In-House 3D Printing and Model Processing Technique for Creating High-Fidelity Transparent Craniofacial Models.

SUMMARY: The use of high-fidelity stereolithographic models that accurately reflect patient-specific pathology has become commonplace in craniofacial surgery. Multiple studies have reported the use of commercially available three-dimensional (3D) printers that allow medical centers with limited resources to reconstruct 3D models comparable to industry-made counterparts. However, most models are printed using only a single filament, which portrays the surface craniofacial anatomy, but fails to highlight relevant intraosseous structures. This presents a significant limitation when used for preoperative planning and intraoperative guidance in surgical procedures requiring osteotomies, where knowledge of the precise location of critical structures is paramount to avoid injury. The authors report a novel technique for creating transparent 3D models of relevant intraosseous craniofacial anatomy at a cost that mitigates the financial burden of industrial 3D model or industrial 3D printer acquisition. Cases are presented to demonstrate the diverse applications of this technique, with accurate display of the tooth roots, the inferior alveolar nerve, and the optic nerve, to aid in preoperative planning of osteotomies. This technique enables production of low-cost, high-fidelity transparent 3D models with applications in preoperative planning for craniofacial surgery.

Burn Prevention in Spanish: Assessment of Content Accuracy, Website Quality, and Readability of Online Sources.

Burn prevention information may be inadequate or inaccessible to communities with non-English language preference. Our objective was to systematically analyze the content accuracy, website quality, and readability of online Spanish information for burn prevention in the home and compare it to English websites. We collected the top ten burn prevention results from a search on Google, Bing, and Yahoo using a list of Spanish key terms. Using recommendations from national organizations and a burn care expert team, content accuracy was evaluated for each website. We assessed website quality following the "Health on the Net" Code of Conduct. Readability was scored by averaging five validated readability tests for the Spanish language. After using the same protocol, a comparison was made with English websites as a control. Once duplicates and non-relevant search results were removed, 23 Spanish websites were assessed. Out of 21 possible points for content accuracy, the top website scored 14 (67%) and the average score was 6.6 (31%). For website quality, the average score was 50%. The average grade level needed to read the websites was 8.6. Compared to English, Spanish websites were less accurate (31% vs 41%), harder to read (9.8 vs 7.8), but were of higher website quality (50% vs 43%). Online burn prevention information in Spanish is often inaccurate, incomplete, and inferior to available English language websites. We propose a call to action to increase the quality of online burn prevention material available in Spanish.

Pancreatic Islets and Gestalt Principles.

The human brain has inherent methodology to efficiently interpret complex environmental stimuli into understanding. This visual perception is governed by the law of simplicity, which is fundamental to Gestalt theory. First introduced in a seminal article by Wertheimer in 1923, the theory explains how the mind groups similar images and fills in gaps in order to perceive an amenable version of reality. The world we see consists of complex visual scenes, but rarely is the entire picture visible to us. Since it is inefficient for all visual data to be analyzed at once, certain patterns are given higher importance and made to stand out from the rest of the field in our brain. Here we propose that Gestalt theory may explain why rodent islet architecture has historically been seen as having a core-mantle arrangement. By filling in apparent gaps in the non-ß-cell lining, the mind interprets it as a "whole" mantle, which may have further led to widely accepted notions regarding islet microcirculation, intra-islet signaling, and islet development. They are largely based on the prevailing stereotypic islet architecture in which an enclosed structure is presumed. Three-dimensional analysis provides more integrated views of islet and pancreatic microcirculation.

Integrated Pancreatic Blood Flow: Bidirectional Microcirculation Between Endocrine and Exocrine Pancreas.

The pancreatic islet is a highly vascularized endocrine micro-organ. The unique architecture of rodent islets, a so-called core-mantle arrangement seen in two-dimensional images, led researchers to seek functional implications for islet hormone secretion. Three models of islet blood flow were previously proposed, all based on the assumption that islet microcirculation occurs in an enclosed structure. Recent electrophysiological and molecular biological studies using isolated islets also presumed unidirectional flow. Using intravital analysis of the islet microcirculation in mice, we found that islet capillaries were continuously integrated to those in the exocrine pancreas, which made the islet circulation rather open, not self-contained. Similarly in human islets, the capillary structure was integrated with pancreatic microvasculature in its entirety. Thus, islet microcirculation has no relation to islet cytoarchitecture, which explains its well-known variability throughout species. Furthermore, tracking fluorescent-labeled red blood cells at the endocrine-exocrine interface revealed bidirectional blood flow, with similar variability in blood flow speed in both the intra- and extra-islet vasculature. To date, the endocrine and exocrine pancreas have been studied separately by different fields of investigators. We propose that the open circulation model physically links both endocrine and exocrine parts of the pancreas as a single organ through the integrated vascular network.