Patient-reported aesthetic outcomes of upper blepharoplasty:a randomized controlled trial comparing two surgical techniques

It is not yet established whether additional orbicularis oculi muscle excision leads to better patient-reported aesthetic outcomes (PRO) compared to a skin-only resection blepharoplasty. A double-blind randomized controlled trial of upper blepharoplasty, with or without muscle excision, was performed on 54 White European patients who assessed the procedure via PRO. FACE-Q questionnaires covering eyes in general, upper eyelids, forehead and eyebrows, overall face, age appearance appraisal, age appraisal, social functioning, satisfaction with the outcome, and adverse effects were completed preoperatively and at 6 and 12 months after upper blepharoplasty. The Patient and Observer Scar Assessment Scale was used to assess scarring. The FACE-Q scores for skin-only and skin/muscle upper blepharoplasty were similar regarding the upper eyelids, forehead and eyebrows, overall face, patient perceived aging and age, social functioning, and satisfaction with the results, and also increased for both procedures with time. The FACE-Q score regarding the eyes in general was higher in the skin-only group at the 12-month follow-up. Scarring and adverse effects did not differ between the groups. Additional muscle resection does not seem to influence patient satisfaction. Thus, when performing an upper blepharoplasty, there is no need for additional muscle resection as a routine procedure to improve patient satisfaction

Postoperative skeletal stability at the one-year follow-up after splintless Le Fort I osteotomy using patient-specific osteosynthesis versus conventional osteosynthesis:a randomized controlled trial

The purpose of this study was to assess the 1-year skeletal stability of the osteotomized maxilla after Le Fort I surgery, comparing conventional osteosynthesis with patient-specific osteosynthesis. Patients were assigned to a conventional or patient-specific osteosynthesis group using prospective randomization. The primary outcome was the three-dimensional change in postoperative skeletal position of the maxilla between the 2-week and 1-year follow-up cone beam computed tomography scans. Fifty-eight patients completed the protocol for the 2-week postoperative analysis, and 27 patients completed the 1-year follow-up study protocol. Of the 27 patients completing the entire protocol, 13 were in the conventional group and 14 in the patient-specific osteosynthesis group. The three-dimensional translation analysis showed that the use of the patient-specific osteosynthesis resulted in a skeletally stable result, comparable to that of conventional miniplate fixation. For both the patient-specific osteosynthesis and conventional miniplate fixation groups, median translations of less than 1 mm and median rotations of less than 1° were observed, indicating that both methods of fixation resulted in a stable result for the 27 patients examined. For the Le Fort I osteotomy, the choice between patient-specific osteosynthesis and conventional osteosynthesis did not affect the postoperative skeletal stability after 1 year of follow-up

The use of xenografts to prevent inferior border defects following bilateral sagittal split osteotomies:three-dimensional skeletal analysis using cone beam computed tomography

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Calcaneal nonunion: three cases and a review of the literature

The long-term follow-up of intra-articular calcaneal fractures is often accompanied by complications. Frequently occurring are arthrosis, arthrofibrosis of the subtalar joint, and malunion. Uncommon is the calcaneal nonunion. A total of three cases is presented in this report, including a review of the literature. The occurrence of a nonunion appears to be more common after conservative treatment, but the pathophysiology remains unclear, however smoking may play a role

Impact of upper blepharoplasty, with or without orbicularis oculi muscle removal, on tear film dynamics and dry eye symptoms:A randomized controlled trial

PURPOSE: Upper blepharoplasty may be related to dry eye symptoms since the function of the orbicularis oculi muscle may affect the tear film. We aimed to assess the effect of blepharoplasty with or without the removal of a strip of orbicularis oculi muscle on tear film dynamics and dry eye symptoms. METHODS: A double-blind, randomized, controlled trial comparing upper blepharoplasty without (group A) or with (group B) orbicularis oculi muscle excision was performed on 54 healthy Caucasian patients. Tear film dynamics and dry eye symptoms were evaluated using multiple dry eye parameters, i.e. tear osmolarity, Schirmer test I, corneal/conjunctival staining, tear break-up time (TBUT), Oxford Scheme, Sicca Ocular Staining Score and Ocular Surface Disease Index questionnaire. All the parameters were assessed preoperatively and 6 and 12 months after upper blepharoplasty. All the groups' outcomes were compared. RESULTS: The differences were not significant between the two upper blepharoplasty techniques regarding most of the above-mentioned outcomes. Subjective symptoms of ocular irritation, consistent with dry eye disease and vision-related impairment, were reduced after upper blepharoplasty independent of the type of the technique applied, while the pre and postoperative outcomes of the objective tear dynamics did not differ 12 months after surgery. However, group B demonstrated a significant increase in tear osmolarity and TBUT at the 6-month follow-up visit. CONCLUSION: An upper blepharoplasty alleviates subjective dry eye complaints in the long term, while not changing the tear dynamics. The improvement was independent of the blepharoplasty technique used

Ambulatory human motion tracking by fusion of inertial and magnetic sensing with adaptive actuation

Over the last years, inertial sensing has proven to be a suitable ambulatory alternative to traditional human motion tracking based on optical position measurement systems, which are generally restricted to a laboratory environment. Besides many advantages, a major drawback is the inherent drift caused by integration of acceleration and angular velocity to obtain position and orientation. In addition, inertial sensing cannot be used to estimate relative positions and orientations of sensors with respect to each other. In order to overcome these drawbacks, this study presents an Extended Kalman Filter for fusion of inertial and magnetic sensing that is used to estimate relative positions and orientations. In between magnetic updates, change of position and orientation are estimated using inertial sensors. The system decides to perform a magnetic update only if the estimated uncertainty associated with the relative position and orientation exceeds a predefined threshold. The filter is able to provide a stable and accurate estimation of relative position and orientation for several types of movements, as indicated by the average rms error being 0.033 m for the position and 3.6 degrees for the orientation

The impact of corporate philanthropy on reputation for corporate social performance

This study seeks to examine the mechanisms by which a corporation’s use of philanthropy affects its reputation for corporate social performance (CSP), which the authors conceive of as consisting of two dimensions: CSP awareness and CSP perception. Using signal detection theory (SDT), the authors model signal amplitude (the amount contributed), dispersion (number of areas supported), and consistency (presence of a corporate foundation) on CSP awareness and perception. Overall, this study finds that characteristics of firms' portfolio of philanthropic activities are a greater predictor of CSP awareness than of CSP perception. Awareness increases with signal amplitude, dispersion, and consistency. CSP perception is driven by awareness and corporate reputation. The authors’ contention that corporate philanthropy is a complex variable is upheld, as we find that CSP signal characteristics influence CSP awareness and perception independently and asymmetrically. The authors conclude by proposing avenues for future research

Splintless surgery using patient-specific osteosynthesis in Le Fort I osteotomies:a randomized controlled multi centre trial

The accuracy of orthognathic surgery has improved with three-dimensional virtual planning. The translation of the planning to the surgical result is reported to vary by >2 mm. The aim of this randomized controlled multi-centre trial was to determine whether the use of splintless patient-specific osteosynthesis can improve the accuracy of maxillary translation. Patients requiring a Le Fort I osteotomy were included in the trial. The intervention group was treated using patient-specific osteosynthesis and the control group with conventional osteosynthesis and splint-based positioning. Fifty-eight patients completed the study protocol, 27 in the patient-specific osteosynthesis group and 31 in the control group. The per protocol median anteroposterior deviation was found to be 1.05 mm (interquartile range (IQR) 0.45-2.72 mm) in the patient-specific osteosynthesis group and 1.74 mm (IQR 1.02-3.02 mm) in the control group. The cranial-caudal deviation was 0.87 mm (IQR 0.49-1.44 mm) and 0.98 mm (IQR 0.28-2.10 mm), respectively, whereas the left-right translation deviation was 0.46 mm (IQR 0.19-0.96 mm) in the patient-specific osteosynthesis group and 1.07 mm (IQR 0.62-1.55 mm) in the control group. The splintless patient-specific osteosynthesis method improves the accuracy of maxillary translations in orthognathic surgery and is clinically relevant for planned anteroposterior translations of more than 3.70 mm

Hadronic interaction of eta and eta-prime mesons with nucleons

Due to their short life-time, flavour-neutral mesons cannot be utilized as free secondary beams or targets, and therefore a study of their interaction with nucleons is not possible via direct scattering experiments. This interaction is, however, accessible via its influence on the energy dependence - and on the phase space distributions of the cross sections for reactions in which these mesons are produced. In case of the p p --> p p eta reaction the experimentally determined distributions of the differential cross sections close to the production threshold cannot be described by taking into account the S-wave proton-proton and proton-eta interaction only. Here we show that the angular distributions determined at the COSY-11 facility reveal some evidence for P-wave admixture in the proton-proton subsystem already at an excess energy as low as Q = 15.5 MeV. We also present that one can estimate the relative strength of the eta-nucleon and eta-prime-nucleon interactions by comparison of the eta and eta-prime production yield.Comment: 4 pages, 3 figures, Talk given at 16th International Conference on Particles and Nuclei (PANIC 02), Osaka, Japan, 30 Sep - 4 Oct 200

Model and Sensor-Based Recommendation Approaches for In-Season Nitrogen Management in Corn

Nitrogen management for corn (Zea mays L.) may be improved by applying a portion of N in-season. This investigation was conducted to evaluate crop modeling (Maize-N) and active crop canopy sensing approaches for recommending in-season N fertilizer rates. These approaches were evaluated during 2012–2013 on 11 field sites, in Missouri, Nebraska, and North Dakota. Nitrogen management also included a no-N treatment (check) and a non-limiting N reference (all at planting). Nitrogen management treatments were assessed for two hybrids and at low and high seeding rates, arranged in a randomized complete block design. In 9 of 11 site-years, the sensor-based approach recommended lower in-season N rates than the model (collectively 59% less N), resulting in trends of higher partial factor productivity of nitrogen (PFPN) and higher agronomic efficiency (AE) than the model. However, yield was better protected by the model-based approach. In some situations, canopy sensing excelled at optimizing the N rate for localized conditions. With abnormally warm and moist soil conditions for the 2012 Nebraska sites and presumed high levels of inorganic N from mineralization, N application was appropriately reduced, resulting in no yield decrease and N savings compared to the non-limiting N reference. Depending on the site, both recommendation approaches were successful; a combination of model and sensor information may optimize in-season decision support for N recommendation