Background: Treatment for sagittal craniosynostosis often involves endoscopic suturectomy (ES) followed by helmet therapy, with cranial shape improvement assessed via cephalic index (CI). The effect of adding barrel-stave osteotomy (BSO) to ES on CI outcomes remains controversial. This study evaluated the impact of BSO on operative burden and postoperative cranial deformity in patients undergoing surgical correction of sagittal craniosynostosis. Methods: A retrospective review of 85 patients treated for sagittal craniosynostosis at BC Children’s Hospital (2010–2021) compared patients undergoing ES alone (n=18) and ES+BSO (n=67). Demographics, operative burden (anesthesia and surgical time, blood loss, hospital stay), and longitudinal CI measurements were analyzed. Mixed effects modeling controlled for age, preoperative CI, and helmet duration. Results: Operative burden did not differ significantly between treatment groups (p > 0.05). The median follow-up duration for CI measurements was 56.0 months. While preoperative CI was similar (67.4 vs. 66.8, p=0.61), CI was significantly improved in the ES+BSO group at all postoperative intervals (p ≤ 0.02). Mixed effects modeling confirmed that BSO independently improved CI (effect size 2.21, p=0.001). Conclusions: In our series, the addition of BSO to ES significantly improved immediate and long-term cranial deformity without increasing operative burden, supporting its use in sagittal craniosynostosis correction.

The description and delineation of trematode species is a major ongoing task. Across the field there has been, and currently still is, great variation in the standard of this work and in the sophistication of the proposal of taxonomic hypotheses. Although most species are relatively unambiguously distinct from their congeners, many are either morphologically very similar, including the major and rapidly growing component of cryptic species, or are highly variable morphologically despite little to no molecular variation for standard DNA markers. Here we review challenges in species delineation in the context provided to us by the historical literature, and the use of morphological, geographical, host, and molecular data. We observe that there are potential challenges associated with all these information sources. As a result, we encourage careful proposal of taxonomic hypotheses with consideration for underlying species concepts and frank acknowledgement of weaknesses or conflict in the data. It seems clear that there is no single source of data that provides a wholly reliable answer to our taxonomic challenges but that nuanced consideration of information from multiple sources (the ‘integrated approach’) provides the best possibility of developing hypotheses that will stand the test of time.

Vascular rings represent a heterogeneous set of aberrant great vessel anatomic configurations which can cause respiratory symptoms or dysphagia due to tracheal or oesophageal compression. These symptoms can be subtle and may present at varied ages. More recently, many have been identified in patients without symptoms, including fetal echocardiogram, resulting in a conundrum for practitioners when attempting to determine who will benefit from surgical correction. Here, we provide a review of vascular rings and a guide to the practitioner on when to consider additional imaging or referral. Additionally, we discuss the changing landscape regarding asymptomatic patients and fetal echocardiogram.

Fully relativistic particle-in-cell (PIC) simulations are crucial for advancing our knowledge of plasma physics. Modern supercomputers based on graphics processing units (GPUs) offer the potential to perform PIC simulations of unprecedented scale, but require robust and feature-rich codes that can fully leverage their computational resources. In this work, this demand is addressed by adding GPU acceleration to the PIC code Osiris. An overview of the algorithm, which features a CUDA extension to the underlying Fortran architecture, is given. Detailed performance benchmarks for thermal plasmas are presented, which demonstrate excellent weak scaling on NERSC's Perlmutter supercomputer and high levels of absolute performance. The robustness of the code to model a variety of physical systems is demonstrated via simulations of Weibel filamentation and laser-wakefield acceleration run with dynamic load balancing. Finally, measurements and analysis of energy consumption are provided that indicate that the GPU algorithm is up to ${\sim }$14 times faster and $\sim$7 times more energy efficient than the optimized CPU algorithm on a node-to-node basis. The described development addresses the PIC simulation community's computational demands both by contributing a robust and performant GPU-accelerated PIC code and by providing insight into efficient use of GPU hardware.