OBJECTIVES Recognizing the anatomical orientation surrounding the sellar floor is crucial in endoscopic endonasal transsphenoidal surgery (ETSS). Zero-echo-time (ZTE) sequences were recently suggested for a new bone identification technique on magnetic resonance imaging (MRI). This study aimed to evaluate the clinical usefulness of three-dimensional (3D)-ZTE-based MRI models in providing anatomical guidance for ETSS. PATIENTS AND METHODS ZTE-based MRI and magnetic resonance angiography (MRA) data from 15 consecutive patients with pituitary tumor treated between September 2018 and May 2019 were used to create 3D-MRI models. From these, the architecture surrounding the sellar floor, particularly anatomical relationships between tumors and internal carotid arteries (ICAs), was visualized to preoperatively plan surgical procedures. In addition, 3D-ZTE-based MRI models were compared to actual surgical views during ETSS to evaluate model applicability. RESULTS These 3D-ZTE-based MRI models clearly demonstrated the morphology of the sellar floor and matched well with intraoperative views, including pituitary tumor, by successively eliminating sphenoidal structures. The models also permitted determination of the maximum marginal line of the opening of the sellar floor by presenting vital structures such as ICAs and tumors. With such 3D-MRI models, the surgeon could access the intracranial area through the sellar floor more safely, and resect the pituitary tumor maximally without complications. CONCLUSION Our 3D-MRI models based on ZTE sequences allowed distinct visualization of vital structures and pituitary tumor around the sellar floor. This new method using 3D-ZTE-based MRI models showed low invasiveness for patients and was useful in preoperative planning for ETSS, facilitating maximum tumor resection without complications. BACKGROUND Suicide among adolescents in the United States is the second leading cause of death. HDAC activity assay Bullying victimization has also been identified as a growing public health concern. Although studies have examined the association between bullying victimization and mental health outcomes, there is a dearth of research investigating the association between bullying victimization and suicidal ideation among adolescents. OBJECTIVE The objective of this study is to investigate the association between bullying victimization and suicidal ideation among adolescents. PARTICIPANTS AND SETTING Data for this study came from the 2017 National Youth Risk Behavior Survey. METHODS An analytic sample of 14,603 adolescents aged 14-18 years (52 % female) was analyzed using binary logistic regression. RESULTS About 18 % of adolescents experienced suicidal ideation during the past 12 months. About one in ten adolescents (9.1 %) were victims of both school bullying and cyberbullying. Bullying victimization was associated with suicidal ideation whereby, adolescents who experienced both school bullying and cyberbullying victimization had 3.26 times higher odds of experiencing suicidal ideation (AOR = 3.26, p less then .001, 95 % CI=3.10-3.43), adolescents who experienced school bullying victimization had 2.15 times higher odds of experiencing suicidal ideation (AOR = 2.15, p less then .001, 95 % CI=2.04-2.27), and adolescents who experienced cyberbullying victimization had twice the odds of experiencing suicidal ideation (AOR = 2.00, p less then .001, 95 % CI=1.87-2.14). Other factors significantly associated with suicidal ideation include forced sexual intercourse, depressive symptoms, cigarette smoking, alcohol use, cannabis use, and illicit drug use. CONCLUSION Understanding the association between bullying victimization and suicidal ideation could contribute to early identification of adolescents who may be at risk for suicide. STUDY OBJECTIVE Due to conflicting results published in the literature regarding the analgesic superiority between the paravertebral block and the PECS block, the study objective is to determine which one should be the first line analgesic treatment after radical mastectomy. DESIGN Systematic review, meta-analysis and trial sequential analysis. SETTING Operating room, postoperative recovery area and ward, up to 24 postoperative hours. PATIENTS Patients scheduled for radical mastectomy under general anaesthesia. INTERVENTIONS We searched five electronic databases for randomized controlled trials comparing any PECS block with a paravertebral block. MEASUREMENTS The primary outcome was rest pain score (0-10) at 2 postoperative hours, analyzed according to the combination with axillary dissection or not, to account for heterogeneity. Secondary outcomes included rest pain scores, cumulative intravenous morphine equivalents consumption and rate of postoperative nausea and vomiting at 24 postoperative hours. MAIN RESULTS Eight trials including 388 patients were identified. Rest pain scores at 2 postoperative hours were decreased in the PECS block group, with a mean difference (95%CI) of -0.4 (-0.7 to -0.1), I2 = 68%, p = 0.01, and a significant subgroup difference observed between radical mastectomy with (mean difference [95%CI] 0.0 [-0.2 to 0.2], I2 = 0%, p = 1.00), or without axillary dissection (mean difference [95%CI] -0.7 [-1.1 to -0.4], I2 = 40%, p  less then  0.001; p for subgroup difference  less then  0.001). All secondary pain-related outcomes were similar between groups. The overall quality of evidence was low. CONCLUSIONS There is low quality evidence that a PECS block provides marginal postoperative analgesic benefit after radical mastectomy at 2 postoperative hours only, when compared with a paravertebral block, and not beyond. Clinical trial number PROSPERO – registration number CRD42019131555. BACKGROUND/AIMS To explore the role of high secure psychiatric care (HSPC) in the assessment and management of individuals with an Autism Spectrum Disorder (ASD) using published studies and clinical experience. Key areas of exploration include the prevalence of ASD within HSPC, some autism specific issues including clinical and cognitive characteristics, psychopathy and emotional regulation, presence of incompatibilities and use of seclusion, as well as experiences of being detained in HSPC. Developing best practice and a specialist ASD service in HSPC is also discussed. METHOD A discussion of available literature, supported by clinical experience. CONCLUSIONS Although individuals with an ASD admitted to HSPC comprise a small group, they are likely to be overrepresented relative to the general prevalence of ASD in the population and present with specific issues. Whilst individuals report a generally positive experience of HSPC, therapeutic outcomes are variable and the factors influencing them poorly understood.