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.

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.

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.

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.

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.

On-sky demonstration of optimal control for adaptive optics at Palomar Observatory.

High-order adaptive optics systems often suffer from significant computational latency, which ultimately limits the temporal error rejection bandwidth when classical controllers are employed. This Letter presents results from an on-sky, real-time implementation of an optimal controller on the PALM-3000 adaptive optics system at Palomar Observatory. The optimal controller is computed directly from open-loop wavefront measurements using a multichannel subspace system identification algorithm, and mitigates latency by explicitly predicting incident turbulence. Experimental results show a significant reduction in the residual wavefront error over the controlled spatial modes, illustrating the superior performance of the optimal control approach versus the nominal integral control architecture.

Negative feedback synchronizes islets of Langerhans.

Insulin is released from the pancreas in pulses with a period of ~ 5 min. These oscillatory insulin levels are essential for proper liver utilization and perturbed pulsatility is observed in type 2 diabetes. What coordinates the many islets of Langerhans throughout the pancreas to produce unified oscillations of insulin secretion? One hypothesis is that coordination is achieved through an insulin-dependent negative feedback action of the liver onto the glucose level. This hypothesis was tested in an in vitro setting using a microfluidic system where the population response from a group of islets was input to a model of hepatic glucose uptake, which provided a negative feedback to the glucose level. This modified glucose level was then delivered back to the islet chamber where the population response was again monitored and used to update the glucose concentration delivered to the islets. We found that, with appropriate parameters for the model, oscillations in islet activity were synchronized. This approach demonstrates that rhythmic activity of a population of physically uncoupled islets can be coordinated by a downstream system that senses islet activity and supplies negative feedback. In the intact animal, the liver can play this role of the coordinator of islet activity.

New low-complexity and robust time synchronization technique for optical IMDD OFDM transmissions.

This paper provides an analysis of the performance of conventional preamble-based time synchronization techniques, which have been proposed for Orthogonal Frequency Division Multiplexing (OFDM) radio transmissions, in the context of optical Intensity Modulated and Direct Detected (IMDD) OFDM transmissions over single-mode fiber. A novel preamble structure along with a two-stage synchronization algorithm is proposed. Thanks to the particular structure of the preamble, a first coarse synchronization metric does not present minor peaks. In addition, without the knowledge of the preamble waveform the receiver can perform both coarse and fine synchronization steps. As maximal delay in arrival time between different frequency components of a signal depends on chromatic dispersion and the signal bandwidth, it is also observed that a slowly time-varying preamble is more robust than a fast time-varying one. By means of numerical simulations, the proposed method is shown to provide better performance when compared to other conventional methods in terms of timing offset variance with reduced receiver complexity. In unamplified transmissions the proposed technique guarantees a quasi-optimal transmission capacity even with a short cyclic prefix.

Fine tuning of micropillar cavity modes through repetitive oxidations.

Repetitive wet thermal oxidations of a tapered oxide aperture in a micropillar structure are demonstrated. After each oxidation step the confined optical modes are analyzed at room temperature. Three regimes are identified. First, the optical confinement increases when the aperture oxidizes toward the center. Then, the cavity modes shift by more than 30 nm when the taper starts to oxidize through the center, leading to a decrease in the optical path length. Finally, the resonance frequency levels off when the aperture is oxidized all the way through the micropillar, but confined optical modes with a high quality factor remain. This repetitive oxidation technique therefore enables precise control of the optical cavity volume or wavelength.

Terahertz ionization of highly charged quantum posts in a perforated electron gas.

"Quantum posts" are roughly cylindrical semiconductor nanostructures that are embedded in an energetically shallower "matrix" quantum well of comparable thickness. We report measurements of voltage-controlled charging and terahertz absorption of 30 nm thick InGaAs quantum wells and posts. Under flat-band (zero-electric field) conditions, the quantum posts each contain approximately six electrons, and an additional ~2.4 × 10(11) cm(-2) electrons populate the quantum well matrix. In this regime, absorption spectra show peaks at 3.5 and 4.8 THz (14 and 19 meV) whose relative amplitude depends strongly on temperature. These peaks are assigned to intersubband transitions of electrons in the quantum well matrix. A third, broader feature has a temperature-independent amplitude and is assigned to an absorption involving quantum posts. Eight-band k·p calculations incorporating the effects of strain and Coulomb repulsion predict that the electrons in the posts strongly repel the electrons in the quantum well matrix, "perforating" the electron gas. The strongest calculated transition, which has a frequency close to the center of the quantum post related absorption at 5 THz (20 meV), is an ionizing transition from a filled state to a quasi-bound state that can easily scatter to empty states in the quantum well matrix.

H1 photonic crystal cavities for hybrid quantum information protocols.

Hybrid quantum information protocols are based on local qubits, such as trapped atoms, NV centers, and quantum dots, coupled to photons. The coupling is achieved through optical cavities. Here we demonstrate far-field optimized H1 photonic crystal membrane cavities combined with an additional back reflection mirror below the membrane that meet the optical requirements for implementing hybrid quantum information protocols. Using numerical optimization we find that 80% of the light can be radiated within an objective numerical aperture of 0.8, and the coupling to a single-mode fiber can be as high as 92%. We experimentally prove the unique external mode matching properties by resonant reflection spectroscopy with a cavity mode visibility above 50%.

Surface acoustic wave mediated carrier injection into individual quantum post nano emitters.

Acousto-electric charge conveyance induced by a surface acoustic wave (SAW) is employed to dissociate photogenerated excitons. Over macroscopic distances, both electrons and holes are injected sequentially into a remotely positioned, isolated and high quality quantum emitter, a self-assembled quantum post. This process is found to be highly efficient and to exhibit improved stability at high acoustic powers when compared to direct optical pumping at the position of the quantum post. These characteristics are attributed to the wide matrix quantum well in which charge conveyance occurs and to the larger number of carriers available for injection in the remote configuration, respectively. The emission of such pumped quantum posts is dominated by recombination of neutral excitons and fully directional when the propagation direction of the SAW and the position of the quantum post are reversed.

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.

Synchronization of mouse islets of Langerhans by glucose waveforms.

Pancreatic islets secrete insulin in a pulsatile manner, and the individual islets are synchronized, producing in vivo oscillations. In this report, the ability of imposed glucose waveforms to synchronize a population of islets was investigated. A microfluidic system was used to deliver glucose waveforms to ∼20 islets while fura 2 fluorescence was imaged. All islets were entrained to a sinusoidal waveform of glucose (11 mM median, 1 mM amplitude, and a 5-min period), producing synchronized oscillations of fura 2 fluorescence. During perfusion with constant 11 mM glucose, oscillations of fura 2 fluorescence were observed in individual islets, but the average signal was nonoscillatory. Spectral analysis and a synchronization index (λ) were used to measure the period of fura 2 fluorescence oscillations and evaluate synchronization of islets, respectively. During perfusion with glucose waveforms, spectral analysis revealed a dominant frequency at 5 min, and λ, which can range from 0 (unsynchronized) to 1 (perfect synchronization), was 0.78 ± 0.15. In contrast, during perfusion with constant 11 mM glucose, the main peak in the spectral analysis corresponded to a period of 5 min but was substantially smaller than during perfusion with oscillatory glucose, and the average λ was 0.52 ± 0.09, significantly lower than during perfusion with sinusoidal glucose. These results indicated that an oscillatory glucose level synchronized the activity of a heterogeneous islet population, serving as preliminary evidence that islets could be synchronized in vivo through oscillatory glucose levels produced by a liver-pancreas feedback loop.

Enhanced sequential carrier capture into individual quantum dots and quantum posts controlled by surface acoustic waves.

Individual self-assembled quantum dots and quantum posts are studied under the influence of a surface acoustic wave. In optical experiments we observe an acoustically induced switching of the occupancy of the nanostructures along with an overall increase of the emission intensity. For quantum posts, switching occurs continuously from predominantly charged excitons (dissimilar number of electrons and holes) to neutral excitons (same number of electrons and holes) and is independent of whether the surface acoustic wave amplitude is increased or decreased. For quantum dots, switching is nonmonotonic and shows a pronounced hysteresis on the amplitude sweep direction. Moreover, emission of positively charged and neutral excitons is observed at high surface acoustic wave amplitudes. These findings are explained by carrier trapping and localization in the thin and disordered two-dimensional wetting layer on top of which quantum dots nucleate. This limitation can be overcome for quantum posts where acoustically induced charge transport is highly efficient in a wide lateral matrix-quantum well.

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.