A Contemporary Review of Trachea, Nose, and Ear Cartilage Bioengineering and Additive Manufacturing.

The complex structure, chemical composition, and biomechanical properties of craniofacial cartilaginous structures make them challenging to reconstruct. Autologous grafts have limited tissue availability and can cause significant donor-site morbidity, homologous grafts often require immunosuppression, and alloplastic grafts may have high rates of infection or displacement. Furthermore, all these grafting techniques require a high level of surgical skill to ensure that the reconstruction matches the original structure.

Racial Disparities and Other Socioeconomic Predictors of Mortality in Acute Pulmonary Embolism Treatment from the National Inpatient Sample.

Purpose: To explore the significance of socioeconomic factors such as race and ethnicity as predictors of mortality in submassive and massive acute pulmonary embolism (PE).

Materials And Methods: Hospitalizations of patients aged >18 years with acute, nonseptic PE from 2016 to 2019 were identified from the National Inpatient Sample and divided into interventional radiology (IR) (catheter-directed thrombolysis and thrombectomy) and non-IR (tissue plasminogen activator) treatments. Statistical analyses calculated significant odds ratios (ORs) via 95% confidence intervals (CIs).

Investigation of a HAP-UAV Collaboration Scheme for Throughput Maximization via Joint User Association and 3D UAV Placement.

In this paper, a collaboration scheme between a high-altitude platform (HAP) and several unmanned aerial vehicles (UAVs) for wireless communication networks is investigated. The main objective of this study is to maximize the total downlink throughput of the ground users by optimizing the UAVs' three-dimensional (3D) placements and user associations. An optimization problem is formulated and a separate genetic-algorithm-based approach is proposed to solve the problem.

Artificial neural network prediction of post-thyroidectomy outcome.

Objectives: The goal of this study was to develop a deep neural network (DNN) for predicting surgical/medical complications and unplanned reoperations following thyroidectomy.

Design, Setting, And Participants: The 2005-2017 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried to extract patients who underwent thyroidectomy. A DNN consisting of 10 layers was developed with an 80:20 breakdown for training and testing.

Impact of esthesioneuroblastoma treatment delays on overall patient survival.

Objectives: To characterize clinical factors associated with esthesioneuroblastoma treatment delays and determine the impact of these delays on overall survival.

Study Design: Retrospective database analysis.

Methods: The 2004-2016 National Cancer Database was queried for patients with esthesioneuroblastoma managed by primary surgery and adjuvant radiation.

Policy-Gradient and Actor-Critic Based State Representation Learning for Safe Driving of Autonomous Vehicles.

In this paper, we propose an environment perception framework for autonomous driving using state representation learning (SRL). Unlike existing Q-learning based methods for efficient environment perception and object detection, our proposed method takes the learning loss into account under deterministic as well as stochastic policy gradient. Through a combination of variational autoencoder (VAE), deep deterministic policy gradient (DDPG), and soft actor-critic (SAC), we focus on uninterrupted and reasonably safe autonomous driving without steering off the track for a considerable driving distance.

Direct contrast-enhanced magnetic resonance lymphangiography in the diagnosis of persistent occult chylous effusion leak after thoracic duct embolization.

Thoracic duct embolization (TDE) is currently the technique of choice for chylothorax refractory to medical management. Diagnosis and treatment of persistent lymphatic leakage after an initially successful TDE are complicated by inadequate imaging to localize the nidus of the lymphatic leak. Traditional imaging modalities including nuclear medicine lymphoscintigraphy, magnetic resonance lymphangiography, and fluoroscopic lymphangiography lack spatial resolution and dynamic physiologic real-time evaluation.

Analysis of intraoperative radiation use in vascular surgery: Catalyst for quality improvement in patient and personnel safety.

Objectives: There is paucity in the literature reporting radiation usage analysis in vascular surgery. In the era of endovascular surgeries, analyzing the surgeons' use of radiation in vascular procedures can help establish quality improvement initiatives.

Methods: A retrospective review was undertaken of intraoperative fluoroscopic-guided vascular surgery procedures at a single institution from 2010 to 2017.

Categorical versus dimensional approaches to autism-associated intermediate phenotypes in 22q11.2 microdeletion syndrome.

Background: 22q11.2 Microdeletion syndrome (22q11DS) is associated with elevated rates of autism spectrum disorders (ASDs), although the diagnosis is controversial. In order to determine whether there is a biological substrate of ASD in 22q11DS, we examined neurocognitive and structural neuroanatomic differences between those with 22q11DS and an ASD diagnosis (22q11DS-ASD+) and those with 22q11DS without ASD (22q11DS-ASD-); we then determined whether these differences were better characterized within a categorical or dimensional framework.

Imaging pancreatobiliary ductal system with optical coherence tomography: A review.

An accurate, noninvasive and cost-effective method of in situ tissue evaluation during endoscopy would be highly advantageous for the detection of dysplasia or early cancer and for identifying different disease stages. Optical coherence tomography (OCT) is a noninvasive, high-resolution (1-10 μm) emerging optical imaging method with potential for identifying microscopic subsurface features in the pancreatic and biliary ductal system. Tissue microstructure of pancreaticobiliary ductal system has been successfully imaged by inserting an OCT probe through a standard endoscope operative channel.

Relationship of drug metabolizing enzyme genotype to plasma levels as well as myelotoxicity of cyclophosphamide in breast cancer patients.

Purpose: The cytotoxic drug cyclophosphamide (CP) is bioactivated into 4-hydroxy-cyclophosphamide (4-OH-CP) through cytochrome P450 enzymes and cleared through aldehyde dehydrogenase and glutathione S-transferase. This prospective study analyzes the influence of drug metabolizing enzyme genotype on (1) plasma 4-OH-CP:CP ratio and (2) myelotoxicity in breast cancer patients on 500 mg/m(2) cyclophosphamide.

Methods: Sixty-eight female breast cancer patients on FAC (fluorouracil, adriamycin, cyclophosphamide) were included.

Two novel mutations in exon 3 and 4 of low density lipoprotein (LDL) receptor gene in patients with heterozygous familial hypercholesterolemia.

Objective: To determine the common mutation of low density lipoprotein receptor in hypercholesterolemia patients requiring screening for heterozygous familial hypercholesterolemia (HeFH) in Karachi.

Study Design: Case-series.

Place And Duration Of Study: Dr.

Carotid intima-media thickness correlation with lipid profile in patients with familial hypercholesterolemia versus controls.

Objective: To determine the variations in carotid intima-media thickness (CIMT) in familial hypercholesterolemia (FH) patients and its use as predictive marker for premature cardiovascular diseases.

Study Design: Comparative study.

Place And Duration Of Study: National Institute of Cardiovascular Diseases and Dr.

Genotype frequencies of selected drug metabolizing enzymes and ABC drug transporters among breast cancer patients on FAC chemotherapy.

Polymorphic genes of drug metabolizing enzymes and transporters may influence drug response. With some exemptions, single nucleotide polymorphisms in such genes, however, are not known to be susceptibility factors for breast cancer. This study explored genotype profiles for the breast cancer patients on fluorouracil, doxorubicin and cyclophosphamide (FAC) in a Pakistani set of population and their comparison with HapMap data.

Granulocytic sarcoma of the nasal cavity: a case report.

Granulocytic sarcoma of the nasal cavity is exceedingly rare. We describe the case of a 55-year-old man who presented with an intranasal mass that was later diagnosed as a granulocytic sarcoma. The mass was treated with rapid initiation of chemotherapy, which produced a substantial decrease in tumor bulk.

Are mature smokers misinformed?

While there are many reasons to continue to smoke in spite of its consequences for health, the concern that many smoke because they misperceive the risks of smoking remains a focus of public discussion and motivates tobacco control policies and litigation. In this paper we investigate the relative accuracy of mature smokers' risk perceptions about future survival, and a range of morbidities and disabilities. Using data from the survey on smoking (SOS) conducted for this research, we compare subjective beliefs elicited from the SOS with corresponding individual-specific objective probabilities estimated from the health and retirement study.

Time preference, time discounting, and smoking decisions.

This study examines the relationship between time discounting, other sources of time preference, and choices about smoking. Using a survey fielded for our analysis, we elicit rates of time discount from choices in financial and health domains. We also examine the relationship between other determinants of time preference and smoking status.

A survey of multiple prescriptions dispensed in Saudi Arabia.

A study of out-patient prescriptions in King Fahad Hospital, Al-Baha, Saudi Arabia was undertaken. Prescribing patterns of 200 doctors were surveyed. For each doctor ten out-patient prescriptions were randomly selected for analysis during month of January 2000.

Aural involvement in loxoscelism: case report and literature review.

An 11-year-old male presented with fever, rash, and a necrotic lesion on the lobule of the left ear. The lesion became tender and formed an eschar over 4 days. The patient developed leukocytosis, hemolytic anemia, and proteinuria, and was diagnosed with systemic loxoscelism from a brown recluse spider bite.

Airway obstruction secondary to tracheobronchial involvement of asymptomatic undiagnosed Crohn's disease in a pediatric patient.

Tracheal involvement in Crohn's disease is extremely rare and can present with airway obstruction in any age group, including the pediatric patient. We describe the case of a 9-year-old female who presented with a 2-week history of intermittent stridor, resolving temporarily with the administration of systemic steroids. The patient denied any abdominal complaints and was otherwise healthy.

Gastrostomy tubes in patients with advanced head and neck cancer.

Objectives: To measure the percentage of patients requiring gastrostomy tubes (G-tubes) and the timing of their placement, in addition to studying whether pretreatment variables (T stage, tumor site, N stage) and intratreatment variables (weight loss during treatment) are valid predictors for the need for G-tube placement.

Study Design: Retrospective case control study.

Methods: Retrospective review of a prospectively collected database with chart reviews was carried out on 477 patients treated on a regimen of intraarterial cisplatin and concurrent radiation.

Second branchial cleft anomaly presenting as a rudimentary pinna in the nasopharynx of a newborn.

We describe the case of a 4-day-old girl who presented with an epiglottic cyst that was later identified as a rudimentary pinna attached to the soft palate.