Synthesis of high quality boehmite and γ-alumina for phosphorus removal from water works sludge by extraction and hydrothermal treatment.

Alum sludge from water treatment was calcined and extracted to synthesize high quality boehmite and γ-alumina for phosphate removal. Synthesized boehmite and γ-alumina were able to remove phosphate quickly and effectively. Boehmite (hydrothermal treatment at 60 °C) showed maximum phosphate removal (adsorption) of 61 mg P/g followed by γ-alumina (50 mg P/g) and the boehmite hydrothermally treated at 120 °C (41 mg P/g). The degree of crystallinity gave more effect on phosphate adsorption of boehmite than that of γ-alumina. The lower the pH, the more phosphate adsorbed on the boehmite and γ-alumina (adsorb phosphate more than 4 times at pH 3 than at pH 11). Spectroscopic analysis (SEM-EDS and FTIR) indicates that phosphate are removed by ligand exchange, electrostatic attraction, and surface precipitation on the synthesized boehmite and γ-alumina.

A new genus of minute stingless bees from Southeast Asia (Hymenoptera, Apidae).

A new genus of minute stingless bees (Meliponini: Hypotrigonina) is described from Southeast Asia. Ebaiotrigona Engel & Nguyen, gen. nov., is based on the type species Lisotrigonacarpenteri Engel, recorded from Vietnam, Thailand, Laos, Cambodia, and southern China. The species was previously considered an enigmatic member of Lisotrigona Moure, but is removed to a new genus based on its unique male terminalia that differs considerably from that of Lisotrigona and instead shares resemblances with Austroplebeia Moure, and the presence of yellow maculation (also similar to that of Austroplebeia). It is possible that Ebaiotrigona is the extant sister group of Austroplebeia, but this requires confirmation by future phylogenetic analyses. Based on available biological observations, Ebaiotrigonacarpenteri could not be confirmed as lachryphagous as is well documented from the tear-drinking species of Lisotrigona and Pariotrigona Moure.

Incidence of thrombosis in relapsed/refractory B-cell lymphoma treated with axicabtagene ciloleucel: Mayo Clinic experience.

Chimeric antigen receptor (CAR) T-cell therapy is effective in relapsed/refractory large B-cell lymphoma and results in a unique toxicity profile, namely cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome. The hyper-inflammatory state associated with these toxicities has been suggested to increase the risk of thrombosis. We conducted a retrospective analysis of patients treated with axicabtagene ciloleucel (axi-cel) to assess the rate of thrombosis with axi-cel therapy from the time of CAR T-cell infusion until the end of hospitalization, when performed in the inpatient setting, or up to day +30 when performed in the outpatient setting. Ninety-two (95%) of 97 patients were hospitalized during axi-cel therapy and 85 (88%) developed CRS. Fifty-five patients (57%) received concurrent anticoagulation (53 as prophylaxis). Patients with prior VTE did not have progression or evidence of new VTE. Only 2 (2.1%) patients developed VTE. These results demonstrate a low-risk for thrombosis in axi-cel recipients.

Phosphate removal using thermally regenerated Al adsorbent from drinking water treatment sludge.

Alum sludge (AS) is an abundant and ubiquitous residue generated from drinking water treatment plants. AS was thermally treated to use as an adsorbent for phosphate removal from wastewater. Organic matter in the AS was a potential competitor and can deter phosphate adsorption. Pyrolysis and drying of AS were adopted to enhance phosphate removal by eliminating organic matter and enriching Al content. Adsorption kinetics showed that phosphate removal was highest with the AS pyrolyzed at 700 °C followed by 500 °C, air-dried and oven-dried (105 °C). Adsorption kinetic modelling showed that chemisorption is the operative mechanism of phosphate removal in all the AS. Adsorption isotherms also showed that the pyrolyzed AS and air-dried AS had similar adsorption capacity of 30.83-34.53 mg P/g AS. Al dissolution was less than 2 mg/g Al in all the AS samples. COD release was significant in the dried AS, up to 8.0 mg COD/g AS, whereas the pyrolyzed AS released less than 1 mg COD/g AS. FTIR and SEM-EDS analyses of the AS after phosphate adsorption showed the formation of aluminum-phosphate complex. Overall, the pyrolysis of AS at 700 °C was most effective in removing phosphate without leaving secondary pollution.

Impact of hypoalbuminemia on the prognosis of relapsed/refractory B-cell lymphoma treated with axicabtagene ciloleucel.

INTRODUCTION: Hypoalbuminemia is a known adverse prognostic factor in lymphomas. Yet, it is unknown if axicabtagene ciloleucel (axi-cel) overcomes the adverse prognostic impact of hypoalbuminemia in relapsed/refractory large B-cell lymphoma. METHODS: We conducted a retrospective analysis across three Mayo Clinic centers to assess the relationship of hypoalbuminemia (defined as a serum albumin (SA) levels ≤ 3.5 g/dL) on outcomes of patients treated with axi-cel. RESULTS: This analysis included 81 patients. Two patients had no available SA levels preceding axi-cel infusion. Eighteen patients (22.8%) had hypoalbuminemia with a median SA of 3.3 g/dL. Patients with normal SA had a statistically higher ORR than those without hypoalbuminemia (P = .018). There was no difference in 1-year PFS and OS between the group with hypoalbuminemia and the group with normal SA levels (48% vs 49%, P = .81) and (74% vs 73%, P = .97), respectively. There was no difference in the severity or median duration of cytokine release syndrome or neurotoxicity between the two groups. CONCLUSION: Notwithstanding the limitations related to the relatively small sample size, axi-cel therapy appears to overcome the adverse effect of hypoalbuminemia on OS and PFS. Large multicenter clinical studies are certainly needed to validate these findings.

Cleft Care Packages and the Impact on Postoperative Care Following a Primary Cleft Lip Repair.

OBJECTIVE: To provide caregivers with all the resources needed to care for a surgical site following a primary cleft lip repair and evaluate its efficacy on postoperative care. SETTING/PARTICIPANTS: Caregivers of infants ages 3 to 6 months with a cleft lip and/or palate undergoing a primary repair at the Texas Children's Hospital. METHODS: Packages were given to caregivers at discharge following repair. Packages included instructions and supplies needed for surgical site care. At discharge an advanced practice provider obtained informed consent and a questionnaire that established baseline knowledge of surgical site care. Following the questionnaire, the advanced practice provider demonstrated how to care for the site using the package provided. Assessment of scar healing, nasal stent compliance, and ease of care was evaluated at postoperative follow up. RESULTS: Thirty-two families were enrolled in this study. Our data supports that caregivers who are provided resources to care for the site had increased comfort level, preparedness, and compliance rates following a primary cleft lip repair. Eighty-four percent of respondents strongly agreed that the package provided aided in preparedness for site care with 100% of respondents recommending the resources to future families undergoing a cleft lip repair. CONCLUSIONS: Caregivers feel comfortable and equipped with their ability to care for their child's repaired cleft lip when given the appropriate instructions and supplies. In addition, they would recommend the packages to future families following a repair. Empowering families to be proactive in postoperative care will potentially lead to better outcomes in cleft care.

Public Reactions in Online Newspapers to Workplace Violence Against Nurses.

BACKGROUND: Nurses frequently suffer from workplace violence, but the public is often not fully aware of the situation because many events are not widely reported. METHODS: This study is an attempt to describe public perceptions of and reactions to reports of incidents of violence against nurses in online newspapers. Articles about such violence in Vietnamese online newspapers published from January to December 2019 as well as readers' comments on those articles were collected for thematic analysis. RESULTS: Nine assaults were reported in 152 articles, and 367 comments were left in the threads. The analysis found four themes: 1) proposing punishment, 2) showing sympathy, 3) being skeptical, and 4) taking gender into account. In particular, the audience called for stricter punishment of the assaulters and showed sympathy for the nurses. However, commenters' prior experiences with poor nursing services sometimes made them skeptical about the motivations of the attackers. Additionally, commenters saw the violence as a conflict between a man (assaulter) and a woman (assaultee) rather than between a client and a professional nurse. CONCLUSIONS: In general, the public showed support to nurses. Nurses should take advantage of this support to advocate improved policies and measures to protect themselves from violence at work.

Scalable Fabrication of Modified Graphene Nanoplatelets as an Effective Additive for Engine Lubricant Oil.

The use of nano-additives is widely recognized as a cheap and effective pathway to improve the performance of lubrication by minimizing the energy loss from friction and wear, especially in diesel engines. In this work, a simple and scalable protocol was proposed to fabricate a graphene additive to improve the engine lubricant oil. Graphene nanoplates (GNPs) were obtained by a one-step chemical exfoliation of natural graphite and were successfully modified with a surfactant and an organic compound to obtain a modified GNP additive, that can be facilely dispersed in lubricant oil. The GNPs and modified GNP additive were characterized using scanning electron microscopy, X-ray diffraction, atomic force microscopy, Raman spectroscopy, and Fourier-transform infrared spectroscopy. The prepared GNPs had wrinkled and crumpled structures with a diameter of 10-30 µm and a thickness of less than 15 nm. After modification, the GNP surfaces were uniformly covered with the organic compound. The addition of the modified GNP additive to the engine lubricant oil significantly enhanced the friction and antiwear performance. The highest reduction of 35% was determined for the wear scar diameter with a GNP additive concentration of approximately 0.05%. The mechanism for lubrication enhancement by graphene additives was also briefly discussed.

Effective Removal of Pb(II) from Aqueous Media by a New Design of Cu-Mg Binary Ferrite.

Metal oxides and their composites have been extensively studied as effective adsorbents for the removal of heavy metals from aqueous solutions in environmental remediation. In this work, Cu0.5Mg0.5Fe2O4 was synthesized by a co-precipitation method followed by calcination (900 °C) and investigated for Pb(II) adsorption. The resultant samples were characterized by various analytical techniques including X-ray diffraction, N2 adsorption-desorption, scanning electron microscopy, thermogravimetric analysis, and Fourier transform infrared spectroscopy. The results revealed that single-phase cubic spinel was obtained by the calcination of as-synthesized samples at a temperature of 900 °C. Cu0.5Mg0.5Fe2O4 ferrite is a mesoporous material with a surface area, a total pore volume, and an average pore size of 41.3 m2/g, 0.2 cm3/g, and 15.1 nm, respectively. Pb(II) adsorption on Cu0.5Mg0.5Fe2O4 fitted well to the Langmuir model, indicating monolayer adsorption with a maximum capacity of 57.7 mg/g. The pseudo-second-order kinetic model can exactly describe Pb(II) adsorption with the normalized standard deviation (Δq) of 1.24%. The obtained results confirmed that the Cu0.5Mg0.5Fe2O4 ternary oxides exhibit a high adsorption capacity toward Pb(II), thanks to the increase in active adsorptive sites of ferrite.

Airway Obstruction Management With Mandibular Distraction and Matthews Device in Pruzansky III Craniofacial Microsomia.

Patients with craniofacial microsomia (CFM) may present with severely malformed mandibles resulting in secondary tongue-based airway obstruction. While surgical management of clinically significant airway obstruction in these patients often involves mandibular distraction osteogenesis (MDO), patients with Pruzansky III CFM typically require additional costochondral bone grafting. In this report, the authors present the successful surgical management of airway obstruction and severe obstructive sleep apnea using a cranio-mandibular fixator (Matthews device) combined with MDO in a 4-year-old female patient with Goldenhar syndrome and associated Pruzansky III CFM. The patient tolerated the procedure without complications and experienced a significant improvement in airway obstruction. With this approach, a severely deformed mandible can be successfully distracted while avoiding tracheostomy and disruption of native TMJ anatomy.

Long-Term Outcomes for Adult Patients With Cleft Lip and Palate.

The purpose of this study was to evaluate a single center's experience with adult patients who had cleft lip, cleft palate, or both. The authors aimed to identify common long-term needs in this patient population and evaluated the relationship of team-based care in meeting those needs. To do so, the authors retrospectively reviewed chart records from a single private practice and tertiary referral cleft center for all patients who were ≥15 years of age and who had a history of clefts of the lip or palate, or both, from January 1, 2013, to June 30, 2014. The authors compared the concerns of the patients who received cleft-team-based care by a single, multidisciplinary cleft team; multiple multidisciplinary cleft teams; or no formal cleft team. The authors analyzed data for 142 patients. The most common patient concerns were lip aesthetics (64%), nose aesthetics (61%), septal deviations (47%), nasal obstruction (44%), malocclusion (32%), oronasal fistulas (29%), and speech (21%). Oronasal fistulas were more commonly reported in the group of patients who had care by multiple teams (42.9%; P < .001). Malocclusion was more commonly reported in the group of patients who had care by multiple teams (50%; P = .001). The authors found that adult patients who have undergone rehabilitation for cleft lip and palate appear to have a common set of long-term needs. Multidisciplinary cleft-team-based care appears to be the most effective way to address these needs.

Nonsyndromic Craniosynostosis.

Nonsyndromic craniosynostosis is significantly more common than syndromic craniosynostosis, affecting the sagittal, coronal, metopic, and lambdoid sutures in decreasing order of frequency. Nonsyndromic craniosynostosis is most frequently associated with only 1 fused suture, creating a predictable head shape. Repair of craniosynostosis is recommended to avoid potential neurodevelopmental delay. Early intervention at 3 to 4 months of age allows minimally invasive approaches, but requires postoperative molding helmet therapy and good family compliance. Open techniques are deferred until the child is older to better tolerate the associated surgical stress. Cranial vault remodeling is generally well-tolerated with a low rate of complications.

Parry Romberg Syndrome.

Parry-Romberg syndrome, or progressive hemifacial atrophy, is a rare disorder of unknown etiology. Patients present with unilateral atrophy of skin that may progress to involve underlying fat, muscle, and osseocartilaginous structures. Neurologic complications are common. After self-limited disease stabilization, various reconstructive options may be used to restore patients' facial symmetry. Serial autologous fat grafting has shown favorable results in reconstruction of mild or moderate soft tissue deficiency, but free tissue transfer remains the treatment of choice for severe disease.

Novel pressure-induced topological phase transitions of supercooled liquid and amorphous silicene.

This molecular dynamics (MD) simulation carries a detailed analysis of a pressure-induced structural transition supercooled liquid and amorphous silicene (a-silicene). Low-density models of supercooled liquid and a-silicene containing 10 000 atoms are obtained by rapid cooling processes from the melts. Then, an a-silicene model at T = 1000 K, a supercooled liquid model at T = 1500 K and a liquid silicon model at T = 2000 K have been isothermally compressed step by step up to a high density in order to observe the pressure-induced structural changes. Specifically 'Cairo tiling' pentagonal and square lattices of silicene are discovered in our calculations. Structural properties of those penta-silicene and tetra-silicene models have been carefully analyzed through the radial distribution functions, interatomic distances, bond-angle distributions under high-pressure condition. The dependence of pressure on formation behaviors is calculated via pressure-volume and energy-density relationships. The first order transition from low-density supercooled liquid/amorphous silicene to high-density penta-silicene and continuous transition from low-density liquid to high-density tetra-silicene are discussed. Atomic mechanism and sp3/sp2 hybridization evolution are inspected whereas the role of low-membered ring defects/boundary promises remarkable application and advanced research in future.

Autologous Ear Reconstruction.

Since the pioneering use of autologous rib cartilage for the reconstruction of microtia, there have been significant advances in surgical technique that have helped to ameliorate the psychological burden of microtia. To date, the use of rib cartilage for auricular reconstruction is one of the most enduring and ubiquitous techniques for microtia reconstruction as it provides excellent aesthetic results with lasting durability. In this review, the authors outline the most common methods of microtia reconstruction with a comparison of each technique and illustrative case examples.

Total Ear Reconstruction Using Porous Polyethylene.

Total ear reconstruction has been approached by several techniques involving autologous graft, prosthetic implant, and alloplastic implant options. Recent studies have shown the superiority of porous polyethylene (Medpor, Porex Surgical) reconstruction over autologous reconstruction based on improved aesthetic results, earlier age of intervention, shorter surgery times, fewer number of required procedures, and a simpler postoperative recovery process. A durable and permanent option for total ear reconstruction, like Medpor, can help alleviate the cosmetic concerns that patients with auricular deformities may be burdened with on a daily basis. In this article, the authors discuss the advantages of Medpor-based ear reconstruction and discuss recent advances in the surgical techniques involved, such as harvesting a temporoparietal fascia flap and full-thickness skin graft to adequately cover the Medpor framework and decrease extrusion rates.