Numerical analysis of aerodynamic performance of the Ram Air Turbine in an aircraft.

A rotor design of a Ram Air Turbine (RAT) for a commercial aircraft was created taking three sections with different airfoils along the blade; those sections were assessed to evaluate their performance at different critical velocities (41, 81 and 251 m/s) and choose the best profile configuration generating a new proposal to increase the glide ratio by reducing the drag, which is helpful in emergency cases. The Blade Element Momentum (BEM) theory and Computational Fluid Dynamics (CFD) were used to analyze an initial design, then validating these results with the open software QBlade. For the BEM theory a program was created for the design and performance of the RAT adding the Viterna methodology for airfoil analysis. 16 designs were proposed by strategically interchanging wing profiles in different blade sections. These designs were analyzed by CFD, using the complete rotor and the S S T k - ω turbulence model. An optimal geometry was found, presenting a significant drag reduction of 25% generating an increase in the glide ratio and improving aircraft control in addition to maintaining the power generation above the desired values; therefore, it recommends using different airfoils for each section of a RAT's rotor blade.

Whole genome sequencing of a family with autosomal dominant features within the oculoauriculovertebral spectrum.

Background: Oculoauriculovertebral Spectrum (OAVS) encompasses a wide variety of anomalies on derivatives from the first and second pharyngeal arches including macrostomia, hemifacial microsomia, micrognathia, preauricular tags, ocular and vertebral anomalies. We present the genetic findings of a large three-generation family with multiple members affected with macrostomia, preauricular tags and uni- or bilateral ptosis following an autosomal dominant segregation pattern. Methods: We generated whole genome sequencing data for the proband, affected parent and unaffected paternal grandparent followed by Sanger sequencing on 23 family members for the top 10 candidate genes: KCND2, PDGFRA, CASP9, NCOA3, WNT10A, SIX1, MTF1, KDR/VEGFR2, LRRK1, and TRIM2. We performed parent and sibling-based transmission disequilibrium tests and burden analysis to explore segregation and burden of candidate gene mutations. Bioinformatic analyses investigated the biological connection between genes and the abnormal phenotypes. Results: Overall, rare missense mutations in SIX1, KDR/VEGFR2, and PDGFRA showed the best evidence of segregation with the OAV phenotypes in this family. When considering affection with any of the 3 OAVS phenotypes as an outcome, parent-TDTs and sib-TDTs (unadjusted p-values) found that SIX1 (p=0.025, p=0.052), followed by PDGFRA (p=0.180, p=0.069) and KDR/VEGFR2 (p=0.180, p=0.069) have the strongest associations in this family. Burden analysis via a penalized linear mixed model identified SIX1 (RC=0.87) and PDGFRA (RC=0.98) as having the strongest association with OAVS severity. Using phenotype-specific ogfrautcomes, sib-TDTs identified associations between (1) SIX1 with uni- or bilateral ptosis (p=0.049) and ear tags (p=0.01), (2) PDGFRA and KDR/VEGFR2 with ear tags (both p<0.01). Conclusion: Our study reports the genomic findings of a large family with multiple individuals affected with OAVS phenotypes with autosomal dominant inheritance. Our findings narrow down to three potential candidate genes, SIX1, PDGFRA, and KDR/VEGFR2. Among these, SIX1 has been previously associated with OAVS ear malformations and it is co-expressed with EYA1 during ear development. Attempts to strengthen the genotype-phenotype co-relation underlying the OAVS of phenotypes are essential to discover the etiological factors leading to this complex and burdensome condition as well as for family counseling and prevention efforts.

DNA methylation differences in monozygotic twins with Van der Woude syndrome.

Introduction: Van der Woude Syndrome (VWS) is an autosomal dominant disorder responsible for 2% of all syndromic orofacial clefts (OFCs) with IRF6 being the primary causal gene (70%). Cases may present with lip pits and either cleft lip, cleft lip with cleft palate, or cleft palate, with marked phenotypic discordance even among individuals carrying the same mutation. This suggests that genetic or epigenetic modifiers may play additional roles in the syndrome's etiology and variability in expression. We report the first DNA methylation profiling of 2 pairs of monozygotic twins with VWS. Our goal is to explore epigenetic contributions to VWS etiology and variable phenotypic expressivity by comparing DNAm profiles in both twin pairs. While the mutations that cause VWS in these twins are known, the additional mechanism behind their phenotypic risk and variability in expression remains unclear. Methods: We generated whole genome DNAm data for both twin pairs. Differentially methylated positions (DMPs) were selected based on: (1) a coefficient of variation in DNAm levels in unaffected individuals < 20%, and (2) intra-twin pair absolute difference in DNAm levels >5% (delta beta > | 0.05|). We then divided the DMPs in two subgroups for each twin pair for further analysis: (1) higher methylation levels in twin A (Twin A > Twin B); and (2) higher methylation levels in twin B (Twin B >Twin A). Results and Discussion: Gene ontology analysis revealed a list of enriched genes that showed significant differential DNAm, including clef-associated genes. Among the cleft-associated genes, TP63 was the most significant hit (p=7.82E-12). Both twin pairs presented differential DNAm levels in CpG sites in/near TP63 (Twin 1A > Twin 1B and Twin 2A < Twin 2B). The genes TP63 and IRF6 function in a biological regulatory loop to coordinate epithelial proliferation and differentiation in a process that is critical for palatal fusion. The effects of the causal mutations in IRF6 can be further impacted by epigenetic dysregulation of IRF6 itself, or genes in its pathway. Our data shows evidence that changes in DNAm is a plausible mechanism that can lead to markedly distinct phenotypes, even among individuals carrying the same mutation.

Evaluación del desempeño de una celda de combustible microbiana con electrodo de grafito modificado para el tratamiento de agua residual del procesamiento del café / Evaluation of the performance of a microbial fuel cell with modified graphite electrode for the treatment of wastewater from coffee processing / Avaliação do desempenho de uma célula combustível microbial com eletrodo de grafite modificado para o tratamento de águas residuais do processamento de café

Resumen La actividad cafetalera en Costa Rica procesa aproximadamente 69.000 toneladas de café mediante la técnica de beneficiado húmedo. Esta actividad conlleva un alto impacto ambiental debido a la generación de8Lde agua residual/kg de café oro producido. El presente trabajo tiene como objetivo utilizar el agua residual del procesamiento de café como sustrato en celdas combustibles microbianas (CCM), con el propósito de generar energía eléctrica a través de su uso y, a la vez, disminuir la carga orgánica del residuo. La CCM empleó un cátodo modificado con ftalocianinas de hierro (FePc), generó una eficiencia coulómbica de 0,7% y una densidad de potencia de 89 UW/ cm2 en un ciclo de operación de cinco días. Además, se determinó que la CCM disminuye la demanda química de oxígeno (DQO) del residuo hasta en 27% bajo las condiciones de operación nativas del sustrato, a temperatura ambiente, sin mediadores químicos para la reacción anódica y con el uso de electrodos de platino para el cátodo. El estudio confirma la oportunidad de emplear el sustrato con una flora microbiana nativa apta para la operación de la tecnología de la CCM, y así perfilar el dispositivo como una opción novedosa para el tratamiento de este residuo en Costa Rica.

Abstract In Costa Rica coffee production is the most traditional agroindustrial activity, each year approximately 69,000 tons of coffee are processed through the technique of wet processing. The process has a high environmental impact since it generates eight liters of wastewater/kg of produced coffee. Consequently, the main goal of this research was to evaluate the electric generation of a Microbial Fuel Cell (MFC) with two chambers, using coffee wastewater as a substrate, which would generate a sustainable solution with an added economic value to this waste in Costa Rica. The MFC with a cathode modified with iron phthalocyanines (FePc) generated a coulombic efficiency of 0.7% and a power density of 89 -uW/cm2 in a 5-day operation cycle. In addition, it was determined that the MFC decreases the COD of the waste by up to 27% under native substrate conditions, without the use of high temperatures, or chemical mediators for the anodic reaction and platinum electrodes for the cathode chamber. The efficiency of the device can be improved with changes at design level that reduce the ohmic internal resistance and improve electrical generation, the study confirms the potential of the substrate with a native microorganism suitable for the use of MFC technology, shaping the device as a novelty option for the treatment of the waste in Costa Rica.

Resumo A indústria do café na Costa Rica processa cerca de 69 000 toneladas de café por meio da técnica de moagem úmida, o que acarreta um alto impacto ambiental devido à geração de 8 L de água residual / kg de café dourado. O objetivo deste trabalho era usar águas residuais do processamento do café como substrato em Células de Combustível Microbianas (CCM) a fim de gerar energia elétrica por meio do seu aproveitamento e ao mesmo tempo reduzir a carga orgânica do resíduo. CCM usando cátodo modificado com ftalocianinas de ferro (FePc) gerou uma eficiência coulômbica de 0,7% e uma densidade de potência de 89 uW/cm2 em um ciclo operacional de cinco dias. Além disso, foi determinado que o CCM reduz a Demanda Química de Oxigénio (DQO) do resíduo em até 27% nas condições nativas de operação do substrato, à temperatura ambiente, sem mediadores químicos para a reação anódica e com a utilização de eletrodos de platina para o cátodo. O estudo confirma a oportunidade de utilizar o substrato com flora microbiana nativa adequada para o funcionamento da tecnologia CCM e, assim, delinear o dispositivo como uma nova opção para o tratamento desses resíduos na Costa Rica.

The role of ageing in the wish to be dead: disentangling age, period and cohort effects in suicide ideation in European population.

AIMS: To investigate potential age, period and birth cohort effects in the prevalence of suicide ideation in European ageing population. METHODS: A total of 50 782 community-dwelling adults (aged + 50) from 20 different European countries were collected in the Survey Health Ageing and Retirement study. A multilevel logistic regression model of repeated measures was modelled to assess the effects of age and other variables, including the variability of observations over three levels: birth cohort groups, time period assessment and individual differences. RESULTS: The larger effect of variability was attributed to individual-level factors (57.8%). Youngest-old people (65-79 years) showed lower suicide ideation than middle-aged people (50-64 years). No significative differences were found for suicide ideation between middle-aged people and oldest-old (80 + years). Only 0.85% and 0.13% of the total variability of suicide ideation accounted for birth cohort and period effects, respectively. Cohorts born between 1941 and 1944 possessed the lowest estimates of suicide ideation. Conversely, suicide ideation started to rise with post-War generations and reached a significant level for people born from 1953-1957 to 1961-1964. Regarding the time period, participants assessed in 2006-2007 showed a lower likelihood of suicide ideation. The rest of the cohorts and period groups did not show any significant effect on the prevalence of suicide ideation. CONCLUSIONS: Our results suggest that age and suicide ideation relationship is not linear in middle and older age. The European Baby boomers born from 50s to mid-60s might report higher suicide ideation than their ancestors. This scenario would imply a greater need for mental healthcare services for older people in the future.

On the (in)efficacy of motor imagery training without feedback and event-related desynchronizations considerations.

Motor imagery (MI) constitutes a recurrent strategy for signals generation in brain-computer interfaces (BCIs) - systems that aim to control external devices by directly associating brain responses to distinct commands. Although great improvement has been achieved in MI-BCIs performance over recent years, they still suffer from inter- and intra-subject variability issues. As an attempt to cope with this, some studies have suggested that MI training should aid users to appropriately modulate their response for BCI usage: generally, this training is performed based on the sensorimotor rhythms' modulation over the primary sensorimotor cortex (PMC), with the signal being feedbacked to the user. Nonetheless, recent studies have revisited the actual involvement of the PMC into MI, and little to no attention has been devoted to understanding the participation of other cortical areas into training protocols. Therefore, in this work, our aim was to analyze the response induced by hands MI of 10 healthy subjects in the form of event-related desynchronizations (ERDs) and to assess whether features from beyond the PMC might be useful for hands MI classification. We investigated how this response occurs for distinct frequency intervals between 7-30 Hz, and ex0plored changes in their evocation pattern across 12 MI training sessions without feedback. Overall, we found that ERD patterns occur differently for the frequencies encompassed by the µ and ß bands, with its evocation being favored for the first band. Over time, the no-feedback approach was inefficient to aid in enhancing ERD evocation (EO). Moreover, to some extent, EO tends to decrease over blocks within a given run, and runs within an MI session, but remains stable within an MI block. We also found that the C3/C4 pair is not necessarily optimal for data classification, and both spectral and spatial subjects' specificities should be considered when designing training protocols.

Sublethal effect of Abamectin in the functional response of the predator Phytoseiulus persimilis (Athias-Henriot) on Tetranychus urticae (Koch) (Acari: Phytoseiidae, Tetranychidae) / Efeito subletal da Abamectina na resposta funcional do predador Phytoseiulus persimilis (Athias-Henriot) em Tetranychus urticae (Koch) (Acari: Phytoseiidae, Tetranychidae)

Abstract The biological control used for the control of Tetranychus urticae (Koch) is the predator mite Phytoseiulus persimilis (Athias-Henriot). It is important to the know the effects of acaricides on the biological behavior the Abamectin on the functional response of P. persimilis. The functional response of the predator was of type II exposed to concentration of Abamectin, the functional response parameters: successful attack rate (a'), handling time (Th), search efficiency and the maximum predation theory (T/Th) were affected by the acaricide. The predator spends more time in persecute, dominate, consume and prepair it self to the next searching comparing with the proof subject an the predation ability was affected.

Resumo O controle biológico utilizado para o controle de Tetranychus urticae (Koch) é o acaro predador Phytoseiulus persimilis (Athias-Henriot). É importante conhecer os efeitos dos acaricidas sobre o comportamento biológico do predador. Foi avaliado o efeito tóxico de a Abamectina na resposta funcional de P. persimilis. A resposta funcional do predador foi tipo II exposta a concentrações subletais de Abacmetina, os parâmetros da resposta funcional: taxa de ataque (a'), tempo de manipulação (Th), a eficiência na procura e predação teórica máxima (T/Th) foram afetados pelo acaricida. O predador passa mais tempo na procura, dominar, consumir e se preparar para a próxima procura em comparação com a testemunha e sua capacidade de predação foi afetada.

Sublethal effect of Abamectin in the functional response of the predator Phytoseiulus persimilis (Athias-Henriot) on Tetranychus urticae (Koch) (Acari: Phytoseiidae, Tetranychidae).

The biological control used for the control of Tetranychus urticae (Koch) is the predator mite Phytoseiulus persimilis (Athias-Henriot). It is important to the know the effects of acaricides on the biological behavior the Abamectin on the functional response of P. persimilis. The functional response of the predator was of type II exposed to concentration of Abamectin, the functional response parameters: successful attack rate (a'), handling time (Th), search efficiency and the maximum predation theory (T/Th) were affected by the acaricide. The predator spends more time in persecute, dominate, consume and prepair it self to the next searching comparing with the proof subject an the predation ability was affected.

Rare and Common Variants Conferring Risk of Tooth Agenesis.

We present association results from a large genome-wide association study of tooth agenesis (TA) as well as selective TA, including 1,944 subjects with congenitally missing teeth, excluding third molars, and 338,554 controls, all of European ancestry. We also tested the association of previously identified risk variants, for timing of tooth eruption and orofacial clefts, with TA. We report associations between TA and 9 novel risk variants. Five of these variants associate with selective TA, including a variant conferring risk of orofacial clefts. These results contribute to a deeper understanding of the genetic architecture of tooth development and disease. The few variants previously associated with TA were uncovered through candidate gene studies guided by mouse knockouts. Knowing the etiology and clinical features of TA is important for planning oral rehabilitation that often involves an interdisciplinary approach.

Portable objective assessment of upper extremity motor function in Parkinson's disease.

INTRODUCTION: Objective, portable measures of motor function for out-of-office assessments are needed in Parkinson's Disease (PD). This study had 3 objectives. First, to examine change in objective motor measurements in PD (as assessed with the Objective PD Measurement (OPDM) system). Second, to correlate objective measures with clinical features and putative PD cerebrospinal fluid (CSF) and dopaminergic imaging biomarkers. Third, to assess participant compliance with and perceptions of serial in-home motor assessments. METHODS: De novo PD subjects participating in this pilot study of the Parkinson Progression Markers Initiative (PPMI) completed OPDM assessments at home weekly for 3 months and in the clinic at baseline and 3-, 6-, and 12-months. Tasks included (i)digitography (ii)a repetitive hand tapping task and (iii)timed pegboard task. A global objective motor score (OMS) was derived from the latter three. MDS-UPDRS-III score was obtained at each time point, and CSF and dopamine transporter (DAT) SPECT at baseline. RESULTS: 27 participants, mean age 62.6 years, 19 male were included. A mean of 10.5 in-home assessments were completed. There was no significant change in in-home OMS over 12 weeks (p = 0.48). There was strong correlation between mean baseline OMS and MDS-UPDRS-III scores (spearman's rho = 0.60, p=<0.0001). Baseline OMS predicted 6-month MDS-UPDRS-III (ß = 0.80, p = 0.0002) but not change in MDS-UPDRS-III score, DAT SPECT, or putative CSF biomarkers. CONCLUSIONS: This study suggests that administration of in-home motor tasks as part of a large multi-center study is feasible and scores derived from these assessments may serve as surrogates of in-person clinician-assessed motor score.

A Population-Based Study of Effects of Genetic Loci on Orofacial Clefts.

Prior genome-wide association studies for oral clefts have focused on clinic-based samples with unclear generalizability. Prior samples were also small for investigating effects by cleft type and exclusively studied isolated clefts (those occurring without other birth defects). We estimated the effects of 17 top loci on cleft types in both isolated and nonisolated cases in the largest consortium to date of European-descent population-based studies. Our analytic approach focused on a mother-child dyad case-control design, but it also allowed analyzing mother-only or child-only genotypes to maximize power. Our total sample included 1,875 cases with isolated clefts, 459 cases with nonisolated clefts, and 3,749 controls. After correcting for multiple testing, we observed significant associations between fetal single-nucleotide polymorphisms (SNPs) at IRF6, PAX7, 8q21.3, 8q24, KIAA1598-VAX1, and MAFB and isolated cleft lip only (CLO) and cleft lip and palate (CLP). Significant associations were observed between isolated CLO and fetal SNPs near TPM1 and NOG1 and between CLP and fetal SNPs at ABCA4-ARHGAP29, THADA, FOXE1, and SPRY2. Overall, effects were similar for isolated CLO and CLP, except for ABCA4-ARHGAP29. A protective effect was observed for the fetal NOG1 SNP on cleft palate only, opposite in direction to the effect on CLO. For most fetal SNPs, a dose-response allelic effect was observed. No evidence of parent-of-origin or maternal genome effects was observed. Overall, effect direction and magnitude were similar between isolated and nonisolated clefts, suggesting that several loci are modifiers of cleft risk in both isolated and nonisolated forms. Our results provide reliable estimates of the effects of top loci on risks of oral clefts in a population of European descent.

Dental Decay Phenotype in Nonsyndromic Orofacial Clefting.

Although children with oral clefts have a higher risk for dental anomalies when compared with the general population, prior studies have shown conflicting results regarding their dental decay risk. Also, few studies have assessed dental decay risk in unaffected relatives of children with clefts. Thus, the question of increased risk of dental decay in individuals with oral clefts or their unaffected relatives is still open for empirical investigation. This study characterizes dental decay in the largest international cohort to date of children with nonsyndromic clefts and their relatives, as compared with controls, and it addresses whether families with oral clefts have a significantly increased risk for dental decay versus the general population. A total of 3,326 subjects were included: 639 case probands, 1,549 unaffected relatives, and 1,138 controls. Decay was identified from in-person dental examinations or intraoral photographs. Case-control differences were tested with regression analysis. No significant differences were shown in percentage decayed and filled teeth and decayed teeth in the primary dentition (dft, dt) and permanent dentition (DFT, DT) in cases versus controls. In the cleft region, no significant differences were seen in primary or permanent decay (dt, DT) when compared with controls. No difference was found with regard to cleft type and percentage dft, dt, DFT, and DT in case probands. Nonsignificant differences were found in unaffected siblings and parents versus controls (primary and permanent dentitions). Collectively, these findings indicate that individuals with nonsyndromic oral clefts and their families do not have a higher dental decay risk as compared with the general population. These results suggest that either genetic or environmental factors underlying a higher susceptibility for dental anomalies do not increase caries risk or that the seemingly higher risk for dental decay associated with increased dental anomalies in case probands may be superseded by possible greater access to dental care.

Sublethal effect of Abamectin in the functional response of the predator Phytoseiulus persimilis (Athias-Henriot) on Tetranychus urticae (Koch) (Acari: Phytoseiidae, Tetranychidae)

Abstract The biological control used for the control of Tetranychus urticae (Koch) is the predator mite Phytoseiulus persimilis (Athias-Henriot). It is important to the know the effects of acaricides on the biological behavior the Abamectin on the functional response of P. persimilis. The functional response of the predator was of type II exposed to concentration of Abamectin, the functional response parameters: successful attack rate (a), handling time (Th), search efficiency and the maximum predation theory (T/Th) were affected by the acaricide. The predator spends more time in persecute, dominate, consume and prepair it self to the next searching comparing with the proof subject an the predation ability was affected.

Resumo O controle biológico utilizado para o controle de Tetranychus urticae (Koch) é o acaro predador Phytoseiulus persimilis (Athias-Henriot). É importante conhecer os efeitos dos acaricidas sobre o comportamento biológico do predador. Foi avaliado o efeito tóxico de a Abamectina na resposta funcional de P. persimilis. A resposta funcional do predador foi tipo II exposta a concentrações subletais de Abacmetina, os parâmetros da resposta funcional: taxa de ataque (a'), tempo de manipulação (Th), a eficiência na procura e predação teórica máxima (T/Th) foram afetados pelo acaricida. O predador passa mais tempo na procura, dominar, consumir e se preparar para a próxima procura em comparação com a testemunha e sua capacidade de predação foi afetada.

Psychosocial well-being of parents of children with oral clefts.

BACKGROUND: Parents of children with oral clefts may be impacted psychosocially in several ways, but empirical evidence remains relatively sparse. The aim of this study was to identify predictors of psychosocial well-being of parents of affected children. METHODS: The study included a total sample of 287 parents (171 mothers and 116 fathers) of children with oral clefts. Parents completed validated psychosocial instruments to measure social avoidance and distress, fear of negative evaluation scale, self-esteem and interpersonal support. Regression analysis was used to evaluate how selected child, parent and household characteristics relate to psychosocial outcomes focusing on child's cleft type, sex and age, differences between mothers and fathers, marital status and household income. RESULTS: Fathers had higher self-esteem than mothers (P = 0.01) and lower concern of being negatively judged by others (P < 0.0001) but also had lower perception of having someone to talk to about their problems (P = 0.01). High household income was associated with greater self-esteem and perception of social support (<0.05). Parents of male affected children had greater perception of social support than parents of female affected children (P = 0.04). No significant differences in parental psychosocial status measures were found by cleft type. Similarly, there is little evidence of changes with child age, except for an increase in parental distress and decline in self-esteem during mid-adolescence (age 15-17 years). CONCLUSIONS: The results indicate that mothers and fathers of children with oral clefts may differ in their psychosocial adjustment and that mothers may overall experience more psychosocial problems than fathers. Also, parents from less wealthy households may be at greater risk. Parental psychosocial status should be considered in holistic family-based treatment approaches to reduce burden on affected families and improve their well-being.

Spectrum of Dental Phenotypes in Nonsyndromic Orofacial Clefting.

Children with oral clefts show a wide range of dental anomalies, adding complexity to understanding the phenotypic spectrum of orofacial clefting. The evidence is mixed, however, on whether the prevalence of dental anomalies is elevated in unaffected relatives and is mostly based on small samples. In the largest international cohort to date of children with nonsyndromic clefts, their relatives, and controls, this study characterizes the spectrum of cleft-related dental anomalies and evaluates whether families with clefting have a significantly higher risk for such anomalies compared with the general population. A total of 3,811 individuals were included: 660 cases with clefts, 1,922 unaffected relatives, and 1,229 controls. Dental anomalies were identified from in-person dental exams or intraoral photographs, and case-control differences were tested using χ(2) statistics. Cases had higher rates of dental anomalies in the maxillary arch than did controls for primary (21% vs. 4%, P = 3 × 10(-8)) and permanent dentitions (51% vs. 8%, P = 4 × 10(-62)) but not in the mandible. Dental anomalies were more prevalent in cleft lip with cleft palate than other cleft types. More anomalies were seen in the ipsilateral side of the cleft. Agenesis and tooth displacements were the most common dental anomalies found in case probands for primary and permanent dentitions. Compared with controls, unaffected siblings (10% vs. 2%, P = 0.003) and parents (13% vs. 7%, P = 0.001) showed a trend for increased anomalies of the maxillary permanent dentition. Yet, these differences were nonsignificant after multiple-testing correction, suggesting genetic heterogeneity in some families carrying susceptibility to both overt clefts and dental anomalies. Collectively, the findings suggest that most affected families do not have higher genetic risk for dental anomalies than the general population and that the higher prevalence of anomalies in cases is primarily a physical consequence of the cleft and surgical interventions.

Phenotype-genotype correlations of facial width and height proportions in patients with Class II malocclusion.

OBJECTIVES: To characterize soft-tissue facial height and width variation in Class II malocclusion and test for correlations with genes HMGA2, AJUBA, and ADK. SETTING AND SAMPLE POPULATION: Nine facial proportions were estimated from 2D frontal repose photographs of 330 Caucasian adults with Class II malocclusion. MATERIAL AND METHODS: After adjustments for age and gender, the facial proportions were submitted to a principal component analyses (PCA). The most meaningful phenotypic variations were correlated with SNPs rs7924176 (ADK), rs17101923 (HMGA2), and rs997154 (AJUBA) genotyped in 106 individuals. RESULTS: Principal component analyses resulted in four principal components (PCs), which explained 75% of total variation. PC1 captured variation in the intercanthus distance and explained 28% of total variation. PC2 explained 21% of the variations in facial taper and facial index. PC3 explained 14% and reflected variations in the vertical dimension of the lower face. PC4 explained 12% and captured variations in distance between the eyes, width of the commissures, and the length of the superior aspect of the lower face height corresponding to the vertical dimension of the philtrum of the upper lip. A suggestive association (p<0.05) was observed between PC4 and rs997154 corroborating the role of AJUBA in variation of facial dimensions. CONCLUSION: 2D frontal photographs can be used to derive quantitative measures of soft-tissue phenotypes that are of clinical relevance. The methods described are suitable for discovery and replication of associations between genotypes and malocclusion phenotypes.

Genetics of the dentofacial variation in human malocclusion.

Malocclusions affect individuals worldwide, resulting in compromised function and esthetics. Understanding the etiological factors contributing to the variation in dentofacial morphology associated with malocclusions is the key to develop novel treatment approaches. Advances in dentofacial phenotyping, which is the comprehensive characterization of hard and soft tissue variation in the craniofacial complex, together with the acquisition of large-scale genomic data have started to unravel genetic mechanisms underlying facial variation. Knowledge on the genetics of human malocclusion is limited even though results attained thus far are encouraging, with promising opportunities for future research. This review summarizes the most common dentofacial variations associated with malocclusions and reviews the current knowledge of the roles of genes in the development of malocclusions. Lastly, this review will describe ways to advance malocclusion research, following examples from the expanding fields of phenomics and genomic medicine, which aim to better patient outcomes.

Candidate Gene Analyses of Skeletal Variation in Malocclusion.

This study evaluated associations between craniofacial candidate genes and skeletal variation in patients with malocclusion. Lateral cephalometric radiographs of 269 untreated adults with skeletal classes I, II, and III malocclusion were digitized with 14 landmarks. Two-dimensional coordinates were analyzed using Procrustes fit and principal component (PC) analysis to generate continuous malocclusion phenotypes. Skeletal class classifications (I, II, or III) were used as a categorical phenotype. Individuals were genotyped for 198 single-nucleotide polymorphisms (SNPs) in 71 craniofacial genes and loci. Phenotype-genotype associations were tested via multivariate linear regression for continuous phenotypes and multinomial logistic regression for skeletal malocclusion class. PC analysis resulted in 4 principal components (PCs) explaining 69% of the total skeletal facial variation. PC1 explained 32.7% of the variation and depicted vertical discrepancies ranging from skeletal deep to open bites. PC1 was associated with a SNP near PAX5 (P = 0.01). PC2 explained 21.7% and captured horizontal maxillomandibular discrepancies. PC2 was associated with SNPs upstream of SNAI3 (P = 0.0002) and MYO1H (P = 0.006). PC3 explained 8.2% and captured variation in ramus height, body length, and anterior cranial base orientation. PC3 was associated with TWIST1 (P = 0.000076). Finally, PC4 explained 6.6% and detected variation in condylar inclination as well as symphysis projection. PC4 was associated with PAX7 (P = 0.007). Furthermore, skeletal class II risk increased relative to class I with the minor alleles of SNPs in FGFR2 (odds ratio [OR] = 2.1, P = 0.004) and declined with SNPs in EDN1 (OR = 0.5, P = 0.007). Conversely, skeletal class III risk increased versus class I with SNPs in FGFR2 (OR 2.2, P = 0.005) and COL1A1 (OR = 2.1, P = 0.008) and declined with SNPs in TBX5 (OR = 0.5, P = 0.014). PAX5, SNAI3, MYO1H, TWIST1, and PAX7 are associated with craniofacial skeletal variation among patients with malocclusion, while FGFR2, EDN1, TBX5, and COL1A1 are associated with type of skeletal malocclusion.

Comparison of observer reliability of three-dimensional cephalometric landmark identification on subject images from Galileos and i-CAT cone beam CT.

OBJECTIVES: Recently, there has been increasing interest in the use of cone beam CT (CBCT) for three-dimensional cephalometric analysis and craniofacial reconstruction in orthodontic and orthognathic surgical treatment planning. However, there is a need to redefine the cephalometric landmarks in three dimensional cephalometric analysis and to demonstrate the reproducibility of landmark identification on the type of CBCT machine being used. METHODS: CBCT images of 20 subjects aged 15-25 years were selected, ten each from Galileos(®) (Sirona Dental Systems Inc., Bensheim, Germany) and Next Generation i-CAT(®) (Imaging Sciences International, Hatfield, PA). 2 observers located 18 landmarks on each subject twice using Dolphin-3D v. 11 software (Dolphin Imaging and Management Systems, Chatsworth, CA). Inter- and intraobserver reliability was assessed using Euclidean distances and linear mixed models. RESULTS: Overall, the intra- and interobserver reliability was excellent for both machines. The landmarks Gonion, Nasion, Orbitale and Anterior Nasal Spine (ANS) showed the greatest median Euclidean distances for both intra- and interobserver measurements. There were significant observer effects in the unified models for Sella, Menton and all six dental landmarks. For Sella, the distances between the measures were significantly smaller (more closely spaced) on the i-CAT machine than on the Galileos in both intra- and interobserver measurements. CONCLUSIONS: The intra- and interobserver reliability was excellent for both machines. Some of the landmarks were not as reproducible as others. Which machine produced the highest reliability depended on the landmark considered.

Muertes provocadas por cinturones de contención en ancianos encamados / Deaths caused by restraining belts in the bed-ridden elderly

Las medidas de contención física se utilizan frecuentemente para prevenir daños en los pacientes agitados, especialmente si presentan deterioro cognitivo. Sin embargo, estas medidas no están exentas de riesgos. Se presentan dos casos de accidentes fatales en pacientes diagnosticados de demencia en relación con el empleo de cinturones de contención en la cama. Se comentan los mecanismos potencialmente causales de estos accidentes con la finalidad de alertar a profesionales e instituciones sanitarias sobre los riesgos y beneficios derivados del uso de cinturones de contención, y con el objetivo de adoptar medidas encaminadas a prevenir posibles fallecimientos como los descritos. La medicina forense es una fuente de información muy valiosa para el conocimiento y prevención de este tipo de muertes(AU)

Physical restraint devices are frequently used in agitated patients, particularly those with cognitive impairment, for preventing self-injury. However, these procedures are not risk-free. We present two cases of fatal accidents in patients with dementia while lying in bed with restraining belts. Causal mechanisms of both accidents are discussed in order to make professionals and healthcare institutions more aware of the benefits and risks of the use of restraining belts, and to improve measures for preventing death. Forensic medicine is a valuable source of information for knowledge and prevention these deaths(AU)