Modespecific characteristics in multichannel effect NH H2

Focused beams of helium ions are a powerful tool for high-fidelity machining with spatial precision below 5 nm. Achieving such a high patterning precision over large areas and for different materials in a reproducible manner, however, is not trivial. Here, we introduce the Python toolbox FIB-o-mat for automated pattern creation and optimization, providing full flexibility to accomplish demanding patterning tasks. FIB-o-mat offers high-level pattern creation, enabling high-fidelity large-area patterning and systematic variations in geometry and raster settings. It also offers low-level beam path creation, providing full control over the beam movement and including sophisticated optimization tools. Three applications showcasing the potential of He ion beam nanofabrication for two-dimensional material systems and devices using FIB-o-mat are presented.Although primary vulvovaginal reconstruction after vulvectomy has high potential to improve patients' outcomes, flap reconstruction is not an established part of the current standard treatment for vulvar cancer. We report a patient with successful secondary vulvar reconstruction 3 years after radical vulvectomy with direct wound closure. A 69-year-old woman presented with chronic, burning vulvar pain 3 years after radical vulvectomy without reconstruction for stage IB vulvar cancer. Her urethral orifice had everted because of the direct wound closure, which resulted in severe pain on contact. We performed secondary vulvar reconstruction using bilateral 14 × 5 cm2 gluteal fold flaps. Postoperative pain management and overall aesthetic outcomes were satisfactory. Secondary vulvar reconstruction with gluteal fold flaps can avoid the sequelae resulting from inadequate direct wound closure after radical vulvectomy. Thus, we strongly advocate immediate vulvar reconstruction to prevent such situations.
This resident application cycle posed academic leadership and applicants with an unprecedented challenge how to virtually match applicants to mutually beneficial programs. The authors sought to refer to previous years' data, specifically geographic trends, to better inform both program directors and applicants. The authors hypothesized that geography, as it pertains to the transition from medical school to residency, impacts match patterns.
The study was designed as a cross-sectional analysis including all current integrated plastic surgery residents. The independent websites of all accredited integrated plastic surgery programs were then queried for the desired demographic resident information. Additionally, as an illustrative endpoint, geospatial heat maps were generated to better understand geographic trends.
All (n = 78) integrated plastic surgery programs and 953 residents were included in the study. U73122 Nearly half (47.2%) of current residents remain in the same geographic region in which they obtaineat a disadvantage during the match process.
Pediatric hand fractures are common, and most can be managed by a period of immobilization. However, it remains challenging to identify those more complex fractures requiring the expertise of a hand surgeon to ensure a good outcome. The purpose of this study was to develop a prediction model for identification of complex pediatric hand fractures requiring care by a hand surgeon.
A 2-year retrospective cohort study of consecutively referred pediatric (<18 years) hand fracture patients was used to derive and internally validate a prediction model for identification of complex fractures requiring the expertise of a hand surgeon. These complex fractures were defined as those that required surgery, closed reduction, or four or more appointments with a hand surgeon. The model, derived by multivariable logistic regression analysis, was internally validated using bootstrapping and then translated into a risk index.
Of 1170 fractures, 416 (35.6%) met criteria for a complex fracture. Multivariable regression analysis identified six significant predictors of complex fracture open fracture, rotational deformity, angulation, condylar involvement, dislocation or subluxation, and displacement. Internal validation demonstrated good performance of the model (C-statistic = 0.88, calibration curve
= 0.935). A threshold of ≥1 point (ie, any one of the predictors) resulted in a simple, easy-to-use tool with 96.4% sensitivity and 45.5% specificity.
A high-performing and clinically useful decision support tool was developed for emergency and urgent care physicians providing initial assessment for children with hand fractures. This tool will provide the basis for development of a clinical care pathway for pediatric hand fractures.
A high-performing and clinically useful decision support tool was developed for emergency and urgent care physicians providing initial assessment for children with hand fractures. This tool will provide the basis for development of a clinical care pathway for pediatric hand fractures.
Congenital midline nasal masses are rare anomalies and are typically benign nasal dermoid sinus cysts (NDSCs). Rhabdomyosarcomas (RMSs) are even less common, and only a fraction affect sites like the external nose, nasal cavity, nasopharynx, and paranasal sinuses. We review the clinical presentation and treatment of nasal, nasopharyngeal, and paranasal RMSs and report the first documented midline presentation.
We queried PubMed for articles with titles containing the terms rhabdomyosarcoma or sarcoma botryoides and nose, nasal, paranasal, sinonasal, nasopharynx, or nasopharyngeal. We then searched the references of each included article using the same parameters and continued this process iteratively until no new articles were found.
The paranasal sinuses were the most commonly affected site, followed by the nasopharynx, nasal cavity, and external nose. Two patients presented with involvement of the external nose, but each presented with involvement of the right ala rather than a midline mass. The ratesctures and early anesthesia. However, early surgical treatment should be considered given this new differential and its predilection for early metastasis.