Concurrent Nasal Symptoms in Non-Rhinogenic Headache.

Objective: This study aims to characterize concurrent nasal symptoms in a cohort of patients with non-rhinogenic headache (NRH) presenting to an otolaryngology clinic.

Study Design: A prospective cohort.

Setting: Single tertiary care institution.

Concordance-based Predictive Uncertainty (CPU)-Index: Proof-of-concept with application towards improved specificity of lung cancers on low dose screening CT.

In this paper, we introduce a novel concordance-based predictive uncertainty (CPU)-Index, which integrates insights from subgroup analysis and personalized AI time-to-event models. Through its application in refining lung cancer screening (LCS) predictions generated by an individualized AI time-to-event model trained with fused data of low dose CT (LDCT) radiomics with patient demographics, we demonstrate its effectiveness, resulting in improved risk assessment compared to the Lung CT Screening Reporting & Data System (Lung-RADS). Subgroup-based Lung-RADS faces challenges in representing individual variations and relies on a limited set of predefined characteristics, resulting in variable predictions.

Preventing pediatric accidental decannulation events: A quality improvement initiative.

Objective: To describe a quality improvement (QI) method to decrease pediatric accidental decannulation (AD) in the early postoperative period for children under age 3.

Methods: A retrospective chart review was conducted on children under age 3 who underwent tracheostomy at Duke University Health System from August 1, 2013 to May 1, 2023 (n = 104). A root cause analysis was used to assess factors associated with AD following pediatric tracheostomy.

Impact of Clinical Practice Guidelines on Pediatric Tonsillectomy for Tonsillitis.

Objective: To determine the impact of the release of updated American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNSF) Clinical Practice Guidelines (CPG) for Tonsillectomy in Children in 2019 on adherence to evidence-based practice.

Methods: Patients between ages 1 and 18 who had tonsillectomies and encounters for throat infection (tonsillitis or pharyngitis) between of February 5, 2015 and February 4, 2023 were identified by International Classification of Diseases and Current Procedural Terminology codes, excluding those with obstructive sleep-disordered breathing. Retrospective chart review was performed to determine adherence to evidence-based practice.

Identification of CDRH3 loops in the B cell receptor repertoire that can be engaged by candidate immunogens.

A major goal for the development of vaccines against rapidly mutating viruses, such as influenza or HIV, is to elicit antibodies with broad neutralization capacity. However, B cell precursors capable of maturing into broadly neutralizing antibodies (bnAbs) can be rare in the immune repertoire. Due to the stochastic nature of B cell receptor (BCR) rearrangement, a limited number of third heavy chain complementary determining region (CDRH3) sequences are identical between different individuals.

Rapid selection of HIV envelopes that bind to neutralizing antibody B cell lineage members with functional improbable mutations.

Elicitation of broadly neutralizing antibodies (bnAbs) by an HIV vaccine will involve priming the immune system to activate antibody precursors, followed by boosting immunizations to select for antibodies with functional features required for neutralization breadth. The higher the number of acquired mutations necessary for function, the more convoluted are the antibody developmental pathways. HIV bnAbs acquire a large number of somatic mutations, but not all mutations are functionally important.