Pilot study of a multidisciplinary single-day cochlear implant selection protocol

Purpose: This study aimed to explore and introduce the potential of a MSCS (Multidisciplinary Single-day Cochlear Implant Selection) protocol. The primary objectives of this pilot were to reduce the duration between referral and surgery, minimize hospital visits and decrease the time healthcare professionals dedicate to the cochlear implant (CI) selection process. Materials and methods: We established a pilot program at the CI center of the Erasmus MC, a tertiary referral center in the Netherlands, with the goal of improving and shorten the selection process. We evaluated our pilot, including 15 CI candidates, and conducted a retrospective analysis for time and cost savings. Results: The results showed that the pilot of the MSCS protocol significantly reduced the length of the CI selection phase (84 days vs 1; standard intake vs MSCS protocol) and the number of hospital visits (6 vs 2 visits; standard vs MSCS protocol), resulting in less travel time and lower costs for the CI candidates. The total time of professionals spend on patients was also reduced with 27 %. Conclusion: This study highlights the potential benefits of the MSCS protocol in terms of reducing the burden on patients and healthcare providers and improving the efficiency of the CI selection process.</p

The effect of precursor structure on porous carbons produced by iron-catalyzed graphitization of biomass

This paper reports a systematic study into the effect of different biomass-derived precursors on the structure and porosity of carbons prepared via catalytic graphitization. Glucose, starch and cellulose are combined with iron nitrate and heated under a nitrogen atmosphere to produce Fe3C nanoparticles, which catalyze the conversion of amorphous carbon to graphitic nanostructures. The choice of organic precursor provides a means of controlling the catalyst particle size, which has a direct effect on the porosity of the material. Cellulose and glucose produce mesoporous carbons, while starch produces a mixture of micro- and mesopores under the same conditions and proceeds via a much slower graphitization step, generating a mixture of graphitic nanostructures and turbostratic carbon. Porous carbons are critical to energy applications such as batteries and electrocatalytic processes. For these applications, a simple and sustainable route to those carbons is essential. Therefore, the ability to control the precise structure of a biomass-derived carbon simply through the choice of precursor will enable the production of a new generation of energy materials

The role of oxygen vacancies in SrTiO3 at the LaAlO3/SrTiO3 interface

Strontium titanate, SrTiO3, a widely used substrate material for electronic oxide thin film devices, has provided many interesting features. In a combination with a similar oxide material, LaAlO3, it has recently received great interest. It was suggested that two-dimensional electron gas is formed at the interface between SrTiO3 and LaAlO3, resulting in high electrical conductivity and mobility. In this report we demonstrate that the transport properties in those heterostructures are very sensitive to the deposition parameters during thin film growth. Using cathode- and photoluminescence studies in conjunction with measurements of electrical transport properties and microstructure we show that the electronic properties observed at a LaAlO3/SrTiO3 interface can be explained by oxygen reduced SrTiO3. In addition, we demonstrate that oxygen can be pushed in and out of the sample, but that re-oxygenation of an initially oxygen depleted LaAlO3/SrTiO3 heterostructure is partly prevented by the presence of the film.Comment: 19 pages, 5 figure

Global trends in the number and diversity of managed pollinator species

Cultivation of pollinator-dependent crops has expanded globally, increasing our reliance on insect pollination. This essential ecosystem service is provided by a wide range of managed and wild pollinators whose abundance and diversity are thought to be in decline, threatening sustainable food production. The Western honey bee (Apis mellifera) is amongst the best-monitored insects but the state of other managed pollinators is less well known. Here, we review the status and trends of all managed pollinators based on publicly accessible databases and the published literature. We found that, on a global scale, the number of managed A. mellifera colonies has increased by 85% since 1961, driven mainly by Asia. This contrasts with high reported colony overwinter mortality, especially in North America (average 26% since 2007) and Europe (average 16% since 2007). Increasing agricultural dependency on pollinators as well as threats associated with managing non-native pollinators have likely spurred interest in the management of alternative species for pollination, including bumble bees, stingless bees, solitary bees, and flies that have higher efficiency in pollinating specific crops. We identify 66 insect species that have been, or are considered to have the potential to be, managed for crop pollination, including seven bumble bee species and subspecies currently commercially produced mainly for the pollination of greenhouse-grown tomatoes and two species that are trap-nested in New Zealand. Other managed pollinators currently in use include eight solitary bee species (mainly for pollination services in orchards or alfalfa fields) and three fly species (mainly used in enclosures and for seed production). Additional species in each taxonomic category are under consideration for pollinator management. Examples include 15 stingless bee species that are able to buzz-pollinate, will fly in enclosures, and some of which have a history of management for honey production; their use for pollination is not yet established. To ensure sustainable, integrated pollination management in agricultural landscapes, the risks, as well as the benefits of novel managed pollinator species must be considered. We, therefore, urge the prioritization of biodiversity-friendly measures maintaining native pollinator species diversity to provide ecosystem resilience to future environmental changes.Fil: Osterman, Julia. Martin Luther University Halle-Wittenberg; Alemania. Helmholtz Centre for Environmental Research; AlemaniaFil: Aizen, Marcelo Adrian. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones en Biodiversidad y Medioambiente. Universidad Nacional del Comahue. Centro Regional Universidad Bariloche. Instituto de Investigaciones en Biodiversidad y Medioambiente; Argentina. Institute for Advanced Study; AlemaniaFil: Biesmeijer, Jacobus C.. Leiden University; Países Bajos. Naturalis Biodiversity Center; Países BajosFil: Bosch, Jordi. Universitat Autònoma de Barcelona; EspañaFil: Howlett, Brad G.. The New Zealand Institute for Plant and Food Research Ltd.; Nueva ZelandaFil: Inouye, David W.. University of Maryland; Estados Unidos. Rocky Mountain Biological Laboratory; Estados UnidosFil: Jung, Chuleui. Andong National University; Corea del SurFil: Martins, Dino J.. University of Princeton; Estados UnidosFil: Medel, Rodrigo. Universidad de Chile; ChileFil: Pauw, Anton. Stellenbosch University; SudáfricaFil: Seymour, Colleen L.. University of Cape Town; Sudáfrica. South African National Biodiversity Institute; SudáfricaFil: Paxton, Robert J. German Centre for integrative Biodiversity Research; Alemania. Martin Luther University Halle-Wittenberg; Alemani

Global agricultural productivity is threatened by increasing pollinator dependence without a parallel increase in crop diversification

The global increase in the proportion of land cultivated with pollinator-dependent crops implies increased reliance on pollination services. Yet agricultural practices themselves can profoundly affect pollinator supply and pollination. Extensive monocultures are associated with a limited pollinator supply and reduced pollination, whereas agricultural diversification can enhance both. Therefore, areas where agricultural diversity has increased, or at least been maintained, may better sustain high and more stable productivity of pollinator-dependent crops. Given that >80% of all crops depend, to varying extents, on insect pollination, a global increase in agricultural pollinator dependence over recent decades might have led to a concomitant increase in agricultural diversification. We evaluated whether an increase in the area of pollinator-dependent crops has indeed been associated with an increase in agricultural diversity, measured here as crop diversity, at the global, regional, and country scales for the period 1961–2016. Globally, results show a relatively weak and decelerating rise in agricultural diversity over time that was largely decoupled from the strong and continually increasing trend in agricultural dependency on pollinators. At regional and country levels, there was no consistent relationship between temporal changes in pollinator dependence and crop diversification. Instead, our results show heterogeneous responses in which increasing pollinator dependence for some countries and regions has been associated with either an increase or a decrease in agricultural diversity. Particularly worrisome is a rapid expansion of pollinator-dependent oilseed crops in several countries of the Americas and Asia that has resulted in a decrease in agricultural diversity. In these regions, reliance on pollinators is increasing, yet agricultural practices that undermine pollination services are expanding. Our analysis has thereby identified world regions of particular concern where environmentally damaging practices associated with large-scale, industrial agriculture threaten key ecosystem services that underlie productivity, in addition to other benefits provided by biodiversity.Fil: Aizen, Marcelo Adrian. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones en Biodiversidad y Medioambiente. Universidad Nacional del Comahue. Centro Regional Universidad Bariloche. Instituto de Investigaciones en Biodiversidad y Medioambiente; ArgentinaFil: Aguiar, Sebastián. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura. Universidad de Buenos Aires. Facultad de Agronomía. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura; ArgentinaFil: Biesmeijer, Jacobus C.. Leiden University; Países Bajos. Naturalis Biodiversity Center; Países BajosFil: Garibaldi, Lucas Alejandro. Universidad Nacional de Río Negro. Sede Andina. Instituto de Investigaciones en Recursos Naturales, Agroecología y Desarrollo Rural; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Inouye, David W.. University of Maryland; Estados Unidos. Rocky Mountain Biological Laboratory; Estados UnidosFil: Jung, Chuleui. Andong National University; Corea del SurFil: Martins, Dino J.. University of Princeton; Estados UnidosFil: Medel, Rodrigo. Universidad de Chile; ChileFil: Morales, Carolina Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones en Biodiversidad y Medioambiente. Universidad Nacional del Comahue. Centro Regional Universidad Bariloche. Instituto de Investigaciones en Biodiversidad y Medioambiente; ArgentinaFil: Ngo, Hien. UN Campus Platz der Vereinten Nationen. Intergovernmental Science Policy Platform on Biodiversity and Ecosystem Services; AlemaniaFil: Pauw, Anton. Stellenbosch University; SudáfricaFil: Paxton, Robert J. Martin Luther University Halle Wittenberg; Alemania. German Centre for Integrative Biodiversity Research; AlemaniaFil: Sáez, Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones en Biodiversidad y Medioambiente. Universidad Nacional del Comahue. Centro Regional Universidad Bariloche. Instituto de Investigaciones en Biodiversidad y Medioambiente; ArgentinaFil: Seymour, Colleen L.. South African National Biodiversity Institute; Sudáfrica. University of Cape Town; Sudáfric

The effect of nitrogen on the synthesis of porous carbons by iron-catalyzed graphitization †

This paper reports a systematic study into the effect of nitrogen on iron-catalyzed graphitization of biomass. Chitin, chitosan, N-acetylglucosamine, gelatin and glycine were selected to represent nitrogen-rich saccharides and amino-acid/polypeptide biomass precursors. The materials were pyrolyzed with an iron catalyst to produce carbons with a wide range of chemical and structural features such as mesoporosity and nitrogen-doping. Many authors have reported the synthesis of nitrogen-doped carbons by pyrolysis and these have diverse applications. However, this is the first systematic study of how nitrogen affects pyrolysis of biomass and importantly the catalytic graphitization step. Our data demonstrates that nitrogen inhibits graphitization but that some nitrogen survives the catalytic graphitization process to become incorporated into various chemical environments in the carbon product

Evaluation of the modified Pittsburgh classification for predicting the disease-free survival outcome of squamous cell carcinoma of the external auditory canal

Background: Squamous cell carcinoma (SCC) of the external auditory canal (EAC) is a rare disease, which is commonly classified with the modified Pittsburgh classification. Our aim was to evaluate the predictive performance of this classification in relation to disease-free survival (DFS). Methods: We examined retrospective data from a nationwide Dutch cohort study including patients with primary EAC SCC. These data were combined with individual patient data from the literature. Using the combined data, the predictive performances were calculated using the c-index. Results: A total of 381 patients were included, 294 for clinical and 281 for the pathological classification analyses. The c-indices of the clinical and the pathological modified Pittsburgh classification predicting DFS were 0.725 (0.668-0.782) and 0.729 (0.672-0.786), respectively. Conclusion: The predictive performance of the modified Pittsburgh classification system as such appears to be acceptable to predict the DFS of EAC SCC. Other factors need to be added to a future model to improve the predicted performance

Evaluation of the SAMEO-ATO surgical classification in a Dutch cohort

Purpose: Differences in the definition and classification of cholesteatoma hinders comparing of surgical outcomes of cholesteatoma. Uniform registration is necessary to allow investigators to share and compare their findings. For many years surgical cholesteatoma procedures were divided into two main groups: canal wall up mastoidectomy (CWU) and canal wall down mastoidectomy (CWD). Recently, mastoid obliteration can be added to both procedures. Because of great variation within these main groups, the International Otology Outcome Group (IOOG) proposed the new SAMEO-ATO classification system to categorize tympanomastoid operations. The aim of our study was to correlate the mastoid bone extirpation (M-stage) with the contemporary (CWU, CWD with or without obliteration) system. Methods: Demographic characteristics and type of performed surgery were registered for 135 cholesteatoma patients from sixteen hospitals, both secondary and tertiary care institutions, across the Netherlands. In addition, the surgical reports were collected, retrospectively classified according to the contemporary system and the new system and compared. Correlations of the outcomes were calculated. Results: In total, there were 112 CWU and 14 CWD (both with or without obliteration) suitable for correlation analysis. Z test for correlation between the M-stage and CWU procedure was significant for M1a and M1b procedure and significant for M2c with the CWD procedure. Conclusion: The newly proposed SAMEO-ATO classification seems to be more detailed in the registration of surgical procedures than surgeons currently are used to. All M-stages of the SAMEO-ATO system are correlating well to the standard CWU and CWD except one ‘in between’ M-stage

Determining a cost effective intervention response to HIV/AIDS in Peru

BACKGROUND: The HIV epidemic in Peru is still regarded as concentrated -- sentinel surveillance data shows greatest rates of infection in men who have sex with men, while much lower rates are found in female sex workers and still lower in the general population. Without an appropriate set of preventive interventions, continuing infections could present a challenge to the sustainability of the present programme of universal access to treatment. Determining how specific prevention and care strategies would impact on the health of Peruvians should be key in reshaping the national response. METHODS: HIV/AIDS prevalence levels for risk groups with sufficient sentinel survey data were estimated. Unit costs were calculated for a series of interventions against HIV/AIDS which were subsequently inputted into a model to assess their ability to reduce infection transmission rates. Interventions included: mass media, voluntary counselling and testing; peer counselling for female sex workers; peer counselling for men who have sex with men; peer education of youth in-school; condom provision; STI treatment; prevention of mother to child transmission; and highly active antiretroviral therapy. Impact was assessed by the ability to reduce rates of transmission and quantified in terms of cost per DALY averted. RESULTS: Results of the analysis show that in Peru, the highest levels of HIV prevalence are found in men who have sex with men. Cost effectiveness varied greatly between interventions ranging from peer education of female commercial sex workers at $US 55 up to$US 5,928 (per DALY averted) for prevention of mother to child transmission. CONCLUSION: The results of this work add evidence-based clarity as to which interventions warrant greatest consideration when planning an intervention response to HIV in Peru. Cost effectiveness analysis provides a necessary element of transparency when facing choices about priority setting, particularly when the country plans to amplify its response through new interventions partly funded by the GFATM

Multicenter evaluation of a lateral-flow device test for diagnosing invasive pulmonary aspergillosis in ICU patients

Introduction: The incidence of invasive pulmonary aspergillosis (IPA) in intensive care unit (ICU) patients is increasing, and early diagnosis of the disease and treatment with antifungal drugs is critical for patient survival. Serum biomarker tests for IPA typically give false-negative results in non-neutropenic patients, and galactomannan (GM) detection, the preferred diagnostic test for IPA using bronchoalveolar lavage (BAL), is often not readily available. Novel approaches to IPA detection in ICU patients are needed. In this multicenter study, we evaluated the performance of an Aspergillus lateral-flow device (LFD) test for BAL IPA detection in critically ill patients. Methods: A total of 149 BAL samples from 133 ICU patients were included in this semiprospective study. Participating centers were the medical university hospitals of Graz, Vienna and Innsbruck in Austria and the University Hospital of Mannheim, Germany. Fungal infections were classified according to modified European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Results: Two patients (four BALs) had proven IPA, fourteen patients (sixteen BALs) had probable IPA, twenty patients (twenty-one BALs) had possible IPA and ninety-seven patients (one hundred eight BALs) did not fulfill IPA criteria. Sensitivity, specificity, negative predictive value, positive predictive value and diagnostic odds ratios for diagnosing proven and probable IPA using LFD tests of BAL were 80%, 81%, 96%, 44% and 17.6, respectively. Fungal BAL culture exhibited a sensitivity of 50% and a specificity of 85%. Conclusion: LFD tests of BAL showed promising results for IPA diagnosis in ICU patients. Furthermore, the LFD test can be performed easily and provides rapid results. Therefore, it may be a reliable alternative for IPA diagnosis in ICU patients if GM results are not rapidly available. Trial registration: ClinicalTrials.gov NCT02058316. Registered 20 January 2014