Volume Changes Research Articles

Fluorine Doping Modulating Pore Structure and Adsorption Capability of Carbon Matrix Boosting Potassium Storage Performance of Red Phosphorus Anode

AbstractThe application of alloying‐typed red phosphorus (red P) anode in potassium‐ion batteries (KIBs) with ultra‐high theoretical capacity is hindered by the limited capacity and fast capacity decay due to poor electronic conductivity and huge volume change. Herein, a facile and efficient strategy of fluorine (F) doping is innovatively developed to modulate the pore structure of carbon matrix (F‐CNS) to encapsulate red P with enhanced potassium storage capability. Theoretical calculations reveal that F doping induces additional defects within the carbon layer, which facilitates P4 molecules embedding into the F‐doping‐induced micropores, enhances the adsorption ability toward K atoms and P4 molecules, and improves electrochemical kinetics assisted with more charge transfer obtained from the electron density difference, thus enabling robust potassium storage capability for such unique Red P@F‐CNS anode. Accordingly, the Red P@F‐CNS anode demonstrates outstanding cycling stability (90% capacity retention after 800 cycles at 2A g−1), and the potassium‐ion full cell (Red P@F‐CNS//KFeHCF) exhibits exceptional long‐term cycling performance (129 mAh g−1 after 2500 cycles at 5 A g−1 with only 0.014% decay per cycle). In situ characterizations confirm the superior structural integrity of the carbon‐based matrix. This study offers a rational design principle for engineering high‐performance carbon‐supported alloying‐typed anodes for KIBs.

High-Performance Pomegranate-Like CuF2 Cathode Derived from Spent Lithium-Ion Batteries.

With the large-scale application of lithium-ion batteries (LIBs), a huge amount of spent LIBs will be generated each year and how to realize their recycling and reuse in a clean and effective way poses a challenge to the society. In this work, using the electrolyte of spent LIBs as solvent, we in situ fluorinate the conductive three-dimensional porous copper foam by a facile solvent-thermal method and then coating it with a cross-linked sodium alginate (SA) layer. Benefiting from the solid-electrolyte interphase (SEI) that accommodating the volume change of internal CuF2 core and SA layer that inhibiting the dissolution of CuF2, the synthesized CuF2@void@SEI@SA cathode with a pomegranate-like structure (yolk-shell) exhibits a large reversible capacity of ~535 mAh g-1 at 0.05 A g-1 and superb cycling stability. This work conforms to the development concept of green environmental protection and comprehensively realizes the unity of environmental, social and economic benefits.

Progression of Bone Marrow Lesions and the Development of Knee Osteoarthritis: Osteoarthritis Initiative Data.

Background Bone marrow lesions (BMLs) are a known risk factor for incident knee osteoarthritis (OA), and deep learning (DL) methods can assist in automated segmentation and risk prediction. Purpose To develop and validate a DL model for quantifying tibiofemoral BML volume on MRI scans in knees without radiographic OA and to assess the association between longitudinal BML changes and incident knee OA. Materials and Methods This retrospective study included knee MRI scans from the Osteoarthritis Initiative prospective cohort (February 2004-October 2015). The DL model, developed between August and October 2023, segmented the tibiofemoral joint into 10 subregions and measured BML volume in each subregion. Baseline and 4-year follow-up MRI scans were analyzed. Knees without OA at baseline were categorized into three groups based on 4-year BML volume changes: BML-free, BML regression, and BML progression. The risk of developing radiographic and symptomatic OA over 9 years was compared among these groups. Results Included were 3869 non-OA knees in 2430 participants (mean age, 59.5 years ± 9.0 [SD]; female-to-male ratio, 1.3:1). At 4-year follow-up, 2216 knees remained BML-free, 1106 showed an increase in BML volume, and 547 showed a decrease in BML volume. BML progression was associated with a higher risk of developing radiographic knee OA compared with remaining BML-free (hazard ratio [HR] = 3.0; P < .001) or BML regression (HR = 2.0; P < .001). Knees with BML progression also had a higher risk of developing symptomatic OA compared with BML-free knees (HR = 1.3; P < .001). Larger volume changes in BML progression were associated with a higher risk of developing both radiographic OA (HR = 2.0; P < .001) and symptomatic OA (HR = 1.7; P < .001). In almost all subchondral plates, especially the medial femur and tibia, BML progression was associated with a higher risk of developing both radiographic and symptomatic OA compared with remaining BML-free. Conclusion Knees with BML progression, according to subregion and extent of volume changes, were associated with an increased risk of OA compared with BML-free knees and knees with BML regression, highlighting the potential utility of monitoring BML volume changes in evaluating interventions to prevent OA development. ClinicalTrials.gov Identifier: NCT00080171 © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Said and Sakly in this issue.

Tumor volume changes after stereotactic, hypofractionated and conventional radiotherapy in paragangliomas of head and neck.

The aim of this study is comparison the effectiveness of stereotactic, hypofractionated and conventional radiotherapy assessed by the tumor volume changes of paraganglioma located in the head and neck region concerning fractional and total doses. We analyzed 76 patients after radiotherapy due to paraganglioma who were assigned to 3 groups considering fractional (≤2 Gy, 3-5.5 Gy, ≥6 Gy) and total (≤20 Gy, 21-40 Gy, >40 Gy) doses. The volumes of irradiated tumors were measured and compared based on diagnostic images performed before and after the treatment. The mean tumor volume after the treatment with the lowest fractional dose (≤2 Gy) was decreased by 14.4 cm3. In patients treated with higher fractional doses (>2 Gy), the mean tumor volumes decreased by less than 1 cm3 for hypofractionated and stereotactic radiotherapy. 15.9 cm3 reduction of the mean tumor volume after the treatment with the highest RT total dose (>40 Gy) was stated. In patients treated with total doses ≤20 Gy and 21-40 Gy, the mean tumor volume was stable and reduced by 1.15 cm3, respectively. The analysis demonstrates a statistically significant (p < 0.05) treatment advantage in patients after the lowest fractional and highest total doses. The reduction of the tumor's volume was reported after conventional and unconventional radiotherapy. The most significant depletion of the paraganglioma volume was noted after a factional dose ≤2 Gy and a total dose >40 Gy.

Which muscle is the external rotation compensator after superior capsular reconstruction?

BackgroundSuperior capsular reconstruction (SCR) is a surgical option for massive irreparable rotator cuff tears, particularly involving the supraspinatus and infraspinatus. In this procedure, the torn infraspinatus is not repaired or reconstructed. However, an improvement in postoperative external rotation (ER) angle and strength is observed. There is a lack of studies explaining how ER is restored after SCR. The aim of this study is to identify the ER compensator by assessing the muscle volume of the posterior deltoid and teres minor. MethodsSixty-eight patients with massive rotator cuff tears underwent SCR during 2016-2021. Of these patients, 28 who met the following inclusion criteria were retrospectively reviewed: (1) massive rotator cuff tears including the supraspinatus and infraspinatus; (2) severe muscle atrophy and fatty change; (3) intact or reparable subscapularis tendon; (4) Hamada of grade 3 or lower. Posterior deltoid and teres minor volume were measured by using an open-source medical image processing software preoperatively and 1-year postoperatively. The percentage of the posterior deltoid and teres minor muscle volume change was compared between patients with 1-year postoperative ER manual motor testing (MMT) of grade 5 and of grade < 5. The relationship between grade of fatty change, percentage of the muscle volume change, and ER angle and strength were evaluated. ResultsThere was a significant increase in the 1-year postoperative teres minor volume compared with the preoperative volume (24.6±10.3 cm³ versus 20.9±8.3 cm³, p<0.000), while the posterior deltoid volume remained unchanged (178.1±48.3 cm³ versus 178.8±47 cm³). Patients with ER MMT of grade 5 had a greater teres minor volume compared to those with an ER MMT grade of less than 5 (22.3% versus 9.4%), although this difference was not significant (p=0.074, 95% CI=-1.3–27.0). The posterior deltoid volume showed no significant change. The percentage of teres minor volume change had a weak positive correlation with ER strength (r=0.308, p=0.055, 95% CI=-0.02–1.0). There was a significant negative correlation between ER strength and the severity of both preoperative and postoperative fatty changes in the teres minor (r=-0.258, p=0.065, 95% CI=-1.0–-0.042 and r=-0.323, p=0.028, 95% CI=-1.0–-0.113, respectively). The pre- and postoperative fatty changes in the teres minor were negatively correlated with the percentage of teres minor volume change (r=-0.298, p=0.062, 95% CI=-1.0–0.031 and r=-0.413, p=0.015, 95% CI=-1.0–-0.1, respectively). ConclusionThe teres minor may serve as a potential compensator for ER in patients with massive rotator cuff tears following SCR.

Sb/Sb4O5Cl2/C composite as a stable anode for sodium-ion batteries

One of the most demanding goals in the field of Na-ion batteries is to find an appropriate anode material that delivers high capacities and can endure numerous cycles without structural degradation. Antimony stands out with a theoretical capacity of 660 mAh·g−1 and relatively high electrical conductivity. However, its challenges are pulverization and degradation of its microstructure due to volume changes. In this work, we used a solvothermal reaction to synthesize the composite material Sb/Sb4O5Cl2/C, which is made of Sb with branch-shaped morphology and Sb4O5Cl2 with cuboids-shaped morphology. The mechanism of the (de)sodiation of the composite material was analyzed both through operando and ex-situ measurements: X-ray diffraction, Raman spectroscopy, X-ray absorption spectroscopy, scanning electron microscopy, dilatometry, and online electrochemical mass spectrometry. The results show great mechanical integrity of the electrode, ensured by a lot of space for volume changes in the branch-shaped microstructure, buffered expansion/contraction by the amorphous matrix (sodiated Sb4O5Cl2), and high electronic conductivity, thanks to carbon. The microstructural features and the multistep (de)sodiation mechanism of the Sb/Sb4O5Cl2/C composite result in excellent cycling stabilities.

Investigating the efficacy of Endolift laser and Nanofat as a combination therapy for horizontal neck lines compared to Nanofat autologous alone.

The emergence of horizontal neck wrinkles is increasingly becoming a focal point for both cosmetic professionals and clients. Various treatment approaches must be considered to address this issue effectively, owing to its diverse underlying causes. The study explores the potential of utilizing the Endolift laser in conjunction with nanofat injection as a viable treatment option. Twenty patients with horizontal neck wrinkles involved in the study. Ten patients underwent treatment with a combination of Endolift laser and nanofat injection and 10 patients treated with nanofat injection alone. The participants were monitored for 6 months post-treatment. Biometric measurements were utilized to assess outcomes, including changes in volume, depth, and area of the wrinkles, skin elasticity, as well as the diameter and density of the epidermis and dermis in the treated area. Skin improvement was evaluated by two independent dermatologists, who compared before and after photos in a blinded manner. Patient satisfaction levels were also documented. The Visioface analysis showed a notable decrease in neck wrinkle depth and area in both groups. However, the group receiving the combination treatment of Endolift laser and nanofat exhibited a significantly greater improvement compared to the group treated with nanofat alone. Skin ultrasonography results demonstrated an increase in thickness and density of the dermis and epidermis in both groups. Particularly, the group treated with Endolift laser-nanofat displayed significant enhancements in dermis and epidermis density and thickness when contrasted with the nanofat-only group. Analysis with Cutometer revealed a marked enhancement in skin elasticity in the Endolift-nanofat treated group in comparison to the nanofat-only treated group. Furthermore, in the Endolift-nanofat treated group, a substantial majority (90%) of patients exhibited improvement. Patient evaluations highlighted significant distinctions between the two groups, with 95% of patients in the Endolift-nanofat treated group demonstrating enhancement. Both methods notably enhance horizontal neck wrinkles; nevertheless, the combination of endolift laser and nanofat seems to be more efficient for treating horizontal neck wrinkles.

Service performance of nitrile rubber sealing ring under 70 MPa high-pressure hydrogen

Abstract The service performance of NBR seals under 70 MPa high-pressure hydrogen was investigated, and the effects of vulcanization additives, fillers, and crude systems on their sealing performance were investigated. The sealing performance was characterized by the changes in volume and hardness before and after the service of the seals.

Nano‐ZnFe2O4 Facilitates Lithium Metal Anode Achieving High Stability

AbstractDue to its remarkably low redox potential and high specific capacity, the lithium metal anode has long been regarded as the ultimate choice for anode in lithium‐ion cells. However, its practical application has been impeded by two major challenges: poor Coulomb efficiency and the inevitable formation of lithium dendrites during charging/discharging processes. In this study, we propose a method to address these issues by fabricating a protective layer for the lithium metal anode using a polyethylene separator that has been modified with a composite of zinc nanoferrite and porous carbon (referred to as ZnFe2O4@PE). By employing this approach, we aim to achieve enhanced stability during anode cycling. The ZnFe2O4@PE serves multiple purposes. Firstly, it effectively reduces the local current density, thereby mitigating the drastic volume changes that occur during charging and discharging. Additionally, the nano‐ZnFe2O4 possesses a favorable affinity for lithium ions, facilitating their homogeneous deposition and suppressing the growth of lithium dendrites. As a result, the lithium metal anodes coated with the ZnFe2O4@PE protective layer exhibit excellent cycling stability, maintaining stable performance for 250 h. This innovative strategy offers a promising application pathway for lithium metal anodes.

TREATMENT FOR REMOVING ZN COMPOUNDS FROM SILICA-FILLED VULCANIZED RUBBER AND ANALYSIS OF SILICA AGGREGATE DISPERSION

ABSTRACT Treatment of silica-filled rubber vulcanizates with a diethyl ether/concentrated hydrochloric acid solution for 96 h at room temperature can remove most Zn compounds smaller than approximately 90 nm, which account for most of the residual ZnO, rubber-soluble Zn compounds and ZnS resulting from crosslinking reactions of by-products. However, a very small number of giant ZnO particles of a few micrometers in size remain after such treatment. In the silica-filled SBR matrix treated for 96 h, a significant increase in crosslink density and Young’s modulus was observed due to crosslinking reactions after HCl was removed from HCl-added rubber molecules. This increase in crosslink density was accompanied by an increase in the surrounding layer of bound rubber closest to the silica of the two bound rubber layers around it and a decrease in the rubber matrix of the same volume. It is inferred that there was little change in the aggregate structure of the silica due to these volume changes. Alternatively, ultra-small X-ray scattering measurements of the treated samples showed shoulders derived from silica aggregates and clear high-resolution X-ray computed microtomography (X-ray CT) images were obtained due to the removal of Zn compounds smaller than approximately 90 nm in size. The relationship between these shoulders and the size of silica aggregates obtained by X-ray CT imaging was qualitatively consistent, and it was not affected by the presence or absence of bis-(3-triethoxysilylpropyl) tetrasulfide and 1,3-diphenylguanidine, but was dependent on the rubber type. The distance between nearest neighbor particles of silica aggregates, determined by X-ray CT imaging, also depended on the types of rubber.

Effect of material anisotropy on the first-order vibration of piezoelectric oscillators in circular plate configurations

Valveless piezoelectric pumps are widely used in microfluidic actuation because of their simple structure, ease of integration, absence of electromagnetic interference, minimal valve wear, and absence of frequency–response lag issues. These pumps primarily rely on chamber volume changes, causing most piezoelectric oscillators to operate in the first-order vibration mode. However, recent studies on valveless piezoelectric pumps have observed that many pumps exhibit two flow peaks at similar operating frequencies; the underlying mechanism behind this anomaly remains underexplored. In this study, we investigated the impact of substrate metal on the first-order vibrations of piezoelectric oscillators. By conducting tensile tests on rolled pure copper sheets, we measured Poisson's ratio and the elastic modulus in both the parallel and perpendicular rolling directions. Subsequently, we derived the natural frequencies on the plane. Experimental verification of the theoretical predictions was achieved through amplitude experiments conducted on piezoelectric oscillators in air. The dual-peak flow phenomenon was demonstrated to be solely related to the substrate metal of the piezoelectric oscillator. This is attributed to the presence of two first-order vibration natural frequencies on the plane of the substrate metal, resulting in the generation of two amplitude peaks and consequently the appearance of two flow peaks.

Computer Modelling Study of Volume Kinetics in Intraocular Segments Following Airbag Impact Using Finite Element Analysis.

We have previously studied the physiological and mechanical responses of the eye to blunt trauma in various situations using finite element analysis (FEA). In this study, we evaluated the volume kinetics of an airbag impact on the eye using FEA to sequentially determine the volume change rates of intraocular segments at various airbag deployment velocities. The human eye model we created was used in simulations with the FEA program PAM-GENERISTM (Nihon ESI, Tokyo, Japan). Different airbag deployment velocities, 30, 40, 50, 60 and 70 m/s, were applied in the forward direction. The volume of the deformed eye impacted by the airbag was calculated as the integrated value of all meshes in each segment, and the decrease rate was calculated as the ratio of the decreased volume of each segment at particular timepoints to the value before the airbag impact. The minimum volume of the anterior chamber was 63%, 69% and 50% at 50, 60 and 70 m/s airbag impact velocity, respectively, showing a curve with a sharp decline followed by gradual recovery. In contrast to the anterior chamber, the volume of the lens recovered promptly, reaching 80-90% at the end of observation, except for the case of 60 m/s. Following the decrease, the volume increased to more than that of baseline at 60 m/s. The rate of volume change of the vitreous was distributed in a narrow range, 99.2-100.4%. In this study, we found a large, prolonged decrease of volume in the anterior chamber, a similar large decrease followed by prompt recovery of volume in the lens, and a time-lag in the volume decrease between these tissues. These novel findings may provide an important insight into the pathophysiological mechanism of airbag ocular injuries through this further evaluation, employing a refined FEA model representing cuboidal deformation, to develop a more safe airbag system.

A Reference Interval for CT-Based Liver Volume in Dogs without Hepatic Disease.

In both human and veterinary medicine, computed tomography (CT) volumetry provides a quantitative and accurate measure of liver volume. While CT volumetry is recognized as a useful method for assessing liver volume in dogs, a statistically significant reference interval for liver volume in dogs with no history of hepatic disease has not been reported. The purpose of the present study was to define a reference interval for liver volume with no history of hepatic disease using CT volumetry. Medical records from 2 June 2020 to 25 July 2022 were retrospectively reviewed, including 121 dogs that underwent abdominal CT scans and had no history of hepatic disease. Liver volumes were measured using CT volumetry and normalized by body weight. The median of normalized CT-based liver volume in 121 dogs was 22.2 cm3/kg. Based on these data, a weight-based reference interval lower limit of 11.1-15.5 (90% confidence interval [CI]) to an upper limit of 31.9-42.6 (90% CI) cm3/kg for CT-based liver volume was defined in dogs without hepatic disease. This study provides an accurate assessment of liver volume changes in dogs with various hepatic diseases.

Modelling beach volume changes caused by moderate and weak hydrodynamic conditions

The goals of this study were the calibration of the XBeach model for moderate and weak hydrodynamic conditions in 2D mode and the determination of the volumetric changes induced by them. An evaluation of model performance was made based on the Brier Skill Score (BSS), the visual match of the profile shape (VMS), the absolute volumetric change error (m3/m) and the relative volumetric change error (%). An analysis of accuracy in determining volumetric changes in the dune coast, with XBeach applied, provided an average absolute error in determination of volumetric changes of 4.0 m3/m for a significant storm and 1.5 m3/m for moderate and weak hydrodynamic conditions in a 2D model calibration process. Simulations of morphological changes caused by moderate and weak hydrodynamic conditions for seven timeframes classified into three groups have been run in 2D mode. Within a validation process, the average absolute error in the determination of volumetric changes in the beach was ranging from 0.64 m3/m to 2.42 m3/m depending on the group of hydrodynamic conditions. A high value of the correlation coefficient (R) between the measured and modelled balance of volumetric changes (m3/m) for all timeframes – 0.79 and for the ‘strongest’ group no. 3 – 0.91 were revealed. For the remaining groups, i.e., group no. 1 and no. 2 of hydrodynamic conditions, no such correlation was observed. Furthermore, the temporal analysis of the sum of beach volumes proved that a rising trend was observed over 4 months. Thus, moderate and weak hydrodynamic conditions dominated the accumulation within the area of study. XBeach reflected this trend well, producing a difference between the measured and modelled sum of volumes at the end of the timeframe of 7.27 m3/m, which is close to the volume determination error by the model.

Ultralong lifespan solid-state sodium battery with a supersodiophilic and fast ionic conductive composite sodium anode

Solid-state sodium batteries (SSNBs) are considered as a promising alternative to organic liquid-based batteries due to their excellent safety, high energy density and cost-effectiveness. However, SSNBs suffer from undesirable interfacial contact between Na and solid-state electrolytes such as NASICON-type Na3Zr2Si2PO12 (NZSP), dendritic growth and dramatic volume changes during cycling, which hinder their development towards actual applications. Herein, dendrite-free composite-type Na/NZSP module with ultrafast built-in ionic conductive framework is designed to promote the Na diffusion kinetics, partially restrict the volume effect, and simultaneously improve the wettability towards NZSP. Thanks to the unique module with supersodiophilic property, the thus-made all-solid-state Na-symmetric cells offer a reduced area specific resistance by more than two orders of magnitudes (from 1774.0 Ω cm2 for the pristine Na/NZSP to 14.1 Ω cm2 for the composite-type Na/NZSP module) and endow an ultralong lifespan of 7800 h at room temperature. Moreover, a full SSNB coupling with the Na/NZSP module and Na3V2(PO4)3 cathode achieves extremely long and stable cycling of more than 5760 cycles at 1.0 C with 87.9 % of capacity retention and high-rate capability at 3.0 C, being among the best achievements reported so far. The findings open a new window of composite-type Na/NZSP module design for high-performance SSNBs.

Human Alzheimer's Disease ATN/ABC Staging Applied to Aging Rhesus Macaque Brains: Association With Cognition and MRI-Based Regional Gray Matter Volume.

The brain changes of Alzheimer's disease (AD) include Abeta (Aβ)amyloid plaques ("A"), abnormally phosphorylated tau tangles ("T"), and neurodegeneration ("N"). These have been used to construct in vivo and postmortem diagnostic and staging classifications for evaluating the spectrum of AD in the "ATN" and "ABC" ("B" for Braak tau stage, "C" for Consortium to Establish a Registry for Alzheimer's Disease [CERAD] neuritic plaque density) systems. Another common AD feature involves cerebral amyloid angiopathy (CAA). We report the first experiment to examine relationships among cognition, brain distribution of amyloid plaques, CAA, tau/tangles, and magnetic resonance imaging (MRI)-determined volume changes (as a measure of "N") in the same group of behaviorally characterized nonhuman primates. Both ATN and ABC systems were applied to a group of 32 rhesus macaques aged between 7 and 33 years. When an immunohistochemical method for "T" and "B" was used, some monkeys were "triple positive" on ATN, with a maximum ABC status of A1B2C3. With silver or thioflavin S methods, however, all monkeys were classified as T-negative and B0, indicating the absence of mature neurofibrillary tangles (NFTs) and hence neuropathologically defined AD. Although monkeys at extremes of the ATN and ABC classifications, or with frequent CAA, had significantly lower scores on some cognitive tests, the lack of fully mature NFTs or dementia-consistent cognitive impairment indicates that fully developed AD may not occur in rhesus macaques. There were sex differences noted in the types of histopathology present, and only CAA was significantly related to gray matter volume.

Assessment of the Change in the Nasal Septum and Nasal Profile After Le Fort I With Cone Beam Computed Tomography.

This study aimed to determine the relationship between nasal changes and the amount of advancement, impaction, and downward movement of the maxilla after Le Fort I osteotomy. The study included 48 patients who underwent Le Fort I surgery and had pre- and postoperative cone-beam computed tomography records. Changes in the nasal septum were evaluated by measuring septal deviation angles and volumes. In addition, nasolabial angle and width of nasal and alar base were examined. Groups were determined according to the movement of point A (the deepest point on the curvature of the maxillary alveolar process), using a threshold of 1.5 mm for vertical movements and 4 mm for sagittal movements. This resulted in the comparison of 6 groups of 8 people each. Results are presented as mean and standard deviation or median and range depending on the data distribution. Significance level was accepted as P < 0.05. There were no significant differences for each group on its own septal deviation volume or angle values pre/postoperatively. Groups 3 and 5, which both had at least 1.5 mm of impaction, showed significant changes in both deviation angle and volume between the preoperative and postoperative measurements. Nasolabial angle did not show significant changes between groups. Alar base width and nasal width increase was significantly highest in Group 1, which has more than 4 mm sagittal movement and less than 1.5 mm vertical movement. Le Fort I osteotomy may lead to undesirable changes in the spatial positioning of the nasal septum. The results of this study suggest that maxillary advancement does not significantly impact septal deviation, whereas maxillary impaction increases the amount of deviation. In addition, nasal width and alar base width tended to increase, and the nasolabial angle tended to decrease slightly, regardless of the direction of movement of the maxilla after orthognathic surgery. Surgeons should consider increased nasal septal deviation risks when planning impaction of the maxilla. The soft tissue changes in the nose vary according to different directions and amounts of Le Fort I surgery.

Pressure never sucks, pressure only pushes: a physiological exploration of the pushing power of pressure.

The movement of air into and out of the lungs is facilitated by changes in pressure within the thoracic cavity relative to atmospheric pressure, as well as the resistance encountered by airways. In this process, the movement of air into and out of the lungs is driven by pressure gradients established by changes in lung volume and intra-alveolar pressure. However, pressure never sucks! The concept that pressure never sucks, pressure only pushes encapsulates a fundamental principle in the behavior of gases. This concept challenges common misconceptions about pressure, shedding light on the dynamic forces that govern the movement of gases. In this Illumination, we explore the essence of this concept and its applications in pulmonary ventilation. Pressure is one of the most important concepts in physics and physiology. Atmospheric pressure at sea level is equal to 1 atmosphere or around 101,325 Pascal [Pa (1 Pa = 1 N/m2)]. This huge pressure is pushing down on everything all the time. However, this pressure is difficult to understand because we do not often observe the power of this incredible force. We used five readily available, simple, and inexpensive demonstrations to introduce the physics and power of pressure. This extraordinarily complex physics concept was approached in a straightforward and inexpensive manner while still providing an understanding of the fundamental concepts. These simple demonstrations introduced basic concepts and addressed common misconceptions about pressure.NEW & NOTEWORTHY The concept that pressure never sucks, pressure only pushes challenges common misconceptions about pressure, shedding light on the dynamic forces that govern the movement of gases. In this Illumination, we will explore the essence of this concept and its applications in pulmonary ventilation. Specifically, we used five readily available, simple, inexpensive demonstrations to introduce the physics and power of pressure.

Surgical Stone Trends from 2013 to 2021 in the US Medicare Population: Before and after the COVID-19 Pandemic.

Introduction and Objective: In early 2020, as the SARS-Cov-2 (COVID-19) pandemic progressed, many institutions limited nonurgent surgical care. This coincided with a decade-long trend of increasing percutaneous nephrolithotomy (PCNL) and ureteroscopy (URS) and decreasing shock wave lithotripsy (SWL) for surgical management of urolithiasis. Herein, we evaluate temporal stone surgery rates and surgeon volumes in the Medicare population and suggest how COVID-19 contributed to them. Methods: Retrospective analysis was conducted using the "Medicare Physician & Other Practitioners" database containing data from January 2013 to December 2021. Adult patients who underwent stone surgery were included. We evaluated surgeon characteristics and changes in case volumes over time adjusted for population. Results: In 2013, urologists performed 68,910 stone surgeries: SWL 42,903 (62%); URS 25,321 (37%); PCNL 686 (1%). Over the next 8 years, there was an average annual increase in URS (+13%) and PCNL (+13%) and decrease in SWL (-2%). In 2020, there was a 14% reduction in all stone cases: SWL (-25%); URS (-6%); PCNL (-8%). By 2021, case volumes recovered to pre-2020 levels, though SWL remained low: SWL 33,974 (34%); URS 64,541 (64%); PCNL 1764 (2%). From 2013 to 2021, the number of urologists performing SWL decreased (1718 to 1361) while URS and PCNL providers doubled (1,347 to 2,914 and 28 to 76, respectively). Conclusions: From 2013 to 2021, there was an increase in URS and PCNL and a decrease in SWL in the US Medicare population. The COVID-19 pandemic was associated with a decline in stone surgeries, particularly SWL. By 2021, PCNL and URS case numbers increased significantly with a smaller increase in SWL.

Behavioral and brain morphological changes before and after hemispherotomy.

Hemispherotomy is an effective surgery for treating refractory epilepsy from diffuse unihemispheric lesions. To date, postsurgery neuroplastic changes supporting behavioral recovery after left or right hemispherotomy remain unclear. In the present study, we systematically investigated changes in gray matter volume (GMV) before and after surgery and further analyzed their relationships with behavioral scores in two large groups of pediatric patients with left and right hemispherotomy (29 left and 28 right). To control for the dramatic developmental effect during this stage, age-adjusted GMV within unaffected brain regions was derived voxel by voxel using a normative modeling approach with an age-matched reference cohort of 2115 healthy children. Widespread GMV increases in the contralateral cerebrum and ipsilateral cerebellum and GMV decreases in the contralateral cerebellum were consistently observed in both patient groups, but only the left hemispherotomy patients showed GMV decreases in the contralateral cingulate gyrus. Intriguingly, the GMV decrease in the contralateral cerebellum was significantly correlated with improvement in behavioral scores in the right but not the left hemispherotomy patients. Importantly, the preoperative voxelwise GMV features can be used to significantly predict postoperative behavioral scores in both patient groups. These findings indicate an important role of the contralateral cerebellum in the behavioral recovery following right hemispherotomy and highlight the predictive potential of preoperative imaging features in postoperative behavioral performance.