Three dimensional study to quantify the relationship between facial hard and soft tissue movement as a result of orthognathic surgery

Introduction Prediction of soft tissue changes following orthognathic surgery has been frequently attempted in the past decades. It has gradually progressed from the classic “cut and paste” of photographs to the computer assisted 2D surgical prediction planning; and finally, comprehensive 3D surgical planning was introduced to help surgeons and patients to decide on the magnitude and direction of surgical movements as well as the type of surgery to be considered for the correction of facial dysmorphology. A wealth of experience was gained and numerous published literature is available which has augmented the knowledge of facial soft tissue behaviour and helped to improve the ability to closely simulate facial changes following orthognathic surgery. This was particularly noticed following the introduction of the three dimensional imaging into the medical research and clinical applications. Several approaches have been considered to mathematically predict soft tissue changes in three dimensions, following orthognathic surgery. The most common are the Finite element model and Mass tensor Model. These were developed into software packages which are currently used in clinical practice. In general, these methods produce an acceptable level of prediction accuracy of soft tissue changes following orthognathic surgery. Studies, however, have shown a limited prediction accuracy at specific regions of the face, in particular the areas around the lips. Aims The aim of this project is to conduct a comprehensive assessment of hard and soft tissue changes following orthognathic surgery and introduce a new method for prediction of facial soft tissue changes.   Methodology The study was carried out on the pre- and post-operative CBCT images of 100 patients who received their orthognathic surgery treatment at Glasgow dental hospital and school, Glasgow, UK. Three groups of patients were included in the analysis; patients who underwent Le Fort I maxillary advancement surgery; bilateral sagittal split mandibular advancement surgery or bimaxillary advancement surgery. A generic facial mesh was used to standardise the information obtained from individual patient’s facial image and Principal component analysis (PCA) was applied to interpolate the correlations between the skeletal surgical displacement and the resultant soft tissue changes. The identified relationship between hard tissue and soft tissue was then applied on a new set of preoperative 3D facial images and the predicted results were compared to the actual surgical changes measured from their post-operative 3D facial images. A set of validation studies was conducted. To include: • Comparison between voxel based registration and surface registration to analyse changes following orthognathic surgery. The results showed there was no statistically significant difference between the two methods. Voxel based registration, however, showed more reliability as it preserved the link between the soft tissue and skeletal structures of the face during the image registration process. Accordingly, voxel based registration was the method of choice for superimposition of the pre- and post-operative images. The result of this study was published in a refereed journal. • Direct DICOM slice landmarking; a novel technique to quantify the direction and magnitude of skeletal surgical movements. This method represents a new approach to quantify maxillary and mandibular surgical displacement in three dimensions. The technique includes measuring the distance of corresponding landmarks digitized directly on DICOM image slices in relation to three dimensional reference planes. The accuracy of the measurements was assessed against a set of “gold standard” measurements extracted from simulated model surgery. The results confirmed the accuracy of the method within 0.34mm. Therefore, the method was applied in this study. The results of this validation were published in a peer refereed journal. • The use of a generic mesh to assess soft tissue changes using stereophotogrammetry. The generic facial mesh played a major role in the soft tissue dense correspondence analysis. The conformed generic mesh represented the geometrical information of the individual’s facial mesh on which it was conformed (elastically deformed). Therefore, the accuracy of generic mesh conformation is essential to guarantee an accurate replica of the individual facial characteristics. The results showed an acceptable overall mean error of the conformation of generic mesh 1 mm. The results of this study were accepted for publication in peer refereed scientific journal. Skeletal tissue analysis was performed using the validated “Direct DICOM slices landmarking method” while soft tissue analysis was performed using Dense correspondence analysis. The analysis of soft tissue was novel and produced a comprehensive description of facial changes in response to orthognathic surgery. The results were accepted for publication in a refereed scientific Journal. The main soft tissue changes associated with Le Fort I were advancement at the midface region combined with widening of the paranasal, upper lip and nostrils. Minor changes were noticed at the tip of the nose and oral commissures. The main soft tissue changes associated with mandibular advancement surgery were advancement and downward displacement of the chin and lower lip regions, limited widening of the lower lip and slight reversion of the lower lip vermilion combined with minimal backward displacement of the upper lip were recorded. Minimal changes were observed on the oral commissures. The main soft tissue changes associated with bimaxillary advancement surgery were generalized advancement of the middle and lower thirds of the face combined with widening of the paranasal, upper lip and nostrils regions. In Le Fort I cases, the correlation between the changes of the facial soft tissue and the skeletal surgical movements was assessed using PCA. A statistical method known as ’Leave one out cross validation’ was applied on the 30 cases which had Le Fort I osteotomy surgical procedure to effectively utilize the data for the prediction algorithm. The prediction accuracy of soft tissue changes showed a mean error ranging between (0.0006mm±0.582) at the nose region to (-0.0316mm±2.1996) at the various facial regions.

Childhood Non-Langerhans Cell Histiocytosis – An Atypical Case

Introduction: Histiocytoses correspond to a heterogeneous group of disorders characterized by the proliferation andinfiltration of histiocytes in tissues. For years, many of the histiocytoses where known by numerous names, reflecting the lack of understanding regarding their origin. Case report: A previously healthy, 4-month-old infant presented a cutaneous lesion of progressive growth on his nose since 1 month ago. The mother has a diagnosis of Sjögren syndrome. On examination, there was a firm well-defined erythematous plaque with 30 mm of diameter and raised edges, on the bridge of the nose. At the left cheek, left thoracic region and right arm there were also small erythematous papules with 5 days of evolution. The analytical study showed elevated antinuclear antibodies and anti-SS-A. Histopathological examination confirmed the diagnosis of non-Langerhans cells histiocytosis. Progressively, more annular erythematous papules and plaques appeared scattered over the face, trunk and limbs with spontaneous resolution of the first lesion on the nose. About 2 months after the initial evaluation, all lesions had regressed spontaneously, with normalization of analytical study at one year-old. Conclusion: Many authors believe that the different subtypes of histiocytosis represent only different stages of the same disease. Immunophenotyping of histiocytosis does not always identify the subtype involved, making the occurrence of atypical cases frequent.

Kissa ihmisen peilinä. Muutos, sukupuoli ja vuorovaikutus taiteessa

Tutkielman aiheena on kissa ja sen representaatiot visuaalisessa taiteessa. Tutkielmassa tarkastellaan 12 eri tekniikoilla valmistettua taideteosta, jotka ovat valmistuneet vuosien 1974 ja 2015 välisenä aikana. Tutkielmaan valitut taiteilijat, teokset ja valmistusvuodet ovat seuraavat: Jan Harrison, Chuff and Roll Over 1997; Jan Harrison, Cat with Raw Nose 2006; Sampsa Indrén, Hello Kitty 2012; Nanna Susi, Maliblue 2013; Olli Lyytikäinen, Kolme pyramidia ja sfinksi 1974, Kari Soinio, Sankarin koti nr 9 2009; elokuvasta Yön ritarin paluu Kissanainen/Selena Kyle (Anne Hathaway) 2012; Stiina Saaristo, Turengin Tuhkimo 2012; sarjakuvasta Simpsonit Matt Groening (piirt.), Crazy Cat Lady/Eleanor Abernathy 1998; sarjakuvahahmo, Jim Davis (hahmotelma ja käsikirj.), Karvinen 1989; Carolee Schneemann, Infinity Kisses (1988) ja Katinka Simonse, alias Tinkebell, My dearest cat Pinkeltje. (2009). Tutkielman tarkoituksena on ollut selvittää, mikä tarkoitus kissan olemassaololla on valituissa teoksissa ja mitä sen avulla on haluttu kertoa. Tutkielman käsittelyaineisto on jaettu kolmeen pääryhmään, 1) kissa ihmisen sisäisen ja tiedostamattoman tulkkina, 2) kissa sukupuoliroolien ja stereotypioiden symbolina, 3) kissa lemmikkinä. Tarkastelussa on käytetty muun muassa psykoanalyyttistä, filosofista, sukupuolentutkinnallista ja fenomenologista lähestymistapaa. Tutkielman psykoanalyyttinen tarkastelutapa perustuu pääasiassa freudilaisiin ja filosofinen näkökulma deleuzelais-guattarilaisiin näkemyksiin. Tutkimuksella on pyritty tulkitsemaan ja kartoittamaan tapoja, joilla taiteilija on kissaa apunaan käyttäen lähestynyt ihmisen henkistä muutosta piilotajunnasta nousevien halujen ja yhteiskunnallisten stereotypioiden puristuksessa. Tuleminen joksikin, muodonmuutos sekä ihmisen ja eläimen yhteys ovat tutkielman tärkeimpiä tulkinnan kohteita.

A model of increased impulsivity in rats with bilateral parkinsonism treated with Pramipexole

Impulse control disorders (ICD) is a common side effect of the dopaminergic treatment in patients with Parkinson's disease, which is more associated with dopamine agonists than with levodopa. To understand its pathophysiology, reliable animal models are essential. Using the variable delay-to-signal (VDS) paradigm, impulsivity was evaluated in bilateral parkinsonian rats treated with pramipexole (PPX). In this test, rats have to introduce the snout into a nose poke that is signaled by a light (presented at variable delays) triggering the delivery of a food reward after a correct response. Reaching a stable baseline performance, a partial bilateral dopaminergic lesion with 6-OHDA was induced in the dorsolateral striatum (AP: +1mm, L: ±3.4mm, V:-4.7 mm, Bregma). Rats undertook the VDS test under 5 conditions: basal state, 6-OHDA-induced lesion, the effect of two doses of PPX (0,25mg/kg and 3mg/kg; Latin-square design), and the day after the last dose of PPX. Only the acute administration of 3 mg/kg of PPX significantly rised the number of premature responses, indicating an increase of impulsive behavior, in parkinsonian but not in sham rats. Both doses of PPX significantly decreased the accuracy of responding (correct/total number of responses) and increased the incorrect and perseverative (compulsive behavior) responses in both parkinsonian and sham treated groups when compared with saline-treated groups. In conclusion, PPX induced attention deficit (lack of accuracy) as well as compulsive behavior in control and parkinsonian rats, but increased impulsivity only in the parkinsonian animals. This model could constitute a valid tool to investigate the pathophysiology of ICD.

Lot production size problem and simulation of urban transport

OBJECTIVES AND STUDY METHOD: There are two subjects in this thesis: “Lot production size for a parallel machine scheduling problem with auxiliary equipment” and “Bus holding for a simulated traffic network”. Although these two themes seem unrelated, the main idea is the optimization of complex systems. The “Lot production size for a parallel machine scheduling problem with auxiliary equipment” deals with a manufacturing setting where sets of pieces form finished products. The aim is to maximize the profit of the finished products. Each piece may be processed in more than one mold. Molds must be mounted on machines with their corresponding installation setup times. The key point of our methodology is to solve the single period lot-sizing decisions for the finished products together with the piece-mold and the mold-machine assignments, relaxing the constraint that a single mold may not be used in two machines at the same time. For the “Bus holding for a simulated traffic network” we deal with One of the most annoying problems in urban bus operations is bus bunching, which happens when two or more buses arrive at a stop nose to tail. Bus bunching reflects an unreliable service that affects transit operations by increasing passenger-waiting times. This work proposes a linear mathematical programming model that establishes bus holding times at certain stops along a transit corridor to avoid bus bunching. Our approach needs real-time input, so we simulate a transit corridor and apply our mathematical model to the data generated. Thus, the inherent variability of a transit system is considered by the simulation, while the optimization model takes into account the key variables and constraints of the bus operation. CONTRIBUTIONS AND CONCLUSIONS: For the “Lot production size for a parallel machine scheduling problem with auxiliary equipment” the relaxation we propose able to find solutions more efficiently, moreover our experimental results show that most of the solutions verify that molds are non-overlapping even if they are installed on several machines. We propose an exact integer linear programming, a Relax&Fix heuristic, and a multistart greedy algorithm to solve this problem. Experimental results on instances based on real-world data show the efficiency of our approaches. The mathematical model and the algorithm for the lot production size problem, showed in this research, can be used for production planners to help in the scheduling of the manufacturing. For the “Bus holding for a simulated traffic network” most of the literature considers quadratic models that minimize passenger-waiting times, but they are harder to solve and therefore difficult to operate by real-time systems. On the other hand, our methodology reduces passenger-waiting times efficiently given our linear programming model, with the characteristic of applying control intervals just every 5 minutes.

Study of new physiological characteristics as protein receptors (RP55) of light, color, heat, motion, smell, electric, vibration and position located in head, body and abdominal, found in mosquito larvae.

The main objective of the research is to demonstrate new physiological characteristics receptors in the presence of mosquito larvae. 100 larvae of different species were collected and studied for a week in periods of 8-24 hrs. Larvae stages I, II, III and IV have photo-thermo receptors of light and heat housed in the body is divided into head, thorax and abdomen, perceive hot or cold environments, and have fibers in chest or hairs lining your body or abdomen, and a pair of antennae on the head. Stages II and III are more developed than the initial stages. They are attracted by the dark green at the bottom, a pair of eyes that perceive light and color. Have receptors proteins (RP55) that capture motion at a speed the slightest movement of waves in the water. Its nose is not well developed but have chemoreceptors. They adapt to changes in pH in alkaline media, are sensitive to chemical, thermal and mechanical changes nociceptors have electroreceptors or galvanoreceptores sensitive to electrical stimuli, have mechanoreceptors that are sensitive to touch, pain, pressure, gravity, sound. They have a GPS position that seems the guides. It is precisely in the fibers, mushrooms or bristles are recipients along with the micro villi in head, thorax and abdomen.
RESUMEN El objetivo principal de la investigación es demostrar nuevas características fisiológicas como la presencia de receptores en las larvas de mosquitos. Se recolectaron 100 larvas de diferentes especies y se estudiaron por una semana en periodos de 8 a 24 hrs. Las larvas de los estadios I,II,III y IV tienen foto-termo receptores de luz y calor alojados en el cuerpo que se divide en cabeza, tórax y abdomen, perciben ambientes fríos o calientes, así como tienen fibras en tórax o pelos que recubren su cuerpo, y un par de antenas en la cabeza. Los estadios II y III son más desarrollados que las etapas iniciales. Tienen receptores proteicos RP55. Les atrae el color verde oscuro en el fondo, un par de ojos que perciben la luz y color con fotoreceptores. Tienen receptores RP55 de movimiento que captan a una velocidad el más mínimo movimiento de ondas en el agua. Su olfato no está muy desarrollado pero tienen quimioreceptores. Se adaptan a cambios de pH en medios alcalinos, tienen nociceptores sensibles a cambios químicos, térmicos y mecánicos, tienen galvanoreceptores o electroreceptores sensibles a estímulos eléctricos, tienen mecanoreceptores que son sensibles al tacto, dolor, presión gravedad, sonido. Tienen un GPS de posición que pareciera las orienta.

Flow around a hemisphere-cylinder at high angle of attack and low Reynolds number. Part II: POD and DMD applied to reduced domains

Three-dimensional direct numerical simulations (DNS) have been performed on a finite-size hemispherecylinder model at angle of attack AoA = 20◦ and Reynolds numbers Re = 350 and 1000. Under these conditions, massive separation exists on the nose and lee-side of the cylinder, and at both Reynolds numbers the flow is found to be unsteady. Proper orthogonal decomposition (POD) and dynamic mode decomposition (DMD) are employed in order to study the primary instability that triggers unsteadiness at Re = 350. The dominant coherent flow structures identified at the lower Reynolds number are also found to exist at Re = 1000; the question is then posed whether the flow oscillations and structures found at the two Reynolds numbers are related. POD and DMD computations are performed using different subdomains of the DNS computational domain. Besides reducing the computational cost of the analyses, this also permits to isolate spatially localized oscillatory structures from other, more energetic structures present in the flow. It is found that POD and DMD are in general sensitive to domain truncation and noneducated choices of the subdomain may lead to inconsistent results. Analyses at Re = 350 show that the primary instability is related to the counter rotating vortex pair conforming the three-dimensional afterbody wake, and characterized by the frequency St ≈ 0.11, in line with results in the literature. At Re = 1000, vortex-shedding is present in the wake with an associated broadband spectrum centered around the same frequency. The horn/leeward vortices at the cylinder lee-side, upstream of the cylinder base, also present finite amplitude oscillations at the higher Reynolds number. The spatial structure of these oscillations, described by the POD modes, is easily differentiated from that of the wake oscillations. Additionally, the frequency spectra associated with the lee-side vortices presents well defined peaks, corresponding to St ≈ 0.11 and its few harmonics, as opposed to the broadband spectrum found at the wake.

Estudo sobre a migração transuterina e a razão sexual de conceptos em bovinos da raça Nelore (Bos taurus indicus)

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Agronomia e Medicina Veterinária, 2016.

Machinability assessment of multi component high entropy alloys

Due to high demand in engineering materials especially with high strength to weight ratio and advantageous material properties such as wear resistance and thermal stability or high entropy. This essential parametric enhancement has led to the development of Multi Component High Entropy Alloys (MCHEA). It has been proposed in this study to investigate the machinability characteristics of MCHEA. The MCHEA are usually amalgamation with multiple elements such as aluminium, cobalt, manganese, nickel, chromium and titanium with their individual concentrations ranging from 5-35% overall. The experimental design consists of basic characterization of the material and conducting machinability trails-milling. The basic material characterization consists of evaluating bulk hardness, microstructural image generation, microhardness and chemical composition using spectrometry. The milling trails are conducted using 2 flute, 30º helix ball nose solid carbide end-mill cutting tool with combination of cutting parameters such as constant cutting speed, 30 m/min; varied feed, 0.01 mm/tooth and 0.02mm/tooth; depth of cuts, 1.5 and 3 mm and coolant on. The outputs obtained from the machining trails are subjected to analysis such as cutting force. In addition, the surface roughness of the material is evaluated using 3D optical surface profilometer. Similarly, the solutions to alleviate the drawbacks are also exemplified during machining of MCHEA.

Geospatial estimation-based auto drift correction in wireless sensor networks

Wireless sensor networks are often deployed in large numbers, over a large geographical region, in order to monitor the phenomena of interest. Sensors used in the sensor networks often suffer from random or systematic errors such as drift and bias. Even if they are calibrated at the time of deployment, they tend to drift as time progresses. Consequently, the progressive manual calibration of such a large-scale sensor network becomes impossible in practice. In this article, we address this challenge by proposing a collaborative framework to automatically detect and correct the drift in order to keep the data collected from these networks reliable. We propose a novel scheme that uses geospatial estimation-based interpolation techniques on measurements from neighboring sensors to collaboratively predict the value of phenomenon being observed. The predicted values are then used iteratively to correct the sensor drift by means of a Kalman filter. Our scheme can be implemented in a centralized as well as distributed manner to detect and correct the drift generated in the sensors. For centralized implementation of our scheme, we compare several krigingand nonkriging-based geospatial estimation techniques in combination with the Kalman filter, and show the superiority of the kriging-based methods in detecting and correcting the drift. To demonstrate the applicability of our distributed approach on a real world application scenario, we implement our algorithm on a network consisting of Wireless Sensor Network (WSN) hardware. We further evaluate single as well as multiple drifting sensor scenarios to show the effectiveness of our algorithm for detecting and correcting drift. Further, we address the issue of high power usage for data transmission among neighboring nodes leading to low network lifetime for the distributed approach by proposing two power saving schemes. Moreover, we compare our algorithm with a blind calibration scheme in the literature and demonstrate its superiority in detecting both linear and nonlinear drifts.

An improved static model for tool deflection in machining of Ti–6Al–4V acetabular shell produced by selective laser melting

Tool deflection during milling operation leads to dimensional error, decreasing surface quality and increasing rejection rate. In this study, tool deflection during the milling of the inner surfaces of Ti–6Al–4V prosthetic acetabular shell produced by selective laser melting (SLM) was modelled. The first purpose of this research is to provide a general static cutting tool deflection model for ball nose cutters where deviation of machine components and tool holder are so small as to be considered negligible. This is because the values of machine component and tool holder deflection were lower than standard tolerances (10 μm) and found to be lower than 1/15 of tool deflection. The second and third objectives of this work involve calculating contact surfaces by determining workpiece and tool geometry and choosing second moment of inertia using a novel cross section method (CSM). Static models for three quasi-analytical methods (QAM) that are simple cantilever beam model (SCBM), two-section model (TWSM) and our three section model (THSM) are presented. THSM showed high accuracy which was validated by 3D finite element method (FEM3D) and experimental measurements. The accuracy of tool deflection calculation using THSM by computing, shank, flute and ball head deflection and also utilizing CSM to determine second moment of inertia showed notable improvements.

Nariz desviado. Rinoplastia fechada ou aberta?

O nariz desviado é resultado de um conjunto de alterações anatómicas diversas. O conceito de " Nariz Desviado" tem inúmeros sinónimos mas representa sempre um nariz desviado no seu plano sagital. A sua etiologia pode ser congénita ou adquirida, mais frequentemente traumática. A correção desta deformidade constitui talvez o maior desafio que se pode colocar ao Cirurgião Rinoplasta. As técnicas de reparação podem ser de "camuflagem", de reconstrução anatómica ou mistas. Neste artigo são discutidas as várias estratégias cirúrgicas, dando especial destaque à rinoplastia aberta.

Intranasal naloxone for the treatment of suspected heroin overdose

AIMS: This paper reviews available literature regarding the effectiveness, safety and utility of intranasal (i.n.) naloxone for the treatment of heroin overdose.

METHODS: Scientific literature in the form of published articles during the period January 1984 to August 2007 were identified by searching several databases including Medline, Cinahl and Embase for the following terms: naloxone, narcan, intranasal, nose. The data extracted included study design, patient selection, numbers, outcomes and adverse events.

RESULTS: Reports of the pharmacological investigation and administration of i.n. naloxone for heroin overdose are included in this review. Treatment of heroin overdose by administration of i.n. naloxone has been introduced as first-line treatment in some jurisdictions in North America, and is currently under investigation in Australia.

CONCLUSION: Currently there is not enough evidence to support i.n. naloxone as first-line intervention by paramedics for treatment of heroin overdose in the pre-hospital setting. Further research is required to confirm its clinical effectiveness, safety and utility. If proved effective, the i.n. route may be useful for drug administration in community settings (including peer-based administration), as it reduces risk of needlestick injury in a population at higher risk of blood-borne viruses. Problematically, naloxone is not manufactured currently in an ideal form for i.n. administration.

Ketamina para el tratamiento de la hiperalgesia causada por remifentanil en cirugía: revisión sistemática de literatura

La hiperalgesia secundaria a la administración de remifentanil se ha documentado tanto en estudios animales como en estudios experimentales en humanos y ha aumentado su incidencia dado su uso cada vez más frecuente para el mantenimiento durante diferentes procedimientos anestésicos, anestesia general balanceada, anestesia total intravenosa y sedaciones. La hiperalgesia secundaria al uso de remifentanil es un proceso pro-nociceptivo relacionado pero que difiere de la tolerancia aguda, en el que los neurotransmisores excitatorios de N- metil D aspartato (NMDA) juegan un rol central. Por tanto la ketamina se ha utilizado en diferentes dosis para la prevención de dicha hiperalgesia sin que se haya establecido su efectividad para la prevención y tratamiento de esta condición. Se encontraron 8 estudios publicados en los últimos 10 años que proponen a la ketamina como una estrategia útil y efectiva el tratamiento de la hiperalgesia inducida por el uso de remifentanil. Los resultados demuestran que la ketamina es un tratamiento costo efectivo para el tratamiento de la hiperalgesia en diferentes poblaciones sometidas a diversos procedimientos quirúrgicos y anestésicos que incluyan la administración de remifentanil tanto en la inducción como en el mantenimiento anestésico sin generar efectos secundarios adicionales, así como que logra disminuir el consumo de opioides y la EVA en el posoperatorio.

El concepto de sublimación en psicoanálisis, una revisión de literatura

Este trabajo es una revisión de literatura que abarca una serie de artículos disponibles en la base de datos de la Universidad del Rosario, publicados entre los años 2006- 2016. En total se revisaron 52 artículos. Se presenta el concepto de sublimación según el psicoanálisis, el cual ha sido investigado en áreas como la religión, la filosofía, el arte, la cultura y en algunos casos en donde este se evidencia; finalmente se presentan conclusiones sobre dicho concepto durante últimos 10 años.