Key Part Research Articles

Research on Typical Fault Diagnosis of Gear based on GHM Multiwavelet Transform and MCKD Algorithm

Background: Gear is the key part of the transmission part of mechanical equipment, which has a high failure rate under complex working conditions or long-term operation, directly affecting the reliability of mechanical equipment. To realize online monitoring of gears and predict gear faults, whether the diagnosis of typical gear faults is accurate and timely is a key link, so it is necessary to study the diagnosis of typical gear faults. Objective: This paper aims to propose a method that can effectively diagnose typical faults of gears and is easy to program, which is beneficial to realize online monitoring of rotating machinery equipment faults. Method: A typical gear fault diagnosis method based on GHM multiwavelet transform and maximum correlation kurtosis deconvolution algorithm (MCKD) is proposed in this paper. The measured vibration signal is decomposed into components with multiple scale spaces and frequency bands through the GHM multiwavelet transform. Then, the MCKD algorithm is run to suppress the noise of GHM multiwavelet transform coefficients, and the periodic components containing fault information are retained and reconstructed. The typical faults such as gear pitting and broken teeth are tested. Results: GHM multiwavelet transform combined with MCKD algorithm can accurately locate the frequency band containing fault information from the vibration signal with multiple modulations, double sideband, and multi-frequency interference and effectively extract the fault frequency and its frequency multiplication. The root means a square error of the extracted fault frequency is 0.08. This method has a good noise suppression effect and high accuracy in extracting fault frequency. Conclusion: The method proposed in this paper is helpful in realizing automatic programming of gear fault diagnosis and is of great significance in realizing real-time monitoring and online diagnosis of rotating machinery equipment faults. More related patents will appear in the future.

A Series Impedance Reshaping Control Method Considering PLL Dynamics for Grid-Connected Inverters Under Weak Grid Conditions

Grid-connected inverters are the key part in renewable energy power generation systems. Usually, phase-locked loop (PLL) is adopted in grid-connected inverters to achieve synchronization. However, prior-art works have revealed that the negative resistance behavior in the low-frequency band caused by PLLs may lead to system instability under weak grids. In this paper, first, a comprehensive small-signal output impedance modeling of the LCL-filtered single-phase grid-connected inverter is derived for stability analysis, where the digital control delays and PLL dynamics have been taken into account. Then, a simple but effective virtual series based impedance reshaping method is proposed. With that, the inverter system can operate stably even under a very weak grid (e.g., short-circuit ratio (SCR) is as low as 1.2). Compared with the traditional grid impedance compensation by virtually increasing grid resistance or reducing the grid inductance, the proposed method does not require grid impedance estimation and is robust against system parameter variations. Thus, its feasibility is improved. Finally, experimental tests are carried out on a single-phase 5-kW prototype, validating the effectiveness of the proposed scheme.

Earth's earliest forest: fossilized trees and vegetation-induced sedimentary structures from the Middle Devonian (Eifelian) Hangman Sandstone Formation, Somerset and Devon, SW England

The evolution of trees and forests through the Devonian Period fundamentally changed the Earth's land biosphere, as well as impacting physical environments and geomorphology by stabilizing sediments and interacting with flowing air and water. From the mid-Givetian Age onwards, lignophyte flora are known to have been key parts of the machinery in the so-called Devonian landscape factory, but the impact of earlier forests, dominated by less woody cladoxylopsids, are not as well understood. We report here evidence for a previously unrecognized cladoxylopsid forest landscape, archived within the Eifelian Hangman Sandstone Formation of Somerset and Devon, SW England. This unit has previously been considered palaeobotanically depauperate, but is here shown to contain the earliest fossil evidence for such trees in the British record, as well as the oldest known evidence globally for the relative position of standing trees: in common parlance, a fossil forest. In addition to abundant fossil material attributable to the cladoxylopsid tree Calamophyton , and other early Mid-Devonian flora, the sedimentary context of the plant remains sheds light on the biogeomorphic impacts of these earliest forests. The trees colonized a sizeable distributive fluvial system that was prone to seasonal disturbance events. The nature of the sedimentary system has created a bias to those facies where biogeomorphic signatures are most frequently recorded (from the distal parts of the system), but across the whole system there is evidence of plant–sediment interactions in the form of vegetation-induced sedimentary structures, rooting features and accumulations of plant debris. Plant remains are also found in nearshore facies adjacent to the distributive fluvial system, attesting to the development of a novel non-marine/marine teleconnection from the production and export of new biological sedimentary particles. The Hangman Sandstone Formation is illustrative of the revolutionary power of cladoxylopsid trees as biogeomorphic agents, forming densely spaced forests and shedding exceptionally abundant plant debris, while also impacting local landforms and sediment accumulations and profoundly changing landform resilience against flood disturbance events. These findings provide evidence that the Eifelian Stage (393.3–387.7 Ma) marks the onset of tree-driven changes to physical environments that would forever change Earth's non-marine landscapes and biosphere. Supplementary material: Details of sedimentary facies and additional images of plant fossils are available at https://doi.org/10.6084/m9.figshare.c.7084873

Multi-Objective Integrated Robust Optimal Control for Wastewater Treatment Processes

Multi-objective optimal control is widely applied in wastewater treatment processes (WWTPs) to ensure the security and stability of the operation processes. However, for the existing stepwise multi-objective optimal control (SMOC) algorithms, the unknown disturbances will further influence the obtain of set-points and the design of control laws, which may degrade the control performance and operation performance of WWTPs. Aim at the above-mentioned problem, this study presents a multi-objective integrated robust optimal control (MIROC) method for WWTPs. The merits of MIROC are three folds. First, a model approximator is designed to capture the nonlinear dynamics of WWTPs. Second, a disturbance observer is utilized to describe the disturbances of WWTPs. Then, based on the model approximator and disturbance observer, a more accurate prediction model of WWTPs with disturbances is established. Third, under the framework of multi-objective model predictive control (MMPC), a MIROC structure with a cooperative cost function (CCF) and a gradient-based multi-objective optimization algorithm (GMOA) is developed to coordinate optimization and control solution of WWTPs with unknown disturbances. Finally, the stability analysis of MIROC is provided in theory. Meanwhile, the results on the benchmark simulation platform demonstrate that MIROC can improve the performance of WWTPs. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Note to Practitioners</i> —The SMOC algorithms may degrade the performance of WWTPs with the unknown disturbances. In the paper, a MIROC scheme is presented for WWTPs with the unknown disturbances. Three key parts are contained, the model approximator, the disturbance observer and the MIROC structure. A prediction model of WWTPs with disturbances is established with the model approximator and the disturbance observer. Then, the model approximator and the disturbance observer are applied to improve modeling accuracy of MIROC. Based on the prediction model of WWTPs, a MIROC structure is designed to comprehensively analyze the optimization process and control process of WWTPs with the unknown disturbances. Then, MIROC structure is composed of a CCF and a GMOA. Finally, the results on an industrial application of WWTPs demonstrate that MIROC can achieve optimal operation of WWTPs.

Single-cell analysis of 5-aminolevulinic acid intraoperative labeling specificity for glioblastoma.

Glioblastoma (GBM) is the most common and aggressive malignant primary brain tumor, and resection is a key part of the standard of care. In fluorescence-guided surgery (FGS), fluorophores differentiate tumor tissue from surrounding normal brain. The heme synthesis pathway converts 5-aminolevulinic acid (5-ALA), a fluorogenic substrate used for FGS, to fluorescent protoporphyrin IX (PpIX). The resulting fluorescence is believed to be specific to neoplastic glioma cells, but this specificity has not been examined at a single-cell level. The objective of this study was to determine the specificity with which 5-ALA labels the diversity of cell types in GBM. The authors performed single-cell optical phenotyping and expression sequencing-version 2 (SCOPE-seq2), a paired single-cell imaging and RNA sequencing method, of individual cells on human GBM surgical specimens with macroscopically visible PpIX fluorescence from patients who received 5-ALA prior to surgery. SCOPE-seq2 allowed the authors to simultaneously image PpIX fluorescence and unambiguously identify neoplastic cells from single-cell RNA sequencing. Experiments were also conducted in cell culture and co-culture models of glioma and in acute slice cultures from a mouse glioma model to investigate cell- and tissue-specific uptake and secretion of 5-ALA and PpIX. SCOPE-seq2 analysis of human GBM surgical specimens revealed that 5-ALA treatment resulted in labeling that was not specific to neoplastic glioma cells. The cell culture further demonstrated that nonneoplastic cells could be labeled by 5-ALA directly or by PpIX secreted from surrounding neoplastic cells. Acute slice cultures from mouse glioma models showed that 5-ALA preferentially labeled GBM tumor tissue over nonneoplastic brain tissue with significant labeling in the tumor margins, and that this contrast was not due to blood-brain barrier disruption. Together, these findings support the use of 5-ALA as an indicator of GBM tissue but question the main advantage of 5-ALA for specific intracellular labeling of neoplastic glioma cells in FGS. Further studies are needed to systematically compare the performance of 5-ALA to that of potential alternatives for FGS.

Environmental Sustainability at Destination Level: The Role of Tourist Citizenship Behavior

Tourist citizenship behavior (TCB) has become a key part of tourist destination management. This study explores how TCB can help tourist destination sustainability. A model is proposed to analyze the relationship between TCB and tourist environmentally responsible behavior. The study also examines which factors are part of this process. Specifically, the influence of the perceived sustainability of a destination on TCB is analyzed, with mediation by destination identification (DI) and perceived value (DPV). According to our findings, perceived sustainability is positively associated with DI and DPV. These two variables are associated with greater TCB. TCB is positively related to environmentally responsible behavior. Accordingly, TCB could encourage tourists to care for the environment by acting as if they were more than just tourists. Implications for destination management organizations are provided to improve destination sustainability and promote both TCB and environmentally responsible behavior among tourists.

Ensuring timely completion and successful thesis outcomes: a case study of an online GIS master’s degree program

ABSTRACT Master of Science (M.S.) programs, including geography through geographic information science and technology (M.S. GIST), play a key part in training the science, technology, engineering, and math (STEM) workforce. A master’s thesis has been a traditional part of geography programs, and across all kinds of disciplines the value of a thesis is well-recognized. However, delivering master’s thesis supervision for large cohorts may result in lengthy completion times and poor completion rates. A growing literature focuses on master’s thesis supervision across a wide array of disciplines, but no study focuses on the master’s thesis for M.S. GIST programs. We offer a mixed-methods case study of a large, online M.S. GIST program showing how problems developed and were resolved over a 13-year period with program-wide structural reforms. Reform elements included increased attention to writing skills in admissions review, addition of writing instruction, earlier student engagement, staff engagement, faculty engagement, and development of thesis courses. Reforms shortened completion times and increased thesis completion rates while sustaining diversity and quality of thesis projects. Although this case study echoes many strategies found in the literature, it emphasizes that replication likely requires linking solutions together through structural reforms across a master’s degree program.

Implementation of a Wireless Sensor Network for Environmental Measurements

Nowadays, the need to monitor different physical variables is constantly increasing and can be used in different applications, from humidity monitoring to disease detection in living beings, using a local or wireless sensor network (WSN). The Internet of Things has become a valuable approach to climate monitoring, daily parcel monitoring, early disease detection, crop plant counting, and risk assessment. Herein, an autonomous energy wireless sensor network for monitoring environmental variables is proposed. The network’s tree topology configuration, which involves master and slave modules, is managed by microcontrollers embedded with sensors, constituting a key part of the WSN architecture. The system’s slave modules are equipped with sensors for temperature, humidity, gas, and light detection, along with a photovoltaic cell to energize the system, and a WiFi module for data transmission. The receiver incorporates a user interface and the necessary computing components for efficient data handling. In an open-field configuration, the transceiver range of the proposed system reaches up to 750 m per module. The advantages of this approach are its scalability, energy efficiency, and the system’s ability to provide real-time environmental monitoring over a large area, which is particularly beneficial for applications in precision agriculture and environmental management.

Estimates of the prevalence of male circumcision in sub-Saharan Africa from 2010-2023-A systematic review and meta-analysis.

Male circumcision (MC) is a key part of the package of interventions to prevent HIV, the biggest health challenge in sub-Saharan Africa. To estimate the male circumcision prevalence and to evaluate the progress towards meeting WHO targets in sub-Saharan Africa during the period 2010-2023. We carried out a systematic review and meta-analysis of studies published during the period 2010-2023. We searched PubMed, Scopus, Cochrane CENTRAL, Google Scholar, WHO and the Demographic and Health Survey for reports on MC prevalence in sub-Saharan Africa. MC prevalence was synthesized using inverse-variance heterogeneity models, heterogeneity using I2 statistics and publication bias using funnel plots. A total of 53 studies were included. The overall prevalence during the study period was 45.9% (95% CI 32.3-59.8), with a higher MC prevalence in Eastern (69.9%, 95%CI 49.9-86.8) compared to Southern African (33.3%, 95%CI 21.7-46.2). The overall prevalence was higher in urban (45.3%, 95%CI 27.7-63.4) compared to rural settings (42.6%, 95% 26.5-59.5). Male circumcision prevalence increased from 40.2% (95% CI 25.0-56.3) during 2010-2015 to 56.2% (95% CI 31.5-79.5) during 2016-2023. Three countries exceeded 80% MC coverage, namely, Ethiopia, Kenya and Tanzania. Overall, the current MC prevalence is below 50%, with higher prevalence in Eastern African countries and substantially lower prevalence in Southern Africa. Most of the priority countries need to do more to scale up medical male circumcision programs.

دور العقل في التجديد الدعوي :دراسة تحليلية

The Intellect is Allah’s (SW) greatest blessing, and like every blessing in this world, it is also part of man’s examination paper. Rather, it is the fundamental part of every human being’s life. He who has no wisdom &amp; intellect has no exam, and he who does not have a wisdom or intellect he/she is not subject to any kind of responsibility. Allah Almighty said: (And when it is said to them, “Follow what Allah has revealed,” they say, “Rather, we follow what we found our fathers upon, even though their fathers were void of wisdom and guidance”) This verse of holy Quran denounces those who have nullified their wisdom and followed their fathers in false beliefs that have no justified reason. Allah Almighty also said: (No soul can believe, except by the will of Allah. And He will place doubt (or obscurity) on those who will not understand). Yes, the key part in a person’s exam is his/her wisdom and intellect. A person’s body and money are linked to his/her work, and the mind is linked to faith. It is clear that faith precedes work, and both are indispensable to succeed, neither in this world nor in the afterlife. The basic point of the test paper is that there are two ways to solve it, either Right or wrong, and for this reason the paths to failure and success emerge from the same test. Allah Almighty said: (It is He who created death and life that He may test you which of you is best in deeds; and He is the Mighty, the Forgiving) ... The meaning of this verse is that Allah is the one who created death and life to test you and to know after the test which of you is righteous and which of you is not, and there is no way to salvation except by doing that in the correct manner. And Allah Almighty said: (So whoever is removed from the Fire and admitted to Paradise has already achieved success). Therefore, the use of the wisdom and intellect must be among the basic and indispensable tasks of life, and it should be used not only to meet some trivial needs, but for great purposes such as salvation, well-being, pride and dignity in this world and clear victory in the afterlife. The belief that modernity is based on bypassing the Sharia texts and denying them cannot be acceptable, because the desired modernity in dealing with the sharia texts means adhering to them completely, while reconsidering the human effort related to interpreting these texts. Because there has become an urgent need for the wisdom to play its effective and fruitful role in renewing the sciences and building civilization. By contemplating the Qur’anic texts calling for the mind’s mobility, its science, and its mission to advance Knowledge, development, walking in the land, and discovering what is new in it, the meditator finds that the role of the mind has become a major role in the fields of construction, progress, and contemporary civilization, and in the field of renewal, development, and giving. God said: God Almighty said: (Indeed, in the creation of the heavens and the earth, and the alternation of night and day, and the ships that sail in the sea for the benefit of people, and what God has sent down from the heaven... water and revives the earth therewith after its death, and scatters in it every living creature, the shifting of the winds, and the clouds subdued between the sky and the earth - these are signs for a people. Akloun). The verse stimulates the wisdom and intellect to think and contemplate the creation of the heavens and the earth, the difference between night and day, and the ships that move in the sea. So, given the importance of this topic, as a researcher I decided to write this research under the title “The Role of wisdom/intellect in Da’wah Renewal”. This research paper is divided into five sections, as follows: First Section: The wisdom does not oppose Alwahy or vice versa Second Section: removing suspicion Third Section: The role of the wisdom in building civilization Fourth Section: The role of the wisdom in renewal Fifth Section: Da’wah renewal

Causes Of Rising Drug Trafficking In India And Ways To Stop Drug Trafficking

Abstract Drug trafficking is the worldwide practice of distributing drugs and other substances which are legally banned under narcotics and associated laws. It includes the cultivation, manufacture, distribution, and sale of controlled substances. In India, the use of drugs in society especially among the younger generation has increased in the past decade and continuous to increase. This has direct and hidden effects on the future growth of the country. This paper discusses the problem of drug trafficking in India, their entry inside the country through the country's border and the various drugs which are seized in the country. It also discussed on how the investigation of drug-related cases can be improved by implementing different approaches to reduce the illegal trade of drugs. Drug trafficking is a global illicit trade involving the cultivation, manufacture, distribution and sale of substances which are subject to drug prohibition laws. UNODC is continuously monitoring and researching global illicit drug markets in order to gain a more comprehensive understanding of their dynamics. The consequences of drug abuse can never be overemphasized as it has birthed a lot of problems not only in family but in the nation as well as the international community. Some medical issues associated with drug abuse include – mental disorder, liver cirrhosis, lethargy, irritability, heart disorders, among others. Studies also reveal that drug addiction contributes largely to social consequences such as internet fraud, gang formation, disruption of normal educational activities, cultism, violence, armed robbery, kidnapping, rape, sexual abuse, reduced productivity. Drug and alcohol abuse are serious problems and has contributed largely to the sorry state of our dear nation. It has birthed a lot of social and medical problems, including school dropout, armed robbery, violence, mental disorder, irritability, heart disorders, to mention but a few. Talking about the way out the government alone cannot eradicate this social menace. It is a joint task of you and me – individuals, communities, families, schools, civil society, religious organizations, the media, business entities. Drug trafficking is a key part of this research. The author delves into analysing the current protective legislations in India in the light of drug trafficking and conclude by suggesting the necessary changes that can be implemented to stop drug trafficking.

A meta-analysis comparing the efficacy of mineralized collagen-polymethylmethacrylate and polymethylmethacrylate bone cements in the treatment of vertebral compression fractures.

Vertebral compression fractures are often treated with vertebroplasty, and filling the injured vertebrae with bone cement is a key part of vertebroplasty. This meta-analysis was performed to compare the clinical efficacy and safety of mineralized collagen-polymethylmethacrylate (MC-PMMA) and polymethylmethacrylate (PMMA) bone cement in the treatment of vertebral compression fractures by vertebroplasty. A computerized search of the published literature on mineralized collagen-polymethylmethacrylate and polymethylmethacrylate bone cement in the treatment of vertebral compression fractures was conducted in the China National Knowledge Infrastructure (CNKI), Wanfang database, PubMed, Embase, and Cochrane Library. The search was carried out from the time the database was created to March 2023 and 2 researchers independently conducted literature searches to retrieve a total of 884 studies, of which 12 were included in this meta-analysis. Cochrane systematic review methods were used to assess the quality of the literature and a meta-analysis was performed using ReviewManager 5.4 software. The results of the present meta-analysis showed that in postoperative adjacent vertebral fractures [OR = 0.25; 95% CI (0.15, 0.41)], postoperative cement leakage [OR = 0.45; 95% CI (0.30, 0.68)], Oswestry Disability Index (ODI) scores in the first 3 days after surgery [OR = -0.22; 95% CI (-0.42, -0.03)], ODI score at 6-12 months postoperatively [OR = -0.65; 95% CI (-0.97, -0.32)], visual analog scale (VAS) score at 6-12 months postoperatively [OR = -0.21; 95% CI (-0.46, 0.04)], and 1-year postoperative CT values [OR = 5.56; 95% CI (3.06, 8.06)], the MC-PMMA bone cement group was superior to the PMMA bone cement group. However, the differences between the two groups were not statistically different in terms of cement filling time, cement filling volume, operation time, intraoperative bleeding, hospitalization time, postoperative (<1 week, 3-6 months) vertebral body posterior convexity Cobb's angle, postoperative (<1 week, 6-12 months) vertebral body anterior margin relative height, postoperative (≤3 days, 1-3 months) pain VAS score and postoperative (1-3 months) ODI score. Compared with PMMA bone cement, the application of MC-PMMA bone cement is advantageous in reducing postoperative complications (adjacent vertebral fracture rate, cement leakage rate), pain relief, and functional recovery in the long-term postoperative period (>6 months), but there is still a need for more high-quality randomized controlled studies to provide more adequate evidence.

Material Wealth or Wealth of Time and Culture? Lessons from Australian Aboriginal Economy for Catholic Social Teaching

This paper will explicate ways in which Aboriginal Australian economy can inform, augment, and vindicate Catholic social teaching and related scholarship on work, the use of technology, and leisure. Collaterally, Aboriginal Australian economy gives an example of what could happen if key parts of Catholic social teaching were to be implemented concretely. That is, we can argue that Aboriginal economy gives an indication of what a society would be like if it adopted these parts of Catholic social teaching.

Forecasting peak electric load: Robust support vector regression with smooth nonconvex ϵ‐insensitive loss

AbstractPeak power load forecasting is a key part of the commercial operation of the energy industry. Although various load forecasting methods and technologies have been put forward and tested in practice, the growing subject of tolerance for abnormal accidents is to develop robust peak load forecasting models. In this paper, we propose a robust smooth non‐convex support vector regression method, which improves the robustness of the model by adjusting adaptive control loss values and adaptive robust parameters and by reducing the negative impact of outliers or noise on the decision function. A concave‐convex programming algorithm is used to solve the non‐convexity of the optimization problem. Good results are obtained in both linear regression model and nonlinear regression model and two real data sets. An experiment is carried out in a power company in Jiangxi Province, China, to evaluate the performance of the robust smooth non‐convex support vector regression model. The results show that the proposed method is superior to support vector regression and generalized quadratic non‐convex support vector regression in robustness and generalization ability.

An Integrated Design Method for Used Product Remanufacturing Process Based on Multi-Objective Optimization Model

The design for the remanufacturing process (DFRP) is a key part of remanufacturing, which directly affects the cost, performance, and carbon emission of used product remanufacturing. However, used parts have various failure forms and defects, which make it hard to rapidly generate the remanufacturing process scheme for simultaneously satisfying remanufacturing requirements regarding cost, performance, and carbon emissions. This causes remanufactured products to lose their energy-saving and emission-reduction benefits. To this end, this paper proposes an integrated design method for the used product remanufacturing process based on the multi-objective optimization model. Firstly, an integrated DFRP framework is constructed, including design information acquisition, the virtual model construction of DFRP solutions, and the multi-objective optimization of the remanufacturing process scheme. Then, the design matrix, sensitivity analysis, and least squares are applied to construct the mapping models between performance, carbon emissions, cost, and remanufacturing process parameters. Meanwhile, a DFRP multi-objective optimization model with performance, carbon emission, and cost as the design objectives is established, and a teaching–learning based adaptive optimization algorithm is employed to solve the optimization model to acquire a DFRP solution satisfying the target information. Finally, the feasibility of the method is verified by the DFRP of the turbine blade as an example. The results show that the optimized remanufacturing process parameters reduce carbon emissions by 11.7% and remanufacturing cost by USD 0.052 compared with the original process parameters, and also improve the tensile strength of the turbine blades, which also indicates that the DFPR method can effectively achieve energy saving and emission reduction and ensure the performance of the remanufactured products. This can greatly reduce the carbon emission credits of the large-scale remanufacturing industry and promote the global industry’s sustainable development; meanwhile, this study is useful for remanufacturing companies and provides remanufacturing process design methodology support.

(040) Anterolateral Thigh Flap Phalloplasty: Outcomes Following Genital Gender Affirmation Surgery

Abstract Introduction Genital gender affirmation surgery (gGAS) is a key part of the management of patients with gender dysphoria. The anterolateral thigh (ALT) free flap was proposed as an alternative to the more common radial forearm free flap (RFFP) phalloplasty due to the twin advantages of a more easily hidden scar and improved flexibility in the length of the flap. A pedicled variant of the ALT flap offers greater security of vascular supply for suitable patients, and if suitable and desired the flap can be formed with an integrated urethra, facilitating voiding while standing. Objective The aim of the study is to report the contemporary surgical and functional outcomes of ALT phalloplasty. Methods All individuals undergoing ALT flap phalloplasty for genital gender affirmation surgery (GAS) between 2009 and 2023 nationwide were included. Individuals were managed in accordance with the World Professional Association for Transgender Health (WPATH) Standards of Care version 7. Data were extracted from a prospectively collected single surgeon database and medical records. Functional outcomes were assessed by non-validated questionnaire. Statistical analysis included Mann-Whitney, chi-squared, Fisher’s exact and unpaired T tests. Results Surgical outcomes: A total of 87 patients were included in the study. More than half (45, 51.7%) had an integrated urethra. The median length of stay following surgery was six days (IQR 6-7). Eleven patients (12.6%) had a 30-day Clavien-Dindo 3b complication or greater. Three patients (3.4%) experienced total flap loss. A further three patients (3.4%) had partial flap loss. Three patients (3.4%) required a salvage phalloplasty later. Thirteen patients (out of 42, 31.0%) without an integrated urethra went onto have a free flap urethroplasty. Functional outcomes: Thirty-nine individuals (44.8%) completed the patient reported outcomes questionnaire. Most patients (77%) were generally satisfied with their phalloplasty. More than half (56%) with an erectile device used their phallus for penetrative intercourse, while one in five reported experiencing orgasm using their phallus alone. Following urethral lengthening, all respondents were able to void standing. There was no significant difference in mean satisfaction scores for those with an integrated urethra compared to those without (4.18/5 vs 3.82/5, p=.45), as well as between those with or without an erectile device, respectively (3.78/5 vs 4.10/5, p=.26). Conclusions This study is one of the largest single centre cohorts of ALT flap phalloplasty reported to date. It further supports the use of the ALT flap as one of the main genital GAS options for transmen. Over half of the patients studied had an integrated urethra, the gold standard for urethral lengthening. Patient reported functional outcomes were promising, with similar scores regardless of urethral lengthening or erectile device insertion. Disclosure No.

Post-traumatic stress disorder, dyssomnias, and metabolic syndrome

Post-traumatic stress disorder (PTSD) and metabolic syndrome (MetS) frequently coexist and share neurobiological and clinical features. In particular, the results of meta-analyses indicate a higher prevalence of MetS in patients with PTSD compared to the general population. PTSD is also a recognized risk factor for MetS. This synchronicity can be partially explained by pathogenetic pathways present in both conditions. These include genetic factors, dysfunction of the hypothalamic-pituitary-adrenal axis, chronic low-grade inflammation, oxidative stress, insulin resistance, and immune dysregulation. Thus, similar mechanisms are involved in the clinical worsening of PTSD and the development of adverse cardiovascular events associated with MetS. Dyssomnias are one of the characteristic clinical features of PTSD. Today, it is believed that posttraumatic circadian rhythm disorders are the core and not a secondary feature of PTSD, which mediate the neurobiological correlates of disorders due to homeostasis imbalance. At the same time, dyssomnias, chronodestruction, and depressive disorders are part of the pathogenesis of insulin resistance, obesity, and MetS. Thus, treatment of dyssomnias is one of the key tasks in the prevention and treatment of comorbid PTSD and MetS. Regulation of sleep processes and circadian rhythms through exogenous intervention, especially with melatonergic drugs, is likely to be a key part of preventing and treating dyssomnias in people who have both PTSD and MetS. The purpose of this review is to analyze the specifics of the relationships between PTSD and MetS, PTSD and dyssomnias, MetS and sleep disorders. We conducted the search in Scopus, Science Direct (from Elsevier), and PubMed, including Medline databases. The key words used were “post-traumatic stress disorder,” “dyssomnias,” “chronodestruction,” and “metabolic syndrome”. The identification of research findings that were not found during online searches involved manual searching of the bibliography of publications.

Current insights into feline osteoarthritis

Osteoarthritis is a painful condition which affects the majority of older cats but is often not recognised because of differences in the ways that affected cats exhibit the signs of chronic joint pain compared to dogs. There are also inherent challenges to the physical examination of cats which add to the difficulty of reaching a diagnosis, including the small size of their appendicular joints and a reluctance to allow manipulation and palpation of painful joints. Furthermore, even when osteoarthritis is identified, it is frequently not treated or is not treated effectively, in part as a result of concerns regarding adverse effects and costs of treatment as well as the practical difficulties of daily dosing with medication. Understanding the gait and behaviour changes that are characteristic of osteoarthritis is a key part of the diagnostic process and is more sensitive than radiography in identifying the presence of the disease. Once the condition has been diagnosed, a wide range of well-tolerated treatment options exist, allowing a multi-modal treatment approach to be adopted and tailored to the needs of the cat and the owner, which will deliver effective pain management in an affordable way and will not become a daily stressor to either party.

How to Create a Diversity, Equity, and Inclusion Curriculum: More Than Checking a Box.

We are beginning to accept and address the role that medicine as an institution played in legitimizing scientific racism and creating structural barriers to health equity. There is a call for greater emphasis in medical education on explaining our role in perpetuating health inequities and educating learners on how bias and racism lead to poor health outcomes for historically marginalized communities. Diversity, equity, and inclusion (DEI; also referred to as EDI) and antiracism are key parts of patient care and medical education as they empower health professionals to be advocates for their patients, leading to better health care outcomes and more culturally and socially humble health care professionals. The Liaison Committee on Medical Education has set forth standards to include structural competency and other equity principles in the medical curriculum, but medical schools are still struggling with how to specifically do so. Here, we highlight a stepwise approach to systematically developing and implementing medical educational curriculum content with a DEI and antiracism lens. This article serves as a blueprint to prepare institution leadership, medical faculty, staff, and learners in how to effectively begin or scale up their current DEI and antiracism curricular efforts.

Photopolymerized 3D Printing Materials for Optical Elements

AbstractThe optical element is a key part of manufacturing optoelectronic systems, which can realize functions such as imaging, spectroscopy, image transmission, filtering, and more. The design and manufacture of optical elements is a key issue that restricts its development, and the traditional optical component preparation method is less capable of preparing optical elements with complex structures and multiple materials. As a mature advanced manufacturing technology, photopolymerization 3D printing technology has the advantages of high printing precision and small layer thickness, which plays an important role in the preparation of optical elements. This review paper briefly provides a concise overview of the benefits and applications of photopolymerization 3D printing technology in optical element preparation The development overview and research progress of materials used for the preparation of optical elements by photopolymerization 3D printing are discussed. Finally, it summarizes the current limitations, challenges, future development prospects, and potential applications in the realm of optical element manufacturing.