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A new type of metal organic frame-based magnetic composite adsorbent UiO-66-NH2/graphene oxide/Fe3O4 was used to eliminate the adverse effects of boron in the desalinated seawater. Through serial characterization, it was found that this adsorbent has the advantages of strong magnetic response, good pore structure and abundant functional groups. On the basis of single-factor experiments on various influencing factors, the simulation and prediction capabilities of the response surface method and artificial neural network method for the adsorption process were studied and compared. Both methods shown strong capacity to make effective prediction on the process of adsorption. However, the error of response surface method is smaller than the error of artificial neural network method. Result of optimization by response surface method shows that the optimal conditions of adsorbent dosage, pH, and temperature are 99.1 mg/L, 3.38 and 318K. Following the above conditions, the boron adsorption capacity of the adsorbent obtained in the real desalinated seawater environment is 22.46 mg/g. In addition, the adsorbent shows good recyclability. Pseudo-second-order kinetic model, intra-particle diffusion model, and Langmuir isotherm model are all suitable for describing adsorption process. Thermodynamic research results reveal the fact that this process is spontaneous and endothermic, and the adsorption of boron by the adsorbent is a composite process consisting of physical adsorption and chemical adsorption.

Z-scheme heterojunctions are considered as prospective photocatalysts for elimination of organic pollutants. However, the origin of enhanced oxidation ability of Z-scheme heterojunctions is not well understood, and the working mechanism based on internal electrical field is still ambiguous. Here, we report Z-scheme AgIn5S8/ZnO heterojunction with superior photocatalytic activity in degrading pharmaceutical pollutants and enhancing biodegradability of pharmaceutical wastewater. The average oxidation state (AOS) and carbon oxidation state (COS) of pharmaceutical wastewater are significantly increased from 0.42 to 1.35 and 2.94 after photocatalytic treatment of AgIn5S8/ZnO. The analysis on the origin of superior photocatalytic activity reveals that the internal electric field in AgIn5S8/ZnO heterojunction works as a driving force to facilitate efficient separation of photogenerated charge carriers via Z-scheme path, thus generating spatially separated holes and electrons with high redox ability and realizing effective elimination of pharmaceutical pollutants. This study provides deep insight into photocatalytic mechanism of Z-scheme heterojunction for efficacious elimination of organic pollutants and boosted biodegradability of pharmaceutical wastewater.

Background Longitudinal analyses of large, detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. Methods Data representing 991,571 consecutive critical care visits to 160 US adult ICUs from 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV–based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality. Results We detected significant trends for increasing age, BMI, and risk of mortality, higher frequency of admission from an ED and stepdown unit, and more frequent hospital discharge to substance abuse centers and skilled nursing facilities. Significantly more patients were admitted for sepsis, emphysema, coma, congestive heart failure, diabetic ketoacidosis, and fewer were admitted for asthma, unspecified chest pain, coronary artery bypass graft, and stroke care. The frequency of noninvasive mechanical ventilation and adherence to critical care best practices significantly increased, whereas the duration of renal replacement therapies, frequency of transfusions, antimicrobial use, critical care complications, LOS, and inpatient mortality decreased. Conclusions Analyses of patients, practices, and outcomes from a large geographically dispersed sample of adult ICUs revealed trends of increasing age and acuity, higher rates of adherence to best practice, use of noninvasive mechanical ventilation, and decreased use of antimicrobials, transfusions, and duration of renal replacement therapies. Acuity-adjusted LOS and in hospital mortality decreased.

4Cr5MoSiV (H11) steel machining chips were crushed to a powder and then consolidated into discs by hot pressing under various consolidation parameters. The discs were subjected to modified spheroidizing annealing treatment, and their evolved microstructure, tensile mechanical properties and fracture behavior were studied. The microstructure consisted of α − Fe as a matrix, together with heterogeneously distributed non metallic inclusions from the chip-crushing step and precipitated secondary phases. The yield strength, fracture strength and elongation to fracture of the consolidated discs were determined to be in the range of 215 ∼ 264 ​MPa, 344 ∼ 415 ​MPa and 1.2 ∼ 2.6%, respectively. The strength of the recycled H11 steel was comparable with that of the ingot metallurgy (IM) H11 steel, but the tensile ductility of the former was significantly lower than that of the latter, being mainly caused by the fracture of the non-metallic inclusions along with the hard secondary phase particles in the IM H11 steel which leads to premature fracture of the samples. The Vickers hardness of the samples were in the range of 144 ∼ 194 HV being comparable to that of the IM counterpart. Factographs of the fracture surface demonstrated that the tensile test specimens fractured in a brittle fracture mode.

Should advanced age be a contraindication to the surgical management of head and neck cancer patients? A retrospective chart review was performed of patients aged ≥80 years treated surgically for a head and neck malignancy during the period 1996-2011 in a tertiary care cancer centre. The average follow-up was 32 months. Fifty-three patients were identified (mean age 85 years). Cardiovascular disease was the most prevalent co-morbidity (43%). Forty-five patients (85%) had oral cavity/oropharynx squamous cell carcinoma. Surgeries performed included 40 neck dissections and 12 microvascular free flaps. The average length of hospital stay (LOS) was 6.4 days. An increased LOS was significant in patients requiring free flap reconstruction (P0.01). There were no perioperative deaths or free flap failures. The most common postoperative complications were cardiovascular (n=8), infection (n=10), and delirium (n=6). Thirty-four patients were discharged directly home. Free flap reconstruction did not adversely affect discharge disposition (P0.05). More than 75% of patients did not report any major limitations to their activities of daily living. Major head and neck surgical procedures can be tolerated by patients of advanced age using careful patient selection. Age alone should not be a primary factor in the management of head and neck cancer patients.

Gingival squamous cell carcinoma (SCC) is relatively uncommon, and little is known about its metastatic pattern. We retrospectively reviewed 864 consecutive patients with oral SCC who were seen at the University of Maryland Department of Oral and Maxillofacial Surgery (1991-2005), and identified 111 cases of gingival SCC. Inclusion criteria were fulfilled in 72 patients (mean duration of follow up 49 (1-153) months). Mean (range) age was 72 (45-93) years; 41 patients were women and 31 men. Distribution was almost equal: mandible 35 and maxilla 37. Forty (56%) were in the early stages (pI/II) and 32 (44%) in the later stages (pIII/IV). Twenty-nine patients had primary neck dissections, of whom 7/21 had clear, and 6/8 invaded, cervical nodes. The total number of occult nodal metastases was 9/29 (31%) in the mandible and 14/35 in the maxilla (one patient with initially clear nodes had both invaded nodes at neck dissection and a recurrence in the neck). The number of early compared with late stage occult metastases was 4 of 20 patients (20% T1/T2) and 5 of 9 patients (55% T3/T4) in the mandible and 2 of 22 patients (9% T1/T2) and 2 of 13 patients (15% T3/T4) in the maxilla. Two of 9 patients developed occult nodes within T2 maxillary gingival SCC. Bony invasion was identified in 17 patients (24%) occurring in 8 of 19 patients (42%) with invaded nodes compared with 9 of 53 patients (17%) with clear nodes. Overall survival at 2 and 5 years was 53 of 72 patients (74%) and 27 of 72 patients (38%) respectively. Elective neck dissection is indicated for all stages of mandibular gingival tumours and T3/T4 carcinomas of the maxillary gingiva. T2 maxillary SCC should be considered for elective neck dissection. Overall disease-free survival was worse among those with cervical metastases (p=0.004) and those who had had marginal resections (p=0.04).

SummaryOvarian cancer is a leading cause of death from gynecologic malignancies. Treatment for advanced-stage disease remains limited and, to date, targeted therapies have been incompletely explored. By systematically suppressing each human tyrosine kinase in ovarian cancer cell lines by RNAi, we found that an autocrine signal-transducing loop involving NRG1 and activated ErbB3 operates in a subset of primary ovarian cancers and ovarian cancer cell lines. Perturbation of this circuit with ErbB3-directed RNAi decreased cell growth in three-dimensional culture and resulted in decreased disease progression and prolonged survival in a xenograft mouse model of ovarian cancer. Furthermore, a monoclonal ErbB3-directed antibody (MM-121) also significantly inhibited tumor growth in vivo. These findings identify ErbB3 as a potential therapeutic target in ovarian cancer.

s / British Journal of Oral and Maxillofacial Surgery 52 (2014) e43–e74 e63 fellowships supported by both research council funding and BAOMS. We emphasise the availability of trainee led collaboratives such as the North West OMFS/Otolaryngology Trainee Collaborative (NOTCh) that exist with the express aim of helping drive novel research projects from concept to implementation. Results & Discussion: As a direct consequence of new initiatives in surgical clinical trial training, fellowship establishment and design education, A Phase III Randomised Controlled Trial aimed at “Determining the Efficacy of Fibrin glue in Neck Dissection (DEFeND)” can be reported upon. http://dx.doi.org/10.1016/j.bjoms.2014.07.064