Outcomes of 8 × 8 mm osteotomy in powered external dacryocystorhinostomy.

Purpose: To study the endoscopic ostium characteristics and outcome of 8 × 8 mm osteotomy in external dacryocystorhinostomy (DCR) using the microdrill system. Methods: This prospective interventional pilot study was performed on 40 eyes of 40 patients with primary acquired nasolacrimal duct obstruction (NLDO) from June 2021 to September 2021 in patients undergoing external DCR. An 8 × 8 mm osteotomy was performed using round, cutting burr attached to a microdrill system. Success was defined as patent ostium on lacrimal syringing (anatomical) and a Munk score <3 (functional) at 12 months. Postoperative endoscopic ostium evaluation was done using a modified DCR ostium (DOS) scoring system at 12 months. Results: The mean age of the study participants was 42.41 ± 11.77 years and the male-to-female ratio was 1:4. The mean duration of surgery was 34.15 ± 1.66 minutes and that for osteotomy creation was 2.5 ± 0.69 minutes. The mean intraoperative blood loss was 83.37 ± 11.89 ml. Anatomical and functional success rates were 95% and 85%, respectively. The mean modified DOS score was "excellent" in 34 patients (85%), "good" in 1 patient (2.5%), "fair" in 4 patients (10%), and "poor" in 1 patient (2.5%). Complications included nasal mucosal injury in 10% (4/40) of patients, complete cicatricial closure of ostium in 2.5% (1/40), incomplete cicatricial closure in 10% (4/40), nasal synechiae in 5% (2/40), and canalicular stenosis in 2.5% (1/40). Conclusion: An 8 × 8 mm-sized osteotomy created by powered drill and covered by lacrimal sac-nasal mucosal flap anastomosis in external DCR is an effective technique that has minimal complications and shorter surgical time.

Identifying and sharing per-and polyfluoroalkyl substances hot-spot areas and exposures in drinking water.

Exposure to per- and polyfluoroalkyl substances (PFAS) in drinking water is widely recognized as a public health concern. Decision-makers who are responsible for managing PFAS drinking water risks lack the tools to acquire the information they need. In response to this need, we provide a detailed description of a Kentucky dataset that allows decision-makers to visualize potential hot-spot areas and evaluate drinking water systems that may be susceptible to PFAS contamination. The dataset includes information extracted from publicly available sources to create five different maps in ArcGIS Online and highlights potential sources of PFAS contamination in the environment in relation to drinking water systems. As datasets of PFAS drinking water sampling continue to grow as part of evolving regulatory requirements, we used this Kentucky dataset as an example to promote the reuse of this dataset and others like it. We incorporated the FAIR (Findable, Accessible, Interoperable, and Reusable) principles by creating a Figshare item that includes all data and associated metadata with these five ArcGIS maps.

A proposed FAIR approach for disseminating geospatial information system maps.

We present a draft Minimum Information About Geospatial Information System (MIAGIS) standard for facilitating public deposition of geospatial information system (GIS) datasets that follows the FAIR (Findable, Accessible, Interoperable and Reusable) principles. The draft MIAGIS standard includes a deposition directory structure and a minimum javascript object notation (JSON) metadata formatted file that is designed to capture critical metadata describing GIS layers and maps as well as their sources of data and methods of generation. The associated miagis Python package facilitates the creation of this MIAGIS metadata file and directly supports metadata extraction from both Esri JSON and GEOJSON GIS data formats plus options for extraction from user-specified JSON formats. We also demonstrate their use in crafting two example depositions of ArcGIS generated maps. We hope this draft MIAGIS standard along with the supporting miagis Python package will assist in establishing a GIS standards group that will develop the draft into a full standard for the wider GIS community as well as a future public repository for GIS datasets.

A geospatial and binomial logistic regression model to prioritize sampling for per- and polyfluorinated alkyl substances in public water systems.

As health-based drinking water standards for per- and polyfluorinated alkyl substances (PFAS) continue to evolve, public health and environmental protection decision-makers must assess exposure risks associated with all public drinking water systems in the United States (US). Unfortunately, current knowledge regarding the presence of PFAS in environmental systems is limited. In this study, a screening approach was established to: (1) identify and direct attention toward potential PFAS hot spots in drinking water sources, (2) prioritize sampling locations, and (3) provide insights regarding the potential PFAS sources that contaminate groundwater and surface water. Our approach incorporates geospatial data from public sources, including the US Environmental Protection Agency's Toxic Release Inventory, to identify locations where PFAS may be present in drinking water sources. An indicator factor (also known as "risk factor") was developed as a function of distance between potential past and/or present PFAS users (e.g., military bases, industrial sites, and airports) and the public water system, which generates a heat map that visualizes potential exposure risks. A binomial logistic regression model indicates whether PFAS are likely to be detected in public water systems. The results obtained using the developed screening approach aligned well (with a 76% overall model accuracy) with PFAS sampling and chemical analysis data from 81 public drinking water systems in the state of Kentucky. This study proposes this screening model as an effective decision aid to assist key decision-makers in identifying and prioritizing sampling locations for potential PFAS exposure risks in the public drinking water sources in their service areas. Integr Environ Assess Manag 2023;19:163-174. © 2022 SETAC.

Balancing incomplete COVID-19 evidence and local priorities: risk communication and stakeholder engagement strategies for school re-opening.

In the midst of the COVID-19 pandemic, United States (U.S.) educational institutions must weigh incomplete scientific evidence to inform decisions about how best to re-open schools without sacrificing public health. While many communities face surging case numbers, others are experiencing case plateaus or even decreasing numbers. Simultaneously, some U.S. school systems face immense infrastructure challenges and resource constraints, while others are better positioned to resume face-to-face instruction. In this review, we first examine potential engineering controls to reduce SARS-CoV-2 exposures; we then present processes whereby local decision-makers can identify and partner with scientists, faculty, students, parents, public health officials, and others to determine the controls most appropriate for their communities. While no solution completely eliminates risks of SARS-CoV-2 exposure and illness, this mini-review discusses engaged decision and communication processes that incorporate current scientific knowledge, school district constraints, local tolerance for health risk, and community priorities to help guide schools in selecting and implementing re-opening strategies that are acceptable, feasible, and context-specific.

Building science approaches for vapor intrusion studies.

Indoor air concentrations are susceptible to temporal and spatial variations and have long posed a challenge to characterize for vapor intrusion scientists, in part, because there was a lack of evidence to draw conclusions about the role that building and weather conditions played in altering vapor intrusion exposure risks. Importantly, a large body of evidence is available within the building science discipline that provides information to support vapor intrusion scientists in drawing connections about fate and transport processes that influence exposure risks. Modeling tools developed within the building sciences provide evidence of reported temporal and spatial variation of indoor air contaminant concentrations. In addition, these modeling tools can be useful by calculating building air exchange rates (AERs) using building specific features. Combining building science models with vapor intrusion models, new insight to facilitate decision-making by estimating indoor air concentrations and building ventilation conditions under various conditions can be gained. This review highlights existing building science research and summarizes the utility of building science models to improve vapor intrusion exposure risk assessments.