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Objectives: Empty nose syndrome (ENS) is an underdiagnosed but burdensome clinical condition. Studies that have addressed the impact of remnant inferior turbinate volume (ITV) on ENS are scarce. We aimed to evaluate the impact of ITV and phenotyping on the severity and presentation of ENS. Methods: All the enrolled patients underwent the following subjective assessments: the ENS 6‐Item Questionnaire (ENS6Q), Sino‐Nasal Outcome Test‐25 (SNOT‐25), Beck Depression Inventory‐II (BDI‐II) and Beck Anxiety Inventory (BAI). The ITV was obtained from finely cut (1‐mm‐thick slices) sino‐nasal computed tomography scan images and analyzed using ImageJ. The correlation between ITV, subjective measurements, and morphology of inferior turbinates was evaluated. ENS was categorized as torpedo type (balanced tissue volume) or pistol type (posterior dominance) based on the morphology. Results: Overall, 54 patients met the inclusion criteria. The ITV was positively correlated with the ENS6Q score and domain of ENS symptoms in SNOT‐25. Neither BDI‐II nor BAI scores had a significant correlation with ITV. Based on their morphological classification, the torpedo type exhibited diverse manifestations in the SNOT‐25 analysis in response to changes in ITV, while the pistol type demonstrated an elevated rhinologic symptom burden and ENS‐specific symptoms as their ITV increased. Nasal resistance did not correlate with the ITV in either type of ENS. Conclusions: Symptoms were paradoxically worse in ENS patients with greater remnant ITV, and distinct morphological phenotypes in the nasal cavities may result in different presentations. Further investigation into the correlation between remnant inferior turbinates and nerve function is warranted. Level of Evidence: 3 Laryngoscope, 134:3060–3066, 2024 [ABSTRACT FROM AUTHOR]

The exhaust back pressure of diesel engines is becoming increasingly higher nowadays. In order to keep discharging exhaust unhindered and operating smoothly under high exhaust back pressure, a large reduction in engine maximum brake output is often observed, as well as increased fuel consumption and lower combustion efficiency with heavy exhaust smokes. In our previous study, "Applicability of Reducing Valve Timing Overlap for Diesel Engines under High Exhaust Back Pressure", a reduced valve timing overlap of 12 °CA partially improves the brake output and BSFC for a fixed-geometry turbocharged diesel engine under high exhaust back pressures. A potential solution for restoring the brake output under high exhaust back pressures could be the use of variable-geometry turbochargers. In this study, a variable-geometry turbocharger is applied to a diesel engine to study the engine performance characteristics and applicability, especially the further improvement of brake output and the brake-specific fuel consumption of the engine. Continuing with the results of our previous research, a basic setting of 12 °CA for the valve timing overlap is set up for the subsequent engine performance simulations in this study (using GT-Power SW). Via simulation, exhaust back pressures of 25 kPa, 45 kPa, and 65 kPa gauge are studied for a turbocharged diesel engine. The results for the engine parameters, including brake output, brake-specific fuel consumption, compressor outlet temperature, turbine inlet temperature, intake air mass flow rate, and exhaust mass flow rate are analyzed. The results of the variable-geometry turbocharger, including turbocharger speed, pressure ratios and efficiencies of compressor and turbine are also analyzed. The results indicate that the brake output and brake-specific fuel consumption are effectively improved under full-load operation with an adequate variable-geometry turbocharger rack position. Operable ranges of rack position are also set up for different back pressures. [ABSTRACT FROM AUTHOR]

Background: Although anterior cruciate ligament (ACL) injury rates have been studied extensively, it is unclear whether levels of functional and psychological readiness for return-to-sport after primary ACL reconstruction (ACLR) differ based on an athlete's primary sport. Hypothesis: Youth athletes in different primary sports will demonstrate differences in short-term functional recovery, as well as patient-reported psychological and functional recovery after primary ACLR. Study Design: Retrospective cohort study of consecutive patients treated for ACL injury in pediatric sports medicine clinics. Level of Evidence: Level 3. Methods: Patients included underwent primary ACLR between December 1, 2015 and December 31, 2019 and reported sports participation at the time of injury. Demographic data, sports participation, surgical data, functional testing scores (Y-Balance Test [YBT]), functional and psychological patient-reported outcome measures (PROMs), and timing of return-to-play clearance were reviewed. YBT scores were the primary metric for clearance. Four groups were studied: soccer, football, basketball, and other. Results: A total of 220 male and 223 female athletes were included; 65.28% of soccer players were female and 100% of football players were male (P < 0.01). At initial postoperative YBT testing (6-9 months), soccer players had higher operative (P < 0.01) and nonoperative (P < 0.01) leg composite scores when compared with basketball players. No significant differences were found between sports in functional or psychological PROMs at presurgical baseline or 6 months postoperatively. When compared with football, soccer players completed functional clearance in a shorter time from surgery (P = 0.02). Multivariate analysis showed level of competition as a significant independent variable for clearance in female athletes. Conclusion: After primary ACLR, athletes, especially female athletes, demonstrated short-term sport-specific differences in YBT scores. Soccer players attained clearance sooner than football players. Level of competition influenced YBT composite scores in all athletes and time to clearance in female athletes. Clinical Relevance: Sport-specific differences in reinjury should be investigated to determine whether changes in return-to-play evaluation should be implemented. [ABSTRACT FROM AUTHOR]