Preferential graphitic-nitrogen formation in pyridine-extended graphene nanoribbons.

Graphene nanoribbons (GNRs), nanometer-wide strips of graphene, have garnered significant attention due to their tunable electronic and magnetic properties arising from quantum confinement. A promising approach to manipulate their electronic characteristics involves substituting carbon with heteroatoms, such as nitrogen, with different effects predicted depending on their position. In this study, we present the extension of the edges of 7-atom-wide armchair graphene nanoribbons (7-AGNRs) with pyridine rings, achieved on a Au(111) surface via on-surface synthesis.

Magnetic Excitations in Ferromagnetically Coupled Spin-1 Nanographenes.

In the pursuit of high-spin building blocks for the formation of covalently bonded 1D or 2D materials with controlled magnetic interactions, -electron magnetism offers an ideal framework to engineer ferromagnetic interactions between nanographenes. As a first step in this direction, we explore the spin properties of ferromagnetically coupled triangulenes-triangular nanographenes with spin . By combining in-solution synthesis of rationally designed molecular precursors with on-surface synthesis, we successfully achieve covalently bonded triangulene dimers and trimers on Au(111).

Single-Sided Peak Nasal Inspiratory Flow as an Adjunct Objective Measure in Functional Septorhinoplasty.

Objective: Nasal obstruction can negatively impact patient quality of life, which can be alleviated by functional nasal surgery. Quantification of improvement is most commonly evaluated with the use of validated survey instruments but lacks widely utilized objective measures. Herein, we evaluate the utility of single-sided peak nasal inspiratory flow (PNIF) as an objective outcome measure in the evaluation and management of nasal obstruction.

Trends in Maxillomandibular Fixation Technique at a Single Academic Institution.

Study Design: Retrospective chart review.

Objective: Restoration of premorbid occlusion is a key goal in the treatment of mandibular fractures. Placement of the patient in maxillomandibular fixation (MMF) is performed during mandibular fracture repair to help establish occlusion.

Women in Facial Plastic and Reconstructive Surgery: The State of the Academy and Why It Matters.

Facial plastic and reconstructive surgery has historically been a male-dominated field. It is critical to assess the current state of female representation within our Society to better gauge how we reflect the changing needs of our community and our patients. Although we have made headway in fostering a community ripe for progress, we must continue to create and promote equal opportunities, dissuade microaggressions, address burnout, and capitalize on the innate strengths of our female constituents.

Exchange Interactions and Intermolecular Hybridization in a Spin-/ Nanographene Dimer.

Phenalenyl is a radical nanographene with a triangular shape hosting an unpaired electron with spin = /. The open-shell nature of the phenalenyl is expected to be retained in covalently bonded networks. As a first step, we report synthesis of the phenalenyl dimer by combining in-solution synthesis and on-surface activation and its characterization on Au(111) and on a NaCl decoupling layer by means of inelastic electron tunneling spectroscopy (IETS).

Observation of the Magnetic Ground State of the Two Smallest Triangular Nanographenes.

Fusion of three benzene rings in a triangular fashion gives rise to the smallest open-shell graphene fragment, the phenalenyl radical, whose π-extension leads to an entire family of non-Kekulé triangular nanographenes with high-spin ground states. Here, we report the first synthesis of unsubstituted phenalenyl on a Au(111) surface, which is achieved by combining in-solution synthesis of the hydro-precursor and on-surface activation by atomic manipulation, using the tip of a scanning tunneling microscope. Single-molecule structural and electronic characterizations confirm its open-shell = 1/2 ground state that gives rise to Kondo screening on the Au(111) surface.

Public and Population Health in U.S. Medical Education: A Review of Guidance in Extraordinary Times.

Generations of medical educators have recommended including public and population health (PPH) content in the training of U.S. physicians.

Exploratory Study of the Brain Response in Facial Synkinesis after Bell Palsy with Systematic Review and Meta-analysis of the Literature.

Background: Facial synkinesis, characterized by unintentional facial movements paired with intentional movements, is a debilitating sequela of Bell palsy.

Purpose: Our aim was to determine whether persistent peripheral nerve changes arising from Bell palsy result in persistent altered brain function in motor pathways in synkinesis.

Data Sources: A literature search using terms related to facial paralysis, Bell palsy, synkinesis, and fMRI through May 2021 was conducted in MEDLINE and EMBASE.

Surgical Treatment of Dynamic Nasal Collapse.

Nasal obstruction is a prevalent issue that significantly impacts patient quality of life and contributes to a large-scale financial burden. Internal or external nasal valve collapse may play a role in nasal obstruction, with varying etiologies. Surgical correction of nasal valve collapse is indicated when septal and/or turbinate surgery alone are not sufficient in correcting the nasal obstruction.

Guided Mindfulness Meditation for Pain Control After Septorhinoplasty: A Randomized-Controlled Pilot Study.

Mindfulness meditation has been shown to alleviate pain and may be an appealing adjunctive pain management option. To compare measures of pain, mindfulness, and opioid usage, and collect evaluative feedback among patients undergoing septorhinoplasty with and without guided meditation. Patients undergoing septorhinoplasty were randomized to online-guided meditation postoperative days 0-3 versus standard care; all received the same pain medications.

Google Search Analysis: What Do People Want to Know About Rhinoplasty and Where Do They Find the Answers?

During online search queries, Google uses machine learning algorithms to provide frequently associated ("People Also Ask" [PAA]) questions with corresponding websites answering the question. We aimed to identify the most frequent questions about rhinoplasty asked online and the sources used to answer them. PAA questions were extracted for the terms "rhinoplasty," "nose surgery," and "nose job.

Anxiety, PTSD, and stressors in medical students during the initial peak of the COVID-19 pandemic.

Purpose: To assess psychological effects of the initial peak phase of the COVID-19 pandemic on United States (US) medical students in clinical training to anticipate sequelae and prepare for future outbreaks.

Methods: Authors emailed a cross-sectional survey in April-May, 2020 to students in clinical training years at six US medical schools which included validated General Anxiety Disorder (GAD-7) and Primary Care-PTSD (PC-PTSD-5) screening tools, and asked students about pandemic-related stress and specific concerns. Authors used quantitative and thematic analysis to present results.

Asymmetric azide-alkyne Huisgen cycloaddition on chiral metal surfaces.

Achieving fundamental understanding of enantioselective heterogeneous synthesis is marred by the permanent presence of multitudinous arrangements of catalytically active sites in real catalysts. In this study, we address this issue by using structurally comparatively simple, well-defined, and chiral intermetallic PdGa{111} surfaces as catalytic substrates. We demonstrate the impact of chirality transfer and ensemble effect for the thermally activated azide-alkyne Huisgen cycloaddition between 3-(4-azidophenyl)propionic acid and 9-ethynylphenanthrene on these threefold symmetric intermetallic surfaces under ultrahigh vacuum conditions.

Effects of the COVID-19 pandemic on medical students: a multicenter quantitative study.

Background: The COVID-19 pandemic disrupted the United States (US) medical education system with the necessary, yet unprecedented Association of American Medical Colleges (AAMC) national recommendation to pause all student clinical rotations with in-person patient care. This study is a quantitative analysis investigating the educational and psychological effects of the pandemic on US medical students and their reactions to the AAMC recommendation in order to inform medical education policy.

Methods: The authors sent a cross-sectional survey via email to medical students in their clinical training years at six medical schools during the initial peak phase of the COVID-19 pandemic.

Simultaneous maxillary and mandibular reconstruction with a single Osteocutaneous fibula free flap: A description of three cases.

Large defects that comprise both the maxilla and mandible prove to be difficult reconstructive endeavors and commonly require two free tissue transfers. Three cases are presented to discuss an option for simultaneous reconstruction of maxillary and mandibular defects using a single osteocutaneous fibula free flap. The first case describes a 16-year-old male with a history of extensive facial trauma sustained in a boat propeller accident resulting in a class IId maxillary and 5 cm mandibular defect status post three failed reconstructive surgeries; the second, a 33-year-old male with recurrent rhabdomyosarcoma of the muscles of mastication with resultant hemi-mandibulectomy and class IId maxillary defects; and lastly, a 48-year-old male presenting after a failed scapular free flap to reconstruct defects resulting from a self-inflicted gunshot wound, which included a 5 cm defect of the right mandibular body and 4.

Early Outcomes in an Emerging Facial Nerve Center: The Oregon Health and Science University (OHSU) Experience.

Objectives: Nerve transfer (NT) and free gracilis muscle transfer (FGMT) are procedures for reanimation of the paralyzed face. Assessing the surgical outcomes of these procedures is imperative when evaluating the effectiveness of these interventions, especially when establishing a new center focused on the treatment of patients with facial paralysis. We desired to discuss the factors to consider when implementing a facial nerve center and the means by which the specialist can assess and analyze outcomes.

Teaching Public and Population Health in Medical Education: An Evaluation Framework.

Curriculum models and training activities in medical education have been markedly enhanced to prepare physicians to address the health needs of diverse populations and to advance health equity. While different teaching and experiential learning activities in the public health and population health sciences have been implemented, there is no existing framework to measure the effectiveness of public and population health (PPH) education in medical education programs. In 2015, the Association of American Medical Colleges established the Expert Panel on Public and Population Health in Medical Education, which convened 20 U.

Monolayers of MoS on Ag(111) as decoupling layers for organic molecules: resolution of electronic and vibronic states of TCNQ.

The electronic structure of molecules on metal surfaces is largely determined by hybridization and screening by the substrate electrons. As a result, the energy levels are significantly broadened and molecular properties, such as vibrations are hidden within the spectral line shapes. Insertion of thin decoupling layers reduces the line widths and may give access to the resolution of electronic and vibronic states of an almost isolated molecule.

Allergic Fungal Sinusitis Imitating an Aggressive Skull Base Lesion in the Setting of Pembrolizumab Immunotherapy.

Objectives: We report a case of acutely worsening allergic fungal sinusitis in a patient receiving immunotherapy with pembrolizumab, a programmed cell death protein 1 (PD-1) inhibitor.

Methods: A 53-year-old man with a history of metastatic melanoma and recent initiation of pembrolizumab therapy presented with acutely worsening headaches, left abducens nerve palsy, and neuroimaging demonstrating an erosive skull base lesion with bilateral cavernous sinus involvement.

Results: Intraoperative findings were consistent with non-invasive allergic fungal sinus disease.

Degree of Self-Reported Facial Impairment Correlates with Social Impairment in Individuals with Facial Paralysis and Synkinesis.

Facial paralysis leads to both aesthetic and functional deficits placing patients at risk for sociopsychological sequelae and social impairment. To examine the effect of facial paralysis and synkinesis on social impairment and quality of life (QOL). This is a cross-sectional study at a tertiary care medical center.