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Click chemistry has been employed for the fabrication of second-order nonlinear optical organic crystals BPTA with efficient second harmonic generation responses.

In this article, authors mainly introduce new digital technology in facial bone contouring surgery. In our experience, these new technologies are crucial in ensuring the satisfaction of surgical accuracy. Our previous studies have shown surgeons can use precise pre-operative design to reduce operative time, reduce bleeding during surgery. Additionally, augmented reality can enhance the perspective perception of surgeons combining virtuality and reality. What's more, robot-assisted surgical technology also has a strong application prospect in facial contouring surgery. In the future, the combination of soft tissue contouring surgery will make the facial bone contouring surgery safer and more effective.

This study aimed to investigate the feasibility and accuracy of osteotomy and distractor placement using a robotic navigation system in a model surgical experiment of mandibular distraction osteogenesis for hemifacial microsomia. Imaging data from 5 patients with Pruzansky-Kaban type II (IIa: 4; IIb: 1) mandibular deformities were used to print 3D models for simulated mandibular distraction osteogenesis. In the experimental group, a robot-assisted surgical navigation system was used to perform the surgery under robotic guidance following registration, according to the preoperative design. Conventional surgery was performed in the control group, in which the operation was based on intraoperative estimations of the preoperative design by experienced surgeons. The accuracies of the osteotomy and distractor placement were assessed based on distance and angular error. Osteotomy accuracy was higher in the experimental group than in the control group, and the distance error (t=9.311, P0.001) and angular error (t=5.385, P=0.001) were significantly reduced. The accuracy of distractor placement was also significantly higher in the experimental group, while the distance error (t=3.048, P=0.016) and angular error (t=3.524, P=0.024) were significantly reduced. The present results highlight the feasibility of robot-assisted distraction osteogenesis combined with electromagnetic navigation for improved surgical precision in clinical settings.

A limited number of clinical studies have focused on the changing trends of facial soft tissue after mandibular angle ostectomy. We conducted this study to investigate the changes in facial muscles and facial soft tissue appearance before and after mandibular angle ostectomy.A single-center retrospective cohort study was conducted on female patients admitted to our hospital for mandibular angle ostectomy between 2019 and 2020. The primary predictor variable was time (preoperative vs 6 months postoperative). The primary outcome variables were surface area and total volume of the manually delineated region of interest (ROI) for the masseter and temporalis muscles. We utilized computed tomography data to reconstruct 3-dimensional models to delineate muscle ROI and then measure them computationally. Secondary outcome variables were indicators of mandible appearance in soft tissue including bilateral mandibular angle distance, mandibular ramus height, and mandibular angle value. Age, preoperative body mass index, and ostectomy volume were chosen as covariates for correlation analysis with outcome variables. Paired t tests and Pearson correlation analysis were conducted, and P values.05 were considered statistically significant.A total of 29 female patients (mean age, 26 years; range, 18 to 37 years) who underwent mandibular angle ostectomy in our hospital were included. The surface area and total volume of the masseter muscle ROI were reduced by 2,541.2 ± 1,925.0 mmWe observed statistically significant levels of atrophy of the masseter muscle ROI and expansion of the temporalis muscle ROI 6 months after mandibular angle ostectomy, which may account for appearance changes after surgery. Besides, ostectomy volume positively correlates with postoperative masseter ROI changes. In summary, our study provided empirical evidence illustrating soft tissue alterations in patients who have undergone mandibular angle ostectomy.

In view of the serious perniciousness and complex diversity of actual wastewater systems, exploiting a robust and multifunctional adsorbent material featuring high sorption efficiency, broad-spectrum applicability, and excellent recyclability in treating multifarious pollutants in water (such as oils and fluoride ions) is highly required; however, it is still a daunting goal to pursue to date. In this work, novel mechanically robust and exceptional graphene oxide/hydroxyapatite nanowire (GO/HAPNW) aerogels (RGHAs/polydopamine (PDA)@RGHAs) with adjustable surface wettability were developed through a facile sol-gel self-assembly technology and subsequently optional bioinspired hydrophilic modification. Thanks to the reinforcing effect of HAPNWs with higher aspect ratio, a remarkably improved mechanical robustness (including superior compressibility and superelasticity) was acquired for the resulting aerogels. Based on the cooperative effect of the favorable selective wetting properties (i.e., hydrophobic/oleophilic for RGHAs) and the excellent mechanic stability, the aerogels displayed an outstanding sorption performance for diverse oils/organic solvents accompanied with a prominent recyclability. Specifically, a fairly high adsorption capacity of as high as 191 times of its own mass (for pump oil) was achieved based on a fast adsorption kinetic process. More importantly, superamphiphilic three-dimensional (3D) PDA@RGHAs revealed an extraordinary removal capability for water-soluble fluoride ions, exhibiting a superior equilibrium adsorption capacity (

Background: Mandibular distraction osteogenesis (MDO) is a major part of the treatment for hemifacial microsomia patients. Due to the narrow surgical field of the intraoral approach, osteotomy accuracy is highly dependent on the surgeons’ experience. Electromagnetic (EM) tracking systems can achieve satisfying accuracy to provide helpful real-time surgical navigation. Our research team developed an EM navigation system based on artificial intelligence, which has been justified in improving the accuracy of osteotomy in the MDO in animal experiments. This study aims to clarify the effect of the EM navigation system in improving the MDO accuracy for hemifacial microsomia patients. Methods:This study is designed as a single-centered and randomized controlled trial. Altogether 22 hemifacial microsomia patients are randomly assigned to the experiment group and control groups. All patients receive three-dimensional CT scans and preoperative surgical plans. The EM navigation system will be set up for those in the experiment group, and the control group will undergo traditional surgery. The primary outcome is the surgical precision by comparing the osteotomy position of pre- and postoperative CT scan images through the Geomagic Control software. The secondary outcomes include mandibular symmetry (occlusal plane deviation angle, mandibular ramus height and body length), pain scale and complications. Other indications, such as the adverse events of the system and the satisfactory score from patients and their families, will be recorded. Discussion: This small sample randomized controlled trial intends to explore the application of an EM navigation system in MDO for patients, which has been adopted in other surgeries such as orthognathic procedures. Because of the delicate structures of children and the narrow surgical view, accurate osteotomy and protection of nearby tissue from injury are essential for successful treatment. The EM navigation system based on artificial intelligence adopted in this trial is hypothesized to provide precise real-time navigation for surgeons and optimally improve patients outcomes including function and aesthetic results. The results of this trial will extend the application of new navigation technology in pediatric plastic surgery. Trial registration: Trial registration: Chinese Clinical Trial Registry: No. ChiCTR2200061565. Registered on June29, 2022.

In order to reduce the possibility of accidental injury to neurovascular and important tissues, this research conduct preoperative design and intraoperative guidance for fibrous dysplasia through augmented reality technology.Five patients with fibrous dysplasia were selected for three-dimensional (3D) Computed Tomography (CT) scan and 3D model was reconstructed. Considering the navigation plan was comprehensively, the guide plate (composed of card groove, connector, and fixator) was designed and 3D printed. Threedimensional software was used to unify the coordinates of the surgical plan and the guide plate, and the relative position was fixed. Then, the virtual and real overlapping registration is completed on the physical model. Pattern recognition technology is used to identify pre-defined markers in the video images before operation. Finally, the registration results are superimposed into the surgical field of vision to guide and remind surgeons.In this study, the navigation based on augmented reality technology was used in the surgical treatment of 5 cases patients with fibrous dysplasia. The 3D navigation information was displayed in real time in the operative field. The operation was accurate and the postoperative effect was good.This paper introduces an effective visual navigation surgical method in treatment with fibrous dysplasia. The augmented- reality based navigation system achieves individualized precise treatment by displaying 3D navigation directly in the surgical field. It is an effective auxiliary method for future research on craniofacial surgery.

The transfer of chirality from organics breaks inherent symmetry, leading to clear second-order NLO responses for chiral zinc halides. Additionally, successful CPL can be induced by doping chiral zinc halides with Sb3+ containing 5s2 electrons.

In previous research, miR-148a-3p deficiency was observed in bone malformation in hemifacial microsomia. Herein, in this article, we probed into the role of miR-148a-3p in bone physiology by utilizing miR-148a knock-out (KO) mice. Compared with wild-type (WT) or heterozygotic (HE) littermates, miR-148a knock-out mice manifested lower body weight, bone dysplasia with increased bone mass. Throughin-vitroexperiments, in terms of miR-148a-3p overexpression (miRNA mimic transfection) and knockout (primary cells from WT and KO littermates), we found that miR-148a-3p can suppress osteogenesis, either in the ALP activity or bone nodules formation. Afterward, by means of proteomics, combined with RNA-sequencing and prediction databases of microRNA targets (miRDB and TargetScan), nine candidate genes targeted by miR-148a-3p were identified. Among them, onlyItga11was regulated by mRNA degradation, while the others were modulated via post-transcriptional inhibition. Based on several online databases (GenePaint, BioGPS, STRING), Integrin Subunit Alpha 11 (Itga11) was suggested to play an essential role in osteogenesis and it was confirmed as one direct target of miR-148a-3p by dualluciferase reporter assay. Meanwhile, gene set enrichment analysis (GSEA) indicated activation of PI3K-Akt signaling pathway and WNT signaling pathway in miR-148a KO mice. The thereafter western blot confirmed that PI3K/Akt/GSK3/β-catenin signaling pathway was involved. Taken together, we demonstrated that miR-148a-3p can inhibit osteogenesis by targeting Itga11 via PI3K/Akt/GSK3/β-catenin pathway.

Aims LY3023414 is a novel oral phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) dual inhibitor designed for advanced cancers, for which a phase II clinical study was completed in March 2020; however, little is known about its effect on bone modelling/remodelling. In this study, we aimed to explore the function of LY3023414 in bone modelling/remodelling. Methods The function of LY3023414 was explored in the context of osteogenesis (bone formation by osteoblasts) and osteoclastogenesis (osteoclast formation and bone resorption). Murine preosteoblast MC3T3-E1 cell line and murine bone marrow-derived macrophage cells (BMMs) were subjected to different treatments. An MTS cell proliferation assay was used to examine the cytotoxicity. Thereafter, different induction conditions were applied, such as MCSF and RANKL for osteoclastogenesis and osteogenic media for osteogenesis. Specific staining, a bone resorption assay, and quantitative real-time polymerase chain reaction (qRT-PCR) were subsequently used to evaluate the effect of LY3023414. Moreover, small interfering RNA (siRNA) was applied to knockdown Akt1 or Akt2 for further validation. Lastly, western blot was used to examine the exact mechanism of action. Results LY3023414 attenuated PI3K/protein kinase B (Akt)/GSK3-dependent activation of β-catenin and nuclear factor-activated T cell 1 (NFATc1) during osteogenesis and osteoclastogenesis, respectively. LY3023414 mainly inhibited osteoclast formation instead of mature osteoclast function. Moreover, it suppressed osteogenesis both in the early stage of differentiation and late stage of calcification. Similarly, gene knockdown of Akt isoforms by siRNA downregulated osteogenic and osteoclastogenic processes, indicating that Akt1 and Akt2 acted synergistically. Conclusion LY3023414 can suppress osteogenesis and osteoclastogenesis through inhibition of the PI3K/Akt/GSK3 signalling pathway, which highlights the potential benefits and side effects of LY3023414 for future clinical applications. Cite this article: Bone Joint Res 2021;10(4):237–249.

PurposeThe purpose of this paper is to verify the mediating role of commitment between market-oriented organizational culture and international market performance, and to discuss the moderator effect of national institutional environment on this mediating role.Design/methodology/approachThe research design follows a mixed methodology, combining qualitative and quantitative data collection and analysis. In the first phase, research hypotheses are proposed based on a literature analysis. In the second phase, sample data are collected through interviews and questionnaires sent to domestic contractors in China and South Korea, and a validity analysis of the results is carried out. Correlation and regression analyses are then performed on the valid data to verify hypotheses to prove the existence and influence of mediating effects. Hayes PROCESS Macro is used on the regression results to test the mediating effect of commitment on international project performance and the moderation effect of institutional environment.FindingsThe results reveal that the commitment between partners has a mediating effect on the relationship between market culture and international project performance; however, no hierarchy culture is revealed. The mediating effect of commitment is regulated by the institutional environment.Research limitations/implicationsAlthough the reliability and validity of the questionnaire data in this study are in line with research standards, a larger sample size would improve the reliability of the results. Further, the interviewed samples are mainly from China and South Korea; large representative samples from additional countries, such as Japan, should be considered to gain a fuller understanding and more comprehensive results.Originality/valueBy emphasizing the differences between the two institutional environments of developing and developed countries in East Asia, a theoretical and empirical basis is provided. International construction enterprises in other countries can apply the findings to improve their international market performance in different institutional environments. The findings also provide an empirical reference that international construction enterprises in China and South Korea may use to adjust their organizational cultures and commitments to improve market performance.

This paper investigates optimal concession contracts of the port authority when terminal operators have private information about their own operation costs. A two-stage game is constructed to characterize the interactions between the port authority and one terminal operator, and the port authority can select among the fixed-fee, the unit-fee and the two-part tariff contracts. We derive the pooling and the separating equilibria, and find that the separating equilibria are always preferred. In addition, incomplete information is at least as important as the minimum throughput requirement in affecting optimal contract types of the port authority. If the operator's marginal service costs are low (high), the port authority will face expected efficiency losses (gains) under incomplete information. However, the throughput requirement can mitigate (enhance) the expected efficiency losses (gains) under specific conditions. Moreover, requiring throughput may also lessen output distortions and information rents. Our findings provide insights and practical policy implications to port authorities and governments.

The relationship between oxidized lipid metabolism and the immunological function of cancer is well known. However, the functions and regulatory mechanisms of lncRNAs associated with oxidized lipid metabolism in head and neck squamous cell carcinoma (HNSCC) remain to be fully elucidated. In this study, we established an oxidized lipid metabolism-related lncRNA prognostic signature to assess the prognosis and immune infiltration of HNSCC patients. The HNSCC transcriptome was obtained from The Cancer Genome Atlas. The choice of the target genes with a relevance score greater than 10 was performed via a correlation analysis by GeneCards. Patients were categorized by risk score and generated with multivariate Cox regression, which was then validated and evaluated using the Kaplan–Meier analysis and time-dependent receiver operating characteristics (ROC). A nomogram was constructed by combining the risk score with the clinical data. We constructed a risk score with 24 oxidized lipid metabolism-related lncRNAs. The areas’ 1-, 2-, and 3-year OS under the ROC curve (AUC) were 0.765, 0.724, and 0.724, respectively. Furthermore, the nomogram clearly distinguished the survival probabilities of patients in high- and low-risk groups, between which substantial variations were revealed by immune infiltration analysis. The results supported the fact that oxidized lipid metabolism-related lncRNAs might predict prognoses and assist with differentiating amid differences in immune infiltration in HNSCC.

Macrostomia is arare congenital craniofacial deformity that influences the appearance and function of patients. In most cases, it coexists with craniomaxillofacial deformities such as craniofacial microsomia (CFM). This study aimed to analyze the relationship between macrostomia and mandibular hypoplasia so as to facilitate the early detection and diagnosis of children with CFM. It included 236 patients diagnosed with CFM. All underwent facial expression analysis, multi-angle photography, computed tomography, and three-dimensional reconstruction of soft and hard tissues. The clinical classification was performed according to OMENS+. Spearman (rank) correlation analysis was used to analyze the relationship between the severity of macrostomia (C1 and C2) and the degree of mandibular involvement (M1, M2a, M2b, and M3), and the correlation among the components of OMENS+. Of the 80 cases of macrostomia (34%) reported, 72 cases (90%) were C1 and 8 (10%) were C2. The analysis of OMENS+ revealed significant correlations among OMENS+ components. Also, a high correlation was observed between macrostomia (C) and hypoplasia of the mandible (M) ( P = 0.002). Macrostomia was closely related to mandibular hypoplasia among children diagnosed with CFM. These results suggested that patients with macrostomia, who might also have craniofacial malformations caused by other first branchial arch anomalies, should be comprehensively physically examined for other syndromes.

Overactivated T cells and overproduced pro-inflammatory cytokines form a self-amplified signaling loop to continuously exacerbate the dysregulated inflammatory response and propel the progression of autoimmune diseases (AIDs). Herein, immuno-engineered nanodecoys (NDs) based on poly(lactic-co-glycolic acid) nanoparticles coated with programmed death-ligand 1 (PD-L1)-expressing macrophage membrane (PRM) are developed to mediate multi-target interruption of the self-promoted inflammatory cascade in AIDs. The PRM collected from IFN-γ-treated RAW 264.7 cells possesses elevated surface levels of adhesion molecule receptors and pro-inflammatory cytokine receptors, and, thus, systemically administered PRM NDs afford higher accumulation level in inflamed tissues and stronger scavenging efficiency toward multiple pro-inflammatory cytokines. More importantly, IFN-γ treatment induces remarkable PD-L1 expression on PRM, thereby allowing PRM NDs to bind membrane-bound programmed death-1 (PD-1) on CD4

The efficacy of Adoptive Cell Therapy (ACT) for solid tumor is still mediocre. This is mainly because tumor cells can hijack ACT T cells' immune checkpoint pathways to exert immunosuppression in the tumor microenvironment. Immune Checkpoint Inhibitors such as anti-PD-1 (aPD1) can counter the immunosuppression, but the synergizing effects of aPD1 to ACT was still not satisfactory. Here we demonstrate an approach to safely anchor aPD1-formed nanogels onto T cell surface via bio-orthogonal click chemistry before adoptive transfer. The spatial-temporal co-existence of aPD1 with ACT T cells and the responsive drug release significantly improved the treatment outcome of ACT in murine solid tumor model. The average tumor weight of the group treated by cell-surface anchored aPD1 was only 18 % of the group treated by equivalent dose of free aPD1 and T cells. The technology can be broadly applicable in ACTs employing natural or Chimeric Antigen Receptor (CAR) T cells.

In this study, an AI osteotomy software was developed to design the presurgical plan of mandibular angle osteotomy, which is followed by the comparison between the software-designed presurgical plan and the traditional manual presurgical plan, thus assessing the practicability of applying the AI osteotomy software in clinical practices.(1) Develop an AI osteotomy software: design an algorithm based on convolutional neural networks capable of learning feature point and processing clustering segmentation; then, select 2296 cases of successful 3D mandibular angle osteotomy presurgical plans, followed by using those 2296 cases to train the deep learning algorithm; (2) compare the osteotomy presurgical plan of AI osteotomy software and that of manual: first step: randomly selecting 80 cases of typical female head 3D CTs, and designing those 80 cases by means of AI osteotomy software designing (group A) and manually designing (group B), respectively; second step: comparing several indexes of group A and those of group B, including the efficiency index (time from input original CT data to osteotomy presurgical plan output), the safety index (the minimum distance from the osteotomy plane to the mandibular canal), the symmetry indexes (bilateral difference of mandibular angle, mandibular ramus height and mandibular valgus angle) and aesthetic indexes (width ratio between middle and lower faces (M/L), mandibular angle and mandibular valgus angle).The efficiency index: the design time of group A is 1.768 ± 0.768 min and that of group B is 26.108 ± 1.137 min, with P = 0.000; the safety index: The minimum distances from the osteotomy plane to the mandibular canal are 3.908 ± 0.361mm and 3.651 ± 0.437mm, p = 0.117 in groups A and B, respectively; The symmetry indexes: Bilateral differences of mandibular angle are 1.824 ± 1.834° and 1.567 ± 1.059° in groups A and B, respectively, with P = 0.278; bilateral differences of mandibular ramus height are 2.083 ± 1.263 and 2.965 ± 1.433, respectively, with P = 0.119 in groups A and B; Aesthetic indexes: M/L in groups A and B is 1.364 ± 0.074 and 1.371 ± 0.067, respectively, with P = 0.793; mandibular angles in groups A and B are 127.724 ± 5.800° and 127.242 ± 5.545°, respectively, with P = 0.681; Valgus angles in groups A and B are 11.474 ± 5.380 and 9.743 ± 4.620, respectively, with P = 0.273.With high efficiency, as well as safety, symmetry and aesthetics equivalent to those of a manual design, the AI osteotomy software designing can be used as an alternative method for manual osteotomy designing.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Background To explore the potential of electromagnetic (EM) navigation technology in the field of robot-assisted surgery, we set up a maxillofacial surgical robotic system (MSRS) guided by an EM navigation tool. Mandibular angle osteotomy was used to analyze the feasibility in confined surgical areas. Methods Model and animal experiments were implemented to validate the system precision. Before the experiment, a customized dental splint was made and then fixed with a standard navigation part. An accurate 3D surgical plan was designed based on the preoperative CT scan. During the experiment, the splint was rigidly mounted on teeth for navigation registration, so the robot could position a specially designed template to guide the accurate osteotomy according to the preoperative plan. For the model experiment, a Coordinate Measuring Machine was used to measure the template's position and angle. For the animal experiment, surgeons completed the surgery by moving a saw along the template, while a postoperative CT scan was carried out to calculate the precision. Results All procedures were successfully completed, with no complications in any of the experimental animals. In the model experiment, the accuracy of the navigation position and angle was 0.44±0.19 mm and 3.5°±2.1°, respectively. In the animal experiment, the lateral osteotomy line error was 0.83±0.62 mm, the interior error was 1.06±1.03 mm, and the angle between the actual cutting plane and preoperative planning plane was 5.9°±4.7°. Conclusions Robot-assisted surgery with EM navigation resulted feasible in the real operating environment. Moreover, this system's precision could meet clinical needs, while the proposed procedure was safe and easy on animals. Consequently, this approach has the potential to be applied to clinical craniomaxillofacial practice in the near future.

This paper investigates how landlord port authorities should offer concession contracts to their terminal operators under two different goals, by building a two-stage game for each goal. If maximiz...

This paper investigates optimal concession contracts offered by a landlord port authority to competing terminal operators given minimum throughput requirements. Three contract types considered are fixed-fee, unit-fee, and two-part tariff. We find that the unit-fee contract is always the best, and the port authority becomes better off by imposing minimum throughput requirements. These results remain true when demands for and/or costs of port’s services are uncertain, when terminal operators compete in service prices, when operators’ congestion costs are considered under specific conditions, when dissimilar contracts are offered to different operators, or when there are more than two operators.

In this work, a novel NiTif-SiCf synergistically reinforced (Al3Ti+Al3Ni)-based metallic-intermetallic laminated (NiTif-SiCf/(Al3Ti+Al3Ni)-MIL) composite was designed and synthesized using NiTi and SiC fibers, Ti and Al foils with the “Ti (TC4)-NiTif-Al-Ti (TA1)-Al-SiCf-Ti (TC4)” stacked unit by hot pressing sintering process in vacuum. The TA1 foils as barrier (Tib) are favorable to promote the consumption of Al, meanwhile, allow NiTif and SiCf to co-exist in one intermetallic layer. SEM, EDS, XRD and EBSD techniques were employed to investigate microstructure features, phase constituents and growth kinetics of the NiTif-SiCf/(Al3Ti+Al3Ni)-MIL composite. Besides, the mechanical performances of the composite were detected through compressive tests. The results showed that the newly formed phases in the composite consisted of Al3Ti, Al3Ti0.8V0.2 and Al3Ni, which were obtained from the reactions of Ti/Al and NiTif/Al, resulting in the generation of inhomogeneous intermetallic layer. In addition, NiTif and SiCf, lined up respectively, were distributed uniformly in one intermetallic layer along parallel orientation and the oval shaped eutectic areas were in-suit formed around NiTif by reaction of NiTif/Al. While Tib layers were disappeared between NiTif and SiCf due to the complete reaction of Tib/Al, and were replaced by Al3Ti and Al3Ni phases. However, the Al3Ti grains at this area grew abnormally by devouring the surrounding grains after recrystallization, which were harmful to the strength of the composite. Furthermore, the kinetic calculation results showed that the growth of NiTif/Al and Tib/Al interfacial layers are governed solely by chemical reaction mechanism at 630 °C. Moreover, the NiTif-SiCf/(Al3Ti+Al3Ni)-MIL composite acquired superior specific strength and ductility in both perpendicular and parallel directions, which were attributed to the pull-out and breakage of SiCf and NiTif, as well as crack deflection at interfaces.

Botulinum toxin injection is a highly efficacious treatment for masseter muscle hypertrophy, while manual injection point localization based on experience can be non-quantitative, subjective and therefore suboptimal and even side-effect risky. To address this important while challenging task, in this paper we present a methodology of automatic ideal point localization for botulinum toxin injection based on automatic segmentation, measurement and quantitative analysis. Specifically, we first present a novel three-dimensional (3D) fully convolutional neural network for fully automatic mandible and masseter regions of interest (RoI) localization and segmentation from head computed tomography (CT) images. Given the segmentation results, the ideal injection points on the face are located using ray casting based automatic thickness measurement. We conducted experiments on an internal dataset consisting of head CT images acquired from 53 patients to evaluate the segmentation performance and localization reliability. The results demonstrate that the segmentation framework outperforms the state-of-the-art method by a significant margin, and the localization system provides intuitive, interactive user interface and reliable injection point decisions.

Mandibular distraction osteogenesis at an early age is the standard hemifacial microsomia treatment. Nevertheless, the recurrence rate remains high and the definition of early age is controversial. We explored the optimal timing for mandibular distraction, when the surrounding skeleton, such as maxilla, can grow compensatory, to reduce recurrence. Hemifacial microsomia patients were prospectively divided into Groups A (1–3 years old) and B (4–6 years old), according to maxillary and mandibular growth curves. Computed tomography scans were obtained before distractor implantation and after removal surgery. Maxillary volume increase percentage was the main outcome indicator; other indicators (maxillary symmetry and complications) were secondary outcomes. Fifty-eight patients were enrolled and all but one patient in Group A (failed distraction) completed the study. Two patients had facial nerve injury and another two had mouth-opening limitation, which was relieved after coracoid resection. The difference in percentage increase in maxillary volume between the affected and unaffected sides was 5.06 ± 2.73% and 3.18 ± 1.99% in Groups A and B, respectively, suggesting better compensatory growth in younger patients (P = 0.004). Maxillary symmetry was apparently elevated after mandibular distraction. Mandibular distraction osteogenesis was confirmed to be feasible and safe at age

Masseter deficits are common in craniofacial microsomia (CFM), however studies on masseter muscle involvement are limited. The aim of this study was to describe the morphology and functional involvement of the masseter muscles quantitatively. Ninety-eight patients with CFM who underwent three-dimensional computed tomography and surface electromyography were included. The mean action potential during maximum voluntary contraction in the intercuspal position was recorded. Asymmetry of the compound muscle action potential (ACMAP) was calculated as an indicator of functional involvement. Differences between the affected and unaffected sides, the correlation between morphology and function, and the relationship between ACMAP and the OMENS-Plus classification were assessed by paired t-test, Pearson correlation analysis, and Spearman correlation analysis. The masseter muscle was absent on the affected side in 11 patients. In the remaining 87 patients, the mean volumes of the affected and unaffected masseters were 5.22±2.47cm3 and 9.62±3.30cm3, respectively, with mean action potentials of 41.40±28.52uV and 73.78±45.90uV, respectively. Both morphology and the function of the masseter showed moderate correlation with the OMENS 'M' classification. No significant correlation was found between ACMAP and the OMENS-Plus soft tissue grading. A masseter function classification is proposed: type I, ACMAP

Microwave-assisted ammonium sulfate/ethanol aqueous two-phase system was used to extract the phenolic compounds from blackcurrant (Ribes nigrum L.) fruits. After purification with AB-8 macroporous resin, the phenolics (RMAP) was obtained with a purity of 80.50 ± 0.26%. The minimum inhibitory concentration (MIC) and inhibition zone tests showed that RMAP exhibited more potent antibacterial properties against Staphylococcus aureus than against Escherichia coli and Salmonella typhimurium. Additionally, high-performance liquid chromatography-electrospray ionization-mass spectrometry analysis confirmed RMAP was mainly composed of four phenolic compounds including kaempferol-3-O-rutinoside, rutin, cyanidin-3-O-glucoside (C3G) and hyperoside. MIC and time-kill curve assays indicated that C3G displayed the highest inhibitory activity on S. aureus among four compounds. Moreover, crystal violet and MTT assays showed that C3G exhibited obviously inhibitory effect on fresh biofilm formation of S. aureus. Transmission electron microscopy observation, alkaline phosphatase, lactate dehydrogenase, protein and DNA leakage assays verified that C3G damaged cell wall and membrane of S. aureus. On the other hand, UV absorption spectroscopy and DNA cleavage assay revealed that C3G was able to interact with DNA in the form of chimera, but had no direct effect on DNA cleavage. Whereas, DNA topoisomerase IV (DNA Topo IV) inhibition assay and molecular docking model manifested that C3G could combine with DNA Topo IV to affect its activity and further restrained the synthesis of DNA. These results indicated that the antibacterial mechanism of C3G against S. aureus was mainly related to its inhibiting biofilm formation, disrupting cell structure and resisting DNA Topo IV activity.

Background Postoperative infection is a complication of mandibular distraction osteogenesis (DO) in patients with hemifacial microsomia (HFM). The risk of surgical wound infection in DO is reported to be high due to the long duration of the distraction process. Treatment during the perioperative period is critical in combating infection. Aim This study aimed to evaluate the effectiveness of red-blue irradiation in the prevention of surgical wound infection after mandibular distraction. Methods In our single-centered, randomized clinical study, 118 patients diagnosed with HFM who had undergone DO between April 2016 and April 2018 were included. The patients were randomly divided into two groups: the experimental group received red-blue irradiation treatment and the control group received white-light irradiation. Results None of the infections occurring in this study resulted in serious complications. The postoperative infection rate during the 4 weeks after DO in the experimental group was 1.7%, whereas that in the control group was 13.6% (p = 0.016) (based on a modified NHSN wound infection criterion). The total social cost during the active period for the experimental group was 3386840 RMB, 5.12% higher than for the control group (3221882 RMB). Conclusions Red-blue irradiation is recommended as adjunctive therapy after mandibular distraction osteogeneis in HFM.

Purpose Augmented reality (AR) is considered to be a valuable tool in craniofacial surgery for preoperative design, intraoperative navigation, and postoperative assessment. Corrective surgery is necessary synostotic plagiocephaly for functional and aesthetic outcomes. Open calvarial reconstruction is a difficult classic surgical procedure with a high accuracy requirement. The purpose of this study was to introduce an AR system application in synostotic plagiocephaly surgery. Materials and methods Seven plagiocephaly patients (ages 6 months–24 months, average 16.7 months) were enrolled. Preoperative design was accomplished based on three-dimensional computed tomography (CT) data for patients with synostotic plagiocephaly. We completed the registration with the predefined markers through an image registration process preoperatively. Then, we overlaid the registration results into the surgical field to assist surgeons intraoperatively. CT scans were performed postoperatively. Intracranial volume was measured to judge the surgical outcomes. We performed a quantitative craniometric analysis between the planning of the reconstruction and post-operative results, and the main evaluation indicator was the intracranial volume asymmetry. Results We successfully applied the AR system in patients undergoing synostotic plagiocephaly, providing real-time navigational images of position and orientation information during open calvarial reconstruction surgery in 7 plagiocephaly patients within a span of 5 years. Good appearances were observed after the surgery. Cranial volume asymmetry was decreased from 27.87% to 16.57%, achieving precise intra-operative goals. No significant differences were found between planning and post-operative results. Conclusions The AR system can be applied to plagiocephaly procedures guiding to obtain reliable and accurate results via a precise osteotomy.