Search

To establish the value of time-resolved contrast-enhanced magnetic resonance angiography (TR-MRA) in identifying transverse sinus (TS) thrombosis in patients with a unilaterally absent TS signal on phase-contrast (PC) magnetic resonance venography (MRV).Forty-five patients who were suspected of TS thrombosis clinically with a unilaterally absent TS signal on PC MRV were evaluated using TR-MRA. The image quality was compared between PC MRV and TR-MRA via calculating signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) of the normal TS. Images obtained by PC MRV and TR-MRA were assessed independently by two neuroradiologists regarding whether the absent signal was thrombosis or hypoplastic TS. Then a consultant neurologist made the final diagnosis based on all available clinical, laboratory, and radiological results (delivered by a consultant neuroradiologist via computed tomography [CT]/CT venography, magnetic resonance imaging [MRI]/MRV or digital subtraction angiography [DSA]), which was set as the reference standard. The accuracy of the radiological diagnosis from both techniques was assessed.For image quality, the SNRs and CNRs of TR-MRA were 452.14 and 440.92, respectively, significantly higher than that of PC MRV (both p0.001). The interobserver agreement of TR-MRA in identifying TS thrombosis from hypoplastic TS was excellent (κ = 0.951; 95% confidence interval [CI], 0.902-1), much higher than PC MRV (κ = 0.526; 95% CI, 0.389-0.663). Consensus of assessment based on TR-MRA was highly consistent with the reference standard (100% sensitivity, 96.67% specificity) and superior to PC MRV (60% sensitivity, 90% specificity).TR-MRA is better than PC MRV for visualising TS and distinguishing thrombosis from congenitally atretic TS.

The phase-field formulation for fracture based on the framework of representative crack elements is extended to transient thermo-mechanics. The finite element formulation is derived starting from the variational principle of total virtual power. The intention of this manuscript is to demonstrate the potential of the framework for multi-physical fracture models and complex processes inside the crack. The present model at hand allows to predict realistic deformation kinematics and heat fluxes at cracks. At the application of fully coupled, transient thermo-elasticity to a pre-cracked plate, the opened crack yields thermal isolation between both parts of the plate. Inhomogeneous thermal strains result in a curved crack surface, inhomogeneous recontact and finally heat flow through the crack regions in contact. The novel phase-field framework further allows to study processes inside the crack, which is demonstrated by heat radiation between opened crack surfaces. Finally, numerically calculated crack paths at a disc subjected to thermal shock load are compared to experimental results from literature and a curved crack in a three-dimensional application are presented.

Tinea capitis is still common in developing countries, such as China. Its pathogen spectrum varies across regions and changes over time.This study aimed to clarify the current epidemiological characteristics and pathogen spectrum of tinea capitis in China.A multicentre, prospective descriptive study involving 29 tertiary hospitals in China was conducted. From August 2019 to July 2020, 611 patients with tinea capitis were enrolled. Data concerning demography, risk factors and fungal tests were collected. When necessary, the pathogens were further identified by morphology or molecular sequencing in the central laboratory.Among all enrolled patients, 74·1% of the cases were in patients aged 2-8 years. The children with tinea capitis were mainly boys (56·2%) and were more likely than adults to have a history of animal contact (57·4% vs. 35·3%, P = 0·012) and zoophilic dermatophyte infection (73·5% vs. 47%). The adults were mainly female (83%) and were more likely than children to have anthropophilic agent infection (53% vs. 23·9%). The most common pathogen was zoophilic Microsporum canis (354, 65·2%), followed by anthropophilic Trichophyton violaceum (74, 13·6%). In contrast to the eastern, western and northeastern regions, where zoophilic M. canis predominated, anthropophilic T. violaceum predominated in central China (69%, P 0·001), where the patients had the most tinea at other sites (20%) and dermatophytosis contact (26%) but the least animal contact (39%). Microsporum ferrugineum was the most common anthropophilic agent in the western area, especially in Xinjiang province.Boys aged approximately 5 years were the most commonly affected group. Dermatologists are advised to pay more attention to the different transmission routes and pathogen spectra in different age groups from different regions.

We evaluate the consistency between lensing and clustering probes of large-scale structure based on measurements of projected galaxy clustering from BOSS combined with overlapping galaxy-galaxy lensing from three surveys: DES Y3, HSC Y1, and KiDS-1000. An intra-lensing-survey study finds good agreement between these lensing data. We model the observations using the Dark Emulator and fit the data at two fixed cosmologies: Planck, with $S_8=0.83$, and a Lensing cosmology with $S_8=0.76$. For a joint analysis limited to scales with $R>5.25h^{-1}$Mpc, we find that both cosmologies provide an acceptable fit to the data. Full utilisation of the small-scale clustering and lensing measurements is hindered by uncertainty in the impact of baryon feedback and assembly bias, which we account for with a reasoned theoretical error budget. We incorporate a systematic scaling parameter for each redshift bin, $A$, that decouples the lensing and clustering to capture any inconsistency. When a wide range of scales ($0.15, Comment: 28 pages, 11 figures

To investigate the correlation between serum cytomegalovirus (CMV) IgM antibody/viral load and infection-related clinical symptoms in neonates infected with CMV, and provide basis for clinical assessment and monitoring of neonatal CMV infection. A total of 70 neonates with CMV infection admitted to neonatology in Women's Hospital, School of Medicine Zhejiang University, from January 2014 to December 2020 were included in this study. Using real-time quantitative PCR as the diagnostic criteria, congenital cytomegalovirus-infected neonates (探讨巨细胞病毒（CMV）感染新生儿的血清CMV-IgM抗体和病毒载量与其出现临床症状的相关性，为临床新生儿CMV感染的病情评估和监测提供参考。本研究回顾性分析2014年1月至2020年12月浙江大学附属妇产科医院新生儿科收治的70例CMV感染新生儿，以荧光定量PCR法为诊断标准方法，出生3周为界分为先天性CMV感染组（

Dumping or disposal of fly ash causes environmental pollution and huge waste of valuable metals. In this work, carbothermic reduction of fly ash under normal pressure to produce Al-Si-Fe alloy, and thermal reduction of magnesia to produce magnesium in vacuum with Al-Si-Fe alloy were investigated. In addition, the surface morphology and composition of Al-Si-Fe alloy and magnesium were studied by means of SEM-EDS, XRD. Based on the thermodynamic analysis, it was found that AlN and SiO2 lowered down the reduction temperature of SiC and Al4C3, respectively. Increase of temperature and decrease of vacuum degree promotes the thermal reduction of magnesia. Results showed that the recovery rate ranked Fe, Si, and Al in a descending order. The evaporation loss of gaseous SiO and Al2O reduced the recovery of Si and Al. Al-Si-Fe alloy containing 33.12% Al, 48.73% Si and 6.41% Fe is obtained under the optimal conditions. Magnesium with content of 94.87% is prepared using the obtained Al-Si-Fe alloy as reductant. The nucleation rate is less than the growth rate during the condensation of magnesium vapor.

BACKGROUND Blepharoplasty has become one of the most popular plastic surgery techniques for generating double-eyelid folds. The mini-incision blepharoplasty technique results in minimal trauma and the formation of supratarsal folds. METHODS In this study, the authors combined mini-incisions with interrupted buried sutures. To perform the blepharoplasty procedure, the authors marked the supratarsal folds and divided them into 5 line segments: 3 cutting lines and 2 noncutting lines. For the cutting lines, the authors used orbicularis-tarsus fixation to form double eyelids and only removed a small strip of muscle under the incision to maintain the physiological structure of the pretarsal tissue. For the noncutting lines, the authors used the interrupted buried suture technique to add 2 fixed points. RESULTS A total of 42 patients (mean age 25.25 years) underwent this minimally invasive blepharoplasty. Among these patients, 42 underwent bilateral surgery. The average follow-up period was 35.91 months (range: 13-47 months). Only one patient underwent a second operation to address a shallow, unilateral supratarsal crease. Nonetheless, all patients were satisfied with their results. CONCLUSION Our minimally invasive blepharoplasty approach resulted in minimal damage to the pretarsal tissues and robust supratarsal folds and is relatively easy to perform for the novice surgeon. EVIDENCE STATEMENT Level IV.

Precise volumetric evaluation of the alveolar cleft facilitates accurate preparation of bone substitutes and reduces donor site morbidity. This study investigates 2 advanced presurgical volumetric assessment methods that use computer-aided engineering (CAE) software. Preoperative computed tomography (CT) scans from 20 unilateral alveolar cleft patients undergoing secondary alveolar bone grafting (SABG) were analyzed by CAE software. Cleft defect volumes were calculated using the mirror-reversed technique and the subtraction method. The mirror-reversed technique determines defect volume by reversing the noncleft side to the cleft side. The subtraction method determines defect volume by subtracting a mask of the preoperative cleft from a mask generated after simulated cleft filling. The mean defect volumes and calculation times of the mirror-reversed technique (1.27 ± 0.35 cm3; 11.80 ± 1.79 seconds) and the subtractive method (1.23 ± 0.32 cm3; 9.43 ± 1.35 seconds) did not differ significantly. In Bland-Altman analysis the 2 methods were equivalent for alveolar cleft defect assessment. Both methods exhibited acceptable interobserver reliability, high precision, clinical convenience, time efficiency, and high reproducibility, and can serve as valuable tools for the planning and execution of SABG. The subtraction method has broader potential applicability and can simulate intraoperative bone grafting more effectively.

The China National Fracture Study has been conducted to provide a national dataset of traumatic fractures across China. A national representative sample of 512,187 individuals was selected. The population-weighted incidence rates, distribution, injury mechanisms, and risk factors for traumatic fractures were identified for various groups of individuals. The China National Fracture Study (CNFS) has been conducted to provide a comprehensive and up-to-date national dataset of traumatic fractures across China. This study aims to report the national incidences and distributions of traumatic fractures that occurred in 2012, 2013, and 2014 and to analyze the risk factors. A national representative sample of individuals was selected from 24 rural counties and 24 urban cities of 8 provinces using stratified random sampling and the probability proportional to size (PPS) methodology. Participants were interviewed to identify whether they sustained traumatic fractures of the trunk and/or four extremities that had occurred in 2012, 2013, and 2014. The main risk factors associated with traumatic fractures were analyzed by multiple logistic regression models. A total of 512,187 individuals, including 259,649 males and 252,538 females, participated in the CNFS. The population-weighted incidence rates of traumatic fractures in China were calculated to be 2.5 (95% CI, 2.2–2.8) per 1000 population in 2012, 2.8 (95% CI, 2.5–3.3) in 2013, and 3.2% (95% CI, 2.8–3.6) in 2014. The population-weighted incidence rates of fragility fractures among participants aged 65 years and older were calculated to be 27.4 (95% CI, 21.4–33.4) per 1000 population in 2012, 36.0 (95% CI, 28.6–43.5) in 2013, and 42.4 (95% CI, 34.9–49.9) in 2014. The most common cause of fracture was low-energy injuries, followed by traffic accidents. For all age groups, sleeping less than 7 h was a risk factor for traumatic fractures. Alcohol consumption and previous fracture history were identified as risk factors for adults aged 15 years and over. Cigarette smoking was found to be a risk factor for males aged 15–64 years old. For individuals aged 15–64 years old, underweight incurred a risk effect for males and overweight for females. Alcohol consumption, sleeping less than 7 h per day, living in the central and eastern regions, a body mass index less of than 18.5, and having a previous fracture history were identified as strong risk factors for fragility fractures. The national incidence, distribution, and injury mechanisms for traumatic fractures were revealed in the CNFS. Risk factors were identified for various groups of individuals.

Effects of a low-temperature solution heat treatment (SHT) below γ′ solvus temperature and a high-temperature partial solution heat treatment (SHT) above γ′ solvus temperature on microstructural evolution and stress rupture properties of a directionally solidified nickel-based superalloy during long-term thermal exposure at 900 °C were investigated in detail. The two heat treatments generated different microstructures, e.g., different γ′ sizes and surface fractions of residual γ–γ′ eutectic phase. Carbides in the two heat-treated samples exhibited different microstructural stability during the subsequent long-term thermal exposure. The creep lifetime at 870 °C/310 MPa of the samples treated by the high-temperature SHT is more than two times of that treated by the low-temperature SHT, whereas the creep lifetime of the samples treated by the high-temperature partial SHT exhibited a sharp reduction after 1000-h exposure and then decreased by a steady rate up to 10,000-h exposure. In comparison, the creep lifetime of the samples treated by the low-temperature SHT exhibits a slower reduction rate from 0- up to 10,000-h exposure.

Since almost all patients with an alveolar cleft have a deviated and thickened vomer bone, the purpose of this study was to investigate the relationship between the vomer shape and the size of the alveolar cleft in patients with unilateral cleft lip and alveolus (CLA). A total of 40 adult patients with unilateral CLA were enrolled, and 40 normal adults without CLA were enrolled as controls. All patients underwent preoperative computed tomography scans and analysis by computer-aided engineering software to obtain the vomer volume (VV), deviated septal angle (DSA), and alveolar cleft volume (ACV). An independent-sample t test or nonparametric test was used to compare the VV and DSA between the unilateral CLA and control groups. The correlation between ACV, VV, and DSA in the unilateral CLA group was assessed using Pearson correlation analysis or Spearman correlation analysis. Vomer volume was significantly higher in patients with CLA (1595.35±48.45 mm3) than in the control group (1043.2±164.976 mm3) (P0.001), as was DSA (13.099±7.0 versus 3.4398±1.74 degrees) (P0.001). In the CLA group, VV and DSA were significantly associated with ACV (VV and ACV: r=0.886, P0.001; DSA and ACV: r=0.543, P0.001), and VV was significantly correlated with DSA (VV and DSA: r=0.582, P0.001). In conclusion, the vomer is thicker and more convex in patients with unilateral CLA than in people without, and the vomer angle and degree of volume deviation correlate with alveolar cleft severity.

The single-nucleotide polymorphism (SNP) rs2235371 ( IRF6 V274I) is associated with nonsyndromic cleft lip with or without cleft palate (NSCL/P) in Han Chinese and other populations but appears to be without a functional effect. To find the common etiologic variant or variants within the haplotype tagged by rs2235371, we carried out targeted sequencing of an interval containing IRF6 in 159 Han Chinese with NSCL/P. This study revealed that the SNP rs12403599, within the IRF6 promoter, is associated with all phenotypes of NSCL/P, especially nonsyndromic cleft lip (NSCLO) and a subphenotype of it, microform cleft lip (MCL). This association was replicated in 2 additional much larger cohorts of cases and controls from the Han Chinese. Conditional logistic analysis indicated that association of rs2235371 with NSCL/P was lost if rs12403599 was excluded. rs12403599 contributes the most risk to MCL: its G allele is responsible for 38.47% of the genetic contribution to MCL, and the odds ratios of G/C and G/G genotypes were 2.91 and 6.58, respectively, for MCL. To test if rs12403599 is functional, we carried out reporter assays in a fetal oral epithelium cells (GMSM-K). Unexpectedly, the risk allele G yielded higher promoter activity in GMSM-K. Consistent with the reporter studies, expression of IRF6 in lip tissues from NSCLO and MCL patients with the G/G phenotype was higher than in those from patients with the C/C phenotype. These results indicate that rs12403599 is tagging the risk haplotype for NSCL/P better than rs2235371 in Han Chinese and supports investigation of the mechanisms by which the allele of rs12403599 affects IRF6 expression and tests of this association in different populations.

An accurate volumetric analysis method for evaluating the outcomes of different types of alveolar cleft reconstruction is essential because it can help determine which graft material is more effective, confirm favorable times for alveolar bone grafting, and improve surgical techniques. This study aimed to introduce a novel method of precisely calculating the bone formation ratio using computer-aided engineering after surgery. A patient with a unilateral alveolar cleft who was treated with anterior iliac crest bone grafting was enrolled in this study. Helical computed tomography scans were performed preoperatively and 12 months postoperatively. The Digital Imaging and Communications in Medicine (DICOM) data were reconstructed as three-dimensional images and saved in the STL format by using Mimics software. STL data were processed by Geomagic Wrap 2017, using the Boolean operation, the newly formed bone of the alveolar was segmented by identifying the differences between the preoperative and the postoperative three-dimensional images. For this patient, the mean volume of the newly formed bone was 0.387 cm, the morphology was clear, the bone formation ratio was 41.4%, the mean time required for calculating the newly formed bone volume was 23 minutes, and the bone survival ratio was 38.7%. This method is a clinically practical, accurately measurement and time-saving method to evaluate the outcome of alveolar cleft reconstruction. Both the volumetric assessment and morphological analysis of the newly formed bone could be determined in a precise manner.

Most wastewater recovered from hydraulically fractured oil and gas wells (i.e. produced water) is transported to government-permitted, salt-water disposal units (SWDs) and discarded via downhole injection. However, there is a limited availability of disposal wells in some states and growing interest over future options for beneficial reuse. One alternative to using SWD facilities is to recycle the water for further use in oilfield operations. Residual oil and grease are one contaminant class in produced water where cost-effective treatment technologies are lacking. In this work, we studied the ability of alumina-supported bimetallic PdAu to degrade organic compounds at room temperature and atmospheric pressure via the catalytic formation of H2O2. Similar to monometallic Pd and Au catalysts, the PdAu catalyst produced H2O2 and hydroxyl radicals in the presence of oxygen and formic acid. The bimetallic catalyst was the most active in terms of initial OH formation rate, and when phenol was present, PdAu showed the highest rate of phenol degradation. We assessed the promotional and inhibitory effects of other species present in produced water including ferrous ion concentration, pH and salt concentration on catalytic phenol oxidation. PdAu was catalytically active for phenol degradation in simulated produced water at salinities as high as ˜0.3 M (˜16,000 ppm). The combination of air-formic acid-bimetallic catalyst is an intriguing approach for the degradation of organics in contaminated water at low pH and moderate salinity.

The main phenotypic features of lesser-form cleft lip include nasal, philtrum, and vermilion deformities. The manifestations of lesser-form cleft lip vary greatly, and it is difficult to rebuild these subunits during the operation."Three subunits" classification of lesser-form cleft lip was identified as nasal deformity (N), philtrum deformity (P), or vermilion deformity (V); and slight deformity (0) or obvious deformity (1). A total of 200 patients with lesser-form cleft lip were classified into one of the following 8 types: N1P1V1, N1P1V0, N0P1V1, N1P0V1, N0P0V1, N1P0V0, N0P1V0, or N0P0V0. Then the authors discussed the deformities of the lesser-form cleft lip and the reconstruction of the muscles in these subunits based on the microanatomic structure of the nasolabial muscle.This retrospective review included 200 patients with a lesser-form cleft lip, who were seen at our center from 2015 to 2017. There were 149 (74.5%) N1P1V1, 11 (5.5%) N1P1V0, 13 (6.5%) N0P1V1, 4 (2.0%) N1P0V1, 8 (4.0%) N0P0V1, 10 (5.0%) N1P0V0, 1 (0.5%) N0P1V0, and 4 (2%) N0P0V0 clefts. The various deformities of nasal floor, philtrum ridge, and vermilion may suggest that the muscle bundles in these subunits are abnormal and the operation should be performed to simulate the running directions and tension lines of these local muscles.The microanatomic structure and the tension lines of the nasolabial muscles can provide new perspectives for better understanding and repairing the lesser-form cleft lip in subunits.

We investigated the dynamic expression of calcium transporters, TRPV5 and TRPV6, in placenta and bone to determine their role in maternal and fetal calcium balance during gestation. In placenta, TRPV5 was expressed predominantly in syncytiotrophoblasts of the labyrinthine zone, whereas TRPV6 was expressed in spongiotrophoblasts of the junction zone. In bone, the two transporters were found in osteoblasts, osteoclasts, cartilage and bone matrices. During the first half of gestation, TRPV5 and TRPV6 levels in bone were increased on pregnancy day (P) 0.5, then decreased on P3.5 followed by a slight increase on P6.5. During the second half of pregnancy, both the proteins and their mRNAs gradually increased from P9.5 to P15.5-P17.5 in both bone and placenta, followed at parturition by relatively high amounts in placenta, but markedly decreased amounts in bone. The expression pattern is likely related to the fetal and maternal calcium requirement during gestation, which may be regulated by estrogen and other hormones, because the fetal demand for calcium is greatest during the last few days of gestation for rats; maternal calcium metabolism is designed to meet the calcium needs of the fetus during this period. We found that TRPV5 and TRPV6 are involved in calcium transport in the placenta and bone, and therefore play a role in calcium homeostasis during embryonic and fetal development.

Mental illness is highly prevalent among adults in the United States, with almost 1 in 5 adults living with some degree of mental illness. Given most of oral and maxillofacial surgery (OMS) procedures are inherently anxiety-generating, the authors sought to determine the burden of psychiatric illness in the population seeking care at an outpatient OMS unit of the University of Cincinnati. The authors hypothesized that psychiatric diagnoses would be common in this population. This is an ongoing retrospective cohort study. Study subjects were identified by searching CPT codes through electronic health records to identify all patients older than 15 years of age who underwent any oral and maxillofacial surgery outpatient procedure in 2018 (January 1 to December 21). Data on demographics, ASA status, presence of psychiatric diagnosis according to DSM-5, type of procedure, and complications were collected by performing a retrospective chart review. A total of 4616 patients were identified for the chosen timeframe. All the duplicates (387 patients) were removed; 252 patients were further removed as they did not meet the inclusion criteria (no procedure performed, Descriptive analysis was conducted and prevalence rates were calculated. Out of total of 1300 patients who were reviewed, 60.9% (792) were females and 39.1% (508) were males. Age range was from 15 to 98 years with a mean age of 34.2 years; 45.2% (588) were Caucasian, 39% (507) were African-American, 0.7% (9) were Asian, 3.1% (40) were Hispanic, 3.3% (43) were other races, and 8.7% (113) were of unknown race; 32.1% (418) of patients were classified as ASA I, 55.6% (723) were ASA II, 11.2% (145) were ASA 3, and 1.1% (14) were ASA IV. Among the total reviewed population through OMS vision, 305 patients were found to have reported psychiatric diagnosis. Further review of medical history of the remaining patients was performed through Epic, and 26 more patients were found to have reported psychiatric diagnosis. A total of 25.5% (331) of patients were found to have a pre-existing psychiatric diagnosis. Out of these patients, 62 had neurogenic disorders, 29 had schizophrenia spectrum disorders, 56 had bipolar disorders, 218 had anxiety and depressive disorders, 82 had substance use and addictive disorders, 5 had personality disorders, and 7 had other disorders. A total of 102 patients had multiple psychiatric diagnosis. Among the 1300 procedures completed, 11.8% (153) of patients experienced postoperative complications and, among these, 24.9% (38) had psychiatric diagnoses. The review shows that psychiatric illnesses are common among the oral and maxillofacial surgery population. This population is also likely to have more complications. The ongoing record review would shed more light in this arena when complete. Prognostic implications of preoperative psychiatric disorders on surgical outcome should be demonstrated prospectively in intervention studies.