bluuebunny/crossref_metadata_2025 huggingface dataset:
Subpopulations of corticotropin‐releasing factor containing neurons and internal circuits in the chicken central extended amygdala
Authors: Pross Alessandra , Metwalli Alek H. , Abellán Antonio , Desfilis Ester , Medina Loreta
Published: December 2023

In mammals, the central extended amygdala is critical for the regulation of the stress response. This regulation is extremely complex, involving multiple subpopulations of GABAergic neurons and complex networks of internal and external connections. Two neuron subpopulations expressing corticotropin‐releasing factor (CRF), located in the central amygdala and the lateral bed nucleus of the stria terminalis (BSTL), play a key role in the long‐term component of fear learning and in sustained fear responses akin to anxiety. Very little is known about the regulation of stress by the amygdala in nonmammals, hindering efforts for trying to improve animal welfare. In birds, one of the major problems relates to the high evolutionary divergence of the telencephalon, where the amygdala is located. In the present study, we aimed to investigate the presence of CRF neurons of the central extended amygdala in chicken and the local connections within this region. We found two major subpopulations of CRF cells in BSTL and the medial capsular central amygdala of chicken. Based on multiple labeling of CRF mRNA with different developmental transcription factors, all CRF neurons seem to originate within the telencephalon since they express Foxg1, and there are two subtypes with different embryonic origins that express Islet1 or Pax6. In addition, we demonstrated direct projections from Pax6 cells of the capsular central amygdala to BSTL and the oval central amygdala. We also found projections from Islet1 cells of the oval central amygdala to BSTL, which may constitute an indirect pathway for the regulation of BSTL output cells. Part of these projections may be mediated by CRF cells, in agreement with the expression of CRF receptors in both Ceov and BSTL. Our results show a complex organization of the central extended amygdala in chicken and open new venues for studying how different cells and circuits regulate stress in these animals.
The association between oral health status and physical function in elderly patients with acute heart failure
Authors: Uemura Yusuke , Shibata Rei , Ishikawa Shinji , Takemoto Kenji , Murohara Toyoaki , Watarai Masato
Published: December 2023

Objectives

Oral health problems are common and are associated with various geriatric conditions in older adults. The importance of oral health has not been fully highlighted in the assessment and management of patients with heart failure. Here, we investigated the association between oral health status and the decline in physical function during hospitalization in elderly patients with acute heart failure.

Materials and Methods

We evaluated oral health using the revised oral assessment guide in 77 patients aged 65 years or older who were admitted to hospital for acute heart failure. Oral health problems were defined as a revised oral assessment guide score ≥9.

Results

Oral health problems were identified in 66.2% of the patients. Patients with oral health problems had high prevalence of decreased physical function, undernutrition, and cognitive impairment. A reduction in the Barthel Index, as an indicator of activities of daily living during hospitalization, was significant in the enrolled patients. The Barthel Index decreased more in patients with oral health problems than those with normal oral health. Furthermore, the revised oral assessment guide score on admission was found to be the only independent predictor of changes in the Barthel Index during hospitalization in the multivariate analyses.

Conclusions

Oral assessment using the revised oral assessment guide during hospitalization could provide useful information for the management of elderly heart failure patients.
The nexus between corporate social responsibility of airports and passenger satisfaction: A cross‐country study
Authors: Alam Fahad , Yang Qing , Bandara Yapa Mahinda , Ahmad Nisar , Chiwaridzo Option Takunda
Published: December 2023

This article investigates the role of passenger perception on corporate social responsibility (CSR) in improving passenger satisfaction by examining the direct and mediating effects through service standards, customer facilities, corporate image, and corporate reputation in a cross‐culture context. A questionnaire survey was carried out on airport user experiences from 528 passengers using China and Pakistan airports. Smart PLS‐3.3 was used to test the formulated hypothesis. The results showed that CSR significantly affects passenger satisfaction. The results also revealed CSR initiatives have a significant effect on the service standard, customer facilities, corporate image, and corporate reputation. Customer facilities and corporate image were found to be significant mediators for CSR‐satisfaction link. However, the service standard and corporate reputation showed an insignificant relationship.
Predictive modeling of the JET D–T plasma boundary
Authors: Kaveeva Elizaveta , Veselova Irina , Rozhansky Vladimir , Pitts Richard A. , Mikhailov Vladislav , Zinoviev Alexander
Published: December 2023

The SOLPS‐ITER3.0.8 code with new Grad‐Zhdanov module was applied for predictive modeling of tritium plasma and deuterium‐tritium mixture in tokamak JET. The moderate power scenario of shot JPN #85278 modeled earlier for deuterium plasma was taken as a starting point. Effect of puffing increase, which was applied in experiment, on divertor conditions and inter‐ELM tungsten sputtering for both working gases and on isotope separation in their mixture is analyzed. Both for attached and for semi‐detached outer targets, the tritium plasma shows moderate increase in SOL width compared to deuterium one. The tungsten sputtering at the outer target in the inter‐ELM period for tritium is an order of magnitude bigger than that for deuterium. The D–T separation in the D–T mixture is moderate.
A High‐Performance Flexible Arch‐Shaped Tribo‐Piezoelectric Hybrid Nanogenerator for Energy Harvesting
Authors: Xiao Yuan , Wang Yuping , Yang Leipeng , Wang Yilei , Che Xinwei , Liu Xin
Published: December 2023

Nanogenerators are attempting to be one of the ideal power supply devices for dealing with the global energy crisis. Nowadays, piezoelectric nanogenerators (PENGs) and triboelectric nanogenerators (TENGs) are widely studied in the energy field. Herein, a hybrid arch‐shaped nanogenerator is fabricated by combining piezoelectric and triboelectric effects. Polyvinylidene fluoride (PVDF) is used for PENGs. The titanium nitride/polydimethylsiloxane (TiN/PDMS) composite films with microporous structures are prepared for use in TENG. The maximum output peak‐to‐peak voltage and output peak‐to‐peak current of the PENG are 24 V and 17 μA, respectively, with peak power of 0.8 μW. The maximum output peak‐to‐peak voltage and peak‐to‐peak current of the TENG are 35 V and 17 μA, respectively, with peak power of 1.6 μW. The hybrid nanogenerator has a maximum output peak‐to‐peak voltage and peak‐to‐peak current of 73 V and 35 μA, respectively, and a peak power of 3.9 μW. In addition, the hybrid nanogenerator has a stable charging voltage of DC 4 V, which is better than a single TENG (DC 0.3 V) or PENG (DC 2.2 V). The hybrid nanogenerator shows excellent output performance and energy conversion efficiency among existing nanogenerators of similar size.
Design and Performance Analysis of New Coupling Magnetic Core Structure for Dynamic Wireless Charging System of Electric Vehicle
Authors: Yin Xiaoju , Zhou Li , Li Bo
Published: December 2023

Aiming at the problems of high cost, low efficiency, low power, and high electromagnetic radiation in the dynamic wireless charging system for electric vehicles (EVs), the cover‐like coupling structure and the return‐like coupling structure are designed, and the unique concave structure has excellent engineering practicability. Using Ansoft software for simulation and analysis, the newly proposed two coupling structures have significantly improved the induced voltage and electromagnetic induction strength at the pickup end compared with other commonly used coupling core structures. According to the advantages of practical applications, the application of its composite core structure for simulation and analysis proves that the cover‐like structure of the magnetic field strength at the pickup end not only enhances the magnetic field strength on the coil but also has a good magnetic field shielding effect. The lateral displacement of the EV is kept within the range of 10 cm, the coupling distance is 0–5 cm, the charging is stable, and the transmission efficiency is high. Finally, a dynamic wireless charging experimental platform for small EVs is constructed, which verifies that the new coupling core structure can significantly improve the transmission power and efficiency of the charging system and significantly reduce the economic cost.
The Ammonia Combustion Engine for Future Power Generation Applications
Authors: Wermuth Nicole , Gumhold Christof , Wimmer Andreas , Url Michael , Laiminger Stephan
Published: December 2023

Energy storage is one of the big challenges for the energy transition and ammonia as a hydrogen carrier is considered a promising candidate for efficient and medium‐ to long‐term chemical storage. Gas engines are well suited for power generation using ammonia as a carbon‐free fuel, making it unnecessary to convert ammonia back to hydrogen for the utilization in the power plant. This study investigates operating strategies for a prechamber combustion concept for a large‐bore gas engine suitable for power generation applications. To overcome the high ignition energy and low laminar flame speed of ammonia, different quantities of hydrogen as a promoting agent to improve the combustion properties of ammonia have been employed in the experimental investigations on a single‐cylinder research engine. The combustion concept shows a wide operating range with stable and robust combustion from 0.3 to 2.5 MPa indicated mean effective pressure and will be transferred to a multicylinder engine for the first combined heat and power demonstration.
Negative emotions increase unhealthy eating: Evidence from the Wuhan lockdown during COVID‐19
Authors: Cai Xiqian , Wu JunJie , Xu Wenchao , Zhu Jialiang
Published: December 2023

This paper studies how negative emotions like stress, anxiety, and boredom can affect unhealthy food consumption. Using the Wuhan lockdown as an external shock, we examine the changes in food consumption in a city that was not in lockdown. We applied the difference‐in‐differences method to a large scanner dataset from a retail monopoly in China. Our findings reveal that negative emotions induced by the pandemic lockdown significantly elevated consumer spending on unhealthy food items such as crisps, sugary beverages, regular soda, and low‐alcohol beverages. Notably, the effect of unhealthy food consumption was more pronounced among younger and wealthier demographics. Triggering factors, like information about confirmed new deaths and infections as well as proximity to local hospitals, were found to strongly influence the consumption of unhealthy foods. Overall, the lockdown's impact extended beyond short‐term increases in snack consumption to substantial increases in overall dietary and nutritional intake.
Aqueous‐phase reforming of model compounds of wet biomass to hydrogen on alumina‐supported metal catalysts
Authors: Zambare Rohini S. , Vaidya Prakash D.
Published: December 2023

Catalytic aqueous‐phase reforming (APR) of wet biomass such as microalgae and activated sludge is a potential technique for the production of H2‐rich gaseous products. In the present work, model compounds such as ethylene glycol, xylose and alanine were selected as representatives of the polyols, carbohydrates and proteins in wet biomass. APR trials were performed in a stirred batch reactor using commercial Pt/Al2O3 and Ru/Al2O3 catalysts. The reforming reactions were investigated at different conditions: temperature (T), 498 to 518 K, feed concentration, 1 to 5 wt. %, catalyst loading (ω), 2 to 6 kg/m3, and reaction time (t), 1 to 6 h. The commercial Pt/Al2O3 catalyst exhibited higher reforming activity. The influence of reaction parameters on turnover frequency (TOFH₂), hydrogen yield (Y‐H2) and carbon‐to‐gas conversion (C to G conversion) was studied. The values of TOFH₂ for Pt/Al2O3 were measured at T = 518 K, ω = 2 kg/m3 and t = 3 h using 1 wt% feed and these values were 19.2, 4 and 6 1/min for ethylene glycol, xylose and alanine. The values of TOFH₂ over Ru/Al2O3 under identical conditions were: ethylene glycol–12.4, xylose–1.4 and alanine–5.4 1/min. The activation energies for H2 production from ethylene glycol, xylose and alanine over Pt/Al2O3 and Ru/Al2O3 catalysts were determined. APR of the mixture of model compounds was also studied over laboratory‐made Pt/Al2O3 and Ru/Al2O3 catalysts at the optimum reaction conditions. Thus, this work has provided crucial insights into the production of H2 from model compounds of wet biomass using Al2O3‐supported catalysts.
Automatic mechanism generation for the combustion of advanced biofuels: A case study for diethyl ether
Authors: Michelbach Christian A. , Tomlin Alison S.
Published: December 2023

Advanced biofuels have the potential to supplant significant fractions of conventional liquid fossil fuels. However, the range of potential compounds could be wide depending on selected feedstocks and production processes. Not enough is known about the engine relevant behavior of many of these fuels, particularly when used within complex blends. Simulation tools may help to explore the combustion behavior of such blends but rely on robust chemical mechanisms providing accurate predictions of performance targets over large regions of thermochemical space. Tools such as automatic mechanism generation (AMG) may facilitate the generation of suitable mechanisms. Such tools have been commonly applied for the generation of mechanisms describing the oxidation of non‐oxygenated, non‐aromatic hydrocarbons, but the emergence of biofuels adds new challenges due to the presence of functional groups containing oxygen. This study investigates the capabilities of the AMG tool Reaction Mechanism Generator for such a task, using diethyl ether (DEE) as a case study. A methodology for the generation of advanced biofuel mechanisms is proposed and the resultant mechanism is evaluated against literature sourced experimental measurements for ignition delay times, jet‐stirred reactor species concentrations, and flame speeds, over conditions covering φ = 0.5–2.0, P = 1–100 bar, and T = 298–1850 K. The results suggest that AMG tools are capable of rapidly producing accurate models for advanced biofuel components, although considerable upfront input was required. High‐quality fuel specific reaction rates and thermochemistry for oxygenated species were required, as well as a seed mechanism, a thermochemistry library, and an expansion of the reaction family database to include training data for oxygenated compounds. The final DEE mechanism contains 146 species and 4392 reactions and in general, provides more accurate or comparable predictions when compared to literature sourced mechanisms across the investigated target data. The generation of combustion mechanisms for other potential advanced biofuel components could easily capitalize on these database updates reducing the need for future user interventions.
Optimizing a high‐sensitivity NanoLuc‐based bioluminescence system for in vivo evaluation of antimicrobial treatment
Authors: Shang Weilong , Hu Zhen , Li Mengyang , Wang Yuting , Rao Yifan , Tan Li , Chen Juan , Huang Xiaonan , Liu Lu , Liu He , Guo Zuwen , Peng Huagang , Yang Yi , Hu Qiwen , Li Shu , Hu Xiaomei , Zou Jiao , Rao Xiancai
Published: December 2023

Focal and systemic infections are serious threats to human health. Preclinical models enable the development of new drugs and therapeutic regimens. In vivo, animal bioluminescence (BL) imaging has been used with bacterial reporter strains to evaluate antimicrobial treatment effects. However, high‐sensitivity bioluminescent systems are required because of the limited tissue penetration and low brightness of the BL signals of existing approaches. Here, we report that NanoLuc (Nluc) showed better performance than LuxCDABE in bacteria. However, the retention rate of plasmid constructs in bacteria was low. To construct stable Staphylococcus aureus reporter strains, a partner protein enolase (Eno) was identified by screening of S. aureus strain USA300 for fusion expression of Nluc‐based luciferases, including Nluc, Teluc, and Antares2. Different substrates, such as hydrofurimazine (HFZ), furimazine (FUR), and diphenylterazine (DTZ), were used to optimize a stable reporter strain/substrate pair for BL imaging. S. aureus USA300/Eno‐Antares2/HFZ produced the highest number of photons of orange‐red light in vitro and enabled sensitive BL tracking of S. aureus in vivo, with sensitivities of approximately 10 CFU from mouse skin and 750 CFU from mouse kidneys. USA300/Eno‐Antares2/HFZ was a powerful combination based on the longitudinal evaluation of the therapeutic efficacy of antibiotics. The optimized S. aureus Eno‐Antares2/HFZ pair provides a technological advancement for the in vivo evaluation of antimicrobial treatment.
Neuromuscular implants: Interfacing with skeletal muscle for improved clinical translation of prosthetic limbs
Authors: Quinn Kiara N. , Tian Yucheng , Budde Ryan , Irazoqui Pedro P. , Tuffaha Sami , Thakor Nitish V.
Published: December 2023

After an amputation, advanced prosthetic limbs can be used to interface with the nervous system and restore motor function. Despite numerous breakthroughs in the field, many of the recent research advancements have not been widely integrated into clinical practice. This review highlights recent innovations in neuromuscular implants—specifically those that interface with skeletal muscle—which could improve the clinical translation of prosthetic technologies. Skeletal muscle provides a physiologic gateway to harness and amplify signals from the nervous system. Recent surgical advancements in muscle reinnervation surgeries leverage the “bio‐amplification” capabilities of muscle, enabling more intuitive control over a greater number of degrees of freedom in prosthetic limbs than previously achieved. We anticipate that state‐of‐the‐art implantable neuromuscular interfaces that integrate well with skeletal muscle and novel surgical interventions will provide a long‐term solution for controlling advanced prostheses. Flexible electrodes are expected to play a crucial role in reducing foreign body responses and improving the longevity of the interface. Additionally, innovations in device miniaturization and ongoing exploration of shape memory polymers could simplify surgical procedures for implanting such interfaces. Once implanted, wireless strategies for powering and transferring data from the interface can eliminate bulky external wires, reduce infection risk, and enhance day‐to‐day usability. By outlining the current limitations of neuromuscular interfaces along with potential future directions, this review aims to guide continued research efforts and future collaborations between engineers and specialists in the field of neuromuscular and musculoskeletal medicine.
Fabrication and lubrication performance of sustainable Pickering‐like water‐in‐water emulsions using plant protein microgels
Authors: You Kwan‐Mo , Murray Brent S. , Connell Simon D. , Sarkar Anwesha
Published: December 2023

Aqueous multiphasic systems have attracted a great deal of interest recently owing to the growing demands of sustainability for the development of stable “oil‐free” emulsions, often complicated by their limited stability against droplet coarsening. Although particles may provide ultrastability to water‐in‐water (W/W) emulsions formed in phase‐separating polymer systems, the need for lubrication in such W/W emulsions presents an important challenge for their use in diverse applications. Herein, W/W Pickering emulsions were stabilized by sustainable plant protein (pea)‐based microgels (PPM) using starch and xanthan gum as the biopolymers to generate the W/W phase separating droplet structures. The lubricity of these systems was compared with that of parallel systems stabilized by animal (whey) protein microgels (WPM). New results reveal that PPM are more soft and adhesive than WPM and outperform the latter in boundary lubrication performance, in striking contrast to the behavior of the non‐microgelled pea or whey proteins. Furthermore, the PPM tend to stabilize a different, less spherical type of W/W droplet than the WPM that may explain the lower friction observed in PPM‐stabilized systems. The novel approach of fabricating W/W emulsions stabilized by sustainable microgels opens up new solutions in designing aqueous lubricants for future nutritional and biomedical applications.
Effects of clamping end‐tidal CO2 on neurofluidic low‐frequency oscillations
Authors: Kish Brianna , Chen J. Jean , Tong Yunjie
Published: December 2023

In recent years, low‐frequency oscillations (LFOs) (0.01–0.1 Hz) have been a subject of interest in resting‐state functional magnetic resonance imaging research. They are believed to have many possible driving mechanisms, from both regional and global sources. Internal fluctuations in the partial pressure of CO2 (PCO2) has long been thought of as one of these major driving forces, but its exact contributions compared with other mechanisms have yet to be fully understood. This study examined the effects of end‐tidal PCO2 (PetCO2) oscillations on LF cerebral hemodynamics and cerebrospinal fluid (CSF) dynamics under “clamped PetCO2” and “free‐breathing” conditions. Under clamped PetCO2, a participant's PetCO2 levels were fixed to their baseline average, whereas PetCO2 was not controlled in free breathing. Under clamped PetCO2, the fractional amplitude of hemodynamic LFOs in the occipital and sensorimotor cortex and temporal lobes were found to be significantly reduced. Additionally, the fractional amplitude of CSF LFOs, measured at the fourth ventricle, was found to be reduced by almost one‐half. However, the spatiotemporal distributions of blood and CSF delay times, as measured by cross‐correlation in the LF domain, were not significantly altered between conditions. This study demonstrates that, while PCO2 oscillations significantly mediate LFOs, especially those observed in the CSF, other mechanisms are able to maintain LFOs, with high correlation, even in their absence.
Evaluating Listening Effort in Unilateral, Bimodal, and Bilateral Cochlear Implant Users
Authors: Nyirjesy Sarah C. , Lewis Jessica H. , Hallak Diana , Conroy Sara , Moberly Aaron C. , Tamati Terrin N.
Published: December 2023

Objective

Evaluate listening effort (LE) in unilateral, bilateral, and bimodal cochlear implant (CI) users. Establish an easy‐to‐implement task of LE that could be useful for clinical decision making.

Study Design

Prospective cohort study.

Setting

Tertiary neurotology center.

Methods

The Sentence Final Word Identification and Recall Task, an established measure of LE, was modified to include challenging listening conditions (multitalker babble, gender, and emotional variation; test), in addition to single‐talker sentences (control). Participants listened to lists of sentences in each condition and recalled the last word of each sentence. LE was quantified by percentage of words correctly recalled and was compared across conditions, across CI groups, and within subjects (best aided vs monaural).

Results

A total of 24 adults between the ages of 37 and 82 years enrolled, including 4 unilateral CI users (CI), 10 bilateral CI users (CICI), and 10 bimodal CI users (CIHA). Task condition impacted LE (P < .001), but hearing configuration and listener group did not (P = .90). Working memory capacity and contralateral hearing contributed to individual performance.

Conclusion

This study adds to the growing body of literature on LE in challenging listening conditions for CI users and demonstrates feasibility of a simple behavioral task that could be implemented clinically to assess LE. This study also highlights the potential benefits of bimodal hearing and individual hearing and cognitive factors in understanding individual differences in performance, which will be evaluated through further research.
Proof‐of‐Concept Computer Vision Model for Instrument and Anatomy Detection During Transcanal Endoscopic Ear Surgery
Authors: Nwosu Obinna , Suresh Krish , Lee Daniel J. , Crowson Matthew G.
Published: December 2023

High‐definition video captured during transcanal endoscopic ear surgery (TEES) can serve as imaging data for computer vision algorithms. This report describes a proof‐of‐concept model for automated anatomy and instrument detection during TEES.
Long‐Term Efficacy and Safety of Subcutaneous Immunotherapy in Monosensitized and Polysensitized Children With Allergic Rhinitis
Authors: Yuan Xuan , Xie Shaobing , Zhang Hua , Zhang Junyi , Fan Ruohao , Jiang Weihong , Xie Zhihai
Published: December 2023

Objective

To evaluate the efficacy and safety of dust mite subcutaneous immunotherapy (SCIT) in monosensitized and polysensitized children with allergic rhinitis (AR).

Study Design

Prospective cohort study.

Setting

Tertiary referral center.

Methods

One hundred thirty children were enrolled and categorized into 2 groups: monosensitized to only dust mites and polysensitized to at least 1 additional allergen beyond dust mites. All patients received SCIT targeting dust mites for 3 years, followed by a 5‐year monitoring period. The Total Nasal Symptom Score (TNSS), Symptom and Medication Score (SMS), Visual Analogue Scale (VAS), and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) were assessed before SCIT (T0); at 1 (T1) and 2 (T2) years of SCIT; immediately after SCIT (T3); and 2 years post‐SCIT (T5). Safety was assessed based on adverse events (AEs).

Results

Fifty‐one monosensitized and 50 polysensitized children completed the study. At T3, 47 monosensitized and 46 polysensitized children were effectively treated, with no significant between‐group difference in efficacy (P > .05). The TNSS, SMS, VAS scores, and RQLQ score were significantly lower at T1, T2, T3, and T5 than at T0 in both groups (P < .05). The differences in the TNSS, SMS, VAS score, and RQLQ score between the 2 groups were nonsignificant at T0, T1, T2, and T3 (P > .05), but significant at T5 (P < .05). No serious AEs were reported.

Conclusion

Monosensitized and polysensitized children exhibited similar beneficial efficacy and safety after 3 years of dust mite SCIT. Monosensitized children derived more benefits 2 years after discontinuation.
Assessment of Prophylactic Internal Carotid Artery Management in Postradiation Nasopharyngeal Necrosis Patients
Authors: Liu Yong‐Long , Wen Kai , Zhang Wei‐Jing , Ouyang Yan‐Feng , Chen Jin‐Hua , Gu Yang‐Kui , Mei Qi , Chen Ming‐Yuan , Hua Yi‐Jun , Li Jian
Published: December 2023

Objective

Postradiation nasopharyngeal necrosis (PRNN) frequently develops after second‐course radiotherapy for nasopharyngeal carcinoma (NPC). PRNN can lead to internal carotid artery (ICA) massive hemorrhage due to ICA rupture, resulting in sudden death. This study aims to explore the pretreatment of the ICA to prevent fatal massive hemorrhage in PRNN patients.

Study Design

Retrospective cohort study.

Setting

Sun Yat‐sen University Cancer Center.

Methods

Patients diagnosed with NPC and PRNN from January 2010 to September 2022 were included. The Cox proportional hazards regression analysis was performed to analyze risk factors for massive hemorrhage and survival. A nomogram was developed to integrate prognostic models and perform parameter calibration.

Results

Two hundred and fifty‐four PRNN patients were included in this study. Prophylactic ICA occlusion significantly reduced the risk of ICA hemorrhage compared to no prophylactic ICA occlusion (3.6% vs 40.6%, P < .001). Surgical repair on necrosis significantly prevented hemorrhage and improved survival. The nomogram, incorporating the above 2 factors and the nearest distance from necrosis to ICA ≤ 3 mm, exhibited excellent discriminative ability for hemorrhage. We identified 3 high‐risk factors that indicate the need for prophylactic ICA management in PRNN patients: (1) exposure of ICA by rhinoscopy; (2) signs of ICA erosion on MRA scanning; (3) the depth of soft tissue coverage surrounding the ICA wall within the necrotic cavity is less than 3 mm on magnetic resonance imaging.

Conclusion

We have identified 3 high‐risk factors for PRNN patients that necessitate prophylactic ICA management. These findings are expected to contribute to improving the quality of life and overall survival of PRNN patients.
Reconstruction of Total Maxillectomy Defects Using Coronoid‐Temporalis Pedicled Flap, Titanium Mesh, and Free Flap
Authors: Liu Wei , Li Chunjie , Ma Zhongkai , Zhang Gaowei , Lubamba Grace Paka , Lian Haosen , Zhang Zhuoyuan , Tang Wei
Published: December 2023

The maxilla plays a crucial role in maintaining midfacial contour, supporting the globe and dentition and separating the oral and nasal cavity. Reconstruction of total maxillectomy defects has always been a challenge in head and neck surgery. In recent years, on the basis of existing methods, we have used the coronoid‐temporalis pedicled flap combined with personalized titanium mesh and free flap to reconstruct total maxillectomy defects. This combination of multiple methods can restore the functional subunits of the maxilla. In this report, we introduce our surgical procedures in detail and assess the postoperative effects. Postoperative facial aesthetic outcomes were satisfactory in all 8 patients. None of the patients showed diplopia, oral‐nasal reflux, hypernasality, titanium mesh exposure, or trismus. This new surgical procedure may be a simple and feasible option for the reconstruction of total maxillectomy defects.
Barbed Repositioning Pharyngoplasty: Tips and Tricks
Authors: Cammaroto Giovanni , Bettini Pierfrancesco , Meccariello Giuseppe , Cannavicci Angelo , Iannella Giannicola , Stringa Luigi Marco , Visconti Irene Claudia , Ciorba Andrea , Bianchini Chiara , Pelucchi Stefano , Vicini Claudio
Published: December 2023

The barbed repositioning pharyngoplasty surgical technique is becoming more widely used for patients with obstructive sleep apnea due to its safety, effectiveness, and rapidity, as evidenced by multicenter studies and Meta‐analyses. In order to achieve uniform surgical outcomes, avoid errors that could worsen outcomes, and enable adequate data comparison, a standardized procedure is required to overcome surgeon‐related variability. The aim of this paper is to provide practical tips and tricks based on our surgical practice that can make the surgeon's work easier and aid in achieving desired outcomes.
Comparison of patients with hepatitis B virus‐associated hepatocellular carcinoma: Data from two hospitals from Turkey and China
Authors: Carr Brian I. , Rui Fajuan , Ince Volkan , Yilmaz Sezai , Zhao Xinya , Feng Yuemin , Li Jie
Published: December 2023

Aims

There are many studies on the incidence of hepatitis B virus (HBV)‐associated hepatocellular carcinoma (HCC), but very little is known about the HCC features in different populations. The study aimed to compare characteristics in two cohorts of patients with HBV‐associated hepatocellular carcinoma from Turkey and China.

Methods

Data on patients with HBV‐associated HCC diagnosed by imaging or liver biopsy were retrospectively collected from Shandong Provincial Hospital (n = 578) and Inonu University Hospital (n = 359) between January 2002 and December 2020, and the liver function and HCC characteristics were compared. Continuous variables were compared using Student's t‐test or Mann–Whitney U test and categorical variables were compared using the χ² test or Fisher's exact test.

Results

The patients in the Turkish cohort had significantly worse Child‐Pugh scores (Child‐Pugh A: 38.3% vs. 87.9%; Child‐Pugh B: 40.3% vs. 11.1%; Child‐Pugh C: 21.4% vs. 1.0%; p < 0.001) and significantly higher levels of aspartate aminotransferase (66.5 [38.0−126.0] vs. 36.0 [27.0−50.0] IU/L; p < 0.001), alanine aminotransferase (47.5 [30.0−87.3] vs. 33.0 [24.0−45.0] IU/L; p < 0.001), total bilirubin (20.8 [13.7−39.3] vs. 17.9 [13.8−24.0] mg/dL; p < 0.001), and lower albumin levels (32.0 [26.0−39.0] vs. 40.0 [36.1−43.8] g/L; p < 0.001) than patients in Chinese cohort. The tumor characteristics showed the Barcelona Clinic Liver Cancer (BCLC) score (BCLC 1: 5.1% vs. 71.8%; BCLC 2: 48.7% vs. 24.4%; BCLC 3: 24.4% vs. 3.8%; BCLC 4: 21.8% vs. 0; all p < 0.001), maximum tumor diameter (5.0 [3.0−9.0] vs. 3.5 [2.5−6.0] cm; p < 0.001), alpha‐fetoprotein values (27.7 vs. 13.2 ng/mL; p < 0.001), and percentage of patients with portal vein tumor thrombus (33% vs. 6.1%; p < 0.001) were all significantly worse in the Turkish cohort compared with Chinese cohort.

Conclusions

HBV‐associated HCC from the Turkish cohort had worse liver function and more aggressive clinical characteristics than patients from the Chinese cohort.
Mapping Analysis of Crystalline Perfection and UV‐C Transparency of 2‐in. Aluminum Nitride Substrates Grown by Physical Vapor Transport
Authors: Dalmau Rafael , Kirby Samuel , Britt Jeffrey , Schlesser Raoul
Published: December 2023

Large‐diameter, single‐crystalline aluminum nitride (AlN) substrates are sought for growth of AlGaN‐based devices. A combination of high crystalline perfection and optical transparency is desired for UV‐C emitter applications. A mapping analysis of 2‐in. AlN substrates grown by physical vapor transport is performed to study the within‐wafer uniformity of structural and optical properties. Substrates with spatially uniform crystalline perfection and UV‐C absorption coefficients, as determined by typical X‐ray rocking curve widths below 15 arcsec and 4.68 eV absorption coefficients below 20 cm−1, are shown. These findings demonstrate a robust mass production process for high‐quality, 2 in. AlN substrates possessing uniform structural and UV optical properties, making them highly suited for growth of next‐generation, AlGaN‐based devices.
Removal of Dibenzothiophene from Liquid Fuels by Photocatalytic Desulfurization over Zn‐Terephthalate Complex: A Process Modelling and Optimization by Response Surface Methodology
Authors: Mohammadzadeh Dawud , Hosseini Seyed Ali
Published: December 2023

The Zn‐terephthalate complex was synthesized by hydrothermal method at 180 °C and applied as a novel macroporous photocatalyst in the desulfurization of dibenzothiophene (DBT) from a fuel model to produce DBT sulfone. The physical‐chemical properties of the photocatalyst were characterized by Fourier Transform Infrared (TIR), Raman spectroscopy, powder X‐ray diffraction (XRD), field‐emission scanning electron microscopy (FESEM), photoluminescence spectroscopy and UV‐Vis diffuse reflectance spectroscopy (UV‐Vis DRS). The characterization results indicated the formation of mono‐nuclear paddlewheel metal‐organic framework (MOF) as Zn [COO]2 frameworks. The photocatalytic experiments were designed by the Box‐Behnken method of response surface methodology (RSM) and the photocatalytic process was modelled and optimized. Three independent process variables i. e. concentration of dibenzothiophene, the amount of photocatalyst and light irradiation time were considered in the experimental design. The determination coefficient (R2) of the model is 0.97. The optimum removal of DBT (50.4 %) resulted in a fuel model containing 50 ppm DBT, desulfurized by 0.060 g of Zn‐MOF photocatalyst under visible light for 180 min. The predicted response (DBT removal%) by the RSM model was 50.68 %. According to the Pareto analysis, the order of importance of independent factors on the response was as follows: Irradiation time>m(photocatalyst)>C(DBT).
Poly(acrylic acid)‐Modified SnO2 Electron Transport Layer for Perovskite Solar Cells
Authors: Wang Yanqing , Wu Yu , Li Mengzhu , Wang Zhaozhao , Zhang Weizhi , Shi Chengwu , Cui Peng
Published: December 2023

SnO2 is one of the most used inorganic electron transport materials for organic‐inorganic halide perovskite solar cells. However, the surface defects of SnO2 will block the electron transport at the SnO2/perovskite buried interface and limit the device performance. Here, poly(acrylic acid) (PAA) is employed to modify the SnO2 electron transport layer. Carboxyl groups can react with KOH in the commercial SnO2 aqueous colloidal dispersion to produce potassium polyacrylate, the −COO− can combine not only with oxygen and Sn4+ on SnO2, but also can chelate with uncoordinated Pb2+ defects on perovskite. Moreover, carboxyl groups can form a chemical linker between SnO2 and perovskite via the esterification reaction, leading to the reduction of surface hydroxyl group defects of SnO2. The optimal solar cells with PAA modification achieve an enhanced power conversion efficiency of 18.88 % and improved stability.
Outcomes of a same day discharge protocol in patients undergoing mastectomy and implant reconstruction
Authors: Hayes Danielle S. , Miles Wandra K. , Solorio Monica , Miranda Suzette G.
Published: December 2023

Background

Finite hospital resources has required a closer look at resource allocation. This has prompted a shift toward same day surgeries and a focus on reducing hospital readmissions. Following the institution of a same day discharge protocol for mastectomy and mastectomy with immediate reconstruction, we sought to assess differences in the length of stay and readmission rates.

Methods

This retrospective review evaluates all cases of mastectomy with or without immediate reconstruction performed at a single high‐volume center between June 2019 and March 2021. Average length of stay, 30‐day readmission rates, Anesthesia Society Assessment class, and type of immediate reconstruction were assessed. Autologous reconstructions were excluded.

Results

A total of 413 patients underwent mastectomy with or without reconstruction (n = 148 pre protocol and n = 265 during protocol) between June 2019 and March 2021. Of those 413 patients, 180 underwent reconstruction (n = 62 pre protocol and n = 118 during protocol). The average length of stay after mastectomy following the implementation of the same day discharge protocol was decreased at 0.6 days (n = 265) compared to preimplementation at 1.02 days (n = 148), p < 0.001. The 30‐day readmission rate was not significant between the groups, p = 0.13. A total of 180 patients underwent immediate reconstruction after mastectomy. The average length of stay after mastectomy with immediate reconstruction following implementation of the same day discharge protocol was shorter than preimplementation at 1.05 days preimplementation (n = 62) versus 0.58 days following implementation (n = 118), p < 0.001; this finding was significant for both prepectoral and subpectoral implants, p < 0.001. There was no significant difference in 30‐day readmission rates between the groups with immediate reconstruction, p = 0.34.

Conclusion

Same day discharge for mastectomy with reconstruction is as safe as the more widely recognized same day discharge practice for patients with mastectomy alone.
Occult appendix pathology in patients undergoing colorectal cancer resection and prophylactic appendectomy
Authors: Di Fabio Francesco , Ravi Prabhu , Allievi Niccolo , Khan Kashuf A. , Abduelraheim Abu , Moran Brendan
Published: December 2023

Background

The risk‐benefit balance of prophylactic appendectomy in patients undergoing left colorectal cancer resection is unclear. The aim of this report is to assess the proportion of histologically abnormal appendices in patients undergoing colorectal cancer resection in a unit where standard of care is appendectomy, with consent, when left‐sided resection is performed.

Methods

A retrospective study on a prospectively collected database was conducted in a single tertiary‐care center. Overall, 717 consecutive patients undergoing colorectal cancer resection between January 2015 and June 2021 were analyzed. The primary outcome was the proportion of histologically abnormal appendix specimens at prophylactic appendectomy. The secondary outcome was complications from prophylactic appendectomy.

Results

Overall, 576/717 (80%) patients had appendectomy at colorectal cancer surgery. In total, 234/576 (41%) had a right‐/extended‐right hemicolectomy or subtotal colectomy which incorporates appendectomy, and 342/576 (59%) had left‐sided resection (left‐hemicolectomy, anterior resection or abdominoperineal excision) with prophylactic appendectomy. At definitive histology, 534/576 (92.7%) had a normal appendix. The remaining 42/576 (7.3%) showed abnormal findings, including: 14/576 (2.4%) inflammatory appendix pathology, 2/576 (0.3%) endometriosis, 8/576 (1.4%) hyperplastic polyp, and 18/576 (3.1%) appendix tumors, which encompassed six low‐grade appendiceal mucinous neoplasms (LAMNs), three carcinoids, and nine serrated polyps. In the 342 patients who had prophylactic appendectomy, 10 (2.9%) had a neoplasm (two LAMN, three carcinoids, and five serrated polyps). There were no complications attributable to appendectomy.

Conclusion

Occult appendix pathology in patients undergoing colorectal cancer resection is uncommon when prophylactic appendectomy was performed. However, approximately 3% of patients had a synchronous appendix neoplasm.
Surgical management of metastatic adrenocortical carcinoma
Authors: Passman Jesse E. , Amjad Wajid , Ginzberg Sara P. , Soegaard Ballester Jacqueline M. , Finn Caitlin , Wachtel Heather
Published: December 2023

Introduction

Adrenocortical carcinoma (ACC) is a notoriously aggressive cancer with a dismal prognosis, especially for patients with metastatic disease. Metastatic ACC is classically a contraindication to operative management. Here, we evaluate the impact of primary tumor resection and metastasectomy on survival in metastatic ACC.

Methods

We performed a retrospective cohort study of patients with metastatic ACC (2010–2019) utilizing the National Cancer Database. The primary outcome was overall survival (OS). Cox proportional hazard models were developed to evaluate the association between surgical management and survival. Propensity score matching (PSM) was utilized to account for selection bias in receipt of surgery.

Results

Of 976 subjects with metastatic ACC, 38% underwent surgical management. Median OS across all patients was 7.6 months. On multivariable Cox proportional hazards regression, primary tumor resection alone (HR: 0.523; p < 0.001) and primary resection with metastasectomy (HR: 0.372; p < 0.001) were significantly associated with improved OS. Metastasectomy alone had no association with OS (HR: 0.909; p = 0.740). Primary resection with metastasectomy was associated with improved OS over resection of the primary tumor alone (HR: 0.636; p = 0.018). After PSM, resection of the primary tumor alone remained associated with improved OS (HR 0.593; p < 0.001), and metastasectomy alone had no survival benefit (HR 0.709; p = 0.196) compared with nonoperative management; combined resection was associated with improved OS over primary tumor resection alone (HR 0.575, p = 0.008).

Conclusion

In metastatic ACC, patients may benefit from primary tumor resection alone or in combination with metastasectomy; however, further research is required to facilitate appropriate patient selection.
Why can’t we improve turnover time? A systematic review
Authors: Cohen Tara N. , Kanji Falisha F. , Zamudio Jennifer , Shouhed Daniel , Gewertz Bruce L. , Sax Harry C.
Published: December 2023

Background

Despite substantial efforts to reduce operating room (OR) turnover time (TOT), delays remain a frustration to physicians, staff, and hospital leadership. These efforts have employed many systems and human factor‐based approaches with variable results. A deeper dive into methodologies and their applicability could lead to successful and sustained change. The aim of this study was to conduct a systematic review to evaluate relevant research focused on improving OR TOT and clearly defining measures of successful intervention.

Material and Methods

A systematic review of OR TOT interventions implemented between 1980 through October 2022 was performed using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) methodology. Research databases included: 1) PubMed; 2) Web of Science; and 3) OVID Medline.

Results

A total of 38 articles were appropriate for analysis. Most employed a pre/post intervention approach (29, 76.3%), the remaining utilized a control/intervention approach. Nine intervention methods were identified: the majority included a process redesign bundle (24, 63%), followed by overlapping induction, dedicated unit/team/space feedback, financial incentives, team training, education, practice guidelines, and redefinition of roles/responsibilities. Studies were further categorized into one of two groups: (1) those that utilized predetermined interventions based on anecdotal experience or prior literature (18, 47.4%) and (2) those that conducted a prospective analysis on baseline data to inform intervention development (20, 52.6%).

Discussion

There are significant variability in the methodologies utilized to improve OR TOT; however, the most effective solutions involved process redesign bundles developed from a prospective investigation of the clinical work‐system.
The First Visits
Authors: Eleonorasdotter Emma
Published: December 2023

This chapter explores how the women encountered drugs for the first time, and where they went after those first encounters. Attention is paid to how these movements in space relate to class. The interviewees describe their use in spatial terms, and I elaborate on the metaphor of a gateway into drugs and the Swedish metaphor of a knarkträsk—a drug swamp—signifying problem-use contexts, as cultural reference points. A queer phenomenological analysis of the feeling of one’s feet sinking into the ground as a feeling of homeliness and orientation is compared to the complexities of sinking into drug use and/or swamp-like social contexts.
Obtaining Drugs
Authors: Eleonorasdotter Emma
Published: December 2023

This chapter, like the last one, deals with encounters between drugs and people. Here, the focus is on how the women acquire drugs in relation to drug markets. The clash between an illegal, masculine-coded street market associated with violence, and the ideal drug-induced state that is described in terms of intimacy and community, is explored. Where does the encounter between the women and the drugs they use take place? On what terms? What are the roles of gender and class? Some women buy their drugs themselves, but many receive most of their drugs as gifts. In the latter case, drugs move into a gift economy that involves different forms of expectation of reciprocation in various different, classed contexts.