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Ehlers-Danlos syndrome:prevalence and outcomes in gender affirming surgery-a single institution experience

Plastic and Aesthetic Research 2022年第1期9卷 605-613页

作者： Alireza Najafian Isabel Cylinder Breanna Jedrzejewski Craig Sineath Zbigniew Sikora Leigh H.Martin daniel dugi Geolani W.Dy Jens Urs Berli Division of Plastic Surgery Department of General SurgeryOregon Health&Science UniversityPortlandOR 97239USA Department of Urology Oregon Health&Science UniversityPortlandOR 97239USA

Aim:Patients with Ehlers-Danlos Syndrome(EDS)are considered to have an increased risk for wound healing complications.Surgeons may therefore be hesitant to offer elective surgeries,including gender-affirming surgeries(GAS),to EDS patients.At our center,we frequently encountered patients presenting for GAS evaluation with the co-existing diagnosis of EDS.This study aims to establish the prevalence of EDS diagnosis in our GAS patients and compare their post-operative complications to patients without EDS diagnosis.Methods:This is a single-institution retrospective case-control study on all patients who underwent GAS from 2016-2020.Data include EDS diagnosis,demographics,operation,and complications(including minor wound healing issues).Results:Of 1363 patients presenting for GAS,36(2.6%)had EDS diagnoses and were matched with 108 control patients.Major complications requiring surgical intervention in the OR occurred in 6 patients(4.2%),(2.8% EDS vs.5.4%controls;P=0.63),while 8.3% of EDS and 14% of controls required minor interventions(P=0.38).The rate of wound healing issues of any severity was 28% in EDS vs.47% in control groups(P=0.04).Conclusion:The prevalence of EDS diagnosis in our patient population is 132 times the highest reported prevalence in the general population.Wound healing issues and the need for additional post-operative interventions in the group with EDS diagnosis were not significantly different from the control group.Our findings suggest that patients with a diagnosis of EDS undergoing GAS have comparable outcomes to patients without EDS.Concerns for post-operative complications should not be a barrier to offering GAS to patients presenting with an EDS diagnosis.

关键词： Ehlers-Danlos gender transgender gender affirmation surgery outcomes

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Comprehensive review of hepatocellular carcinoma with portal vein tumor thrombus:State of art and future perspectives

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 221-227页

作者： Paschalis Gavriilidis Timothy M Pawlik daniel Azoulay Department of Surgery Colchester General HospitalTurner RoadColchester CO45JLUK Department of Surgery The Ohio State Wexner Medical CenterJames Comprehensive Cancer CenterColumbusOHUSA Department of Hepato-Biliary and Liver Transplantation surgery Paul Brousse University HospitalParis-Saclay UniversityVillejuif 94800France

Background:Despite advances in the diagnosis of patients with hepatocellular carcinoma(HCC),70%-80%of patients are diagnosed with advanced stage disease.Portal vein tumor thrombus(PVTT)is among the most ominous signs of advanced stage disease and has been associated with poor survival if untreated.Data sources:A systematic search of MEDLINE(PubMed),Embase,Cochrane Library and Database for Systematic Reviews(CDSR),Google Scholar,and National Institute for Health and Clinical Excellence(NICE)databases until December 2022 was conducted using free text and MeSH terms:hepatocellular carcinoma,portal vein tumor thrombus,portal vein thrombosis,vascular invasion,liver and/or hepatic resection,liver transplantation,and systematic review.Results:Centers of surgical excellence have reported promising results related to the individualized surgical management of portal thrombus versus arterial chemoembolization or systemic chemotherapy.Critical elements to the individualized surgical management of HCC and portal thrombus include precise classification of the portal vein tumor thrombus,accurate identification of the subgroups of patients who may benefit from resection,as well as meticulous surgical technique.This review addressed five specific areas:(a)formation of PVTT;(b)classifications of PVTT;(c)controversies related to clinical guidelines;(d)surgical treatments versus non-surgical approaches;and(e)characterization of surgical techniques correlated with classifications of PVTT.Conclusions:Current evidence from Chinese and Japanese high-volume centers demonstrated that patients with HCC and associated PVTT can be managed with surgical resection with acceptable results.

关键词： Hepatectomy Liver surgery Liver neoplasms Portal vein tumor thrombus

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Assessment of scale interactions associated with wake meandering using bispectral analysis methodologies

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Theoretical & Applied Mechanics Letters 2024年第2期14卷 65-75页

作者： Dinesh Kumar Kinjangi daniel Foti Department of Mechanical Engineering University of MemphisMemphisTennesseeUSA

Large atmospheric boundary layer fluctuations and smaller turbine-scale vorticity dynamics are separately hypothesized to initiate the wind turbine wake meandering phenomenon,a coherent,dynamic,turbine-scale oscillation of the far wake.Triadic interactions,the mechanism of energy transfers between scales,manifest as triples of wavenumbers or frequencies and can be characterized through bispectral analyses.The bispectrum,which correlates the two frequencies to their sum,is calculated by two recently developed multi-dimensional modal decomposition methods:scale-specific energy transfer method and bispectral mode decomposition.Large-eddy simulation of a utility-scale wind turbine in an atmospheric boundary layer with a broad range of large length-scales is used to acquire instantaneous velocity snapshots.The bispectrum from both methods identifies prominent upwind and wake meandering interactions that create a broad range of energy scales including the wake meandering scale.The coherent kinetic energy associated with the interactions shows strong correlation between upwind scales and wake meandering.

关键词： Wind turbine wake Mode decomposition Bispectral analysis

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Testing and modelling of transient adhesion phenomena in rolling-sliding contacts

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Friction 2024年第5期12卷 1016-1027页

作者： daniel KVARDA Alexander MEIERHOFER Klaus SIX Faculty of Mechanical Engineering Brno University of TechnologyBrno61669Czech Republic Virtual Vehicle Research GmbH Graz8010Austria

Transient adhesion effects in rolling–sliding contacts influence all aspects of train–track interaction.This is of high importance specifically when these effects result in critically low adhesion,which poses a risk to traction and braking of railway vehicles.This study presents a model that can replicate the transient changes of the coefficient of adhesion with tested water and solid particle mix.The experimental data for the model are measured using a commercial ball-on-disc tribometer.The experimental results showed a liquid reservoir in front of the contact area that slowly reduces in size.This observation was used in the modelling approach to divide the calculation into two stages where the reservoir is present and when it disappears.The model was able to reproduce the occurrence of low adhesion region seen in experimental results with different particle concentrations.

关键词： coefficient of adhesion tribology transient effects wheel-rail contact

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Rapid growth in a large Cambrian apex predator

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National Science Review 2024年第3期11卷 128-136页

作者：吴雨 Stephen Pates daniel Pauly 张兴亮傅东静 State Key Laboratory of Continental Dynamics and Shaanxi Key Laboratory of Early Life and Environment Department of Geology Northwest University Department of Zoology University of Cambridge Institute for the Oceans and Fisheries University of British Columbia Nanjing Institute of Geology and Palaeontology Chinese Academy of Sciences

Despite the importance of ontogenetic data on early diverging euarthropods to our understanding of the ecology and evolution of past life, the data are distinctly lacking, as reconstructing life histories of fossil animals is often challenging. Here we report the growth trajectory of frontal appendages of the apex predator Amplectobelua symbrachiata, one of the most common radiodont arthropods from the early Cambrian Chengjiang biota(c. 520 Ma) of China. Analysis of 432 specimens(9.1–137.1 mm length; 1.3–25.6 mm height) reveals that appendages grew isometrically, with an estimated maximum size of the whole animal of c. 90 cm. Individuals grew rapidly compared to extant arthropods, as assessed using the electronic length-frequency analysis(ELEFAN) approach. Therefore, we show that the Cambrian apex predator A. symbrachiata was an extremely fast-growing arthropod, with an unusual life history strategy that formed as part of the escalatory ‘arms race’ that shaped the Cambrian explosion over 500 Ma.

关键词： stem-group Euarthropoda Radiodonta post-embryonic development growth dynamics Cambrian Explosion

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Diagnosing upper tract urothelial carcinoma: A review of the role of diagnostic ureteroscopy and novel developments over last two decades

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Asian Journal of Urology 2024年第2期11卷 242-252页

作者： Paul Gravestock daniel Cullum Bhaskar Somani Rajan Veeratterapillay Urology Department Freeman HospitalNewcastle Upon TyneUK Department of Urology University Hospital SouthamptonSouthamptonUK

Objective: The role of ureteroscopy in the diagnosis of upper tract urothelial carcinoma is yet to be fully determined. We aimed to provide an up to date evaluation of its role and the emerging technologies in the field.Methods: A literature search of the last two decades (from 24th May, 2001 to 24th May, 2021) was carried out identifying 147 papers for potential inclusion within this narrative review.Results: Diagnostic ureteroscopy is undeniably useful in its ability to visualise and biopsy indeterminate lesions, and to risk stratify malignant lesions that may be suitable for kidney sparing surgery. However, an increased risk of intravesical recurrence following nephroureterectomy when a prior diagnostic ureteroscopy has been performed, inadequate sampling at biopsy, complications from the procedure, and difficult ureteric access are all potential drawbacks. Furthermore, whilst generally an accurate diagnostic procedure, it risks missing carcinoma in-situ lesions. Despite this, evidence shows that routine use of ureteroscopy changes the management of patients in a large proportion of cases, preventing unnecessary surgery or facilitating kidney sparing surgery. The overall rate of complications is low, and improved biopsy techniques and the use of tissue biomarkers for improved staging and grading are encouraging. The risks of delays to definitive management and post-ureteroscopy intravesical recurrence do not seem to affect survival, and trials are in progress to determine whether intravesical therapy can mitigate the latter. Further promising techniques are being investigated to improve shortcomings, particularly in relation to improved diagnosis of carcinoma in situ and preoperative staging.Conclusion: Ureteroscopy has a role in the diagnosis of upper tract malignancy, though whether it should be used routinely is yet to be determined.

关键词： Ureteroscopy Carcinoma Transitional cell Ureteralneoplasms Urinary bladder neoplasms Carcinomainsitu Biopsy

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Online Demand Response Characterization Based on Variability in Customer Behavior

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Journal of Modern Power Systems and Clean Energy 2024年第3期12卷 936-946页

作者： Lester Marrero daniel Sbárbaro Luis García-Santander the Department of Electrical Engineering University of Concepción IEEE

This paper proposes an online framework to characterize demand response(DR) over time. The proposed framework facilitates obtaining and updating the daily consumption patterns of customers. The essential concept of response profile class(RPC) is introduced for characterization and complemented by the measure of the variability in customer behavior. This paper uses a modified version of the incremental clustering by fast search and find of density peaks(CFSFDP) algorithm for daily profiles, considering the multivariate normal kernel density estimator and incremental forms of the Davies-Bouldin(i DB) and Xie-Beni(i XB) validity indices. Case studies conducted using real-world and simulated daily profiles of residential and commercial Chilean end-users have demonstrated how the proposed framework can continuously characterize DR. The proposed framework is proven to achieve realistic customer models for effective energy management by estimating the customer response to price signals at the distribution system operator(DSO) level.

关键词： Clustering algorithms Behavioral sciences Streams Pricing Feature extraction Monitoring Kernel

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Iron regulatory protein 1: the deadly switch of ferroptosis

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Neural Regeneration Research 2024年第3期19卷 477-478页

作者： daniel A.Bórquez Pamela J.Urrutia Center for Biomedical Research Faculty of MedicineUniversidad Diego PortalesSantiagoChile Institute of Nutrition&Food Technology(INTA) Universidad de ChileSantiagoChile Geroscience Center for Brain Health and Metabolism SantiagoChile

Ferroptosis,an iron-dependent cell death:Ferroptosis is a type of regulated necrosis,characterized by redox-active iron accumulation and increased free radical production derived by Fenton chemistry,that triggers oxidation of polyunsaturated fatty acids in phospholipids,loss of cellular membranes integrity,and leakage of intracellular contents.

关键词： integrity switch Iron

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A test of the species confidence hypothesis in dusky damselfish

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Current Zoology 2024年第1期70卷 79-86页

作者： Elle Overs Sydney Stump Isabel Severino daniel T.Blumstein Department of Ecology and Evolutionary Biology University of CaliforniaLos AngelesCA 90095-1606USA

Visual cues are important in both interspecific and intraspecific communication.The species confidence hypothesis proposes that animals are more attracted to conspecific colors and repelled by colors,not on their bodies.Studies on terrestrial lizards and birds have tested the species confidence hypothesis and shown that conspecific colors elicit reduced antipredator behavior.To date,the species confidence hypothesis has not been tested in the marine environment,specifically on coral reefs where color communication is of vital importance.We addressed this knowledge gap by measuring flight initiation distance(the distance an individual moves away from an approaching threat)in dusky damselfish(Stegastes nigricans)in response to an approaching disc of 1 of 4 different color treatments:conspecific,blue,yellow,and black.If the species confidence hypothesis explained variation in damselfish flight initiation distance,then we expected individuals to tolerate closer approaches when approached by a conspecific color.In addition,we calculated the color difference between each stimulus and its corresponding back-ground as a potential alternative explanation for flight responses.Damselfish tolerated the closest approach from the conspecific color stimulus;there were no significant differences between other colors and there was no support for the alternative color difference hypothesis.As with similar terrestrial studies,these results are relevant to ecotourists'choice of swimsuit and wetsuit colors because color choice may modify naturalantipredatorbehavior.

关键词： antipredator behavior flight initiation distance risk assessment species confidence hypothesis Stegastes nigricans

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Twisted fiber microfluidics:a cutting-edge approach to 3D spiral devices

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Microsystems & Nanoengineering 2024年第1期10卷 193-202页

作者： Shunsuke Kato daniel W.Carlson Amy Q.Shen Yuanyuan Guo Department of Electrical Information and Physics EngineeringSchool of EngineeringTohoku UniversityAoba-kuSendai 980-8579 MiyagiJapan Micro/Bio/Nanofluidics Unit Okinawa Institute of Science and TechnologyOnnaKunigami-gun 904-0495 OkinawaJapan Frontier Research Institute for Interdisciplinary Sciences(FRIS) Tohoku UniversityAoba-kuSendai 980-0845 MiyagiJapan Graduate School of Biomedical Engineering Tohoku UniversityAoba-kuSendai 980-8579 MiyagiJapan Department of Physiology Graduate School of MedicineTohoku UniversityAoba-kuSendai 980-8575 MiyagiJapan

The development of 3D spiral microfluidics has opened new avenues for leveraging inertial focusing to analyze small fluid volumes,thereby advancing research across chemical,physical,and biological disciplines.While traditional straight microchannels rely solely on inertial lift forces,the novel spiral geometry generates Dean drag forces,eliminating the necessity for external fields in fluid manipulation.Nevertheless,fabricating 3D spiral microfluidics remains a labor-intensive and costly endeavor,hindering its widespread adoption.Moreover,conventional lithographic methods primarily yield 2D planar devices,thereby limiting the selection of materials and geometrical configurations.To address these challenges,this work introduces a streamlined fabrication method for 3D spiral microfluidic devices,employing rotational force within a miniaturized thermal drawing process,termed as mini-rTDP.This innovation allows for rapid prototyping of twisted fiber-based microfluidics featuring versatility in material selection and heightened geometric intricacy.To validate the performance of these devices,we combined computational modeling with microtomographic particle image velocimetry(uTPiM)to comprehensively characterize the 3D flow dynamics.Our results corroborate the presence of a steady secondary flow,underscoring the effectiveness of our approach.Our 3D spiral microfluidics platform paves the way for exploring intricate microflow dynamics,with promising applications in areas such as drug delivery,diagnostics,and lab-on-a-chip systems.

关键词： thereby straight twisted

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