School-Located Vaccine Clinics: An Effective Strategy for Expanding Access to COVID-19 Vaccines in Los Angeles County.

A key component of decreasing severe disease, hospitalizations, and death due to COVID-19 has been increasing vaccine accessibility to residents in communities where access to health care is poor and residents are at increased risk of poor health outcomes. Driven by the expansive geography and diverse population it serves, the Los Angeles County Department of Public Health built an extensive school vaccination network by partnering with the county's roughly 3000 schools and vaccine providers. We report on the process of building this network and its impact on vaccination coverage. We describe a unique equity metric (HPI+) that used a combination of the Healthy Places Index (HPI) and COVID-19 transmission and vaccination data to prioritize school-located vaccination efforts. More than 328 991 doses of COVID-19 vaccine were administered at 1050 schools in Los Angeles County from April 15, 2021, through June 18, 2022. Nearly 10% of all doses administered to children aged 5-11 years in Los Angeles County were at school-located vaccine clinics. Most vaccine clinic days (77.3%) were held at schools in HPI+ zip codes. Most doses (68.3%) were administered in HPI+ regions and to people aged ≥12 years (70.3%). Vaccinating the community at schools is an effective public health intervention; however, increased outreach efforts were required in HPI+ regions to ensure equitable access to vaccines. This case study can be used to replicate public health interventions using schools to support access to health care services for students and the surrounding community.

Active Unilateral Condylar Hyperplasia Treated With Simultaneous Condylectomy and Orthognathic Surgery: A Clinical Report.

PURPOSE: To review and report the demographic and diagnostic data in a population with active unilateral condylar hyperplasia. The surgical intervention, sequencing of surgery, and treatment outcomes, including a quality-of-life survey, are described. MATERIALS AND METHODS: Eighty patients were diagnosed with active disease. Demographic, treatment, and treatment outcomes were assessed. Quality of life was assessed by a 21-question questionnaire. RESULTS: Women were affected more frequently than men (W - 52; 65%; P = .008). Hemimandibular elongation (HE) (49; 61%; P - .004) occurred more frequently than hemimandibular hyperplasia (HH) (24; 30%) and HH-HE (7; 9%). Right side was affected more than left (R - 49; 61%; P - .003) overall, and when stratified. All racial groups were represented. Of the 80 patients in the sample, 80 (100%) underwent condylectomy on the side of active growth, 70 (87%) underwent bimaxillary osteotomies, 53 patients (66%) had single-piece maxillary osteotomies, 17 (21%) underwent segmental maxillary osteotomies, and 38 (48%) genioplasties were performed. Four patients (5%) underwent a second operation within a year of the first surgery to adjust the position of the mandible. Four (5%) facial nerve deficits were recorded. Class I cuspid occlusion was achieved with coincident maxillary and mandibular midlines and resolution of crossbite in 70 (88%) patients. Twenty three of the 24 respondents (96%) reported that they were satisfied with the treatment. CONCLUSIONS: Both HH and HE are diagnosed through clinical and radiographic examinations. Our results showed that HE occurs more frequently, all deformity subclassifications occur more frequently in females, the majority present in adolescence, and all racial groups are affected. The right side predominated. This study suggests that simultaneous condylectomy and orthognathic surgery provides predictable and stable outcomes for patients with active unilateral condylar hyperplasia and associated dentofacial deformities with an improvement in quality of living.

RNA chain length and stoichiometry govern surface tension and stability of protein-RNA condensates.

Proteomic studies have shown that cellular condensates are frequently enriched in diverse RNA molecules, which is suggestive of mechanistic links between phase separation and transcriptional activities. Here, we report a systematic experimental and computational study of thermodynamic landscapes and interfacial properties of protein-RNA condensates. We have studied the affinity of protein-RNA condensation as a function of variable RNA sequence length and RNA-protein stoichiometry under different ionic environments and external crowding. We have chosen the PolyU sequences for RNA and arginine/glycine-rich intrinsically disordered peptide (RGG) for proteins as a model system of RNA-protein condensates, which we then investigate through in vitro microscopy measurements and coarse-grained molecular dynamics simulations. We find that crowding and RNA chain length can have a major stabilizing effect on the condensation. We also find that the RNA-protein charge ratio is a crucial variable controlling stability, interfacial properties, and the reentrant phase behavior of RGG-RNA mixtures.

Massive Exophytic Brown's Tumor of the Bilateral Maxilla with Mandibular Involvement.

ABSTRACT: Brown's tumor is a benign bone lesion that occurs in the setting of hyperparathyroidism and can affect the facial skeleton. It often presents as a single lesion and is usually less than 3 centimeters. To our knowledge, no cases have been reported to have bilateral involvement of the maxilla and mandible with the largest dimension measuring over 7 centimeters. This report describes such a case and provides a review of the literature.

Programmable viscoelasticity in protein-RNA condensates with disordered sticker-spacer polypeptides.

Liquid-liquid phase separation of multivalent proteins and RNAs drives the formation of biomolecular condensates that facilitate membrane-free compartmentalization of subcellular processes. With recent advances, it is becoming increasingly clear that biomolecular condensates are network fluids with time-dependent material properties. Here, employing microrheology with optical tweezers, we reveal molecular determinants that govern the viscoelastic behavior of condensates formed by multivalent Arg/Gly-rich sticker-spacer polypeptides and RNA. These condensates behave as Maxwell fluids with an elastically-dominant rheological response at shorter timescales and a liquid-like behavior at longer timescales. The viscous and elastic regimes of these condensates can be tuned by the polypeptide and RNA sequences as well as their mixture compositions. Our results establish a quantitative link between the sequence- and structure-encoded biomolecular interactions at the microscopic scale and the rheological properties of the resulting condensates at the mesoscale, enabling a route to systematically probe and rationally engineer biomolecular condensates with programmable mechanics.

Nanoparticles for protein delivery in planta.

Delivery of proteins into walled plant cells remains a challenge with few tractable solutions. Recent advances in biomacromolecule delivery using nanotechnology may evince methods to be exploited for protein delivery. While protein delivery remains no small feat, even in mammalian systems, the ability for nanoparticles to penetrate the cell wall and be decorated with a plethora of functional moieties makes them ideal protein vehicles in plants. As advances in protein biotechnology accelerate, so does the need for commensurate delivery systems. However, the road to nanoparticle-mediated protein delivery is fraught with challenges in regard to cell wall penetration, intracellular delivery, endosomal escape, and nanoparticle chemistry and design. The dearth of literature surrounding protein delivery in walled plant cells hints at the challenge of this problem but also indicates vast opportunity for innovations in plant-tailored nanotechnology.

Modified Carnoy's Compared to Carnoy's Solution Is Equally Effective in Preventing Recurrence of Odontogenic Keratocysts.

PURPOSE: Carnoy's solution (CS), the gold standard for adjunctive chemical cautery in treatment of odontogenic keratocysts (OKCs), has been banned for 7 years, leading to substitution with the non-chloroform containing modified Carnoy's solution (MC) without data to support its effectiveness. We performed this study to compare the earlier data with CS to the more current outcomes with MC. METHODS: A retrospective cohort study was conducted on patients diagnosed with OKC and treated by a single surgeon (GHB) with enucleation and curettage (EC), peripheral ostectomy, and application of CS or MC. The primary predictor variables were use of CS or MC. The primary outcome variables were recurrence (yes vs. no) and time to recurrence. Secondary variables included demographics, anatomic location, and whether teeth adjacent to the lesion were extracted. Statistical analyses included chi-squared test/Fisher's exact test, Wilcoxon rank sum test, and Kaplan-Meier curves. RESULTS: 77 patients, 36 patients in the CS group and 41 in the MC group, met inclusion criteria, including at least 1 year of follow-up time. Characteristics of the groups were similar: median age 41.5 and 46, 61% and 71% male gender, 81% and 90% posterior, and 64% and 50% mandibular lesions, respectively. Overall recurrence was similar, 14.29%, with 5 (13.9%) recurrences in the CS group and 6 (14.6%) in the MC group (P = 0.92). Median time to recurrence was 24 months for both groups. Preserving adjacent teeth was associated with a significant increase in recurrence (P = 0.0036). CONCLUSION: Based on this comparison of retrospective outcome data, we found no significant difference in recurrence rate or distribution of time to recurrence between OKCs treated with CS or MC. Aggressiveness of surgical technique is likely a predictive factor in recurrence rate. Future studies should focus on prospective studies and continuing follow-up of the MC group.

Ligand structure and adsorption free energy of nanocrystals on solid substrates.

We present an investigation on the absorption of alkylthiolated nanocrystals on a solid substrate. We calculate adsorption free energies and report a number of effects induced by the substrate. Nearest neighbor distances and bonding free energies are significantly different than for a free floating case, there is a weakening of bonding free energies among nanocrystals, and the adsorption is manifestly anisotropic, i.e., stronger along certain directions of the nanocrystal core. We contend that this last result accounts for the Bain transition (fcc → bcc) observed in experimental results. We report the presence of vortices induced by the substrate, which explain the increased nearest neighbor distance among nanocrystals, which is in excellent quantitative agreement with experimental results and with the predictions of the Orbifold Topological Model. Implications for the assembly of nanostructures and future experiments are also discussed.

Wound Healing Complications After Cranial Vault Reconstruction for Craniosynostosis.

Craniosynostosis is a congenital cranial malformation involving premature fusion of cranial sutures. Indications for surgical repair of craniosynostosis include elevation of intracranial pressure, which can result in impaired vision and mental disability, as well as correction of abnormal skull shape. Resorbable plating systems have become the preferred technique for bony fixation in the repair of craniosynostosis. Multiple studies demonstrate the safety and low complication rate of resorbable plating systems.However, there is no consensus on which plating system is superior for patient outcomes. This study aims to investigate how the polymer composition of resorbable plating systems utilized in cranial vault reconstruction contributes to wound healing complications. A retrospective chart review was performed at the institution between January 1, 2005 and December 31, 2015. About 202 patients who underwent surgical repair of craniosynostosis were identified. The results showed that patients receiving the Biomet Lactosorb plating system were over twice as likely to have a wound complication within a year of surgery compared to other plating systems used at the institution. Wound complications continued to occur in the Biomet Lactosorb group at ≥180 days after surgery, whereas complications among the other plating systems occurred ≤80 days postoperatively. Half of all patients with wound complications had to undergo reoperation. These data demonstrate the effect of unique polymer compositions on wound healing, and will help to guide future clinical practice and industry development of resorbable plating systems.

Severe bleeding from a duodenal ulcer after orthognathic surgery: a case report.

Chronic non-steroidal anti-inflammatory drug use is strongly associated with peptic ulcer disease, and corticosteroid use has also been cited as a risk factor. Both are frequently prescribed for short courses after orthognathic surgery to minimize edema. It appears that no cases of severe bleeding from a duodenal ulcer have been reported during the postoperative period after orthognathic surgery. This case describes a patient who experienced this severe bleeding despite having no risk factors.

Trends in U.S. Community hospitalizations due to herpes zoster: 2001-2015.

BACKGROUND: In 2007, based on decisions by the U.S. Advisory Committee on Immunization Practices, the CDC recommended a booster dose at 4-6 years in the varicella vaccine schedule. In 2008, a herpes zoster vaccine was recommended for use in persons age ≥60 years. The purpose of this study was to examine trends in herpes zoster hospitalization rates and assess the impact of both policy recommendations using U.S. hospital discharge data. METHODS: Nationwide Inpatient Sample discharge data from 2001 to 2015 were used to identify primary or secondary herpes zoster diagnoses. Trends in annual total and age-specific herpes zoster hospitalization rates and average length of stay were examined. Average annual rates for the pre (2001-2005) and post (2012-2015)-zoster vaccine policy eras were compared. Absolute change in herpes zoster hospitalizations were calculated. RESULTS: The rate difference of U.S. herpes zoster hospitalizations in the post vs. pre-zoster vaccine policy era was -1.9 per 100,000 population (6,200 fewer hospitalizations in 2015 than expected). Key age group rate differences: 0-3 years (-0.4 per 100,000; 50 fewer), 4-6 years (-0.6 per 100,000; 50 fewer), 7-14 years (-1.3 per 100,000; 400 fewer), 50-59 years (0.7 per 100,000; 300 more), 60-69 years (-2.5 per 100,000; 900 fewer), 70-79 years (-10.2 per 100,000; 2,000 fewer), 80+ years (-29.9 per 100,000; 3,600 fewer). CONCLUSIONS: Reduction of wild-type varicella due to the 2-dose varicella vaccination recommendation may have impacted declining herpes zoster hospitalization rates among children ≤14 years. The 2008 herpes zoster vaccine may have impacted declining herpes zoster hospitalization rates for adults age ≥60 years despite vaccination coverage <31% by 2015.

A multimodal analgesic protocol may reduce opioid use after third molar surgery: A pilot study.

OBJECTIVE: This study was designed to assess the number of opioid doses available to patients from filled prescriptions after adoption, in 2017, of a multimodal analgesic protocol that included opioid prescribing to manage postoperative pain. STUDY DESIGN: Data were retrieved from records of the first 24 patients having third molar surgery in 2017 identified from appointment schedules. Inclusion criteria were American Society of Anesthesiologists risk classification I or II, age 18 to 35 years, and at least 2 lower third molars removed. The exclusion criterion was being treated for opioid addiction/abuse. The primary outcome variable was the number of opioid doses filled by prescriptions at each patient's discretion. The primary predictor variable was the multimodal analgesic protocol. RESULTS: Data from records of 24 consecutive patients were analyzed; 83% were females. Median age was 25 years (interquartile range [IQR] 12-29 years). Median surgery time was 35 minutes (IQR 27-32 minutes). The median number of opioid doses filled in 2017 was 4 (IQR 0-4). CONCLUSIONS: The outcomes from this pilot study suggest that implementation of a multimodal analgesic protocol to manage postoperative pain, while limiting the number of opioid doses available to the patient, may be an effective strategy for a wider range of patients and procedures.