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Innovations in otorhinolaryngology in the age of COVID-19: A systematic literature review

World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第3期8卷 224-238页

作者： E.Berryhill McCarty Liuba Soldatova jason A.Brant jason g.newman Perelman School of Medicine at the Universityof Pennsylvania PhiladelphiaPAUSA Department of Otorhinolaryngology-Head and Neck Surgery Universityof Pennsylvania Health SystemPhiladelphiaPennsylvaniaPAUSA

Objective: Otolaryngologists are at increased occupational risk of Coronavirus Disease 2019 (COVID-19) infection due to exposure from respiratory droplets and aerosols generated during otologic, nasal, and oropharyngeal examinations and procedures. There have been a variety of guidelines and precautions developed to help mitigate this risk. While many reviews have focused on the personal protective equipment (PPE) and preparation guidelines for surgery in the COVID-19 era, none have focused on the more creative and unusual solutions designed to limit viral transmission. This review aims to fill that *** Sources: PubMed, Ovid/Medline, and ScopusMethods: A comprehensive review of literature was performed on September 28, 2020 using PubMed, Ovid/Medline, and Scopus databases. All English-language studies were included if they proposed or assessed novel interventions developed for Otolaryngology practice during the COVID-19 pandemic. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were ***: A total of 41 papers met inclusion criteria and were organized into 5 categories ("general Recommendations for Otolaryngologic Surgery’, "Equipment Shortage Solutions’, "Airway Procedures’, "Nasal Endoscopy and Skull Base Procedures’, and "Otologic Procedures’). Articles were summarized, highlighting the innovations created and evaluated during the COVID-19 pandemic. Creative solutions such as application of topical viricidal agents, make-shift mask filters, three-dimensional (3-D) printable adapters for headlights, aerosol containing separation boxes, and a variety of new draping techniques have been developed to limit the risk of COVID-19 ***: Persistent risk of COVID-19 exposure remains high. Thus, there is an increased need for solutions that mitigate the risk of viral transmission during office procedures and surgeries, especially given that most COVID-19 positive patients present asymptomatically

关键词： COVID-19 Innovations Inventions Literature Review Otolaryngology

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Use of the O-Z flap as an alternative to free tissue transfer for reconstruction of large scalp defects

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第4期8卷 355-360页

作者： Austin C.Cao Ryan M.Carey Mitali Shah Kevin Chorath Robert M.Brody Steven B.Cannady jason g.newman Rabie M.Shanti Karthik Rajasekaran Perelman School of Medicine University of PennsylvaniaPhiladelphia19104PA Department of Otorhinolaryngology-Head and Neck Surgery University of PennsylvaniaPhiladelphia19104PA Drexel University College of Medicine Drexel UniversityPhiladelphia19102PA Department of Oral and Maxillofacial Surgery University of PennsylvaniaPhiladelphia19104PA Leonard Davis Institute of Health Economics University of PennsylvaniaPhiladelphiaPA

Objective:The reconstruction of large scalp defects poses both functional and cosmetic *** free tissue transfer remains the standard for defects larger than 30 cm^(2),prolonged anesthesia and postoperative complications remain significant *** purpose of this study is to evaluate the use of O-Z flaps for the reconstruction of large scalp defects and to describe the techniques ***:This is a retrospective analysis of ten patients who underwent reconstructive surgery using an O-Z flap approach for large scalp defects between July 2017 and June *** parameters included in this study were patient demographics,tumor characteristics,and postoperative management,collected for at least a year after ***:In this cohort,the mean age was 76.1 years and 90%were *** patients were treated for neoplastic skin lesions,with 70%located on the vertex and 30%located on the temporoparietal *** mean size of defect was 52.0 cm^(2)(range:38.6 to 63.8 cm^(2)).The maximum hospital stay was two days,and no patients were readmitted within 30 days of *** were no cases of wound infection or flap *** patients reported pain control with acetaminophen and *** patients received adjuvant radiation,and there was no delay to receiving treatment following ***:The O-Z flap is a reliable alternative for the reconstruction of non-irradiated scalp defects in the vertex and temporoparietal regions up to 63 cm^(2).This technique provides advantages for patients,including hairline preservation,shorter hospital stays,and decreased postoperative complications.

关键词： Scalp reconstruction Local flaps Free flap reconstruction Facial plastics Microvascular surgery Head and neck cancer

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Evaluation of an interactive virtual surgical rotation during the COVID-19 pandemic

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第4期8卷 302-307页

作者： Yasmeen M.Byrnes Neil N.Luu Ariel S.Frost Tiffany N.Chao Robert M.Brody Steven B.Cannady Karthik Rajasekaran Rabie M.Shanti jason g.newman Perelman School of Medicine at the University of Pennsylvania Jordan Medical Education Center3400 Civic Center BlvdPhiladelphia19104PAUSA Department of Otorhinolaryngology-Head& Neck SurgeryHospital of the University of Pennsylvania3400 Spruce StreetPhiladelphia19104PAUSA

Objective:To evaluate medical student and attending surgeon experiences with a novel interactive virtual Otolaryngology-Head and Neck Surgery(OHNS)medical student elective during the COVID-19 *** Design:A virtual OHNS elective was created,with three components:(1)interactive virtual operating room(OR)experience using live-stream video-conferencing,(2)telehealth clinic,(3)virtual ***:OHNS Department at the University of Pennsylvania(May 2020 to June 2020).Methods:Six medical students from the University of Pennsylvania;five attending *** surveys were designed and distributed to participating medical students and attending *** included 5-point Likert scale items,with 1 indicating"not at all"and 5 indicating"very much so".Results:Response rate was 100%for both *** on average rated the educational value of the telehealth experience as 4.2±1.2,and the virtual OR experience as 4.0±*** students(n=5,83%)indicated that they had enough exposure to faculty they met on this rotation to ask for a letter of recommendation(LOR)for residency if needed,while attending surgeons had an average response of 3.0±1.0 when asked how comfortable they would feel writing a LOR for a student they met through the rotation.A majority of students(n=4,67%)felt they connected enough with faculty during the rotation to ask for *** the students(n=5,50%)indicated that the rotation allowed them to evaluate the department's culture either"extremely well"or"somewhat well".Conclusions:Overall,participating students described this innovative virtual surgical rotation as an educationally and professionally valuable *** the continued suspension of visiting student rotations due to the COVID-19 pandemic,this virtual model may have continued relevance to medical education.

关键词： Virtual surgical education Otolaryngology Undergraduate medical education Covid-19 Telemedicine Surgical video capture

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Predictors of nodal metastasis in sinonasal squamous cell carcinoma:A national cancer database analysis

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2020年第2期6卷 137-141页

作者： Viran J.Ranasinghe Vanessa C.Stubbs Danielle C.Reny Ramie Fathy jason A.Brant jason g.newman Department of Otorhinolaryngology e Head and Neck Surgery University of PennsylvaniaPhiladelphiaPAUnited States Perelman School of Medicine University of PennsylvaniaPhiladelphiaPAUnited States

Objective:We present the largest population based study of sinonasal squamous cell carcinoma(SCC)to identify risk factors for presentation with nodal ***:The National Cancer Database(NCDB)was used for this *** codes corresponding to the nasal cavity and paranasal sinuses and histology codes representing SCC malignancy were *** regression analysis was performed to identify factors associated with presentation with nodal ***:6448 cases met inclusion *** metastasis at presentation was seen in 13.2%of patients,with the sinus subsite(19.3%)being a significant risk factor for nodal metastasis at presentation when compared to the nasal cavity(7.9%).Logistic regression analysis showed black,uninsured and Medicaid patients were more likely than white and privately insured patients,respectively,to present with nodal ***:In sinonasal SCC,the sinus subsite has a significantly increased risk of nodal metastasis compared to the nasal *** race,uninsured and Medicaid patients are more likely to have nodal metastasis at presentation.

关键词： Squamous cell carcinoma National cancer database Nodal metastasis Maxillary sinus Nasal cavity

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Degradation and resynthesis of chlorophyll during increased oxidative stress and prolonged darkness differ between annual and perennial flax(Linum L.)

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Oil Crop Science 2024年第2期9卷 121-130页

作者： Kenyon J. Nisbett Abida Alokozai Su Hyun Elizabeth Ko g. Adam Mott jason C.L. Browna Department of Biological Sciences University of Toronto ScarboroughTorontoONCanada Department of Cell&Systems Biology University of TorontoTorontoONCanada Centre for the Analysis of genome Evolution&Function University of TorontoTorontoONCanada

Among plants,there is considerable variation in lifespan:annuals live less than one year,whereas perennials live for several years,with the longest-living perennial having survived 43,600 *** proposed by the Disposable Soma Theory,this lifespan variation among plants likely reflects differential investment of limited energy and nutrient resources,with perennials investing more energy and nutrients into biomolecular maintenance compared to annuals in order to ensure persistence over multiple *** differential investment may be particularly important during periods of exogenous stress,which are known to accelerate biomolecular *** present study evaluated this hypothesis using annual and perennial flax(Linum L.)subjected to two exogenous stressors—increased oxidative stress(i.e.,foliar H2O2spraying)and complete prolonged *** chlorophyll has been shown to exhibit degradation in response to changes in environmental conditions,we utilized changes in chlorophyll levels during and after periods of exogenous stress to evaluate our *** predicted that i)perennials would exhibit a slower rate of chlorophyll degradation during exposure to exogenous stressors compared to annuals,and ii)perennials would exhibit a faster rate of chlorophyll resynthesis following such exposure compared to *** levels before,during,and after exposure to both exogenous stressors were measured in two separate trails,once using image colour analysis and once using *** chlorophyll degradation rates in response to oxidative stress did not differ between annuals and perennials,contrary to our predictions,chlorophyll resynthesis rates following such exposure were significantly higher in perennials,as *** plants were subjected to complete prolonged darkness,chlorophyll degradation rates were significantly lower in perennials than annuals,as predicted;however,when plants were subsequently reintroduced to natural photoperiod,ch

关键词： Ageing Life history Maximum lifespan Oxidative stress Somatic maintenance

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Construction of a novel six-gene signature to predict tumour response to induction chemotherapy and overall survival in locoregionally advanced laryngeal and hypopharyngeal carcinoma

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genes & Diseases 2024年第3期11卷 148-150页

作者： Chen Tan Lingwa Wang Yifan Yang Shizhi He george g.Chen jason YK.Chan Michael CF.Tong C.A.van Hasselt Wenbin Xu Ling Feng Ru Wang Jugao Fang Department of Otolaryngology Head and Neck Surgery Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China Key Laboratory of Otolaryngology Head and Neck Surgery(Ministry of Education of China) Beijing Institute of OtolaryngologyBeijing 100730China Department of Otorhinolaryngology Head and Neck SurgeryThe Chinese University of Hong KongPrince of Wales HospitalHongKong SAR999077China Department of Medical genetics Institute of Basic Medical ScienceChinese Academy of Medical Science&Peking Union Medical CollageBeijing 100730China

Locoregionally advanced laryngeal and hypopharyngeal cancers(LA-LHCs)are traditionally treated with surgery followed by postoperative radiotherapy,which impairs speech and swallowing functions and reduces the quality of life.^(1,2)The use of induction chemotherapy(IC)as a larynxpreserving approach for LA-LHCs has been verified and refined.^(3)However,the short-term tumor response to IC varies,non-responders usually show poor survival and little benefit.

关键词： chemotherapy laryngeal surgery

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Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIgHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： jason Philip Appleton Lisa J Woodhouse Craig S Anderson Sandeep Ankolekar Lesley Cala Mark Dixon Timothy J England Kailash Krishnan grant Mair Keith W Muir John Potter Christopher I Price Marc Randall Thompson g Robinson Christine Roffe Else C Sandset Jeffrey L Saver Angela Shone Aloysius Niroshan Siriwardena Joanna M Wardlaw Nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The george Institute China at Peking University Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for Clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(gTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of gTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with glyceryl trinitrate in Hypertensive stroke Trial-2(RIgHT-2).Methods RIgHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,gTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(MWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting gTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal gTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS ALREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(gTN)was associat-ed with less death and dependency in those w

关键词： glasgow nitrate random

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CD8+T cell metabolic flexibility elicited by CD28-ARS2 axisdriven alternative splicing of PKM supports antitumor immunity

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Cellular & Molecular Immunology 2024年第3期21卷 260-274页

作者： g.Aaron Holling Colin A.Chavel Anand P.Sharda Mackenzie M.Lieberman Caitlin M.James Shivana M.Lightman jason H.Tong guanxi Qiao Tiffany R.Emmons Thejaswini giridharan Shengqi Hou Andrew M.Intlekofer Richard M.Higashi Teresa W.M.Fan Andrew N.Lane Kevin H.Eng Brahm H.Segal Elizabeth A.Repasky Kelvin P.Lee Scott H.Olejniczak Department of Immunology Roswell Park Comprehensive Cancer CenterBuffaloNY 14263USA Department of Medicine Roswell Park Comprehensive Cancer CenterBuffaloNY 14263USA Human Oncology and Pathogenesis Program Memorial Sloan Kettering Cancer CenterNew YorkNY 10065USA Center for Environmental Systems Biochemistry Department of Toxicology and Cancer Biology and Markey Cancer CenterLexingtonKY 40536USA Department of Cancer genetics and genomics Roswell Park Comprehensive Cancer CenterBuffaloNY 14263USA Present address:University of Colorado Boulder BoulderCO 80309USA Present address:Dana Farber Cancer Institute BostonMA 02215USA Present address:Massachusetts Institute of Technology BostonMA 02139USA Present address:Melvin and Bren Simon Comprehensive Cancer Center Indiana University School of MedicineIndianapolisIN 46202USA

Metabolic flexibility has emerged as a critical determinant of CD8+T-cell antitumor activity,yet the mechanisms driving the metabolic flexibility of T cells have not been *** this study,we investigated the influence of the nuclear cap-binding complex(CBC)adaptor protein ARS2 on mature T *** doing so,we discovered a novel signaling axis that endows activated CD8+T cells with flexibility of glucose ***2 upregulation driven by CD28 signaling reinforced splicing factor recruitment to pre-mRNAs and affected approximately one-third of T-cell activation-induced alternative splicing *** these effects,the CD28-ARS2 axis suppressed the expression of the M1 isoform of pyruvate kinase in favor of PKM2,a key determinant of CD8+T-cell glucose utilization,interferon gamma production,and antitumor effector ***,PKM alternative splicing occurred independently of CD28-driven PI3K pathway activation,revealing a novel means by which costimulation reprograms glucose metabolism in CD8+T cells.

关键词： Immunometabolism mRNA splicing CD8 T cells ARS2 PKM2

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Data-augmentation for graph neural network learning of the relaxed energies of unrelaxed structures

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npj Computational Materials 2022年第1期8卷 2037-2043页

作者： jason gibson Ajinkya Hire Richard g.Hennig Department of Materials Science and Engineering University of FloridaGainesvilleFL32611USA Quantum Theory Project University of FloridaGainesvilleFL32611USA

Computational materials discovery has grown in utility over the past decade due to advances in computing power and crystal structure prediction algorithms(CSPA).However,the computational cost of the ab initio calculations required by CSPA limits its utility to small unit cells,reducing the compositional and structural space the algorithms can *** studies have bypassed unneeded ab initio calculations by utilizing machine learning to predict the stability of a ***,graph neural networks trained on large datasets of relaxed structures display high fidelity in predicting formation ***,the geometries of structures produced by CSPA deviate from the relaxed state,which leads to poor predictions,hindering the model’s ability to filter unstable *** remedy this behavior,we propose a simple,physically motivated,computationally efficient perturbation technique that augments training data,improving predictions on unrelaxed structures by 66%.Finally,we show how this error reduction can accelerate CSPA.

关键词： material relaxed utilizing

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Changes in otolaryngology application requirements and match outcomes:Are we doing any better?

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2023年第2期9卷 144-152页

作者： Emma De Ravin Ariel S.Frost Neal R.godse Amber D.Shaffer Noel Jabbour Barry M.Schaitkin jason newman Leila J.Mady Department of Otorhinolaryngology-Head and Neck Surgery University of Pennsylvania Health SystemPhiladelphiaPennsylvaniaUSA Head and Neck Institute Cleveland ClinicClevelandOhioUSA Division of Pediatric Otolaryngology Children's Hospital of Pittsburgh of UPMCPittsburghPennsylvaniaUSA Department of Otolaryngology University of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA Department of Otolaryngology-Head and NeckSurgery Medical Universityof South CarolinaCharlestonSouth CarolinaUSA MUSC Hollings Cancer Center CharlestonSouthCarolinaUSA Department of Otolaryngology-Head and Neck Surgery Thomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA Cancer Risk and Control Program of Excellence Sidney Kimmel Cancer CenterPhiladelphiaPennsylvaniaUSA

Objectives:Otolaryngology-specific requirements were piloted to minimize applicant and program *** investigated the impact of introducing and then removing these requirements on Match ***:2014-2021 National Resident Matching Program?data were *** primary outcome was the impact of Otolaryngology Resident Talent Assessment(ORTA;prematch 2017,postmatch 2019)and Program-Specific Paragraph(PSP;implemented 2016,optional 2018)on applicant numbers and match *** survey analysis assessed candidate perceptions of PSP/***:Applicant numbers declined significantly during PSP/ORTA(18.9%;p=0.001).With the optional PSP and postmatch ORTA,applicant numbers increased significantly(39.0%;p=0.002).Examined individually,mandatory PSP was associated with a significant decline in applicants(p=0.007),whereas postmatch ORTA was associated with significant increases in applicants(p=0.010).ORTA and PSP negatively impacted the decision to apply to otolaryngology in 59.8%and 51.3%of applicants,***,match rate success improved significantly from 74.8%to 91.2%during PSP/ORTA(p=0.014),followed by a significant decline to 73.1%after PSP was made optional and ORTA moved to postmatch(p=0.002).Conclusions:ORTA and PSP correlated with decreased applicant numbers and increased match rate *** programs seek ways to remove barriers to applying to otolaryngology,the potential consequences of an increasing pool of unmatched candidates must also be considered.

关键词： academic success internship and residency medical students otolaryngology surveys and questionnaires

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