Background: Skin aging is an unavoidable process aggravated by environmental agents. Among other energy devices, non-invasive radiofrequency (RF) technology is widely used for skin tightening and body contouring as it...Background: Skin aging is an unavoidable process aggravated by environmental agents. Among other energy devices, non-invasive radiofrequency (RF) technology is widely used for skin tightening and body contouring as it is simpler and more affordable than other technologies that also minimize pain and side-effects. However, most of the current RF devices do not provide automatic skin temperature control and it is difficult to achieve controlled, deep, and harmless thermal increase, so treatment performance and safety is dependent on the operator’s movements and expertise. Objective: To show the potential of numerical simulations for optimizing the design of monopolar and bipolar RF electrodes that are capable of providing homogeneous, deep and controlled heating. Materials and methods: In-silico models were developed and analyzed using Comsol Multiphysics software to simulate the RF effect produced in tissue by rotating monopolar and bipolar electrodes with different geometries from the Sculpt & Shape RF device (Sinclair, Spain), operating at frequencies of 0.5 and 1 MHz. Ex-vivo and in-vivo proof-of-concept tests were carried out to validate the simulations. Finally, treatments were performed on 16 subjects and a total of 78 body areas to assess the clinical results generated by the RF electrodes for skin tightening and body contouring. Results: In-silico studies emulated the superficial and deep dispersion of heat due to the release of RF energy into human skin tissue. The rotating electrodes (monopolar and bipolar) and the selected RF frequency (0.5 and 1 MHz) determined the homogeneity of the thermal distribution, the penetration depth (between 4.37 mm and 25.0 mm) and the heating dynamics (between 30 and 100 seconds to reach the target skin temperature), which were confirmed by ex-vivo and in-vivo tests. In addition, real treatments on facial and body areas using skin temperatures of between 43˚C and 44˚C showed consistent results with good clinical efficacy for skin tightening, circumference reduction and cellulite reduction, with no adverse effects and high subject satisfaction. Conclusions: New monopolar and bipolar RF electrodes with rotating technology have been designed and optimized using numerical simulations. The use of in-silico studies and accurate models that reproduce the thermal behavior of human biological tissues can be used to better understand RF devices and to develop superior, efficient, and safer products more quickly.展开更多
Background: Non-ablative radiofrequency (RF) technology is widely used for the treatment of signs of aging, skin laxity, localized fat and cellulite. However, many RF devices suffer from technical limitations that mak...Background: Non-ablative radiofrequency (RF) technology is widely used for the treatment of signs of aging, skin laxity, localized fat and cellulite. However, many RF devices suffer from technical limitations that make the results highly dependent on the user’s experience or clinical limitations that compromise safety, efficacy and comfort. Objective: To evaluate the efficacy and safety of a novel semi-automatic non-ablative RF device for skin tightening, body shaping and cellulite reduction. Materials and methods: A retrospective multicenter study was performed using a novel rotative RF device with temperature and impedance control (Sculpt&Shape<sup>®</sup>, Sinclair, Spain). 58 subjects underwent a minimum of 4 treatments every 1-2 weeks. A total of 120 treatments (56.7% body and 43.3% facial) and 1034 sessions were performed. Efficacy was evaluated by 3 researchers using the Global Aesthetic Improvement Scale (GAIS) and anthropometric measurements were collected. Subject and practitioner satisfaction were recorded. Safety was evaluated by analyzing the perception of pain during the treatment and the side and adverse effects immediately after treatment and over the next 48 hours. Results: Between 25% and 50% improvement was achieved according to the GAIS. Statistically significant (p < 0.01) abdominal fold reduction of 5.1 mm and circumference reduction of 32.0 mm, 16.4 mm and 13.9 mm were recorded for the abdomen, legs and arms, respectively. 77.5% of subjects and 94.9% of practitioners were either satisfied or very satisfied. Minor adverse effects were found in 0.97% of the sessions. Conclusion: This novel semi-automatic rotative RF device has been found to provide treatments that are effective, safe and comfortable for both practitioners and subjects. .展开更多
The purpose of this systematic review was to identify the effects of weight-lifting or resistance exercise on breast cancer-related lymphedema.Published articles written in English were retrieved from electronic datab...The purpose of this systematic review was to identify the effects of weight-lifting or resistance exercise on breast cancer-related lymphedema.Published articles written in English were retrieved from electronic databases,including ScienceDirect,PubMed,Scopus,and CINAHL databases.Hand-searches for unpublished papers were also completed.Content analysis was used to examine articles that met the inclusion criteria.Among 525 searched papers,15 papers met the inclusion criteria:13 trials evaluated weight-lifting or resistance exercise alone and two trials evaluated weight-lifting or resistance exercise plus aerobic exercise.The results of the review showed that no arm volume change was observed for either exercise modality.In addition,six included studies showed that weight-lifting or resistance exercise did not cause lymphedema or adverse events in patients at risk of breast cancer-related lymphedema.For patients with breast cancer-related lymphedema,six studies reported that change of swelling outcome measures were not significantly different between the weight-lifting or resistance exercise group and the control group.However,three included studies reported that volume of arm was significantly more reduced in the weight-lifting or resistance exercise group than those in the control group.The findings suggest that supervised resistance exercise may be safe,feasible,and beneficial in patients with breast cancer-related lymphedema or at risk for breast cancer-related lymphedema.However,the limitation of small sample size implies that further research is needed to confirm these findings.展开更多
BACKGROUNDWeight gain is a potential negative outcome of breast-cancer treatment,occurringin 50%-to-96%of breast-cancer patients,although the amount of weight gain isinconsistently reported in the literature.Research ...BACKGROUNDWeight gain is a potential negative outcome of breast-cancer treatment,occurringin 50%-to-96%of breast-cancer patients,although the amount of weight gain isinconsistently reported in the literature.Research has also shown a relationshipbetween overweight/obesity and breast-cancer mortality.Correspondingly,weight management is a self-care approach known to benefit quality of life(QOL).These research questions and analysis add to existing literature byexamining participants’body mass index(BMI)trend and its relationship withQOL indicators over seven years.AIMTo examine:(1)BMI trends among breast cancer survivors;and(2)The trends’relationship to QOL indicators over seven years.METHODSDuring the Breast Cancer and Lymphedema Project,378 patients’weight andheight were recorded by nurses prior to or just after beginning breast cancertreatment and repeated at quarterly-to-semiannual intervals over seven years.Additionally,participants annually completed the 36-Item Short Form HealthSurvey(SF-36),a valid and reliable tool assessing QOL and health concepts,including physical function,pain,and emotional well-being.BMI trends,changein BMI,and change in SF-36 subscales over seven years were calculated using arandom-intercept repeated-measures regression.Patients were placed into BMIcategories at each time point:Normal,Overweight and Obese.As patients’weights changed,they were categorized accordingly.RESULTSDuring the seven-year study and while controlling for age and residence,participants gained an average of 0.3534 kg/m^2(P=0.0009).This amountremained fairly consistent across BMI categories with those in the normal-weight category(n=134)gaining 0.4546 kg/m^2(P=0.0003);Overweight(n=190)gaining 0.2985 kg/m^2(P=0.0123);and obese(n=199)gaining 0.3147 kg/m^2,(P=0.0649).Age(under or over 55)and region(metro/micro vs small/rural)weresignificantly associated with BMI increase in both the normal and obesecategories.There were statistically significant(P<0.0100)changes in five of theeight SF-36 domains;however,the directions of change were different andsomewhat divergent from that hypothesized.Controlling for age and region,these five were statistically significant,so there were no change or differencesbetween the micropolitan/metropolitan and small town/rural groups.CONCLUSIONAlthough only modest increases in mean BMI were observed,mean BMI changewas associated with selected QOL indicators,suggesting the continued need forself-care emphasis during breast cancer survivorship.展开更多
Lymphedema is the swelling of soft tissues as a result of the accumulation of protein-rich fluid in extracellular spaces.Secondary lymphedema is precipitated by an event causing blockage or interruption of the lymphat...Lymphedema is the swelling of soft tissues as a result of the accumulation of protein-rich fluid in extracellular spaces.Secondary lymphedema is precipitated by an event causing blockage or interruption of the lymphatic vessels.Secondary lymphedema is a potential complication that may affect the quality of life of patients treated for breast cancer.Lifelong risk factors of post-breast cancer lymphedema are related to the extent of axillary node involvement,type of breast surgery,and radiation therapy.These factors decrease lymphatic drainage and increase stasis of fluids in the areas of skin and subcutaneous tissues that drain to regional lymph nodes.Breast cancer-related lymphedema can involve the arm and hand,as well as the breast and trunk on the operative side.Clinical symptom assessment and circumferential measures are widely used to evaluate lymphedema.Treatment of lymphedema associated with breast cancer can include combined modality approaches,compression therapy,therapeutic exercises,and pharmacotherapy.展开更多
Lymphedema is an atypical accumulation of high-proteinfluid located just beneath the skin, which often occurs in the arm or leg. Exercising with lymphedema was traditionally considered to be unsafe. However, recent re...Lymphedema is an atypical accumulation of high-proteinfluid located just beneath the skin, which often occurs in the arm or leg. Exercising with lymphedema was traditionally considered to be unsafe. However, recent research indicates that exercise may be beneficial to individuals with lymphedema. Studies indicate that exercise can improve the range of motion and strength of the afflicted limb(s), as well as overall fitness and functional quality of life, and can be performed without exacerbating symptoms of lymphedema.展开更多
The main removal mechanisms for the degradations of seven pollutants in wastewater treatment wetlands were analysed,and a mathematical model was established to quantify the removal of each pollutant,based on its main ...The main removal mechanisms for the degradations of seven pollutants in wastewater treatment wetlands were analysed,and a mathematical model was established to quantify the removal of each pollutant,based on its main removal mechanisms.Subsurface horizontal flow wetlands were treated as a series of continuous stirred-tank reactors(CSTRs).Kinetic models for the removal of biochemical oxygen demand,chemical oxygen demand,ammonia,total nitrogen and faecal coliforms were established by combining Monod or first-order kinetics with CSTR assumptions.These tentative models account for a wide range of factors that affect wetland performance,but the models have not been proven by experiment data.Depending on the derivation of various coefficients in the models and verification by actual performance data,this study may provide a starting point for an integrated pollutant removal model to be developed,and experimentally verified,thereby making a step forward from the current greenbox'approach of wetland design.展开更多
In laser hair removal treatments on dark skin, the high concentration of melanin in the skin competes with the melanin in the hair. During standard laser procedures, with wavelengths of 755 nm or 810 nm, a high level ...In laser hair removal treatments on dark skin, the high concentration of melanin in the skin competes with the melanin in the hair. During standard laser procedures, with wavelengths of 755 nm or 810 nm, a high level of laser light absorption by melanin in the skin is observed. Therefore, to avoid side effects, lower fluence values are used, which further reduces hair-removal efficacy. To improve results, 810 nm diode lasers operating in dynamic mode, with high frequency and multiple passes, are typically used. The aim of this study is to compare the efficacy and safety of triple-wavelength diode lasers (810 nm, 940 nm, 1060 nm) with that of 810 nm diode lasers on Indian patients. A side-by-side comparison was performed using a triple-wavelength diode laser in stamping mode on one side, and an 810 nm diode laser in dynamic mode on the other. Three subjects with skin type IV on the Fitzpatrick scale participated in the study. Efficacy was assessed through hair counting using clinical photographs, taken before and after the treatments, and the Global Aesthetic Improvement Scale (GAIS). Additionally, comparisons related to epidermal heating and thermal damage to the hair follicle were conducted through mathematical 3D simulations using COMSOL Multiphysics<sup>®</sup> software. Side effects were also evaluated. A superior end point was observed with triple wavelength compared to the 810 nm diode laser. Hair counting showed a 27% greater hair reduction with triple wavelength. No adverse effects were observed. Thermal simulations revealed 29% higher thermal damage with the triple-wavelength laser compared to the 810 nm diode laser. To conclude, on darker skin types, the triple-wavelength diode laser has been shown to be more effective at removing hair, compared to the 810 nm diode laser, while also being a safe procedure.展开更多
Objectives:From the view of everyday practices and the socio-technical coordination lens,this study aimed to analyz the gap between creators’intention and the users’implementation(mainly nursing staff and social wor...Objectives:From the view of everyday practices and the socio-technical coordination lens,this study aimed to analyz the gap between creators’intention and the users’implementation(mainly nursing staff and social workers)of an alert system in assisted living communities.Methods:Qualitative methods were employed by way of five user interviews and focus groups with six system developers.Modeling instruments were applied for data collection to analyze the different clinical workflows versus the expectations of the system development team.Results:Results indicate that the clinical workflow changed over time,which led to a mismatch of nurse care coordination,social practices,and technology use.The results show different mental models of the socio-technical practice.Applying the coordination theory,the following recommendations could be developed to overcome the mismatch.First,it is recommended that nursing staff set goals together.Second,a communication rhythmwith the nursing staff and developer teams should be established,with guided questions to facilitate the conversation,to shed light on the different workflows and the difference in social practices when using sensor technologies or alert systems.Third,a checklist for new employees should be created so they know how and on which devices to use the alert system.Fourth,the user experience with the alert system should be improved(e.g.,an improved user interface).Conclusions:This work indicates recommendations to close the mental model gap to overcome the mismatch between optimal use of the alert system and how the nursing staff is actually using it.展开更多
Data assimilation(DA)and uncertainty quantification(UQ)are extensively used in analysing and reducing error propagation in high-dimensional spatial-temporal dynamics.Typical applications span from computational fluid ...Data assimilation(DA)and uncertainty quantification(UQ)are extensively used in analysing and reducing error propagation in high-dimensional spatial-temporal dynamics.Typical applications span from computational fluid dynamics(CFD)to geoscience and climate systems.Recently,much effort has been given in combining DA,UQ and machine learning(ML)techniques.These research efforts seek to address some critical challenges in high-dimensional dynamical systems,including but not limited to dynamical system identification,reduced order surrogate modelling,error covariance specification and model error correction.A large number of developed techniques and methodologies exhibit a broad applicability across numerous domains,resulting in the necessity for a comprehensive guide.This paper provides the first overview of state-of-the-art researches in this interdisciplinary field,covering a wide range of applications.This review is aimed at ML scientists who attempt to apply DA and UQ techniques to improve the accuracy and the interpretability of their models,but also at DA and UQ experts who intend to integrate cutting-edge ML approaches to their systems.Therefore,this article has a special focus on how ML methods can overcome the existing limits of DA and UQ,and vice versa.Some exciting perspectives of this rapidly developing research field are also discussed.Index Terms-Data assimilation(DA),deep learning,machine learning(ML),reduced-order-modelling,uncertainty quantification(UQ).展开更多
The fruit of the acai palm （Euterpe oleracea Mart.） is a rich source of potential bioactive phytochemicals, however neither its precise composition nor the putative benefits to health from its consumption have been ...The fruit of the acai palm （Euterpe oleracea Mart.） is a rich source of potential bioactive phytochemicals, however neither its precise composition nor the putative benefits to health from its consumption have been fully characterised. This study aims to elucidate the composition of acai fruit pulp and to explore the potential of these extracts to confer protection in a cell culture based model of oxidative DNA damage. Extractions ofcai pulps were dissolved in a 80% methanol （methanol： water, 80：20 v/v） based solvent and the phytochemicals present in the extract were analysing by HPLC detector. Lipids were assessed via GC. The Folin-Ciocalteau assay was used to determine the purposes of providing a phytochemical rich food based comparator with established health benefits. Finally, protection against oxidative DNA damage was assessed in HT-29 cell lines exposed to hydrogen peroxide via the comet assay. Acai pulp extracts were found to be rich in flavonoids, anthocyanins and carotenoids. These extracts were found to protect against oxidative DNA damage （anti-genotoxicity）. A^ai extracts were more effective at preventing oxidative DNA damage than the blueberry extracts, although their antioxidant capacities as assessed by the FRAP assay were similar. These data shown that acai is a rich source of plant phytochemicals and that these chemicals may protect against oxidative stress in human colon cells （HT-29）. Further work is needed to establish the digestive fate of these phytochemicals and to prove the beneficial effects in human.展开更多
A 16-year-old girl presented with a 12-month history of generalized hair shedding from the scalp. The onset of shedding coincided with the development of Hashimoto’s thyroiditis and iron deficiency. At the time of in...A 16-year-old girl presented with a 12-month history of generalized hair shedding from the scalp. The onset of shedding coincided with the development of Hashimoto’s thyroiditis and iron deficiency. At the time of initial presentation, the Has himoto’s thyroiditis had been treated with Neo-Mercazole and she was euthyroid. Her iron stores were low, with a ferritin level of 13 μg/L. As she was vegetarian, oral iron replacement therapy was commenced without further investigation. On follow-up 6 months later, her iron stores were normal (ferritin, 36 μg/L),but the hair shedding had continued. On examination, there was a positive hair pull test from both the vertex of the scalp and the occipital scalp. There was mild bitemporal recession, but no widening of the central part, and she appeared to have a full, thick head of hair (Fig. 1). Additional investigations at that time revealed normal thyroid function and negative antinuclear antibody (ANA) and syphilis serology. She was on no medication other than Neo-Mercazole. Serum testosterone, dihydroepiandosterone sulphate(DHEAS) and sex hormone binding globulin (SHBG) were normal. Two 4-mm punch biopsies were taken from the vertex of the scalp; one was sectioned horizontally and the other vertically. The vertical section was unremarkable. On the horizontal section, there were 32 hair follicles in total, 30 of which were terminal hairs and two of which were vellus hairs. One hair was in telogen. The ratio of terminal to vellus hairs was 15 : 1. A diagnosis of chronic telogen effluvium was made. The condition was explained to the patient and she was reassured that chronic telogen effluvium is not a progressive condition and does not lead to baldness. No treatment was recommended. At follow-up 12 months later, the hair loss had obviously progressed and the patient was assessed as having Ludwig Stage 1 and rogenetic alopecia with widening of the central part (Fig. 2). Repeat blood tests showed normal iron studies, thyroid function, and hormone parameters. Three 4mm punch biopsies were taken from the vertex of the scalp and all were sectioned horizontally. The terminal to vellus hair ratios were 1: 1, 2.6: 1, and 1.9: 1. A diagnosis of and rogenetic alopecia was made and she was commenced on oral spironolactone, 200 mg/day.展开更多
基金supported by the Research Unit in Palliative Care for Adults and Older Adults,Faculty of Nursing,Thammasat University,Thailand and Bualuang ASEAN Chair Professor Fund for the project leading to this publication.
文摘Background: Skin aging is an unavoidable process aggravated by environmental agents. Among other energy devices, non-invasive radiofrequency (RF) technology is widely used for skin tightening and body contouring as it is simpler and more affordable than other technologies that also minimize pain and side-effects. However, most of the current RF devices do not provide automatic skin temperature control and it is difficult to achieve controlled, deep, and harmless thermal increase, so treatment performance and safety is dependent on the operator’s movements and expertise. Objective: To show the potential of numerical simulations for optimizing the design of monopolar and bipolar RF electrodes that are capable of providing homogeneous, deep and controlled heating. Materials and methods: In-silico models were developed and analyzed using Comsol Multiphysics software to simulate the RF effect produced in tissue by rotating monopolar and bipolar electrodes with different geometries from the Sculpt & Shape RF device (Sinclair, Spain), operating at frequencies of 0.5 and 1 MHz. Ex-vivo and in-vivo proof-of-concept tests were carried out to validate the simulations. Finally, treatments were performed on 16 subjects and a total of 78 body areas to assess the clinical results generated by the RF electrodes for skin tightening and body contouring. Results: In-silico studies emulated the superficial and deep dispersion of heat due to the release of RF energy into human skin tissue. The rotating electrodes (monopolar and bipolar) and the selected RF frequency (0.5 and 1 MHz) determined the homogeneity of the thermal distribution, the penetration depth (between 4.37 mm and 25.0 mm) and the heating dynamics (between 30 and 100 seconds to reach the target skin temperature), which were confirmed by ex-vivo and in-vivo tests. In addition, real treatments on facial and body areas using skin temperatures of between 43˚C and 44˚C showed consistent results with good clinical efficacy for skin tightening, circumference reduction and cellulite reduction, with no adverse effects and high subject satisfaction. Conclusions: New monopolar and bipolar RF electrodes with rotating technology have been designed and optimized using numerical simulations. The use of in-silico studies and accurate models that reproduce the thermal behavior of human biological tissues can be used to better understand RF devices and to develop superior, efficient, and safer products more quickly.
文摘Background: Non-ablative radiofrequency (RF) technology is widely used for the treatment of signs of aging, skin laxity, localized fat and cellulite. However, many RF devices suffer from technical limitations that make the results highly dependent on the user’s experience or clinical limitations that compromise safety, efficacy and comfort. Objective: To evaluate the efficacy and safety of a novel semi-automatic non-ablative RF device for skin tightening, body shaping and cellulite reduction. Materials and methods: A retrospective multicenter study was performed using a novel rotative RF device with temperature and impedance control (Sculpt&Shape<sup>®</sup>, Sinclair, Spain). 58 subjects underwent a minimum of 4 treatments every 1-2 weeks. A total of 120 treatments (56.7% body and 43.3% facial) and 1034 sessions were performed. Efficacy was evaluated by 3 researchers using the Global Aesthetic Improvement Scale (GAIS) and anthropometric measurements were collected. Subject and practitioner satisfaction were recorded. Safety was evaluated by analyzing the perception of pain during the treatment and the side and adverse effects immediately after treatment and over the next 48 hours. Results: Between 25% and 50% improvement was achieved according to the GAIS. Statistically significant (p < 0.01) abdominal fold reduction of 5.1 mm and circumference reduction of 32.0 mm, 16.4 mm and 13.9 mm were recorded for the abdomen, legs and arms, respectively. 77.5% of subjects and 94.9% of practitioners were either satisfied or very satisfied. Minor adverse effects were found in 0.97% of the sessions. Conclusion: This novel semi-automatic rotative RF device has been found to provide treatments that are effective, safe and comfortable for both practitioners and subjects. .
文摘The purpose of this systematic review was to identify the effects of weight-lifting or resistance exercise on breast cancer-related lymphedema.Published articles written in English were retrieved from electronic databases,including ScienceDirect,PubMed,Scopus,and CINAHL databases.Hand-searches for unpublished papers were also completed.Content analysis was used to examine articles that met the inclusion criteria.Among 525 searched papers,15 papers met the inclusion criteria:13 trials evaluated weight-lifting or resistance exercise alone and two trials evaluated weight-lifting or resistance exercise plus aerobic exercise.The results of the review showed that no arm volume change was observed for either exercise modality.In addition,six included studies showed that weight-lifting or resistance exercise did not cause lymphedema or adverse events in patients at risk of breast cancer-related lymphedema.For patients with breast cancer-related lymphedema,six studies reported that change of swelling outcome measures were not significantly different between the weight-lifting or resistance exercise group and the control group.However,three included studies reported that volume of arm was significantly more reduced in the weight-lifting or resistance exercise group than those in the control group.The findings suggest that supervised resistance exercise may be safe,feasible,and beneficial in patients with breast cancer-related lymphedema or at risk for breast cancer-related lymphedema.However,the limitation of small sample size implies that further research is needed to confirm these findings.
基金Supported by the National Institute for Nursing Research,National Institutes of Health,No.R01NR05342 and R01 NR010293
文摘BACKGROUNDWeight gain is a potential negative outcome of breast-cancer treatment,occurringin 50%-to-96%of breast-cancer patients,although the amount of weight gain isinconsistently reported in the literature.Research has also shown a relationshipbetween overweight/obesity and breast-cancer mortality.Correspondingly,weight management is a self-care approach known to benefit quality of life(QOL).These research questions and analysis add to existing literature byexamining participants’body mass index(BMI)trend and its relationship withQOL indicators over seven years.AIMTo examine:(1)BMI trends among breast cancer survivors;and(2)The trends’relationship to QOL indicators over seven years.METHODSDuring the Breast Cancer and Lymphedema Project,378 patients’weight andheight were recorded by nurses prior to or just after beginning breast cancertreatment and repeated at quarterly-to-semiannual intervals over seven years.Additionally,participants annually completed the 36-Item Short Form HealthSurvey(SF-36),a valid and reliable tool assessing QOL and health concepts,including physical function,pain,and emotional well-being.BMI trends,changein BMI,and change in SF-36 subscales over seven years were calculated using arandom-intercept repeated-measures regression.Patients were placed into BMIcategories at each time point:Normal,Overweight and Obese.As patients’weights changed,they were categorized accordingly.RESULTSDuring the seven-year study and while controlling for age and residence,participants gained an average of 0.3534 kg/m^2(P=0.0009).This amountremained fairly consistent across BMI categories with those in the normal-weight category(n=134)gaining 0.4546 kg/m^2(P=0.0003);Overweight(n=190)gaining 0.2985 kg/m^2(P=0.0123);and obese(n=199)gaining 0.3147 kg/m^2,(P=0.0649).Age(under or over 55)and region(metro/micro vs small/rural)weresignificantly associated with BMI increase in both the normal and obesecategories.There were statistically significant(P<0.0100)changes in five of theeight SF-36 domains;however,the directions of change were different andsomewhat divergent from that hypothesized.Controlling for age and region,these five were statistically significant,so there were no change or differencesbetween the micropolitan/metropolitan and small town/rural groups.CONCLUSIONAlthough only modest increases in mean BMI were observed,mean BMI changewas associated with selected QOL indicators,suggesting the continued need forself-care emphasis during breast cancer survivorship.
文摘Lymphedema is the swelling of soft tissues as a result of the accumulation of protein-rich fluid in extracellular spaces.Secondary lymphedema is precipitated by an event causing blockage or interruption of the lymphatic vessels.Secondary lymphedema is a potential complication that may affect the quality of life of patients treated for breast cancer.Lifelong risk factors of post-breast cancer lymphedema are related to the extent of axillary node involvement,type of breast surgery,and radiation therapy.These factors decrease lymphatic drainage and increase stasis of fluids in the areas of skin and subcutaneous tissues that drain to regional lymph nodes.Breast cancer-related lymphedema can involve the arm and hand,as well as the breast and trunk on the operative side.Clinical symptom assessment and circumferential measures are widely used to evaluate lymphedema.Treatment of lymphedema associated with breast cancer can include combined modality approaches,compression therapy,therapeutic exercises,and pharmacotherapy.
文摘Lymphedema is an atypical accumulation of high-proteinfluid located just beneath the skin, which often occurs in the arm or leg. Exercising with lymphedema was traditionally considered to be unsafe. However, recent research indicates that exercise may be beneficial to individuals with lymphedema. Studies indicate that exercise can improve the range of motion and strength of the afflicted limb(s), as well as overall fitness and functional quality of life, and can be performed without exacerbating symptoms of lymphedema.
文摘The main removal mechanisms for the degradations of seven pollutants in wastewater treatment wetlands were analysed,and a mathematical model was established to quantify the removal of each pollutant,based on its main removal mechanisms.Subsurface horizontal flow wetlands were treated as a series of continuous stirred-tank reactors(CSTRs).Kinetic models for the removal of biochemical oxygen demand,chemical oxygen demand,ammonia,total nitrogen and faecal coliforms were established by combining Monod or first-order kinetics with CSTR assumptions.These tentative models account for a wide range of factors that affect wetland performance,but the models have not been proven by experiment data.Depending on the derivation of various coefficients in the models and verification by actual performance data,this study may provide a starting point for an integrated pollutant removal model to be developed,and experimentally verified,thereby making a step forward from the current greenbox'approach of wetland design.
文摘In laser hair removal treatments on dark skin, the high concentration of melanin in the skin competes with the melanin in the hair. During standard laser procedures, with wavelengths of 755 nm or 810 nm, a high level of laser light absorption by melanin in the skin is observed. Therefore, to avoid side effects, lower fluence values are used, which further reduces hair-removal efficacy. To improve results, 810 nm diode lasers operating in dynamic mode, with high frequency and multiple passes, are typically used. The aim of this study is to compare the efficacy and safety of triple-wavelength diode lasers (810 nm, 940 nm, 1060 nm) with that of 810 nm diode lasers on Indian patients. A side-by-side comparison was performed using a triple-wavelength diode laser in stamping mode on one side, and an 810 nm diode laser in dynamic mode on the other. Three subjects with skin type IV on the Fitzpatrick scale participated in the study. Efficacy was assessed through hair counting using clinical photographs, taken before and after the treatments, and the Global Aesthetic Improvement Scale (GAIS). Additionally, comparisons related to epidermal heating and thermal damage to the hair follicle were conducted through mathematical 3D simulations using COMSOL Multiphysics<sup>®</sup> software. Side effects were also evaluated. A superior end point was observed with triple wavelength compared to the 810 nm diode laser. Hair counting showed a 27% greater hair reduction with triple wavelength. No adverse effects were observed. Thermal simulations revealed 29% higher thermal damage with the triple-wavelength laser compared to the 810 nm diode laser. To conclude, on darker skin types, the triple-wavelength diode laser has been shown to be more effective at removing hair, compared to the 810 nm diode laser, while also being a safe procedure.
基金This work was supported by the National Library of Medicine grant #1R01LM01222.
文摘Objectives:From the view of everyday practices and the socio-technical coordination lens,this study aimed to analyz the gap between creators’intention and the users’implementation(mainly nursing staff and social workers)of an alert system in assisted living communities.Methods:Qualitative methods were employed by way of five user interviews and focus groups with six system developers.Modeling instruments were applied for data collection to analyze the different clinical workflows versus the expectations of the system development team.Results:Results indicate that the clinical workflow changed over time,which led to a mismatch of nurse care coordination,social practices,and technology use.The results show different mental models of the socio-technical practice.Applying the coordination theory,the following recommendations could be developed to overcome the mismatch.First,it is recommended that nursing staff set goals together.Second,a communication rhythmwith the nursing staff and developer teams should be established,with guided questions to facilitate the conversation,to shed light on the different workflows and the difference in social practices when using sensor technologies or alert systems.Third,a checklist for new employees should be created so they know how and on which devices to use the alert system.Fourth,the user experience with the alert system should be improved(e.g.,an improved user interface).Conclusions:This work indicates recommendations to close the mental model gap to overcome the mismatch between optimal use of the alert system and how the nursing staff is actually using it.
基金the support of the Leverhulme Centre for Wildfires,Environment and Society through the Leverhulme Trust(RC-2018-023)Sibo Cheng,César Quilodran-Casas,and Rossella Arcucci acknowledge the support of the PREMIERE project(EP/T000414/1)+5 种基金the support of EPSRC grant:PURIFY(EP/V000756/1)the Fundamental Research Funds for the Central Universitiesthe support of the SASIP project(353)funded by Schmidt Futures–a philanthropic initiative that seeks to improve societal outcomes through the development of emerging science and technologiesDFG for the Heisenberg Programm Award(JA 1077/4-1)the National Natural Science Foundation of China(61976120)the Natural Science Key Foundat ion of Jiangsu Education Department(21KJA510004)。
文摘Data assimilation(DA)and uncertainty quantification(UQ)are extensively used in analysing and reducing error propagation in high-dimensional spatial-temporal dynamics.Typical applications span from computational fluid dynamics(CFD)to geoscience and climate systems.Recently,much effort has been given in combining DA,UQ and machine learning(ML)techniques.These research efforts seek to address some critical challenges in high-dimensional dynamical systems,including but not limited to dynamical system identification,reduced order surrogate modelling,error covariance specification and model error correction.A large number of developed techniques and methodologies exhibit a broad applicability across numerous domains,resulting in the necessity for a comprehensive guide.This paper provides the first overview of state-of-the-art researches in this interdisciplinary field,covering a wide range of applications.This review is aimed at ML scientists who attempt to apply DA and UQ techniques to improve the accuracy and the interpretability of their models,but also at DA and UQ experts who intend to integrate cutting-edge ML approaches to their systems.Therefore,this article has a special focus on how ML methods can overcome the existing limits of DA and UQ,and vice versa.Some exciting perspectives of this rapidly developing research field are also discussed.Index Terms-Data assimilation(DA),deep learning,machine learning(ML),reduced-order-modelling,uncertainty quantification(UQ).
文摘The fruit of the acai palm （Euterpe oleracea Mart.） is a rich source of potential bioactive phytochemicals, however neither its precise composition nor the putative benefits to health from its consumption have been fully characterised. This study aims to elucidate the composition of acai fruit pulp and to explore the potential of these extracts to confer protection in a cell culture based model of oxidative DNA damage. Extractions ofcai pulps were dissolved in a 80% methanol （methanol： water, 80：20 v/v） based solvent and the phytochemicals present in the extract were analysing by HPLC detector. Lipids were assessed via GC. The Folin-Ciocalteau assay was used to determine the purposes of providing a phytochemical rich food based comparator with established health benefits. Finally, protection against oxidative DNA damage was assessed in HT-29 cell lines exposed to hydrogen peroxide via the comet assay. Acai pulp extracts were found to be rich in flavonoids, anthocyanins and carotenoids. These extracts were found to protect against oxidative DNA damage （anti-genotoxicity）. A^ai extracts were more effective at preventing oxidative DNA damage than the blueberry extracts, although their antioxidant capacities as assessed by the FRAP assay were similar. These data shown that acai is a rich source of plant phytochemicals and that these chemicals may protect against oxidative stress in human colon cells （HT-29）. Further work is needed to establish the digestive fate of these phytochemicals and to prove the beneficial effects in human.
文摘A 16-year-old girl presented with a 12-month history of generalized hair shedding from the scalp. The onset of shedding coincided with the development of Hashimoto’s thyroiditis and iron deficiency. At the time of initial presentation, the Has himoto’s thyroiditis had been treated with Neo-Mercazole and she was euthyroid. Her iron stores were low, with a ferritin level of 13 μg/L. As she was vegetarian, oral iron replacement therapy was commenced without further investigation. On follow-up 6 months later, her iron stores were normal (ferritin, 36 μg/L),but the hair shedding had continued. On examination, there was a positive hair pull test from both the vertex of the scalp and the occipital scalp. There was mild bitemporal recession, but no widening of the central part, and she appeared to have a full, thick head of hair (Fig. 1). Additional investigations at that time revealed normal thyroid function and negative antinuclear antibody (ANA) and syphilis serology. She was on no medication other than Neo-Mercazole. Serum testosterone, dihydroepiandosterone sulphate(DHEAS) and sex hormone binding globulin (SHBG) were normal. Two 4-mm punch biopsies were taken from the vertex of the scalp; one was sectioned horizontally and the other vertically. The vertical section was unremarkable. On the horizontal section, there were 32 hair follicles in total, 30 of which were terminal hairs and two of which were vellus hairs. One hair was in telogen. The ratio of terminal to vellus hairs was 15 : 1. A diagnosis of chronic telogen effluvium was made. The condition was explained to the patient and she was reassured that chronic telogen effluvium is not a progressive condition and does not lead to baldness. No treatment was recommended. At follow-up 12 months later, the hair loss had obviously progressed and the patient was assessed as having Ludwig Stage 1 and rogenetic alopecia with widening of the central part (Fig. 2). Repeat blood tests showed normal iron studies, thyroid function, and hormone parameters. Three 4mm punch biopsies were taken from the vertex of the scalp and all were sectioned horizontally. The terminal to vellus hair ratios were 1: 1, 2.6: 1, and 1.9: 1. A diagnosis of and rogenetic alopecia was made and she was commenced on oral spironolactone, 200 mg/day.
