Engineering Electrode Rinse Solution Fluidics for Carbon-Based Reverse Electrodialysis Devices

Natural salinity gradients are a promising source of so-called "blue energy", a renewable energy source that utilizes the free energy of mixing for power generation. One promising blue energy technology that converts these salinity gradients directly into electricity is reverse electrodialysis (RED). Used at its full potential, it could provide a substantial portion of the world's electricity consumption. Previous theoretical and experimental works have been done on optimizing RED devices, with the latter often focusing on precious and expensive metal electrodes. However, in order to rationally design and apply RED devices, we need to investigate all related transport phenomena─especially the fluidics of salinity gradient mixing and the redox electrolyte at various concentrations, which can have complex intertwined effects─in a fully functioning and scalable system. Here, guided by fundamental electrochemical and fluid dynamics theories, we work with an iron-based redox electrolyte with carbon electrodes in a RED device with tunable microfluidic environments and study the fundamental effects of electrolyte concentration and flow rate on the potential-driven redox activity and power output. We focus on optimizing the net power output, which is the difference between the gross power output generated by the RED device and the pumping power input, needed for salinity gradient mixing and redox electrolyte reactions. We find through this holistic approach that the electrolyte concentration in the electrode rinse solution is crucial for increasing the electrical current, while the pumping power input depends nonlinearly on the membrane separation distance. Finally, from this understanding, we designed a five cell-pair (CP) RED device that achieved a net power density of 224 mW m-2 CP-1, a 60% improvement compared to the nonoptimized case. This study highlights the importance of the electrode rinse solution fluidics and composition when rationally designing RED devices based on scalable carbon-based electrodes.

Energetic Valorisation of Saltworks Bitterns via Reverse Electrodialysis: A Laboratory Experimental Campaign

Concentrated bitterns discharged from saltworks have extremely high salinity, often up to 300 g/L, thus their direct disposal not only has a harmful effect on the environment, but also generates a depletion of a potential resource of renewable energy. Here, reverse electrodialysis (RED), an emerging electrochemical membrane process, is proposed to capture and convert the salinity gradient power (SGP) intrinsically conveyed by these bitterns also aiming at the reduction of concentrated salty water disposal. A laboratory-scale RED unit has been adopted to study the SGP potential of such brines, testing ion exchange membranes from different suppliers and under different operating conditions. Membranes supplied by Fujifilm, Fumatech, and Suez were tested, and the results were compared. The unit was fed with synthetic hypersaline solution mimicking the concentration of natural bitterns (5 mol/L of NaCl) on one side, and with variable concentration of NaCl dilute solutions (0.01-0.1 mol/L) on the other. The influence of several operating parameters has also been assessed, including solutions flowrate and temperature. Increasing feed solutions' temperature and velocity has been found to lower the stack resistance, which enhances the output performance of the RED stack. The maximum obtained power density (corrected to account for the effect of electrodic compartments, which can be very relevant in five cell pairs laboratory stacks) reached around 10.5 W/m²_cellpair, with FUJIFILM Type 10 membranes, temperature of 40 °C, and a fluid velocity of 3 cm s^-1 (as empty channel, considering 270 μm thickness). Notably, the present study results confirm the large potential for SGP generation from hypersaline brines, thus providing useful guidance for the harvesting of SGP in seawater saltworks all around the world.

Long-term patient-reported outcomes after anterior distraction osteogenesis of the maxilla in patients with cleft

Maxillary growth inhibition in patients with cleft lip and palate (CLP) is an undesired effect that may occur in the teens despite proper primary care. Dental malocclusion and distortion of facial appearance can be treated with external distraction osteogenesis (DO) of the maxilla. This entails a Le Fort I osteotomy, fastening a semi-circular distractor to the skull, distraction for three weeks, and fixation for three months before removal of the device.The aim of this descriptive long-term follow-up study was to evaluate DO of the maxilla from the patient-reported long-term perspective.Fourteen patients underwent a long-term follow-up including a questionnaire regarding their experience of DO. Sex, CLP diagnosis, age at DO and follow-up, and time required for active distraction and fixation were noted. Furthermore, documentation on rhinoplasty, lip plasty and velopharyngeal plasty after DO was registered. Objective results were assessed by a positive dental overjet in the front.Ten patients considered the distractor an everyday constraint, but all thought the procedure was worthwhile and would recommend it to others. Thirteen patients experienced improved bite and chewing, whereas one considered function unchanged. All were satisfied with their dental alignment. Three patients underwent a velopharyngeal plasty after DO. Moreover, six rhinoplasties and two lip plasties were performed.Despite a long and challenging treatment, teenagers and young adults with CLP and maxillary hypoplasia tolerate DO of the maxilla very well. Secondary measures to improve speech and appearance are often indicated.

Improving the Accuracy of the Effective Atomic Number (EAN) and Relative Electron Density (RED) with Stoichiometric Calibration on PCD-CT Images

The photon counting detector (PCD) in computed tomography (CT) can count the number of incoming photons in order to obtain energy information for photons corresponding to user-defined thresholds. Research on the extraction of effective atomic number (EAN) and relative electron density (RED) using dual-energy CT (DECT) is currently underway. This study proposes a method for improving EAN and RED accuracy of tissue-equivalent materials by using PCD-CT-based stoichiometric calibration. After obtaining DECT images in energy bin (EB) and full spectrum (FS) modes for eight tissue-equivalent materials, the EAN was calculated with stoichiometric calibration. Using the EAN image, the RED image was acquired to evaluate the accuracy. The errors of both EAN and RED obtained with EB were within 4%. In particular, the accuracy of RED was higher than that of the FS method. Study results indicate that PCD-CT contributes to improving EAN and RED accuracy. Further studies will be aimed at reducing ring artifacts by pixel-correcting PCD images and improving stopping power ratio (SPR) measurements for dose calculation in particle therapy.

Power Generation Performance of a Pilot-Scale Reverse Electrodialysis Using Monovalent Selective Ion-Exchange Membranes

Reverse electrodialysis (RED) is a promising process for harvesting energy from the salinity gradient between two solutions without environmental impacts. Seawater (SW) and river water (RW) are considered the main RED feed solutions because of their good availability. In Okinawa Island (Japan), SW desalination via the reverse osmosis (RO) can be integrated with the RED process due to the production of a large amount of RO brine (concentrated SW, containing ~1 mol/dm³ of NaCl), which is usually discharged directly into the sea. In this study, a pilot-scale RED stack, with 299 cell pairs and 179.4 m² of effective membrane area, was installed in the SW desalination plant. For the first time, asymmetric monovalent selective membranes with monovalent selective layer just at the side of the membranes were used as the ion exchange membranes (IEMs) inside the RED stack. Natural and model RO brines, as well as SW, were used as the high-concentrate feed solutions. RW, which was in fact surface water in this study and close to the desalination plant, was utilized as the low-concentrate feed solution. The power generation performance investigated by the current-voltage (I-V) test showed the maximum gross power density of 0.96 and 1.46 W/m² respectively, when the natural and model RO brine/RW were used. These are a 50-60% improvement of the maximum gross power of 0.62 and 0.97 W/m² generated from the natural and model SW, respectively. The approximate 50% more power generated from the model feed solutions can be assigned to the suppression of concentration polarization of the RED stack due to the absence of multivalent ions.

Testing Re-Engineered Discharge Program Implementation Strategies in SNFs

The Re-Engineered Discharge (RED) program, designed for hospitals, is being trialed in skilled nursing facilities (SNFs) with promising results. This paper reports on the quantitative results of a multimethod study testing two different RED program implementation strategies in SNFs. A pretest-posttest design was used to compare utilization outcomes of two different RED implementation strategies (Enhanced and Standard) and overall group differences in four Midwestern SNFs. In the Standard group there were higher odds of being readmitted in the pre-intervention versus post-intervention period. After adjusting coefficients using Poisson regression, in the pre-intervention period the adjusted number of rehospitalizations for the Standard group was 45% higher at 30 days, 50% higher at 60 days (p = .01), and 39% higher at 180 days (p = .001). SNF RED may be a useful program to reduce rehospitalizations after discharge. Benefit of SNF RED is dependent on degree of adoption of the intervention.

Rigid External Distractors in Midface Fractures: A Review of Relevant and Related Literature

INTRODUCTION

Literature discussing the use of rigid external distraction devices in midfacial trauma is limited. Rigid external distraction devices have been described for use in craniofacial surgery, allowing for distraction and stabilization of bony segments. In complex facial trauma, bony fragments are often comminuted and unstable, making traditional approaches with internal fixation difficult. Moreover, these approaches require subperiosteal dissection, limiting blood supply that is important for bone healing.

OBJECTIVE

The goal of this study was to evaluate the role of rigid external distraction devices for the treatment of complex facial trauma.

METHODS

We performed a literature review of rigid external distraction devices, as relevant both for facial trauma and for other craniofacial indications, to better elucidate their use and efficacy in complex facial fractures.

RESULTS

The review revealed only 2 articles explicitly describing rigid external distraction devices for facial trauma, while 6 other articles describing its use for other craniofacial cases. An important benefit associated with the use of rigid external distraction devices is their ability to provide controlled traction of bony segments while also allowing for movement as needed for fracture reduction. Various articles describe performing internal fixation following rigid external distraction device usage, while others emphasize that internal fixation is not necessarily indicated if the rigid external distraction device is left intact long enough to ensure bony healing. One potential setback described is unfamiliarity with using the rigid external distraction device, which can preclude its use by many surgeons. In addition, the literature review did not provide any uniform guidelines or recommendations about how long rigid external distraction devices should remain intact.

CONCLUSION

Based on relevant literature, rigid external distraction devices have been shown to be useful in the stabilization and treatment of complex facial fractures. Further studies should be conducted to better elucidate the specific indications for rigid external distraction devices in complex facial trauma.

Development of a process for the treatment of synthetic wastewater without energy inputs using the salinity gradient of wastewaters and a reverse electrodialysis stack

Electrochemical processes are considered very effective methods for the treatment of wastewater contaminated by organics resistant to conventional biological processes and various inorganic pollutants. Large sites that treat wastewaters usually deal with a large number of waters often characterized by different salinity contents, that could be potentially used to provide the energy necessary for the electrochemical remediation. Hence, in this work a reverse electrodialysis (RED) process for the treatment of synthetic wastewaters contaminated by organics, without energy inputs, using the salinity gradient of different wastewaters, was studied, for the first time. It was found that two synthetic wastewaters with different NaCl content can be effectively used in a RED system to drive anodic and cathodic processes for the removal of their organic contents without external energy supplies. The effects of salinity gradient, external resistance and set-up of the process was evaluated. Under optimized operating conditions, a fast and high removal of TOC (about 70% every hour) in the anodic compartment and a good stability of operating conditions for all the monitored time (10 h) were achieved. In addition, about 67% of the solution with high salinity used in the stack to provide the salinity gradient was effectively treated in the anodic compartment of the stack.

Rapid enrollment design for finding the optimal dose in immunotherapy trials with ordered groups

In immunotherapy dose-finding trials, the optimal dose is usually defined based on both toxicity and response because the relationship between toxicity and response is different than that seen with cytotoxic anti-neoplastic therapies. In immunotherapy trials, toxicity and response often require a longer follow-up time compared to trials with cytotoxic agents. The rapid enrollment design has been proposed for dose-finding trials to find the maximum-tolerated dose where the follow-up for toxicity is long and it is desirable to assign a patient to a dose of a new therapy as soon as the patient is enrolled. We extend the rapid enrollment design to immunotherapy trials to find the optimal dose. We further describe how to use the design in immunotherapy trials with ordered groups where efficacy and safety considerations dictate running dose-finding trials in each group separately as efficacy and toxicity at the same dose can vary across groups. The estimation of the optimal dose in each of the groups can be improved in many, but not all, cases by using the monotonicity of toxicity and response among groups.

Geometry determination and refinement in the rotation electron diffraction technique

The necessary parameters (rotation axis, incident electron beam direction and beam tilt path) in order to describe the diffraction geometry in the Rotation Electron Diffraction (RED) method during data collection are determined and refined. These parameters are prerequisites for the subsequent calculations of excitation errors, s_g, for zero (ZOLZ) or higher order Laue zones (HOLZ) reflections. Comparison with simulated results, for a CoP₃ thermoelectric crystal, shows excellent agreement between the two approaches -calculated and simulated. In addition to their determination, a thorough refinement methodology for the incident electron beam direction and beam tilt path has been applied, too, based on Kikuchi lines of HOLZ reflections. Incorporation of the refined excitation error values can be considered both in theoretical calculations for diffracted beam intensities, based on the Bloch wave method, as well as in deducing integrated intensities from experimental rocking curves. The methodology described in this study is quite indispensable, as it forms an essential step for performing dynamical calculations in RED, enabling thus enhanced accuracy in structural parameter clarification. The latter is especially important in the case of thermal factors refinement for e.g. thermoelectrics, which are imperative for material properties' evaluation.

Adapting Project RED to Skilled Nursing Facilities

This article describes our recommendation for adapting hospital-based RED (Reengineered Discharge) processes to skilled nursing facilities (SNFs). Using focus groups, the SNFs' discharge processes were assessed twice additionally, research staff then recorded field notes documenting discussions about facility discharge processes as they related to RED processes. Data were systematically analyzed using thematic analysis to identify recommendations for adapting RED to the SNF setting including (a) rapidly identifying, involving, and preparing family/caregivers to implement a patient focused SNF discharge plan; (b) reconnecting patients quickly to primary care providers; and (c) educating patients at discharge about their target health condition, medications, and impact of changes on other chronic health needs. Limited SNF staff capacity and corporate-level policies limited adoption of some key RED components. Transitional care processes such as RED, developed to avoid discharge problems, can be adapted for SNFs to improve their discharges.

Reverse electrodialysis performed at pilot plant scale: Evaluation of redox processes and simultaneous generation of electric energy and treatment of wastewater

This paper describes the experimental campaign carried out with a reverse electrodialysis (RED) demonstration plant (Marsala, Italy) with the main aims of: (i) evaluating the effect of various operating parameters, including the redox processes, on the system performances; (ii) using the plant for the simultaneous generation of electric energy and treatment of wastewater. The prototype (44 × 44 cm², 500 cell pairs) was tested using both real (brackish water and brine) and artificial solutions. Tests with two different electrode rinse solutions (with or without iron redox couples) were performed. In agreement with the data obtained in the laboratory, the presence of iron ions contributes positively to the power production. The effect of flow rates in the electrode and saline compartments, as well as aging of the electrode rinse solution was also investigated. The possibility to remove an organic pollutant (the azoic dye Acid Orange 7) from the electrode solution was tested, obtaining a very fast and total removal of the pollutant. This experimental campaign represents the first demonstration in a real environment of the abilities of a RED plant to treat wastewater, thus giving useful indications for the spreading of RED technology in the near future.

The rapid enrollment design for Phase I clinical trials

We propose a dose-finding design for Phase I oncology trials where each new patient is assigned to the dose most likely to be the target dose given observed data. The main model assumption is that the dose-toxicity curve is non-decreasing. This method is beneficial when it is desirable to assign a patient to a dose as soon as the patient is enrolled into a study. To prevent assignments to doses with limited toxicity information in fast accruing trials we propose a conservative rule that assigns temporary fractional toxicities to patients still in follow-up. We also recommend always using a safety rule in any fast accruing dose-finding trial. Copyright © 2016 John Wiley & Sons, Ltd.

Vaccination protects rats from methamphetamine-induced impairment of behavioral responding for food

(+)-Methamphetamine (METH) addiction is a chronic disease that interferes with fundamental brain-mediated behaviors and biological functions like eating. These studies present preclinical efficacy and safety profiles for a METH conjugate vaccine (IC(KLH)-SMO9) designed to treat METH abuse. ICKLH-SMO9 efficacy and safety were assessed over a 16-week period by monitoring general health and stability of responding in a food maintained behavioral paradigm. Male Sprague-Dawley rats were trained to lever press for food reinforcers until stable behavior was established. Rats (n=9/group) were then immunized with 100 μg of a control antigenic carrier protein (IC(KLH)-Cys) or IC(KLH)-SMO9 in Alhydrogel adjuvant, with booster immunizations at 4, 8 and 12 weeks. Health, immunization site and behavior were assessed daily. No adverse effects were found. During weeks 14-16, when antibody titers and METH affinity (K(d)=13.9 ± 1.7 nM) were maximal, all rats received progressively higher METH doses (0.3-3.0 mg/kg) every 3-4 days, followed by behavioral testing. Even though the lower METH doses from 0.3 to 1.0 mg/kg produced no impairment in food maintained behavior, 3.0-mg/kg in control rats showed significantly (p<0.05) reduced response rates and number of reinforcers earned, as well as reduced food intake. In sharp contrast, the IC(KLH)-SMO9 group showed no changes in food maintained behavior at any METH dose, even though METH serum concentrations showed profound increases due to anti-METH antibody binding. These findings suggest the IC(KLH)-SMO9 vaccine is effective and safe at reducing adverse METH-induced effects, even at high METH doses.