Pediatric skull inflammatory myofibroblastic tumor: a rare case report and literature review.

Inflammatory myofibroblastic tumors (IMTs) represent rare neoplasms, particularly infrequent in the pediatric skull. We present a novel case of a newborn male with a 5 cm right temporal mass and discuss current diagnostic and treatment options for IMTs. A multidisciplinary effort to surgically remove the lesion was successful, and the patient's skull defect healed without neurological deficits. The etiology of IMTs remains elusive, with proposed associations with chromosomal mutations in the anaplastic lymphoma kinase (ALK) gene. Surgical excision remains the primary treatment for IMTs. Promising pharmacological treatments, like Crizotinib, warrant further research into understanding potential alternatives in IMT management.

Differential CRE Expression in Lhrh-cre and GnRH-cre Alleles and the Impact on Fertility in Otx2-Flox Mice.

There is an increasing trend in studies utilizing cell-specific deletion of genes through conditional gene deletion by CRE recombination. Despite numerous advantages, this strategy also has limitations such as ectopic CRE-expression and germline recombination. Two commonly used gonadotropin-releasing hormone (Gnrh)-driven CRE-expressing mice both target GnRH neurons. However, a direct comparison of the cells targeted and their phenotypic outcome have not yet been presented. To compare where recombination takes place, we crossed the Gnrh-cre and Lhrh-cre lines with the Rosa26-LacZ reporter mouse. Lhrh-cre allowed recombination of the Rosa26-LacZ gene in ∼700 cells, which is comparable to the GnRH neuronal population. Surprisingly, there were > 20 times more LacZ expressing cells in the adult Gnrh-cre:Rosa26-LacZ than the Lhrh-cre:Rosa26-LacZ brain. The greatest differences in targeting of the Gnrh-cre and Lhrh-cre lines were found in the septum, the suprachiasmatic nucleus, and the septohypothalamic area. This difference in cells targeted was present from embryonic day 12. A prior study using the Gnrh-cre to delete the transcription factor Otx2 found fewer GnRH neurons, leading to male and female subfertility. To recapitulate this study, we performed a fertility assay in Otx2:Lhrh-cre mice. We confirmed the requirement for Otx2 in GnRH neuron development, fertility and correct gonadotropin hormone release in Otx2:Lhrh-cre males, but the subfertility was more modest than in Otx2:Gnrh-cre and absent in female Otx2:Lhrh-cre. This suggests that ectopic expression of Gnrh-cre contributes to the reproductive phenotype observed. Finally, the Cre alleles caused germline recombination of the flox allele when transmitted from either parent, generating embryonic lethal knock-out offspring, producing smaller live litters.

Diversity and Cultural Competency in Oral and Maxillofacial Surgery.

Health disparities in the United States have been well documented over the past several decades and continue to affect the American population. As the world becomes more diverse, it is imperative that the health care professional workforce is trained to care for the diversifying patient population, striving to improve health disparities in the United States and worldwide. Improving the diversity within the health care professional workforce likely will aid in emphasizing the importance of cultural competency of health care professionals, with the development of programs aimed at cultural competency training and assessment.

Oral and Maxillofacial Surgery in Low-Income and Middle-Income Countries.

Five billion people worldwide do not have access to safe, affordable surgical and anesthesia care. The burden of inadequate access to safe and affordable surgical care falls heaviest on individuals living in low-income and middle-income countries (LMIC), where 9 out of 10 people do not have access to basic surgical care. Global oral and maxillofacial surgical care is included in the global burden of surgical disease, and increased awareness of the need for global oral and maxillofacial surgery (OMS), with the initiation, support, and funding of research on the need to develop a global OMS capacity-building strategy is imperative.

Evaluation of a Local Anesthesia Simulation Model with Dental Students as Novice Clinicians.

The aim of this study was to evaluate the use of a local anesthesia (LA) simulation model in a facilitated small group setting before dental students administered an inferior alveolar nerve block (IANB) for the first time. For this pilot study, 60 dental students transitioning from preclinical to clinical education were randomly assigned to either an experimental group (N=30) that participated in a small group session using the simulation model or a control group (N=30). After administering local anesthesia for the first time, students in both groups were given questionnaires regarding levels of preparedness and confidence when administering an IANB and level of anesthesia effectiveness and pain when receiving an IANB. Students in the experimental group exhibited a positive difference on all six questions regarding preparedness and confidence when administering LA to another student. One of these six questions ("I was prepared in administering local anesthesia for the first time") showed a statistically significant difference (p<0.05). Students who received LA from students who practiced on the simulation model also experienced fewer post-injection complications one day after receiving the IANB, including a statistically significant reduction in trismus. No statistically significant difference was found in level of effectiveness of the IANB or perceived levels of pain between the two groups. The results of this pilot study suggest that using a local anesthesia simulation model may be beneficial in increasing a dental student's level of comfort prior to administering local anesthesia for the first time.