. Optic nerve sheath diameter (ONSD) measurements can be used to identify changes in intracranial pressure as an auxiliary tool to distinguish the cause of headache.
METHODS: The dura of a 32-year-old woman undergoing cesarean section was accidentally penetrated while administering epidural anesthesia, and the patient developed PDPH the subsequent day. The patient refused epidural blood patch (EBP) treatment and was discharged after conservative treatment. Fourteen days post-discharge, she was readmitted for a seizure. Magnetic resonance imaging (MRI) and Magnetic resonance angiography (MRA) indicated low cranial pressure syndrome and superior sagittal sinus thrombosis with acute infarction. The next morning, the EBP was performed with 15 ml autologous blood. Subsequently, the headache symptoms decreased during the day and worsened at night. ONSD measurement suggested dilation of the optic nerve sheath, and subsequently, the patient showed intracranial hypertension with papilledema. After dehydration and anticoagulant treatment, the patient\'s symptoms were relieved and she was discharged from the hospital 49 days later.
CONCLUSIONS: Headache is the main symptom of PDPH and cerebral venous thrombosis, which are difficult to distinguish. ONSD measurement may help to estimate the intracranial pressure, and early measurement may be helpful for women with PDPH to avoid serious complications, such as CVST.

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The most common problem faced by dentists during root canal therapy is instrument separation. Instrument separation leads to the inefficient biomechanical preparation of the canals, which can affect the outcome of the root canal-treated tooth. Hence, bypassing the fractured instrument or removal can be accounted as a viable choice to maintain the structural integrity of the tooth. This article illustrates a case series wherein the fractured instrument was managed successfully with the use of conservative techniques.

Neuroblastoma is one of the most common tumors in children. Cases where an isolated soft-tissue metastasis mass is the initial symptom are rare, with only four such cases reported to date. We describe the imaging findings of ten cases of neuroblastoma patients in our hospital with superficial soft tissue mass (SSTM) as the primary symptom. The main ultrasound finding of SSTM was hypoechoic masses or scattered speck-like hyperechoic masses. However, when this type of SSTM is caused by soft tissue metastasis, the location is often atypical, and ultrasound findings are difficult to distinguish from other benign diseases. Therefore, this research should remind clinicians to recognize atypical presentations of this common childhood malignant tumor. Radiologists should also consider the possibility of neuroblastoma when finding this type of SSTM with atypical ultrasound features.

OBJECTIVE: Ultrasound medical reports are an important means of diagnosing diseases and assessing treatment effectiveness. However, their professional terms and complex sentences often make it difficult for ordinary people to understand. Therefore, this study explores the clinical value of using artificial intelligence systems based on ChatGPT to interpret ultrasound medical reports.
METHODS: In this study, a combination of online and offline questionnaires were used to survey both physicians and non-medical individuals. The questionnaires evaluated ChatGPT\'s interpretation of ultrasound reports from both professional and comprehensibility perspectives, and the results were analyzed using Excel spreadsheets. Additionally, a portion of the research content was evaluated using the Likert Scale 5-point method in the questionnaire.
RESULTS: According to survey results, 67.4% of surveyed doctors believe that using ChatGPT for interpreting ultrasound medical reports can help improve work efficiency. At the same time, 69.72% of non-medical professionals believe it is necessary to enhance their understanding of medical ultrasound reports through ChatGPT interpretation, and 62.58% support the application of ChatGPT to ultrasound medical reports. The non-medical group\'s understanding of ultrasound medical reports significantly improved (p < 0.01) after implementing ChatGPT, However, 67.49% of the general public are concerned about ChatGPT\'s imperfect functionality, which may cause misleading information. This reflects that the public\'s trust in new technology is not high enough, and they are also worried about possible privacy leaks and security issues with ChatGPT technology.
CONCLUSIONS: The higher acceptance and support of non-medical individuals for the interpretation of medical reports by ChatGPT might be due to the system\'s natural language processing abilities that allow them to better understand and evaluate report contents. However, the expertise and experience of physicians are still irreplaceable. This suggests that the ChatGPT-based ultrasound medical report interpretation system has certain clinical value and application prospects, but further optimization is necessary to address its shortcomings in data quality and professionalism. This study provides a reference and inspiration for promoting the application and development of ultrasound technology and artificial intelligence systems in the medical field.

BACKGROUND: Severe forms of depression have been linked to hyperactivity of the subcallosal cingulate cortex. The ability to stimulate the subcallosal cingulate cortex or associated circuits noninvasively and directly would maximize the number of patients who could receive treatment. To this end, we have developed an ultrasound-based device for effective noninvasive modulation of deep brain circuits. Here we describe an application of this tool to an individual with treatment-resistant depression.
METHODS: A 30-year-old Caucasian woman with severe treatment-resistant non-psychotic depression was recruited into a clinical study approved by the Institutional Review Board of the University of Utah. The patient had a history of electroconvulsive therapy with full remission but without sustained benefit. Magnetic resonance imaging was used to coregister the ultrasound device to the subject\'s brain anatomy and to evaluate neural responses to stimulation. Brief, 30-millisecond pulses of low-intensity ultrasound delivered into the subcallosal cingulate cortex target every 4 seconds caused a robust decrease in functional magnetic resonance imaging blood-oxygen-level-dependent activity within the target. Following repeated stimulation of three anterior cingulate targets, the patient\'s depressive symptoms resolved within 24 hours of the stimulation. The patient remained in remission for at least 44 days afterwards.
CONCLUSIONS: This case illustrates the potential for ultrasonic neuromodulation to precisely engage deep neural circuits and to trigger a durable therapeutic reset of those circuits. Trial registration ClinicalTrials.gov, NCT05301036. Registered 29 March 2022, https://clinicaltrials.gov/ct2/show/NCT05301036.