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The aim of the study was to determine the relationship between preoperative buccal plate thickness (BPT) and radiographic healing at the osteotomy site after endodontic microsurgery (EMS) with and without guided tissue regeneration (GTR) using cone beam computed tomography (CBCT) imaging.The retrospective sample of 143 individuals who had EMS with pre- and postoperative CBCT scans available were divided into 2 groups: group 1 (GTR) and group 2 (no GTR), which were further divided into teeth where BPT was1.0 mm or ≤1.0 mm. Bone healing was assessed by subjective evaluation of bone formation at the resected root surface (IThere was no significant impact on surgical healing with the use of GTR when BPT is1.0 mm. The GTR had a significant impact on surgical healing when the BPT was ≤1.0 mm.This study supported the use of CBCT to evaluate three-dimensional healing after EMS. The Author2-Author1 index was found to be a clinically relevant method for assessing healing. To improve healing rate, the EMS cases with a preoperative BPT of ≤1.0 mm may benefit from GTR.

Copyright © 2018 by the American Society of Plastic Surgeons. Background: Soft-tissue complications often dictate the success of limb salvage and the overall outcome of open fractures. Based on prior work at the R Adams Cowley Shock Trauma Center, the authors hypothesize that wounds larger than 200 cm2 are associated with a greater likelihood of both flap-related reoperation and wound complications among patients requiring soft-tissue reconstruction with a rotational flap or free tissue transfer. Methods: This study was a secondary analysis of Fluid Lavage in Open Wounds trial data that included all patients who received a rotational or free tissue flap transfer for an open fracture. The primary outcome was flap-related reoperation within 12 months of injury. The secondary outcome was wound complication, which included events treated operatively or nonoperatively. Multivariable logistic regression was used to assess the association between wound size and outcomes, adjusting for confounders. Results: Seventeen percent of the 112 patients required a flap-related reoperation. A wound size greater than 200 cm2 was not associated with reoperation in an unadjusted model (p = 0.64) or adjusting for Gustilo type (p = 0.70). The sample had an overall wound complication rate of 47.3 percent. Patients with a wound size of greater than 200 cm2 were three times more likely to experience wound complications (OR, 3.05; 95 percent CI, 1.08 to 8.62; p = 0.04) when adjusting for moderate to severe wound contamination and wound closure in the operating room. Conclusion: The findings of this study demonstrate that wound surface area is an integral determinant for wound complication following soft-tissue flap treatment, but found no association between wound surface area and flap-related reoperation rates.

Varying forms of precipitation during winter weather events cause disruptions to commercial operations and transportation networks, particularly in densely populated regions. Developing a better understanding of the characteristics surrounding these events may lead to better prediction and subsequent mitigation. This study constructs a 21-year cold season climatology of precipitation type over highly urbanized areas of the northeastern United States. By using quality-controlled station reports, a specific focus is placed on the influence of urbanization in precipitation processes. In events involving multiple precipitation types, the ambient atmospheric profile is very close to the freezing point in lower levels. The influence of the boundary layer urban heat island may play a role in increasing melting of hydrometeors. Statistically significant findings from linear regression modeling show that proximity to urban centers, as derived from mean road density, plays a role in the surface observation of mixed precipitation events. 21% of any mixed precipitation observation may be attributed to its distance from a high density urban area. Decreases in mean surface wind speed and direction during mixed precipitation events increase the likelihood of an intact boundary layer urban heat island and melting of hydrometeors when compared to stronger wind speeds during snowfall events.

While only a small fraction of the Earth’s total land cover, the majority of the world population resides in cities. Urbanization is critical to the social, political, and economic vibrancy of society, but it also has significant impacts on the environment. NASA-related satellite, modeling, and scientific resources have enabled a systems perspective on the Earth’s water cycle, climate, weather, interior and biogeochemical cycles. A particular advancement has been the advancement of knowledge on the complex interactions and pathways by which urbanization interacts with hydrometeorological processes. Herein, a synopsis of the most significant perspectives gained from urban studies funded under the auspices of the Precipitation Measurement Missions program is presented.

Urban modification of precipitation regimes is well documented in the urban climate literature. Studies investigating urbanization and non-convective precipitation, specifically winter precipitation, are limited. The theoretical framework here argues that the collective influence of urbanization extends beyond traditional city limits and the surrounding rural areas and can impact regional climate in non-adjacent cities. This paper utilizes the weather research and forecasting model (WRF-ARW) to simulate a cold-season synoptic system over the Northeastern United States over a variety of urban land surface scenarios. This case study centers on the potential boundary layer urban heat island effect on the lower troposphere and its ability to impact winter precipitation type at the local to regional scales. Results show a significant reduction in temperatures near the modified surface and subtle reductions over adjacent urban areas. When surface wind speeds are less than 5 ms−1, the boundary layer heat island increases air temperatures on the order of 3–4 °C at altitudes up to 925 mb. When combined with encroaching warm air near 850 mb during transitional precipitation events, the boundary layer heat island increases the thickness of the melting layer and consequently exposes falling hydrometeors to longer melting duration and phase change. Model simulations also show regional connections through remote temperature and relative humidity changes in urban areas removed from reforested areas.

Atmospheric dust affects climate, biogeochemistry, and human health, with total emissions estimated at 1,500 to 3,000 Tg yr−1. The Bodele Depression, Chad (17˚N, 18˚E) in the Saharan Desert is the largest single point source of dust in the world, and dust from the Bodele, and the Sahara in general, has been tracked across much of the world, including to the Caribbean and the Americas. Although it has been linked to negative health effects in sink regions, few have worked to understand its local health effects in Africa. The lack of ground-based stations in North Africa and the inaccessibility of much of the region call for a remote technique to track dust concentration and composition as it moves across Africa. Such a method would provide a more detailed understanding of dust dynamics in North Africa and reveal the potential health effects of dust in the region. Here, we combine aerosol optical thickness measurements from MODIS and dust concentrations from the DREAM model with hyperspectral imagery from t...

This study addresses the predictability of rainfall variations over South America and the Amazon basin. A primary factor leading to model inaccuracy in precipitation forecasts is the coarse resolution data utilized by coupled models during the training phase. By using MERRA reanalysis and statistical downscaling along with the superensemble methodology, it is possible to obtain more precise forecast of rainfall anomalies over tropical South America during austral fall. Selective inclusion (and exclusion) of member models also allows for increased accuracy of superensemble forecasts. The use of coupled atmospheric–ocean numerical models to predict the rainfall anomalies has had mixed results. Improvement in individual member models is also possible on smaller spatial scales and in regions where substantial topographical changes were not handled well under original model initial conditions. The combination of downscaling and superensemble methodologies with other research methods presents the potential opportunity for increased accuracy not only in seasonal forecasts but on shorter temporal scales as well.

Kentucky, despite its relatively small area, has an extensive multimodal freight transportation network. Presented are findings of the statewide freight commodity flow analysis that relate to one of the multimodal transportation planning issues currently facing Kentucky—the relative role of various modes in freight transport and the potential for modal substitution. Issues affecting the type of data required for statewide freight planning studies also are discussed. Statewide issues, such as modal substitution questions, require freight commodity data by origin, destination, and mode. The aggregation of data from the Bureau of Transportation Statistics or other publicly available data was considered unfeasible and the study team was referred to Reebie Associates for detailed freight commodity flow information. The Reebie freight commodity flow data were analyzed by mode, commodity, and spatial zone within Kentucky to determine where the potential for modal substitution was greatest. Three areas of the state were found in which improvements for intermodal facilities for water and rail transportation might be considered. The data confirmed the extent of Kentucky’s multimodal reliance, that is, the majority of freight (by weight and volume) traveling to and from Kentucky moves by nonhighway modes. However, it was also noted that rail and water connections between Kentucky and certain areas of the United States may need further consideration because almost all freight to and from these areas moves by truck. Several other projects within the state are ongoing with these data.

Taditional new business underwriting, especially in small group and individual markets, is limited by the amount of information that carriers obtain. The current method of medical underwriting driven by questionnaire responses is labor-intensive and time-consuming for the prospective insured, the broker, and the insurance carrier.