Evaluation of 4 Outcomes Measures in Microtia Treatment: Exposures, Infections, Aesthetics, and Psychosocial Ramifications.

BackgroundIn craniofacial microsomia, microtia and canal atresia pose formidable reconstructive challenges. We review our institutional experience in treating microtia and atresia to identify variables associated with 4 outcomes measures: complications, surgical revisions, aesthetic outcomes, and psychosocial function.MethodsCraniofacial microsomia patients treated at the University of California Los Angeles Craniofacial Clinic between 2008 and 2014 greater than 13 years of age (n = 68) were reviewed for microtia and atresia treatment and outcomes.ResultsIn total, 91.2% of patients diagnosed with craniofacial microsomia presented with microtia, affecting 75 ears. Both a male and right-sided predominance were observed. Fifty-six patients (90.3%) underwent autologous external ear reconstruction at an average age of 8.5 years. Age, type of incision, and size of cartilage framework did not predict total number of surgeries or complications. Severity of ear anomalies correlated with increased number of surgeries (P < 0.001) and decreased aesthetic outcomes (P < 0.001) but not complications. In total, 87.1% of patients with microtia had documented hearing loss, of which the majority were conductive and 18.5% were mixed sensorineural and conductive. Hearing deficits were addressed in 70.4% of patients with external hearing aids, bone anchored hearing aids, or canaloplasty. Of all variables, improvement of psychosocial function was correlated only to hearing loss treatment of any type (P = 0.01).ConclusionsOn evaluation of surgical and patient characteristics, severity of microtia predicted the total number of surgical revisions performed and aesthetic ratings. In addition, we found that the only factor that correlated with improved patient and parent-reported psychosocial outcomes was treatment of hearing loss

Using a Clinic-based Screening Tool for Primary Care Providers to Identify Commercially Sexually Exploited Children

Introduction: Commercial Sexual Exploitation of Children (CSEC), which encompasses acts of domestic minor sex trafficking, is a hidden problem in the U.S. that affects an estimated 300,000 children. Significant health impacts to victims include violence, substance abuse, mental illness, sexually transmitted diseases, and unintended pregnancy. However, due to the covert nature of sexual exploitation, the lack of understanding among service providers and law enforcement, and complex psychological factors experienced by victims, identifying CSEC is a tremendous challenge. Primary care providers can play a critical role in identifying CSEC victims within clinical settings to help address this silent epidemic. Objective: The goal of this project was to assess the prevalence of CSEC using a clinic-based screening tool within a community health center serving indigent populations, with a large proportion of the patients being of Asian and Pacific Islander descent. Methods: Medical charts were reviewed of young female patients (n=621) between 13-23 years of age and seeking clinical services in Asian Health Services’ Teen Clinic from 2008 through 2011, during the implementation of a clinic-based CSEC screening tool used by primary care providers. The CSEC screening tool consists of two questions about sexual exploitation. Results: Of the 621 patients in the study, 57.5% were Asian and Pacific Islander. Clinical providers applied the CSEC screening tool on 28.5% (n=177) of female patients in the study. Of the 177 patients who were screened, 7.3% (n=13) responded positive to questions about commercial sexual exploitation. Discussion: Using a clinic-based screening tool with patients who have identified risk factors helps primary care providers identify CSEC victims and link them to available resources. Under-reporting among victims and under-screening among providers remain major considerations in estimating CSEC prevalence. To address under-screening, it is important to raise awareness among primary care providers around the CSEC epidemic and their potential role for intervention, including screening for a history of sexual exploitation among youth patients

Isolating Triggered Star Formation

Galaxy pairs provide a potentially powerful means of studying triggered star formation from galaxy interactions. We use a large cosmological N-body simulation coupled with a well-tested semi-analytic substructure model to demonstrate that the majority of galaxies in close pairs reside within cluster or group-size halos and therefore represent a biased population, poorly suited for direct comparison to ``field'' galaxies. Thus, the frequent observation that some types of galaxies in pairs have redder colors than ``field'' galaxies is primarily a selection effect. We select galaxy pairs that are isolated in their dark matter halos with respect to other massive subhalos (N=2 halos) and a control sample of isolated galaxies (N=1 halos) for comparison. We then apply these selection criteria to a volume-limited subset of the 2dF Galaxy Redshift Survey with M_Bj <= -19 and obtain the first clean measure of the typical fraction of galaxies affected by triggered star formation and the average elevation in the star formation rate. We find that 24% (30.5%) of these L^\star and sub-L^{\star} galaxies in isolated 50 (30) kpc/h pairs exhibit star formation that is boosted by a factor of >~ 5 above their average past value, while only 10% of isolated galaxies in the control sample show this level of enhancement. Thus, 14% (20 %) of the galaxies in these close pairs show clear triggered star formation. The isolation criteria we develop provide a means to constrain star formation and feedback prescriptions in hydrodynamic simulations and a very general method of understanding the importance of triggered star formation in a cosmological context. (Abridged.)Comment: 12 pages, 10 figures, emulateapj format, accepted by Ap

Association between Outdoor Air Pollution and Childhood Leukemia: A Systematic Review and Dose-Response Meta-Analysis.

BackgroundA causal link between outdoor air pollution and childhood leukemia has been proposed, but some older studies suffer from methodological drawbacks. To the best of our knowledge, no systematic reviews have summarized the most recently published evidence and no analyses have examined the dose-response relation.ObjectiveWe investigated the extent to which outdoor air pollution, especially as resulting from traffic-related contaminants, affects the risk of childhood leukemia.MethodsWe searched all case-control and cohort studies that have investigated the risk of childhood leukemia in relation to exposure either to motorized traffic and related contaminants, based on various traffic-related metrics (number of vehicles in the closest roads, road density, and distance from major roads), or to measured or modeled levels of air contaminants such as benzene, nitrogen dioxide, 1,3-butadiene, and particulate matter. We carried out a meta-analysis of all eligible studies, including nine studies published since the last systematic review and, when possible, we fit a dose-response curve using a restricted cubic spline regression model.ResultsWe found 29 studies eligible to be included in our review. In the dose-response analysis, we found little association between disease risk and traffic indicators near the child's residence for most of the exposure range, with an indication of a possible excess risk only at the highest levels. In contrast, benzene exposure was positively and approximately linearly associated with risk of childhood leukemia, particularly for acute myeloid leukemia, among children under 6 y of age, and when exposure assessment at the time of diagnosis was used. Exposure to nitrogen dioxide showed little association with leukemia risk except at the highest levels.DiscussionOverall, the epidemiologic literature appears to support an association between benzene and childhood leukemia risk, with no indication of any threshold effect. A role for other measured and unmeasured pollutants from motorized traffic is also possible. https://doi.org/10.1289/EHP4381

Calpains mediate p53 activation and neuronal death evoked by DNA damage.

DNA damage is an initiator of neuronal death implicated in neuropathological conditions such as stroke. Previous evidence has shown that apoptotic death of embryonic cortical neurons treated with the DNA damaging agent camptothecin is dependent upon the tumor suppressor p53, an upstream death mediator, and more distal death effectors such as caspases. We show here that the calcium-regulated cysteine proteases, calpains, are activated during DNA damage induced by camptothecin treatment. Moreover, calpain deficiency, calpastatin expression, or pharmacological calpain inhibitors prevent the death of embryonic cortical neurons, indicating the important role of calpain in DNA damage-induced death. Calpain inhibition also significantly reduced and delayed the induction of p53. Consistent with the actions of calpains upstream of p53 and the proximal nature of p53 death signaling, calpain inhibition inhibited cytochrome c release and DEVD-AFC cleavage activity. Taken together, our results indicate that calpains are a key mediator of p53 induction and consequent caspase-dependent neuronal death due to DNA damage

Sixth Drag Prediction Workshop Results Using FUN3D with k-kL-MEAH2015 Turbulence Model

The Common Research Model wing-body configuration is investigated with the k-kL-MEAH2015 turbulence model implemented in FUN3D. This includes results presented at the Sixth Drag Prediction Workshop and additional results generated after the workshop with a nonlinear Quadratic Constitutive Relation (QCR) variant of the same turbulence model. The workshop provided grids are used, and a uniform grid refinement study is performed at the design condition. A large variation between results with and without a reconstruction limiter is exhibited on medium grid sizes, indicating that the medium grid size is too coarse for drawing conclusions in comparison with experiment. This variation is reduced with grid refinement. At a fixed angle of attack near design conditions, the QCR variant yielded decreased lift and drag compared with the linear eddy-viscosity model by an amount that was approximately constant with grid refinement. The k-kL-MEAH2015 turbulence model produced wing root junction flow behavior consistent with wind tunnel observations

Brane Decay of a (4+n)-Dimensional Rotating Black Hole. III: spin-1/2 particles

In this work, we have continued the study of the Hawking radiation on the brane from a higher-dimensional rotating black hole by investigating the emission of fermionic modes. A comprehensive analysis is performed that leads to the particle, power and angular momentum emission rates, and sheds light on their dependence on fundamental parameters of the theory, such as the spacetime dimension and angular momentum of the black hole. In addition, the angular distribution of the emitted modes, in terms of the number of particles and energy, is thoroughly studied. Our results are valid for arbitrary values of the energy of the emitted particles, dimension of spacetime and angular momentum of the black hole, and complement previous results on the emission of brane-localised scalars and gauge bosons.Comment: Latex file, JHEP style, 34 pages, 16 figures Energy range in plots increased, minor changes, version published in JHE

Norepinephrine and dopamine transmission in 2 limbic regions differentially respond to acute noxious stimulation

Acute tail pinch induces distinct changes in limbic catecholamine neurotransmission, which may promote the physiological and behavioral responses necessary for survival

Counts-in-Cylinders in the Sloan Digital Sky Survey with Comparisons to N-body Simulations

Environmental statistics provide a necessary means of comparing the properties of galaxies in different environments and a vital test of models of galaxy formation within the prevailing, hierarchical cosmological model. We explore counts-in-cylinders, a common statistic defined as the number of companions of a particular galaxy found within a given projected radius and redshift interval. Galaxy distributions with the same two-point correlation functions do not necessarily have the same companion count distributions. We use this statistic to examine the environments of galaxies in the Sloan Digital Sky Survey, Data Release 4. We also make preliminary comparisons to four models for the spatial distributions of galaxies, based on N-body simulations, and data from SDSS DR4 to study the utility of the counts-in-cylinders statistic. There is a very large scatter between the number of companions a galaxy has and the mass of its parent dark matter halo and the halo occupation, limiting the utility of this statistic for certain kinds of environmental studies. We also show that prevalent, empirical models of galaxy clustering that match observed two- and three-point clustering statistics well fail to reproduce some aspects of the observed distribution of counts-in-cylinders on 1, 3 and 6-Mpc/h scales. All models that we explore underpredict the fraction of galaxies with few or no companions in 3 and 6-Mpc/h cylinders. Roughly 7% of galaxies in the real universe are significantly more isolated within a 6 Mpc/h cylinder than the galaxies in any of the models we use. Simple, phenomenological models that map galaxies to dark matter halos fail to reproduce high-order clustering statistics in low-density environments.Comment: 17 pages, 10 figures. Accepted, Ap