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Electron beam quality in accelerators is crucial for light source application. Here the authors demonstrate beam conditioning of laser plasma electrons thanks to a specific transport line enabling the control of divergence, energy, steering and dispersion and the application to observe undulator radiation.

The original version of this Article contained an error in the last sentence of the first paragraph of the Introduction and incorrectly read ‘A proper electron beam control is one of the main challenges towards the Graal of developing a compact alternative of X-ray free-electron lasers by coupling LWFA gigaelectron-volts per centimetre acceleration gradient with undulators in the amplification regime in equation 11, nx(n-β) x β: n the two times and beta the two times should be bold since they are vectorsin Eq. 12, β should be bold as well.’ The correct version is ‘A proper electron beam control is one of the main challenges towards the Graal of developing a compact alternative of X-ray free-electron lasers by coupling LWFA gigaelectron-volts per centimetre acceleration gradient with undulators in the amplification regime.’This has been corrected in both the PDF and HTML versions of the Article.

Short period, high field undulators are used to produce hard x-rays on synchrotron radiation based storage ring facilities of intermediate energy and enable short wavelength free electron laser. Cryogenic permanent magnet undulators take benefit from improved magnetic properties of RE_{2}Fe_{14}B (Rare Earth based magnets) at low temperatures for achieving short period, high magnetic field and high coercivity. Using Pr_{2}Fe_{14}B instead of Nd_{2}Fe_{14}B, which is generally employed for undulators, avoids the limitation caused by the spin reorientation transition phenomenon, and simplifies the cooling system by allowing the working temperature of the undulator to be directly at the liquid nitrogen one (77 K). We describe here the development of a full scale (2 m), 18 mm period Pr_{2}Fe_{14}B cryogenic permanent magnet undulator (U18). The design, construction and optimization, as well as magnetic measurements and shimming at low temperature are presented. The commissioning and operation of the undulator with the electron beam and spectrum measurement using the Nanoscopmium beamline at SOLEIL are also reported.

A new concept of wiggler has been designed and realized at SOLEIL to produce high energy photons in low/intermediate electron storage rings. Instead of using the superconducting technology which requires new equipment and instrumentation, heavy maintenance, and additional running costs, we have proposed to build a compact in-vacuum small gap short period wiggler that operates rather at moderate field than at high field. The wiggler composed of 38 periods of 50 mm produces 2.1 T at a gap of 5.5 mm. The moderate value of the magnetic field enables one to limit the effects on the beam dynamics and to avoid excessive power and magnetic forces. In this purpose, the narrow magnetic system has been equipped with a counterforce device made of nonmagnetic springs. The roll-off resulting from the small size of poles has been compensated in situ by permanent magnet magic fingers. This paper reports the phases of design, construction, magnetic measurements, and on-beam tests of the in-vacuum wiggler WSV50.

In this paper, we study the dynamics of the radiative heat transfer of between two slabs. In these systems, depending on the type of slabs and the thermal interaction they have with their surroundings, they can have one or several stable states in the phase space. It can be seen that in these systems, quantities such as distance and thickness affect the states of these systems. We show that the distance between the slabs greatly affects the slabs reaching equilibrium. he Temperature of slabs in systems which has one equilibrium states, reach this state, regardless of the initial temperatures. However, systems with phase-change materials, could have several fixed points in their phase space. If the phase space of the system contains several fixed points, the final state of the system will be determined by the initial temperature of the slabs.

Prcis: In a diverse database ( All of Us ), we report significant dose-response associations between alcohol use frequency and glaucoma, with alcohol use of 4 or more drinks per week associated with significantly increased odds of glaucoma., Purpose: Current evidence on the association between alcohol use and primary open angle glaucoma (POAG) is mixed. We utilize the diverse All of Us Research Program to further examine this relationship., Methods: This is a retrospective cohort study using the diverse All of Us Research Program, a nationwide effort by the United States National Institutes of Health to recruit those historically under-represented in biomedical research. Electronic health records and survey data from the All of Us program were analyzed. A randomized 1:4 case/control ratio was utilized for POAG patients and randomly selected control patients. χ 2 , bivariable, and multivariable regression were utilized to examine the associations between alcohol use and POAG., Results: Of the 3876 POAG patients, 2015 (52%) were female, 1943 (50%) were White, 1152 (30%) were Black, 117 (3%) were Asian, and 584 (15%) were Hispanic. Alcohol use of 4 or more drinks per week was significantly higher in the glaucoma cohort relative to controls (15% vs. 12%, P <0.001). On bivariate analysis, diagnosed alcohol misuse was associated with higher odds of POAG [odds ratio (OR): 1.20, 95% CI: 1.17-1.23, P <0.001]. In multivariable regression, more frequent alcohol use was associated with higher odds of glaucoma; alcohol use with a frequency of 4 or more drinks per week was significantly associated with increased odds of glaucoma (OR: 1.22, 95% CI: 1.03-1.44, P =0.023). This dose-response relationship was also observed and more pronounced for female participants, where alcohol use frequency of monthly or less was already associated with increased odds of glaucoma (OR: 1.21, 95% CI: 1.002-1.46, P =0.048)., Conclusion: In the diverse All of Us database, there was a dose-response relationship between alcohol consumption and POAG risk, which was more pronounced in female participants. Overall, a higher frequency of alcohol consumption was associated with an increased risk of POAG; 4 or more drinks per week significantly was associated with higher glaucoma risk., Competing Interests: Disclosure: S.B. reports equipment support from Topcon and Optomed, and consulting/speaking fees from Topcon, outside of the submitted work. R.N.W. reports grants from National Eye Institute, National Institute of Minority Health and Health Disparities, and Research to Prevent Blindness (New York, NY); consultant for AbbVie, Alcon, Allergan, Amydis, Balance, Editas, Eyenovia, Iantrek, Implandata, iSTAR Medical, Nicox, Santen, and Topcon; Patents licensed to Toromedes from UCSD and licensed to Carl Zeiss Meditec from UCSD; nonfinancial support (research instruments) from Carl Zeiss Meditec, Centervue, Optovue, Topcon, co-Founder -Toromedes. The remaining authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

In this paper, we performed thorough experimental and theoretical calculations to examine the interaction between Pt derivative, as an anticancer, and ct-DNA. The mode of DNA binding with [Pt(NH 3 ) 2 (Isopentylgly)]NO 3 , where Isopentylgly is Isopentyl glycine, was evaluated by various spectroscopic methods, docking, and molecular dynamics simulation studies. UV-Vis and fluorescence spectroscopic titration results and CD spectra of DNA-drug showed this interaction is via groove binding. Also, thermal stability studies or DNA melting temperature changes (ΔT m ), as well as the quenching emissions monitoring proved it. Also, the thermodynamic parameter and binding constant displayed that complex-DNA formation is a spontaneous process, and H-binding and also groove binding were found to be the main forces. Theoretical studies stated [Pt(NH 3 ) 2 (Isopentylgly)]NO 3 -DNA formation occurs on C-G center on DNA, along with rising DNA-compound stability. IC 50 value against the human breast cell line probably is due to the Isopentyl glycine ligand in the structure of the Pt compound, and it was obtained more than cisplatin and less than carboplatin against the MCF7 cell.Communicated by Ramaswamy H. Sarma.

Background: Despite high complication rates, patients persistently present for single-stage augmentation mastopexy. In empty, deflated breasts, we perform one-stage augmentation mastopexy; however, in heavy ptotic breasts, our preference is to stage the procedure with mastopexy and fat graft first. With volume from fat grafting focussing on the upper pole and cleavage areas, many of our patients avoid implants altogether. This reduces subsequent risks of waterfall deformity, implant displacement, rupture and a lifetime of implant exchanges., Objectives: We aim to describe our findings and technique for reducing progression to the second stage of a two-stage augmentation mastopexy with the appropriate use of moderate to high volume of fat grafting at the primary operation., Methods: This is a retrospective review of all patients who presented to the senior author (KT) requesting breast implants and requiring mastopexy, from January 2018 to December 2022., Results: Over the five-year period, 137 patients were identified. Seventy-one (51.8%) underwent single-stage augmentation mastopexy, 55 (40.1%) underwent mastopexy with fat grafting and 11 (8.0%) underwent mastopexy with no fat grafting. Our key finding in this study is that 52 of 66 (78.8%) of planned staged patients, who underwent mastopexy with or without fat grafting, were happy with the volume attained and no longer wished to undergo further implant augmentation., Conclusion: In selected patients, appropriate volume and position of fat grafting at the time of primary mastopexy can significantly obviate the need for a second stage implant (alloplastic) augmentation., Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Purpose: To evaluate the association between the systemic use of calcium channel blockers (CCBs) and primary open-angle glaucoma (POAG) using a diverse nationwide dataset., Design: Retrospective cohort study., Subjects: 213 424 individuals aged 40 years and older in the National Institutes of Health All of Us dataset, notable for its demographic, geographic, and medical diversity and inclusion of historically underrepresented populations. Patients with a diagnosis of POAG prior to use of any kind of antihypertensive medication were excluded., Methods: Bivariate and multivariable regression analyses were performed to evaluate associations between CCB use and POAG. Calcium channel blocker use was further divided into exposure to dihydropyridine CCBs and nondihydropyridine CCBs, and subgroup analyses were performed using chi-square and Fisher tests., Main Outcome Measures: Diagnosis of POAG., Results: Within our cohort, 2772 participants (1.3%) acquired a diagnosis of POAG, while 210 652 (98.7%) did not. Among patients who developed POAG, the mean age was 73.3 years, 52.5% were female, and 48.2% identified as White. Among patients with POAG, 32.6% used 1 or more CCB, 28.2% used a dihydropyridine CCB, and 2.2% used a nondihydropyridine CCB. In bivariate analysis, use of any CCBs was associated with an increased risk of POAG (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.27-1.31, P < 0.001). In multivariable analysis adjusting for age, gender, race, ethnicity, and comorbidities such as diabetes, hyperlipidemia, and hypertension, use of any CCBs remained associated with an increased risk of developing POAG (OR: 1.52, 95% CI: 1.33-1.74, P < 0.001). When stratified by type of CCB, the use of dihydropyridine CCBs (OR: 1.31, 95% CI: 1.14-1.50, P < 0.001) was associated with increased POAG risk., Conclusions: Use of dihydropyridine CCBs was associated with a significantly higher risk of developing POAG, both before and while adjusting for demographic factors and comorbid medical conditions., Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article., (Copyright © 2024 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Atrial fibrillation (AF)/atrial flutter (AFL) is the most common cardiac tachyarrhythmia, with an increasing trend in its burden in recent years. However, the burden of AF/AFL in Iran remains unclear. This study aimed to estimate the burden of AF/AFL and its attributable risk factors from 1990 to 2019 at national and subnational levels. Using the comparative risk assessment method of the Global Burden of Disease (GBD) Study 2019, we extracted data on AF/AFL incidence, prevalence, deaths, disability-adjusted life years (DALYs), and their age-standardized rates from 1990 to 2019 and analyzed them based on by age, sex, and socio-demographic index (SDI). The percentage contribution of AF/AFL major risk factors was calculated. Moreover, the AF/AFL burden in 2050 was projected using the United Nations world population prospect data. In 2019, there were 339.1 (259.4-433.7) thousand AF/AFL patients in Iran, with 30.2 (23.2-38.5) thousand new cases, 1.7 (1.5-2) thousand deaths and 48 (37.7-60.5) thousand DALYs. Females and 50-69-year-old patients recorded a higher burden for AF/AFL; however, the increasing trend was more pronounced in males and more than 85-year-old patients. High systolic blood pressure and elevated body mass index (BMI) were the predominant attributable risk factors for AF/AFL-related deaths and DALYs. It is estimated that in 2050, the number of AF/AFL patients will increase to 1.1 million people, the incidence of AF/AFL will increase to 91 thousand patients, and the number of AF/AFL-related deaths and DALYs will surge to 7.2 and 170.8 thousand, respectively. Despite advancements in prevention and treatment, AF/AFL remains a major public health problem in Iran. Given its largely preventable and treatable nature, more cost-effective strategies are required to target modifiable risk factors, especially within susceptible age and sex groups., (© 2024. The Author(s).)

Background: It remains controversial whether adding ezetimibe to low/moderate-intensity statins has a more beneficial impact on the treatment efficacy and safety of patients with existing atherosclerotic cardiovascular disease (ASCVD) compared to high-intensity statin regimens., Hypothesis: A combination of low/moderate-intensity statins plus ezetimibe might be more effective and safer than high-intensity statin monotherapy., Methods: We searched databases for randomized controlled trials comparing lipid profile alterations, drug-related adverse events, and MACE components between high-intensity statin monotherapy and low/moderate-intensity statin plus ezetimibe combination therapy. Pooled risk ratios (RR), mean differences (MD), and 95% confidence intervals (95% CI) were estimated using a random-effects model., Results: Our comprehensive search resulted in 32 studies comprising 6162 patients treated with monotherapy against 5880 patients on combination therapy. Combination therapy was more effective in reducing low-density lipoprotein cholesterol (LDL-C) levels compared to monotherapy (MD = -6.6, 95% CI: -10.6 to -2.5); however, no significant differences were observed in other lipid parameters. Furthermore, the combination therapy group experienced a lower risk of myalgia (RR = 0.27, 95% CI: 0.13-0.57) and discontinuation due to adverse events (RR = 0.61, 95% CI: 0.51-0.74). The occurrence of MACE was similar between the two treatment groups., Conclusions: Adding ezetimibe to low/moderate-intensity statins resulted in a greater reduction in LDL-C levels, a lower rate of myalgia, and less drug discontinuation compared to high-intensity statin monotherapy in patients with existing cardiovascular disease. However, according to our meta-analysis, the observed reduction in LDL-C levels in the combination group did not correlate with a reduction in MACE compared to the high-intensity statin group., (© 2024 The Author(s). Clinical Cardiology published by Wiley Periodicals, LLC.)

Aim: Sleep duration has been suggested to be associated with hypertension (HTN). However, evidence of the nature of the relationship and its direction has been inconsistent. Therefore, we performed a meta-analysis to assess the relationship between sleep duration and risk of HTN incidence, and to distinguish more susceptible populations., Methods: PubMed, Embase, Scopus, Web of Science, and ProQuest were searched from January 2000 to May 2023 for cohort studies comparing short and long sleep durations with 7-8 hours of sleep for the risk of HTN incidence. Random-effect model (the DerSimonian-Laird method) was applied to pool risk ratios (RR) and 95% confidence interval (CI)., Results: We included sixteen studies ranging from 2.4 to 18 years of follow-up duration evaluating HTN incidence in 1,044,035 people. Short sleep duration was significantly associated with a higher risk of developing HTN (HR: 1.07, 95% CI: 1.06-1.09). The association was stronger when the sleep duration was less than 5 hours (HR: 1.11, 95% CI: 1.08-1.14). In contrast to males, females (HR: 1.07, 95% CI: 1.04-1.09) were more vulnerable to developing HTN due to short sleep duration. No significant difference between different follow-up durations and age subgroups was observed. Long sleep duration was not associated with an increased incidence of HTN., Conclusion: Short sleep duration was associated with higher risk of HTN incidence, however, there was no association between long sleep duration and incidence of HTN. These findings highlight the importance of implementing target-specific preventive and interventional strategies for vulnerable populations with short sleep duration to reduce the risk of HTN., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Hosseini et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The prevalence and burden of substance and opium use have increased worldwide over the past decades. In light of rapid population changes in Tehran, we aimed to evaluate the prevalence of opium and other substance use among adult residents in Tehran, Iran., Method: From March 2016 to March 2019, we utilized data from 8 296 participants in the Tehran Cohort Study recruitment phase (TeCS). We calculated the age-sex-weighted prevalence of substance use and the geographic distribution of substance use in Tehran. We also used logistic regression analysis to determine possible determinants of opium use., Result: We analyzed data from 8 259 eligible participants with complete substance use data and the average age of participants was 53.7 ± 12.75 years. The prevalence of substance use was 5.6% (95% confidence interval [CI]: 4.6- 7.1%). Substance use was more common in males than females (Prevalence: 10.5% [95% CI: 8.6- 12.6%] vs. 0.5% [95% CI: 0.2- 1.2%], respectively). The age-sex weighted prevalence of substance use was 5.4% (95% CI: 4.6-7.1%). Moreover, opium was the most frequently used substance by 95.8% of substance users. Additionally, we found that male gender (Odds ratio [OR]: 12.1, P < 0.001), alcohol intake (OR: 1.3, P = 0.016), and smoking (OR: 8.5, P < 0.001) were independently associated with opium use., Conclusions: We found that the prevalence of substance use in Tehran was 5.6%, and opium was the most frequently used substance. In addition, male gender, lower levels of education, alcohol, and tobacco consumption are the main risk factors for substance use in Tehran. Healthcare providers and policymakers can utilize our results to implement preventive strategies to minimize substance use in Tehran., (© 2024. The Author(s).)

Background: The rate of lead extraction has steadily increased alongside the extensive use of cardiovascular implantable electronic devices. Data on the complications and safety of this challenging procedure are limited. We investigated inhospital and midterm outcomes following lead extraction., Methods: Data were retrieved from 51 patients who underwent pacemaker/defibrillator lead extraction procedures at Tehran Heart Center between 2016 and 2021. The procedural success rate, patients' demographic characteristics, and inhospital and midterm procedure-related complications were investigated., Results: Fifty-one patients were enrolled, including 44 men (86.3%). A total of 109 leads were extracted, with a 90.2% complete procedural success rate. In-hospital death occurred in 4 patients (7.8%): 1 patient (1.9%) died from pneumonia, 1 (1.9%) from septic shock, and 2 (3.9%) from septic shock besides heparin-induced thrombocytopenia. Adverse events in 3 patients (5.8%) were directly related to the procedure: 1 patient (1.9%) suffered lung laceration and hemorrhage, 1 (1.9%) sustained subclavian injury, and 1 (1.9%) developed tamponade. Neither reinfection nor rehospitalization was observed during follow-up., Conclusion: Lead extraction can be considered a highly successful procedure with a low rate of death-related events and complications., (Copyright© 2024 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)

Background: Breast augmentation mammaplasty (BAM) remains the most popular cosmetic procedure done worldwide. Bleeding in this procedure increases the chance of capsular contracture. Tranexamic acid (TXA), an antifibrinolytic, has been widely used by other surgical specialties to reduce bleeding., Objectives: We aimed to evaluate the use of TXA in BAM surgery., Methods: This was a single-surgeon case series of all patients who underwent primary BAM from March 2017 to March 2018 and received topical TXA spray to the implant pocket before implant insertion. Early postoperative complications and long-term outcomes, such as capsular contracture and revisional surgery, were recorded and described., Results: Two hundred and eighty-eight patients were included in the study with an overall complication rate of 2.8% over 5 years. No patients had postoperative bleeding or hematoma formation. One patient had a seroma, managed with ultrasound drainage. Complications requiring reoperation included rippling (3, 1.0%), pocket revision (2, 0.7%), capsule contracture (1, 0.3%) and rupture (1, 0.3%)., Conclusions: This study highlights the safety and potential benefits of the use of topical TXA in breast augmentation, with low bleeding and capsular contracture rates., (© The Author(s) 2023. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Despite the past few decades since the discovery of anticancer drugs, there is still no definitive treatment for its treatment. Cisplatin is a chemotherapy medication used to treat some cancers. In this research, the DNA binding affinity of Pt complex with butyl glycine ligand was studied by various spectroscopy methods and simulation studies. Fluorescence and UV-Vis spectroscopic data showed groove binding in ct-DNA-[Pt(NH 3 ) 2 (butylgly)]NO 3 complex formation by the spontaneous process. The results were also confirmed by small changes in CD spectra and thermal study (T m ), as well as the quenching emission of [Pt(NH 3 ) 2 (butylgly)]NO 3 complex on DNA. Finally, thermodynamic and binding parameters displayed that hydrophobic forces are the main forces. Based on docking simulation, [Pt(NH 3 ) 2 (butylgly)]NO 3 could bind to DNA and via minor groove binding on C-G center on DNA, formed a stable DNA complex., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: There is not any conflict in reviewing our manuscripts, such as former advisors, students, or recent collaborators. The work was supported by Payame Noor University of Iran. Also, this article does not contain any studies with human participants or animals performed by any of the authors. We are not scientists employed by the Government of Iran. We are teachers and researchers at the Institute of Educational Research and advisors of some graduate and Ph.D. students. We are scientists of a private University, independent of the Government of Iran. Our responsibilities at our university are the teaching and guidance of research students. This research is funded by our private University, independent of the Government of Iran and related sections., (Copyright © 2023. Published by Elsevier B.V.)

Background: Tuberous breast deformity (TBD) is a common abnormality, particularly in patients presenting for breast augmentation. Failure to correct each regional abnormality, including the inframammary fold, lower pole deficiency, nipple-areola complex widening or herniation, or any degree of ptosis, will result in exaggeration of the deformity and a poor aesthetic outcome., Objectives: To describe an algorithm, including novel techniques, to address each region of mild TBD in patients undergoing breast augmentation., Methods: This is a retrospective review and description of the senior author's (K.T.) techniques for correction of early-stage TBD from 2016 to 2021., Results: One hundred forty-two patients underwent a stepwise approach to correct milder TBD features when undergoing breast augmentation., Conclusions: The authors propose a regional algorithm for management of TBD, to allow mostly single-stage correction, except in cases with marked ptosis, severe asymmetry, or marked macroareola., (© The Author(s) 2023. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: To analyze recent publications in Ophthalmology , the journal of the American Academy of Ophthalmology., Design: Retrospective review of published articles., Participants: No human participants were involved in the study., Methods: Articles published in Ophthalmology from January 2018 to December 2022 were reviewed and analyzed., Main Outcome Measures: Research and review articles were included and analyzed per the following: total number of published articles based on related subspecialty area, level of evidence using the modified Oxford level of evidence, number of citations, number of listed authors, gender of the corresponding author, country of affiliation of the corresponding and contributing author(s), and involvement of consortium(s), group(s), or committee(s)., Results: A total of 965 articles were included. The mean (standard deviation) number of authors per article was 8.6 (5.7) and the majority of corresponding authors were male (665, 70.7%). The greatest number of published articles were related to retina (296, 30.7%) followed by glaucoma (172, 17.8%). The greatest number of Preferred Practice Pattern guidelines were also related to retina (7/24, 29.1%), followed by cornea/dry eye syndrome/external disease (6/24, 25%). Retina (77) had the most level 1 evidence, glaucoma (30) for level 2 evidence, and retina for levels 3 (69) and 4 (65). There were 223 articles contributed by consortia/groups/committees, with most from retina (73, 32.7%) followed by glaucoma (40, 17.9%). The mean number of citations per subspecialty article was highest in retina (45.8/article), followed by uveitis (31.7/article). The United States had the greatest number of affiliated corresponding authors (544, 56.4%), followed by the United Kingdom (68, 7.0%). There were 357 (37.0%) articles with coauthors affiliated outside the corresponding author's country of affiliation, although with a downward trend over the most recent 5-year period. There has been an increasing trend in the number of authors and consortia/group/committee involvement in publications., Conclusions: Although team science and collaborations have increased recently, ongoing efforts to diversify individuals, groups, and subspecialties may be needed., Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article., (© 2023 by the American Academy of Ophthalmology.)

Background  Though in facial plastic surgery, the ideal nasal characteristics are defined by average European-American facial features known as neoclassical cannons, many ethnicities do not perceive these characteristics as suitable. Methods  To investigate the preferences for nasofrontal angle, nasolabial angle, dorsal height, alar width, and nasal tip projection, manipulated pictures of one male and one female model were shown to 203 volunteer patients from a tertiary university hospital's facial plastic clinic. Results  The most aesthetically preferred nasofrontal angles were 137.64 ± 4.20 degrees for males and 133.55 ± 4.53 degrees for females. Acute nasofrontal angles were more desirable in participants aged 25 to 44. The most preferred nasolabial angles were 107.56 ± 5.20 degrees and 98.92 ± 4.88 degrees, respectively. Volunteers aged 19 to 24 preferred more acute male nasolabial angles. A straight dorsum was the most desirable in both genders (0.03 ± 0.78 and 0.26 ± 0.75 mm, respectively). The ideal male and female alar widths were -0.51 ± 2.26 and -1.09 ± 2.18 mm, respectively. More 45- to 64-year-old volunteers preferred alar widths equal to intercanthal distance. The ideal female and male tip projections were 0.57 ± 0.01 and 0.56 ± 0.01, respectively. Conclusion  Results indicate that the general Iranian patients prefer thinner female noses with wider nasofrontal angles for both genders. However, the ideal nasolabial angles, dorsal heights, and tip projections were consistent with the neoclassical cannons. Besides ethnic differences, the trend of nasal beauty is also affected by gender, age, and prior history of aesthetic surgery., Competing Interests: Conflict of Interest None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. ( https://creativecommons.org/licenses/by/4.0/ ).)

Objective: The aim of this study is to evaluate the effect of using anti-stress balls in reducing patients' pain during injection of the inferior alveolar nerve block (IANB)., Materials and Methods: In this randomized clinical trial, 32 individuals were divided into two groups. The conventional method of anesthesia injection was performed using IANB conventional injection technique. During the injection, individuals in the anti-stress ball group were asked to use the anti-stress ball as a distraction technique. For the control group, no supersede methods were used for pain control. Finally, both groups were asked to record their pain utilizing the numerical rating scale (NRS). The participants' vital signs were monitored before and after injection. Kolmogorov-Smirnov test, independent T-test, and Fisher's exact chi-square test were performed for statistical analysis (α = 0.05)., Results: Sixteen females and 16 males in the age range of 40 to 20 years old participated in this study. The mean pain score in the anti-stress ball group was significantly lower (p < 0.001). In both sexes, the pain score in the anti-stress ball group was significantly lower (males p < 0.001 and females p = 0.001). In addition, in all age ranges, the pain score in the control group was higher except for the above 35 years old participants (p = 0.078). Moreover, there were no significant differences in individuals' vital signs (p > 0.05)., Conclusion and Clinical Relevance: Utilizing an anti-stress ball reduces patients' pain significantly during IANB in both sexes and individuals who are below 35 years without changing vital signs., Clinical Registration Number: IRCT20220815055704N1., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: Widespread electronic health record adoption has generated a large volume of data and emphasized the need for standardized terminology to describe clinical concepts. Here, we undertook a systematic concept coverage analysis to determine the representation of clinical concepts in ophthalmic infection and ophthalmic trauma among standardized medical terminologies, including the Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT), the International Classification of Diseases (ICD) version 10 with clinical modifications (ICD-10-CM), and ICD version 11 (ICD-11)., Design: Extraction of concepts related to ophthalmic infection and ophthalmic trauma and structured search in terminology browsers., Data Sources: The American Academy of Ophthalmology Basic and Clinical Science Course (BCSC), SNOMED-CT, and ICD-10-CM terminologies from the Observational Health Data Sciences and Informatics Athena browser, and the ICD-11 terminology browser., Methods: Concepts pertaining to ophthalmic infection and ophthalmic trauma were extracted from the 2022 BCSC free text and index terms. We searched terminology browsers to identify corresponding codes and classified the extent of semantic alignment as equal , wide , narrow , or unmatched in each terminology. The overlap of equal concepts in each terminology was represented in a Venn diagram., Main Outcome Measures: Proportions of clinical concepts with corresponding codes at various levels of semantic alignment., Results: A total of 443 concepts were identified: 304 concepts related to ophthalmic infection and 139 concepts related to ophthalmic trauma. The SNOMED-CT had the highest proportion of equal coverage, with 82.0% (249 of 304) among concepts related to ophthalmic infection and 82.0% (115 of 139) among concepts related to ophthalmic trauma. Across all concepts, 28% (124 of 443) were classified as equal in ICD-10-CM and 52.8% (234 of 443) were classified as equal in ICD-11., Conclusions: The SNOMED-CT had significantly better semantic alignment than ICD-10-CM and ICD-11 for ophthalmic infections and ophthalmic trauma. This demonstrates opportunity for continuing advancement of representation of ophthalmic concepts in standardized medical terminologies., (© 2023 by the American Academy of Ophthalmology.)

Purpose: This systematic review aimed to evaluate the effect of transcutaneous auricular vagus nerve stimulation on heart rate variability and baroreflex sensitivity in healthy populations., Method: PubMed, Scopus, the Cochrane Library, Embase, and Web of Science were systematically searched for controlled trials that examined the effects of transcutaneous auricular vagus nerve stimulation on heart rate variability parameters and baroreflex sensitivity in apparently healthy individuals. Two independent researchers screened the search results, extracted the data, and evaluated the quality of the included studies., Results: From 2458 screened studies, 21 were included. Compared with baseline measures or the comparison group, significant changes in the standard deviation of NN intervals, the root mean square of successive RR intervals, the proportion of consecutive RR intervals that differ by more than 50 ms, high-frequency power, low-frequency to high-frequency ratio, and low-frequency power were found in 86%, 75%, 69%, 47%, 36%, and 25% of the studies evaluating the effects of transcutaneous auricular vagus nerve stimulation on these indices, respectively. Baroreflex sensitivity was evaluated in six studies, of which a significant change was detected in only one. Some studies have shown that the worse the basic autonomic function, the better the response to transcutaneous auricular vagus nerve stimulation., Conclusion: The results were mixed, which may be mainly attributable to the heterogeneity of the study designs and stimulation delivery dosages. Thus, future studies with comparable designs are required to determine the optimal stimulation parameters and clarify the significance of autonomic indices as a reliable marker of neuromodulation responsiveness., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Objectives: This study aims to evaluate the effects of histogram equalization (HE) and contrast limited adaptive histogram equalization (CLAHE) on periapical images and fractal dimensions in the periapical region., Methods: In this cross-sectional study, digital periapical images were selected from the archive of Dentistry School of Isfahan University of Medical Sciences. The radiographs were taken from mandibular and maxillary anterior single root teeth with healthy root and periodontium. After applying HE and CLAHE algorithms to images, two radiologists evaluated the quality of apex detection from using a 5-point Likert scale (from 5 for very good image quality to 1 for very bad image quality). Afterward, all the images were imported to the ImageJ application, and the region of interest (ROI) was specified as the region between the two central incisors. The fractal box-counting method was used to determine fractal dimensions (FD) values. Nonparametric Wilcoxon-Friedman test, Intraclass Correlation Coefficient test, T-test, and Pair T-test were performed as statistical analysis (α = 0.05)., Results: Fifty-three radiographs were analyzed and the image quality assessments were significantly different between raw images and images after performing HE, CLAHE (p value < 0.001), and using CLAHE algorithm significantly increases image quality assessments more than HE (p value = 0.009). There was a significant difference in FD values for images after applying CLAHE and HE compared to raw images (p value < 0.001), and HE decreased the FD value significantly more than CLAHE (p value = 0.019)., Conclusions: Employing CLAHE and HE algorithm via OpenCV python library improves the periapical image quality, which is more significant using the CLAHE algorithm. Moreover, applying CLAHE and HE reduces trabecular bone structure detection and FD values in periapical images, especially in HE., (© 2022. The Author(s) under exclusive licence to Japanese Society for Oral and Maxillofacial Radiology.)

Thirty years ago, patients with low ejection fraction (EF) have often been excluded from rehabilitation programs due to concern about possibility of sudden death or other adverse cardiovascular events during exercise sessions. Recent studies have highlighted the fact that cardiac rehabilitation could improve exercise capacity, cardiac function, and health-related quality of life in congestive heart failure patients. This encouraged us to write a review article and update our latest knowledge about the outcome of rehabilitation program in patients with severely depressed cardiac function. We were particularly interested in effect of cardiac rehabilitation on exercise capacity, quality of life, vascular effects, neuro-hormonal changes, and mortality. We also conducted a mini-systematic review and meta-analysis on randomized controlled trials comparing exercise training with usual care in patients with severely reduced left ventricular ejection fraction, for the mortality subsection to obtain precise estimates of overall treatment benefit on mortality. It is our privilege to submit our manuscript for possible publication in your prestigious journal., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Glaucoma is a leading cause of blindness worldwide. Blood pressure (BP) dysregulation is a known risk factor, and home-based BP monitoring is increasingly used, but the usability of digital health devices to measure BP among glaucoma patients is not well studied. There may be particular usability challenges among this group, given that glaucoma disproportionately affects the elderly and can cause visual impairment. Therefore, the goal of this mixed-methods study was to assess the usability of a smart watch digital health device for home BP monitoring among glaucoma patients. Adult participants were recruited and given a smartwatch blood pressure monitor for at-home use. The eHEALS questionnaire was used to determine baseline digital health literacy. After a week of use, participants assessed the usability of the BP monitor and related mobile app using the Post-study System Usability Questionnaire (PSSUQ) and the System Usability Scale (SUS), standardized instruments to measure usability in health information technology interventions. Variations in scores were evaluated using ANOVA and open-ended responses about participants' experience were analyzed thematically. Overall, usability scores corresponded to the 80th-84th percentile, although older patients endorsed significantly worse usability based on quantitative scores and additionally provided qualitative feedback describing some difficulty using the device. Usability for older patients should be considered in the design of digital health devices for glaucoma given their disproportionate burden of disease and challenges in navigating digital health technologies, although the overall high usability scores for the device demonstrates promise for future clinical applications in glaucoma risk stratification., Competing Interests: Conflicts of Interest: The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Background: Several surgical techniques used for rhinoplasty can change the upper lip form over the long term. By eliminating the membranous septum and causing dysfunction of the depressor septi nasi muscle and performing other maneuvers, the tongue-in-groove (TIG) technique can exaggerate changes in the upper lip shape, length, and slope., Methods: This study was conducted to compare the effects of the TIG technique with and without a septal extension graft (SEG) on lip slope and aesthetic angles on the profile view. A retrospective review was performed on 367 patients who underwent primary rhinoplasty using the TIG technique from 2016 to 2020. The upper lip angle (ULA), the nasolabial angle (NLA), and the columellar facial angle (CFA) were measured for comparison pre-and post-operatively., Results: Of 367 patients, 209 underwent TIG, while the rest underwent TIG over SEG (TIG+SEG). Comparison of pre-and post-operative ULAs showed significant changes in both groups. Although mean ULAs increased in both groups, some of the patients in each group experienced a decrease in ULA. The percentage of the patients with increased post-operative ULA significantly grow with increase in the pre-operative NLA (p &lt; 0.05). However, no significant correlation was found between pre-operative CFA and post-operative ULA., Conclusion: The present study suggests that TIG with and without SEG can change the lip slope on the profile view, possibly due to the shift of the subnasal point superiorly and posteriorly., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2022. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Background: Surgical reconstruction is the gold standard of treatment for Peyronie's disease (PD). Grafting procedures provide satisfactory outcomes in patients with complex curvature, short penile length, and without previous erectile dysfunction (ED). We aimed to compare two different grafting methods of reconstruction in patients with PD., Method: Fifty-two PD patients at Imam-Reza hospital of Mashhad from October 2011 to January 2019 with stable plaque, penile angulation of >60˚, complex curvature, and without ED who consented to cooperate, included in our study and divided into two groups. The first group consists of 26 patients, undergone grafting through a double-Y incision and a single saphenous graft placed within the incision. For the second group, two smaller saphenous vein grafts were placed in the two parallel incisions. ED assessed pre- and post-operational via the International index of erectile function. Penile angulation less than 20 degrees was considered a favorable outcome. Patients followed for 18 months, and sacculation, penile shortening, post-operation infection, and penile hypoesthesia were assessed as complications. We used a paired t-test to compare these two groups., Results: ED was 25% and 12% in the first and the second group, respectively. Statistics showed no difference between the two groups regarding pre and post-operational ED ( P =0.1). Regarding complications during follow-up, sacculation occurred in four patients of the first group and none of the second group patients but no significant difference ( P =0.23)., Conclusion: We found no superiority to declare between these two procedures, although regarding the small sample size of our study, further evaluations are needed to establish more reliable results., Competing Interests: The authors declare that there is no conflict of interests.

Objective: The outcome of rhinoplasty was evaluated in patients undergoing tongue-in-groove technique (TIG) with and without septal extension grafts (SEG) placement for stabilization of nasal tip rotation., Subjects and Methods: Three hundred and sixty-seven patients who underwent rhinoplasty using TIG from 2016 to 2020 were included in this study. SEG was used if the caudal segment of the septum was not suitable for TIG. All patients were photographed pre- and postoperatively. Columellar Facial angle (CFA) and Nasolabial angle (NLA) were measured preoperatively at three intervals including up to six months after the operation (early or T1), up to one year after T1 (midterm or T2), and up to two years after T2 (late or T3)., Results: Two hundred and nine patients (56.94%) underwent TIG and the rest of them (43.06%) received SEG plus TIG (SEG+TIG). The TIG group had a mean CFA of 95.9±7.56 degrees preoperatively, 106.5±6.77 degrees at T1, 105.4±6.48 degrees at T2, and 104.8 ±7.52 at T3. The SEG+TIG had a mean CFA of 98.9±7.65 degrees preoperatively, 108.8±6.58 degrees at T1, 107.7±6.86 degrees at T2, and 106.2 ±15.6 at T3. Comparison of T1, T2, and T3 showed that the CFA changes were less than 1%, indicating a nonsignificant difference. The same results were obtained for NLA as well., Conclusion: Adding of SEG to TIG may be an effective technique to create and maintain a stable rotation comparing to TIG independently., Level of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., (© 2021. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Infections caused by Candida species have shown a considerable increase in frequency in the recent past, and hence they are a cause of significant concern among medical practitioners. There are many factors that contribute to the occurrence of Candida-related infections in particular groups of patients. In this report, we present a case that highlights the causes and appropriate treatment methods of the condition. Patients with acute necrotizing cholecystitis often show poor outcomes after treatment, and hence physicians need to be alert when dealing with patients with this condition and should provide the best treatment method. We report a case of necrotizing cholecystitis in a 55-year-old female with a medical history of cholelithiasis, obesity, seizures, cocaine abuse, and anemia. She also reported lower abdominal pain, felt bloated, and complained of headache, dizziness, lack of appetite, shortness of breath, and vomiting. The patient underwent several lab tests as well as a CT scan of the abdomen, hepatobiliary iminodiacetic acid (HIDA) scan, endoscopy, and cholecystectomy., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Katta et al.)