Evaluation of a custom made anatomical guide for orthognathic surgery

Orthognathic surgery is a routinely used surgical technique for the correction of dento-facial deformities. During a Le Fort I orthognathic procedure the maxilla is surgically separated from the skull and the surgical positioning wafer is placed between the occlusal surfaces of the upper and lower dentition. However, the physiological response to general aesthesia results in loss of muscle tone in the mandible, which has a profound influence on the correct amount of maxillary advancement required. The expertise and visual judgement of the surgeon is relied upon to foresee and eliminate this potential source of error. However, this may not be possible to achieve in all cases, therefore there is a need for a device to guide the surgical position of the maxilla independent of the mandibular dentition. The aim of this study was to design and validate a custom made anatomical repositioning surgical framework for accurately repositioning the maxilla independently of the mandible during a Le Fort I osteotomy. A single plastic anatomical skull was scanned using a helical Computed Tomography (CT) scanner. Utilising 3D manipulation software, forty-three Le Fort I orthognathic surgery movements were planned. A custom made anatomical repositioning guide was designed and 3D printed for all movements. Each guide was used to reposition the maxilla of the physical skull and then laser scanned using a GOM blue light scanner. GOMinspect software was used to compare the planned and physical position of the repositioned maxilla. The results of the experiment were statistically evaluated.Orthognathic surgery is a routinely used surgical technique for the correction of dento-facial deformities. During a Le Fort I orthognathic procedure the maxilla is surgically separated from the skull and the surgical positioning wafer is placed between the occlusal surfaces of the upper and lower dentition. However, the physiological response to general aesthesia results in loss of muscle tone in the mandible, which has a profound influence on the correct amount of maxillary advancement required. The expertise and visual judgement of the surgeon is relied upon to foresee and eliminate this potential source of error. However, this may not be possible to achieve in all cases, therefore there is a need for a device to guide the surgical position of the maxilla independent of the mandibular dentition. The aim of this study was to design and validate a custom made anatomical repositioning surgical framework for accurately repositioning the maxilla independently of the mandible during a Le Fort I osteotomy. A single plastic anatomical skull was scanned using a helical Computed Tomography (CT) scanner. Utilising 3D manipulation software, forty-three Le Fort I orthognathic surgery movements were planned. A custom made anatomical repositioning guide was designed and 3D printed for all movements. Each guide was used to reposition the maxilla of the physical skull and then laser scanned using a GOM blue light scanner. GOMinspect software was used to compare the planned and physical position of the repositioned maxilla. The results of the experiment were statistically evaluated

An improved process for the fabrication and surface treatment of custom-made titanium cranioplasty implants informed by surface analysis

Cranioplasty implants are routinely fabricated from commercially pure titanium plates by maxillofacial prosthetists. The differing fabrication protocols adopted by prosthetists working at different hospital sites gives rise to considerable variations in surface topography and composition of cranioplasty implants, with residues from the fabrication processes having been found to become incorporated into the surface of the implant. There is a growing recognition among maxillofacial prosthetists of the need to standardise these protocols to ensure quality and consistency of practice within the profession. In an effort to identify and eliminate the source of the inclusions associated with one such fabrication protocol, the present study examined the surfaces of samples subjected to each of the manufacturing steps involved. Surface and elemental analysis techniques identified the main constituent of the surface inclusions to be silicon from the glass beads used to texture the surface of the implant during fabrication. Subsequent analysis of samples prepared according to a revised protocol resulted in a more homogeneous titanium dioxide surface as evidenced by the reduction in area occupied by surface inclusions (from 8.51% ± 2.60% to 0.93% ± 0.62%). These findings may inform the development of improved protocols for the fabrication of titanium cranioplasty plates

Age-Dependent Changes in the Cerebrospinal Fluid Proteome by Slow Off-Rate Modified Aptamer Array

An important precondition for the successful development of diagnostic assays of cerebrospinal fluid (CSF) biomarkers of age-related neurodegenerative diseases is an understanding of the dynamic nature of the CSF proteome during the normal aging process. In this study, a novel proteomic technology was used to quantify hundreds of proteins simultaneously in the CSF from 90 cognitively normal adults 21 to 85 years of age. SomaLogic's highly multiplexed proteomic platform can measure more than 800 proteins simultaneously from small volumes of biological fluids using novel slow off-rate modified aptamer (SOMAmer) protein affinity reagents with sensitivity, specificity, and dynamic ranges that meet or exceed those of enzyme-linked immunosorbent assays. In the first application of this technology to CSF, we detected 248 proteins that possessed signals greater than twofold over background. Several novel correlations between detected protein concentrations and age were discovered that indicate that both inflammation and response to injury in the central nervous system may increase with age. Applying this powerful proteomic approach to CSF provides potential new insight into the aging of the human central nervous system that may have utility in discovering new disease-related changes in the CSF proteome

The Journal of BSN Honors Research, Volume 5, Issue 1, Summer 2012

University of Kansas School of Nursing. Bachelor of Science in Nursing Honors ProgramExploration Of Health Care Needs Among Sudanese Refugee Women - Albin, J M, Domian, E. Is There An App For That? Developing An Evaluation Rubric For Apps For Use With Adults With Special Needs - Buckler, T, Peterson, M. The Relationship Between Nursing Characteristics And Pain Care Quality - Davis, E, Dunton, N. The Relationship Between Sleep And Night Eating On Weight Loss In Individuals With Severe Mental Illness - Huynh, Thu Nhi, Hamera, E. Examining Nurse Leader/Manager-Physician Communication Strategies: A Pilot Study - Jantzen, M, Ford, D J. Comparison Of Personal, Health And Family Characteristic Of Children With And Without Autism - Martin, A, Bott, M J. Association Between Obstructive Sleep Apnea And Postoperative Adverse Events - Nielsenshultz, Y, Smith, C, Bott, M, Schultz, M P, Cole, C. Challenges Associated With Partnering With Sudanese Refugee Women In Addressing Their Health Issues - Pauls, K L, Baird, M B. Complementary Therapy To Relieve Pediatric Cancer Therapy-Related Symptoms In The Usa - Slaven, A, Williams, P D

Influences on diet quality in older age:The importance of social factors

Background: poor diet quality is common among older people, but little is known about influences on food choice, including the role of psychosocial factors at this age.Objective: to identify psychosocial correlates of diet quality in a community-dwelling population of men and women aged 59–73 years; to describe relationships with change in diet quality over 10 years.Design: Longitudinal cohort, Hertfordshire Cohort Study (HCS).Subjects: HCS participants assessed at baseline (1998–2003: 1,048 men, 862 women); 183 men and 189 women re-assessed in 2011.Methods: diet was assessed by administered food frequency questionnaire; diet scores were calculated to describe diet quality at baseline and follow-up. A range of psychosocial factors (social support, social network, participation in leisure activities, depression and anxiety, sense of control) were assessed by questionnaire.Results: at baseline, better diet quality was related to a range of social factors, including increased confiding/emotional social support (men and women), practical support (men) and a larger social network (women) (all P < 0.05). For both men and women, greater participation in social and cognitive leisure activities was related to better diet quality (P < 0.005). There were few associations between measured psychosocial factors at baseline and change in diet score over 10 years, in the follow-up sub-group. However, greater participation in leisure activities, especially cognitive activities, at baseline was associated with smaller declines in diet quality over the 10-year follow-up period for both men (P = 0.017) and women (P = 0.014).Conclusions: in community-dwelling older adults, a range of social factors, that includes greater participation in leisure activities, were associated with diets of better quality

Serial monitoring of genomic alterations in circulating tumor cells of ER-positive/HER2-negative advanced breast cancer: feasibility of precision oncology biomarker detection.

Nearly all estrogen receptor (ER)-positive (POS) metastatic breast cancers become refractory to endocrine (ET) and other therapies, leading to lethal disease presumably due to evolving genomic alterations. Timely monitoring of the molecular events associated with response/progression by serial tissue biopsies is logistically difficult. Use of liquid biopsies, including circulating tumor cells (CTC) and circulating tumor DNA (ctDNA), might provide highly informative, yet easily obtainable, evidence for better precision oncology care. Although ctDNA profiling has been well investigated, the CTC precision oncology genomic landscape and the advantages it may offer over ctDNA in ER-POS breast cancer remain largely unexplored. Whole-blood (WB) specimens were collected at serial time points from patients with advanced ER-POS/HER2-negative (NEG) advanced breast cancer in a phase I trial of AZD9496, an oral selective ER degrader (SERD) ET. Individual CTC were isolated from WB using tandem CellSearch® /DEPArray™ technologies and genomically profiled by targeted single-cell DNA next-generation sequencing (scNGS). High-quality CTC (n = 123) from 12 patients profiled by scNGS showed 100% concordance with ctDNA detection of driver estrogen receptor α (ESR1) mutations. We developed a novel CTC-based framework for precision medicine actionability reporting (MI-CTCseq) that incorporates novel features, such as clonal predominance and zygosity of targetable alterations, both unambiguously identifiable in CTC compared to ctDNA. Thus, we nominated opportunities for targeted therapies in 73% of patients, directed at alterations in phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), fibroblast growth factor receptor 2 (FGFR2), and KIT proto-oncogene, receptor tyrosine kinase (KIT). Intrapatient, inter-CTC genomic heterogeneity was observed, at times between time points, in subclonal alterations. Our analysis suggests that serial monitoring of the CTC genome is feasible and should enable real-time tracking of tumor evolution during progression, permitting more combination precision medicine interventions

The Long-Baseline Neutrino Experiment: Exploring Fundamental Symmetries of the Universe

The preponderance of matter over antimatter in the early Universe, the dynamics of the supernova bursts that produced the heavy elements necessary for life and whether protons eventually decay --- these mysteries at the forefront of particle physics and astrophysics are key to understanding the early evolution of our Universe, its current state and its eventual fate. The Long-Baseline Neutrino Experiment (LBNE) represents an extensively developed plan for a world-class experiment dedicated to addressing these questions. LBNE is conceived around three central components: (1) a new, high-intensity neutrino source generated from a megawatt-class proton accelerator at Fermi National Accelerator Laboratory, (2) a near neutrino detector just downstream of the source, and (3) a massive liquid argon time-projection chamber deployed as a far detector deep underground at the Sanford Underground Research Facility. This facility, located at the site of the former Homestake Mine in Lead, South Dakota, is approximately 1,300 km from the neutrino source at Fermilab -- a distance (baseline) that delivers optimal sensitivity to neutrino charge-parity symmetry violation and mass ordering effects. This ambitious yet cost-effective design incorporates scalability and flexibility and can accommodate a variety of upgrades and contributions. With its exceptional combination of experimental configuration, technical capabilities, and potential for transformative discoveries, LBNE promises to be a vital facility for the field of particle physics worldwide, providing physicists from around the globe with opportunities to collaborate in a twenty to thirty year program of exciting science. In this document we provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess.Comment: Major update of previous version. This is the reference document for LBNE science program and current status. Chapters 1, 3, and 9 provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess. 288 pages, 116 figure

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy