The Satisfaction and Quality of Life of Patients After Breast Reconstruction: A Cross-Sectional Multicenter Study Comparing Immediate, Delayed, and Nonreconstructive Outcomes.

BACKGROUND: Breast reconstruction following mastectomy can be performed through various surgical techniques that prioritize the patient's safety and quality of life. Plastic surgeons are trained to choose the most appropriate surgical approach based on the individual patient's needs and medical history. The safety of the patient is always the primary concern, followed by considerations such as aesthetic outcomes and long-term health implications. OBJECTIVES: The aim of this study was to assess and document patients' satisfaction and quality of life after breast reconstruction across Saudi Arabia. METHODS: This is a cross-sectional multicenter study among female patients who underwent mastectomy with or without breast reconstruction between 2015 and 2022. Two hundred eighty patients participated in this study through a call-based Arabic version of the BREAST-Q questionnaire to analyze the quality of their lives and satisfaction. RESULTS: Our results showed that patients who underwent delayed reconstruction had lower satisfaction than those who underwent immediate reconstruction. The average BREAST-Q score was lower in patients who used tissue expanders than those with implant-based reconstruction, autologous reconstruction, or combined approaches. Patients who underwent simple mastectomy had lower satisfaction (M = 66.1) than those who had a skin-sparing mastectomy (M = 71.1) and/or nipple-sparing mastectomy (M = 72.6). CONCLUSIONS: This retrospective multicenter study observed a significant association between the time of the reconstructive surgery and patient's satisfaction; patients who underwent immediate reconstruction had higher satisfaction rate. Lower satisfaction rate was associated with tissue expander breast reconstruction. There is a significant association between satisfaction rate and smoking history.

Optimum Placement of Distribution Generation Units in Power System with Fault Current Limiters Using Improved Coyote Optimization Algorithm.

Electric power frameworks become intensely loaded because of the expanded power demand, and as a result, the power system faces great power losses and fault currents. The integration of Distribution Generation (DG) units plays a key role in minimizing the load pressure on a power system. DGs are transmitted with a high fault current, which surpasses the evaluations of circuit breakers. This paper presents various DG units' optimal placement with Fault Current Limiters (FCLs) in different phases. The Improved Coyote Optimize Algorithm (ICOA) and Electrical Transient Analyzer Program (ETAP) are assessed for the proposed technique in terms of normal and faulty working status. Similarly, to enhance the efficiency of a distribution system, a fuzzy-based multi-objective mechanism is applied. The proposed method is employed on an IEEE 21-bus and 28-bus distribution system. The simulation analysis proved that the power losses and fault levels are reduced at an acceptable level.

Prevalence of The Arterial Hand Dominance Using the Modified Allen Test and Pulse Oximetry among Plastic Surgery Patients.

Background: The ulnar and radial arteries are the major source of blood supply in the hand, as they form the superficial and deep palmar arches. Arterial hand circulation is one of the most complicated arterial trees and connections in the body, with tremendous variations in its structure. This study aimed to evaluate whether the ulnar artery or radial artery is the dominant artery in hand circulation among plastic surgery patients at King Khalid University Hospital and to correlate the arterial hand dominance with handedness and gender. Methods: This is an analytical cross-sectional study conducted at King Khalid University Hospital in Riyadh, Saudi Arabia, on plastic surgery patients. The sampling method is purposive sampling. The calculated sample size is 28; however, 100 participants have been enlisted in the study. The data have been collected using the modified Allen test with a pulse oximeter. Results: The collective prevalence of dual arterial dominance in our study was 69% compared with 56% and 30% for Little et al (P = 0.013) and Fuhrman et al (P < 0.001), respectively. With regard to gender, women were more likely to have a dual arterial blood supply than men, with the frequency values of 85% and 58.3% for women and men, respectively (P = 0.017). Conclusions: Our study found that dual arterial supply is predominant among our participants, with 69% of our participants possessing a dual arterial supply, while 18% and 13% constitute the prevalence of radial and ulnar dominance, respectively. This contrasts with what has been reported previously in the literature.

Optimal energy management via day-ahead scheduling considering renewable energy and demand response in smart grids.

The energy optimization in smart power grids (SPGs) is crucial for ensuring efficient, sustainable, and cost-effective energy management. However, the uncertainty and stochastic nature of distributed generations (DGs) and loads pose significant challenges to optimization models. In this study, we propose a novel optimization model that addresses these challenges by employing a probabilistic method to model the uncertain behavior of DGs and loads. Our model utilizes the multi-objective wind-driven optimization (MOWDO) technique with fuzzy mechanism to simultaneously address economic, environmental, and comfort concerns in SPGs. Unlike existing models, our approach incorporates a hybrid demand response (HDR), combining price-based and incentive-based DR to mitigate rebound peaks and ensure stable and efficient energy usage. The model also introduces battery energy storage systems (BESS) as environmentally friendly backup sources, reducing reliance on fossil fuels and promoting sustainability. We assess the developed model across various distinct configurations: optimizing operational costs and pollution emissions independently with/without DR, optimizing both operational costs and pollution emissions concurrently with/without DR, and optimizing operational costs, user comfort, and pollution emissions simultaneously with/without DR. The experimental findings reveal that the developed model performs better than the multi-objective bird swarm optimization (MOBSO) algorithm across metrics, including operational cost, user comfort, and pollution emissions.

Nationwide Study: Public Adults' Perception of Cosmetic Surgery in Saudi Arabia.

Background: Knowing what influences people to pursue cosmetic surgery can aid current and aspiring cosmetic surgeons as they develop their techniques and enhance their market practice. This study aimed to evaluate Saudi adults' perceptions of cosmetic surgery using the three subscales of the Acceptance of Cosmetic Surgery Scale, namely Social, Consider, and Intrapersonal. Methods: This cross-sectional, nationwide study involved members of the public from all provinces of Saudi Arabia. The inclusion criteria were being a Saudi resident over 18 years old and consenting to participate; those who did not meet the criteria were excluded. The study was implemented between October 25 and December 16, 2022. The electronic survey was composed of a demographic characteristics section and a previously constructed questionnaire modified for Arabic speakers to assess the population's perceptions of cosmetic surgery. Statistical analysis was conducted using the SPSS 22 statistical package. Results: Of the 8006 Saudi adults who participated in the study, 5551 (69.3%) were women, and 2245 (30.7%) were men. We found that intrapersonal factors were the primary motivator, followed by factors addressed by the Consider and Social subscales. However, attitudes differed by gender, age, and other demographic characteristics: men and younger individuals (18-29) showed the lowest score for likelihood to pursue cosmetic surgery, whereas women and older individuals (40-50) ranked the highest on total scale scores. Overall, the Saudi adult population showed diminished perceptions of cosmetic surgery nationwide. Conclusion: The results confirmed the authors' hypothesis that there is a diminished perception of cosmetic surgery among adults in Saudi Arabia.

Effectiveness and safety of immediate application of negative pressure wound therapy in head and neck free flap reconstruction: a systematic review.

To our knowledge this is the first systematic review of the immediate application of negative pressure wound therapy (NPWT) to the head and neck in free flap reconstruction. We conducted a systematic search of the PubMed and Cochrane databases in October 2021 using the MeSH terms 'negative pressure wound therapy', 'free flaps', 'microsurgery', and 'vacuum-assisted closure'. Included studies evaluated the use of immediate NPWT in head and neck free flap reconstruction. Outcomes, indications, monitoring, and reported complications were retrieved. Of the 908 articles searched, nine published between 2000 and 2021 were included: four retrospective studies and five case series. NPWT was applied to 56 free flaps, and 54 had successful outcomes. The most common reported indication for flap reconstruction was malignancy. NPWT has the potential to be a valuable tool for complicated wounds, and further studies are needed to quantify functional and aesthetic outcomes.

Wearable Metamaterial Dual-Polarized High Isolation UWB MIMO Vivaldi Antenna for 5G and Satellite Communications.

A low-profile Multiple Input Multiple Output (MIMO) antenna showing dual polarization, low mutual coupling, and acceptable diversity gain is presented by this paper. The antenna introduces the requirements of fifth generation (5G) and the satellite communications. A horizontally (4.8-31 GHz) and vertically polarized (7.6-37 GHz) modified antipodal Vivaldi antennas are simulated, fabricated, and integrated, and then their characteristics are examined. An ultra-wideband (UWB) at working bandwidths of 3.7-3.85 GHz and 5-40 GHz are achieved. Low mutual coupling of less than -22 dB is achieved after loading the antenna with cross-curves, staircase meander line, and integration of the metamaterial elements. The antennas are designed on a denim textile substrate with εr = 1.4 and h = 0.5 mm. A conductive textile called ShieldIt is utilized as conductor with conductivity of 1.8 × 104. After optimizing the proposed UWB-MIMO antenna's characteristics, it is increased to four elements positioned at the four corners of a denim textile substrate to be employed as a UWB-MIMO antenna for handset communications, 5G, Ka and Ku band, and satellite communications (X-band). The proposed eight port UWB-MIMO antenna has a maximum gain of 10.7 dBi, 98% radiation efficiency, less than 0.01 ECC, and acceptable diversity gain. Afterwards, the eight-ports antenna performance is examined on a simulated real voxel hand and chest. Then, it is evaluated and compared on physical hand and chest of body. Evidently, the simulated and measured results show good agreement between them. The proposed UWB-MIMO antenna offers a compact and flexible design, which is suitably wearable for 5G and satellite communications applications.

Compact Elliptical UWB Antenna for Underwater Wireless Communications.

The increasing needs of free licensed frequency bands like Industrial, Scientific, and Medical (ISM), Wireless Local Area Network (WLAN), and 5G for underwater communications required more bandwidth (BW) with higher data transferring rate. Microwaves produce a higher transferring rate of data, and their associated devices are smaller in comparison with sonar and ultrasonic. Thus, transceivers should have broad BW to cover more of a frequency band, especially from ultra-wideband (UWB) systems, which show potential outcomes. However, previous designs of similar work for underwater communications were very complicated, uneasy to fabricate, and large. Therefore, to overcome these shortcomings, a novel compact elliptical UWB antenna is designed to resonate from 1.3 to 7.2 GHz. It is invented from a polytetrafluoroethylene (PTFE) layer with a dielectric constant of 2.55 mm and a thickness of 0.8 mm. The proposed antenna shows higher gain and radiation efficiency and stability throughout the working band when compared to recent similarly reported designs, even at a smaller size. The characteristics of the functioning antenna are investigated through fluid mediums of fresh-water, seawater, distilled water, and Debye model water. Later, its channel capacity, bit rate error, and data rate are evaluated. The results demonstrated that the antenna offers compact, easier fabrication with better UWB characteristics for underwater 5G communications.