An Endoscopic Cap Electrode for Posterior Cricoarythenoid Muscle Stimulation in a Porcine Model

alexandrossfakianakis shared this article with you from Inoreader An Endoscopic Cap Electrode for Posterior Cricoarythenoid Muscle Stimulation in a Porcine Model via The Laryngoscope The article describes the development of a diagnostic procedure with a novel endoscopic cap to identify patients with vocal fold immobility who are eligible for implantation of future laryngeal pacing systems. The concept aims at transferring the examination to a gastroscopy setting. Objective Laryngeal pacing (LP) is a highly anticipated therapeutic option for patients suffering from bilateral vocal fold paralysis with synkinesis. Identification of candidate patients requires confirmation of a stimulable posterior cricoidarythenoid muscle (PCA) by neuromuscular electrical stimulation (NMES). A silicone endoscopic cap electrode (ECE50) was designed to be operated as an endoscopic extension tip for selective PCA stimulation and confirmation of a glottic opening movement in a setting comparable to a gastroscopy procedure. Methods A porcine animal model (n = 6) was applied to develop and test endoscopic cap prototypes in general anesthesia and sedation at a biomedical research center. Two ENT endoscopy experts evaluated and refined the cap design and performance in regard to procedure safety, endoscope handling, accessibility of the PCA by the transoral approach and selective muscle stimulation. Results Vocal fold opening movements could be evoked by the investigators in 9 of 12 PCA muscles to stimulate with similar electric parameters. The endoscopic approach using the ECE50 proved to be atraumatic and sufficiently controlled under sedation to locate the required hotspot for NMES of the PCA. Conclusion The functionality of the novel endoscopic cap concept has been proven in a porcine model. It can be expected to be transferable to human application and to be of diagnostic importance in the screening and identification of LP candidate patients in future. Level of Evidence NA Laryngoscope, 2022 View on Web

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Exploring Patient's Preference of Patient‐Reported Outcome Measures in Laryngeal Movement Disorders

alexandrossfakianakis shared this article with you from Inoreader Exploring Patient's Preference of Patient‐Reported Outcome Measures in Laryngeal Movement Disorders via The Laryngoscope Background Despite many available patient-reported outcome measures (PROMs) for laryngeal movement disorders, there is a lack of patient input regarding which PROM most accurately and conveniently captures aspects related to their vocal disease. This study aimed to assess patients' preferences among a selection of voice-related PROMs (Voice Handicap Index-10 [VHI-10], OMNI-Vocal Effort Scale [OMNI-VES], Communicative Participation Item Bank-General Short Form [CPIB-10], and Visual Analog Scales [VAS]) within the laryngeal movement disorder population and investigate associations between selected instruments. Methods Prior to botulinum toxin A injection, patients with laryngeal dystonia and/or essential tremor of the vocal tract were administered the VHI-10, OMNI-VES, CPIB-10, and three novel VAS questions in a randomized order. Patients rank ordered the four PROMs based on the PROMs' reflection of their voice problems. Pearson's correlation coefficients evaluated pairwise associations among PROM scores. Fisher's exact test compared the preferred PROM rankings. Results Seventy patients (53 female, mean age = 60.7 years) participated. The VHI-10 and CPIB-10 were most preferred at 33.9% and 27.4% respectively. The OMNI-VES and VAS scales were less favored (19.4%, each). When analyzed by age ≥60 years, the CPIB-10 was most favored (33.3%), but for age <60 years, VHI-10 was most preferred (42.3%). There was a strong correlation between scores of all administered PROMs (strongest correlation between OMNI-VES and VAS, r = 0.8, p < 0.001; the weakest correlation between OMNI-VES and VHI-10, r = 0.6, p < 0.001). Conclusions With an increasing trend in PROMs usage and a strong correlation between all evaluated outcome instruments, insight regarding patients' PROM preferences is an area for further consideration. Level of Evidence N/A Laryngoscope, 2022 View on Web

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“Alexa, lock my front door”: An empirical study on factors affecting consumer's satisfaction with VCA‐controlled security devices

alexandrossfakianakis shared this article with you from Inoreader “Alexa, lock my front door”: An empirical study on factors affecting consumer's satisfaction with VCA‐controlled security devices via Psychology & Marketing Abstract Voice conversation agents (VCAs) have moved beyond simple tasks such as information gathering. The integration of VCAs in smart technologies for security has grown in the consumer market. This paper investigates consumers' motivation to use smart technologies controlled by voice conversational agents and how that impacts their perceived hedonic and utilitarian value, which eventually leads to their satisfaction with smart technologies usage. Two cross-sectional studies and a netnography were conducted. The findings showed that the variables measuring technology acceptance mediate the relationship between consumers' motivation and the perceived value of the VCA-controlled smart technologies. Study 1 results show that ease of use and usefulness of the VCA-controlled smart technologies have a more substantial mediating effect between motivation and hedonic value than utilitarian value. For study 2, results show that the mediators had a stronger influence on hedonic and utilitarian va lues for outdoor voice conversational agent-controlled smart technologies than indoor smart technologies. Study 3 showed that smart technologies have both risks and benefits and depend on whether they are being used for themselves or others. The results suggest that marketers need to consider consumer's emphasis on the products' features including its ease of use and usefulness, and strategically complement it with consumers' prevention and promotion focus for each product. View on Web

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Efficacy of the autogenous dentin graft for implant placement: a systematic review and meta-analysis of randomized controlled trials

alexandrossfakianakis shared this article with you from Inoreader Efficacy of the autogenous dentin graft for implant placement: a systematic review and meta-analysis of randomized controlled trials via International Journal of Oral and Maxillofacial Surgery via MedWorm.com The aim of this study was to determine whether the autogenous dentin graft (ADG) shows comparable results and similar clinical performance to other graft materials when utilized for implant placement. Four databases were searched, and controlled human studies that applied autogenous dentin for implant surgery, comparing it with other bone grafts, were included. Nine articles met the inclusion criteria, five of which were randomized controlled trials and were included in the meta-analysis. ADG showed equivalent primary and secondary implant stability when compared to Bio-Oss (primary: mean difference −0.74, 95% confidence interval (CI) − 3.36 to 1.88, P = 0.58; secondary: mean difference − 1.29, 95% CI − 5.69 to 3.11, P = 0.57). (Source: International Journal of Oral and Maxi... View on Web

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Accessibility of Level III trauma centers for underserved populations: A cross-sectional study

alexandrossfakianakis shared this article with you from Inoreader Accessibility of Level III trauma centers for underserved populations: A cross-sectional study via Journal of Trauma and Acute Care Surgery - Current Issue BACKGROUND By providing definitive care for many, and rapid assessment, resuscitation, stabilization, and transfer to Level I/II centers when needed, Level III trauma centers can augment capacity in high resource regions and extend the geographic reach to lower resource regions. We sought to (1) characterize populations served principally by Level III trauma centers, (2) estimate differences in time to care by trauma center level, and (3) update national estimates of trauma center access. METHODS In a cross-sectional study (United States, 2019), we estimated travel time from census block groups to the nearest Level I/II trauma center and nearest Level III trauma center. Block groups were categorized based on the level of care accessible within 60 minutes, then distributions of population characteristics and differences in time to care were estimated. RESULTS An estimated 22.8% of the US population (N = 76,119,228) lacked access to any level of trauma center care within 60 minutes, and 8.8% (N = 29,422,523) were principally served by Level III centers. Black and American Indian/Alaska Native (AIAN) populations were disproportionately represented among those principally served by Level III centers (39.1% and 12.2%, respectively). White and AIAN populations were disproportionately represented among those without access to any trauma center care (26.2% and 40.8%, respectively). Time to Level III care was shorter than Level I/II for 27.9% of the population, with a mean reduction in time to care of 28.9 minutes (SD = 31.4). CONCLUSION Level III trauma centers are a potential source of trauma care for underserved populations. While Black and AIAN disproportionately rely on Level III centers for care, most with access to Level III centers also have access to Level I/II centers. The proportion of the US population with timely access to trauma care has not improved since 2010. LEVEL OF EVIDENCE Prognostic/Epidemiological; Level IV. View on Web

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Integrating traffic safety data with area deprivation index: A method to better understand the causes of pediatric pedestrian versus automobile collisions

alexandrossfakianakis shared this article with you from Inoreader Integrating traffic safety data with area deprivation index: A method to better understand the causes of pediatric pedestrian versus automobile collisions via Journal of Trauma and Acute Care Surgery - Current Issue BACKGROUND The purpose of this study was to identify clinical and traffic factors that influence pediatric pedestrian versus automobile collisions (P-ACs) with an emphasis on health care disparities. METHODS A retrospective review was performed of pediatric (18 years or younger) P-ACs treated at a Level I pediatric trauma center from 2008 to 2018. Demographic, clinical, and traffic scene data were analyzed. Area deprivation index (ADI) was used to measure neighborhood socioeconomic disadvantage (NSD) based on home addresses. Traffic scene data from the California Statewide Integrated Traffic Records System were matched to clinical records. Traffic safety was assessed by the streetlight coverage, the proximity of the collision to home addresses, and sidewalk coverage. Descriptive statistics and univariate analysis for key variables and outcomes were calculated using Kruskal-Wallis, Wilcoxon, χ2, or Fisher's exact tests. Statistical significance was attributed to p values of View on Web

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Postinjury platelet aggregation and venous thromboembolism

alexandrossfakianakis shared this article with you from Inoreader Postinjury platelet aggregation and venous thromboembolism via Journal of Trauma and Acute Care Surgery - Current Issue BACKGROUND Posttraumatic venous thromboembolism (VTE) remains prevalent in severely injured patients despite chemoprophylaxis. Importantly, although platelets are central to thrombosis, they are not routinely targeted in prevention of posttraumatic VTE. Furthermore, platelets from injured patients show ex vivo evidence of increased activation yet impaired aggregation, consistent with functional exhaustion. However, the relationship of this platelet functional phenotype with development of posttraumatic VTE is unknown. We hypothesized that, following injury, impaired ex vivo platelet aggregation (PA) is associated with the development of posttraumatic VTE. METHODS We performed a secondary analysis of 133 severely injured patients from a prospective observational study investigating coagulation and inflammation (2011–2019). Platelet aggregation in response to stimulation with adenosine diphosphate (ADP), collagen, and thrombin was measured at presentation (preresuscitation) and 24 hours (postresuscitation). Viscoelastic clot strength and lysis were measured in parallel by thromboelastography. Multivariable regression examined relationships between PA at presentation, 24 hours, and the change (δ) in PA between presentation and 24 hours with development of VTE. RESULTS The 133 patients were severely injured (median Injury Severity Score, 25), and 14% developed VTE (all >48 hours after admission). At presentation, platelet count and PA were not significantly different between those with and without incident VTE. However, at 24 hours, those who subsequently developed VTE had significantly lower platelet counts (126 × 109/L vs. 164 × 109/L, p = 0.01) and lower PA in response to ADP (p View on Web

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Sapovirus infections in an Australian community-based healthy birth cohort during the first 2-years of life

alexandrossfakianakis shared this article with you from Inoreader Sapovirus infections in an Australian community-based healthy birth cohort during the first 2-years of life via Clinical Infectious Diseases Advance Access Abstract Background Sapovirus is an important cause of acute gastroenteritis (AGE) in young children. However, knowledge gaps remain in community settings. We investigated the epidemiology, disease characteristics and healthcare use associated with sapovirus infections in Australian children during their first 2-years of life. Methods Children in the Brisbane-based Observational Research in Childhood Infectious Diseases birth cohort provided daily gastrointestin al symptoms (vomiting/loose stools), weekly stool swabs, and healthcare data until age 2-years. Swabs were batch-tested for sapovirus using real-time polymerase chain reaction assays. Incidence rates and estimates of associations were calculated. Results Overall, 158 children returned 11,124 swabs. There were 192 sapovirus infection episodes. The incidence rate (IR) in the first 2-years of life was 0.89 episodes per child-year (95% confidence interval [CI] 0.76–1.05), the symptomatic IR was 0.26 episodes per child-year (95%CI 0.17–0.37). Age ≥6-months, the fall season and childcare attendance, increased disease incidence significantly. Fifty-four (30%) of the 180 infections with linked symptom diaries were symptomatic, with 72% recording vomiting and 48% diarrhea. Prior infection reduced risk of further infections (adjusted hazard risk 0.70; 95%CI 0.54–0.81) in the study period. Viral loads were higher and viral shedding duration was longer in symptomatic than asymp tomatic children. Twenty-three (43%) symptomatic episodes required healthcare, including six emergency department presentations and two hospitalizations. Conclusion Sapovirus infections are common in Australian children aged 6–23 months. Efforts to reduce childhood AGE after the global rollout of rotavirus vaccines should include sapovirus where estimates of its incidence in communities will be crucial. View on Web

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Histological features associated with Human Monkeypox Virus Infection in 2022 outbreak in a non-endemic country

alexandrossfakianakis shared this article with you from Inoreader Histological features associated with Human Monkeypox Virus Infection in 2022 outbreak in a non-endemic country via Clinical Infectious Diseases Advance Access Abstract Skin histology of papule and pustules from 5 MSM patients with Monkeypox infection showed viral intracytoplasmic cytopathic changes, interface dermatitis, marked inflammatory dermic infiltrate including superficial neutrophils and deep lymphocytes perivascular and periadnexal. Histologic description of Monkeypox lesions improves our understanding about clinical presentations and may have some therapeutic implications. View on Web

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New perspectives for prosthetic valve endocarditis - impact of molecular imaging by FISHseq diagnostics

alexandrossfakianakis shared this article with you from Inoreader New perspectives for prosthetic valve endocarditis - impact of molecular imaging by FISHseq diagnostics via Clinical Infectious Diseases Advance Access Abstract BackgroundThe causative microbial etiology of prosthetic valve infective endocarditis (PVE) can be difficult to identify. Our aim was to investigate the benefit of the molecular imaging technique fluorescence in situ hybridization (FISH) combined with 16S rRNA-gene PCR and sequencing (FISHseq) for the analysis of infected prosthetic heart valves. Methods We retrospectively evaluated the diagnostic outcome of 113 prosthetic valves from 105 patients with suspected PVE, treated in the years 2003-2013 in the Department of Cardiac Surgery, Charité University Medicine Berlin. Each prosthetic valve underwent cultural diagnostics and was routinely examined by FISH combined with 16S rRNA-gene PCR and sequencing. We compared classical microbiological culture outcomes (blood and valve cultures) with FISHseq results and evaluated the diagnostic impact of the molecular imaging technique. Results Conventional microbiological diagnostic alone turned out to be insufficient, as 67% of p reoperative blood cultures were non-informative (negative, inconclusive or not obtained) and 67% valve cultures remained negative. FISHseq improved the conventional cultural diagnostic methods in PVE in 30% of the cases and increased diagnostic accuracy. Out of the valve culture-negative PVE cases, FISHseq succeeded to identify the causative pathogen in 35%. Conclusions FISHseq improves PVE diagnostics, complementing the conventional cultural methods. In addition to species identification, FISH provides information about the severity of PVE and state of the pathogens, e.g. stage of biofilm formation, activity and localization on and within the prosthetic material. As a molecular imaging technique, FISHseq enables the unambiguous discrimination of skin flora as contaminant or infectious agent. View on Web

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