Three-Dimensional Repositioning of the Maxilla in Orthognathic Surgery Using Patient-Specific Titanium Plates: A Case Series.

PURPOSE: Successful orthognathic surgery is fundamentally based on accurately carrying out the intended surgical plan intraoperatively. The purpose of this study was to evaluate the accuracy of bone-borne patient-specific maxillary cutting guides and 3-dimensional (3D)-printed plates in repositioning the maxilla during bimaxillary orthognathic surgery. MATERIALS AND METHODS: This was a retrospective case series consisting of patients who had undergone Le Fort I osteotomy with a patient-specific cutting guide and 3D-printed plate as well as a bilateral sagittal split osteotomy and had 6-week postoperative cone-beam computed tomography studies. The primary outcome variable was the difference between the position of the postoperative maxilla and the virtually planned maxilla measured at 10 landmarks in 3 dimensions. Other study variables included the preoperative diagnosis and planned surgical movement at each landmark. Descriptive statistics were tabulated, and bivariate analyses were performed. RESULTS: A total of 10 patients were included in this study. The mean age was 25.7 ± 8.1 years, and there were 5 female patients. The median planned surgical movement was 0.350 mm on the x-axis (right-left), 3.750 mm on the y-axis (anterior-posterior), and 1.704 mm on the z-axis (superior-inferior). The median absolute discrepancy between the postoperative position and the planned position on the x-axis, y-axis, and z-axis was 0.638, 0.798, and 0.481 mm, respectively. There was no significant difference in the discrepancies between the x-axis and y-axis (P = .575), x-axis and z-axis (P = .332), and y-axis and z-axis (P = .114). CONCLUSIONS: Using a patient-specific cutting guide and 3D-printed plate when performing Le Fort I osteotomy allows for accurate 3-dimensional positioning of the maxilla in accordance with the surgical plan.

The Hybrid Arch Bar Is a Cost-Beneficial Alternative in the Open Treatment of Mandibular Fractures.

Obtaining maxillomandibular fixation (MMF) to achieve fracture reduction and functional occlusion is essential in the management of maxillofacial trauma. The aims of this retrospective review were to compare the total time spent in the operating room (OR) when using the Erich arch bar (EAB) versus the bone anchored hybrid arch bar (HAB) as well as performing a cost-benefit analysis (CBA). The study sample comprised patients older than 18 years who underwent open reduction internal fixation of mandible fractures at two separate institutions over a 5-year period. The primary outcome variable was total surgical time in minutes, defined as the time from incision to the completion of closure. Average operative time was significantly longer for the EAB than for the HAB (186.74 ± 70.73 vs. 135.98 ± 2.69 minutes, p < 0.001). A significant amount of time was saved by using the HAB for unilateral (37.17 ± 13.19 minutes; p = 0.007) and bilateral fractures (55.83 ± 18.89 minutes; p = 0.005). In-depth CBA showed that, for average OR fees of $60 per minute, the HAB produced savings of at least 4.01 and 11.63% of the total cost of surgery for unilateral and bilateral fractures. These results support the hypothesis that the HAB is a time-saving maneuver in the open treatment of mandible fractures. The HAB saves more time in bilateral fracture cases despite the longer overall operative times. This study shows the differential time-saving effect of the HAB regardless of fracture laterality as well as its cost minimization benefit compared with the EAB.

Covering the Last Kilometer: Using GIS to Scale-Up Voluntary Medical Male Circumcision Services in Iringa and Njombe Regions, Tanzania.

BACKGROUND: Based on the established protective effect of voluntary medical male circumcision (VMMC) in reducing female-to-male HIV transmission, Tanzania's Ministry of Health and Social Welfare (MOHSW) embarked on the scale-up of VMMC services in 2009. The Maternal and Child Health Integrated Project (MCHIP) supported the MOHSW to roll out VMMC services in Iringa and Njombe, 2 regions of Tanzania with among the highest HIV and lowest circumcision prevalence. With ambitious targets of reaching 264,990 males aged 10-34 years with VMMC in 5 years, efficient and innovative program approaches were necessary. PROGRAM DESCRIPTION: Outreach campaigns, in which mobile teams set up temporary services in facilities or non-facility settings, are used to reach lesser-served areas with VMMC. In 2012, MCHIP began using geographic information systems (GIS) to strategically plan the location of outreach campaigns. MCHIP gathered geocoded data on variables such as roads, road conditions, catchment population, staffing, and infrastructure for every health facility in Iringa and Njombe. These data were uploaded to a central database and overlaid with various demographic and service delivery data in order to identify the VMMC needs of the 2 regions. FINDINGS: MCHIP used the interactive digital maps as decision-making tools to extend mobile VMMC outreach to "the last kilometer." As of September 2014, the MOHSW with MCHIP support provided VMMC to 267,917 men, 259,144 of whom were men were aged 10-34 years, an achievement of 98% of the target of eligible males in Iringa and Njombe. The project reached substantially more men through rural dispensaries and non-health care facilities each successive year after GIS was introduced in 2012, jumping from 48% of VMMCs performed in rural areas in fiscal year 2011 to 88% in fiscal year 2012 and to 93% by the end of the project in 2014. CONCLUSION: GIS was an effective tool for making strategic decisions about where to prioritize VMMC service delivery, particularly for mobile and outreach services. Donors may want to consider funding mapping initiatives that support numerous interventions across implementing partners to spread initial start-up costs.

Affective orientation influences memory for emotional and neutral words.

Memory is better for emotional words than for neutral words, but the conditions contributing to emotional memory improvement are not entirely understood. Elsewhere, it has been observed that retrieval of a word is easier when its attributes are congruent with a property assessed during an earlier judgment task. The present study examined whether affective assessment of a word matters to its remembrance. Two experiments were run, one in which only valence assessment was performed, and another in which valence assessment was combined with a running recognition for list words. In both experiments, some participants judged whether each word in a randomized list was negative (negative monitoring), and others judged whether each was positive (positive monitoring). We then tested their explicit memory for the words via both free recall and delayed recognition. Both experiments revealed an affective congruence effect, such that negative words were more likely to be recalled and recognized after negative monitoring, whereas positive words likewise benefited from positive monitoring. Memory for neutral words was better after negative monitoring than positive monitoring.Thus, memory for both emotional and neutral words is contingent on one's affective orientation during encoding.

Disruptive effect of holistic bias on processing of other-race faces following face categorization.

Prior work on own-race bias in visual face recognition has considered cognitive and social-cognitive explanations to account for the more efficient recognition of own-race faces as compared to faces of models from other races. One perceptual account with reasonable support suggests that the pattern reflects a cognitive tendency away from holistic processing of other-race faces. The present study engaged participants in an orientation task that provoked either global (holistic) or local (feature) processing prior to a face recognition task. Response latencies suggested that inducing a global processing bias slowed recognition of other-race faces relative to that of own-race faces, whereas inducing a local processing bias led to nearly equal face recognition times for both categories of faces. Furthermore, processing of other-race faces was slower with a global rather than a local processing bias. Results provide converging evidence that own-race faces and other-race faces differ in global analysis received.

The size and direction of saccadic curvatures during reading.

Eye movements during the reading of multi-line pages of texts were analyzed to determine the trajectory of reading saccades. The results of two experiments showed that the trajectory of the majority of forward-directed saccades was negatively biased, i.e., the trajectory fell below the start and end location of the saccadic movement. This is attributed to a global top-to-bottom orienting of attention. The curvature size and the proportion of negative trajectories were diminished when linguistic processing demands were high and when the beginning lines of a page were read. Longer pre-saccadic fixations also yielded smaller saccadic curvatures, and they resulted in fewer negatively curved forward-directed saccades in Experiment 1 although not in Experiment 2. These findings indicate that the top-to-bottom pull of saccadic trajectories is modulated by processing demands and processing opportunities. The results are in general agreement with a time-locked attraction-inhibition hypothesis, according to which the horizontal movement component of a saccade is initially subject to an automatic top-to-bottom orienting of attention that is subsequently inhibited.

Word integration and regression programming during reading: a test of the E-Z reader 10 model.

Participants read sentences with two types of target nouns, one that did and one that did not require a determiner to form a legal verb-noun phrase sequence. Sentences were presented with and without the critical determiner to create a local noun integration difficulty when a required determiner was missing. The absence of a required determiner did not influence 1st-pass reading of the verb, the noun, and the posttarget word. It did, however, have a profound effect on 2nd-pass reading. All three words were a likely target of a regression when a required determiner was missing, and the noun and the posttarget word were likely sources of a regression. These results are consistent with novel E-Z reader model assumptions, according to which identification of the noun should be followed by its integration, and integration difficulties can lead to the initiation of a regression to the noun. However, integration difficulties influenced eye movements earlier and later than predicted by the new model.

Not all faces are processed equally: evidence for featural rather than holistic processing of one's own face in a face-imaging task.

The present work considers the mental imaging of faces, with a focus in own-face imaging. Experiments 1 and 3 demonstrated an own-face disadvantage, with slower generation of mental images of one's own face than of other familiar faces. In contrast, Experiment 2 demonstrated that mental images of facial parts are generated more quickly for one's own face. Finally, Experiment 4 established that a bias toward local processing is advantageous for one's own face, whereas a global-processing bias produces an enhanced own-face disadvantage. The results suggest that own-face imaging is more synchronized with retrieval of face features and less attuned to a face's holistic pattern than is imaging of other people's faces. The authors propose that the salient information for own and other face identification reflects, in part, differences in the purpose and experiences (expertise) generally associated with processing of own and other faces. Consistent with work examining the range of face processing, including other-race faces, our results suggest that not all faces receive the same holistic emphasis.

Familiarization effects for bilingual letter detection involving translation or exact text repetition.

In two experiments, English-Spanish bilinguals read passages, performing letter detection on some passages by circling target letters as they read. Detection passages were sometimes familiarized (primed) by prior reading of the same passage or a translation of it. Participants detected letters in English passages in Experiment 1 and in Spanish passages in Experiment 2. For both experiments, a missing letter effect occurred (depressed detection accuracy on frequent function words relative to less frequent content words). Familiarization promoted overall improvements in letter detection only for English passages, suggesting that reprocessing benefits depend on high language fluency. For Spanish passages, cognates engendered greater error rates than noncognates; the visual similarity of Spanish and English cognates apparently enabled faster identification of Spanish cognates in a way unaffected by familiarization of the whole text passage. Priming by familiarized text was significantly higher when the passages were in the same language than when they were in different languages, suggesting that the reprocessing benefits are at the word level instead of the semantic level. These results are consistent with the GO model of reading (Greenberg, Healy, Koriat, & Kreiner, 2004) but require an expanded consideration of attention redistribution processes in that model.

The impact of letter detection on eye movement patterns during reading: Reconsidering lexical analysis in connected text as a function of task.

A comparison was made between reading tasks performed with and without the additional requirement of detecting target letters. At issue was whether eye movement measures are affected by the additional requirement of detection. Global comparisons showed robust effects of task type with longer fixations and fewer word skippings when letter detection was required. Detailed analyses of target words, however, further showed that reading with and without letter detection yielded virtually identical effects of word class and text predictability for word-skipping rate and similar effects for different word viewing duration measures. The overall oculomotor pattern suggested that detection does not substantially shift normal reading movements in response to lexical cues and thereby indicated that detection tasks are informative about word and specifically word class processing in normal reading.

The GO model: a reconsideration of the role of structural units in guiding and organizing text on line.

Healy (1994) and Koriat and Greenberg (1994) offered different theoretical accounts of the missing-letter effect (MLE) in the letter-detection task, whereby a disproportionate number of letter-detection errors occur in frequent function words. Healy emphasized identification processes, whereas Koriat and Greenberg viewed the structural role of the embedding word to be crucial. Recent research suggests that neither position alone can account for the complete set of observations pertaining to the MLE. The present paper offers a theoretical integration of these competing explanations of letter detection in terms of a GO (guidance-organization) model of reading. This model specifies how structural processing of connected text helps guide eye movements to semantically informative parts of the text, enabling readers to achieve on-line fluency.

Evaluation of a community-based intervention to promote rear seating for children.

OBJECTIVES: We evaluated the short-term effect of a community-based effort to promote child rear seating in a low-income Hispanic community. METHODS: Child seating patterns were observed pre- and postintervention at intersections in 1 intervention and 2 control cities. Brief interviews assessed exposure to program messages. RESULTS: Child rear seating increased from 33% to 49% in the intervention city (P <.0001), which represented a greater increase than that in the control cities (P <.0001). The greatest improvement was observed in relatively higher-income areas. Rear seating was significantly correlated with reported program exposure. Incentives and exposure to the program across multiple channels seemed to have the greatest effect. CONCLUSIONS: Independent of legislation, community-based programs incorporating incentives can increase child rear seating.

Factors associated with rear seating of children in motor vehicles: a study in two low-income, predominantly Hispanic communities.

This study examined child seating patterns in two predominantly low-income, Hispanic communities in Massachusetts. The purpose was to determine the factors associated with child rear seating in the community as a whole and for a subset of Hispanic motorists. Five hundred and five vehicles carrying child passengers and no adult other than the driver were observed in parking lots of fast food restaurants and grocery stores. Four hundred and thirty-two vehicle drivers agreed to be interviewed. A child was defined as a passenger younger than age 12 as determined by appearance and height (head below the vehicle headrest when seated). Variables under study included driver gender, age, ethnicity, and educational attainment; driver shoulder belt use; driver perception of passenger-side airbag presence; and the number and ages of children in the car. Overall, 51% of vehicles were observed with all children seated in the rear. In a bivariate analysis, child rear seating was strongly associated with female drivers ( P = 0.01), younger drivers ( P = 0.02) driver shoulder belt use ( P < 0.00), perceived presence of a passenger-side airbag ( P < 0.00), all children in the vehicle

The extraction of structure during reading: evidence from reading prosody.

According to the structural approach to reading, the extraction of structure precedes the analysis of meaning and paves the way for it. In this study, reading prosody was used to examine this proposition. Specifically, we tested the hypothesis that reading prosody produced on line reflects the early extraction of structure. In Experiment 1, readers were successful in assigning natural prosody to unfamiliar text immediately upon its reading. Experiment 2 showed that the prosodic patterns applied are tuned to the structure of the sentence and are largely indifferent to the content of the sentence or to its semantic coherence. The results join with other findings in speech production and comprehension in supporting the precedence of structure to meaning in reading.

Evidence for processing of constituent singleand multiletter codes: Support for multilevel coding in word perception.

This investigation assessed whether constituent codes are activated during word processing. In two experiments, a priming procedure was used to test whether printed word primes facilitate skilled readers' identification of subsequently presented letter and letter bigram targets appearing in the primes (present condition), relative to the same targets not appearing in the primes (absent condition). Experiment 1 demonstrated the priming of single-letter targets and indicated that priming effects are facilitative and not inhibitory. In Experiment 2, high- and low-frequency bigram targets appearing in word primes were shown to have a processing advantage over bigram targets not appearing in word primes. Single-letter constituents in low-frequency bigrams also benefited from priming; however, single letters in high-frequency bigrams showed no such benefit. The results in general suggest that both single- and multiletter constituents are available during word processing, and hence support multicomponent models of word perception.