bluuebunny/crossref_metadata_2025 huggingface dataset:
Reduction of nickel content from the model solution by consortium of fungal pellets and green algae
Authors: Remenarova M , Takacova A , Simonovicova A , Danc L , Nosalj S
Published: February 2020

The accumulation of Ni from the model aqueous solution (100 mg/L) by pellets of Aspergillus niger (A. niger) together with the green algae Chlorella sp., as a microbial consortium, during five days was compared. In the experiment, already formed pellets were used (5 mL A. niger conidia in Sabouraud Dextrose Broth, shaked with 200 rpm for 5 days). The experiment was carried out under static and also dynamic conditions at 25 °C. Oxidation-Reduction-Potential (ORP) and pH were measured as well in the first, third and fifth days. Microbial consortium (A. niger with Chlorella sp.) was found always more effective – reduction of the Ni content was higher 48.95 mg/L (under static conditions) and 56.45 mg/L (dynamic conditions), pH values were medium acidic (5.84 static conditions), to weak acid (6.52 dynamic conditions). Monitored ORP values were significantly reduced in the range of -309 mV up to - 385 mV in the Ni model aqueous solution, when the both microorganisms were present. This reduction was attributed to the anoxic conditions occurred when the Reactive Oxygen Species (ROS) radicals were produced by the photoactive pigments in the algae chloroplasts.
Combined aeration and mixing system and its use in practice
Authors: Singrova V , Sevcik J
Published: February 2020

The article deals with combined systems, which are mainly used in wastewater treatment plants for the purpose of aeration and mixing. These systems are mainly installed in activation reactors, but their use is also possible, for example, in sludge storage tanks. The combined systems are capable of guaranteeing the required values of relevant monitored pollution indicators at the WWTP effluent. The aim of this article is to describe the activation reactor control algorithm with the combined system. Reliable functionality is proved by the presented average values at the WTP effluent, which meet the required emission limits set by relevant permits.
Environmental Awareness and its Influence on Household Consumption of Goods
Authors: Stofejova L
Published: February 2020

The thesis was aimed at investigation of the level of environmental awareness of consumers in the Slovak Republic and its influence on household consumption, production and treatment of household waste. The survey examined the average amount of separated household waste, the average food costs, the level of environmental awareness, the possibilities to separate waste in a household or nearby and other features. The results of the investigation revealed that the average amount of separated waste in a household was just about 50%, despite of the fact that consumers had possibilities for separation in their household. There were used eligible mathematical and statistical methods and the hypothesis testing that confirmed differences between the estimated rate of recycled waste in Slovakia and in households.
Developing a Water Quality Index (WQI) for River Resources Management in Kien Giang Province, Vietnam
Authors: Tran Q B , Pham A D
Published: February 2020

The objective of this study was to develop a water quality index (WQI) for the surface water management of about 6,299 Km2 in Kien Giang Province. The water quality index (WQI) methodology, which recommended by the Delphi method and Liou et (2004) was used. Seven parameters were selected to derive the WQI for the estimation of water quality in Kien Giang including pH, dissolved oxygen (DO), Biochemical Oxygen Demand (BOD5), total solid suspended (TSS), chloride (Cl−), ammonia (NH4
+), and coliform. Total 48 samples were taken in March and September of 2014, 2015, 2016, 2017, and 2018. Through the result of WQI caculation for each monitoring time and seasonal differences in WQI were noted. The WQI was categorized from 51 to 85 in March 2018; and from 48 to 77 in September 2018. The water quality at the 48 sites in the study area was divided into three levels: (1) use for domestic purposes but need appropriate handling measures; (2) use for irrigation purposes; and, (3) use for other appropriate purposes. The WQI was established to assess the rivers and streams’s quality in Kien Giang as a tool to evaluate the river and canal water’s total quality. This WQI contributes to control of water quality effectively in order to provide informations to protect water resources as well as to serve people’s lives.
Sn-Doped Hematite Nanoparticles for Potential Photocatalytic Dye Degradation
Authors: Em Svetlana , Yedigenov Mussa , Khamkhash Laura , Molkenova Anara , Sh. Atabaev Timur
Published: February 2020

Recently, low-cost hematite (α-Fe2O3) metal oxide semiconductor has attracted enormous attention for the photoelectrochemical water splitting and photocatalytic applications. The main purpose of this work is to study the effects of Sn-doping on the photocatalytic properties of hematite nanoparticles (NPs). Morphology and physicochemical properties of prepared samples were analyzed using X-ray diffraction analysis (XRD), transmission electron microscope (TEM), and UV-vis spectroscopy. Rhodamine B (RB) dye was used as a model organic pollutant to test the photocatalytic activity of prepared samples. It was found that the photocatalytic activity of Sn-doped hematite NPs was higher than that of the undoped hematite NPs. The recyclability tests suggested that 3 mol% Sn-doped hematite NPs can be used as a promising reusable photocatalyst for dyes degradation.
Interior Inspection for Equipment and Furnishings System of Civil Aircraft
Authors: Jianbin Zhou , Xinyuan Zhang , Xiaozheng Wang
Published: February 2020

Equipment and Furnishings System of civil aircraft has many sub-systems, including Pilot Seat, Observer Seat, Cabin Attendant Seat, Galley, Lavatory, Passenger Seat, Overhead Bin, Cockpit Lining, Cabin Lining, Cargo Lining, Emergency Equipment, Passenger Service Unit and Placards/Markings. Inspection (MOC7), as one of means of compliance for certification, is usually used for the certification of the regulations of FAR25.562, 785, 815, etc. The sub-systems in Equipment and Furnishings System are very different at every aspect. They have different functions, working principles and system architectures. These differences make the inspection of Equipment and Furnishings System complicated. A lot of details need attention. This article described the inspection requirement and Pass/Failure criteria for Equipment and Furnishings System.
Automated assessment of the low-rigid composite parts influence on the product assemblability in the GePARD system
Authors: Leonovich D S , Zhuravlev D A , Karlina Yu I , Govorkov A S , Karlina A I
Published: February 2020

Composite components tend to have higher deviations from the nominal dimension in conjunction with metal components. Composites production processes simulation methods have already been developed before long time ago. This article presents the possibility of integrating the technique of non-rigid dimensional chains, taking into account the elastic properties of composite materials to assess the products assemblage with machinery parts from composite materials, on the basis of three-dimensional GePARD system. The fundamental points of the dimensional chain calculating method with non-rigid parts, as well as methods of assessing the stiffness for some types of composite materials, which take into account some peculiarities of its structure, are also examined. The assemblability of an assembly unit is represented by the parameter of the functional assembly requirement depending on the critical accuracy characteristics.
Synthesis, characterization and photocatalytic performance of iron molybdate (Fe2(MoO4)3) for the degradation of endosulfan pesticide
Authors: Parveen S , Bhatti I A , Ashar A , Javed T , Mohsin M , Hussain M T , Khan M I , Naz S , Iqbal M
Published: February 2020

Iron molybdate was prepared via simple solution chemistry method and the photocatalytic degradation of a pesticide (endosulfan) was investigated under visible light irradiation. As-prepared (Fe2(MoO4)3) was characterized using scanning electron microscope (SEM), x-ray diffraction (XRD), energy dispersive x-ray spectra (EDX), diffused reflectance spectroscopy (DRS) and Zeta particle sizer techniques. The iron molybdate crystallite size was 36 nm, while grain size was in the range of 160–340 nm. The particles of polymetallic compound were spherical, highly porous and with fluffy texture indicating high surface area. DRS revealed Fe2(MoO4)3 was active under visible region since band gap value calculated was 2.7 eV. Response surface methodology (RSM) was employed for the optimization of photocatalytic activity (PCA) of Fe2(MoO4)3 as a function of catalyst dose, H2O2 dose, solution pH and concentration of endosulfan and up to 77% degradation was achieved at optimum conditions, which was monitored by UV/vis spectroscopy. In response to endosulfan degradation, the chemical oxygen demand (COD) and total organic carbon (TOC) were reduced up to 76% and 67%, respectively. Results revealed that iron molybdate is highly efficient photocatalyst for the degradation of endosulfan under solar light irradiation and could possibly be used for the treatment of endosulfan containing wastewater.
Coupled thermo-fluidic model for thermal energy storage based on liquid solid phase change
Authors: Ben zohra Mouna , Riad Amine , Alhamany Abdelilah , Sennoune Mohamed
Published: February 2020

The production and storage of thermal energy are important processes that contribute to the satisfaction of daily needs. They are effective ways of managing the thermal energy available from various solar applications. The most efficient storage technique is the use of phase change materials (PCMs) because these components can keep large amounts of thermal energy in stock. The problem is that this approach continues to be confronted with difficulties despite significant progress in research, design and modelling. Nevertheless, these difficulties can be resolved through numerical simulations that enable the identification of powerful tools for optimising thermal system design and predicting thermal behaviour. Correspondingly, in this work, thermo-mechanical modelling was conducted to describe the different methods of heat transfer that can optimise thermal energy storage via PCMs. This study also established a numeric resolution and the spatio-temporal discretisation of the basic equations accompanying the numerical model. The proposed numerical solution improves the prediction of thermal behaviour and can be used as a guide in designing new systems capable of producing and storing solar energy.
A novel synthesis of TiO2/GO nanocomposite for the uptake of Pb2+ and Cd2+ from wastewater
Authors: Siddeeg Saifeldin M
Published: February 2020

Ionic liquids attract attention in the last years due to its powerful solvation properties. For this reason, in current study 1-ethyl-3-methylimidazolium tetrafluoroborate [EMIM-BF4] ILs was used for the synthesis of high surface TiO2/GO nanocomposite, as an active material for heavy metal removal from aqueous media. FT-IR, transmission electron microscopy (TEM), scanning electron microscope (SEM), and x-ray diffraction (XRD) techniques were employed for identification of the novel nanocomposite. Batch experiments were conducted for Cd+2 and Pb+2 uptake from wastewater by the synthesized nanocomposite. The effect of parameters affecting adsorption capicity, such as contact time, pH, nanocomposite dosage and the initial concentration of heavy metals were examined for Cd+2 and Pb+2 removal by the prepared nanocomposite. The removal efficiency of Cd+2 and Pb+2 was 69.36% and 89%, respectively, under optimal conditions confirming the ability to use the prepared nanocomposite for wastewater treatment from heavy metals with high efficiency.
Characterizations of TIG welded MB3/AZ80 joint using various filler wires
Authors: Xu Chuan , Zhang Lizhi
Published: February 2020

In this study, the MB3 and AZ80 Mg alloys were welded by tungsten inert gas welding process with different filler wires. The influences of Al content in filler metal on weld morphologies, microstructure and mechanical performances were studied. Experimental results reveal that the seam width of joint increased with the improvement of welding current and pores occurred in the weld seam with excessive heat input. In the weld seam zone, a great deal of Mg17Al12 precipitated phases occurred owing to the Al element in filler wire, which resulted in the enhanced metallurgical bonding and the increased micro hardness. The maximum tensile strength of 208 MPa was obtained with optimal current of 80 A and AZ61 filler wire, representing an 85% joining efficiency relative to MB3 Mg alloy parent plate. And fracture occurred at weld seam zone, revealing the potential point of joint strength improvement.
Endangered elements
Authors: Stevenson Richard
Published: February 2020

As the International Year of the Periodic Table of Chemical Elements comes to as end, Richard Stevenson investigates whether the long-term supply of key elements in many hi-tech devices – including gallium, hafnium and indium – is really under threat
Europe plans huge gravitational-wave laboratory
Authors: Banks Michael
Published: February 2020

The ELGAR underground laboratory, if built, would consist of two 32 km-long arms to detect gravitational waves via atom interferometry, as Michael Banks reports
Paper tools
Authors: Crease Robert P
Published: February 2020

Feynman diagrams reveal why the tools theorists use are as important as the theories themselves, writes Robert P Crease
Protected space
Authors: Budden John
Published: February 2020

In reply to Monica Vidaurri’s forum article “Building an ethical consensus” (November p19), about the ethics of human space travel.
Artificial assistance
Authors: Abbott Paul
Published: February 2020

In reply to the letter “Data for days” (November p24), which continued the discussion of annoying lab tasks that are now obsolete.
Kamchatka or bust: an unlikely quest
Authors: Johnston Hamish
Published: February 2020

A rip-roaring adventure tale, featuring a mild-mannered theoretical physicist, who found himself leading an expedition to the mosquito-and-bear-infested wilderness of eastern Russia in search of tiny grains of rock from outer space. That's on offer in physicist Paul Steinhardt's book The Second Kind of Impossible: the Extraordinary Quest for a New Form of Matter.
Gianotti to remain CERN boss until 2025
Authors: Banks Michael
Published: February 2020

The Italian particle physicist will now oversee the completion of the high-luminosity upgrade to CERN’s Large Hadron Collider, as Michael Banks reports
Rural ecotourism planning and design based on SWOT analysis
Authors: Shang Yunfeng , Sun Yunpeng , Xu Aidi
Published: February 2020

With the increasing pace of urban life, people are yearning more and more for a slow-paced rural life. Rural ecotourism is a new type of tourism produced for people to experience rural scenery. In order to ensure the sustainable development of rural eco-tourism, it is necessary to analyze its planning in many aspects. In this study, Tianjin rural eco-tourism was analyzed using the superiority, weakness, opportunity and threats analysis method. Then, according to the analysis, the superiority, weakness, opportunity and threat were obtained, and they were quantitatively analyzed by means of a questionnaire. The results showed that the development of Tianjin rural eco-tourism had four superiorities, i.e. convenient transportation, rich water resources, rich animal and plant resources and rich eco-tourism resources; three weakness, i.e. homogeneous content, unclear theme and low quality of staff; three opportunities, i.e. government support, effective combination of local culture with tourism activities and increased demand for tourism; and two threats, i.e. fierce competition among peers and diversified demands of tourists. In the comprehensive quantitative analysis, the comprehensive scores of superiorities, weakness, opportunities and threats were 3.6, −2.8, 4.4 and −4.4, respectively. To sum up, Tianjin rural ecotourism has superiorities over weakness and equivalent opportunities and threats; i.e. it is basically in a state of sustainable development.
Densities of Currents on Non-Kähler Manifolds
Authors: Vu Duc-Viet
Published: February 2020

We give a natural generalization of the Dinh–Sibony notion of density currents in the setting where the ambient manifold is not necessarily Kähler. As an application, we show that the algebraic entropy of meromorphic self-maps of compact complex surfaces is a finite bi-meromorphic invariant.
Racial and Ethnic Disparities Among Burn Surgery Leadership
Authors: Kettering Caroline E , Egro Francesco M , Konanur Anisha , Smith Brandon T , Corcos Alain C , Stofman Guy M , Ziembicki Jenny A
Published: February 2020

The underrepresentation of racial and ethnic minority groups has been well-documented in general and plastic surgery but not in burn surgery. The aim of this study is to evaluate current minority group disparities among burn surgery leadership. A cross-sectional analysis was performed. Burn surgeons included directors of American Burn Association-verified burn centers in the United States, past and current presidents of the American Burn Association, and editorial board members of five major burn journals (Journal of Burn Care & Research, Burns, Burns & Trauma, Annals of Burns & Fire Disasters, and the International Journal of Burns and Trauma). Surgeons were compared based on factors including age, gender, training, academic rank, and Hirsch index (h-index). Among 71 burn center directors, 50 societal presidents, and 197 journal editors, minority groups represented 18.3, 2.0, and 34.5%, respectively. Among burn center directors, the group classified collectively as nonwhite was significantly younger (49 vs 56; P < .01), graduated more recently (2003 vs 1996; P < .01), and had a lower h-index (9.5 vs 17.4; P < .05). There were no significant differences in gender, type of residency training, advanced degrees obtained, fellowships, academic rank, and academic leadership positions between white and nonwhite groups. When compared with the 2018 U.S. National Census, burn unit directors had a 5.1% decrease in nonwhite representation. Disparities in representation of ethnic and racial minorities exist in burn surgery despite having similar qualifying factors.
High-mass star formation in Orion possibly triggered by cloud–cloud collision. III. NGC 2068 and NGC 2071
Authors: Fujita Shinji , Tsutsumi Daichi , Ohama Akio , Habe Asao , Sakre Nirmit , Okawa Kazuki , Kohno Mikito , Hattori Yusuke , Nishimura Atsushi , Torii Kazufumi , Sano Hidetoshi , Tachihara Kengo , Kimura Kimihiro , Ogawa Hideo , Fukui Yasuo
Published: February 2020

Using the NANTEN2 Observatory, we carried out a molecular-line study of high-mass star forming regions with reflection nebulae, NGC 2068 and NGC 2071, in Orion in the $^{13}$CO($J = 2$–1) transition. The $^{13}$CO distribution shows that there are two velocity components at ${9.0}$ and ${10.5}\:$km$\:$s$^{-1}$. The blue-shifted component is in the northeast associated with NGC 2071, whereas the red-shifted component is in the southwest associated with NGC 2068. The total intensity distribution of the two clouds shows a gap of $\sim\!\! 1\:$pc, suggesting that they are detached at present. A detailed spatial comparison indicates that the two show complementary distributions. The blue-shifted component lies toward an intensity depression to the northwest of the red-shifted component, where we find that a displacement of ${0.8}\:$pc makes the two clouds fit well with each other. Furthermore, a new simulation of non-frontal collisions shows that observations from $60^\circ$ off the collisional axis agreed well with the velocity structure in this region. On the basis of these results, we hypothesize that the two components collided with each other at a projected relative velocity of ${3.0}\:$km$\:$s$^{-1}$. The timescale of the collision is estimated to be ${0.3}\:$Myr for an assumed axis of the relative motion $60^\circ$ off the line of sight. We assume that the two most massive early B-type stars in the cloud, illuminating stars of the two reflection nebulae, were formed by collisional triggering at the interfaces between the two clouds. Given the other young high-mass star-forming regions, namely, M 42, M 43, and NGC 2024 (Fukui et al. 2018a, ApJ, 859, 166; Ohama et al. 2017, arXiv: 1706.05652), it seems possible that collisional triggering has been independently working to form O-type and early B-type stars in Orion in the last Myr over a projected distance of ∼80 pc.
Electrophysiological Estimates of the Electrode–Neuron Interface Differ Between Younger and Older Listeners With Cochlear Implants
Authors: Jahn Kelly N. , Arenberg Julie G.
Published: February 2020

Objectives:

The primary objective of this study was to quantify differences in evoked potential correlates of spiral ganglion neuron (SGN) density between younger and older individuals with cochlear implants (CIs) using the electrically evoked compound action potential (ECAP). In human temporal bone studies and in animal models, SGN density is the lowest in older subjects and in those who experienced long durations of deafness during life. SGN density also varies as a function of age at implantation and hearing loss etiology. Taken together, it is likely that younger listeners who were deafened and implanted during childhood have denser populations of SGNs than older individuals who were deafened and implanted later in life. In animals, ECAP amplitudes, amplitude growth function (AGF) slopes, and their sensitivity to stimulus interphase gap (IPG) are predictive of SGN density. The authors hypothesized that younger listeners who were deafened and implanted as children would demonstrate larger ECAP amplitudes, steeper AGF slopes, and greater IPG sensitivity than older, adult-deafened and implanted listeners.

Design:

Data were obtained from 22 implanted ears (18 individuals). Thirteen ears (9 individuals) were deafened and implanted as children (child-implanted group), and nine ears (9 individuals) were deafened and implanted as adults (adult-implanted group). The groups differed significantly on a number of demographic variables that are implicitly related to SGN density: (1) chronological age; (2) age at implantation; and (3) duration of preimplantation hearing loss. ECAP amplitudes, AGF linear slopes, and thresholds were assessed on a subset of electrodes in each ear in response to two IPGs (7 and 30 µsec). Speech recognition was assessed using a medial vowel identification task.

Results:

Compared with the adult-implanted listeners, individuals in the child-implanted group demonstrated larger changes in ECAP amplitude when the IPG of the stimulus was increased from 7 to 30 µsec (i.e., greater IPG sensitivity). On average, child-implanted participants also had larger ECAP amplitudes and steeper AGF linear slopes than the adult-implanted participants, irrespective of IPG. IPG sensitivity for AGF linear slope and ECAP threshold did not differ between age groups. Vowel recognition performance was not correlated with any of the ECAP measures assessed in this study.

Conclusions:

The results of this study support the theory that young CI listeners who were deafened and implanted during childhood may have denser neural populations than older listeners who were deafened and implanted as adults. Potential between-group differences in SGN integrity emphasize a need to investigate optimized CI programming parameters for younger and older listeners.
Iatrogenic Peroneal Nerve Palsy Rates Secondary to Open Reduction Internal Fixation for Tibial Plateau Fractures Using an Intraoperative Distractor
Authors: Pattyn Ryan , Loder Randall , Mullis Brian H.
Published: February 2020

Objective:

To report the rate of peroneal nerve palsy after routine use of intraoperative distraction during open reduction internal fixation (ORIF) for lateral unicondylar and bicondylar tibial plateau fracture (TPF) repairs.

Design:

Retrospective chart review.

Setting:

Level I trauma center.

Patients:

Patients with traumatic TPF treated with ORIF between 2007 and 2017.

Intervention:

ORIF for lateral unicondylar and bicondylar TPF.

Main Outcome Measurement:

Presence and resolution of neurovascular injury.

Results:

There were a total of 21 lateral unicondylar and 40 bicondylar TPFs repaired through ORIF in 60 patients identified during the study period with 1-year follow-up and complete records for review. Thirty-six patients had staged external fixation before ORIF while 24 were treated with ORIF initially. Of the staged patients, 9 of 36 (25%) developed nerve palsy while those undergoing initial ORIF (not staged) developed palsy in only one case (1 of 24, or 4%). Of the patients who developed nerve palsy, 9 of 10 (90%) were staged with an initial external fixator before ORIF. The incidence of iatrogenic peroneal nerve palsy secondary to intraoperative distraction was 16.4% (10 of 61). Only 60% (6 of 10) of peroneal nerve palsies recovered clinically with a mean recovery time of approximately 14 weeks. Comparison of demographics in patients with peroneal nerve palsy versus those without yielded no significant difference by sex (P = 0.08), age (P = 0.27), fracture type (P = 0.29), tobacco use (P = 0.44), or alcohol use (P = 0.78).

Conclusions:

Peroneal nerve palsy is a common sequela of ORIF for TPFs involving the lateral compartment using an intraoperative distractor. Staged external fixation followed by definitive ORIF using intraoperative distraction was associated with significant risk for developing nerve palsy (9/10). Many patients (40%) who develop peroneal nerve palsies do not recover, leading to permanent loss of motor and/or sensory function for 7% of patients studied. None of the epidemiologic variables evaluated yielded predictive value for development of peroneal nerve palsy or subsequent resolution. Caution should be exercised in avoiding overdistraction when using intraoperative distraction, especially in those cases that had staged fixation, most notably bicondylar injuries.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Order of Live and Inactivated Vaccines and Risk of Non–vaccine-targeted Infections in US Children 11–23 Months of Age
Authors: Newcomer Sophia R. , Daley Matthew F. , Narwaney Komal J. , Xu Stan , DeStefano Frank , Groom Holly C. , Jackson Michael L. , Lewin Bruno J. , McLean Huong Q. , Nordin James D. , Zerbo Ousseny , Glanz Jason M.
Published: February 2020

Background:

Some findings from observational studies have suggested that recent receipt of live vaccines may be associated with decreased non–vaccine-targeted infection risk and mortality. Our objective was to estimate risk of non–vaccine-targeted infections based on most recent vaccine type (live vaccines only, inactivated vaccines only or both concurrently) received in US children 11–23 months of age.

Methods:

We conducted a retrospective cohort study within the Vaccine Safety Datalink. We examined electronic health record and immunization data from children born in 2003–2013 who received 3 diphtheria-tetanus-acellular pertussis vaccines before their first birthday. We modeled vaccine type as a time-varying exposure and estimated risk of non–vaccine-targeted infections identified in emergency department and inpatient settings, adjusting for multiple confounders.

Results:

Among 428,608 children, 48.9% were female, 4.9% had ≥1 immunization visit with live vaccines only and 10.3% had a non–vaccine-targeted infection. In males, lower risk of non–vaccine-targeted infections was observed following last receipt of live vaccines only or live and inactivated vaccines concurrently as compared with last receipt of inactivated vaccines only [live vaccines-only adjusted hazard ratio (aHR) = 0.83, 95% confidence interval (CI): 0.72–0.94; live and inactivated vaccines concurrently aHR: 0.91, 95% CI: 0.88–0.94]. Among females, last receipt of live and inactivated vaccines concurrently was significantly associated with non–vaccine-targeted infection risk (aHR = 0.94, 95% CI: 0.91–0.97 vs. last receipt of inactivated vaccines only).

Conclusions:

We observed modest associations between live vaccine receipt and non–vaccine-targeted infections. In this observational study, multiple factors, including healthcare-seeking behavior, may have influenced results.
The Effect of Patient Volume and Experience on Management of Menière's Disease
Authors: Sacks Cody , Saadi Robert , Isildak Huseyin
Published: February 2020

Hypothesis:

Treatment modalities administered by Otolaryngologists vary based on patient volume and years of experience.

Objective:

It was our goal to evaluate the current trends in treatment modalities administered by Otolaryngologists based on patient volume and years of experience.

Methods:

An electronic questionnaire was distributed to all General Otolaryngologists and fellowship-trained Neurotologist members of the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS). Respondents were separated into groups by patients per year (<10, 10–29, 30–49, 50–99, or >100 patients) and years in practice (0–5, 6–10, 11–15, 16–20, or >20 yrs).

Results:

Eight hundred and sixty members replied for a response rate of 14.5% for generalists and 35% for neurotologists. Patient volume was found to have a positive association with perceived benefit of lifestyle and diet modification, and use of intratympanic steroids, intratympanic gentamycin, oral steroids, benzodiazepines, acetazolamide, endolymphatic sac procedures, vestibular nerve section, and surgical labyrinthectomy. Only endolymphatic sac procedures were found to have a significant positive association with a physician's length in practice. The only negative association was between intratympanic steroids and a physician's length in practice.

Conclusion:

Physicians who see more MD patients annually are more likely to use these treatment modalities: diet and lifestyle modification, intratympanic steroids, intratympanic gentamycin, surgical labyrinthectomy, vestibular nerve section, acetazolamide, alprazolam, lorazepam, dexamethasone, and prednisone. Physicians with a longer length of time in practice are more likely to use only endolymphatic sac procedures, and they are less likely to use intratympanic steroids.
Stereologic Investigation of Mastoid Air Cell Geometry: Volume, Surface Area, and Anisotropy
Authors: Søndergaard Nikolaj , Nyengaard Jens Randel , Bloch Sune Land
Published: February 2020

Objective:

To assess mastoid geometry using computed tomography (CT) scans and design-based stereological methods.

Background:

The anatomical organization of the mastoid air cell system (MACS) remains debated. Geometrical parameters have previously been determined by automated image-analysis algorithms. Stereology is an alternative approach, which has previously been applied to estimate the volume of the MACS, but has not previously been used to estimate surface area or study anisotropy.

Methods:

Twenty-three clinical CT scans of aerated temporal bones obtained from various ENT patients were studied. The structural orientation and anisotropy of the MACS was investigated by test-grid rotation and rose plots. Volume, surface area, and surface area-to-volume ratio were estimated with design-based stereology.

Results:

Anisotropy of the mastoid air cells was demonstrated by a significant difference in surface area estimates between the axial and coronal planes (p = 0.0065). Rose plots illustrated variances in surface area estimates with different grid rotations, and a minimum value in the craniocaudal direction was shown. Sampling in the axial plane provided the least variance due to anisotropy. The mean (±SD) volume and surface area estimates were 5.71 ± 2.98 cm3 and 117 cm2 ± 60 cm2, respectively. A large biological variation was noted. The mean (±SD) surface-to-volume ratio was 20.6 ± 2.8 cm−1.

Conclusions:

The stereological technique proved to be a robust method for volume and surface area estimation in clinical CT scans. The mastoid air cells constitute an anisotropic cell-system that seems to have a predominant orientation in the craniocaudal direction.
Early detection of progressive disease using thyroglobulin doubling-time in metastatic differentiated thyroid carcinoma treated with radioactive iodine
Authors: Zhang Xieyi , Higuchi Tetsuya , Tomonaga Hiroyasu , Lamid-Ochir Oyunbold , Bhattarai Anu , Nguyen-Thu Huong , Taketomi-Takahashi Ayako , Hirasawa Hiromi , Tsushima Yoshito
Published: February 2020

Objective

Detectable serum thyroglobulin (Tg) in patients with differentiated thyroid carcinoma (DTC) after total thyroidectomy indicates progression of the disease. Thyroglobulin doubling-time (TgDT) is a powerful prognostic predictor in patients with DTC. We aimed to evaluate the value of the dynamic TgDT for early detection of progressive disease (PD) in the patients of metastatic DTC with 131I radioactive iodine (RAI) therapy.

Methods

We retrospectively evaluated 21 patients undergoing RAI therapy with metastatic DTC. Patients were defined as PD or non-PD according to Response Evaluation Criteria in Solid Tumors 1.1. TgDT was calculated by Excel-based software using Tg values measured during routine follow-up. Whole data (WDT), initial four data (IDT) and recent four data (RDT) of TgDT after total thyroidectomy were calculated and compared.

Results

Among the 21 patients (10 men; median age, 62 years old; range, 33–80), 11 patients were classified into PD and 10 were into non-PD. The initial Tg after total thyroidectomy showed a significant difference between PD and non-PD patients (P = 0.013). Short WDT, IDT and RDT (less than one year) showed a high correlation with PD (P < 0.05). RDT showed the highest predictive value for PD (P < 0.001). All the 11 PD patients showed RDT less than one year before PD (median follow-up, 157 days; range, 88–252).

Conclusions

RDT is a powerful PD predictor in patients with metastatic DTC. Dynamic monitoring of RDT should be applied for the early detection of PD in clinic.
Instilling Hope and Resiliency
Authors: Lurie Jacob Michael , Lever Hazel , Goodson Lucy , Lyons Daniel Jack , Yanagisawa Robert T. , Katz Craig L.
Published: February 2020

On March 11, 2011 (“3/11”), a magnitude 9.0 earthquake in Northeastern Japan triggered a tsunami and nuclear power plant meltdown that killed 16,000 people and displaced more than 470,000 people. Since 2012, a group of volunteer docents from the September 11th Families Association in New York City has traveled throughout Northeastern Japan and held organized meetings where 9/11 and 3/11 survivors share their experiences and stories of trauma as part of an intercultural exchange to promote posttraumatic recovery. We sought to elucidate whether participating 9/11 docents developed a sense of increased resiliency by participating in this international outreach. This study employed photo-taking as well as framing questions, which were developed by 9/11 docents from the August 2016 trip. These questions guided photo-taking and resulting photographs informed discussion in individual and group sharing sessions. This process helped identify codes that guided analysis. Participants acquired a deeper appreciation of their own ability to overcome adversity and experienced a gratifying desire to help 3/11 survivors better cope with their experiences. This narrative photo-taking and group sharing experience demonstrates that a cross-cultural exchange between survivors of different disasters can instill feelings of resilience among participants. It additionally provides early evidence of the efficacy of such an exchange in benefitting disaster survivors in the long term.
Prepectoral Direct-to-Implant Breast Reconstruction: Safety Outcome Endpoints and Delineation of Risk Factors
Authors: Nealon Kassandra P. , Weitzman Rachel E. , Sobti Nikhil , Gadd Michele , Specht Michelle , Jimenez Rachel B. , Ehrlichman Richard , Faulkner Heather R. , Austen William G. , Liao Eric C.
Published: February 2020

Background:

Continued evolution of implant-based breast reconstruction involves immediate placement of the implant above the pectoralis muscle. The shift to prepectoral breast reconstruction is driven by goals of decreasing morbidity such as breast animation deformity, range-of-motion problems, and pain, and is made possible by improvements in mastectomy skin flap viability. To define clinical factors to guide patient selection for direct-to-implant prepectoral implant reconstruction, this study compares safety endpoints and risk factors between prepectoral and subpectoral direct-to-implant breast reconstruction cohorts. The authors hypothesized that prepectoral direct-to-implant breast reconstruction is a safe alternative to subpectoral direct-to-implant breast reconstruction.

Methods:

Retrospective chart review identified patients who underwent prepectoral and subpectoral direct-to-implant breast reconstruction, performed by a team of five surgical oncologists and two plastic surgeons. Univariate analysis compared patient characteristics between cohorts. A penalized logistic regression model was constructed to identify relationships between postoperative complications and covariate risk factors.

Results:

A cohort of 114 prepectoral direct-to-implant patients was compared with 142 subpectoral direct-to-implant patients. The results of the penalized regression model demonstrated equivalence in safety metrics between prepectoral direct-to-implant and subpectoral direct-to-implant breast reconstruction, including seroma (p = 0.0883), cancer recurrence (p = 0.876), explantation (p = 0.992), capsular contracture (p = 0.158), mastectomy skin flap necrosis (p = 0.769), infection (p = 0.523), hematoma (p = 0.228), and revision (p = 0.122).

Conclusions:

This study demonstrates that prepectoral direct-to-implant reconstruction is a safe alternative to subpectoral direct-to-implant reconstruction. Given the low morbidity and elimination of animation deformity, prepectoral direct-to-implant reconstruction should be considered when the mastectomy skin flap is robust.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
A Comparative Evaluation of Cardiothoracic Radiology Fellowship Website Content
Authors: Gibney Brian , Redmond Ciaran E. , Niu Bonnie , Hamid Saira , Kim Gio , O’Neill Siobhán B. , Khosa Faisal
Published: February 2020

Purpose:

Prospective radiology fellows often rely on the internet to obtain information with regard to the application process for and the unique qualities of different fellowship programs. The aim of this study was to analyze the content of websites of the United States’ and Canadian cardiothoracic radiology fellowships.

Methods:

All active Cardiothoracic Radiology fellowship websites as of July 2019 were evaluated and compared using 25 criteria in the following domains: Application, Recruitment, Clinical Training, Education/Research, and Incentives. Program website information availability was compared by geographic region.

Results:

There were 60 active cardiothoracic radiology fellowships, and 59 of these fellowships had a dedicated fellowship website. Websites, on average, had 9.3 of the 25 criteria (37.2%). The mean number of schools that satisfied the criterion in the “Incentives” domain ([7.75/59] 10.5%±2.8%) was significantly lower than that for the “Application Process” domain ([40.50/59]; 68.7%±40.6%) (P=0.01). There was no significant difference in the information content of programs in different geographic regions (P=0.246).

Conclusion:

Most cardiothoracic radiology fellowship websites were lacking content relevant to prospective fellows. Provision of more relevant and easily accessible online content may support programs to better inform and recruit residents and to promote the specialty of cardiothoracic radiology.
Accelerating availability of clinically-relevant parameter estimates from thromboelastogram point-of-care device
Authors: Pressly Michelle A. , Parker Robert S. , Neal Matthew D. , Sperry Jason L. , Clermont Gilles
Published: February 2020

BACKGROUND

Modeling approaches offer a novel way to detect and predict coagulopathy in trauma patients. A dynamic model, built and tested on thromboelastogram (TEG) data, was used to generate a virtual library of over 160,000 simulated RapidTEGs. The patient-specific parameters are the initial platelet count, platelet activation rate, thrombus growth rate, and lysis rate (P(0), k1, k2, and k3, respectively).

METHODS

Patient data from both STAAMP (n = 182 patients) and PAMPer (n = 111 patients) clinical trials were collected. A total of 873 RapidTEGs were analyzed. One hundred sixteen TEGs indicated maximum amplitude (MA) below normal and 466 TEGs indicated lysis percent above normal. Each patient's TEG response was compared against the virtual library of TEGs to determine library trajectories having the least sum-of-squared error versus the patient TEG up to each specified evaluation time ∈ (3, 4, 5, 7.5, 10, 15, 20 minutes). Using 10 nearest-neighbor trajectories, a logistic regression was performed to predict if the patient TEG indicated MA below normal (<50 mm), lysis percent 30 minutes after MA (LY30) greater than 3%, and/or blood transfusion need using the parameters from the dynamic model.

RESULTS

The algorithm predicts abnormal MA values using the initial 3 minutes of RapidTEG data with a median area under the curve of 0.95, and improves with more data to 0.98 by 10 minutes. Prediction of future platelet and packed red blood cell transfusion based on parameters at 4 and 5 minutes, respectively, provides equivalent predictions to the traditional TEG parameters in significantly less time. Dynamic model parameters could not predict abnormal LY30 or future fresh-frozen plasma transfusion.

CONCLUSION

This analysis could be incorporated into TEG software and workflow to quickly estimate if the MA would be below or above threshold value within the initial minutes following a TEG, along with an estimate of what blood products to have on hand.

LEVEL OF EVIDENCE

Therapeutic/Care Management: Level IV.
Memory T Cells in Transplantation: Old Challenges Define New Directions
Authors: Nicosia Michael , Fairchild Robert L. , Valujskikh Anna
Published: February 2020

Immunologic memory is the ability of adaptive immune system to quickly and specifically recognize previously encountered antigens and initiate an effector response. Alloreactive memory cells can mount rapid and robust responses to the transplanted organ resulting in allograft injury. Thus preexisting humoral or cellular memory alloresponses are typically associated with poor graft outcomes in experimental and clinical transplantation. While both B and T lymphocytes exhibit memory responses, this review discusses recent updates on the biology of memory T cells and their relevance to the field of transplantation. Three major areas of focus are the emergence and characterization of tissue resident memory T cells, manipulation of T cell metabolic pathways, and the latest promising approaches to targeting detrimental T cell memory in the settings of organ transplantation.
Insulin-like signalling influences the coordination ofDrosophilalarval hemocyte number with body size
Authors: Bakopoulos Daniel , Beadle Lauren Forbes , Esposito Katherine M. , Mirth Christen K. , Warr Coral G. , Johnson Travis K.
Published: February 2020

Blood cells, known as hemocytes in invertebrates, play important and conserved roles in immunity, wound healing and tissue remodelling. The control of hemocyte number is therefore critical to ensure these functions are not compromised, and studies usingDrosophilaare proving useful for understanding how this occurs. Recently, the well characterised embryonic patterning gene,torso-like(tsl), was identified as being required both for normal hemocyte number and for providing immunity against certain pathogens. Here, we report that Tsl is required specifically during the larval phase of hematopoiesis, and that the reduced hemocyte number found intslmutant larvae is likely the result of a reduced larval growth rate and compromised insulin signalling. Consistent with this, we find that impairing insulin-mediated growth, either by nutrient deprivation or genetically, results in fewer hemocytes. This is likely the result of impaired insulin-like signalling in the hemocytes themselves since modulation of Insulin-like Receptor (InR) activity specifically in hemocytes causes concomitant changes to their population size in developing larvae. Taken together, our work reveals the strong relationship that exists between body size and hemocyte number, and suggests that insulin-like signalling contributes to, but is not solely responsible for, keeping these tightly aligned during larval development.
Growth differentiation factor-15 is associated with age-related monocyte immunosenescence
Authors: Pence Brandt D. , Yarbro Johnathan R. , Emmons Russell S.
Published: February 2020

Background

Immunosenescence is an age-associated decrease in function of immune cells precipitated by a variety of mechanisms and affecting nearly every immune cell subset. In myeloid cell subsets, aging reduces numbers of phagocytes and impairs their functional abilities, including antigen presentation, phagocytosis, and bacterial clearance. Recently, we have described an aging effect on several functions indicating immunosenescence in monocytes, including impaired mitochondrial function and reduced inflammatory cytokine gene expression during stimulation with lipopolysaccharide (LPS). We hypothesized that circulating factors altered by the aging process underly these changes. Growth/differentiation factor-15 (GDF-15) is a distant member of the transforming growth factor-beta superfamily that has known anti-inflammatory effects in macrophages and has recently been shown to be highly differentially expressed during aging. We used biobanked serum and plasma samples to assay circulating GDF-15 levels in subjects from our previous studies and examined correlations between GDF-15 levels and monocyte mitochondrial function and inflammatory responses.

Results

Monocyte interleukin-6 production due to lipopolysaccharide stimulation was negatively correlated to plasma GDF-15 levels. Additionally, serum GDF-15 was positively correlated to circulating CD16+ monocyte proportions and negatively correlated to monocyte mitochondrial respiratory capacity.

Conclusions

The results of these analyses suggest that GDF-15 is a potential circulating factor affecting a variety of monocyte functions and promoting monocyte immunosenescence, and thus may be an attractive candidate for therapeutic intervention to ameliorate this.