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First promulgated in 1959, the 3Rs of Replacement, Reduction and Refinement have evolved as fundamental principles underlying the use of animals and alternatives in science throughout the modern world. This review describes a contemporary approach to delivering the 3Rs through acknowledging the contribution of new technologies and emphasising that applying the 3Rs can be beneficial to good science as well as to animal welfare. This science-led approach moves the concept of the 3Rs out of an ethical silo where they were often considered by scientists to be an inconvenient obligation. On the contrary, relevant examples demonstrate the opportunity to practise better science using 3Rs technologies which deliver faster, more reproducible and more cost-effective results. Indeed, methods harnessing Replacement approaches may permit discoveries which are simply not feasible using animals and frequently are more flexible and agile since compliance with regulatory oversight requirements is simplified. Although the necessity for rigorous oversight is well recognised, it is important that the associated bureaucracy is not allowed to become prohibitive, causing scientists to avoid pursuing justifiable and important research involving animals. Public support for research is conditional – animals should not suffer unnecessarily and sufficient potential benefit should accrue from the research. However, society also actively seeks pioneering medical and scientific advances which can only be achieved through research. Therefore, a balance must be struck between safeguarding animal welfare whilst enabling high-quality science. It is this balance which promotes and sustains public confidence that animal based research is acceptable and being appropriately managed.

Quantification of lean body mass and fat mass can provide important insight into epidemiological research. However, there is no consensus on generalisable anthropometric prediction equations to validly estimate body composition. We aimed to develop and validate practical anthropometric prediction equations for lean body mass, fat mass and percent fat in adults (men, n 7531; women, n 6534) from the National Health and Nutrition Examination Survey 1999–2006. Using a prediction sample, we predicted each of dual-energy X-ray absorptiometry (DXA)-measured lean body mass, fat mass and percent fat based on different combinations of anthropometric measures. The proposed equations were validated using a validation sample and obesity-related biomarkers. The practical equation including age, race, height, weight and waist circumference had high predictive ability for lean body mass (men: R 2=0·91, standard error of estimate (SEE)=2·6 kg; women: R 2=0·85, SEE=2·4 kg) and fat mass (men: R 2=0·90, SEE=2·6 kg; women: R 2=0·93, SEE=2·4 kg). Waist circumference was a strong predictor in men only. Addition of other circumference and skinfold measures slightly improved the prediction model. For percent fat, R 2 were generally lower but the trend in variation explained was similar. Our validation tests showed robust and consistent results with no evidence of substantial bias. Additional validation using biomarkers demonstrated comparable abilities to predict obesity-related biomarkers between direct DXA measurements and predicted scores. Moreover, predicted fat mass and percent fat had significantly stronger associations with obesity-related biomarkers than BMI did. Our findings suggest the potential application of the proposed equations in various epidemiological settings.

Automated visual anthropometrics produced by mobile applications are accessible and cost effective with the potential to assess clinically relevant anthropometrics without a trained technician present. Thus, the aim of this study was to evaluate the precision and agreement of smartphone-based automated anthropometrics against reference tape measurements. Waist and hip circumference (WC; HC), waist:hip ratio (WHR) and waist:height ratio (W:HT) were collected from 115 participants (69 F) using a tape measure and two smartphone applications (MeThreeSixty®, myBVI®) across multiple smartphone types. Precision metrics were used to assess test-retest precision of the automated measures. Agreement between the circumferences produced by each mobile application and the reference were assessed using equivalence testing and other validity metrics. All mobile applications across smartphone types produced reliable estimates for each variable with intraclass correlation coefficients ≥ 0·93 (all P < 0·001) and root mean square coefficient of variation between 0·5 and 2·5 %. Precision error for WC and HC was between 0·5 and 1·9 cm. WC, HC, and W:HT estimates produced by each mobile application demonstrated equivalence with the reference tape measurements using 5 % equivalence regions. Mean differences via paired t-tests were significant for all variables across each mobile application (all P < 0·050) showing slight underestimation for WC and slight overestimation for HC which resulted in a lack of equivalence for WHR compared with the reference tape measure. Overall, the results of our study support the use of WC and HC estimates produced from automated mobile applications, but also demonstrates the importance of accurate automation for WC and HC estimates given their influence on other anthropometric assessments and clinical health markers.

Assessments of visceral adipose tissue (VAT) are critical in preventing metabolic disorders; however, there are limited measurement methods that are accurate and accessible for VAT. The purpose of this cross-sectional study was to evaluate the association between VAT estimates from consumer-grade devices and traditional anthropometrics and VAT and subcutaneous adipose tissue (SAT) from dual-energy X-ray absorptiometry (DXA). Data were collected from 182 participants (female = 114; White = 127; Black/African-American (BAA) = 48) which included anthropometrics and indices of VAT produced by near-infrared reactance spectroscopy (NIRS), visual body composition (VBC) and multifrequency BIA (MFBIA). VAT and SAT were collected using DXA. Bivariate and partial correlations were calculated between DXAVAT and DXASAT and other VAT estimates. All VAT indices had positive moderate–strong correlations with VAT (all P < 0·001) and SAT (all P < 0·001). Only waist:hip (r = 0·69), VATVBC (r = 0·84), and VATMFBIA (r = 0·86) had stronger associations with VAT than SAT (P < 0·001). Partial associations between VATVBC and VATMFBIA were only stronger for VAT than SAT in White participants (r = 0·67, P < 0·001) but not female, male, or BAA participants individually. Partial correlations for waist:hip were stronger for VAT than SAT, but only for male (r = 0·40, P < 0·010) or White participants (r = 0·48, P < 0·001). NIRS was amongst the weakest predictors of VAT which was highest in male participants (r = 0·39, P < 0·010) but non-existent in BAA participants (r = –0·02, P > 0·050) after adjusting for SAT. Both anthropometric and consumer-grade VAT indices are consistently better predictors of SAT than VAT. These data highlight the need for a standardised, but convenient, VAT estimation protocol that can account for the relationship between SAT and VAT that differs by sex/race.

With increasing environmental awareness and consumer demand for high-quality food products, industries are strongly required for technical innovations. The use of various emerging techniques in food processing indeed brings many economic and environmental benefits compared to conventional processes. However, lipid oxidation induced by some “innovative” processes is often “an inconvenient truth”, which is scarcely mentioned in most studies but should not be ignored for the further improvement and optimization of existing processes. Lipid oxidation poses a risk to consumer health, as a result of the possible ingestion of secondary oxidation products. From this point of view, this review summarizes the advance of lipid oxidation mechanism studies and mainly discloses the shade of innovative food processing concerning lipid degradation. Sections involving a revisit of classic three-stage chain reaction, the advances of polar paradox and cut-off theories, and potential lipid oxidation factors from emerging techniques are described, which might help in developing more robust guidelines to ensure a good practice of these innovative food processing techniques in future.

The majority of studies in the field of organizational strategies have concentrated on strategy formulation, distinct from strategy implementation. Disunion of these two processes often leads to disappointing results in the implementation of strategy. In such a condition, the creation of a suitable strategy in a way that could resolve the divergence of formulation from implementation is suggested by researchers. This means that the implementers of a strategy turn into the formulators. Therefore, presenting creative ideas and solutions is encouraged between related organizational staff at different levels. Noting that the possibility of emerging creative ideas in organizational meetings between persons from different organizational levels is low, fostering creativity and innovation techniques can be an ideal solution for successful group meetings. In this paper, after introducing the effective criteria that should be considered in the creation of collective action strategies in organizations, the suitable techniques for fostering creativity in this kind of meeting will be ranked based on the Fuzzy MADM approach.

BackgroundHypertrophic osteoarthropathy (HOA) is a rare and intricate hereditary disease. The appearance and functional deformity of the forehead caused by thickened folds are the main clinical manifestations of patients with hypertrophic osteoarthropathy. The cause of this disease is still unknown. Currently, surgical treatment has become one of the best strategies, mainly for improving the appearance of the forehead. There has been no literature report on the use of \"W\"-shaped skin flap resection for thickened forehead skin in patients with hypertrophic osteoarthropathy.MethodsAll cases of hypertrophic osteoarthropathy in our department in the last 7 years, and previous literature on hypertrophic osteoarthropathy, were reviewed.ResultsA total of 5 cases of hypertrophic osteoarthropathy in our department (mean age 21 years, all male patients) were reviewed. All patients underwent open surgery to remove the thickened skin on the forehead or the wrinkles and gyrus-shaped scalp. The jagged skin tissue was removed (8–9) cm × (1–2.5) cm × 0.5 cm. The folds and thickness of the frontal skin of the patients were greatly improved after the operation. Patient satisfaction with the treatment outcomes was unanimous. However, one case experienced a postoperative wound infection during follow-up. The utilization of the \"W\"-shaped excision technique allowed for the maximal removal of excessively diseased tissue, thereby facilitating a smoother resolution of the depression.ConclusionsA total of 5 cases of hypertrophic osteoarthropathy were treated in our department, and all of them underwent frontal skin \"W\"-shaped excision, which was safe, feasible, and practical, and the postoperative results were satisfactory.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

With the inexorable aging of the global populace, neurodegenerative diseases (NDs) like Alzheimer’s disease (AD), Parkinson’s disease (PD), and amyotrophic lateral sclerosis (ALS) pose escalating challenges, which are underscored by their socioeconomic repercussions. A pivotal aspect in addressing these challenges lies in the elucidation and application of biomarkers for timely diagnosis, vigilant monitoring, and effective treatment modalities. This review delineates the quintessence of biomarkers in the realm of NDs, elucidating various classifications and their indispensable roles. Particularly, the quest for novel biomarkers in AD, transcending traditional markers in PD, and the frontier of biomarker research in ALS are scrutinized. Emergent susceptibility and trait markers herald a new era of personalized medicine, promising enhanced treatment initiation especially in cases of SOD1-ALS. The discourse extends to diagnostic and state markers, revolutionizing early detection and monitoring, alongside progression markers that unveil the trajectory of NDs, propelling forward the potential for tailored interventions. The synergy between burgeoning technologies and innovative techniques like -omics, histologic assessments, and imaging is spotlighted, underscoring their pivotal roles in biomarker discovery. Reflecting on the progress hitherto, the review underscores the exigent need for multidisciplinary collaborations to surmount the challenges ahead, accelerate biomarker discovery, and herald a new epoch of understanding and managing NDs. Through a panoramic lens, this article endeavors to provide a comprehensive insight into the burgeoning field of biomarkers in NDs, spotlighting the promise they hold in transforming the diagnostic landscape, enhancing disease management, and illuminating the pathway toward efficacious therapeutic interventions.

BackgroundIn-depth understanding of facial anatomy is the foundation of clinical education and practices. Lately, anatomy education has undergone many changes due to the adoption of integrated medical curriculums. The time allocated to anatomy teaching on occasion been shortened to allow more time for clinical education. Innovation in visual technology such as virtual reality (VR), augmented reality (AR) and mixed reality (MR) has added a new dimension to anatomy education. The authors present a mixed reality virtual face model to facilitate complex anatomy teaching using Microsoft HoloLens in various educational settings.Materials and MethodsClose-range photogrammetry technique was utilised to construct a virtual face using a dissected fresh-frozen cephalus. Scanning was undertaken using DSLR cameras, capable of capturing ten frames per second, in ten different angles on the dissected side and four for the undissected side. The images of the entire cephalous were also separately captured in twenty different angles. These images were processed using software to reconstruct the three-dimensional virtual face.ResultThe virtual face using a mixed reality platform was able to demonstrate individual layers of the face and relevant clinically significant structures clearly with interactive labelling. Face and the content validity by 12 experts (plastic surgeons and dermatologists) demonstrated strong inter-rater reliability expressed as interclass correlation coefficient.ConclusionAn immersive experience by using Microsoft HoloLens provides an accurate 3D perception of the face to enhance anatomy learning. This can be utilised in undergraduate, postgraduate and continued medical education as an additional teaching tool in the constraints of cadaveric dissection.Level of Evidence VThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.

BackgroundIn scenarios of a dorsal hump with minor bony cap, ideal esthetic dorsal lines can be preserved and refined by component separation of the upper lateral cartilages from the septal T, resection of a septal strip and ethmoid bone wedge, adjustment of width and symmetry and final re-suture of the cartilaginous dorsum after pushdown, improving width and symmetry. The associated bony cap is managed by osteoplasty only with or without narrowing osteotomies, and septal deviations can be concomitantly corrected.ObjectivesA novel technique of modified dorsal cartilaginous pushdown after component separation is described in detail. This method illustrates the importance of preserving the integrity of the septal T anatomy and the elastic keystone junction.MethodsA preliminary series of 41 consecutive patients with follow-up up to 1 year, with a mean of 6 months, is reviewed.ResultsAll patients presented favorable outcomes with a natural looking dorsum. A learning curve led to progressive improvements by suture fixation of the septal T, finesse adjustment of dorsal width and symmetry, fine-tuning of deviation and gradual extension of the technique to include cases that required osteotomies without transverse element and those with any degree of septal manipulation.ConclusionDisrupting the keystone area is fraught with potential complications which often lead to secondary revision. A modified dorsal preservation technique with pushdown limited to the septal T component of the cartilaginous dorsum combines the popular component separation concept with the preservation of the delicate anatomy of the mid-vault.Level of Evidence VThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.