In macromastia, especially in patients with a raised BMI, the nipple areola complex (NAC) may be displaced from the breast midline/meridian. This is poorly documented, and there is little published on surgical management. The aim of the study was to identify the incidence of displaced NAC in macromastia and discuss the management using the superomedial pedicle, by canting the vertical limbs of the inverted T/keyhole. The study also aimed to postulate a theory of pathogenesis.

Methods: The study is a retrospective review for a two-and-a-half year period. For study inclusion, the NAC had to be displaced 3 cm or more from the breast meridian. A superomedial pedicle was used with an inverted T pattern. The vertical limbs of the keyhole were canted medially for medially displaced NACs and laterally for laterally displaced NACs.

Results: Fifteen patients were identified: three with medial and 12 with laterally displaced NAC. Mean age was 35 years (range 21-61) with a mean BMI of 31 (range 27-37). The mean mass of tissue excised was 1158 g (range 330-1969 g). The mean follow up is 7 months (range 2-21 months). One patient suffered partial areola loss, and 2 patients had a breakdown at the angle of sorrow/inverted T junction.

Conclusions: The displaced NAC is not uncommon in women with a raised BMI presenting for breast reduction. Canting the vertical limbs of the keyhole away from the deviated NAC yields satisfactory results in treating patients with a displaced NAC using a superomedial pedicle. A theory of possible pathogenesis is postulated; global attenuation of the breast footplate occurs, leading to lateral and inferior displacement of the NAC.

Obstructive sleep apnea is a serious health issue affecting more than one billion people worldwide. Although continuous positive airway pressure is the mainstay for the treatment of obstructive sleep apnea, hypoglossal nerve stimulation is a surgical option for patients who are unable to tolerate or adhere to this therapy. As more hypoglossal nerve stimulators are implanted, these patients will present with increasing frequency for medical procedures requiring general anesthesia or deep sedation. We describe our experience with one such patient and hope this information can be used to develop future guidelines to aid in the anesthetic management of these patients.

Keywords: alveolar hypoventilation; central alveolar hypoventilation; continuous positive airway pressure (cpap); hypoglossal nerve stimulator; implantable medical device; obstructive sleep apnea (osa); perioperative evaluation.

The fallen lung sign describes the lung collapse at the dependent region away from the hilum. It is usually a specific sign for complete bronchial tear. We present a case of a young patient post mechanical ventilation for a traumatic head injury with unexpected CT thorax findings of fallen lung secondary to a partial bronchial tear. The patient was managed conservatively with specific ventilator strategy and successfully discharged home. Partial bronchial tear with fallen sign is a very rare cases reported.

Keywords: Bronchial tear; Fallen lung sign; Trauma.

Botulinum toxin injection has been widely used for facial rejuvenation, with high rates of efficacy and patient satisfaction. In this article, we describe a reproducible phenomenon of unilateral double eyelid formation with the treatment of upper facial rhytides using botulinum toxin. A 38-year-old man was given onabotulinum toxin A injections in the frontal stria and glabellar lines. The procedure was repeated after 6 months. Unilateral double eyelids were noted twice on the right side about 7 days after each injection. The maintenance time for each procedure was about 1 month. The rhytides improved about 3 days after each injection and were maintained for about 4 months. No adverse effects were observed. This rare phenomenon could be due to the compensatory increased strength of the levator palpebrae superioris muscle and the anatomical structure of the patient's right eyelid.

Anemarrhena asphodeloides is an immensely popular medicinal herb in China, which contains an abundant of mangiferin. As an important bioactive xanthone C-glycoside, mangiferin possesses a variety of pharmacological activities and is derived from the cyclization reaction of a benzophenone C-glycoside (maclurin). Biosynthetically, C-glycosyltransferases are critical for the formation of benzophenone C-glycosides. However, the benzophenone C-glycosyltransferases from Anemarrhena asphodeloides have not been discovered. Herein, a promiscuous C-glycosyltransferase (AaCGT) was identified from Anemarrhena asphodeloides. It was able to catalyze efficiently mono-C-glycosylation of benzophenone, together with di-C-glycosylation of dihydrochalcone. It also exhibited the weak O-glycosylation or potent S-glycosylation capacities toward 12 other types of flavonoid scaffolds and a simple aromatic compound with -SH group. Homology modeling and mutagenesis experiments revealed that the glycosylation reaction of AaCGT was initiated by the conserved residue H23 as the catalytic base. Three critical residues H356, W359 and D380 were involved in the recognition of sugar donor through hydrogen-bonding interactions. In particular, the double mutant of F94W/L378M led to an unexpected enzymatic conversion of mono-C- to di-C-glycosylation. This study highlights the important value of AaCGT as a potential biocatalyst for efficiently synthesizing high-value C-glycosides.

Keywords: Active sites; Anemarrhena asphodeloides; Benzophenone; C-glycosides; C-glycosyltransferases.

Smartphone abuse interferes with all activities in daily life. Young people who tend to have a smartphone addiction (SA) also have social, familiar and academic problems. Furthermore, smartphone provides immediate access to communication as well as avoids experiencing social anxiety. This research aims to evaluate the factorial structure of Smartphone Addiction Risk Children Questionnaire (SARCQ), a specific questionnaire created to assess the risk of SA in primary school children (8-11 years). An exploratory factor analysis before and a confirmatory factor analysis after were performed in order to establish the factorial structure of the questionnaire. Results showed a two-factor structure explaining 49.30% of total variance. The outstanding dimensions are: "I'm not afraid with you" (INAWY) and "Linus blanket" (LB). SARCQ will be useful to assess the risk of SA in childhood in order to operate early effective therapeutic interventions.

Keywords: C.F.A; Childhood; New technology; Questionnaire; SARCQ; Smartphone addiction.

A method for quantitative estimation of density in a high-speed flow field is presented, which uses structured illumination to interrogate the region of interest (ROI). Wavefront distortion suffered by the interrogating beam as it passes through the shock-induced flow field is investigated. Customized camera optics is used to measure the cross-sectional intensities of the exiting wavefront at two different planes, concurrently. A technique is proposed that uses the displacement of the structured light pattern to estimate the axial intensity derivative, ∂I∂z, which is the input to the transport-of-intensity equation (TIE) for phase estimation. The proposed method allows the use of images with larger defocused distances, ∂z, as it does not follow the conventional recipe of finite-difference (FD) approximation for intensity derivative estimation. This flexes two requirements of conventional TIE imaging: first, it brings flexibility in imaging optics, not restricted to small f-number objectives; second, use of a sensitive camera is optional, as ∂I∂z estimation does not use absolute intensities but information from the distorted pattern of structured light. The recovered phase from the TIE is used as an input to the phase tomography algorithm to obtain the refractive index followed by density distributions in the flow field quantitatively. The proposed phase estimation technique is verified through simulations first and then is implemented in experiments conducted in a hypersonic shock tunnel for flow Mach No. of 8.8. Estimated cross-sectional densities of the flow field around the aerodynamic test model are presented and compared with the numerically estimated values, which shows good agreement.

The potential of Brillouin scattering lidar for detecting the mixed layer depth (MLD) was studied. We simulated the Brillouin scattering lidar signal in various water environmental parameters and developed an MLD retrieval model for Brillouin scattering lidar data. We first analyzed the theoretical maximum detectable depth for Brillouin scattering lidar in low-latitude sea regions based on the multiple scattering lidar equations. Subsequently, a theoretical method for calculating the Brillouin scattering frequency shift and linewidth was derived based on the international thermodynamic equation of seawater-2010 and the coupled wave equations. Then we used the theoretical method and the temperature-salinity (T-S) profile of the global Argo data in low-latitude regions to simulate the vertical profile distribution of the Brillouin scattering frequency shift and linewidth. Furthermore, we used a maximum angle method to estimate the ocean MLD in low-latitude regions based on the vertical profile distribution of the Brillouin scattering frequency shift and density in seawater. They are well correlated, which indicates that the frequency-shift component of the Brillouin scattering lidar signal for estimating ocean MLD is feasible and reliable. It appears that airborne or spaceborne Brillouin scattering lidar technology provides great potential for high-efficiency, large-area, and long-term monitoring of the global ocean MLD and upper-ocean water bodies.

Three-dimensional direct laser writing based on a two-photon polymerization process of hybrid organic-inorganic material was used to print micrometer-scale refractive phase elements that were designed to manipulate incoming Gaussian beams into line and square intensity-flattened profiles. Here we present new results of shaping light beams, enabled by tailoring a two-photon absorption process for printing hybrid material structures based on a fast solgel process. The optical design and calculations of the optical elements are described, along with characterization of their performance in manipulating incoming light beams. The novelty described in this work, to the best of our knowledge, is the implementation of 3D solgel materials as better and improved micro-optics. This new ability provides upgraded 3D high resolution and smooth, printed optical phase structures using tailored hybrids with improved optical and mechanical properties compared to standard common photoresists. This opens new and exciting opportunities for compact and robust beam shaping by reaching glassy material properties and overcoming limitations of organic polymers.

By offering a wide license-free spectrum, visible light communication (VLC) has emerged as a game-changing technology for networks beyond 5G. In this study, the multiple-input multiple-output (MIMO) technology is combined with a non-orthogonal multiple access VLC (NOMA-VLC) system to provide a reliable error-free high data rate network for multi-user scenarios. A generalized L-PPM modulated MIMO based multi-user NOMA-VLC system with M×N line-of-sight connections for each user is presented. Considering a practical scenario of imperfect successive interference cancellation, a novel closed form formulation of error probability for the proposed system is obtained. This study also includes a comprehensive analysis of two-user and three-user L-PPM modulated 2×2 MIMO-NOMA-VLC systems, and exact error probability expressions are derived. With the identical set of parameters, the L-PPM modulated MIMO-NOMA-VLC system totally outperforms the on-off keying modulated MIMO-NOMA-VLC system. As the number of photodetectors per user increases, the error probability of the considered system decreases. An L-PPM modulated 2×2 MIMO based three-user NOMA-VLC system offers the best performance at a power allocation co-efficient of 0.3. The simulation results validate the derived error probability expressions.

Line laser scanning measurement is a major area of interest within the field of 3D laser scanning measurement. Traditionally, sub-pixel extraction of laser stripes is a dominant point for line laser scanning measurement. In particular, the noise separation of laser stripe images and the accuracy of feature extraction of the laser stripe are the main challenges for sub-pixel extraction of laser stripes in complex circumstances. To this end, this study utilizes a robust and accurate method with two steps to extract sub-pixel features of laser stripes for 3D laser scanning measurement. Laser stripe segmentation based on a deep semantic segmentation network is initially implemented for noise elimination of images. Then, the sub-pixel extraction of the gray peak points of laser stripes is accomplished by Shepard sub-pixel interpolation and gray surface fitting, which can adequately utilize the gray distribution of laser stripes and obtain high-precision and anti-interference results. The robustness, effectiveness, and accuracy are verified by comparative experiments with classical methods. The results indicate that the proposed method can obtain much more complete, denser, and smoother results than traditional methods, especially in challenging measurement conditions, such as a large curved surface, a highly reflective surface, or intense ambient light. The accuracy of the proposed method can meet the requirements of high-precision measurement.

In this study, we proposed a point diffraction interferometer based on birefringence polarization beam splitting (BPBS-PDI) for transmission wavefront measurements. Using the polarization beam splitting property of birefringent crystals and a specially designed calcite crystal as a polarization beam splitter, two beams of linearly polarized light with orthogonal polarization directions and a small angular separation can be obtained to produce the reference and test beams with perpendicular polarization directions through a pinhole point diffraction plate. By introducing spatial synchronization phase-shifting technology, influencing factors such as environmental vibrations on the measurement results, are reduced. Subsequently, the birefringent crystal and system error calibration methods were studied. Finally, a BPBS-PDI experimental device was set up to obtain the wavefront distribution of the lens to be tested. The experimental results are consistent with those of the ZYGO interferometer, indicating that the BPBS-PDI wavefront measurement method can be used to measure a lens transmission wavefront with high accuracy.

Polarization detection of space targets is one of the most important research directions in the field of space target recognition. In view of the fact that there are problems such as strong background noise and inconspicuous details of contour features in the polarization image of space targets, an image denoising and enhancement strategy is proposed. To solve the problem of high intensity of Gaussian noise in degree of polarization (DoP) images, a denoising method named adaptive noise template prediction (ANTP) is proposed to eliminate the noise. Compared to the existing methods, the ANTP algorithm performs better at reducing noise and improving image quality. Aiming at the difficulty of separating the background noise from angle of polarization (AoP) images, a denoising method named gray analysis of local area (GALA) is proposed. Compared to traditional methods, the GALA algorithm can effectively extract the contour features of targets and improve the contrast of AoP images. An image fusion method based on discrete cosine transform and local spatial frequency (LSF) is used to fuse the denoised DoP image and AoP image. The experimental results of the simulated and real space target polarization detection confirm the effectiveness of our proposed strategy.

In this paper, an annular winding structure made of single-mode optical fiber is proposed as the core of a cost-efficient and reliable annular optical fiber temperature sensor (AOFTS). The sensor is mainly due to the multi-mode interference effect to achieve real-time response to external temperature changes. The experimental results show that the average temperature sensitivity of the sensor is about 255.5 pm/°C in the temperature range of -20^∘C-110^∘C; it has higher sensitivity at low temperatures. At -20^∘C, the sensitivity of the AOFTS reaches 450 pm/°C. The sensor has the advantages of simple fabrication, low fabrication cost, strong stability, and good reproducibility and repeatability. It has great application prospects in the field of low-temperature detection.

This erratum serves to correct an error in Appl. Opt.60, 9167 (2021).APOPAI0003-693510.1364/AO.438287.

Approximately half of all women presenting to the emergency department with angina chest pain do not have obstructive coronary artery disease (CAD) on coronary angiography. This condition is termed non-obstructive coronary artery disease (NOCAD), and includes ischemia with no obstructive coronary artery disease (INOCA) and myocardial infarction with non-obstructive coronary arteries (MINOCA). Oxidative stress has been reported to be involved in the development and progression of CAD. However, a scarcity of studies has assessed a correlation between oxidative stress and NOCAD. Thus, a literature review was performed of available reports on the role of oxidative stress in NOCAD. Possible mechanisms involved in oxidative stress that may contribute to NOCAD were identified and evaluated. A key finding of this literature review was that oxidative stress caused vasoconstriction and endothelial damage, and this results in coronary microvascular dysfunction and vasospasm, which, in turn, lead to the pathogenesis of NOCAD.

Keywords: coronary artery disease; non-obstructive coronary artery disease; oxidative stress.

Computer vision plays an important role in the accurate foreground detection of medical images. Diagnosing diseases in their early stages has effective life-saving potential, and this is every physician's goal. There is a positive relationship between improving image segmentation methods and precise diagnosis in medical images. This relation provides a profound indication for feature extraction in a segmented image, such that an accurate separation occurs between the foreground and the background. There are many thresholding-based segmentation methods found under the pure image processing approach. Minimum cross entropy thresholding (MCET) is one of the frequently used mean-based thresholding methods for medical image segmentation. In this paper, the aim was to boost the efficiency of MCET, based on heterogeneous mean filter approaches. The proposed model estimates an optimized mean by excluding the negative influence of noise, local outliers, and gray intensity levels; thus, obtaining new mean values for the MCET's objective function. The proposed model was examined compared to the original and related methods, using three types of medical image dataset. It was able to show accurate results based on the performance measures, using the benchmark of unsupervised and supervised evaluation.

Keywords: MRI Alzheimer; MRI brain tumor; heterogeneous mean filters; images segmentation; improving minimum cross entropy thresholding; skin lesion.

Model understanding is critical in many domains, particularly those involved in high-stakes decisions, e.g., medicine, criminal justice, and autonomous driving. Explainable AI (XAI) methods are essential for working with black-box models such as convolutional neural networks. This paper evaluates the traffic sign classifier of the Deep Neural Network (DNN) from the Programmable Systems for Intelligence in Automobiles (PRYSTINE) project for explainability. The results of explanations were further used for the CNN PRYSTINE classifier vague kernels' compression. Then, the precision of the classifier was evaluated in different pruning scenarios. The proposed classifier performance methodology was realised by creating an original traffic sign and traffic light classification and explanation code. First, the status of the kernels of the network was evaluated for explainability. For this task, the post-hoc, local, meaningful perturbation-based forward explainable method was integrated into the model to evaluate each kernel status of the network. This method enabled distinguishing high- and low-impact kernels in the CNN. Second, the vague kernels of the classifier of the last layer before the fully connected layer were excluded by withdrawing them from the network. Third, the network's precision was evaluated in different kernel compression levels. It is shown that by using the XAI approach for network kernel compression, the pruning of 5% of kernels leads to a 2% loss in traffic sign and traffic light classification precision. The proposed methodology is crucial where execution time and processing capacity prevail.

Keywords: convolutional neural network; explainable AI; network compression.

Using polarized light sensors to obtain only two-dimensional heading information does meet actual needs in navigation. Instead, an alternative method is proposed that uses the positional information of the Sun and geomagnetic information to calculate the three-dimensional attitude of a vehicle. First, the theoretical background of the polarization mode of skylight is described, and the scheme in using the atmospheric polarization pattern to calculate the solar position is presented. Second, the traditional three-axis attitude-determination (TRIAD) algorithm that exploits the solar position vector and the geomagnetic vector to obtain the three-dimensional attitude and the optimized TRIAD algorithm are introduced. Static and turntable experiments are described that verify the accuracy of the attitude calculation. Experimental results show that when using the optimized TRIAD algorithm, the root mean square errors for the roll angle, pitch angle, and heading angle are 0.1225°, 0.668°, and 1.0234°, respectively. This means that the optimized TRIAD algorithm performs significantly better than the traditional TRIAD algorithm and demonstrates that using the solar position and the geomagnetic information to obtain the three-dimensional attitude of the vehicle is very effective.

Metalenses exhibit excellent performance as a new type of optical element; mid-infrared devices based on metalenses are advantageous to numerous applications in biomedical, military and industrial fields. The demand for large-area and high-efficiency mid-infrared metalenses has increased in recent years. However, the current processing methods for metalens production introduce different types of processing errors. Therefore, qualitative analyses of various errors that may exist in the processing of metalenses should be performed. In this study, we use the finite-difference time-domain calculation method and introduce various typical errors into a transmission phase-based mid-infrared metalens for simulation and analysis. The simulation results show that the defects caused by these processes affect focusing efficiency, and that some defects affect the quality of light. Subsequently, we prepare a metalens within the allowable error range and test its optical performances. The experiment confirms the excellent imaging performance of our metalens. Our study can help manufacturers identify defects to improve manufacturing processes, thereby enabling the incorporation of metalenses in industrial applications.

The machining of freeform surfaces is a current research hotspot: A slow tool servo (STS) has limitations in machining accuracy and efficiency for large steep freeform surfaces. Most fast tool servo (FTS) tools are limited by their stroke and cannot manufacture freeform surfaces with a large sag. We propose a hybrid slow-fast tool servo method that combines STS and FTS to machine large steep freeform surfaces by decomposing the freeform surfaces and simultaneously turning efficiently with STS and FTS. Experimental studies were undertaken to fabricate a saddle surface. Meanwhile, a variable feedrates tool path was designed and applied to further improve the machining efficiency. The results show that this method can improve the processing efficiency by 47.5%. The arithmetic mean of surface roughness (Ra) is 2-4 nm, and the peak-to-valley (PV) value is 0.4780 µm at the hollows and 0.3884 µm at the swells.

Data on the refractive index of silver thin films are scarce in the literature, and largely dependent on both the deposition method and thickness. We measure the refractive index of silver films at cryogenic temperature with a technique that takes advantage of the absorption of the films and the corresponding peculiar properties of Fabry-Perot cavities: a frequency shift between the reflection and transmission peaks, together with a modified cavity bandwidth. We demonstrate a decrease in the real value of the refractive index, together with a decrease in its imaginary value at 4 K.

We present an erratum to our recent work [Appl. Opt.60, 10862 (2021)APOPAI0003-693510.1364/AO.440435] that corrects errors in Fig. 4 and the body of the paper. The corrections do not affect the results and conclusions of the original paper.

Background: External rectal prolapse is a relatively rare disease, in which male patients account for a minority. The selection of abdominal repair or perineal repair for male patients has rarely been investigated.

Methods: Fifty-one male patients receiving abdominal repair (laparoscopic ventral rectopexy) or perineal repair (Delorme or Altemeier procedures) at the Sixth Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) between March 2013 and September 2019 were retrospectively analysed. We compared the recurrence, complication rate, post-operative defecation disorder, length of stay, and quality of life between the abdominal and perineal groups.

Results: Of the 51 patients, 45 had a complete follow-up, with a median of 48.5 months (range, 22.8-101.8 months). A total of 35 patients were under age 40 years. The complication rate associated with abdominal repair was less than that associated with perineal repair (0% vs 20.7%, P = 0.031) and the recurrence rate was also lower (9.5% vs 41.7%, P = 0.018). Multivariate analysis showed that perineal repair (odds ratio, 9.827; 95% confidence interval, 1.296-74.50; P = 0.027) might be a risk factor for recurrence. Moreover, only perineal repair significantly improved post-operative constipation status (preoperative vs post-operative, 72.4% vs 25.0%, P = 0.001). There was no reported mortality in either of the groups. No patient's sexual function was affected by the surgery.

Conclusions: Both surgical approaches were safe in men. Compared with perineal repair, the complication rate and recurrence rate for abdominal repair were lower. However, perineal repair was better able to correct constipation.

Keywords: Altemeier; Delorme; external rectal prolapse; laparoscopic ventral rectopexy; male.