Three contrasts in 3 min: Rapid, high-resolution, and bone-selective UTE MRI for craniofacial imaging with automated deep-learning skull segmentation.

PURPOSE: Ultrashort echo time (UTE) MRI can be a radiation-free alternative to CT for craniofacial imaging of pediatric patients. However, unlike CT, bone-specific MR imaging is limited by long scan times, relatively low spatial resolution, and a time-consuming bone segmentation workflow. METHODS: A rapid, high-resolution UTE technique for brain and skull imaging in conjunction with an automatic segmentation pipeline was developed. A dual-RF, dual-echo UTE sequence was optimized for rapid scan time (3 min) and smaller voxel size (0.65 mm3). A weighted least-squares conjugate gradient method for computing the bone-selective image improves bone specificity while retaining bone sensitivity. Additionally, a deep-learning U-Net model was trained to automatically segment the skull from the bone-selective images. Ten healthy adult volunteers (six male, age 31.5 ± 10 years) and three pediatric patients (two male, ages 12 to 15 years) were scanned at 3 T. Clinical CT for the three patients were obtained for validation. Similarities in 3D skull reconstructions relative to clinical standard CT were evaluated based on the Dice similarity coefficient and Hausdorff distance. Craniometric measurements were used to assess geometric accuracy of the 3D skull renderings. RESULTS: The weighted least-squares method produces images with enhanced bone specificity, suppression of soft tissue, and separation from air at the sinuses when validated against CT in pediatric patients. Dice similarity coefficient overlap was 0.86 ± 0.05, and the 95th percentile Hausdorff distance was 1.77 ± 0.49 mm between the full-skull binary masks of the optimized UTE and CT in the testing dataset. CONCLUSION: An optimized MRI acquisition, reconstruction, and segmentation workflow for craniofacial imaging was developed.

Condylar Volumetric Asymmetry Predicts Need for Surgical Intervention in Patients With Cleft Lip and/or Palate.

OBJECTIVE: In this study, the authors investigate the associations between the mandibular condyle and facial asymmetry in patients with cleft lip and/or palate (CLP). METHODS: Condylar volume was calculated by measuring the bony volume of the posterior mandible superior to the sigmoid notch in skeletally mature patients with CLP and controls. Relationships between condylar asymmetry, facial deviation, and malocclusion were compared using t-tests, correlation analysis, and receiver operating characteristic curves. RESULTS: This study included 118 patients: 60 with CLP preparing for orthognathic surgery, 17 with CLP who did not undergo orthognathic surgery, and 41 controls. Condylar volumes in patients with CLP preparing for orthognathic surgery were more asymmetric than those with CLP not requiring surgery (16.4 ± 17.4% vs 7.1 ± 6.0%, P = 0.03). Patients with CLP who did not undergo orthognathic surgery and controls had similar degrees of condylar asymmetry (7.1 ± 6.0% vs 5.9 ± 3.8%, P = 0.35). Condylar asymmetry correlated with chin deviation (P < 0.01). Patients with CLP and clinically significant chin deviation (>4 mm) had more asymmetric condyles than those without significant chin deviation, and the chin usually deviated toward the smaller condyle (P = 0.03). Condylar asymmetry >11% predicted undergoing orthognathic surgery in CLP with 70% sensitivity and 67% specificity. CONCLUSION: Condylar asymmetry is associated with facial asymmetry in patients with CLP, and the facial midline often deviates towards the smaller condyle. Condylar volumetric asymmetry in patients with CLP may be a predictor for needing orthognathic surgery, useful information for surgeons and families alike.

Comparative evaluation of PCR and loop-mediated isothermal amplification (LAMP) assays for detecting Pasteurella multocida in poultry.

AIMS: To develop a colourimetric loop-mediated isothermal amplification (LAMP) assay for the detection of Pasteurella multocida in clinical poultry samples and compare the performance of this assay with PCR. A secondary aim was to evaluate a simple DNA extraction method that could enable LAMP-based testing in the field without the need for specialised laboratory equipment. METHODS: Primer sets for both LAMP and PCR were designed to amplify the KMT1 gene of P. multocida. DNA was extracted from 12 P. multocida isolates using a commercial extraction kit, and subjected to analysis using both LAMP and PCR. The analytical specificity of the LAMP assay was evaluated by testing it against a panel of 12 unrelated bacterial species, and the analytical sensitivity (limit of detection) was determined through testing of serial dilutions of the target DNA and compared to that of PCR. Subsequently, cloacal swabs (n = 40) from a commercial turkey flock were subjected to analysis using both LAMP and PCR assays, using a rapid DNA extraction method and a commercial extraction kit. Clinical sensitivity and specificity of the LAMP assay were calculated in comparison to PCR. RESULTS: A single DNA fragment of the expected size (∼ 200 base pairs), was amplified by PCR from 12 P. multocida isolates, which were also all positive by the LAMP assay. The identity of all PCR amplicons was confirmed by sequencing. Both PCR and LAMP showed similar analytical sensitivity, with a LOD of 20 pg of target DNA. As neither PCR nor LAMP assays produced positive results with 12 non-related bacterial species, the analytical specificity was assessed as 100%. However, LAMP demonstrated lower clinical specificity (94.74%) compared to PCR (100%) when 40 clinical samples were tested. None of the DNA samples extracted using the simplified DNA extraction method were amplified by either LAMP or PCR. CONCLUSION: The LAMP assay developed in this study exhibits comparable performance to PCR in detecting P. multocida. CLINICAL RELEVANCE: The use of a rapid and portable DNA extraction method, in conjunction with LAMP assays, could create opportunities for point-of-care testing for fowl cholera in field settings.

Thyroid Disease of Fishes.

The paraphyletic group referred to as fishes represents several extant and extinct classes that demonstrate the greatest diversity and abundance of any of the vertebrates on the Earth. Anatomically and physiologically, the systems of fish are comparable to those of other vertebrates and the thyroid and hypothalamic-pituitary-thyroid (HPT) axis are no exceptions. This article reviews the current literature on thyroid endocrinology of elasmobranch and teleost fishes with an emphasis on relevance to clinical management and highlights some of the anatomic and physiologic differences of the HPT axis in fishes.

Surgical Management of 2,350 Pediatric Dermoid Cysts.

BACKGROUND: We examined operative and pathologic findings of a large series of dermoid cysts at a high-volume pediatric hospital over 23 years. METHODS: A retrospective review was performed of all dermoid cysts excised from 2000 to 2023 at the Children's Hospital of Philadelphia. Lesions were classified by location. Depth was stratified into Type 1, superficial; Type 2, subperiosteal or containing a stalk to a cranial suture; Type 3, intraosseous or intracartilaginous; Type 4, intracranial extradural; and Type 5, intracranial intradural. RESULTS: Of 2,350 lesions, 2,237 (95.2%) were in the head and neck. Most common locations were lateral brow and orbit, 892 (38%); anterior neck, 303 (12.9%); and frontal, 253 (10.8%). Among the series, 67.9% were Type 1, 10.1% were Type 2, 16.5% were Type 3, 2.3% were Type 4, and 3.2% were Type 5. Older age at surgery correlated with depth among locations demonstrating intracranial extension (r=.061, p=.016). Anterior fontanelle (59.1%), nasal (16.2%), occipital (5.6%), and temporal (4.7%) lesions had the highest intracranial extension rates. Temporal (49.4%), frontal (32.8%), nasal (29.9%), and occipital (22.2%) lesions had higher rates of osseous/cartilaginous involvement. On histopathologic examination, 403 (17.1%) were ruptured. Ruptured lesions were associated with giant cell reaction (46.4 versus 5.7%, p<.001). CONCLUSIONS: Anterior fontanelle, nasal, occipital, and temporal lesions are at higher risk of intracranial extension and may require preoperative imaging. Frontal and parietal lesions have a lower risk of intracranial involvement. Lateral brow and orbit, periauricular, and anterior neck lesions demonstrate a higher rate of osseous involvement without intracranial tracking.

Examining self-efficacy among recent graduates of postgraduate dental education programs.

PURPOSE: To examine the perceived self-efficacy of dentists who recently completed Graduate Dental Education (GDE) programs and identify how closely it aligns with their supervisors' assessments of them. Self-efficacy has been associated with academic pursuits, motivation, and engagement, which may affect how dental providers practice, seek continuing education, and pursue future opportunities.  METHODS: Recent graduates of military GDE programs rated their self-efficacy on specific tasks within each of the seven domains of dental competencies. Their supervisors completed a similar survey, rating the graduate's performance in the same tasks. Graduates' mean ratings were calculated for each domain, spearman correlations were calculated for all graduate-supervisor task ratings, and the magnitude of differences between graduate and supervisor domain means were examined. RESULTS: Graduates' perceived self-efficacy ranged from 3.57 to 4.41 out of 5.0. Correlations for each task were universally weak (ρ  =  -0.04-0.27). Correlations for domain means were also weak (ρ  =  0.06-0.14).  Overall, graduates rated themselves lower than their supervisors, with mean differences ranging from -0.17 (p = 0.003, Cohen's d = 0.20) for Professionalism to -0.95 (p < 0.001, Cohen's d = 0.90) for Health Promotion. CONCLUSIONS: Overall, graduates' perceived self-efficacy was moderate to high for 26 tasks across seven domains. However, in aggregate, graduates underestimated their abilities compared to performance measures from their current supervisors, although effect sizes were small. The accuracy of graduates' self-efficacy varied by program length and the clinical specialty of their supervisors. High-performing graduates always underestimated themselves while low-performing graduates often overestimated themselves.

The Evolution of Unicoronal Synostosis Correction: Long-Term Aesthetic Outcomes of Fronto-Orbital Distraction Versus Traditional Advancement.

INTRODUCTION: This study compares the long-term aesthetic outcomes of patients with unicoronal synostosis (UCS) who underwent fronto-orbital distraction osteogenesis (FODO) versus traditional fronto-orbital advancement and remodeling (FOAR). METHODS: Patients treated for nonsyndromic UCS from 2009 to 2023 were retrospectively reviewed. Perioperative and complication characteristics were compared between all patients who underwent FOAR, open FODO, and endoscopic-assisted FODO ("endo-FODO"). Aesthetic outcomes at greater than five years postoperatively were compared between patients who underwent FODO and a contemporaneous cohort of age-matched controls who underwent FOAR. Differences between pre- and postoperative periorbital symmetry ratios, canthal tilt symmetry, orbital dystopia angle (ODA), and frontal bossing angle were calculated, with positive differences representing postoperative improvement. RESULTS: Forty-one patients were treated at a median age of 9.7, 5.4, and 5.4 months in the FOAR, open FODO, and endo-FODO groups, respectively. Among 28 patients photographed at a median of 6.3 years postoperatively, the FODO cohort demonstrated greater margin-to-reflex distance 1 symmetry (6.5 [-9.3, 0.0] vs. -13.9 [-22.9, -11.5], p=0.010) and canthal tilt symmetry (0.9° [0.2°, 2.9°] vs. 3.3° [2.3°, 5.3°], p=0.004) postoperatively as well as ODA correction (5.4° [4.0°, 7.5°] vs. 3.0° [2.5°, 4.4°], p=0.027) compared to the FOAR cohort. Fewer patients in the FODO cohort exhibited temporal hollowing postoperatively compared to the FOAR cohort (14% vs. 71%, p=0.002). CONCLUSIONS: Compared to FOAR, FODO was associated with greater periorbital symmetry, greater orbital dystopia correction, and reduced temporal hollowing in the long-term. Follow-up to cranial maturity is needed to adequately compare the two techniques.

Serial and regional assessment of the right ventricular molecular and functional response to pressure-loading.

BACKGROUND: Right ventricular(RV) function determines outcomes in RV pressure-loading. A better understanding of the time-course and regional distribution of RV remodeling may help optimize targets and timing for therapeutic intervention. We sought to characterize RV remodeling between zero and 6-weeks after initiation of RV pressure-loading. METHODS AND RESULTS: Thirty-six rats were randomized to either sham surgery or to pulmonary artery banding(PAB). After echocardiography and conductance catheter studies, groups of rats were euthanized at 1-week, 3-weeks and 6-weeks after sham surgery, or induction of RV pressure-loading, for RV histological, RNA and molecular analysis. A vigorous inflammatory response characterized by increased RV inflammatory cytokines, chemokines and macrophage markers was observed at 1-week following PAB. Metabolic changes, TGF-ß1 canonical signaling, collagenous fibrosis deposition and apoptosis were already significantly increased by 1-week after PAB. Genes marking fibroblast activation were upregulated at 1-week but not 6-week post-PAB surgery. Mitochondrial dysfunction as evidenced by increased PDK activity and decreased PDH phosphorylation significantly at 6-week post PAB. These processes preceded the development of overt myocardial hypertrophy and impaired echo parameters of systolic and diastolic function which occurred significantly from 3-weeks after PAB. CONCLUSION: RV myocardial inflammation, metabolic shift, metabolic gene transcription and pro-fibrotic signaling occur early after initiation of pressure-loading when RV pressures are only moderately elevated, before the development of overt myocardial hypertrophy and dysfunction, suggesting that adaptive hypertrophy and maladaptive remodeling occur simultaneously. These results suggest that therapeutic intervention to reduce adverse RV remodeling may be needed earlier and at lower thresholds than currently employed.

Mapping the Evidence for Measuring Energy Expenditure and Indicating Hypermetabolism in Motor Neuron Disease: A Scoping Review.

OBJECTIVE: To map the international methods used to measure energy expenditure of adults living with motor neuron disease (MND) and to highlight discrepancies when indicating hypermetabolism in the MND literature. BACKGROUND: A decline in the nutritional status of patients is associated with exacerbated weight loss and shortened survival. Assessments of energy expenditure, using a variety of methods, are important to ensure an adequate energy intake to prevent malnutrition-associated weight loss. Assessments of energy expenditure are also commonly used to indicate hypermetabolism in MND, although these approaches may not be optimal. METHODS: A protocol based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews Guidelines was developed. Three electronic databases (Medline [Ovid], CINAHL [EBSCO], and Web of Science) were exhaustively searched. Identified publications were systematically screened according to predefined PICOS eligibility criteria. The primary outcome was the identification of methods used to measure energy expenditure in MND. The secondary outcome was the identification of applications of energy expenditure assessments to indicate hypermetabolism in MND. RESULTS: Thirty-two observational primary research publications were identified. Thirteen (40.6%) were longitudinal in design, with data on repeated measurements of energy expenditure presented in 3 (9.4%). Thirteen (40.6%) were case-control studies, of which 11 use a matched control group. Pulmonary function was used to assess eligibility in 10 publications. Energy expenditure was measured using indirect calorimetry (IC) in 31 studies. Discrepancies in the durations of fasted, measurement, and washout periods were observed. Of all included publications, 50% used assessments of resting energy expenditure to identify hypermetabolism. Bioelectrical impedance analysis was used to assess body composition alongside energy expenditure in 93.8% of publications. CONCLUSIONS: Resting energy expenditure is most frequently measured using an open-circuit IC system. However, there is a lack of a standardized, validated protocol for the conduct and reporting of IC and metabolic status in patients with MND.

Rising rates of traumatic fractures among mountain bikers: A national review of emergency department visits.

HYPOTHESIS/PURPOSE: Mountain biking (MTB) is a quickly growing sport, with fractures being the most common injury among MTB athletes. Currently, there is a lack of analysis of MTB fractures based on emergency department (ED) data obtained on a national scale. It was hypothesized that the total number of fractures presenting to United States (US) EDs increased significantly over the last decade, and adult male riders experienced higher rates of fracture and fracture-related hospitalization than other demographics. METHODS: All data was extracted from the National Electronic Injury Surveillance System (NEISS), a public database representing approximately 100 US EDs. NEISS was queried for all MTB-related fractures from January 1st, 2013-December 31, 2022. RESULTS: NEISS returned a national estimate (NE) of 35,260 MTB fractures visiting EDs between 2013 and 2022. Fracture injuries increased significantly over the study period, including a 247 % increase from 2019 to 2020. The mechanism of injury most likely resulting in fracture was being thrown from the bike (39.6 %, NE:5,436). The upper extremity was the most commonly fractured body region (32.8 %, NE:11,574), and trunk fractures had the highest rate of hospitalization (44.2 %, NE:3705). Males accounted for the majority of fractures (87.9 %, NE:30,996), and were more likely to be hospitalized than females (22.2 %>17.4 %). Adults (age≥40) were more likely to sustain a fracture (48.8 %) and be hospitalized because of it (25.8 %) than other age groups. Adults were also most likely to fracture their trunk (33.9 %). CONCLUSION: MTB fractures increased significantly from 2013 to 2022, possibly due to the gaining popularity of MTB since COVID-19. The upper extremity was the most frequently fractured body region, and being thrown from the bike was the mechanism most likely to result in a fracture. Adult male riders are at a high risk for trunk fractures, demonstrating the importance of protective equipment such as chest and torso protectors for these athletes. LEVEL OF EVIDENCE: III.

The common element of test taking: Reading and responding to questions.

Taking a reading comprehension (RC) test is a goal-oriented task, with the goal of answering questions correctly. We assume the number of questions students correctly answer represents their ability to engage successfully in the RC processes necessary to understand texts. Students, however, use various test-taking strategies, some of which negatively impact passage comprehension. The present study used eye-tracking procedures to measure what students do when reading the one part of the tests that all students must read to perform well on an RC test, the questions. Participants included 248 third-, fifth-, and eighth-grade students who read six texts and responded to associated questions while researchers recorded their eye movements. Eye-movement records were used to code students' test-taking strategy and measure the time students spent reading multiple-choice questions and each response option. Students were also administered a measure of reading achievement. Analyses suggest eye movements on multiple-choice questions were associated with reading achievement, and the challenges less-skilled readers experience with texts are also present when reading in the question region. Differences in strategies and processes do not only occur in the text region. Therefore, researchers and practitioners should pay increased attention to the strategies that are taught and used by students when reading and responding to RC questions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evidence of Human Bourbon Virus Infections, North Carolina, USA.

Bourbon virus is a tickborne virus that can cause human disease. Cases have been reported in Kansas, Oklahoma, and Missouri, USA. We identified Bourbon virus-specific neutralizing antibodies in patients from North Carolina. Bourbon virus infections are likely more common than previously thought, highlighting the need for improved diagnostics and surveillance.

The zoonotic LCK-3110 strain of Rocahepevirus ratti leads to mild infection in chickens after experimental inoculation.

Rocahepevirus ratti [rat hepatitis E virus (HEV)] was originally isolated from rats and found to be non-infectious to nonhuman primates, suggesting humans were not a susceptible host. However, in 2018, rat HEV infections were identified in human patients. High seroprevalence for rat HEV in rats in many countries necessitates studying this emerging zoonotic outbreak. Lack of a human derived rat HEV infectious clone, cell culture systems, and animal models have hindered this effort. In response to the increase in human infection cases by rat HEV, we utilized an infectious clone of the zoonotic rat HEV LCK-3110 strain originally reported from human cases. Capped RNA transcripts of the rat HEV LCK-3110 strain were synthesized, and replication was assessed in both cell culture via transfection and chickens via intrahepatic inoculation. Naive chickens were cohoused together with inoculated chickens. Our results demonstrated that although chickens were susceptible, virus replication was inefficient with only a few of the chickens inoculated with rat HEV having low levels of viremia and fecal virus shedding. However, LCK-3110 HEV was able to transmit between chickens as several naive cohoused chickens became infected as evidenced by viremia, fecal shedding, and the presence of viral protein upon histopathology of the liver. Rat HEV is an emerging zoonotic virus with an ability to spillover across species. Chickens have potential to serve as intermediary hosts, possibly playing a role in rat HEV spread and exposure to humans.

Engineered Tendon-Fibrocartilage-Bone Composite With Mechanical Stimulation for Augmentation of Rotator Cuff Repair: A Study Using an In Vivo Canine Model With a 6-Month Follow-up.

BACKGROUND: Rotator cuff repair augmentation using biological materials has become popular in clinical practice to reduce the high retear rates associated with traditional repair techniques. Tissue engineering approaches, such as engineered tendon-fibrocartilage-bone composite (TFBC), have shown promise in enhancing the biological healing of rotator cuff tears in animals. However, previous studies have provided limited long-term data on TFBC repair outcomes. The effect of mechanical stimulation on TFBC has not been explored extensively. PURPOSE: To evaluate functional outcomes after rotator cuff repair with engineered TFBC subjected to mechanical stimulation in a 6-month follow-up using a canine in vivo model. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 40 canines with an acute infraspinatus (ISP) tendon transection model were randomly allocated to 4 groups (n =10): (1) unilateral ISP tendon undergoing suture repair only (control surgery); (2) augmentation with engineered TFBC alone (TFBC); (3) augmentation with engineered TFBC and bone marrow-derived stem cells (BMSCs) (TFBC+C); and (4) augmentation with engineered TFBC and BMSCs, as well as mechanical stimulation (TFBC+C+M). Outcome measures-including biomechanical evaluations such as failure strength, stiffness, failure mode, gross appearance, ISP tendon and muscle morphological assessment, and histological analysis-were performed 6 months after surgery. RESULTS: As shown in the mechanical test, the TFBC+C+M group exhibited higher failure strength compared with other repair techniques. The most common failure mode was avulsion fracture in the TFBC+C+M group, but tendon-bone junction rupture was observed predominantly in different groups. Engineered TFBC with mechanical stimulation showed over 70% relative failure strength compared with normal ISP, and the other groups showed about 50% relative failure strength. Histological analysis revealed less fat infiltration and closer-to-normal muscle fiber structure in the mechanical stimulation group. CONCLUSION: This study provides evidence that mechanical stimulation of engineered TFBC promotes rotator cuff regeneration, thus supporting its potential for rotator cuff repair augmentation. CLINICAL RELEVANCE: This study provides valuable evidence supporting the use of a novel tissue-engineered material (TFBC) in rotator cuff repair and paves the way for advancements in the field of rotator cuff regeneration.

Comparing Military and Civilian Dentists' Treatment Planning Decisions: A Pilot Study.

INTRODUCTION: Clinical decision-making varies among dentists. However, the literature is limited and narrow in scope regarding the variation between public and private sector dentists. Because both types of dentists' decisions can directly influence military dental readiness, it is important to understand the potential differences in diagnosis, treatment planning, and the delivery of care. The purpose of this pilot study was to compare treatment planning recommendations between civilian and military providers. MATERIALS AND METHODS: Patient-level data from the 2018 Recruit Surveillance, a stratified, cross-sectional study of 1,208 randomly selected U.S. Air Force recruits, were used to evaluate treatment planning outcomes for the 2 provider groups (2 civilians; seven military providers). Treatment planning outcomes included type of noninvasive, operative, and oral surgery treatment recommended, temporomandibular disorder referrals, and orthodontic referrals. Patient demographic variables included age, gender, education, race/ethnicity, and military component ("status"). Data were examined both at the tooth level and patient level for statistical significance. Multivariate analyses were performed with statistically significant variables included in each final model for patient-level data. Data were analyzed with logistic regression and Poisson regression (alpha = 0.05). Bivariate logistic regression analyses were performed for tooth-level data. RESULTS: Significant differences were found between military and civilian dentists' treatment planning decisions (P < .05) for both patient-level and tooth-level data. Adjusted for significant bivariate predictors of patient demographics at the patient level, civilian dentists were more likely to refer patients for orthodontic treatment, prescribe remineralization for sound tooth surfaces, incipient caries, and carious teeth, and prescribe direct restorations for teeth with 3 to 5 carious surfaces instead of single crowns compared to military dentists. Additionally, civilian dentists were less likely to prescribe sealants for sound tooth surfaces or carious teeth. No statistically significant difference in treatment planning outcomes was observed between civilian and military dentists for sealants for incipient caries, single crowns, or extraction of third molars. At the tooth level, civilian dentists were more likely to prescribe remineralization for sound tooth surfaces, remineralization instead of sealants for carious surfaces, and extraction of third molars. No statistically significant differences were noted between civilian and military providers for recommending sealant or remineralization for teeth with incipient caries or prescribing a single crown versus placing a direct restoration on posterior teeth with 3 to 5 carious surfaces. CONCLUSIONS: Significant differences in treatment planning outcomes between civilian and military providers exist. Civilian providers are more likely to refer patients for orthodontic treatment and prescribe remineralization, direct restorations instead of single crowns, and third molar extractions, while military providers are more likely to prescribe sealants for sound tooth surfaces or carious teeth. Therefore, comparisons of treatment planning outcomes between civilian and military providers warrant further research.

Description of a new species of Chrysonotomyia Ashmead from Houston, Texas, USA (Hymenoptera, Chalcidoidea, Eulophidae).

A new species of the genus Chrysonotomyia Ashmead, Chrysonotomyiasusbelli sp. nov., is described from the Rice University campus in Houston, Texas, USA. The species is a parasitoid emerging from Neuroterusnr.bussae galls in leaves of the southern live oak (Quercusvirginiana). This represents the 6th species described from North America north of Mexico and the first in the world known to parasitize cynipid gall wasps. This discovery hints at an entire undiscovered niche between Chrysonotomyia parasitoids, cynipid gall wasps, and oaks in the Nearctic, which is a global biodiversity hotspot for oaks and cynipids. This new species description is complemented by mtDNA-COI-barcode data and information on the natural history of this species. We record host association, phenology, and report a leaf-scanning behavior performed by females, presumably to search for host galls. Modifications to the key of New World members of the genus (Hansson 2004) are included to integrate this new species.

Comparison of autonomic reactivity to trauma and nightmare imagery: A Pilot Study.

Study Objectives: Trauma-related nightmares (TRNs) are a hallmark symptom of PTSD and are highly correlated with PTSD severity and poor sleep quality. Given the salience and arousal associated with TRNs, they might be an effective target for imaginal exposures during Prolonged Exposure (PE) therapy. As a first step in this line of research, the current study compared participants' emotional reactivity during recollection of TRNs to their recollection of the index traumatic event. Methods: Seventeen trauma-exposed participants with clinical or sub-clinical PTSD who reported frequent TRNs engaged in script-driven imagery using scripts depicting their index trauma and their most trauma-like TRN. Heart rate (HRR), skin conductance (SCR), corrugator EMG (EMGR) responses, and emotional ratings were recorded. Results: HRR, SCR, and EMGR did not differ significantly between trauma-related and TRN scripts. Bayesian analyses confirmed support for the null hypothesis, indicating no differences. With the exception of "Sadness," for which TRNs elicited significantly lower ratings than trauma scripts, individual emotion ratings showed no significant differences, suggesting likely parity between the emotionality of trauma-related and TRN recollections. Conclusions: Together, TRN content elicited psychophysiological reactivity similar to that of the index trauma in this pilot study. Upon replication, studies testing TRNs as potential targets for imaginal exposures during PE may be warranted.

Long-Term Surgical Outcomes of Primary Rhinoplasty.

OBJECTIVE: To examine the impact of primary rhinoplasty on subsequent rhinoplasties for patients with cleft lip nasal deformity. DESIGN: Retrospective cohort study. SETTING: Tertiary care pediatric hospital. PATIENTS/PARTICIPANTS: Individuals who underwent definitive cleft lip repair at our institution from 2000 to 2006 with a current age of 18 or older. MAIN OUTCOME MEASURES: Number and timing of subsequent rhinoplasties. RESULTS: Among 199 individuals, 94 (47.2%) underwent primary rhinoplasty. Follow-up was 15.0 ± 4.8 years in the PR cohort and 15.0 ± 5.1 years in the NPR cohort (p = 0.993). In bilateral cleft lip, interdomal suture predicted fewer subsequent rhinoplasties (ß=-0.310, p = 0.033), while history of primary rhinoplasty predicted greater age at subsequent rhinoplasty (ß=1.800, p = 0.040). Among individuals with follow-up beyond age 18, intranasal stenting predicted fewer subsequent rhinoplasties (ß=-0.609, p = 0.015). Most underwent subsequent nasal correction aside from 7 (19.4%) and 9 (20.9%) in the PR and NPR cohorts, respectively (p = 0.536). There was no difference in mean subsequent rhinoplasties between cohorts (1.1 ± 0.8 versus 1.3 ± 1.1, p = 0.284). Individuals with complete cleft lip underwent more lifetime rhinoplasties (1.9 ± 1.0 versus 1.2 ± 1.2, p = 0.007). CONCLUSIONS: Primary rhinoplasty with interdomal tip sutures in bilateral cleft lip was associated with fewer subsequent rhinoplasties. Primary rhinoplasty may delay subsequent nasal correction, though most who underwent primary rhinoplasty ultimately required nasal correction later in childhood. Postoperative nasal stenting may provide longer-term nasal benefits and should be considered at time of definitive cleft lip repair.

Hepatitis E virus immunosuppressed animal models.

Hepatitis E virus (HEV) is an important emerging pathogen producing significant morbidity in immunosuppressed patients. HEV has been detrimental to solid organ transplant (SOT) patients, cancer patients, and HIV-positive patients, where chronic HEV infections occur. Blood-borne transfusions and multiple cases of chronic HEV infection in transplant patients have been reported in the past few decades, necessitating research on HEV pathogenesis using immunosuppressed animal models. Numerous animal species with unique naturally occurring HEV strains have been found, several of which have the potential to spread to humans and to serve as pathogenesis models. Host immunosuppression leads to viral persistence and chronic HEV infection allows for genetic adaptation to the human host creating new strains with worse disease outcomes. Procedures necessary for SOT often entail blood transfusions placing immunosuppressive patients into a "high risk group" for HEV infection. This scenario requires an appropriate immunosuppressive animal model to understand disease patterns in these patients. Hence, this article reviews the recent advances in the immunosuppressed animal models for chronic HEV infection with emphasis on pathogenesis, immune correlates, and the liver pathology associated with the chronic HEV infections.