Surgical management of intramuscular hemangioma of left masseter muscle: A case report.

Hemangiomas are benign soft tissue tumors which are congenital and occur due to abnormal proliferations of blood vessels. Most common location of hemangiomas is subcutaneous adipose tissue, but skeletal muscle hemangiomas are very rare which make up to 0.8% of all hemangiomas. Usually, the intramuscular lesions are common in thigh region and calf muscles and are relatively rare in the facial muscles. Long-standing lesions results in phleboliths, and this may cause some symptoms. Conventional treatment of these isolated lesions may not yield satisfactory results. Hence, surgical excision of the lesion in toto results in aesthetically pleasing results with low chances of recurrence. In this article, we report a case of a left masseter intramuscular hemangioma in 19-year-old patient which was successfully managed by complete surgical excision.

Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources.

BACKGROUND: Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community. OBJECTIVE: This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults. METHODS: A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources. RESULTS: The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services. CONCLUSIONS: A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.

Reconstructive rhinoplasty using cadaver cartilage in relapsing polychondritis.

Relapsing polychondritis is a rare autoimmune disorder of unknown cause characterized by recurrent inflammation of cartilage predominantly affecting the ears, nose, and upper airway. The bridge of the nose and surrounding tissue can collapse, producing a saddle nose deformity. Nasal reconstruction is often challenging in these patients due to impaired wound healing and graft take caused by autoimmune inflammatory disease and prolonged immunosuppressant treatment. Many different reconstruction techniques like autologous rib, fascia lata, and calvarial bone grafts have been used. Herein we report the use of a cadaver cartilage graft in a 55-year-old woman with relapsing polychondritis and saddle nose deformity. Because of the characteristic chondritis of her autoimmune condition, cadaver cartilage was selected because it is antigenically different from the patient's own cartilage, offering significant structural integrity for nasal reconstruction compared to other techniques.

Identifying Patterns and Sources of Fine and Ultrafine Particulate Matter in London Using Mobile Measurements of Lung-Deposited Surface Area.

We performed more than a year of mobile, 1 Hz measurements of lung-deposited surface area (LDSA, the surface area of 20-400 nm diameter particles, deposited in alveolar regions of lungs) and optically assessed fine particulate matter (PM2.5), black carbon (BC), and nitrogen dioxide (NO2) in central London. We spatially correlated these pollutants to two urban emission sources: major roadways and restaurants. We show that optical PM2.5 is an ineffective indicator of tailpipe emissions on major roadways, where we do observe statistically higher LDSA, BC, and NO2. Additionally, we find pollutant hot spots in commercial neighborhoods with more restaurants. A low LDSA (15 µm2 cm-3) occurs in areas with fewer major roadways and restaurants, while the highest LDSA (25 µm2 cm-3) occurs in areas with more of both sources. By isolating areas that are higher in one source than the other, we demonstrate the comparable impacts of traffic and restaurants on LDSA. Ratios of hyperlocal enhancements (ΔLDSA:ΔBC and ΔLDSA:ΔNO2) are higher in commercial neighborhoods than on major roadways, further demonstrating the influence of restaurant emissions on LDSA. We demonstrate the added value of using particle surface in identifying hyperlocal patterns of health-relevant PM components, especially in areas with strong vehicular emissions where the high LDSA does not translate to high PM2.5.

Development of temperature-responsive polymeric gels with physical crosslinking due to intermolecular 𝜋-𝜋 interactions.

Poly(N-isopropylacrylamide) PNIPAAm was polymerized with co-monomers containing a biphenyl moiety to create a unique thermoresponsive physically crosslinked system due to the presence of pi-pi interactions between the biphenyl moieties. The biphenyl monomers used were 2-phenylphenol monoacrylate (2PPMA) and 4-phenylphenol monoacrylate (4PPMA). These monomers were utilized to synthesize a set of polymers with biphenyl monomer (2PPMA/4PPMA) content from 2.5 to 7.5 mole percent and with initiator concentrations from 0.1 and 1.0 weight percent. The resulting polymers were characterized by various techniques, such as gel permeation chromatography (GPC), swelling studies and mechanical testing. The decrease in the average molecular weight of the polymers due to the increase in the concentration of initiator was confirmed by GPC results. Swelling studies confirmed the expected temperature dependent swelling properties and explored the impact of the biphenyl comonomers. These studies indicated that with the increase in biphenyl comonomers, the physical crosslinking increases which leads to decrease in the swelling ratio. The results from the mechanical tests also depict the effect of the concentration of biphenyl comonomers. These physically crosslinked polymeric systems with their unique properties have potential applications spanning environmental remediation/sensing, biomedicine, etc.

Dietary Patterns and Their Association With Symptoms Activity in Inflammatory Bowel Diseases.

BACKGROUND: Existing studies on diet and inflammatory bowel disease (IBD) have largely focused on evaluating the effects of single nutrients or whole predesigned diets but not on evaluating the effects of diverse dietary patterns. This study applied unsupervised methods to identify dietary patterns of individuals with IBD and evaluated their association with symptoms activity. METHODS: This retrospective study of adults with IBD collected current clinical data and typical diet recalled from the time when in clinical remission. Discrete dietary structures were defined by k-means clustering. Multivariable logistic regression evaluated the relationship between diet clusters and the presence of active symptoms, while adjusting for age, sex, disease duration, disease behavior, and medication use. RESULTS: Of 691 participants, 36% had Crohn's disease (CD) and 64% had ulcerative colitis (UC) or IBD-unclassified. Five major dietary clusters were identified: 2 resembled a Western diet (WD) (WD1, WD2), 1 resembled a balanced diet, and 2 resembled a plant-based diet (PB) (PB1, PB2). Compared with WD1, PB2 was associated with lower odds of active symptoms for CD (odds ratio [OR], 0.32; 95% confidence interval [CI], 0.12-0.83) and UC (OR, 0.31; 95% CI, 0.15-0.62). PB1 was associated with lower odds of active symptoms for participants with UC (OR, 0.45; 95% CI, 0.23-0.90) but not for participants with CD (OR, 0.95; 95% CI, 0.36-2.51). CONCLUSIONS: Diets with increased intake of fruits and vegetables, reduction of processed meats and refined carbohydrates, and preference of water for hydration were associated with lower risk of active symptoms with IBD, although increased intake of fruits and vegetables alone did not reduce risk of symptoms with CD.

The study used machine learning methods to provide minimally biased classifications of dietary patterns among individuals with inflammatory bowel diseases, followed by an evaluation of the association between the different diet clusters and symptoms activity.

Avoidant Restrictive Food Intake Disorder Prevalent Among Patients With Inflammatory Bowel Disease.

BACKGROUND & AIMS: Patients with inflammatory bowel disease (IBD) alter their dietary behaviors to reduce disease-related symptoms, avoid feared food triggers, and control inflammation. This study aimed to estimate the prevalence of avoidant/restrictive food intake disorder (ARFID), evaluate risk factors, and examine the association with risk of malnutrition in patients with IBD. METHODS: This cross-sectional study recruited adult patients with IBD from an ambulatory clinic. ARFID risk was measured using the Nine-Item ARFID Screen. Nutritional risk was measured with the Patient Generated-Subjective Global Assessment. Logistic regression models were used to evaluate the association between clinical characteristics and a positive ARFID risk screen. Patient demographics, disease characteristics, and medical history were abstracted from medical records. RESULTS: Of the 161 participants (Crohn's disease, 45.3%; ulcerative colitis, 51.6%; IBD-unclassified, 3.1%), 28 (17%) had a positive ARFID risk score (≥24). Most participants (92%) reported avoiding 1 or more foods while having active symptoms, and 74% continued to avoid 1 or more foods even in the absence of symptoms. Active symptoms (odds ratio, 5.35; 95% confidence interval, 1.91-15.01) and inflammation (odds ratio, 3.31; 95% confidence interval, 1.06-10.29) were significantly associated with positive ARFID risk. Patients with a positive ARFID risk screen were significantly more likely to be at risk for malnutrition (60.7% vs 15.8%; P < .01). CONCLUSIONS: Avoidant eating behaviors are common in IBD patients, even when in clinical remission. Patients who exhibit active symptoms and/or inflammation should be screened for ARFID risk, with referrals to registered dietitians to help monitor and address disordered eating behaviors and malnutrition risk.

DEVELOPMENT OF BIPHENYL MONOMERS AND ASSOCIATED CROSSLINKED POLYMERS WITH INTRAMOLECULAR PI-PI INTERACTIONS.

Monomers containing biphenyl moieties were employed to create two sets of covalently crosslinked polymers that displayed noncovalent interactions in their 3-dimensional network. The biphenyls (precursors) used were 2-phenylphenol, 4-phenylphenol and 4,4'-dihydroxybiphenyl, and their acrylated forms were synthesized and named as 2-phenylphenolmonoacrylate (2PPMA), 4-phenylphenolmonoacrylate (4PPMA), and 4,4'-dihydroxybiphenyldiacrylate (44BDA), respectively. These were characterized by differential scanning calorimetry (DSC), nuclear magnetic resonance (NMR) and Fourier transform infrared spectroscopy (FTIR) to confirm the successful acrylation reaction. Polymers were synthesized via free radical polymerization reactions with varying crosslinker contents, and their network properties were characterized using swelling studies and compressive modulus tests. Interestingly, swelling studies did not show the expected decreasing swelling ratio with increasing crosslinker content, while compression testing indicated the expected trend of increasing modulus with increasing crosslinking density. The unexpected swelling results are hypothesized to result from the intramolecular interactions between the biphenyl side groups that result in noncovalent crosslinks.

Multifunctional temperature-responsive polymers as advanced biomaterials and beyond.

The versatility and applicability of thermoresponsive polymeric systems have led to great interest and a multitude of publications. Of particular significance, multifunctional poly(N-isopropylacrylamide) (PNIPAAm) systems based on PNIPAAm copolymerized with various functional comonomers or based on PNIPAAm combined with nanomaterials exhibiting unique properties. These multifunctional PNIPAAm systems have revolutionized several biomedical fields such as controlled drug delivery, tissue engineering, self-healing materials, and beyond (e.g., environmental treatment applications). Here, we review these multifunctional PNIPAAm-based systems with various cofunctionalities, as well as highlight their unique applications. For instance, addition of hydrophilic or hydrophobic comonomers can allow for polymer lower critical solution temperature modification, which is especially helpful for physiological applications. Natural comonomers with desirable functionalities have also drawn significant attention as pressure surmounts to develop greener, more sustainable materials. Typically, these systems also tend to be more biocompatible and biodegradable and can be advantageous for use in biopharmaceutical and environmental applications. PNIPAAm-based polymeric nanocomposites are reviewed as well, where incorporation of inorganic or carbon nanomaterials creates synergistic systems that tend to be more robust and widely applicable than the individual components.

Recent developments in stimuli responsive nanomaterials and their bionanotechnology applications.

Bionanotechnology is an ever-expanding field as innovations in nanotechnology continue to be developed based on biological systems or to be applied to address unmet needs in biology, biomedicine, etc., including various sensor and drug delivery solutions. Amidst the wide range of bionanomaterials that have been developed, stimuli responsive bionanomaterials are of particular interest and are thus emphasized within this review. Here, we have highlighted the most recent advances for stimuli responsive bionanomaterials with focus on those possessing responses based on activation, expansion/contraction and self-assembly/disassembly. The aim of this review is to bring attention to some of the most current bionanotechnology research and the interesting applications within this field.

Urban Oxidation Flow Reactor Measurements Reveal Significant Secondary Organic Aerosol Contributions from Volatile Emissions of Emerging Importance.

Mobile sampling studies have revealed enhanced levels of secondary organic aerosol (SOA) in source-rich urban environments. While these enhancements can be from rapidly reacting vehicular emissions, it was recently hypothesized that nontraditional emissions (volatile chemical products and upstream emissions) are emerging as important sources of urban SOA. We tested this hypothesis by using gas and aerosol mass spectrometry coupled with an oxidation flow reactor (OFR) to characterize pollution levels and SOA potentials in environments influenced by traditional emissions (vehicular, biogenic), and nontraditional emissions (e.g., paint fumes). We used two SOA models to assess contributions of vehicular and biogenic emissions to our observed SOA. The largest gap between observed and modeled SOA potential occurs in the morning-time urban street canyon environment, for which our model can only explain half of our observation. Contributions from VCP emissions (e.g., personal care products) are highest in this environment, suggesting that VCPs are an important missing source of precursors that would close the gap between modeled and observed SOA potential. Targeted OFR oxidation of nontraditional emissions shows that these emissions have SOA potentials that are similar, if not larger, compared to vehicular emissions. Laboratory experiments reveal large differences in SOA potentials of VCPs, implying the need for further characterization of these nontraditional emissions.

Efficacy of morpho-functional repair in management of different morphological variants of unilateral complete cleft lip.

BACKGROUND: To study the surgical outcome in various morphological variants of unilateral complete cleft lip in our high volume centre over a period of 4 years, using Morpho-Functional technique in all cases by indirect two dimensional photographic analysis. METHODS: In this prospective cohort study, 749 patients with Unilateral Cleft Lip with palate were included over a period of 4 years from January 2010 to December 2014. All Subjects underwent surgery before the age of 1 year with the follow-up two dimensional photographs taken at 4 years post-operatively. Eight measurements were performed on the photographs. All parameters were measured on both Cleft & Non cleft sides and the ratio was considered with the normal side as the base line. Shapiro-Wilk and Kolmogrov-Smirnoff tests were used to confirm that the data was normally distributed. One way ANOVA was done to find out if there were any significant differences amongst the different groups along various parameters, respectively. Further Tukey post hoc analysis was done to confirm where the differences occurred between groups. RESULTS: None of the groups showed any statistical differences on any parameters. There were minor variations between the different groups due to the ranging morphology of the defect but overall satisfactory to good results were seen on all measured parameters evaluated. CONCLUSION: This shows that the Morphofunctional technique, with its combinations & modifications of various school of thought, is versatile enough to achieve good surgical outcomes despite the wide variations seen in size and type of defects in unilateral cleft lip. This comes about because of the comprehensive nature of the technique & the balance that it creates among the affected structures.

Land-Use Regression Modeling of Source-Resolved Fine Particulate Matter Components from Mobile Sampling.

This study presents land-use regression (LUR) models for submicron particulate matter (PM1) components from an urban area. Models are presented for mass concentrations of inorganic species (SO4, NO3, NH4), organic aerosol (OA) factors, and total PM1. OA is source-apportioned using positive matrix factorization (PMF) of data collected from aerosol mass spectrometry deployed on a mobile laboratory. PMF yielded a three-factor solution: cooking OA (COA), hydrocarbon-like OA (HOA), and less-oxidized oxygenated OA (LO-OOA). This study represents the first time that LUR has been applied to source-resolved OA factors. We sampled a roughly 20 km2 area of West Oakland, California, USA, over 1 month (mid-July to mid-August, 2017). The road network of the sampling domain was comprehensively sampled each day using a randomized driving route to minimize temporal and spatial bias. Mobile measurements were aggregated both spatially and temporally for use as discrete spatial observations for LUR model building. LUR model performance was highest for those species with more spatial variability (primary OA factors: COA R2 = 0.80, HOA R2 = 0.67) and lowest for secondary inorganic species (SO4 R2 = 0.47, NH4 R2 = 0.43) that were more spatially homogeneous. Notably, the stepwise selective LUR algorithm largely selected predictors for primary OA factors that correspond to the associated land-use categories (e.g., cooking land-use variables were selected in cooking-related PM models). This finding appears to be robust, as we demonstrate the predictive link between land-use variables and the corresponding source-resolved PM1 components through a subsampling analysis.

Restaurant Impacts on Outdoor Air Quality: Elevated Organic Aerosol Mass from Restaurant Cooking with Neighborhood-Scale Plume Extents.

Organic aerosol (OA) is a major component of fine particulate matter (PM2.5) in urban environments. We performed in-motion ambient sampling from a mobile platform with an aerosol mass spectrometer (AMS) to investigate the spatial variability and sources of OA concentrations in Pittsburgh, Pennsylvania, a midsize, largely postindustrial American city. To characterize the relative importance of cooking and traffic sources, we sampled in some of the most populated areas (∼18 km2) in and around Pittsburgh during afternoon rush hour and evening mealtime, including congested highways, major local roads, areas with high densities of restaurants, and urban background locations. We found greatly elevated OA concentrations (10s of µg m-3) in the vicinity of numerous individual restaurants and commercial districts containing multiple restaurants. The AMS mass spectral information indicates that majority of the high concentration plumes (71%) were from cooking sources. Areas containing both busy roads and restaurants had systematically higher OA concentrations than areas with only busy roads and urban background locations. Elevated OA concentrations were measured hundreds of meters downwind of some restaurants, indicating that these sources can influence air quality on neighborhood scales. Approximately 20% of the population (∼250 000 people) in the Pittsburgh area lives within 200 m of a restaurant; therefore, restaurant emissions are potentially an important source of outdoor PM exposures for this large population.

Reduced Ultrafine Particle Concentration in Urban Air: Changes in Nucleation and Anthropogenic Emissions.

Nucleation is an important source of ambient ultrafine particles (UFP). We present observational evidence of the changes in the frequency and intensity of nucleation events in urban air by analyzing long-term particle size distribution measurements at an urban background site in Pittsburgh, Pennsylvania during 2001-2002 and 2016-2017. We find that both frequency and intensity of nucleation events have been reduced by 40-50% over the past 15 years, resulting in a 70% reduction in UFP concentrations from nucleation. On average, the particle growth rates are 30% slower than 15 years ago. We attribute these changes to dramatic reductions in SO2 (more than 90%) and other pollutant concentrations. Overall, UFP concentrations in Pittsburgh have been reduced by ∼48% in the past 15 years, with a ∼70% reduction in nucleation, ∼27% in weekday local sources (e.g., weekday traffic), and 49% in the regional background. Our results highlight that a reduction in anthropogenic emissions can considerably reduce nucleation events and UFP concentrations in a polluted urban environment.

A comparative clinical evaluation of analgesic efficacy of Tapentadol and ketorolac in mandibular third molar surgery.

INTRODUCTION: The surgical removal of impacted mandibular third molars is one of the most commonly performed dentoalveolar procedures in oral and maxillofacial surgery and is associated with varying degrees of postoperative discomfort. Pain, trismus, and swelling are the most common postoperative complaints, and these influence a patient's quality of life in the days after surgery. MATERIALS AND METHODS: A comparative study of the 32 patients, 16 were allocated to receive ketorolac and 16 patients were allocated to receive tapentadol. As the data for this study were collected at different time points, analysis for the longitudinal study was done. The main outcome variable, pain level was measured in five-ordered categories. As we had ordinal data in our study, we first checked for marginal homogeneity through Cochran-Mantel-Haenszel test. RESULTS: In the present study, the results show that there is no statistically significant difference between the two treatment groups (P = 0.1184). According to results, there is no significant group by time interaction, which means both drugs have shown almost equal efficacy at different time points. Similarly, there is no difference in efficacy of the two drugs across gender level. CONCLUSION: The present findings showed that there is no statistically significant difference between the two treatment groups, although ketorolac is more effective for immediate pain reduction than tapentadol. However, the overall reduction of pain using both groups has no significant difference.

Knowledge, attitude and awareness of speciality of oral and maxillofacial surgery amongst medical consultants of vadodara district in gujarat state.

BACKGROUND AND AIM: Aim of this study was to survey the knowledge, attitude and awareness of the subject of oral and maxillofacial surgery speciality amongst the consultants and practitioners of medicine in district of Vadodara. MATERIALS AND METHODS: List of members of various specialities in medical faculty were obtained from Indian Medical Association, Baroda branch and staff members of medical colleges of Vadodara district. A questionnaire survey was made which was distributed and their options were noted. RESULTS: Surgical removal of third molar, oral submucous fibrosis and implants were the problems where oral surgeons were preferred. For maxillofacial trauma plastic surgeons and orthopaedic surgeons were preferred than oral surgeons. For maxillofacial pathology E.N.T surgeons were mostly preferred. There is low awareness regarding oral and maxillofacial surgery amongst the general practitioners and medical consultants in Vadodara district. CONCLUSION: Survey shows that our training needs to be upgraded and revamped so that our trainees (post graduates in oral surgery) and have a greater "hands-on" exposure during their postgraduate training. They will then be able to handle increasingly complex cases in a multispecialty setup when they graduate and earn the mutual respect of the medical and dental fraternity and also the general public. MBBS students during their dental postings should be made aware of the depth and scope of oral surgery branch.