bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost of Total Intravenous Anesthesia Versus Inhalation Anesthesia in Obstructive Sleep Apnea Surgery
Authors: Alnemri Angela , Sussman Sarah , Estephan Leonard , Hamilton Callum , Stewart Matthew , Zhan Tingting , Thaler Adam , Ananth Ashwin , Boon Maurits , Huntley Colin , Hunt Patrick
Published: March 2022

Objectives

To compare cost and time spent in surgical and postoperative courses in patients with obstructive sleep apnea (OSA) undergoing surgery with either total intravenous anesthesia (TIVA) or inhalational anesthesia.

Study Design

Retrospective chart review.

Methods

Retrospective review on patients undergoing surgery for OSA under general anesthesia from January 2019 to October 2020. Cost per service was acquired for the day of surgery.

Results

A total of 230 patients were included: 95 received TIVA; 135 received inhalation anesthesia. Total cost was significantly higher in the TIVA nasal surgery group by $286 (P = .035). TIVA produced significantly higher pharmacy and operating room costs across all surgeries and OSA severities. These increased costs were offset by significantly lower supply costs in upper airway stimulator (UAS, −$419.50; P = .007) and uvulopalatopharyngoplasty (UPPP, −$115.16; P = .015) patients receiving TIVA. In the TIVA cohort, there was a trend toward lower recovery room costs after UAS (−$111.09; P = .063) and nasal surgery (−$64.45; P = .096) and anesthesia costs after nasal surgery (−$36.67; P = .054). Total recovery time was reduced by 18 minutes (P = .004) for nasal surgery, 25 minutes (P = .043) for UAS, and 27 minutes (P = .147) for UPPP patients receiving TIVA.

Conclusion

When used in an outpatient setting for patients with OSA, TIVA adds to pharmacy and operating room costs, but this is usually offset by lower supply, anesthesia, and recovery room costs. We found decreased recovery times in the TIVA cohort. TIVA has proven benefits in patient outcomes and can be cost‐effective in OSA surgery.

Level of Evidence

3 Laryngoscope, 132:1487–1494, 2022
Phenotypic variability of syndromic craniosynostosis caused by c.833G > T in FGFR2: Clinical and genetic evaluation of eight patients from a five‐generation family
Authors: Wei Xianda , Huang Guori , Gui Baoheng , Xie Bobo , Chen Shaoke , Fan Xin , Chen Yujun
Published: March 2022

Objective

Craniosynostosis is the result of the early fusion of cranial sutures. Syndromic craniosynostosis includes but not limited by Crouzon syndrome and Pfeiffer syndrome. Considerable phenotypic overlap exists among these syndromes and mutations in FGFR2 may cause different syndromes. This study aims to investigate the explanation of the phenotypic variability via clinical and genetic evaluation for eight patients in a large pedigree.

Methods

For each patient, comprehensive physical examination, cranial plain CT scan with three‐dimensional CT reconstruction (3D‐CT), and eye examinations were conducted. Whole exome sequencing was applied for genetic diagnosis of the proband. Variants were analyzed and interpreted following the ACMG/AMP guidelines. Sanger sequencing was performed to reveal genotypes of all the family members.

Results

A pathogenic variant in the FGFR2 gene, c.833G > T (p.C278F), was identified and proved to be co‐segregate with the disease. Some symptoms of head, hearing, vision, mouth, teeth expressed differently by affected individuals. Nonetheless, all the eight patients manifested core symptoms of Crouzon syndrome without abnormality in the limbs, which could exclude diagnosis of Pfeiffer syndrome.

Conclusion

We have established clinical and genetic diagnosis of Crouzon syndrome for eight patients in a five‐generation Chinese family. Variability of clinical features among these familial patients was slighter than that in previously reported sporadic cases.
Triceps to teres minor motor nerve transfer to restore glenohumeral external rotation after neonatal brachial plexus injury
Authors: Soldado Francisco , Barrera‐Ochoa Sergi , Romero‐Larrauri Pablo , Nguyen Trong‐Quynh , Diaz‐Gallardo Paula , Knörr Jorge
Published: March 2022

Introduction

Attaining active glenohumeral external rotation (aGHER), whether via primary reconstruction or spontaneous recovery, is infrequent in patients with neonatal brachial plexus palsy (NBPI). We evaluated the effectiveness of triceps‐to‐teres minor motor branch transfers to restore this function, both performed primarily (i.e., in conjunction with microsurgical plexus reconstruction) or secondarily (after primary surgery has failed to restore aGHER).

Patients and Methods

This was a retrospective study of 12 children with NBPI undergoing triceps‐to‐teres minor motor branch transfer via an axillary approach, six undergoing primary surgery and six secondary. The primary outcome was post‐operative restoration of aGHER in abduction. The primary‐surgery group consisted of six children of mean age 8 months (range 5–11) with partial injuries ranging from C5–C6 to C5–C8. The secondary‐surgery group included six patients with C5–C6 injuries of mean age 43 months (range 23–120), undergoing re‐operation a mean 40 months (range 18–116) after their primary surgery.

Results

No complications occurred after surgery. At a mean follow‐up of 22 months (range 14–30), aGHER in abduction only was restored in one patient in the primary group while in the secondary group, aGHER in abduction was restored in all patients to a mean 73° (range 70–80) after a mean follow‐up of 16 months (range 6–26).

Conclusions

Triceps‐to‐teres minor motor branch transfer is not indicated as primary surgery for NBPI. However, they can be effective in children in whom primary surgery has failed to restore aGHER, even if the spinal accessory nerve is unavailable for transfer to the infraspinatus motor branch.
Detection of anatomical changes using two‐dimensional x‐ray images for head and neck adaptive radiotherapy
Authors: Hirotaki Kouta , Moriya Shunsuke , Tachibana Hidenobu , Sakae Takeji
Published: March 2022

Purpose

To develop a system for detecting anatomical changes using two‐dimensional (2D) x‐ray images.

Methods

Ten patients with head and neck cancer were retrospectively analyzed using 2D x‐ray and cone‐beam computed tomography (CBCT) images. The 2D x‐ray images were acquired daily, whereas the CBCT images were acquired weekly during the treatment period. The developed system imported the 2D x‐ray images obtained on the initial treatment day and on another day, and thereafter converted them into the water equivalent thickness (WET) using the conversion table. The difference between the WET images for the first and other treatment days (ΔWET) was calculated as the quantitative value for anatomical changes and visualized to recognize the anatomical change location. We compared ΔWET and the difference in the lateral neck distance (ΔLND) on the corresponding CBCT images. ΔLND was used as the ground truth for anatomical changes. ΔWET and ΔLND were measured at the first cervical vertebra (C1) and the tumor center (TC). C1 and TC were selected to observe the volume changes in the parotid gland and tumor, respectively. Sensitivity and specificity were calculated to evaluate the performance of the 2D‐WET system. The cut‐off values of WET and LND were set to 2–10 mm. Furthermore, intensity‐modulated proton therapy (IMPT) plans for six patients with rescan CT images were generated. The IMPT plans on the rescan CT images were compared to the original plans on simulation CT using the dosimetric parameters for the target and the organs at risk.

Results

The mean differences between ΔWET and ΔLND for C1 and TC were −0.62 ± 1.66 mm and −0.93 ± 1.28 mm (mean ± 1 SD), respectively. ΔWET in the proposed system was in good agreement with ΔLND using the CBCT images. In the sensitivity and specificity results for C1 and TC with cut‐off values from 2 to 10 mm, the sensitivity was >85% for all cut‐off values, while the specificity was >90% at 5–10 mm and <90% at less than 5 mm. The average ΔWET at the time of replanning was 12.8 mm which resulted in maximum dose increase in the spinal cord D1cc by 8.4 Gy, the parotid gland D50 by 26.6 Gy, and the oral cavity D50 by 23.2 Gy.

Conclusions

We developed a new system for detecting anatomical changes using 2D x‐ray images. The developed system with ΔWET showed an agreement with ΔLND at C1 and TC with an average difference of less than 1 mm. ΔWET detected anatomical changes with high sensitivity and specificity with a cut‐off value of 5–10 mm. This system can monitor daily anatomical changes without causing high exposure to patients and requiring any inefficient work, and it can be applied to daily online adaptive proton beam therapy and triggered adaptive radiotherapy.
What is the real burden of the overactive bladder? Results from a national prevalence study
Authors: Santander Jessica , Plata Mauricio , Zuluaga Laura , Azuero Julián , Daza Fabián , Trujillo Carlos Gustavo , Caicedo Juan Ignacio , Rondón Martín
Published: March 2022

Objective

To describe the prevalence of overactive bladder determining patient‐reported outcome measures (PROMS) and potential risk factors.

Methods

A cross‐sectional population‐based study to estimate lower urinary tract symptoms (LUTS) prevalence in the Colombian population was performed (COBaLT study). Overactive bladder (OAB) was assessed using 2002 International Continence Society definitions and the Report on the Terminology for Female Pelvic Floor Dysfunction. PROMS were included to evaluate participant's perceptions of health‐related quality of life (QoL). Spanish validated questionnaires were used, including the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ‐OAB) and Patient Perception of Bladder Condition (PPBC) scale.

Results

A total of 1060 individuals were assessed. The mean age of participants was 42.2 years, and most participants were Hispanic (93.15%). The overall prevalence of OAB syndrome was 31.70%, and it was more frequently reported in women than in men (39.25% vs. 24.15%). Most participants with OAB did not perceive their symptoms as bothersome. The most bothersome symptom, associated with moderate/severe impact in QoL was urinary urgency. According to the PPBC questionnaire 75.6% of the participants reported that their bladder condition does not cause any problem, while 11.% reported moderate to severe bother. The multivariable model showed high blood pressure and anxiety were associated with OAB in men. In females, depression, obstructive sleep apnea, IBS, and pelvic organ prolapse were associated with OAB syndrome.

Conclusions

Using the symptomatic definition of OAB can overestimate the real impact and burden of the condition, and treatment should be targeted to those symptomatic patients with QoL impairment as they would benefit from further management. The questionnaires seem to overestimate the condition, since we assessed it from a PROMS perspective there is not such a marked QoL impact.
A prediction model of residual stress for belt‐grinding blade based on geometrical characteristic and progressive wear of abrasive grains
Authors: Wang Tingting , Zou Lai , Li Heng , Huang Yun
Published: March 2022

The formation mechanism of residual stress on the machined surface of belt grinding is sophisticated, and residual stress is an important factor affecting the fatigue life of aero‐engine blades. In this study, a prediction model of residual stress in a belt grinding blade is proposed with the geometrical characteristics and progressive wear of the grains as the research topic. By extracting the morphological features of abrasive belt, the residual stress based on different geometrical characteristics of grains (pyramidal, hexahedral, spherical, and conical belts) were investigated, and the optimal grain geometry was determined to be a uniformly arranged positive quadrilateral cone. Accordingly, a grinding experiment with a pyramidal belt was conducted to obtain an experienced model of the grain wear height. A numerical simulation model of the grain wear evolution under four wear states (no abrasion, early abrasion, middle abrasion, and late abrasion) was developed. Additionally, more detailed progressive wear of the abrasive grains was also applied to grind the entire profile of the complex curved blade. The residual stress on the blade surface was mainly compressive, and the surface stress values were distributed between −385 and −117 MPa with the service life of the pyramidal abrasive belt.
Notes on Sovereignty in Vanuatu
Authors: Lindstrom Lamont
Published: March 2022

The colonial New Hebrides acquired independence and a new name, Vanuatu, in July 1980. The nascent state despite its expectations and exhortations of national sovereignty has dealt with challenges at several levels to its authority. I review a series of Vanuatu's sovereign competitors, both internal and external. These have included insurgent social movements, claimants to traditional (kastom) chiefly authority, foreign freebooters, former colonial powers France and Great Britain, and developmental aid donors with their political entanglements, including Australia and China. Understandings of sovereignty refract through local expectations of personal and communal interdependency. As such, Vanuatu's ‘fractionated’ sovereignty conforms to the current global economic and political situation.
Second cancer risk in childhood cancer survivors treated with intensity‐modulated radiation therapy: An updated analysis of more than 10 years of follow‐up
Authors: Tringale Kathryn R. , Casey Dana L. , Niyazov Gregory , Lavery Jessica A. , Moskowitz Chaya , Friedman Danielle N. , Wolden Suzanne L.
Published: March 2022

Background

It is unclear how intensity‐modulated radiation therapy (IMRT) impacts long‐term risk of second malignant neoplasms (SMNs) in childhood cancer patients.

Procedure

Patients aged ≤21 years treated with IMRT between 1998 and 2009 and who survived ≥5 years after IMRT were included. SMN site in relation to isodose level (IDL) of IMRT was evaluated. Standardized incidence ratios (SIR) and excess absolute risks (EAR) were calculated. Cumulative incidences were estimated with death as a competing risk.

Results

Three‐hundred twenty‐five patients were included with median follow‐up of 11.2 years from IMRT (interquartile range: 9.4–14.0) among patients alive at the end of follow‐up. Two hundred (62%) patients had ≥10 years of follow‐up and 284 (87%) patients were alive at the time of analysis. Fifteen patients developed SMNs (11 solid, four hematologic). Median time from IMRT to solid SMN was 11.0 years (range: 6.8–19.2) with 10‐ and 15‐year cumulative incidences 1.8% (95% CI: 0.7–3.9) and 3.5% (95% CI: 1.4–7.5), respectively; SIR was 13.7 (95% CI: 6.9–24.6) and EAR was 2.8 per 1000 person‐years (95% CI: 1.0–4.6). Eight solid SMNs developed within the IMRT field (100% IDL [n = 5], 80% IDL [n = 1], 50% IDL [n = 1], 40% IDL [n = 1]), one within the 70%–80% IDL of a conventional field, one was out‐of‐field, and one could not be determined.

Conclusions

With median follow‐up of >10 years, many solid SMNs after IMRT in childhood cancer survivors develop in the high‐dose region. These data serve as a foundation for comparison with other modalities of radiation treatment (e.g., proton therapy).
Coagulopathy and related complications following sclerotherapy of congenital venous malformations
Authors: Swerdlin Rachel F. , Briones Michael A. , Gill Anne E. , Hawkins C. Matthew
Published: March 2022

Background

Congenital venous malformations (VMs) are low‐flow vascular anomalies that can cause coagulation abnormalities. This phenomenon, referred to as localized intravascular coagulopathy (LIC), is characterized by elevated D‐dimer, hypofibrinogenemia, and/or thrombocytopenia. Increased risk for LIC includes patients with an extensive VM, multifocal VM, and Klippel–Trenaunay and CLOVES syndromes. Peri‐procedural anticoagulation has been given to prevent complications from LIC in patients undergoing surgical/interventional procedures; however, the rate of clinically relevant complications from sclerotherapy is largely unknown. The purpose of this study is to describe a single‐institution's incidence of LIC in patients with VMs and coagulopathy‐related complications following sclerotherapy.

Design/methods

Retrospective chart review of patients, 0–21 years of age, with VM who underwent sclerotherapy without peri‐procedural anticoagulation and had coagulation profiles evaluated within 1 month prior to sclerotherapy. Data collected: diagnosis type (high vs. low risk for LIC), coagulation profile (including PT/PTT, D‐dimer, fibrinogen, and platelet count), sclerosant used, and post‐procedure outcomes. Coagulopathy‐related complications included clinically relevant bleeding, deep vein thrombosis (DVT), and pulmonary embolism (PE).

Results

N = 138 patients; 59.4% were female. The most common location of VM was the lower extremity (47.8%; 66/138). Of patients with high‐risk VMs (29/138 [21%]), 11/29 (37.9%) had laboratory values consistent with LIC, whereas 5% (5/109) of low‐risk VMs had LIC. In sum, 492 sclerotherapy procedures were performed with no complications of bleeding, DVT, or PE.

Conclusion

Patients undergoing sclerotherapy for VM with abnormal coagulation profiles may not require peri‐procedural low molecular weight heparin (LMWH). Further studies are needed to precisely define which patients would benefit from anticoagulation.
Reduction in the cerebrospinal fluid protein level after bevacizumab treatment in patients with optic pathway low‐grade gliomas
Authors: da Costa Marcos Devanir , Watanabe Rodrigo Akira , Soares Carolina Torres , Dassi Natalia , Dastoli Patricia Alessandra , Nicácio Jardel Mendonça , Cappellano Andrea Maria , Silva Nasjla Saba , Cavalheiro Sergio
Published: March 2022

Optic pathway gliomas (OPG) can cause elevated cerebrospinal fluid (CSF) protein concentrations. We report on two patients with suprasellar low‐grade gliomas and high CSF protein levels (590 and 551 mg/dl) that precluded shunt implantation. After two and three doses of bevacizumab, respectively, the levels dropped dramatically to 191 and 178 mg/dl, respectively. Bevacizumab treatment was associated with a decrease in CSF protein level, allowing successful shunt placement. Our results are consistent with the pharmacological mechanism of bevacizumab, which decreases protein leakage from blood vessels to the ventricles.
Beyond counting the correct responses: Metacognitive monitoring and score estimations in mathematics
Authors: Başokçu Tahsin Oğuz , Güzel Mehmet Akif
Published: March 2022

This study investigated how well students differentiate their responses' accuracies (metacognitive monitoring) and estimate their test scores beyond counting—and counting on—the number of correct responses alone. Monitoring abilities of 2832 sixth‐graders (1410 male and 1422 female native in Turkish) at an 11‐item Program for International Student Assessment (PISA)‐equivalent mathematics test were measured via response‐contingent Type‐2 signal detection theory. The students also made score estimations right before and immediately after completing the test (pre‐ and posttest estimations, respectively). Although high‐scoring students underestimated and low‐scoring ones overestimated how they would perform in the test, high‐scorers were accurate in their posttest estimations unlike the low‐scoring group, where the lattaer retained their overestimation tendencies. Having better monitoring performance, the high‐scoring group could subsequently calibrate their posttest estimations. Additional assessment methods such as measuring monitoring and score estimations seem to have the potential to reveal how mathematics students behave before, during, and after responding.
Measuring discomfort—An objective method for quantifying peak pressure discomfort and improved fit in adults with transtibial amputation
Authors: Binedell Trevor , Ghazali Mohd Fazli Bin , Wong Clara , Subburaj Karupppasamy , Blessing Lucienne
Published: March 2022

Background

Prosthetic socket coupling with the residual limb should be comfortable without causing skin breakdown or excessive pressure. However, users report socket discomfort, and there is a scarcity of objective measurements available to assess this feeling of discomfort. Quantifying the specific pressure may enable clinicians and users to determine and improve comfort levels objectively.

Objectives

(1) To evaluate if a peak pressure reduction assists in resolving wounds, redness, and pain inside prosthetic sockets in people with transtibial amputation. (2) To determine if peak pressures measured inside the prosthetic socket due to external forces could be used to quantify the level of improvement in socket discomfort.

Design

In this cohort study, we used a pressure sensor to quantify and facilitate adjustments to the prosthetic socket, correlating this information to the userʼs socket comfort.

Setting

Outpatient clinic in a tertiary hospital in Singapore.

Participants

People (N = 16) with unilateral transtibial lower limb amputation using a prosthesis.

Interventions

NA.

Main Outcome Measures

Peak pressure and socket comfort score (SCS).

Results

The peak pressure value showed a statistically significant reduction across all participants following adjustments at a 50% delta change in pressure (p = .001). This was achieved with a mean number of 2.6 ± 1.4 adjustments per participant. Following the adjustments, the paired t‐test results showed a mean increase between the first SCS and final SCS was 2.6 (p = .001).

Conclusion

The wound, redness, and pain resolved in 15 of 16 participants regardless of diabetic status following socket adjustments. Although the peak pressures values did not correlate to the SCS score, the reduction in peak pressure saw significant improvement to the SCS. The use of a portable sensor is a fast and efficient means to quantify adjustments inside the prosthetic socket and could potentially be considered as part of future care delivery.
Botanical boom: A new opportunity to promote the public appreciation of botany
Authors: Burke Rory , Sherwood Orla L. , Clune Stephanie , Carroll Rebecca , McCabe Paul F. , Kane Adam , Kacprzyk Joanna
Published: March 2022

Societal Impact Statement

Plants are indispensable to life on Earth. Securing our future requires protecting plant biodiversity and the development of climate‐resilient crops. Activities fostering public appreciation of plant science, and promoting plant‐related professions, are therefore critical. These efforts can be hindered by plant awareness disparity, manifesting as difficulty in recognizing the presence and importance of plants. However, interest in plants as a hobby and as lifestyle elements has rapidly increased in younger demographics over the last decade. We suggest these topics should be exploited urgently by researchers and educators to increase further the reach of science communication, thereby enhancing societal awareness of botany and stimulating interest in plant‐related degrees and career pathways.

Plants are the basis of life on Earth as we know it and the study of plants is essential to protect our future. Yet botany and plant science are in crisis and suffer a low uptake at the level of undergraduate degrees. Increasing science communication about exciting advances in our knowledge of plants and their importance to society may be a strategy to counteract this. Here, we comment on the recent trends in the public perception of plants and explore them using infoveillance tools. Our observations highlight that paradoxically over the last decade public interest in plant‐related topics has increased considerably, with the advent of a new type of social media influencer—‘plantfluencers’. Additionally, recent studies demonstrate that the COVID‐19 pandemic has boosted awareness of the therapeutic value of interacting with plants and their positive effect on human well‐being. We suggest that this offers a window of opportunity to develop an appreciation of plant science among the wider public, who are reconnecting with plants in new ways. Plant‐focused communities and online groups on social media platforms can facilitate engagement with new audiences. In particular, trends relating to houseplants, plant‐based diets and the benefits of interacting with plants on mental health and well‐being together provide an attractive springboard for science outreach and botany‐focused conversations. Here, we discuss these trends and make recommendations for researchers and educators.
Curcumin regulates the homeostasis of Th17/Treg and improves the composition of gut microbiota in type 2 diabetic mice with colitis
Authors: Xiao Qiu‐Ping , Zhong You‐Bao , Kang Zeng‐Ping , Huang Jia‐Qi , Fang Wei‐Yan , Wei Si‐Yi , Long Jian , Li Shan‐Shan , Zhao Hai‐Mei , Liu Duan‐Yong
Published: March 2022

Diabetes mellitus (DM) is one of the most common complications in patients with ulcerative colitis (UC). Curcumin has a wide range of bioactive and pharmacological properties and is commonly used as an adjunct to the treatment of UC and DM. However, the role of curcumin in UC complicated by DM has not been elucidated. Therefore, this study was conducted to construct a model of UC complicating diabetes by inducing UC in DB mice (spontaneously diabetic) with dextran sodium sulfate. In this study, curcumin (100 mg/kg/day) significantly improved the symptoms of diabetes complicated by UC, with a lower insulin level, heavier weight, longer and lighter colons, fewer mucosal ulcers and less inflammatory cell infiltration. Moreover, compared to untreated DB mice with colitis, curcumin‐treated mice showed weaker Th17 responses and stronger Treg responses. In addition, curcumin regulated the diversity and relative abundance of intestinal microbiota in mice with UC complicated by DM at the phylum, class, order, family and genus levels. Collectively, curcumin effectively alleviated colitis in mice with type 2 diabetes mellitus by restoring the homeostasis of Th17/Treg and improving the composition of the intestinal microbiota
Semi‐Markov reliability model of manufacturing systems considering machine degradation, human errors, and their mutual facilitation effects
Authors: Che Haiyang , Zeng Shengkui , Guo Jianbin
Published: March 2022

Reliability plays a significant role in the overall performance of manufacturing systems, and accurate reliability assessments can guarantee their functionalities and efficiencies. This paper develops a reliability model of a manufacturing system considering machine degradation, human errors, and their mutual facilitation effects (MFE): machine degradation may increase fatigue rate and weaken learning process, thereby facilitating the occurrence of human errors, while human errors may, in turn, facilitate the machine degradation process. Although MFE may reduce system reliability, current reliability models ignore this effect. In this paper, to describe the MFE, a stochastic human error model under the effects of learning–forgetting and fatigue–recovery is proposed, where the human error rate depends on the current machine degradation state; next, based on their facilitation effects on machine degradation, human errors are divided into safety, damage, and fatal zones; finally, we incorporate the zoned human error model into the machine degradation model and develop a Semi‐Markov reliability model. A Monte Carlo method is implemented to calculate system reliability. The turret of a lathe operated by a worker is utilized to illustrate the effectiveness of the reliability model.
Evaluation of the learning curve and safety outcomes in robotic assisted vaginal natural orifice transluminal endoscopic hysterectomy: A case series of 84 patients
Authors: Liu Juan , Tan Liping , Thigpen Brooke , Koythong Tamisa , Zhou Xingnan , Liu Qihuang , Wang Qianqing , Guan Xiaoming
Published: March 2022

Background

To explore the learning curve and safety outcomes of robotic assisted transvaginal natural orifice transluminal endoscopic surgery (R‐vNOTES) for hysterectomy in benign gynaecological diseases.

Methods

A retrospective chart review of all patients undergoing R‐vNOTES hysterectomy for benign gynaecological disease from 2019 to 2021.

Setting

An academic tertiary care university hospital in Houston, TX, USA.

Results

84 patients were identified that met the study requirements. The mean hysterectomy time was 77.27 ± 2.89 min. The median additional operation time was 63 (8–206) min. There were two conversions to robotic assisted single incision laparoscopy. Thirteen (15.48%) patients had an associated complication. Analysis of the learning curve suggests plateauing of hysterectomy time at approximately 10 cases and time for robot docking and port placement after 10–20 cases.

Conclusion

R‐vNOTES is a safe and effective route for hysterectomy. For a surgeon with experience in laparoscopic single site surgery and abdominal robotic surgery, they need to perform 10 cases of R‐vNOTES hysterectomy and 10–20 cases in port placement and robotic docking to achieve proficiency.
Future hydropower operations in the Zambezi River basin: Climate impacts and adaptation capacity
Authors: Arias Mauricio E. , Farinosi Fabio , Hughes Denis A.
Published: March 2022

Southern Africa could experience major hydrological changes in coming decades, bringing drastic changes to hydropower. Focusing on four large hydropower dams in the Kafue and Zambezi Rivers (Itezhi‐Tezhi, Kafue Gorge Upper, Kariba, and Cahora Bassa), accounting for over 90% of the installed capacity in the basin, this study analyzed how these dams have altered river flows in the past, and how hydropower generation could be affected by future climate change and water use scenarios based on dynamically downscaled simulations from the Fifth Coupled Model Intercomparison Project for a Representative Concentration Pathway of 8.5 W/m2. Future climate change could affect reservoir levels by decreasing water inflows and by increasing evaporation. Results showed a decrease in median annual water levels for all reservoirs, with largest changes expected at Itezhi‐Tezhi (−1.3 to −3.3 m), followed by Cahora Bassa (−0.8 to −2.8 m), Kariba (−0.2 to −0.9), and Kafue Gorge (0.1–0.2 m). Flows downstream of dams show a consistent negative trend, with mean annual flow changes of −30% to −49% at the furthest downstream gauge. The combined reduction in water levels and flows could result in decreases on average annual hydropower generation and increases in interannual variability; annual generation could decrease by −61% to −28% at Kariba, by −51% to −21% at Itezhi‐Tezhi, by −7% to −39% at Kafue Gorge, and −27% to −9% at Cahora Bassa. Reservoir operation optimization could marginally offset the projected changes in hydropower generation, with largest gains for Kariba (+6%) and Cahora Bassa (+10%). Overall, opportunities to offset losses via operations would probably decrease with the expected drier climate and escalating reduction in river discharge and water availability. Given these negative projections, it is becoming critical to adapt and coordinate reservoir operations to best cope with the expected challenging future in this important river basin.
Graphene‐Based Conductive Networks to Enhance the Performance of Polyimide Anode Materials for Dual‐Ion Batteries
Authors: Jiang Bo , Zhu Weichen , Cai Zehua , Zeng Yong , Xiao Rengui
Published: March 2022

Organic electrodes suffer from undesirable active site utilization and instability to solvents. Generally, polymerization is an effective way of inhibiting the dissolution of organics and ameliorating the rapid decline in battery capacity. However, the low electrical conductivity of polymers restricts their practical application. In this study, a dual‐ion battery based on a polyimide/graphene compounds was constructed. Experiments reveal that the π electrons of polyimide can be quickly transferred through graphene and exhibit ultrafast reaction kinetics, thereby improving the capacity performance. Consequently, the dual‐ion battery with a polyimide–graphene anode achieves a discharge capacity of 76.6 mAh g−1 and demonstrates a capacity retention of 80 % at a high rate of 6300 mA g−1 after 500 cycles. Additionally, the redox reaction process was studied systematically.
The effects of welfare time limits on access to financial resources: Evidence from the 2010s
Authors: Pepin Gabrielle
Published: March 2022

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 established the Temporary Assistance for Needy Families (TANF) program within the United States. TANF mandated 60‐month lifetime time limits for federal cash assistance dollars. Because states reserve the right to set their own stricter or more generous time limits, the 60‐month lifetime limit did not bind in all cases. In recent years, however, several states imposed TANF time limits for the first time or made existing time limits more stringent. Using administrative and survey data, I find that stricter time limits decrease TANF participation within the past 12 months by 26%. Unlike previous research, I find heterogeneous effects of time limits on labor supply. I show that expected effects on employment and earnings decrease—and eventually become negative—as a state's unemployment rate increases. Evidence suggests that removing welfare recipients from TANF during periods of high unemployment inhibits their access to financial resources.
Proton Radiation Hardness of Organic Photovoltaics: An In‐Depth Study
Authors: Lee Harrison Ka Hin , Stewart Katherine , Hughes Declan , Barbé Jérémy , Pockett Adam , Kilbride Rachel C. , Heasman Keith C. , Wei Zhengfei , Watson Trystan M. , Carnie Matthew J. , Kim Ji-Seon , Tsoi Wing Chung
Published: March 2022

Recent developments of solution‐processed bulk‐heterojunction organic photovoltaic (OPV) cells have demonstrated power conversion efficiencies (PCEs) as high as 18% for single‐junction devices. Such a high PCE in addition to its desirable lightweight property and high mechanical flexibility can realize high specific power and small stowed volume, which are key considerations when choosing PV for space missions. To take one important step forward, their resilience to ionizing radiation should be well studied. Herein, the effect of proton irradiation at various fluences on the performance of benchmark OPV cells is explored under AM0 illumination. The remaining device performance is found to decrease with increasing proton fluence, which correlates to changes in electrical and chemical properties of the active layer. By redissolving the devices, the solubility of the active layer is found to decrease with increasing proton fluence, suggesting that the active materials are likely cross‐linked. Additionally, Raman studies reveal conformational changes of the polymer leading to a higher degree of energetic disorder. Despite a drop in performance, the retaining percentage of the performance is indeed higher than the current market‐dominating space PV technology—III–V semiconductor‐based PV, demonstrating a high potential of the OPV cell as a candidate for space applications.
Import and export trade forecasting algorithm based on blockchain security andPSOoptimized hybrid RVM model
Authors: Wang Yue
Published: March 2022

With the rapid development of globalization economy, countries in the world are more and more closely connected in business, and international import and export trade has also achieved rapid development. Based on the analysis of the status quo of the country's import and export trade, this article combines the main national economic indicators to analyze and study the algorithm of import and export trade forecasting. RVM is a sparse probability model and a new supervised learning method. Firstly, this paper introduces the protection system of block chain technology for import and export trade data information. Then, a hybrid RVM model is constructed, which is optimized by PSO algorithm, and the import and export volume is predicted based on this model. Based on the analysis of the data, it is tested that the security protection coefficient of the blockchain security technology for import and export trade data can reach up to 99.9%, and the accuracy of the import and export trade forecast based on the PSO optimized hybrid RVM model can reach up to 85.79%. A series of experiments show that the import and export trade forecast model studied in this paper can accurately predict the volume of import and export trade, thus providing a new method for the country's import and export trade, with high practical significance.
The Effect and Regulation Mechanism of Powdery Mildew on Wheat Grain Carbon Metabolism
Authors: Gao Hongyun , Niu Jishan , Zhao Wanyong , Zhang Dale , Li Suoping , Xu Yanhua , Liu Yumiao
Published: March 2022

The effects of powdery mildew on gene expressions and activities of carbon (C) metabolism enzymes in Zhengmai 103 (resistant) and Xi'nong 979 (susceptible) are studied. Under severe powdery mildew, expressions and activities of sucrose synthase, uridine‐diphosphate glucose pyrophosphorylase, glyceraldehyde‐3‐phosphate dehydrogenase (GAPDH), and cytosolic α‐1,4‐glucan phosphorylase decrease at 20 or 25–30 days after anthesis, and total soluble sugars content also decreases. It indicates that the first part of C metabolism (sucrose degradation) changes and total C flux reduces. Meanwhile, decreases in expressions and activities of adenosine‐diphosphate glucose pyrophosphorylase (AGPase), soluble starch synthase (SSS), starch‐branching enzyme I and II (SBEI and SBEII), and plastidic α‐1,4‐glucan phosphorylase coincide with decreases in amylopectin content, whereas increases in granule‐bound starch synthase I (GBSSI) expression and activity coincide with increases in amylose content. It shows that the second part of C metabolism (starch synthesis) changes. Therefore, powdery mildew alters C metabolism. In addition, it also induces defense responses in grains, such as the up‐regulation of a defense‐related protein endogenous α‐amylase/subtilisin inhibitor. Since GAPDH, AGPase, SSS, SBEII, and GBSSI are regulated by redox, changes of C metabolism are mainly regulated by cellular redox status.
Compression behavior of reinforced concrete columns jacketed with multi‐spiral transverse reinforcement
Authors: Hao Meijing , Zheng Wenzhong , Chang Wei
Published: March 2022

The objective of this study was to investigate the compressive behavior of reinforced concrete (RC) columns jacketed by modified multi‐spiral transverse reinforcement, in which columns were jacketed by a large welded octagonal stirrup at the center and four small spiral stirrups at the corners of specimens. Sixteen large‐scale concrete columns were jacketed by the proposed method and subjected to axial compression tests. The investigated parameters included the axial compression ratio of existing column and the volumetric ratio of stirrups in jacket. The experimental results revealed that the jacketed columns failed by the formation of an inclined shear failure plane and specimens still kept rather high load‐bearing capacity after core concrete crushed, owing to the multiple confinement materials in jacket. The axial load‐strain curves of specimens could be divided into four phases, corresponding to failure modes. Furthermore, increasing the volumetric ratio of stirrups in jacket effectively improved ductility of jacketed RC columns compared to the load‐bearing capacity, while increasing the axial compression ratio of existing column decreased the enhancement of jacket. Six recent confinement models were selected to predict the peak strength of confined concrete and the corresponding strain. The predicted models performed well in the ascending branch of the analytical stress–strain curves, while the descending branch showed a lower rate of decrease than experimental values. The compression behavior of RC columns jacketed by modified multi‐spiral transverse reinforcement was analyzed, and the effects of axial compression ratios of existing columns and the volumetric ratio of stirrups of jacket on the compression behavior of columns were exhibited. Furthermore, the experimental results were evaluated by six existing models.
Static test and theoretical study on semirigid pin joint for modular steel reticulated shell
Authors: Zhang Ai‐Lin , Li Chong , Zhang Yan‐Xia , Liu Xue‐Chun
Published: March 2022

In order to realize the modularity and rapid assembly of steel reticulated shells in the construction site, a new type of simple assembled joint named semirigid pin joint is proposed for modular steel reticulated shell in this paper. While on the premise of meeting the stiffness and strength requirement, complicated procedures such as tightening nuts and controlling pretightening force are avoided in this joint. In addition, the joints can adapt to the complex curvature changes of reticulated shells. When it is connected in the middle of the member, the new joint can realize the connection of arc members. First, experiments were carried out on different screw rod diameters, wing plate pin diameters, and the number of wing plate pins. Different failure modes and M–Φ curves of semirigid pin joints were obtained. The stiffness and strength of the joints were studied. Second, a three‐dimensional finite element model of the joint was established by ABAQUS, and the comparison between the simulated results and the experimental results proved the accuracy of the finite element numerical analysis. On this basis, the antirotation stiffness, strength, and failure mode of the new joint with different parameters were compared and discussed, and the influence law of each parameter on the mechanical properties of the new joint was obtained. Finally, based on the power function model, a theoretical analysis model for estimating the M–Φ curve of the joint was established. Compared with the results of the experiments, the results indicated that the prediction formula has high accuracy.
Modified Lipschitz Optimization and its Application to Maximum Power Point Tracking Control for Photovoltaic Systems
Authors: Masuda Eiji , Wakasa Yuji , Adachi Ryosuke
Published: March 2022

In this paper, we propose a modified Lipschitz optimization (LO) method and apply it to maximum power point tracking (MPPT) control for photovoltaic (PV) systems. The standard LO can find a global maximum of a Lipschitz continuous function over a closed interval in a deterministic way. However, the standard LO tends to evaluate low objective function values, and this feature leads to low MPPT efficiency in its application to MPPT control. The proposed method skips the evaluation of low objective function values (i.e., low power points) by using prior information on the output characteristics of a PV array. Moreover, we show theoretically that the proposed method guarantees convergence to a global optimal solution. We compare the proposed method with some of well‐known MPPT methods and verify its effectiveness through simulations. © 2022 Institute of Electrical Engineers of Japan. Published by Wiley Periodicals LLC.
Bioelectricity‐coupling patches for repairing impaired myocardium
Authors: Li Yuedan , Qiu Xiaozhong
Published: March 2022

Cardiac abnormalities, which account for extensive burdens on public health and economy, drive necessary attempts to revolutionize the traditional therapeutic system. Advances in cardiac tissue engineering have expanded a highly efficacious platform to address cardiovascular events, especially cardiac infarction. Current efforts to overcome biocompatible limitations highlight the constructs of a conductive cardiac patch to accelerate the industrial and clinical landscape that is amenable for patient‐accurate therapy, regenerative medicine, disease modeling, and drug delivery. With the notion that cardiac tissue synchronically contracts triggered by electrical pulses, the cardiac patches based on conductive materials are developed and treated on the dysfunctional heart. In this review, we systematically summarize distinct conductive materials serving as the most promising alternatives (conductive nanomaterials, conductive polymers, piezoelectric polymers, and ionic electrolytes) to achieve electric signal transmission and engineered cardiac tissues. Existing applications are discussed considering how these patches containing conductive candidates are fabricated into diverse forms with major strategies. Ultimately, we try to define a new concept as a bioelectricity‐coupling patch that provides a favorable cardiac micro‐environment for cardiac functional activities. Underlying challenges and prospects are presented regarding industrial processing and cardiovascular treatment of conductive patch progress.

This article is categorized under:

Therapeutic Approaches and Drug Discovery > Nanomedicine for Cardiovascular Disease
Effect of inclined magnetic field on flow of Williamson nanofluid over an exponentially stretching surface in Darcy‐Forchheimer model
Authors: Sharma Diksha , Sood Shilpa
Published: March 2022

The present study elaborates magnetohydrodynamics (MHD) boundary layer flow with heat and mass transfer of pseudo‐plastic nanofluid over an exponentially stretching sheet embedded in a porous medium. Also, the effects of Brownian motion and thermophoresis on heat transfer and nanoparticle concentration are taken into account. With the help of suitable similarity transformations, the governing partial differential equations (PDEs) are transformed into a system of ordinary differential equations (ODEs). An inbuilt solver of MATLAB is being used to solve the system of mathematical equations. The effects of dimensionless parameters on the flow, heat transfer and nanoparticle concentration have been investigated. Graphs have been plotted and discussed to analyze the effects of various dimensionless parameters on velocity, temperature and concentration. As per the results, fluid velocity diminishes as the values of the aligned angle elongate, although temperature and concentration profiles reflect a switch pattern. Furthermore, as the values of Brownian motion, thermophoresis parameter and Lewis number rise, the temperature and concentration profiles rise as well. However, the concentration profiles for Brownian motion and Lewis number shows the reverse tendency.
Transformative Literacy as the Ability to Look Forward from Within
Authors: Dewandre Nicole
Published: March 2022

Acquiring transformative literacies calls for a critical review of our underlying conceptual assumptions, in order to bring new light to old words, such as human, equality, freedom and power. Indeed, the transition towards sustainability requires leaving behind the modern paradigm, and embracing a conceptual framework proposed by Hannah Arendt, notably in the Human Condition. With her reconceptualisation of humanness, focused on relationality instead of rationality, she creates the conditions for cherishing and honouring interdependence, from each other, from artefacts and from nature. With this renewed understanding of what it means to be human and how it entails to rely on nature, Arendt offers a new framework that dissolves misleading beliefs and activates alternative ways to look and engage with reality in a meaningful way. And so she does, by keeping fear and rage away, but instead mobilising trust and …love of the world, as difficult it may be.