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BACKGROUND: Soil quality (SQ) assessment is affected by methods that convert data sets into indices, and such analyses are expensive and time-consuming. Qualitative SQ assessments are faster and cheaper than quantitative methods and they can be repeated to monitor SQ in crop and pasture systems. We evaluated SQ using qualitative and quantitative SQ indicators of two grazing systems under Voisin rational grazing (VRG) with trees (WT) or without trees (NT). We took an adjacent native forest as a reference and we used principal component analysis (PCA) to compare the accuracy of the assessment methods. RESULTS: According to the set of indicators used for quantitative assessment, the WT system and the Forest had higher SQ than other systems as a result of higher values of soil physical and chemical indicators. This the reflected better performance of soil in functions related to structural support, nutrient cycling and biological productivity. According to the set of indicators used for qualitative assessment, the WT system showed better SQ than the NT areas because of the higher scores of all indicators and better performance of the soil functions, and those values were close to the Forest in the indicators. PCA applied to integrate the data of qualitative and quantitative indicators indicated that SQ in WT was similar to Forest. CONCLUSION: The qualitative evaluation was as efficient as the quantitative evaluation for SQ assessment in VRG areas with and without trees. Its use can promote farmers' autonomy and the development of skills to identify environmental factors that help to evaluate their practices. © 2023 Society of Chemical Industry.

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BACKGROUND: In 2001, Elkwood and Matarasso published an American Society of Plastic Surgeons (ASPS) member survey detailing brow lift practice patterns. Interval changes in practice patterns have not been studied. OBJECTIVES: The previous survey was revised to elucidate current trends in brow lift surgery. METHODS: A 34-question descriptive survey was distributed to a random group of 2360 ASPS members. Results were compared to the 2001 survey. RESULTS: A total of 257 responses were collected (11% response rate; ± 6% margin of error at 95% CI). The most frequent technique for the correction of brow ptosis in both surveys was the endoscopic approach. The use of hardware fixation has increased in endoscopic brow lifting, whereas the use of cortical tunnels has decreased. Although coronal brow lifting has decreased in frequency, hairline and isolated temporal lift have increased. Neuromodulators have replaced resurfacing techniques as the most common nonsurgical adjunct. Frequent use of neuromodulators has risen from 11.2% to 88.5%. Nearly 30% of current surgeons feel that neuromodulators have replaced formal brow lifting procedures to a significant degree. CONCLUSIONS: In comparing the 2001 and current ASPS member survey there has been a clear transition to less invasive procedures over time. Although the endoscopic approach was the most popular means of forehead correction in both surveys, coronal brow lifting has decreased in frequency and the hairline and temporal approaches have increased. Neurotoxins have replaced laser resurfacing and chemical peeling methods as an adjunct, and in some cases replaced the invasive procedure entirely. Possible explanations for these findings will be discussed.

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Conventional electron spectroscopy is an established one-electron-at-the-time method for revealing the electronic structure and dynamics of either valence or inner shell ionized systems. By combining an electron-electron coincidence technique with the use of soft X-radiation we have measured a double ionisation spectrum of the allene molecule in which one electron is removed from a C1s core orbital and one from a valence orbital, well beyond Siegbahns Electron-Spectroscopy-for-Chemical-Analysis method. This core-valence double ionisation spectrum shows the effect of symmetry breaking in an extraordinary way, when the core electron is ejected from one of the two outer carbon atoms. To explain the spectrum we present a new theoretical approach combining the benefits of a full self-consistent field approach with those of perturbation methods and multi-configurational techniques, thus establishing a powerful tool to reveal molecular orbital symmetry breaking on such an organic molecule, going beyond Löwdins standard definition of electron correlation.

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Chemical substituents can influence photodynamics by altering the location of critical points and the topography of the potential energy surfaces (electronic effect) and by selectively modifying the inertia of specific nuclear modes (inertial effects). Using nonadiabatic dynamics simulations, we investigate the impact of methylation on S2(ππ*) internal conversion in acrolein, the simplest linear α,ß-unsaturated carbonyl. Consistent with time constants reported in a previous time-resolved photoelectron spectroscopy study, S2 → S1 deactivation occurs on an ultrafast time scale (∼50 fs). However, our simulations do not corroborate the sequential decay model used to fit the experiment. Instead, upon reaching the S1 state, the wavepacket bifurcates: a portion undergoes ballistic S1 → S0 deactivation (∼90 fs) mediated by fast bond-length alternation motion, while the remaining decays on the picosecond time scale. Our analysis reveals that methyl substitution, generally assumed to mainly exert inertial influence, is also manifested in important electronic effects due to its weak electron-donating ability. While methylation at the ß C atom gives rise to effects principally of an inertial nature, such as retarding the twisting motion of the terminal -CHCH3 group and increasing its coupling with pyramidalization, methylation at the α or carbonyl C atom modifies the potential energy surfaces in a way that also contributes to altering the late S1-decay behavior. Specifically, our results suggest that the observed slowing of the picosecond component upon α-methylation is a consequence of a tighter surface and reduced amplitude along the central pyramidalization, effectively restricting the access to the S1/S0-intersection seam. Our work offers new insight into the S2(ππ*) internal conversion mechanisms in acrolein and its methylated derivatives and highlights site-selective methylation as a tuning knob to manipulate photochemical reactions.

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The developments of the open-source OpenMolcas chemistry software environment since spring 2020 are described, with a focus on novel functionalities accessible in the stable branch of the package or via interfaces with other packages. These developments span a wide range of topics in computational chemistry and are presented in thematic sections: electronic structure theory, electronic spectroscopy simulations, analytic gradients and molecular structure optimizations, ab initio molecular dynamics, and other new features. This report offers an overview of the chemical phenomena and processes OpenMolcas can address, while showing that OpenMolcas is an attractive platform for state-of-the-art atomistic computer simulations.

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The lifetimes of electronic excited states have a strong influence on the efficiency of organic solar cells. However, in some molecular systems a given excited state lifetime is reduced due to the non-radiative decay through conical intersections. Several strategies may be used to suppress this decay channel. The use of the strong light-matter coupling provided in optical nano-cavities is the focus of this paper. Here, we consider the meso-tert-butyl-4,4-difluoro-4-bora-3a,4a-diaza-s-indacene molecule (meso-tert-butyl-BODIPY) as a showcase of how strong and ultrastrong coupling might help in the development of organic solar cells. The meso-tert-butyl-BODIPY is known for its low fluorescence yield caused by the non-radiative decay through a conical intersection. However, we show here that, by considering this system within a cavity, the strong coupling can lead to significant changes in the multidimensional landscape of the potential energy surfaces of meso-tert-butyl-BODIPY, suppressing almost completely the decay of the excited state wave packet back to the ground state. By means of multi configuration electronic structure calculations and nuclear wave packet dynamics, the coupling with the cavity is analyzed in-depth to provide further insight of the interaction. By fine-tuning the cavity field strength and resonance frequency, we show that one can change the nuclear dynamics in the excited state, and control the non-radiative decay. This may lead to a faster and more efficient population transfer or the suppression of it.

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BACKGROUND: In 2000, Matarasso et al. performed a survey of American Society of Plastic Surgeons members' face lift practice patterns. Since that publication, the aesthetic marketplace has changed dramatically, as have ancillary face lift techniques. In an attempt to detail these changes, we repeated that original survey, adding questions to address more recent technical issues and advances. The goal of this report was to define current face lift practice patterns, compare current patterns to the previous ones, and define recent advances. METHODS: A 38-question survey assessing face lift techniques, perioperative management, complications, and concomitant procedures was electronically distributed to a random cohort of American Society of Plastic Surgeons members. Data were recorded and statistically analyzed utilizing the Pearson chi-square test. RESULTS: A total of 251 forms were returned and analyzed. Details of demographics, face lift techniques, ancillary procedures, perioperative care, and complications are presented. Current results were compared to the previously published society member practice patterns delineated in the 2000 Plastic and Reconstructive Surgery publication. CONCLUSIONS: The basic approach of American Society of Plastic Surgeons members to the face lift operation has not changed dramatically over the past 20 years. The development of operative adjuncts, however, has been positive, including fat grafting techniques, concomitant use of skin resurfacing, and means of minimizing blood loss with tranexamic acid. In certain instances, respondents do not follow evidence-based guidelines for perioperative care. Finally, common complications of practicing members appear to coincide with published retrospective reviews.

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As an example of symmetry breaking in NEXAFS spectra of protonated species we present a high resolution NEXAFS spectrum of protonated dinitrogen, the diazynium ion N2H+. By ab initio calculations we show that the spectrum consists of a superposition of two nitrogen 1s absorption spectra, each including a π* band, and a nitrogen 1s to H+ charge transfer band followed by a weak irregular progression of high energy excitations. Calculations also show that, as an effect of symmetry breaking by protonation, the π* transitions are separated by 0.23 eV, only slightly exceeding the difference in the corresponding dark (symmetry forbidden) and bright (symmetry allowed) core excitations of neutral N2. By DFT and calculations and vibrational analysis, the complex π* excitation band of N2H+ is understood as due to the superposition of the significantly different vibrational progressions of excitations from terminal and central nitrogen atoms, both leading to bent final state geometries. We also show computationally that the electronic structure of the charge transfer excitation smoothly depends on the nitrogen-proton distance and that there is a clear extension of the spectra going from infinity to close nitrogen-proton distance where fine structures show some, although not fully detailed, similarities. An interesting feature of partial localization of the nitrogen core orbitals, with a strong, non-monotonous, variation with nitrogen-proton distance could be highlighted. Specific effects could be unraveled when comparing molecular cation NEXAFS spectra, as represented by recently recorded spectra of N2+ and CO+, and spectra of protonated molecules as represented here by the N2H+ ion. Both types containing rich physical effects not represented in NEXAFS of neutral molecules because of the positive charge, whereas protonation also breaks the symmetry. The effect of the protonation on dinitrogen can be separated in charge, which extends the high-energy part of the spectrum, and symmetry-breaking, which is most clearly seen in the low-energy π* transition.

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Although previous publications have reviewed face and necklift anatomy and technique from different perspectives, seldom were the most relevant anatomical details and widely practiced techniques comprehensively summarized in a single work. As a result, the beginner is left with a plethora of varied publications that require sorting, rearrangement, and critical reading. A recent survey of US plastic surgery residents and program directors disclosed less facility with facelift surgery compared with aesthetic surgery of the breast and trunk. To this end, 4 of the widely practiced facelift techniques (ie, minimal access cranial suspension-lift, lateral-SMASectomy, extended-SMAS, and composite rhytidectomy) are described in an easy review format. The highlights of each are formatted followed by a summary of complications. Finally, the merits and limitations of these individual techniques are thoroughly compared and discussed.

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BACKGROUND: Despite the rapid increase in the number of publications pertaining to COVID-19, there is a lack of data examining patient outcomes following elective procedures performed during this pandemic. OBJECTIVES: The purpose of this investigation was to examine the postoperative outcomes of patients who underwent elective procedures in an ambulatory surgery center during the COVID-19 pandemic, and to share the preoperative screening and patient selection protocol implemented in our center. METHODS: Elective procedures performed in an ambulatory surgery center between March 1, 2020 and April 16, 2020 were retrospectively reviewed. The primary outcomes were occurrence of COVID-19-related postoperative complications. These complications include pneumonia, stroke, myocardial infarction, and clotting disorders. The predictive variables analyzed in this study were age, American Society of Anesthesiologists score, specialty conducting the procedure, operating time, and the type of plastic and reconstructive surgery procedure being performed. RESULTS: A total of 300 consecutive electives cases were included in the study. The most common procedures were pain management (43.0%), gastrointestinal (26.0%), aesthetic (14.0%), orthopedic (10.3%), reconstructive (4.0%), otorhinolaryngology (2.0%), and gynecology (0.67%). The median age of the cohort was 54.6 years (range, 1-90 years) and the median procedure time was 47 minutes (range, 11-304 minutes). COVID-19-related symptoms or complications following the procedures were not observed in any of the patients or in the healthcare care personnel. CONCLUSIONS: In this cohort of 300 elective cases, we found no patients with COVID-19-related symptoms postoperatively. This suggests that with proper preoperative screening and patient selection, elective procedures can be safely performed in an ambulatory surgery center during this pandemic.

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Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a complex topic with evolving classification and etiology. Commonalities between BIA-ALCL and lymphoproliferative disorders exist, suggesting that BIA-ALCL may be better represented on a spectrum of disease from benign effusion to malignant metastatic lymphoma. Meticulous sterile surgical technique, involving the use of betadine-containing irrigation, should be used to decrease the biological burden introduced into the surgical field and possibly prevent future incidences of BIA-ALCL.

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We present and analyze high resolution near edge X-ray absorption fine structure (NEXAFS) spectra of CO+ at the carbon and oxygen K-edges. The spectra show a wealth of features that appear very differently at the two K-edges. The analysis of these features can be divided into three parts; (i) repopulation transition to the open shell orbital - here the C(1s) or O(1s) to 5σ transition, where the normal core hole state is reached from a different initial state and different interaction than in X-ray photoelectron spectroscopy; (ii) spin coupled split valence bands corresponding to C(1s) or O(1s) to π* transitions; (iii) remainder weak and long progressions towards the double ionization potentials containing a manifold of peaks. These parts, none of which has correspondence in NEXAFS spectra of neutral molecules, are dictated by the localization of the singly occupied 5σ orbital, adding a dimension of chemistry to the ionic NEXAFS technique.

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X-ray processes involve interactions with high-energy photons. For these short wavelengths, the perturbing field cannot be treated as constant, and there is a need to go beyond the electric-dipole approximation. The exact semi-classical light-matter interaction operator offers several advantages compared to the multipole expansion such as improved stability and ease of implementation. Here, the exact operator is used to model x-ray scattering in metal K pre-edges. This is a relativistic two-photon process where absorption is dominated by electric-dipole forbidden transitions. With the restricted active space state-interaction approach, spectra can be calculated even for the multiconfigurational wavefunctions including second-order perturbation. However, as the operator itself depends on the transition energy, the cost for evaluating integrals for hundreds of thousands unique transitions becomes a bottleneck. Here, this is solved by calculating the integrals in a molecular-orbital basis that only runs over the active space, combined with a grouping scheme where the operator is the same for close-lying transitions. This speeds up the calculations of single-photon processes and is critical for the modeling of two-photon scattering processes. The new scheme is used to model Kα resonant inelastic x-ray scattering of iron-porphyrin complexes with relevance to studies of heme enzymes, for which the total computational time is reduced by several orders of magnitude with an effect on transition intensities of 0.1% or less.

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BACKGROUND: The muscle-sparing descending branch latissimus dorsi muscle (MSLD) flap is a versatile flap with numerous benefits. It is an often overlooked but useful option when considering free flap donors. In this article, the authors present the largest experience with the MSLD flap, with focus on its use in lower extremity reconstruction. METHODS: Patients undergoing lower extremity reconstruction with the MSLD flap at a single institution from 2012 to 2017 were identified. Patient and wound characteristics, surgical details, complications, and outcomes were examined. Outcomes were compared to a cohort who underwent lower extremity reconstruction with other free muscle flaps during the same period. RESULTS: Thirty-six consecutive patients who underwent MSLD flap surgery were identified. Mean follow-up was 18.8 months. Mean body mass index was 29.2 kg/m and 56 percent were smokers. The most common wound causes were motor vehicle collision (46 percent) and fall (22 percent). The most common anatomical location was the distal third of the tibia (33 percent). Mean operative time was 380 minutes. Complications included three total losses (8 percent) and one partial loss (3 percent). No donor-site seromas were reported. Four patients required subsequent amputation for orthopedic issues (nonunion/pain). Patients receiving MSLD and other flaps had similar rates of amputation, donor- and recipient-site complications, and ambulation status (p > 0.05). CONCLUSIONS: The MSLD flap is a useful and reliable option for free flap reconstruction of the lower extremity. Advantages include an easily contourable flap, low revision rate, low complication rate, and the ability to harvest in supine position. In addition, the MSLD flap preserves donor function useful for rehabilitation and minimizes seroma risk. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

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BACKGROUND: Rebound bleeding as a result of loss of epinephrine effect is a common problem encountered during facelift surgery. Tranexamic acid (TXA) is an anti-fibrinolytic agent whose safety and efficacy in reducing bleeding are well documented. We have found that local infiltration of TXA combined with a lidocaine with epinephrine solution during facelift surgery has been effective in decreasing rebound bleeding and the time required to gain hemostasis. OBJECTIVES: The authors sought to share their local infiltration protocol of TXA combined with epinephrine solution in facelift. METHODS: Patients who underwent facelift received subcutaneous injection of TXA-lidocaine 0.5% solution following the authors' protocol. After completing both sides of the facelift and the submental platysmaplasty, the first and second sides were sequentially closed. The time to gain hemostasis on each side prior to closure was prospectively measured. RESULTS: Twenty-seven consecutive patients who underwent facelift surgery received local infiltration of TXA-lidocaine solution. In 23 of the 27 patients, the time required for hemostasis was prospectively recorded. The mean age was 62.1 years (±9.3) and all were females. The average time spent achieving hemostasis on the right, left, and both sides of the face was 6.5 (±2.7), 6.3 (±2.1), and 12.9 (±4.2) minutes, respectively. The total surgical time saving is approximately 25 to 60 minutes. Although primary facelift [13.6 (± 4.3)] exhibited a longer time of hemostasis compared with the secondary group [10.2 (± 2.8)], this was not statistically significant (P = 0.09). CONCLUSIONS: Local infiltration of TXA with local anesthetic prior to a facelift appears to decrease bleeding, operative time, and postoperative facelift drainage output.Level of Evidence: 4.

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In this article, the authors aim to thoroughly describe the critical surgical anatomy of the facial layers, the retaining ligamentous attachments of the face, and the complex three-dimensional course of the pertinent nerves. This is supplemented with clarifying anatomic dissections and artwork figures whenever possible to enable easy, sound, and safe navigation during surgery. The historic milestones that led the evolution of cervicofacial rejuvenation to the art we know today are summarized at the beginning, and the pearls of the relevant facial analysis that permit accurate clinical judgment and hence individualized treatment strategies are highlighted at the end. The facelift operation remains the cornerstone of face and neck rejuvenation. Despite the emergence of numerous less invasive modalities, surgery continues to be the most powerful and more durable technique to modify facial appearance. All other procedures designed to ameliorate facial aging are either built around or serve as adjuncts to this formidable craft.

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A prematuridade é um problema mundial, sendo a principal causa de óbito neonatal. É o determinante mais importante de mortalidade infantil e assistência antenatal, parto e atendimento neonatal. Assim sendo, o objetivo deste trabalho foi analisar a prevalência de óbito em curto prazo e as principais complicações associadas em prematuros nascidos no Hospital Regional de São José Dr. Homero de Miranda Gomes (HRSJ) de janeiro de 2011 a dezembro de 2017. Os dados foram coletados através de instrumento de coleta de dados. Os prematuros foram divididos em quatro grupos de acordo com a classificação de gravidade. Realizou-se a análise descritiva das variáveis e a seguir, variáveis associadas ao óbito em curto prazo foram determinadas por odds ratio (OR) e análise multivariada com regressão logística. Observou-se taxa de 9,8% de nascimentos prematuros, sendo 58,5% na faixa da prematuridade leve. A prevalência de óbitos total em curto prazo foi de 7,8%, sendo a maior taxa no grupo da prematuridade extrema (66,6%). A complicação neonatal mais frequente foi a síndrome do desconforto respiratório, seguida pela sepse, enterocolite necrosante e hemorragia intraventricular. As características que mostraram associação com o óbito foram a ausência de síndrome hipertensiva materna, a não administração de corticoide antenatal, o recém-nato do sexo masculino, escore de Apgar menor que 7 no quinto minuto e a presença de crescimento intrauterino restrito (CIUR). A presença de CIUR foi relacionada com o óbito na prematuridade grave, moderada e leve.

Prematurity is a worldwide problem, being the main cause of neonatal death. It is the most important determinant of infant mortality and antenatal care, delivery and neonatal care. Therefore, the objective of this study was to analyze the prevalence of death and the main complications associated in premature babies born in the Hospital Regional de São José Dr. Homero de Miranda Gomes (HRSJ) from January 2011 to December 2017. The data were collected through an instrument of data collection. Premature infants were divided into four groups according to the severity classification(11). A descriptive analysis of the variables was performed, and then variables associated with death were determined by odds ratio (OR) and multivariate analysis with logistic regression. A rate of 9.8% of preterm births was observed, being 58.5% in the mild prematurity range. The prevalence of total deaths was 7.8%, the highest rate in the group of extreme prematurity (66.6%). The most frequent neonatal complication was respiratory distress syndrome, followed by sepsis, necrotizing enterocolitis and intraventricular hemorrhage. The characteristics that showed association with death were absence of maternal hypertensive syndrome, non-administration of antenatal corticoid, newborn male, Apgar score less than 7 in the fifth minute and the presence of restricted intrauterine growth (IUGR). The presence of IUGR was related to death in severe, moderate and mild prematurity.

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Significant volume deflation and redundant inelastic skin is seen after massive weight loss (MWL). These changes parallel those found with natural aging; thus, patients exhibit accelerated facial aging appearance. A facelift procedure may enhance the cervicofacial contour and reduce the apparent age in MWL patients; nonetheless, fully correcting this facial deformity is challenging. Extensive skin undermining is the most critical aspect of the MWL facelift, as it allows the resection of the excess skin and adequate redraping. This article describes the surgical and medical modifications that need to be considered in the MWL facelift to ensure a successful outcome.

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