This research delves into the critical domain of high-temperature pressure vessel design, focusing on SA 387 Grade 11 Class 2 steel—an exceptional material known for its resistance to both corrosion and high temperatures. The study combines experimental investigations and numerical simulations to explore the intricate temperature distributions within this material during the Submerged Arc Welding (SAW) process. Experimental endeavors entailed welding SA387 steel plates under controlled conditions, precisely measuring temperatures at key locations. Concurrently, a numerical finite element analysis (FEA) model was developed, incorporating a 3D Goldak’s double ellipsoidal heat source model within ANSYS software. The research seamlessly integrates these two approaches, allowing for a comprehensive comparison of experimental and numerical temperature data. The results highlight the capacity of the FEA model to predict temperature profiles during SAW accurately, presenting a potent tool for optimizing welding parameters without extensive trial and error. Furthermore, this study advances our comprehension of welding processes involving high-temperature-resistant materials, offering valuable insights for industries requiring operations at elevated temperatures.

Passiflora is a plant genus known for its extremely distinctive and colorful flowers and a wide range of genome sizes (over ten-fold variation). However, the relationship between differences in genome size and organization and the variations in flower size and morphology among Passiflora species remains largely unexplored. Here, we assembled a chromosome-scale genome of Passiflora foetida, which is a close relative of the commercial passionfruit P. edulis. While the genome of P. foetida contains a substantial proportion of repetitive elements (66.7% of 424.16 Mb), it possesses significantly fewer copies of long terminal repeat retrotransposons (LTR-RTs) compared to P. edulis (83.94% of 1278.14 Mb; 87.29% of 1241.66 Mb). The disparity in LTR-RTs is one of the main contributors to the differences in genome sizes between these two species and possibly in floral traits. Additionally, we observed variation in insertion times and copy numbers of LTR-RTs across different TE lineages. Then, by integrating transcriptomic data from 33 samples (eight floral organs and flower buds at three developmental stages) with phylogenomic and metabolomic data, we conducted an in-depth analysis of the expression, phylogeny, and copy number of MIKC-type MADS-box genes and identified essential biosynthetic genes responsible for flower color and scent. Our study provides new insights on genome size variation and the evolution of flower development in two important Passiflora species.

Anthropogenic climate change is creating a more flammable future by increasing the number of days when vegetation is dry enough to burn. Indices representing the percent moisture content of dead fine fuels as derived from meteorological data have been used to assess geographic patterns and temporal trends in vegetation flammability. To date, this approach has assumed a single flammability threshold, typically between 8 and 12%, controlling fire potential regardless of the vegetation type or climate domain. Here we investigate geographic variation in fuel moisture levels associated with observed fire activity among ecoregions by analysing global reanalysis data and remotely sensed burnt area products. This geospatial analysis identified a wide range of ecoregion flammability thresholds (EFTs) associated with fire activity, often well above or below the commonly used range of values. Many boreal and temperate forests, for example, can burn with much higher fuel moisture than previously identified; Mediterranean forests, on the other hand, tend to burn with consistently low fuel moisture. Bayesian modelling showed that EFTs are primarily driven by eco-climatological variables, particularly precipitation and temperature. Our analysis also identified complex associations between vegetation structure, fuel types, and climatic conditions highlighting the complexity in vegetation-climate-fire relationships globally. Our study provides a critical, necessary step in understanding and describing global pyrogeography and tracking changes in spatiotemporal fire activity.

Epithelial ovarian cancer is a disease with the highest mortality rate among gynecological tumors. After years of studies, despite targeted drugs and immunotherapies have been developing, their therapeutic effects are still not ideal. Statins, as lipid-lowering medicines, have many findings beyond expectation in the fight against cancer, and have shown promisingly positive results in clinical trials. Actually, statins cannot be used as a monotherapy to achieve complete remission due to its efficacy established, but for its great potential lying in effects about synergism and sensibilization with other drugs, and even the reduction of side effects of anti-cancer treatment. This review summarizes the evidence and potential of combining statins with first-line chemotherapy, bevacizumab, PARP inhibitors and immunotherapy drugs in the pharmacotherapy of ovarian cancer, and proposes hypothesises about new combination therapies based on the current mechanisms and theories, to provide a new perspective to further experimental research and clinical trials.

Background and Purpose: The co-use of opioids and other drugs is prevalent, both in a clinical setting and during opioid misuse. We investigated whether drug-drug interactions occur between oxycodone and xylazine, diazepam, etizolam, and methamphetamine using rat liver microsomes. Experimental Approach: Michaelis–Menten parameters (Km, Vmax), and intrinsic clearance (CLint) of oxymorphone and noroxycodone formation were determined. Inhibition Kis for xylazine, diazepam, and etizolam were assessed. Inhibition of oxycodone and dextromethorphan (probe substrate) metabolite formation by selective P450- and test-inhibitors was investigated. Key Results: Km values of oxymorphone (75 μM) and noroxycodone (74 μM) formation were similar. The Vmax of noroxycodone formation (1235 pmol/min/mg) was higher than oxymorphone (354 pmol/min/mg), leading to three times higher CLint of noroxycodone. Xylazine and etizolam were competitive inhibitors of oxymorphone (Ki = 0.5 and 9.5 μM, respectively) and noroxycodone (Ki = 2.6 and 14.6 μM, respectively) formation, while diazepam was a competitive inhibitor of oxymorphone formation (Ki = 3.7 μM) and a mixed inhibitor of noroxycodone formation (Ki = 8.3 μM). Xylazine, diazepam, and etizolam, as well selective P450-inhibitors, were confirmed to inhibit both CYP2D- and CYP3A-mediated pathways in rat liver microsomes. Methamphetamine was a moderate inhibitor of oxymorphone formation, and weak inhibitor of noroxycodone formation. Conclusion and Implications: Xylazine, diazepam, and etizolam are potent inhibitors of the formation of both primary oxycodone metabolites and leading to potential drug-drug interactions. Further, xylazine, diazepam, and etizolam could inhibit both CYP2D- and CYP3A-mediated pathways, leading to potentially altered drug metabolism of other opioids and substrates.

Background Single-lead ECG devices may allow detection and diagnosis of cardiac rhythms. However, data on their accuracy for detecting cardiac arrhythmias beyond atrial fibrillation are limited. Objectives To determine the accuracy of the AliveCor KardiaMobile (AC; AliveCor Inc, Mountain View, CA) for the diagnosis of arrhythmias against gold standard cardiac electrophysiology study (EPS). Methods Patients undergoing clinically indicated EPS underwent simultaneous rhythms recording with an infraclavicular-placed AC, standard 12-lead ECG and EP catheters for intracardiac electrograms. Rhythms recorded during EPS were classified based on electrogram, 12-lead ECG and clinical findings. Blinded reviewers provided differential diagnoses for the single-lead AC tracings; a separate reviewer compared diagnoses made between the AC tracings and EPS findings. Results From 49 patients, 843 cardiac rhythms were captured during 502 AC recordings. Analysis of tracings containing sinus rhythm (n=273) returned overall accuracy of 92%, with sensitivity and specificity values of 93% and 92%, respectively. Accuracy for tracings per rhythm were atrial fibrillation 91% (n=51); supraventricular tachycardia accuracy was 89% (n=191), ventricular tachycardia 91% (n=198), ventricular fibrillation 98% (n=11), asystole 100% (n=5). Accuracy for supraventricular ectopy was 93% (n=28) and premature ventricular complexes was 91% (n=86). Overall accuracy was 94% for uninterrupted rhythms and 93% in tracings from patients with baseline bundle branch block. Conclusions When compared against the gold standard EPS diagnosis, interpretation of arrhythmias recorded by an AliveCor single-lead ECG device had reasonable diagnostic accuracy.

Title: Leadless Pacemakers in Post Operative Patients: Is It Time For the New to Become the Normal?Invited Editorial: Manuscript ID JCE-23-0567.R2Tyler P. Rasmussen, MD, PhD and E. Michael Powers, MD, MBAUniversity of Iowa Carver College of MedicineDivision of Cariology, Clinical Cardiac Electrophysiology200 Hawkins Dr.Iowa City, IA 52242Edward-powers@uiowa.eduMerchant et al. describe a single center retrospective analysis of leadless pacemaker (LP) implant following cardiac surgery or transcatheter valvular procedures that highlights the performance of LPs when implanted in patients with atrioventricular block (AVB) and either high risk features for conventional transvenous pacing or permanent atrial fibrillation (1). LPs performed well with a limited number of patients (7%) requiring conversion to transvenous pacing and only a single procedural complication. However, there was a statistically significant decline in left ventricular ejection fraction (LVEF) in the overall cohort. When subgroup analysis was performed, LVEF decline was only seen in those implanted with VVI devices but not in patients with VDD devices. Here, we discuss implications of this study.Transcatheter aortic valve implantation (TAVI) is now more common than surgical AVR but carries a greater risk of high degree atrioventricular block (AVB) (~10%) (2,3). Cardiac surgery has been linked to a 1-3% risk of permanent pacemaker implantation with higher rates in patients undergoing valve replacement (4). Therefore, the number of patients at risk for AVB related to cardiac surgery and catheter-based valve interventions is increasing over time and warrants a critical evaluation of optimal pacing strategy.Longitudinal registry data show that Micra (Medtronic, Minneapolis, MN) LPs have fewer required reinterventions and chronic complications compared to conventional transvenous pacing systems (5). Furthermore, mortality is comparable despite being implanted in patients with higher rates of end stage renal disease (ESRD) and medical complexity (5). LPs greatly outperform transvenous systems with respect to device related infections, as the rate of infection in LPs is trivial both short and long term (5,6). The risk of pacing induced cardiomyopathy (LVEF drop ≥ 10%) in pacemaker dependent patients is suggested to be equivalent or lower in those implanted with an LP (3%) versus those with a transvenous system (~13%) (7). A major drawback to the use of LPs is their inability to provide atrial pacing, which typically limits their use to patients without sinus node dysfunction.The current paper demonstrates that the use of LPs is a viable strategy in post-operative patients. Their cohort included 50 patients having undergone cardiac surgery and 28 with a transcatheter valvular procedure (1). Of the 28 transcatheter procedures, 25 were TAVI. Factors prompting an LP implant versus transvenous were permanent AF, ESRD, tricuspid valve pathology, history of endovascular infection, and dermatological disease. Mean time from surgery to device implant was 7.3 ± 8.0 days, which suggests an adequate waiting period for AV conduction recovery in most circumstances. The only complication in the cohort (1.3%) was an access site hematoma requiring evacuation. Device parameters were stable at follow-up with a small but clinically insignificant decline in impedance and trivial rise in threshold, which is consistent with previously published data regarding Micra (6). The two major findings were that the pacing burden declined significantly in the follow-up period and that there was a significant reduction in the left ventricular ejection fraction (LVEF) in this cohort. Pacing percentages fell from mean 75% at implant to mean 48% at follow-up. The reduction in pacing burden suggests that many patients have late recovery in AV conduction post procedure. There was a drop in LVEF from baseline (55.0% ± 10.6%) versus follow-up (51.5% ± 11.2%, p =< 0.001), but this study is not designed to determine if the LVEF drop is because of the Micra or another unidentifiable factor. Importantly, the drop in LVEF was significant in the Micra VR group: baseline (54.1% ± 11.9%) versus follow-up (48.8% ± 11.9%, p = 0.003) but not in the Micra AV group: baseline (56.1 ± 9.0%) versus (54.6% ± 9.7%, p = 0.06). The only patient characteristic that was associated with a significant drop in LVEF (> 10%) versus those with stable EF was having a prior history of heart failure with a reduced ejection fraction. Taken together, this study showed that both Micra AV and VR can provide safe RV pacing in post-operative patients with a small, but significant risk for LVEF reduction that is likely linked to right ventricular pacing.

Alzheimer’s Disease (AD) is a neurodegenerative disorder that causes loss of neural connections in the cells, and brain tissue volume. The disease first affects the hippocampus and entorhinal complex, which produce memories, then the cerebral cortex, which controls language, logic, and social conduct. Genetic mutations and environmental factors may cause AD, but the exact reason is unknown. AD is diagnosed using CT scans, MRIs, PET scans, and lumbar punctures to detect brain abnormalities, aberrant protein deposits, and cerebrospinal fluid biomarkers. Beta-amyloid plaques and neurofibrillary tau tangles impede neuronal transmission and function in AD. AD also causes chronic inflammation, blood-brain barrier impairment, brain atrophy, and neuronal death. AD has no cure, and current medications mainly manage symptoms and halt cognitive loss. Genetic, cellular, and molecular pathways are being studied to develop targeted medicines to stop disease progression. Extensive studies have shown that tau tangle accumulation and pathogenic changes to tau protein mechanics are correlated with AD pathogenesis. Thus, investigating the potential for therapies focused on restoring normal tau pathways and preventing tau accumulation is critical. Nanoparticulate drug delivery technologies may improve investigational medicines and lead to AD therapy breakthroughs.

Background: Deprescribing, a process of dose reduction or withdrawal of inappropriate medication that no longer has benefit, is a proposed intervention in the care of older adults living with frailty. Objective/Aim: To evaluate safety, clinical impact, and long-term outcomes of deprescribing services in frail patients, including the barriers and enablers of deprescribing services in such settings. Methods: A systematic review was performed in Scopus, CINAHL PLUS (EBSCO), MEDLINE (OVID and EMBASE) and Cochrane library. The Mixed Methods Appraisal tool (MMAT) was used for appraising the methodological quality of the included papers. Studies were selected after title, abstract, and full text screening, with independent review. Thematic analysis was used for analysing data from the selected articles. Results: 590 unique titles were identified, with 9 (6 trials, 1 interview, 1 survey, and 1 designed-delay study) meeting inclusion and exclusion criteria. Five mains descriptive themes have been identified: barriers, enablers, deprescribing services in frailty, safety management and deprescribing outcomes. Conclusion: This study provides limited evidence that deprescribing services in frail patients are effective in reducing the number of potentially inappropriate medications and medication costs. To further improve deprescribing in frailty, clinicians should consider a customised safety plan and benefit/risk assessment for each patient.

Background and Purpose: Drug repurposing has potential to improve the care for treatment resistant high-grade serous ovarian cancer (HGSOC). We hypothesised that broadly targeting PARP for drug repurposing would elicit cytotoxic responses in HGSOC through multiple biological processes. Experimental Approach: in-silico ligand-based virtual screening BLAZE was used to identify drugs with potential PARP-binding activity. The list was refined by dosing and known cytotoxicity, lipophilicity, teratogenicity, and side effects. The highest ranked drug, efavirenz, progressed to in vitro testing. Eight HGSOC cell lines were used to determine the IC50 for efavirenz. To determine the cytotoxic effects of efavirenz in a more physiologically relevant model, 3D hydrogel-encapsulated models of HGSOC and patient-derived organoid models of HGSOC were established. Live-cell imaging was employed to quantify apoptosis and cell death. Western blots, cell cycle analysis and PARP activity assays were performed to determine whether PARP1 enzyme expression and activity was inhibited following efavirenz treatment. Key Results: IC50 for efavirenz was 25.02-46.28µM for cells grown in 2D. After 7 days, IC50 doses of efavirenz reduced cell confluency and induced cell death and apoptosis. IC50 values for efavirenz in 3D models were higher ranging from 27.8-55.11µM, and in four HGSOC patient-derived organoids ranged from 14.52-42.27µM. Interestingly, COV362 cells that have a BRCA1 mutation and HRD, displayed the highest IC50 to efavirenz in both 2D and 3D models. The percentage of cells in sub-G1 and G1 phase increased after 35µM and 45µM doses of efavirenz, indicating an increase in stalling in G1. Conclusions and Implications: Efavirenz may be a viable therapeutic option for HGSOC independent of HRD

Pediatric cutaneous T-cell lymphoma with γδ immunophenotype is extremely rare. Only a few cases of γδ T-cell neoplasm have been reported in the literature and therefore little is known whether γδ T-cell neoplasms in children are distinct from their adult counterparts with respect to the clinicopathological presentation, behavior and prognosis. In this study, we demonstrate three unique cases with increased γδ T-cells in malignant and non-malignant skin conditions of children. All cases showed an indolent clinical course. Full integration of clinical presentation, morphology, immunophenotype, and genetics supports the correct diagnosis and guides the treatment.

In response to the demand for battery packages in electric vehicles (EVs), a charging system with constant current (CC) and constant voltage (CV) two-stage output characteristics should be designed and implemented. This paper proposes an inductive power transfer (IPT) system with a double-sided inductor-capacitor-capacitor (LCC) compensation network connected with a series variable inductor (VI) on the secondary side. An IPT prototype with a transfer distance of 150mm and an output power of 3kW is built. In addition, within the set misalignment range, A constant current output mode of 7.85A and a constant voltage output mode of 400V can be achieved successively, avoiding adding DC/DC converters. The experimental results show that the energy transfer efficiency reaches 87.9% with the alignment of the magnetic coupling mechanism.

Infection with human papillomavirus (HPV) typically leads to cervical cancer, skin related cancers and many other tumors. HPV is mainly responsible for evading immune tumor monitoring in HPV related cancers. Toll like receptors (TLRs) are particular pattern recognition molecules. When the body is facing immune danger, it can lead to innate and direct adaptive immunity. TLR plays an important role in initiating antiviral immune responses. HPV can affect the expression level of TLR and interfere with TLR related signaling pathways, resulting in sustained viral infection and even carcinogenesis. This paper introduces the HPV virus and HPV related cancers. We discussed the present comprehension of TLR, its expression and signaling, as well as its role in HPV infection. We also provided a detailed introduction to immunotherapy methods for HPV related diseases based on TLR agonists. This will provide insights into methods that support the therapeutic method of HPV related conditions with TLR agonists.

A document by Hiba J. Mustafa. Click on the document to view its contents.

Context: In Colombia, the digital procedures carried out by a citizen must comply with a series of regulations and requirements. Problem: As a result, the implementation of these procedures can be very cumbersome and time-consuming. Proposal: Instead of using traditional development approaches, our proposal consists of (1) modeling the processes using BPMN - Business Process Modeling and Notation, (2) automatically generating the user interfaces so that they comply with the presentation and usability requirements established by Colombian regulations, and (3) managing the execution of the processes using a BPMS - Business Process Management System engine. Methodology: We followed the Design Science Research to develop a solution following the feedback of users and developers. Implementation: We performed an implementation using Camunda BPMS, Angular and .NET. Lessons Learned: The Camunda engine and its API met the requirements for modeling, implementing and controlling the digital procedures; however, special attention must be done to data definition (names, rules, type, etc.) and the process model design itself. Former can generate data quality problems and latter can produce unnecesary complex business process models. Conclusions: We note an acceleration in the digitization of the procedure used, because the flow of activities rested easily in the BPM engine and we were able to focus on developing the interface generator (complying the government requirements).

A document by Huang Ranran. Click on the document to view its contents.

The necessary conditions for the optimal control of partially observed, fully coupled forward-backward mean-field stochastic differential equations driven by Teugels martingales are discussed in this paper. In this context, we make the assumption that the forward diffusion coefficient and the martingale coefficient are independent of the control variable, and the control domain may not necessarily be convex. For this class of optimal control problems, we derive the stochastic maximum principle based on the classical method of spike variations and the filtering techniques. The adjoint processes that are related to the variational equations are determined by the solutions of proposed forward-backward stochastic differential equations in finite-dimensional spaces. Further, the Hamiltonian function is used to obtain the maximum principle for the optimality of the given control system. Our results are then applied to the mean-field type problem of linear quadratic stochastic optimization.

Introduction: Acute bronchiolitis (AB) is a common reason for admission to the pediatric emergency department (ED). Evidence has shown that most interventions do not change the natural course of the disease. Methodology: The aim of this study was to evaluate the economic impact of the non-compliance with the AB Portuguese national clinical guideline (CG). A retrospective study of pediatric emergency episodes (EP) of a Portuguese hospital that had a diagnosis of AB during 2019 was conducted. Results: The sample included 344 EP. Non-compliance with the national CG occurred in 71,8% of the episodes, mostly due to unjustified treatment. Following GC in the studied ED for one year would have resulted in an estimated overall 76,6% cost reduction, with a reduction in mean direct costs (MDC) per patient of 14,93 \euro, corresponding to a medium saving of 3,89 \euro for each patient and a reduction of 11,03 \euro for the Portuguese National Health Service (NHS). Analyzing the unjustified MDC, of these 2,97 \euro were related to DT and treatment in the ED and the remaining 11,96 \euro were related to outpatient therapy. MDC imputed to the patient for outpatient treatment represented only 3,31 \euro, in this sense most of MDC is paid by the NHS. Conclusions: Compliance with GC would allow the reduction of total estimated costs by about 76.6%, representing a waste of resources, without compromising the quality of care provided. Most of the cost associated with non-compliance with the CG is justified by outpatient therapy, 67% of which was paid by the NHS.

A 24-year-old man presented with fever, throat pain, and diffuse myalgia. Examination revealed an ulcerated right tonsil, twice the size of the contralateral one, which showed no signs of inflammation. No trismus or abscess were observed, and airway obstruction was ruled out with fiberendoscopy. Blood tests showed an elevated white blood

The analysis of the law of drought propagation under climate change is of great significance for drought early warning and reducing social and economic losses. In spite of large spatiotemporal variability in drought propagation, the propagation probability and threshold from meteorological to hydrological droughts were not examined at seasonal and regional scales over the Luanhe River basin. To estimate the propagation probability and threshold of the Luanhe River basin, the meteorological and hydrological variables were obtained at a grid resolution of 0.25◦ Lat × 0.25◦ Lon in this study. Based on the GAMLSS framework, the stationary model and the non-stationary model were constructed to capture the characteristics of seasonal droughts without considering climate change and considering climate change. Then the Copula model was constructed, and the drought propagation probability and the threshold under stationary and non-stationary conditions were calculated. The results show that, under the combined influence of AMO, temperature, relative humidity and wind speed, the propagation probabilities became larger and the propagation thresholds became higher, especially in spring and winter in the upstream and midstream regions. The increase in temperature and the decrease in relative humidity may be the key factors contributing to the occurrence of hydrological drought in the basin.

Genetic studies of Domesticated-Weed-Wild Complexes (DWWC) have typically focused on one-way introgression of crop alleles into wild or weedy populations, with little consideration of the entire natural ecosystem. In Sri Lanka, DWWC is diverse, comprising six evolutionarily discrete groups in the genus Oryza. Using 33 neutral simple sequence repeat (SSR) loci, we characterized six Oryza groups to understand the genetic background and evolution of DWWC components. Our analysis found that Oryza groups have large population sizes and high inter-group long-term gene flows. Asymmetric gene flows were found between wild and weedy rice groups, but the rare alleles shared among DWWC components provide additional evidence for extensive and enduring exchange, highlighting the dynamic nature of this complex genetic admixture among different Oryza lineages. We found high genetic diversity at the population and species levels due to mixed DWWC components over the generations. Weedy rice types exhibit genetic incorporation through admixture from both crop and wild species, highlighting the multi-way genetic transfer in the evolution of weedy rice types. Our findings support the idea that the DWWC is an integrated complex in the Sri Lankan rice ecosystem and that its weedy rice has multiple origins, including de-domestication via feralization of cultivated rice, inter-varietal hybridization among distinct cultivated rice types, adaptation, and invasion of rice cultivation areas by wild Oryza species, and hybridization events between crop and wild rice populations. Abandoned rice domesticates can also evolve into weedy forms with less intimate human relationships and contaminate the rice ecosystem.

Camouflage treatment of Severe Skeletal Class II and Gummy Smile Patient with 3D Simulation, Mini-Screws, and Botulinum Toxin: A case report after 1-year follow-up. Viet HoangDang Thi Nhu ThaoIntroductionThe most common reason to approach an orthodontist is esthetic concern which is compromised by malocclusion [1]. Skeletal Class II malocclusion has always been a challenge and often needs the assistance of surgical orthodontics in orthodontics, especially when it is combined with a gummy smile. However, if patients can't afford orthognathic surgery treatment, non-surgical orthodontic treatment is a viable option. The skeletal anchorage system has now widened the spectrum of orthodontics and is also very well accepted by patients [2-3]. Besides, botulinum toxin is a good option after orthodontic treatment for treating gummy smiles [4-5]. Case reportDiagnosis and etiologyThe patient was a 29-year-old woman with the chief complaint of deep bite, retrudedmaxillary incisors retruded mandibular incisors, and excessive overjet. Extraorally, she had a convex profile with a normal nasolabial angle, a gummy smile 5mm on both sides, and incompetent lips. The symptom of temporomandibular disorders was a painful joint on both sides. (Figure 1b)Intraorally, the patient had a Class II molar and canine relationship on both sides. In the lower arch, she had mild crowding and a deep Curve of Spee. The small upper lateral incisors created Bolton tooth size discrepancy 3-3. The lower midline was coincident with the facial midline, but the upper midline was deviated 1 mm to the left. The gingival biotype is thin-scalloped. (Figure 1a)The lateral cephalometric analysis showed a skeletal Class II jaw relationship with the normal maxilla and retruded mandible (SNA, 82.4°; SNB, 75°; ANB, 7.4°), and normal lower facial height (FMA, 25°). The maxillary incisors were retroclined and the mandibular incisors were proclined (U1-SN, 89.8°; L1-MP, 89.5°). Both the upper and lower lips were in front of the E-line. The panoramic radiograph showed all the teeth were present. (Figure 1c,1d) Treatment plan1st Stage: Orthodontic treatmentAfter making the individual 3D simulation [6] for the decision (Figure 1e), the treatment plan was a wisdom teeth extraction upper and lower with 3 mini screws distalization upper and torque upper incisors, proclined lower incisors a little by class II elastic for compromise treatment. After treatment, 12 22 filling for solving Bolton discrepancies. To reduce excessive overbite and distalize the upper and retract maxillary incisors, control the occlusal plane and gummy smile. 3 mini-screws were used in the maxillary arch. After the treatment, filling was indicated for 12 and 22 for aesthetics and good occlusion achievement. (Figure 2a, 2b, 2c, 2d) 2nd Stage: Botulinum toxinBotulinum toxin after treatment is an indication for reducing gummy smile. Two doses of botulinum toxin were indicated. (Figure 3f) Treatment resultsAll treatment objectives were achieved with a well-aligned dentition and improved facialesthetics. Upper incisors were retracted and torque and lower incisors were proclined a little, overbite and overjet are normal, as class I occlusion and reduced gummy smile after treatment. We got Class I "canine" and molar relationships, normal overbite, and achieved midline correction by distalization upper, torque intrude upper incisors.Maxillary and mandibular intra-arch width was slightly expanded with the uprighting of molars. The whole treatment resulted in the retraction of both upper and lower lips, resulting in a passive lip seal and straight profile after treatment. Good root parallelism was achieved with a little root resorption because of torque and intrusion of upper incisors. On cephalometric superimposition, the lower curve of Spee was leveled by upper and lower incisors intrusion and lower incisors proclination. There was an improvement in the incisor inclination and soft tissue profile, particularly the E-line and nasolabial angle. These changes were further confirmed with cephalometric analysis, which showed an increase in the inclination of the maxillary incisors by 5.2°. But after the treatment, the L1 – MP angle is 105° for achieving dental lass I relationship of compromise treatment. Combining orthodontic treatment and botulinum toxin, the gummy smile was treated well. (Figure 3a, 3b, 3c, 3d, 3e) After 1 year follow-up, the occlusion was stable but the gummy smile relapsed because the time for botulinum is 4-6 months, so we need to redo it every 4-6 months. The patient was happy with the result so we don’t do it again. (Figure 4) Discussion:The patient complained about her gummy smile, maxillary protrusion, and difficulty in closing her lips. After active treatment and retention, these orthodontic problems were satisfactorily relieved through the intrusion of the upper incisors and the elimination of the class II dental malocclusion. The upper lip became more relaxed and was placed more backward, which allowed the patient to close her lips effortlessly For camouflage of severe class II skeletal malocclusion combined gummy smile, 3D simulation for treatment planning is useful for clinicians. In 3D views, we can see the problems and prepare for the mechanics. In this case, mini-screws are the key to a successful result. With mini-screws, we can manage the gummy smile, and control the occlusal plane and distalization for solving class II dental malocclusion at the same time. Conclusion:Surgical orthodontics is not a very common and acceptable procedure. However, the use of a skeletal anchorage system has broadened the horizon of camouflage treatment in moderate to severe skeletal dysplasia. Simultaneous intrusion and distalization of anterior teeth are now possible with mini-screws without losing anchorage and vertical control. Stable occlusion is key in the long term for orthodontic treatment. Ethical StatementBecause this report involves no experiment, ethics approval was not required.  AcknowledgmentThe authors would like to thank the patient for giving their consent. Patient consentWritten informed consent was obtained from the patient to publish this report by thejournal's patient consent policy. Conflict of InterestThe authors report no conflict of interest. Author contributions: VH: patient treatment, diagnosis, treatment planning, manuscript preparation, review, and editing. DTNT: manuscript preparation, review, and editing.  References:1.     Ackerman M. B. Enhancement Orthodontics: Theory and Practice. Wiley-Blackwell; 20072.     Chen Y.-J., Chang H.-H., Huang C.-Y., Hung H.-C., Lai E. H.-H., Yao C.-C. J. A retrospective analysis of the failure rate of three different orthodontic skeletal anchorage systems. Clinical Oral Implants Research. 2007;18(6):768–775. doi: 10.1111/j.1600-0501.2007.01405.x.3.     Mattos C. T., de Oliveira Ruellas A. C., Elias C. N. Is it possible to re-use mini-implants for orthodontic anchorage? Results of an in vitro study. Materials Research. 2010;13(4):521–525. doi: 10.1590/S1516-14392010000400015.4.     Razmaitė A, Trakinienė G: The effect of Botox for the correction of the gummy smile: a systematic review. Stomatologija. 2021, 23:63-8.5.     Gracco A, Tracey S: Botox and the gummy smile. Prog Orthod. 2010, 11:76-82. 10.1016/j.pio.2010.04.0046.     Kesling HD. The diagnostic setup with consideration of the third dimension. Am J Orthod. 1956;42:740–8. https://doi.org/10.1016/0002-9416(56)90042-2.   Figure Legends 

This letter proposes a polarization microwave correlation imaging method based on the orthogonal complement space. It utilizes the orthogonal complement space of the HV antenna radiation field to cross-multiply the echo information, enabling simultaneous correlation imaging and instantaneous polarization measurement of the target. Currently, there is a significant research gap in polarization-driven microwave correlation imaging methods, and the existing relevant studies focus on enhancing the randomness of the radiation field using polarized antenna elements, without incorporating polarization information into the imaging process. Through simulation analysis, this method further improves the quality of microwave correlation imaging and its ability to resist interference. Moreover, under low time-frequency products, the peak sidelobe level (PSL) and isolation (I) of this method are approximately 3.5 dB and 12.5 dB higher, respectively, than those of traditional instantaneous polarization measurement (TIPM)methods.

INTRODUCTIONThe concept of cantilevered fixed partial denture (CFPD) was described as early as 1960.1 Subsequently, the innovations in dental materials and adhesive dentistry allowed for the description of full ceramic CFPDs as a sound solution for the replacement of missing anterior teeth in 1997.2 Since this initial description, this therapeutic solution has provided patients with a minimally invasive alternative to three-unit fixed partial dentures (FPD). The indication of CFPD is often disputed in comparison with an implant-based treatment, which in some cases, can present challenges, or even be contraindicated. In this regard, CFPDs benefits from more reproducible esthetics, quicker execution and lower costs.2The question remains, however, whether this method would also be suitable for the replacement of missing teeth in the posterior sector, the main problem being the significant increase in occlusal loads on the premolars and molars.3 Different teams have begun to develop posterior CFPDs and some already have the necessary follow-up to validate this practice.4-8 The material used in these early clinical trials has been zirconia doped with 3%mol yttrium oxide (3Y-TZP), which gives the best mechanical properties at the expense of low aesthetic translucency. Yazigii and Kern recommend a thickness of 0.7mm zirconia of the overlay part and a connector of at least 3mm in vertical section and 3mm in horizontal section to ensure the mechanical resistance of the CFPD’s pontic in the posterior sector.6 This case report describes the realization of a reinforced glass-ceramic CFPD replacing à first premolar, this material opens the possibility of single appointment chairside production, and has superior adhesive and esthetic characteristics compared to zirconia.9-11 Its lower mechanical resistance is however to be taken into consideration,12 but still might be suitable if some prerequisites are met.