Science with Practice

THE slogan at Iowa State is Science with Practice. Or is it sacrilege to call a crested motto a slogan? Perhaps I should write with saccharine hypocrisy about high scholastic standards, the emphasis upon basic fundamentals, or the complexity of subjects offered..

Sketch Presents

A study of human nature, from a dozen varied perspectives, in this first issue of its fourteenth year of publication. Written by students, run by students, supported by students, Sketch believes that the content of each manuscript is the author\u27s own responsibility..

Rat Story

I work hard all day in the sun..

Development of a Prediction Model for Cranioplasty Implant Survival Following Craniectomy

BACKGROUND: Cranioplasty after craniectomy can result in high rates of postoperative complications. Although determinants of postoperative outcomes have been identified, a prediction model for predicting cranioplasty implant survival does not exist. Thus, we sought to develop a prediction model for cranioplasty implant survival after craniectomy. METHODS: We performed a retrospective cohort study of patients who underwent cranioplasty following craniectomy between 2014 and 2020. Missing data were imputed using multiple imputation. For model development, multivariable Cox proportional hazards regression analysis was performed. To test whether candidate determinants contributed to the model, we performed backward selection using the Akaike information criterion. We corrected for overfitting using bootstrapping techniques. The performance of the model was assessed using discrimination and calibration. RESULTS: A total of 182 patients were included (mean age, 43.0 ± 19.7 years). Independent determinants of cranioplasty implant survival included the indication for craniectomy (compared with trauma-vascular disease: hazard ratio [HR], 0.65 [95% confidence interval (CI), 0.36-1.17]; infection: HR, 0.76 [95% CI, 0.32-1.80]; tumor: HR, 1.40 [95% CI, 0.29-6.79]), cranial defect size (HR, 1.01 per cm 2 [95% CI, 0.73-1.38]), use of an autologous bone flap (HR, 1.63 [95% CI, 0.82-3.24]), and skin closure using staples (HR, 1.42 [95% CI, 0.79-2.56]). The concordance index of the model was 0.60 (95% CI, 0.47-0.73). CONCLUSIONS: We have developed the first prediction model for cranioplasty implant survival after craniectomy. The findings from our study require external validation and deserve further exploration in future studies

Cosmetic satisfaction and patient-reported outcome measures following cranioplasty after craniectomy - A prospective cohort study

INTRODUCTION: Evaluating patient-reported outcomes (PROMs) helps optimize preoperative counseling and psychosocial care for patients who underwent cranioplasty. RESEARCH QUESTION: This study aimed to evaluate cosmetic satisfaction, level of self-esteem, and fear of negative evaluation (FNE) of patients who underwent cranioplasty. MATERIAL AND METHODS: Patients who underwent cranioplasty from 1 January 2014 to 31 December 2020 ​at University Medical Center Utrecht and a control group consisting of our center' employees were invited to fill out the Craniofacial Surgery Outcomes Questionnaire (CSO-Q), consisting of an assessment of cosmetic satisfaction, the Rosenberg Self-Esteem Scale (RSES), and the FNE scale. To test for differences in results, chi-square tests and T-tests were performed. Logistic regression was used to study the effect of cranioplasty-related variables on cosmetic satisfaction. RESULTS: Cosmetic satisfaction was seen in 44/80 patients (55.0%) and 52/70 controls (74.3%) (p ​= ​0.247). Thirteen patients (16.3%) and 8 controls (11.4%) had high self-esteem (p ​= ​0.362), 51 patients (63.8%) and 59 controls (84.3%) had normal self-esteem (p ​= ​0.114), and 7 patients (8.8%) and 3 controls (4.3%) had low self-esteem (p ​= ​0.337). Forty-nine patients (61.3%) and 39 controls (55.7%) had low FNE (p ​= ​0.012), 8 patients (10.0%) and 18 controls (25.7%) had average FNE (p ​= ​0.095), and 6 patients (7.5%) and 13 controls (18.6%) had high FNE (p ​= ​0.215). Cosmetic satisfaction was associated with glass fiber-reinforced composite implants (OR 8.20, p-value ​= ​0.04). DISCUSSION AND CONCLUSION: This study prospectively evaluated PROMs following cranioplasty, for which we found favorable results

Identification of the Peri-oral Mimic Muscles on Cadaver Slices and 3 and 7 Tesla MRI Scans

Background: Decreased smile dynamics is reported as an unwanted side effect after Le Fort I osteotomies. It is assumed that this negative sequela might be caused by postoperative changes in the anatomy of peri-oral mimic muscles. Due to a lack of specific anatomical knowledge, the exact mechanism is not yet clarified. This makes prevention of the undesired changes in smile dynamics difficult. The first aim of this study is to increase basic anatomical and radiological MRI knowledge of the peri-oral mimic muscles. The second aim is to investigate if 7 Tesla MRI scans are better suited to identify these muscles than 3 Tesla MRI scans. Methods: Eleven peri-oral mimic muscles were chosen as subjects of the present study. Three and 7 Tesla MRI scans of a cadaver head were made. The same head was cut in axial slices using a cryomacrotome. Every second slice was digitally photographed. A three-dimensional model was created utilizing EMAC software, which served as gold standard for the identification and comparison of the chosen peri-oral mimic muscles on both MRI scans. Results: All predetermined peri-oral mimic muscles could be identified in the cadaver head, and a detailed radiological atlas was created. The ease of identification and separation of the peri-oral mimic muscles was significantly higher on the 7 Tesla MRI than on the 3 Tesla MRI scan (P < 0.001). Conclusion: A 7 Tesla MRI scanner offers great improvement in the identification of peri-oral mimic muscles compared with a 3 Tesla scanner

Dental implants in dentate primary and secondary Sjögren's syndrome patients:A multicenter prospective cohort study

Objectives: To prospectively assess the clinical performance and patient-reported outcomes of dental implants in dentate patients with primary and secondary Sjögren's syndrome (pSS and sSS, respectively) compared to patients without SS. Materials and Methods: Thirty-seven implants were placed in 17 patients with pSS/sSS and 26 implants in 17 non-SS patients to replace missing (pre)molars. Clinical performance, marginal bone-level changes, patient satisfaction, and oral health-related quality of life (OHRQoL) were assessed at 1 (T1), 6 (T6), 12 (T12), and 18 (T18) months after placement of the superstructure. Marginal bone-level changes were measured on standardized dental radiographs. Clinical parameters included implant and crown survival, plaque, bleeding and gingival indices, and probing depth. Patient satisfaction and OHRQoL were assessed with validated questionnaires. Results: Implant survival at T18 was 100% in the patients with pSS/sSS and 96.2% in the non-SS group. Mean marginal bone loss at T18 did not differ between patients with pSS/sSS and non-SS patients, 1.10 ± 1.04 and 1.04 ± 0.75 mm, respectively (p =.87). Clinical performance was good with no differences between the groups for all outcome measures (p >.05). OHRQoL in patients with pSS/sSS had improved significantly after placement of implant supported crowns at all measuring moments compared to baseline (p <.05). Nevertheless, patient satisfaction and OHRQoL remained significantly higher for patients without SS at all measuring moments (p <.05). Conclusion: Dental implants can be successfully applied in dentate patients with pSS/sSS and have a positive effect on OHRQoL

Magic Mop Cleaning Service

El presente plan de negocio tiene como objetivo principal atender la necesidad de los hogares de Lima Metropolitana de las zonas 6 y 7 para que puedan contratar un servicio de limpieza personalizado, profesional y confiable, de acuerdo con nuestro contexto actual por la COVID-19, se ha vuelto muy necesario el servicio de limpieza y desinfección. Por tal motivo, Magic Mop tiene como principal propósito facilitar la contratación de personal de limpieza profesional. El valor innovador de este proyecto es que los hogares podrán tener acceso a contratar personal de limpieza con un perfil hotelero desde la comodidad de sus casas. Nuestro público target son los hogares que cuentan con internet y que hacen uso de las redes sociales y valoran la calidad del servicio. Para ello contaremos con una página web super amigable que permita a los usuarios conocer nuestros planes de servicio y puedan elegir el que mejor se adecúe a sus necesidades. Principalmente se emplearon dos tipos de metodologías. La investigación cualitativa a través de entrevistas a profundidad y también a través de la creación de una landing page que nos ayudó a identificar nuestra tasa de conversión, la cual que fue del 19%, ello nos ha permitido conocer a nuestros potenciales clientes de acuerdo con una adecuada segmentación. Finalmente, el análisis financiero nos indica que el proyecto es rentable teniendo una VAN del inversionista de 725,562 soles y una TIR de 64.93% del FCNI.The main objective of this business plan is to meet the needs of the homes of Metropolitan Lima in zones 6 and 7 so that they can hire a personalized, professional and reliable cleaning service, in accordance with our current context due to COVID-19, cleaning and disinfection service has become very necessary. For this reason, Magic Mop's main purpose is to facilitate the hiring of professional cleaning personnel. The innovative value of this project is that households will have access to hire cleaning staff with a hotel profile from the comfort of their homes. Our target audience is households that have internet and that make use of social networks and value the quality of the service. For this we will have a super friendly web page that allows users to know our service plans and can choose the one that best suits their needs. Mainly two types of methodologies were used. Qualitative research through in-depth interviews and also through the creation of a landing page that helped us identify our conversion rate, which was 19%, which has allowed us to meet our potential clients. Finally, the financial analysis indicates that the project is profitable with a NPV of S/.725,562 and an IRR of 64.93% of the FCNI.Trabajo de investigació

Best practices for the diagnosis and evaluation of infants with robin sequence:a clinical consensus report

Importance: Robin sequence (RS) is a congenital condition characterized by micrognathia, glossoptosis, and upper airway obstruction. Currently, no consensus exists regarding the diagnosis and evaluation of children with RS. An international, multidisciplinary consensus group was formed to begin to overcome this limitation. Objective: To report a consensus-derived set of best practices for the diagnosis and evaluation of infants with RS as a starting point for defining standards and management. Evidence Review: Based on a literature review and expert opinion, a clinical consensus report was generated. Findings: Because RS can occur as an isolated condition or as part of a syndrome or multiple-anomaly disorder, the diagnostic process for each newborn may differ. Micrognathia is hypothesized as the initiating event, but the diagnosis of micrognathia is subjective. Glossoptosis and upper airway compromise complete the primary characteristics of RS. It can be difficult to judge the severity of tongue base airway obstruction, and the possibility of multilevel obstruction exists. The initial assessment of the clinical features and severity of respiratory distress is important and has practical implications. Signs of upper airway obstruction can be intermittent and are more likely to be present when the infant is asleep. Therefore, sleep studies are recommended. Feeding problems are common and may be exacerbated by the presence of a cleft palate. The clinical features and their severity can vary widely and ultimately dictate the required investigations and treatments. Conclusions and Relevance: Agreed-on recommendations for the initial evaluation of RS and clinical descriptors are provided in this consensus report. Researchers and clinicians will ideally use uniform definitions and comparable assessments. Prospective studies and the standard application of validated assessments are needed to build an evidence base guiding standards of care for infants and children with RS