Ipsilateral pulmonary edema may occur in a lung that has been rapidly reinflated after a period of collapse. The syndrome of re-expansion pulmonary edema is associated with variable degrees of hypotension and hypoxemia. In its extreme form, it may result in cardiac arrest and death. The initial cause of uninflated pulmonary parenchyma described with re-expansion pulmonary edema has typically been either a large undrained pleural effusion or a pneumothorax. The authors describe a patient in whom re-expansion pulmonary edema developed when inadvertent puncture of large emphysematous bullae released previously atelectatic lung.

Introduction: Surgically Facilitated Orthodontic Therapy (SFOT) has been utilized for years to overcome the limitations encountered with traditional orthodontic treatment of dentoalveolar and alveoloskeletal malocclusions. The procedure, which consists of full flap corticotomies and bone grafting, has many proposed benefits including increased speed and range of tooth movement. The purpose of this study is to evaluate arch expansion in patients treated with SFOT and clear aligners. Materials and Methods: A retrospective cohort study design was used to evaluate 51 consecutive adult patients that were treatment planned for significant arch expansion with corticotomies, bone grafting, and clear aligners. 17 of the 51 patients refused the surgical procedure and served as controls. Eight transverse arch width measurements were obtained at three different time points (Initial, ClinCheck, Refinement). Five calculations were performed to determine the magnitude, predictability, and efficiency of arch expansion. Results: The difference in treatment time between the two groups was statistically significant at 5.2 months (P < .0001). On average, corticotomies reduced the length of treatment by 46% and increased the rate of expansion 2.4x. Patients that received SFOT achieved a greater magnitude (+28%) of expansion at a significantly higher rate (P< 0.002) than controls for all eight interarch measurements. The SFOT group displayed higher predictability (% goal achieved) and a smaller difference between predicted and achieved tooth movements for all measures obtained. The mean age for the entire sample was 42.81 (+12.51 years). Conclusion: Arch expansion with corticotomy-assisted clear aligner therapy is significantly more effective, efficient, and predictable than with clear aligners alone. The predictability of expansion with aligners appears to have a higher range than initially thought, even in patients that do not receive corticotomies.

This retrospective cohort study investigated the effects of rapid maxillary expansion on the soft tissues using CBCTs. The sample consisted of 60 subjects: experimental group (n=30, treated with rapid maxillary expansion (RME), age:10.93 ± 2.20) and control group (n=30, age 11.43 ± 2.8). Soft tissue measurements were made using soft tissue landmarks. Paired t-test was used to compare the changes after expansion, and student t-test was used to compare the experimental and the control group. Intraclass correlation coefficient was used to evaluate intra-examiner reliability. Statistically significant differences were noted when comparing the experimental to the control group in transverse and anterior posterior dimensions. Increase was noted at the bialar distance (0.90mm, p=0.0363), nostril medium left to midsagittal plane (0.75mm, p=0.0423), the angle of pronasale to nostril base right and left (1.640, p<.001), columella width (0.56mm, p=0.0272), nostril base left to midsagittal plane, (1.03mm, p=0.0207), chelion right to endocanthus right (1.57mm, p=0.0086), chelion left to endocanthus left (1.96mm, p=0.0015). Anteroposteriorly, the tip of the nose moved forward (pronasale to coronal plane (1.97mm, p=0.0018), nostril medium right to coronal plane (1.07mm, p=0.0486), alare right to coronal plane (1.67mm, p=0.0117), pronasale to nostril base left (2.24mm, p<0.001) and right (2.12mm, p<0.001). Finally comparing genders, all the measurements were significantly greater in males compared to females except for columella width. In conclusion, RME influences soft tissue changes of the face, specifically in the nasal area. The base of the nose, bialar distance and columella widened while the tip of the nose moved forward.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: Suture expansion is a very important clinical approach to correct maxillary width deficiency, but it has a high potential for treatment relapse. Accelerating bone formation and mineralization in the midpalatal suture during suture expansion is beneficial in preventing relapse of the arch width and reducing the retention period. Pyk2 is tyrosine kinase which has been shown to mediate signaling pathways that are involved in the process of bone remodeling. Pyk2 knock-out (KO) mice have augmented bone formation and increased bone mass, suggesting that therapeutic strategies that inhibit Pyk2 may be useful to enhance bone remodeling and prevent suture relapse during suture expansion. Objectives: To determine if Pyk2-deficiency affects midpalatal suture bone mass and bone remodeling with or without suture expansion in mice. Methods: Thirty-six Pyk2-KO and thirty-six wild type (WT) 6 week-old male mice were randomly assigned into three groups: receiving no expansion force (0 g), 10 g or 20 g force of rapid maxillary expansion for 14 days. Half of the mice in each group were used for histology analysis; the other half was assigned for fluorescence analysis. Suture width, maxilla width and bone volume/tissue volume around suture bone edges were measured using micro-CT. Histological analyses of osteoclasts (tartrate resistant acid phosphatase, TRAP), osteoblasts (alkaline phosphatase, ALP) and chondrocytes (alcian blue) were performed. Results: The BV/TV ratio was significantly higher in Pyk2-KO control mice compared to WT control mice. Suture expansion in WT and Pyk2-KO mice led to an increase in bone marrow spaces around the suture edge and significantly reduced BV/TV. Expansion also led to a significant increase in suture width, suture fibrous area, osteoclast number, cartilage area and hypertrophic chondrocyte number. However, BV/TV in Pyk2-KO mice was significantly higher than in WT mice at both the 10 g and 20 g force levels. In addition, Pyk2-KO exhibited reduced suture width, maxilla width, fibrous area and osteoclast number per bone surface (OC.S/BS) compared to WT mice under expansion forces. Cartilage area and hypertrophic chondrocyte number were increased by force but were independent of mouse genotypes. Conclusion: Pyk2-KO mice have higher BV/TV and narrower suture width compared to WT mice, which may be due to decreased osteoclast activity. The higher BV/TV of the midpalatal sutures of Pyk2-KO mice following suture expansion may suggest the presence of a more stable suture that has a reduced potential for relapse. Therapeutic strategies to inhibit Pyk2 during RME may be beneficial in increasing bone mass and preventing relapse of the suture.

Indiana University-Purdue University Indianapolis (IUPUI) / Vibration forces (VF) have been shown to alter the formative and resorptive activities of bone. Studies have investigated the use of VF in applications such as the treatment of osteoporosis, bone fracture healing and implant osteointegration with favorable results. In dentistry, orthodontic tooth movement and maxillary suture expansion are common procedures typically requiring prolonged treatment durations with high relapse rates. We hypothesized that local, intermittent VF applications can enhance bone formation during rapid maxillary expansion and accelerate orthodontic tooth movement. Moreover, we also investigated expression of periostin/OSF-2, an adhesion molecule implicated in the formation of bone during maxillary suture expansion. Our results showed that intermittent VF significantly increased bone volume density of the expended palatal bone but limited the amount of palatal expansion and mineral apposition rate at the suture margins. Also, intermittent VF forces did not show statistically significant acceleration of orthodontic tooth movement but significantly enhanced bone volume density of the interradicular bone after tooth movement. Maxillary expansion was also shown to induce the expression of periostin which was proportional to the magnitude of the expansion force with increased bone mineral deposition.

Thesis advisor: Abhishek Chatterjee / Thesis advisor: Eranthie Weerapana / In nature, just twenty canonical amino acids are responsible for the creation of nearly all proteins. Genetic code expansion (GCE), or the incorporation of noncanonical amino acids (ncAAs) into living cells, is a powerful tool that expands the studies we are capable of performing using proteins. This technology relies on engineered aminoacyl-tRNA synthetase (aaRS)/tRNA pairs that are orthogonal to the host cells’ endogenous aaRS/tRNA pairs, and one of the main limitations of GCE arises from the inefficiency of these suppressor tRNAs when expressed in a foreign host cell. To address this limitation, we have previously reported a strategy for the virus-assisted directed evolution of tRNAs (VADER) which is uniquely capable of addressing the specific needs of tRNA evolution. In order to advance the capabilities of VADER, we made a number of modifications to the VADER selection scheme. First, we designed and executed a modified VADER selection that enabled the evolution of a new class of tRNAs, and with this VADER selection, we were able to generate a first-generation E. coli tyrosyl tRNA (tRNATyr) variant that was three times as active as its wild-type equivalent. Next, we introduced a number of refinements to the VADER strategy to generate VADER 2.0, an improved workflow capable of screening larger libraries and libraries encoding more active variants. Using VADER 2.0, we created second-generation tRNAPyl and tRNATyr mutants that achieved incorporation efficiencies that were greater than five-fold higher than their wild-type equivalents across a wide variety of substrates, enabling exciting GCE experiments that would not be possible otherwise. / Thesis (PhD) — Boston College, 2023. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Chemistry.

Currently, mediation in Florida is a pre-suit requirement only for condo associations, homeowner disputes, and medical malpractice suits, as discussed in Florida Statute Chapter 720.311, 718.1255, 766.108, as well as those ordered by a judge. The American Bar Association (ABA) also reported that only 23 of the 204 law schools (11%) approved by the ABA require some form of Alternative Dispute Resolution (ADR) coursework to graduate. Changes need to be made for the ADR program to thrive and reach its full potential within our judicial system. This thesis will highlight that by calling for the government to make mediation a pre-suit requirement for other suitable areas in the civil court system. This thesis will also address the need for more law schools to require ADR training within their curriculum to create a new generation who understands and has the skills to implement ADR into their future law practices. By examining successful trends in ADR, statutes, and programs that have encouraged or forced the use of ADR, this thesis will provide ways ADR can reach its full potential within our court system. This thesis will contribute to the field of law, specifically in terms of contributing to the lack of data on ADR programs that reflect their positive impacts and where they might be most beneficial.

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