Marked Improvement Research Articles

Improvement of wire marks on the surface of Si3N4 ceramics cut by diamond wire saw

The presence of wavy wire marks on the cut surface of silicon nitride (Si3N4) ceramics reduces the mechanical properties of the slices and increases the workload of subsequent grinding and polishing processes. To improve the wire marks, a workpiece reciprocating movement-assisted diamond wire sawing (RMA-DWS) technology is proposed in this paper. While diamond wire sawing the Si3N4 ceramics, the workpiece is moved back and forth in the direction of the saw wire movement to assist in sawing. Single factor and orthogonal experiments were carried out to analyze the characteristics of the surface created by this sawing technology. The effects of workpiece reciprocating movement distance, workpiece reciprocating movement speed, saw wire speed and feed speed on the sawn surface morphology, surface roughness Ra and wire marks PV value, as well as the primary and secondary relationships of the effects, were investigated. And the optimal parameter combinations were explored. The results show that within the range of process parameters studied in this paper, the surface morphology of Si3N4 ceramics slices shows a comprehensive effect of material ductility and brittleness removal, the RMA-DWS technology can improve wire marks on the slice surface. Surface wire marks PV value can be reduced by increasing the workpiece reciprocating movement distance and saw wire speed, reducing the feed speed, while increasing the reciprocating movement speed of the workpiece, the PV value shows a trend of first decreasing and then increasing. The variation amplitude of surface roughness Ra value is not significant, and the variation trend is roughly similar to the change trend of PV value. It was determined that the experiment with the process parameters combination of 0.1 m/min feed speed, 90 mm workpiece reciprocating distance, 15 mm/s workpiece reciprocating speed and 1400 m/min saw wire speed yielded the optimal result, significantly improving the wire marks of the sliced surface. The results of this paper provide ideas for the development of sawing wire marks improvement technology.

Teaching Scientific Literature Analysis: A Systematic Adoption of Skill-Building Methods to Enrich Research Training for Undergraduate Students.

Teaching scientific literature analysis skills is a critical step in research training. Here I describe a 6-week skill-building module on understanding scientific literature, incorporated into a 10-week undergraduate honors research practice course in Neuroscience. Key pedagogical components include: 1) student-centered active-learning, skill-building and community-building activities; 2) persistent adoption of a proven CREATE method and a novel curate scientific summary (CSS) method for teaching scientific literature analysis skills; 3) collaborative class organization consisting of persistent learning pods (PLPs) to facilitate student-driven participation and peer learning; and, 4) role play of a real research lab. Skill development was assessed using a self-assessment survey (SAS) and longitudinal evaluation of the CREATE and CSS methods application by the PLPs to analyze primary research articles (PRAs) over four weeks. Outcomes demonstrate alleviation of pre-existing student anxiety to read complex scientific literature and advancement of critical-thinking and collaborative skills. Specifically, the SAS responses indicate that student perception about reading scientific literature transformed from being a daunting task to an enjoyable activity; this enhanced their confidence in evaluating scientific literature. PLPs fostered student engagement, peer instruction, and community building, and contributed to skill development. Weekly assessment of CREATE and CSS application highlighted marked improvements in students' abilities to analyze and critique complicated scientific material. Role playing a research lab setting with a focused research theme facilitated integrative understanding of a frontier topic in Neuroscience. The outlined innovative approach can be adopted in Course-based Undergraduate Research Experience (CURE) and should help contribute to systematizing didactic practices to train neuroscientists.

Assessment of Wound Healing Potential of Simvastatin Emulgel in Rat Excision Wound Model

Background: Microorganisms can infect wounds and disrupt healing by causing inflammation and tissue injury Objective: Simvastatin (SIM) is reported to have antibacterial activity; therefore, this research is designed to evaluate the efficacy of simvastatin emulgel in wound healing. Methods: The simvastatin emulgel was assessed for physical appearance, rheological behaviour, spreadability, pH, ex vivo drug release and in vivo activity. The wound-healing activity was assessed by percent wound contraction, hydroxyproline estimation and histopathological evidence in wound-induced albino rats. Results: The simvastatin emulgel exhibited viscosity and spreadability of 6875 ± 531.21 mPa.s and 10.15 ± 0.31 g.cm/sec, respectively. The simvastatin emulgel exhibited wound contraction in wound healing studies compared to the reference product (p < 0.05). This activity was statistically significant (p < 0.05) in comparison to the control. The hydroxyproline content supported the wound-healing promoting effect of simvastatin emulgel, and marked improvements in the skin histological architecture were seen in the histopathological study. Conclusion: The study manifested the promising potential of simvastatin emulgel in speeding the healing of rat wounds with epithelization. Therefore, the designed simvastatin emulgel can be used as an option for the conventional topical dosage form.

A hierarchical atlas of the human cerebellum for functional precision mapping.

The human cerebellum is activated by a wide variety of cognitive and motor tasks. Previous functional atlases have relied on single task-based or resting-state fMRI datasets. Here, we present a functional atlas that integrates information from 7 large-scale datasets, outperforming existing group atlasses. The new atlas has three further advantages: First, the atlas allows for precision mapping in individuals: The integration of the probabilistic group atlas with an individual localizer scan results in a marked improvement in prediction of individual boundaries. Second, we provide both asymmetric and symmetric versions of the atlas. The symmetric version, which is obtained by constraining the boundaries to be the same across hemispheres, is especially useful in studying functional lateralization. Finally, the regions are hierarchically organized across 3 levels, allowing analyses at the appropriate level of granularity. Overall, the new atlas is an important resource for the study of the interdigitated functional organization of the human cerebellum in health and disease.

Case Report: Opposite Tumoral and Hormonal Responses to Low-dose Pasireotide in Cushing’s Disease

Background:: Pasireotide is a multireceptor somatostatin analogue approved for the treatment of patients with Cushing's disease (CD) who are ineligible or poor candidates for pituitary surgery. Here we present a patient with severe recurrent CD who was treated with pasiretide and showed opposite results between hormonal levels and pituitary tumour size. Case Presentation:: A 54-year-old woman was diagnosed with CD, a first surgical transsphenoidal procedure was performed at the time of diagnosis, and the disease recurred seven years later. She underwent a second transsphenoidal surgery, but despite apparent complete removal of the adenoma, the hypercortisolism worsened. Magnetic resonance imaging showed a tiny remnant of the adenoma adjacent to the cavernous sinus, and ketoconazole was started at a dose of 800 mg/day. Due to the persistence of pathological urinary free cortisol levels, 600 μg bid pasireotide was added. The combination therapy induced first normalisation of urinary free cortisol and later hypoadrenalism, so that ketoconazole was discontinued and pasireotide was maintained. A marked clinical improvement was achieved with pasireotide. Adrenal insufficiency persisted despite progressive tapering of the pasireotide dose to 150 mg once daily. Pituitary magnetic resonance imaging performed at 12 and 24 months during low-dose pasireotide treatment showed a few millimetres increase of the remnant. Conclusions:: This report suggests that CD Pas induces an opposite effect between hormonal profile and increase of pituitary tumor size. This peculiar phenomenon may be a consequence of the unusually low doses of pasireotide needed to control hormonal hypersecretion.

Impact of self-assessment on dental student’s performance in pre-clinical conservative dentistry course

BackgroundSelf-assessment (SA) is an interactive course that endorses the accomplishment of learning objectives through learners’ identification of insufficiencies in their didactic knowledge and pre-clinical skills. This study was planned to determine whether there is any improvement in the faculty assessment (FA) score following the implementation of SA in the Pre-clinical Conservative Dentistry Course.MethodsFifty-four first-semester dental students were given an introductory lecture followed by a demonstration for Class I Cavity Preparation in typhodont mandibular first molar. At the end of the demonstration, the Scoring Rubric (SR) was explained point-wise in the prepared cavities. During the next session, all students performed Class I cavity preparation and they were given an assessment sheet to enter their scores (SA1). All teeth were evaluated by the Grading Faculties in a blinded manner (FA1). Each participant was explained the difference in their respective SA1 from FA1 and their queries were resolved individually. During the next sessions, Students and Grading Faculties followed the same protocol and scores were recorded as SA2, FA2, SA3 and FA3.ResultsThe mean score of SA1 was significantly higher than that of FA1 (p < 0.001). However, no significant difference was obtained between SA and FA in the second (p = 0.352) and third (p = 0.434) assessments. In contrast with first assessment, mean marks obtained in FA were higher compared to SA in both second and third assessments. There was a statistically significant improvement in mean marks obtained by the students over time (p < 0.001).ConclusionSA endorsed student-faculty communication and enhanced student’s poise and technical skills in operative pre-clinical dentistry.

Optimizing Ship Airwake Database for Predicting Autospectra Using Deep Learning

Airwakes are shed behind a ship’s superstructure, and they represent a highly turbulent and rapidly distorting flow field. Because of this complexity, they require a baseline: A database of flow velocity points, preferably through experiments and also through high-fidelity computational fluid dynamics simulations. However the database is prohibitively costly, and in situ measurements, at a constant wind angle, are often affected by the weather. A previously developed perturbation scheme helps to generate the autospectrum in closed form from a given wind database, specifically, from the numerically extracted autospectrum for this database. The primary objective of this paper is to demonstrate how deep neural networks can be fruitfully exploited to reduce the dependence on a database of flow velocity points in generating the autospectra, by reducing the amount of in situ data required to achieve the same accuracy as established methods. Two machine learning approaches are developed to predict the autospectrum for a data set when provided with a subset of the wind data set at the input and are assessed using cross-validation. In the first, a neural network is applied to predict the perturbation scheme. Though this method did not predict the autospectrum better than the previously developed perturbation scheme, it laid the foundation for the second method. In the second, a neural network is applied to the autospectra which can be numerically extracted from a database. An improvement is found in the average error computed over all data sets for the model-predicted autospectrum compared to the average error in the autospectrum predicted using the conventional method. The model provided better results for 51.4% of the data sets compared to the conventional method, with many data sets showing marked improvement. The database measured from the Naval Academy YP676 training vessel is used for training and testing the neural network.

257 Breaking the Mold: An International, Multicenter Study on Active and Continuous Irrigation With Cerebrospinal Fluid Exchange for Improving Outcomes in Cerebral Ventriculitis

INTRODUCTION: Cerebral ventriculitis remains one of the most challenging neurosurgical conditions, with poor outcome and a long course of treatment and duration of hospital stay. Despite the current conventional management plans, i.e., using antibiotics in addition to CSF drainage, the outcome remains unsatisfactory in some cases, with no definitive therapeutic guidelines. METHODS: We conducted a multicenter, international, retrospective study of ventriculitis patients treated with a novel automated active irrigation, and drainage system. Data collected included patients’ demographics, comorbidities, admission Glasgow Coma Scale (GCS) score, and pre-hospital modified Rankin Scale (mRS). Catheter occlusions, infections, and shunt placement was recorded for outcome assessment, along with discharge mRS, and in-hospital mortality. RESULTS: Four centers (3 from U.S and 1 from Finland) contributed data for a total of 21 ventriculitis patients who had IRRAflow placement. Thirteen (61.9%) were males (mean age = 49.8 ± 14.87 years). The baseline median mRS was 1 and the median GCS at time of ventriculitis diagnosis was 13. Etiology of ventriculitis was iatrogenic in 12 (57.4%), and secondary to abscess in 9 (42.6%). No cases reported hemorrhage, or failure of IRRAflow placement. Antibiotics were administered in through the IRRAflow in 13 (61.9%) cases in addition to systemic dosing. Sixteen (76.19%) patients had significant clinical improvement and resolution of ventriculitis. Seven (33.33%) patients required shunt placement after resolution. There were 6 (28.6%) in-hospital mortalities reported. CONCLUSIONS: Use of active and continuous irrigation with drainage for continuous delivery of intraventricular irrigation fluid with antibiotics led to dramatically lower mortality when compared to literature (mortality approx. 70%). In our case series, it led to marked improvement in neurologic status, imaging findings, and CSF profiles making it technically feasible and safe treatment for ventriculitis.

Experimental assessment of the exposure to airborne exhaled contaminants using general and personalised ventilation systems in a hospital room

Ensuring good indoor air quality is critical in hospitals. An environment free from airborne particles can prevent the spread of various diseases and improve patient health. In this study, the efficiency of a personalised ventilation supply system (PSS) and personalised ventilation extraction system (PES) for diluting and removing contaminants exhaled by a patient in a hospital bed was evaluated. These systems, which were integrated into the head and foot of a hospital bed, were combined with three general ventilation strategies in the room. Fifteen ventilation strategies were analysed experimentally. Two breathing thermal manikins (BTMs) were used to simulate a patient and health worker in a hospital. The breathing of each BTM was controlled by the patient (source) generating particles that can increase the risk of infection in a healthy person (target). Experimental results show that using a PES combined with general ventilation of the room reduces the exposure of the target manikin compared to general ventilation strategies alone. However, no marked improvement was observed when the PSS was activated. The reduction in exposure to the target manikin was considerable when the PES was located at the foot of the hospital bed, which is the preferred option for integrating personalised systems in a hospital bed.

Tuning the mechanical and thermomechanical properties through the combined effect of crosslinking and annealing in poly(lactic acid)/acrylonitrile‐EPDM‐styrene blends

AbstractAcrylonitrile‐EPDM‐styrene (AES) was applied as an impact modifier for poly(lactic acid) (PLA), and the combined effect of dicumyl peroxide (DCP) crosslinking and annealing heat treatment was investigated. Torque rheometry, melt flow index (MFI), mechanical properties (impact, tensile, and Shore D hardness), X‐ray diffraction (XRD), infrared spectroscopy (FTIR), heat deflection temperature (HDT), differential scanning calorimetry (DSC), and scanning electron microscopy (SEM) were investigated. There was a considerable torque increment and fluidity drop in the PLA/AES/DCP blends caused by the crosslinking process and the formation of PLA‐g‐AES. Consequently, the impact strength and elongation at break properties improved. As an engineering terpolymer, AES was decisive in maintaining high elastic modulus, Shore D hardness, and HDT values. The PLA/AES/DCP (0.8 phr) composition leaned towards a synergism of mechanical properties, gaining 505.6% and 264.8% in impact strength and elongation at break, respectively, compared to neat PLA. FTIR and XRD analysis revealed high crystallinity, with samples presenting large crystals. The higher crystallinity had a deleterious effect on the mechanical properties of the PLA/AES/DCP blends. However, there was a marked improvement in HDT and higher toughness compared to PLA. The results before and after annealing the PLA/AES/DCP (0.8 phr) blend are promising for constructing new semi‐biodegradable materials for additive manufacturing.

Characterizing personalized ecologies

AbstractPeople have unique sets of direct sensory interactions with wild species, which change through their days, weeks, seasons, and lifetimes. Despite having important influences on their health and well‐being and their attitudes towards nature, these personalized ecologies remain surprisingly little studied and are poorly understood. However, much can be inferred about personalized ecologies by considering them from first principles (largely macroecological), alongside insights from research into the design and effectiveness of biodiversity monitoring programmes, knowledge of how animals respond to people, and studies of human biology and demography. Here I first review how three major sets of drivers, opportunity, capability and motivation, shape people's personalized ecologies. Second, I then explore the implications of these mechanisms for how more passively and more actively practical improvements can be made in people's personalized ecologies. Particularly in light of the declines in the richness of these ecologies that are being experienced in much of the world (the so‐called ‘extinction of experience’), and the significant consequences, marked improvement in many people's interactions and experiences with nature may be key to the future of biodiversity.

A randomized double-blind pilot study to evaluate the efficacy, safety, and tolerability of intravenous iron versus oral iron for the treatment of restless legs syndrome in patients with iron deficiency anemia.

Restless legs syndrome (RLS) is a neurological disorder that can have a profound effect on sleep and quality of life. Idiopathic RLS is associated with brain iron insufficiency despite normal peripheral iron stores. There is, however, a five- to six-fold increase in prevalence of RLS in patients with iron deficiency anemia (IDA). Several open-label trials have demonstrated symptomatic improvement in RLS following treatment of IDA using oral or intravenous iron supplementation. To date, there have been no randomized double-blind controlled trials of intravenous iron compared with oral iron for the treatment of RLS patients with IDA. In the current study, oral ferrous sulfate and ferumoxytol were compared for efficacy and speed of response for treatment of RLS occurring in patients with IDA. The planned recruitment for this study was 70 patients with RLS and IDA, to be randomly assigned 1:1 to oral or intravenous iron, using double-blind, double-dummy procedures. At Week 6, the primary outcomes of Clinical Global Impression-Improvement score and change from baseline in the International Restless Legs Syndrome Study Group rating scale score were assessed. Due to challenges, performing the clinical trial during the COVID-19 pandemic, final-week data were found missing for 30 patients. As a result, in order to maintain the prespecified statistical analysis, an additional 30 patients were recruited. Both IV and oral iron were associated with a marked improvement in RLS symptoms, with no statistically significant difference between treatment groups. No serious adverse events were observed in either treatment group.

Promoting CO2 Electroreduction Over Nano-Socketed Cu/Perovskite Heterostructures via A-Site-Valence-Controlled Oxygen Vacancies.

Despite the intriguing potential, nano-socketed Cu/perovskite heterostructures for CO2 electroreduction (CO2 RR) are still in their infancy and rational optimization of their CO2 RR properties is lacking. Here, an effective strategy is reported to promote CO2 -to-C2+ conversion over nano-socketed Cu/perovskite heterostructures by A-site-valence-controlled oxygen vacancies. For the proof-of-concept catalysts of Cu/La0.3-x Sr0.6+x TiO3-δ (x from 0 to 0.3), their oxygen vacancy concentrations increase controllably with the decreased A-site valences (or the increased x values). In flow cells, their activity and selectivity for C2+ present positive correlations with the oxygen vacancy concentrations. Among them, the Cu/Sr0.9 TiO3-δ with most oxygen vacancies shows the optimal activity and selectivity for C2+ . And relative to the Cu/La0.3 Sr0.6 TiO3-δ with minimum oxygen vacancies, the Cu/Sr0.9 TiO3-δ exhibits marked improvements (up to 2.4 folds) in activity and selectivity for C2+ . The experiments and theoretical calculations suggest that the optimized performance can be attributed to the merits provided by oxygen vacancies, including the accelerated charge transfer, enhanced adsorption/activation of reaction species, and reduced energy barrier for C─C coupling. Moreover, when explored in a membrane-electrode assembly electrolyzer, the Cu/Sr0.9 TiO3-δ catalyst shows excellent activity, selectivity (43.9%), and stability for C2 H4 at industrial current densities, being the most effective perovskite-based catalyst for CO2 -to-C2 H4 conversion.

Sage (Salvia officinalis) alleviates trazadone induced rat cardiotoxicity mediated via modulation of autophagy and oxidative stress.

The antidepressant drug trazodone (TRZ) is commonly used for treating depression, anxiety, and insomnia, however, it causes cardiotoxicity, which is one of its limitations. The objective of this work was to investigate the impact of sage (Salvia officinalis) in rats against cardiotoxicity induced by TRZ and to investigate the mechanisms involved in its cardio-protective properties through autophagy and oxidative stress. Fifty male albino rats were split randomly into five experimental groups: control group, sage oil group (100 mg/kg), TRZ group (20 mg/kg), protective group, and curative group. Cardiac function biomarkers (aspartate aminotransferase [AST], creatine kinase-MB [CK-MB], and cardiac troponin T [cTnI]) were assessed in serum. Oxidative stress and inflammatory biomarkers in cardiac tissue (total antioxidant capacity, malondialdehyde, and tumor necrosis factor-α) were evaluated. Heart tissues were subjected to histological, immunohistochemical, and ultrastructural evaluations. DNA damage also evaluated. Significant rise in the levels of AST, CK-MB, and cTnI were observed with enhanced autophagy along with marked histopathological changes in the form of interrupted muscle fibers with wide interstitial spaces with areas of hemorrhage and extravasated blood and interstitial mononuclear cellular infiltration in TRZ group. DNA damage was also significantly increased in TRZ group. However, administration of sage in both protective and curative groups show marked improvement of the cardiac alterations. In conclusion, sage ameliorated the alterations in the heart induced by trazadone through modulation of autophagy and oxidative stress.

Infrared–Visible Image Fusion through Feature-Based Decomposition and Domain Normalization

Infrared–visible image fusion is valuable across various applications due to the complementary information that it provides. However, the current fusion methods face challenges in achieving high-quality fused images. This paper identifies a limitation in the existing fusion framework that affects the fusion quality: modal differences between infrared and visible images are often overlooked, resulting in the poor fusion of the two modalities. This limitation implies that features from different sources may not be consistently fused, which can impact the quality of the fusion results. Therefore, we propose a framework that utilizes feature-based decomposition and domain normalization. This decomposition method separates infrared and visible images into common and unique regions. To reduce modal differences while retaining unique information from the source images, we apply domain normalization to the common regions within the unified feature space. This space can transform infrared features into a pseudo-visible domain, ensuring that all features are fused within the same domain and minimizing the impact of modal differences during the fusion process. Noise in the source images adversely affects the fused images, compromising the overall fusion performance. Thus, we propose the non-local Gaussian filter. This filter can learn the shape and parameters of its filtering kernel based on the image features, effectively removing noise while preserving details. Additionally, we propose a novel dense attention in the feature extraction module, enabling the network to understand and leverage inter-layer information. Our experiments demonstrate a marked improvement in fusion quality with our proposed method.

Research on sector scanning imaging technology of EMAT for through-hole defects in aluminium plates

ABSTRACT To overcome the drawbacks of traditional electromagnetic acoustic transducers (EMATs) that depend on mechanical scanning, adding to both cost and complexity, this study introduces a sector scanning imaging method utilizing Electromagnetic Ultrasonic Shear Vertical (SV) waves. A simulation model for EMAT was developed, optimizing through variable frequency and unidirectional line focusing coils. The simulation revealed that a novel composite magnetic structure significantly enhanced the magnetic flux density to 1.318 T, a 159.44% increase over conventional magnets, leading to a 102.08% rise in ultrasonic signal intensity and a marked improvement in the signal-to-noise ratio. By converting echo signal time data into spatial coordinates, the technology enables high-resolution defect imaging. The variable frequency-EMAT (VF-EMAT) technique accurately identified defects, with minor discrepancies from actual defect centers, showcasing its precision. The unidirectional line focusing-EMAT (ULF-EMAT) method further improved defect detection accuracy and shape restoration. However, the technique’s reliance on the main-pulse limits its ability to detect near-surface defects, suggesting an avenue for future research.

A spark of change: developing an innovative gerontological nursing intervention mapping initiative for training and education (IGNITE)

BackgroundWith an aging global population and advancements in medical technology, there is an urgent need for innovative gerontological nursing education programs. This study aimed to develop and evaluate the Innovative Gerontological Nursing Intervention Mapping Initiative for Training and Education (IGNITE) program. This program is a digital platform-based postgraduate nursing curriculum that employs the Intervention Mapping Approach (IMA) and Transformative Learning Theory to address the evolving needs of gerontological nursing.MethodsThe IGNITE program’s development process encompassed a comprehensive approach, including needs assessment, mapping of course objectives, integration of theory-based methods and strategies, course design, implementation, and rigorous evaluation. The pilot evaluation study involved pre- and post-tests focused on ageism, attitudes towards elder care, knowledge about older adults, transformative behavior change, and program satisfaction. The findings revealed significant improvements across all these dimensions, affirming the effectiveness of the program.ResultsThe program leveraged experiential learning, critical reflection, and rational discourse to facilitate transformative educational experiences. Notably, pre- and post-test comparisons showed marked improvements in attitudes towards older adult care and dementia care knowledge. Participants expressed high satisfaction with the program, with significant reported changes in transformative behaviors. The study also illuminated the initial negative attitudes of clinical nurses towards older adults and underscored the importance of transformative learning experiences in fostering empathy and understanding.ConclusionsThe IGNITE program lays a foundational framework for developing educational materials that promote transformative learning and self-reflection among healthcare professionals. This approach can lead to innovative nursing practices and personal growth. The application of the IMA and Transformative Learning Theory in gerontological nursing education shows significant promise. Future research should focus on exploring the long-term impacts of such programs and their applicability in diverse healthcare settings.

Functional Laryngectomy and Quality of Life in Survivors of Head and Neck Cancer With Intractable Aspiration

Late effects of head and neck cancer (HNC) treatment include profound dysphagia, chronic aspiration, and death. Functional laryngectomy (FL) can improve patient survival and quality of life (QoL); however, removing a failing larynx for a noncancer reason is a difficult decision. Data regarding the ability of FL to improve self-perceptions of voice, swallowing, and QOL in survivors of HNC with intractable aspiration are inconclusive. To investigate the association of FL with changes in self-reported perceptions of voice, swallowing, oral intake, QoL, and mood in survivors of HNC experiencing profound dysphagia and intractable aspiration. This cohort study was conducted at a single academic institution and included survivors of HNC with profound swallowing dysfunction and intractable aspiration who underwent FL from July 2016 through March 2022. Of the initial 22 patients enrolled, 2 patients (15%) died of aspiration pneumonia before receiving FL. Data analyses were performed from July 2016 through March 2023. Self-reported measures of voice using the VHI (30-item Voice Handicap Index), swallowing using the EAT-10 (10-item Eating Assessment Tool), functional oral intake scale using the FOIS (Functional Oral Intake Scale), and quality of life using the FACT-H&N (Functional Assessment of Cancer Therapy-Head & Neck) were assessed before FL and at 1, 3, and 6 months after FL. Mood states were evaluated using the POMS (Profile of Mood States, second edition), before FL and at 6 months after FL. The study analyses included 20 patients (mean [SD] age, 72.4 (7.0) years; 19 [95%] males and 1 [5%] female) who underwent FL and had complete data across all time points. Among these, 12 patients (60%) had received chemoradiation for oropharyngeal, 7 (35%) for laryngeal, or 1 (5%) for nasopharyngeal cancer. The mean (SD) time from completion of oncologic treatment to FL was 15.5 (5.5) years. Mean (SD) score on the EAT-10 improved from 33.2 (7.4) to 23.1 (10.8) at 1 month; 12.1 (9.1) at 3 months; and 8.3 (7.4) at 6 months, with a large effect size (η2 = 0.72; 95% CI, 0.54-0.80). Mean (SD) score on the FOIS improved from 2.0 (1.5) to 2.9 (1.7) at 1 month; 4.8 (2.5) at 3 months; and 5.2 (1.7) at 6 months, with a large effect size (η2 = 0.6; 95% CI, 0.38-0.71). Improvement in oral intake was achieved in 19 patients (95%), and feeding tubes were removed in 10 of 16 patients (63%) who were feeding tube-dependent; 6 patients (27%) continued to require supplemental tube feedings. Mean (SD) score on the VHI improved from 63.6 (34.0) to 86.9 (33.7) at 1 month; 71.3 (36.1) at 3 months; and 39.7 (26.9) at 6 months, with a large effect size (η2 = 0.42; 95% CI, 0.19-0.56). Seventeen patients (85%) were able to use a tracheoesophageal voice prosthesis for alaryngeal communication. Mean (SD) score on the FACT-H&N improved from 86.2 (17.8) to 93.6 (18.4) at 1 month; 109.0 (18.4) at 3 months; and 121.0 (16.8) at 6 months, with a large effect size (η2 = 0.64; 95% CI, 0.42-0.74). Mean (SD) score on the POMS improved from 58.9 (13.2) at baseline to 44.5 (9.9) at 6 months, with a large effect size (Cohen d = 1.04; 95% CI, 0.48-1.57). None of the patients experienced major complications of FL; 1 patient (5%) had a postoperative pharyngocutaneous fistula. The findings of this cohort study indicate that FL was associated with marked improvements in self-perception of voice and swallowing, functional oral intake, QoL, and mood state among survivors of HNC. These findings can serve as a framework for FL counseling among HNC survivors experiencing profound dysphagia and intractable aspiration.

On the fourth-order hybrid beta polynomial kernels in kernel density estimation

This paper introduces a novel family of fourth-order hybrid beta polynomial kernels tailored for statistical analysis. The efficacy of these kernels is evaluated using two principal performance metrics: asymptotic mean integrated squared error (AMISE) and kernel efficiency. Comprehensive assessments were conducted using both simulated and real-world datasets, enabling a thorough comparison with conventional fourth-order polynomial kernels. The evaluation process entailed computing AMISE and efficiency metrics for both the hybrid and classical kernels. Consistently, the results illustrated the superior performance of the hybrid kernels over their classical counterparts across diverse datasets, underscoring the robustness and effectiveness of the hybrid approach. By leveraging these performance metrics and conducting evaluations on simulated and real world data, this study furnishes compelling evidence supporting the superiority of the proposed hybrid beta polynomial kernels. The heightened performance, evidenced by lower AMISE values and elevated efficiency scores, strongly advocates for the adoption of the proposed kernels in statistical analysis tasks, presenting a marked improvement over traditional kernels.

Interfacial charge associated reliability improvement in arsenide/antimonide tunneling interfaced-junctionless TFET

This article focuses on the investigation of reliability improvement in the arsenide/antimonide tunable bandgap tunneling interfaced junctionless TFET (HD-HJLTFET) by introducing positive (donor) and negative (acceptor) localized interfacial trap charges (ITCs) at the semiconductor/oxide (S/O) and semiconductor/semiconductor (S/S) interface. The compound semiconducting materials, InAs (lower bandgap) and AlGaSb (higher bandgap) have been incorporated in the source and channel regions in the proposed device (HJLTFET). Further, to improve the device reliability against ITCs, a hetero dielectric engineered gated device has also been designed and analysed (HD-HJLTFET). In HD-HJLTFET, a high-k dielectric near source to channel (S/C) interface and low-k dielectric region towards drain to channel (D/C) interface has been used. It has been obtained that HD engineering enhances the microwave and harmonic distortion performance of HD-HJLTFET. It has been evaluated that HD-HJLTFET/ HJLTFET delivers ON current of 38.3 μA/14μA, transconductance 108 μS/23.2μS, cut-off frequency 805.8GHz/406.7GHz and gain of 223.5/197.4. Further results show that HD delivers gm2 (∼28% ↓), gm3 (∼9 times), second-order and third-order harmonic distortion (∼42% ↓ and ∼90% ↓), and total harmonic distortion (∼26% ↓) as compared to HJLTFET. The linearity parameters of HD-HJLTFET (VIP2, VIP3, IIP3, 1dB compression point, and IMD3) also showed marked improvement with negligible variation against different ITC polarity than its counter device, making it more reliable for low power microwave and distortion-free wireless communication systems.