Electron crystallography and dedicated electron-diffraction instrumentation

Electron diffraction (known also as ED, 3D ED or microED) is gaining momentum in science and industry. The application of electron diffraction in performing nano-crystallography on crystals smaller than 1 µm is a disruptive technology that is opening up fascinating new perspectives for a wide variety of compounds required in the fields of chemical, pharmaceutical and advanced materials research. Electron diffraction enables the characterization of solid compounds complementary to neutron, powder X-ray and single-crystal X-ray diffraction, as it has the unique capability to measure nanometre-sized crystals. The recent introduction of dedicated instrumentation to perform ED experiments is a key aspect of the continued growth and success of this technology. In addition to the ultra-high-speed hybrid-pixel detectors enabling ED data collection in continuous rotation mode, a high-precision goniometer and horizontal layout have been determined as essential features of an electron diffractometer, both of which are embodied in the Eldico ED-1. Four examples of data collected on an Eldico ED-1 are showcased to demonstrate the potential and advantages of a dedicated electron diffractometer, covering selected applications and challenges of electron diffraction: (i) multiple reciprocal lattices, (ii) absolute structure of a chiral compound, and (iii) R-values achieved by kinematic refinement comparable to X-ray data.

Anthropomorphic cardiac phantom for dynamic SPECT

BACKGROUND

As myocardial blood flow measurement (MBF) in SPECT systems became recently available, significant effort has been devoted to its validation. For that purpose, we have developed a cardiac phantom that is able to mimic physiological radiotracer variation in the left ventricle cavity and in the myocardium, while performing beating-like motion. The new phantom is integrated inside a standard anthropomorphic torso allowing a realistic tissue attenuation and gamma-ray scattering METHODS AND RESULTS: A mechanical cardiac phantom was integrated in a commercially available anthropomorphic torso. Using a GE Discovery 530c SPECT, measurements were performed. It was found that gamma-ray attenuation effects are significant and limit the MBF measurements to global/three-vessel resolution. Dynamic SPECT experiments were performed to validate MBF accuracy and showed mean relative error of 14%. Finally, the effect of varying radiotracer dose on the accuracy of dynamic SPECT was studied CONCLUSIONS: A dynamic cardiac phantom has been developed and successfully integrated in a standard SPECT torso. A good agreement was found between SPECT-reported MBF values and the expected results. Despite increased noise-to-signal ratio when radiotracer doses were reduced, MBF uncertainty did not increase significantly down to very low doses, thanks to the temporal integration of the activity during the measurement.

Spatial Computing for preoperative planning and postoperative evaluation of single-position lateral approaches in spinal revision surgery

Spatial computing (SC) in a surgical context offers reconstructed interactive four-dimensional models of radiological imaging. Preoperative and postoperative assessment with SC can offer more insight into personalized surgical approaches. Spine surgery has benefitted from the use of perioperative SC assessment. Herein, we describe the use of SC to perform a perioperative assessment of a revision spinal deformity surgery. A 79-year-old wheelchair-bound male presented to the neurosurgery clinic with a history of chronic lumbar pain associated with bilateral lower extremity weakness. His surgical history is significant for an L2-L5 lumbar decompression with posterior fixation 1 year prior. On examination, there were signs of thoracic myelopathy. Imaging revealed his previous instrumentation, pseudoarthrosis, and cord compression. We perform a two-staged operation to address the thoracic spinal cord compression and myelopathy, pseudoarthrosis, and malalignment with a lack of global spinal harmony. His imaging is driven by a spatial computing and SC environment and offers support for the diagnosis of his L2-3 and L4-5 pseudoarthrosis on the reconstructed SC-based computed tomography scan. SC enabled the assessment of the configuration of the psoas muscle and course of critical neurovascular structures in addition to graft sizing, trajectory and approach, evaluation of the configuration and durability of the anterior longitudinal ligament, and the overlying abdominal viscera. SC increases the familiarity of the patient's specific anatomy and enhances perioperative assessment. As such, SC can be used to preoperatively plan for spinal revision surgery.

OpenVNT: An Open Platform for VIS-NIR Technology

Spectrometers measure diffuse reflectance and create a "molecular fingerprint" of the material under investigation. Ruggedized, small scale devices for "in-field" use cases exist. Such devices might for example be used by companies in the food supply chain for inward inspection of goods. However, their application for the industrial Internet of Things workflows or scientific research is limited due to their proprietary nature. We propose an open platform for visible and near-infrared technology (OpenVNT), an open platform for capturing, transmitting, and analysing spectral measurements. It is built for use in the field, as it is battery-powered and transmits data wireless. To achieve high accuracy, the OpenVNT instrument contains two spectrometers covering a wavelength range of 400-1700 nm. We conducted a study on white grapes to compare the performance of the OpenVNT instrument against the Felix Instruments F750, an established commercial instrument. Using a refractometer as ground truth, we built and validated models to estimate the Brix value. As a quality measure, we used coefficient of determination of the cross-validation (R2CV) between the instrument estimation and ground truth. With 0.94 for the OpenVNT and 0.97 for the F750, a comparable R2CV was achieved for both instruments. OpenVNT matches the performance of commercially available instruments at one tenth of the price. We provide an open bill of materials, building instructions, firmware, and analysis software to enable research and industrial IOT solutions without the limitations of walled garden platforms.

There Is Plenty of Room in Plant Science: Nanobiotechnology as an Emerging Area Applied to Somatic Embryogenesis

Somatic embryogenesis is an essential technology for high productivity in plant culture, and with the advent of nanotechnology, the synergism between these areas could be the answer to developing concepts involving Agriculture 4.0. This perspective permeates both areas, presenting the opportunities and challenges for the consolidation of ideas involving the application of nanoparticles to micropropagation processes (callus induction, preservation, growing, and modification, among others) and also to the production of byproducts (such as biosynthesis of nanoparticles and production of secondary metabolites). Nanotoxicological aspects are also emphasized as well as up-to-date instrumentation involved in these studies.

Optimization of a Microwave Polarimeter for Astronomy with Optical Correlation and Detection

Cosmic Microwave Background (CMB) B-modes detection is the main focus of future CMB experiments because of the valuable information it contains, particularly to probe the physics of the very early universe. For this reason, we have developed an optimized polarimeter demonstrator sensitive to the 10-20 GHz band in which the signal received by each antenna is modulated into a Near Infrared (NIR) laser by a Mach-Zehnder modulator. Then, these modulated signals are optically correlated and detected using photonic back-end modules consisting of voltage-controlled phase shifters, a 90-degree optical hybrid, a pair of lenses, and an NIR camera. During laboratory tests, a 1/f-like noise signal related to the low phase stability of the demonstrator has been found experimentally. To solve this issue, we have developed a calibration method that allows us to remove this noise in an actual experiment, until obtaining the required accuracy level in the measurement of polarization.

Design and Validation of a Custom-Made Hyperspectral Microscope Imaging System for Biomedical Applications

Hyperspectral microscope imaging (HMI) is an emerging modality that integrates spatial information collected by standard laboratory microscopy and the spectral-based contrast obtained by hyperspectral imaging and may be instrumental in establishing novel quantitative diagnostic methodologies, particularly in histopathology. Further expansion of HMI capabilities hinges upon the modularity and versatility of systems and their proper standardization. In this report, we describe the design, calibration, characterization, and validation of the custom-made laboratory HMI system based on a Zeiss Axiotron fully motorized microscope and a custom-developed Czerny-Turner-type monochromator. For these important steps, we rely on a previously designed calibration protocol. Validation of the system demonstrates a performance comparable to classic spectrometry laboratory systems. We further demonstrate validation against a laboratory hyperspectral imaging system for macroscopic samples, enabling future comparison of spectral imaging results across length scales. An example of the utility of our custom-made HMI system on a standard hematoxylin and eosin-stained histology slide is also shown.

Development of the Gross Motor Function Family Report (GMF-FR) for Children with Cerebral Palsy

Purpose: To describe the initial steps in the development of a family-completed, modified version of the Gross Motor Function Measure (GMFM-88) to report gross motor function of young people with cerebral palsy in their natural environments. Methods: Development of the Gross Motor Function - Family Report (GMF-FR) was based on expert opinion involving 13 experienced clinicians and researchers, in four steps: (1) item identification to target items that reflect functional gross motor performance; (2) item selection; (3) critical analysis of the items; and (4) item and scoring modification. Results: Several modifications to existing items and scoring were made, including wording changes to optimize ease of families' understanding, the addition of photographs to illustrate all items, changes to the items to enable use of furniture instead of specialized equipment, and modifications to scoring criteria to ensure a focus on functional motor skills. Ultimately, 30 items were selected, and specific testing/scoring instructions were created for each item. Conclusions: GMF-FR is a new family-report tool, based on the GMFM-88. When validated, it can be used as a telehealth outcome measure to capture family-reported functional motor skill performance in home and community environments.

A 2D lightweight instrumented wheel for assessing wheelchair functionality/activity

Introduction

Force measurement wheels are essential instruments for analysing manual wheelchair propulsion. Existing solutions are heavy and bulky, influence propulsion biomechanics, and are limited to confined laboratory environments. In this paper, a novel design for a compact and lightweight measurement wheel is presented and statically validated.

Methods

Four connectors between the push-rim and wheel-rim doubled as force sensors to allow the calculation of tangential and radial forces as well as the point of force application. For validation, increasing weights were hung on the push-rim at known positions. Resulting values were compared against pre-determined force components.

Results

The implemented prototype weighed 2.1 kg and was able to transmit signals to a mobile recording device at 140 Hz. Errors in forces at locations of propulsive pushes were in the range up to ±3.1 N but higher at the frontal extreme. Tangential force components were most accurate.

Conclusion

The principle of instrumenting the joints between push-rim and wheel-rim shows promise for assessing wheelchair propulsion in daily life.

An Affordable NIR Spectroscopic System for Fraud Detection in Olive Oil

Adulterations of olive oil are performed by adding seed oils to this high-quality product, which are cheaper than olive oils. Food safety controls have been established by the European Union to avoid these episodes. Most of these methodologies require expensive equipment, time-consuming procedures, and expert personnel to execute. Near-infrared spectroscopy (NIRS) technology has many applications in the food processing industry. It analyzes food safety and quality parameters along the food chain. Using principal component analysis (PCA), the differences and similarities between olive oil and seed oils (sesame, sunflower, and flax oil) have been evaluated. To quantify the percentage of adulterated seed oil in olive oils, partial least squares (PLS) have been employed. A total of 96 samples of olive oil adulterated with seed oils were prepared. These samples were used to build a spectra library covering various mixtures containing seed oils and olive oil contents. Eighteen chemometric models were developed by combining the first and second derivatives with Standard Normal Variable (SNV) for scatter correction to classify and quantify seed oil adulteration and percentage. The results obtained for all seed oils show excellent coefficients of determination for calibration higher than 0.80. Because the instrumental aspects are not generally sufficiently addressed in the articles, we include a specific section on some key aspects of developing a high-performance and cost-effective NIR spectroscopy solution for fraud detection in olive oil. First, spectroscopy architectures are introduced, especially the Texas Instruments Digital Light Processing (DLP) technology for spectroscopy that has been used in this work. These results demonstrate that the portable prototype can be used as an effective tool to detect food fraud in liquid samples.

The Behavioral Assessment Screening Tool for Mobile Health (BASTmHealth): Development and Compliance in 2 Weeks of Daily Reporting in Chronic Traumatic Brain Injury

OBJECTIVES

To develop and evaluate the feasibility of a short form of the Behavioral Assessment Screening Tool (BASTmHealth) for high frequency in situ self-reported assessment of neurobehavioral symptoms using mobile health technology for community-dwelling adults with traumatic brain injury (TBI).

DESIGN

Prospective, repeated-measures study of mHealth assessment of self-reported neurobehavioral symptoms in adults with and without a lifetime history of TBI over a 2-week period.

SETTING

Community.

PARTICIPANTS

Community-dwelling adults with (n=52) and without (n=12) a lifetime TBI history consented to the study (N=64).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

BASTmHealth subscales (2-items each): negative affect, fatigue, executive function, substance abuse, impulsivity; feasibility measured via compliance (assessments assigned/assessments completed) and participant-reported usability.

RESULTS

We developed the 10-item BASTmHealth as a screener for high frequency in situ self-reported assessment of neurobehavioral symptoms leveraging mHealth. Compliance for 2 weeks of BASTmHealth supports its feasibility. Fifty-six of 64 participants (87.5%) who completed baseline assessments completed the 2 weeks of daily assessments; all 8 participants who did not complete ecological momentary assessment had a history of TBI. Overall compliance was 81.4% (496 completed of 609 assigned assessments) among all 52 participants with TBI and 96.7% (494 completed of 511 assigned assessments) among the 44 who completed any daily measures, compared with 91.8% (135 completed of 147 assigned assessments) among those with no TBI history. Participants thought the daily surveys were easy to understand and complete and the number of prompts were reasonable.

CONCLUSIONS

Conducting daily high-frequency in situ self-reported assessment of neurobehavioral symptoms using the BASTmHealth is feasible among individuals with and without a lifetime history of TBI. Developing and evaluating self-reported assessments for community-based assessment is a critical step toward expanding remote clinical monitoring systems to improve post-TBI outcomes.

Development of "The Safe Psychiatric Ward Battery"

This study reports the development process and psychometric testing of the safe environment in psychiatric wards instrument. In this mixed-methods study, the concept of a safe environment was explained with a qualitative study by performing semi-structured interviews with patients and staff and ward observation. Then, the items of the instrument were designed using qualitative data and a literature review. Content and construct validity, internal consistency, stability, and inter-rater agreement were evaluated. This study produced an instrument consisting of two sections. The first section was a scale (α = .920). Exploratory factor analysis of the scale identified two dimensions of "engagement" (α = .931) and "perception" of the physical environment (α = .760). The second section was a checklist with two dimensions, "accident-free living environment" and "staff empowerment." The intra-class correlation coefficients for the scale and checklist were .912 and .809, respectively. This study suggests that this instrument is a valid and reliable tool to assess safety in psychiatric wards.

Influence of eight debridement techniques on three different titanium surfaces: A laboratory study

OBJECTIVES

Debridement methods may damage implant surfaces. This in vitro study investigated eight debridement protocols across three implant surfaces to assess both biofilm removal and surface alterations.

MATERIAL AND METHODS

One hundred sixty commercially pure titanium discs were treated to simulate commercially available titanium implant surfaces-smooth, abraded and abraded and etched. Following inoculation with whole human saliva to create a mixed species biofilm, the surfaces were treated with eight debridement methods currently used for clinical peri-implantitis (n = 10). This included air abrasion using powders of glycine, sodium bicarbonate and calcium carbonate; conventional mechanical methods-piezoelectric scaler, carbon and stainless steel scalers; and a chemical protocol using 40% citric acid. Following treatment, remaining biofilm was analysed using scanning electron microscopy and crystal violet assays. For statistical analysis, ANOVA was applied (p < 0.05).

RESULTS

All debridement techniques resulted in greater than 80% reduction in biofilm compared with baseline, irrespective of the surface type. Glycine powder delivered through an air polishing system eliminated the most biofilm. Mechanical instruments were the least effective at eliminating biofilm across all surfaces and caused the greatest surface alterations. Citric acid was comparable with mechanical debridement instruments in terms of biofilm removal efficacy. Titanium surfaces were least affected by air abrasion protocols and most affected by mechanical methods.

CONCLUSIONS

Mechanical protocols for non-surgical debridement should be approached with caution. Glycine powder in an air polisher and 40% citric acid application both gave minimal alterations across all implant surfaces, with glycine the superior method in terms of biofilm removal.

Treatment of Thoracolumbar Pyogenic Spondylitis with Minimally Invasive Posterior Fixation without Anterior Lesion Debridement or Bone Grafting: A Multicenter Case Study

The usefulness of minimally invasive posterior fixation without debridement and autogenous bone grafting remains unknown. This multicenter case series aimed to determine the clinical outcomes and limitations of this method for thoracolumbar pyogenic spondylitis. Patients with thoracolumbar pyogenic spondylitis treated with minimally invasive posterior fixation alone were retrospectively evaluated at nine affiliated hospitals since April 2016. The study included 31 patients (23 men and 8 women; mean age, 73.3 years). The clinical course of the patients and requirement of additional anterior surgery constituted the study outcomes. The postoperative numerical rating scale score for lower back pain was significantly smaller than the preoperative score (5.8 vs. 3.6, p = 0.0055). The preoperative local kyphosis angle was 6.7°, which was corrected to 0.1° after surgery and 3.7° at the final follow-up visit. Owing to failed infection control, three patients (9.6%) required additional anterior debridement and autogenous bone grafting. Thus, in this multicenter case series, a large proportion of patients with thoracolumbar pyogenic spondylitis could be treated with minimally invasive posterior fixation alone, thereby indicating it as a treatment option for pyogenic spondylitis.

Third-Generation Dynamic Anterior Plate-Screw System for Quadrilateral Fractures: Digital Design Based on 834 Pelvic Measurements

Background and Objectives: To investigate the digital measurement method for the plate trajectory of dynamic anterior plate-screw system for quadrilateral plate (DAPSQ), and then design a third-generation DAPSQ plate that conforms to the needs of the Chinese population through collating a large sample anatomical data. Materials and Methods: Firstly, the length of the pubic region, quadrilateral region, iliac region, and the total length of the DAPSQ trajectory were measured by a digital measurement approach in 22 complete pelvic specimens. Then, the results were compared with the direct measurement of pelvic specimens to verify the reliability of the digital measurement method. Secondly, 504 cases (834 hemilateral pelvis) of adult pelvic CT images were collected from four medical centers in China. The four DAPSQ trajectory parameters were obtained with the digital measurement method. Finally, the third-generation DAPSQ plate was designed, and its applicability was verified. Results: There was no statistically significant difference in the four trajectory parameters when comparing the direct measurement method with the digital measurement method (p > 0.05). The average lengths of the pubic region, quadrilateral region, iliac region, and the total length in Chinese population were (60.96 ± 5.39) mm, (69.11 ± 5.28) mm, (84.40 ± 6.41) mm, and (214.46 ± 10.15) mm, respectively. Based on the measurement results, six models of the DAPSQ plate including small size (A1,A2), medium size (B1,B2), and the large size (C1,C2) were designed. The verification experiment showed that all these six type plates could meet the requirement of 94.36% cases. Conclusions: A reliable computerized method for measuring irregular pelvic structure was proposed, which not only provided an anatomical basis for the design of the third-generation DAPSQ plate, but also provided a reference for the design of other pelvic fixation devices.

A proof-of-concept of cross-luminescent metascintillators: testing results on a BGO:BaF2metapixel

Objective: Time-of-flight positron emission tomography (PET) is the next frontier in improving the effective sensitivity. To achieve superior timing for time-of-flight PET, combined with high detection efficiency and cost-effectiveness, we have studied the applicability of BaF2 in metascintillators driven by the timing of cross-luminescence photon production.Approach: Based on previous simulation studies of energy sharing and analytic multi-exponential scintillation pulse, as well as sensitivity characteristics, we have experimentally tested a pixel of 3 × 3 × 15 mm3 based on 300μm BGO and 300μm BaF2 layers. To harness the deep ultraviolet cross-luminescent light component, which carries improved timing, we use the FBK VUV SiPM. Metascintillator energy sharing is addressed through a double integration approach.Main results: We reach an energy resolution of 22%, comparable to an 18% resolution of simple BGO pixels using the same readout, through the optimized use of the integrals of the metascintillator pulse in energy sharing calculation. We measure the energy sharing extent of each pulse with a resolution of 25% and demonstrate that experimental and simulation results agree well. Based on the energy sharing, a timewalk correction is applied, exhibiting significant improvements for both the coincidence time resolution (CTR) and the shape of the timing histogram. We reach 242 ps CTR for the entire photopeak, while for a subset of 13% of the most shared events, the CTR value improves to 108 ps, comparable to the 3 × 3 × 5 mm3 LYSO:Ce:Ca reference crystal.Significance: While we are considering different ways to improve further these results, this proof-of-concept demonstrates the applicability of cross-luminescence for metascintillator designs through the application of VUV compatible SiPM coupling, and easily implementable digital algorithms. This is the first test of BaF₂-based metascintillators of sufficient stoppng power to be included in a PET scanner, demonstrating the industrial applicability of such cross-luminescent metascintillators.

FIAT: A Device for Objective, Optical Measures of Accommodation in Phakic and Pseudophakic Eyes

Purpose

To present FIAT, a novel optical instrument and analysis package that is designed to elicit and optically record accommodation in human eyes.

Methods

FIAT employs a Shack-Hartmann wavefront sensor and a retro-illumination pupil camera that records from a single eye at video rates. It is effective at eliciting accommodation by offering the subject a full-field binocular view of an alternating distant target and a near-eye display. FIAT analysis software computes wave aberrations for each video frame over full- or subpupil sizes and computes accommodative dynamics and accommodative range.

Results

The system is validated by showing accurate refraction measurements in model eyes and human eyes with trial lenses. Robust accommodative responses are shown for young eyes, and a lack of accommodative response is shown for a known presbyopes. Accommodative stimulus-response curves from five phakic subjects over a range of ages show expected results. Results from two individuals with monofocal intraocular lenses are shown.

Conclusions

FIAT is an effective instrument for making accurate, objective measures of accommodation in phakic and pseudophakic eyes.

Translational Relevance

We present a device that can play an important role in the development and testing of accommodating intraocular lenses.

A New Instrument for Balloon-Borne In Situ Aerosol Size Distribution Measurements, the Continuation of a 50 Year Record of Stratospheric Aerosols Measurements

Profiles of stratospheric aerosol size distributions have been measured using balloon-borne in situ optical particle counters, from Laramie, Wyoming (41°N) since 1971. In 2019, this measurement record transitioned to the Laboratory for Atmospheric and Space Physics (LASP) in Boulder, Colorado (40°N). The new LASP Optical Particle Counter (LOPC), the fourth generation of instruments used for this record, is smaller and lighter (2 kg) than prior instruments, measures aerosols with diameters ≥0.3-30 μm in up to 450 size bins, with a flow rate of 20 L min^-1. The improved size resolution enables the complete measurement of size distributions, and calculation of aerosol extinction without fitting a priori distribution shapes. The higher flow provides the sensitivity required to measure super-micron particles in the stratosphere. The LOPC has been validated against prior Wyoming OPCs, through joint flights, laboratory comparisons, and statistical comparisons with the Wyoming record. The agreement between instruments is generally within the measurement uncertainty of ±10%-20% in sizing and ±10% in concentration, and within ±40% for calculated aerosol moments. The record is being continued with balloon soundings every 2 months from Colorado, coordinated with measurements of aerosol extinction from the SAGE III instrument on the International Space Station. Comparisons of aerosol extinction from the remote and in situ platforms have shown good agreement in the stratosphere, particularly for wavelengths <755 nm and altitudes <25 km. For extinction wavelengths ≥1,021 nm and altitudes above 25 km SAGE III/International Space Station extinction has a low bias relative to the in situ measurements, yet still within the ±40% uncertainty.

Pinch force generation during scaling by dental professionals: A systematic review

OBJECTIVE

The objective of this review was to examine the impact of instrument designs on pinch force generation during scaling by dental professionals.

METHODS

Three databases were utilized from September 2019 to November 2021 in addition to hand-searching specific journals and reference lists. Research articles that examined pinch force generation in dental professionals during scaling with manual instruments only were included. Bias was assessed in the individual articles.

RESULTS

Six research articles were included with sample populations that varied from 12 to 24 participants. Four articles evaluated instrument designs in relation to pinch force generation during scaling by dental professionals. Two articles evaluated the clinicians' experience levels and the impact on pinch force generation. Results of three articles revealed instruments with large diameters and low weights produced the least amount of pinch force (p < 0.05). Additionally, two articles found instruments with a round, tapered shape produced less pinch force and instrument handles made of silicone produced higher pinch strength post-scaling (p < 0.05). One study indicated instrument designs associated with modified scaling techniques may reduce thumb and index finger pinch force (p < 0.05).

CONCLUSION

The findings from this review indicate weak evidence for instrument choices to reduce pinch force during scaling. Dental professionals should consider lightweight and large diameter instruments for manual scaling. Clinicians may also want to consider round, tapered handles and instrument designs with modified scaling techniques. This systematic review further identified the need for clinical research studies with rigorous research designs that examine the ergonomic impacts of instrument designs.

Recent Trends in Multiclass Analysis of Emerging Endocrine Disrupting Contaminants (EDCs) in Drinking Water

Ingestion of water is a major route of human exposure to environmental contaminants. There have been numerous studies exploring the different compounds present in drinking water, with recent attention drawn to a new class of emerging contaminants: endocrine-disrupting compounds (EDCs). EDCs encompass a broad range of physio-chemically diverse compounds; from naturally occurring to manmade. Environmentally, EDCs are found as mixtures containing multiple classes at trace amounts. Human exposure to EDCs, even at low concentrations, is known to lead to adverse health effects. Therefore, the ability to evaluate EDC contamination with a high degree of sensitivity and accuracy is of the utmost importance. This review includes (i) discussion on the perceived and actual risks associated with EDC exposure (ii) regulatory actions that look to limit EDC contamination (iii) analytical methods, including sample preparation, instrumentation and bioassays that have been advanced and employed for multiclass EDC identification and quantitation.

Time and Angle-Resolved Time-of-Flight Electron Spectroscopy for Functional Materials Science

Electron spectroscopy with the unprecedented transmission of angle-resolved time-of-flight detection, in combination with pulsed X-ray sources, brings new impetus to functional materials science. We showcase recent developments towards chemical sensitivity from electron spectroscopy for chemical analysis and structural information from photoelectron diffraction using the phase transition properties of 1T-TaS₂. Our development platform is the SurfaceDynamics instrument located at the Femtoslicing facility at BESSY II, where femtosecond and picosecond X-ray pulses can be generated and extracted. The scientific potential is put into perspective to the current rapidly developing pulsed X-ray source capabilities from Lasers and Free-Electron Lasers.

Portable mass spectrometry system: instrumentation, applications, and path to 'omics analysis

Mass spectrometry (MS) is an information rich analytical technique and plays a key role in various 'omics studies. Standard mass spectrometers are bulky and operate at high vacuum, which hinder their adoption by the broader community and utility in field applications. Developing portable mass spectrometers can significantly expand the application scope and user groups of MS analysis. This review discusses the basics and recent advancements in the development of key components of portable mass spectrometers including ionization source, mass analyzer, detector, and vacuum system. Further, major areas where portable mass spectrometers are applied are also discussed. Finally, a perspective on the further development of portable mass spectrometers including the potential benefits for 'omics analysis is provided.

Trends of single-level anterior cervical discectomy and fusion documentation after the 2015 Centers for Medicare & Medicaid Services coding audit

OBJECTIVE

With the use of anterior cervical discectomy and fusion (ACDF) expected to rise by 13.3% from 2020 to 2040, the increased usage of interbody cages with integral anterior fixation prompted a Centers for Medicare & Medicaid Services (CMS) review, which resulted in coding changes affecting anterior instrumentation documentation. CMS determined that Current Procedural Terminology (CPT) code 22845 should not be used to report integrated instrumentation (plate) with an interbody device, and if additional anterior instrumentation (e.g., plates and screws) is placed with an integrated interbody device, then a 59 modifier should be used. There is sparse literature examining the trends of ACDF without and with additional anterior instrumentation after the 2015 CMS audit. Therefore, this study aimed to evaluate the trends of single-level subaxial ACDF utilization from 2011 to 2019 to determine whether the 2015 CMS audit influenced the documented usage of additional anterior instrumentation.

METHODS

A retrospective cohort study was performed using the commercially available database PearlDiver. Patient records were queried from 2011 to 2019 for single-level subaxial ACDF without (CPT code 22551) and with (CPT codes 22551 + 22845) instrumentation. Cochran-Armitage trend analyses were performed to evaluate the hypothesis that ACDF with additional anterior instrumentation decreased over the given time period.

RESULTS

Between 2011 and 2019, the total number of single-level ACDFs decreased from 6202 to 4402. From 2011 to 2015, an average of 6240 patients per year underwent single-level subaxial ACDF; of those, 950 patients (15.2%) had ACDF without instrumentation and 5290 patients (84.8%) had ACDF with instrumentation. In 2016, the total number of single-level subaxial ACDFs decreased to 5525, with 1006 patients (18.2%) receiving no instrumentation and 4519 patients (81.8%) receiving instrumentation. From 2017 to 2019, an average of 4283 patients per year underwent a single-level subaxial ACDF; of these, 1280 (29.9%) had no instrumentation and 3003 (70.1%) had instrumentation (all p < 0.0001).

CONCLUSIONS

From 2015 to 2019, single-level ACDF without instrumentation significantly increased by 91.5% and ACDF with anterior instrumentation significantly decreased by 18.1%. The 2015 CMS audit of interbody cages and anterior instrumentation coding (CPT code 22845) may account for the decreased documentation of anterior instrumentation in the 9-year period. Understanding CMS auditing could help surgeons perceive changes in practice patterns that may lead to a more thorough evaluation of patient outcomes, cost, and overall value.

Biomechanical assessment of the effect of sublaminar band tensioning on lumbar motion

OBJECTIVE

Adjacent-segment disease (ASD) proximal to lumbosacral fusion is assumed to result from increased stress and motion that extends above or below the fusion construct. Sublaminar bands (SBs) have been shown to potentially mitigate stresses in deformity constructs. A similar application of SBs in lumbar fusions is not well described yet may potentially mitigate against ASD.

METHODS

Eight fresh-frozen human cadaveric spine specimens were instrumented with transforaminal lumbar interbody fusion (TLIF) cages at L3-4 and L4-5, and pedicle screws from L3 to S1. Bilateral SBs were applied at L2 and tightened around the rods extending above the L3 pedicle screws. After being mounted on a testing frame, the spines were loaded at L1 to 6 Nm in all 3 planes, i.e., flexion/extension, right and left lateral bending, and right and left axial rotation. Motion and intradiscal pressures (IDPs) at L2-3 were measured for 5 conditions: intact, instrumentation (L3-S1), band tension (BT) 30%, BT 50%, and BT 100%.

RESULTS

There was significant increase in motion at L2-3 with L3-S1 instrumentation compared with the intact spine in flexion/extension (median 8.78°, range 4.07°-10.81°, vs median 7.27°, range 1.63°-9.66°; p = 0.016). When compared with instrumentation, BT 100% reduced motion at L2-3 in flexion/extension (median 8.78°, range 4.07°-10.81°, vs median 3.61°, range 1.11°-9.39°; p < 0.001) and lateral bending (median 6.58°, range 3.67°-8.59°, vs median 5.62°, range 3.28°-6.74°; p = 0.001). BT 50% reduced motion at L2-3 only in flexion/extension when compared with instrumentation (median 8.78°, range 4.07°-10.81°, vs median 5.91°, range 2.54°-10.59°; p = 0.027). There was no significant increase of motion at L1-2 with banding when compared with instrumentation, although an increase was seen from the intact spine with BT 100% in flexion/extension (median 5.14°, range 2.47°-9.73°, vs median 7.34°, range 4.22°-9.89°; p = 0.005). BT 100% significantly reduced IDP at L2-3 from 25.07 psi (range 2.41-48.08 psi) before tensioning to 19.46 psi (range -2.35 to 29.55 psi) after tensioning (p = 0.016).

CONCLUSIONS

In this model, the addition of L2 SBs reduced motion and IDP at L2-3 after the L3-S1 instrumentation. There was no significant increase in motion at L1-2 in response to band tensioning compared with instrumentation alone. The application of SBs may have a clinical application in reducing the incidence of ASD.

Fleet's Geode: A Breakthrough Sensor for Real-Time Ambient Seismic Noise Tomography over DtS-IoT

As most of the outcropping and shallow mineral deposits have been found, new technology is imperative to finding the hidden critical mineral deposits required to transition to renewable energy. One such new technique, called ambient seismic noise tomography, has shown promise in recent years as a low-cost, low environmental impact method that can image under cover and at depth. Wireless and compact nodal seismic technology has been instrumental to enable industry applications of ambient noise tomography, but these devices are designed for the active seismic reflection method and do not have the required sensitivity at low frequencies for ambient noise tomography, and real-time data transmission in remote locations requires significant infrastructure to be installed. In this paper, we show the development and testing of the Geode-a real-time seismic node purpose-built by Fleet Space Technologies for ambient seismic noise tomography on exploration scales. We discuss the key differences between current nodal technology and the Geode and show results of a field trial where the performance of the Geode is compared with a commercially popular nodal geophone. The use of a 2 Hz high sensitivity geophone and low noise digitiser results in an instrument noise floor that is more than 30 dB lower below 5 Hz than nodes that are commonly used in the industry. The increased sensitivity results in signal-to-noise ratios in the cross-correlation functions in the field trial that are more than double that of commercially available nodal geophone at low frequencies. When considering the full bandwidth of retrievable correlations in our study, using the Geode would reduce the required recording time from 75 h to 32 h to achieve an average signal-to-noise ratio in the cross-correlation functions of 10. We also discuss the integration of a real-time direct-to-satellite Internet of Things (DtS-IoT) modem in the Geode, which, together with edge processing of seismic data directly on the Geode, enables us to image the subsurface in real-time. During the field trial, the Geodes successfully transmitted more than 90% of the available preprocessed data packets. The Geode is compact enough so that several devices can be carried and installed by one field technician, whilst the array of stations do not require a base station to transmit data to the cloud for further processing. We believe this is the future of passive seismic surveys and will result in faster and more dynamic seismic imaging capabilities analogous to the medical imaging community, increasing the pace at which new mineral deposits are discovered.