Statewide GNSS-RTN Systems: Current Practices

The applications of geospatial technologies and positioning data embrace every sphere of modern-day science and industry. With technological advancement, the demands for highly accurate positioning services in real-time led to the development of the Global Navigation Satellite System—Real-Time Network (GNSS-RTN). While there is numerous published information on the technical aspects of the GNSS-RTN technology, information on the best practices or guidelines in building, operating, and managing the GNSS-RTN networks is lacking in practice. To better understand the current practice in establishing and operating the GNSS-RTN systems, an online questionnaire survey was sent to the GNSS-RTN system owners/operators across the U.S. Additionally, a thorough review of available literature on business models and interviews with representatives of two major manufacturers/vendors of GNSS-RTN products and services were conducted. Study results revealed a great deal of inconsistency in current practices among states in the way the GNSS-RTN systems are built, operated, and managed. Aspects of the diversity in state practices involved the business models for the GNSS-RTN systems besides the technical attributes of the network and system products. The information gathered in this study is important in helping state agencies make informed decisions as they build, expand or manage their own GNSS-RTN systems.

Current practices regarding middle turbinate resection among otolaryngologists

Objectives:Resection of the middle turbinate(MT)during endoscopic sinus surgery(ESS)has been a controversial topic among otolaryngologists for many years.Some studies advocate resection and have shown improved outcomes postoperatively,while studies favoring preservation show a decreased incidence of postoperative complications.The current practice pattern regarding this subject is unknown.The goal of this study was to learn the current practice of MT resection during ESS among otolaryngologists.Method:We performed an electronic anonymous survey of practicing otolaryngologists.Results:We found that the majority of the 252 responders stated that they will perform an MT resection in certain clinical situations,while there is a small subset that advocates never resecting the MT for inflammatory sinus disease(n=6,2.4%).Participants were significantly more likely to perform MT resection in patients undergoing revision compared to primary ESS for all conditions included.The complication of greatest concern among participants was iatrogenic frontal sinus obstruction,while empty nose was of the least concern.The majority of participants responded that MT resection was of extreme or moderate benefit for improved visualization and drug delivery postoperatively.When compared to general otolaryngologists,fellowship-trained rhinologists were less concerned about potential complications following MT resection and were more likely to perceive an extreme or moderate benefit from turbinate resection postoperatively.Conclusion:There remains debate over MT resection among otolaryngologists,but the results of this study show that the majority of participating otolaryngologists will perform a resection in certain clinical situations.

The current trend of autologous costal cartilage harvest by facial plastic surgeons for rhinoplasty in the United States

Aim: To assess the safety profile and practice trend of autologous costal cartilage harvest by facial plastic surgeons in the United States (US).Methods: A 10-question online survey was distributed by the American Academy of Facial Plastic and Reconstructive Surgery to its members.Results: Of the 2,639 members, 2,379 received the survey with 137 (5.76%) members responded. The majority (33.6%)of the respondents were expert facial plastic surgeons. One hundred and nine (79.6%) of the respondents performed rib harvest with 49.6% of them performing the procedure at a hospital facility. Among them, 21.5% exclusively performed their surgery at an ambulatory surgical center not physically attached to a hospital while 6.67% of them at the in-office accredited operating room. When comparing techniques, 64.7% performed only full-thickness rib grafts vs. 12.0%harvesting partial-thickness rib grafts. Most used an incision length between 2.1 and 4 cm (64.4%) while 2 surgeons used < 1 cm incision. The occurrence of pneumothorax after autologous rib harvest remained low (< 1%) in most (73.1%).Regarding safety practices of the surgeons, only 24.6% would order a chest X-ray post-operatively while 54.5% would not. In addition, 58.7% of respondents never kept their patients overnight for observation after autologous rib grafting while 15.0% always would. For pain management, most respondents (50.4%) did not utilize any additional analgesia protocol besides oral pain medications.Conclusion: Two thirds of the US facial plastic surgeons performed autologous costal cartilage harvest in a hospital setting. Routine chest imaging or overnight observation post-operatively was not warranted as the percentage of pneumothorax remained low and pain control was adequate.