Near-Earth injection of MeV electrons associated with intense dipolarization electric fields: Van Allen Probes observations.

Substorms generally inject tens to hundreds of keV electrons, but intense substorm electric fields have been shown to inject MeV electrons as well. An intriguing question is whether such MeVelectron injections can populate the outer radiation belt. Here we present observations of a substorm injection of MeV electrons into the inner magnetosphere. In the premidnight sector at L ∼ 5.5, Van Allen Probes (Radiation Belt Storm Probes)-A observed a large dipolarization electric field (50 mV/m) over ∼40 s and a dispersionless injection of electrons up to ∼3 MeV. Pitch angle observations indicated betatron acceleration of MeV electrons at the dipolarization front. Corresponding signals of MeV electron injection were observed at LANL-GEO, THEMIS-D, and GOES at geosynchronous altitude. Through a series of dipolarizations, the injections increased the MeV electron phase space density by 1 order of magnitude in less than 3 h in the outer radiation belt (L > 4.8). Our observations provide evidence that deep injections can supply significant MeV electrons

The Major Pre- and Postmenopausal Estrogens Play Opposing Roles in Obesity-Driven Mammary Inflammation and Breast Cancer Development

Many inflammation-associated diseases, including cancers, increase in women after menopause and with obesity. In contrast to anti-inflammatory actions of 17β-estradiol, we find estrone, which dominates after menopause, is pro-inflammatory. In human mammary adipocytes, cytokine expression increases with obesity, menopause, and cancer. Adipocyte:cancer cell interaction stimulates estrone- and NFκB-dependent pro-inflammatory cytokine upregulation. Estrone- and 17β-estradiol-driven transcriptomes differ. Estrone:ERα stimulates NFκB-mediated cytokine gene induction; 17β-estradiol opposes this. In obese mice, estrone increases and 17β-estradiol relieves inflammation. Estrone drives more rapid ER+ breast cancer growth in vivo. HSD17B14, which converts 17β-estradiol to estrone, associates with poor ER+ breast cancer outcome. Estrone and HSD17B14 upregulate inflammation, ALDH1 activity, and tumorspheres, while 17β-estradiol and HSD17B14 knockdown oppose these. Finally, a high intratumor estrone:17β-estradiol ratio increases tumor-initiating stem cells and ER+ cancer growth in vivo. These findings help explain why postmenopausal ER+ breast cancer increases with obesity, and offer new strategies for prevention and therapy.This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 84510

Essentials of plastic surgery

This is a concise but comprehensive textbook for plastic surgery residents reviewing for in-service and certifying examinations as well as practicing plastic surgeons preparing for Maintenance of Certification. The book is divided into chapters based on the 24 so-called common plastic surgical procedures. This will allow a discussion of the procedure prior to embarking on surgery and serve as a basis for the development of a basic fund of knowledge in the specialty of Plastic, Reconstructive, and Aesthetic Surgery. Contributors have been selected based on their clinical expertise and academic excellence.Sample Chapter(s)Foreword (40 KB)Chapter 1: Wound Repair (259 KB)Contents:Core Knowledge and General Principles:Wound Repair (Jason P Ulm and Kevin O Delaney)Grafts and Flaps (Jason P Ulm and Dennis K Schimpf)Anesthetic Implications in Cosmetic Surgery (Gian Paparcuri and Miguel Cobas)Lasers and Aesthetic Devices (Mark S Nestor and Matthew B Zarraga)Plastic Surgery Involving the Integument:Benign and Malignant Skin Lesions (Wrood M Kassira)Infantile Hemangioma (Karim W Sadik and Haaris S Mir)Burn Injury and Treatment (Jessica A Ching and C Wayne Cruse)Cleft Lip and Palate: Anatomy, Embryology, and Repair (Kenneth L Fan, Raja Mohan and Seth R Thaller)Essentials in Plastic Surgery Microtia Chapter (Kenneth L Fan, Raja Mohan and Seth R Thaller)Head and Neck Malignancy (David Nesky and Donald Weed)Principles in Facial Injury Management (Patrick Cole and Larry Hollier, Jr)Aesthetic Surgery of the Face: Face Lift (Erick Martell and Alan Matarasso)Eyelid, Cheek, Lip, Nasal, Scalp, Ear Reconstruction (Anuja K Antony, Victor J Hassid and Mimis N Cohen)Plastic Surgery of the Upper Extremity:Infectious and Inflammatory Disorders of the Upper Extremity (Joshua M Adkinson and Robert X Murphy, Jr)Compression Neuropathies in the Upper Extremity (Askari Morad)Benign and Malignant Tumors of the Upper Extremity (Sara Yegiyants, Yash Avasha and Zubin J Panthaki)Rheumatoid Arthritis of the Hand (Haaris S Mir and Stacy R Henderson)Congenital Hand Anomalies (Sara Yegiyants and Zubin J Panthaki)Upper Extremity Trauma (Deniz Dayicioglu and Derek Ulvila)Dupuytren's Disease (Sara Yegiyants and Zubin J Panthaki)Microsurgery: General Principles (Harvey W-M Chim and Christopher J Salgado)Plastic Surgery of the Lower Extremity:Lower Extremity Reconstruction (John R Barbour and Milton B Armstrong)Reduction Mammaplasty, Augmentation Mammaplasty, and Mastopexy (John C Oeltjen)Breast Reconstruction (John C Oeltjen)Aesthetic Body Contouring: Abdominoplasty (Steven Rueda and Seth R Thaller)Aesthetic Body Contouring: Abdominoplasty Body Contouring after Bariatric Surgery (Benjamin Lemelman, Paul G Cofnas and Seth R Thaller)Body Contouring via Suction Lipectomy (Michelle De Souza and Garry Martin II)Abdominal and Thoracic Reconstruction (Umbareen Mahmood and Deniz Dayicioglu)Pressure Ulcers (Jessica S Suber, Rajiv P Parikh and Deniz Dayicioglu)Vascular Anomalies (Harvey Chim and Arun K Gosain)Readership: Practicing plastic surgeons preparing for Maintenance of Certification examinations, plastic surgery residents, general surgery and other specialty residents rotating through plastic surgery rotations; medical school students rotating through a plastic surgery rotation

Management of Mandibular Fractures

The complex physiology of the masticatory system is extremely sensitive to its intricate anatomic relationships. With the ever-increasing number of patients admitted to our institution with traumatic facial injuries, it seemed an appropriate time to evaluate the most widely employed treatment modalities available for the management of mandibular fractures. Maxillomandibular fixation remains the mainstay of mandible fracture stabilization. Within recent years, rigid internal fixation with miniplates and screws has become popular. This study compares the results of the most commonly used treatment modalities available for the repair of acute mandibular fractures. (Arch Otolaryngol Head Neck Surg. 1994;120:44-48