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We report a comparative study using "knowledge space theory" (KAT) to assess the impact of a hands-on laboratory exercise that used molecular model kits to emphasize the connections between a plane of symmetry, Charity, and isomerism in an introductory organic chemistry course. The experimental design compared three groups of students--two that carried out the laboratory exercise (treatment groups) and one that did not (control group). Our assessments revealed that all three groups made significant improvements in their understanding of Charity and isomerism, but that the two treatment groups showed more improvements than the control group. The KAT analysis showed that the acquisition of the skills for finding a plane of symmetry in a molecule came late in the students' critical learning pathways, which indicated that this was difficult for many students. Students were unfamiliar with this type of reasoning, and our studies revealed that the laboratory exercise was useful in teaching the method to introductory organic chemistry students. (Contains 3 notes, 1 table, and 3 figures.)

Objective: To evaluate evolving practice patterns in secondary cleft rhinoplasty. Design: Retrospective review of data submitted during Maintenance of Certification (MOC). Setting: Evaluation of MOC data from the American Board of Plastic Surgery. Participants: Tracer data for secondary cleft rhinoplasty were reviewed from August 2006 through March 2020, and the data subdivided from 20062012 and 20132020 to evaluate changes in practice patterns. Interventions: Practice patterns in tracer data were compared to those from evidence-based medicine (EBM) literature over this time period. Main Outcome Measures: Practice patterns were compared to EBM trends during the study period. Results: A total of 90 cases of secondary cleft rhinoplasty were identified. The average age at operation was 13 years (range 4-77). Cumulative data demonstrated 61% to present with nasal airway obstruction and 21% to have undergone primary nasal correction at the time of cleft lip repair; 72% of patients experienced no complications, with the most common complications being asymmetry (10%) and vertical asymmetry of alar dome position (6%). Cartilage graft was used in 68% of cases, with 32% employing septal cartilage. Change in practice patterns between 2006 to 2012 and 2013 to 2020 demonstrated increase in dorsal nasal surgery (26% vs 43%, P =.034), use of osteotomies (14% vs 38%, P =.010), septal resection and/or straightening (26% vs 48%, P =.034), and turbinate reduction (8% vs 30%, P =.007). Conclusions: These tracer data provide long-term data by which to evaluate evolving practice patterns for secondary cleft rhinoplasty. When evaluated relative to EBM literature, future research to further improve outcomes can be better directed. [ABSTRACT FROM AUTHOR]

A two-step method for the synthesis of 9-aryl-6-hydroxy-3H-xanthen-3-one flurophores involving condensation of aryl aldehydes and fluororesorcinol is shown to produce through a triarylmethane intermediate. The condensation is complicated by retro-Friedel-Crafts reactions, which can be minimized by controlling the amount of acid.

Background: A significant proportion of patients seeking labiaplasty are nulliparous and may experience later changes to their labia following vaginal delivery.Objectives: In the present study, the authors reported the long-term outcomes of a single surgeon's patient cohort who had vaginal delivery after labiaplasty.Methods: A retrospective chart review of the senior author's database was conducted. All patients who underwent in-office labiaplasty from 2007 to 2018 were surveyed. The resulting cohort was stratified into patients who had delivered children prior to labiaplasty and those who delivered after labiaplasty.Results: A total of 204 patients responded to a phone survey. Seventy patients had children prior to undergoing labiaplasty, and 33 had children after labiaplasty. The rate of vaginal delivery was lower in the women who had children before labiaplasty (82.6% vs 91.8%, P = 0.015). The tear/episiotomy rate for vaginal deliveries was lower in women who had children prior to labiaplasty compared with after labiaplasty (3.1% vs 17.8%, P < 0.001). Among the women who had children only after labiaplasty, the reported tear/episiotomy rate was 7/39 vaginal deliveries (17.9%).Conclusion: Patients in our cohort had over 90% success with vaginal deliveries after labiaplasty. For nulliparous patients contemplating the procedure, the data we present suggest the risk of episiotomy or vaginal tear risk with vaginal birth after labiaplasty is comparable with or lower than the general population, further supporting the safety of this procedure. For patients with previous delivery, the data are more limited but suggest no increased risk in this small cohort.Level Of Evidence:4: [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to help understand national practice patterns in carpometacarpal (CMC) arthroplasty and how they have evolved with evidence-based recommendations over the past 15 years. Methods: The American Board of Plastic Surgery (ABPS) started collecting practice data on primary CMC joint arthroplasty in 2006 as a portion of its continuous certification (CC) process. Data on primary CMC arthroplasty from May 2006 through December 2013 were reviewed and compared to those from January 2014 to March 2020. National practice trends observed in these data were evaluated. Comprehensive evidence-based medicine reviews published in 2008, 2011, 2013, and 2017 were reviewed alongside the CC data. Results: In all, 570 primary CMC joint arthroplasty cases were included from May 2006 to March 2020. The average age at the time of repair was 62 years and the patient population was predominantly female (79%). Most cases were done under general anesthesia (69%), and there was an increase in the use of regional anesthesia with nerve block when our 2 cohorts were compared (27% vs 37%; P =.020). A trapezium excision with flexor carpi radialis tendon ligament reconstruction was the most popular technique (72%) and an increase in the use of simple trapeziectomy was observed (6% vs 14%; P =.001). One-third of patients did not receive any form of deep vein thrombosis prophylaxis. Conclusions: The ABPS CC data provide a databank that allows for direct observation of national practice trends and sheds light on potential avenues for improvement in patient care. [ABSTRACT FROM AUTHOR]

Abstract: Leukotrienes (LT’s) are known to play a physiological role in inflammatory immune response. Leukotriene A4 hydrolase (LTA4H) is a cystolic enzyme that stereospecifically catalyzes the transformation of LTA4 to LTB4. LTB4 is a known pro-inflammatory mediator. This paper describes the identification and synthesis of substituted benzofurans as LTH4H inhibitors. The benzofuran series demonstrated reduced mouse and human whole blood LTB4 levels in vitro and led to the identification one analog for advanced profiling. Benzofuran 28 showed dose responsive target engagement and provides a useful tool to explore a LTA4H inhibitor for the treatment of inflammatory diseases, such as asthma and inflammatory bowel disease (IBD). [Copyright &y& Elsevier]

Abstract: Previously, benzthiazole containing LTA4H inhibitors were discovered that were potent (1–3), but were associated with the potential for a hERG liability. Utilizing medicinal chemistry first principles (e.g., introducing rigidity, lowering c Log D) a new benzthiazole series was designed, congeners of 1–3, which led to compounds 7a, 7c, 12a–d which exhibited LTA4H IC50 =3–6nM and hERG Dofetilide Binding IC50 =8.9–> >10μM. [Copyright &y& Elsevier]

Objective: To evaluate evolving practice patterns in secondary cleft rhinoplasty., Design: Retrospective review of data submitted during Maintenance of Certification (MOC)., Setting: Evaluation of MOC data from the American Board of Plastic Surgery., Participants: Tracer data for secondary cleft rhinoplasty were reviewed from August 2006 through March 2020, and the data subdivided from 20062012 and 20132020 to evaluate changes in practice patterns., Interventions: Practice patterns in tracer data were compared to those from evidence-based medicine (EBM) literature over this time period., Main Outcome Measures: Practice patterns were compared to EBM trends during the study period., Results: A total of 90 cases of secondary cleft rhinoplasty were identified. The average age at operation was 13 years (range 4-77). Cumulative data demonstrated 61% to present with nasal airway obstruction and 21% to have undergone primary nasal correction at the time of cleft lip repair; 72% of patients experienced no complications, with the most common complications being asymmetry (10%) and vertical asymmetry of alar dome position (6%). Cartilage graft was used in 68% of cases, with 32% employing septal cartilage. Change in practice patterns between 2006 to 2012 and 2013 to 2020 demonstrated increase in dorsal nasal surgery (26% vs 43%, P = .034), use of osteotomies (14% vs 38%, P = .010), septal resection and/or straightening (26% vs 48%, P = .034), and turbinate reduction (8% vs 30%, P = .007)., Conclusions: These tracer data provide long-term data by which to evaluate evolving practice patterns for secondary cleft rhinoplasty. When evaluated relative to EBM literature, future research to further improve outcomes can be better directed.