Contemporary Protocols Research Articles

418P - Lessons learnt from treatment of foot sarcomas: Analysis from dedicated sarcoma clinic in North India

BackgroundThere is sparse data available on foot sarcomas treated on contemporary protocols. MethodsThis retrospective analysis involved 27 cases of foot sarcomas managed with multi-modality treatment under Sarcoma Clinic, at tertiary care hospital between January 2014 to May 2019. Baseline demographics, radiographic tumour characteristics, histological diagnosis, type of treatment received and oncological outcomes were noted for all cases. Statistical analysis was done by STATA version 13.0. Survival curves were analyzed by Kaplan Meir test and univariate analysis was done by Log Rank test. ResultsMedian age was 26 years (range: 20 – 46 years). Median duration of symptoms were 11 months (Range: 5 – 24 months). Radiologically mean largest diameter of tumour was 6.5 cm (CI: 1.1 – 12 cm). Seven tumours (26%) arose from bone and 20 form soft tissue (74%). In tumours arising from bone, metatarsal was most commonly site of involvement (3 out of 7). Most common histology was synovial sarcoma (44%) f/b Ewing’s sarcoma (26%) f/b others (RMS, DFSP, MPNST, angiosarcoma). Ten patients (37%) had metastatic disease at presentation, lung being most common site (80%). Histological discordance with review diagnosis was seen in 50 % cases. Amputation was needed in 10 cases (37%) (palliative - 5, curative - 5) while limb salvage surgery was done in 10 (all curative). Adjuvant radiation was given in 7 out of 10 cases (70%). At last follow up 16 out of 27 patients (60%) were alive without disease, 4 (11%) with disease while 8 (29%) have died. With median follow-up of 43 months (Range 8 - 63 months) median PFS was 22 months. Median PFS in non-metastatic group was 48 months, while in metastatic group it was 8 months. On univariate analysis, median OS was significantly different between metastatic vs non-metastatic group (HR 10.93, p = 0.03). ConclusionsFoot sarcomas happen in young adults irrespective of pathology with synovial sarcoma and Ewing’s sarcoma being most common histologies. Amputation rates are quite high even considering small size, owing to anatomy of the region as noted in previous studies. The treatment required for non metastatic disease is multimodality including use of radiation. If treated in multidisciplinary clinic outcomes can certainly be improved. Legal entity responsible for the studySameer Rastogi. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

Do protocols for new randomised trials take previous similar trials into account? Cohort study of contemporary trial protocols

ObjectiveTo investigate to what extent evidence from previous similar trials or systematic reviews was considered before conducting new trials.DesignCohort study of contemporary protocols for trials with ethical approval.MethodsAll protocols for...

Evaluation of protocols for rRNA depletion-based RNA sequencing of nanogram inputs of mammalian total RNA.

Next generation RNA-sequencing (RNA-seq) is a flexible approach that can be applied to a range of applications including global quantification of transcript expression, the characterization of RNA structure such as splicing patterns and profiling of expressed mutations. Many RNA-seq protocols require up to microgram levels of total RNA input amounts to generate high quality data, and thus remain impractical for the limited starting material amounts typically obtained from rare cell populations, such as those from early developmental stages or from laser micro-dissected clinical samples. Here, we present an assessment of the contemporary ribosomal RNA depletion-based protocols, and identify those that are suitable for inputs as low as 1–10 ng of intact total RNA and 100–500 ng of partially degraded RNA from formalin-fixed paraffin-embedded tissues.

Physical Response to Pad- and Bag-Based Boxing-Specific Training Modalities.

Finlay, MJ, Greig, M, McCarthy, J, and Page, RM. Physical response to pad- and bag-based boxing-specific training modalities. J Strength Cond Res 34(4): 1052-1061, 2020-This study examined the differences in the physical response elicited from a contemporary Boxing-Specific Exercise Protocol (BSEP) performed using a punch bag and a pad routine. Fourteen male elite amateur boxers (age = 22 ± 2 years; height = 176.9 ± 7.3 cm; body mass = 78.8 ± 8.7 kg; and V[Combining Dot Above]O2max = 55.94 ± 5.96 ml·kg·min) were recruited. The BSEP comprised 3 × 3-minute rounds. Average (HRave) and peak (HRpeak) heart rate, average (V[Combining Dot Above]O2ave) and peak oxygen consumption (V[Combining Dot Above]O2peak), blood lactate (BLa) concentrations, rating of perceived exertion (RPE), and both triaxial and uniaxial PlayerLoad metrics were recorded during each trial. The PlayerLoad metrics were recorded at both the cervical and lumbar spine. BLa increased significantly across rounds, with higher values recorded in the pad trial (pad = 2.7 ± 0.8 mmol·L; bag = 2.3 ± 0.9 mmol·L). A similar response was also identified for the HRave (pad = 160 ± 9 b·min; bag = 150 ± 16 b·min) and V[Combining Dot Above]O2ave data (pad = 38.00 ± 0.31 ml·kg·min; bag = 34.40 ± 1.06 ml·kg·min). A significant main effect for time was also recorded for the RPE data; however, there were no significant differences between trials. Conversely, the triaxial (PLTotal) and medial-lateral (PLML) data were higher in the punch bag trial. There was also a main effect for time for all the PlayerLoad metrics. PLTotal, PLML, and vertical PlayerLoad were significantly higher in the lumbar region when compared with the cervical region. With implications for boxing-specific conditioning, the pad routine was more physiologically demanding, but less mechanically demanding than the bag routine.

Mutated WT1, FLT3-ITD, and NUP98-NSD1 Fusion in Various Combinations Define a Poor Prognostic Group in Pediatric Acute Myeloid Leukemia.

Acute myeloid leukemia is a life-threatening malignancy in children and adolescents treated predominantly by risk-adapted intensive chemotherapy that is partly supported by allogeneic stem cell transplantation. Mutations in the WT1 gene and NUP98-NSD1 fusion are predictors of poor survival outcome/prognosis that frequently occur in combination with internal tandem duplications of the juxta-membrane domain of FLT3 (FLT3-ITD). To re-evaluate the effect of these factors in contemporary protocols, 353 patients (<18 years) treated in Germany with AML-BFM treatment protocols between 2004 and 2017 were included. Presence of mutated WT1 and FLT3-ITD in blasts (n=19) resulted in low 3-year event-free survival of 29% and overall survival of 33% compared to rates of 45-63% and 67-87% in patients with only one (only FLT3-ITD; n=33, only WT1 mutation; n=29) or none of these mutations (n=272). Including NUP98-NSD1 and high allelic ratio (AR) of FLT3-ITD (AR ≥0.4) in the analysis revealed very poor outcomes for patients with co-occurrence of all three factors or any of double combinations. All these patients (n=15) experienced events and the probability of overall survival was low (27%). We conclude that co-occurrence of WT1 mutation, NUP98-NSD1, and FLT3-ITD with an AR ≥0.4 as triple or double mutations still predicts dismal response to contemporary first- and second-line treatment for pediatric acute myeloid leukemia.

Distribution of hospital care among pediatric and young adult Hodgkin lymphoma survivors-A population-based cohort study from Sweden and Denmark.

The burden of late effects among Hodgkin lymphoma (HL) survivors treated according to contemporary protocols remains poorly characterized. We used nation‐wide registers to assess number of inpatient bed‐days and specialist outpatient visits among 1048 HL‐patients (<25 years, diagnosed 1990‐2010) and 5175 country‐, sex‐, and age‐matched comparators. We followed them for up to 24 years, with time‐dependent assessment of relapse status. International Classification of Diseases (ICD‐10) chapter‐specific hazard ratios (HRs) were assessed in Cox regression analyses, and nonparametric statistics described patterns of health‐care‐use. Relative to comparators, relapse‐free survivors were at increased risk of infections, diseases of the blood, endocrine, circulatory and respiratory systems, and unspecific symptoms, HRs ranging from 1.86 to 3.05. Relative to comparators, relapsed survivors had at statistically significantly increased risk of diseases reflecting practically all investigated disease‐chapters, HRs ranging from 1.60 to 18.7. Among relapse‐free survivors, 10% of the patients accounted for 80% of all hospital bed days, and 55% were never hospitalized during follow‐up. Among relapsed‐survivors, 10% of the patients accounted for 50% of the bed days, and only 24% were never hospitalized during follow‐up. In contrast, 10% of the comparators accounted for 90% of hospital bed days and 75% were never hospitalized. These findings challenge the impression of a uniformly distributed long‐term morbidity among all HL survivors and emphasize the need for early identification and attention to patients particularly susceptible to late effects, such as relapsed survivors.

CUMAC-CAM: a channel allocation aware MAC protocol for addressing triple hidden terminal problems in multi-channel UWSNs

In this paper, a cooperative underwater multi-channel MAC (CUMAC) protocol has been proposed with both delay mapping and channel allocation assessment in order to improve network performance and handle triple hidden terminal (THT) problems in underwater sensor networks. A novel channel allocation matrix (CAM) was developed for estimating propagation delay and increasing utilization of channel. In the proposed scheme, every node maintains a database for delay mapping, based on which the sender runs a scheduling algorithm prior to transmitting any data. This delay mapping database assists a node in predicting packet collision probability. The overall objectives are—first, to increase the rate of successful transmission through mitigation of THT problems in multi-channel underwater sensor networks; and second, to increase channel utilization leveraging the database of delay mapping and channel allocation assessment. Results from performance evaluation demonstrate the efficiency of the proposed CUMAC-CAM protocol in terms of packet delivery ratio, energy consumption, end-to-end delay, network throughput, collision probability, packet loss ratio and fairness index compared to the contemporary CUMAC protocol and RTS/CTS based multi-channel MAC protocols.

Sex Differences in Recovery from Extreme and Severe Intensity Exercise

Previous protocols investigating neuromuscular fatigue have typically discarded the first 2 of 6 electrical stimulation sets in recovery and have reported the average of the remaining force values. However, our lab has recently shown that central (as measured by maximal voluntary contraction force, MVC; and voluntary activation, VA) and peripheral fatigue (as measured by potentiated twitch force, Qtw) had significantly recovered within 90 s following extreme intensity exercise and would otherwise be missed using contemporary protocols. PURPOSE: The purpose of this study was to test the hypothesis that MVC, VA, and Qtw immediately following task failure of extreme intensity exercise would be significantly lower than those measured 2 min into recovery in both men and women, while remaining suppressed following severe exercise. METHODS: Two men (26 ± 5 yrs; 109 ± 9 kg; 179 ± 1 cm) and two women (23 ± 2 yrs; 55 ± 3 kg; 159 ± 1 cm) performed 2 intermittent isometric knee extension tests to exhaustion at 40% (severe intensity) and 70% (extreme intensity) MVC in random order. Neuromuscular measurements were made every 30 s beginning immediately after task failure for a total of 6 sets. The last two MVC, VA, and Qtw were averaged and compared to the first measurement immediately following task failure using paired t-tests. RESULTS: Qtw and MVC significantly decreased following severe and extreme exercise (p<0.01). However, VA was not different across severe or extreme exercise. VA was not different across recovery following severe or extreme exercise. MVC was not different following severe, however, had increased following extreme (p=0.02) exercise. Qtw was significantly recovered after severe (p<0.01) and extreme (p<0.02) exercise. Further, qualitative analysis suggests women may be able to recover MVC and Qtw faster than men following extreme exercise, while these differences may not be evident following severe exercise. CONCLUSIONS: These current data suggest central fatigue (as measured by VA) does not significantly impact exercise tolerance during severe or extreme exercise. Importantly, these data suggest that the measurements typically used to represent the condition of the muscle are taken too far post-exercise such that much of the recovery of the muscle has already occurred, especially following extreme exercise.

Experimental Characterization of Routing Protocols in Urban Vehicular Communication

Abstract Vehicular communication is a cynosure in automotive industry these days. V2V communication is one of the types of vehicular communication which render lane change warning, emergency vehicle alert, intersection alert, congestion alert, payment at tolls etc. A simulation research on the utilization of vehicle to vehicle connectivity via different routing protocols in VANET, contemplating the instance of a city situation has been introduced in our paper in order to resolve the issue of traffic routing. A routing algorithm is proposed which firstly selects optimal path via carry and forward approach and then transmits information on that path and the proposed algorithm is then compared with contemporary routing protocols based on different QoS parameters like throughput, packet delivery ratio, delay which are measured using NETSIM simulator to evaluate the behaviour of dissimilar routing protocols. The proposed algorithm outperforms most of the simulation cases.

SAFE-MAC: Speed Aware Fairness Enabled MAC Protocol for Vehicular Ad-hoc Networks.

Highly dynamic geographical topology, two-direction mobility, and varying traffic density can lead to fairness issues in Vehicular Ad-hoc Networks (VANETs). The Medium Access Control (MAC) protocol plays a vital role in sharing the common wireless channel efficiently between vehicles in a VANET system. However, ensuring fairness between vehicles can be a challenge in designing MAC protocols for VANET systems. The existing protocol, IEEE 802.11 DCF, ensures that the packet transmission rate for a particular vehicle is directly proportional to the amount of time a vehicle spends within a service area, but it does not guarantee that faster vehicles will be able to send the minimum number of packets. Other existing MAC protocols based on IEEE 802.11 are able to provide a minimum amount of data transmission regardless of velocity, but are unable to provide an amount of data transmission that is more proportionate to the time a vehicle spends in the service area. To address the above limitations, we propose a Speed Aware Fairness Enabled MAC (SAFE-MAC) protocol that calculates the residence time of a vehicle in a service area by using mobility metrics such as position, direction, and speed to synthesize the transmission probability of each individual vehicle with respect to its residence time. This is achieved by dynamically altering the values of parameters such as minimum contention window, maximum backoff stage, and retransmission limit in the MAC protocol. We then develop an analytical model to compare the performance of our proposed protocol with contemporary MAC protocols. Numerical analysis results show that our proposed protocol significantly improves fairness among the speed-varying vehicles in VANET.

Cardiac events in survivors of childhood cancer treated in more recent eras: A report from the Childhood Cancer Survivor Study.

10058 Background: Contemporary cancer protocols have incorporated modifications to minimize cardiotoxic exposures and preserve long-term health. We investigated the impact of these changes on late cardiac outcomes in a large cohort of adult survivors of childhood cancer. Methods: Congestive heart failure (CHF), myocardial infarction (MI), valvular disease, pericardial disease, and arrhythmias were graded by the National Cancer Institute’s Common Terminology Criteria for Adverse Events among 23,462 five-year cancer survivors [6,193 (26%) treated in the 1970s, 9,363 (40%) in the 1980s, and 7,906 (34%) in the 1990s] and 5,057 siblings. Cumulative incidence and 95% confidence intervals (95% CI) were estimated by treatment decade. Adjusted multivariable subdistribution hazard models were used to estimate hazard ratios (HR) and 95% CI for cardiac outcomes by decade. Mediation analysis examined risks with and without cardiotoxic exposures. Results: For survivors [median age 6 years (range: 0-21) at diagnosis, 28 years (8.2-58) at follow-up], cardiac radiation (RT) exposure declined from 77% of those treated in the 1970s to 55% and 40% in the 1980s and 1990s. Anthracycline exposure increased from 28% to 50% to 64%. The 20-year cumulative incidence of CHF (0.69% for those treated in 1970s, 0.74% in the 1980s, 0.54% in the 1990s) and MI (0.38%, 0.24%, 0.19%) declined in more recent treatment eras (p &lt; 0.01). This change was not seen for valvular disease (0.06%, 0.06%, 0.05%), pericardial disease (0.04%, 0.02%, 0.03%) or arrhythmias (0.08%, 0.09%, 0.13%). Compared to survivors diagnosed in the 1970s, the risk of CHF, MI, and valvular disease decreased in the 1980s and 1990s, but only significantly for MI (HR 0.64 95% CI 0.47-0.89 and 0.52 95% CI 0.32-0.83). The overall MI risk was attenuated by adjustment for cardiac RT exposure (HR 0.94 95% CI 0.80-1.11), mostly among Hodgkin lymphoma (HL) survivors (HR 0.82 95% CI 0.69-0.98 [unadjusted for RT]; 1.03 95% CI 0.83-1.28 [adjusted for RT]). Conclusions: Reductions in exposure to cardiotoxic cancer therapies have resulted in declines in adverse cardiac outcomes, particularly for the RT-associated risk of myocardial infarction among HL survivors.

Contemporary HCV pangenotypic DAA treatment protocols are exclusionary to real world HIV-HCV co-infected patients

BackgroundTreatments for Hepatitis C virus (HCV) infection have vastly improved over the past few decades with current regimens now offering pangenotypic activity with excellent cure rates reported in clinical trials, including in the HIV-HCV coinfected population. However, there is some concern that stringent inclusion and exclusion criteria in the trials may lead to results that are not achievable in real-world populations.MethodsOur study evaluated a real-world HIV-HCV coinfected population and compared them to the eligibility criteria for trials of two of the most recent approved HCV agents; sofosbuvir/velpatasvir and glecaprevir/pibrentasvir.ResultsOur study included 219 HIV-HCV coinfected patients and found that 89% met exclusion criteria for the sofosbuvir/velpatasvir trial and 90% met exclusion criteria for the glecaprevir/pibrentasvir trial. The majority of patients met more than one exclusion criteria with the most frequent criteria for exclusion being a non-approved ART regimen (58 and 47% respectively), having a psychiatric disorder (52%), active alcohol or injection drug use (27%), having an HIV viral load > 50 copies/ml (15%), a CrCl < 60 ml/min (13%) and a history of decompensated cirrhosis (13%).ConclusionAlthough the newer Hepatitis C treatments are very effective, the real world HIV-HCV coinfected population often have comorbidities and other characteristics that make them ineligible for clinical trials, such that they are barriers to treatment. These barriers need to be recognized and addressed in order to optimize treatment outcomes in the HIV patient population.

Undervaluation in probate inventories probate inventory values and auction protocol market prices in eighteenth and nineteenth century Sweden

ABSTRACTIn this article we examine the accuracy of valuations of movable property for a sample of 22 probate inventories from Swedish. The sample comprises a total of 785 probated items which we have been able to match with contemporary auction protocols, giving us an official sales price for each item. This enables us to determine the consistency between the appraisal values in the probates and prevailing market prices, despite the fact that the probated items were invariably second-hand and of uncertain quality, as the comparison can be made for one and the same items. Our results show that probate appraisal values were marked underestimates of contemporary market prices, but also, that they lacked internal consistency. We find a mean undervaluation for probated items of −36 ± 3 percent, but the degree of undervaluation varied both depending on (i) the category of item, (ii) the year of the probate, as well as depending on (iii) the social class of the deceased. Our results apply, first and foremost, for the Swedish counties of Uppland and Södermanland, but as there is no reason to assume that Swedish probate proceedings exhibited significant regional variation, our results are most likely valid for the whole country.

"Redox lipidomics technology: Looking for a needle in a haystack".

Aerobic life is based on numerous metabolic oxidation reactions as well as biosynthesis of oxygenated signaling compounds. Among the latter are the myriads of oxygenated lipids including a well-studied group of polyunsaturated fatty acids (PUFA) - octadecanoids, eicosanoids, and docosanoids. During the last two decades, remarkable progress in liquid-chromatography-mass spectrometry has led to significant progress in the characterization of oxygenated PUFA-containing phospholipids, thus designating the emergence of a new field of lipidomics, redox lipidomics. Although non-enzymatic free radical reactions of lipid peroxidation have been mostly associated with the aberrant metabolism typical of acute injury or chronic degenerative processes, newly accumulated evidence suggests that enzymatically catalyzed (phospho)lipid oxygenation reactions are essential mechanisms of many physiological pathways. In this review, we discuss a variety of contemporary protocols applicable for identification and quantitative characterization of different classes of peroxidized (phospho)lipids. We describe applications of different types of LCMS for analysis of peroxidized (phospho)lipids, particularly cardiolipins and phosphatidylethanolalmines, in two important types of programmed cell death - apoptosis and ferroptosis. We discuss the role of peroxidized phosphatidylserines in phagocytotic signaling. We exemplify the participation of peroxidized neutral lipids, particularly tri-acylglycerides, in immuno-suppressive signaling in cancer. We also consider new approaches to exploring the spatial distribution of phospholipids in the context of their oxidizability by MS imaging, including the latest achievements in high resolution imaging techniques. We present innovative approaches to the interpretation of LC-MS data, including audio-representation analysis. Overall, we emphasize the role of redox lipidomics as a communication language, unprecedented in diversity and richness, through the analysis of peroxidized (phospho)lipids.

Safety of Everolimus With Reduced Calcineurin Inhibitor Exposure in De Novo Kidney Transplants: An Analysis From the Randomized TRANSFORM Study.

The safety profiles of standard therapy versus everolimus with reduced-exposure calcineurin inhibitor (CNI) therapy using contemporary protocols in de novo kidney transplant recipients have not been compared in detail. TRANSFORM was a randomized, international trial in which de novo kidney transplant patients were randomized to everolimus with reduced-exposure CNI (N = 1014) or mycophenolic acid (MPA) with standard-exposure CNI (N = 1012), both with induction and corticosteroids. Within the safety population (everolimus 1014, MPA 1012), adverse events with a suspected relation to study drug occurred in 62.9% versus 59.2% of patients given everolimus or MPA, respectively (P = 0.085). Hyperlipidemia, interstitial lung disease, peripheral edema, proteinuria, stomatitis/mouth ulceration, thrombocytopenia, and wound healing complications were more frequent with everolimus, whereas diarrhea, nausea, vomiting, leukopenia, tremor, and insomnia were more frequent in the MPA group. The incidence of viral infections (17.2% versus 29.2%; P < 0.001), cytomegalovirus (CMV) infections (8.1% versus 20.1%; P < 0.001), CMV syndrome (13.6% versus 23.0%, P = 0.044), and BK virus (BKV) infections (4.3% versus 8.0%, P < 0.001) were less frequent with everolimus. CMV infection was less common with everolimus versus MPA after adjusting for prophylaxis therapy in the D+/R- subgroup (P < 0.001). Study drug was discontinued more frequently due to rejection or impaired healing with everolimus, and more often due to BKV infection or BKV nephropathy with MPA. De novo everolimus with reduced-exposure CNI yielded a comparable incidence, though a distinctly different pattern, of adverse events versus current standard of care. Both regimens are safe and effective, yet their distinct profiles may enable tailoring for individual kidney transplant recipients.

An optional remote state preparation protocol for a four-qubit entangled state

In this paper, we introduce a remote state preparation protocol for the case of a known four-qubit entangled state in which there are two possible receivers and the sender has the option of choosing one of the two possible parties for a preparation of the intended state at the end of the chosen party. The sender begins with a measurement on a two-qubit system in which the measurement basis is chosen by using the known information of the state. After that she exercises her option which is exclusively her own prerogative. The protocol has four components depending on the four different measurement results of the sender. The scheme is compared in terms of efficiency with other contemporary remote state preparation protocols for similar purposes.

Trust-Based IoT Cloud Participatory Sensing of Air Quality

In this paper we present a case study of IoT cloud participatory sensing where a user sends a query to the cloud about the air quality of a location at a particular time to decide if it should enter the location based on its susceptibility to the air quality detected. All IoT devices (e.g., smart phones carried by humans or smart cars driven by humans) capable of detecting air quality can act as participants and submit sensing reports to the cloud for sensing result aggregation. The major challenge is the selection of trustworthy participants because not all IoT devices will be trustworthy. We leverage a “Trust as a Service” (TaaS) cloud utility to address the issue of selecting trustworthy participants. Using real traces of ozone (O3) levels and mobility traces of users in the O3 community of interest (O3COI) group in the city of Houston, we demonstrate that TaaS outperforms contemporary IoT trust protocols in selecting trustworthy participants. We compare the performance of the TaaS cloud utility with two contemporary IoT trust protocols for supporting trust-based IoT participatory sensing applications. With the help of the TaaS cloud utility, a user in this O3COI group is able to obtain O3 readings very close to the ground truth O3 level despite 30% participants are untrustworthy.

Impact of surface modification on adsorptive removal of BTX onto activated carbon

The wastewater from chemical industries encapsulates a variety of different volatile organic compounds. Among these hydrophobic pollutants, benzene, toluene and xylene (BTX) are the most harmful organic compounds. The abatement of these deleterious compounds is mandatory. The efficacy of surface modified activated carbon for the uptake of these carcinogenic moieties was analyzed. The commercial activated carbon was functionalized with green oxidizing agents. The structural properties of pristine AC (P-AC) and oxidized AC (O-AC) were analyzed by BET surface area analyzer, Fourier transform infrared spectroscopy-attenuated total reflection (FTIR-ATR), thermogravimetric analysis (TGA), Raman spectroscopy, X-ray diffraction (XRD), and variable pressure field emission scanning electron microscope (VPFESEM). The effect of all the variables namely contact time, temperature, pH and dose was substantially analyzed and optimized. The sorption equilibrium was quickly established within 30 min. The present sorption process conforms to pseudo 2nd order kinetic model and is controlled by intra-particle diffusion. The maximum sorption capacity was computed to be 260.78 mg/g, 263.16 mg/g, 269.55 mg/g for benzene, toluene, and p-xylene respectively, outlining that Langmuir isotherm model fits the data reasonably well as compared to that of Freundlich and D-R model. Furthermore, electrostatic interaction is the plausible mechanism for sorption of BTX onto O-AC. Thus, this mode of functionalization is regarded as the contemporary protocol with high adsorption capacity towards the uptake of BTX as compared to that of previous studies reported in literature.

A Survey on Contemporary and Core IoT Standards and Protocols

A Survey on Contemporary and Core IoT Standards and Protocols

Long-Term Results of a 2-Stage Exchange Protocol for Periprosthetic Joint Infection Following Total Hip Arthroplasty in 164 Hips.

Limited data exist that show the long-term risks of reinfection and mechanical failure with a contemporary 2-stage exchange protocol for periprosthetic joint infection following total hip arthroplasty. The purpose of this study was to determine the long-term reinfection and mechanical failure rates of 2-stage exchange for periprosthetic joint infection after total hip arthroplasty. We identified 164 hips (162 patients) with infection after total hip arthroplasty between 1991 and 2006 treated with a 2-stage exchange protocol with no prior treatment for periprosthetic joint infection. With regard to Musculoskeletal Infection Society diagnostic criteria, at least 1 major criterion or 4 of 6 minor criteria were fulfilled in 129 hips (79%). The cumulative incidence with a competing risk of death was calculated for reinfection, aseptic revisions, and all-cause revisions. The risk factors for reinfection were evaluated using Cox proportional hazards regression. Harris hip scores were calculated. The mean age at the time of spacer insertion was 68 years, and 35% of the patients were female. Excluding the patients with <2 years of follow-up, the mean follow-up was 12 years (range, 2 to 21 years). The cumulative incidence of recurrence of infection was 10% at 1 year, 14% at 5 years, and 15% at 10 and 15 years. Seventeen patients (11%) used chronic antibiotic suppression (>6 months), with 7 (41%) of these having recurrent infection at the time of the latest follow-up. Use of chronic antibiotic suppression was the only predictive factor for reinfection (hazard ratio, 4.5 [95% confidence interval (CI), 1.9 to 10.9]; p = 0.001). The cumulative incidence of aseptic femoral and acetabular revisions was 2.6% at 5 years and 3.3% at 10 and 15 years. The cumulative incidence of all-cause revisions was 15% at 5 years and 16% at 10 and 15 years. Dislocation was the most common complication, with 28 dislocations occurring in 20 patients (12%). The mean Harris hip score improved from 52 points prior to spacer insertion to 70 points at 15 years after reimplantation (p < 0.01). The rate of recurrence of infection of 15% for up to 15 years after total hip arthroplasty was similar to previous shorter-term reports of 2-stage exchange for periprosthetic joint infection. Surgeons should anticipate mitigating instability after reimplantation. Implant survivorship free of aseptic loosening and clinical outcomes were preserved for the long term. The role of chronic antibiotic suppression in the long-term treatment of periprosthetic joint infection requires further investigation. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.