Biodegradable fixation for craniomaxillofacial surgery: a 10-year experience involving 761 operations and 745 patients

Patient acceptance, safety, and efficacy of poly-L/DL-lactic acid (PLLDL) bone plates and screws in craniomaxillofacial surgery are reported in this article. Included in the sample are 745 patients who underwent 761 separate operations, including more than 1400 surgical procedures (orthognathic surgery (685), bone graft reconstruction (37), trauma (191) and transcranial surgery (20)). The success (no breakage or inflammation requiring additional operating room treatment) was 94%. Failure occurred because of breakage (14) or exuberant inflammation (31). All breakage occurred at mandibular sites and the majority of inflammatory failure occurred in the maxilla or orbit (29), with only two in the mandible. Failures were evenly distributed between the two major vendors. PLLDL 70/30 bone plates and screws may be used successfully in a variety of craniomaxillofacial surgical applications. The advantages include the gradual transference of physiological forces to the healing bone, the reduced need for a second operation to remove the material and its potential to serve as a vehicle to deliver bone-healing proteins to fracture/osteotomy sites. Bone healing was noted at all sites, even where exuberant inflammation required a second surgical intervention

Long-term stability of adolescent versus adult surgery for treatment of mandibular deficiency

In mandibular deficient patients, mandibular growth is not expected after the adolescent growth spurt, so mandibular advancement surgery is often carried out at 13 years. To test if the long-term stability for younger patients is similar to that for adult patients, the authors compared cephalometric changes from 1 year postsurgery (when changes due to the surgery should be completed) to 5 year follow up. 32 patients who had early mandibular advancement with or without simultaneous maxillary surgery (aged up to 16 for girls and 18 for boys), and 52 patients with similar surgery at older ages were studied. Beyond 1 year postsurgery, the younger patients showed significantly greater change in the horizontal and vertical position of points B and pogonion, the horizontal (but not vertical) position of gonion, and mandibular plane angle. 50% of younger patients had 2–4 mm backward movement of Pg and another 25% had >4 mm. 15% of older patients had 2–4 mm change and none had >4 mm. Long-term changes in younger patients who had 2-jaw surgery were greater than for mandibular advancement only. Changes in younger groups were greater than for adult groups. Satisfaction with treatment and perception of problems were similar for both groups

Soft-mode anisotropy in the negative thermal expansion material ReO3

We use a symmetry-motivated approach to analyse neutron pair distribution function data to investigate the character of the soft phonon modes in negative thermal expansion (NTE) material ReO3. This analysis shows that its local structure is dominated by an in-phase octahedral tilting mode and that the octahedral units are far less flexible to scissoring type deformations than in the related NTE compound ScF3. The lack of flexibility in ReO3 restricts the NTE-driving phonons to a smaller region of reciprocal space, limiting the magnitude and temperature range of NTE. These results support the idea that structural flexibility is an important factor in NTE materials. Surprisingly, our results show that the local fluctuations, even at elevated temperatures, respect the symmetry and order parameter direction of the initial pressure induced phase transition in ReO3. The result indicates that the dynamic motions associated with rigid unit modes are highly anisotropic in these systems

Facial altered sensation and sensory impairment after orthognathic surgery

The aim of this study was to determine whether impairment of sensory function after trigeminal nerve injury differs in severity among patients who report qualitatively different altered sensations. Data were obtained from 184 patients. Before and at 1, 3 and 6 months after orthognathic surgery, patients were grouped as having no altered sensation, negative sensations only (hypoesthetic), mixed sensations (negative + active), or active sensations only (paresthetic or dysesthetic). Bias-free estimates of contact detection and two-point discrimination were obtained to assess, via ANOVA, whether patients in the four groups exhibited different levels of sensory impairment. Impairment in contact detection and two-point discrimination was found to differ significantly among the groups at 6 months but not at 1 month. At 6 months, patients who reported negative sensations only exhibited the greatest impairment, on average, in contact detection; in contrast, patients who reported mixed sensations exhibited the greatest impairment in two-point discrimination. The least residual impairment at 6 months was observed in patients who reported no altered sensation. It is recommended that clinical judgments regarding nerve injury-associated sensory dysfunction not be based on threshold testing results without consideration of patients’ subjective reports of altered sensation

A review of the effects of wind on the movement, behavior, energetics, and life history of seabirds

For decades, studies have highlighted links between wind patterns and the behavior, ecology, distribution, energetics and life history of seabirds. However, only relatively recently have advancements in tracking technologies and improvements in the resolution of globally available wind data allowed wind impacts on seabirds to be quantified across multiple spatiotemporal scales. Here, we review and synthesize current knowledge of the effects of wind on seabirds. We first describe global patterns of wind circulation and relevant atmospheric processes and discuss the relationship between seabird morphology, flight performance and behavior relative to wind. We then develop a conceptual model linking seabird movement strategies to wind, morphology, flight capabilities and central-place constraint. Finally, we examine how wind influences seabird populations via effects on flight efficiency and energetics, and wind impacts associated with climate variability and severe weather. We conclude by highlighting research priorities for advancing our understanding of the effects of wind on seabird ecology and behavior; these include assessing how and to what extent seabirds use ocean waves for efficient flight, understanding how seabirds sense and anticipate wind patterns, and examining how wind has shaped seabird evolution. Future research should also focus on assessing how wind modulates habitat accessibility, and how this knowledge could be incorporated into theory of seabird habitat use. Moreover, approaches that focus on mechanistic links between climate, wind and demography are needed to assess population-level effects, and will be imperative to understanding how seabirds may be impacted by climate-driven changes to wind patterns

Postoperative nausea and vomiting following orthognathic surgery

The purpose of this study was to assess the incidence and risk factors associated with postoperative nausea (PON) and vomiting (POV) after orthognathic surgery. A review of the clinical records of consecutively enrolled subjects (2008–2012) at a single academic institution was conducted between 9/2013 and 3/2014. Data on the occurrence of PON and POV and potential patient-related, intraoperative, and postoperative explanatory factors were extracted from the medical records. Logistic models were used for the presence/absence of postoperative nausea and vomiting separately. Data from 204 subjects were analyzed: 63% were female, 72% Caucasian, and the median age was 19 years. Thirty-three percent had a mandibular osteotomy alone, 27% a maxillary osteotomy alone, and 40% had bimaxillary osteotomies. Sixty-seven percent experienced PON and 27% experienced POV. The most important risk factors for PON in this series were female gender, increased intravenous fluids, and the use of nitrous oxide, and for POV were race, additional procedures, and morphine administration. The incidence of PON and POV following orthognathic surgery in the current cohort of patients, after the introduction of the updated 2007 consensus guidelines for the management of postoperative nausea and vomiting, has not decreased substantially from that reported in 2003–2004

The 3-Band Hubbard-Model versus the 1-Band Model for the high-Tc Cuprates: Pairing Dynamics, Superconductivity and the Ground-State Phase Diagram

One central challenge in high-$T_c$ superconductivity (SC) is to derive a detailed understanding for the specific role of the $Cu$-$d_{x^2-y^2}$ and $O$-$p_{x,y}$ orbital degrees of freedom. In most theoretical studies an effective one-band Hubbard (1BH) or t-J model has been used. Here, the physics is that of doping into a Mott-insulator, whereas the actual high-$T_c$ cuprates are doped charge-transfer insulators. To shed light on the related question, where the material-dependent physics enters, we compare the competing magnetic and superconducting phases in the ground state, the single- and two-particle excitations and, in particular, the pairing interaction and its dynamics in the three-band Hubbard (3BH) and 1BH-models. Using a cluster embedding scheme, i.e. the variational cluster approach (VCA), we find which frequencies are relevant for pairing in the two models as a function of interaction strength and doping: in the 3BH-models the interaction in the low- to optimal-doping regime is dominated by retarded pairing due to low-energy spin fluctuations with surprisingly little influence of inter-band (p-d charge) fluctuations. On the other hand, in the 1BH-model, in addition a part comes from "high-energy" excited states (Hubbard band), which may be identified with a non-retarded contribution. We find these differences between a charge-transfer and a Mott insulator to be renormalized away for the ground-state phase diagram of the 3BH- and 1BH-models, which are in close overall agreement, i.e. are "universal". On the other hand, we expect the differences - and thus, the material dependence to show up in the "non-universal" finite-T phase diagram ($T_c$-values).Comment: 17 pages, 9 figure

Are bioresorbable polylactate devices comparable to titanium devices for stabilizing Le Fort I advancement?

AbstractThe purpose of this study was to evaluate whether skeletal and dental outcomes following Le Fort I surgery differed when stabilization was performed with polylactate bioresorbable devices or titanium devices. Fifty-seven patients with preoperative records and at least 1 year postoperative records were identified and grouped according to the stabilization method. All cephalometric X-rays were traced and digitized by a single operator. Analysis of covariance was used to compare the postsurgical change between the two stabilization methods. Twenty-seven patients received bioresorbable devices (group R), while 30 received titanium devices (group M). There were no statistically significant differences between the two groups with respect to gender, race/ethnicity, age, or dental and skeletal movements during surgery. Subtle postsurgical differences were noted, but were not statistically significant. Stabilization of Le Fort I advancement with polylactate bioresorbable and titanium devices produced similar clinical outcomes at 1 year following surgery

In Situ Template Generation for Zincophosphate Synthesis Leading to C2H7N4O-ZnPO4 Containing Template-to-Template N--H...O Hydrogen Bonds

The synthesis, structure and some properties of C{sub 2}H{sub 7}N{sub 4}O {center_dot} ZnPO{sub 4} (guanylurea zinc phosphate) are reported. The cationic template was prepared in situ by partial hydrolysis of the neutral 2-cyanoguanidine starting material. The resulting structure contains a new, unprotonated, zincophosphate layer topology as well as unusual N-H-O template-to-template hydrogen bonds which help to stabilize a ''double sandwich'' of templating cations between the inorganic sheets. Crystal data: C{sub 2}H{sub 7}N{sub 4}O {center_dot} ZnPO{sub 4}, M{sub r} = 229.44, monoclinic, P2{sub 1}/c, a = 13.6453 (9) {angstrom}, b = 5.0716 (3) {angstrom}, c = 10.6005 (7) {angstrom}, {beta} = 95.918 (2){sup 0}, V = 729.7 (1) {angstrom}{sup 3}, R(F) = 0.034, wR(F) = 0.034

Transformation of in-plane ρ(T)\rho (T) in YBa2Cu3O7−δYBa_{2}Cu_{3}O_{7-\delta} at fixed oxygen content

This paper reveals the origin of variation in the magnitude and temperature dependence of the normal state resistivity frequently observed in different YBCO single crystal or thin film samples with the same $T_{c}$. We investigated temperature dependence of resistivity in $YBa_{2}Cu_{3}O_{7-\delta}$ thin films with 7- $\delta = 6.95$ and 6.90, which were subjected to annealing in argon at 400-420 K ($120-140^{o}C$). Before annealing these films exhibited a non-linear $\rho_{ab}(T)$, with a flattening below 230 K, similar to $\rho_{b}(T)$ and $\rho_{ab}(T)$ observed in untwinned and twinned YBCO crystals, respectively. For all films the annealing causes an increase of resistivity and a transformation of $\rho_{ab}(T)$ from a non-linear dependence towards a more linear one (less flattening). In films with 7- $\delta = 6.90$ the increase of resistivity is also associated with an increase in $T_{c}$. We proposed the model that provides an explanation of these phenomena in terms of thermally activated redistribution of residual O(5) oxygens in the chain-layer of YBCO. Good agreement between the experimental data for $\rho_{ab}(t,T)$, where t is the annealing time, and numerical calculations was obtained.Comment: 8 pages, 9 figures, submitted to PR