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Background: The burden of musculoskeletal conditions continues to grow in low‐ and middle‐income countries. Among thousands of surgical outreach trips each year, few organizations electronically track patient data to inform real‐time care decisions and assess trip impact. We report the implementation of an electronic health record (EHR) system utilized at point of care during an orthopedic surgical outreach trip. Methods: In March 2023, we implemented an EHR on an orthopedic outreach trip to guide real‐time care decisions. We utilized an effectiveness‐implementation hybrid type 3 design to evaluate implementation success. Success was measured using outcomes adopted by the World Health Organization, including acceptability, appropriateness, feasibility, adoption, fidelity, and sustainability. Clinical outcome measures included adherence to essential quality measures and follow‐up numerical rating system (NRS) pain scores. Results: During the 5‐day outreach trip, 76 patients were evaluated, 25 of which underwent surgery beforehand. The EHR implementation was successful as defined by: mean questionnaire ratings of acceptability (4.26), appropriateness (4.12), feasibility (4.19), and adoption (4.33) at least 4.00, WHO behaviorally anchored rating scale ratings of fidelity (6.8) at least 5.00, and sustainability (80%) at least 60% follow‐up at 6 months. All clinical quality measures were reported in greater than 80% of cases with all measures reported in 92% of cases. NRS pain scores improved by an average of 2.4 points. Conclusions: We demonstrate successful implementation of an EHR for real‐time clinical use on a surgical outreach trip. Benefits of EHR utilization on surgical outreach trips may include improved documentation, minimization of medical errors, and ultimately improved quality of care. [ABSTRACT FROM AUTHOR]

Gender classification on normalized iris images has been previously attempted with varying degrees of success. In these previous studies, it has been shown that occlusion masks may introduce gender information; occlusion masks are used in iris recognition to remove non-iris elements. When, the goal is to classify the gender using exclusively the iris texture, the presence of gender information in the masks may result in apparently higher accuracy, thereby not reflecting the actual gender information present in the iris. However, no measures have been taken to eliminate this information while preserving as much iris information as possible. We propose a novel method to assess the gender information present in the iris more accurately by eliminating gender information in the masks. This consists of pairing iris with similar masks and different gender, generating a paired mask using the OR operator, and applying this mask to the iris. Additionally, we manually fix iris segmentation errors to study their impact on the gender classification. Our results show that occlusion masks can account for 6.92% of the gender classification accuracy on average. Therefore, works aiming to perform gender classification using the iris texture from normalized iris images should eliminate this correlation. [ABSTRACT FROM AUTHOR]

The LivDet‐2020 competition focuses on Presentation Attacks Detection (PAD) algorithms, has still open problems, mainly unknown attack scenarios. It is crucial to enhance PAD methods. This can be achieved by augmenting the number of Presentation Attack Instruments (PAI) and Bona fide (genuine) images used to train such algorithms. Unfortunately, the capture and creation of PAI and even the capture of Bona fide images are sometimes complex to achieve. The generation of synthetic images with Generative Adversarial Networks (GAN) algorithms may help and has shown significant improvements in recent years. This paper presents a benchmark of GAN methods to achieve a novel synthetic PAI from a small set of periocular near‐infrared images. The best PAI was obtained using StyleGAN2, and it was tested using the best PAD algorithm from the LivDet‐2020. The synthetic PAI was able to fool such an algorithm. As a result, all images were classified as Bona fide. A MobileNetV2 was trained using the synthetic PAI as a new class to achieve a more robust PAD. The resulting PAD was able to classify 96.7% of synthetic images as attacks. BPCER10 was 0.24%. Such results demonstrated the need for PAD algorithms to be constantly updated and trained with synthetic images. [ABSTRACT FROM AUTHOR]

The main contribution of this study is to show the effect of light-emitting diode (LED) modelling in the design of offline drives. The authors propose the use of a source voltage and resistance model (SVRM), consisting of a threshold voltage source in series with the characteristic resistance, for the modelling of the LED. The offline drive used for the analysis is the flyback converter operating in discontinuous conduction mode. The equivalent circuit is analysed by superposition and the AC circuit is analysed with phasors. The analysis has proven that the flyback converter can be modelled as a current source feeding the output capacitor in parallel with the load. Likewise, the analysis demonstrated that the current ripple is always greater than the voltage ripple when an LED is used as a load. In order to validate the theoretical analysis, a design methodology for the flyback converter with the SVRM as a load was developed. The designed circuit was simulated in Spice and implemented in a prototype. Experimental results using an LED as load are compared with the same circuit using a simple resistance as load. The experimental results confirm the theoretical analysis with an error of <6.6%. [ABSTRACT FROM AUTHOR]

In this contribution, the use of glycidyl methacrylate and styrene copolymers synthesized by nitroxide‐mediated polymerization (NMP) as chain extenders of postconsumer poly(ethylene terephthalate) waste (r‐PET) is described. Our observations revealed that the copolymers synthesized by NMP act as efficient chain extenders for the regeneration of PET waste. Epoxide groups in the copolymers react with PET end reactive groups producing chain extended PET with higher molecular weight and improving performance. The increase in molecular weight of PET waste results in important improvement in both, elongation‐at‐break, and strength impact. r‐PET complex viscosity and rheological moduli are also greatly improved as the epoxide content in the chain extenders increases. The loss tangent and phase angle versus angular frequency plots for chain‐extended r‐PET reveal that melt elasticity is also improved. These results confirm that use of NMP‐synthesized copolymers is a plausible solution for the recycling of PET. POLYM. ENG. SCI., 59:2255–2264, 2019. © 2019 Society of Plastics Engineers [ABSTRACT FROM AUTHOR]

Most gender classifications methods from near‐infrared (NIR) images have used iris information. Recent work has explored the use of the whole periocular iris region which has surprisingly achieved better results. This suggests the most relevant information for gender classification is not located in the iris as expected. In this work, the authors analyse and demonstrate the location of the most relevant features that describe gender in periocular NIR images and evaluate their influence in classification. Experiments show that the periocular region contains more gender information than the iris region. They extracted several features (intensity, texture, and shape) and classified them according to their relevance using the XgBoost algorithm. Support vector machine and nine ensemble classifiers were used for testing gender accuracy when using the most relevant features. The best classification results were obtained when 4000 features located on the periocular region were used (89.22%). Additional experiments with the full periocular iris images versus the iris‐occluded images were performed. The gender classification rates obtained were 84.35 and 85.75%, respectively. From results, they suggest focusing only on the surrounding area of the iris. This allows us to realise a faster classification of gender from NIR periocular images. [ABSTRACT FROM AUTHOR]

Summary: In this paper, the analysis, design, and implementation of a power supply based on a multi‐stage‐shunt class E amplifier applied to ozone generation are presented. The proposed topology operates with pulsating waveforms and allows unidirectional energy flow from the power supply to the load with no energy return. Furthermore, due to the multi‐stage operation, it presents a lower stress in the switches compared with other similar topologies. To validate the proposed topology, a prototype was designed to feed a set of ozone generating cells in a power range of 0 to 500 W. This prototype provides an efficiency of 95% with an ozone production of 10.5 g/h and efficacy of 22.89 g/kWh. The proposed power supply is an alternative to feed any other type of dielectric barrier discharge load while keeping the efficiency of the power supply above 90%. The analysis, design, and implementation of a power supply based on a multi‐stage‐shunt class E amplifier applied to ozone generation are presented; due to the multi‐stage operation, it presents a lower stress in the switches compared with other similar topologies and higher efficiency. To validate the proposed topology, a prototype was designed to feed a set of ozone generating cells in a power range of 0 to 500 W. [ABSTRACT FROM AUTHOR]

Involuntary choreiform movements are clinical hallmark of Huntington's disease, an autosomal dominant neurodegenerative disorder caused by an increased number of CAG trinucleotide repeats in the huntingtin gene. Involuntary movements start with an impairment of facial muscles and then affect trunk and limbs muscles. Huntington's disease symptoms are caused by changes in cortex and striatum neurons induced by mutated huntingtin protein. However, little is known about the impact of this abnormal protein in spinal cord motoneurons that control movement. Therefore, in this study we evaluated abnormalities in the motor unit (spinal cervical motoneurons, motor axons, neuromuscular junctions and muscle) in a mouse model for Huntington's disease (BACHD). Using light, fluorescence, confocal, and electron microscopy, we showed significant changes such as muscle fibers atrophy, fragmentation of neuromuscular junctions, axonal alterations, and motoneurons death in BACHD mice. Noteworthy, the surviving motoneurons from BACHD spinal cords were smaller than WT. We suggest that this loss of larger putative motoneurons is accompanied by a decrease in the expression of fast glycolytic muscle fibers in this model for Huntington's disease. These observations show spinal cord motoneurons loss in BACHD that might help to understand neuromuscular changes in Huntington's disease. [ABSTRACT FROM AUTHOR]

Objectives To test a new cognitive behavioral therapy for insomnia ( CBT-I) program designed for use by nonclinicians. Design Randomized controlled trial. Setting Department of Veterans Affairs healthcare system. Participants Community-dwelling veterans aged 60 and older who met diagnostic criteria for insomnia of 3 months duration or longer (N = 159). Intervention Nonclinician 'sleep coaches' delivered a five-session manual-based CBT-I program including stimulus control, sleep restriction, sleep hygiene, and cognitive therapy (individually or in small groups), with weekly telephone behavioral sleep medicine supervision. Controls received five sessions of general sleep education. Measurements Primary outcomes, including self-reported (7-day sleep diary) sleep onset latency ( SOL-D), wake after sleep onset ( WASO-D), total wake time ( TWT-D), and sleep efficiency ( SE-D); Pittsburgh Sleep Quality Index ( PSQI); and objective sleep efficiency (7-day wrist actigraphy, SE-A) were measured at baseline, at the posttreatment assessment, and at 6- and 12-month follow-up. Additional measures included the Insomnia Severity Index ( ISI), depressive symptoms (Patient Health Questionnaire-9 ( PHQ-9)), and quality of life (Medical Outcomes Study 12-item Short-form Survey version 2 ( SF-12v2)). Results Intervention subjects had greater improvement than controls between the baseline and posttreatment assessments, the baseline and 6-month assessments, and the baseline and 12-month assessments in SOL-D (−23.4, −15.8, and −17.3 minutes, respectively), TWT-D (−68.4, −37.0, and −30.9 minutes, respectively), SE-D (10.5%, 6.7%, and 5.4%, respectively), PSQI (−3.4, −2.4, and −2.1 in total score, respectively), and ISI (−4.5, −3.9, and −2.8 in total score, respectively) (all P < .05). There were no significant differences in SE-A, PHQ-9, or SF-12v2. Conclusion Manual-based CBT-I delivered by nonclinician sleep coaches improves sleep in older adults with chronic insomnia. [ABSTRACT FROM AUTHOR]

Different studies have demonstrated the importance of micronutrients, such as vitamins, for normal adult brain function and development. Vitamin C is not synthesized in the brain, but high levels are detected in this organ because of the existence of specific uptake mechanisms, which concentrate ascorbic acid from the bloodstream to the cerebrospinal fluid and then into neurons and glial cells. Two different isoforms of sodium-vitamin C cotransporters ( SVCT1 and SVCT2) have been cloned. SVCT2 expression has been observed in the adult hippocampus and cortical neurons by in situ hybridization. In addition, the localization of SVCT2 in the rat fetal brain has been studied by immunohistochemistry and in situ hybridization, demonstrating that SVCT2 is highly expressed in the ventricular and subventricular areas of the brain cortex. However, there are currently no immunohistochemical data regarding SVCT2 expression and function in the post-natal brain. Therefore, we analyzed SVCT2 expression in the developing brain cortex of mice, and demonstrated an increase in SVCT2 mRNA in mice at 1-15 days of age. The expression of a short isoform, SVCT2sh, was also detected within the same period. SVCT2 expression was concentrated in neurons within the inner layer of the brain cortex. Both SVCT2 isoforms were coexpressed in N2a cells to obtain functional data. Fluorescence resonance energy transfer analysis revealed a molecular interaction between SVCT2wt and SVCT2sh. Finally, differences in transport ratios suggested that SVCT2sh expression inhibited ascorbic acid uptake in N2a cells when both isoforms were coexpressed. [ABSTRACT FROM AUTHOR]

At birth, synaptic sites in developing rodent muscles are innervated by numerous motor axons. During subsequent weeks, this multiple innervation disappears as one terminal strengthens, and all the others are eliminated. Experimental perturbations that alter neuromuscular activity affect the rate of synaptic refinement, with more activity accelerating the time to single innervation and neuromuscular blockade retarding it. However, it remains unclear whether patterns of muscle use (driven by endogenous neuronal activity) contribute to the rate of synapse elimination. For this reason we examined the timing of supernumerary nerve terminal elimination at synapses in extraocular muscles (EOMs), a specialized set of muscles controlling eye movements. On the basis of their exceptionally high patterns of activity, we hypothesized that synaptic refinement would be greatly accelerated at these synapses. We found, however, that rates of synaptic refinement were only modestly accelerated in rectus and oblique EOMs compared with synapses in somite-derived skeletal muscle. In contrast to these results, we observed a dramatic delay in the elimination of supernumerary nerve terminals from synapses in the levator palpebrae superioris (LPS) muscle, a specialized EOM that initiates and maintains eyelid elevation. In mice, natural eye opening occurs at the end of the second postnatal week of development. Thus, although synapse elimination is occurring in most EOMs and somite-derived skeletal muscles, it appears to be dramatically delayed in a set of specialized eyelid muscles that remain immobile during early postnatal development. J. Comp. Neurol. 519:2907-2921, 2011. © 2011 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

The article discusses the characterization of high trans-1,4-poly(butadiene) (TPBD), examining the synthesis of TPBD via anionic polymerization in determining the effects of 1,4-trans units of the polymers' properties. Poly(butadiene)-containing polymers improve viscoelastic properties of modified asphalt and engineering plastics, the authors state. Other topics include experience-induced crystallization and the direct relationship between a polymer's microstructure and its thermal properties.

In this study, a series of reactive block copolymers of glycidyl methacrylate (G), styrene (S), and maleic anhydride (MA) (GS–SMA–GS), with well‐defined properties and high number average functionalities, is presented. They were synthesized through reversible addition–fragmentation chain transfer polymerization (RAFT) and evaluated as chain extenders in reactive extrusion recycling of poly(ethylene terephthalate) (rPET). Modification of the process using GS–SMA–GS results in increased melt flow and intrinsic viscosities higher than those of conventional rPET. Results show that increasing epoxide content makes chain organization in rPET difficult and promotes lower crystallization rates and lower degrees of crystallinity, both of which are characteristics suited to produce preforms with the desired clarity. Chain‐extended rPET exhibits improved rheological characteristics with increasing glycidyl methacrylate content. Chain‐extended rPET using GS–SMA–GS shows enhanced complex viscosity; elastic and viscous modules, which are indicative of high melt elasticity, improved mechanical properties, and processability. © 2018 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2018, 135, 46771. [ABSTRACT FROM AUTHOR]

The bulk reversible addition‐fragmentation chain transfer (RAFT) copolymerization of glycidyl methacrylate (GMA) and styrene (S) at several GMA molar feed fractions in the presence of 2‐cyano isopropyl dodecyl trithiocarbonate as RAFT agent and 1,10‐azobis(cyclohexane carbonitrile) as initiator is reported. The reaction conditions are similar to those used in the industrial production of crystal and high‐impact polystyrene by free radical polymerization with the purpose of synthesizing well‐defined copolymers in current industrial processes with only minor changes. Reactivity ratios calculated with linear Kelen–Tüdos, extended Kelen–Tüdos, and nonlinear regression (error in all variables) methods are reported. The results obtained suggest that the RAFT process modifies copolymer composition development. Increased preference for the monomer with the higher reactivity ratio is observed. The reversible addition‐fragmentation chain transfer (RAFT) copolymerization of styrene and glycidyl methacrylate is carried out at reaction conditions similar to those used in the industrial production of crystal and high‐impact polystyrene. The combination of monomers, initiators, and RAFT agents used is unique. Reactivity ratios calculated with linear and nonlinear regression methods suggest that the RAFT process modifies the development of copolymer composition. [ABSTRACT FROM AUTHOR]