bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic Operation of Multi-terminal Interlinking Microgrid Based on the Decentralized Protocol
Authors: Wang Zeyi , Zhang Weihua , Xu Weijin , Zhang Jiajun , Wang Panbao
Published: September 2023

This paper develops a decentralized control strategy based on an interlinking converter to realize the global economic optimal operation of a multi-terminal interlinking microgrid (MG). The control objective is to minimize the total generation cost (TGC) of the interlinking microgrid system. The proposed control is composed of local and global controllers, which deal with sub-MG and interlinking MG systems respectively. The local controller regulates the incremental cost (IC) value matching in the sub-microgrid based on the nonlinear dynamic droop control with equal IC to achieve the optimal load power distribution in the local DG units. The global controller controls BIC through the bus voltage signal to match the IC value of the entire interlinking MG system in a decentralized form, which significantly improves the reliability and scalability of the system and achieves the global optimal economic optimal operation under the condition of meeting the power demand and production constraints. The feasibility and superiority of the proposed controller are verified by PLECS under various test cases.
Correlation and K-means clustering based small current ground fault line selection algorithm
Authors: Gao Wenli , Xi Dongmin , Zheng Linan
Published: September 2023

The existing small current grounding line selecting technique has consequences by transition resistance, fault closure angles, and the fault location, and there is a problem of low selection accuracy, which is addressed by proposing a line-choosing algorithm that employs a combination of transient zero-sequential current (TZSC) waveform correlation and K-means clustering. First, to obtain the correlation coefficient matrix, the correlation analysis is performed for each line of the zero-sequence currents transient measurement values; second, to address the issue of the difficulties in manually setting the threshold, we apply the K-mean cluster analysis algorithm to group the row vectors of the correlation coefficients matrices; and finally, we output the label of the cluster to realize the fault line selection. Simulation and real-world fault data validate the method, showing that it is independent of transition resistance, fault closure angles, and fault location. It can achieve precise and dependable line selectivity.
Analysis of Partial Discharge Fault Diagnosis Technology for High Voltage Switch Cabinet
Authors: Liu Jiaxin , Yu Hao , Mo Zhongyue
Published: September 2023

In order to enhance the security and reliability of high-voltage switch cabinet operation, the diagnosis of internal discharge defects in high-voltage switch cabinet equipment is analyzed in this paper. Firstly, a variety of partial discharge live detection technologies such as three-dimensional voiceprint monitoring technology and three-dimensional ultraviolet technology for partial discharge are studied. Then, a variety of partial discharge live detection technologies are constructed. Finally, the data fusion of the relevant detection data is carried out, and the monitoring results of the equipment’s running state are analyzed. The analysis results show that the data sensitivity and specificity of creepage, non-breakdown discharge, and breakdown discharge at different output values in the application of various partial discharge detection technologies have obvious effects. It is believed that the technology constructed in this study can improve detection accuracy and equipment safety. It provides important parameters and a basis for the maintenance of high-voltage switch cabinets. It is of extremely good importance to take partial live detection measures for the operating switch cabinet and provides a reference for field application.
SO3 removal rate and emission test of the limestone-gypsum wet desulfurization system for coal-fired power plants
Authors: Han Yuan , Zhu Yujie
Published: September 2023

This paper studies the SO3 removal ability of dual tower wet desulfurization (in series) and adopts a combination of on-site flue gas sampling and laboratory condensation control. A dual tower (series) supported boiler is used. The SO3 content in the original and clean flue gas of the dual cycle wet desulfurization device was measured, and the removal rate of SO3 of the device was measured. Desulfurization is calculated on the basis of the influence of unit electrical load, coal sulfur content, and desulfurization (raw material flue gas) inlet particle concentration on removal rate. This paper discusses and analyzes the SO3 and SO3 emission concentrations for SO3 removal rules in desulfurization systems. The results indicate that the total sulfur content of coal is relatively high, and the concentration of SO3 is relatively high. The traditional flue gas and net flue gas content in the dual tower wet desulfurization system (series) is relatively high. When burning sulfur-containing coal, there may be “blue smoke” in the flue gas. When the unit load changes between 182 MW and 350 MW, the SO3 removal rate of dual tower wet desulfurization (in series) is between 46.7% and 65.3%, with a net flue gas SO3 concentration of 16.0 mg/m3∼20.5 mg/m3. Due to equipment layout and other reasons, the SO3 removal rate of the primary tower is lower than that of the secondary tower. The removal rate of SO3 is also affected by the concentration of original smoke particles. Due to the condensation of SO3 on the particles and the dust removal of the adsorption tower, the higher the concentration of raw flue gas particles is, the higher the removal rate is. SO3 will be higher. The study also suggests the SO3 removal ability of double tower (series) and double ring wet desulfurization, which is better adapted to changes in load and coal. The next step is to explore the SO3 removal capacity of the dual tower system by optimizing its operating parameters. In addition, due to the arrangement of a desulfurization system after dust removal, it is impossible to control the SO3 source. Subsequent research can control the production of existing SO3 through coal distribution and combustion control.
Optimal configuration for the wind-solar complementary energy storage capacity based on improved harmony search algorithm
Authors: Li Jinwei , Wu Yiming , Li Dongjie , Liang Jinzhao , Chen Haomin , Ma Yun , Xiong Feng , Guo Jianyi
Published: September 2023

With the increase in the permeability of renewable energy, the randomness and uncertainty of photovoltaic power generation and wind power generation have an impact on the stable operation of the power grid. Energy storage technology can effectively improve the controllability of new energy, but the optimal allocation of energy storage capacity has always been a difficult problem limiting the development of energy storage technology. In this paper, the capacity optimization model of the complementary energy storage system is established based on the analysis of the wind-solar energy storage principle and the energy balance criterion. Then, with the minimum investment cost, the highest economic benefit, low wind and light abandonment rate and low load power shortage rate as the optimization objectives, the harmony search algorithm was used to solve the optimization model under the constraint of stable operation of the system, and the optimal capacity allocation scheme was obtained. The results of the example show that the optimization strategy in this paper can reduce the investment cost of the system and improve the reliability of the power supply and energy efficiency of the system.
Behind-the-Meter Solar Generation Disaggregation Based on Attention Mechanism and Bidirectional Gated Recurrent Unit
Authors: Xu Yutao , Tan Zhukui , Zhang Junwei , Liu Bin , Tang Saiqiu
Published: September 2023

With the rising installed capacity of rooftop PV, there is an urgent need to improve the accuracy of the behind-the-meter solar generation decomposition to realize the local consumption of distributed PV in order to alleviate the grid stability problem caused by the large-scale rooftop PV access. This paper proposes a bidirectional Gated Recurrent Unit neural network based on the Attention mechanism for a behind-the-meter solar generation decomposition model. First, the temporal characteristics of customer net load data are extracted using bidirectional gated recurrent units. Then, the Attention mechanism is introduced to improve the attention to key net load information. Finally, a nonlinear mapping relationship is constructed from net load data to behind-the-meter solar generation. 184 household PV customers in the SGSC dataset are used for the example analysis. The simulation results show that the proposed method does not rely on accurate physical modeling as well as accurate numerical weather forecast data, and has good generalization in scenarios of different climate zones and good adaptability in scenarios of different seasons.
Research on identification method of power equipment hot spot temperature based on the particle filter algorithm
Authors: Luo Chuansheng , Qin Zhixian , Zhou Chuang , Fang Fan , Xu Zhaodan , Wu Yan
Published: September 2023

With the construction of new power systems, the load shows significant differences between peak and valley, and the traditional system planning and scheduling operation mode faces problems such as insufficient flexibility. The power system mainly focuses on transmission lines and transformers to improve the grid’s transmission capacity. Based on the existing grid structure and substation layout, the thermal stability value algorithm is used to evaluate the load capacity of substation equipment, fully tap its operation potential, and improve the equipment’s total utilization rate, which is of great significance to ensure the reliability of the power supply. Based on the principle of heat transfer, this paper establishes the temperature model of electrical equipment contact. Finally, the experimental results demonstrate that the particle filter method proposed in this paper can effectively predict the model temperature.
Biomimetic human skin model patterned with rete ridges
Authors: Nagarajan Maxwell B , Ainscough Alexander J , Reynolds Daniel S , Uzel Sebastien G M , Bjork Jason W , Baker Bryan A , McNulty Amy K , Woulfe Susan L , Lewis Jennifer A
Published: September 2023

Rete ridges consist of undulations between the epidermis and dermis that enhance the mechanical properties and biological function of human skin. However, most human skin models are fabricated with a flat interface between the epidermal and dermal layers. Here, we report a micro-stamping method for producing human skin models patterned with rete ridges of controlled geometry. To mitigate keratinocyte-induced matrix degradation, telocollagen–fibrin matrices with and without crosslinks enable these micropatterned features to persist during longitudinal culture. Our human skin model exhibits an epidermis that includes the following markers: cytokeratin 14, p63, and Ki67 in the basal layer, cytokeratin 10 in the suprabasal layer, and laminin and collagen IV in the basement membrane. We demonstrated that two keratinocyte cell lines, one from a neonatal donor and another from an adult diabetic donor, are compatible with this model. We tested this model using an irritation test and showed that the epidermis prevents rapid penetration of sodium dodecyl sulfate. Gene expression analysis revealed differences in keratinocytes obtained from the two donors as well as between 2D (control) and 3D culture conditions. Our human skin model may find potential application for drug and cosmetic testing, disease and wound healing modeling, and aging studies.
Integrated silicon photonics chip fabricated by CMOS compatible technology for low-bit-error-rate quantum key distribution
Authors: Zhen Zhen , Jin Si-Yue , Jie Ren , Xu Xing-Sheng
Published: September 2023

Quantum communication has extremely high security and is a development direction of future communication networks. In this paper, an on-chip path, off-chip polarization encoded quantum key distribution (QKD) chip is designed and fabricated using advanced silicon photonics fabrication technology. Using a special two-dimensional grating, we can convert light of different path states into corresponding polarization states and propagate in fiber. The performance of the basic optics, waveguides, gratings, and Mach–Zehnder interferometers on the chip is characterized. In the demonstrated QKD experiment, the quantum bit error rate is as low as 1.08%. It provides an important device for the future development of advanced integrated quantum information.
Two-photon polymerization-based 4D printing and its applications
Authors: Jian Bingcong , Li Honggeng , He Xiangnan , Wang Rong , Yang Hui Ying , Ge Qi
Published: September 2023

Two-photon polymerization (TPP) is a cutting-edge micro/nanoscale three-dimensional (3D) printing technology based on the principle of two-photon absorption. TPP surpasses the diffraction limit in achieving feature sizes and excels in fabricating intricate 3D micro/nanostructures with exceptional resolution. The concept of 4D entails the fabrication of structures utilizing smart materials capable of undergoing shape, property, or functional changes in response to external stimuli over time. The integration of TPP and 4D printing introduces the possibility of producing responsive structures with micro/nanoscale accuracy, thereby enhancing the capabilities and potential applications of both technologies. This paper comprehensively reviews TPP-based 4D printing technology and its diverse applications. First, the working principles of TPP and its recent advancements are introduced. Second, the optional 4D printing materials suitable for fabrication with TPP are discussed. Finally, this review paper highlights several noteworthy applications of TPP-based 4D printing, including domains such as biomedical microrobots, bioinspired microactuators, autonomous mobile microrobots, transformable devices and robots, as well as anti-counterfeiting microdevices. In conclusion, this paper provides valuable insights into the current status and future prospects of TPP-based 4D printing technology, thereby serving as a guide for researchers and practitioners.
Pathophysiologic and prognostic importance of cardiac power output reserve in heart failure with preserved ejection fraction
Authors: Takizawa Daiki , Harada Tomonari , Obokata Masaru , Kagami Kazuki , Sorimachi Hidemi , Yuasa Naoki , Saito Yuki , Murakami Fumitaka , Naito Ayami , Kato Toshimitsu , Wada Naoki , Ishii Hideki
Published: September 2023

Aims

Heart failure with preserved ejection fraction (HFpEF) is a syndrome characterized by multiple cardiac reserve limitations during exercise. Cardiac power output (CPO) is an index of global cardiac performance and can be estimated non-invasively by echocardiography. We hypothesized that CPO reserve during exercise would be associated with impaired cardiovascular reserve, exercise intolerance, and adverse outcomes in HFpEF.

Methods and results

Exercise stress echocardiography was performed in 425 dyspnoeic patients [217 HFpEF and 208 non-heart failure (HF) controls] to estimate CPO at rest and during exercise. We classified patients with HFpEF based on the median value of changes in CPO from rest to peak exercise (ΔCPO >0.49 W/100 g). Patients with HFpEF and a lower CPO reserve had poorer biventricular systolic function, impaired chronotropic response during exercise, and worse aerobic capacity than controls and those with a higher CPO reserve. During a median follow-up of 358 days, a composite outcome of all-cause mortality or HF events occurred in 30 patients. Patients with a lower CPO reserve had four-fold and nearly 10-fold increased risks of the outcomes compared with those with a higher CPO reserve and controls, respectively [hazard ratio (HR) 4.05, 95% confidence interval (CI) 1.16–10.1, P = 0.003 and HR 9.61, 95% CI 3.58–25.8, P < 0.0001]. We further found that a lower CPO reserve had an incremental prognostic value over the H2FPEF score and exercise duration. In contrast, resting CPO did not predict clinical outcomes in patients with HFpEF.

Conclusion

A lower CPO reserve was associated with biventricular systolic dysfunction, chronotropic incompetence, exercise intolerance, and adverse outcomes in patients with HFpEF.
Epistemological Jangle and Jingle Fallacies in the Consumer–Brand Relationship Subfield: A Call to Action
Authors: Albert Noel , Thomson Matthew
Published: September 2023

For more than 20 years, the consumer–brand relationship (CBR) subfield has flourished with scores of constructs being employed. We provide an epistemological examination of its 14 most commonly measured relational constructs (e.g., Brand Love, Self-Brand Connection) collected from 767 research articles, reflecting 1,753 scales and approximately 9,200 items. We demonstrate that constructs overlap an average of 43% across all journals and 21% in top journals due to assessing highly similar or synonymous ideas (i.e., jangle). We use a combination of text and cluster analyses to show that measures of allegedly the same construct are polysemic, having an average of 5.3 different meanings (i.e., jingle). The results document in the CBR subfield the types of measurement inconsistencies and ambiguities that have sown confusion and frustration in other academic fields. We discuss the roots of these problems and offer recommendations aimed at helping scholars to improve measurement practices and to limit the presence of jingle and jangle in the CBR subfield.
Microbial dietary protein metabolism regulates GLP‐1 mediated intestinal transit
Authors: Toft Pernille Baumann , Yashiro Hiroaki , Erion Derek M. , Gillum Matthew Paul , Bäckhed Fredrik , Arora Tulika
Published: September 2023

Depletion of gut microbiota is associated with inefficient energy extraction and reduced production of short‐chain fatty acids from dietary fibers, which regulates colonic proglucagon (Gcg) expression and small intestinal transit in mice. However, the mechanism by which the gut microbiota influences dietary protein metabolism and its corresponding effect on the host physiology is poorly understood. Enteropeptidase inhibitors block host protein digestion and reduce body weight gain in diet‐induced obese rats and mice, and therefore they constitute a new class of drugs for targeting metabolic diseases. Enteroendocrine cells (EECs) are dispersed throughout the gut and possess the ability to sense dietary proteins and protein‐derived metabolites. Despite this, it remains unclear if enteropeptidase inhibition affects EECs function. In this study, we fed conventional and antibiotic treated mice a western style diet (WSD) supplemented with an enteropeptidase inhibitor (WSD‐ETPi), analyzed the expression of gut hormones along the length of the intestine, and measured small intestinal transit under different conditions. The ETPi‐supplemented diet promoted higher Gcg expression in the colon and increased circulating Glucagon like peptide‐1 (GLP‐1) levels, but only in the microbiota‐depleted mice. The increase in GLP‐1 levels resulted in slower small intestinal transit, which was subsequently reversed by administration of GLP‐1 receptor antagonist. Interestingly, small intestinal transit was normalized when an amino acid‐derived microbial metabolite, p‐cresol, was supplemented along with WSD‐ETPi diet, primarily attributed to the reduction of colonic Gcg expression. Collectively, our data suggest that microbial dietary protein metabolism plays an important role in host physiology by regulating GLP‐1‐mediated intestinal transit.
A Perspective on Artificial Intelligence
Authors: Kirton Carl A.
Published: September 2023

How this technology might impact nursing practice
Artificial Intelligence and Nursing: Promise and Precaution
Authors: Molyneux Jacob
Published: September 2023

It's important for nurses to join the conversation.
Critical Care Nursing
Authors: Marsh Rebekah
Published: September 2023

These nurses care for patients with complex clinical conditions.
Activism Is an Essential Nursing Role
Authors: Chinn Peggy L. , Kennedy Maureen Shawn
Published: September 2023

Nursing has a long history of activism, yet nurses are often heard to express their dislike of “politics” and their desire to stay away from the tense and contentious situations associated with political activism. Nurses, however, have a fundamental duty to advocate on behalf of their patients and communities. In this article, the authors discuss the rationale for and roots of political activism in nursing, the values that shape it, and the importance of nursing's stance on policies related to the health and well-being of those they serve. The authors also present exemplars of political activism and approaches nurses can use to address the pressing health care challenges of our time.
New Guidelines Issued for Diagnosis and Management of Acute Liver Failure
Authors: Rosenberg Karen
Published: September 2023

According to this study:
Pregnancy Plus Anaphylaxis: A Nurse's Perspective-Changing Health Scare
Authors: Fritz Maddison Margaret McGee
Published: September 2023

Finding a deeper space for empathy
Understanding psychosis
Authors: Williams Tommy , Rollings-Mazza Pamela
Published: September 2023

Psychotic behavior is often unpredictable; thus, there can be an increased risk of violence toward others and oneself. This article details the etiology and diagnosis of psychosis and nursing interventions to provide appropriate care.
Promoting civility and safety with cognitive rehearsal
Authors: Black Amy Conner
Published: September 2023

Uncivil behaviors have detrimental consequences that can impact healthcare team cohesion, resulting in conflicts and poor teamwork. This article details civil and uncivil behaviors and how the latter affects healthcare, and provides a tool to prepare nurses for uncivil encounters.
Exploring Competency-Based Medical Education Through the Lens of the UME–GME Transition: A Qualitative Study
Authors: Zetkulic Marygrace , Moriarty John P. , Amin Alpesh , Angus Steve , Dalal Bhavin , Fazio Sara , Hemmer Paul , Laird-Fick Heather S. , Muchmore Elaine , Nixon L. James , Olson Andrew , Choe John H.
Published: September 2023

Purpose

Competency-based medical education (CBME) represents a shift to a paradigm with shared definitions, explicit outcomes, and assessments of competence. The groundwork has been laid to ensure all learners achieve the desired outcomes along the medical education continuum using the principles of CBME. However, this continuum spans the major transition from undergraduate medical education (UME) to graduate medical education (GME) that is also evolving. This study explores the experiences of medical educators working to use CBME assessments in the context of the UME–GME transition and their perspectives on the existing challenges.

Method

This study used a constructivist-oriented qualitative methodology. In-depth, semistructured interviews of UME and GME leaders in CBME were performed between February 2019 and January 2020 via Zoom. When possible, each interviewee was interviewed by 2 team members, one with UME and one with GME experience, which allowed follow-up questions to be pursued that reflected the perspectives of both UME and GME educators more fully. A multistep iterative process of thematic analysis was used to analyze the transcripts and identify patterns across interviews.

Results

The 9 interviewees represented a broad swath of UME and GME leadership positions, though most had an internal medicine training background. Analysis identified 4 overarching themes: mistrust (a trust chasm exists between UME and GME); misaligned goals (the residency selection process is antithetical to CBME); inadequate communication (communication regarding competence is infrequent, often unidirectional, and lacks a shared language); and inflexible timeframes (current training timeframes do not account for individual learners' competency trajectories).

Conclusions

Despite the mutual desire and commitment to move to CBME across the continuum, mistrust, misaligned goals, inadequate communication, and inflexible timeframes confound such efforts of individual schools and programs. If current efforts to improve the UME–GME transition address the themes identified, educators may be more successful implementing CBME along the continuum.
Historical Primer on Obstetrics and Gynecology Health Inequities in America
Authors: Nnoli Aisha
Published: September 2023

Four historical events provide context for racial injustices and inequities in medicine in the United States today: the invention of race as a social construct, enslavement in the Americas, the legal doctrine of Partus sequitur ventrem, and the American eugenics movement. This narrative review demonstrates how these race-based systems resulted in stereotypes, myths, and biases against Black individuals that contribute to health inequities today. Education on the effect of slavery in current health care outcomes may prevent false explanations for inequities based on stereotypes and biases. These historical events validate the need for medicine to move away from practicing race-based medicine and instead aim to understand the intersectionality of sex, race, and other social constructs in affecting the health of patients today.
Disparities in Timeliness of Endometrial Cancer Care
Authors: Najor Anna , Melson Valerie , Lyu Junrui , Fadadu Priyal , Bakkum-Gamez Jamie , Sherman Mark , Kaunitz Andrew , Connor Avonne , Destephano Christopher
Published: September 2023

OBJECTIVE:

We use the person-centered Pathway to Treatment framework to assess the scope of evidence on disparities in endometrial cancer stage at diagnosis. This report is intended to facilitate interventions, research, and advocacy that reduce disparities.

DATA SOURCES:

We completed a structured search of electronic databases: PubMed, EMBASE, Scopus, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials databases. Included studies were published between January 2000 and 2023 and addressed marginalized population(s) in the United States with the ability to develop endometrial cancer and addressed variable(s) outlined in the Pathway to Treatment.

METHODS OF STUDY SELECTION:

Our database search strategy was designed for sensitivity to identify studies on disparate prolongation of the Pathway to Treatment for endometrial cancer, tallying 2,171. Inclusion criteria were broad, yet only 24 studies addressed this issue. All articles were independently screened by two reviewers.

TABULATION, INTEGRATION, AND RESULTS:

Twenty-four studies were included: 10 on symptom appraisal, five on help seeking, five on diagnosis, and 10 on pretreatment intervals. Quality rankings were heterogeneous, between 3 and 9 (median 7.2) per the Newcastle–Ottawa Scale. We identified three qualitative, two participatory, and two intervention studies. Studies on help seeking predominantly investigate patient-driven delays. When disease factors were controlled for, delays of the pretreatment interval were independently associated with racism toward Black and Hispanic people, less education, lower socioeconomic status, and nonprivate insurance.

CONCLUSIONS:

Evidence gaps on disparities in timeliness of endometrial cancer care reveal emphasis of patient-driven help-seeking delays, reliance on health care–derived databases, underutilization of participatory methods, and a paucity of intervention studies.

SYSTEMATIC REVIEW REGISTRATION:

Given that PROSPERO was not accepting systematic scoping review protocols at the time this study began, this study protocol was shared a priori through Open Science Framework on January 13, 2021 (doi: 10.17605/OSF.IO/V2ZXY), and through peer review publication on April 13, 2021 (doi: https://doi.org/10.1186/s13643-021-01649-x).
The Role of En Bloc Resection in the Modern Era for Primary Spine Tumors
Authors: Yeung Caleb M. , Bilsky Mark , Boland Patrick J. , Vaynrub Max
Published: September 2023

Study Design.

A literature review.

Objective.

The aim of this review is to provide an overview of benign and malignant primary spine tumors and a balanced analysis of the benefits and limitations of (and alternatives to) surgical treatment with en bloc resection.

Summary of Background Data.

Primary spine tumors are rare but have the potential to cause severe morbidity, either from the disease itself or as a result of treatment. The prognosis, goals, and treatment options vary significantly with the specific disease entity. Appropriate initial management is critical; inappropriate surgery before definitive treatment can lead to recurrence and may render the patient incurable, as salvage options are often inferior.

Methods.

We performed a comprehensive search of the PubMed database for articles relevant to primary spine neoplasms and en bloc spine surgery. Institutional review board approval was not needed.

Results.

Although Enneking-appropriate en bloc surgery can be highly morbid, it often provides the greatest chance for local control and/or patient survival. However, there is growing data to support modern radiotherapy as a feasible and less morbid approach to certain primary neoplasms that historically were considered radioresistant.

Conclusions.

Choosing the optimal approach to primary spine tumors is complex. A comprehensive and up-to-date assessment of the evidence is required to guide patient care and to balance the often-competing goals of prolonging life and preserving quality of life.
Conjunctival Kaposi's Sarcoma as an Initial Diagnosis of AIDS
Authors: Guerrero-Becerril Jesus , Vera-Duarte Guillermo Raul , Jin Kim Hae , Müller-Morales Carlos Adolfo , Navas Alejandro , Graue-Hernandez Enrique O.
Published: September 2023

Purpose:

To report an interesting and rare case of conjunctival Kaposi's sarcoma, which led to the diagnosis of acquired immunodeficiency syndrome (AIDS) in a 25-year-old male.

Methods:

Interventional case report. A 25-year-old male presented with an asymptomatic red-violaceous lesion on his left eye for approximately 3 weeks. He had a history of tattooing 2 years ago, otherwise, his medical history was unremarkable.

Results:

HIV viral load of 451,958 copies/mL and 74 CD4+cells were reported, confirming the diagnosis of HIV infection. An excisional biopsy was performed which reported neoplastic cells, vascular channels lined up with red blood cells, and highly mitotic cells, immunohistochemical reactions were carried out as well and were all positive for human herpesvirus-8, factor VIII, and CD31, confirming Kaposi's sarcoma (KS).

Conclusions:

Nowadays KS is very rare. The clinical characteristics of the neoplasm, absence of remarkable medical history at the time of presentation, prompt diagnosis of AIDS, and rapid treatment make this an interesting and important case for all ophthalmologists to diagnose AIDS.
Complications of Silicone Fillers in Gluteal Augmentation: An Unusual Case of Filler Migration and Granuloma Formation
Authors: Mortada Hatan , Murrad Khalid , Alkadi Danah , AlAbdali Ahmed , Alhamzah Hamzah Ali , Kattan Abdullah
Published: September 2023

Silicone liquid (polydimethylsiloxane) is an inert material commonly used for cosmetic purposes. A combination of both systematic and local devastating complications can cause end-organ toxicity and multi-organ dysfunction. In this article, we examine the literature and present a case of a patient who presented with lower extremity filler migration and granuloma formation 11 years post gluteal silicone injection. A 31-year-old woman who had received a gluteal silicone injection 11 years ago was experiencing painful erythema, progressive fibrosis, and swelling as the result of the injection. The patient was diagnosed with postfiller autoimmune syndrome. Multiple surgical interventions were conducted to remove the permanent filler from her left knee. As a result of multiple surgical sessions, the patient has been managed successfully with no relapses. This case demonstrated complications of an unusual silicone injection technique for gluteal augmentation. Despite silicone being considered inert, complications can arise years after injection, necessitating extensive medical intervention. This case also raises questions regarding the systemic effects of silicone fillers, warranting further research. Through this report, we aimed to enhance awareness and management of similar future cases.
Comparing Postoperative Taping vs Customized 3D Splints for Managing Nasal Edema after Rhinoplasty
Authors: Patel Anmol , Townsend Alexandra N. , Gordon Alexandra R. , Schreiber Jillian S. , Tepper Oren M. , Layke John
Published: September 2023

Background:

Significant swelling after rhinoplasty can temporarily obscure results and lead to distress for patients and surgeons. We recently developed three dimensional (3D)-printed nasal splints that aim to protect the nose and limit edema by applying gentle compression. This prospective, randomized study compares postoperative nasal edema in patients being treated with traditional taping versus 3D-printed splints.

Methods:

Patients undergoing primary rhinoplasty (2019–2020) were randomized into two groups: taping versus 3D-printed splinting. For 12 weeks, patients either applied steri-strips to the dorsum and tip, or used 3D-printed splints, which were based on nasal simulations. The percentage change in volume (cm3) was calculated for the total nose, dorsum, and nasal tip at various time points.

Results:

Nasal taping (n = 34) demonstrated a volume reduction of 4.8%, 9.9%, 10.0%, 10.3%, and 10.6% (compared with baseline) at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year, respectively. In contrast, the resolution of swelling with 3D splints (n = 36) was 5.0%, 8.6%, 11.0%, 14.9%, and 15.1% at the same time points. Inter-group comparison showed that 3D splints led to significantly less edema of the total nose at 6 months and 1 year (P ≤ 0.05), as well as consistent reductions in the tip and dorsum, specifically (1 year, P ≤ 0.1, 0.01, respectively).

Conclusions:

3D-printed splints after rhinoplasty leads to a significant reduction of edema, most noticeable at 6 months and 1 year. This study suggests that customized 3D-printed splints offer an effective clinical alternative to traditional taping to reduce postoperative edema after rhinoplasty.
Infected Galactorrhea after Augmentation Mastopexy: A Clinical Case
Authors: Suslavičius Kristupas A. , Jakutis Nerijus , Sakalauskaitė Indrė
Published: September 2023

We report the case of a 35-year-old female patient who presented with stabbing pain on inspiration and expiration, fever, and dyspnea. The patient had undergone breast augmentation with mastopexy and upper quadrant liposuction 5 days earlier. Seven days after hospitalization, a fistula ruptured in the left breast at the suture, and copious outflow of thick whitish fluid was observed. The breast implants were then removed. During surgery, a small amount of fluid was found, and bacterial culture revealed a Cutibacterium acnes infection, for which antibiotics were prescribed. Fifteen days after implant removal, the patient complained of uncomfortable tingling sensations, similar to breastfeeding. A dressing was applied, which resulted in the copious discharge of whitish, viscous fluid through the wound and nipple. The prolactin level was four times higher than the normal range. The patient was diagnosed with hyperprolactinemia and prescribed bromocriptine treatment, which restored her prolactin levels to normal within 4 days. After 4 weeks of hospitalization, the patient was discharged in good condition. This is the first case in the world to show that, in addition to infection, galactorrhea can be an extremely rare complication, which in our case was detected at a late stage at a similar clinic.
Telomere length and risk of cirrhosis, hepatocellular carcinoma, and cholangiocarcinoma in 63,272 individuals from the general population
Authors: Gellert-Kristensen Helene , Bojesen Stig E. , Tybjærg Hansen Anne , Stender Stefan
Published: September 2023

Background and Aims:

Inherited short telomeres are associated with a risk of liver disease, whereas longer telomeres predispose to cancer. The association between telomere length and risk of HCC and cholangiocarcinoma remains unknown.

Approach and Results:

We measured leukocyte telomere length using multiplex PCR in 63,272 individuals from the Danish general population. Telomere length and plasma ALT concentration were not associated (β = 4 ×10−6, p-value = 0.06) in a linear regression model, without any signs of a nonlinear relationship. We tested the association between telomere length and risk of cirrhosis, HCC, and cholangiocarcinoma using Cox regression. During a median follow-up of 11 years, 241, 76, and 112 individuals developed cirrhosis, HCC, and cholangiocarcinoma, respectively. Telomere length and risk of cirrhosis were inversely and linearly associated (p-value = 0.004, p for nonlinearity = 0.27). Individuals with telomeres in the shortest vs. longest quartile had a 2.25-fold higher risk of cirrhosis. Telomere length and risk of HCC were nonlinearly associated (p-value = 0.009, p-value for nonlinearity = 0.01). This relationship resembled an inverted J-shape, with the highest risk observed in individuals with short telomeres. Individuals with telomeres in the shortest versus longest quartile had a 2.29-fold higher risk of HCC. Telomere length was inversely and linearly associated with the risk of cholangiocarcinoma. Individuals with telomeres in the shortest versus longest quartile had a 1.86-fold higher risk of cholangiocarcinoma.

Conclusions:

Shorter telomere length is associated with a higher risk of cirrhosis, HCC, and cholangiocarcinoma.
Construction of curcumin-loaded micelles and evaluation of the anti-tumor effect based on angiogenesis
Authors: Liu Rui , Liu Zhongyan , Guo Xueli , Kebebe Dereje , Pi Jiaxin , Guo Pan
Published: September 2023

Objective:

Inhibition of tumor angiogenesis has become a new targeted tumor therapy. In this study, we established a micellar carrier with a tumor neovascularization-targeting effect modified by the neovascularization-targeting peptide NGR.

Methods:

The targeted polymer poly(ethylene glycol)-b-poly(lactide-co-glycolide) (PEG-PLGA) modified with Asn–Gly–Arg (NGR) peptide was prepared and characterized by 1H nuclear magnetic resonance and Fourier-transform infrared spectrometry. NGR-PEG-PLGA was used to construct curcumin (Cur)-loaded micelles by the solvent evaporation method. The physicochemical properties of the micelles were also investigated. Additionally, we evaluated the antitumor efficacy of the polymer micelles (PM) using in vitro cytology experiments and in vivo animal studies.

Results:

The particle size of Cur-NGR-PM was 139.70 ± 2.51 nm, and the drug-loading capacity was 14.37 ± 0.06%. In vitro cytological evaluation showed that NGR-modified micelles showed higher cellular uptake through receptor-mediated endocytosis pathways than did unmodified micelles, leading to the apoptosis of tumor cells. Then, in vivo antitumor experiments showed that the modified micelles significantly inhibited tumor growth and were safe.

Conclusions:

NGR-modified micelles significantly optimized the therapeutic efficacy of Cur. This strategy offers a viable avenue for cancer treatment.
Paper waste from instructions for use brochures in cataract surgery implant packaging in Europe and the United States
Authors: Stern Benjamin , Rampat Radhika , Shahnazaryan David , Gatinel Damien
Published: September 2023

Purpose:

To assess the extent of paper waste generated per year by instructions for use (IFUs) brochures included in intraocular lens (IOL) packaging in Europe and the U.S.

Setting:

Rothschild Foundation Hospital, Paris, France; Royal Free London NHS Foundation Trust; Center for Sight, London, United Kingdom.

Design:

Experimental study.

Methods:

A sample of IOLs were collected and each IFU was weighed. In addition, the cumulative weight of these brochures used in cataract surgeries performed annually in Europe and the U.S. was estimated, and the potential annual paper conservation that could be achieved if all manufacturers adopted electronic IFUs (e-IFUs) in Europe and the U.S. was determined.

Results:

The mean and standard deviation of the weight for overall IFUs, classic IFUs, and e-IFUs were 17.6 ± 13.8 g, 23.5 ± 13.2 g, and 2.9 ± 1.9 g, respectively. The estimated cumulative weight of paper generated from the IFUs accompanying implants used in European and U.S. cataract surgeries is 153 tons. If all manufacturers transition to e-IFUs, the cumulative weight saved would be 128 tons (−84%), equivalent to 120 tons of carbon dioxide equivalent and the preservation of more than 2000 trees annually.

Conclusions:

The classic IFUs in IOL packaging result in a significant amount of paper waste annually. Therefore, there is an urgent need for a rapid transition to e-IFU technology. The adoption of e-IFUs has already been authorized in Europe and the U.S., and it is crucial to expedite this process.
Using adaptive optics to optimize the spherical aberration of eyes implanted with EDOF and enhanced monofocal intraocular lenses
Authors: Shetty Naren , Shetty Rohit , Ranade Reshma , Narasimhan Raghav , Artal Pablo , Nuijts Rudy M.M.A. , Sinha Roy Abhijit
Published: September 2023

Purpose:

To assess the effect of change in ocular spherical aberration (SA) with adaptive optics on visual acuity (VA) at different defocus after implantation of extended depth-of-focus (EDOF) and enhanced monofocal intraocular lenses (IOLs).

Settings:

Narayana Nethralaya Eye Hospital, Bangalore, India.

Design:

Prospective, longitudinal, observational.

Methods:

80 eyes (40 patients) that had cataract surgery were included in the study. 40 eyes were implanted with Eyhance EDOF IOLs and the remaining with Vivity EDOF IOLs. Baseline ocular aberrations were measured with a visual adaptive optics aberrometer, then the optimal SA was determined by increasing it in steps of −0.01 μm up to −0.1 μm until the maximum improvement in near distance VA was observed for a given eye. Then the defocus curve for each eye was measured after modifying the ocular SA by magnitude equal to optimal SA.

Results:

Most of the eyes accepted a negative induced SA of −0.05 μm (Eyhance group: 67.6%; Vivity group, 45.2%). In the Eyhance group (dominant eyes), VA improved at −2 diopters (D) (P < .02) only and degraded at 0 D, +0.5 D, and +1 D defocus (P < .05). In the Vivity group, the VA remained unchanged at all defocus (P > .05). In the Eyhance group (nondominant eyes), VA improved at −3.5 D defocus only and degraded at +1.5 D and +2 D defocus (P < .05). In the Vivity group, VA improved at −2.5 D defocus (P < .05) only.

Conclusions:

A negative induced SA of −0.05 μm in implanted eyes was optimal for a slight improvement in distance-corrected near and intermediate VA without any significant decrease in baseline distance-corrected VA.
Gut microbiota dysbiosis alters chronic pain behaviors in a humanized transgenic mouse model of sickle cell disease
Authors: Kashyap Yavnika , Wang Zaijie Jim
Published: September 2023

Pain is the most common symptom experienced by patients with sickle cell disease (SCD) throughout their lives and is the main cause of hospitalization. Despite the progress that has been made towards understanding the disease pathophysiology, major gaps remain in the knowledge of SCD pain, the transition to chronic pain, and effective pain management. Recent evidence has demonstrated a vital role of gut microbiota in pathophysiological features of SCD. However, the role of gut microbiota in SCD pain is yet to be explored. We sought to evaluate the compositional differences in the gut microbiota of transgenic mice with SCD and nonsickle control mice and investigate the role of gut microbiota in SCD pain by using antibiotic-mediated gut microbiota depletion and fecal material transplantation (FMT). The antibiotic-mediated gut microbiota depletion did not affect evoked pain but significantly attenuated ongoing spontaneous pain in mice with SCD. Fecal material transplantation from mice with SCD to wild-type mice resulted in tactile allodynia (0.95 ± 0.17 g vs 0.08 ± 0.02 g, von Frey test, P < 0.001), heat hyperalgesia (15.10 ± 0.79 seconds vs 8.68 ± 1.17 seconds, radiant heat, P < 0.01), cold allodynia (2.75 ± 0.26 seconds vs 1.68 ± 0.08 seconds, dry ice test, P < 0.01), and anxiety-like behaviors (Elevated Plus Maze Test, Open Field Test). On the contrary, reshaping gut microbiota of mice with SCD with FMT from WT mice resulted in reduced tactile allodynia (0.05 ± 0.01 g vs 0.25 ± 0.03 g, P < 0.001), heat hyperalgesia (5.89 ± 0.67 seconds vs 12.25 ± 0.76 seconds, P < 0.001), and anxiety-like behaviors. These findings provide insights into the relationship between gut microbiota dysbiosis and pain in SCD, highlighting the importance of gut microbial communities that may serve as potential targets for novel pain interventions.
Co-occurrence of chronic pain and anxiety/depression symptoms in U.S. adults: prevalence, functional impacts, and opportunities
Authors: De La Rosa Jennifer S. , Brady Benjamin R. , Ibrahim Mohab M. , Herder Katherine E. , Wallace Jessica S. , Padilla Alyssa R. , Vanderah Todd W.
Published: September 2023

Co-occurrence of chronic pain and clinically significant symptoms of anxiety and/or depression is regularly noted in the literature. Yet, little is known empirically about population prevalence of co-occurring symptoms, nor whether people with co-occurring symptoms constitute a distinct subpopulation within US adults living with chronic pain or US adults living with anxiety and/or depression symptoms (A/D). To address this gap, this study analyzes data from the 2019 National Health Interview Survey, a representative annual survey of self-reported health status and treatment use in the United States (n = 31,997). Approximately 12 million US adults, or 4.9% of the adult population, have co-occurring chronic pain and A/D symptoms. Unremitted A/D symptoms co-occurred in 23.9% of US adults with chronic pain, compared with an A/D prevalence of 4.9% among those without chronic pain. Conversely, chronic pain co-occurred in the majority (55.6%) of US adults with unremitted A/D symptoms, compared with a chronic pain prevalence of 17.1% among those without A/D symptoms. The likelihood of experiencing functional limitations in daily life was highest among those experiencing co-occurring symptoms, compared with those experiencing chronic pain alone or A/D symptoms alone. Among those with co-occurring symptoms, 69.4% reported that work was limited due to a health problem, 43.7% reported difficulty doing errands alone, and 55.7% reported difficulty participating in social activities. These data point to the need for targeted investment in improving functional outcomes for the nearly 1 in 20 US adults living with co-occurring chronic pain and clinically significant A/D symptoms.