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Background: The presence of white adipose tissue inflammation (WATi) in the breast has been associated with increased breast cancer risk and a worse clinical course. Elevated body mass index (BMI) and the post-menopausal state are both associated with breast WATi. Breast WATi has also been associated with increased expression of aromatase, the rate-limiting enzyme for estrogen biosynthesis. Currently, WATi is diagnosed in surgical samples of breast tissue by the identification of crown-like structures (CLS), which are comprised of a dead or dying adipocyte enveloped by macrophages. In contrast to surgical specimens, core biopsies have been shown to be inadequate for assessing WATi. Hence, there is an unmet need for strategies to non-invasively diagnose WATi. Here we used a novel lipidomics platform to identify potential non-invasive blood signatures of breast WATi. Methods: We conducted a cross-sectional study which included 100 patients who underwent mastectomy for breast cancer treatment or risk reduction. WATi was detected by CD68 immunohistochemistry to identify CLS. Breast aromatase expression levels were measured by qPCR. Clinicopathologic data were abstracted from electronic medical records. Lipidomic data were measured from blood plasma in collaboration with Waters Technologies Corporation. Lipid levels in association with breast WATi (presence/absence) and levels of aromatase expression (high/low) in non-tumorous breast tissue were examined using Welch’s t-test. P-values were adjusted for multiple comparisons by controlling the false discovery rate (FDR) using the Benjamini-Hochberg method. A logistic regression model was used to develop predictive models that evaluated potential lipid biomarkers of the presence of breast WATi and high breast aromatase expression levels. Stepwise regression was used for variable selection. AUC of the ROC curves was used to evaluate the performance of the predictive models. Results: Among 140 lipids analyzed, 13 were identified to be associated with breast WATi (P0.3). Specifically, 8 lipids had lower levels, and 6 lipids had higher levels in patients with breast WATi compared to those without. Levels of 7 lipids were significantly higher in patients with an increased level of aromatase (P0.3). After variable selection, LPE(22:6) (P=0.018), LPE(20:3) ES-(P=0.006), along with menopausal status and BMI provided an 86.0% (95% CI, 77.6%-94.5%) accuracy in predicting higher breast aromatase levels. Combining the effect of two lipids improved the accuracy by 10.4%(P=0.030) compared to the model only using menopausal status and BMI. A model with 5 lipids and menopausal status provided an 88.8%(95% CI, 81.9%-95.8%) accuracy for predicting breast WATi. The model performance improved by 9.2% (P=0.026) compared to the model only using menopausal status and BMI. Conclusions: Our study identified several lipid species that showed significant changes in association with breast WATi and levels of aromatase expression. Further validation of these blood signatures could provide non-invasive assessment of WATi and aromatase levels. The availability of such a diagnostic algorithm could help, in turn, to both identify women at elevated risk for breast cancer and for monitoring the efficacy of interventions aimed at reducing inflammation and aromatase levels. Citation Format: Xiao Cai, Siqi Wei, Zizhuo Xu, Xi K Zhou, Andrew Peck, Steven Lai, Giorgis Isaac, Hernando Olivos, Nayasha Munjoma, Suraj Dhungana, Rob Plumb, Andrew J Dannenberg, Neil M Iyengar. Plasma lipidomics analysis to identify potential non-invasive biomarkers for breast white adipose inflammation and aromatase expression levels [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-08-05.

Purpose:Patients with human EGFR2-positive (HER2+) breast cancer have a high incidence of brain metastases, and trastuzumab emtansine (T-DM1) is often employed. Stereotactic radiosurgery (SRS) is frequently utilized, and case series report increased toxicity with combination SRS and T-DM1. We provide an update of our experience of T-DM1 and SRS evaluating risk of clinically significant radionecrosis (CSRN) and propose a mechanism for this toxicity.Experimental Design:Patients with breast cancer who were ≤45 years regardless of HER2 status or had HER2+ disease regardless of age and underwent SRS for brain metastases were included. Rates of CSRN, SRS data, and details of T-DM1 administration were recorded. Proliferation and astrocytic swelling studies were performed to elucidate mechanisms of toxicity.Results:A total of 45 patients were identified; 66.7% were HER2+, and 60.0% were ≤ 45 years old. Of the entire cohort, 10 patients (22.2%) developed CSRN, 9 of whom received T-DM1. CSRN was observed in 39.1% of patients who received T-DM1 versus 4.5% of patients who did not. Receipt of T-DM1 was associated with a 13.5-fold (P = 0.02) increase in CSRN. Mechanistically, T-DM1 targeted reactive astrocytes and increased radiation-induced cytotoxicity and astrocytic swelling via upregulation of Aquaporin-4 (Aqp4).Conclusions:The strong correlation between development of CSRN after SRS and T-DM1 warrants prospective studies controlling for variations in timing of T-DM1 and radiation dosing to further stratify risk of CSRN and mitigate toxicity. Until such studies are completed, we advise caution in the combination of SRS and T-DM1.

Chemotherapy effects on astrocytes

Introduction: Radiology training is an important component of emergency medicine (EM) education, but its delivery has been variable. Program directors have reported a lack of radiology skills in incoming interns. A needs assessment is a crucial first step toward improving radiology education among EM residencies. Our objective was to explore the current state of radiology education in EM residency programs. Methods: This was a cross-sectional survey study of all Accreditation Council for Graduate Medical Education-accredited EM programs in the United States. Program leadership completed an online survey consisting of multiple choice, Likert scale, and free-response items. We calculated and reported descriptive statistics. Results: Of eligible EM programs, 142/252 (56%) completed the survey including 105 postgraduate year (PGY) 1-3 and 36 PGY 1-4 programs. One respondent opted out of answering demographic questions. 23/141 (16%) were from the Western region, 29/141 (21%) were from the North Central region, 14/141 (10%) were from the South-Central region, 28/141 (20%) were from the Southeast region, and 47/141 (33%) were from the Northeast region. A total of 88/142 (62%) of responding programs did not have formal radiology instruction. Of the education that is provided, 127/142 (89%) provide it via didactics/lectures and 115/142 (81%) rely on instruction during clinical shifts. Only 51/142 (36%) provide asynchronous opportunities, and 23/142 (16%) have a dedicated radiology rotation. The majority of respondents reported spending 0-2 hours per month on radiology instruction (108/142; 76%); 95/141 (67%) reported that EM faculty “often” or “always” provide radiology instruction; 134/142 (95%), felt that it was “extremely” or “very important” for ED providers to be able to independently interpret radiograph results; and 129/142 (90.84%) either “sometimes” or “always” rely on their independent radiograph interpretations to make clinical decisions. The radiology studies identified as most important to be able to independently interpret were radiographs obtained for lines/tubes, chest radiographs, and radiographs obtained for musculoskeletal-related complaints. Conclusion: A minority of EM residency programs have formal instruction in radiology despite the majority of responding program leadership believing that these are important skills. The most important curricular areas were identified. These results may inform the development of formal radiology curricula in EM graduate medical education.

Introduction: Brain metastases (BM) occurs in ~40% of breast cancer patients with Her2+ tumors, which are typically treated with the Her-2 targeting drugs ado-trastuzumab emtansine (T-DM1) and trastuzumab. Radiotherapy (RTx), including stereotactic radiosurgery (SRS), is often utilized to treat BM. A subset of BM patients treated with SRS develops brain edema and radionecrosis (ERN), causing neurological deterioration, functional loss, and rarely death. We have reported an increased rate of ERN in patients treated with T-DM1 and SRS (39.1%), compared to those receiving SRS alone (4.5%). Thus, defining the mechanisms underlying ERN alone or in combination with T-DM1, is critical to reduce life-threatening side effects. While brain edema associated with BM and RTx is often attributed to blood-brain-barrier (BBB) disruption (vasogenic edema), recent studies now identify cytotoxic edema (osmotic cell expansion) as the initial andreversible step in a sequence of changes that leads to ionic edema, vasogenic edema, and ultimately brain swelling and necrosis. Here, we test the hypothesis that RTx alone and in combination with T-DM1 induces cytotoxic edema in astrocytes via upregulation of the water channel Aquaporin 4 (AQP4) and that blockage of cytotoxic edema will decrease ERN. Results: A cohort of BM from Her2+ patients treated with T-DM1/SRS showed enlarged reactive astrocytes expressing high levels of AQP4. To assess the role of astrocytic swelling in ERN, human astrocytes (THV) were treated with increasing doses of RTx and astrocytic cell size was measured 24 h later. A single 8 Gy RTx-dose increased cell size by 4.5 times compared to non-treated astrocytes (1248 ± 760.8 µm2 vs 5685 ± 4475 µm2, P Citation Format: María J Contreras-Zárate, Steven Lai, Priscilla Stumpf, Christine Fisher, Ryan Ormond, Sana D Karam, Peter Kabos, Diana M Cittelly. Mechanisms of radiation-induced brain edema alone and in combination with T-DM1 in Her2+ brain metastases [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-14-20.

OBJECTIVES: We sought to answer the following question: Does educational debt burden affect decisions by emergency medicine residents about whether to pursue academic versus community medicine jobs directly after residency? METHODS: In this observational study, graduating residents across eight emergency medicine residencies were surveyed concurrent with their in‐training examinations over 2 years to assess levels of educational debt and demographic information. Job types chosen by residents upon graduation were obtained from their respective program directors. The impact of debt on type of job chosen was assessed through multivariate logistic regression with demographic controls and program fixed effects, with additional analysis of observed differences by gender. RESULTS: Information was collected on 159 residents from 14 graduating classes across eight programs representing six different states. Residents with higher levels of debt had lower odds of choosing an academic fellowship or faculty position upon graduation (odds ratio [OR] = 0.77, confidence interval [CI] = 0.60 to 0.98). On further analysis, higher debt predicted lower odds of choosing an academic position for men (OR = 0.59, CI = 0.41 to 0.82), but not for women (OR = 1.05, CI = 0.63 to 1.76). CONCLUSIONS: When male emergency medicine residents have higher levels of debt, they are significantly less likely to pursue an academic fellowship or faculty position after residency. This may not be the case for female residents. Results may reflect differences in the factors that affect men and women’s decisions about jobs after residency, which merits further study.

A comprehensive Collision Cross Section (CCS) library was obtained via Travelling Wave Ion Guide mobility measurements through direct infusion (DI). The library consists of CCS and Mass Spectral (MS) data in negative and positive ElectroSpray Ionisation (ESI) mode for 463 and 479 endogenous metabolites, respectively. For both ionisation modes combined, TWCCSN2 data were obtained for 542 non-redundant metabolites. These data were acquired on two different ion mobility enabled orthogonal acceleration QToF MS systems in two different laboratories, with the majority of the resulting TWCCSN2 values (from detected compounds) found to be within 1% of one another. Validation of these results against two independent, external TWCCSN2 data sources and predicted TWCCSN2 values indicated to be within 1–2% of these other values. The same metabolites were then analysed using a rapid reversed-phase ultra (high) performance liquid chromatographic (U(H)PLC) separation combined with IM and MS (IM-MS) thus providing retention time (tr), m/z and TWCCSN2 values (with the latter compared with the DI-IM-MS data). Analytes for which TWCCSN2 values were obtained by U(H)PLC-IM-MS showed good agreement with the results obtained from DI-IM-MS. The repeatability of the TWCCSN2 values obtained for these metabolites on the different ion mobility QToF systems, using either DI or LC, encouraged the further evaluation of the U(H)PLC-IM-MS approach via the analysis of samples of rat urine, from control and methotrexate-treated animals, in order to assess the potential of the approach for metabolite identification and profiling in metabolic phenotyping studies. Based on the database derived from the standards 63 metabolites were identified in rat urine, using positive ESI, based on the combination of tr, TWCCSN2 and MS data.

Spontaneous, atraumatic rupture of the spleen is an uncommon but potentially fatal cause of acute abdominal pain. Splenic abscesses are equally rare and can be a risk factor for spontaneous splenic rupture. We present a 45-year-old man with no past medical or surgical history who presented with acute worsening of left upper abdominal pain that had been present for months, who was discovered to have a ruptured spleen. Splenic abscess was discovered intra-operatively and was thought to have developed after dental work. Recognizing presenting features of spontaneous splenic rupture and understanding its potential causes, such as splenic abscesses, may prevent delayed or missed diagnosis and guide treatment, which typically includes emergent splenectomy.

A metro system is normally designed for an operation life of 100 years or above. Thus, a smart, energy-efficient metro system should be designed to cater for potential changes in passenger flow and passenger comfort needs. In Singapore, the Land Transport Authority (LTA) has put much effort in driving the use of innovative systems and the latest technologies to achieve smart green underground metro stations. This paper provides a brief introduction on the Building and Construction Authority Green Mark Rating and the various energy-saving initiatives that have been implemented recently in Singapore metro stations. More studies and exploration of green design engineering solutions, such as the use of fuel cells to replace the uninterrupted power supplies (UPSs) etc. will be carried out as part of the LTA’s continuous efforts to improve the energy efficiency of its metro station.

Purpose: Patients with human EGFR2-positive (HER2+) breast cancer have a high incidence of brain metastases, and trastuzumab emtansine (T-DM1) is often employed. Stereotactic radiosurgery (SRS) is frequently utilized, and case series report increased toxicity with combination SRS and T-DM1. We provide an update of our experience of T-DM1 and SRS evaluating risk of clinically significant radionecrosis (CSRN) and propose a mechanism for this toxicity. Experimental Design: Patients with breast cancer who were ≤45 years regardless of HER2 status or had HER2+ disease regardless of age and underwent SRS for brain metastases were included. Rates of CSRN, SRS data, and details of T-DM1 administration were recorded. Proliferation and astrocytic swelling studies were performed to elucidate mechanisms of toxicity. Results: A total of 45 patients were identified; 66.7% were HER2+, and 60.0% were ≤ 45 years old. Of the entire cohort, 10 patients (22.2%) developed CSRN, 9 of whom received T-DM1. CSRN was observed in 39.1% of patients who received T-DM1 versus 4.5% of patients who did not. Receipt of T-DM1 was associated with a 13.5-fold (P = 0.02) increase in CSRN. Mechanistically, T-DM1 targeted reactive astrocytes and increased radiation-induced cytotoxicity and astrocytic swelling via upregulation of Aquaporin-4 (Aqp4). Conclusions: The strong correlation between development of CSRN after SRS and T-DM1 warrants prospective studies controlling for variations in timing of T-DM1 and radiation dosing to further stratify risk of CSRN and mitigate toxicity. Until such studies are completed, we advise caution in the combination of SRS and T-DM1.

Author(s): Nadir, Nur-Ain; Hart, Danielle; Cassara, Michael; Noelker, Joan; Moadel, Tiffany; Kulkarni, Miriam; Sampson, Christopher; Bentley, Suzanne; Naik, Neel; Hernandez, Jessica; Krzyzaniak, Sara; Lai, Steven; Podolej, Gregory; Strother, Christopher | Abstract: Introduction: Resident remediation is a pressing topic in emergency medicine (EM) training programs. Simulation has become a prominent educational tool in EM training and been recommended for identification of learning gaps and resident remediation. Despite the ubiquitous need for formalized remediation, there is a dearth of literature regarding best practices for simulation-based remediation (SBR).Methods: We conducted a literature search on SBR practices using the terms “simulation,” “remediation,” and “simulation based remediation.” We identified relevant themes and used them to develop an open-ended questionnaire that was distributed to EM programs with experience in SBR. Thematic analysis was performed on all subsequent responses and used to develop survey instruments, which were then used in a modified two-round Delphi panel to derive a set of consensus statements on the use of SBR from an aggregate of 41 experts in simulation and remediation in EM.Results: Faculty representing 30 programs across North America composed the consensus group with 66% of participants identifying themselves as simulation faculty, 32% as program directors, and 2% as core faculty. The results from our study highlight a strong agreement across many areas of SBR in EM training. SBR is appropriate for a range of deficits, including procedural, medical knowledge application, clinical reasoning/decision-making, communication, teamwork, and crisis resource management. Simulation can be used both diagnostically and therapeutically in remediation, although SBR should be part of a larger remediation plan constructed by the residency leadership team or a faculty expert in remediation, and not the only component. Although summative assessment can have a role in SBR, it needs to be very clearly delineated and transparent to everyone involved.Conclusion: Simulation may be used for remediation purposes for certain specific kinds of competencies as long as it is carried out in a transparent manner to all those involved.

Quantitative biases in the abundance of precursor and product ions due to mass discrimination in RF-only ion guides results in inaccurate collision induced dissociation (CID) spectra. We evaluated the effects of collision cell RF voltage and collision energy on CID spectra using ten singly protonated compounds (46–854 Da) in an orthogonal acceleration time-of-flight mass spectrometer. The relative ion transfer efficiency, i.e. the relative amount of ions transferred through the ion guide at any particular RF voltage was shown to be dependent on the ion’s m/z. We developed an algorithm to correct for the mass discriminating effects of RF voltage on CID spectra. The algorithm was tested for both precursor and product ions at multiple RF voltages and collision energies in order to ensure reliability. Our results suggest that compounds that generate major product ions with m/z values

Background/purpose We studied the correlation between clinical covariates and blood loss under hypotensive anesthesia, in patients undergoing a bilateral vertical ramus osteotomy (BVRO). Materials and methods BVROs were performed on 37 patients with mandibular prognathism. The preoperative and postoperative values of blood constituents were examined and analyzed. Correlations among blood loss, sex, age, operative time, and reduced values of blood constituents were statistically assessed. Results The average operative time was 255.5 ± 42.56 minutes, and blood loss was 105.9 ± 66.83 mL. No patient required a blood transfusion in this study. There were no significant correlations between blood loss and related factors (sex, operative time, and reductions in blood constituents). Comparing sexes, blood loss and reductions in blood constituents exhibited non-significant differences. However, male patients had significantly larger values for presurgical and postsurgical blood constituents than female patients. Conclusion In our study, blood loss was acceptable in patients who underwent a BVRO, and thus, no preoperative autologous blood donation was necessary.

Background/purpose Postoperative skeletal stability is associated with osteotomy design of orthognathic surgery. The purpose of this study was to investigate osteotomy site-related factors of intraoral vertical ramus osteotomy (IVRO) related to skeletal relapse in a 2-year postoperative follow-up. Materials and methods Twenty-seven patients with mandibular prognathism underwent surgical mandibular setback with IVRO. Cephalometric radiographs of the patients were collected after completing preoperative orthodontic treatment (T1), at the stage immediately after surgery (T2), and in the 2-year postoperative follow-up (T3). Pir was located at the posterior most and inferior most ramus point. Io was the inferior most osteotomy point of the mandible. Relapse was defined as forward movement of menton (Me) in the 2-year follow-up. Hierarchical modeling analyses were used to assess changes in the variables, including the amount of postoperative relapse (MeT32), the quantity of surgical setback (MeT21), the available setback horizontal distance (Pir–Io), and the available setback ratio (MeT21/Pir–Io). Results The mean setback of Me was 12.6 mm, and the mean relapse was 0.9 mm (7.1% = 0.9/12.6). In the 1-by-1 and 1-by-2 models, there were no significant differences between the relapse and other variables. However, we found a significant difference in the 1-by-3 model. The MeT21 and MeT21/Pir–Io were significant factors in postoperative relapse. Conclusion We found that multiple factors contributed to postoperative relapse of IVRO. Our study also confirmed the 2-year stability of IVRO in treating mandibular prognathism.

Occidiofungin, a glyco-lipopeptide obtained from the liquid culture of Burkholderia contaminans MS14, has been identified as a novel fungicide. The natural product was shown to have a minimal amount of toxicity in a previous mouse toxicity study following intraperitoneal and subcutaneous administration. In this study, the toxicity of occidiofungin was evaluated following a 5 mg/kg intravenous tail vein injection. In addition, the toxicity of occidiofungin was evaluated against human fibroblast and cancer cell lines. Weight loss was the most significant observation following intravenous administration of occidiofungin. Histology, hematology, and blood serum chemistry did not reveal any significant signs of toxicity. The activity observed in the in vitro cytotoxicity assay against the cancer cell lines was all below 75 nM concentration of occidiofungin. To date, the potency of occidiofungin against these cancer cell lines is greater than any activity observed against fungi. The findings in this study support the need to further evaluate occidiofungin’s chemotherapeutic potential.

This paper reports a new local interconnect structure using Co M0/contact and a Co-Ti amorphous single layer barrier. Good adhesion and low film resistivity were obtained for as-deposited and annealed samples. The metal-oxide-semiconductor samples of Co/Co-Ti/SiO2/p-Si showed a high breakdown voltage and no negative shift of flat band voltage after annealing up to 700 °C for 10 min. The amorphous structure of the Co-Ti layer was maintained throughout annealing and prevented Co diffusion into dielectric. The obtained results indicated that Co-Ti could be a potential candidate to replace conventional local interconnect structure of Ti/TiN.

RATIONALE The determination of the center-of-mass energy at which 50% of a precursor ion decomposes (Ecom50) during collision-induced dissociation (CID) is dependent on the chemical structure of the ion as well as the physical and electrical characteristics of the collision cell. The current study was designed to identify variables influencing Ecom50 values measured on four different mass spectrometers. METHODS Fifteen test compounds were protonated using + ve electrospray ionization and the resulting ions were fragmented across a range of collision energies by CID. Survival yield versus collision energy curves were then used to calculate Ecom50 values for each of these [M+H]+ ions on four different mass spectrometers. In addition, the relative recovery of the [M+H]+ ions of eight compounds ranging in molecular weight from 46 to 854 Da were determined at collision cell radiofrequency (RF) voltages ranging from 0 to 600 V. RESULTS Ecom50 values determined on the four instruments were highly correlated (r2 values ranged from 0.953 to 0.992). Although these overall correlations were high, we found different maximum ion recoveries depending on collision cell RF voltage. High-mass ions had greater recovery at higher collision cell RF voltages, whereas low-mass ions had greater recovery at lower collision cell RF voltages as well as a broader range of ion recoveries. CONCLUSIONS Ecom50 values measured on four different instruments correlated surprisingly well given the differences in electrical and physical characteristics of the collision cells. However, our results suggest caution when comparing Ecom50 values or CID spectra between instruments without correcting for the effects of RF voltage on ion transfer efficiency. Copyright © 2012 John Wiley & Sons, Ltd.

During surgical correction of facial deformities, accurate prediction of the resulting facial profile is important for the patient and the surgeon. The purpose of the present study was to investigate profile changes after surgical treatment of mandibular prognathism. Thirty patients (20 females and 10 males; ages 17–28 years) with mandibular prognathism underwent vertical ramus osteotomy. Preoperative and postoperative cephalograms were analyzed; landmarks were identified and compared. The mean horizontal setback of the pogonion (Pog) was 11.7mm. The setback ratios of labrale inferius (Li)/incision inferius (Ii), labiomental sulcus (Si)/point B, and soft tissue pogonion (PogS)/pogonion (Pog) were 0.98, 0.99, and 0.95, respectively. There were no sex-related changes in soft tissue. These findings indicate that changes in soft tissue closely correlate with the amount of mandibular setback in the horizontal direction. Such information might facilitate more accurate prediction of the outcome of orthognathic surgery.

The objectives of this study were to explore the factors influencing urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels in diesel engine exhaust emission inspectors (inspectors), the association between polycyclic aromatic hydrocarbons (PAHs) exposure and fine particulate matter (PM(2.5)) levels in diesel exhaust particles (DEPs), and the PAHs exposure levels in diesel vehicle emission inspection stations (inspection stations).Twenty-eight inspectors and a control group of thirty-eight individuals matched by age and gender were recruited for this study. Fifteen ambient air samples and eighty-four personal air samples were monitored during 3-day work periods using a repeated-measures study design in each inspection station. Airborne samples were analyzed with a fluorescence detector and by high-performance liquid chromatography. Urinary 8-OHdG was measured in 168 pre- and post-work urine samples from inspectors, and in 38 urine samples from controls.The concentrations of PAHs in DEP(2.5) (PM(2.5) in DEPs) were significantly and positively related to urinary log(10) 8-OHdG levels after adjusting for smoking status and BMI. Statistically, there was a significant correlation between air log(10) PAHs and air log(10) PM(2.5) concentrations in inspectors. Fifteen PAHs compounds within DEP(2.5) revealed the concentrations ranged from 5.18 to 22.93 ng/m(3) in ambient air monitoring and 1.03 to 12.60 ng/m(3) in personal air monitoring.This study is the first to indicate an association between occupational PAHs exposure from DEP(2.5) at an inspection station and an increased excretion of urinary 8-OHdG in inspectors. In addition, this study also found smoking is not a confounder in inspectors exposed to PAHs in DEP(2.5).

The gonial region is coincided with harmonious face and masticatory function. The aims of the present study were to assess changes in the gonial region in patients who had mandibular setback surgery by intraoral vertical ramus osteotomy (IVRO) and to investigate the contributing factors in relation to skeletal relapse.Twenty-one patients with mandibular prognathism were corrected by IVRO. Three cephalometric radiographs were collected from preoperative orthodontic treatment (T1), immediately after surgery (T2), and at 2-year postoperative follow-up (T3). Relapse was defined as forward movement of menton (Me) after the 2-year follow-up. Three angular (SN-Go angle, mandibular plane angle, and gonial angle) and 2 linear (horizontal-Me and vertical-Me) measurements were compared after immediate operation and at the 2-year follow-up. Spearman rank correlation and Student t tests were used for statistical analysis.The mean setback of the Me was 12.7 mm, and the mean relapse was 1.5 mm. The magnitude of setback was not significant for relapse. There were weak correlations between relapse and factors concerned with the gonial region (SN-Go angle, mandibular plane angle, and gonial angle).Surgical correction of mandibular prognathism using IVRO can lead to an increase in the angle changes of gonial region but not correlate to skeletal relapse in long-term follow-up.

The aim of this study was to determine the correlation between pre- and postsurgical loss of blood and blood components among patients undergoing treatment of facial deformities by bilateral parasymphyseal osteotomy (BPsO).The pre- and postoperative values of blood components were determined in 30 facial deformity patients who underwent orthognathic surgery by hypotensive anesthesia. Correlations among the blood loss, sex, age, operation time, and reduced values of blood components were assessed by a correlation matrix. The mean blood loss and operation time were 437.5 (± 52.5) mL and 355.8 (± 209.42) minutes, respectively. Two patients included in this study had required blood transfusion. The mean reduced red blood cell (× 10/μL), hemoglobin (g/dL), and hematocrit (%) were -1.02, -2.98, and -9.18, respectively. There was no significant correlation between blood loss and other related factors (eg, age, operation time, and reduced blood components). All patients, however, showed significantly lower values of blood components after surgery. In conclusion, no significant factor was associated with blood loss and reduced blood components among patients undergoing BPsO. Furthermore, hypotensive anesthesia is a well-accepted method to reduce blood loss during orthognathic surgery.

Quantitative biases in the abundance of precursor and product ions due to mass discrimination in RF-only ion guides results in inaccurate collision induced dissociation (CID) spectra. We evaluated the effects of collision cell RF voltage and collision energy on CID spectra using ten singly protonated compounds (46–854 Da) in an orthogonal acceleration time-of-flight mass spectrometer. The relative ion transfer efficiency, i.e. the relative amount of ions transferred through the ion guide at any particular RF voltage was shown to be dependent on the ion’s m/z. We developed an algorithm to correct for the mass discriminating effects of RF voltage on CID spectra. The algorithm was tested for both precursor and product ions at multiple RF voltages and collision energies in order to ensure reliability. Our results suggest that compounds that generate major product ions with m/z values

Purpose. The aim of this study was to determine the correlation between the pharyngeal airway space and head posture after mandibular setback surgery for mandibular prognathism.Materials and Methods. Serial lateral cephalograms of 37 patients with mandibular prognathism who underwent intraoral vertical ramus osteotomy (IVRO) were evaluated before (T1) and immediately (T2), between 6 weeks and 3 months (T3), and more than 1 year (T4) after surgery. Pairedt-tests and Pearson’s correlation analysis were used to evaluate the postoperative changes in all cephalometric parameters, including the mandible, hyoid, head posture (craniocervical angle), and pharyngeal airway space.Results. The mandible and hyoid were set back by 12.8 mm and 4.9 mm, respectively, at T2. Furthermore, the hyoid showed significant inferior movement of 10.7 mm, with an 8 mm increase in the tongue depth. The upper oropharyngeal airway (UOP) shortened by 4.1 mm, the lower oropharyngeal airway (LOP) by 1.7 mm, and the laryngopharyngeal airway by 2 mm. The craniocervical angle showed a significant increase of 2.8°. UOP and LOP showed a significant correlation with the craniocervical angle at T2 and T4.Conclusions. Our findings conclude that the oropharyngeal airway space is significantly decreased and correlated with a change in the head posture after mandibular setback surgery.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access. Despite recent advances in analytical and computational chemistry, lipid identification remains a significant challenge in lipidomics. Ion-mobility spectrometry provides an accurate measure of the molecules' rotationally averaged collision cross-section (CCS) in the gas phase and is thus related to ionic shape. Here, we investigate the use of CCS as a highly specific molecular descriptor for identifying lipids in biological samples. Using traveling wave ion mobility mass spectrometry (MS), we measured the CCS values of over 200 lipids within multiple chemical classes. CCS values derived from ion mobility were not affected by instrument settings or chromatographic conditions, and they were highly reproducible on instruments located in independent laboratories (interlaboratory RSD < 3% for 98% of molecules). CCS values were used as additional molecular descriptors to identify brain lipids using a variety of traditional lipidomic approaches. The addition of CCS improved the reproducibility of analysis in a liquid chromatography-MS workflow and maximized the separation of isobaric species and the signal-to-noise ratio in direct-MS analyses (e.g., "shotgun" lipidomics and MS imaging). These results indicate that adding CCS to databases and lipidomics workflows increases the specificity and selectivity of analysis, thus improving the confidence in lipid identification compared to traditional analytical approaches. The CCS/accurate-mass database described here is made publicly available. NIH/GM087714 eu-repo/grantAgreement/EC/FP7/232816 Alzheimer's Association/NIRG-11-203674

Objective.To investigate the factors affecting intraoperative hemorrhage and postoperative sequelae after orthognathic surgery.Materials and Methods.Eighty patients with mandibular prognathism underwent surgical mandibular setback with intraoral vertical ramus osteotomy (IVRO). The correlation between the blood loss volume and postoperative VAS with the gender, age, and operating time was assessed using thet-test and Spearman rank correlation coefficient. The correlation between the magnitude of mandibular setback with the presence of TMJ clicking symptoms and lip sensation was also assessed.Results.The mean operating time and blood loss volume for men and women were 249.52 min and 229.39 min, and 104.03 mL and 86.12 mL, respectively. The mean VAS in men and women was 3.21 and 2.93, and 1.79 and 1.32 on the first and second postoperative days. There is no gender difference in the operating time, blood loss, VAS, TMJ symptoms, and lip numbness. The magnitude of mandibular setback was not correlated with immediate and long-term postoperative lip numbness.Conclusion.There are no gender differences in the intraoperative hemorrhage and postoperative sequelae (pain, lip numbness, and TMJ symptoms). In addition, neither symptom was significantly correlated with the amount of mandibular setback.

Exposure to ionizing radiation has dramatically increased in modern society, raising serious health concerns. The molecular response to ionizing radiation, however, is still not completely understood. Here, we screened mouse serum for metabolic alterations following an acute exposure to γ radiation using a multiplatform mass-spectrometry-based strategy. A global, molecular profiling revealed that mouse serum undergoes a series of significant molecular alterations following radiation exposure. We identified and quantified bioactive metabolites belonging to key biochemical pathways and low-abundance, oxygenated, polyunsaturated fatty acids (PUFAs) in the two groups of animals. Exposure to γ radiation induced a significant increase in the serum levels of ether phosphatidylcholines (PCs) while decreasing the levels of diacyl PCs carrying PUFAs. In exposed mice, levels of pro-inflammatory, oxygenated metabolites of arachidonic acid increased, whereas levels of anti-inflammatory metabolites of omega-3 PUFAs decreased. Our results indicate a specific serum lipidomic biosignature that could be utilized as an indicator of radiation exposure and as novel target for therapeutic intervention. Monitoring such a molecular response to radiation exposure might have implications not only for radiation pathology but also for countermeasures and personalized medicine.

Angstrom-level plasma etching precision is required for semiconductor manufacturing of sub-10 nm critical dimension features. Atomic layer etching (ALE), achieved by a series of self-limited cycles, can precisely control etching depths by limiting the amount of chemical reactant available at the surface. Recently, SiO2 ALE has been achieved by deposition of a thin (several Angstroms) reactive fluorocarbon (FC) layer on the material surface using controlled FC precursor flow and subsequent low energy Ar+ ion bombardment in a cyclic fashion. Low energy ion bombardment is used to remove the FC layer along with a limited amount of SiO2 from the surface. In the present article, the authors describe controlled etching of Si3N4 and SiO2 layers of one to several Angstroms using this cyclic ALE approach. Si3N4 etching and etching selectivity of SiO2 over Si3N4 were studied and evaluated with regard to the dependence on maximum ion energy, etching step length (ESL), FC surface coverage, and precursor selection. Sur...