Management of the Middle Vault.

Early reductive rhinoplasty techniques focused on hump reduction and tip plasty with minimal focus on treating or preserving the integrity and width of the middle vault. With time, rhinoplasty surgeons noted the aesthetic and functional complications of the deformities that may occur in the middle vault with reduction techniques and developed methods to treat and also avoid these complications. Thus, the importance of protecting the integrity of the middle third of the nose has been increasingly emphasized over the years. Primary deformities of the middle vault that result in nasal obstruction require attention of the rhinoplasty surgeon, as well as preservation of support structures of the middle vault and internal nasal valve to minimize secondary deformities and functional compromise after rhinoplasty surgery.

Methamphetamine and Opioid Cue Database (MOCD): Development and Validation.

INTRODUCTION: Drug cue reactivity (DCR) is widely used in experimental settings for both assessment and intervention. There is no validated database of pictorial cues available for methamphetamine and opioids. METHODS: 360 images in three-groups (methamphetamine, opioid and neutral (control)) matched for their content (objects, hands, faces and actions) were selected in an initial development phase. 28 participants with a history of both methamphetamine and opioid use (37.71 ± 8.11 years old, 12 female) with over six months of abstinence were asked to rate images for craving, valence, arousal, typicality and relatedness. RESULTS: All drug images were differentiated from neutral images. Drug related images received higher arousal and lower valence ratings compared to neutral images (craving (0-100) for neutral (11.5 ± 21.9), opioid (87.7 ± 18.5) and methamphetamine (88 ± 18), arousal (1-9) for neutral (2.4 ± 1.9), opioid (4.6 ± 2.7) and methamphetamine (4.6 ± 2.6), and valence (1-9) for neutral (4.8 ± 1.3), opioid (4.4 ± 1.9) and methamphetamine (4.4 ± 1.8)). There is no difference between methamphetamine and opioid images in craving, arousal and valence. There is a significant positive relationship between the amount of time that participants spent on drug-related images and the craving they reported for the image. Every 10 points of craving were associated with an increased response time of 383 ms. Three image sets were automatically selected for equivalent fMRI tasks (methamphetamine and opioids) from the database (tasks are available at github). CONCLUSION: The methamphetamine and opioid cue database (MOCD) provides a resource of validated images/tasks for future DCR studies. Additionally, researchers can select several sets of unique but equivalent images based-on their psychological/physical characteristics for multiple assessments/interventions.