Large Cup Research Articles

A Comprehensive Approach to Pattern Drafting for Women with Large Bust Cup Sizes through Advanced 3D Virtual Clothing Systems

A Comprehensive Approach to Pattern Drafting for Women with Large Bust Cup Sizes through Advanced 3D Virtual Clothing Systems

Making cups and rings: the 'stalled-wave' model for macropinocytosis.

Macropinocytosis is a broadly conserved endocytic process discovered nearly 100 years ago, yet still poorly understood. It is prominent in cancer cell feeding, immune surveillance, uptake of RNA vaccines and as an invasion route for pathogens. Macropinocytic cells extend large cups or flaps from their plasma membrane to engulf droplets of medium and trap them in micron-sized vesicles. Here they are digested and the products absorbed. A major problem - discussed here - is to understand how cups are shaped and closed. Recently, lattice light-sheet microscopy has given a detailed description of this process in Dictyostelium amoebae, leading to the 'stalled-wave' model for cup formation and closure. This is based on membrane domains of PIP3 and active Ras and Rac that occupy the inner face of macropinocytic cups and are readily visible with suitable reporters. These domains attract activators of dendritic actin polymerization to their periphery, creating a ring of protrusive F-actin around themselves, thus shaping the walls of the cup. As domains grow, they drive a wave of actin polymerization across the plasma membrane that expands the cup. When domains stall, continued actin polymerization under the membrane, combined with increasing membrane tension in the cup, drives closure at lip or base. Modelling supports the feasibility of this scheme. No specialist coat proteins or contractile activities are required to shape and close cups: rings of actin polymerization formed around PIP3 domains that expand and stall seem sufficient. This scheme may be widely applicable and begs many biochemical questions.

Development and characterization of a rotary ultrasonic grinding tool with large cup wheel for SiCp/Al composites

Development and characterization of a rotary ultrasonic grinding tool with large cup wheel for SiCp/Al composites

Automated Optic Nerve Head Hemoglobin Measurements versus General Ophthalmologists Evaluation to Differentiate Glaucomatous from Large Physiological Cupping: A Diagnostic Performance Comparative Study.

The aim of this study is to compare the diagnostic performance in differentiating patients with glaucoma from those with presumed large physiological optic disc cupping (LPC), using optic nerve head hemoglobin levels (ONH Hb), as a screening method, versus the evaluation of general ophthalmologists. Twenty general ophthalmologists evaluated PowerPoint images of 40 patients with glaucoma and 40 presenting LPC. Presentation of patient's exams were distributed as follows: Group 1 (GI): color retinography (CR), Group 2 (GII): CR + visual field (VF), Group 3 (GIII): CR + optical coherence tomography (OCT), Group 4 (GIV): CR + VF + OCT. The Laguna ONhE software was used to estimate ONH Hb based on CR. Main outcomes were the comparison of sensitivity and accuracy between general ophthalmologists' evaluation and the glaucoma discriminant function (GDF) index from Laguna ONhE and also the agreement between examiners (Kappa statistics). Laguna ONhE GDF index demonstrated higher sensitivity values (GI- 90%; GII-90%; GIII-100%; GIV-100%) comparing to all groups (GI-59%; GII-86.5%; GIII-86.5%; GIV-68.5%). In GI, in which it was observed the worst accuracy result (64.8%), we found 75% for GDF. In GII, the accuracy was 81.3% and we found 55% for GDF. The highest agreement was in GII (Kappa=0.63; 95% CI=0.53-0.72), and the lowest in GI (Kappa=0.30; 95% CI=0.20-0.39). Laguna ONhE software, a low-cost and non-invasive method, showed good sensitivity and great utility as a screening method in differentiating patients with glaucoma from those with LPC, compared with evaluation of general ophthalmologists.

Adding quilting sutures to Y plasty to avoid postmastectomy lateral dog ears in patients with large cup sized breast

Background Total mastectomy without reconstruction is a commonly adopted procedure for managing breast cancer. Formation of lateral dog ears is very common, especially with large breast cup size. In this study, we assessed the feasibility of adding quilting sutures to the Y plasty technique to achieve more acceptable results in the avoidance of lateral dog ears in comparison to using Y plasty alone. Methods The study included 150 female patients with large breast cup size. Patients were randomized 2 : 1 between group A and group B. In group A, 3–5 quilting sutures were added to the lateral flaps of Y plasty. In group B, Y plasty only was adopted without the quilting sutures. Patients were followed up at 4-month intervals for at least 1 year. One year after surgery, patients filled in a questionnaire inquiring about the degree of discomfort in the area beneath the arm. Also, a plastic surgeon was asked to give a score about the cosmetic outcome of managing lateral dog ears both at 3 weeks and 12 months after surgery. Results Both groups were comparable in regard to age, BMI, breast cup size, and postoperative radiotherapy exposure. Patients in group A had better scores for satisfaction with the shape of the scar and comfort with the bra. Also, the blinded cosmetic outcome assessment was in favor of group A. Conclusion Adding quilting sutures to the lateral flap of the V-Y plasty technique is associated with a better cosmetic outcome in the management of lateral dog ears in mastectomy patients with large breast cup size.

Artificial intelligence in glaucoma detection using color fundus photographs.

To explore the potential of artificial intelligence (AI) for glaucoma detection using deep learning algorithm and evaluate its accuracy for image classification of glaucomatous optic neuropathy (GON) from color fundus photographs. A total of 1375 color fundus photographs, 735 normal optic nerve head and 640 GON, were uploaded on the AI software for training, validation, and testing using deep learning model, which is based on Residual Network (Res Net) 50V2. For initial training and validation, 400 fundus images (200 normal and 200 GON) were uploaded and for the final training and testing 975 (535 normal and 440 GON) were uploaded later. Accuracy, sensitivity, and specificity were used to evaluate the image classification performance of the algorithm. Also, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were calculated. The model used in the study showed an image classification accuracy of 81.3%, sensitivity of 83%, and specificity of 80% for the detection of GON. The false-negative grading was 17% and false-positive grading was 20% for the image classification of GON. Coexistence of glaucoma in patients with high myopia, early glaucoma in a small disc, and software misclassification of GON were the reasons for false-negative results. Physiological large cupping in a large disc, myopic or titled disc, and software misclassification of normal optic disc were the reasons for false-positive results. The model employed in this study achieved a good accuracy, and hence has a good potential in detection of GON using color fundus photographs.

The Feasibility of Tube Current Modulation (TCM) to Reduce dose of the Surface Breast in Various Breast Sizes

This study aims to develop three sizes of breast phantoms from silicone rubber (SR) material and evaluate tube current modulation (TCM) to reduce surface doses of the developed breast phantoms. The in-house breast phantom has three sizes: small (cup 34), medium (cup 36), and large (cup 38). The cross-sectional areas of cup 34, 36, and 38 are 78.5, 113.04, and 153.87 cm2, respectively. The in-house phantom was attached to the adult anthropomorphic phantom for dose measurement. Dose measurement was performed using an Optically Stimulated Luminescence (OSL) dosimeter. Scans were performed with and without TCM technique. It was found that the TCM effectively reduce the radiation dose to the breast surface up to approximately 60%. However, the dose reduction was accompanied by a 66% increase in noise when using the TCM technique.

Surgery for gigantomastia at the AKANDA Army Training Hospital: Analysis of 4 cases and literature review

Objective: This study aims to evaluate the outcomes of surgical interventions for gigantomastia in at the obstetrics and gynaecology department of the Hôpital d'Instruction des Armées d'Akanda (HIAA). Patients and Methods: This was a prospective, descriptive study conducted from 1 June 2019 to 31 October 2022, Inclusion criteria comprised women who seeked consultation at HIAA due to unilateral or bilateral gigantomastia, have a benign primary or tumoral gigantomastia. Participants were required to consent to a minimum follow-up period of 6 months post-operation by the HIAA medical team and be available for telephone follow-ups beyond the initial 6 months. Results: The prevalence of gigantomastia was 1.05% (10/952). The mean age of the patients was 27 years. The mean BMI was 27.7 kg/m2. All patients wore a very large (≥D) cup size. The mean breast axis was 36.25 cm for straight breasts. The most frequently performed method was the inverted T with superior-internal flap (57%). The average weight of the operative parts was 1350 g for right breasts. Only one patient had delayed skin wound closure. Only one patient had a suture disunion. Regarding the plastic result, two patients were classified <<average result>> and the other two (50%) <<good result>>. Two patients report << very satisfied>>and the other two were satisfied. Conclusion: This study presented the preliminary results of an ongoing study at the HIAA. The inverted T technique with syuperomedial flap was the most commonly used, with few early complications. The plastic results after the 6th month are appreciable.

Upright patient positioning for gantry-free breast radiotherapy: feasibility tests using a robotic chair and specialised bras.

For external beam radiotherapy using photons or particles, upright patient positioning on a rotating, robotic chair (a gantry-less system) could offer substantial cost savings. In this study, we considered the feasibility of upright breast radiotherapy using a robotic radiotherapy chair, for (i) a cohort of 9 patients who received conventional supine radiotherapy using photons for a diagnosis of primary breast cancer, plus (ii) 7 healthy volunteers, selected to have relatively large bra cup sizes. We studied: overall body positioning, arm positioning, beam access, breast reproducibility, and comfort. Amongst the healthy volunteer cohort, the impact of specialised radiotherapy bras upon inframammary skinfolds (ISF) was also determined, for upright treatment positions. In conclusion, upright body positioning for breast radiotherapy appears to be comfortable and feasible. Of the 9 patients who received conventional, supine radiotherapy (mean age 63.5 years, maximum age 90 years), 7 reported that they preferred upright positioning. Radiotherapy bras were effective in reducing/eliminating ISF for upright body positions, including for very large breasted volunteers. For upright proton radiotherapy to the breast, beam access should be straightforward, even for arms-down treatments, as en-face field directions are typically used. For photon radiotherapy, additional research is now required to investigate beam paths and whether, for certain patients, additional immobilisation will be required to keep the contralateral breast free from exposure. Future research should also investigate arm supports custom-designed for upright radiotherapy.

Letter to the Editor: Longitudinal Assessment of Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses in Patients With Large Optic Disc Cups and Normal Intraocular Pressure and Visual Fields.

Letter to the Editor: Longitudinal Assessment of Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses in Patients With Large Optic Disc Cups and Normal Intraocular Pressure and Visual Fields.

Response to Letter to the Editor: Longitudinal Assessment of Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses in Patients With Large Optic Disc Cups and Normal Intraocular Pressure and Visual Fields.

Response to Letter to the Editor: Longitudinal Assessment of Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses in Patients With Large Optic Disc Cups and Normal Intraocular Pressure and Visual Fields.

Natural History of Optic Disc With Physiologic Large Cup: Incidence, Predictors of Glaucoma Conversion After Minimum 10-Year Follow-up

To investigate the natural history of optic disc with physiologic large cup (PLC) (ie, vertical cup/disc ratio [VCDR] ≥0.6 without retinal nerve fiber layer defect) and the risk factors for glaucoma conversion. Observational retrospective cohort study. Subjects who underwent a health screening examination at Seoul National University Hospital Healthcare System Gangnam Center from 2003 to 2010 (n=76,030) were involved. The prevalence of PLC in the cohort was analyzed. The incidence rate of glaucoma conversion was estimated per 100 person-years among cases with a follow-up period longer than 10 years. Multivariate Cox proportional hazards regression was used to identify ocular and systemic factors associated with glaucoma conversion. Among 74,617 eligible subjects, 3569 subjects (4.8%) had PLC. Of those with a follow-up period longer than 10 years (n=859), the incidence rate of glaucoma conversion was 0.95 per 100 person-years. A total of 12.1% of PLC eyes progressed to glaucoma after 8.7 ± 3.9 years (range, 2.0-16.5 years). Higher VCDR (adjusted hazard ratio [aHR]=4.36; 95% CI=2.675-7.103), violation of the inferior superior nasal temporal neuroretinal rim thickness rule (aHR=1.86; 95% CI=1.057-3.258), presence of retinal arterial sclerosis (aHR=1.63; 95% CI=1.040-2.550), and lower total bilirubin level (aHR=0.58; 95% CI=0.340-0.991) were associated with glaucoma development. This study identified the prevalence of PLC as well as the incidence rate of glaucoma conversion and the risk factors for glaucoma development in PLC eyes. The natural history of PLC may help clinicians to better understand its risk factors and the specific management needs of their patients.

Longitudinal Assessment of Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses in Patients With Large Optic Disc Cups and Normal Intraocular Pressure and Visual Fields.

The thicknesses of the circumpapillary retinal nerve fiber layer (cpRNFL) and ganglion cell complex (GCC) did not change during 5 years in physiological large disc cupping. We evaluated longitudinal changes in the thicknesses of the cpRNFL and GCC in large disc cupping with a normal intraocular pressure (IOP) (<21mmHg) and visual field. This retrospective, consecutive case series study included 269 eyes of 269 patients with large disc cupping and normal IOP. We analyzed patient demographics, IOP, central corneal thickness, vertical cup-to-disc ratios using color fundus photography, the thicknesses of the cpRNFL and GCC using RTVue-100, and mean deviation using visual field examinations. The differences in IOP, vertical cup-to-disc ratios, and mean deviation between the baseline and each follow-up visit were not statistically significant. The baseline average and mean average at 60 months follow-up of the cpRNFL thickness were 106.5±8.5 and 105.1±9.3μm, respectively; differences between the baseline and each follow-up visit were not statistically significant. The baseline average and mean average at 60 months follow-up of the GCC thickness were 82.8±9. and 81.5±9.2μm, respectively; differences between baseline and each follow-up visit were not statistically significant. The thicknesses of the cpRNFL and GCC did not change in well-maintained optic nerve head findings with normal IOP and visual field during a 5-year follow-up period. Optical coherence tomography evaluations of the thicknesses of the cpRNFL and GCC help accurately diagnose physiological optic disc cupping.

Investigation of flame and flow response in the swirler with different divergence cups and central body under external excitation

Effects of swirl divergence cup and the central bluff body on premixed flame response with external excitation are experimentally investigated. Flame transfer functions (FTFs) associated with different swirlers are measured in 50–450 Hz. The corresponding flame and flow responses are examined with the help of chemiluminescence images and Particle Image Velocimetry (PIV) method. Results show that FTF gain curves of swirlers with different divergence cups are characterized by alternating regions with first a minimum and then a maximum value as the excitation frequency increases. Increasing the divergence cup may greatly reduce the corresponding FTF minimum gain. Dynamic mode decomposition and proper orthogonal decomposition analysis indicate that flames with large divergence cup angles are dominated by the flame angle oscillations at the minimum gain point, while the flame with zero cup presents both the flame angle oscillations and vortex shedding. PIV results indicate that vortical structures located at the outer shear layer (OSL) could induce high-flame response, while the impacts of vortical structures located at inner shear layer are much weaker. Increasing the divergence cup could largely weaken the strength of vortical structures at OSL. In addition, effects of the central bluff body on flame response are significant. The flame in the swirler without the central bluff body is mainly governed by flame angle oscillations, and the elongated flame induced by the swirler with a large body is almost not sensitive to acoustic excitations. These results are useful for the understanding of flame response mechanisms in premixed swirling combustion.

Posterior segment indications of handheld spectral domain optical coherence tomography in pediatric age group in a tertiary eye center in Egypt

Objective The aim of this study was to detect the posterior segment indications for the use of handheld optical coherence tomography in the pediatric age group. Patients and methods This was a retrospective observational study that included patients who were candidates for handheld spectral domain optical coherence tomography (HH-OCT) imaging for retinal or optic nerve (ON) diseases in Abo Elreesh hospital during the period from June 2018 to June 2022. The image, demographic, and clinical database of the included patients were reviewed. Data were tabulated using Microsoft Excel. Appropriate statistical methods were used to analyze and correlate the obtained data. Results A total of 189 patients were included in this study, comprising 109 (57.7%) male patients. The mean age was 7.2±3.9 (range: 0.2–16 years) years. Overall, 46 (24.3%) patients were less than 5 years of age (i.e. infants and preschool age). Patients who underwent HH-OCT scanning due to retinal causes (i.e. nystagmus, unexplained poor vision, uveitis, Coat's disease, trauma, and high myopia) were 130 (68.8%) patients, whereas 59 (31.2%) patients were indicated due to ON disease (i.e. primary congenital glaucoma and juvenile open angle glaucoma, optic disc hyperemia, swelling or pallor, and cases of large physiological cupping). Conclusion HH-OCT is a noninvasive feasible image modality for evaluation of retina and ON in infants and young children. The lack of a normative database for retinal nerve fiber layer thickness and ON head parameters in the pediatric age group in the device available in our service is considered a limitation in its use for proper evaluation of different pathologies involving the ON.

Development of the Dual-Beam Ion Irradiation Facility for Fusion Materials (DiFU).

The Dual-beam ion irradiation facility for Fusion materials (DiFU) has been developed and installed at the Ruđer Bošković Institute with the purpose to perform irradiation of samples of fusion materials by one or two ion beams. Ion beams are delivered to the DiFU chamber by a 6 MV EN Tandem Van de Graaff and a 1 MV HVE Tandetron accelerator, enabling irradiation of areas up to 30 × 30 mm2. The sample holder enables the three-dimensional positioning of samples that can be irradiated while being heated, cooled, or kept at room temperature. Ion fluxes are measured indirectly by the insertion of two large Faraday cups. Besides, the ion flux is monitored continuously by two sets of horizontal and vertical slits, which, in turn, define the limits of the irradiation area on the sample. Sample temperature and conditions during irradiation are additionally monitored by a set of thermocouples, an IR camera, and a video camera. Particular care is dedicated to the mitigation of carbon contamination during ion irradiation.

Modernizing Our Understanding of Total Hip Arthroplasty in the Pediatric and Young Adult Patient: A Single-center Experience.

Pediatric hip disorders represent a broad range of pathology and remain a significant source of morbidity for children and young adults. Surgical intervention is often required for joint preservation, but when salvage is not possible, joint replacement may be indicated to eliminate pain and preserve function. Although there have been significant updates in the management of both pediatric hip disease and the field of total hip arthroplasty (THA), there is a paucity of literature reflecting advancements in the area of pediatric and young adult (PYA) arthroplasty. No study has investigated the impact of approach on outcomes after PYA THA. The purpose of this study is to describe the indications, techniques, and early outcomes of THA in the PYA population in a modern practice setting. We performed a retrospective descriptive analysis of all patients undergoing primary THA performed at a tertiary care children's hospital from 2004 to 2019. Ninety-three hips in 76 patients were evaluated. Demographics, intraoperative variables, postoperative pain and function ratings, and complication and revision rates were collected. Eighty-five hips in 69 patients were included. Patients were aged 12 to 23 years old, with males and females represented equally (33 vs. 36, respectively). The most common cause of hip pain was avascular necrosis (AVN, 56/85, 66%), most commonly due to slipped capital femoral epiphysis (13/56, 23%) idiopathic AVN (12/56, 21%), and chemotherapy (12/56, 21%). Half of all hips had been previously operated before THA (43/85). Thirty-six procedures were performed via the posterolateral approach (36/85, 42%), 33 were performed via direct anterior approach (33/85, 39%), and 16 were performed via the lateral approach (LAT, 16/85, 19%). At final follow-up, 98% (83/85) of patients had complete resolution of pain, 82% (70/85) had no notable limp, and 95% (81/85) had returned to all activities. There were 6 complications and 1 early revision. Average Hip disability and Osteoarthritis Outcomes Score for Joint Replacement scores increased by 37 points from 56 to 93. The overall revision-free survival rate for PYA THA was 98.8% (at average 19-mo follow-up). Modern PYA THA is dissimilar in indications and surgical techniques to historic cohorts, and conclusions from prior studies should not be generalized to modern practice. In our practice, PYA patients most commonly carry a diagnosis of AVN, and THA can be performed with modern cementless fixation with large cup and head sizes and ceramic-on-cross-linked polyethylene bearings utilizing any approach. Further study is required to better characterize middle-term and long-term results and patient-reported outcomes. Therapeutic Level IV-retrospective case series.

An Association Between Large Optic Cupping and Total and Regional Brain Volume: The Women's Health Initiative

To investigate the relationships between optic nerve cupping and total and regional brain volumes. Secondary analysis of randomized clinical trial data. Women 65 to 79 years of age without glaucoma with cup-to-disc ratio (CDR) measurements from the Women's Health Initiative (WHI) Sight Examination study and magnetic resonance imaging (MRI)-based total and regional brain volumes from the WHI Memory Study MRI-1 were included. Large CDR was defined as 0.6 or greater in either eye. Generalized estimating equation models were used to account for intra-brain correlations between the right and left sides. The final analysis was adjusted for demographic and clinical characteristics and for total brain volume (for regional analyses). Final analyses included 471 women, with the mean age ± SD was 69.2 ± 3.6 years; 92.8% of the subjects were white. Of 471 women, 34 (7.2%) had large CDR. Controlling for total brain volume and for demographic and clinical characteristics, lateral ventricle volume was 3.01 cc larger for subjects with large CDR compared to those without large CDR (95% CI=0.02 to 5.99; P=.048). Furthermore, frontal lobe volume was 4.78 cc lower for subjects with large CDR compared to those without (95% CI=-8.71, -0.84; P=0.02), and occipital lobe volume was 1.86 cc lower for those with large CDR compared to those without (95% CI=-3.39, -0.3; P =.02). Our analysis suggests that in women aged 65 years or more, large CDR is associated with lower relative total brain volume and absolute regional volume in the frontal and occipital lobes. Enlarged CDR in individuals without glaucoma may represent a sign of optic nerve and brain aging, although more longitudinal data are needed.

Screening fundus photography predicts and reveals risk factors for glaucoma conversion in eyes with large optic disc cupping

This study aimed to investigate the risk factors for glaucoma conversion and progression in eyes with large optic disc cupping without retinal nerve fiber layer defect (RNFLD). Five hundred forty-two eyes of 271 subjects who had a vertical cup-to-disc ratio (CDR) ≥ 0.6 without RNFLD were enrolled. Characteristics for optic disc configuration (including CDR, vertical cupping, ISNT rule, disc ovality, peripapillary atrophy [PPA]-to-disc area [DA] ratio, and lamina cribrosa pore visibility) and blood vessels (including central retinal vessel trunk [CRVT] nasalization, bayoneting of vessels, baring of circumlinear vessels, history of disc hemorrhage [DH] and vessel narrowing/sclerotic change) were evaluated. From a median follow-up of 11.3 years, 26.6% of eyes (n = 144) developed RNFLD within a median of 5.1 years. Baseline factors, including vertical CDR ≥ 0.7 (hazard ratio [HR] = 2.12), vertical cupping (HR = 1.93), ISNT rule violation (HR = 2.84), disc ovality ≥ 1.2 (HR = 1.61), PPA-to-DA ratio ≥ 0.4 (HR = 1.77), CRVT nasalization ≥ 60% (HR = 1.77), vessel narrowing/sclerotic change (HR = 2.13), DH history (HR = 5.60), and baseline intraocular pressure ≥ 14 mmHg (HR = 1.70) were significantly associated with glaucoma conversion (all Ps < 0.05). An HR-matched scoring system based on initial fundus photography predicted glaucoma conversion with specificity of 90.4%. Careful examination of the optic nerve head and vascular structures can help to predict the risk of glaucoma conversion in eyes with large optic disc cupping.

Little Amal’s New York Journey: The Big Puppet in the Big Apple

Little Amal’s New York Journey: The Big Puppet in the Big Apple