Preoperative digital three-dimensional planning for rhinoplasty

BACKGROUND: This report describes preoperative digital planning for rhinoplasty using a new three-dimensional (3D) radiologic viewer that allows both patients and surgeons to visualize on a common monitor the 3D real aspect of the nose in its inner and outer sides. METHODS: In the period 2002 to 2008, 210 patients underwent rhinoplasty procedures in the authors' clinic. The patients were randomly divided into three groups according to the type of preoperative planning used: photos only, a simulated result by Adobe Photoshop, or the 3D radiologic viewer. The parameters evaluated included the number of patients that underwent surgery after the first consultation, the number of patients who asked for a reintervention, patient satisfaction (according to a test given to the patients 12 months postoperatively), the surgical time required for a functional intervention, and the improvement in nasal function by postoperative rhinomanometry and subjective evaluation. RESULTS: Computer-aided technologies led to a higher number of patients deciding to undergo a rhinoplasty. Simulation of the postoperative results was not as useful in the postoperative period due to the higher number of reintervention requests. CONCLUSION: The patients undergoing rhinoplasties preferred new technologies in the preoperative period. The advantages of using the 3D radiologic viewer included improved preoperative planning, reduction in intraoperative stress, a higher number of patients undergoing surgery, reduction in postoperative surgical corrections, reduction in surgical time for the functional intervention, a higher rate of improvement in nasal function, a higher percentage of postoperative satisfaction, and reduced costs

Adalimumab in refractory cystoid macular edema associated with birdshot chorioretinopathy

Purpose To report the clinical outcomes of adalimumab therapy in cases of birdshot chorioretinitis (BCR) with cystoid macular edema (CME) refractory to conventional immunotherapy. Methods This is a retrospective case series of three BCR patients treated with adalimumab for refractory CME. The main outcome measure was central subfield thickness (CST) on optical coherence tomography. Any patients treated with local steroids and/or receiving systemic steroids higher than 40 mg prednisolone daily during adalimumab therapy were excluded. Results At baseline, all patients were receiving systemic corticosteroids and two second-line immunosuppressive agents. The mean duration of treatment with adalimumab was 31.2 months (range 17.2–52). The mean CST was 327 ± 112.7 μm (mean ± SD) at baseline and 256.2 ± 39.7 μm at 6 months and 235.5 ± 32.5 μm at 12 months. Adalimumab permitted cessation or reduction in the daily dose of oral prednisolone plus withdrawal of a second-line agent in all patients. Conclusions In these patients, adalimumab was effective in the treatment of refractory CME

Processing and characterization of aluminium-based MMCs produced by gas pressure infiltration

International audienceA device has been designed and built for unidirectional infiltration of ceramic preforms with a molten metal. It allows production of Al or Mg alloys reinforced with short or continuous ceramic fibres. The apparatus has been tested for different alloys and preforms by varying the process parameters (infiltration pressure, fibre content, melt superheat, preform preheat and solidification speed). As an example, full infiltration of Al 2 O 3-SAFFIL chopped preforms with an Al-4wt.%Cu-1wt.%Mg-0.5wt.%Ag alloy has been achieved under controlled conditions by using a gas pressure between 1 and 3 MPa. The resulting metal matrix composite has been characterised by microscopical observations and mechanical tests. Measurements of Young's modulus, density, microhardness and mechanical loss show that the optimal process conditions for Al-4wt.%Cu-1wt.%Mg-0.5wt.%Ag-SAFFIL composites are a temperature of 750°C for both preform and melt and the maximum infiltration pressure of 3 MPa. Preliminary tests have shown that the gas pressure infiltration apparatus is also suitable to produce continuous fibre reinforced and hybrid metal matrix composites

"If I get sick here, I will never see my children again" : The mental health of international migrants during the COVID-19 pandemic in Chile

Background The COVID-19 pandemic has had an impact on the mental health of international migrants globally. Chile has managed its response to the pandemic in an ongoing context of social unrest and combined regional migratory and humanitarian crisis. The country's population presents a high prevalence of common mental disorders and a high suicide rate, with limited access to mental healthcare. International migrants in Chile represent 8% of the total population, and although a socioeconomically heterogenous group, they face social vulnerability, a range of mental health stressors and additional barriers to access mental healthcare. This study describes the mental health outcomes, stressors, response, and coping strategies perceived by international migrants during the COVID-19 pandemic in Chile.Methods and findings A qualitative case study was carried out through individual online interviews to 30 international migrants living in Chile during the pandemic and 10 experts of the social and health care sectors. An inductive content analysis was carried out, a process during which the researchers sought to identify patterns and themes derived from the data. Participants experienced mainly negative mental health outcomes, including anxiety and depression symptomatology. Stressors included the virus itself, work, living and socioeconomic conditions, discrimination, fear for their family and distance caring. Institutional responses to address the mental health of international migrants during the pandemic in Chile were limited and participants relied mainly on individual coping strategies.Conclusions The pandemic can represent an important opportunity to strengthen mental health systems for the general population as well as for population groups experiencing social vulnerability, if the issues identified and the lessons learned are translated into action at national, regional, and international level. Promoting the mental health of international migrants means recognising migration as a social determinant of mental health and adopting a cross-cultural as well as a Human Rights approach.Peer reviewe

Primer reporte de cepas de Enterobacter spp productoras de metalobetalactamasas de Venezuela

Clinical strains of Enterobacter were isolated from Cumana's Central Hospital in Venezuela, and classified as E. cloacae (21), E. aerogenes (7), E. intermedium (1), E. sakazakii (1) and three unclassified. The strains showed high levels of resistance, especially to SXT (58.1%), CRO (48.8%), CAZ (46.6%), PIP (46.4%), CIP (45.2%) and ATM (43.3%). This is the first report for South America of blaVIM-2 in two E. cloacae and one Enterobacter sp., which also showed multiple mechanisms of resistance. Both E. cloacae showed blaTEM-1, but only one showed blaCTX-M-15 gene, while no blaSHV was detected.Cepas clínicas de Enterobacter fueron aisladas del Hospital central de Cumaná en Venezuela, y se clasificaron como E. cloacae (21), E. aerogenes (7), E. intermedium (1), E. sakazakii (1) y 3 sin clasificar. Las cepas mostraron altos niveles de resistencia, especialmente a SXT (58.1%), CRO (48.8%), CAZ (46.6%), PIP (46.4%), CIP (45.2%) and ATM (43.3%). Este es el primer reporte de América del Sur de blaVIM-2 en dos cepas de E. cloacae y una de Enterobacter sp., las cuales también mostraron múltiples mecanismos de resistencia. Ambas especies de E. cloacae mostraron genes blaTEM-1, pero solo una mostro el gen blaCTX-M-15, mientras que blaSHV no fue detectado

Actin dynamics coupled to clathrin-coated vesicle formation at the trans-Golgi network

In diverse species, actin assembly facilitates clathrin-coated vesicle (CCV) formation during endocytosis. This role might be an adaptation specific to the unique environment at the cell cortex, or it might be fundamental, facilitating CCV formation on different membranes. Proteins of the Sla2p/Hip1R family bind to actin and clathrin at endocytic sites in yeast and mammals. We hypothesized that Hip1R might also coordinate actin assembly with clathrin budding at the trans-Golgi network (TGN). Using deconvolution and time-lapse microscopy, we showed that Hip1R is present on CCVs emerging from the TGN. These vesicles contain the mannose 6-phosphate receptor involved in targeting proteins to the lysosome, and the actin nucleating Arp2/3 complex. Silencing of Hip1R expression by RNAi resulted in disruption of Golgi organization and accumulation of F-actin structures associated with CCVs on the TGN. Hip1R silencing and actin poisons slowed cathepsin D exit from the TGN. These studies establish roles for Hip1R and actin in CCV budding from the TGN for lysosome biogenesis

Joint subnatural-linewidth and single-photon emission from resonance fluorescence

Resonance fluorescence—the light emitted when exciting resonantly a two-level system—is a popular quantum source as it seems to inherit its spectral properties from the driving laser and its statistical properties from the two-level system, thus providing a subnatural-linewidth single-photon source (SPS). However, these two qualities do not actually coexist in resonance fluorescence, since an optical target detecting these antibunched photons will either be spectrally broad itself and not benefit from the spectrally narrow source, or match spectrally with the source but in this case the antibunching will be spoiled. We first explain this failure through a decomposition of the field-emission and how this gets affected by frequency resolution. We then show how to restore the sought joint subnatural linewidth and antibunched properties, by interfering the resonance fluorescence output with a coherent beam. We finally discuss how the signal that is eventually generated in this way features a new type of quantum correlations, with a plateau of antibunching which suppresses much more strongly close photon pairs. This introduces a new concept of perfect SPS

In situ delivery of nanoparticles formulated with micron-sized crystals protects from murine melanoma.

INTRODUCTION Intratumoral injections of novel therapeutics can activate tumor antigen-specific T cells for locoregional tumor control and may even induce durable systemic protection (against distant metastases) via recirculating T cells. Here we explored the possibility of a universal immunotherapy that promotes T-cell responses in situ and beyond, upon intratumoral injection of nanoparticles formulated with micron-sized crystals. METHODS Cucumber mosaic virus-like particles containing a tetanus toxin peptide (CuMVTT) were formulated with microcrystalline tyrosine (MCT) adjuvant and injected directly in B16F10 melanoma tumors. To further enhance immunogenicity, we loaded the nanoparticles with a TLR7/8 ligand and incorporated a universal tetanus toxin T-helper cell peptide. We assessed therapeutic efficacy and induction of local and systemic immune responses, including RNA sequencing, providing broad insight into the tumor microenvironment and correlates of protection. RESULTS MCT crystals were successfully decorated with CuMVTT nanoparticles. This 'immune-enhancer' formed immunogenic depots in injected tumors, enhanced polyfunctional CD8+ and CD4+ T cells, and inhibited B16F10 tumor growth locally and systemically. Local inflammation and immune responses were associated with upregulation of genes involved in complement activation and collagen formation. CONCLUSIONS Our new immune-enhancer turned immunologically cold tumors into hot ones and inhibited local and distant tumor growth. This type of immunotherapy does not require the identification of (patient-individual) relevant tumor antigens. It is well tolerated, non-infectious, and affordable, and can readily be upscaled for future clinical testing and broad application in melanoma and likely other solid tumors

Dynamical mass measurements of two protoplanetary discs

ALMA observations of line emission from planet forming discs have demonstrated to be an excellent tool to probe the internal disc kinematics, often revealing subtle effects related to important dynamical processes occurring in them, such as turbulence, or the presence of planets, that can be inferred from pressure bumps perturbing the gas motion, or from detection of the planetary wake. In particular, we have recently shown for the case of the massive disc in Elias 2-27 how one can use such kind of observations to measure deviations from Keplerianity induced by the disc self-gravity, thus constraining the total disc mass with good accuracy and independently on mass conversion factors between the tracer used and the total mass. Here, we refine our methodology and extend it to two additional sources, GM Aur and IM Lup, for which archival line observations are available for both the 12CO and the 13CO line. For IM Lup, we are able to obtain a consistent disc mass of Mdisc=0.1 Msun, implying a disc-star mass ratio of 0.1 (consistent with the observed spiral structure in the continuum emission) and a gas/dust ratio of ~ 65 (consistent with standard assumptions), with a systematic uncertainty by a factor ~2 due to the different methods to extract the rotation curve. For GM Aur, the two lines we use provide slightly inconsistent rotation curves, that cannot be attributed only to a difference in the height of the emitting layer, nor to a vertical temperature stratification. Our best fit disc mass measurement is Mdisc=0.26Msun, implying a disc-star mass ratio of ~0.35 and a gas/dust ratio of ~130... ABRIDGEDComment: 14 pages, 10 figures, MNRAS in pres