BACKGROUND: Nonspecific neck pain (NSNP) is a well-established global burden affecting. It is also a common problem in Pakistan. The burden of neck pain is also increasing day by day due to poor work ergonomics, and increased use of computers and mobiles after the pandemic. An individual\'s poor posture is often associated with forward head posture (FHP). Limited evidence is available about the effects of neck stabilization (NSE) and dynamic exercises (NDE) for nonspecific neck pain particularly in patients with FHP. This aimed to compare the effects of NSE versus NDE among patients having NSNP with FHP in reducing pain, disability, forward head posture and improving neck range of motion.
METHODS: It is a single-blinded randomized clinical trial with 60 patients aged 18-40 years, with moderate intensity NSNP for > 3 weeks and < 6 months along with FHP with a moderate disability on neck disability index (NDI) randomly assigned to the treatment groups. Group 1 was doing NSE and group 2 was doing NDE. Transcutaneous Electical Nerve Stimulation, cold packs, and stretching exercises were given to both groups. A total of 9 sessions (3 sessions/ week) were given to participants. NDI questionnaire, Visual analogue scale (VAS), goniometry, and plumb line measurement tool were used as baseline and assessment at the end of 3rd week. The data was analyzed on SPSS version 21. Descriptive analysis was performed. Independent t-test was used for between group comparison and paired t-test used for within group comparison. A p-value less than 0.05 was considered statistically significant.
RESULTS: After treatment within-group analysis of both NSE and NDE showed significant (p < 0.001) improvement in pain on VAS, all ROMs of the neck including flexion, extension, left and right lateral flexion and left rotation, plumb line and NDI score with very large effect size. However, between-group analysis showed non-significant differences (p > 0.05) for post-treatment mean VAS, neck ROM, NDI and plumb line measurement.
CONCLUSIONS: Between NSE and NDE, no one is more beneficial than another. Both are equally effective in alleviating pain, increasing ROM, decreasing functional disability, and improving forward head posture in patients with NSNP.
BACKGROUND: Registered trial at ClinicalTrials.gov Identifier: NCT05298631, 28/03/2022, prospectively registered.

BACKGROUND: The emergence of horizontal neck wrinkles is increasingly becoming a focal point for both cosmetic professionals and clients. Various treatment approaches must be considered to address this issue effectively, owing to its diverse underlying causes. The study explores the potential of utilizing the Endolift laser in conjunction with nanofat injection as a viable treatment option.
METHODS: Twenty patients with horizontal neck wrinkles involved in the study. Ten patients underwent treatment with a combination of Endolift laser and nanofat injection and 10 patients treated with nanofat injection alone. The participants were monitored for 6 months post-treatment. Biometric measurements were utilized to assess outcomes, including changes in volume, depth, and area of the wrinkles, skin elasticity, as well as the diameter and density of the epidermis and dermis in the treated area. Skin improvement was evaluated by two independent dermatologists, who compared before and after photos in a blinded manner. Patient satisfaction levels were also documented.
RESULTS: The Visioface analysis showed a notable decrease in neck wrinkle depth and area in both groups. However, the group receiving the combination treatment of Endolift laser and nanofat exhibited a significantly greater improvement compared to the group treated with nanofat alone. Skin ultrasonography results demonstrated an increase in thickness and density of the dermis and epidermis in both groups. Particularly, the group treated with Endolift laser-nanofat displayed significant enhancements in dermis and epidermis density and thickness when contrasted with the nanofat-only group. Analysis with Cutometer revealed a marked enhancement in skin elasticity in the Endolift-nanofat treated group in comparison to the nanofat-only treated group. Furthermore, in the Endolift-nanofat treated group, a substantial majority (90%) of patients exhibited improvement. Patient evaluations highlighted significant distinctions between the two groups, with 95% of patients in the Endolift-nanofat treated group demonstrating enhancement.
CONCLUSIONS: Both methods notably enhance horizontal neck wrinkles; nevertheless, the combination of endolift laser and nanofat seems to be more efficient for treating horizontal neck wrinkles.

UNASSIGNED: To describe cytologic findings from mandibular and superficial cervical lymph nodes in dogs with thyroid carcinoma and to determine prognostic factors associated with lymph node metastasis.
UNASSIGNED: A total of 71 client-owned dogs with confirmed thyroid carcinoma that had cytologic results from at least 1 mandibular or superficial cervical lymph node between 2010 and 2020.
UNASSIGNED: Medical records from 2 referral veterinary hospitals were retrospectively reviewed. Cytology of lymph nodes was reviewed for presence of metastasis by diplomates of the American College of Veterinary Pathologists. Thyroid tumor diameter and volume, tumor fixation, bilateral location, vascular invasion, and stage were recorded to determine effects on nodal metastasis.
UNASSIGNED: A total of 154 lymph nodes (104 mandibular and 50 superficial cervical lymph nodes) from 71 dogs were cytologically evaluated, and 1/154 (0.6%) and 2/154 (1.3%) lymph nodes were noted to be definitively metastatic or probably metastatic, respectively. Given the infrequent rate of nodal metastasis (1.9% or less), statistical analysis of potential prognostic variables was not completed.
UNASSIGNED: Routine lymph node cytology of mandibular and superficial cervical lymph nodes appeared to be of low yield when assessing for metastasis of canine thyroid carcinomas. The medial retropharyngeal and deep cervical lymph nodes should continue to be evaluated as they appeared to have higher metastatic rates, based on historic reports. Additional studies are needed to determine prognostic factors associated with lymph node metastasis and effects on patient survival.
Résultats cytologiques dans les ganglions lymphatiques cervicaux mandibulaires et superficiels de chiens atteints d’un carcinome thyroïdien.
UNASSIGNED: Décrire les résultats cytologiques obtenus des ganglions lymphatiques mandibulaires et cervicaux superficiels chez des chiens atteints d’un carcinome thyroïdien et déterminer les facteurs pronostiques associés aux métastases ganglionnaires.
UNASSIGNED: Un total de 71 chiens appartenant à des clients atteints d’un carcinome thyroïdien confirmé avec des résultats cytologiques d’au moins un ganglion lymphatique cervical mandibulaire ou superficiel entre 2010 et 2020.
UNASSIGNED: Les dossiers médicaux de 2 hôpitaux vétérinaires de référence ont été examinés rétrospectivement. La cytologie des ganglions lymphatiques a été examinée pour détecter la présence de métastases par des diplomates de l’American College of Veterinary Pathologists. Le diamètre et le volume de la tumeur thyroïdienne, la fixation de la tumeur, la localisation bilatérale, l’invasion vasculaire et le stade ont été notés pour déterminer les effets sur les métastases ganglionnaires.
UNASSIGNED: Au total, 154 ganglions lymphatiques (104 ganglions lymphatiques mandibulaires et 50 ganglions lymphatiques cervicaux superficiels) provenant de 71 chiens ont été évalués par cytologie, et 1/154 (0,6 %) et 2/154 (1,3 %) ganglions lymphatiques ont été notés comme définitivement métastatiques ou probablement métastatiques, respectivement. Compte tenu du taux peu fréquent de métastases ganglionnaires (1,9 % ou moins), l’analyse statistique des variables pronostiques potentielles n’a pas été complétée.
UNASSIGNED: La cytologie de routine des ganglions lymphatiques mandibulaires et cervicaux superficiels semblait être de faible rendement lors de l’évaluation des possibilités de métastases des carcinomes thyroïdiens canins. Les ganglions lymphatiques rétropharyngés médiaux et cervicaux profonds doivent continuer à être évalués car ils semblent présenter des taux métastatiques plus élevés, sur la base des rapports historiques. Des études supplémentaires sont nécessaires pour déterminer les facteurs pronostiques associés aux métastases ganglionnaires et les effets sur la survie des patients.(Traduit par Dr Serge Messier).

Accurate and precise rigid registration between head-neck computed tomography (CT) and cone-beam computed tomography (CBCT) images is crucial for correcting setup errors in image-guided radiotherapy (IGRT) for head and neck tumors. However, conventional registration methods that treat the head and neck as a single entity may not achieve the necessary accuracy for the head region, which is particularly sensitive to radiation in radiotherapy. We propose ACSwinNet, a deep learning-based method for head-neck CT-CBCT rigid registration, which aims to enhance the registration precision in the head region. Our approach integrates an anatomical constraint encoder with anatomical segmentations of tissues and organs to enhance the accuracy of rigid registration in the head region. We also employ a Swin Transformer-based network for registration in cases with large initial misalignment and a perceptual similarity metric network to address intensity discrepancies and artifacts between the CT and CBCT images. We validate the proposed method using a head-neck CT-CBCT dataset acquired from clinical patients. Compared with the conventional rigid method, our method exhibits lower target registration error (TRE) for landmarks in the head region (reduced from 2.14 ± 0.45 mm to 1.82 ± 0.39 mm), higher dice similarity coefficient (DSC) (increased from 0.743 ± 0.051 to 0.755 ± 0.053), and higher structural similarity index (increased from 0.854 ± 0.044 to 0.870 ± 0.043). Our proposed method effectively addresses the challenge of low registration accuracy in the head region, which has been a limitation of conventional methods. This demonstrates significant potential in improving the accuracy of IGRT for head and neck tumors.

The excessive use of electronic devices for prolonged periods has led to problems such as neck pain and pressure injury in sedentary people. If not detected and corrected early, these issues can cause serious risks to physical health. Detectors for generic objects cannot adequately capture such subtle neck behaviors, resulting in missed detections. In this paper, we explore a deep learning-based solution for detecting abnormal behavior of the neck and propose a model called NABNet that combines object detection based on YOLOv5s with pose estimation based on Lightweight OpenPose. NABNet extracts the detailed behavior characteristics of the neck from global to local and detects abnormal behavior by analyzing the angle of the data. We deployed NABNet on the cloud and edge devices to achieve remote monitoring and abnormal behavior alarms. Finally, we applied the resulting NABNet-based IoT system for abnormal behavior detection in order to evaluate its effectiveness. The experimental results show that our system can effectively detect abnormal neck behavior and raise alarms on the cloud platform, with the highest accuracy reaching 94.13%.

OBJECTIVE: Compared to other cervical localizations, masses of the nuchal region are rare in the clinical practice of otolaryngologists. This study presents the relevant etiologies of nuchal tumors.
METHODS: This study included 61 cases (5.3%) from 1,150 consecutive cervical biopsies/neck tumor excisions between 2010 and 2022. Lipomatosis or Madelung fat neck diagnoses were excluded.
RESULTS: Seventy-seven percent of the biopsies included lymph node tissue. Among the patients, 26 were female and 35 were male. The average diameter of the tumors was 3.5 cm (1.5-9 cm). Of the 33 non-malignant formations (54%, 42.3 years), lymphadenopathy (e.g., toxoplasmosis and tuberculosis) was found in 58% of cases. Lipomas were most common among benign tumors (8 out of 14). Malignant tumors (46%, 63.4 years) included lymphomas (10 cases, 6 recurrences) and metastases (18 cases). The metastases were predominantly squamous cell carcinomas of the pharynx (9 cases, 5 recurrences) and the skin (7 cases, 4 recurrences), as well as two cases of adenocarcinomas from the lung and pancreas.
CONCLUSIONS: Indications of the malignant genesis of a nuchal mass include older patient age and a history of carcinomas in the head and neck region. In carcinomas of the posterior and parietal scalp and neck skin, the nuchal region should be included in the staging and follow-up examinations.

Genes encoding subunits of SWI/SNF (BAF) chromatin remodeling complexes are mutated in nearly 25% of cancers. To gain insight into the mechanisms by which SWI/SNF mutations drive cancer, we contributed ten rhabdoid tumor (RT) cell lines mutant for SWI/SNF subunit SMARCB1 to a genome-scale CRISPR-Cas9 depletion screen performed across 896 cell lines. We identify PHF6 as specifically essential for RT cell survival and demonstrate that dependency on Phf6 extends to Smarcb1-deficient cancers in vivo. As mutations in either SWI/SNF or PHF6 can cause the neurodevelopmental disorder Coffin-Siris syndrome, our findings of a dependency suggest a previously unrecognized functional link. We demonstrate that PHF6 co-localizes with SWI/SNF complexes at promoters, where it is essential for maintenance of an active chromatin state. We show that in the absence of SMARCB1, PHF6 loss disrupts the recruitment and stability of residual SWI/SNF complex members, collectively resulting in the loss of active chromatin at promoters and stalling of RNA Polymerase II progression. Our work establishes a mechanistic basis for the shared syndromic features of SWI/SNF and PHF6 mutations in CSS and the basis for selective dependency on PHF6 in SMARCB1-mutant cancers.

Introduction Dynamic contrast-enhanced computed tomography (DCE-CT) and conventional contrast-enhanced computed tomography (CE-CT) are widely used to evaluate neck lesions, including lymph node metastases, thyroid nodules, salivary gland tumors, and other soft tissue masses. DCE-CT, which captures multiple phases of contrast enhancement over time, is hypothesized to provide superior diagnostic accuracy compared to the single-phase images obtained by CE-CT due to its ability to offer dynamic information about tissue perfusion, blood volume, and vascular permeability. Methods This retrospective observational diagnostic study included 100 patients who underwent neck imaging, divided equally into DCE-CT and CE-CT groups. Patient demographics (age, gender, body mass index) and lesion characteristics (type, location, size, enhancement pattern, margins) were recorded. Diagnostic performance metrics (sensitivity, specificity, accuracy, positive predictive value, negative predictive value) were evaluated alongside inter-observer variability using the kappa statistic. Clinical impact was assessed based on changes in treatment plans and improvements in patient outcomes. The radiation dose for each modality was documented. Statistical analysis was performed using SPSS software (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY) with chi-square tests for categorical variables and t-tests for continuous variables. Results The study included 58 males and 42 females with a mean age of 55.5 years. A total of 145 lesions were detected: 75 by DCE-CT and 70 by CE-CT. DCE-CT demonstrated higher sensitivity (93.33%) and specificity (96.00%) compared to CE-CT (sensitivity 86.67%, specificity 92.00%). The accuracy of DCE-CT was 94.00% versus 88.00% for CE-CT. Inter-observer agreement was higher for DCE-CT (kappa = 0.85) compared to CE-CT (kappa = 0.80). DCE-CT led to treatment plan changes in 40% of cases and resulted in a 75% improvement in outcomes compared to 25% and 60%, respectively, for CE-CT. The mean radiation dose was slightly higher for DCE-CT (8.5 mSv) compared to CE-CT (7.0 mSv). Conclusion DCE-CT offers superior diagnostic efficacy compared to CE-CT for imaging neck lesions with enhanced sensitivity, specificity, and accuracy. Its ability to capture multiple phases of contrast enhancement allows for detailed lesion characterization and provides crucial quantitative data on tissue perfusion and blood volume. These benefits lead to more frequent improvements in patient outcomes and changes in treatment plans. Despite the slightly higher radiation dose, the diagnostic advantages of DCE-CT outweigh the disadvantages, particularly in complex cases requiring detailed lesion analysis. Further prospective studies are recommended to validate these findings and explore the broader clinical benefits of DCE-CT.

UNASSIGNED: To analyze the radiomic and clinical features extracted from 2D ultrasound images of thyroid tumors in patients with Hashimoto\'s thyroiditis (HT) combined with papillary thyroid carcinoma (PTC) using machine learning (ML) models, and to explore the diagnostic performance of the method in making preoperative noninvasive identification of cervical lymph node metastasis (LNM).
UNASSIGNED: A total of 528 patients with HT combined with PTC were enrolled and divided into two groups based on their pathological results of the presence or absence of LNM. The groups were subsequently designated the With LNM Group and the Without LNM Group. Three ultrasound doctors independently delineated the regions of interest and extracted radiomic features. Two modes, radiomic features and radiomics-clinical features, were used to construct random forest (RF), support vector machine (SVM), LightGBM, K-nearest neighbor (KNN), and XGBoost models. The performance of these five ML models in the two modes was evaluated by the receiver operating characteristic (ROC) curves on the test dataset, and SHapley Additive exPlanations (SHAP) was used for model visualization.
UNASSIGNED: All five ML models showed good performance, with area under the ROC curve (AUC) ranging from 0.798 to 0.921. LightGBM and XGBoost demonstrated the best performance, outperforming the other models (P<0.05). The ML models constructed with radiomics-clinical features performed better than those constructed using only radiomic features (P<0.05). The SHAP visualization of the best-performing models indicated that the anteroposterior diameter, superoinferior diameter, original_shape_VoxelVolume, age, wavelet-LHL_firstorder_10Percentile, and left-to-right diameter had the most significant effect on the LightGBM model. On the other hand, the superoinferior diameter, anteroposterior diameter, left-to-right diameter, original_shape_VoxelVolume, original_firstorder_InterquartileRange, and age had the most significant effect on the XGBoost model.
UNASSIGNED: ML models based on radiomics and clinical features can accurately evaluate the cervical lymph node status in patients with HT combined with PTC. Among the 5 ML models, LightGBM and XGBoost demonstrate the best evaluation performance.

Cutaneous metastasis from head and neck cancers is rare, typically presenting as single or multiple nodules. This report presents a truly unique and intriguing case of squamous carcinoma of the tongue, in which the patient developed numerous metastatic nodules in the face and neck, a phenomenon rarely seen in clinical practice. The patient, a known case of carcinoma tongue, was treated radically with concurrent chemoradiation. He presented with small cutaneous lesions in his neck and upper chest, which were confirmed as cutaneous malignancies. Despite receiving one cycle of palliative chemotherapy, the management of this case posed significant and complex challenges, requiring a deep understanding of the nature of the spread and metastatic pathway for choosing the appropriate management.