bluuebunny/crossref_metadata_2025 huggingface dataset:
End‐winding wire‐insulation heat conduction model for precise thermal predictions of permanent magnet synchronous machines
Authors: Li Longnv , Liu Shijie , Shang Yatao , Xue Ming , Liu Tao , Zhu Gaojia
Published: June 2023

Accurate thermal calculations of end‐winding temperature rises are the key issue in designing and developing cooling systems of permanent magnet synchronous machines (PMSMs). Due to the complex connections of the end‐windings, it is challenging to precisely predict the heat dissipation capacities through a traditional wire‐insulation equivalent model. Numerical simulations and lumped parameter thermal networks (LPTN) are used by the authors to develop thermal models that illustrate the end‐winding properties of a 2.1‐kW PMSM. As multi‐strand end wires are bent and bound together by ribbons, they have thermal interrelations which can hardly be considered in LPTN models. An equivalent coefficient enhancing the axial heat conduction capacities of end‐windings is proposed for LPTN calculations to model the aforementioned thermal interrelations with circumferential symmetric structures. To correctly model the mutual thermal coupling between various strands of end‐windings, the thermal conductivity of the equivalent insulation sheets between the multi‐strand end‐windings is determined for exact numerical calculations. The external insulation sheet thickness is calculated based on the equivalent thermal conductivity. After developing heat conduction models for LPTN and numerical simulations, LPTN and FEA are used to determine the PMSM's temperature rise characteristics. To verify the approaches, the computation findings are contrasted with experimental ones.
Park‐and‐ride choice behaviour under multimodal travel information—Analysis based on panel mixed logit model
Authors: Huang Yue , Gan Hongcheng , Lu Huan , Wang Xinyu , Wang Wenjing
Published: June 2023

Understanding the impact of smartphone‐based multimodal information (SMMI) on travellers' P&R (park‐and‐ride) choice behaviour is very limited so far. The purpose of this study is to better understand how SMMI, social network information, and individual characteristics influence travellers' mode choices. A stated preference experiment consisting of one P&R option and two auto‐driving routes was conducted to collect car commuters’ P&R choice data in Shanghai, China. The panel mixed logit model was utilized to determine the influencing factors. It was found that the panel mixed logit model, accounting for correlations among repeated observations of the same respondent and random taste, significantly outperforms the cross‐sectional multinomial logit model in terms of goodness‐of‐fit. Specifically, travellers are highly sensitive to the information offered by SMMI on travel time, parking fare, and crowding level in subway cars, and heterogeneities do exist in travellers' preferences for these factors. In terms of social network information, the positive propensity of online reviews and information about P&R play a positive role in P&R promotion. In addition, individual characteristics including gender, age, occupation, years of driving, and P&R experience all contribute to explaining the choice of P&R. Finally, the elasticity analysis reveals that commuters are more satisfied with P&R time than with car time, and the cross elasticity of P&R time demonstrates a limited substitution effect of P&R on private cars.
Dual‐band filtering power amplifier with extended passband bandwidths and wide stopband rejection
Authors: Dong Gaoya , Yang Xiaolong , Fang Yunnan , Tenzeris Manos M.
Published: June 2023

This article presents a dual‐band filtering power amplifier (DB‐FPA) with extended passband bandwidths and wide stopband rejection, which is helpful in reducing the number of microwave components in the dual‐band radio frequency front end, resulting in compact circuit size and low loss. In the designed DB‐FPA, a wideband low‐pass filter is applied as the input matching network (IMN) to provide wideband impedance matching and good stopband rejection, while a dual‐band filtering impedance transformation is adopted as the output matching network (OMN) to provide dual‐band impedance matchings and filtering responses simultaneously. Specifically, the IMN is constructed by high‐impedance transmission‐line sections and low‐impedance open‐circuit stubs. The OMN is designed based on the specific external quality factors and coupling coefficients during two bands, resulting in dual‐band impedance transformations and dual‐band filtering responses. Then, based on the above IMN and OMN, the design procedure of the presented DB‐FPA is summarised. To verify the proposed idea, a novel DB‐FPA has been fabricated and measured. During the two frequency bands, the measured maximum power added efficiencies are 55.11% and 47.78% within 33.0 dBm input power, while the measured peak gains are 15.4 and 14.0 dB within 15.0 dBm input power.
Research progress of intrinsic polymer dielectrics with high permittivity
Authors: Chen Kaijin , Liu Zunchu , Zheng Weiwen , Liu Siwei , Chi Zhenguo , Xu Jiarui , Zhang Yi
Published: June 2023

The high permittivity of polymer dielectrics facilitates their use in the electronics industry. Compared to inorganic ceramics and composites, intrinsic high permittivity polymer dielectrics have the advantages of easy solution processing and better homogeneity. The permittivity of common polymers is generally low, hence it would be worthwhile to explore avenues for augmenting the permittivity of polymer dielectrics via judicious and efficient structural design. The effective strategies used to increase the permittivity of intrinsic polymers encompass elevating local polarisabilities by fortifying electron delocalisation capabilities, exploiting ion pairs to generate atomic clusters with larger dipole moments, amplifying dipole density, augmenting dipole mobility, and so forth. Due to the rigidity and flexibility of the polymer backbone's decisive influence on the dielectric's all‐around performance, its selection also requires a total consideration of the requirements of practical applications. This work provides an overview and a brief evaluation of the dominant design strategies and mentions possible future design paradigms for polymer dielectrics.
Optimal resource optimisation based on multi‐layer monitoring
Authors: Uzunidis Dimitrios , Karkazis Panagiotis , Leligou Helen C.
Published: June 2023

The satisfaction of the Quality of Service (QoS) levels during an entire service life‐cycle is one of the key targets for Service Providers (SP). To achieve this in an optimal way, it is required to predict the exact amount of the needed physical and virtual resources, for example, CPU and memory usage, for any possible combination of parameters that affect the system workload, such as number of users, duration of each request, etc. To solve this problem, the authors introduce a novel architecture and its open‐source implementation that a) monitors and collects data from heterogeneous resources, b) uses them to train machine learning models and c) tailors them to each particular service type. The candidate solution is validated in two real‐life services showing very good accuracy in predicting the required resources for a large number of operational configurations where a data augmentation method is also applied to further decrease the estimation error up to 32%.
Measurement point layout strategy of free-form surface based on gridding using coordinate measuring machine
Authors: Zeng Linan , Chen Yueping
Published: June 2023

The layout of measurement points is the key to the efficient inspection of free-form surfaces. Two algorithms are proposed for the layout of free-form surface measurement points: the free-form surface Gaussian curvature variation grid method and the isoparametric line curvature variation grid method. The former first divides the free-form surface into a uniform grid, determines the number of measurement points for each grid based on the change in the Gaussian curvature of each grid, and selects points within each grid based on a uniform distribution of the Gaussian curvature. The latter is achieved by first taking points from the curvature change on the initial U- and V-direction isoparametric lines, generating isoparametric lines from the points to divide the free-form surface into a grid, and selecting the grid intersections as measurement points. The effectiveness of the algorithm was verified by designing free-form surfaces, performing coordinate measuring machine (CMM) measurement experiments, and comparing the results with those of existing algorithms.
Smoking Status Trends between Primary Total Hip Arthroplasty Patients and the General Population from 2012 to 2021
Authors: Nwakoby Ekenedilichukwu , Bieganowski Thomas , Singh Vivek , Anil Utkarsh , Schwarzkopf Ran , Lajam Claudette M.
Published: June 2023

Smoking is associated with an increased risk of complications, higher opioid use, and mortality following primary elective total hip arthroplasty (THA). Interventions for smoking cessation have been enhanced since value-based care was initiated in 2013. It remains unclear whether surgical optimization has influenced the proportion of smokers undergoing THA over time. Our study examines trends in the yearly proportions of smokers for primary elective THA versus patients having annual physical examinations (APEs). We retrospectively reviewed all patients of 18 years of age or older who underwent primary elective THA and those who had an APE at our institution between January 2012 and December 2021. The electronic medical record was queried for baseline demographics and documented smoking status. Linear regression analysis was used to determine trend significance. In total, 12,524 primary THA patients were matched in a 1:5 ratio to 62,630 APE patients using nearest-neighbor matching. Our analysis demonstrated significantly higher proportions of documented current and former smokers within the THA group at each time point compared with the APE group. The rate of current smokers undergoing THA demonstrated a downward trend that was not significant. There was a significant upward trend in documented current smokers presenting for an APE. Although there has been a decrease in active smokers undergoing THA at our institution over the past decade, this trend is not significant. Therefore, it remains unclear whether smoking cessation interventions have influenced patients undergoing primary THA. Continued vigilance in smoking cessation strategies is warranted, and improved documentation of smoking status may enhance our current understanding of whether optimization efforts are successful.

Level III Evidence Retrospective cohort study.
Pulmonary Physiology and Medicine of Diving
Authors: Tetzlaff Kay
Published: June 2023

Pulmonary physiology is significantly altered during underwater exposure, as immersion of the body and increased ambient pressure elicit profound effects on both the cardiovascular and respiratory systems. Thoracic blood pooling, increased breathing gas pressures, and variations in gas volumes alongside ambient pressure changes put the heart and lungs under stress. Normal physiologic function and fitness of the cardiovascular and respiratory systems are prerequisites to safely cope with the challenges of the underwater environment when freediving, or diving with underwater breathing apparatus. Few physicians are trained to understand the physiology and medicine of diving and how to recognize or manage diving injuries. This article provides an overview of the physiologic challenges to the respiratory system during diving, with or without breathing apparatus, and outlines possible health risks and hazards unique to the underwater environment. The underlying pathologic mechanisms of dive-related injuries are reviewed, with an emphasis on pulmonary physiology and pathophysiology.
Pulmonary Vein Varix: A Diagnostic Enigma
Authors: Howdekar Madhuri , Susarla Rammurti , Mutnuru Phani Chakravarty , GK Paramjyothi , Kalva Sanjeeva Prasad
Published: June 2023

We report a case of a 34-year-old woman who presented with chest pain, shortness of breath, and dry cough of 1 month duration. Contrast-enhanced computed tomography of the chest revealed an enlarged and tortuous right pulmonary vein that could not conclusively exclude a pulmonary arteriovenous malformation. Further evaluation with digital subtraction angiography excluded an arteriovenous malformation and confirmed the presence of a pulmonary vein varix. Accordingly, the patient was managed conservatively. This report highlights the need for catheter angiography in the diagnosis of pulmonary vein varix and provides a brief review of literature on the entity.
Andreev reflection between aluminum and graphene across van der Waals barriers
Authors: Huang Ko-Fan , Gül Önder , Taniguchi Takashi , Watanabe Kenji , Kim Philip
Published: June 2023

We present planar aluminum superconductor–graphene junctions whose hybrid interface is engineered for couplings ranging from tunneling to the strongly coupled regime by employing an atomically thin van der Waals tunneling barrier. Without the vdW barrier, we find Al makes strongly coupled contacts with the fully proximities graphene channel underneath. Using a large band gap hexagonal boron nitride (hBN) barrier, we find the junctions always remain in the weak coupling regime, exhibiting tunneling characteristics. Using monolayer semi-conducting transition metal dichalcogenides (TMDs) such as MoS2, we realize intermediate coupling with enhanced junction conductance due to the Andreev process. In this intermediate regime, we find that junction resistance changes in discrete steps when sweeping a perpendicular magnetic field. The period of the resistance steps in the magnetic field is inversely proportional to the junction area, suggesting the physical origin of our observations is due to magnetic-field-induced vortex formation in the planar junction.
Vacuum deposited organic solar cells with BTIC-H as A–D–A non-fullerene acceptor
Authors: Habib Irfan , Kaienburg Pascal , Xia Dondong , Gough Olivia , Zhu Ming , Spruce Joseph , Li Weiwei , Riede Moritz
Published: June 2023

The record power conversion efficiency of solution-processed organic solar cells (OSCs) has almost doubled since non-fullerene acceptors (NFAs) replaced fullerene derivatives as the best-performing acceptor molecules. The successful transition from C60 to NFAs is still pending for vacuum-thermal evaporated (VTE) OSCs, not least because most NFAs are too large to be evaporated without breaking. Due to VTE’s relevance in terms of industrial manufacturing, discovering high-performing VTE NFAs is a major opportunity for OSCs. Here, we fabricate evaporated OSCs based on the NFA BTIC-H known from solution processing. This A–D–A molecule has an unfused bithiophene core, 1,1-dicyanomethylene-3-indanone end groups, and hexyl side chains, making it small enough to be evaporated well. We pair BTIC-H with four commonly used evaporated donors—DCV5T-Me(3,3), DTDCPB, HB194, and SubNc—in planar heterojunctions. We observe appreciable photocurrents and a voltage loss of ∼0.8 V, matching that of corresponding C60 devices. Donor:BTIC-H bulk heterojunctions likely face charge collection issues due to unfavorable microstructure. Our work demonstrates one of few NFA based evaporated OSCs with encouraging performance results and gives one potential starting point for molecule design of further NFAs suitable for VTE.
Effects of malachite green on biochemistry and photosystem II photochemistry of Eichhornia crassipes
Authors: Sharma Jyotshana , Shah Garishma , Strasser Reto J. , Soni Vineet
Published: June 2023

Malachite green (MG) is a common synthetic dye that raises environmental concerns. This study reveals that MG has inhibitory effects on the biochemistry and physiology of Eichhornia crassipes. Effects of different concentrations of MG on ROS-scavenging enzymes, α-amylase, proline, chlorophyll pigments, and various photosynthetic parameters of E. crassipes were investigated. Chlorophyll fluorescence analysis coupled with the JIP test showed the inhibitory effects of MG on biochemistry and photosynthetic potential depended on concentration and time. Up to 2 days of MG exposure, α-amylase and proline were upregulated with increasing MG concentration. When exposure time and concentration increased, all the parameters initially increased, then sharply declined. Chlorophyll content decreased with exposure time and concentration. Due to the slowing down of electron transport on the donor side brought on by MG exposure, P680+ builds up. According to an analysis of E. crassipes PSII activity, exposure to MG raises the proportion of inactive PSII reaction centres and active PSII centres. After increasing the exposure period (2, 4, and 6 days) and MG concentration (50, 100, 150, and 200 mg L−1), it decreased the absorption efficiency electron transport potential, maximal quantum yield of primary photochemistry, and the quantum yield of electron transport. These modifications led to a decline in the entire photosynthesis performance. The current research suggests that MG has detrimental effects on plants; therefore, the need for stringent regulations to prevent the release of dye-containing effluents into aquatic environments.
Exploring terminological relations between multi-word terms in distributional semantic models
Authors: Wang Yizhe , Daille Béatrice , Hathout Nabil
Published: June 2023

A term is a lexical unit with specialized meaning in a particular domain. Terms may be simple (STs) or multi-word
(MWTs). The organization of terms gives a representation of the structure of domain knowledge, which is based on the relationships
between the concepts of the domain. However, relations between MWTs are often underrepresented in terminology resources. This work
aims to explore distributional semantic models for capturing terminological relations between multi-word terms through lexical
substitution and analogy. The experiments show that the results of the analogy-based method are globally better than those of the
one based on lexical substitution and that analogy is well suited to the acquisition of synonymy, antonymy, and hyponymy while
lexical substitution performs best for hypernymy.
Cats in the Outdoors
Authors: Tully Paul
Published: June 2023

This case is about domestic cats who follow instincts for outdoor roaming and, thus, wander in human-made places. People construct these places via ideals regarding aspects of health, safety, and acceptable behaviour. As cats roam in outdoor places, they challenge such ideals through the reality of their lives and human choices. This case considers the issues cats’ presence creates for people and questions the solutions humans contemplate in attempts to protect outdoor place ideals. It asks questions regarding if strategies humans think about to tackle their issues of cats in the outdoors are morally right or wrong in order to stimulate debate.

Information

© The Author 2023
Synthesis and characterization of a dental cement based on bioactive glass/zinc oxide modified with organic resin as a novel pulp capping agent
Authors: Pedram Parham , Najafi Farhood , Heidari Soolmaz , Hodjat Mahshid , Bolhari Behnam , Hooshmand Tabassom
Published: June 2023

This study aimed to synthesize and characterize a novel dental pulp capping cement containing bioactive glass (BG)/zinc oxide modified with an organic resin. BG (45S5) with or without ZnO (Zn) and hemaphosphate (HP) combined with a liquid consisting of polyacrylic and itaconic acids (AA) were synthesized and the structural, physical, and mechanical properties were assessed. Hydroxyapatite formation was evaluated by immersion in simulated body fluid. Biological analysis including methyl thiazolyl tetrazolium assay, alizarin red staining, alkaline phosphatase (ALP) activity, and gene expression of odontogenic markers were performed to evaluate the cytotoxic effect and biomineralization potential of the cements on human dental pulp stem cells (hDPSCs). A commercial mineral trioxide aggregate (MTA) served as control. The highest compressive strength value and the shortest setting time were belonged to the BG + HP + AA and BG + AA groups, respectively. The shear bond strength to dentin was the highest for the BG + HP + AA cement. Scanning electron microscope showed only scarce deposits of calcium phosphate formation on the surface of the synthesized cements. BG + HP + AA and BG + HP + Zn + AA groups had significantly lower cytotoxicity than MTA. The mineralization potential of hDPSCs after stimulation by the novel cements increased. Quantitative reverse-transcription-polymerase chain reaction showed higher odontogenic marker expression in hDPSCs exposed to the BG + HP + Zn + AA cement compared to other synthesized cements, although it was higher in MTA group. Based on the obtained results, the novel synthesized cements can be used as appropriate capping agents in the treatment of dental pulp.
3D bioprinting: opportunities for wound dressing development
Authors: Wang Xiudan , Wang Yanhua , Teng Yanjiao , Shi Jie , Yang Xinran , Ding Ziling , Guo Xiaoqin , Hou Shike , Lv Qi
Published: June 2023

The skin is the body’s first line of defence, and its physiology is complex. When injury occurs, the skin goes through a complex recovery process, and there is the risk of developing a chronic wound. Therefore, proper wound care is critical during the healing process. In response to clinical needs, wound dressings have been developed. There are several types of wound dressings available for wound healing, but there are still many issues to overcome. With its high controllability and resolution, three-dimensional (3D) printing technology is widely regarded as the technology of the next global industrial and manufacturing revolution, and it is a key driving force in the development of wound dressings. Here, we briefly introduce the wound healing mechanism, organize the history and the main technologies of 3D bioprinting, and discuss the application as well as the future direction of development of 3D bioprinting technology in the field of wound dressings.
Highly sensitive detection of bacteria (E. Coli) endotoxin using novel PANI-benzimidazole-Ag nanocomposite by DMMB dye displacement assay
Authors: Alemu Tadele Ageru , Ayele Delele Worku , Parveen J Shahitha , Worku Ababay Ketema , Teshager Minbale Admas , Ramamurthy Praveen C , Mani Dhakshnamoorthy
Published: June 2023

In the present study, a new biochemical biosensor material of conductive Silver (Ag) reinforced polyaniline (PANI)-Benzimidazole copolymer nanocomposite was fabricated via in situ chemical oxidative polymerization method for the detection of endotoxin. The fabricated PANI-Benz-Ag nanocomposite was characterized by FTIR, XRD, UV–visible spectrometer, DSC, TGA, Zeta-potential, SEM, TEM, and Confocal fluorescence imaging microscopy. The measured particle size, zeta-potential, and conductivity of the PANI-Benz-Ag nanocomposite were 4.942 nm, −10.4 mV, and 73.7 μS cm−1 respectively. The crystallite size of Ag nanoparticles was around 67 nm calculated by XRD analysis and TGA analysis was carried out to determine weight loss and thermal stabilities of PANI-Benz and PANI-Benz-Ag nanocomposite. The endotoxin (E. coli) bacteria detection ability of the synthesized PANI-Benz-Ag nanocomposite-based biochemical biosensor using DMMB dye displacement assay through the hitchhiking method by confocal fluorescence microscopy was found to be simple and effective. Endotoxin (E. coli) can form a stable interaction with other bioactive molecules and thus it binds readily with Ag-doped PANI-Benzimidazole nanocomposite. Further, the DMMB dye displacement assay method is more accurate and sensitive than the other existing methods for the detection of endotoxin.
‘Will I wear purple?’—a school arts-based research project in the UK to disseminate findings from a qualitative evidence synthesis about living to an extreme age
Authors: Toye Francine , Cox Alexa , Jenkins Cathy , Barker Karen
Published: June 2023

Background

a change in attitude towards ageing is needed. Arts-based research (ABR) refers to the use of any creative art in research. ABR can provide an environment to reflect on challenging social issues and has the potential to make lasting impressions.

Objective

we aimed to explore the use of ABR to disseminate findings from a qualitative evidence synthesis exploring what it means to live well beyond the age of 80.

Design

ABR using art as a stimulus for recorded discussions and written annotations.

Setting

a mixed catchment state secondary school in the UK.

Subjects

fifty-four secondary school pupils aged 14–15. The majority identified as female (ratio 5:1).

Methods

school pupils created artwork to represent themes about ageing drawn from a qualitative evidence synthesis. The artwork was a stimulus for recorded discussions. We used thematic analysis to develop themes about children’s response to ageing.

Results

we developed six themes. Pupils found comfort in recognising that old age can be lived well; they began to see themselves in the older person; they explored the ambiguous nature of memory; they highlighted the dangers of disconnection; they affirmed a need to restore connection with elders and they recognised the need to cherish time and live meaningfully.

Conclusions

this project encouraged pupils to think about what it means to grow old. ABR has the potential to contribute to a more positive relationship with older people and towards ageing. Research stakeholders should not undervalue the potential power of shifts in perspective for powering social change.
Risk prediction models for antineoplastic-associated cardiotoxicity in treatment of breast cancer: A systematic review
Authors: Rodriguez Ryan , Joseph Honey , Macrito Rosa , Lee Todd A , Sweiss Karen
Published: June 2023

Purpose

The objective of this systematic review is to assess methodology of published models to predict the risk of antineoplastic-associated cardiotoxicity in patients with breast cancer.

Methods

We searched PubMed and Embase for studies that developed or validated a multivariable risk prediction model. Data extraction and quality assessments were performed according to the Prediction Model Risk of Bias Assessment Tool (PROBAST).

Results

We identified 2,816 unique publications and included 8 eligible studies (7 new risk models and 1 validation of a risk stratification tool) that modeled risk with trastuzumab (n = 5), anthracyclines (n = 2), and anthracyclines with or without trastuzumab (n = 1). The most common final predictors were previous or concomitant chemotherapy (n = 5) and age (n = 4). Three studies incorporated measures of myocardial mechanics that may not be frequently available. Model discrimination was reported in 7 studies (range of area under the receiver operating characteristic curve, 0.56-0.88), while calibration was reported in 1 study. Internal and external validation were performed in 4 studies and 1 study, respectively. Using the PROBAST methodology, we rated the overall risk of bias as high for 7 of 8 studies and unclear for 1 study. Concerns for applicability were low for all studies.

Conclusion

Among 8 models to predict the risk of cardiotoxicity of antineoplastic agents for breast cancer, 7 were rated as having a high risk of bias and all had low concerns for clinical applicability. Most evaluated studies reported positive measures of model performance but did not perform external validation. Efforts to improve development and reporting of these models to facilitate their use in practice are warranted.
Patient satisfaction with pharmacist-led chronic care management services combined with medication synchronization
Authors: Awad Magdi , Furdich Kenneth , Webb Dana
Published: June 2023

Purpose

Chronic care management (CCM) improves clinical outcomes, enhances patients’ adherence with medical treatments, reduces overall cost, and increases patient satisfaction. However, multiple reports have indicated the underutilization of CCM. Implementation literature has emphasized feasibility and different approaches to providing pharmacist-led CCM. This article examines patient acceptability and provides an innovative implementation approach combining both CCM and medication synchronization (MedSync) services.

To introduce CCM services to underserved Medicare beneficiaries at a federally qualified health center, the pharmacy department of a federally qualified health center (FQHC) pilot tested a program whereby pharmacists provided CCM to Medicare beneficiaries enrolled in the MedSync service offered by the FQHC’s in-house pharmacies. Both services were provided during the same phone call by the pharmacist. After successful completion of the pilot program, a retrospective chart review and patient satisfaction survey were conducted to enhance the quality of the service. A total of 49 patients were enrolled in the CCM program at the time of data collection. Overall, participants were satisfied with the service. The average number of medications per patient was 13.7. Pharmacists were able to identify an average of 4.8 medication-related problems (MRPs) per patient. Most of the MRPs (62%) were resolved directly by the pharmacists via education, over-the-counter medication adjustments, or interventions under consult agreements.

Conclusion

In addition to positive patient satisfaction, pharmacists were able to identify and address a significant number of MRPs when providing CCM.
The Optimal Layer for Breast Augmentation in an Autologous Fat Grafting Murine Model
Authors: Zhang Ziang , Qin Zijin , Li Yu , Long Jie , Chen Guo , Gao Botao , Zhou Xuhua , Zhang Yuge , Song Baoqiang
Published: June 2023

Background

Fat grafting is an effective procedure for breast augmentation, but the variations in this technique result in unpredictable fat retention. Therefore, animal models are needed to simulate the operation and the optimal layer for fat retention.

Objectives

An autologous fat grafting murine model for breast augmentation was built to detect a new layer for fat grafting in the chest.

Methods

The left side of the female rat inguinal fat flap was harvested, dissected into small pieces, and autotransplanted into 3 different layers of the breast. Retention rate and hematoxylin and eosin (H&E) staining were measured at 1, 4, 8 12, and 16 weeks. Immunofluorescence staining was utilized to detect adipocytes and endothelial cells, and immunohistochemistry was conducted to evaluate the expression of integrins β1 and α6.

Results

The volume of fat grafts slightly grew in the intramuscular and submuscular layers at Week 4. Retention rates in the subcutaneous layer and submuscular layer were significantly higher than the intramuscular layer at Week 16. H&E staining showed that oil cysts existed in the subcutaneous layer throughout the 16 weeks. At the terminal time point, well-vascularized mature adipose structures were observed in intramuscular and submuscular layers, with smaller adipocytes in intramuscular layers. Immunohistochemistry analysis showed that integrin β1 was identically expressed in every adipocyte in all the layers, whereas integrin α6 selectively expressed in bigger adipocytes in the intramuscular layer. The expression intensities of integrin β1 and α6 were significantly higher in the intramuscular layer than in the subcutaneous and submuscular layers.

Conclusions

The angiogenic and moderate mechanical environment makes the submuscular layer the optimal layer for fat retention.
Factors Influencing Patient Satisfaction With Breast Augmentation: A BREAST-Q Effect of Magnitude Analysis
Authors: Jørgensen Mads G , Hemmingsen Mathilde N , Larsen Andreas , Weltz Tim K , Strålman Kristina B , Andersen Peter S , Nezame Sarmady Faranak , Toyserkani Navid M , Herly Mikkel , Elberg Jens J
Published: June 2023

Background

Breast augmentation is one of the most performed cosmetic surgeries. Despite this, patient satisfaction following breast augmentation is poorly understood.

Objectives

The aim of this study was to investigate what patient and surgical factors influence patient satisfaction following primary breast augmentation.

Methods

The BREAST-Q Augmentation module was sent to all females undergoing primary breast augmentation at a single private clinic (Amalieklinikken, Copenhagen, Denmark) between 2012 and 2019. Patient and surgical characteristics at the time of surgery were obtained from the patients’ medical records, and data on factors that occurred after the surgery (eg, breastfeeding) were obtained by patient contact. Multivariate linear regression modeled the impact of these factors on BREAST-Q outcomes.

Results

A total of 554 females with a mean follow-up time of 5 years after primary breast augmentation were included in this study. Implant type and volume did not affect patient satisfaction. However, higher patient age was associated with significantly higher postoperative patient satisfaction, psychosocial well-being, and sexual well-being (P < .05). Conversely, higher patient BMI, postoperative weight gain, and breastfeeding were associated with significantly lower satisfaction (P < .05). Additionally, subglandular implant placement was associated with significantly lower satisfaction than submuscular implant placement (P < .05).

Conclusions

Implant type and volume did not affect patient satisfaction with breast augmentation. However, young age, higher BMI, subglandular implant placement, and postoperative weight gain were associated with lower patient satisfaction. These factors should be considered when aligning outcome expectations with breast augmentation.

Level of Evidence: 4
The influence of Canidae social behaviour on reproductive traits
Authors: Porto Lucas M V , Penido Gabriel , Fiedler Maico S
Published: June 2023

There is an intense debate in the literature about how life-history traits of species interact and influence each other over evolutionary time because, in most biological systems, the targets of selection are sets of traits. However, most of what we know about the tempo and mode of trait evolution is based on studies that focus on single traits. Here, we applied phylogenetic path analysis to uncover the most probable causal relationships linking seven relevant traits of the Canidae family, focusing on social behaviour and its influence on the reproductive traits of canids. Our findings suggest that biogeographic events throughout the planet’s history are important in understanding how the social behaviour of Canidae was shaped throughout the past 13 Myr, which is more likely to be influencing changes in the length of gestation. In addition, we suggest that cooperative behaviour can be a key element in understanding the evolution of the length of gestation in canids.
The open system of FGF-23 at the crossroad between additional P-lowering therapy, anemia and inflammation: how to deal with the intact and the C-terminal assays?
Authors: Magagnoli Lorenza , Cozzolino Mario , Galassi Andrea
Published: June 2023

Fibroblast growth factor 23 (FGF-23) has been associated with increased cardiovascular risk and poor survival in dialysis patients. It is well established that FGF-23 synthesis is directly induced by positive phosphate (P) balance. On the other hand, P-lowering treatments such as nutritional P restriction, P binders and dialysis are capable of reducing FGF-23 levels. However, there are many uncertainties regarding the possibility of adopting FGF-23 to guide the clinical decision-making process in the context of chronic kidney disease–mineral bone disorder (CKD-MBD). Furthermore, the best assay to adopt for measurement of FGF-23 levels (namely the intact vs the C-terminal one) remains to be determined, especially in conditions capable of altering the synthesis as well as the cleavage of the intact and biologically active molecule, as occurs in the presence of CKD and its complications. This Editorial discusses the main insights provided by the post hoc analysis of the NOPHOS trial, with particular attention given to evidence-based peculiarities of the intact and the C-terminal assays available for measuring FGF-23 levels, especially in patients receiving additive P-lowering therapy in the presence of inflammation, anemia and iron deficiency.
Higher-Achievement Schools, Peers and Mental Health
Authors: Bütikofer Aline , Ginja Rita , Løken Katrine V , Landaud Fanny
Published: June 2023

Although many students suffer from anxiety and depression, and often identify school pressure and concerns about their futures as the main reasons for their worries, little is known about the consequences of the schooling environment on students’ mental health. Using a regression discontinuity analysis in the largest Norwegian cities, we show that eligibility to enrol in a higher-achievement high school increases the probability of enrolment in higher education and decreases the probability of diagnosis or treatment of psychological conditions. We provide suggestive evidence that changes in both teacher and peer characteristics are likely drivers of these effects.
The effect of statins on mortality and cardiovascular disease in primary care hypertensive patients without other cardiovascular disease or diabetes
Authors: Andersson Tobias , Nåtman Jonatan , Mourtzinis Georgios , Bager Johan-Emil , Bengtsson Boström Kristina , Franzén Stefan , Hjerpe Per
Published: June 2023

Aims

Studies in primary healthcare (PHC) assessing the effect of primary prevention with statins on mortality and cardiovascular disease (CVD) are scarce. This study aimed to estimate the effect of statins on all-cause mortality, cardiovascular mortality, myocardial infarction (MI), and stroke in individuals in PHC with hypertension without CVD or diabetes.

Methods and results

Using the Swedish PHC quality assurance register QregPV, the study included 13 193 individuals with hypertension without CVD or diabetes, who had filled a first statin prescription between 2010 and 2016, and 13 193 matched controls without a filled statin prescription at the index date. Controls were matched on sex and propensity score using clinical data and data from national registers on comorbidities, prescriptions, and socioeconomic status. The effect of statins was estimated in Cox regression models. During a median of 4.2 years of follow-up, 395 individuals in the statin group vs. 475 in the control group died, 197 vs. 232 died of cardiovascular disease, 171 vs. 191 had an MI, and 161 vs. 181 had a stroke. The treatment effect of statins was significant for all-cause mortality [hazard ratio (HR) 0.83, 95% confidence interval (CI) 0.74–0.93] and cardiovascular mortality (HR 0.85, 95% CI 0.72–0.998). Overall, no significant treatment effect of statins was seen for MI (HR 0.89, 95% CI 0.74–1.07), but there was a significant interaction with sex (P = 0.008) with decreased risk of MI for women but not for men (HR 0.66, 95% CI 0.49–0.88 vs. HR 1.09, 95% CI 0.86–1.38).

Conclusion

Primary prevention with statins in PHC was associated with reduced risk of all-cause mortality, cardiovascular mortality, and in women, lower risk of MI.
Liver resection versus liver transplantation for hepatocellular carcinoma within the Milan criteria based on estimated microvascular invasion risks
Authors: Yang Pinghua , Teng Fei , Bai Shilei , Xia Yong , Xie Zhihao , Cheng Zhangjun , Li Jun , Lei Zhengqing , Wang Kui , Zhang Baohua , Yang Tian , Wan Xuying , Yin Hao , Shen Hao , Pawlik Timothy M , Lau Wan Yee , Fu Zhiren , Shen Feng
Published: June 2023

Background

Preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) may optimize individualized treatment decision-making. This study aimed to investigate the prognostic differences between HCC patients undergoing liver resection (LR) and liver transplantation (LT) based on predicted MVI risks.

Methods

We analysed 905 patients who underwent LR, including 524 who underwent anatomical resection (AR) and 117 who underwent LT for HCC within the Milan criteria using propensity score matching. A nomogram model was used to predict preoperative MVI risk.

Results

The concordance indices of the nomogram for predicting MVI were 0.809 and 0.838 in patients undergoing LR and LT, respectively. Based on an optimal cut-off value of 200 points, the nomogram defined patients as high- or low-risk MVI groups. LT resulted in a lower 5-year recurrence rate and higher 5-year overall survival (OS) rate than LR among the high-risk patients (23.6% vs 73.2%, P < 0.001; 87.8% vs 48.1%, P < 0.001) and low-risk patients (19.0% vs 45.7%, P < 0.001; 86.5% vs 70.0%, P = 0.002). The hazard ratios (HRs) of LT vs LR for recurrence and OS were 0.18 (95% confidence interval [CI], 0.09–0.37) and 0.12 (95% CI, 0.04–0.37) among the high-risk patients and 0.37 (95% CI, 0.21–0.66) and 0.36 (95% CI, 0.17–0.78) among the low-risk patients. LT also provided a lower 5-year recurrence rate and higher 5-year OS rate than AR among the high-risk patients (24.8% vs 63.5%, P = 0.001; 86.7% vs 65.7%, P = 0.004), with HRs of LT vs AR for recurrence and OS being 0.24 (95% CI, 0.11–0.53) and 0.17 (95% CI, 0.06–0.52), respectively. The 5-year recurrence and OS rates between patients undergoing LT and AR were not significantly different in the low-risk patients (19.4% vs 28.3%, P = 0.129; 85.7% vs 77.8%, P = 0.161).

Conclusions

LT was superior to LR for patients with HCC within the Milan criteria with a predicted high or low risk of MVI. No significant differences in prognosis were found between LT and AR in patients with a low risk of MVI.
Quantifying Healthy Aging in Older Veterans Using Computational Audio Analysis
Authors: Yin Yunting , Hanes Douglas William , Skiena Steven , Clouston Sean A P
Published: June 2023

Background

Researchers are increasingly interested in better methods for assessing the pace of aging in older adults, including vocal analysis. The present study sought to determine whether paralinguistic vocal attributes improve estimates of the age and risk of mortality in older adults.

Methods

To measure vocal age, we curated interviews provided by male U.S. World War II Veterans in the Library of Congress collection. We used diarization to identify speakers and measure vocal features and matched recording data to mortality information. Veterans (N = 2 447) were randomly split into testing (n = 1 467) and validation (n = 980) subsets to generate estimations of vocal age and years of life remaining. Results were replicated to examine out-of-sample utility using Korean War Veterans (N = 352).

Results

World War II Veterans’ average age was 86.08 at the time of recording and 91.28 at the time of death. Overall, 7.4% were prisoners of war, 43.3% were Army Veterans, and 29.3% were drafted. Vocal age estimates (mean absolute error = 3.255) were within 5 years of chronological age, 78.5% of the time. With chronological age held constant, older vocal age estimation was correlated with shorter life expectancy (aHR = 1.10; 95% confidence interval: 1.06–1.15; p < .001), even when adjusting for age at vocal assessment.

Conclusions

Computational analyses reduced estimation error by 71.94% (approximately 8 years) and produced vocal age estimates that were correlated with both age and predicted time until death when age was held constant. Paralinguistic analyses augment other assessments for individuals when oral patient histories are recorded.
Exponential Riesz Bases in L2 on Two Intervals
Authors: Belov Yurii , Mironov Mikhail
Published: June 2023

We give sufficient conditions for an exponential system to be a Riesz basis in $L^{2}(E)$, where $E$ is a union of two intervals. We show that these conditions are close to be necessary. In addition, we demonstrate “extra point effect” for such systems, that is, it may happen that a Riesz basis in $L^{2}(E)$ differs by one point from a Riesz basis on an interval.
Experience of stigma among persons with type 2 diabetes in Africa: a systematic review
Authors: Akyirem Samuel , Ekpor Emmanuel
Published: June 2023

Diabetes stigma is a pervasive social phenomenon with significant impacts on individuals living with type 2 diabetes mellitus (T2DM). Despite the negative health impact of diabetes stigma, little is known about the experience of this phenomenon in Africa. This review aimed to synthesize existing quantitative and qualitative studies that examine the experiences and outcomes of T2DM stigma in Africa. A mixed studies review methodology was utilized to conduct this research. Relevant articles were identified by searching the Cumulative Index to Nursing and Allied Health Literature, PubMed, MEDLINE and PsycINFO databases. The mixed method appraisal tool was used to assess the quality of included studies. Of 2626 records identified, 10 articles met the inclusion criteria. The prevalence of diabetes stigma was as high as 70%. The results of the review indicate that individuals with T2DM in Africa are labelled as ‘having HIV’, ‘nearing their death’ and ‘wasting resources’. These experiences were associated with low quality of life, disease concealment and avoidance of self-management behaviours. The findings highlight the urgent need for further stigma-centric studies to fully understand how T2DM stigma is experienced in Africa. The evidence from such studies would inform the development and evaluation of effective interventions to address this social consequence of T2DM.
Favorable prognostic impact of phosphatase and tensin homolog alterations in wild-type isocitrate dehydrogenase and telomerase reverse transcriptase promoter glioblastoma
Authors: Higa Nayuta , Akahane Toshiaki , Yokoyama Seiya , Makino Ryutaro , Yonezawa Hajime , Uchida Hiroyuki , Takajo Tomoko , Kirishima Mari , Hamada Taiji , Noguchi Naoki , Otsuji Ryosuke , Kuga Daisuke , Nagasaka Shohei , Yamahata Hitoshi , Yamamoto Junkoh , Yoshimoto Koji , Tanimoto Akihide , Hanaya Ryosuke
Published: June 2023

Background

Telomerase reverse transcriptase promoter (TERTp) mutations are a biological marker of glioblastoma; however, the prognostic significance of TERTp mutational status is controversial. We evaluated this impact by retrospectively analyzing the outcomes of patients with isocitrate dehydrogenase (IDH)- and TERTp-wild-type glioblastomas.

Methods

Using custom next-generation sequencing, we analyzed 208 glioblastoma samples harboring wild-type IDH.

Results

TERTp mutations were detected in 143 samples (68.8%). The remaining 65 (31.2%) were TERTp-wild-type. Among the TERTp-wild-type glioblastoma samples, we observed a significant difference in median progression-free survival (18.6 and 11.4 months, respectively) and overall survival (not reached and 15.7 months, respectively) in patients with and without phosphatase and tensin homolog (PTEN) loss and/or mutation. Patients with TERTp-wild-type glioblastomas with PTEN loss and/or mutation were younger and had higher Karnofsky Performance Status scores than those without PTEN loss and/or mutation. We divided the patients with TERTp-wild-type into 3 clusters using unsupervised hierarchical clustering: Good (PTEN and TP53 alterations; lack of CDKN2A/B homozygous deletion and platelet-derived growth factor receptor alpha (PDGFRA) alterations), intermediate (PTEN alterations, CDKN2A/B homozygous deletion, lack of PDGFRA, and TP53 alterations), and poor (PDGFRA and TP53 alterations, CDKN2A/B homozygous deletion, and lack of PTEN alterations) outcomes. Kaplan–Meier survival analysis indicated that these clusters significantly correlated with the overall survival of TERTp-wild-type glioblastoma patients.

Conclusions

Here, we report that PTEN loss and/or mutation is the most useful marker for predicting favorable outcomes in patients with IDH- and TERTp-wild-type glioblastomas. The combination of 4 genes, PTEN, TP53, CDKN2A/B, and PDGFRA, is important for the molecular classification and individual prognosis of patients with IDH- and TERTp-wild-type glioblastomas.