Complications of Cartilage Sparing Otoplasty: A Systematic Review and Meta-Analysis.

OBJECTIVE: To study the prevalence of complications in patients who have undergone cartilage sparing otoplasty. METHODS: On December 26, 2021, the authors searched 8 databases using the search term "(otoplasty) AND (cartilage sparing OR cartilage sparing)" for collecting the most appropriate studies. The authors used R software version 4.1.2 for conducting the meta-analysis. RESULTS: Of the 414 records screened, the authors included 14 studies. Recurrence/reoperation was the most common reported complication with a prevalence of 4.27% (95% CI: 2.93-6.22), followed by suture erosion 2.46% (95% CI: 0.86-7.07) and hematoma/hemorrhage 1.34% (95% CI: 0.79-2.27). The authors did not find any significant difference between cartilage sparing and cartilage scoring in terms of recurrence/reoperation [odds ratio (OR): 0.92; 95% CI: 0.53-1.60; P = 0.766], hematoma/hemorrhage (OR: 1.39; 95% CI: 0.28-7.01; P = 0.688), and wound infection (OR: 0.37; 95% CI: 0.06-2.24; P = 0.279). CONCLUSION: Various complications have been reported, including recurrence and reoperation, hematoma, wound infections, suture erosions, keloid formation, and skin necrosis. However, the prevalence of these events is not high, although significant heterogeneity was reported for some outcomes. Therefore, it can be concluded that cartilage sparing otoplasty is a safe and reproducible technique.

Measurement of Nasal Skin Thickness and Body Mass Index in Preoperative Rhinoplasty Patients Utilizing Computed Tomography Scanning and Ultrasound Techniques: A Prospective Comparative Study.

One of the most important indicators of rhinoplasty success is nasal skin thickness. Nasal thickness can lead to irregularities over the osseocartilaginous framework among patients with thin nasal skin and difficulty making tip work changes in patients with thick nasal skin. This study aimed to compare different objective methods. These include computed tomography (CT) and ultrasound (US) techniques, and report the relationship between nasal skin thickness and body mass index (BMI). A prospective cross-sectional study that included all patients at the rhinoplasty clinic (King Abdul-Aziz University Hospital), Riyadh, Saudi Arabia, between December 2022 and March 2023. Age, sex, and Fitzpatrick skin type were collected from the patients' histories and physical examinations. Body mass index was calculated for the subjects. The study sample included 29 patients. The median age of the patients was 25 years (interquartile range: 20-32 y). Most of the included patients were Saudi (89.7%, n = 26). Females represented 62.1% of the study sample. The average BMI was 25.6 ± 4.95 kg/m 2 . The highest correlation was observed between the US and CT tip ( r = 0.544, P < 0.01) and rhinion ( r = 0.525, P < 0.01) measurements. Body mass index was not associated with any US or CT measurements when BMI was used as a continuous or ordinal variable. The correlation between the US and CT measurements was highest for rhinoin and tip measurements, whereas supratip measurements were not correlated ( r = -0.029, P = 0.88). The correlation between mid-dorsum and nasion measurements was low (~0.3). The correlation between nasal skin thickness using CT and US varies depending on the nasal point and location. Body mass index was not associated with nasal skin thickness.

Surgical Approaches and Outcomes of Short Nose Correction: A Descriptive Systematic Review of the Literature.

OBJECTIVES: The purpose of this study is to describe all published techniques of short nose correction released by surgeons over the years and summarize their outcomes in a descriptive systematic review of the literature. PATIENTS AND METHODS: A computerized literature search was conducted using 5 major databases. All original studies discussing correction methods and/or outcomes of shortened noses were included. The risk of bias was evaluated blindly by 2 reviewers, and the data were descriptively presented. The study protocol was recorded in the International Prospective Register of Systematic Reviews. RESULTS: A total of 24 studies including 1450 patients were included. Lengthening of the nose was performed through a cartilage-only graft in 14 studies, whereas bone graft was used in 3 studies. The mean increase in nasal tip projection in 5 reports ranged from 0.05 to 2.2 mm. The mean nasal length before and after rhinoplasty was reported in 8 studies, with a mean increase ranging from 0.28 to 6.2 mm. Regarding surgical complications, 30 patients had implant deviation or migration, 22 patients experienced postoperative infection, and 12 patients required corrective surgery. CONCLUSIONS: Augmentation of a short nose is a challenging surgical procedure for rhinoplasty. There are several techniques for short nose correction; however, it is difficult to evaluate the outcomes in the absence of a standard tool of assessment. Further analytical studies are warranted to fully evaluate surgical techniques.

Twelve-Year Experience With Nasofrontal Angle (Radix) Augmentation in Rhinoplasty.

ABSTRACT: The nasofrontal angle (radix) has a great impact on the rhinoplasty outcome. Minimal alterations in this area can give an unusual nasal appearance and midfacial length. Different management approaches have been described with regard to radix augmentation. This study aimed to describe the techniques of rhinoplasty, different materials used in the procedure, and results of at least 1 year of follow-up in our 12-year experience in this field. The authors retrospectively reviewed the data of patients who underwent rhino-plasty/septorhinoplasty with radix augmentation performed by 1 of the authors (a senior surgeon at our institution) using different graft materials, between January 2007 and December 2019. Patients younger than 18 years or who were followed up for less than 1 year were excluded from the study. In total, 387 patients (235 [60.7%] female; age range, 19-39 years) were included. Primary procedures were performed in 311 patients (80.5%), and revision procedures were performed in 76 patients (19.6%). Most patients (97%) were satisfied with the aesthetic result. There was no incidence of infection, displacement, or extrusion of the graft. The only complications observed were irregularities; 3% required revision surgery. It is important to consider the nasal radix when pursuing a balanced profile in rhinoplasty. Many graft materials can be used safely and can achieve good aesthetic outcomes. Proper anatomical analysis and patient selection are essential for successful graft placement.

Do various personal hygiene habits protect us against influenza-like illness?

BACKGROUND: Several studies have reported an association between improvements in hand hygiene and the reductions in rates of intestinal parasitic diseases. However, only a some have addressed its link to the frequency of influenza-like illness. The current study aimed to find the correlation between personal hygiene habits and the frequency of influenza-like illness. METHODS: A cross-sectional study targeting 3000 participants conducted in Riyadh city, Saudi Arabia. A systematic random sampling methodology was applied for participant from different part of Riyadh city using a computer generating system. The researcher first started by calling each participant. A full explanation was given to each participant in details (from the purpose of the research, consent to answer the questionnaire, to the explanation of the outcome definition). Each point of the questionnaire was explained to them to make sure they had excellent comprehension, and therefore, respond accurately. Descriptive statistics and Odds Ratio and its 95% confidence intervals were used to determine the association between frequency of influenza-like illness and the studied variables. RESULTS: Two thousand eighty-two (69.4%) completed the questionnaire. The participants who spent 5-10 s in handwashing with soap and rubbing were at increased risk of more frequent influenza-like illness (odds ratio = 1.37, 1.08-1.75). Handwashing with soap and rubbing after handshaking is an independent protective habit against frequent influenza-like illness (adjusted OR = 0.59, 0.37-0.94). CONCLUSION: The decrease of the frequency of influenza-like illness could be done through the following: getting the influenza vaccine annually, washing hands with soap and hand rubbing not less than 15 s after getting out of the bathroom, before and after handshaking and before eating. Soap companies should invent soaps that take less rubbing time to kill bacteria, and subsequently may maximize compliance in the community.

Prediction of Chloride Diffusion Coefficient in Concrete Modified with Supplementary Cementitious Materials Using Machine Learning Algorithms.

The chloride diffusion coefficient (Dcl) is one of the most important characteristics of concrete durability. This study aimed to develop a prediction model for the Dcl of concrete incorporating supplemental cementitious material. The datasets of concrete containing supplemental cementitious materials (SCMs) such as tricalcium aluminate (C3A), ground granulated blast furnace slag (GGBFS), and fly ash were used in developing the model. Five machine learning (ML) algorithms including adaptive neuro-fuzzy inference system (ANFIS), artificial neural network (ANN), support vector machine (SVM), and extreme learning machine (ELM) were used in the model development. The performance of the developed models was tested using five evaluation metrics, namely, normalized reference index (RI), coefficient of determination (R2), mean absolute error (MAE), and root mean square error (RMSE). The SVM models demonstrated the highest prediction accuracy with R2 values of 0.955 and 0.951 at the training and testing stage, respectively. The prediction accuracy of the machine learning (ML) algorithm was checked using the Taylor diagram and Boxplot, which confirmed that SVM is the best ML algorithm for estimating Dcl, thus, helpful in establishing reliable tools in concrete durability design.

Experimental Analysis of Channel Steel Member under Tension Load with Damage in the Unconnected Legs.

Damage occurring to steel element structures is highly possible due to tearing ruptures, corrosion, or the adoption of sudden loads. The damage has a great effect on their capacity to bear load and the corresponding elongation, as well as the distribution of the stresses in the cross-section of the element. Therefore, in the present research, experimental tests were carried out on 15 specimens of channel steel elements with different damage ratios in the unconnected legs and at different locations along the element's length. Through the test, the load and the corresponding elongation values were obtained for the control and damaged specimens. From the study of the different variables, it was demonstrated that the damage location does not significantly affect the load capacity, with a maximum difference of 1.9%. With the presence of the damage in only one leg at a ratio of less than or equal to 40%, the prediction of the value of the loss in the load is within the safe limit. However, if this ratio increases, there is a defect in calculating the loss in the load as it is greater than the effect of the damage. If there is any damage in the two legs of the channel together, the prediction of the loss of load is within the safe limit, where the loss is less than the effect of the damage ratio. We propose a model that can predict the capacitance of the axial load of steel channel elements through identifying the ratio of damage in the unconnected leg.

Optimization and Modelling the Mechanical Performance of Date Palm Fiber-Reinforced Concrete Incorporating Powdered Activation Carbon Using Response Surface Methodology.

Date palm fiber (DPF) has been reported to have many advantages when used in concrete, however, its major disadvantage is that it causes a reduction in compressive strength. In this research, powdered activated carbon (PAC) was added to cement in the DPF-reinforced concrete (DPFRC) to lessen the loss in strength. PAC has not been properly utilized as an additive in fiber reinforced concrete even though it has been reported to enhance the properties of cementitious composites. Response surface methodology (RSM) has also been utilized for experimental design, model development, results analysis, and optimization. The variables were DPF and PAC as additions each at proportions of 0%, 1%, 2%, and 3% by weight of cement. Slump, fresh density, mechanical strengths, and water absorption were the responses that were considered. From the results, both DPF and PAC decreased the workability of the concrete. DPF addition improved the splitting tensile and flexural strengths and reduced the compressive strength, and up to 2 wt% PAC addition enhanced the concrete's strength and lowered the water absorption. The proposed models using RSM were extremely significant and have excellent predictive power for the concrete's aforementioned properties. Each of the models was further validated experimentally and was found to have an average error of less than 5.5%. According to the results of the optimization, the optimal mix of 0.93 wt% DPF and 0.37 wt% PAC as cement additives resulted in the best properties of the DPFRC in terms of workability, strength, and water absorption. The optimization's outcome received a 91% desirability rating. The addition of 1% PAC increased the 28-day compressive strength of the DPFRC containing 0%, 1% and 2% DPF by 9.67%, 11.13% and 5.5% respectively. Similarly, 1% PAC addition enhanced the 28-day split tensile strength of the DPFRC containing 0%, 1% and 2% by 8.54%, 11.08% and 19.3% respectively. Likewise, the 28-day flexural strength of DPFRC containing 0%, 1%, 2% and 3% improved by 8.3%, 11.15%, 18.7% and 6.73% respectively with the addition of 1% PAC. Lastly, 1% PAC addition led to a reduction in the water absorption of DPFRC containing 0% and 1% DPF by 17.93% and 12.2% respectively.

Study of the Interfacial Transition Zone Characteristics of Geopolymer and Conventional Concretes.

The properties and performance of geopolymer at different length scales have been intensively studied, but only limited studies on geopolymer have investigated the zone located between paste and aggregates, which is called the interfacial transition zone (ITZ). The microstructure of ITZ and its nanomechanical properties in geopolymer concrete are examined in this study. Fly ash-based geopolymer has great potential to be an alternative to traditional concrete. To this end, scanning electron microscopy (SEM) and nanoindentation tests were performed to investigate the microstructural characteristics and nanomechanical properties of the ITZ, and the results were compared with the ITZ of traditional concrete. Results show that traditional concrete demonstrated a weak ITZ with pores and microcracks, while the geopolymer concrete microstructure did not present weak ITZs in the vicinity of aggregates. More pores and crack were observed in the ITZ in traditional concrete. Further, a considerable amount of fly ash particles, that appear to be unreacted or partially reacted in the matrix phase, was observed. Based on the nanoindentation results, 58% of the microstructure is composed of unreacted or partially reacted fly ash particles. The results of nano- and microscale tests will enhance the understanding of how concrete behaves and performs at large scales.

Evaluating the Influence of Elevated Temperature on Compressive Strength of Date-Palm-Fiber-Reinforced Concrete Using Response Surface Methodology.

Due to its availability and affordable processing, date palm fiber (DPF) is among the natural and sustainable fibers used in cementitious composites. Furthermore, DPF is an agricultural, organic, and fibrous material that when subjected to higher temperature can easily degrade and cause reduction in strength. Therefore, the influence of elevated temperatures on the unit weight and strengths of DPF-reinforced concrete needs to be examined. Under this investigation, DPF is used in proportions of 0-3% weight of binder to produce a DPF-reinforced concrete. Silica fume was utilized as a supplemental cementitious material (SCM) in various amounts of 0%, 5%, 10%, and 15% by weight to enhance the heat resistance of the DPF-reinforced concrete. The concrete was then heated to various elevated temperatures for an hour at 200 °C, 400 °C, 600 °C, and 800 °C. After being exposed to high temperatures, the weight loss and the compressive and relative strengths were examined. The weight loss of DPF-reinforced concrete escalated with increments in temperature and DPF content. The compressive and relative strengths of the concrete improved when heated up to 400 °C, irrespective of the DPF and silica fume contents. The heat resistance of the concrete was enhanced with the replacement of up to 10% cement with silica fume when heated to a temperature up to 400 °C, where there were enhancements in compressive and relative strengths. However, at 800 °C, silica fume caused a significant decline in strength. The developed models for predicting the weight loss and the compressive and relative strengths of the DPF-reinforced concrete under high temperature using RSM have a very high degree of correlation and predictability. The models were said to have an average error of less than 6% when validated experimentally. The optimum DPF-reinforced concrete mix under high temperature was achieved by adding 1% DPF by weight of binder materials, replacing 12.14% of the cement using silica fume, and subjecting the concrete to a temperature of 317 °C. The optimization result has a very high desirability of 91.3%.

Evaluation of the mechanical performance of concrete containing calcium carbide residue and nano silica using response surface methodology.

Calcium carbide residue (CCR) is generated from acetylene gas production, and it is highly alkaline and contains a very high amount of calcium. Nano silica (NS), on the other hand, is mostly used in combination with other pozzolanic materials in concrete to ignite the reactivity of the material and to improve the properties of the concrete. This study investigated the effect of CCR incorporated in concrete mixtures to partially replace cement content at 0 to 30% (interval of 7.5%). NS was used as an additive by weight of binder at levels 0 to 4% in increment of 1%. Thus, response surface methodology (RSM) was employed to investigate the effects of CCR and NS on the properties of the concrete, including compressive strength, flexural strength, splitting tensile strength, modulus of elasticity (MoE), and water absorption. The RSM was used for model development predicted concrete's properties and carried out mixture multi-objective optimization by maximizing strengths, MoE, and minimizing water absorption. The results showed that using up to 15% CCR improved the strengths, MoE, and water absorption of the concrete. Adding up to 3% NS further enhanced the strengths, MoE, and water absorption significantly. The developed models for predicting the properties of the concrete using RSM were highly efficient with high degree of correlation. The optimization solutions indicated that the best optimum or best mix combination based on maximum strengths and MoE with minimum water absorption was achieved by replacing 10.6% cement with CCR and adding 1.95% NS by the weight of cementitious materials.

Multiscale Characterization at Early Ages of Ultra-High Performance Geopolymer Concrete.

The main obstacle of using geopolymer as a construction repair material is its slow strength development rate, which is the most significant attribute of an early-age opening for traffic and striking-off formwork. Geopolymer technology has recently attracted huge interest as an alternative to traditional cementitious materials with low environmental impact. Thus, this study investigates the feasibility of developing an ultra-high performance geopolymer concrete (UHPGC) with the aim of achieving high early-age strength. For this purpose, UHPGC mixtures activated with different potassium hydroxide molarities and aluminosilicate material types were developed and examined being cured with different curing temperatures. The early strength and durability of the UHPGC after 8 and 24 h were investigated. Experimental results revealed that the optimal mix design of UHPGC corresponds to a KOH molarity of 16 M and a 30% silica fume content. Furthermore, former mixture cured at 100 °C gave superior 8 and 24 h early strength values of 79 and 134 MPa, respectively. Moreover, a superior interaction of slag, silica fume, and activator solution at early age for UHPGC is revealed by the microstructural characteristics examined by a field emission scanning electron microscope (FESEM) with energy dispersive X-ray spectroscopy (EDS), Fourier transform infrared spectroscopy analysis, and thermogravimetric (TGA) techniques. It was also found that the compressive strength results and the results of the microstructure analysis are well coincided. The experimental results obtained in this study emphasize the feasibility of using developed UHPGC as an eco-friendly quick repair materials The development of one-part UHPGC as a quick, cost-effective, and high-strength product for all construction repair maintenance will lead to huge improvements in the structural capacity and durability of structural components.

Diagnostic Value of 3D Segmentation in Understanding the Anatomy of Human Inner Ear Including Malformation Types.

OBJECTIVE: To understand the anatomical and dimensional variations of the human inner ear using 3-dimensional (3D) segmentation within the Middle East population. DESIGN: Retrospective study. SETTING: King Abdullah Ear Specialist Center (KAESC) Riyadh, Saudi Arabia. PARTICIPANT: Forty computed tomography (CT) images of patients with sensorineural hearing loss who underwent cochlear implant (CI) were taken for analysis. MAIN OUTCOME MEASURES: Three-dimensional images showing the anatomical variations of the inner ear including various pathological conditions, cochlear parameters including basal turn diameter ("A" value), "B" value which is perpendicular to "A" value, cochlear height, length, and width of the internal auditory canal (IAC), intercochlear spacing, and electrode angular insertion depth (AID). RESULTS: Out of 40 CT image data sets, 12 had normal inner-ear anatomy (NA), 4 with enlarged vestibular aqueduct syndrome (EVAS), 8 with only 2 turns of the cochlea (2TL), 7 with incomplete partition (IP) type II, 5 with cochlear hypoplasia, 1 with common cavity, and 3 with abnormal IAC. Taking the NA, EVAS, 2TL, and the IP type II cases altogether, age of the patient had no correlation with the "A" value; however, the "A" value had a linear correlation with the "B" value. The age of the patient had an increasing logarithmic correlation with the IAC length and the intercochlear spacing. The "A" value did not have any meaningful correlation with the cochlear height. Three data sets showed asymmetric inner-ear malformation types on either side of the ears. All these 40 cases were implanted with various CI electrode array variants and the corresponding postoperative plain film X-ray images showing the electrode AID are given separately in figures. CONCLUSIONS: Three-dimensional segmentation of the inner ear from the temporal bone CT is a valuable clinical and training tool for surgeons and radiologists especially in difficult cases which will certainly help to understand the overall anatomical and dimensional variations.

Mechanical Properties and Durability Performance of Concrete Containing Calcium Carbide Residue and Nano Silica.

Calcium carbide residue (CCR) is the end-product of production of acetylene gas for the applications such as welding, lighting, ripening of fruits, and cutting of metals. Due to its high pH value, disposing of CCR as a landfill increases the alkalinity of the environment. Therefore, due to its high calcium content, CCR is mostly blended with other pozzolanic materials, together with activators as binders in the cement matrix. In this study, cement was partially substituted using CCR at 0%, 7.5%, 15%, 22.5% and 30% by weight replacement, and nano silica (NS) was utilized as an additive by weight of binder materials at 0%, 1%, 2%, 3% and 4%. The properties considered were the slump, the compressive strength, the flexural strength, the splitting tensile strength, the modulus of elasticity, and the water absorption capacity. The microstructural properties of the concrete were also examined through FESEM and XRD analysis. The results showed that both CCR and NS increase the concrete's water demand, hence reducing its workability. Mixes containing up to 15% CCR only showed improved mechanical properties. The combination of CCR and NS significantly improved the mechanical properties and decreased the concrete's water absorption through improved pozzolanic reactivity as verified by the FESEM and XRD results. Furthermore, the microstructure of the concrete was explored, and the pores were refined by the pozzolanic reaction products. The optimum mix combination was obtained by replacing 15% cement using CCR and the addition of 2% NS by weight of cementitious materials. Therefore, using a hybrid of CCR and NS in concrete will result in reduction of cement utilization in concrete, leading to improved environmental sustainability and economy.