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Objectives: This study evaluated the content and patient educational quality of YouTube videos on facelift surgery for facial rejuvenation. This study investigated the relationship between education quality compared to video content, video metrics, and popularity. Methods: Two hundred videos were identified across 4 search terms: “facelift surgery,” “facelift surgery what to expect,” “facelift surgery patient education,” and “what is facelift surgery.” Unrelated videos, operating room recordings, medical professional lectures, non-English, non-audio, and testimonials were excluded from review. Video quality was assessed using the Global Quality Score (GQS) (range: 1-5), modified DISCERN score (range: 5-25), and JAMA Benchmark Criteria (range: 0-4). Secondary outcomes included upload source, video metrics (views, likes, dislikes, duration, days since upload, comments), and Video Power Indexto measure popularity. The first 10 comments on videos were characterized as positive, neutral, or negative. Results: One hundred forty-three videos were excluded (43 did not meet criteria, 100 duplicates), and 57 videos were included. Fifty-five videos (96.5%) were uploaded by private medical practices. Overall video quality was poor across all 3 scoring systems: GQS (2.92 ± 1.14), modified DISCERN (13.03 ± 3.64), and JAMA Benchmark Criteria (1.78 ± 0.52). Popularity positively correlated with JAMA Benchmark Criteria ( R = .49, P Conclusions: For patients undergoing facelift surgery, there are limited educational videos on YouTube with few videos detailing indications, alternatives, complications, and the postoperative course. YouTube is a growing resource for patient education and opportunities exist for medical institutions to produce higher-quality videos for prospective patients.

Mycotoxins are toxic compounds mainly produced by fungi of the genera Aspergillus, Penicillium and Fusarium. They are present, often as mixtures, in many feed and food commodities including cereals, fruits and vegetables. Their ubiquitous presence represents a major challenge to the health and well being of humans and animals. Hundreds of compounds are listed as possible mycotoxins occurring in raw and processed materials destined for human food and animal feed. In this study, mycotoxins of major toxicological relevance to humans and target animal species were investigated in a range of crops of interest (and their derived products). Extensive Literature Searches (ELSs) were undertaken for data collection on: (i) ecology and interaction with host plants of mycotoxin producing fungi, mycotoxin production, recent developments in mitigation actions of mycotoxins in crop chains (maize, small grains, rice, sorghum, grapes, spices and nuts), (ii) analytical methods for native, modified and co-occurring mycotoxins (iii) toxicity, toxicokinetics, toxicodynamics and biomarkers relevant to humans and animals (poultry, suidae (pig, wild boar), bovidae (sheep, goat, cow, buffalo), rodents (rats, mice) and others (horses, dogs), (iv) modelling approaches and key reference values for exposure, hazard and risk modelling. Comprehensive databases were created using EFSA templates and were stored in the MYCHIF platform. A range of approaches were implemented to explore the modelling of external and internal exposure as well as dose-response of mycotoxins in chicken and pigs. In vitro toxicokinetic and in vivo toxicity databases were exploited, both for single compounds and mixtures. However, large data gaps were identified particularly with regards to absence of common statistical and study designs within the literature and constitute an obstacle for the harmonisation of internal exposure and dose-response modelling. Finally, risk characterisation was also performed for humans as well as for two animal species (i.e. pigs and chicken) using available tools for the modelling of internal dose and a component-based approach for selected mycotoxins mixtures.

Background Despite increasing international interest, there is a lack of evidence about the most efficient, effective and acceptable ways to implement patient and public involvement (PPI) in clinical trials. Objective To identify the priorities of UK PPI stakeholders for methodological research to help resolve uncertainties about PPI in clinical trials. Design A modified Delphi process including a two round online survey and a stakeholder consensus meeting. Participants In total, 237 people registered of whom 219 (92%) completed the first round. One hundred and eighty‐seven of 219 (85%) completed the second; 25 stakeholders attended the consensus meeting. Results Round 1 of the survey comprised 36 topics; 42 topics were considered in round 2 and at the consensus meeting. Approximately 96% of meeting participants rated the top three topics as equally important. These were as follows: developing strong and productive working relationships between researchers and PPI contributors; exploring PPI practices in selecting trial outcomes of importance to patients; and a systematic review of PPI activity to improve the accessibility and usefulness of trial information (eg participant information sheets) for participants. Conclusions The prioritized methodological research topics indicate important areas of uncertainty about PPI in trials. Addressing these uncertainties will be critical to enhancing PPI. Our findings should be used in the planning and funding of PPI in clinical trials to help focus research efforts and minimize waste.

A retrospective chart review analyzed the effect of customized nutrition on the incidence of pregnancy-induced hypertension (PIH), gestational diabetes (GDM), and small- and large-for-gestational-age (SGA, LGA) neonates, examining consecutive deliveries between January 1, 2011, and Decem ber 31, 2012, at a low-risk community hospital. The population was divided into 3 groups: (1) study group (SG), (2) private practice (PP), and (3) community healthcare clinic (CHCC). All groups received standard perinatal management, but additionally the study group was analyzed for serum zinc, carnitine, total 25-hydroxy cholecalciferol (25 OH-D), methylene tetrahydrofolate reductase, and catechol-O-methyl transferase polymorphisms in the first trimester prior to intervention, with subsequent second trimester and postpartum assessment of zinc, carnitine, and 25 OH-D after intervention. Intervention consisted of trimesterby-trimester nutrition and lifestyle education, supplementation of L-methyl folate, magnesium, essential fatty acids, and probiotics for all SG patients, with targeted supplementation of zinc, carnitine, and 25 OH-D. Because of small case occurrence rates of individual conditions in the study group, unreportable reductions were found, except GDM (SG vs CHCC, P value .046 with 95.38% confidence interval [CI]), and PIH (SG vs PP, P value .0505 with 94.95% CIl). The aggregated occurrence rate of the four conditions, however, was significantly lower in the study population than in either comparison population (PP P value .0154 with 98.46% CI, and CHCC P value .0265 with 97.35% CI). Customized nutritional intervention appears to have significantly reduced adverse perinatal outcomes. Prospective study within larger, at-risk populations is needed to determine whether customized nutrition improves conditions individually.我们从 2011 年 1 月 1 日至 2012 年 12 月 31 日，连续观察了一所 低风险社区医院的分娩病例，通过 回顾性病历审查分析了定制式营养 干预对妊娠高血压综合征 (pregnancy induced hypertension, PIH) 、妊娠糖尿病 (gestational diabetes, GDM)，以及小于和大于胎龄儿 (small and large for gestational age neonates, SGA、LGA) 发生率的 影响。人群分为 3 组：(1) 研究组 (study group, SG)，(2) 私人诊所 (private practice, PP) 和 (3) 社 区医疗诊所(community healthcare clinic, CHCC)。各组均接受标准围 产期管理，但研究组另外在干预前 的妊娠早期分析了血清锌、肉毒 碱、总 25 羟胆钙化醇 (25 OH-D)、 亚甲基四氢叶酸还原酶和儿茶酚-O-甲基转移酶基因多态性，并随后在 干预后的孕中期和产后评估了锌、 肉毒碱和 25 OH-D。干预措施包括 对所有 SG 患者按孕期给予营养和 生活方式教育，以及补充 L-甲基叶 酸、镁、必需脂肪酸和益生菌，另 外还有针对性地补充锌、肉毒碱和 25 OH-D。由于单种疾病的病例发生 率较低，除 GDM（SG 对比 CHCC，P 值为 0.046，置信水平为 95.38%） 和 PIH（SG 对比 PP，P 值为 0.0505，置信水平为 94.95%）外， 研究组各疾病的发生率仅观察到不 可报告的下降。然而，相比对照人 群（PP：P 值为 0.0154，置信水平 为 98.46%；CHCC ：P 值为 0.0265 ，置信水平为 97.35%），研究人群 中四种疾病的总发生率显著降低。 定制式营养干预似乎显著减少了不 良围产期结局。需要在高危人群中 开展大样本前瞻性研究，以确定定 制式营养干预是否可降低单种疾病 的发生率。En una revisión retrospectiva de historias clínicas se analizó el efecto de la nutrición personalizada sobre la incidencia de hipertensión inducida por el embarazo (HIE), diabetes gestacional (DG) y los neonatos pequeños o grandes para su edad gestacional (PEG, GED), examinando partos consecutivos entre el 1 de enero de 2011 y el 31 de diciembre de 2012 en un hospital general de bajo riesgo. La población se dividió en 3 grupos: (1) grupo del estudio (GE), (2) consulta privada (CP), y (3) clínica de atención médica general (CAMG). Todos los grupos recibieron una gestión perinatal estándar, pero en el grupo del estudio se realizaron, además, análisis del zinc en suero, carnitina, 25-hidroxicolecalciferol (25 OH-D) total, metilentetrahidrofolato reductasa y polimorfismos en catecol-o-metil-transferasa en el primer trimestre, antes de la intervención, con las posteriores valoraciones en el segundo y tercer trimestre y postparto de zinc, carnitina y 25 OH-D tras la intervención. La intervención consistió en un proceso educativo trimestral sobre nutrición y estilo de vida, suplementos de L-metilfolato, magnesio, ácidos grasos esenciales y probióticos, para todas las pacientes del GE, con suplementos dirigidos con zinc, carnitina y 25 OH-D. Debido a las bajas tasas de incidencia de las afecciones individuales en el grupo del estudio, se encontraron reducciones que no deben comunicarse, exceptuando la DG (GE frente a CAMG, valor de P 0,046 con un nivel de confianza del 95,38 %) y la HIE (GE frente a CP, valor de P 0,0505 con un nivel de confianza del 94,95 %). Sin embargo, la tasa de incidencia agregada de las cuatro afecciones fue significativamente más baja en la población del estudio que en cualquiera de las poblaciones de comparación (CP, valor de P 0,0154 con un nivel de confianza del 98,46 %, y CAMG, valor de P 0,0265 con un nivel de confianza del 97,35 %). La intervención nutricional personalizada parece tener resultados perinatales adversos significativamente reducidos. Es necesario un estudio prospectivo con poblaciones más grandes y de riesgo, para determinar si la nutrición personalizada mejora las afecciones de forma individual.

The Spallation Neutron Source (SNS) was designed and constructed by a collaboration of six U.S. Department of Energy national laboratories. The SNS accelerator system consists of a 1 GeV linear accelerator and an accumulator ring providing 1.4 MW of proton beam power in microsecond-long beam pulses to a liquid mercury target for neutron production. The accelerator complex consists of a front-end negative hydrogen-ion injector system, an 87 MeV drift tube linear accelerator, a 186 MeV side-coupled linear accelerator, a 1 GeV superconducting linear accelerator, a 248-m circumference accumulator ring and associated beam transport lines. The accelerator complex is supported by ~100 high-power RF power systems, a 2 K cryogenic plant, ~400 DC and pulsed power supply systems, ~400 beam diagnostic devices and a distributed control system handling ~100,000 I/O signals. The beam dynamics design of the SNS accelerator is presented, as is the engineering design of the major accelerator subsystems.

The neutron long counter NERO was built at the National Superconducting Cyclotron Laboratory (NSCL), Michigan State University, for measuring β -delayed neutron-emission probabilities. The detector was designed to work in conjunction with a β -delay implantation station, so that β decays and β -delayed neutrons emitted from implanted nuclei can be measured simultaneously. The high efficiency of about 40%, for the range of energies of interest, along with the small background, are crucial for measuring β -delayed neutron emission branchings for neutron-rich r-process nuclei produced as low intensity fragmentation beams in in-flight separator facilities.

Observed neutron-capture elemental abundances in metal-poor stars, along with ongoing analysis of the extremely metal-poor Eu-enriched sub-class provide new guidance for astrophysical models aimed at finding the r-process sites. The present paper emphasizes the importance of nuclear physics parameters entering in these models, particularly β -decay properties of neutron-rich nuclei. In this context, several r-process motivated β -decay experiments performed at the National Superconducting Cyclotron Laboratory (NSCL) are presented, including a summary of results and impact on model calculations.

The hypotheses of a visual basis to reading disabilities in some children have centered around deficits in the visual processes displaying more transient reponses to stimuli although hyperactivity in the visual processes displaying sustained reponses to stimuli has also been proposed as a mechanism. In addition, there is clear evidence that colored lenses and/or colored overlays and/or colored backgrounds can influence performance in reading and/or may assist in providing comfortable vision for reading and, as a consequence, the ability to maintain reading for longer. As a consequence, it is surprising that the color vision of poor readers is relatively little studied. We assessed luminance increment thresholds and equi-luminous red-green and blue-yellow increment thresholds using a computer based test in central vision and at 10° nasally employing the paradigm pioneered by King-Smith. We examined 35 poor readers (based on the Neale Analysis of Reading) and compared their performance with 35 normal readers matched for age and IQ. Poor readers produced similar luminance contrast thresholds for both foveal and peripheral presentation compared with normals. Similarly, chromatic contrast discrimination for the red/green stimuli was the same in normal and poor readers. However, poor readers had significantly lower thresholds/higher sensitivity for the blue/yellow stimuli, for both foveal and peripheral presentation, compared with normal readers. This hypersensitivity in blue-yellow discrimination may point to why colored lenses and overlays are often found to be effective in assisting many poor readers.

Recent observations of r-process-enriched metal-poor star abundances reveal a non-uniform abundance pattern for elements $Z\leq47$. Based on non-correlation trends between elemental abundances as a function of Eu-richness in a large sample of metal-poor stars, it is shown that the mixing of a consistent and robust light element primary process (LEPP) and the r-process pattern found in r-II metal-poor stars explains such apparent non-uniformity. Furthermore, we derive the abundance pattern of the LEPP from observation and show that it is consistent with a missing component in the solar abundances when using a recent s-process model. As the astrophysical site of the LEPP is not known, we explore the possibility of a neutron capture process within a site-independent approach. It is suggested that scenarios with neutron densities $n_{n}\leq10^{13}$ $cm^{-3}$ or in the range $n_{n}\geq10^{24}$ $cm^{-3}$ best explain the observations., 28 pages, 7 Postscript figures. To be published in The Astrophysical Journal

The purpose of this study was to validate existing 12-lead electrocardiographic (ECG) ST-segment elevation myocardial infarction (STEMI) criteria in the diagnosis of acute myocardial infarction (AMI) and the application of similar ST-segment depression (STEMI-equivalent) criteria with contrast-enhanced cardiac magnetic resonance imaging (ceMRI) as the diagnostic gold standard.The admission ECG is the cornerstone in the diagnosis of AMI, and ceMRI is a new diagnostic gold standard that can be used to validate existing and novel 12-lead ECG criteria.One hundred fifty-one consecutive patients with their first hospital admission for chest pain underwent ceMRI. The 116 patients without ECG confounding factors were included in this study, and AMI was confirmed in 58 (50%). The admission ECG was evaluated on the basis of the lead distribution of ST-segment deviation according to current American College of Cardiology/European Society of Cardiology (ACC/ESC) guidelines.A sensitivity of 50% and specificity of 97% for AMI were achieved with the currently applied ST-segment elevation criteria. Consideration of ST-segment depression in addition to elevation increased sensitivity for detection of AMI from 50% to 84% (p0.0001) but only decreased specificity from 97% to 93% (p = 0.50). There were no significant differences in AMI location or size between patients meeting the 12-lead ACC/ESC ST-segment elevation criteria and those only meeting the ST-segment depression criteria.In patients admitted to hospital with possible AMI, the consideration of both ST-segment elevation and depression in the standard 12 lead-ECG recording significantly increases the sensitivity for the detection of AMI with only a slight decrease in the specificity.

The level structure of 30 S was studied at the NSCL by using neutron removal reactions with a radioactive 31 S beam. The γ -decay from excited states in 30 S was measured in a Ge-detector array. The results discussed for this work will reduce the uncertainties in the determination of the astrophysical 29 P(p, γ ) 30 S reaction rate under rp -process conditions.

The effect of intravenous physostigmine on cerebral perfusion of patients with cortical stroke was investigated using hexamethyl-propyleneamine oxime (HMPAO) single-photon emission computed tomography. Each patient was studied twice, afteran intravenous infusion of either 1 mg of physostigmine salicylate or saline. A marked increase in HMPAO activity was observed in all regions of post-physostigmine scans when compared to the corresponding post-saline scans, except for the area of infarction and its mirror area in the contralateral hemisphere. In conclusion, physostigmine improves perfusion in the area of penumbra of patients with cortical infarction.

Tissue Harmonic Imaging (THI) is now a feature on almost all ultrasound systems, yet it has arrived on the ultrasound scene remarkably quickly. It appeared almost as a by-product of work on microbubble contrast agents in the mid-1990s, with commercial systems becoming available towards the end of that decade. Fortunately, although there are different ways of generating a THI image, this is one new technical development that is not hidden away behind a host of patented trademarks. Your scanner is likely to have a button labelled simply 'Harmonic', 'Tissue Harmonic' or 'THI'. This article will describe the principles, use and benefits of THI.

Prediction of coordinated dynamic loads induced by groups and crowds of people remains one of the most significant problems faced by designers of grandstands in entertaining venues, such as stadia and concert halls. Available guidance portrays humans as deterministic robot-like force generators moving at a single frequency with either perfect synchronisation or with random phases. Humans are not robots, and natural variability and imperfect synchronisation of individuals point to a random approach for crowd loading.

Gremlin (Grem1) is a member of the DAN family of secreted bone morphogenetic protein (BMP) antagonists. Bone morphogenetic protein-7 (BMP-7) mediates protective effects during renal fibrosis associated with diabetes and other renal diseases. The pathogenic mechanism of Grem1 during diabetic nephropathy (DN) has been suggested to be binding and inhibition of BMP-7. However, the precise interactions between Grem1, BMP-7 and other BMPs have not been accurately defined. In the present study, we show the affinity of Grem1 for BMP-7 is lower than that of BMP-2 and BMP-4, using a combination of surface plasmon resonance and cell culture techniques. Using kidney proximal tubule cells and HEK (human embryonic kidney)-293 cell Smad1/5/8 phosphorylation and BMP-dependent gene expression as readouts, Grem1 consistently demonstrated a higher affinity for BMP-2>BMP-4>BMP-7. Cell-associated Grem1 did not inhibit BMP-2- or BMP-4-mediated signalling, suggesting that Grem1–BMP-2 binding occurred in solution, preventing BMP receptor activation. These data suggest that Grem1 preferentially binds to BMP-2 and this may be the dominant complex in a disease situation where levels of Grem1 and BMPs are elevated.

Steam assisted gravity drainage (SAGD) is an effective method to produce heavy oil and bitumen which are important energy resources. In a typical SAGD approach, steam is injected into a horizontal well located directly above a horizontal producer helping to displace heated oil. Single-well (SW) SAGD attempts to create a similar process using only one horizontal well. To improve early-time response of SW-SAGD, it is necessary to heat the near-wellbore area to reduce oil viscosity and allow gravity drainage to begin. Ideally heating should occur with minimal circulation or bypassing of steam. We have investigated early-time processes to improve reservoir heating. A numerical simulation study was performed to gauge combinations of cyclic steam injection and steam circulation prior to SAGD in an effort to better understand and improve early-time performance. Results from this study, include cumulative recoveries, temperature distributions, and production rates. It is found that cyclic steaming of the reservoi...

There is a lack of reliable models of dynamic loading of civil engineering structures, such as footbridges, floors and grandstands, due to active groups and crowds of people. The key reason for this is the lack of knowledge on coordination of body motion between multiple individuals walking, running, jumping and bouncing in groups of various sizes. This paper presents a potential of the previously published video-based motion tracking method to measure kinematics of multiple individuals in groups. Unlike traditional motion tracking methods, such as maker-based optical systems, this new method is inexpensive, does not require any preparation of test subjects (e.g. attaching tracking markers) and is not constrained to artificial laboratory environment. Moreover, it provides motion data of the similar high quality.

Prediction of dynamic loads induced by groups and crowds of people bouncing is a hot topic among designers of grandstands and floors in entertaining venues. Using motion capture technology transferred and adapted from biomedical research, this study aims to investigate effect of visual, auditory and tactile cues on the ability of people to coordinate or synchronise their bouncing movements in groups of two. The numerical results showed a great significance of such stimuli on people’s mutual interaction during bouncing, signifying that their effect should be considered in developing much-needed models of crowd dynamic loading of structures due to coordinated rhythmic activities.

It has recently been recognized that the ability of insulin to augment blood flow is reduced in insulin-resistant conditions such as obesity and noninsulin-dependent diabetes mellitus. Normal aging is characterized by resistance to insulin-mediated glucose uptake. We undertook the following studies with the hypothesis that the resistance to insulin-mediated glucose uptake that occurs with aging is caused in part by a reduction in insulin-mediated blood flow. These experiments were conducted on healthy young (n = 13; age, 24 +/- 1 yr; body mass index: 22.2 +/- 0.6 kg/m2) and old (n = 13; age, 77 +/- 1 yr; body mass index: 24.2 +/- 0.5 kg/m2) subjects. Each subject underwent two studies. In the control study, saline was infused for 4 h. In the euglycemic clamp study, insulin was infused for 4 h at a rate of 40 mU/m2.min in the young subjects and 34 mU/m2.min in the old subjects. Blood samples were taken, and calf blood flow was measured using venous occlusion plethysmography at regular intervals in each study. Basal calf blood flow was lower in the elderly (young subjects: 1.51 +/- .08 mL/100 mL tissue per min; old subjects: 1.15 +/- 0.07 mL/100 mL tissue per min, P < 0.002). During the euglycemic clamp studies, steady-state insulin and glucose values were similar in the two age groups. Glucose disposal rates were significantly higher in the young subjects (P = 0.01 by analysis of variance). Mean arterial pressure values were significantly higher in the elderly (P < 0.001 by analysis of variance) throughout the clamp, but there was no significant change over time in either age group. The mean incremental blood flow rate at steady-state (180-240 min) was significantly higher in the young subjects (0.76 +/- 0.23 mL/100 mL tissue per min) than in the old subjects (0.05 +/- 0.09 mL/100 mL tissue per min, P < 0.01). There was a significant correlation between steady-state glucose disposal rate values and incremental blood flow rates in the young subjects (r = 0.59, P < 0.05) but not in the old subjects (r = 0.21, P = NS). We conclude that normal aging is characterized by an impairment in the ability of insulin to modulate blood flow, which may contribute in part to the insulin resistance of aging.

Background: Nuclear structure plays a significant role on the rapid neutron capture process ($r$ process) since shapes evolve with the emergence of shells and subshells. There was some indication in neighboring nuclei that we might find examples of a new $N=56$ subshell, which may give rise to a doubly magic ${}_{34}^{90}$Se${}_{56}$ nucleus.Purpose: $\ensuremath{\beta}$-decay half-lives of nuclei around ${}^{90}$Se have been measured to determine if this nucleus has in fact a doubly magic character.Method: The fragmentation of a ${}^{136}$Xe beam at the National Superconducting Cyclotron Laboratory at Michigan State University was used to create a cocktail of nuclei in the $A=90$ region.Results: We have measured the half-lives of 22 nuclei near the $r$-process path in the $A=90$ region. The half-lives of ${}^{88}\phantom{\rule{-0.16em}{0ex}}$As and ${}^{90}$Se have been measured for the first time. The values were compared with theoretical predictions in the search for nuclear-deformation signatures of a $N=56$ subshell, and its possible role in the emergence of a potential doubly magic ${}^{90}$Se. The impact of such hypothesis on the synthesis of heavy nuclei, particularly in the production of Sr, Y, and Zr elements was investigated with a weak $r$-process network.Conclusions: The new half-lives agree with results obtained from a standard global QRPA model used in $r$-process calculations, indicating that ${}^{90}$Se has a quadrupole shape incompatible with a closed $N=56$ subshell in this region. The impact of the measured ${}^{90}$Se half-life in comparison with a former theoretical predication associated with a spherical half-life on the weak $r$ process is shown to be strong.